北京市通州区2010-2013年0～6岁儿童贫血状况分析

目的了解北京市通州区0~6岁儿童贫血状况及其变化趋势,探讨儿童贫血的防治办法。方法收集北京市通州区2010-2013年儿童保健年报表,对报表中贫血相关数据进行统计分析。结果通州区0~6岁儿童贫血患病率自2010年3.87%下降至2013年2.81%,呈逐年下降趋势。儿童贫血患病均以轻度为主(90%以上),0~2岁儿童患病率四年来均高于3~6岁儿童。结论 0~2岁儿童是通州区防治儿童贫血的重点人群,应采取综合措施预防儿童贫血的发生。     

Enabling young 'ventilator-dependent' people to express their views and experiences of their care in hospital

Discussion in this paper is drawn from a phenomenological study carried out in England describing the views and experiences of young 'ventilator-dependent' people aged 6-18 years, regarding their health and social care, education, and aspirations for the future. This study presented many methodological and ethical challenges in order to elicit and present their views in a meaningful way. Data were elicited through focused face-to-face interviews with 18 young people. Innovative methods of data collection were used with younger children and those who had a range of communication impairments. In addition, family members of 15 young people were interviewed. Presentation of findings is limited to views and experiences of the young people's care in hospitals. Findings reveal that a significant number of Articles in the United Nations (UN) Convention on the Rights of the Child were not respected or upheld. Young 'ventilator-dependent' people were discriminated against when trying to access health services because of their need for assisted ventilation. They were particularly excluded from making important decisions about their lives and were not always offered the full protection of the Children Act 1989 (England). Some young people were not able to maintain adequate contact with their families, first language, culture, nationality and religion. Almost all spent prolonged periods of time (in some cases years) in hospital when they no longer wanted or needed to be there. All those interviewed wanted to be discharged home far sooner. The generalizability of findings is unknown; however, important questions are posed in relation to nursing practice and research regarding the overall management of this group of young people. Issues include: respecting and upholding human rights; and challenging the boundaries of current nursing practice in order to move towards child-centred, appropriate and effective models of care.     

Best Interests in the MCA 2005—What can Healthcare Law Learn from Family Law?

The 'best interests' standard is a highly seductive standard in English law. Not only does it appear to be fairly uncontroversial but it also presents as the most sensible, objective and 'fair' method of dealing with decision making on behalf of those who are perceived to be the most vulnerable within society. This article aims to provide a critical appraisal of how the standard has been applied within family law, to outline how the standard is to be applied within healthcare law and, finally, to assess the relevance of the family law experience of the best interests standard to the operation of the standards as envisaged by the MCA.     

急性中毒患者的相关因素分析与救护

目的探讨急性中毒患者的相关因素和救护。方法对98例急性中毒病人有关资料进行回顾性分析计数归类,应用χ^2进行统计学处理。结果本组患者服用毒类类别、发病季节与其生活区域有显著差异（P〈0.01）;服毒原因与性别有显著差异（P〈0.001）;急性中毒以服毒自杀的青壮年居多,而误服者以农村留守儿童为主。结论加强农村农药及镇静催眠药物的管理和对留守儿童人文关怀,加强社区女性人群及季节性健康教育是控制急性中毒发生的有效措施。     

鄂尔多斯市蒙汉族5～7岁儿童心理行为发育与家庭养育环境的调查和分析

目的了解鄂尔多斯市5～7岁儿童心理行为发育状况,探讨儿童养育环境对其的影响。方法采用儿童心理行为量表（SDQ）和家庭养育环境量表对鄂尔多斯市234名5～7岁儿童进行问卷调查。结果 234名儿童的心理发育水平处于正常总体范围;不同性别儿童在行为和社会关系维度差异有统计学意义（P〈0.05）;不同民族儿童的心理行为发育差异没有统计学意义;不同家庭养育环境对儿童心理行为发育有影响,差异有统计学意义（P〈0.01）。结论儿童的心理行为发育状况与性别、家长育儿感受、养育态度、夫妻关系和家庭生活有关,而与民族无关。     

Regulation of energy metabolism by creatine in cardiac and skeletal muscle cells in culture

Cardiac and skeletal muscle cells grown in culture were used in experiments designed to test the regulatory function of creatine. An increased concentration of intracellular phosphorylcreatine resulted from the addition of creatine to the growth media and the addition of metabolic inhibitors prevented the new high steady state concentration without depletion of ATP. With 1-fluoro-2, 4-dinitrobenzene the high concentration of phosphorylcreatine remained unchanged, while ATP was depleted. The use of the inhibitors provided additional evidence for creatine as the effector molecule in a feedback regulation of energy production, and for phosphorylcreatine in the regulation of energy charge at the contractile site. The effect of creatine on the fusion of myoblasts into myotubes supported its role in the control of cellular functions other than those involved in the energy metabolism. The correlation of the growth of muscle with increased muscular activity might be mediated through creatine, the end product of muscle activity. Creatine, synthesized in tissues other than muscle, might be involved in the coordination of muscle development throughout the body. Furthermore, it is suggested that the metabolic regulatory function of creatine is limited to the cells which do not synthesize creatine de novo, while in the tissues, such as the liver and kidney which have the mechanism for de novo synthesis of creatine, the absence of mitochondrial CPK precludes metabolic regulation of ～ P synthesis by creatine.     

7～9岁儿童口腔疾病综合干预效果的探讨

目的:通过对滁州市7～9岁儿童集中开展口腔疾病综合干预研究,探索科学高效的干预方法。方法:随机抽取7～9岁12个班级540名学生,用问卷调查的方法研究两种不同的口腔健康教育方式对学生的口腔健康知识知晓率、正确刷牙率的影响。比较第一恒磨牙窝沟封闭三种不同的组织方式,获得单牙封闭时间及3个月、6个月复诊完好保留率的差异。结果:经医生培训教师直接给学生进行口腔健康教育,比医生直接给学生讲授的知晓率和正确的刷牙率分别提高25%和28%。由学校组织以班级为单位,集体到医疗机构进行第一恒磨牙窝沟封闭最高效,差异有统计学意义(P<0.05)。结论:健康教育方式和组织方式影响口腔疾病综合干预效果。     

A meta-analysis of imagery rehearsal for post-trauma nightmares: Effects on nightmare frequency, sleep quality, and posttraumatic stress

This meta-analysis evaluates the efficacy of imagery rehearsal as a treatment for nightmares, general sleep disturbance, and symptoms of post-traumatic stress. Bibliographic databases and cited references were searched to identify clinical trials of imagery rehearsal in individuals with post-trauma nightmares. Thirteen studies met inclusion criteria and reported sleep and post-traumatic stress outcomes in sufficient detail to calculate effect sizes. Results indicate that imagery rehearsal had large effects on nightmare frequency, sleep quality, and PTSD symptoms from the initial to post-treatment assessments. These effects were sustained through 6 to 12months follow-up. Furthermore, interventions that included both imagery rehearsal and cognitive behavioral therapy for insomnia resulted in greater treatment-related improvement in sleep quality than imagery rehearsal alone. Combined treatment did not improve outcomes for PTSD or nightmares. Notably, effect sizes were small in the single study that included an active-treatment control condition. Future research should identify necessary and sufficient components of interventions for trauma-related sleep disturbance and post-traumatic stress (e.g., exposure, cognitive reappraisal, sleep and circadian regulation).     

小儿急性重症病毒性心肌炎50例临床分析

目的研究分析重症心肌炎发病进展与诊疗。方法总结1999年2月至2002年12月收治的50例急性重症病毒性心肌炎分析。结果本组3例急性期死亡,其中1例死于急性肺水肿,2例死于心脑综合征。6例心电图遗留有不同程度异常改变。结论急性重症病毒性心肌炎发病急骤、病程进展迅速,常在短时间内发生严重心力衰竭、心律失常、心源性休克、合并急性肺水肿、心脑综合征及多脏器功能损害等,抢救治疗不当,常可危及患儿生命。     

Protection of White Leghorn chickens by recombinant fowlpox vector vaccine with an updated H5 insert against Mexican H5N2 avian influenza viruses

Despite decades of vaccination, surveillance, and biosecurity measures, H5N2 low pathogenicity avian influenza (LPAI) virus infections continue in Mexico and neighboring countries. One explanation for tenacity of H5N2 LPAI in Mexico is the antigenic divergence of circulating field viruses compared to licensed vaccines due to antigenic drift. Our phylogenetic analysis indicates that the H5N2 LPAI viruses circulating in Mexico and neighboring countries since 1994 have undergone antigenic drift away from vaccine seed strains. Here we evaluated the efficacy of a new recombinant fowlpox virus vector containing an updated H5 insert (rFPV-H5/2016), more relevant to the current strains circulating in Mexico. We tested the vaccine efficacy against a closely related subcluster 4 Mexican H5N2 LPAI (2010 H5/LP) virus and the historic H5N2 HPAI (1995 H5/HP) virus in White Leghorn chickens. The rFPV-H5/2016 vaccine provided hemagglutinin inhibition (HI) titers pre-challenge against viral antigens from both challenge viruses in almost 100% of the immunized birds, with no differences in number of birds seroconverting or HI titers among all tested doses (1.5, 2.0, and 3.1 log₁₀ mean tissue culture infectious doses/bird). The vaccine conferred 100% clinical protection and a significant decrease in oral and cloacal virus shedding from 1995 H5/HP virus challenged birds when compared to the sham controls at all tested doses. Virus shedding titers from vaccinated 2010 H5/LP virus challenged birds significantly decreased compared to sham birds especially at earlier time points. Our results confirm the efficacy of the new rFPV-H5/2016 against antigenic drift of LPAI virus in Mexico and suggest that this vaccine would be a good candidate, likely as a primer in a prime-boost vaccination program.