Objective To investigate the clinical characteristics of the patients with central brain herniation,and the operation effect of high coronary craniotomy for bilateral decompressive craniectomy.Methods A retrospective analysis was conducted on 26 cases of central brain herniation.The effectiveness of high coronary craniotomy for bilateral decompressive craniectomy and the influential factor of prognosis in patients with central brain herniation were analyzed.Results According to the Glasgow outcome score (GOS) 6 months after operation,5 cases were recovered well,6 cases moderately disabled,4 cases severely disabled,3 cases vegetative survived and 8 cases died.Conclusions High coronary craniotomy and timely and effective bilateral decompressive craniectomy are the most important treatment in patients with central brain herniation.The prognosis is unfavourable prognosis in patients with central brain herniation within 1 h after injury and older than 75 years old.

Objective To explore the microsurgical experience of supra- and infra-tentorial meningioma of the posterior petrous bone.Methods Clinical data of 21 patients who had undergone microsurgical treatment were retrospectively reviewed.Results All patients underwent surgical treatment via a suboccipital retrosigmoid approach,and hyperostosis of the petrous bone and infiltrated cerebellar tentorium were resected intraoperatively.Tumor resection was categorized as Grade Ⅰ in 16 patients,Grade Ⅱ in 5 patients,according to the Simpson classification system.The main postoperative complications included slight facial paresis and hearing function deterioration.The mean follow-up time was 3.2 years.All patients resumed normal daily activity and no tumor recurrence happened.Conclusions Total resection for supra- and infra-tentorial meningioma of the posterior petrous bone can be achieved with an excellent prognosis by use of microsurgical technique.

OBJECTIVETo study the clinical characteristics, diagnosis and surgical treatment of malignant intracranial teratomas.

METHODSThirty-four patients with intracranial teratoma proved by histopathology were treated by operation. The growth pattern of this tumor, assessed by its clinical manifestations and neuroimaging together with surgical treatment and results were analyzed retrospectively.

RESULTSOnly 6 lesions had been correctly suspected as teratoma before surgery. Total removal was achieved in 14 patients with a operative mortality of 32.4%. The survival of 23 patients with lesions showing aggressive growth was significantly different from those without (P < 0.05). Nineteen of these patients did not survive beyond the sixth month after surgery.

CONCLUSIONAccurate preoperative diagnosis is difficult in malignant intracranial teratoma, especially for patients with the tumor in the sella region. The invasive biological behavior of the tumor is proved to be the main cause of surgery being dwarfed. Protection of the hypothalamus and brainstem, relief of hydrocephalus are the crucial points in surgical treatment. Comprehensive histopathologic examination combined with serum and CSF tumor marker detection is necessary for correct diagnosis and treatment.

Adolescent ; Adult ; Biomarkers, Tumor ; blood ; cerebrospinal fluid ; Brain Neoplasms ; diagnosis ; mortality ; pathology ; surgery ; Child ; Female ; Humans ; Male ; Neoplasm Invasiveness ; Prognosis ; Teratoma ; diagnosis ; mortality ; pathology ; surgery

Objective:To examine the concordance between bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DXA) in determining body composition of children aged between 3 and 6.Methods:A total of 230 children aged 3-6 from a kindergarten in Jinnan, Tianjin were enrolled in this study from November 16 th to December 8 th, 2017.The soft lean mass (SLM) and the body fat mass (BFM) of the children were measured by using BIA and DXA.The children were divided into several groups by sex, age and body mass index (BMI). The consistency of the body composition results between BIA and DXA in each group was analyzed. Results:The SLM and BFM assessed by BIA were significantly correlated with those measured by DXA ( R2=0.951, 0.947, all P<0.001). The Bland-Altman plots suggested that the SLM measured by BIA was 0.70 kg(95% CI: -1.78-0.38) higher in that by DXA, and the BFM measured by BIA was 1.36 kg (95% CI: 0.19-2.52) lower in that by DXA.A similar trend could be seen in children stratified by age, sex and BMI.The SLM of boys and girls measured by BIA was 0.57 kg (95% CI: -1.63-0.49) and 0.84 kg (95% CI: -1.88-0.20) higher than those by DXA, respectively.The BFM of boys and girls measured by BIA was 1.23 kg (95% CI: 0.11-2.36) and 1.49 kg (95% CI: 0.34-2.64) lower than that by DXA, respectively.The SLM measured by BIA was 0.67 kg (95% CI: -1.74-0.41), 0.76 kg (95% CI: -1.65-0.13), 0.69 kg (95% CI: -1.85-0.47) and 0.67 kg (95% CI: -1.75-0.41) higher than those by DXA in the 3 to 6-year-old groups, respectively.The BFM measured BIA was 1.09 kg (95% CI: -0.12-2.30), 1.44 kg (95% CI: 0.60-2.28), 1.39 kg (95% CI: 0.15-2.64)and 1.43 kg(95% CI: 0.38-2.48)lower than that by DXA in the 3 to 6-year-old groups, respectively.Moreover, the smallest difference of the SLM and BFM were observed between BIA and DXA in the obese child.The SLM deviation between BIA and DXA was estimated within ± 0.39 kg and the BFM deviation was within ± 0.93 kg. Conclusions:There is high consistency between BIA and DXA in the assessment of the SLM and BFM of children aged from 3 to 6.

ObjectiveTo analyze the serum creatinine level among apparently healthy primary and secondary school students in Inner Mongolia and explore the distribution of serum creatinine by ethnic,regional,gender and age,and establish the reference interval of serum creatinine in different gender and different age groups of primary and secondary school students.MethodsLargesample clinical epidemiological investigation was applied by two-stage clustering sampling method.Random sample of 2630 primary and secondary school students from 9 to 18-year-old was selected from four district in Inner Mongolia including Hohhot,Wulanchabu,Xilin Gol and Bayan Drow from July 2009 to June 2010.After screening outlier individual,the total of 2614 subjects were enrolled,involving 1288 male and 1326 female subjects,1584 Han and1030 Mongolian.The venous blood was collected and serum was separated.The serum creatinine concentration was measured as soon as possible.Furthermore, creatinine levels of different regions,ethnic,gender and age group were compared by analysis of variance or t-test and that of different group were compared by SNK method.Percentile was used to describe the distribution of serum Cr level of different age groups.The reference interval of serum Cr for primary and secondary school students were established by gender and age (P2.5 -P97.5 ).The curve was smoothed using age-specific percentile ( LMS )curve smoothing method.ResultsThe differences of Cr levels were statistically significant between different regions,ethnic,gender and age groups.The reference intervals of creatinine for 9 - 11,12,13 - 14,15,and 16 - 18 year-old males were 35 - 66,37 - 73,39 - 78,47 - 87 and 49 - 91 μmol/L,respectively.The intervals for 9 - 10,11 - 12,13 - 15,and 16 - 18 year-old females were 32 - 60,34 - 63,38 -73 and 40 -74 μmol/L,respectively.Conclusion The reference intervals of serum creatinine for health primary and secondary school students in the Inner Mongolia is established,which is useful for clinicians,especially pediatricians to judge and assess renal function for 9 to 18 year-old patients.( Chin J Lab Med,2012,35:805-809 )

OBJECTIVETo evaluate the reliability and validity of Professional Quality of Life Scale (ProQOL-30, 4th version, 30 items) among government staff in the Wenchuan earthquake-stricken areas

METHODSA total of 1,175 members of government staff in the Wenchuan earthquake-stricken areas were selected by convenience sampling and required to complete the ProQOL and Self-Reporting Questionnair (SRQ). The reliability and validity of the scale was evaluated by correlation analysis, t-test, and confirmatory factor analysis.

RESULTSItem-total correlation coefficients of the three subscales were 0.590 - 0.752, 0.389 - 0.603, and 0.340 - 0.647, respectively (P<0.05), and the average coefficients were 0.672, 0.482, and 0.555 respectively (P<0.05). The Cronbach's α coefficients of the three subscales were 0.864, 0.569, and 0.742 respectively, and the split-half reliabilities were 0.829, 0.490, and 0.677, respectively. P value was 0.88 in thE chi-square test of confirmatory factor analysis model. Goodness-of-fit indices of ProQOL-30 included GFI=0.895 NFI=0.856, CFI=0.895, RMSEA=0.063, and AGFI=0.912. For the ProQOL-28 as an optimized version o ProQOL-30, the Cronbach's a coefficients for burnout and trauma/compassion fatigue increased to 0.616 and 0.757, respectively. P value was 0.91 in the chi-square test of confirmatory factor analysis model test. Goodness-of-fit indices of ProQOL-28 were GFI =0.913, AGFI =0.924, NFI =0.900, CFI =0.913, and RMSEA =0.031 CONCLUSION: ProQOL-28 has good reliability and validity among government staff in the earthquake-stricker areas in China.

China ; Disasters ; Earthquakes ; Factor Analysis, Statistical ; Government ; Humans ; Quality of Life ; Reproducibility of Results ; Surveys and Questionnaires

Objective To explore the effect of behavior training on the rehabilitation of homeless patients with schizophrenia .Methods Totals of 72 homeless patients with schizophrenia were randomly divided into study group and control group with 36 cases in each group .Both groups received the routine treatment and care, and the study group received behavior training in addition .The Nurse Observation Scale for Inpatient Evaluation(NOSIE)and the Quality of Life Questionnaire for Psychiatric patients (QOL-P)were used to evaluate the rehabilitation effectiveness before and 8 weeks after behavior training .Results There were no differences in NOSIE and QOL-P scores in patients before behavior training ( P >0.05 ).While 8 weeks after behavior training, NOSIE scores of personal hygiene (19.06 ±3.15),social interest (16.89 ±2.64) and social competence (20.11 ±2.79)in study group were higher than(14.44 ±2.71),(12.28 ±2.71),(13.67 ±2.22) in control group,and the differences were statistically significant (t=6.656,7.314,10.086,respectively;P<0.01).Irritation(12.00 ±3.28)and retardation(8.61 ±2.78)scores were significantly lower than (17.33 ± 2.99),(14.00 ±2.53)in control group(t=7.218,8.602,respectively;P<0.01).The total score of QOL-P (54.58 ±8.77) in study group was lower than (77.78 ±5.49) in control group,and the difference was statistically significant(t=13.443,P<0.01).Conclusions Behavior training helps to improve the life ability and social function of homeless patients with schizophrenia .It has a positive effect for enhancing the quality of life of patients and promoting the rehabilitation of the disease.

Objective:To explore the effect of preoperative visit with Child Life mode in the management of preschool children′s anxiety.Methods:A total of 80 cases of children of pre-school age who were operated from September 2018 to February 2019 were selected by cluster sampling method. The children from September to November 2018 who were given the traditional mode of preoperative visit were set as the control group. Children from December 2018 to February 2019 who were given preoperative visit with Child Life mode were set as the experimental group. The Modified Yale Perioperative Anxiety Scale (m-YPAS) scores, Induction Compliance Checklist (ICC) scores and Pediatric Anesthesia Emergence Delirium (PAED) scores were compared between the two groups at 4 different perioperative time points (6 hours after admission, waiting for surgery, induction of anesthesia, and 6 hours after surgery).Results:Totally three patients were suspended from the study due to surgery. A total of 77 children were studied, 38 in the experimental group and 39 in the control group. The score of m-YPAS in the experimental group was significantly lower than that of the control group(17.57±16.64 vs. 42.04±27.46, t value was 3.85, P<0.01) while waiting for surgery. The score of m-YPAS in the experimental group was significantly lower than control group (31.64±27.95 vs. 62.22±25.13, t value was 4.26, P<0.01) at the anesthesia induction. Compare with the control group, the score of m-YPAS in the experimental group showed no significant difference at both time of 6 hours after admission (18.19±17.83 vs.19.85±17.92, t value was 0.87, P>0.05) and 6 hours after surgery(35.61±15.70 vs. 41.81±17.97, t value was 1.37, P>0.05). Compare with the control group the score of ICC in the experimental group was significantly decreased (1.40±1.39 vs. 3.78±2.60, t value was 4.88, P<0.01) at the anesthesia induction. The score of PEAD in the experimental group and control group, there was no significant difference between the two groups (7.18±2.45 vs. 7.85±3.05, t value was 0.91, P>0.05). Conclusions:Compared with the traditional preoperative visit mode, the preoperative visit mode of Child Life can effectively relieve the anxiety of preschool children undergoing general anesthesia surgery while they are waiting for surgery and during anesthesia induction, and can improve the degree of cooperation during anesthesia induction.

Objective:To understand the current status of pubertal sexual characteristics development of girls aged 6-18 years in Tongzhou District of Beijing and to compare the differences in sexual characteristics development among girls characterized as thin, normal, overweight, and obese.Methods:A cross-sectional survey was conducted among 2 844 girls aged 6-18 years in Tongzhou District of Beijing from September 2022 to July 2023. The developmental stages of breast and pubic hair were assessed on site, and menarche status was inquired. Weight and height were measured. The girls were subsequently characterized into thin, normal, overweight and obese groups. Basic information (including family and personal history) was obtained through questionnaires. Probit probability unit regression was applied to calculate the age of each Tanner stage of sexual characteristics development and the age of menarche. The χ 2 test was applied to compare the counting data between two or multiple groups. Results:A total of 2 844 girls were surveyed and 2 704 girls met the inclusion criteria, resulting in a valid response rate of 95.1%. Among these girls, 1 105 (40.9%) were aged 6-9 years, 1 053 (38.9%) were aged 10-13 years, and 546 (20.2%) were aged 14-18 years. The of height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and body mass index-for-age Z-score (BAZ) were 0.46(-0.23,1.16), 0.69(-0.16,1.67), and 0.67(-0.27,1.73) respectively. The prevalences of thin, overweight, and obesity were respectively 1.7% (45/2 704), 17.3% (467/2 704), and 19.9% (538/2 704), respectively. There were 45 girls in the thin group, 1 654 girls in the normal weight group, 1 005 girls in the overweight and obesity group. The age of Tanner stage breast 2 (B2), Tanner stage pubic hair 2 (P2), and menarche was 9.0 (95% CI 8.9-9.1), 10.5 (95% CI 10.4-10.6), and 11.4 (95% CI 11.3-1.5) years, respectively. The current status of breast and pubic hair maturity in girls with pubertal development shows that 64.6% (1 211/1 874) of these girls had breast development preceding pubic hair development, 32.4% (607/1 874) had concurrent breast and pubic hair development, and 3.0% (56/1 874) had pubic hairs development preceding breast development. The interval age between B2 and B5 was 4.7 (95% CI 4.6-4.8) years, between P2 and P5 was 4.5 (95% CI 4.4-4.6) years, and between B2 and menarche was 2.4 (95% CI 2.3-2.5) years. The ages of sexual characteristics development in overweight and obese groups were earlier than that in normal and thin groups. The ages of B2 in thin, normal, overweight, and obese groups were 10.0 (95% CI 9.5-10.6), 9.3 (95% CI 9.2-9.4), and 8.6 (95% CI 8.4-8.7) years, respectively. The age of menarche in thin, normal, overweight, and obese groups were 13.1 (95% CI 12.4-13.7), 11.6 (95% CI 11.4-11.7), and 11.1 (95% CI 11.0-11.2) years, respectively. The interval ages between B2 and B5 and between P2 and P5 was 4.5 and 4.1 years, respectively in the overweight and obese groups, and those in normal group and thin group was 4.7 and 4.5 years, 4.6 and 4.7 years, respectively. Conclusions:The ages of sexual characteristics development and menarche tend in Tongzhou District of Beijing to be earlier than that being reported of Beijing's survey 20 years ago. Girls characterized as overweight and obese not only start puberty at an earlier age than girls of normal weight, but also have a shorter developmental process.

Purpose: The risk stratification of pediatric anaplastic large cell lymphoma (ALCL) has not been standardized. In this study, new risk factors were included to establish a new risk stratification system for ALCL, and its feasibility in clinical practice was explored. Materials and Methods: On the basis of the non-Hodgkin’s lymphoma Berlin–Frankfurt–Munster 95 (NHL-BFM-95) protocol, patients with minimal disseminated disease (MDD), high-risk tumor site (multiple bone, skin, liver, and lung involvement), and small cell/lymphohistiocytic (SC/LH) pathological subtype were enrolled in risk stratification. Patients were treated with a modified NHL-BFM-95 protocol combined with an anaplastic lymphoma kinase inhibitor or vinblastine (VBL). Results: A total of 136 patients were enrolled in this study. The median age was 8.8 years. The 3-year event-free survival (EFS) and overall survival of the entire cohort were 77.7% (95% confidence interval [CI], 69.0% to 83.9%) and 92.3% (95% CI, 86.1% to 95.8%), respectively. The 3-year EFS rates of low-risk group (R1), intermediate-risk group (R2), and high-risk group (R3) patients were 100%, 89.5% (95% CI, 76.5% to 95.5%), and 67.9% (95% CI, 55.4% to 77.6%), respectively. The prognosis of patients with MDD (+), stage IV cancer, SC/LH lymphoma, and high-risk sites was poor, and the 3-year EFS rates were 45.3% (95% CI, 68.6% to 19.0%), 65.7% (95% CI, 47.6% to 78.9%), 55.7% (95% CI, 26.2% to 77.5%), and 70.7% (95% CI, 48.6% to 84.6%), respectively. At the end of follow-up, one of the five patients who received maintenance therapy with VBL relapsed, and seven patients receiving anaplastic lymphoma kinase inhibitor maintenance therapy did not experience relapse. Conclusion This study has confirmed the poor prognostic of MDD (+), high-risk site and SC/LH, but patients with SC/LH lymphoma and MDD (+) at diagnosis still need to receive better treatment (ClinicalTrials.gov number, NCT03971305).