广元地区0～6岁智力低下儿童的致残危险因素分析

目的 分析四川省广元地区0～6岁儿童智力低下的主要致残因素,为预防和降低MR发病率提供重要依据.方法 用丹佛智力筛查量表-DDST和韦氏儿童智力量表-CWYCSI,对广元地区的46839例儿童进行智力筛查和测试,对确诊为智力低下(MR)的儿童进行分析,探讨其致残原因.结果 广元地区0～6岁MR儿童的发病率为10.82‰,其中严重智力障碍发病为203例(4.33‰),轻度智力障碍发病为304例(6.49‰),高于文献报道的发达国家发病率(2‰～4‰).躯体因素中各种围生期因素(早产、窒息、缺血缺氧性脑病等)、重度脑瘫和社会心理因素占主要地位,相应比例为27.42%、22.29%和17.16%;农村和城市的病因分布存在显著差异(P＜0.01).多数农村儿童的双亲受教育水平低于同类的城市水平.结论 维生期因素是影响儿童智力发育的重要原因;宫内感染、出生后的脑部感染、脑损伤及营养不良等均可以独立影响到患儿的智力发育;父母文化水平的差异也是影响儿童智力发育的原因之一.     

智力低下儿童病因特征分析及护理措施

目的:探讨智力低下儿童的病因特征并制定出高效的护理措施。方法:选取1542户进行访问调查,接受调查的儿童共1380人。筛查方法视儿童年龄决定。研究采集受调查儿童父母的一般资料,通过神经科/遗传科以及儿科等方法进行病因特征分析。1380例儿童中0~8岁儿童621例,9~14岁儿童759例。农村儿童725例,占52﹒5%;城市儿童655例,占47﹒5%。研究分析儿童智力低下的病因特征,并进行相应的护理干预。结果:1380人中智力低下者15例,占1﹒1%,其中7例为轻度智力低下,占46﹒7%;4例为中度智力低下儿童,占26﹒7%;2例为重度智力低下,占13﹒3%;剩余2例为极重度智力低下,占13﹒3%。0~8岁儿童621例,其中智力低下儿童有8例,占1﹒29%;9~14岁儿童759例,其中存在智力低下儿童7例,占0﹒92%,0~8岁儿童出现智力低下的概率显著高于9-14儿童(P0﹒05);农村儿童725例,其中智力低下儿童有9例,占1﹒24%;城市儿童655例,发现智力低下儿童有6例,占0﹒92%,农村儿童出现智力低下的概率显著高于城市儿童(P0﹒05)。病因特征调查显示:出生前病因6例;出生时因素4例;出生后病因4例;病因不明者1例。结论:儿童智力低下受到多种因素干扰,要加强健康知识的宣传以及进行必要的护理干预以减少智力低下儿童的发生概率。     

贵州省2000～2004年AFP病例中GBS的流行病学特征分析

目的:了解贵州省15岁以下儿童GBS的流行病学特点。方法:对2000～2004年APF病例中GBS的发病情况进行描述流行病学分析。结果:①贵州省GBS年平均发病率较高。为1.03/10万。②流行病学特点存在三高现象,即高发地区、高发季节、高发人群,病例多集中于北部遵义市和西部毕节地区(占60.4%),呈丛集性发病现象;夏、秋季为高发季节(占71.2%);7岁以下儿童为高发年龄(占64.3%),其中2～3岁组发病最多,占25.3%。③GBS残留麻痹发生率较高(43.4%),病死率也较高(8.2%)。结论:应加强对GBS高危地区、高危人群的监测和研究,提高麻痹恢复率,减少病死率。     

边缘智力儿童被家长识别、学习成绩与家长期望值的对照研究

目的:了解边缘智力儿童被家长识别、学习成绩与家长期望值的差异.方法:对48例边缘智力儿童被识别状况、比较其学习成绩与家长期望值,并与对照组比较.结果: 48例边缘智力儿童被家长识别率4.2%;语文考试成绩低于对照,家长的期望值也低于对照组.结论:家长对智力问题的识别率极低,对其学业成绩要求过高,可能存在教育目标的误区.     

南通市区2005年托幼机构学龄前儿童健康评价

目的:了解南通市区托幼机构学龄前儿童的健康状况和疾病分布特点。方法:对南通市区托幼机构在园儿童进行一次全面体格检查。结果:各年龄组年龄别身高、年龄别体重90%以上在中等以上水平,儿童超均值率达到卫生部要求。营养不良的患病率为2.91%;儿童肥胖患病率为3.89%,6岁年龄组肥胖患病率最高;轻度贫血患病率为2.37%,中度贫血患病率为0.02%,6岁组轻度贫血患病率最高;患龋率为37.95%,5岁前患龋率随年龄的增长而上升,5岁组患病率最高;儿童视力异常患病率为0.997%,并随年龄的增长而上升。结论:南通市区学龄前儿童营养状况良好,但仍要加强膳食管理,减少营养不良发病率,以及采取有效措施减少肥胖、龋齿及弱视的发病率。     

偏头痛的临床表现和注意事项

偏头痛高发于中青年(25～39岁)和女性(女∶男=4∶1).全球患病率约为12%,亚洲和非洲低于欧美国家. 　　1 偏头痛的分型 　　ICHD-Ⅱ将偏头痛分为6类:无先兆偏头痛,先兆偏头痛,儿童周期综合征(常为偏头痛的先驱),视网膜偏头痛,偏头痛并发症和可能偏头痛6大类.其中以无先兆型偏头痛最多见约占80%;先兆型占15%,其他类型少见.以下主要介绍无先兆和先兆偏头痛.……     

智力低下的病因

智力低下(Mental Retardation,MR)是遍及全世界的一个严重的社会问题。据估计,全世界约有一亿五千万MR患者。国内报道,患病率为3-5％。因此,开展MR病因的研究,对推动优生,提高人口素质是一个重要的课题。智力低下的病因相当复杂,既有生物医学因素,也有社会的和心理的因素。分别叙述如下:     

会宁城区4～6岁儿童智力发育与贫血状况相关分析

目的:了解会宁地区部分儿童智力与贫血状况,探讨贫血与智力关系。方法:整群抽取幼儿园儿童,检测其血红蛋白水平,评价贫血状况;采用学龄前儿童50项智力筛查量表进行智力测验,同时以体检通知单形式调查儿童及家庭基本信息。结果:两年儿童智力低下检出率为0.2%,智力超常儿童检出率为1.8%;2006及2008年贫血患病率分别为36.3%、24.3%,儿童贫血患病率存在明显年龄差异;不同智力等级儿童血红蛋白水平存在明显差异,贫血与非贫血儿童智力等级构成存在统计学差异。结论:调查对象贫血状况严重,智力发育良好,贫血与智力发育存在一定相关性;建议加强儿童营养及智力监测,采取针对性措施改善儿童贫血及智力发育状况。     

安徽省宿州地区农村居民银屑病流行病学调查

目的了解安徽省宿州地区农村居民银屑病患病率的分布情况. 方法采用分层随机整群抽样方法对安徽省宿州地区农村居民进行银屑病现况调查.结果宿州地区农村居民银屑病总患病率为1.120‰.男性和女性患病率分别为1.158‰、1.080‰,两者差异无显著性(χ2=1.12,P>0.05) .不同年龄组患病率存在不同程度差异,其中20～60岁为银屑病的高发年龄,占患病总数88 .4%.春、冬季节为银屑病初发或复发的高发季节,分别占40.86%、33.34%;银屑病的阳性家族史为22.12%(23/104).结论银屑病的农村居民患病率有增高的趋势,应加强对其预防和监测.     

宁夏部分地区小学生注意缺陷多动障碍的现况调查

目的 了解宁夏部分地区小学生ADHD的流行现状及影响因素.方法 采用Conners教师量表得分作阳性筛检进行现况调查研究.结果 宁夏部分地区小学生ADHD总患病率为12.7%;男生患病率（16.3%）高于女生（9.6%）（P＜0.01）;6岁～为ADHD高发年龄;吴忠地区患病率（17.3%）较高;汉族患病率（10.5%）较低,不是双亲抚养、出生时损伤是儿童ADHD患病的影响因素（均P＜0.05）.结论 宁夏部分地区小学生ADHD流行现状不容乐观,抚养关系及出生损伤与ADHD发生有一定关系,应在不同地区采取针对性的预防措施,可减少儿童ADHD的发生.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.