婴幼儿回应性照护评价量表的初步编制与评价

目的 开发适用于评价婴幼儿照护人回应性照护水平的量表,并检验其信效度.方法 以依恋理论为基础,参考国际上回应性照护评估量表,初步构建量表条目,2020年3-5月对2 759名0～4岁儿童家长进行问卷调查,进一步检验量表信效度.采用探索性因子分析与验证性因子分析检验量表的结构效度,长处与困难问卷(SDQ)被用于检测量表的...     

2010至2012年中国东部地区3岁儿童队列龋病监测

 目的   了解我国东部地区儿童3～5岁期间乳牙龋病的流行现况和变化趋势,为改善儿童口腔健康提供科学依据。方法  采用多阶段分层整群抽样方法,抽取我国东部地区北京、上海、广东三省(市)2010年新入园的3岁儿童建立了乳牙龋病监测队列(n=896),连续3年检查队列儿童牙齿状况。结果  本队列随访率为79.8% (n=715)。715名儿童3岁、4岁、5岁时患龋率分别为41.4%、55.0%、63.9%,患龋率逐年增加(Z=-8.535,P<0.05);龋均分别为1.76、2.54、3.31,年均增加0.78颗(F=33.886,P<0.05),每年的显著性龋均指数(significant caries indices,SiC)分别是当年整体龋均的2.9倍、2.6倍、2.4倍。3~4岁、4~5岁龋齿年发病率分别为43.6%、46.9%,2年累积发病率为62.7%。农村儿童累积发病率大于城市儿童(P<0.05),基线患龋儿童2年累积发病率大于无龋儿童(P<0.05)。上颌中切牙、下颌乳磨牙的患病率和发病率均较高。结论  东部地区儿童3~5岁期间患龋率高,发病率高,一级预防应从喂养早期开始;应针对无龋儿童、高患龋水平区域、高患龋水平个体、好发牙位进行综合防治。     

NAFLD: genetics and its clinical implications

Worldwide non-alcoholic fatty liver disease (NAFLD) is recognized as the most common type of liver disease and its burden increasing at an alarming rate. NAFLD entails steatosis, fibrosis, cirrhosis, and, finally, hepatocellular carcinoma (HCC). The substantial inter-patient variation during disease progression is the hallmark of individuals with NAFLD. The variability of NAFLD development and related complications among individuals is determined by genetic and environmental factors. Genome-wide association studies (GWAS) have discovered reproducible and robust associations between gene variants such as PNPLA3, TM6SF2, HSD17B13, MBOAT7, GCKR and NAFLD. Evidences have provided the new insights into the NAFLD biology and underlined potential pharmaceutical targets. Ideally, the candidate genes associated with the hereditability of NAFLD are mainly involved in assembly of lipid droplets, lipid remodeling, lipoprotein packing and secretion, redox status mitochondria, and de novo lipogenesis. In recent years, the ability to translate genetics into a clinical context has emerged substantially by combining genetic variants primarily associated with NAFLD into polygenic risk scores (PRS). These score in combination with metabolic factors could be utilized to identify the severe liver diseases in patients with the gene regulatory networks (GRNs). Hereby, we even have highlighted the current understanding related to the schedule therapeutic approach of an individual based on microbial colonization and dysbiosis reversal as a therapy for NAFLD. The premise of this review is to concentrate on the potential of genetic factors and their translation into the design of novel therapeutics, as well as their implications for future research into personalized medications using microbiota.     

Lifetime risk of cardiovascular disease and life expectancy with and without cardiovascular disease according to changes in metabolic syndrome status

Background and aimsThe relationship between dynamic changes in metabolic syndrome (MetS) status and lifetime risk of cardiovascular disease (CVD) has not been reliably quantified. This study aimed to estimate lifetime risk of CVD and life expectancy with and without CVD according to dynamic MetS status.Methods and ResultsDynamic changes in MetS status were assessed: MetS-free, MetS-chronic, MetS-developed, and MetS-recovery groups. We used Modified Kaplan–Meier method to estimate lifetime risk and used multistate life table method to calculate life expectancy. Participants free of CVD at index ages 35 (n = 40 168), 45 (n = 33 569), and 55 (n = 18 546) years. At index age 35 years, we recorded 1341 CVD events during a median follow-up of 6.1 years. Lifetime risk of 33.9% (95% CI: 26.9%–41.0%) in MetS-recovery group was lower than that of 39.4% (95% CI: 36.1%–42.8%) in MetS-chronic group. Lifetime risk of 37.8% (95% CI: 30.6%–45.1%) in MetS-developed group was higher than that of 26.4% (95% CI: 22.7%–30.0%) in MetS-free group. At index age 35 years, life expectancy free of CVD for MetS-recovery group (44.1 years) was higher than that for MetS-chronic group (38.8 years). Life expectancy free of CVD for MetS-developed group (41.9 years) was lower than that for MetS-free group (46.7 years).ConclusionsRecovery from MetS was associated with decreased lifetime risk of CVD and a longer life expectancy free of CVD, whereas development of MetS was associated with increased lifetime risk of CVD and a shorter life expectancy free of CVD.     

High prevalence of overweight and obesity among inner city Chinese children in Shanghai, 2011

Background: In China, the prevalence of overweight and obesity appears to be increasing at unacceptable levels among young people living in major cities undergoing rapid economic growth.

Objective: To report the prevalence of overweight and obesity among Shanghai inner city youth using the recently published International Obesity Task Force (IOTF) Asian definition.

Methods: Secondary analysis of children aged 8–15 years who participated in the Shanghai Schools’ Physical Fitness Examinations, a representative school-based survey. Height and weight were measured and body mass index (kg/m²) was calculated. The prevalence of overweight and obesity was determined using the IOTF children’s BMI cut-points for Asian populations, equivalent to an adult BMI of 23?kg/m² (overweight) and 27?kg/m² (obese).

Results: The prevalence of combined overweight and obesity was 49.1% for boys and 30.8% for girls aged 8–15-years. Almost one-in-five boys were obese, compared with 8.4% of girls. In boys the prevalence of overweight appeared to increase from age 10 years.

Conclusion: The high prevalence of combined overweight and obesity among urban Chinese youth, especially among boys, requires immediate health promotion intervention.     

四川省凉山州2004至2012年美沙酮受治者队列基本情况及随访影响因素分析

 目的   了解四川省凉山州2004年3月至2012年3月美沙酮门诊受治者的基本情况和随访情况,为凉山地区开展美沙酮门诊维持治疗工作提供依据。方法    以凉山州11个美沙酮维持治疗门诊中所有参加过治疗的9 013例受治者为研究对象,将信息系统中的受治者一般情况、既往吸毒行为和随访情况的数据进行整理,采用描述性分析、单因素分析和多因素Logistic 回归分析等方法进行数据分析。结果    9 013例受治者以彝族男性农民为主,平均年龄(31.17±7.42)岁,84.25%的受治者分布在20~39岁年龄组;已婚有配偶者占73.65%,其次是未婚占21.28%;文化程度以小学为主(44.20%),其次是初中和文盲,高中级以上学历者少。美沙酮门诊受治者首次吸毒年龄(25.12±7.63)岁,美沙酮门诊受治者报告的首次吸毒时间主要为1991年至2011年,2007年至2008年报告例数最多。参加治疗前,99.06%受治者使用的毒品为海洛因,其中47.84%有注射史,36.51%共用注射器,47.70%的人曾经戒过毒。美沙酮门诊受治者6、12、24、36、48、60、72个月随访率分别为45.41%、18.75%、8.98%、3.92%、0.96%、0.28%、0.02%。影响6个月随访率的因素很多,年龄越大(OR=1.20),女性(OR=1.34),已婚有配偶(OR=1.17),文化程度为初、高中(OR=1.31,1.54),民族为汉族(OR=1.28),曾经戒过毒(OR=1.35)的受治者6个月随访率较高;职业为农民(OR=0.80)、首次吸毒年龄为高年龄组的(OR=0.85)和不与父母/亲属同住(OR=0.56)的受治者随访率低。结论   凉山地区吸毒人群低龄化低素质化严重,也影响了美沙酮门诊队列各时间段的随访率,需加强当地美沙酮维持治疗工作。     

上海市青浦区民工子弟学校新生强化免疫前麻疹血清流行病学横断面调查

 目的  掌握上海市青浦区民工子弟学校新生强化免疫前的麻疹免疫水平。 方法  采用多阶段抽样方法,抽取民工子弟学校新生606名,采用定量ELISA测定调查对象血清中的麻疹IgG抗体水平,同时调查就学史、麻疹相关疫苗接种史、麻疹患病史等情况。 结果 民工子弟学校新生强化免疫前麻疹IgG抗体几何平均浓度(geometric mean of concentration,GMC)为998.96 mIU/mL (95%CI,912.93~1093.10),阳性率为94.88%。不同学校类别(幼托、小学、初中)对象的GMC差异无统计学意义(F=1.19,P=0.30),抗体阳性率差异无统计学意义(χ2=0.36,P=0.83);不同就学史(此前无就学史、于户籍地就学、于上海其他学校就学)对象的GMC差异无统计学意义(F=1.22,P=0.30),抗体阳性率差异无统计学意义(χ2=3.46,P=0.18);38.29%调查对象无预防接种证或已经丢失,麻疹相关疫苗接种≥2剂次者占37.95%,接种史不详者占48.18%,不同接种史对象的GMC差异无统计学意义(F=0.75,P=0.53)。 结论  上海市青浦区民工子弟学校新生强化免疫前麻疹抗体水平及抗体阳性率均处于较高水平,但不能提供明确麻疹疫苗接种史是其中一个突出问题,预防接种证的管理和入托/入园、入学接种证查验工作是外来民工子弟学校学生免疫规划工作的薄弱环节。     

上海市学龄前儿童气质特征分析

目的了解上海市学龄前儿童的气质特征,为学龄前儿童的科学教育提供依据。方法采用《3～7岁儿童气质量表》家长评定问卷,对整群抽取的上海市4个城区10所幼儿园的1 082名学龄前儿童进行调查。结果学龄前儿童的气质类型分布为易养型9.6%,中间型70.1%,启动缓慢型10.1%,难养型10.3%。气质类型分布无性别和年龄差异。在活动水平和反应阈2个维度,男童得分高于女童(P值均<0.01);而在心境和注意分散度2个维度,女童得分高于男童(P值均<0.01);不同年龄组男童在趋避性、适应性、反应强度和反应阈等维度的得分差异均有统计学意义(P值均<0.05);女童不同年龄组在活动水平、趋避性和反应强度等维度的得分差异均有统计学意义(P值均<0.05)。与北京1995年常模组相比,上海2011年各年龄组同性别儿童的节律性和心境得分均较高。结论学龄前儿童的气质类型分布以中间型最多,部分气质维度具有年龄差异和性别差异。