不同年份山东省高身材和矮身材儿童少年筛检及体质评价

利用1985年、1995年和2000年山东省学生体质与健康调研资料,按照中国汉族儿童少年身高的P97和P3百分位数,筛检高身材和矮身材儿童少年。分析了15年来高身材和矮身材儿童少年检出率的变化,对2000年高身材和矮身材儿童少年的体质状况进行了分析评价。高身材儿童少年检出率明显上升,高身材儿童少年在运动素质方面既有优势也有不足,并非意味着体质与健康状况有更高的优势;矮身材儿童少年体质较差,应采取措施促进其健康成长。     

全国九地区学龄前儿童智力水平及其影响因素分析

目的：了解学龄前儿童智力水平及其影响因素,为促进和改善学龄前儿童智力发育提供依据。方法：采用多阶段整群抽样法选取973名学龄前儿童,使用《中国比内测试》量表对其进行智力测试,同时由家长辅助填写一般情况调查问卷,了解学龄前儿童智力状况及分布,并进行单因素和多元回归分析。结果：儿童平均智商为99.48±14.26。不同地区儿童智力水平存在差异,除邢台山区外,儿童性别与智力水平无关。多因素回归分析显示,影响儿童智商的因素有儿童年龄、前4个月喂养方式、父母文化程度、出生时母亲年龄、父亲职业、家庭经济水平等。结论：儿童智商受到社会经济、营养和遗传因素综合作用。为提高儿童智商,既要提高父母的文化程度、职业状况和经济水平,又要注重优生优育。     

广西农村留守儿童人格特质特点及其影响因素研究

目的:了解广西农村留守儿童人格特质的特点及其影响因素。方法:运用儿童十四种人格特质问卷(CPQ)对1477名留守儿童和286名非留守儿童进行问卷调查。结果:(1)留守儿童和非留守儿童在大多数人格维度上并不存在显著差异;(2)留守儿童人格特质多维度皆存在显著的性别和年级差异;(3)留守儿童人格特质不同家庭经济状况、父母文化程度、父母与留守儿童的联系频率之间存在显著的差异。结论:"留守"只是一个较远端的环境变量,留守状态并不足以直接导致儿童人格特征的改变;家庭经济状况、父母文化程度、父母与留守儿童的联系频率和性别、年龄皆为影响留守儿童人格特质的重要影响因素。     

3—12岁儿童膳食补充剂摄入现状及影响因素分析

目的：通过横断面调查,描述中国3—12岁儿童膳食补充剂的摄入现状,并讨论其相关因素。方法：采用多阶段随机整群抽样抽取中国7城市2农村3—12岁儿童1 806名,通过问卷调查获得其一般情况,通过膳食补充剂频率调查获得其摄入情况。 结果：家庭人均月经济收入高（P=0.001）、喂养人认为孩子体重偏低（P=0.024）、认为孩子营养状况不好（P=0.023）、每周外出就餐多（P<0.001）、父亲文化程度高（P＜0.001）、母亲文化程度高（P＜0.001）的儿童更容易使用补充剂。 结论：补充剂使用与儿童年龄、父母文化程度、家庭经济状况,生活习惯和喂养人对儿童健康的认知有关。应加强健康教育,建立对儿童健康和对营养素补充剂的正确认识。     

严重缺碘对体质及遗传性状影响的研究

对严重缺碘地区一个容貌特殊,身材较矮,智力低下的人群进行了体质特征及遗传性状的研究,并与国内有关本地区的调查资料进行了对照,提出人类体质特征和遗传性状除与人种、地理环境异同直接相关外,人体不可缺少的微量元素的摄入水平在一定程度上对其也产生影响。并且认为同一人种、民族居住同一地理位置所产生的体质差异应从水文、地质、生活方式、生活水平的不同进行综合分析。     

体外受精-胚胎移植女性患者焦虑状况的影响因素分析及对妊娠结局的影响

摘要 目的：探讨体外受精-胚胎移植（IVF-ET）女性患者焦虑状况的影响因素及对妊娠结局的影响。方法：选择2019年3月~2021年4月期间南京鼓楼医院生殖医学科收治的192例IVF-ET女性患者。采用焦虑自评量表（SAS）评估所有患者焦虑状况。收集患者的临床资料,单因素及多因素Logistic回归分析IVF-ET女性患者焦虑的影响因素。观察不同焦虑状况患者的妊娠结局。结果：192例IVF-ET女性患者中,有37例（19.27%）患者出现焦虑状况。其中轻度焦虑15例（40.54%）、中度焦虑10例（27.03%）、重度焦虑12例（32.43%）。单因素分析结果显示,IVF-ET女性患者是否焦虑与家庭月收入、辅助生殖技术治疗失败史、文化程度、职业、不孕年限、年龄、社会支持、不孕类型、不孕原因有关（P<0.05）。多因素Logistic回归分析结果显示：不孕类型为原发不孕、不孕原因为女方因素、年龄>34岁、家庭月收入<3000元、文化程度为高中或中专及以下是导致IVF-ET女性患者发生焦虑的危险因素（P<0.05）。无焦虑患者优胚例数、2PN受精例数、获卵例数、临床妊娠例数占比均高于焦虑患者（P<0.05）。结论：IVF-ET女性患者较易产生焦虑情绪,其焦虑状况受不孕类型、不孕原因、年龄、家庭月收入、文化程度影响,且焦虑状况还会影响患者的妊娠结局,临床工作中应对存在上述影响因素的患者进行积极心理疏导。     

老年白内障患者术前焦虑障碍的影响因素分析及对术后干眼症状和视觉相关生活质量的影响

摘要 目的：探讨老年白内障患者术前焦虑障碍的影响因素,并观察术前焦虑障碍对术后干眼症状和视觉相关生活质量的影响。方法：选择2020年12月~2022年5月期间江苏省人民医院眼科收治的老年白内障患者100例作为研究对象。所有患者入院第1天采用状态-特质焦虑问卷（STAI）评估焦虑状况,采用单因素和多因素Logistic回归分析老年白内障患者发生术前焦虑障碍的影响因素,并观察其对术后干眼症状和视觉相关生活质量的影响。结果：本研究100例老年白内障患者中,有46例患者出现术前焦虑障碍,占比46.00%,平均STAI评分为（59.27±3.16）分;有54例未出现术前焦虑障碍,占比54.00%,平均STAI评分为（35.39±5.28）分。根据是否出现术前焦虑障碍将患者分为焦虑障碍组（n=46）和无焦虑障碍组（n=54）。单因素分析显示,老年白内障患者术前焦虑障碍与年龄、性别、文化程度、家庭人均月收入、外科手术史、合并基础疾病种类、是否双眼白内障、付费方式、家庭关系有关（P<0.05）,而与婚姻状况、居住地无关（P>0.05）。年龄为60~69岁、家庭关系差、性别为女、文化程度为小学及以下、无外科手术史、双眼白内障、合并基础疾病种类为2种及以上是老年白内障患者发生术前焦虑障碍的危险因素（P<0.05）。焦虑障碍组术后干眼症状评分高于无焦虑障碍组（P<0.05）。焦虑障碍组社会角色限制、精神健康状态、社交功能、近距离工作、总体视觉情况、远距离工作、周边视野、独立性、一般健康状态、驾驶、色彩视觉、眼痛分值及总分均低于无焦虑障碍组（P<0.05）。结论：年龄、家庭关系、性别、文化程度、外科手术史、双眼白内障、合并基础疾病种类是老年白内障患者术前焦虑障碍的影响因素。老年白内障患者存在术前焦虑障碍可增加术后发生干眼症状的风险,并降低其视觉相关生活质量。     

更好的经济状况就一定能改善农村儿童的体质指数吗？ ——来自湖南湘西与山西吕梁农村儿童的调查

目的：探究影响两地学生BMI合格状况的显著性因素。方法：以山西吕梁、湖南湘西两地4所农村小学862名小学生为调查对象,统计学生的BMI合格率;利用SPSS 23.0软件进行多元线性回归分析。结果：经济状况较好的山西吕梁学生BMI总体合格率与湖南湘西不存在显著性差异,而超重及肥胖率显著增加,因此,经济条件的改善并不一定能改善农村儿童的营养和体质状况;计量结果显示,小学生“膳食营养与食品安全认知”状况对其自身的BMI具有显著影响,认知越高,营养和体质状况越佳。结论：建议从家庭、学校两方面对小学生进行膳食教育。     

乳腺癌根治术患者术前焦虑的影响因素分析及其对术后恢复、细胞免疫功能和生命质量的影响

摘要 目的：分析乳腺癌根治术患者术前焦虑的影响因素,并探讨术前焦虑对患者术后恢复、细胞免疫功能和生命质量的影响。方法：选择我院2020年3月~2021年12月期间收治的拟行乳腺癌根治术的120例患者作为研究对象,术前1 d采用焦虑自评量表（SAS）评估所有患者的焦虑状况,根据是否存在焦虑分为焦虑组和无焦虑组,乳腺癌根治术患者术前焦虑的影响因素采用多因素Logistic回归分析。对比焦虑组和无焦虑组的术后恢复、细胞免疫功能和生命质量情况。结果：120例乳腺癌根治术患者中,有31例患者无术前焦虑,89例患者存在焦虑症状,根据是否存在术前焦虑分为焦虑组（n=89）和无焦虑组（n=31）。乳腺癌根治术患者术前焦虑与年龄、文化程度、家庭人均月收入、付费方式、婚姻状况、家庭支持、既往有无全麻史、术前住院时长、定期体检有关（P<0.05）。多因素Logistic回归分析结果表明：年龄＜60岁、文化程度为小学及其以下、家庭人均月收入＜3000元、婚姻状况为未婚、无家庭支持、既往无全麻史、术前住院时长>1 d是乳腺癌根治术患者术前焦虑的危险因素（P<0.05）。焦虑组的术后首次肛门排气时间、首次下床活动时间、术后住院时间均长于无焦虑组（P<0.05）。两组术后1个月CD3⁺、CD4⁺、CD4⁺/CD8⁺水平升高,且无焦虑组高于焦虑组（P<0.05）,两组术后1个月CD8⁺水平下降,且无焦虑组低于焦虑组（P<0.05）。两组术后1个月生理状况、情感状况、社会/家庭状况、功能状况、附加关注评分和总分下降,且无焦虑组低于焦虑组（P<0.05）。结论：乳腺癌根治术患者术前焦虑发生率较高,其发生受到年龄、文化程度、家庭人均月收入、婚姻状况、家庭支持、既往有无全麻史、术前住院时长等多种因素的影响,可导致患者术后恢复时间延长,细胞免疫功能和生命质量降低。     

浅谈家庭体育策略的制定和实施

家庭体育是良好生活方式的具体而生动的反映形式。国家的体育策略、家庭经济状况、体育环境、受教育程度等对家庭体育的影响颇大。现代生活方式中存在着很多健康隐患,如环境污染、营养过剩、运动不足、精神紧张等。对家庭体育的研究及家庭体育策略的制定和实施,有利于使家庭内部结构更稳定,有利于提高生活质量,使家庭成员的归属感更强,有利于社会繁荣昌盛。     

Genetic analysis of short stature

Short stature is a major concern for patients and their parents, and represents a diagnostic challenge to the clinician. A correct diagnosis is of particular importance in view of the availability of effective, but costly, therapy in a small subset of cases. Many different genetic etiologies of short stature are known. Therefore, chromosome as well as molecular analysis are requisite diagnostic investigations in children with short stature. Particularly in the group of children with idiopathic short stature, possibilities of molecular analysis are often underestimated. Important options are UPD7 and the FGFR3, SHOX, GH1 and GHR genes. Furthermore, analysis of the IGF and IGF1R genes should be considered. We propose a flow chart for molecular analysis in short stature.     

Growth hormone receptor sequence changes do not play a role in determining height in children with idiopathic short stature

BACKGROUND/AIMS: In children with short stature, in whom growth hormone deficiency has been excluded, the presence of a normal or elevated growth hormone concentration concomitant with low insulin-like growth factor I suggests growth hormone insensitivity (GHI). Previous reports suggest that heterozygous mutations in the growth hormone receptor gene (GHR) may account for about 5% of children with idiopathic short stature (ISS). In the present study we have attempted to determine whether mutations in the GHR explain the short stature and growth retardation in a cohort of children with ISS and characteristics suggesting GHI. METHODS: For the present study 33 children with clinical and biochemical characteristics of GHI were selected from a cohort of 150 children of short stature. Molecular analysis of the GHR was performed using a single-strand conformation polymorphism technique and sequencing. Ten different sequence changes in 19 (58%) out of 33 children were identified, 9 of them novel and 1 that had been described previously. RESULTS: Two changes were found in exons 2 and 6. The known polymorphism of exon 6 (G168) was significantly more common in the control subjects than in our study group (63.5 vs. 30%; p < 0.0001). In the intronic sequences 8 previously undescribed DNA changes were found. The screening of the affected children's family members revealed that both normal and short stature members carried the same variants. The study group did not significantly differ from the controls in retention (GHRfl) or exclusion (GHRd3) of exon 3. CONCLUSION: Our study suggests that sequence changes of the GHR are common in children with ISS. The presence of these sequence changes in the control subjects as well as in normal stature family members indicates that these changes represent a simple polymorphism of the GHR. Such DNA changes are more prevalent than previously recognized, and they do not seem to play a contributory role in the etiology of short stature.     

陕西地区人群克罗恩病发病危险因素的病例对照研究

目的:探讨陕西地区人群克罗恩病发病的危险因素.方法:采用病例对照研究,选择2009年1月～2010年12月在我院就诊的64例克罗恩病患者和64例健康对照者为研究对象,通过问卷的方式进行调查,调查内容包括饮食习惯、受教育情况、职业、家庭卫生情况、吸烟、母乳喂养、肠道疾病家族史、感染性肠病史、阑尾切除术、麻疹等内容,采用条件logistic回归分析影响陕西地区人群克罗恩病发病的危险因素.结果:64例克罗恩病患者及64例配对的健康对照者均完成问卷调查,多因素条件logistic回归分析结果显示,人均居住面积(大)(OR 0.4003,95％CI 0.1577,1.0165)、饮茶(OR 0.2597,95％CI 0.0662,1.0184)、油炸食品(OR3.1465,95％CI 1.2841,7.7101)、口服避孕药(OR 5.4500,95％CI 0.8400,35.1158)是陕西地区人群克罗恩病发病的危险因素.结论:油炸食品、服避孕药可能为陕西地区人群克罗恩病发病的危险因素,人均居住面积(大)、饮茶可能为陕西地区人群克罗恩病发病保护因素.     

Identification of a major recombination hotspot in patients with short stature and SHOX deficiency

Human growth is influenced not only by environmental and internal factors but also by a large number of different genes. One of these genes, SHOX, is believed to play a major role in growth, since defects in this homeobox-containing gene on the sex chromosomes lead to syndromal short stature (Leri-Weill dyschondrosteosis, Langer mesomelic dysplasia, and Turner syndrome) as well as to idiopathic short stature. We have analyzed 118 unrelated patients with Leri-Weill dyschondrosteosis and >1,500 patients with idiopathic short stature for deletions encompassing SHOX. Deletions were detected in 34% of the patients with Leri-Weill dyschondrosteosis and in 2% of the patients with idiopathic short stature. For 27 patients with Leri-Weill dyschondrosteosis and for 6 with idiopathic short stature, detailed deletion mapping was performed. Analysis was performed by polymerase chain reaction with the use of pseudoautosomal polymorphic markers and by fluorescence in situ hybridization with the use of cosmid clones. Here, we show that, although the identified deletions vary in size, the vast majority (73%) of patients tested share a distinct proximal deletion breakpoint. We propose that the sequence present within this proximal deletion breakpoint "hotspot" region predisposes to recurrent breaks.     

精神病患者家属心理健康状况调查研究

目的:探讨精神病患者家属的心理健康状况,并找出相关的影响因素.方法:对中山市91位住院以及门诊精神科病人家属进行问卷调查和访谈,采用的是症状自评量(SCL-90)和家庭疾病负担量表(Family Burden Scale of Disease).结果:家属心理健康状况与患者给家庭带来的负担存在明显的相关,患者患病对配偶的心理健康的影响明显大于对其他亲人或者朋友的影响(F=5.358,P＜0.001),15-30岁年龄段的SCL-90的得分要明显的高于其他年龄段(F=1.436,P＜0.01),而精神分裂症患者的家属SCL-90的得分也要明显高于其他疾病家属的得分.结论:影响家属心理健康的因素有多个方面,应该有针对性的采取家庭护理措施并加强家庭健康教育.     

Views on Short Stature of Female vs Male Endocrine Pediatric Patients Undergoing Provocative Growth Hormone Testing and Their Parents

ObjectiveBoys outnumber girls in short stature evaluations and growth hormone treatment despite absence of gender differences in short stature prevalence. Family views on short stature influence medical management, but gender-based analysis of these views is lacking. This study explored endocrine patients’ and their parents’ perceptions of short stature and its impact on quality of life by patient gender.MethodsPatients aged 8 to 14 years undergoing provocative growth hormone testing and 1 parent each completed semistructured interviews. Clinical data were extracted by chart review.ResultsTwenty-four patient-parent dyads (6 female patients, 22 mothers; predominantly non-Hispanic White) participated. Six major themes emerged: (1) patients’ perceptions of their short stature were similar by gender, (2) physical experiences of short stature were similar by gender, (3) social experiences of short stature were both similar and different by gender, (4) parental perceptions of short stature as a factor limiting their child’s functionality were similar by gender, (5) concern about societal stigma related to short stature arose for both genders, and (6) patients’ perceptions of parental messaging about the import of their short stature were similar by gender.ConclusionOur data reveal more similarities than differences between genders in patient perceptions and patient and parent-reported experiences of short stature. Worry about stature-related stigma was noted for patients of both genders. Parental messaging about short stature emerged as an important area to explore further by patient gender. Our findings suggest that clinicians should be wary of making gender or stigma-based assumptions when evaluating children with short stature.     

Perceived versus measured height. Which is the stronger predictor of psychosocial functioning?

The relationship between perceptions versus measured height and children's psychosocial adaptation in a sample of medically referred youth with short stature was investigated. All children referred for a growth evaluation to one regional pediatric endocrinology clinic received a psychosocial screening assessment as a routine component of their initial visit. Data were collected for patients ages 4-18 years (n = 620) with heights ranging from -4.0 to -1.1 SD for age- and gender-adjusted population norms. Patients (8 years and older) and in all cases a parent/guardian served as informant through paper-and-pencil questionnaires. Both children and parents overestimated the child's height. Overestimations of height were associated with greater patient and parent satisfaction with stature. Perceived height was more strongly associated with psychosocial adaptation than was measured height. Clinical management decisions designed to enhance patient quality of life by increasing projected adult height through hormonal interventions should take into account both measured and perceived patient height.     

Metabolic consequences of growth hormone treatment in paediatric practice

No metabolic side-effects of clinical significance have been reported during a 5-year study of growth hormone (GH) therapy in children with GH deficiency, Turner syndrome, idiopathic short stature or chronic renal insufficiency. In particular, insulin levels increase but remain within the normal range, as do glucose and haemoglobin A(1c). A recent study showed that the effects of growth on insulin sensitivity in prepubertal children with idiopathic short stature represent the changes in carbohydrate tolerance observed during normal adolescence. Thus, GH treatment may lead to prolongation of the physiological state of insulin resistance observed in normal puberty. Insulin levels during the fasting state and 2 h after a standard glucose load showed no further rise after the first 3 years of continuous GH therapy. The hyperinsulinaemia observed during GH therapy may, therefore, amplify the anabolic effects of insulin on protein metabolism during puberty.