血清胆红素水平与糖尿病周围血管病变的关系

目的探讨2型耱尿病患者周围血管病变与血清胆红素水平的关系。方法搜集内分泌科2005年6月～2008年5月住院的2型搪尿病病人402例,分为无下肢病变组（NPAD）和下肢病变组（PAD）,对照组选取我院同期健康体检人群202例,比较胆红素水平差异;并以下肢病变作为自变量,对危险因素作Logistic回归分析;按血清胆红素水平将所有样本三等分,比较各组下肢病变发病率的差异。结果PAD组胆红素水平低于NPAD纽,以下肢病雯作为因变量进行、Logistic回归显示胆红素是糖尿病人患周围血管病变的保护因素,低胆红素水平组下肢病雯发病率显著高于高胆红素水平组．结论胆红素水平与糖尿病周围血管病变的发生发展相关,应重视胆红素作为内源性抗氧化剂的作用。     

Exclusive breastfeeding frequency during the first seven days of life in term neonates

SUMMARY The study evaluated the effect of frequent suckling on neonatal serum bilirubin level, weight gain and passage of meconium in exclusively breastfed (Ebfed) neonates in the first week of lactation. These variables were investigated for 358 healthy full-term, EBfed Nigerian newborn, delivered vaginally without complications at the Jos University Teaching Hospital (JUTH) in their first week of life. Their maternal breast problems and time of achievement of let-down reflex were also evaluated. Mothers nursed their newborns on the average of 13.3 + 1.6 times in the first 24 hours. This non-significantly decreased to 13.1 + 1.2 by the 7th day. Significant positive correlations were found between the frequency of EBfing and passage of meconium in the first 24 hours of life ( r = 0.41, p < 0.05), and weight gain by day 7 ( r = 0.34, p<0.001). Inverse relationship was observed between frequency of suckling and neonatal serum bilirubin level on days 3 and 7 (r = -.13 and -.15), time of achievement of maternal let-down reflex ( r = -.43) and their breast problems (r = -.38), P values < 0.05. We therefore concluded that frequent suckling during EBfing has beneficial health effect on both the mother and her newborn in the first week of lactation. BG.     

Lymphocyte subsets in healthy children during the first 5 years of life.

OBJECTIVE--To assess whether relative and absolute values of CD4 and CD8 lymphocytes and CD4/CD8 ratio change in relation to age, and to estimate the fifth and 95th percentiles for these values in children of various ages. PATIENTS AND METHODS--Phenotypic analysis of lymphocyte subsets was performed on blood samples from 208 healthy children, aged 1 through 59 months, using standard flow cytometric techniques. RESULTS--Regression analysis demonstrated that CD4 and CD8 lymphocyte counts declined significantly with advancing age (P less than .000001 and P = .03, respectively). Since CD4 and CD8 counts depend on total lymphocyte count, the percentage of total lymphocytes of each phenotype was also analyzed and demonstrated that the CD4 percentage was highly age dependent (P less than .000001). The CD8 percentage increased with age (P = .0001) but not as much as the CD4 percentage decreased. Median CD4 counts (fifth and 95th percentiles) for children 2 through 3, 4 through 8, 12 through 23, and 24 through 59 months of age were 2.83 (1.46 to 5.11), 2.95 (1.69 to 4.61), 2.07 (1.02 to 3.60), and 1.80 (0.90 to 2.86) x 10(9)/L, respectively. CONCLUSION--Healthy children's CD4 lymphocyte counts are considerably higher than previously established adult values. These data demonstrate that age is an important consideration in interpretation of lymphocyte subsets in children. This may be especially relevant in children who are infected with the human immunodeficiency virus, where CD4 lymphocyte values play a central role in monitoring disease progression and determining thresholds for medical interventions.     

新生儿缺氧缺血性脑病血清及脑脊液胆红素浓度变化

目的 :探讨新生儿缺氧缺血性脑病 (HIE)患儿血清及脑脊液胆红素浓度的变化及其临床意义。方法 :38例HIE组和12例对照组均于生后 48h内抽取股静脉血 ,同时对HIE组做腰穿抽取脑脊液 ,测定胆红素进行对比分析。结果 :HIE组患儿血清总胆红素为 10 7.80± 5 1.74μmol/L ,脑脊液胆红素为 9.84± 3.83μmol/L ;血清胆红素和脑脊液胆红素随着HIE程度的加重而增高 ;对照组血清胆红素与轻度HIE比较无显著性差异 ,但与中、重度HIE有显著性差异。结论 :HIE患儿血清胆红素和脑脊液胆红素较正常新生儿明显增高 ,因此治疗HIE应积极治疗高胆红素血症 ,以减少后遗症的发生     

毛细支气管炎患者血清IL-13表达及其与病情相关性探讨

目的 探讨IL-13水平在急性期毛细支气管炎(简称毛支)中的表达及其与病情的相关性.方法 急性期毛支患儿42例(其中轻症组22例,重症组20例),正常对照组16例.采用双抗体夹心酶联免疫吸附试验(ELISA法),检测血清中IL-13的水平.结果 急性毛支患儿血清IL-13的含量为(6.68±2.12)ng/L.其中轻症组(7.11±1.95)ng/L,重症组(6.64±2.24)ng/L.两组比较差异无统计学意义(P＞0.05),而急性期毛支患儿与正常对照组比较,差异有统计学意义(P＜0.05).结论 急性期毛支患儿血清水平均增高.与对照组比较差异有统计学意义.但轻、重各组比较,差异无统计学意义,提示IL-13参与了毛支的发病过程,但lL-13不能反映病情的严重程度.     

不同胎龄早产儿血胃泌素和生长抑素水平的研究

目的探讨早产儿生后12h和7d内血胃泌素（GAS）和生长抑素（SS）水平的变化。方法选择新生儿科收治的早产儿70例,按胎龄分为≤32周组、33~34周组、35~36周组;选择同期出生的健康足月儿45例为对照组。早产儿组与对照组均于生后12h和7d采集空腹静脉血,行GAS、SS测定。结果4组生后12h和7dGAS和SS水平总体比较差异均有统计学意义（均P＜0.05）;其中早产儿3组生后12h和7dGAS水平均低于对照组,生后12hSS水平均高于对照组,差异均有统计学意义（均P＜0.05）;早产儿各组间生后12h和7dGAS水平及生后12hSS水平比较,差异均有统计学意义（均P＜0.05）;而生后7dSS水平比较差异无统计学意义（P＞0.05）。4组生后12hGAS和SS水平与生后7d比较差异均有统计学意义（均P＜0.05）。早产儿组喂养不耐受发生率明显高于对照组,差异有统计学意义（P＜0.05）。结论新生儿GAS、SS水平与胎龄有关,早产儿生后7d内消化功能低下,考虑与GAS低水平及SS高水平有关,临床应根据胃肠激素水平选择合适的喂养时机和方式。     

Serum and erythrocyte magnesium levels in hypertensives and their first degree relatives

Essential hypertension is an arbitrarily defined disorder to which both genetic and environmental factors contribute. Magnesium and its interactions with other cations may play an important role in the pathogenesis of essential hypertension. Various studies have been carried out on the levels of serum and erythrocyte magnesium in hypertensives and the results are controversial and there is no systematic study in Indian population. In the present study serum and erythrocyte magnesium levels in 86 hypertensives and their 77 first degree relatives as well as in sex and age matched controls were studied. Serum and erythrocyte magnesium levels showed a significant decrease both in the hypertensives and their first degree relatives (p < 0.01). The significantly decreased levels of magnesium in the first degree relatives suggest genetic basis of essential hypertension and may be used as marker to identify those at risk.     

Respiratory symptoms in preterm infants: burden of disease in the first year of life

Objective

While respiratory symptoms in the first year of life are relatively well described for term infants, data for preterm infants are scarce. We aimed to describe the burden of respiratory disease in a group of preterm infants with and without bronchopulmonary dysplasia (BPD) and to assess the association of respiratory symptoms with perinatal, genetic and environmental risk factors.

Methods

Single centre birth cohort study: prospective recording of perinatal risk factors and retrospective assessment of respiratory symptoms during the first year of life by standardised questionnaires. Main outcome measures: Cough and wheeze (common symptoms), re-hospitalisation and need for inhalation therapy (severe outcomes). Patients: 126 preterms (median gestational age 28.7 weeks; 78 with, 48 without BPD) hospitalised at the University Children''s Hospital of Bern, Switzerland 1999-2006.

Results

Cough occurred in 80%, wheeze in 44%, rehospitalisation in 25% and long term inhalation therapy in wheezers in 13% of the preterm infants. Using logistic regression, the main risk factor for common symptoms was frequent contact with other children. Severe outcomes were associated with maximal peak inspiratory pressure, arterial cord blood pH, APGAR and CRIB-Score.

Conclusions

Cough in preterm infants is as common as in term infants, whereas wheeze, inhalation therapy and re-hospitalisations occur more often. Severe outcomes are associated with perinatal risk factors. Preterm infants who did not qualify for BPD according to latest guidelines also showed a significant burden of respiratory disease in the first year of life.     

Morbidity and mortality in breastfed and formula-fed infants of HIV-1-infected women: A randomized clinical trial.

CONTEXT: Breastfeeding among women infected with human immunodeficiency virus type 1 (HIV-1) is associated with substantial risk of HIV-1 transmission, but little is known about the morbidity risks associated with formula feeding in infants of HIV-1-infected women in resource-poor settings. OBJECTIVE: To compare morbidity, nutritional status, mortality adjusted for HIV-1 status, and cause of death among formula-fed and breastfed infants of HIV-1-infected women. DESIGN: Randomized clinical trial conducted between 1992 and 1998. SETTING: Four antenatal clinics in Nairobi, Kenya. PARTICIPANTS: Of 401 live-born, singleton, or first-born twin infants of randomized HIV-1-seropositive mothers, 371 were included in the analysis of morbidity and mortality. INTERVENTIONS: Mothers were randomly assigned either to use formula (n = 186) or to breastfeed (n = 185) their infants. MAIN OUTCOME MEASURES: Mortality rates, adjusted for HIV-1 infection status; morbidity; and nutritional status during the first 2 years of life. RESULTS: Two-year estimated mortality rates among infants were similar in the formula-feeding and breastfeeding arms (20.0% vs 24.4%; hazard ratio [HR], 0.8; 95% confidence interval [CI], 0.5-1.3), even after adjusting for HIV-1 infection status (HR, 1.1; 95% CI, 0.7-1.7). Infection with HIV-1 was associated with a 9.0-fold increased mortality risk (95% CI, 5.3-15.3). The incidence of diarrhea during the 2 years of follow-up was similar in formula and breastfeeding arms (155 vs 149 per 100 person-years, respectively). The incidence of pneumonia was identical in the 2 groups (62 per 100 person-years), and there were no significant differences in incidence of other recorded illnesses. Infants in the breastfeeding arm tended to have better nutritional status, significantly so during the first 6 months of life. CONCLUSIONS: In this randomized clinical trial, infants assigned to be formula fed or breastfed had similar mortality rates and incidence of diarrhea and pneumonia during the first 2 years of life. However, HIV-1-free survival at 2 years was significantly higher in the formula arm. With appropriate education and access to clean water, formula feeding can be a safe alternative to breastfeeding for infants of HIV-1-infected mothers in a resource-poor setting.     

支气管肺发育不良患儿与生后1年内下呼吸道感染

目的了解支气管肺发育不良患儿生后1年内下呼吸道感染临床特点。方法回顾BPD患儿生后1年内的下呼吸道感染临床资料。结果7例BPD患儿生后1年内再入院18次,平均（2．97±0．97）次,再入院平均住院时间（16．1±10．1）d;18次入院均为下呼吸道感染,发生喘息14例次。结论BPD增加了生后1年的再入院风险,再入院时间长。BPD增加了生后1年下呼吸道感染风险。     

Rectal bleeding in the first month of life.

Sixty-nine infants were examined who presented with rectal bleeding in the first month of life. In 64% of these children no cause was found. Infantile diarrhoea, haemorrhagic disease of the newborn and anal fissure were the most common diagnoses made. The mortality in the entire group was less than 3%. It is concluded that rectal bleeding in this age group is a relatively benign condition and in certain cases hospital admission may not be required.     

动脉粥样硬化患者血清胆红素浓度的变化

目的:通过动脉粥样硬化患者和同期健康体检者血清胆红素水平的测定以探讨其与动脉粥样硬化发病间的关系。方法:采用钒酸氧化法测定60例冠心病患者、48例脑梗死患者和50例同年龄段健康体检者的血清胆红素水平情况并进行统计学分析。结果:冠心病组、脑梗死组患者血清胆红素水平较低,与健康对照组比较差异有统计学意义(均P<0.05)。结论:血清胆红素水平偏低是脉粥样硬化发病的危险因素。临床测定血清胆红素水平对动脉粥样硬化的预防是有意义的。     

Bacterial meningitis in the first three months of life.

A retrospective study of infants with bacterial meningitis admitted to our hospital during 1949-52, highlighted the lack of ''classical'' signs of meningitis in these infants. We carried out a similar review of 44 infants aged less than three months, admitted during 1982-91. We also determined the causative organisms and their antibiotic sensitivities. Symptoms and signs were similar in the two series. Forty infants in the later series were either febrile, irritable or had seizures on the day of admission. Overall mortality fell from 30% to 11%. Between 1982 and 1991 Group B Streptocococcus and Neisseria meningitidis were the commonest causes of meningitis. All organisms, except one, were sensitive to ampicillin and/or cefotaxime. Bacterial meningitis should be suspected in young infants who are febrile, irritable or having seizures. Initial treatment with ampicillin and cefotaxime is appropriate.     

血清胆红素水平在冠心病诊断中的意义

目的: 探讨血清胆红素水平变化对冠心病(coronary heart disease,CHD)诊断的意义。方法: 设冠心病组(CHD组)52例与对照组36例,测定血清总胆红素(TBIL)、总胆固醇(CHO)、甘油三酯(TG)、高密度脂蛋白(HDL)。结果: CHD组TBIL浓度明显低于对照组(P<0.01),CHD组TBIL浓度与CHO、TG均呈负相关关系(P<0.01),与HDL呈正相关关系(P<0.01)。结论: TBIL具有防止脂质氧化,从而可减少CHD的发生。