Lenke 2型青少年特发性脊柱侧凸患者第一胸椎倾斜与双肩美学平衡的相关性研究

目的 探索青少年特发性脊柱侧凸(AIS)患者第一胸椎(T1)倾斜与双肩美学平衡的相关性.方法 选择2010年1月至2011年12月就诊的71例Lenke 2型AIS患者进行研究.其中女性61例,男性10例;年龄10 ～18岁,平均(15.1±2.9)岁;Risser征1～5,平均2.8.患者在自然站立位拍摄后前位照片及进行全脊柱X线检查.在X线片上测量T1倾斜,并在照片上测量内侧美学双肩高度差(CSHi)以及外侧美学双肩高度差(CSHo),CSHi和CSHo统称为CSH.T1向右倾斜为正值,反之为负值.T1倾斜＞5°定义为正性倾斜,T1倾斜＜-5°定义为负性倾斜,-5°≤T1倾斜≤5°定义为T1水平.左肩高于右肩时CSH为正值,反之为负值.CSH＞5 mm定义为正性CSH,CSH＜-5 mm定义为负性CSH;-5 mm≤CSH≤5 mm定义为双肩水平.T1倾斜与CSHi、CSHo之间进行Pearson相关分析.结果 T1倾斜与CSHi、CSHo之间呈正相关关系(r=0.25和0.28,P ＜0.05).T1正性倾斜患者中,正性CSHo、水平CSHo、负性CSHo患者比例分别为59.0％ (36/61)、37.7％(23/61)和3.3％(2/61);T1水平患者则分别为3/10、5/10和2/10.T1正性倾斜患者中,正性CSHi、水平CSHi、负性CSHi患者比例分别为83.6％ (51/61)、11.5％ (7/61)和4.9％ (3/61);T1水平患者则分别为6/10、2/10和2/10.结论 T1倾斜与双肩美学平衡之间有相关性,但是正性T1倾斜患者可以表现为左肩高,也可以表现为双肩等高或者右肩高.     

成人脊柱-骨盆矢状面分型的初步研究

目的 探讨以腰椎前凸角(LL)及胸腰椎转折椎间隙(IP)为基础对成人脊柱-骨盆矢状面分型的可行性.方法 2011年7月至8月对223名志愿者进行脊柱全长正位X线检查,符合纳入标准的研究对象111名,女性56名,男性55名.测量脊柱-骨盆矢状面参数值,包括胸椎后凸角(TK)、胸腰段后凸角(TLK)、LL、骨盆倾斜角(PT)、骶骨倾斜角(SS)、骨盆指数(PI)、各椎体间终板夹角、脊柱骶骨角(SSA)、矢状面垂轴(SVA)、IP.根据LL、IP将成人脊柱-骨盆矢状面分为3型,Ⅰ型:LL＞-40.,IP为L2～3以下;Ⅱ型:-60.≤LL≤-40.,IP为L1～2或T12 ～L1;Ⅲ型:LL＜-60.,IP为T11～12以上.采用Pearson相关分析对各变量间的相关性进行分析,Ⅰ～Ⅲ型组间各参数分别进行单因素方差分析及多重比较.结果 经测量LL为-49.±10.,TK为36.±7.,TLK为6.±7.,PT为11.±7.,SS为34.±8.,PI为45.±9°,SSA为127.±9.,SVA为(-2.7±22.8)mm.仅LL与其他参数的相关性均有统计学意义,与TK、PI、SS、SSA呈负相关(r=-0.387、-0.536、-0.858、-0.801,P＜0.05),与TLK、SVA、PT呈正相关(r=0.319、0.296、0.262,P＜0.05).入选志愿者均可纳入分型:Ⅰ型19例,Ⅱ型75例,Ⅲ型17例.各型间LL、TK、TLK、PT、SS、PI、SSA、SVA差异均有统计学意义(F=164.559、7.431、14.099、4.217、53.856、6.252、35.995、8.626,P＜0.05).进一步多重比较示LL、SS、SSA、PI组间两两比较差异均有统计学意义(P＜0.05).结论 LL是脊柱矢状面平衡的核心参数,以腰椎前凸角及胸腰椎转折椎间隙为基础可将成人脊柱-骨盆矢状面分为3型.该分型系统可较好反映脊柱-骨盆矢状面的形态差异及平衡.     

Evolution of weight and height of children with congenital heart disease undergoing surgical treatment

Objective

To evaluate the height and weight development of children with congenital heart disease undergoing surgery with the goal of determining when they reach the threshold of normal development and whether there are differences between patients with developmental pattern below the level of normality preoperatively (z-score<-2 for the analyzed parameter) in comparison to the total group of cardiac patients.

Methods

We prospectively followed up 27 children undergoing operation into five time periods: preoperatively and at four subsequent outpatient appointments: 1^st month, 3^rd month, 6^th month and 12^th month after hospital discharge. The anthropometric parameters used were median z-score (MZ), weight (WAZ), height (HAZ), subscapular skinfold (SSFAZ), upper arm circumference (UAC) and triceps skinfold (TSFAZ). The evolution assessment of the parameters was performed by analysis of variance and comparison with the general normal population from unpaired t test, both in the total group of cardiac patients, and in subgroups with preoperative parameters below the normal level (Zm<-2).

Results

In the total group there was no significant evolution of MZ of all parameters. WAZ was statistically lower than the normal population until the 1^st month of follow-up (P=0.028); HAZ only preoperatively (P=0.044), SSFAZ in the first month (P=0.015) and at 12^th month (P=0.038), UAC and TSFAZ were always statistically equal to the general population. In patients whose development was below the level of normality, there were important variation of WAZ (P=0.002), HAZ (P=0.001) and UAC (P=0.031) after the operation, and the WAZ was lower than the normal population until the 3^rd month (P=0.015); HAZ and UAC, until the first month (P=0.024 and P=0.039 respectively), SSFAZ, up to the 12^th month (P=0.005), the TSFAZ only preoperatively (P=0.011).

Conclusion

The operation promoted the return to normalcy for those with heart disease in general within up to three months, but for the group of patients below normal developmental pattern of the return occurred within 12 months.     

Evaluation of Bone Mineral Status in Adolescent Idiopathic Scoliosis

Background

Several reports have suggested low bone mineral density (BMD) in patients with adolescent idiopathic scoliosis (AIS). We determined bone mineral status in patients with AIS to evaluate the effect of brace treatment on BMD.

Methods

BMD was measured in 46 patients (mean age, 17.8 ± 4.9 years) with AIS (17 with brace and 29 without brace) by dual-energy X-ray absorptiometry scan and compared the results to an age-matched (mean age, 16.6 ± 3.9 years) control group (n = 54).

Results

The AIS group had significantly lower bone mass at the lumbar spine (Z-score, -1.500 vs. -0.832) and hip (Z-score, -1.221 vs. -0.754) except at the femoral neck. No difference in BMD was found between patients with AIS who used a brace and those who did not.

Conclusions

The results confirmed that BMD was low in AIS patients and it was not affected by brace treatment.     

单中心汉族足月新生儿18个体表信息横断面研究

目的在单中心汉族人口中建立正常足月新生儿18个体表信息的参考范围值。方法依据《人体测量手册》上提供的方法,选取复旦大学附属妇产科医院37～40周生后2 h内的595名健康足月、汉族和单胎新生儿,行身长、体重、头围、乳距、胸围、内眦间距、外眦间距、睑裂长、耳长、耳宽、鼻长、鼻宽、鼻高、口宽、人中线长、手长、手中指长和足长信息的直接测量,每个体表信息连续重复测量3次,取3次测量的平均值行统计学分析。应用LMS软件 （light version）来构建分性别按照孕周的各测量的光滑的百分位数曲线。 结果2011年8月至2012年9月间符合本文纳入和排除标准的新生儿595例进入分析,男性305例,女性290例,其中37周83例（男40例,女43例）,38周218例（男118例,女100例）,39周185例（男91例,女94例）,40周109例（男54例,女55例）。构建18个体表信息第3~97百分位数。37周新生儿中5/18个（27.8%）体表信息值男性>女性,P均＜0.05,分别为耳长、耳宽、鼻宽、鼻长和足长;38周新生儿中11/18个（61.1%）体表信息值男性>女性,P均＜0.05,分别为身长、体重、耳长、耳宽、鼻高、鼻宽、鼻长、口宽、手长、中指长和足长;39周新生儿中14/18个（77.8%）体表信息值男性>女性,P均＜0.05,分别为身长、体重、头围、胸围、内眦间距、外眦间距、睑裂长、耳长、耳宽、鼻宽、鼻长、人中线长、手长和足长;40周新生儿中11/18个（61.1%）体表信息值男性>女性,P均＜0.05,分别为身长、体重、头围、胸围、内眦间距、外眦间距、耳长、耳宽、鼻宽、足长和乳距,其余体表信息值性别差异均无统计学意义,P均＞0.05。 结论建立了单中心汉族足月新生儿18个体表信息的参考范围值和百分位数。男女新生儿5～14个体表信息值有差异,男性体表信息值>女性。     

Perioral aging – An anthropometric appraisal

To adequately perform perioral rejuvenation procedures, it is necessary to understand the morphologic changes caused by facial aging. Anthropometric analyses of standardized frontal view and profile photographs could help to investigate such changes.Photographs of 346 male individuals were evaluated using 12 anthropometric indices. Data from two groups of health subjects, the first exhibiting a mean age of nearly 20 and the second of nearly 60 years, were compared.To evaluate the influence of combined nicotine and alcohol abuse, the data of the second group were compared to a third group exhibiting a similar mean age who were known alcohol and nicotine abusers.Comparison of the first to the second group showed significant decrease of the vertical height of upper and lower vermilion and relative enlargement of the cutaneous part of upper and lower lips. This effect was stronger in the upper vermilion and medial upper lips. The sagging of the upper lips led to the appearance of an increased mouth width. In the third group the effect of sagging of the upper lips, and especially its medial portion was significantly higher compared to the second group. The photo-assisted anthropometric measurements investigated gave reproducible results related to perioral aging.     

Sagittal abdominal diameter and waist circumference appear to be equally good as identifiers of cardiometabolic risk

Background and aimsBody mass index (BMI) and waist circumference (WC) are commonly used markers of cardiometabolic risk. However, sagittal abdominal diameter (SAD) has been proposed as a possibly more sensitive marker of intra-abdominal obesity. We investigated differences in how SAD, WC, and BMI were correlated with cardiometabolic risk markers.Methods and resultsThis cross-sectional study investigated anthropometric and metabolic baseline measurements of individuals from six trials. Multiple linear regression and (partial) correlation coefficients were used to investigate associations between SAD, WC, and BMI and cardiometabolic risk markers, including components of the metabolic syndrome as well as insulin resistance, blood lipids, and lowgrade inflammation.In total 1516 mostly overweight or obese individuals were included in the study. SAD was significantly more correlated with TG than WC for all studies, and overall increase in correlation was 0.05 (95% CI (0.02; 0.08). SAD was significantly more correlated with the markers TG and DBP 0.11 (95% CI (0.08, 0.14)) and 0.04 (95% CI (0.006, 0.07), respectively compared to BMI across all or most studies.ConclusionThis study showed that no single anthropometric indicator was consistently more strongly correlated across all markers of cardiometabolic risk. However, SAD was significantly more strongly correlated with TG than WC and significantly more strongly correlated with DBP and TG than BMI.     

Standard curves for mid arm circumference and mid-arm/head circumference ratio in newborns

One Thousand singleton neonates, between 28 and 44 weeks of estimated gestational age (EGA) were measured within 48 hours of their birth for upper mid-arm circumference (MAC), head circumference (HC) and birth weight (BW). Regression analysis was used to draw standard curves for MAC versus EGA and mid-arm circumference/head circumference ratio (MAC/HC) versus EGA. Correlation coefficients were 0.961 for MAC versus EGA and 0.889 for MAC/HC versus EGA (p < 0.001). MAC, MAC/HC and HC were also highly correlated with birth weight (p < 0.001). These standard curves make available a discriminating method for evaluation of intra-uterine growth and a noninvasive technique for following somatic protein status in growing preterm infants.     

Undernutrition and childhood infections: a prospective study of childhood infections in relation to growth in the Sudan

The relationships between both diarrhoea and respiratory infections and linear and ponderal growth were prospectively examined among 28 753 Sudanese pre-school children. Childhood infections were significantly and inversely associated with attained height and attained weight and gain in height and weight over a 6-mo period. They were significantly and positively associated also with stunting after adjusting for age, gender, socio-economic status, dietary variables and previous morbidity. Attained height was on average 17 mm lower (95% CI [-19 -15]) for children with diarrhoea and 11 mm lower (95% CI [-3 -9]) for children with complicated cough than for those without these symptoms. The association between morbidity and attained weight was significant for diarrhoea and complicated cough, but the differences between children with and without symptoms were negligible. The risk of being stunted 6 mo later was 1.38 times (95% CI [1.20 1.59]), 1.29 times (95% CI [0.97 1.72]) and 1.32 times (95% CI [1.13 1.54]) greater among normally-nourished children with diarrhoea, febrile diarrhoea and fever, respectively, than among children without these symptoms. The difference in attained height between children with diarrhoea or complicated cough and those without symptoms increased with age, and was larger among the non-breastfed children compared with breastfed children. CONCLUSION: The results underline the need to reduce child morbidity to prevent the impairment of growth and development.