Assessment of nutritional status in children with cystic fibrosis: conventional anthropometry and bioelectrical impedance analysis. A cross-sectional study in Dutch patients

BACKGROUND: Assessment of nutritional status in children with cystic fibrosis (CF) is clinically relevant. Methods to measure nutritional status should be reliable and non-invasive, and reference values should be available. AIM: To compare weight and height measurements and measurements of specific body compartments in children with CF. METHODS: In a cross-sectional survey of 58 children with CF (28 females), we compared height and weight (expressed as: weight-for-height, body mass index (BMI), height-for-age and weight-for-age) with fat mass (skinfold sum (SFS)), muscle mass (upper arm circumference (UAC)) and bioelectrical impedance analysis (BIA). Results were expressed as Z-scores, using Dutch reference values. RESULTS: BMI and weight-for-height were within the normal range (mean Z-score (range): -0.13 (-1.5, 2.7) and -0.02 (-1.7, 2.8)). Weight and height corrected for age were below normal (mean Z-score (range): -0.79 (-2.4, -0.05) and -1.2 (-2.8, 1.4) (P<0.01)). Lean body mass by skinfold sum (LBM(sfs)), UAC and BIA were also significantly below reference values (mean Z-score (range): -0.9 (-2.2, 1.8), -0.95 (-2.4, 1.8) and -1.1 (-3.6, 1.0) (P<0.01)). Lean body mass (LBM) by BIA correlated with LBM(sfs). BIA systematically underestimated LBM in both CF patients and in control subjects. CONCLUSION: Nutritional status of children with CF must be evaluated, using age-corrected weight and height expressed in Z-score. LBM estimated by SFS, UAC and by BIA appear to be useful, although longitudinal studies in CF children should be performed to evaluate their clinical significance in detecting changes in nutritional status.     

Treatment of Motor Neuron Disease with Qi-invigorating Herbs—— A Report of 31 Cases

The motor neuron disease (MND) refers to a group of progressive diseases with unknown reasons, which attacks the cells of the anterior horn of the spinal cord, the motor nuclei of the brain stem cranial nerves and the pyramidal cells of the cerebral motor cortex. It is characterized in clinic by atrophy of the muscles, myasthenia and even death due to paralysis of the respiratory muscle. Currently, there is still no any effective cure for this illness. 50-70% of the victims will die in 3 to 5 years, and the survival time for those with brain stem injuries is no more than two years.1 Since 1996, the authors have treated 31 cases of motor neuron disease with large dosage of qi-invigorating drugs in accordance with Prof. Liu Mocai's experience, and obtained certain therapeutic effects. A report follows.     

Nonablative dermal remodeling with a 585-nm, 350-microsec, flashlamp pulsed dye laser: clinical and ultrastructural analysis.

BACKGROUND: A nonablative 350-microsec, 585-nm, flashlamp pulsed dye laser is currently being used for the treatment of rhytides. OBJECTIVE: To analyze both clinical rhytid improvement and electron microscopic evidence of ultrastructural changes after treatment with a nonablative 350-microsec, 585-nm, flashlamp pulsed dye laser. RESULTS: At 6 months after two treatments, 40% of the treated subjects noted mild improvement in rhytid appearance. Nontreating physician evaluation revealed some degree of improvement in 50% of the treated subjects. Mild improvement in quality and texture of the skin was also reported by 50% of the subjects. Electron microscopic evaluation showed ultrastructural changes that are consistent with new collagen formation. CONCLUSION: Treatment with a nonablative 350-microsec, 585-nm, flashlamp pulsed dye laser can lead to both clinical and electron microscopic evidence of improvement in photo-damaged skin.     

Comparative double-blinded study between mupirocin and tetracycline ointments for treating skin infections

A double-blinded study was conducted to compare the effects of mupirocin and tetracycline ointments in the treatment of skin infections. 111 patients were available for clinical assessment, of which 53 were treated with mupirocin and 58 treated with tetracycline. Clinically, both groups were improved, and there was no significant difference. Bacteriological assessment however revealed a better response to mupirocin. Staphylococcus aureus and Streptococcus pyogenes were the most common organisms isolated. 99% of Staphylococci were sensitive to mupirocin compared with 61% to tetracycline and 29% to penicillin G. 57% of Group A beta haemolytic Streptococci were resistant to tetracycline compared to 14% to mupirocin. Gram-negative organisms were mostly resistant to both preparations. No side effects were observed in both treatment groups. This study suggests that mupirocin is a safe and effective topical preparation for treating most of our common skin infections.     

雾化吸入对新生儿肺炎患儿血氧饱和度的影响

采用动脉血氧饱和度仪对５２例新生儿肺炎患儿，在雾化吸入治疗过程中的动脉血氧饱和度（ＳａＯ２）进行了监测，对比了吸氧与否对ＳａＯ２改变的影响。结查表明：与基础值比较，雾化吸入时患儿的ＳａＯ２显著下降（Ｐ＜０．０１），而雾化吸入同时吸氧者ＳａＯ２无明显变化（Ｐ＞０．０５），但两者比较具有显著性差异（Ｐ＜０．０１）。结果提示雾化吸入可使新生儿肺炎患儿ＳａＯ２下降；同时吸氧，对防止ＳａＯ２的下降有一定作用。     

Respiratory symptoms and lung function effects of domestic exposure to tobacco smoke and cooking by gas in non-smoking women in Singapore.

STUDY OBJECTIVES--To investigate the effects of passive exposure to tobacco smoke and gas cooking at home on respiratory symptoms and lung function of non-smoking women. SETTING--Evidence on the effects of passive smoking and exposure to nitrogen dioxide from gas cooking on the respiratory health of adults is limited and variable. Over 97% of women in Singapore do not smoke, and a principal source of indoor air pollution for housewives is passive smoking and gas cooking. DESIGN--This was a cross sectional (prevalence) study of a population based sample of 2868 adults aged 20 to 74 years in Singapore. A structured questionnaire administered by trained interviewers was used to collect data on passive smoking, gas cooking, respiratory symptoms, and other relevant variables. Passive smoking was defined as exposure to cigarette smoke from one or more members of the household who had ever smoked. Gas cooking was defined in terms of the weekly frequency of gas cooking, as well as the frequency with which the respondent's kitchen was filled with heavy cooking fumes (rarely, occasionally, often). Forced expiratory volume in one second (FEV1) was measured by using a portable Micro-spirometer. Multivariate analyses were used to estimate relative odds of association for respiratory symptoms and FEV1 effect, with adjustment for potential confounding variables. PARTICIPANTS--Of a total of 1438 women in the sample, 1282 women who had never smoked provided questionnaire data and 1008 women provided acceptable readings of FEV1 for analysis. MAIN RESULTS--Passive smoking was significantly associated with greater relative odds of usual or chronic cough and phlegm, wheezing, and breathlessness on exertion, as well as lower FEV1. Greater relative odds of respiratory symptoms were also associated with the weekly frequency of gas cooking, although these results were statistically insignificant. Chronic cough and phlegm and breathlessness on exertion, however, were significantly associated with the frequency with which the kitchen was filled with heavy cooking fumes. A lower FEV1 was found in women who cooked frequently (more than thrice a week). CONCLUSION--Domestic exposure to cigarette smoke and gas cooking is associated with increased risks of respiratory symptoms and impairment of lung function in non-smoking women in Singapore.     

乾坤宁胶囊治疗原发性肝癌的临床观察附：93例病例报告

对照观察了以舒肝解郁，清热解毒，软坚散结，活血化瘀，益气养阴原则配伍而成的乾坤宁胶囊与复方天仙胶囊对原发性肝癌９３例的临床疗效，结果表明：乾坤宁治疗组总有效率为３６．８４％，复方天仙组为３８．８８％。两组总有效率、总显效率及主要症状疗效比较均无统计学意义（Ｐ＞０．０５）。治疗组ＡＦＰ治疗前后比较有统计学意义（Ｐ＜０．０５）。提示乾坤宁胶囊对原发性肝癌有一定疗效     

Audit of 149 consecutive carotid endarterectomies performed by a single surgeon in a district general hospital over a 12-year period.

Carotid endarterectomy has been established by two large randomised controlled trials (European Carotid Surgery Trial (ECST) and North American Symptomatic Carotid Endarterectomy Trial (NASCET)) as an important surgical procedure for the prevention of ischaemic strokes in patients presenting with transient cerebral ischaemia or non-disabling strokes attributable to severe ipsilateral carotid artery stenosis. The operation carries significant risk of death and stroke and it has been advocated by some that carotid endarterectomy should only be performed in a small number of designated regional centres in order to achieve good surgical results. It is doubtful that the regional centres alone can cope with the increasing numbers of patients requiring carotid endarterectomy and there is therefore a requirement for the procedure to be carried out by vascular surgeons in district general hospitals. It is important that surgical results are audited to ensure that comparable outcomes are achieved. We present an audit of our experience of carotid endarterectomy since 1981. A total of 149 consecutive carotid endarterectomies were performed by a single surgeon with a special interest in carotid surgery. The results are comparable to ECST with a 30-day mortality of 0% and an overall 30-day stroke rate of 5.7% (major strokes) for patients with severe, ie 70-99%, ipsilateral carotid artery stenoses. We have shown that carotid endarterectomy is an operation that can be performed safely and with good results by suitably trained surgeons in district general hospitals.     

频闪喉镜对声带病理情况观察的研究

对1997年以来423例病态喉的频闪喉镜表现进行分析,结果显示声带有病理改变者其粘膜波、振幅、闭合相、运动周期性、对称性均有不同程度的变化,这种变化能直接反映声带病变的深度及范围,对喉部疾病的诊断、鉴别诊断、治疗指导及预后评价具有重要意义.