RÉSUMÉ
Objective To investigate the effect of B7-H3 protein,a collaborative signal molecule,on macrophage-inflammatory protein 2 (MIP-2) mRNA level in Streptococcus pneumococcal meningitis mouse models.Methods Forty-eight healthy male BALB/C mice at the age of 1.5-2.0 months were randomly divided into 4 groups:9 g/L saline group(NS group),B7-H3 protein group(B7-H3 group),Streptococcus pneumoniae group(SP group),and Streptococcus pneumoniae plus B7-H3 protein group(combination group),12 mice in each group.Mouse models were established by intracerebral ventricular injection with 9 g/L saline,B7-H3 protein,Streptococcus pneumoniae type 3 or Streptococcus pneumoniae type 3 plus B7-H3 protein.Neurobehavior of different groups was evaluated according to loeffler rule after injection for 6 h and 24 h,then the mice were sacrificed and MIP-2 mRNA levels were tested by Real-time PCR.The results were analyzed by SPSS 18.0 software.Results Neurobehavior scoring results showed that there were no significant differences between B7-H3 group and NS group (P > 0.05) after infection for 6 h and 24 h,while the score of SP group was decreased compared with that of NS group (P < 0.05),and the score of combination group was significantly decreased compared with that of SP group (P < 0.05).Real-time PCR results showed that,compared with the NS group,the relative MIP-2 mRNA level in SP group increased after injection for 6 hours (1.210 ±0.932 vs 1.000 ± 0.008),but the difference was not significant (P > 0.05),while at 24 h post infection,the relative MIP-2mRNA expressions in SP group were significantly increased compared with that of NS group(12.880 ± 7.792 vs 1.000 ±0.091),the difference was significant (P < 0.05).At 6 h post infection,SP + B7-H3 treatment enhanced the MIP-2mRNA production compared to SP infection alone,but the difference was not significant [(1.240 ± 0.804) vs (1.210 ± 0.932)] (P > 0.05) ; while at 24 h post infection,the difference was significant (38.760 ± 6.601 vs 12.880 ± 7.792) (P < 0.05).Conclusion Collaborative signal molecule B7-H3 protein may increase MIP-2 mRNA level in Streptococcus pneumococcal meningitis mouse model,and exaggerate the clinical disease condition.
RÉSUMÉ
Objective To explore the surgical treatment of refractory cerebrospinal fluid rhinorrhea with recurrent bacterial meningitis.Methods The clinical data of 1 case of a 10-year-old boy who had 9 episodes of bacterial meningitis and underwent 4 surgical repair procedures for congenital cerebrospinal fluid rhinorrhea at the Children's Hospital Affiliated to Soochow University were analyzed,and the related literatures were reviewed.Results During the intervals of 9 episodes of bacterial meningitis,the patient experienced 4 neurosurgical repairs of cerebrospinal fluid rhinorrhea,including 2 endoscopic repairs via the lateral nasal cavity,a craniotomy approach repair via forehead epidural,and an endoscopic repair in combination with a ventriculo-peritoneal shunt.The first 3 surgeries were all failed,but the final surgery was successful,with no recurrence of cerebrospinal fluid rhinorrhea or bacterial meningitis in 3.5 years of follow-up.Conclusions For recurrent meningitis and refractory cerebrospinal fluid rhinorrhea,the ventriculo-peritoneal shunt can be considered in addition to conventional nasal endoscopic cerebrospinal fluid repair to eliminate the increased cerebrospinal fluid attributable to long-term chronic compensation,and effectively reduce postoperative intracranial hypertension to make the operation success.