Study on the effect of a community-based early education and service program regarding intelligence development of infants / 中华流行病学杂志

<p><b>UNLABELLED</b>Study on the effect of a community-based early education and service program regarding intelligence</p><p><b>OBJECTIVE</b>To assess the effect on a community-based early education and service programs regarding the development of infants' intelligence.</p><p><b>METHODS</b>A community-based intervention study was carried out among 359 infants and their families. Base-line survey were carried out when infants reached their one month, where after infants and their families in the intervention group received instructions and services focused on baby fostering and intelligence development. When the infants reached their six-months and twelve-months of age, their families were informed to complete the follow-up surveys, using both questionnaire investigation and testing the infants' intelligence quotients. The infants' intelligence quotients were measured by Development Screening Test for children under six. By comparing intelligence quotients of infants in two study groups in the follow-up surveys, this paper evaluated the impacts of community intervention on the infants' intelligence development.</p><p><b>RESULTS</b>During two follow-ups, no statistical difference had been detected between the two groups of infants in term of gender or delivery process. Baseline data showed that infants' mental index (MI) scored 98.26 in the intervention group and 101.79 in the control one, and development quotient (DQ) scored 94.50 and 99.36 in respective groups. Infants' MI score increased 6.07 and 8.86 at the six-month and twelve-month follow-up periods respectively in the intervention group compared during the baseline, higher than the MI increments of the control group at the two follow-up periods (-2.46 and 1.05 respectively). DQ score of infants in the intervention group increased 12.94 and 11.24 respectively in the two follow-up surveys, which were also higher than increments in the control group (-0.18 and 0.34). The group x time effect(interaction effect) of MI and DQ in six-month and twelve-month follow-ups were both significantly higher than that of the baseline level.</p><p><b>CONCLUSION</b>The community-based early education and service programs could effectively improve the infants' intelligence.</p>

Analyses of polysomnogram in children suspected of obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze polysomnogram characteristics of children with suspected obstructive sleep apnea hypopnea syndrome (OSAHS) and to explore the role of obstructive apnea index (OAI), apnea hypopnea index (AHI) and arousal index for pediatric OSAHS diagnosis.</p><p><b>METHODS</b>Sixty one suspected pediatric OSAHS cases had overnight polysomnography for at least 8 h in a quiet, dark room. Sleep studies were interpreted according to diagnostic criteria of Guangzhou Children's Hospital (Obstructive apnea was defined as cessation of nose and mouth airflow, while the respiratory effort continues for any duration. Hypopnea was defined as reduction of oronasal flow > 50% accompanied by a desaturation of 0. 04 or greater) and Urumqi diagnostic criteria (Obstructive apnea was defined as cessation of airflow at the nose and the mouth, while the respiratory effort continues for at least two breaths. Hypopnea was defined as reduction of oronasal flow > 50% accompanied by a desaturation of more than 0.03, or/and by an arousal) respectively. The OAI, AHI and arousal index were recorded and analyzed according to the two different diagnostic criteria respectively.</p><p><b>RESULTS</b>(1) Forty - one children (67.2%) had 206 obstructive apneas. Fifty - four children (88.5%) had 2249 obstructive hypopneas. Apnea - hypopnea events mainly occurred during rapid eye movement sleep. (2) OAI and AHI were analyzed by diagnostic criteria of Guangzhou Children's Hospital and Urumqi diagnostic criteria respectively. OAI < 1 was observed in 68. 9% and 75.4% children respectively and AHI < 5 occurred in 34.4% and 24.6% children respectively. (3) Statistically significant difference found between spontaneous arousal index and respiratory - related arousal index (z = -5.787, P = 0.000).</p><p><b>CONCLUSIONS</b>As the criteria of pediatric OSAHS, arbitrary OAI number should be determined on the basis of large sample investigation, the significance of spontaneous arousal index still needs further investigation.</p>

Clinical features and surgery in children with plastic bronchitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To review the clinical features and therapeutic experience in children with plastic bronchitis.</p><p><b>METHODS</b>Fourteen children with plastic bronchitis were reviewed retrospectively, 12 of which were under two years old. The clinical features are characterized by sudden onset, episodes of profound hypoxia and respiratory tract obstruction. SaO2 was between 0.70 and 0.80 even with mask oxygen inhalation. Eight cases were pyretic, 4 cases expectorated jel-like bronchial casts. The chest X-ray picture showed patchy consolidation or atelectasis unilaterally (10 cases) or bilaterally (2 cases). Pulmonary marking thickening and patchy shadow were observed in 2 cases. Twelve cases underwent rigid bronchoscopy and the bronchial casts were removed. Two cases underwent endotracheal intubation.</p><p><b>RESULTS</b>Eight cases of 12 children received therapeutic bronchoscopy were cured. Other 4 cases had second therapeutic bronchoscopy and bronchial casts were removed again in 3 cases, one died from pulmonary hemorrhage. Two cases who underwent endotracheal intubation died from the multiple organ failure (MOF). Pathologic results showed:the bronchial casts were composed mainly of mucus and fibrin, inflammatory cell infiltrate were observed in 6 cases (Type 1, inflammatory), no cellular infiltrate occurred in 8 cases (Type 2, acellular).</p><p><b>CONCLUSIONS</b>Plastic bronchitis is a severe and dangerous disease. The branching plastic casts may obstruct part or the entire tracheobronchial, causing respiratory failure. Bronchoscopy and pathologic examination are essential for it's diagnosis and treatment.</p>

Diagnosis and treatment of laryngeal web in infants / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To summarize the clinical manifestation, operative method and therapeutic effect of various type of laryngeal web in infants.</p><p><b>METHODS</b>The clinical data of 12 cases were analyzed, 5 cases of which were congenital laryngeal web (4 cases, glottic type; 1 case, subglottic type), 7 cases of which were secondary laryngeal web (1 case, tuberculous laryngeal web; 6 cases, traumatic laryngeal web). Diagnosis was mainly depended on history and clinical manifestation. Final diagnosis was depended on fibrolaryngoscope and pathological report. Microlaryngoscopic surgery was the main operative method. However, specific infection should be cured before operation.</p><p><b>RESULTS</b>During 3-18 months follow-up, 4 glottic laryngeal webs were cured. One subglottic laryngeal web case well recovered and secondary surgery is not needed at least recently. One tuberculous laryngeal web was followed up for 6 months, no vocal adhesion was observed. During 3-6 months follow-up, 1 traumatic laryngeal web was cred, while the other 6 cases need secondary surgery.</p><p><b>CONCLUSIONS</b>Final diagnosis of congenital laryngeal web is mainly depended on fibrolaryngoscope. And prognosis of it is well. Laryngeal web induced by specific infection should be cured specific infection before operation. The prevention is the key for traumatic laryngeal web because the surgery outcome is not satisfactory.</p>

Changes of sleep architecture in children with obstructive sleep apnea syndrome / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore how obstructive sleep apnea syndrome (OSAS) affects children's sleep architecture.</p><p><b>METHODS</b>Eighty-three children with OSAS were reviewed; every patient was monitored with polysommography for 7 hours at night for 11 parameters, including the number of arousal, snoring index, nadir O(2) desaturation, stage I %, stage II %, show wave sleep (SWS)% and rapid eye movement (REM)%. The basis for diagnosis of OSAS was the widely accepted pediatric diagnostic criteria of apnea/hypopnea index, apnea/ hypopnea index of > 1 episode/hour, nadir O(2) desaturation < 92%. Sleep was scored manually according to the standard set by Rechtschaffen.</p><p><b>RESULTS</b>In OSAS group, the number of arousal was 22.5 +/- 1.4, snoring index was 70.6 +/- 16.5, and/or SaO(2) was (73.8 +/- 1.9)%. OSAS group had increased stage I : (45.8 +/- 2.0)% vs. (2.3 +/- 1.1)%, t = 22.46, P < 0.01 and decreased stage II : (23.9 = 1.7)% vs (47.9 = 4.4)%, t = - 14.18, P < 0.01, SWS (15.6 +/- 1.8)% vs. (21.1 +/- 5.0)%, t = - 3.123, P < 0.01, REM (14.7 +/- 1.5)% VS. (28.2 +/- 4.1)%, T = -8.923, p < 0.01.</p><p><b>CONCLUSION</b>The severity of OSAS relates to changes of sleep architecture in children. Intermittent nocturnal hypoxia secondary to apnea/hypopnea, and frequent electroencephalogram arousals from sleep may result in significant sleep fragmentation. Children with OSAS had learning problems and failure to thrive.</p>

Study on the occurrence of cesarean section (CS) and factors related to CS in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To find out the occurrence of cesarean section (CS) and to probe the factors associated with CS.</p><p><b>METHODS</b>Women with CS as "case group" and women without CS as "control group" were chosen in a case-control study.</p><p><b>RESULTS</b>Among 14 071 childbirth women, 6 421 had CS (case group) with the occurrence rate of 45.6% and 7 650 (54.4%) had normal delivery (control group). In comparison with the control group, the CS group had following several higher rates [with significant differences between case group and control group (P < 0.01)]: well-educated (78.9% vs 69.5%), white collar jobs (38.0% vs 32.3%), urban residents (79.1% vs 70.6%), high monthly income (>/= 500 Yuan) (81.0% vs 70.6%), of older age (>/= 25 years) (73.3% vs 63.0%), heavier baby weight (> 4 000 gram) (8.3% vs 2.9%), male babies (53.9% vs 51.4%), BMI of mother (> 24) (8.8% vs 4.8%), cephalopelvic disproportion (21.1% vs 0.9%), intrauterine asphysia (20.3% vs 6.7%), abnormality of force of labor (4.2% vs 2.7%), prolonged labor (2.9% vs 1.0%) and placenta previa (1.4% vs 0.4%). Our study also indicated that the higher the educational level was, the higher the rate of CS appeared; and the older the pregnant women was, the higher the rate of CS was. In CS group, over 70% primipara were over 24 years, and over 20% primipara had cephalopelvic disproportion and over 20% had intrauterine asphysia in CS group.</p><p><b>CONCLUSIONS</b>At present, the occurrence rate of cesarean section was rather high (45.6%) in China. The high rate of CS was more likely to associate not only with abnormal physiological/medical factors (eg. cephalopelvic disproportion, intrauterine asphysia, abnormality of force of labor, and prolonged labour, etc.), but also with some demographic factors as education, occupation, income and age, etc. It is necessary to take measures to reduce the unnecessary CS in China.</p>