高热惊厥患儿视听诱发电位的研究

【目的】获得一组高热惊厥（febrile convulsion，FC）患儿的视听同步诱发电位的试验室参考值，与同时检测的听性脑干反应（auditory brainstem response，ABR）和闪光视觉诱发电位（flash visual evoked potentials，FVEP）进行对比，讨论视听同步诱发电位的特点，为临床早期同步发现并诊断婴幼儿视听功能障碍提供有力的电生理技术支持。【方法】30例1～3岁FC患儿，于惊厥24h内和惊厥一周后分别进行单独ABR、FVEP和视听同步诱发电位的检测。【结果】①2～3岁组FC患儿单独ABR各波的潜伏期、波问期及单独FVEP各波潜伏期均长=F其它年龄组；②同步ABR—FVEP各波在同步诱发后波形分化良好，潜伏期稳定，较单独ABR和单独FVEP检测波变得更易辨认；③2～3岁组FC患儿同步FVEP—ABR各波的潜伏期、波问期均长于其它组；④FVEP在同步诱发电位中占主导地位，对同步ABR潜伏期影响显著；⑤FC患儿同步ABR和同步FVEP的标准差较单独ABR和FVEP减小，同步ABR和FVEP的异常率较单独ABR和FVEP的异常率有明显提高。【结论】同步诱发电位可早期发现并诊断FC患儿视听功能障碍。     

视听同步诱发电位在婴幼儿视听功能检查中的应用

目的:讨论视听同步诱发电位的特点,初步探讨其作为新颖的电生理检查方法应用于婴幼儿视听功能检查中的可行性。方法:30例1～3岁高热惊厥(FC)患儿和正常婴幼儿,分别进行单独听性脑干反应(ABR)、闪光视觉诱发电位(FVEP)和视听同步诱发电位的检测,与同时检测ABR和FVEP进行对比。结果:①婴幼儿各组ABR的Ⅰ、Ⅲ、Ⅴ波和FVEP的N1、P1、N2波在同步诱发后波形分化良好,潜伏期稳定,较单独ABR和单独FVEP检测波变得易辨认。②同步ABR-FVEP潜伏期随年龄增长亦有缩短的趋势,FVEP对ABR的各波潜伏期值影响显著(P<0.01),对ABR波间期影响无显著性(P>0.05)。③2～3岁组FC患儿同步FVEP-ABR各波的潜伏期、波间期均长于其他年龄组。④FC患儿同步ABR-FVEP的标准差较单独ABR和FVEP减少,异常率较单独ABR和FVEP的异常率有明显提高。结论:同步诱发电位作为一项全新的电生理检测手段,提高了检测效率,为婴幼儿视听功能的检测提供有力的技术支持。     

0～6个月足月儿和早产儿闪光视觉诱发电位研究

【目的】研究足月儿和早产儿的闪光视觉诱发电位(flash visual evoked potentials,FVEP)特点及临床应用。【方法】应用重庆康华公司的眼多功能检查仪对91名婴儿(足月儿61名,早产儿30名)进行FVEP检测。【结果】获得足月儿和早产儿FVEP波的潜伏期和振幅正常值,及其随月龄的改变而改变的趋势。足月儿0~2、2~4、4~6个月组足月儿P1波潜伏期均值分别为181.77、153.451、32.44 ms,早产儿为213.25、184.22、166.47 ms。组间潜伏期值差异有显著性(P<0.05);比较了早产儿与足月儿FVEP各波潜伏期值的差异及矫正月龄后各波潜伏期值差异,足月儿和早产儿的主波P1出波率相对其它波稳定,且早产儿P1波的潜伏期较足月儿延长,矫正月龄后早产儿的P1波潜伏期与足月儿差异无显著性。【结论】以FVEP波的主波P1潜伏期值为参考值对小婴儿的视功能检查具有可行性;在为早产儿作视功能检查时,建议检查矫正月龄后的潜伏期值是否在正常值范围内。     

正常328名1~6月龄婴儿脑干听觉诱发电位结果分析

目的 探讨1~6月龄正常婴儿脑干听觉诱发电位(ABR)的变化规律,建立婴幼儿ABR波Ⅰ、Ⅲ、Ⅴ潜伏期及Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期的正常值范围,为临床工作提供依据。方法 2017年1月-2018年1月对328名听力正常婴儿和40例成人进行ABR测试。结果 1~6月龄婴儿Ⅰ波潜伏期分别为(1.65±0.07)、(1.59±0.07)、(1.59±0.05)、(1.57±0.07)、(1.56±0.05)ms和(1.54±0.06)ms,该指标至5月龄时已与成人值(1.53±0.02)ms相近(P>0.05);Ⅲ、Ⅴ波潜伏期及Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期随月龄增长而缩短,至6月龄时各值分别为(4.04±0.12)、(6.11±0.13)、(2.50±0.11)、(2.07±0.13)、(4.57±0.12)ms,但仍未达到成人水平(3.90±0.08)、(5.77±0.07)、(2.37±0.08)、(1.87±0.11)ms和(4.24±0.07)ms,差异有统计学意义(P<0.05)。各波潜伏期及波间期无性别及左右耳差异(P>0.05)。结论 建立1~6月龄婴儿ABR潜伏期及波间期正常值标准,为听力及发育障碍的早期诊断和随访检测提供可靠依据。     

高胆红素血症婴幼儿的听力学特征分析

[目的]探讨高胆红素血症婴幼儿的听力学特征，为临床诊治提供理论依据。【方法】对54例（108耳）高胆红素血症患儿进行听觉脑千诱发电位（auditory brainstem response，ABR）及畸变产物耳声发射（distortion product otoacoustic emissions．DPOAE）测试，设立同年龄段正常对照组、蜗性病变对照组、中枢神经系统病变组进行对比研究。【结果】高胆组本身，可出现双耳蜗性、双耳蜗后、双耳ABR及DPOAE严重异常、双耳中一耳为蜗性、一耳为蜗后的不同表现；与中枢组比较。高胆组表现为蜗后病变的比率较中枢组高（P〈0．05）；与正常组相比，除F7外，高胆组各频点的DPOAE幅值均较低；F6～F11各频点的引出率与正常组相比无明显差异；与蜗性病变组相比，高胆组的波V阈值较高（P〈0．05）；与蜗性病变组及正常组相比，高胆组的Ⅰ、Ⅲ、Ⅴ波潜伏期均延长（P〈0．05）。【结论】高胆红素血症婴幼儿在听力测试中可表现多种多样的特征。     

庐阳区42天婴儿听觉脑干诱发电位反应分析

【目的】了解42d婴儿听觉脑干诱发电位（auditory brainstem response．ABR）反应波的正常参考值，为临床提供参考依据。【方法】采用中国科技大学生物技术公司生产的NGT-Ⅱa型听觉脑干诱发电位测定仪．测定42d要儿听觉脑干诱发电位反应，将重现良好、分化清晰的听觉脑干诱发电位反应进行统计学分析。【结果】42d婴儿听觉脑干诱发电位反应的正常参考值为：波Ⅰ1．98毫秒，波Ⅲ4．72毫秒．波Ⅴ6．82毫秒。【结论】对听觉脑干诱发电位反应超出正常参考值的42d要儿在觉醒状态时利用各种方式进行听刺激，促进其听能力的发展。     

609例1～18月龄正常婴幼儿脑干听觉诱发电位检测结果分析

目的 分析1～18月龄正常婴幼儿脑干听觉诱发电位(BAEP)的变化规律,为建立婴幼儿BAEP波 Ⅰ、Ⅲ、Ⅴ潜伏期及Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期的参考值范围提供科学依据。方法 选取2017年1月—2018年1月于湖北省妇幼保健院就诊的609例听力正常婴幼儿(共1 218耳)为研究对象和40例听力正常成人(共80耳)为对照组,进行BAEP测试。结果 1～18月龄婴儿Ⅰ、Ⅲ、Ⅴ波潜伏期及Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期随月龄增长而缩短。Ⅰ波潜伏期至6月龄后与成人相近(P＞0.05)。Ⅲ、Ⅴ波潜伏期及Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期至7月龄仍未达到成人水平(P＜0.05),Ⅴ波,Ⅰ-Ⅴ波间期在9月仍未达到成人水平(P＜0.05)。各波潜伏期及波间期性别及左右耳比较,差异无统计学意义(P＞0.05)。结论 建立1～18月龄婴幼儿BAEP潜伏期及波间期参考值标准,为听力及发育障碍的早期诊断和随访检测提供参考依据。     

婴儿肝炎综合征脑干听觉诱发电位的分析

【目的】探讨婴儿肝炎综合征（infan thepatitis syndrome，IHS）脑干听觉诱发电位（brainstem auditory eyoked potential，BAEP）的变化及其对听觉传导通路的影响。【方法】将67例IHS患儿分为巨细胞病毒（cytomegalovirus,CMV）感染组和非CMV感染组，人院后进行BAEP的检测，并在治疗后5～6个月复查BAEP。【结果】CMV组36例表现为Ⅰ、Ⅲ、Ⅴ波绝对潜伏期（PL）及Ⅲ-V、Ⅰ—Ⅴ波峰间期（IPL）延长为主;而非CMV组31例表现为Ⅴ波PL及Ⅰ-Ⅲ、Ⅰ—Ⅴ波IPL延长为主，二者参数有明显变化。CMV组Ⅴ波反应阈值明显增高。两组患儿经治疗后听力损害均有不同程度的恢复。【结论】IHS患儿尤其是CMV感染者的听觉传导通路有一定程度的损害，BAEP的早期监测有重要意义。     

窒息新生儿听力损伤早期治疗临床研究

【目的】研究窒息新生儿听力损伤早期治疗的效果。【方法】对60例有听力损伤的窒息新生儿在7日龄内进行药物及高压氧的综合治疗。并将治疗前后测得的脑干听觉诱发电位(auditorybrainstemresponse,ABR)结果做比较。【结果】治疗前双耳I、Ⅲ、V波的出现率分别为90.83％、92.50％、82.50％,各波峰潜伏期(peaklatency,PL)及峰间潜伏期(interpeaklatency,IPL)均延长。治疗后双耳Ⅰ、Ⅲ、Ⅴ波的出现率分别为100％、100％、98.3％,各波峰潜伏期及峰间潜伏期正常或接近正常,其治疗前后ABR测试结果差异有显著性(P<0.01或<0.05)。【结论】新生窒息儿应及时做ABR测试,使有听力损伤的患儿得以早期发现、早期治疗、早期干预,避免影响婴幼儿的语言发育及智力发育,避免聋残儿的发生。     

6～24月龄婴幼儿闪光视觉诱发电位纵向随访

【目的】获得6～24月龄婴幼儿闪光视觉诱发电位(flash visualevoked potentials,FVEPs)主波P2潜伏期的正常值,分析2岁以内FVEPs的成熟过程,探讨FVEPs应用于婴幼儿视功能检查的可行性。【方法】根据家长自愿原则,于上海市卢湾区妇幼保健院收集小于6月龄正常足月儿。通过电话预约方式,通知其于6、12、18、24月龄至复旦附属儿科医院儿童保健科,应用重庆康华科技有限公司的眼多功能检查仪进行FVEPs检测。【结果】共收集小于6月龄正常足月儿28例。所有婴幼儿FVEPs均能引出N2-P2-N3(负-正-负)的波形,各波潜伏期值随月龄增长而逐渐缩短,且P2波潜伏期与月龄存在负相关(r=-0.52;P0.01)。振幅值未显示有随月龄而改变的趋势。【结论】FVEP主波P2出波稳定、个体变异小,以其为参考值,评估婴幼儿的视觉发育状态是可行的,评估时要密切结合小儿月龄。     

企业职工高尿酸血症与血压、血脂、血糖的相关性研究

目的探讨企业职工高尿酸血症（HUA）与血压、血脂、血糖的相关性,为企业进行健康管理提供依据。方法以中国石油长庆油田公司各下属企业为抽样单位,整群随机抽取2个单位,每个单位中所有的HUA者作为HUA组,共720人;同时在尿酸水平正常者中随机选取620人为正常组。通过Logistic回归分析HUA与年龄、性别、血压、血脂、血糖的关系。结果HUA合并高血压、高血脂、空腹m糖受损任意一项、两项、三项的比例均远高于正常组（OR值分别为：4．036,2．562,4．174）。多因素Logistic回归发现：男性、收缩压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇是HUA的危险因素（OR值分别为7．736,2．309,1．721,2．761,1．411）;高密度脂蛋白胆固醇为HUA的保护因素（OR值为0．211）。结论HUA存在性别差异,且与血压、血脂密切相关。企业对职工的健康管理应充分考虑多危险因素的综合作用,全面的进行健康教育及干预。     

癌缺氧病因及预防和治疗

目的 探讨癌及安阳林州市食管癌高发原因及癌病因预防和治疗措施.方法 对林州市食管癌等疾病现场进行调查,在进行10余年统计分析基础上,综合分析了全国156篇文献成果.结果 提出癌缺氧病因学说,使用制氧机、按摩器、饮用纯净水治疗恶性肿瘤,取得良好效果,改水能够大幅降低林州市居民食管癌发病率、死亡率.结论 癌可能是由于机体长...     

Recruitment and retention challenges and successes

Objective: Addressing health disparities requires well designed, culturally adapted research. However, recruiting/retaining minority participants has often been challenging. We present strategies used to successfully recruit and retain rural Hispanic women during a breastfeeding education intervention.

Design: This study involved a two-group repeated measures quasi-experimental design with assessments at seven intervals between enrollment and 6 months postpartum. Participants (Hispanic women?≥?15 years old) were recruited through a regional hospital.

Results: We successfully met our recruitment goals, most women contacted were enrolled (46 of 58), and 100% completed the study.

Discussion: Research staff with ties within the community helped establish trust. Using bilingual study materials, simple language, and an interpreter addressed language/literacy concerns. Phone assessments facilitated participation as transportation was an issue. Accommodating requests to deliver or mail study materials and providing incentives were important. Extra effort was needed to maintain contact when phone service was disrupted or participants moved. Keys to success were persistence, flexibility, and alleviating barriers to participation.     

初产妇与经产妇焦虑抑郁状态分析及干预

目的：分析初产妇、经产妇心理状态特点,以便采取更有效的干预措施。方法筛选2014年6月至2015年1月在咸阳市旬邑县妇幼保健院产科门诊产前检查的健康初产和经产妇各60名,孕周为28~40周。入组时用焦虑自评量表( SAS)、抑郁自评量表(SDS)对两组孕妇进行心理评定,并给1次支持性心理干预(40~60分钟),1周后再次用SAS、SDS对两组孕妇进行评定分析。结果经产妇干预前SAS(50.73±3.45)、SDS(49.13±3.86)评分明显高于初产妇SAS(42.45±2.08)、SDS(41.77±2.21),差异均有统计学意义(t值分别为-15.921、-12.817,均P<0.01);干预后两组SAS、SDS评分均比干预前明显降低,差异均有统计学意义(t值分别为14.999、15.413;15.724、15.832,均P<0.01);干预后经产妇 SAS(38.61±5.02)、SDS(39.10±3.03)评分明显高于初产妇SAS(34.88±3.31)、SDS(32.01±4.27),差异均有统计学意义(t值分别为-4.805、-10.489,均P<0.01)。结论初产妇和经产妇均伴有焦虑、抑郁情绪,干预前后经产妇抑郁、焦虑情绪均较初产妇明显,支持性心理干预能有效改善孕妇的不良情绪。     

Continuity and change in neighborhood disadvantage and adolescent depression and anxiety

We used data from the Fragile Families and Child Wellbeing Study which includes a sample of adolescents of age 15 at the most recent wave (between 2014 and 2017) from mainly low-income urban families in the United States, to examine the association between neighborhood poverty entries and exits and adolescent depression and anxiety. In addition, we examined whether these associations differed by gender. Adolescents who consistently lived in disadvantaged neighborhoods had the highest level of depression and anxiety. Those who entered poor neighborhoods were more depressed than those who never lived in poor neighborhoods. Those who exited poor neighborhoods showed no significant difference in depression and anxiety compared to those never lived in poor neighborhoods. Furthermore, these associations applied to adolescent girls only and were not statistically significant for boys. The results suggest that neighborhood poverty has cumulative negative impacts on adolescent mental health and disproportionally affects adolescent girls. Reducing neighborhood poverty would substantially improve the health of adolescents, especially girls, which would reduce health disparities.     

Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights

At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described – fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.     

儿童青少年超重肥胖评价方法及SPSS和SAS实现

超重肥胖已成为世界各国儿童青少年面临的重大公共卫生问题之一。现行的儿童青少年超重肥胖筛查标准不统一,逐条评价或自行编写程序容易出错且效率较低。本研究以中国学龄儿童青少年超重与肥胖筛查标准为例,详细介绍了国际和中国共四种评价儿童青少年超重肥胖的方法和步骤,结合具体案例详细介绍其应用方法,同时编制SPSS和SAS程序包和解...     

Car ownership and the association between fruit and vegetable availability and diet

Objective

Nearly all research on the food environment and diet has not accounted for car ownership — a potential key modifying factor. This study examined the modifying effect of car ownership on the relationship between neighborhood fruit and vegetable availability and intake.

Methods

Data on respondents' (n = 760) fruit and vegetable intake, car ownership, and demographics came from the 2008 New Orleans Behavioral Risk Factor Surveillance System. Shelf space data on fresh, frozen, and canned fruits and vegetables were collected in 2008 from a random sample of New Orleans stores (n = 114). Availability measures were constructed by summing the amount of fruit and vegetable shelf space in all stores within defined distances from respondent households. Regression analyses controlled for demographics and were run separately for respondents with and without a car.

Results

Fruit and vegetable availability was positively associated with intake among non-car owners. An additional 100 m of shelf space within 2 km of a residence was predictive of a half-serving/day increase in fruit and vegetable intake. Availability was not associated with intake among car owners.

Conclusions

Future research and interventions to increase neighborhood healthy food options should consider car ownership rates in their target areas as an important modifying factor.