哮喘患儿诱导痰液中NO3^—／No2^—含量的变化及其意义

探讨儿童哮喘诱导痰液中一氧化氮(NO)代谢终产物硝酸盐/亚硝酸盐(NO-3/NO-2)含量的变化及临床意义,采用3%高渗盐水雾化吸入诱导患儿咳痰,0.1%DTT和PBS缓冲液裂解痰液,应用硝酸酶还原法和荧光酶标法分别测定诱导痰液中NO-3/NO-2和嗜酸性粒细胞阳离子蛋白(ECP)含量,便携式肺功能仪测定肺通气功能.结果表明,稳定期、轻度和中、重度发作期患儿诱导痰液中NO-3/NO-2浓度较对照组显著增高,P<0.05;ECP含量较对照组显著增高,P<0.05;不同时期哮喘患儿各组间诱导痰液中NO-3/NO-2含量和ECP均有显著性差异,P<0.05.哮喘患儿诱导痰液中NO-3/NO-2和ECP含量与1秒钟用力呼气容积占预计值百分比(FEV1.0%)呈显著负相关,r=-0.512,P<0.01;而NO-3/NO-2含量与痰液中ECP浓度呈显著正相关r=0.607,P<0.01.提示NO参与了儿童哮喘的发生和发展,诱导痰液中NO-3/NO-2水平可反映气道炎症的变化,可用于儿童哮喘病情监测及指导药物治疗.     

Altered Na+-K+ ATPase activity in uraemic adolescents

The Na⁺-K⁺ ATPase enzyme plays an essential role in the regulation of cell composition and volume. Enzyme activity itself is regulated by substrate availability and several hormones. In adult uraemic patients red blood cell Na⁺-K⁺ ATPase activity is decreased. However, it is unknown if children with uraemia exhibit the same phenomenon. Therefore, in the present study we examined whether endogenous digoxin-like factors (EDLF) and physicochemical membrane properties play a role in the regulation of erythrocyte Na⁺-K⁺ ATPase activity in uraemic children and adolescents. Healthy age-matched children were used as controls. Enzyme activity was measured in detergent-pretreated red blood cells and erythrocyte ghosts. Na⁺-K⁺ ATPase activity (2204 ± 538nmol Pi ml erythrocyte^?1 h^?1 in detergent pretreated erythrocytes; 204 ± 56 nmol Pi mg protein^?1 h^?1 in ghosts) in adolescents with uraemia was lower compared to controls (3245 ± 362 nmol Pi ml erythrocyte ¹ h^?1; 266 ± 37 nmol Pi mg protein^?1 h^?1, p < 0.001, p < 0.05, respectively). Plasma levels of EDLF were elevated in uraemic patients (0.30 ± 0.05 versus 0.21 ±0.04 ng ml^?1, p < 0.01). Furthermore, the membrane lipid component was decreased in patients with uraemia, while the cholesterol/phospholipid ratio and membrane fluidity were similar in both groups. No correlation was found between the decrease in Na⁺-K⁺ ATPase and the increase in EDLF concentration and altered membrane lipid components. Our results demonstrate, that similar to the findings of adults, the activity of Na⁺-K⁺ ATPase is diminished in uraemic adolescent patients, and that uraemia-associated elevation in EDLF and altered membrane components do not play a role in the down-regulation of Na⁺-K⁺ ATPase. Therefore other factors (presence of other inhibitors and/or reduced number of enzyme molecules) should contribute to the lower activity of the Na⁺-K⁺ pump.     

Concentrations of LTB4, LTC4, LTD4 and LTE4 in bronchiolitis due to respiratory syncytial virus

Fifty-five infants with bronchiolitis due to respiratory syncytial virus were evaluated for the presence of leukotriene B₄, C₄, D₄ and E₄ in nasopharyngeal secretions. An attempt was made to correlate concentrations of leukotrienes to arterial oxygen tension. Forty participants received conventional therapy consisting primarily of aerosolized albuterol and occasional aminophylline therapy. The other 15 individuals received ribavirin therapy in addition to conventional therapy, and leukotriene concentrations were compared among individuals in these groups. RSV infection was documented by standard methods, and leukotrienes were measured by reverse-phase high pressure liquid chromatography. The leukotriene detected most commonly was LTC₄ (up to 83% of subjects); LTD₄ and LTB₄ were present in approximately 30% of individuals. The mean partial pressure of oxygen was found to be lower in those individuals with detectable LTB₄ than in those without detectable LTB₄ (p < 0.025), and an overall inverse correlation of LTB₄ concentrations with initial pO₂ values was observed (r = 0.318, p < 0.05). The presence and quantity of other leukotrienes did not correlate with the severity of illness. During the first week of illness, the concentration of leukotrienes declined sharply in ribavirin recipients. Individuals receiving conventional therapy during the same time interval exhibited stable or increasing leukotriene concentrations. These observations suggest that LTB₄ may be important in the pathogenesis of bronchiolitis, and that ribavirin therapy may inhibit leukotriene release in the respiratory tract.     

儿童1型糖尿病TH1/TH2免疫应答状况研究

目的研究儿童1型糖尿病T     

Cytochrome B558 Component of O-2M Generating Oxidase in the Neutrophils From Patients With Chronic Granulomatous Disease

Cytochrome b₅₅₈ is probably a component of an electron transport chain which is called NADPH oxidase. Cytochrome b₅₅₈ from the neutrophils of two male patients with chronic granulomatous disease (CGD) and their parents was studied. One of the CGD patients had decreased amounts of cytochrome b₅₅₈, The α-band of light absorption of cytochrome b₅₅₈ at 558 nm was found as a trace, and the peak of the γ-band was shifted to 420 nm, whereas the normal γ-band is at 426 nm. Intermediate amounts of cytochrome b₅₅₈ were present in his mother, whereas his father had a normal amount. Another patient had normal peaks of α- and γ-bands of cytochrome b₅₅₈. Thus, abnormalities in NADPH oxidase of the two patients were different.     

GnIH/GPR147和Kisspeptin/GPR54与青春发育启动

小儿青春发育启动与下丘脑-垂体-性腺轴的发动有关,而下丘脑促性腺激素释放激素（ gonadotropin-releasing hormone,GnRH）神经元的激活是青春期启动的关键。青春期启动过程是一个复杂的过程,GnRH又受到许多相关神经肽调节的影响。近来研究发现促性腺激素抑制激素（ gonadotropin-inhibitory hormone,GnIH）和 Kisspeptin 分别能够抑制和促进哺乳类动物的下丘脑 GnRH 的分泌,提示 GnIH 和Kisspeptin对生殖内分泌轴起着非常重要的调节作用。因此,GnIH/GPR147和Kisspeptin/GPR54两条通路可能与小儿青春发育启动密切相关。     

A note on interdisciplinary research in developmental/behavioral pediatrics/psychology

In sum, we have offered a few observations about the practice of interdisciplinary research. Now, in addition to our rather specific suggestions, we want to add a few general comments about the interactions of professionals who are actually involved in interdisciplinary research. Collaboration between physicians and psychologists can be enriching, stimulating, and rewarding. But it can also be problematic, because the former do not have much exposure to research and the latter do not have much exposure to clinical issues. Bringing these skills together may require many hours of discussion and reading each other's publications. Overall, physicians need to improve their research skills. Reading statistics texts, taking courses, handling data sets, reviewing other researchers' statistical designs are all reasonable strategies. Psychologists also need to expand their knowledge base. Reading the clinical literature is a start, but this ought to be supplemented by consistent exposure to the clinical milieu. The physician, who has access to the clinical milieu, needs to be sensitive to the question of exposure. Our final comments about collaboration are perhaps the most sensitive ones. The maintenance of a solid physician and psychologist research collaboration requires thoughtfulness, understanding, tact, and nurturance. Consider the status and responsibilities of the physician. He or she often outranks the psychologist, has access to the subject population, daily confronts ethical issues surrounding patient diagnoses, and controls communication of information to child and family. A sense of being in charge develops. Consequently, the psychologist may be perceived as being an adjunct to the research, responsible for day-to-day operations and committing ideas to paper.(ABSTRACT TRUNCATED AT 250 WORDS)     

Malignant liver disease in alpha1-antitrypsin deficiency

Ever since the first report by Sharp et al. (1) that alpha₁-antitrypsin deficiency (AATD) PiZ is associated with liver disease in infants and children, hepatologists were captured by this association. Whereas the major manifestation of alpha₁-antitrypsin (AAT) PiZ deficiency in infants and children involves the liver, many adults affected with this phenotype develop chronic obstructive lung disease. However, in addition to severe panacinar emphysema, adults with AATD also face the risk of the development of chronic liver disease and hepatocellular carcinoma (HCC).     

A1c hemoglobin values in children with overt diabetes maintained in high degree of control

Studies of nine children 4 7/12 to 13 years of age who had rickets are presented. No evidence of renal abnormalities, vitamin D deficiency, or of the inherited varieties of rickets was found. The salient features were their rural origins, mild hypocalcemia with evidence of secondary hyperparathyroidism, and improvement with a normal diet that contained an average of 944 mg calcium/24 hours. It is proposed that the etiology of the rickets is related to low calcium intake with or without a high oxalate concentration in the diet.     

Comparison of glucose/electrolyte and glucose/glycine/electrolyte oral rehydration solutions in hospitalized children with diarrhea in Costa Rica

The experience of Nalin et al. and Patra et al. with a "super oral rehydration solution (ORS)" containing glucose plus glycine to enhance the intestinal absorption of sodium and water prompted us to investigate a similar ORS containing the standard World Health Organization (WHO/ORS) plus either 55 or 110 mmol/L glycine in infants and small children with noncholera diarrhea. We did not find a statistically significant difference between the glycine-fortified ORS and the standard WHO/ORS with respect to the clinical outcome and composition of serum electrolytes.