Hypoxic-hemodynamic pathogenesis of brain lesions in the newborn

For more than a century two opposing views on the pathogenetic mechanisms and the timing of the origin of cerebral palsy (CP) have prevailed: the idea first formulated by Little attributing CP to “difficult deliveries” has been opposed by the view by Freud recognizing fetal influences, and the issue seems to be unsettled. The present review seeks to bridge the gap by recognizing that late prenatal or perinatal hypoxic-hemodynamic insult is a dominating final common path in the pathogenesis of static encephalopathies during development, in particular in premature infants. In turn, however, such lesions are determined by early genetic and environmental influences. The pathogenesis of static encephalopathy should therefore be seen as a chain of events, with its origin before gestation.     

多索茶碱在大鼠体内的药代动力学

为全面了解多索茶碱在大鼠体内代谢情况,用高效薄层色谱法和光密度扫描法,给大鼠ig多索茶碱后,测定在不同时间各组织和体液中多索茶碱的含量。结果表明,多索茶碱在大鼠体内药代动力学为一室模型并能在体内迅速转化为其它代谢产物。T_1/2(Ke)为1.17～3.75h,达峰时间T(peak)为0.72～1.46h,Cmax,AUC及CL/F呈剂量依赖关系。给药1h,以胃壁浓度最高,8h除胃肠组织浓度降低较慢外,其它组织中药物浓度明显降低。尿、粪及胆汁中原形药总排出量占给药量的5.2%。血浆蛋白结合率约25%。提示多索茶碱在体内可能转化为其它代谢产物。     

鼻内镜鼻窦术致眶炎性假瘤的防治探讨

目的探讨鼻内镜鼻窦手术纸样板损伤后致眶炎性假瘤的防治。方法对1805例鼻内镜鼻窦手术的临床资料进行回顾性分析。按纸样板损伤出现眼睑瘀斑后处理方式的不同分为对照组和观察组。对照组653例按常规于术后48小时抽出鼻腔内填塞物,而观察组1152例在出现瘀斑后则立即抽出。在出现瘀斑后,两组均添加大剂量糖皮质激素。结果纸样板损伤术后出现眼睑瘀斑后是否及时抽出鼻腔内填塞物并发眶炎性假瘤的比率不同。对照组眼睑瘀斑32例,发生率4.90%,其中并发眶炎性假瘤11例,并发率34.38%;观察组眼睑瘀斑51例,发生率4.43%,其中并发眶炎性假瘤1例,并发率1.96%。发生眶炎性假瘤后,全身使用糖皮质激素和局部肿物切除可达到治愈。结论鼻内镜鼻窦术后发现眼睑瘀斑后立即抽出鼻腔内填塞物和应用大剂量糖皮质激素是预防眶炎性假瘤的重要手段。全身使用糖皮质激素和局部单纯肿物切除是治疗眶炎性假瘤的有效手段。     

Repeating cytological preparations on liquid‐based cytology samples: A methodological advantage?

This study investigates the rule that repeating cytological preparations on liquid-based cytology improves sample adequacy, diagnosis, microbiological, and hormonal evaluations. We reviewed 156 cases of pap-stained preparations of exfoliated cervical cells in two slides processed by DNA-Cytoliq System. After sample repeat/dilution, limiting factors affecting sample adequacy were removed in nine cases and three unsatisfactory cases were reclassified as satisfactory. Diagnosis was altered in 24 cases. Of these, the original diagnosis in 15 was atypical squamous cells of undetermined significance; after the second slide examination, diagnosis in 5 of the 15 cases changed to low-grade squamous intraepithelial lesion, 3 to high-grade squamous intraepithelial lesion, and 7 to absence of lesion. Microbiological evaluation was altered, with Candida sp. detected in two repeated slides. Repeat slide preparation or dilution of residual samples enhances cytological diagnosis and decreases effects of limiting factors in manually processed DIGENE DCS LBC.     

鼻血管瘤患者术后医院感染与炎症因子水平的相关性研究

目的探讨鼻血管瘤患者术后医院感染与炎症因子水平的相关性,为鼻血管瘤患者术后医院感染的防治提供参考。方法选取行鼻内镜下低温等离子手术治疗鼻血管瘤术后发生医院感染的30例为研究对象(感染组),以1∶2的比例随机选取同期行鼻内镜下低温等离子手术治疗鼻血管瘤术后未发生医院感染的60例为对照(无感染组),对感染患者用无菌棉试子采集感染部位分泌物进行病原菌分离、培养、菌株鉴定,检测两组患者血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、T淋巴细胞亚群(CD3、CD4、CD8、CD4/CD8)水平,观察结果。结果30例医院感染患者,其中呼吸道感染21例、泌尿道感染6例、皮肤黏膜感染3例,分别占70.00%、20.00%、10.00%,总检出病原菌21株,其中革兰阴性菌16例、革兰阳性菌5株,分别占76.29%、33.71%;血清IL-6、IL-8、TNF-α、CRP水平感染组分别为(29.12±5.54)ng/ml、(28.05±3.66)ng/ml、(8.63±3.32)ng/ml、(14.27±5.51)mg/l,高于无感染组(14.97±4.81)ng/ml、(15.21±4.02)ng/ml、(2.35±0.92)ng/ml、(6.25±2.35)mg/l,比较差异有统计学意义(P<0.05);血清CD3、CD4、CD4/CD8水平感染组分别为(48.45±1.38)%、(34.15±1.23)%、(1.11±0.13),低于无感染组(50.97±1.56)%、(35.91±1.39)%、(1.25±0.20),CD8水平感染组为(33.85±2.67)%,高于无感染组(28.42±2.87),比较差异有统计学意义(P<0.05)。结论鼻血管瘤患者术后容易发生呼吸道感染,感染病原菌主要为革兰阴性菌,术后发生医院感染的患者血清炎症因子明显增高,同时存在免疫功能的异常。     

Role of metabolic changes of mucosal layer in the intestinal barrier dysfunction following trauma/hemorrhagic shock

Background

The mucosal layer plays an important role in regulating the intestinal barrier function. However, the underlying mechanisms of intestinal barrier dysfunction caused by trauma-hemorrhagic shock (THS) are still unknown.

激光眼底扫描仪在开角型青光眼诊断中的应用

目的评价激光眼底扫描仪对原发性开角型青光眼 (POAG )的诊断价值。方法利用海德堡共焦激光眼底扫描仪(HRT Ⅱ )检测高度近视合并可疑青光眼者、POAG患者和正常人的盘沿面积、盘沿体积和神经纤维层 (RNFL)厚度 ,对比 3者之间的关系。结果POAG患者、高度近视并可疑青光眼和正常人各象限盘沿面积、盘沿体积和RNFL厚度存在显著差异 (P <0 0 5 )。结论激光眼底扫描仪 (HRT Ⅱ )可应用于原发性开角型青光眼的诊断。     

The role of TNF alpha polymorphism and expression in susceptibility to nasal polyposis

Objective: In this study, we first performed a meta-analysis to assess the role of single-nucleotide polymorphism (SNP) within tumor necrosis factor alpha (TNF alpha) gene and TNF alpha expression in the risk of nasal polyposis.

Methods: STATA 12.0 software was utilized to conduct the Mantel–Haenszel statistics, Cohen statistics, Begg’s test, Egger’s tests and sensitivity analysis.

Results: We systemically carried out the database retrieval and initially identified 486 articles. After screening, 15 articles were included in our meta-analysis. For TNF alpha rs1800629 G/A SNP, compared with control group, an increased risk of nasal polyposis of case group was observed in the models of A vs. G [p (P value of association) = 0.009, OR (odds ratio) = 1.35], GA vs. GG (p = 0.001, OR = 1.69), GA+AA vs. GG (p = 0.010, OR = 1.47). The similar results were observed in Caucasian subgroup (p < 0.05, OR > 1). For TNF alpha rs361525 G/A SNP, no significant difference between control and case group was detected (all p > 0.05). In addition, a significant difference exists between case and control groups in the meta-analyses of TNF alpha expression in nasal mucosal cells, secreted TNF alpha (p < 0.05, OR > 1), but not serum TNF alpha (p = 0.090).

Conclusion: The present meta-analysis revealed that TNF alpha rs1800629, increased TNF alpha expression and secretion of nasal mucosal cells were associated with an increased risk of nasal polyposis.     

血管内皮生长因子在阻塞性睡眠呼吸暂停低通气综合征中的意义探讨

目的探讨血管内皮生长因子(VEGF)在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)病理生理过程中的意义。方法①应用酶联免疫吸附法检测40例OSAHS患者(OSAHS合并心脑血管病26例,未合并心脑血管病的单纯OSAHS14例)和30例正常人的血浆VEGF浓度。②将26例OSAHS合并心脑血管病患者分为2组:15例经鼻持续正压通气(nCPAP)治疗(nCPAP治疗组);11例OSAHS合并心脑血管病患者不予任何针对OSAHS的治疗(对照组);比较2组治疗前后的血浆VEGF浓度。结果①OSAHS组血浆VEGF浓度高于正常对照组[(182.5±41.6)ng/L与(117.0±56.2)ng/L,P<0.01],并且与呼吸紊乱指数(r=0.919,P<0.01)、夜间缺氧时间(r=0.945、P<0.01)呈正相关。且OSAHS合并心脑血管病患者VEGF均高于单纯OSAHS患者[(248.4±105.9)ng/L与(161.7±43.2)ng/L,P<0.01]。②经nCPAP治疗半年后,OSAHS合并心脑血管病患者血浆VEGF浓度下降[(252.3±124.9)ng/L与(154.3±50.1)ng/L,P<0.01];对照组观察终点的血浆VEGF浓度较观察起点略有增加[(239.6±101.2)ng/L与(270.0±88.3)ng/L],但差异无显著性(P>0.05)。结论VEGF可能参与了OSAHS相关性心脑血管病的发生发展过程。     

鼻内窥镜下微波治疗鼻后部出血的护理

目的：总结鼻内窥镜下采用微波治疗鼻后部出血的护理经验。方法：经鼻内窥镜应用微波对50例鼻后部出血的患进行治疗。结果：50例患均一次治愈，随访3个月无复发。结论：在治疗中应针对患不同情况做好心理护理，掌握适应证及治疗方法，做好术前及术后护理是确保成功的关键。