癫痫儿童认知学习能力的研究

目的:探讨癫痫儿童的认知学习状况。方法:采用学习障碍筛查量表(PRS)测量60例癫痫儿童和60例健康对照,并用丹麦维迪Keypoint诱发电位仪检测其事件相关电位P300。结果:①癫痫儿童PRS量表总分、言语得分及非言语得分均较正常儿童降低,差异有显著性(P<0.01);②癫痫儿童P300潜伏期较正常儿童延长,差异有显著性(P<0.01);③全面性发作组与部分性发作组比较,P300与PRS量表均未见显著性差异(P>0.05)。结论:本研究表明癫痫儿童存在学习障碍,PRS量表与P300可从不同角度反映癫痫儿童的认知学习状况。     

Assessment of quality of life in children with peanut allergy

Children with a peanut allergy (PA) are faced with food and social restrictions due to the potentially life-threatening nature of their disease, for which there is no cure or treatment. This inevitably impacts upon their quality of life (QoL). QoL of 20 children with PA and 20 children with insulin-dependent diabetes mellitus (IDDM) was measured using two disease-specific QoL questionnaires (higher scores correspond to a poorer QoL). One questionnaire was designed by us and the other was adapted from the Vespid Allergy QoL questionnaire. We gave subjects cameras to record how their QoL is affected over a 24-h period. Response rates for both questionnaires were 100%. Mean ages were 9.0 and 10.4 years for PA and IDDM subjects, respectively. Children with a PA reported a poorer quality of life than children with IDDM: mean scores were 54.85 for PA subjects and 46.40 for diabetics (p = 0.004) in questionnaire 1 and 54.30 and 34.50 (p≤0.001) in questionnaire 2. PA children reported more fear of an adverse event and more anxiety about eating, especially when eating away from home. Photographs fell into seven common categories: food, management, environment, away from home, physical activities, restaurant and people. Most photographs related to food and management issues and revealed difficulties for both groups regarding food restrictions. PA subjects felt more threatened by potential hazards within their environment, felt more restricted by their PA regarding physical activities, and worried more about being away from home. However, they felt safe when carrying epinephrine kits and were positive about eating at familiar restaurants. The QoL in children with PA is more impaired than in children with IDDM. Their anxiety may be considered useful in some situations, promoting better adherence to allergen avoidance advice and rescue plans.     

Dorsal inlay graft urethroplasty for primary hypospadiac repair

OBJECTIVE: Tubularized incised plate urethroplasty has become a popular technique for repairing distal and proximal hypospadias in many institutions. Dorsal inlay graft urethroplasty has been used in our institution since 2003 to reduce the risk of meatal stenosis. In the present study, we evaluated the results of the dorsal inlay graft procedure. METHODS: A total of 28 patients with no deep groove and no severe curvature underwent one-stage urethroplasty using an inner preputial-based dorsal inlay graft. The medical records of all patients were retrospectively reviewed with regard to complication rate and cosmetic appearance. RESULTS: Mean patient age at surgery was 21 months (range, 14 months to 4.6 years). Preoperatively the urethral meatus was coronal in two cases, distal shaft in 17, proximal shaft in six and penoscrotal in three. Nine patients required testosterone therapy before surgery. Mean operative time was 200 min (range, 154-249 min). Mean length of inlay graft was 20.9 mm (range, 12-30 mm). In all patients, a straight penis was achieved without dorsal plication of the corposa cavernosa, and the neomeatus with a slit-like appearance was positioned at the glans tip. At a mean of 22 months of follow up, a urethrocutaneous fistula developed in only one patient (3.6%), requiring repair surgery 6 months after urethroplasty. No patient had meatal stenosis, neourethral stricture or urethral diverticulum along the inlay graft. CONCLUSION: Dorsal inlay graft urethroplasty is an effective method for hypospadiac repair and leads to good cosmetic outcome with low risk of complications.     

94例有肺外并发症的儿童肺炎支原体肺炎临床分析

目的探讨肺炎支原体肺炎（myeoplasma pneumoniae pneumonia，MPP）临床、肺外并发症和诊治。方法对94例确诊为MPP患儿进行回顾性分析。结果发病多集中在学龄前及学龄儿童，3～10岁55例（58．4％），发热69例（73．4％），持续性咳嗽80例（85．1％），多数肺部可闻及干啰音，胸片呈斑点状阴影41例，呈阶段性肺炎26例，呈间质性损害16例，表现肺门影增浓11例，大多患者（84．0％）外周血白细胞总数正常，血红蛋白低于正常值29例，全部病例均有肺外并发症，72例静脉使用红霉素，后改阿奇霉素口服治疗，47例痊愈。结论MPP好发学龄前及学龄儿童，其肺外并发症常见，红霉素、阿奇霉素序贯治疗安全、疗效满意。     

NOS1 polymorphism is associated with atopy but not exhaled nitric oxide levels in healthy children

Exhaled nitric oxide (FE_NO) is raised in atopy. The mechanism for this is unclear. The aim of this study was to investigate whether the number of AAT repeats in intron 20 of the NOS1 gene, recently associated with variations in FE_NO in adults with asthma and cystic fibrosis, was associated with the raised FE_NO in healthy atopic children. Eighty-seven healthy children (44 girls, 42 atopic, age range 6–18 years) underwent measurements of FE_NO, spirometry, airway responsiveness and skin prick testing. Genotyping was carried out to determine the number of AAT repeats. There was no association between the number of AAT repeats and FE_NO in either the whole sample of healthy children (n = 87) or in the subsample of healthy atopics (n = 42). However, a greater number of atopic children had two high repeat alleles compared with non-atopic children (33.3% vs. 13.6%, respectively, p = 0.03). This suggests that variations in the NOS1 gene may contribute to atopy without this relationship being reflected by FE_NO.     

Circulating adipocytokines in non-diabetic and Type 1 diabetic children: relationship to insulin therapy, glycaemic control and pubertal development.

AIM: To determine the influence of Type 1 diabetes mellitus on circulating adipocytokines in children. METHODS: The circulating concentrations of leptin, adiponectin, resistin and tumour necrosis factor (TNF)-alpha were measured in 91 children, aged 11.1 +/- 2.7 years, with Type 1 diabetes mellitus (T1DM). Ninety-one healthy children were selected as control subjects. RESULTS: Body mass index-adjusted leptin concentrations were higher in the pubertal diabetic children compared with the control children. There was a significant positive correlation between leptin and daily insulin dose in the diabetic group. Circulating adiponectin concentrations were higher in the prepubertal diabetic children and were positively associated with HbA(1c). Resistin concentrations were lower in the prepubertal non-diabetic subjects compared with the pubertal non-diabetic children, whose values were higher than those of the diabetic children. TNF-alpha concentrations were similar in non-diabetic and diabetic children. CONCLUSIONS: Circulating concentrations of adipocytokines are abnormal in Type 1 diabetic children, although the direction of change differs by cytokine. Pubertal development, in addition to insulin treatment and glycaemic control, also influences the concentrations.     

运用反应时探究小学生情绪认知发展特点

目的：探究小学儿童情绪认知的发展特点。方法：采用计算机实验方法和反应时评价指标，运用80对情绪词汇推测小学儿童对四个不同类别情绪（基本积极情绪、基本消极情绪、积极自我意识情绪、消极自我意识情绪）的认知发展差异，以及对引发情绪的原因、情绪的外在行为反应、情绪的后继调节三个维度的认知发展差异。结果：小学儿童对引发情绪的原因、外在行为反应、后继调节三个维度的反应时差异有统计学意义（1289．5、1164．6、1295．7，F=13．535，P〈0．001），且三个维度认知反应时2年级学生均长于4、6年级（P〈0．01），对四个不同类别情绪认知的反应时差异无显著性（1237．1、1269．8、1222．8、1305．2，F=1．520，P=0．220），四个类别的情绪认知反应时2年级均长于4、6年级（P〈0．01）。结论：儿童对情绪行为认知的加工速度最快，对消极自我意识认知的发展相对较慢，且均在2—4年级间发展迅速。     

Caries experience and fluorosis prevalence in Chilean children from different socio-economic status

Abstract Caries experience and enamel fluorosis prevalence in 8-year-old children belonging to different socio-economic classes were determined in two Chilean twin cities that are served by optimally fluoridated community water from the same waterworks facility. Low socio-economic status (LSES) children had a higher mean dm ft and DMFT indices (P<0.001) than high socioeconomic status (HSES) children. Prevalence of enamel fluorosis in the permanent teeth of LSES children was 0.79, significantly higher (X²= 9.0; P<0.003) than the value 0.59 found in HSES children. The proportion of Dean's scores 2. 3, 4 and 5 in first molars, mandibular and maxillary incisors in LSES children was higher than in HSES children (P<0.001). Differences in prevalence and seventy of enamel fluorosis between both groups are tentatively attributed lo a different pattern of tap water and tea consumption at pre-school ages. Suggestions are advanced to minimize the undesirable prevalence and severity of enamel fluorosis.