Objective To explore the association between behavioral, emotional problems and life events among adolescents, and to determine which factors of life events correlate most highly with the behavioral, emotional problems. Method A total of 1 325 adolescents were investigated with Youth Self-Report (YSR) of Achenbach’s behavior checklist and Adolescent Self-Rating Life Events Checklist (ASLEC), and the data were analyzed with canonical correlation analysis. Results Canonical correlation was statistically significant. The correlation coefficients of the first pair of canonical variables in the male and female group were 0.631 3 and 0.621 1, respectively, and the cumulative proportion of the first two pairs of canonical variables was above 0.95. In the first pair of canonical variables, the loadings of anxious/depressed, interpersonal sensitivity and study pressure were higher, while in the second pair, withdrawal and punishment were the most important factors. Conclusions The effects of life events on emotional problems mainly contributed to interpersonal sensitivity and study pressure.
Objective To review the advances in double-bundle anterior cruciate ligament (ACL) reconstruction in adolescents at home and abroad. Methods Recent literature about double-bundle ACL reconstruction in adolescents at home and abroad was extensively consulted, and the relationship between bone canal and epiphyseal plate, clinical verification of surgical safety, and clinical effectiveness of double-bundle ACL reconstruction in adolescents were summarized and analyzed. Results Double-bundle ACL reconstruction has certain advantages in clinical stability and re-rupture rate when compared with single-bundle ACL reconstruction in adolescents, and there is no significant difference in safety between them. Conclusion Double-bundle ACL reconstruction in adolescents can achieve lower re-rupture rate and better stability when compared with single-bundle reconstruction. However, the sample size of clinical research is too small, and the follow-up time is too short, so the effectiveness needs to be continuously observed.
ObjectiveTo systematically review the efficacy of exercise intervention in adolescents with mild to moderate idiopathic scoliosis (AIS). MethodsPubMed, Web of Science, The Cochrane Library, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of exercise intervention in adolescents with mild to moderate AIS from inception to November 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 16.0 software. ResultsA total of 11 RCTs involving 638 patients were included. The results of meta-analysis showed that exercise intervention significantly improved the Cobb angle of the spine in patients with AIS (MD=−1.65, 95%CI −2.63 to −0.68, P<0.01), reduced the angle of trunk rotation (ATR) (MD=−0.68, 95%CI −0.96 to −0.40, P<0.01), and increased their forced vital capacity (FVC) (MD=0.63, 95%CI 0.10 to 1.15, P=0.02). However, there was no statistically significant improvement in the forced expiratory volume in the first second (FEV1) or the ratio of FEV1/FVC between the two groups. ConclusionCurrent evidence shows that the exercise intervention could improve the Cobb angle of the spine, reduce ATR and enhance FVC. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo investigate the short-term effectiveness of proximal fixation of one vertebra above to the upper end vertebra and the upper end vertebra in the treatment of Lenke type 1 adolescent idiopathic scoliosis (AIS) patients with preoperative right higher shoulder.MethodsThe clinical data of 37 Lenke type 1 AIS patients treated with posterior correction between January 2010 and December 2015 were retrospectively analysed. According to proximal fixation vertebra, the patients were divided into 2 groups: group A (n=17), proximal fixation of one vertebra above to the upper end vertebra; group B (n=20), proximal fixation of the upper end vertebra. There was no significant difference in gender, age, Risser stage, radiographic shoulder height (RSH), flexibility of proximal thoracic curve, flexibility of main thoracic curve, flexibility of thoracolumbar/lumbar curve between 2 groups (P>0.05). The main thoracic curve Cobb angle, proximal thoracic curve Cobb angle, thoracolumbar/lumbar curve Cobb angle, apical vertebral translation (AVT), clavicle angle (CA), RSH, coronal trunk shift, sagittal trunk shift, thoracic kyphosis (TK), and lumbar lordosis (LL) were measured by X-ray film before operation, and at 1 month, 1 year, and 2 years after operation. The correction indexes of main thoracic curve were evaluated, including the correction degree and correction rate of main thoracic curve and AVT correction at 1 month after operation, the loss degree and the loss rate of the correction of main thoracic curve at 2 years after operation.ResultsThe operation time and intraoperation blood loss in group A were significantly greater than those in group B (P<0.05). All the patients were followed up, and the follow-up time was 2-4 years (mean, 2.8 years) in group A and 2-3.5 years (mean, 2.6 years) in group B. No serious complication such as nerve damage occurred during perioperative period and follow-up period. No complication such as failure of fusion, loosening and rupture of internal fixator, adjacent segment degeneration, and proximal junctional kyphosis occurred. There was no significant difference between 2 groups in the correction degree and correction rate of main thoracic curve and AVT correction at 1 month after operation, the loss degree and the loss rate of the correction of main thoracic curve at 2 years after operation (P>0.05). Comparison within the two groups: except for LL had no significant difference between pre- and post-operation (P>0.05), the other indicators were significantly improved after operation (P<0.05) in the two groups. There were significant differences in RSH, CA, proximal thoracic curve Cobb angle, and thoracolumbar/lumbar curve Cobb angle at each time point after operation (P<0.05), and there were spontaneous correction during follow-up; however, there was no significant difference in main thoracic curve Cobb angle, AVT, TK, LL, trunk shift at each time point after operation (P>0.05), and there was no significant loss during follow-up. Comparison between the two groups: there was no significant difference in all the radiographic indexes at pre- and post-operation (P>0.05).ConclusionFor Lenke type 1 AIS patients with preoperative right high shoulder, proximal fixation vertebra be fixed to the upper end vertebral can obtain satisfactory short-term orthopedic effectiveness and reduce blood loss and operation time.
Objective To systematically review literature on the influencing factors related to adolescent sub-health problems. Methods We electronically searched the following four databases including CBM, VIP, CNKI and WanFang Data to collect Chinese literature on adolescent sub-health status and problems in China published before May 2012. Two reviewers independently screened literature, extracted data, and cross checked records. Then qualitative analysis was applied. Results According to the inclusion and exclusion criteria, 41 cross-sectional studies were included. The results of qualitative analysis showed that the influencing factors of adolescent sub-health could be classified into four categories including social factors, family factors, school factors, and interpersonal relationships. The main ones were social support, employment pressure, family economic conditions, learning burden, unhealthy habits, etc. Conclusions There are many influencing factors of adolescent sub-health with interaction. Due to the limitation of the included studies, more prospective cohort studies are needed to provide high quality evidence.
ObjectiveTo systematically review the prevalence of enuresis in Chinese children and adolescents. MethodsA computer search was conducted for epidemiological research on the prevalence of enuresis among Chinese children and adolescents in databases including CNKI, WanFang Data, VIP, SinoMed, PubMed, Embase, and Web of Science. Two researchers independently carried out literature screening, data extraction, and quality evaluation. Meta-analysis was executed using R language, with baujat plots and subgroup analysis to investigate heterogeneity sources, and leave-one-out for sensitivity analysis. ResultsA total of 38 papers were included, encompassing 327 065 participants, with 18 392 children suffering from enuresis. The aggregate prevalence rate was 5.59% (95%CI 4.58% to 6.81%). The prevalence rate showed a significant decreasing trend with increasing age, with rates at ages 5, 12, and 18 being 12.30% (95%CI 9.96% to 15.11%), 2.07% (95%CI 1.68% to 2.56%), and 1.95% (95%CI 0.90% to 4.20%), respectively. The incidence rate in male children was higher at 6.36% (95%CI 5.49% to 7.36%) than that in female children at 4.30% (95%CI 3.57% to 5.16%). Using DSM-IV as the diagnostic criteria, the prevalence rate was 3.78% (95%CI 2.58% to 5.52%), while it was 5.99% (95%CI 4.75% to 7.52%) using ICCS as the criteria. ConclusionThe prevalence of enuresis among Chinese children and adolescents is affected by factors such as region, age, gender, and diagnostic standards. The prevalence is higher in South China, decreases with age, and is significantly higher in males than in females.
ObjectiveTo systematically review the association between chronotype and quality of life in adolescents. MethodsPubMed, EMbase, Cochrane Library, Web of Science, CBM, WBM, VIP, WanFang Data and CNKI databases were electronically searched to collect studies on the association between chronotype and quality of life in adolescents from inception to April 21, 2022. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. A qualitative systematic review was then performed. ResultsA total of 7 studies were included. The results of systematic review suggested that the association between chronotype and quality of life in adolescents was statistically significant. Moreover, chronotype completely affected quality of life via insomnia symptoms, sleep related irrational cognition and general self-efficacy. ConclusionCurrent evidence shows that chronotype is associated with quality of life in adolescents. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the association between acid suppressive drug use and fracture risk in children and adolescents. MethodsThe PubMed, Web of Science, EMbase, Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect observational studies on the association between acid suppressive drug use and fracture risk in children and adolescents from inception to October 1, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using R4.1.2 software. ResultsA total of 6 studies involving 1 886 423 children and adolescents were included. Meta-analysis results showed that the use of proton pump inhibitors (PPIs) increased the risk of fracture (RR=1.19, 95%CI 1.10 to 1.29, P<0.01), whereas the use of histamine H2 receptor antagonists (H2RAs) did not increase the risk of fracture (P>0.05). Subgroup analysis showed that PPIs use increased risk of fracture in the lower limb and other sites (P<0.05). ConclusionCurrent evidence shows that PPIs can increase fracture risk in children and adolescents, but no association has been found between the use of H2RAs and increased fracture risk in this group. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To analyze the cl inical features of scol iosis associated with Chiari I malformation in adolescent patients, and to explore the val idity and safety of one-stage posterior approach and vertebral column resection for the correction of severe scol iosis. Methods Between October 2004 and August 2008, 17 adolescent patients with scol iosis associated with Chiari I malformation were treated with surgical correction through posterior approach and pedicle instrumentation. There were 9 males and 8 females with an average age of 15.1 years (range, 12-19 years). The MRI scanning showed that 16 of 17 patients had syringomyel ia in cervical or thoracic spinal cord. Apex vertebra of scol iosis were located atT7-12. One-stage posterior vertebral column resection and instrumental correction were performed on 9 patients whose Cobb angle of scol iosis or kyphosis was more than 90°, or who was associated with apparent neurological deficits (total spondylectomy group). Other 8 patients underwent posterior instrumental correction alone (simple correction group). All patients’ fixation and fusion segment ranged from upper thoracic spine to lumbar spine. Results The operative time and the blood loss were (384 ± 65) minutes and (4 160 ± 336) mL in total spondylectomy group, and were (246 ± 47) minutes and (1 450 ± 213) mL in simple correction group; showing significant differences (P lt; 0.05). In total spondylectomy group, coagulation disorder occurred in 1 case, pleural perforation in 4 cases, and lung infection in 1 case. In simple correcction group, pleural perforation occurred in 1 case. These patients were improved after symptomatic treatment. All patients were followed up 24-36 months (32.5 months on average). Bony heal ing was achieved at 6-12 months in total spondylectomy group. No breakage or pull ingout of internal fixator occurred. The angles of kyphosis and scol iosis were significantly improved at 1 week after operation (P lt; 0.01) when compared with those before operation. The correction rates of scol iosis and kyphosis (63.4% ± 4.6% and 72.1% ± 5.8%) in total spondylectomy group were better than those (69.4% ± 17.6% and 48.8% ± 19.3%) in simple correction group. Conclusion Suboccipital decompression before spine deformity correction may not always be necessary in adolescent scol iosis patients associated with Chiari I malformation. In patients with severe and rigid curve or apparente neurological deficits, posterior vertebral column resection would provide the opportunity of satisfied deformity correction and decrease the risk of neurological injury connected with surgical correction.
ObjectiveTo observe the clinical efficacy of minimally invasive vitreous surgery (MIVS) for special rhegmatogenous retinal detachment (RRD) in children and adolescents.MethodsA retrospective clinical comparative study. Fourteen eyes with special type of RRD in 14 children and adolescents who received the MIVS treatment from January 2014 to January 2019 in Ophthalmology Department of The First Affiliated Hospital Ophthalmology of Air Force Military Medical University, were included in this study. Among them, 8 eyes from 8 males and 6 eyes from 6 females. The age of them ranged from 5 to 17, with the mean age of 12.64±4.11 years. The course of disease was ranged from 1 d to 1 year, and the average of it was 30 d. All the eyes developed the special type RRD, including pseudophakic and aphakic retinal detachment, giant retinal tear with retinal detachment, choroidal detachment associated with retinal detachment, and RRD with ocular dysplasia. In the 14 eyes, there was 2 eyes with retinal detachment in 1 quadrant, 4 eyes in 2 quadrants, 1 eye in 3 quadrants and 7 eyes in total 4 quadrants. All the eyes were treated with 23G or 25G MIVS and filled with irrigation solution, air and silicone oil. In addition, 10.4 months' follow-up for average after surgery were taken to observe the occurrence of retinal reattachment, BCVA and related complications in the eyes.ResultsIn the 14 eyes, 13 (92.9%) of them attained retinal reattachment and 1 eye (7.1%) got a poor retinal reattachment after one operation. At the last follow-up, all the 14 eyes (100.0%) attained retinal reattachment and 5 of them at the filling state of silicone oil. The vision of 8 eyes (57.1%) were improved, 4 eyes (28.6%) have no notable changes and 2 eyes decreased (14.3%). During the operation, iatrogenic retinal breaks were occurred in 1 eye, and silicone oil entered underneath the retina in 1 eye. After the operation, 1 eye suffered a relapse of retinal detachment after the removal of silicone oil and then were filled with it again.ConclusionsMIVS is a safe and effective way to treat the special type RRD among the children and adolescents. The rate of retinal reattachment is 92.9% after one surgery and 100.0% at the last follow-up. Therefore, MIVS can help most of eyes with special type RRD to get a stable and improved vision.