OBJECTIVETo evaluate the authenticity of the parents' memory on their children's immunization status.

METHODSTwo counties and 1 district in each of the 18 prefectures were selected, and parents of the children 1 - 2 years old, residents in counties or floating in district, were studied on the authenticity of their memory regarding their children's immunization status.

RESULTSThe rates of inoculation with all the four expanded programme on immunization (EPI) vaccines were 89.7% in the whole province, and 77.9% among floating children. The authenticity of the reply from parents on their children, inoculation status with vaccines was above 96%. However, less than 50% of the parents could remember what specific vaccines that their children had received. The authenticity of parents' memory was higher in the parents with high school or college education than those who were illiterates or only having had elementary school education. Mothers had better memory than the fathers. Of the children whose parents could not remember the vaccination status, 97% of them had been inoculated.

CONCLUSIONThe definite answer of parents to children's immunization status had high creditability, especially when the mothers having had more schooling. Those children whose parents failed to remember whether vaccination had been received should not be ranked as unimmuned.

Cross-Sectional Studies ; Humans ; Immunization ; statistics & numerical data ; Immunization Schedule ; Infant ; Memory ; Parent-Child Relations ; Parenting ; psychology ; Social Class

Objective: To explore the relationship between pubertal status, pubertal KAP and adolescents quality of life and the moderating effect of pubertal KAP between pubertal status and quality of life, and to provide a reference for making measures to improve adolescents quality of life. Methods: A descriptive cross-sectional study design which recruited 6 746 adolescents in two districts of Chongqing with cluster sampling was applied. Data was collected by Adolescent Quality of Life Scale developed by our team, Pubertal Development Scale(PDS) from Petersen and Crockett, self-designed KAP questionnaire and basic situation questionnaire. Results: The early puberty, mid-puberty and late puberty suffered lower physical, psychological and total quality of life than the pre-pubertal(P<0.05). The mid-puberty (B=-1.10, P<0.01) and late puberty (B=-2.88, P<0.01) had lower social quality of life than the pre-pubertal Significant difference was not found between pubertal dimension and pubertal status(P>0.05). Pubertal KAP impacted on psychological(B=0.02), social(B=0.04), pubertal(B=0.04) dimensions and total quality of life(B=0.09) positively(P<0.01), but no physical dimension(P=0.06). Moderating effect results revealed that pubertal KAP moderated the negative impact of pubertal status on social dimension (B=0.03, P=0.02) and total quality of life(B=0.06, P=0.01), but no psychological dimension(P>0.05). Conclusion Promoting puberty health education of adolescents was the key to improving their quality of life.

Objective: To explore the relationship between pubertal knowledge-attitude-practice(KAP) and quality of life (QoL) of left-behind children in adolescence, and to provide a scientific reference for making measures to improve QoL of left-behind children. Methods: In December 2017, 3 524 left-behind children from 5 primary schools and 5 middle schools in Chongqing were selected by stratified cluster sampling method carry out the Quality of Life Scale of adolescent children and the Questionnaire of Adolescent Knowledge and Belief. Results: The scores of total QoL, physicaland social dimensions of left-behind children[(140.81±17.19)(30.05±5.07)(50.99±8.32)points, respectively]were lower than those of non-left-behind children[(141.81±17.53)(30.35±5.06)(51.73±8.44)point, respectively](P<0.05). Gender, School period, puberty timing, family rearing pattern and economic status had significant influence on the QoL of left-behind children (P<0.05). The adolescent attitude and behavior had a positive effect on total QoL and the scores of physical, psychological, social and adolescent dimensions of left-behind children(B=0.62, 0.08, 0.11, 0.30, 0.13；0.77, 0.11, 0.20, 0.26, 0.19, P<0.01); and knowledge had a positive effect on the adolescence of QoL(B=0.04, P<0.01). Conclusion The adolescent attitude, behavior and quality of life of left-behind children were positively correlated. Strengthening adolescent health education for left-behind children, focusing on conveying correct adolescent attitude to students, and promoting the transformation of correct attitude to positive practice, can improve the QoL of adolescent left-behind children.

Objective: To determine the relationship between peer attachment and quality of life among adolescents in Chongqing, to provide scientific basis for intervention of quality of life. Methods: A total of 6 073 respondents were selected from 5 middle schools and 6 primary schools in a district of Chongqing in December 2017 by stratified cluster sampling method. The revised Chinese version of Adolescent Attachment Questionnaire (IPPA-R) Peer Attachment Subscale and Adolescent Children s Quality of Life Scale were used to conduct the survey. Results: The total score of life quality of students with secure attachment type (144.97±17.39) was significantly higher than that of students with insecure attachment type(136.45±17.75)(t=18.90，P<0.01). The scores of four dimensions of life quality of students with secure attachment[(30.40±5.11)(39.42±6.42)(53.45±7.99)(21.73±3.69)] were significantly higher than those of students with insecure attachment[(29.54±5.15)(37.87±6.66)(49.02±8.69)(20.02±3.60)](P<0.05). Multivariate stepwise regression analysis showed that peer attachment was correlated with physical, psychological, social, adolescent dimensions and the total score of life quality(B=0.28，0.03，0.05，0.14，0.05，P<0.05). Conclusion Adolescent peer attachment is positively correlated with the total score and specific dimensions of life quality. Improving the safety of peer attachment is helpful to improve life quality among adolescents.

Rational nutritional support shall be based on nutritional screening and nutritional assessment.This study is aimed to explore nutritional risk screening and its influencing factors of hospitalized patients in central urban area.It is helpful for the early detection of problems in nutritional supports,nutrition management and the implementation of intervention measures,which will contribute a lot to improving the patient's poor clinical outcome.A total of three tertiary medical institutions were enrolled in this study.From October 2015 to June 2016,1202 hospitalized patients aged ≥18 years were enrolled in Nutrition Risk Screening 2002 (NRS2002) for nutritional risk screening,including 8 cases who refused to participate,5 cases of same-day surgery and 5 cases of coma.A single-factor chi-square test was performed on 312 patients with nutritional risk and 872 hospitalized patients without nutritional risk.Logistic regression analysis was performed with univariate analysis (P＜0.05),to investigate the incidence of nutritional risk and influencing factors.The incidence of nutritional risk was 26.35％ in the inpatients,25.90％ in male and 26.84％ in female,respectively.The single-factor analysis showed that the age ≥60,sleeping disorder,fasting,intraoperative bleeding,the surgery in recent month,digestive diseases,metabolic diseases and endocrine system diseases had significant effects on nutritional risk (P＜0.05).Having considered the above-mentioned factors as independent variables and nutritional risk (Y=1,N=0)as dependent variable,logistic regression analysis revealed that the age ≥60,fasting,sleeping disorders,the surgery in recent month and digestive diseases are hazardous factors for nutritional risk.Nutritional risk exists in hospitalized patients in central urban areas.Nutritional risk screening should be conducted for inpatients.Nutritional intervention programs should be formulated in consideration of those influencing factors,which enable to reduce the nutritional risk and to promote the rehabilitation of inpatients.

OBJECTIVETo discuss the characteristics of lumbar disc herniation (LDH) with symptom aggravated caused by spinal manipulative therapy (SMT).

METHODSDetailed clinical profiles of a total number of 10 LDH patients with symptoms aggravated after SMT were reviewed including 5 males and 5 females with age from 46 to 68 years old, 7 patients of them were more than 50 years old. The clinical data of 10 patients were analyzed involving age, gender, clinical symptoms, signs, imaging findings, surgical treatment and prognosis. Laminectomy and discectomy were performed, and follow-up was carried out in all patients.

RESULTSThe duration of symptoms in all the patients before SMT was 4 to 15 years. After the therapy, an acute exacerbation of back and radicular pain was observed within 24 hours. MRI showed intervertebral disc herniation, 7 patients were observed in L4-L5. The time internal between the exacerbation of presentation and surgery was 23.1 days. No perioperative complications occurred. All the patients were relieved of radicular pain a few days after surgery. During postoperative follow-up, all patients regained the ability to walk; Eight patients reported a complete resolution of presentation and the rest two patients were significantly improved.

CONCLUSIONSSMT should be prohibited in some LDH patients to prevent neurological damages, in whom there are 5 possible risk factors.

Objective: To compare the effects of three treatment options: emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery, on the pathological characteris- tics of surgically-resected specimens from patients with completely obstructive colorectal cancer. Methods: This was a retrospective cohort study analyzing clinicopathological data of patients with complete obstructive colorectal cancer who were admitted to the General Surgery Department of Beijing Chaoyang Hospital, Capital Medical University, between May 2012 and August 2020. The inclusion criteria were diagnosed with complete colorectal obstruction, pathologically confirmed as adenocarcinoma, resectable on imaging assessment, and without distant metastasis, combined with the patients' clinical manifestations and imaging examination findings. Patients with multiple colorectal cancers, refusal to undergo surgery, and concurrent peritonitis or intestinal perforation before stenting of the intestinal obstruction were excluded. Eighty-nine patients with completely obstructive colorectal cancer were enrolled in the study and were divided into emergency surgery group (n=30), stent-surgery group (n=34), and stent-neoadjuvant chemotherapy- surgery group (n=25) according to the treatment strategy. Differences in the pathological features (namely perineural infiltration, lymphovascular infiltration, tumor deposits, specimen intravascular necrosis, inflammatory infiltration, abscesses, mucus lake formation, foreign body giant cells, calcification, and tumor cell ratio) and biomolecular markers (namely cluster of differentiation (CD)34, Ki67, Bcl-2, matrix metalloproteinase-9, and hypoxia-inducible factor alpha) were recorded. Pathological evaluation was based on the presence or absence of qualitative evaluation of pathological features, such as peripheral nerve infiltration, vascular infiltration, and cancer nodules within the specimens. The evaluation criteria for the pathological features of the specimens were as follows: Semi-quantitative graded evaluation based on the proportion of tissue necrosis, inflammatory infiltrates, abscesses, mucus lake formation, foreign body giant cells, calcification, and tumor cells in the field of view within the specimen were classified as: grade 0: not seen within the specimen; grade 1: 0-25%; grade 2: 25%-50%; grade 3: 50%-75%; and grade 4: 75%-100%. The intensity of cellular immunity was classified as none (0 points), weak (1 point), moderate (2 points), and strong (3 points). The two evaluation scores were then multiplied to obtain a total score of 0-12. The immunohistochemical results were also evaluated comprehensively, and the results were defined as: negative (grade 0): 0 points; weakly positive (grade 1): 1-3 points; moderately positive (grade 2): 4-6 points; strongly positive (grade 3): 7-9 points; and very strong positive (grade 4): 10-12 points. Normally-distributed values were expressed as mean±standard deviation, and one-way analysis of variance was used to analyze the differences between the groups. Non-normally-distributed values were expressed as median (interquartile range: Q1, Q3). A nonparametric test (Kruskal-Wallis H test) was used for comparisons between groups. Results: The differences were not statistically significant when comparing the baseline data for age, gender, tumor site, American Society of Anesthesiologists score, tumor T-stage, N-stage, and degree of differentiation among the three groups (all P>0.05). The differences were not statistically significant when comparing the pathological characteristics of the resected tumor specimens, such as foreign body giant cells, inflammatory infiltration, and mucus lake formation among the three groups (all P>0.05). The rates of vascular infiltration were 56.6% (17/30), 41.2% (15/34), and 20.0% (5/25) in the emergency surgery, stent-surgery, and stent- neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences between the groups (χ²=7.142, P=0.028). Additionally, the rate of vascular infiltration was significantly lower in the stent-neoadjuvant chemotherapy-surgery group than that in the emergency surgery group (P=0.038). Peripheral nerve infiltration rates were 55.3% (16/30), 41.2% (14/34), and 16.0% (4/25), in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences (χ²=7.735, P=0.021). The infiltration peripheral nerve rates in the stent-neoadjuvant chemotherapy-surgery group were significantly lower than those in the emergency surgery group (P=0.032). The necrosis grade was 2 (1, 2), 2 (1, 3), and 2 (2, 3) in the emergency surgery, stent- surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences (H=10.090, P=0.006). Post hoc comparison revealed that the necrosis grade was higher in the stent-surgery and stent-neoadjuvant chemotherapy-surgery groups compared with the emergency surgery group (both P<0.05). The abscess grade was 2 (1, 2), 3 (1, 3), and 2 (2, 3) in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences (H=6.584, P=0.037). Post hoc comparison revealed that the abscess grade in the emergency surgery group was significantly lower than that in the stent-surgery group (P=0.037). The fibrosis grade was 2 (1, 3), 3 (2, 3), and 3 (2, 3), in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences (H=11.078, P=0.004). Post hoc analysis revealed that the fibrosis degree was higher in both the stent-surgery group and the stent- neoadjuvant chemotherapy-surgery group compared with the emergency surgery group (both, P<0.05). The tumor cell ratio grades were 4 (3, 4), 4 (3, 4), and 3 (2, 4), in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, with statistically significant differences (H=8.594, P=0.014). Post hoc analysis showed that the tumor cell ratio in the stent-neoadjuvant chemotherapy-surgery group was significantly lower than that in the emergency surgery group (P=0.012). The CD34 grades were 2 (2, 3), 3 (2, 4), and 3 (2, 3) in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups, respectively, and the difference was statistically significant (H=9.786, P=0.007). Post hoc analysis showed that the CD34 grades in the emergency surgery, stent-surgery, and stent-neoadjuvant chemotherapy-surgery groups were 2 (2, 3), 3 (2, 4), and 3 (2,3), respectively. Post hoc analysis revealed that the CD34 concentration was higher in the stent-surgery group than that in the emergency surgery group (P=0.005). Conclusion: Stenting may increase the risk of distant metastases in obstructive colorectal cancer. The stent-neoadjuvant chemotherapy-surgery treatment model promotes tumor cell necrosis and fibrosis and reduces the proportion of tumor cells, vascular infiltration, and peripheral nerve infiltration, which may help decrease local tumor infiltration and distant metastasis in completely obstructive colorectal cancer after stent placement.
Humans ; Neoadjuvant Therapy/methods* ; Abscess ; Retrospective Studies ; Intestinal Obstruction/etiology* ; Stents ; Colorectal Neoplasms/therapy* ; Necrosis

OBJECTIVE To evaluate the effectiveness， safety， economy， innovation， suitability and accessibility of recombinant Mycobacterium tuberculosis fusion protein （EC）， and to provide evidence for selecting skin detection methods for tuberculosis infection diagnosis and auxiliary diagnosis of tuberculosis. METHODS The effectiveness and safety of EC compared with purified protein derivative of tuberculin （TB-PPD） were analyzed by the method of systematic review. Cost minimization analysis， cost-effectiveness analysis and cost-utility analysis were used to evaluate the short-term economy of EC compared with TB-PPD， and cost-utility analysis was used to evaluate the long-term economy. The evaluation dimensions of innovation， suitability and accessibility were determined by systematic review and improved Delphi expert consultation， and the comprehensive score of EC and TB-PPD in each dimension were calculated by the weight of each indicator. RESULTS The scores of effectiveness， safety， economy， innovation and suitability of EC were all higher than those of TB-PPD. The affordability scores of the two drugs were consistent， while the availability score of EC was lower than those of TB-PPD. After considering dimensions and index weight， the scores of effectiveness， safety， economy， innovation， suitability， accessibility and the comprehensive score of EC were all higher than those of TB-PPD. CONCLUSIONS Compared with TB-PPD， EC performs better in all dimensions of effectiveness， safety， economy， innovation， suitability and accessibility. However， it is worth noting that EC should further improve its availability in the dimension of accessibility.