Human resources and access to maternal health care.

The lack of human resources is one of the main bottlenecks to achieving the Millennium Development Goals on maternal and child health. A coherent national policy, recognized across government, needs to be in place to overcome this especially in countries severely affected by HIV/AIDS. Such a policy should cover selection of pre-service students, the qualifications of trainers and training sites, supportive supervision, career path development, a package of carefully thought-out incentives for the retention of staff, strategies for interaction with communities, and an agreed-upon health staff HIV/AIDS policy. Without such coherent human resource planning, a large number of countries will fail to reduce maternal and newborn mortality.     

Neuroimaging findings in infantile GM1 gangliosidosis

GM1 gangliosidosis is an autosomal recessive glycosphingolipid storage disease caused by defects in the enzyme beta-galactosidase. Three clinical forms (infantile-, juvenile-, and adult-onset) of the disease are recognized. Patients with infantile GM1 gangliosidosis present at birth or shortly thereafter with somatic and bony changes, followed by severe neurological deterioration ultimately leading to death within the first 2 years of life. We present the brain CT, MRI and MR spectroscopy (MRS) findings in a 17-month-old Turkish girl with infantile GM1 gangliosidosis. Neuroimaging findings in patients with infantile GM1 gangliosidosis have been reported only in a few cases. In this study, MRS of the thalamus was performed to study the metabolic changes in GM1 gangliosidosis. We showed a a decreased NAA/Cr ration and an increased Cho/Cr ratio. To our knowledge, this is the first report of magnetic resonance spectroscopy findings in type-1 GM1 gangliosidosis.     

应变率成像对正常儿童左心室心肌形变能力的定量研究

目的 定量研究我国正常儿童左心室心肌应变率参数及其随年龄变化的特点。方法 正常儿童92名,按年龄分为4组,应用GEVivid7超声仪及Q-analyze软件分别对各组儿童左心室侧壁、下壁、前壁、后壁及前、后室间隔心肌各节段进行应变率定量分析。结果 前3组（1～9岁）儿童左心室心肌应变率在各节段的分布不一致,差异有统计学意义;10～14岁组左心室心肌各节段收缩期和舒张早期应变率差异无统计学意义,呈均衡分布。结论 正常儿童左心室心肌各节段收缩期、舒张早期应变率随年龄增长逐渐趋向一致,10岁后分布模式与成人相似。     

利妥昔单抗治疗难治性激素耐药型肾病综合征的疗效和安全性

目的:探讨利妥昔单抗(RTX)治疗儿童难治性激素耐药型肾病综合征(SRNS)的疗效和安全性。方法:回顾性分析2013年9月至2018年3月东部战区总医院儿科收治并接受RTX治疗的10例难治性SRNS患儿的临床资料。结果:10例患儿发病年龄(4.47±2.75)岁,男女各5例;5例(50%)肾活检为局灶节段性肾小球肾炎,...     

头体针联合治疗小儿抽动秽语综合征25例

目的 针刺与单纯服用西药治疗小儿抽动秽语综合征的临床疗效差别。方法 针刺组采用辨证选取穴,西药组采用氟哌啶醇口服。结果 针刺组25例,有效率为93％,西药组24例,有效率为82％。结论 针刺治疗小儿抽动秽语综合征疗效满意。     

小儿胸膜肺母细胞瘤临床特点及病理分析

目的探讨小儿胸膜肺母细胞瘤（pleuro．pulmonaryblastoma,PPB）的临床特点、病理学特征及早期诊治方法。方法对4例反复咳嗽,x线及CT检查发现胸腔内巨大占位性病变患儿的临床特点进行分析,l例放弃治疗,3例手术切除,病理学检查及免疫组化染色确诊为PPB,结合文献进行分析。结果肿瘤组织由原始胚胎小圆细胞及梭形细胞组成,核圆形或卵圆形,部分细胞呈巢状分布,原始细胞胞质空泡状,核深染,可见明显核分裂现象。免疫组化Vimentin（＋）,Desmin（＋）。结论 小儿胸膜肺母细胞瘤是罕见的肺间质恶性肿瘤,临床表现不典型,预后差,病理学检查和免疫组织化学检查有助于诊断,应及早完全手术切除,必要时辅以术后化疗。     

Prevalence and related factors of child posttraumatic stress disorder during COVID-19 pandemic: A systematic review and meta-analysis

BackgroundThe COVID-19 pandemic has drastically impacted many aspects of society and has indirectly produced various psychological consequences. This systematic review aimed to estimate the worldwide prevalence of posttraumatic stress disorder (PTSD) in children due to the COVID-19 pandemic, as well as to identify protective or risk factors contributing to child PTSD.MethodsWe conducted a systematic literature search in the PubMed, ProQuest, PsycINFO, Embase, Web of Science, WanFang, CNKI, and VIP databases. We searched for studies published between January 1, 2020 and May 26, 2021, that reported the prevalence of child PTSD due to the COVID-19 pandemic, as well as factors contributing to child PTSD. Eighteen studies were included in our systematic review, of which 10 studies were included in the meta-analysis.ResultsThe estimated prevalence of child PTSD after the COVID-19 outbreak was 28.15% (95% CI: 19.46–36.84%, I ² = 99.7%). In subgroup analyses for specific regions the estimated prevalence of post-pandemic child PTSD was 19.61% (95% CI: 11.23–27.98%) in China, 50.8% (95% CI: 34.12–67.49%) in the USA, and 50.08% in Italy (95% CI: 47.32–52.84%).ConclusionsFactors contributing to child PTSD were categorized into four aspects: personal factors, family factors, social factors and infectious diseases related factors. Based on this, we presented a new framework summarizing the occurrence and influence of the COVID-19 related child PTSD, which may contribute to a better understanding, prevention and development of interventions for child PTSD in forthcoming pandemics.     

Lower-Income Predicts Increased Smartphone Use and Problematic Behaviors Among Schoolchildren During COVID-19 Related School Modification: A Longitudinal Study

BackgroundAs the coronavirus disease 2019 (COVID-19) has continued for a couple of years, the long-term effects of the pandemic and the subsequent school curriculum modification on the mental health of children and parents need to be investigated. To clarify the changes that can occur during one school year and to predict the risk factors for vulnerable groups, this study identified parameters relative to children’s screen time, their problematic behavior, and parental depression.MethodsA total of 186 participants were analyzed who were parents of elementary schoolchildren in South Korea. These parents were required to complete a web-based questionnaire twice. The questionnaires were conducted in June 2020 and September 2021. Participants’ general demographics including family income, children’s screen time, sleep patterns, problematic behavior, and parental depression were assessed via the parental questionnaire that included various measurement tools.ResultsChildren’s body mass index (BMI) increased significantly in 2021 (18.94 ± 3.75 vs. 18.14 ± 3.30, P < 0.001). Smartphone frequency of use per week (5.35 vs. 4.54, P < 0.001) and screen time per day (3.52 vs. 3.16, P < 0.001) significantly increased during the period of the COVID-19 pandemic. The television screen time (2.88 vs. 3.26, P < 0.001), frequency of viewing (3.77 vs. 4.77, P < 0.001), and children’s problematic behaviors significantly decreased (9.15 vs. 11.85, P < 0.001). A lower income household was a key predictor of increased smartphone frequency (B = 1.840, 95% confidence interval [CI], 0.923–2.757, P < 0.001) and smartphone screen time (B = 1.992, 95% CI, 1.458–2.525, P < 0.001). The results showed that the lower income household (B = 5.624, 95% CI, 2.927–8.320, P < 0.001) and a child’s psychiatric treatment history (B = 7.579, 95% CI, 5.666–9.492, P < 0.001) was the most significant predictor of problematic behaviors of children and parental depression (B = 3.476, 95% CI, 1.628–5.325, P < 0.001; B = 3.138, 95% CI, 1.827–4.450, P < 0.001).ConclusionThis study suggested that children’s smartphone screen time and BMI increased during COVID-19 because of the school curriculum modification following school closures in South Korea. The increased children’s problematic behaviors and parental depression were predicted by lower-income households and the previous psychiatric history of children. These results indicate that multiple social support systems to the vulnerable group are needed during the ongoing pandemic and that a modified school setting is required.     

基于人工智能的骨龄辅助评价系统对四川地区完全性生长激素缺乏症患儿骨龄研究

目的 探讨采用基于“人工智能(AI)的骨龄辅助评价系统(上海初云医疗科技有限公司与四川大学华西第二医院合作开发)”(以下简称为AI系统)对完全性生长激素缺乏症(CGHD)患儿诊断及骨龄评价准确性。方法 选择2014年7月至2019年11月,于四川大学华西第二医院确诊的66例来自四川地区CGHD患儿为研究对象,纳入研究组。选择同期于病例收集医院儿童保健科进行骨龄测定的67例来自四川地区身高达标儿童作为对照,纳入对照组。对每例受试儿进行左手腕关节正位X射线摄片骨龄测定,由2位医师采用《TW₂骨龄评分法中国未成年人南方标准》(以下简称为TW₂CHN)》与《TW₃骨龄评分法标准》(以下简称为TW₃),盲法评价受试儿TW₂CHN-桡、尺、掌指骨(RUS)与TW₂CHN-腕骨(carpal)、TW₂CHN-20、TW₃-RUS及TW₃-carpal骨龄(以下简称为5种传统骨龄),以及以同性别、年龄身高达...     

小儿尿道下裂尿道板组织中雌激素受体及微血管密度的表达及临床意义

目的 探讨尿道下裂患儿尿道板组织和尿道部皮肤组织中雌激素受体(ER)和微血管密度(MVD)的表达及意义.方法 选取2013年6月-2015年1月天津儿童医院收治的尿道下裂手术患儿30例,术中分别取部分尿道板和尿道部皮肤组织,检测不同组织中ER及MVD的表达及分布情况.结果 2组均检测到ER及MVD的表达.尿道板组织与尿道部皮肤组织中ER表达水平比较差异无统计学意义(P＞0.05),尿道板组织中MVD低于尿道部皮肤组织(P＜0.05).结论 尿道板组织和尿道部皮肤组织ER含量接近,可能与尿道发育异常有关;尿道板组织中存在微血管分布,为保留尿道板的尿道成形术提供了理论依据;尿道板组织内MVD显著降低,可能为术后发生尿瘘的原因之一.