哮喘儿童呼吸道合胞病毒感染后血清抗F和抗G蛋白特异性IgG抗体？…

目的 探讨血清抗呼吸道合胞病毒（ＲＳＶ）抗Ｆ和抗Ｇ蛋白ＩｇＧ抗体水平与哮喘儿童ＲＳＶ感染及感染后病情轻重的关系。方法 以ＲＳＶ（Ｌｏｎｇ株）及表达ＲＳＶ Ｆ和Ｇ蛋白的重组痘苗病毒为抗原，采用酶联免疫吸附试验，检测了６６例６岁以下哮喘患儿ＲＳＶ流行期间双份血清中抗ＲＳＶ Ｆ和Ｇ蛋白特异性ＩｇＧ抗体水平。结果 （１）本组哮喘患儿ＲＳＶ感染率为３５％；（２）ＲＳＶ感染组哮喘患儿血清抗Ｆ和Ｇ蛋白ＩｇＧ抗体     

哮喘儿童呼吸道合胞病毒感染后血清抗F和抗G蛋白特异性IgG抗体的变化

目的探讨血清抗呼吸道合胞病毒（ＲＳＶ）抗Ｆ和抗Ｇ蛋白ＩｇＧ抗体水平与哮喘儿童ＲＳＶ感染及感染后病情轻重的关系。方法以ＲＳＶ（Ｌｏｎｇ株）及表达ＲＳＶＦ和Ｇ蛋白的重组痘苗病毒为抗原，采用酶联免疫吸附试验，检测了６６例６岁以下哮喘患儿ＲＳＶ流行期间双份血清中抗ＲＳＶＦ和Ｇ蛋白特异性ＩｇＧ抗体水平。结果（１）本组哮喘患儿ＲＳＶ感染率为３５％；（２）ＲＳＶ感染组哮喘患儿血清抗Ｆ和Ｇ蛋白ＩｇＧ抗体滴度明显低于非ＲＳＶ感染组；（３）ＲＳＶ感染后哮喘中～重度发作组血清抗Ｆ蛋白ＩｇＧ抗体滴度明显低于轻度发作组；（４）哮喘患儿ＲＳＶ感染后恢复期较急性期血清抗Ｆ和Ｇ蛋白抗体滴度均有明显升高，其升高程度在不同年龄组及两种蛋白间差异均无显著意义。结论血清抗Ｆ和抗Ｇ蛋白特异性ＩｇＧ抗体对哮喘患儿ＲＳＶ感染有一定保护作用；ＲＳＶ感染后抗Ｆ和抗Ｇ蛋白特异性ＩｇＧ抗体滴度的高低亦反映哮喘急性发作的轻重程度     

呼吸道合胞病毒疫苗的研究和临床应用

简介呼吸道合胞病毒（ＲＳＶ）的生物学特点和疫苗研究的进展。已经和正在研制的 ＲＳＶ疫苗包括：（１）福尔马林灭活ＲＳＶ疫苗；（２）活病毒疫苗，是通过冷传代和温度敏感传代获得的ＲＳＶ减毒活疫苗，其免疫反应与自然感染相似，感染野生型ＲＳＶ不加剧病情，能被动获得ＲＳＶ中和抗体产生保护性免疫反应，是目前正在婴幼儿中试用观察的疫苗；（３）ｃＤＮＡ疫苗，是从ＲＳＶ ｃＤＮＡ克隆中回收具有感染性重组ＲＳＶ的活病毒疫苗，在下呼吸道高度减活，可显著提高对野生型－ＲＳＶ感染的免疫力，安全性好，可构建含有ＲＳＶ Ａ、Ｂ组的 Ｇ基因ｃＤＮＡ２价疫苗；（４）载体疫苗，ＲＳＶ Ｆ、Ｇ嵌合疫苗由表达含有ＲＳＶＦ和Ｇ蛋白的杆状病毒纯化获得；（５）亚单位疫苗，对下呼吸道感染具有保护作用，中和抗体滴度高；（６）合成肽类疫苗等。     

呼吸道合胞病毒免疫球蛋白治疗儿童骨髓移植后下呼吸道感染

呼吸道合胞病毒（ＲＳＶ）感染是骨髓移植（ＢＭＴ）后常见的并发症之一．据报道ＢＭＴ患者并发ＲＳＶ下呼吸道感染,若未经抗病毒治疗病死率接近１００％,而应用利巴韦林（ｒｉｂａｒｉｒｉｎ）治疗者病死率高达５０％－７０％．报道静注呼吸道合胞病毒免疫球蛋白（ＲＳＶ－ＩＧＹＶ）治疗儿童ＢＭＴ合并ＲＳＶ感染的疗效． 病例和方法ＲＳＶ－ＩＧＩＶ是一种含有高浓度ＲＳＶ中和抗体（抗体滴度＞１９２００ＭＵ／ｍｌ）的ＩｇＧ免疫球蛋白．１９９１年６月至１９９６年２月,１１例ＢＭＴ合并ＲＳＶ感染患儿接受了ＲＳＶ－ＩＧＩＶ治疗…     

应用免疫酶组化法检测外周血呼吸道合胞病毒IgM抗体的研究

应用免疫酶组化法检测外周血呼吸道合胞病毒ＩｇＭ抗体的研究张传湘胡姣荣刘孟秋刘仲熊呼吸道合胞病毒（ＲＳＶ）是婴幼儿急性下呼吸道感染（ＡＬＲＩ）的重要病原，可致喘憋性肺炎流行和院内交叉感染，探索简便、快速、敏感、特异的诊断方法十分必要。我们应用ＲＳＶ抗原...     

快速诊断单纯疱疹病毒脑炎

目的探讨快速诊断单纯疱疹病毒脑炎（ＨＳＥ），比较不同病毒学试验的诊断价值。方法用聚合酶链反应技术检测１７７例急性脑炎患儿的脑脊液（ＣＳＦ）标本中单纯疱疹病毒（ＨＳＶ）特异性ＤＮＡ；用酶联免疫吸附方法检测ＣＳＦ和血清标本中ＨＳＶ特异性ＩｇＭ和ＩｇＧ抗体。结果ＣＳＦ中ＨＳＶ特异性ＤＮＡ、ＩｇＭ和ＩｇＧ抗体阳性率分别为１．７％（３／１７７）、１０％（１／１００）和４７０％（４７／１００），血清ＨＳＶＩｇＭ、ＩｇＧ抗体阳性率分别为１２．５％（６／４８）、７２．９％（５１／７０）（因为标本量不足或缺如，未能对全部病例进行抗体检测）；３例患儿确诊为ＨＳＥ。结论用套式ＰＣＲ检测ＣＳＦ诊断ＨＳＥ较敏感、特异。     

小剂量α-干扰素降低呼吸道合胞病毒感染后哮喘患病率的研究

呼吸道合胞病毒 (ＲＳＶ)是引起婴幼儿严重下呼吸道感染的重要病原之一 ,并与儿童哮喘关系密切 ,不仅能诱发哮喘 ,且与哮喘的病情加重有关。为寻找降低ＲＳＶ感染后哮喘患病率的有效方法 ,我科从１９９４年至１９９８年对ＲＳＶ感染患儿应用小剂量α -干扰素治疗 ,疗效明显 ,现报道如下。资料与方法一、对象全部病例均为我院住院患儿 ,经鼻咽部分泌物免疫荧光ＲＳＶ检测或血清特异性ＲＳＶ＿ＩｇＭ阳性者。随机分为观察组和对照组 ,观察组６０例 ,男３６例 ,女２４例 ,年龄１月～２岁３月 ;对照组５５例 ,男２８例 ,女２７例 ,年龄１月～２…     

细胞因子与呼吸道合胞病毒感染

呼吸道合胞病毒（ＲＳＶ）是引起婴幼儿毛细支气管炎和肺炎的最常见病原体，越来越多的研究表明ＲＳＶ感染的发病机制与机体异常的免疫病理有关。ＲＳＶ感染后细胞因子的变化，如：ＩＬ－１抑制物的产生，ＩＬ－２活性降低，ＩＬ－２Ｒ表达障碍，ＩＦＮγ减少和ＩＬ－４、ＩＬ－５、ＩＬ－６、ＩＬ－８、ＴＮＦα的活性增强，在ＲＳＶ感染的免疫保护和免疫病理中起重要作用。     

巨细胞病毒性肝炎特异性IgG亚群检测及临床意义

对２１例婴儿巨细胞病毒性肝炎患儿（简称肝炎组）与１０例无症状巨细胞病毒感染婴儿（简称无症状组），应用ＥＬＩＳＡ方法进行抗巨细胞病毒（ＣＭＶ）ＩｇＧ亚群检测，肝炎组中１３例做了恢复期的复查。结果表明，肝炎组抗ＣＭＶＩｇＧ＿２、ＩｇＧ＿４值均为较低水平，无症状组抗ＣＭＶＩｇＧ＿１、ＩｇＧ＿３，值明显高于肝炎组；肝炎组恢复期抗ＣＭＶＩｇＧ＿３明显增高，而抗ＣＭＶＩｇＧ＿１增高不显著。提示体液免疫反应特别是抗ＣＭＶＩｇＧ＿３在抗ＣＭＶ感染中起到一定作用，对ＣＭＶ感染高危婴幼儿可考虑应用含高滴度抗ＣＭＶ抗体的免疫球蛋白。     

输血后丙型肝炎抗C22,C33C和NS5IgG及其亚群的检测和意义

为探讨抗丙型肝炎病毒（ＨＣＶ）ＩｇＧ型抗体及其亚群在ＨＣＶ感染过程中的作用，采用酶联免疫吸附法对６６例输血后ＨＣＶ感染患儿的９２份急、慢性期血清和３２份α干扰素（αＩＦＮ）治疗后血清进行抗Ｃ２２、抗Ｃ３３Ｃ和抗ＮＳ５及其亚群的检测。结果表明，急性期抗Ｃ２２和抗Ｃ３３Ｃ检出率高，分别为９８．４３％和１００．００％；而抗ＮＳ５在急性期检出率仅为５３．１２％，明显低于慢性期（９１．６７％）和同期抗Ｃ２２和抗Ｃ３３Ｃ检出率（分别为９６．８８％和１００．００％）。三种抗体ＩｇＧ亚群在急性期的检出率和抗体水平均显著低于慢性期。抗Ｃ２２ＩｇＧ１为该抗体的优势亚群；而抗Ｃ３３Ｃ无明显优势亚群；抗ＮＳ５ＩｇＧ１及ＩｇＧ３至慢性期才显示其优势。６６例患儿中，１３例接受αＩＦＮ治疗，其中５例复发患儿在ＨＣＶＲＮＡ再次出现时，抗Ｃ２２ＩｇＧ１呈现有意义的下降，而抗Ｃ２２总水平并无明显变化，而接受αＩＦＮ治疗４例有效和另４例无效患儿无类似变化。提示抗Ｃ２２和抗Ｃ３３Ｃ是诊断急性ＨＣＶ感染的敏感指标；抗Ｃ２２ＩｇＧ１可能有助于评价αＩＦＮ治疗ＨＣＶ感染的疗效。     

Book Reviews

HANDBOOK OF PEDIATRICS, by Henry K. Silver, C. Henry Kempe, Henry B. Bruyn, Vincent A. Fulginiti
ESSENTIAL MEDICAL GENETICS, 2nd edn, by J. M. Connor and M.A. Ferguson-Smith
SEVERE BEHAVIOR DISORDERS OF CHILDREN AND YOUTH, by Robert B. Rutherford, Jr, C. Michael Nelson, Steven R. Forness
PATIENT CARE IN PEDIATRIC SURGERY, by L. L. Leape
PRIMARY CARE OF THE NEWBORN, by R. W. Coen, H. Koffler
PROGRESS IN RESPIRATION RESEARCH SERIES, edited by H. Herzog: VOLUME 22: LUNG FUNCTION IN CHILDREN AND ADOLESCENTS, by A. Zapletal, M. Samanek, T. Paul
UPPER-LIMB DEFICIENCIES IN CHILDREN: PROSTHETIC, ORTHOTIC, AND SURGICAL MANAGEMENT, by D. W. Lamb, H. T. Law
POCKET GUIDE TO PEDIATRIC FRACTURES, by J. A. Ogden
CLINICAL EXAMINATION OF THE INJURED KNEE, M. Cross, K. Crichton
DIAGNOSTIC RECOGNITION OF GENETIC DISEASE, by W. Nyhan, N. Sakati     

Book Reviews

Book reviewed in this article:
RECOGNIZING PATTERNS OF OCULAR CHILDHOOD DISEASES, by Leonard B. Nelson, Gary C. Brown, Juan J. Arentsen
THE CHROMOSOMES AND THEIR DISORDERS: AN INTRODUCTION FOR CLINICIANS, 4th edn, by G. H. Valentine
RELATED SERVICES FOR HANDICAPPED CHILDREN, by Morton M. Esterson and Linda F. Bluth
PERSPECTIVES IN PAEDIATRIC PATHOLOGY, Series Editors: Harvey S. Rosenberg and Jay Bernstein, Volume 9: NEOPLASIA IN INFANCY AND CHILDHOOD, edited by Harvey S. Rosenberg, Jay Bernstein and William A. A. Newton Jr
PEDIATRIC NEPHROLOGY, 2nd edn, edited by M. Holliday, T. Barratt and R. Vernier
CANCER IN CHILDREN: CLINICAL MANAGEMENT, 2nd edn. edited by P. A. Voute, A. Barrett, H. J. G. Bloom, J. Lemerle and M. K. Neidhardt     

BOOK REVIEWS

ABSTRACT. Eveleth PB, Tanner JM. Worldwide Variation in Human Growth , 2nd ed. Cambridge: Cambridge University Press, 1990.
Barkovich JA, Truwit LC. Practical MRI Atlas of Neonatal Brain Development. New York: Raven Press, 1990.
Ichikawa I, ed. Pediatric Textbook of Fluids and Electrolytes. Baltimore: Williams & Wilkins, 1990.
Advances in Pediatrics, vol 37. Barness LA, ed., De Vivo DC, Morrow III G, Oski F, Rudolph AM, assoc. eds. Chicago: Mosby Year Book, 1990.     

Book Reviews

ABSTRACT. Book reviewed in this article
A PRIMER OF CHILD PSYCHOTHERAPY, 2nd edition, by Paul L. Adams
EARLY DIAGNOSIS AND THERAPY IN CEREBRAL PALSY, by Alfred L. Scherzer and Ingrid Tscharnuter
TEMPERAMENTAL DIFFERENCES IN INFANTS AND YOUNG CHILDREN. Ciba Foundation symposium 89
FATHER AND CHILD. Developmental and Clinical Perspectives. edited by Stanley H. Cath, Alan R. Gurwitt and John Munder Ross
DEVELOPMENTAL DISABILITIES. Theory, Assessment, and Intervention, edited by Michael Lewis and Lawrence T. Taft
DIABETES EXPLAINED, 4th edition, by Arnold Bloom; 1982. GB: MTP Press Limited
CHILDREN WITH CANCER. Mainstreaming and Reintegration, edited by Jan van Eys, 1982. GB: MTP Press Limited
RESPIRATORY ILLNESS IN CHILDREN, by Peter D. Phelan, Louis I. Landau and Anthony Olinsky
THE MUSCULOSKELETAL SYSTEM. Embryology, Biochemistry and Physiology, edited by Richard L. Cruess
EARLY HUMAN DEVELOPMENT, Volume 6 (1982) Supplement, edited by A. Ashworth, S. R. Allen and G. A. Fookes.
HUMAN GENETICS. PROBLEMS AND APPROACHES, by F. Vogel and A. G. Motulsky.     

Book Reviews

Cancer Source Book. Edited by Frank E. Bair Health Reference Series, Vol 1 Detroit, Omnigraphics, 1990, 932 pages, $75.00.

The Laboratory Consultant. Hugo C. Pribor Philadelphia, Lea & Febiger,1992, 780 pages, $59.95.

Pediatric Molecular Pathology. Edited by A. J. Garvin, T. J. O'Leary, J. Bernstein, and H. S. Rosenberg Perspectives in Pediatric Pathology, H. S. Rosenberg and J. Bernstein, series editors, Vol. 15 Basel, Karger, 1991, 152 pages, $214.50.     

Book Reviews

Holoprosencephaly. An Overview and Atlas of Cases J. R. Siebert, M. Cohen, Jr., K. K. Sulik, C . M. Shaw, and R. Lemire New York, Wiley-Liss, 1990, 420 Faces, $190.00.

Diagnostic Flow Cytometry Edited by J. S. Coon and R. S. Weinstein Baltimore, Wilkins, 1991, 199 pages, $55.00

Pathology of the Human Embryo and Previable Fetus: An Atlas D. K. Kalousek, N. Fitch, and B. A. Paradice New York, Sprinser-Verlaf, 1990, 241 bases, $129.00     

Retrospective clinical and laboratory evaluation of children with brucellosis

Background: Acute brucellosis is a zoonotic disease seen in childhood, with non‐specific complaints and clinical findings that can affect the locomotor, gastrointestinal, genitourinary, hematologic, cardiovascular, respiratory, and central nervous systems. Particularly in endemic regions, it occurs as a result of consumption of unpasteurized milk and dairy products. In this study, clinical and laboratory findings of children with acute brucellosis are presented. Methods: Data for 147 patients, aged 2–16 years, were evaluated retrospectively. Results: The most frequent complaints and clinical findings were abdominal pain and fever. Other complaints and clinical findings included arthralgia, myalgia, loss of appetite, weakness, sweating, fatigue, headache, arthritis, hepatomegaly, and splenomegaly. Anemia was the most frequent hematological abnormality detected; other abnormalities included leukopenia, thrombocytopenia, and pancytopenia. Conclusion: Childhood brucellosis can cause non‐specific complaints and particularly anemia and leukopenia as hematological abnormalities. It is easily treated, however, with appropriate antibiotics.     

Gluconeogenesis defect presenting with resistant hyperglycemia and acidosis mimicking diabetic ketoacidosis

Fructose-1,6-diphosphatase (FDPase) enzyme deficiency is a rare inherited metabolic disease. Affected patients usually present with metabolic crisis including hypoglycemia, acidosis, ketonuria, and hyperuricemia. A previously healthy 8-month-old male infant presented with fever, vomiting, and hypoactivity. He had tachycardia, tachypnea, and a tendency to sleep. The patient had signs of severe dehydration and shock. Laboratory findings revealed significant lactic acidosis, hyperuricemia, hyperglycemia, elevated liver enzyme level, and hyperlipidemia. The urine analysis had evidence of glycosuria and ketonuria. Hyperuricemia, lactic acidemia, and hyperglycemia persisted despite insulin infusion, adequate hydration, and perfusion. Consequently, peritoneal dialysis was started. About 12 hours after dialysis, his metabolic derangements were normalized, and clinical status was improved dramatically. His metabolic disease workup was compatible with FDPase deficiency. Here, we described a metabolic attack of FDPase deficiency presented with hyperglycemia mimicking diabetic ketoacidosis.     

Abuse and toxicity of methylphenidate

The therapeutic use of methylphenidate for the management of attention-deficit hyperactivity disorder in children is increasing. As therapeutic use increases, the risk increases of unintentional overdoses, medication errors, and intentional overdoses caused by abuse, misuse, or suicide gestures and attempts. Side effects during therapy, which include nervousness, headache, insomnia, anorexia, and tachycardia, increase linearly with dose. Clinical manifestations of overdoses include agitation, hallucinations, psychosis, lethargy, seizures, tachycardia, dysrhythmias, hypertension, and hyperthermia. Methylphenidate tablets can be abused orally, or they can be crushed and the powder injected or snorted. Despite its abuse potential, there is disagreement regarding the extent to which methylphenidate is being diverted from legitimate use to abuse in preteens and adolescents.     

Bulimia nervosa: an update and treatment recommendations.

Bulimia nervosa is a common eating disorder in adolescent women. Biological, psychological, and social factors are implicated in onset and important in treatment. Diagnosis of the syndrome, but not its subtypes, can be made well using the DSM-IV system. Screening tools, laboratory findings, and physical findings can be helpful in making the diagnosis. Comorbid disorders include affective disorders, addictive disorders, anxiety disorders, personality disorders, and anorexia nervosa. The etiology of bulimia nervosa is complex, with biologic, psychological, social, and family factors, which likely differ somewhat from patient to patient. Treatment, accordingly, should be comprehensive, individualized, and multifaceted. Many patients respond well to the use of an antidepressant, and cognitive-behavioral therapy is a useful approach for many patients. Combining these two treatments seems to be a good strategy. Environmental and family issues also need to be addressed. Many patients are treated insufficiently. More research on bulimia nervosa specific to adolescence is needed.