急性横贯性脊髓炎是一种以脊髓局灶性炎症为特征的脊髓疾病,虽然少见,但可能遗留严重的神经系统后遗症。近年来,随着脱髓鞘相关抗体的发现,对该病的认识也不断提高。因此,本文拟通过对急性横贯性脊髓炎相关文献的分析和总结,探讨急性横...急性横贯性脊髓炎是一种以脊髓局灶性炎症为特征的脊髓疾病,虽然少见,但可能遗留严重的神经系统后遗症。近年来,随着脱髓鞘相关抗体的发现,对该病的认识也不断提高。因此,本文拟通过对急性横贯性脊髓炎相关文献的分析和总结,探讨急性横贯性脊髓炎的流行病学、发病机制、临床表现、诊断方法、鉴别诊断、治疗和预后,旨在为临床医生提供对该病的更好认识,指导临床的早期规范化诊断、针对性治疗,最终改善患者预后。Acute transverse myelitis is a spinal cord disease characterized by focal inflammation of the spinal cord. Although it is rare, it may leave serious neurological sequelae. In recent years, with the discovery of demyelinating-related antibodies, the understanding of this disease has been continuously improved. Therefore, this article aims to analyze and summarize the relevant literature on acute transverse myelitis to explore its epidemiology, pathogenesis, clinical manifestations, diagnostic methods, differential diagnosis, treatment, and prognosis. The goal is to provide clinicians with a better understanding of the disease and guide early standardized diagnosis and targeted treatment in clinical practice, ultimately improving the prognosis of patients.展开更多
目的:考察儿童生存质量量表PedsQLTM3.0神经肌肉疾病模块(Pediatric quality of life inventoryTM3.0 neuromuscularmodule,PedsQLTM3.0 NMM)中文版的信度和效度。方法:采用规范的量表引进程序,将英文版的PedsQLTM 3.0 NMM翻译改造成中...目的:考察儿童生存质量量表PedsQLTM3.0神经肌肉疾病模块(Pediatric quality of life inventoryTM3.0 neuromuscularmodule,PedsQLTM3.0 NMM)中文版的信度和效度。方法:采用规范的量表引进程序,将英文版的PedsQLTM 3.0 NMM翻译改造成中文,并应用于39例Duchenne型肌营养不良(Duchenne muscular dystrophy,DMD)患儿及其家长。分析量表的可行性、内部一致性、内容效度、结构效度等。结果:39份问卷中,父母代评量表及儿童自评量表的缺失率为0.31%、0.64%,均<1%。量表总分及各维度的克伦巴赫系数α(Cronbach’sα)介于0.74～0.88,均>0.7;评定者间的信度(Intraclass correlation coefficient,ICC)介于0.74～0.86,均>0.6。量表各条目与所属维度的Spearman相关系数(rs)分别为0.42～0.88和0.39～0.84,均呈中、高度相关,而与其他维度的相关较弱。不同病情的疾病维度差异有统计学意义(P<0.05),余维度差异无统计学意义(P>0.05)。实证性因子分析结果显示相对拟合指数(Comparative fit index,CFI)分别为0.94、0.93,均>0.9。结论:PedsQLTM3.0 NMM中文版具有较好的信度和效度,可应用于中国神经肌肉疾病患儿生存质量的评价。展开更多
丙戊酸作为一种经典的广谱抗癫痫药,具有多种抗癫痫机制,被广泛的用于治疗几乎所有类型的癫痫及癫痫综合征。尽管大量的研究已证明丙戊酸具有良好的安全性,但因儿童群体有着不同于成人的生理及药物代谢特点,一些药物不良反应,特别是与...丙戊酸作为一种经典的广谱抗癫痫药,具有多种抗癫痫机制,被广泛的用于治疗几乎所有类型的癫痫及癫痫综合征。尽管大量的研究已证明丙戊酸具有良好的安全性,但因儿童群体有着不同于成人的生理及药物代谢特点,一些药物不良反应,特别是与年龄相关的药物不良反应仍限制了其应用。因此,本文围绕丙戊酸的药理作用、药代谢动力学、儿童药物代谢特点以及成人与儿童药物不良反应的异同来对丙戊酸在治疗儿童癫痫中的安全性作出综述。Valproic acid (VPA), as a broad-spectrum antiepileptic drug, is widely used in the treatment of almost all types of seizure, epilepsy and epilepsy syndrome due to its multiple mechanisms of action. Although numerous studies suggest the acceptable safety profile of VPA, some adverse drug reactions, especially those age-dependent, limit its application in children as the physiological and drug metabolism characteristics of children are different from adults. Herein, this article reviews the safety of VPA in the treatment of childhood by focusing on its action mechanisms, pharmacokinetics, characteristics of drug metabolism in children and similarities and differences of adverse drug reactions in adults and children.展开更多
目的：评价和确定Braden-Q儿童压疮评估量表用于诊断住院患儿压疮高风险的最佳临界值。方法：对2014年1至6月在我院住院且Braden-Q量表≤24分的372例患者进行住院期间压疮发生情况追踪分析,采用灵敏度、特异度、阳性预测值、阴性预测值...目的：评价和确定Braden-Q儿童压疮评估量表用于诊断住院患儿压疮高风险的最佳临界值。方法：对2014年1至6月在我院住院且Braden-Q量表≤24分的372例患者进行住院期间压疮发生情况追踪分析,采用灵敏度、特异度、阳性预测值、阴性预测值、约登指数和受试者工作特征曲线（receiver operating characteristic,ROC）确定和评价Braden-Q量表诊断压疮高度危险的临界值。结果：372例研究对象中有37.73%的患者Braden-Q评分≤16分（最低11分）,72.27%的患者Braden-Q评分17～24分;共发生院内压疮21例,其分值主要集中在13～16分。当Braden-Q量表诊断压疮高危的临界值为16分时,其预测压疮危险的灵敏度为0.826,特异度为0.759,阳性预测值为0.185,阴性预测值为0.985,约登指数（0.585）较其他临界值更大,Braden-Q量表ROC曲线下面积（area under curve,AUC）为0.923。结论：Braden-Q量表16分是诊断儿童压疮高度危险的最佳临界值,能够很好地预测儿童发生压疮的风险,具有较高的诊断价值。展开更多
文摘急性横贯性脊髓炎是一种以脊髓局灶性炎症为特征的脊髓疾病,虽然少见,但可能遗留严重的神经系统后遗症。近年来,随着脱髓鞘相关抗体的发现,对该病的认识也不断提高。因此,本文拟通过对急性横贯性脊髓炎相关文献的分析和总结,探讨急性横贯性脊髓炎的流行病学、发病机制、临床表现、诊断方法、鉴别诊断、治疗和预后,旨在为临床医生提供对该病的更好认识,指导临床的早期规范化诊断、针对性治疗,最终改善患者预后。Acute transverse myelitis is a spinal cord disease characterized by focal inflammation of the spinal cord. Although it is rare, it may leave serious neurological sequelae. In recent years, with the discovery of demyelinating-related antibodies, the understanding of this disease has been continuously improved. Therefore, this article aims to analyze and summarize the relevant literature on acute transverse myelitis to explore its epidemiology, pathogenesis, clinical manifestations, diagnostic methods, differential diagnosis, treatment, and prognosis. The goal is to provide clinicians with a better understanding of the disease and guide early standardized diagnosis and targeted treatment in clinical practice, ultimately improving the prognosis of patients.
文摘丙戊酸作为一种经典的广谱抗癫痫药,具有多种抗癫痫机制,被广泛的用于治疗几乎所有类型的癫痫及癫痫综合征。尽管大量的研究已证明丙戊酸具有良好的安全性,但因儿童群体有着不同于成人的生理及药物代谢特点,一些药物不良反应,特别是与年龄相关的药物不良反应仍限制了其应用。因此,本文围绕丙戊酸的药理作用、药代谢动力学、儿童药物代谢特点以及成人与儿童药物不良反应的异同来对丙戊酸在治疗儿童癫痫中的安全性作出综述。Valproic acid (VPA), as a broad-spectrum antiepileptic drug, is widely used in the treatment of almost all types of seizure, epilepsy and epilepsy syndrome due to its multiple mechanisms of action. Although numerous studies suggest the acceptable safety profile of VPA, some adverse drug reactions, especially those age-dependent, limit its application in children as the physiological and drug metabolism characteristics of children are different from adults. Herein, this article reviews the safety of VPA in the treatment of childhood by focusing on its action mechanisms, pharmacokinetics, characteristics of drug metabolism in children and similarities and differences of adverse drug reactions in adults and children.
文摘目的：评价和确定Braden-Q儿童压疮评估量表用于诊断住院患儿压疮高风险的最佳临界值。方法：对2014年1至6月在我院住院且Braden-Q量表≤24分的372例患者进行住院期间压疮发生情况追踪分析,采用灵敏度、特异度、阳性预测值、阴性预测值、约登指数和受试者工作特征曲线（receiver operating characteristic,ROC）确定和评价Braden-Q量表诊断压疮高度危险的临界值。结果：372例研究对象中有37.73%的患者Braden-Q评分≤16分（最低11分）,72.27%的患者Braden-Q评分17～24分;共发生院内压疮21例,其分值主要集中在13～16分。当Braden-Q量表诊断压疮高危的临界值为16分时,其预测压疮危险的灵敏度为0.826,特异度为0.759,阳性预测值为0.185,阴性预测值为0.985,约登指数（0.585）较其他临界值更大,Braden-Q量表ROC曲线下面积（area under curve,AUC）为0.923。结论：Braden-Q量表16分是诊断儿童压疮高度危险的最佳临界值,能够很好地预测儿童发生压疮的风险,具有较高的诊断价值。
