真空采血避免医源性污染的方法研究

真空采血法就是使用一次性自动定量静脉采血管进行采血，其在临床的广泛应用为护士的操作带来了安全和方便，但也存在一定的弊端，如发生血液污染现象，会引起血液传播性疾病。经反复的临床实践和观察，认为采用改良真空采血法能有效避免医源性污染，现报道如下。     

儿童特应性皮炎的居家护理

儿童期特应性皮炎(atopic dermatitis,AD)皮疹多分布于肘膝屈侧、颈侧、腕、踝等处,以苔藓样皮损为主,反复发作,伴剧烈瘙痒。AD患儿约占普通儿科就诊人数的1%,占小儿皮肤科人数的20%以上[1]。居家护理是在家庭中向慢性患儿提供医疗和护理。本研究于2000-2003年在本院皮肤科就诊     

Managing atopic dermatitis in children and adults

Although the etiology of atopic dermatitis is not well understood, it appears to be linked to a combination of genetic and environmental factors, and it is usually associated with other atopic diseases such as asthma and hay fever. A definitive diagnosis in children and adults depends on identifying the nature and distribution of the lesions and on eliciting a personal or family history of the disease. Although no cure exists, atopic dermatitis often resolves spontaneously and can be controlled through proper management. Avoiding factors that precipitate or exacerbate inflammation is key to preventing disease flares. In children and adults, hydration and topical corticosteroids are the mainstays of therapy. Current advances in understanding the immunologic basis of the disease have led to the development of highly effective new treatments. Using patient education and support, the clinician can help adults and children successfully manage their disease.     

150例特应性皮炎患儿皮肤屏障功能分析

目的分析特应性皮炎（atopic dermatitis,AD）患儿及健康儿童皮肤屏障功能的差异。方法 1~10岁AD患儿（AD组）和健康儿童（对照组）各150例,取其前臂伸侧、前臂屈侧、面颊和胫前4个非皮损部位,依次进行角质层含水量及经皮失水量测量,并进行比较。结果 AD组前臂伸侧、前臂屈侧及胫前部角质层含水量分别为（33.30±11.50）、（28.98±11.51）、（36.36±14.99）au,对照组分别为（36.31±11.90）、（32.75±11.92）、（39.19±15.00）au,2组比较差异均有统计学意义（P〈0.05）;AD组面颊角质层含水量（（35.56±13.01）au）与对照组（（36.25±12.98）au）比较差异无统计学意义（P〉0.05）;AD组前臂伸侧、前臂屈侧、面颊和胫前部经皮失水量（（9.30±4.29）、（8.86±4.59）、（8.13±3.98）、（8.85±3.84）g/（m2·h））均高于对照组（（7.51±4.89）、（6.70±2.35）、（7.09±4.01）、（7.70±3.09）g/（m2·h））（P〈0.05）。结论 AD患儿皮肤屏障功能存在明显障碍。     

Minimum effective dosage in the treatment of chronic atopic dermatitis with itraconazole

Fungi including Malassezia furfur and Candida albicans are involved in the development of atopic dermatitis (AD), due to increased sensitivity to these allergens or increased serum immunoglobulin E levels in AD patients. Previously, I reported successful treatment of AD with oral administration of the anti-mycotic agent, itraconazole. Recently, I developed protocols for AD treatment, based on the determined minimum effective dose. Three oral administration regimens with itraconazole were studied: single-phase treatment (regimen 1), 100 mg/day for 1 week with a 3-week rest, repeating; regimen 2, 200 mg/week for 4 weeks, repeating; and dual-phase treatment (regimen 3), 100 mg/day for 1 week (introduction phase) then 200 mg/week (maintenance phase) for 11 weeks. For regimens 1 and 2, each treatment cycle was 4 weeks, and three cycles were undertaken. Each regimen was completed in 12 weeks. All three regimens reduced AD symptoms, regimen 3 being the most effective and efficient therapy as evaluated by overall efficacy and low drop-out rate.     

Allergy in atopic dermatitis

Approximately 10 per cent of patients with atopic dermatitis have clinical manifestations that are significantly affected by allergens. Food allergies appear to be more common in infants, while aeroallergens probably affect older children and adults more frequently. Patients who do not respond favorably to standard regimens of lubrication, topical corticosteroids, and antihistamines should be evaluated for allergies to foods and aeroallergens. Historical information, radioallergosorbent tests, and prick tests guide in the selection of allergens to be eliminated, but elimination and challenge tests are most useful in the determination of allergens that may affect atopoic dermatitis.     

特应性皮炎研究进展

特应性皮炎是一种与遗传有关的慢性复发性炎症性皮肤病,近年发病率呈上升趋势,其病因及发病机制尚未完全明了,无满意的治疗方法.本文就其病因、发病机制及治疗做一综述.     

Assessment and management of atopic eczema in children

Atopic eczema is a chronic inflammatory itchy skin condition caused by a defect in skin barrier function. It is common in infants and children and may continue into adulthood. Assessment of eczema in children must be holistic, taking into account physical and psychosocial factors. There is no cure for eczema and treatments aim to control the disease. First-line treatment consists of emollients, but many children will also require the use of topical corticosteroids and other treatments as appropriate. Healthcare professionals have an important role to play in educating children, and their parents and carers, in the management of atopic eczema to prevent exacerbation of the condition and improve quality of life.     

Plasma levels of polyunsaturated fatty acids in children with atopic dermatitis and in atopic and nonatopic controls

BACKGROUND: Atopic dermatitis has been thought to be associated with a disturbance in n-6 polyunsaturated fatty acid (PUFA) metabolism, but randomized trials investigating the clinical efficacy of oral supplementation with gammalinolenic acid have revealed conflicting results. AIM OF THE STUDY: To re-investigate the proposed linkage between PUFA dysregulation and atopic dermatitis. MATERIALS AND METHODS: Plasma levels of linoleic acid (LA), gammalinolenic acid (GLA), dihomogammalinolenic acid (DGLA) and arachidonic acid (AA) were measured using HPLC in 22 children with atopic dermatitis. Patients were subdivided into those with elevated total serum IgE (group A, n = 15, IgE > +1 SD of age-specific normal values) and those with normal IgE (group B, n = 7) and compared with children suffering from allergic rhinitis/asthma (group C, n = 8) and with non-atopic controls (group D, n = 6). RESULTS: GLA levels were significantly lower (p < 0.05) in eczema patients with elevated IgE (A, 0.19 +/- 0.06%) and in atopic controls (C, 0.23 +/- 0.06%) than in eczema patients with low IgE (B, 0.42 +/- 0.19%) and non-atopic controls (D, 0.43 +/- 0.16%). There were no significant differences between groups for LIN, DGLA and AA, except for lower LIN levels in atopic controls. Correlation of individual LA and GLA values showed significantly steeper regression lines in low-IgE responders (B and D, k(x) = 0.058) than in high-IgE responders (A and C, k(x) = 0.012; p < 0.02), suggesting impaired delta-6-desaturase function in the latter. For the study population as a whole, there was a clear negative correlation between total levels of IgE and GLA (r(s) = -0.64) and a moderate negative correlation between total IgE and AA (r(s) = -0.38). CONCLUSIONS: Dysregulation of n-6 PUFA metabolism is neither consistently found in nor specifically associated with atopic dermatitis but rather appears to be associated with IgE production and atopy in general. The finding of decreased GLA levels in eczema patients with elevated total IgE and in children with allergic rhinitis and asthma but not in eczema patients with normal total IgE questions the proposed pathophysiologic role of fatty acid dysregulation in atopic dermatitis.     

The temperament profiles of school-age children

Maternal reports of child temperament were used to develop temperament profiles of school-age children. The subjects were 883 children who were between 4 and 12 years of age. The children's families varied substantially in their socioeconomic status and race/ethnicity. To develop the profiles, the dimensions derived from the School-Age Temperament Inventory were subjected to a second order principal factor analysis with varimax rotation. Pearson chi-squares were used to determine whether sociodemographic variables were proportionally represented among the profiles. Forty-two percent of the children were classified into four temperament profiles. High maintenance and cautious/slow to warm up were deemed as challenging temperaments. Industrious and social/eager to try were mirror images of those profiles and were labeled easy. Some children were both types of challenging or easy profiles. The generalizability of the profiles in relation to the sociodemographic variables of gender, age, race/ethnicity, and socioeconomic status was also examined. Challenging temperament profiles were disproportionately represented by boys, Hispanic children, and those from lower socioeconomic families. Girls were over represented in the group that included both types of easy temperaments. Social/eager to try children were more often from higher rather than lower socioeconomic status families. Clinical applications and research implications for the profiles are discussed. The profiles can be used as exemplars that parents can use to recognize their child's temperament. Further research is needed to explore whether different developmental outcomes are associated with the profiles.     

Natural-killer-cell activity in atopic dermatitis

Natural-killer (NK)-cell activity was measured in the peripheral blood of twenty patients with atopic dermatitis and in a group of thirteen age-matched non-atopic controls (nine subjects on thirteen occasions). The method uses a chromium-release assay with the human leukaemia cell line, K562, labelled with 51Cr as the target cell. A highly significant reduction in NK-cell activity was found in the patients with atopic dermatitis.     

Paediatric atopic dermatitis: parameters of aetiology, diagnosis and management

Atopic dermatitis is not merely a skin condition. It can have a profound physical and psychological effect on the child and his/her family. This article discusses aetiology of the disease and describes appropriate management strategies.