猫爪草胶囊治疗婴儿接种卡介苗后腋窝淋巴结反应的临床观察

目的探讨猫爪草胶囊治疗婴儿接种卡介苗后腋窝淋巴结反应的疗效。方法将80例患儿随机分为两组,对照组常规应用异烟肼抗结核治疗,治疗组在常规治疗的基础上加用猫爪草胶囊。结果治疗组的临床治愈例数明显高于对照组,治疗2个月治疗组和对照组的治愈率分别达72.5%和40.0%,两组比较,差异有非常显著性(χ2=8.58,P<0.01),治疗组疗程亦明显缩短。结论猫爪草加用异烟肼治疗婴儿接种卡介苗后腋窝淋巴结反应,有明显缩短疗程、提高疗效的作用,且没有毒副作用。     

Surgical repair of congenitally corrected transposition of the great arteries: Results and follow-up

Eighteen patients with congenitally corrected transposition of the great arteries had open heart repair for intracardiac associated defects. Fourteen patients (78%) are alive during the follow-up period (mean 4.5 years). Seventeen (94%) of the 18 patients had ventricular septal defect closure, and 12 (66%) insertion of a pulmonary artery conduit. Surgical repair of the tricuspid valve was required in 6 patients (33%) during the first operation and in 3 additional patients during a second operation (total 50%). When hemodynamic overload or cardiac compromise was detected after surgery it was directly related to identifiable residual defects such as atrioventricular valvular insufficiency, residual ventricular septal defect, or pulmonary conduit stenosis. Repeat open heart operation for residual defects was common during the follow-up period (8 of 18 patients, 44%). No patient showed primary systemic or pulmonary ventricular dysfunction during the follow-up period. None of the last 11 patients developed complete heart block. Postoperative intraventricular conduction defects were common and are presumably caused by surgical injury of the bundle branches.Our observations suggest that surgical repair of congenitally corrected transposition of the great arteries can be currently achieved with acceptable risk. Improved knowledge of the precise location of the specialized conduction system resulted in a marked decrease in the Incidence of atrioventricular (A-V) block in patients with congenitally corrected transposition of the great arteries undergoing intracardiac repair. In the absence of postoperative residual defects it can be expected that longevity and quality of life will improve considerably, but many of these patients may require a repeat operation.     

婴幼儿佝偻病与血铅水平关系的研究

目的:探讨佝偻病的发病及治疗与血铅水平的关系。方法:将资料完整的842例患儿分为佝偻病组、对照组和治疗组,比较其血铅水平。结果:血铅水平与儿童性别有关(P<0.05),与佝偻病发病无关(P>0.05);排铅治疗对佝偻病有一定的治疗效果。结论:环境铅污染可能是儿童佝偻病高发及常规治疗效果不佳的原因之一。     

Changing trends of neonatal and postneonatal deaths in very-low-birth-weight infants

Advances in perinatal care have resulted in a decline in mortality of very-low-birth-weight infants (<1.5 kilograms) and also in an extension of the mortality period. To determine the current relevance of neonatal mortality results as indicators of outcome, all deaths among 427 very-low-birth-weight infants admitted during 1975–1977 were documented. A total of 145 infants died; 90 of the deaths (62%) occurred during the early neonatal period (0 to 6 days), 35 (24%) in the late neonatal period (7 to 27 days), and 20 (14%) in the postneonatal period. Death in 17 of the 20 postneonatal losses was due to neonatal complications of prematurity, and 16 of the 20 deaths occurred during the initial hospitalization. The postponement of these deaths to the postneonatal period has important epidemiologic implications and indicates a need for a reconsideration of accepted reporting mechanisms for infants of very low birth weight.     

The effect of a low continuous positive airway pressure on the reflex control of respiration in the preterm infant

The airway occlusion technique was used to measure the strength of the Hering-Breuer inflation reflex before and during the administration of low pressure CPAP. In five of 12 preterm infants studied in the first two weeks of life, CPAP did not alter the inflation reflex. In the other seven premature infants, shortened rather than lengthened inspiratory efforts were observed on occlusion 32 times of CPAP but only twice on CPAP. In seven term infants at 1 to 2.5 hours of age this shortening was noted only twice in 58 occlusions. In the preterm infants exhibiting short responses, the peak inspiratory pressure generated in response to occlusion rose on CPAP from 3.4 to 7.1 cm H2O (p less than 0.005), while respiratory rate fell from 61 to 49 breaths/minute (p less than 0.025). This data suggests that CPAP enhances these infants' ability to adjust to increased respiratory loads, possibly by the elimination of a Hering-Breuer deflation reflex.     

A rapid tube ELISA for human IgG in body fluids using Staphylococcus aureus

An ELISA was designed for measurement of human IgG in urine and CSF using protein A containing Staphylococcus aureus as sorbent. This assay was performed in test tubes. An OD difference of approximately 1.0 was developed between non-specific binding and 10 μg/ml IgG solution. The method has a sensitivity of 70 ng IgG/ml. The test is simple and rapid and does not require concentration of samples. Once prepared S. aureus reagent is stable for at least one year. The merits of this method in comparison to radial immunodiffusion (RID) are discussed.     

对血浆HCMV-IgM、尿HCMV-DNA阳性患儿用更昔洛韦干预意义

目的：调查对巨细胞病毒感染婴儿用更昔洛韦治疗的必要性。方法：本研究对2007年10月～2008年10月在深圳市宝安区妇幼保健院住院的0～6个月龄婴儿2840例,以ELISA法及PCR技术对患儿血浆HCMV—IgM、患儿尿及其母乳汁HCMV—DNA进行了检测,并对结果阳性及有临床症状的患儿分治疗组及对照组。治疗组采用更昔洛韦为主的综合治疗,对照组主要采取对症治疗,并判断疗效。结果：2840例患婴中血浆HCMV—IgM阳性者184例,占6．478％,尿HCMV—DNA升高者180例,占血浆HCMV—IgM阳性者97．8％,其母乳汁HCMV—DNA升高者170例,占血浆HCMV—IgM阳性者92．4％,对血清HCMV—IgM阳性、尿及其母乳汁HCMV—DNA升高的患儿分治疗组45例及对照组125例,发现治疗组临床症状改善42例（占93．3％）,尿HCMV—DNA滴度降低30例（占66．7％）,血浆HCMV—IgM转阴22例（占48．9％）。对照组临床症状改善80例（占64％）,尿HCMV—DNA滴度降低10例（占8％1,血浆HCMV—IgM转阴2例（占1．6％）。结论：采用更昔洛韦为主的综合治疗与采取单纯对症治疗相比。差异具有统计学意义,P〈0．01。