Objective:To develop the children′s postoperative health-related quality of life scale for thyroid cancer and to test its reliability and validity.Methods:The first draft of the scale was developed through literature search, focus group meetings, and a pre-survey, and 116 children (76 for testing and 40 for external validation) with thyroid cancer attending Beijing Children′s Hospital of Capital Medical University were selected to answer the scale, to screen and categorize the questions and to form the final scale with multiple dimensions.Results:The children′s postoperative health-related quality of life scale for thyroid cancer contained 5 dimensions and 29 questions. Exploratory factor analysis showed that the cumulative variance explained by the 5 factors was 64.343%. Confirmatory factor analysis showed correlations between the questions and dimensions of this scale, fair convergent validity for the scale, and good discriminant validity. The validity of the validity scale showed that there was a existing correlation between the questions and the validity scale of this scale. The item-dimension correlation coefficients showed that the questions in each dimension were well differentiated. The total Cronbach′s α coefficient of the scale was 0.930, the folded half reliability was 0.843, and retest reliabilities at 2 weeks, 1 month, and 3 months after the initial test were respectively 0.936, 0.922, and 0.910.Conclusion:The developed children′s postoperative health-related quality of life scale for thyroid cancer has good reliability and validity and can be used to assess the health-related quality of life of children after thyroid cancer surgery.

Objective:To evaluate the effectiveness and safety of ultrasound-guided percutaneous polidocanol sclerotherapy of the thyroglossal duct cysts in children.Methods:A retrospective analysis of 26 children who were treated with ultrasound-guided percutaneous puncture sclerosis for thyroglossal duct cysts in Beijing Children′s Hospital, Capital Medical University from October 2019 to April 2022, the size of the cyst before treatment was recorded, and the cyst volume in accordance with V(ml) =1/6 πabc cyst volume was calculated. The follow-up time was the 1st, 3rd, 6th, and 12th months after sclerotherapy. And the cyst volume and volume reduction ratio at different time points was calculated. According to changes in the cystic volume, the treatment was considered effective if the cyst volume reduction rate was≥50%. Cosmetic grading scores (CGS) were performed pre-treatment and at the last follow-up after sclerotherapy using the WHO grading system. Complications were recorded during the follow-up period.Results:The cyst volume before treatment was 2.67 (3.78)ml, and the cyst volume at the 1st, 3rd, 6th and 12th month after treatment were 0.66(1.83), 0.45(0.87), 0.40(0.70), 0.38 (0.63)ml, respectively, there were significant differences between pre-treatment and each time point after-treatment (all P<0.001); the volume reduction rate at the last follow-up was (81.48±14.57)%. The reduction rate of cyst volume was more than 50% at the last follow-up in 22 children, the treatment efficiency was 84.62% (22/26). The cosmetic grading scores at the last follow-up after sclerotherapy was 1.74(1.50), and it decreased significantly compared with the pre-treatment score 3.85(0)( P<0.001). There was no skin pigmentation, pain in the injection area, local urticaria and blistering after sclerotherapy, no adverse reactions such as cyst bleeding and drunkenness-like reaction, and no serious complications occurred. There were 2 cases of cysts that presented infection with fever, and no serious complications occurred. Conclusions:Ultrasound-guided percutaneous sclerotherapy is a safe and effective minimally invasive treatment for thyroglossal duct cysts in children.

Objective:To evaluate the efficacy and influencing factors of surgery combined with neoadjuvant chemoradiotherapy in the treatment of children with non-orbital head and neck rhabdomyosarcoma (HNRMS).Methods:Information from 45 children diagnosed as non-orbital HNRMS and subjected to surgery combined with neoadjuvant chemoradiotherapy in Beijing Children′s Hospital affiliated to Capital Medical University from August 2017 to July 2021 was analyzed. The patients included 25 males and 20 females, aged from 1 to 17 years old. The primary tumor site, pathological subtype, clinical stage, risk group, therapeutic regimen, resection range and outcome of all cases were also collected. The survival curves were made using the Kaplan-Meier method and the potential prognostic factors were investigated by Cox regression analysis.Results:Fifteen (33.3%) of 45 children achieved negative surgical margin under complete tumor resection. The postoperative pathological results showed that there were 20 cases of embryonic subtype, 19 cases of alveolar subtype and 6 cases of spindle sclerosis subtype. The postoperative follow-up time ranged from 4 to 71 months, with a median of 26 months. During the follow-up period, 13 children died, among whom brain metastasis was the most common cause of death, accounting for 7/13. The 3-year overall survival rate was 67.6%. Multivariate analysis showed that non-embryonic subtype ( HR=6.26, 95% CI: 1.52-25.87, P=0.011) and failure to reach R0 resection ( HR=9.37, 95% CI: 1.18-74.34, P=0.034) were independent risk factors affecting overall survival rate. Conclusion:Surgery combined with neoadjuvant chemoradiotherapy can offer a good efficacy for children with non-orbital HNRMS. Non-embryonic subtype and resection without negative operative microscopic margins are independent risk factors for poor prognosis, and brain metastasis is the main cause of death in these children.

Objective:To systematically evaluate the efficacy and safety between neoadjuvant chemoradiotherapy followed by surgery and immediate surgery in the treatment of resectable and borderline resectable pancreatic cancer.Methods:Literature review was performed from PubMed, Embase, Cochrane Library, Web of Science, CBM, Wanfang, CNKI and VIP from the inception date to February, 2020 using the key words including "pancreatic neoplasm, pancreatic cancer, surgery, preoperative chemoradiotherapy, neoadjuvant chemoradiotherapy" in both English and Chinese. The randomized controlled clinical trials (RCTs) of neoadjuvant chemoradiotherapy followed by surgery versus immediate surgery in the treatment of resectable and borderline resectable pancreatic cancer were searches. Literature screening, data extraction and estimation of the risk of bias were independently conducted by two researchers. The HR and 95% CI were used for estimating the overall survival time. The R 0 resection rate, overall incidence of postoperative complications, and mortality rate throughout treatment were assessed by the RR and 95% CI. The heterogeneity of the studies was analyzed using the I2 test. Results:A total of 4 RCTs were included. Among 400 patients, 197 cases were assigned into the neoadjuvant chemoradiotherapy combined with surgery group and 203 in the immediate surgery group. The results of Meta-analysis showed that patients in the neoadjuvant chemoradiotherapy followed by surgery group obtained longer overall survival ( HR=0.76, 95% CI: 0.60-0.97, P=0.03) and higher R 0 resection rate ( RR=1.72, 95% CI: 1.40-2.13, P<0.01). Besides, the overall incidence of postoperative complications ( RR=1.02, 95% CI: 0.73-1.43, P=0.90) and mortality rate throughout treatment ( RR=1.19, 95% CI: 0.48-2.93, P=0.71) did not significantly differ between two groups. Conclusions:During the treatment of resectable or borderline resectable pancreatic cancer, neoadjuvant chemoradiotherapy followed by surgery may bring more survival benefits than immediate surgery and does not increase the incidence of postoperative complications and mortality rate throughout treatment. Therefore, neoadjuvant chemoradiotherapy followed by surgery can be used as a recommended treatment for patients with resectable or borderline resectable pancreatic cancer.

Objective:To systematic review the clinical efficacy and safety of neoadjuvant chemotherapy and neoadjuvant concurrent chemoradiotherapy for resectable esophageal squamous cell carcinoma.Methods:Literature search was performed from Web of Science, Pubmed, Cochrane Library, Embase, CBM, Wanfang Data, CNKI and Chongqing VIP. The clinical controlled studies of neoadjuvant chemotherapy versus neoadjuvant concurrent chemoradiation in the treatment of resectable esophageal squamous cell carcinoma was searched. Relevant outcome indicators were analyzed by Revman 5.3 statistical software.Results:Nine studies were included, with a total of 1, 369 patients. Compared with the neoadjuvant chemoradiotherapy, the neoadjuvant chemotherapy had lower overall survival rates at 3 and 5 years( OR=0.68, 95% CI: 0.53-0.86, P<0.05; OR=0.51, 95% CI: 0.34-0.77, P<0.05) , lower pathological complete remission rate( OR=0.28, 95% CI: 0.18-0.45, P<0.05)and R0 resection rate( OR=0.39, 95% CI: 0.22-0.68, P<0.05), The total postoperative complication rate is similar( OR=1.07, 95% CI: 0.75-1.51, P>0.05). Conclusion:Neoadjuvant concurrent radiochemotherapy maybe superior to neoadjuvant chemotherapy among patients with resectable esophageal squamous cell carcinoma.

Gastric schwannoma is a tumor originating from mesenchymal tissue. The clinical incidence is relatively rare, accounting for 6.3% of all gastric stromal tumors. The tumor is more likely to occur in the body of the stomach and usually originates from the gastric submucosal nerve. Most gastric schwannomas do not have any clinical symptoms. Imaging examination can play a diagnostic role, but the diagnosis still requires pathological examination, especially S-100 protein which is the gold standard for the diagnosis of gastric schwannomas. Gastric schwannoma usually needs to be distinguished from gastrointestinal stromal tumors and gastrointestinal autonomic nerve tumors. In terms of treatment, complete surgical resection is the first choice.

Objective: To investigate the snoring status and related family factors of children from 3 to 14 years old in Beijing. Methods: From May to July, 2015, data of children from 3 to 14 years old were obtained from a status survey from 7 districts(Xicheng, Chaoyang, Changping, Shunyi, Fangshan, Huairou and Mentougou) in Beijing. A total of 11 420 children from 25 primary and middle schools were randomly selected. Pediatric Sleep Questionnaire (PSQ) and a self-administered questionnaire were carried out for the adopted children. Self-administered questionnaire included the snoring related family factors. Logistic regression was used to estimate the odd ratio(OR) with 95% confidence intervals for variables. Results: A total of 9 198 children meet the inclusion criteria and are analyzed in the study, of whom 901 (9.80%) were found with snoring behavior. The incidence of boys is higher than girls. Obese children take higher risk of snoring. Compared with younger children (≤6 years old), older children (≥12 years old) have a significantly lower risk of snoring (OR=0.464, 95%CI 0.368-0.585). There is no statistical association between full-term infants, infant feeding pattern, parental cigarette smoking and child snoring.The children with family history of snoring have a significantly higher risk of snoring occurrence. The educational background of mother is statistically related to children snoring (OR=1.241, 95%CI 1.058-1.457). Conclusions The incidence of children snoring in Beijing is 9.80%, male gender, obesity, and young age are all risk factors for children snoring. There is a significantly statistical relationship between snoring and related family factors, such as family snoring history and education experience.

Objective: To investigate the sleep quality of children in Beijing and to analyze the related factors. Methods: The data were collected from the survey of 3-14 years old children in 7 urban districts of Beijing in 2015. By using multi-stage stratified cluster random sampling method, 26 kindergartens and primary and secondary schools in 7 districts and counties, including Xicheng, Chaoyang, Changping, Shunyi, Fangshan, Huairou and Mentougou, were randomly selected, with a total of 11 420 children. Children′s sleep status was investigated with Children′s Sleep Questionnaire (PSQ), and the proportion of children with sleep quality problems when the PSQ score was greater than 7. Various sleep related factors were investigated with self-made questionnaire. A multilevel model was used to analyze the relationship between PSQ score and related factors. Results: The average PSQ score of the children was 3.60±2.69. The proportion of children with sleep quality problems was 8.87%(816/9 198). Multilevel model analysis showed that the younger the children, the higher the PSQ score (<6 years old vs. 6~12 years old vs. >12 years old: 3.94±2.58 vs. 3.58±2.66 vs. 3.30±2.84, F=33.015, P<0.001); male PSQ score higher than female (3.89±2.75 vs. 3.30±2.60, t=10.560, P<0.001); and snoring, obesity, father/mother snoring, playing games before bed, surfing the internet, eating and other factors were statistically related to PSQ. Conclusions Sleep quality of children in Beijing should not be neglected, especially preschool children with high PSQ scores. Parents should pay attention to children′s snoring problems and try to reduce some pre-sleep behaviors that may affect sleep quality.

Objective To assess the safety and influence of the stents extended into inferior vena cava in patients with non-thrombotic iliac vein lesions (NIVLs) on the bilateral iliac vein blood flow.Methods We retrospectively reviewed data from July 2008 to June 2017 in 197 patients with NIVLs who underwent iliac vein stenting and complete follow-up was obtained at our institution.Of these patients,stents extended into IVC more than 10 mm in 141 cases,less than 5 mm in 22 cases,and 34 cases were between 5 and 10 mm.Restenosis and thrombosis of bilateral iliac vein and patency of these stents were assessed in the follow-up.The count data were expressed by percentage (％),and the sample comparison rate was analyzed by Fisher exact test formula.The measurement data were first tested for normal distribution and homogeneity of variance,and then corrected t test.Results The two hundred and five iliac vein stents were placed in 197 patients.During a mean follow-up of 58.7 months (6 to 98 months),there were no thrombosis occurred in the contralateral iliac vein,6 patients suffered restenosis or new thrombosis in the stents,the incidence between stenting positions less than 5 mm (13.6％,3/22) and those more than 5 mm (3.43％,6/175) was sighificantly different (P ＜0.001),and 5 of 6 patients had a good patency after endovascular therapy.During the fllow-up,the primary and assisted-primary patency rates were 97.0％ and 99.5％.Conclusions From these data,it appears that there is a very high patency rates of the stenting treatment for the NIVLs,and it is safe for the stents extended into the IVC,stenting across the iliocaval confluence can result in a small number of new contralateral thromboses.Moreover,the risk of stents restenosis or occlusion is high when stents are not extended into IVC.

Objective: To investigate the snoring status of school-aged children in Beijing and explore the association of snoring and academic performance. Methods: A total of 7 925 children aged from 6 to 14 were selected from 15 primary and middle schools at 7 districts (Xicheng, Chaoyang, Changping, Shunyi, Fangshan, Huairou and Mentougou) in Beijing in 2015, using multi-stage stratified cluster random sampling method. The recruited children were asked to complete the Pediatric Sleep Questionnaire (PSQ) and a questionnaire related to sleep behavior. The multiplelogistic regression was used to analyze the association of snoring and academic performance. Results: A total of 794 (12.44%) children showed a decline in academic performance among 6 383 eligible respondentsfor data analysis. 580 (9.08%) children with snoring was identified, of which 333 and 247 were in frequency of 1-2 times per week and frequency of ≥3 times per week, respectively; 357, 170 and 53 were in snoring grade Ⅰ, grade Ⅱ and grade Ⅲ, respectively. Compared with the children without snoring, the OR (95%CI) for children with 1-2 times per week and ≥3 times per week was 1.363 (1.000-1.857) and 1.605 (1.135-2.269), respectively; and the OR (95%CI) for children with grade Ⅰ, grade Ⅱ and grade Ⅲ of snoring was 1.226 (0.893-1.683), 1.595 (1.062-2.397) and 2.31 (1.17-4.565), respectively. Conclusion There is a statistical relationship between snoring and the decline of academic performance. The decline of academic performance positively associated with increased frequency and grade of snoring.