早期综合发展指导用于儿童保健中的效果及对小儿发育的影响评价

目的 分析早期综合发展指导用于儿童保健中的效果,及对小儿发育的影响。方法 抽取2020年1～12月开展儿童保健的儿童84例,根据儿童保健方式分组为参照组（n=42）、研究组（n=42）,参照组行常规儿童保健干预,研究组行早期综合发展指导。对比两组儿童的发育情况、儿童家属保健知识掌握度。结果 干预后,研究组儿童智力发育项目（适应能力、运动能力、社交能力、语言能力、精细动作）分值高于参照组（P <0.05）。随访1年内儿童常见病发病率低于参照组（9.52%vs. 26.19%）,儿童家属的儿童保健知识（预防疾病知识、喂养知识、健康锻炼知识、生活注意事项）掌握程度项目分值高于参照组（P <0.05）。结论 早期综合发展指导用于儿童保健对促进小儿智力发育有积极意义,同时可降低常见病发病率,提升儿童家属儿童保健知识掌握程度,效果显著。     

早期综合发展在儿童保健中的应用效果

目的研究在儿童保健中应用早期综合发展的价值以及产生的效果。方法对我院妇产科出生的婴幼儿进行随机选取,所有儿童均收治于2014年1~12月,以出生时间作为分组标准,将200例婴幼儿分为两组,将早期综合发展教育模式应用于100例研究组儿童中,将常规保健措施应用于对照组儿童中。将体格以及发育商进行对比。结果结果显示研究组儿童患佝偻病以及缺铁性贫血的概率比对照低,同时其发育商,包括语言、适应性以及大运动等评分均比对照组儿童高。使用相关软件统计分析两组儿童的对比数据,上述差异经检验和分析,结果显示P<0.05,统计学意义存在并且较为显著。结论在儿童保健工作中,使用早期综合发展能够有效提高其对于某些疾病的抵抗力,同时使其发育商得到改善,对儿童的身体以及智力发展都具有一定的影响。     

儿童保健中开展早期综合发展指导对小儿发育的作用探讨

目的分析儿童保健中开展早期综合发展指导对小儿发育的作用,评估早期综合发展指导的实施效果。方法选取我院2016年1月至2016年12月儿童保健门诊定期体检的儿童200例作为研究对象,按照随机数字表法进行分组,每组各100例,其中A组100例体检幼儿在常规儿童保健基础上给予早期综合发展指导,B组100例体检幼儿给予常规儿童保健,对两组幼儿的发育状况进行比较。结果 A组儿童体质量、身高、血红蛋白及各智能区发育商均高于B组,P <0.05。结论在儿童保健中融合早期综合发展指导对儿童健康成长发育有积极作用,有利于儿童体格发育、神经行为发育,促进儿童智能发育潜能的开发,值得进一步研究和推广应用。     

儿童保健中早期综合发展指导的开展对小儿发育的影响

目的对早期综合发展指导在儿童保健中应用的效果进行观察。方法选取2018年1月至2019年1月174例健康体检儿童,随机分为观察组与对照组,各87例,对照组给予常规保健,观察组给予早期综合发展指导,对比两组小儿发育情况。结果在体格发育方面,两组无明显差异(P> 0.05);在精细动作、适应能力、语言能力、运动能力及社交能力等智力发育指标评分方面,观察组均高于对照组(P <0.05)。结论早期综合发展指导在儿童保健中应用,对小儿智力发育有促进作用,值得推广。     

儿童保健中开展早期综合发展指导对小儿发育的影响分析

目的研究儿童保健中开展早期综合发展指导对小儿发育的影响。方法 400例健康体检儿童,采用随机双盲法分为观察组和对照组,各200例。对照组接受常规保健,观察组接受早期综合发展指导。比较两组儿童的体格发育、神经行为发育、营养性疾病发生情况。结果 1岁时,观察组儿童的头围、身高、体质量分别为(48.94±0.62)cm、(90.85±2.64)cm、(12.56±1.66)kg,均优于对照组的(45.80±0.43)cm、(76.63±1.75)cm、(9.25±1.07)kg,差异均有统计学意义(P<0.05)。1岁时,观察组儿童的语言、适应性、社交行为、大动作、精细动作评分分别为(95.08±4.54)、(95.34±3.72)、(98.62±4.18)、(97.76±5.45)、(97.59±5.23)分,均高于对照组的(88.64±3.30)、(89.25±2.71)、(93.15±4.02)、(91.07±2.88)、(92.71±3.46)分,差异均有统计学意义(P<0.05)。观察组儿童营养性疾病发生率11.00%(22/200)明显低于对照组的20.00%(40/200),差异具有统计学意义(P<0.05)。结论儿童保健早期综合发展指导的开展有助于小儿体格和神经行为的发育,预防营养性疾病的发生。     

早期综合发展在儿童保健中的应用研究

目的探讨早期综合发展在儿童保健中的应用效果。方法 2011年2月至2012年2月期间,出生至1岁愿意接受早期综合发展指导的60例儿童作为观察组研究对象,另外选择60例常规保健服务的出生至1岁儿童作为对照组研究对象,对两组智能发育、体重、身高、血红蛋白等方面,进行观察和比较。结果与对照组相比,观察组智能发育评分明显升高,（P〈0.05）,差异有统计学意义,而对体重、身高、血红蛋白没有影响。结论早期综合发展明显促进儿童智能发育,值得临床广泛推广。     

医院中早期干预对发育迟滞儿童的影响

目的：观察早期干预对发育迟滞儿童的作用。方法：随机选取2005年10月～2007年10月在儿保科确诊的发育迟滞儿童35例，20例为干预组，进行早期干预，训练时间为每次40min，每周4次，同时对家长进行家庭训练指导。15例不进行医院干预患儿作为对照组，半年后对两组儿童进行发育商测评。结果：干预组发育商显著超过对照组（P〈0．01）。结论：说明适当的早期干预可以在一定程度上弥补其生理发育的不足，提高智力水平。     

早期综合教育和保健服务在促进儿童体格与智力发育中的效果

目的研究并探讨早期综合教育与保健服务在促进儿童体格与智力发育中的应用效果。方法于2014年1月~2015年6月,选取该阶段内在我院出生的足月健康新生儿400例作为研究对象,按照随机分配原则将新生儿分为两组,每组200例。对照组新生儿接受常规儿童保健服务,观察组新生儿在接受常规儿童保健服务的同时,还接受早期综合教育,比较两组新生儿出生后6、12个月的体格发育情况、智力发育情况以及营养状况。结果出生后6个月,观察组新生儿的身长发育情况较对照组更优(P0.05);出生后12个月时,观察组新生儿的身长、头围等发育情况较对照组更优(P0.05)。出生后6、12个月,观察组新生儿的智力发育情况均较对照组更优(P0.05),其营养不良发生率较对照组更低(P0.05)。结论在新生儿的早期保健服务过程中施加早期综合教育,可有效改善新生儿的营养状况,促进新生儿的体格发育和智力发育。     

西城区妇幼保健院儿童早期综合发展优质护理服务效果评估

随着医疗卫生系统优质护理服务工作的全面开展,2012年9月,西城区妇幼保健院全面启动“优质护理服务示范工程”,确定妇产科、老年病房为优质护理服务病房,作为一所承担公共卫生职能、保健特色的医疗保健机构,我们积极尝试保健领域优质护理服务工作,按照北京市西城区卫生局实施优质护理工作方案,在儿保科儿童早期综合发展中心,采取护理“分组包干责任制”的工作模式,进一步落实护士管服务对象,从扎实基础护理、健康咨询和健康指导等方面入手;结合护士队伍分级管理,在保证护理安全的前提下,确保基础护理落到实处,使护理服务精益求精。     

早期综合发展在社区儿童保健中的推广应用

目的 探讨早期综合发展在社区儿童保健中的推广应用意义.方法 选择2009年3月～2012年3月在本院社区实施儿童保健的390例儿童作为观察对象,随机分为观察组（195例）和对照组（195例）.对照组实施常规儿童保健,观察组在对照组的基础上,行早期综合发展干预.对比两组儿童发育商、营养型疾病发病情况以及保健满意度.结果 随访12个月后,＜1岁的观察组儿童发育商显著高于对照组;1～3岁的观察组儿童佝偻病患病率和缺铁性贫血患病率在各时间段均显著低于对照组;4～6岁儿童家长对社区保健满意度均显著高于对照组,差异均有统计学意义（P＜0.05）.结论 实施早期综合发展干预,能够明显提升社区儿童发育商,降低其营养型疾病发病率,同时还可增加保健满意度,效果显著,值得临床推广应用.     

《国家基本药物目录》儿童用药分析及思考

目的分析《国家基本药物目录》中儿童用药的分布情况,为单独制定我国儿童基本药物目录提供建议。方法统计《国家基本药物目录》中口服化学药物涉及儿童用药的说明,查阅《中国药典临床用药须知》（2010版）单个药品说明书中与儿童用药有关的内容,列表分析;在国家食品药品监督管理总局CFDA网站数据查询窗口,以2012年版《国家基本药物目录》中纳入的儿童用药为检索词检索相关信息,对药品的剂型、规格、生产企业等信息列表统计。结果化学药物部分有288种口服药物,其中儿童专用药物1种,儿童可用药物207种（71.88%）,含新生儿用药说明药物19种（6.60%）。中成药部分9种儿童用药,剂型以颗粒剂为主,共20种规格,其中9种为独家品种。结论现版目录仍不能满足儿童用药需求,建议增加对儿童药物研发等环节的经济补偿;制定符合我国儿童疾病需求的儿童基本药物目录,完善儿童用药信息。     

Evaluation of the toxic potentials of a new camptothecin anticancer agent CKD-602 on fertility and early embryonic development in rats

This study examined the potential adverse effects of a new camptothecin anticancer agent, CKD-602, on the fertility and early embryonic development of Sprague-Dawley rats. Ninety-six rats of each gender were divided into four groups: three treatment groups and a control group. CKD-602 was administered intravenously to male rats at 0, 4.7, 14, and 42 microg/kg from 63 days prior to mating until the end of the mating period, and to female rats from 14 days before mating until day 6 of gestation. All the males were sacrificed after the end of the 14-day mating period, while all the females were subjected to a caesarean section on day 15 of gestation. In the high dose group, a high incidence of hair loss was observed in both genders. A decrease in the level of food consumption, followed by a decrease in body weight gain was also observed in both genders. At the scheduled necropsy, the gross postmortem examinations revealed an increase in the incidence of thymic atrophy, paleness of the thoracic and abdominal organs in both genders and an increase in the serum testosterone concentration. In addition, there was a decrease in the thymus weight of the males and an increase in the liver, spleen, kidneys, lung, and heart weights of the females. There was an increase in the number of fetal deaths and post-implantation losses as well as a decrease in the litter size found at the caesarean section of the dams. No treatment-related effect on the histopathological findings, sexual cycle, pre-coital time, mating index, fertility index, pregnancy index, and sperm parameters was observed. There were no adverse effects on the general findings and reproductive performance of the parent animals and early embryonic development in the low and medium dose groups. Overall, the no-observed-adverse-effect levels (NOAELs) of CKD-602 are believed to be 14 microg/kg for both general toxicity and early embryonic development, and more than 42 microg/kg for the reproductive performance of the parent animals.     

儿童哮喘辅以布地奈德的治疗效果及其用药后1～2年对生长发育的影响

目的 探讨吸入布地奈德混悬液用于儿童哮喘治疗中的效果及其用药后1～2年对生长发育的影响。方法 选择于2016年10月至2017年1月收诊的68例儿童哮喘患者,均为急性发作并持续用药,分为两组：34例应用硫酸沙丁胺醇吸入气雾剂治疗的患者为对照组,34例应用吸入布地奈德混悬液联合硫酸沙丁胺醇吸入气雾剂治疗的患者为观察组。比较两组儿童哮喘急性发作期患者的白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、超敏-C反应蛋白（hs-CRP）、最大呼吸流量、IS最大呼气量、调节性B细胞比例、喘憋消失时间、气促缓解时间、湿啰音消失时间、咳嗽消失时间,并对比随访2年后的生长发育指标。结果 用药结束,观察组的IL-6、TNF-α、hs-CRP、调节性B细胞比例、喘憋消失时间、气促缓解时间、湿啰音消失时间、咳嗽消失时间均低于对照组（P<0.05）;观察组的最大呼吸流量、IS最大呼气量高于对照组（P<0.05）。观察组患儿随访结束后的生长激素水平、身高和体重均低于对照组（P<0.05）。结论 吸入用布地奈德混悬液联合硫酸沙丁胺醇吸入气雾剂雾化吸入疗法可缓解患儿的炎症反应,改善患儿的肺功能及免疫功能,加快临床症状的消失,但一定程度上会影响患儿的生长发育。     

抚触对低出生体重儿早期生长发育的影响

目的　了解抚触对低出生体重儿早期生长发育的影响。方法　选择 4 2天儿保健卡筛出低出生体重儿136例 ,对其中 6 0例未查出疾病的低出生体重儿随机分为抚触组和对照组 ,抚触 10、 30天后分别观察其体重、身长 ,并做组间比较。结果　接受抚触治疗后 10天的低出生体重儿的体重、身长增长与对照组差别无显著性 (P>0 .0 5 ) ,30天后抚触组的体重、身长增长显著优于对照组 (P<0 .0 5 )。结论　抚触对低出生体重儿的早期生长具有促进作用 ,值得推广。     

Reflections on the development and implementation of an early warning system for ecstasy and related drug markets in Australia

Regular and systematic monitoring of drug markets provides the basis for evidence-based policy. In Australia, trends in ecstasy and related drug (ERD) markets have been monitored in selected jurisdictions since 2000 and nationally since 2003, by the Party Drugs Initiative (PDI). The PDI maximises the validity of conclusions by triangulating information from (a) interviews with regular ecstasy users (REU), (b) interviews with key experts and (c) indicator data. There is currently no other system in Australia for monitoring these markets systematically; however, the value of the PDI has been constrained by the quality of available data. Difficulties in recruiting and interviewing appropriate consumers (REU) and key experts have been experienced, but largely overcome. Limitations of available indicator data from both health and law enforcement continue to present challenges and there remains considerable scope for enhancing existing routine data collection systems, to facilitate monitoring of ERD markets. With an expanding market for ecstasy and related drugs in Australia, and in the context of indicator data that continue to be limited in scope and detail, there is a strong argument for the continued collection of annual, comparable data from a sentinel group of REU, such as those recruited for the PDI. [Kinner SA, Degenhardt L. Reflections on the development and implementation of an early warning system for ecstasy and related drug markets in Australia. Drug Alcohol Rev 2006;25:445 - 449]     

Chronic low-level lead toxicity in the rat: II. Effects on postnatal physical and behavioral development

This report is the second in a series dealing with the chronic exposure of rats to lead (Pb) in drinking water. Weanling female CD rats were provided semipurified diets and deionized water containing 0, 0.5, 5, 25, 50, or 250 ppm Pb (as lead acetate). Following exposure for 6–7 weeks, females were mated with unexposed males and exposure continued throughout pregnancy and lactation. At 21 days of age, offspring were weaned onto the same concentration their mothers had been given, and exposure continued until sacrifice at 6 or 9 months of age. Significant depressions in body weight were seen at most time points for offspring exposed to 50 and 250 ppm Pb. Clinical signs of respiratory infection, as well as poor fur condition, tail-tip necrosis, and sialodacryoadenitis were noted to occur at 250 ppm. Highly significant delays in age at vaginal opening were noted in 25-, 50-, and 250-ppm females. Surface righting and air righting were delayed in 50- and 250-ppm animals. Locomotor development was unaffected except for an increase in pivoting in 250-ppm animals at Day 14 of age. Postweaning activity levels were unaltered when measured in either the open field or the circular photocell activity cage and evaluations of motor coordination using the rotorod test showed no effects of Pb. Food and water consumption based on body weight were essentially unchanged. Overall, the “lowest effect level” for Pb using chronic oral exposure was 25 ppm, a level associated with alterations in reproductive development. In other reports from this study, immune function and performance of an operant task in adults were altered at 25 ppm (blood Pb, 20–40 μg/dl), and renal morphology after 9 months of exposure was altered at 5 ppm (blood Pb, 10–16 μg/dl). The importance of reporting blood and tissue Pb concentrations for comparing Pb dose-effect among studies is emphasized.     

早期妊娠血清六项激素与胚胎发育相关性研究分析

目的 探讨妊娠6～8周孕妇血清促卵泡生成素（FSH）、黄体生成素（LH）、孕酮（Po）、游离雌三醇（uE3）、游离β-绒毛膜促性腺激素（Fβ-HCG）、睾酮（T）六项激素水平与早孕胚胎发育的关系.方法 采用电化学发光法和时间分辨荧光免疫分析法分别检测早期正常妊娠组106例、非正常妊娠组（先兆流产及胚胎停育、异位妊娠）94例孕妇的血清六项激素水平.结果 正常妊娠组孕妇血清Po、Fβ-HCG、uE3水平较非正常妊娠组显著升高,两组比较差异有统计学意义（P＜0.05）,且三种激素随孕周增加而逐渐升高（P＜0.05）.而孕妇血清FSH、LH、T在早孕期不随妊娠正常与否及孕周的增加而发生明显改变,两组比较差异无统计学意义（P＞0.05）.结论 ①Po、Fβ-HCG任何一项降低,对早孕的维持都有显著影响.②uE3维持在正常参考值范围,对正常妊娠的维持具有协同作用.③FSH、LH、T在妊娠早期维持在低水平,对早期胚胎发育影响和妊娠结局关系不大.     

早期上皮性卵巢癌高危组患者术后单药顺铂化疗临床疗效探讨及其与血清激肽释放酶6表达的关系研究

目的探讨单药顺铂治疗早期上皮性卵巢癌高危组患者的临床疗效,及其与血清激肽释放酶6表达的关系。方法选取我院入院治疗的早期上皮性卵巢癌高危组患者40例,采用单药顺铂进行治疗。比较化疗前后患者血清中激肽释放酶6的表达差异,分析血清激肽释放酶6降低程度与临床疗效的关系。结果顺铂单药治疗总有效率为37.5%。其中,化疗开始时间与手术治疗间间隔〈10d组有效率为50%,11～21d组有效率为42.9%,〉21d组有效率为28.6%。〉21d组患者的有效率明显低于其余两组（P〈0.05）。15例（CR＋PR）患者血清激肽释放酶6.05±0.57μg/L,显著低于25例（SD＋PD）患者血清激肽释放酶4.38±0.79μg/L,两组比较差异有统计学意义（P〈0.05）。结论单药顺铂化疗治疗早期上皮性卵巢癌高危组患者能达到较好的疗效,且血清激肽释放酶6的表达高低与临床疗效关系密切。     

Timely awareness and prevention of emerging chemical and biochemical risks in foods: Proposal for a strategy based on experience with recent cases

A number of recent food safety incidents have involved chemical substances, while various activities aim at the early identification of emerging chemical risks. This review considers recent cases of chemical and biochemical risks, as a basis for recommendations for awareness and prevention of similar risks at an early stage. These cases include examples of unapproved genetically modified food crops, intoxications with botanical products containing unintentionally admixed toxic herbs, residues of unapproved antibiotics and contaminants in farmed aquaculture species such as shrimp and salmon; and adverse effects of chemical and biological pesticides of natural origin. Besides case-specific recommendations for mitigation of future incidents of the same nature, general inferences and recommendations are made. It is recommended, for example, to establish databases for contaminants potentially present within products. Pro-active reconnaissance can facilitate the identification of products potentially contaminated with hazardous substances. In international trade, prevention and early identification of hazards are aided by management systems for product quality and safety, rigorous legislation, and inspections of consignments destined for export. Cooperation with the private sector and foreign authorities may be required to achieve these goals. While food and feed safety are viewed from the European perspective, the outcomes also apply to other regions.     

Evaluation of research activities and research needs to increase the impact and applicability of alternative testing strategies in risk assessment practice

The present paper aims at identifying strategies to increase the impact and applicability of alternative testing strategies in risk assessment. To this end, a quantitative and qualitative literature evaluation was performed on (a) current research efforts in the development of in vitro methods aiming for alternatives to animal testing, (b) the possibilities and limitations of in vitro methods for regulatory purposes and (c) the potential of physiologically-based kinetic (PBK) modeling to improve the impact and applicability of in vitro methods in risk assessment practice. Overall, the evaluation showed that the focus of state-of-the-art research activities does not seem to be optimally directed at developing in vitro alternatives for those endpoints that are most animal-demanding, such as reproductive and developmental toxicity, and carcinogenicity. A key limitation in the application of in vitro alternatives to such systemic endpoints is that in vitro methods do not provide so-called points of departure, necessary for regulators to set safe exposure limits. PBK-modeling could contribute to overcoming this limitation by providing a method that allows extrapolation of in vitro concentration-response curves to in vivo dose-response curves. However, more proofs of principle are required.