血清SIL-2R、IL-8和TNF水平在轮状病毒（RV）肠炎发病中的作用机制研究

目的：了解血清SIL-2R、IL-8和TNF水平在轮状病毒(RV)肠炎发病中的作用机制。方法随机择取该院2012年3月-2014年3月收治的50例RV肠炎患儿为实验组,并选择同期来该院体查的50例健康体检者为对照组,应用双抗体夹心ELISA法,对两组血清中SIL-2R、IL-8及TNF-A水平进行检测,观察两组各个指标变化情况。结果实验组RV肠炎患儿在急性期血清中SIL-2R、TNF-A、IL-8水平(45.23±11.23)pg/mL,(122.23±6.75)pg/mL,(526.43±12.54)pg/mL明显高于正常对照组(28.64±9.62)pg/mL,(68.12±5.46)pg/mL,(197.32±14.24) pg/mL,差异有统计学意义(P<0.05)。与对照组比较,轻症组、中症组、重症组RV肠炎患儿血清IL-8、SIL-2R及TNF-A水平亦呈增高趋势,差异有统计学意义(P<0.05),提示三者与病情轻重具有关联性。结论血清IL-8、SIL-2R、TNF-A在轮状病毒感染免疫防御与免疫损伤机制中具有重要的引导作用,临床上应引起足够重视。     

腹腔镜探查在单侧腹股沟疝患儿LPEC术中的应用及对对侧异时性疝的预防价值*

目的探讨腹腔镜探查在经皮腹膜外疝囊高位结扎术(LPEC)中的应用效果及对对侧异时性疝(MCH)的预防价值。方法回顾性分析300例行开放疝囊修补术(对照组)、200例行LPEC治疗(观察组)的单侧腹股沟疝患儿,其中观察组术中通过腹腔镜探查对侧腹股沟情况,若有对侧鞘状突未闭(CPPV),则给予结扎处理,对照组术中未探查。比较各组手术指标、术后并发症及MCH发生率,并分析MCH发生率与CPPV、年龄的关系。结果术后疼痛视觉模拟评分(VAS)、术后开始下床活动时间及住院时间方面,观察组均明显优于对照组(P0.05);手术时间、术后并发症总发生率方面两组比较差异无统计学意义(P0.05);观察组术后MCH发生率1.00%,明显低于对照组的4.67%(P0.05);观察组术中发现CPPV 72例,CPPV发生率36.00%,其发生率与观察组患儿年龄相关(P0.05);MCH/CPPV风险率比(RR)=0.03,1/RR≈33;所有患儿中2.0~4.0岁者(不包括2.0岁)MCH占43.75%,0.5~2.0岁占31.25%。结论腹腔镜下LPEC相比开放疝囊修补术治疗单侧腹股沟疝具有术后疼痛轻、恢复快特点,能明显降低MCH发生率;腹腔镜探查能准确发现CPPV,结扎处理虽能减少MCH发生,但会过度医疗。     

中药治疗糖尿病难愈性创面愈合的研究进展

摘 要 难愈性创面是糖尿病的常见并发症,目前糖尿病难愈性创面及其治疗手段引起人们的广泛关注。本文就中药对糖尿病创面愈合的影响从促进成纤维细胞的增殖、促进肉芽组织生成、增加生长因子分泌、减少创面瘢痕及临床研究等方面进行了系统综述,以期为中药治疗难愈性创面愈合提供科学依据。     

大肠杆菌K1穿越血脑屏障机制研究进展

新生儿化脓性脑膜炎是一种危重的中枢神经系统感染性疾病.大肠杆菌K1菌株(Escherichia coli K1,Ecoli K1)是常见的导致新生儿化脓性脑膜炎的革兰阴性菌,大部分大肠杆菌脑膜炎是血源性传播所导致,其穿过血脑屏障(blood-brain barrier,BBB)的机制一直是研究的重点.相关研究表明,Ecoli K1穿越BBB与高水平菌血症、对脑微血管内皮细胞的侵袭、受体介导的胞吞转运、活菌穿越BBB密切相关.该文从上述四个方面对E.coli K1穿过BBB进入大脑引起新生儿化脓性脑膜炎的发病机制进行综述.     

细菌感染与支气管哮喘关系及其机制的研究进展

支气管哮喘的发病机制尚不明确,目前认为感染在哮喘的发病中有着重要作用,已证实病毒、支原体、衣原体感染可诱发或加重哮喘发作.目前,细菌感染与哮喘的关系尚不明确.有学者研究发现细菌感染可以降低哮喘的发病率、减轻症状,而有研究则报道细菌感染导致哮喘发病及病情的加重.为进一步探讨细菌与哮喘的关系,该文对细菌感染与支气管哮喘关系及其可能机制进行初步探讨,以期为了解哮喘的发病及早期防治提供思路.     

未湿化鼻导管吸氧法在急诊患者中的应用探讨

目的：探讨未湿化鼻导管吸氧法在急诊患者中应用的可行性。方法将680例急诊输氧患者按入院时间的单、双日分为2组,单日为湿化组,双日为未湿化组。湿化组按常规吸氧程序操作,未湿化组患者用干燥的湿化瓶直接吸氧,比较2组患者鼻咽部黏膜干燥发生的概率和程度、湿化瓶污染情况、护士执行氧疗操作时间。结果2组患者鼻咽部黏膜干燥情况和吸氧后其他不适症状比较无明显差异（P>0.05）;湿化组湿化瓶细菌污染率高于未湿化组（P<0.05）;护士氧疗操作时间未湿化组少于湿化组（P<0.05）。结论未湿化吸氧不会增加急诊患者鼻咽部黏膜干燥症状和不适感,而且操作简单,既减少了湿化瓶的污染,又缩短了护士执行氧疗操作时间,为危重患者抢救羸得了时间,在急诊科应用具有可行性。     

Role of clinical suspicion in pediatric blunt trauma patients with severe mechanisms of injury

Objectives

In adult patients with blunt trauma, severe mechanism of injury leads to routine pan-computed tomography (CT). Due to concerns about the risk of radiation, we sought to determine whether clinical suspicion could identify children requiring radiographic imaging.

Is computed tomography tractography reliable in patients with anterior abdominal stab wounds?

Introduction

The current literature and guidelines recommend that determination of peritoneal violation is done first in cases of anterior abdominal stab wounds. The primary endpoint of this study was to determine the reliability of computed tomographic (CT) tractography to assess peritoneal violation in anterior abdominal stab wounds. The secondary endpoint is to compare local wound exploration between conventional CT and CT tractography in the evaluation of peritoneal violation.

Mechanism of adrenocortical toxicity induced by quinocetone and its bidesoxy-quinocetone metabolite in porcine adrenocortical cells in vitro

Quinocetone (QCT) is a new feeding antibacterial agent in the QdNOs family. The mechanism of its adrenal toxicity is far from clear. This study was conducted to estimate the adrenal cell damage induced by QCT and its bidesoxy-quinocetone (B-QCT) metabolite and to further investigate their mechanisms. Following doses of QCT increasing from 5 to 50 μM, cell apoptosis and necrosis, mitochondrial dysfunction and redox imbalance were observed in porcine adrenocortical cells. The mRNA levels of the six components of intermediary enzymes and the adrenal renin-angiotensin-aldosterone system (RAAS) displayed a dysregulation induced by QCT, indicating that QCT might influence aldosterone secretion not only through the upstream of the production but also through the downstream of the adrenal RAAS pathway. In contrast, B-QCT had few toxic effects on the cell apoptosis, mitochondrial dysfunction and redox imbalance. Moreover, LCMS-IT-TOF analysis showed that no desoxy metabolites of QCT were found in either cell lysate or supernatant samples. In conclusion, we reported on the cytotoxicity in porcine adrenocortical cells exposed to QCT via oxidative stress, which raised awareness that its toxic effects resulted from N→O groups, and its toxic mechanism might involve the interference of the steroid hormone biosynthesis pathway.