Génétique du déficit en C1 inhibiteur

C1 esterase inhibitor deficiency is an uncommon disorder characterized by recurrent episodes of angioedema without urticaria, abdominal pain attacks, and life-threatening upper airway obstruction. C1 inhibitor is a serine protease inhibitor that inactivates several different proteases in the complement, contact, coagulation, and fibrinolytic systems. Diagnosis requires careful medical and family history and the measurement of antigenic and functional C1 inhibitor and C4 levels. Inherited C1 inhibitor deficiency is usually transmitted as an autosomal dominant trait and detected during the first or second decades of life. More than 200 mutations have been described (deletion, missense mutations, splice site mutations, stop codon mutations).     

烧伤休克期有关补液公式的临床应用与评价

目的 评价第三军医大学烧伤休克期补液公式(简称三医大公式)在大面积烧伤患者休克防治中的应用.方法 选择2005-2007年笔者单位收治的热力烧伤患者(烧伤总面积大于或等于30%TBSA、伤后8 h内入院且无特殊疾患)共71例,分为成人组(46例)、小儿组(25例).患者入院后即按照三医大公式进行液体复苏治疗,同时监测尿量、心率、血压等指标,根据患者实际情况随时调整补液速度.记录并统计2组患者补液量、实际补液系数、尿量. 结果 71例患者均平稳度过休克期,未发生明显的因液体复苏引起的相关并发症.成人组伤后第1、2个24 h及小儿组伤后第2个24 h的实际补液量超过各自计划补液量的16%～38%.成人组第1、2个24 h的实际补液系数大于公式所要求的补液系数.2组患者第1个24 h尿量为1.1～1.2 mL·kg-1·h-1左右;第2个24 h成人组为(1.2±0.4)mL·kg-1·h-1,小儿组为(1.7±0.5)mL·kg-1·h-1. 结论 三医大公式是大面积烧伤患者休克期治疗的较好选择,在应用此公式时须强调进行个性化液体复苏治疗.     

Induction de tolérance orale aux aliments chez l’enfant : aspects pratiques

Specific oral tolerance induction (SOTI) to food is a new topical-therapeutic approach of food allergy. When successful, it improves significantly the patients’ quality of life. SOTI’s practical aspects for child are discussed from our recent experience concerning cow milk, hen’s egg and wheat. Family’s motivation and education are crucial questions to achieve SOTI correctly. A detailed information of possible side effects is essential.     

晋京两地护理学硕士研究生择业效能感比较研究

目的：了解晋京应届、非应届护理研究生择业效能感情况,探讨不同年龄、年级、城市学生间的差异。方法：运用“择业效能感问卷”,结合深度访谈法。结果：应届生、非应届生年龄比较结果均有统计学差异（P〉0.05）;应届生年级和城市两因素存在交互效应（P〈0.01）;非应届生不同年级、城市学生择业效能比较结果均有统计学差异（P〈0.01）。     

Effets physiopathologiques des mélanges de pesticides

Pesticides are considered as risk factors for human health. Indeed, epidemiological studies often show a positive correlation between occupational exposure and the risk of developing diseases for users and/or their descendants. The exposure of the general population is different from the exposure of professionals. Indeed, the consumer is exposed through the diet to mixtures of pesticides at low doses and during a long-term period. Now the question raised is what may be the impact of such an exposure on the health of consumers or their descendants. The hypothesis that compounds at doses corresponding to their No Observable Adverse Effect Level (NOAEL), which act via different mechanisms of action, could not exert an effect even when they are present in combination is today rebutted. Studies on endocrine disrupters or on pesticides mixture in general, as we develop in our laboratory, show that the effects of mixtures cannot be predicted from the effect of the single molecule. The effects of mixtures can be cumulative, antagonistic, additive or synergistic depending on the function or the parameter of the studied physiological function. Even if it is difficult to evaluate experimentally all possible combinations to which consumers may be exposed, it is essential to evaluate the effects of representative mixtures for a better understanding of the risk assessment of consumers.     

Impact des activités sédentaires sur la prise alimentaire des jeunes

Sedentary behavior has progressed with modern society, generating very low levels of energy expenditure and subsequent body weight disorders (obesity). There is also evidence that the absence of physical activity associated with short sleep time and watching television or playing video games leads to poor eating habits and favors high-energy intake. These findings have generally been reported in adults, with a few studies including data on children and adolescents. This brief review summarizes the current literature regarding the impact of such activities on food consumption and eating behavior in children and adolescents. There appears to be an uncoupling effect dissociating these activities from the sensation of hunger and thus energy intake. Children and adolescents seem to increase their energy intake during and after such activities without any alteration of their subjective appetite. In addition to considering the impact of sedentary behavior and physical activity level, future public health recommendations should also focus on associated nutritional adaptations (energy balance).     

La diversification alimentaire

The transition between full breastfeeding and introduction of a diversified diet, adult type, conferring to the child feeding autonomy must take place around the 6^th month of age. Until this age, exclusive breastfeeding is now advocated by WHO. When the child is formula fed, the same delay should be respected before introducing solid foods. In any case, diversification should not occur before completion of the 4^th month of life. Family habits and traditions, if in accordance with these global recommendations, may nonetheless be respected in the parents’choices concerning food diversification. Food diversification allows the child to learn new textures, new tastes and new feeding modes, thus providing education to feeding variety, an essential component in the nutritional prevention of degenerative diseases.     

Acceptability of Elderly Cancer Patients and Tolerance to COVID-19 Vaccination in the Brittany Region<br/>L’acceptabilité du Patient Âgé Porteur de Cancer et la Tolérance à la Vaccination Anti-COVID-19 dans la Région Bretagne

Context: Since January 2021, vaccination for COVID-19 has been made possible in France for people aged 75 and over. Patients suffering from a cancer disease are part of a group at risk to develop severe complications to COVID-19. Method: The « Unité de coordination en Onco-Gériatrie région Bretagne » (the Brittany This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Coordinating Unit in Onco-Geriatrics) has wished to set up an inquest about the acceptability and the tolerance to COVID-19 vaccination by old-aged patients suffering from cancer in the Brittany region. Results: The study has been carried out between May 1, 2021 and August 31, 2021 in 7 Breton centers. 50 patients have been included in the study with an average age of 84 (72-93). At the time of inclusion, 43 patients had already been vaccinated (80% having had 2 injections and 8% only one). Among them, 86% have declared they had had a very good tolerance to the first injection of the vaccine, and 90% to the second injection. 12% of the patients had not been vaccinated. Conclusion: Overall, in our study, old-aged patients suffering from cancer haven’t been reluctant to the antiCOVID-19 vaccination and have shown a very good tolerance to these vaccines. However, seen the profile of these patients and the period of inclusion, the number of patients showing a complete vaccinal outline should have been more consistent, indeed even total.

RÉSUMÉ
Contexte: Depuis le 25 janvier 2021, la vaccination de la COVID-19 a pu être réalisée en France auprès des personnes âgées de 75 ans et plus. Les patients souffrant d’une maladie cancéreuse font partie des groupes à risque de développer des complications sévères à la COVID-19. Méthode: L’Unité de Coordination en Onco-Gériatrie région Bretagne a souhaité mettre en place une enquête sur l’acceptabilité du patient âgé porteur de cancer et sur la tolérance à la vaccination anti-COVID 19 dans la région Bretagne. Résultats: L’étude a été réalisée entre le 1^er mai 2021 et le 31 août 2021 dans 7 centres bretons. 50 patients ont été inclus avec un âge médian de 84 ans (72–93). 43 patients au moment de l’inclusion avaient été vaccinés (80% ayant eu 2 injections et 8% une seule injection). Parmi eux, 86% ont déclaré avoir eu une très bonne tolérance à la première injection du vaccin et 90 % à la seconde injection. 12% des patients n’étaient pas vaccinés. Conclusion: Globalement, dans notre étude, les patients âgés porteurs de cancer ne présentaient pas de réticence à lavaccination anti-COVID19 et ont eu une très bonne tolérance à ces vaccins. Cependant, au vu du profil de ces patients et de la période d’inclusion, le nombre de patients présentant un schéma vaccinal complet aurait pu être plus conséquent.     

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重症急性胰腺炎相关诊治指南制定的目的就是为了规范其诊治过程,在复杂多变的病程中能够选用相应的对策。解读基于临床的诊治指南,关键在于对其正确、正面地理解,这样才能对临床起至指导和帮助作用。实施急性胰腺炎的治疗应根据急性胰腺炎的特点,全面考虑。