小儿先天性巨结肠42例手术疗效分析

手术治疗小儿先天性巨结肠４２例，其中Ｄｕｈａｍｅｌ术９例，Ｓｗｅｎｓｏｎ术１１例，Ｓｏａｖｅ术６例，Ｒｅｈｂｅｉｎ术１０例，直肠后壁肌切除４例，直肠肛管纵切心形斜吻合术２例。术后污粪、便秘、小肠结肠炎及肛门狭窄发生率２１％。认为：手术疗效是与术前充分准备，选择适宜术式，术中精细操作，术后加强护理，精心喂养等直接相关     

Abnormalities in visceral evoked potentials from the anal canal in children with chronic constipation

The integrity of the sensory nervous system in the anal canals of chronically constipated children was investigated using evoked potential techniques examining cerebral and spinal evoked potentials from the lower extremities and anal canal. Stimulation of the posterior tibial nerve produced no significant difference in the parameters of spinal and cerebral evoked potentials between 18 controls and 12 chronically constipated chidren. However, stimulation of the anal canal resulted in evoked potentials related to the age and/or consciousness level of the control children. Reproducible cerebral responses were obtained only from nine of these control children, all aged over 4 years, who were examined while awake without sedatives. A typical response was characterized by a polyphasic wave occurring with an onset latency of 79.4± 27.7ms (mean ±SD). In the 12 chronically constipated children, the 5 sedated patients examined while asleep did not show any reproducible potential, as in the controls. However, in the remaining 7 children examined while awake, the occurrence of the anal canal evoked potential was significantly reduced, and only two exhibited a cerebral response. These findings suggest that rectal mucosal perception of the intraluminal stimuli might be disturbed in some children with chronic constipation.     

乳牙釉质表面氟浓度与患龋状况的关系

目的 探讨牙齿不同部位之间、易患龋牙与非易患龋牙之间牙釉质表面氟浓度有无差异。方法 收集上海、北京和深圳3个地区儿童的下颌乳中切牙45颗,并利用微样酸蚀法分析乳牙釉质表面氟元素的分布。结果 氟浓度从釉质表面到内部有由高到低的变化趋势,牙磨耗是牙齿丧失氟的重要元素,未发现釉质表层氟浓度与龋蚀指数(CSI)、龋补牙数(dft)有相关性(P>0.05)。结论 乳牙釉质表面氟浓度与患龋状况无明显相关性。     

67Ga心肌炎症显像对小儿病毒性心肌炎的诊断价值

目的 :探讨6 7Ga心肌显像对小儿病毒性心肌炎 (VMC)诊断的临床价值。方法 :静脉注射6 7Ga 枸橼酸盐 ,48h、72h后开始显像 ,观察心脏部位放射性浓聚情况 ,并计算心 /肺 (H/L)指数 ,根据H/L指数判断心肌炎性病变的严重程度 (H/L指数 >1.2为阳性 )。结果 :78例病毒性心肌炎患儿中 ,50例阳性 (占 64% ) ,其中急性期阳性率为 84% ,恢复期阳性率为 50 % ,慢性期为 2 9% ,急性期阳性率明显高于恢复期和慢性期 (P<0 .0 5)。结论 :心肌6 7Ga放射性浓聚与心肌炎病变程度呈正相关 ,直接反映了病变心肌的炎症反应情况 ,对诊断VMC有较高的临床价值 ,并对VMC治疗、预后有指导作用     

A prospective study of allergy development in 158 children and 128 adults with new extensive exposure to furred animals

BACKGROUND: There is still controversy over whether exposure to furred animals increases or decreases the risk of developing sensitization and allergic symptoms to such animals, and there is a need for further knowledge on this subject. OBJECTIVE: The aim of this study was to follow allergy development in relation to new extensive exposure to furred animals in adults and children. METHODS: A total of 286 individuals, 128 parents and 158 children, were recruited from 68 families who intended to buy a dog or a cat, or where one child of the family intended to start riding a horse. Subjects were examined before the new allergen exposure and once a year thereafter for 5 years, in all at six occasions, and they also completed questionnaires covering allergy symptoms. Serum IgE antibodies to cat, dog and horse were determined each year, and fur allergens from beds and living rooms were analysed. RESULTS: Two-hundred and fifty-six study subjects remained for evaluation, 37 of whom showed signs of allergic sensitization at the start of the study. Four children (11%) in this pre-sensitized group developed IgE antibodies to their new animal and six (16%) to another animal. Among the 219 participants who were not sensitized when entering the study, one male adult (0.4%) developed a sensitization to his new animal, and nobody developed sensitization to other animals. Pre-sensitized individuals had significantly more allergic symptoms at the study start, but the symptom scores did not change over time. CONCLUSIONS: When the first year of a human's life has passed, we have no strong evidence to recommend avoidance of a domestic animal in order to prevent new allergy development, even if there are known allergies in the family or if the individual is sensitized and has allergic symptoms to another allergen. Five years exposure to new fur allergens does not seem to influence sensitization to these animals in either sensitized or non-sensitized children and adults.     

Noonan syndrome associated with central giant cell granuloma

We report a case of Noonan syndrome associated with central giant cell granuloma. The patient was a 101/2-year-old boy with the chief complaint of proptosis of the right eye. He also had various malformations such as short stature, webbed neck, pectus excavatum, cubitus valgus, pulmonary valve stenosis and patent foramen ovale, a characteristic face appearance and cryptorchidism and so on. Chromosome analysis showed a 46, XY karyotype. A computed tomographic scan and magnetic resonance imaging showed a mass originated from the lateral wall of the right maxillary sinus. The patient underwent Caldwell-Luc operation. Histological examination of the mass showed the characteristics of central giant cell granuloma. This case report describes a patient with the features of the recently described Noonan-like/multiple giant cell lesion syndrome.     

Do insecticide-treated curtains reduce all-cause child mortality in Burkina Faso?

To evaluate whether insecticide-treated netting (ITN) reduces child mortality in different epidemiological settings, 4 large, randomized, controlled trials were conducted in Africa. Here we report the findings from the trial in Burkina Faso, in an area of hyperendemic and markedly seasonal malaria transmission. The trial involved 158 villages, with a total population of some 90,000, grouped into 16 geographical clusters. Ascertainment of mortality among children aged 6–59 months began in early 1993. In June/July 1994, 8 of the clusters, randomly selected, received permethrin-treated curtains. Follow-up of children and ascertainment of mortality continued until May 1996. A 15% reduction in all-cause mortality among children aged 6–59 months was observed over the 2-year period following the installation of the curtains (95% c.i. – 4% to 30%). In the first year, post-intervention mortality was substantially lower in the clusters receiving curtains compared with the control clusters (rate ratio = 0.74; 95% c.i. 0.57, 0.95) but in the second year, there was no difference between mortality in the two groups (rate ratio = 0.99). The overall two-year impact of the intervention is consistent with the impacts observed in other trials which have demonstrated reductions in child mortality of from 17% to 33%. However, the year-by-year analysis raises some concerns about the long-term effect of ITN. Further follow-up of this population is warranted.     

自动化分析仪同时测定血清12项生化指标的正常值

本文将生化自动分析仪应用于健康检诊中,就其中1089名健康者的血清进行12项生化指标的检测,并对测得的结果进行分析整理,确定国人的正常值范围。同时又对自动分析仪的质量管理进行了探讨。     

MANIPULATION OF CHILDREN'S EATING PREFERENCES

Giving foods as rewards can enhance consumption of those foods, while giving rewards to induce consumption of foods can decrease subsequent consumption of those foods.     

影响注意缺陷多动障碍患儿就诊因素的分析

目的分析探讨影响注意缺陷多动障碍（ADHD）患儿延迟就诊的因素。方法采用家庭环境量表（FES-CV）及自编简明就诊因素问卷对68例ADHD患儿的家长进行调查评定，分析影响延迟就诊的相关因素。结果61例患儿完成调查。所有因素经多元线性逐步回归分析，3个自变量差异具有统计学意义，分别为分型（Beta值：-0．449），接触知识（Beta值：0．369），父亲文化（Beta值：-0．268）。结论影响患儿就诊时间延迟的因素有3种情况，其顺序如下：（1）ADHD的注意缺陷型；（2）家长缺乏儿童心理卫重知识；（3）父亲的文化程度低。