河南省部分地区风湿热及风湿性心脏病流行病学调查分析

１９９２年－１９９４年我们对漯河市、临颖县９所幼儿园、１２０所中小学的５－１８岁儿童、青少年５６８６６人进行风湿热（ＲＦ）监测及风湿性心脏病（ＲＨＤ）的流行病学调查。统一诊断标准，首次得出河南省风湿热年均发病率３．６２／１０万，农村为５．１４／１０万，城市为１．９２／１０万，两年间风湿性心脏病患病率为０．１６％，城市０．２２％，农村０．１１％，男性０．０７％，女性０．２６％。此研究提示：风湿热发病     

江苏省0～14岁儿童车祸损伤死亡流行病学调查

目的 掌握江苏省０－１４岁儿童因车祸死亡的流行病学特征。方法 采用分层整群随机抽样技术,对江苏省４个市９个县,共１３个监测点４７．４１万０～１４岁儿童１９９４～１９９５年车祸死亡进行监测。结果 江苏省０～１４岁儿童车祸损伤死亡率为１１．０／１０万,在儿童意外死亡中排第三位,但在城市是第一位意外２死因,占意外２死亡的２９．９％,农村儿童车祸死亡率是城市的２倍,车祸死亡男童明显高于女童,男女之比为３：     

1991～1993年中国0～4岁儿童意外死亡监测结果

以分层随机抽样方法，对１９９１～１９９３年全国８１个市县８５５万５岁以下儿童意外死亡进行监测。结果表明，３年平均婴儿和１～４岁儿童意外死亡率分别为５０２．１／１０万、７０．８／１０万，是婴儿死亡的第三位死因；１～４岁儿童死亡的第一位死因。农村儿童意外死亡率为城市的６．６倍，儿童意外死亡率是边远＞内地＞沿海地区。说明意外窒息和溺水是我国儿童意外死亡的主要死因，占我国０～４岁儿童意外死亡的５０．１％。     

1991—1993年中国5岁以下儿童肺炎死亡监测结果

为了解我国５岁以下儿童肺炎的死亡情况，以随机抽样方法，对１９９１～１９９３年全国８１个市县８５５万５岁以下儿童进行肺炎死亡监测。结果表明，肺炎仍是我国儿童死亡的最重要疾病。全国及农村不论婴儿、１～４岁，还是０～４岁儿童，肺炎均为第１位死因，占同年龄儿童总死亡的２０．０％～２５．０％。１９９１～１９９３年全国平均５岁以下儿童肺炎死亡率为１３１９．２／１０万，城市为２６６．４／１０万，农村为１５６２．２／１０万（为城市的６倍）。农村儿童因肺炎死亡者６３．０％死在家中，５０．０％仅接受门诊治疗，未治疗占１８．５％。监测结果表明，近１０年来，城市儿童肺炎死亡率有所下降，但农村儿童肺炎死亡率仍居高不下，欲实现２０００年全国５岁以下儿童死亡率下降三分之一的目标，降低儿童肺炎死亡乃是当务之急。     

中国妇幼卫生项目县儿童意外死亡流行病学研究

调查了我国５个妇幼卫生项目县１９９０～１９９１年０～１４岁儿童意外死亡水平及８０６例意外死亡原因，并分析了５７７例０～４岁儿童意外死亡的主要影响因素。结果表明，五县０～１４岁儿童意外死亡的年发生率为６７．１３／１０万，占儿童总死亡的３１．３０％，是儿童死亡的首要原因。儿童意外死亡前三位死因依次为溺水、窒息、车祸，占全部意外死亡原因的８０％。男孩意外死亡率高于女孩。１～４岁组是儿童意外死亡的重点人群，占儿童期意外死亡的一半以上。０～４岁儿童意外死亡发生地点主要是家中及其周围场所，无成人照看是意外发生的根本原因。说明意外是农村儿童死亡的首要原因，预防儿童溺水、窒息与车祸是减少儿童意外死亡的关键。     

学龄前儿童瓣膜成形术

目的 探讨学龄前儿童瓣膜疾患行瓣膜成形术的疗效。方法 总结１９９０年１月－１９９８年４月收治的学龄前儿童瓣膜疾患２８３例，男１３０例，女１５３例，年龄２个月－６岁，平均３．０５岁，其中≤１岁２２例（７．７７％）。≤３岁１７０例（６０．０７％）。体重３．１－２１．０ｋｇ，平均１１．８４ｋｇ，≤１０ｋｇ１０６例（３７．４６％）。主要瓣膜疾患包括：单纯瓣膜疾病９例（３．１８％），其中二尖瓣关闭不全（ＭＩ     

桂林市儿童Ⅰ型糖尿病发病率调查

目的　了解桂林市儿童Ⅰ型糖尿病（ＩＤＤＭ） 发病情况。方法　按照ＷＨＯ 儿童糖尿病多国计划（ ＷＨＯ ＤＩＡ ＭＯＮＤ计划）登记方法,采用捕获—再捕获方法,共调查１ ６７２ ２５７ 名儿童。结果　１９８９ 年～１９９８ 年间１５ 岁以下儿童发病率男性为０．５８／１０ 万,女性０ ．６２／１０ 万,总发病率为０．６０／１０ 万。结论　桂林市ＩＤＤＭ 发病率与ＷＨＯＤＩＡＭＯＮＤ 计划获得的多国发病率情况相一致,与东方及中国其它地区的情况也相近。     

rhG—CSF在小儿ANLL强烈化疗中的应用

为探讨ｒｈＧ－ＣＳＦ对小儿ＡＮＬＬ强烈化疗后粒细胞缺乏的疗效，采用ＡＡＥ方案（ＡＤＭ、Ａｒａ－Ｃ、ＶＰ１６或ＶＭ２６），化疗后当ＷＢＣ〈１×１０＾９／Ｌ或ＡＮＣ〈０．５×１０＾９／Ｌ时，给予ｒｈＧ－ＣＳＦ２００μｇ／ｍ＾２·ｄ（５￣１０μｇ／ｋｇ·ｄ），皮下注射，一般连续５￣１０天。本文１５例ＡＮＬＬ，用ｒｈＧ－ＣＳＦ３０例次。用ｒｈＧ－ＣＳＦ前，ＷＢＣ平均０．７８×１０＾９／Ｌ、ＡＮＣ０．１５×     

1994～1997年哈尔滨市七岁以下儿童意外死亡原因分析

目的 探讨７岁以下儿童意外死亡原因及相关因素,方法 按国际疾病分类（ＩＣＤ－９）进行死因分类,将１９９４～１９９７年间２４５例７岁以下儿童意外死亡资料分布城市和农村２个组进行分析。结果 儿童意外死亡前５位主要原因为意外窒息,溺水,一氧化碳中毒,车祸,烫伤,１岁以内意外死亡多见于意外窒息,死于溺水,车祸者多见于２岁以上儿童,因气管异物而死亡者为１－３岁儿童为多见,本组９例均发生在该年龄组,儿童意外死     

脑脊液肿瘤坏死因子测定在中枢神经系统白血病的临床意义

本文检测１００例正常人，急性白血病患儿脑脊液中肿瘤坏死因子（ＴＮＦ），并对已发生中枢神经系统白血病（ＣＮＳＬ）的１０例患儿进行动态监测，测得正常儿童脑脊液（ＣＳＦ）中ＴＮＦ为８．８６±０．８０ｎｇ／ｍｌ，无发生ＣＮＳＬ儿童ＣＳＦ中ＴＮＴ为９．３２±１．５２ｎｇ／ｍｌ，而发生ＣＮＳＬ儿童ＣＳＦ中ＴＮＴ显著升高达２０．６１±２．２１ｎｇ／ｍｌ，治疗缓解后下降为９．１６±０．７６ｎｇ／ｍｌ。提示ＴＮＦ检     

The rural-urban continuum: variability in statewide serious firearm injuries in children and adolescents

OBJECTIVE: To compare rates of serious firearm injuries among children and adolescents treated in a statewide trauma system. MATERIALS AND METHODS: We reviewed the Pennsylvania Trauma Systems Foundation (Mechanicsburg) registry from January 1, 1987, through December 31, 2000, for all pediatric and adolescent patients (age 0-19 years) who sustained a serious firearm injury. Data included age, sex, weapon, geographic region, injury circumstance, and outcome. RESULTS: During the 14-year period, 3781 children and adolescents sustained a serious firearm injury and were treated at a participating Pennsylvania trauma center. The population was 90.7% male, with a mean age of 16.5 years. Adolescents (age 15-19 years) represented more than 85% of the study population. There were 744 deaths (19.7%). The urban counties had an average annual population-based rate of serious firearm injury of 28.3/100 000; suburban counties, 2.8/100 000; metropolitan counties, 2.4/100 000; and nonmetropolitan counties, 2.4/100 000. Urban counties had a higher rate for all injury circumstances (unintentional, assault, and self-inflicted) than all nonurban counties. Assault was the most common overall injury circumstance (78.7%), and was the most common circumstance in urban counties (88.5%) and among adolescents (age 15-19 years [84.2 %]). Unintentional injuries predominated in nonmetropolitan counties (56.7%) and in young children (aged <5 years [50.6%] and 5-9 years [61.4%]). Handguns were the most common weapon type in all age groups, geographic regions, and injury circumstances. CONCLUSIONS: Rates of serious firearm injuries among children and adolescents are 10-fold higher in urban than nonurban regions. Assaultive injury mechanisms predominated in urban areas, unintentional injuries in the nonurban counties. Firearm injury statistics are heavily influenced by events in the urban counties. Intervention and prevention strategies need to account for these regional discordances to optimize efficacy.     

Trends in childhood injury mortality in Canada, 1979–2002

OBJECTIVE: To examine national trends in mortality rates for injuries among Canadian children younger than 15 years in 1979-2002. METHODS: Data on injury deaths were obtained from the Canadian Vital Statistics system at Statistics Canada. Injuries were classified using the codes for external cause of injury and poisoning (E-codes) by intent and by mechanism. Mortality rates were age adjusted to the 1990 world standard population. Negative binomial regression was used to estimate the secular trends. RESULTS: Annual mortality rates for total and unintentional injuries declined substantially (from 23.8 and 21.7 in 1979 to 7.2 and 5.8 in 2002, respectively), whereas suicide deaths among children aged 10-14 showed an increasing trend. All Canadian provinces and territories showed a decreasing trend in mortality rates of total injuries. Motor vehicle related injuries were the most common cause of injury deaths (accounted for an average of 36.4% of total injury deaths), followed by suffocation (14.3%), drowning (13.5%), and burning (11.1%); however, suffocation was the leading cause for infants. The number of potential years of life lost due to injury before age 75 decreased from 89 343 in 1979 to 27 948 in 2002 for children aged 0-14 years. CONCLUSIONS: During the period 1979-2002, there were dramatic decreases in childhood mortality for total injuries and unintentional injuries as well as various degrees of reduction for all causes of injury except suffocation in children aged 10-14 years and drowning in infants. The reason for the reduction in injury mortality might be multifactoral.     

Bunk bed-related injuries sustained by young children treated in emergency departments in the United States, 2001-2004, National Electronic Injury Surveillance System - All Injury Program.

OBJECTIVE: To characterize children's bunk bed-related injuries. METHODS: Data are from the 2001-2004 National Electronic Injury Surveillance System - All Injury Program. Cases were defined as children aged 0-9 years treated for a non-fatal, unintentional injury related to a bunk bed. RESULTS: An estimated 23 000 children aged 0-9 years were treated annually in emergency departments for bunk bed fall-related injuries, including 14 600 children aged <6 years. Overall, 3.2% were hospitalized. The injuries sustained were largely fractures, lacerations, contusions and abrasions, and internal injuries, with 25.2% injured in a fall from the top bunk. The most commonly injured body region was the head and neck. CONCLUSIONS: Strategies are needed to reduce the most serious injuries. Bunk beds should meet CPSC standards, and the youngest children should not sleep or play in the upper bunk or on ladders. Making care givers aware of the risks, and modifying the living environment are essential.     

Nationwide study of injury‐related deaths among children aged 1–4 years in China, 2000–2008

Aims: The aims of this study are to investigate injury mortality in children aged 1–4 years, to analyse prevalent mortality rates of childhood injury and to identify the leading causes of child injury deaths in China from 2000 to 2008. Methods: The data were obtained from a nationwide mortality surveillance system for children under 5 years of age in China. The injury mortality rates of children aged 1–4 years were compared between rural and urban areas, boys and girls and among five major injury types between 2000 and 2008. Results: During the 9‐year study period, the injury mortality rates for children aged 1–4 years declined significantly by an average of 5.4% each year (P < 0.001; 95% confidence interval (CI): 3.6–7.0%) overall in China, with a decrease of 4.8% (P < 0.001; 95% CI: 2.5–7.1%) and 9.9% (P < 0.001; 95% CI: 4.9–14.7%) in rural and urban areas, respectively. The proportion of injury‐related deaths to total mortality rates dropped from 32.9% in 2000 to 18.8% in 2008 in urban areas but increased from 45.6% to 56.9% in rural areas. The injury mortality rates in both boys and girls decreased significantly by an average of 5.4% each year (P < 0.001; 95% CI: 2.6–8.0%) and 6.1% (P < 0.001; 95% CI: 2.7–9.4%), respectively. Drowning and traffic accidents were the most prevalent causes of injury‐related deaths in children aged 1–4 years. Conclusion: Childhood injury is still the leading cause of death in children aged 1–4 years in China. Drowning and traffic accidents were the most prevalent causes of childhood deaths in this study. Boys living in rural areas are at a higher risk and therefore require increased attention to help control and prevent childhood injury.     

Incidence and circumstances of nonfatal firearm-related injuries among children and adolescents.

OBJECTIVE: To describe the incidence and circumstances of nonfatal firearm-related injuries among children and adolescents treated in US emergency departments. DESIGN: Data were obtained from the Firearm Injury Surveillance Study, 1993-1997; data were collected through medical record review at hospitals participating in the National Electronic Injury Surveillance System. SETTING: The hospitals participating in National Electronic Injury Surveillance System are a stratified probability sample of all US hospitals. MAIN OUTCOME MEASURES: Numbers and population rates for nonfatal firearm-related injuries among children and adolescents younger than 20 years old. RESULTS: An estimated 115,131 (95% confidence interval, 76,769-153,493) children and adolescents were treated for a nonfatal gunshot wound during the study period. The estimated annual rates of injury (per 100,000) were 2.0 (children 0-4 years old), 2.2 (children 5-9 years old), 15.4 (children 10-14 years old), and 106.5 (adolescents 15-19 years old). The ratios of nonfatal to fatal firearm-related injuries were 4.0 (children 0-4 years old), 4.4 (children 5-9 years old), 5.0 (children 10-14 years old), and 4.4 (adolescents 15-19 years old). An additional estimated 103,814 children (95% confidence interval, 69,223-138,405) were shot with a nonpowder firearm (BB or pellet gun). Boys 5 to 9 and 10 to 14 years old had the highest rates of injury related to nonpowder firearms, an estimated 36.2 and 99.8 per 100,000, respectively. Fifty-six percent of those 15 to 19 years old were assault victims. An estimated 48% of children and adolescents with powder firearm-related gunshot wounds and an estimated 4% with nonpowder firearm injuries were admitted to the hospital. CONCLUSIONS: Nonfatal injuries related to powder firearms and nonpowder firearms (BB or pellet guns) are an important source of injury among US children and adolescents. Ongoing surveillance of nonfatal firearm-related injury among children and adolescents is needed.     

Childhood injury mortality in Ohio, 1979 to 1986. Setting priorities for prevention

Injury deaths in Ohio children aged 1 to 16 years account for less than 0.5% of all deaths in the state but 6% of all years of life lost before age 65 years. In this study, injury mortality rates were calculated by sex for three age groups (1 to 5, 6 to 11, and 12 to 16 years) and three population groups (metropolitan white, metropolitan nonwhite, and nonmetropolitan). The 15 metropolitan counties were those with a central city of at least a population of 50,000, containing 60% of the state's population. Fire is the leading cause of injury mortality for metropolitan children aged 1 to 5 years, while motor vehicle injuries and drowning are the leading causes for nonmetropolitan children in this age group. Fire is also the leading cause for metropolitan nonwhite children aged 6 to 11 years, while motor vehicle injuries are the leading cause for nonmetropolitan children, and pedestrian injuries are the leading cause for metropolitan white children. For nonmetropolitan and metropolitan white children aged 12 to 16 years, motor vehicle injuries are the leading cause, while for metropolitan nonwhite children homicide is the leading cause. Excess deaths for each cause were estimated by calculating the number of deaths expected for each age group if the rate experienced by the second-lowest population race group had applied to the whole population in that age group, and comparing this with the observed number. Using this approach, highest priority would be placed on prevention of motor vehicle deaths in 12- to 16-year-old nonmetropolitan and metropolitan white children, of fire deaths in metropolitan nonwhite children aged 1 to 11 years, and of drowning deaths in boys aged 12 to 16 years in all three population groups.     

Childhood injuries in an urban area of Ghana A hospital-based study of 677 cases

To the best of our knowledge, there has not been any recent available study of trauma-related hospitalisation of paediatric patients in an urban area of the sub-Saharan countries. Accidental injury, especially among children, has become one of the most serious major health problems facing developing countries, including those in sub-Saharan Africa. We reviewed 677 children admitted to the Komfo Anokye Teaching Hospital in Kumasi, Ghana, from August 1995 to July 1996 to elicit the incidence of various injuries, causes, rates of injury, and survival of children aged 0 to 14 years who had sustained trauma during this period. The most common mechanisms of injury were pedestrian knockdowns (40.0%), falls (27.2%), and burns (17.6%). The annual rate of injury was 230/100 000 children. Boys sustained higher injury rates in all age groups than girls, with an overall rate of, 136/100 000 children as compared to 92/100 000 for girls. Rates of injury were higher for children over 5 years of age in six of the seven specific causes of injury studied. When analysing the region of principal injury, for severe injuries (abbreviated injury scale 3–5) the extremities suffered most, followed by the skin and head. There was increased mortality for patients with an injury severity score >20. The overall mortality for this study was 5.5%. There is, therefore, a need to establish prevention priorities and to design effective prevention strategies for children of school-going age, who are most at risk of sustaining trauma. Accepted: 24 November 1997     

Trends in BB/pellet gun injuries in children and teenagers in the United States, 1985–99

OBJECTIVE: To characterize national trends in non-fatal BB/pellet gun related injury rates for persons aged 19 years or younger in relation to trends in non-fatal and fatal firearm related injury rates and discuss these trends in light of injury prevention and violence prevention efforts. SETTING: The National Electronic Injury Surveillance System (NEISS) includes approximately 100 hospitals with at least six beds that provide emergency services. These hospitals comprise a stratified probability sample of all US hospitals with emergency departments. The National Vital Statistics System (NVSS) is a complete census of all death certificates filed by states and is compiled annually. METHODS: National data on BB/pellet gun related injuries and injury rates were examined along with fatal and non-fatal firearm related injuries and injury rates. Non-fatal injury data for all BB/pellet gun related injury cases from 1985 through 1999, and firearm related injury cases from 1993 through 1999 were obtained from hospital emergency department records using the NEISS. Firearm related deaths from 1985 through 1999 were obtained from the NVSS. RESULTS: BB/pellet gun related injury rates increased from age 3 years to a peak at age 13 years and declined thereafter. In contrast, firearm related injury and death rates increased gradually until age 13 and then increased sharply until age 18 years. For persons aged 19 years and younger, BB/pellet gun related injury rates increased from the late 1980s until the early 1990s and then declined until 1999; these injury rates per 100 000 population were 24.0 in 1988, 32.8 in 1992, and 18.3 in 1999. This trend was similar to those for fatal and non-fatal firearm related injury rates per 100 000 which were 4.5 in 1985, 7.8 in 1993, and 4.3 in 1999 (fatal) and 38.6 in 1993 and 16.3 in 1999 (non-fatal). In 1999, an estimated 14 313 (95% confidence interval (CI) 12 025 to 16 601) cases with non-fatal BB/pellet gun injuries and an estimated 12 748 (95% CI 7881-17 615) cases with non-fatal firearm related injuries among persons aged 19 years and younger were treated in US hospital emergency departments. CONCLUSIONS: BB/pellet gun related and firearm related injury rates show similar declines since the early 1990s. These declines coincide with a growing number of prevention efforts aimed at reducing injuries to children from unsupervised access to guns and from youth violence. Evaluations at the state and local level are needed to determine true associations.