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Objective: To investigate the effectiveness of rotationplasty in treating osteosarcoma of distal femur in children. Methods: A clinical data of 10 children with osteosarcoma of distal femur treated with rotationplasty between March 2014 and June 2016 was retrospectively analyzed. There were 7 boys and 3 girls with an average age of 6.7 years (range, 4-10 years). There were 4 cases of osteoblastic osteosarcoma, 4 cases of mixed osteosarcoma, and 2 cases of chondroblastic osteosarcoma. All children were staged as Enneking stage ⅡB. The disease duration ranged from 3.5 to 6.0 months (mean, 4.6 months). The lower limb functional scoring system of 1993 Musculoskeletal Tumor Society (MSTS93), Toronto Extremity Salvage Score (TESS), and knee mobility were used to evaluate postoperative function. Tumor recurrence and metastases were monitored by radiograph. Results: Poor superficial incision healing occurred in 1 patient, and healed after dressing change. The other incisions healed by first intention. All children were followed up 24-72 months (mean, 52.6 months). No local recurrence was observed during follow-up. Three of the ten patients suffered from metastases including 1 dying of multiple organ dysfunction syndrome, 1 alive with tumor, and 1 tumor free survival. Painful callosities and ulcers which related to prosthetic wear occurred in 2 patients and turned up after optimizing prosthetic fit and physiotherapy. The fracture healing time was 2.5-5.0 months (mean, 3.5 months). All children could walk independently at 4 months postoperatively. At last follow-up, the MSTS93 score was 19-25 (mean, 22) and the TESS score was 87-93 (mean, 90). The extension of knee joint mobility with artificial limbs was 0°-10° (mean, 5°), and the flexion of knee joint mobility with artificial limbs was 85°-95° (mean, 90.5°). Conclusion: Rotationplasty in treating osteosarcoma of distal femur in children with limb salvage difficulties can effectively preserve the limb function and improve the quality of life, and it can be used as an alternative to amputation.
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Objective To investigate the association between activity energy expenditure ( AEE ) and body composition in school-age children.Methods A total of 62 students ( Grades 3 and 4, aged 8 -10 years) from a primary school in Shanghai were enrolled in this study .AEE was estimated with a metabolic cart (energy metabolism determination system ).Body composition (body mass, body mass index, fat percentage, fat mass, fat-free mass, fat mass index, fat-free mass index, obesity degree) was evaluated by bioelectrical im-pedance analysis .The above indicators were compared between obese and non-obese students .Results There were no statistically significant differences in exercise time , total AEE and relative AEE between obese and non-obese boys [ (9.70 ±1.91) min vs.(10.00 ±1.97) min, t=0.336, P=0.739; (198.74 ±53.33) kJ vs.(171.54 ±41.75) kJ, t =-1.422, P =0.165; (0.46 ±0.09) kJ/(min· kg) vs.(0.51 ± 0.04) kJ/(min· kg), t=2.043, P=0.051], while obese boys had higher absolute AEE than non-obese boys [(20.06 ±3.14) kJ/min vs.(16.93 ±1.85) kJ/min, t=-2.910, P=0.007].Obese girls had shor-ter exercise time and lower relative AEE than non-obese girls [ (7.35 ±3.05) min vs.(9.98 ±1.82) min, t=2.509, P=0.027;(0.41 ±0.09) kJ/(min· kg) vs.(0.51 ±0.07) kJ/(min· kg), t=3.244, P=0.003 ] , whereas there were no statistically significant differences in total AEE and absolute AEE between obese and non-obese girls [ (129.29 ±71.13) kJ vs.(161.50 ±35.38) kJ, t =1.351, P =0.203; (16.82 ± 3.26) kJ/min vs.(16.17 ±2.00) kJ/min, t=-0.676, P=0.504].After controlling for age and gender, absolute AEE was significantly positively correlated with body mass index ( P=0.015 ) , obesity degree ( P=0.010), fat mass (P=0.047), fat-free mass (P=0.010), and fat-free mass index (P=0.003) in boys, but not in girls.Relative AEE was significantly negatively correlated with body mass index ( boys: P =0.000, girls: P=0.000), obesity degree (boys: P=0.002, girls: P=0.000), fat percentage (boys:P=0.000, girls:P=0.001), fat mass (boys:P=0.000, girls:P=0.000), fat-free mass (boys: P=0.002 , girls: P=0.022 ) , and fat mass index ( boys: P=0.000 , girls: P =0.000 ) in both boys and girls.Conclusions In obese children, AEE is correlated with body composition, with relative AEE reducing as obesity degree increasing.There may be complex relationships among body size , body composition, and energy metabolism in children.
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Objective To survey the nutritional status and nutritional knowledge,attitude and practice (KAP) of primary and middle school teachers in Shanghai,and to study the possible correlation of nutritional KAP with overweight/obesity and obesity-related complications.Method Using stratified cluster random sampling,a questionnaire survey was conducted among 544 hygiene teachers and 150 non-hygiene teachers selected from all primary and middle schools in all districts in Shanghai,investigating the nutritional status and nutritional KAP in this population.Results The prevalence of overweight/obesity and obesity-related complications were significantly lower in hygiene teachers than in non-hygiene teachers (19.81％ vs.38.15％,t =22.303,P=0.000; 18.6％ vs.26.39％,t =4.156,P=0.047).The attitude score was the highest among the 3 surveyed parts,significantly higher than the lowest,which was practice score (hygiece teachers:91.76 ±13.66 vs.74.42±11.61,t=14.595,P=0.000; non-hygiene teachers:85.67 ±18.77 vs.69.88 ±13.30,t =25.400,P =0.000).Hygiene teachers scored significantly higher than non-hygiene teachers in all the 3 parts of KAP (knowledge:84.43 ± 11.98 vs.75.73 ± 16.82,t =5.822,P =0.000; attitude:91.76 ± 13.66 vs.85.67±18.77,t =3.640,P=0.000; practice:74.42 ±11.61 vs.69.88 ±13.30,t =4.030,P=0.000).There was no correlation between the teachers' body mass index and KAP scores,nor between obesityrelated complications and knowledge or attitude scores,while obesity-related complications was found correlated with practice score and KAP score (t =-0.146,P =0.005 ; t =-0.105,P =0.043).Conclusions The nutritional status of teachers in Shanghai primary and middle schools is associated with their nutritional KAP.There is a correlation between obesity-related complications and practice score.Hygiene teachers have better nutritional KAP compared with non-hygiene teachers.
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Objective To describe aerobic capacity and body composition of school-aged children in Shanghai and explore the potential relationship between body composition and aerobic capacity.Methods Totally 63 school-aged children in Shanghai were measured for height,weight,fat percentage (FAT％),and fat-free mass (FFM).Body composition was estimated from bioelectrical impedance analysis (BIA).Body mass index (BMI),fat mass index (FMI),and fat-free mass index (FFMI) were calculated.Aerobic capacity (VO2max and the maximum oxygen pulse) were measured using the COSMED fitmate metabolic systems (combined heart rate and cycling test).Results The boys who were obese or overweight had both higher absolute value of VO2max and lower relative values of VO2max than other boys [(1 038.50 ± 157.93) ml/min vs (923.90±82.03) ml/min,F=4.812,P=0.005; (23.62±4.22) ml/ (kg· min) vs (27.75 ±2.41) ml/ (kg · min),F =5.633,P =0.002].The girls who were obese or overweight tended to have higher absolute value of VO2max [(966.70 ± 131.22) ml/min vs (892.55 ± 108.71) ml/min] and lower relative values of VO2 max [(23.84 ± 4.30) ml/ (kg · min) vs (28.09 ± 4.52) ml/ (kg · min)] than other girls.After controlling for age,the relative VO2max values were negatively associated with body mass index (BMI),degree of obesity,FAT％,FM,FFM,FMI,FFMI (boys:r =-0.675,P ＜ 0.000 1 ; r =-0.634,P＜0.000 1; r=-0.667,P＜0.000 1; r=-0.726,P＜0.000 1; r=-0.594,P＜0.000 1;r=-0.686,P＜0.000 1; r=-0.456,P=0.010; girls:r=-0.651,P ＜0.000 1; r=-0.552,P=0.002; r=-0.527,P=0.003; r=-0.633,P＜0.000 1; r=-0.520,P=0.004; r=-0.579,P=0.001 ; r =-0.597,P =0.001).In boys,the maximum oxygen pulse was positively correlated with BMI,FFM,and FFMI (r =0.358,P=0.048; r =0.543,P=0.002; r =0.554,P=0.001); in girls,the maximum oxygen pulse was positively correlated with FFM and FFMI (r =0.378,P =0.043 ; r =0.449,P =0.014).Conclusions Aerobic capacity is associated with body composition in school-aged children.Higher degree of obesity is associated with poorer aerobic capacity.Maximum oxygen pulse is also associated with FFM.