甘肃省金昌市儿童血铅水平调查分析

目的了解甘肃省金昌市2~7岁儿童血铅水平。方法随机抽取2004年10月~2005年6月金昌市部分幼儿园256名儿童。男133名,女123名;用石墨炉原子吸收分光光度仪测定血铅水平。结果儿童血铅水平为(126.30±52.98)μg/L。血铅水平最低值为28.3μg/L,最高值为268.0μg/L,超过100μg/L者160例,占62.54%。血铅水平随年龄增加有上升趋势,2~3岁组明显低于5~6岁组、6~7岁组,差异有统计学意义(P<0.05,0.01);性别间血铅水平差异无统计学意义(P>0.05)。结论甘肃金昌市儿童血铅水平较高,铅中毒现象不容忽视。     

儿童铅中毒高危因素分析

目的探讨儿童铅中毒发生的高危因素,以便能更好地进行预防。方法选择1055例门诊患儿。年龄5个月~16岁,平均(7.2±3.5)岁。应用3010-B血铅分析仪对患儿进行血铅测定;同时对每位患儿进行铅中毒影响因素问卷调查。结果儿童血铅水平(110.1±41.9)μg/L,铅中毒(血铅≥100μg/L)检出率为43.51%,各年龄组血铅水平无显著差异。多因素逐步回归分析显示,对儿童血铅水平发生显著影响因素依次是不勤洗手、经常吃膨化食品、偏(挑)食、不常补钙和锌及经常居室装修。结论不良的饮食和生活习惯是儿童铅中毒发生的高危因素。     

中毒

074036儿童药物超敏综合征9例临床分析/汤建萍…∥中国皮肤性病学杂志.-2007,21(7).-412~413回顾分析9例住院儿童药物超敏综合征的临床资料和随访结果。结果:9例患儿均出现发热、全身皮疹、浅表淋巴结肿大和内脏损害。致敏药物苯巴比妥6例、卡马西平4例、磺胺嘧啶和阿司匹林各1例。随访时均已痊愈。参6(原文摘要)0740373~12岁儿童铅中毒流行病学调查/张淑莲…∥中国妇幼保健.-2007,22(17).-2414~2415被调查的44052名儿童中,血铅水平≥100μg/L有14603名,铅中毒检出率为33.15%;区域间儿童铅中毒检出率差异非常显著(P<0.005),其中7~12岁组儿…     

登封地区新生儿血铅的相关因素调查分析

目的调查分析登封地区新生儿血铅水平及其相关因素。方法按照河南省儿童青少年铅中毒监测与防治工作方案,采用原子吸收光谱法(GFAAS)对199例新生儿和产妇进行指尖微量血血铅水平测定,并对其出生情况、母孕情况、家庭环境等相关因素进行问卷式调查。结果1.共发放儿童少年血铅监测登记表、产妇血铅监测调查登记表400份,回收398份,回收率99.5%,应答合格率100%。2.新生儿199例。男102例,女97例。血铅2.1~45.9μg/L,中位数13.6μg/L,均值13.9μg/L。3.产妇199例。年龄19~41岁;血铅27.0~112.4μg/L,血铅≥100μg/L占6.03%。4.经方差分析得出,新生儿与产妇之间存在显著线性正相关关系。通过相关性分析,除产妇化妆比例对血铅值呈负相关外,其他因素均对血铅水平有明显的高危影响。结论登封地区新生儿血铅水平与孕妇情况、父母职业、居住环境、拥有车辆等有关,应引起重视。     

神经系统疾病儿童的血铅水平调查:单中心初步研究(英文)

目的儿童铅中毒具有很大的潜在危害。慢性低水平铅暴露会导致学习障碍及行为问题,如腹痛,失眠,多动,生长发育落后,听力损失,上肢无力。该研究旨在调查神经系统疾病儿童的血铅水平,并与健康儿童作比较。方法100名患有神经系统疾病的1～10岁儿童作为研究对象。100名年龄和性别匹配的健康儿童作为对照。采用火焰原子吸收光谱法检测血铅含量。结果神经系统疾病组儿童的平均血铅含量显著高于对照组,差异有显著性(113.2±47.5μg/Lvs84.7±38.0μg/L;P<0.01)。神经系统疾病组和对照组分别有44%和19%的儿童血铅超标(>100μg/L)。结论儿童血铅水平增高可能与神经系统疾病有关。建议对患神经系统疾病的儿童常规作血铅测定。     

湖南省城镇学龄前儿童血铅水平流行病学调查

目的：调查湖南省城镇学龄前儿童血铅水平及影响因素,为儿童铅中毒的防治提供科学依据。方法：2008年9月至2009年6月整群随机抽取湖南省12个地区城镇学龄前儿童2 044名,男1 108名,女936名,年龄2～6岁,平均4.4±1.1岁。采用原子吸收光谱法测定末梢血血铅水平, 并采用《中国部分城市儿童铅中毒防治项目调查表》进行问卷调查。Logistic回归分析血铅水平的影响因素。结果：湖南省学龄前儿童平均血铅值为81.9±34.5 μg/L。血铅水平≥100 μg/L者482例,占23.58%。其中血铅水平100～199 μg/L(高铅血症)472例,占23.09%,血铅水平≥200 μg/L（铅中毒）10例,占0.49%。不同年龄组间血铅异常(血铅水平≥100 μg/L)率差异有统计学意义(P<0.01)。男童的血铅异常率为28.99%,高于女童的 21.98% （P<0.01）。不同地区儿童血铅异常率差异亦有统计学意义 (P<0.01)。回归分析显示,男性(OR=1.449, P<0.01)、父亲从事铅暴露职业(OR=1.314, P<0.01)及母亲常用染发剂（OR=1.678,P<0.05）为儿童血铅异常的危险因素。结论：湖南省城镇学龄前儿童血铅异常率较高。该省城镇学龄前儿童血铅异常率与儿童所在地区和年龄有关。男性、父亲从事铅暴露职业及母亲常用染发剂为儿童血铅异常的危险因素。［中国当代儿科杂志,2010,12（8）：645-649］     

多发性抽动症患儿血铅水平测定的意义

目的研究多发性抽动症儿童血铅水平及铅接触的相关因素。方法对76例多发性抽动症患儿父母进行问卷调查铅接触相关因素,采用原子吸收光谱仪进行血铅测定。结果对多发性抽动症患儿76例进行血铅水平测定,结果36例血铅≥100μg/L,铅中毒发生率为47.37%(36/76),其中学龄前组铅中毒发生率为45.16%(14/31),学龄组为48.84%(22/45)。结论血铅增高与儿童多发性抽动症有一定关系,治疗多发性抽动症的同时应关注患儿血铅水平。     

儿童铅中毒诊治进展

理想的血铅水平应是零,但由于环境污染体内血铅常 常并不为零.美国国家疾病控制中心(CDC)1991年将血 铅质量浓度≥100μg/L定义为儿童铅中毒(childhood lead poisoning).近来开始重视血铅≥100μg/L是一个群体流 行病学的概念,而并非临床医学上的诊断标准.2006年我 国调整了儿童铅中毒的诊断标准,提出了高铅血症概念,制 定了铅中毒的干预和治疗方案(试行)[1].     

3岁以下儿童铅中毒临床分析

目的 了解婴幼儿铅中毒状态及程度。 方法 对前来保健门诊健康体检的4 543例3岁以下儿童进行血铅含量测定,并将婴幼儿分为1个月-、6个月-、12个月-、18个月-、24个月-、30-36个月6组。以SAS 8.0统计软件进行统计分析。结果 铅中毒检出率为2.05%,3岁以下儿童血铅水平随月龄的增长而增高。结论 在接受血铅水平检测的婴幼儿中,高铅血症的检出率随年龄增长而增加,铅中毒则年龄越小检出率越高。要注意控制婴幼儿接触铅的各种途径。     

急性喉炎患儿非细菌病原学分析

目的了解儿童急性喉炎的非细菌病原学特点。方法收集2006年1月至2015年12月连续10年间因急性喉炎住院治疗的325例患儿的病史资料及痰标本,进行多病原联合检测并结合病史资料进行分析。直接免疫荧光法检测7种常见呼吸道病毒,荧光定量PCR法检测肺炎支原体(MP)、肺炎衣原体(CP)及博卡病毒(HBo V),RT-PCR法检测鼻病毒(HRV)及偏肺病毒(h MPV),入院24 h内及治疗7~10 d采集静脉血,ELISA法检测血清特异性MP抗体Ig G、Ig M。结果325例急性喉炎患儿非细菌病原学检出率为46.2%(150/325)。检出病毒76例(23.4%),MP 99例(30.5%)。1~3岁组患儿病毒检出率明显高于1岁及≥3岁组患儿(χ~2=9.527,P=0.009)。随着年龄的增加,MP检出率逐渐升高(χ~2=10.132,P?=0.006)。0~3岁组RSV及hBoV检出率较高。冬春季病毒检出率明显高于夏秋季(χ~2=5.064,P=0.024)。冬、春、夏、秋季MP检出率分别为13.1%、25.0%、38.2%、44.9%,MP检出率逐渐升高(χ~2=4.438,P=0.035)。RSV冬季检出率高,hBoV夏季检出率较高。结论急性喉炎主要发生于3岁儿童,不同年龄及季节的病原检出不同。病毒是小年龄组的主要病原,大年龄组则以MP较为多见。     

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.     

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   

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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.     

A profile of respiratory symptoms in urban and rural South Australian school children

This report describes the cross-sectional analyses of data from the first year of a longitudinal study using questionnaire and respiratory function data over a 5 year period from a sample of rural South Australian school children. The cumulative or lifetime prevalences of respiratory symptoms were estimated in 825 rural and 1261 urban school children aged between 5 and 15 years in order to determine if the prevalence rates differed between rural and urban school children. The study found the overall cumulative prevalence of asthma and/or wheezy breathing (AWB) to be 24.1% in the rural school children compared to 27.6% in the urban school children. Most children developed AWB symptoms before the age of 7 years, with 20% reporting moderately severe symptoms and 10% having more than one attack per fortnight. The cumulative prevalence of bronchitis, loose/rattly cough (BLRC) differed significantly between the rural school children (34.1%) and urban school children (47.9%). The BLRC symptoms preceded the development of AWB in many cases. Urban school children also reported a higher prevalence of atopic conditions.     

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.     

Hauttemperaturen verschiedener Körperoberflächenareale des Rumpfes bei Säuglingen

Summary In two groups of infants (3–53 weeks old) skin temperatures were controlled in different areas of the trunk—i.e.: regions of sternum, lungs, heart, liver, spleen, kidneys—at different room-temperatures (group I: 21–25°C; group II: 29–32°C). Rectal temperatures of some probands in both groups also had been controlled simultaneously. A definite change in the reaction to heat was proofed in different periods of the first year of life. In higher environmental temperatures the skin temperature was almost constant at every controll-point of the skin, even in older infants. In lower environmental temperatures the skin temperatures lowered continuously with age till 7. to 9. moth. From 10. to 12. month the lowering of skin temperature discontinued. The rectal temperatures were relatively constant in all infants. Only in infants from 7. to 12. month, whose skin temperatures were controlled in lower as well as in higher environmental temperatures, a tendency to higher rectal temperatures was proofed in warmer environmental temperatures.The significance of these results is discussed.

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Untersuchungen mit Unterstützung durch die Deutsche Forschungsgemeinschaft.