Fulminant childhood hemophagocytic syndrome mimicking histiocytic medullary reticulosis. An atypical form of Epstein-Barr virus infection.

Ten cases of pediatric fulminant hemophagocytic syndrome, encountered between 1986 and 1989, are described. They occurred in the summer, and the patients presented with fever, jaundice, hepatosplenomegaly, pancytopenia, coagulopathy, and abnormal liver function. Bone marrow studies revealed infiltration by atypical T-lymphoid cells, rare B immunoblasts, and mature histiocytes with hemophagocytosis. Initially, histiocytic medullary reticulosis was suspected in six cases. The clinical course was characterized by rapid deterioration, with a mean period of 16 days from onset of fever to death. The main causes of death were coagulopathy with multiple organ failure and opportunistic infection. In seven of eight cases studied by serologic assay and Southern blot hybridization, acute or active Epstein-Barr virus (EBV) infection was documented. It is suggested that an atypical or fulminant form of primary EBV infection distinct from classic infectious mononucleosis was prevalent in previously healthy children in Taiwan. Younger age involvement and seasonal clustering were characteristic of the disorder described.     

人体中氧氟沙星的立体选择性代谢

５名健康志愿者日服单剂３００ｍｇ氧氟沙星［（±）－Ｏｆ１］后，采用立体选择性的ＲＰ－ＨＰＬＣ手性流动相添加剂法测定尿中Ｓ－（－）－Ｏｆ１和Ｒ－（＋）－Ｏｆ１浓度结果显示Ｏｆ１在人体内呈现立体选择性代谢。尿中排泄的Ｓ－（－）－Ｏｆ１／Ｒ－（＋）－Ｏｆ１之比随时间变化。服药后２ｈＳ／Ｒ是０．８７５，２４ｈ增加到１．１５０．Ｓ－（－）－Ｏｆ１的消除半衰期（ｔ１／２）是４．５７ｈ；消除速率常数（ｋ）是０．１５４ｈ；药时曲线下的面积（ＡＵＣ）为１．１７ｍｇ·ｈ－１．ｍＬ－１；Ｒ－（＋）－Ｏｆ１的ｔ１／２为４．１８ｈ，ｋ为０．１６８ｈ－１，ＡＵＣ是１．７８ｍｇ·ｈ－１·ｍＬ－１；经配对ｔ检验这三对参数间有显著性差异，Ｐ值分别小于０．０１，０．００１和０．００５．因此两对映体在人体内呈现立体选择性处置     

荧光定量聚合酶链反应检测乙肝病毒及其临床意义

OBJECTIVE: To study the relationship between the serum contents of HBV DNA copies and the HBV serum index of immunology and the degree of hepatocyte injury in patients with HBV hepatitis. METHODS: The contents of HBV DNA copies were detected by fluorescence quantitative PCR (FQ-PCR), and the HBV serum index of immunology by ELISA. RESULTS: The contents of HBV DNA copies had a significant difference between HBeAg (+)/anti-HBe (-) group (42 patients) and HBeAg (-)/anti-HBe (+) group (57 patients) or HBeAg (-)/anti-HBe (-) group(11 patients) (P < 0.05), while there was no significant difference between HBeAg (-)/anti-HBe (+) group and HBeAg (-)/anti-HBe (-) group(P > 0.05). The contents of HBV DNA copies had no correlation with the severe degree of hepatocyte injury(P > 0.05). CONCLUSION: Anti-HBe is not the terminal sign of HBV replication. The severe degree of hepatocyte injury has not a direct correlation with the contents of HBV DNA copies.     

经阴道超声诊断子宫内膜癌

目的 探讨应用经阴道超声（TVS）诊断绝经前后出血妇女子宫内膜癌的价值。方法 采用彩色多普勒超声诊断仪检测74例阴道异常出血的妇女，其中绝经前28例，绝经后46例，所有患者均取子宫内膜组织行病理对照。结果 TVS检测子宫内膜癌的敏感性、特异性、假阳性率、假阴性率、阳性预测值和阴性预测值，绝经前妇女依次为61．5％，50．0％，14．3％，23．8％，94．1％和54．5％，绝经后妇女依次为97．3％，55．6％，44．4％，2．7％，90．0％和83．0％。结论 TVS检测可作为子宫内膜癌首选的筛查方法，尤其对于绝经后妇女价值更大。     

枢椎齿突骨折的治疗进展

枢椎齿突骨折是一种累及寰枢椎区稳定性的严重损伤 ,人们对它的认识是不断变化和深入的。近年来 ,出现了很多新的治疗观念和方法 ,作者对此作一综述     

婴儿脑损伤早期诊断和早期医学干预探讨

目的探讨婴儿脑损伤筛查专科门诊在早期发现婴儿脑损伤的作用以及神经发育疗法治疗脑损伤的效果。方法采用专科门诊筛查，早期发现脑损伤忠儿。对婴儿脑损伤进行早期诊断和早期综合康复治疗，以临床疗效评估。结果专科门诊对早期发现婴儿脑损伤有意义，88．1％的患儿由门诊筛查发现而被诊断，筛查中应着重注意小婴儿肌张力改变（48％）和运动发育落后（35％），脑损伤中不明原因占18％，1岁以内脑损伤诊断以中枢性发育障碍（89％）、运动落后（11％）为主，治疗以神经发育疗法为主的综合方法，20d一疗程，108例1岁以下脑损伤忠儿治疗效果：显效46．2％，好转47．2％，无效6．6％，总有效率为93.4％，6mo以下疗效显著高于6mo以上脑损伤忠儿。结论婴儿脑损伤专科门诊定期筛查能够早期发现患儿，CDD和MD作为婴儿脑损伤早期诊断的名称是可取的，治疗以神经发育疗法为主，治疗愈早，效果愈好，婴儿脑损伤早期诊断和早期医学干预方法可以在医疗保健机构推广和应用。     

复方广金钱草冲剂检验方法研究

应用薄层层析法，对制剂中广金钱草、黄芩、陈皮所含黄酮类成分，在同一色谱中得到的分离与鉴定，并以薄层一分光光度法对制剂中大黄所含成分大黄素进行了含量测定，方法重现性好，回收率为１００．１％，ＲＳＤ为１．０９％。     

尿羟脯氨酸测定及临床意义

本文测定100名健康人尿羟脯氨酸参考值范围、其中藏族12名,经统计学处理男女性别之间、民族之间无显著性差异。测定15名甲状腺机能亢进、6例甲状腺机能减退、50例糖尿病患者尿羟脯氨酸值。结果甲亢在这四组(正常成人甲减、糖尿病)中含量最高,与其它三组比较有显著性差异(P<0.01)。甲减最低与其它三组比较有显著性差异(P<0.02)。糖尿病人略高于正常人。与文献报导基本相符。     

Studies on monoclonal anti-isotypic and anti-idiotypic antibodies against leukemia and myeloma: IV modulation of membrane fluidity of leukemic cell lines and tonsillar cell stimulated with McAbs

Summary In this study the technique of labelling the cell membrane with DPH fluorescence polarization was used to observe the membrane fluidity of B lymphocytic cell lines and tonsillar cells from healthy persons; the modulation effect on membrane-fluidity induced by McAbs against isotypic and idiotypic determinants of IgM from patients with leukemia was studied as well. The expression of the corresponding isotypic and idiotypic determinants of IgM on the cell membrane was determined. The results show that the membrane fluidity of leukemic cell lines is remarkably higher than that of tonsillar cells from healthy persons, and McAbs against isotypic determinants of leukemic IgM can enhance the membrane fluidity of all kinds of cells mentioned above. However, the anti-idiotypic monoclonal antibody increased only the membrane fluidity of leukemic cell lines. These results indicated that there was a close relationship between the effect of McAbs on cell membrane fluidity and the expression of corresponding isotypic and idiotypic determinants of IgM on the cell membrane.     

参芪胶囊的鉴别与含量测定方法研究

对参区胶囊中黄芪、人参、当归、知母、黄连等味药进行了薄层鉴别。并对黄连中小檗碱进行了薄层光密度法测定，方法灵敏，重现性好，回收率１００％，相对标准偏差ＲＳＤ％＝２．０（ｎ＝６）。