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目的探讨尿微量蛋白和尿酶在过敏性紫癜(HSP)患儿早期肾损伤中的作用和临床意义。方法2004-10—2005-10在内蒙古医学院第三附属医院儿科和皮肤科住院的HSP患儿共43例,采用免疫散射比浊法和酶法测定患儿尿微量白蛋白(MA)、转铁蛋白(TRF)、β2微-球蛋白(β2-MG)和尿酶N-乙酰-β-D氨-基-葡萄糖胺酶(NAG)的水平,同时检测尿常规和血尿素氮(BUN)、肌酐(Scr)水平。结果HSP患儿尿4项指标明显高于对照组,4项指标异常率79.07%(34/43),尿常规异常率13.95%(6/43);37例尿常规正常者4项指标异常率达70.57%(28/37),且4项指标较单项指标异常发生率高。结论尿4项指标联合检测是诊断HSP早期肾损伤的灵敏指标,可作为临床早期诊断、早期干预治疗以降低肾损伤程度的可靠依据。     

CONGENITAL CATARACT SURGERY: A RETINAL SURGEON'S VIEWPOINT

Rhegmatogenous retinal detachments presenting many years after surgery for congenital cataracts frequently present formidable problems in management. de techniques and results of treatment are being presented and the implications for modern-day congenital cataract surgery are discussed.     

Early intrathoracic migration of Kirschner wires used for percutaneous osteosynthesis of a two-part humeral neck fracture: a case report

We present an unusual case of early migration of three Kirschner wires used for percutaneous osteosynthesis of a two-part humeral neck fracture, causing hemothorax. An 85-year-old woman was admitted to the emergency room after casual accident. She was found to have suffered a two-part fracture of the surgical neck of the right humerus. The humeral fracture was treated by closed reduction and percutaneous osteosynthesis with three threaded Kirschner wires, which were bent subcutaneously. Ten days after the accident the patient presented with dyspnea and laterocervical pain. Plain X-rays and complementary CT demonstrated intrathoracic migration of the three Kirschner wires with hemothorax. Two of the wires were seen under the right clavicle and adjacent to the C7 vertebra. The third wire reached the lateral chest wall. Immediate surgery was performed, with withdrawal of the wires and placement of a drainage tube. The patient had an uneventful recovery after surgery. The humeral fracture resulted in a nonunion, which was well tolerated by the patient and was left untreated. The use of Kirschner wires for osteosynthesis of proximal humeral fractures may cause significant thoracic morbidity, even if various prophylactic measures, including the use of threaded wires, subcutaneous bending, and close radiographic follow-up, are adopted. The use of Kirschner wires should anyway be restricted to carefully selected cases, in order to avoid major complications.     

Effect of maternal and neonatal interleukin-6 − 174 G/C polymorphism on preterm birth and neonatal morbidity

Objective: The aim of this study was to analyze maternal and neonatal interleukin 6 (IL-6) (?174?G/C) polymorphism and to determine effect on preterm birth and neonatal morbidity.

Study Design: One hundred and sixty-four mothers (100 term births, 64 preterm births) and 183 newborn infants who were 100 healthy term and 83 preterm babies followed in newborn intensive care units were evaluated. PCR-RFLP was performed for IL-6 (?174?G/C) genotyping.

Results: The rate of GG genotype in mothers of term and preterm infants were 54% (n?=?54/100), 75% (n?=?48/64), respectively (p?>?.05) and the rate of GC?+?CC genotype was 46% (n?=?46/100) and 25% (n?=?16/64) in mothers giving term and preterm birth (PTB), respectively (p?n?=?65/100) and 81.9% (n?=?68/83) in term infants and preterm infants, respectively. GC?+?CC genotype was 35% (n?=?35/100) in term infants and 18.1% (n?=?15/83) in preterm infants (p?Conclusion: The IL-6 174?G/C gene polymorphism was significantly different between mothers who were giving to term and preterm birth. The presence of polymorphism is protective against preterm birth and was not associated with neonatal outcome.