RESUMEN

Objective To discuss the diagnosis significance of soluble triggering receptor expressed on myeloid cells-1 (STREM-1) and lactate in children with purulent meningitis,and to investigate the changes of STREM-1,lactate in cerebrospinal fluid(CSF) of purulent meningitis before and after treatment.Methods Dry chemical method and enzyme linked immunosorbent assay(ELISA) were used to measure STREM-1 and lactate levels in CSF of purulent meningitis group (24 cases),viral meningitis group (27 cases),CSF normal group (25 cases) and purulent meningitis after treatment group(22 cases).Results 1.STREM-1 and lactate levels in CSF were higher in patients with purulent meningitis than in those with viral meningitis and CSF normal group(all P ＜ 0.05).2.STREM-1 and lactate levels in CSF were higher in patients with purulent meningitis before treatment than those after treatment(all P ＜ 0.05).3.The area under the curve(AUC) of STREM-1 in CSF was 0.891,and at a cutoff level of 27.86 ng/L STREM-1 yielded a sensitivity of 80.8％ and specificity of 75.0％ ;the AUC of CSF lactate was 0.940,and at a cutoff level of 1.75 mmol/ L lactate yielded a sensitivity of 90.4％ and specificity of 83.3％.Conclusions 1.STREM-1 and lactate were associated with bacterial infection,they have considerable diagnostic values in purulent meningitis.2.STREM-1 and lactate maybe worthless in differential diagnosis of purulent meningitis when treated by effective antibiotics.3.The decline of STREM-1 and lactate in CSF prompts the control of infection and good prognosis.

RESUMEN

Objective To explore the efficacy and safety of sodium valproate in a higher dose in the evening for treating nocturnal and early-morning seizures.Methods A total of 69 newly diagnosed pediatric patients with nocturnal or early-morning seizures were enrolled.They were randomly distributedinto experimental group (35 cases) and control group (34 cases) and treated with sodium valproate tablets.The initial dose was little.It was gradually increased to the effective maintenance dose.With sodium valproate given twice a day,the post meridiem(PM) dose was twice the ante meridiem(AM) dose in the experimental group,while the PM/AM dose was equal in the control group.All patients were at least been followed up for 6 months.Results In the experimental group,28 cases were seizure free (80.0％),and the total effective rate was 85.7％.In the control group,20 cases were seizure free (58.8％),and the total effective rate was 64.7％.The difference in the total effective rate between the 2 groups was significant (P ＜ 0.05).No severe adverse effect was found among all patients.The incidence of daytime sleepiness (0/35 cases) in the experimental group was lower than that in the control group (2/34 cases).Conclusions A higher dose of sodium valproate in the evening for nocturnal and early-morning seizures led to better seizure control,better nocturnal sleep,less daytime somnolence,and the side effects are slight.

RESUMEN

Objective To explore the expression ofapoptosis inducing factor (AIF) and the apoptosis ofnervous cells in infectious brain injury rat models induced by pneumolysin (PLY) and their significance.Methods A total of 80 infant SD rats were randomly divided into normal saline treatment group (NS group,n=40) and PLY treatment group (PLY group,n=40).Each group was divided into 4 subgroups:NS observation subgroups at the 6,12,24 and 48 h of treatment and PLY observation subgroups at the 6,12,24 and 48 h of treatment (n=10).Five rats in these subgroups were injected with Evan' s blue (EB) to determine the damage of BBB by measuring the content of EB in the brain tissues;the other 5 rats in these subgroups were not given EB,and their brain tissues were obtained to detect the protein expressions of NSE,GFAP and AIF by immunohistochemistry,and their apoptosis was examined by TUNEL staining.Results As compared with those in the NS treatment subgroups,the brain EB content and the expression levels of NSE,GFAP and AIF in the PLY treatment subgroups were significantly higher,and the number of apoptotic cells was significantly increased (P＜0.05).The number of apoptotic cells was positively correlated to the protein expression level of AIF in the PLY treatment group (r=0.959,P=0.000).Conclusion Apoptosis plays a role in the formation and development of infectious brain injury of rats and AIF might involve in the apoptosis ofneurocyte.

RESUMEN

Objective To establish the brain injured models induced by lipopolysaccharide (LPS) in the infantile rats, and then, investigate the expression changes ofneutrophil elastase (NE) in the models to explore its mechanism. Methods Eighty 1-month-old SD rats were randomly divided into LPS inducement group (injected LPS via external carotid, n=40) and control group (injected normal saline via external carotid, n=40). Each group was equally subdivided into 2 subgroups: 24 and 48 h after the injection groups, respectively. Rats were drawn blood at different time points to detect the content of NE,and then, they were decapitated to detect the content of NE and Evans blue (EB) by the methods of formamide and enzyme linked immunosorbent assay, respectively. Results The content of EB and NE in the brain tissue and the content of NE in the serum in LPS inducement group were significantly higher than those in the control group at each time point (P＜0.05). Positive correlation was noted between the content of NE and EB in the brain tissue 24 and 48 h after the LPS inducement (r =0.903, P＜0.00 1; r =0.908, P＜0.001). Conclusion NE involves in the process of infectious brain injury of infantile rats,which is positively correlated to the damage degree of blood-brain-barrier.

RESUMEN

<p><b>OBJECTIVE</b>To study the clinical features, diagnosis and therapy of hydroa vacciniforme-like cutaneous T cell lymphoma.</p><p><b>METHODS</b>The clinical presentations and the findings of laboratory examinations and skin biopsy of affected tissue in a child with hydroa vacciniforme-like cutaneous T cell lymphoma were retrospectively reviewed.</p><p><b>RESULTS</b>The child manifested as rash, fever and lymph node intumesce. Rash was pantomorphia, including edematous erythema, vesicles, crusts, necrosis and depressed scar, and it was mild in winter and severe in summer, mainly involving in the face and extremities. Epstein-Barre virus (EBV)-IgM was positive. Histopathological findings revealed focal lymphocyte invasion in subcutaneous panniculus adiposus, mainly surrounding the blood vessels. Immunohistochemistry showed CD3 (+), CD43 (+), CD20 (-), pax-5 (-), TIA (+), CD5 (+), CD8 (+), Granmye (+) and CD4 (-). The clinical symptoms were improved after glucocorticoid treatment in this child.</p><p><b>CONCLUSIONS</b>Hydroa vacciniforme-like cutaneous T cell lymphoma has special clinical manifestations. This disorder may be definitely diagnosed by skin biopsy of affected tissue and immunohistochemistry assay. Glucocorticoid treatment is effective. EBV infection may be related to the development of this disorder.</p>

Asunto(s)

RESUMEN

Objective To investigate the expression of aquaporin-9(AQP-9)in the brain tissue of rats with infectious brain edema and explore the role of AQP-9 in the oecurrgnce and progression of the brain edema. Methods A total of 128 normal 1-month-old SD rats weighing 70-100 g of either sex were randomly divided into two equal groups, namely the normal saline(NS) group and lipopolysaecharide(LPS)group.Acute infectious brain edema was induced in rats in the LPS group by injecting LPS via the left internal carotid artery,and the rats in the NS groups received NS injection.At 6,12,24 and 48 h after the injection,the brain tissue was taken from the rats to observe the histopathology by Hernatoxylin-Eosin Stain and lneasure the brain water content(BWC).The permeability of the blood-brain barrier of the rats was tested using Evans blue(EB)method.The expressions of AQP-9 protein and mRNA in the brain tissue Were detected using immunohistochemistry and RT-PCR,respectively. Results InLPS group,the space around the blood vessels was obviously broadened in the brain tissue,where inflammatory cell infiltration,glioeyte swelling,vacuolar degeneration of the neurons and neuronal nuclear shrinkage were seen.At 6,12,24,and 48 h following LPS or NS injection,the BWC,EB content,and expressions of AQP-9 protein and mRNA in the LPS group were all significantly higher than those in the NS group(P<0.05),In the LPS group,positive correlations were found between BWC and EB content,AQP-9 protein expression and BWC,AQP一9 mRNA and BWC,AQP-9mR.NA and EBcontent,and between AQP-9 protein andmRNA.Conclusion AQP-9 might participate in occurrcnce and development of infectious brain edema in rats,it might be positive correlation.

RESUMEN

Objective To investigate the diagnosis and treatment of mixed connective tissue disease(MCTD)complicating pulmonary hypertension(PAH) in childhood in order to improve the recognition of this disease.Method According to the symptoms,signs,past history,labratory examinations,the child′s disease was diagnosed and treated,and the relative literature was reviewed.Results The main symptom of the child was interruptable apsychia.Ultrasound showed severe PAH,positive of anti-RNP antibody.After given immunosuppressant and decreased PAH,the patient′s condition was more improved.Conclusions MCTD complicating PAH in childhood onstes delitescently,and it′s difficult to diagnose.Recognition should be elevated to diagnose and treat it earlier.The prognosis can be improved.

RESUMEN

Objective To study the expression of macrophage inflammatory protein 2(MIP-2) and the interfering effects of naloxone in the brain edema caused by lioposacchride (LPS)in rats.Methods Eithty-four SD rats were randomly divided into 3 groups:normal saline group(NS group,n=28) 0.2 mL normal saline was injected by carotid into each rat;LPS group(n=28) with 200 ?g LPS;naloxone interfering group(NAL group,n=28)1 mg/kg naloxone was intraperitoneally injected at 10 min,1,2,6,12 h and following LPS injected 2 h before decapitation.The content of MIP-2 and even blue(EB) in brain tissue were detected at different time point.The brain water content was measured by drying method.Results The content of water and EB in LPS group were significan higher than those in NS group(P