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Objective@#To understand the trend of changes of hygiene status in the teaching environment among primary and secondary schools in Beijing City during 2016-2020, so as to provide basis for further improving the teaching environment and campus hygiene conditions in primary and secondary schools.@*Methods@#A proportional systematic sampling method covered over 50% of schools selected annually in Beijing from 2016 to 2019, and 34% were selected in 2020. Two representative classrooms were selected from each selected school for testing based on their structure and other factors, with 6 196 classrooms supervised, from 2016 to 2020,1 330,1 312,1 384,1 322,848 classrooms were monitored for each year.@*Results@#From 2016 to 2020, the overall lighting qualification rate of classrooms (lighting coefficient 72.8%, window to floor area ratio 41.8%, rear wall reflectance ratio 42.2%, blackboard reflection ratio 37.4%), the overall qualification rate of average blackboard illumination and uniformity (50.6%, 34.9 %), and the overall qualification rate of desk and chair allocation (58.6%) were all below 80%. The overall qualification rate of per capita classroom area (87.5%), blackboard size (83.2%), average desk illumination ( 80.1% ), average desk illumination and uniformity (82.9%), the distance between lamp and desk (99.1%), carbon dioxide ( 86.6% ), temperature (84.9%), and noise (96.6%) were all above 80%. The following indicators, blackboard size, the distance between lamp and desk, average blackboard illumination, lighting coefficient, blackboard reflectance, rear wall reflectance, carbon dioxide, temperature, and noise ( χ 2=78.38, 9.71, 11.76, 320.59, 37.63, 58.45, 236.45, 1 347.56, 101.97), had statistically significance between years. Among those indicators, the qualified rates of blackboard size, blackboard reflectance, lighting coefficient, and noise had been increasing year by year ( χ 2 trend =69.98, 15.82, 240.02, 5.77) ( P <0.05). The qualified rates of per capita classroom area, window to floor area ratio, and blackboard reflection ratio in primary schools (81.6%, 39.8%, 36.3%) were all lower than those in secondary schools (94.9%, 44.5%, 40.3%) ( χ 2=246.32, 12.03, 10.51, P <0.05). The qualified rates of blackboard size, average blackboard illumination, average blackboard illumination and uniformity, and desk and chair allocation (89.3%, 55.6% , 36.0%, and 60.2%) were all higher than those in secondary schools (75.4%, 44.1%, 33.3%, and 56.5%) ( χ 2=209.33, 78.41, 4.44, 8.22) ( P <0.05). The qualified rates of average desk illumination and uniformity, average blackboard illumination, rear wall reflectance ratio, desk and chair allocation, carbon dioxide, temperature, and noise indicators in urban area (82.9%, 84.1% , 51.9%, 45.0%, 60.9%, 91.2%, 89.5%, 97.8%) were all higher than those in suburban area (77.3%, 81.7%, 49.2%, 39.5%, 56.3%, 82.3%, 80.4%, 95.5%) ( χ 2=31.16, 6.28, 4.36, 16.40, 13.39, 105.29, 98.23, 24.66， P <0.05). The qualified rates of the distance between lamp and desk, lighting coefficient, window to floor area ratio, blackboard size, blackboard reflection ratio, average blackboard illumination and uniformity, and per capita classroom area in urban areas (98.8%, 65.2%, 34.3%, 76.7%, 35.9%, 30.1%, 84.6%) were all lower than those in suburban areas (99.4%, 81.4%, 49.8%, 89.7%, 40.2%, 39.6%, 90.3%) ( χ 2=6.80, 171.67, 132.43, 188.46 , 12.45, 60.28, 44.82) ( P <0.05).@*Conclusions@#The main problems in the teaching environment of schools in Beijing are classroom lighting, as well as desk and chair allocation. The findings suggest technical rationality and operability of relevant standard should be considered when under revision, and standard training and supervision management should be strengthened, with the aim of teaching environment improvement.
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Objective@#To analyze the status of health risk behaviors among middle school students in Beijing City from 2018 to 2022, in order to provide reference for scientific and effective intervention.@*Methods@#Using multi stage stratified cluster random sampling method,data of student health and associated factors monitoring among 84 712 middle school students from 16 districts of Beijing during 2018 to 2022 were compared regarding the differences of health risk behaviors among students in different groups by Chi quare test. And their change trends were evaluated by annual percentage change (APC). @*Results@#In the five surveys during 2018 to 2022,reporting rates of unhealthy diet, unintentional injury, intentional injury, substance abuse and Internet addiction (only in 2018 and 2020) behaviors were higher in boys than in girls ( χ 2=4.91-297.52, P ＜0.05).Reporting rate of physical inactivity behavior in girls was higher than that in boys ( χ 2=56.49-160.88, P ＜0.05). Reporting rates of unhealthy diet, physical inactivity, unintentional injury (except 2021), substance abuse and Internet addiction (only in 2018 and 2019) behaviors were the highest in vocational high school, followed by general high school, and the lowest in junior middle school ( χ 2=23.30-1 285.98, P ＜0.01). Intentional injury behavior was highest in junior high school, followed by vocational high school, and lowest in general high school ( χ 2=96.18-378.32, P ＜0.01).Reporting rate of Internet addiction (2020-2022) behavior was highest in general high school, followed by vocational high school, and lowest in junior high school ( χ 2=16.93-60.11, P＜0.01). Reporting rates of unhealthy diet, intentional injury (2020 and 2022) and substance abuse (except 2018) behaviors were higher in suburban areas than in urban areas (χ 2=6.70-117.56, P＜0.05). Reporting rates of physical inactivity, unintentional injury, intentional injury (2018 and 2019) and Internet addiction behaviors were higher in urban areas than in suburban areas (χ2=3.90-130.80, P＜0.05). Standardized rates of unintentional injury, intentional injury, substance abuse and Internet addiction behaviors showed a statistically significant downward trend from 2018 to 2022 (APC=-14.16, -13.43, -16.03, -8.48, t =-6.94, -4.46, -11.98, -4.36, P ＜0.05).@*Conclusions@#During 2018-2022, unintentional injury, intentional injury, substance abuse and Internet addiction behaviors of middle school students in Beijing City have improved, and the reporting rates of unhealthy diet and physical inactivity behaviors are high and don t show a downward trend. Efforts should be made to strengthen intervention in unhealthy diet and physical inactivity behaviors among middle school students, in order to reduce the occurrence of health risk behaviors.
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Objective@#To analyze prevalence and associated factors of attempting e cigarettes use among senior high school students in Beijing City between 2019 and 2023, in order to providing references for the construction of smoke free senior high schools environments.@*Methods@#In 2019, 9 137 students from 44 senior high schools in Beijing City were monitored, including 27 general senior high schools and 17 vocational senior high schools. In 2023, the study included 6 709 students from 30 senior high schools comprising 21 general senior high schools and 9 vocational senior high schools. On site investigations using anonymous questionnaires were conducted. The monitoring content included demographic information, second hand smoke exposure, tobacco product use and tobacco awareness. Chi square test was used to compare the differences of various indicators in different groups, and multivariate Logistic regression analysis was adopted to analysis the influencing factors among senior high school students attempting to use e cigarettes between 2019 and 2023.@*Results@#In 2019, the rates of vocational senior high school and general senior high school students attempting to use e-cigarettes were 22.57% and 9.78%, respectively. In 2023, it decreased to 14.39% and 6.43%, respectively. In 2019 ( OR =1.59,95% CI =1.35-1.88) and 2023 ( OR =1.71,95% CI =1.38-2.11), vocational senior high school students both hold higher risk of attempting to use e-cigarettes,compared with general senior high school students. In 2019, non-indigenous senior high school students attempting to use e cigarettes were more than indigenous senior high school students ( OR = 1.28 , 95% CI =1.05-1.56). In 2019 ( OR =1.62, 95% CI =1.34-1.95) and 2023 ( OR =1.77, 95% CI =1.35-2.31), smoking anywhere in households increased the risk of attempting to use e-cigarettes among senior high school students. In both 2019 and 2023, not attempting to smoke cigarettes ( OR =0.24,95% CI =0.21-0.29; OR =0.15,95% CI =0.11-0.19), not currently smoking cigarettes ( OR =0.29,95% CI =0.22-0.40; OR =0.30,95% CI =0.17-0.53), not being exposed to secondhand smoke in school ( OR =0.62, 95% CI = 0.53 -0.72; OR =0.51, 95% CI =0.41-0.64) or in outdoor public places ( OR =0.74, 95% CI =0.63-0.86; OR = 0.62 , 95% CI =0.50-0.78) all reduced the risk of attempting to use e-cigarettes among senior hgih school students( P <0.05).@*Conclusion@#The influencing factors of attempts by senior high school students in Beijing City to use e-cigarettes are generally consistent between 2023 and 2019, with a focus on vocational senior high schools to ensure the continuity of intervention measures and promote the construction of smoke free senior high schools.
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Objective@#To assess the nutritional status of primary and secondary school students in Beijing City and to analyze the related factors, so as to provide a scientific basis for improving the nutritional status of primary and secondary school students in a targeted manner.@*Methods@#Based on the 2021 Beijing Student Common Diseases and Health Influencing Factors Surveillance Project, a stratified random cluster sampling method was used to conduct a physical examination and questionnaire survey on 25 487 primary and secondary school students from September to November 2021. The Chi square test was used for comparison of nutritional status detection rates, and disordered multi classification Logistic regression analysis was used to explore the factors associated with students nutritional status.@*Results@#The detection rates of malnutrition, overweight and obesity among primary and secondary school students in Beijing City were 4.7%, 18.0% and 23.8% respectively. The detection rates of malnutrition, overweight and obesity were higher among male students (5.1%, 20.4%, 29.7%) than female students (4.2%, 15.5%, 17.4%) ( χ 2= 12.23, 101.71, 526.99, P <0.01). The detection rate of obesity was higher in the suburbs than urban areas(26.6%, 19.8%), and the detection rate of malnutrition was lower in the suburbs than urban areas (4.2%,5.5%)( χ 2=157.25, 23.61, P <0.01). The results of disordered multi classification Logistic regression showed that the related factors for malnutrition, overweight and obesity were gender, residence, moderate to vigorous exercise ≥60 min per day and lack of sleep( OR =1.70, 1.88,2.48; 1.14, 0.87, 0.67; 0.85, 0.92, 0.81 ; 0.83, 1.08, 1.07); frequency of fried food intake daily was a related factor for overweight ( OR =0.70); whether eating breakfast daily or not was a related factor for overweight and obesity ( OR =0.91, 0.84); academic level (middle and high school) was a related factor for malnutrition and obesity ( OR =1.38, 1.37; 0.77, 1.40)( P <0.05).@*Conclusions@#The problem of overweight and obesity among primary and secondary school students in Beijing City continues to be serious, especially among boys and suburban areas. It is recommended that society, schools, families and individuals should work together to improve the nutritional status of primary and secondary school students by adopting a graded and classified approach.
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Objective@#To explore the effects of group sports game intervention on social ability and quality of life of children with austism spectrum disorders (ASD),so as to provide reference for rehabilitation intervention of social and quality of life of children with ASD.@*Methods@#From September 2021 to January 2022, 72 children with ASD aged 4-6 in the children s rehabilitation department of Xiangyang Central Hospital were selected to participate in the study, and were randomly divided into experimental group ( n =36) and control group ( n =36). The control group received routine rehabilitation training (including individual sports game training), and the experimental group replaced individual sports game training with group sports game training on the basis of routine rehabilitation.The course content mainly included three parts: warm up before class, group sports games and relaxation after class. The course combined social skills with sports games, and was carried out in a group form (divided into 12 groups with 3 people in each group), and was trained five times a week for 60 minutes, for a total of 12 weeks. The scores of Childhood Autism Rating Scale (CARS), Autism Treatment Evaluation Checklist (ATEC), Social Responsiveness Scale (SRS) and Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales (PedsQL 4.0) were observed before and after treatment. t-test and χ 2 test were used for statistical analysis.@*Results@#There was no significant difference in SRS scores between the experimental group and the control group before intervention ( t =-0.63, P >0.05). After the intervention, the total response rate in the experimental group was 83.33 %, higher than 41.67% in the control group χ 2=13.33, P <0.05),and the SRS scores decreased in the experimental group and control group ( t =17.75,8.71, P <0.05). The SRS scale score of the experimental group Social perception (17.67±4.12) , social cognition (30.33±4.99) , social communication (50.33±9.39) , social motivation (24.25±6.78) scores and total scores ( 152.67± 25.82) were lower than those of the control group(22.17±5.34，36.00±4.13，62.58±11.07，34.42±7.13，186.33±29.03)( t = -4.88，-2.03，-2.13，-3.58，-3.01， P ＜0.05).After the intervention, the scores of social function (53.33±18.01) and total score (283.83±51.83) on PedsQL 4.0 scale in experimental group were higher than those in control group(23.33±15.13，218.00±39.01) ( t =4.42，3.52， P ＜0.05). After the intervention, Autism Treatment Evaluation Scale (ATEC) scores of experimental groups(44.33±14.72) was lower than that in control group ( 59.33±16.95)( t =-2.32, P ＜0.05).@*Conclusion@#The intervention of group sports game has a significant effect on improving social ability and life quality of children with ASD.
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Objective@#The study was aimed at exploring the latent classes and factors influencing middle school students health risk behaviors in Beijing, so as to provide a scientific basis for determining key intervention targets and formulating relevant intervention measures.@*Methods@#A questionnaire survey was conducted among 17 730 junior middle school, senior high school and vocational high school students in 16 districts of Beijing from October to December 2022. Six types of health risk behaviors were assessed with latent class analysis, including unhealthy diet, lack of exercise, unintentional harm, intentional harm, substance abuse and Internet addiction behavior.@*Results@#The latent classes of health risk behavior among middle school students in Beijing were divided into three classes:high risk behavior (961 participants, 5.42%), low lack of exercise/high intentional injury (1 099 participants, 6.20%), and low risk behavior (15 670 participants, 88.38%). Disordered multiple Logistic regression analysis indicated that middle school students who were male ( OR =1.45), in high school ( OR =2.00), had other family types ( OR =1.90), possibly had depressed feelings ( OR =2.27), had depressed feelings ( OR =6.18), or were absent from school because of illness in the past year ( OR =1.79) were more likely to be in the high risk than the low risk behavior group. Moreover, middle school students who were male ( OR =2.30), had an extended family ( OR =1.18), had a reorganized family ( OR =1.70), had other family types ( OR =1.94), possibly had depressed feelings ( OR =3.10), had depressed feelings ( OR =4.91), had taken sick leave in the prior 2 weeks ( OR =1.54), or had absence from school because of illness in the past year ( OR =1.71) were relatively more likely to be in the low lack of exercise or high intentional injury group ( P <0.05).@*Conclusion@#Clear latent classes of health risk behaviors among middle school students are found to be present in differing proportions in Beijing. Relevant departments should take targeted intervention measures in a timely manner to reduce the occurrence of health risk behaviors among middle school students.
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Objective@#To explore the association between reading and writing posture with the occurrence of myopia in Chinese children and adolescents, so as to provide a reference for reducing its prevalence among primary and secondary school students.@*Methods@#Using data from the 2020 survey on the current status of hyperopia reserve in primary and secondary school students from six provinces/cities, namely Beijing, Zhejiang, Chongqing, Shaanxi, Liaoning, and Henan selected by multi stage stratified cluster probability sampling method during November 2020 to June 2022. A total 16 782 students who completed the optometry examination of cycloplegia according to the Children and Adolescents Myopia Screening Standard and questionnaire survey were included for analyzing analyze the association between reading and writing posture with myopia.@*Results@#The overall detection rate of myopia among primary and secondary school students was 45.7%, of which 35.0% were primary school students, 84.1% junior high school students, and 90.4% senior high school students. Poor reading and writing posture was found in 73.6% of primary and secondary school students. Adjusting for confounding factors such as gender, school period, region, outdoor time every day, and whether parents were myopic, the results of the multilevel Logistic regression showed that the following factors were positively correlated with myopia:poor reading and writing posture ( OR=1.17, 95%CI =1.07-1.28), never/occasionally reading and writing with a reading distance which was more than one foot away between the eyes and book ( OR=1.28, 95%CI=1.08-1.53, OR=1.23, 95%CI = 1.08- 1.40), teachers occasionally reminding the child of their reading and writing posture ( OR=1.13, 95%CI =1.01-1.25), and often/always reading and writing while lying down or with the face on the arm ( OR=1.15, 95%CI=1.01-1.32, OR=1.46, 95% CI = 1.17-1.82), always reading and writing with the head in the hand ( OR=1.56, 95%CI =1.20-2.01). Further, a negative correlation was detected between myopia and parents occasionally reminding their children of their reading and writing posture ( OR= 0.85 , 95%CI =0.76-0.96) ( P <0.05).@*Conclusion@#Poor reading and writing posture is a risk factor for the development of myopia in primary and secondary school students, and interventions for reading and writing posture need to be strengthened to reduce the occurrence of myopia among primary and secondary school students.
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Objective: To investigate the clinicopathological, immunophenotypic, and genetic features of malignant peripheral nerve sheath tumor (MPNST). Methods: Twenty-three cases of MPNST were diagnosed at the Jiangsu Province Hospital (the First Affiliated Hospital of Nanjing Medical University), China, between January 2012 and December 2022 and thus included in the study. EnVision immunostaining and next-generation sequencing (NGS) were used to examine their immunophenotypical characteristics and genomic aberrations, respectively. Results: There were 10 males and 13 females, with an age range of 11 to 79 years (median 36 years), including 14 cases of neurofibromatosis type I-associated MPNST and 9 cases of sporadic MPNST. The tumors were located in extremities (7 cases), trunk (4 cases), neck and shoulder (3 cases), chest cavity (3 cases), paraspinal area (2 cases), abdominal cavity (2 cases), retroperitoneum (1 case), and pelvic cavity (1 case). Morphologically, the tumors were composed of dense spindle cells arranged in fascicles. Periphery neurofibroma-like pattern was found in 73.9% (17/23) of the cases. Under low magnification, alternating hypercellular and hypocellular areas resembled marbled appearance. Under high power, the tumor cell nuclei were irregular, presenting with oval, conical, comma-like, bullet-like or wavy contour. In 7 cases, the tumor cells demonstrated marked cytological pleomorphism and rare giant tumor cells. The mitotic figures were commonly not less than 3/10 HPF, and geographic necrosis was often noted. Immunohistochemically, tumor cells were positive for S-100 (14/23, 60.9%) and SOX10 (11/23, 47.8%). The loss of the CD34-positive fibroblastic network encountered in neurofibromas was observed in 14/17 of the MPNST cases. The loss of H3K27me3 expression was observed in 82.6% (19/23) of the cases. Moreover, SDHA and SDHB losses were presented in one case. NGS revealed that NF1 gene loss of function (germline or somatic) were found in all 5 cases tested. Furthermore, four cases accompanied with somatic mutations of SUZ12 gene and half of them had somatic mutations of TP53 gene, while one case with germline mutation in SDHA gene and somatic mutations in FAT1, BRAF, and KRAS genes. Available clinical follow-up was obtained in 19 cases and ranged from 1 to 67 months. Four patients died of the disease, all of whom had the clinical history of neurofibromatosis type Ⅰ. Conclusions: MPNST is difficult to be differentiated from a variety of spindle cell tumors due to its wide spectrum of histological morphology and complex genetic changes. H3K27me3 is a useful diagnostic marker, while the loss of CD34 positive fibroblastic network can also be a diagnostic feature of MPNST. NF1 gene inactivation mutations and complete loss of PRC2 activity are the common molecular diagnostic features, but other less commonly recurred genomic aberrations might also contribute to the MPNST pathogenesis.
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Female , Male , Humans , Child , Adolescent , Young Adult , Adult , Middle Aged , Aged , Neurofibrosarcoma , Neurofibromatosis 1 , Histones , Genes, p53 , Nerve Sheath NeoplasmsABSTRACT
Background/Aims@#The discrepancies between the diagnosis of preoperative endoscopic forceps biopsy (EFB) and endoscopic submucosal dissection (ESD) in patients with early gastric neoplasm (EGN) exist objectively. Among them, pathological upgrading directly influences the accuracy and appropriateness of clinical decisions. The aims of this study were to investigate the risk factors for the discrepancies, with a particular focus on pathological upgrading and to establish a prediction model for estimating the risk of pathological upgrading after EFB. @*Methods@#We retrospectively collected the records of 978 patients who underwent ESD from December 1, 2017 to July 31, 2021 and who had a final histopathology determination of EGN. A nomogram to predict the risk of pathological upgrading was constructed after analyzing subgroup differences among the 901 lesions enrolled. @*Results@#The ratio of pathological upgrading was 510 of 953 (53.5%). Clinical, laboratorial and endoscopic characteristics were analyzed using univariable and binary multivariable logistic regression analyses. A nomogram was constructed by including age, history of chronic atrophic gastritis, symptoms of digestive system, blood high density lipoprotein concentration, macroscopic type, pathological diagnosis of EFB, uneven surface, remarkable redness, and lesion size. The C-statistics were 0.804 (95% confidence interval, 0.774 to 0.834) and 0.748 (95% confidence interval, 0.664 to 0.832) in the training and validation set, respectively. We also built an online webserver based on the proposed nomogram for convenient clinical use. @*Conclusions@#The clinical value of identifying the preoperative diagnosis of EGN lesions is limited when using EFB separately. We have developed a nomogram that can predict the probability of pathological upgrading with good calibration and discrimination value.
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Objective@#To understand the vision status of primary and secondary school students in Beijing, in order to provide scientific reference for myopia prevention and control.@*Methods@#From 2018 to 2021, a stratified cluster sampling method was used to monitor myopia among 191 293 primary and secondary school students selected from 6 urban areas and 10 suburban areas in Beijing. Myopic screening was in accordance with the "standards for children and adolescents myopic screening", and was measured by an automatic desktop computer optometer under non-cycloplegic conditions. Statistical analysis was used by Chi-square test.@*Results@#The total myopia rate of primary and middle school students in Beijing from 2018 to 2021 were 60.7%, 57.6%, 59.2% and 59.7%, respectively. In 2018, the myopia rates of primary school students, middle school students, regular high school students and vocational high school students were 38.3%, 77.3%, 88.3% and 73.2% respectively. In 2019, they were 34.7%, 76.4%, 87.7% and 72.0%, respectively; in 2020, they were 37.5%, 76.8%, 86.8%, 74.9%; in 2021, they were 38.7%, 77.4%, 86.5% and 74.9 % respectively. Significant differences in educational stage were observed ( χ 2=7 386.07, 11 104.28, 9 850.08, 9 714.59, P <0.01). From 2018 to 2021, the overall myopia rate of girls (62.1%) was higher than that of boys (56.5%)( χ 2=613.75, P <0.01). The myopia rate of girls were higher than that of boys in each year, and significant differences in educational stage were observed, respectively( χ 2=120.47, 163.47, 168.01, 162.24, P <0.01). The overall myopia rate of urban students(63.0%) was higher than that of suburban students (56.0%)( χ 2=978.82, P <0.01). The myopia rate of urban students were higher than that of suburban students every year, and significant differences in educational stage were observed, respectively ( χ 2=86.71, 240.96, 302.56, 409.30 , P < 0.01 ).@*Conclusion@#The detection rate of myopia rate of primary and middle school students in Beijing is still high. It is necessary to strengthen the publicity and intervention of poor visual acuity in primary and middle school students, especially among urban area students, with the aim of effectively control and reduction in the myopia rate, and the improvement of student visual health.
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Abstract@#Flood disasters are the common public health emergencies, mainly leading to environmental damage, water pollution, food pollution, vector breeding, infectious disease epidemic and other risk factors of sanitary and anti epidemic work. The guideline has been formulated with reference to the technical documents such as Guideline for Environmental Sanitation Disposal and Preventive Disinfection in Flooded Areas and Technical Proposal for Sanitary and Anti epidemic Measures after Flood Disasters, as well as the latest research progress at home and abroad. In order to guide the sanitary and anti epidemic measures in flooded areas, protect the health and safety of students and teachers and ensure the normal educational and teaching order, the guideline introduces the key measures that should be taken by schools, teachers and students in flood striken areas.
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Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of ectopic meningothelial hamartoma (EMH). Methods: Three cases of EMH diagnosed in the First Affiliated Hospital of Nanjing Medical University from January 2014 to December 2020 were enrolled. All cases were evaluated by clinical and imaging features, HE and immunohistochemical staining, and the relevant literature was reviewed. Results: There were one male and two female patients, aged 2, 67 and 19 years, respectively. Clinically, they presented as skin masses in the head and face region (two cases) and sacro-coccygeal region (one case). Grossly, the lesions ranged in size from 1.6 cm to 8.9 cm. Microscopically, the lesions were ill-defined, and located in the dermis and subcutis, and showed pseudovascular channels lined by monolayer of cuboidal to flattened epithelium with mild atypia, with variable cystic cavity formation. There was prominent interstitial fibrosis. Concentric, lamellated, onion skin-like arrangement with short spindle or ovoid cells and psammoma bodies were noted. Immunohistochemically, these cells were strongly positive for SSTR2, EMA, vimentin and progesterone receptor. Ki-67 positive index was low, approximately 1%. Conclusions: EMH is uncommon. Definitive diagnosis relies on histopathologic examination. The importance in recognizing the lesions is to differentiate from other more aggressive tumors.
Subject(s)
Female , Humans , Male , Choristoma/pathology , Diagnosis, Differential , Hamartoma/pathology , Meninges , Skin Diseases/pathologyABSTRACT
Objective@#To investigate the relationship between depressive symptoms and dietary behaviors among middle school and college students in Beijing，so as to provide the basis for carrying out related research and intervention.@*Methods@#A total of 18 130 middle school and college students from 16 districts in Beijing were collected through stratified cluster sampling from October to December, 2020. The relationship between middle school and college students depressive symptoms and dietary behaviors was analyzed by conducting a questionnaire.@*Results@#The detection rate of depressive symptoms was 18.2%. The detection rate of depressive symptoms in girls was 19.0%, which was higher than 17.4% in boys( P <0.05), and the differences were of statistical significance( χ 2=8.47, P <0.01). The detection rate of depressive symptoms in city was 17.9%, and in 10 urban areas was 18.5 %( P > 0.05 ), and the differences were of statistical significance( χ 2=1.15, P =0.28). The detection rates of depressive symptoms in vocational high school (21.8%) and high school students(20.6%) were and, higher than that in college students (18.2%) and in junior high school students(15.2%), and the differences were of statistical significance( χ 2=100.38, P <0.01). The rates of students with depressive symptoms drinking sugary drinks(14.4%), eating sweets (22.1%) and eating fried foods every day (12.4%) were higher than that of students without depressive symptoms(7.6%, 12.0%, 5.9%), and the differences were of statistical significance( χ 2=154.62, 215.67, 164.49, P <0.01). The rates of eating fresh fruits(63.3%), vegetables (81.7%) and breakfast every day (53.4%) of the students with depressive symptoms were lower than those without depressive symptoms (72.0%, 88.1%, 74.1%), and the differences were of statistical significance( χ 2=90.77, 90.59, 518.69, P <0.01) Logistic regression analysis showed that the detection rate of depression was the important factor of influencing dietary behaviors( P <0.05).@*Conclusion@#The detection rates of depressive symptoms of vocational high school students and senior high school students in Beijing are higher than those of junior high school students and college students. Depression is closely related to dietary behaviors. Promoting students mental health may help promote students healthy eating.
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Objective@#To understand the current situation of teaching and living environment in primary and secondary schools in Beijing and to provide basis for further intervention.@*Methods@#According to the national plan, an annual average of 92 schools in 16 districts of Beijing were investigated from 2017 to 2020, including school drinking water, canteen, toilet, dormitory management and equipment allocation. Classroom environment of some schools were tested,including the per capita area of classrooms, the agreement rate of desks and chairs distribution, blackboard reflectance, the average illumination and uniformity of desks, the average illumination and uniformity of blackboards, and noise.@*Results@#From 2017 to 2020,most of schools provided water purifiers and direct drinking water, accounting for 85.1% of all investigated schools. The proportion of students canteens in urban schools was increasing,accounting for 90.5% of all schools in 2020. And there was little change in suburban schools,reaching 85.1% in 2020. The proportion of school toilets equipped with soap increased significantly, 92.0% of school toilets were equipped with soap in 2020. The proportion of student dormitories with a per capita area of less than 3 m 2 decreased by year, and all reached the standard in 2020. The qualified rates of various classroom testing indicators, including per capita area in classroom, desk illumination uniformity, and noises, were higher than 80%, while the qualified rates of the blackboard illumination uniformity, desk allotment were lower than 80%.@*Conclusion@#The teaching and living environment in Beijing has improved in recent years, but there are still some problems need to be solved.
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Objective: To compare the safety and effectiveness of esophagojejunostomy (EJS) through extracorporeal and intracorporeal methods after laparoscopic total gastrectomy (LTG). Methods: A retrospective cohort study was carried out. Clinicopathological data of 261 gastric cancer patients who underwent LTG, D2 lymphadenectomy, and Roux-en-Y EJS with complete postoperative 6-month follow-up data at the General Surgery Department of Nanfang Hospital from October 2018 to June 2021 were collected. Among these 261 patients, 139 underwent EJS with a circular stapler via mini-laparotomy (extracorporeal group), while 122 underwent intracorporeal EJS (intracorporeal group), including 43 with OrVil(TM) anastomosis (OrVil(TM) subgroup) and 79 with Overlap anastomosis (Overlap subgroup). Compared with the extracorporeal group, the intracorporeal group had higher body mass index, smaller tumor size, earlier T stage and M stage (all P<0.05). Compared with the Overlap subgroup, the Orvil(TM) subgroup had higher proportions of upper gastrointestinal obstruction and esophagus involvement, and more advanced T stage (all P<0.05). No other significant differences in the baseline data were found (all P>0.05). The primary outcome was complications at postoperative 6-month. The secondary outcomes were operative status, intraoperative complication and postoperative recovery. Continuous variables with a skewed distribution are expressed as the median (interquartile range), and were compared using Mann-Whitney U test. Categorical variables are expressed as the number and percentage and were compared with the Pearson chi-square, continuity correction or Fisher's exact test. Results: Compared with the extracorporeal group, the intracorporeal group had smaller incision [5.0 (1.0) cm vs. 8.0 (1.0) cm, Z=-10.931, P=0.001], lower rate of combined organ resection [0.8% (1/122) vs. 7.9% (11/139), χ(2)=7.454, P=0.006] and higher rate of R0 resection [94.3% (115/122) vs. 84.9 (118/139), χ(2)=5.957, P=0.015]. The morbidity of intraoperative complication in the extracorporeal group and intracorporeal group was 2.9% (4/139) and 4.1% (5/122), respectively (χ(2)=0.040, P=0.842). In terms of postoperative recovery, the extracorporeal group had shorter time to liquid diet [(5.1±2.4) days vs. (5.9±3.6) days, t=-2.268, P=0.024] and soft diet [(7.3±3.7) days vs. (8.8±6.5) days, t=-2.227, P=0.027], and shorter postoperative hospital stay [(10.5±5.1) days vs. (12.2±7.7) days, t=-2.108, P=0.036]. The morbidity of postoperative complication within 6 months in the extracorporeal group and intracorporeal group was 25.9% (36/139) and 31.1%, (38/122) respectively (P=0.348). Furthermore, there was also no significant difference in the morbidity of postoperative EJS complications [extracorporeal group vs. intracorporeal group: 5.0% (7/139) vs. 82.% (10/122), P=0.302]. The severity of postoperative complications between the two groups was not statistically significant (P=0.289). In the intracorporeal group, the Orvil(TM) subgroup had more estimated blood loss [100.0 (100.0) ml vs.50.0 (50.0) ml, Z=-2.992, P=0.003] and larger incision [6.0 (1.0) cm vs. 5.0 (1.0) cm, Z=-3.428, P=0.001] than the Overlap subgroup, seemed to have higher morbidity of intraoperative complication [7.0% (3/43) vs. 2.5% (2/79),P=0.480] and postoperative complications [37.2% (16/43) vs. 27.8% (22/79), P=0.286], and more severe classification of complication (P=0.289). Conclusions: The intracorporeal EJS after LTG has similar safety to extracorporeal EJS. As for intracorporeal EJS, the Overlap method is safer and has more potential advantages than Orvil(TM) method, and is worthy of further exploration and optimization.
Subject(s)
Humans , Anastomosis, Surgical/methods , Gastrectomy/methods , Intraoperative Complications , Laparoscopy/methods , Postoperative Complications/surgery , Retrospective Studies , Stomach Neoplasms/surgery , Treatment OutcomeABSTRACT
The incidence and mortality rates of gastric cancer are among the top three cancers in China, which poses great threat to people's lives and health. So far, surgery remains to be the cornerstone of treatment for gastric cancer. With the development of laparoscopic surgery, minimally invasive treatment techniques, together with the deepening of clinical researches, as we review the research progress in 2021, the core controversial issues of gastric cancer surgery have been basically addressed. The series of "minimal-innovation" concepts and technologies represented by single-incision/reduced-port laparoscopic surgeries have been further developed; radiomics and artificial intelligence aided prediction have been applied into the forefront of surgical accurate decision-making; targeted and immune-therapy is about to break through the bottleneck of surgical efficacy of gastric cancer. Currently, molecular imaging and targeted tracer guided precision cancer surgery are being explored, which is expected to revolutionize in key links such as real-time in-vivo determination of tumor margin, tracing of metastatic lymph nodes and visualization of nerves. Looking forward into the future, gastric cancer surgery will break through the century-old ceiling of "gross appearance by naked eye" and "traditional extensive experience", and set off a new round of technological revolutions in molecular visualization intelligent precision minimally invasive surgery.
Subject(s)
Humans , Artificial Intelligence , Digestive System Surgical Procedures , Gastrectomy , Laparoscopy , Lymph Node Excision , Minimally Invasive Surgical Procedures , Stomach Neoplasms/surgeryABSTRACT
Objective@#To understand current situation of e cigarette use and associated factors in primary and secondary school students in Beijing, in order to promote the construction of smoke free schools.@*Methods@#During April to June in 2019, PPS sampling was used to select primary schools, secondary schools and trade schools. In each selected school, randomly sampling method was conducted until the sample size was reached. There were 18 312 students included in the analysis. Surveillance information mainly included the current situation of electronic cigarette use and associated factors.@*Results@#Among primary and secondary school students who have known about e cigarettes, female students were less likely to use e cigarettes than male students ( OR = 0.47 , 95% CI =0.42- 0.54 ). After entering the second year of junior high school, the possibility of using e cigarettes increased. Smoke free home was associated less e cigarettes usage ( OR =0.78, 95% CI =0.69-0.88). Primary and secondary school students with average daily allowance of 30~<150 yuan and no less than 150 yuan were 1.43 (95% CI =1.22-1.67) times and 2.24 (95% CI =1.79-2.79) times more likely to use e cigarettes than those with 0-10 yuan allowance, respectively. The probability of using e cigarettes among primary and secondary school students who have not tried using cigarettes was only 16.4% compared with those who have tried cigarettes ( OR =0.16, 95% CI =0.14-0.19).@*Conclusion@#It is necessary to curb the prevalence of e cigarettes among primary and secondary school students. Actions need to be taken urgently to fill in the gaps or correct the mistakes in children and adolescents cognition of e cigarettes, and to adopt more innovative methods to scientifically guide children and adolescents to stay away from e cigarettes.
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Objective:To observe the effect of Yuxuebi tablets on hyperalgesia and foot swelling in mice with chronic inflammatory pain， and to explore the preliminary mechanism of action. Method:A mouse model of chronic inflammatory pain was established with left plantar injection of complete Freund's adjuvant （CFA）. The mice were divided into model group， positive drug ibuprofen group （91 mg·kg<sup>-1</sup>）， Yuxuebi tablets low， medium and high dose groups （55， 110， 220 mg·kg<sup>-1</sup>），with the sham operation group as the control. After successful modeling， the daily dose was divided into two doses in the morning and evening by gavage to give Yuxuebi tablets or ibuprofen to the stomach for a total of 19 days. On the 18<sup>th</sup> day after the administration， the thermal pain threshold was detected by the hot plate method. On the 19<sup>th</sup> day， the standard Von Frey fiber needle was used to detect the mechanical pain threshold of the mice， and the degree of foot swelling was scored and photographed. The liquid-phase suspension chip technology was used to quantitatively analyze 36 classic broad-spectrum inflammation-related factors like inflammatory factors and receptors. Bioinformatics were used to screen core targets and perform enzymelinked immunosorbent assay （ELISA） detection. Result:Compared with the sham operation group， the mechanical pain threshold and foot swelling score of the model froup significantly increased （<italic>P</italic><0.01）， the latent time of heat sensitivity significantly decreased（<italic>P</italic><0.01）， the expressions of 30 inflammatory factors in the foot increased（<italic>P</italic><0.05）. Compared with the model group， the high dose of Yuxuebi tablets significantly reduced the mechanical pain threshold and foot swelling score of mice with chronic inflammatory pain（<italic>P</italic><0.01）， significantly increased the latent time of heat sensitivity（<italic>P</italic><0.05）， and reduced the expressions of 30 inflammatory factors in the foot（<italic>P</italic><0.05）， among which tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， interleukin-6 （IL-6）， interleukin-17A （IL-17A）， and C-C chemokine ligand 2 （CCL2） were the core targets screened out， and the expressions of TNF-<italic>α</italic>， IL-17A， and CCL2 significantly decreased （<italic>P</italic><0.01）. Conclusion:Yuxuebi tablets can relieve hyperalgesia and foot swelling in mice with chronic inflammatory pain， and its mechanism may be related to the inhibition of the expressions of peripheral inflammatory factors such as TNF-<italic>α</italic>， IL-17A， and CCL2 .
ABSTRACT
Surgery is the cornerstone of gastric cancer treatment. However, the traditional open surgery, which has been followed for more than 100 years, has restricted the development of gastric cancer surgery due to its "major trauma" defects. Therefore, how to scientifically develop laparoscopic and minimally invasive surgery (MIS) has become the main research orientation and focus worldwide for the development of gastric cancer surgery in recent 30 years, especially in China, a region of high incidence of gastric cancer. In the past 30 years, our Chinese colleagues in gastric cancer surgery have carried out systematic researches on key issues, and offered new theories of minimally invasive anatomy, new techniques for MIS, and new evidence of MIS for advanced gastric cancer. The system of the key surgical technology innovation for gastric cancer MIS was established, promoting a crucial move in the development of gastric cancer surgery. This article aims to commemorate the 30-year development of laparoscopic surgery in China and pay tribute to the strength produced by all the Chinese minimally invasive surgeons.
Subject(s)
Humans , China , Gastrectomy , Laparoscopy , Lymph Node Excision , Stomach Neoplasms/surgeryABSTRACT
Objective: Although single port laparoscopic surgery has achieved good clinical results, many surgeons are discouraged by the difficulties of operation, conflict of instruments, lack of antagonistic traction, and straight-line perspective. Therefore, some surgeons have proposed a single incision plus one hole laparoscopic surgery (SILS+1) surgical method. This study explored the safety and feasibility of SILS+1 for radical resection of colorectal cancer. Methods: A descriptive cohort study was carried out. The clinical data, including the operation, pathology and recovery situation, of 178 patients with colorectal cancer undergoing SILS+1 at Department of General Surgery, Nanfang Hospital, Southern Medical University from March 2018 to January 2019 were prospectively collected and retrospectively analyzed. Clavien-Dindo criteria was used for postoperative complication evaluation and visual analog scale was used for pain standard. Follow-up studies were conducted through outpatient service or telephone and the follow-up period was up to May 2019. Results: A total of 178 patients with colorectal cancer underwent SILS+1, including 111 male patients (62.4%) with an average age of 59 years. Eleven (6.2%) patients received added 1-3 operation ports during operation, and 1 patient was converted to open surgery due to ileocolic artery hemorrhage. The operative time was (135.2±42.3) minutes. The intraoperative blood loss was (34.6±35.5) ml. The number of harvested lymph nodes was 33.1±17.6. The distal margin was (4.7±17.8) cm. The proximal margin was (10.2±5.3) cm. Operation-related complications were observed in 16 patients (9.0%) within 30 days after the operation, of whom 6 had Clavien-Dindo III complications (3.4%). The postoperative pain scores were lower than 3. The average postoperative hospital stay was (5.6±2.6) days. Three patients (1.7%) returned to hospital within 30 days after operation due to intestinal obstruction and infection around stoma. The cosmetic evaluation of all the patients was basically satisfied. Conclusion: SILS+1 is safe and feasible in the treatment of colorectal cancer, and can reduce the postoperative pain.