应用不同版智商常模对同一批儿童智商的分析

目的 验证第二次修订的中国联合型瑞文测验智商常模的实用性和准确性。方法 应用中国联合型瑞文测验图册和ＣＲＴ－ＲＣ,ＣＲＴ－ＲＣ２及ＣＲＴ－ＣＣ,ＣＲＴ－ＣＣ２,测验及判定同一批农村,城市的７－１４岁儿童智商水平。结果 ＣＲＴ－ＲＣ的智商均值为１０４．７５±１３．８３,智商呈轻度偏态分布,ＩＱ≤７９占７．６％,ＩＱ≥１２０占１２．７％,两者差异显著;     

联合型瑞文测验湖南城区和农村儿童常模的研制

目的　研制联合型瑞文测验湖南城区儿童常模（ Ｃ Ｒ Ｔ－ Ｈ Ｎ Ｃ）和农村儿童常模（ Ｃ Ｒ Ｔ－ Ｈ Ｎ Ｒ）。方法　运用联合型瑞文测验方法。结果　测题难度达理想值（ Ｃ Ｐ＝ ０．３～０．７）,区分度较好（ｒｐｂ＞ ０．１９５, Ｐ ＜ ０．０５）鉴别指数 Ｄ ＞ ０．２０ 者占 ８７７１％ 复测信度高（ｒ＝ ０．９１１３, Ｐ ＞ ０．０５）,同时效度理想（ｒ语＝ ０．４８, ｒ数＝ ０．４１, Ｐ ＜ ０．０１）。结论　此常模可作为我省卫生、教育等部门评价儿童智力状况的测量工具。     

济南市学龄儿童智力水平调查研究

本文报告应用瑞文测验（ＣＲＴ－ＲＣ）中国农村版和城市智商常模对济南市区学龄儿童的智商进行了测试，结果表明：济南市儿童智商基本呈正常分布，略向高值偏移。儿童的智商除受碘元素影响外，也与学生的生活营养水平和父母的文化程度有关，且不同年龄、性别和不同测试时间儿童的智商水平无显著性差异（Ｐ〉０．０５），但智商与学生的学习成绩明显相关（Ｐ〈０．０１），智商与数学的相关系数大于与语文的相关系数，说明ＣＲＴ－Ｒ     

碘缺乏病病区轻度智力落后儿童精神运动测验结果评价

目的　验证津医精神运动成套测验（ＪＰＢ）检查轻度智力落后儿童精神运动障碍的灵敏度,评估碘缺乏病（ＩＤＤ）病区亚克汀病患病率。方法　对中国联合型瑞文测验智商常模（ＣＲＴ－Ｃ２）判定的４１５ 名７～１４ 岁轻度智力落后儿童进行ＪＰＢ检查,用Ｔ 分数与损伤指数确定其精神运动功能状况。结果　Ｔ 分数确定的ＪＰＢ检出ＩＤＤ 重、中病区ＩＱ ５０～６９ 儿童精神运动功能异常率为５７．８％ ,其中ＩＱ ５０～５９ 人群异常率达７０．９％ ;损伤指数确定的异常率与Ｔ 分结果差异不显著（ Ｐ＞ ０．０５）。结论　ＪＰＢ是发现和定量描述轻度智力落后儿童精神运动功能障碍的有效实用方法,可用于诊断亚克汀病。     

新疆莎车县不同缺碘区10～13岁儿童智力水平调查

为了解缺碘环境对新疆维吾尔族儿童智力水平的影响程度,１９９２年５月按照《新疆ＩＤＤ防治科研协作攻关课题方案》的要求,采用中国联合型瑞文测验农村版（ＣＲＴ～ＲＣ）,对新疆缺碘区莎车县３６４名１０～１３岁农村儿童的智力水平进行了调查,其中轻度缺碘区荒地镇小学调查２０８名,重度缺碘区托木吾斯塘乡中心小学调查１５６名。结果表明轻度区平均智商（ＩＱ）为８０．１２,智商低于６９的２６名（１２．５％）;重度区调查１５６名,平均智商７５．３１,智商低于６９的４２名（２６．９％）,不同缺碘区的儿童智商频数分布和均…     

联合型瑞文测验福建省儿童常模的研制

目的建立适合福建省儿童特点的城市、农村联合型瑞文测验的常模。方法在9个设区市的城区和农村小学中按照分层整群随机抽样的原则确定被试的学校和儿童,运用联合型瑞文测验。结果试题的难度达到理想值(城市为0.62,农村为0.58),区分度较好(rpb>0.195,P<0.05),鉴别指数D>0.2的测试题占80%,复测信度高(相关系数rtt=0.91),构想效度较高。结论实现了将联合型瑞文测验在福建省标准化的目的,建立适合福建省儿童特点的城市、农村联合型瑞文测验的常模。     

缺碘地区补碘后儿童智力发育的追踪观察

１９９０—１９９１年［１］作者对吉林省缺碘地区 ６个县市部分中心小学进行了智商值调查,参见表１。７年后为进一步了解儿童智商值的变化与食盐中碘浓度的关系,于１９９７年６月又从第一次调查中抽１个县４所乡中心小学做了追踪观察,现将结果报告如下。１对象与方法１１对象 两次检查在校学生５２２６名,年龄７～１５岁,男女为１１ １。１２智力测验 以王栋主编的瑞文氏测验联合型指导（中国农村修订版ＣＲＴ－ＲＴ）进行测验。智商 （ＩＱ）等级判定： ＩＱ≥ １３０为超优;１２９— １２０为优秀,１ １９— １１０为中上; １０…     

糖尿病酮症酸中毒并肝损害临床分析

目的探讨导致糖尿病酮症（ＤＫ）及酮症酸中毒（ＤＫＡ）患者肝损害的相关因素．方法ＤＫ或ＤＫＡ患者９９例,其中ＡＬＴ及ＡＳＴ均异常升高１１例（Ａ组）,单项ＡＬＴ异常升高１３例（Ｂ组）,肝功能正常７５例（Ｃ组）,对以上各组患者的血二氧化碳结合力（ＣＯ２ＣＰ）、尿素氮（ＢＵＮ）、血糖（ＢＧ）和血浆渗透压（ＯＳＭ）进行了统计分析．结果Ａ,Ｂ两组患者的ＣＯ２ＣＰ明显低于Ｃ组（Ｐ＜００１,ｔ＝６３３和ｔ＝６４３）,而ＢＵＮ则明显升高（Ｐ＜００１,ｔ＝３６１,ＡｖｓＣ;Ｐ＜００１,ｔ＝４３５,ＢｖｓＣ）,Ａ组的ＢＧ（Ｐ＜００５,ｔ＝２８４）和血浆ＯＳＭ（Ｐ＜００５,ｔ＝３１０）水平也显著高于Ｃ组,而Ｂ组患者的ＢＧ及血浆ＯＳＭ与Ｃ组比较无差异;与Ｂ组相比,Ａ组患者的ＣＯ２ＣＰ明显降低（Ｐ＜００２,ｔ＝２７１）,ＢＧ（Ｐ＜００５,ｔ＝２８９）和血浆ＯＳＭ（Ｐ＜００５,ｔ＝２３６）明显升高．此外,Ⅰ型糖尿病患者血清转氨酶异常升高的发生率明显高于Ⅱ型糖尿病患者（Ｐ＜００５,χ２＝４３８）．结论酸中毒和脱水是导致糖尿病酮症及酮症酸中毒患者肝损害的重要因素,酸中毒及脱水程度与肝损害程度相关．     

幽门螺杆菌感染对胃病细胞动力学的影响

目的　观察 Ｈｐ 感染在正常粘膜演变为胃癌过程中对细胞增殖动力学的影响,以探讨 Ｈｐ 的致癌机制．方法　研究对象为正常胃粘膜的消化不良患者（ ＮＳ,ｎ ＝ １４） 及慢性浅表性胃炎（ ＣＳＧ, ｎ ＝ ５６） 、慢性萎缩性胃炎（ ＣＡＧ,ｎ ＝ ２０） 、慢性萎缩性胃炎伴肠上皮化生（ＣＡＧＩＭ ,ｎ ＝ １６） 、不典型增生（Ｄｙｓ ,ｎ ＝ １８） 、胃癌（ ＧＣ,ｎ ＝ １７） Ｈｐ 阳性与阴性患者．应用Ｋｉ６７ 免疫组化技术评价胃幽门窦上皮细胞增生,并用标记指数百分率（ＬＩ％ ） 来表示．结果　Ｈｐ 阳性患者（ ｎ ＝ ７５） 的Ｋｉ６７ ＬＩ％ 为１７ ±５ , Ｈｐ 阴性患者（ ｎ ＝ ５２ ） 的 Ｋｉ６７ ＬＩ％ 为 １３ ±６ , 差异有 显著 性（ Ｐ＜ ０－０５） ;伴有 Ｈｐ 感染的ＣＳＧ 与ＮＳ 或 Ｈｐ 阴性的ＣＳＧ 患者相比ＬＩ％ 增加（ Ｐ＜ ０－０１） ;ＣＡＧ,ＣＡＧＩＭ ,Ｄｙｓ ,ＧＣ 的 Ｈｐ 阳性与阴性患者的ＬＩ％ 相比无显著差异;五种胃病无论 Ｈｐ 阳性或阴性患者与正常者相比,ＬＩ％ 明显增加（ Ｐ＜ ０－０１） ． ＬＩ％ 与胃粘膜炎症程度无关．结论　Ｈｐ 感染促进胃上皮细胞过度增殖主要发生在胃粘膜病变的早期,并不影响在癌前病变或胃癌患者中所     

一氧化碳与肝硬化大鼠血脑屏障通透性的关系

目的 研究肝硬化大鼠血浆一氧化碳（ＣＯ）水平与血脑屏障通透性改变之间的关系。方法 将ＳＤ大鼠分为两组，ＣＣｌ４肝硬化模型组（ｎ＝１０）及正常对照组（ｎ＝１０），用联二亚硫酸盐还原法测定血浆ＣＯ的含量，用伊文思蓝法测定血脑屏障通透性，生理多导仪测定血压、心率等。结果 与对照组相比，肝硬化组血浆ＣＯ水平明显升高［（１８．３７±１．７９）μｍｏｌ／Ｌ ｖｓ （１０．２７±１．２１）μｍｏｌ／Ｌ，ｔ＝７．５，Ｐ＜０．０１］而平均动脉压（ｋＰａ）降低（１８．９３±０．７１　ｖｓ　１５．９２±０．７４），ｔ＝５．８３，Ｐ＜０．０１；血脑屏障通透性增加，脑内伊文思蓝含量肝硬化组明显高于对照组（１８．５２±１．３９ ｖｓ１５．０８±１．０６）ｎｇ／ｍｇ，ｔ＝３．９４，Ｐ＜０．０１。在肝硬化组血浆 ＣＯ水平与脑内伊文思蓝含量成正相关（ｒ＝０．７２，Ｐ ＜ ０．０１）而与平均动脉压成负相关（ｒ＝－０．６７，Ｐ＜０．０５）。结论 ＣＯ作为一种信使分子，不仅参与肝硬化大鼠低血压的发生，还与血脑屏障通透性增加有关，可能是肝硬化易诱发肝性脑病的重要介质之一。     

Coronary and peripheral blood flow changes following biventricular pacing and their relation to heart failure improvement.

AIMS: To study the effect of cardiac resynchronization therapy (CRT) on coronary and peripheral arterial circulation and to assess whether their changes are related to the improvement in patients' functional capacity and prognostically important biochemical markers. METHODS AND RESULTS: Twenty-five patients were studied (New York Heart Association classes III and IV, left ventricular ejection fraction <35%, QRS>120 ms, mean age 66 +/- 2.1 years). Coronary blood flow (CBF), forearm blood flow (FBF), and their reserve were measured by transoesophageal echocardiography (in cm/s) and venous occlusion plethysmography (in mL/100 mL/min) at baseline and following 3 months of CRT. N-terminal-pro-brain natriuretic peptide (Nt-pro-BNP) and serum adhesion molecules, sICAM-1 and sVCAM-1 levels were also assessed. CRT induced a non-significant increase in resting CBF (baseline vs. CRT: 52.1 +/- 5.5 vs. 58.2 +/- 3.6, P: NS), whereas hyperaemic CBF was increased by CRT (baseline vs. CRT: 67.8 +/- 6.8 vs. 79.8 +/- 6.2, P < 0.05). Significant increases were observed in resting FBF (baseline vs. CRT: 1.6 +/- 0.2 vs. 2.6 +/- 0.2, P < 0.05) and hyperaemic FBF (baseline vs. CRT: 2.1 +/- 0.2 vs. 3.2 +/- 0.3, P < 0.05). The per cent difference in hyperaemic FBF was related to the per cent change in Nt-pro-BNP (r = -0.71, P < 0.05) and the per cent improvement in exercise duration (r = 0.80, P < 0.05). CONCLUSION: CRT induces favourable changes in coronary and peripheral arterial function. Changes in peripheral blood flow are related to patients' improvement and may be prognostically significant.     

农村非IDD病区智力正常儿童精神运动成套测验的检测结果分析

目的:掌握非IDD病区智力正常儿童精神运动成套测验的正常值,为制定全国儿童精神运动测验量表提供依据。方法:按“九五”国家医学科技攻关项目的设计,在沿海和内陆平原农村非IDD病区对IQ80～119的无甲肿7～14岁儿童进行10项精神运动测验。结果:选择反应时测验的反应时间(ms)间隔均值是由小年龄组向大年龄组逐渐递降,相临两个年龄组差异显著(P<0.01或P<0.05);连续作业、划消数字、目标追踪、符号记入、数字符号、转动插棒6项测验的个数(次)均值,均由小年龄组向大年龄组逐渐递增,相临两个年龄组差异显著(P<0.01或P<0.05);连续数字测验的从①连到(25)所用时间(秒)均值,三对相临年龄组差异不显著(P>0.2或P>0.05);视觉保持测验的辨别、记忆图形准确个数均值,多数相临两个年龄组差异不显著(P>0.5);动作稳定测验的数值均值,其相临两个年龄组差异均不显著(P>0.5)。结论:选择反应时、连续作业、划消数字、目标追踪、符号记入、数字符号、转动插棒7项测验的检测结果可信,能编制精神运动测验量表,进行实证研究及用于诊断轻度精神运动障碍。     

血浆氮末端-前体脑钠肽水平预测心脏再同步化治疗的近期临床疗效

目的:探讨血浆氮末端-前体脑钠肽(NT-proBNP)水平对心脏再同步化治疗(CRT)近期临床疗效的预测价值。方法:入选成功施行CRT的心力衰竭(心衰)患者42例,ELISA法测定血浆NT-proBNP水平。随访6个月,记录心功能分级、左室射血分数(LVEF)、左室舒张末期内径(LVEDd)、QRS间期及心血管事件(心衰再入院、恶性心律失常、心脏性猝死)。结果:入选患者中,CRT有反应者34例,无反应者8例,有效率达81%。CRT术前反应组血浆NT-proBNP水平低于无反应组(P<0.05)。CRT术后6个月反应组LVEF、LVEDd、QRS间期与无反应组比较,均差异有统计学意义(均P<0.01)。Logistic回归分析显示术前NT-proBNP能独立预测CRT临床疗效。术前NT-proBNP对CRT近期临床疗效判定的ROC曲线下面积为0.770,灵敏度为87.5%,特异度为55.9%。结论:血浆NT-proBNP水平可作为评价CRT近期临床疗效的指标。     

Insulin resistance and the metabolic syndrome in obese French children

OBJECTIVE: To estimate the frequency of the metabolic syndrome (MS) and of the insulin resistance syndrome (IRS) in overweight or obese French children and to determine the risk factors. DESIGN, PATIENTS AND METHODS: A total of 308 overweight and obese children [166 girls, 142 boys, aged 7-17 years; median body mass index (BMI) 4.7 standard deviation (SD) (Q1-Q3: 3.9-5.8) adjusted for age and sex] were included. The frequency of the MS was assessed with the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria and the frequency of the IRS with World Health Organization (WHO) criteria. RESULTS: The overall frequency of MS and IRS was 15.9% and 42.5%, respectively. The most common component, after abdominal obesity (95.8%) and IR (71.8%), was elevated systolic blood pressure (28.6%). The frequency of glucose tolerance disorders was low (3.6%). The frequency of MS was independently influenced by homeostatic model assessment (HOMA) (P = 0.06) and waist-to-hip ratio (P = 0.09), whereas the frequency of IRS was influenced by adiposity (degree of obesity: P = 0.02; waist-to-hip ratio: P = 0.05), puberty (P = 0.05) and mother's BMI (P = 0.01). Ethnicity had no effect on either MS or IRS. CONCLUSIONS: Metabolic complications and IR are frequent in overweight and obese children whereas the frequency of glucose tolerance disorders is very low. IRS is more prevalent than MS, indicating a major role of IR, which could precede the other metabolic complications in obese children. IRS is a relevant marker for the risk of type 2 diabetes (T2D) and cardiovascular complications in obese European children.     

Carbon monoxide pollution and lung function in urban compared with rural Mongolian children

BACKGROUND AND OBJECTIVE: Mongolia is experiencing rapid urbanization, and this presents a unique opportunity to assess the effects of this process on the lung health of children. METHODS: Two cross-sectional cohorts of school-age children (5-15years of age) from the capital (Ulaanbaatar) (n=116) and a rural district (Tuv Aimag) (n=108) were studied. Demographical information, exposure to tobacco smoke, and ambient and exhaled CO, as well as FEV(1) and FEF(25-75%) were recorded for each child. Results: Ambient CO levels were threefold higher in the capital city than in the rural Aimag (0.63 vs 0.21 parts per million (ppm), P<0.00005), while exhaled CO was twofold higher (0.94 vs 0.47ppm, P<0.00001). Rural Mongolian children were 6cm shorter on average than urban children. However, when adjusted for age and height, FEV(1) was 140% of predicted in rural children compared with 106% of predicted in urban children (P<0.00001). There was no significant difference in small airway expiratory flow (FEF(25-75%) ; 104 in urban children, 100 in rural children, P=0.63). Conclusions: 'Normal' FEV(1) was actually 40% higher in rural Mongolian children than in urban children, suggesting that the FEV(1) of apparently healthy children living in urbanized societies may in fact not be normal, but may instead reflect the deleterious effects of air pollution in cities, as indicated by increased levels of both environmental and exhaled CO.     

Long-term efficacy of perioperative chemoradiotherapy on esophageal squamous cell carcinoma

AIM: To investigate the role of perioperative chemoradiotherapy (CRT) in the treatment of locally advanced thoracic esophageal squamous cell carcinoma (ESCC). METHODS: Using preoperative computed tomography (CT)-based staging criteria, 238 patients with ESCC (stage ⅡⅢ ) were enrolled in this prospective study between January 1997 and June 2004. With informed consent, patients were randomized into 3 groups: preoperative CRT (80 cases), postoperative CRT (78 cases) and surgery alone (S) (80 cases). The 1-, 3-...     

Repercussion of functional mitral regurgitation on reverse remodelling in cardiac resynchronization therapy.

AIMS: Cardiac resynchronization therapy (CRT) reduces the degree of functional mitral regurgitation (FMR). However, FMR has also been associated with a lack of clinical response to CRT. We undertook this study to determine whether the presence of FMR influences the reverse remodelling induced by CRT. METHODS AND RESULTS: We used Doppler echocardiography to assess 20 patients with dilated cardiomyopathy before and 6 months after undergoing CRT. We evaluated the effect of reverse remodelling (reduction > or = 10% in end-systolic volume) according to the presence or absence of important FMR, defined as a regurgitant orifice area (ROA) of > or = 0.20 cm(2). Of the 20 patients (mean age, 64.7 +/- 8.2 years, eight women), 9 had marked FMR (ROA 0.40 +/- 0.12 cm(2)), 6 mild FMR (ROA 0.15 +/- 0.02 cm(2)), and 5 had trivial or no FMR. CRT reduced the presence of mitral regurgitation by 33.3% and induced reverse remodelling in 60% of the patients. A ROA > or = 0.20 cm(2) was associated with a lack of reverse remodelling, despite presenting similar baseline characteristics and a reduction in asynchrony to the other patients. Reverse remodelling was produced in all the other patients, with a significant reduction in end-systolic volume (41.7 +/- 21%; P = 0.003), accompanied by improvement in the ejection fraction (P = 0.003) and myocardial performance index (P = 0.027). CONCLUSION: CRT improved FMR, although the baseline presence of important mitral regurgitation, with a ROA > or = 0.20 cm(2), in patients undergoing CRT was associated with a lack of response in reverse remodelling.     

安徽芜湖市城乡托幼机构儿童蛲虫感染调查

目的调查比较芜湖市城乡儿童蛲虫感染状况,探讨农村儿童蛲虫感染的变化及其对策。方法采用透明胶纸肛周粘贴法随机对芜湖市城区和乡村幼儿园3～6岁儿童463名开展蛲虫感染情况的检查,并对相应幼儿园的从业人员和儿童监护人进行问卷调查。结果芜湖市儿童蛲虫平均感染率为12.74%,其中农村儿童的蛲虫感染率为17.07%;城市儿童的蛲虫感染率为5.68%,农村高于城市,差异有显著性（p〈0.05）;儿童蛲虫感染率没有随年龄增减而定向升降的趋向;不同性别之间感染率差异无显著性（p〉0.05）。结论农村儿童蛲虫感染率的增高,与其接受集体生活和教育机会的增加密切相关,应采取对策,加强控制农村儿童的蛲虫感染。     

Predictive factors of survival in patients treated with definitive chemoradiotherapy for squamous cell esophageal carcinoma

AIM: The aim of the study was to evaluate the predictive factors of survival in patients with locally advanced squamous cell esophageal carcinoma (LASCOC) treated with definitive chemoradiotherapy (CRT) regimen based on the 5FU/CDDP combination. METHODS: All patients with LASCOC treated with a definitive CRT using the 5FU/CDDP combination between 1994 and 2000 were retrospectively included. Clinical complete response (CCR) to CRT was assessed by esophageal endoscopy and CT-scan 2 mo after CRT completion. Prognostic factors of survival were assessed using univariate and multivariate analysis by the Cox regression model. RESULTS: A total of 116 patients were included in the study. A CCR to CRT was observed in 86/116 (74.1%). The median survival was 20 mo (range 2-114) and the 5-year survival was 9.4%. Median survival of responder patients to CRT was 25 mo (range 3-114) as compared to 9 mo (range 2-81) in non-responder patients (P < 0.001). In univariate analysis, survival was associated with CCR (P < 0.001), WHO performance status < 2 (P = 0.01), tumour length < 6 cm (P = 0.045) and weight loss < 10% was in limit of significance (P = 0.053). In multivariate analysis, survival was dependant to CCR (P < 0.0001), weight loss < 10% (P = 0.034) and WHO performance <2(P = 0.046). CONCLUSION: Our results suggest that survival in patients with LASCOC treated with definitive CRT was correlated to CCR, weight loss and WHO performance status.