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儿童九维健康效用量表的应用介绍 认领
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作者 林小惠 聂雪坤 +2 位作者 林敏华 黄维英 陈子春 《中国卫生经济》 北大核心 2020年第5期8-11,共4页
文章系统介绍了儿童九维健康效用(CHU9D)量表的发展历程、结构及效用积分体系,并应用文献计量学分析了CHU9D量表的研究现状,探讨了儿童健康效用值测量中存在的困难和挑战,期望能为我国开展儿童生命质量评价及卫生领域经济学研究提供参考。
关键词 儿童 效用值 多属性效用量表 儿童九维健康效用量表
童年不良经历评估工具研究进展 认领
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作者 王路 屈燕花 邹海欧 《中国全科医学》 CAS 北大核心 2020年第24期3000-3005,共6页
世界卫生组织(WHO)的调查显示,全球超过1/3的人口有过童年不良经历。美国疾病预防与控制中心(CDC)在2019年的报告中也指出,过去的一年中至少有1/7的儿童遭受过虐待和/或忽视等不良经历。作为全球性公共健康问题,童年不良经历不仅会在短... 世界卫生组织(WHO)的调查显示,全球超过1/3的人口有过童年不良经历。美国疾病预防与控制中心(CDC)在2019年的报告中也指出,过去的一年中至少有1/7的儿童遭受过虐待和/或忽视等不良经历。作为全球性公共健康问题,童年不良经历不仅会在短期内损害个体的身心健康,甚至会产生终身的影响。近些年国内外诸多学者探索了童年不良经历并研发了相关评估工具,为此,本文综述了国内外应用较广泛、信效度较好的童年不良经历评估工具,旨在为国内童年不良经历的评估提供全面的资料,并对我国童年不良经历研究及干预有所启示。 展开更多
关键词 儿童 心理压抑 童年不良经历 儿童虐待 评估工具 综述
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Hospital Acquired Infections at the Service of Pediatric Surgery in Gabriel TouréAcademic Hospital, Bamako, Mali 认领
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作者 Y. Coulibaly O. Kone +9 位作者 I. Amadou T. H. M. Diop O. Coulibaly A. Doumbia B. Kamaté H. Ouologuem D. Konaté M. Coulibaly B. Maiga M. I. Mangané 《儿科学期刊(英文)》 2020年第1期185-193,共9页
Introduction:?Health care-associated infection is an infection acquired during the care delivered in the hospital or in any other care establishment which was neither present, nor in incubation at the admission of the... Introduction:?Health care-associated infection is an infection acquired during the care delivered in the hospital or in any other care establishment which was neither present, nor in incubation at the admission of the patient or at the time of delivering the care or which does not manifest itself only after the patient has been discharged or an infection contracted by the professional in the course of his duties. Objectives:?To identify mean causative germs?and to determine their sensitivity to antibiotics and to identify the risk factors of?health care-associated infection.?Material and methods:?It was about a prospective longitudinal study conducted from November 1, 2017 to April 1, 2018?(6 months) in all children admitted to the pediatric surgery service. Non-consenting parents and outpatient necrosectomy case have not been included in this study.?Results:?This study included 200 patients, of whom 30 experienced the hospital acquired infections with an infection rate of 15%. The surgical site infection was the most common type, with 16 cases (53.3%), followed by burns in 13 cases (43.3%) and urinary tract infection in 1 case (3.3%). The average age of patients with infection was 56.33 ± 48.66 months with extremes of 1 and 180 months. The sex ratio was 1.30 for infected patients and was 1.83 for uninfected patients. The main bacteria responsible for surgical site infection were: Escherichia coli?(4 cases), Acinetobacter baumanii?(3 cases), Klebsiella pneumoniae?(2 cases), Staphylococcus aureus?(2 cases), Enterobacter cloacae?(1 case), Pseudomonas aeruginosa (1 case) and Enterobacter faecalis?(1 case). Among burn patients, the most frequent germs were: Acinetobacter baumanii?(7 cases), Klebsiella pneumoniae?(6 cases), Staphylococcus aureus?(6 cases), Escherichia coli?(4 cases), Pseudomonas aeruginosa?(2 cases) and Enterobacter faecalis?(2 cases). Escherichia coli?was?noted only in the case of urinary tract infection. Antibiotics tested were: amoxicillin, amoxicillin associated with clavulanic acid, ceftriaxone, 展开更多
关键词 Infection GERMS SENSITIVITIES Risk Factors Child MALI
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Growth and Associated Factors in Children and Adolescents Living with HIV/AIDS Followed at the Mother and Child Centre of the Chantal Biya Foundation, Yaoundé-Cameroon: A Case Control Study 认领
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作者 David Chelo Eulalie Landrine Moguon Fondjo +4 位作者 Pierre Fotsing Kwetche Séraphin Nguefack Félicitée Nguefack Suzanne Ngo Um Georges Nguefack Tsague 《儿科学期刊(英文)》 2020年第1期194-205,共12页
Background: HIV/AIDS has a negative impact on child growth. Assessing the growth of infected children is an important part of the overall care of these children which in turn improves the monitoring and prognosis of t... Background: HIV/AIDS has a negative impact on child growth. Assessing the growth of infected children is an important part of the overall care of these children which in turn improves the monitoring and prognosis of the disease. The purpose of the study was to describe and compare the growth of children living with HIV with those not infected and to identify the associated factors. Method: This was an analytical case control study conducted in a pediatric hospital, Yaoundé from January 25th to June 20th 2019. Our study population consisted of 164 children with an age range from 06 weeks to 19 years old of which we had 41 HIV-infected cases and 123 uninfected controls matched by sex and age plus or minus 02 months. Anthropometric parameters were measured according to the standards described by the WHO. The data was entered and analyzed using Epi info 3.5.4, WHO Anthro and WHO Anthropoplus softwares. The chi-square and the Fisher’s exact tests were used to compare qualitative variables, with a significance threshold set at P less than 5%. Results: Of the 41 cases, 15 (36.6%) had at least one anthropometric index (weight for age, height for age, weight for height) -2 Z score versus 05 for controls (4.1%). 36.6% of cases had growth retardation (Height for age -2 Z score) compared to 4.1% in controls with a significant difference (p = 0.000). In 18.2% of cases, underweight was found (Weight for age -2 Z score) with a significant difference compared to controls (p = 0.000). Wasting was present in 10% of infected children (P = 0.240). We found 7.3% obesity/overweight in cases and 25.2% in controls (P = 0.003). We did not find any associated factor with growth disorders in our study. Conclusion: Infected children are smaller in weight and size. After multivariate analysis, there remained a significant difference between cases and controls regarding stunting, obesity and overweight. No factors studied were associated with the growth disorders detected, which suggests that growth disorders in children and adolescents li 展开更多
关键词 GROWTH HIV/AIDS CHILD ADOLESCENT Yaoundé
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Surgical Complications of Pica Syndrome: About 03 Cases 认领
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作者 A. Doumbia Y. Coulibaly +10 位作者 I. Amadou M. Keita O. Coulibaly B. Kamaté M. K. Djiré M. Y. Coulibaly S. Camara H. Diall B. Maiga D. Konaté K. Sacko 《儿科学期刊(英文)》 2020年第1期159-167,共9页
The Pica syndrome is an eating disorder characterized by an excessive or abnormal desire to consume a non-nourishing substance which can be relatively harmless, or potentially harmful for the health. It is a rare affe... The Pica syndrome is an eating disorder characterized by an excessive or abnormal desire to consume a non-nourishing substance which can be relatively harmless, or potentially harmful for the health. It is a rare affection secondary to the accumulation of diverse nature foreign bodies inside the digestive tract and more especially at the stomach level. Gastro-intestinal localization is the most frequent, and can remain long time asymptomatic. Treatment is surgical. We report 3 cases of digestive complication of Pica syndrome. The first one was operated for gastric perforation due to nail (53 nails, a pin and bands of tape recorder cassette ingested), the second one for trichobezoar and the last had a subocclusion by pieces of granite. 展开更多
关键词 PICA SYNDROME COMPLICATIONS BEZOAR CHILD MALI
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Prospective Study of Domestic Accidents of the Child in Brazzaville, Congo 认领
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作者 Kambourou Judica?l Moyen-Engoba   +5 位作者 Oko Aymar Pierre Gildas Lombet Leticia Diall Boubakar Massamba Alphonse Moyen Georges 《儿科学期刊(英文)》 2020年第1期175-184,共10页
Background:?Home related accidents have emerged as an important public health issue in pediatrics. However, very few studies have been conducted in sub-saharan countries on domestic accidents among children. The purpo... Background:?Home related accidents have emerged as an important public health issue in pediatrics. However, very few studies have been conducted in sub-saharan countries on domestic accidents among children. The purpose of this study was to determine the hospital frequency of domestic accidents in Brazzaville children, the type of accident, establish etiological factors and mortality.?Methods:?A total of 173 cases of domestic accidents were collected through a prospective study conducted from 1 January to 31 December 2017 in the pediatric intensive care unit of the University Hospital of Brazzaville. Medical records of children victims of unintentional trauma at home or in its immediate surroundings were collected. The following variables were recorded: the age and sex of the child, the hour, day and month of occurrence of the accident, parental attitudes in the management, and the prognosis (mortality).?Results:?Domestic accidents accounted for 9.2% of all admissions. The average age was 28.8 ± 10.5 months, a male predominance was noted (sex ratio equal to 1.6). Domestic accidents were found in 57.5% of children under two years (p??0.05). These children belong with more than 3 children in 63% of the cases. Accidents were dominated by ingestions (56.1% of cases), followed by falls (16.2%), burns (10.9%) and drug poisoning (9.2%). They often occurred between 12?pm and 8?pm, most often in the yard, the kitchen and the surroundings of the home. Three cases of death (1.53%) were enrolled including 2 cases of burns.?Conclusion:?domestic accidents are common in Brazzaville but their frequency is underestimated. Accidental ingestion remains the most frequent type of accident and mortality is high. Control of the causative factors is necessary to undertake effective preventive actions. 展开更多
关键词 DOMESTIC Accidents BURN Fall CHILD INTOXICATION
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湖州市区托幼机构幼儿洗手行为调查 认领
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作者 丁昱 莫小春 +1 位作者 沈益妹 俞梅华 《中国学校卫生》 CAS 北大核心 2020年第5期697-699,703,共4页
目的了解湖州市两区幼托机构幼儿洗手行为现况及可能影响因素,为开展手卫生相关疾病健康教育提供依据。方法采用分层整群随机抽样,对湖州市两区6所幼儿园343名幼儿进行手卫生行为观察。结果共观察幼儿手卫生指征总数1 042次,发生洗手行... 目的了解湖州市两区幼托机构幼儿洗手行为现况及可能影响因素,为开展手卫生相关疾病健康教育提供依据。方法采用分层整群随机抽样,对湖州市两区6所幼儿园343名幼儿进行手卫生行为观察。结果共观察幼儿手卫生指征总数1 042次,发生洗手行为886次(85.03%),总体洗手合格率为53.35%(83名);不同等级幼儿园中,三级幼儿园儿童洗手行为较差,随着幼儿园等级提升,幼儿正确洗手行为显著提升;男童的洗手行为相对较差,45.35%的男童洗手行为不合格,女童不合格的比例仅为19.88%。小班幼儿洗手行为优于中班,小、中班幼儿洗手不合格的比例分别为23.13%和39.80%。结论托幼机构儿童手卫生行为具有较大提升空间,应加强对幼儿手卫生依从性以及正确洗手行为的培养。 展开更多
关键词 洗手 行为 健康教育 儿童 日托幼儿园
<i>Helicobacter pylori</i>Infection (<i>Hp</i>) among Children in the Northern Benin in 2018 认领
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作者 J. Agossou K. Alassan Saké +5 位作者 F. Mohamed Agbeille A. Noudamadjo S. Gasso M. G. Kpanidja J. D. Adédémy Z. R. Ahodègnon 《儿科学期刊(英文)》 2020年第1期75-84,共10页
Background: Hp infection is the most common chronic bacterial infection in developing countries and is contracted especially in childhood where it remains silent. Because of its involvement in the genesis of certain c... Background: Hp infection is the most common chronic bacterial infection in developing countries and is contracted especially in childhood where it remains silent. Because of its involvement in the genesis of certain cancers, the WHO has classified Hp in the category of carcinogen class I. The aim of this study was to determine the prevalence of Hp infection among children from a District in Northern Benin, and to identify the factors associated with it. Patients and methods: This scientific investigation is a cross-sectional, descriptive, and analytical study based on a prospective collection of data carried out from July to September 2018. Recruitment was probabilistic;it was based on the WHO cluster sampling technique implemented among children aged 3 to 10 years without recent history of antibiotic treatment and proton pump inhibitors. Hp infection was diagnosed during the search for bacteria antigen in the feces through a quick Elisa test which proved positive. Results: We included 250 children in the study. Among them, 151 (60.4%) had Hp infection. 79 (52.3%) out of the 151 infected children were female, i.e. a sex ratio of 0.91. Mean age for those infected children was 6 ± 2.3 years. Among the 151 children infected with Hp, 98 (64.9%) were asymptomatic. Factors associated with that infection were: children’s age > 5 years (p = 0.0461), use of contaminated drinking water (p = 0.0001), meals away from home (p = 0.0039), mothers’ low educational status (p = 0.0137) and low monthly income (p = 0.0116) as well as household size > 3 (p = 0.0002). Conclusion: Hp infection is common among children aged 3 to 10 years in Northern Benin. Often asymptomatic, it is facilitated and exacerbated by unsanitary conditions and low socioeconomic status. 展开更多
关键词 HELICOBACTER PYLORI Child Northern BENIN
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Kaposi’s Disease (KS) in a Senegalese Child Living with HIV 认领
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作者 F. Ly B. Niang +8 位作者 Y. Keita C. Dial A. Sow A. Sakho Kane B. S. Ndiaye A. Sylla B. Camara A. Ly Ba O. Ndiaye 《儿科学期刊(英文)》 2020年第1期85-93,共9页
Kaposi’s Disease or Kaposi’s Sarcoma (SK ) is a multifocal malignant proliferation induced by viral growth factors, including interleukin 6 of human herpes virus type 8 (HHV8). We describe four forms of this disease... Kaposi’s Disease or Kaposi’s Sarcoma (SK ) is a multifocal malignant proliferation induced by viral growth factors, including interleukin 6 of human herpes virus type 8 (HHV8). We describe four forms of this disease who poses a real public health problem in East and Central Africa. The purpose of our observation was to report a rare condition in a Senegalese HIV-positive child. It was an 11-year-old girl from a region in central Senegal. She was an orphan of both parents, tested and monitored since the age of 5 for HIV infection 1. She was on the 1st line protocol. Due to a lack of support and good observance, she was referred to us at the age of 11 for follow-up in our structure in the suburbs of Dakar. The initial follow-up assessment showed a very low CD4 count and a very high viral load. Before the lack of clinical and immune-virological response, a genotypic resistance test was performed and showed immunological and virological failure. The initial development was marked by the appearance of lesions which were highly suggestive of Kaposi’s disease. She was on 2nd line treatment. The histopathological aspect of cutaneous biopsy was very suggestive of Kaposi’s disease. The subsequent course after ART and bleomycin treatment was clinically marked by regression of skin lesions. Virologically, it was marked by a fall in the viral load. Immunologically there was a gradual recovery of CD4 levels which came back to normal. Our observation demonstrates that absence of effective antiretroviral therapy for HIV increases the risk to develop Kaposi’s sarcoma. 展开更多
关键词 Kaposi’s SARCOMA ANTIRETROVIRAL Therapy HIV CHILD
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Profile and Antibiotic Sensitivity of Acute Pyelonephritis in Children at Gabriel Toure Teaching Hospital, Bamako 认领
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作者 Djénèba Konaté Lala N’Driany Sidibé +25 位作者 Karamoko Sacko Bakary Koné Adama Koné Aminata Doumbia Fatoumata Tiero Pierre Togo Fatouamata Léonie Diakité Abdoul Karim Doumbia Belco Maiga Fousseyni Traoré Aamadou Touré Hawa Diall Mohamed Elmouhouloud Cissé Adama Dembélé Oumar Coulibaly Yacouba Aba Coulibaly H. Konaré Isabelle Traoré Guédiouma Dembélé Issiaka Koné Leyla Ma?ga Ibrahima Ahamadou Abdoul Aziz Diakité Boubacar Togo Mariam Sylla Fatoumata Dicko-Traoré 《儿科学期刊(英文)》 2020年第1期94-108,共15页
Background: Very common symptom in children, fever, perhaps a warning sign of more or less severe pathology, rapidly progressive, including an invasive bacterial infection such as acute pyelonephritis (APN). The aim o... Background: Very common symptom in children, fever, perhaps a warning sign of more or less severe pathology, rapidly progressive, including an invasive bacterial infection such as acute pyelonephritis (APN). The aim of this work was to study the bacteriological profile and antibiotic sensitivity of APN in children. Methods: A prospective study involving any infant or child aged 3 months to 15 years with an acute fever (≥38°C) in which a urine test strip was performed in the pediatric department of the teaching hospital Gabriel Toure between April 1st and May 15th, 2019 (45 days). Results: 124 children were included out of 244 febrile patients. Infants (3 - 23 months) predominated (52.8%) with a sex ratio of 2. Seventy-five percent of children came directly from home and 30.6% were on antibiotic prior to admission. The urine bag sample was taken in 55.6% and the urine was macroscopically cloudy in 32.3%. Stigmas of urinary tract infection at the urinary strip were present in 56.5%. Confirmation of acute pyelonephritis (APN) by CytoBacteriological Urine Examination (CBUE) was 29% with Escherichia coli (63.9%) or Enterococcus faecalis (30.5%). Sensitivity was excellent for ciprofloxacin and imipenem (100%). The overall resistance was greater for gentamicin, cotrimoxazole, ceftriaxone, cefotaxime and amoxicillin-clavulanic acid (Threshold: 17.9% - 95.6%). APN was associated with bacteremia in 2.8% with hospitalization for 45.2% and mortality of 11.1% (due to severe acute malnutrition, severe dehydration and multifocal infection). Conclusion: The APN, daily activity of pediatrician in Bamako, is observed in one third of febrile children associated with a major life-threatening condition of risk factors, then the likely antibiotherapy could be amikacin in our context. 展开更多
关键词 APN FEVER CHILD BAMAKO
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Childhood Tuberculosis: A Descriptive Study in the Pediatric Ward of a University Hospital in Abidjan 认领
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作者 G. L. S. Couitchéré S. J. E. Enoh +2 位作者 G. B. Aka L. Zaho L. Cissé 《儿科学期刊(英文)》 2020年第1期206-216,共11页
Introduction:?Tuberculosis is one of the top ten causes of death in the world. Purpose:?The purpose of this study was to describe the different locations of tuberculosis and the diagnostic means used in our department... Introduction:?Tuberculosis is one of the top ten causes of death in the world. Purpose:?The purpose of this study was to describe the different locations of tuberculosis and the diagnostic means used in our department. Methods:?This was a descriptive retrospective study of children under 15 years of age admitted in 2018 for tuberculosis. The variables under study were socio-demographic, clinical, paraclinical and evolutionary data Results:?Forty-eight children were enrolled. The median age was 8.2 years (± 4.5) and the M/F ratio was 1.4. TB contamination was found?in 20.8% of cases and the index was often a family member (80%). The median diagnostic time was 49 (± 33) days. Six patients had positive HIV serology, 82% had acute malnutrition and lung examination was abnormal in the majority of cases (70.8%). Thorax-ray abnormalities were common (81%) and tuberculin skin testing was positive in 70.6% of cases. The diagnosis was confirmed in 29.2% of the children and the confirmatory examinations were direct examination (9 cases), lymph node biopsy (4?cases) and rapid test (Expert MTB/RIF) (one case). In 70.8% of cases, this was a diagnostic presumption. Pulmonary tuberculosis accounted for 72.9% of which 39.6% multifocal forms and extra-thoracic form 27.1%. Thirty-nine patients had received standard TB treatment and death occurred in 22.9% of cases. Conclusion:?Children are a high-risk population for TB, especially in cases of family infection. Contacts screening through a systematic approach to diagnosis will reduce deaths. Diagnostic difficulties can be partly overcome by improving the accessibility of rapid testing. 展开更多
关键词 TUBERCULOSIS CHILD DIAGNOSIS
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广西3~6岁幼儿欺负行为现况调查 认领
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作者 张庭辉 杨秀清 +1 位作者 张丽 佘少华 《中国全科医学》 CAS 北大核心 2020年第24期3006-3011,共6页
背景既往欺负行为的研究多聚焦于小学生和初中生,而针对3~6岁幼儿的相关研究较少。目的了解广西3~6岁幼儿欺负行为的现状,为更好地预防幼儿欺负行为的发生提供参考。方法2018年3—5月,采用整群抽样法在广西桂林市、柳州市、来宾市、南... 背景既往欺负行为的研究多聚焦于小学生和初中生,而针对3~6岁幼儿的相关研究较少。目的了解广西3~6岁幼儿欺负行为的现状,为更好地预防幼儿欺负行为的发生提供参考。方法2018年3—5月,采用整群抽样法在广西桂林市、柳州市、来宾市、南宁市、玉林市选取10所幼儿园,以班级为单位,每所幼儿园抽取小班、中班、大班各1个班,共30个班1054例幼儿进行调查研究。使用本课题组编制的《3~6岁幼儿欺负行为评定问卷》进行调查。调查问卷由各班班主任填写,借助摄像头现场观察并记录幼儿欺负行为发生状况。问卷包括基本情况、欺负行为评定量表(由间接受欺负、直接受欺负、欺负他人、对欺负的应对4个分量表组成,其中直接受欺负分量表可细分为言语欺负、身体欺负、财物欺负项目)、欺负行为发生场所。结果共发放调查问卷1054份,回收有效问卷982份,回收有效率为93.2%。982名幼儿中男518例,女464例;卷入欺负行为184名(占18.7%,其中间接受欺负34名、直接受欺负98名、欺负他人52名),未卷入欺负行为798名(占81.3%)。男性幼儿卷入欺负行为、欺负他人发生率高于女性(P<0.05)。不同班段幼儿卷入欺负行为、直接受欺负发生率比较,差异有统计学意义(P<0.05)。男性受欺负幼儿受到直接言语欺负发生率低于女性,直接身体欺负发生率高于女性(P<0.05)。不同班段受欺负幼儿受到直接言语欺负、间接受欺负发生率比较,差异有统计学意义(P<0.05)。受欺负幼儿对欺负的应对分量表得分〔(19.9±4.1)分〕高于未卷入欺负行为幼儿〔(10.3±3.5)分〕(t=28.15,P<0.01)。卷入欺负行为的184名幼儿中,欺负行为发生的场所排在前3位的分别是活动室〔76例(41.3%)〕、室外活动场〔36例(19.6%)〕、过道和大厅〔34例(18.5%)〕。不同班段幼儿欺负行为发生在室外活动场、活动室、幼儿园角落所占比例比较, 展开更多
关键词 欺负 攻击 儿童 学龄前 日托幼儿园 横断面研究
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先天性类脂性肾上腺皮质增生症的临床及基因突变特点并文献复习 认领
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作者 李国红 陈晓波 +1 位作者 宋福英 董倩 《中华妇幼临床医学杂志:电子版》 CAS 2020年第2期188-195,共8页
目的探讨儿童先天性类脂性肾上腺皮质增生症(CLAH)的临床及类固醇激素合成急性调节蛋白(StAR)基因突变特点。方法选择2018年7月至2019年5月,于首都儿科研究所附属儿童医院接受治疗的3例CLAH患儿为研究对象。回顾性分析其临床病例资料,... 目的探讨儿童先天性类脂性肾上腺皮质增生症(CLAH)的临床及类固醇激素合成急性调节蛋白(StAR)基因突变特点。方法选择2018年7月至2019年5月,于首都儿科研究所附属儿童医院接受治疗的3例CLAH患儿为研究对象。回顾性分析其临床病例资料,包括临床表现、家系基因检测结果、治疗和随访结果等。以“先天性类脂性肾上腺皮脂增生症”“肾上腺皮质增生”“StAR基因”“congenital lipoid adrenal hyperplasia”“congenital adrenal hyperplasia”“StAR”等为中、英文关键词,在PubMed数据库、中国医知网、中国生物医学文献服务系统(SinoMed)、中国知网和万方数据库中,检索有关类CLAH及StAR基因突变相关文献,检索时间设定为各数据库建库至2019年5月1日。本研究经首都儿科研究所附属儿童医院伦理委员会批准(审批文号:SHERLL2020006),基因检测均征得患儿家属知情同意,并与其签署知情同意书。结果3例患儿的临床StAR基因突变特点如下。①临床表现:均在婴儿期起病,有皮肤色素沉,呕吐,体重不增等肾上腺功能不全症状。②实验室检查结果:均有低血钠、高血钾及低血糖,皮质醇水平显著降低,促肾上腺皮质激素(ACTH)水平明显升高。③肾上腺增强CT检查结果:均提示可见双侧肾上腺显著增生,表现为低密度影(类似液体密度)。④染色体核型分析结果:患儿1、3为46,XY,表现为女性外阴外观。⑤高通量测序结果:均发生StAR基因的纯合突变,突变位点分别位于c.772C>T,c.707_708delinsCTT和c.229G>A。本研究文献检索结果显示,国内文献曾报道23例CLAH患儿,均经StAR基因突变检测而被确诊,结合本研究3例,共计26例CLAH患儿纳入本研究。StAR基因的纯合突变中,突变位点位于c.772C>T(p.Q258X)为23.1%(12/52),c.707_708delAG ins CTT(p.K236Tfs*47)为15.4%(8/52),c.229G>A(p.Q77X)所占比例为15.4%(8/52)。结论CLAH为先天性肾上腺皮质增生症(CAH)的罕见 展开更多
关键词 先天性类脂性肾上腺皮质增生症 肾上腺皮质增生 基因测定 StAR基因 高通量核苷酸测序 儿童
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哮喘预测指数在基层医院低龄喘息儿童管理中的应用 认领
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作者 盛凯华 黄祖辉 +1 位作者 刘晓艳 田娟 《中国基层医药》 CAS 2020年第8期909-912,共4页
目的探讨哮喘预测指数(API)在基层医院低龄喘息儿童管理中的应用价值。方法选择启东市人民医院2014年7月至2016年12月诊治的反复喘息儿童137例,进行API评估,API阳性46例(治疗组)患儿按照儿童哮喘进行规范化治疗,API阳性43例(观察组)和AP... 目的探讨哮喘预测指数(API)在基层医院低龄喘息儿童管理中的应用价值。方法选择启东市人民医院2014年7月至2016年12月诊治的反复喘息儿童137例,进行API评估,API阳性46例(治疗组)患儿按照儿童哮喘进行规范化治疗,API阳性43例(观察组)和API阴性48例(对照组)均给予常规治疗(间断抗炎、平喘治疗);给予所有患儿喘息健康教育与管理,随访观察喘息控制情况。结果治疗组有1例患儿退出治疗,治疗组、观察组、对照组完全缓解率分别为86.7%(39/45)、9.3%(4/43)、43.8%(21/48),治疗组、对照组完全缓解率均高于观察组,差异均有统计学意义(χ2=53.39、14.78,均P<0.05)。结论API可有效帮助基层医院儿科医生管理低龄喘息儿童,提高完全缓解率。 展开更多
关键词 哮喘 哮喘预测指数 医院 疾病管理 儿童
关注卡介苗病 认领
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作者 陈艳萍 张继燕 《中华实用儿科临床杂志》 CSCD 北大核心 2020年第10期730-732,共3页
随着社会生活水平的提高及全球的重视,儿童结核病的诊治水平得到很大提高,但儿童结核病仍然是重大的社会卫生问题,目前公认接种卡介苗(BCG)是预防重症结核感染的重要手段之一。我国是结核高负荷国家,BCG是国家免疫规划儿童常规出生接种... 随着社会生活水平的提高及全球的重视,儿童结核病的诊治水平得到很大提高,但儿童结核病仍然是重大的社会卫生问题,目前公认接种卡介苗(BCG)是预防重症结核感染的重要手段之一。我国是结核高负荷国家,BCG是国家免疫规划儿童常规出生接种的疫苗。绝大多数婴儿接种BCG后无不良反应,少部分婴儿会发生BCG感染,严重者发生播散性感染甚至死亡。现就BCG常见异常反应进行阐述,并呼吁关注严重异常反应背后的原发性免疫缺陷病。 展开更多
关键词 儿童 结核病 卡介苗 不良反应 全身播散性卡介苗病 原发性免疫缺陷病
儿童血行播散型肺结核的影像学诊断及鉴别诊断 认领
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作者 于彤 王蓓 +1 位作者 段晓岷 彭芸 《中华实用儿科临床杂志》 CSCD 北大核心 2020年第10期733-737,共5页
结核病是全球十大死亡原因之一。结核杆菌易通过血行播散累及全身各脏器。儿童是结核菌易感人群,急性血行播散性肺结核在儿童最多见,其中包括部分先天性肺结核。急性血行播散性肺结核的影像学可表现为双肺弥散均匀分布的粟粒影/结节影,... 结核病是全球十大死亡原因之一。结核杆菌易通过血行播散累及全身各脏器。儿童是结核菌易感人群,急性血行播散性肺结核在儿童最多见,其中包括部分先天性肺结核。急性血行播散性肺结核的影像学可表现为双肺弥散均匀分布的粟粒影/结节影,病灶大小一致,密度相等,随机分布,伴肺门、纵隔淋巴结大及钙化。小年龄患儿血行播散型肺结核结节较大,易融合。亚急性/慢性血行播散性肺结核结节大小不一,密度不等,随机分布,渗出与增殖性改变相互混杂。先天性肺结核常于出生1个月内发病,表现为弥散粟粒影或广泛分布的结节及斑片影,病灶可发生融合,可伴纵隔及肺门淋巴结增大。幼儿血行播散性肺结核的鉴别诊断主要考虑慢性肉芽肿病、衣原体肺炎,儿童血行播散性肺结核的鉴别诊断需要考虑隐球菌肺炎、血源性金黄色葡萄球菌肺炎、血行播散型肺曲霉菌病、气管支气管结核、过敏性肺炎、巨细胞病毒肺炎、肺朗格罕组织细胞增生症、肺淋巴管瘤病、肿瘤肺转移、肺霍奇金/非霍奇金淋巴瘤、特发性肺含铁血黄素沉着症、尼曼-匹克病等。现对儿童血行播散型结核的分类及影像学特征进行总结,并结合临床经验,对儿童血行播散型结核的诊断及鉴别诊断进行阐述,旨在提高对该病的影像学认识和影像学诊断水平。 展开更多
关键词 儿童 血行播散型肺结核 影像诊断 鉴别诊断 体层摄影扫描仪
新型冠状病毒肺炎疫情期间对4岁儿童右示指末节两截离断显微再植成功一例 认领
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作者 高增阳 彭志纯 +4 位作者 佘立军 陈演志 潘潮星 雷彦文 张敬良 《中华显微外科杂志》 CSCD 北大核心 2020年第2期126-127,共2页
报道1例对4岁儿童右示指末节两截完全离断,离体两截断面挫伤严重,按照新型冠状病毒肺炎(COVID-19)防护需要进行核酸检查和排除诊断后,在严格的防护措施下,进行断指再植术,术后随访2周,再植指体成活良好.
关键词 新型冠状病毒肺炎 儿童 断指再植 显微外科技术
新型生物标志物在儿童结核病诊断中的应用进展 认领
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作者 肖婧 焦伟伟 申阿东 《中华实用儿科临床杂志》 CSCD 北大核心 2020年第10期737-743,共7页
结核病目前仍是严重危害儿童健康的重要疾病,儿童结核病的早期发现和诊断仍面临诸多问题,如传统检测方法检出率低、漏诊率高,儿童咳痰困难、痰标本细菌载量低,肺外结核病诊断困难。因此,迫切需要发现新的结核病诊断标志物以建立快速敏... 结核病目前仍是严重危害儿童健康的重要疾病,儿童结核病的早期发现和诊断仍面临诸多问题,如传统检测方法检出率低、漏诊率高,儿童咳痰困难、痰标本细菌载量低,肺外结核病诊断困难。因此,迫切需要发现新的结核病诊断标志物以建立快速敏感且高效的结核病诊断方法,而生物标志物则为我们指明了方向。现从转录组学、蛋白质组学、代谢组学和microRNA等4个方面,对儿童结核病新型生物标志物的应用研究进展进行阐述。 展开更多
关键词 儿童结核病 结核病诊断 诊断标志物 咳痰困难 肺外结核病 生物标志物 痰标本 传统检测方法
儿童咳嗽变异型哮喘误诊为呼吸系统感染原因分析 认领
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作者 柳俊芳 刘红 +3 位作者 许丽娟 付丽 滕瑞红 刘英杰 《临床误诊误治》 2020年第5期1-4,共4页
目的探讨儿童咳嗽变异型哮喘(cough variant asthma, CVA)的临床特点、误诊原因及防范措施。方法对曾误诊为呼吸系统感染的儿童CVA 23例的临床资料进行回顾性分析并复习相关文献。结果本组误诊率23.96%。23例均以慢性咳嗽就诊,呈反复或... 目的探讨儿童咳嗽变异型哮喘(cough variant asthma, CVA)的临床特点、误诊原因及防范措施。方法对曾误诊为呼吸系统感染的儿童CVA 23例的临床资料进行回顾性分析并复习相关文献。结果本组误诊率23.96%。23例均以慢性咳嗽就诊,呈反复或持续咳嗽,时轻时重,以清晨明显,皆伴少量白色黏液样痰。咽部充血14例;双肺呼吸音增粗10例,可闻及干湿性啰音6例,可闻及哮鸣音2例。胸部X线检查示肺纹理增粗12例。血白细胞升高6例,中性粒细胞升高7例。初步诊断为上呼吸道感染5例、慢性支气管炎12例、支气管肺炎6例。误诊时间1~12(8.57±2.36)个月。23例按呼吸系统感染给予对症治疗后,病情均无明显改善或加重。后进一步行支气管舒张及激发试验、肺功能检查、皮肤变应原试验,结合病史和家族史等,确诊为CVA,给予相应治疗后病情稳定。随访1年,21例咳嗽症状消失,2例仍有咳嗽症状,但发作频率降低。结论 CVA临床表现缺乏特异性,易误诊。临床接诊长期反复慢性咳嗽患者时,应考虑到CVA,要详细询问病史、开阔诊断思维、综合全面分析病情,并及时行支气管舒张及激发试验、肺功能检查、皮肤变应原试验等特异性检查,以减少或避免CVA误诊误治。 展开更多
关键词 哮喘 儿童 误诊 呼吸道感染 支气管炎 慢性 支气管肺炎
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根据痰液性状判断下呼吸道感染患儿病原菌及选择抗生素的临床研究 认领
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作者 李仲霞 冉建瑜 +3 位作者 梁飞雁 黄华 梁驰 黎德郡 《中国基层医药》 CAS 2020年第8期927-931,共5页
目的探讨根据痰液性状初步判断下呼吸道感染患儿病原菌及选择相应抗生素的准确性,分析患儿年龄、入院前病程、住院时间等与痰培养阳性率、多重耐药率的相关性。方法选择广西医科大学第七附属医院(梧州市工人医院)2015年3月至2016年11月... 目的探讨根据痰液性状初步判断下呼吸道感染患儿病原菌及选择相应抗生素的准确性,分析患儿年龄、入院前病程、住院时间等与痰培养阳性率、多重耐药率的相关性。方法选择广西医科大学第七附属医院(梧州市工人医院)2015年3月至2016年11月收治的下呼吸道感染患儿300例为观察对象,经鼻取患儿下呼吸道痰液记录其性状并进行细菌培养,记录入院初期及住院3~4 d后抗生素调整情况,分析年龄、住院时间等对疾病恢复的影响。结果300例下呼吸道感染患儿中,痰培养阳性110例,主要病原菌为肺炎链球菌、大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯杆菌肺炎亚种。与痰培养阳性者比较,黏白痰及黏黄痰组,痰培养阴性者初次用药准确率高(黏白痰64.4%,黏黄痰57.1%),差异有统计学意义(χ2=36.04,P<0.01)。入院前病程长短在病原菌阳性率、多重耐药率方面差异无统计学意义(P>0.05),但住院时间长短在病原菌阳性率(住院时间≤7 d为24.7%,住院时间>7 d为48.1%,χ2=17.66)、多重耐药率(住院时间≤7 d为13.9%,住院时间>7 d为35.1%;χ2=5.40)方面差异均有统计学意义(均P<0.05)。不同年龄组的病原菌阳性率差异有统计学意义(1~6个月组48.1%,>6~36个月组28.3%,>36个月组25.0%,χ2=13.64,P<0.05)。结论抗生素使用准确率与痰液性状及痰培养结果有关,黏白痰及黏黄痰组的痰培养阴性者初次用药准确率高,一旦明确病原菌,更换敏感抗生素的概率增加。病原菌阳性率和多重耐药率与住院时间、患儿年龄有一定的关系。 展开更多
关键词 数量性状 颜色 呼吸道感染 集落计数 微生物 抗菌药 时间因素 儿童
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