Breast feeding and blood lipid concentrations in male Brazilian adolescents

OBJECTIVE: To assess the association between breast feeding and blood lipid levels in adolescence. DESIGN: Population based prospective birth cohort study. SETTING: City of Pelotas, Brazil. SUBJECTS: All hospital births taking place in 1982; 79% of all males (n = 2250) were followed up for 18 years, and 2089 blood samples were available. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Total cholesterol and fractions (very low density lipoprotein cholesterol (VLDL), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL)), LDL/HDL ratio, serum triglycerides. RESULTS: Three breast feeding variables were studied: total duration of breast feeding, duration of exclusive or predominant breast feeding, and ever compared with never breast fed. Adjusted analyses were controlled for family income, household assets index, maternal education, maternal pre-pregnancy body mass index (BMI), skin colour, birth weight, gestational age, maternal smoking during pregnancy, and adolescent BMI, and behavioural variables (fat content of diet, physical activity, smoking, and alcohol drinking). Only one association reached borderline significance (p = 0.05): LDL cholesterol was slightly higher among never (mean 41.0 mg/dl; 95% CI 39.4 to 42.7) than among ever breast fed men (38.6 mg/dl; 95% CI 38.6 to 40.3), in the adjusted analyses. All other associations were not significant (p> or =0.09). There was no evidence of effect modification according to preterm status, intrauterine growth retardation, socioeconomic level, growth velocity in the first two years of life, or nutritional status at 2 years of age. CONCLUSIONS: There was no clear association between breast feeding duration and serum lipid concentrations at the age of 18 years in this sample of Brazilian men.     

心房颤动患者血浆C反应蛋白浓度的变化研究

目的探讨C反应蛋白（CRP）作为系统因子在心房颤动的发生与维持中的变化及意义。方法用酶联免疫吸附双抗体夹心法（hsCRP ELLSA）对21例孤立性阵发性房颤者（LPAF）分别于房颤发作及终止后1周测定外周静脉血浆CRP浓度，并与28例孤立性持续性房颤（LSAF）、27例风心病二尖瓣狭窄伴持续性房颤（RHD）、32例阵发性室上性心动过速（PSVT）及20例健康对照组相比较。结果LB心病人房颤发作时及终止后，LSAF和RHD组病人血浆CRP浓度较PS、丌及正常对照组明显上升。LPAF病人房颤发作时血浆CRP浓度与房颤发作持续时间呈正相关，与患者年龄、性别及左心房内径无关。而PSVT时血浆CRP浓度与心动过速持续时间无明显相关性。结论炎症反应可能参与孤立性房颤的发生与维持。     

早期C反应蛋白水平测定对预测轻重症急性胰腺炎的临床意义

目的 探讨急性胰腺炎（AP）早期血清C反应蛋白（CRP）水平对预测AP分型和预后的临床意义。方法 AP患者43例，入院后立即采用免疫散射速率比浊法测定血清CRP水平，7d后评估AP的轻重分型。根据血清CRP水平分为两组：CRP≤300mg／L（I组）和CRP〉300mg／L（Ⅱ组）。对两组患者血清CRP水平与胰腺增强ＣT检查分级及各种影响AP预后的临床指标（血钙、血脂、血糖、血气分析）进行比较分析。结果 Ⅱ组患者中肥胖（62．5％）、原发性高血压（31．2％）、脂肪肝（62．5％）、高脂血症（56．2％）、高血糖（62．5％）、低钙血症（56．2％）比例明显高于Ⅰ组，两组比较差异有统计学意义（P〈0．05）。Ⅱ组患者胰腺增强ＣT检查分级多为Ｃ级及Ｃ级以上，重症AP发生率明显高于Ⅰ组，两组比较差异有统计学意义（P〈0．05）。结论 以血清CRP300mg／L作为诊断阈值界定。在AP早期测定来预测患者病情轻重及判断预后，对指导临床治疗有重要参考价值。     

急性期C-反应蛋白在儿童支原体肺炎诊断中的价值

目的探讨急性期C-反应蛋白（CRP）检测在儿童支原体肺炎诊断中的临床价值。方法2007年5月至2009年1月笔者所在科室收治住院临床诊断为肺炎的患儿215名,分为支原体肺炎组和细菌性肺炎组,分别采用免疫比浊法及ELISA法测定血清CRP及血清支原体抗体IgM（MP—IgM）,同时测定35例正常儿童的血清CRP。结果支原体肺炎组CRP阳性率（31．2％）较细菌性肺炎组阳性率低（82．2％）（P〈0．05）。CRP阳性肺炎患儿治疗后CRP水平较治疗前均明碌降低（P〈0．05）。结论CRP在早期鉴别诊断儿童肺炎类型上有一定的辅助作用,对临床用药效果也有一定的判定意义。     

前白蛋白与C反应蛋白在新生儿感染性疾病早期诊断中的临床价值

目的:探讨前白蛋白(PA)、C反应蛋白(CRP)在新生儿感染性疾病早期诊断中的临床应用价值。方法:以48例新生儿非感染性疾病为对照组,研究348例新生儿感染性疾病PA、CRP检测情况。结果:感染组各种疾病与对照组比较,经q检验分析均有统计学差异(P<0.05),其中PA相对于对照组出现降低,尤其败血症、细菌性肺炎、上呼吸道感染下降较为显著,CRP相对于对照组出现升高,以败血症、细菌性肺炎、上呼吸道感染较为明显;感染组重症感染及普通感染PA、CRP平均浓度经q检验分析均有统计学差异(P<0.05),重症组PA降低、CRP升高比较显著。结论:PA、CRP是评价新生儿感染性疾病早期诊断、病情监测及药物疗效的良好观察指标。     

C-反应蛋白对老年人感染性疾病诊断试验评价

目的　探讨C 反应蛋白 (CRP)对老年感染性疾病诊断价值。方法　对 1 4 2例感染性疾病和 2 1 6例非感染疾病老年患者 ,测定血清C 反应蛋白。以CRP 7～ 2 0mg L、2 1～40mg L和 41～60mg L分层 ,计算诊断试验评价指标。结果　各种感染性疾病老年患者CRP平均水平 (30 .1± 2 .8～69.3± 35.6)mg L ,明显高于对照组 (5 .2± 2 .9)mg L。分层分析显示CRP诊断感染性疾病特异度为83 .3 %～ 99.0 % ,阳性似然比为 3.6、2 7.0和 1 2 8.0。结论　CRP是老年感染性疾病重要诊断指标     

血清降钙素原及C反应蛋白检测在早期诊断烧伤患者感染中的应用价值

目的 探讨血清降钙素原(PCT)和C反应蛋白(CRP)在早期判断烧伤患者感染中的应用价值.方法 对2011年6月—2012年6月86例烧伤住院患者进行回顾性分析,分为重症感染组15例、局部感染组40例和未感染组31例,对其进行血清PCT、CRP水平检测.结果 重症感染组PCT、CRP水平分别为(9.3±7.5)ng/ml、(55.5±19.7)mg/L,其阳性率分别为93.3％、86.7％,局部感染组分别为(1.2±0.8)ng/ml、(33.5±14.5)mg/L、87.5％、82.5％,对照组分别为(0.2±0.1) ng/ml、(5.6±3.2)mg/L、9.7％、22.6％,重症感染组均明显高于对照组,差异有统计学意义(P＜0.05);PCT在重症感染组和局部感染组间比较,差异也有统计学意义(P＜0.05),而CRP在两感染组间比较差异无统计学意义;以PCT≥0.5 ng/ml,CRP≥9 mg/L为阳性阈值,PCT和CRP联合检测的敏感度为87.2％,特异度为93.3％,诊断符合率为88.4％.结论 血清PCT与CRP联合检测对烧伤患者早期感染的诊断及预后判断具有重要的指导意义,并为临床治疗提供有效依据.     

通心络胶囊对不稳定型心绞痛的治疗作用和对C反应蛋白的影响

目的 观察通心络胶囊对不稳定型心绞痛患者的疗效和对C反应蛋白的影响。方法82例患者随机分为治疗组和对照组，治疗组在对照组常规治疗的基础上加服通心络胶囊，疗程均为4周。分别于治疗前和治疗4周后观察病情变化并检测C反应蛋白。结果 两组治疗后病情较前均有好转、C反应蛋白较治疗前均降低（P〈0．01）；治疗组疗效较对照组为好，（P〈0．05）；C反应蛋白差值较对照组大（P〈0．05）。结论 通心络胶囊治疗不稳定型心绞痛疗效显著。     

TC／HDL-C与hs-CRP的检测在冠心病诊断中的意义

目的研究血清超敏C反应蛋白（hs-CRP）与总胆固醇（TC）／高密度脂蛋白-胆固醇（HDL-C）对冠状动脉粥样硬化性心脏病（CHD）的诊断价值。方法选取260例住院行冠状动脉造影的患者。所有患者术前取静脉血测定hs-CRP和血脂（TC、HDL-C）水平。根据冠状动脉造影结果将患者分为两组：冠心病组和冠状动脉正常组。比较两组hs-CRP及TC／HDL-C升高与冠心病的相关程度。结果冠心病组患者的hs-CRP浓度和TC／HDL-C均显著高于冠状动脉正常组，P〈0．01。另外，hs-CRP浓度在二支及三支病变组显著高于单支病变组，P〈0．01；三支病变组显著高于二支病变组，P〈0．05。联合hs-CRP和TC／HDL-C两种指标，对冠心病患者诊断阳性率（96．0％）高于hs-CRP（86．0％）和TC／HDL-C（78．7％）单一指标。结论血hs-CRP与冠状动脉病变密切相关，而且与病变的严重程度呈正相关，可以作为对冠状动脉病变程度的估测指标。联合血脂的危险预测模式明显比单独的hs-CRP对冠心病诊断符合率高，即hs-CRP和血脂均高时患冠心病的可能性更大。     

C‐reactive protein: an independent predictor of cardiovascular disease in Aboriginal Australians

Objectives: We assessed the independent contribution of C‐reactive protein to the risk of cardiovascular disease in Aboriginal Australians. Methods: High sensitivity CRP levels were measured in 705 Aboriginal participants aged 20–74 years free from CVD at baseline. Participants were followed for a median of 11 years. Cox proportional hazards models were used to assess the association of CRP with the risk of developing CVD events. Results: A total of 114 participants were diagnosed with CVD. Incidence rates were 5.4 and 21.4 per 1,000 person‐years for the lower (<3 mg/l) and the higher (≥3 mg/l) CRP groups, respectively. After adjusting for age, sex, total cholesterol, systolic blood pressure, smoking status, diabetes, BMI and waist circumference, the association between CRP and CVD remained significant, with a hazard ratio of 2.40 (95% CI: 1.25, 4.62) for the higher CRP group relative to the lower CRP group. The population attributable risk was 52% (95% CI: 14%, 74%). Conclusions: CRP is an independent predictor of CVD in Aboriginal people. A large proportion of CVD cases are associated with elevated CRP levels. Therefore, controlling the conditions that cause inflammation may be beneficial to cardiovascular health in Aboriginal communities.     

C反应蛋白与血糖相关性的临床研究

目的探讨2型糖尿病患者血清C反应蛋白（CRP）变化情况与血糖动态波动的关系。方法选择2型糖尿病患者30例，治疗前后行72h动态血糖监测，并测定CRP，分析血糖与CRP的关系。结果患者治疗后，血糖均有明显改善，空腹血糖全部达标，血糖达标时间从（35．37±5．70）h增加为（66．20±4．71）h，最高血糖从（15．14±1．08）mmol／L下降为（10．77±1．50）mmol/L，平均血糖从（11．38±1．56）mmol/L下降为（7．63±0．77）mmol／L；同时治疗后血清CRP低于治疗前。结论通过研究血清CRP与2型糖尿病疗效的关系。为治疗2型糖尿病及其血管并发症提供了有效的监测指标。     

超敏C反应蛋白检测在尘肺肺感染中的应用

目的探讨超敏C反应蛋白(hs-CRP)检测在尘肺肺感染中的应用价值。方法选择尘肺并发肺部感染患者40例为尘肺组,30例门诊男性体检者为对照组,检测hs-CRP值并进行分析;观察组检测hs-CRP、白细胞计数(WBC)、血沉(ESR)、痰培养,抗感染治疗后再次测定上述指标,进行统计分析。结果尘肺组hs-CRP值与对照组比较明显增高,两组比较,差异有统计学意义(P0.01);尘肺组hs-CRP阳性率与WBC、血沉、痰培养阳性率相比,差异有统计学意义(P0.05)。尘肺组hs-CRP值治疗后明显降低,与治疗前比较,差异有统计学意义(P0.01)。结论 hs-CRP的检测对尘肺肺部感染早期诊断和判断疗效有重要的实用价值。     

Infant feeding in risk society

A large percentage of British women, in common with women in other Western countries, feed their young babies formula milk. The paper reports some findings of a study of infant feeding that focussed on women's experiences of feeding their babies this way. Data about this issue were collected through detailed, qualitative face to face interviews with 33 mothers and through telephone interviews using a structured questionnaire with 503 mothers. The study found overall that mother's accounts of feeding babies formula milk draw attention to contradictions and tensions in motherhood and mothering. Formula feeding is predominantly experienced by mothers as ‘easy,’ enabling them to address a wide range of demands and difficulties that mothering a small baby poses for them. At the same time, mothers demonstrate awareness of the socio-cultural construction of the ‘moral mother’ as the mother who minimizes and avoids risk, and so does not use formula milk for infant feeding. How women react to this tension between ‘real life’ and ‘doing what is healthy’ varies, but the study reported here found a large minority of women experience manifestly difficult and debilitating feelings as they attempt to reconcile a pragmatic wish or need to formula feed with dominant constructions of the ‘moral mother.’ By detailing women's accounts of this aspect of motherhood, the paper contributes to sociological investigation of everyday experiences of risk society. To contextualize this discussion, a brief account of the relationship between eating, feeding babies and risk society is also offered.     

竹叶青蛇伤患者C反应蛋白和凝血功能变化及其临床意义

目的分析竹叶青蛇伤患者C反应蛋白(CRP)和凝血功能变化及其临床意义。 方法以2011年5月至2013年5月广东湛江中心人民医院急诊科收治的竹叶青蛇咬伤患者138例为研究对象(男性85例,女性53例;年龄14～70岁)患者按照被竹叶青蛇咬伤后的就诊时间分为5组(2 h内组、3～6 h组、7～12 h组、13～24 h组合25～48 h组),比较各组间症状、体征、凝血功能及CRP水平的差异。 结果竹叶青蛇咬伤2 h内的患者有疼痛、局部肿胀等症状,但凝血功能及CRP与正常对照组差异无统计学意义,咬伤12 h后与2 h内组相比,血小板技术降低、活化部分凝血活酶时间(APTT)增高且凝血功能及CRP均增高(P<0.05)。 结论竹叶青蛇毒不仅可引起凝血功能障碍,同时可引起局部的快速炎症反应,导致肢体肿胀及激烈疼痛等,应重视抗炎治疗。     

Evaluation of an Australian intervention to encourage breast feeding in primiparous women

Breast feeding has nutritional, immunologic and antiallergicadvantages for the infant. Although it has been widely recommendedthat infants be exclusively breast fed until 4–6 monthsof age, only about half of all Australian babies currently receiveextended breast feeding. The present study evaluated an intensiveprogramme designed to increase the proportion ofprimi-parousmothers who breast fed for 4 months or longer. Women who registeredwith the hospital at least 20 weeks before delivery and whointended to breastfeed were eligible for the study. Two hundredand thirty-five women were allocated to receive either usualcare or an intensive breast feeding programme when they registeredwith the hospital. The intensive programme consisted of writtenmaterials, and group and individual sessions with a lactationcounsellor. It also included a visit from a breastfeeding consultantwhile in hospital after the birth and contact on return home.Women were followed up 6 weeks and 4 months after delivery.There were no significant differences in breastfeeding ratesbetween the control and intervention groups at either follow-uppoint. Breast feeding until 4 months was more likely among womenwhose baby did not receive a bottle feed while still in hospitaland who did not smoke, use the combined oral contraceptive pillor introduce solid food before 4 months. Those mothers who enjoyedand felt satisfied with breastfeeding were more likely to continueto 4 months. It seems likely that programmes designed to increasebreastfeeding will need to address underlying factors such ashospital policy rather than simply providing more health education.     

血清降钙素原和C反应蛋白在脓毒性休克患者中的变化及对预后的评估

目的探讨血清降钙素原(PCT)和C反应蛋白(CRP)在脓毒性休克患者中的变化及临床意义。方法选取2013年1月—2015年6月某医院重症监护病房(ICU)严重感染患者,按感染程度分为脓毒性休克组(66例)[根据1个月生存情况分为存活组(50例)和死亡组(16例)]和重症脓毒症组(62例),对照组为同期住院非脓毒性休克患者60例,分别比较分析各组患者治疗前和治疗后不同时间血清PCT、CRP及WBC水平。结果脓毒性休克组治疗前,治疗1、3、7 d后血清PCT、CRP及WBC水平均高于对照组;重症脓毒症组治疗1、3、7 d后血清PCT和CRP水平均高于对照组;死亡组治疗1、3、7 d后血清PCT水平均高于存活组,治疗3、7 d后血清CRP水平均高于存活组(均P0.05)。ROC曲线显示,PCT、CRP和WBC的曲线下面积(AUC)及95%CI分别为:0.786(0.703~0.864)、0.754(0.691~0.827)和0.603(0.542~0.679)。Spearman相关分析显示,脓毒性休克患者治疗前、治疗7 d后血清PCT与CRP呈正相关[(r=0.596,P=0.004)和(r=0.523,P=0.012)],治疗7 d后血清PCT与WBC呈正相关(r=0.604,P=0.001)。结论 PCT可作为脓毒性休克患者早期诊断的指标,动态联合观察PCT和CRP水平对评估患者病情严重程度及判断患者预后具有重要意义。     

降钙素原、高敏C反应蛋白和白介素6对导管相关血流感染早期诊断的价值

目的研究降钙素原(PCT)、高敏C反应蛋白(hs-CRP)、白介素6(IL-6)对重症监护病房(ICU)患者导管相关血流感染(CRBSI)早期诊断的临床价值。方法选择某院2013年4月—2015年4月ICU留置中心静脉导管(CVC)疑诊CRBSI的78例患者,患者入住ICU及疑诊CRBSI当日采集患者血液标本,同时行血培养和静脉导管尖端培养,根据血培养和静脉导管尖端培养结果将患者分为CRBSI组与非CRBSI组,比较PCT、hs-CRP、IL-6对CRBSI诊断的价值。结果 28例疑诊患者最终诊断为CRBSI。疑诊CRBIS当日,CRBSI组患者的PCT、hsCRP、IL-6和血白细胞(WBC)水平分别为(3.35±1.52)μg/L、(32.90±11.10)mg/L、(423.20±171.70)ng/L、和(12.70±2.70)×109/L,均高于非CRBSI组[分别为(1.22±0.44)μg/L、(23.50±6.00)mg/L、(257.90±81.40)ng/L、和(11.20±1.90)×109/L],差异均有统计学意义(均P0.05)。ROC曲线分析:PCT、hs-CRP、IL-6和血白细胞(WBC)水平曲线下面积(AUC)及95%CI分别为0.92(0.85,0.99)、0.75(0.62,0.88)、0.80(0.67,0.92)和0.64(0.50,0.72);灵敏度分别为0.82、0.64、0.71和0.46;特异度分别为0.92、0.94、0.92和0.88。结论 PCT和IL-6对ICU患者CRBSI的早期诊断具有较高的价值,对及早诊断CRBSI具有一定的预测作用。     

乳酸及C反应蛋白联合检测对重症肺炎的诊断价值

目的评价乳酸及C反应蛋白（CRP）联合检测对重症肺炎的诊断价值。方法检测某院普通肺炎和重症肺炎患者（各40例）,以及健康体检者（30例）血清中乳酸及CRP水平,评价其在重症肺炎中的诊断价值。结果重症肺炎组患者血清中乳酸及CRP水平［分别为（9.90+1.30）mmol/L、（80.10+12.30）mg/L］均高于普通肺炎组［分别为（4.90+0.50）mmol/L、（30.20+5.70）mg/L］和健康对照组［分别为（1.20+0.10）mmol/L、（5.01+0.50）mg/L］,差异均有统计学意义（均P<0.05）。单独检测乳酸、CRP的灵敏度为75.0%、60.0%,特异度为90.0%、70.0%,联合检测乳酸和CRP的灵敏度为90.0%,特异度为85.7%,联合检测的灵敏度高于单个指标的检测（P<0.05）;各组特异度比较,差异无统计学意义（P>0.05）。结论血清乳酸水平在重症肺炎中的诊断价值优于CRP,乳酸和CRP联合检测能够提高灵敏度,而不降低特异度。     

Breast and bottle feeding in rural and urban South African children

We studied breast and bottle feeding in 1264 children aged 1–4 years from five South African communities using a questionnaire on feeding habits completed by trained interviewers. The proportion of infants breast feeding ranged from 73% to 94% for mean periods of 9–16 months. The group with the most consistent and prolonged breast feeding habits were rural black children. Different bottle feeding practices were used within the various communities. At the ages studied the types of infant feeding practice varied little within the groups although each group differed significantly from the others for the preferred feeding method.     

不同类型炎症中C反应蛋白水平与基因型差异及其意义

目的研究不同类型炎症中C反应蛋白(CRP)含量与1059G/C基因型差异及其意义。方法采用免疫比浊法检测感染性炎症与自身免疫性炎症两组患者(各110例)及对照组(80例)患者血清高敏CRP含量,聚合酶链反应-限制性片段长度多态法检测各组CRP1059G/C基因型。计量资料经对数转换(LN)后以t或t’检验。结果感染性炎症者CRP值为(2.576±0.31)LN mg/L,升高持续时间平均为9.92 d,6 h内呈高值者21例(19.09%),48 h内呈高值者100例(90.91%);自身免疫性炎症者CRP值为(3.293±0.24)LN mg/L,升高持续时间平均为19.92 d,6 h内达高值者11例(10.00%),48 h内达高值者83例(75.45%);两组CRP值、CRP升高持续时间及呈高值时间比较,差异均有显著性(P<0.01)。两组炎症患者CRP 1059G/C基因型表现为GG,GC,CC三型,基因型和等位基因分布符合Hardy-Weinberg平衡,与对照组比较,差异无显著性(P>0.05)。GG基因型者CRP水平显著高于GC与CC型者(P<0.01)。结论自身免疫性炎症CRP升高水平及持续时间均高于感染性炎症,CRP 1059G/C基因型与等位基因分布无差异。不同基因型者CRP升高水平不同,GG型高于GC与CC型。