305例低出生体重儿发生的相关因素回顾性分析

目的探讨低出生体重儿发生率及相关因素，为有关部门制定政策和预防措施提供依据。方法对我院2003年1月～2008年12月出生的305例低出生体重儿进行回顾性分析。结果低出生体重儿发生率3．07％（305／9948）。2003年-2008年6年间各年度低出生体重儿的发生率没有明显变化，其中早产发生率36．72％，是低出生体重儿发生的第一因素，而双胎、妊高征、胎盘和胎膜因素等是造成胎儿宫内发育迟缓从而引发低出生体重的重要因素。结论降低早产的发生加强孕晚期保健管理是降低低出生体重儿的发生，提高儿童生命早期质量，降低婴儿死亡率的重要环节之一。     

极低出生体重儿临床相关因素及与预后的关系

目的探讨极低出生体重儿的围产期及临床特点,分析其与预后的关系.方法分析110例极低出生体重儿(含12例超低出生体重儿)的一般情况、产科及母孕期情况、新生儿临床特点.结果胎龄小于32w者占79%,小于胎龄儿占17.3%,41%为多胎;32%有胎膜早破史,18%母亲有妊高征;36%有窒息复苏史;产科异常是胎儿早产的主要原因.呼吸暂停、低体温、高胆红素血症及低血糖是常见的并发症;多胎、围产期异常及小于胎龄儿是极低出生体重儿主要死亡原因,生于院内或转运者死亡率明显低于院外出生者(P<0.01).结论加强对高危孕妇及新生儿的监护,普及新生儿窒息复苏知识,将有助于改善极低出生体重儿的预后.     

双胎儿童智能发育的影响因素及预防

目的探讨出生体重及父母文化程度对双胎儿智能发育的影响及预防.方法出生体重及父母文化程度的资料采取复习病案结合随访调查所获得,对每个儿童进行绘人智能测验.结果出生体重＜2500g儿童的绘人能力商明显低于出生体重≥2500g组,P＜0.05.父亲文化程度的高低对子女的智力影响较小,而母亲文化程度的高低对子女的智力有一定影响.结论加强围产期保健,避免早产和降低低出生体重儿出生率,提高母亲的文化素质是预防低智能儿童的重要措施.     

293例早产及低出生体重儿原因分析

目的为了降低早产儿低出生体重儿的出生,分析发生的危险因素,提出干预措施。方法把我市2003年~2007年出生的293例早产儿低出生体重儿进行回顾性分析。结果随着产科技术和新生儿重症救护技术的提高,早产儿低出生体重儿的存活率明显提高。有统计资料表明,这些儿童一般到9个月左右身高体重能达到标准,但大运动发育、精细运动发育、语言发育等会有一定的影响。日后对外界环境适应能力差,易患各种疾病。结论加强围产期保健积极防治早产儿低出生体重儿的出生危险因素,是减少早产儿低出生体重儿发生的关键。     

低出生体重儿童智能发育及其影响因素分析

目的:了解低出生体重儿智能发育状况及其影响因素.方法:采用Gesell婴幼儿智能发育量表,对190例低出生体重儿进行测试,并与正常对照儿童进行比较,同时对可能影响智能发育的相关因素进行了逐步回归分析.结果:1岁和2岁时低出生体重儿童动作能、应物能、应人能等发育商数均低于对照组,2岁时言语能发育商数也低于对照组,差别在统计学上有显著性(P<0.05、P<0.001),逐步回归分析结果提示与儿童智能发育相关的因素是:儿童的年龄、性别、头围、是否为低出生体重儿、父母亲文化水平及喂养方式.结论:低出生体重儿童1岁及2岁时智能发育均落后于正常对照儿童.儿童智能发育水平受多种因素的影响.     

早产极低出生体重儿的病因和防治探讨

目的探讨早产极低出生体重儿发生的病因和防治。方法分析1993-2004年我院住院早产极低体重儿109 例临床资料。结果早产极低体重儿发生的主要原因为妊娠高血压综合征、双胎妊娠、胎膜早破,孕母疾病。早产极低出生体重儿的主要种并症依次为硬肿症、出生时窒息、感染性疾病、肺透明膜病、呼吸暂停、早产儿贫血、先天畸形等。109 例早产极低体重儿的死亡率为23．85％,胎龄≤30w组高,与胎龄>30w织相比有统计学差异P<0．05)。早产极低体重儿死因构成以肺透明膜病居首,窒息和畸形居次。结论加强围产期保健、及时治疗高危妊娠,防治早产、肺透明膜病和窒息,客观认真地评判Apgar评分和有效复苏是优生优育的重要环节。     

围产期低体重儿1103例临床分析

目的探讨围产期低体重儿的死亡原因及其与孕妇一般社会因素的关系。方法对我院2000年1月至2006年1月围产期低体重儿1103例临床资料进行回顾性分析。结果低体重儿的发生率与孕妇孕龄、年龄、职业、文化程度及妊娠并发症和合并症有着密切的关系。结论提高全民文化素质,加强农村围产期保健,积极治疗孕妇并发症、合并症,大力宣传优生优育、避孕知识,避免过早或过晚生育,能够降低低出生体重儿的发生。     

低出生体质量儿适宜的分娩方式及适时终止妊娠的时机研究分析

目的探讨低出生体质量(LBW)儿适宜的分娩方式及适时终止妊娠的时机。方法选取自2010年1月到2015年1月于我院分娩的6244例新生儿作为研究对象,通过孕产妇管理系统获得相关病史资料,统计低出生体重儿的发生情况、分娩方式和终止妊娠的时机。结果统计结果显示低出生质量儿的发生率为7.43%(464/6244),其中早产低出生体质量儿占全部早产儿的60.56%(344/568),足月低出生体质量儿占全部足月儿的2.11%(120/5676),两者比较有统计学差异(P﹤0.05);低出生体质量儿的刨宫产的比率要高于正常体重儿的比率(P﹤0.05)。在低出生体质量儿中的新生儿窒息率和新生儿死亡率上,阴道分娩者比刨宫产分娩者明显低;但是随着孕周的增加低出生体质量儿的新生儿窒息率和死亡率会逐渐降低。结论为了减少低出生体质量儿的发生,对于有早产迹象的胎儿和孕妇,应积极为其做个体化分析,尽可能延长其孕周至34w之后再行终止妊娠;根据孕妇和胎儿的具体情况制定合理的分娩方式可以显著提高新生儿的存活率。     

极低出生体重儿346例10年回顾

目的探讨极低出生体重儿发生原因、主要并发症的特点及影响其存活率的相关因素,为降低其死亡率提高其生存质量提供帮助。方法对本院近10年收治的346例极低出生体重儿的临床资料进行回顾性分析,按住院年份(1994~1999年和2000~2004年)分两组,对其疾病的构成及其生存和死亡进行分析比较。结果极低出生体重儿的主要原因有妊娠并发症(31.8%)、羊膜早破(24.9%)、多胎妊娠(20.8%)和原因不明(11.3%)。所有住院患儿均有一种以上并发症,主要有低体温278例(80.3%)、呼吸暂停195例(56.4%)、出生窒息188例(54.3%)、脑室内出血177例(51.2%)、呼吸窘迫综合征112例(32.4%)、感染98例(28.6%)、各种畸形36例(10.4%)。前后5年比较,呼吸窘迫综合征、出生窒息、脑室内出血、院内感染的发生率下降;宫内感染、先天畸形的发生率上升;低体温,呼吸暂停的发生率仍高。本组极低出生体重儿的存活率80.9%。前后5年比较,近5年存活率明显提高(74.6%比85.1%,P<0.05)。死亡的主要原因是呼吸窘迫综合征、脑室内出血、感染及各种畸形。结论对极低出生体重儿必须密切监护;早期发现并及时处理并发症,维持机体内环境稳定,防治院内感染。适时、合理采用肺表面活性物质、常频机械通气和高频通气,从而提高极低出生体重儿的存活率。     

4909例活产儿低体重情况分析

目的通过对4909例活产儿的出生低体重分析，找出影响出生低体重的相关因素，为降低出生低体重儿的发生提供有力数据。方法通过对4902例活产儿中385例出生低体重儿的住院病历及起母亲的住院病历进行详细分析，并进行相关调查。结果出生低体重与母亲居住地区、母亲文化程度等有关。结论提高母亲文化程度，降低母亲并发症，从而降低早产是降低出生低体重的关键。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.