目的 分析全胃切除、食管空肠Roux-en-Y吻合术后患者出现腹泻的原因,并探讨其护理策略.方法 分析8例全胃切除术后患者出现腹泻的原因,并指导患者术后少量多餐、细嚼慢咽、餐后平卧10～20 min,制定个体化食谱.结果 8例腹泻患者经护理之后,腹泻、乏力、头晕症状明显缓解,均未出现水、电解质紊乱,体重、血清白蛋白、总蛋白均未出现明显下降,并顺利康复出院.结论 全胃切除术后患者出现腹泻时应及时分析原因,警惕发生早期倾倒综合征的可能,并及时给予正确的饮食指导,对防治饮食相关并发症、促进术后康复具有积极意义.

目的 分析肠造口护理中实施延续性护理的具体方法 与效果情况.方法 研究资料均出自本院,是在2015年11月～2016年12月期间收治的60例全膀胱切除回肠代膀胱造口患者,将全部患者按照平均分的方式分为两组:观察组与对照组,每组患者有30例.其中对照组实施常规护理干预,观察组实施延续护理干预,干预后比较两组患者的护理效果.结果 在生活质量方面两组进行比较,观察组显著优于对照组,经比较,有显著的统计学意义(P<0.05).比较两组患者的不良反应发生率,观察组显著低于对照组,经比较,差异显著(P<0.05).结论 对造口患者实施延伸护理干预措施,取得了理想的治疗效果,因此这种护理模式是非常有价值的.

Objective To investigate the changes and significances of interleukin-5(IL-5) and immunoglobulin E(IgE) levels in children with different subtypes asthma,ranging from moderate to severe cases.Methods Sixty-five moderate to severe asthmatic children(asthma group) and 20 healthy children(healthy control group) were selected from Sep.2008 to Mar.2009 in Department of Pediatrics,Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University in the research.The asthmatic children in the acute stage were divided into 2 groups according to the cell type in induced sputum,one group was labeled as eosinophilic(EOS) asthma(EA)group,and the the other non-EOS asthma(NEA) group.The whole levels of serum IgE of asthmatic children with different subtypes asthma were checked with enzyme linked immunosorbent assay(ELISA).The vitro peripheral blood mononuclear cells(PBMC) in vitro in both asthmatic groups and healthy control group were cultured with CD3 and CD28 monoclonal antibody collectively.The excretive level of IL-5 in PBMC stimulated by monoclonal antibody was detected with ELISA.A correlation analysis on the metrical level of IL-5 and IgE was carried out in order to investigate the mechanism of IL-5 and IgE in different asthma types.Results The percentages of EOS in the induced sputum in EA group were significantly higher than those in NEA group(P=0.000).The IL-5 level in PBMC in vitro in asthmatic group was significantly higher than that in the healthy control group.The IL-5 level in acute group was significantly higher than that in remission group,and in the acute group,the IL-5 level in severe persistent group was significantly higher than that in moderate persistent group.Furthermore,the IL-5 level in EA group was significantly higher than that in the healthy control group and NEA group.The IgE level in peripheral blood in EA group was significantly hig-her than that in NEA group(P=0.010).The percentages of EOS in the peripheral blood and the induced sputum had positive correlation with the IgE and IL-5 levels(Pa=0.000).There was a positive correlation between IL-5 level and IgE level of asthmatic children(r=0.482,P=0.001).Conclusions IL-5 and IgE play active roles in the pathogenesis of asthma,and the roles of IL-5 and IgE in EA are more prominent than those in NEA.The IL-5 level is related to the disease severity.

【Objective】 To investigate the effect of interleukin-17 (IL-17) on the pathogenesis of moderate to severe children asthma and on the airway neutrophil inflammation reaction. 【Methods】 Forty-five patients (20 patients with moderate persistent asthma,25 patients with severe persistent asthma),as well as 20 normal control subjects,were included in this study. ELISA was used to measure IL-17 concentration in peripheral blood mononuclear cells (PBMC) from 65 children. PBMC were stimulated by anti-CD3 monoclonal antibody (OKT3) (0.2 mg / L) and anti-CD28 monoclonal antibody (anti-CD28) (1 mg / L). The sputum specimens were assayed for cellular differential count. Then the asthmatic children received combined treatment for 3 months,20 cases were relieved,their IL-17 concentration in PBMC were measured again. The correlation between the IL-17 levels and the percentage of eosinophil,neutrophil in the induced sputum was analyzed. IL-17 levels were compared between moderate persistent group and severe persistent group,between the acute group and the remission group. The relationship between IL-17 and the disease severity and airway inflammation was analyzed. 【Results】 The IL-17 levels of asthmatic group were significantly higher than that of control group (2 685 ± 1 081) pg / mL,and the level of acute group (5 355 ± 813) pg / mL were also significantly higher than that of remission group (4 504 ± 687) pg / mL (P 0.05). The IL-17 levels of severe persistent group (5 830 ± 807) pg / mL were significantly higher than those of moderate persistent group (4 962 ± 751) pg / mL (P 0.05). The IL-17 level (5 355 ±813) pg / mL was positively related to the percentage of neutrophil in the induced sputum (Xmin = 0,Xmax = 98.8,M = 44.73)% and the percentage of neutrophil in the peripheral blood (51.72 ± 13.43) % (r = 0.820,0.736,P 0.001). 【Conclusion】 The levels of IL-17 expressed by PBMC of moderate to severe asthmatic children increased and had close correlation with asthma severity and the degree of airway inflammation.

目的:探讨儿童支气管哮喘(哮喘)气道炎症的细胞多型性,分析不同分型的患儿对治疗的反应。方法:54例急性发作期哮喘患儿根据痰涂片细胞分类中嗜酸性粒细胞所占比例分为非嗜酸性粒细胞性哮喘(non-eosinophilic asthma,NEA)组及嗜酸性粒细胞性哮喘(eosinophilic asthma,EA)组,分别检测2组的血常规,观察其血细胞形态,记录痰涂片结果,并对其入组时及接受常规联合治疗3个月后达缓解期的肺功能进行检查,比较2组差异。结果:EA组25例,NEA组29例。EA组96%患儿血嗜酸性粒细胞升高,无中性粒细胞升高者,血细胞形态异常者多为偶见异形淋巴细胞(占44%);NEA组则有21%中性粒细胞升高,无嗜酸性粒细胞升高者,血细胞形态异常者以中性粒细胞见中毒颗粒及空泡变性改变者(24%)及偶见异形淋巴细胞者(24%)居多。EA组的痰涂片嗜酸性粒细胞明显高于NEA组(P<0.01),NEA组的痰涂片中性粒细胞明显高于EA组(P<0.01)。2组缓解期的各项肺功能指标均比急性发作期改善(均为P<0.05),其中EA组的FEV1改善程度明显高于NEA组(P<0.01)。结论:哮喘是一种多型性的气道炎症性疾病,嗜酸性粒细胞、中性粒细胞均可参与其气道炎症,EA患儿对联合治疗反应优于NEA患儿,应根据哮喘患儿的痰涂片细胞分类了解其分型,制定个体化治疗方案。

目的 评价蒙洛英注射液对儿童高热的退热疗效和安全性.方法 选择体温超过39.0℃的发热儿童50例,予蒙洛英深部肌肉注射.结果 蒙洛英退热效果显著,其显效率为84%,总有效率为100%,不良反应少且轻微.结论 蒙洛英注射液在年龄大于或等于6岁儿童高热的临床治疗中退热效果好,不良反应少,安全可靠,值得临床应用.

Objective To evaluate the healing effect and safety of Motrin Suspension and Compound Aminopyrine Injection on children with high fever.Methods 100 children with high fever whose body temperature higher than 39.0 ℃,were randomly divided into 2 groups,one group took Motrin Suspension and the other was injected with Compound Aminopyrine Injection.Results The start time of fever abatement and adverse events of both groups were the same,while the effect of fever abatement and duration of Motrin Suspension were superior to Compound Aminopyrine Injection.Conclusion In the clinical treatment of children with high fever,Motrin Suspension has stronger fever abatement effect,longer maintaining duration,less side effects and more safety and reliability.Besides,it avoids the pain from injection and side effects.So it can replace Compound Aminopyrine Injection and is worthy of clinical application.

Objective To evaluate the sterilizing efficiency ofabscrbable poly-L-lactide (PLLA) screws sterilized with ethylene oxide and 60Co-γ radial. Methods One group of PLLA screws was sterilized in the ethylene oxide sterilization ease. In order to eliminate the rudimental ethylene oxide, the sterilized screws was put in the air for five days. The other group of PLLA screws was sterilized with 60Co-γ radial with absorbable dose of 15 kGy. Then all sterilized screws were characterized. Results Compared with the primal bend intensity of the PLLA screws, the bend intensity of sterilized screws did not descend remarkably (P＞0.05). Compared with the primal molecular weight of the PLLA screws, the molecular weight of screws with 60Co-γ radiation sterilization re-markably decreased 11%. It indicated that the material had degraded. The molecular weight of screws with ethylene oxide sterilization ordy decreased 3%. It indicated that the material didn't degrade obviously. Conclusion Ethylene oxide sterilization is a better way for sterilizing absorbable PLLA screws.

[Objective] To explore the effect of T-bet and GATA-3 mRNA expression on profiles of type 1 and type 2 Th cells in asthmatic children. [Method] To detect the mRNA expression of T-bet and GATA-3 in the PBMC by semi-quantitative PCR and determine Th1 and Th2 cell numbers by FACS in 38 asthmatic children, including acute attack group of 20 (age 3-13, 6.2 ± 2.9); 18 of remission group (age 3-12, 6.1 ± 2.5); and 20 healthy control children (age 3-12, 6.9 ± 2.7). [Result] It was showed that T-bet mRNA in asthmatic children was lower than control group and lower in attack stage than in remission stage (0.14 ± 0.035 vs 0.21 ± 0.033 vs 0.28 ± 0.031, P 0.05). To opposite, GATA-3 mRNA was higher in asthmatic children than control group and higher in attack stage than in remission stage (0.49 ± 0.091 vs 0.44 ± 0.083 vs 0.37 ± 0.041, P 0.05). It was showed that Th1 percentage was lower in asthmatic children than those of control group and lower in attack stage than those of remission stage (9.67 ± 3.80 vs 14.69 ± 3.16 vs 21.18 ± 3.45,P 0.05). Th2 percentage in asthmatic children was higher than that of control group and higher in attack stage than that of remission stage (20.76 ± 7.95 vs 14.28 ± 1.71 vs 4.1 ± 1.55,P 0.05). Spearman correlation analysis revealed that T-bet mRNA was positively correlated with Th1 percentage (r=0.731) and negatively correlated with Th2 percentage (r=-0.685). GATA3 mRNA level was negatively correlated with Th1 percentage (r=-0.692) and positively correlated with Th2 percentage (r=0.717). The T-bet/GATA-3 mRNA ratio was positively correlated with Th1 percentage (r=0.793) and Th1/Th2 ratio (r=0.801), but negatively correlated with Th2 percentage (r=-0.639). [Conclusion]The T-bet/GATA-3 mRNA expression is closely correlated with Th1/Th2 balance, and the T-bet/GATA-3 ratio may act as a new measure of the Th1/Th2 balance in asthmatic children.

Objective To observe the curative effect of racecadotril on acute watery diarrhea in infants. Methods A total of 100 infants with acute watery diarrhea enteritis were randomly divided into 2 groups. Both groups received a mixture treatment, the control group were given Montmorillonite power, while the treatment group were assistedly treated with racecadotril. The clinical effects were compared between the 2 groups after 5~7 d of treatment. Results The diarrhea controlling time and the diarrhea period of the treatment group were shortened, and the total effective rates of the treatment group was higher than the control group. There were significant statistical difference between those two groups (P0.01), and no side effect was found in the treatment group. Conclusion Racecadotril is an effective and secure drug for the treatment of acute enteritis in infants.

Objective To detect the changes of lung aquaporin 1(AQP1) expression in acute allergic asthma mice and after the dexamethasone treatment.Methods An allergic asthma mice model was established,and randomly divided in three groups:asthma model group,normal saline control group and treatment group.Mice in treatment group were treated with dexamethasone during the activated period.Bronchoalveolar larvage fluid(BALF) of each group was collected to determine the total number of white blood cells and their classification,and the level of interleukin 5(IL-5) and interferon γ(IFN-γ).The level of AQP1mRNA,AQP1 protein,and AQP1 distribution in lung tissue were detected by RT-PCR,Western blot,and immunohistochemical method.Results(1) The count of total number of white blood cells(WBC)(52±8)×106/mL,eosinophils(9.8±1.7)×106/mL and the level of IL-5(71±27) pg/mL in BALF of asthma group were all higher than those of the control group(all P 0.01),the level of IFN-γ(294±26) pg/mL was lower than that of the control group(P 0.05).After treatment,they were significantly lower than before(P 0.05,P 0.01,P 0.01),the level of IFN-γ was significantly higher than before(P 0.05);(2) The level of AQP1mRNA(1.90±0.29) and AQP1 protein(1.31±0.10) of asthma group were significantly higher than those of control group(all P 0.01);After treatment,they were significantly lower than before(P 0.01,P 0.05);(3) There were extensive inflammatory changes,mucus hypersecretion,sever edema,and large amount of inflammatory cells infiltrations around the blood vessels in the lung tissue of asthma group.The morphological changes of the treatment group were significantly ameliorated.The AQP1 of the control group was positively stained on bronchial mucosal epithelium,microvascular endothelium,vessel beds of bronchi and inflammatory cells,the AQP1 of asthma group was strong positively.Conclusion AQP1 was over-expressed in acute asthma mice,dexamethasone could inhibit the expression of AQP1,may be significantly ameliorated the pathophysiology process of the allergic airway inflammation and airway water abnormal exchange.

目的研究不同透皮促进剂对宝泻灵提取物中各指标性成分体外经皮渗透的影响,筛选出有效的透皮吸收促进剂。方法采用改良的Franz扩散池,以离体大鼠皮肤为透皮屏障,通过体外透皮实验,用高效液相色谱法测定不同渗透促进剂对提取物中各指标性成分吴茱萸次碱、丁香酚和肉桂醛的累积渗透量、透皮渗透速率等体外透皮吸收动力学参数的影响。结果低比例氮酮、以及3%氮酮与不同比例丙二醇联合使用时的累积渗透量均有明显提高,其中以3%氮酮+10%丙二醇作为复合促进剂时的促渗作用最强。结论通过考察渗透促进剂对宝泻灵提取物各指标性成分的影响,为研究其透皮给药提供了参考依据。

目的探讨血清肺炎支原体(mycoplasmapneumoniae,MP)特异性抗体IgM滴度在判断儿童肺炎支原体感染病情中的临床价值。方法回顾性分析113例MP感染患儿的临床资料。采用双变量Spearman等级相关分析研究应用间接凝集试验法检测所得的血清MP-IgM的滴度与MP感染患儿病情的关系。结果113例患儿中,轻度MP感染58例(51.3%),中度感染32例(28.3%),重度感染23例(20.4%);MP-IgM滴度1∶80有19例(16.8%),滴度1∶160有24例(21.2%),滴度1∶320有28例(24.8%),滴度1∶640有29例(25.7%),滴度1∶1280有13例(11.5%)。经统计学分析血清MP-IgM的滴度与MP感染患儿的病情严重程度呈正相关(r=0.682,P<0.01)。结论血清MP-IgM滴度的测定有助于判断患儿的病情,为临床采取有效的治疗方案提供依据。

Objective:To study the risk factors of wheezing onset in children with mycoplasma pneumoniae(MP) infections. Methods:The retrospective analysis included 291 cases with MP infections from Jan 1998 to Dec 2003. Results:Age (P=0.002) and history of asthma (P=0.007) have the significant correlation to wheezing onset. The value of age OR is 0.91 and history of asthma (without) OR is 0.0005, so we think age and the patients without history asthma are protective factors. Conclusion:The age is the protective factor of wheezing onset, which means older children are less with wheezing onset than younger ones. And the children who had suffered asthma in past will be prone to have wheezing onset after MP infection.

随着近年来经皮给药制剂的迅猛发展,有着悠久历史的中药复方经皮给药制剂也受到越来越多的关注。主要从体外经皮渗透研究、在体经皮吸收研究、经皮吸收促进剂研究等3个方面对近年来中药复方经皮给药制剂的研究进行概述,并就存在的问题进行了初步探讨和展望。指出中药复方经皮给药制剂在突出自己特色的基础上,与现代科技相结合,必定会为中药复方经皮给药制剂的发展带来曙光。

特发性肺含铁血黄素沉着症(idiopathic pulmonary hemosiderosis,IPH)是一种肺泡毛细血管出血性疾病.临床上以反复咳嗽、咯血或咳血丝痰为特征.反复的肺泡出血,含铁血黄素沉积在肺泡间质,导致广泛的肺间质纤维化,影响肺循环,引起肺动脉高压、肺心病和呼吸循环衰竭.临床上常以贫血为首发症状而造成误诊或延误诊断.现将本院收治的3例IPH报告如下.