西安市儿童青少年身高发育的比较

了解西安市儿童青少年身高发育与发达国家的差距及今后的发展趋势。方法采用λ－中位数－变异系数法（λ－ｍｅｄｉａｎ－ｃｏｅｆｆｉｃｉｅｎｔｏｆ ｖａｒｉａｔｉｏｎ，ＬＭＳ）计算各地身高的中位数，比较各地身高中位数的差距和各地身高年增长值及男女生身高生长曲线的交叉年龄。     

Growth after renal transplantation: an update

Several factors influencing post-transplant growth were analysed in a total of 163 children receiving transplants at the Medical School Hannover. Statural height at the time of transplantation depended on the length of the pre-transplant period of chronic renal failure, and was more retarded in children with congenital renal diseases than in those with acquired diseases. The retardation of bone age correlated significantly with the degree of growth retardation. The immunosuppressive regimen of cyclosporine A (CyA) and low-dose predinisolone was followed by significantly better growth rates than azathioprine (Aza) plus high-dose prednisolone. In 22 prepubertal children receiving CyA, poor graft function with a glomerular filtration rate below 40 ml/min per 1.73 m² inhibited catch-up growth. The final height of 20 grown-up transplant recipients was found to be in the lower range of normal. A comparison of conventional and CyA treatment showed that adult height in the CyA group was higher than in the Aza group due to a significantly higher growth velocity.     

Fitness for work after surgery for lumbar disc herniation: a retrospective study

This report retrospectively evaluates fitness for work in 3956 cases of surgery for lumbar disc herniation between 1992 and 1994. Patient records were derived from a database including all interventions of the insured population of the largest Belgian sickness fund. The datafile consisted of 126 cases of percutaneous nucleotomy (nucleotomy group), 286 cases of lumbar disc surgery with fusion (fusion group) and 3544 cases of standard lumbar disc surgery (standard group). Fitness to resume work within 12 months after intervention was obtained in about 70% of the patients in the standard and nucleotomy groups but in only 45% of the patients in the fusion group. Ten medicosocial factors were related to fitness for work as outcome measure. Incapacity for work more than 12 months after intervention was defined as a bad outcome. Logistic regression was used to test the combined relative significance of the different variables. For the standard group a long duration of work incapacity before intervention, older age, lower benefit, employment as a blue-collar worker, a long duration of hospital stay and unemployment were significantly associated with a poor outcome. Related factors for the fusion group were a long duration of work incapacity before operation, a long duration of hospital stay and unemployment. For the nucleotomy group, no factor was significantly associated with a poor outcome. For the total group, discectomy combined with fusion was significantly related to a poor outcome whereas a standard discectomy and a percutaneous nucleotomy did not differ in their impact on fitness for work. Received: 12 February 1997 Revised: 26 July 1997 Accepted: 23 August 1997     

Growth hormone treatment of short children born small for gestational age: metanalysis of four independent, randomized, controlled, multicentre studies

A minority of children born small for gestational age (SGA) fail to achieve sufficient catch-up growth during infancy and remain short throughout childhood, apparently without being growth hormone (GH) deficient. The effect of GH administration was evaluated over 2 years in short prepubertal children born SGA. The children ( n = 244), who were taking part in four independent multicentre studies, had been randomly allocated to groups receiving either no treatment or GH treatment at a daily dose of 0.1, 0.2 or 0.3 IU/kg (0.033, 0.067 or 0.1 mg/kg) s.c. At birth, their mean length SD score (SDS) was -3.6 and their mean weight SDS -2.6; at the start of the study, mean age was 5.2 years, bone age 3.8 years, height SDS -3.3, height SDS adjusted for parental height -2.4, weight SDS -4.7 and body mass index (BMI) SDS -1.4. The untreated children had a low-normal growth velocity and poor weight gain. Although bone maturation progressed more slowly than chronological age, final height prognosis tended to decrease, according to height SDS for bone age. GH treatment induced a dose-dependent effect on growth, up to a near doubling of height velocity and weight gain; BMI SDS was not altered. Bone maturation was also accelerated differentially; however, final height prognosis increased in all GH treatment groups. The more pronounced growth responses were observed in younger children with a lower height and weight SDS. In conclusion, GH administration is a promising therapy for normalizing short stature and low weight after insufficient catch-up growth in children born SGA. Long-term strategies incorporating GH therapy now remain to be established.     

中小学生视力减退与发育营养关系的初步探讨

近视是中小学生视力减退的主要原因,调查天津市3884名中小学生身高、体重和视力三项指标,根据统计学分析得出结论:不能断定视力与身高有相关关系,而与体重有正相关关系。指出身高和体重二者中影响视力的主要因素是体重,影响体重的因素是学生膳食结构不合理,偏食和营养供给不足。中小学生学习负担过重,也是近视发病率增高的众多诱因之一。     

How are children's growth problems diagnosed?

Summary Members of the Child Growth Foundation were surveyed to ascertain how children's growth problems were diagnosed. For many (46%) it was the parents who first expressed a concern about the child's growth. Routine height monitoring detected only 8%. Parents consulted a doctor promptly when worried, but there were often delays between the first medical consultation and referral to a hospital consultant. Many parents reported that their concerns were not taken seriously.     

Growth Data in the School Health Service: An Indicator for Public Health?: A Nordic review

Monitoring the height and weight of school children is a standardprocedure in Nordic schools. These data are used for individualassessments of health and for the development and revision ofgrowth standards. Growth data born previous Nordic studies areanalysed. Secular charges in height and weight are described.The usefulness of height as an indicator of social inequalityis discussed. The mean height of 10 year old Nordic childrenincreased about 1 cm per decade since the 1930s. There wereconsiderable differences in children's mean height among thefive Nordic countries and among children of different socio-economicconditions. The studies of height and weight of Nordic schoolchildren differ too much in design to allow closer analyses.Systematic time series studies of growth data from the schoolhealth service to assess secular changes in growth and changesof social inequalities are desirable.     

Operative treatment of symptomatic lumbar spondylolysis and mild isthmic spondylolisthesis in young patients: direct repair of the defect or segmental spinal fusion?

Summary The results of 23 patients with symptomatic spondylolysis or mild isthmic spondylolisthesis treated by Scott's direct repair of the defect (secclusion) were analyzed with particular reference to spinal mobility and the condition of the intervertebral discs, and compared with the outcome of 25 patients treated by posterolateral segmental fusion without instrumentation. The two groups were comparable as to age at operation (17.4±5.7 vs. 15.6±2.6 years), follow-up time (54±8 vs. 54±25 months), gender, and preoperative subjective symptoms. The mean preoperative vertebral slip was greater in the fusion group (7.2±8.4 vs. 13.1±4, P=0.003). The follow-up assessment was carried out by an independent observer. It included an interview, Oswestry questionnaire, pain scale drawing, physical examination, plain radiographs, magnetic resonance imaging (MRI), and functional testing (lumbar spine mobility, static lifting power). For statistical analysis, the Student's t-test, the x² test, and the paired t-test were used. At follow-up, 87% of the Scott's group and 96% of the fusion group had occasional pain, not interfering with daily activities, or no pain at all. There was no statistical difference in the subjective, clinical, or functional outcome between the two operation groups. Plain radiographs in both groups showed significant loss of disc height in the operated segment during follow-up, indicating post-operative progression of disc degeneration. In flexion/extension radiographs the total range of movement in the three lowermost lumbar segments was slightly greater after secclusion. This difference was not significant. In MRI there was no statistical difference in disc hydration index between the two groups. The condition of the disc above the fusion was not worse than that of the corresponding disc above the secclusion. There was no correlation between pathologic disc findings in MRI and clinical outcome. It is concluded that in a small group of young patients the early results both after direct repair of the defect and after segmental fusion are satisfactory in the majority of cases. At this point of follow-up it is impossible to say which of the two procedures should be preferred for operative treatment of this condition in young patients. Direct repair does not protect the disc of the lytic/olisthetic segment from further degeneration. Pathologic disc changes in MRI should be interpreted with caution because their clinical relevance is still unclear.