160例平板运动试验诱发心律失常分析

目的：分析平板运动试验诱发心律失常的特点。方法：选择160例患者应用标准Bruce方案进行次极量平板运动试验,同步监测血压和12导联心电图,记录运动前、运动中及恢复期的血压和心电图。结果：160例运动试验诱发心律失常共36例,发生率为22.5%,运动试验阳性组心律失常发生率（44.9%）高于阴性组（12.7%）。结论：运动试验可辅助临床对冠心病的诊断,运动试验阳性组诱发的心律失常多于阴性组,以室性心律失常多见,运动中、运动后发生心律失常可能与心肌缺血等因素有关。     

平板运动试验不同阶段出现的室性心律失常分析

目的：通过进行平板运动试验鉴别室性早搏的性质。方法：从所有做平板运动试验的2383例室性心律失常病例中，选出在不同阶段出现室行早搏的217例患者进行分析。结果：经冠状动脉造影证实确定为冠心病的174例，高血压性心脏病合并冠心病12例，X综合症4例，心律失常15例，植物神经功能紊乱12例。174例冠心病患者7例为左主干病变，58例为双支病变，109例为单支病变。结论：平板运动试验对室性心律失常的定性分析具有较高的临床价值。     

活动平板运动试验室性早搏分析

目的：评价活动平板运动试验室性早搏(室早)的临床意义。方法：在活动平板运动试验中观察室早QRS间期、定位、电压、出现时间、室性心律失常性质等指标的变化，并与冠脉造影结果进行对照分析。结果：在136例的活动平板活动试验中，室早ORS间期与活动平板运动试验的结果、冠脉造影的结果相关，室早QRS间期≥0．14s冠脉造影阳性率显性升高。且随着冠脉狭窄程度增加、累及冠脉病变范围越多，室早QRS间期则越宽。冠脉造影阳性中89．83％室早来源于左心室(除左后支外)，而阴性组仅10．17％例来源于左室，大部分来源于右室及左后支。QRS低电压与活动平板运动试验的结果相关，且随着冠脉狭窄增加，低电压增多。但与冠脉病变范围无关。室性心律失常严重程度与冠脉造影结果相关，冠脉狭窄程度增加、累及冠脉病变范围越多，室性心律失常则越严重。结论：室早在活动平板运动试验中可能有一定临床意义。活动平板运动试验中如室早QRS间期0．14s以上，起源于左室，低电压，Lown氏分级≥3级对冠心病的诊断有一定指导意义。     

自体骨髓间充质干细胞移植脑性瘫痪儿童运动功能的评价

背景：干细胞具有修复和替代受损脑组织的潜力,被认为是一种新的治疗小儿脑性瘫痪的方法。 目的：用粗大运动功能测试量表88项及精细运动功能评估量表45项评价自体骨髓间充质干细胞移植对脑性瘫痪患儿运动功能的改善情况。 方法：对20例脑性瘫痪患儿进行自体骨髓间充质干细胞移植治疗,用粗大运动功能测试量表88项及精细运动功能评估量表45项对治疗前及治疗后1,3,6 个月时患儿的粗大及精细运动功能进行评估。 结果与结论：随访过程中有3例患儿失访。顺利完成研究的17例患儿治疗后 1,3,6个月的粗大运动功能测试量表88项总分及A(卧位与翻身)、B(坐位)、C(爬与跪)功能区得分,精细运动功能评估量表45项总分及B(上肢关节活动能力)、C(抓握能力)功能区得分均较移植前显著提高(P < 0.05),以治疗后1个月的提升速度最显著,且未见明显不良反应。提示自体骨髓间充质干细胞移植可改善脑性瘫痪患儿的粗大运动和精细运动功能,对治疗小儿脑性瘫痪是安全、有效、可行的。     

隐匿型冠心病平板运动试验分析

目的：探讨平板运动试验对隐匿型冠心病的诊断价值。方法：对107例不典型胸部疼痛的患，平静心电图检查正常而临床疑似冠心病，行平板运动试验。对其结果进行回顾性分析。结果：53例患的心电图出现不同程度的异常改变，阳性率49．5％。结论：平板运动试验对隐匿型冠心病有较高的辅助诊断价值。     

平板运动试验与冠状动脉造影的对比分析

目的 通过平板运动试验与冠状动脉造影的对比分析,评价平板运动试验诊断冠心病的价值.方法 选择100例临床拟诊冠心病或排除冠心病患者分别行平板运动试验与冠状动脉造影术,将两种检查结果对比分析.结果 平板运动试验诊断冠心病敏感性77.6%,特异性72.5%,阳性预测率60.3%,阴性预测率39.7%,假阴性22.4%.结论 平板运动试验具有安全、无创、价廉、操作简单等优点,对冠心病的诊断有重要参考价值.     

心电图运动平板试验对冠状介入治疗与溶栓治疗急性心肌梗死临床疗效的系统评价研究

目的：对比急性心肌梗死(AMI)患者行冠状介入治疗(PCI)与药物溶栓治疗后，心电图运动平板试验检测结果，指导临床疗法选择。方法以98例AMI患者为研究对象，随机均分为A组与B组，分别行PCI治疗及药物溶栓治疗。病情稳定6个月后，行心电图运动平板试验初步评判两组疗效；继而行超声心动图检测左心射血分数(LVEF)、左室舒张末径(LVEDD)，评价心电图运动平板试验有效性。结果心电图运动平板实验结果提示：A组最大运动负荷(8.8±2.1)METS，运动时间(9.5±3.0)min，均显著性高于B组(6.5±2.2)METS和(7.2±2.5)min；超声心动图检测结果提示：A组LVEF(52.5±5.2)%，LVEDD(48.5±3.0)cm，均显著性优于B组(46.6±5.0)%和(52.3±3.5)cm。上述差异均有统计学意义(P<0.05)。结论相较于药物溶栓，PCI术对急性心肌梗死具有更确切的效果；行心电图运动平板实验可有效评价患者预后。     

GMAE软件系统在脑瘫患儿评估及康复治疗中的临床意义

目的为脑瘫患儿粗大运动功能障碍程度及康复疗效评估提供科学、简便的工具。方法采用GMAE、GDSGM分别对34例脑瘫患儿治疗前后粗大运动功能进行评估比较。对83例脑瘫患儿随机分组,分别在治疗前后评估,将得分输入GMAE进行数据分析。A组：治疗时间3个月,常规治疗加GMAE提供的预期训练目标;B组：治疗2个月,方案同A组;C组：仅常规治疗3个月。对照组为30例健康患儿,两次测评间隔3个月。结果 34例脑瘫患儿治疗前后评估,GMAE结果差异显著（t=5.26,P〈0.0001）;GDS-GM结果差异不显著（S=87.5,P〉0.05）。83例患儿中,各组首次、二次检测及两次检测GMAE结果差值均低于对照组（P〈0.05）;A组两次检测结果差值明显高于B组和C组（P〈0.05）。对照组中,3岁以上组GMAE首次测量值显著高于3岁以内组（P〈0.05）。3岁以内组两次测量差值明显高于3岁以上儿童,差异显著（P〈0.05）。结论 GMAE可量化脑瘫患儿粗大运动功能障碍程度及康复训练后进步变化幅度,具有科学、简便、实用的特点。其敏感性、特异性均优于GDS-GM。还能反映不同年龄粗大运动发育水平的特点,其显示的预期训练目标对脑瘫患儿个体精细化康复训练有一定的指导意义,适合国内临床广泛使用。     

小儿心房扑动11例分析

目的：探讨心房扑动患儿的病因与临床特点.方法：总结本院2011年1月至2014年1月收治的所有房扑患儿,对其临床特点及治疗加以分析总结.结果：以基础综合治疗为主,房扑治疗常首选抗心律失常药物,采用射频消融术可根治房扑.结论：先天性心脏病是发生心房扑动的基础,及时发现,及时治疗,大多预后良好.     

冠心病患者平板运动试验中QT离散度变化与运动诱发的缺血性室性心律失常的关系

冠心病是猝死的最重要原因之一，其猝死的原因多为恶性室性心律失常。近年来QT离散度(QTd)增加被认为是预测恶性心律失常的指标。本文通过测定分析40例冠D病患者平板运动试验前、后QTd变化，探讨冠心病患者运动诱发的缺血性室性心律失常的发生与QTd增加的关系。     

Ventilatory and circulatory responses at the onset of voluntary exercise and passive movement in children

The purpose of this study was to investigate whether or not the ventilatory and circulatory responses at the onset of voluntary exercise and passive movement, especially at the initial stage (phase I), in children are the same as in adults. Ten pre-teenage male children and ten adult men participated in this study. Voluntary exercise and passive movement were performed in a sitting position for about 20 s. Both the exercise and the movement consisted of flexion-extensions of the lower leg from a vertical to horizontal position, either voluntarily or passively, with a frequency of about 60 · min⁻¹. Inspiratory minute ventilation (V˙ _I), tidal volume (V _T), respiratory frequency, partial pressure of end-tidal CO₂ and O₂, heart rate (f _c) and mean blood pressure (BˉPˉ) before, during and after exercise or movement were measured using breath-by-breath and beat-to-beat techniques. Cardiorespiratory responses at the onset of voluntary exercise and passive movement were compared with the relative change (Δ), which was estimated from the value at rest (100%). In the present study, it was found that: (1) the V˙ _I during voluntary exercise were significantly lower in the children, mainly due to lower ΔV _T; (2) the Δf _c during voluntary exercise was almost the same in both groups, while Δf _c was significantly lower in the children during the last part of passive movement; (3) in the voluntary exercise and passive movement, the BˉPˉ in the children was increased a little or remained close to the value at rest, while it was significantly decreased in the adults. As a result, there were significant differences in ΔBˉPˉ between the two groups during voluntary exercise. These results suggest that the cardiorespiratory responses at the onset of voluntary exercise and passive movement may be modified during the growth process. Accepted: 30 June 2000     

微型接骨板治疗儿童尺桡骨骨折疗效观察

目的：探讨微型接骨板内固定治疗儿童尺桡骨骨折的疗效。方法：自2007年5月至2008年8月共收治的25例儿童尺桡骨骨折,应用微型接骨板进行内固定治疗,根据术中固定情况,指导患儿进行功能锻炼,观察骨折愈合情况。结果：随访2～12个月,平均随访时间6个月。术后切口愈合良好,肘腕部屈伸及前臂旋转活动满意。根据临床骨折愈合评判标准和X线摄片,所有骨折均达临床一期愈合标准。结论：切开复位微型接骨板内固定治疗儿童尺桡骨骨折,固定可靠,术后可早期进行功能锻炼,利于前臂功能的康复,是一种较理想的治疗儿童尺桡骨骨折方法。     

广州地区2009年~2012年1655例病残儿鉴定病种分析

目的探讨广州市2009年∽2012年的病残儿疾病种类、病种构成情况,为降低再生育二胎出生缺陷发生率提供理论依据。方法对广州市2009∽2012年1655例申请鉴定的病残儿资料进行整理分析。结果本次鉴定1655例病残儿中,疾病发生系统主要集中在神经系统、眼耳鼻疾病、心血管系统、血液系统等,前10位多发病残为精神发育迟滞、孤独症、先天性心脏病、脑瘫、感音神经性耳聋、癫痫、白血病、地中海贫血、21三体综合征、肾病综合征。遗传性疾病668例,占病残儿鉴定总数40.37%;非遗传性疾病997例,占病残儿鉴定总数59.63%。其中非遗传疾病前五位依次为神经系统疾病、血液系统疾病、泌尿生殖系统疾病、眼耳鼻疾病、运动系统疾病;遗传疾病前五位依次为神经系统疾病、心血管系统疾病、眼耳鼻疾病、其他系统疾病、运动系统疾病。结论儿童残疾涉及病种多,病因复杂,应根据引起病残疾病的发病原因,寻找针对性宣传教育方式,为再生育夫妇提供优生指导,并大力开展优生遗传检测和出生缺陷干预。     

婴幼儿中央区小棘波103例脑电图和临床分析

目的：研究婴幼儿中央区小棘波的脑电图（EEG）特点及临床意义。方法：收集2010年5月～2012年3月我院视频脑电图（V—EEG）检查中具有中央区小棘波的婴幼儿103例,回顾性分析其EEG特点和临床资料。结果：103例患儿的EEG均可见中央区小棘波,以双极纵联明显,见于非快速眼动睡眠Ⅱ期和（或）快速眼动睡眠期。103例患儿中婴儿良性部分性癫痫23例（22．3％）,轻度胃肠炎伴良性婴幼儿惊厥（BICE）17例（16．5％）,热性惊厥15例（14．6％）,正常婴幼儿46例（44．7％）,婴儿痉挛控制后2例（1．9％）。结论：婴幼儿EEG中央区小棘波常出现在3～24个月龄的婴幼儿,双极纵联明显,棘波成分多数≤50μV。这种小棘波除见于癫痫外,更多见于正常婴幼儿或不诊断为癫痫的癫痫发作,应结合临床判定其临床意义。     

儿童癫痫发作与睡眠觉醒周期的关系

目的：研究儿童癫痫发作与睡眠觉醒周期的关系。方法：经同步录像脑电图（V—EEG）监测,对142例儿童癫痫发作期的临床表现与V-EEG进行同步分析。结果：142例患儿中94例（66．2％）患儿的发作与睡眠觉醒周期相关。此94例患儿的154次发作中,思睡期36次（23．4％）,睡眠I-Ⅱ期64次（41．6％）,睡眠Ⅲ-Ⅳ期10次（6．5％）,REM期1次（0．6％）,觉醒后43次（27．9％）;发作类型中,部分性发作或伴泛化全面性发作81次（52．6％）,痉挛发作27次（17．5％）,肌阵挛25次（16．2％）,强直发作11次（7．1％）,失神发作7次（4．6％）,强直阵挛发作3次（2．0％）。结论：儿童癫痫发作与睡眠觉醒周期密切相关,了解发作与睡眠觉醒周期的关系,既有助于更好地管理和治疗癫痫患儿,又有助于合理安排EEG检查的方式和时机,提高检查阳性率,确定发作类型。     

身体活动与运动对代谢综合征的影响与作用

文题释义： 代谢综合征：是指遗传和环境因素共同所致人体的蛋白质、脂肪、碳水化合物等物质发生代谢紊乱的病理状态,是多个心脑血管危险因素集聚于同一个体的慢性症候群,其可分为中心性肥胖、血脂紊乱、高血压、糖尿病或糖耐量异常等多种代谢性疾病,是导致糖尿病及心血管等疾病的危险因素。 身体活动与运动：身体活动与运动是不同的概念,身体活动是由骨骼肌收缩引起能量代谢的任何机体活动,即潜在表现在人们的生活、劳动、学习等方面;体育运动则是为了保持一种或几种身体能力而进行的有计划、有组织、重复性的身体活动。 背景：目前,代谢综合征呈现出“高龄化”和“低龄化”两大趋势。增加身体活动量和积极运动能有效提高代谢综合征患者的胰岛素敏感度,调节机体脂代谢和糖代谢,以及有降血压的作用,降低代谢综合征发病率。 目的：全面评述身体活动及运动介入对代谢综合征的影响作用,进一步揭示身体活动、有氧运动、抗阻运动等对儿童青少年和中老年人代谢综合征产生的正向效益,从而为有效预防、缓解及治疗代谢综合征提供理论及实践参考。 方法：利用PubMed、ElsevierSDOL以及CNKI等中、英文资料数据库,以 “代谢综合征”“身体活动” “运动”等中英主题词搜索研究文献,关键词主要有“代谢综合征、身体活动、运动”“Metabolic syndrome, physical activity, exercise”。针对代谢综合征发病机制及身体活动和运动对代谢综合征的影响等进行归纳、整理,以确保最终入围的文献符合研究目的。 结果与结论：①充分的身体活动是代谢综合征的保护独立因素,少坐多动、改变出行方式、增加家务活动等健康的生活方式能有效加快能量代谢,提高各人群胰岛素敏感度,降低代谢综合征及各个组分疾病的患病率;②规律运动对防治代谢综合征具有显著正向效益,有氧运动与抗阻运动均可降低机体脂含量及胰岛素抵抗等危险因素;其中抗阻运动在增加骨骼肌含量、提升基础代谢率和胰岛素敏感度,控制血糖效果更为显著;但仅有氧运动可纠正代谢综合征的炎症反应,并在减少体脂和降血压方面更有优势;③儿童、青少年肥胖与代谢综合征密切相关,身体活动及运动对预防及改善代谢综合征有显著作用,而代谢综合征的改善则可控制儿童及青少年肥胖,从而有利于减少其成年后发病率;中老年代谢综合征患者生存率降低,血管粥样硬化及心脑血管疾病发病风险及死亡率升高,生活方式的转变及规律运动是防治中老年代谢综合征及心脑血管疾病发生的重要举措。 ORCID: 0000-0002-9648-5510(田露) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Electrocardiographic ST-segment depression in children with fontan circulation.

Despite successful operation, many patients palliated with a Fontan-type procedure continue to show effort limitation. We previously observed that these children showed electrocardiographic ST depression during exercise tests. The purpose of the study was to investigate whether electrocardiographic ST depression is a common finding in children with Fontan circulation. Forty-two children in two groups were examined: group A consisted of 14 patients who had all undergone a modified Fontan procedure, and group B consisted of 28 children with a structurally normal heart, matched for length, weight and gender to group A. Complete echocardiographic examinations were performed in all patients and controls. All 14 patients and all 28 healthy children underwent standard 24 h ambulatory electrocardiographic monitoring. All the recordings were analysed by a PC-based Holter system where an analysis of ST changes was performed. Seven patients and 14 matched healthy children were exercised on bicycle ergometers. Four patients and eight matched healthy children underwent exercise testing by walking/running a treadmill. Ten of 13 patients analysed had significant ST depressions on ambulatory electrocardiogram (>0.20 mV). Three of the 10 patients with ST depression were on digoxin. Three patients showed depressions of the ST segment in the electrocardiogram during exercise, with a maximal depression of 0.20-0.35 mV. None of the 28 matched healthy children showed electrocardiographic ST depression on the ambulatory 24 h ECG. These findings indicate that ST depression in daily activity is a common finding in children with Fontan circulation.     

Effects of a Low-Volume, Vigorous Intensity Step Exercise Program on Functional Mobility in Middle-Aged Adults

Aging-related decline in functional mobility is associated with loss of independence. This decline may be mitigated through programs of physical activity. Despite reports of aging-related mobility impairment in middle-aged adults, this age group has been largely overlooked in terms of exercise programs that target functional mobility and the preservation of independence in older age. A method to quantitatively assess changes in functional mobility could direct rehabilitation in a proactive rather than reactive manner. Thirty-three healthy but sedentary middle-aged adults participated in a four week low-volume, vigorous intensity stepping exercise program. Two baseline testing sessions and one post-training testing session were conducted. Functional mobility was assessed using the timed up and go (TUG) test, with its constituent sit-to-walk and walk-to-sit phases examined using a novel inertial sensor-based method. Additionally, semi-tandem balance and knee extensor muscle isometric torque were assessed. Trunk acceleration during walk-to-sit reduced significantly post-training, suggesting altered movement control due to the exercise program. No significant training-induced changes in sit-to-walk acceleration, TUG time, balance or torque were observed. The novel method of functional mobility assessment presented provides a reliable means to quantify subtle changes in mobility during postural transitions. Over time, this exercise program may improve functional mobility.     

口部肌肉训练和感知训练治疗孤独症儿童 语言交流障碍的疗效

目的 观察口部肌肉训练和感知训练治疗孤独症儿童语言交流障碍的效果。方法 选择2016年8月~2017年8月在我院接受治疗的118例孤独症儿童作为研究对象,随机分为研究组和对照组,各59例。对照组采取感知训练,研究组在此基础上加用口部肌肉训练,比较两组患儿语言交流能力与口部运动能力。 结果 两组患儿过渡群及Ⅱ群人数比较,差异无统计学意义（P＞0.05）;研究组在Ⅰ群患儿多于对照组（74.58% vs 38.98%）,差异有统计学意义（P＜0.05）;研究组患儿下颌口部、唇口部及舌口部运动能力均优于对照组,差异均有统计学意义（P＜0.05）。结论 针对孤独症患儿采取口部肌肉训练和感知训练,能够有效提升患儿的语言交流能力,并提升其口部运动能力,临床效果较好。     

Spectral and bout detection analysis of physical activity patterns in healthy,prepubertal boys and girls

Little is known about the frequency-intensity patterns of naturally occurring physical activity in children. A data set obtained previously by direct observation of physical activity in 8 girls and 7 boys (all prepubertal, ages 6–10) was analyzed with spectral analysis to detect significant frequency-intensity relationships. Pulse detection algorithms were used to characterize the number of exercise bouts, their duration and relative intensity. Spectral analysis revealed that physical activity bouts were frequent, pulsatile, and random with no significant frequencies detected during many 24-min periods of observation. An average of 83 ± 11 bouts per hour were observed in boys and 89 ± 12 bouts per hour in girls, and the mean duration of an exercise bout was 21 ± 5 sec for boys and 20 ± 4 sec for girls (NS). While high-intensity exercise bouts comprised less than 20% of the time spent in physical activity, duration of high intensity exercise bouts tended to be longer and accounted for about 40% of the energy expenditure associated with physical activity. Spontaneous physical activity in prepubertal children is characterized by frequent bouts of brief, mostly low intensity exercise, randomly interspersed with less frequent, but metabolically substantial high intensity bouts. These findings are potentially useful in assessing the impact of disease on quality of life in children, investigating the relationship between physical activity and mechanisms of growth and development, and creating new approaches for in-laboratory exercise testing in children. Am. J. Hum. Biol. 10:289–297, 1998. © 1998 Wiley-Liss, Inc.