福建省宁德市774名城市儿童血铅水平的调查

目的进行儿童血铅水平及相关危险因素调查,更好地开展儿童铅中毒预防工作。方法2001-04/2002-02在宁德市医院我院儿科儿童保健门诊就诊除外非本地常住户口的0～14岁城市儿童进行血铅水平测定,并对个人状况、生活环境等相关因素进行调查。结果儿童血铅≥100μg/L有156例占20.2%(1μg/L=0.00483umol/L)。4～6岁年龄组儿童的血铅值(75±36)μg/L显著高于0～3岁年龄组(61±31)μg/L,不良卫生习惯组血铅值(78±33)μg/L)、被动吸烟组(73±29)μg/L、未补充钙剂组(71±31)μg/L,均显著高与对照组(P<0.01)。结论良好的卫生习惯、常服钙剂是降低血铅的重要措施。     

香港少儿运动员血清瘦素、身体成分及体适能参数关系

目的:探讨长期运动对青春前7～12岁的儿童瘦素分泌的影响。方法:比较36名(男21名,女15名)青春期前的香港运动员(n=25)与非运动员(n=11)安静状态下的血清瘦素、身体成分和体适能的区别及其相互关系。结果:身体成分相似的运动员与非运动员血清瘦素(4.61±2.89)μg/L和(6.34±5.14)μg/L、血清皮质醇(0.25±0.11)μmmol/L和(0.21±0.07)μmmol/L、血胆固醇(3.8±0.8)mmol/L和(4.1±1.1)mmol/L、高密度脂蛋白(1.1±0.3)mmol/L和(1.2±0.3)mmol/L等差异无显著性意义(t=1.030,1.279,0.935,0.758;P均>0.05),运动员的体适能显著优于非运动员,瘦素与脂肪含量、皮下脂肪量显著高度相关(r=0.84,0.89,P均<0.001),与体适能参数无关。男童的瘦素、身体成分、血液生化指标与上述变化及相关关系相似,体适能参数只有跪地俯卧撑有显著差异(t=3.789,P<0.001),男童运动员优势手握力(r=0.76,P<0.05)、男童非运动员的坐位体前屈(r=-0.70,P<0.05)与瘦素显著相关。结论:长期运动对瘦素的分泌无影响,瘦素水平仅是脂肪含量的标志。     

3621例儿童血铅水平调查

目的调查2009年深圳市妇幼保健院门诊儿童血铅水平和铅中毒状况。方法采用钨舟原子吸收光谱法测定3621例0～12岁儿童血铅水平,对各年龄组儿童血铅值应用SPSS15.0软件进行分析。结果 3621例0～12岁儿童血铅水平为43.58μg/L,按年龄分为4组,组间差异有统计学意义,男、女童血铅水平分别为45.61、41.23μg/L,幼儿前期和小学阶段儿童血铅水平存在性别差异。血铅水平大于或等于100μg/L者130例,铅中毒率为3.59%,铅中毒率最低为婴儿组(2.76%),最高是小学阶段(7.05%);男童铅中毒51例,铅中毒率为4.16%,女童铅中毒49例,铅中毒为2.76%,中毒的比例在男女童间差异具有统计学意义(P0.05)。结论儿童血铅水平及中毒率随年龄增长而增加,男童血铅水平及中毒率均高于女童。     

足月妊娠妇女静脉血中瘦素及胰岛素样生长因子-Ⅰ与其新生儿体重关系的研究

【目的】研究足月妊娠妇女静脉血中瘦素 (Leptin)水平及胰岛素样生长因子 Ⅰ (IGF Ⅰ )水平与其体重的关系。【方法】采用放射免疫法测定 90例孕 37～ 4 1周正常妊娠妇女 (研究组 )及 30例健康非妊娠妇女(对照组 )的血瘦素水平及IGF Ⅰ水平 ,并对其进行相关分析。【结果】①妊娠晚期妇女静脉血中瘦素水平为(9 .95± 2 .4 4 ) μg/L ,明显高于对照组妇女的 (5 .30± 1.31) μg/L ;妊娠晚期妇女IGF Ⅰ水平为 (2 0 3.96± 5 6 .6 9) μg/L ,明显高于对照组妇女的 (180 .31± 5 0 .2 4 ) μg/L。②妊娠晚期妇女瘦素水平与新生儿体重无明显相关 (r为 0 .93和 1.5 7,P >0 .0 5 ) ;妊娠晚期妇女IGF Ⅰ水平与新生儿体重明显正相关 (r为 4 .5 5 ,4 .94 ,2 .4 6 ,P <0 .0 0 1和P <0 .0 5 )。【结论】①妊娠晚期妇女血中瘦素水平增高 ,推测其与孕妇的脂肪积累和体重增加有关。②妊娠晚期妇女血中IGF Ⅰ可能参与促进胎儿生长发育的过程。     

上海地区儿童肾功能生化项目参考区间的建立

目的分析上海地区3～17岁健康儿童肾功能生化项目[尿素、肌酐(Cr)、尿酸(UA)、总蛋白(TP)、白蛋白(Alb)],建立儿童肾功能生化项目的参考区间。方法选取上海地区3～17岁健康儿童1038名,其中男543名、女495名。按年龄分为3组:3～6岁组(345名)、7～12岁组(434名)、13～17岁组(259名)。采用日立7180全自动生化分析仪检测血清尿素、Cr、UA、TP、Alb,以±1.96s方式建立参考区间。结果除血清尿素水平外,不同年龄组血清Cr、UA、TP、Alb水平差异均有统计学意义(P0.05),且随年龄的增长呈明显上升趋势。7～12岁组和13～17岁组男童与女童之间血清UA、Cr水平差异均有统计学意义(P0.05)。将年龄、性别因素合并分析后建立参考区间。尿素:3～17岁为3.36～5.41 mmol/L;Cr:3～6岁为24.47～38.07μmol/L,7～12岁男童为33.45～49.27μmol/L、女童为33.09～46.05μmol/L,13～17岁男童为46.00～70.00μmol/L、女童为42.67～60.63μmol/L;UA:3～6岁为210.00～312.42μmol/L,7～12岁男童为216.70～364.58μmol/L、女童为217.27～336.53μmol/L,13～17岁男童为287.93～474.13μmol/L、女童为260.39～340.11μmol/L;TP:3～6岁为66.23～74.75 g/L,7～12岁为69.12～77.64 g/L,13～17岁为70.08～78.24 g/L;Alb:3～6岁为43.62～48.14 g/L,7～12岁为44.62～48.86 g/L,13～17岁为45.28～50.28 g/L。结论初步建立了上海地区3～17岁健康儿童肾功能生化项目的参考区间。     

血清sFas和sFasL在系统性红斑狼疮诊治中的应用

目的　旨在探讨血清sFas和sFasL的变化在系统性红斑狼疮 (SLE)临床诊治中的应用。方法　采用ELISA法检测 39例SLE患者和 2 0例健康人血清中sFas和sFasL的水平。结果　SLE患者血清中的sFas和sFasL的水平分别为 (16± 4 0 ) μg/L和 (0 0 8± 0 0 3) μg/L。健康人血清中的sFas和sFasL的水平分别为 (3 1± 1 1) μg/L和 (0 0 5± 0 0 1) μg/L ,二者经统计学检验有非常显著的差异 (P <0 0 1)。活动期患者和缓解期患者血清中的sFas水平分别为 (2 0± 5 ) μg/L和 (10± 2 ) μg/L ,前者较后者明显增高 ,P <0 0 1。sFasL的水平活动期患者和缓解期患者之间无显著性差异 ,P >0 0 5。结论 :sFas及sFasL参与了SLE的发病 ,且可作为SLE活动性的实验诊断指     

慢性肾功能衰竭患者瘦素水平及其影响因素

目的　探讨慢性肾功能衰竭 (CRF)患者血清瘦素水平及其影响因素。方法　选择CRF非透析患者 5 5例、维持性血液透析患者 30例和健康对照 30例 ,应用放射免疫分析法测定血清瘦素 ,同时观察体重指数 (BMI)、性别、年龄及检测血清C反应蛋白 (CRP)、肿瘤坏死因子α(TNF α)、白细胞介素 6 (IL 6 )、空腹胰岛素及肾功能等指标 ,分析瘦素与各项参数的关系。结果　校正BMI差异后 ,非透析组CRF患者血清瘦素水平比健康对照组明显增高 (P<0 .0 5 ) ,血透组的血清瘦素水平虽高于对照组 ,但差异无统计学意义 (P >0 .0 5 )。女性CRF患者瘦素水平 (15 .2 4±13.2 1)高于男性 (8.5 5± 8.37) ,P <0 .0 5。多元逐步回归分析显示 ,血清瘦素水平与BMI、性别、血清IL 6相关 (标准偏回归系数分别为 0 .5 10、0 .343、- 0 .198)。结论　CRF患者存在高瘦素血症 ;血清瘦素水平同时受到体脂含量、性别等多因素的影响。     

急性白血病患者血清sICAM-1的水平变化及其意义

目的探讨急性白血病患者血清可溶性细胞间粘附分子 - 1(sICAM 1)的水平变化及其临床意义。方法采用酶联免疫吸附试验法 (ELLSA)测定 5 0例急性白血病患者的血清sICAM 1含量 ,比较其水平在不同病理状态下的变化。结果初诊治疗前的急性淋巴细胞白血病 (ALL)、急性非淋巴细胞白血病 (ANLL)、不缓解或复发ALL及ANLL患者的血清sICAM 1测定值分别为 (10 5 8± 114) μg/L、(10 0 8± 84) μg/L、(885± 146 ) μg/L、(910± 174) μg/L ,与完全缓解或部分缓解组ALL组 (5 6 7± 15 5 ) μg/L、ANLL的 (493± 76 ) μg/L及正常对照组的 (5 78± 16 8) μg/L相比 ,其差异有非常显著性意义 (P <0 .0 1) ;而处于相同病理状态的ALL与ANLL患者血清sICAM 1水平比较 ,其差异未见显著性意义 (P >0 .0 5 )。结论血清sICAM 1含量升高与急性白血病的化疗效果及预后不良有关     

重组人促红细胞生成素对尿毒症患者血清瘦素水平的影响

目的观察重组人促红细胞生成素对尿毒症患者血清瘦素水平的影响.方法 30例尿毒症患者早八时抽空腹血,用酶标法测定重组人促红细胞生成素应用前及用药二周、四周、八周后的血清瘦素水平. 结果男(6.24±4.18)μg/L,女(9.86±5.86)μg/L;重组人促红细胞生成素应用前尿毒症患者血清瘦的水平为男(21.18±7.42)μg/L,女(29.04±6.48)μg/L;应用二周后为男(16.24±5.88)μg/L,女(20.28±6.36)μg/L;四周后为男(13.76±4.24)μg/L,女(16.82±5.25)μg/L;八周后为(14.84±6.496)μg/L,女(18.47±5.34)μg/L.结论尿毒症患者血清瘦素水平明显高于正常人;红细胞生成素的应用能够有效降低患者的血清瘦素水平、增加食欲、改善营养状态.     

蒙古族牧民血清瘦素水平与肥胖度的关系

目的探讨牧区蒙古族牧民血清瘦素水平与年龄、性别及肥胖的关系。方法用放射免疫分析法测定150例蒙古族正常非肥胖和50例超重或肥胖个体[体质量指数(BMI)≥25]的血清瘦素水平。结果蒙古族牧民正常非肥胖者平均瘦素浓度男性为(2.25±1.13)μg/L,女性为(6.76±3.60)μg/L;超重或肥胖者平均瘦素浓度男性为(4.92±2.12)μg/L,女性为(16.20±5.42)μg/L,女性较男性高2~3倍。血清瘦素水平与BMI显著相关(男子r=0.70,P﹤0.01;女子r=0.62,P0.01)。结论蒙古族牧民超重和肥胖个体瘦素浓度升高,BMI、脂肪含量、性别和年龄是影响血清瘦素浓度的主要因素。     

Identified risk factors and adolescents’ beliefs about triggers for headaches: results from a cross-sectional study

Although there are few studies on adolescents’ beliefs about triggers of headache, none of these compared the associations between perceived and observed triggers. This study aimed at comparing the prevalence of self-perceived and observed risk factors for headache among adolescents. Adolescents from the 10th and 11th grades of high schools answered questionnaires on their headaches and on potential risk factors regarding lifestyle, stress and muscle pain. Individuals reporting to have experienced headache in the preceding 6 months were asked to report what they believed to cause their headache (self-perceived triggers). 1,047 (83 %) of 1,260 adolescents reported headaches. Stress, lack of sleep and too much school work were the most frequently reported self-perceived triggers of headache; in contrast the statistical analysis identified alcohol and coffee consumption, smoking, neck pain, stress and physical inactivity as risk factors for headache. Among individuals with headache, 48 % believed that stress might trigger their headaches, while increased stress scores were only observed in 23 %. In contrast, while 7, 4, 0.3 and 0 % of individuals reporting headache considered consumption of too much alcohol, neck pain, physical inactivity and consumption of coffee might trigger their headache, 56, 51, 36 and 14 %, respectively, were exposed to these risk factors. The prevalence of self-perceived triggers of headache does not correspond to the prevalence of identified risk factors for headaches. While the role of stress was overestimated, the high prevalence of the other confirmed risk factors in adolescents with headache suggests potential for prevention by increasing awareness for these risk factors and appropriate interventions.     

峨眉山疗养因子对老年慢性失眠症的疗效观察

目的　观察峨眉山疗养因子对老年慢性失眠症的治疗作用。方法　７５ 例老年慢性失眠症患者用峨眉山疗养因子治疗,观察治疗前后的睡眠情况。结果　治疗后失眠症状明显改善,总有效率达９４ ．７ ％ 。结论　峨眉山疗养因子对慢性失眠症有良好的治疗作用。     

胚胎停止发育相关因素分析

目的探讨胚胎停止发育(胎停育)与相对不良因素的关系。方法采用询问病史和收集病例资料的方法,观察年龄、孕产史、血型分布、夫妇的工作、生活环境、生活习惯、健康状况等方面与胎停育的关联性。结果 518例胎停育孕妇中,25～29岁年龄组所占构成比最高(46.72%);210例O型血孕妇中,25～29岁年龄组占42.56%;345例流产次数≥2次孕妇中,25～29岁年龄组占67.77%。占构成比最高的为25～29岁年龄组、流产次数≥2次及O型血孕妇。518例胎停育孕妇中,有精神刺激者占46.13%;环境因素占26.64%;孕前半年内取环和停服避孕药者占7.1%,明显高于孕前半年以上取环和停服避孕药所占的3.47%;而孕前接受医学检查和咨询的胎停育孕妇占13.13%,又明显低于孕前未接受医学检查和咨询的87.07%。结论为防止多次妊娠行人工流产导致的胎停育,应选择最好的、合理的、有效的避孕措施;在育龄期夫妇中,加强孕前宣传教育,有计划地生育,控制或减少在工作、生活和环境中的不良因素,对降低胎停育的发生尤为重要。而夫妇孕前半年内接受医学检查和医学咨询,是避免胎停育发生的保护性方法之一。     

我院剖官产率上升原因的调查分析

目的 探讨引起剖宫产率上升的相关因素,提出降低剖宫产率的可行性措施.方法 对2000年1月至2009年12月我院剖宫产病例进行回顾性分析.结果 剖宫产率逐年升高,2000年为32.0%,2001年为34.5%,2002年为35.0%,2003年为32.3%,2004年为37.1%,2005年为37.9%,2006年为40.2%,2007年为41.7%,2008年为43.6%,2009年为46.1%.结论 应采取有效措施,降低剖宫产率.

Abstract：

Objective To discuss the related factors about the rising cesarean section rates, and to propose feasible measures to reduce cesarean section rates. Methods Cesarean section cases in our hospital from January, 2000 to December, 2009 were retrospectively analyzed. Results The cesarean section rate increased year by year,32.0% in 2000,34.5% in 2001,35.0% in 2002,32.3% in 2003,37.1% in 2004,37.9% in 2005,40.2% in 2006,41.7% in 2007,43.6% in 2008,46.1% in 2009. Conclusions Effective measures should be taken to reduce the cesarean section rate.     

Relative contribution of intrapersonal and partner factors to contraceptive behavior among taiwanese female adolescents.

PURPOSE: To explore the relative contribution of intrapersonal factors (demographic data, sexual history, and self-efficacy for contraception) and partner factors (perceptions of support from sexual partners for contraception, and relationship power) to contraceptive behaviors among sexually active female adolescents in Taiwan. DESIGN: A cross-sectional design. Female adolescents who have had a steady male sexual partner in the past 3 months (N=375) were recruited as participants. METHODS: Questionnaires including demographic data, sexual history, contraceptive behavior, self-efficacy for contraception, perceptions of support from sexual partner for contraception, and perceptions of relationship power were submitted anonymously for this study. FINDINGS: Participants who had their first sexual experience at less than 14 years of age and were from one-parent families had the least comprehensive contraceptive behavior than did other participants. Number of steady sexual partners was significantly negatively correlated with contraceptive behavior. Self-efficacy, perceptions of support from sexual partner for contraception, and relationship power all were positively correlated with contraceptive behavior. The important explanatory variables of contraceptive behavior were self-efficacy, age of first sexual intercourse, intervals between sexual intercourse, and perceptions of support from sexual partner for contraception. These accounted for 39.1% of variance in contraceptive behavior. CONCLUSIONS: Intrapersonal factors (self-efficacy, age of first sexual intercourse, and intervals between sexual intercourse) were more important than were partner factors (perceptions of support from sexual partners for contraception and relationship power) in influencing contraceptive behavior among sexually active female adolescents in Taiwan. CLINICAL RELEVANCE: Intervention to increase contraceptive behavior among female adolescents should be focused more on intrapersonal factors than on partner factors.     

冠状动脉介入患者围手术期疾病不确定感及影响因素分析

目的调查分析冠状动脉介入患者围手术期的疾病不确定感水平及其影响因素，为提出针对性的干预措施提供依据。方法以一般资料问卷、Mishel疾病不确定感量表（中文版）在术前1d、手术当天及术后3d对97例冠状动脉介入患者进行问卷调查。结果冠状动脉介入患者存在较高水平的疾病不确定感；患者介入史、与冠状动脉介入术手术结果有关的因素（是否放置支架、支架数）、以及性别、病程、文化程度是疾病不确定感的重要影响因素，差异有显著意义。结论冠状动脉介入患者疾病不确定感水平较高，护士应改进常规护理工作，根据患者特点给予个性化信息支持，提高护理质量。     

不同性别人群的冠心病主要危险因素分析

目的分析冠心病(CHD)主要危险因素年龄、高血压、高脂血症、糖尿病在男性和女性人群中的差别。方法经冠状动脉造影检查确诊的冠心病患者608例,其中合并高血压350例,高血脂158例,糖尿病222例。分析男女冠心病发病的年龄及危险因素在不同年龄段的分布。结果冠心病发病平均年龄男性组(55.2±9.9)岁与女性组(64.5±10.1)岁比较有差异(P=0.04),在<50岁亚组中,男性较女性发病率高(P<0.05)。女性组危险因素中高血压病、糖尿病、高脂血症的发生率均明显高于男性组(均P<0.05)。女性高血压在70~79岁亚组较60~69岁亚组下降;糖尿病在男性和女性70~79岁亚组较60~69岁亚组都下降;高脂血症在男性70~79岁亚组构成比下降。冠心病人高血压和糖尿病在男性和女性各年龄亚组构成比差异有统计学意义(P<0.01);高血脂年龄构成比差异无统计学意义(P=0.134)。结论年龄、高血压、高脂血症、糖尿病在男性和女性冠心病患者中有差别。     

Inter-relation of coagulation factors and d-dimer levels in healthy individuals

Summary.  Recently, high levels of coagulation factor (F)VIII, FIX and FXI have been associated with an increased risk of venous thrombosis. For several coagulation factors a substantial hereditary component was found. If regulatory genes are located outside the clotting factor genes, they may regulate the levels of several proteins in the coagulation system. Thus levels would then cluster in individuals. The aim of the present study was to assess the inter-relation among levels of the pro- and anticoagulant proteins in the coagulation cascade. We also investigated the relation between the coagulation factors and d -dimer levels (marker of coagulation activity). All analyses were performed in healthy subjects, the control population of the Leiden Thrombophilia Study (LETS), to eliminate the influence of a prior thrombosis on the interpretation of the results ( n  = 466). Using principal-components analysis, a method intended to explain relationships among several correlated variables, we found a clustering between the vitamin K-dependent factors (prothrombin, VII, IX, X) and FXI and FXII. FV and FVIII clustered with fibrinogen and d -dimer. FXIII remained relatively independent of the other factors. Adding the anticoagulant factors to the analysis resulted in minor changes in the clustering pattern. The anticoagulant factors clustered together. We found relatively independent clusters within the group of pro- and anticoagulant factors, which may suggest that the genetic basis for high or low levels of factors in the coagulation system may, at least partly, lie outside the genes coding for these factors.     

Comparison of Rehabilitation Training at Different Timepoints to Restore Shoulder Function in Patients With Breast Cancer After Lymph Node Dissection: A Randomized Controlled Trial

ObjectiveTo investigate whether advancing the initiation of rehabilitation training compared with the time recommended by the guidelines after breast cancer (BC) surgery is beneficial to the recovery of shoulder function and quality of life.DesignProspective, observational, single center, randomized controlled trial.SettingThe study was conducted between September 2018 and December 2019, with a 12-week supervised intervention and 6-week home-exercise period concluding in May 2020.ParticipantsTwo hundred BC patients received axillary lymph node dissection (N=200).InterventionsParticipants were recruited and randomly allocated into 4 groups (A, B, C, and D). Group A started range of motion (ROM) training at 7 days postoperative and progressive resistance training (PRT) at 4 weeks postoperative; group B started ROM training at 7 days postoperative and PRT at 3 weeks postoperative; group C started ROM training at 3 days postoperative and PRT at 4 weeks postoperative; and group D started ROM training at 3 days postoperative and PRT at 3 weeks postoperative.Main Outcome MeasuresThe primary outcome measure was Constant-Murley Score. Secondary outcome measures included ROM, shoulder strength, grip, European Organization Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module (EORTC QLQ-BR23), and SF-36. Incidence of adverse reactions (drainage and pain) and complications (ecchymosis, subcutaneous hematoma, lymphedema) were also assessed.ResultsParticipants who started ROM training at 3 days postoperative obtained more benefits in mobility, shoulder function, and EORTC QLQ-BR23 score, while patients who started PRT at 3 weeks postoperative saw improvements in shoulder strength and SF-36. Incidence of adverse reactions and complications were low in all 4 groups, with no significant differences among the 4 groups.ConclusionsAdvancing ROM training initiation to 3 days postoperative or PRT to 3 weeks postoperative can better restore shoulder function after BC surgery and lead to faster quality of life improvement.     

哮喘儿童保护因素的研究

目的调查河北省南部地区儿童哮喘发病的保护因素,进而指导临床采取有效的干预措施。方法收集2005年6月至2007年5月河北省儿童医院呼吸科收治的哮喘患儿共311例,同时根据年龄、性别、居住地区选择非哮喘患儿进行1∶1配对,以问卷形式调查,入选病例从生后首次喘息开始追溯,查找哮喘发病保护因素。结果本研究调查了43个因素,经χ2检验初筛,最终进入回归模型的有32个相关因素,其中保护因素有母孕期常吃苹果及鱼、地面瓷砖、护墙板、母乳喂养、第1胎、及时补钙及维生素D、同居人口数多等8个。结论母孕期合理饮食,提倡母乳喂养,儿童发育期营养均衡,改善居住环境等均可减少哮喘的发生。