早期识别及干预婴儿牛奶蛋白过敏引起湿疹的效果分析

目的 研究婴儿湿疹与牛奶蛋白过敏的关系,提高婴儿湿疹牛奶蛋白过敏的诊断率。方法 243例儿童保健科门诊常规保健出生30 d的湿疹婴儿作为研究对象,根据家长意愿将患儿分为观察组(158例)及对照组(85例)。观察组湿疹婴儿遵医嘱全程采用回避牛奶饮食,人工喂养儿食用氨基酸配方粉或深度水解蛋白配方粉,母乳喂养儿的母亲回避牛奶及其制品,混合喂养者同时按照以上两种方法喂养;对照组湿疹婴儿饮食不变。比较两组患儿的喂养方式及治疗效果。结果 观察组患儿母乳喂养42例、混合喂养60例、人工喂养56例,对照组患儿母乳喂养30例、混合喂养37例、人工喂养18例;两组患儿的喂养方式比较,差异无统计学意义(χ^2=5.537, P=0.063>0.05)。干预后,观察组总有效率为88.6%,明显高于对照组的52.9%,差异具有统计学意义(P<0.05)。结论 牛奶蛋白容易导致婴儿过敏,临床需密切观察,早期采用饮食排除法诊断与治疗,可减少婴儿湿疹发生的几率,促进儿童生长发育。     

深度水解蛋白配方治疗牛奶过敏的疗效分析

目的研究探讨深度水解蛋白配方喂养治疗牛奶蛋白过敏婴儿,并与普通配方喂养的牛奶蛋白过敏婴儿对照,以便判断其治疗方法的可行性。方法通过皮肤点刺试验,结合临床症状、病史研究135例牛奶蛋白过敏婴儿,随机分成治疗组和对照组,治疗组采用深度水解蛋白配方喂养、常规对症处理;对照组采用普通牛奶配方喂养、同样的常规对症处理。每个婴幼儿研究期为4周,研究期间婴儿不能喂养其他辅食,纳入研究后婴儿回院每周复诊一次,观察患儿的临床症状。结果治疗组中有7例退出,其中3例因配方昧苦婴儿不肯进食,要求退出;2例大便稀,次数多要求退出;2例自行退出,治疗总有效率为94％。结论深度水解蛋白配方治疗牛奶蛋白过敏疗效显著,为基层医院提供简单、安全有效的治疗途径。     

喂养干预对婴儿过敏性疾病影响的跟踪研究

目的研究喂养干预对婴儿过敏性疾病的影响,为过敏性疾病的早期预防提供依据。方法根据喂养方式研究组分为母乳组(Human Milk,HM)、适度水解配方(Partially Hydrolyzed Formula,PHF)组、母乳与适度水解配方(HM+PHF)组;对照组分为HM组、普通配方(Cows'Milk Formula,CMF)组、母乳与普通配方(HM+CMF)组。鼓励各组纯母乳喂养至少4个月,母乳不足或没有时,补充或只喂养初始随机分配的配方奶粉至6月龄,定期随访婴儿过敏性疾病的发生情况。结果调查问卷显示HM组、HM+PHF组、HM+CMF组与CMF组的婴儿过敏性疾病的发生率有显著差异。婴儿出现过敏性疾病症状的平均月龄HM组、HM+PHF组、HM组与PHF组之间差异显著。结论母乳喂养可有效降低婴儿过敏性疾病的发生率。母乳不足时添加适度水解配方可降低婴儿过敏风险并推迟过敏症状的出现时间,从而有效地预防婴儿过敏性疾病的发生。     

益生菌早期干预对婴儿过敏性疾病的影响

目的：探讨益生菌早期干预对婴儿过敏性疾病的影响。方法：选择我院2014年8月～2016年2月妇产科经阴道分娩正常出生的婴儿86例作为研究对象,按随机数字表法分为观察组和对照组各43例。观察组于出生后d2给予口服益生菌,口服至6个月龄,对照组未添加益生菌。两组新生儿均于出生7d后取新鲜大便1.0g进行厌氧和需氧培养,分析并记录厌氧菌（双歧杆菌、乳杆菌）和需氧菌（肠球菌、肠杆菌）菌落数量,随访6个月过敏性疾病发生率。结果：两组婴儿出生7d后大便培养肠道菌落数量比较,观察组双歧杆菌、乳杆菌多于对照组,条件致病菌肠球菌少于对照组,差异具有统计学意义（P<0.05）;肠杆菌比较差异无统计学意义（P>0.05）。两组婴儿发生新生儿皮炎、婴儿湿疹、卡他性鼻炎、婴儿哮喘的率比较,差异无统计学意义（P>0.05）;观察组过敏症状总发生率为16.28%,对照组过敏症状总发生率为39.53%,差异显著（P<0.05）。结论：益生菌早期干预可有效降低婴儿过敏性疾病的发病率,值得推广。     

婴儿特应性湿疹与孕妇饮牛奶关系的临床观察

目的：探讨孕期饮食牛奶与出生婴儿湿疹之间的关系,并通过对孕妇饮食的护理干预来影响婴儿湿疹的发生。方法筛选2011年3月~2013年6月两年多来本院门诊孕检的160名晚期妊娠孕妇,将饮用牛奶孕妇分成观察组,将未饮用牛奶作为对照组,追踪其产后婴儿其特应性湿疹的发生率,观察孕晚期饮用牛奶与婴儿湿疹的发生关系。结果观察组孕母其婴儿湿疹发生率明显高于对照组,分别为62.6%、42.4%,经统计学处理,差异具有统计学意义（ P〈0.05）。结论孕妇晚期过多食用牛奶等大分子食物可能是导致婴儿湿疹的主要原因之一,婴儿湿疹与蛋白质类过敏原密切相关。     

维生素K1合水解配方奶粉治疗婴儿过敏性黏液血丝便23例临床观察

目的探讨维生素K1联合喂水解配方奶粉治疗婴儿牛奶蛋白过敏黏液血丝便的临床疗效。方法选取2011年11月至2013年5月在我院儿科治疗的45例黏液血丝便婴儿，并随机分为2组，治疗组23例，对照组22例，对照组给予胃肠黏膜保护剂及微生态疗法，有合并感染加用抗生素治疗等常规治疗，治疗组在常规治疗基础上加用维生素K1并喂养水解配方奶粉，观察两组的疗效，结果统计资料显示总有效率（显效＋有效）治疗纽为78．2％，对照纽为45％，差异有统计学意义P=0．025。结论婴儿牛奶蛋白过敏性黏液血丝便，采用维生素K1联合喂养水解配方奶粉治疗，疗效可靠。适宜在基层推广。     

饮食干预对牛奶蛋白诱导的婴儿过敏性直肠结肠炎的护理效果评价

<正>牛奶蛋白过敏是婴幼儿最为常见的食物过敏,发生率为2%～7%[1],影响婴儿的正常生长发育,因此给予婴儿过敏性直肠、结肠炎患儿饮食干预,采用回避牛奶蛋白,利用氨基酸奶粉,深度水解蛋白奶粉,部分水解蛋白奶粉,逐步过渡到整蛋白奶粉,能有效降低牛奶蛋白过敏的发生,减轻患儿的临床症状。我科对116例确诊由牛奶蛋白过敏导致的婴儿过敏性直肠、结肠炎患儿进行饮食干预,效果显著。现报告如下。     

母乳喂养与配方乳喂养对极低出生体重儿的影响探讨

目的观察和比较母乳喂养与配方乳喂养对极低出生体重儿(VLBWI)的影响。方法选取2015年7月～2018年7月于我院新生儿重症监护病房住院的506例VLBWI为研究对象,根据随机数字表法将其分为母乳组(n=133,予以母乳喂养)和配方乳组(n=373,予以配方乳喂养),比较其胃肠动力、体重增长情况及并发症发生情况。结果母乳组婴儿体重开始增长时间显著早于配方乳组(P 0.05),母乳组婴儿干预10d后的体重及净增长体重均显著高于配方乳组(P 0.05);喂养干预10d期间,母乳组发生喂养不耐受28例(11.28%),并发症总发生例数为24例(18.05%),与配方乳组的71例(19.03%)和101例(27.08%)相较显著更低(P 0.05)。结论母乳喂养VLBWI有利于其胃肠改善,降低喂养不耐受及并发症发生,更有利于婴儿生长发育。     

社区早期干预对婴儿湿疹发病率的影响研究

目的 探讨社区早期干预对婴儿湿疹发病率的影响.方法 选择93例有过敏性疾病家族史且脐血IgE＞1 IU/ml的高风险婴儿作为研究对象,随机分为干预组(48例)和对照组(45例).干预组给予饮食、环境、护理等影响因素的综合干预,对照组采用常规护理和健康教育.比较两组的婴儿湿疹发病率及两组照顾者的湿疹相关知识合格率.结果 干预组的湿疹发病率14.58％,显著低于对照组的51.11％,差异有统计学意义(P＜0.01).干预组照顾者在饮食、抚触方面的湿疹知识知晓率显著高于对照组,差异有统计学意义(P＜0.01).结论 饮食、护理的社区早期干预可以降低高风险婴儿的湿疹发病率,是预防高风险婴儿发生过敏性疾病的有效初级干预措施.     

婴儿饮食及生活习惯的干预效果分析

目的研究儿保门诊对婴儿饮食及生活习惯的干预效果。方法在重庆市城区随机抽取0³个月龄婴儿为研究对象,干预组接受本研究的所有干预措施,对照组按常规保健服务,定期监测两组婴儿的母乳喂养率、辅食添加时间及添加频次、睡眠状况等指标。结果干预组婴儿4个月内母乳喂养率、43个月龄婴儿为研究对象,干预组接受本研究的所有干预措施,对照组按常规保健服务,定期监测两组婴儿的母乳喂养率、辅食添加时间及添加频次、睡眠状况等指标。结果干预组婴儿4个月内母乳喂养率、4⁶个月龄辅食添加率较高(P<0.05),而对照组没有每天进食肉类、蔬菜、水果的频率较高(P<0.01);12个月龄时干预组婴儿白天睡眠时间较长(P<0.01),夜间睡眠时间较短(P<0.01),但两组全天睡眠时间无差异。结论儿保门诊可部分改善婴儿饮食生活习惯,而如何培养良好睡眠习惯还有待进一步研究。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.