400例独生子女病残儿鉴定分析与二胎儿随访

１９８１年１１月－１９９４年１２月，我院共鉴定独生子女病残儿４００例。除１０例未发现明显异常外，余下的疾病有百余种，大致分了七类，神经系统疾病２００例（５０％），其中智力低下（ＭＲ）１７４例，又占神经系统疾病中的８７％，说明ＭＲ已是当前引致小儿残疾的主要疾患。先天性遗传性疾病２１５例，占了总数的５３．７５％，说明加强优生与孕期保健工作的重要性。作者对可生育二胎者随机随访了５４例，３６例（６６．７％）已生育了二胎，大部小儿生长健康，仅２例异常，１例６个月死于心肌炎，另一例为出生低体重（２２５０ｇ），似乎与第一胎之残疾关系不大。说明病残儿医学鉴定小组的监护对第二胎的出生质量是至关重要的。     

高电压胸部摄影诊断和防护效果研究

作者以体模实验为基础。测定了不同管电压拍摄胸片时的病人剂量，考察了提高管电压对胶片影像质量的影响，结果表明，使用高电压拍摄胸片比使用低电压有利于降低病人剂量，在增加影像信息量，提高肋骨阴影区和纵膈区灶检出率方面更有较大优越性，此外，使用高电压技术不家利于延长Ｘ射线管的使用寿命。     

Respiratory health status in swine producers using respiratory protective devices

A cross-sectional survey on respiratory health in swine producers showed that 30% of 301 examined men usually used a dust mask when working inside a barn. They did not differ significantly from dust mask nonusers in respect to respiratory symptoms and lung function. This analysis was undertaken to determine whether the respiratory health of dust mask users was associated with reasons why they had started individual respiratory protection. The subjects were recontacted in order to identify those who started using a mask to deliberately prevent symptoms (42 men) and those who started protection because of pre-existing respiratory symptoms (44 men). Not unexpectedly, betweengroup comparisons of respiratory symptoms and lung function suggest that swine producers who wear dust masks for preventive purposes have better respiratory health than those who wear dust masks because of symptoms or those who do not use individual respiratory protection. The individual reasons for starting dust mask usage should be examined among potential determinants of the outcomes of prospective studies which can then provide more valid assessment of the effect of individual respiratory protection. © 1993 Wiley-Liss, Inc.     

An analysis of the deep social structure preventing the development of a national policy for children and families in the United States

The United States is one of the few economically developed nations without a national policy supporting children and their families. This paper suggests that the United States has a unique national ideology, based on the “Calvinistic Ethic,” which results in opposition to not only social programs for children and families, but to all government supported welfare programs. Such an ethic is not found in European countries. Finally, since the United States does not have a national family policy, millions of children and their families go without health care, lack social services, and suffer from inadequate economic supports.     

低位无肛术术中完整保留瘘口组织的必要性和可行性

目的探讨低位肛门直肠畸形术术中保留瘘口组织的必要性和可行性。方法对67例无肛前庭及会阴瘘患儿的临床资料进行回顾性分析。其中女童无肛前庭瘘59例,男童无肛会阴瘘8例。年龄3个月~16岁,平均10个月。患儿多以排便困难或肛门位置异常就诊。4例无肛前庭瘘患儿曾在婴儿期行瘘口后切术。患儿均采用完整保留瘘口的前矢状入路肛门成形术治疗。结果患儿术后3及6个月常规来院复诊,最长随访8年。65例(97.0%)患儿会阴部矢状切口一期愈合,会阴及肛门外观良好;另2例(男、女各1例)术中直肠破损患儿,自修补处穿孔导致会阴部矢状切口感染(占直肠破损修补术的40%),最终形成直肠会阴瘘,但肛门外观良好。67例均采用肛门功能临床评分标准评估患儿排便功能,64例(95.5%)患儿排便功能良好,总评分为5~6分;另3例(男1例,女2例)顽固便秘,需开塞露协助排便。结论低位无肛术中完整保留瘘口组织非常必要。     

构建和谐团队打造诚信医院

探讨医院管理、发展问题.通过综合分析医疗和医院管理工作的实际,提出构建和谐团队,打造诚信医院.     

Psychiatrists' Use of Melatonin with Children

Background:  Melatonin is gaining popularity as a sedative agent with children. This study sought to characterise this practice more precisely as well as examine aspects of its safety and efficacy in order to develop treatment guidelines.
Method:  Postal surveys of two groups of psychiatrists: generic child psychiatrists and psychiatrists who regularly treat learning disabled children.
Results:  Both groups (all of the specialists and 81% of the non-specialists) reported regular but not frequent use of melatonin in their usual practice, mostly for night-settling sleep problems refractory to behavioural modification strategies, commonly in the context of neurodevelopmental disability (especially autism). Treatment was described as being 'usually successful' and side-effects were highly infrequent and mild in nature. Variations in most prescribing practices were identified (dosage, timing).
Conclusions:  Melatonin appears to represent a useful and relatively safe drug when used in specific circumstances; however, the evidence-base underpinning its use, particularly over the long-term, remains modest. Thus caution and clinical audit of practice is required.     

滤网式脑保护装置下颈动脉狭窄支架置入术的临床研究

目的探讨颈动脉支架置入术中滤网式脑保护装置的有效性及安全性。方法19例颈动脉狭窄患者在滤网脑保护装置下使用自膨胀支架行颈动脉支架置入术。观察脑栓塞的发生和所回收的过滤网。术后短期随访。结果19例滤网式脑保护装置下颈动脉支架置入术均成功实施,回收的过滤伞中8个发现组织碎片,无手术死亡及症状性脑梗塞并发症。临床短期随访无脑缺血发生。结论脑保护装置下支架置入术治疗颈动脉狭窄是安全和有效的。     

轻度贫血对学龄儿童体力工作能力的影响

本文报告29对轻度贫血和非贫血儿童在平板机运动试验条件下的最大运动耐受时间,耗氧量、心率和运动后血乳酸浓度。结果表明,轻度贫血组儿童最大耐受时间、最大耗氧量均低于非贫血组。运动后血乳酸高于非贫血组。经一个月补铁治疗后,贫血组最大耐受时间提高0.9分钟,血乳酸降至非贫血组水平,但最大耗氧量无显著性变化。由此说明轻度贫血对学龄儿童体力工作能力有一定的影响。     

Pediatric lung transplantation: Literature review 2005

This review summarizes important original articles in the field of pediatric lung transplantation that were published in 2005. The review is intended to be comprehensive, but not exhaustive.