Acute severe combined demyelination

We present a second case in which Guillain-Barré syndrome (GBS) and acute disseminated encephalomyelitis (ADEM) appeared simultaneously, both in acute and fulminant form. The patient, a 10-year-old girl, presented with acute onset of coma and flaccid, areflexic quadriparesis. The elevated CSF protein levels and delayed F waves fulfilled the criteria of GBS and an MRI study revealed extensive multifocal demyelination compatible with a diagnosis of ADEM. Prompt clinical response followed by complete recovery was achieved by treatment with corticosteroids. It is suggested that acute severe combined demyelination might constitute a separate entity in which the demyelinating process, involving simultaneously the central and the peripheral nervous systems, indicates immune response against a component of the myelin of one system carrying cross-antigenicity with the other.     

Local fibrinolysis for superior mesenteric artery thromboembolism

A 66-year-old man with atrial fibrillation was referred soon after developing left lower limb and abdominal pain with rectal bleeding. An immediate flush aortogram showed embolic occlusion of the left distal superficial femoral artery and superior mesenteric artery (SMA), 3 cm from its ostium. Recombinant tissue plasminogen activitor (rtPA) 40 mg was selectively in stilled in the SMA in two boluses. Abdominal symptoms resolved within 48 h, and complete recanalization of the SMA was shown on angiography. Exploratory laparotomy after 72 h showed a normal small bowel and right colon, and was completed by femoropopliteal embolectomy. Six months later, the patient remained asymptomatic.     

Gadolinium ring enhancement and mass effect in acute disseminated encephalomyelitis

A 9-year-old boy presented with a subacute history of optic neuritis followed by brainstem involvement, with fever and a lymphocytic pleocytosis in the cerebrospinal fluid. Gadolinium-enhancing ring lesions were demonstrate in the white matter of the cerebrum, brainstem and cerebellum on day 17 of the illness, all appearing simultaneously as part of a monophasic illness. A parietal lesion exerted mass effect. Needling and biopsy yielded no evidence of a pyogenic lesion, tumour or tuberculosis and showed vasculitis. There was insufficient material for myelin staining. Dexamethasone therapy lead to rapid improvement of the radiological lesions: MRI and CT on day 34 of the illness showed complete clearing of the lesions except for residual abnormality at the biopsy site.     

654─2在小儿急性脑水肿及中枢性呼吸衰竭中的应用探讨

感染性脑水肿病儿在感染得到有效控制，应用654—2（山莨菪碱）后未再用脱水剂，笔者认为．654—2具有解除脑血管痉挛及微循环障碍的作用。急性脑水肿在脱水剂应用后，用654—2有利于脑水肿液的吸收和回流。目前，治疗小儿捂热综合征（IMS）之细胞内水肿仍没有有效的方法，研究结果表明654—2能改善脑细胞供氧．其还能通过解除呼吸中枢血管痉挛而治疗中枢性呼吸衰竭。     

急性胰腺炎与内皮素、一氧化氮和氧自由基关系研究

目的　研究急性胰腺炎 (AP)与内皮素 (ET)、一氧化氮 (NO)和氧自由基关系。方法　急性胰腺炎 71例 ,应用放射免疫分析法测定血浆ET、NO和超氧化物歧化酶 (SOD) ,并与健康体检者 15例作对照。结果　急性胰腺炎血浆ET、NO明显升高 ,而SOD明显降低 ,与健康对照组比较差异显著 (P <0 0 1) ;且重症胰腺炎的ET和NO增高、SOD降低尤为明显 ,与轻症胰腺炎相比较有统计学意义 (P <0 0 1)。结论　血浆的ET、NO和SOD异常消长在急性胰腺炎发生、发展过程中具有重要作用。     

儿童急性荨麻疹的心电图观察

目的 了解儿童急性荨麻疹对心脏的影响。方法 对急性荨麻疹患儿593例行常规心电图检查。结果 33例(5．6％)患儿出现心电图异常改变，主要表现为I度房室传导阻滞、室性早搏、T波低平。皮损消失后心电图亦恢复正常。结论 急性荨麻疹患儿可伴有心脏的损害，临床上应予以重视。     

急性阑尾炎术中外用过氧化氢液冲洗疗效观察─—附50例报告

本文报导采用过氧化氢液在急性阑尾炎术对局部腹腔及切口进行冲洗的方法。并用５０个病例进行了对比分析。认为此法简单、可靠。对腹腔脓肿，预防切口感染有一定效果。可适用于一般基层医院。     

老年急性心肌梗塞37例临床分析

对３７例老年急性心肌梗塞与５０例老年前期急性心肌梗塞病人进行临床对比分析．结果显示：部分老年急性心肌梗塞病人发病不典型，并发症多，死亡率高，这可能与并发室颤、房室或束支传导阻滞、心衰等有关．     

内皮素与P-选择素在冠心病中的意义

目的：研究内皮素（ET－1）、P－选择素、肌钙蛋白I（CTn1)在急性心肌梗死（AMI）和不稳定性心绞痛（UA）中的意义，方法：用放射免疫法测ET－1，流式细胞术测定P－选择素，Access化学发光测CTn1，共检测23例AMI患、21例UA患及28例健康对照。结果：AMI组的ET－1、P－选择素、CTn1值均显高于对照组（P＜0．05－0．005）；UA组的ET－1、P－选择素显高于对照组（P＜0．05）；UA组的CTn1与对照组差异无显性（P＞0．05）；UA组的P－选择素、CTn1显低于AMI组（P＜0．05）。多元回归分析发现P－选择与CTn1相关，相关系数r=0.404，P＜0．01。结论：ET－1、P－选择素是检测血栓前状态的敏感指标。     

六草二苓汤治疗急性黄疸型病毒性肝炎的临床研究

目的 对六草二苓汤治疗急性黄疸型病毒性肝炎的疗效进行对比临床研究,并探讨其作用机制。方法采用六草二苓汤的治疗组治疗急性黄疸型病毒性肝炎72例,并与使用肝泰乐、益肝灵、甘草甜素片的67例对照组作对比研究。结果 治疗组总有效率为93.1％,对照组总有效率为76.1％。在治疗后显效率、显效者复发率二方面,治疗组明显优于对照组(P<0.01)。在治疗前后主要症状体征变化、治疗前后肝功能变化、治疗后肝功能复常天数三方面,治疗组优于对照组(P<0.05)。结论 六草二苓汤治疗急性黄疸型病毒性肝炎,在较快地消除主要症状体征、消退黄疸、恢复肝功能、减少复发率方面有较好的疗效。