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.

Objective:To compare the reliability between infrared thermal imaging technology(IRT) and colour Doppler ultrasound (CDU) in the detection of perforators for anterolateral femoral perforator flap(ALTPF).Methods:From September, 2017 to September, 2019, a total of 25 patients(16 males and 9 females, aged 12-53 years old with an average age of 38.7 years old) underwent ALTPF surgery for the purpose of resurfacing and reconstruction. All patients had pedicled or free ALTPF sized from 5.0 cm×8.0 cm to 7.5 cm×30.0 cm. Among all cases, 21 received free flaps and 4 received pedicled flaps. All patients underwent routine IRT and CDU examinations to locate the perforators preoperatively.Results:Of the 25 patients, CDU detected 53 perforators and IRT detected 51 "hot spots". There were 50 "hot spots" that corresponded to the findings of CDU with a κ index at 0.712( P<0.05), representing a high degree of consistency. The sensitivity and specificity were 94.3% and 85.7%, respectively. Conclusion:IRT has a high consistency in detecting perforators for ALTPF in comparison with CDU. IRT features portable, low cost, non-invasive, and easy to operate. At the same time, IRT has advantages in the patients who have thin subcutaneous tissue. With higher accuracy, IRT is expected to become an important part of preoperative perforator navigation.

Objective To understand the change of plasma lipopolysaccharide(LPS) in Kazakh children with overweight and obesity and to investigate the correlation between LPS and physical measurement indexes .Methods One hundred and four children were selected from 7648 native school age children in Altay area participating in the Epidemiological Investigation of Overweight and Obesity of School Age Children in Xinjiang as the research subjects .The physical measurement indexes such as body weight , height ,waist circumference(WC) ,hip circumference(HP) and blood pressure were measured ,and the body mass index (BMI) and waist to height ratio(WHtR) were calculated .LPS and biochemical indexes such as blood glucose(FPG) and blood lipid were detec-ted .Results With BMI increase ,the indexes including WC ,HP ,systolic blood pressure(SBP) and WHtR were also increased .The serum LPS and TG levels in the obesity group were significantly higher than those in the overweight group and control group .LPS had positive correlation with BMI grade (normal ,overweight and obesity ) ,r=0 .865 ,P= 0 .000 ,and also had positive correlation with WC (r=0 .556 ,P=0 .000) and WHtR(r=0 .477 ,P=0 .000) respectively ;the Kazakh school age chidren with WHtR abnor-mal increase had higher blood pressure and LPS level .WHtR and SBP had a positive correlation(r=0 .441 ,P=0 .000) .Conclusion LPS is correlated with overweight and obesity in Kazakh school age children .The child with abdominal obesity is easier to appear SBP abnormal elevation and LPS level increase .

OBJECTIVETo explore the surgical strategy for postburn cervical scar contracture.

METHODSSixty-five patients with scar contracture as a result of burn injury in the neck were hospitalized from July 2013 to July 2014. Release of cervical scar contracture was conducted according to different demands of the 3 anatomic subunits of neck, i.e. lower lip vermilion border-supramaxillary region, submaxillary region, and anterior region of neck. After release of contracture, platysma was released. For some cases with chin retrusion, genioplasty with horizontal osteotomy was performed. The coverage of wound followed the principle of similarity, i.e. the skin tissue covering the wound in the neck should be similar to the characters of skin around the wound in terms of color, texture, and thickness. Based on this principle, except for the preschool children in whom skin grafting was performed, the wounds of the other patients were covered by local skin flaps, adjacent skin flaps, or free skin flaps.

RESULTSAll patients underwent release of scar and platysma, while 9 patients underwent genioplasty with horizontal osteotomy. Wounds were covered with local skin flaps in 32 patients, with adjacent skin flaps in 7 patients, with free skin flaps in 11 patients, and with skin grafts in 15 patients. All skin grafts and flaps survived. Good range of motion was achieved in the neck of all patients, with the cervicomental angle after reconstruction ranging from 90 to 120°. All patients were followed up for 6 to 24 months. Six patients who had undergone skin grafting were found to have some degrees of skin contracture, while none of the patients who had undergone flap coverage showed any signs of contracture recurrence.

CONCLUSIONSRestoration of the cervicomental angle is critical in the treatment of postburn cervical scar contracture, and the release of scar contracture should conform to the subunit principle. The coverage of wound should be based on the principle of similarity, with repair by skin flaps as the first choice, and skin grafting as the second choice. Satisfactory effect of repair would be achieved by following the above surgical principles.

Burns ; complications ; surgery ; Child ; Child, Preschool ; Cicatrix ; etiology ; surgery ; Contracture ; etiology ; surgery ; Free Tissue Flaps ; Humans ; Neck ; surgery ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; methods ; Skin ; Skin Transplantation ; Superficial Musculoaponeurotic System ; Surgical Flaps ; Treatment Outcome

Objective Currently, the prefabricated flap is used for reconstructing the post-burn scar in head and face.The aim is to analyze the nature of the post-op edema in the prefabricated flaps, to determine whether it is lymphedema, and to study the prognosis of the edema.Methods From January, 2011 to March, 2015, 18 cases of post-operation edema in superficial temporal fascia prefabricated flaps were studied and each case was followed for 5 months.We used ultrasound and indocyanine green (ICG) fluorescent imaging to study the nature of the edema.Apart from that, we monitored the recovery process of the post-operation edema by a) measuring the horizontal diameter of the flap by a tape, b) measuring the thickness of the flap by the ultrasound, c) monitoring the condition of edema by ICG and d) monitoring the reconstruction and recanalization of the lymphatic system by ICG.Results Pitting edema always occurred in the prefabricated flap from the first day after operation.These patients were diagnosed as mild lymphedema (7 cases), moderate lymphedema (10 cases), and severe lymphedema (1cases) by ultrasound and ICG florescent imaging.The degree of flap lymphedema improved gradually and it improved significantly from 3 days to 6 days post-op eration.The condition of flap lymphedema became stable from the 12 days post-operation.The fluorescence image of ICG showed that the stage of flap lymphedema improved from 3 weeks post-operation and the transportation capability of lymphatic vessels increased most from the 3 days to 6 days post-op eration.We also found lymphatic vessels reconnected from the 6 days post-operation and lymphatic system reconstructed following the direction to lymph nodes.We could discover the collecting lymphatic vessels from 2 months post-operation and the lymphatic system in prefabricated flap matured from 5 months post-operation.Conclusion The post-operation edema in the prefabricated flaps is lymphedema, the incidence rate of which is high.The lymphatic drainage system recovers in 6 days after the operation.It is reconstructed along the lymph nodes.The edema disappears in 2-3 weeks post-operation, the reconstructed the lymph system matures in 5 months.

Objective To investigate the relationship between β3 - adrenergic receptor(β3 - AR)gene poly-morphism and the susceptibility of occurrence in children obesity. Methods The database of PubMed,Web of Science,Springer Link,Medlink,SinoMed,Wanfang,VIP and CNKI were systematically browsed online. The study re-ports regarding β3 - AR associated with children obesity from January 1995 to February 2014 were included in the re-search. The data were extracted,evaluated and heterogeneity tested by using software RevMan 5. 1. Results A total of 162 related literature were retrieved,and 9 of them were eligible with 1 494 obese children and 1 623 normal children were included. Allele T compared with C,the differences between the study group and the control group were statistical-ly significant(P < 0. 05),the findings from the same TC + CC compared to TT and TC compared with TT + CC were similar. Japanese research findings were similar to those of China,but the differences between the study group and the control group had no statistical significance(P ﹥ 0. 05)in Hungary. The sensitivity analysis in each study was stable and the funnel graphics were basically symmetric. The results of sensitivity analysis and publication bias diagnostics demonstrated the reliability and stability of the Meta analysis. Conclusions TC + CC/ TT,TC/ TT + CC genotype and allele T/ C are related to the occurrence of childhood obesity in China,Japan,but there is no significant correlation with childhood obesity in Hungary. There are regional difference between β3 - AR gene polymorphism and genetic susceptibility to children obesity.

Objective To evaluate the relationship between vitamin D receptor(VDR) (rs731236)single nucleotide polymorphisms and genetic susceptibility to overweight/obesity in school-age children of Han and Kazakh in Xinjiang Uygur Autonomous Region.Methods The VDR gene rs731236 genotypes were detected by using polymerase chain reaction-restriction fragment length polymorphism method in 250 overweight/obesity school-age children(127Han,123 Kazakh) and 255 healthy controls(131 Han,124 Kazakh) as well.Results (1)There were statistically significant differences in the frequencies of rs731236 genotypes and alleles between the healthy controls of Han and Kazakh (x2 =9.904,P =0.005;x2 =9.312,P =0.002).(2)There were statistically significant differences in the frequencies of TT/Tt + tt genotype and the alleles between the overweight/obesity cases and healthy controls of Kazakh (x2 =3.891,P =0.049 ; x2 =5.871,P =0.015).But the difference in frequencies of rs731236 genotypes and alleles between the overweight/obesity cases and controls of Han were not statistically significant (x2 =0.064,P =0.800 ; x2 =0.190,P =0.663).(3)There were statistically significant differences in the frequencies of TT/Tt + tt genotype and alleles between the overweight/obesity cases and healthy controls of male school-age children of Kazakh (x2 =5.25,P =0.02;x2 =4.57,P =0.03),but the differences in frequencies of rs731236 genotypes and alleles between the overweight/obesity cases and controls were not statistically significant in female school-age children of Kazakh (x2 =0.06,P =0.80 ; x2 =1.40,P =0.24).There was no statistically significant difference in the frequencies of TT/Tt + tt genotype and alleles between the overweight/obesity cases and healthy controls of female school-age children of Han (x2 =0.04,P =0.84 ; x2 =0.04,P =0.84),and there was no statistically significant difference in male school-age children of Han(x2 =0.05,P=0.82;x2 =0.18,P=0.67).Conclusions VDR gene(rs731236)polymorphism bears ethnic diffe-rence.The polymorphisms of VDR gene polymorphism rs731236 are not associated with the susceptibility to overweight/obesity in school-age children of Han,while it is associated with the susceptibility to overweight/obesity school-age children in Kazakh,especially in male school-age children.

Keloid scars are often considered aesthetically unattractive and frustrating problems that occur following injuries. They cause functional and cosmetic deformities, displeasure, itching, pain, and psychological stress and possibly affect joint movement. The combination of these factors ultimately results in a compromised quality of life and diminished functional performance. Various methods have been implemented to improve keloid scars using both surgical and non-surgical approaches. However, it has proven to be a challenge to identify a universal treatment that can deliver optimal results for all types of scars. Through a PubMed search, we explored most of the literature that is available about the intralesional injection treatment of hypertrophic scars and keloids and highlights both current (corticosteroid, 5-fluorouracil, bleomycin, interferon, cryotherapy and verapamil) and future treatments (interleukin-10 and botulinum toxin type A). The reference lists of retrieved articles were also analysed. Information was gathered about the mechanism of each injection treatment, its benefits and associated adverse reactions, and possible strategies to address adverse reactions to provide reliable guidelines for determining the optimal treatment for particular types of keloid scars. This article will benefit practitioners by outlining evidence-based treatment strategies using intralesional injections for patients with hypertrophic scars and keloids.
Bleomycin ; Botulinum Toxins ; Cicatrix ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Cryotherapy ; Fluorouracil ; Humans ; Injections, Intralesional* ; Interferons ; Joints ; Keloid* ; Pruritus ; Quality of Life ; Stress, Psychological ; Treatment Outcome

Objective To investigate intestinal bacteria genera distribution between normal weight and overweight/obesity school-age children in Yili region of Xinjiang.Methods Selecting eligible 150 fecal samples from school-age children (aged from 7 to 13 years old),all samples were divided into normal weight group and overweight/obesity group according to the body mass index (BMI),and each group contained 75 samples.Fecal samples were collected and DNA was extracted,then 6 types of intestinal bacteria genera were detected by the quantitative real-time polymerase chain reaction.Results The distribution of age,gender,ethnicity and hip circumference between 2 groups had no statistically significance (all P ＞ 0.05),except that of BMI and waist circumference (t ＝ 20.740,8.533,all P ＜ 0.01).The concentration of Lactobacillus,Clostridium and Enterococcus were significantly higher in the obese/overweight children (t =9.735,9.681,26.070,all P ＜ 0.01),whereas no significant differences were found in the concentration of Escherichia,Bifidobacterium and Bacteroides between 2 groups.According to the stratified analysis of ethnicity,gender and age,there was no significant difference among Han,Kazakh and Uyghur children.While stratified by gender,Bifidobactcrium was significantly lower in girls than that of boys (t =4.931,P ＜ 0.05).The distribution of the 6 types of intestinal bacteria genera was no statistically significant among different ethnicity,gender and age groups.Conclusions The intestinal bacteria genera number distribution in different ethnicity,gender and age groups makes no sense.The 16SrRNA type number of the Lactobacillus,Clostridium and Enterococcus may be associated with childhood obesity.

Objective The fat mass-and obesity-associated (FTO) gene is related to increased body mass index (BMI) and elevated energy intake .This study explored the contribution of the interaction between FTO gene polymorphism and 1ife style to the risk of obesity in the Kazakh schoolchildren . Methods A total of 279 Kazakh schoolchildren aged 6-13 years were selected from Yili Ka-zakh Child Obesity Study and divided into an obesity group (n=141) and a normal weight group (n=138) based on the BMI cutoffs rec-ommended by the Chinese Working Group on Obesity for Children .The children were subjected to anthropometric measurement , question-naire investigation , and determination of the rs9939609 polymorphism of the FTO gene. Results Six risk factors of obesity were extrac-ted by factor analysis, including harmful eating habits, appetite status, outdoor activities, fussiness about food, activity mode, and hours of sleep.Logistic regression analysis showed that the interaction between rs 9939609 polymorphism and appetite status constituted an obe-sity risk of 76.49%, and that between rs9939609 polymorphism and outdoor activities constituted an obesity risk of 79.95%. Conclusion Appetite status and outdoor activities might modify the relationship of the FTO gene with the risk of obesity in Kazakh school-children.However, further prospective interventions are needed verify the influence of the interaction between the FTO gene and life style on the risk of obesity.