Guillain–Barre Syndrome and JEV Infection Japanese encephalitis virus infection was confirmed in 161 patients in a northern area of Ningxia, China. Signs and symptoms and electromyographic findings...

目的 探讨新生儿脑脊液的特点及临床意义.方法 回顾性分析63例新生儿肺炎并发脑膜炎的临床资料,比较不同性别、不同发病时间患儿的实验室检查特点.结果 98.41％新生儿肺炎并发脑膜炎,脑脊液细胞学分类单核细胞占(77.60±12.36)％.不同性别组实验室检查结果比较差异无统计学意义(P＞0.05);早发性肺炎组并发脑膜炎患儿的脑脊液葡萄糖较晚发性肺炎组高,差异有统计学意义(P＜0.05).结论 新生儿肺炎并发脑膜炎的脑脊液细胞学以单核细胞反应为主,男孩比女孩更容易患新生儿肺炎并发脑膜炎,性别与发病时间对新生儿肺炎并发脑膜炎患儿的实验室检查指标无影响.

Objective To explore the prenatal diagnosis methods of spinocerebellar ataxia type 3 ( SCA3 )/Machado-Joseph disease ( MJD ) based on amniotic fluid cells culturing and fragment analysis with capillary electrophoresis.Methods The amniocentesis and aminotic cell culture were performed in a SCA3/MJD pregnant women at 20 weeks of gestation and 8 pregnant women at 16 -19 weeks of gestation.The MJD1 gene ( CAG ) n dynamic mutation were detected by capillary electrophoresis separation.Results The number of MJD1 gene ( CAG) n in fetal of SCA3/MJD patient was 22/78, the fragments of abnormal alleles was come from his mother.The fetus was diagnosed with SCA3/MJD.The number of MJD1 gene (CAG)n in fetal of 8 controls were 13-26, they were in normal range.Conclusions Amniotic fluid cells culturing and fragment analysis with capillary electrophoresis are very simple and precise methods.It worths to be recommended as a promising protocol for SCA3/MJD’s prenatal diagnosis and genetic consultation.

Objective To investigate the morphological characteristics of meningeal carcinomatosis cells in the cerebrospinal fluid with cell CT technique and immunofluorescence staining,rising the research level of meningeal carcinomatosis cells from the plane to the three-dimensional,and explore the diagnostic value of the tests in the patients with meningeal carcinomatosis.Methods Meningeal carcinomatosis cells were serially optical sectioned,stained with EMA and CEA by double-immunofluorescence,and tomographically scanned by confocal scanning laser microscope,then the morphological characteristics of cells was investigated.Results The meningeal carcinomatosis cells showed stronger fluorescence staining.By tomography,24 images were obtained with meningeal carcinomatosis cells from the top to the bottom along the Z-axis.EMA and CEA were not expressed both in the control group cells.3D images were obtained with meningeal carcinomatosis cells in 15°,30°,45°,60°,75°,90°,105°,120°,135°,150°,165° and 180° rotated along the Y-axis.Conclusion In comparison with the conventional method,this technique is of practical value in differentiating benign cells of the cerebrospinal fluid.These may provide an important experimental basis for diagnosis and differential diagnosis of meningeal carcinomatosis.

Background Tuberculous meningitis (TBM) is a common central nervous system (CNS) infectious disease,and is a serious threat to people's health. Due to its diverse clinical manifestations, especially atypical in infants and young children, it is easy to be misdiagnosed and can lead to high disablility rate and mortality rate. At present, cerebrospinal fluid (CSF) cytology still plays an important role in the etiological diagnosis of CNS infectious diseases. Based on the observation of CSF cytological changes of children with TBM, this study is to further understand the performance and evolution characteristics of this disease, so as to improve the ability of early diagnosis and judgment on the treatment effect. Methods Fresh CSF was collected to make smears by using cytological slide centrifugation, and apply May-Grunwald-Giemsa (MGG) staining for morphological classification. Results CSF cytology of all patients were abnormal. The average leukocyte count of children with TBM was (310.19 ± 156.26) × 106/L, and was significantly different from that of children with purulent meningitis (P = 0.000). Lymphocyte proportion of TBM group was (66.56 ± 14.08)% , and there were significant differences among different groups (P = 0.037, 0.000). Compared to children with purulent meningitis, higher proportion of monocytes (P = 0.000, 0.020) and plasma cells (P = 0.001, 0.004) were found in children with TBM and viral meningitis. The positive detection rate of plasma cells in children with TBM was higher than that in children with purulent meningitis (P = 0.001). Conclusion The CSF cytology changing characteristics of children with TBM are revealed. In the beginning the lymphocyte proportion is dominant in CSF cytology, and then different extents of mixed cellular response appear as disease develops. For children with effective treatment, the proportion of neutrophils decreases rapidly and turns to lymphocyte reaction gradually, with monocytes and plasma cells, lasting for a long time. Long-term mixed cellular response will happen in children with ineffective treatment. All in all, the CSF cytology changing characteristics are significant in clinical diagnosis and differential diagnosis of TBM in children.

Objective To analyze the clinical and cerebrospinal fluid (CSF) cytological features of patients with tuberculous meningitis (TBM), to improve early diagnostic accuracy and treatment of TBM. Methods Clinical presentations, etiology and biochemical and cytological features of CSF were analyzed retrospectively among 60 adult cases with TBM hospitalized at Neurology Department of General Hospital of Ningxia Medical University from January 2005 to May 2011. Results Most patients (58/60, 96.67%) had fever and headache at onset. In some patients, disturbance of consciousness (9/60, 15.00%), seizure (5/60, 8.33%) occurred in 1 week and focal neurological signs developed during the course. Forty⁃four patients (73.33%) had pulmonary tuberculosis history. In CSF examination, acid⁃fast bacillus positive was found in 8 patients. Positive acid ⁃ fast myobacterium tuberculous culture was detected in 5 patients and positive myobacterium tuberculosis DNA were seen in 5 patients. The main changes of CSF were intracranial hypertension, increase of protein, and decrease of glucose. CSF presented mixed cellular response with predominace in the increasing of leucocytes. During early stage the mean percentage of neutrophil in CSF was less than 40%. After short term (as long as 2 months) of regular antituberculotic therapy no significant changes in total cell count and the proportion of neutrophils were seen. In 60 patients, 44 patients were ameliorated, 11 were not healed or were discharged or transferred to other hospital and 5 were dead. Prognosis of patients treated within 3 weeks after onsets was superiorly to those treated at more than 3 weeks after onset. Conclusion There are no specific clinical features in TBM and it is hard to perform early diagnosis for TBM, particularly, existing of low efficiency in pathogenic detection, but pulmonary tuberculosis is of accessary value to diagnose TBM. Whereas mixed cellular response may complementarily provide the diagnosis of TBM in early stage. Cytologic changes of CSF can be very slow even after therapy. Therefore persistent mixed cellular response in CSF cannot exclude TBM. The time of treatment will determine the therapeutic effectiveness in a great degree. DOI：10.3969/j.issn.1672⁃6731.2012.02.021

Objective To explore the value of combination of immunofluorescence cytochemical staining (ICS) and laser-scanning confocal microscopy (LSCM) in the diagnosis of meningeal carcinomatosis. Methods ICS and LSCM were used to detect the cellular distribution and quantity of epithelial membrane antigen (EMA) in cerebrospinal fluid (CSF) cells of patients with meningeal carcinomatosis (MC group) and controls (control group). Results The EMA was expressed with red fluorescence in the cytoplasm of meningeal carcinomatosis cells. The mean fluorescent intensity of cellular EMA in meningeal carcinomatosis cells of CSF in MC group (44.84 ± 13.05) was significantly higher than the cells of CSF in control group (3.98 ± 1.58; t = 43.954, P = 0.001). The positive rate of routine cerebrospinal fluid cytologic examination (May-Grunwal-Giemsa staining) and EMA immunofluorescence examination combined LSCM was 60% (12/20) and 90% (18/20), respectively, the difference was significant ( χ 2 = 4.800, P = 0.010). Conclusion The combination of immunofluorescence cytochemical staining and LSCM for the detection of EMA expression changes in cells of CSF is useful for the diagnosis and differential diagnosis of meningeal carcinomatosis. DOI：10.3969/j.issn.1672-6731.2011.05.012

Objective To study the sensibility and differential of serous cavity effusion cytology,tumor maker,tumor cell culture and chromosome in diagnosing malignant tumor.Methods Serous cavity effusion were tested by CSF centrifuge,May-Grunwald-Giemsa,AO,and parts of PAS staining while tumor cell culture,tumor maker and tumor chromosome were analysis in some of specimen.Results In all 78 cases of malignant tumor specimen,we found 45 were adenocarcinoma,14 were squamous cell carcinoma,8 were undifferentiated carcinoma,5 were leukemia and 3 were malignant lymphoma,et al.Conclusion Combined with tumor cell culture,tumor maker,and tumor chromosome analysis,serous cavity effusion cytology plays an important role in diagnosis of malignant tumor.

Objective To investigated the cellular distribution and quantitatively of CEA in cerebrospinal fluid meningeal carcinomatosis cells by immunofluorescence staining and laser scanning confocal microscopy (LSCM), explore the diagnostic value of the examination in the patients with meningeal carcinomatosis.Methods All cerebrospinal fluid cells (control group and meningeal carcinomatosis) were stained with CEA by immunofluorescence, scanogram and fluorescent intensity stereophotography were obtained and finally fluorescent values of CEA were individually measured by LSCM.Results Compared with meningeal carcinomatosis cells(44.33±29.58)and control group cells (2.37 ± 2.16), fluorescent value difference CEA was statistically significant (P0.01). Conclusion The sensitivity of CEA by immunofluorescence examination and LSCM is useful for the diagnosis,differential diagnosis of meningeal carcinomatosis.

Objective To evaluate the clinical significance of S-100b protein in serum and cerebrospinal fluid of patients with acute and recovery cerebral infarction and to find its correlation with neurologic deficit s, infarct volume and ages. Methods 46 patients with cere bral infarction in test group and 25 in control group were measured for S-100b protein of cerebrospinal fluid and serum by enzyme-linked immunosorbent assay. Comparison was performed by SPSS10.0 statistical package. Results Patients with acute cerebral infarction has a higher concentration of S -100b protein of serum and cerebrospinal fluid than in control group( P 0. 01). The release of S-100b protein into serum and cerebrospinal fluid in patie nts with acute cerebral infarction is associated with the neurological outcome at discharge from hospital as assessed by Chinese stroke scale scores( P 0. 01)and the volume of brain lesions( P 0.01)in acute cerebral infarction( P 0.01). Conclusion Our results show that the conce ntration of S-100b protein in serum and cerebrospinal fluid of patients with ac ute cerebral infarction imply the acquity of the disease or the extent of lesion of nueroglial cell.

危重状态下的麻醉插管与常规麻醉插管有很大不同.多数患者因生命体征的极不稳定,使麻醉插管过程复杂化,且危险性大,死亡率高.虽然诱导麻醉药物的作用快,作用时间短,但其引发的血流动力学改变对危重病人插管后期的循环状态可以造成难以克服或不可恢复的间接影响,为临床不可忽视的插管后期并发症.现就我院综合性ICU内44例危重病患者的诱导麻醉及其插管前和插管后4 h内的循环状态作了回顾性分析.

对30例酒精性肝损伤的患者临床表现、治疗及预后进行分析,认为酒精性肝损伤临床表现及预后与其他原因引起的肝损伤有所区别.治疗以戒酒、支持治疗为主,应注意戒酒综合征的治疗.早期诊断、早期戒酒、综合治疗,预后良好;反复酗酒者预后不良.

为提高对艾滋病的诊断水平,减少漏诊误诊,本文回顾了宁夏首例艾滋病的临床资料及诊断思路.艾滋病的主要特点是免疫功能严重受损,因此导致多种严重条件致病菌感染并伴发罕见恶性肿瘤.患者确诊一周后死于呼吸循环衰竭,提示临床医师需熟悉艾滋病的多种临床表现、流行病学,对疑似病例进行抗HIV抗体检测.