OBJECTIVE: To explore the application of polysomnography (PSG) and lateral cephalometric radiographs (LCR) in the diagnosis and treatment of sleep-disordered breathing (SDB) in children. METHOD: To select 157 cases of children suffering from SDB, 115 cases with primary snoring (PS) and 42 cases with obstructive sleep apnea hypopnea syndrome (OSAHS). After bilateral tonsillectomy and adenoidectomy, preoperative and postoperative LCR and PSG of measure were observed for statistical analysis. RESULT: Compared the group PS and group OSAHS; the thickness of adenoids was significantly different(P<0. 01). The preoperative oblique diameter of nasopharyngeal airway was significantly different (P<0. 05). There were significant differences on the preoperative and postoperative nasopharyngeal airway oblique diameter and oropharyngeal airway anteroposterior diameter in group PS and group OSAHS (all, P<0. 01). There were significant differences on the preoperative and postoperative AHI and LSaO2 in the group OSAHS (both, P<0. 01). The total effective rate of group PS was 97. 4% (112/115), and the total effective rate of group OSAHS was 97. 6% (41/42). CONCLUSION PSG and LCR have a very important role in the diagnosis and treatment of SDB in children. Bilateral tonsillectomy and adenoidectomy are the primary means of treatment in children with SDB.
Adenoidectomy ; Cephalometry ; Child ; Humans ; Polysomnography ; Sleep Apnea Syndromes ; diagnosis ; surgery ; Sleep Apnea, Obstructive ; diagnosis ; surgery ; Snoring ; Tonsillectomy

Objective To analyze the characteristic of trauma in 246 fatal falls. Methods We collect 246 cases of fatal falls from Pudong district of Shanghai from 2005 to 2014, and then analyze the characteristics of trauma by using different parameters. Results The height in suicides by fall is higher than accidents by fall (25.7m:13.98m). In all fatal falls, head has a higher possibility in suffering trauma than other body regions (75.2%), while neck has a lower possibility (6.5%). The possibility of head trauma in accidents by fall is higher than suicides by fall (89.4%:75.2%). Conclusion Comparing with suicides by fall, victims in accidents by fall have lack of protection from limbs. Besides, the low rate of ifnding neck trauma suggests legal physicians should be more careful in examining this area.

Objective This study aims to explore the characteristics of gender and age in six different suicide methods in urban area of China. Methods We collected 548 suicides from Shanghai, Jinhua, Wuhan, Loudi and Duyun, and then analyzed the age and gender characteristics in each suicide method. Results In the age characteristics, the mean age for jumping and hanging was oldest (about 55 years old), followed by drowning and hanging (about 49 years old), oral intake poisoning was much younger (about 49 years old), while carbon monoxide poisoning was youngest (about 37 years old). In the gender differences, male were more than females in suicides by sharp object (52:24), hanging (67:33) and jumping (55:45), while females were more than males in suicides by drowning (58:42). Conclusion The age and gender difference was eminent in different suicide methods. Carbon monoxide poisoning was the youngest age group in suicides and males involved more than females in suicides by mechanical methods.

With the in-depth study of alpha-fetoprotein (AFP) and lymphocyte immune regulation, tumor suppressor protein factor and stem cell factor, it is found that AFP is involved in tumorigenesis, growth, metastasis and maintenance of liver cancer cell stem cell function. AFP inhibits natural killer cell activity by inhibiting lymphatic system to protect the liver cancer cells from immune surveillance; AFP can also inhibit the activity of tumor suppressor genes such as caspase-3, pten, p53 and tumor suppressor proteins; AFP can promote the formation of liver cancer stem cells and maintains stability through activating the expressions of other cancer stem cells factors. This paper reviews the biological functions of AFP by regulating hepatocellular carcinoma cells to evade immune surveillance, inhibiting apoptosis and maintaining the generation of liver cancer stem cells.

Objective: To investigate the current status and relationship between loneliness and negative emotional symptoms among first generation college students in the family, so as to provide reference for improving mental health of this population. Methods: A convenience sampling method was used to select 3 017 college students from 10 colleges and universities in Guangdong Province and Yunnan Province, China, in May 2023. Questionnaires were administered to the students, and the Depression Anxiety Stress Scale (DASS-21) and the short form of the University of California at Los Angeles Loneliness Scale (ULS-6) were employed. Results: The total ULS-6 score of first generation college students in the family was (12.38±4.16), while the score of non first generation college students in the family was (11.89±4.38), with a statistically significant difference ( t=2.79, P <0.05). The total DASS-21 score of first generation college students in the family was (71.13±26.97), while the score of non first generation college students in the family was (70.20±26.66), with a statistically significant difference ( t=2.69, P <0.05). Among the first generation college students in the family, male students experienced more DASS-21 score (77.55±29.36) than female students (70.43±25.03)( t =5.79, P <0.05). Urban students (12.00±4.15, 70.34±25.68) reported lower levels of loneliness score and DASS- 21 score than rural students (12.62±4.15, 74.93±27.63), and the depression subscale scores showed statistically significant differences among students with different professional achievement rankings ( t/F =-3.42, -3.94, 4.25, P <0.05). There was a positive correlation between loneliness, depression, anxiety, pressure and DASS-21 scales of first generation college students in the family ( r=0.64, 0.62, 0.64, 0.66, P <0.01). The linear regression analysis results showed a positive correlation between loneliness and all dimensions and total scores of the DASS-21, explaining 44% of the variance in negative emotional symptoms. Conclusions A positive correlation is found between loneliness and negative emotional symptoms among first generation college students in the family. Improving the loneliness of the first generation college students in the family can reduce their negative emotional symptoms and improve their mental health level.

Objective To investigate the risk factors of femoral head necrosis after internal fixation of fem-oral neck fracture,and to clarify the predictive role of serological index plasminogen activator inhibitors-1(PAI-1)on femoral head necrosis.Methods A total of 95 patients undergoing internal fixation for femoral neck fracture were included in the study.Relevant clinical information of patients was obtained and the serum PAI-1 levels of the patients before surgery,1,2,and 3 days after surgery were detected.After 1-year follow-up,patients were divided into necrosis group and non-necrosis group according to the occurrence of femoral head necrosis.Visual Analog Scale(VAS),Western Ontario McMaster University Osteoarthritis Index(WOMAC),and Harris Hip Score(HHS)were conducted in all patients one year after the surgery.The differences of basic clinical information and serum PAI-1 levels before and after the surgery between necrosis group and non-necrosis group were compared,and Logistic regression analysis was performed to identify the relevant risk factors for femoral head necrosis.The relationships between the PAI-1 level after operation and the VAS,WOMAC,and HHS scores of patients were figured out.The receiver operating characteristic(ROC)curve of serum PAI-1 as a predictive indicator for femoral head necrosis was drawn to clarify its predictive val-ue.Results Garden classification and reduction quality between the necrosis group and the non-necrosis group were risk factors for femoral head necrosis(P＜0.05).The serum PAI-1 at 1 day and 2 days after surgery in the necrosis group were significantly higher than that in the non-necrosis group(P＜0.05).The level of PAI-1 at 1 day and 2 days after surgery was positively correlated with VAS and WOMAC(P＜0.05),and negative-ly correlated with HHS(P＜0.05).Logistic regression analysis showed that the increase of serum PAI-1 level at 1 day and 2 days after surgery were risk factors for femoral head necrosis(P＜0.05).The ROC curve showed that serum PAI-1 level at 2 days after surgery had higher predictive value than that at 1 day after sur-gery,and the cut-off value was 44.8 ng/L,the sensitivity was 68.49％,the specificity was 86.36％,and the ar-ea under the curve(AUC)was 0.807.Conclusion The serum PAI-1 level at 1 day and 2 days after internal fixation of femoral neck fracture could be used to predict the occurrence of femoral head necrosis,especially the serum PAI-1 levels at 2 days after surgery.

Chronic disease management is a challenging issue in China. To address the needs of talents and mature innovation ecosystem related to chronic disease management, The First Affiliated Hospital of Sun Yat-sen University(FAH-SYSU) actively responds to the national strategy to promote the high-quality development of the hospital through strengthening strategic planning, top-level design, and systematic consideration. Precise management of chronic diseases was taken as key measure for the construction of a national medical center. With continuous exploration in establishing talent pool, innovation center and application platform, and chronic disease management system that focuses on core elements of talent and innovation, the FAH-SYSU Model for the precise management of chronic diseases has been initially formed.

Objective:To investigate the clinical and pathological characteristics and prognosis of children with lupus nephritis(LN)and thrombotic microangiopathy (TMA).Methods:In this retrospective case-control study, clinical and pathological data of LN children confirmed by renal biopsy from January 2008 to January 2023 in Xuzhou Children′s Hospital, Xuzhou Medical University were analyzed.There were 46 LN children complicated with TMA (LN-TMA group). With matched age, sex and pathology, 92 LN children (1∶2) without TMA were selected as the control group (LN group). The Kaplan-Meier method was used to evaluate the overall and renal survival rates of children with LN, and the Cox regression model was used to analyze the risk factors for the progression to end-stage renal disease (ESRD).Results:TMA was moderately associated with serum creatinine, serum C3, anti-C1q antibody (a-C1q), estimated glomerular filtration rate (eGFR), endocapillary proliferation, fibrinoid necrosis, and renal C1q deposition (all r>0.5). Serum a-C1q≥20 U/mL ( HR=8.724, 95% CI: 0.976-16.114, P=0.026) and eGFR≤60 mL/(min·1.73 m 2) ( HR=12.213, 95% CI: 1.147-25.048, P=0.038) were independent risk factors for TMA in children with LN.Glomerular sclerosis ( HR=7.228, 95% CI: 0.186-22.358, P=0.016), TMA ( HR=11.387, 95% CI: 3.426-42.554, P=0.009) and eGFR≤60 mL/(min·1.73 m 2) ( HR=3.116, 95% CI: 0.592-10.064, P=0.030) were independent risk factors for developing ESRD in LN children.The 5-year and 10-year renal survival rates in the LN-TMA group were lower than those in the LN group (97.44% vs.98.28%, 80.90% vs.87.27%, χ2=4.918, P=0.027). Conclusions:Children with LN-TMA present with severe symptoms and poor prognosis.TMA is an independent risk factor for progression to ESRD in children with LN, and the mechanism may be related to complement activation.