ObjectiveTo evaluate the mortality and morbility of children with severe traumatic brain injury (sTBI) following treatment with decompressive craniectomy and further analyze its long-term outcomes.Methods Seventeen children with sTBI undergone decompressive craniectomy between 2004 and 2010 were retrospectively studied.Quality of life of the patients who survived the operation was assessed by using the King' s outcome scale for childhood head injury (KOSCHI).ResultsOf 17 children with sTBI,the mean preoperative Glasgow Coma Scale (GCS) score was 5.27.Five children (29％) died postoperatively,of whom three children were died of cerebral infarction.Twelve children who survived the operation were followed up for average 4.6 years,which showed the mean KOSCHI score of 4.75.Among the 12 survivors,five patients (42％) experienced posttraumatic shunt-dependent hydrocephalus and four (33％) suffered ipsilateral and/or contralateral hygroma.ConclusionsAlthough a high mortality rate is observed in the children with sTBI after decompressive craniectomy,the survived patients have satisfactory outcomes. Posttraumatic hydrocephalus and hygroma are two common complications after decompressive craniectomy for children with sTBI.

Objective To explore the expression of Speckle-type POZ protein-like(SPOPL)in human glioma tis?sues and its relationship with clinical pathological parameters and prognosis. Methods Immunohistochemical and west?ern blotting method were used to detect SPOPL expression in glioma tissues and tumor peripheral tissues in 68 cases of glioma patients including 32 cases of low grade gliomas (WHO I- II), and 36 cases of high grade gliomas (WHO III-IV). T test,χ2 test, Kaplan-Meier method and the Cox regression model were used to analyze the relationship between the expression and clinical indicators. Results The expression of SPOPL was significantly lower in gliomas than in tumor pe?ripheral tissues (t=-8.754, P<0.05), the expression of SPOPL was lower in high pathological grade tissues than in low grade of glioma tissues (t=-13.552, P<0.05). SPOPL expression was associated with pathological grade ( χ2=4.023, P<0.05). Cox regression model showed that the tumor pathological grade and different SPOPL protein expression were inde?pendent risk factors for the prognosis of patients with glioma. Conclusions SPOPL may be a biomarkers of human brain gliomas and can help to evaluate the prognosis of brain glioma.

Objective To analyze the clinical characteristics of children massive cerebral infarction after traumatic brain injury. Methods The clinical data of 33 children with massive cerebral infarction after traumatic brain injury were retrospectively analyzed. Results Among the 33 children, 24 cases suffered from falling, 10 cases were involved in traffic accidents, 1 case suffered from violence and 1 case was hit by falling object. The massive cerebral infarction occurred in all objects: 9 cases in 1 day after head trauma, 14 cases in 1 - 3 days, 7 cases in 4 - 7 days, and 3 cases after 7 days. Eighteen patients were performed operation to evacuate the intracranial hematoma and decompression. Antiplatelet agents, calcium antagonist and low molecular dextran were administered in all patients after exclusion of bleeding tendency. The follow-up period of all children ranged from 6 months to 24 months. According to Glasgow outcome score (GOS):18 cases showed a good outcome, 6 cases were moderately disabled, 1 case was severely disabled, 1 case survived in a permanent vegetative state and 7 cases died. Conclusions The main causes of children massive cerebral infarction with traumatic brain injury are falling and traffic accident. With proactive treatment, the prognosis of children survivors is acceptable.

Objective:To explore whether there was intraoperative myocardial protection effect of dexmedetomidine in patients with hypertension.Methods:A total of 60 patients with hypertension undergoing elective abdominal surgery,who were classi-fied as Ⅰ-Ⅱ according to American Society of Anesthesiologists(ASA)criteria and aged 22-60 years old with body mass index (BMI)19-26 kg/m2 ,were randomly divided into dexmedetomidine group and control group,with 30 cases in each group.Pa-tients in dexmedetomidine group were given a loading dose of dexmedetomidine 0.5 μg/kg(10 min before the operation)which was followed by a continuous infusion of 0.2 μg/(kg·h)till 30 minutes before the end of operation.Patients in the control group were intravenously pumped 0.9% sodium chloride solution.The serum concentration of cardiac troponin I (cTnI),inter-leukin 6(IL-6)and tumor necrosis factor-α(TNF-α)were measured before anesthesia induction and at 6h and 24h after opera-tion.Results:There were significant differences in cTnI,IL-6 and TNF-αin control group at 6 h and 24 h after operation com-pared with those before anesthesia induction(P <0.05).There were significant differences in IL-6 at 24 h after operation and TNF-αat 6 h and 24 h after operation in dexmedetomidine group compared with those before anesthesia induction(P <0.05). The concentration of cTnI,IL-6 and TNF-αin dexmedetomidine group were significantly lower than those in the control group at 6 h and 24 h after operation(P <0.05).Conclusions:There was certain intraoperative myocardial protection effect of dexme-detomidine in patients with hypertension.

To elucidate the expression of WT1 in all types of leukemias and its implications for monitoring minimal residual disease in patients with acute leukemia, the peripheral blood from 55 leukemia patients and 10 normal voluteer was detected by using FQ-RT-PCR. Follow-up monitoring of WT1 expression of peripheral blood was performed for 20 patients with acute leukemia. The results showed that the expression of WT1 gene in all types of leukemias was significantly higher than that in normal control (P < 0.001). For ANLL and ALL patients, the survival time in the group of WT1 6.8 x 10(-3), (P = 0.027). Follow-up detection of the expression of WT1 in peripheral blood samples from 20 acute leukemia patients, 7 cases relapsed after complete remission has been done. In 5 of 7 relapsed patients, the expression of WT1 had obviously increased about 2 - 3 months before clinical relapse became apparent. It is concluded that the established FQ-RT-PCR method is accurate and specific. The expression of WT1 gene is relatively high in all types of leukemias compared with normal peripheral blood cells, the higher WT1 expression may associate with poor prognosis in acute leukemia, and the dynamics of WT1 level correlate with the disease status. The quantitative assessment of WT1 expression in peripheral blood samples by FQ-RT-PCR may be a useful tool for monitoring minimal residual disease.
Acute Disease ; Adolescent ; Adult ; Aged ; Biomarkers, Tumor ; genetics ; Child ; Female ; Gene Expression Regulation, Leukemic ; Humans ; Leukemia ; blood ; genetics ; pathology ; Male ; Middle Aged ; Neoplasm, Residual ; blood ; diagnosis ; genetics ; Reproducibility of Results ; Reverse Transcriptase Polymerase Chain Reaction ; methods ; Sensitivity and Specificity ; WT1 Proteins ; genetics

OBJECTIVES: Few studies have attempted to explain the association between socioeconomic status (SES) and obesity in Korea. Especially the studies on same race with different SES at same time are good for SES influence estimation. The present study highlights the influence of SES of parents on adolescent obesity. The subjects are the same race, but live in different areas, with different SES, Seoul and Yangpung in Korea, and Yanbian in China. METHODS: The cross-sectional study was conducted in Mar-Jun 1996. We carried out anthropometry, 24 hour-recall diet survey, self-reported questionnaire about sociodemographic characteristics and physical activity. For SES indicators, we used income and education of parents. RESULTS: The relationship between SES of parents, defined as educational status, and obesity in boys in Korea and China is direct, but not significant. The relationship is inverse and non-significant among Korean girls. However, for the Korean girls in severe obesity, the relationship is significant. For the Korean-Chinese girls, there is an inverse relationship between the education level and obesity but a direct relationship between the income level of parents and obesity. For the Korean adolescent, there are a direct association between the SES of parents and the nutrients factors such as energy, protein, and fat intake. The energy expenditure of adolescent has no relationship with SES of parents. CONCLUSION: Among boys, the higher the SES, the greater the risk of obese. Among girls in Korea and Korean-Chinese, on the other hand, the lower the educational status of parents, the greater the risk of obese.
Adolescent* ; Anthropometry ; China ; Continental Population Groups ; Cross-Sectional Studies ; Diet Surveys ; Education ; Educational Status ; Energy Metabolism ; Female ; Hand ; Humans ; Korea ; Motor Activity ; Obesity ; Obesity, Morbid ; Parents* ; Pediatric Obesity* ; Surveys and Questionnaires ; Seoul* ; Social Class*

Objective To study the status and environment-related risk factors for falls among older adults in the urban community,and to provide evidences for the development of specific interventions.Methods A total of 993 older adults aged ≥60 years old from 2 communities in Cixi City were selected by stratified cluster sampling. Face-to-face interview and field investigation were carried out to collect participants' basic information,the situation and environment-related risk factors for falls occurred to them from November 2012 to October 2013.Results The overall incidence of falls was 14.90%,and it was significantly higher in wowen (17.19%) than in men(12.47%)(P<0.05). There were 109 participants reported to have fall-related injury with an incidence of 10.98%(109/993). Moreover,the incidence of fall-related injury for women(13.87%) was significantly higher than that for men(7.69%)(P<0.05). Among them, 35.14% falls occurred in home,the washroom(93.62%)and drawing room(85.02%) had higher proportion of having falling-related environmental risk factors. The multivariate logistic analysis showed that uneven carpet in aisle (OR=3. 542,95% CI:1.235-10.161)and having clutters beside the bed (OR=8.611,95% CI:2.051-36.574) were two main environmental risk factors for elder falls in home.Conclusion The incidence of falls of older adult in Cixi was 14.90%. Uneven carpet in aisle and having clutters beside the bed were two main environmental risk factors for falls among the elderly at home.

Objective To compare insulin secretion and action with impaired fasting glucosc (IFG),impaircd glucose tolerance (IGT) and combined glucose intolerance (CGI,IFG and IGT) between Han and Uygur populations living in Xinjiang.Methods A multicenter cross-section survey (The Third Diabetes Epidemiological Survey in China) was conductcd in Xinjiang from 2007 to 2008 including 2203 subjects (Han 1118,Uygur 1085) underwent an oral glucosc test (OGTT).Homeostasis model assessment on insulin resistance (HOMA-IR) and β cell function (HOMA-β)were calculated.The ratio of incrcmcntal insulin(Δ130 ) and glucose (ΔG30)response was used to evaluate the early insulin secretion.ΔI30/ΔG30/HOMA-IR was used to evaluate the glucosc disposition index (DI).Results There were differences noticed regarding the waist circumstances (WC),body mass index (BMI),lipids,0 and 120 min insulin lcvcls in different glucose tolerance status between the Hans and Uygurs.Data related to NGT,IFG,CGI,WC from the Uygurs was significantly diffcrcnt from that of the Hans (P＜0.01),while the NGT,IFG,IGT and 120-minute plasna insulin levels of the Hans were significantly different from that of the Uygurs (P＜0.01).HOMA-IR and HOMA-β in Hans were significantly different from those of the Uygurs (P＜0.01).There were significant differences noticed on data reoated to Δ130/ΔG30,and DI among the two populations with different ethnicities.Conclusion Regarding the regulation of impaired glucose,the insulin resistance among the Hans was significantly different from that of the Uygurs,while there seemed to be a compensatory secretion of pancreatic β cells which played the role of maintaining blood glucose homeostasis.

Objective:To evaluate the value of intraoperative magnetic resonance imaging (iMRI) combined with neuronavigation for the resection of insular gliomas.Methods:From August 2014 to October 2017 in the First Hospital Affiliated to Sun Yat-sen University,clinical data of 41 patients with insular glioma,who underwent the surgery assisted with 3.0T iMRI and neuronavigation,were analyzed retrospectively,and the resection extent,complications and prognosis were evaluated.Results:Subtotal tumor resection was achieved in 21 patients and partial resection was done in 20 after iMRI scanning.After further resection,total tumor resection was achieved in 16 patients,subtotal resection in 18 and partial resection in 7.There was a statistical significant difference in tumor resection between pre-iMRI and post-iMRI according to the Fisher test (P＜0.05).In the follow-up from 3 months to 3 years,the symptoms of the 41 patients had improved.Conclusion:iMRI corrected the shift of brain.Neuronavigation can accurately and timely assess the degree of resecting tumor.The combination of neuronavigation with surgery can maximally and safely resect insular glioma.

Objective:To explore the effect of oral nutritional supplements (ONS) during labor on delivery outcomes in low-risk pregnant women and the risk factors of cesarean section.Methods:A retrospective analysis was conducted in a total of 206 full-term pregnant women with singleton and cephalic presentation at the delivery center in our hospital from March 15th to May 15th, 2022. Standard diet education was given to all those women by midwives. Pregnant women who received the enteral nutrient solution prepared by the Department of Clinical Nutrition during labor were in the ONS group ( n = 110), while those who did not were in the control group ( n = 96). The baseline characteristics and delivery outcomes were compared between the two groups, and the risk factors of cesarean section were also analyzed. Results:There were no significant differences in terms of maternal age, height, baseline weight, baseline body mass index (BMI), weight gain during pregnancy, prenatal BMI, gestational week, intraspinal labor analgesia, oxytocin, gastrointestinal intolerance, neonatal length, and weight between the two groups ( P > 0.05). However, the total oral energy intake during labor in the ONS group was significantly higher than that in the control group ([1 349.99± 569.51] kJ vs [249.59 ± 455.19] kJ, P < 0.01). The rate of vaginal delivery in the ONS group was significantly higher than that in the control group (93.6% vs 81.3%, P = 0.01), and the duration of the first stage of labor ([487.06 ± 232.94] min vs [416.17 ± 191.13] min, P = 0.03) was also significantly longer in the ONS group. There were no significant differences between the two groups in terms of the duration of the second and third stages of labor, perineal laceration, cervical laceration, vaginal laceration, amount of bleeding, hospital stay, and Apgar score after birth ( P > 0.05). Multivariate logistic regression analysis showed that maternal age was a risk factor for changing to cesarean section in women with low-risk pregnancies ( OR 1.20, 95% CI 1.03 to 1.40, P = 0.02), while ONS during labor ( OR 0.31, 95% CI 0.11 to 0.85, P = 0.02) and intraspinal labor analgesia ( OR 0.10, 95% CI 0.04 to 0.26, P < 0.01) were protective factors. Conclusions:ONS during labor can significantly increase the vaginal delivery rate, without increasing the incidence of gastrointestinal intolerance in low-risk pregnant women. Maternal age is a risk factor for cesarean section while ONS during labor and intraspinal labor analgesia are protective factors in women with low-risk pregnancies.