口服双歧杆菌三联活菌散对婴幼儿湿疹患者的疗效

目的 探讨口服双歧杆菌三联活菌散对婴幼儿湿疹患者免疫状态的影响及其临床治疗效果。方法 将106例湿疹患儿随机分为观察组（64例）和对照组（62例）,两组患儿均给予丁酸氢化可的松乳膏涂抹治疗,观察组患儿在此基础上口服双歧杆菌三联活菌散剂,0.5 g/次,2次/d。全部患儿均连续治疗30 d,观察两组患儿的疗效和不良反应发生情况。采用ELISA法检测患儿治疗前后血清干扰素-γ（IFN-γ）、白介素-4（IL-4）以及IgE水平,并计算IFN-γ/IL-4值。结果 观察组患儿治疗总有效率（87.50%）高于对照组（72.58%）,差异有统计学意义（P0.05）。结论 口服双歧杆菌三联活菌散可有效改善湿疹患儿免疫状态,提高临床疗效,且安全性高。     

乌司他丁对体外循环法洛四联症患儿围心脏手术期循环和呼吸功能的影响

目的:探讨乌司他丁对体外循环法洛四联症患儿围心脏手术期循环和呼吸功能的影响。方法:选取我院于收治的60例法洛四联症婴幼儿参与研究,并将其随机分为对照组和试验组两组,每组患儿30例。其中试验组患儿在体外循环前以及患儿进行手术后的三天内每天均给予10000U/kg乌司他丁,而对照组患儿则在相应的时间点给予等量的生理盐水。分析比较两组患儿的体外循环时间、心脏停搏时间、手术时间、在监护室治疗的时间以及患儿术后住院时间和患儿肺部感染发生例数等临床病理情况。结果:所有入选患儿均痊愈出院,在两组患儿的手术操作情况和治疗效果对比中,对照组患儿的手术时间、体外循环时间和心脏停搏时间均显著低于试验组患儿,但重症监护时间及术后住院时间则高于试验组患儿;在两组患儿治疗后的循环功能指标比较中,试验组患儿超滤后CVP和血管活性药物均低于对照组患儿而超滤后MAP则显著高于对照组患儿;在两组患儿治疗后的呼吸功能指标的比较中,试验组患儿的动脉血氧分压明显高于对照组患儿以及试验组患儿的术后机械通气时间和肺部感染例数均低于对照组患儿,两组患儿的数据比较差异除手术时间、体外循环时间和心脏停搏时间外均具有统计学意义(均P0.05)。结论:乌司他丁对体外循环法洛四联症患儿围心脏手术期的循环和呼吸功能具有较好的保护作用,值得在临床上加以广泛推广和运用。     

不同时间段睡眠剥夺配合改良式水合氯醛保留灌肠法在婴幼儿肺功能检查中的效果分析

摘要 目的：探讨不同时间段睡眠剥夺配合改良式水合氯醛保留灌肠法在婴幼儿肺功能检查中的镇静效果。方法：前瞻性选取2018年2月~2020年8月本院收治并需行肺功能检查的婴幼儿临床资料,纳入194例婴幼儿作为研究对象,根据随机数字表法简单随机分为四组。对照组（n=48）不进行睡眠剥夺,短时段组（n=48）行短时段睡眠剥夺,中时段组（n=49）行中时段睡眠剥夺,长时段组（n=49）行长时段睡眠剥夺。对比四组婴幼儿的入睡时间、镇静效果及不良反应。结果：四组婴幼儿入睡时间的组间差异具有统计学意义（P＜0.05）。与对照组相比,联合睡眠剥夺干预的三组婴幼儿在10 min内进入睡眠的例数明显增多;随着睡眠剥夺时间增加,睡眠剥夺的三组婴幼儿超过30 min才进入睡眠的例数明显少于对照组。四组婴幼儿镇静效果的组间比较差异具有统计学意义（P＜0.05）;与对照组相比,联合睡眠剥夺干预的三组婴幼儿镇静效果明显升高,镇静总有效率均高于对照组（P＜0.05）。在实验期间,四组婴幼儿均出现不同类型的不良反应,各类型不良反应发生率及总发生率的组间比较,差异均无统计学意义（P>0.05）,但长时段组出现情绪烦躁的比例略高。结论：睡眠剥夺配合改良式水合氯醛灌肠法对婴幼儿具有良好的镇静效果,但长时段睡眠剥夺可能会使其情绪烦躁,需在检查完成后悉心安抚婴幼儿情绪。     

Late effects of childhood cancer treatment in long-term survivors diagnosed before the age of 3 years – A multicenter,nationwide study

BackgroundThe effect of age on the incidence of late sequelae that occur after anticancer treatment in childhood is still not fully elucidated. In this multicenter study of long-term survivors diagnosed before age of three, we investigated the prevalence of late effects many years after treatment.MethodsThe study group (n = 561) was selected from the Polish National Childhood Cancer Survivors Registry (n = 1761) created in 2007. A survivor was defined as an individual who has survived at least 5 years after completion of anticancer treatment. All children were diagnosed between 1991 and 2016, mean age at diagnosis was 1.82 years (range 0.03–2.99) and median follow up time - 9.85 years (range 5.0–23.6). They were treated in accordance with international protocols approved by the Polish Pediatric Leukemia and Lymphoma Group and Polish Solid Tumor Group. Chemotherapy alone was used in 192 (34.2%), chemotherapy and radiotherapy – 56 (10%), chemotherapy and surgery – 176 (31.4%), chemotherapy, radiotherapy, and surgery – 79 (14.1%), and surgery alone in 58 patients (10.3%).ResultsOf all patients enrolled to the study, only 94 (16.8%) had normal function of all organs. Seventy-six (13.5%) children developed dysfunction in one organ, another 83 (14.8%) had symptoms or complaints suggestive of dysfunction in two organs or systems, 88 (15.7%) had abnormalities in three organs, and 220 (39.2%) had at least four or more dysfunctions. In the entire study group, dysfunctions most frequently (> 20% of cases) involved the following organs/systems: circulatory – 21.8%, urinary – 30.8%, gastrointestinal – 20.8%, immune – 23.5%, vision – 20.7%, hearing – 21.8%, and oral and masticatory dysfunction – 26.9%. We did not find any significant differences in organ dysfunction between children diagnosed under the age of 1 and those diagnosed at the age of 1–3, except for a lower incidence of thyroid abnormalities (p = 0.007) and the higher prevalence of liver dysfunction in youngest patients. In the subset with longer follow-up period (> 10 years) more frequent thyroid abnormalities (p = 0.019), male (p = 0.002) and female (p = 0.026) gonads dysfunction, as well as musculoskeletal problems (p < 0.001) were observed. Among subjects who received radiotherapy compared to those who did not, short stature (p = 0.001), and dysfunction of the following systems/organs – circulatory (p = 0.049), urinary (p = 0.012), thyroid gland (p < 0.0001), nervous (p = 0.007), immunological (p = 0.002), liver (p = 0.03), dental or chewing difficulties (p = 0.001), hearing (p = 0.001) and musculoskeletal (p = 0.026) were more frequently reported. When multimodal therapy was applied (chemotherapy, radiotherapy, and surgery) a higher incidence of short stature (p = 0.007), urinary system disorders (p < 0.0001), thyroid dysfunction (p < 0.0001), hearing loss (p < 0.0001), and skin problems (p = 0.031) were observed.ConclusionThis study confirms that radiotherapy and some specific toxicity of cytostatics are the most important factors affecting organ function. Apart from a higher incidence of liver dysfunction in the youngest patients, there were no significant differences in organ and system toxicities between children diagnosed under the age of 1 and those diagnosed at the age of 1–3. We have shown that this group requires systematic, careful and long-term follow-up.     

婴幼儿艰难梭菌的无症状定植与防治措施研究进展

艰难梭菌是一种肠道条件致病菌,能形成芽胞有效抵抗抗生素的杀灭.由于临床上抗生素的不规范使用,导致人体肠道有益菌被杀死.艰难梭菌因抵抗力强而大量繁殖,破坏人体肠道菌群平衡,引起抗生素相关性腹泻.艰难梭菌同时也是院内感染的主要病原菌.艰难梭菌可在人体肠道无症状定植,不同年龄阶段艰难梭菌定植率有较大差异,相比于成人,婴幼儿时...     

A pilot study of synbiotic supplementation on breast milk mineral concentrations and growth of exclusively breast fed infants

Despite the crucial role of breast milk mineral contents for health and growth of the infants, they decrease with the duration of lactation. So, this pilot study aimed to determine the effects of synbiotic supplementation on breast milk mineral composition and infants’ growth. In this pilot, randomized, double-blind, placebo-controlled trial, 57 lactating mothers were randomly divided into two groups to receive a daily supplement of synbiotic (n = 30) or a placebo (n = 27) for 30 days. Breast milk zinc, copper, Iron, magnesium and, calcium concentrations were determined by flame atomic absorption spectrometry. Weight for age Z-score (WAZ) and height for age Z-score (HAZ) were assessed for infants. Dietary intake was collected from lactating women using the 24-h recall method. Data analyses were carried out using nutritionist IV, Epi Info and SPSS soft wares. Synbiotic supplementation led to an insignificant increase of the mean breast milk levels of zinc (from 2.44 ± 0.65 to 2.55 ± 0.55 mg L⁻¹), copper (from 0.35 ± 0.24 to 0.40 ± 0.26 mg L⁻¹), iron (from 0.28 ± 0.42 to 0.31 ± 0.38 mg L⁻¹), magnesium (from 17.14 ± 1.35 to 17.17 ± 1.09 mg L⁻¹), and calcium (from 189 ± 25.3 to 189.9 ± 21.7 mg L⁻¹); whilst in the placebo group, these variables decreased significantly (P = 0.001). The observed changes between two groups were statistically significant (P < 0.05). Although WAZ and HAZ of infants increased slightly in the supplemented group (from 1.19 ± 0.79 to 1.20 ± 0.69 and 0.36 ± 0.86 to 0.37 ± 0.85 respectively), these two parameters decreased in the placebo group which was significant only for WAZ (P = 0.01). Moreover, no significant association was found between mineral intake and breast milk mineral contents. It seems, synbiotic supplementation may have positive effects on breast milk mineral contents.     

用益生菌治疗婴儿厌食症的临床疗效观察

目的探讨尝试用益生菌来治疗婴儿厌食症,从而达到早期干预,早期治疗的目的。方法随机选取生后3月一1岁的患有厌食症的婴儿,在排除其他器质性疾病的前提下,将其完全随机地分成两组。A组用益生菌加健脾的中成药治疗,B组只用健脾的中成药对照治疗。分别观察两组治疗的时间及治疗前后变化情况。结果A．B两组有效率分别是92．9％和79．0％,经统计学分析,X2=6．74,两组比较差异有统计学意义（P〈0．05）。结论对于婴儿厌食症加用益生菌治疗,其疗效好,治疗时间短,且无毒副作用,适合临床推广应用。     

3-6岁幼儿的Heath-Carter体型法研究

本文主要运用Heath-Carter体型测量法,对芜湖市区汉族441例(男222人,女219人)3-6岁的健康幼儿进行了体型分析.结果显示汉族幼儿随着年龄的增长,中因子值和内因子值略有下降,但变化不大,外因子值逐步上升,变化较快;男女孩各年龄组体型均值都是中因子值＞内因子值＞外因子值.幼儿期低龄段体型分布较集中,在随后的增长过程中,体型分布逐渐扩散,3-5岁男女各组体型均为偏内胚型的中胚型为主,6岁时男孩均衡中胚,女孩三胚层中间型比例增多.与布拉格幼儿相比,体型特征存在着显著性差异.     

哺乳期补充鼠李糖乳杆菌在预防婴幼儿湿疹以及特应性疾病中的价值

目的 探究哺乳期补充鼠李糖乳杆菌对婴幼儿湿疹以及特应性疾病的预防作用。方法 选择2015年1月至2016年12月间于我院分娩和定期体检的哺乳期妇女及其新生儿152例,随机数表法分为对照组（76例）和实验组（76例）,对照组采用常规哺乳期婴幼儿湿疹预防策略,实验组在此基础上补充鼠李糖乳杆菌。比较两组婴儿的免疫学指标（嗜酸性粒细胞百分比,IgE和特异性IgE）水平、皮肤点刺试验（SPT）阳性率及24个月内湿疹以及特应性疾病的发病情况。结果 实验组6个月后的EOS%、IgE、sIgE均明显低于对照组（均P<0.05）;对照组和实验组的SPT阳性率分别为15.79%和5.26%,差异有统计学意义（χ2=4.471,P=0.034）。实验组婴幼儿肠道菌群中双歧杆菌、乳杆菌明显多于对照组（t=6.173,5.070,均P<0.001）,而肠球菌及肠杆菌明显少于对照组（t=5.111,5.919,均P<0.001）。对照组婴幼儿的湿疹累积发病率为38.16%（29/76）,实验组的湿疹累积发病率为25.00%（19/76）,实验组的湿疹发病率明显低于对照组（Log-rank χ2=3.949,P=0.047）。对照组和实验组婴幼儿的特应性疾病累积发病率分别为17.11%（13/76）和6.58%（5/76）,实验组的发生风险明显低于对照组（Log rank χ2=4.275,P=0.039）。结论 哺乳期补充鼠李糖乳杆菌能够有效调节肠道菌群,降低婴幼儿2岁以内的湿疹以及特应性疾病发生风险。     

Efficacy,safety and immunogenicity of hexavalent rotavirus vaccine in Chinese infants

A randomized, double-blind, placebo-controlled multicenter trial was conducted in healthy Chinese infants to assess the efficacy and safety of a hexavalent live human-bovine reassortant rotavirus vaccine (HRV) against rotavirus gastroenteritis (RVGE). A total of 6400 participants aged 6–12 weeks were enrolled and randomly assigned to either HRV (n = 3200) or placebo (n = 3200) group. All the subjects received three oral doses of vaccine four weeks apart. The vaccine efficacy (VE) against RVGE caused by rotavirus serotypes contained in HRV was evaluated from 14 days after three doses of administration up until the end of the second rotavirus season. VE against severe RVGE, VE against RVGE hospitalization caused by serotypes contained in HRV, and VE against RVGE, severe RVGE, and RVGE hospitalization caused by natural infection of any serotype of rotavirus were also investigated. All adverse events (AEs) were collected for 30 days after each dose. Serious AEs (SAEs) and intussusception cases were collected during the entire study. Our data showed that VE against RVGE caused by serotypes contained in HRV was 69.21% (95%CI: 53.31–79.69). VE against severe RVGE and RVGE hospitalization caused by serotypes contained in HRV were 91.36% (95%CI: 78.45–96.53) and 89.21% (95%CI: 64.51–96.72) respectively. VE against RVGE, severe RVGE, and RVGE hospitalization caused by natural infection of any serotype of rotavirus were 62.88% (95%CI: 49.11–72.92), 85.51% (95%CI: 72.74–92.30) and 83.68% (95%CI: 61.34–93.11). Incidences of AEs from the first dose to one month post the third dose in HRV and placebo groups were comparable. There was no significant difference in incidences of SAEs in HRV and placebo groups. This study shows that this hexavalent reassortant rotavirus vaccine is an effective, well-tolerated, and safe vaccine for Chinese infants.