436例小儿肺炎的中西医结合治疗

对436例肺炎患儿在抗生素治疗的同时，给予清热宣肺，化痰平喘，健脾益气，养阴清肺中药口服，结果总有效率达97．25％。中西医结合治疗小儿肺炎可以缩短病程，减少抗生素的使用。     

儿童非霍奇金淋巴瘤与p53蛋白表达的关系

目的探讨儿童非霍奇金淋巴瘤 (NHL)与p53蛋白表达的关系。方法用免疫组化En vision法检测 64例 (惰性淋巴瘤 8例 ,侵袭性淋巴瘤 42例 ,高度侵袭性淋巴瘤 1 4例 )NHLp53蛋白 ,根据p53蛋白阳性细胞百分率将表达水平分为 4级 :0级 (阴性 ) ,1级 (1 %～ 2 5 % ) ,2级 (2 6 %～ 50 % ) ,3级 (>50 % )。结果惰性淋巴瘤组 7 8(87 5 % )p53表达为 0级 ,侵袭性淋巴瘤组 36 42 (86 1 % )表达为1级 ,高度侵袭性淋巴瘤组 1 1 1 4 (78 6 % )表达为 2～ 3级 ,儿童NHL蛋白表达水平与其侵袭性密切相关 (P <0 0 1 )。 2 5例随访 7～ 68个月 ,p53 0～ 1级NHL完全缓解率 (CRR ,1 1 1 4 )高于p53 2～ 3级NHLCRR(1 1 1 ,P <0 0 1 ) ,前者生存率 (1 3 1 4 )高于后者 (3 1 1 ,P <0 0 1 )。结论p53蛋白表达阳性细胞百分率是判断NHL恶性度、疗效及预后较可靠的参数。肿瘤性p53蛋白表达检测对中高度恶性儿童NHL的诊断有参考价值     

Specific and nonspecific lymphadenitis in childhood: etiology, diagnosis, and therapy

Over a period of 4 years, 39 children with lymphadenitis were treated surgically; in 31 cases cervical lymph nodes were the main location. In 9 cases the lymphadenitis was caused by mycobacterial infection.Staphylococcus aureus was the most frequent causative organism of unspecific lymphadenitis (11 cases). The therapy of choice appears to be surgical treatment and medical care after operation. Especially in mycobacterial lymphadenitis, complete surgical excision of the lymph node is decisive for definitive healing. There was only 1 case of therapy-resistant, relapsing cervical lymphadenitis that needed a second operation. Causative organisms in this case wereMycobacterium avium andMycobacterium intracellulare. All other patients showed an uneventful postoperative clinical course. We believe that a consequent diagnostic process and cooperation between the pediatric surgeon and pediatrician are necessary for effective therapy.     

Aggregation of childhood leukemia in geographic areas of Greece)

A total of 872 children aged up to 14 years, who were diagnosed withleukemia in Greece during the decade 1980-89, were allocated by place ofresidence to the 601 administrative districts of the country. Evaluation ofspatial clustering was done using the Potthoff-Whittinghill method, whichvalidly assesses heterogeneity of leukemia risk among districts with variableexpected numbers of cases. There was highly significant evidence for spatialclustering occurring particularly among children living in urban and, to alesser extent, semi-urban areas. The evidence was stronger for childrenyounger than 10 years old, applied also to children in different five-yearage groups, and persisted when cases of acute lymphoblastic leukemia wereanalyzed separately. These findings provide support to the hypothesis thatlocalized environmental exposures could contribute to the etiology ofchildhood leukemia, but they cannot distinguish between exposures of physicalor chemical nature, nor can they exclude socially conditioned patterns ofexposure to infectious agents.     

Surgical Treatment of Aortic Root Aneurysm Related to Marfan Syndrome in Early Childhood

The prognosis of Marfan syndrome in both adult and pediatric patients is primarily related to the cardiovascular complications. In infantile Marfan syndrome, although involvement of the mitral valve is the most frequently encountered cardiovascular lesion, the aortic root can be more worrisome because of its excessive dilatation, leading to aortic insufficiency or dissection. If the role of elective surgery is relatively well defined for adult patients, it is still debated during childhood. We report two patients, aged 22 months and 5 years, each presenting an aortic root aneurysm related to Marfan syndrome, and each treated with the Bentall procedure without specific age-related mortality or morbidity. These two patients experienced normal growth and were free of any complication for a follow-up period of 8 and 2 years, respectively. More than an absolute value of the aortic root dimension, it is the conjunction of the rate of progression of the aortic root dilatation, the degree and the duration of the aortic valve regurgitation, and its resulting left ventricular dysfunction that must be taken into consideration in choosing the surgical option.     

Physical performance in long-term survivors of acute leukaemia in childhood

The aim of this study was to assess the physical performance in long-term survivors of acute leukaemia in childhood and to evaluate the effects of anthracycline therapy. Electrocardiography, echocardiography and spiroergometry were carried out on 56 patients aged 9–28 years, of whom 44 patients had been treated with 15–483 mg/m² doxorubicin (or equivalent). Acute leukaemia had been diagnosed 1.5–16 years earlier. Of the patients 75% reached normal maximal oxygen uptake, 69% normal oxygen uptake at the anaerobic threshold and 95% normal maximal work rate. Of the patients 75% achieved adequate values for maximal heart rate and 78% normal blood lactate concentration. No difference was seen between patients treated with and without anthracyclines. Conclusion The results of this study provide little evidence for cardiopulmonary impairment in long-term survivors of ALL. Both the cardiac function, as evaluated by ECG and echocardiography, and the physical performance in spiroergometry are normal in a large number of these patients. Anthracycline treatment does not appear to have a negative effect on these parameters. Received: 30 October 1996 / Accepted in revised form: 7 October 1997     

石家庄市学龄儿童超重、肥胖与血压、血脂和血糖的关系

目的探讨城市学龄儿童超重、肥胖与血压、血脂和血糖等心血管疾病危险因素的聚集性。方法采用多阶段分层抽样，测定石家庄市区913名7～13岁儿童的身高、体重、收缩压（SBP）、舒张压（DBP）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）和空腹血糖水平。结果儿童超重和肥胖总检出率为29．24％（男34．98％，女24．23％）。与正常儿童相比，超重和肥胖儿童的SBP、DBP、TC和TG水平明显升高，HDL-C明显降低。超重和肥胖儿童的高血压、高TG、高TC、高血糖和低HDL-C检出率也明显高于正常儿童。校正年龄和性别后，超重和肥胖儿童的SBP、DBP、TC、TG、血糖升高和HDL-C降低的危险性分别为正常儿童的6．77、3．22、2．55、6．42、3．85和2．94倍（95％CI分别是4．15～11．04、1．38～7．49、1．59～4．11、3．46～11．92、1．69～8．78和1．83～4．73）；超重与肥胖儿童有任意1、2、3个所选心血管疾病危险因素的危险性分别是正常儿童的2．74、13．15和15．33倍（95％CI分别是1．92～3．92、6．69～25．87和4．17～56．39）。结论儿童期超重与肥胖增加儿童心血管疾病危险因素的聚集性以及儿童获得多个心血管疾病的危险性。控制儿童超重和肥胖有助于心血管疾病的早期预防。     

The impact of childhood epilepsy on neurocognitive and behavioral performance: a prospective longitudinal study

PURPOSE: To assess neurocognitive and behavioral performance in children with idiopathic epilepsy (CWE, n = 74), their siblings without epilepsy (control, n = 23), and children with migraine (CWM, n = 13), and to identify medical factors related to learning or behavioral problems in CWE. METHODS: Subjects, ages 8-13 years with IQs of >/=80, completed a neurocognitive test battery annually for 相似文献   

Spinal Papillary Meningioma: A Case Report and Review of the Literature

Summary  A rare case of a spinal papillary meningioma in a 19-year-old adolescent is described. Six months after radical resection the patient showed dissemination along the cerebrospinal pathway. Papillary meningiomas are rare tumours with a relatively high incidence in childhood. Most papillary meningiomas reported in the literature are considered as aggressive variants of meningioma with often local recurrence, dissemination in the CSF and metastases to remote sites. This case supports that, although the histogenesis remains unexplained, papillary meningiomas deserve recognition on the basis of their high morbidity and mortality.     

Socioeconomic status and prevalence of allergic rhinitis and atopic eczema symptoms in young adolescents

Environmental factors are known to influence the development of allergic rhinitis and atopic eczema in genetically susceptible individuals. Socioeconomic status (SES) may be an important indicator of risk for these conditions. The International Study of Asthma and Allergies in Childhood (ISAAC) Phase 1 written questionnaire was used to determine the prevalence and severity of allergic rhinoconjunctivitis and atopic eczema symptoms in 4947 pupils aged 13-14 years attending 30 schools in socioeconomically diverse areas of Cape Town. Home addresses were used to stratify participants into five SES bands. Relationships between symptom prevalence and severity, and SES, recent urbanization and upward socioeconomic mobility were examined. Logistic regression was used to generate odds ratios (OR) and 95% confidence intervals (CI) in order to assess overall trends by SES. The prevalences of self-reported allergic rhinitis symptoms and recurrent itchy rash in the past year were 33.2% and 11.9% respectively. Girls had a significantly higher prevalence of all symptoms than boys. The prevalence of allergic rhinitis symptoms increased from lowest to highest SES (overall OR for rhinitis symptoms in past year = 1.16, 95% CI 1.11-1.21). There was no significant trend in reported eczema symptoms by SES other than for the question, 'Have you ever had eczema' (OR = 0.88, 95% CI 0.83-0.93). Longer period of urbanization was weakly associated only with recurrent itchy skin rash (OR = 1.05, 95% CI 1.01-1.09). 'Socially mobile' pupils, i.e. those resident in the lowest SES areas but attending highest SES schools showed significantly higher prevalences of eczema and some rhinitis symptoms than pupils attending lowest SES schools. These findings may reflect differences in reporting related to language, culture and access to medical care rather than real differences in prevalence.