ABSTRACT
Objective:To investigate the clinical features of adenoviral encephalitis (AE), and to provide reference for clinical diagnosis and treatment of adenoviral encephalitis.Methods:From January 2012 to December 2020, 1 185 cerebrospinal fluid (CSF) samples of hospitalized children with suspected central nervous system infection in the Second Affiliated Hospital of Shantou University Medical College were collected for the detection of 22 common respiratory pathogens and common pathogens for encephalitis by polymerase chain reaction. Records of patients with adenovirus positive in CSF were reviewed and relevant clinical manifestations, laboratory tests and imaging examination results were collected for analysis.Results:Among 1 185 CSF samples, 242 samples were positive for viral nucleic acid, with detection rate of 20.4%, including 1.9%(23/1 185) of adenovirus. As for 23 children diagnosed with AE, 18 were male, five were female, with the age of (44.8±35.9) months, ranging from two months and 19 days to 10 years. Of 23 children, 21(91.3%) presented with fever, followed by convulsions (16 cases, 69.6%), headache (four cases, 17.4%), vomiting (11 cases, 47.8%), consciousness change (11 cases, 47.8%) and emotion disturbance (three cases, 13.0%). Among 23 children, eight cases had white blood cell counts (WBC) of (6 to <10)×10 9/L, 10 cases had WBC of (10 to 20)×10 9/L and the white blood cell classification was mainly neutrophils (21 cases, 91.3%), and C reactive protein of 20 cases (87.0%) was in the normal range. Cerebrospinal fluid examination showed that WBC were less than 15×10 6/L in 20 cases (87.0%), and WBC ≥15×10 6/L in three cases, which were up to 500×10 6/L; the protein of 19 cases was in the normal range, the glucose of 15 cases was in the normal range, and the chloride of 19 cases was in the normal range. Among 16 cases with brain magnetic resonance imaging examination, eight cases did not show abnormality, six cases with local meningeal linear enhancement, one case with small intracranial malacia, and one case with extensive intracranial lesions. For 13 cases who received electroencephalogram (EEG) test, seven cases showed normal EEG or marginal state, four cases showed extensive medium and high amplitude slow wave, one case showed spike wave or spike slow wave and one case had both of the above two changes. Among 23 children, 22 cases recovered including one case had secondary epilepsy, and the remaining one case had severe brain dysfunction and was unable to suck when discharged, with an indwelling gastric tube and accompanied by secondary epilepsy. Conclusions:The clinical manifestations and auxiliary examinations of children with AE have no obvious specificity. Most children with AE have a good prognosis, but a small number of them may have serious sequelae.
ABSTRACT
Objective To discuss of the therapeutic effects of treating three TCM types of Chronic superficial gastritis (CSG)disharmony of liver and stomach, weakness of the spleen and the stomach, and damp heat in the spleen and the stomach with chinese medicine, and to discuss its impact on the changes of three gastrointestinal hormones-- motilin (MTL), gastrin (GAS), and somatostatin (SS). Methods The data of 150 CSG patients in Shenzhen Bao’an Hospital from Feb, 2011 to Mar, 2013 were selected. These patients belonged to three kinds of syndrome, which was disharmony of liver and stomach, weakness of the spleen and the stomach, and damp heat in the spleen and the stomach, each syndrome had 50 cases. Different Chinese medicines were applied to different syndrome of patients. After one month treatment, the therapeutic effects and the changes of MTL, GAS, SS in these patients were detected by radioimmunoassay. Results After treatment, the total effective rate of the damp heat in the spleen and the stomach syndrome was 94%, the weakness of the spleen and the stomach type was 88%, disharmony of liver and stomach type was 90%, the difference was not statistically significant among the three types(χ2=3.84, P>0.05);after treatment, the serum MTL, SS level of disharmony of liver and stomach, weakness of the spleen and the stomach, and damp heat in the spleen and the stomach type were [damp heat in the spleen and the stomach type were (240.25±7.29)pg/ml, (68.23± 5.97)pg/ml;the weakness of the spleen and the stomach type were (260.16±8.84)pg/ml, (75.35±4.65)pg/ml;disharmony of liver and stomach type were(258.32±15.23)pg/ml, (80.12±7.88)pg/ml] higher than before treatment [damp heat in the spleen and the stomach type were (87.26±7.58)pg/ml, (49.34±4.93)pg/ml;the weakness of the spleen and the stomach type were (67.11±7.81)pg/ml, (57.15±5.11)pg/ml; disharmony of liver and stomach type were (89.26±7.60)pg/ml, (40.63±7.26)pg/ml], and the levels of serum GAS [(156.38±17.36)pg/ml, (146.15±15.56)pg/ml, (140.26±13.37)pg/ml] was lower than before treatment [(274.59 ± 17.82)pg/ml, (320.83 ± 15.02)pg/ml, (216.15 ± 13.77)pg/ml], the difference was statistically significant (P<0.05 or 0.01). Conclusions The changes of three hormones-MTL, GAS, SS can be used as an objective basis for the diagnosis and the judgment of healing efficacy of CSG treated by traditional Chinese medicine.