矮小症患儿生活质量现状调查及影响因素分析

目的 调查矮小症患儿生活质量现状,并分析其影响因素,以期为改善该类患儿身心健康、促进其健康成长提供参考依据。方法 选取2019年1月—2020年7月湖南省4所三级甲等医院儿科门诊的231例矮小症患儿为研究对象,采用一般资料调查表、儿童生活质量测定量表和儿童自我意识量表对其进行调查。结果 矮小症患儿生活质量总分为(75.57±13.46)分。多元线性回归分析显示,主要照顾者受教育程度、与标准身高差值、自我意识水平为矮小症患儿自我意识水平的独立影响因素(_△R²=0.497,F=23.452,P＜0.001)。结论 矮小症患儿生活质量欠佳,护理人员以及卫生保健人员应引起重视。不同特征的患儿生活质量存在较大的差异,主要照顾者教育程度低、与标准身高差值大以及自我意识较差的儿童生活质量更差。     

汪沟遗址仰韶文化居民的肢骨特征

目的 探讨新石器时代居民体质发育情况。方法 参照《人体测量方法》，对汪沟遗址出土的108例人骨标本的肱骨、胫骨和股骨主要测量项分别进行测量，用Excel 2019软件对肢骨指数、性别二态性和身高进行对比分析。结果 肱骨、股骨整体发育水平较同时期对比组强壮，较内蒙古地区对比组弱，股骨中部肌肉附着偏少；两性肱骨粗壮程度差异无统计学意义（t＝0.811 ，P>0.05），股骨粗壮程度差异无统计学意义（t＝0.63，P>0.05）；男性股骨最大长变异范围在40.6~49.4 cm，在对比组中处于中等偏低水平；男性平均身高为166.22 cm，变异范围在164.47~167.68 cm。女性平均身高为158.06 cm，变异范围在154.02~160.34 cm；两性身高差异性显著（t＝4.96，P<0.01）；汪沟组两性差异性指数为5.7%。结论 汪沟组男性肱骨、胫骨、股骨整体比女性强壮，男性上肢发育比女性强壮，下肢强壮程度的差异不大。我们推测汪沟组男性与女性生长过程中获得的营养相差不多。     

First growth reference curves for Tunisian children and adolescents

A growth chart is a powerful graphical tool displaying children's growth patterns. The aim of this study was to develop growth reference curves appropriate for Tunisian children. The collection of data from this cross-sectional study was conducted on 4358 healthy subjects (2182 girls and 2176 boys) in three pediatric centers and 15 schools. Smoothed growth curves were estimated using the LMS method. The smoothed percentile curves for height, weight, sitting height (SH), and leg length (LL) increase rapidly during the 1st years of life and then progress slowly until 18 years. However, the sitting height-to-height ratio (SHTHR) curves decrease sharply before the age of 4 and then stabilize in both sexes. In addition, the comparison between boys and girls indicated that the values are very similar at most ages. Except during puberty, the values in boys increase (P < 0.0001) for the weight, height, SH, and LL parameters and decline (P < 0.0001) in the SHTHR compared to the values in girls. The growth rate curves presented two remarkable velocity peaks: the first appears during the 1st years of life and the second at puberty. Height gains at the last stage of growth (puberty) are around 15.45% of final height for boys and 15.52% for girls. This study showed a number of discrepancies for certain age groups when comparing the median weight and height values with those of the World Health Organization, the National Center for Health Statistics, and Algerian references in both sexes. Conclusion: The smoothed percentile curves for weight and height will be useful to access the general growth of Tunisian children. Furthermore, the SH, LL, and SHTHR curves can be used to monitor body proportions during childhood.     

Sit-to-walk and sit-to-stand-and-walk task dynamics are maintained during rising at an elevated seat-height independent of lead-limb in healthy individuals

IntroductionSit-to-walk (STW) is a common transitional motor task not usually included in rehabilitation. Typically, sit-to-stand (STS), pause, then gait initiation (GI) before walking is used, which we term sit-to-stand-and-walk (STSW). Separation between centre-of-pressure (COP) and whole-body centre-of-mass (BCOM) during GI is associated with dynamic postural stability. Rising from seats higher than knee-height (KH) is more achievable for patients, but whether this and/or lead-limb significantly affects task dynamics is unclear. This study tested whether rising from seat-heights and lead-limb affects STW and STSW task dynamics in young healthy individuals.MethodsTen (5F) young (29 ± 7.7 years) participants performed STW and STSW from a standardised position. Five trials of each task were completed at 100 and 120%KH leading with dominant and non-dominant legs. Four force-plates and optical motion capture delineated key movement events and phases with effect of seat-height and lead-limb determined by 2-way ANOVA within tasks.ResultsAt 120%KH, lower peak vertical ground-reaction-forces (vGRFs) and vertical BCOM velocities were observed during rising irrespective of lead-limb. No other parameters differed between seat-heights or lead-limbs. During GI in STSW there was more lateral, and less posterior, COP excursion than expected.ConclusionReduction in vGRFs and velocity during rising at 120%KH is consistent with reduced effort in young healthy individuals and is likely therefore to be an appropriate seat-height for patients. Lead-limb had no effect upon STSW or STW parameters suggesting that normative data independent of lead-limb can be utilised to monitor motor rehabilitation should differences be observed in patients. STSW should be considered an independent movement transition.     

Reference data for performances on the standardized walking obstacle course in children developing typically

PurposeTo establish reference performance groups on the Standardized Walking Obstacle Course (SWOC) a pathway to screen ambulation for children developing typically.MethodsSWOC tests ambulation under three conditions: walk (W), walk with tray (WT) and walk wearing sunglasses (WG). One trial consisted of standing up, walking the course in one direction and sitting down. Children (n = 355) completed two trials per condition. Trial measures included time to complete (seconds) and numbers of steps, stumbles, and steps off path.ResultsTrial 1 and trial 2 for time and number of steps are significantly different (p = 0.0005), but highly correlated (r = 0.93 and r = 0.96) therefore their average was used to establish reference data. Gender was not a significant factor. Age and height predict performances in all conditions, but measures between age groups were not always significantly different. Significant different measures by height groups could be established across all conditions, therefore reference data was established using three height groups.ConclusionReference values will assist clinicians to compare a child’s performance on the SWOC based on an individual height because this can vary within and between ages thus screening for possible ambulation limitations.     

Growth and psychomotor development of patients with Duchenne muscular dystrophy

Duchenne muscular dystrophy (DMD) is one of the most common hereditary degenerative neuromuscular diseases and caused by mutations in the dystrophin gene. The objective of the retrospective study was to describe growth and psychomotor development of patients with DMD and to detect a possible genotype–phenotype correlation. Data from 263 patients with DMD (mean age 7.1 years) treated at the Departments of Pediatric Neurology in three German University Hospitals was assessed with respect to body measurements (length, weight, body mass index BMI, head circumference OFC), motor and cognitive development as well as genotype (site of mutation). Anthropometric measures and developmental data were compared to those of a reference population and deviations were analyzed for their frequency in the cohort as well as in relation to the genotypes. Corticosteroid therapy was implemented in 29 from 263 patients. Overall 30% of the patients exhibit a short statue (length < 3rd centile) with onset early in development at 2–5 years of age, and this is even more prevalent when steroid therapy is applied (45% of patients with steroid therapy). The BMI shows a rightwards shift (68% > 50th centile) and the OFC a leftwards shift (65% < 50th centile, 5% microcephaly). Gross motor development is delayed in a third of the patients (mean age at walking 18.3 months, 30% > 18 months, 8% > 24 months). Almost half of the patients show cognitive impairment (26% learning disability, 17% intellectual disability). Although there is no strict genotype–phenotype correlation, particularly mutations in the distal part of the dystrophin gene are frequently associated with short stature and a high rate of microcephaly as well as cognitive impairment.     

无鼾男性人群上气道截面大小与体格指标的相关性研究

目的探讨正常无鼾男性人群上气道横截面大小与身高、体重、体重指数(body mass index,BMI)的相关性。方法正常无鼾男性志愿者30人,年龄38.67±10.74(平均值±标准差)岁。所有志愿者进行核磁共振扫描,利用计算机固有软件测量上气道鼻咽、腭咽、舌咽及喉咽的截面积大小,分析其与身高、体重、BMI的相关性。结果体重与腭咽截面积最小值、最大值及平均值负相关,并与舌咽截面积最小值负相关;BMI与腭咽截面积最大值及平均值负相关。结论随着体重、BMI的增加,气道截面积有变小的趋势;身高与上气道截面大小无明显关系;体重、BMI对腭咽与舌咽截面积的影响较大。     

上颌窦提升植骨同期植入种植体的临床效果观察

目的观察上颌窦提升术并同期种植的临床效果。方法对10例患者14侧上颌窦行上颌窦外提升术同期植入种植体,完整剥离窦黏膜12侧,在开窗口覆盖和不盖生物膜各6侧。术后当天,1、3、6、12个月摄X线全景片,观察植骨及种植体周围情况。结果上颌窦窦底骨高度为1～6mm时,植入种植体与骨组织结合良好。开窗口覆盖与不盖生物膜的12侧,种植体均与周围骨组织结合良好。结论上颌窦提升植骨同期植入种植体,上颌窦窦底骨高度对种植成功有影响,未发现开窗口术后盖膜与否对术后种植体成功修复有影响。     

内蒙古自治区3~18岁儿童体格发育调查

  目的  调查内蒙古自治区3~18岁儿童的体格发育情况。  方法  在2017年10月—2018年10月期间,采用分层整群抽样的方法选取内蒙古自治区4盟市(呼和浩特市、包头市、通辽市、呼伦贝尔市)15 199名儿童为研究对象,收集身高、体重并计算体重指数;以2005年九市儿童体格发育调查数据为参考标准,计算超重、肥胖的检出率,并分析其特点。  结果  内蒙古自治区3~18岁男、女儿童均有2个身高增长高峰段,男童为3~4岁和11岁阶段;女童为4~5岁和10~11岁阶段;随年龄的增长体重增长无明显规律,青春期前后出现增幅单高峰,男、女儿童分别出现在15岁、10岁。各年龄段身高、体重均明显高于2005中国九市标准(均P＜0.001),其中6岁男童、13岁女童身高超过全国标准最明显;7岁男童、10岁女童体重高于全国标准最明显。超重的总检出率为12.31%,肥胖的总检出率为20.27%,其中男、女童超重检出率差异无统计学意义,分别为11.55%、13.10%(P=0.132);男童肥胖检出率显著高于女童,分别为22.67%、17.76%(P＜0.001)。  结论  内蒙古自治区3~18岁儿童体格发育状况良好,但超重、肥胖检出率高。建议相关部门重视儿童的体格发育,加强儿童健康管理,养成良好的生活习惯。      

Relationship between height and hypertension among women in India: Evidence from the fourth round of National Family Health Survey

Background and aimsHypertension (HTN) is associated with significant morbidity and mortality, especially among women. Literature suggests an association between height and hypertension. We did this study to ascertain an association between hypertension and height and explore their determinants among Indian women of reproductive age group (15–49 years).MethodsWe did a secondary data analysis of the National Family Health Survey-4 (2015–16) and included 5,36,093 women between 20 and 49 years. Blood pressure and height were measured using the standard procedures. Weighted analysis was done to depict the association between the two variables.ResultsOverall prevalence of HTN was 13.49%. We observed an inverse association between height and mean blood pressure of the women, and shorter women had a higher prevalence of HTN. The height of women was found to be associated with lower systolic blood pressure but not with diastolic blood pressure. Women's height depicted significant associations with age and other socio-economic and geographical parameters. Prevalence of HTN depicted a significant association with height and across other subgroups stratified by these parameters.ConclusionWe observed a positive association between the systolic BP and the height of the female. Height is one of the most convenient forms of identifying target groups that should not be missed during screening women for NCDs, especially during pregnancy to prevent premature morbidity and mortality. We recommend disseminating this concept to our primary health care workers, who are also the point of first contact for early screening and halt the burden of disease.