ObjectiveTo study the clinical significance of color Doppler ultrasound in the diagnosis of intussusception in children. MethodsWe retrospectively analyzed the color Doppler ultrasound results of 150 children with intussusception confirmed by X-ray air enema and surgery between January 2010 and December 2012. ResultsThe 150 children included 18 cases of necrosis, and 132 cases of simple edema; there were 122 cases of ileocecal intussusception, 22 cases of colon, and 6 of small intestine. Surgical treatment was performed for 30 cases, and 120 cases were treated with X-ray air enema reduction. Ultrasonic diagnosis was correct in 144 cases with an accurate rate of 96.0%; 6 cases were misdiagnosed, and misdiagnosis rate was 4.0%. ConclusionUltrasound in the diagnosis of children intussusception is simple, rapid, non-invasive, with no side-effects of radiation exposure, and selection of this method clinically has a very important significance.
Objective To observe the neuroprotective effect of alpha;-lipoic acid (ALA) on cultured retinal ganglion cells (RGC-5) under elevated pressure in vitro. Methods Cultured RGC-5cells were divided randomly into 4 groups, including normal control group (group A), negative control group (group B), elevated pressure group (group C) and elevated pressure + ALA group (group D). The cells of group A and C were not intervened with ALA. The cells of group B were treated with 200 mu;mol/L ALA. The cells of group D were treated with different concentrations of ALA (50, 100, 200 mu;mol/L) for one hour. Then cells of group C and D were exerted to 50 mm Hg (1 mm Hg=0.133 kPa) for 24 hours, while the cells of group A and B were exerted to normal pressures for 24 hours. The cell viability was measured using the methyl thiazolyl tetrazolium (MTT) assay and apoptosis was evaluated using 4prime;,6-diamidino-2-phenylindole (DAPI) staining. Expression of MnSOD was determined by realtime polymerase chain reaction (RT-PCR) and Western blot, respectively. Results The cell viability of group B was (65.6plusmn;3.4)%, which lower than that in group D of three concentrations of ALA［(75.1plusmn;3.3)%, (81.8plusmn;2.9)%,(87.9plusmn;3.1)%］, the differences were significantly (t=5.108, 10.007, 12.513;P＜0.05). DAPI staining revealed that characteristic apoptotic changes, such as chromatin condensation,convoluted nuclei with cavitations, fragmentation of the nucleus, and apoptotic bodies appeared in RGC-5cells after 24 ours pressure. There was almost no evidence of apoptosis in group D. RT-PCR and Western blot analysis revealed that the expression of MnSOD mRNA and protein were weakly expressed in group C compared with control A (t=22.045，26.979;P＜0.01). Compared group C with group D, the level of MnSOD mRNA and protein in group D increased significantly (t=9.171, 12.267, 23.567, 7.723, 12.009, 28.198;P＜0.05).In addition, the presence of ALA was found to inhibit hydrostatic pressure induced damage of RGC-5cells in a dose-dependent manner (F=134.273,194.597;P＜0.01). Conclusion ALA can effectively improve the expression of MnSOD in RGC-5cells under the condition of elevated pressure, enhance the ability of RGC-5cells against oxidative damage.
目的 探讨静脉留置针封管用肝素诱导的血小板减少症（HIT）的临床特点。 方法 分析2010年1月－2011年12月，在1 215例静脉留置针肝素封管患者中发生的14例HIT患者的临床表现，血小板（PLT）、HIT抗体的变化，氯吡格雷、阿加曲班、地塞米松等治疗的结果。 结果 1 215例患者中：发生HIT 14例，发生率1.15%；HIT并血栓形成综合征4例，发生率0.33%。14例HIT患者中：经典型12例，占85.7%。出血7例，发生率50.0%，其中1级、2级出血发生率分别为42.9%（6/14）、7.1%（1/14），分别占出血的85.7%（6/7）、14.3%（1/7）。血栓形成4例，发生率28.6%，其中静脉血栓3例，占血栓形成的75.0%。14例均发生于肝素封管后第1～14天，其中第6～7天8例，占57.1%。PLT降低到最低值的时间为肝素封管后2～10 d内，其中2～5 d内13例，占92.9%。PLT降低的最低值为（1.81～101）×109/L，其中PLT（20～70）×109/L12例，占85.7%；PLT降至最低时下降的比值为51.1%～90.1%，其中50%～80%10例、占71.4%。1例至28 d死亡时血小板没有恢复至肝素封管前水平，其余13例患者PLT减少持续时间5～13 d，其中5～10 d 10例，占76.9%。14例（100%）HIT患者HIT抗体阳性，其中13例（92.9%）在PLT开始减少时即阳性，1例在PLT减少2周后呈阳性。14例HIT患者中12例（85.8%）痊愈，1例（7.1%）脑血栓后遗症，1例（7.1%）死于急性肺栓塞。 结论 静脉留置针封管用肝素可导致HIT，PLT减少及血栓、HIT抗体是诊断的可靠依据。及时停用肝素，必要时抗凝、抗PLT、类固醇激素治疗效果好，部分患者进展快，死亡率高。