儿童溺水院前院内急救20例临床分析

目的探讨溺水儿童最佳的院前、院内急救方法，提高复苏成功率。方法对近2年我院急诊与PICU救治的20例溺水儿童病例作回顾分析。结果20例惠儿中15例在现场进行了人工呼吸及胸外心脏按压。平均到达医院时间0．5－3小时。至我院急诊时，心肺停止、瞳孔散大者7例；意识障碍者8例；抽搐者1例；完全清醒4例。对心肺停止的7例惠儿立即进行复苏。3例急诊室死亡；其余4例均恢复自主循环，其中2例心肺停止30分钟复苏成功，目前基本恢复正常。2例进入PICU后8－24小时死于多脏器功能衰竭；非心肺停止组13例忠儿中4例遗留轻度缺氧性脑病，其余均治愈出院。结论及时的现场心肺复苏、完善的转运机制、一体化的急救体系，是提高复苏成功率、降低伤残率的有效保障。溺水的预防应关注高危人群，加强安全教育。     

The effects of maternal drug dependence on neonatal mortality

Addiction in pregnancy has become an important health problem owing to the tendency of drug-dependent women to neglect general health care and to avoid seeking prenatal care. In addition, continued heroin administration during pregnancy carries additional risks for the maternal-fetal unit. Thus, there is an increased incidence of obstetrical and medical complications in these mothers, resulting in high incidences of prematurity, low birth weight and mortality in their infants. Therefore, there is a high neonatal mortality rate due to clinical conditions most commonly seen among premature infants. Data from three groups of drug-dependent women and their infants and one control group demonstrate that the high mortality rate, as well as the incidence of low birth weight, can be reduced to a rate similar to the control group in infants of mothers who receive comprehensive services that include prenatal care in conjunction with methadone maintenance.     

Stability of liposome encapsulated hemoglobin dispersions

The demand for artificial blood substitutes in cases of elective surgeries, trauma, and civilian mass catastrophes increases every day. However, few studies have been done to characterize the mechanical stability of blood substitutes, especially liposome encapsulated hemoglobin (LEHb) dispersions. In this work, the stability of LEHb dispersions was investigated by fitting Jung et al.'s liposome size distribution model to experimentally measured LEHb size distributions [6] (produced via extrusion) using asymmetric flow field-flow fractionation coupled with multi-angle static light scattering. The effective bending constant (KB) and radius of curvature (R0) of each liposome dispersion were regressed from the size distribution fits. The model was found to be in agreement with the size distributions of LEHbs extruded through 400, 200 and 100 nm pore diameter membranes, but not in agreement with LEHbs extruded through 80 and 50 nm pore diameter membranes. Although the magnitude of KB fluctuated, we deduced a general trend for KB to decrease with decreasing pore diameter, and increasing initial Hb concentration. LEHbs extruded through 400nm pore diameter membranes were stabilized by the spontaneous curvature effect, while those extruded through 80 and 50 nm pore diameter membranes were mostly stabilized by thermal undulations, regardless of the initial Hb concentration. For LEHb dispersions extruded through 200 and 100 nm pore diameter membranes, there was a transition of stabilization mechanism from spontaneous curvature to thermal undulations with increasing initial Hb concentration. Taken together, these results suggest that moderate Hb encapsulation might actually impart better mechanical stability to LEHb dispersions extruded through 200 and 100 nm pore diameter membranes.     

Electroretinography as a screening method for mutations causing retinal dysfunction in mice

PURPOSE: To detect mice with hereditary retinal impairment, a high-throughput electroretinography (ERG) screening system was established. METHOD: Mice from eight different strains without known retinal disorders (102, 129/SvJ, AKR, C57BL/6J, C57BL/6JIco, CBA/CaJ, and DBA/2NCrlBR) and one control strain with retinal degeneration (C3HeB/FeJ) were fixed on a specially constructed sled, ERG electrodes were placed on the cornea, and mice were moved into a Ganzfeld stimulator. From a luminance range of 0.0125 to 500 cd-s/m(2) in a pretest series two levels (5 and 125 cd-s/m(2)) were chosen to shorten examination times. The root mean square (RMS) of the ERG-recording was analyzed to detect animals with abnormal retinal function. ERG responses of the left and right eyes were compared in amplitudes and implicit times of the a- and b-waves. Statistical analysis of the latter parameters was performed in all wild-type animals. Histology was performed on selected mice. RESULTS: ERG recordings of individual animals for the left and right eye revealed good agreement in amplitudes and implicit times of the a- and b-waves (P < 0.05). Comparison of these parameters among the wild-type strains showed several differences. Evaluation of the RMS revealed, in addition to the C3HeB/FeJ mice, a subgroup of mice within the 129/SvJ strain with abnormal retinal function. Molecular analysis of these mice demonstrated the presence of the same retroviral insertion in the Pde6b gene, which is causative of the Pde6b(rd1) allele carried in C3HeB/FeJ mice. Histologic analysis demonstrated good correlation between retinal electrophysiology and morphology. CONCLUSIONS: The present results demonstrate the feasibility of ERG for screening a large number of mice to detect animals with functional retinal impairment.     

产后抑郁症患者血浆孤啡肽及5-羟色胺水平变化的意义

目的　探讨产后抑郁症患者血浆中孤啡肽及 5 羟色胺水平变化与产后抑郁症发病的关系。方法　采用放射免疫法测定 2 5例正常产妇 (对照组 )及 2 1例产后抑郁症患者 (抑郁症组 )血浆中孤啡肽及 5 羟色胺水平。结果　 (1)抑郁症组血浆孤啡肽水平为 (2 8 5± 5 8)ng/L ,对照组血浆孤啡肽水平为 (10 4± 3 7)ng/L。抑郁症组血浆孤啡肽水平显著高于正常组 ,两组比较 ,差异有极显著性 (P <0 0 1)。 (2 )抑郁症组血浆 5 羟色胺水平为 (1 0± 0 3) μmol/L ,对照组为 (1 4± 0 4 ) μmol/L。抑郁症组血浆 5 羟色胺水平低于对照组 ,两组比较 ,差异有显著性 (P <0 0 5 )。 (3)抑郁症组血浆孤啡肽水平与 5 羟色胺水平呈显著负相关 (r=- 0 5 71,P <0 0 5 )。结论　产后抑郁症患者血浆孤啡肽水平变化与产后抑郁症的发生密切相关。     

FG syndrome in a premature male

A 30-week premature male infant is presented with dolichocephaly, frontal bossing, down-slanting palpebral fissures, hypertelorism, long philtrum, micrognathia, cleft palate, and imperforate anus. He is the fifth patient to be presented with FG syndrome and sensorineural deafness. The patient's syndromic manifestations became more obvious during an inpatient observation period of 3 months.     

儿童溺水院前院内急救20例临床分析

目的探讨溺水儿童最佳的院前、院内急救方法,提高复苏成功率。方法对近2年我院急诊与PICU救治的20例溺水儿童病例作回顾分析。结果20例患儿中15例在现场进行了人工呼吸及胸外心脏按压。平均到达医院时间0.5￣3小时。至我院急诊时,心肺停止、瞳孔散大者7例;意识障碍者8例;抽搐者1例;完全清醒4例。对心肺停止的7例患儿立即进行复苏。3例急诊室死亡;其余4例均恢复自主循环,其中2例心肺停止30分钟复苏成功,目前基本恢复正常。2例进入PICU后8￣24小时死于多脏器功能衰竭;非心肺停止组13例患儿中4例遗留轻度缺氧性脑病,其余均治愈出院。结论及时的现场心肺复苏、完善的转运机制、一体化的急救体系,是提高复苏成功率、降低伤残率的有效保障。溺水的预防应关注高危人群,加强安全教育。     

幽门螺杆菌诱导胃粘膜上皮细胞凋亡与Bax蛋白的表达

目的 观察幽门螺杆菌(Hp)感染诱导胃粘膜上皮细胞凋亡与Bax蛋白表达的关系,探讨Hp诱导胃粘膜上皮细胞凋亡的机制.方法 采用脱氧核糖核酸末端转移酶介导的缺口末端标记(TUNEL)技术原位观察和比较73例慢性胃炎患者胃粘膜上皮细胞凋亡情况,对其中50例Hp阳性患者Hp根除前后胃粘膜上皮细胞凋亡的变化进行检测;并采用免疫组织化学染色检测Bax蛋白表达变化.结果 Hp阳性患者胃粘膜上皮细胞凋亡指数为12.8%,明显高于Hp阴性者(3.6%)(t=6.64,P＜0.01);Hp根除后胃粘膜上皮细胞凋亡指数(4.4%)较治疗前明显降低(12.5%,t=5.39,P＜0.01),而持续阳性者凋亡指数无明显降低.Hp阳性患者胃粘膜上皮细胞Bax蛋白表达率为62.3%,显著高于Hp阴性者(35.0%,χ2=4.36,P＜0.05);Bax蛋白表达阳性的Hp阳性患者在Hp根除后Bax阳性细胞密度显著减少(t=3.18,P＜0.01),而Hp未被根除者Bax阳性细胞密度无明显变化.结论 Hp感染可诱导胃粘膜上皮细胞凋亡,这可能是Hp参与胃癌发生的重要机制之一;Hp感染可促进Bax蛋白表达增加,这可能是Hp感染诱导胃粘膜上皮细胞凋亡的机制之一.