米索前列醇联合水囊引产用于肝肾功异常患者的临床分析

目的探索并验证米索前列醇联合水囊引产在肝肾功异常的高危妊娠患者中的应用效果。方法选择16~30孕周、肝肾功异常需要引产的高危妊娠患者共78例,随机分成两组,两组患者的年龄、孕产次等差异无统计学意义（P〉0.05）。观察组40例,先常规行水囊术,术毕于阴道后穹窿放置米索前列醇1片（0.2mg/片）;对照组38例,常规行水囊术。结果观察组单次引产成功率高于对照组,差异有统计学意义（P〈0.05）,观察组胎儿排出时间短于对照组,且产后出血量明显少于对照组,差异有统计学意义（P〈0.05）。两组术前术后肝肾功无明显变化。结论米索前列醇联合水囊引产用于肝肾功异常的高危妊娠患者是一种较理想的引产方法,引产总时间短,并发症少,成功率及安全性高。

厄贝沙坦治疗肾功轻度异常高血压的疗效观察

目的:研究厄贝沙坦治疗肾功轻度异常的高血压的安全性及有效性。方法:入选40例肾功轻度异常的原发性高血压病患者,随机分为两组,分别给予厄贝沙坦或波依定治疗4周,每2周随访1次,并于服药前后进行24小时动态血压监测、肾功、电解质测定。结果:厄贝沙坦降压总效率达80%,波依定降压有效率为74%,同时对肾功无恶化,电解质无影响。结论:厄贝沙坦治疗肾功能轻度异常安全、有效。

以中药制剂康爱保生丸为主治疗艾滋病重度肝肾功能异常1例

本科于2010年3月收治1例重度肝功、肾功异常的患者。人院后经云南省CIX：确诊为艾滋病，经请云南省中医药治疗艾滋病试点项目专家组专家会诊后，给予口服中药制剂康爱保生丸（滇药制字（Z）2009006A）及综合治疗，病情逐渐好转，现报道如下。

肺出血-肾炎综合征1例

病例资料患者男,64岁,农民,以＂发现肾功异常1月,伴咯血3天＂之主诉于2015年5月4日入院。于1月前因咯血,活动后气短,全身乏困无力,重体力活动受限,在宝鸡市某三甲医院住院,行血常规、骨髓、肾功（UA 595.5 mmol/L,BUN 30.08 mmol/L,CR365.99 Umol/L）及胸部CT等检查后,确诊为＂慢性肾功能不全肾性贫血;双肺继发型结核并咯血,涂（无痰）,复治;慢性阻塞性肺疾病;间质性肺炎;肺大疱＂,给予纠正贫血、保肾等治疗后（因肾功异常,未行抗结核治疗）,病情好转出院。

甘油果糖注射液和甘露醇用于缺血性脑梗塞的疗效比较

目的比较甘油果糖注射液和甘露醇对脑梗塞后脑水肿患者神经功能和肾功能的影响。方法选择符合诊断标准的首次发生缺血性脑梗塞患者40例,随机分成甘油果糖组和甘露醇组进行治疗。结果两组在治疗后均有显著疗效,但甘油果糖组较甘露醇组发生肾功能异常者少。结论甘油果糖用于治疗脑梗塞后脑水肿,可改善神经功能,且能减少肾功能损害的程度和几率。

3197例干部体检颈动脉彩色多普勒超声检查结果分析

目的探讨干部人群颈动脉彩色多普勒超声检查结果及其相关因素,实施健康干预,以降低心、脑血管疾病的发生。方法对3197例干部健康体检人员颈动脉彩色多普勒超声检查结果,进行不同年龄和性别颈动脉斑块发生率和内膜中层厚度分析,研究颈动脉斑块的发生与年龄、性别、体重指数、血压和生化指标的关系,找出危险因素。结果 3197例颈动脉超声检查,颈动脉内膜中层增厚和斑块发生率分别为34.34%和20.80%,斑块的发生率随年龄的增加而升高,男性发生率(36.86%)高于女性(16.74%),差异有统计学意义(χ2=55.288,P<0.01);单纯高血压、单纯高血糖、单纯高血肌酐、单纯高尿素氮的颈动脉斑块发生率分别为76.82%,54.38%,62.22%和96.22%。Pearson方法分析显示颈动脉斑块的发生与单纯高血压、单纯高血糖、单纯高血肌酐、单纯高尿素氮有明显关联性。结论干部人群中存在着较高的颈动脉斑块发生率,其发生率随年龄的增加而升高,男性高于女性,颈动脉斑块的发生与肾功异常、高血压和高血糖相关。

病案（30）分析

临床特点 ①中年女性，既往身体健康；②慢性起病，首先表现为精神失常，未系统检查治疗；③冬季裸身到室外，着凉后寒战、高热、抽搐而急诊，当时意识不清，发热、心率快，双巴宾斯基征阳性，次日神志转清后兴奋、话多、欣快并不断尖叫，面神经叩击征阳性，双巴宾斯基征阴性；④血钙降低，血磷增高，血镁正常，24小时尿钙、尿磷降低，脑盯双基底核区钙化，脑电图异常，肾功、碱性磷酸酶正常。

Chronic bile duct hyperplasia is a chronic graft dysfunction following liver transplantation

AIM: To investigate pathological types and influential factors of chronic graft dysfunction (CGD) following liver transplantation (LT) in rats. METHODS: The whole experiment was divided into three groups: (1) Normal group (n = 12): normal BN rats without any drug or operation; (2) SGT group (syngeneic transplant of BN-BN, n = 12): both donors and recipients were BN rats; and (3) AGT group (allogeneic transplant of LEW-BN, n = 12): Donors were Lewis and recipients were BN rats. In the AGT group, all recipients were subcutaneously injected by Cyclosporin A after LT. Survival time was observed for 1 year. All the dying rats were sampled, biliary tract tissues were performed bacterial culture and liver tissues for histological study. Twenty-one d after LT, 8 rats were selected randomly in each group for sampling. Blood samples from caudal veins were collected for measurements of plasma endotoxin, cytokines and metabonomic analysis, and faeces were analyzed for intestinal microflora. RESULTS: During the surgery of LT, no complications of blood vessels or bile duct happened, and all rats in each group were still alive in the next 2 wk. The long term observation revealed that a total of 8 rats in the SGT and AGT groups died of hepatic graft diseases, 5 rats in which died of chronic bile duct hyperplasia. Compared to the SGT and normal groups, survival ratio of rats significantly decreased in the AGT group (aP < 0.01, bP < 0.001, respectively). Moreover, liver necrosis, liver infection, and severe chronic bile duct hyperplasia were observed in the AGT group by H and E stain. On 21 d after LT, compared with the normal group (25.38 ± 7.09 ng/L) and SGT group (33.12 ± 10.26 ng/L), plasma endotoxin in the AGT group was remarkably increased (142.86 ± 30.85 ng/L) (both P < 0.01). Plasma tumor necrosis factor-α and interleukin-6 were also significantly elevated in the AGT group (593.6 ± 171.67 pg/mL, 323.8 ± 68.30 pg/mL) vs the normal (225.5 ± 72.07 pg/mL, 114.6 ± 36.67 pg/mL) and SGT groups (321.3 ± 88.47 pg/mL, 205.2 ± 53.06 pg/mL) (P < 0.01). Furthermore, Bacterial cultures of bile duct tissues revealed that the rats close to death from the SGT and AGT groups were strongly positive, while those from the normal group were negative. The analysis of intestinal microflora was performed. Compared to the normal group (7.98 ± 0.92, 8.90 ± 1.44) and SGT group (8.51 ± 0.46, 9.43 ± 0.69), the numbers of Enterococcus and Enterobacteria in the AGT group (8.76 ± 1.93, 10.18 ± 1.64) were significantly increased (both aP < 0.01, bP < 0.05, respectively). Meanwhile, compared to the normal group (9.62 ± 1.60, 9.93 ± 1.10) and SGT group (8.95 ± 0.04, 9.02 ± 1.14), the numbers of Bifidobacterium and Lactobacillus in the AGT group (7.83 ± 0.72, 8.87± 0.13) were remarkably reduced (both aP < 0.01, bP < 0.05, respectively). In addition, metabonomics analysis showed that metabolic profiles of plasma in rats in the AGT group were severe deviated from the normal and SGT groups. CONCLUSION: Chronic bile duct hyperplasia is a pathological type of CGD following LT in rats. The mechanism of this kind of CGD is associated with the alterations of inflammation, intestinal barrier function and microflora as well as plasma metabolic profiles.

Regime Behavior in the Sea Surface Temperature-Cloud Radiative Forcing Relationships over the Pacific Cold Tongue Region

Previous analyses on the estimates of water vapor and cloud-related feedbacks in the tropics usually use observations over the Earth Radiation Budget Experiment （ERBE） period （1985-89）. To examine the sample dependence of previous estimates, the authors extend the analysis to two additional periods： 1990-94 and 1995-99. The results confirm our hypothesis, i.e., the values of the feedbacks depend on the period of data coverage. The differences in the feedbacks from cloud radiative forcings （CRFs） estimated from the three periods are particularly significant. Two possible causes for these differences are proposed. First, a regime behavior in the CRFs-Sea Surface Temperature Anomaly （SSTA） rela- tionship over the cold tongue region is revealed： when SSTA is below -0.5℃, the CRF anomalies are insensitive to the SSTA; when the SSTA is between -0.5℃ and 2.0℃, the CRF anomalies are positively correlated with the SSTA; however, when the SSTA exceeds 2.0℃, the CRF anomalies decrease with the SSTA. This regime behavior is due to the regime behavior of cirrostratus and deep convective clouds. Second, the CRFs-SSTA relationship is regulated by remote forcings. Warming of the far eastern equatorial Pacific would reduce the water vapor convergence over the central Pacific by weakening the trade wind over the southeastern Pacific, thereby reducing the feeding of moisture to the convective flow. The results suggest that CRFs-SSTA relationships during ENSO events are nonlinear and strongly depend on the magnitude and the spatial distribution of the SSTA.