ObjectivesTo investigate the prevalence of respiratory diseases and lung function of school-age children in Chongqing and to compare them with that of children in 25 years ago and to explore the possible causes of this change.MethodsAccording to the air quality data of Chongqing from 1998 to 2016, the annual variation of air quality days and pollutant concentrations were plotted. 2 126 school-age children in two districts of Chongqing were selected by random cluster sampling for questionnaires. 771 children were randomly selected from the children who completed the questionnaire for pulmonary function tests. The results were compared with that of 25 years ago.ResultsFrom 1998 to 2016, the number of days with good air quality in Chongqing increased annually, and the concentration of SO2 decreased significantly. The main air pollution composition changed from SO2 to PM10 and PM2.5. The prevalence of bronchitis (P<0.05) was higher than that of 25 years ago. After adjusting for confounding factors by multivariate logistic regression, the OR value of bronchitis in children was 1.667 (P<0.05) compared with 25 years ago. After adjusting for age, sex, height and weight by multiple linear regression, the results showed that the subjects' lung function indexes (FVC, FEV1, PEF and FEV3) were lower than that of 25 years ago. In this survey, there were differences in lung function indexes between children with different frequency of eating fruits and dairy products (P<0.05), and those with high frequency consumption were higher than low frequency. In terms of exercise time, subjects exercising ≥1 hour/day had greater FVC and FEV3 values than those exercising <1 hour/day (P<0.05).ConclusionsThe overall air quality in Chongqing has improved from 1998 to 2016; The respiratory health of children has decreased when compared with that of 25 years ago. Changes in the composition of air pollutants may endanger children's respiratory health, and fruit and dairy foods and exercise may be protective factors for children's respiratory health.
【摘要】 目的 探讨颅内原发生殖细胞瘤的临床特征。方法 收集华西医院脑外科2000年1月—2009年3月119例颅内原发生殖细胞瘤的临床资料进行回顾性分析。结果 发病率约占同期颅内肿瘤的 1.1%。男〖DK〗∶女=1.64〖DK〗∶1,平均发病年龄15.4岁。临床表现主要为颅内高压症状及视力视野改变,分别为61、56例；肿瘤主要来源于松果体区及鞍区；64例患者行放疗或放疗加化疗,随访45例。55例患者行手术治疗(其中术后行单纯放疗19例,放疗加化疗5例),随访36例。随访时间3~94个月,平均29.7个月。行放疗和放化疗的患者3、5年生存率明显高于单纯行手术治疗的患者。结论 颅内原发生殖细胞瘤多见于儿童及青少年,男性多见,肿瘤大多位于松果体区及鞍区。临床表现位于松果体区者主要为颅内高压症状等,位于鞍区者主要为视力视野改变、尿崩等。放疗联合化疗是主要治疗手段。
ObjectivesTo systematically review the status quo of studies on the influencing factors of early puberty timing.MethodsWe searched VIP, CNKI, CBM, WanFang Data, PubMed, Ovid, Web of Science, EBSCO and The Cochrane Library to collect studies on the influencing factors of early puberty timing published up to November 16th, 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, quantitative analysis and qualitative synthesis methods were used to analyze the studies.ResultsA total of 146 studies were included, among which 74 were case-control studies. The results showed that: the influencing factors on early puberty timing mainly included 10 aspects: obesity, dietary preference and nutritional intake, environmental endocrine disruptors, genetic, social psychologycal stress, social economic status, lifestyle, intrauterine fetal growth, maternal age at menarche and weight, adverse factors during pregnancy.ConclusionsThe current systematic review showed that obesity, genetic, environmental endocrine disruptors, intrauterine fetal growth and early maternal age at menarche may increase the risk of early puberty timing, while other factors remain controversial. While the definition of early puberty timing and related factors have not been unified, most studies focus on females and qualitative data with lack of in-depth analysis. Therefore high quality cohort studies and studies on males are required.
ObjectiveTo analyze the current status of children's clinical practice guidelines from 2010 to 2021, and to evaluate the quality of evidence-based guidelines for children. MethodsPubMed, EMbase, CNKI, WanFang Data, and VIP databases and relevant domestic and foreign guideline websites were searched to collect Chinese pediatric clinical guidelines from January 1st 2010 to September 13th 2021. Two reviewers independently screened literature, extracted data; 4 reviewers used AGREE Ⅱ to evaluate the quality of the included evidence-based guidelines. ResultsA total of 164 guidelines were included, which involved 65 evidence-based guidelines and 99 non-evidence-based guidelines, 113 western medicine guidelines and 51 traditional Chinese medicine guidelines. The majority of the diseases with high hospitalization burden were covered by those guidelines, including 35 guidelines for respiratory diseases, ranking first among all diseases. However, there was no guideline for pediatric cardiovascular disease in China. The average scores for 65 evidence-based guidelines in 6 individual domains were 65.2%, 49.6%, 59.3%, 68.5%, 23.9% and 83.6%. ConclusionsThe scores for applicability, stakeholder involvement, and rigor of development are low for Chinese guideline for children. There is a lack of pediatric clinical guidelines for circulatory disorders.