肾病综合征患儿细胞免疫和细胞因子的变化及其意义

目的探讨肾病综合征(NS)患儿细胞免疫功能和IL-1、IL-6、IL-8及TNFα与NS发病机制的关系.方法应用流式细胞术和酶联免疫吸附(ELISA)方法,对23例NS患儿在活动期和缓解期(21例)以及20例正常儿童外周血T细胞亚群以及血清和外周血单个核细胞(PBMC)培养上清诱生IL-1、IL-6、IL-8、TNFα水平进行测定.结果NS活动期血清和PBMC上清液IL-1、IL-6、IL-8和TNFα水平明显高于缓解期和对照组,IL-6和TNFα增高显著,缓解期上述细胞因子仍高于对照组.外周血总CD3+、CD4+、CD4+/CD8+细胞比值、CD(16+56)+细胞均降低,CD8+细胞增高.相关分析发现NS活动期IL-1、IL-6、IL-8和TNFα与CD3+、CD4+、CD4+/CD8+和CD(16+56)+细胞呈负相关,与CD8+细胞呈正相关.结论NS患儿在活动期多种细胞因子失调,T细胞亚群的比例结构发生变化,细胞免疫功能异常及细胞因子网络失调在NS发病中起一定作用.     

病毒性脑炎患儿一氧化氮和肿瘤坏死因子α的变化

目的 探讨病毒性脑炎（病脑）患儿血清和脑脊液一氧化氮（NO）和肿瘤坏死因子α（TNF－α）的变化。方法 应用ELISA等方法测定34例病脑患儿的血清和脑脊兴中NO和TNF－α的水平。结果 病服患儿血清NO和TNF－α水平较对照组明显升高（P＜0．01），昏迷患者比较症更高（P＜0．01），NO和TNF－α与病情严重程度呈正相关。脑脊液NO和TNF－α急性期恢复期有明显增同。结论 提示血清NO和TNF－α的水平与病脑的发生发展和病情严重程度有关。     

化脓性脑膜炎和病毒性脑炎患儿脑脊液中IL—8和INF水平的改变及意义

目的：了解化脓性脑膜炎和病毒性脑炎患儿脑脊液（CSE）中白细胞介素－8（IL－8）和肿瘤坏死因子（TNF）水平的改变及临床意义,方法：采用ELISA法对20例化脓性脑膜炎（PM）,17例病毒性脑膜脑炎（VME）,25例病毒性脑炎（VE）患儿和15例对照组儿童CSF中IL－8和TNF水平进行了检测,并观察CSF中IL－8,TNF水平与CSF常规及生化检查各指标的相关性。结果：PM组CSF中IL－8和TNF水平分别为（443&;#177;247）ng/L和（640&;#177;283）ng/L,明显高于VME组[(184&;#177;86）ng/L和（154&;#177;95）ng/L],VE组[(54&;#177;36)ng/L和（30&;#177;26）ng/L]和对照组[(27&;#177;20)ng/L和（23&;#177;21)ng/L]（P&;lt;0.01);VME组CSF中IL－8和TNF水平亦高于VE组和对照组（P＜0．01）,VE组CSF中IL－8较对照组有所升高（P＜0．05）,但其TNF水平与对照组比较差异无显著性（P＞0．05）,对患儿CSF中IL－8与TNF进行相关性分析显示;PM组IL－8与TNF呈明显正相关(r=0.682,P&;lt;0.01),VME组IL－8与TNF亦呈一定正相关关系（r=0.534,P&;lt;0.05),对患儿CSF常规和生化检查各指标IL-8,TNF进行相关性分析显示：PM组患儿CSF中性粒细胞计数与IL－8水平呈明显正相关（r=0.777,P&;lt;0.01),而VME组和VE组患儿CSF中性粒细胞数与IL－8水平未见显著相关性,3组患儿CSF中性粒细胞数与TNF水平未见相关性;CSF单核细胞数,蛋白质及糖定量与IL－8和TNF间均无相关性。结论：IL－8参与了化脓性脑膜炎和病毒性脑炎的病理生理过程,而TNF可能主要参与脑膜局部（包括化脓性和病毒性）的炎症过程,提示CSF中IL－8和TNF的检测可作为化脓性脑膜炎诊断的一项参考指标。&;#177;&;#177;&;#177;&;#177;&;#177;     

支气管哮喘患儿吸入糖皮质激素治疗前后细胞因子及免疫功能变化

目的　探讨支气管哮喘患儿吸入糖皮质激素前后细胞因子、T细胞亚群等指标的变化。方法　采用双抗体夹心ELISA法检测 2 8例哮喘患儿吸入糖皮质激素前、吸入 1个月、吸入 1年后血清白细胞介素 6 (IL 6 )、IL 8、肿瘤坏死因子α(TNF α)水平 ,同时检测外周血T细胞及其亚群、B细胞变化。结果　哮喘患儿吸入前血清IL 6、IL 8、TNF α均显著高于正常对照组 (P <0 .0 1)。吸入 1个月、1年时 ,3种细胞因子水平渐降低 ,但仍高于正常水平。哮喘患儿外周血CD3+ 、CD4 + 、CD8+ 细胞均显著低于正常对照组 ,而CD4 + /CD8+ 、B细胞下降 ,但仍未降至正常水平。结论　哮喘患儿存在多种细胞因子失调及T细胞亚群、B细胞失衡。IL 6、IL 8、TNF α可能参与哮喘的炎症反应。吸入糖皮质激素可显著降低体内炎症细胞因子水平 ,促进T细胞亚群恢复平衡     

格林—巴利综合征急性期免疫学改变

目的探讨格林-巴利综合征（GBS）急性期IL-2、IL-6、TNF-α和免疫球蛋白等免疫学改变及其与临床的关系。方法采用ELISA法测定GBS组21例，正常对照组16例血清及外用血单个核细胞（PBMC）上清液IL-2、IL-6、TNF-α及IgG水平，同时检测血清IgA、IgM、IgG亚类。结果GBS患者血清IL-2、TNF-α，PBMC上清液IL-2、IL-6、TNF-α及IgG均高于对照组（P＜0．05或0．01）。14例有一种以上血清免疫球蛋白或IgG亚类升高。重型组TNF-α高于轻型组（P＜0．05）。结论GBS患者存在T细胞功能紊乱和B细胞多克隆活化，IL-2、免疫球蛋白、尤其TNF-α升高在GBS发病中起重要作用。     

病毒性脑炎儿脑脊液细胞因子测定的临床意义

目的 探讨病毒性脑炎（病脑）与细胞因子的关系。方法 测定23例病脑患儿和对照组脑脊液肿瘤坏死因子-α（TNF-α）、白细胞介素-2（IL-2）、IL-8、干扰素-α（IF-α）的水平,对TNF-α、IL-8、IFN-α及IL-2两两之间进行相关分析。结果 病脑组脑脊液TNF-α、IL-8、IFN-α、IL-2（ng/L）分别为374.90±74.38、16.55±3.73、257.80±47.23、179.66±40.60,明显高于对照组（P<0.01）。病脑组TNF-α与IL-8、IFN-α、IL-2均呈正相关,IL-8与IL-2成正相关,差异有显著性（r=0.76,0.80,0.63,0.68P<0.01）。结论TNF-α、IL-8、IFN-α、IL-2在病脑发病过程中相互作用形成细胞因子网络,参与了机体抗病毒免疫和病脑的病理损害过程。     

新生儿细菌感染时血清 TNF-α和 IL-10水平变化

为了解血清TNF－α和IL-10的水平与新生儿感染状态和预后的关系，将2000年1月－2002年1月新生儿病房收治的足月儿207例，分为败血症组82例，一般感染组98例，非感染组27例，用ELISA法检测血清TNF－α和IL-10水平。结果显示，败血症组的TNF－α，IL-10水平显著高于无感染组的和一段感染组；血培养阳性和血培养阴性的败血症组之间TNF－α和IL-10水平差异无显著性；IL－10的水平和IL－10／TNF－α的比值在恶化或死亡的感染病例中显著升高。提示TNF－α和IL-10水平可能更敏感地反映机体感染的情况及预测预后。     

过敏性紫癜患儿外周血CD40L mRNA表达及其与血清IL-6和IL-8的关系

目的 探讨过敏性紫癜患儿外周血单个核细胞(PBMC)中CD40L mRNA的表达及其与血清中IL-6和IL-8的关系.方法 应用逆转录一聚合酶链式反应(RT-PCR),从转录水平检测30例过敏性紫癜(HSP)患儿和20例正常儿童(对照组)PBMC中CD40L mRNA的表达,并应用ELISA双抗体夹心法检测血清中细胞因子IL-6和IL-8的水平.结果 HSP患儿(PBMC)中CD4JDL mRNA的表达明显高于对照组(P<0.05);HSP患儿血清中IL-6和IL-8水平明显高于对照组(P<0.05),加入抗-CD40L mAb后恢复正常.结论 HSP患儿PBMC中CD40L的表达异常增高,且CD40L的表达与血清中IL-6和IL-8呈正相关.     

急淋白血病血清细胞因子水平及其临床相关

为探讨急淋白血病患者血清细胞因子水平及其临床意义，我们对相应的年龄组的急淋白血病患儿与正常儿各7例采用ELISA法检测了其血清中部分细胞因子水平（TNF－α、IL－2、IL－4、α-IFN)，并进行了统计学处理。结果显示，急淋白血病组患儿的TNF－α血清水平显著高于正常对照组（P＜0．05），而两组的IL－2、IL－4和α－IFN血清水平无显著差异（P＞0．05）。上述结果提示血清TNF－α水平不仅是其它肿瘤，也是急淋白血病患儿的生物因子微环境之一，而IL－2在急淋白血病患儿的血清中的水平并不象其它肿瘤患者那样降低。     

肾病综合征细胞免疫功能动态变化的临床意义

目的 探讨儿童原发性肾病综合征（NS）淋巴细胞免疫功能的动态变化和可溶性白介素2受体（sIL-2R)、T细胞亚群、IL－1、IL－6及IL－8改变的临床意义。方法 应用ELISA方法对25例NS活动期和缓解期患儿检测血清和尿液sIL-2R和血清IL－1、IL－6和IL－8浓度。应用流式细胞仪检测T细胞亚群的变化。结果 1．NS活动期组血清和尿液sIL-2R分别高于缓解期组（P＜0．01）;2．NS活动期组血清IL－1、IL－6和IL－8明显高于缓解期组（P＜0．01）;3．NS活动期组CD3^ 、CD4^ 、CD4^ /CD8^ 、NK[CD(16 56)^ 细胞明显低于缓解期组（P＜0．01）。结论 NS患儿细胞免疫功能减低,促进IL－1、IL－6和IL－8的产生,血和尿sIL-2R及细胞因子的变化可作为NS活动指标之一。     

Age-dependency of alpha- and beta-adrenoceptors on thrombocytes and lymphocytes of asthmatic and nonasthmatic children

Among the possible mechanisms which may cause wheezing or asthmatic episodes a genetically determined -adrenoceptor blockade and a hyperresponsiveness of -andrenoceptors has been postulated. Evidence to support this hypothesis stems from an increased bronchial sensitivity to -blockers, a reduced formation of cyclic AMP in response to -adrenergic stimulation and enhanced -adrenergic responses in asthmatic subjects. The recent development of techniques for measuring the specific, high-affinity binding of radiolabeled -and -adrenergic antagonists made it possible to study - and -adrenoceptors in vitro. Based upon the assumption that a change in the number and/or affinity of adrenergic receptors might be a general phenomenon, we have performed - and -receptor binding studies on lymphocytes and platelets from wheezing infants and asthmatic children as well as of infants, children, and adults not suffering from these diseases.Using ¹²⁵[I]-cyanopindolol (ICYP) and ³[H]-yohimbine (HYOH) as highly specific ligands for - and -adrenoceptors, the following results were obtained: (1) Lymphocytes and platelets from control subjects and asthamatics bound similar amounts of ICYP and HYOH and thus showed no differences either in the number or the affinity of - and -adrenoceptors. Lymphocytes and platelets of wheezing and nonwheezing infants also bound the same amounts of the radioligands. (2) In asthmatic children receiving 4×2 puffs salbutamol -adrenoceptor were down-regulated and this may mimic -adrenoceptor blockade. (3) When subjects were divided into four categories according to age (0–5, 5–10, 10–20 years, adults) the number of -adrenoceptor binding sites showed an age-dependent increase. The number and affinity of -adreneceptor binding sites on platelets was neither influenced by age nor disease.It is concluded that the - and -adrenoceptors of wheezing infants and asthmatic children at least on blood cells are normal. However the -adrenoceptors show an age-dependent maturation process, which may account for an unresponsiveness to -adrenoceptor agonists in wheezing infants.Supported by a grant from the Ministerium für Wissenschaft und Forschung, NRWPresented at the 19th Workshop for Pediatric Research, University of Göttingen, March 10–11, 1983     

Parent Preferences and Perceptions of Milliliters and Teaspoons: Role of Health Literacy and Experience

Background and Objectives

A recent American Academy of Pediatrics policy statement recommends milliliter-exclusive dosing for pediatric liquid medications. Little is known about parent preferences regarding units, perceptions about moving to milliliters only, and the role of health literacy and prior milliliter-dosing experience.

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??The physiological characteristics of children determine their own particularity of their needs for the quality and quantity of proteins. Proteins not only play an important role in the development of children’s growth and development??cognitive function and immune function??but also have important effects on the long-term health of children.In this paper??the dietary protein reference intakes??amino acid patterns??dietary amino acid reference intakes??sources of high quality protein??and harm of deficiency and excess of protein in children were discussed in detail.     

婴幼儿膳食营养与生长发育指标调查

目的确定当前3岁以下儿童主要的营养问题，为制定营养改善对策提供科学依据。方法对在本院儿童保健中心定期进行体检的386例6—36个月儿童进行体格测量及智力发育检测，并同时进行膳食分析。结果膳食中能量、蛋白质、视黄醇、硫胺素、抗坏血酸及铁、钙的摄入均达到膳食营养素参考摄入量（DRIs）标准，膳食锌平均摄入量未达到DRIs的80％。Logistic回归分析提示碳水化合物摄入量过高是婴幼儿肥胖的一个危险因素。能量和碳水化合物摄入越多，智力发育指数越高。结论婴幼儿生长发育和膳食状况良好，父母要注意培养婴幼儿科学的膳食习惯。     

Prenatal and postnatal administration of prebiotics and probiotics

Colonization of the neonatal gut by beneficial bacteria is important for the establishment and maintenance of the mucosal barrier, thus protecting the neonate from enteric pathogens and local and systemic inflammation. The neonatal microbiome is influenced by infant diet, environment, and the maternal microbiome. Dysbiosis in pregnancy increases the risk of pre-eclampsia, diabetes, infection, preterm labor, and later childhood atopy. Dysbiosis of the neonatal gut plays an important role in colic in the term infant, in the disease processes which plague preterm infants, including necrotizing enterocolitis and sepsis, and in the long-term outcomes of neonates. Administration of enteral prebiotics, probiotics, and synbiotics during pregnancy, lactation, and postnatal life appears to be a safe and feasible method to alter the maternal and neonatal microbiome, thus improving pregnancy and neonatal outcomes.     

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??Bronchiolitis has been one of the hot spots in the researches on diseases of respiratory system nowadays. However?? the concepts and classifications of this disease remain unclear. In this paper?? the denotative and connotative concepts of bronchioles and bronchiolitis were analyzed from the views of anatomy and development biology?? and the classification changes of adult bronchiolitis were introduced. These content can be used as references for the systematic studies of pediatric bronchiolitis.     

Caring for the health and medical and emotional needs of children of migrants and asylum seekers

Political turmoil, military conflicts and other international sociological upheavals are causing significant immigration of large numbers of people, including infants and children, in Europe. Many of these young migrants are refugees. These youngsters have significant health needs, and medical conditions (such as infectious diseases) and mental health problems due to their previous stressful situations and the difficulties that they often experience while settling, even temporarily, into their new environments. Government authorities must screen for transmissible diseases and ensure that vaccine-preventable infections are adequately covered. Paediatricians must give the best possible care for these children and act as their advocates. This can be enhanced by collaborating with national and international paediatric societies and with international non-government agencies. This problem is not confined to Europe; world-wide, it occurs on a massive scale and causes huge burdens for poorer countries that have serious difficulties in coping with the extra financial, personnel and infrastructure needs imposed by massive, uncontrolled migration of populations that are often unhealthy and inadequately nourished. However, this should not be used as a pretext to deny safe refuge to children and their families who need it.

Conclusion: Massive movements of infant and child immigrants and refugees across European borders over recent years have brought challenges to paediatricians because of the needs for the health and medical and mental health care of these young people. Paediatricians have an important role in their care and by acting, wherever possible, as their advocates. This is a massive problem, world-wide, in which paediatricians can have a potentially significant positive impact.