早产儿与足月儿精细运动发育差异及影响因素的研究

【目的】 了解早产儿与足月儿精细运动发育水平的差异及其影响因素。 【方法】 采用Peabody运动发育量表第2版(Peabody Developmental Motor Scales 2,PDMS-2)对215例婴儿(早产儿97例、足月儿118例)进行精细运动发育水平测试,并对结果精细运动发育商(fine motor quotient,FMQ)进行统计分析。 【结果】 1)早产儿FMQ显著小于足月儿FMQ(t＝5.142,P＜0.05);2)精细运动的抓握标准分低于视觉运动整合标准分(d＝1.00±1.24,t＝11.881,P＜0.05);3)FMQ受到胎龄、出生体重、进食能力训练、身高、体重多方面因素的影响。 【结论】 早产儿精细运动发育落后于足月儿,且抓握能力发育较视觉运动整合能力发育落后;孕期加强保健延长胎龄和增加出生体重、生后有意识通过进食能力训练加强动手能力的提高、保持适宜的生长发育对精细运动的发育极其重要。     

早产小于胎龄儿发育特征研究

【目的】探讨早产小于胎龄儿(small for gestational age,SGA)生长发育特征,为今后对早产儿进行有效干预提供依据。【方法】将胎龄在206-258 d的早产儿按体重进行胎龄评估,分为SGA组(出生体重小于同胎龄出生体重P10)45例,适于胎龄儿(appropriate for gestational age,AGA)组76例,对照组200例(正常足月儿)。三组均于出生后定期接受体格发育监测和52项神经运动检查,并进行相应干预指导。在1-2岁间做智力(CDCC)检查。【结果】早产SGA儿体重在3-6月时与其他两组差异有显著性,9-12个月与早产AGA儿体重差异缩小,但仍与足月儿有差异。早产SGA儿52项神经运动检查部分指标异常率明显高于其他两组。早产儿智能发育指数(mental development index,MDI)与足月儿差异有显著性,早产儿两组之间差异不大。早产儿贫血发生率高。【结论】早产SGA儿1岁以内的体格生长发育具有快速追赶特征,6个月后仍能保持较快的追赶速度。但1岁以内体重落后危险仍较大,神经运动发育也落后。早产儿2岁以内MDI较低,应该针对性地进行干预指导。     

新生儿窒息的相关因素及并发症

由于围生医学水平的提高 ,新生儿窒息导致的死亡逐年下降。窒息后并发症成为早期新生儿的常见疾病。为了解窒息的相关因素及窒息后并发症的发病率、临床表现及转归 ,探讨减轻损伤、改善预后的措施 ,对我院分娩的新生儿窒息进行了临床监测。对象与方法1.对象 :自 2 0 0 1年 7月至 2 0 0 2年 4月我院分娩新生儿4 0 18例 ,窒息 118例 ,男 77例 ,女 4 1例 ,足月儿 10 2例(小于胎龄儿 5例 ) ,胎龄 ( 38.2± 2 .2 )周 ,出生体重 ( 3119.4± 6 35 .6 ) g;早产儿 16例 ,胎龄 ( 34.5± 1.7)周 ,出生体重 ( 2 2 70 .3± 4 0 7.0 ) g。随机选取同期 2 0…     

无锡市77484例新生儿出生体重现状分析

【目的】了解无锡市新生儿出生体重现状,并对妇幼保健工作提供一些科学依据。【方法】对无锡市2003~2005年住院分娩的活产新生儿的出生体重进行分析。【结果】①77 484例新生儿中,早产儿2.07%,低出生体重儿1.54%,巨大儿5.72%;②平均出生体重为(3 370.32±427.84)g,37~42周出生的新生儿出生体重随胎龄增长而增长;③婴儿低出生体重发生率随胎龄增加而显著减少,足月低体重儿比例较早产儿明显少。【结论】无锡市新生儿出生体重超过了WHO的国际参照值;各胎龄新生儿出生体重均高于我国15个城市同胎龄新生儿出生体重;巨大儿及低出生体重儿发生率较低;新生儿平均出生体重及低体重儿、巨大儿发生率在性别方面存在显著差异。     

新生儿胎粪吸入综合征血液中淋巴细胞ICAM-1的研究

目的:了解新生儿胎粪吸入综合征(MAS)血液中淋巴细胞ICAM水平的变化,探讨其在MAS的意义。方法:采用流式细胞仪检测21例MAS患儿生后第1 d及25例足月健康新生儿脐血淋巴细胞表面ICAM的水平。结果:MAS患儿生后第1 d血液淋巴细胞ICAM-1水平为4.99％±2.60％,与对照组比较无显著性差异。MAS患儿淋巴细胞ICAM-1水平与血白细胞总数、中性粒细胞绝对值、淋巴细胞绝对值的相关系数分别为0.241、0.215、0.205。MAS患儿ICAM-1与生后1 h血PH值的相关系数为0.134。结论:MAS患儿生后第1 d淋巴细胞ICAM-1与对照组比较无差异,与血白细胞、PH值均无关。     

影响早产儿屈光状态的临床因素分析

【目的】探讨影响早产儿眼屈光状态的临床因素,为早产儿早期开展眼保健工作提供依据。【方法】选取2003年5月~2004年5月新生儿科收住院的213例早产儿为研究对象,分别检测纠正胎龄40周,3月,6月,1岁,2岁时眼屈光状态;同期出生的56例足月儿为对照组,比较早产儿与足月儿屈光发育差别,分析可能影响早产儿屈光状态的临床危险因素。【结果】早产儿近视、屈光参差、散光的发生率及程度均较足月儿高,而早产儿远视的度数较足月儿低;出生体重<1 500 g,胎龄<33周及出生后伴有头颅影像学异常,则是影响早产儿屈光状态发展的临床危险因素。【结论】对胎龄<33周、出生体重<1 500 g及出生后伴有头颅影像学异常的早产儿应早期开展眼保健工作,即从2岁开始对他们进行早期视觉追踪及屈光筛查,以便早期纠正屈光不正,降低弱视发生率。     

新生儿胎粪吸入综合征血液中淋巴细胞ICAM-1的研究

目的了解新生儿胎粪吸入综合征(MAS)血液中淋巴细胞ICAM水平的变化,探讨其在MAS的意义.方法采用流式细胞仪检测21例MAS患儿生后第1 d及25例足月健康新生儿脐血淋巴细胞表面ICAM的水平.结果MAS患儿生后第1 d血液淋巴细胞ICAM-1水平为4.99%±2.60%,与对照组比较无显著性差异.MAS患儿淋巴细胞ICAM-1水平与血白细胞总数、中性粒细胞绝对值、淋巴细胞绝对值的相关系数分别为0.241、0.215、0.205.MAS患儿ICAM-1与生后1 h血PH值的相关刎系数为0.134.结论MAS患儿生后第1 d淋巴细胞ICAM-1与对照组比较无差异,与血白细胞、PH值均无关.     

广西农村120 145例新生儿出生体重分析

【目的】研究新生儿出生体重与性别、孕母年龄、胎龄、分娩方式的关系,为孕产期保健和儿童保健提供基础资料。【方法】回顾性分析120145例新生儿出生体重及其相关因素。【结果】新生儿出生体重平均值为(3.02±0.41)kg,男婴大于女婴;出生体重随胎龄增加而增大,早产儿组平均体重只有(2.33±0.45)kg;孕母的年龄<20岁的新生儿平均出生体重低于其他组;县级剖宫产率高于乡级,巨大儿剖宫产率明显高于正常体重和低体重儿。【结论】广西新生儿出生体重低于我国出生体重正常值,提高孕期保健工作质量,加强孕期营养,加强儿童早期综合干预,是广西"十一五"期间农村孕产期保健和儿童保健工作的重点。     

早产儿暂时性低甲状腺素血症的早期临床观察

【目的】　了解早产儿暂时性低甲状腺素血症(transient hypothyroxinemia of prematurity,THP)生后发病情况,对其早期生活质量进行量化观察。【方法】　对胎龄≤32 周或出生体重≤1 500 g的早产儿生后筛查甲状腺素(T4),促甲状腺素(thyroid stimulating hormone,TSH)。对新生儿发病情况、早期生活质量及体重增长进行量化观察并与正常组进行比较。　【结果】　THP组与对照组新生儿期发病率差异无显著性,但THP组规则自行排便日龄、高胆红素血症持续日龄、热量达100 Cal/(kg·d)日龄、恢复出生体重日龄及住院天数均较对照组延迟,差别具有显著性(P<0.05)。　【结论】　THP与新生儿围生期疾病无关,但降低了早产儿早期生活质量。     

新生儿血压与日龄、胎龄、出生体重的关系

目的通过测量正常新生儿和早产儿生后7 d内的血压,探讨正常足月新生儿和早产儿血压的变化规律,以及血压与日龄、出生体重、胎龄的关系.方法应用美国Omni-TrakTMNVS型监护仪上的DINAMAP测压装置,随机检查50例正常足月新生儿和55例早产儿生后7 d内的血压.结果①日龄、出生体重、胎龄对正常足月新生儿和早产儿收缩压、舒张压、平均动脉压有非常显著的影响,出生体重、胎龄对第1 d收缩压、舒张压、平均动脉压均有显著的影响,正常足月新生儿和早产儿相比,收缩压、舒张压、平均动脉压均有显著差异;②收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)与日龄(X1)、出生体重(X2)、胎龄(X3)的回归方程分别为SBP=32.4+0.7X1+3.7X2+0.6X3(mmHg),DBP=13.1+0.6X1+2.9X2+0.6X3(mmHg),MAP=17.3+0.4X1+2.0X2+0.8X3(mmHg),并得到平均动脉压=舒张压+0.45(收缩压-舒张压)(mmHg).结论生后7 d内正常足月新生儿和早产儿收缩压、舒张压、平均动脉压随日龄而增加.早产儿每日的收缩压、舒张压、平均动脉压低于正常足月新生儿.日龄、出生体重、胎龄与新生儿收缩压、舒张压、平均动脉压有线形依赖关系.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.