目的探讨奥曲肽对小儿上消化道出血的治疗作用及机制。方法选择上消化道出血小儿患者(以下简称患儿)64例,随机分为治疗组及对照组,两组患儿给予相同的止血、抗酸、补液治疗,治疗组在此治疗的基础上另给予奥曲肽治疗;观察两组患者临床治疗效果、患者消化道出血停止时间及再出血率。结果观察组总有效率为96.9%,对照组总有效率为87.5%,对照组治愈时间为2.7d,对照组治愈时间为3.4d,治疗组短于对照组,治疗组复发率3.1%,对照组复发率为9.4%,治疗组低于对照组。结论奥曲肽能够缩短上消化道出血的止血时间,提高临床治疗效果。

Objective To establish a stable neonatal rat model of hyperoxic lung injury with a simple procedure.Method\ 1) To design and construct an automatically controlling oxygen density hyperoxia animal feeding cabin.2) SPF neonatal rats born at 21 days of gestation were divided into 4 groups: hyperoxia group Ⅰ(fed in the hyperoxic cabin for 1～7 d),hyperoxia group Ⅱ(fed in the hyperoxic cabin for 14 d),and corresponding air control group I and Ⅱ,14 rats per each group.The oxygen density in the cabin was kept ≥90%,23 hours per day.Histopathological changes of the lung tissues were examined by HE staining and the lung factor was calculated.Result\ To compare the hyperoxia groups with corresponding air control groups,the rats of hyperoxia groups showed deceased body weight,greater lungs factor,partial alveolar atrophy,hemorrage and edema in the pulmonary interstitium and alveolar cavity,neutrophil infiltration,evident retardation of alveolar growth,and distinctly decreased radial alveolar count.Conclusion\ The animal feeding cabin described in this study is simple to construct and with stable performance.The pulmonary pathological changes in neonatal rats fed in this feeding system are well consistent with those of hyperoxic lung injury.

Objective To study and compare the preventive effect of superoxide dismutase(SOD)and radix salviae milliorrhizae extract on hyperoxic lung injury in neonatal rats.Methods Sprague Dawley neonatal rats were put in high concentrtion Oxygen(≥90%)to establish hyperoxic lung injury.Rats were divided into 4 groups,hyperoxia group,air control group,hyperoxia and SOD group(SOD group),and hyperoxia and radix salviae milliorrhizae extract group.Lung index,contents of malondialdehyde(MDA),activity of SOD,pathological changes and apoptosis index were studied at 7th and 14th day.Results Compared with hyperoxia group,SOD group and radix salviae milliorrhizae extract group had low lung index,contents of MDA and apoptosis index(P0.05),better pathological result,higher activity of SOD(P0.05)at 7th day and 14th day respectively.The effects of SOD and radix salviae milliorrhizae extract was similar,except SOD group had more decline in apoptosis index at 14th day.Conclusion Both SOD and radix salviae milliorrhizae extract may have therapeutic effect on hyperoxia-induced lung injury.

Objective To study the protective effect of Radix Salviae Milliorrhizae Extract (764-3) on hyperoxia-induced acute lung injury of neonatal rats and to compare the effect of it with that of superoxide dismutase (SOD).Methods Hyperoxia lung injury model was established by putting Sprague Dawley neonatal rats into self-made oxygen box within high-concentration oxygen(≥90 % O2)for 7 days. Interfered with SOD and 764-3 respectively, the lung index, contents of malondialdehyde (MDA), activity of SOD, radical alveolar counts (RAC) and pathological changes have been compared. Meanwhile, terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL) was utilized to detect the number of apoptosis of lung cells. Results On the seventh day, the contents of MDA and the number of apoptosis of lung cells of SOD prevention group and 764-3 prevention group were lower than those of the hyperoxia-exposed group( P < 0.05 or P < 0.01 ), while RAC and activity of SOD were higher(P < 0.05 or P < 0.01) ; pathological changes of apoptosis of lung cells of SOD prevention group and 764-3 prevention group were less than those of the hyperoxia-exposed group. The protective effect of SOD and 764-3 were similar(P >0.05).However, compared with those of hyperoxia-exposed group, the lung index of 764-3 prevention group showed insignificant difference(P >0.05). Conclusion Radix Salviae Milliorrhizae Extract (764-3) may have certain protective effect on hyperoxia-in-duced acute lung injury.

目的 分析极低出生体重儿(very low birth weight infant,VLBWI)在纠正胎龄40周时的生长赶超情况及影响因素.方法 以50例VLBWI作为研究对象.以40周胎龄健康足月儿和15个城市不同胎龄婴儿出生体重为正常值,比较50例VLBWI在出生、出院时及纠正胎龄40周时的小于胎龄Jh(small for gestational age,SGA)发生率;分析喂养方式、并发症、辅助治疗等对VLBWI生长赶超的影响. 结果 50例VLBWI在纠正胎龄40周时的体重为(3290±640)g,与同胎龄足月儿比较差异无统计学意SL(P＞0.05).50例VLBWI出院时SGA所占比例为64.0%(32/50),明显高于出生时的24.0H(12/50)和纠正胎龄40周时的32.0%(15/50),P均＜0.05.出生时SGA(OR=0.035,95% CI 0.003～0.487)、低T3综合征(OR=0.101,95%CI 0.013～0.774)及长期使用静脉营养(OR=0.307,95%C1 0.097～0.972);是导致VLBWI生长赶超失败的危险因素,而早期开展肠道喂养(0R=8.241,95%CI 1.373～49.470)则有利于VLBWI的生长赶超.并发低T3综合征的VLBWI住院4周期间及出院后平均体重增长速度均低于未并发低T3综合征的VLBWI(P均＜0.05).结论 合理的营养方案、降低并发症的发生率是VLBWI实现早期生长赶超的关键.

Objective To discuss the relationship between the nutrition methods with risk factors and body mass growth associated in very low birth mass infants(VLBMI).Methods Fifty-four VLBMI in NICU received parenteral nutrition(PN) in 12 hours after birth,and commenced nasogastric feeding if the infants started to have bowel tones or discharged meconium.The infants with serious condition were fed by continuous nasogastric feeding using minipump from(0.5)-1 ml/h.When enteral nutrition was started,PN transitted from total to partial gradually.PN would be stopped wien an enteral intake of(418.4) kJ·kg~(-1)·d~(-1) was established.All the infants were devided into two groups according to the duration of parenteral nutrition: group 1: using PN 10 days,((5.79)±(1.99)) days on average,n=28;group 2: using PN ≥ 10 days((15.92)±(5.36)) on average,n=26.Results The average duration of using PN in 54 infants was((10.67)±(6.47)) days.Two groups were different in gestational age,birth mass and the morbidity of hypothyroidism(P(0.05)).Conclusion Early and minimal feeding can help establish enteral nutrition,which is more profitable to get adequate energy for body mass growth.Energy deficit existed in infants who received PN,so the traditional therapeutic method of PN should be improved.