Objective To investigate the role of survivin and P53 in apoptosis of gastric adeno- carcinoma,as well as its relationship with the clinicopathologic features and the prognosis.Methods The gas- tric tissue microarrays were composed of those from 100 cases of gastric cancer and 30 controls.At these tissue microarrays,expressions of survivin and P53 were investigated immunohistochemically,and tumor cell apoptosis index was examined by TUNEL method.Of the 100 cases,47 cases were followed-up from 14 months to 13 years,in which the survival was analyzed.Results Two paraffin-embedded gastric carcinoma tissue micro- arrays were successfully constructed,including 114 and 116 tissue spots,respectively.Immunohistochemical analysis showed that survivin was expressed in 78 cases (78%).No expression of survivin was detected in control tissue (P0.05).In the 47 cases with followed-up data,univariant analysis revealed that the survival was correlated with invading of vessel and nerve,TNM stages,and expression of survivin.The histological grades and expression of P53 were not related to prognosis.However,Cox stepwise proportional hazards analysis showed that only TNM staging and survivin status retained significant independently in prospecting prognosis.Conclusions The expression of survivin was associated with the pathologic features,TNM stages and prognosis in gastric carcinoma,indicating that overex- pression of survivin may be a poor prognosis factor for gastric carcinoma.

Objective To describe the distribution of body mass index (BMI) and evaluate the prevalence of overweight and obesity among first to sixth graders in 8 Chinese provinces.Methods Data came from the baseline survey of the Chinese Center for Disease Control and Prevention (CDC) funded project Study on Intervention Models for Main Chronic Diseases among children in China.A stratified random cluster sampling strategy was used to select study participants in 8 provinces,including Inner Mongolia,Jiangsu,Anhui,Shandong,Hunan,Guangxi,Gansu provinces,and Chongqing,with diverse geographical and economic level distributions in China.Counties in each province were stratified into three strata according to economic level,and one county was selected systematically from each stratum.In each county,one urban and one rural elementary school were randomly selected ; and in each school,2-3 classes were randomly selected from each of 1-6 grades.All students in these selected classes were invited for participation.Physical examination was performed by trained local CDC staff using standardized instruments to measure height and weight.Overweight and obesity were diagnosed based on the BMI classification standards for Chinese children and adolescents by Working Group for Obesity in China (WGOC).Results A total of 26558(14225 boy,12333 girl) students aged 6-12 years eventually participated in 8 provinces.The average age was 9.3 ±1.8 years old.Mean BMI among boys (17.0 kg/m2) was higher than that among girls (16.4 kg/m2,t =19.60,P＜0.01).There were statistically significant differences in mean BMI of each age group of boys and 6-11 age groups of girls between urban and rural regions and among those with three economic levels (P＜0.05).The 85th and 95th percentiles of BMI among boys aged 7-11 years in urban region were higher than BMI reference in the standards from WGOC.Lower percentiles were observed among girls aged 7-12 years in rural region.The prevalence of overweight and obesity were 9.3％ and 6.5％ among schoolchildren aged 7-12 years.The prevalence of overweight among boys (10.9％) was higher than that among girls(7.6％,x2 =88.89,P＜0.01) ; while prevalence of obesity were 8.0％ among boys and4.7％ among girls,respectively (x2 =107.17,P＜0.01).The prevalence of overweight was 11.3％ in urban and 7.4％ in rural children(x2 =131.94,P＜0.01).The prevalence of obesity was 8.7％ in urban and 4.3％ in rural children(x2 =188.99,P＜0.01).The prevalences of overweight were 10.3％,8.6％ and 9.0％ in individuals with high,medium,and low economic levels,respectively(x2 =10.76,P＜0.01) ; while the prevalences of obesity were 8.2％,5.6％,and 5.4％,respectively (x2 =51.71,P ＜ 0.01).Conclusions The overall prevalence of overweight and obesity in Chinese school children was high.The prevalence in urban region with high economic level was significantly higher than that in rural region with middle and low economic level.The nutritional and behavioral intervention programs are needed to control the rising trend of obesity in children.

Objective To analyze the influencing factors for sleep duration of school children aged 6-12 years in school-day in 8 provinces in China.Methods The cross sectional study was conducted among 20 603 children aged 6-12 years and selected through stratified random cluster sampling in 8 provinces (municipality and autonomous region) with different geographic characteristics and economic development level in China from September to November,2010 to understand their sleep duration in school-day and related habits.t test and x2 test were used to compare the sleep duration of the children.Multivariate stepwise logistic regression analysis was conducted to identify the influencing factors.Results The survey indicated that the daily average sleep duration of the children in school days was 9.11 hours.The proportions of the children with serious insufficient sleep,insufficient sleep and sufficient sleep were 32.82％ (7 672/20 603),39.70％ (8 179/20 603) and 27.48％ (5 662/20 603),the children's sleep duration declined with age,so did proportion of children with serious insufficient sleep.There were no sex,urban or rural area and household income level specific significant differences in sleep duration among the children surveyed,and there were no sex specific differences in the proportion of children with serious insufficient sleep,insufficient sleep and sufficient sleep,however,these proportions were statistically different between urban area and rural area and among the regions with different economic level.The proportions of children with serious insufficient sleep and sufficient sleep was higher in rural area than in urban area (x2=59.96,x2=45.47,P＜ 0.05),while the proportion of children with insufficient sleep was lower in rural area than in urban area.In the economy developed region,the proportion of children with insufficient sleep was lowest,the difference was statistical significant.After adjusting for sex,weight,diet and exercise time,multivariate logistic regression analysis showed that the factors benefiting children to have 10 hours sleep every day included having high protein diet,exercise,high household economic status and living in urban area.Conclusion The problem of school children having insufficient sleep was serious in China,especially in the rural area.

Objective To understand the differences on sleeping-time between school-days and weekends among elementary school children.Methods This cross-sectional study was conducted from September to November,2010.A stratified random cluster sampling strategy was used to select the participants,under diverse geographical and economic levels in eight provinces,municipalities or autonomous regions,in mainland China.A total number of 20 603 elementary school children aged from 6-12 years old were chosen as research subjects to record their time of sleeping during school-days or weekends.Results Among the 6-12 year old,their time of sleeping was longer on weekends than that on school-days,while the average sleeping time during the weekends was longer in boys than in girls (t=3.35,P＜0.05).However,there was no linearly decreasing trend along with the increase of age regarding the time of sleeping on weekends,in girls.Proportions of serious lack of sleep,lack of sleep or with sufficient sleep during the weekends were 13.63％ (2 809/20 603),27.27％ (5 618/20 603) and 59.10％ (12 176/20 603).The proportion of sufficient sleep (over 50％) was significantly higher on weekends than that on school-days (less than 30％),however,nearly one third of the first grade primary school children were sleep insufficiently even on weekends.Nearly 10.00％ of the children under seriously or moderately lack of sleep on school-days were still in a serious lack of sleep state on weekends.The three groups who were categorized as serious lack of sleep (less than 9 h),lack of sleep (9-10 h) or having sufficient (over 10 h) sleep on school-days accounted for 29.75％,64.48％,86.44％,respectively,when compared with the national regulation set as 10 h daily sleep for the children in China.The proportions of those whose time of sleep on weekends was less than school-days in the three groups as the same,moderate (within 1 h),with 1 h caught-up or over,were 9.41％,22.77％,43.32％,24.50％,respectively.The percentage of pupils who caught up sleep appropriately (within 1 h) on weekends among those who were serious lack of sleep in school-days would exceed 40.00％ while the proportions among those who lack of sleep or having sufficient on school-days were 54.00％ and 30.00％.The percentage of children who slept less on weekends than on school-days among those having sufficient sleep on school-days appeared the highest,nearly 20.00％.However,the proportions among those who lack of sleep or seriously lack of sleep on school-days were 3.45％ and 8.16％,respectively.Conclusion We found that the elementary school children who could catch up time of sleep or lack of sleep on weekends coexisting in our study.This situation called for attention and the sleeping habit in primary school children should also be urgently improved.

Objective To investigate the effects of standardized tertiary rehabilitation (STR) on limb motor function (LMF) after stroke.Methods Eighty-two patients were divided into a primary cerebral infarction group (PCI group) and a primary cerebral hemorrhage group (PCH group),and then randomly further divided into experi- mental and control sub-groups.All patients received routine internal medicine treatment,supplemented with stand- ardized tertiary" rehabilitation in the experimental groups.All patients were assessed with the simplified Fugl-Meyer motor function assessment (S-FMMFA) at enrollment,and 1,3 and 6 months after their stroke.Results The scores of the experimental groups were higher than those of the controls.The experimental groups scores were 26.10% of normal at the time of the enrollment,and improved to 42.52%,65.62% and 83.71% by the end of the 1st,3rd and 6th month,respectively.The control groups started at 18.51%,and progressed to 24.85% ,37.24% and 45.84% over the same interval.Conclusion STR was associated with improved LMF scores of stroke pa- tients.

BACKGROUNDAlthough bronchoscopy has been widely performed in China, little has been known about its current state and development. In order to investigate the clinical application of bronchoscopy and make instructions for future education and development, the Chinese Society of Respiratory Diseases conducted postal surveys in both 2008 and 2010 in China.

METHODQuestionnaires were sent to 40 tertiary grade A hospitals in 2008 and 58 tertiary grade A hospitals in 2010 to investigate bronchoscopies performed in 2007 and 2009 respectively.

RESULTSThirty (75%) hospitals returned the completed questionnaires in 2008 and forty-one (71%) hospitals in 2010. All the respondents possessed flexible bronchoscopes. Fifty percent of the respondents had less than five in 2007, while more than 50% of the respondents had 5-9 bronchoscopes in 2009. All the respondents performed a radiograph or CT scan before bronchoscopy. Percentage of general anesthesia and no pre-medication before bronchoscopy increased, while atropine usage decreased in 2009 compared to 2007. During bronchoscopy, pulse oximetry was the most widely used monitoring method. Most respondents used the nasal route to perform routine bronchoscopy. After the procedure, they used sinks to wash and glutaraldehyde to disinfect the bronchoscopes. The total number of flexible bronchoscopies performed during 2007 was 37 874 and the average was 1262. Whereas in 2009, the total number was 60 178 and the average was 1468. Diagnostic bronchoscopy was more widely used than therapeutic bronchoscopy. The mortality rate was 0.076‰ in 2007 and 0.032‰ in 2009.

CONCLUSIONSThe two surveys, to some extent, reflected the current status and development of bronchoscopy in China. The results are worthy of future education and developing of new guidelines. Regular surveys and monitoring of bronchoscopies across China are needed.

Bronchoscopy ; methods ; utilization ; China ; Hospitals ; statistics & numerical data ; Humans ; Surveys and Questionnaires

OBJECTIVETo establish a rapid method for detecting MTHFR gene 677C>T polymorphisms with high-resolution melting curve method (HRM) and pyrosequencing.

METHODSPeripheral blood samples were collected from 155 Down syndrome patients and 182 normal controls from Children's Hospital of Shanghai. The accuracy of three methods including regular HRM, internal control HRM and artificial heterozygosity HRM was compared. Meanwhile, allele frequencies in 10, 30 and 50 mixed samples were measured with pyrosequencing, and the results were compared with that of HRM.

RESULTSHeterozygosity of 677C>T polymorphism could be distinguished by various HRM methods. However, homozygotes CC and TT were only identifiable by internal control HRM and artificial heterozygosity HRM. The accuracy of pyrosequencing for allele frequency has improved with increased sample number. When the number of mixed samples has exceeded 30, the difference between pyrosequencing results and actual values became less than 4%. TT genotype was more frequent in Down syndrome patients than controls (25.2% vs. 14.3%). No significant difference was found in T allele frequency between the two groups (44.9% vs. 40.1%).

CONCLUSIONRespectively, internal control HRM and pyrosequencing may be ideal methods for determination of genotypic and allelic frequencies.

Child ; Child, Preschool ; Down Syndrome ; diagnosis ; enzymology ; genetics ; Female ; Humans ; Male ; Methylenetetrahydrofolate Reductase (NADPH2) ; genetics ; Point Mutation ; Polymorphism, Single Nucleotide ; Sequence Analysis, DNA ; methods ; Transition Temperature

Objective:To explore the feasibility and safety of robotic-assisted living donor left lateral segmentectomy (LDLLS) in a large pediatric liver transplant program.Methods:Retrospective analysis was performed for clinical data of 45 LDLLS donors and recipients from June 2021 to September 2022.Traditional open donor liver resection (n=30) and robotic-assisted segmentectomy (n=15) were performed.Two groups were compared with regards to operative duration, intraoperative hemorrhage, postoperative healing and postoperative complications.SPSS 21.0 was utilized for statistical analysis.Independent sample T, paired sample T, Wilcoxon rank sum and Chi-square tests were performed for examining the inter-group differences.Results:Operative duration of robot-assisted surgery group was substantially longer than that of traditional open surgery group ( P<0.001). Intraoperative blood loss was less in robot-assisted surgery group was less than that in traditional open surgery group[(106.0±39.8) vs.(251.0±144.8) ml, P=0.001]. Postoperative hospital stay of robot-assisted surgery group was shorter than that of traditional open surgery group[6.0(6.0, 6.0) vs.7.0(6.0, 9.0), P<0.05]. Two cases of postoperative biliary leakage were observed in donor of traditional open surgery group.Among 2 cases of abdominal infection, one was due to biliary leakage from liver section and secondary surgery was then performed.One case of incisional infection and another case of thrombosis occurred in donor of traditional open surgery group.In robot-assisted surgery group, only one donor had amylase elevation.In traditional open surgery group, there were one case of local thrombosis in middle hepatic vein and one case of bile duct stricture.No long-term complications occurred in robot-assisted surgery group during a follow-up period of over 6 months.Finally recipient data analysis indicated that no significant inter-group differences existed in operative duration, intraoperative blood loss, postoperative hospital stay or postoperative abdominal infection ( P=0.634, P=0.180, P=0.86 and P=0.153). Conclusions:Robotic-assisted LDLLS proves to be be a safe and reliable option for living donor segmentectomy.It is superior to conventional LDLLS in terms of shorter hospital stay, less intraoperative blood loss and fewer postoperative complications.

The traditional methods of skeletal age estimation mainly include Numeration, Atlas, and Counting scores. In recent years, other new methods were proposed by several scholars. Utilizing image logical characteristics of X-ray film to extrapolate skeletal age is a key means by present forensic medicine workers in evaluating skeletal age. However, there exist some variations when we present the conclusion of skeletal age as an "evidence" directly to the Justice Trial Authority. In order to enhance the accuracy of skeletal age determination, further investigation for appropriate methodology should be undertaken. After a collective study of pertinent domestic and international literatures, we present this review of the research and advancement on skeletal age evaluation methods of X-ray film.
Age Determination by Skeleton/trends* ; Carpal Bones/diagnostic imaging* ; Elbow/diagnostic imaging* ; Female ; Forensic Medicine/methods* ; Hand Bones/diagnostic imaging* ; Humans ; Image Processing, Computer-Assisted/methods* ; Male ; Radius/diagnostic imaging* ; Tomography, X-Ray Computed/methods* ; X-Ray Film

OBJECTIVETo analyze the relationship between socioeconomic status (SES) and overweight and obesity among elementary school children.

METHODSThis cross-sectional study was conducted from September to November, 2010. A stratified random cluster sampling was used from sampling frame of eight provinces by the geographical and economic development distributions in mainland China. A total of 19 934 students aged 7-12 years old participated in this study. All subjects were evaluated the status of overweight and obesity. Green's scoring SES was used to evaluate the SES of the participants. Multivariate logistic regression analysis was performed to examine the relationship between SES and overweight and obesity among children.

RESULTSAccording to the scores of Green's SES, the participants' SES were divided into three levels, the prevalence of overweight were 7.4% (538/7295), 9.3% (560/6013) and 12.6% (832/6626), and the prevalence of obesity were 4.4% (321/7295) , 6.4% (387/6013) and 10.2% (677/6626) from low to high SES level, respectively (χ(2) value were 133.82, 180.27, respectively, P < 0.01). After adjusted by age, urban and rural and economic regions, compared with the participants with low SES, the OR (95%CI) of having overweight and obesity among participants with high SES were 1.83(1.61-2.08) for boys and 1.67(1.42-2.00) for girls; the OR (95%CI) with middle SES were 1.30(1.15-1.48) for boys and 1.23(1.04-1.46) for girls.

CONCLUSIONThe prevalence of overweight and obesity rises with the family's SES levels. There was a positive correlation between SES and overweight and obesity among school-aged children.

Child ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Obesity ; economics ; epidemiology ; Overweight ; economics ; epidemiology ; Prevalence ; Social Class