Assessment of pulmonary artery pulse wave velocity in children: An MRI pilot study

Purpose

To assess the feasibility of measuring pulmonary artery (PA) pulse wave velocity (PWV) in children breathing ambient air and 12% oxygen.

Methods

Velocity-encoded phase-contrast MR images of the PA were acquired in 15 children, aged 9–12 years, without evidence of cardiac or pulmonary diseases. PWV was derived as the ratio of flow to area changes during early systole. Each child was scanned twice, in air and after at least 20 minutes into inspiratory hypoxic challenge. Intra-observer and inter-observer variability and repeatability were also compared.

Results

PA PWV, which was successfully measured in all subjects, increased from 1.31 ± 0.32 m/s in air to 1.61 ± 0.58 m/s under hypoxic challenge (p = 0.03). Intra- and inter-observer coefficients of variations were 9.0% and 15.6% respectively. Good correlation within and between observers of r = 0.92 and r = 0.72 respectively was noted for PA PWV measurements. Mean (95% limit of agreement) intra- and inter-observer agreement on Bland–Altman analysis were − 0.02 m/s (− 0.41–0.38 m/s) and -0.28 m/s (− 1.06–0.49 m/s).

Conclusion

PA PWV measurement in children using velocity-encoded MRI is feasible, reproducible and sufficiently sensitive to detect differences in PA compliance between normoxia and hypoxia. This technique can be used to detect early changes of PA compliance and monitor PAH in children.     

慢性咳嗽患儿呼出气一氧化氮与特应性体质及血清总免疫球蛋白E水平的相关性研究

目的研究慢性咳嗽患儿呼出气一氧化氮（fractional exhaled nitric oxide ,FeNO）与特应性体质及血清总免疫球蛋白E（TIgE）水平的相关性。方法对91例慢性咳嗽的患儿进行FeNO、血TIgE的检测及变应原皮肤点刺试验并进行分组对比。结果特应性体质组FeNO值为（29.74±14.24）ppb,TIgE为（483.95±384.57）IU/ml,非特应性体质组FeNO值为（13.82±7.91） ppb,TIgE为（154.09±143.42）IU/ml,差异均有统计学意义（均P＜0.05）。血清TIgE增高患儿FeNO值为（29.15±15.30）ppb,血清IgE正常患儿FeNO值为（16.22±9.75）ppb,差异有统计学意义（P＜0.05）。相关性分析发现FeNO水平与过敏原数目不存在相关（P=0.278）。结论特应性体质可使慢性咳嗽患儿FeNO水平明显升高,而FeNO与皮肤过敏原阳性数目无明显相关性,在诊断哮喘时应注意特应性体质的存在。     

Should Singing Activities Be Included in Speech and Voice Therapy for Prepubertal Children?

Customarily, speaking and singing have tended to be regarded as two completely separate sets of behaviors in clinical and educational settings. The treatment of speech and voice disorders has focused on the client's speaking ability, as this is perceived to be the main vocal behavior of concern. However, according to a broader voice-science perspective, given that the same vocal structure is used for speaking and singing, it may be possible to include singing in speech and voice therapy. In this article, a theoretical framework is proposed that indicates possible benefits from the inclusion of singing in such therapeutic settings. Based on a literature review, it is demonstrated theoretically why singing activities can potentially be exploited in the treatment of prepubertal children suffering from speech and voice disorders. Based on this theoretical framework, implications for further empirical research and practice are suggested.     

长沙市500例2～6岁儿童铁缺乏症调查分析

对５００例２－６岁儿童铁缺乏症了调查，采用耳垂动脉化微量取因，用纸片法检测，其中Ｈｂ采用ＨｉＣＮ法，ＦＥＰ采用芯荧光分析，缺铁性盆血期绝大多数为轻度贫血，占９７．５％，７岁以下儿童轻度贫血者铁缺乏显著。     

广州市3～6岁幼儿膳食硒营养状况探讨

通过对广州市幼儿园3～6岁生长发育不正常及正常儿童的配对膳食结构进行了调查，以及对进食的普通釉米与营养豆米中硒进行了比较，并通过大白鼠的喂养试验对营养米中硒的吸收利用效果进行了初步观察，从而对改进膳食中硒的营养水平进行初步的探讨．     

不同区域儿童血铅浓度及铅危害的防治

实验选择了生活在杭州市区５￣６岁学龄前儿童１２０名，男女各半，并选择了生活在杭州近郊海查市农村同龄儿童１００名为观察对照组，进行了血铅含量的测试。结果显示，生活在杭州市中心的儿童受到铅污染的危害程度比生活在农村的儿童较为严重。以目前公认推荐血铅可接受上限值０．４８３μｍｏｌ／Ｌ计算，杭州市有４９．１％、而海宁农村有３１．９％的儿童血铅浓度超过允许标准。儿童的严重铅危害，应引起人们高度重视。     

广州铁路346名儿童锌营养状况分析

为了解广州铁路地区儿童锌营养水平高低对体格发育的影响，对羊城铁路总公司属下８间托幼所３４６名３～５岁儿童进行了发锌含量及体格发育状况的调查．结果提示，６０名健康组小儿发锌与身高，体重有明显正相关性．身高相关系数为γ＝０．１５０，体重相关系数为γ＝０．３４１．５０名缺锌组儿童身高、体重均低于富锌组儿童，两组身高Ｐ值＜０．０２５，体重Ｐ值＜０．００５，有显著差异．这说明锌作为亚临床营养素之一，与小儿身高、体重休戚相关．锌营养不足，可使小儿生长速度受到抑制，因此，在集体儿童体检时，应注意锌营养状况的检验，以及时纠正锌营养缺乏，避免小儿体格发育受锌缺乏的影响．     

铅污染对幼儿健康影响的调查研究

对调查区和对照区共２０３名￣６岁幼儿进行了血铅汪洋的调查。结果显示，生活在不同环境下的幼儿，已受到程度不同的铅污染。工业相对集中的城镇（调查区）幼儿血铅含量为５．１５μｇ／ｄＬ，大于郊区（对照区）幼儿的血铅含量３．５４μｇ／ｄＬ，交通和工矿企业对周围环境的污染是幼儿体内铅的主要来源。     

含锌冲剂治疗小儿缺锌的临床观察

本文通过含锌冲剂治疗小儿血锌低下２４例．对患儿临床症状改善情况进行比较，发现改善厌食症状有效率达８６．３６％，反应呼吸道感染有效率达９５．２４％．对缺锌组治疗前与正常儿童血铸进行比较．治疗组血锌比正常组明显偏低，Ｐ＜０．００１，其差异有极显著意义．对治疗组治疗前后的血锌等元素进行测定与比较，口服含锌冲剂治疗后，血锌大部分升高，经ｌ检验，Ｐ＜０．００５，其差别有显著意义。而Ｚｎ／Ｃｕ比值在治疗后明显升高，Ｐ＜０．００１，更说明含锌冲剂对调整微量元素有肯定的效果。     

多动症患儿发中铅的含量分析

调查和分析了３４８名多动症患儿发中铅含量，提出了小儿多动症的防治原则。