Influence of breastfeeding and complementary food on growth between 5 and 10 months

The aim of this study was to examine the nature of the association between breastfeeding, complementary feeding and growth in a random sample of infants from Denmark, where the prevalence of breastfeeding is high. A semiquantitative food frequency questionnaire and a questionnaire on breastfeeding duration and on weight and length measurements taken at the infant welfare visit at 5 and 10 months were sent to 590 families with 10-month-old infants. A total of 339 infants with complete growth data were included in the analyses. When controlling for mid-parental height and birth weight infants breastfed for ≥ 7 months gained 198 g less in weight ( p < 0:01) and 7 mm less in length ( p < 0:01) during the period from 5 to 10 months than infants breastfed for < 7 months. Controlling for these effects, the 10% of the sample with the highest protein intake (i.e. ≥16 energy percentage) gained 262g more than those with a lower protein intake ( p = 0:03). Infants breastfed for ≥ 7 months received significantly less cow's milk ( p < 0:01), and fewer meat-containing dishes ( p < 0:05) and sweets or cakes ( p < 0:01), which may partly explain the effect of breastfeeding. The long-term consequences of this moderate difference in growth velocity are unknown and the findings should not be used to advocate against breastfeeding during late infancy.     

Calorie intake in sick versus respiratory stable very low birthweight babies

A comparison between the calorie intake and energy source of sick versus respiratory stable very low birthweight (VLBW, less than 1500 g) babies was made to ascertain the time taken for them to achieve adequate daily calorie intake. It was an observational study of 23 consecutive VLBW babies in which sick respiratory unstable babies were defined as those who required ventilation beyond 72 h of life. Data were collected on the daily fluid and calorie intake for 30 days of life, and beyond if necessary until the babies achieved full enteral feeding and calorie intake of more than 100 kcal/kg per day. Growth parameters at the time of transfer or discharge were also analyzed. In the study, there were 14 sick VLBW and 9 respiratory stable babies with a mean birthweight of 1027 g and 1212 g, respectively. Their mean gestational age (28.7 weeks vs 31.2 weeks), mean age when calorie intake of 100 kcal/kg per day was achieved (19.8 days vs 7.0 days), mean duration of parenteral nutrition (17.1 days vs 2.7 days), mean age when enteral feeds commenced (8.9 days vs 1.7 days) and mean age when full enteral feeding was established (20.6 days vs 7.3 days) were statistically different for the two groups. For the respiratory unstable babies, parenteral nutrition provided more energy than milk until 15 days of life. The average daily energy intake of 100 kcal/kg per day was only achieved by 30 days of life in this group. In the respiratory stable group, milk provided more than 100 kcal/kg per day from 10 days of life. There were no significant differences in somatic growth with regard to bodyweight, length and head circumference for these two groups of babies at the time of transfer or discharge. The daily calorie intake of sick VLBW babies was suboptimal even with the use of parenteral nutrition. The respiratory stable babies, through enteral feeding, easily achieved the recommended daily calorie intake.     

GASTROINTESTINAL AUTONOMIC NERVE TUMOUR PRESENTING AS SMALL BOWEL VOLVULUS: A RARE DISEASE WITH A RARE PRESENTATION

A 78-year-old Chinese woman presented with recurrent postprandial abdominal pain. Computerised tomography revealed a small bowel tumour causing volvulus of a segment of the small bowel. Laparotomy confirmed an extraluminal ileal tumour with partial volvulus of the involved small bowel segment. Small bowel resection was done. Histological and ultrastructural studies confirmed a gastrointestinal autonomic nerve tumour. We review the medical literature on this rare tumour.     

Endoscopic haemoclip ligation of pedunculated polyp before polypectomy

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Autologous bone marrow transplantation in acute leukemia: a phase I study of in vitro treatment of marrow with 4- hydroperoxycyclophosphamide to purge tumor cells

This phase I study was conducted to determine the maximal safe concentration of 4-hydroperoxycyclophosphamide (4HC) that could be used for in vitro treatment of bone marrow from patients with acute leukemia undergoing autologous bone marrow transplantation. Concentrations of 40 to 120 micrograms/mL of 4HC were used in 30 patients with relapsed or high-risk acute leukemia and in six patients with nonleukemic malignancies. All patients received marrow-lethal cytoreductive therapy followed by infusion of the 4HC-treated marrow. Complete inhibition of granulocyte and macrophage colony-forming cells was obtained at 80 micrograms/mL. Nevertheless, only one transplant-related death and otherwise full hematologic recovery was observed at concentrations of 4HC up to 100 micrograms/mL. At 120 micrograms/mL, there were three transplant-related deaths, including two of the three patients who required the infusion of reserve marrow. Among the acute leukemia patients, three remain in complete remission at 1,337, 1,017, and 967 days after transplant. Among the nonleukemic patients, two remain in complete remission at 1,081 and 1,017 days after transplant. At the maximum safe concentration of 4HC (100 micrograms/mL), satisfactory hematologic recovery can be obtained, despite elimination of detectable hematopoietic progenitors.     

纤维胆道镜临床应用160例

0　引言　纤维胆道镜 (下称胆道镜 )在肝内外胆道疾病中的应用 ,其诊治价值已得到充分肯定 .我院 1996 - 0 1/ 1999- 12 ,术中、术后使用胆道镜诊治胆道肿瘤及结石 16 0例 ,取得了较满意的效果 .1　对象和方法1.1　对象　术中应用胆道镜行胆道探查共 38(男 2 3,女 15 )例 ,其中胆总管结石 2 9例 ,肝内胆管多发结石 5例 ,胆管肿瘤4例 .术后经 T管瘘道取石或活检 12 2 (男 78,女 44 )例 ,年龄18～ 77岁 ,其中肝外胆管残余结石 114例 ,多发性肝内胆管残余结石 5例 ,胆总管下端肿瘤活检 2例 ,置管造影 1例 .1.2　方法　日本 Olympus CHP2 OQ…     

肝移植治疗原发性肝细胞癌的临床研究进展

肝细胞肝癌行肝脏移植的指征、效果及相关问题一直存在争论. 本文我们收集并分析近年国内外文献,对肝癌肝移植的受体选择、影响预后/复发的因素、过渡性治疗以及术后注意的问题等相关问题进行探讨. 笔者认为在肝癌患者拟行肝移植治疗之前,严格、合理选择病例,结合围手术期辅助治疗,肝癌肝移植可以获得满意的疗效和较高的生活质量.