小儿复方氨基酸和锌佐治小儿难治性腹泻疗效分析

目的：探讨小儿复方氨基酸和锌佐治小儿难治性腹泻的临床效果。方法100例小儿难治性腹泻患儿，随机分为实验组与对照组，各50例。对照组患儿给予常规腹泻对症治疗，实验组患儿在对照组的基础上注射小儿复方氨基酸和口服葡萄糖酸锌口服液联合治疗，比较两组的临床疗效。结果实验组总有效率92%明显高于对照组62%，差异具有统计学意义(P<0.05)。结论小儿复方氨基酸和锌佐治小儿难治性腹泻疗效显著，具有借鉴性。     

推拿配合中药外用治疗婴幼儿腹泻168例临床分析

目的：分析推拿配合中药外用治疗婴儿腹泻的临床疗效。方法：抽取我院于2010年3月-2013年3月收治的门诊婴幼儿患者168例，患者均采用推拿配合中药外敷神阙穴治疗小儿腹泻，观察临床治疗效果。结果：经针对性治疗，治疗第3天，有效113例，显效50例，疗效不显5例。治疗第6天，患者均痊愈康复，治愈率为100%。结论：采用推拿配合中药外用治疗法治疗婴幼儿腹泻，具有较好的临床治疗效果，值得推广使用。     

Sequential Gastroenteritis Episodes Caused by 2 Norovirus Genotypes

We investigated sequential episodes of acute norovirus gastroenteritis in a young child within an 11-month period. The infections were caused by 2 distinct genotypes (GII.4 and GII.6). Failure to achieve cross-protective immunity was linked to absence of an enduring and cross-reactive mucosal immune response, a critical consideration for vaccine design.     

炎琥宁联合更昔洛韦治疗小儿轮状病毒感染性腹泻的临床疗效

目的：观察炎琥宁联合更昔洛韦治疗小儿轮状病毒感染性腹泻的疗效。方法选取2010年5月-2013年12月延安市人民医院确诊的小儿轮状病毒感染性腹泻患儿235例，随机分为治疗组（120例）和对照组（115例）。对照组在常规治疗基础上静脉滴注更昔洛韦注射液，5 mg/（kg·d）加入5%葡萄糖注射液150 mL，15滴/min，1次/d。治疗组静脉滴注炎琥宁注射液，10 mg/（kg·d）加入250 mL葡萄糖注射液中，1次/d；其他治疗同对照组。两组患者均持续治疗5 d。治疗结束后比较两组患儿临床治疗总有效率、症状消失时间、人轮状病毒抗原（RV-Ag）转阴率及不良反应情况。结果治疗后，治疗组和对照组的总有效率分别为91.7%、71.3%，两组比较差异有统计学意义（P＜0.05）。治疗组体温恢复时间、呕吐消失时间、腹泻改善时间、住院时间均明显短于对照组，两组比较差异有统计学意义（P＜0.05）。治疗3 d后，治疗组患儿大便RV-Ag转阴率为85.8%，对照组转阴率为71.3%，两组比较差异有统计学意义（P＜0.05）；治疗5 d后，治疗组转阴率为100.0%，对照组转阴率为91.3%，两组比较差异有统计学意义（P＜0.05）。两组均未发生严重不良反应。结论炎琥宁联合更昔洛韦治疗小儿轮状病毒感染性腹泻有较好的临床疗效，不良反应轻微，值得临床推广应用。     

Cell attenuated porcine epidemic diarrhea virus strain Zhejiang08 provides effective immune protection attributed to dendritic cell stimulation

Since 2010, the porcine epidemic diarrhea coronavirus (PEDV) has caused significant damage to the global pork industry. However, classical PEDV vaccine strains only provide limited protection against emerging strains. In this study, we successfully isolated and attenuated the PEDV epidemic strain Zhejiang08, which was characterized by good cell adaptation and high-titer production 48 h post infection in Vero E6 cells. The attenuated virus induced a high level of virus-specific neutralizing antibodies until 120 days after immunization in piglets and provided complete protection when challenged with an emerging virus strain on day 14 post immunization. Moreover, the capability to activate dendritic cells (DCs) of this isolate was identified. Higher expression levels of IL-12 and IFN-γ were recorded in DCs after treatment with Zhejiang08 for 24 h. Furthermore, genome sequencing and phylogenetic analysis revealed high homology between the main antigen epitopes of Zhejiang08 and PEDV pandemic isolates following 2011. Combining the glycosylation site prediction results and their distribution within the spatial structure of the S protein, led to the conclusion that the observed more effective host immune response of Zhejiang08 compared to CV777 was possibly associated with a lack of the potential glycosylation site in the 296 amino acids of the S protein. In summary, we illustrated that the attenuated virus represents a promising vaccine candidate.     

Post-infectious irritable bowel syndrome:Mechanistic insights into chronic disturbances following enteric infection

Irritable bowel syndrome(IBS)is a commonly encountered chronic functional gastrointestinal(GI)disorder.Approximately 10%of IBS patients can trace the onset of their symptoms to a previous a bout of infectious dysentery.The appearance of new IBS symptoms following an infectious event is defined as post-infectiousIBS.Indeed,with the World Health Organization estimating between 2 and 4 billion cases annually,infectious diarrheal disease represents an incredible international healthcare burden.Additionally,compounding evidence suggests many commonly encountered enteropathogens as unique triggers behind IBS symptom generation and underlying pathophysiological features.A growing body of work provides evidence supporting a role for pathogen-mediated modifications in the resident intestinal microbiota,epithelial barrier integrity,effector cell functions,and innate and adaptive immune features,all proposed physiological manifestations that can underlie GI abnormalities in IBS.Enteric pathogens must employ a vast array of machinery to evade host protective immune mechanisms,and illicit successful infections.Consequently,the impact of infectious events on host physiology can be multidimensional in terms of anatomical location,functional scope,and duration.This review offers a unique discussion of the mechanisms employed by many commonly encountered enteric pathogens that cause acute disease,but may also lead to the establishment of chronic GI dysfunction compatible with IBS.     

Migration,health, and socioenvironmental safety net among children of Dhaka,Bangladesh

This study quantifies the diarrhea burden among migrant children under age 5 (who have migrated due to environmental degradation) in Dhaka. We used a multifactor socioepidemiological as well as environmental approach with pretested questionnaires and observations. It was found that 52% of the children were affected by diarrhea. Disability-adjusted life years (DALYs) lost was reduced manifold with the increase of mothers' behavioral determinants. Health losses were 1,718 fold with significant coefficient (β) in the migrant group. DALYs lost were significantly associated with socioenvironmental factors such as mother's illiteracy (β = .18; p < .001), no hand wash before eating (β = .08; p = .004), and no hand wash after defecation (β = .10; p < .001). This puts emphasis clearly on the awareness at household level, especially of mothers and children under age 5 in Dhaka, Bangladesh, in formulating migration-related policies.