Use of influenza vaccines in children with an egg allergy

Children are at increased risk of morbidity from influenza. Influenza vaccines are grown in eggs, leading to a minute amount of egg protein in their composition. Recent research and new practice parameters spurred by the 2009 global influenza pandemic have challenged the need to withhold influenza vaccine from patients with an egg allergy. The available data suggest that anaphylaxis from influenza vaccines is exceptionally rare, even in patients with an egg allergy. Reported allergic reactions to trivalent inactivated influenza vaccine and pH1N1 influenza vaccines have been rare; when reactions occurred, they have not caused anaphylaxis. This position statement reviews the available evidence on influenza vaccine/egg allergy-related anaphylaxis, and recommends protocols to safely administer the trivalent inactivated influenza vaccine in lower- and higher-risk children with an egg allergy.     

Management of childhood asthma in Western Australia

Aims:   The study aimed to determine how childhood asthma is managed in Western Australia by general practitioners (GPs) and specialist paediatricians.
Methods:   A questionnaire survey was sent to 992 GPs and specialist paediatricians, asking about practice and preferences regarding maintenance management of childhood asthma and treatment of acute asthma. Questions about asthma in infants, pre-school and school-aged children were asked separately.
Results:   The overall response rate was 24.7%, with 188/878 (21.4%) of GPs and 44/62 (71.0%) of paediatricians returning the questionnaire. The decision to start maintenance therapy was generally based on symptom frequency and severity. The first choice for maintenance treatment in all age groups was inhaled corticosteroids (ICS). The second most common treatment varied according to age group, with short-acting β₂-agonist (SBA) preferred for infants, montelukast or short-acting β₂-agonist for pre-schoolers and combination therapy (ICS + long action β₂-agonist) for school-aged children. Objective monitoring of lung function with peak flow or spirometry, was used by 40% of GPs and 59% of paediatricians. Acute asthma was primarily managed with inhaled salbutamol and oral corticosteroids. There were few differences in treatment choice between GPs and paediatricians. Many GPs indicated that they did not treat asthma in infants without specialist consultation.
Conclusions:   These data show good compliance by the minority of GPs responding to the survey and by paediatricians practising in Western Australia with current Australian asthma management guidelines. Major differences in treatment preferences between the groups were not detected.     

细粒棘球蚴重组抗原B的表达提取及其血清学检测初探

用基因工程技术制备出的细粒棘球绦虫重组抗原B（rAgB）表达载体,经诱导表达、亲和层析纯化获得具生物活性的重组蛋白质rAgB,用Western-Blot法检测病人血清。结果显示rAgB敏感性为91．6％（44／48）,特异性为93．8％（30／32）,其中10例泡球蚴（AE）病人及10例肿瘤病人血清均无交叉反应。说明rAgB具有较高的敏感性及特异性,可用于包虫病的常规血清学诊断,rAgB在宿主菌JM109内稳定表达,因此可在实验室内大量制备用于血清学诊断的rAgB。     

泡状棘球蚴病宿主淋巴细胞的变化及意义

目的　为探讨泡状棘球蚴病宿主体内淋巴细胞在免疫调节和发病中的作用。方法　对泡球蚴感染BALB/c小鼠观察至 2 5周 ,在不同时间取脾制备细胞悬液 ,检测CD+ 4 ,CD+ 8细胞数量。对 2 5例泡球蚴病患者和 18例健康人群 ,用FCM分析了CD+ 3 ,CD+ 4 ,CD+ 8,CD+ 19,CD+ 3 8,CD+ 56和HLA -DR+ 细胞的变化。结果　泡球蚴感染BALB/c小鼠后 ,1～ 8周以CD+ 4 细胞为主 ,随后CD+ 4 细胞减少 ,CD+ 8细胞增加 ,2 0周后改变显著 (P <0 0 5 ) ,CD+ 4 /CD+ 8比值迅速倒置。泡状棘球蚴病患者CD+ 3细胞未发生改变 ,CD+ 4 细胞较正常对照组下降 (P <0 0 5 ) ,CD+ 8细胞上升 (P <0 0 5 ) ,使CD+ 4 /CD+ 8比值降低 (P <0 0 5 )。CD+ 56细胞较正常对照组显著性降低 (P <0 0 1) ,CD+ 19,CD+ 3 8和HLA -DR+ 细胞未发生改变 (P >0 0 5 )。结论　泡球蚴感染小鼠前 8周 ,以CD+ 4 细胞反应为主 ,具有保护性免疫。感染后期逐渐以CD+ 8细胞为主 ,使机体呈免疫抑制状态 ,有利于泡球蚴生存。泡状棘球蚴病患者机体呈免疫抑制状态 ,有利于泡状棘球蚴在体内的生长