牛奶蛋白过敏致婴儿下消化道出血60例临床分析

目的 对牛奶蛋白过敏导致的婴儿下消化道出血进行临床资料分析,为早期诊断和有效治疗提供依据。方法 回顾性分析2014年1月-2016年5月深圳市儿童医院60例牛奶蛋白过敏导致婴儿下消化道出血的临床资料。结果 牛奶蛋白过敏致1~6月婴儿下消化道出血最多41例(68.33%),不同性别患儿年龄分布差异无统计学意义(χ²=1.371,P=0.242),人工喂养多见25例(41.67%);临床表现突然大便带鲜血或血丝46例(76.67%);实验检查IgG抗体增高48例(80%);电子肠镜检查:发现多发性结节增生(81.33%);病理检查表现慢性非特异性炎症,固有层嗜酸性粒细胞增多;回避牛奶蛋白治疗后,患儿治愈率情况:2周后治愈率比1周后治愈率明显增多,差异有统计学意义(P<0.05);4周后治愈率比2周治愈率两者比较,差异无统计学意义(P>0.05)。结论 牛奶蛋白过敏致婴儿下消化道出血,以1~6月人工喂养患者多见,IgG抗体升高可能参与了其机制,回避牛奶蛋白2-4周后未见缓解,需要考虑嗜酸粒细胞结肠炎引起可能。     

Risk as a relational phenomenon: a cross-cultural analysis of parents’ understandings of child food allergy and risk management

Western culture can be seen as permeated by risk-consciousness. In particular, parents are under scrutiny in their roles as risk managers. In this article, we address parental experiences of children more at risk than other children, children with food allergy, and the management of allergy risk in everyday life. Drawing on a notion of risk as ‘situated’ in local everyday life, we argue that a further exploration of parental understandings of child food allergy risk would benefit from an analysis of studies across different local contexts. In this article, we draw on a secondary qualitative cross-cultural analysis of interview data from several studies of parents in Sweden and Scotland through 2006–2010, which focused on parents’ understandings of the nature of food allergy and the children’s management of the allergy risk. We found some common themes in the different data sets. First, parents depicted food allergy as life-threatening, a ‘death risk’ lurking in the background, more or less constantly present in different everyday situations, amounting to an existential condition in parenting. Second, they talked about food allergy risk as a relational phenomenon, meaning that the risk emerged in the encounter between the young person’s individual competence to manage allergy risk and the understandings of allergy risk in others – thus depending on contexts and interaction between several actors. Finally, the analysis showed that unpredictability and risk in constant flux are the prominent aspects of living with food allergy. We also discussed the ways risk and trust are related, as well as how the involvement of others can be seen as both a risk and a safeguard.     

Prevalence of respiratory allergy in a platinum refinery

Summary In a cross-sectional study, 65 workers in the chemical industry with exposure to platinum salts were investigated with regard to the prevalence to allergic respiratory tract diseases. A respriatory questionnaire, a skin-prick test with K₂PtCl₆ and environmental allergens, determination of total IgE, platinum-specific IgE and histamine release in basophilic granulocytes and lung function tests were applied before and after a Monday shift and after a Friday shift. Work-related symptoms of respiratory allergy were present in 23% of all workers, but were significantly more frequent in the most exposed group in the platinum refinery (52.4%). Of all workers, 18.7% had a positive skin-prick test with platinum salt. As compared to the other workers, the workers with work-related symptoms of respiratory allergy had significantly more positive skin-prick tests (64.3%) and a higher total IgE and platinum-specific IgE; they did not, however, show higher histamine release. In the course of the week, a significant fall in lung function, namely in FEV₁ and FEF25, was recorded in the group of workers with work-related symptoms.     

IgE介导食物过敏和婴幼儿特应性皮炎的相关性研究

目的 探讨婴幼儿IgE介导的食物过敏和特应性皮炎(AD)的相关性.方法 选取2014年1月至2016年12月在济宁市第一人民医院皮肤科和儿科变态反应门诊确诊为AD的婴幼儿80例,年龄3个月至3岁.详细询问病史并填写食物过敏调查问卷,再行血清食物特异性IgE(sIgE)检测.除极高水平sIgE外,sIgE阳性患儿需要口服食物激发试验(OFCs),采用二元Logistic回归分析食物sIgE阳性分级对诊断食物过敏的影响.结果 26(32.50%)例AD患儿有食物过敏史或可疑食物过敏史.食物sIgE阳性38例,占总数的47.50%.不同程度的AD患儿在一种食物sIgE阳性和两种及以上食物sIgE阳性比较差异有统计学意义(χ2=12.88,P<0.05).其中极高水平sIgE(6级)5例.结合过敏史、sIgE阳性和OFCs,确诊食物过敏18例(鸡蛋12例、牛奶5例、鱼1例),总阳性率为22.50%.食物sIgE阳性分级越高,IgE介导的食物过敏发生率越高(Waldχ2=13.24,P<0.05,OR=2.81).结论 婴幼儿AD与IgE介导的食物过敏存在密切关联性.个人史和家族过敏史为诊断提供线索,sIgE分级为诊断提供有价值的参考,确诊需要OFCs.牛奶和鸡蛋是婴幼儿最常见的过敏原.     

Auditory event-related potential (P300) in relation to peripheral nerve conduction in workers exposed to lead, zinc, and copper: effects of lead on cognitive function and central nervous system.

By measuring auditory event-related potential (P300 and N100) and peripheral nerve conduction velocities, the subclinical effects of lead, zinc, and copper on the central and peripheral nervous system were examined in 22 male gun metal foundry workers exposed to these metals. Their blood lead (BPb) concentrations ranged from 12 to 59 micrograms/dl (median 30). Control subjects were 14 healthy workers, employed at the same factory, who had never been occupationally exposed to these metals. In the gun metal foundry workers, the latencies of P300 and N100 were significantly prolonged; the latency of P300 was significantly correlated with BPb concentrations and other indicators of lead absorption. Similarly, the maximal motor and sensory conduction velocities in the radial and median nerves were significantly slowed, and were significantly correlated with indicators of lead absorption. The data suggest that lead exposure at low levels affects cognitive and central auditory nervous system function together with peripheral nerve conduction.     

Heated Allergens and Induction of Tolerance in Food Allergic Children

Food allergies are one of the first manifestations of allergic disease and have been shown to significantly impact on general health perception, parental emotional distress and family activities. It is estimated that in the Western world, almost one in ten children have an IgE-mediated allergy. Cow’s milk and egg allergy are common childhood allergies. Until recently, children with food allergy were advised to avoid all dietary exposure to the allergen to which they were sensitive, in the thought that consumption would exacerbate their allergy. However, recent publications indicate that up to 70% of children with egg allergy can tolerate egg baked in a cake or muffin without apparent reaction. Likewise, up to 75% of children can tolerate baked goods containing cow’s milk, and these children demonstrate IgE and IgG4 profiles indicative of tolerance development. This article will review the current literature regarding the use of heated food allergens as immunotherapy for children with cow’s milk and egg allergy.     

Childhood Overweight/Obesity and Pediatric Asthma: The Role of Parental Perception of Child Weight Status

Childhood obesity and asthma are on the rise in the U.S. Clinical and epidemiological data suggest a link between the two, in which overweight and obese children are at higher risk for asthma. Prevention of childhood obesity is preferred over treatment, however, in order to be receptive to messages, parents must perceive that their child is overweight. Many parents do not accurately assess their child’s weight status. Herein, the relation between parental perceptions of child weight status, observed body mass index (BMI) percentiles, and a measure of child feeding practices were explored in the context of asthma, food allergy, or both. Out of the children with asthma or food allergy that were classified as overweight/obese by BMI percentiles, 93% were not perceived as overweight/obese by the parent. Mean scores for concern about child weight were higher in children with both asthma and food allergy than either condition alone, yet there were no significant differences among the groups in terms of pressure to eat and restrictive feeding practices. In summary, parents of children with asthma or food allergy were less likely to recognize their child’s overweight/obese status and their feeding practices did not differ from those without asthma and food allergy.     

硬质合金粉尘生物学作用的体外研究

本文应用体外细胞培养技术,通过测定豚鼠肺泡巨噬细胞培养液中乳酸脱氢酶活性、人胚肺二倍体成纤维细胞的DNA合成及扫描电镜观察,研究了我国有代表性的4种硬质合金粉尘的细胞毒性。结果表明,硬质合金粉尘可引起乳酸脱氢酶活性一定程度升高,和成纤维细胞DNA合成不同程度降低,以及细胞表面形态学改变,说明硬质合金粉尘具有一定的生物学作用,其细胞毒性明显低于二氧化硅粉尘。     

上海市康桥镇金属制造业职业伤害流行现况及影响因素分析

目的了解金属加工企业职工意外伤害发生现况及其影响因素,为开展意外伤害干预提供资料。方法采用随机整群抽样方法,抽取康桥镇5家企业共1921名职工,对其过去一年中发生职业意外伤害情况进行问卷调查。结果康桥镇金属加工企业职业伤害发生率为6．9％,男性高于女性,男性职工职业伤害随着年龄的增长而降低。在187例伤害事件中．主要伤害原因为锐物穿刺伤,构成比为47．1％;主要受伤部位为手指,构成比为43.3％。职业伤害的主要影响因素有年龄、性别、文化程度以及单位安全管理措施等。结论职业伤害在康桥镇金属制造企业流行情况比较普遍,需要加以干预。     

哈尔滨地区野生黄鼠脑组织中重金属含量检测

目的检测野生环境中黄鼠脑组织重金属铅、砷、汞含量。方法解剖分离捕获的哈尔滨道里、香坊2区13~24月龄野生黄鼠大脑组织,将大脑皮层和其他部分分离,应用原子荧光光度计检测大脑皮层组织内铅、砷、汞含量。结果 道里区野生黄鼠脑组织中的重金属铅、砷、汞含量分别为(49.4±32.5)、(46.7±28.5)、(4.271±1.786)μg/kg;香坊区野生黄鼠脑组织中重金属铅、砷、汞含量分别为(90.1±45.0)、(23.0±18.0)、(4.740±0.952)μg/kg;2区野生黄鼠脑组织内铅、汞含量差异无统计学意义(P>0.05);与香坊区比较,道里区野生黄鼠脑组织中砷含量较高,差异有统计学意义(P<0.05)。结论 哈尔滨地区野生黄鼠脑内可检出重金属铅、砷、汞,其负荷对环境重金属污染具有指示作用。