手足口病患儿的护理

回顾性总结了435例手足口病患儿的护理管理。结果显示通过严格执行医院感染管理制度、密切观察病情、积极对症护理、做好健康教育和心理指导是有效防治手足口病患儿的重要措施,实现了患儿全部康复出院、零院内感染的目标。     

试析陆懋修从阳明论治温病之特色

陆懋修（1818-1886），又名免研，字九芝，号江左下工，又号林屋山人，江苏元和（今江苏吴县）人，为清代后期著名的医学家。陆氏出身于官宦之家，儒医兼通，陆氏秉承家学，对先人的医学成就颇为敬重。他曾三十余年坚持潜心研究《内经》、《伤寒》等医学经典著作，终于贯通医理而成为一代名医。陆氏一生博览群书之余，著述不断，     

Isoflurane Preconditioning Improves Long-term Neurologic Outcome after Hypoxic-Ischemic Brain Injury in Neonatal Rats

Background: Preconditioning the brain with relatively safe drugs seems to be a viable option to reduce ischemic brain injury. The authors and others have shown that the volatile anesthetic isoflurane can precondition the brain against ischemia. Here, the authors determine whether isoflurane preconditioning improves long-term neurologic outcome after brain ischemia.

Methods: Six-day-old rats were exposed to 1.5% isoflurane for 30 min at 24 h before the brain hypoxia-ischemia that was induced by left common carotid arterial ligation and then exposure to 8% oxygen for 2 h. The neuropathology, motor coordination, and learning and memory functions were assayed 1 month after the brain ischemia. Western analysis was performed to quantify the expression of the heat shock protein 70, Bcl-2, and survivin 24 h after isoflurane exposure.

Results: The mortality was 45% after brain hypoxia-ischemia. Isoflurane preconditioning did not affect this mortality. However, isoflurane preconditioning attenuated ischemia-induced loss of neurons and brain tissues, such as cerebral cortex and hippocampus in the survivors. Isoflurane also improved the motor coordination of rats at 1 month after ischemia. The learning and memory functions as measured by performance of Y-maze and social recognition tasks in the survivors were not affected by the brain hypoxia-ischemia or isoflurane preconditioning. The expression of Bcl-2, a well-known antiapoptotic protein, in the hippocampus is increased after isoflurane exposure. This increase was reduced by the inhibitors of inducible nitric oxide synthase. Inducible nitric oxide synthase inhibition also abolished isoflurane preconditioning-induced neuroprotection.     

Lethal effect of mononuclear cells derived from human umbilical cord blood differentiating into dendritic cells after in vitro induction of cytokines on neuroblastoma cells

BACKGROUND: Dendritic cell is the most major antigen presenting cell of organism. It is proved in recent studies that human umbilical cord blood mononuclear cells induced and cultured in vitro by recombinant human granulocyte-macrophage colony stimulating factor (rhG-MCSF) and recombinant human interleukin-4(rhIL-4) can generate a great many dendritic cells and promote the lethal effect of T cells on human neuroblastoma, but it is unclear that whether the lethal effect is associated with the most proper concentration of dendritic cells. OBJECTIVE: To investigate the lethal effect of human umbilical cord blood mononuclear cells induced in vitro by cytokines differentiating into dendritic cells on human neuroblastoma, and its best concentration range. DESIGN: Open experiment. SETTING: Department of Pediatrics, the Medical School Hospital of Qingdao University. MATERIALS: The study was carried out in the Shandong Provincial Key Laboratory (Laboratory for the Department of Pediatrics of the Medical School Hospital of Qingdao University) during September 2005 to May 2006. Human umbilical cord blood samples were taken from the healthy newborn infants of full-term normal delivery during October to November 2005 in the Medical School Hospital of Qingdao University, and were voluntarily donated by the puerperas. Main instruments: type 3111 CO2 incubator (Forma Scientific, USA), type 550 ELISA Reader (Bio-Rad, USA). Main reagents: neuroblastoma cell line SK-N-SH (Shanghai Institute of Life Science, Chinese Academy of Sciences), RPMI-1640 culture fluid and fetal bovine serum (Hyclone), rhIL-4 (Promega, USA), rhG-MCSF (Harbin Pharmaceutic Group Bioengineering Co.Ltd), rat anti-human CD1a monoclonal antibody and FITC-labeled rabbit anti-rat IgG (Xiehe Stem cell Gene Engineering Co.Ltd). METHODS: ① Human umbilical cord blood mononuclear cells obtained with attachment methods differentiated into human umbilical cord blood dendritic cells, presenting typical morphology of dendritic cells after in vitro induction by rhG-MCSF and rhIL-4. ② Different concentrations of dendritic cells[ dendritic cells: neuroblastoma cells=20∶1,50∶1,100∶1（2×108 L-1，5×108 L-1，1×109 L-1）], 1×109 L-1 T cells and 1×107 L-1 neuroblastoma cells were added in the experimental group. 1×109 L-1 T cells and 1×107 L-1 neuroblastoma cells were added in the control group. ③ Main surface marker CD1a molecules of dendritic cells were detected with indirect immunofluorescence, and the percent rate of dendritic cells was counted with ultraviolet light and expressed as the expression rate of CD1a+ cells. ④ Single effector cells and target cells were respectively set in the experimental group and control group to obtain the lethal effect. The lethal effect of dendritic cells on neuroblastoma cells was indirectly evaluated by detecting cellular survival with MTT assay. The lethal effect(%)=（1-A experimental well-A effector cell well/A target cell well）×100%.⑤The experimental data were presented as Mean ±SD, and paired t test was used. MAIN OUTCOME MEASURES: ① Morphological characters of dendritic cells in the process of induction and differentiation. ②CD1a+ cellular expression rate. ③Lethal effect of dendritic cells on neuroblastoma cells. RESULTS: ①Morphological characters of dendritic cells in the process of induction and differentiation: On the 15th day after human umbilical cord blood mononuclear cells were induced by rhG-MCSF and rhIL-4, typical morphology of dendritic cells could be seen under an inverted microscope. ②Expression rate of CD1a+ cells was （43.12±5.83）%. ③Lethal effect of dendritic cells on neuroblastoma cells: Lethal effect of dendritic cells stimulated T cells in each experimental group ( dendritic cells: neuroblastoma cells=100∶1,50∶1,20∶1 respectively) on neuroblastoma cells was significantly higher than that in control group[（31.00 ±4.41）%，（30.92±5.27）%，(33.57±5.35)%,(26.23±5.20)%, t=3.51，2.98，4.24, P < 0.01）; But the lethal effect of dendritic cells on neuroblastoma was significantly lower when their ratio was 100∶1 and 50∶1 in comparison with 20:1 （t=2.01，2.36, P < 0.05）, and no significant difference in lethal effect existed between the ratio at 100∶1 and 50∶1（t=0.06,P > 0.05）. CONCLUSION: Dendritic cells differentiated from human umbilical cord blood mononuclear cells after in vitro induction of cytokines can promote the lethal effect of T cells on neuroblastoma cells. The lethal effect is associated with the concentration of dendritic cells within some range.     

北京农村居民健康状况及卫生服务需求调查

目的了解北京农村居民健康状况及卫生服务需求特点。方法从昌平区、顺义区、大兴区、房山区随机抽取25～64岁农民1605人进行统一问卷调查。结果农民高血压自报患病率为22．4％，超重和肥胖率为56．1％；现在吸烟率为34．4％，缺乏运动率为41．6％；家庭主要经济支出为学生上学(35．3％)，建房(25．4％)和疾病(21．2％)；54．9％家庭医疗费用支出占总收入的10％以上；最关心的健康问题主要是慢性疾病防治(70．2％)；最希望获得的健康知识是慢性病预防知识(72％)；希望获得健康知识的途径是广播和电视(81％)；家庭最希望获得的医疗保健服务是方便看病和获得药物(73．8％)。结论慢性病给农民带来沉重负担，并成为农民关心的主要健康问题。     

100例SARS患者外周血T淋巴细胞亚群分析

目的 :探讨SARS患者外周血T淋巴细胞亚群变化。方法 :采用流式细胞仪检测10 0例SARS住院患者外周血T淋巴细胞亚群。结果 :与正常组比较 ,SARS组白细胞总数显著下降 ,淋巴细胞百分数和绝对数显著下降 ,粒细胞绝对数显著下降 ,CD3 、CD4 、CD8 细胞绝对数显著下降 ,CD4 细胞百分数 ,CD8 细胞百分数及CD4 /CD8 比值差异无统计学意义。比较SARS患者各病程CD3 、CD4 、CD8 ,于病程第一至第三周较第四周下降明显 (P <0 .0 5 ) ,病程第一至第三周之间差别无显著性 (P >0 .0 5 ) ;结论 :SARS患者外周血T淋巴细胞亚群的变化对阐明SARS的发病机制有一定意义。     

妊娠期肝内胆汁淤积症与血清甘胆酸的关系

检测了７４例正常足月妊娠妇女和５６例妊娠期肝内胆汁淤积症（ＩＣＰ）患血清甘胆酸（ＣＧ）的浓度，结果ＩＣＰ患血ＣＧ浓度显升高（１３．５２±９．５４ｍｇ／Ｌ），为正常孕妇（２．６７±１．９２ｍｇ／Ｌ）的５～１０倍，根据血ＣＧ浓度将ＩＣＰ患分为〈１０、１０～２０，〉２０ｍｇ／Ｌ３组，将３组胎儿出生情况与正常组相对照，结果显示血ＣＧ浓度〈１０ｍｇ／Ｌ组羊水胎粪污染率及新生儿窒息率与正常组无差异，而     

大鼠胎胰胰岛组织培养及移植的实验观察

本实验对培养中的大鼠胎胰胰岛组织及其移植后的形态功能进行了观察。结果表明,大鼠胎胰经短期培养,不仅内分泌胰岛β细胞的活力保存良好,而且胰外分泌腺泡大大减少以致消失。21只糖尿病大鼠,同种移植经过7天培养的胎胰胰岛,未用免疫抑制剂,术后糖尿病缓解率76.2％。