学龄儿童单纯性肥胖对智商影响的meta分析

目的 应用meta分析正确评价学龄儿童单纯性肥胖对智商的影响。方法 对检索到的符合标准的11篇相关文献进行meta分析，选择随机效应模型进行统计处理。结果 单纯性肥胖组与对照组儿童智商比较，平均较应尺度为-0．3385，平均效应尺度的95％可信区间为-0．8036～0．1266。结论 单纯性肥胖对智商影响的meta分析结果无统计学意义。     

微量元素和重金属对儿童的影响

目的通过对检测微量元素的分析，了解近阶段儿童微量元素分布状况，社会人群对补足常规微量元素的认知情况；通过对检测重金属铅和镉的分析，了解儿童受铅和镉的污染状况，干预后的改变情况。方法随机将2年门诊就诊的资料齐全的122例患儿进行静脉血检测常规微量元素、铅和镉；并对干预处理后的106例儿童进行复查。结果缺铁占22．13％，缺钙占7．37％，缺锌占4．1％，缺镁占1．64％，无铜和磷的缺乏。重金属铅大于100μg／L的49例，占40．16％；镉大于5μg／L的2例，占1．64％。对血铅大于40μg／L的106例患儿进行干预，对干预前后进行统计学比较及u检验，差异具有统计学意义。结论常规微量元素的缺乏有明显下降趋势，人群对补足常规微量元素有很高的认识，其危害明显的减少。重金属的污染对儿童健康的危害有上升的趋势，社会人群的知晓度很小；用合适的干预来降低血铅是很有效的，值得临床推广宣传。     

轻度贫血对学龄儿童体力工作能力的影响

本文报告29对轻度贫血和非贫血儿童在平板机运动试验条件下的最大运动耐受时间,耗氧量、心率和运动后血乳酸浓度。结果表明,轻度贫血组儿童最大耐受时间、最大耗氧量均低于非贫血组。运动后血乳酸高于非贫血组。经一个月补铁治疗后,贫血组最大耐受时间提高0.9分钟,血乳酸降至非贫血组水平,但最大耗氧量无显著性变化。由此说明轻度贫血对学龄儿童体力工作能力有一定的影响。     

先天性心脏病并发脑脓肿的影像学诊断

目的探讨影像学对儿童先天性心脏病合并脑脓肿的诊断价值。方法回顾性分析13例先天性心脏病合并脑脓肿患儿的临床资料和影像学表现，其中男性10例，女性3例；最小年龄19个月，最大年龄14岁，平均8岁8个月。10例行CT检查，3例行MRI检查。结果13例全部为青紫型先心，其中法洛四联症（tetralogy of Fallot，TOF）9例，大血管转位（transposition of great arteries，D-TGA）2例，伴有肺动脉狭窄的单心室（single ventricle with pulmonary stenosis，SV／PS）1例，室隔完整的肺动脉闭锁伴动脉导管未闭（pulmonary atersia with intact venticle septum and patem duct artery，PA／IVS／PDA）1例。发生部位有额叶、额顶、枕顶、颞顶、枕叶、丘脑和一侧额颞顶叶。单房10例，多房3例，增强后呈环行强化。结论先心病尤其是青紫型先心，极易并发脑脓肿。影像学方法对本病能作出诊断，有利于及时治疗，减少死亡率。     

Expressed emotion in children: associations with sibling relationships

Objective   To investigate the reliability and validity of the expressed emotion (EE) measure, the Pre-school Five Minute Speech Sample (PFMSS), in child-to-child sibling relationships.
Method   A total of 106 boys aged 7–11 were recruited from 12 mainstream primary schools in North Wales. The children completed the PFMSS regarding their sibling and two self-report measures of sibling relationship: the Sibling Relationship Questionnaire (SRQ) and a Child Visual Analogue Scale (CVAS). The parents of 60 participants completed the Strengths and Difficulties Questionnaire regarding the behavioural problems of the participating child and his younger sibling.
Results   The PFMSS demonstrated good inter-rater and code–recode reliability. The significant associations between EE dimensions such as relationship, positive comments and critical comments with various components of the SRQ and CVAS provided support for the concurrent validity of the PFMSS. Significantly higher levels of Conflict and Rivalry and significantly lower levels of Warmth/Closeness on the SRQ were reported by children with high EE, demonstrating good discriminant validity for the PFMSS. There was no significant association between the child's EE profile and the behavioural difficulties of both siblings as reported by parents.
Conclusions   The study found that the PFMSS is a valid and reliable measure of child EE. Future research is needed to clarify the concurrent validity of the warmth and initial statement components of the measure as well as the association between EE dimensions and behaviour.     

Providence School Asthma Partnership: School-based Asthma Program for Inner-City Families

Over 3 years, 972 families participated in an after-school asthma program at their child's school. Parents and children attended concurrent 2¹/₂ -hour workshops. Parents were 74% Latino; 45% non-English speaking, with 77% of children on Medicaid. Asthma symptoms were significantly reduced, from multiple times per week to less than once per week on average. Oral steroid use decreased to one third of baseline use. Hospital days decreased from 11% to 2%; emergency visits decreased 35% to 4%; and school days missed decreased 48% to 20%. This program has now become sustainable with both private and Medicaid insurance coverage.     

武汉市3～5岁儿童牙齿酸蚀症的研究

目的：调查武汉市3～5岁儿童的酸蚀症流行状况；评价儿童饮用饮料和饮食习惯、口腔卫生习惯与酸蚀症的关系。方法：随机抽样武汉市4所幼儿园3～5岁儿童共500人。对所有儿童进行酸蚀症和龋齿发病情况的临床检查以及问卷调查，问卷内容包括：儿童每天消耗饮料或食物的频率，以及口腔健康行为。收集酸蚀症儿童和无酸蚀症儿童各20人，对其唾液pH值、流速和缓冲能力进行测定和比较。结果：武汉市3—5岁儿童酸蚀症的患病率为9．3％。儿童睡觉时含奶瓶、喝饮料的习惯与酸蚀症的发生呈正相关。酸蚀症儿童和对照组儿童唾液分析结果无显著性差异。结论：预防酸蚀症应该减少酸性食物及饮料的消费量及频率。     

Results of the Ross operation in a pediatric population

Objective: To analyse the results of the mid-term clinical and echocardiographic follow-up of the pediatric Ross operation. Methods: Echo-Doppler follow-up of 53 consecutive pediatric Ross procedures performed between 1994 and 2003. Median age was 9.7 years at time of operation (2 weeks–17.7 years). Six patients were younger than 3 months. Median age at follow-up was 15.6 years. Aortic valve/left ventricular outflow tract (LVOT) anomalies were congenital in 49 (92%). Seventy percent had previous surgery or balloon valvuloplasty. Root replacement was used in all. Thirteen patients (25%) had LVOT enlargement. Mean cross-clamp time was 113 (69–189) minutes. Results: Early mortality occurred in 3 patients after emergency surgery following balloon failure (n=1) and extended Ross following interrupted arch/VSD repair (n=2). Late mortality was due to LV fibroelastosis in 2 patients and complicated pulmonary artery stenting in another. RVOT reoperations were required because of late homograft obstruction in 2 patients and because of pulmonary artery stenosis in another. Five patients (9.4%) were reoperated for pulmonary autograft dilatation (n=3) and for leaflet fibrosis or perforation (n=2). Autografts were repaired in two patients, while a mechanical valve was inserted in 3 cases. At 9 years the actuarial survival and event free survival were 89 and 74%, respectively. At last follow-up 90% of autograft diameters indexed to body surface area was above the 90th percentile of normal aortic root diameters. LVOT and RVOT gradients were low and autograft insufficiency was trivial to mild in 84% and mild to moderate in 16%. Autograft stenosis was not noticed. Conclusions: The pediatric Ross procedure remains an important tool but autograft dilatation also occurs in the pediatric population. The significance of this finding has yet to be determined.