Severe infusion of dopamine can improve renal patients

Dr University of Nice, France. Ichai and his colleagues compared the dopamine and dobutamine (dobutamine) on the 12 non-oliguric renal dysfunction patients role. According to a random order, every patient received four different doses of dopamine and dobutamine infusion.

Dr. Ichai group, dopamine and dobutamine can significantly enhance the patient’s cardiac index. Dopamine infusion every minute 12 mg per kg of body weight can mean arterial pressure increased to 20. Dobutamine infusion does not affect mean arterial pressure, nor any change in renal function.

On the contrary, the infusion of dopamine can significantly increase the volume of all patients, and creatinine clearance rate of sodium excretion subparagraph. The author found that dopamine infusion every minute 7 mg per kg body weight patients, the average creatinine clearance rate from 61 ml per minute increased to 85.7 ml per minute. Dopamine infusion per kg body weight per minute to 12 mg sodium excretion subparagraph rose to 0.62 from 0.26. Dr. Ichai team also found that, during dopamine infusion, creatinine clearance rate and mean arterial pressure have a significant correlation.

Based on the above information, the study team concluded that dopamine specific role at least improve renal glomerular filtration rate and the increase in the number. Changes in the role of cardiac function can be ruled out, and on the increase of mean arterial pressure might play a role.

In an accompanying commentary, Dr the University of California. Vovan and Dr. Brenner praised Dr. Ichai group careful experimental design, but also to their conclusions, the doubt.

Dr. Vovan and Dr. Brenner that since the study patients were only a few, so, despite the role of this group showed a significant statistical significance, but people can still doubt the authenticity of this role. They added that this information can not prove that low-dose dopamine to improve renal hemodynamic changes and nothing to do.

Black habits trigger breast cancer

Gaozhifangyinshi large number of long-term intake of fat, can produce significant quantities of estrogen-like substances and prostate, which are to stimulate tumor growth “killers.”

Drinking alcohol daily, or 1 cup 1 cup or more, risk of breast cancer than those drinking little more than 45 per cent higher.

Coffee, cocoa, chocolate, the food contains large amounts of xanthine, to be benign breast hyperplasia.

Refined sugar is high sucrose intake of 45 women over the age of breast cancer risk factors.

Tobacco smoking history of more than 10 years of women’s chance of getting breast cancer other women more than three times.

- Intake did not exercise habits not only to consume excessive accumulation of body fat, but also to the risk of cancer in the body index soaring.

Information in the diagnosis of ovarian tumors

Information in the diagnosis of ovarian tumors

Http://www.39.net Time: April 17, 2006

Ovarian cancer is common gynecologic cancer, female genital tumors about 1 / 3. Can occur at any age, The incidence of malignant ovarian tumors Although Habitat female genital mutilation, the third cancer, as early diagnosis difficult, often found at the already advanced, but its mortality rate for the first gynecologic malignancies.

[Diagnosis]

1, symptoms

(1) abdominal discomfort or medium-sized benign tumor rapid growth of malignant tumors and often cause stomach discomfort.

(2) abdominal mass benign swelling growth slow and difficult to be discovered, patients are often inadvertently touched. Malignant tumors grow fast, easily detected.

(3) benign abdominal pain with torsion and rupture, bleeding, infection, there may be varying degrees of pain. If the surrounding malignant tumor invasion, oppression or nerve can cause abdominal pain, low back pain or leg pain.

(4) larger earned oppression symptoms of pelvic tumors can cause symptoms of oppression, such as frequency, dysuria, constipation, dyspnea, such as palpitations.

(5) uterine disorders and endocrine tumors produce symptoms of steroid hormones or damage bilateral ovarian tumors, can cause menstrual disorders, or abnormal uterine bleeding. Granulosa cell tumor, theca cell tumor can produce too much estrogen caused precocious puberty cols = 1 & target = _blank> precocious puberty, or postmenopausal bleeding. Testicular tumor cells can produce excessive androgen caused masculine performance.

(6) If the performance of metastasis from lung metastasis hemoptysis, and dyspnea; intestinal transfer from feces change blood in the stool, such as intestinal obstruction.

2, benign ovarian tumors and more signs for the unilateral, in the next uterus. A spherical, solid or cystic mass, surface smoothness, activities, and the uterus-defined. Bilateral malignant ovarian tumors, or is it part of the rugged surface, a fixed mass in the uterus Xianao rectum can be scattered in nature nodules.

Information in the diagnosis of ovarian tumors

Http://www.39.net Time: April 17, 2006

3, auxiliary

(1) B-ultrasound imaging can detect tumor location, size, shape and nature.

(2) diagnostic radiology or barium contrast barium enema, air contrast can understand whether digestive tract tumors. CT examination can be carried out on the pelvic tumor localization and characterization, and understanding of the liver, lung and retroperitoneal lymph node metastasis. Pelvic lymph node imaging ovarian tumors milk can be judged without lymph node metastasis.

(3) laparoscopy can be directly observed tumor sources and generally, as well as the entire basin and transverse abdominal cavity filters to determine the scope and stage lesions. Ascites and lessons for cytology, or from suspicious organizations for pathological examination. However, the enormous mass or tumor adhesion taboo.

(4) cytology abdominal puncture or posterior vaginal fornix culdocentesis for cytology, contribute to the diagnosis of ovarian cancer.

(5) tumor markers inspection embryonic carcinoma, endodermal sinus cancer patients in the alpha-fetoprotein (aFP) concentration, aFP more than 20 μ g / L for the positive. Β-hCG Determination of primary ovarian choriocarcinoma and ovarian germ cells mixed with choriocarcinoma components have diagnostic value. Cancer antigen CA125 radioimmunoassay (CA125 greater than 65 U / ml positive) on the epithelial carcinoma higher diagnostic significance. Lactate dehydrogenase (LDH) clones of cells help in the diagnosis.

(6) found that before puberty laparotomy ovarian increased postmenopausal ovarian still palpable; women of childbearing age have ovarian cystic tumor, larger than 6 cm in diameter were observed 3 to 6 months are not reduced or increased large diameter solid tumors in the 4 cm; pregnant early detection of ovarian tumor, four months pregnant is not reduced, indications are laparotomy.

Benign and malignant ovarian tumors performance

(1) benign ovarian tumor clinical manifestations

Development has been slow and early asymptomatic more often in gynecological examination accidental discovery. Medium large abdominal tumor regular flu Wang fitness, palpable mass, grow upward from the side of the lower abdomen. Gynecological examination in the womb hit the side of spherical mass, cystic or solid, smooth surface, with no uterus adhesion comfortable with the elderly. Large or huge tumor earned pots, abdominal compression symptoms can occur, such as frequency, constipation, dyspnea, such as palpitations. Abdominal mass can be touched, activities of the poor, was porphyrin Kouzhen sound, no mobile voiced. Gynaecological examinations, vaginal fornix full, the tumor can be very touched, the Palace at the side or the tumor before and after, with the cervix and activities.

(2) and malignant ovarian tumor clinical manifestations

Early consciously have no symptoms, disease symptoms often have been late session. The rapid tumor growth, the short term can have abdominal distention, abdominal mass and ascites. How to surrounding tissue tumor infiltration or nerve compression can cause abdominal pain, low back pain or leg pain; if oppression pelvic veins, lower extremity edema can occur if the function of the tumor, a corresponding estrogen or symptoms of androgen excess. Advanced patients performance cachexia phenomenon. Gynaecological examinations can be touched after vaginal fornix scattered in terms of quality hard nodules, masses for more than a side of the solid or semi-substantive, uneven surface, fixed and accompanied bloody ascites. Sometimes in the groin, armpit or supraclavicular lymph node enlargement can be touched.

Sequelae of polio

Sequelae of polio
Polio has been introduced by the above concept, we are now being raised polio sequelae term, the two concepts are differentiated. The children against the polio virus had disease called polio, if in the end disease cured, children did not leave any sequels, it is impossible to tell polio sequelae; only after children with the disease never fully recovered, and left after-effects, can be called polio sequelae. For example, children with physical illness after a muscle atrophy, bone deformities, the two lower limbs, one a short walking difficulties. In general incidence in children two years later, there can be known as the after-effects of polio sequelae.

Pinpoint governance cerebral palsy

Cerebral palsy refers to the fetus before birth after birth a month, brain damage and dysfunction in the body for the performance of a major common diseases, accounting born population 0.4 percent. Its etiology can be divided into prenatal, delivery and postnatal three to production factors (ie, birth injuries) most common. Children with growth retardation, often gaining ground, stood up, crawling, sitting, standing, walking, etc. or dysfunction caused a late parents attention, the majority of middle injury in children with cerebral palsy spastic paralysis and limb contracture deformity. Some patients with mental retardation, language barriers, such as drooling more than performance.
Acupuncture therapy in the patient’s body on the implementation of specific sites, according to that call,掐to shoot a way, the whole operation can be divided into regional and acupuncture therapy, each treatment 20 to 30 minutes a week to 5 times and 40 times for a course of treatment. I use acupuncture therapy for hospital pediatric cerebral palsy 20, received good effect, especially under the age of 3 patients with more obvious. Through the study, we demonstrated acupuncture therapy for children with cerebral palsy is the mechanism Blood Circulation, the relevant national research projects has been the ministerial level scientific research in Chinese medicine.

Overall pinpoint: total operating 10 minutes
Head and neck: Lim Chuen, for pulp, Tianzhu, brain House, the wind House, the wind pool, the rate Valley, Chui-kan (earlobe root), End bones, Dazhui and other points along the Governor Vessel, the sun, Yangming, triple burner by kowtowing to the neck meridian points, while head percutaneous needle movement, feeling, a Xingnao, Jiejing, promoting blood circulation, only saliva role. If Drooling, speech detrimental to point pressure, inexpensive-chuen, such as point-Ying, thumb and index finger relative, massage laryngeal tuberculosis, above the hyoid and small hyoid muscle. Convection to increase saliva point Chuigen, speech disadvantaged increase by dumb doors Point.
Trunk: Well shoulder pressure point, Geshu, Yao Yan, Guan Yu and other yuan Point, along the Governor Vessel, to the point of knocking bladder meridian, point pressure Hua Jiaji Points, direction sacral spine muscle, Huoxue Tongluo role to strengthen the back muscle strength, improving sitting, adjusting balance positive.
Limbs: in the limbs along the Sanyinjiao, GLORY liable on the pinpoint focus points after knocking spastic muscles and the meridian points. At the same time squeezing means (toe) between joints, 12 wells, and other points, Huoxue Tongluo, spasmolysis Xifeng role.

Regional Treatment: including regional pinpoint and orthopedic practices a total of 10 ~ 20 minutes
Regional acupuncture is targeted mainly caused by muscle spasm joint contracture (malformation) treatment. The main point of call, pressing involvement of the Department of muscle and joint Acupoint, pay attention to muscle beginning and ending points, abdominal muscle, tendon and transitional abdominal muscle, muscle interval and the direction and peripheral nerve distribution regions, the intensity of stimulation can be slightly heavy, referring to the vertical force, thorough, profound and to the patients of pain.
Orthopedic practices refers to acupuncture treatment at the same time, intermittent combination spanner law, for law, pushed law practices. Reverse pull method is forced traction, traction slow muscle spasticity (muscle), attention must act relaxed, so that the muscle reflex spasm is not properly. For muscle relaxation in the law is a state led by the Law and pull tight, muscular fingers plucked string of beginning and ending points, abdominal muscle and abdominal muscle and the tendon transitional method. Shun muscle is pushing rules, pushed Feeling the pulse Meridian to a method. If forearm pronation deformity, doctors left hand entrusted with children Department, thumb-point deduction pool, the right hand feet of the distal radius, radial thumb placed in the dorsal, two-handed relative strength, passive children with right forearm rotation, while the left index finger, middle finger, ring finger closely, plucked string pronation circular muscle, the right hand the appropriate plucked string pronator quadratus muscles.
After treatment with a wrinkle microcirculation checks suggest that the average flow velocity accelerated 0.128 mm / sec, the increase in the number of capillaries of the loop, the caliber broadbanding, clarity increased. Dog blood rheology of observation, simulated acupuncture treatment 30 minutes after the plasma and whole blood viscosity decreased platelet adhesion rate, the decline was reduced fibrinogen levels, in vitro shorten the length of thrombosis, wet weight and dry weight are lower. The cerebral cortex of the dog soft membrane microcirculation observation, after the simulated acupuncture treatment leptomeningeal deep microvascular mean flow velocity increased 0.23 mm / sec, for pinpoint ago 1.85 times.

Clinical manifestations in children with cerebral palsy

Children with cerebral palsy symptoms are:

1) Campaign obstacles: poor ability to exercise self-control, not serious, hands grasping things, the feet will not walk, and some may not even stand up, not standing, not normal chewing and swallowing.

2) Posture obstacles: various abnormal posture, poor postural stability, three, Kennedy still can not head straight, accustomed to the side of bias, or before and after shaking around. Children do not like to bathe, wash their hands, will be difficult to open up fist.

3) intellectual disabilities: mental normal child about 1 / 4, intellectual mild, moderate shortage of about 1 / 2, the severe shortage of intelligence about 1 / 4.

4) language barriers: language difficulties, pronunciation unclear or stuttering.

5) audio-visual barriers within strabismus McGREGOR voice and the rhythm of the most difficult to identify common.

6) growth stunting, short stature.

7) tooth development obstacles, loose texture, easy to pack. Dysfunction of the mouth, tongue and facial muscle spasm or sometimes uncoordinated muscle contraction, chewing and swallowing difficulties, difficulties and closed mouth drooling.

emotional and behavioral disorders: stubborn willfulness, irritability, eccentric, emotional volatility, and sometimes forced, self-injury, invasion behavior.

9) 39% -50% of the children with cerebral palsy due to brain lesions and the fixed-induced epilepsy, particularly intellectual severe lower children.

Reference 1956 American Institute of cerebral palsy classification method (Amendment) can be divided into spastic, Xu mobile hand-foot-and soft-type - type low muscle tone (sometimes easily misdiagnosed as low calcium), ataxia type of tremor, rigidity and type. Mixed, there are no classification type. Paralysis by single-site, double paralysis, the three limb paralysis, paraplegia, hemiplegia, double hemiplegia.

Cerebral palsy rehabilitation learned

● a brain injury on the history of high-risk infants should be careful observation;

● regular child after birth should be related to pediatric check;

● spastic children with the parents, we want to learn rehabilitation training methods, adopt children,

● age, a secondary barriers, the children are indications, it should consider surgery;

● governance cerebral palsy, the most effective rehabilitation therapy, drug therapy only play a supporting role.

The father of one full of joy, after learning that their baby has just come to the minds of the world when there are problems, tears, “Save my child!” This is a hospital in a true. For a family, with children suffering from cerebral palsy, the same spirit to carry a huge burden of heavy financial burden. Parents will be forced to seek medical attention running everywhere, and it could even fooled.

Your in the “three early”

Yan Oi Hospital of Shanghai Shen Yucheng children with cerebral palsy expert Professor: children with cerebral palsy to achieve the best therapeutic effect, it is necessary to achieve the “three long”, that is, early detection, early diagnosis and early treatment. She said that because 70% to 80% of pediatric patients with cerebral palsy, hypoxic by perinatal asphyxia, caused factors such as intracranial hemorrhage caused by brain damage, brain injury are considered risk factors for cerebral palsy. Early detection of children with cerebral palsy should, we should have a history of brain damage focus monitoring high-risk groups.

Because the symptoms of children with cerebral palsy different time sooner or later, to varying degrees, we now rely on parents of children with early detection there are certain difficulties. In his view, the high-risk infants paediatricians consecutive meticulous observation, the early detection of cerebral palsy plays a vital role. He also reminded a brain injury at birth parents of infants in the birth of a child a month, 3 months, 6 months, should be regularly associated with children to the pediatric examination, take precautions.

Professor Shen said that once a child has been diagnosed with cerebral palsy, the parents do not pessimism, we should immediately conditional children to the formal hospital treatment, There are a variety of treatment methods can cerebral palsy, but stressed that the treatment is started sooner the better.

Treatment to fight a “protracted war”

Professor Shen pointed out that the treatment of cerebral palsy is a slow process, parents must not no illusions that by taking medicine or do an operation, we can cure your disease. Only under the guidance of a doctor on a regular basis, combined therapy is the only correct choice.

After years of effort, Professor Shen Yucheng the treatment of children with cerebral palsy and research done a lot of fruitful work, especially in recent years, preventive health care Branch, a pediatrician and physical medicine rehabilitation collaboration on 100 cases of cerebral palsy high-risk infants to early intervention, received very good results. He exhorted the children with parents, because the treatment of cerebral palsy children in the growth and development process, we need to continue for a fairly long period of time, therefore, rely on a doctor’s efforts, we can not fundamentally solve the problem, only in close collaboration with the parents, if it is desired effect. Professor Shen said, in children with cerebral palsy, spastic most common, accounting for about 70 percent to 80 percent. She suggested that parents with children go to the hospital for regular treatment at the same time, but also, under the guidance of the doctors learn some family rehabilitation training methods. Example: For the spastic children, the children can not hold a straight hold, should we let him riding on the legs or parents waist; children will be sleeping on both sides of the scapula pad up or allow lateral; speak with the children, to take his parallel position; so that rehabilitation training throughout the child’s daily life.

At present, the children with their rehabilitation training, the main use is imported from abroad to the development of neural-based integrated therapy treatment, to correct abnormalities in children with the campaign mode, and help them establish a normal campaign mode.

The most important rehabilitation training

Professor Shen said, he said that the treatment of cerebral palsy There are many ways, including Chinese massage, Chinese medicine, Chinese medicine, such as Point-injection. Western medicine with exercise therapy, language training, physical therapy, cognitive education and with the necessary drugs, surgery. She pointed out that as cerebral palsy mainly for motor dysfunction in the main, often combined mental deficiency, epilepsy, serious or even chewing swallowing, and other obstacles, is a syndrome, so treatment should adopt comprehensive measures. Professor Shen said that, in the treatment of the specific cases to conduct a comprehensive evaluation, we must address the specific circumstances of the child determine the method of treatment. For instance, orthopedic surgery, a large secondary age barriers, surgical indications of a child can do.

Experts agreed that in the treatment of cerebral palsy, although many ways, but rehabilitation is the main and most effective, such as drug treatment is secondary and only play a supporting role. Experts also believe that the cerebral palsy treatment for older children, the functional improvement more difficult, but as long as they stick rehabilitation training, children’s function is an improvement.

How discovered congenital hip dislocation

If congenital hip dislocation in the neonatal period he detailed observation, early detection, timely treatment, the treatment method is simple, the effect it. Neonatal treatment from the beginning, the majority of the three, can be effective, if the nine months ago received treatment, most curable. If not promptly treated or handled properly, can cause side grow up hip and waist pain claudication , the impact of labor and shape.

Symptoms and Inspection Methods: carefully compare both sides of the thigh, the thigh short side and rough, skin wrinkles and more. Change diapers to children when not fully hip outreach, and sometimes can have bombs beep, knee flexion, the contralateral side of the knee than low. Lying on the table in children, adults will be the knee and hip flexor 90 °, and then used his hands He sank at the same time holding the pediatric outreach. When normal knee can be outreaching 90 °, aloof side to touch the desktop. The dislocation of the hip, the only side of the outreach 75 ° -80 °, the process can not touch on the desktop side. Some of the neonatal hip dislocation, limb outreach 75 ° around when suddenly bouncing hip flu and shells beep, and then can be outreaching to 90 °, but is still not normal. Parents who are found above suspicion, to a hospital for further examination confirmed.

Treatment and care:

1. Law neonatal period triangular pillow

(1) legs perineal put triangle pillow so that the legs of frog maintain outreach.

(2) diaper should be some thick pad.

2.连衣pull a treatment method (special clothing socks)

(1) preparation of the two sets of pull with the use of alternative cleaning.

(2) avoid replacement, releasing a long time.

(4) According to an increase in children age Mobile maintain the correct position.

3. Outreach stent fixation

(1) shall not be fixed without any mobile stent site.

(2) attention to both lower extremities color, and whether or not hurt.

4. Gypsum fixation

(1) observation of the end of the cold limbs.

(2) gypsum dry after regular emancipated, prevention hurt.

(3) maintain the gypsum is not urine soaked.

(4) to read short gypsum, encourage sick child practice sitting.

(5) Training in contravention of infants do hands foot movements, activities hip and knee flexion assist.

Children with muscular torticollis

Children with muscular torticollis also known as “congenital torticollis,” “sternocleidomastoid muscle contracture torticollis”, commonly known as “Web.” Modern medicine and the production of multiple injuries, fetal head position unjust or fetal head position in the womb, such as in a state of the skew. So that side of the above reasons and blood pressure through the sternocleidomastoid muscle trip disrupted cause ischemic changes, the final result sternoclavicular milk, a sudden muscle contraction arising torticollis. Chinese medicine practitioners believe that blood running sluggish, the mechanism is in torticollis. Common symptoms for more than a few days after birth found that children with head tilted to the side, face to the other side of spin. As for now reluctantly turn, would cause children crying, and quickly switch back in situ. Checks can be in touch sternocleidomastoid muscle in the side of mass, a spindle or irregular shape, with muscle movement. If no mass loss, but also got a side of cord-like muscles, hard, on both sides of contrast, shorter side sternocleidomastoid muscle contracture. A period of long, side face, eyes may be smaller than normal side. In serious cases, the secondary will have a thoracic scoliosis deformity.

Massage methods

1. Common practices

(2) parents for a while its head and neck, a walking mandibular body, with both hands forced relatively lightly along the longitudinal axis for cervical extension shaking and gently rotating to the side, repeat twice.

Life conditioning

(1) Massage therapy torticollis, the general daily treatment 1 times, not more than 15 minutes.
(2) massage, gentle way to use massage, pinch practices used talc to prevent scratches and other children with medium skin. With Stubbs stretch shaking practices, preferably from light to heavy, the margin grow from small to large, sudden use violence must not exceed the normal physiological limits.
(3) to the parents of children in day-to-day lactation, and the embrace of sleep intended that the children head to the contralateral rotation to help correct deformities.
(4) be compatible with local hyperthermia or infrared, and other physical therapy to promote blood circulation and help mass absorption.
(5) regularly to the hospital referral, and if the best surgical treatment in the 8 to 10-year-old before, if age after surgery, the head face and neck deformity correction it will be very difficult.