流行性感冒病毒病原学诊断

流行性感冒 (简称流感 )的诊断需通过流行病史、临床症状、体征以及病原学检查资料综合分析而获得。有明确的流行病史、典型的临床表现及体征 ,就应先作出流感拟诊 ,同时作病原学检查以确定诊断。病原学检查可为检测流感流行、病毒变异及预测流行提供重要依据。流感的病原学诊断包括病毒分离、血清学检测、流感病毒抗原检测、特异性基因检测以及新近建立的神经氨酸酶检测法。一、病毒分离病毒分离与鉴定是病毒学诊断技术的主体。病毒分离为诊断病毒感染公认的“金标准” ,也是唯一能发现新毒株的手段。(一 )鸡胚分离从 190 2年Ｃｅｎｔａｎ…     

Allogeneic hematopoietic stem‐cell engraftment and graft failure

Abstract: Two immunologically mediated reactions, the graft‐versus‐host (GvH) and host‐versus‐graft (HvG) responses, form primary and opposing barriers to successful transplantation of allogeneic hematopoietic stem‐cells (HSC). The HvG barrier is set by the strength of the allogeneic immune response, which is determined by antigenic stimulation provided by donor cells, owing to differences in histocompatibility antigens, and the capacity of host immune cells to generate a response. Risk of graft failure must be viewed as the interplay of multiple factors, including degree of human leukocyte antigen and minor histocompatibility antigen disparity, capacity of host immune response, and the capacity of donor hematopoietic and immunologic cells for overcoming residual host immunity.     

Etiologic factors in cerebral palsy

A variety of insults can cause cerebral palsy, but the dominant mechanism of damage is ischemic and/or asphyxial. Table 2 provides a rough estimate of the relative contribution of each of the several risk factor groups to the total burden of cerebral palsy. This table is only approximate both because of our lack of knowledge, and because risk factors often interact with one another. Cerebral palsy is frequently multifactorial in nature. For example the small-for-gestational age infant is both more likely to experience labor asphyxia, and is also more susceptible to its effects. The numerically largest etiologic grouping in cerebral palsy consists of pre-term/low birthweight infants, many of whom have experienced ischemic damage perinatally. The second largest grouping is infants born at term experiencing severe perinatal asphyxia. Congenital infections, and metabolic conditions such as hyperbilirubinemia certainly play some role in the genesis of cerebral palsy but genetic conditions as such rarely cause cerebral palsy. Some infants, if carefully studied, will prove to have a congenital brain malformation. The role of intrauterine ischemic events is at present not well understood, but is probably significant.     

Etiologic diagnosis of hypoglycemia in children

When the etiology of an hypoglycemia is not easily recognizable, the diagnosis can be guided by 2 signs: hepatomegaly and ketosis. If an hepatomegaly is present, an abnormality of glycogen metabolism or neoglucogenesis or an hereditary fructose intolerance may be suspected. A hypoketotic hypoglycemia suggests a hyperinsulinism or an impaired fatty acid oxydation. If the liver is normal and ketosis is normal or increased, an abnormality of branched amino acid metabolism or a ketotic hypoglycemia may be evoked.     

Etiology and outcome of graft failure in pediatric hematopoietic stem cell transplant recipients

PURPOSE: To determine the incidence, etiology and outcome of graft failure in pediatric allogeneic bone marrow transplant (BMT) recipients. PATIENTS AND METHODS: Patients with primary or secondary graft failure were identified by database review. A retrospective chart review was performed. Etiologic factors were identified and assessed for statistical significance. RESULTS: 309 children underwent allogeneic BMT during the time interval studied. Four cases of primary graft failure and 7 cases of secondary graft failure occurred. Nonmalignant diagnosis, lower total nucleated cell (TNC) dose, and conditioning without total body irradiation were associated with a higher incidence of graft failure. Donor source, donor/recipient CMV status, CD34+ cell dose, and alloimmunization were not associated with graft failure. CONCLUSIONS: Graft failure is a relatively uncommon occurrence in pediatric patients. Autologous reinfusion may allow time to prepare the patient for a second transplant and decrease complications associated with aplasia. More immunosuppressive conditioning regimens may decrease the incidence of graft failure, particularly in patients with non-malignant diseases or those with lower stem cell doses. More frequent monitoring of chimerism by VNTR analysis may detect late graft failure earlier and allow for more rapid intervention.     

儿童造血干细胞移植后泌尿系统常见并发症及机制

造血干细胞移植(hematopoietic stem cell transplantation,HSCT)是多种血液系统疾病的重要治疗手段,而泌尿系损伤是HSCT常见并发症之一,包括急性肾损伤、慢性肾脏病、移植后肾病综合征、移植相关性血栓性微血管病、泌尿道感染、出血性膀胱炎等.按照其发生原因分为肾前性、肾性及肾后性三个方面,不同因素相互影响.其临床表现、治疗及预后因疾病类型及严重程度的不同而有差异.肾活检对于病因分析、指导治疗和判断预后有重要意义.该文就儿童HSCT泌尿系统常见并发症及其机制作一综述.     

先天性巨结肠症的病因学研究进展

先天性巨结肠症(congenital megacolon)又称肠无神经节细胞症,为小儿外科常见疾病之一,发病率居先天性消化道畸形第二位。Fredetick Ruys于1691年最早注意到这一疾病,Hirschsprung将其详细描述,所以通常称之为Hirschsprung’s Disease（HD）。有关HD的病因目前尚不完全清楚,但大多数认为本病属多因子遗传性疾病,即由遗传和环境因素共同作用所致。本文就研究的最新进展作一综述。     

Etiologic classification of attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder is a neurobiological syndrome with an estimated prevalence among children and adolescents of 5%. It is a highly heritable disorder, but acquired factors in etiology are sometimes uncovered that may be amenable to preventive measures or specific therapy. Early reports have described symptoms similar to attention-deficit/hyperactivity disorder that followed brain trauma or viral encephalitis, and recent MRI studies have demonstrated brain volumetric changes that may be involved in the pathophysiology of the syndrome. The American Psychiatric Association's Diagnostic Statistical Manual, introduced in 1968, emphasizes symptomatic criteria in diagnosis. Here, an overview of environmental factors in the etiology of attention-deficit/hyperactivity disorder is presented to encourage more emphasis and research on organic causal factors, preventive intervention, and specific therapies. An organic theory and the genetic and biochemical basis of attention-deficit/hyperactivity disorder are briefly reviewed, and an etiologic classification is suggested. Environmental factors are prenatal, perinatal, and postnatal in origin. Pregnancy- and birth-related risk factors include maternal smoking and alcohol ingestion, prematurity, hypoxic-ischemic encephalopathy, and thyroid deficiency. Childhood illnesses associated with attention-deficit/hyperactivity disorder include virus infections, meningitis, encephalitis, head injury, epilepsy, toxins, and drugs. More controversial factors discussed are diet-related sensitivities and iron deficiency. Early prenatal recognition, prevention, and treatment of environmental etiologies of attention-deficit/hyperactivity disorder may reduce physician reliance on symptomatic modification with medication, a frequent reason for parental concern.     

肠道炎症阻滞儿童体格生长的免疫和内分泌机制

肠道炎症常伴发儿童的生长落后。生长激素(GH)和胰岛素生长因子-1(IGF-1)是调控出生后骨骼纵向生长的重要物质,抑制GH/IGF轴可阻滞儿童体格生长。肠道发生炎症时,异常升高的促炎症因子IL-1β、IL-6和TNF-α通过干扰GH/IGF轴,系统性以及在生长板局部水平影响骨骼生长,进而导致儿童生长阻滞。     

先天性马蹄内翻足病因学研究进展

先天性马蹄内翻足(congenital clubfoot熏CCF)是小儿常见的一种严重影响足部功能的畸形,发病率约为1‰,主要畸形包括前足内收、踝跖屈、跟骨内翻以及继发性胫骨远端内旋。病因目前还不清楚,有多种学说,如:神经肌肉病变,血管发育异常,骨骼发育异常,软组织异常,遗传基因学说以及宫内发育阻滞学说等。在某一领域部分学者达成共识,如:神经肌肉病变学说,但尚无定论。因此,对先天性马蹄内翻足病因学的研究对指导和改进治疗有重要的意义。1神经肌肉病变学说1.1肌纤维变性和肌纤维型的改变有学者认为肌力不平衡是先天性马蹄内翻足畸形发生的直接原…