利多卡因雾化吸人治疗儿童哮喘临床研究

目的 观察利多卡因对儿童支气管哮喘急性发作临床作用及对免疫状态的影响。方法 儿童支气管哮喘急性发作60例，随机分为雾化吸入利多卡因治疗组38例，对照组22例，观察治疗前后的临床疗效和免疫功能的变化。结果 治疗组咳嗽、呼吸困难和肺部哮喘音消失时间均较对照组明显缩短(P值均＜0．01)，治疗组与对照组在心率、呼吸颇率、呼气流速增值(PEF)、第一秒用力呼气量(FEVl)等方面．有显著差异(P＜0．01)，治疗组治疗后嗜酸性险细胞(EOS)减少(P＜0．01)，IgE下降(P＜0．01)，IL—5减少(P＜0．01)。结论 利多卡因雾化吸入治疗儿童哮喘急性发作有明显临床疗效，且有调节哮喘免疫状态的作用。     

γ-干扰素雾化吸入治疗呼吸道合胞病毒诱发儿童哮喘疗效观察

目的观察γ-干扰素(IFN-γ)对儿童呼吸道合胞病毒(RSV)诱发的支气管哮喘治疗作用及对免疫状态的影响。方法RSV感染儿童哮喘68例,随机分为雾化吸入IFN-γ治疗组35例,对照组33例,观察治疗前后的临床疗效和免疫功能的变化。结果IFN-γ雾化吸入治疗组咳嗽、呼吸困难和肺部哮喘音消失时间均较对照组明显缩短(P值均＜0．01)。治疗组自身前后对照IgE降低(t=5．12,P＜0．01),IL-4减少(t=7．9,P＜0．01),IFN-γ上升(t=9．4,P＜0．01)。ISG、IgA、IgM变化无统计学意义。结论IFN-γ雾化吸入治疗RSV感染儿童哮喘有较好临床疗效。具有调节哮喘免疫状态的作用。     

预防性皮质激素吸入与三联雾化吸入治疗哮喘急性发作疗效观察

目的　评价缓解期预防性吸入皮质激素必可酮对儿童哮喘急性发作时博利康尼、普米克和爱全乐三联雾化治疗效果的影响。方法　对 36例哮喘急性发作儿童联合应用三联药物压力雾化吸入治疗 ,采用配对t检验观察治疗前后的疗效 ,采用秩和检验分析缓解期预防性吸入皮质激素对急性发作时压力雾化吸入治疗效的影响果。结果　缓解期规则预防性吸入皮质激素组哮喘急性发作时 ,三联药物压力雾化吸入治疗效果优于不吸入和不规则吸入组 ,P <0 0 5 ;急性发作期三联药物压力雾化治疗疗效满意 ,P <0 0 1。结论　缓解期预防性吸入皮质激素与急性发作期三联压力雾化吸入结合是目前治疗哮喘最理想、最安全有效的方法。     

哮喘患儿支气管诱导痰液中P物质含量变化的临床研究

目的　研究支气管哮喘患儿急性发作期、缓解期支气管诱导痰液中P物质含量变化及临床意义。方法　用高渗盐水超声雾化吸入法留取研究组及对照组儿童支气管诱导痰液。其中哮喘急性发作期组 34例 (3d内无静脉或口服激素史 ) ;哮喘缓解期组 30例 ;健康对照组 2 2例。用放射免疫方法检测各组支气管诱导痰中P物质含量。结果　哮喘患儿急性发作期支气管诱导痰中P物质含量明显高于缓解期及正常对照组 ,差异显著 ,P均 <0 0 1。缓解期组与正常对照组比较 ,差异无显著性 ,P >0 0 5。结论　哮喘患儿急性发作期支气管诱导痰中P物质含量显著增高 ,缓解期降低 ,接近正常水平 ;提示支气管诱导痰中P物质含量与儿童哮喘的发作及缓解关系密切 ,可做为一种临床监测指标。     

预防吸入丙酸倍氯米松对哮喘急性发作疗效观察

目的评价缓解期预防性吸入丙酸倍氯米松对儿童哮喘急性发作时三联雾化疗效的影响。方法选择36例哮喘急性发作儿童为对象,治疗组18例,在缓解期预防性每日规则吸入丙酸倍氯米松;对照组18例,在缓解期未吸入丙酸倍氯米松;两组在急性发作期治疗均采用三联药物雾化吸入法。结果治疗组在哮喘急性发作时总有效率明显高于对照组(P< 0.01)。结论缓解期预防性吸入皮质激素结合急性发作期三联压力雾化吸入是目前治疗哮喘安全有效的方法。     

布地奈德联合全乐宁雾化吸入治疗婴幼儿哮喘疗效分析

目的探讨布地奈德联合全乐宁雾化吸入治疗婴幼儿哮喘的疗效。方法将86例婴幼儿哮喘急性发作患儿分为治疗组（30例），对照组1组（26例），对照组2组（30例），3组病例在综合治疗基础上，治疗组给予布地奈德联合全乐宁雾化吸入治疗，对照1组给全乐宁雾化吸入，对照2组给氨茶碱片曰服。结果治疗组临床控制率明显高于对照1组及对照2组，差异有统计学意义（P〈0．05）。结论布地奈德联合全乐宁雾化吸入能有效控制婴幼儿哮喘急性发作，值得临床推广。     

细辛脑注射液雾化吸入治疗小儿支气管哮喘临床观察

目的观察中药细辛脑注射液雾化吸入治疗支气管哮喘的疗效。方法将40例支气管哮喘急性发作患儿随机分成两组各20例,分别雾化吸入细辛脑注射液(观察组),万托林、普米克令舒溶液(对照组);观察两组治疗后症状、体征改善程度。结果两组患儿症状均明显改善,经统计学分析,观察组和对照组总有效率无明显差异,疗效相当。结论中药细辛脑注射液雾化吸入治疗支气管哮喘有效。     

普米克令舒雾化吸入治疗婴幼儿哮喘急性发作

为评价普米克令舒雾化吸入治疗婴幼儿哮喘急性发作的疗效。采用随机对照 ,对 12例婴幼儿哮喘急性发作进行普米克令舒 (0 .5ｍｇ/ｍｌ)加博利康尼雾化溶液 (2 .5ｍｇ/ｍｌ)雾化吸入治疗 ,另 2 0例用琥珀酸氢化可的松 (5～ 7ｍｇ/ｋｇ)静滴加博利康尼雾化溶液 (2 .5ｍｇ/ｍｌ)吸入治疗 ,进行疗效观察 ,结果治疗组和对照组显效率分别为 6 6 .5 %和 75 .0 % ,两组疗效无显著差异。故雾化吸入普米克令舒和博利康尼雾化液联合应用与静滴琥珀酸氢化可的松加雾化吸入博利康尼雾化溶液疗效相同。普米克令舒雾化吸入治疗婴幼儿哮喘急性发作@李双双     

硫酸镁与喘乐宁联合吸入治疗小儿哮喘疗效观察

目的　探讨硫酸镁加喘乐宁联合雾化吸入治疗小儿支气管哮喘的有效性和安全性。方法　将 30例哮喘急性发作患儿随机分为硫酸镁和喘乐宁联合吸入组、单用喘乐宁吸入组。吸入喘乐宁的剂量均为每次 2 5 0～3 75mg ,单用喘乐宁组加 2mL生理盐水 ,联合组加 2mL的 7 5 %硫酸镁溶液。观察两组治疗前后呼吸、心率、血压 ;测量治疗前以及治疗后 10min、2 0min最大呼气峰流速 (PEFR)。结果　联合组PEFR明显高于单用喘乐宁组 ,联合组PEFR增加的百分比是单用喘乐宁组的 2倍 (P <0 0 5 ) ,联合组治疗前PEFR越低治疗后PEFR上升幅度越高。硫酸镁吸入治疗后无一例患儿出现血压下降等不良反应。结论　哮喘急性发作患儿在喘乐宁吸入的基础上加用硫酸镁吸入比单用喘乐宁吸入有更好的治疗效果 ;硫酸镁吸入治疗在儿童是安全的。     

儿童支气管哮喘急性发作吸入与静脉治疗回顾分析

目的研究布比奈德混悬液与硫酸特布他林雾化液联合吸入与静脉使用激素、氨茶碱控制儿童哮喘急性发作疗效比较。方法72例单纯静脉给药组为对照组，86例雾化吸入组为治疗组，比较其治疗天数、输液率、住院天数、静脉激素用量。结果对照组与治疗组治疗后临床表现均有明显改善。3天后治疗组临床缓解优于对照组，而输液率、住院天数、静脉激素用量均明显低于对照组。结论儿童支气管哮喘急性发作的雾化吸人治疗优于静脉给药。     

Role of nutrients in the regulation of in vivo protein metabolism in humans

Nutrients regulate protein metabolism both in an acute fashion and on a long-term basis. The ingestion of meals is associated with a dramatic switch from an overall catabolic state to a state of net protein anabolism. The acute response of protein metabolism to meal ingestion is mediated, in part, by an increase in insulin secretion, itself a consequence of glucose absorption. Whereas insulin may primarily suppress rates of proteolysis, amino acids are responsible for the stimulation of protein synthesis that follows food intake. In the long run, the effects of nutrition on protein metabolism depend on the energy supply, the source of the energy (carbohydrate versus fat) and dietary protein intake. Finally, specific amino acids, such as glutamine, may play an additional role as protein anabolic agents.     

氨磷汀在儿童肿瘤化疗中的应用

目的研究氨磷汀在儿童肿瘤化疗中的作用及不良反应。方法随机选择肿瘤32例患儿,采用自身对照,观察患儿在同一化疗方案中使用氨磷汀辅助治疗后黏膜损伤、骨髓抑制时间、发热持续时间、抗生素及刺激因子应用时间及氨磷汀的不良反应。结果氨磷汀辅助治疗组发生黏膜溃疡4例,明显低于对照组9例;中性粒细胞<0.5×109/L持续时间缩短,血小板<5×109/L持续时间缩短;发热持续时间、抗生素和刺激因子应用时间缩短。两组化疗过程中均未出现低体温、皮疹、低血压等情况,化疗后肾功能、心电图均正常;对肝功能影响程度相似;氨磷汀组低钙血症尤其是低钙性抽搐发生率高。结论氨磷汀能够有效保护正常组织细胞,不良反应较低,可在儿童肿瘤患者化疗中应用。     

Determinants of pregnancy in adolescents in Nepal

Objective : Social factors and prevalent norms in the community determine the proportion of teenage pregnancy in the community. In the light of high risk associated with teenage pregnancy, the socio-cultural determinants, which influence the conception among teenagers in Nepal, need to be understood. These determinants may be modified by suitable interventions to reduce teenage pregnancy. Aim of this study was to examine the socio-cultural determinants of teenage pregnancy in eastern Nepal.Methods : A case-control study design was selected for comparing the education, economic status, family support and freedom towards conception among teenagers as compared to higher age group women.Result : Seventy adolescent pregnant women were compared with seventy primigravida women in the 20 to 29 years age group. The teenage pregnant women were less educated, had poor economic background, more likely to have accidental pregnancies as compared to the other group and more likely to have love marriages. Husbands were more likely to decide about continuation of pregnancy. They had less psychological and social support from the family.Conclusion : Marriage at young age and pregnancy during teens are associated with less social acceptance and poor support in the family.     

Role of nutrients in the regulation of in vivo protein metabolism in humans

Nutrients regulate protein metabolism both in an acute fashion and on a long-term basis. The ingestion of meals is associated with a dramatic switch from an overall catabolic state to a state of net protein anabolism. The acute response of protein metabolism to meal ingestion is mediated, in part, by an increase in insulin secretion, itself a consequence of glucose absorption. Whereas insulin may primarily suppress rates of proteolysis, amino acids are responsible for the stimulation of protein synthesis that follows food intake. In the long run, the effects of nutrition on protein metabolism depend on the energy supply, the source of the energy (carbohydrate versus fat) and dietary protein intake. Finally, specific amino acids, such as glutamine, may play an additional role as protein anabolic agents.     

他汀类药物在儿童家族性高胆固醇血症治疗中的研究进展

家族性高胆固醇血症(FH)是一种常染色体显性遗传的脂质代谢障碍疾病,由于FH早期就可引起动脉粥样硬化病变,增加患者严重心血管疾病的患病风险和死亡风险,因此目前越来越强调患者自儿童期就使用他汀类药物进行治疗,以改善远期预后。文章综述他汀类药物治疗儿童FH的必要性、有效性和安全性,同时也提出目前存在的一些问题和思考。     

Diagnosis of Chlamydia pneumoniae in community-acquired pneumonia in children in Chile

The incidence of Chlamydia pneumoniae in community-acquired pneumonia in children was studied prospectively in 112 children aged 1 mo to 14 y. Diagnosis of C. pneumoniae was performed by polymerase chain reaction (PCR) on nasopharyngeal aspirates and serology by the microimmunofluorescence test on a single serum specimen. Three (2.7%) cases of pneumonia due to this agent were diagnosed by both PCR and serology. C. pneumoniae was not found in any of 62 children below 5 y of age. In the age group 5-8 y, only 1/30 (3%) was found positive, and in the age group 9-14 y, C. pneumoniae was diagnosed in 2/20 (10%) children. Conclusion: Although the number of enrolled patients is small, and the diagnostic techniques used may have some limitations, the results of this study suggest that C. pneumoniae plays a minor role in the aetiology of pneumonia in children less than 9 y of age in our country. However, it should be considered as a potential agent in pneumonia in older children.     

皮质激素在癫痫治疗中的应用

皮质激素在癫痫中的应用已有近50a的历史，现已证明其对某些癫痫综合征如婴儿痉挛症、Landau—Kleffner综合征、Rassmussen综合征、具有睡眠中癫痫性电持续状态的癫痫综合征等具有肯定的治疗作用，其确切的作用机制尚不清楚。在皮质激素应用过程中应注意其不良反应。     

皮质激素在癫(癎)治疗中的应用

皮质激素在癫(癎)中的应用已有近50 a的历史,现已证明其对某些癫(癎)综合征如婴儿痉挛症、landau-Kleffner综合征、Rassmussen综合征、具有睡眠中癫(癎)性电持续状态的癫(癎)综合征等具有肯定的治疗作用,其确切的作用机制尚不清楚.在皮质激素应用过程中应注意其不良反应.