先天性胸腺缺如一家两例报告

[例1]男,5个月,因咳嗽1月余,加重伴皮肤疱疹10余天于1999年12月22日入院.患儿1月余前受凉后出现咳嗽,为阵咳,在当地卫生所予“抗菌素及对症治疗”无效,并呈进行性加重.10余天前无明显诱因出现皮肤疱疹,始出现在头面部,后波及全身,伴腹泻,为稀便,无脓血.     

幼年大鼠溺水应激后胰岛素信号传导变化及外源胰岛素治疗反应

Objective To explore the alteration of insulin signal transduction in drowning-induced stress hyperglycemia and to investigate therapeutic effect of insulin on it.Methods Stress hyperglycemia model was induced by drowning.Thirty-two infant rats were randomized into control,drowning,air resuscitation and air-insulin resuscitation groups.Insulin was injected abdominally into the air-insulin resuscitation rats.Fasting serum glucose and insulin were determined routinely,and protein expressions and serine phosphorylation levels of insulin receptor substrate 1(IRS-1) in muscle tissue were detected by Western blot and immunoprecipitation.The expressions of glucose transporter 4(GLUT4) in the intracellular and plasma membranes of muscle tissue were detected by Western blot.Results In the drowning group,insulin resistance index(HOMA-IR) increased significantly as compared with that of the control group,but the level of IRS-1 had no significantly change as compared with the other three groups.As compared with that of the drowning group(0.71±0.12),IRS-1 serine phosphorylation levels of the two resuscitation groups decreased significantly(0.56±0.13 and 0.46±0.08 respectively).The intracellular GLUT4 expression in the two resuscitation groups(1.82±0.11 and 1.96±0.28 respectively)increased significantly in contrast to that of the drowning group(1.45±0.15),and the air-insulin resuscitation groups showed an especially high increase of intracellular GLUT4 expression.Conclusion During the drowning-induced stress hyperglycemia,the alteration of serine phosphorylation and GLUT4 distribution is one of the important mechanism of insulin resistance.Insulin may decrease the blood glucose through decreasing serine phosphorylation levels of IRS-1 and increasing the intracellular GLUT4 expressions.     

幼年大鼠溺水应激后胰岛素信号传导变化及外源胰岛素治疗反应

Objective To explore the alteration of insulin signal transduction in drowning-induced stress hyperglycemia and to investigate therapeutic effect of insulin on it.Methods Stress hyperglycemia model was induced by drowning.Thirty-two infant rats were randomized into control,drowning,air resuscitation and air-insulin resuscitation groups.Insulin was injected abdominally into the air-insulin resuscitation rats.Fasting serum glucose and insulin were determined routinely,and protein expressions and serine phosphorylation levels of insulin receptor substrate 1(IRS-1) in muscle tissue were detected by Western blot and immunoprecipitation.The expressions of glucose transporter 4(GLUT4) in the intracellular and plasma membranes of muscle tissue were detected by Western blot.Results In the drowning group,insulin resistance index(HOMA-IR) increased significantly as compared with that of the control group,but the level of IRS-1 had no significantly change as compared with the other three groups.As compared with that of the drowning group(0.71±0.12),IRS-1 serine phosphorylation levels of the two resuscitation groups decreased significantly(0.56±0.13 and 0.46±0.08 respectively).The intracellular GLUT4 expression in the two resuscitation groups(1.82±0.11 and 1.96±0.28 respectively)increased significantly in contrast to that of the drowning group(1.45±0.15),and the air-insulin resuscitation groups showed an especially high increase of intracellular GLUT4 expression.Conclusion During the drowning-induced stress hyperglycemia,the alteration of serine phosphorylation and GLUT4 distribution is one of the important mechanism of insulin resistance.Insulin may decrease the blood glucose through decreasing serine phosphorylation levels of IRS-1 and increasing the intracellular GLUT4 expressions.     

肿瘤科护士细胞毒性药物防护知识调查及培训效果评价

目的 了解护理人员对细胞毒性药物防护知识的掌握程度,评价安全防护知识集中培训的效果.方法 采用美国肿瘤护理学会"细胞毒性药物安全手册"作为培训教材,对上海市4所医科大学的12家附属三级甲等医院的216名接触细胞毒性药物的肿瘤科护理人员就细胞毒性防护知识和技能进行培训,并采用问卷调查培训前后护理人员对细胞毒性药物安全防护知识的掌握程度.结果 培训后护理人员测试成绩(14.48±1.84)分,与培训前(11.87士2.20)分比较,差异有显著性意义(P＜0.01).培训前、后测试存在显著性差异的题目共有12题,其中8题与细胞毒性药物药理知识相关.培训后仍有40%以上错误率的题目有7题,主要与医院的硬件设施、环境要求及政策有关.结论 肿瘤科护士对细胞毒性药物安全防护知识的掌握程度不够,对护士进行细胞毒性药物安全防护知识的培训可提高护理人员对相关知识的掌握程度,有效的培训方法仍需不断探索.     

护士安全防护存在的问题与对策

护理人员在护理操作过程中的服务对象是患有各种疾病的患者 ,除心理、精神病等外 ,绝大多数的患者患有感染性或潜在感染性疾病。患者所有的血液、体液、分泌排泄物等均应被视为传染媒介[1] 。美国职业安全协会倡议 ,在接触所有患者的血液、体液、黏膜、破溃的皮肤 ;处理被血液和体液污染的物品 ;进行静脉穿刺和其他操作 (换药、导管 )时必须戴手套[2 ] 。那么我国的护士在护理患者时 ,安全防护工作做得如何 ?现将在临床观察护理操作技术及护士安全防护方面存在的不足分析如下。1　存在问题和原因分析1 1　医院管理部门对安全防护重视不够1 1…     

注意缺陷多动障碍儿童智力发育研究

目的；研究注意缺陷多动障碍儿童的智力发育特点。方法：采用韦氏儿童智力量表和注意力测试软件进行智力评估和注意力评定。结果：研究组的智力水平，智力结构，注意力与对照组差异有显著性。结论：注意缺陷多动障碍儿童智力发展不平衡，记忆注意因子智商较低，持续注意困难，视，听辨别能力低下。     

视频脑电图对婴幼儿非癫疒间性发作的诊断价值

目的评估视频脑电图对婴幼儿非癫疒间性发作的诊断价值。 方法无锡市儿童医院于2004年1月至2005年1月，对152例拟诊或需排除癫疒间的患儿进行视频脑电图检查。 结果非癫疒间性发作51例，其中非癫疒间性强直发作10例，良性夜间肌阵挛8例，屏气发作7例，婴幼儿擦腿综合征6例，脑瘫及运动发育迟缓肌张力增高导致异常动作强直、震颤、手足徐动5例，良性非癫疒间性婴儿痉挛5例，轻度胃肠炎伴发婴幼儿良性惊厥4例，其他疾病6例。 结论视频脑电图是鉴别发作性质及类型的最有效的检查方法,也是鉴别癫疒间与非癫疒间性发作的有效方法。     

家庭照护对慢性病患儿心理行为的影响

目的 探讨家庭照护对慢性病患儿心理行为的影响,为有针对性进行家庭干预提供依据.方法 选择上海和北京7家医院的618名慢性病患儿家属为研究对象,采用家庭管理测量量表(FaMM)和Achenbach儿童行为量表(CBCL)进行调查.利用单因素方差分析及相关性检验分析家庭照护对患儿心理行为的影响因素,从单因素分析结果中选择差异有统计学意义的变量建立多元分层回归模型.结果 患儿认可度低、照护能力强、家庭收入≥3 000元/月、与祖父母同住和母亲无业是患儿内向行为的预测因素；患儿认可度低、疾病影响大、家长关系不佳、病程＜1年、男性患儿和父亲受教育水平在初中以下为患儿外向行为的预测因素.结论 家庭照护是影响慢性病患儿心理行为问题的重要因素,着重改善家庭照护过程中关键环节,能直接影响患儿的心理健康.     

新生儿面神经麻痹1例

新生儿面神经麻痹１例承德市医院儿科张世红，沈南平承德医学院基础部杨振江关键词新生儿；面神经麻痹患儿男，２０大，因口角歪斜半天于１９９４年３月２１日就诊。半天前家属在患儿哭闹时发现口角歪斜，吸奶无力，无发热、呕吐及抽搐。患儿系第一胎第一产，足月顺产，生...     

儿童病毒性脑膜脑炎262例临床分析

目的 :了解 2 0 0 3年 5～ 8月我院住院的病毒性脑膜脑炎发病状况。方法 :对我院病毒性脑膜脑炎住院病例发病年龄、临床表现、实验室资料进行分析。结果 :脑脊液病毒抗体检查 CBV-Ig M阳性 68例 ,阳性率 2 5 .95 %。 >5岁患儿 (179例 )为高发年龄段。经抗病毒、降温、降颅压等综合治疗后治愈 2 3 2例 ,好转 2 4例 ,自动出院 6例。结论 :儿童夏秋季应警惕肠道病毒所致脑膜脑炎。