儿童布氏杆菌病4例

布氏杆菌病是由布氏杆菌引起的重要的人畜共患病,儿童布氏杆菌病报道较少,由于儿童往往不能提供明确的流行病学史,无典型波浪热,常易误诊。本文将2004~2007年5月期间在北京儿童医院诊断的4例布氏杆菌病临床资料进行总结分析。1临床资料病例1,女,8岁7月,因“发热6d”入院,体温最     

护理干预对飞行人员高血压病的影响及效果评价（摘要）

目的通过健康教育干预飞行人员高血压患者,评价干预后飞行人员高血压控制效果。方法采用自身前后对照的方法,对39例飞行人员高血压患者进行高血压病相关知识宣教,并通过对患者合理的生活指导,改变他们的生活方式,增强患者的药物依从性,结果护理干预后飞行人员对高血压病基础知识掌握情况以及高血压并发症的严重后果的认识明显提高,干预后患者的各种生活行为方式也得到明显改善。     

小儿亚急性坏死性淋巴结炎的病因及特征

目的探讨亚急性坏死性淋巴结炎（SNL）的病因及临床特征,提高对儿童SNL的认识,减少误诊。方法回顾分析28例SNL病儿的临床资料。结果本组28例病儿经淋巴结活检确诊为SNL;其中85.7%病儿冬春及初夏季节发病,以学龄儿童为主,男女之比约为3∶1;临床表现均有发热、淋巴结大,可伴有肝大和（或）脾大（31.6%）、多形性皮疹（14.3%）;实验室检查多数病儿白细胞总数减少、红细胞沉降率增快、LDH升高;急性期多有病毒及支原体感染;病理特点为淋巴结广泛的凝固性坏死伴组织细胞反应性增生;其中1例发展为系统性红斑狼疮（SLE）,复发2例,其余病儿预后良好。结论对不明原因发热伴淋巴结大病儿,除行相关实验室检查外,应早期行淋巴结活检以明确诊断。SNL属自限性疾病,预后多良好,亦有复发,少数发展为SLE,应长期随访。     

PI3K/AKT/Bcl-2通路在吡格列酮保护缺血再灌注损伤心肌细胞中作用的研究

目的 研究吡格列酮对缺血再灌注损伤心肌细胞的保护作用机制中PI3K/AKT/Bcl-2信号通路的作用.方法 取Wistar大鼠乳鼠心室肌细胞进行体外培养,缺氧、复氧各3 h后建立缺血再灌注损伤细胞模型.采用免疫细胞化学染色法检测细胞内Bcl-2蛋白含量,采用Western-bloting检测细胞内Bcl-2蛋白表达水平.结果 免疫细胞化学染色法及Western-bloting结果均显示：与Ⅰ组比较,P组Bcl-2表达明显增加（P〈0.05）;与P组比较,P＋Ly组Bcl-2表达明显减少（P〈0.05）.结论 吡格列酮减轻心肌缺血再灌注损伤保护机制与其激活PI3K/AKT/ Bcl-2信号通路有关.     

Oral premedication with midazolam in paediatric anaesthesia. Effects on sedation and gastric contents

The aim of this study was to assess oral premedication with midazolam in paediatric anaesthesia. Sedation, quality of induction, recovery time, acceptance and effects on gastric contents were analysed. This prospective, double blind, at random and controlled study was performed in 107 children, aged between three and ten years. They were divided into: group 1 (control, n=29), group 2 (placebo) receiving 5 ml of water in the preoperative stage (n=40), and group 3 (midazolam) with 0.75 mg·kg^-1 midazolam by mouth (n=38). Two children refused to take medication. In children aged five years or more (n=48) of groups 2 and 3, acceptance of premedication was evaluated. The midazolam group showed a better level of sedation as compared with the placebo (P<0.05). The recovery time was similar for the two groups. There were no statistically significant differences in gastric pH or residual volume among the three groups. It is concluded that midazolam given by mouth is an efficient and safe drug for premedication in paediatric anaesthesia.     

Lack of in Vivo Mutagenicity and Testicular Toxicity of Triamterene in Mice

Lack of in Vivo Mutagenicity and Testicular Toxicity of Triamterenein Mice. MANSON, J.M., GUERRIERO, F.J., BROWN, T., AND SAN SEBASTIAN,J. (1986). Fundam. Appl. Toxicol. 7, 533-546. Triamterene (2,4,7-triamino-6-phenylpteridine),a widely used diuretic/antihyper-tensive agent with weak antifolateactivity, has been found to be positive in several in vitroassays for mutagenicity. The present studies were undertakento characterize the potential mutagenic and antifolate activityof triamterene in the bone marrow and testes of mice with invivo treatment. Triamterene had no clastogenic effects on thebone marrow at 6,16, or 24 hr after a single oral dose of 25,125, or 250 mg/kg. No alterations in hematopoietic cell maturationcharacteristic of antifolate action were observed in a dose-rangestudy in which triamterene was orally administered to mice at5-300 mg/kg/day for 5 days. Triamterene had no adverse effectson mating or fertility and did not induce dominant lethal mutationsin the germ cells of male mice when given for 5 days at 5-100mg/kg/day. Oral exposure to mice under identical conditionshad no effect on testicular weight, DNA content, or activityof the de novo pathway for thymidine synthesis from deoxy [6-3H]uridine.The present findings are consistent with an absence of mutageniceffect and antifolate action on the bone marrow and testes within vivo administration.     

AGGRESSIVE TRICHOEPITHELIOMA VERSUS KERATOTIC BASAL CELL CARCINOMA

A 43-year-old white man presented with an infiltrative le-sion on the left nasolabial fold, which had grown slowly over 15 years. There was a history of moderate sun expo-sure. Prior history was negative for cutaneous carcinomas. Family history was negative for trichoepithelioma. Physical examination revealed a patient with a fair complexion, blue eyes, light skin, and light brown hair. There was evidence of severe actinic damage manifested by marked solar elas-tosis of the face. A 1.5 × 1.3 cm infiltrative, depressed, skin-colored plaque, with elevated pearly borders was noted on the left nasolabial fold. There was nodule formation with superficial ulceration in the center of the lesion (Fig. 1). No other skin tumors were present.
A punch biopsy showed a deeply infiltrating tumor. Sub-sequently, the tumor was excised by Mohs micrographic surgery in six stages, revealing deep and wide clinically un-detected invasion into the orbicularis oris, zygomaticus minor, and the levator labii superioris muscles. The final size of the defect was 5.0 × 5.0 cm (Fig. 2). Reconstruction was later performed by otolaryngology with satisfactory results.
Pathological Study : The tumor was composed of multiple islands of basaloid cells embedded in a dense fibrotic stro-ma. Some islands showed peripheral palisading of their cells (Fig. 3). Other areas contain numerous horn cysts with abrupt and complete keratinization surrounded by basaloid cells (Fig. 4). Areas of calcification and foreign body reac-tion are present secondary to ruptured cysts. Stromal-stro-mal clefting characteristic of trichoepithelioma is seen adjacent to some tumor islands (Fig. 5). The tumor infil-trates into the underlying muscle (Fig. 6). Stromal muco-polysaccharide deposition and stromal-tumor separation as seen in basal cell carcinoma (BCC) were not present.     

To the editor

Letters to the Editor are wdcomed for publication (subject to editing). Letters must be signed by aU authors, typewrittes double spaced, and most not exceed two pages of text including references. Two copies of all letters should be submitted. Letters should not duplicate material snbmitted or published in other Journals. Prepublication proofs will not be provided.     

Immunogenicity of recombinant Plasmodium falciparum rhoptry associated proteins 1 and 2

Mice and rabbits immunized with recombinant forms of malaria vaccine candidate antigens rhoptry-associated proteins 1 and 2 (RAP-1, RAP-2 and rRAP-l, rRAP-2) produce antibodies at litres equivalent to monoclonal antibody ascites fluid raised against the native proteins. Sera from animals immunized with rRAP-l contain antibodies which recognize the native protein by indirect immunofluorescence and immunoblotting, partially inhibit erythrocyte invasion in vitro and are long lasting. Epitope mapping shows these antibodies predominantly recognize epitopes in the N-terminal third of rRAP-l, some of which coincide with the targets of inhibitory monoclonal antibodies. By contrast, sera from animals immunized with rRAP-2 contain antibodies which recognize the recombinant but not the native protein