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51.
新生儿破伤风七例临床分析   总被引:1,自引:0,他引:1  
郑东升吕祥  李若飞 《中国全科医学》2005,8(20):1713-1713,1727
目的总结新生儿破伤风的临床治疗经验及预防措施.方法对7例新生儿破伤风的治疗做回顾性分析.结果 5例患儿治愈,1例转院,1例死亡.结论大剂量应用破伤风抗毒素(TAT)及地西泮,积极防治感染,保证热量供应,保持环境安静是治疗的主要措施,小剂量TAT治疗可能会延误或加重病情.推广新法接生可预防新生儿破伤风.  相似文献   
52.
The ability of 125I-labeled botulinum type A and tetanus neurotoxins to adhere to blots of synaptosomal proteins separated by SDS-polyacrylamide gel electrophoresis was studied. Both neurotoxins appeared to adhere preferentially to an approximately 80 kDa and to a lesser extent to an approximately 116 kDa protein(s). Adherence of the neurotoxins to these proteins was enhanced by preincubation of the neurotoxins with GT 1b. The approximately 100 kDa heavy chain segment of BTxA adhered to the same proteins. The carboxy terminal half of the heavy chain adhered primarily to the approximately 80 kDa protein(s) while the amino terminal portion bound most intensely to the approximately 116 kDa protein(s). The ability of the approximately 80 and approximately 116 kDa proteins to stain positively with the periodic acid-Schiff reagent and to bind 125I-labeled wheat germ lectin suggests that they are glycosylated. Both neurotoxins appear to adhere to the same approximately 80 and approximately 116 kDa proteins because tetanus neurotoxin preincubated with GT 1b was able to reduce binding of radiolabeled botulinum type A neurotoxin to both proteins. Neither neurotoxin adhered to blots of proteins from liver, spleen, or kidney, suggesting that the proteins adhered to are neural components.  相似文献   
53.
BACKGROUND: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) enrolls almost 50% of the US birth cohort and these children have significantly lower immunization coverage rates than their counterparts not eligible for WIC. In 1994, the Centers for Disease Control and Prevention (CDC) and USDA began a national initiative to increase immunization coverage in low-income children by incorporating immunization-promoting activities into WIC visits (WIC/Immunization linkages). Since 1998, CDC has monitored the WIC/Immunization linkages assessment and referral (with and without the more aggressive strategy of monthly voucher pick-up, client outreach and tracking and parental incentives) and three other immunization supporting activities (computerized systems to assess immunization status, collocation of WIC and immunization services, coordination of WIC and immunization services). METHODS: Through an annual survey of state Immunization and WIC programs, a trend analysis was conducted for years 1998 through 2004 to determine changes in the use and frequency of WIC/Immunization linkage activities. RESULTS: During the 7-year study period, the use of assessment and referral increased from 71% to 94%, monthly voucher pick-up from 24% to 35%, and coordination of WIC and immunization services from 61% to 78% (p<0.0001 for all comparisons) in WIC sites nationwide. The frequency of assessment and referral (at each visit [four or more times/ year] versus certification visits [two times/year]) was reported to decrease during the study period (p<0.0001). Outreach and tracking and collocation of services did not change significantly while the use of parental incentives decreased (p<0.0001). The availability of computers and their use immunization assessment increased during the period. From 2002-2004, the number of states reporting that they base assessment and referral on a single vaccine (diphtheria-tetanus-acellular pertussis) instead of counting multiple vaccines increased from 5 to 10. CONCLUSIONS: Immunization promoting activities, especially those known to be most effective in improving coverage such as monthly voucher pickup, are increasing in WIC. Focusing on effective interventions including supporting activities such as computerized assessment will be essential in meeting Healthy People 2010 infant and childhood immunization coverage goals. In addition, the use of WIC resources can be minimized by encouraging evaluation of diphtheria-tetanus-acellular pertussis coverage as a marker for up to date status, instead of counting all vaccine doses.  相似文献   
54.
Munro P  Flatau G  Lemichez E 《Vaccine》2007,25(52):8702-8706
Although often requiring the development of efficient adjuvants, needle-free mucosal delivery of vaccine is of major interest as a strategy of mass immunization against infectious diseases. We report that mucosal immunization against tetanus toxoid through nasal route, together with active cytotoxic necrotizing factor 1 (CNF1), elicits a specific and long lasting anti-tetanus toxin response, comprising seric IgG and IgA, as well as mucosal IgA. Immunized mice were protected against a challenge with lethal doses of tetanus toxin (10 × LD50). The Rho GTPase activating toxin CNF1 is thus an attractive mucosal adjuvant candidate for nasal vaccines.  相似文献   
55.
Summary The specific IgE response that appears in subjects immunized with tetanus toxoid does not induce hypersensitivity reactions at subsequent immunizations. The type I immune response, therefore, was studied bothin vivo andin vitro, in 11 subjects who had specific IgE antibodies for tetanus toxoid. The results showed that: 1. the specific IgE antibodies are heterogeneous regarding their affinity for the mast cell and basophil receptors; 2. the specific IgG antibodies for tetanus toxoid, at serum concentrations, are not able to interfere with thein vitro specific basophil degranulation; 3. in the PEG precipitare there are aggregates of specific IgE antibodies for tetanus toxoid.In vitro, these molecular aggregates are not able to sensitize the basophil cells.  相似文献   
56.
黄辉  胡国超  邓俊兴 《疾病监测》2005,20(3):128-130
目的 了解韶关市健康人群百日咳、白喉和破伤风免疫状况,及时为免疫策略提供科学依据。方法 随机抽查部分0~4 0岁健康人群进行了百日咳、白喉和破伤风抗体水平监测。结果 百日咳抗体几何平均滴度GeimetricMeanTiter(GMT)和抗体保护率分别为1∶374 2、67.74% ;白喉、破伤风抗毒素GMT分别为0.1699IU/ml、0.1804IU/ml,阳性率分别为88.94 %、91.83%。结论 对百日咳、白喉和破伤风已经形成了较好的免疫屏障,但人群百日咳抗体水平偏低,应大力推广应用吸附无细胞百日咳、白喉、破伤风联合疫苗.  相似文献   
57.
The incidence of tetanus in patients with wounds is unknown; however, recently concern has been raised over the proportion of tetanus cases in which a chronic wound is the portal of entry for Clostridium tetani. Varicose ulcers, dermatosis and necrosed tumours are estimated to be the point of entry for C. tetani spores in 11-14% of three cases. Of diabetic patients in the USA who contracted tetanus, a diabetic foot ulcer was responsible in 25% of cases despite this chronic wounds have yet to be considered as a risk factor for tetanus. An audit was undertaken and a survey devised to form the basis of the data collection to assess if patients with chronic wounds are up-to-date in accordance with the tetanus immunisation programme. Over a 5-day period, the data were prospectively collected and the tetanus status of a 100 patients retrospectively analysed. The status was then compared with general practitioner (GP) records via telephone follow-up. One hundred patients (n = 100) were available in the audit period, with the majority being male (n = 51). The age range was 22-91 years old (median 70 years). Nearly half of the samples (n = 48) were diabetic, with the majority of patients (n = 35) having venous leg ulcers. Only 15% had a biopsy of their wound. The duration of wounds varied from 1 to 480 months. Patients were asked to confirm their tetanus status. Almost half of the patients were unsure of their tetanus status 48% (n = 48), almost a third 30% (n = 30) thought they were not covered and 22% (n = 22) thought they were up-to-date. After confirming with the GP records, the results were as follows: almost half of the patients, 43% (n = 43) were not covered, 33% (n = 33) were up-to-date, 13% had no immunisation records available at the GPs, 10% had no GP contact details and 1% no contact was possible. Currently, tetanus prophylaxis is given based on the vaccination history of the patient but as identified that this can prove to be unreliable. With the burden of chronic wound and ageing population set to increase, levels of protection amplify the risk of tetanus faced by those suffering from chronic wounds. Strict caution should be taken in those patients who were born before the national childhood vaccination programme, implemented in 1961. Moreover, every effort should be made to ensure that such individuals complete their primary course. By ensuring each patient is actively immunised, protection against tetanus, a potential killer, is provided.  相似文献   
58.

Objectives

To compare humoral and cellular immune responses to tetanus booster vaccination in infants born prematurely with those born at full term and identify factors associated with the humoral response.

Methods

A prospective study was carried out on children born prematurely and with a birth weight <1500 g and with infants born at full term. At 15 months (pre-vaccination) and 18 months (post-vaccination), anti-tetanus antibodies were measured by ELISA; the intracellular interferon-gamma percentages of CD4+ T and CD8+ T cells after in vitro stimulation with tetanus toxoid were determined by flow cytometry. Chi-squared or Fisher's exact test was used to compare categorical variables. Student's t-test or Mann–Whitney test was used to compare numerical variables. Regression analysis was performed to determine factors associated with humoral immunity. Statistical significance was considered if p < 0.05.

Results

Sixty-four premature and 54 full-term infants were studied. The proportion of children immune against tetanus at 15 and 18 months was similar in both groups. The geometric mean of the antibodies was lower among the premature children at 15 months (p = 0.025) and was similar in both groups at 18 months (p = 0.852). The percentages of CD4+ and CD8+ T cells expressing intracellular IFN-γ were similar in both groups at 15 and 18 months. Gestational age <32 weeks was associated with a reduction of −0.116 IU/mL in the level of antibodies at 15 months. Breastfeeding >6 months was associated with a 3.5-fold greater chance of optimal protective (≥0.1 IU/mL) antibody level against tetanus at 15 months and an increase of 0.956 IU/mL in the level of antibodies at 18 months.

Conclusions

Humoral and cellular response following a tetanus booster was similar in both groups. Premature infants exhibited lower levels of anti-tetanus antibodies at 15 months of age, with the lowest levels in those born at a gestational age of less than 32 weeks. Breastfeeding was associated with greater levels of antibody against tetanus.  相似文献   
59.
1989年10月~1990年10月,对我市1444名正常人群进行了脊髓灰质炎、麻疹、白喉、破伤风抗体检测,结果表明:脊髓灰质炎抗体处于较高免疫力水平,I、II、III型抗体阳性率分别为95.00%、93.61%、94.71%,几何平均滴度(GMT)分别为103.57、94.61、83.80;白喉抗体处于中等免疫力水平(GMT=0.0829IU/ml);育龄妇女破伤风抗体处于低免疫力水平(GMT=0.0014IU/m1);母婴胎传麻疹抗体呈明显正相关(r=0.7153, P<0.0005)。本次调查为了解我市计划免疫人群的免疫水平及今后预防工作提供了可靠的科学依据。  相似文献   
60.
A small dose of tetanus toxin injected into the rat hippocampus produces a chronic model of temporal lobe epilepsy. We have examined whether morphological changes occur in hippocampal CA1 pyramidal cells in this model by using intracellular injections of biocytin. Eight weeks after the injection of tetanus toxin, significantly more ‘dye-coupled’ cells were found in this group than in the buffer (control) injected group (63% compared with 7%). Half of these coupled cells appeared to be linked at the soma, and the other half by dendrodendritic contacts. Analysis of the dendritic trees revealed that the tetanus toxin group showed a decrease in complexity around the proximal to mid-apical dendritic regions and around the mid- to distal basal dendritic regions. The dye-coupling indicates that electrotonic interaction is induced or strengthened between hippocampal neurones, possibly as a result of the epilepsy-induced dendritic damage.  相似文献   
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