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Objective:To investigate the characteristics of early motor development in small for gestational age (SGA) infants at high risk of brain injury.Methods:This study retrospectively enrolled a total of 81 SGA infants and appropriate for gestational age (AGA) infants who were at high risk of brain injury and attended outpatient follow-up visits in Xi'an Children's Hospital from February to October 2022. Seventeen SGA infants (SGA group) and 24 AGA infants (AGA group) were assessed for motor development using the Test of Infant Motor Performance (TIMP) at 2-5 weeks of corrected age (CA) and 20 SGA infants (SGA group) and 20 AGA infants (AGA group) were assessed at 14-17 weeks of CA. Independent samples t-test, rank-sum test, and Chi-square test were used to compare the demographic characteristics, high-risk factors of brain injury, and TIMP scores between the two groups. Results:At 2-5 weeks and 14-17 weeks of CA, the birth weights of SGA group were both less than those of AGA group [(1 817.1±440.3) vs. (2 630.0±560.9) g, t=－4.98; (1 752.0±434.4) vs. (2 226.3±699.8) g, t=－2.58; both P<0.05], but there were no significant differences in gestational age at birth or high-risk factors of brain injury between the two groups (all P>0.05). (1) At 2-5 weeks of CA: SGA group had lower total TIMP score [(71.6±13.7) vs. (80.5±11.5) scores, t=－2.26, P=0.029], elicited item score [61.0 scores (41.0-85.0 scores) vs. 69.1 scores (49.0-96.0 scores), Z=－2.15, P=0.037], sitting position score [8.8 scores (3.0-19.0 scores) vs. 11.2 scores (5.0-22.0 scores), Z=－2.07, P=0.038], and prone position score [(9.8±3.1) vs. (12.3±3.1) scores, t=－2.19, P=0.034] when compared with AGA group. (2) At 14-17 weeks of CA: The standing position score of the SGA group was lower than that of the AGA group [6.5 scores (4.0-11.0 scores) vs. 7.7 scores (2.0-11.0 scores), Z=－2.05, P=0.040], but no statistical difference was observed in the total TIMP score or the scores of sitting, supine, prone, turning, and lateral positions between the two groups (all P>0.05). Conclusion:Early motor performance of SGA infants is inferior to AGA infants before five months of age, which is embodied in the poor head control at 2-5 weeks of CA that further affects the stability of standing posture in them at 14-17 weeks of CA.
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Objective To evaluate the efficacy of transanal opening of intersphincteric space(TROPIS)for the treatment of complex anal fistula.Methods 41 patients with complex anal fistula were randomly divided into two groups by random envelope method:21 patients in the treatment group were treated with TROPIS;20 patients in the control group were treated with traditional low incision and high thread drawing surgery.The curative effect,postoperative pain score,wound healing time,treatment failure rate,anal sphincter function and postoperative complications were compared between the two groups.Results The visual analoguescale scores(VAS)of anal pain in the treatment group and the control group 8 hours,24 hours,3 days,7 days and the first defecation after operation were(1.81±1.12)vs.(5.00±1.49),(1.10±1.14)vs.(4.35±1.42),(0.86±1.01)vs.(4.35±1.27),(0.81±1.08)vs(4.25±1.41),(3.05±1.56)vs(6.70±1.17),respectively,with significant differences(P＜0.01).The VAS of anal pain in the treatment group and the control group 14 days after operation were(0.67±1.07)vs(0.80±1.11),respectively,with no significant difference(P＞0.05).1 case in the treatment group(4.76％)and 1 case in the control group(5.00％)had wound infection after surgery,there was no significant difference in the rate of wound infection between the two groups(P＞0.05).2 cases(9.52％)in the treatment group and 3 cases(15.00％)in the control group underwent postoperative catheterization,there was no significant difference in urinary retention between the two groups(P＞0.05).In the treatment group,16 cases were cured,3 cases were markedly effective,and the total effective rate was 90.48％,while in the control group,16 cases were cured,2 cases were markedly effective,and the total effective rate was 90.00％,there was no significant difference between the two groups(P＞0.05).The wound healing time of the treatment group and the control group were(37.31± 3.42)days vs(48.13±4.08)days,respectively,with a statistically significant difference(P＜0.01).12 months after operation,2 patients in the treatment group and 1 patient in the control group lost the follow-up.12 months after operation,the ST Marks anal incontinence scores in the treatment group and the control group were(0.53±1.07)and(1.74±2.77),respectively,with a statistically significant difference(P＜0.05).There were 6 patients(31.58％)in the treatment group and 4 patients(21.05％)in the control group who failed in treatment,there was no significant difference in the rate of treatment failure between the two groups(P＞0.05).Conclusion The TROPIS is reliable in treating anal fistula,and has the advantages of less pain,quick recovery and less damage to anal function.
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Objective:To assess the characteristics and correlation of motor development in preterm infants of different gestational weeks by using the Test of Infant Motor Performance (TIMP) method, and to develop better individualized early interventions based on TIMP test results.Methods:A prospective study involving 43 full-term healthy infants and 77 preterm followed up in 3201 Hospital from June 2019 to July 2021 was conducted.Preterm infants were divided into the early preterm group (39 cases) and late preterm group (38 cases) according to their gestational age at birth.TIMP assessment was performed at the gestational age of 40 weeks and the corrected age of 16 weeks after birth.Similarly, the full-term healthy infants were assessed by TIMP at the postnatal age of 16 weeks.The differences between groups were investigated using ANOVA or Mann- Whitney rank sum test.Correlations were analyzed by the Pearson correlation method. Results:There were no significant difference in TIMP scores between early and late preterm infants at the gestational age of 40 weeks [(65.74±6.52) scores vs.(66.96±8.51) scores] and the corrected age of 16 weeks [(101±10) scores vs.(104±8) scores] (all P>0.05). TIMP scores in the full-term healthy group at the corrected age of 16 weeks [(108±10) scores] differed significantly from those of early and late preterm infants ( P<0.05). Compared with full-term infants, early and late preterm infants had lower TIMP scores in observation, supine position, and supine turning (all P<0.05), but a higher TIMP score in standing position ( P<0.05). For both early and late preterm infants, TIMP scores at the gestational age of 40 weeks were significantly positively correlated with those at the corrected age of 16 weeks ( r=0.565, 0.302, all P<0.01). Conclusions:There were significant differences in motor development between preterm infants of different gestational ages and term infants, which had guiding significance for early intervention.English version TIMP could play a positive role in promoting individualized follow-up and early intervention of preterm infants in China.
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Objective@#To develop the Adolescent Mental Health Literacy Assessment Questionnaire (AMHLAQ), and to evaluate its reliability and validity among undergraduates.@*Methods@#On the basis of the definition of mental health literacy (MHL) and the Knowledge, Attitudes and Practices (KAP) theory, this study constructed a total of 36 items consisting of four dimensions, and scores were measured according to a five point Likert type scale. Using a cluster sampling method, a questionnaire survey was conducted among 3 826 freshmen and sophomore students from two medical schools in Anhui Province. The items were screened by performing t tests, Pearson s correlation coefficient analysis and factor analysis. The reliability and validity of the questionnaire were evaluated using indicators including homogeneity reliability, the split half reliability coefficient, and construct validity.@*Results@#Factor analysis revealed that the AMHLAQ consisted of 22 questions grouped into four domains. The variance cumulative contribution rate was 62.213%. The reliability result showed that the Cronbach s alpha coefficient of the total questionnaire was 0.897, the split half reliability was 0.800, the Cronbach s coefficient of each dimension was 0.796 to 0.885, the split half reliability of each dimension was 0.725 to 0.846, and the indicators had a high level of reliability. Confirmatory factor analysis showed that the model fit was good ( χ 2/df =19.319, P <0.01; RMSEA=0.069).@*Conclusion@#AMHLAQ is consistent with the evaluation standard of psychometrics, has good reliability and validity, and can be used to estimate the level of MHL among undergraduates.
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Objective:To investigate the prevalence of autism spectrum disorders (ASD)among children in kindergartens in Xi′an urban districts.Methods:A stratified cluster sampling method was adopted, and selected all children from 12 kindergartens in 6 urban districts of Xi′an.Primary screening positive children with ASD were identified by filling out the Autism Behavior Checklist (ABC) by their parents and the guardians reports, and then the beha-vioral observations were made to identify suspicious ASD children.Finally these children were diagnosed in the hospital through the autism diagnostic observation schedule, 2 nd edition (ADOS-2). The data were calculated with SPSS 18.0. Results:Totally, 38 cases with ASD were diagnosed among 5 178 children, the prevalence of children ASD in kindergartens in Xi′an urban districts was 7.3‰, and the 95% confidence interval was 4.98‰-9.62‰.The prevalence of ASD in children was statistically significant in different age groups ( χ2=9.914, P<0.05) and gender groups ( χ2=18.812, P<0.05). The accuracy of ASD screening by guardians reports is better than that by ABC. Conclusions:(1)The prevalence of ASD children in kindergartens in Xi′an urban districts is at high level in similar reports in China.If ASD children at the special education institutions and home are considered, the overall prevalence rate is higher, indicating that the prevalence of ASD children in China may be underestimated.(2)With the increase of age, the attendance rate of ASD children in kindergartens has a decreasing trend.
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Objective@#To analyze the epidemiological history, clinical manifestations, treatment and the short-term prognosis of 31 cases of 2019 novel coronavirus(2019-nCoV) infection in children from six provinces (autonomous region) in northern China.@*Methods@#A retrospective analysis of the epidemiological history, clinical symptoms, signs, laboratory examinations, chest imaging, treatment and the short-term prognosis of 31 cases of 2019-nCoV was conducted. The patients were diagnosed between January 25th, 2020 and February 21st, 2020 in 21 hospitals in 17 cities of six provinces(autonomous region) of Shaanxi, Gansu, Ningxia, Hebei, Henan and Shandong.@*Results@#The age of the 31 children with 2019-nCoV infection was 7 years and 1 month (6 months -17 years). Nine cases (29%) were imported cases. Other 21 cases (68%) had contact with confirmed infected adults. One case (3%) had contact with asymptomatic returnees from Wuhan. Among the 31 children, 28 patients (90%) were family cluster cases. The clinical types were asymptomatic type in 4 cases (13%), mild type in 13 cases (42%), and common type in 14 cases (45%). No severe or critical type existed. The most common symptom was fever (n=20, 65%), including 1 case of high fever, 9 cases of moderate fever, 10 cases of low fever. Fever lasted from 1 day to 9 days. The fever of fifteen cases lasted for ≤3 d, while in other 5 cases lasted > 3 d. Other symptoms included cough (n=14, 45%), fatigue (n=3, 10%) and diarrhea (n=3, 9%). Pharyngalgia, runny nose, dizziness, headache and vomiting were rare. In the early stage, the total leukocytes count in peripheral blood decreased in 2 cases (6%), the lymphocytes count decreased in 2 cases (6%), and the platelet count increased in 2 cases (6%).Elevation of C-reactive protein (10%, 3/30), erythrocyte sedimentation rate(19%,4/21), procalcitonin(4%,1/28), liver enzyme(22%, 6/27) and muscle enzyme (15%, 4/27) occurred in different proportions. Renal function and blood glucose were normal. There were abnormal chest CT changes in 14 cases, including 9 cases with patchy ground glass opacities and nodules, mostly located in the lower lobe of both lungs near the pleural area. After receiving supportive treatment, the viral nucleic acid turned negative in 25 cases within 7-23 days. Among them, 24 children (77%) recovered and were discharged from hospital. No death occurred.@*Conclusions@#In this case series, 2019-nCoV infections in children from six provinces (autonomous region) in northern China are mainly caused by close family contact. Clinical types are asymptomatic, mild and common types. Clinical manifestations and laboratory examination results are nonspecific. Close contact history of epidemiology, nucleic acid detection and chest imaging are important bases for diagnosis. After general treatment, the short-term prognosis is good.
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Objective:To investigate the effect of Xuanfei-Liyan patch on T lymphocyte subsets in recurrent respiratory tract infection children. Methods:One hundred twenty recurrent respiratory tract infections children who met the inclusion criteria in the Health service Center of Youyi Street community of Shanghai Baoshan District from January 2017 to January 2019 were selected as the study subjects. A random number table method was used to divide them into observation group and control group with 60 cases in each group. The control group was given with conventional treatment measures. On the basis of treatment in the control group, the observation group was treated with Xuanfei-Liyan patch once every other day. Two groups were treated for 2 months. The forced expiratory volume (FEV1) and maximum peak flow rate (PEF) were measured with a pulmonary function meter, the recovery time of symptoms and signs were recorded, the levels of CD3 +, CD4 +, and CD8 + were detected by flow cytometry, and clinical efficacy was evaluated. Results:The total effective rate of the observation group and the control group was 98.33% and 86.67%, respectively, and the difference was statistically significant ( χ2=4.324, P=0.038). After treatment, FEV1 (1.61 ± 0.22 L vs. 1.30 ± 0.19 L, t=8.261) and PEF (122.93 ± 14.49 L/min vs. 103.05 ± 12.06 L/min, t=8.168) in the observation group were significantly higher than those in the control group ( P<0.01). The time of temperature recovery, cough relief, ralogue disappearance, and pharyngeal normalcy in the observation group were significantly shorter than those in the control group ( t value were 16.851, 15.667, 12.387, 8.746, respectively, all Ps<0.001). After treatment, the levels of CD3 + and CD4 + were significantly higher than those in the control group ( t=3.656 and 4.667, respectively, all Ps<0.01), and level of CD8 + was significantly lower than that of the control group ( t=5.149, P<0.01). Conclusions:The Xuanfei-Liyan patch sticking point application can improve the pulmonary function and immunity of children with recurrent respiratory tract infection, improve clinical symptoms and curative effect.
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Objective To explore the early clinical characteristics and influencing factors in children with autism spectrum disorders(ASD).Methods From January 2005 to December 2014,193 children with ASD were collec-ted by continuous grouping method from Children's Rehabilitation Training Center in Xi'an.According to the 1∶1 matched case-control study requirements,and the other 193 children from kindergartens and primary schools in the urban areas of Xi'an were collected as healthy control group from March 1 to July 1,2016.The age of children in the case group was(40.78±14.86)months and the age of the healthy control group was(40.61±14.40)months.There were 167 boys and 26 girls in 2 groups and the ratio of boys to girls was 6.42∶1.00.The general status questionnaires,medical history questionnaire,diagnostic chart,Autism Behavior Checklist(ABC)and Family Environment Scale of Chinese version(FES-CV)were completed by parents between 2 groups.Childhood Autism Rating Scale(CARS)was completed by doctors in the case group.By using Excel software,the original questionnaires were completed in 2 entries by 2 persons to set up the database.All data were analyzed by SPSS 17.0 statistical software and conditional Logistic regression was used for multivariate analysis.Results Seventy point eight percent(137/193 cases)of children with ASD had been found abnormal under 2 years old or at 2 years old,and 54.9％(106/193 cases)had been diagnosed under 3 years old or at 3 years old.The average delay from the discovery to the diagnosis was 17 months.The initial abnormalities appea-rances were mainly manifested as no response to calling in 153 cases(79.3％),very little active contact with others in 141 cases(73.1％),silent or less use of oral language in 137 cases(71％),avoiding contact with the eyes of others or lack of facial expressions in 121 cases(62.7％).Their signs were easy to be misdiagnosed as mental retardation and language retardation.Children in the case group began to walk alone at the age of 8 months to 3 years old,and only 62.2％(120/193 cases)of them could walk alone at the age of 18 months or before.The age of conscious speech was at 8 months to 4 years and 4 months,and only 39.4％(76/193 cases)of the ASD children could speak at the age of 18 months or before.The total scores of the ABC scale of the case group were(56.520±22.140)scores and the sub-scales and total scores were significantly higher than those of the healthy control group,and the difference was statistically significant(t=16.845,27.390,16.527,26.320,23.371,32.206,all P<0.001).The positive consistent rate of ABC and clinical diagnosis was 56.5％.The total scores of CARS in the case group was(36.4±8.6)scores,and the positive consistent rate of CARS and clinical diagnosis was 78.8％.There was a statistical significance between the 2 groups in parental education,mother's occupation,family history(x2=29.670,44.593,15.439,6.095,all P<0.05),and there were statistical significance in the main caregivers,family harmony and family income(x2=19.006,7.129,109.027,all P<0.05).There was no statistical significance between the 2 dimensions of independence and achievement orientation between the 2 groups(t=-1.559,-0.139,P=0.120,0.890).The case group in the family cohesion,expressiveness,intellectual-cultural orientation,active-recreational orientation,moral-religious emphasis,organization and control of the 7 dimension scores were significantly lower than those in the healthy control group,and the differences were statistically significant(t=-7.683,-5.734,-8.762,-14.109,-2.026,-4.530,-2.464,all P<0.05).In the case group,the scores of the conflict dimension were higher than those of the healthy control group,and the difference was statistically significant(t=4.925,P<0.001).There was a statistical significance between the 2 groups in gestational age and birth hypoxia(x2=6.898,27.180,all P<0.05).According to multivariate analysis of Logistic regression,people other than parents serving as the primary support,anoxia of newborn,mother of non professional and technical personnel and lower scores of family active-recreational orientation might be the risk factors of ASD,family per capita income of 3 000 Yuan RMB or more monthly,mother education level of high school and above,and lower scores of family conflict might be the protective factors for ASD.Conclusions Clinical features of most ASD children can be easily identified under 2 years old,but if the diagnosis is delayed,the related intervention is late,so importance should be attached to early diagnosis.Mother's occupation and education level,family economic status,family environment,their supervisors,and anoxia of newborn may be the effective entry points in the prevention and treatment of ASD.
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OBJECTIVE:To provide reference for rational use of polycystic ovary syndrome(PCOS)drugs. METHODS:The utilization of PCOS drugs in our hospital during Jan.-Dec. 2013 were analyzed in respects of consumption sum,DDDs,sorting and so on. The rationality of prescription was analyzed according to guidelines and drug package inserts and so on. RESULTS:There were 1 551 prescriptions,involving 76 kinds of drugs,and their total consumption sum was 181 072.90 yuan. Main types of drugs were hormone related drugs (accounting for 81.37% of prescription frequency,73.51% of consumption sum) and Chinese patent medicine (accounting for 15.41% of prescription frequency,19.43% of consumption sum). Top 5 hormone drugs in the list of DDDs were Ethinylestradiol and Cyproterone acetate tablets,Metformin hydrochloride enteric-coated tablets,Progesterone soft cap-sule,Dydrogesterone tablets and Progesterone soft capsules. Top 5 Chinese patent medicines in the list of DDDs were Kuntai cap-sule,Yougui capsule,Huanshao capsule,Jiawei xiaoyao capsule and Nvjin capsule. Single drug accounted for 72.08% in prescrip-tion. The proportion of irrational drug use was 1.69%. CONCLUSIONS:The application of drug in patients with PCOS is reason-able generally. Some prescriptions are unreasonable,mainly manifesting as incomplete clinical diagnosis,irrational usage and dos-age. Pharmacists should strengthen prescription verification and intervention.
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Autism spectrum disorders have gradually been known and its concept is also changing.It is important that comprehend the changing timely for clinical work.This paper is mainly about the formation and evolution for the term,as well as the change in Diagnostic and Statistical Manual of Mental Disorders 5th ed and the significance.
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Objective To discover the influence of thiomersalate exposure on the behavior and humoral immunity of premature rats.Methods According to common thiomersalate dose of vaccine used in human,the surface conversation method was used to change the dose to 1,2,3,4 times for rats(32.8,65.6,98.4 and 131.2 μg/kg),and the thiomersalate was separately injected to the gluteus maximus of premature rats respectively,which were delivered on the 20th day of gestation by cesarean for the injection on day 1 (premature).Simultaneously,saline was injected to the control group.On day 44 to 48 after injection,the Morris water maze test was used to evaluate the spatial learning and memory abilities of rats and on the post-injection day 49,immunoglobulin content in rat blood and cerebrospinal fluid was measured.Results The spatial learning abilities of rats in 131.2 μg/kg group and the memory abilities in 65.6 μg/kg,98.4 μg/kg and 131.2 μg/kg group were significantly weaker than those in 9 g/L saline group(all P ＜0.001).The immunoglobulin content in blood and cerebrospinal fluid changed in different groups exposed to thiomersalate.The levels of IgG,IgA,IgE,IgM in 98.4 μg/kg group and 131.2 μg/kg group rose significantly higher than those in 9 g/L saline group(all P ＜ 0.01).Analysis of rectilinear correlation between the immunoglobulin and learning abilities of rats revealed that IgG,IgA,IgE levels in the blood were correlated with the spatial learning abilities (r =0.36,0.47,0.50,all P ＜ 0.05) and the levels of IgG,IgA,IgE,IgM in blood were rectilinear correlated with the memory abilities of rats (r =-0.39,-0.43,-0.49,-0.38,all P ＜ 0.05).In rats'cerebrospinal fluid,IgG,IgA,IgE,IgM levels were rectilinear correlative with both the spatial learning and memory abilities (r =0.48,0.59,0.54,0.41,all P＜0.05;r=-0.39,-0.61,-0.57,-0.44,all P＜0.05).Conclusion With the dose ofthiomersalate increased,the learning and memory and humoral immunity are sustained damaged for premature rats.