【Objective】 To investigate the incidence of clinical massive blood transfusion in hospitals, the proportion of departments conducted massive blood transfusion and the current situation of component transfusion, so as to provide a theoretical basis for medical decision-making and further research on massive blood transfusion. 【Methods】 The basic clinical data and transfusion of blood components were retrospectively collected from 489 patients (514 occasions) who received massive blood transfusion at Sun Yat-sen Memorial Hospital of Sun Yat-sen University from Jan. 1 2014 to Dec. 31 2018. 【Results】 The incidence of massive blood transfusion during the 5-year period was 1.2/1 000 inpatients (95%CI: 1.1-1.3), and the 30-day all-cause mortality was 21.88%; in the departments where massive blood transfusion occurred, the mortality rate was the highest in the trauma emergency department (60%), followed by intensive care unit (56.25%) and other surgery department (46.67%), while there was no death in the obstetric department. All patients received red blood cells [median 14 U (11.5-19.13)] and plasma [median 1 600 mL (1 200-2 200)], of which 47% received platelet [median 0 U (0-10)] and 32.68% received cryoprecipitate [0 U (0-10)]. The results of logistics regression analysis of all-cause mortality risk showed that compared with the youth group, the risk of all-cause death at 30 days of elderly patients over 65 years old (65 < age ≤79 years old: OR=2.471, 95%CI=[1.044, 5.847], P<0.05; patients with age > 80 years old: OR=7.563, 95%CI=[1.587, 36.049], P<0.05) and 24-hour RBC infusion volume greater than 18 U (18≤RBC<27: OR=2.948 95%CI=[1.592, 5.462], P<0.05; RBC≥28: OR=3.992, 95%CI=[1.178, 13.536], P<0.05) was higher. 【Conclusion】 A dynamic definition should be included in massive transfusion studies. If only a 24-hour RBC infusion volume ≥18 U was used as the mass transfusion definition, about 68% of cases would be lost. The mortality rate of patients with massive blood transfusion was higher, and the incidence of massive blood transfusion was higher in the departments of cardiac surgery, general surgery and orthopedics surgery. More attention should be paid to the increasing number of female patients with massive blood transfusion. In addition, the risk of 30-day all-cause death was highest in elderly patients over 65 years of age and those with a 24-hour erythrocyte transfusion level of ≥18 U.

Objective: To understand physical activity status of children and adolescents in Tujia inhabited areas, and to provide reference for the intervention model of physical activity of children and adolescents in minority areas. Methods: A cluster sample of 2 466 Tujia pupils from two primary schools in Lichuan City, Enshi Tujia and Miao Autonomous Prefecture of Hubei Province was selected to investigate physical activity status of Tujia pupils. The univariate χ 2 test was used to analyze the physical activity status of Tujia children and adolescents and its influencing factors. Results: The median duration of high intensity activity was 49.9 minutes/day in the last week, and 47.93% of participants met the physical activity standard( χ 2=80.47, P <0.01), the median duration of sitting was 396.1 minutes/day in the last week, and the qualified rate of screen time was 78.99%, and the differences of qualified rate between daystudents and residential students were of statistical differences( χ 2=35.12, P <0.01)). Conclusion The children and adolescents in the Tujia community are lack of physical activity. Therefore, it is necessary to take effective intervention measures to pay attention to the children and adolescents physical activity.

Objective: To understand the prevalence of low vision among Tujia and Han children and adolescents in Tujia inhabited areas, and to provide reference for the prevention and control of myopia in children and adolescents in minority areas. Methods: A cluster sampling of Tujia and Han primary school students from two primary schools in Lichuan City, Enshi Tujia and Miao Autonomous Prefecture, Hubei Province (2 466 Tujia and 971 Han) were selected for visual acuity assessment. Univariate χ 2 test and multivariate Logistic analysis were used. Low vision and associated factors between Tujia and Han nationality were compared. Results: The overall detection rate of low vision among children and adolescents in Tujia inhabited areas was 44.9%. There were differences in the degree of low vision in the left and right eyes of individuals, and the detection rate of low vision varied significantly by ethnic, gender and grade ( χ 2=22.10, 18.43, 19.06, 17.97 for the left eye, 17.52, 20.44, 21.49, 18.61 for the right eye, P < 0.05). There were many factors affecting low vision among children and adolescents in Tujia inhabited areas, overweight and obesity were negatively associated with low vision ( OR=1.81, 1.70, 95%CI=1.76-1.92, 1.66-1.82, P <0.01). Conclusion Low vision is highly prevalent in Tujia children and adolescents. Effective intervention measures should be taken to treat and prevent myopia in children and adolescents.

Objective: To investigate effectiveness of different intensities of basketball exercise on body compositions among obese junior middle school students, and to provide theoretical support for healthy weight loss among obese children and adolescents. Methods: From September to November 2020,a typical sampling method was used to select 48 obese junior middle school students were recruited from Wuhan Optical Valley Experimental Middle School according to body mass index(BMI), all the students were divided into high, moderate and low intensity basketball training group, as well as the control group, the 45 min per times basketball exercise intervention was administered three times per week for 12 weeks, while the control group did not received no intervention, body composition was assessed before and after intervention. Results: After 12 weeks of low intensity basketball exercise, the percentage of body fat of obese junior high school students after intervention was significantly higher than that before intervention[(32.16±2.26)% v.s. (34.33±2.35)%] ( t =3.52, P <0.05). There was no significant difference in other indexes body weight, body mass index, waist circumference, skeletal musclebetween before and after intervention ( t =2.31, 1.98, 1.26,-1.65, P >0.05). For moderate intensity basketball exercise group obdy weight, BMI, percentage of body fat and waist circumference showed statistical changes before and after intervention( t=3.44, 3.76, 6.56, 2.45, P <0.05). For high intensity basketball exercise group, all body composition indicators showed significant changes( t=4.14, 5.18, 11.26, 5.89, -2.56, P <0.05). Conclusion Twelve weeks of basketball exercise can effectively improve body composition of obese junior middle school students, with higher the intensity of exercise, the better the effectiveness.

Objective: To understand physical development of children aged 7 to 12 in the oroqen autonomous banner experimental primary school in the oroqen settlement area from 2013 to 2018, and to provide scientific basis for their physical fitness and health. Methods: According to the standards of "National Student Physical Health Standards (2014 Revised Edition)" and the standards of "Overweight and Obesity Screening for School age Children and Adolescents" issued by the National Health and Family Planning Commission in 2018, the Oroqen Autonomous Banner Experimental Primary School was 7-12 years old. The average value and growth rate of children s height, weight and BMI in the past 6 years. Results: From 2013 to 2018, the height and weight of boys and girls aged 7 to 12 showed an increasing trend, with height growth values of boys were 1.8,1.7,1.9,2.6,5.7,5.9 cm,girls were 2.8,4.5,1.9,1.8,3.6,2.9 cm.And the weight groups values of boys were 2.2,2.5,5.1,6.3,6.4,7.2 kg,girls were 2.4,3.6,3.1,1.3,4.6,3.0 kg. The growth rate of girls aged 7 to 8 was higher than that of boys, and the growth rate of boys aged 9 to 12 was higher than that of girls. With the increase of age, the average BMI of boys and girls aged 7 to 12 showed an upward trend, and the BMI of boys of the same age was always higher than that of girls. Among them, the average BMI of boys aged 7 to 12 in 2018 exceeded the critical value of overweight BMI. Conclusion The physical shape of children aged 7-12 years increases with age, but the development tends to be overweight and obese, which is related to the natural environment of life, lifestyle, and reduction in physical activity.

BACKGROUND: The 2019 novel coronavirus disease (COVID-19) emerges in China, which spreads rapidly and becomes a public health emergency of international concern. Chinese government has promptly taken quarantine measures to block the transmission of the COVID-19, which may cause deleterious consequences on everyone's behaviors and psychological health. Few studies have examined the associations between behavioral and mental health in different endemic areas. This study aimed to describe screen time (ST), physical activity (PA), and depressive symptoms, as well as their associations among Chinese college students according to different epidemic areas. METHODS: The study design is cross-sectional using online survey, from 4 to 12 February 2020, 14,789 college students accomplished this online study, participants who did not complete the questionnaire were excluded, and finally this study included 11,787 college students from China. RESULTS: The average age of participants was 20.51 ± 1.88 years. 57.1% of the college students were male. In total, 25.9% of college students reported depression symptoms. ST > 4 h/day was positively correlated with depressive symptoms (β = 0.48, 95%CI 0.37-0.59). COVID-19ST > 1 h/day was positively correlated with depressive symptoms (β = 0.54, 95%CI 0.43-0.65), compared with COVID-19ST ≤ 0.5 h/day. Compared with PA ≥ 3 day/week, PA < 3 day/week was positively associated with depression symptoms (β = 0.01, 95%CI 0.008-0.012). Compared with low ST and high PA, there was an interaction association between high ST and low PA on depression (β = 0.31, 95%CI 0.26-0.36). Compared with low COVID-19ST and high PA, there was an interaction association between high COVID-19ST and low PA on depression (β = 0.37, 95%CI 0.32-0.43). There were also current residence areas differences. CONCLUSIONS Our findings identified that high ST or low PA was positively associated with depressive symptoms independently, and there was also an interactive effect between ST and PA on depressive symptoms.
Adult ; COVID-19/psychology* ; China/epidemiology* ; Cross-Sectional Studies ; Depression/etiology* ; Exercise ; Female ; Humans ; Male ; Mental Health/statistics & numerical data* ; Screen Time ; Students/psychology* ; Time Factors ; Universities ; Young Adult

Objective: To understand the differences in physical indices, physical functions, and physical fitness among primary school students of De’ang and Han nationalities in the De’ang community, and to provide a reference for the healthy development of the physique of children and adolescents. Methods: The cluster sampling method was used to select the test data of height, weight, vital capacity, 50 meter running, seated forward flexion, and 1 minute skipping rope of 2 493 De’ang and Han pupils in five complete primary schools in Mangshi, Dehong Prefecture. Differences in each indices were compared between groups. Results: For physical indicators: height in boys in 8,9 and 11 year old group, girls in 7 and 8 year old group, were significantly higher in Han nationality,weight among Han boys of 9 years old was higher than Deang nationality; For physical function indicators: vital capacity of girls 11 years old group and 12 years old group, boys 9 years old group, 10 years old group, 12 years old group, children of Han nationality were higher than Deang peers. For physical fitness indicators: in 50 m running, Han boys of 8,9,10 and 12 year old,as well as Han girls of 8 year old were higher than age matched peers of De’ang nationality;For seated forward flexion, Han boys of 11 years old and girls of 9 years old, were lower than Deang; in 1 min skipping, Han boys of 9,10,11 and 12 year old,as well as Han girls of 9 and 10 year old, were lower than the De’ang nationality. Conclusion Unbalanced development of physical fitness is observed among primary school students of De’hong and Han nationality, with significant differences in physical, functional and fitness indices.

Objective: To explore body shape changes among Jinuo boys and girls aged 7-12 years during 2011 to 2016, and to fill in the data gaps of the "National Physique Monitoring" and "Chinese Students’ Physique and Health" database. Methods: Height and weight of children aged 7-12 years living in Jinuo nationality during 2011-2016 were measured. Inter-and intra-individual variation in body mass index (BMI) and BMI growth rate of Jinuo male and female girls were compared. Results: From 2011 to 2016, boys and girls aged 7-12 years living in Jinuo community showed an overall increase trend in height. Some temporal and small declines in specific year were also noticed; the overall weight average showed an increasing trend; BMI increased with the age. The trends in boys and girls are basically the same. Growth rate in BMI showed a positive increasing trend. Conclusion During 2011-2016, body shape among boys and girls aged 7-12 years living in Jinuo community is generally thin. All the indicators in body shape show an increasing trend with age, which fits within the basic principal of human growth and development.

Objective To determine the diagnostic value of cardiovascular magnetic resonance (CMR) in children with myocarditis. Methods A total of 27 children with myocarditis were examined with cardiac MRI, including 16 new?onset cases and 11 chronic cases, as well as 14 cases with non?myocarditis. Sequences included SSFP in axial, two chamber, four chamber and short axis, T2?weighted triple inversion recovery, T1?weighted spin echo before and after gadolinium injection, and inversion recovery?gradient echo after gadolinium injection(late gadolinium enhancement, LGE) in axial and short axis. Qualitative and quantitative image analysis was performed to obtain focal T2 signal intensity and early enhancement signal intensity(SI) ratio of myocardium to skeletal muscleon EGE and LGE.The sensitivity, specificity and accuracy were calculated. Mann?Whitney and χ2 test were used for statistical comparison. Results The median value of EF was 60.20%(44.40%,70.20%), median value of T2W SI ratio was 2.50(2.04, 3.79),and there were 13 cases with LGE positive findings in myocarditis group. The median value of EF was 73.60%(65.40%,75.85%), the median value of T2WI SI ratio was 1.85(1.77, 2.15), and one case presented LGE positive sign in non?myocarditis group. There were significant statistical differences between the two groups (Z=-2.94,-2.52 ,χ2=5.19 ,P<0.05). The sensitivities for T2WI, EGE, LGE were 81.5%(22/27), 14.8%(4/27) and 48.1%(13/27) respectively. The specificities for T2WI, EGE, LGE were 57.1%(8/14), 100.0%(14/14)and 92.9%(13/14) respectively. The diagnostic accuracies for T2WI, EGE, LGE were 73.2%(30/41), 43.9%(18/41) and 63.4%(26/41) respectively. The best diagnostic performance was obtained when“any?two”of the three sequences were positive in the same patient, yielding a 51.9%(14/27)sensitivity, 92.9%(13/14) specificity, and 65.9%(27/41) diagnostic accuracy.Conclusions The combined CMR approach using T2?weighted imaging, early and late gadolinium enhancement, provides a high diagnostic accuracy and is a useful tool in the diagnosis and assessment of children with myocarditis.

Objective To assess the application value of high time-resolved MR angiography (TR-MRA) in postoperative follow-up study of children with congenital heart diseases. Methods Seventy-three patients (median age 6 years, range 1-20 years) with congenital heart diseases who underwent TR-MRA scan after operation were retrospectively analyzed. Twenty-nine cases also were performed conventional contrast-enhanced MRA and forty-four cases were performed phase-contrast MRA. A 3D T1-weighted fast gradient-echo sequence was used for time-resolved three-dimensional MRA (10-20 dynamic data sets, less than three seconds per dynamic data set). The flow dynamics and morphology of pulmonary circulations, lung perfusion and collaterals flow direction were noted. All imaging quality was evaluated by using 5 scales. Left and right pulmonary artery flow volumes were measured and left and right pulmonary artery ratio was noted. SPSS22.0 was used in statistic analysis. The statistical analysis of comparing imaging quality was performed by using paired t-test. The intermodality agreement between TR-MRA and phase contrast in assessing left and right pulmonary perfusion was tested by Kappa coefficient. Results In 73 cases, imaging scores were over 3 and imaging quality was good enough for diagnosis. In 29 cases, there was no statistic difference between TR-MRA and conventional CE-MRA in demonstrating great vessels (P>0.05) except that CE-MRA scores(3.77 ± 0.39)was higher than TR-MRA scores(3.44 ± 0.55)of
inferior vena cava (IVC). There was statistic difference(t=3.68,P=0.01)between two sequences. TR-MRA could qualitatively demonstrate the pulmonary perfusion comparing to the results of PC. In PC sequence, there were 8 cases with symmetric and 36 cases with asymmetric left and right pulmonary perfusion. In TR-MRA sequence, there were 6 cases with symmetric and 38 cases with asymmetric left and right pulmonary perfusion. There was an excellent agreement between PC and TR-MRA (Kappa=0.83,P=0.01). Conclusions TR-MRA not only supplies with high spatial resolution imaging which demonstrates postoperative great arteries anatomy and also with high temporal resolution imaging which can demonstrate the preferential or balanced pulmonary blood flow and collaterals flow direction. TR-MRA is a very important sequence in follow-up study of congenital heart disease.