急性肾小球肾炎急性期血清丙二醛的测定及其临床意义

为了探讨急性肾小球肾炎患儿肾脏损伤与脂质过氧化反应的关系,我们检测了34例急性肾小球肾炎住院患儿血清脂质过氧化反应代谢终产物——丙二醛(MDA)的含量,并与正常儿童68例对照比较,以了解急性肾小球肾炎急性期血清MDA的变化。     

超声心动图诊断先天性冠状动脉瘘

超声心动图诊断左、右冠状动脉痿4例,均经选择性冠状动脉造影和手术证实。其二维超声心动图特征是于胸骨旁主动脉根部短轴查见显著扩张的左、右冠状动脉,内径为7.8±0.15mm,与正常儿童有显著差异(P<0.01)。肋下五腔心查见扩张的左冠状动脉,目前尚未见文献报告。此外,我们采用同样方法观察正常儿童30例,其左、右冠状动脉内径均<3mm。本文结果提示:当儿童冠状动脉内径>3mm,并结合临床体征,应考虑有冠状动脉扩张。     

心血管系统疾病

073936学龄前儿童植入永久心脏起搏器的研究/陈晓彬…∥中国医学工程.-2007,15(6).-483~485073937210例正常儿童冠状动脉内径超声心动图测定初步研究/张园海…∥重庆医学.-2007,36(15).-1506~1507,1510选择14岁以下正常儿童210例,分7个年龄组,采用HP SONOS5500型多普勒超声诊断仪测定左、右冠状动脉内径和主动脉根部内径。结果:除新生儿组外,各同年龄组中左冠状动脉与右冠状动脉均值间差异有统计学意义。冠状动脉内径与年龄、身高、体重和体表面积呈正相关。左右冠状动脉/主动脉根内径与右冠状动脉/主动脉根部内径值处在较小的范围,各年…     

急性肾小球肾炎与肾病综合征患儿体液免疫指标比较

目的 检测急性链球菌感染后。肾小球肾炎与肾病综合征（NS）患儿体液免疫指标，进行比较、分析，以达到早期鉴别诊断、早期合理用药目的。方法 对23例链球菌感染后肾小球肾炎、48例Ns、正常对照18例儿童检测血IgG、IgA、IgM、C3、C4水平，采用英国MININEPH仪器及配套试剂，散射比浊法检测。IgE定量检测采用美国E＆ELABSINC公司全套试剂盒，ASO采用免疫比浊法，血沉采用魏氏法检测。结果急性肾小球肾炎与正常对照组比较，IgG、IgA、IgE、C3、C4有显著性差异（Pa〈0.05），ASO、血沉具有均明显升高（Pa〈0．05）。NS与正常对照组比较，IgG、IgM、IgE具有显著性差异（Pa〈0．05）；急性。肾小球肾炎与NS比较，IgG、IgA、C3、C4具有显著性差异（Pa〈0．05），前者IgG、IgA明显升高，c3、c4明显降低，而后者IgG则明显降低。结论急性肾小球肾炎与NS患儿临床表现不典型者可通过检测血IgG、IgA、C3、C4水平加以鉴别．再辅以ASO、血沉检测，可达到早期诊断、早期治疗的目的。     

小儿急性肾功能衰竭的护理体会

小儿急性肾功能衰竭的护理体会中国医科大学第二临床学院（１０００３）刘静我院儿科自１９９２年１月～９４年６月共收治小儿急性肾功能不全（急性肾衰）患儿１６例，其中男１０例，女６例，３～６岁５例，７～１４岁１１例。原发病中急性肾小球肾炎５例，肾炎型肾病５例...     

30例儿童毛细血管内增生性肾小球肾炎临床和病理分析

为了解毛细管内增生性肾小球肾炎的特殊临床表现,探讨肾穿刺活检术在急性肾小为中的应用,采用回顾分析法,对３０例毛细血管内增生 性肾小球肾炎临床、病理进行统计分析,结果显示,临床表现为肾病综合征８例,急性肾功能衰竭８例,ＩｇＡ肾病６例,急性肾炎６例,隐匿性肾炎２便。病理学表明,以肾病型、肾衰型病变重,分别有不同程度的新月体形成。肾病型有５例免疫荧光示ＩｇＧ、Ｃ３沉积呈“花环状”,提示毛细血管内增生性肾     

川崎病冠状动脉病变九年的回顾分析

川崎病是儿科常见的后天性心血管病之一 ,因其对心脏的损害 ,受到了普遍的关注。其中冠状动脉病变最为严重 ,多发生在疾病的急性期。我们回顾了 1992年 1月～ 2 0 0 0年12月在我院住院的川崎病患儿 875例 ,其中 313例患儿有川崎病急性期冠状动脉病变 ,初步分析如下。方法及诊断标准本组病例诊断均符合 1984年日本川崎病研究委员会修订的诊断标准。采用日本东芝 14 0Ａ及美国ＡＬＴ公司Ｕ 9超声诊断仪 ,探头频率 3或 5ＭＨｚ。冠状动脉 (ＣＡ)内径正常值采用我院资料[1] ,内径超过该年龄的正常值为冠状动脉扩张(ＣＡＤ)。左冠状动脉 /主动脉…     

川崎病患儿血脂代谢变化的检测及分析

一般资料:川崎病(KD)组为我院1999年6月至2 0 0 2年1月收治的5 0例KD患儿,男30例,女2 0例,年龄4个月至6岁,平均(2 7 1±6 6 )个月,所有患儿均符合1984年日本川崎病委员会修订的KD诊断标准。其中4 3例分别在入院时至病程6周内用HP 10 0 0型超声仪检测冠状动脉2～3次,发现冠状动脉病变10例。冠状动脉病变包括冠状动脉扩张(7例,冠状动脉内径>3mm)和冠状动脉瘤(3例,冠状动脉呈瘤样扩张或冠状动脉内径/主动脉内径≥0 3)。正常对照组2 0例,男12例,女8例,年龄5个月至7岁,平均(2 9 5±7 8)个月,为本院健康体检儿童,近3个月无感染病史。感染疾…     

川崎病并发冠状动脉病变的超声心动图表现的动态观察

目的 探讨川崎病(KD)所引起的冠状动脉扩张(CAD)以及冠状动脉瘤(CAA)的超声心动图特点.方法 用彩色多普勒超声心动图检测KD患儿冠状动脉开口和内径,并动态观察静脉免疫球蛋白治疗前后冠状动脉内径的变化情况.结果 本组46例KD患儿,41例患儿行超声心动图检查,合并CAD 12例,左冠状动脉(LCA)较右冠状动脉(RCA)更易受累及(P<0.05);CAA 4例,均为双侧冠状动脉病变,最大内径10 mm.治疗后6～18 d复查超声心动图,CAD组LCA较治疗前明显回缩(P<0.05),RCA内径无变化(P>0.05);CAA组LCA和RCA内径均无明显变化(P>0.05).对10例冠状动脉病变患儿进行随访,其中8例CAD冠状动脉内径均恢复正常,1例CAA冠状动脉病变加重,1例CAA完全恢复正常.结论 (1)在KD所引起的CAD中,LCA比RCA更易受累及,静脉免疫球蛋白治疗后短期内LCA明显回缩.(2)超声心动图是动态观察KD并发CAD和CAA的无创手段.     

急性肾小球肾炎患儿红细胞免疫功能探讨

我们研究了１９９５年１０月至１９９７年５月本院儿科３２例急性肾小球肾炎患儿红细胞免疫粘附功能的动态变化,报告如下。临床资料：根据全国儿科肾脏病科研协作组制订的“关于小儿肾小球疾病临床分类和治疗的建议”及广州修订意见进行诊断、治疗。急性肾小球肾炎３２例...     

Allergic factors associated with the development of asthma and the influence of cetirizine in a double-blind, randomised, placebo-controlled trial: First results of ETA®

There is a common progression known as the allergic march from atopic dermatitis to allergic asthma. Cetirizine has several antiallergic properties that suggest a potential effect on the development of airway inflammation and asthma in infants with atopic dermatitis. Methods. Over a two year period, 817 infants aged one to two years who suffered from atopic dermatitis and with a history of atopic disease in a parent or sibling were included in the ETAC^® (Early Treatment of the Atopic Child) trial, a multi-country, double-blind, randomised, placebo-controlled trial. The infants were treated for 18 months with either cetirizine (0.25mg/ kg b.i.d.) or placebo. The number of infants who developed asthma was compared between the two groups. Clinical and biological assessments including analysis of total and specific IgE antibodies were performed. Results. In the placebo group, the relative risk (RR) for developing asthma was elevated in patients with a raised level of total IgE (≥ 30 kU/I) or specific IgE (≥ 0.35 kUA/I) for grass pollen, house dust mite or cat dander (RR between 1.4 and 1.7). Compared to placebo, cetirizine significantly reduced the incidence of asthma for patients sensitised to grass pollen (RR = 0.5) or to house dust mite (RR = 0.6). However, in the population that included all infants with normal and elevated total or specific IgE (intention-to-treat - ITT), there was no difference between the numbers of infants developing asthma while receiving cetirizine or placebo. The adverse events profile was similar in the two treatment groups. Discussion. Raised total IgE level and raised specific IgE levels to grass pollen, house dust mite or cat dander were predictive of subsequent asthma. Cetirizine halved the number of patients developing asthma in the subgroups sensitised to grass pollen or house dust mite (i.e. 20% of the study population). In view of the proven safety of the drug, we propose this treatment as a primary pharmacological intervention strategy to prevent the development of asthma in specifically sensitised infants with atopic dermatitis.     

�¶�֢��ϵ�ϰ���ע��ȱ�ݶද�ϰ������ڵ�ת��

孤独症谱系障碍(autistic-spectrum disorders,ASDs)近年来患病率逐年攀升至1%左右,其症状往往伴随终生,成为严重威胁儿童健康和发展的神经发育性疾患;注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)是儿童期最常见的精神障碍,国内报道患病率为4.13%～5.83%,其症状可延续至青少年期,甚至到成年期[1]。这两类精神障碍在成年期的临床表现、共患病、治疗策略和预后与儿童期有哪些不同呢?本文通过回顾相     

EXCITING NEW TREATMENT APPROACHES FOR PATHYPHYSIOLOGIC MECHANISMS OF SICKLE CELL DISEASE

During the past several decades, our understanding of the complex pathophysiology of vasoocclusion associated with sickle cell disease has improved greatly. Interaction of genes, hemoglobin molecules, red cell membrane and metabolic changes, cell-cell interactions and cell-plasma interactions, red cell adhesion to vascular endothelium, activation of coagulation, and vascular reactivity play a role in vaso occlusion. Penicillin prophylaxis of pneumococcal infections and appropriate use of blood transfusions and other supportive measures improved survival of sickle cell patients. Hydroxyurea made a major impact on sickle cell therapy when it was shown to decrease acute painful episodes, acute chest syndrome, and the need for blood transfusion in adults. Significant experience in the use of hydroxyurea has been accumulated in older children. The benefits and risks of hydroxyurea for younger children and long-term risks in all patients will be evaluated in future investigations. Other promising therapies include butyrate compounds, clotrimazole, magnesium supplementation, poloxamer 188, antiadhesion agents, anticoagulant approaches, and nitric oxide. Hemopoietic transplantation remains the only curative therapy. However, several transgenic mouse models are available for studies of gene therapy or other treatment approaches on biochemical, cellular, and pathologic effects of mutant genes.     

Infiltrations of Epstein-Barr virus-carrying cells in granular lymphocyte-proliferative disorders corresponding to chronic active Epstein-Barr virus infection

A 21-year-old man with granular lymphocyte-proliferative disorders (GLPD) associated with chronic active Epstein-Barr virus (EBV) infection is described. Chromosomal analyses revealed several clonal abnormalities and two of them were mainly repetitious. High copy numbers of monoclonal EBV genome were also detected in the proliferative large granular lymphocytes (LGLs), indicating the monoclonal expansion of EBV-infected LGLs. The patient had an indolent course for several years, and there was no evidence of infiltrations of his bone marrow until the end stage. At autopsy, microscopic studies revealed marked infiltrations of LGL in the liver and spleen, and the infiltrating cells were NK-cell immunophenotype. The infiltrated LGLs showed latency I.     

LUTEINIZING HORMONE RECEPTOR MUTATIONS IN DISORDERS OF SEXUAL DEVELOPMENT AND CANCER

Human male sexual development is regulated by chorionic gonadotropin (CG) and luteinizing hormone (LH). Aberrant sexual development caused by both activating and inactivating mutations of the human luteinizing hormone receptor (LHR) have been described. All known activating mutations of the LHR are missense mutations caused by single base substitution. The most common activating mutation is the replacement of Asp-578 by Gly due to the substitution of A by G at nucleotide position 1733. All activating mutations are present in exon 11 which encodes the transmembrane domain of the receptor. Constitutive activity of the LHR causes LH releasing hormone-independent precocious puberty in boys and the autosomal dominant disorder familial male-limited precocious puberty (FMPP). Both germline and somatic activating mutations of the LHR have been found in patients with testicular tumors. Activating mutations have no effect on females. The molecular genetics of the inactivating mutations of the LHR are more variable and include single base substitution, partial gene deletion, and insertion. These mutations are not localized and are present in both the extracellular and transmembrane domain of the receptor. Inactivation of the LHR gives rise to the autosomal recessive disorder Leydig cell hypoplasia (LCH) and male hypogonadism or male pseudohermaphroditism. Severity of the clinical phenotype in LCH patients correlates with the amount of residual activity of the mutated receptor. Females are less affected by inactivating mutation of the LHR. Symptoms caused by homozygous inactivating mutation of the LHR include polycystic ovaries and primary amenorrhea.     

Resurgence of measles in Singapore: profile of hospital cases

OBJECTIVE: To ascertain the profile of cases of measles seen at a general hospital during a recent outbreak that occurred despite a measles vaccination program. METHODOLOGY: A retrospective study from January 1991 to March 1998. All patients with measles (ICD code 055. 9) seen at the emergency unit or as inpatients were included. RESULTS: There were 87 cases identified. The diagnosis was clinical in all and proven serologically in 71%. Eighty-five per cent of the cases occurred between January 1997 and March 1998. There was a bi-modal age distribution with peaks in the very young (相似文献   

Personality profiles and heart rate variability (vagal tone) in children with recurrent abdominal pain

The aim of the study was to explore psychological factors and autonomic activity in children with recurrent abdominal pain and to compare them with those in a control group of healthy children. The Personality Inventory for Children was used for assessment of developmental, emotional and psychosocial factors in 25 children with recurrent abdominal pain (age, 7-15 y). Parasympathetic and sympathetic functions in these children and in 23 healthy control subjects (age, 7-13 y) were also investigated, non-invasively using a computerized polygraph. Vagal tone (parasympathetic function) was indexed by calculation of respiratory sinus arrhythmia in beats/min. Skin conductance (sympathetic function) was recorded by the constant current method. On the Personality Inventory for Children, 16 patients had high scores on somatic concern. Several patients had scores in the clinical range for depression, withdrawal and anxiety, but the mean scores for these personality profile scales were well within the normal range of healthy children. Interestingly, there was a spike on the L (Lie)-scale for most of the patients and 15 patients had scores above or close to the clinical cut-off value. As compared with the scores in healthy children, vagal tone and sympathetic tone were normal. Conclusion: Many children with recurrent abdominal pain have scores in the clinical range for depression, withdrawal, anxiety and L-scale indicating coping problems, denial and a trend towards somatic concern that may contribute to the evolution of abdominal pain. Autonomic nerve activity was not disturbed in these children.     

Overcoming surfactant inhibition with polymers

Inhibition of the function of pulmonary surfactant in the alveolar space is an important element of the pathophysiology of many lung diseases, including meconium aspiration syndrome, pneumonia and acute respiratory distress syndrome. The known mechanisms by which surfactant dysfunction occurs are (a) competitive inhibition of phospholipid entry into the surface monolayer (e.g. by plasma proteins), and (b) infiltration and destabilization of the surface film by extraneous lipids (e.g. meconium-derived free fatty acids). Recent data suggest that addition of non-ionic polymers such as dextran and polyethylene glycol to surfactant mixtures may significantly improve resistance to inhibition. Polymers have been found to neutralize the effects of several different inhibitors, and can produce near-complete restoration of surfactant function. The anti-inhibitory properties of polymers, and their possible role as an adjunct to surfactant therapy, deserve further exploration.     

Understanding infant formula

The World Health organisation recommends breast feeding infants for the first six months of life. When this breast feeding does not occur either through parental choice or medical need, infant formulas will be required. There is a bewildering array of formulas on the UK market for many different requirements. When faced with an unsettled infant many parents (and healthcare professionals) will experiment with the infant formula available and then attend the paediatric clinic looking for help and advice. It is therefore essential that paediatricians understand what milks are available and what the key differences between different products are. This review attempts to provide a simple guide through many of the formulations currently available in the UK; and offers advice for the dietary management of the child with extra calorie requirements, infants with cow's milk protein allergy, gastro oesophageal reflux disease, apparent unresolved hunger and infantile colic. Whatever the underlying condition, there is likely to be an infant formula that is suitable in this generation of ever expanding formulations.