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??Pediatric professionals are facing two challenges when following up the preterm and young infants. One of the challenges is to identify those infants at high risk of neurodevelopmental disorders as early as possible and provide intervention for them. Another one is to identify the infants with normal developmental outcomes to avoid excessive diagnosis and intervention. In resent years??the general movements assessment has been widely used at home and abroad to predict the developmental outcomes of high risk infants with its high sensitivity and specificity??especially for cerebral palsy. It is suitable for application in the basic maternal and child health care institutions and the pediatric clinics at various levels in China. This paper describes the results of clinical studies of general movements assessment at home and abroad as well as its clinical experience in China.     

Indicators of Well-Being Among Children in the United States Child Welfare System

The second National Survey of Child and Adolescent Well-Being (NSCAW II) is a longitudinal study intended to answer a range of fundamental questions about the functioning, service needs, and service use of children who come in contact with the child welfare system. The study includes 5,873 children ranging in age from birth to 17.5?years old at the time of sampling. The current analysis summarizes the well-being of these children at NSCAW II baseline. Overall, children reported for maltreatment in 2008?C2009 were at higher risk for poor health and negative developmental, behavioral/emotional, and cognitive outcomes than children in the general population. Overall, 32.2?% of children from birth to 5?years old had a score indicating developmental problems. Among school-aged children and adolescents, 10.3?% showed some risk of cognitive problems or low academic achievement and 41.6?% exhibited risk of emotional or behavioral problems. Child well-being outcomes differed by age and gender but not by substantiation status or type of maltreatment. Proactively providing needed services at an early age to all children in need in the CWS is urged, because early services may well preempt these children??s need for extensive future developmental, mental health, and educational services.     

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??Now in the child health care??developmental screening and developmental surveillance has been put in the clinics as a routine. In this article??we explain the conceptional terms which are related to the developmental screening and developmental surveillance. We also emphasize how to scientifically apply them and how to interpret the result of the developmental screening and developmental surveillance??and the important influence of the nurture environment on the child development. To the children of normal development??it is suggested to use the internet technics to collect the big data of children health. To the children of abnormal development??there is different management based on the severity degree and the pediatric resources.     

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??Objective To summarize and analyze the clinical characteristics?? diagnostic and therapeutic measures for the first child case of severe H5N6 avian influenza pneumonia in China. Methods The clinical data of the first case of severe H5N6 avian influenza infection in China admitted in April 13?? 2016 in Department of Emergency Center?? Hunan Children’s Hospital were analyzed and summarized. Results The case was an 11 years old girl?? acute onset?? was similar with early symptoms of common respiratory infection including high fever?? fatigue?? vomiting?? but catarrhal symptoms was not obvious. Since fever of unknown origin?? obvious weakness?? vomiting and other suspected influenza symptoms??clinicians speculated “flu” or “bird flu” possibility considering her history of exposure to her mother died of unknown illness. The girl was admitted to the Department of Infectious Isolation Ward and received oral oseltamivir treatment. On the 8th day of the course?? the condition was aggravated?? which showed large areas of dense shadow on chest X-ray film.The girl was diagnosed as acute respiratory distress syndrome??ARDS???? and was transferred to the Intensive Care Unit for isolation and treatment. Based on the reports of Hunan CDC and National CDC?? the girl was confirmed to be a case of avian influenza A H5N6 virus infection case. The treatment started with oseltamivir and then peramivir antivirus treatmnet?? nCPAP ventilation?? synchronous glucocorticoid treatment?? and the gradual weaning of noninvasive ventilator. The girl recovered and was tolerance without oxygen therapy?? then discharged from hospital. Conclusion It is very important for clinicians to pay more attention to epidemiological history. Timely detection?? early diagnosis are crucial to the treatment of avian influenza virus pneumonia and the effective treatment can get better prognosis.     

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??Early interventions are comprehensive services which provide preventive and treatment measures to 0??3 year-old children with developmental disorder??DD?? and DD risk or significant developmental delays??to help them improve their abilities of cognition??emotion?? behavior and social adaptation and support the adaptive capacity of the families. The basic principles of early intervention include early stage??emphasizing the importance of relationships within the family??individualized intervention??focusing on social adaptation??training a variety of comprehensive developmental abilities??cooperation of multi-discipline and multi-system. Early intervention management should adopt systematic management mode??involving pediatricians??family??special education institutions and social public welfare organizations??Council for special children. Early intervention services cover 6 aspects such as medical diagnosis??developmental assessment and nursing services??direct early intervention services of medical institutions??personalized family services??parental education??counseling and technical support. Early intervention methods for DD children include portage guide to early education??parenting skills training??PST?? and other methods.     

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目的 了解2004年北京市0～6岁残疾抽样调查诊断的270例智力低下患儿的智力发育特点及转归.方法 2007年6～11月北京市残疾人康复服务指导中心和北京妇幼保健院采用Gesell发育诊断法、韦氏儿童智力量表、婴儿初中生活能力量表、线索调查通过现场或入户调查,获得237例儿童的资料.采用SPSS 10.0统计软件分析数据.结果 124例(52.32%)诊断正常;113例(47.68%)诊断智力低下,其中轻度46例(40.71%)、中度32例(28.32%)、重度16例(14.16%)、极重度19例(16.81%).轻度以转归正常为多,中度转为轻度及正常者多于加重者,重度以程度加重为主.儿童好转影响因素有:2004年测查个人社会能区发育商(DQ)高、适应性能区D9高、接受过教育、具有早产因素的儿童、父母认为儿童将来生存状况较好、认为孩子发育属于正常.结论 "发育迟缓"诊断较"智力低下"更符合发育量表诊断的儿童;对北京市0～6岁轻、中度智力低下儿童发育转归研究宜采用定期监测方式.     

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??With the development of medical technology??survival rates have greatly improved in recent years in premature and critically ill newborns. However??these infants are at risk of long-term adverse neurobehavioral outcomes??including cognitive??motor and psychological problems and behavioral impairments. Neurodevelopmental disabilities and recurrent health problems take a toll in early childhood. Subsequently hidden disabilities??such as school difficulties and behavioural problems??become apparent and persist into adolescence. At present??the focus for early screening and interventions are to develop strategies to reduce long-term morbidity??especially to prevent brain injury and abnormal brain development. Due to the late start and weak foundation??the related researches in China is still in the early stages of development. To find abnormality is the first step to intervene??so it is particularly important to screen early. Thus??this review discusses key components of early evaluation??including commencing the evaluation as early as possible??preferably in the neonatal intensive care unit??and promoting developmental skills overtime in an appropriate enriched environment.     

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??Milestones are useful in the early identification and evaluation of motor delay. Considering the wide age range for the motor developmental milestones??it is not always easy to distinguish the abnormal from the normal. Generally speaking??Median Age may be helpful in primary judgement of normal development??while the Limited Age??which is 2SDs from the mean??could be a warning sign of developmental delay. Some mild developmental delay can be transient. Standardized developmental screening scales and diagnostic scales can help assess the development in different domains. We can use motor developmental scales to evaluate children with simple motor delay. As the reliability and validity of developmental scales are usually not good enough??no one scale can replace the physician’s clinical judgement. A protocol of motor surveillance??screening and diagnosis should be followed in the practice of children health care. Muscle tone examination is very important in those children with motor delay. The increased muscle tone always suggest the disorder of central nervous system??and a cranial MRI is often recommended??while the decreased muscle tone could be either central or peripheral. Elevated CK levels may indicate myopathy. Global developmental delay often suggest an impairment of cerebral disorder. As the underlying etiologies of motor delay are miscellaneous??it usually needs to be referred to a pediatric neurologist.     

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??Objective??To explore the clinical characteristics of hydrocephalus in children with purulent meningitis. Methods??The children??aged??14 years??treated for purulent meningitis at the Shengjing Hospital of China Medical University during the period from January 2010 to December 2016??were retrospectively enrolled in the study. The clinical data of every child who fulfilled the criteria were obtained and analyzed. Data were analyzed using the Statistical Package for Social Sciences??SPSS??13.0. Results??The morbidity of hydrocephalus in children with purulent meningitis was 9.36%??25/267??. In these cases with hydrocephalus??the ageofonset was mainly under 6 months old??and the period from onset to diagnosis of hydrocephalus was mainly 1-4 weeks. Fifteen cases of hydrocephalus had a confirmed bacterial etiology as follows??Escherichia coli??n??6????Streptococcus pneumoniae??n??2????staphylococcus??n??2????Group B beta-hemolytic streptococcus??n??2????acinetobacter??n??2??and Listeria monocytogenes??n??1??. The incidence of obstructive hydrocephalus was 48%??12/25??. About 56% patients received a previously treatment with antibiotics. The prognoses of these children were??survival in 12 cases??death in 1 case and loss of follow-up in 11 cases. The related factors of the development of hydrocephalus included??a rural living situation??OR??17.64??95%CI 1.23??252.86????altered level of consciousness??OR??7.59??95%CI 1.09??52.86????CSF protein??2.0 g/L??OR??177.02??95%CI 3.53??8866.51????C-reactive protein??100 mg/L??OR??52.29??95%CI 3.26??840.19????initial therapy with dual-agent antibiotic??OR??0.06??95%CI 0.01??0.62????dexamethasone use??OR??149.47??95%CI 2.56??8713.78?? and previous treatment with antibiotics??OR??36.28??95%CI 2.84??462.78??. Conclusion??Hydrocephalus is a serious complication of purulent meningitis. The severe clinical manifestations and significantly abnormal laboratory indexes represent the most important predictor of hydrocephalus in children with purulent meningitis.     

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??Abstract?? Objective To investigate the early clinical features of children's liver degeneration ??hepatolenticular degeneration??HLD?? and prenatal genetic types. Methods The misdiagnoses and prenatal genetic testing results of 5 cases of HLD in the First Hospital Affiliated to China Medical University from January 2002 to December 2013 were retrospectively analyzed??whose main clinical feature was liver enzymes elevated. Results Fivecaseshadelevatedliverenzymes. Among them??two cases were found in the nursery physical examination??and the others' initial symptom was upper respiratory tract infection ??1 case?? and abdominal discomfort ??2 cases??. The misdiagnosis time was two months to eighteen months. Moreover??a HLDchild’smother had aprenatalgenetictest??and the result showed that the second child was arecessivegenecarrier. However??the liverenzymes and ceruloplasmin??CP?? were normal when he was born at term. Conclusion Unexplained liver enzyme abnormalities should be suspected in children with HLD. We should detect serum CP??urinarycopperandcornealK-Fring timely for earlydiagnosis andtimelytreatmenttoimprovetheprognosis. The prenatal genetic test is an important factor to ensure the health of next generation.