新生儿缺氧缺血性脑病血浆内皮素与肺功能的关系

目的 :探讨内皮素 (ET)、在新生儿缺氧缺血性脑病 (HIE)中的作用及与肺功能关系。方法 :将 4 2例 HIE患儿按病情分为轻、中、重三组 ,各组均在入院后第 2天采用婴儿体描箱进行潮气呼吸分析、有效气道阻力及功能残气量等肺功能测定同时用放射免疫法测定血浆 ET水平。结果 :中、重度 HIE组血浆 ET水平均高于轻度组及对照组 ;中、重度HIE组肺功能测定提示 TPTEF/ TE、VPEF/ VE、PEF的下降。重度 HIE组潮气量下降 ,有效气道阻力增高。结论 :血浆ET水平增高与 HIE病情的严重程度相一致 ,肺功能检测指标可以解释血浆 ET水平的增高在新生儿中、重度 HIE发生肺动脉高压及急性肺损伤中起的作用 ,对 HIE临床治疗有一定的指导作用     

Atypical Allergic Colitis in Preterm Infants

ABSTRACT. Two atypical cases of colitis due to cow's milk protein intolerance (CMPI) are reported, affecting preterm infants. One developed a toxic dilatation of the colon and responded well to a casein hydrolysate based feed. The second presented insidiously and failed to tolerate a casein hydrolysate, but responded well to a chicken-based modular feed.     

新生儿胃穿孔18例诊治报告

目的 :探讨新生儿胃穿孔的诊断、治疗效果及预后因素。方法 :对 1 8例新生儿胃穿孔病例诊断、治疗及预后因素进行分析。结果 :1 8例患儿均有拒奶、腹胀、呕吐、呼吸困难等症状。腹部立位 X线片示膈下有大量游离气体。其中单纯穿孔 6例 ,多发穿孔 4例 ,胃壁缺损 7例 ,全胃壁缺如 1例。单纯及多发胃穿孔行胃修补术 ,3例同时行胃造痿术。胃壁肌层缺损行病变组织切除、胃壁修补及胃造痿术。 1例全胃壁肌层缺如仅行腹腔引流术。本组存活 8例 ;死亡 1 0例 ,病死率 5 5 .5 6%。死亡原因为多脏器功能衰竭、DIC。结论 :新生儿胃穿孔预后差 ,且受发病时间、就诊时间、病变严重程度等综合因素影响     

Effect of mite-impermeable mattress encasings and an educational package on the development of allergies in a multinational randomized, controlled birth-cohort study – 24 months results of the Study of Prevention of Allergy in Children in Europe

BACKGROUND: Sensitization to house dust mite (HDM) is an important risk factor for the development of asthma and allergic disease in childhood. Higher levels of HDM allergen are linked to increased sensitization to HDM. OBJECTIVE: To study the effect of mite-impermeable mattress encasings and an educational package on the development of allergies in a newborn cohort. METHODS: Six hundred and ninety-six newborns at high risk of developing allergies were enrolled in three European countries (Germany, Austria, UK) in a prospective, randomized, controlled birth-cohort study. Children were randomly assigned to an intervention and control group. Intervention measures included the use of mite-impermeable mattress encasings for the child's bed and a simple educational package on allergen avoidance. The control group received basic information about allergies. Children were followed up at age 6, 12, 18 and 24 months. RESULTS: 80.9% of the children were followed up to the age of 24 months. No difference in the prevalence of sensitization to HDM (control vs. intervention group: 8.4% vs. 6.1%, P=0.33) or the development of symptoms (recurrent wheezing 10.3% vs. 10.7%, nocturnal cough 12.5% vs. 12.5%) or allergic diseases (asthma 3.5% vs. 5.1%, eczema 20.0% vs. 19.6%, rhinitis 28.9% vs. 25.8%) could be found between the control and intervention group. CONCLUSION: In this study, HDM avoidance did not show a protective effect on the development of sensitization to HDM or symptomatic allergy in children at age 24 months.     

第1产程潜伏期指导对分娩的影响

目的 :观察规范指导对处于分娩第 1产程潜伏期孕妇的影响。方法 :为处于分娩第 1产程潜伏期的 15 0例产妇讲解分娩知识 ,训练助产动作 ,树立自然分娩信心 ,并动态观察产妇的分娩情况。以条件相同 ,未在潜伏期做指导的产妇 15 0例为对照组。结果 :观察组总产程、第 1产程活跃期及第 2产程明显短于对照组 (P <0 0 1) ,新生儿窒息率、剖宫产率明显低于对照组(P <0 0 1)。第 1产程潜伏期、阴道助产率及产后出血发生率两组差异无显著性。结论 :在第 1产程潜伏期对产妇进行规范指导可以缩短产程 ,促进自然分娩 ,降低新生儿窒息发生率。     

新生儿血糖监测（附32例临床分析）

应用英国产“ＨＹＰＯＣＯＵＮＴＧＡ”微量血糖测定仪（氧化酶光电比色法）对同期住院新生儿不分病种连续３天进行空腹血糖监测。结果在原发疾病情况下表现出低血糖发生频率高，而低血糖症状又被原发疾病所掩盖。在３２例中足月儿２３例，足月小样儿４例，早产儿５例，在３２例９６次监测中发现低血糖１４例，其中足月儿９例，早产儿５例．发病率为４３．７％；高血糖３例。无一例死亡。提示：新生儿患病情况下，易发生低血糖，其发生与疾病、孕周有关而与体重无关。因此，在新生儿期必须注意及时喂养与补充葡萄糖，防止低血糖时间过长对脑部造成损伤。     

足月新生儿颅内出血的CT诊断

经CT扫描诊断的足月新生儿颅内出血8例,就其病因、CT表现特点及CT与超声检查的比较进行讨论。提出新生儿颅内出血与孕期、胎次、分娩方式均有一定的关系,同时还应注意新生儿因脑发育不成熟在CT扫描图像上有其特殊表现。     

足月新生儿缺氧缺血性脑病的CT临床应用与预后评估

目的:提高对足月新生儿窒息缺氧缺血性脑病(简称HIE)头颅CT的临床应用。方法:时80例有明确围产期窒息史和临床症状的患儿进行头颅CT扫描,其中72例进行复查扫描。作治疗前后CT对照并分析预后。结果:80例均有按CT诊断分度标准的轻(33例、占41.2％)、中(28例、占35.0％)、重度(19例、占23.8％)。CT表现,CT诊断阳性率为100％。结论:头颅CT检查能早期、直观、清楚地对足月新生儿窒息反映出脑缺氧缺血性损害及程度和变化。对指导治疗。评估预后有重要意义。     

Development of mucosal immune function in man: potential for Gl disease states

The human mucosal immune system is structurally mature and has all the necessary cellular components to generate an immune response at birth. However, in the absence of dietary antigens and bacterial flora, there are no secondary follicles in the Peyer's patches and virtually no immunoglobulin A plasma cells in the lamina propria. Reactive follicle centers develop after birth but it takes 2 years for mucosal IgA plasma cell density to reach adult levels. T cells are present in the epithelium and lamina propria at birth, albeit at a lower frequency than later in life and there are major differences in phenotype between T cells in fetal intestine and postnatal intestine. There is no information on the impact of the massive antigenic challenge at birth on the mucosal immune system. Well-documented deficiencies in the ability of the blood T cells of the neonate to produce interleukin-4 and interferon-gamma may also occur in the intestine. It is still an open question whether it is better to try to prevent immunological sensitization of the newborn by avoiding potential allergens (i.e. cow's milk), or whether early exposure (as happens when premature infants are given formula feeds) might tolerize the infant. Hydrolysed cow's milk formulae are probably less antigenic than whole cow's milk and have been widely used in the treatment of cow's milk allergy. Some thought is now being given as to whether the prophylactic use of hydrolysates can reduce cow's milk allergy in ‘at-risk’ infants.