甘肃省合作市藏族地区儿童龋齿患病现状调查

目的了解甘肃省合作市6～12岁学生龋齿患病现状和流行病学分布情况,掌握龋齿变化趋势,为今后开展儿童龋齿防治工作提供依据。方法随机抽取合作市3所城区小学和13所乡、村级小学6。12岁小学生,按照《全国学生体质健康状况调查研究实施方案》要求,对学生进行口腔调查,同时调查口腔卫生及刷牙、饮食、饮茶等生活行为习惯。结果合作市城市和农村儿童患龋率分别为35．1％和44．2％,失牙率分别为0.3％和2．6％,补牙率分别为1．3％和0．9％;农村儿童龋患率、龋均和失牙率明显高于城区,而补牙率城市高于农村;男生龋患率、龋均和失牙率均低于女生,龋补率高于女生;无论城乡2011年龋患率、龋均和失牙率均高于2010年。结论合作市的龋齿患病率相对较高,且呈现明显的上升趋势,必须尽快推广和应用安全有效的防龋措施（窝沟封闭）、开展针对性的口腔健康教育并加强食品监管等综合防治措施。     

甘肃省泾川县补硒防治大骨节病20年效果观察

为探索和总结补硒防治大骨节病（KBD）的方法和经验。回顾分析了练范村1980年以来施用硒片和硒盐防治大骨节病20年的X线观察结果，并结合观察同期未使用任何防治措施的邓家峪村儿童X线资料作比较分析，认为硒片防治与儿童KBD患病率下降有关，具有促进干骺端变修复和预防KBD新发的显效果，硒盐防治仍可使病情下降达到控制标准。     

2007年广西碘缺乏病高危地区重点调查结果分析

目的了解广西碘缺乏病重点地区新发克汀病病人情况和5个高危县防治工作现况。方法对34个重点县进行新发克汀病病人搜索,并对5个高危县进行盐碘、尿碘、甲状腺肿大率、智商水平、健康教育等指标监测。结果搜索、诊断7例新发克汀病病人;检查8～10岁儿童3007人,触诊法检测甲状腺肿大率平均为6．45％,B超法检测甲状腺肿大率平均为12．50％;儿童尿碘中位数为262．30μg／L,孕妇和哺乳期妇女尿碘中位数为233．20μg／L;儿童智商平均水平为87．64,智商〈69的占16．5％,智商〉130的占3．6％;680份居民食盐半定量检测,其含碘率为96．03％;家庭主妇碘缺乏病防治知识知晓率为45．88％。结论广西存在散发克汀病病例,碘缺乏病防治工作在巩固成绩的基础上,重点抓好薄弱地区和薄弱环节的工作。     

地方性砷中毒的干预实验及其效应分析

为探讨防治地方性砷中毒的方法及效果,在新疆奎中屯病区对干预实验前后不同时间的高砷井水、患病情和居民患病进行了流行病学调查。结果表明干预实验15年来77％病区饮用水已符合卫生要求,环境已无砷污染,砷中毒患90％以上病情有了好转,再无新发病例。     

宰相村大骨节病防治效果的报告

宰相村是全省大骨节病区之一,60～70年代病情持续严重。为贯彻执行中央卫生部。地病司控制和消灭地方病、发展生产力等指示精神。我们自1984年对该村大骨节病进行了普查,并借鉴国内防治经验,采用1/6万硒盐全民防治,13岁以下儿童加服适量硒片的措施进行防治。同时对人体内外环境因素与病情变化的关系进行观察研究。经连续观察至1993年该村病情显著下降且无1例新发,防治效果显著,已达到基本控制标准,取得了明显的社会效益。现总结报告如下。     

四川省重点地区消除碘缺乏病综合干预措施效果分析

目的了解重点地区综合干预措施效果,推进重点地区消除碘缺乏病进程。方法在2001年四川省碘盐监测基线调查的基础上,于2003年1月至2004年12月对非碘盐较严重的甘孜、阿坝州实施以加强碘盐市场管理和开展健康教育为重点的综合干预措施,并选择部分县按地理方位各抽取5个乡每年进行盐碘、儿童尿碘监测和健康教育问卷调查,以了解综合干预措施的效果。结果居民合格碘盐食用率上升了31．6％,非碘盐率下降了64．6％,儿童尿碘中位数为148．6μg/L,学生碘缺乏病防治知识知晓率上升了44．4％,家庭主妇防治知识知晓率上升了60．1％。结论综合干预措施效果显著,使综合干预地区各项技术指标接近国家消除碘缺乏病目标的标准。     

贵州省12岁儿童口腔流行病学调查结果分析

目的 调查贵州省12岁儿童口腔健康状况,为开展儿童口腔预防保健提供科学依据.方法 按全国第四次口腔健康流行病学调查方案的方法和标准执行进行抽样和口腔检查,抽取875名12岁学生进行检查.结果 12岁儿童患龋率和龋均分别为32.1％和0.64,患龋率男27.8％,女36.4％,不同性别之间差异有意义(P＜0.05);龋齿...     

呼伦贝尔市大骨节病病情分析

目的了解呼伦贝尔市大骨节病的病情势态,为今后大骨节病防治决策提供客观依据。方法2005年对呼伦贝尔市8个大骨节病重病村进行病情调查,以7～13岁儿童大骨节病X线检出率为指标,与1999年曾调查过的6个村的历史病情资料进行对比分析。结果1999年6个村的儿童大骨节病X线检出率在4．55％～11．83％,平均为7．66％;而2005年X线检出率在3．22％～10．53％,平均为7．99％。在6个村间隔7年的对比中,病情上升与下降各有3个村,基本呈现稳定态势,差异无统计学意义(P>0．05)。本次调查8个村的7～13岁儿童大骨节病X线检出45人,均系7年后新发病例,以此推算全市646个病村7年中新发病例3 634人,平均每年新发儿童大骨节病519人。结论除继续深入贯彻以换粮为主切断病因链的预防措施外,在合理营养、改善生活方式的基础上,应尽早开展以治疗现患为目的的二级预防,控制病情的发生发展。     

结核病诊断技术研发现状与未能满足的临床需求

自2000年中国开始加大发现新结核病患者力度,并实施免费的直接督导下短程治疗(DOTS)方案.经过十余年的努力,结核病的发病率与现患率出现下降趋势,但与期望值仍有差距.据世界卫生组织(WHO)2010年发布的统计数据显示,全球新发结核患者880万,现患病例1100万,中国分别为100万和150万病例,无论是新发还是现患病比例均超过10％.     

健康教育在绦、囊虫病防治中的价值研究

为了观察健康教育在绦、囊虫病防治中的效果，１９９４～１９９６年在河南夏邑县进行了健康教育干预及驱绦工作。两年干预后，结果为：关于绦囊虫病防治知识正确答卷率由干预前的２２．５％提高至１００％；绦虫感染率从０．０４％下降到０．００２％（Ｐ＜０．０１）；无新发囊虫病例。提示：抓好健康教育，提高居民的自我防病意识，在逐步消灭绦、囊虫病工作中具有重大的意义和价值。     

2015-2019年大英县1~15岁儿童水痘突破病例流行特征分析

目的分析2015-2019年大英县1~15岁儿童水痘突破病例的流行病学特征,为制定水痘防控免疫策略提供依据。方法收集中国疾病预防控制信息系统中2015-2019年大英县1~15岁儿童水痘病例的疫情数据及四川省免疫规划信息管理系统中接种1剂次水痘疫苗的数据,并对其进行描述性流行病学方法分析。率的比较采用χ2检验,以P<0.05为差异有统计学意义。结果2015-2019年大英县1~15岁儿童水痘突破病例258例,发生率为0.89%,各乡镇均有报告,以蓬莱镇位居首位(63.18%),男女比例为1.28∶1,主要集中在5~10岁儿童,以托幼儿童为主(44.96%),夏秋季高发。突破病例发病与接种疫苗最短45 d,最长11年,平均为(4.52±2.67)年。结论为形成有效的免疫屏障,应严格按照《四川省水痘疫苗使用指导意见(试行)》的接种程序对4岁儿童接种第2剂次水痘疫苗;加强夏秋季托幼机构、中小学校水痘疫情的预防与控制工作。     

2个村实施的2种血吸虫病防治策略成本-效果3年对比研究

目的：对单纯人畜扩大化疗（策略1）与人畜扩大化疗辅以易感地带灭螺（策略2）这2种防治策略控制湖沼型垸内亚型血吸虫病的流行进行3年的成本－效果对比研究，以期找出经济、有效的防治对策。方法：计算策略1与策略2的防治成本与效果。结果：3年累计成本－效果比为：策略2是策略1的2．13倍。策略1的人群感染率下降40％，仍维持在11％－12％之间，无抗洪涝能力。策略2的人群感染率持续下降。在3年中，策略2使人群感染率下降了89．2％，使耕牛感染率下降了73．8％，使有螺面积下降了93．7％，使活螺密度感染率下降了99．7％。结论：策略1成本虽低，但效果不理想。策略2能达到基本控制的目的，其防治成本有逐年下降趋势。     

Long term prognosis of Crohn''s disease with onset in childhood and adolescence

The long term outcome has been determined in 67 children with Crohn's disease whose symptoms started at or before 16 years of age. The mean period of follow up was 15.0 years (range 1.5-47 years). The number of children diagnosed in each quinquennium has not increased. Nearly all patients had gastrointestinal symptoms at presentation, but in some cases these were only elicited on careful enquiry. Only four children presented with growth retardation alone. Twenty one per cent of the children had diffuse small bowel disease at onset or during the period of review and posed major problems in management with high morbidity and mortality. They were generally treated medically to suppress disease activity and surgical intervention was restricted to resection of local stricture formation. The outcome in distal ileal +/- right colonic disease was similar to that in the adult. Patients with colonic disease (27% of total) were treated medically but 83% required surgical resection after a mean interval of only four years (range 0-9 years). Growth failure occurred in 21 children (height and weight less than 3rd centile) and 11 of these had a period of catch up growth; 10 after resection (ileal +/- right colon resected, eight; colonic resection, two) and one after medical treatment. Ten have permanent growth and height retardation, of whom four had diffuse small bowel disease and three had early recurrence after surgical resection. Nine children have died during the period of review, of whom six had diffuse small bowel disease. Despite the high morbidity, 38 of the 58 survivors are now well with no evidence of recurrent disease. A further 14 are well, but with radiological evidence of residual (colon, three; diffuse small bowel, eight) or recurrent (three) disease. Only six have symptomatic disease at present.     

山西省1990～2012年大骨节病病情消长趋势分析

目的通过对1990～2012年大骨节病监测结果进行分析,掌握山西省大骨节病病情动态及消长趋势,为实现基本消除大骨节病防治目标提供依据。方法按照全国大骨节病监测方案要求,统一标准和方法。对监测点7～12岁儿童进行临床检查及右手正位x线检查,个别年份进行全体居民或16岁以上成人临床检查。结果1990、1999年2个定点监测点大骨节病Ⅰ度以上临床患病率分别为24．93％、11．70％和10．60％、8．20％;2008年成人大骨节病共计调查了13871人,临床检出人数801人,检出率为5．77％。7～12岁儿童临床及x线检查结果显示,1994～2012年所有监测点临床未检出阳性病例;1992—2012年x线阳性率全部〈5％,骨端阳性率〈3％。结论山西省大骨节病从20世纪90年代起病情持续下降,现已处于稳定控制态势,“十二五”末能够达到基本消除大骨节病的阶段目标。     

Shorter remission period in young versus older children with diabetes mellitus type 1.

BACKGROUND: The initial period of diabetes type 1 is of great importance, since early metabolic adjustment has profound impact on long term control. The majority of pediatric centers in Germany participate in a national quality initiative, providing longitudinal data for central analysis. PATIENTS: 104543 anonymous data sets were obtained from 6123 pediatric patients under 18 years who were treated in 157 pediatric centers and monitored for 36 months at the same center starting from diagnosis. RESULTS: Partial remission (insulin <0.5 U/kg/d and HbA1c < or = 7.0%) was present in 1992 children (32.5%) within the first 3 months after diagnosis. Remission phase lasted in average for 0.74 +/- 0.77 years and was significantly shorter in children below 10 years of age at onset of diabetes compared to the older patients. The remission period was significantly longer in boys, particularly in children under 10 years (p=0.0039). Multiple regression analysis showed a longer remission phase in children with pubertal diabetes onset. The children entering remission were younger, more often boys and had a lower initial HbA1c level. CONCLUSION: These data from a large multicenter group of children with diabetes type 1 emphasize the influence of gender, pubertal stage and age at manifestation on the amount of insulin required, and therefore the clinical remission, during the first three years of the disease.     

Congenital syphilis as a cause of heart disease

Of 40,470 children under fifteen years of age admitted to the outpatient department of the St. Louis Children's Hospital, during a ten-year period from 1915 to 1924 inclusive, 939, 2.3 per cent, were found to have congenital syphilitic infection and 458 were found to have recognizable heart disease. Of the 939 children with syphilis, 441 were under two years of age. It was possible to obtain autopsies on 32 children who died at this age period and 3 showed the presence of syphilitic heart disease. No one of the other 29 who died, or 409 who lived, had symptoms at any time referable to heart disease.Four hundred and ninety-eight of the syphilitic children were over two years of age and of this number, 5, or 1.0 per cent, were known to have heart disease. Two of these 5 died but without post-mortem examination and 3 were living when last heard from. The signs of heart disease in these 5 children were similar to those seen in children with rheumatic heart disease but without syphilitic infection. This frequency of 1.0 per cent coincides with the frequency of 458 children (1.1 per cent) with heart disease among the total of 40,470 children admitted to the general clinic, or in other statistical surveys of the incidence of heart disease among normal or control children.No one of the children up to the age of fifteen years of life has died suddenly or showed signs of heart disease similar to syphilitic heart disease seen in adult or later life. The observations made on routine examination of this group of children were not done with the idea of proving the existence or nonexistence of a causal relationship between congenital syphilis and heart disease. The number included seems large enough to represent a satisfactory experience in a general Children's Clinic.     

Epidemiological trends of childhood tuberculosis in Taiwan, 1998-2005.

SETTING: Understanding tuberculosis (TB) epidemiology among children is critical to overall TB control. OBJECTIVE: To investigate the trends and epidemiological and clinical characteristics of TB in children aged 0-14 years in Taipei City, Taiwan. DESIGN: Data on all childhood TB cases in Taipei City from 1998 to 2005 were obtained from the National Tuberculosis Registry Database. RESULTS: TB incidence rates increased significantly in both adults and children aged 0-14 years during the study period. The age-specific rate in children was highest in 10-14-year-olds and lowest in the 5-9 years age group. Of the 163 childhood TB cases, 52 cases (31.9%) were extra-pulmonary, with the highest proportional rate, of 39.6%, in the 0- 4 years age group. The most common site of extra-pulmonary involvement was the lymph nodes, followed by the bones and joints and the pleura. Bone and joint involvement occurred significantly more often in children aged 0- 4 years, while pleural disease was significantly more frequent in children aged 10-14 years. Only two cases of TB meningitis were identified. CONCLUSIONS: The increase in childhood TB may be associated with the increase in the incidence of the disease in adults. Identifying and treating infectious sources, usually adults, can reduce the risk of TB exposure in children.     

Yield of endoscopy in children with hematemesis.

Upper gastrointestinal (UGI) endoscopy is an important tool in the evaluation of patients presenting with haematemesis. The objective of this study was to report the yield of this procedure in a Saudi Arabian population. We analysed the result UGI endoscopy in children and adolescents of 0-18 years of age who presented with haematemesis over a period of 10 years. From 1993 to 2003, endoscopy was performed on 60 consecutive children presenting with haematemesis. This group represented 12% of the indications during the same period. The majority (98%) were Saudi nationals, with an age range from 4 days to 18 years, and a male to female ratio of 1:1.5. The overall yield of endoscopy was 75%; however, the yield was higher (91%) in children below 12 years of age. Gastritis was the commonest cause of haematemesis (44%), followed by oesophagitis (36%). However, age-related analysis shows that oesophagitis was a more common cause of haematemesis in the younger age group (45%) than gastritis in adolescents (30%). In contrast, gastritis was more common in older children (56%) than oesophagitis (28%). Peptic ulcer disease and oesophageal varices were seen in only 3 (7%) and 2 children (4.3%), respectively. The overall yield of endoscopy in our patients is similar to that in most reports. However, oesophagitis and gastritis were the commonest causes of haematemesis, whereas oesophageal varices and peptic ulcer disease were much less common.     

Epidemiology of type 1 (insulin-dependent) diabetes in Scotland 1968–1976: Evidence of an increasing incidence

Summary A computer file of all Scottish hospital admissions in the period 1968–1976 was searched to identify the 2,505 children (aged < 19 years) with a diagnosis of diabetes. The average annual incidence of the disease (based on first hospital admission) was estimated to be 13.8 per 100,000 children aged < 19 years (boys 14.4 per 100,000; girls 13.2 per 100,000). The highest incidence, 20.0 per 100,000 was in the age group 10–14 years and the lowest 7.1 per 100,000 in those aged < 5 years. It is estimated that during the study period there was an 80% increase in the annual incidence of juvenile diabetes, from about 10 per 100,000 in 1968 to about 18 per 100,000 in 1976. First admission rates showed seasonal variations for those aged 5 years or more, with peaks in October/November and January/February. Marked variation was found in the incidence rates in the different counties of Scotland. The central lowlands which includes the cities of Edinburgh and Glasgow was an area of low incidence. There appeared to be an inverse correlation between the incidence rate in each county and population density. In Glasgow, there was an inverse association between the incidence rate in each city ward and the average number of persons per room. There was no evidence of space-clustering of the disease in different years within the parishes (rural districts) of each county and there was no convincing evidence that the variation in the incidence of diabetes between parishes in the same county was more than might have been expected to arise by chance. The observations are compatible with the disease having a viral aetiology but it is difficult to explain the striking rise in incidence over the study period on this basis.     

Long-term outcome of mothers of children with isolated heart block in Finland

OBJECTIVE: To study the long-term outcome of mothers of children with isolated heart block in a defined population. METHODS: We reviewed the Finnish hospital registries for patients born between 1950 and 1999 who had been diagnosed as having isolated heart block before the age of 15 years. We identified 101 children with isolated congenital heart block (CHB) and 55 with isolated heart block detected after the newborn period. Eighty-three (91%) of the 91 mothers of children with CHB and 48 (87%) of the 55 mothers of children with heart block detected after the newborn period were studied according to a protocol defining clinical characteristics (mean 9.9 years, range 0-49 years, and mean 22.9 years, range 4-47 years after the index delivery, respectively). Maternal survival was compared with survival in an age-matched population of normal Finnish women. RESULTS: Before the index delivery, 29 (37%) of the 78 surviving mothers of children with CHB had a self-reported clinical diagnosis of a chronic autoimmune disease, and 55 (71%) had had symptoms, signs, or abnormal laboratory findings suggesting an underlying subclinical disease. Of the 23 mothers who were completely asymptomatic before the index delivery, 10 (13% of the surviving mothers) remained so after a mean followup of 9.6 years (range 0-21 years). In mothers of children with CHB, clinical characteristics different from those of healthy mothers were photosensitivity, fatigue, dry eyes, and dry mouth. Forty-eight (58%) of these 83 mothers developed an autoimmune disease during followup. The most common diagnosis was primary Sj?gren's syndrome (22 definite, 11 probable), followed by systemic lupus erythematosus (SLE). The standardized mortality ratio of mothers of children with CHB was 5.1, and 3 of the 5 deaths were associated with SLE. Mothers of children with heart block detected after the newborn period had similar symptoms and signs of autoimmune diseases as the healthy controls, and their standardized mortality ratio was 1.9. CONCLUSION: Primary Sj?gren's syndrome, either definite or subclinical, is the predominant autoimmune disorder in mothers of children with CHB. Mothers of children with isolated heart block detected after the newborn period do not, as a group, have clinical features suggestive of autoimmune diseases.