Objective To assess the growth station, the upper respiratory infection frequency and consultation frequency of the geographically defined high risk neonatal population at 1-year-old based on both birthweight and gestational age. Methods All infants admitted in our hospital from May in 2008 to May in 2009 were divided into three groups according to gestational age and birth weight, that were, group 1: born lt;32 completed gestational weeks and weighing ≥1 500 g; group 2: born after 32 completed gestational weeks and weighing lt;1 500 g; and group 3: born lt;32 completed gestational weeks and weighing lt;1 500 g. Information at 12 months corrected age about growth, the upper respiratory infection frequency and consultation frequency was collected. Results The growth rate of weight and head circumference in group 3 were lower than that in group 1, and the length growth rate was lower than that in group 1 and group 2. Infants in group 3 suffered from more airway infections (median: 15.5) than in group 1 (12.5) and group 2 (8.5). Infants in group 3 needed more medical consultations (median: 27.5) than those in group 1(17.5) and group 2 (15.5). Conclusions This study gives estimates for growth outcome, airway infection and consultation frequency at 12 months corrected age for very low birthweight infants (lt;1 500 g) and for very preterm infants (lt;32 completed gestational weeks). Gestational age and birth weight are the same important for predicting infants’ outcome and should therefore be integrated into clinical statistics.
As a novel soluble guanylate cyclase stimulator, vericiguat can improve myocardial and vascular function, reduce ventricular remodeling, myocardial hypertrophy, inflammation and fibrosis, and delay the progression of heart failure by interfering with cell signaling pathways. Vericiguat not only can significantly reduce the risk of heart failure-related hospitalization or cardiovascular death, but also is well tolerated and compliant by patients, which can increase the additional benefit and improve prognosis of patients with heart failure with reduced ejection fraction. This article will review the mechanism and research progress of vericiguat in heart failure with reduced ejectionfraction.
目的探讨晚期恶性梗阻性黄疸减黄、保肝的处理方式。方法回顾性分析我科2008年1月至2009年10月期间收治的80例恶性梗阻性黄疸患者，根据肿瘤部位、患者身体、经济条件等确定无法行根治性手术者，采用不同的减黄术式。结果本组80例患者中，9例行PTCD，42例行PTBS，29例行ERBD。并发症发生情况: PTBS组有15例，ERBD组6例，PTCD组2例。PTCD组的住院时间和住院费用明显低于PTBS组和ERBD组(Plt;0.05)。结论晚期恶性梗阻性黄疸，一经确诊，尽早处理，微创引流减黄是首选方式。
目的 探讨闭孔疝的诊断和治疗方法。方法 回顾性分析了我院2001年10月至2009年8月期间收治并经手术证实的8例闭孔疝患者的临床资料。结果 8例均为女性，其中7例是老年、体弱的多产妇，1例是已婚年轻女性。平均年龄74.6岁（46～85岁），平均体重为39.1 kg（34～43 kg），平均生育5胎（1～10胎）。8例患者中5例术前经CT检查确诊而行手术治疗，3例由外院转入者在行急诊剖腹探查术中确诊。7例行坏死小肠切除吻合术，1例行嵌頓小肠复位术。 术后4例出现并发症：1例肺炎、1例切口感染、1例低蛋白水肿、1例为酸中毒和低血钾（死亡）。7例痊愈出院，1例死亡。结论 闭孔疝缺乏特异性表现，对年老体弱的经产妇出现腹痛、呕吐和股部疼痛应想到闭孔疝的可能；CT检查能提高闭孔疝的诊断率。准确的诊断和及时的手术干预是改善闭孔疝患者预后的关键。
【摘要】 目的 对骶正中动静脉的位置分布及变异进行解剖观察及实际测量其与周围重要结构的位置关系，为临床医师提高腰骶椎前路手术安全性提供必要的参考信息。 方法 收集2008年5月-2011年1月期间因疾病及意外死亡者新鲜人体尸体标本30例，对其进行解剖学研究，观察并测量骶正中动、静脉的发出点与走行，骶正中动、静脉的数量与缺失情况，以及骶正中动、静脉间的相互走行关系。 结果 ①骶正中动脉在主动脉发出以及走行的位置相对固定，无明显多支与缺失情况；骶正中动脉均为腹主动脉根部背侧发出，未见发出点位于左右髂总动脉。发出后行于左侧髂总静脉后方，跨过腰5/骶1椎间盘下行。骶正中静脉与骶正中动脉伴行的情况占总数的60.0%；②骶正中静脉多支常见，没有发现有骶正中静脉的缺失。1支的占总标本数的66.7%，2支的占30.0%，3支的占3.3%。 结论 当选择分叉下入路，应该特别注意骶正中动静脉的解剖位置。动脉的变异相对较小，而静脉的变异程度非常大，发出点变异，多支的情况多见，这些原因都造成了静脉容易损伤的原因，在手术中应该特别注意。【Abstract】 Objective To investigate the clinical significance of anatomical features of middle sacral artery and vein for lumbar-sacral spinal surgery. Methods We carried out anatomical research on 30 cadavers caused by diseases or accidents collected between May 2008 and January 2011. We dissected the vascular system anterior to lumbar vertebrae to learn their characteristics. The initial point of middle sacral artery and confluent point of veins, and the numbers of, and the companion relationship between middle sacral arteries and veins were chosen as the indexes to be measured. Results The middle sacral arteries started from the aorta, and their locations were relatively fixed without absence or multi-branches. All the middle sacral arteries derived from the dorsal side of abdominal artery root, and were not started from the common iliac artery. Then, the sacral arteries went at the back of left common iliac vein, and went down after traversing the inter-vertebral disk between the fifth lumbar and first sacral vertebra. About 60% of the middle sacral veins were accompanied with the arteries. Multi-branches of the middle sacral veins were frequently seen, and no absence was observed. One-branch, two-branch and three-branch middle sacral veins occupied 66.7%, 30.0% and 3.3% respectively out of the total. Conclusions When choosing downward branch approach during the operation, we should pay special attention to the anatomical locations of the middle sacral arteries and veins. Compared with the arteries, there are greater variations of the veins including variations of the confluent point and branches which can cause the veins to be quite vulnerable.
Fetal heart sound is nonlinear and non-stationary, which contains a lot of noise when it is colleced, so the denoising method is important. We proposed a new denoising method in our study. Firstly, we chose the preprocessing of low-pass filter with a cutoff frequency of 200 Hz and the re-sampling. Secondly, we decomposed the signal based on empirical mode decomposition method (EMD) of Hilbert-Huang transform, then denoised some selected target components with wavelet soft threshold adaptive noise cancellation algorithm. Finally we got the clean fetal heart sound by combining the target components. In the EMD, we used a mask signal to eliminate the mode mixing problem, used mirroring extension method to eliminate the end effect, and referenced the stopping rule from the research of Rilling. This method eliminated the baseline drift and noise at once. To compare with wavelet transform(WT), mathematical morphology (MM) and the Fourier transform (FT), the SNR was improved obviously, and the RMSE was the minimum, which could satisfy the need of the practical application.