Ventilatory anaerobic threshold in healthy children

Summary The ventilatory anaerobic threshold (VAT) during graded exercise was defined as the oxygen uptake ( ) immediately below the exercise intensity at which pulmonary ventilation increased disproportionally relative to . Since VAT is considered to be a sensitive and noninvasive measure for evaluating cardiorespiratoy endurance performance, the purpose of the present study was to determine normal values in children. We examined 257 healthy children (140 boys and 117 girls) varying in age from 5.7 to 18.5 years, during treadmill exercise. The data were analyzed in relation to sex and age. In boys the lowest (ml · min⁻¹ · kg⁻¹) was found in the youngest age group (5–6 year). In girls, on the other hand, no significant increase occurred with age. For VAT, expressed as ml O₂ · min⁻¹ · kg⁻¹ or as a percent of a significant decrease was found in boys and girls with age. This suggests an increase in lactacid anaerobic capacity during growth. In contrast to observations in adults, only low correlations were found between and VAT (r=0.28 in boys and r=0.52 in girls), which suggests that the development of the underlying physiological mechanism does not occur at the same rate in growing children. These data provide normal values for VAT that can be used for clinical exercise testing in the pediatric age group.     

小儿重症哮喘多因素回归分析

应用电脑对111例儿童哮喘50项指标进行多因素逐步回归分析,把发作时喘憋严重,平时也有不同程度的喘息症状患儿列入小儿重症哮喘,与非重症哮喘比较,结果显示夜间喘、急性发作持续天数、非特异性刺激诱发、间歇期症状、发绀、呼吸困难、入院后激素治疗、中性粒细胞、IgA、pH、哮喘持续状态等11个因素入选重症哮喘回归方程,表明这些因素与小儿重症哮喘相关,提出儿童哮喘危险信号的临床指标。     

儿童原发性夜间遗尿症生理心理治疗的疗效及随访评估

目的应用生理心理治疗观察儿童原发性夜间遗尿症(PNE)的临床远期疗效,并探讨其治疗机制。方法对2004年9月至2006年1月在上海交通大学医学院附属上海儿童医学中心发育行为儿科应用生理心理治疗PNE患儿的资料进行回顾性分析,治疗中2周随访1次(随访观察6个月),治疗结束后1个月随访1次,家长每日记录患儿遗尿频率和夜间自行起床排尿次数。B超测定治疗前和治疗结束时最大憋尿状态下的膀胱容量。统计分析生理心理治疗的远期疗效,遗尿频率、膀胱容量以及夜间自行起床排尿次数的变化情况,采用Logistic回归分析影响生理心理治疗远期疗效的危险因素。结果研究期间应用生理心理治疗的68例PNE患儿远期疗效为:治愈43例(63.2%),显效18例(26.5%),部分有效5例(7.4%),无效2例(2.9%)。治疗前平均遗尿频率为每周(6.12±1.32)次,停止治疗6个月后遗尿频率为每周(1.23±0.18)次(t=2.65,P=0.011)。治疗前平均夜间自行起床排尿次数为每周(0.72±0.15)次,停止治疗6个月后平均夜间自行起床排尿次数为每周(6.83±1.16)次(t=2.25,P=0.026)。治疗前患儿平均膀胱容量/...     

Transmission of HIV-1 infection between trophoblast placental cells and T-cells take place via an LFA-1-mediated cell to cell contact

HIV-1 vertical transmission is thought to mainly take place by virus crossing the placental barrier. However, the mechanism by which HIV-1-infects placental cells remains to be elucidated. We have found that purified cytotrophoblasts as well as trophoblastic cell lines are susceptible to infection by different HIV-1 isolates as detected by DNA-PCR and release of infectious virus, although with very low efficiency. Purified trophoblast or trophoblastic cell lines express low levels of chemokine receptors CCR-5 and CXCR-4 but not CD4 on the cell surface. To test if those molecules were used as receptors for HIV-1 infection, placental cells were pretreated with antibodies to CD4, CC-chemokines, C-X-C chemokines. None of those treatments inhibited HIV-1 infection. In contrast, we have found that HIV-1 infection of placental cells was increased in cocultures of infected T-cell blasts and placental cells. More interestingly, antibodies to beta(2) integrins and to LFA-1 were able to significantly block infection of placental cells. Cell surface expression of ICAM-1, an adhesion molecule involved in attachment of leukocytes to placenta, was upregulated in HIV-1-infected placental cells. Placental cells were able to transfer HIV-1 infection to T-cell blasts. This transmission required cell to cell contact and was also inhibited by anti-LFA-1 antibodies. In summary our results suggest that placental trophoblast could be infected by HIV-1 by a mechanism involving T cell to placental contact. Moreover, placental infection enhanced ICAM-1 expression and leukocyte adherence, an event which was required to transfer HIV-1 infection to T cells. This provides an explanation of the virus passing through the placental barrier during in utero HIV-1 vertical transmission.     

小学生中抑郁症状现况调查

目的：初步了解儿童中抑郁障碍的患病现况，探讨儿童抑郁的常见表现。方法：使用儿童抑郁自评量表(DSRSC)调查长沙市某小学二年级到六年级的565名小学生，并对量表总分≥划界分的学生进行面谈。结果：在565名小学生(男生290名，女生275名)中，量表总分≥划界分的有97名，占总人数的17．17％。使用CCMD-3成人抑郁发作的诊断标准对量表总分≥划界分的93名进行了面谈(面谈率为95．90h，)，发现符合抑郁发作的症状学标准的有38名(其中男生28名，女生10名)，占面谈者的40．9％，无一名达到病程标准和严重程度标准。结论：在儿童中抑郁症状存在较普遍，但真正构成抑郁症临床诊断的极少。     

Undifferentiated Carcinoma of the Parotid Gland in a 10-Month-old Child

Malignant salivary gland tumors in children are very rare. This report describes the autopsy of a child with parotid gland cancer. The patient, a 10 month old girl, was admitted to the Nagoya First Red Cross Hospital with facial nerve palsy. lncisional biopsy of a post-auricular tumor was performed, and undifferentiated carcinoma was diagnosed. The patient died 6 months later of respiratory failure due to pulmonary lymphangitis carcinomatosis. Light and electron microscopic and immunohistochemical examinations of the tumor tissue were performed. The tumor cells were arranged in a medullary, sheet-like manner. Keratinization or mucus lakes were not observed. PAS-alcian blue staining demonstrated intracytoplasmic mucus as granules, and also small intercellular droplets of mucus that might otherwise have been unnoticed. Ultrastructurally, some of the tumor cells had tonofilament-like keratin filaments, and also small hollow spaces bounded by microvilli and containing secretory particles. These were stained by antisera against CEA and keratin. These findings are suggestive of differentiation to mucoepider-moid carcinoma. We also review and discuss malignant salivary tumors of epithelial origin in children. Acta Pathol Jpn 40: 149–152, 1990.     

Validity of heart rate and ratings of perceived exertion as indices of exercise intensity in a group of children while swimming

Summary The purpose of this study was to investigate the validity of heart rate (f _c) and ratings of perceived exertion (RPE) as indices of exercise intensity in a group of children while swimming. Six healthy male swimmers, aged 10–12, swam tethered using the breast-stroke in a flume. The resistance started at 1.0 kg and increased in 1.0 kg steps up to the point of their exhaustion. The subjects swam for 5 min during each period, with a rest of 10–20 min until they had returned to their resting f _c level. The last exercise intensity was with the maximal mass the subjects could support for 2 min. The last min of oxygen consumption (VO₂) and 30 s of f _c were measured during each exercise period. The subjects gave their RPE assessment at the end of exercise.The individual relationships between f _c and VO₂, and percentage maximal oxygen consumption (% VO_2max, were linear with a high correlation r=0.962–0.996 and r=0.962–0.996, respectively. Therefore, it was concluded that f _c was valid as an index of the exercise intensity of children while swimming. Compared to the results found in adults using a similar protocol, the children's f _c were 8.3–26.9 beats·min^–1 higher than those of the adults at the given % VO_2max. The present study showed two different patterns in the relationship between VO₂ and RPE in individuals. In two subjects the RPE increased linearly with VO₂ while in the other four subjects the increase was discontinuous. If f _c and RPE were to be applied to the setting and evaluation of exercise intensity during swimming, it would seem that f _c would be a more useful guide than RPE for some children.     

In vivo and in vitro correlates of food allergy.

Sera of 86 patients clinically sensitive to foods were tested by passive sensitization of human and/or monkey lung (127 tests) and the radioallergosorbent test (RAST) (72 tests), using whole-food antigens; the results were compared with skin (prick) testing. Results of the prick test correlated with history in 76% of cases; lung sensitization correlated with history in 37% and with prick test in 57%; and RAST correlated with history in 54% and prick test in 72%. It is concluded that a very large percentage of adverse reactions to foods are IgE-mediated. The prick test is of use in diagnosis, particularly when combined with RAST; the lung sensitization test is technically impractical and not a reliable indicator. The best diagnostic method is careful history with food challenge and withdrawal and rechallenge; the latter is safe except in patients with a history of violent reaction.     

广西三江县侗族青少年头发中9种元素的含量

目的　确定广西三江县侗族青少年头发中 9种人体必需元素含量的正常值。方法　用偏振塞曼原子吸收仪 ,检测了来自三江县的 993名 7～ 16岁中小学生头发中镍、硒、钴、铬、铁、锌、钙、铜和镁 9种人体必需元素的含量 ,并用SPSS统计软件进行统计分析。结果　广西三江县侗族中小学生头发中 ,镍、硒、钴、铬、铁、锌、钙、铜和镁 9种人体必需元素的含量没有性别差异 ;硒、铬、铁、锌、钙和铜与年龄呈负相关 ;制订了镍、硒、钴、铬、铁、锌、钙、铜、镁 9种元素的头发含量的正常值范围。结论　广西三江县中学生头发中硒、铬、铁、锌、钙和铜含量有明显年龄差异 ,而镍、钴和镁却没有年龄差异。     

中学生对立违抗性障碍的父母养育方式和家庭环境特征的初步研究

目的：了解单纯对立违抗性障碍（ODD）儿童的父母养育方式及家庭功能。方法：应用向制儿童行为调查表、家庭环境量表中文版（FES～CV）、父母养育方式量表（EMBU），对115例单纯ODD儿童（研究组）和115名非ODD正常儿童（对照组）进行评定和病例对照分析，结果：ODD组儿童家庭矛盾性得分较对照组高（P〈0．01），ODD组父母双亲的“情感温暖．理解”得分均明显比对照组得分低（父亲P〈0．01，母亲P〈0.05）．而其“惩罚，严厉”和“拒绝，否认”二因子得分则明显比对照组高（P〈0．01）；ODD组母亲的“过分干涉，过度保护”，因子得分也明显高于对照组（P〈0．01）。结论：ODD中学生的家庭存在高度的矛盾性．他们的父母养育方式不良，应引起重视。