Primary hyperparathyroidism (PHPT) in children is a rare condition,co-existing with vitamin D deficiency can lead to more diagnostic uncertainty.Here we report a case of a boy with PHPT complicated with vitamin D deficient rickets.The diagnosis and treatment of this patient was analyzed against literature review to summarize evidence-based clinical features of PHPT in children.We found that compared with adult PHPT,PHPT in children is associated with severer symptoms,higher serum calcium level,lower parathyroid hormone,preponderance of single adenoma in pathology,and higher cure rate of surgery.Co-existence of osteomalacia may induce reduction of the serum calcium level to the normal range,but cause more severe bone lesions.

We investigated the antibiotic‐resistant genes and genetic diversity of Pseudomonas aeruginosa from patients in hospital ,the smear samples from hospital and clinic environment ,and from medical staff’ hands respectively in 2011‐2012 in Nanshan District of Shenzhen .Polymerase chain reaction were used to detect the 20 kinds of antibiotic‐resistant genes (TEM , VEB,CARB,OXA,SHV,PER,GES,GTX,SPM,GIM,IMP,VIM,DHA,oprD,Aac(6′)‐Ⅰ ,Aac(6′)‐Ⅱ ,Aac (3′)‐Ⅰ ,A ac(2″)‐Ⅰ ,qacE1‐sull and int‐Ⅰ) .Multilocus sequencing typing was used to analyze the clonal complexes .The 11 kinds resistant genes TEM ,SHV ,IMP ,DHA ,Aac(6′)‐Ⅰ ,Aac(6′)‐Ⅱ ,Aac(3′)‐Ⅰ ,Aac(2″)‐Ⅰ ,qacE1‐sull ,int‐Ⅰand oprD were detected ,for the positive rates respectively ,and which were 8 .1% ,6 .4% ,4 .8% ,9 .7% ,4 .8% ,14 .5% ,9 .7% , 56 .5% ,8 .1% ,and 8 .1% ;the loss rate of oprD gene was 61 .2% .The 19 antibiotic resistance gene profiles existed in 52 Pseudomonas aeruginosa strains .Multilocus sequencing typing found 39 sequence types and 5 clonal complexes in 62 Pseudo‐monas aeruginosa strains ,CC244 and ST856 were dominant .There were some differences of antibiotic resistance gene profiles between different samples ,the Pseudomonas aeruginosa strains from patients carried multiple resistant genes .In our research , the Pseudomonas aeruginosa had the genetic diversity and the dominant clonal complexes existed .

Objective To observe the abdominal ultrasonic manifestations of children with Langerhans cells histiocytosis (LCH).Methods Imaging features of histopathologically proved LCH in 28 children were retrospectively analyzed.Results Among 28 eases,multi system involvement was found in 25 cases,while only liver and bile duct involvement were detected in 3 cases.Different degrees of enlarged liver,inhomogeneous echo of liver parenchyma,scattered or diffuse hypoechoic regions were found in all 28 cases.Uneven thickening and echo enhancement of the bile duct wall,as well as local expansion or stricture of bile duct cavity were found in 13 cases.Splenomegaly was found in 17 cases,swelling of the pancreas was found in 5 cases,varying degrees of ascites were found in 13 cases,and hepatic hilar lymphadenectasis were found in 14 cases.Conclusion There are specific ultrasonographic manifestations of LCH in children,which may be helpful to improving diagnostic accuracy of LCH.

Objective To observe the psychological status in patients with acute anterior uveitis and to investigate the effects of comprehensive nursing intervention on the depressive status and nursing service satisfactory degree of the patients.Methods Totally 96 patients with acute anterior uveitis diagnosed and treated in Qianfoshan Hospital, Shandong Province from January 2012 to October 2015 were selected and assigned to the control group ( n=46 ) and the intervention group ( n=50 ) at random. The patients of intervention group received comprehensive nursing intervention, while the patients of control group received routine nursing intervention. Self-rating depression scale ( SDS) was applied to evaluate the psychological status of the patients before and after the treatment and nursing intervention. The nursing service satisfactory degree of patients was compared between two groups.Results After positive anti-inflammatory treatment, 96 patients with uveitis were improved and stay stable. There was no statistically difference between two groups in SDS scale score before intervention (P>0.05).After intervention,the SDS scale score of both groups were significantly lower than those of score before intervention(P<0.05), and the score of intervention group was lower than that in the control group (P<0.05). The nursing service satisfactory degree in the intervention group was (72.3±5.7), and was (68.4±7.0) in the control group after intervention (t=3.03,P=0.003).Conclusions Comprehensive nursing intervention and treatment is good for improving the depression status, alleviating the adverse psychological emotions, improving the nursing service satisfactory degree and accelerating the recovery of the illness in the patients with acute anterior uveitis.

Objective: To evaluate the application effect of oral health management program based on behavior change wheel (BCW) theory, so as to provide a reference for improving children s awareness of oral self management and the development of healthy oral behaviors. Methods: A total of 120 children aged 5-6 from 2 kindergartens in Yubei District in Chongqing City, selected by convenience sampling method from September 2023 to March 2024, were divided into a experimental group and a control group (60 each). Children in the experimental group were given an oral health education programme based on BCW theory (promoted health awareness, cultivated healthy behavior ability, strengthened awareness and ability, and provided opportunitiess) on the basis of conventional oral health education, and children in the control group were given conventional oral health education; data were collected before and 3 months after the intervention, respectively. Comparisons between groups were made using the Mann-Whitney U test and χ 2 test. Results: Before intervention, there were no significant differences in plaque index [2.00(1.00,2.00), 2.00(1.00,2.00)] and the number of filled teeth [0.00(0.00,1.00), 0.00( 0.00 ,1.00)] between the experimental group and the control group ( Z=-0.88, -0.42, P >0.05). After intervention, the plaque index of the experimental group [1.00(0.00,1.00)] was lower than that of the control group [1.00(0.25,2.00)] and before intervention, and the number of filling teeth in the experimental group [1.00(0.00,2.00)] was higher than that of the control group [1.00(0.00,1.00)] and before intervention, the differences were statistically significant ( Z =-3.14, -5.48; -2.08, -3.02, P <0.05). Before intervention, there were no significant differences in oral health behavior report rate and oral health knowledge mastery rate between the two groups ( χ 2=0.30-0.91, 0.15-1.43, P > 0.05 ). After intervention, the report rates of health tooth brushing (method, frequency and duration) and preventive behavior (using fluoride toothpaste, pit and fissure sealing prevention and fluoride application prevention) in the experimental group were better than those in the control group and before intervention, and the differences were statistically significant ( χ 2=4.88-9.38, 9.13- 22.63 , P <0.05). The mastery rates of oral health knowledge in the experimental group were better than that in the control group, and the differences were statistically significant ( χ 2=4.62-8.54, P <0.05). Conclusion Oral health management programs based on the BCW theory are more conducive to improving children s oral hygiene, as well as enhancing children s basic oral knowledge and promoting the development of oral health behaviors.

Objective This study aimed to explore issues about dysandia female during pregnancy,peripartum and contraception and to supply reference for their reproductive health improvement. Methods Purposive sampling strategy was used. With the aid of an interview guide, 12 dysaudia women who met inclu-sion and exclusion criteria were invited to be interviewed. Interviews were recorded, validated and then ana-lyzed. Results Four themes were generated, limited knowledge, passive information acquisition, total depen-dence on family and reluctant to talk about contraception. Total dependence on family was noticeable during pregnancy and peripartum. Though little was known about health protection related to pregnancy, peripartum and contraception, participants were passive at seeking for relevant information. Conclusions Deaf women may experience more threats to reproductive health in relation to pregnancy, peripartum and contraception that they require more guidance and assistance.

OBJECTIVETo evaluate the role of brain magnetic resonance imaging (MRI) and tumor markers in the cerebral spinal fluid (CSF) and serum in the diagnosis and treatment of intracranial germinoma in children.

METHODSTotally 5 children (3 girls and 2 boys) who were treated in our hospital between January 2009 and December 2010 due to central diabetes insipidus. All patients received contrast-enhanced brain MRI at presentation and during each follow-up: meanwhile, their anterior pituitary hormones and tumor markers including human chorionic gonadotropin (hCG) and alpha fetoprotein (AFP) were also determined.

RESULTSThree patients presented without prior evaluation, and two patients were referred to our hospital due to exaggerated disease of unknown cause. Their ages at presentation ranged from 8 years to 12 years 1 month, and the duration of symptoms at presentation was between 1 month to 78 months. All of them had polyuria and polydipsia at presentation. Except one child, the other 4 patients had growth retardation and failure in initiation of puberty. Although the growth rate and puberty development were normal during the 2-year follow-up for the excepted child, all child experienced anterior pituitary hypofunction and an increased concentration of plasma prolactin after the lesion became enlarged. Three patients had cerebral hernia, which presented in 18, 24, and 78 months, respectively. In three patients, brain MRI at presentation showed isolated pituitary stalk thickening, which further developed into massive tumor in the hypothalamus pituitary region 18-22 months later; in the remaining two patients, large brain tumor was found via MRI at their first presentations. In all five patients, the posterior pituitary gland (bright spot) disappeared on T1-weighted MRI images. CSF hCG elevated in all five patients, and serum hCG increased in four patients; the level of hCG varied with the mass size of tumor. Serum and CSF AFP increased in only one patient.

CONCLUSIONSPatients with idiopathic central diabetes insipidus must be closely followed to identify the etiology, especially when anterior pituitary hormone deficiencies are detected. For patients with normal brain MRI results or simply isolated pituitary stalk thickening at presentation, the changes of serial contrast-enhanced brain MRI should be observed during follow-up to ensure the early detection of an evolving occult hypothalamic-stalk lesion. Determination of CSF hCG at the first presentation may be useful, because an increased CSF level of hCG precedes MRI abnormalities.

Biomarkers, Tumor ; analysis ; blood ; cerebrospinal fluid ; Brain Neoplasms ; blood ; cerebrospinal fluid ; diagnosis ; Child ; Female ; Germinoma ; blood ; cerebrospinal fluid ; diagnosis ; Humans ; Magnetic Resonance Imaging ; Male ; Retrospective Studies

This paper reviewed the advances on effective constituents and biological activities of coumarins in recent ten years. Coumarins are a group of important natural compounds, and have been found to have multi-biological activities such as anti-HIV, anti-tumor, anti-hypertension, anti-arrhythmia, anti-osteoporosis, assuaging pain, preventing asthma and antisepsis. Therefore, further investigation should emphasize on improving techniques for extraction and separation, searching the effective precursory compound, and synthesizing and screening out courmarin derivatives with high activity and low toxicity.
Animals ; Anti-Arrhythmia Agents ; pharmacology ; Anti-HIV Agents ; pharmacology ; Antihypertensive Agents ; pharmacology ; Antineoplastic Agents, Phytogenic ; pharmacology ; Coumarins ; isolation & purification ; pharmacology ; Humans ; Plants, Medicinal ; chemistry

Background:Blood glucose control is closely related to type 2 diabetes mellitus (T2DM) prognosis.This multicenter study aimed to investigate blood glucose control among patients with insulin-treated T2DM in North China and explore the application value of combining an elastic network (EN) with a machine-learning algorithm to predict glycemic control.Methods:Basic information,biochemical indices,and diabetes-related data were collected via questionnaire from 2787 consecutive participants recruited from 27 centers in six cities between January 2016 and December 2017.An EN regression was used to address variable collinearity.Then,three common machine learning algorithms (random forest [RF],support vector machine [SVM],and back propagation artificial neural network [BP-ANN]) were used to simulate and predict blood glucose status.Additionally,a stepwise logistic regression was performed to compare the machine learning models.Results:The well-controlled blood glucose rate was 45.82％ in North China.The multivariable analysis found that hypertension history,atherosclerotic cardiovascular disease history,exercise,and total cholesterol were protective factors in glycosylated hemoglobin (HbA1c) control,while central adiposity,family history,T2DM duration,complications,insulin dose,blood pressure,and hypertension were risk factors for elevated HbA1c.Before the dimensional reduction in the EN,the areas under the curve of RF,SVM,and BP were 0.73,0.61,and 0.70,respectively,while these figures increased to 0.75,0.72,and 0.72,respectively,after dimensional reduction.Moreover,the EN and machine learning models had higher sensitivity and accuracy than the logistic regression models (the sensitivity and accuracy of logistic were 0.52 and 0.56;RF:0.79,0.70;SVM:0.84,0.73;BP-ANN:0.78,0.73,respectively).Conclusions:More than half of T2DM patients in North China had poor glycemic control and were at a higher risk of developing diabetic complications.The EN and machine learning algorithms are alternative choices,in addition to the traditional logistic model,for building predictive models of blood glucose control in patents with T2DM.

Objective:The purpose of this study was to investigate the IgG antibody levels of whooping cough, diphtheria, and tetanus in pregnant women in Nanshan District.Methods:From January to March 2019, 495 pregnant women who met the inclusion criteria in a hospital in Nanshan District, Shenzhen were selected as the survey subjects. The enzyme-linked immunosorbent assay was used to detect serum levels of pertussis, diphtheria, and tetanus IgG antibodies and we compared the differences in antibody levels of pregnant women with different characteristics.Results:The maternal age was (29.23±4.08) years old. The geometric mean concentration of pertussis antibody was 2.589 (1.172-4.953) IU/ml, 1.01% (5 cases) of pregnant women had pertussis antibody concentration ≥ 40 IU/ml, and 75.15% (372 cases) of pregnant women had pertussis antibody concentration<5 IU/ml. The GMC value and antibody positive rate of diphtheria in pregnant women were 0.024(0.009-0.065) IU/ml and 72.53% (359 cases), respectively. The GMC value and antibody positive rate of tetanus in pregnant women were 0.014 (0.006-0.034) IU/ml and 53.74% (266 cases), respectively. There was no statistical difference in the antibody level and antibody positive rate among pregnant women of diphtheria and tetanus, respectively.Conclusion:The concentration of antibodies against pertussis, diphtheria, and tetanus in pregnant women are all at a low level, which is not enough to protect themselves from disease infection.