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【Objective】 To compare the efficacy and safety between partial tubeless and standard percutaneous nephrolithotomy in the treatment of upper urinary tract calculi. 【Methods】 The clinical data of 802 patients with upper urinary tract calculi treated at our hospital during Jun.2018 and Dec.2021 were retrospectively analyzed. The patients were divided into the partial tubeless group and standard group, and 60 cases in either group were selected by a simple random method. Clinical data, complications and stone-free rate were compared between the two groups. 【Results】 All 120 patients completed the operation successfully. The postoperative hospital stay, pain score and postoperative recovery of the partial tubeless group were significantly superior to those of the standard group (P0.05). 【Conclusion】 In the treatment of upper urinary tract calculi, partial tubeless percutaneous nephrolithotomy can achieve satisfactory surgical results, and has obvious advantages in postoperative recovery and patients’ experience. It is worthy of clinical application.
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Objective:To investigate the clinical diagnostic value of combined detection of serum and bronchoalveolar lavage fluid (BALF) galactomannan (GM) for invasive pulmonary aspergillosis (IPA) in children with non-neutropenia.Methods:An analysis was made on 100 children with non-neutropenia suspected of invasive pulmonary aspergillosis in the respiratory ward of the Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 2019 to March 2020. All of them were tested by serum and BALF GM tests as well as sputum and BALF culture for fungi. The sensitivity, specificity and accuracy of serum and BALF GM in the diagnosis of IPA in non-neutropenic children were analyzed. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to evaluate the clinical diagnostic value of serum and BALF GM tests for IPA in children with non-neutropenia.Results:The recruited 100 cases included one confirmed case, 85 clinically diagnosed cases and two suspected cases, while the 12 cases were excluded. The accuracy and 95% confidence interval (95%CI) of serum and BALF GM tests used alone and in combination in the clinical diagnosis of IPA in non-neutropenic children were 29.0% (95%CI: 20.1%-37.9%), 75.0% (95%CI: 66.5%-83.5%) and 81.0% (95%CI: 73.3%-88.7%), respectively. The AUC and 95%CI were 0.645 (95%CI: 0.513-0.778), 0.785 (95%CI: 0.644-0.926) and 0.819 (95%CI: 0.681-0.953), respectively.Conclusions:The combined detection of serum and BALF GM was better than a single indicator in the clinical diagnosis of IPA in non-neutropenic children, suggesting the combined detection was of great value in clinical diagnosis.
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A case of severe complications is presented that replaced the double J tubeless misguided by zebra guidewire into ileum in a patient with ureteral dermostomy, causing a ureteral ileum fistula.The result suggests improper operation of zebra guidewire could have a risk of ureteral perforation when the ureter is distorted, narrow or with inflammatory lesions.Standardized diagnosis and treatment and correct selection of guidewire can reduce the risk of ureteral perforation.
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Objective:To assess the predictive values of bioelectrical impedance analysis(BIA)-measured body fat indices to abnormal lipid profiles, and to preliminary propose optimal cut-off values of body fat in children and adolescents.Methods:Children and adolescents, aged 6-16 years, were selected from 30 schools (8 primary schools, 21 middle schools and one 12-year education school) in Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by adopting a stratified cluster sampling method from November 2017 to January 2018.Questionnaire survey, body mass index(BMI), body fat mass index (FMI), fat mass percentage (FMP) and four lipid profiles were conducted.Results:A total of 14 309 participants, aged (11.0±3.3) years, were enrolled in the analysis, with 49.9% boys.In boys and girls, the percentile values ( P60- P95) fitted by FMI and FMP with K-median-coefficient of variation(LMS) method were taken as the cutting points, and P75 values were selected as the cut-off points of excessive body fat for their better sensitivity, specificity, predictive value and area under curve (AUC) for identification of abnormal lipid profiles.Boys with FMI above P75 accounted for 28% of the total population, and controlling boys with FMI below P75 could prevent dyslipidemia of 8%-57%.FMI in girl population occupied about 26% of the above, and controlling FMI in girl population below this cut-off point may prevent dyslipidemia from 8%-42%.FMP observed similar results to FMI.Assessed by FMI or FMP with P75 cut-off values, adiposity performed better than BMI for recognizing abnormal lipid profiles in boys (AUC: 52.4%-69.6% vs.50.2%-67.1%, P<0.05) rather than in girls ( P>0.05). In addition, when FMI or FMP beyond P90, the specificity of each abnormal lipid profiles was around 90%. Conclusions:The recommend cut-off points for body fat may be to assess children′s adiposity, and can be applied in preventive activities.
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Objective@#To compare the power of dyslipidemia diagnosis by different sets of cut points in the prediction of cardiovascular metabolic risk factors and identify the appropriate cut points for the diagnosis of dyslipidemia in children and adolescents in China.@*Methods@#Data were obtained from the baseline survey of 'School-based Cardiovascular and Bone Health Promotion Program’ in Beijing in 2017. Dyslipidemia was diagnosed by using two set of cut points. Receiver operating characteristic curve analysis was conducted to assess the power of dyslipidemia diagnosis by the two set of cut points to predict the prevalence of hypertension, obesity, high fat mass percentage and impaired fasting glucose.@*Results@#A total of 14 390 children and adolescents were in included in the study. The prevalence rates of high TC, high LDL-C, low HDL-C, and high TG in the participants were 2.7%, 2.7%, 14.4%, and 3.7% according to 'Chinese Reference Standard’, and 5.0%, 3.7%, 13.3%, and 3.5% according to 'China Expert Consensus’. Low HDL-C and high TG defined by the 'Chinese Reference Standard’ had better performance for the prediction of high fat mass percentage and obesity in boys, but worse performance in girls (P<0.001).@*Conclusions@#Using 'China Reference Standard’ can increase the true positive rate in the prediction of obesity or high fat mass percentage in boys, and reduce the false positive rate in girls. The cut points for the diagnosis of dyslipidemia in Chinese children and adolescents need to be further validated by using national representative sample and in longitudinal study.
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Objective@#To investigate the sleep status in children and adolescents and explore the relationship between the sleep and high blood pressure in them.@*Methods@#Data was from the Schoolbased Cardiovascular and Bone Health Promotiow Program (SCVBH) in Beijing. And 13 471 children and adolescents aged 6-16 years were selected from grades 1 to 4 in 8 primary schools, grade 1 in 21 middle schools and senior grade 1 in one twelve-year education school in Dongcheng, Fangshan, Miyun and Tongzhou Districts of Beijing during 2017-2018 by using a cluster sampling method. Self-reported questionnaires were used to collect the demographic characteristics, lifestyle habits of children and adolescents. The blood pressure was measured by electronic sphygmomanometer. Multiple logistic regression model was used to analyze the association between sleep and hypertension risk.@*Results@#The sleep duration was (8.4±1.1) hours. The prevalence of high blood pressure was 15.0%(2 021/13 471). The incidence of mouth breathing, slobber, snoring, and suffocate was 28.4%(3 823/13 471), 23.6%(3 184/13 471) and 18.7%(2 513/13 471), 2.8%(378/13 471) respectively. After adjusting for age, gender, snoring, mouth breaking, slobber, suffocate, the time for bed and sleep duration, we found that snoring and sleep duration (5.0-6.9 h) were both associated with high blood pressure (OR=1.49, 95%CI:1.32-1.69; OR=1.53, 95%CI: 1.28-1.81).@*Conclusion@#Snoring and sleep duration were positively associated with high blood pressure in this study. Interventions focusing on sleep status should be developed to reduce the incidence of high blood pressure in children and adolescents.
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Objective@#To describe the baseline characteristics of School-based Cardiovascular and Bone Health Promotion Program(SCVBH) in Beijing.@*Methods@#Children and adolescents were selected in 30 schools (8 primary schools, 21 middle schools and one 12-year education school) from Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by using a stratified cluster sampling method. 15 391 students in grade 1 to 4 from primary schools, grade 1 from junior and senior high schools were enrolled in the investigation with an exclusion of students who were not able to participate due to trauma or other uncomfortable physical conditions. The baseline survey including a questionnaire survey, physical examination and blood biochemical test was conducted from September 2017 to January 2018. Obesity, blood pressure, fasting blood glucose, lipid, bone density and grip were evaluated.@*Results@#The prevalence of obesity, hypertension, hyperglycemia (impaired fasting glucose and diabetes), dyslipidemia, lower bone density were 22.3%(3 394), 14.8%(2 248), 10.4%(1 490), 20.3%(2 919) and 2.1%(316) in total respectively, and 27.2%(2 081), 16.3%(1 244), 12.8%(922), 22.2%(1 595) and 1.2%(94) for boys, 17.3%(1 313), 13.3% (1 004), 7.9%(568), 18.4%(1 324) and 2.9%(229) for girls. Boys had higher prevalence of obesity, hypertension, hyperglycemia, and dyslipidemia and lower prevalence of low bone density than girls (all P values <0.05) The mean of body mass index, systolic blood pressure, fasting plasma glucose and grip of boys were significantly higher than that of girls (all P values <0.05).The mean of body mass index, systolic blood pressure, fasting plasma glucose and grip of boys were significantly higher than that of girls (all P values <0.05), the mean of fat mass percentage, total cholesterol, triglyceride, high density lipoprotein-cholesterol and low density lipoprotein-cholesterol of boys were significantly lower than those of girls (all P values <0.05).@*Conclusion@#The prevalence of risk factors of chronic cardiovascular disease was high and the low bone density was appearing in children and adolescents in this study. The promotion of cardiovascular and bone health should be implemented in children and adolescents.
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<p><b>OBJECTIVE</b>To examine the prevalence of obesity phenotypes and cardiometablic disorders (CDs) among children aged 6- 17 in Beijing from 2004 to 2013.</p><p><b>METHODS</b>Data were obtained from two cross-section surveys, which were conducted in 2004 and 2013. In 2004, by using stratified cluster sampling design, 20 primary or middle schools were selected from 7 districts (Xicheng, Dongcheng, Chaoyang, Haidian, Daxing, Pinggu, and Yanqing) in Beijing, and 20 554 school children aged 6-17 were recruited, with weight, height, waist circumference and blood pressure measured. Fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were measured in 962 subjects from one school. In 2013, by using the same sampling design, 7 211 students from two districts (Haidian and Dongcheng) were surveyed with weight, height, waist circumference and blood pressure measured, and fasting plasma glucose and lipid profile (TC, TG, HDL-C, LDL-C) were measured for 1 344 subjects in the same school measured in 2004. Student's-t test was used to analyze the difference in body mass index(BMI), WC, and waist to height ratio (WHtR) among children between 2004 and 2010. Chi-square test was used to analyze the difference of hypertension, impaired fasting glucose(IFG), dyslipidemia, and metabolic disorders clustering between 2004 and 2010, and among different types of obesity; logistic regression model was used to analyze the association between three types of obesity and risks of cardiovascular metabolic disorders.</p><p><b>RESULTS</b>In boys, BMI ((20.3 ± 4.4) vs (19.4 ± 4.2) kg/m(2), t=11.18, P<0.001), WC ((70.6 ± 12.8) vs (66.7 ± 11.8) cm, t=17.20, P<0.001) and WHtR (0.451 ± 0.064 vs 0.437 ± 0.059, t=11.64, P<0.001) were significantly higher in 2013 than those in 2004. Similarly in girls, BMI ((18.9 ± 3.6) vs (18.7 ± 3.7) kg/m(2), t=12.21, P<0.001), WC ((64.5 ± 9.6) vs (63.0 ± 9.3) cm, t=8.15, P<0.001) and WHtR (0.430 ± 0.047 vs 0.423 ± 0.047, t=14.13, P<0.001) were also significantly higher in 2013 than those in 2004. The prevalence of combined obesity rose from 8.27% (1 697/20 526) in 2004 to 10.74% (774/7 209) in 2013, and central obesity from 3.08% (632/20 526) to 4.44% (320/7 209). The prevalence of hypertension (10.78%(313/1 344) vs 4.29% (42/962), χ(2)=36.76, P<0.001), IFG(49.54%(664/1 344) vs 6.45%(63/962), χ(2)=506.61, P<0.001), high TC(11.53%(155/1 344) vs 5.03%(49/962), χ(2)=28.31, P< 0.001), high TG(7.51%(101/1 344) vs 3.59%(35/962), χ(2)=29.59, P<0.001) were significantly higher in 2013 than those in 2004. Subjects with combined obesity had higher risks of hypertension (OR=5.88, 95% CI: 4.42-7.82), high TG (OR=7.12, 95%CI: 4.35-11.64), low HDL-C (OR=3.04, 95%CI: 1.55-5.95), high LDL-C (OR=2.27, 95% CI: 1.22-4.02), CDs≥2 (OR=3.07, 95% CI: 2.09-4.50), comparing to children without obesity.</p><p><b>CONCLUSION</b>The prevalence of types of obesity and obesity-related metabolic disorders, except for low HDL-C and high HDL-C, were significantly higher in 2013 than those 2004 among chlildren aged 6-17 year in Beijing. Children with combined obesity had higher prevalence of metabolic disorders.</p>
Subject(s)
Adolescent , Child , Female , Humans , Male , Beijing , Blood Glucose , Blood Pressure , Body Mass Index , Body Weight , Cardiovascular Diseases , Epidemiology , Cholesterol, HDL , Blood , Cholesterol, LDL , Blood , Cross-Sectional Studies , Dyslipidemias , Epidemiology , Hypertension , Epidemiology , Lipids , Blood , Logistic Models , Obesity, Abdominal , Epidemiology , Pediatric Obesity , Epidemiology , Phenotype , Prevalence , Triglycerides , Blood , Waist CircumferenceABSTRACT
Objective To observe the prevalence of hyperuricemia(HUA)among obese children,and to ex-plore the association between uric acid(UA)levels and cardiometabolic risk factors,acanthosis nigricans and non - al-cohol fatty liver disease(NAFLD). Methods By using representative sampling method,1 753 obese children aged 6 -17 years old from 18 schools in 3 districts of Beijing(Xicheng,Haidian,Miyun)were selected to participate in the clini-cal examinations,including anthropometric measurements(height,weight)and blood pressure. Serum biochemical pa-rameters were assessed,including fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),high - densi-ty lipoprotein cholesterol(HDL - C),low - density lipoprotein cholesterol(LDL - C)and UA. Acanthosis nigricans and B - model ultrasonography of the liver were conducted. Results The prevalence of hypertension,impaired fasting glu-cose,dyslipidemia,acanthosis nigricans,and NAFLD among these 1 753 obese children was 33. 6%(589 cases), 66. 5%(1 156 cases),54. 3%(943 cases),23. 3%(408 cases),and 17. 0%(298 cases),respectively. The preva-lence of HUA was 40. 70%(714 / 1 753 cases),with 50. 17%(581 / 1 158 cases)in boys and 22. 34%(133 / 595 ca-ses)in girls. There was a significant increase in body mass index,systolic blood pressure,diastolic blood pressure, FPG,TG and LDL - C with the increase of UA,but there was a decrease in HLD - C with the increase of UA(all P ﹤0. 05). In boys,the adjusted odds ratios( OR)and 95% CI of the highest quartile of UA for hypertension,impaired fasting glucose,dyslipidemia,acanthosis nigricans,and NAFLD were 1. 16(0. 77 - 1. 74),1. 34(0. 90 - 1. 99),1. 29 (0. 89 - 1. 87),1. 89(1. 17 - 3. 04),and 1. 71(1. 03 - 2. 84),respectively;in girls,the adjusted OR and 95% CI of the highest quartile of UA for hypertension,impaired fas-ting glucose,dyslipidemia,acanthosis nigricans,and NAFLD was 0. 70(0. 40 - 1. 24),0. 60(0. 40 - 1. 00),1. 69(1. 04 - 2. 70),1. 67(0. 80 - 3. 49),and 1. 33(0. 48 - 3. 66),re-spectively. Conclusions The prevalence of HUA is relatively high in obese children and there is a strong association between UA and some car-diovascular metabolic disorders,acanthosis nigricans and NAFLD.
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Objective To evaluate the prevalence of metabolic syndrome (MS) in Chinese children and adolescents to provide scientific basis for early prevention of MS in the related populations.Methods Studies on CNKI,Wanfangdata,VIP and PubMed databases on related prevalence of metabolic syndrome in Chinese children and adolescents between 2004-2014 were searched.Quality of literatures was evaluated according to the cross-sectional study standard in Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.Stata 12.0 software was used to estimate the prevalence of MS,as well as on gender,weight and other factors to make subgroup analysis.According to funnel plot and Egger assess publication bias,sensitivity analysis performed by excluding the impact of any article was generated by the combined effect of the value of literature.Results This study included 19 papers from the literature (5 in English,14 in Chinese).According to International Diabetes Federation (IDF),National Cholesterol Education Program Ⅲ (NCEP Ⅲ) and The definition and prevention recommends of metabolic syndrome in Chinese children and adolescents (CHN2012),the prevalence rates of MS in Chinese children were seen as 1.8％,2.6％ and 2.0％.According to IDF,the prevalence rates of MS appeared 2.9％ in boys and 1.8％ in girls,0.2％ in children with normal weight,4.7％ in overweight and 17.3％ in obesity.Both the results from NCEP Ⅲ and CHN2012 showed that the prevalence rates of MS as boys＞girls,obesity＞overweight＞normal weight.Conclusion Prevalence of MS in Chinese children and adolescents showed a general trend.Data under different standards showed different prevalence rates.Obesity appeared an important risk factor of MS,suggesting that in order to control obesity in children,attention should be paid to identifying and carrying out effective interventions on children under overweight or obesity.
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<p><b>OBJECTIVE</b>To analyze the trends on the prevalence rates of obesity and cardiometabolic among children and adolescents in Beijing, during 2004-2013.</p><p><b>METHODS</b>Data was collected from three cross-sectional studies among children and adolescents, aged 7-17 years old in Beijing. Two studies in 2004 and 2013 were conducted in general population, and one was among obese children in 2007. Data on anthropometric measurements including weight, height, and age was collected from all the subjects. The obese children from all three studies underwent a clinic examination that containing blood pressure, fasting plasma glucose, lipid profile (TC, TG, LDL-C, HDL-C), and acanthosis nigricans. Liver transaminases detection (ALT and AST) and liver ultrasound examination were performed in obese children from surveys in 2007 and 2013.</p><p><b>RESULTS</b>The prevalence of severe obesity increased from 1.86% in 2004 to 4.17% in 2013, with an annual increase rate as 0.26%. The proportion of severe obesity in obesity increased from 18.92% in 2004 to 25.15% in 2013. After adjusting for age and gender, the prevalence of IFG, hypertriglyceridemia and low HDL-C in both obese children and adolescents increased during 2004-2013 (all P < 0.05). The prevalence rates of hypertension, dyslipidemia, hypertriglyceridemia, and acanthosis nigricans in severe obese children were higher than those in moderate obesity. The proportion of children with 2 or more cardiometabolic risk factors in severe obese children was higher than in moderate obese children.</p><p><b>CONCLUSION</b>The prevalence rates of obesity and cardiometabolic risk factors among children and adolescents in Beijing showed an increase during 2004-2013.</p>
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Adolescent , Child , Female , Humans , Male , China , Epidemiology , Pediatric Obesity , Epidemiology , Prevalence , Risk FactorsABSTRACT
Objective To understand the current status of physical activity among urban school-aged children and its association with obesity.Methods 295 pupils,aged 9 to 13 years were selected,using the method of convenience sampling.Data on anthropometric measurements was collected,including weight and height.Questionnaire survey,clinic examination,dietary investigation of school lunch and surveillance on 7-day physical activity by pedometers,were done and Multi-linear regression was used to analyze the relationship between waist to height ratio (WHtR),fat mass percentage (FMP),body mass index (BMI) and physical activity.Single-variable and multiple non-conditional logistic regression modeling were applied to analyze data collected from obesity and physical activities.Results 15.5％ of boys and 13.1％ of girls reached 60 minutes per day of ‘ moderate-vigorous physical activities’.Compared with normal children,overweight/obesity children showed an increase of sedentary activity time,total energy expenditure,and energy expenditure of physical activity.With the increase of 1 hours daily on going to school by private car,WHtR and FMP increased by 0.01 and 2.06 units,respectively.FMP increased 0.89 units among with the increase of sedentary activity time,1 hour daily.BMI and the intake of leafy vegetables (eg.spinach,cabbage)showed a negative correlation.As the frequency of leafy vegetables consumption increased once weekly,BMI fell 0.10 units.After adjustment for sex and age,the risk of overweight/obesity was 3.82-fold (95％CI:1.17-12.47) among children who had sedentary activity time more than 120 min/ d,than those having less than 120 min/d.Conclusion Our data showed that children' s daily physical activity was not enough and measures should be taken to decrease the time of sedentary behavior and increase the energy expenditure through physical activities.