复发性单纯疱疹性角膜炎患者血清IL-2及SIL-2R水平的研究

目的研究复发性单纯疱疹性角膜炎患者血清白细胞介素-2（IL－2）及其可溶性白细胞介素-2受体（SIL－2R）水平。方法本文测定了30例复发性单纯疱疹性角膜炎患者（实验组）和25例健康人（对照组）血清白细胞介素－2（IL－2）及其可溶性白细胞介素－2受体（SIL－2R）的水平。结果对照组IL－2的水平为5．41±1．45mg·L－1,实验组IL－2R水平为2．80±1.47mg·L-1,2组比较t＝2．90,P＜0．01,说明复发性单纯疱疹性角膜炎患者血清IL－2水平较对照组明显降低。对照组SIL－2R水平为90．86±17．90mg·L－1,实验组SIL－2R水平为171·46±19.30mg·L－1,2组比较t＝5．17,P＜0．01。复发性单纯疱疹性角膜炎患者血清SlL－2R水平较对照组显著升高。结论复发性单纯疱疹性角膜炎患者体内免疫功能紊乱,血清IL－2活性降低、SlL－2R水平升高可能是其原因之一,这也为免疫治疗提供了一定依据。     

Language disturbances associated to insular and entorhinal damage: study of a patient affected by herpetic encephalitis

The herpes simplex encephalitis (HSE) patient reported in this study presented a left hemisphere lesion limited to the left insula and to the left anterior parahippocampal region. The patient was followed longitudinally, focusing on the aphasia type, the language recovery, and the integrity of semantic representations. The language deficit was of fluent type, without phonological impairment, and showed a good but incomplete recovery after four months. A semantic impairment was possible at the onset, but recovered quickly and did not present a disproportionate impairment of living categories.     

中药内服外用治疗小儿疱疹性咽峡炎58例临床观察

目的观察银花解毒口服液口服联合开喉剑口腔喷雾剂外喷治疗小儿疱疹性咽峡炎的临床疗效。方法选取2017年7月至2018年7月襄阳市中医医院儿科确诊的疱疹性咽峡炎患儿98例,按照随机数字表法分为治疗组58例和对照组40例。在对症、支持治疗的基础上,对照组予阿糖腺苷静脉滴注,治疗组予银花解毒口服液口服联合开喉剑喷雾剂外喷,连续治疗5 d后,比较2组的中医证候总评分、总有效率及临床症状消失时间。结果对照组总有效率为77.5%(31/40),治疗组为96.6%(56/58),2组比较,差异有统计学意义(P<0.05)。治疗前,2组中医证候总积分比较,差异无统计学意义(P>0.05),具有可比性。治疗后,2组中医证候总积分均明显下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。治疗组热退、疱疹消失时间均明显短于对照组,差异有统计学意义(P<0.05)。结论银花解毒口服液口服联合开喉剑口腔喷雾剂外喷治疗小儿疱疹性咽峡炎,能有效减轻患儿临床症状,缩短病程,疗效显著,值得临床推广应用。     

消肿愈溃散外敷治疗小儿疱疹性口炎临床观察

目的观察消肿愈溃散外敷治疗小儿疱疹性口炎的临床疗效。方法将213例疱疹性口炎患儿随机分为2组。治疗组115例予消肿愈溃散外涂,对照组98例予锡类散外涂。观察2组疗效及2组6~8岁患儿各45例用药后疼痛消退时间。结果治疗组痊愈率为66.1%,总有效率为99.5%;对照组痊愈率为39.1%,总有效率为59.1%,2组比较均有显著性差异(P均<0.01)。治疗组疼痛消失时间为(1.08±0.36)日,对照组为(2.06±0.53)日,2组比较有显著性差异(P<0.01)。结论消肿愈溃散治疗小儿疱疹性口炎疗效较好,止痛效果理想。     

Animal models of neuropathic pain

Animal models are pivotal for understanding the mechanism of neuropathic pain and development of effective therapy for its optimal management. A battery of neuropathic pain models has been developed to simulate the clinical pain conditions with diverse etiology. The present review exhaustively discusses the methodology, behavioral alterations, limitations, and advantages of about 40 different animal models of neuropathic pain along with their modifications. Development of these models has contributed immensely in understanding the chronic pain and underlying peripheral as well as central pathogenic mechanisms. Furthermore, research has resulted in the development of new therapeutic agents for neuropathic pain management, and the preclinical data obtained using these animal models have been successively translated to effective pain management in clinical setup also. As each animal model has been created with specific methodology and results tend to vary largely with the slight changes related to methodology, therefore, it is essential that data from different models should be reported and interpreted in the context of the specific pain model.     

Chronic herpes simplex virus type I glossitis in an immunocompromised man

Herpes simplex virus (HSV) type 1 (HSV-1) infection of the tongue commonly accompanies acute primary herpetic gingivostomatitis. However, recurrent infection of the tongue is exceptional and is restricted to immunocompromised individuals. A 57-year-old man with corticosteroid-dependent chronic obstructive pulmonary disease and sciatica presented with a chronic median glossitis due to HSV-1. The main clinical and histological feature was massive necrosis of the entire mucosa. Immunohistochemistry demonstrated a considerable amount of HSV gB, gC and gD envelope glycoproteins dispersed in the chorion. In contrast, HSV-1 DNA was detected only in a limited number of epithelial cells using in situ hybridization. The extent of necrosis and the pattern of viral DNA and envelope protein distribution represent unique features of median herpetic glossitis, which are not found in more common types of HSV infection.     

Successful Treatment of Chronic Neuropathic Pain With Subcutaneous Peripheral Nerve Stimulation: Four Case Reports

Introduction. Chronic pain is a prevalent medical condition in the general population and is one of the most common reasons patients visit their primary care doctors. When the pain is resistant to the common treatment modalities, it presents a challenge for the physician and may have profound consequences for the quality of life of the patient. Methods. We present four case reports in which subcutaneous peripheral nerve stimulation was successfully used to treat chronic neuropathic pain after all other treatment efforts had failed. Results. In all cases, the patients underwent a trial of peripheral nerve stimulation with good results. The patients reported decreased use of pain medications, increased quality of life, and high satisfaction with the procedure results. Conclusion. The use of subcutaneous peripheral nerve stimulation as a viable treatment alternative in certain cases of chronic neuropathic pain should continue to be rigorously evaluated.     

张炜教授临证之三仁汤新用举隅

三仁汤为清代吴鞠通所著《温病条辨》中的名方,是治疗湿温病的代表方,备受后世医家喜爱,笔者依据老师张炜教授在临床上辨证应用三仁汤治疗儿科常见病(小儿厌食、荨麻疹)及疑难病(血小板减少性紫癜、肺含铁血黄素沉积症)验案举隅,探讨三仁汤在中医学的辨证论治和异病同治理论指导下,被广泛应用于临床各类疾病的治疗。     

No evidence of family history as a risk factor for herpes zoster in patients with post‐herpetic neuralgia

Little is known about reactivation of latent varicella zoster virus as herpes zoster in individuals with no underlying immunosuppression. Risk factors include age, sex, ethnicity, exogenous boosting of immunity from varicella contacts, underlying cell‐mediated immune disorders, mechanical trauma, psychological stress, and immunotoxin exposure. An association between herpes zoster and family history of zoster has been proposed. A case‐control study involving patients affected by post‐herpetic neuralgia, which usually follows more severe acute herpes zoster, was performed. The patients with post‐herpetic neuralgia were enrolled at the Pain Clinic of the Policlinico Tor Vergata in Rome, Italy, within 1 year from the onset of acute zoster. The controls matched for sex and age were chosen among healthy subjects without a history of herpes zoster presenting at the Internal Medicine Outpatient Clinic for hypertension in the same time period. All the participants in the study gave informed consent and were interviewed by medically trained and blinded investigators using a questionnaire. Similar proportions of the patients and the controls reported a family history of herpes zoster irrespective of the degree of relationship, i.e., 17.4% and 18.2%, respectively, by analyzing only the first‐degree relatives [RR 1.03 (CI 95%: 0.78–1.37)], and 28.4% and 29.6%, respectively, by analyzing the total number of relatives [RR 1.03 (CI 95%: 0.81–1.31)]. Further and larger prospective cohort studies are needed to ascertain whether a family history of herpes zoster is really an independent predictor of zoster in different geographical settings. J. Med. Virol. 82:1007–1011, 2010. © 2010 Wiley‐Liss, Inc.