双歧杆菌对迁延性及慢性腹泻患儿部分胃肠激素的影响

目的：探讨双歧杆菌对迁延性及慢性腹泻患儿血清胃泌素(GAS)、血浆胃动素(MOT)和血浆生长抑素(SS)水平的影响。方法：应用放免法测定20例用双歧杆菌和19例未用微生态制剂治疗的迁延性及慢性腹泻患儿治疗前和治疗7d后空腹及餐后1h的血清GAS、血浆MOT和血浆SS水平,结果与20例正常儿童比较,并分析三种胃肠激素间的相关性。结果：治疗前两组病例空腹和餐后的血清GAS、血浆MOT和血浆SS水平高于正常儿童。除空腹未用微生态制剂病例的血清GAS水平外,治疗前两组病例血中的三种胃肠激素水平高于治疗7d后。治疗7d后双歧杆菌治疗病例空腹和餐后的血清GAS和血浆MOT水平低于未用微生态制剂病例,且血清GAS水平与正常儿童差异无显著性。治疗7d后血浆SS水平三组间差异无显著性。另两组病例治疗前空腹和餐后三种胃肠激素间均无关联,治疗7d后的双歧杆菌治疗病例和正常儿童GAS与SS和MOT与SS则呈正相关。结论：双歧杆菌制剂对迁延性及慢性腹泻儿童胃肠激素的分泌有调理作用,应用双歧杆菌治疗的患儿血清GAS、血浆MOT和血浆SS水平较未用微生态制剂的患儿更快恢复正常。     

Clinical course of congenital toxoplasmosis in children]

Hundred eleven children with the congenital toxoplasmosis were treated at the Department of Infectious and Parasitic Diseases in Childhood in 1979-1988. Multi-symptomatic toxoplasmosis has been diagnosed in 35 cases, ocular form in 65, oligosymptomatic in 6, and asymptomatic in 5 cases. Clinical symptoms suggesting congenital toxoplasmosis was seen in the majority of children (63 cases) in the first year of life and the disease was diagnosed in 50% of cases (33 children) at this age. Congenital toxoplasmosis in the group of 78 children has been diagnosed later. The majority of cases was ocular form. Diagnosis of the oligo- and asymptomatic congenital toxoplasmosis is possible in the first year of life, only. A titre of antibodies is exclusively an indicator of the immunologic response, not a severity of infection and does not contribute to the prognosis. Antitoxoplasma drugs were administered to 102 children including 33 under the first year of life. Pyrimethamine, sulphonamides, and spiramycin were used in the treatment. Dosage, duration of therapy, and way of administration have been established individually in dependence of patients age and clinical form of the congenital toxoplasmosis. Two out of 35 children with multi-symptomatic congenital toxoplasmosis died whereas 13 demonstrate psychomotor retardation of significant degree despite the fact that 11 of them were treated in the first year of life.     

Follow-up of children born of bromocriptine-treated mothers

A survey carried out in France at the beginning of 1984 concerning development of children born of mothers treated with bromocriptine (BC) during part or all of the pregnancy showed the absence of any adverse effects of BC in 64 children born from 53 mothers. In 60 cases, BC was prescribed (2.5-7.5 mg/day) for hyperprolactinemia; 23 mothers were treated with BC for 4 weeks or less, and 23 others for 30 weeks or more. After a follow-up of between 6 months and 9 years, all children are normal. Psychological development in the 23 children born to mothers treated with BC during more than 30 weeks of pregnancy actually appears more precocious, with excellent scholastic performance in the oldest.     

Treatment of neuroblastoma with [131I]metaiodobenzylguanidine: long-term results in 25 patients.

From 1984 to 1990 we have treated altogether 25 children with [131I]metaiodobenzylguanidine (131I-MIBG) for a refractory, relapsed or metastasized neuroblastoma. Three children had stage III and 22 children had stage IV of the disease; at diagnosis their ages were between 4 months and 10 years. Children with stage III disease had at diagnosis a median age of 3.0 years and at treatment 3.8 years. After first-line chemotherapy 2 children had achieved a complete remission (CR), while in 1 child the tumor did not respond (NR) to the initial treatment. At the time of 131I-MIBG treatment 2 children had relapsed and in the other one no further response was achievable. The children were treated by a 13.5 +/- 12.9 mCi/kg BW per course with a mean total dose of 280.7 +/- 243.9 mCi. One child achieved CR by 131I-MIBG alone, while in 2 cases no measurable success was observed. All 3 children were treated additionally by surgery, chemotherapy and bone marrow transplantation (BMT). Two children have died but one is alive and in CR. The 22 children with stage IV disease were treated in two different study groups. In group A, 14 children were studied for side-effects and response to 131I-MIBG. All children were pretreated with standard chemotherapy. Five were treated in relapse, 5 in progression and 3 at a refractory state of the disease; only 1 child was in complete remission when being treated with 131I-MIBG. Group A patients were treated with a mean of 2.4 courses, with 10.3 mCi/kg BW for each course.(ABSTRACT TRUNCATED AT 250 WORDS)     

Comparative morphological analysis of the articular cartilage, epiphyseal plate, spongy bone, and synovial membrane of the knee joint in children treated and not treated with ciprofloxacin]

Comparative data on he postmortem morphological examination of the knee joint in children treated and not treated with ciprofloxacin while alive are presented. Nine children were ill with mucoviscidosis and 8 children were ill with aplastic anemia. The patients were ill with mucoviscidosis and 8 children were ill with aplastic anemia. The patients were treated with ciprofloxacin in a daily dose of 20 to 40 mg/kg body weight at the average for 148 days. The condition of the articular cartilage, growth area, spongy bone and synovial membrane of the knee joint was examined visually, histologically and morphologically. It was revealed that ciprofloxacin had no chondrotoxic effect. The structure affected in some cases by the ciprofloxacin treatment was the synovial membrane which developed subacute synovitis not clinically manifested (latent) in life. The phenomenon is explained.     

Long term observation of children with Giardia intestinalis invasion treated with metronidazole and furazolidone]

The results of a long-term (3-year) follow-up of children infected with G. intestinalis treated with metronidazole and furazolidone are presented. Therapy was effective in 84-95% of cases, depending of the duration or the follow-up. Repetition of therapy with tinidazole was indicated in 5% of children after 6 months and in 15% of children after 1 and 2 years of observation because of persisting symptoms of the infection or recurrence. More frequent the treatment was necessary in children under 3 years of age. Some (14%) children required milk free diet and in a few cases (underlying disease--coeliac) gluten-free diet or a diet free of main allergens.     

小儿复发性肠套叠的微创治疗研究

目的：探讨小儿复发性肠套叠（套叠3 次及以上）的微创治疗。方法：回顾性分析2007 年12 月~2013 年1 月期间收治的21 例复发性肠套叠（套叠3 次及以上）患儿的临床资料。结果：21 例患儿均予以腹腔镜探查,3 例患儿仅发现回肠末端肠系膜淋巴结 增生,18 例探及原发病灶：其中Meckel憩室10 例,结肠息肉3 例,肠重复畸形2 例,非霍奇金淋巴瘤1 例,异位胰腺1 例,小肠腺 瘤1 例。20 例术后随访至今均未再次复发,1 例失访。结论：年龄＞2 岁,有多次复发肠套叠病史（套叠3 次及以上）,尤其是短期内 复发频繁的患儿,大多存在肠道器质性病变,应积极手术治疗,且以腹腔镜治疗为佳。     

Experience with using leukocytic interferon with methacil in influenza in children]

For prophylaxis influenza in the infection foci under stationary conditions 213 children were treated with leucocytic interferon with metacyl and 192 children were observed as the control group. The drug was administered intranasally in a dose of 0.25 ml once a day. The observations showed that among the children treated prophylactically with interferon and metacyl the number of influenza cases decreased 2.17 times a compared to the control group. In contact children who were taken ill with influenza the severety of the infection and the number of complications decreased. Under the stationary conditions in the children treated with interferon and metacyl the numbers of the wave-like infection and complications decreased 2.5 and 2.9 times respectively as compared to the children not treated with the drugs. Addition of metacyl to leucocytal interferon provided its administration once a day instead of 3-4 times a day.     

Leukemia; duration of life in children treated with corticotropin and cortisone

The average duration of survival of 15 cases of childhood leukemia treated with corticotropin and cortisone was 6.8 months. This survival was the same as observed among 59 children who received no treatment, or treatment with x-ray, or blood transfusion alone. Despite the fact that objective evidence of remission was observed in 7 of 15 children treated with corticotropin and cortisone, the remissions were not reflected by a longer duration of life. Treatment of childhood leukemia with corticotropin and cortisone appears to be a palliative measure, without significant effect on the duration of life.     

LEUKEMIA—Duration of Life in Children Treated with Corticotropin and Cortisone

The average duration of survival of 15 cases of childhood leukemia treated with corticotropin and cortisone was 6.8 months. This survival was the same as observed among 59 children who received no treatment, or treatment with x-ray, or blood transfusion alone.Despite the fact that objective evidence of remission was observed in 7 of 15 children treated with corticotropin and cortisone, the remissions were not reflected by a longer duration of life.Treatment of childhood leukemia with corticotropin and cortisone appears to be a palliative measure, without significant effect on the duration of life.     

Part III – Treatment of Ureterovesical Reflux

Of 134 girls with demonstrable ureterovesical reflux, 61 (105 ureters) had the reflux surgically corrected with an overall surgical cure rate of 97 percent. In the remaining 73 children (112 ureters), the reflux was treated conservatively with medical management alone. During the follow-up period no significant differences were demonstrated in the overall incidence of urinary tract infection; two years following corrective operation or medical treatment more than 50 percent of both medically and surgically treated children were still experiencing infections. A pronounced decrease, however, occurred in the incidence of clinical pyelonephritis among the surgically treated group. Following correction of reflux, the incidence of pyelonephritis was similar in both medically and surgically treated cases and was approximately the same as that found in a comparable group of children without reflux.In approximately two-thirds of refluxing renal units in which there was evidence of clubbing and scarring before medical or surgical therapy, deterioration progressed during the follow-up period. In most of these cases infection control was felt to be inadequate with episodes of clinical pyelonephritis occurring during the period of medical management, or, in the surgically treated group, occurring just before corrective operation and the scar appearing within two years after operation.The majority of renal units in which calyceal clubbing and parenchymal scarring was present had the most severe grades of reflux.     

"Smouldering" and symptomatic forms of central nervous system involvement in the course of non-Hodgkin's lymphoma in children

34 children with Non-Hodgkin's lymphoma (NHL) were treated with LSA2L2 protocol from 1978 to 1981. In 12 cases (31.4%) the central nervous system (CNS) was involved, including 3 cases at the onset of the disease. CNS involvement was always diagnosed by the presence of blast cells in cerebro-spinal fluid, also in cases with normal pleocytosis and no neurological symptoms. Such cases were called "smouldering" CNS involvement. Four children had a smouldering form of CNS involvement. 3 of them are in continuous complete remission with cessation of therapy, while all those 6 patients with symptomatic CNS involvement died. "Smouldering" CNS involvement seems to have a better prognosis than the symptomatic one.     

双歧杆菌菌液保留灌肠治疗小儿腹泻初探

本文就婴儿双歧杆菌菌液保留灌肠对小儿腹泻的治疗作用进行了初步观察。结果发现,31例试验组患儿治疗后,其大便双歧杆菌活菌计数及革兰氏阳性菌比例均较治疗前和对照组明显升高。提示双歧杆菌菌液保留灌肠对小儿腹泻有治疗作用。     

口服补液盐治疗儿童急性腹泻轻中度脱水的疗效研究

目的:观察口服补液盐治疗儿童急性腹泻轻中度脱水的临床疗效。方法:选取我院儿科收治的63例急性腹泻伴轻中度脱水症状患儿,采取随机数表法分为两组,其中对照组32例患儿予标准口服补液盐,而治疗组31例患儿予补液盐溶液。对比治疗前后两组患儿血浆内Na+、K+、Cl-离子水平,临床症状恢复时间及改善情况。结果:治疗后,两组患儿的电解质水平均有所改善,治疗组患儿Na+、K+及Cl-水平均优于对照组,差异有统计学意义(P0.05);治疗组患儿口渴、头晕、乏力及腹痛症状的恢复时间均较对照组明显缩短,差异有统计学意义(P0.05)。治疗组临床总有效率明显优于对照组,差异具有统计学意义(P0.05)。结论:口服补液盐能明显改善儿童急性腹泻而致的轻中度脱水症状,减少静脉输液对患儿造成的负面影响,值得在临床上进行推广。     

两性霉素B对小儿白血病化疗后肺部侵袭性真菌感染的疗效研究

目的探讨两性霉素B对小儿白血病化疗后肺部侵袭性真菌感染（PIFI）的疗效。方法选取沈阳军区总医院于2012年4月至2014年8月收治的54例白血病化疗后PIFI患儿为研究对象,随机分成A、B两组,每组27例。B组采用米卡芬净,A组采用两性霉素B。对比两组临床疗效、G试验结果、肺部CT改变情况及不良反应发生率。结果 （1）A组治疗有效率为66.67%,明显优于B组的44.44%,且治疗后A组死亡6例（22.22%）,低于B组的13例（48.15%）,组间对比差异有统计学意义（P〈0.05）;（2）所有受试患儿均行动态G试验检测,发现阳性者43例（79.63%）,A组22例、B组21例（P〉0.05）。其中37例（86.05%）治疗后转阴,A组20例,B组17例（P〉0.05）;治疗前,54例患儿高分辨CT影像显示其肺部出现片状或结节状高密度影,呈现明显新月形或空洞改变;（3）治疗后,两组患者均无严重腹泻、头晕、头痛等不良反应发生（P〉0.05）;A组3例因耐受不足停药,B组4例因肾功能改变而停止治疗,不良反应发生对比差异无统计学意义（P〉0.05）。结论对白血病化疗后出现PIFI症状的患者给予两性霉素B进行治疗,疗效显著,安全可靠,值得临床推广。     

经纤维支气管镜灌洗治疗儿童顽固性肺炎的临床研究

目的:探讨经纤维支气管镜灌洗治疗儿童顽固性肺炎的治疗效果。方法:选择儿童顽固性肺炎患者48例,随机选择26例行纤维支气管镜灌洗治疗+常规治疗(实验组),另22例行单存常规治疗(对照组),对比两组治疗方案的有效率。结果:实验组22例(84.62%)有效,肺炎治疗有效时间为(9±2.1)d,对照组12例(54.55%)有效,肺炎治疗有效时间为(15.6±3.8)d。实验组肺炎治疗有效率明显高于对照组(p<0.05),且肺炎治疗有效时间明显少于对照组(p<0.05)。结论:纤维支气管镜灌洗是治疗儿童顽固性肺炎的一种有效方法。     

Studies on the relations of selenium and Keshan disease

Keshan disease is an endemic cardiomyopathy of unknown cause in The People’s Republic of China that occurs most frequently in children under 15 years of age and women of child-bearing age. Studies of children 1–9 years old in Mianing County of Sichuan Province have indicated that Keshan disease is a selenium responsive condition. Incidence rates of 9.5–13.5/1000 in 1974–1975 were reduced to 1–2/1000 in children treated with a tablet weekly of 0.5–1 mg sodium selenite. During 1974–1977, only 21 cases of the disease occurred in 36,603 treated children, compared with 106 cases in 9430 untreated children, of whom 53 died and 5 still have insufficient heart function. Occurrence of the disease was invariably associated with a lower selenium content of cereals, and of hair (less than 0.12 ppm Se) in residents from affected, compared with non-affected, areas. The dose relationship between selenium and regional characteristics of Keshan disease suggests that it is probably a biogeochemical disease; other etiological factors have also been considered.     

经纤维支气管镜灌洗治疗儿童顽固性肺炎的临床研究

目的：探讨经纤维支气管镜灌洗治疗儿童顽固性肺炎的治疗效果。方法：选择儿童顽固性肺炎患者48例,随机选择26例行纤维支气管镜灌洗治疗＋常规治疗（实验组）,另22例行单存常规治疗（对照组）,对比两组治疗方案的有效率。结果：实验组22例（84.62%）有效,肺炎治疗有效时间为（9±2.1）d,对照组12例（54.55%）有效,肺炎治疗有效时间为（15.6±3.8）d。实验组肺炎治疗有效率明显高于对照组（p〈0.05）,且肺炎治疗有效时间明显少于对照组（p〈0.05）。结论：纤维支气管镜灌洗是治疗儿童顽固性肺炎的一种有效方法。     

丙种球蛋白联合注射用甲泼尼龙琥珀酸钠治疗重症手足口病患儿的临床研究

目的:探讨丙种球蛋白联合注射用甲泼尼龙琥珀酸钠治疗重症手足口病(HFMD)患儿的临床效果。方法:选择我院2013年1月至2014年1月收治的重症HFMD患儿80例,按随机数字表法平均分为两组,研究组及对照组各40例。对照组患者在常规治疗基础上给予甲泼尼龙琥珀酸钠治疗,研究组患者给予丙种球蛋白联合注射用甲泼尼龙琥珀酸钠治疗,比较两组患儿治疗疗效,发热、疱疹、神经系统受累症状消退时间及住院时间。结果:研究组患儿治疗总有效率为97.5%,明显高于对照组87.5%,比较差异具有统计学意义(x2=3.85,P0.05)。研究组患儿发热消退时间、疱疹消退时间、神经系统受累症状消退时间及住院时间均明显短于对照组,比较差异具有统计学意义(均P0.05)。结论:丙种球蛋白联合注射用甲泼尼龙琥珀酸钠治疗重症HFMD患儿疗效显著,可有效改善患儿临床症状,值得临床推广应用。     

腺样体手术治疗儿童分泌性中耳炎的临床疗效观察

目的:观察腺样体手术治疗儿童分泌性中耳炎的临床效果。方法:选择分泌性中耳炎合并腺样体肥大患儿80例(160耳),将其随机分为手术组和对照组,每组40例,手术组患儿给予腺样体消融手术治疗,而对照组患儿进行保守治疗,观察和比较两组治疗1个月后的临床疗效。结果:治疗1个月后,手术组治愈72耳,好转6耳,治疗总有效率为97.5%,而对照组治愈8耳,好转20耳,治疗总有效率为35%,较手术组显著降低(P0.05)。结论:腺样体切除是治疗分泌性中耳炎的有效途径,治疗中应尽可能避免并发症的发生,恢复和保护咽鼓管的生理功能。