Objective To explore the advantage of anterior cervical muscle group approach at sternal end transection in removal of bilateral huge thyroid neoplasm.Methods One hundred and seven patient underwent removal of bilateral huge thyroid neoplasm were selected.Fifty-two patients were given neck white line incision thyroid surgery (control group) and 55 patients were given anterior cervical muscle group approach at sternal end transection for thyroid surgery (observation group).The operative time,operation field exposure effect,amount of bleeding in operation,postoperative complications,and postoperative drainage volume were compared between two groups.Results The operative time [(88.53 ± 5.95) min],amount of bleeding [(18.58 ± 5.95) ml],and postoperative drainage volume [(47.58 ± 14.76) rnl] in observation group were less than those in control group [(113.98 ± 15.85) min,(39.27 ± 16.32) ml,(73.90 ± 14.40) ml] (P ＜ 0.05),the postoperative complication rate was lower than that in control group (P ＜ 0.05).Operation field exposure effect in observation group was better than that in control group (P ＜ 0.05).Conclusions Removal of bilateral huge thyroid neoplasm with the sternal end approach is feasible and simple.The operation field exposure is better than the neck white line incision,complications after operation is less.It is worthy of clinical application.

Objective: To analyze the relationship between family behaviors and overweight/obesity in primary and junior school students aged 6-14 years in Xuzhou, and to provide a reference for a targeted measure to prevent and control overweight and obesity. Methods: Using multistage stratified cluster random sampling, a total of 6 220 students aged 6-14 years old from 10 primary schools and 10 junior schools were investigated by a self-designed questionnaire. Chi-square and multivariate Logistic regression models were used to explore the relationship between family behaviors and overweight/obesity in primary and junior school students. Results: The rate of overweight/obesity in primary and junior boys was higher than that in primary and junior girls. The rate of overweight/obesity in urban students was higher than that of rural students(P<0.05). The Chi-square analysis showed that overweight of parents, irregular breakfast, eating fast food, eating sweets, drinking sweetened beverage, long screen time and short sleep duration were risk family behavior factors of overweight/obesity in primary and junior boy students(P<0.05). The risk family behavior factors of overweight/obesity in primary and junior girl students were overweight of parents, irregular breakfast, eating fast food and eating sweets(P<0.05). The risk family behavior factors of overweight/obesity, such as drinking sweetened beverage and short sleep duration, were also related to primary girls(P<0.05), and long screen time was related to junior girls(P<0.05). The multivariate Logistic regression showed that such family behavior factors as irregular breakfast(OR-boy=1.58, OR-girl=1.74), eating fast food(OR-boy=1.37, OR-girl=1.11), eating sweets(OR-boy=1.85, OR-girl=1.52), drinking sweetened beverage(OR-boy=1.64, OR-girl=1.33) and short sleep duration(OR-boy=1.56, OR-girl=1.69) were positively correlated with the prevalence of overweight/obesity in primary students. Long screen time was also correlated to overweight/obesity primary boy students(OR=1.18). Family behavior factors for child overweight and obesity induded overweight of parents(OR-boy=1.29, OR-girl=1.23) and eating sweets(OR-boy=1.44, OR-girl=1.51). Irregular breakfast(OR=1.51), eating fast food(OR=1.22), drinking sweetened beverage (OR=1.75) and long visual screen time (OR=1.15) were also positively correlated with the prevalence of overweight/obesity in junior boy students. Conclusion Family behavior factors were positively correlated with the prevalence of overweight/obesity in primary and junior students. The influence of family behavior factors were different between primary and junior students. Behavioral interventions based on family should be adopted to prevent and control the overweight/obesity of children.

Objective To analyze the relationship between sleep duration, screen viewing time, and the prevalence of overweight/obesity among primary school students in Xuzhou. Methods Using a cluster sampling method, a total of 3 228 students (including 1 679 boys and 1 549 girls with an average age of 10.78±0.69 years) from grade one to six from 10 primary schools in Xuzhou underwent interview using a self?designed questionnaire containing basic characteristics, sleep duration, and screen viewing time. Data on height and weight were also collected. The relationship between sleep duration, screen viewing time, and overweight/obesity was analyzed using a logistic regression analysis. Results The prevalence rates of overweight among boys and girls were 16.56% and 11.94%, respectively (χ2=13.59, P<0.05). The prevalence rates of obesity among boys and girls were 14.47% and 10.07%, respectively (χ2=14.01, P<0.05). In total, 74.41% students reported a lack of sleep; the average sleeping time was (9.24±1.07) h. The average sleeping time among boys was (9.35 ± 1.12) h and among girls was (9.13 ± 1.03) h. The difference in sleep duration between boys and girls was significant (t=5.79, P<0.05). The differences in sleep duration and overweight/obesity were significant between both boys (χ2=18.62, P<0.05) and girls (χ2=21.14, P<0.05). Regarding screen viewing time, 17.29% of students spent more than 2 hours per day viewing a screen. The difference in screen viewing time between boys and girls was significant (Z=3.02, P=0.014). The proportion of children with screen viewing time of more than 2 h/d among overweight/obese and healthy weight male students was 29.50% (82/278) and 22.56% (316/1401), respectively, which was significantly different (χ2=6.18, P=0.01). However, there was no significant difference when examining the same groups among girls (12.98% (24/185;obese/overweight) vs . 9.97% (136/1364; healthy weight); χ2=1.59, P=0.21). After adjusting for parental obesity, eating sweets, and physical activity, logistic regression analysis showed that students who had a sleep duration less than 10 h/d had an odds ratio of 1.4 (95% CI: 1.15-1.71), the odds ratio for boys and girls was 1.56 (95% CI: 1.13-2.14) and 1.69 (95% CI: 1.15-2.46). The students who had a screen viewing time of more than 2 h/d had an odds ratio of 1.14 (95% CI: 1.05-1.80); the odds ratio for boys in this group was 1.18 (95% CI: 1.03-1.67). Conclusion Short sleep duration is a risk factor for being overweight/obese in both boys and girls. However, long screen viewing times were associated with being overweight/obese only in boys.

OBJECTIVE: To investigate the reliability of the Chinese version of Satisfaction with Amplification in Daily Life (SADL). METHOD: The cross-cultural adaption measures were used to translate the SADL into Chinese version. Thirty hearing aid users no younger than 18 years old were included. Test-retest analysis was administrated to the patients without significant changes in health and social status with an interval of two weeks between test and retest. RESULT: Test-retest reliability of the SADL was proved to be satisfactory. All subscales and global score had coefficients that exceeded 0.70 (P < 0.01). Except for "personal image", the score of other subscales and global score in this study are higher than the U. S. interim norms described by Cox and Alexander (1999) (P < 0.01). CONCLUSION This study completed the translation and test-retest analysis of Chinese version of SADL. We need further discussion about validation of Chinese version of SADL in order to meet basic psychometric criteria of a standard outcome measurement.
Activities of Daily Living ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Female ; Hearing Aids ; Humans ; Middle Aged ; Personal Satisfaction ; Reproducibility of Results ; Surveys and Questionnaires ; Young Adult

Objective:To investigate the epidemiological characteristics, diagnosis, treat-ment and prognosis of gallbladder cancer in China from 2010 to 2017.Methods:The single disease retrospective registration cohort study was conducted. Based on the concept of the real world study, the clinicopathological data, from multicenter retrospective clinical data database of gallbladder cancer of Chinese Research Group of Gallbladder Cancer (CRGGC), of 6 159 patients with gallbladder cancer who were admitted to 42 hospitals from January 2010 to December 2017 were collected. Observation indicators: (1) case resources; (2) age and sex distribution; (3) diagnosis; (4) surgical treatment and prognosis; (5) multimodality therapy and prognosis. The follow-up data of the 42 hospitals were collected and analyzed by the CRGGC. The main outcome indicator was the overall survival time from date of operation for surgical patients or date of diagnosis for non-surgical patients to the end of outcome event or the last follow-up. Measurement data with normal distribu-tion 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) or M(range), and com-parison between groups was conducted using the U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis was performed using the Logistic forced regression model, and variables with P<0.1 in the univariate analysis were included for multivariate analysis. Multivariate analysis was performed using the Logistic stepwise regression model. The life table method was used to calculate survival rates and the Kaplan-Meier method was used to draw survival curves. Log-rank test was used for survival analysis. Results:(1) Case resources: of the 42 hospitals, there were 35 class A of tertiary hospitals and 7 class B of tertiary hospitals, 16 hospitals with high admission of gallbladder cancer and 26 hospitals with low admission of gallbladder cancer, respectively. Geographical distribution of the 42 hospitals: there were 9 hospitals in central China, 5 hospitals in northeast China, 22 hospitals in eastern China and 6 hospitals in western China. Geographical distribution of the 6 159 patients: there were 2 154 cases(34.973%) from central China, 705 cases(11.447%) from northeast China, 1 969 cases(31.969%) from eastern China and 1 331 cases(21.611%) from western China. The total average number of cases undergoing diagnosis and treatment in hospitals of the 6 159 patients was 18.3±4.5 per year, in which the average number of cases undergoing diagnosis and treatment in hospitals of 4 974 patients(80.760%) from hospitals with high admission of gallbladder cancer was 38.8±8.9 per year and the average number of cases undergoing diagnosis and treatment in hospitals of 1 185 patients(19.240%) from hospitals with low admission of gallbladder cancer was 5.7±1.9 per year. (2) Age and sex distribution: the age of 6 159 patients diagnosed as gallbladder cancer was 64(56,71) years, in which the age of 2 247 male patients(36.483%) diagnosed as gallbladder cancer was 64(58,71)years and the age of 3 912 female patients(63.517%) diagnosed as gallbladder cancer was 63(55,71)years. The sex ratio of female to male was 1.74:1. Of 6 159 patients, 3 886 cases(63.095%) were diagnosed as gallbladder cancer at 56 to 75 years old. There was a significant difference on age at diagnosis between male and female patients ( Z=-3.99, P<0.001). (3) Diagnosis: of 6 159 patients, 2 503 cases(40.640%) were initially diagnosed as gallbladder cancer and 3 656 cases(59.360%) were initially diagnosed as non-gallbladder cancer. There were 2 110 patients(34.259%) not undergoing surgical treatment, of which 200 cases(9.479%) were initially diagnosed as gallbladder cancer and 1 910 cases(90.521%) were initially diagnosed as non-gallbladder cancer. There were 4 049 patients(65.741%) undergoing surgical treatment, of which 2 303 cases(56.878%) were initially diagnosed as gallbladder cancer and 1 746 cases(43.122%) were initial diagnosed as non-gallbladder cancer. Of the 1 746 patients who were initially diagnosed as non-gallbladder cancer, there were 774 cases(19.116%) diagnosed as gallbladder cancer during operation and 972 cases(24.006%) diagnosed as gallbladder cancer after operation. Of 6 159 patients, there were 2 521 cases(40.932%), 2 335 cases(37.912%) and 1 114 cases(18.087%) undergoing ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) examination before initial diagnosis, respec-tively, and there were 3 259 cases(52.914%), 3 172 cases(51.502%) and 4 016 cases(65.205%) undergoing serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis, respectively. One patient may underwent multiple examinations. Results of univariate analysis showed that geographical distribution of hospitals (eastern China or western China), age ≥72 years, gallbladder cancer annual admission of hospitals, whether undergoing ultrasound, CT, MRI, serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis were related factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.45, 1.98, 0.69, 0.68, 2.43, 0.41, 1.63, 0.41, 0.39, 0.42, 95% confidence interval as 1.21-1.74, 1.64-2.40, 0.59-0.80, 0.60-0.78, 2.19-2.70, 0.37-0.45, 1.43-1.86, 0.37-0.45, 0.35-0.43, 0.38-0.47, P<0.05). Results of multivariate analysis showed that geographical distribution of hospitals (eastern China or western China), sex, age ≥72 years, gallbladder cancer annual admission of hospitals and cases undergoing ultrasound, CT, serum CA19-9 examination before initially diagnosis were indepen-dent influencing factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.36, 1.42, 0.89, 0.67, 1.85, 1.56, 1.57, 0.39, 95% confidence interval as 1.13-1.64, 1.16-1.73, 0.79-0.99, 0.57-0.78, 1.60-2.14, 1.38-1.77, 1.38-1.79, 0.35-0.43, P<0.05). (4) Surgical treatment and prognosis. Of the 4 049 patients undergoing surgical treatment, there were 2 447 cases(60.435%) with complete pathological staging data and follow-up data. Cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb were 85(3.474%), 201(8.214%), 71(2.902%), 890(36.371%), 382(15.611%), 33(1.348%) and 785(32.080%), respectively. The median follow-up time and median postoperative overall survival time of the 2 447 cases were 55.75 months (95% confidence interval as 52.78-58.35) and 23.46 months (95% confidence interval as 21.23-25.71), respectively. There was a significant difference in the overall survival between cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb ( χ2=512.47, P<0.001). Of the 4 049 patients undergoing surgical treatment, there were 2 988 cases(73.796%) with resectable tumor, 177 cases(4.371%) with unresectable tumor and 884 cases(21.833%) with tumor unassessable for resectabi-lity. Of the 2 988 cases with resectable tumor, there were 2 036 cases(68.139%) undergoing radical resection, 504 cases(16.867%) undergoing non-radical resection and 448 cases(14.994%) with operation unassessable for curative effect. Of the 2 447 cases with complete pathological staging data and follow-up data who underwent surgical treatment, there were 53 cases(2.166%) with unresectable tumor, 300 cases(12.260%) with resectable tumor and receiving non-radical resection, 1 441 cases(58.888%) with resectable tumor and receiving radical resection, 653 cases(26.686%) with resectable tumor and receiving operation unassessable for curative effect. There were 733 cases not undergoing surgical treatment with complete pathological staging data and follow-up data. There was a significant difference in the overall survival between cases not undergoing surgical treatment, cases undergoing surgical treatment for unresectable tumor, cases undergoing non-radical resection for resectable tumor and cases undergoing radical resection for resectable tumor ( χ2=121.04, P<0.001). (5) Multimodality therapy and prognosis: of 6 159 patients, there were 541 cases(8.784%) under-going postoperative adjuvant chemotherapy and advanced chemotherapy, 76 cases(1.234%) under-going radiotherapy. There were 1 170 advanced gallbladder cancer (pathological staging ≥stage Ⅲa) patients undergoing radical resection, including 126 cases(10.769%) with post-operative adjuvant chemotherapy and 1 044 cases(89.231%) without postoperative adjuvant chemo-therapy. There was no significant difference in the overall survival between cases with post-operative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.23, P=0.629). There were 658 patients with pathological staging as stage Ⅲa who underwent radical resection, including 66 cases(10.030%) with postoperative adjuvant chemotherapy and 592 cases(89.970%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.05, P=0.817). There were 512 patients with pathological staging ≥stage Ⅲb who underwent radical resection, including 60 cases(11.719%) with postoperative adjuvant chemotherapy and 452 cases(88.281%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemo-therapy and cases without post-operative adjuvant chemo-therapy ( χ2=1.50, P=0.220). Conclusions:There are more women than men with gallbladder cancer in China and more than half of patients are diagnosed at the age of 56 to 75 years. Cases undergoing ultrasound, CT, serum CA19-9 examination before initial diagnosis are independent influencing factors influencing initial diagnosis of gallbladder cancer patients. Preoperative resectability evaluation can improve the therapy strategy and patient prognosis. Adjuvant chemotherapy for gallbladder cancer is not standardized and in low proportion in China.