Haemophilus influenzae meningitis in school-aged children

The relative frequency of meningitis caused by Haemophilus influenzae in school-age children was determined by reviewing etiologic diagnoses in children 6 to 15 years old admitted to four hospitals from 1974 to 1978. Sixty-five (45%) of 145 patients had aseptic meningitis and 29 (20%) had bacterial meningitis. Thirty-two (22%) of the patients had received antibiotic therapy before diagnosis, and 19 (13%) could not be classified. Six (21%) of the 29 patients with bacterial meningitis had H influenzae meningitis. Although aseptic disease was the most common type of meningitis, initial antibiotic therapy for presumed bacterial meningitis in school-aged children should include adequate coverage for H influenzae.     

Survey: Chinese children get inadequate sleep

Background The identification of vulnerable plaques before rupture is an important clinical goal. The purpose of the present study was to assess the difference in plaque composition among patients with acute coronary syndrome （ACS） and stable coronary artery disease （SCAD） by intravascular ultrasound virtual histologic analysis. Methods One hundred and thirty-nine patients were divided into ACS group and SCAD group according to clinical presentation. A total of 229 de novo lesions with 〉50% stenosis in native coronary arteries with diameters 〉2.5 mm were studied with intravascular ultrasonography. Geometric and compositional data were obtained using intravascular ultrasound virtual histology software. Results There were no significant differences in overall lesions for fibrous （（52.0±11.9）% vs （54.3±8.5）%, P〉0.05）, fibrolipidic （（12.3±10.1）% vs （13.8±9.5）%,P〈0.05）, calcium （（14.0±9.1）% vs （19.3±13.1）%, P〉0.05）, or necrotic core （（22.0±11.1）% vs （19.7±5.4）%, P〉0.05） percentages in ACS and SCAD patients, respectively. There were also no significant differences in culprit lesions for fibrous （（46.4±12.0）% vs （53.6±8.8）%, P〉0.05）, fibrolipidic （（9.1±9.0）% vs （12.9±9.7）%, P〉0.05）, calcium （（16.6±9.7）% vs （21.8±26.3）%, P〉0.05）, or necrotic core （（28.0±12.6）% vs （20.6±5.2）%, P〉0.05） percentages in ACS and SCAD patients, respectively. High density lipoprotein-cholesterol levels 〉1.04 mmol/L were associated with more fibrolipidic （（14.5±10.4）% vs （7.1±6.5）%, P〈0.05） and less necrotic core （（20.6±9.7）% vs （27.9±12.6）%,P〈0.05） percentages in the cohort with ACS. Conclusions In this study, coronary plaque composition assessed by intravascular ultrasound virtual histologic analysis was not significantly different between ACS and SCAD patients. The anatomic relationship of the specific plaque components to the lumen of the vessel was more important than th     

Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis

Context  The cognitive and behavioral outcomes of school-aged children who were born preterm have been reported extensively. Many of these studies have methodological flaws that preclude an accurate estimate of the long-term outcomes of prematurity. Objective  To estimate the effect of preterm birth on cognition and behavior in school-aged children. Data Sources  MEDLINE search (1980 to November 2001) for English-language articles, supplemented by a manual search of personal files maintained by 2 of the authors. Study Selection  We included case-control studies reporting cognitive and/or behavioral data of children who were born preterm and who were evaluated after their fifth birthday if the attrition rate was less than 30%. From the 227 reviewed studies, cognitive data from 15 studies and behavioral data from 16 studies were selected. Data Extraction  Data on population demographics, study characteristics, and cognitive and behavioral outcomes were extracted from each study, entered in a customized database, and reviewed twice to minimize error. Differences between the mean cognitive scores of cases and controls were pooled. Homogeneity across studies was formally tested using a general variance-based method and graphically using Galbraith plots. Linear meta-analysis regression models were fitted to explore the impact of birth weight and gestational age on cognitive outcomes. Study-specific relative risks (RRs) were calculated for the incidence of attention-deficit/hyperactivity disorder (ADHD) and pooled. Quality assessment of the studies was performed based on a 10-point scale. Publication bias was examined using Begg modified funnel plots and formally tested using the Egger weighted-linear regression method. Data Synthesis  Among 1556 cases and 1720 controls, controls had significantly higher cognitive scores compared with children who were born preterm (weighted mean difference, 10.9; 95% confidence interval [CI], 9.2-12.5). The mean cognitive scores of preterm-born cases and term-born controls were directly proportional to their birth weight (R² = 0.51; P<.001) and gestational age (R² = 0.49; P<.001). Age at evaluation had no significant correlation with mean difference in cognitive scores (R² = 0.12; P = .20). Preterm-born children showed increases in externalizing and internalizing behaviors in 81% of studies and had more than twice the RR for developing ADHD (pooled RR, 2.64; 95% CI, 1.85-3.78). No differences were noted in cognition and behaviors based on the quality of the study. Conclusions  Children who were born preterm are at risk for reduced cognitive test scores and their immaturity at birth is directly proportional to the mean cognitive scores at school age. Preterm-born children also show an increased incidence of ADHD and other behaviors.      

金乡县部分学龄儿童营养教育效果评价

目的对学龄儿童开展营养教育的效果和途径进行评价。方法在2所小学整群抽取学生1226名,按班级随机分为单纯学生教育组、学生与家长教育组和对照组,进行3个月不同形式的营养教育;采用问卷和膳食调查的方法,分析营养教育后学生营养知识、态度、行为和膳食结构的变化。结果两教育组学生接受营养教育后,营养知识得分与对照组比较显著提高,学生和家长教育组学生饮食行为的改善更为明显。结论学校营养教育结合家长的参与是改善学生营养行为的有效途径,但需针对不同年龄段学生施以有效的教育。     

医疗费用增长的研究与对策

通过对我国医疗费用快速上涨问题的现状与原因进行分析研究,借鉴国外控制医疗费用方法与经验,探讨有效控制我国医疗费用快速上涨的对策,对控制医疗费用快速上涨和制定医改政策起到指导及参考作用.     

促进青少年体育锻炼的措施有效

一项研究对已发表的57篇有关少年儿童体育锻炼促进措施之有效性的文献进行了系统回顾，其中33项研究是针对儿童的，24项研究是针对青少年的。     

学龄前儿童和学龄儿童的免疫接种率和适时接种情况

虽然有关免疫接种的覆盖情况已经在瑞士人群中得到反复的评价，但在瑞士和其他国家地区，统一推荐的免疫接种是否及时实施的情况很少见有报道。本研究旨在确定瑞士巴塞尔地区官方推荐的学龄前和学龄儿童标准化免疫接种的依从性，研究重点是免疫接种率和适时接种情况。2001年巴塞尔所有进入幼儿园和小学三年级的儿童群体中，按4个城区中年龄人口总比例分别抽取310例学龄前儿童和310例学龄儿童，排除外籍儿童。资料来自于免疫接种记录，由父母自愿提供。白持续时间的延长，患T1DM的风险下降，而无母乳喂养与患病风险增加相关，（OR1．93，95％CI 1．33～2．80），接受母乳喂养12个月以上为保护性因素，（OR0．42，95％CI 0．22～0．81），两均以1～3月龄婴儿母乳喂养的分类作为参考。日间照顾时间短（0或少于1年）与T1DM发病风险弱相关，（OR1．65，95％CI 1．05～2．62）。     

美国儿童接种二次水痘疫苗

自1995年起，美国儿童一直常规接种水痘疫苗，其最初方法是单次接种抗水痘一带状疱疹病毒的减毒活疫苗。但从去年中期开始，美国免疫实践咨询委员会（ACIP）推荐，在有迹象表明儿童免疫力开始减退时应二次接种水痘疫苗。一项研究发现，加利福尼亚儿童接种水痘疫苗后，暴发性水痘发生率逐渐升高，第8年超过第1年发生率的12倍，这种趋势很明显，说明在单次接种水痘疫苗后，其免疫力随时间延长会逐渐降低，儿童还是会发生严重的水痘，不过此项研究只局限于8～12岁的儿童。该研究还发现，中重度水痘（超过50个水痘）患儿出现并发症的风险增加，如：肺炎、共济失调、皮肤细菌感染等。[第一段]     

学龄期癫痫儿童睡眠问题及其影响因素分析

目的 探讨原发性或可能症状性学龄期癫痫儿童的睡眠问题及其相关影响因素.方法 采用中文版儿童睡眠习惯问卷(CSHQ)对54例学龄期(7~12周岁)原发性和可能症状性癫痫儿童及54例性别、年龄严格匹配的学龄期健康儿童进行调查.结果 癫痫组在CSHQ总分及8个层面中的6个(睡眠抵触、入睡潜伏期、睡眠焦虑、夜醒、异态睡眠、白天嗜睡)得分与对照组相比差异有统计学意义(P<0.05).在癫痫组中,不同年龄段CSHQ总分及睡眠抵触、入睡潜伏期、睡眠持续时间、睡眠焦虑4个层面相比差异有统计学意义(P<0.05);发作控制组和未控制组在CSHQ总分及除入睡潜伏期层面的其他层面差异均有统计学意义(P<0.05);不同发作频率CSHQ总分及除睡眠呼吸障碍层面的其他层面差异均有统计学意义(P<0.05);不同发作类型CSHQ总分和睡眠抵触、睡眠持续时间、睡眠焦虑、白天嗜睡4个层面相比差异有统计学意义(P<0.05);不同发作时间段CSHQ总分及睡眠抵触、入睡潜伏期、睡眠持续时间、睡眠焦虑、夜醒层面5个层面相比差异有统计学意义(P<0.05);单药治疗组和多药治疗组CSHQ总分和入睡潜伏期、夜醒、异态睡眠、白天嗜睡4个层面差异有统计学意义(P<0.05).多元线性回归分析显示,性别、年龄、控制与否、发作频率、发作类型、发作时间段、抗癫痫药物种类是CSHQ总分或其某些层面分数的主要影响因素.结论 癫痫患儿较健康儿童更易出现睡眠问题,其睡眠问题的发生可能与多种因素相关.     

重症哮喘对学龄儿童产生负面心理行为的调查研究

目的调查重症哮喘的学龄期儿童负面心理行为问题的存在情况,促进患儿的身心健康发展。方法选择重症哮喘的学龄期患儿36例,设为研究组,并以36例健康学龄期儿童作为对照组,对两组患儿进行行为问题调查。结果研究组患儿的行为问题检出率为52.8%,对照组为8.3%,研究组显著高于对照组,差异有统计学意义(P<0.05),研究组男性患儿在分裂性、多动、强迫性以及攻击性等因素方面与对照组比较,差异有统计学意义(P<0.05),而女性患儿在活动能力、抑郁和社交退缩等因素方面与对照组差异有统计学意义(P<0.05)。结论重症哮喘患儿存在明显负面心理行为问题,应引起临床重视。     

正常学龄儿童P300和智力的关系研究

目的 探讨学龄儿童听觉P300与智力的关系。方法 应用日本光电大脑诱发电位仪检测儿童的听觉事件相关电位(ERP)，应用联合型瑞文测验中国第二版(CRT-C2)N韦氏儿童智力测(WISC-CR)测量儿童的智力。结果 儿童P300潜伏期和WISC-CR的操作智商（PIQ)、全量表智商(FSIQ)及常识、填图和积木分测验成绩呈显著负相关。P300波幅与IQ无显著相关。结论 P300潜伏期与儿童智力有密切关系。在探讨P300和智力关系时加大P300任务难度是十分必要的。     

正常学龄儿童P300和智力的关系研究

目的探讨学龄儿童听觉P300与智力的关系.方法应用日本光电大脑诱发电位仪检测儿童的听觉事件相关电位(ERP),应用联合型瑞文测验中国第二版(CRT-C2)和韦氏儿童智力测验(WISC-CR)测量儿童的智力.结果儿童P300潜伏期和WISC-CR的操作智商(PIQ)、全量表智商(FSIQ)及常识、填图和积木分测验成绩呈显著负相关.P300波幅与IQ无显著相关.结论 P300潜伏期与儿童智力有密切关系.在探讨P300和智力关系时加大P300任务难度是十分必要的.     

学龄前癫痫儿童日间身体活动时数与夜间睡眠型态的相关研究

目的 探讨学龄前癫痫儿童日间身体活动时数与夜间睡眠型态的相关性。方法 采用便利抽样法,选择2018年1月至2021年12月浙江省东阳市人民医院139例学龄前癫痫患儿为研究对象,收集患儿的一般资料、儿童睡眠习惯问卷和睡眠活动日志等数据,采用Pearson相关分析及多元线性回归分析日间中高强度身体活动时数与夜间睡眠时数和睡眠效率的关联。结果 学龄前癫痫儿童平均每日中高强度身体活动时数为（45.89±4.29）min,平均夜间睡眠时数（8.14±0.76）h,儿童睡眠习惯问卷得分（52.51±4.33）分;学龄前癫痫儿童日间中高强度身体活动时数与夜间睡眠时数呈负相关（r=–0.708,P<0.01）,与夜间睡眠效率呈正相关（r=0.368,P<0.05）;中高强度身体活动时数愈长,夜间睡眠效率愈佳（β=0.375,t=2.294,P<0.05）,夜间睡眠时数愈短（β=–0.398,t=–3.205,P<0.01）,母亲周工作时数愈短（β=–0.350,t=–2.714,P<0.05）。结论 建议常规评估学龄前癫痫儿童身体活动与睡眠,适度增加中高强度身体活动进而提升睡眠效率。     

上海市闵行区学龄儿童尿碘和盐碘水平的现况调查

 目的  了解和掌握上海市闵行区学龄儿童尿碘水平及家庭食用盐碘水平及其分布。方法  采用分阶整群抽样方法选定上海市闵行区某小学三到五年级12个班级(每个年级4个班级)的所有学生,采集尿样、检测尿碘,并收集、检测学生家中食用盐的碘含量。结果  共收集并检测498份尿样(男生246份,女生252份)。调查对象尿碘中位数为143.28 μg/L(男生为147.46 μg/L;女生为141.66 μg/L)。尿碘水平低于适宜标准者比例达27.11%,超过适宜水平者占27.51%。483份盐样含碘均值为20.61 mg/kg。食盐加碘率79.09%,合格碘盐仅占71.43%,无碘盐及不合格碘盐分别占20.91%及7.66%。食用合格碘盐的学生其尿碘水平显著低于其他学生(χ2=6.34,P=0.04)。结论  上海市闵行区学龄儿童尿碘中位水平适中,但呈现碘缺乏、碘适宜及碘过量并存的现象。     

上海市学龄儿童电视和电脑使用对睡眠行为的影响

目的 研究上海市学龄儿童电视和电脑使用对就寝/晨起习惯、睡眠时间和睡眠问题的影响.方法 采用多级整群抽样,对上海市10所小学一到五年级的4 108名学龄儿童进行问卷调查.采用自制问卷调查儿童电视和电脑使用情况、个人及家庭状况;采用中文版儿童睡眠习惯问卷调查儿童的睡眠行为.采用多元线性回归和逐步Logistic回归分析方法,研究电视和电脑使用对儿童就寝/晨起习惯、睡眠时间和睡眠问题的影响.结果 4.1%的儿童平时(非周末)平均每天看电视时间≥2 h,周末看电视时间≥2 h的儿童占49.2%.88.2%的儿童"偶尔"(0～1次/周)使用电脑,11.0%的儿童"经常"(2～4次/周)使用电脑,0.8%的儿童"几乎每天"(5～7次/周)使用电脑.随着年龄的增长,每天看电视时间>12 h和"经常"使用电脑的比例逐渐上升.多元线性回归和逐步Logistic回归分析显示,电视和电脑使用可使儿童就寝时间和晨起时间推迟,睡眠时间缩短,并且是导致儿童就寝习惯不良、入睡潜伏期延长、睡眠持续时间不规律、睡眠焦虑和异态睡眠的危险因素.结论 看电视和使用电脑对儿童睡眠行为的影响不仅体现在就寝/晨起习惯和睡眠时间上,而且会导致多种睡眠问题.关注电视和电脑使用对儿童睡眠行为的潜在不良影响,有助于促进儿童培养健康的睡眠习惯和改善睡眠质量.