建立新生儿不良健康结局高危评分标准的探讨

为在农村基层儿保人员中推广使用新生儿高危管理这一适宜技术，作者利用１９９０年对甘肃张掖地区１１１６例农村新生儿３种主要不良结局的危险因素监测资料，运用多元ｌｏｇｉｓｔｉｃ标准偏回归系数权重法，建立并比较全危险因素和显著危险因素两种识别高危新生儿综合评分标准的方法。本研究推荐采用全危险因素综合评分方法作为建立不同地区识别高危新生儿的评分标准。     

婴儿中枢性协调障碍48例诊断分析

目的:探讨中枢性协调障碍的临床诊断特点。方法:对我院诊断为中枢性协调障碍的48例患儿进行回顾性分析。结果:48例中Vojta姿势反射1～3项异常者11例,4～5项异常21例,6项异常者11例,7项反射异常并有肌张力异常者5例。分别诊断为极轻、轻、中、重度中枢性协调障碍。结论:中枢性协调障碍的诊断要点为Vojta姿势反射,头颅CT仅能作为参考。     

新生儿和幼婴儿坏死性小肠结肠炎X线表现分析

本文报告我院十余年来确诊ＮＥＣ病例１２０例，根据Ｂｅｌｌ等的分期标准，早期１９例，典型期４２例，晚期５９例。详尽地分析了各期Ｘ线表现，另外讨论了如下问题：①传统Ｘ线检查的价值及注意事项，②早产生活力不足患儿Ｘ线表现的特殊性，③胃部受累的发病率，④手术适应证。     

Psychosocial and economic factors associated with infant feeding intentions of adolescent mothers

The infant feeding intentions of 64 primiparous, adolescent females, ages 14–18 years, were studied to assess factors which differentiated those who chose breastfeeding from those who did not. The study population consisted of 43 Hispanic, 9 black, 7 non-Hispanic white, and 5 Filipino or Southeast Asian subjects interviewed after delivery. Among the Hispanics, 31 primarily spoke Spanish, and 12 primarily spoke English. A total of 72% intended to breastfeed, and 22% planned to exclusively formula feed. Those teens who intended to breastfeed were significantly older, more often married, more likely to be Hispanic and Spanish speaking, and less likely to have been in school during the pregnancy. In addition, teens were more likely to choose breastfeeding if they had been breastfed themselves or exposed to other women who breastfed. These data suggest that the younger, non-Hispanic, single teen who is enrolled in school and lacking exposure to breastfeeding is the most in need of breastfeeding-promotion programs.     

81例新生儿高胆红素血症的病因分析

我院93年1月至94年5月共收治81例高胆红血素血症患儿，占同期住病人的4．9％，81例黄疸病例均用经皮胆红素测定仪监测胆红素动态变化。其中46例接受光疗，光疗最长时间为72小时，最短时间为12小时，胆红素值由“34”降至“15”，平均下降“5－6”。19例轻型患儿进行日光浴。窒息、羊水吸入、早产儿、早产合并硬肿症、ABO溶血、Rh溶血等所引起的黄疸，临床表现轻重不一；针对不同病因，采取相对应的处理措施，可防止黄疸进一步加重，有利于优生优育。     

The lack of effect of added dibasic calcium phosphate on the bioavailability of electrolytic iron in infant cereals

Infant cereals are generally fortified with about 1.0% Ca, 0.8% P and 0.03% Fe. The effect of such high levels of added Ca and P on the bioavailability of iron is not known. The purpose of this investigation was, therefore, to determine the effect of adding 0.25, 0.50 and 1.00% Ca as CaHPO₄.2H₂O to iron-fortified (0.03% added as electrolytic iron) rice cereal on the 2-week hemoglobin regeneration in iron-depleted male Sprague-Dawley rats. The mixed cereal with banana was also tested but only at the normal level of Ca and P. The cereals provided 30 or 60 mg Fe/kg diet. From the initial and final body weights, 2-week food intake and hemoglobin levels it was concluded that there was no significant effect of the Ca-P addition on the bioavailability of iron.     

The lack of effect of added dibasic calcium phosphate on the availability of zinc in infant cereals to the rat

Generally, calcium phosphate (dibasic) is added to infant cereals so that they contain approximately 1.0% calcium and 0.8% phosphorus. The effect of this on the bioavailability of endogenous zinc is not known. The aim of this study was to determine the effect of adding 0.50 and 1.0% calcium as CaHPO₄.2H₂O to three iron-fortified (0.30% iron added as electrolytic iron powder) cereals, viz. Rice, Mixed and Infantsoy. Each cereal was added to a low zinc basal diet to provide 4 mg zinc/kg. For 3 weeks male weanling rats were fed diets containing one of the cereals with and without added dibasic calcium phosphate. Body weight and food intake were recorded weekly. At the end of the feeding period the right femur was taken from each rat and analysed for zinc. The resslts did not show any consistent significant effect of the addition of dibasic calcium phosphate on the bioavailability of zinc as reflected by body weight gain or femur zinc.     

Parturition influences initial pup preferences at later onset of maternal behavior in primiparous rats

Initial maternal responsiveness as a function of varying pup stimuli was assessed in primiparous Long-Evans rats. Pups were removed during parturition and the dams tested beginning 24 hr later. These dams were most likely to respond maternally towards newborn (0-2-day-old) rat pups (100%) and 6-8-day-old hamsters, which are the size of newborn rats (83.3%). In contrast, dams were significantly less likely to respond maternally towards newborn hamsters (50%) and 8-10-day-old rats (16.7%), pups which are half as large and twice as large, respectively, as newborn rats; indeed, dams were likely to attack these pups (33.3% and 25%, respectively). The maternal response (less than or equal to 1 hr) to dead newborn rats was similar to that towards live newborn rats, except that fewer dams retrieved dead pups rapidly (less than or equal to 1 min). Cesarean-delivered dams did not display higher maternal responsiveness towards 0-2 than towards 8-10-day-old rats. Further, whereas no parturition-experienced dam displayed infanticide towards newborn rats, 21.9% of primiparous Cesarean-delivered dams did. Thus, the exogenous and/or endogenous stimuli associated with parturition enhance selective maternal responsiveness and diminish infanticide towards pups the size of newborn rats.     

Intracranial tumors during the 1st year of life

Twenty-eight patients with intracranial tumors symptomatic during the 1st year of life were managed from January 1970 to March 1988. Supratentorial location (19 cases) was dominant over the infratentorial. The most common histological type was astrocytoma; choroid plexus papilloma and ependymal tumors followed in frequency. Twenty-two infants (78.6%) had associated hydrocephalus. Macrocrania, vomiting, delayed milestones, and behavioral disturbances were the chief clinical manifestations. Four patients were admitted in extremely deteriorated condition and died preoperatively. Twenty cases underwent surgery for tumor removal with a 1-month mortality rate of 20%. Tumor excision provided permanent relief of hydrocephalus in the majority of the surviving cases. Five patients received conventional radiotherapy. Stereotactic brachytherapy yielded an excellent result in 1 case. Overall 13 cases are currently alive; 6 of them have survived longer than 6 years. Fourteen of the 15 patients who were dead at follow-up succumbed within 1 year after diagnosis.     

婴儿母传麻疹抗体的动态观察及对麻疹疫苗的免疫应答

检测142对母、婴血清中的麻疹血凝抑制抗体(HI),结果有19对母、婴抗体均为阴性,7例低滴度(≤1∶4)抗体母亲的婴儿抗体也为阴性,麻疹抗体的阴性率母亲为13.4%,刚出生的婴儿为18.3%,抗体几何均值(GMT)分别为8.3和6.5.婴儿在3、5、7及8月龄时抗体累积阴性率分别为51.0%、78.1%、97.8%及100%.对母传麻疹抗体消失的14例3月龄、39例5月龄及21例7月龄婴儿进行沪_(191)麻疹减毒活疫苗接种,免疫1月后的抗体阳转率分别为57.2%、97.5%及100%.抗体GMT为12.34、18.89和22.23,在有麻疹患者的地区可考虑将免疫年龄提前到6月龄.