0~5岁儿童血铅水平及相关因素调查结果分析

目的:了解郑州市0~5岁儿童血铅水平及其影响因素。方法:原子吸收光谱法检测末梢血铅值,对血铅水平影响因素进行分析。结果:2 273名儿童血铅水平平均为(67.33±37.57)μg/L,铅中毒检出率为17.16%。儿童血铅水平存在着性别差异,男童较女童高。儿童吸吮手指、常吃含铅高的食品、每日在马路上时间长、家庭装修、父母职业铅接触是儿童血铅水平增高的主要因素。结论:0~5岁儿童铅中毒检出率接近国内其他城市水平。为提高儿童生存质量,预防儿童铅中毒,应引起多方高度关注。     

乌鲁木齐市维汉族儿童血铅水平及其影响因素分析

目的了解乌鲁木齐市维吾尔、汉族儿童血铅水平及其影响因素,为防治儿童铅中毒提供依据。方法整群抽取乌鲁木齐市区6~10岁维、汉族儿童987名,对其血铅水平进行测定,并进行铅暴露危险因素的问卷调查。结果儿童血铅均值为54.46μg/L,血铅值≥100μg/L的比例为23.30%。维吾尔族儿童血铅值略高于汉族儿童,但差异无统计学意义。影响儿童血铅水平的危险因素主要是父母亲的文化程度低、父母亲从事铅接触作业、家庭装修以及家庭居住环境。结论乌鲁木齐市儿童铅水平受到多种因素影响,应预防环境铅污染对儿童健康的危害。     

铅冶炼企业周边儿童血铅水平及相关因素研究

目的了解某铅冶炼企业周边儿童血铅水平及相关因素。方法采取分层整群随机抽样和单纯随机抽样相结合的方法,2012年5—6月调查某铅冶炼企业周边10 km范围内的Z镇常驻人口中3~14岁儿童1 047名。采用电感耦合等离子体质谱法(ICP-MS)进行血中铅含量的测定,并做相关因素问卷调查。结果该企业周边儿童血铅中位数为205.82μg/L,P_(25)为158.31μg/L,P_(75)为280.35μg/L。达到高铅血水平的儿童比例为95.32%(998/1 047),达到铅中毒水平的儿童比例为53.01%(555/1 047);不同污染区儿童血铅水平:重度污染区中度污染区轻度污染区;3~7岁儿童血铅水平明显高于8~14岁儿童(P0.01);多重线性回归显示,年龄较大、与父母共同生活的儿童血铅水平较低(P0.05,P0.01)。结论该企业周边儿童血铅水平和血铅超标率情况已非常严重。我国涉铅企业周边铅污染现状,尤其是周边儿童血铅水平调查亟待开展。     

188例儿童铅中毒相关因素分析

目的:探索宝山区集体机构儿童血铅水平及铅中毒相关因素,为防治铅中毒提供参考依据。方法:使用末梢血微量法检测仪,应用血细胞阳性溶出伏安法(ASV)对3~6岁6429名集体儿童进行末梢血铅水平筛查,并对血铅浓度≥100μg/L的儿童由家长填写铅中毒相关因素问卷。结果:宝山区集体儿童3~6岁血铅水平均值为56.47μg/L,血铅≥100μg/L的为188例,检出率为2.92%,儿童铅中毒中男>女。家长问卷回收率达到86.7%,儿童轻度铅中毒未影响造血系统,儿童饮食、学习、生活习惯等相关铅暴露因素下降。结论:宝山区集体儿童血铅水平及检出率正在下降,儿童铅中毒防治工作可关注儿童钙、铁、锌的摄入、家庭中吸烟的危害性及减少居住地区车流量,同时需加强健康宣传教育。     

重庆大足区3～6岁儿童血铅水平 及其铅中毒相关因素分析

摘要:目的　研究大足地区3～6岁儿童血铅水平及铅中毒的危险因素。方法　采用BH2101S型钨舟原子吸收光谱分析仪对本地区8个乡镇幼儿园的3～6岁儿童血铅水平进行检测,同时进行问卷调查,分析不同性别、年龄段及地区3～6岁儿童血铅值及铅中毒发生率,并对升高血铅的危险因素进行筛选。结果　1 393名3～6岁儿童血铅平均值为（54.96±26.81）μg/L,铅中毒儿童772名,中毒率为55.42%,男童血铅水平明显高于女童（P＜0.05）,各年龄段及各地区儿童血铅水平有显著性差异（P＜0.05）,其中以三驱镇3～6岁儿童血铅水平和铅中毒率最高。致使儿童血铅升高的危险因素主要有父母从事工作与铅相关、常接触富铅物品、常进食富铅食物、家庭住房最近装修过,补充锌钙制剂是血铅升高的保护因素。结论　重庆大足地区3～6岁儿童血铅水平与中国其他城市相似,需针对致使血铅水平升高的因素采取有效的措施防控铅中毒。     

大庆市区3～6岁学龄前儿童血铅水平的流行病学调查

【目的】　了解大庆市区3~6岁学龄前儿童血铅水平现状及影响因素,为有效预防铅中毒提供参考依据。【方法】　采用石墨炉原子吸收光谱法检测末梢血铅值,同时做相关因素分析。　【结果】　大庆市区儿童血铅水平为0.693μmol/L,铅中毒检出率为62.25%。儿童咬指甲或玩具、家庭近期装修、住房离马路近、儿童常吃含铅食品、进餐前不洗手、年龄、父母职业与铅接触是儿童血铅水平增高的主要因素。　【结论】　目前大庆市区儿童血铅水平及儿童铅中毒的检出率很高,对危险因素的预防应引起高度重视。     

慈溪市3岁以下儿童血铅测试结果分析

目的:了解3岁以下儿童血铅水平及铅中毒状态。方法:对前来儿童保健门诊健康体检的1921例3岁以下儿童进行血铅检测,并将儿童分为0岁～,1岁～,2岁～,3个年龄组,数据采用χ2检验。结果:3岁以下儿童平均血铅水平为(50.62±30.59)μg/L,血铅水平随年龄增长而增高,检出高铅血症115例,检出率为5.99%,男童的血铅水平及高铅血症检出率均较女童高。结论:在接受血铅水平检测的3岁以下儿童中血铅水平随年龄增长而增高;男童较女童更易患铅中毒。要注意控制儿童接触铅的途径,加强宣教,定期开展铅中毒筛查,早期发现铅中毒,早期干预铅中毒。     

顺德区龙江镇学龄前儿童血铅水平及影响因素研究

目的研究佛山市顺德区龙江镇学龄前儿童血铅水平情况,分析影响儿童血铅的主要因素,为制定学龄前儿童铅中毒的预防策略和干预措施提供科学依据。方法于2017年1月-10月,在顺德区龙江社区服务中心门诊入托与儿检845名学龄前儿童,采用ICP-MS方法测定血铅,并做相关因素问卷调查。结果调查儿童的血铅浓度为5. 5μg/L～229μg/L,平均血铅水平为(24. 86±14. 72)μg/L,血铅含量≥100μg/L的儿童有5名,铅中毒检出率为0. 59%。其中不同年龄组儿童铅中毒的检出率以1岁～2岁组最高(2. 12%),0岁～1岁组与4岁～7岁组未检出。问卷调查显示儿童的饮食习惯与卫生习惯较好;父母大多无从事铅暴露职业,同时从事铅暴露工作的父母大多不穿工作服回家或回家后立即洗手。结论佛山市顺德区龙江镇学龄前儿童血铅均数及铅中毒率均低于全国城市儿童平均水平。     

韶关市2～6岁1 139名儿童血铅水平及影响因素的分析

【目的】了解韶关市2～6岁儿童血铅水平分布特点及影响因素，以期为做好儿童保健工作提供依据。【方法】根据韶关市布局特点，随机抽取居民、近郊、交通繁忙及厂矿区8个幼儿园1139名2～6岁儿童为调查对象,采指端末梢血20μl，用钨舟原子吸收光谱法．测定血铅水平，并进行问卷调查。【结果】2～6岁1130名儿童血铅水平均值为0．47μmol／L，铅中毒率30．955％，以轻度铅中毒者居多（38.02％）；男、女童血铅水平及铅中毒率差异无显著性;随年龄的增加．铅中毒率逐渐增高。5岁组血铅水平、铅中毒率最高;近郊及厂矿区血铅水平,铅中毒率较高;不良卫生习惯、铅作业家庭成员、被动吸烟是影响血铅的高危因素，常用乳类食品则是保护因素。【结论】韶关市近郊及厂矿区儿童是高危人群15岁左右可能是铅暴露的关键时期;不良卫生习惯和环境因素增加铅吸收风险。     

福州市儿童血铅检测结果分析

生命早期的铅暴露不仅危害儿童期智能和行为发育,而且对成年后心血管异常、骨质疏松等也有影响。随着现代工业和交通的迅速发展,汽车日益增多,环境污染程度日趋严重,尤其铅污染日趋加剧,铅中毒逐渐增多,儿童铅中毒也被广泛关注〔1-3〕。为了解福建省福州市0~14岁儿童血铅水平,对587例儿童体检者血铅水平进行了检测分析。结果报告如下。     

长春新碱过量引起严重毒副反应1例的护理体会

报道1例霍奇金淋巴瘤患者因误用长春新碱（VCR）10mg一次性静脉推注后治疗护理情况。其出现间断性神志恍惚、眼睑闭合不全、言语不清、口腔黏膜糜烂、全身疼痛、麻痹性肠梗阻、尿潴留、手足麻木等症状,经积极解救,禁食,持续胃肠减压、胃管内注入麻油、开塞露、生理盐水灌肠,合理应用肠外营养,注重疼痛、心理护理,做好口腔、肛周护理,预防感染加重,患者病情得到控制好转出院。     

Correlates of stages of change of smoking among inhabitants of deprived neighbourhoods

BACKGROUND: This study examines the prevalence and correlates of stages of change of smoking, in terms of psychosocial, structural and sociodemographic factors, among inhabitants of deprived neighbourhoods. METHODS: Cross-sectional data were obtained from a survey on health related behaviour. Subjects were 2009 current and former smokers, aged 20-46, living in deprived neighbourhoods in Rotterdam, the second largest city in the Netherlands. Three groups of smokers were formed according to the stages of change-definitions of the Transtheoretical Model: smokers not planning to quit (precontemplators), smokers planning to quit (contemplators/preparators) and former smokers (actors/maintainers). Smokers planning to quit and smokers not planning to quit were compared regarding psychosocial factors (attitude, social norm, self-efficacy), structural factors (neighbourhood problems, material deprivation, financial problems, employment status) and sociodemographic factors (age, gender, marital status, cultural background, educational level). Former smokers were compared with smokers planning to quit regarding structural and sociodemographic factors. Logistic regression was used to assess correlates of stages of change. RESULTS: Smokers planning to quit (prevalence = 19%) reported a more positive attitude, stronger social norms and higher self-efficacy expectations in quitting smoking than smokers not planning to quit (prevalence = 57%). Smokers planning to quit less often were Dutch-born, more often had attended higher vocational schooling or university and more often reported experiencing two or more neighbourhood problems compared to smokers not planning to quit. Former smokers (prevalence = 24%) were older, more often Dutch-born, married, employed and higher educated, compared to smokers planning to quit. Furthermore, former smokers less often reported material deprivation and financial problems than smokers planning to quit. CONCLUSION: Among people living in deprived neighbourhoods, different factors correlate with different stages of change of smoking. Implications for health promotion are discussed.     

Choice of measures of vaccination and estimates of risk of pediatric pertussis

BackgroundVaccination uptake at the individual level can be assessed in a variety of ways, including traditional measures of being up-to-date (UTD), measures of UTD that consider dose timing, like age-appropriate vaccination, and risk reduction from individual doses. This analysis compared methods of operationalizing vaccination uptake and corresponding risk of pertussis infection.MethodsCity-wide case-control study of children in Philadelphia aged 3 months through 6 years, between 2001 and 2013. Multiple logistic regression was used to isolate the independent effects of each measure of vaccination uptake and the corresponding relative odds of pertussis.ResultsBeing UTD on vaccinations was associated with a 52% reduction in risk of pertussis (OR 0.48, 95% CI: 0.34, 0.69). Evaluation of delayed receipt of vaccine versus on-time UTD yielded similar results. There was a decrease in risk of pertussis for each additional dose received with the greatest reduction in pertussis infection observed from the first (OR 0.48, 95% CI: 0.28, 0.83) and second dose (OR 0.17, 95% CI: 0.08, 0.34). Additional doses conferred minimal additional protection in this age group.ConclusionExamining vaccination status by individual doses may offer improved predictive capacity for identifying children at risk for pertussis infection compared to the traditional UTD measure.     

两种不同肌瘤剔除术治疗子宫肌瘤的临床疗效比较

目的:比较腹腔镜子宫肌瘤剔除术与腹式子宫肌瘤剔除术的临床疗效。方法:回顾分析63例腹腔镜子宫肌瘤剔除术与61例腹式子宫肌瘤剔除术的临床资料,比较2种手术方式的手术时间、术中出血量、肛门排气时间、使用抗生素时间、术后感染率、体温恢复正常时间、住院时间等情况。结果:两组患者接受子宫肌瘤剔除术顺利完成,腹腔镜组手术时间长于开腹组(P0.05),腹腔镜组术中出血量及剔除肌瘤个数均少于开腹组(P0.05),术后腹腔镜组体温恢复正常时间、肛门排气时间、抗生素使用及住院时间均短于开腹组,两组患者最多随访6个月,腹腔镜组平均康复时间较开腹组短(P0.05),两组随访B超均未发现明显肌瘤结节。结论:腹腔镜子宫肌瘤剔除术损伤小,恢复快,住院时间短,是值得推广的微创手术。     

上海市某医院骨科平均住院日影响因素分析

对上海市某医院2003年-2007年骨科出院病人的住院日描述性分析．2003年-2007年骨科的床位利用指数与平均住院日相关性分析．2003年-2007年骨科床位与医护比例分析．2007年骨科前10大病种平均住院目影响因素分别进行单因素相关性分析和多因素逐步回归分析（STATA软件）。通过对骨科10大病种住院日影响因素分析,术前等待天数、手术类型、是否输血分别对10个、9个和8个病种的住院目有影响。输血因素和手术类型是医院不可控、由病人的病情决定的,术前等待天数是管理因素,是最值得医院重视的影响因素。     

性发育异常发病机制的研究进展

正常的性腺分化可分为3个过程：原始性腺形成、性别决定和卵巢/睾丸发育。在任一环节中,基因表达或调控发生异常均有可能导致性发育异常疾病的发生。性发育异常是指染色体、性腺和解剖性别不典型。随着分子生物学技术的发展,不断地发现新的基因或信号通路参与性腺分化和发育,如SRY、SF1、WT1、Sox9等基因与睾丸发育密切相关,Wnt/Rspo1/B连环蛋白通路、Dax1、Foxl2等基因在卵巢分化中发挥着重要作用,一些非编码RNA和转化生长因子也有重要的调节功能,且睾丸和卵巢发育均为主动过程,即使在出生后因某些基因的改变两者间也可出现横向分化。这些为揭示性分化异常的发病机制提供了可能。     

尘肺病患者145例死因调查

目的分析汉中市尘肺病的发生、发展和死亡原因，以提高尘肺病患者的生存质量。方法对145例尘肺病患者的死因进行回顾性分析，计算其平均发病年龄、死亡年龄及患尘肺病后的存活年限。结果矽肺的平均发病年龄和死亡年龄均早于煤工尘肺和石棉肺，尘肺病的主要死因为患肺部疾患，患尘肺病后的平均存活年限为12a。结论加强职业健康体检工作，对尘肺病人做到早发现早治疗和预防并发症的发生。     

One-year stability of the Measure of Processes of Care

BACKGROUND: The Measure of Processes of Care (MPOC) is a 56-item self-administered measure designed to examine what parents of a child with a chronic health problem think of the services they and their child receive, and to measure the extent to which these services are family-centred. Reliability and validity of the MPOC were established in prior studies. The aim of the present study was to assess the 1-year stability of the MPOC to justify its use as an evaluative tool. METHODS: Nine paediatric rehabilitation centres in the Netherlands participated in this short longitudinal survey study. Subjects were 205 parents (response rate 74.8%) of children aged 1-18 years who received care in one of the participating paediatric rehabilitation centres. All subjects filled out two MPOCs with a 1-year interval. RESULTS: All correlations between the scale scores of the MPOC at the first and second administration were relatively high and significant (range: 0.443-0.609, all P < 0.001), demonstrating high inter-individual stability. However, all mean scale scores, except for Providing General Information, significantly reduced after 1 year. CONCLUSIONS: The MPOC has a moderate 1-year stability. However, because of its tendency to score lower when repeated after 1 year, its use as an evaluative follow-up instrument to assess the effectiveness of a programme intervention is restricted.     

儿童皮质发育畸形的MRI诊断

目的探讨儿童皮质发育畸形(MCD)的MRI表现特点,为MCD的早期诊断提供依据。 方法选择2010年1月至2012年12月在四川省医学科学院·四川省人民医院放射科经MRI检查确诊为MCD的44例患儿为研究对象。回顾性分析及总结其MRI影像学特征。本研究遵循的程序符合四川省医学科学院·四川省人民医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象及其监护人知情同意,并与监护人签署临床研究知情同意书。 结果本组44例经MRI确诊为MCD患儿中,巨脑回-无脑回为17例,多小脑回为14例,灰质异位为9例,脑裂畸形为4例。MCD的MRI特点中,巨脑回表现为脑回增宽、皮质增厚及白质变薄;无脑回表现为正常脑沟、脑回消失,皮质增厚及白质变薄;多小脑回表现为脑回增多、细小;灰质异位表现为皮质下及侧脑室周围深部白质区结节状、团块状或带状病灶,信号与灰质信号相同;脑裂畸形表现为从侧脑室到脑表面贯穿大脑半球的裂隙,表面覆盖灰质。 结论MRI是诊断儿童MCD的可靠影像学方法。     

244株真菌鉴定结果分析

目的 了解某院2000～2001年各类真菌的检出率。方法 用酵母样真菌同化试验编码鉴定板TH-15进行编码鉴定。结果 真菌分离率为8．85％；244株真菌分为10种，其中以白色念珠菌和热带念珠菌较高，分别占真菌总数的75．41％和11．47％；检出真菌的主要标本是痰和阴道分泌物。结论 及时进行真菌培养，有利于合理使用抗菌药物和控制真菌感染。