应用丹佛发育筛查法评价婴幼儿发育状况

目的 评价婴幼儿发育状况。方法 抽取苏州地区1岁以内小儿602名，应用丹佛发育筛查法进行测查，并评价其发育状况。结果 近20个项目的通过率明显高于量表通过率，语言、个人-社交能区尤为明显。结论 小儿发育呈发育提前的趋势，各功能区发育不平衡。     

Spread of extended-spectrum β-lactamase genes of bla OXA-10, bla PER-1 and bla CTX-M in Pseudomonas aeruginosa strains isolated from burn patients

BackgroundPseudomonas aeruginosa is resistant to many antibiotics due to production of different classes of extended spectrum β-lactamases (ESBLs). Prevalence of ESBLs among P. aeruginosa has been increased in recent years, demonstrate a serious health problem especially in burn units worldwide.ObjectivePresent study was designed to determine the ESBL producing strains and identify the genes encoding three different ESBLs of bla PER-1, bla OXA-10 and bla CTX-M genes in P. aeruginosa isolates from burn patients.MethodsIn total 185 clinical isolates of P. aeruginosa were collected from infectious wounds of hospitalized burn patients. Antimicrobial susceptibility testing and phenotypic detection of ESBL were performed by disk diffusion method and Double disk Synergy Test (DDST). Polymerase Chain Reaction (PCR) was done for detection of bla OXA-10, bla PER-1 and bla CTX-M ESBL encoding genes.ResultsIn total, 176 (95.13%) isolates were multidrug resistant. The DDST demonstrated 96 (51.9%) isolates as putative ESBL producers with 100% or highly resistance to ofloxacin, cephalexin, aztreonam (97.57%) and ceftriaxone (91.6%). By PCR amplification, bla PER-1, bla OXA-10 and bla CTX-M genes were detected in 52 (54.16%), 66 (68.75%) and 1 (1.04%) isolates of ESBL producers respectively. Forty-three isolates (44.79%) were simultaneously positive for both bla OXA-10 and bla PER-1 related genes.ConclusionThe rate of ESBL producing P. aeruginosa was notable in present study. Since there are only limited effective antibiotics against the bacterium, therefore all isolates must be investigated by antimicrobial susceptibility testing, which limits resistance development in burn units and helps the management of treatment strategy.     

ESBL菌株的检测及临床意义

目的：了解产超广谱β-内酰胺酶（FSBL）菌株在本地区的分离、分布情况，以利于对产ESBL细菌的监控与治疗。方法：双纸片协同试验（DDST）检测ESBL；K－B法药敏试验。结果：6种常见革兰氏阴性（G^-)菌产ESBL总阳性率（14．5％），以阴沟肠杆菌最高（43．2％）；产ESBL细菌来自痰标本最高（57．4％）；病房中神经科病房分离的产ESBL阳性率最高（39．5％）。其中大肠埃希氏菌、阴沟杆菌、肺炎克雷伯菌对头孢噻肟、头孢曲松、氨曲南的体外耐药率达90％－100％，对头孢他啶耐药率为47％－78％；不产ESBL菌株对此四种药物的耐药率明显偏低（P＜0．05）。大肠、肺炎、阴沟杆菌对氨基糖甙类、氟喹诺酮类、磺胺类的耐药性显著高于非产ESBL菌株（P＜0．05）。其他菌株（不动、嗜麦芽、铜绿）由于菌株数太少，无统计学意义，进一步研究应做长期统计。结论：DDST可以快速准确的检测出产ESBL菌株；三代头孢的长期和大量应用是产生ESBL菌的主要原因，应用亚胺培南治疗产ESBL细菌引起的感染效果最佳。     

397名碘缺乏病区儿童DDST测试结果分析

在采用碘盐防治措施的碘缺乏病区，对３９７名６岁以下儿童作ＤＤＳＴ测定，结果表明：ＤＤＳＴ结果正常者占８５．１％，异常和可疑者占７．８％，不合作者占７．１％。对ＤＤＳＴ结果异常和可疑的３１名儿童进一步作了Ｇｅｓｅ ｌｌ测定，智力发育商低于正常者２９名，占９３．４％，ＤＤＳＴ假阳性比例占６．６％，说明ＤＤＳＴ信度较强。     

Developmental screening in context: adaptation and standardization of the Denver Developmental Screening Test-II (DDST-II) for Sri Lankan children

Background Developmental problems in children can be alleviated to a great extent with early detection and intervention through periodic screening for developmental delays during pre-school ages. Currently, there is no established system for developmental screening of children in Sri Lanka. Although some developmental norms, which are similar to those of Denver Developmental Screening Test-II (DDST-II), have been introduced into the Sri Lankan Child Health Developmental Record (CHDR), those norms have not been standardized to the Sri Lankan child population. The aim of this research was to establish Sri Lankan norms for DDST-II and to test the universal and regional applicability of developmental screening tests by comparing the Sri Lankan norms with the norms of DDST-II and DDST-Singapore norms, the geographically nearest standardization of DDST-II. The norms were also compared with the milestones already available in the CHDR. Methods DDST-II was adapted and standardized on a sample of 4251 Sri Lankan children aged 0-80 months. Thirteen public health nursing sisters were trained to collect the data as part of their routine work. The 25th, 50th, 75th and 90th percentile ages of acquiring each developmental milestone were then calculated using logistic regression. Results The Denver Developmental Screening Test for Sri Lankan Children (DDST-SL) was created. Most of the established DDST-SL norms were different to the comparable norms in DDST-II, DDST-Singapore and the CHDR. Conclusions In view of the results of the study, it is imperative that developmental screening tests are used in context and are adapted and standardized to the populations in question before utilization.     

0～6岁农村儿童早期智力发育的调查分析

目的:调查分析0～6岁农村儿童智力发育的现状。方法:随机对1124名0～6岁农村儿童进行入户调查,采用丹佛发育筛查量表(DDST)对应人能、细动作应物能、言语能、运动能四个能区逐项测试,对结果异常或者可疑者询问母亲文化程度及孕期情况、儿童身体状况及受教育方式。结果:1124例接受调查儿童中,116例(10.32%)DDST测试异常,确证智力低下(MR)7例(0.623%)。其中,1～6月儿童1例(0.8%),-12月16例(13.79%),-2岁25例(21.55%),-3岁22例(18.97%),-4岁21例(18.10%),-5岁18例(15.79%),-6岁13例(11.21%)。曾患新生儿疾病42例(36.21%)、早产18例(15.52%)、低体重15例(12.93%)、营养性疾病13例(12.21%)、神经系统疾病9例(7.76%)、外伤17例(14.66%)、先天性疾病2例(1.72%)。母亲文化程度:高中32例(27.59%)、初中72例(62.07%)、小学12例(10.34%)。孕期情况:母亲妊娠高血压综合征(简称妊高征)或其他疾病23例(19.83%)、怀孕早期患病(感冒或其他情况)服药...     

Denver Developmental Screening Test Norms: A Cross-Cultural Comparison

Norms on the Denver Developmental Screening Test (DDST) developedin Denver, Metro-Manila, Tokyo, Okinawa, and the Netherlandswere compared. The ages at which each DDST item was passed by50% of the sample groups were compared using the z statistic.Items that were attained significantly earlier, later, and aroundthe same age by the Metro-Manila children compared to the othergroups were determined. The Metro-Manila children performedsimilarly on the test as the Tokyo and Okinawa children on thegross motor, fine motor-adaptive, language, and personal-socialsectors of the test. Denver children were advanced on all sectors.The Dutch children were advanced on all sectors except the grossmotor. The implications of the findings and the possible reasonsfor the differences are discussed.     

Sampling survey on intellectual disability in 0 approximately 6-year-old children in China

Objectives To understand the current status of intellectually disabled children and the prevalence of intellectual disability (ID) in children aged 0～6 years and its risk factors, and to provide scientific evidence to formulate relevant policies for helping intellectually disabled children. Methods Multiphase, stratified, unequal proportional and cluster sampling was adopted to investigate 60 124 children aged 0～6 years. All the children investigated were screened for ID using the Denver Developmental Screening Test, and those with positive screening test would be further diagnosed by varied specialists using the Gesell Developmental Inventory. Results In total, 560 of 60 124 children were diagnosed as intellectually disabled with an overall prevalence of 0.93%. Prevalence of ID was highest in children living in medium‐developed areas with a prevalence of 1.20%, higher than in those living in developed areas (0.75%) and in underdeveloped areas (0.84%). It was higher in rural areas (1.03%) than in urban areas (0.83%), and higher in boys (1.01%) than in girls (0.84%). Prevalence of ID increased with the age of children and decreased with the educational level of their parents. Conclusions The study suggested that ID is still prevalent in the children of China, and rehabilitation for them is lagging behind current needs. Early prevention of ID in children and pre‐school education for them should be strengthened.     

256例DDST测试异常儿童相关因素分析

目的：分析丹佛发育筛查量表（denver developmental screening test,DDST）在儿童保健临床工作中的实用性。方法：采用DDST对0N6岁儿童的应人能、细动作应物能、言语能、运动能4个能区逐项测试。结果：256例DDST异常儿童中,应人能、细动作应物能、言语能、运动能4个能区具有2项以上迟长的一般因素有,在农村生活、县以下医疗机构出生、父母文化水平偏低。疾病因素有,脑性瘫痪、重度窒息、早产、低体重、精神发育迟滞、核黄疸后遗症、颅内出血、小头畸型。结论：DDST筛查能早期发现智力发育障碍儿童,对基层儿童保健临床工作具有一定的实用价值。