Expression of Toll-like receptors 3 (TLR3) on peripheral blood mononuclear cells and serum IFN-γ,TNF-α levels in children with acute rotavirus diarrhea

Objective To explore the relationship between TLR3 mRNA expression on peripheral blood mononuclear cells(PBMCs)and acute rotavirus(RV)diarrhea.Methods Sixty-one children with acute RV diarrhea served as study subject,the expression of TLR3 mRNA on PBMCs was detected by real-time fluorescence quantitative RT-PCR.the concentrations of IFN-γand TNF-α in serum were measured by the method of Enzyrme-linked immunosorbent assay(EUSA).Results The expression of TLR3 on PBMCs and the serum levels of IFN-γ and TNF-α in the serious diarrhea group were 0. 820±0.051,(33.67±12.88)Pg/ml, (62.21±14.65)pg/ml,respectively,while it were 0.717±0.040,(24.01±10.06)pg/ml,(50.99± 12.18)pg/ml in the slight diarrhea group,and 0.525±0.029,(12.52±5.19)pg/ml,(28.65±7.44)pg/ml in the control group.Compared with the control group.the expression of TLR3 on PBMCs and the serum levels of IFN-γ,TNF-α in the serious and slight diarrhea group were significantly higher(P<0.01).There were significant differences between the serious and slight diarrhea group(P<0.01).There were positive relationship between the expression of TLR3 on PBMCs and tHe serum IFN-γ,TNF-α levels(r=0.431,P< 0.05,r=0.372,P<0.05).Conclusion The expression of TLR3 on PBMCs in children with acute rotavirus dialThea iS up-regulated,TLR3 and its mediated immune response are associated with the development of acute rotavirus diarrhea.     

昼间变动青少年帕金森综合征一例报告

1病例资料 患者,男,19岁,11岁时逐渐出现行走困难,行走时脚尖着地、躯干前倾、易摔跤,上述症状晨轻暮重、昼间变动、睡眠可使症状缓解。15岁时,患者开始出现声音低沉、言语欠清晰,双上肢震颤。病情缓慢进行性加重。无家族史。体查：生命体征正常,发育正常,心肺、腹部体查未见异常。     

小儿87例尸检病理及临床分析

近十年来我院对死亡原因不甚明确的 110例患儿进行了尸检病理分析。其中有肺炎组织学改变的有 87例。现将该 87例报告如下。1　临床资料1 1　一般资料　 87例患儿系 1988年1月— 1997年 12月在我院住院 (83例 )和门诊 (4例 )期间死亡。男 49例 ,女38例。最小出生 1ｈ ,最大 9岁。其中新生儿 2 4例。～ 5岁 6 1例 ,～ 9岁 2例。住院天数 <1ｄ 5 0例 (包括门诊 4例 ) ,～ 3ｄ 2 4例 ,～ 6ｄ 5例 ,>7ｄ 8例。1 2　临床表现　有不同程度青紫 35例 ,咳嗽 2 4例 ,抽风 2 0例 ,腹泻 18例 ,腹胀 9例 ,营养不良 14例 ,黄疸 8例 ,硬肿 6例 ,肝肿大 3例…     

医院内电话细菌污染情况调查

电话作为一种通信工具在医院内确实为医务人员及广大病友提供了极大方便。然而,在病原微生物聚集的医院内使用电话,如不注意做好消毒隔离工作,将是引起院内感染的环节之一。为此,我们对本院９４部电话污染情况进行了细菌学调查,为预防院内感染提供了可靠的依据。１材料与方法１．１材料电话、无菌棉签、无菌镊子、酒精灯、无菌试管（内盛无菌生理盐水１０ｍｌ）、０．４％消佳净、营养琼脂平板等。１．２方法对医院９４部电话（其中５０部内线电话,４４部外线电话）用无菌棉签在 ５ｃｍ × ５ｃｍ规格板空心处作涂抹法进行表面采样,…     

脑脊液置换术联合蛛网膜下腔注射小剂量尿激酶治疗蛛网膜下腔出血

目的:探讨脑脊液置换术联合蛛网膜下腔注射小剂量尿激酶治疗蛛网膜下腔出血（SAH）的临床效果。方法:134例经头颅CT或核磁共振成像及腰穿确定的SAH患者,随机分为脑脊液置换术联合蛛网膜下腔注射小剂量尿激酶组（治疗组,n=68）及脑脊液置换术组（对照组,n＝66）。比较两组患者主要并发症发生情况、治疗前后神经功能缺损评分及疗效。结果:治疗组脑血管痉挛（CVS）、脑积水并发症发生率明显少于对照组（P<0.01）,再出血发生率与对照组相比无明显改善（P>0.05）;神经功能缺损评分较对照组明显减少（P<0.01）;两组疗效比较差别有统计学意义（P<0.05）。结论:脑脊液置换术并蛛网膜下腔注射小剂量尿激酶是一种治疗蛛网膜下腔出血的有效方法,可提高蛛网膜下腔出血患者的生存质量和生存率。     

腹股沟疝无张力修补术后谵妄的相关因素分析及护理

Objective To analyze the correlation factors and to explore the care measures of postopera-tive delirium in elderly patients with tension - free inguinal hernia repairing. Methods 185 cases of elderly pa-tients with tension - free inguinal hernia repairing were analyzed by single - factor analysis and multi - factor logis-tic regression analysis. Results 24 cases of patients with delirium was delirium group, 161 cases who had not de-lirium was non - delirium group. The average age of delirium group, surgical time, the degree of postoperative wound pain, and the incidence of lumbodynia, the original brain heart and lung disease, dysuria, constipation, postoperative use of analgesics were significantly higher than those of non - delirium group (P<0.01～0.05) . Conclusions The occurrence of postoperative delirium in elderly patients with tension -free inguinal hernia re-pairing is correlated with age, operative time, postoperative pain, heart disease, lung disease, brain disease, dys-uria, constipation, postoperative use of analgesics, degree of postoperative wound pain.     

修改Graeb评分标准预测脑室积血并发急性梗阻性脑积水

目的寻找一种客观实用的方法,预测脑室积血(IVH)并发急性梗阻性脑积水(AOH)的发生概率.方法用原Graeb及修改Graeb 2种评分标准,对积血为主要部位的第四脑室组15例、第三脑室组19例及基底节出血所致侧脑室组38例,根据有无AOH,用四格表确切概率法及Logistic回归分析法分析积分与脑积水的关系.结果按修改Graeb标准在敏感性和特异性二曲线交点时,敏感性、特异性、误诊率、漏诊率、诊断效率、Youclen和K值分别为0.952、0.90、0.1、0.048、0.93、0.852和0.85.用Logistic回归分析5～12分者并发AOH的概率分别为: 0.02、 0.07、 0.26、 0.62、 0.88、 0.97、 0.99及1.0.结论修改Graeb标准能较好地预测第三、第四脑室及幕上出血量小于30 ml所致IVH并发AOH的发生概率.     

局灶性脑缺血再灌注大鼠神经元凋亡及七叶皂甙钠干预的研究

目的:观察七叶皂甙钠在大鼠脑缺血再灌注后神经元细胞凋亡过程中的作用。方法:运用大鼠右侧大脑中动脉缺血再灌注模型,比较正常对照组、假手术组、缺血3h组、缺血3h再灌注3h/6h/12h/24h/48h/72h组、缺血3h再灌注β-七叶皂甙钠药物干预后3h/6h/12h/24h/48h/72h组等大鼠脑组织中的神经元凋亡情况。结果:七叶皂甙钠干预治疗后,缺血组缺血侧凋亡阳性细胞减少。结论:七叶皂甙钠有明显抑制大鼠脑缺血再灌注后神经元细胞凋亡的作用。