ABSTRACT
Purpose@#Whether craniospinal irradiation (CSI) could be replaced by limited-field radiation in non-metastatic bifocal germinoma remains controversial. We addressed the issue based on the data from our series and the literature. @*Methods@#Data from 49 patients diagnosed with non-metastatic bifocal germinoma at our hospital during the last 10 years were collected. The Pediatric Quality of Life Inventory 4.0 was used to evaluate health-related quality of life (HRQOL). Additionally, 81 patients identified from the literature were also analyzed independently. @*Results@#In our cohort, 34 patients had tumors in the sellar/suprasellar (S/SS) plus pineal gland (PG) regions and 15 in the S/SS plus basal ganglia/thalamus (BG/T) regions. The median follow-up period was 52 months (range, 10 to 134 months). Our survival analysis showed that patients treated with CSI (n=12) or whole-brain radiotherapy (WBRT; n=34) had comparable disease-free survival (DFS; p=0.540), but better DFS than those treated with focal radiotherapy (FR; n=3, p=0.016). All 81 patients from the literature had tumors in the S/SS+PG regions. Relapses were documented in 4/45 patients treated with FR, 2/17 treated with whole-ventricle irradiation, 0/4 treated with WBRT, and 1/15 treated with CSI. Survival analysis did not reveal DFS differences between the types of radiation field (p=0.785). HRQOL analysis (n=44) in our cohort found that, compared with S/SS+PG germinoma, patients with BG/T involvement had significantly lower scores in social and school domains. However, HRQOL difference between patients treated with CSI and those not treated with CSI was not significant. @*Conclusion@#In patients with non-metastatic bifocal germinoma, it is rational that CSI could be replaced by limited-field radiation. HRQOL in patients with BG/T involvement was poorer.
ABSTRACT
Objective To validate bioelectrical impedance analysis(BIA) for measuring the area of visceral fat of school-age populations using MRI as a reference method.Methods Sixty healthy children (30 boys and 30 girls) aged 7 to 18 years were enrolled in the study.Both MRI and BIA were completed in seven days.We obtained the indexes of the body composition from BIA and MRI in the morning before the participants had their breakfast.For reference,the navel plane image obtained with MRI was used to analyze the area of adipose tissue.With BIA,the area of visceral adipose tissue could be derived directly.Results Sixty healthy school-age children were enrolled in the study.The average age of the school children was (11.9±4.6) years,and their BMI was (22.8±7.3) kg/m2.The average area of visceral fat obtained with BIA was (85.4±64.2) cm2,which was higher than that obtained with MRI [(49.4±32.4) cm2](t=-6.524,P =0.000).The Pearson correlation coefficient was r=0.806 (P=0.000) and the simple linear regression equation for the areabetween the two was:y=0.41x + 14.78;β (95％CI) was 0.41(0.04-0.81).The Bland-Altman plot was (x-) ±1.96 s:(35.9± 83.7) cm2.Conclusion BIA is comparable to MRI for assessing the area of visceral fat and is a reliable and simple tool to evaluate the visceral fat area in school-age children.
ABSTRACT
Objective To investigate the effects of protein-enriched meal on uric acid and renal function among overweight and obese Chinese adults during weight loss. Methods People, 18-55 yearsold, with body mass index 25-35 kg/m2 and triglycerides 1.7-5.4 mmol/L were enrolled. Major exclusion criteria were: type 2 diabetes, weight reducing surgery or use of weight loss drugs, chronic kidney disease, and hepatic dysfunction. A high-protein (HP) diet (protein energy ratio was 30%) or a standard-protein (SP) diet (protein energy ratio was 15%) was provided to eligible subjects for 12 weeks (84 days). Energy intake was calculated by Katch-McArdle formula:basal metabolic rate=370+21.6 × lean body mass (kg) and coefficient of variation. All the subjects were followed up at day 0,week 4,week 8,and week12. The changes of triglyceride (TG), total cholesterin (TC), low density lipoprotein (LDL), uric acid (UA), blood urine nitrogen (BUN) and creatinine (Cre) were determined at day 0, week 4, and week 12. Results Ninety-four subjects with HP (n=49) or SP (n=45) were enrolled, and seven subjects were withdrawn for refusing the following visit. The average age was (42.68±8.98) years in HP group, and (41.09±9.67) years in SP group (P>0.05). At week 12, the BMI drop was significant in both groups from baseline, but with no significant difference between the two groups. The decreases of TG (mmol/L) at 4 weeks and 12 weeks were significant compared with the baseline (0 d, 4weeks, 12 weeks:HP:2.18±1.18, 1.77±0.82, 1.86±0.83;SP:2.60±2.67, 2.03±1.28, 1.92±0.79) (P<0.05),but with no significant difference between the two groups. Compared with the baseline, the decrease of UA (mmol/L) at 4 weeks in HP group was significant (0 d, 4 weeks, 12 weeks:HP:326.12± 88.31, 294.76 ± 106.57,307.15 ± 94.70;SP:325.62 ± 87.16,321.51 ± 101.19,315.71 ± 86.77) (P<0.05). The BUN and CRE in both groups increased slightly compared to baseline level, but remained in the normal range. Conclusion Comparison of HP and SP groups showed that renal function did not change significantly, the levels of UA in HP group decreased significantly than that in SP group.