《中西医结合防治小儿腹泻病专家共识》解读

小儿腹泻病是儿童消化系统最常见的疾病,2022年中国中西医结合学会儿科专业委员会制定了《中西医结合防治小儿腹泻病专家共识》。现结合临床实践及最新的研究结果,对《中西医结合防治小儿腹泻病专家共识》中小儿腹泻病的发病机制、诊断和治疗中的重点内容进行解读,以期加深医务工作者对《中西医结合防治小儿腹泻病专家共识》的认识,促进中西医结合规范化治疗小儿腹泻病。     

张声生教授运用风药治疗脾胃病经验

风药者,取象春季生发之气也,兼轻巧活泼、芳香辛散、轻扬升浮、通达宣散之性,此药可调肝宣肺运脾、斡旋气机升降,辅有承转机体脏腑气机以交通各脏之功,配伍风药医脾胃之疾,每获良效。张声生教授巧用风药于脾胃之疾,配伍敛阴、补气、活血、降气之药以取风药之长兼制风药之弊,其虽属佐使之品,然组方配伍之术于诊疗临床脾胃之疾常为点睛之笔,甚有裨益。     

产气荚膜梭菌毒素研究进展

产气荚膜梭菌通过产生大量的毒素导致人类和动物患气性坏疽、肠炎和肠毒素血症。目前,已知产气荚膜梭菌可产生20多种毒素和水解酶。不同的毒素类型与特定的疾病类型相关。毒素分型已由毒素基因的分子检测替代了传统的血清分型方法。因此本文围绕产气荚膜梭菌毒素种类、基本特征、致病机制以及与疾病的关系进行系统回顾总结和展望,为后续的毒素分型等快速检测技术的建立、免疫抗原筛选、抗体制备以及相关致病机制研究提供基础。     

Impact of rotavirus vaccination on diarrheal hospitalizations in children younger than 5 years of age in a rural southern Mozambique

BackgroundRotavirus vaccine (Rotarix®) was introduced in Mozambique through its Expanded Program of Immunization in September 2015. We assessed the impact of rotavirus vaccination on childhood gastroenteritis-associated hospitalizations post-vaccine introduction in a high HIV prevalence rural setting of southern Mozambique.MethodsWe reviewed and compared the trend of hospitalizations (prevalence) and incidence rates of acute gastroenteritis (AGE), and rotavirus associated-diarrhea (laboratory confirmed rotavirus) in pre- (January 2008–August 2015) and post-rotavirus vaccine introduction periods (September 2015–December 2020), among children <5 years of age admitted to Manhiça District Hospital.ResultsFrom January 2008 to December 2020, rotavirus vaccination was found to contribute to the decline of the prevalence of AGE from 19% (95% CI: 18.14–20.44) prior to the vaccine introduction to 10% (95% CI: 8.89–11.48) in the post-introduction period, preventing 40% (95 % IE: 38–42) and 84% (95 % IE: 80–87) of the expected AGE and laboratory confirmed rotavirus cases, respectively, among infants. Similarly, the overall incidence of rotavirus was 11.8-fold lower in the post-vaccine introduction period (0.4/1000 child-years-at-risk [CYAR]; 95% CI: 0.3–0.6) compared with the pre-vaccination period (4.7/1000 CYAR; 95% CI: 4.2–5.1) with the highest reduction being observed among infants (16.8-fold lower from the 15.1/1000 CYAR in the pre-vaccine to 0.9/1000 CYAR in the post-vaccine eras).ConclusionsWe documented a significant reduction in all-cause diarrhea hospitalizations and rotavirus positivity after vaccine introduction demonstrating the beneficial impact of rotavirus vaccination in a highly vulnerable population.     

思密达治疗婴幼儿腹泻86例临床实验

目的 评价思密达治疗婴幼儿腹泻的疗效。方法 思密达口服治疗婴幼儿腹泻。病例为儿科门诊病人,年龄２－６０个月,疗程在３天内,症状为排稀水样便。就诊前未服用过本组实验组物的腹泻病人１７３人,随机分二组,分别给予服思密达或黄连素片。结果 治疗组平均疗程２．９３天,对照组４．４７天,ｘ＾２＝４．３９,ｐ〈０．０５。思密达总有效率９４．１％,对照组７９．３％,ｘ＾２＝１３．８,ｐ〈０．０１。两组结果比较,差     

隔药灸治疗抗生素相关性腹泻80例疗效观察

目的 :寻找治疗抗生素相关性腹泻的最佳方法。方法 :将 80例患者随机分为治疗组与对照组。治疗组取生姜切片、附子理中丸成饼 ,覆盖于神阙穴 ,施以艾灸治疗 ;对照组应用甲硝唑、思密达常规治疗。结果 :治疗组 3日有效率 80 0 % ,5日内退热率 88 9% ;对照组分别为 47 5 % ,5 7 2 %。统计学卡方检验 ,表明两组疗效差异有极显著性意义 (P <0 0 1 ) ,治疗组疗效显著优于对照组。结论 :隔药灸法治疗抗生素相关性腹泻是一种良好的方法     

金双歧、肯特令联合治疗婴幼儿秋季腹泻疗效观察

目的：观察金双歧、肯特令联合治疗婴幼儿秋季腹泻的疗效。方法：228例患儿随机分为三组，A组采用金双歧治疗；B组有用肯特令治疗；C组采金双歧肯特令联合治疗，结果：联合治疗组的总有效率93．1％，明显高于金双岐组（79．5％）和肯特令组（77．9％），结论：金双歧、肯特令联合治疗婴幼儿秋季腹泻的疗效显著。     

穴位注射加灸治疗小儿腹泻疗效观察

目的　观察穴位注射加灸治疗小儿腹泻的疗效。方法　选用庆大霉素和 6 5 4 - 2肌注、穴注、穴注加灸治疗小儿腹泻 ,每日 1次 ,3次后比较 3组疗效。结果与结论　穴注组治愈率明显高于肌注组 (P<0 .0 5 ) ,穴注加灸组治愈率明显高于穴注组(P<0 .0 0 5 )     

Augmentation of Shoulder Contour Using a Calf Implant

Sprengel deformity is a rare orthopedic condition that is associated with functional and cosmetic impairment. Results of orthopedic procedures are usually inconsistent and cosmetic results are far from satisfactory in these patients. A silicone-gel-filled calf prosthesis was used to correct the shoulder contour in a patient with Sprengel deformity. Cosmetically the deformity can be restored by using a calf implant for patients in whom orthopedic procedures are not likely to yield a satisfactory outcome.     

双黄连粉针剂加蒙脱石治疗婴幼儿秋季腹泻的疗效观察

目的: 观察双黄连粉针剂加蒙脱石口服治疗婴幼儿秋季腹泻的疗效.方法: 双黄连粉针剂加蒙脱石口服治疗102例秋季腹泻患儿,并与单用蒙脱石或双黄连组相比较.结果: 治疗组总有效率达92.1%,病程明显缩短(4.52±0.56)d;而单用蒙脱石或双黄连组有效率分别为67.4%,60.2%;病程分别为(5.90±0.72)d,(6.15±0.92)d,联合用药组与单用蒙脱石或双黄连组相比较,总有效率及病程均有显著性差异(P＜0.01).结论: 双黄连加蒙脱石治疗婴幼儿秋季腹泻疗效好,可提高治愈率,缩短病程,是较为安全而有效的药物.