小儿支气管哮喘血清微量元素的改变

本文探讨了微量元素与小儿哮喘的发病关系。按中华儿科学会第1届呼吸病会议拟订的哮喘诊断标准，符合小儿哮喘的有48例。男22例，女26例。年龄～1岁18例，～3岁20例，7～12岁10例，病程6个月～9年，绝大多数都曾长期对症治疗仍反复发作，有哮喘家族史者30％。对48例患儿血清微量元素（Zn、Ca、Fe、Cu）进行检测分析，并与同年龄健康儿35例作对照，结果显示血锌及钙元素均比健康对照组显著下降（PCO．001），有高度显著性到异，而Fe、Cu在各年龄组无显著性差异（P）005）。本组32例在常规脱敏治疗基础上加用葡萄糖锌【锌元素1～2mg／（kg…     

小儿阿米巴痢疾50例

小儿阿米巴痢疾临床表现缺乏特征性，容易延误诊断及治疗1994年1月～1995年12月共收治小儿阿米巴痢疾50例。现报告如下。临床资料520例有腹泻症状患儿中，粪便检出阿米已滋养体和（或）包囊50例（9．6％）。其中男37例。女13例；年龄13天～7岁，3岁以下占74％。全年散发发病，7     

小儿实体肿瘤310例分析

目的 总结各种类型小儿实体肿瘤的诊治以及各年龄段的大致分布情况。方法 选择1996年1月-2006年1月,我院收治的310例小儿实体肿瘤患儿病例资料,对其年龄分布、诊断及治疗进行回顾性分析。结果 310例患儿中,良性肿瘤147例,占总病例数的47．4％;恶性肿瘤163例,占总病例数的52．6％。男：女=1．25：1。年龄在1岁以内126例,占总病例数的40．7％;1。3岁93例,占30％;7-14岁44例,占14.2％。根据肿瘤类型和病人的个体差异分别采取手术、化疗、放疗以及支持疗法等。治疗不同,疗效各异。结论 小儿恶性肿瘤除需采取积极的手术治疗外,尚需要化疗、放疗以及营养支持治疗等多种方法的紧密配合。     

厌食儿血清中铜、锌、铁、锰的测定

为了探讨厌食患儿血清中铜、锌、铁、锰的变化，我们对1990年5月至1993年3月在我院就诊的102例厌食患儿进行血清微量元素的测定，现报告如下。一、临床资料102例中男67例，年龄6个月～13岁，以上患儿均排除了各种器质性和代谢性疾病，均以厌食为主诉就诊。二、方法取思儿血2毫升，用日本岛津公司生产的原子吸收分光光度计检测。三、结果锌的含量明显低于正常值，与正常值相比PCO．01，余P＞0．05。其中锌低于正常值者62例，占60．8凡铜低者22例，占21．5％，铁低者仅6例，占5．1％，锰低者21例，占19．5几讨论1．本组病例结果可知，厌食患…     

肾病综合征血清锌,铜含量分析

肾病综合征血清锌、铜含量分析济南军区总医院儿科（２５００３１）许波，郭建华我院１９９３年１０月～１９９４年９月期间检测住院小儿肾病综合征１７例，观察其血清锌、铜的变化，现报告如下。对象和方法一、病例选择随机选择１７例患儿，男１３例，女４例，年龄２岁～...     

营养不良小儿伴有急性腹泻时的补锌研究

营养不良小儿多有微量元素缺乏，且腹泻时丢失锌更多，而锌缺乏可影响肠道功能．观察了补锌对营养不良小儿急性腹泻时的治疗效果．材料和方法孟加拉国国际腹泻病研究中心收治的，年龄在3～24个月．体重低于国家健康中心（HCHS）标准的同年龄体重中位数兀％以下，病程在3天以内的急性腹泻小儿ill例作为研究对象．除常规补液外，随机分二组：补锌组（对例）加眼含醋酸锌的多种维生素糖浆（油四元素锌川；对照组（54例）口服不含锌的多种维生素糖浆，疗程共2周．观察治疗前后患儿体重、腹泻病程、腹泻大使量及血锌水平的变化．其中县长低于同…     

小儿急性淋巴细胞白血病长期生存(附4例报告)

我院儿科从1987年5月～1990年5月共收初治小儿急性淋巴细胞白血病（ALL）10例，经化疗及辅助治疗获完全缓解（CR）者7例（70．0％），其中4例（占CR者57·1％）存活M3年，4例中有1例（占CR者14．3％）存活＞5年，现就该4例临床特征，治疗及随诊情况报告如下：资料和方法一、临床资料该4例患儿根据临床表现，血象与骨髓细胞形态结果，按1986年杭州会议“小儿急性白血病诊疗建议（修订案）”标准“‘确诊，其中男1例，女3例，年龄1十岁～10岁，骨髓片报告示原淋十幼淋数为68％～85％，血片均可见幼稚细胞，白细胞数3．5X10’八。～32X10…     

衣原体IgM及IgG抗体在小儿呼吸道感染病因学诊断中的意义

为阐明4岁内小儿衣原体感染的病因及发病率，检测151例下呼吸道感染小儿血清衣原体特异性抗体，结果有24．7％确诊为呼吸道衣原体感染，且22．7％为肺炎衣原体引起，沙眼衣原体仅占2％。衣原体是引起继发性免疫缺陷的危险因子，研究100例7个月－15岁反复呼吸道感染小儿的血清沙眼衣原体特异性抗体，其中55例IgM和IgG抗体阳性，8例（14．5％）有两种抗体。患儿之母亲血清抗体阳性率亦高（75％），并发现沙眼衣原体抗体平均滴度值与患儿年龄呈线性关系，在6岁以内反复呼吸道感染最多的组内特异性IgG抗体平均滴度明显高于7－15岁小儿（P＜0．05）。所以宫内感染是主要传播途径，其次是日常生活接触传染（家庭性衣原体病）。     

健儿补血糖浆治疗小儿贫血、厌食的临床疗效观察

本院门诊在厌食患儿50例中发现贫血34例(68.00％),单纯厌食16例(32.00％),而人体内微量元素锌是影响小儿厌食的因素之一,铁的缺乏更竞争性抑制了锌的吸收。铁剂中硫酸亚铁众多对胃肠道的副作用,往往不易使患儿所接受。鉴于上述情况,我们配制了健儿补血糖浆,以观察防治贫血及厌食的效果,现报告如下。 50例中男41例,女9例,年龄1.5～12岁,病程4天～10年。其中贫血34例(男27例,女7例),     

小儿血清透明质酸测定及临床意义的探讨

为了评价血清透明质酸测定在儿科疾病诊断中的临床意义，我们检测了肝肾疾病和胶原系统疾病患儿血清透明质酸含量，现将结果报告如下。研究对象及方法一、研究对象疾病组131例，其中婴儿肝炎7例，慢性活动性肝炎9例，肝硬化14例（门脉性肝硬化3例，胆汁性肝硬化11例），急性肾小球肾炎27例，肾病综合征31例（肾炎型16例，单纯型15例），类风湿性关节炎15例，过敏性紫扭10例，系统性红斑狼疮3例，急性上呼吸道感染15例．男79例，文52例，年龄为1月～14岁。健康对照组25例，为本市某托儿所小儿及散居儿童，男15例，女10例，年龄为1岁～14岁。…     

Allergic factors associated with the development of asthma and the influence of cetirizine in a double-blind, randomised, placebo-controlled trial: First results of ETA®

There is a common progression known as the allergic march from atopic dermatitis to allergic asthma. Cetirizine has several antiallergic properties that suggest a potential effect on the development of airway inflammation and asthma in infants with atopic dermatitis. Methods. Over a two year period, 817 infants aged one to two years who suffered from atopic dermatitis and with a history of atopic disease in a parent or sibling were included in the ETAC^® (Early Treatment of the Atopic Child) trial, a multi-country, double-blind, randomised, placebo-controlled trial. The infants were treated for 18 months with either cetirizine (0.25mg/ kg b.i.d.) or placebo. The number of infants who developed asthma was compared between the two groups. Clinical and biological assessments including analysis of total and specific IgE antibodies were performed. Results. In the placebo group, the relative risk (RR) for developing asthma was elevated in patients with a raised level of total IgE (≥ 30 kU/I) or specific IgE (≥ 0.35 kUA/I) for grass pollen, house dust mite or cat dander (RR between 1.4 and 1.7). Compared to placebo, cetirizine significantly reduced the incidence of asthma for patients sensitised to grass pollen (RR = 0.5) or to house dust mite (RR = 0.6). However, in the population that included all infants with normal and elevated total or specific IgE (intention-to-treat - ITT), there was no difference between the numbers of infants developing asthma while receiving cetirizine or placebo. The adverse events profile was similar in the two treatment groups. Discussion. Raised total IgE level and raised specific IgE levels to grass pollen, house dust mite or cat dander were predictive of subsequent asthma. Cetirizine halved the number of patients developing asthma in the subgroups sensitised to grass pollen or house dust mite (i.e. 20% of the study population). In view of the proven safety of the drug, we propose this treatment as a primary pharmacological intervention strategy to prevent the development of asthma in specifically sensitised infants with atopic dermatitis.     

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孤独症谱系障碍(autistic-spectrum disorders,ASDs)近年来患病率逐年攀升至1%左右,其症状往往伴随终生,成为严重威胁儿童健康和发展的神经发育性疾患;注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)是儿童期最常见的精神障碍,国内报道患病率为4.13%～5.83%,其症状可延续至青少年期,甚至到成年期[1]。这两类精神障碍在成年期的临床表现、共患病、治疗策略和预后与儿童期有哪些不同呢?本文通过回顾相     

EXCITING NEW TREATMENT APPROACHES FOR PATHYPHYSIOLOGIC MECHANISMS OF SICKLE CELL DISEASE

During the past several decades, our understanding of the complex pathophysiology of vasoocclusion associated with sickle cell disease has improved greatly. Interaction of genes, hemoglobin molecules, red cell membrane and metabolic changes, cell-cell interactions and cell-plasma interactions, red cell adhesion to vascular endothelium, activation of coagulation, and vascular reactivity play a role in vaso occlusion. Penicillin prophylaxis of pneumococcal infections and appropriate use of blood transfusions and other supportive measures improved survival of sickle cell patients. Hydroxyurea made a major impact on sickle cell therapy when it was shown to decrease acute painful episodes, acute chest syndrome, and the need for blood transfusion in adults. Significant experience in the use of hydroxyurea has been accumulated in older children. The benefits and risks of hydroxyurea for younger children and long-term risks in all patients will be evaluated in future investigations. Other promising therapies include butyrate compounds, clotrimazole, magnesium supplementation, poloxamer 188, antiadhesion agents, anticoagulant approaches, and nitric oxide. Hemopoietic transplantation remains the only curative therapy. However, several transgenic mouse models are available for studies of gene therapy or other treatment approaches on biochemical, cellular, and pathologic effects of mutant genes.     

Infiltrations of Epstein-Barr virus-carrying cells in granular lymphocyte-proliferative disorders corresponding to chronic active Epstein-Barr virus infection

A 21-year-old man with granular lymphocyte-proliferative disorders (GLPD) associated with chronic active Epstein-Barr virus (EBV) infection is described. Chromosomal analyses revealed several clonal abnormalities and two of them were mainly repetitious. High copy numbers of monoclonal EBV genome were also detected in the proliferative large granular lymphocytes (LGLs), indicating the monoclonal expansion of EBV-infected LGLs. The patient had an indolent course for several years, and there was no evidence of infiltrations of his bone marrow until the end stage. At autopsy, microscopic studies revealed marked infiltrations of LGL in the liver and spleen, and the infiltrating cells were NK-cell immunophenotype. The infiltrated LGLs showed latency I.     

LUTEINIZING HORMONE RECEPTOR MUTATIONS IN DISORDERS OF SEXUAL DEVELOPMENT AND CANCER

Human male sexual development is regulated by chorionic gonadotropin (CG) and luteinizing hormone (LH). Aberrant sexual development caused by both activating and inactivating mutations of the human luteinizing hormone receptor (LHR) have been described. All known activating mutations of the LHR are missense mutations caused by single base substitution. The most common activating mutation is the replacement of Asp-578 by Gly due to the substitution of A by G at nucleotide position 1733. All activating mutations are present in exon 11 which encodes the transmembrane domain of the receptor. Constitutive activity of the LHR causes LH releasing hormone-independent precocious puberty in boys and the autosomal dominant disorder familial male-limited precocious puberty (FMPP). Both germline and somatic activating mutations of the LHR have been found in patients with testicular tumors. Activating mutations have no effect on females. The molecular genetics of the inactivating mutations of the LHR are more variable and include single base substitution, partial gene deletion, and insertion. These mutations are not localized and are present in both the extracellular and transmembrane domain of the receptor. Inactivation of the LHR gives rise to the autosomal recessive disorder Leydig cell hypoplasia (LCH) and male hypogonadism or male pseudohermaphroditism. Severity of the clinical phenotype in LCH patients correlates with the amount of residual activity of the mutated receptor. Females are less affected by inactivating mutation of the LHR. Symptoms caused by homozygous inactivating mutation of the LHR include polycystic ovaries and primary amenorrhea.     

Resurgence of measles in Singapore: profile of hospital cases

OBJECTIVE: To ascertain the profile of cases of measles seen at a general hospital during a recent outbreak that occurred despite a measles vaccination program. METHODOLOGY: A retrospective study from January 1991 to March 1998. All patients with measles (ICD code 055. 9) seen at the emergency unit or as inpatients were included. RESULTS: There were 87 cases identified. The diagnosis was clinical in all and proven serologically in 71%. Eighty-five per cent of the cases occurred between January 1997 and March 1998. There was a bi-modal age distribution with peaks in the very young (相似文献   

Personality profiles and heart rate variability (vagal tone) in children with recurrent abdominal pain

The aim of the study was to explore psychological factors and autonomic activity in children with recurrent abdominal pain and to compare them with those in a control group of healthy children. The Personality Inventory for Children was used for assessment of developmental, emotional and psychosocial factors in 25 children with recurrent abdominal pain (age, 7-15 y). Parasympathetic and sympathetic functions in these children and in 23 healthy control subjects (age, 7-13 y) were also investigated, non-invasively using a computerized polygraph. Vagal tone (parasympathetic function) was indexed by calculation of respiratory sinus arrhythmia in beats/min. Skin conductance (sympathetic function) was recorded by the constant current method. On the Personality Inventory for Children, 16 patients had high scores on somatic concern. Several patients had scores in the clinical range for depression, withdrawal and anxiety, but the mean scores for these personality profile scales were well within the normal range of healthy children. Interestingly, there was a spike on the L (Lie)-scale for most of the patients and 15 patients had scores above or close to the clinical cut-off value. As compared with the scores in healthy children, vagal tone and sympathetic tone were normal. Conclusion: Many children with recurrent abdominal pain have scores in the clinical range for depression, withdrawal, anxiety and L-scale indicating coping problems, denial and a trend towards somatic concern that may contribute to the evolution of abdominal pain. Autonomic nerve activity was not disturbed in these children.     

Overcoming surfactant inhibition with polymers

Inhibition of the function of pulmonary surfactant in the alveolar space is an important element of the pathophysiology of many lung diseases, including meconium aspiration syndrome, pneumonia and acute respiratory distress syndrome. The known mechanisms by which surfactant dysfunction occurs are (a) competitive inhibition of phospholipid entry into the surface monolayer (e.g. by plasma proteins), and (b) infiltration and destabilization of the surface film by extraneous lipids (e.g. meconium-derived free fatty acids). Recent data suggest that addition of non-ionic polymers such as dextran and polyethylene glycol to surfactant mixtures may significantly improve resistance to inhibition. Polymers have been found to neutralize the effects of several different inhibitors, and can produce near-complete restoration of surfactant function. The anti-inhibitory properties of polymers, and their possible role as an adjunct to surfactant therapy, deserve further exploration.     

Understanding infant formula

The World Health organisation recommends breast feeding infants for the first six months of life. When this breast feeding does not occur either through parental choice or medical need, infant formulas will be required. There is a bewildering array of formulas on the UK market for many different requirements. When faced with an unsettled infant many parents (and healthcare professionals) will experiment with the infant formula available and then attend the paediatric clinic looking for help and advice. It is therefore essential that paediatricians understand what milks are available and what the key differences between different products are. This review attempts to provide a simple guide through many of the formulations currently available in the UK; and offers advice for the dietary management of the child with extra calorie requirements, infants with cow's milk protein allergy, gastro oesophageal reflux disease, apparent unresolved hunger and infantile colic. Whatever the underlying condition, there is likely to be an infant formula that is suitable in this generation of ever expanding formulations.