Objective To analyze the changes in nutritional status changes of pediatric acute lymphoblastic leukemia (ALL) patients before and after chemotherapy and to evaluate the effects of enteral nutritional support on the states of nutrition and complication of chemotherapy.Methods Sixty-two newly diagnosed ALL patients from Novem-ber 2012 to December 2013 in Center of Hematology,Beijing Children's Hospital Affiliated to Capital Medical University were enrolled in this study.Patients were randomly assigned into an intervention group and a control group.During the induction and the early consolidation chemotherapy,the control group was given routine low fat diet routinely,and the intervention group was given Nestle peptamen [20 mL/(kg · d)] as the enteral nutritional support,meanwhile the routine low fat diet was also given.Changes in the nutritional status before and after chemotherapy and effectiveness of nutritional complementary therapy for preventing the chemotherapy complications were analyzed.Results (1) Basic information:there was no significant difference in age,gender,risk group,anthropometry,albumin and pre-albumin level between 2 groups before chemotherapy.(2)Nutritional status:the rate of malnutrition was 11.3 ％,and skinniness cases under 5 years of age occupied 10.0％.In the control group,the Z scores of W/H (weight-for-length/height,t =3.160,P =0.040),the Z scores of BMI (body mass index,t =3.490,P =0.010) and the albumin level(t =-1.805,P ＜0.001) decreased after chemotherapy,and the difference was statistically significant.On the other hand,the Z scores of W/H and BMI kept stable after chemotherapy in the intervention group,the albumin level raised from (40.53 ±3.96) g/L to (44.36 ± 3.31) g/L (t =-4.500,P ＜ 0.001) and the pre-albumin level raised from (126.55 ± 39.28) g/L to (189.55 ± 51.81) g/L(t =2.710,P =0.010),which was of statistical difference.The albumin level(t =5.020,P ＜ 0.001),pre-albumin level (t =3.036,P =0.040) and the Z scores of W/H (t =2.790,P =0.010),BMI (t =3.370,P ＜ 0.001),weight for age (W/A,t =2.830,P =0.010) were all higher in the intervention group,and the differences in statistical significance were found.(3)Side effects of chemotherapy:patients in the intervention group had higher hemoglobin (t =2.070,P =0.043) and platelet (Z =-2.19,P =0.033) level during the chemotherapy which induce less platelet [(0.50 ± 1.00) U vs (2.00 ± 2.00) U ; Z =-3.53,P =0.003] and red blood cells [(3.87 ± 2.01) U vs (5.25 ± 1.87) U ;t =-2.810,P =0.007] transfusion.Period of neutrophil deficiency [(15.67 ± 8.85)d vs (25.94 ±8.72) d;t =-4.601,P ＜0.001]was also shorter than that in the control group.Other complications had no difference between two groups exclude mild liver function abnormality was found more in the controls(x2 =6.680,P =0.010).(4)Safety:the complete remission rate 15 days after chemotherapy was 83.3％ in the intervention group and 81.2％ in the control group (x2 =0.046,P =0.830).All patients got complete remission on day 33.There was no significant difference.No pancreatitis happened in both groups during the chemotherapy.Conclusions Malnutrition rate is high among newly diagnosed ALL pediatric patients,and the nutritional status will deteriorate during the chemotherapy.Enteral nutritional support contributes to maintaining the stability of nutritional status.Enteral nutritional support improves the tolerance of hematopoietic system to chemotherapy.The effect for other complications remains to be confirmed by more extensive study in future.Nestle peptamenas enteral nutritional support productions are safe for ALL patients undergoing chemotherapy.

Abstract: Objective To analyze the epidemiological characteristics of outbreaks of infectious diseases in schools in Yunnan Province from 2004 to 2021, to provide a scientific basis for prevention and control strategies. Methods The data on outbreaks of infectious diseases in schools in Yunnan Province from 2004 to 2021 from the National Emergency Public Health Events Information Management System and on-site epidemiological surveys were collected and analyzed using descriptive epidemiology method. Results From 2004 to 2021, a total of 1 806 outbreaks of infectious diseases in schools in Yunnan Province was reported. The majority of the reports were of general events (90.25%), affecting 2 183 493 people with reported cases numbering 94 643 and 13 deaths. The main modes of transmission were respiratory infectious diseases. The top three reported diseases were chickenpox (588), influenza (300) and hand-foot-and-mouth disease (267), accounting for 64.0% of the total reported events. The events were distributed in 121 counties and districts throughout the province, concentrated in March–June and September–January of the following year. The main outbreaks were of chickenpox, with an average duration of 19 days. Most public health emergencies (1 386) occurred in kindergartens and primary schools, and the median time to discover the outbreak was 7 days (ranging from 4 to 13 days). Conclusions Respiratory infectious diseases are the main type of outbreak of infectious diseases in schools in Yunnan Province. Kindergartens and primary schools are the focus of prevention and control. Early reporting and effective handling will help control the spread of events and reduce hazards. At the same time, the prevention and control of school infectious diseases and the emergency drill of the plan during peak periods need to be particularly strengthened.

Objective To analyze the clinical characteristics and outcomes of angiographically confirmed drug-eluting stent thrombosis (ST). Methods All the angiographically confirmed ST was enrolled in the study from March 2005 to March 2009. Clinical data, angiographic outcomes, procedures of PCI, and anti-platelet treatment of ST were retrospectively collected. Results Total 20 cases of ST included 18 cases (90.0%) of sirolimus and derives eluting stents and 2 cases (10.0%) of paclitaxel eluting stent. Ten (50.0%) stent thromboses were subacute, 1 (5.0%) were late, and 9 (45.0%) were very late. ST reoccurred in 3 cases and occurred simultaneously in two arteries in 1 case. All the cases presented with ST-segment elevation myocardial infarction (STEMI). ST occurred in 16 cases after emergency PCI and 4 cases after selective PCI. Nine late stent thrombosis occurred after clopidogrel cessation. Long stents (stent length ≥ 30 mm) were implanted in 12 cases (60.0%), of which overlap stents were implanted in 8 cases (40.0%).Balloon angioplasty was used in 16 cases (80.0%). The 2 patients died from STEMI during hospitalization and 1 patient accepted coronary artery bypass graft for repetitive ST. Conclusions Angiographically confirmed ST appears rarely, but most frequent ST presents with STEMI. ST is related with long stent implantation and emergency PCI. Balloon angioplasty is frequently used for ST. Some patients have the risk of multiple arteries and repetitive ST.

Objective To investigate the corelation between platelet activating factor acetylhydrolase (PAF-AH) genetic polymorphism and ischemic stroke. Methods The plasma PAF-AH genotype was determined in 205 patients with iachemic stroke and 114 normal subjects by the polymerase chain reaction. The levels of plasma platelet activating factor (PAF), platelet α-granule membrane glycoprotein-140(GMP-140), β-thromboglobulin (β-TG) and the levels of platelet factor 4 (PF4) were analyzed. Results The prevalence of the mutation genotype and plasma PAF, GMP-140, β-TG and PF4 in the patients with isehemic stroke [42.44%,(91.08 ± 39.10) ng/L, (36.46 ± 13.10) μg/L, (41.75 ± 11.18) μg/L, (29.05 ± 9.16) g/L, respectively] were significantly higher than those in the controls[21.05%,(64.30 ± 18.81) ng/L, (18.27 ± 7.68) μg/L, (30.94 ± 8.47) μg/L, (18.75 ± 6.06) μg/L](P< 0.01). The levels of plasma PAF, GMP-140 were significantly higher in mutation genotype patients than those in the normal genotype patients (P < 0.01). Conclusions The activation function of platelet in the acute phase of patients with ischemic stroke increases, and it is associated with genetic polymorphism of PAF-AH. The PAF-AH gene mutation may be a novel genetic marker for high risk of ischemic stroke.

A new adaptively hybrid filtering algorithm is proposed to reduce the artifacts caused by metal in CT image. Firstly, the method is used to preprocess the projection data of metal region and is reconstruct by filtered back projection (FBP) method. Then the expectation maximization algorithm (EM) is performed on the iterative original metal project data. Finally, a compensating procedure is applied to the reconstructed metal region. The simulation result has demonstrated that the proposed algorithm can remove the metal artifacts and keep the structure information of metal object effectively. It ensures that the tissues around the metal will not be distorted. The method is also computational efficient and effective for the CT images which contains several metal objects.
Algorithms ; Artifacts ; Metals ; Tomography, X-Ray Computed ; methods

Objective:In this study, the feasibility of this method was evaluated in children with large distance femoral lengthening cases, and the acute correction and staging surgeries were compared at healing speed. At the same time the key points of surgical techniques would be summarized, so as to clarify the application value of this technology in children patients.Methods:Since July 7 of 2014 to January 16 of 2018, a total of 10 cases of Lengthening Over Retrograde Nail (LORN) surgery have been formulated and carried out, including 9 males and 1 females.The average age of the operation was 13.10±2.18 y. In all cases, the osteotomy point was located in the metaphysis of the distal femur, and the records from the first meeting to the end of follow-up included gender, date of birth, reason of discrepancy and treatment history, age at surgery, lengthing distance, the length of duration with frame, healing time, ROM of the knee joint, complications, et al. To compare the healing time of acute correction and staging surgery. Statistical analysis was made by SPSS 22.0 software, and then reasonable treatment strategies were proposed.Results:The average lengthing distance of 7.07±1.01 cm. The median time of the duration with frame was 8.5 (4,16) months, and the median follow-up time was 39 (34, 54) months. All cases obtained good clinical and imaging healing (1.70±1.10 month/cm vs. 1.16±0.54 month/cm), and all regained to normal walking function (136.67°±20.82° vs. 125.71°±26.37°), without the occurrence of fracture after therapy. There were no statistically significant differences in the speed of healing, range of joint motion or complication rate between acute correction and staging treatment. Conclusion:It is feasible for femoral lengthening surgery assisted by retrograde intramedullary nail in the treatment of femoral shortening deformityin children. The correction of mild angular deformity and lengthening surgery can be performed simultaneously. The osteotomy site was proposed at distal metaphysealof the femur for better quality of osteogenesis and shorter duration for fixator. It is safe to osteotomy and lengthening in the area of enchondroma.

Objective To study the characteristics of the diseases spectrum in hospitalized children.Methods The items of main diagnosis,gender,age,etc.in the inpatients medical records home page data aged 0? 12 years old in second-level and above hospitals of Chongqing City during 2015 were performed the disease spectrum sequence and constituent ratio analysis for deeply digging the relation between the disease change trend with the age and sex.Results The top 5 main system diseases affecting children's health were respiratory system diseases (male 43.84％,female 45.74％),some conditions originated from prenatal period (male 12.01 ％,female 13.87 ％),infectious diseases and parasites diseases (male 9.48 ％,female 9.88 ％),digestive system diseases (male 9.09 ％,female 6.95 ％),injury,poisoning and some other consequences of external causes(male 6.86 ％,female 5.27 ％).Respiratory system diseases always ranked the first place,the sexual difference among various system disease was unobvious,the sequence of injury,poisoning and some other consequence of external causes was increased with the age increasing;in the ranking of respiratory system diseases,pneumonia(38.73 ％),acute bronchitis(17.29 ％) and acute tonsillitis(13.83％) were the top 3 diseases affecting children's health.Conclusion Respiratory system diseases are the concerned key point for children health promotion.The health and epidemic prevention departments should provide effective methods and measures for preventing respiratory system diseases in children.Furthermore,the targeted prevention and treatment measures should be proposed aiming at the difference of disease sequence in different age groups.

Objective To explore the reproduction needs of men with spinal cord injury. Methods Data was collected with questionnaire. Results 57 men with spinal cord injury had urgent needs of reproduction meanwhile professional services were deficient seriously. Conclusion The professional services for reproduction can't meet the needs of persons with spinal cord injury

Objective To explore the risks and its influencing factors of patients with psychotic disorders in communities.Methods A total of 457 patients with psychotic disorders in communities were investigated by use of the multistage stratified cluster random sampling method.Results Totally 257 patients with psychotic disorders in communities were with risks,which accounted for 56.2％.Among them,200 patients (43.8％) were with level-0 risk,113 patients (24.7％) were level-1 risk,85 patients (18.6％) were level-2 risk,43 patients (9.4％) were level-3 risk,11 patients (2.4％) were level-4 risk,while 5 patients (1.1％) were level-5 risk.There were significant differences in risks among patients with different gender,family income,duration,type of disease,medication and the history of violent behavior.Logistic regression analysis showed that low family income (OR=0.515,95％ CI=0.386-0.689,P＜0.01),long course of disease (OR=1.378,95％CI=1.179-1.609,P＜0.01),patients with schizophrenia (OR=6.285,95％CI=2.456-16.086,P＜ 0.01) and patients with a history of violence history (OR=28.988,95％CI=10.692-78.592,P＜0.01) were the risk factors of the influencing of patients with psychotic disorders in communities.Conclusions Low family income,long course of disease,patients with schizophrenia and a history of violence history are the influencing factors of patients with psychotic disorders in communities,and the management of follow-up and the strength of supervision among these patients should be reinforced.

OBJECTIVE: To explore the genetic basis of three children with unexplained mental retardation/developmental delay. METHODS: Peripheral venous blood samples were collected for routine G-banding karyotyping analysis and chromosomal microarray analysis (CMA). Whole exome sequencing (WES) was also carried out for patient 3. RESULTS: The karyotypes of the 3 children were normal. The result of CMA analysis of patient 1 was arr[GRCh37]: 2q22/3(145 128 071-145 159 029)×1, with a 31 kb deletion, which was predicted to be a pathogenic copy number variation. The deletion has involved exons 8 to 10 of the ZEB2 gene. Patient 2 was arr[hg19]:2q22.3 (145 071 457-146 881 759)×1, with a 1.81 Mb deletion involving the ZEB2 and GTDC1 genes. Patient 3 was arr[GRCh37]: 9p23p23(11 698 261-12 106 261)×1, with a 408 kb deletion containing no disease-associated gene. WES has identified a c.2102C>A (p.Ser701*) variant in exon 8 of the ZEB2 gene, which was included in ClinVar database and rated as pathogenic, and verified by Sanger sequencing as a de novo variant. CONCLUSION For the substantial clinical and genetic heterogeneity of Mowat-Wilson-syndrome, CMA and WES are helpful to identify the etiology of children with developmental delay/mental retardation of unknown causes, particularly those with peculiar facial features and multiple congenital malformations.
Child ; DNA Copy Number Variations ; Facies ; Glycosyltransferases/genetics* ; Hirschsprung Disease ; Humans ; Intellectual Disability/genetics* ; Microcephaly/genetics*