Chemiluminescence activity of phagocytes from tracheal aspirates of premature infants after surfactant therapy

The effect of surfactant on the respiratory burst of phagocytic cells was studied in the tracheobronchial tract of 40 mechanically ventilated neonates (gestational age 24–37 weeks) over the first week of life. We measured the luminol-dependent chemiluminescence (CL) activity of granulocytes and macrophages isolated from tracheal aspirates in 23 preterm infants 1–6 days after administration of bovine surfactant and in 17 untreated controls. Following stimulation by the chemotactic peptide N -for-mylmethionylleucylphenylalanine, CL activity was not or only slightly impaired in the surfactant group. In contrast, treatment with exogenous surfactant significantly reduced CL response to opsonized zymosan (OPZ), which involves phagocytosis, for up to 6 days ( P < 0.05). The impairment of CL activity seemed to be dose dependent, as repeated surfactant applications (cumulative phospholipid dose of 200 mg/kg) reduced OPZ-elicited CL activity to a greater extent than application of a single dose of 100 mg/kg. In agreement with in vitro studies, our data suggest that high-dose application of exogenous surfactant may affect the antibacterial function of phagocytic cells in the lung.     

A Prospective Study of Respiratory Infections in 12-Year-Old Children Actively Engaged in Sports

ABSTRACT. Data on the incidence of respiratory tract infections, antimicrobial treatment, days with fever and absence from school on account of these infections were studied in children participating in extracurricular sports activities with regular supervised training and competitive events. Swimmers, ice-hockey players and apparatus gymnasts were compared to a control group of children. Their mean age was 12.7 years at the end of the one year study. The children were examined three times during the year. More information was collected by a nurse who contacted the mothers of the children every two months. The girls had contracted more respiratory tract infections than the boys during the study. This difference was only seen regarding common colds, not regarding major bacterial respiratory infections, i.e. otitis media, tonsillitis, sinusitis and pneumonia. Because of this difference the results were analysed separately for the sexes. No differences between the sports and the control groups were seen in any respect regarding respiratory infections. Contrary to general opinion, sports participation does not seem to have a preventive effect on the occurrence of respiratory infections in children.     

健康儿童102例脉冲振荡肺功能检测的意义

目的探讨国内健康儿童脉冲振荡肺功能的正常参数。方法102名儿童经采用德国Jaeger公司生产的Master-screen IOS测定仪进行脉冲振荡肺功能测定,并分析其结果。结果儿童随年龄增大和身高的增长,呼吸总阻抗和呼吸道阻力逐步减少,弹性阻力负值减少,与预计值比较部分值有显著性差异。结论我国儿童脉冲振荡正常值参数与国外预计值有差异性,应尽量采用相应人群的预计值。     

严重急性呼吸综合征患儿血清抗严重急性呼吸综合征相关冠状病毒免疫球蛋白G远期随访

目的远期随访严重急性呼吸综合征(SARS)患儿血清中特异性抗SARS相关冠状病毒(CoV)IgG(SARS-CoV-IgG)抗体,并探讨其临床意义。方法儿童SARS临床诊断病例16例和患儿的父母及与其密切接触家庭成员(其中包括7例SARS临床诊断病例、12例非SARS病例)19例。在SARS患儿病程1.5年左右,进行随访。采集患儿及其密切接触家庭成员外周静脉血2 mL,常规分离血清。应用间接免疫荧光法(IFA)检测受试者血清中抗SARS-CoV-IgG抗体。结果16例儿童SARS病例中,8例血清中抗SARS-CoV-IgG阳性,其中4例SARS患病期间抗SARS-CoV-IgM阳性,4例未查抗SARS-CoV-IgM抗体。另8例血清中抗SARS-CoV-IgG阴性,其中4例SARS患病期间抗SARS-CoV-IgM阴性,4例未查抗SARS-CoV-IgM抗体。8例血清中抗SARS-CoV-IgG阳性的SARS患儿的8个家庭中均有2例及2例以上SARS患者。8例血清中抗SARS-CoV-IgG阴性的儿童SARS病例的8个家庭中均只有患儿本人为SARS患者。结论在病程1.5年后,实验室确诊的儿童SARS病例的血清中仍能检测到抗SARS-CoV-IgG抗体。家庭聚集发病是实验室确诊的SARS病例的一个重要特征。     

严重急性呼唆综合征患儿血清抗严重急性呼吸综合征相关冠状病毒免疫球蛋白G远期随访

目的远期随访严重急性呼吸综合征（SARS）患儿血清中特异性抗SARS相关冠状病毒（CoV）IgG（SARS-CoV-IgG）抗体，并探讨其临床意义。方法儿童SAILS临床诊断病例16例和患儿的父母及与其密切接触家庭成员（其中包括7例SARS临床诊断病例、12例非SARS病例）19例。在SARS患儿病程1.5年左右，进行随访。采集患儿及其密切接触家庭成员外周静脉血2mL，常规分离血清。应用间接免疫荧光法（IFA）检测受试者血清中抗SARS-CoV-IgG抗体。结果16例儿童SAPS病例中，8例血清中抗SARS-CoV-IgG阳性，其中4例SARS患病期间抗SARS-CoV-IgM阳性，4例未查抗SARS-CoV-IgM抗体。另8例血清中抗SARS-CoV-IgG阴性，其中4例SAPS患病期间抗SARS-CoV-IgM阴性，4例未查抗SARS-CoV-IgM抗体。8例血清中抗SARS-CoV-IgG阳性的SARS患儿的8个家庭中均有2例及2例以上SARS患者。8例血清中抗SARS-CoV-IgG阴性的儿童SARS病例的8个家庭中均只有患儿本人为SARS患者。结论在病程1．5年后，实验室确诊的儿童SARS病例的血清中仍能检测到抗SARS-CoV-IgG抗体。家庭聚集发病是实验室确诊的SARS病例的一个重要特征。     

温州地区2005～2006年急性呼吸道感染患儿病毒病原学检测的情况

目的了解2005～2006年温州地区急性呼吸道感染（ARI）患儿7种呼吸道病毒感染情况。方法选择3970例ARI患儿。其中急性上呼吸道感染308例,下呼吸道感染3662例。采集门诊患儿咽拭子及病房患儿的鼻咽分泌物,应用直接免疫荧光法检测呼吸道合胞病毒（RSV）,流感病毒（IV）A、B型,副流感病毒（PIV）1、2、3型及腺病毒（ADV）7种常见呼吸道病毒。结果送检标本阳性1773例,阳性率44.7%,以RSV最高（36.2%）。病毒总检出率在性别间（χ^2=9.2P〈0.01）、年龄组间（χ^2=120.5P〈0.01）、疾病种类间（χ^2=101.3P〈0.01）及门诊、住院患儿间（χ^2=180.4P〈0.01）比较均有非常显著性差异。结论RSV仍是温州地区2005～2006年ARI患儿的主要病毒病原,男性患儿较女性患儿对呼吸道病毒易感,且婴幼儿（尤其〈6个月）易感;住院患儿病毒检出率高,以毛细支气管炎阳性率最高。     

Hepatic Erythropoiesis in Infants of Diabetic Mothers: A Morphometric Study

Hepatic erythropoietic tissue is inversely proportional to the gestational age both in infants of diabetic mothers and in control cases. Hepatic erythropoietic and indices range from 17.8 in fetuses and babies before 28 week's gestational age to about 1.0 in fetuses and babies at 40-42 week's gestational age. The decline with gestational age is gradual in the last 10-12 weeks of in utero development. Infants of diabetic mothers who are normally grown have normal amounts of erythropoiesis in their livers. At term, large infants of diabetic mothers have excessive hepatic erythropoiesis. Hypoxia, a frequent feature in infants of diabetic mothers, is probably responsible for the increased erythropoiesis, but an alternate mechanism may be that hyperinsulinemia directly stimulates erythroid precursors or erythropoietin production.     

激素敏感型单纯性肾病综合征患儿尿液呼吸道病毒表达及其与发病的相关性

目的探讨呼吸道病毒感染与激素敏感型单纯性肾病综合征（SRSNS）发病的关系。方法采用反转录-聚合酶链反应（RT-PCR）、桥联酶标（APAAP）法,分别对38例SRSNS患儿（急性期28例,缓解期10例）、18例肾炎性肾病、15例继发性肾病、16例毛细支气管炎和15例健康对照儿童尿液呼吸道病毒基因、抗原进行检测。结果SRSNS急性期组尿液呼吸道病毒基因、抗原检出率均明显高于其他各组,差异有统计学意义（Pa〈0.05）,其中呼吸道合胞病毒（RSV）检出率最高。病毒检出率在是否应用激素间差异无统计学意义。病毒基因与抗原检测结果有较好一致性。结论呼吸道病毒可能是SRSNS重要的触发因素。     

严重急性呼吸综合征易发季节200例住院肺炎患儿临床分析

目的对2004年SARS易发的整个季节中,符合SARS诊断标准2 3 4条的肺炎病例的临床资料作回顾性分析,以供日后鉴别诊断参考。方法对2004年1～5月本院收治的符合《传染性非典型肺炎临床诊断标准》2 3 4条共200例肺炎患儿住院期间血、呼吸道分泌物等临床资料作回顾性分析。结果所有患儿均有发热,白细胞计数不高或降低,入院时胸片均有改变,绝大部分为斑片状渗出影;200例中51例肺炎支原体检测阳性,38例呼吸道合胞病毒(RSV)检测阳性,10例肺炎链球菌阳性,9例流感嗜血杆菌阳性,8例副流感病毒检测阳性及少数其他病原体;入院48h内124例体温降至正常。结论SARS易发季节儿童SARS需与肺炎支原体、呼吸道合胞病毒、流感病毒等病原体引起的肺炎相鉴别。     

北京地区2005年12月～2006年4月下呼吸道感染住院患儿病毒病原检测分析

目的探讨病毒病原在北京地区下呼吸道感染住院患儿中感染特点,为儿童急性下呼吸道感染的诊断和治疗提供参考。方法连续采集2005年12月～2006年4月北京儿童医院因急性下呼吸道感染住院患儿的鼻咽分泌物。采用间接免疫荧光法检测7种呼吸道病毒抗原,包括呼吸道合胞病毒(RSV)、流感病毒(IV)A、B型、副流感病毒(PIV)1、2、3型及腺病毒(ADV)。结果共935例患儿采集了鼻咽分泌物标本。男597例,女338例;年龄1d～6岁,平均7.5个月。935例标本中检出阳性516例(55.2%)。RSV是各年龄组下呼吸道感染的主要病毒病原,所占比例随年龄增加而下降;IV和PIV所占病例随年龄增加而增加,ADV只在3岁以下儿童病例中检出,所占比例为0.6%～6.2%。结论病毒病原是2005年12月～2006年4月北京地区引起儿童下呼吸道感染的主要病原,以RSV为主,其次是IV和PIV。     

急性呼吸窘迫综合征患儿气道吸出物内皮素-1、白细胞介素-8检测的意义

目的探讨内皮素-1(ET-1)和白细胞介素-8(IL-8)在急性呼吸窘迫综合征(ARDS)中的作用。方法采用酶联免疫吸附法(ELISA)检测ARDS 13例及对照组11例气道吸出物(TA)中ET-1、IL-8浓度,并对所有患儿进行肺损伤评分(LIS)。结果ARDs组TA中ET-1、IL-8含量较对照组显著增高(P<0.01),死亡组TA中ET-1、IL-8水平显著高于存活组(P<0.01),LIS评分与ET-1、IL-8水平呈显著正相关(P<0.01)。结论ET-1、IL-8参与ARDS发病过程,早期测定肺内ET 1、IL-8水平可作为判断其肺损伤严重程度和预后的指标。     

History of respiratory infections in the first 12 yr among children from a birth cohort

Respiratory infections are the most frequent health problem in childhood. There is little precise information on how many respiratory illness episodes can be expected in a normal child. This study was designed to create reference values for the frequency of respiratory infections as recordable by history. Respiratory illnesses were recorded in a prospective birth cohort of 1314 German children born in 1990 and tracked until age 12 yr (760 children). Parents recorded the child's illnesses in a diary and answered structured questions yearly up to age 12. Age of study subjects was categorized into infancy (0–2 yr), pre-school age (3–5 yr), and school age (6–12 yr). The mean cumulative number of respiratory infection episodes up to age 12 yr was 21.9 (s.d. 9.0) episodes. In infancy, the mean annual number was 3.4 (3.7) episodes; at pre-school age, 2.3 (2.6) episodes; and at school, age 1.1 (1.2) episodes. The mean cumulative time of episodes up to age 7 yr was 20.1 (15.2) wk. Forty-five percent of the infants in the upper episode incidence tertile continued to be in the upper tertile at school age. Based on a twofold standard deviation of the mean number, up to 11 respiratory infection episodes per year in infancy, 8 episodes per year at pre-school age, and 4 episodes per year at school age could be regarded as normal. Episodes within these reference values per se should not cause unwarranted concern or intervention because of suspected immunodeficiency.     

Short Normal Children and Environmental Disadvantage: A Longitudinal Study of Growth and Cognitive Development from 4 to 11 Years

The aim of this investigation was to follow up a sample of exceptionally short but medically healthy children, and a normal comparison group, previously studied at 4 years of age. They lived in an inner-city area which was, on objective criteria, seriously disadvantaged in socioeconomic terms. When first seen at 4 years, cases were significantly impaired in cognitive abilities relative to comparisons, although firstborns were much less severely affected. Of the original 46 cases, 45 were assessed again at 11 years. Most continued to live in the same geographical area. Case children remained exceptionally short, even when parental stature was taken into account, although a degree of catch-up had occurred. One third had special educational needs, and a similar proportion had been referred for speech therapy. Verbal and nonverbal cognitive skills of both case and comparison children had, on the whole, changed little and group differences persisted. In conclusion, short normal children from socioeconomically disadvantaged backgrounds are at high risk of educational failure at elementary school.     

A Children of Twins Study of parental divorce and offspring psychopathology

BACKGROUND: Although parental divorce is associated with increased substance use and internalizing problems, experiencing the separation of one's parents may not cause these outcomes. The relations may be due to genetic or environmental selection factors, characteristics that lead to both marital separation and offspring functioning. METHOD: We used the Children of Twins (CoT) Design to explore whether unmeasured genetic or environmental factors related to the twin parent, and measured characteristics of both parents, account for the association between parental divorce and offspring substance use and internalizing problems. RESULTS: The association between parental divorce and offspring substance use problems remained robust when controlling for genetic and environmental risk from the twin parent associated with parental divorce, and measured characteristics of both parents. The results do not prove, but are consistent with, a causal connection. In contrast, the analyses suggest that shared genetic liability in parents and their offspring accounts for the increased risk of internalizing problems in adult offspring from divorced families. CONCLUSIONS: The study illustrates that unmeasured genetic and environmental selection factors must be considered when studying parental divorce. In explaining associations between parental divorce and young-adult adjustment, our evidence suggests that selection versus causal mechanisms may operate differently for substance abuse (a causal relation) and internalizing problems (an artifact of selection). The CoT design only controls for the genetic and environmental characteristics of one parent; thus, additional genetically informed analyses are needed.     

C1q and C1 Subcomponent Complexes in Otitis-Prone and Non-Otitis-Prone Children A Prospective Study of Children during their First Years of Life

ABSTRACT. Children with recurrent acute otitis media (rAOM) often show reduced C1q concentrations and an excess of (C1r-C1s)₂ complexes. It is not known if such C1 aberrations precede development of rAOM or are a consequence of the infections. For this reason, serial investigation of C1q and C1 subcomponent complexes from birth until the age of three was performed in 113 children, 13 of whom developed rAOM. Clq concentrations at birth were found to be lower in the rAOM group than in children who did not experience acute otitis media, and were also correlated with age at the time of the first AOM episode. However, the wide variation of C1q within the groups precluded the use of C1q as a predictive marker. Excess (C1r-C1s)₂ complexes were consistently absent at birth. High concentrations were found in children with established otitis media and the complexes persisted in association with recurrent disease. In conclusion, the C1 aberrations characteristic of rAOM were mainly acquired as a result of infection.