目的分析早产儿校正24月龄内生长轨迹,以了解早产儿的生长趋势和规律。方法基于互联网+随访系统建立早产儿随访数据库,纳入2018年4月至2021年4月3188例早产儿,收集其出生及校正1、3、6、12、18、24月龄时的身长、体重、头围数据。按不同的围生期因素分组,绘制生长曲线,并与21世纪国际胎儿和新生儿生长联合会(International Fetal and Newborn Growth Consortium for the 21st Century,INTERGROWTH-21st)标准和世界卫生组织(World Health Organization,WHO)标准进行比较。结果按不同的围生期因素分组的各组早产儿体重、身长、头围曲线均在校正6月龄内快速上升,校正6月龄后增长速度减缓。按实际月龄比较,各出生胎龄组早产儿(<28周、28~31^(+6)周、32~33^(+6)周、34~36^(+6)周)身长曲线在实际9月龄后逐渐与WHO曲线重合(P=0.082),<32周早产儿的体重和头围则一直落后于WHO曲线(P<0.001)。校正月龄后,不同出生胎龄组早产儿(<28周、28~31+6周、32~33+6周、34~36+6周)的体格生长曲线基本重合(P>0.05)。超低出生体重儿和小于胎龄儿的身长、体重、头围曲线均低于INTERGROWTH-21st标准和WHO标准(P<0.05)。结论早产儿在校正6月龄内体格增长速度较快,校正6月龄后增长速度减缓。胎龄越小,体重和头围追赶的时间越长。应重点关注超早产儿、超低出生体重儿和小于胎龄儿的体格生长。
Placebo has been reported to exert beneficial effects in patients regarding the treatment of pain. Human functional neuroimaging technology can study the intact human brain to elucidate its functional neuroanatomy and...
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Placebo has been reported to exert beneficial effects in patients regarding the treatment of pain. Human functional neuroimaging technology can study the intact human brain to elucidate its functional neuroanatomy and the neurobiological mechanism of the placebo effect. Blood flow measurement using functional magnetic resonance imaging and positron emission tomography （PET） has revealed that analgesia is related to decreased neural activities in pain-modulatory brain regions, such as the rostral anterior cingulate cortex （rACC）, insula, thalamus, and brainstem including periaqueductal gray （PAG） and ventromedial medulla. The endogenous opioid system and its activation of g-opioid receptors are thought to mediate the observed effects of placebo. The μ-opioid receptor-selective radiotracer-labeled PET studies show that the placebo effects are accompanied by reduction in activation of opioid neural transmission in pain-sensitive brain regions, including rACC, prefrontal cortex, insula, thalamus, amygdala, nucleus accumbens （NAC） and PAG. Further PET studies with dopamine D2/D3 receptor-labeling radiotracer demonstrate that basal ganglia including NAC are related to placebo analgesic responses. NAC dopamine release induced by placebo analgesia is related to expectation of analgesia. These data indicate that the aforementioned brain regions and neurotransmitters such as endogenous opioid and dopamine systems contribute to placebo analgesia.
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