中国河北省卢龙县儿童轮状病毒腹泻研究

轮状病毒是我国儿童重症腹泻的主要病原。按照WHO轮状病毒监测方案,于1999年7月至2003年6月,在河北省卢龙县开展了医院和社区为基础<5岁儿童轮状病毒腹泻的监测。结果表明:卢龙县<5岁儿童腹泻的发病率为1 3次/人/年。4年中全县共有2350名<5岁急性腹泻患儿住院,占所有住院儿童的38%(2350/6213)。住院的腹泻患儿每年有两个高峰,一个是夏季(6～8月),占全年腹泻住院病例的22%;另一个在冬季(12月至次年2月),占58%。住院的轮状病毒腹泻只有一个高峰,是在冬季(12月至次年2月),高峰期的轮状病毒腹泻住院患儿数占全年轮状病毒腹泻患儿住院数的86%。按全年统计,轮状病毒腹泻占住院腹泻患儿的46%,轮状病毒腹泻的住院率为11/1000儿童/年。在门诊腹泻患儿中轮状病毒腹泻患儿占28%,在社区腹泻患儿中轮状病毒腹泻占10%。轮状病毒毒株的分布,G3型(45%)最常见,其次为G1型(35%)、G2型(8%)、G4型(3%)、G9型(0 6%),混合感染较少(1%)。还有8%的毒株未能分出型别。在轮状病毒腹泻患者中,9～11月龄的儿童检出率最高(53%),其次是12～17月龄(51%)、18～23月龄(36%)和6～8月龄(30%)。在4年研究期间共有5～10名1～59月龄儿童可能因为轮状病毒腹泻死亡,其中有1例确诊为P[8]G1型毒株感染。初步估计,该县1～59月龄儿童轮状病毒腹泻的死     

儿童慢性鼻窦炎的综合治疗

目的探讨儿童慢性鼻窦炎的有效治疗方法。方法回顾分析2001年1月～2004年10月在大连大学附属中山医院治疗的113例儿童慢性鼻窦炎的临床资料,分析5种治疗方法的疗效。结果根据患儿的病情,分别采取5种治疗方法,按1997年海口会议标准评定疗效,总有效率为88．5％。结论儿童慢性鼻窦炎的治疗要根据病情及伴随的相关疾病采取相应的治疗方法,才能提高疗效。     

Use of the IEUBK Model for Determination of Exposure Routes in View of Site Remediation

The Integrated Exposure Uptake Biokinetic (IEUBK) model is frequently used to estimate blood lead concentrations of children exposed to lead. Simulations with the IEUBK model were run to estimate the blood lead concentration in children living in the vicinity of a non-ferrous plant, situated in Hoboken, Belgium. Concentrations in soil ranged from 59–2425 mg Pb/kg dm, average concentrations in house dust ranged from 234–73394 mg Pb/kg dm. Measured blood lead concentrations in children aged 2–7 years were between 3 and 35 μ g/dl. Exposure sources were indoor dust in the house and the school, outdoor dust and soil in the home surrounding and at the school's playground, and suspended dust in the air. Soil ingestion values and lead exposure from food were changed to Flemish values. The model was able to predict the measured blood lead concentrations adequately except for the lowest exposure group. Predictions showed a systematic overestimation. Analysis of the data revealed that the neighbourhood's school is an important source of exposure to lead; indoor house dust dominates exposure for children going to school outside the area, because of the high concentrations of lead in indoor dust (3 to 5 times higher than in outdoor soil).     

White families and race: colour-blind and colour-conscious approaches to white racial socialization

This paper examines the role that social context plays in mediating racial socialization in upper-middle-class white families. Outcomes of white racial socialization, as well as the process itself, depend in large part on the distinctive racial contexts designed by parents in which white children live and interact. I examine variation in white middle-school-aged children's common-sense racial knowledge and discuss the importance of exploring the social reproduction and reworking of racial ideologies and privilege in childhood.     

Diurnal Rhythms in Performance Tests of School Children with and Without Language Disorders

Time-of-day related changes on four tests used by speech therapists and four other performance tests, in addition to oral temperature, were documented in 16 school children (7-9 years of age). Six of them had language disorders and were receiving speech therapy. Children were synchronized with diurnal activity from around 0730 to around 2100 and nocturnal rest. For each child, at each test time point (e.g. 0900, 1100, 1530 and 1930) tests were performed three times, with two different speech therapists, in a random order, with only one session per day. Conventional methods (r-tested mean differences; AINOVA; correlation tests) were used for statistical analyses. Among 29 parameters (items) which were analyzed, only nine exhibited time-of-day related changes, mainly in speed to-perform measures. In most detected rhythms best performance occurred either at 1100 or at 1530 with no difference in subgroups except for the fastest performance of the sentence repetition test. With regard to the daily mean M, controls performed better than children with language disorders for the word (syllabic) repetition test (P < 0.0004) but this was reversed for both computing and colouring skill tests (P < 0.04 and < 0.002). A difference related to sex (but not to language disorders) was observed in the Ms of speed in sign reproduction (P < 0.0000) and sorting cards (P < 0.01), with boys being faster than girls. In children, as in adults, time-of-day effects should be considered when the quantification of performance is desired.     

Summary and Perspectives: Sustained-Release Theophylline and Nocturnal Asthma,Once-Daily and Unequal Dosing Schedules

Many asthmatic patients experience aggravation of symptoms overnight resulting in disruption of their sleep. Sustained-release theophylline represents at this time a major bronchodilator medication which possesses a sufficient duration of activity to avert the nocturnal breathing distress of asthma. Circadian rhythm-adapted theophylline schedules consisting of unequal dosing—more or all the drug taken in the evening—have proven efficacious in clinical investigations for certain patients. Although the kinetic behavior of some formulations is affected by food, the circadian rhythm-adapted schedules represent a significant step forward toward the goal of optimizating sustained-release theophyllines for patients who experience nighttime symptoms.     

ALTERATIONS WITH AGING OF THE ENDOCRINE AND NEUROENDOCRINE CIRCADIAN SYSTEM IN HUMANS

This was an open-label study in 19 children aged 9–13 years, weighing 27–44 kg, with bronchial asthma. Twenty-four-hour steady-state concentrations of theophylline and its metabolites 1,3-dimethyl uric acid, 3-methyl xanthine and 1-methyl uric acid were assessed after daily dosing of 600 mg (ca18 mg/kg/day) of the sustainedrelease theophylline micro-pellet sprinkle system BY158K, for 4 days. The dosing regimen used was an unequal twice-daily dose of 200 mg in the morning after breakfast and 400 mg in the evening after dinner. Twenty-four-hour peak expiratory flow (PEF) profiles were compared before treatment and at steady-state, along with lung function parameters after bronchial provocation. Mean values±SD (n=16) of the steady-state characteristics were C_min6.8±2.1 mg/1, C_max14.5±4.8 mg/1 and C_av10.S±2.9 mg/1, the plateau time was 11.7±4.8 hr and peak-trough fluctuation and swing were 72±21 and 118±52%, respectively. There was an excellent reproducibility of theophylline pre-dose levels at corresponding time points of the 24-hr sampling period [r=0.864 (p< 0.001)]. Mean values±SD of the 24 hr average serum metabolite levels were 0.9±0.2 mg/1 for 1, 3-dimethyl uric acid, 0.6±0.1 mg/1 for 3-methyl xanthine and 0.4±0.1 mg/1 for 1-methyl uric acid. Lung function (n=17) following bronchial provocation, improved in 10 children after theophylline treatment of 4 days, remained stable in 2 patients and deteriorated in 5 patients. Serum theophylline profiles and PEF profiles ran largely in parallel over the 24-hr period. Six children exhibited typical theophylline induced side-effects, headache (n=3), nausea (n=4), dizziness (n=l), vomiting (n=4), sleep disturbances (n=1), pallor (n=1) and tremor(n=1), necessitating in 3 children one dose omission/reduction (n=2) or subsequent dose reduction (n=1). It has been shown that a twice daily dosing regimen with unequal doses of anhydrous theophylline (BY158K) is well suited to this population of fast metabolisers. The patients were well protected throughout the day, including the critical early morning hours.     

The social and economic circumstances of mixed ethnicity children in the UK: findings from the Millennium Cohort Study

The number of people with a ‘mixed’ ethnicity heritage is growing in contemporary Britain. Research in this area has largely focused on implications for cultural and racialized identities, and little is known about associated economic and social factors. Data from the Millennium Cohort Study, a representative panel survey of children born in 2000–2001, are used to examine the circumstances of mixed ethnicity children in comparison with their non-mixed and white counterparts. Findings suggest a cultural location between ‘white’ and minority identities, and socio-economic advantage in comparison with non-mixed counterparts. For example, households of non-mixed white children had poorer economic profiles than households of both mixed white and mixed Indian children. This effect is associated with the presence of a white parent, and the factors underlying it are examined. Although the statistical approach used bypasses a consideration of the dynamics of identity, it provides important evidence on stratification and inequality, and the factors driving this.