运脾开胃散联合复方胃蛋白酶颗粒治疗小儿厌食症的临床疗效观察

目的观察和评价运脾开胃散联合复方胃蛋白酶治疗小儿厌食症的临床应用与疗效。方法从在我院就诊的符合中西医诊断标准的厌食症患儿选取90例,随机分为两组,治疗组给予运脾开胃散联合复方胃蛋白酶颗粒口服,对照组给予复方胃蛋白酶颗粒口服。结果两组患儿治疗后,食欲、食量均较前明显改善,但治疗组疗效更佳(P0.05)。治疗组痊愈15例,显效21例,有效4例,无效3例,总有效率为93.02%;治疗组痊愈10例,显效15例,有效7例,无效9例,总有效率为78.05%(P=0.0410.05)。结论运脾开胃散联合复方胃蛋白酶颗粒治疗小儿厌食症临床疗效显著,值得推广,同时为中西医结合治疗小儿厌食症提供了新思路。     

银花三黄愈疡方熏洗治疗肛门湿疹疗效观察

为观察银花三黄愈疡方熏洗治疗肛门湿疹的效果,将肛门湿疹患者160例随机分为研究组和对照组,每组80例。对照组外用派瑞松霜治疗,研究组采用银花三黄愈疡方熏洗治疗,对比治疗效果和两组治疗前后症状积分变化。结果显示,研究组总有效率75．0％,显著高于对照组52．6％（P〈0．05）;研究组患者症状积分明显低于对照组（P〈0．05）,均未发生不良反应。结果表明,银花三黄愈疡方消肿止痒止痛功效显著,治疗肛门湿疹性皮肤病效果佳,安全性好。     

14q12 duplication including FOXG1: Is there a common age-dependent epileptic phenotype?

Introduction: Duplications of 14q12 encompassing FOXG1 gene have been recently associated with developmental delay, severe speech impairment, epilepsy, aspecific neuroimaging findings and minor dysmorphisms. Aim and methods: In order to refine the epileptic phenotype associated with 14q12 duplications, we have performed a review of the electroclinical picture of the patients reported to date in the literature, adding a new personal case. A comprehensive set of clinical and instrumental data (with a particular focus on the electroclinical aspects including seizure type, age of onset, EEG at onset and after antiepileptic therapy, drug efficacy) has been taken into account. Results: 9/14 patients carrying 14q12 duplications developed seizures, all in the first months of life. Most of them developed infantile spasms (8/9 epileptic patients) and presented hypsarrhythmia or modified hypsarrhythmia on EEG. After therapy 5/9 patients became seizure free and 3/9 present a good seizure control. At last available follow up, 2/3 of the epileptic patients displayed an almost normal EEG, or a quite organized background activity, with diffuse or focal (mostly temporal) slowing. Conclusions: The review of the available data allowed to recognize a common epileptic core, characterized by early onset, age dependent epileptic encephalopathy with infantile spasms and typical, atypical or modified hypsarrhythmia. Antiepileptic therapy soon led to a good or complete control of seizures with a nearly normal background activity in most patients.     

Girl with a PRRT2 mutation and infantile focal epilepsy with bilateral spikes

This paper documents the case of a female Japanese patient with infantile focal epilepsy, which was different from benign infantile seizures, and a family history of infantile convulsion and paroxysmal choreoathetosis. The patient developed partial seizures (e.g., psychomotor arrest) at age 14 months. At the time of onset, interictal electroencephalography (EEG) showed bilateral parietotemporal spikes, but the results of neurologic examination and brain magnetic resonance imaging were normal. Her seizures were well controlled with carbamazepine, and she had a normal developmental outcome. EEG abnormalities, however, persisted for more than 6 years, and the spikes moved transiently to the occipital area and began to resemble the rolandic spikes recognized in benign childhood epilepsy. Her father had paroxysmal kinesigenic dyskinesia, with an onset age of 6 years, and her youngest sister had typical benign infantile seizures. Genetic analysis demonstrated that all affected members had a heterozygous mutation of c.649_650insC in the proline-rich transmembrane protein-2 (PRRT2) gene. This case indicates that the phenotypic spectrum of infantile seizures or epilepsy with PRRT2-related pathology may be larger than previously expected, and that genetic investigation of the effect of PRRT2 mutations on idiopathic seizures or epilepsy in childhood may help elucidate the pathological backgrounds of benign childhood epilepsy.     

Vigabatrin pediatric dosing information for refractory complex partial seizures: Results from a population dose–response analysis

We predicted vigabatrin dosages for adjunctive therapy for pediatric patients with refractory complex partial seizures (rCPS) that would produce efficacy comparable to that observed for approved adult dosages. A dose–response model related seizure‐count data to vigabatrin dosage to identify dosages for pediatric rCPS patients. Seizure‐count data were obtained from three pediatric and two adult rCPS clinical trials. Dosages were predicted for oral solution and tablet formulations. Predicted oral solution dosages to achieve efficacy comparable to that of a 1 g/day adult dosage were 350 and 450 mg/day for patients with body weight ranges 10–15 and >15–20 kg, respectively. Predicted oral solution dosages for efficacy comparable to a 3 g/day adult dosage were 1,050 and 1,300 mg/day for weight ranges 10–15 and >15–20 kg, respectively. Predicted tablet dosage for efficacy comparable to a 1 g/day adult dosage was 500 mg/day for weight ranges 25–60 kg. Predicted tablet dosage for efficacy comparable to a 3 g/day adult dosage was 2,000 mg for weight ranges 25–60 kg. Vigabatrin dosages were identified for pediatric rCPS patients with body weights ≥10 kg.     

普萘洛尔治疗对增生性血管瘤患儿血清中VEGF、bFGF、MMP-9的影响

目的：观察口服普萘洛尔治疗增生期血管瘤,对患儿血清中VEGF、bFGF、MMP-9的影响。方法选择增生期血管瘤患儿40例,口服普萘洛尔治疗,抽取服药前与服药后8周血液样本,用Elisa方法检测血清中VEGF、bFGF、MMP-9的浓度。结果服药8周后血清中VEGF、bFGF、MMP-9的浓度比服药前明显降低,存在统计学差异。结论普萘洛尔治疗增生期血管瘤,其作用机制可能与下调VEGF、bFGF、MMP-9的表达有关。     

重用黄芪之经方联用治疗疑难重症举隅

[目的] 介绍重用黄芪之经方联用治疗四则疑难重症的体会。[方法] 通过整理、分析临床治疗心包积液、不明原因单侧上肢肿胀疼痛、湿疹重症、黄汗重症四则验案,总结联合运用经方且重用黄芪,发挥其利水之功效治疗疑难重症的经验。[结果] 黄芪具有益气固表、利水消肿的功效,临床上黄芪用量达80～100 g可发挥其利水之功。结合患者整体临床表现,验案一选用防己黄芪汤、枳实薤白桂枝汤等以温振心阳、化气利水;验案二选用黄芪桂枝五物汤、防己地黄汤等以活血通阳、利水燥湿;验案三选用桂枝加黄芪汤、麻黄连轺赤小豆汤等以祛风散邪、清利湿热;验案四选用芪芍桂酒汤、防己茯苓汤等以通调气血、行水利湿,治疗后临床效果显著。[结论] 临床上遵循“观其脉证,知犯何逆,随证治之”的原则联合应用经方,以疾病症状体征为导向,谨守病因病机遣方用药,能治疗多种疑难重症。     

Intestinal microbiota in infants at high risk for allergy: Effects of prebiotics and role in eczema development

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