ObjectiveTo explore pathogenesis of headache after subarachnoid hemorrhage (SAH) whether related with immune inflammatory reaction in subarachnoid and observe the effect of immunosuppressive action of dexamethasone on headache.Methods80 patients who was consciousness and complained headache after SAH were randomly divided into four groups, treated only with mannitol, mannitol plus cerebrospinal fluid (CSF) replacement, intrathecal and vein injection with dexamethasone. Effects of four groups were observed.ResultsEfficiencies of four groups were respectively the mannitol group 27.27%, the permutation group 66.67%, the intrathecal group 92.36% and the vein group 30.00%. There was a significantly difference between the intrathecal group and other three groups, and the time of headache remission for intrathecal group was also longer than that of other three groups (P<0.01).ConclusionThe wide immune inflammatory responses in subarachnoid induced by degenerative and hemic CSF is likely main cause of headache after SAH and intrathecal injection with dexamethasone has an obviously effect.

Asthenia ; physiopathology ; Cyanosis ; physiopathology ; Expert Testimony ; Fatigue ; physiopathology ; Heart Defects, Congenital ; physiopathology ; Humans ; Walking

Objective To investigate the mechanism of the permeability change in the blood brain barrier(BBB)at early stage of infectious brain edema which was pretreated with LPS.Methods PMNs were isolated and purified.The concentration of Glu was measured in the supernatant without cells.The rat BMECs were primarily isolated and cultured.The permeability of BMECs waB evaluated by measuring the passing rate of 125 I-BSA via γ ray counter.The expression of NMDAR1 on BMECs was evaluated.Results The concentration of Glu in the LPS preconditioning PMNs subgroup at 5 rain time point was highest.In each group conditioned for 240 min,the permeability index of Bake average of the LPS preconditioning PMNs extract group was highest(P＜0.01).The expression of NMDARI increased in the LPS preconditioning PMNs extract group was more than that in other groups.Conclusions The research showed for the first time that the concentration of Glu increased after LPS preconditioning and the Glu excreted by PMNs can promote the permeability of BMECs and change the function of BBB,which possibly may be related the mechanism of NMDAR1 expression increased in BMECs.

Objective To investigate the effect of selenium on proliferation and apoptosis of chondrocytes of articular cartilage cultured in vitro in Kaschin-Beck disease(KBD) patients and normal person, to explore the role of selenium in control of KBD, and to provide evidence for selenium's effect on the growth of normal cartilage cells. Methods The articular cartilage samples of grade Ⅱ and Ⅲ KBD patients were selected according to the national "Clinical Diagnosis of KBD" (GB 16003-1995). Chondrocytes of 5 KBD and 5 non-endemic normal accidentswere separated and cultured in vitro. KBD group and control group were given different doses of selenium (0,0.0125,0.0250,0.0500,0.1000,0.2500,0.5000,1.0000 mg/L, respectively). Methyl thiazolyl tetrazolium (MTT),flow cytometric analysis, and immunocytochemical staining were used to observe the effect of selenium on cell growth and apoptosis in KBD and normal persons. Results MTT results showed that the cell proliferation rate in each dosage group of the control group at the 6th day(0.086 ± 0.025,0.077 ± 0.012,0.073 ± 0.027,0.071 ± 0.017,0.058 ± 0.028,0.052 ± 0.028 and 0.046 ± 0.037) was significantly lower than that of 0 mg/L group(0.138 ± 0.026,all P ＜ 0.05);the average cell proliferation rate was negative( - 0.001 ± 0.001, - 0.003 ± 0.000, - 0.003 ± 0.001and - 0.004 ± 0.001 ) in 0.1000 - 1.0000 mg/L dose group, which was significantly lower than that of the 0 mg/L group(0.025 ± 0.003, all P ＜ 0.05);compared with 0 mg/L group(0. 115 ± 0.011), the KBD 0.2500 mg/L dose group promoted cell proliferation(0.128 ± 0.037, P ＜ 0.05), the KBD 1.0000 mg/L dose group inhibited cell growth (0.071 ± 0.019, P ＜ 0.05). The apoptotic rate of 0.0500 - 1.0000 mg/L dose control group [ (18.88 ± 0.02)%,(17.58 ± 0.01)%, (17.09 ± 0.04)%, (56.00 ± 0.02)%, (57.85 ± 0.03)% ] were higher than that of the 0 mg/L group[(13.51 ± 0.01)%, all P ＜ 0.05];compared with 0 mg/L group[(25.84 ± 0.02)%], the apoptotic rate in KBD 0.0250 - 0.2500 mg/L dose group [ ( 13.69 ± 0.02) %, ( 15.96 ± 0.03 ) %, ( 16.68 ± 0.03 ) %, ( 16.67 ± 0.02) % ]were lower, and the apoptotic rate in 0.5000, 1.0000 mg/L dose group [ (59.58 ± 0.03)%, (73.48 ± 0.04)% ] were significantly higher(all P ＜ 0.05). The Fas expression in KBD 0.0500 - 0.2500 mg/L dose groups[ (41.2 ± 1.5)%,(40.3 ± 2.0)%, (50.2 ± 2.5)%] were lower than those of the same dose control group with selenium intervention [(52.4 ± 1.0)%, (67.2 ± 4.0)%, (75.1 ± 5.0)%, all P ＜ 0.05], the caspase-3 expression in KBD 0.0500,0.1000 mg/L dose groups[ (40.8 ± 1.1 )%, (45.1 ± 2.1 )%] were lower than those of the same dose control group with selenium intervention[ (68.0 ± 3.0)%, (70.6 ± 3.5)%, all P ＜ 0.05 ]. Conclusions Appropriate dose of selenium supplementation (0.1000 - 0.2500 mg/L) could promote the growth of KBD chondrocyte, decrease cell apoptosis,but have a damage when the dose of selenium ＞ 0.5000 mg/L;doses of selenium that could promote the growth of KBD chondrocyte does not mean to promote the growth of normal cartilage cells in vivo.

Objective: To observe the clinical effect of Tongfu granules(通腑颗粒) on the gastro- intestinal dysfunction in patients with multiple organ dysfunction syndrome(MODS).Methods: The trial was prospective,multi-centric and clinically controlled.One hundred and forty patients with MODS who had been selected were randomly divided into two groups: mosapride citrate group and Tongfu granules group.Respectively at 0 hour,the 48 th hour,the 7 th day or before death, the following scoring systems were calculated: the intestinal dysfunction score,acute physiology and chronic health evaluationⅡ((APACHEⅡ)) score and Marshall score.The duration of mechanical ventilation,hospitalization in intensive care unit(ICU) and the prognosis within 28 days were recorded.Results: After treatments,the intestinal dysfunction score,(APACHEⅡ) score and Marshall score of all patients decreased,at the same time,the therapeutic effects of Tongfu granules group were more significant than those in mosapride citrate group(P20 scores.The mortality was elevated with the increased number of dysfunction organs.Conclusion: Tongfu granules can ameliorate the severity of the disease situation andimprove the prognosis of patients with MODS.

Objective To explore the changes of tumor necrosis factor-α (TNF-α),nuclear factor kappa B (NF-κB),free radical in brain tissue in newborn rats with hypoxic-ischemic brain damage(HIBD),to clarify the role of TNF-α,NF-κB,free radical in HIBD.Methods The 56 SD neonatal rats were randomly divided into control group and hypoxic-ischemic 6 h,12 h,24 h,48 h,72 h,7 d groups.The conventional method was used to establish HIBD model.The level of TNF-α was measured by enzyme-linked immumosorbent assay,NF-κB was detected by electrophoretic mobility shift assay.The neuron apoptosis was identified by flow cytometry.Superoxide dismutase(SOD),molondialdehyde (MDA),glutathione peroxidase(GSH-Px) were identified by spectrophotography.Results The rate of neuron apoptosis,the contents of TNF-α,NF-κB,MDA in brain tissue were significantly higher in 6 h,12 h,24 h,48 h,72 h groups than those in contral group(all P ＜0.05),and the apoptosis,MDA reached the peak at the 24 h after hypoxia,TNF-α reached the peak at the 12 h after hypoxia,NF-κB reached the peak at the 48 h after hypoxia.But the content of SOD and the activity of GSH-Px in hypoxic-ischemic group were significantly lower than those in control group at 6 h,12 h,24 h,48 h,72 h after hypoxia.And the rate of neuronal apoptosis was positively correlated with TNF-α,NF-κB and MAD (all P ＜ 0.05),negatively correlated with GSH-Px and SOD (all P ＜ 0.05),the contents of TNF-α,NF-κB were positively correlated with MAD (all P ＜ 0.05),negatively correlated with the content of SOD and the activity of GSH-Px (all P ＜ 0.05).Conclusions TNF-α,NF-κB,free radical are early changed after HIBD,So they play an important role in HIBD,inflammation and free radical can promote brain damage.

Primary mediastinal choriocarcinoma is a very rare malignant tumor unrelated to pregnancy. Here a case of primary mediastinal choriocarcinoma was reported. The patient was a 13-year-old boy. He presented with shortness of breath, chest pain, fever, irritable cough and weight loss. The imaging examination showed a huge space-occupying lesion at the right edge of mediastinum. The autopsy results showed right lung and mediastinal choriocarcinoma cell carcinoma. After the introduction of the case, this paper reviewed the clinical characteristics, diagnosis and treatment of primary mediastinal choriocarcinoma.
Adolescent ; Choriocarcinoma, Non-gestational ; diagnosis ; pathology ; therapy ; Diagnosis, Differential ; Humans ; Male ; Mediastinal Neoplasms ; diagnosis ; pathology ; therapy

OBJECTIVEBacterial meningitis is a kind of central nervous system infection with a high incidence, disability and fatality in children. Prompt diagnosis and treatment are associated with an improved prognosis. Low positive rate of bacterial cultures of the cerebrospinal fluid (CSF) makes it difficult to make a definite diagnosis. This experiment aimed to investigate a proteome profile of normal CSF of Chinese children by two-dimensional polyacrydamide gel electrophoresis (2-DE), and to sieve the disease-specific proteins of Staphylococcus epidermidis meningitis (SeM) to provide basis for early diagnosis and treatment of SeM.

METHODSFour mL CSF samples were obtained respectively from SeM and normal children. The separated proteins with immobile pH gradient (IPG) 2-DE technology and protein spots were visualized by Coomassie Brilliant Blue staining. The stained 2-DE gels were scanned on the Imagescanner and pictures were obtained through Labscan software. The images were analyzed with PDQuest software and the differences of protein spots were compared between the SeM and normal children.

RESULTSMean protein spots of the 2-DE gels were 438 and 425 in the SeM and normal groups respectively. Twenty-five protein spots only occurred in normal CSF and 12 spots only occurred in the SeM group. The expression of 6 protein spots showed up-regulation and that of 19 showed down-regulation in the SeM group compared with that in the normal group.

CONCLUSIONSA 2-DE profile of CSF proteome was successfully established in SeM and normal children through proteomic technique. By the differentiated analysis of these CSF 2-DE gels, the differences of CSF proteome profiles were found between SeM and normal children. Future analysis and identification of these spots will contribute to find out the disease specific proteins of SeM and to provide basis for early diagnosis and therapy of this disorder.

Cerebrospinal Fluid Proteins ; analysis ; Child ; Humans ; Meningitis, Bacterial ; cerebrospinal fluid ; Pilot Projects ; Proteomics ; Reagent Kits, Diagnostic ; Staphylococcal Infections ; cerebrospinal fluid ; Staphylococcus epidermidis

Hennekam syndrome (HS) is a rare autosomal recessive syndrome characterized by defective lymphatic development. A 34-month-old boy with HS and who had unexplained developmental retardation and hypoalbuminemia as main clinical manifestations is reported here. He had a history of generalized edema and poor feeding. He was not thriving well. He manifested as facial anomalies (hypertelorism, flat nasal bridge and flat face), fracture of teeth, and superficial lymph nodes enlargement. He had low serum total protein, low serum albumin, and low serum immunoglobulin levels. Duodenal bulb biopsy revealed lymphangiectasia. Color Doppler ultrasound, magnetic resonance imaging and CT scan showed multi-site lymphangioma, and HS was thus confirmed. Mutations in CCBE1 and FAT4 have been found responsible for the syndrome in a part of patients. Diagnosis of the disease depends on the familial history, clinical signs, pathological findings and genetic tests.
Child, Preschool ; Craniofacial Abnormalities ; diagnosis ; etiology ; therapy ; Genital Diseases, Male ; diagnosis ; etiology ; therapy ; Humans ; Lymphangiectasis, Intestinal ; diagnosis ; etiology ; therapy ; Lymphedema ; diagnosis ; etiology ; therapy ; Male ; Syndrome

OBJECTIVETo summarize the major pathological findings, causes of deaths and reasons for misdiagnosis of 141 autopsy cases and thereby to improve the diagnosis level and reduce misdiagnosis.

METHODA retrospective analysis of pathological reports and clinical materials of 141 pediatric autopsy cases from June, 1986 to June, 2006 of our department was performed. Classification was based on (1) international classification of diseases of the World Health Organization; (2) age: cases 28 d-3 years old were defined as infants and young children group, -7 yeas olds were defined as preschool age group, -14 years olds were school age group; (3) when statistics was conducted, the first 3 items of the clinical diagnoses were counted. If one of them was consistent with the pathological diagnosis, it was regarded as basically in accordance with the pathology, if none of the first 3 was consistent with pathological diagnosis, the case was regarded as misdiagnosed.

RESULTS(1) The top three major pathological diagnosis and causes of death were: 1) Classified according to system: 41 cases had tumor (29.1%), 25 cases had respiratory diseases (17.7%), 18 cases had infectious diseases (12.7%); 2) Classified according to disease: 18 cases had malignant histiocytosis, 12 cases had sepsis, 11 cases had lobular pneumonia. (2) The causes of deaths changed gradually. The top cause of death was respiratory diseases during the former 10 years and was tumor during the latter 10 years; the materials showed that 95 cases were 28 d-3 years old (67.4%), and some rare diseases, such as mediastinal and lung chorionic epithelioma (choriocarcinoma), and pulmonary alveolar proteinosis were found. (3) In 90 cases the clinical diagnosis was basically in accordance with the pathological diagnosis (63.8%) and misdiagnosis was found in 51 cases (36.2%).

CONCLUSIONFor clinical diagnosis of critically ill patients, both common and rare diseases should be considered. Analysis of autopsy materials could confirm and/or correct clinical diagnosis and is helpful to summarize clinical diagnosis experience.

Adolescent ; Autopsy ; statistics & numerical data ; Cause of Death ; Child ; Child, Preschool ; Diagnostic Errors ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Pathology, Clinical ; Retrospective Studies