1983年 · 第21卷第04期

In industrial cities in China, breast feeding rate is declining recently. The factors influencing the success of breast feeding are rather complicated. It is necessary to design a series of research projects to clarify them. For instance: (1) to organize a breast-feeding general servey in various provinces (municipality or au tonomous regions) to find out the actual breast-feeding rate, ⑵ to find out factors influencing the volume and composition of breast milk, (3) to study the contents of immunological substances in colustrum, (4) to compare the growth and development of infants, breast fed, mixed fed or bottle fed, (5) to improve the quantity and quality of breast milk by various methods, (6) to observe the effects of changing perinatal environment on success of breast feeding.

There is no doubt that breast milk is the best and natural nutrient for infants. In order to promote the success of breast feeding, besides the efforts made by obs tetricians and pediatricians, national auth orities, family members, labor union, women's federation, youth league are all required to support this appeal.

11 Healthy women, primipara, full term and normal delivery, 25-35 years of age were included in this study. The items of study of their breast milk included: protein, non-protein nitrogen, lipids, lactose, SIgA, IgM, IgG, cell counts and cell differential counts.

Results: in the first 3-5 days post partum, protein (chiefly immune globulin), SIgA, IgM and IgG were very high but decreased quickly by day 5 and remained rather stable afterwards. The contents of fat, lactose were low in the first few days and increased gradually later. Neutrophiles, lymphocytes, coloctrum cells and macrophages were all found in the breast milk.

The functions of all the constituents in the breast milk were discussed briefly.

The purpose of this study was to find out the prevalance of breast-feeding and factors influencing milk secretion.

0-6 months old infants, 1206 in total, were included in this study. The findings showed that 77.78% were breast fed and 22.22% were mixed fed and bottle fed.

Of the factors we worked on, it was found that the following ones were the most important: mothers' appetite, prema ture birth of infants, hours of sleep per day during lactation, return of menstrua tion contraceptive measures (IUD), attitute toward breast-feeding, smoking, drinking and education of mothers.

This report reviews Bruce treadmill exercise test results in 157 normal children and adolescents (male 78, female 79), aged 3 to 18 years. The role of develop ment of aerobic working capacity and change of heart rate during maximal treadmill exercise test were observed.

Mean maximal endurance time in boys increased from 10'38〃 at age 3-4 years to 18'13〃 at age 16-18 years; in girls from 10'15〃 at 3-4 years to 13'03" at age 16-18 years. Mean maximal oxygen uptake (ml/kg/min) in boys increased from 40.0to 72.3; in girls from 38.0 to 55.8. Mean maximal heart rate ranged from 196 to 212beats/min. Age and sex differences in mean maximal heart rate were minimal. There were positive correlations between endurance time and the mean maximal oxygen uptake ranged from 0.52 to 0.86 (except age 34 years in boys and girls and age 16-18in girls) For clinical purposes endurance time alone is a satisfaction of exercise performance and has a predictive values on measuring oxygen uptake.

Recovered heart rate may be used as the an index of the function of the heart and one of the working load which nearly reached the maximal one the subject can perform.

The Denver Developmental Screening Test was devised to provide a simple method of screening for evidences of slow development in infants and preschool children. It is simple to administer, easy to score and interpret, and useful for repeated evaluation of the small children. In order to investigate and to find out the feasibility of adopting this method in the wide areas of our country, the collaborative study group decided to extend the study to a bigger scale. From April 1980 to April 1982, DDST was administered to 6886children in six cities (Beijing, Xian, Shingyang, Harbin, Dalian and Jiamusi) of North China. All children sampled were healthy and children with high risk of developmental abnormalities were excluded. All tests were based on one plan with the same equipment according to the original methods of W. K. Frankenburg and by reference to "The Examination on Children's Mental Development" translated and edited by Song Jie and Zhuu Yue-mei. All the original test items were used except for one in the language sector: "uses plurals" omitted because there is no distinction of singular and plural in Chinese for nouns.

Then we grouped the results and computed the percentile (25%, 50 %, 75%, 90% respectively) of children in each age group who passed each item according to Probit's method. The reliability among the examiners ranged from 81-100%, mean 93%. The validity was 81%.

These data which compared with Denver's were more similar in total (78.487.0 % of items) than in each cities respectively. The developmental scale ob tained from this restandardization can be used for children in North China.

In order to evaluate the development of children's hand-carpal bone, 1080 infants and preschool children were investigated in 1980. Using the method of the radiograph to ascertain the median a set of the atlas of the hand-carpal bone were made. The centers of ossification of carpal bones and its degree of development showed no difference between boys and girls under 3years of age. However, it showed signifi cant difference in 3-7 years of age as the girls being 1.5-2 years earlier than the boys of the same age.

The skeletal ages had a positive correlation with their body height by age. The rate of bone development coincides with the body height in each group of sex and age.

A country's infant mortality rate reflects its level of politics, economy, culture and health and is one of the basic criteria of maternal and child health. So obtaining a correct mortality rate is very important.

From 1974-1979 an investigation of infant mortality rate was made in Jingan District, Shanghai. The results show that of 21,073 live births, 236 infants died, an infant mortality rate of 11.2‰, and 154 new borns died within 4 weeks of birth, a neonatel mortality rate of 7.3‰. The infant mortality rate in this district is slightly lower than that reported in the literature (8-20‰).

The method of investigation is discussed and experience in obtaining a correct infant mortality rate is introduced.

Fifteen cases of DKA and two cases of hyperglycemia with ketosis treated with low-dose continuous intravenous insulin infusion were studied. 0.1 u/kg/hr of insulin administered intravenously by continous infusion without priming dose, human albumin or infusion pump, but dripped by gravity at a given speed. The result was as good as those treated by other means in addition reported by other authors. Normal saline was used mainly for the correction of dehydration. Potassium and sodium bicarbonate were given appropriately. According to insulin determination and the metabolic improvement, serum insulin did. reach an effective level. All patients recovered without any complication.

Stress hormone levels were elevated in all cases before treatment, and declined as the condition improved after treatment had begun. The result indicates that there is some relationship between the occurrence of DKA and elevated stress hormone levels.

From November 1, 1978 to October 31,1981, 936 cases of acute respiratory infec tion in children were studied. The diagno sis of viral infection was confirmed in 429cases (45.8%) by the virus isolation and/or serological study. In all cases their pathogenicity was verified by a positive seroconversion. When it was not in the influenza epidemic period, the respiratory syncytial virus (RSV) was found most frequently in cases of lower respiratory tract infection followel by adenoviruses (ADV) types 3,7 and parainfluenza virus type 3, whereas the ADV (mainly types 1,2,3,5,7) was revealed most frequently in the upper respiratory tract infections and then RSV. Among the 429 cases, 72%were due to these two viruses (RSV, ADV). Obviously they were the most important agents in the upper as well as the lower respiratory tract infection. Most of the children infected with either of these two viruses were under two years of age. The locally epidemic charateristics of these viruses in Guangzhou were discussed.

The observations on microcirculation of nail-fold in 200 healthy 7—12-yearold children in Lhasa, Tibet (altitude 3,658 meters above sea level) were reported. Among them there were 100 Tibetan native children and 100 Han children (residing from 3 months to 11 years, average 6.4 years).

As compared with the same age children residing in plain areas both the Tibetan and the Han children showed a marked decrease in clarity of microcircula tion (most of them being indistinct), the capillary loops and deformed loops, increased in number while the evidence of slow blood flow, increasing flocculent flow and cells agglutination also appeared. These findings were more significant in Han children and different in intensity related to their resident duration. It was considered that changes of microcirculation may deve lop from physiologic stress to pathologic disturbance of microcirculation, thus moun tain sickness occurs.

The observations of the nail-fold microcirculation would provide a useful means to study mountain sickness and mountain physiology and to predict the adaptability of children moving to high altitude.