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一般资料:选择2005-02—2006-06在本院住院的下呼吸道感染的患儿85例,年龄为2个月至6岁,其中男56例,女29例,病程<5d。按入院日期分为两组,对照组42例,其中支气管肺炎22例,支气管炎15例,毛细支气管炎5例;治疗组43例,其中支气管肺炎23例,支气管炎14例,毛细支气管炎6例。两组均符合《诸福棠实用儿科学》第6版关于支气管肺炎、支气管炎、毛细支气管炎的诊断标准。两组患儿均表现有发热、咳嗽、喘息、肺部听诊可闻及干性啰音和(或)湿性啰音阶榛级谀炅洹⒉〕獭⒓膊」钩伞?病情等方面差异无统计学意义(P>0.05)。方法:对照组给予抗感染、吸氧、…     

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??Objective??To investigate the change of the platelet state and function in acute lymphocytic leukemia. Methods??The changes of platelet indices??PLT??PCT??MPV??PDW????immature platelet fraction??IPF%????immature platelet counts??IPC????granule membrane glycoprotein of platelet ??CD62p?? and PAC-1 were obtained by using automatic blood cell analyzer and whole blood flow cytometry??FCM?? respectively??in children with acute lymphocytic
leukemia??ALL????ALL in first complete remission ??ALL-CR1?? and children undergoing elective surgical procedure??control group??. Results????1??Without addition of platelet agonists ADP??expression of platelet surface activated CD62p and PAC-1 in ALL was higher than that in control group??P??0.05????while expression of platelet surface activated PAC-1 in ALL-CR1 was higher than that in control group??P??0.05????and lower than that in ALL??P??0.05??????2??With addition of platelet agonists ADP??expression of platelet surface activated CD62p and PAC-1 in ALL was lower than that in control group??P??0.05????while expression of platelet surface activated PAC-1 in ALL-CR1 was lower than that in control group??P??0.05????and higher than that in ALL??P??0.05??????3?? PLT??PCT and MPV in ALL was lower than that in control group and ALL-CR1 ??P??0.05??????4?? IPF% in ALL was higher than that in control group and ALL-CR1??P??0.05????and IPC was lower than that in control group and ALL-CR1??P??0.05??. Conclusion??The children who are newly diagnosed with acute lymphocytic leukemia have peripheral platelet reactivity and platelet function defects. Platelet indices and platelet membrane glycoprotein can be used as effective indicators to judge the effect on ALL.     

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特应性皮炎(atopic dermatitis,AD)是儿童常见皮肤病,多于婴幼儿时期发病。近三四十年,随着环境变化和全球工业化快速发展,AD患病率呈逐年上升趋势,在发达国家影响了20%～30%的儿童[1]。我国1988—1989年上海地区7～18岁中小学生AD患病率为0.46%,1998年城市6～20岁年龄段AD患病率为0.62%,2002年1～7岁儿童AD患病     

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所谓食物过敏是指由免疫机制介导的某种食物或食品添加剂等引起肠道内或全身的变态反应;而不由免疫介导的反应则称之为食物不耐受[1]。食物过敏又进一步分为IgE介导和非IgE介导的反应,前者属于Ⅰ型变态反应,常在进食后数分钟内出现症状,可以累及皮肤、呼吸道、消化道,这些症状常常同时出现,但无特异性。非IgE介导的食物过敏涉及了IgG、免疫复合物及细胞介导的免疫反应等多种机制,常于进食后数小时或数天后出现症状[2-3]。食物过敏在儿童中的发病率较成人高,据欧洲和美国的资料,7%8%3岁以下儿童曾发生过食物过敏,1岁以内婴儿牛奶过敏发生…     

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目的了解单次小剂量(0.4g/kg)静脉输注免疫球蛋白(IVIG)提升初发免疫性血小板减少性紫癜(ITP)患儿血小板至安全范围(≥30×109/L)的作用。方法研究对象为北京大学第一医院儿科2008-04-01—2011-04-01收治初发ITP患儿62例,其中2008-04-01—2009-10-01收治的30例为激素组,初始接受常规剂量醋酸泼尼松治疗;2009-10-02—2011-04-01就诊的32例为IVIG组,初始接受0.4g/(kg·d)IVIG治疗1～5d,每天复查血常规,血小板升至安全范围则规范停用。比较两组治疗第1、3、5天时血小板升至安全范围比例及长期随访结果。结果治疗前,激素组和IVIG组血小板中位值分别是10×109/L和6×109/L。治疗1d后两组血小板升至安全范围的比例分别是3.33%和43.75%,差异有统计学意义(P<0.01)。随访7～42个月后激素组和IVIG组分别有3.45%和3.23%血小板未升至正常(≥100×109/L)。所有患儿均无颅内出血发生及死亡。结论单次小剂量IVIG可使近半数初治ITP患儿血小板升至≥30×109/L相对安全范围,明显高于常规剂量醋酸泼尼松疗效。     

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肌阵挛(myoclonus)是一种起源于中枢或周围神经系统的突然、快速、短暂、闪电样的不自主肌肉收缩或放松[1-3],单次发作时间一般小于0·2s。除某些特定的类型外,肌阵挛的发生机制尚不完全清楚,对其诊断和治疗依然存在许多问题,其中,对小儿时期肌阵挛的诊断与认识更为肤浅。本文从神经生理学的角度,就近年对肌阵挛发病机制的研究,以及小儿时期常见肌阵挛发作作一简要综述。1肌阵挛临床分类及其发生机制按肌阵挛可能的起源部位,可以把肌阵挛分为:皮层性、皮层下性、脊髓性和周围性4种类型[2]。1.1皮层性肌阵挛皮层性肌阵挛是指由于大脑感觉运动…     

Managing functional constipation in children

Constipation is a common childhood problem, with both somatic and psychological effects. The etiology of paediatric constipation is likely multifactorial, and seldom due to organic pathology. Children benefit from prompt and thorough management of this disorder. The goal of treatment is to produce soft, painless stools and to prevent reaccumulation of feces. Education, behavioural modification, daily maintenance stool softeners and dietary modification are all important components of therapy. Fecal disimpaction may be necessary at the outset of treatment. Investigations are rarely necessary. Polyethylene glycol is a safe, effective and well-tolerated long-term treatment for constipation. Regular follow-up for children with constipation is important. Referral to a gastroenterologist should be made in refractory cases or when there is a suspicion of organic pathology.     

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??Functional constipation is a common functional disease of digestive system that arises in children of all ages. The symptoms include infrequent defecation??hard?? painful stools that are difficult to pass??fecal incontinence and abdominal pain. These symptoms are known to have a significant impact on the mood??appetite and life quality of children. The pathogenesis underlying FC remains unclear??but with the development of the research in micro-ecosystem of intestines?? more and more evidences support that an alteration of the gut microbiota may be a possible mechanism for the development of FC. Probiotics are live microorganisms that can enrich microorganism species?? lower intraluminal pH and regulate intestinal immune function??which make it a good prospect in the treatment of FC. Then??this paper will make a brief introduction to the application of probiotics in children with FC by referring to its domestic and abroad research progresses.     

儿童功能性便秘与慢性传输型便秘

儿童功能性便秘 (functionalconstipation ,FC)在罗马Ⅱ标准关于儿童功能性胃肠病 (functionalgastrointestinaldisorders ,FGIDs)分类中已被列入排便紊乱中[1],借以区分胃肠动力疾病 (disorderofgastrointestinalmotility ,DGIM)中由于结肠运动障碍、结肠移行时间延迟而导致的     

儿童功能性便秘肛门直肠动力学分析

<正>功能性便秘(functional constipation,FC)是儿童消化系统较为常见的症候之一,以持续性或间断性排便困难,粪质坚硬而不伴有腹部不适或腹痛为主要表现。其发病机制仍不十分明确,治疗效果欠佳。目前国内外均有报道,直肠动力和感觉功能变化在很多FC患儿中均有异常,推测肛门直肠动力及感觉异常可能是FC产生的基础。为探讨FC发生与肛门直肠动力学异常之间的关系,本研究将30例FC患儿与30例健康儿童的肛门直肠动力学改变进行比较,报道如下。     

生物反馈治疗小儿功能性便秘的疗效研究

目的 评价生物反馈治疗盆底肌协调障碍引起的小儿功能性便秘的疗效.方法 对47例肛门直肠动力检查提示盆底肌协调障碍的功能性便秘患儿进行生物反馈治疗,每周2次,对完成3次及以上生物反馈治疗者进行了疗效分析.结果 共有27例患儿完成至少3次生物反馈治疗,其中男20例,女7例,年龄4～12岁[(6.7±2.2)岁],病程6个月～8年[(3.0±2.3)年].共完成5次生物反馈治疗者有16例,完成7次生物反馈治疗者8例.随着生物反馈治疗次数增加,直肠最大排便压力(mm Hg,1 mm Hg=0.133 kPa)增高,治疗前和治疗3、5、7次后依次为36.2±10.4,45.1±9.5,47.6±9.1,47.8±8.8(P<0.01),而肛门外括约肌肌电值逐渐下降,但差异无统计学意义.治疗后通过电话随访3个月至1年,根据排便症状改善情况进行疗效评定.27例患儿中治愈13例,显效8例,有效3例,无效2例,失访1例,总有效率88.9%(24/27).结论 生物反馈疗法可提高最大排便压力,能有效地治疗盆底肌协调障碍引起的儿童功能性便秘.     

儿童功能性便秘相关检查的研究进展

功能性便秘(FC)是儿童时期的常见病、多发病。临床诊断除了要符合便秘的诊断标准,完善一般常规检查外,还需进一步行胃肠传输时间测定、肛门直肠测压及结肠镜等相关检查以除外其他原因造成的便秘。文章介绍几种便秘相关检查的最新研究进展,为临床医师提供一定的指导与借鉴。     

功能性便秘儿童5-羟色胺转运体基因多态性研究

目的探讨5-羟色胺转运体(SERT)基因在儿童功能性便秘(FC)的发病机制中的意义。方法选择2009年7-12月中国医科大学附属盛京医院FC患儿35例(便秘组),对照儿童50名(对照组),对5-羟色胺转运体基因两个多态区5-羟色胺转运体基因多态(5-HTTLPR)、内含子2的可变串联重复区(VNTRs)进行PCR扩增。结果便秘组患儿基因型分布与对照组差异有统计学意义(χ2=10.24,P<0.05);便秘组患儿S/S基因型显著高于对照组(χ2=9.21,P<0.05);便秘组患儿S等位基因频率显著高于对照组(χ2=4.86,P<0.05)。SERT基因内含子2VNTRs多态性位点基因型分布差异无统计学意义(χ2=0.40,P>0.05);SERT基因内含子2VNTRs多态性位点等位基因分布差异无统计学意义(χ2=0.01,P>0.05)。结论 SERT基因5-HTTLPR可能与儿童FC有关,S/S基因型可能是FC的易感基因之一。     

Treatment of chronic functional constipation in children by administration of vegetable fiber (Dicoman 5)

Chronic functional constipation is a common clinical disorder in pediatric age. Thirteen children with functional constipation were treated by administration of vegetable fibres together with a toilet training program, for two months. In each patient anorectal manometry showed presence of inhibitory anal reflex and diagnosis of constipation was confirmed by a prolonged gastrointestinal transit time measured by radio-opaque markers. In all patients there was a significant improvement in both stool frequency and intestinal transit time; furthermore, a normalization of anorectal motility variables was observed at rectal manometry. No changes in the blood levels of nutritional parameters were seen in any patient. It is concluded that vegetable fibres represent an effective treatment of functional chronic constipation in children.