布拉酵母菌治疗婴幼儿轮状病毒肠炎随机对照临床观察

目的 探讨布拉酵母菌治疗婴幼儿轮状病毒（RV）肠炎的疗效.方法 采用前瞻性随机对照研究方法,将78例RV肠炎患儿随机分为治疗组和对照组,两组在口服蒙脱石混悬液及补液对症治疗基础上,治疗组给予布拉酵母菌散剂口服,对照组给予枯草杆菌二联活菌颗粒口服.72 h后观察两组疗效及不良反应.结果 治疗组退热、止泻及脱水纠正时间均小于对照组（P＜0.05）,总有效率治疗组（91.67％）高于对照组（81.82％）（P＜0.05）.两组均未发现药物相关不良反应.结论 布拉酵母菌治疗婴幼儿轮状病毒肠炎疗效满意,安全性好.     

中药保留灌肠配合推拿治疗小儿腹泻病疗效观察

观察中药保留灌肠配合推拿治疗小儿腹泻病的疗效.方法：辨证论治采取不同的中药方剂煎液后保留灌肠,并配合不同的推拿手法以分型治疗小儿腹泻病.结果：治疗组120例,痊愈104例,显效14例,无效2例,总有效率98.3%;对照组120例,痊愈50例,显效40例,无效30例,总有效率75.0%.两组疗效经统计学处理有显著差异（P〈0.05）,表明中药保留灌肠配合推拿治疗小儿腹泻病疗效显著,值得在临床上推广使用.     

周耀庭教授辨治小儿哮喘用药经验总结

总结周耀庭教授临证辨治小儿哮喘的用药经验。提出消除伏痰,审因论治,贯穿始终除夙根的治疗思路,强调辛散解表,宣肺散寒,祛除闭肺之诱因的重要性;病机是本虚邪实,治疗应攻补兼施,单纯补益不可取;处方须配伍化痰逐饮,降气平逆之品,则肃降肺气平喘逆之功益增;注意病有兼夹,随证治之,照顾儿童生理特点;提倡综合治疗,坚持用药,巩固疗效防复发的观点。     

5%咪喹莫特乳膏联合普萘洛尔治疗婴幼儿血管瘤42例疗效观察

目的 观察5％咪喹莫特乳膏联合普萘洛尔治疗婴儿血管瘤的疗效和安全性.方法 将入选的122例患者随机分成3组,治疗组42例予普萘洛尔2.0 mg/（kg·d）口服,分3次餐后口服,同时每周3次外用5％咪喹莫特乳膏;对照Ⅰ组39例单纯口服普萘洛尔2.0 mg/（kg· d）,分3次餐后口服;对照Ⅱ组41例单纯每周3次外用5％咪喹莫特乳膏.疗程均为6个月.结果 治疗结束后,治疗组有效率为95.24％,对照Ⅰ组有效率为79.49％,对照Ⅱ组有效率为39.02％,治疗组与对照Ⅰ组、对照Ⅱ组对比,差异均有统计学意义（P＜0.05）,不良反应发生率与2组对照组比较差异无统计学意义.结论 普萘洛尔联合5％咪喹莫特乳膏治疗婴儿血管瘤安全有效.     

温肺化痰饮治疗小儿咳嗽变异性哮喘随机平行对照研究

[目的]观察温肺化痰饮治疗小儿咳嗽变异性哮喘疗效。[方法]使用随机平行对照方法,将84例住院患者按抽签法随机分为两组。对照组42例氨茶碱缓释片,0.1~0.2g/次,早晚口服。治疗组42例温肺化痰饮(法半夏、炙麻黄、桂枝、甘草各3g,杏仁、陈皮、茯苓各10g,紫草、紫苑各8g,矮地茶6g),1剂/d,水煎400mL,早晚口服。连续治疗7d为1疗程。观测临床症状、不良反应。治疗1疗程,判定疗效。[结果]治疗组痊愈6例,显效23例,有效7例,无效6例,总有效率85.71%。对照组痊愈1例,显效14例,有效13例,无效14例,总有效率66.67%。治疗组疗效优于对照组(P0.05)。[结论]温肺化痰饮治疗小儿咳嗽变异性哮喘效果显著,值得推广。     

广西汉族婴幼儿皮肤血管瘤与HLA-DRB1等位基因的相关性研究

目的:探讨HLA-DRB1等位基因多态性与广西汉族婴幼儿皮肤血管瘤的遗传相关性。方法:将广西汉族88例婴幼儿皮肤血管瘤患者(病例组)和105例正常汉族婴幼儿(对照组)作为研究对象。采用聚合酶链反应-序列特异性引物分型技术对两组HLA-DRB1等位基因进行分型,SPSS软件进行统计分析。结果:病例组HLA-DRB1*16等位基因频率为28.98%,明显高于对照组的14.76%(RR=3.29,P<0.05);病例组HLA-DRB1*1401等位基因频率为6.82%,明显低于对照组的16.67%(RR=0.32,P<0.05)。结论:HLA-DRB1*16可能为广西汉族婴幼儿皮肤血管瘤的易感基因。而HLADRB1*1401可能为其保护基因。     

Oligonucleotide ligation assay: applications to molecular diagnosis of inherited disorders

Oligonucleotide ligation assay combined with polymerase chain reaction (PCR-OLA) is a technique which can be used for the detection of characterized sequence variations. In the present study, new PCR-OLA methods were developed for the detection of the major mutations causing infantile neuronal ceroid lipofuscinosis (INCL_Fin), congenital nephrotic syndrome of Finnish type (NPHS1 Fin_Major and Fin_Minor) and medium chain acyl-CoA dehydrogenase deficiency (MCAD A985G). The prevalence of these mutations in the Finnish population was studied by analyzing blood samples collected in eastern Finland. The throughput of PCR-OLA was further enhanced by optimizing the direct use of dried blood spot (DBS) specimens for PCR. This study demonstrated that PCR-OLA is an accurate method for the detection of gene defects causing inherited disorders. With automation, PCR-OLA can be applied for routine diagnosis and for carrier screening from a large number of specimens.     

婴儿湿疹相关风险因素调查分析

目的了解接种疫苗后婴儿湿疹(IE)的相关风险因素。方法通过问卷调查方法对婴儿预防接种人群中IE相关因素进行分析,并对其皮肤的糠秕马拉色菌和细菌定植进行检测。结果 IE组和对照组各纳入30例。接触多尘或花粉,IE组明显低于对照组(P=0.000);喂养方式,IE组母乳喂养比率明显高于对照组(P=0.015);接种疫苗后出现皮疹,IE组高于对照组(P=0.028);糠秕马拉色菌镜检,IE组面部及背部糠秕马拉色菌阳性率均高于对照组(P=0.020);IE组皮损细菌培养阳性率明显高于对照组(P=0.001),且金黄色葡萄球菌培养阳性率也明显高于对照组(P=0.020)。以上差异均有统计学意义。结论接种疫苗有不良反应(尤其是有皮疹出现),经常接触粉尘或花粉等吸入性变应原、金黄色葡萄球菌和糠秕马拉色菌的皮肤定植等因素可能与婴儿湿疹有关。     

丙种球蛋白辅助治疗对重症肺炎合并心力衰竭患儿预后的改善效果

目的分析丙种球蛋白辅助治疗对重症肺炎合并心力衰竭患儿预后的改善效果。方法选取2017年5月-2018年10月湖州市南浔区人民医院收治的重症肺炎合并心力衰竭患儿80例,采用随机数字表分为观察组和对照组,每组40例患儿。两组患儿均进行常规治疗,观察组在对照组基础上给予丙种球蛋白治疗。比较两组患儿的疗效,IgG水平,T细胞亚群CD4⁺、CD8⁺及CD4⁺/CD8⁺水平,阳性症状、体征的缓解时间及住院时间。结果观察组患儿有效率为95.00%,显著高于对照组患儿的72.50%(P<0.05)。治疗后,观察组患儿IgG、CD4⁺、CD4⁺/CD8⁺水平显著高于对照组患儿(均P<0.05),CD8⁺水平显著低于对照组患儿(P<0.05)。治疗后,观察组患儿IgG、CD4⁺、CD4⁺/CD8⁺水平显著高于治疗前(均P<0.05),CD8⁺水平显著低于治疗前(P<0.05)。观察组患儿阳性症状、体征的缓解时间及住院时间均显著短于对照组患儿(均P<0.05)。结论丙种球蛋白辅助治疗可提高重症肺炎合并心力衰竭患儿的疗效,增强患儿免疫功能,减轻阳性症状与体征,缩短住院时间,改善预后,值得临床推广。     

The VASCERN-VASCA working group diagnostic and management pathways for severe and/or rare infantile hemangiomas

The European Reference Network on Rare Multisystemic Vascular Diseases (VASCERN), is dedicated to gathering the best expertise in Europe and provide accessible cross-border healthcare to patients with rare vascular diseases. Infantile Hemangiomas (IH) are benign vascular tumors of infancy that rapidly growth in the first weeks of life, followed by stabilization and spontaneous regression. In rare cases the extent, the localization or the number of lesions may cause severe complications that need specific and careful management. Severe IH may be life-threatening due to airway obstruction, liver or cardiac failure or may harbor a risk of functional impairment, severe pain, and/or significant and permanent disfigurement. Rare IHs include syndromic variants associated with extracutaneous abnormalities (PHACE and LUMBAR syndromes), and large segmental hemangiomas. There are publications that focus on evidence-based medicine on propranolol treatment for IH and consensus statements on the management of rare infantile hemangiomas mostly focused on PHACES syndrome. The Vascular Anomalies Working Group (VASCA-WG) decided to develop a diagnostic and management pathway for severe and rare IHs with a Nominal Group Technique (NGT), a well-established, structured, multistep, facilitated group meeting technique used to generate consensus statements. The pathway was drawn following two face-to-face meetings and in multiple web meetings to facilitate discussion, and by mail to avoid the influence of most authoritative members.The VASCA-WG has produced this opinion statement reflecting strategies developed by experts and patient representatives on how to approach patients with severe and rare IH in a practical manner; we present an algorithmic view of the results of our work.