OBJECTIVETo evaluate the process of smoking prevention and control among Chinese adolescent with a model on health promotion in junior high school.

METHODSA cluster-randomized, controlled and schooled-based trial on smoking prevention was conducted among 2343 students at four secondary schools in Huangpu District of Guangzhou. Students 'reports and investigators' daily records were used to evaluate the intervention measures.

RESULTSDuring the one-year period of intervention (Dec. 2004 through Dec. 2005), eighteen activities had been implemented among students, teachers, parents and cigarette retailers. Ranked by the rate of awareness, the top six activities were shown as follows: "the nicotine toxicity experiment" (90.7%), "agreement of building families free of smoking"(77.7%), "a letter to parents" (77.1%), "no-smoking signs" (76.5%), "Blackboard information about health and smoking" (75.0%), and "signature on the 18th World Day of No Smoking" (70.2%). Among all the activities, "the nicotine toxicity experiment" had the highest rate of participation (88.5%), followed by "a letter to parents" (73.6%), "agreement of building families free of smoking" (69.8%), "health education through experiments"(68.6%), "health education through multimedia" (65.7%) and "signature on the 18th World Day of No Smoking" (65.6%). The top seven activities in which students showed greatest interests were "the nicotine toxicity experiment" (64.5%), "signature on the 18th World Day of No Smoking" (33.0%), "health education through experiments" (31.2%), "health education through multimedia" (29.8%), "class meetings with a thesis of smoking" (26.8%), "health pamphlets" (26.6%), "specific textbooks" (25.9%). The extent of students' general satisfaction to the work of tobacco control in school during the last year was 52.4%. The biggest perceived shortcoming for the intervention plan was the low participation of students.

CONCLUSIONSome intervention measures had not been fully carried out among the students and only covered part of them. It is necessary to adjust the previous intervention measures through keeping the nicotine toxicity experiment, health education through multimedia and other measures with extensive participation of students and at the same time, to avoid literal materials, exhibition boards and traditional single-way health education program.

China ; Health Education ; Health Promotion ; Humans ; Smoking Prevention ; Students

OBJECTIVETo investigate the main causes of deaths and the influencing factors in children with malignant tumors in the hospital, explore the possible way to improve the treatment.

METHODSClinical data of 84 patients with malignant tumors who died during hospitalization in the Department of Hematology/Oncology from June 1999 to December 2008 were collected and retrospectively analyzed. Major causes of deaths and their influencing factors were analyzed.

RESULTS(1) Treatment related complications which occurred in 73 cases (86.9%) were the leading cause of death, including infection-related death which was the most common cause of 51 cases (60.7%), hemorrhage-related death occurred in up to 28 cases (33.3%), and acute tumor lysis syndrome (ATLS) related death occurred in 2 cases (2.4%), graft versus host disease (GVHD) related death after allogeneic hematopoietic stem cell transplantation occurred in 4 cases (4.8%). Moreover, primary diseases related death occurred in 30 cases (35.7%). (2) In this group, there were no significant differences in treatment phases when the death occurred among patients with leukemia (56 cases), lymphoma (9 cases) and other non-hematopoietic and lymphoid tissue tumors (7 cases, chi(2) = 4.784, P = 0.310). (3) The infection related death increased significantly when WBC count was lower than 1.0 x 10(9)/L, which is totally different from those whose WBC was higher than or equal to 1.0 x 10(9)/L (chi(2) = 25.486, P < 0.001). (4) Twenty-six cases were detected to be infected with definite pathogens; different pathogens were identified 36 times in the 26 patients. Gram-negative bacteria (15/36, 41.7%) were the most common pathogens, followed by fungal organisms (14/36, 38.9%) and gram-positive bacteria (7/36, 19.4%).

CONCLUSIONMore attention should be paid to the prevention and treatment of cancer therapy related complications in children with malignant tumors. Infection was the leading cause of death, gram-negative bacteria and fungi were predominating pathogens. Application of effective antibiotics and combined antifungal drugs timely, especially in the remission induction or first chemotherapy period as well as in the period of neutropenia, may reduce mortality of children with malignant tumors significantly.

Adolescent ; Cause of Death ; Child ; Child, Preschool ; Female ; Hospital Mortality ; Hospitalization ; Humans ; Infant ; Male ; Neoplasms ; complications ; mortality ; Neoplasms, Second Primary ; mortality

【Objective】 To evaluate the cerebral hemodynamic changes due to interictal epileptic discharges(IEDs) and explore the associated neuroelectrophysiological factors and cognition deficits on electrical status epilepticus during sleep(ESES) through real-time transcranial Doppler ultrasound-video-electroencephalogram(TCD-vEEG) . 【Methods】 Eighteen ESES patients from August, 2017 to March, 2019 were recruited to undergo TCD-vEEG. The trend curve of mean cerebral blood flow velocity(MCBFV) was generated and analyzed. The spike wave index(SWI) and various TCD parameters during non-rapid eye movement(NREM) sleep were measured. The patients were divided into three clinical level groups based on seizures, their cognitive functions and the Activity of Daily Living Scale. According to the patterns of EEG during pre-ESES, the patients were also separately grouped to three groups: bilateral synchronous epileptogenic foci(BSEF), bilateral asynchronous epileptogenic foci(BAEF) and multiple epileptogenic foci(MEF). The patients were also separated into near-ESES and asymmetric ESES groups based on EEG patterns during ESES. We then performed Fisher's precise test, an analysis of variance(ANOVA) and Student's t-test, to determine that those parameters significantly varied according to clinical level and/or EEG pattern through SPSS 17.0. 【Results】 SWI was(85.22±10.33) % on average; MCBFV oscillations during deep sleep was(17.98±7.27) % on average(t = 7.579, P < 0.01); the mean of MCBFV(MCBFVm) was(92.81±21.53) cm/s on average(t = 6.464, P < 0.01); all increased significantly more than those of healthy children. SWI(F = 3.996, P < 0.05) revealed a statistically significant difference among three clinical level groups. ESES pattern had no obvious relation with the SWI, but Near-ESES influenced MCBFV oscillations during deep sleep significantly more(t = 2.885, P = 0.011) . 【Conclusions】 There are obvious cerebral hemodynamic changes during NREM in ESES, and IEDs frequency are the important factors of cognitive impairment due to ESES. ESES pattern is closely related to MCBFV oscillations during deep sleep.

"Karoshi" originates from Japan's economic take-off period in the 1960s and 1970s. It is generally believed that overwork lead to the accumulation of fatigue, which triggers the outbreak of potential diseases, and results in sudden death. Karoshi causes great harm to both the community and families because it occurs primarily in 30 to 60 year old young adults. Japan put Karoshi into the category of industrial injury for the first time in 2001 and started to undertake a series of studies in the sociological and pathological fields. However, there is a tremendous gap in the forensic pathological diagnosis domain. In China, research on Karoshi started from the 1990s and is closely related to the reform and opening up policy as well as economic development. According to the incomplete statistics, 600 thousand people die from overwork each year in China, the highest in the world. Karoshi has become one of the most serious social problems in China at the present stage, thus a systematic study in the sociology and forensic pathology fields is urgently required. This paper summarizes the past and present status of Karoshi, and puts forward the problems that need attention during the judicial expertise of Karoshi from forensic pathology perspective.
Adult ; China ; Death, Sudden/etiology* ; Fatigue/epidemiology* ; Forensic Pathology ; Humans ; Middle Aged ; Occupational Stress/epidemiology* ; Risk Factors

Objective: To analyze the clinical characteristics, treatment and prognosis of Hashimoto's encephalopathy presenting with isolated cerebellar ataxia in children. Methods: A retrospective analysis was performed on the clinical features, laboratory tests, neuroelectrophysiological examination, imaging, treatment and outcomes of 13 patients with Hashimoto's encephalopathy presenting with isolated cerebellar ataxia, who were admitted to the Department of Pediatric Neurology of Guangzhou Women and Children's Medical Center from January 2016 to May 2021. Results: Among the 13 cases, 6 were males and 7 were females. The onset age was 2.6 (2.0,3.3) years, 9 children had precursor infection or vaccination before the first course of disease. All the 13 children had gait abnormalities or unsteady sitting, 10 had intentional tremor, 6 had dysarthria, 3 had body tremor, 2 had nystagmus, 3 had fatigue, 3 had hypotonia, 2 had vomiting and 1 had irritability. Thyroglobulin antibody (TgAb) was 500.0 (298.9,587.2) kU/L and thyroid peroxidase antibody (TPOAb) was 621.9 (449.6,869.4) kU/L in 13 cases. Autoantibodies were positive in 9 cases, and cerebrospinal fluid leukocytosis was seen in 4 cases. Regarding electroencephalography result, 4 cases had background slowing and 1 case had occasional sharp waves. Among the 3 patients who had relapses, 1 had cerebellar atrophy shown on cranial magnetic resonance imaging (MRI) during the recurrence. All the patients received intravenous immunoglobulin (IVIG) and intensive methylprednisolone therapy during the first onset, followed by the disappearance of the symptoms, 1 patient had repeated episodes which was decreased after immunosuppressive treatment with Rituximab.Followed up for 25.0 (22.5,33.3) months after the last episode, 12 achieved complete remission and 1 had a wide base gait. Conclusions: Trunk ataxia is the common symptom of Hashimoto's encephalopathy presenting with isolated cerebellar ataxia in children.Children with cerebellar ataxia should be tested for TgAb and TPOAb to detect Hashimoto's encephalopathy, avoiding missed diagnosis and treatment delays; IVIG and intensive steroid therapy is effective, and immunosuppressive therapy for patients with multiple relapses could reduce the recurrence.
Autoantibodies ; Cerebellar Ataxia ; Child ; Encephalitis ; Female ; Hashimoto Disease ; Humans ; Male ; Retrospective Studies

Objective To explore the performance of mobile health platform for standardized management of pregnant women with gestational diabetes mellitus(GDM). Methods A randomized controlled trial was conducted,in which 295 women with GDM were randomized into two groups(traditional management group and mobile health management group)by a computer-generated sequence.The traditional management group accepted standardized GDM management,and the mobile health management group was supplemented by mobile health management based on the standardized management.The glycemic control rate and the incidences of low birth weight,macrosomia,preterm birth,premature rupture of membranes,postpartum hemorrhage after cesarean section,neonatal asphyxia,malformation,and admission to the neonatal intensive care unit were compared between the two groups. Results The glycemic control rate in mobile health management group was significantly higher than that in the traditional management group [(67.22±22.76)%
Cesarean Section ; Diabetes, Gestational/therapy* ; Female ; Fetal Macrosomia ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Outcome ; Premature Birth ; Telemedicine