Sun Qiang,Ye Jiajun,Zhou Ying.Epidemiological survey and influencing factors of developmental dysplasia of the hip in Tibetan children of Sichuan and Tibet[J].Journal of Clinical Pediatric Surgery,2023,22(11):1050-1054.[doi:10.3760/cma.j.cn101785-202204079-009]
川藏藏族儿童发育性髋关节脱位的影响因素分析
- Title:
- Epidemiological survey and influencing factors of developmental dysplasia of the hip in Tibetan children of Sichuan and Tibet
- 关键词:
- 发育性髋关节发育不良; 关节脱位; 流行病学研究; 藏族; 儿童
- Keywords:
- Developmental Dysplasia of the Hip; Joint Dislocations; Epidemiologic Studies; Tibetan Nationality; Child
- 摘要:
- 目的 探讨川藏藏族儿童发育性髋关节脱位的影响因素。方法 本研究为回顾性研究。以四川省骨科医院儿童骨科2013年1月至2021年12月收治的99例来自四川省甘孜藏族自治州、阿坝藏族羌族自治州、凉山彝族自治州及西藏自治区的藏族发育性髋关节脱位患儿作为研究对象,对患儿监护人进行问卷调查。按照受试者常住地分为四组:甘孜藏族自治州组(A组),阿坝藏族羌族自治州组(B组),凉山彝族自治州组(C组)和西藏自治区组(D组)。问卷调查内容包括受试者相关性因素(受试者是否早产,生产方式为顺产或剖宫产,生产时体位为头位或臀位,受试者是否为头胎或二胎及以上);以及监护人及家庭相关性因素[监护人是否为15岁以上、不识字且不会写字的成年人(以下简称文盲),受试者出生后襁褓方式是否绑腿,受试者是否定期接受儿童保健,受试者家庭经济情况]。结果 四组DDH患儿是否早产(χ2=7.564、P＜0.05)、生产方式(χ2=7.524、P＜0.05)、生产胎位(χ2=6.801、P＜0.05)、是否头胎(χ2=13.008、P＜0.05)、监护人文化程度(χ2=14.114、P＜0.05)、襁褓方式(χ2=13.080、P＜0.05)、是否定期进行儿童保健(χ2=11.107、P＜0.05),以及家庭经济状况(χ2=11.935、P＜0.05)等因素比较,差异均有统计学意义。儿童受试者相关因素中"早产和臀位产",监护人及家庭相关性因素中"监护人是文盲"、"襁褓方式为绑腿"、"未定期接受儿童保健"是川藏藏族儿童DDH发病的主要影响因素(P<0.05)。结论 早产、臀位生产、监护人是文盲、襁褓方式为绑腿、未规范进行儿童保健可能与藏族儿童DDH发病率升高有关。
- Abstract:
- Objective The construction of animal models of neonatal necrotizing enterocolitis (NEC) is still not uniform,and animal modeling approaches that are more relevant to the actual clinical situation of NEC childern should be clarified.Methods Fifty-four neonatal mice were randomly divided into five groups: control group (Ctrl),hypoxia + artificial feeding group (HF),hypoxia + artificial feeding + cold stimulation group (Cold),hypoxia + artificial feeding + lipopolysaccharide group (LPS),and hypoxia + artificial feeding + intestinal bacteria in NEC group (Bac).After the animal models of NEC were established,the intestinal pathology,NEC-related intestinal epithelial barrier proteins (β-catenin and Occludin),intestinal epithelial cell death (CC3,RIPK1 and PARP1) and pro-inflammatory cytokines (IL-6,TNF-α and MCP1) were evaluated.Results Nadler score ≥2 according to intestinal histology was considered as NEC-like intestinal injury.In this study,the intestinal histopathology of the three NEC-modeled groups met the criteria for NEC-like intestinal injury,except for the Ctrl and HF groups.Compared with the NEC modeling groups HF (30%),Cold (83.3%) and LPS (81.8%),the Bac group had the highest modeling success rate (100%),and the mental status,bloating and diarrhea,and mobility of the mice in the Bac group during the modeling period were more consistent with clinical NEC.Meanwhile,the expression of intestinal barrier proteins β-catenin and Occludin was decreased in the Bac group mice,and the difference was statistically significant compared with the Ctrl group (P<0.05).the expression of intestinal epithelial cell death marker molecules RIPK1 and PARP1 was upregulated in the LPS and Bac groups,and the expression levels of inflammatory factors IL-6,TNF-α and MCP1 were increased compared with the Ctrl group,with statistically significant differences (P<0.05).Conclusions In this study,we successfully compared four animal models of NEC and identified an animal modeling method,namely "hypoxia+artificial feeding+intestinal bacteria in NEC",that is more relevant to the actual situation of clinical NEC children.This modeling method has a high success rate,and the intestinal histopathological damage,intestinal barrier protein expression and systemic inflammatory response are more similar to the characteristics of clinical NEC children.
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备注/Memo
收稿日期:2022-4-26。
基金项目:四川省医学会医学科研课题(S19065); 四川省中医药管理局四川省名中医周英工作室活态传承建设项目(川中医药办发[2022]16号)
通讯作者:孙强,Email:2357401669@qq.com.