昆明地区小儿急性下呼吸道感染非细菌病原研究

急性呼吸道感染(ARI)是小儿常见多发病,发病率在全国小儿各类疾病中占首位,近年来国内外对小儿ARI病原学方面进行了大量研究,我省尚缺乏本地区小儿ARI病原学资料.为掌握本地区小儿呼吸道病原感染、混合感染状况及流行病学资料,2005年10月-2006年12月,我们对昆明地区485例小儿急性下呼吸道感染(ALRI)患儿进行了呼吸道感染病变部位多病原(病毒、非典型病原体)联合]检测,为临床提供本地区小儿呼吸道感染病变部位多病原学资料,现报道如下.     

儿童呼吸道病毒感染的实验室诊断方法及合理应用

病毒是儿童呼吸道感染的主要病原。在呼吸道感染中,早期、快速、准确的病原学诊断,可避免抗生素滥用。呼吸道病毒感染的不同实验室诊断方法各具优缺点,合理运用和正确解读其检测结果有助于临床医生做出准确的病原学诊断。     

儿童呼吸道病毒感染的实验室诊断方法及合理应用

病毒是儿童呼吸道感染的主要病原。在呼吸道感染中,早期、快速、准确的病原学诊断,可避免抗生素滥用。呼吸道病毒感染的不同实验室诊断方法各具优缺点,合理运用和正确解读其检测结果有助于临床医生做出准确的病原学诊断。     

肺动脉移位联合Slide方法矫治肺动脉吊带一例

正肺动脉吊带(pulmonay artry sling,PAS)是一种罕见的婴幼儿期先天性心血管疾病,解剖特征为异常左肺动脉走形于食管气管之间压迫气管造成气管狭窄,半数以上患者气管软骨呈全环"O"型环样改变(complete trachtal rings,CTR)~([1,2])。PAS患者常存在反复呼吸道感染、气道梗阻,预后不佳,故一经确诊,无论有无肺部感染,都需及时行手术治疗~([3-5])。PAS的外科治疗方法主要包括血管再植术和气管成形术~([3])。肺动脉移位(pulmonary artery translocation,PAT)联合Slide方法矫治肺动脉吊带合并气道狭窄目前临床应用较少~([6])。2020年12月,浙江大学医学院附属儿童医院收治了1例肺动脉吊带合并长段气管狭窄患者,在全麻体外循环下行左肺动脉移位以及Slide重建术,现报道如下。     

儿童缺铁与免疫功能损害相关性及其防治研究进展

正近年来,虽然我国儿童的总体健康水平已得到明显改善,但近期流行病学调查资料显示,儿童铁缺乏症(iron deficiency,ID)和缺铁性贫血(iron deficiency anemia,IDA)的发病率仍然分别高达40.3%和7.8%~([1-2])。儿童ID不仅可导致IDA,也可导致免疫功能缺陷或下降~([3-7])。例如,近年国外学者研究结果显示,ID和IDA与儿童反复呼吸道感染(recurrent respiratory tract infection,RRTI)存在明显相关性~([6-9]),但国内罕见类似报道,近年也未见有关     

呼吸道合胞病毒病原学检测技术的研究进展

呼吸道合胞病毒(RSV)是全球婴幼儿下呼吸道感染最重要的病毒病原,目前检测RSV的技术主要有病毒分离培养、免疫学和分子生物学检测。病毒分离培养技术不适合临床早期诊断和疫情应急诊断的需要;免疫学检测技术具有灵敏和快速的特点,主要有免疫荧光检测技术和酶免疫测定等;分子生物学检测技术主要有核酸分子杂交、PCR和随机扩增多态DNA指纹技术等,特别是PCR技术具有更高的灵敏度和特异性。所有针对RSV病原学的检测技术均有其优缺点,开发快速、灵敏和特异的检测技术是未来RSV病原学检测技术的发展方向。     

先天性锁骨假关节一例报告及文献复习

正先天性锁骨假关节(congenital pseudarthrosis of the clavicle,CPC)是一种罕见畸形,1910年由Fitzwilliams首次报道~([1-17])。最多见于右锁骨中1/3~([4,18-21]),约10%累及双侧~([14,22]),左侧极少受累~([7,12,23])。左侧发病者常伴发右位心~([9,17,18,23-25])或颈肋~([1-6,10,11,14,22,26])。患儿出生时即可发现锁骨干中部有一无痛性包块,随年龄逐渐增大,多数不影响上肢功能~([19])。现将我科收治的1例先天性锁骨假关节及文献复习报告如下。     

小婴儿下呼吸道炎血清肺炎支原体,衣原体及巨细胞病毒抗体检测分析

随着诊治水平的提高,对呼吸道感染的病原学检测日益受到重视,特别是近年来除了对引起小儿肺炎常见的病毒、细菌感染进一步明确外,已发现引起小儿呼吸道感染的另一些病原,如肺炎支原体、衣原体等。为明确小耍儿下呼吸道炎的病原学情况,我们对6个月以下的小婴儿肺炎同时进行了血清肺炎     

急性下呼吸道感染病原学分析

目的　探讨近期本地区引起小儿下呼吸道感染的病原学变化。方法　应用ELISA法检测住院患儿急性期血清EB病毒 (EBV)、呼吸道合胞病毒 (RSV)、柯萨奇病毒 (CBV)、流感病毒 (IV)及肺炎支原体 (MP)特异性抗体IgM。结果　 934例疑似感染者中检出 5种抗体均阳性 4 5 8例 ,下呼吸道感染 2 6 7例 ,其中气管炎、支气管炎 14 1例 ,支气管肺炎 12 6例 ;单一病原感染占 72 .7% ,两种病原混合感染占 2 4 .3% ,三种病原混合感染占3.0 % ;MP感染者居首位 ,余依次分别为EBV、RSV、IV、CBV。结论　引起下呼吸道感染的病原学复杂 ,其分布特点及流行季节各异。对混合感染者及早明确致病病原体 ,有利于及时采取相应治疗措施 ,提高疗效     

苏州地区急性呼吸道感染住院患儿病毒病原学分析

目的：了解苏州地区急性呼吸道感染（ARI）住院患儿的病毒病原学情况。方法：采集1 668例7岁以下ARI住院患儿鼻咽分泌物,直接免疫荧光法检测呼吸道合胞病毒（RSV）,流感病毒A,B型（IV A,B）,副流感病毒1,2,3型（PIV 1,2,3）及腺病毒A(ADA)等7种常见呼吸道病毒,用RT-PCR法检测人类偏肺病毒（hMPV）N基因。结果：① 1 668例患儿中,病毒检测阳性597例（35.8%）。单项病毒感染561例（33.6%）,其中7种常见呼吸道病毒检出率为23.1%,以RSV为主（17.6%）,好发于冬春季,主要见于1岁以下婴幼儿;② hMPV阳性率为10.6%,3~5月份为检出高峰期。③ 36例混合感染中,22例为RSV合并hMPV感染,主要见于1岁以下婴幼儿。结论：RSV是该地区ARI的主要病毒病原,RSV感染好发于冬春季,多见于1岁以下婴幼儿,hMPV是3~5月份ARI患儿的主要病毒病原,混合感染多见于1岁以下婴幼儿。［中国当代儿科杂志,2009,11（7）：529-531］     

Adenovirus 7a: a community-acquired outbreak in a children's hospital

BACKGROUND: Adenoviruses produce many illnesses in children, particularly respiratory and gastrointestinal disease. The most common adenoviral respiratory infections in children are caused by types 1, 2, 3 and 5. Adenoviruses spread rapidly in closed environments often causing epidemic disease. Serotype 7a has been responsible for outbreaks of respiratory disease in children living in close proximity with one another. This report describes a large community-acquired adenovirus 7a epidemic in hospitalized children. METHODS: Evaluation of all patients with cultures positive for adenovirus from a children's hospital-based virology laboratory during a recognized adenovirus outbreak. All such adenovirus isolates were typed, and patients with adenovirus 7a are described by review of medical records. RESULTS: Between March 1 and July 26, 1997, 47 children admitted to the hospital were identified as infected with adenovirus. Of these 47 patients 26 (55%) were infected with adenovirus 7a. Twenty-four (92%) infections were community-acquired. The age range was 11 days to 10 years with a median of 9.5 months. Twenty-two patients (84%) had respiratory symptoms, and 21 (8%) had fever, making these the most common symptoms. The mean durations of fever and hospitalization were 5.5 and 7 days, respectively. One of 26 patients died. CONCLUSIONS: Adenovirus 7a can cause large community epidemics affecting children. The disease produced by adenovirus 7a in children is almost exclusively of the respiratory tract, and in some individuals it may be very severe and possibly fatal.     

Peritoneal metastasis of a pineoblastoma in a patient with a ventriculo-peritoneal shunt

A 12 years old child had an increase of intra cranial pressure secondary to a large pinealoblastoma. A ventriculo peritoneal shunt procedure was performed followed several days later by a partial resection of the pinealoblastoma. One year later, ultrasound and computed tomography examinations discovered a solid mass in the pelvis. At surgery it appeared to be a metastasis of the pinealoblastoma. It is a very seldom complication of the shunt and various mechanisms are discussed.     

Chest-deformities: a proposal for a classification

Background  

In this article we assess the significance of classifying chest-deformities based on morphological findings in type-related treatment and its results.