先天性神经母细胞瘤尸检2例

先天性神经母细胞瘤极为少见 ,本院尸检中发现 2例 ,报道如下。例 1男 ,生后 2 0天 ,体重 3 1 0 0ｇ。腹腔肿物急剧增大 2 0天 ,此间曾 3次就诊 ,诊断不明。此次就诊时 ,患儿高热 40℃ ,呼吸急促 ,哭叫不宁 ,频频惊厥。皮肤苍白 ,腋窝及腹膜沟处能扪及花生米大小淋巴结数个。腹部膨大 ,腹壁静脉曲张 ,肝肿大 ,右叶已入盆腔 ,左叶下缘抵左髂骨最高点 ,肝表面扪及密布如黄豆大小之结节。以“贫血、肝脾肿大待查”急诊入院。入院后抢救无效死亡。图 1　神经母细胞瘤细胞及菊形团ＨＥ× 40尸检 :腹腔为肿大之肝脏所占据 ,肝下缘在盆腔 ,肝重 980…     

IGF-1对学龄前阻塞性睡眠呼吸暂停综合征儿童认知能力的影响

目的:探讨IGF-1对学龄前阻塞性睡眠呼吸暂停综合征(OSAS)儿童认知能力的影响。方法:对OSAS组52例和对照组49例学龄前儿童进行多导睡眠监测,利用韦氏记忆量表、韦氏儿童智力测验量表和图形划销测验进行认知能力评定。血清IGF-1浓度测定采用放射免疫分析方法,同时对血清IGF-1浓度与记忆能力、智商和注意力进行相关性分析。结果:OSAS组记忆能力(数字顺背、数字倒背、数字广度测验合计)和总智商均明显低于对照组(P0.05)。OSAS组注意力失误分明显高于对照组(P0.05)。OSAS组血清IGF-1浓度明显低于对照组(P0.05)。血清IGF-1浓度与数字广度测验合计分数及总智商呈正相关,与注意力失误分呈负相关。结论:学龄前阻塞性睡眠呼吸暂停综合征儿童存在记忆能力、智力水平和注意力方面的认知功能障碍;IGF-1水平的下降是引起认知功能障碍的机制之一。     

妥洛特罗贴剂治疗轻中度婴幼儿支气管哮喘临床观察

目的 观察妥洛特罗贴剂对轻中度婴幼儿支气管哮喘的治疗效果及其安全性.方法 将62例支气管哮喘患儿分为妥洛特罗贴剂组(32例)和对照组(30例),在丙酸氟替卡松气雾剂治疗基础上分别加用妥洛特罗贴刑和盐酸丙卡特罗片剂治疗2周.记录患儿的哮喘症状评分、喘鸣发作次数和短效β2受体激动剂的用量,并记录不良反应发生情况.结果 贴剂组治疗后哮喘日间症状评分[治疗1周后为(2.2±0.9)分/周、治疗2周后为(0.9 ±0.5)分/周]明显低于对照组[治疗1周后为(3.4 ±1.1)分/周、治疗2周后为(1.3±0.6)分/周],差异均有统计学意义(P均<0.05);贴剂组治疗1周后哮喘夜间症状评分[(1.8±0.7)分/周],明显低于对照组[(3.3 ±0.9)分/周],差异有统计学意义(P<0.05);贴荆组治疗期间喘鸣发作次数为(2.3±1.2)次,对照组为(3.6±1.3)次,2组比较差异有统计学意义(t=4.09,P<0.05);贴剂组的β2受体激动剂用量为(2.6 ±0.9)喷/周,对照组为(3.7 ±0.8)喷/周,差异有统计学意义(t=5.07,P<0.05);贴剂组不良反应发生率(3.12%)明显低于对照组(23.33%),2组比较差异有统计学意义(X2=3.89,P<0.05).结论 妥洛特罗贴剂是一种安全、有效的轻中度婴幼儿支气管哮喘治疗药物.     

妥洛特罗贴剂治疗轻中度婴幼儿支气管哮喘临床观察

Objective To evaluate the therapeutic effect of tulobuterol tape on mild or moderate bronchial asthma in children less than three years old . Methods Sixty-two children with mild or moderate asthma were randomized to receive either tulobuterol tape(treatment group) or procaterol hydrochloride tablet(control group) on the basis of inhaled fluticasone propionate for 2 weeks. Symptom scores of asthma, frequencies of episode of wheeze, doses of inhaled ventolin as rescue drug and the incidence of adverse reactions were recorded. Results In the treatment group,the symptom scores during daytime in the treatment group were (2. 2 ±0. 9)/week and (0. 9 ±0. 5)/week after 1 and 2 weeks of treatment, respectively, which were significantly lower than that in the control group(3.4 ± 1. 1)/week and (1. 3 ± 0. 6)/week after 1 and 2 weeks of treatment, respectively) (P < 0. 05). The symptom scores during night in the treatment group was significantly lower than that in the control group after one week of treatment (1. 8 ± 0. 7) /week v. s. (3. 3 ± 0. 9) /week, P < 0. 05). The frequencies of episode of wheeze was significantly different between the two groups (2. 3 ±1.2 and 3. 6 ± 1.3 in the treatment and control groups, respectively (P < 0.05) .The doses of inhaled ventolin in the treatment group (2. 6 ±0.9 spray/week) was significantly lower than that in the control group (3.7 ± 0. 8) spray/week) (P < 0. 05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group (3. 12% v. s. 23. 33% ,x2 = 3. 89,P<0.05). Conclusions Tulobuterol tape is a safe and effective medication for the treatment of mild or moderate bronchial asthma in children less than three years old.     

妥洛特罗贴剂治疗轻中度婴幼儿支气管哮喘临床观察

Objective To evaluate the therapeutic effect of tulobuterol tape on mild or moderate bronchial asthma in children less than three years old . Methods Sixty-two children with mild or moderate asthma were randomized to receive either tulobuterol tape(treatment group) or procaterol hydrochloride tablet(control group) on the basis of inhaled fluticasone propionate for 2 weeks. Symptom scores of asthma, frequencies of episode of wheeze, doses of inhaled ventolin as rescue drug and the incidence of adverse reactions were recorded. Results In the treatment group,the symptom scores during daytime in the treatment group were (2. 2 ±0. 9)/week and (0. 9 ±0. 5)/week after 1 and 2 weeks of treatment, respectively, which were significantly lower than that in the control group(3.4 ± 1. 1)/week and (1. 3 ± 0. 6)/week after 1 and 2 weeks of treatment, respectively) (P < 0. 05). The symptom scores during night in the treatment group was significantly lower than that in the control group after one week of treatment (1. 8 ± 0. 7) /week v. s. (3. 3 ± 0. 9) /week, P < 0. 05). The frequencies of episode of wheeze was significantly different between the two groups (2. 3 ±1.2 and 3. 6 ± 1.3 in the treatment and control groups, respectively (P < 0.05) .The doses of inhaled ventolin in the treatment group (2. 6 ±0.9 spray/week) was significantly lower than that in the control group (3.7 ± 0. 8) spray/week) (P < 0. 05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group (3. 12% v. s. 23. 33% ,x2 = 3. 89,P<0.05). Conclusions Tulobuterol tape is a safe and effective medication for the treatment of mild or moderate bronchial asthma in children less than three years old.     

胰岛素样生长因子-Ⅰ对高氧致新生鼠慢性肺疾病Ⅰ型胶原表达的影响

目的研究collagen Ⅰ在高氧致新生鼠慢性肺疾病中的表达、作用及IGF-Ⅰ对collagenⅠ表达的影响。方法将足月新生大鼠144只随机分为高氧组和空气组，分别于实验1d，3d，7d，10d，14d和21d应用免疫组化染色分别检测collagenⅠ和IGF～Ⅰ蛋白表达，并将IGF—Ⅰ和collagenⅠ蛋白表达进行相关分析。结果高氧组在3d～10d IGF—Ⅰ和collagenⅠ蛋白表达与空气组相比较明显降低（P〈0．05）；14d和21d IGF—Ⅰ和collagenⅠ蛋白表达与空气组相比较明显增加（P〈0．05），IGF—Ⅰ和collagenⅠ表达呈正相关。结论collagenⅠ与CLD时肺泡发育受阻和肺纤维化发生有关，IGF—Ⅰ是影响collagenⅠ合成的重要生长因子之一。