热性惊厥与血清钠浓度的关系

热性惊厥是儿科急症之一 ,发病率很高 ,在婴儿期有过一次热性惊厥者占全部小儿的 4 %～ 5 % [1] .对1997年 1月～ 1999年 12月热性惊厥患儿血钠、血钙分析如下 .1　资料和方法1.1　临床资料　观察组热性惊厥 4 2例 ,均符合 1983年全国小儿神经病专题讨论会议诊断标准[2 ] ,其中男2 3例 ,女 19例 ;年龄 <1岁 8例 ,1～ 3岁 2 3例 ,>3岁11例 (最大为 6岁 ) ;上呼吸道感染 30例 ,支气管炎 5例 ,肺炎 2例 ,扁桃体炎 3例 ,急性喉炎 2例 ;一次热程中惊厥发作 1次 34例 ,2次 5例 ,≥ 3次 3例 ;惊厥时的体温 ,38～ 38.9℃ 16例 ,≥ 39℃ 2 8例 .对照…     

重组人血小板生成素联合免疫抑制治疗对儿童重型再生障碍性贫血的疗效及对细胞因子表达的影响

目的:探讨重组人血小板生成素(rhTPO)联合免疫抑制(IST)治疗对儿童重型再生障碍性贫血(SAA)的疗效及对细胞因子的影响.方法:选取2017年2月～2021年2月医院收治的SAA患儿64例,随机分为两组,32例/组,对照组接受IST治疗,观察组接受rhTPO联合IST治疗,对比两组临床疗效、血液因子[血小板(pl...     

儿童原发性肾病综合征中西医结合分段治疗——附34例长期观察分析

原发性肾病综合征(肾综)不断调塑和改进激素治疗方案,本病的缓解率已逐年提高.然而,许多治疗有效的患儿,在撤停激素过程中易复发.因此,寻求一种较好的疗法以提高激素的疗效及预防肾病复发是治疗成败的关键.1 资料与方法1.1 观察对象 全部为住院及专科门诊长期追踪的患儿,随机分为两组:结合组34例,男21例,女13例,平均年龄6.5岁(18个月～14岁);西药组30例,男22例,女8例,平均年龄7.2岁(20个月～13岁).病程平均15.2个月(8天～6年).1.2 临床诊断 两组诊断标准均符合1981年全国儿科肾脏疾病科研协作组《关于小儿肾小球疾病临床分类和治疗的建议》修订意见.治疗前临床分型①单纯性贤病:结合组21例;西药组19例.②肾炎性肾病:结合组13例,其中血尿9例、高血压3例、氮质血症2例、具两项以上改变者2例.西     

气管炎菌苗、酮替芬联用防治反复呼吸道感染120例临床分析

反复呼吸道感染是儿科常见病,如果不及时治疗,使其迁延不愈、反复发作,严重影响患儿的发育,致免疫功能低下[1]．对于反复呼吸道感染患儿无特殊治疗方法．我院气管炎菌苗、酮替芬联用防治反复呼吸道感染,取得较好的疗效,现报告如下．1临床资料1．1对象选择1995年以来在我院门诊就诊的反复呼吸道感染患儿120例,均符合1987年全国小儿呼吸道疾病会议制订的反复呼吸道感染的诊断标准．男69例,女sl例,年龄最小6个月,最大12岁．其中6个月至1岁4冽,l岁至3岁42例,3岁至7岁67例,7岁至12岁7例．病程最长45年,平均病程1．9年．每年最多门…     

小儿甲型肝炎血清铁蛋白的RIA

我们对38例甲型肝炎(以下称甲肝)患儿在发病的急性期、恢复期及恢复后期进行了血清铁蛋白(Serum Ferritin,简称SF)的RIA,发现SF的恢复比丙氨酸转氨酶(ALT)的恢复慢,且早期SF高者恢复较快。现报告如下。材料和方法一、对象:38例患者均为住院病人(1987年～1991年),男性24例,女性14例,年龄1～14岁,平均7岁。根据1984年(南宁)全国病毒性肝炎学术会议制定的诊断标准进行确诊,全部确诊为甲型肝炎。同时以正常30例小儿为对照,男19例,女11例,年龄在2～12岁,平均8岁。两组小儿     

无症状糖尿病患者血生化和血流变指标分析

近 几年来 ,不少糖尿病 (ＤＭ )患者因起病隐匿而不典型 ,症状不明显[1] ,而延误诊治。笔者对我院 1996年元月至 2 0 0 2年 2月门诊内分泌专科就诊的 72例无症状ＤＭ患者初诊资料作一临床分析 ,以便从中发现其临床特点及规律 ,为早期ＤＭ的防治提供依据。1　资料与方法1.1　一般资料72例无症状ＤＭ患者 ,全部按 1985年ＷＨＯ糖尿病诊断标准确诊 ,其中男 2 9例、女 43例 ,年龄 33～ 6 5岁 ,<45岁36例 (5 0 % ) ,45岁～ 5 5岁者 30例 (4 1.7% ) ,5 5岁～ 6 5岁者6例 (8.3% )。对照组 6 8例 ,男 31例、女 37例 ,年龄 37～ 6 3岁 ,均无糖尿病、…     

68例精神发育迟缓患儿的CT与脑电图分析

精神发育迟缓 (ＭＲ)是一种较常见的脑发育障碍疾病。现将我院 1986～ 1998年经各种检查后确诊的 6 8例ＭＲ患儿的ＣＴ及脑电图分析如下。1　病例资料一般资料 :6 8例ＭＲ患儿中 ,男 45例 ,女 2 3例 ,男女之比 2∶1。年龄 4岁～ 2 3岁。 4～ 6岁 16例 ,7～ 8岁 2 0例 ,9～10岁 13例 ,11～ 13岁 9例 ,14～ 16岁 8例 ,17～ 2 3岁 2例。其中城市 6例 (9% ) ,农村 6 2例 (91% )。可能病因 :6 8例中 ,早产 (7个月 ) 4例 ,近亲结婚 3例 ,出生时难产 5例、窒息 8例和用过产钳助产 4例 ,产后反复高热伴抽搐 6例 ,服避孕药期怀孕 2例 ,患过乙脑 3例 ,…     

静脉注射丙种球蛋白治疗川崎病的临床应用

川崎病病因及发病机制未明 ,但发病率呈上升趋势 .目前已取代风湿病成为小儿后天性心脏病的主要原因之一[1] .本文对静脉滴注丙种球蛋白治疗川崎病2 4例进行疗效分析 .1　资料与方法1.1　对象　 2 4例川崎病患儿 ,年龄 8月～ 5岁 ,男 15例 ,女 9例 ,全部病例均符合日本川崎病研究委员会制定的诊断标准[1] .入院时病程 5～ 8天 .1.2　方法　根据用药情况随机分为 2组 ,即静滴丙球 +阿司匹林口服组 (ＩＶＩＧ组 )和阿司匹林口服组 (ＡＳ组 )各 12例 ,2组患儿开始治疗时病程长短、病情轻重均无明显差异 .采用卫生部生物制品研究所的冻干低ｐＨ…     

合成促皮质素及维生素B6联合治疗婴幼儿癫痫的疗效观察

目的 :探讨合成促皮质素 (Cortrosyn ,长效确杜先 )及维生素B6 (吡哆醇 )联合治疗婴幼儿癫的疗效。方法 :14例年龄为 3个月至 4岁的患儿 (婴儿痉挛症 6例 ,其它顽固性癫 8例 )给予维生素B6 5 0～ 10 0mg d肌肉注射 10天后 ,再以逐渐延长用药间隔的方式肌肉注射Cortrosyn0 0 15～ 0 .0 2 5mg kg.d ,总疗程约 2个月 ,观察用药后的癫发作情况、脑电图 (EEG)改变、血像、肝肾功能及血电解质变化。结果 :治疗后 11例患儿癫发作停止 ,2例顽固性癫患儿发作减少 ,分别由每周 15次及 2 0次减少至每周 3次及 8次 ,1例顽固性癫患儿因不良反应明显终止治疗。EEG及一般临床情况有改善。治疗过程中部分患儿有低血钾、低血钙、浮肿等 ,但血液肝肾功能检查未见异常变化。结论 :Cortrosyn及维生素B6联合治疗婴儿痉挛症及顽固性癫的近期疗效肯定。     

精神运动性癫痫儿童社会适应能力及行为问题的研究

精神运动性癫痫 (ＰｓｙｃｈｏｍｏｔｏｒＥｐｉｌｅｐｓｙ)是儿童癫痫的一种常见类型 ,临床上较难控制 ,国内外已有的研究多侧重于药物治疗以控制发作 ,对其心理及社会功能却研究甚少 ,为此 ,我们对 1997年 1月～1999年 12月在我院癫痫研究所诊治的 6 3例精神运动性癫痫儿童的社会适应能力及行为问题进行研究 ,现报告分析如下。1　资料与方法1.1　资料6 3例患儿均为我院癫痫研究所癫痫专科门诊病人 ,均依据 1989年国际癫痫会议中有关癫痫分类[1] 而确诊。其中男 36例 ,女 2 7例 ;年龄 8～ 12岁 ,平均 10 .6岁 ;起病年龄 5～ 10岁 ,平均 6 .…     

Improved bronchodilation with levalbuterol compared with racemic albuterol in patients with asthma

Background: Racemic albuterol is an equal mixture of (R)-albuterol (levalbuterol), which is responsible for the bronchodilator effect, and (S)-albuterol, which provides no benefit and may be detrimental. Objective: We sought to compare 2 doses of a single enantiomer, levalbuterol (0.63 mg and 1.25 mg), and equivalent amounts of levalbuterol administered as racemic albuterol with placebo in patients with moderate-to-severe asthma. Methods: This was a randomized, double-blind, parallel-group trial. Three hundred sixty-two patients 12 years of age or older were treated with study drug administered by means of nebulization 3 times daily for 28 days. The primary endpoint was peak change in FEV₁ after 4 weeks. Results: The change in peak FEV₁ response to the first dose in the combined levalbuterol group was significantly greater compared with the combined racemic albuterol group (0.92 and 0.82 L, respectively; P = .03), with similar but nonsignificant results after 4 weeks (0.84 and 0.74 L, respectively). Improvement in FEV₁ was similar for levalbuterol 0.63 mg and racemic albuterol 2.5 mg and greatest for levalbuterol 1.25 mg. Racemic albuterol 1.25 mg demonstrated the weakest bronchodilator effect, particularly after chronic dosing. The greatest increase in FEV₁ was seen after levalbuterol 1.25 mg, especially in subjects with severe asthma. All active treatments were well tolerated, and β-adrenergic side effects after administration of levalbuterol 0.63 mg were reduced relative to levalbuterol 1.25 mg or racemic albuterol 2.5 mg. At week 4, the predose FEV₁ value was greatest in patients who received levalbuterol or placebo when compared with those who received racemic albuterol. The difference was more evident and was statistically significant in patients who were not receiving inhaled corticosteroids. Conclusion: Levalbuterol appears to provide a better therapeutic index than the standard dose of racemic albuterol. These results support the concept that (S)-albuterol may have detrimental effects on pulmonary function. (J Allergy Clin Immunol 1998;102:943-52.)     

Infectious diseases and immunological markers associated with patients with non-Hodgkin lymphoma treated with rituximab

Background: The use of rituximab (RTX) is increasing, even in developing countries. It has become the first-line therapy or adjuvant to chemotherapy (CHOP; cyclophosphamide, hydroxydaunorubicin, oncovin and prednisone) for various diseases, including B cell lymphoma and autoimmune diseases.

Aim: We describe the infectious diseases and immunological markers associated with RTX treatment of patients with non-Hodgkin lymphoma (NHL).

Methods: Serum immunoglobulins were determined before and after intravenous immunoglobulin (IVIg) administration. Pneumo-23IgG-specific anti-pneumococcal antibodies were evaluated before and after vaccination. Immunophenotyping and lymphocyte proliferation were determined in the course of the treatment.

Results: Seven patients were followed and median age was 56.0?±?5.0?years (range, 41.9–71.6?years). At baseline, the mean level of IgG was 333.7?±?40.8?and IgM 40.9?±?11.3?mg/dL, respectively; immunoglobulin A and E (IgA and IgE) were under the limit of detection. Two patients had reduced or absent B cells and T cell subsets were at normal levels in five patients. All patients failed to mount an efficient post-vaccination immune response against hepatitis B virus, tetanus, diphtheria and against the 23-valent pneumococcal polysaccharide vaccine. During RTX/CHOP treatment, human-IgG-immunoglobulin (IVIg) therapy was introduced in six patients after recurrent infections, including community-acquired pneumonia (85.7%), chronic sinusitis (85.7%) and gastroenteritis (42.9%).

Conclusion: Poor response against pneumococcal vaccines increases the susceptibility of respiratory diseases in these patients. In patients with NHL treated with RTX, the benefits achieved with IVIg replacement for the control of recurrent infectious diseases is of paramount importance. Clinicians dealing with monoclonal antibodies against cancer therapy, especially RTX, should be aware of the increasing risks for symptomatic induced hypogammaglobulinemia and respiratory infections.     

Gynecomastia with marked cellular atypia associated with chemotherapy

Gynecomastia is a common benign male breast disease, which may exhibit mild cellular atypia in cytology specimens. However, marked cytologic atypia can be seen in gynecomastia superimposed by chemotherapy. The case described in this report demonstrated severe cytologic atypia of gynecomastia mimicking carcinoma in a patient treated with chemotherapy for acute leukemia. A distinct cytologic feature helpful in avoiding the diagnostic error is described, namely, atypical cells admixed with bland ductal cells and appearing at a different plane. The importance of applying strict diagnostic criteria in breast cytology and clinical correlation is also emphasized.     

Intervention with epinephrine in hypotension associated with mastocytosis

The occurrence of the episodes of vasodilatory hypotension can be a life-threatening manifestation of systemic mastocytosis. This article describes the reversal by epinephrine of episodes of severe hypotension in two hospitalized patients with mastocytosis. Recognition of the efficacy of epinephrine in hypotension associated with mastocytosis can be important when other methods fail to restore hemodynamic stability.     

Establishing Safety with Patients with Dissociative Identity Disorder

Abstract

The incidence of self-mutilation and suicidality among patients with dissociative disorders is quite high. It is necessary for clinicians working with this population to be adept at dealing with safety problems. This article presents a sequence of basic steps that can be used when helping dissociative patients establish safety, a discussion of the functions of self-destructiveness, and an overview of specific experiences and thinking patterns that contribute to self-destructiveness among dissociative patients.     

Satellite RNA associated with bamboo mosaic potexvirus shares similarity with satellites associated with sobemoviruses

Summary A putative nonstructural protein encoded by a satellite RNA associated with bamboo mosaic potexvirus shares 46% identity with the capsid protein of satellite virus of panicum mosaic sobemovirus. The sequence similarity among satellite plant viruses which have no apparent relationship implies a common origin.