血清超敏C反应蛋白在小儿麻疹并肺炎中的临床意义

目的 探讨血清超敏C反应蛋白(Hs-CRP)在小儿麻疹并肺炎中的临床意义.方法设188例麻疹并发肺炎的住院患儿为观察组,156例无并发症的麻疹住院患儿为对照组,比较两组患儿在出疹期及恢复期的血清Hs-CRP水平.结果 麻疹出疹期血清Hs-CRP值:观察组为(79.56±14.89)mg/L,对照组为(6.35±4.08)mg/L,两组Hs-CRP水平差异有显著性(t=24.45,P=0.001).观察组出疹期有163例患儿血清Hs-CRP值为10～<100 mg/L,其中重症肺炎14例(8.59%);15例患儿血清Hs-CRP值≥100 mg/L,其中重症肺炎13例(86.67%),不同Hs-CRP值组重症肺炎构成比比较,差异有显著性(χ2=59.15,P=0.005).进入恢复期后,两组患儿血清Hs-CRP水平均在正常范围.结论 小儿麻疹出疹期并发肺炎时血清Hs-CRP明显增高,进入恢复期即降至正常;血清Hs-CRP是判断小儿麻疹并发肺炎及病情程度的指标之一.     

穴位注射氟哌啶预防输卵管结扎术中牵拉反应200例

穴位注射氟哌啶预防输卵管结扎术中牵拉反应２００例王海波，李萍我们在局部麻醉的基础上，结合内关穴注射氟哌陡，以预防输卵管结扎术中牵拉反应及术中术后患者的恶心、呕吐症状，取得了满意效果。现报告如下。临床资料１９９５年２月～１９９５年１２月，对在我科门诊准...     

小儿泻速停冲剂治疗秋季腹泻101例

小儿泻速停冲剂治疗秋季腹泻１０１例福建省三明市第三医院儿科（福建３６５００１）潘用再小儿泻速停冲剂（简称泻速停）是治疗小儿腹泻病新药，对各种小儿腹泻具有快速止泻作用。为进一步验证该药对小儿秋季轮状病毒性腹泻的疗效，我们于１９９３年１０～１２月使用该药...     

肺炎时维生素A的检测及其意义

目的探讨小儿肺炎对维生素Ａ的变化及其意义。方法肺炎患儿２６例，男１４例．女１２例，健康对照组３０例。于肺炎极期和肺炎恢复期分别取血，采用荧光法，专人检测维生素Ａ含量，与对照组血维生素Ａ含量进行比较，同时分析肺炎过程中维生素Ａ变化的特征。结果肺炎极期患儿血维生素Ａ含量较对照组显著下降；恢复期维生素Ａ含量回升．结论肺炎时存在亚临床维生素Ａ缺乏现象，炎症使维生素Ａ消耗增加．     

The impact of a catastrophic earthquake on morbidity rates for various illnesses

It has been reported that some natural catastrophes increase morbidity rates for illness. In this study, we investigated the impact of the 1995 Hanshin-Awaji earthquake on morbidity rates for various illnesses by analysis for correlations between the extent of damage due to the earthquake and occurrences of various illnesses. We searched the medical records of 1948 patients hospitalized due to illness in 48 hospitals during the first 15 days after the earthquake. In each of 14 affected areas, the hospital admission rate and estimated morbidity ratio for each illness were calculated. Destruction ratios were determined based upon the number of dwellings completely destroyed in each area. For total illnesses and each major illness, linear regression analyses were performed comparing hospital admission rates, estimated morbidity ratios, and destruction ratios. Hospital admission rates and estimated morbidity ratios among the 1948 patients were significantly correlated to destruction ratios. With pneumonia, dehydration, acute heart failure, asthmatic attack, and peptic ulcer, hospital admission rates and estimated morbidity ratios were significantly related to destruction ratios, while no significant correlations between estimated morbidity ratios and destruction ratios existed for cerebral vascular disease or ischemic heart disease. Peptic ulcer and pneumonia showed especially high correlation values (age- and sex-adjusted R2>0.7). The present study revealed a strong link between the extent of damage due to the catastrophic earthquake and an increase in morbidity rates for acute illnesses, especially peptic ulcer and pneumonia.     

超微量肝素对婴幼儿重症肺炎并充血性心力衰竭的治疗研究

研究目的 探讨超微量肝素对婴幼儿重症肺炎并充血性心力衰竭的治疗作用。 研究方法 重症肺炎并充血性心力衰竭患儿40例,男21例,女19例,年龄6个月至2岁,随机分为超微量肝素治疗组(20例)和对照组(20例)。在一般性治疗基础上,治疗组加用肝素,每小时腹壁皮下缓慢注射一次,每次每公斤体重1单位(1mg=125单位),疗程为1～3天。 治疗结果 超微量肝素治疗组和对照组症状、体征恢复正常的时间有显著差异。两组中烦躁、面色改变、心率、心音、呼吸困难、肝肿大、尿量、下肢浮肿、心脏增大等恢复正常的时间分别为4.20±1.28小时比5.50±1.28小时(P<0.001)、7.10±1.41比10.10±2.07小时(P<0.001)、 4.40±1.05比5.18±1.21小时(P<0.05)、2.08±0.57比2.86±0.72小时(P<0.001)、4.06±0.91比4.96±0.72小时(P<0.005)、10.10± 1.14比11.20± 2.02小时(P<0.05)、10.20±1.54比11.53±1.97小时(P<0.001)、10.13±1.31比11.45±1.74小时(P<0.01)、21.60±7.39比23.40±7.26小时(P<0.001)。 研究结论 超微量肝素治疗婴幼儿重症肺炎合并充血性心力衰竭有效。     

Failure of calcitriol treatment in a patient with malignant osteopetrosis

In an attempt to stimulate bone resportion, a 10-week-old infant with malignant infantile osteopetrosis was treated with high doses of calcitriol, a potent bone resorption stimulatory agent, combined with a low calcium diet to prevent hypercalcaemia. Although calcitriol administration was initiated at this very young age, our patient did not show any clinical, radiological, or histological improvement. Despite reports of positive results of this treatment in the literature, our patient did not reveal any signs of bone resorption. She eventually died from the complications of osteopetrosis at the age of 6 months after 88 days of therapy.     

Eosinophil cationic protein in nasopharyngeal secretions and serum of infants infected with respiratory syncytial virus

Eosinophil cationic protein (ECP) was assayed in nasopharyngeal secretion (NPS) and serum from 42 infants, hospitalized with acute lower respiratory infection, in El Salvador and the results analyzed in relation to etiology of the infection. ECP concentrations were high in NPS, at an average 50 times higher than those found in serum. Exceedingly high levels of ECP (> 1000 μg/L) were found more frequently in wheezing than in non-wheezing children (30% vs 7%) and, accordingly, were more commonly found in children hospitalized with bronchiolitis than in those with pneumonia. Excessive levels were significantly more common in girls than in boys. Of the 42 cases, 28 were found to be caused by respiratory syncytial virus (RSV) subgroup A, and 3 by RSV-B, by means of detection of RSV antigen in nasopharyngeal cells. ECP serum levels were moderately elevated during the acute phase of the respiratory infection and increased slightly but significantly, in cases with RSV antigen-positive bronchiolitis, but not in those with pneumonia. The ECP levels in NPS from patients in Sweden who, by antigen detection in NPS cells, were diagnosed as either RSV or para-influenza 3 infection or none of these, were similar. These results indicate that elevation of ECP in NPS is associated with acute lower respiratory infection in general, but particularly pronounced in cases of bronchiolitis. Elevation of ECP is not an exclusive consequence of RSV infection, but may occur to an equal extent in infections caused by other agents. Girls generally seem to be less prone than boys to developing airway obstruction and may, therefore, acquire severe bronchiolitis only when large amounts of inflammatory mediators, such as ECP, accumulate in the airways.     

Dietary modifications versus dicyclomine hydrochloride in the treatment of severe infantile colics

This study examined 120 infants, aged 3–12 weeks, with severe colics and compared the results of a specific hypoallergenic diet (group A) with those of pharmacological treatment (group B). Non-breastfed group A infants received soy milk and if unresponsive, hydrolyzed milk formulas; mothers of breast-fed infants received a diet without cow's milk, eggs or fish. Breast-fed and non-breast-fed group B infants received dicyclomine hydrochloride 3 mg/kg/day. Results, based on quantitative measurements of crying. indicated that in breast-fed infants there was no significant improvement between group A (62.5%) and group B (66.6%) infants. Among formula-fed infants, comparison of positive results using soy milk (65.9%) with positive results using dicyclomine (53.3%) was not significant; positive results using soy milk and hydrolyzed milk formulas in non-responders to soy milk, provided an improvement in 95.4% of cases. Pharmacological treatment provided an improvement in 53.3%) of cases. The diffcrence was significant ( p <0.01).     

Decreased salivary vascular endothelial growth factor in elderly patients with pneumonia during the course of recovery

Background: Elderly individuals are known for their high risk of acquiring pneumonia. Poor oral hygiene and high incidence of gastro‐oesophageal reflux continue to cause persistent oropharyngeal mucosal injuries and results in overgrowth of bacterial population and alteration of bacterial flora to respiratory pathogens in the oropharyngeal cavity. Salivary secretion contributes in maintaining homeostasis of the oropharyngeal mucosal barrier. Vascular endothelial growth factor (VEGF) acts as an angiogenic and permeability‐enhancing cytokine but is normally secreted in saliva. It has been previously demonstrated that VEGF secreted in the airway functions in the restoration or repair of the injured tissue. We hypothesized that salivary VEGF is a candidate as a marker to evaluate the degree of oropharyngeal mucosal injury. Methods: We compared the volumes, protein contents, and the amount of VEGF secreted in the saliva of patients with pneumonia during the course of recovery (P; n = 7) and those without pneumonia (n = 10). Results: Volumes and protein contents within the secreted saliva were similar between the patients with P and the control subjects (0.60 ± 0.28 mL versus 0.41 ± 0.34 mL, P = 0.126, 7.12 ± 5.57 µg/mL versus 3.92 ± 3.58 µg/mL, P = 0.231, respectively). The concentrations of salivary VEGF were significantly lower in patients with P than those of the controls (0.71 ± 0.37 versus 2.66 ± 3.44 µg/µg protein, P = 0.032). Conclusion: Lower concentrations of salivary VEGF in patients with pneumonia during the course of recovery suggested the presence of persistent oropharyngeal mucosal injury even after normalization of systemic C‐reactive protein levels. The concentration of salivary VEGF is capable of being a marker for discriminating impaired oral mucosal barrier that precipitates in development of pneumonia in elderly individuals.