Research progress on the characteristics and influencing factors of energy expenditure in children and adolescents of different ages / 中国学校卫生

Abstract@#The physical health of children and adolescents has received widespread attention in recent years, and a series of problems due to unbalanced energy expenditure have come into focus. Energy expenditure in children and adolescents is influenced by multiple factors including body composition and physical activity level. By analyzing and summarizing the characteristics and specificities of energy expenditure in children and adolescents at different ages, the review aims to formulate a targeted design and implementation plans for future intervention studies.

Clinical characteristics analysis of acute pancreatitis / 中华消化外科杂志

Objective:To analyze the clinical characteristics of acute pancreatitis.Methods:The retrospective case-control study was conducted. The clinical data of 558 patients with acute pancreatitis who were admitted to The First Affiliated Hospital of Xi′an Jiaotong University from June 2015 to June 2023 were collected. There were 352 males and 206 females, aged (46±15)years. Observation indicators: (1) general situations of acute pancreatitis patients; (2) etiology of acute pancreatitis patients; (3) severity of acute pancreatitis patients; (4) chronic diseases in acute pan-creatitis patients; (5) complications in acute pancreatitis patients; (6) subgroup analysis of patients with recurrent acute pancreatitis. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Wilcoxon rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was analyzed using the rank sum test. Bonferroni correction was used for pairwise comparison. Results:(1) General situations of acute pancreatitis patients. There were significant differences in gender, age, total duration of hospital stay, smoking, and alcohol consumption between the first episode of acute pancreatitis patients and the recurrent acute pancreatitis patients ( P<0.05). (2) Etiology of acute pancreatitis patients. There were significant differences in gallstones and hyperlipidemia between the first episode of acute pancreatitis patients and the recurrent acute pancreatitis patients ( P<0.05). (3) Severity of acute pancreatitis patients. Of the 443 patients with first episode of acute pancreatitis and 115 patients with recurrent acute pancreatitis, cases with mild acute pancreatitis, cases with moderate-severe acute pancreatitis, cases with severe acute pan-creatitis were 320 and 83, 24 and 9, 99 and 23, showing no significant difference between them ( P>0.05). (4) Chronic diseases in acute pancreatitis patients. There were significant differences in com-plication as hyperlipidemia, fatty liver and diabetes between the first episode of acute pancreatitis patients and the recurrent acute pancreatitis patients ( P<0.05). (5) Complications in acute pancrea-titis patients. There was no significant difference in terms of acute necrotic collection, acute peripan-creatic fluid accumulation, walled-off necrosis, pancreatic pseudocyst, infectious pancreatic necrosis, systemic inflammatory response syndrome, respiratory system complications, circulatory system complications, renal complications, sepsis, abdominal compartment syndrome, or pancreatic ence-phalopathy between the first episode of acute pancreatitis patients and the recurrent acute pancrea-titis patients ( P>0.05). (6) Subgroup analysis of patients with recurrent acute pancreatitis. ① Combination with chronic diseases. Of the 115 patients with recurrent acute pancreatitis, cases with mild acute pancreatitis, cases with moderate-severe acute pancreatitis, cases with severe acute pancreatitis were 83, 9, 23, and there were 25, 8, 11 cases of them with hyperlipidemia, respectively, showing a significant difference among them ( P<0.05). ② Complications. Of the 115 patients with recurrent acute pancreatitis, there were 44 cases with hyperlipidemia and 71 cases without hyper-lipidemia, and there were significant differences in acute peripancreatic fluid accumulation and renal complications between them ( P<0.05). Conclusions:Recurrent acute pancreatitis is more common in males. Compared with first episode of acute pancreatitis, cases with recurrent acute pancreatitis usually have younger age, shorter total duration of hospital stay, higher proportion of smoking and drinking. The etiology of recurrent acute pancreatitis is composed of lower levels of biliary diseases and higher levels of hyperlipidemia. Patients with recurrent acute pancreatitis have higher proportion of comorbidities as hyperlipidemia, fatty liver and diabetes. There was no signifi-cant difference in the incidence of complications between first episode of acute pancreatitis and recurrent acute pancreatitis. Compared with recurrent acute pancreatitis patients without concomi-tant hyperlipidemia, recurrent acute pancreatitis patients with concomitant hyperlipidemia are more prone to acute peripancreatic fluid accumulation and renal complications.

Analysis of the efficacy of Cheneau brace in the treatment of adolescent idiopathic scoliosis and evolution of the curve types during brace treatment / 中国脊柱脊髓杂志

Objectives:To analyze the clinical efficacy of Cheneau brace in adolescent idiopathic scoliosis(AIS)patients and to discuss the changes of curve type during the treatment.Methods:75 patients with AIS treated with Cheneau brace from October 2016 to November 2021 were included.There were 69 females and 6 males,averaged 11.9±1.0 years old when starting to wear the brace,with a mean initial main curve Cobb angle of 29.8°±8.5° and an initial Risser's sign ≤2.Clinical and imaging data were collected,including age,gender,menarche age,time of daily wear,and full-length radiographs of the spine before initial treatment and at the final follow-up.All the patients were followed up for 1 year after finishing brace treatment.The curve types of the patients were counted using the main curve type and the modified Lenke classification system(mLenke),and changes in curve types and the efficacy of bracing in patients with different curve types were analyzed.Results:After 25.7±10.8 months of brace treatment,the patients averaged 14.2±1.2 years old when finishing brace treatment,and the mean main Cobb angle was 27.6°±12.0°.Among the patients,scoliosis was controlled in 63 while progressed in 12,and 23 patients were treated surgically.The rates of success of brace and control of curve were higher in patients with main lumbar curve than those in patients with main thoracic curve(P=0.043,P=0.003).There was a difference in the rate of brace success and control of curve in patients with each mLenke classification(P＜0.001,P=0.005).The highest rates of brace success and control of curve were found in patients of mLenke type Ⅴ,while mLenke type Ⅳ patients had the lowest success rate of brace treatment success and mLenke type Ⅱ patients had the lowest rate of control of curve.Before and after brace treatment,there was a difference in the proportion of patients with each main curve type(P=0.019),and the proportion of patients with each mLenke classification had no statistical difference(P=0.071).There were differences in the rate of change of curve type in each main curve type and each mLenke classification both(P＜0.001,P=0.020).No significant differences were seen in the rates of success of brace treatment and control of curve between patients with and without change in curve type under the two curve type classifications.Conclusions:The efficacy of Cheneau brace varies among AIS patients with different curve types.Patients with a main thoracic curve tend to have a poor response to bracing compared with patients of main lumbar curve;During the treatment with Cheneau brace,the patient's curve types may change,and the overall trend of curve type change is upward shifting of the main curve.The rate and outcome of curve type changes vary among patients with different curve types,and curve type changes may also occur in curve controlled or corrected patients.

Emergency iliosacral screw fixation assisted by TiRobot for unstable posterior pelvic ring fracture / 中华创伤骨科杂志

Objective:To evaluate the emergency iliosacral screw fixation assisted by TiRobot for unstable posterior pelvic ring fracture.Methods:The 26 patients with unstable pelvic fracture were analyzed retrospectively who had undergone emergency iliosacral screw fixation at Department of Orthopedics & Traumatology, Beijing Jishuitan Hospital from June 2018 to December 2020. They were divided into 2 groups depending on whether orthopaedic TiRobot was used to assist screw insertion. In the observation group of 14 cases subjected to TiRobot-assisted insertion of iliosacral screws, there were 10 males and 4 females with an age of (45.9 ± 10.1) years; in the control group of 12 cases subjected to conventional manual insertion of iliosacral screws, there were 9 males and 3 females with an age of (49.2 ± 11.3) years. All the surgeries were conducted within 24 hours after injury. The 2 groups were compared in terms of screw insertion time, pin insertion, intraoperative blood loss, fluoroscopy time, postoperative screw position, fracture reduction and Harris hip score at the final follow-up.Results:The 2 groups were comparable because there was no significant difference between them in their preoperative general clinical data or follow-up time ( P>0.05). The screw insertion time [(16.1 ± 3.4) min] and fluoroscopy time [(8.1 ± 3.3) s] in the observation group were significantly shorter than those in the control group [(26.4 ± 5.4) min and (25.2 ± 7.4) s], and the pin insertions [1 (1, 2) times] and intraoperative blood loss [(10.5 ± 6.4) mL] in the former were significantly less than those in the latter [6 (3, 8) times and (24.8 ± 6.7) mL] (all P<0.05). Postoperatively, the sacroiliac screw position was excellent in 18 cases and good in 2 in the observation group while excellent in 14 cases, good in 2 and poor in 2 in the control group; the fracture reduction was excellent in 12 cases, good in one and fair in one in the observation group while excellent in 10 cases, good in one and fair in one in the control group, showing insignificant differences in the above comparisons ( P>0.05). There was no significant difference either in the Harris hip score at the final follow-up between the 2 groups ( P>0.05). Conclusion:Compared with conventional manual insertion of iliosacral screws, emergency iliosacral screw fixation assisted by TiRobot can effectively decrease surgical time and reduce operative invasion due to a higher accuracy rate of screw insertion.

Risk factors for massive blood loss in pediatric patients with congenital scoliosis undergoing posterior hemivertebra resection / 中华麻醉学杂志

Objective:To identify the risk factors for massive blood loss in pediatric patients with congenital scoliosis undergoing posterior hemivertebra resection.Methods:The clinical data of pediatric patients with congenital scoliosis who underwent posterior hemivertebra resection in our hospital from May 2017 to July 2019 were collected.The children were divided into group A (massive blood loss, blood loss/blood volume ≥30%) and group B (non-massive blood loss, blood loss/blood volume <30%) according to intraoperative blood loss.Logistic regression analysis was used to stratify the risk factors.Results:A total of 108 pediatric patients were enrolled in the study including 29 cases in group A and 79 cases in group B, respectively.There were significant differences in the preoperative Cobb angle, body mass index, the number of fused levels, the number of screws and operative time between the two groups ( P<0.05). Logistic regression analysis showed that the preoperative Cobb angle, operative time, the number of fused levels and body mass index were the risk factors for intraoperative massive blood loss ( P<0.05). Conclusion:Lower BMI, larger Cobb angle, increased operative time and more fused levels are the risk factors for massive blood loss in pediatric patients with congenital scoliosis undergoing posterior hemivertebra resection.

The comparison of outcomes between internal fixation and total hip arthroplasty for displaced femoral neck fracture / 实用医学杂志

Objective To compare the clinical outcome of internal fixation(IF)and total hip arthroplasty (THA)for the elderly patients with displaced femoral neck fracture. Methods A total of 128 patients with dis-placed femoral neck fracture admitted from January 2010 to December 2012 were selected and divided into IF group(61 cases)and THA group(67 cases). The operation and hospitalization index were compared between the 2 groups. All patients underwent follow-ups after operation. The functional recovery scale for hip fracture (FRS) and EQ-5D index were applied to evaluate the clinical outcomes periodically. Results Compared to THA group, the intraoperative trauma ,operation time and bed days were less in IF group(P0.05). Follow-ups at all time points revealed hip function in THE group is better than that in IF group(P 0.05). Within 3 years,the costs related to fracture were 41772 yuan for IF group and 61174 yuan for THA group respectively. Conclusion Both internal fixation and total hip arthroplasty can provide satisfactory outcome for elderly patients with displaced femoral neck fracture. Compared with IF ,THA causes bigger trauma and costs more ,but ends up with lower complication incidences ,and improve hip function in a shorter period.

Epidemiological analysis of hospitalized patients with femoral neck fracture in a first-class hospital of Beijing / 北京大学学报(医学版)

Objective:To analyze the clinical parameters of the patients with femoral neck fracture such as general condition,therapy method,hospitalized expense so as to provide more effective management plan for the clinical work.Methods:The patients with femoral neck fracture above 50 years who received in-patient treatment from 2008 January to 2012 December were admitted into this study.We collected and analyzed the information,such as age,chronic medical disease,therapy method,hospitalized duration and expense and so on.Results:There were 1 794 femoral neck fracture patients above 50 years (male/female=1/2.06)in our hospital in recent 5 years and the annual average rate of increase was 7.3%. The average age of the patients was (69.9 ±10.7)years and the annual average rate of increase was 0.6%.The chronic medical disease diagnosis ratio was 55.0%.The average waiting time for operation was (6.8 ±4.2)days and the average hospitalized duration was (12.9 ±4.9)days which showed down-ward trend in recent years. The most popular operations were cannulated screw internal fixation (41.8%)and artificial femoral head replacement (34.1%).In the study,146 cases (7.9%)received nonsurgical treatment which showed downward trend.The average hospitalized expense was (35 075 .7 ± 1 1 343.2)yuan which showed no obvious change in recent years.The cost for the females was more than that for the males.The expense for hemiarthroplasty and total hip arthroplasty increased while that for cannulated screw internal fixation decreased gradually.Conclusion:The cannulated screw internal fixa-tion and artificial femoral head replacement were the most important operations for the patients with femo-ral neck fracture.The number and the average age of the patients were on the rise while the expense showed no obvious change in recent years.

Comparison of mid-term effects between microendoscopic discectomy and microsurgical lumbar discectomy for operatively treating lumbar disc herniation / 重庆医学

Objective To evaluate the mid‐term efficacy of microendoscopic discectomy (MED) and microsurgical lumbar discectomy (MSLD) for treating lumbar disc herniation (LDH) .Methods 98 patients with single segment LDH in the Orthopedic department of the Second Hospital of Lanzhou University from March 2009 to April 2010 were divided into 2 groups ,including 44 cases undergoing MED and 54 cases undergoing MSLD .The operative efficacies were assessed by the visual analogue scale (VAS) , Japanese Orthopedic Association (JOA) scores and Oswestry Disability Index (ODI) .Results There were statistically significant differences in the skin incision length ,amount of intraoperative blood loss and time of returning to work between the two groups (P0 .05) .The mean follow‐up duration was 49 .13 months in the MED group and 47 .24 months in the MSLD group respectively .At the last follow‐up the postoperative back and leg pain VAS scores ,JOA scores and ODI in each group were signifi‐cantly improved compared with the preoperative data (P<0 .01) .However ,there were no statistically significant differences in the intergroup comparison .Conclusion MED and MSLD are the effective methods for treating single segment LDH .However ,MED has less trauma and early out‐of‐bed ambulation ,is an ideal minimally invasive surgery .