Objective The age and seasonal variation in children's serum 25-hydroxyvitamin D (25(OH) D] were analyzed retrospective and to provide some guides on clinical application.Methods The serum 25(OH) D level was detected by using enzyme-linked immunosorbent assay kit in 13 502 children that took health examination in Guangzhou Women and Children's Medical Center in February,march,September and October from 2009 to 2011.The cases were divided into five age groups.The average levels,deficiency and overdose of vitamin D (VD),were analyzed.Results The average 25(OH)D in serum was (80.81±42.39) nmol/L in 13 502 cases,(72.71 ± 33.47) nmol/L in Feb.and Mar.group,(89.91 ± 49.01) nmol/L in Sep.and Oct.group.There was statistically significant difference on serum 25 (OH)D level between seasons and between boys and girls for 6 years older groups.The serum 25 (OH) D levels significantly decreased with increasing age.There were statistically significant differences in serum 25 (OH) D levels and between the VD deficiency and the lack of number of cases in the 5 age groups of the two seasons.The number of VD deficiency was 482 cases (3.57％) whose 25 (OH) D ＜ 37.5 nmol/L,and 1850 cases (13.7％) whose 25 (OH) D ＜ 50.0 nmol/L.The VD deficiency in each age group was 8.19％,13.97％,37.72％,52.63％,57.92％ in Spring,and 2.38％,4.15％,10.36％,16.85％,27.47％ in Summer.The number of lack of VD was in 6 973 cases (51.64％);Excessive and poisoning of VD were 34 cases (0.25％) and 35 cases (0.26％).Conclusions Children had a relatively low level of VD in Guangzhou area,especially in the spring and school-age children with more severe VD deficiency.It is necessary to supplyVD timely in accordance with the age and season,and children were encouraged to spend more time outdoors.

Objective To analyze the levels of 25-hydroxyvitamin D [25-(OH)D],serum calcium,and calcium-phosphorus product (CPP) in 69 cases of vitamin D excess and the relationships among them.Methods The serum 25-(OH)D level was detected by enzyme-linked immunosorbent assay kit in 13 502 children aged from 0 to 17 years old that took health examination in our hospital from September 2009 to March 2011.The rates of vitamin D excess,and poisoning were calculated for each age group.Compared the levels of serum Ca,IP,ALP,and CPP of children with VD excess [25-(OH)D 250-375.0 nmol/L] and children with VD poisoning [25-(OH)D ≥375.0 nmol/L],and did the correlation analysis of serum Ca,CPP,and VD.Results In 13 502 children,there were 34 cases (0.25％) of VD excess and 35 cases (0.26％) of VD poisoning.The maximum value of serum Ca was 2.78 mmol/L,there were only 3 cases with serum Ca＞2.74 mmol/L.There were no statistically significant differences in Ca,IP,ALP,and CPP between the two groups (P＞0.05).There was positive linear correlation between serum Ca and CPP (r=0.762,P=0.000);there were no obvious linear correlation between serum Ca and VD,CPP and VD.There were statistically significant differences in the intergroup rank-sum test in 69 cases of excess and poisoning and 36 cases of CPP more than 60 (Mann-Whitney U=427.500,88.000;P=0.044,0.025).Conclusions Serum Ca had no obvious rise in this set of VD excess cases,the cases with CPP more than 60 significantly increased with the VD level increased,which suggested the possibility of potential soft tissue calcification.

目的:探讨早期综合发展指导对儿童体格及智能发育的影响。方法 :2010年1月至2011年12月在我院儿童保健门诊接受早期综合发展指导的0～24个月正常婴幼儿582例作为实验组;分别在6 m,12m,18 m,24 m这4个时段测量头围,身长,体重并检测血清中25-羟维生素D[25-(OH)D]浓度及血红蛋白(Hb)值,同时采用Gesell发育量表测定儿童发育商(developmental quotient,DQ)进行评价幼儿神经系统发育情况。结果:实验组儿童维生素D缺乏,缺铁性贫血发生率小于对照组;实验组儿童除6 m外,其余阶段体格发育(头围、身长、体重)及心理行为发育商(DQ)明显高于对照组。结论:早期综合发展指导不仅改善儿童体格发育,减少营养性疾病的发生,而且促进儿童的神经心理行为发育,开发智能发育潜能。

目的:探讨婴幼儿期患有慢性支气管感染小儿血液中25(OH)D3、BALP、HGB、锌(Zn2+)、钙(Ca2+)、铁(Fe2+)值变化规律,为临床治疗学提供实验依据.方法:收集临床资料应用配对研究的方法,在两组小儿人口学一致的条件下将患病组与正常对照组(体检组)血液检测25(OH)D3、BALP、HGB、Zn2+、Ca2+、Fe2+并对比研究分析.结果:1000例慢性支气管感染组小儿血25(OH)D3HGB、Zn2+、Ca2+、Fe2+值均低于正常对照组,BALP值升高,两组样本对比差异有统计学意义.结论:慢性支气管感染患儿存在明显的微量营养不足的情况,在治疗呼吸道感染同时重视营养支持、指导喂养、及时补充鱼肝油、微量元素,增加机体免疫力抵抗力对呼吸疾病的恢复有帮助.

目的了解单纯性肥胖儿童体内维生素D的水平及干预效果。方法对212例6～12岁单纯性肥胖儿童(肥胖组)和235例体质量指数(BMI)正常儿童(对照组),晨起空腹采集静脉血并采用酶联免疫吸附法(ELISA)检测其血清中25-羟维生素D浓度。对62例BMI异常的维生素D缺乏患儿补充维生素D制剂,1个月后复查25-羟维生素D浓度。结果肥胖组中维生素D不足及缺乏的有140例(66.0%);对照组中维生素D不足及缺乏的有66例(28.1%),两组间差异有统计学意义(P<0.01)。62例维生素D治疗干预者中,维生素D水平达到适宜水平的超重患儿占91.7%(33/36),而肥胖患儿只占65.4%(17/26),两者间差异有统计学意义(P<0.01)。结论单纯性肥胖儿童血清25-(OH)D浓度低于正常儿童,超重儿童补充维生素D制剂的效果较明显。

Objective To explore the significance of quantitative and qualitative measurements of bone alkaline phosphatase ( BAP-E and BAP-CIT ) and detection of serum AP in the diagnosis of rickets. Methods Serum AP level was measured, quantitative BAP was detected by ELISA, and qualitative BAP was determined by CIT in 55 children with rickets and 26 control subjects. Results AP level and BAP-E were ( 164.38 ± 23.87 ) U/L and ( 57.99 ± 7.67 ) U/L in controls, and were ( 209.50 ± 44.28 ) U/L, ( 80.38 ± 15.75 ) U/L, ( 206.06 ± 30.80 ) U/L, ( 78.05± 11.69) U/L, ( 1000.47 ± 464.65) U/L, and (283.22 ± 96.42) U/L in mild or severe rickets ,respectively. AP and BAP-E were elevated significantly in children with rickets ( P＜ 0.05 ), and there were significant differences between the severe groups and the mild groups ( P ＜ 0.05 ). AP positively related with BAP-E ( r= 0.921, P＜ 0.01 ) and BAP-CIT ( r= 0.49, P＜ 0.01 ). In the control group,BAP-CIT within the normal range was only in one patient and that beyond the normal range was in the remaining patients. Conclusions AP and BAP-E are positively correlated with the severity of rickets.AP may be used in severe patients. BAP-CIT should be used carefully in the diagnosis of rickets.

To explore womens personal experiences and perceptions of breastfeeding and to analysis the situation and factors affecting the initiation of breastfeeding in Zengceng City,a qualitative study of 69 women was undertaken and completed via Maternal and Child Health Hospital in Zengceng from Dec.2003 to Feb.2004.Participants were recruited to the study and interviewed during they took routine physical examination 42 days after childbirth.The results showed that 54(78%) of them had initiated breastfeeding,but only 4% exclusively breastfed up to 42 days.Reasons for add milk-substitute were the feeling of the breast milk could not meet the need of the baby(74%),the perception that presume colostrums were unhealthy(12%),etc.Add starchy foods prematurely mainly influenced by local traditional feeding concept.It concludes local culture and the incorrect cognition about the mechanism of breast milk secretion are the main reasons of the low exclusive breastfeeding rate.Breastfeeding health educations need to fully understand the local culture.Education targets in addition to lactating mother should also include their close relatives and friends.

目的通过对佝偻病患儿骨钙素(OC)、骨碱性磷酸酶(BALP)、脱氧吡啶啉(DPD)、25-羟维生素D3(25-OHD)的检测,探讨佝偻病患儿的骨代谢情况。方法采用ELISA法检测了91例佝偻病患儿和29例对照组小儿的血清OC,BALP,DPD,25-OHD水平,依病情严重程度进行分组分析。结果佝偻病组OC,BALP,DPD显著高于对照组(P<0.05),病情严重组OC,BALP,DPD水平明显高于轻度组(P<0.001);佝偻病组与对照组之间25-OHD水平差异无显著性。佝偻病组和对照组各指标的相关性:BALP与25-OHD呈负相关(P<0.01);DPD与25-OHD呈负相关(P<0.01);BALP与OC呈正相关(P<0.001);BALP与DPD呈正相关(P<0.001);OC与DPD呈正相关(P<0.001)。结论佝偻病患儿BALP和OC升高提示成骨细胞功能活跃,DPD升高提示骨吸收增加,这三个指标均与佝偻病的病情严重程度呈正比。

[Objective] To observe the effect of the content of Pb、Zn、Cu、Fe、Ca and Mn after the treatment by traditional Chinese medicine. [Methods] 184 children with blood lead level exceeding 0.1μg/ml were randomly divided into the treatment group and control group. The treatment group with traditional Chinese medicine, the control group with no drug, the observation period for both 30 days. [Results] The blood lead in treatment group was significantly lower than that of the children cured by traditional Chinese medicine(P<0. 001) ,the blood Zn increased(P<0. 05); The blood lead in treatment group was significantly lower than in the control group(P<0. 001) , while the content of Cu、Fe、Ca、Mn remained stable(P>0. 05). [Conclusion] Traditional Chinese medicine was effective in curing children with Pb poisoning, which would not cause trace elements inbalance.

婴幼儿反复上呼吸道感染是儿保门诊中最常见病种之一,这类婴幼儿在原发病的同时多伴有汗多、夜睡不宁等类似佝偻病的表现,为了探讨两者之间的相互关系,我们对165例反复上呼吸道感染患儿和170例对照组婴幼儿进行血骨碱性磷酸酶的检测,现将结果报道如下.

为探讨佝偻病与血微量元素的关系,检测了326例佝偻病患儿全血微量元素水平.结果显示,本组佝偻病40.1%的病例血锌低于第25百分位数值,病情严重组的血锌值明显低于病情较轻组,且有统计学意义,按全血锌百分位数值分布及结合资料,显示病情愈重低血锌病例愈多;病情较轻组的铁水平较病情严重组低,且有统计学意义,按全血铁百分位数值分布及结合资料亦显示,病情严重的佝偻病组铁在中位数以上的病例数较病情较轻的佝偻病组多,有统计学意义;本组佝偻病69.6%的病例血铅含量超过100 μg/L,病情严重组的血铅值明显高于病情较轻组,且有统计学意义,按全血铅百分位数值分布结合资料,显示病情愈重高血铅的病例愈多.提示佝偻病的治疗需提高血锌水平及防治铅中毒.

In order to investigation the relationship between blood lead levels (Pb) and some other trace elements in blood including zinc (Zn),iron(Fe),copper (Cu),calcium (Ca) and manganese (Mn),their blood levels of 2 172 children were examined with multiple linear regression analysis for the independent asociations.The results demonstrated that blood lead levels were high from 0.10 to 0.44 μg/mL in 47.56% cases who could be classifed as mild to moderate lead poisoning.The correlations of Ca,Fe,Mn levels with the reversed values of blood lead (PB 1)were significant but not strong and the partial correlation coefficients were -0.079,0.07,0.06 respectively.The influences of blood Ca on PB 1 were associated with Cu and Zn levels while the interaction among Ca and Zn,Cu were significant.Fe and Mn levels were parallel to PB 1,indicating their reversed relation of values.The influence of Fe and Mn on lead levels was partly subduced by their own interaction.Therefor it could be concluded that mild to moderate lead poisoning still widely exists in urban children.To redress the situation,higher iron intake with balanced micronutrients of dietary Ca,Mn and other trace elements should be recommended besides going away from the source of Pb pollution.

In order to investigate the frequency and age-related characters of trace elements abnormalities in children under 7 year-old,levels of zinc, iron, copper, calcium, manganese and lead in whole blood of 2 148 children were analyzed with SPSS 11.0 statistical package. The results demonstrated that mild to moderate lead poisoning occurred most frequently (47.49%), followed by zinc deficiency(9.64%)and calcium deficiency (1.49%). When comparing the 6 kind trace elements levels among different age groups, it was found that the trace element levels in age group 2 to 3 and 5 to 7 year-old varied greatly, but with no statistical significance (P0.05).In conclusion, for Guangzhou children less than 7 year-old the most frequent abnormalities of trace elements levels are lead poisoning and zinc deficiency, but calcium and manganese deficiency also exist.

To explore the relationships of children with recurrent respiratory infection(RRI)and blood trace elements during spring and summer in Guangzhou district,blood trace elements of 95 cases of children with RRI and 37 cases of healthy children were tested from Jan 2004 to June 2004.The results showed that blood zinc levels of RRI group were lower,and blood lead levels were higher than those of control group.There were significant differences between two groups.The differences of blood calcium and blood magnesium between two groups had not significance in statistic.These indicated that children with RRI need enhance the levels of blood zinc and prevention and treatment lead poisoning.

选取1999年7～8月136例与2001年7～8月216例广州地区保健儿童全血中铅含量的分析结果,研究了本地区儿童的铅污染的水平状况,结论是环境干预、健康教育对儿童铅污染的防治效果显著.

To explore the relationship between rickets and blood lead,the levels of blood lead of 120 cases of moderate,severe rickets and 35 cases of subclinical rickets were determined.The result showed that the lead levels of 86 5% cases of rickets were over 100 μg/L.There were no direct relationships of blood lead to calcium,phosphorus,alkaline phosphatase.There were no significant differences in the degrees of lead poisoning among three rickets groups.In treating rickets, prevention and treatment lead poisoning is important.

随着经济发展,人们生活水平提高及对疾病认识的提高,佝偻病的发病已逐年下降,门诊病例多以轻症居多,但也不乏严重病例,本文将一组中重度佝偻病病例报告如下. 1 对象和方法 1.1 对象 1999年5月～2001年5月到我院保健门诊就诊的佝偻病患儿,以1986年<全国佝偻病防治方案>为诊断标准,选取中重度佝偻病患儿,年龄范围为10～60月,予摄右腕、右膝X片,由放射科专人阅片,选择X片异常病例102例.

Objective To detect the serum estrogen level in women with involution al depression (ID) and to study the effect of estrogen on the occurrence of ID. Methods Serum estrogen levels at 7:00 am were detec ted by r adioimmunoassay in 40 normal menopausal women (Group A) and 49 cases of ID (Grou p B), and compared with those of 36 cases previously detected. Results Estro gen level was much lower in Group B than Group A (P 0.01 ) but similar to Group C (P 0.05 ). Co nclusion The occurrence of ID in menopausal women may be related to t he decrease of estrogen level, but the specific correlation of the above two has not been proved yet.

Objective: To investigate inhibitory effects of ketamine racemates on superoxide anion generation and interleukin-6 production of leukocytes. Methods: (1) Isolate human PMN, incubate with ketamine and then stimulate with either FMLP or PMA, observe spectrometrical changes of the supernatant indicated with cytochrome C; (2) Incubate human whole blood with LPS and different concentrations of ketamine and then determine the supernatant IL-6 levels with ELISA. Results: Ketamine inhibited human PMN O_2~- generation dose-dependently but not stereo-selectively. IL-6 production was also inhibited dose-dependently. Conclusion: Ketamine suppreses pro-inflammatory function of leukocytes and inhibition is most likely not mediated through specific receptor interaction. Considering other beneficial effects such as sympathemimetie action and bronchial dilation, ketamine could be suggested to be an analgiosedative drug of choice for patients with SIRS and sepsis.