CONGENITAL ROSAI-DORFMAN DISEASE WITHOUT LYMPHADENOPATHY

Rosai-Dorfman disease (RDD) is a rare histiocytic proliferative disorder with massive lymphadenopathy. We here describe RDD of a neonate who presented with paleness and hepatosplenomegaly but not lymph-node swelling. Routine laboratory studies showed anemia, thrombocytopenia, and an elevated value of γ-glutamyl transpeptidase. Histological examination of the liver revealed a proliferation of histiocytes with abundant eosinophilic cytoplasm, which were positive for S-100 protein and CD68 but not CD1a and did not reveal Birbeck granules. Radiological studies showed hepatosplenomegaly and a narrowing of the hepatic vein, which might have contributed to hypersplenism resulting in anemia and thrombocytopenia. This case is thought to be congenital RDD without lymphadenopathy.     

广州市新生儿卡介苗接种质量监测

目的　了解 2 0 0 1～ 2 0 0 3年广州市新生儿卡介苗接种质量。方法　对 2 0 0 1～ 2 0 0 3年广州市越秀、荔湾、东山、海珠区 2 4个接种单位的新生儿卡介苗接种报表和质量监测结果进行分析。结果　新生儿卡介苗接种率、接种后1 2周结核菌素纯蛋白衍化物 (TB -PPD)阳转率、PPD反应平均直径、卡痕率、卡痕平均直径等指标均较稳定。结论　广州市新生儿卡介苗接种工作质量较高并保持稳定。     

Immunohistochemical examination of the INK4 and Cip inhibitors in the rat neonatal cerebellum: cellular localization and the impact of protein calorie malnutrition

Expression of the cyclin-dependent kinase inhibitors (CKIs) has been linked to the inhibition of cellular proliferation and the induction of differentiation. Based on structure function analysis, two distinct families of CDKIs, the INK4 and the Cip/Kip family have been identified. The INK4 family member p16(Ink4), and the Cip/Kip protein p27(Kip1) have been implicated in normal development of the CNS and cerebellum. Recent studies have suggested a functional inter-dependence between the CKI and the abundance of cyclin D1 in orchestrating growth factor-induced cellular proliferation. The neonatal rat cerebellum undergoes proliferative growth and differentiation, localized to distinct topographical regions and cell types. The cell type and the temporal profile of CKI expression during postnatal cerebellar development had not been described. The current studies determined the specific cerebellar cell types in which the CKIs were expressed during post natal development by co-staining for cell-type specific markers. p16(Ink4a) and p27(Kip1) immunostaining was identified in both neurons and glial cells, increasing progressively between postnatal days 6 to 13 into adulthood. By contrast, neuronal and glial cell p21(Cip1) staining was prominent at days 6-11 and decreased thereafter. Cyclin D1 was expressed in the proliferating external granular cells, with occassional staining in the molecular, and internal granular layers. Dual immunostaining demonstrated cyclin D1 within cells expressing CKI (p16(Ink4a), p21(Cip1),p27(Kip1)). Cerebellar cellular growth arrest, induced by protein-calorie malnutrition, inhibited cyclin D1 protein levels without affecting CKI immunostaining suggesting CKI do not mediate the developmental arrest. These results demonstrate that the CKIs are induced by differentiation cues in specific cell types with distinct kinetics in the developing cerebellum in vivo.     

新生儿脐血铅含量与神经行为发育的关系

目的 :探讨孕期低水平铅暴露下 ,脐血血铅含量对新生儿神经行为发育的影响。方法 :随机选择 2 0 0 3年 1～4月出生足月新生儿 135例。以脐血铅作为孕期铅暴露的指标 ,新生儿神经行为发育 (NBNA)评分作为效应指标 ,采用描述性分析方法评价二者之间的相关性。结果 :高暴露组和低暴露组在新生儿主动肌张力、神经行为发育总评分上差异有显著性 (P<0 .0 5 ) ,原始反射评分差异有非常显著性 (P<0 .10 ) ,在新生儿行为能力、被动肌张力、一般估价上差异无显著性。结论 :孕期低水平铅暴露对新生儿神经行为发育影响明显。     

新生儿筛查健康教育适宜方式探讨

目的 :探讨广州地区 13个区县新生儿健康教育适宜方式的需求状况 ,根据需求 ,提供最适宜的健康教育方式。方法 :以定性问卷方式调查 13个区县新生儿健康教育适宜方式的需求状况并统计分析。结果 :各区县对健康教育的总需求为 10 0 % ,但需求的各种健康教育方式有显著性差异。结论 :根据不同的需求 ,提供最适宜的健康教育方式 (各种教材及各种教学方式 ) ,使达到“知、信、行”的 〔1〕目的 ,对促进新生儿筛查工作的开展 ,提高出生人口素质有着积极的作用     

现代复苏技术在危重新生儿转运中的应用体会

目的：探讨现代复苏技术在危重新生儿转运中的应用及其临床价值。方法:对我院2000年3月-2004年2月危重新生儿转运中接受心肺脑复苏(CPCR)的26例息儿进行回顾性分析，总结出危重新生儿转运中CPCR程序及其要点。结果：在26例息儿中，转运前给予CPCR 18例，占69.2％；转运途中给予CPCR 8例，占30.8％；除2例息儿复苏失败于转运途中死亡外，其余24例均复苏成功，成功率为92.3％。结论：危重新生儿转运中的CPCR程序具有临床实用价值。     

MR imaging of the neonatal brain at 3 Tesla

3 Telsa MR scanners are now becoming more widely available and 3 Telsa is likely to become the filed strength of choice for clinical imaging of the brain. The neonatal brain can be safely and successfully imaged at 3 Telsa. The improved signal to noise afforded by a higher field strength may be used to improve image quality or shorten acquisition times. This may be exploited for conventional T1 and T2 weighted imaging and also for advanced techniques such as diffusion tensor imaging, angiography and functional magnetic resonance studies.     

无菌性发热新生儿单个核细胞肠道病毒基因表达的研究

目的　探讨无菌性发热新生儿外周血单个核细胞 (PBMC)中肠道病毒 (EV)基因表达情况和临床表现特点。方法　采用逆转录聚合酶链反应 (RT PCR)、原位杂交和病毒分离技术检测了 2 9例发热待查组和 18例中枢感染组新生儿PBMC、脑脊液及血清中EVRNA ,并对其临床特点进行总结分析。结果　发热待查组EV感染 14例 (48 3% ) ,9例PBMC中EVRNA阳性者 ,血清中全部阳性 ,其中 4例脑脊液中同时阳性 ;中枢感染组EV感染 11例 (6 1 1% ) ,5例外周血PBMC中EVRNA阳性者 ,血清和脑脊液中也全部阳性。两组比较 ,只有RT PCR法检测中枢感染组脑脊液中EVRNA阳性数高于发热组 ,而不同方法检测PBMC和血清中EVRNA两组间差异均无显著性。EV感染的主要症状有喂养困难 (71% )、易激惹 (6 4 % )、腹泻 (6 1% )、嗜睡 (5 4 % )、肝脏肿大 (46 % )及皮疹(36 % )等。结论　EV可感染新生儿的PBMC ;新生儿感染后EV易在全身播散 ;临床表现不典型 ,早期、快速病原诊断可缩短住院天数和减少抗生素的应用 ,有较高的社会和经济效益。     

剖宫产术后自控镇痛对母婴的影响

目的　观察剖宫产术后产妇自控镇痛对母婴的影响。方法　 2 0 0 2年 1月至 2 0 0 3年 1月首都医科大学附属复兴医院将剖宫产产妇 2 16例分为观察组和对照组 ,两组均为连续硬膜外麻醉 ,手术结束时 ,观察组将自控镇痛泵接在硬膜外管上。术后分别取产妇肘静脉血、初乳、尿及新生儿尿 ,测定吗啡含量 ;观察镇痛效果及副反应。结果　与对照组比较观察组镇痛效果明显 (P <0 0 5 )。观察组血吗啡质量浓度 5 0～ 12 6 0 μg/L ,初乳吗啡质量浓度 5 0～ 33 6 μg/L ,91 8%的产妇尿吗啡呈阳性 ,12 7%的新生儿尿吗啡呈阳性。随访 1年两组婴儿的体格及发育商比较 ,P >0 0 5。结论　剖宫产术后硬膜外腔应用吗啡镇痛 ,对产妇及新生儿是安全可行的     

新生儿用吲哚美辛栓剂的制备与含量测定

目的：探索新生儿用吲哚美辛栓剂的制备工艺及质量控制方法。方法：混合脂肪酸甘油酯42 g，卡波姆0.2 g，吲哚美辛0.1 g，超声波混合后，采用新工艺生产新生儿用吲哚美辛栓剂，用反相高效液相色谱法测定吲哚美辛含量。结果：吲哚美辛在1～20 mg·L 1的浓度范围内线性关系良好(r＝0.999 9)，日内、日间RSD 0.15%～1.56%，高、中、低浓度回收率98.6%～99.7%。结论：新生儿用吲哚美辛栓剂制法简单，所建方法可用于新生儿用吲哚美辛栓剂的质量控制。