Dengue haemorrhagic fever in children in the 1996 Delhi epidemic.

An epidemic of dengue haemorrhagic fever (DHF) occurred in Delhi in 1996. A total of 240 children between the age of 4 months to 13 years of either sex, admitted in one hospital, were evaluated. Two hundred and sixteen (90%) children were from Delhi. A clinical diagnosis of dengue fever (DF) was made in 25 (10%), dengue fever with unusual bleeding (DFB) in 22 (9%), DHF in 80 (33%) and dengue shock syndrome (DSS) in 113 (47%) of the children strictly according to the WHO classification. The age peaked at 8 years. There was no association between various grades of severity of illness and age-groups though girls suffered from more severe illness. No association between severity of malnutrition and severity of illness was observed. Tourniquet test was positive in 40% with DF, 18% with DFB, 62% with DHF and 64% with DSS. In DSS haematemesis was present in 55 (49%), epistaxis in 39 (35%), melaena in 27 (24%) and ecchymosis in 34 (30%) patients. Children diagnosed as DFB had haematemesis and epistaxis in 12 (55%) and 10 (45%) respectively. Intravenous fluid requirement was clearly less in DFB patients than in DHF/DSS patients. Unusual clinical features in the form of jaundice were present in 7 (6%), hepatic encephalopathy in 6 (5%) and dengue encephalopathy in 6 (5%) patients. Dengue 2 virus was isolated from 10 of the 50 patients for whom viral culture was done on C6/36 clone of Aedes albopictus cell line. Eighteen patients suffering from DSS died giving an overall case fatality of 7.5%. The mortality rate in DHF/DSS was 9.3%. It is further suggested that DFB is a distinct entity. Most patients could be classified by the WHO classification if a retrospective packed cell volume was used to assess haemoconcentration. We suggest that development of area-specific criteria for diagnosis and management is desirable.     

Modulation of immune response with ornithine A-ketoglutarate in burn injury: an arginine or glutamine dependency?

Enterally administered ornithine alpha-ketoglutarate (OKG) is an efficient complement of nutritional support in trauma situations, especially after burn injury. A typical feature observed in this intense catabolic state is insufficient production of glutamine (Gln) and arginine (Arg), two amino acids (AAs) involved in the immune response. As OKG in vivo metabolism generates these two AAs, we investigated, in burned rats, the action of OKG with regard to modulation of immunity. Male Wistar rats were randomly allocated to four groups. On day 0, 12 rats were burned with boiling water (20% body surface area). After a 24-h fast, they were enterally refed for 48 h using Osmolite, as a low-calorie low-nitrogen regimen, supplemented with either 5 g OKG x kg(-1) x d(-1) (n = 6) or an equivalent amount of nitrogen in the form of glycine (n = 6). Non-burned pair-fed controls treated with glycine (n = 6) and healthy rats fed ad libitum (n = 6) were also studied. Nitrogen balance was assessed from daily measurement of total nitrogen excretion. On day 3, thymus, Anterior tibialis muscle and proximal jejunum weights were recorded. Muscle and intestinal AA concentrations were also quantified. OKG counteracted (P<0.01) the thymic involution that occurs with burn injury, and increased the concentrations of Gln and Arg in both the muscle (P<0.01 and P<0.05, respectively) and the jejunum (P<0.01 for Gln). When all groups were taken together, a positive correlation was found between thymus weight, and Gln and Arg muscle concentrations (r = 0.71, P<0.001 and r = 0.58, P<0.01, respectively). Furthermore, as expected, OKG improved nitrogen balance. As it is known that total number of thymocytes parallels thymic weight, and as Gln and Arg are essential nutrients for activated immune cells, our results suggest that Gln and Arg derived from OKG are responsible for the immunomodulating properties of this molecule in burn injury.     

Effect of synthetic triglycerides of myristic, palmitic, and stearic acid on serum lipoprotein metabolism.

OBJECTIVES: To determine relative effects of diets high in synthetic sources of myristic (14:0), palmitic (16:0) or stearic (18:0) acid on concentrations and metabolism of serum lipoproteins. DESIGN: Eighteen healthy women participated in a three-way cross-over study for five week periods separated by seven week washout periods, diets were assigned in random order. SUBJECTS: Premenopausal women, not on medication, were from three races (Caucasian, African-American, Asian) and four apolipoprotein E phenotype groups (3/3, 3/2, 4/3, and 4/2). INTERVENTION: During the first week the subjects consumed a baseline diet providing 11 energy (en)% saturated fat, 10en% polyunsaturated fat and 14en% monounsaturated fat. Followed by test diets with 19en% saturated fat (including 14en% test saturated fatty acid), 3en% polyunsaturated fat, and 14en% monounsaturated fat for four weeks. Synthetic fats (trimyristin, tripalmitin, and tristearin) were used in blends with natural fats and oils. RESULTS: Mean concentrations of serum total, esterified and LDL cholesterol were significantly lower after 18:0 than after 16:0 (n = 16-18, P < 0.01 for treatment effect). Myristic acid (14:0) had an intermediate effect. Receptor-mediated degradation of 125I-LDL in mononuclear cells obtained from the subjects was lower after 16:0 than after 14:0 and 18:0 (n = 16-18, P=0.05 for treatment effect). Differences in the digestibilities of the fats were not a major factor in the results. Strong cholesterolemic responses to the 16:0 diet were partly explained by apoE phenotype. CONCLUSIONS: As noted previously, stearic acid was neutral compared to 14:0 and 16:0. In contrast to studies involving natural fats, 14:0, fed as a synthetic triglyceride, was less cholesterolemic than 16:0 in a majority of subjects. ApoE phenotype influenced the cholesterolemic response particularly when diets high in 16:0 were eaten.     

学习障碍儿筛检测试的应用研究

目的：为在我国开展学习障碍的研究提供筛查工具,对日本PRS在江苏省进行标准化研究。方法：采用PRS测试江苏省12市城乡5～15岁普通学校中小学生和幼儿园儿童6676名,进行标准化研究。结果：PRS项目测试具有较高的可靠性,言语性以及非言语性领域Cronbach’sa系数均大于093,全项目则达到096;因子分析则间接提示本次测试的有效性;各项目得分比日本样本更接近正态分布,各项目以及各领域得分均略高于日本。作为筛查学习障碍界值是合适的。结论：PRS在江苏省可用于筛俭学习能力障碍,需进一步加强应用研究。     

反复呼吸道感染患儿机体免疫功能观察

目的：观察反复呼吸道感染（ＲＲＴＩ）患儿体液免疫和细胞免疫功能。方法：选择符合诊断标准的ＲＲＴＩ患儿５３例为观察组,健康儿童３１例为对照组,测定血清免疫球蛋白和Ｔ细胞亚群,并行ｔ检验。结果：ＲＲＴＩ患儿血清ＩｇＧ低于对照组（Ｐ＜０．０５）,ＩｇＡ、ＩｇＭ与对照组无差异。Ｔ细胞亚群ＣＤ３、ＣＤ４、ＣＤ４／ＣＤ８低于或明显低于对照组,而ＣＤ８高于对照组。结论：本组ＲＲＴＩ患儿反复呼吸道感染的原因与细胞免疫功能低下密切相关,与血清ＩｇＧ含量下降也有一定关系。     

Trans-sclerally fixated PC-IOLs: six year of investigations

PURPOSE: To present the results of PC IOLs transscleral fixation to the ciliary sulcus in six years follow-up. MATERIAL AND METHODS: 152 eyes in 3 groups: 15 eyes with primary fixations of PC IOLs, 92 eyes with secondary fixations of PC IOLs and 45 eyes with secondary fixations of PC IOLs combined with penetrating keratoplasty. RESULTS: Postoperative corrected visual acuity was 0.5 or better in 32.2% of cases, the most common complications in our material was CME (9.9%), lens tilt (4.6%) and increase of IOP (3.95%). CONCLUSION: Transscleral fixation of PC IOLs offers good visual outcome with relatively low rate of complications and is recommended in cases with inadequate posterior capsule support.     

延边农村地区朝鲜族HBV、HCV、HDV感染状况调查

为摸清延边农村地区朝鲜族人群乙、丙、丁型肝炎病毒(HBV、HCV、HDV)感染状况,用ELISA法对585名朝鲜族成年人进行了HBV、HCV和HDV感染标志物的检测.HBV、HCV标化感染率与HBsAg标化阳性率分别为50.91%、4.85%和8.57%,年龄组间差异无显著性.HBV、HCV双重感染率为2.56%,HBV与HCV的感染相关无显著性.42例HBsAg阳性者中HDV感染率4.76%.HBV感染模式有15种,其中以单项抗-HBs阳性多见,人群中占31.97%.表明人群中HBV、HCV和HDV感染的流行情况不同.     

放射状角膜切开手术中微穿孔对角膜内皮的影响

目的：评价放射状角膜切开术（ＲＫ）中微穿孔对术后１年内角膜内皮的影响。方法：应用角膜内皮镜及角膜内皮分析仪研究４８例ＲＫ术中微穿孔和未穿孔眼的角膜内皮形态学变化,分别在术前及术后１、３、６、１２个月行角膜内皮检查及分析。结果：比较手术前后角膜内皮的数量、平均面积、最大面积和最小面积,穿孔眼及未穿孔眼差异无显著性,但内皮细胞面积两组都有扩大的趋势。结论：ＲＫ术后一年内无论微穿孔还是未穿孔眼的角膜内皮     

维生素C在晶体蛋白光氧化中的作用及其机制

目的：观察维生素Ｃ（ＡＳＡ）在晶体蛋白发生光氧化时的作用及其机制。方法：牛日体蛋白溶液在加入或不加入ＡＳＡ时,于５天内共接受２００ｍＪ／ｃｍ＾２紫外线Ｂ（ＵＶＢ）照射,接着在３７℃继续孵育至第３周,然后测定晶体蛋白的非色氨酸我、游离巯基和进行蛋白电泳分析。结果：ＡＳＡ在溶液中易被氧化,蛋白溶液中加入ＡＳＡ促使晶体蛋白 非色氨酸荧光产生明显增强,导致非二硫键聚合形成,对晶体蛋白的游离巯基减少有保护作