A亚型呼吸道合胞病毒毛细支气管炎的临床研究

目的 了解呼吸道合胞病毒（ＲＳＶ）的亚型感染情况及其所致毛细支气管炎的临床特征。方法 （１）对１９９５年冬￣１９９７年春住院的８５例临床拟诊为毛细支气管炎的患儿进行鼻咽分泌物病毒培养、抗原检测及ＲＳＶ阳性分离株的单克隆抗体间接免疫荧光法亚型鉴定;（２）分析亚型感染病例的临床资料。结果 （１）共培养出ＲＳＶ２２株,阳性率为２６％,经鉴定全部为Ａ亚型株;（２）２２例Ａ亚型ＲＳＶ毛细支气管炎中幼婴（１￣     

我国流行性喘憋性肺炎呼吸道合胞病毒分离株F蛋白基因特征初探

目的 探讨流行性喘憋性肺炎（简称流喘肺炎）与散发肺炎呼吸道合胞病毒（ＲＳＶ）分离株Ｆ蛋白的异同。方法 采用ＰＣＲ片段直接测序及克隆测序。对１１株流喘肺炎ＲＳＶ分离株及５株散发肺炎ＲＳＶ分离株Ｆ蛋白基因序列进行了分析比较,结果 被检测流喘肺炎ＲＳＶ分离株中３６％（４／１１）的毒株其Ｆ蛋白基因３′非编码区（３′－ＮＣＲ）（第１７４１位核苷酸）存在６个核苷酸插入,而散发肺炎ＲＳＶ分离株均无此插入存在。结     

我国部分地区呼吸道合胞病毒分离株的亚型鉴定

为了解我国部分地区呼吸道合胞病毒（ＲＳＶ）的亚型分布情况，采用单克隆抗体和免疫荧光技术，对近年来从北京、广州、南京、长春、和ＲＳＶ感染爆发流行的津冀地区分离出的共１００株ＲＳＶ进行了亚型鉴定。结果：其中９７株为Ａ亚型，３株为Ｂ亚型。提示：近年来这些地区无论是南方还是北方流行的ＲＳＶ主要为Ａ亚型；津冀地区流行性喘憋性肺炎的爆发流行也与Ａ亚型有关。     

哮喘儿童呼吸道合胞病毒感染后血清抗F和抗G蛋白特异性IgG抗体？…

目的 探讨血清抗呼吸道合胞病毒（ＲＳＶ）抗Ｆ和抗Ｇ蛋白ＩｇＧ抗体水平与哮喘儿童ＲＳＶ感染及感染后病情轻重的关系。方法 以ＲＳＶ（Ｌｏｎｇ株）及表达ＲＳＶ Ｆ和Ｇ蛋白的重组痘苗病毒为抗原，采用酶联免疫吸附试验，检测了６６例６岁以下哮喘患儿ＲＳＶ流行期间双份血清中抗ＲＳＶ Ｆ和Ｇ蛋白特异性ＩｇＧ抗体水平。结果 （１）本组哮喘患儿ＲＳＶ感染率为３５％；（２）ＲＳＶ感染组哮喘患儿血清抗Ｆ和Ｇ蛋白ＩｇＧ抗体     

应用逆转录聚合酶链反应鉴别呼吸道合胞病毒亚型

目的为了使鉴别呼吸道合胞病毒（ｒｅｓｐｉｒａｔｏｒｙｓｙｎｃｙｔｉａｌｖｉｒｕｓ，ＲＳＶ）Ａ、Ｂ亚型的方法更为简单、特异、有效。方法根据ＲＳＶＧ蛋白编码基因的核苷酸序列设计一套引物，其中Ｐ１为亚型间通用的引物，Ｐ２和Ｐ３分别为Ａ、Ｂ亚型特异性引物。将这些引物用于同一逆转录聚合酶链（ＲＴＰＣＲ）反应，Ａ、Ｂ亚型株的扩增产物分别为２７７ｂｐ和８６３ｂｐ，根据ＰＣＲ产物的大小即可鉴别所测毒株的亚型。用这一方法对ＲＳＶ原型株和９株我国分离株进行亚型鉴定。结果分离株８株为Ａ亚型，１株为Ｂ亚型，分型结果与单克隆抗体检测和基因序列分析完全相符。结论ＲＴＰＣＲ方法鉴别呼吸道合胞病毒亚型具有快速、简便、敏感、特异等特点，适用于ＲＳＶ临床标本的亚型分型及流行病学研究     

流行性喘憋性肺炎病原与合胞病毒抗原亚型的研究

1992年春河北省发生了一次婴幼儿流行性喘憋性肺炎(简称流喘肺炎)的暴发流行。流行波及7个地区,40余个县,住院患儿逾万例。我们于1992年1月7～17日从13个(市)县医院采用床边接种分离患儿咽拭子标本69例,成功地分离到18株呼吸道合胞病毒(RSV),阳性率为26.1％。经8株RSV亚型特异性单克隆抗体鉴定均属RSVA亚型。67例患儿单份血清经ELISA检出RSV IgM阳性22例,阳性率为32.8％。研究结果不仅为国内首次直接从流行现场分离到RSV,而且也是国内首次对导致流喘肺炎的RSV进行了抗原分型,这为今后进一步对RSV防治研究提供了依据。     

呼吸道合胞病毒感染的防治

呼吸道合胞病毒（ｒｅｓｐｉｒａｔｏｒｙ ｓｙｎｃｙｔｉａｌ ｖｉｒｕｓ，ＲＳＶ）属副粘病毒科，肺炎病毒属。１９５６年Ｍｏｒｒｉｓ从一只有“感冒”症状的实验动物黑猩猩的鼻咽分泌物中分离出第一株。１９５７年Ｃｈａｎｏｃｋ先后从ＢＡＬＴＩＭＯＲＥ市两名分别患肺炎和有喘息症状患儿的咽拭子中分离到。因其在组织培养中能形成特殊的细胞融合病变而得名。ＲＳＶ是婴幼儿下呼吸道感杂的最主要病原体，２～６个月发病率最高。早产、先天性心脏病、肺发育不良等是致危的主要因素。ＲＳＶ感染不仅可诱发哮喘，而且与病情的加重有关。 …     

小儿单纯疱疹病毒性肺炎51例报告

对广州地区２５７２例肺炎患者进行了病毒分离，分出单纯疱疹病毒－Ｉ型（ＨＳＶ－１）５１例，阳性率２％，其中１例从尸解肺组织分离出来。从５１例ＨＳＶ－１患儿中取回１７例双份血清，ＨＳＶ－１ＩｇＧ阳性９例，血清试验阳性率为５２．３％，正常对照组２８６例儿童中ＨＳＶ－１阳性７例，其中３例取到双份血清，无１例抗体阳性。     

合胞病毒感染后血清中抗F和G蛋白特异性IgG抗体反应

为深入了解婴幼儿呼吸道合胞病毒（ＲＳＶ）感染后特异性保护抗体的反应，探明ＲＳＶ感染后血清保护性抗体的类型及其相互关系；以表达呼吸道合胞病毒（ＲＳＶ）Ｆ和Ｇ蛋白的重组痘苗病毒为抗原，用间接免疫荧光法检测３３例ＲＳＶ感染后婴幼儿双份血清中抗ＲＳＶ的Ｆ和Ｇ蛋白特异性ＩｇＧ抗体反应。结果表明，１岁以内婴幼儿ＲＳＶ感染后，血清中Ｆ和Ｇ蛋白特异性ＩｇＧ抗体有不同程度的升高，但Ｇ蛋白特异性ＩｇＧ抗体反应明显低于Ｆ蛋白；１岁以后，机体对ＲＳＶ感染的抗Ｆ和Ｇ蛋白特异性ＩｇＧ抗体反应较１岁以前明显增强。说明婴幼儿ＲＳＶ感染后，机体抗ＲＳＶ的Ｆ和Ｇ蛋白特异性ＩｇＧ抗体反应受年龄因素的影响，尤其以Ｇ蛋白更为显著。     

小剂量α-干扰素降低呼吸道合胞病毒感染后哮喘患病率的研究

呼吸道合胞病毒 (ＲＳＶ)是引起婴幼儿严重下呼吸道感染的重要病原之一 ,并与儿童哮喘关系密切 ,不仅能诱发哮喘 ,且与哮喘的病情加重有关。为寻找降低ＲＳＶ感染后哮喘患病率的有效方法 ,我科从１９９４年至１９９８年对ＲＳＶ感染患儿应用小剂量α -干扰素治疗 ,疗效明显 ,现报道如下。资料与方法一、对象全部病例均为我院住院患儿 ,经鼻咽部分泌物免疫荧光ＲＳＶ检测或血清特异性ＲＳＶ＿ＩｇＭ阳性者。随机分为观察组和对照组 ,观察组６０例 ,男３６例 ,女２４例 ,年龄１月～２岁３月 ;对照组５５例 ,男２８例 ,女２７例 ,年龄１月～２…     

Cost-Utility Analysis of Neonatal Screening Program,Shiraz University of Medical Sciences,Shiraz, Iran, 2010

Objective

The most important cause of infant mortality during the first month of life is related to congenital abnormalities. Nevertheless, timely diagnosis of these diseases can reduce the severity of their effects. The present study aimed to investigate the cost-effectiveness of the neonatal screening program in Fars Province, Iran.

Methods

In this study, costs of executing the screening programs, treatment of the diagnosed cases, treatment of affected, non-screened individuals, quality of life, and incremental cost-effectiveness ratios were measured in two study groups.

Findings

Performing the screening programs for phenylketonuria, congenital hypothyroidism, galactosemia, and favism resulted in respectively $3386, $13078, $19641, and $1088 saving per patient. Overall, the study results revealed the cost-effectiveness of execution of the neonatal screening program.

Conclusion

Neonatal screening program is one of the health interventions which lead to long-term beneficial outcome for the patients, financial saving for the society, and improvement of the patients’ quantity as well as quality of life.     

Human milk supplementation. Delivery of energy, calcium, phosphorus, magnesium, copper, and zinc

Human milk when fed to preterm infants is frequently supplemented with human milk fortifiers that provide an additional source of protein, energy, and minerals. Human milk that was provided by the mother of a preterm infant, and that was supplemented with commercially available human milk fortifiers, was assessed under simulated syringe-pump and bolus feeding circumstances for the delivery of energy, calcium, phosphorus, copper, magnesium, and zinc to an infant. In general, the nutrients were not completely delivered with syringe-pump feedings, with the greatest losses occurring in the concentrations of calcium and phosphorus. The losses were more pronounced with the use of a powdered fortifier than with the use of a liquid fortifier. Little or no change in the concentrations of the various nutrients were observed with simulated bolus feeding. We suggest that human milk fortified with supplements be fed with care to assure complete delivery of the nutrients and that infants receiving such feedings be monitored to assure adequate nutritional status.     

Serum protein binding of diazepam, desmethyldiazepam, furosemide, indomethacin, warfarin, and phenobarbital in human fetus, mother, and newborn infant

The protein binding of diazepam, desmethyldiazepam, furosemide, indomethacin, warfarin, and phenobarbital in maternal and fetal cord serum at the time of birth, and in serum of neonates between 1 and 11 days of age was studied. The protein binding of diazepam and desmethyldiazepam was higher in the fetus than in the mother, thus explaining the fetal cumulation of these drugs in vivo. After birth, both drugs were partially displaced from neonatal binding sites. The decreased protein binding capacity in the mother and the neonate related to increased free fatty-acid levels. The pattern of protein binding of warfarin in the groups investigated was a mirror image of those of diazepam and its metabolite. The protein binding of indomethacin progressively decreased in the neonate during the first two postnatal weeks, while that of furosemide remained at lowered levels throughout this time interval. The protein binding of phenobarbital was similar in the groups investigated. Our results suggest that drugs such as diazepam, which can be displaced from binding sites by free fatty acids, may cumulate in the fetus and may exhibit much decreased protein binding and possibly unexpectedly strong effects in the neonate after birth.     

Effect of lactate, pyruvate, acetone, acetoacetate, and beta-hydroxybutyrate on albumin binding of bilirubin

Lactate, pyruvate, acetone, acetoacetate, and beta-hydroxybutyrate were tested for their bilirubin-displacing effect on human serum albumin. Only lactate had a significant effect at levels found in asphyxiated infants (up to 20 mM). The reserve albumin equivalent for binding bilirubin was determined, using the deputy ligand monoacetyldiaminodiphenyl sulfone (MADDS), in adult human serum albumin solution, neonatal serum, and neonatal albumin solution. Twenty mM lactate caused a 23% decrease of reserve albumin when adult albumin was used, but did not cause any change of binding when neonatal serum or neonatal albumin solution was used. It is unlikely that endogenous substances, acting as competitive ligands, cause the low binding affinity of albumin for bilirubin in sick, premature infants.