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??There are still problems??including difficulty in feeding baby?? apnea?? stunting on infants with bronchopulmonary dysplasia??BPD?? after being discharged from hospital. The risk of sudden infant death syndrome also increases. Healthcare after discharge from hospital is a continuation after treatment in hospital?? which is important for BPD treatment. Healthcare includes home oxygen after discharge from hospital?? continuing to strengthen infant’s nutrition and feeding guidance?? regular follow-up and prevention of sudden infant death syndrome.     

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??Premature infants often suffer from chronic respiratory diseases and need supplementary oxygen at home after being discharged??and there exists increased rehospitalization?? more frequent cough and wheezing symptoms?? and abnormal lung function reflecting airway obstruction?? hyper-responsiveness and air-trapping. Also?? the neurological problems are more common in preterm survivors with bronchopulmonary dysplasia ??BPD?? compared to those without BPD. Severe BPD could be a predictor for poor neurodevelopmental outcome in certain type of patients.     

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??Objective??To explore the clinical characteristics of hydrocephalus in children with purulent meningitis. Methods??The children??aged??14 years??treated for purulent meningitis at the Shengjing Hospital of China Medical University during the period from January 2010 to December 2016??were retrospectively enrolled in the study. The clinical data of every child who fulfilled the criteria were obtained and analyzed. Data were analyzed using the Statistical Package for Social Sciences??SPSS??13.0. Results??The morbidity of hydrocephalus in children with purulent meningitis was 9.36%??25/267??. In these cases with hydrocephalus??the ageofonset was mainly under 6 months old??and the period from onset to diagnosis of hydrocephalus was mainly 1-4 weeks. Fifteen cases of hydrocephalus had a confirmed bacterial etiology as follows??Escherichia coli??n??6????Streptococcus pneumoniae??n??2????staphylococcus??n??2????Group B beta-hemolytic streptococcus??n??2????acinetobacter??n??2??and Listeria monocytogenes??n??1??. The incidence of obstructive hydrocephalus was 48%??12/25??. About 56% patients received a previously treatment with antibiotics. The prognoses of these children were??survival in 12 cases??death in 1 case and loss of follow-up in 11 cases. The related factors of the development of hydrocephalus included??a rural living situation??OR??17.64??95%CI 1.23??252.86????altered level of consciousness??OR??7.59??95%CI 1.09??52.86????CSF protein??2.0 g/L??OR??177.02??95%CI 3.53??8866.51????C-reactive protein??100 mg/L??OR??52.29??95%CI 3.26??840.19????initial therapy with dual-agent antibiotic??OR??0.06??95%CI 0.01??0.62????dexamethasone use??OR??149.47??95%CI 2.56??8713.78?? and previous treatment with antibiotics??OR??36.28??95%CI 2.84??462.78??. Conclusion??Hydrocephalus is a serious complication of purulent meningitis. The severe clinical manifestations and significantly abnormal laboratory indexes represent the most important predictor of hydrocephalus in children with purulent meningitis.     

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目的通过观察Turner综合征(TS)患儿使用重组人生长激素(rhGH)后糖、脂质代谢的变化,为其安全性治疗提供临床数据。方法对2007年7月至2010年6月在卫生部中日友好医院明确诊断为TS的28例患儿进行体脂、血脂检测,葡萄糖耐量试验(OGTT),采用rhGH替代治疗6个月后复查上述指标,比较治疗前后糖、脂代谢指标的变化。结果在28例患儿中发现单体型、嵌合体型、X染色体长臂等臂型、X染色体长臂缺失型4类异常的染色体核型;体脂测量中,体脂含量(FAT%)治疗前后差异有统计学意义(P<0.05),脂肪重量(FM)治疗前后差异无统计学意义(P>0.05);血脂检测中,血清高密度脂蛋白(HDL-C)、低密度脂蛋白(LDH-C)治疗前后差异有统计学意义(P<0.05);血清甘油三酯(TG)、胆固醇(CHO)治疗前后差异无统计学意义,治疗前TG异常5例,CHO异常6例,治疗后均变为2例异常。在OGTT试验中,5例患儿存在糖耐量减低(IGT),治疗后IGT例数无改变,胰岛素抵抗指数(HOMA-IR)治疗前后(1.63±0.45对1.58±0.44)差异无统计学意义。结论 TS患儿存在糖、脂质代谢紊乱的高风险,通过rhG...     

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??Abstract??Objective??To analyse the clinic characteristics of American children with feeding difficulties??and to provide reference for the diagnosis and treatment of feeding difficulties in our country. Methods ??Retrospective analysis was made on 126 children’s medical charts of feeding difficulties at Interdisciplinary Feeding Team in Cincinnati Children’s Hospital Medical Center in USA. All the children were the first time visit. We analyzed the clinical characteristics of children with feeding difficulties including the ages of first visit?? reasons for referral?? types of feeding?? nutritional status??oral functions and co-morbid conditions. Results??The most children with feeding difficulties were under 3 years old?? of whom 28??22.2???? were younger than 1 year old and 63??50.0???? were 1 to 3 years old. Of the 126 feeding difficulties children?? 91??72.2???? were full oral feeding?? 31??24.6???? were provided nutrients by partial enteral feeding and 4??3.2???? were by full enteral feeding. There were 83??65.9????children with normal status of nutrition??33??26.2???? were mild malnutrition and 10??7.9???? were moderate malnutrition. Ninety ??71.4???? children with feeding difficulties had developmental oral function delays?? of whom 71??56.3????had oral-motor skills delays?? 42??33.3???? had oral sensitivity problems and 30??23.8???? had swallowing problems. The following three co-morbid conditions were most frequent?? 68??54.0????chronic gastrointestinal conditions?? 59??46.8???? neurodevelopmental delays?? and 39??30.9????chronic respiratory diseases. Conclusion??Feeding difficulties are common in infants and young children. Most children present with one or more co-morbid conditions. The children who have chronic gastrointestinal conditions?? neurodevelopmental delays and chronic respiratory diseases are at high risk of feeding difficultes.     

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目前国内外在研究脑瘫患儿脑细胞功能方面报道甚少。笔者于2002—2005年应用18氟脱氧葡萄糖(FDG)正电子发射计算机断层扫描(PET)显像检测19例脑瘫患儿治疗前后脑细胞葡萄糖代谢的变化,现报道如下。选择2002-07—2005-06在广东省人民医院住院及门诊的小儿脑瘫患儿19例,按脑瘫诊断标准诊断[1],并排除遗传代谢病。其中男12例,女7例,年龄最小11个月,最大4岁。临床分型:痉挛型8例,徐动型2例,混合型8例,共济失调1例。19例患儿全部先行MRI检查,脑电图检查,然后在本院PET中心行18F-FDG、PET检测。治疗方法:①采用运动疗法:Bobath法为主,配合…     

哮喘预测指数对婴幼儿哮喘临床应用及评价

哮喘是儿童时期最常见的慢性疾病,也是临床儿科医生难以在婴幼儿期作出明确诊断的疾病之一。40%～50%的儿童在3岁前出现过至少1次喘息和呼吸困难等哮喘样症状[1],但是仅有约30%的反复喘息学龄前儿童到6岁时仍有哮喘症状[2]。事实上,发生喘息的幼龄儿童中约半数仅发生过1次喘息[3]。另一方面,约80%儿童持续哮喘患者的喘息症状出现在6岁以前,50%以上的喘息症状发生在3岁以前[4]。幼龄儿童喘息的疾病负担远高于年长儿,与学龄儿童相比,小于3岁儿童的哮喘控制情况较差,这部分患     

Utility of impulse oscillometry in young children with asthma

Impulse Oscillometry (IOS) was developed as a tool to measure lung function, and as it only requires passive cooperation, it has been successfully used in younger children. The aim of this study was to assess the utility of IOS compared to conventional spirometry for lung function measures in asthmatic Korean children aged 3 to 6 yrs. Total serum IgE levels, total eosinophil counts, and specific IgE levels were measured in 77 children with asthma and 55 control subjects. IOS and spirometry were performed in the children before and after bronchodilator administration. Asthmatic children significantly differed from control subjects in baseline resistance at 10 Hz and in their IOS-assessed bronchodilator responses through a Δresistance at 5 Hz (mean, −27.4% vs. −13.1%; p = 0.002), 10 Hz (mean, −20.4% vs. −11.5%; p = 0.012), 20 Hz (mean, −16.4% vs. −9.4%; p = 0.016), and 35 Hz (mean, −17.2% vs. −10.2%; p = 0.020). Conventional spirometry did not show statistically significant findings. Asthmatic children significantly differed from control subjects in IOS-assessed bronchodilator response through a Δresistance at 5 Hz, both in atopic children and in non-atopic children. For atopic children, atopic asthmatic children (n = 58) also significantly differed from atopic controls (n = 30) in baseline resistance at 10 Hz, 20 Hz, 35 Hz and impedance and in IOS-assessed bronchodilator responses through a Δ resistance at 10 Hz and 35 Hz. There were some significant correlations between bronchodilator responses of spirometric parameters and IOS parameters. IOS is useful diagnostic tool in early asthma development and might be a helpful objective outcome measure of early interventions.     

潮气呼吸肺功能在反复喘息婴幼儿中的应用及临床意义

目的探讨不同类型反复喘息婴幼儿潮气呼吸肺功能的变化及临床意义。方法选取2013年10月至2014年2月收治的3岁以下反复喘息患儿80例,根据哮喘预测指数分为阳性组和阴性组,分别在入院时(急性期)、出院时(缓解期)和出院后1周(恢复期)测定其潮气呼吸肺功能,比较两组喘息患儿的达峰时间比(TPTEF/TE)和达峰容积比(VPEF/VE);并与20例健康儿童对照比较。结果从急性期、缓解期至恢复期,阳性组和阴性组的TPTEF/TE和VPEF/VE均呈上升趋势,不同时期之间的差异均有统计学意义(P均=0.000)。急性期时,TPTEF/TE和VPEF/VE在阳性组和阴性组间的差异无统计学意义(P0.05),但均低于对照组,差异有统计学意义(P0.05);到缓解期时,阴性组的TPTEF/TE和VPEF/VE均已高于阳性组,但低于对照组,差异有统计学意义(P0.05);恢复期时,阴性组和对照组间TPTEF/TE、VPEF/VE的差异无统计学意义(P0.05),且均高于阳性组,差异有统计学意义(P0.05)。结论哮喘预测指数阳性婴幼儿的肺功能损害比哮喘预测指数阴性患儿持续时间长;运用潮气呼吸肺功能为反复喘息婴幼儿预测哮喘提供客观的临床指标。     

白细胞介素-4受体基因多态性及IgE水平与哮喘预测指数相关性研究

目的研究新疆维吾尔自治区儿童白细胞介素-4受体(IL-4R)基因多态性及Ig E水平与哮喘预测指数(API)的相关性。方法选取167例API(+)、187例API(-)及203例健康婴幼儿(对照组),应用PCR聚合酶链反应和DNA测序法进行基因分型。同时ELISA法检测三组婴幼儿血清Ig E水平。结果 IL-4R基因Arg551Gln位点各基因型频率分布在API(+)组、API(-)组、对照组三组中差异无统计学意义(P0.05);API(+)组血清Ig E水平明显高于API(-)及对照组(P0.01);API(+)患儿中2岁者血清Ig E水平明显低于≥2岁者(P0.01)。结论 Arg551Gln位点多态性与API结果无相关性,而API阳性与Ig E水平升高存在关联性,年龄≥2岁是API阳性的儿童Ig E水平升高的风险因素。     

婴幼儿潮气呼吸肺功能临床应用进展

潮气呼吸肺功能检测经由流量传感器获得潮气流量、容积信号,可用于评价潮气呼吸状态肺功能,虽然受部分因素干扰,但因其具有高敏感性、高安全性、无需儿童主动配合且易操作等明显优势,所以临床广泛应用于婴幼儿,包括婴幼儿喘息、新生儿支气管肺发育不良等疾病的临床诊断与鉴别诊断、预后评价等方面。该文对国内外潮气呼吸肺功能在婴幼儿中的应...