m-Dinitrobenzene intoxication due to skin absorption

Summary A case of m-dinitrobenzene intoxication is described. Clinical picture of the patient who was exposed to an industrial material containing m-dinitrobenzene, methaemoglobinemia and excretion of urinary metabolites observed in a volunteer who experimentally worked with the same material, absence of m-dinitrobenzene in the ambient air during the exposure, and penetration of m-dinitrobenzene through the protective gloves which were used by the patient indicate that m-dinitrobenzene was the toxic agent and that the main route of the invasion was skin absorption.     

孟鲁司特钠对大鼠异丙肾上腺素心肌坏死的保护作用

 目的观察白三烯受体拮抗剂孟鲁司特钠对大鼠心肌坏死的保护作用。方法大鼠皮下注射异丙肾上腺素(2 mg·kg^-1)造成心肌坏死模型，ig给予孟鲁司特钠，测定血清AST，LDH，CK，MDA含量，心肌NO含量和坏死心肌面积。结果大鼠预先给予孟鲁司特钠10.0，30.0 mg·kg^-1，可以降低血清LDH，CK，MDA含量，减少心肌坏死面积。孟鲁司特钠30.0 mg·kg^-1还能促进心肌NO释放。结论孟鲁司特钠对大鼠异丙肾上腺素心肌坏死具有保护作用，有进一步研制成心肌缺血治疗药物的可能。     

大黄与芒硝对高腹内压危重患者脏器功能的保护作用

目的　观察大黄、芒硝对高腹内压危重患者脏器功能的保护作用。方法　将 6 2例高腹内压危重患者分为治疗组 (30例 )和对照组 (32例 ) ,在综合治疗的基础上 ,治疗组予鼻饲大黄、芒硝或大黄灌肠复加芒硝腹部热敷 ,每日 2次 ;对照组予吗丁啉鼻饲 ,72h后观察相关指标。结果　治疗组患者肛门排气、排便明显提前 ,血pH ,HCO3 -增高 (P <0 .0 1) ,尿量增加 ,膀胱内压下降 ,血 p(CO2 )下降、p(O2 ) /Fi(O2 )增高 (P <0 .0 5 ) ,能较早改善胃、肠、肾、肺功能。结论　及时合理应用大黄、芒硝能减低腹腔内压 ,改善脏器灌注及心、肺、肾功能 ,减少多器官功能不全的发生     

A Competency-based Model of Child Depression: A Longitudinal Study of Peer, Parent, Teacher, and Self-evaluations

In a two-wave longitudinal study of third and sixth graders ( N = 617), we obtained self-reports of depression and peer, teacher, parent, and self-reports of competence in five domains: academic, social, attractiveness, conduct, and athletic. Competency evaluations by others predicted change in self-perceived competence over time for girls, but not for boys. Depression predicted change in self-perceived competence over time for boys but not for girls. Among girls, the relative importance of parent, teacher, and peer appraisals shifted from third to sixth grade. For both boys and girls, self-perceptions of competence predicted change in depression scores over time. Furthermore, self-perceived competencies mediated the relation between competency appraisals by others and children's self-reported depression. Results are interpreted in light of a competency-based model of child depression.     

Effects of Pediatric Chronic Physical Disorders on Child and Family Adjustment

Research conducted primarily over the past 5–8 years on the psychosocial effects of pediatric chronic physical disorders on children and their families is reviewed. A large body of studies show that both children and their mothers, as groups, are at increased risk for psychosocial adjustment problems compared to peers, but that there is considerable individual variation in outcome. Since the last review on this topic (Eiser, 1990a), many studies have been conducted to identify risk and resistance factors associated with differences in adjustment among these children and their mothers. Improvements are noted in the theoretical basis for this work, programmatic nature of some of the research, and efforts at producing clinically relevant information. Evaluations of interventions, however, are lagging. Critical issues and future directions regarding developmental approaches, theory, method, measurement and intervention are discussed.     

表没食子儿茶素没食子酸酯对大鼠心肌缺血再灌注损伤的保护作用

目的观察表没食子儿茶素没食子酸酯(EGCG)对大鼠心肌缺血再灌注损伤的保护作用。方法结扎左冠状动脉前降支30mm再灌注60m in复制大鼠心肌缺血再灌注模型,实验分假手术组、缺血再灌注组(IR)、EGCG1(10mg.kg-1)、EGCG2(20mg.kg-1)和丹参(SM,1.0g.kg-1)治疗组。用心功能分析系统测定左室心功能,按试剂盒说明测定血浆SOD,MDA,LDH和CK水平,用TUNEL法检测凋亡细胞,SABC免疫组化法检测凋亡相关基因bc l-2与bax的蛋白表达。结果①缺血再灌注期间,IR组大鼠左室LVSP,±dp/dtm ax呈进行性下降,LVEDP则进行性升高(与假手术组比,P<0.01),EGCG组虽有相似的变化趋势,但明显较缓(与IR组比,P<0.01)。②IR组大鼠血浆SOD水平显著降低;MDA,LDH与CK水平显著升高。EGCG组SOD水平则明显升高;MDA,LDH与CK水平明显降低(P<0.01)。③IR组心肌凋亡细胞明显,bc l-2与bax蛋白表达增多,bc l-2/bax值下降;EGCG组凋亡细胞减少,bc l-2蛋白表达显著增多,bax则明显减少,bc l-2/bax值升高(P<0.01)。结论EGCG通过提高机体清除自由基能力减轻心肌细胞损伤和抑制心肌细胞凋亡而改善心功能,对大鼠心肌缺血再灌注损伤具有保护作用。     

破伤风抗毒素与氧氟沙星等联合保护在小鼠创伤弧菌实验性攻击中的应用

目的旨在进一步探讨创伤弧菌(Vibriovulnificus,Vv)致病机制以及破伤风抗毒素与氧氟沙星等药物(强的松龙、异丙嗪)联合对创伤弧菌(Vibriovulnificus,Vv)致死性感染小鼠的保护效果,为高危人群Vv感染预防和临床治疗提供实验依据。方法160只清洁级小鼠,随机分1LD50和10LD50Vv攻击组,各攻击组又分盐水(NS)保护对照,破伤风抗毒素预注射与氧氟沙星等药物联合保护组、氧氟沙星等药物保护和破伤风抗毒素单独保护等4组(每小组n=20)。并观察各组12h和24h存活数,比较各组间存活率差异。结果无论是1LD50或10LD50Vv攻击下,破伤风抗毒素和与氧氟沙星等药物联合保护组保护效果显著优于破伤风抗毒素或氧氟沙星等药物单独保护组(P<0.05,P<0.01)。结论破伤风抗毒素预注射与氧氟沙星等药物的联合应用保护效果明显优于氧氟沙星等药物保护组或破伤风抗毒素单独保护组,对预防Vv感染和感染后病人抢救有指导意义。     

梗死前心绞痛诱发的免疫炎症反应对心肌保护作用的临床研究

目的通过对有无梗死前心绞痛的急性心肌梗死患者免疫标志物的测定,研究梗死前心绞痛诱发的免疫炎症反应对心肌的保护作用。方法观察梗死前心绞痛组(48例)和无梗死前心绞痛组(40例)在住院期间严重心律失常、心功能不全、心源性休克的发生情况及住院期间的病死率;比较两组心肌梗死面积、心室功能、冠状动脉造影结果;测定两组免疫炎症反应标志物水平。结果梗死前心绞痛组严重心律失常发生率、心功能不全发生率、住院期间病死率明显低于无梗死前心绞痛组;梗死前心绞痛组肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)、左室收缩末容量(LVESV)、左室舒张末容量(LVEDV)明显低于无梗死前心绞痛组,左室射血分数(LVEF)高于无梗死前心绞痛组;冠状动脉造影显示梗死前心绞痛组冠状动脉多支病变多,梗死区周围侧支循环丰富;梗死前心绞痛组白细胞计数、C-反应蛋白明显低于无梗死前心绞痛组,IgE明显高于无梗死前心绞痛组。结论梗死前心绞痛诱发的免疫炎症反应对心肌有保护作用。     

婴幼儿哮喘的危险因素

目的寻找婴幼儿喘息、儿童哮喘的危险及保护因素。方法1个月~3岁肺炎患儿82例、毛细支气管炎65例、婴幼儿哮喘76例,107例正常儿童作为对照。采用向家长书面问卷调查方法询问各组婴儿既往病史、家族及个人过敏史、怀孕出生及婴幼儿喂养情况、生活条件等。结果父母任何一方有喘息史、父母任何一方有其他过敏史、父母任何一方吸烟、湿疹等个人过敏史任何一种、父(母)亲有哮喘史及过敏史、兄弟姐妹有哮喘史及过敏史、个人有过敏性鼻炎、个人有药物过敏、母妊娠期间早孕反应重、母亲是素食者、母亲文化程度低是婴幼儿哮喘的危险因素;而自然分娩、婴幼儿期补充VitD和钙剂、生后冬季户外活动时间长、每天平均睡眠时间长、住所有上下水设备是婴幼儿哮喘的保护因素。结论个人过敏史和家族过敏史为婴幼儿哮喘的主要危险因素。     

肺保护性通气策略在儿童急性呼吸窘迫综合征中的应用价值

Objective To assess the effect of lung protective ventilation on outcome of children with acute respiratory distress syndrome(ARDS).Methods Between January 1999 and December 2007,43 children with ARDS were enrolled from PICU of Shanghai Children's Medical Center and assigned to the protective-ventilation group(group A) or the conventional-ventilation group(group B).The patients in group A (from January 2004 to December 2007)received lower tidal volume(6～7 ml/kg) and high levels of positive end-expiratory pressure(PEEP),and optimal oxygenation was achieved by adjusting FiO2 and PEEP.The patients in group B(from January 1999 to December 2003) received relatively higher tidal volume(8～12 mL/kg) with lower PEEP(2～6 cm H2O),and optimal oxygenation was achieved by adjusting FiO2.Tidal volume,PEEP,arterial blood gas,mortality and the number of ventilator-free days were compared between the two groups.Results Since protective ventilation was adopted after 2004,tidal volume was significantly lower in group A[(7.09±1.66)ml/kg]as compared with that in group B[(9.82±2.31) ml/kg](P=0.001).PEEP was significantly higher in group A[(7.15±2.08) cm H2O]as compared with that of group B[(5.40 + 1.84) cm H2O](P=0.021).The mortality was 30.3% in group A and 60.0% in group B.The number of ventilator-free days were(10.88±8.84) d in group A and(8.40±10.86) d in group B.Although mortality was lower and number of ventilator-free days was greater in group A,no significant differences were found between the two groups(P＞0.05).Conclusion Lung protective ventilation may improve the outcome for pediatric patients with ARDS,however,larger trials are required before a definite conclusion can be reached.