普萘洛尔联合其他治疗措施治疗婴幼儿血管瘤有效率的网状Meta分析

目的:采用网状Meta分析方法,将普萘洛尔联合其他治疗与各对照治疗措施进行对比。方法:以“普萘洛尔”,“血管瘤”为关键词检索CNKI、VIP、万方数据;以“propranolol”“hemangioma”为关键词检索Cochrane Library、Embase、pubmed。检索期限为建库至2019年6月1日。采用STATA14.0软件Network程序包进行数据分析。结果:共纳入18篇文献,涉及8项治疗措施,共纳入1469例血管瘤患者。网状Meta分析结果显示:4种联合治疗方式与单纯口服普萘洛尔相比疗效均优于单纯口服普萘洛尔治疗。普萘洛尔联合注射平阳霉素、普萘洛尔联合外用噻吗洛尔、普萘洛尔联合敷贴器的有效率均优于对应的注射平阳霉素、外用噻吗洛尔及敷贴器。各治疗措施的有效性排序为:普萘洛尔联合敷贴器>普萘洛尔联合外用噻吗洛尔>普萘洛尔联合口服糖皮质激素>普萘洛尔联合注射平阳霉素>敷贴器照射>外用噻吗洛尔>口服普萘洛尔>注射平阳霉素。结论:对于婴幼儿血管瘤的治疗,普萘洛尔联合治疗措施疗效均优于单纯的口服普萘洛尔治疗,其中普萘洛尔联合敷贴器的疗效最佳。     

Agminated fibroblastic connective tissue nevus in a 1‐year‐old boy

Fibroblastic connective tissue nevus (FCTN) is a benign cutaneous mesenchymal lesion characterized by proliferation of CD34‐positive fibroblastic/myofibroblastic spindle‐shaped cells. We report a case of agminated FCTN on the right lower abdomen of a 1‐year‐old boy.     

Apparently increased trough levels of tacrolimus caused by acute infantile diarrhea in two infants with biliary atresia after liver transplantation

Two infants with biliary atresia who exhibited three-fold increased trough levels of tacrolimus and required reduced doses during episodes of acute infantile diarrhea within 5 months of liver transplantation are described. The cause of the increase was not explained simply by hemoconcentration as a result of significant loss of extracellular fluid during these episodes. It does highlight an important issue: that of the continuing need to carefully monitor the trough levels of tacrolimus in such infants.     

Acute encephalopathy associated with influenza and other viral infections

Acute encephalopathy is the most serious complication of pediatric viral infections, such as influenza and exanthem subitum. It occurs worldwide, but is most prevalent in East Asia, and every year several hundreds of Japanese children are affected by influenza-associated encephalopathy. Mortality has recently declined, but is still high. Many survivors are left with motor and intellectual disabilities, and some with epilepsy. This article reviews various syndromes of acute encephalopathy by classifying them into three major categories. The first group caused by metabolic derangement consists of various inherited metabolic disorders and the classical Reye syndrome. Salicylate is a risk factor of the latter condition. The second group, characterized by a systemic cytokine storm and vasogenic brain edema, includes Reye-like syndrome, hemorrhagic shock and encephalopathy syndrome, and acute necrotizing encephalopathy. Non-steroidal anti-inflammatory drugs, such as diclofenac sodium and mephenamic acid, may aggravate these syndromes. Severe cases are complicated by multiple organ failure and disseminated intravascular coagulation. Mortality is high, although methylprednisolone pulse therapy may be beneficial in some cases. The third group, characterized by localized edema of the cerebral cortex, has recently been termed acute encephalopathy with febrile convulsive status epilepticus, and includes hemiconvulsion-hemiplegia syndrome and acute infantile encephalopathy predominantly affecting the frontal lobes. Theophylline is a risk factor of these syndromes. The pathogenesis is yet to be clarified, but an increasing body of evidence points to excitotoxicity and delayed neuronal death.     

玉屏风散预防小儿反复呼吸道感染60例

目的:探讨玉屏风散预防小儿反复呼吸道感染(简称反复呼感)的疗效.方法:治疗组给予玉屏风散加味治疗,对照组百令胶囊治疗.结果:治疗有效率90.0%、对照组仅63.3%,有显著差异(P<0.05).结论:玉屏风能增强免疫功能,较有效地预防小儿反复呼感.     

Case Report: Gianotti-Crosti Syndrome Associated with Human Herpesvirus-6 Infection

We report a case of Gianotti-Crosti syndrome associated with human herpesvirus-6 (HHV-6) infection. An eight-month-old girl developed monomorphous papules on her cheeks, buttocks, and extremities after the subsidence of exanthema subitum. Viral antibody analysis confirmed primary HHV-6 infection. HHV-6 may be added to the list of causative agents of Gianotti-Crosti syndrome.     

Neurology of the neuronal ceroid-lipofuscinoses: Late infantile and juvenile types

My experience with more than 80 cases of the late infantile and juvenile forms of the neuronal ceroid-lipofuscinoses over the last 5 years has led to the following realizations. The 2 variants are neurologically distinct entities and probably are the result of different genetic defects. Treatment includes supportive measures and anticonvulsant medication. Therapy for behavioral and psychiatric disturbances in the juvenile type proves to be particularly challenging as neuroleptic medications tend to worsen parkinsonian like symptoms. Neuropathologic and neuro radiologic explanation of clinical symptomatology correlates best with neuronal loss and not neuronal storage. There is a paucity of neuropathologic documentation of these 2 types; additional reports are encouraged.     

高原地区小儿病毒性心肌炎T细胞亚群检测及临床意义

本文对２８例小儿病毒性心肌炎患者进行了Ｔ细胞检测，发现患儿外周血Ｔ细胞亚群有明显改变。提示：小儿病毒性心肌炎患者均有不同程度的一过性细胞免疫功能低下。而体液免疫功能正常，我们在临床给与一般治疗的同时，佐以胸腺因子治疗，明显改善症状，取得良好疗效。     

喜炎平注射液联合维生素K3治疗小儿秋季腹泻的疗效观察

目的观察喜炎平与维生素K3联合治疗小儿秋季腹泻的疗效.方法将89例秋季腹泻患儿随机分为2组.治疗组采用喜炎平与维生素K3联合治疗,对照组则采用利巴韦林治疗,疗程5d.结果治疗组的总有效率为93.3%,显著优于对照组的65.9%(X2=10.37,P＜0.01).结论喜炎平与维生素K3联合治疗小儿秋季腹泻值得进一步推广.     

L'adolescence dans l'histoire de la psychanalyse

The concept of adolescence emerged progressively during the twentieth century. At the onset psychoanalysis focused on puberty as a second stage in the sexual maturity of Man, before it considered adolescence as an active process in the psychic life of the human being. The present article reexamines the development of this concept in the history of ideas in general in order to demonstrate its importance in the history of psychoanalysis. The themes that are sucessively covered include the precursors of the concept in the nineteenth century, the birth of its theorization, the Aichhorn years, and adolescence identified as a psychic process, which participates to a significant degree in subjectivization.