Humans ; Child ; Neurofibromatosis 1/drug therapy* ; Benzimidazoles/therapeutic use*

Group A Streptococcus (GAS) is a very important pathogen, especially for children.On a global scale, GAS is an important cause of morbidity and mortality.But the burden of disease caused by GAS is still unknown in China and also has not obtained enough attention.For this purpose, the expert consensus is comprehensively described in diagnosis, treatment and prevention of GAS diseases in children, covering related aspects of pneumology, infectiology, immunology, microbiology, cardiology, nephrology, critical care medicine and preventive medicine.Accordingly, the consensus document was intended to improve management strategies of GAS disease in Chinese children.

BACKGROUND: Shenyankangfu Tablet (SYKFT) is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease. OBJECTIVE: This trial compared the efficacy and safety of SYKFT, for the control of proteinuria in primary glomerulonephritis patients, against the standard drug, losartan potassium. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION: This was a multicenter, double-blind, randomized, controlled clinical trial. Primary glomerulonephritis patients, aged 18-70 years, with blood pressure ≤ 140/90 mmHg, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min per 1.73 m MAIN OUTCOME MEASURES: The primary outcome was change in the 24-hour proteinuria level, after 48 weeks of treatment. RESULTS: A total of 735 participants were enrolled. The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78% ± 2.56% (P = 0.006) more than that in the losartan 50 mg group, which was 0.51% ± 2.54% (P = 1.000) less than that in the losartan 100 mg group. Compared with the losartan potassium 50 mg group, the SYKFT plus losartan potassium 50 mg group had a 13.39% ± 2.49% (P < 0.001) greater reduction in urine protein level. Compared with the losartan potassium 100 mg group, the SYKFT plus losartan potassium 100 mg group had a 9.77% ± 2.52% (P = 0.001) greater reduction in urine protein. With a superiority threshold of 15%, neither was statistically significant. eGFR, serum creatinine and serum albumin from the baseline did not change statistically significant. The average change in TCM syndrome score between the patients who took SYKFT (-3.00 [-6.00, -2.00]) and who did not take SYKFT (-2.00 [-5.00, 0]) was statistically significant (P = 0.003). No obvious adverse reactions were observed in any group. CONCLUSION: SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients, with no change in the rate of decrease in the eGFR. SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone. TRIAL REGISTRATION NUMBER NCT02063100 on ClinicalTrials.gov.

Objective To systematically analyze the framework and core content of physical activity inclusive school health policies. Methods This study conducted systematic content analysis of key messages of WHO key documents related to physical activity and school health services, and constructed policy and research framework. WHO's key policy documents in the field of school health included: Making Every School a Health-Promoting School Implementation Guidelines, WHO Guidelines on School Health Services, and the Global Criteria and Indicators for Making Every School a Health-Promoting School, and the key documents in the field of physical activity mainly include Global Action Plan for Physical Activity Promotion 2018-2030: Strengthening Physical Activity for a Healthy World, and WHO Guidelines on Physical Activity and Sedentary Behavior (Children and adolescents). Results Physical activity, as a health strategy and development strategy, is one of the most important tools for achieving health-promoting schools. In the area of health and education, the key to building health-promoting schools is to focus on child functioning and development, with the goal of promoting healthy inclusion and equity in schools. In the school setting, physical activity for children and adolescents is integrated into the school health service continuum with a focus on health promotion. At the macro level, the state and relevant authorities should establish a strategic structure and strategic planning for the integration of physical activity into the school health service system. At the meso level, educational institutions should develop and improve school health service policies and programs, and improve school health service tools based on the requirements of WHO school health service guidelines. Child health services are achieved through the provision of high-quality physical education programs and after-school physical activities. At the micro level, guided by global standards for building health-promoting schools, physical activity is promoted in the form of lessons and activities for healthy child development. Integrating physical activity into the school health service system can be done in six areas: school health leadership and governance, school infrastructure funding, school health service delivery that supports physical activity, human resources for school health, school health-related medicine and technology, and school health information system. We need to implement health-promoting school policies, strengthen multi-level school leadership and governance, raise the necessary funds to develop human resources adapted to the construction of health-promoting schools and build programs to support physical activity. Conclusion School health service is an important area for promoting children's health and achieving the UN 2030 Sustainable Development Goals, and physical activity is an important strategy of school health services. Policy documents issued by WHO construct the integration of physical activity into the policy framework of the school health service system, of which the core component is to integrate physical activity into the health-promoting school with educational and physical activity approaches. According to the WHO six building blocks of health service system, the integration of physical activity into the school health requires strengthening school health leadership and governance, improving school infrastructure financing, developing school health human resources, developing school-based health-related medical technologies, and establishing a health information system for sharing student health data.

Objective To explore the theories, content and approaches of integrating physical activity in children's eye health service system in the context of health services. Methods From the perspectives of six building blocks of WHO health system, namely, leadership and governance, financing, human resources for health, service delivery, medical technology, and health information system, we analyzed the policy framework and key contents related to school-based eye health and physical activity, and explored how to promote the implementation of physical activity into the school-based eye health service system, and the integration of physical activity into the eye health continuum: prevention, intervention, rehabilitation, and health promotion. Results In perspective of health system, the integration of physical activity into school-based eye health services should be in accordance with the five principles of cross-cutting health services, namely, universal accessibility and equity, human rights, evidence-based, life-span, and empowerment. According to the World Vision Report, WHO advocates to build a person-centered eye health service system, and person-centeredness is the core concept of the new model of school-based eye health services and physical activity integration. WHO advocates a school-based approach to education and physical activity in health-promoting schools to promote student health, physical activity as a preventive, interventional, rehabilitation and health promotive measure related to children's eye health, and vigorously train professionals within schools who have knowledge and skills related to physical activity and eye health, build an information system on physical activity and children's eye health, and promote the integration of physical activity into the school-based eye health service system. Conclusion Physical activity is an important measure to promote children's eye health and an important component to achieve a person-centered eye health service system. Based on the six building blocks of the WHO health service system, a school-based eye health service that integrates a theoretical and methodological system of physical activity is constructed, requiring the provision of health promotion methods such as education and physical activity in the school setting, to enhance leadership and governance of eye health services based on educational and physical activity approaches in the school setting, establish new funding mechanisms, provide financial security, develop human resources related to physical activity for eye health, improve related service delivery systems, develop high-quality physical activity intervention eye health techniques and equipment, and integrate information on children's physical activity and eye health into school health information systems to achieve children's eye health and promote their physical and mental development.

Objective To explore the roles of frequency domain OCT in measuring the retinal thickness around the optic disc and optic disc parameters in early glaucoma diagnosis.Methods The optic disc parameters and retinal nerve fiber layer (RNFL) thickness in the 40 healthy volunteers (control group) and 85 cases of primary open angle glaucoma (POAG),including 36 patients as the early glaucoma subgroup and 49 patients as the glaucoma evolutum subgroup,were measured by frequency domain OCT.Then,the correlation analysis of RNFL thickness,optic disc parameters and the mean deviation (MD) of visual field in each group was performed,and the area under the curve was used to evaluate the diagnostic efficiency of RNFL thickness around the optic disc and optic disc parameters in the diagnosis of glaucoma.Results The RNFL thickness and the complete cycle mean RNFL thickness in the temporal,upper,nasal and inferior quadrant in the glaucoma patients were significantly lower than those in the controls (all P ＜ 0.05),and the above indexes in the glaucoma evolutum subgroup were significantly decreased compared with those in the early glaucoma subgroup (all P ＜ 0.05).There were statistically significant differences in the optic disc parameters between the groups except the optic disc area (all P ＜ 0.05).Pearson correlation analysis showed the RNFL thickness and the complete cycle mean RNFL thickness in the temporal,upper and inferior quadrant were negatively correlated with the MD in the glaucoma patients (all P ＜ 0.05),and the parameter of optic cup volume and cup/disc area ratio were positively correlated with the MD (both P ＜ 0.05),and the rim area,rim volume and disc volume were negatively correlated with MD (all P ＜ 0.05).The ROC curve analysis showed that the largest area under the curve of RNFL thickness in the inferior quadrant of the optic disc region was 0.886,and the specificity and sensitivity was 0.775 and 0.924,respectively.Moreover,the area under the curve of the optic cup/optic disc area was the largest,with sensitivity and specificity of 0.741 and 0.815,respectively.Conelusion OCT for measuring optic disc structure and RNFL thickness can be used for early diagnosis of glaucoma,and it has a high sensitivity and specificity.

Objective To explore effects of the nursing care combined with low molecular weight heparin on the lower extremity deep venous thrombosis after cesarean section incidence. Methods 192 patients who underwent cesarean section from October 2015 to October 2016 in Yongkang maternal and child health hospital, excluding the relevant taboos, according to the different nursing methods, were divided into the control group (n=96) and the study group (n=96). Two groups of patients after 24 h of cesarean section were treated with low molecular weight heparin calcium 5000 IU subcutaneous injection, once a day, continuous treatment for 5 days; the control group was given routine cesarean section nursing after the operation; the study group was given targeted nursing (psychological guidance, preoperative guidance, postoperative care, dietary guidance, exercise guidance, and environmental care). Results The incidence of deep venous thrombosis of patients (2.08%) in the study group was significantly lower than (9.38%) in the control group with statistical significance (P<0.05); the plasma D dimer in the study group was significantly lower than the control group with statistical significance (P<0.05); nursing satisfaction rate of patients in the study group was (95.83%) higher than (81.25%) of the control group with statistical significance (P<0.05). Conclusion The combination of targeted care plus low molecular weight heparin could improve the satisfaction of nursing and the quality of life, reduce the incidence of postoperative deep vein thrombosis. It is worthy of clinical application.

Objective To evaluate the clinical application and security of percutaneous endoscopic gastrostomy (PEG) with the Introducer method using ultrathin gastroseopy in dysphagia patients. Methods Clinical data of 22 cases dysphagia patients implemented with PEG with the Introducer method using ultrathin gastroseopy or conventional gastroseopy were retrospectively analyzed, the clinical effect and the complication were observed. Results 22 patients underwent PEG with the Introducer method using conventional gastroscopy (6 cases) or ultrathin gastroscopy (16 cases). Among the 16 patients underwent PEG using ultrathin gastroseopy by transnasal or peroral approach, 2 cases with trimus by received radiotherapy for nasopharyngeal cancer and 14 cases with pharyngeal or esophagus narrowing, could not completed PEG by conventional gastroscopy. The average procedure time of PEG was (12.2 ± 2.9) min in conventional gastroscopy group and (11.8 ± 3.2) min in control group. No complications were observed in these patients, but the patients in ultrathin gastroseopy group reported less discomfort associated with the procedure. 17 patients with advanced nasopharyngeal carcinoma and esophagus cancer who received PEG could completely finished 6 cycles of concurrent chemoradiotherapy. Paired-sample t test of nutrition indicators (hemoglobin, albumin and RBC) before and after the treatment showed significant difference (P < 0.05). Conclusion PEG with the introducer method using ultrathin gastroseopy is a safe and effective method of enteral nutrition, Ultrathin gastroscopy reduces the discomfort of the procedure, especially in patients with serious trimus and pharyngeal or esophagus narrowing. For patients with advanced nasopharyngeal carcinoma, preventative PEG improved the tolerance of chemoradiotherapy,reduce the incidence of adverse events.

AIM To establish HPLC fingerprints of Zhihuang Tongfeng Decoction (Phellodendri chinensis Cortex,Anemarrhenae Rhizoma,Plantaginis Semen,etc.) and to determine the contents of four constituents.METHODS The analysis of aqueous extract of this drug was performed on a 30 ℃ thermostatic Wondasil C18 column (4.6 mm ×250 mm,5 μm),with the mobile phase comprising of acetonitrile-0.5％ acetic acid in a gradient elution manner,and the detection wavelength was set at 245 nm.RESULTS There were sixteen common peaks in the HPLC fingerprints of ten batches of samples with the similarities of more than 0.9.Berberine hydrochloride,mangiferin,geniposidic acid and salvianolic acid B showed good linear relationships within the ranges of 0.636 2-3.575 μg (R2 =0.9999),0.338-1.425 μg (R2 =0.9990),0.6452-2.7188 μg (R2 =1) and0.938 8-5.275 μg (R2 =0.999 3),whose average recoveries were 100.56％,98.35％,100.25％ and 102.11％ with the RSDs of 2.41％,1.17％,1.24％ and 2.02％,respectively.CONCLUSION This accurate,reliable and specific method can be used for the quality control of Zhihuang Tongfeng Decoction.