Clinical analysis of six cases of prurigo pigmentosa associated with ketogenic diet and bariatric surgery / 中华皮肤科杂志

Objective:To analyze clinical characteristics of ketosis-associated prurigo pigmentosa after ketogenic diet and bariatric surgery.Methods:Clinical data were collected from patients with ketosis-associated prurigo pigmentosa, who were diagnosed and treated in Department of Dermatology, Peking University People′s Hospital from September 2018 to September 2020. The clinical characteristics, sequelae and therapeutic effect of dietary modification were analyzed and summarized.Results:A total of 6 patients with ketosis-associated prurigo pigmentosa were collected, including 5 females who developed prurigo pigmentosa after ketogenic diet, and 1 male who developed prurigo pigmentosa after bariatric surgery. The skin lesions mainly involved the chest, back, waist and abdomen, and rarely involved the eyelids, axillae, elbows and mons pubis. Common skin lesions included urticaria-like erythema, papules and pigmentation arranged in a reticular distribution, and rare skin lesions included mung bean- to soybean-sized blisters, whose walls were liable to break. Among 5 patients undergoing routine urine analysis, 4 were positive (from + to ++++) for ketone bodies in the urine, and 3 were positive for urinary protein (+) . Pathological examination in 2 patients showed epidermal spongiosis, scattered necrotic keratinocytes, basal cell liquefaction, lymphocyte infiltration in the superficial dermis, and erythrocyte extravasation. The 6 patients were advised to eat staple foods. After dietary modification, 5 patients were nearly cured within 1 week; 1 patient, who continued ketogenic diet for weight loss, still received marked improvement after the treatment with minocycline at a dose of 100 mg/d in spite of restriction of carbohydrate intake. The levels of urinary ketone bodies and urinary protein in the 6 patients all returned to normal within 1 week after treatment.Conclusions:Ketosis plays an important role in the occurrence of prurigo pigmentosa. Dietary modification alone or adjuvant medical treatment such as minocycline is effective for the treatment of ketosis-related prurigo pigmentosa.

Mental health and related influencing factors among rural elderly in 14 poverty state counties of Chongqing, Southwest China: a cross-sectional study

BACKGROUND@#China has the largest elderly population in the world; little attention has been paid to the mental health of elderly in areas of extreme poverty. This is the first study to investigate the mental health of the rural elderly in poverty state counties in Chongqing and was part of the Chongqing 2018 health literacy promotion project.@*METHODS@#In 2019, a cross-sectional study was conducted to investigate the mental health status of the rural elderly in fourteen poverty state counties of Chongqing, in which a total of 1400 elderly aged ≥ 65 years were interviewed, where mental health status was measured by the ten-item Kessler10 (K10) scale. Ordered multivariate logistic regression was performed to evaluate the influencing factors related to mental health of the elderly in these areas.@*RESULTS@#The average score of K10 in 14 poverty state counties was 17.40 ± 6.31, 47.6% was labeled as good, 30.2% was moderate, 17.0% was poor, and lastly 5.1% was bad, and the mental health status of the elderly in the northeastern wing of Chongqing was better than the one in the southeastern wing of Chongqing. A worse self-rated health was the risk factor for mental health both in the northeastern and southeastern wings of Chongqing (all P < 0.001). Lower education level (OR (95% CI) = 1.45 (1.12-1.87), P = 0.004) was a risk factor in the northeastern wing, whereas older age (OR (95% CI) = 1.33 (1.13-1.56), P = 0.001) was a risk factors in the southeastern wing.@*CONCLUSIONS@#The results showed that mental health of the elderly in poverty state counties was poor, especially in the southeastern wing of Chongqing. Particular attention needs to be paid to the males who were less educated, older, and single; female with lower annual per capital income; and especially the elderly with poor self-rated health.

Prevalence and risk factors of hypertension combined with diabetes in middle and elder population in Nan’an district of Chongqing / 中华流行病学杂志

Objective@#To analyze the prevalence and risk factors of hypertension combined with diabetes in the middle to elder population in the Nan’an district of Chongqing, and to provide evidence for formulating relevant prevention and control strategies.@*Methods@#Middle or elder adults were enrolled by a Stratified multistage cluster sampling method. Questionnaire survey and the related measurements were conducted. The epidemiology of hypertension combined with diabetes was analyzed descriptively, and the risk or protective factors were analyzed by logistic regression method.@*Results@#A total of 24 792 people were surveyed, with 1 547 patients identified as having hypertension combined with diabetes. The overall prevalence rate appeared as 6.2%, of which 6.0% in males and 6.4% in females, respectively. The prevalence of hypertension combined with diabetes in the general population was increasing with age (χ2=343.766, P<0.001). Factors as age, education, smoking, marital status, exercise, BMI, triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol were related to the prevalence of hypertension and diabetes. High density lipoprotein cholesterol appeared as a protective factor for hypertension combined with diabetes (OR=0.817, 95%CI: 0.715-0.934). Age, education, low density lipoprotein cholesterol and lack of exercise all appeared as risk factors for hypertension combined with diabetes (P<0.05), respectively.@*Conclusions@#The prevalence rate of hypertension combined with diabetes in the middle or elder adults in Nan’an of Chongqing seemed high. Attention should be paid to the health status of people being elderly, overweight or obese, low cultural level, smoking, triglyceride abnormality, total cholesterol abnormality and high low density lipoprotein cholesterol, so as to reduce the risk on hypertension combined with diabetes.

A survey of learning satisfaction on the organ-system-based teaching model among medical students / 中华医学教育探索杂志

To understand the learning satisfaction on the organ-system-based teaching model among medical students,the questionnaire on the model was designed referring to the actual situation,and the learning satisfaction was evaluated by questionnaire among all the students of excellent clinical medicine class in Chongqing Medical University.Questionnaire survey of learning satisfaction showed that most of the medical students thought highly of the teaching model and they had more harvest.The satisfaction scores of curriculum arrangement,classroom teaching,teachers and teaching material were relatively high.They agreed with the school to carry out the reform.Medical schools should not only fully sum up the achievements of organ-system-based teaching model,but also pay more attention to draw on the advanced experiences both at home and abroad.It should put emphasis on compiling teaching materials of integrated curriculum,strengthening the teaching staff construction,constructing the teaching organization of integrated curriculums,training students' clinical practice ability,as well as cultivating students' autonomous learning ability,to improve learning satisfaction and teaching quality.

The noise analysis of CT imaging based on noise power spectrum of different reconstruction type / 中国医学装备

Objective: To evaluate the noise characteristic of different reconstruction type CT image by using the noise power spectrum (NPS), and analyze the correlation between this results and subjective vision noise evaluation. Methods: QA water phantom of CT equipment was scanned and 8 common reconstruction algorithms were applied to dispose image. NPS peak value, the peak frequency and standard deviation (SD) were compared with the subjective evaluation measurements, such as granularity, contrast, sharpness and optical noise level, by using the correlation analysis. Results: Each reconstruction algorithm owned different peak value and peak frequency. Granularity negatively correlated with the peak frequency. A positive correlation was found between contrast and peak value. Sharpness was positively correlated with both peak value and peak frequency. All of the subjective evaluation measurements were correlated with SD. Conclusion: Comparing with SD, NPS can reflect both intensity and morphological feature of the noise and possess applicative potential as a more comprehensive evaluation index.

Stability tests and action limits setting for central frequency and transmitter gain of MRI scanners / 中国医学影像技术

Objective To test the central frequency (CF) and transmitter gain(TG) of MRI scanners,and set up their action limits.Methods Three different MRI devices (GE 3.0T HD,GE 1.5T HDi and GE 3.0T 750W) were tested by scanning American College of Radiology (ACR) phantom with the axial T1WI series.In the pre-scanning of T1WI series for the ACR phantom,the CF and TG were recorded.It was tested for eight times when MRI scanners were in good condition.The action limits of CF and TG were calculated based on mean values and standard deviations.Results The mean values of CF for three devices were (127 725 772.38±39.68)Hz,(63 875 740.13± 34.15)Hz,and (127 771 958.38±12.19)Hz,respectively.Their action limits were ≤119.04 Hz,≤68.30 Hz,and ≤36.57 Hz,respectively.The mean values of TG for three devices were (125.25±1.28)dB,(101.75±1.98)dB,and (113.25±0.89)dB,respectively.Their action limits were (125.25±2.56)dB,(101.75±3.96)dB,and (113.25±1.78)dB,respectively.Conclusion The CF and TG for three MRI scanners are all consistent with the action limits in this study.The CF and TG action limits will provide criterions for the clinical quality control.

Protection of recombinant human growth hormone on rat liver with severe acute pancreatitis / 中华普通外科杂志

Objective To investigate the effect of recombinant human growth hormone (rhGH) on rat liver injury with severe acute pancreatitis.Methods Severe acute pancreatitis model was established by injection of sodium taurocholate into the pancreatobiliary duct in 40 male Sprague-Dawley rats.Rats were randomly divided into experiment group (n =20) and control group (n =20).Another 20 male SD rats injected saline served as negative control group.The experiment group were treated with subcutaneously injected rhGH for 3 days,1 U·kg-1 ·d-1.12 h and 24 h after operation,the level of ALT,AST,TNF-α,IL-1 β,SOD,MDA,endotoxin and D-lactate was detected respectively;the degree of live cell apoptosis and pathological score of pancreatic tissue were compared among these groups.Results In comparison with negative control group,the level of ALT,AST,TNF-α,IL-1β,MDA,endotoxin and D-lactate,the liver cell apoptosis index and pathological score of pancreatic tissuc were significantly higher in the control group and experiment group at 12 h and 24 h after operation (P ＜ 0.05).ALT,AST,TNF-α,endotoxin and D-lactate at 12 h and 24 h were significantly lower in the experiment group (P ＜ 0.05).MDA level significantly declined at 12 h and 24 h after operation in experiment group(P ＜ 0.05).Liver cell apoptosis index of the control group was higher than experiment group (P =0.003).Conclusion rhGH pretreatment relieves liver injury in rat with severe acute pancreatitis.

Status analysis on child neglect of rural pupils aged 6-11 year-old in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze pupils' neglect status aged 6-11 years in China's rural.</p><p><b>METHODS</b>According to the principle of multi-stage stratified cluster sampling, to extract 7,943 pupils aged 6-11 years for the survey from 56 primary schools in 28 counties in nine provinces, from December 2012 to March 2013. Proceed questionnaire survey by the scale from "Neglect Evaluation Norms for pupils aged 6-8 years in Rural Areas of China" and "Neglect Evaluation Norms for pupils aged 9-11 years in Rural Areas of China". And analyze neglect rates and neglect degrees of the different grades, gender, family types and different levels of neglect.</p><p><b>RESULTS</b>The total neglect rate of China's rural pupils aged 6-8 and 9-11 years was 40.2% (1,258/3,130) and 42.5% (1,498/3,526) respectively, which differences had no statistical significant (χ2=3.59, P=0.058); the total neglect degree was 46.04±8.87 and 44.78±10.43 respectively, which differences had statistical significant (t=5.01, P<0.001); the differences of neglect rates and neglect degrees between male (41.4% (657/1,587) and 46.28±8.76) and female (39.0% (601/1,543) and 45.78±8.97) of aged 6-8 were all no statistical significant (χ2=1.87, P=0.171; t=1.49, P=0.136); the neglect rates and neglect degrees of male (46.3% (816/1,763) and 45.53±10.11) were higher than female (38.7% (682/1,763) and 44.06±10.69) in the group of aged 9-11, which differences were all statistical significant (χ2=20.84, t=3.97, P<0.001); the male neglect rate in the group of aged 6-8 in social neglect (11.7% (198/1,691)) and the neglect degree in educational neglect (48.09±9.70) were higher than female (9.4% (155/1,648) and 47.37±9.89), which differences were all statistical significance (χ2=14.55, P<0.001, t=2.22, P=0.026), the male neglect rate in the group of aged 9-11 in physical neglect (20.4% (398/1,954)) was higher than female (16.7% (326/1 957)), which differences had statistical significance (χ2=8.92, P=0.003).</p><p><b>CONCLUSION</b>The neglect status of Chinese pupils aged 6-11 years in rural was serious, and we should find out risk factors and provide efficient prevention measures.</p>

Impact factors analysis on child neglect of children aged 3-6 year-old in rural areas of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the major influence factors of child neglect among rural areas children aged 3-6 years in China.</p><p><b>METHODS</b>According to multi-stage stratified cluster sampling, distribution characteristics and the level of economic development, we randomly sampled 10 provinces, 26 cities (8 capital cities, 16 prefecture-level cities and 2 municipalities) using lottery method. Depending on the different level of economic and cultural, we sampled one medium county from each city (municipalities sampled two counties), a total of 28 counties. All towns were divided into high, medium and low three levels in accordance with economic and cultural, each level sampled one town, each conty sampled three towns, a total of 84 towns were sampled. Each town sampled 40 children, including 20 boys and 20 girls (including each 10 children aged 3 to 6, half and half boys and girls). 4 096 rural children aged 3-6 years old were sampled and surveyed of China. Based on "the Neglect Norms for Children Aged 3 to 6 Years Old in Rural Areas of China" explored the risk factors of child neglect. SPSS 18. 0 for windows was employed for statistics analysis. Multifactorial analysis was conducted through multivariate Logistic Regression.</p><p><b>RESULTS</b>The total neglected rate of the rural children aged 3 to 6 was 53.7% (2,047/3,810), and the total neglected degree was 44.42±7.57. The multivariate logistic regression analysis showed that, neglected risk of the boys was higher than the girls (OR=1.30, 95% CI: 1.13-1.49), neglected risk of children were higher, when their mothers were migrant workers (OR=2.18, 95% CI: 1.59-3.00); the lower educational level of mothers, the higher neglected risk of children, the children in families that mothers only received primary education or was uneducated were most likely to be neglected (OR=2.92, 95% CI: 1.91-4.47), the second was the families that mothers received primary education (OR=1.86, 95% CI: 1.29-2.69); the lower the household income, the easier to be neglected the children, the easiest one was the household income less than 5000 RMB (OR=2.85, 95% CI: 2.14-3.79), the second was 5000-9,999 RMB (OR=1.76, 95% CI: 1.40-2.20); the relationship between children and mothers was distanced, neglect risk of children was higher (OR=3.88, 95% CI: 1.31-11.52); left behind children were easier to be neglected (OR=1.30, 95% CI: 1.09-1.54).</p><p><b>CONCLUSION</b>The influence factors among children aged 3-6 years in the rural areas of China were boys, mother's occupation, maternal education level, the relationship between children and mothers, household income and left-behind children.</p>

Research on child neglect situation and influential factors of left-behind children and living-with-parents children aged 6-17 year-old in rural areas of two provinces, western China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the situation and the influential factors of child neglect between left-behind children and living-with-parents children aged 6-17 years in the rural areas in western China.</p><p><b>METHODS</b>Students were randomly selected according to the principle of multi-stage stratified cluster sampling and they were from three cities in Shanxi and four districts in Chongqing. Among the 4,131 children, there were 1,874 students in the 6-11 years group and the left-behind children accounted for 50.21% (941/1,874) in this group. There were 2,257 students in the 12-17 years old group and the left-behind children accounted for 53.35% (1,204/2,257) in this group. The questionnaire named "Evaluation on Neglect for Elementary and Secondary School Students Aged 6-17 Years in Rural Areas in China" was used in the field investigation. The students' neglect frequency was described by neglect rate and the factors affecting students' neglect were analyzed by means of binary logistic regression.</p><p><b>RESULTS</b>In the 6-11 years old group, the neglect rates of left-behind children and living-with-parents children were 63.03% (474/752) and 43.87% (347/791), respectively (χ2=58.86, P<0.001). In the 12-17 years old group, the neglect rates of left-behind children and living-with-parents children were 60.64% (627/1 034) and 53.57% (495/924), respectively (χ2=9.96, P<0.001). For factors influencing left-behind children, compared to the factors about boys, younger mother (≤40 years old), presence of parents' income reduction within the last year and nuclear family, the factors about girls, elder mother (41-49 years), absence of parents' income reduction within the last year and three-generation family or single-parent family were associated with lower neglect risk, and OR values were 0.67, 0.68, 0.70, 0.73, and 0.43 (P<0.05); compared to the factors about Han nationality, only child, with separate room at home, and resident children, the factors about other nationalities, non-only child, no separate room at home, and non-resident children were associated with high neglect risk, and OR values were 1.85, 1.34, 1.46, and 1.32 (P<0.05); compared to the lower father's education background (primary school or uneducated), the higher father's education background (junior middle school, senior middle school, technical secondary school, college and above) was associated with lower neglect risk, and OR values were 0.66, 0.50, and 0.25 (P<0.05); compared to good relationship between children and parents as well as good relationship between parents, fair or poor relationship was associated with high neglect risk, and OR values were 1.57-3.79 (P<0.05). For factors influencing non-left-behind children, compared to the factors about younger mother (≤40 years old), changes of patient's work in the last year, presence of parents' income reduction within the last year and nuclear family, the factors about elder mother (41-49 years), no changes of patients' work in the last year, absence of parents' income reduction within the last year and three-generation family or single-parent family were associated with lower neglect risk, and OR values were 0.69, 0.71, 0.75, 0.82, and 0.56 (P<0.05); compared to the factors about Han nationality, only child and younger father (≤40 years old), other nationalities, the factors about non-only child, and elder father (41-49 years) were associated with high neglect risk, and OR values were 1.45, 1.56, and 1.57 (P<0.05); compared to lower father's education background (primary school or uneducated), higher father's education background (junior middle school, senior middle school, technical secondary school, college and above) was associated with lower neglect risk, and OR values were 0.65 and 0.49 (P<0.05); compared to good relationship between children and parents as well as good relationship between parents, fair or poor relationship was associated with high neglect risk, and OR values were 1.56-7.69 (P<0.05).</p><p><b>CONCLUSION</b>The situation of child neglect among left-behind children aged 6-17 years in rural areas of the two provinces in western China was serious, their neglect rates were higher than those of living-with-parents children, and there were many risk factors affecting the neglect rates of the two group children.</p>

Development of Neglect Evaluation Scale for primary school students aged 6-11 years old in rural areas of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To develop a standard Neglect Evaluation Scale which is suitable for rural primary school students in China.</p><p><b>METHODS</b>According to the principle of multi-stage stratified cluster sampling, a field investigation was conducted among primary school students in 28 counties from 7 provinces and 2 municipalities. The questionnaires were self-designed, and determined by multiple rounds of pilots and revisions. Among 5 862 students, 2 792 (6-8 years' old) and 3 070 (9-11 years' old) were investigated by using two kinds of Neglect Evaluation questionnaires, respectively. After project analysis, factor analysis, reliability and validity analysis, the reliability and stability of the scale were tested. Then percentile method was used to determine the evaluation standard to develop and finalize the formal scale.</p><p><b>RESULTS</b>The numbers of the remaining items for 6-8 year-old group and 9-11 year-old group is 69 and 58, respectively, both of which contain six levels of neglect, including body, emotion, health care, education, security, and society. 4 times of factor analysis were conducted in both of the two groups. The factor loadings in these two groups were 0.290-0.700 and 0.276-0.729 respectively. Reliability test results showed that the two kinds of scales' Cronbach alpha coefficient were 0.924 and 0.929 respectively, split-half reliability were 0.891 and 0.904 respectively, the retest reliability were 0.559 and 0.892 respectively, the differences were statistically significant (P < 0.05). The retest reliability among 6-8 year-old group in medical neglect level had no statistical significance, but was close to the cut-off point (P = 0.054). The test results of external validity indicated that both of the two scales could reflect the neglect status of the subjects (P < 0.05), but the subjective and objective evaluation towards neglect were not consistent. The cut-off points for judging whether the children were neglected or not among 6-8 year-old and 9-11 year-old groups were 159 and 137 respectively; and the adjusted values were 160 and 135 respectively.</p><p><b>CONCLUSION</b>The two norm scales developed by this study showed good discriminability, reliability, validity, and stability. The norms developed on the basis of the scales was suitable for the situation of rural students in primary schools in China.</p>

Efficiency and outcome of Boari bladder flap plasty surgery for the treatment of middle and lower ureteral carcinoma / 中南大学学报(医学版)

OBJECTIVE@#To study the effect and outcome of Boari bladder flap plasty surgery for the treatment of kidney-sparing strategy for patients with middle and lower ureteral carcinoma.@*METHODS@#Database at the department of urology in the Second Xiangya Hospital from 2002-2007 was screened and all cases of primary solitary lower ureteral carcinoma treated with Boari bladder flap plasty surgery or radical nephroureterectomy were collected. We performed a retrospective review of the clinical data including sex, age, smoking history, tumor site, size, stage, grade, bladder recurrence, renal function et al and evaluated survival rate. The Cox proportional hazards regression model was build to analyze the correlation between each variable and survival time.@*RESULTS@#Thirty nine patients in total were enrolled, including 16 cases underwent Boari bladder flap plasty surgery and 23 cases underwent radical nephroureterectomy. The median follow-up time was 53 months (range 10-84 months). During the follow-up time, 18 patients died, including 6 patients treated with Boari bladder flap plasty surgery and 12 patients treated with radical nephroureterectomy. The estimated bladder recurrence-free survival rate and cancer-specific survival rate at 5 years were 63% vs 59% and 73.8% vs 73.5%, respectively (P>0.05). The survival rate at 5 years and the overall survival rate were 61% vs 57 % and 64.8% vs 58.1% respectively in the 2 groups (P>0.05). There was no significant difference in renal function before surgery between the two groups [creatinine clearance 57 (32-104 ) mL/ min vs 55 (30-102) mL/ min, P>0.05]. Patients underwent Boari bladder flap plasty showed better renal function than patients underwent radical nephroureterectomy [creatinine clearance 55 (35-102) mL/ min vs 43 (30-89) mL/min, P<0.05]. In multivariate Cox regression analysis, the tumor size, pT stage, tumor cell grade and the estimated glomerular filtration rate level were independent factors that affected the overall survival rate of the patients (P<0.05). The tumor size, pT stage and tumor cell grade were positively correlated to the survival time, and the estimated glomerular filtration rate was negatively correlated to the survival time.@*CONCLUSION@#Boari bladder flap plasty surgery could be used to treat lower ureteral carcinoma. Compared with radical nephroureterectomy, Boari bladder flap plasty surgery has equal survival rate and shows superior postoperative renal function.

Study of genome-wide association study identified lipid-associated genes and susceptibility to coronary heart disease / 实用医学杂志

Objective To explore the relation of newly genome-wide association study (GWAS) identified lipid-associated genes by euramerican white and coronary heart disease ( CHD ) susceptibility in Chinese Han population. Methods One thousand patients with CHD were enrolled according to WHO criteria. 1000 age-and sex-matched controls were included. Single-nucleotide polymorphisms (SNPs) were detected by Taqman technique. Results Two novel SNPs (rs599839 in SORT1 region and rs16996148 in NCAN region) were significantly associated with CHD risk in Chinese Han population. Compared to AA genotype of rs599839, subjects with AG genotype of rs599839 (OR=0.64, 95%CI=0.48~0.85, P=0.002 and OR=0.67, 95%CI=0.52~0.91, P=0.008, respectively). Compared to GG genotype of rs16996148, subjects with GT genotype were associated with significantly decreased risk of CHD(OR=0.67, 95%CI=0.52~0.91, P=0.008). Two another SNPs (rs12695382 in B4GALT4 region and rs2254287 in B3GALT4 region) were not significantly associated with CHD in Chinese Han population. Conclusions Two novel SNPs (rs599839 and rs16996148) at newly identified lipid-associated loci were significantly associated with CHD susceptibility in Chinese Han population.

The effect of health education intervention on iodine deficiency disorders in Chinese pupils and housewives:a Meta-analysis / 中华地方病学杂志

Objective To comprehensively evaluate the effect of health education on intervening iodine deficiency disorders(IDD) in Chinese pupils and housewives,and to provide a basis for prevention and intervention of the disease.Methods A computerized literature search was carried out in Chinese Biomedical Database (CBM),Chinese National Knowledge Infrastructure(CNKI),VIP,Wangfang and PubMed to collect articles published from 1997-2012 concerning the effect of education intervention on iodine deficiency disorders (IDD).The study was a self-controlled intervention study.Meta-analyses were performed to assess the knowledge on IDD prevention and behavior changes.Fixed and random effect models were employed to combine results after a heterogeneity test,and rate different(RD) was used as an indicator of the intervention effect.Results A total of 20 controlled before and after studies were included in our meta-analysis.The quality of individual studies was assessed by EPOC,and all studies were grade B.Because the heterogeneity was higher,each knowledge point was stratified analyzed according to the baseline rate.The results showed that the lower the baseline rate,the better the effect of the intervention.The analysis indicated that the RD for the main harm of IDD,the RD for the key measure to prevent IDD,the RD for the meaning of the pattern on the bags,and the RD for knowledge dissemination of IDD were increased by 35％,29％,27％,42％ and 47％,respectively.Conclusion Health education is helpful to Chinese pupils and housewives in improving their IDD related knowledge and their attitudes toward IDD.

Immunogenicity and safety of the acellular pertussis, diphtheria, tetanus,inactivated poliomyelitis, Haemophilus influenza type b conjugate vaccine (DTaP-IPV/Hib combined vaccine)：a meta-analysis / 临床儿科杂志

Objective To evaluate the effectiveness and safety of DTaP-IPV/Hib combined vaccine in comparison with commercially available DTaP (diphtheria, tetanus and pertussis), Haemophilus influenzae type b (Hib), tetanus conjugate and IPV monovalent vaccine. Methods Randomized controlled trials (RCTs) on DTaP-IPV/Hib were retrieved by searching interna-tional and national databases. The pooled mean difference and relative risk and 95% CI were assessed by meta analysis with RevMan 5.0 software. Results Totally 6 studies were included for the final analysis. The seroprotection/seroconversion level of the Anti-PT (RR=0.26, 95%CI: 0.14, 0.48) in combination vaccine was higher. The antibody titer levels of Anti-PT (WMD=21.11, 95%CI:9.36, 32.86), Anti-polio type1 (WMD=59.15, 95%CI:2.81, 115.48), Anti-polio type 3 (WMD=169.82, 95%CI:75.33, 264.30) were higher respectively. But the antibody titer level of Anti-PRP (WMD=-3.58, 95%CI:-5.52,-1.64) in the com-bination vaccine group was lower. Redness (RR=0.82, 95%CI:0.72, 0.93) and Tenderness (RR=0.45, 95%CI:0.30, 0.65) were lower in the combination vaccine. Swelling (RR=2.03, 95%CI:1.02, 4.01) was more common in the patients given the combina-tion vaccine. Conclusions This study supports the conclusion that the DTaP-IPV/Hib combination vaccine is equivalent to the separate injections based on similar antibody responses to the vaccine antigens, effectiveness and safety after primary doses.

The situation of neglect state among elementary and high school students aged 6-17 years in rural areas of two western provinces of China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the neglect situation of elementary and high school students aged 6-17 years in western rural areas of China.</p><p><b>METHODS</b>Using multi-stage stratified cluster sampling method, 4 131 students were recruited from 26 rural elementary and high schools of 7 districts in Shanxi province and Chongqing from September 2012 to April 2013. The investigation was conducted based on 'The Development of Neglect Evaluation Norms and Influence Factors for Primary and Middle School Students' in rural areas of China. SAS 9.21 software was used for analyzing neglect rate and neglect degree for groups of age, sex and neglect types (including neglect of physical, emotional, medical, educational, safety and social).</p><p><b>RESULTS</b>The total neglect rate and degree were 55.50% (1 943/3 501) and 49.96 ± 9.67; the neglect rates for males and females were 56.78% (1 018/1 793) and 54.16% (925/1 708) (P = 0.119); the neglect degrees were 50.08 ± 9.31 and 49.83 ± 10.02 (P = 0.479), respectively. The girls' medical neglect rate (18.25%, 348/1 907) was significantly higher than that in boys (14.72%, 294/1 997) (P < 0.01); the boys' neglect degrees of physical, educational and social neglect (50.05 ± 10.46, 49.99 ± 10.81, 57.63 ± 14.63) were significantly higher than that in girls (49.34 ± 10.70, 49.07 ± 11.30, 56.37 ± 14.80) (P < 0.05). The total neglect rates of 6-8, 9-11, 12-14 and 15-17 groups were 44.48% (310/697), 60.40% (511/846), 60.89% (601/987) and 53.66% (521/971) (P < 0.01), and the total neglect degrees among these groups were 46.89 ± 8.57, 51.88 ± 9.25, 51.88 ± 9.25 and 51.72 ± 8.89 (P < 0.01), respectively. Except the neglect rates of medical and social neglect, significant differences were found in other three neglect rates and neglect degrees. The rates of social, emotional and safety neglect in 9-11 group were higher than that in other groups (28.39% (264/930), 26.41% (239/905), 20.35% (187/919)). The 12-14 group has the highest educational neglect rate(29.41%, 317/1 078). While the physical and emotional neglect degrees in 12-14 and 15-17 group were higher than that in other groups(12-14 group: 51.59 ± 10.02, 53.43 ± 12.02, 15-17 group: 51.96 ± 9.80, 52.61 ± 11.59). The social, safety, educational and medical neglect degrees were the highest in 6-8, 9-11, 12-14 and 15-17 group (60.91 ± 13.13, 48.29 ± 11.34, 52.43 ± 10.55, 51.15 ± 17.25), respectively. The neglect rates and neglect degrees were significantly higher in minorities(68.88% (374/543) and 52.91 ± 9.14) than those in Han population (53.04% (1 569/2 958), 49.44 ± 9.67)(P < 0.01 in both indexes); and the neglect rates and neglect degrees were significantly higher in children with siblings group (58.20% (1 504/2 584), 50.58 ± 9.54) than those the in one-child group (47.87% (439/917), 48.27 ± 9.80) (P < 0.01 in both indexes); and the neglect rates and neglect degrees were significantly higher in left-hand students (61.65% (1 101/1 786), 51.41 ± 9.51) than those in living-with-parents students(49.10% (842/1 715), 48.56 ± 9.61) (P < 0.01 in both indexes).</p><p><b>CONCLUSION</b>The children neglect situation is serious in western rural areas, close attention from families, schools and the society is in urgent need.</p>

Application of tube gastrostomy in radical cystectomy with ileal conduit: a retrospective, comparative study / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the clinical results of tube gastrostomy in radical cystectomy and ileal conduit.</p><p><b>METHODS</b>We retrospectively analyzed the data of 98 patients undergoing radical cystectomy and ileal conduit between March 2007 and February 2010. According to postoperative gastrointestinal decompression methods, the patients were divided into nasogastric decompression group (n=50) and tube gastrostomy group (n=48), and the gastrointestinal recovery time, surgical complications and hospital stay were compared between them.</p><p><b>RESULTS</b>No statistical difference was found in gastrointestinal recovery time, hospital stay, or surgical complications between the two groups, but the incidence of pulmonary infection was significantly lower in tube gastrostomy group than in nasogastric decompression group (P<0.05).</p><p><b>CONCLUSION</b>Tube gastrostomy is an easy, safe and effective means for gastric decompression after radical cystectomy with ileal conduit, especially suitable for elderly patients and those with potential pulmonary disorder.</p>

Diagnosis and treatment of renal oncocytoma of 6 cases and literature review / 中南大学学报(医学版)

To improve the diagnosis and treatment of renal oncocytoma and avoid unnecessary radical nephrectomy. The clinical data of 6 cases of renal oncocytoma diagnosed at the Second Xiangya Hospital Central South University from March 2005 to November 2010, including symptoms, laboratory tests, imaging, style of operation, pathological examination, and follow-up were retrospectively analyzed.There were no special symptoms and obvious abnormal laboratory tests in the patients. Two patients had relatively special imaging. Partial nephrectomy was performed in 2 cases of renal oncocytoma with typical imaging, while radical nephrectomy was performed on other patients because of misdiagnosis. No relapse and metastasis were found in the following 1 to 5 years.Renal oncocytoma is an uncommon benign tumor. Partial nephrectomy or tumor excision can be performed on patients diagnosed with renal oncocytoma according to typical imaging and intraoperative frozen section biopsy. The final diagnosis depends on pathological examination and regular follow-up is imperative for patients with renal oncocytoma.

rare Para neoplastic manifestation associated with squamous cell carcinoma of bladder: dermatomyositis

Dermatomyositis is a rare Para neoplastic syndrome, especially in urinary tract malignancy. We report a case of bladder squamous cell carcinoma in a 50-year old patient who presented with Para neoplastic dermatomyositis when tumor recurred. A radical cystectomy was performed for him and symptoms of dermatomyositis improved dramatically. The case shows that complete resection of bladder cancer may lead to resolution of Para neoplastic dermatomyositis and to our knowledge it is the first case of dermatomyositis in association with squamous cell carcinoma of bladder reported

The application of PBL in evidence-based medicine teaching among international students / 中华医学教育探索杂志

PBL ( Problem-based learning) is a problem-based and student-centered learning pattern.PBL teaching method has been applied to evidence-based medicine ( EBM ) courses for international students.By this method,the students' learning enthusiasm was stimulated,the ability of ananlyzing and resolving problem was improved,and good teaching effect was achieved,which provided knowledge to improve further EBM teaching and evidence-based clinical practice.