抚触与游泳对促进婴儿身心健康成长的作用

目的 探讨抚触与游泳对婴儿身心健康成长的作用.方法 将160例足月婴儿随机分为对照组和实验组各80例,实验组在出生24h后进行抚触与游泳,对照组不进行抚触与游泳.比较42d后两组婴儿的身高、体重、头围及智能发育情况.结果 出生42d后,实验组婴儿的身高、体重、头围与对照组灯较有显著性差异(P<0.05);实验组婴儿的智能发育情况与对照组比较有极显著性差异(P<0.01).结论 抚触与游泳有利于婴儿的智商和情商的发育,促进亲子情感交流,使婴儿自身素质及平衡的发育得以提高.     

规范游泳与抚触操作对婴儿体格与智能发育的影响

[目的]探讨规范婴儿抚触和游泳对其智能和体格发育的影响。[方法]在天使宝贝游泳馆选取正常出生的足月新生儿100例,按照随机、双盲的方法分为观察组和对照组各50例,对照组由没有参加培训的人员给予游泳和抚触,观察组则由参加培训的人员进行操作,比较两组婴儿6个月时智能和体格发育情况。[结果]观察组婴儿6个月时的精神发育指数、运动发育指数显著优于对照组(P0.01),身长、体重、头围发育情况均优于对照组(P0.05)。[结论]规范游泳和抚触能够促进婴儿智能和体格的发育。     

抚触与游泳对促进婴儿身心健康成长的作用

目的：探讨抚触与游泳对婴儿身心健康成长的作用。方法：将160例足月婴儿随机分为对照组和实验组各80例，实验组在出生24h后进行抚触与游泳，对照组不进行抚触与游泳。比较42d后两组婴儿的身高、体重、头围及智能发育情况。结果：出生42d后，实验组婴儿的身高、体重、头围与对照组比较有显著性差异（P〈0．05）；实验组婴儿的智能发育情况与对照组比较有极显著性差异（P〈0．01）。结论：抚触与游泳有利于婴儿的智商和情商的发育，促进亲子情感交流，使婴儿自身素质及平衡的发育得以提高。     

早期干预对婴儿智能和运动发育的影响

目的探讨游泳结合抚触及被动操对婴儿发育的影响。方法从系统体检的婴儿中抽取200名〉6个月婴儿，将其按干预方法的不同分为2组，每组100例。对照组只定期体检；观察组于出生48h开始游泳，且每次游泳后给予抚触及被动操训练。2组婴儿都纳人儿童系统管理且按时体检．并在婴儿6个月月龄时作智力发育测试（CDCC）。结果观察组智能、运动发展指数优于对照组（P〈0．05），智能和运动优秀率也高于对照组（P〈0．05）。结论婴儿游泳、抚触结合被动操能促进婴儿的生长发育。     

新生儿早期干预对心理发育的临床观察

目的 观察新生儿早期综合干预对其智力发育的作用.方法 选择2012年3月至8月出生的新生儿210例,生后一般状况良好,其父母均健康,除外先天发育障碍、智力低下、遗传、躯体性疾病新生儿,干预组112例,对照组98例,两组婴儿均给予常规喂养、护理,干预组在此基础上给予大动作、精细动作、适应能力、语言、社交行为等领域的干预训练.干预期为1~6个月,比较两组婴儿4~6个月时智能发育和各能区发育情况.结果 干预组神经心理发育均高于对照组,差异有统计学意义（P＜0.05）.结论 新生儿早期干预可促进其神经心理发育.     

婴儿抚触在108例黄疸儿童智能发育中的促进作用

目的：探讨婴儿抚触在黄疸儿童智能发育中的作用。方法：将108例黄疽儿童随机分为两组，其中要儿抚触组54例，对照组54例。婴儿抚触组自新生儿期开始抚触至1岁，两组黄疽儿童均于1岁、2岁时进行智能发育检测。结果：婴儿抚触组1岁、2岁时智力发育指数（MDI）和心理运动发育指数（PDI）均高于对照组，差别有统计学意义。结论：婴儿抚触可以促进黄疽儿童的智力发育。有利于减少黄疸对儿童智能发育的影响。     

标准化抚触及游泳示范演练护理在初产妇婴儿智护照顾中的应用

[目的]观察标准化抚触及游泳示范演练护理在初产妇婴儿智护照顾中的应用效果。[方法]将90例初产妇及其婴儿按随机数字表法分为观察组、对照组,每组45例,对照组仅给予婴儿游泳与抚触意义宣讲及方式指导,观察组接受婴儿标准化抚触及游泳示范演练护理干预,对两组干预后各观察指标进行比较。[结果]干预后观察组初产妇婴儿游泳与抚触护理技能评分高于对照组,观察组婴儿娩出后6个月时智能体格发育指标均优于对照组(P0.05)。[结论]采用标准化抚触及游泳示范演练护理对初产妇家庭开展新生儿智护照顾培训,可提高初产妇的婴儿游泳抚触护理技能水平,促使婴儿智能体格发育。     

抚触对巨大儿生长发育影响的研究

目的　观察抚触对巨大儿生长发育的影响。方法　 6 3例足月剖宫产出生的巨大儿随机分为抚触组 31例与对照组 32例。从出生 2 4h后开始对抚触组巨大儿进行抚触 ,2次 /d ,15～2 0min/次 ,坚持抚触至少 4个月 ,对照组常规护理不进行抚触。 1岁时对 2组巨大儿的体重、身长进行测量 ,并应用SM社会生活能力量表对 2组巨大儿在 1岁时的智能发育进行测定 ,同时统计 2组巨大儿由出生至 1岁时门诊看病次数及住院次数 (呼吸系统疾病及腹泻为主 )。结果　抚触组巨大儿体格正常发育例数及智能发育得分均显著优于对照组 ;患病率明显低于对照组 ,3项统计结果均为P <0 .0 5。结论　抚触对巨大儿体格的正常发育及智能发育均有良好的促进作用。     

游泳和抚触对新生儿神经行为及体格发育的影响

目的:探讨游泳和抚触对新生儿神经行为及体格发育的影响.方法:将健康足月新生儿190例随机分为两组,观察组100例,从出生24 h后进行游泳和抚触,住院期间由专业的护理人员操作,出院后由培训过的双亲继续对婴儿进行操作,医护人员定期随访,以检查操作是否规范.对照组90例,按常规护理.并在第2、20、30天对新生儿神经行为评分及42 d进行体格发育比较.结果:观察组新生儿神经行为及体格发育各项指标与对照组相比,差异有显著性(P ＜ 0.01).结论:游泳及抚触能够促进新生儿的神经行为和体格发育,是值得推广的保健与健康活动.     

早期抚触对早产低出生体质量儿神经心理发育的影响研究

目的探讨早期抚触对低出生体质量早产儿神经心理发育的影响。方法选取2012年1月至2014年6月该院新生儿儿科收治的低出生体质量早产儿382例,根据随机数字表将患儿分为观察组(n=191)及对照组(n=191)。对照组患儿给予常规性对症治疗,观察组在对照组基础上应用早期抚触干预措施,干预时间为12个月,比较2组患儿干预前及干预3、6个月后体质量、身长、头围、增长情况。同时应用婴幼儿智能发育量表及Gesell婴幼儿发育诊断量表对2组患儿智能发育及神经心理发育进行评价。结果观察组干预3、6个月后体质量、头围、身长增长显著大于对照组,差异有统计学意义(P0.05)。观察组干预3、6、9、12个月后智力发育指数及运动发育指数评分显著高于对照组,差异有统计学意义(P0.05)。观察组干预3、6、9、12个月后适应性、大运动、精细运动、语言、社会行为评分及神经行为总评分均高于对照组,差异有统计学意义(P0.05)。结论早期抚触能有效促进低出生体质量早产儿生长发育、智能发育及神经心理发育,有利于改善患儿远期生命质量。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.