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）。     

Preschool detection of asymptomatic bacteriuria: a public health program.

A total of 95% of parents registering their children for kindergarten agreed to screening for urinary tract infection (UTI) in their children. Urine specimens from 1591 children (87%), obtained at the school or at home, were tested. Only minor problems were encountered when parents prepared the specimens at home and mailed them to the laboratory for reading; the proportion of false-positive results was higher in these samples. If screening for UTI becomes established, it appears worth while to conduct this at the time of registration for kindergarten, either in the school by lay persons or in the home by parents.     

Prevalence of asymptomatic bacteriuria in school going children in Pokhara valley

Objectives: There were mainly two objectives of the study. One was to detect bacteriuria in school going children in Pokhara valley and the other was to identify the causative organisms in various age groups in children. Materials and methods: This study was carried out in the Microbiology laboratory of The School of Pharmaceutical and Biomedical Sciences, Simalchaur, Pokhara University, Nepal. A total of 502 urine samples of 5 to 13 years children from different schools of Pokhara valley were screened to see asymptomatic bacteriuria during January 2005 to June 2005. A sterile wide mouth container was given to each student to collect mid-stream urine samples. All the urine samples were transported to the Microbiology laboratory within half an hour to one hour. The samples were processed for microscopical examination to observe for turbidity and the presence of protein and sugar by dipstick method, microscopical examination to see pus cells, RBCs, epithelial cells, casts and crystals, culture of urine samples on Blood agar and MacConkey agar to identify the potential pathogens. The antibiotic sensitivity test was performed for those bacteria which were grown on culture. The colony count was evaluated and organisms were identified by biochemical tests. Result: Out of 502 samples, 7(1.39%) samples grew the bacterial pathogens that are responsible to cause urinary tract infection. Among them Escherichia coli 4(57.14%) was the predominant bacterial pathogen. Conclusion: Study of asymptomatic bacteriuria is important as found in the present study in which Escherichia coli was the most frequently incriminated as the causative agents. Key words: Asymptomatic bacteriuria, Escherichia coli, children.     

上海市闵行区学龄女生青春期发育与甲状腺功能的相关性

目的 调查上海市闵行区学龄女生青春发育、碘营养及甲状腺功能状况,探讨青春发育对甲状腺功能的影响.方法 2019年1—3月采用整群抽样的方法,在上海市闵行区东、南、北和中片共选取6所初中,将新入学的532名预初女生纳入研究.对研究对象进行体格检查,收集尿样及血样以检测尿碘及甲状腺激素水平;采用青春发育事件自我评定量表(P...     

连接酶链反应检测男性就诊者尿标本中的沙眼衣原体

OBJECTIVE: To determine the sensitivity and specificity of ligase chain reaction (LCR) for detection of Chlamydia trachomatis (C. trachomatis) in the urine of symptomatic and asymptomatic men. METHODS: C. trachomatis was detected by LCR in both first-void urine (FVU) and urethral swab cultures from 852 randomly selected male outpatients seeking medical attention for sexually transmitted diseases. In cases with discrepancy between the results yielded by the two methods, a second LCR directed against a gene fragment encoding the major outer membrane protein was performed. The results were evaluated on the basis of an expanded gold standard. RESULTS: The sensitivity and specificity was 98.6% and 99.4% with LCR, respectively, and was 77.4% and 99.5% with urethral swab culture. The sensitivity of LCR was much higher than that of urethral swab culture P<0.001 .The presence or absence of urethral symptoms did not show any influence on the results. CONCLUSION: LCR is sensitive and specific for detecting C. trachomatis infections, and FVU can be used for non-invading diagnosis and screening of the infection in men.     

晨尿联合盆腔超声及血清基础促性腺激素水平在女童中枢性性早熟初步诊断中的应用

目的：探讨晨尿联合盆腔超声及血清基础促性腺激素（gonadotropin,Gn）水平检测在女童中枢性性早熟（central precocious puberty,CPP）初步诊断中的意义。方法：以就诊于南京医科大学附属淮安第一医院的83例性早熟女童为研究对象,收集年龄、骨龄、盆腔超声、血清基础Gn等资料,对可疑CPP女童行促性腺激素释放激素（gonadotropin-releasing hormone,GnRH）激发试验,根据结果分为CPP组和非CPP组。同期留取所有病例晨尿3 mL,测定Gn水平。采用SPSS 25.0软件对数据进行统计分析,并绘制受试者工作特征（receiver operating characteristic,ROC）曲线。结果：(1)CPP组晨尿黄体生成素（luteinzing hormone,LH）、卵泡刺激素（follicle-stimulating hormone,FSH）显著高于非CPP组,差异有统计学意义（P <0.05）。(2)晨尿LH与血清LH峰值、子宫容积、卵巢容积呈正相关（P均<0.001）;晨尿LH/FSH比值与血清LH/FSH峰...     

集尿袋与导尿管中尿液细菌学及药敏检查分析

①目的了解集尿袋与导尿管中尿液的细菌污染状况.②方法对30例导尿病人在导尿期间,每隔2～3d,同时采集集尿袋与导尿管中的尿液进行细菌培养和药敏试验.③结果细菌培养结果表明,集尿袋第4天、导尿管第7天出现阳性结果,集尿袋阳性12例,导尿管阳性2例,集尿袋较导尿管易受细菌污染(X2=8.1,P＜0.01).尿中细菌计数均＜108/L,培养出的细菌大多为条件致病菌,对大多数抗生素不敏感.④结论保持集尿袋的无菌是预防医院内泌尿系逆行感染的重要措施.     

重庆地区学龄前和学龄后健康儿童常用肝肾功能检验项目参考区间的调查

目的：建立重庆地区学龄前和学龄后健康儿童常用肝肾功能检验项目的参考区间,更好地为临床诊断和治疗服务。方法：通过随机分层抽样筛选出545名健康学龄前（1～6周岁）和学龄后（7～12周岁）儿童（男320名,女225名）取静脉血,用日立7600全自动生化仪检测13项常用肝肾功能检验项目。正态分布资料按x±1.96 s计算参考区间;偏态分布资料按P2.5～P97.5计算参考区间。结果：（1）学龄前健康儿童与学龄后健康儿童除血清尿素氮（blood urea nitrogen,BUN）总体均数比较无显著性差异外,血清总胆红素（total bilirubin,TB）、直接胆红素（direct bilirubin,DB）、总蛋白（total protein,TP）、清蛋白（albumin,ALB）、丙氨酸转移酶（alanine aminotransferase,ALT）、天冬氨酸氨基转移酶（aspertate aminotransferase,AST）、碱性磷酸酶（alkaline phos－phatase,ALP）、r-谷氨酰转肽酶（gamma-glutamyl transpeptidas,GGT）、乳酸脱氢酶（lactate dehydrogenase,LDH）、肌酐（creatinine,CREA）、尿酸（uric acid,UA）和血糖（blood glucose,GLU）的总体均数均存在统计学差异。（2）不同性别学龄前儿童血清TB、DB、TP、ALB、ALT、AST、ALP、GGT、LDH、BUN、CREA、UA的总体均数比较无统计学差异,95%的参考区间分别为5.4~18.9 μmol/L、0~6.7 μmol/L、58~71 g/L、42~50 g/L、8.7~26 U/L、21~41 U/L、112~312 U/L、7.1~15.8 U/L、190~312 U/L、2.3~6.4 μmol/L、14~42 μmol/L、156~366 μmol/L;血清GLU有统计学差异：男童为3.7~6.0 mmol/L,女童为3.4~5.8 mmol/L。（3）不同性别学龄后健康儿童血清GLU、TB、DB、TP、ALB、AST、ALP、LDH、CREA、UA的总体均数比较无统计学差异,95%的参考区间分别为4.2~6.0 mmol/L,6.6~23.6 μmol/L,0~6.8 μmol/L,60~76 g/L,43~52 g/L,18~36 U/L,116~366 U/L,162~293 U/L,22~51 μmol/L,174~401 μmol/L;血清ALT、GGT和BUN有统计学差异：血清ALT95%的参考区间男童为8.9~28 U/L,女童为7.2~29.5 U/L,血清GGT95%的参考区间男童为8.8~21 U/L,女童为6.1~22.5 U/L,血清BUN95%的参考区间男童为2.8~7.0 μmol/L,女童为2.2~6.2 μmol/L。结论：建立了本地区学龄前和学龄后健康儿童13个常用肝肾功能检验项目的参考区间,为本地区儿童相关疾病的诊疗提供更准确的实验依据。     

611例尿细菌培养及药敏试验分析

为了解本地区泌尿系感染病原菌菌谱的变化及病原菌的耐药情况,指导临床合理使用抗生素,对我院1997～1999年611例尿培养结果进行了分析,结果报告如下.     

Routine screening of blood and urine for severe reactions to anticonvulsant drugs in asymptomatic patients is of doubtful value.

Severe or fatal reactions to anticonvulsant agents are fortunately rare. We examined the value of routine screening of blood and urine to detect early signs of such reactions in asymptomatic patients. The basic assumptions of this type of screening program have been faulty or unproven, and the results of studies, although not definitive, have not supported the value of such programs. Our recommendations, approved by the Canadian Association for Child Neurology, suggest that asymptomatic patients not undergo routine screening of blood and urine but, rather, be informed of the early symptoms of severe toxic reactions and be asked to report them immediately to a physician.     

尿培养病原菌分布及耐药性分析

目的：分析泌尿系统感染尿标本培养的病原菌分布及耐药性。方法：对我院2007年1月~2010年12月泌尿系感染患者的中段尿进行分离培养,病原菌的鉴定及药敏试验采用珠海迪尔公司的黑马全自动分析仪进行操作,取纯菌落稀释后加入试验板中培养18~24 h后由全自动分析仪鉴定及报告药敏结果。结果：4年共分离菌株1 161例,其中,大肠埃希菌占31.2%,真菌占14.2%,肠球菌属占10.4%,肺炎克雷伯菌占9.4%,金黄色葡萄球菌占7.8%,绿脓假单胞菌占5.9%,其他菌属占21.2%。菌株耐药率呈现较高的状况。结论：泌尿系感染病原菌种类较多,耐药率较高,应引起临床高度重视。     

导尿管长期留置患者尿培养病原菌分布及耐药性探讨

目的 探讨导尿管长期留置患者尿培养病原菌分布及耐药性。方法 回顾性分析我院2019年1～6月收集的导尿管长期留置患者共101例尿液培养资料,共含菌株181株,分析病原菌分布特点,同时检测耐药性。结果①101例送检尿培养标本病原菌阳性率为98.02%(99/101),其中单一病原菌感染46例,包括细菌31例,真菌15例;混合病原菌感染53例,其中混合细菌感染30例,混合真菌感染3例,细菌伴真菌感染20例。②全部标本共分离病原菌株181株,其中革兰阴性杆菌105株,以大肠埃希菌为主,占比达33.333%(35/105);革兰阳性球菌36株,以屎肠球菌为主,占比达38.889%(14/36);真菌40株,以白色念球菌为主,占比达42.500%(17/40)。③101例送检尿培养标本分离病原菌中,革兰氏阴性菌、革兰氏阳性菌及真菌分别以大肠埃希菌、屎肠球菌为主、念珠菌为主;导尿管留置时间2年标本常用抗菌药物耐药率显著高于1年,1～2年标本(P0.05);导尿管留置时间1～2年标本常用抗菌药物耐药率显著高于1年(P0.05)。结论 导尿管长期留置患者尿培养病原菌种类繁多,多重细菌和多重耐药比例较高;故临床应重视对导尿管长期留置患者尿路感染防治工作。