ABSTRACT
ObjectiveTo explore the effects of after-school tutoring for school-age children on their emotions and behaviors， and to provide a basis for developing after-school tutoring and psychological support strategies for school-age children. MethodsFour elementary schools in a district of Shanghai were selected by simple random sampling method. Whole group sampling was conducted by class， and parents of students were surveyed by general questionnaire and the scale of strengths and difficulties. Information was collected on the basic conditions of children and families and the results were compared and analyzed. ResultsThis study showed that 88.26% of children attended extracurricular classes， of which 26.16% attended 3 or more classes， 42.5% attended cultural classes， 28.3% attended sports classes， and 59.8% attended art classes. Children who did not attend classes had higher pro-social scores. Children who attended reading class had lower scores for emotional problems that was a protective factor for emotional problems. Children who chose extracurricular programs in sports and reading also had lower overall scores for difficulties. Excessive use of electronic devices by school-age children on weekdays or weekends had a negative effect on emotional and conduct problem scores regardless of whether they chose extracurricular programs. It appeared that the choice of cultural programs， art programs and different levels of exercise intensity had no effect on children's emotions and behaviors. ConclusionFor children with low pro-social level， extracurricular classes should be carefully selected. For extracurricular classes， more reading and sports-related courses can be considered， which have positive effects on school-age children’s emotions and behaviors. Regardless of the choice of extracurricular classes， try to avoid excessive online classes.
ABSTRACT
Objective:To analyze the diagnostic and prognostic value of routine bone marrow examination in patients with extranodal NK/T-cell lymphoma (ENKTCL) based on PET-CT staging.Methods:Clinical data of 186 patients who received bone marrow biopsy and bone marrow aspiration in Fujian Medical University Union Hospital from 2013 to 2021 were retrospectively analyzed. All patients were divided into bone marrow biopsy + bone marrow aspiration group ( n=186) and PET-CT + bone marrow biopsy group ( n=139). The sensitivity, specificity, positive and negative predictive values were compared between two groups. The data were analyzed and plotted. Survival analysis was performed using Kaplan-Meier method and log-rank test. Results:In the whole cohort, 45 patients were positive for bone marrow biopsy, and 30 of them were positive for bone marrow aspiration. A total of 141 patients who were negative for bone marrow biopsy also achieved negative results for bone marrow aspiration. A total of 139 patients completed PET-CT staging and bone marrow biopsy. And 30 patients were diagnosed with positive bone marrow by PET-CT, in which 22 of them were confirmed positive by bone marrow biopsy. Among 109 patients diagnosed with negative bone marrow by PET-CT, 5 of them were confirmed positive by bone marrow biopsy. All these cases were classified as stage Ⅳ due to distant metastases. PET-CT had a diagnostic sensitivity of 81.5%, a specificity of 92.9%, a positive predictive value of 73.3%, and a negative predictive value of 95.4%. Among early stage (Ⅰ-Ⅱ stage) patients diagnosed with PET-CT, all of them were negative for bone marrow biopsy (the negative predictive value was 100%). In stage Ⅳ patients ( n=55), the 1-year overall survival of patients with bone marrow involvement by bone marrow biopsy or PET-CT ( n=35) compared with their counterparts with the involvement of other organs ( n=20) was 28.7% vs.42.0% ( P=0.13), and 1-year progression free survival rates was 23.2% vs. 23.3% in ( P=0.94). Conclusions:Routine bone marrow biopsy does not change the original staging of patients with early stage ENKTCL based on PET-CT staging. Advanced stage patients with positive bone marrow biopsy tend to obtain worse prognosis, indicating that bone marrow biopsy still has certain value.
ABSTRACT
Objective:To explore the related factors affecting the prognosis of children with parenteral nutrition-associated cholestasis (PNAC).Methods:Twenty children with PNAC admitted to Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2014 to December 2020 were selected as research objects by retrospective study. According to prognosis, children were divided into good (15 cases) and poor prognosis group (5 cases). Clinical data such as general condition, intravenous nutrition duration, related biochemical examination indexes and main treatment methods of children in the two groups were collected. Spearman correlation analysis was used to quantify the correlation between alanine aminotransferase (ALT) and poor prognosis. Univariate analysis was used to analyze the risk factors affecting the prognosis of children with PNAC, and receiver operating characteristic curve (ROC curve) was drawn to evaluate the predictive value of ALT on the prognosis of children.Results:There were no significant differences in gender, body weight, gestational age, age, feeding mode, duration of intravenous nutrition, direct bilirubin (DBil), aspartate aminotransferase (AST), γ-glutamyltranspeptidase (GGT), total protein (TP), serum albumin (Alb), globulin (GLB), alkaline phosphatase (ALP), platelet count (PLT), white blood cell count (WBC), red blood cell count (RBC), hemoglobin (Hb), lymphocyte count (LYM), urine culture, AST/PLT ratio (APRI) and main treatment methods between the two groups. Total bilirubin (TBil), ALT, neutrophil count (NEU) and monocyte count (MONO) in the good prognosis group were significantly lower than those in the poor prognosis group [TBil (μmol/L): 120.00±48.63 vs. 175.26±29.14, ALT (U/L): 73.25±44.29 vs. 145.30±74.33, NEU (×10 9/L): 2.55±1.29 vs. 5.08±4.10, MONO (×10 9/L): 1.23±0.87 vs. 2.13±0.60, all P < 0.05]. Logistic regression analysis showed that ALT was the risk factor affecting the prognosis of children with PNAC, when ALT increased by 1 U/L, the probability of poor prognosis increased by 3.6% [odds ratio ( OR) = 1.04, 95% confidence interval (95% CI) was 1.00-1.07, P = 0.04]. Spearman correlation analysis showed that the incidence of poor prognosis was positively correlated with ALT ( r = 0.49, P = 0.03). ROC analysis showed that ALT had certain predictive value for the prognosis of children with PNAC [area under ROC cure (AUC) = 0.83, 95% CI was 0.00-1.00, P = 0.03]; when the cut-off value was 121.50 U/L, its sensitivity was 80% and specificity was 93%, suggesting that ALT could be used as the main indicator for clinical prediction of poor prognosis for PNAC. Conclusion:ALT is an independent risk factor of poor prognosis in children with PNAC.
ABSTRACT
Objective:To investigate the clinical manifestations and characteristics of children infected with 2019 novel coronavirus (2019-nCoV) in Wuhan City.Methods:The clinical data of 146 children diagnosed with 2019 novel coronavirus infection by nasopharyngeal swab real-time reverse transcription polymerase chain reaction in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 21 to February 24, 2020 were retrospectively analyzed. The basic data, clinical symptoms, laboratory examinations, pulmonary imaging, clinical classification, treatment medication and the prognosis of disease were included for analysis.Results:Among the 146 cases, 86 (58.9%) were males and 60 (41.1%) were females, with a median age of 6 years and 10 months.Three cases (2.1%) had a history of underlying diseases, 127 cases (87.0%) had a clear history of infected family clusters, and two cases (1.4%) had a history of exposure with Huanan Seafood Wholesale Market in Wuhan City. The clinical classifications included 20 asymptomatic cases (13.7%), 26 mild cases (17.8%), 99 ordinary cases (67.8%), and one critical case (0.7%). A total of 146 patients were tested positive for nasopharyngeal swabs by 2019-nCoV nucleic acid. Among them, 10 patients had a negative nasopharyngeal swab nucleic acid test before diagnosis, and one of them had a negative nasopharyngeal swab nucleic acid test for two consecutive times. The initial symptoms were mainly fever (59 cases, 40.4%) and cough (52 cases, 35.6%). Thirteen cases (8.9%) showed decreased leukocyte counts and three cases (2.1%) showed decreased lymphocyte counts. In addition, aspartate aminotransferase increased in 23 cases (15.8%), serum creatinine increased in seven cases (4.8%), lactic acid dehydrogenase increased in 26 cases (17.8%), and C reactive protein increased in 38 cases (26.0%). Fifty-nine cases (40.4%) were tested positive for IgM antibody to Mycoplasma pneumoniae. One hundred cases (68.5%) were abnormal in pulmonary imaging and 50 cases (34.2%) presented with multiple frosted glass shadows. All the 146 children were given general treatment, and the antiviral treatment was mainly interferon or interferon combined with oral medication. As of February 24, 2020, 72 cases (49.3%) were discharged from the hospital after reaching the de-isolation standard, with a median length of stay of 10 days, and there was no death case.Conclusions:Children with 2019-nCoV infection in Wuhan City are mainly caused by family aggregation. The clinical classification is mainly ordinary type, and the laboratory examination has no specificity. Specimens could be collected from multiple repeatable sites for 2019-nCoV nucleic acid test in suspected cases. Chest computed tomography has certain value for the diagnosis of children with 2019-nCoV infection. The recent prognosis of the patients is good with general treatment.
ABSTRACT
Objective To evaluate the efficacy and safety of intracoronary thrombolysis during primary percutaneous coronary intervention(PCI)in elderly patients with acute ST segment elevation myocardial infarction(STEMI).Methods This prospective study was conducted at the Department of Cardiology of Shangqiu First People's Hospital.Elderly patients diagnosed with STEMI and undergoing primary PCI were consecutively recruited from September 2016 to September 2017.Of all recruited patients,106 patients were successfully followed up and were randomly divided into a treatment group(intracoronary thrombolysis group,n=54)and a control group (intracoronary saline group,n=52).Patients in the treatment group received an injection of 10 mg recombinant prourokinase (10 ml)via a balloon catheter while patients in the control group were injected with 10 mL saline instead.The incidences of slow flow,bleeding in 3 days after operation,left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter(LVEDD),and major adverse cardiovascular events (MACE) in 90 days after operation were compared between the two groups.Results Compared with the control group,the treatment group had a decreased incidence of slow flow (x2 =4.06,P＜ 0.05).The incidence of bleeding in 3 days after operation showed no difference between the two groups(x2 =0.71,P＞0.05).The treatment group also had an elevated incidence of LVEF(t=-2.95,P ＜0.05)and a decreased incidence of LVEDD in 90 days after operation(t=2.86,P＜0.05),compared with the control group.No significant difference in the incidence of MACE in 90 days after operation was observed between the two groups(x2 =1.46,P＞0.05).Conclusions In elderly patients with STEMI,intracoronary thrombolysis during primary PCI can reduce the incidence of slow flow during operation,and improve the function and size of left ventricle without increasing the incidence of bleeding.
ABSTRACT
Objective To observe and analyze the changes of inflammatory cytokines levels in patients with progressive cerebral infarction (PCI ).Methods The patients with progressive cerebral infarction (progressive cerebral infarction group),the patients with non-progressive cerebral infarction(non progressive cerebral infarction group)and the healthy individuals(control group)were selected as the research subjects.Sixty individuals were included in each group.The levels of IL-8,hs -CRP,SAA of the research subjects were detected and observed. Results The levels of IL -8[(201.89 ±46.41)mg/L],hs -CRP[(16.55 ±4.49)mg/L],SAA[(20.65 ± 4.17 )mg/L]of the progressive cerebral infarction group were significantly higher than those of non -progressive cerebral infarction group[(132.02 ±40.26 )mg/L,(8.09 ±4.06)mg/L and (15.35 ±4.07 )mg/L).]The differ-ences were statistically significant (t=4.289,P=0.000;t=2.276,P=0.006 and t=2.269,P=0.031).Compared with the control group[(50.70 ±31.14 )mg/L,(0.70 ±0.11 )mg/L and (5.15 ±2.21)mg/L],the levels of IL-8, hs-CRP,SAA in the progressive cerebral infarction group and non -progressive cerebral infarction group were significantly higher on the first day (PCI group vs control:t=3.614,P=0.000;t=3.406,P=0.007;t=2.559, P=0.009;NPCI group vs control:t=3.602,P=0.000;t=3.181,P=0.009;t=1.520,P=0.026).Conclusion The changes of the inflammatory factors levels such as IL-8,hs-CRP,SAA have certain predicative value on the development of the PCI.
ABSTRACT
Objective To understand the cooperation experiences of doctors and nurses from the Infectious Department,that may be contributive to promote a harmonious relationship between doctors and nurses.Methods Sixteen nurses and nine doctors came from Infectious Department were interviewed.The data were collected through face-to-face in-depth semi-structured interviews.Thematic analysis based on Qualitative Research method,qualitative content analysis was used for data interpretation by analysis and management.Results Three themes were identified and described as the cooperation experiences between doctors and nurse,the cooperation troubles,suggestions about promoting a harmonious relationship between doctors and nurses.Conclusion Harmonious relationship is particularly important in the clinical work,but in fact,there are many factors affect the harmonious relationships,so it is recom-mended that hospital leaders should take measures to build a harmonious relationship between doctors and nurses.
ABSTRACT
Objective: To explore the advantage of RR-Lorenz plot (RR-LP) in analyzing the patients of sinus rhythm with long RR interval. Methods: A total of 308 RR-LP patients with long RR interval were retrospectively studied. The patients were divided into 7 groups according to the type of long RR intervals. ① Sinus bradycardia with arrhythmia group, n=63,②Repeated transient sinus arrest group, n=16, ③Ⅱ° sino-atrial block group, n=14, ④Ⅱ° atrial ventricular block (Ⅱ° AVB) group, n=47, ⑤ Un-passed atrial premature beats (APB) group, n=28, ⑥ Atrial premature beats group, n=72 and ⑦ Premature ventricular beats group, n=68. We analyzed the patients of RR interval greater than 1500 ms with ambulatory electrocardiogram record. Results: ①RR-LP of sinus bradycardia with arrhythmia group showed a single distributing area with 1500 ms for the origin of transverse and longitudinal axis with B line slope at 1, tilt angle of 45°.②RR-LP of repeated transient sinus arrest,Ⅱ° sino-atrial block,Ⅱ° AVB and APB groups showed special four distributing areas with B line slope at (0.51 ± 0.01), tilt angle of (23.04 ± 0.50) °, B line slope at 0.6, tilt angle of (27°), B line slope at (0.57 ± 0.21), tilt angle of (25.69 ± 9.59)° and B line slope at (0.50 ± 0.01), tilt angle of (22.59 ± 0.54) ° respectively.③RR-LP of premature beats groups showed special four regional distributing areas, B line slope for atrial premature beats was at (0.38 ± 0.12), tilt angle of (17.06 ± 5.22) ° and B line slope for ventricular premature beats was at (0.07 ± 0.05), tilt angle of (3.02 ± 2.39) °. Conclusion: RR-LP in patients of sinus rhythm with long RR interval had speciifc morphology and distribution features, the local abnormality could be found in a plane via all RR intervals which provided a differential diagnosis for repeated occurrence of short RR interval.
ABSTRACT
There is a long history of Toad venom in the treatment of cancer in China.Bufalin,extracted from Toad venom,is one of the biologically active compounds of anticancer.We elaborate the molecular mechanism of bufalin on anticancer activity from several aspects such as inducing cell apoptosis and differentiation,inhibitting cell proliferation and angiogenesis,enhancing the sensitivity of chemotherapeutics,which can provide the basis for in-depth study of Toad venom and its development and clinical medication.
ABSTRACT
Since the laparoscopic thyroidectomy carried out in China for ten years,this technique has become more and more mature,indications gradually broadened,and playing a vital role in the field of thyroid surgery.This article will explain this technique in the aspects of approaches,the establishment and maintenance of the surgical space,indications,antiindications and complications.
ABSTRACT
Objective To explore aescin's inhibition of in vitro proliferatim in L1210 murine acute lymphoid leukemia cells and its in vivo antileukemic effects.Methods MTT assay was used to determine the anti-proliferative effect in vitro;Leukemia transplant models were used to test the antileukemic effect. Mice inoculated with L1210 cells were treated with ten daily doses of aescin or/and each other day of DOX, and were observed for survival.Antileukemic effects were assessed by calculating the extension of lifespan. Results Aescin(20～60?g/mL) was found to be able to inhibit the proliferation of L1210 cells.The effects were in a dose- and time- dependent manner.The IC_(50) value of aescin in L1210 cells after 72 h was (24.86?2.23)?g/mL.In vivo study showed that after treating the L1210 cells bearing mice with higher, middle,and low dosage(4.5,3.5,and 2.5 mg/kg) of aescin for ten consecutive days,The extension of lifespan were 25.8%(P