20例小儿喉乳头状瘤治疗体会

目的　探讨小儿喉乳头状瘤的疗效。方法　 2 0例患儿均于支撑喉镜下以手术方法彻底切除肿瘤 ,其中单纯手术 (Ⅰ组 ) 11例 ,手术 +微波治疗 (Ⅱ组 ) 6例 ,术后以干扰素治疗 (Ⅲ组 ) 3例。结果　总治愈率 60 % ,Ⅰ组、Ⅱ组、Ⅲ组治愈率分别为 :45 .4%、83 .3 %、66.7%。Ⅱ组治愈率高于Ⅰ组 (P <0 .0 5 )。结论　术后以微波处理创面可提高手术治疗率。     

A 500‐ml plastic bottle: An effective spacer for children with asthma

Inhaled therapy using a metered‐dose inhaler (MDI) with attached spacer has been increasingly recognized as the optimal method for delivering asthma medication for acute attacks and chronic prophylaxis. However, in developing countries the cost and availability of commercially produced spacers limit the use of MDI‐spacer delivery systems. A 500‐ml plastic bottle has been recently adapted to function as a spacer. This article reviews the current data on the efficacy of this bottle‐spacer and discusses its advantages and limitations. It is concluded that a modified 500‐ml plastic bottle is an effective spacer; modification and use of this device should be incorporated into international guidelines for the management of children with asthma.     

麻城市农村某社区O～6岁儿童意外伤害流行状况及影响因素研究

目的 探讨农村地区0-6岁儿童意外伤害流行病学特征及影响因素，为开展伤害预防干预提供依据。方法 以问卷方式调查湖北省麻城市宋埠镇1998年所有发生意外伤害的0—6岁儿童，采用1：1配对病例对照研究的方法探索危险因素。结果 该地区0—6岁儿童意外伤害发生率为3．56％，男女比例为2．67：1。跌伤、烧烫伤和动物咬伤是最常见类型。13．63％的受伤儿童需住院治疗，因伤害致残疾者占1．82％。意外伤害医疗资用支出占家庭年总收入的3．94％。农村儿童意外伤害的影响因素为儿童的照顾者、家庭社会经济状况及儿童性格行为特点等。结论 意外伤害严重影响着农村地区0-6岁儿童的健康，给家庭和社会造成经济损失。预防重点是培训村级医师，开展健康教育，尤其需要提高儿童家长的安全知识水平。     

Prevalence of juvenile periodontitis in a circumpubertal population

A cross-sectional radiographic screening was performed on bite-wing pairs (BW) from 1872 10-12 year old schoolchildren in the Greater Worcester, Massachusetts area to assess the prevalence of juvenile periodontitis (JP). The 3-stage screening process entailed: (1) visual identification of possible cases based upon a visual assessment of BW for interproximal crestal bone levels greater than or equal to 2 mm from the cemento-enamel junction (CEJ) on greater than or equal to 1 permanent first molar; (2) identification of probable cases based upon BW from possible cases measured with a transparent ruler calibrated in millimeters; (3) finally, clinical confirmation of JP in consenting probable cases. A total of 1038 subjects were eligible to be included in the study (greater than or equal to 3 mesial sites readable). Of the 1038 eligible subjects, 117 possible and 103 probable cases were identified in stage 1 and stage 2, respectively. A total of 99 probable cases could be contacted and 43 were examined clinically. Two cases of JP were confirmed clinically in stage 3, yielding a prevalence rate of 4.6/1000. Specifically, this report defines a rate of JP in 10-12 year-old schoolchildren for the first time. In addition, these results indicate that BW can be used to identify children with JP from large data sets. However, further studies including complete clinical and radiographic examinations are necessary to determine whether this method is adequate for large epidemiologic studies.     

The concept of self-management of type 1 diabetes in children and adolescents: an evolutionary concept analysis

AIM: An evolutionary concept analysis was undertaken to clarify the concept of self-management of type 1 diabetes in children and adolescents. BACKGROUND: Several problems exist in the literature on self-management of type 1 diabetes in children and adolescents. There is no uniform terminology and there is no uniform definition of the concept. Also, there is no differentiation in the literature between self-management of diabetes in children and adults. METHODS: Ninety-nine references were reviewed and analysed in the disciplines of nursing, medicine, and psychology. After separate analyses revealed no significant differences across disciplines, the analyses were combined to describe the attributes, antecedents, consequences, and surrogate and related concepts. RESULTS: The three essential attributes of the concept were identified as process, activities, and goals. Self-management of type 1 diabetes in children and adolescents is an active and proactive process; it is daily, lifelong, and flexible, and it involves shifting and shared responsibility for diabetes care tasks and decision-making between child and parent. It is a process that involves collaboration with health care providers. Self-management of type 1 diabetes in children and adolescents also consists of varied and many activities related to giving insulin, monitoring metabolic control, regulating diet and exercise, to name just a few. The concept also involves goals, which may differ from one parent/child dyad to another. A working definition of the concept is suggested. CONCLUSIONS: It is hoped that a more uniform definition of the concept will enable researchers to continue investigating antecedents and consequences of the concept in a way that allows for aggregating results.     

Transforming growth factor-β1 and interleukin-10 in breast milk and development of atopic diseases in infants

BACKGROUND: Precise relationship between breastfeeding and infant allergy is poorly understood. Objective Aim was to quantify TGF-beta(1) and IL-10 in colostrum and mature milk from allergic and non-allergic mothers and to verify relationship with allergic disease development. METHODS: Mothers (13 allergics, nine controls) of 22 newborns participated to prospective study on development of children atopy. Colostrum and mature milk were assayed for TGF-beta(1) and IL-10 by ELISA. Children underwent paediatrician evaluation at 6 months of life. RESULTS: Data are presented as median values and range. A significant difference in concentration of TGF-beta(1) between colostrum (330, range 0-3400 pg/mL) and mature milk (215, range 0-2400 pg/mL) was observed in samples from allergic mothers (P=0.015). In mature milk TGF-beta(1) was significantly lower in allergic (215, range 0-2400 pg/mL) than in non-allergic mothers (1059, range 0-6250 pg/mL) (P=0.015). IL-10 was weakly expressed without significant differences between allergic (4.8, range 0-42 and 9.5, range 0-42 pg/mL in colostrum and in mature milk) and non-allergic mothers (0, range 0-42 pg/mL in colostrum and 0, range 0-42 pg/mL in mature milk). After 6 months 46% infants from allergic mothers, but none from controls, presented atopic dermatitis. CONCLUSION: TGF-beta(1) was significantly less secreted in mature milk of allergic mothers, while no difference in IL-10 was found. Particular cytokine patterns in milk could influence development of atopic diseases. Further immunological studies in this field are necessary.     

Food allergy and non-allergic food hypersensitivity in children and adolescents

BACKGROUND: Previous studies have shown a 10-fold discrepancy of self-reported food-induced symptoms and physician-diagnosed food hypersensitivity. Little information is available on the prevalence of food hypersensitivity in unselected paediatric populations. No data were available for German children. OBJECTIVE: To study the perception of food-induced symptoms in the paediatric population, to investigate the allergens accused, to objectify patients' reports, and to identify subgroups at risk of having food-induced allergy (FA) or non-allergic food hypersensitivity (NAFH) reactions. METHODS: This paper presents the data of the paediatric group (0-17 years) of a representative, randomly sampled, cross-sectional population-based survey studying 13 300 inhabitants of the German capital city Berlin regarding food-related symptoms. Instruments included mailed questionnaires, structured telephone interviews, physical examination, skin-prick tests, specific serum IgE and standardized, controlled and blinded oral food challenges. RESULTS: Two thousand three hundred and fifty-four individuals were contacted by mailed questionnaire, 739 (31.4%) responses could be fully evaluated. Four hundred and fifty-five (61.5%) participants reported symptoms related to food ingestion, 284 (38.4%) affirmed reproducible symptoms in the standardized telephone interview. One hundred and eighty-four (24.8%) individuals were fully examined. Reproducible symptoms to food were found in 31 (4.2%) children and adolescents: 26 (3.5%) showed symptoms of FA and five (0.7%) of NAFH. The oral allergy syndrome was most often observed. Foods most commonly identified by oral challenges were apple, hazelnut, soy, kiwi, carrot and wheat. CONCLUSION: The perception of food-related symptoms is common among children and adolescents from the general population. Self-reports could be confirmed in around one out of 10 individuals, still resulting in 4.2% of proven clinical symptoms. However, most reactions were mild and mainly because of pollen-associated FA, while NAFH reactions were less common. Severe IgE-mediated FA was observed in individuals with pre-existing atopic disease, who should be fully investigated for clinically relevant FA.     

健康儿童血浆游离氨基酸与体格生长的研究

本文采用丹酰氯聚酰胺薄层分析法研究了65名3～7岁健康儿童的血浆游离氨基酸,研究其与体格生长的关系.结果表明:赖氨酸,甘氨酸,羟脯氨酸,与年龄别身高、体重和身高别体重百分位成正相关.并有显著意义.异亮氨酸.赖氨酸.甘氨酸在营养优组中显著高于差组.提示血浆游离氨基酸对健康学龄前儿童的体格生长发挥重要的生理作用.     

乌鲁木齐市维汉族学龄儿童细胞免疫功能及影响因素的探讨

本文应用植物血凝素(PHA)检测了乌市维汉族学龄儿童的细胞免疫功能。结果表明,汉族儿童的PHA红斑直径均值高于维族,不论维汉族男女生均以9～10岁年龄段PHA红斑均值最大,并有随年龄增加而下降的趋势。同时对缺铁性贫血、生长发育水平及营养状况对细胞免疫功能的影响进行了初步探讨。