巨细胞病毒感染在婴儿痉挛发病中作用的临床研究

目的探讨巨细胞病毒（CMV）感染在婴儿痉挛发病中的作用。方法收集整理23例婴儿痉挛患儿的临床资料,包括患儿尿CMVDNA定量、血清巨细胞病毒抗体,患儿母亲乳汁中CMVDNA定量等。结果尿CMVDNA定量〉10^3 18例（78．3％）,血清CMV—IgM抗体阳性5例（21．7％）,患儿母亲乳汁中CMV—DNA定量〉10^3 4例（17.4％）。结论婴儿痉挛患儿尿CMV—DNA定量、血清CMV—IgM抗体以及患儿母亲乳汁中CMV—DNA定量阳性率高,3种CMV检测方法联合应用,检出阳性率较高,提示CMV感染可能与婴儿痉挛发病有关。     

血小板减少性紫癜患儿巨细胞病毒感染的研究

研究人类巨细胞病毒（HCMV）感染与原发性血小板减少性紫癜（ITP）之间的关系，采用ACD抗凝外周血HCMV－DNA PCR以及非抗凝血清CMV－IgM、IgG ELISA方法，进行HCMV感染的检测。结果显示，ITP患儿组HCMV－DNA PCR阳性率为71．7％，体检儿童对照组为20．8％，P＜0．01，差异有显著性。ITP患儿组CMV－IgM阳性率为41．5％，CMV－IgG阳性率为75．5％，体检儿童对照组中未检出CMV－IgM阳性者，CMV－IgG阳性率为22．9％，P＜0．01差异有显著性。结论认为：HCMV感染与ITP密切相关，HCMV病毒是ITP致病病因中很重要的一个致病病毒，对ITP患者的实验室检测不仅需要血液学检测而且需要HCMV等病毒学检测，对HCMV活动性感染的ITP患者加用更昔洛韦，可能会很好地提高疗效。     

婴儿迁延性和慢性腹泻与巨细胞病毒感染的关系

目的 探讨婴儿迁延性和慢性腹泻与巨细胞病毒（CMV）感染的关系。方法 应用荧光定量聚合酶链反应（PQ-PCR）方法检测26例迁延性和慢性腹泻患儿血、尿及其母亲母乳CMV-DNA;应用ELISA检测患儿血清CMV-IgM水平，并与20例正常儿童比较。结果 患儿26例中24例血清或尿液CMV-DNA阳性（92．30％），其中8例同时有血清CMV-IgM阳性。对照组5例尿液CMV-DNA阳性（25％），两组具有极显著性差异（P〈0．01）。患儿大便乳糖阳性占80．76％。母乳CMV-DNA阳性占90．90％。结论 CMV感染是婴儿迁延性和慢性腹泻原因之一；传播途径主要是含CMV的母乳；多数患儿同时伴继发性乳糖不耐受症。     

婴儿先天性巨结肠与巨细胞病毒感染

为了解婴儿先天性巨结肠（ＨＤ）与巨细胞病毒（ＣＭＶ）感染的关系，对１９例２～１８个月的ＨＤ患儿（经病理证实）的血清、尿和组织块用病毒分离和ＤＮＡ探针杂交方法进行ＣＭＶ检测。结果：１９例ＨＤ患儿分离ＣＭＶ的１９份尿标本中２份污染，在１７份尿标本中７份阳性，阳性率为４１．２％；正常儿尿标本阳性率为１４．４％（Ｐ＜０．０５）。１９例ＨＤ血清中，ＣＭＶＩｇＭ抗体２例阳性，阳性率为１０．５％；正常儿阳性率为８．０％（Ｐ＞０．０５）。１９例ＨＤ痉挛段组织块中无一例ＣＭＶ阳性，但６例ＨＤ痉挛段组织块ＣＭＶ－ＤＮＡ探针杂交全部阳性，其中２例强阳性，阳性率为１００％。说明婴儿ＨＤ与ＣＭＶ感染关系密切，ＣＭＶ感染可能是包括ＨＤ在内的一些先天性畸形的重要致畸因素。     

聚合酶链反应在检测脑性瘫痪患儿人巨细胞病毒感染中的应用

目的　探讨聚合酶链反应 (PCR)在检测脑性瘫痪 (CP)患儿人巨细胞病毒 (HCMV)感染中的意义。方法　对 5 6例CP患儿用PCR检测尿巨细胞病毒 (CMV)DNA ,病毒分离检测尿标本 ,观察CMV特征性致细胞病变效应 (CPE) ,ELISA检测血清CMVIgM和IgG。结果　PCR检测CMVDNA阳性率为 5 3 .6% ,9例CMV病毒分离结果阳性 ;CMVIgM、IgG阳性率分别为 12 .5 %、3 7.5 % ;病毒分离 :CMVIgM阳性与CMVDNA阳性的符合率分别为 10 0 %、10 % ,前两者与后者比较均有显著差异 (P <0 .0 1) ;CMVIgG阳性与PCR阳性符合率为 6.7% ,两者无显著差异 (P >0 .0 5 )。结论　PCR检测CMVDNA能够早期快速检测到CP患儿CMV感染 ,可应用于CP患儿中CMV感染的检测 ,为早期干预提供可靠依据。     

脆骨蓝巩膜综合征一例

目的 探讨巨细胞病毒(CMV)感染在婴儿痉挛发病中的作用.方法 收集整理23例婴儿痉挛患儿的临床资料,包括患儿尿CMV DNA定量、血清巨细胞病毒抗体,患儿母亲乳汁中CMVDNA定量等.结果 尿CMV DNA定量＞10~3 18例(78.3%),血清CMV-IgM抗体阳性5例(21.7%),患儿母亲乳汁中CMA-DNA定量＞10~3 4例(17.4%).结论 婴儿痉挛患儿尿CMV-DNA定量、血清CMV-IgM抗体以及患儿母亲乳汁中CMV-DNA定量阳性率高,3种CMV检测方法联合应用,检出阳性率较高,提示CMV感染可能与婴儿痉挛发病有关.     

巨细胞病毒感染与孤立性血尿的临床研究

巨细胞病毒(cytomegalovirus,CMV)感染在儿童可高达83％。CMV感染可引起多种不同的感染综合征,而CMV对上皮细胞的易感性,引起人们对CMV感染与肾脏疾病的关注。我们采用酶联免疫吸附法检测孤立性血尿患儿血清标本CMV特异性IgM,同时应用聚合酶链反应(PCR)法检测尿中 CMV-DNA,以探求CMV感染与孤立性血尿的关系。     

母婴配对巨细胞病毒感染的研究

目的进一步探讨母婴之间巨细胞病毒(CMV)的感染与传播.方法对36对母婴配对的尿和16例母乳标本进行CMV分离,其中26例检测CMVIgM抗体.结果婴儿尿CMV分离阳性率为47.2%,其中1个月内、～4个月、～1岁婴儿阳性率分别为0、60.0%和33.3%,存在显著差异(χ2＝6.57,P＜0.05).母亲母乳CMV分离阳性率为75%,显著高于其尿的排毒率5.6%(χ2＝23.74,P＜0.01).在喂养方式中,纯母乳喂养儿CMV阳性率为57.7%与非纯母乳喂养儿的20%相比,差异显著(χ2＝4.12,P＜0.05).在不同病种中,婴儿肝炎综合征(婴肝)患儿CMV培养及IgM的阳性率为55%,支气管肺炎患儿CMV阳性率则高达80%,而6例其它病种患儿仅2例阳性.结论母乳是婴儿获得CMV感染的主要来源.婴肝及小婴儿肺炎以CMV感染为主.     

新生儿室管膜下囊肿的病因研究

为了探讨新生儿室管膜下囊肿（ＳＥＣ）与先天性感染的关系，采用ＥＬＩＳＡ酶标法检测母婴双方囊肿组与对照组各７０例血巨细胞病毒（ＣＭＶ）、风疹病毒、弓形虫的抗体，并应用聚合酶链反应（ＰＣＲ）技术直接检测病原ＤＮＡ（风疹病毒除外），同时作尿ＣＭＶ的ＰＣＲ检测。结果：囊肿组新生儿血ＣＭＶ－ＩｇＭ抗体和ＣＭＶ－ＰＣＲ阳性率显著高于对照组（分别为１７．１％、５．７％和１２．９％、２．９％）；且尿ＣＭＶ－ＰＣＲ的阳性率达４０．０％（２８／７０），高于对照组的１７．１％（１２／７０）；分别进行两组自身对照，尿ＣＭＶ－ＰＣＲ的阳性率显著高于血ＣＭＶ－ＰＣＲ阳性率（Ｐ＜０．０５）。囊肿组母亲的尿ＣＭＶ－ＰＣＲ阳性率亦显著高于对照组（３０％、１０％、Ｐ＜０．０１）。提示新生儿ＳＥＣ是宫内感染损害中枢神经系统的表现之一，与先天性ＣＭＶ感染有关，尿ＣＭＶ－ＰＣＲ检查可作为宫内ＣＭＶ感染的首选实验室诊断方法。     

更昔洛韦（丽科伟）在先天性巨细胞病毒感染的临床应用

目的：评价更昔洛韦治疗先天性巨细胞病毒（CMV）感染的疗效及其影响因素。方法：将30例确诊为先天性CMV感染的患儿分为症状性16例和无症状性14例两组，按照丙昔洛韦诱导和维持治疗组结合的方案。根据定量CMV－PCR结果判断其疗效。结果：更昔洛韦诱导治疗结束后转阴率为17／30（56．8％），维持治疗结束后转阴率为26／30（86．7％），CMV－DNA≤10^4/ml的患儿诱导治疗结束后的转阴率高于＞10^4/ml的患儿（P＜0．05），而且无症状性感染诱导治疗结束后的转阴率高于症状性感染（P＝0．007），维护治疗结束后两两比较均无差异。结论：更昔洛韦治疗先在性CMV感染安全有效，其疗程与CMV－DNA拷贝数大小及感染类型有关，建议对所有先天性CMV感染的患卵均应提前干预治疗。     

Prevalence of overweight and obesity in children and adolescents in a county in Sweden

Overweight among young people in Sweden is increasing. The aim of the present study was to investigate the frequency of overweight and obesity based on body mass index (BMI) values among children and adolescents. Overweight was defined as a BMI value > or = 91st percentile and obesity as a BMI value > 98th percentile on an international reference BMI curve. The study population included boys and girls from four age groups: 9, 12, 15 and 18 y. The data consisted of self-reported measures of height and weight that were obtained from questionnaires used in a cross-sectional study in December 1997. A validation study was performed using a part of the study population. A total of 7011 (81.7%) participants completed the questionnaire. The correlation between self-reported estimations and objective measures of height and weight was high in the oldest age groups (0.88-0.98), but lower in the 9-y-old age groups (0.37-0.72). These self-reported estimations in the 9-y-olds were excluded from further analysis. It was found that 12.3%, 11.6% and 11.4% of the boys in the 12-, 15- and 18-y-old age groups and 6.8%, 5.5% and 4.8% of the girls in the same age groups were overweight and 7.9%, 8.9% and 7.3% of the boys and 5.1%, 4.2% and 3.9% of the girls were obese. Conclusion: The prevalence of overweight and obesity was found to be high in the study population and is a serious public health problem. The prevalence of obesity was significantly higher (p < 0.05) in 15-y-old boys living in rural areas than in city and town dwellers of the same age.     

The prostate in the neonate and infant in cryptorchism and hypospadias

The prostates of 8 neonates with cryptorchism and of 4 neonates and 1 infant with hypospadias have been examined and the findings have been compared with those in 127 controls.The processes of proliferation of the prostatic tubule epithelium, squamous metaplasia and secretion were normal in 7 of the 8 cases with cryptorchism and in all 5 cases with hypospadias. These findings are in contrast to 4 other cases where cryptorchism was associated with congenital renal malformations and all of whom showed an abnormal appearance of the prostate (as described elsewhere).The secretory activity of the prostate was markedly reduced in a neonate with cryptorchism who also had extreme testicular hypoplasia and marked underdevelopment of the penis, probably indicating a prenatal hormonal imbalance.2 cases with hypospadias showed a very large and distended utricle and the possible significance of this has been discussed.Associated congenital malformations, involving other than the genital system, were present in 7 of the 8 cryptorchid cases and in all 5 cases with hypospadias, as compared with 17 of the 127 controls.     

Dietary patterns in infancy and cognitive and neuropsychological function in childhood

Background: Trials in developing countries suggest that improving young children’s diet may benefit cognitive development. Whether dietary composition influences young children’s cognition in developed countries is unclear. Although many studies have examined the relation between type of milk received in infancy and subsequent cognition, there has been no investigation of the possible effect of variations in the weaning diet. Methods: We studied 241 children aged 4 years, whose diet had been assessed at age 6 and 12 months. We measured IQ with the Wechsler Pre‐School and Primary Scale of Intelligence, visual attention, visuomotor precision, sentence repetition and verbal fluency with the Developmental Neuropsychological Assessment (NEPSY), and visual form‐constancy with the Test of Visual Perceptual Skills. Results: In sex‐adjusted analyses, children whose diet in infancy was characterised by high consumption of fruit, vegetables and home‐prepared foods (‘infant guidelines’ dietary pattern) had higher full‐scale and verbal IQ and better memory performance at age 4 years. Further adjustment for maternal education, intelligence, social class, quality of the home environment and other potential confounding factors attenuated these associations but the relations between higher ‘infant guidelines’ diet score and full‐scale and verbal IQ remained significant. For a standard deviation increase in ‘infant guidelines’ diet score at 6 or 12 months full‐scale IQ rose by .18 (95% CI .04 to .31) of a standard deviation. For a standard deviation increase in ‘infant guidelines’ diet score at 6 months verbal IQ rose by .14 (.01 to .27) of a standard deviation. There were no associations between dietary patterns in infancy and 4‐year performance on the other tests. Conclusions: These findings suggest that dietary patterns in early life may have some effect on cognitive development. It is also possible that they reflect the influence of unmeasured confounding factors.     

小儿食管裂孔疝和胃食管返流的超声检查

介绍１４０例正常小儿和７例疑为胃食管返流（ＧＥＲ）患儿的食管腹腔部分和贲门的超声显像法、形态和测量值，说明Ｂ型超声和超声多普勒双功扫描不仅有助于对食管远端和贲门部生理状态的研究，也有助于食管裂孔疝和ＧＥＲ的诊断。     

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??Up to 650 000 deaths annually are associated with respiratory diseases from seasonal influenza??indicating the high burden of influenza and its substantial social cost to the world. The incidence of Influenza is high among children. Vaccine and antiviral medicine can both prevent influenza??and health education is always neglected. Neuraminidase inhibitor remains the main antiviral drug. During the management of influenza infections??doctors should pay great attention to its complications??especially pneumonia and encephalopathy.     

Normal and abnormal height and weight development in children and adolescents in Krakow--changes and trends in the last thirty years

The aim of this study is to determine the frequency of height and weight disharmony in children and adolescents in Krakow, i.e. both overweight and underweight in relation to height and the trends in last thirty years. MATERIALS AND METHODS: 4532 individuals -- a random sample of children and adolescents (2416 boys and 2107 girls) were examined in 2000. The results of the examination were compared with data obtain in 1971 (random sample of 4090 individuals) and with results from 1983 (random sample of 6536 individuals). Percentile position of height and weight were compared: the difference of two or more percentiles channels classified the results as overweight or underweight depending on height. THE RESULTS: Of the research prove that the frequency of occurrence of dis-harmonious body built increases with age, both with regard to overweight and underweight related to height and this phenomenon is more frequent in girls. In last thirty years a progressive increase of frequency of overweight was observed, but in girls it was noticeable and statistically significant only in 1971 -- 1983.     

Resistin and leptin in breast milk and infants in early life

Background

The role of adipokines in early life is considered an emerging topic issue in nutritional researches.

Aims

To evaluate serum resistin and leptin concentrations and their relations in infants and in breast milk.

Study design

We enrolled 41 term, AGA, healthy infants, of which 23 exclusively breast-fed (BF) and 18 formula-fed (FF), aged less than 6 months. Breast milk (BM) samples were collected from 23 breastfeeding mothers of the infants enrolled. Resistin concentration in serum and BM was determined by ELISA test (Human-Resistin-ELISA, Mediagnost, Reutlingen, Germany). Leptin concentration was determined by Radioimmunoassay method (LEP-R40, Mediagnost, Reutlingen, Germany). Infants weight, length and body mass index were measured. We used Mann–Whitney test. Spearman correlation was applied. Statistical significance was set at p < 0.05. Data are reported as median and interquartile range (IR).

Results

Infants serum resistin concentration was 9.30 (5.02) ng/ml. Breast milk resistin concentration (n = 23) was 0.18 (0.44) ng/ml. Leptin concentration was 3.04 (3.68) ng/ml in infants serum and in BM was 2.34 (5.73) ng/ml. Serum resistin concentrations in BF infants correlated positively with BM resistin (r = 0.636, p = 0.035). We have shown a positive correlation between resistin and leptin in total group of infants (r = 0.44, p = 0.05), confirmed in breastfed subjects (r = 0.65, p = 0.02). No correlations were found between serum hormones and anthropometric parameters of infants.

Conclusion

Our findings show interestingly a positive correlation between resistin concentrations in BF infants serum and in BM and between resistin and leptin in infants.