常规剂量奥美拉唑治疗早产儿喂养不耐受的疗效研究

目的:探讨常规剂量奥美拉唑治疗早产儿喂养不耐受的疗效及对血清胃泌素(gastrin,GAS)的影响.方法:选取60例出现喂养不耐受的早产患儿随机分为2组,对照组30例给予常规处理,治疗组30例在常规治疗基础上于生后第4天开始给予奥美拉唑注射液静脉滴注(0.7mg/kg·d),1次/d,连用5天.采用放射免疫分析法测定治疗组血清胃泌素水平.结果:治疗组胃潴留及腹胀症状消失时间、恢复至出生体重所需日龄、足量胃肠道喂养时间、2周末奶量与对照组比较有显著差异(P＜0.01).治疗组血清GAS水平较对照组明显升高,差异有显著性(P＜0.05).结论:奥美拉唑促进早产儿胃泌素分泌,治疗早产儿喂养不耐受有显著疗效,未见不良反应,为早产儿喂养不耐受的治疗提供了新的治疗方法.     

布拉酵母菌散联合非营养性吸吮治疗早产儿喂养不耐受的疗效观察

目的探讨布拉酵母菌散联合非营养性吸吮治疗早产儿喂养不耐受的疗效观察。方法选取早产儿喂养不耐受患者70例,随机分为观察组(n=35例)和对照组(n=35例)。两组患儿喂养方案参照中国新生儿营养支持临床应用指南进行。观察组患儿在此基础上加用布拉酵母菌散0.125 g/次,1次/d,鼻饲或奶瓶给药;并在喂奶前后予以早产儿型硅胶安抚奶嘴吸吮10~15 min。观察两组患儿症状消失时间、达全胃肠喂养时间及恢复出生体重时间,并比较其治疗后的临床效果及并发症发生率。结果观察组患儿呕吐、腹胀消失时间、达全胃肠喂养时间及恢复出生体重时间均明显短于对照组(P0.05);治疗7 d后,观察组患儿临床总有效率(94.29%)明显高于对照组(77.14%)(χ2=4.20,P0.05),观察组患儿总并发症的发生率(40.0%)明显低于对照组(65.7%)(χ2=4.20,P0.05)。结论布拉酵母菌散联合非营养性吸吮治疗早产儿喂养不耐受的疗效较显著,能缩短患儿呕吐、腹胀消失时间,促进患儿体重增长,缩短恢复出生体重时间及达全胃肠喂养时间,减少并发症发生。     

早期应用微生态制剂对极低出生体重儿影响的临床观察

目的观察早期应用微生态制剂对极低出生体重儿黄疸、喂养、生长以及免疫功能的影响。方法我院NICU收治的生后24h内极低出生体重儿84例,随机分为观察组46例,对照组38例。观察组生后4h内开始口服或鼻饲胃管服用妈咪爱0.5g,2次/d,连用14d。观察两组达到高胆红素血症标准的人数,以及生后24h、5d总胆红素值;喂养不耐受人数;生后5d生理性体重下降及1个月体重增长情况;生后1个月免疫学指标。并加以对比。结果24h内血清胆红素比较无统计学意义(P0.05),治疗5d后观察组血清总胆红素明显低于对照组(P0.05),观察组出现高胆红素血症人数明显低于对照组(P0.05);观察组喂养不耐受出现例数明显低于对照组(P0.01);观察组生后5d体重下降的克数低于对照组(P0.05),1个月时体重增长克数高于对照组(P0.01);观察组IgA水平较对照组明显增加(P0.05),但IgG及IgM含量与对照组比较差异无统计学意义(P0.05)。结论早期应用微生态制剂能降低血清胆红素水平,对预防极低出生体重儿高胆红素血症有一定作用;能提高喂养的耐受性,有利于患儿生长发育;对极低出生体重儿的肠道功能及免疫功能有明显影响,能增加免疫球蛋白IgA水平,从而促进体液免疫的发展。     

布拉酵母菌散联合早期微量喂养 对早产儿喂养不耐受及肠道菌群的影响

目的探讨布拉酵母菌散联合早期微量喂养对早产儿喂养不耐受及肠道菌群的影响。方法选取2014年1月至2018年6月在我院住院治疗的喂养不耐受早产儿80例,随机分为2组,各40例。对照组早产儿生后早期间歇持续微量喂养(12～24 h内),观察组早产儿在对照组基础上加用布拉酵母菌散0.125 g/次,1次/d,通过奶瓶或鼻饲给药。两组患儿均连用3周。观察两组早产儿治疗后恢复情况、肠道菌群变化及治疗效果。结果观察组早产儿呕吐腹胀消失时间、达全胃肠喂养时间及恢复出生体重时间均明显短于对照组(均P0.05)。治疗3周后,两组早产儿肠道乳杆菌和双歧杆菌数量较治疗前明显上升(均P0.05),且观察组早产儿上升幅度较对照组更大(均P0.05)。治疗后观察组早产儿临床总有效率明显高于对照组,差异有统计学意义(95.0%vs 80.0%,χ~2=4.16,P0.05)。结论布拉酵母菌散联合早期微量喂养治疗早产儿喂养不耐受的疗效显著,能加快患儿的恢复,其作用机制可能与其能促进肠道正常菌群定植,加快肠道菌群的建立密切相关。     

早期微量喂养联合静脉营养与胃肠营养在早产低出生体重儿中的应用效果比较

目的：比较早期微量喂养联合静脉营养与胃肠营养两种喂养方式在早产低出生体重儿中的应用效果。方法：将选取的100例早产低出生体重儿随机分为两组,早期微量喂养联合静脉营养组采用早期微量喂养结合静脉营养方案,胃肠营养组先采用静脉营养,患儿吞咽功能协调后经口喂养,观察并比较两组患儿喂养效果、喂养不耐受情况、并发症情况。结果：微量喂养联合静脉营养组患儿每日体重增长显著高于胃肠营养组,微量喂养联合静脉营养组患儿生理体重下降恢复时间、住院时间及达到足量肠内营养时间均低于胃肠营养组（P＜0.05）;微量喂养联合静脉营养组患儿呕吐、胃潴留发生率显著低于胃肠营养组（P＜0.05）;两组腹胀、腹泻发生率没有差异（P＞0.05）;微量喂养联合静脉营养组患儿高胆红素血症、胆汁淤积发生率显著低于胃肠营养组（P＜0.05）;两组高血糖、低血糖发生率没有差异（P＞0.05）。结论：早期微量喂养联合静脉营养喂养效果良好、喂养不耐受情况发生率低、并发症发生率低,该方式是一种针对早产低体重儿良好的营养供给方式。     

益生菌制剂治疗极低出生体重儿喂养不耐受的临床研究

目的探讨益生菌制剂对极低出生体重儿（very low birth weight infant,VLBW）喂养不耐受的影响。方法将56例极低出生体重儿随机分成治疗组和对照组,每组28例。2组均予静脉营养及早产儿配方奶喂哺,治疗组在早产儿配方奶喂哺时添加益生菌制剂,每次0．5g,3次／d,2组同时记录恢复出生体重时间、达全胃肠喂养时间及黄疽消退时间。结果治疗组恢复出生体重时间、达全胃肠喂养时间均显著短于对照组（P〈0．01）,治疗组黄疸消退时间也明显缩短（P〈0．05）。微生态制剂治疗过程中无不良反应发生。结论益生菌制剂可改善极低出生体重儿喂养不耐受,促进患儿体重增长,缩短达到全胃肠喂养时间,值得推广应用。     

生长抑素联合奥美拉唑治疗肝硬化并发上消化道大出血的疗效分析

目的:观察生长抑素联合奥美拉唑治疗肝硬化并发上消化道大出血的临床效果.方法:将确诊的42例肝硬化合并上消化道大出血患者随机分为两组.治疗组采用生长抑素联合奥美拉唑的治疗方案,对照组生长抑素用法同治疗组.结果:治疗组在平均止血时间、输血量、止血有效率上均明显优于对照组(P＜0.05).结论:生长抑素联合奥美拉唑治疗肝硬化并上消化道大出血临床效果明显,能缩短止血时间,减少输血量.     

格拉司琼联合隔药灸治疗肝癌介入术后恶心呕吐临床观察

目的:观察格拉司琼联合隔药灸治疗肝癌介入术后恶心呕吐临床疗效。方法:将符合纳入标准的肝癌介入术后恶心呕吐患者72例,分为治疗组与对照组,每组36例,对照组给予注射用盐酸格拉司琼静脉滴注治疗,治疗组在对照组的基础上给予隔药灸治疗。观察两组患者恶心、呕吐症状、胃液引流量及胃管留置时间,统计临床疗效。结果:治疗后治疗组在恶心、呕吐症状评分、胃液引流量、胃管留置时间方面明显均低于对照组(均P0.05)。治疗组、对照组临床疗效总有效率分别为91.67%、72.22%,比较有统计学意义(P0.05)。结论:格拉司琼联合隔药灸可以明显改善肝癌介入术后恶心呕吐症状,缩短胃管留置时间,临床疗效显著。     

奥美拉唑联合生长抑素治疗肝硬化并上消化道大出血的临床疗效

目的:探讨垂体后叶素、奥美拉唑联合生长抑素与垂体后叶素联合三腔两囊压迫止血治疗肝硬化并上消化道大出血的临床疗效及安全性。方法:收集58例于我院治疗的肝硬化并上消化道大出血患者。随机分为A组和B组,每组各29例。两组患者均给予保肝、输血、禁食、补充血容量。A组给予垂体后叶素50 U 0.1 u/min维持静滴,加用三腔两囊管压迫止血进行治疗;B组给予垂体后叶素50 U 0.1 u/min维持静滴,0.1~0.2 mg生长抑素加入20 m L生理盐水静脉缓慢推注,继以0.2 mg生长抑素以25~50μg/h静脉滴入,同时静脉滴注奥美拉唑40 mg,2次/日。治疗结束后,比较两组患者临床总有效率、不良反应发生率、止血时间及输血量。结果:与A组患者相比较,B组患者的临床总有效率、不良反应发生率、止血时间及输血量水平较低,差异具有统计学意义(P0.05)。结论:垂体后叶素、奥美拉唑联合生长抑素治疗肝硬化并上消化道大出血患者比垂体后叶素联合三腔两囊压迫止血治疗的临床总有效率高,不良发应少,止血时间短,输血量少。     

吗丁啉和小剂量红霉素治疗极低出生体重儿喂养不耐受的疗效比较

目的:比较吗丁啉和小剂量红霉素治疗极低出生体重儿喂养不耐受的临床疗效。方法:回顾性分析我科2011年1月至2013年12月期间收治的90例极低出生体重儿喂养不耐受患儿的临床资料。根据选用的治疗药物,将患儿分为A组(吗丁啉组,n=42)和B组(小剂量红霉素组,n=48)两组。患儿在综合治疗的基础上配合上述的药物治疗喂养不耐受的症状。观察并比较两组患儿喂养不耐受症状的消退时间、恢复出生体重时间、完全胃肠内喂养时间、住院时间及治疗副作用的发生情况。结果:两组患儿经积极干预治疗后,喂养不耐受症状消失、恢复出生体重、完全胃肠内营养等出院标准。两组患儿间上述指标实现时间及住院时间的比较未见统计学差异(P0.05);A组患儿治疗期间未见与服用吗丁啉相关的不良反应;B组患儿有6例因静滴红霉素引起的局部疼痛发生,发生率为12.5%,未见静脉炎等不良反应发生。两组患儿间治疗副作用发生率的比较,差异具有统计学意义(P0.05)。结论:吗丁啉和静滴低剂量红霉素均可有效治疗极低出生体重儿的喂养不耐受症状。二者的治疗效果相当,但吗丁啉可能具有更高的安全性。     

Characteristics of the membranes of the pellicle of the ciliatePseudomicrothorax dubius

Summary The membranes of the pellicle of the ciliatePseudomicrothorax dubius are investigated using thin section electron microscopy and freeze-fracture replicas. The plasma membrane is covered by a surface coat and is connected to the outer alveolar membrane by short, sometimes branched, bridges. The inner alveolar membrane is coated on both sides. The epiplasm lies in intimate contact with the cytoplasmic surface of this membrane, and there is a corresponding deposit on the other surface. This deposit is regularly striated.The epiplasmic layer and the alveoli are interrupted at sites of cytotic activity,e.g., the attachment sites of trichocysts, the cytoproct, and the parasomal sacs. The striated deposit ends where the epiplasm ends, indicating a direct relationship between these two epimembranous layers.There is a deposit along the sides of the first part of the tip of the trichocysts, and in this region the trichocyst membrane is free of intramembranous particles.The membrane of the parasomal sacs has a coat on both surfaces. That on the extraplasmic surface is similar to the surface coat of the plasma membrane. The origin of the cytoplasmic coat is unknown. The cytotic activity of these sacs is indicated by their highly irregular profiles.     

The early development of the tail and the transformation of the shape of the nucleus of the spermatid of the domestic fowl,Gallus gallus

Summary The differentiation of the spermatid, especially in reference to the formation of the flagellum, and transformation of the shape of the nucleus was investigated in the domestic fowl.In the early stage of the spermatid, a prominent Golgi apparatus appears around the centrioles. The Golgi vesicles then surround the axial-filament complex which develops from the distal centriole. These vesicles fuse to form continuous membrane at the earliest stage of flagellar formation, and in the succeeding stage Golgi lamellae are attached to the plasma membrane of the developing flagellum. From these observations, it is assumed that Golgi apparatus may be a source of the membrane system of the flagellum.The microtubules distributed around the nucleus form the circular manchette. The anterior region of the nucleus with the manchette is cylindrical in shape and the posterior region without it remains irregular in shape. When the circular manchette has been completed, the whole nucleus acquires a slender cylindrical shape. The circular manchette then changes into the longitudinal manchette. The nuclei of spermatids without a longitudinal manchette are abnormal in shape. In view of these observations it is assumed that the nuclear shaping of the spermatid may be accomplished by circular manchette and the maintenance of shape of the elongated nucleus by longitudinal manchette.The authors wish to thank Mr. Takayuki Mori for his helpful suggestions and technical advices     

Characterization of the composition of the aqueous humor and the vitreous body of the eye of the frog Rana temporaria L

This study aimed to analyze the aqueous humor (AH) and the vitreous body (VB) of the eye of the adult frog Rana temporaria L. as a representative species of amphibians, which lead a semi-terrestrial life. The presence of collagen, albumin, uric acid and electron donors was shown in both media; however, there are slight differences in their concentrations. To determine collagen, a spectral-fluorescent probe, cyanine dye, was used. The presence of collagen in AH of the frog was found at the first time. The total content of electron donors (ascorbic and uric acids, tryptophan, and tyrosine) in VB and HA was roughly estimated at ~ 1.5 × 10^− 4 mol/L. Both VB and AH absorb light in similar UV regions. The total protein and albumin contents in AH were found to be somewhat higher than those in VB. The uric acid content was at an equally low level in both intraocular media. It is supposed that the similarity of VB and AH compositions shown in this work is due to some exchange between VB and AH contents in the course of accommodation. The role of intraocular fluids in physiological functions of the eye and in protecting the retina against UV light is discussed.