目的 研究颈源性头痛患者颈椎X线中C2~C7棘突偏歪和椎体滑脱情况,总结其中存在的规律,为治疗颈源性头痛提供影像学理论支持。方法 选取颈源性头痛患者96例,观察并记录每位患者颈椎X线片中C2~C7棘突偏歪和椎体滑脱情况。用统计软件分别对棘突偏歪和椎体滑脱数据进行分析。结果 颈源性头痛患者较常出现棘突偏歪,右侧偏歪明显多于左侧偏歪。其中C2棘突偏歪最常见,出现比例为66.7%。C2棘突偏歪率与C3~C7分别进行χ²检验,其中C5、C6与C2均有显著差异。C3、C4、C7与C2均无显著差异。椎体滑脱亦常出现于颈源性头痛患者,其中C7椎体向前Ⅰ度滑脱最常见,出现比例为50.0%。C7椎体向前Ⅰ度滑脱率与C2~C6分别进行χ²检验,其结果均有显著差异。结论 C2棘突偏歪和C7椎体向前Ⅰ度滑脱较常出现于颈源性头痛患者。在治疗颈源性头痛患者时,与C2和C7相关的软组织损伤和关节紊乱应引起重点关注。

Objective To study the skew of C2~C7 spinous process deviation and spondylolisthesis in cervical spine X-ray of patients with cervical headache,and summarize the existing rules,so as to provide imaging theoretical support for the treatment of cervical headache．Methods The C2~C7 spinous process distortion and spondylolisthesis in cervical radiographs of 96 patients with cervical headache were observed,recorded and analyzed．Results Skew of spinous process was more common in patients with cervicogenic headache,and skew of right side was more obvious than skew of left side．C2 spinous process was the most common,and the proportion of occurrence was 66.7%．The skew rate of C2 spinous process were compared with that of C3~C7 by χ² test．There were significant differences between C5,C6 and C2．There were no significant difference between C3,C4,C7 and C2．Spondylolisthesis was commonly seen in patients with cervicogenous headache,and I degree spondylolisthesis was most commonly seen in C7,and the proportion of occurrence was 50.0%．There were significant differences between the anterior Ⅰ degree slip rate of C7 vertebrae and that of C2~C6 vertebrae by χ² test．Conclusions C2 spinous process and C7 spondylolisthesis I are more commonly seen in patients with cervicogenic headache．Soft tissue injuries and joint disorders associated with C2 and C7 should be paid more attention in the treatment of patients with cervicogenic headache．

目的 研究慢性非特异性腰痛患者腰椎正侧位X线中腰椎侧弯、L1-5棘突偏歪和椎体滑脱情况,总结规律,为慢性非特异性腰痛患者治疗提供依据。方法 选取164例慢性非特异性腰痛患者,观察并记录每例患者腰椎正侧位X线中腰椎侧弯、L1~L5棘突偏歪和椎体滑脱情况。用统计学软件分析腰椎侧弯、棘突偏歪和椎体滑脱情况。结果 共有59例发生腰椎侧弯,占35.98%,其中Cobb角5°~10 °有47例,占28.66%;Cobb角>10°有12例,占7.32%。腰椎侧弯发病以L4为下端椎为主。以L3为下端椎有12例患者,占20.34%;以L4为下端椎有37例患者,占62.71%;以L5为发椎有10例患者,占16.95%。共119例发生棘突偏歪,占总例数的72.56%。L5棘突偏歪最常见,发生率为57.93%;L4次之,发生率为48.17%。L5棘突偏歪率与L1~L3棘突偏歪率比较差异均有统计学意义（χ²分别为14.580,11.771,7.484,P分别为<0.001,0.001,0.006）,但与L4棘突偏歪率比较差异无统计学意义（χ²=3.124,P=0.077）。共30例患者存在椎体滑脱,占18.29%。L5最常发生滑脱,发生率为8.54%;L4次之,发生率为7.93%。L4与L5椎体滑脱率比较差异无统计学意义（χ²=0.040,P=0.841）;L4分别与L1,L2,L3以及L5分别与L1,L2,L3椎体滑脱率差异均有统计学意义（L5与L1、L2、L3：χ²分别为14.580、11.771、7.484,P分别为<0.001、<0.001、<0.006;L4与L1、L2、L3：χ²分别为13.495、10.712、6.550,P分别为<0.001、<0.001、<0.010）。结论 慢性非特异性腰痛患者较常发生腰椎侧弯,侧弯以L4为下端椎为主;慢性非特异性腰痛患者较常发生棘突偏歪,L5棘突偏歪最常见,L4次之;L5和L4是慢性非特异性腰痛患者最常发生滑脱的椎体。在治疗慢性非特异性腰痛患者时,与L5和L4相关的肌肉、筋膜等软组织损伤以及关节退行性变或紊乱应引起重点关注。

Objective To study the lumbar scoliosis,L1-5 spinous process deviation and spondylolisthesis in spine X-ray of patients with chronic non-specific low back pain（CNLBP）,and summarizing the existing rules,so as to provide imaging theoretical support for the treatment of CNLBP．Methods A total of 164 patients with CNLBP were selected．The lumbar scoliosis,L1-5 spinous process deviation and spondylolisthesis were observed and recorded in the anteroposterior and lateral X-ray films of each patient．The lumbar scoliosis,spinous process deviation and spondylolisthesis were statistically analyzed by statistical software．Results A total of 59 people had lumbar scoliosis,accounting for 35.98%．There were 47 patients with 5°-10°Cobb angle,accounting for 28.66%．There were 12 patients with Cobb angle >10°,accounting for 7.32%．L4 was the main lower apical vertebra of lumbar scoliosis．There were 12 patients with L3 as the lower apical vertebra,accounting for 20.34%;37 patients with L4 as the lower apical vertebra,accounting for 62.71%;10 patients with L5 as the lower apical vertebra,accounting for 16.95%．A total of 119 people appeared spinous process deviation,accounting for 72.56%．L5 spinous process deviation was the most common,with proportion of 57.93%,and L4 was the second,with proportion of 48.17%．The results of chi-square test showed that there were significant differences between L5 and L1-L3 spinous process deviation（χ² were 14.580,11.771,7.484,and P values were <0.001,0.001,0.006 respectively）,but no significant difference between L5 and L4 spinous process（χ²=3.124,P=0.077）．A total of 30 patients had spondylolisthesis,accounting for 18.29%．L5 was the most common of spondylolisthesis,with an occurrence rate of 8.54%．L4 was the second,with an occurrence rate of 7.93%．There was no significant difference in spondylolisthesis rate between L4 and L5（χ²=0.040,P=0.841）．The spondylolisthesis rates of L4 and L5 were significantly different from those of L1,L2 and L3（L5 and L1,L2,L3：χ² were 14.580,11.771,7.484,and P values were <0.001,0.001,0.006 respectively;L4 and L1,L2,L3：χ² was 13.495,10.712,6.550,P values was <0.001,0.001,0.010 respectively）．Conclusions Lumbar scoliosis is more common in patients with CNLBP,and L4 is the main lower apical vertebra of lumbar scoliosis．Patients with CNLBP often have spinous process deviation,and the most common is L5 spinous process deviation,followed by L4．L5 and L4 are the most common vertebrae with spondylolisthesis in patients with CNLBP．The soft injury and joint degeneration or disorder related to L5 and L4 should be paid more attention in the treatment of patients with CNLBP．

目的 分析儿童危重症乙型流感患者的临床特点,提高临床医师对此危重症的认识水平。方法 对2017年12月—2018年2月广州市妇女儿童医疗中心收治的7例儿童危重症乙型流感患者的临床资料进行回顾性分析。结果 危重患儿好发年龄以幼儿及学龄前期为主。5例表现为呼吸衰竭,1例表现为心源性休克,1例表现为急性坏死性脑病。起病初(3 d内)均未见白细胞减少,白细胞数最高28.1×10⁹/L。白细胞分类以中性粒细胞为主。痰培养出流感嗜血杆菌、肺炎链球菌各1例。3例存在塑型性支气管炎改变。经积极治疗,体温恢复正常最短2 d,最长7 d,平均(4.20±1.79) d。住院时间最短12 d,最长23 d,平均(16.71±3.90)d。结论 乙型流感危重患儿临床表现多样,可累及多个系统器官;呼吸道合并症最多见,可出现塑型性支气管炎改变;及早识别及积极治疗,预后良好。

Objective To analyze the clinical characteristics of the children with severe influenza B and to provide reference for identifying severe cases. Methods Clinical data of 7 children with severe influenza B were retrospectively analyzed. Results The age ranged from 11 months to 7 years old, with an average was (4.13±2.06) years old. Five cases were characterized by respiratory failure, one by cardiogenic shock and one by acute necrotizing encephalopathy. No leukopenia was observed at the beginning of the disease(in 3 days), and the number of white blood cells was as high as 28.1×10⁹/L, White blood cell classification is dominated by neutrophils. haemophilus influenzae and streptococcus pneumoniae were produced by sputum culture in 1 case for each. Three patients had plastic bronchitis changes. After active treatment, the body temperature returned to normal with minimum 2 days, longest 7 days and average (4.20+1.79)days. The length of stay was the shortest 12 days, the longest 23 days, and the average (16.71+3.90) days. Conclusion The clinical manifestations of severe influenza B are diverse and may involve multiple system organs. Respiratory complications were the most common, with plastic bronchitis changes. Early recognition and active treatment had a good prognosis.

目的 探讨儿童不明原因肝功能异常的临床特点、病因及预后,为临床及时对因治疗提供帮助。方法 回顾性分析本院2016年1月—2017年12月期间205例以不明原因肝功能异常住院患者的临床资料,并对其临床特点、病因及预后进行分析。结果 在205例不明原因肝功能异常患者中,其中166例(80.97%)得到明确诊断,涉及多种疾病。其中分别为非嗜肝病毒所致感染性肝损104例(50.73%),遗传代谢疾病38例(18.54%),药物性肝损11例(5.37%),全身性疾病如川崎病6例(2.93%)、血液肿瘤疾病4例(1.95%)、营养不良3例(1.46%)等,原因未明 39例(19.02%)。结论 引起肝功能异常病因多且复杂。婴幼儿肝功能异常以非嗜肝病毒所致感染性肝损为主,感染主要为巨细胞病毒及EB病毒;遗传代谢性疾病、药物性肝损、全身性疾病也是造成肝功能异常的重要原因。

Objective To investigate the clinical features, etiology and prognosis of children patients with unexplained liver dysfunction. Methods The clinical data of 205 inpatients with unexplained liver dysfunction from January 2016 to December 2017 were analyzed retrospectively. The clinical characteristics, etiology and prognosis were analyzed. Results Of 205 patients with unexplained abnormal liver function, 166 patients with liver dysfunction (80.97%) were clearly diagnosed and involved in a variety of diseases. Among them, 104 cases were infected liver damage caused by non-hepatophilic virus, 38 cases were related to genetic metabolic diseases, 11 cases were drug-induced liver damage, 6 cases were Kawasaki disease, 4 cases were hematologic tumor diseases, 3 cases were malnutrition. The cause of abnormal liver function was not clear in 39 cases. Conclusion There are many and complicated causes of abnormal liver function, and part of the causes are unknown. Infantile liver dysfunction was mainly caused by non-hepatophilic virus, the first was cytomegalovirus, the second was Epstein-Barr virus; genetic metabolic disease, drug-induced liver damage, systemic disease are also an important cause of liver dysfunction.

目的 通过开展QC活动降低PICU患儿补液外渗发生率。减轻患儿不适,强化护士主动服务的意识,提高护理质量,提升管理效果。方法 成立QC小组,按照PDCA循环法,调查PICU患儿补液外渗情况及存在问题,制定对策,组织实施,定期对效果进行评价、总结。结果 外渗发生率由活动前的15.48%下降至活动后的10.44%,严重外渗发生率由活动前的2.38%下降至活动后的0.55%,P<0.05,差异有统计学意义。结论 QC活动有效降低PICU患者补液外渗发生率。

Objective To conduct QC activities to reduce the incidence of fluid extravasation in PICU patients. Relieve discomfort in PICU patients,and strengthen the awareness of nurses active service,improve quality of care and management effectiveness. Methods Establishing QC circle,applying the method of PDCA cycle,investigating fluid extravasation in PICU patients,analyzing the main reasons for fluid extravasation,developing countermeasures,Implementing strategies,summarizing and evaluating the effects regularly.Comparing the incidence of fluid extravasation in PICU patients before and after the activity. Results After the activity,the incidence of fluid extravasation decreased from 15.48% to10.44%,the incidence of severe fluid extravasation decreased from 2.38% to 0.55%,P<0.05,the difference was statistically significant. Conclusion The QC activity effectivelycan reduce the incidence of severe fluid extravasation in PICU patients.

目的 探讨儿童登革热(DF)合并肝功能损害的临床特征。方法 对2014年8—12月我院感染科收治住院的78例儿童DF的临床资料进行回顾性分析。结果 并发肝功能损害36例(46.15%),其中血清丙氨酸转氨酶(ALT)升高24例(30.77%),血清天冬氨酸转氨酶(AST)升高33例(42.31%);27例(75%)ALT/AST病程2周内恢复正常,9例于1月复查恢复正常。仅有1例总胆红素(TBIL)升高80.8 μmol/L,直接胆红素升高为主,1周后恢复正常。肝功能损害组较无肝功能损害组在外周血白细胞水平、血小板水平差异有统计学意义(P<0.05)。结论 儿童DF并肝功能损害较普遍,以轻度损害为主。与年龄、性别、皮疹、外周血白细胞、血小板有相关性。

Objective To approach the clinical characteristics of children dengue fever combined liver function damage. Methods Clinical data of 78 cases of children dengue fever in our hospital were retrospectively analyzed from August to December in 2014. Results 36 cases (46.15%) complicated with liver function damage. Among them 24 cases (30.77%) of serum alanine aminotransferase (ALT) increased, 33 cases (42.31%) of serum aspartate aminotransferase (AST) increased; 27 cases (75%)ALT/AST returned to normal within 2 weeks, 9 cases were recovered to normal in 1 month. Only 1 cases of total bilirubin (TBIL) increased to 80.8 mol/L, recovered after 1 week. Liver injury group and non liver injury group of peripheral blood leukocytes, platelets level comparison was statistically significant (P<0.05). Conclusion Children dengue fever combined liver function damage was common, mainly mild. There was correlation with age, gender, skin rash, peripheral blood leukocytes and platelets.

       目的   研究慢性非特异性腰痛患者腰椎正侧位X线中腰椎侧弯、L1-5棘突偏歪和椎体滑脱情况，总结规律，为慢性非特异性腰痛患者治疗提供依据。方法   选取164例慢性非特异性腰痛患者，观察并记录每例患者腰椎正侧位X线中腰椎侧弯、L1~L5棘突偏歪和椎体滑脱情况。用统计学软件分析腰椎侧弯、棘突偏歪和椎体滑脱情况。结果   共有59例发生腰椎侧弯，占35.98%，其中Cobb角5°~10 °有47例，占28.66%；Cobb角＞10°有12例，占7.32%。腰椎侧弯发病以L4为下端椎为主。以L3为下端椎有12例患者，占20.34%；以L4为下端椎有37例患者，占62.71%；以L5为发椎有10例患者，占16.95%。共119例发生棘突偏歪，占总例数的72.56%。L5棘突偏歪最常见，发生率为57.93%；L4次之，发生率为48.17%。L5棘突偏歪率与L1~L3棘突偏歪率比较差异均有统计学意义（χ ²  分别为14.580，11.771，7.484，P分别为＜0.001，0.001，0.006），但与L4棘突偏歪率比较差异无统计学意义（χ ² =3.124，P=0.077）。共30例患者存在椎体滑脱，占18.29%。L5最常发生滑脱，发生率为8.54%；L4次之，发生率为7.93%。L4与L5椎体滑脱率比较差异无统计学意义（χ ²  =0.040，P=0.841）；L4分别与L1，L2，L3以及L5分别与L1，L2，L3椎体滑脱率差异均有统计学意义（L5与L1、L2、L3：χ ²  分别为14.580、11.771、7.484，P分别为＜0.001、0.001、0.006；L4与L1、L2、L3：χ ²  分别为13.495、10.712、6.550，P分别为＜0.001、0.001、0.010）。结论   慢性非特异性腰痛患者较常发生腰椎侧弯，侧弯以L4为下端椎为主；慢性非特异性腰痛患者较常发生棘突偏歪，L5棘突偏歪最常见，L4次之；L5和L4是慢性非特异性腰痛患者最常发生滑脱的椎体。在治疗慢性非特异性腰痛患者时，与L5和L4相关的肌肉、筋膜等软组织损伤以及关节退行性变或紊乱应引起重点关注。

       Objective  To study the lumbar scoliosis，L1-5  spinous process deviation and  spondylolisthesis in  spine X-ray of patients with chronic non-specific low back pain（CNLBP），and summarizing the existing rules，so as to provide imaging theoretical support for the treatment of CNLBP．Methods  A total of 164 patients with CNLBP were selected．The lumbar scoliosis，L1-5 spinous process deviation and spondylolisthesis were observed and recorded in the anteroposterior and lateral X-ray films of each patient．The lumbar scoliosis，spinous process deviation and spondylolisthesis were statistically analyzed by statistical software．Results  A total of 59 people had lumbar scoliosis，accounting for 35.98%．There were 47 patients with 5°-10° Cobb angle，accounting for 28.66%．There were 12 patients with Cobb angle ＞10°，accounting for 7.32%．L4 was the main lower apical vertebra of lumbar scoliosis．There were 12 patients with L3 as the lower apical vertebra，accounting for 20.34%；37 patients with L4 as the lower apical vertebra，accounting for 62.71%；10 patients with L5 as the lower apical vertebra，accounting for 16.95%．A total of 119 people appeared spinous process deviation，accounting for 72.56%．L5 spinous process deviation was the most common，with proportion of 57.93%，and L4 was the second，with proportion of was 48.17%．The  results of chi-square test showed that there were significant differences between L5 and L1-L3 spinous process deviation（χ ²   was 14.580，11.771，7.484，and P values were ＜0.001，0.001，0.006 respectively），but no significant difference between L5 and L4 spinous process（χ ²  =3.124，P=0.077）．A total of 30 patients had spondylolisthesis，accounting for 18.29%．L5 was the most common of spondylolisthesis，with an occurrence rate of 8.54%．L4 was the second，with an occurrence rate of 7.93%．There was  no significant difference in spondylolisthesis rate between L4 and L5（χ ²  =0.040，P=0.841）．The spondylolisthesis rates of L4 and L5 were significantly different from those of L1，L2 and L3（L5 and L1，L2，L3：χ ²   was 14.580，11.771，7.484，and P values was ＜0.001，0.001，0.006 respectively；L4 and L1，L2，L3：χ ²  was 13.495，10.712，6.550，P values were ＜0.001，0.001，0.010 respectively）．Conclusions  Lumbar scoliosis is more common in patients with CNLBP，and L4 is the main lower apical vertebra of lumbar scoliosis．Patients with CNLBP often have spinous process deviation，and the most common is L5 spinous process deviation，followed by L4．L5 and L4 are the most common vertebrae with spondylolisthesis in patients with CNLBP．The soft injury and joint degeneration or disorder related to L5 and L4 should be paid more attention in the treatment of patients with CNLBP．

    目的   研究羽毛球颠球运动对低年级小学生近视的改善效果，为制定儿童青少年近视干预方案提供依据。方法   采用方便抽样方法，抽取广州市1个城区1所小学三年级4个班共182名学生作为研究对象。基线调查完成后，以班为单位，采用随机数字表法将4个班分为干预组（2个班，91例）和对照组（2个班，91例），干预组安排羽毛球颠球项目体育活动，对照组按原教学计划安排非球类常规体育活动。比较两组干预前后筛查性近视率、视力不良率和近视进展程度。结果  干预前两组的年龄、性别、筛查性近视率、视力不良率及近视分级比较，差异均无统计学意义（P＞0.05）。两组干预后的等效球镜度数（SE）比较，差异无统计学意义（P＞0.05）；对照组干预后的裸眼远视力（UDVA）低于干预组，△UDVA、△SE均高于干预组，差异均有统计学意义（P＜0.05）。对照组新发筛查性近视率29.13%、累积筛查性近视率49.45%、累积视力不良率68.13%及近视进展程度，均高于干预组新发筛查性近视率7.69%、累积筛查性近视率34.07%、累积视力不良率52.74%及近视进展程度，差异均有统计学意义（P＜0.05）。结论   羽毛球颠球运动能降低低年级小学生视力不良进展速度，减少近视的发生率及近视程度，学校可结合引起近视的因素进行灵活应用，以预防近视的发生发展。

      Objective  To study the impact of badminton juggling on the myopia of lower-grade primary school students and to provide a basis for developing myopia intervention strategies for children and adolescents．Methods  By using the convenience sampling method，182 third-grade students from four classes in a primary school in a district of Guangzhou were selected as subjects．After completing the baseline survey，the four classes were divided into an intervention group（2 classes，91 students）and a control group（2 classes，91 students）using a random number table．The intervention group was arranged to participate in badminton juggling sports activities，while the control group followed the original teaching plan without ball games．The study compared the screening rate of myopia，the rate of poor vision，and the degree of myopia progression before and after the study in both groups．Results  On baseline，there were no statistically significant differences between the two groups in terms of age，gender，rate of screening myopia，poor vision，and myopia grading（P＞0.05）．After 12 months，there was no statistically significant difference in the spherical equivalent（SE） comparison between the two groups（P＞0.05）．However，the uncorrected distance visual acuity（UDVA） of the control group after 12 months was significantly lower than that of the intervention group，and both △UDVA and △SE were significantly higher than those of the intervention group，with all differences being statistically significant（P＜0.05）．Incidence of screening myopia in the control group （29.13%），the cumulative rate of screening myopia（49.45%），the cumulative rate of poor vision （68.13%），and the degree of myopia progression was significantly higher than those in the intervention group，which had incidence of screening myopia at 7.69%，the cumulative rate of screening myopia at 34.07%，cumulative rate of poor vision at 52.74%．All these differences were statistically significant（P＜0.05）．Conclusions  Badminton juggling can slow down vision deterioration，reduce the incidence and severity of myopia in lower grade primary school students．Schools can flexibly apply these findings in conjunction with factors that contribute to myopia to prevent its occurrence and development．