Awareness of HPV and HPV vaccine and willingness to be vaccinated among parents of children aged 9-14 / 公共卫生与预防医学

Objective To investigate the HPV vaccination status of children aged 9-14 years, parents’ vaccine-related cognition, willingness to vaccinate children and their influencing factors. Methods From January to April 2021, the convenience sampling method was used to collect data based on the online platform and the Department of Pediatrics and Adolescent Gynecology of the Children's Hospital of Zhejiang University School of Medicine. The data were analyzed by descriptive analysis, Chi-square test, and logistic regression. Results A total of 864 questionnaires were collected, and 846 valid questionnaires were obtained after screening, with an effective rate of 97.9%. 13.57% of mothers and 3.09% of girls were vaccinated, and the vaccine awareness rate was 68.43%. 87.22% of parents were willing to bring their children for vaccination. Risk perception (OR=4.79, 95% CI: 2.22-10.35), willingness to vaccinate themselves (OR =29.01, 95% CI: 12.62-66.69), awareness of sex education (OR =3.73, 95% CI: 1.08-12.83) and whether the vaccines were free (P<0.001) were related to whether parents were willing to vaccinate their children. Conclusion Parents of children aged 9-14 have high awareness of HPV and HPV vaccine and are willing to vaccinate their children with HPV vaccine , but the vaccination rate in children is low. Disease perception, willingness to vaccinate, awareness of sex education, and whether vaccines are free are all the factors influencing parents' willingness to vaccinate children.

Clinical and etiological characteristics of infectious vulvovaginitis in children in Zhejiang province from 2009 to 2019 / 中华儿科杂志

Objective: To explore the clinical characteristics, common pathogens in children with vulvovaginitis. Methods: This was a retrospective cases study. A total of 3 268 children with vulvovaginitis were enrolled, who visited the Department of Pediatric and Adolescent Gynecology, Children's Hospital, Zhejiang University School of Medicine from January 2009 to December 2019. Patients were divided into 3 groups according to the age of <7, 7-<10 and 10-18 years. Patients were also divided in to 4 groups according to the season of first visit. The pathogen distribution characteristics of infective vulvovaginitis were compared between the groups. Their clinical data were collected and then analyzed by χ2 test. Results: The were 3 268 girls aged (6.2±2.5) years. There were 1 728 cases (52.9%) aged <7 years, 875 cases (26.8%) aged 7-<10 years, and 665 cases (20.3%) aged 10-18 years. Of these cases, 2 253 cases (68.9%) were bacterial vulvovaginitis, 715 cases (21.9%) were fungal vulvovaginitis and 300 cases (9.2%) were vulvovaginitis infected with other pathogens. Bacterial culture of vaginal secretions was performed in 2 287 cases, and 2 287 strains (70.0%) of pathogens were detected, of which the top 5 pathogens were Streptococcus pyogenes (745 strains, 32.6%), Haemophilus influenzae (717 strains, 31.4%), Escherichia coli (292 strains, 12.8%), Staphylococcus aureus (222 strains, 9.7%) and Klebsiella pneumoniae (67 strains, 2.9%). Regarding different age groups, H.influenzae was the most common in children under 7 years of age (40.3%, 509/1 263), S.pyogenes (41.9%, 356/849) was predominantly in children aged 7 to 10 years, and E.coli was predominant in children aged 10 to 18 years (26.3%, 46/175). Susceptibility results showed that S.pyogenes was susceptible to penicillin G (610/610, 100.0%), ceftriaxone (525/525, 100.0%), and vancomycin (610/610, 100.0%); the resistance rates to erythromycin and clindamycin were 91.9% (501/545)and 90.7% (495/546), respectively. For H.influenzae, 32.5% (161/496) produced β-elactamase, and all strains were sensitive to meropenem (489/489, 100.0%) and levofloxacin (388/388, 100.0%), while 40.5% (202/499) were resistant to ampicillin. Among E.coli, all strains were sensitive to imipenem(100%, 175/175). The resistance rates of E.coli to levofloxacin and ceftriaxone were 29.1% (43/148) and 35.1% (59/168), respectively. A total of 48 strains of methicillin-resistant Staphylococcus aureus (MRSA) were isolated with a proportion of 28.3% (45/159) in 3 268 patients. The results of drug susceptibility test showed that all MRSA strains were sensitive to linezolid 100.0% (40/40), vancomycin (45/45, 100.0%), and tigecycline (36/36, 100.0%); the resistance rates of MRSA to penicillin G, erythromycin and clindamycin were 100% (45/45), 95.6% (43/45) and 88.9% (40/45), respectively. All methicillin-sensitive Staphylococcus aureus (MSSA) strains were sensitive to oxacillin (114/114, 100.0%), linezolid (94/94, 100.0%), vancomycin (114/114, 100.0%), and tigecycline (84/84, 100.0%); it's resistance rates to penicillin G, erythromycin and clindamycin were 78.1% (89/114), 59.7% (68/114) and 46.5% (53/114), respectively. The drug resistance rate of MSSA to penicillin G, erythromycin and clindamycin were lower than those of MRSA (χ²=11.71,19.74,23.95, respectively, all P<0.001). Conclusions: The age of consultation for pediatric infectious vulvovaginitis is mainly around 6 years. The most common pathogens are S.pyogenes, H.influenzae and Escherichia coli. Third generation cephalosporins can be used as the first choice of empirical anti-infection drugs. However, the results of drug susceptibility should be considered for targeted treatment.

Research progress of a new immune checkpoint inhibitor T-cell immunoglobulin and immunoreceptor tyrosine-based inhibitory motif domain in anti-tumor immunotherapy / 中国热带医学

@#The T-cell immunoglobulin and immunoreceptor tyrosine-based inhibitory motif domain (TIGIT) is an inhibitory receptor mainly expressed on active T-cells, or natural killer cells (NK cells) that activate negative stimulus signals in immune cells by combining with multiple ligands on the surface of target cells including tumor cells and infected cells. TIGIT plays an important regulatory role in the immune pathogenesis of tumors, viral infections and various autoimmune diseases by inhibiting the over activation of cells and the over secretion of proinflammatory cytokines. Recent researches show that TIGIT is highly expressed in T cells and NK cells of cancer patients, and is related to disease progression and poor clinical prognosis. Researchers try to enhance the activity of T cells or NK cells by blocking the binding of TIGIT and its ligand for therapeutic intervention. At present, there have been many reports about the use of anti-TIGIT monoclonal antibody treatment in different mouse tumor models leading to tumor regression, TIGIT has received extensive attention in cancer immunotherapy as a promising target for next generation cancer immunotherapy. Several clinical trials are currently evaluating the efficacy of anti-TIGIT monoclonal antibodies (mAbs) in patients with several cancers. The most advanced candidate, tiragolumab, has exhibited remarkable efficacy in programmed cell death ligand 1 (PD-L1)-positive non-small cell lung carcinoma (NSCLC) patients in phase Ⅱ clinical trials, in combination with PD-L1 blockade. However, the specific mechanism of TIGIT blockade remains to be fully elucidated.

Knowledge, attitude and practice about myopia prevention and control among young children s parents in Guangzhou City / 中国学校卫生

Objective@#To understand the status and associated factors of knowledge, attitude and practice (KAP) about myopia prevention and control among young children s parents in Guangzhou, so as to provide reference for family health education on myopia prevention and control.@*Methods@#During January to February 2023, 4 584 parents of children from kindergarten and primary school (grade 1-3) were recruited. Two to three kindergartens and 2 primary schools were selected from each of the 3 urban districts and 2 suburb districts of Guangzhou by stratified cluster random sampling method. Parents of children were administered with online questionnaire survey on KAP about myopia prevention and control. Descriptive analyses and multivariate Logistic regression models were used.@*Results@#The proportion of parents reaching standard of KAP about myopia prevention and control was 61.54%, the knowledge awareness rate was 57.30%, the positive attitude holding rate was 76.98% and the health practice formation rate was 63.31 %. Internet (70.35%) and lectures on school health education/health education materials (66.14%) were the most common ways for obtaining knowledge for parents. Multivariate Logistic regression analysis showed that urban area, higher education ( college /undergraduate or above), annual household income 50 000-90 000, 100 000-290 000, 300 000-490 000, 500 000- 590 000 , and ≥600 000 Yuan, being aware of vision status (normal/poor) of their children, one or both parents with myopia, both parents with non myopia, acquiring knowledge by multi ways(2, 3, ≥4) were associated with higher KAP about myopia prev ention and control ( OR =1.23, 1.34, 1.36, 1.25，1.49, 1.93, 2.34, 1.64, 1.66, 1.89, 3.48, 3.09, 2.42, 1.65, 2.29, 3.22, P ＜ 0.05).@*Conclusion@#Knowledge and practice about myopia prevention and control among young children s parents in Guangzhou are insufficient, yet the attitude was satisfactory. It is necessary to carry out targeted education for parents, especially those living in suburb area, with low education and income level.

Predictors of extubation outcomes among extremely and very preterm infants: a retrospective cohort study

Abstract Objective: To explore the clinical or sociodemographic predictors for both successful and failed extubation among Chinese extremely and very preterm infants Methods: A retrospective cohort study was carried out among extremely and very preterm infants born at less than 32 weeks of gestational age (GA). Results: Compared with the infants who experienced extubation failure, the successful infants had higher birth weight (OR 0.997; CI 0.996-0.998), higher GA (OR 0.582; 95% CI 0.499-0.678), a caesarean section delivery (OR 0.598; 95% CI 0.380-0.939), a higher five-minute Apgar score (OR 0.501; 95% CI 0.257-0.977), and a higher pH prior to extubation (OR 0.008; 95% CI 0.001-0.058). Failed extubation was associated with older mothers (OR 1.055; 95% CI 1.013-1.099), infants intubated in the delivery room (OR 2.820; 95% CI 1.742-4.563), a higher fraction of inspired oxygen (FiO2) prior to extubation (OR 5.246; 95% CI 2.540-10.835), higher partial pressure of carbon dioxide (PCO2) prior to extubation (OR 7.820; 95% CI 3.725-16.420), and higher amounts of lactic acid (OR 1.478;95% CI1.063-2.056). Conclusions: Higher GA, higher pre-extubation pH, lower pre-extubation FiO2 and PCO, and lower age at extubation are significant predictors of successful extubation among extremely and very preterm infants.

Epidemiological characteristics and influencing factors of scoliosis in primary and secondary school students in Guangdong Province / 中国学校卫生

Objective@#To investigate the epidemiological characteristics and associated factors of scoliosis in primary and secondary school students in Guangdong, and to provide guidance for scoliosis control.@*Methods@#Using a stratified cluster random sampling method, a total of 38 649 students aged 9-18 were selected from 132 primary and secondary schools in the Pearl River Delta and non Pearl River Delta cities for scoliosis screening and related associated factors questionnaire survey from September to October 2020.@*Results@#A total of 1 440 students were detected with scoliosis, with a detection rate of 3.73%. The detection rate of girls was 4.90%, which was higher than that of boys at 2.66%( χ 2=386.89, P <0.01). The detection rate in the Pearl River Delta region was 4.09%, which was higher than the non Pearl River Delta region at 3.38%( χ 2=13.22, P <0.01). The detection rate in urban areas was 4.51%, which was higher than counties at 2.79%( χ 2=78.70, P <0.01). The detection rate increased with the increase of the school period, high school (5.94%)>junior high school (4.50%)>elementary school (1.35%)( χ 2=386.89, P <0.01). Multivariate Logistic regression analysis showed that region, urbanicity, gender, educational stage, exercise, using electronic mobile devices, nutritional status are the influencing factors for scoliosis ( OR=0.41-3.78, P <0.05).@*Conclusion@#The detection rate of scoliosis in primary and secondary school students in Guangdong Province varies by gender, urbanicity and educational stages. Female students, as well as junior and senior high school students should be paid more attention.

Scoliosis and associated factors among middle school students in Guangzhou City / 中国学校卫生

Objective@#To investigate the general situation of scoliosis and influencing factors among middle school students in Guangzhou, so as to provide evidence for behavioral intervention measures.@*Methods@#By stratified cluster random sampling method, 2 121 students from 8 middle schools of Guangzhou were selected to conduct questionnaire survey and physical examination.@*Results@#The detection rate of scoliosis among middle school students in Guangzhou was 8.20%, girls (9.50%)＞boys (7.00%), urban area (10.45%)＞suburb area (4.77%), senior high school (10.08%)＞junior school (6.39%) ( P ＜0.05). Among the most of the 174 positive students were found to have large thoracic curve, right lateral bending, being girls with medium scoliosis. Multivariate Logistic regression analysis showed that students in urban area ( OR=2.56, 95%CI =1.71-3.82), with mobile electronic devices usage time≥3 h/d( OR=1.59, 95%CI =1.12-2.27), prolonged near vision work ≥1 h ( OR=1.40, 95%CI =1.00-1.95), outdoor activity time＜2 h/d( OR=1.82, 95%CI =1.24-2.67) had a higher detection rate of scoliosis ( P <0.05).@*Conclusion@#The detection rate of scoliosis among middle school students in Guangzhou is much higher, which might be related to district, mobile electronic devices usage, prolonged near vision work and insufficient outdoor activity. Health education regarding spinal knowledge should be strengthened.

Relationship between moderate to vigorous physical activity, screen time and depressive symptoms among middle school students in Guangzhou / 中国学校卫生

Objective@#To describe the prevalence and relationship between moderate to vigorous physical activity(MVPA), screen time (ST) and depressive symptoms among middle school students in Guangzhou, and to provide a reference for adolescent depression prevention and control.@*Methods@#Using stratified cluster random sampling method, a total of 2 140 students were selected from one urban area and one suburban country for MVPA, ST and depressive symptoms investigation. Logistic regression was used to analyze relations among MVPA, ST and their combined patterns for depressive symptoms.@*Results@#A total of 89.72% students failed to meet the MVPA recommendations, girls (95.52%) were higher than boys(84.38%). Totally 67.38% of the students failed to meet the ST recommendations, boys (69.75%) were higher than girls(64.81%). The prevalence of depressive symptoms was 27.01%, girls (31.58%) higher than boys(22.80%). MVPA, ST failure compliance rate and depression symptoms detection rate of vocational high school and ordinary high school were higher than junior high school ( χ 2=6.40,121.71,27.37, P ＜ 0.05 ). Logistic regression analysis showed that the OR for depressive symptoms was 1.19 ( P =0.35) in students whose MVPA time achieving 1 h<7 d in the last week, and was 1.93 ( P <0.01) in students with the ST>2 h/d independently, no significant interactions were observed. Students with both MVPA time 1 h<7 d in the last week and the ST>2 h/d were more likely to report depressive symptoms( OR=2.03, P <0.05).@*Conclusion@#Insufficient MVPA, prolonged ST and high prevalence of depressive symptoms are observed among middle school students in Guangzhou. Students with both insufficient MVPA and prolonged ST are more likely to suffer from depressive symptoms. Specific psychological care and health education regarding physical activity and screen behavior should be implemented to students with different characteristics, as well as their parents for depressive symptom prevention.

Corneal differences between healthy and subclinical patients assessed using two diferente corneal tomographers / Diferenças entre as córneas de pacientes saudáveis e pacientes subclínicos avaliados com dois tipos de tomógrafos de córnea

ABSTRACT Purpose: To analyze subclinical keratoconus topography indexes using Pentacam and Orbscan-II measurements to identify evidences for seeking sensitive indexes to screen and diagnose subclinical keratoconus. Methods: Fifty healthy participants (50 eyes) and 40 patients with subclinical keratoconus (40 eyes) were included. Seven common parameters including corneal thickness at the thinnest point; minimum curvature of the front surface (minimum simulated keratometry value, SimK's Min); maximum curvature of the front surface (maximum simulated keratometry value, SimK's Max); the frontal corneal surface best-fit spherical radius of the curvature; the back corneal surface best-fit spherical radius of curvature; the anterior corneal surface height (anterior Diff value); and the posterior corneal surface height (posterior Diff value) measured by Pentacam and Orbscan-II between normal and subclinical keratoconus eyes were compared. Results: Statistical differences between the healthy and subclinical keratoconus groups (p<0.01) were found in all corneal parameters measured using both devices. Differences in the minimum curvature of the front surface (SimK's Min), thinnest point, anterior Diff value, and posterior Diff value were significant between Pentacam and Orbscan-II in the subclinical keratoconus group (p<0.05). Conclusion: The findings of this study identify the differences between normal and subclinical keratoconus eyes at the minimum curvature of the front surface, maximum curvature of the front surface, frontal corneal surface best-fit spherical radius of curvature, back corneal surface best-fit spherical radius of curvature, Anterior Diff value, and Posterior Diff value measures using Orbscan II and Pentacam that can help eye care practitioners clinically diagnose subclinical keratoconus.

RESUMO Objetivo: Analisar os índices subclínicos de to pografia de ceratocone utilizando as medidas feitas com Pentacam e com Orbscan-II para identificar evidências para a busca de índices sensíveis para triagem e diagnóstico de ceratocone subclínico. Métodos: Cinquenta participantes saudáveis (50 olhos) e 40 pacientes com ceratocone subclínico (40 olhos) foram incluídos. Sete parâmetros comuns, incluindo a espessura da córnea no ponto mais fino; a curvatura mínima da superfície frontal (valor mínimo da ceratometria simulada, Min de SimK); a curvatura máxima da superfície frontal (valor máximo da ceratometria simulada, Max de SimK); a superfície frontal e a superfície posterior da córnea de melhor ajuste ao raio da curvatura, a altura da superfície anterior da córnea (valor Diff anterior) e a altura da superfície corneana posterior (valor Diff posterior) medidos pelo Pentacam e pelo Orbscan-II entre os olhos normais e com ceratocone subclínico foram comparados. Resultados: As diferenças estatísticas entre os grupos saudável e com ceratocone subclínico (p<0,01) foram encontradas em todos os parâmetros corneanos medidos usando ambos os dispositivos. Diferenças na curvatura mínima da superfície frontal (Min de SimK) no ponto mais fino, no valor Diff anterior e no valor Diff posterior foram significativas entre Pentacam e Orbscan-II no grupo com ceratocone subclínico (p<0,05). Conclusão: Os achados deste estudo identificam as diferenças entre olhos normais e com ceratocone subclínico para a curvatura mínima da superfície frontal, a curvatura máxima da superfície frontal, a superfície corneana frontal e a superfície corneana posterior de melhor ajuste ao raio esférico da curvatura e as medidas de Diff anterior e posterior usando Orbscan II e o Pentacam que podem auxiliar os profissionais de oftalmologia a diagnosticar clinicamente o ceratocone subclínico.

Evaluation of skin phototoxicity of transdermally administered pharmaceuticals in Sprague-Dawley rats / 한국실험동물학회지

Some drugs cause phototoxicity in humans when exposed to light, thus there is a need for an in vivo phototoxicity test to evaluate them. However, an in vivo phototoxicity test method to evaluate this has not been established. This study aimed to establish an in vivo phototoxicity test method for transdermally administered drugs. For this, we evaluated the phototoxicity using Sprague-Dawley (SD) rats for transdermal administered drugs and we studied the appropriate UVA dose using 8-methoxypsalen, which is a well-known phototoxic drug. We found that a UVA dose of 15 J/cm2 was dose and time dependent response compared to other UVA doses. We performed the Minimum Erythema Dose (MED) test because UVB can cause skin irritation by itself and selected 0.01 J/cm2 as an appropriate dose of UVB. Using the selected UVA and UVB doses, we performed a phototoxicity study of 6 pharmaceutical drugs, which included phototoxic and non-phototoxic drugs. As a result of the phototoxicity test, 100% accuracy was obtained when compared with previous studies. In addition, we performed histopathology to confirm the new findings. We found that histopathology can be used as an additional indicator of phototoxicity test for transdermally administered drugs.

Effects of Self-efficacy and Self-control on Internet Addiction in Middle School Students: A Social Cognitive Theory-Driven Focus on the Mediating Influence of Social Support

Purpose@#The aim of this study was to investigate internet addiction among middle school students and to examine the mediating effects of social support in the relationships of self-efficacy and self-control with internet addiction. @*Methods@#The participants in the study were 119 middle school students in J city. The measurements included a self-efficacy scale, a self-control scale, a social support scale, and the Internet Addiction Scale for Youth. Data were analyzed using the independent t-test or Mann-Whitney U test, one-way analysis of variance, the Scheffé test, Pearson correlation coefficients, and multiple-regression using SPSS version 22.0. Mediation effects were analyzed by the Sobel test and Baron and Kenny's hierarchical analysis technique. @*Results@#Significant correlations were found among self-efficacy, self-control, and internet addiction. Social support had partial mediating effects in the relationship between self-efficacy and internet addiction, as well as in the relationship between self-control and internet addition. @*Conclusion@#In order to prevent internet addiction, the promotion of interactions among peers, which is a component of social support, is particularly important. It is also necessary to promote face-to-face activities that can strengthen relationships. The findings suggest that intensifying social support may help reduce the level of internet addiction in middle school students.

Evaluation of skin phototoxicity of transdermally administered pharmaceuticals in Sprague-Dawley rats / 한국실험동물학회지

Some drugs cause phototoxicity in humans when exposed to light, thus there is a need for an in vivo phototoxicity test to evaluate them. However, an in vivo phototoxicity test method to evaluate this has not been established. This study aimed to establish an in vivo phototoxicity test method for transdermally administered drugs. For this, we evaluated the phototoxicity using Sprague-Dawley (SD) rats for transdermal administered drugs and we studied the appropriate UVA dose using 8-methoxypsalen, which is a well-known phototoxic drug. We found that a UVA dose of 15 J/cm2 was dose and time dependent response compared to other UVA doses. We performed the Minimum Erythema Dose (MED) test because UVB can cause skin irritation by itself and selected 0.01 J/cm2 as an appropriate dose of UVB. Using the selected UVA and UVB doses, we performed a phototoxicity study of 6 pharmaceutical drugs, which included phototoxic and non-phototoxic drugs. As a result of the phototoxicity test, 100% accuracy was obtained when compared with previous studies. In addition, we performed histopathology to confirm the new findings. We found that histopathology can be used as an additional indicator of phototoxicity test for transdermally administered drugs.

Risk factors of postoperative sexual function in patients with urethral diverticulum and their partners: A cohort study of 83 women

ABSTRACT Introduction and Objective: Several studies have focused on the treatment and recurrence of urethral diverticulum (UD). However, few investigations have addressed sexual function in patients with UD. Therefore, we sought to examine sexual function in women affected by UD. Materials and Methods: There were 108 accepted cases involving transvaginal diverticulectomy at our institution. Ultimately, 83 women were included for further analysis, only 61 of these women had sexual partners. We collected data for the Female Sexual Function Index (FSFI) from the female patients and the Male Sexual Health Questionnaire (MSHQ) from their male partners before and after surgery. Results: Preoperatively, the UD size affected the female patient's arousal and lubrication (p=0.04), and the UD location affected their satisfaction. However, no significant between-group differences were found in the total FSFI score. For all women, sexual activity improved after surgery (p=0.0087). In addition to improvements in arousal for women with a large UD, improvements in lubrication were affected by the UD size, number and shape, increases in satisfaction scores were impacted by the UD location and shape, and pain relief was linked to the UD number and shape. Analysis of the MSHQ results revealed no between-group differences among the male partners. Conclusion: Only the UD size and location affected sexual function in women with a small UD. Surgery could improve female sexual function but did not affect the sexual function of the patient's partners.

Two new mixed-ligand coordination polymers based on multi-N chelating ligand inhibit YAP expression and induce caspase-mediated spinal tumor cell apoptosis

Two new coordination polymers [Zn (bdc)(bpybzimH2)](DMF)0.5 (1, H2bdc=1,4-dicarboxybenzene, bpybzimH2=6,6′-bis-(1H-benzoimidazol-2-yl)-2,2′-bipyridine, DMF=N,N-dimethylformamide) and [Co (bpybzimH2)(sbc)]H2O (2, H2sbc=4-mercaptobenzoic acid) have been successfully prepared under solvothermal conditions using the multi-N chelating organic ligand bpybzimH2 as the foundational building block. In addition, the Cell Counting Kit-8 assay was conducted to evaluate the anti-proliferation activity of compounds 1 and 2 against human spinal tumor cells OPM-2. The cell viability curves showed that the two compounds have anti-proliferation activity on spinal tumor cells, and the activity of compound 1 is higher than compound 2. The annexin V-FITC/PI assay and western blot were used to detect the apoptotic percentage of OPM-2 cells incubated with compounds 1 and 2. The YAP protein expression and its role in cell apoptosis were further studied with qRT-PCR, immunoblotting, and flow cytometer.

Association between body mass index and physical fitness index in Chinese and Japanese children and adolescents / 中国学校卫生

Objective@#To determine the relationship between body mass index (BMI) and physical fitness index (PFI) in Chinese and Japanese children and adolescents and to provide theoretical support for physical fitness improvement in Chinese children and adolescents.@*Methods@#A total of 9 594 children and adolescents aged 7-18 years were tested in China and Japan, 4 800 of which with various BMI were randomly selected for analyzing and comparing PFI between the two countries. The relationship between different BMI-Z scores and PFI was analyzed.@*Results@#In general, the PFI of wasting, normal weight, overweight and obesity in Chinese boys was -1.17, -0.03, 0.04 and 0.26, the figures were -2.59, -0.34, -1.46 and -2.44 for Japanese boys, significant differences were found in overweight and obese group (P<0.01). the PFI of wasting, normal weight, overweight and obesity in Chinese girls was -1.18, -0.08, 0.01 and 1.03, the figures were -1.21, 0.51, 0.11 and -1.30 for Japanese girls, significant differences were found in normal weight and obese group(P<0.05). Significant differences in PFI were found within Chinese boys, Chinese children, Japanese boys, Japanese girls and Japanese children with different BMI-Z levels(F=2.89, 3.05, 4.81, 2.33,5.34,P<0.01).@*Conclusion@#There is an inverted "U" curve relationship between BMI and PFI in Chinese and Japanese children and adolescents. With the increase of BMI-Z score, decreasing rate of PFI in Chinese boys is higher than Japanese boys. Practical and effective intervention measures should be taken to improve physical fitness of children and adolescents in China.

Effects of Team-based Problem-based Learning Combined with Smart Education: A Focus on High-risk Newborn Care

PURPOSE: This study was conducted to examine the effects of team-based problem-based learning combined with smart education among nursing students.METHODS: A quasi-experimental non-equivalent control group, pre-posttest design was used. The experimental group (n=36) received problem-based learning combined with smart education and lectures 7 times over the course of 7 weeks (100 minutes weekly). Control group (n=34) only received instructor-centered lectures 7 times over the course of 7 weeks (100 minutes weekly). Data were analyzed using the χ2 test, the Fisher exact test, and the independent t-test with SPSS for Windows version 21.0.RESULTS: After the intervention, the experimental group reported increased learning motivation (t=2.70, p=.009), problem-solving ability (t=2.25, p=.028), academic self-efficacy (t=4.76, p<.001), self-learning ability (t=2.78, p<.001), and leadership (t=2.78, p=.007) relative to the control group.CONCLUSION: Team-based problem-based learning combined with smart education and lectures was found to be an effective approach for increasing the learning motivation, problem-solving ability, academic self-efficacy, self-learning ability, and leadership of nursing students.

Association between poor vision and time spent in outdoor activity of students in Guangzhou / 中国学校卫生

Objective@#To investigate the association of poor vision with time spent in outdoor activity among students from primary and middle schools, as well as from universities in Guangzhou, so as to provide targeted scientific basis for prevention and control of low vision.@*Methods@#According to the requirements of National Monitoring of Common Diseases and Health Risk Factors among Students Manual, a total of 2 908 students were selected in 1 urban area and 1 suburban county for monitoring and investigation in Guangzhou.@*Results@#The poor vision rate was 69.2% among students in Guangzhou, with girls (74.4%) > boys (64.2%), suburban country (76.3%) > urban areas (54.1%), university (95.0%) > vocational high school (82.5%) > regular high school (81.1%) > junior high school (73.4%) > primary school (45.6%). With the exception of primary students, the severe poor vision has the largest proportion in each age group. The proportion of spending less than 1 or 2 h for outdoor activities per day: girls>boys, suburban country > urban area, university and regular high school are higher. The poor vision rate of students who spent <2 h(72.3%) for outdoor activities daily was higher than those spent ≥2 h(65.6%). Compared with students who spent ≥2 h/d for outdoor activities, those spent < 2 h/d were at 1.24 times risk of being low vision(OR=1.24, 95%CI=1.04-1.48), controlling for the available confounders.@*Conclusion@#Poor vision rate of students in Guangzhou is high, occurring mainly with severe impairment and in younger age, the daily outdoor activity time is low. Girls, students from suburban country and junior high school should be considered as the emphasis for prevention and control of low vision.

Effects of Parity and Breast Feeding Duration on the Risk of Osteoporosis in Postmenopausal Korean Women: A Systematic Review and Meta-Analysis

OBJECTIVES: To summarize the evidence regarding the association of parity and breast feeding duration with the risk of osteoporosis in postmenopausal Korean women. This was because studies have been inconsistent regarding the effect of parity and breast feeding duration on the risk of osteoporosis. METHODS: A systematic literature search of relevant studies published by December 26, 2018 was conducted in PubMed, EMBASE, the Cochrane Library, CINAHL, RISS, KISS, KMbase, and KoreaMed. Outcome estimates of odds ratio (OR) or standardized mean difference were pooled with fixed or random-effect model. In case of heterogeneity, subgroup analysis was conducted. RESULTS: Seven cross-sectional studies (with 3,813 subjects) were included in the analysis. OR for osteoporosis was 1.43 (95% confidence interval [CI] = 1.09–1.88, P = 0.010) in postmenopausal women with higher parity compared to those with less parity. Moreover, OR for osteoporosis was 1.93 (95% CI = 1.28–2.93, P = 0.002) in postmenopausal women with longer durations of breast feeding than in those with shorter durations of breast feeding. CONCLUSIONS: This study revealed that duration of breast feeding increased the risk of osteoporosis in postmenopausal Korean women. More cohort studies with high quality research designs are needed to confirm our results.

Clinical application of serum anti-Müllerian hormone in women / 대한생식의학회지

Anti-Müllerian hormone (AMH), a peptide growth factor of the transforming growth factor-β family, is a reliable marker of ovarian reserve. Regarding assisted reproductive technology, AMH has been efficiently used as a marker to predict ovarian response to stimulation. The clinical use of AMH has recently been extended and emphasized. The uses of AMH as a predictive marker of menopause onset, diagnostic tool for polycystic ovary syndrome, and assessment of ovarian function before and after gynecologic surgeries or gonadotoxic agents such as chemotherapy have been investigated. Serum AMH levels can also be affected by environmental and genetic factors; thus, the effects of factors that may alter AMH test results should be considered. This review summarizes the findings of recent studies focusing on the clinical application of AMH and factors that influence the AMH level and opinions on the use of the AMH level to assess the probability of conception before reproductive life planning as a “fertility test.”

Assessment of hemodynamic parameters distribution in normal carotid artery by using computational fluid dynamics based on CE-MRA data / Avaliação da distribuição dos parâmetros hemodinâmicos na artéria carótida normal utilizando a dinâmica de fluidos computacional baseada em dados CE-MRA

This study was to analyze the in vivo distribution of wall shear stress (WSS), velocity and inplane pressure difference in normal carotid artery by using computational fluid dynamics (CFD) based on contrastenhanced MRA (CE-MRA) data and to determine whether there were differences in these hemodynamic parameters between atherosclerosis-free and atherosclerosis-prone areas. CE-MRA was performed on 16 normal carotid arteries to obtain carotid three-dimensional surface data. CFD analysis was then performed to estimate those parameters in atherosclerosis-free (distal common carotid artery and distal internal carotid artery) and atherosclerosis-prone (carotid bifurcation) areas. One-way analysis of variance (ANOVA) was conducted to analyze differences among these three areas. CFD analysis revealed that WSS and velocity were significantly lower in carotid bifurcation compared to distal common carotid artery (CCA) (P =0.011, P <0.001, respectively) and distal internal carotid artery (ICA) (P <0.001, P <0.001, respectively). While in-plane pressure difference was significantly higher in carotid bifurcation compared to distal CCA (P <0.001) and distal ICA (P =0.005). Hemodynamic environment in carotid bifurcation of normal carotid artery which assessed by using CFD analysis appeared to be with lower WSS and lower velocity, while with higher in-plane pressure difference. These characterizations might facilitate the initiation of atherosclerosis.

Este estudo teve como objetivo analisar a distribuição in vivo da tensão de cisalhamento da parede (WSS), velocidade e plano diferença de pressão na artéria carótida normal usando dinâmica de fluidos computacional (CFD) baseada em contraste Dados do MRA (CE-MRA) e para determinar se houve diferenças nesses parâmetros hemodinâmicos entre áreas livres de aterosclerose e propensas à aterosclerose. O CE-MRA foi realizado em 16 artérias carótidas normais para obter dados de superfície tridimensional da carótida. A análise CFD foi então realizada para estimar esses parâmetros em livre de aterosclerose (artéria carótida comum distal e artéria carótida interna distal) e propensa a aterosclerose (carótida bifurcação). Análise de variância unidirecional (ANOVA) foi realizada para analisar as diferenças entre essas três áreas. A análise de CFD revelou que o WSS e a velocidade foram significativamente menores na bifurcação carotídea em comparação com a comum distal artéria carótida (ACC) (P = 0,011, P <0,001, respectivamente) e artéria carótida interna distal (ACI) (P <0,001, P <0,001, respectivamente). Enquanto a diferença de pressão no plano foi significativamente maior na bifurcação carotídea em comparação com a CCA distal (P <0,001) e ICA distal (P = 0,005). Ambiente hemodinâmico na bifurcação carotídea da artéria carótida normal que avaliada por meio de análise de CFD parece estar com menor WSS e menor velocidade, enquanto com maior pressão no plano diferença. Essas caracterizações podem facilitar o início da aterosclerose.