目的 探讨早期经鼻持续气道正压通气(NCPAP)对新生儿呼吸窘迫综合征(NRDS)患儿肺功能的影响.方法 选取入医院治疗的呼吸窘迫综合征患儿60例作为研究对象,入院后均予以肺表面活动物质(PS)治疗,根据通气方式将患者分为观察组和对照组,观察组30例予以NCPAP,对照组予以常规机械通气(CMV),记录两组用机时间、氧疗时间,观察两组治疗24 h后指标呼吸频率(RR)潮气呼气峰流量(PEF)、达峰时间(TPEF)、达峰容积比(VPEF/VE),评估两组治疗治疗成功率.结果 观察纽治疗成功率为93.33％显著高于对照组的73.33％,差异有统计学意义(P＞0.05);观察组用机时间和氧疗时间分别为(54.26±9.64)h、(73.21±16.59)h均显著短于对照组,差异有统计学意义(P＜0.05);观察组治疗后RR为(54.15±6.21)L/min较对照组快,TPEF为(0.23±0.09)s较对照组短,差异有统计学意义(P＜0.05).结论 NCPAP能够改善NRDS肺功能,缩短用机时间,提高治疗成功率.

Objective To investigate the effect of alpha-lipoic acid on oxidative stress and cerebral edema after hypoxic-ischemic brain damage (HIBD)in neonatal rats.Methods A total of 108 neonatal 7-day-old Wistar rats were randomly divided into 3 groups:sham-operated group(sham, n=36), HIBD group(HIBD, n=36) and alpha-lipoic acid-treated group (treated group, n=36).Each group was divided into 3 sub-groups (n=12, per sub-group) based on different time points after HIBD (1 d, 3 d, 7 d).HIBD rat models were established by ligating the left common carotid artery, The sham-operated group and the HIBD group were treated with normal sodium injection intraperitoneally; treated group were treated with alpha-lipoic acid 100 mg/kg every 12 hours in 5 days.Animals were sacrificed at different time points.Changes of brain water content were determined by dry-wet weight method.And the levels of SOD,MDA,GSH-PX were measured.Results HIBD group showed an upward trend in brain water content and the level of MDA after HIBD, were higher than that of sham-operated group at each time point (P<0.05).Meanwhile, the levels of SOD and GSH-PX showed the downward trend in HIBD group.The levels of brain water content and the level of MDA in treated group were significantly lower than HIBD group at each time point ( P<0.05 ) .And the levels of SOD and GSH-PX in treated group were significantly higher than HIBD group at 3 d and 7 d.on the contrary , the level of MDA in treated group was significantly lower than HIBD group at 3 d and 7 d.Conclusion Alpha-lipoic acid can amiliorate cerebral edema, so it can prevent HIBD.The neuronal protective mechanism might be reverse oxidative imbalance in the brain of neonatal rats with HIBD.

Objective To explore predictive factors to evaluate the neurodevelopmental prognosis in term neonates with hypoxic ischemic encephalopathy(HIE).Methods Electroencephalography,neuroimaging,periodic neurological exams and a developmental test at 44-48 months after discharge from the hospital were performed on 50 term neonates with HIE.The dead and abnormally developed neonates were taken as problematic prognosis group,and well developed neonates taken asgood prognosisgroup.Logistic analysiswas made of risk factors affecting neurodevelopmental prognosis.Results Normal/mildly abnormal neonatal electroencephalography was correlated with favorable outcome,particularly if neuroimaging was normal.The cranial MRI sensitivity and specificity was higher,and the predictive value was higher.Moderate/severely abnormal electroencephalography and multifocal/diffuse cortical or deep gray matter lesions were correlated with poor outcomes.Conclusion Neurological developmental scores,abnormal electroencephalogram and brain imaging are predictive risk factors to evaluate the neurodevelopmental prognosis in term neonates with HIE.

Objective To explore the risk factors of term neonates with respiratory distress syndrome.Methods The clinical data of 80 term neonates with respiratory distress syndrome and 79 healthy term neonates were retrospectively analyzed.Results There were significant differences on sex,body weight,cesarean section,intrauterine distress,asphyxia,maternal diabetes between the two groups.The results showed respiratory distress syndrome was closely related with low body weight,cesarean section,asphyxia and maternal diabetes.Conclusion The risk factors of term neonates with respiratory distress syndrome are low body weight,cesarean section,asphyxia and maternal diabetes.

目的 探讨足月新生儿缺氧缺血性脑病神经发育预后的相关危险因素.方法 50例HIE足月患儿出院后44～～48月行脑电图、影像学检查、神经系统相关检查和神经发育评分,将死亡和发育异常者归为预后不良组,发育正常者归为预后良好组.Logistic回归分析影响神经发育预后的危险因素.结果 脑电图异常程度、颅脑成像异常程度(头颅MRI等)以及神经发育评分与足月新生儿缺氧缺血性脑病神经发育预后密切相关.结论 脑电图异常程度、颅脑成像异常程度(头颅MRI等)以及神经发育评分是评估足月新生儿缺氧缺血性脑病神经发育的重要参考指标.

目的探讨环孢菌素A(CsA)联合免疫球蛋白(IVIG)治疗难治性特发性血小板减少性紫癜(ITP)的疗效。方法选择31例难治性ITP患者,采用CsA联合IVIG治疗,剂量分别为5mg/(kg.d)和0.4g/(kg.w)。结果与治疗前相比,治疗后血小板计数明显升高(P<0.01),总有效率为71.8%。结论 CsA联合IVIG可作为难治性ITP的一种有效治疗方法。

Objective:To explore the dynamic changes and clinical significance of IL-6,IL-8 and TNF-α in neonatal hypoxic ischemic encephalopathy(HIE).Methods: Serum levels of IL-6,IL-8 and TNF-α of newborns with HIE and normal controls were detected by enzyme-linked immunosorbent assay.Results: Serum levels of IL-6,IL-8 and TNF-α of newborns with HIE were significantly higher than those of normal controls respectively(P0.01).Serum levels of IL-6,IL-8 and TNF-α of newborns with moderate HIE were higher significantly than those of newborns with mild HIE(P0.01).Serum levels of IL-6,IL-8 and TNF-α of newborns with severe HIE were higher significantly than those of newborns with moderate HIE(P0.05).Conclusion: IL-6,IL-8 and TNF-α may play an important role in the pathogenesis of neonatal HIE,the serum levels of them are related to the severity of HIE.

OBJECTIVE The prupose of this paper is to investigate pathogenic bacteria isolated from children with Acute Respiratory Infection (ARI) on the experiences in Longgang District, Shenzhen, and then analyze their drug resistance in order to provide some effective strategy for clinical treatment. METHOD Routine methods were used to isolate pathogenic bacteria from samples of children's throat swabs and sputum.Some bacteria identification and drug susceptibility tests were performed by means of VITEK-32. The results were analyzed statistically. RESULTS Our study has proved that Streptococcus pneumoniae, Klebsiella pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, Escherichia coli and Enterobacter aerogenes are the main pathogenic bacteria in children’s acute respiratory infection, with the detection rates of 14.28% 、 13.14% 、 11.43% 、 10.86% 、 10.86% 、 7.71% , respectively. CONCLUSIONS The situation of drug resistance for all of the pathogenic bacterium is serious and multidrug resistant strains exist prevailingly.Therefore, a study on the pathogenic distrbution and their resistant states from children with ARI in Longgang District of Shenzhen will help us to use antibiotics reasonably and decrease the appearance of drug resistant strains.

目的:探讨霉酚酸酯(MMF)对紫癜性肾炎(HSPN)的治疗效果。方法:将41例HSPN患儿随机分为两组:治疗组21例用MMF联合泼尼松治疗,对照组20例单用泼尼松治疗。结果:MMF能缓解临床症状,降低尿蛋白,减轻血尿,疗效优于对照组。结论:MMF是治疗HSPN的有效药物,其疗效安全、可靠,不良反应少。

目的观察光疗联合鲁米那治疗母乳性黄疸的疗效。方法46例入组患儿随机分为两组,对照组23例单用蓝光治疗;治疗组23例光疗联合鲁米那治疗。观察患儿黄疸消退情况监测治疗前、停光疗24h及7d后血清胆红素水平。结果光疗24h后两组患儿黄疸消退程度无统计学差异,但治疗组患儿7天后血清胆红素水平明显低于对照组。结论光疗联合鲁米那治疗母乳性黄疸对预后优于单用光疗治疗。

Objective:To study the effect of baicalin used in treatment of bacterial meningitis.Methods:63 cases of bacterial meningitis were divided into two groups,32 cases of treatment group were treated with baicalin and antibiotic,31 cases of control group were treated with antibiotic.The levels of TNF-α,IL-1,NO of plasma and cerebrospinal fluid(CSF) were determined in two groups by ELISA method and Griess method to compare the curative effect,mortality and sequelae rate between two groups.Results:①The levels of TNF-α,IL-1,NO of plasma and CSF of treatment group were significantly lower than those of control group(P<0.05);②The curative effect of treatment group was significantly better than that of control group(P<0.05);③The mortality and sequelae rate of treatment group was significantly lower than those of control group(P<0.05).Conclusion:Baicalin has some effect on treatment of bacterial meningitis,the treatment mechanism is inferred to restrain the excessive release of TNF-α,IL-1,NO in the body.

Objective:To probe into the effective therapy of treating infective brain edema.Methods:87 cases of infective brain edema were divided into two groups, 44 cases of treatment group were treated with dexamethasone and mannitol, 43 cases of control group were treated with lasix and mannitol.The levels of TNF-α, IL-1, NO of CSF were determined in two group by ELISA method and Griess method to compare the curative effect, mortality and sequelae rate in two groups.Results:①The levels of TNF-α, IL-1, NO of treatment group were significantly lower than those of control group (P<0.05);②The curative effect of treatment group was significantly better than that of control group (P<0.05);③The mortality and sequelae rate of treatment group were significantly lower than that of control group (P<0.05).Conclusion:Dexamethasone was effective drug of infective brain edema of choice, and dexamethasone united mannitol could be regimen of choice.

Objective:To explore the effect of erythrocyte ferritin (EF) contents on growth development in newborns. Methods:In 115 pairs normal labor women and their newborns, erythrocyte ferritin was determined by radioimmunoassay. Results:There was a positive correlation between the maternal and neonatal erythrocyte ferritin levels(r=0.25, P0.01); In newborns whoes mothers had Higher levels of erythrocyte ferritin, their means of Hb,birth weight,body height,head circumference and gestational age were significantly higher than that of lower levels of erythrocyte ferritin(u=4.09, 2.33, 2.45, 2.89, 2.64;P0.01, 0.05,0.05, 0.01, 0.01, respectively). Conclusion:The contents of maternal erythrocyte ferritin played an important role on growth development in newborns.

郎格罕细胞组织细胞增生症是一组原因不明的非肿瘤性增生性疾病.该病可侵犯全身多个系统及器官,临床表现多样化,轻重悬殊,极易误诊[1,2].为提高该病的诊断水平,对我院郎格罕细胞组织细胞增生症误诊9例分析如下.

亚急性坏死性脑脊髓病义称为线粒体脑肌病[1,2],是一种进行性神经变性疾病.我们最近遇到1例,现报告如下.

目的提高小儿恶性淋巴瘤的诊断水平.方法收集经病理检查确诊的曾被误诊的小儿恶性淋巴瘤23例.结果误诊为结核病8例,白血病6例,肠套叠、淋巴结炎各2例,脊髓炎、睾丸炎、出血性鼻炎、组织细胞增生症、皮肤过敏症各1例.结论对原因不明的进行性淋巴结肿大、原因不明的发热、贫血、骨痛及肝脾肿大、原因不明的截瘫、睾丸肿大、皮肤肿块,应常规进行病理学检查.

评价红细胞铁蛋白(EF)在母婴铁代谢关系中的作用.方法:采用放射免疫法测定EF.结果:母血脐血EF之间呈显著正相关关系(r=0.253,P＜0.01),母血EF值高的婴儿脐血铁指标显著高于母血EF值低的婴儿(P＜0.05).结论:EF在母婴铁代谢关系中起重要作用,母亲EF含量对婴儿铁营养状态有直接影响.

目的:评价红细胞锌铜对新生儿生长发育的影响.方法:采用原子吸收分光光度法测定115对产妇及其新生儿红细胞锌、铜含量.结果:母血红细胞锌铜与新生儿脐血红细胞锌铜呈正相关(P＜0.01),母血红细胞锌铜含量高的新生儿,其生长发育指标显著优于母血红细胞锌铜含量低的新生儿.结论:红细胞锌铜含量对新生儿生长发育具有重要作用.

患儿女,3个月.因皮疹2个月,进行性面色苍白3d于1999年10月12日入院.患儿生后常规预防用Vitk1 3d,每日5mg肌注.人工喂养.生后4周左右患儿手掌足跖皮肤出现皮疹为斑丘疹,半月后出现小水泡、脱屑.入院3d前出现面色苍白,进行性加重,伴哭闹不安、呕吐,无发热及抽搐.

原发性血小板减少性紫癜(ITP)是常见的出血性疾病之一.为提高对该病的认识,现将我院近年收治的107例ITP病儿报道如下.