China ; epidemiology ; Humans ; Pneumoconiosis ; epidemiology

Objective To explore the application of high-frequency oscillatory ventilation(HFOV)postoperatively after open heart surgery in children with congenital heart disease.Methods From Jun.2007 to Jun.2008,a total of 1 957 cases were operated in pediatric center of Fuwai cardiovascular hospital.Thirteen cases of 1 957 were given HFOV.Among these 13 patients,8 were male and 5 were female;Age was(13.4?15.4)months.The range of weight was 4.2-12.5 kg.Four cases were tetralogy of Fallot,3 cases were transposition of the great arteries(1 case was corrective transposition of the great arteries),2 cases were total anomalous pulmonary venous connection,2 cases were total endocardial cushion defects,2 cases were pulmonary artery atresia,all patients were under cardiopulmonary bypass repaired operation except 1 patient with PAA under Blalock-Taussig procedure.All patients were mechanical ventilated after surgery.Results The duration of switching general mechanical ventilation to HFOV was(15.70?20.33)days and patients continued to be on HFOV about(10.0?7.5)days.In short term,the lung function of ventilation and gas exchange were be improved by HFOV,but the long-term result was not sa-tisfactory due to a high mortality.There were 5 survived(38.4%)in this group.Six cases of the patients succumbed to consolidation of lung.The commonest complication was pneumothorax(7 cases).Conclusions Short term of HFOV in children with congenital heart disease was satisfactory postoperatively.But there was a high mortality.HFOV can be regarded as a transition method for unsatisfactory long-term.

Objectives To study the age and gender distribution of clinical and non-clinical depressive symptoms in chil-dren, and the potential link between non-clinical and clinical depressive symptoms. Methods 4520 children aged 8-15 years old were screened for mental disorders by Strength and Dififculties Questionnaire (SDQ) and the Development and Well Being Assessment (DAWBA), and further assessed by the Depression Self-Rating Scale for Children (DSSC). Fifty-three children diagnosed as depressive disorder were included in clinical group and 1504 children without depression disorders whose DSSC scores≥14 were included in non-clinical group. The relationship between gender, age and DSSC scores was analyzed. Results Interaction effect on DSSC scores between gender and age was found in clinical group (F=4.40, P=0.049), but not found in non-clinical group (F=1.04, P=0.409). DSSC scores of girls were higher than that of boys in clinical group (t=2.16, P=0.048). There was no statistically signiifcant main effect of gender in non-clinical group (F=0.21, P=0.646). No signiifcant difference in DSSC scores existed among different age groups in clinical group (F=0.82, P=0.573). There was signiifcant main effect of age in non-clinical group (F=1.96, P=0.048). Conclusions There were different age and gender distribution of clinical and non-clinical depressive symptoms in children.

Objective To investigate domestic child abuse within one year before the survey being conducted in Grades 4-6 preliminary school students and explore the relationship between domestic child abuse and mental health problems including prevalence of mental disorders,anxiety,depression as well as children's selfawareness in this sample.Methods Screen Questionnaire of Child Abuse was used to screen all the students participated in the survey.For those students whose screen results were positive,further face to face interview was needed to verify the abuse history.Once a child was identified as abused one,a student without abuse history would be matched by sex and the same age.Both groups with abused history and without abuse history over past year were evaluated by the two child psychiatrists with diagnostic an statistical manual of mental disorder (DSM-Ⅳ) and mental health scales.Results 1500 10-13 year-old children received child abuse screening.23.73％ students surveyed over the past year suffered child abuse in the family.The proportion of boys who were victims of domestic child abuse was 30.44％ while 17.44％ to girls (x2 =5.95,P ＜ 0.01).The proportion of male students who were victims of domestic abuse was two times that of female students.For all participants,14.6％ had been suffered one-way abuse,5％ for two-way abuse,and 3％ for three-way abuse.Prevalence of anxiety disorder in abused students was higher than in non-abused ones (9.26％ vs 3.45％,x2 =3.19,P=0.0015).Similarly,the rate of disruptive behavior disorder in abused students was higher than in non-abused ones(18.53％vs 9.22％ x2 =3.61,P=0.0001).The total scores of The Screen for Child Anxiety Related Emotional Disorder was higher in abused students group than in non-abused students group while the total scores of Piers-Harris Children's self-concept Scale was lower in abused student group than in non-abused student group.Conclusion Domestic child abuse in 10-13 old-age students is a widespread phenomenon and abuse history over last year is associated with current mental health level.

The design space of the high shear wet granulation process was established and validated within the framework of quality by design (QbD). The system of microcrystalline cellulose-de-ioned water was used in this study. The median granule size and bulk density of granules were identified as critical quality attributes. Plackeet-Burmann experimental design was used to screen these factors as follows: dry mixing time, the impeller and chopper speed of dry mixing, water amount, water addition time, wet massing time, the impeller and chopper speed of wet massing and drying time. And the optimization was implemented with the central composite experimental design based on screened critical process parameters. The design space of the high shear wet granulation process was established based on the quadratic polynomial regression model. Since the P-values of both models were less than 0.05 and values of lack of fit were more than 0.1, the relationship between critical quality attributes and critical process parameters could be well described by the two models. The reliability of design space, illustrated by overlay plot, was improved with the addition of 95% confidence interval. For those granules whose process parameters were in the design space, the granule size could be controlled within 250 to 355 μm, and the bulk density could be controlled within a range of 0.4 to 0.6 g x cm(-3). The robustness and flexibility of the high shear wet granulation process have been enhanced via the establishment of the design space based on the QbD concept.
Cellulose ; chemistry ; Reproducibility of Results ; Technology, Pharmaceutical ; methods ; Water

Objective To explore the care burden and its influencing factors of primary caregiver of patients with spinal cord injury. Methods A total of 120 primary caregiver of spinal cord injury patients were selected as research object. The general information of SCI patients and their primary caregiver were investigated by SCI patient general data questionnaire and primary caregiver in SCI patient general data questionnaire, caregiver burden of spinal cord injury were investigated bycaregiver burden inventory. The relationship between the general information of patients and caregivers and the care burden analyzed. Results Caregiver burden of elderly patients was significantly lower than that of younger ones (F=54.053,P<0.01). The more serious of spinal cord injury, the higher of care burden (F=315.104,P<0.01). The patients with neck and multiple segmental spine injury and postoperative complications had a higher care burden (F=199.203,t=6.462, 32.195,P<0.01). When the caregivers were female, spouses or children, with poor health condition, with higher education degree, and as cadres or workers, caregiver burden was higher (t=6.061,F=22.073-52.392,P<0.01). Multiple linear regression analysis showed that the degree of spinal cord injury, complications, gender, and the relationship between the patients were the main factors that influenced the care burden. Conclusions The main factors influencing the care burden are spinal cord injury degree, complications, gender, and the relationship between the patients. Clinical managers needs to develop appropriate social support system for the factors which affect the caregiver, in order to ease the caregiver′s care burden.

Objective To investigate the clinical features and disease-causing mutations of familial hypomagnesaemia with hypercalciuria and nephrocalcinosis.Methods In February 2016,a 24 year old female patient with left kidney stone and nephrocalcinosis in bilateral kidneys was admitted to our hospital.One month prior to this admission,she had been treated by PCNL to remove the most part of left kidney stone in otherhospital.Mter admission,She was found hypomagnesaemia (serum magnesium 0.65 mmol/ L) and hypercalciuria (24h urine calcium 364.0 mg) but with normal renal function (serum creatinine 101.5μmol/L).And the remained part of left kidney stone was removed by flexible ureteroscope.As she was considered probably with an autosomal recessive FHHNC,an analysis of CLDN16 and CLDN19 gene mutations was performed using her and her parents'peripheral white blood cells.Results Mutation analysis revealed this patient had two heterozygous mutations in the CLDN16.One is an one-base deletion mutation in the 123th codon in exon 2:368delA.The other is a missense mutation in the 139th codon in exon 2:416C →T which resulted in an amino acid change Ala139Val.Her parents respectively had one of each heterozygous mutation.In the six months follow-up,an oral administration with hvdrochlorothiazide,potassium citrate,and calcium magesium supplements significantly reduced her hypomagnesaemia (serum magnesiun 1.0 mmol/L) and hypercalciuria (24-h urine calcium 156.0 mg),and no stone recurrence and aggravation of nephrocalcinosis and renal dysfunction occurred.Conclusions We diagnosed a patient with FHHNC who had a novel compound heterozygous mutation of CLDN16.This rare disease should be suspected if there are three constant clinical features of hypomagnesaemia,hypercalciuria and nephrocalcinosis,and verified with CLDN16 and CLDN19 gene test.Currently the option for treatment of FHHNC is symptomatic treatment until severe deterioration of renal function.The hydrochlorothiazide,potassium citrate,and calcium magesium supplements may have considerable effects on hypomagnesaemia and hypercalciuria.

The achievements inspection and the drive standard of our country' universities and colleges is unscientific.The inspection result and the incentive mechanism have a lot of questions.Based on some medical university,the author analyzed the indicator system's construction,proposed displaying school culture guidance value,construcing the easy and feasible achievements inspection indicator system and completing measures and so on to better inspection feedback.

Objective To establish a rat model of coal-burning-borne fluorosis,and to observe the expression changes of bone morphogenetic protein-2 (BMP-2) and bone morphogenetic protein-3 (BMP-3) in the serum of rat treated with different dose of fluoride and different treatment duration.Methods A total of 120 clean grade SD rats(body mass between 80 to 120 g) weaned for 4 weeks were randomly assigned into four groups,which were control,low-dose fluorid,medium-dose fluorid and high-dose fluorid groups,respectively,and 30 rats in each group (female 15,male 15).All of the rats were fed with coal drying corn from fluorosis area.Ten rats were killed by femoral artery bleeding 30 d,90 d and 180 d after exposed to fluoride,respectively.Serum BMP-2 and BMP-3 level was tested by enzyme-linked immunosorbent assay (ELISA).Results ①Results of BMP-2:after exposed to fluoride for 90 d and 180 d,the differences of serum BMP-2 level between groups were statistically significant(F=385.08,173.98,all P ＜ 0.01).In low-dose fluorid,medium-dose fluorid and high-dose fluorid groups,the expression of serum BMP-2 at 90 d[(18.80 ± 0.43),(22.22 ± 0.85),(25.14 ± 0.69)μg/L] and 180 d[(7.98 ± 0.68),(8.97 ± 0.78),(15.04 ± 0.89)μg/L] was higher than that of control group[(12.54 ± 1.29),(7.53 ± 0.97)μg/L,all P ＜ 0.05],and the level of BMP-2 increased with increasing dose of fluoride (all P ＜ 0.05).Within each group,the difference of serum BMP-2 was statistically significant(F =55.42,511.58,686.35,671.64,all P ＜ 0.01).The expression of BMP-2 in each group at 90 d [(12.54 ± 1.29),(18.80 ± 0.43),(22.22 ± 0.85),(25.14 ± 0.69)μg/L] was higher than that at 30 d[(11.75 ± 1.15),(11.42 ± 1.07),(11.38 ± 0.92),(11.15 ±1.03)μg/L,all P ＜ 0.05].The expression of BMP-2 in each group at 180 d[(7.53 ± 0.97),(7.98 ± 0.68),(8.97 ± 0.78),(15.04 ± 0.89) μg/L] was lower than that at 90 d.②Results of BMP-3:the difference between groups was not statistically significant at every experimental stage(F =0.7215,1.2951,0.0964,all P ＞ 0.05).Conclusions Longer excessive fluoride intake stimulates the expression of BMP-2 in rats,but with prolonged fluoride intake,the stimulation becomes weak.The effect of fluoride on BMP-3 is not as sensitive as that on BMP-2.

Objective To evaluate the eradication rate and long-term therapeutic effect of a triple therapy consisted of cla-(rithromycin) (CLA), amoxicillin (AMO)and omeperazole on Hp infection,and explore the alternative therapeutic programs and their effects after first therapeutic failure.Methods A total of 92 children with Hp infection were divided into two groups: 70 children were given the triple therapy for one week (CLA group);Twenty-two children were given another triple therapy composed of metronida-(zoole) (MET), AMO and omeperazole for two weeks (MET group).All of the children were followed up for 1-30 months after the therapies ended.Children of the two groups who were therapeutic failure were given retreatment as follows.CLA triple therapy were given for one week to the children who were failure after MET triple therapy;increased doses of CLA with longer treatment course was given to the children who were failure after CLA triple therapy . A tetra therapy consisted of colloidal bismuth subcitrate (CBS), furazolidone (FUR) ,omeperazole and AMO was given to children in whom the retreatment failed.Results The Hp eradication rate of CLA group was 91.4%(64/70),and the Hp eradication rate of MET group was 72.7%(16/22).There was significant difference between eradication rate of the two groups(?~2=5.16 P