皮肤疱疹、指(趾)甲脱落及营养不良

病例摘要 患儿，女，2个月，主因皮肤疱疹50余d，伴消瘦、腹泻入院。患儿系第2胎第2产，孕37周顺产，出生体重2．9kg。母乳喂养，生后7d无诱因皮肤出现疱疹始于臀部，绿豆大小水疱，疱内液体清亮透明，未予特殊处理，水疱逐渐增大，自然破溃后可见红色糜烂面，边缘轻度充血，无水肿，疱疹渐波及到全身，遍及臀部、躯干、四肢及手足，大小不等，直径在0．2-5．0cm，伴指（趾）甲脱落。全身表现体重不增，间断性腹泻，消瘦，面色苍白，烦躁哭闹等，无发热、纳差、精神萎靡等。     

左旋咪唑对肾病患儿吞噬细胞功能影响的观察

采用鲁米诺吞噬细胞化学发光（ｐｈａｇｏｃｙｔｅｃｈｅｍｉｌｕｍｉｎｅｓｃｅｎｃｅ，ＰＣＬ）技术，观察左旋咪唑治疗对肾病患儿外周血ＰＣＬ的影响，探讨了其对肾病免疫机能的调节作用。实验对象为肾上腺皮质激素治疗４～８周的肾病患儿，包括左旋咪唑组１５例；患儿对照组２４例；正常对照组１６例。结果显示：左旋咪唑组ＰＣＬ峰值显著高于患儿对照组（Ｐ＜０．０５），与正常对照组无差异。肾病患儿接受激素治疗期存在外周血吞噬细胞吞噬活性低下，左旋咪唑可以提高受抑制的吞噬细胞功能。     

肾病综合征患儿血浆纤维结合蛋白的临床研究

原发性肾病综合征 (简称肾病 )患儿机体血清免疫调理作用紊乱 ,如低ＩｇＧ血症 ,另一免疫调理因子血浆纤维结合蛋白(ｐｌａｓｍａｆｉｂｒｏｎｅｃｔｉｎ ,ＰＦｎ)对肾病的影响也日益受到重视 ,动物实验观察到小鼠肾小球硬化的基底膜ＦｎｍＲＮＡ表达增加和Ｆｎ沉积 ,认为Ｆｎ是形成肾小球硬化的成份之一。我们采用免疫琼脂扩散法观测了 6 2例不同临床期肾病患儿ＰＦｎ含量的变化。1　资料和方法1.1　对象　本院儿科肾病住院患儿 6 2例 ,男∶女 =2 .8∶1,平均年龄 6 .5岁。诊断符合 1981年全国小儿肾脏病科研协作组制定的诊断标准[1] 。实验…     

白细胞粘附分子与肾脏疾病

肾脏疾病发生与免疫性炎症密切相关,如急性肾小球肾炎、血管炎、间质性肾炎和移植物排斥反应等。目前,对上述疾病缺乏特异性免疫治疗措施,关键在于对肾脏炎症的发生机制认识不足。近年来免疫学研究注意到白细胞粘附作用在肾脏炎症中的重要性,并提出进行治疗干预。粘附作用是由白细胞表面粘附分子(Leukocyte Adhesion Molecules,LAM)与宿主细胞同族配体相互作用的结果。因此,人们开始研究LAM与肾脏疾病的关系。本文系统阐述了LAM的分类和特性,LAM与肾小球细胞;LAM在肾脏疾病的表达和抗LAM治疗干预作用。     

新生儿局部脑组织氧检测的多中心研究

Objectives To understand the value of measuring neonatal cerebral regional oxygen ‘saturation(rSO2)using near infrared spectroscopy (NIRS) in assessing cerebral oxygenation,to establish the normal range of neonatal cerebral rSO2,and to collect data of the changes of cerebral rSO2 under certain disease status.Methods Nine large hospitais participated in the multicenter randomized clinical trial from Jan 2007 to Apr 2008.Using the NIRS human tissue oximeter(TSAH-100)independently developed in China.tIle cerebral rSO2 of 223 normal full-term and 95 otherwise healthy preterm neonates without any stmcial disease,Was detected at 1.2 and 3 days after birth,respectively.The cerebral rSO2 of 102 neonates with diseases which may affect the cerebral oxygenation.Was also detected during the severe phases.The pulse oxygen saturation(SpO2)measured at the finger tip,and also the arterial oxygen saturation(SaO2) measured by blood gas analysis,which could indicate the oxygen supply of the whole body,were obtained simultaneously.The correlations among cerebral rSO2,putse SpO2 and arterial SaO2 were analyzed.Results (1)The cerebral rSO2 of the normal full-term neonates wag(62±2)%.Cerebral hypoxia Was deftned as rSO2 lower than 58%. The cerebral rSO2 of the normal full-terms was steady at 1, 2 and 3 days after birth respectively, without any significant differences among them (F = 0. 610, P >0. 05 ). The cerebral rSO2 of the neonates with diseases was ( 55 + 7 ) %, which was significantly lower that that of the normal full-term neonates (t = 15.492,P <0. 05). (2) The cerebral rSO2 was positively correlated with the SpO2(r =0. 74,P < 0. 01 ) and the SaO2 ( r = 0. 71, P < 0. 01 ). ( 3 ) Under some special diseases, the changes of cerebral relatively low hemoglobin concentration, the cerebral rSO2 was significantly low (50%～58% ), but the cerebral rSO2 was lagged as compared with that of pulse SpO2. Especially, during the severe phases of 6 cases with multi-organ failure, the SpO2 and the cerebral rSO2 were both significantly low (55%～80% for SpO2, and 44%～50% for cerebral rSO2 ) ; when the diseases were alleviated, although the SpO2 recovered phases of serious hypoxic-ischemic encephalopathy (HIE), the cerebral rSO2 significantly increased to 70%～72%, which was significantly higher than the normal value (62%). Condusions The range of cerebral rSO2 of the normal full-term neonates was (62 + 2) %. Cerebral oxygenation can be externally indicated by the rSO2 noninvasively and continuously measured by NIP, S, which was positively correlated with traditional pulse SpO2 and arterial SaO2. In some special diseases, the rSO2 measured by NIRS can be helpful for clinical diagnoses and treatments.     

化学发光法测定肾病综合征患儿吞噬细胞功能

化学发光法测定肾病综合征患儿吞噬细胞功能王俊怡耿佩琛任秉钧原发性肾病综合征（简称肾病）发病机制与机体免疫功能紊乱有关。吞噬细胞功能是反映机体免疫防御机能的重要指标。我们采用鲁米诺吞噬化学发光技术对６２例肾病患儿外周血吞噬细胞化学发光（ｐｈａｇｏｃｙｔ...     

利巴韦林治疗小儿呼吸道感染的应用探讨

2003年12月—2004年2月，笔者经不同给药方式予利巴韦林治疗小儿呼吸道感染90例，现报道如下。     

肾病综合征血清肿瘤坏死因子水平的临床研究

原发性肾病综合征(primary nephrotic syndrome,PNS)发病机制尚不清楚,多数学者认为与机体免疫功能紊乱有关。研究已证实PNS患儿血液循环中免疫细胞及细胞因子可以直接或间接引起肾小球损伤,肿瘤坏死因子(tumor necrosis factor,TNF)是与肾小球损伤密切相关的细胞因子之一。我们观测了PNS不同临床分期血清TNF的动态变化,并与其它生化指标进行了相关分析。目的是深入探讨TNF与PNS的发生和发展的关系,为PNS的诊断和治疗提供理论依据。