A novel method for electroencephalography background analysis in neonates with hypoxic-ischemic encephalopathy / 中国当代儿科杂志

OBJECTIVES@#To explore a new method for electroencephalography (EEG) background analysis in neonates with hypoxic-ischemic encephalopathy (HIE) and its relationship with clinical grading and head magnetic resonance imaging (MRI) grading.@*METHODS@#A retrospective analysis was performed for the video electroencephalography (vEEG) and amplitude-integrated electroencephalography (aEEG) monitoring data within 24 hours after birth of neonates diagnosed with HIE from January 2016 to August 2022. All items of EEG background analysis were enrolled into an assessment system and were scored according to severity to obtain the total EEG score. The correlations of total EEG score with total MRI score and total Sarnat score (TSS, used to evaluate clinical gradings) were analyzed by Spearman correlation analysis. The total EEG score was compared among the neonates with different clinical gradings and among the neonates with different head MRI gradings. The receiver operating characteristic (ROC) curve and the area under thecurve (AUC) were used to evaluate the value of total EEG score in diagnosing moderate/severe head MRI abnormalities and clinical moderate/severe HIE, which was then compared with the aEEG grading method.@*RESULTS@#A total of 50 neonates with HIE were included. The total EEG score was positively correlated with the total head MRI score and TSS (rs=0.840 and 0.611 respectively, P<0.001). There were significant differences in the total EEG score between different clinical grading groups and different head MRI grading groups (P<0.05). The total EEG score and the aEEG grading method had an AUC of 0.936 and 0.617 respectively in judging moderate/severe head MRI abnormalities (P<0.01) and an AUC of 0.887 and 0.796 respectively in judging clinical moderate/severe HIE (P>0.05). The total EEG scores of ≤6 points, 7-13 points, and ≥14 points were defined as mild, moderate, and severe EEG abnormalities respectively, which had the best consistency with clinical grading and head MRI grading (P<0.05).@*CONCLUSIONS@#The new EEG background scoring method can quantitatively reflect the severity of brain injury and can be used for the judgment of brain function in neonates with HIE.

Risk factors of bronchopulmonary dysplasia in very preterm infants: a national multicenter study / 中国小儿急救医学

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Phenotypes and ATP7B gene variants in 316 children with Wilson disease / 中华儿科杂志

Objectives: To summarize the clinical phenotypes and the variation spectrum of ATP7B gene in Chinese children with Wilson's disease (WD) and to investigate their significance for early diagnosis. Methods: Retrospective analysis was performed on the clinical data of 316 children diagnosed as WD in Guangzhou Women and Children's Medical Center during the period from January 2010 to June 2021. The general situations, clinical manifestations, lab test results, imaging examinations, and ATP7B gene variant characteristics were collected. The patients were divided into asymptomatic WD group and symptomatic WD group based on the presence or absence of clinical symptoms at the time that WD diagnosis was made. The χ2 test, t test or Mann-Whitney U test were used to compare the differences between groups. Results: Among the 316 children with WD, 199 were males and 117 were females, with the age of 5.4 (4.0, 7.6) years at diagnosis; 261 cases (82.6%) were asymptomatic with the age of 4.9 (3.9, 6.4) years; whereas 55 cases (17.4%) were symptomatic with the age of 9.6 (7.3, 12.0) years. The main symptoms invloved liver, kidney, nervous system, or skin damage. Of all the patients, 95.9% (303/316) had abnormal liver function at diagnosis; 98.1% (310/316) had the serum ceruloplasmin lever lower than 200 mg/L; 97.7% (302/309) had 24-hour urine copper content exceeding 40 μg; only 7.4% (23/310) had positive corneal K-F rings, 8.2% (23/281) had abnormal MRI signals in the lenticular nucleus, and all of them had symptoms of damage in liver, kidney or nervous system. Compared with the group of symptomatic WD, asymptomatic group had higher levels of serum alanine aminotransferase and lower levels ceruloplasmin and 24-hour urine copper [(208±137) vs. (72±78) U/L, (55±47) vs. (69±48) mg/L, 103 (72, 153) vs. 492 (230, 1 432) μg; t=9.98, -1.98, Z=-4.89, all P<0.001]. Among the 314 patients completing genetic sequencing, a total of 107 mutations in ATP7B gene were detected, of which 10 are novel variants, and 3 cases (1.0%) had large heterozygous deletion (exons 10 to exon 11) in ATP7B gene. The percentage of missense mutation in asymptomatic WD children was significantly higher than that in symptomatic WD (81.5% (422/518) vs. 69.1% (76/110), χ²=8.47, P<0.05). WD patients carrying homozygous variant of c.2 333G>T had significantly low levels of ceruloplasmin than those not carrying this variant ((23±5) vs. (61±48) mg/L, t=-2.34, P<0.001). Conclusions: The elevation of serum ALT is an important clue for early diagnosis of WD in children, while serum ceruloplasmin and 24-hour urine copper content are specific markers for early diagnosis of WD. In order to confirm the diagnosis of WD, it is necessary to combine the Sanger sequencing with multiplex ligation-dependent probe amplification or other testing technologies.

Incidence of extrauterine growth retardation and its risk factors in very preterm infants during hospitalization: a multicenter prospective study / 中国当代儿科杂志

OBJECTIVES@#To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China.@*METHODS@#A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined.@*RESULTS@#The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05).@*CONCLUSIONS@#It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.

Characteristics and prognosis of neonatal pneumothorax: a clinical analysis of 150 cases / 国际儿科学杂志

Objective:To investigate the clinical characteristics of different gestational ages in neonatal pneumothorax and the influencing factors of adverse outcomes.Methods:Newborns with pneumothorax hospitalized in the neonatal intensive care unit, the division of neonatology of Shengjing hospital, China Medical University from Jan.2012 to Dec.2018 were included.Babies were divided into both premature group and full-term group according to gestational age(GA), and survival group and death group according to the outcomes.Multivariate logistic regression analysis was used to explore the influencing factors of death from pneumothorax in neonates.Results:150 children were included, of them 101 males, 49 females(2.06: 1), 103 outborn(68.7%)and 123 unilateral pneumothorax(82.0%). The overall mortality was 9.3%(14/150). There were 60 premature infants with gestational age(GA)28~36w and birth weight(BW)624~4 000 g, 5(8.3% in the premature group)died, and the other 90 were full-term infants with GA37~42w, BW2 650~4 700 g, 9(10.0% in the fullterm group)died.The rates of premature rupture of membranes(26.7%), resuscitation(26.7%), pulmonary surfactant(PS)(30.0%)and mechanical ventilation before pneumothorax(56.7%)in the preterm group were significantly higher than that in the term group(12.2%, 13.3%, 3.3% and 26.7%, P<0.05). Premature rupture of membranes more than 24 h( OR=1.230, 95% CI 3.800~3.940, P<0.05), mechanical ventilation( OR=2.491, 95% CI 1.322~4.694, P<0.05)and pulmonary hemorrhage( OR=36.846, 95% CI 5.840~232.462, P<0.05)were independently influencing factors of mortality.Apgar scores≥7 at one minute( OR=0.157, 95% CI 0.032~0.761, P<0.05)decreased the mortality. Conclusion:The majority of neonatal pneumothorax occurs within 48 h of birth and most are unilateral.The pneumothorax in preterm was mostly resulted from perinatal factors.Some factors are associated with the increasing of mortality.

Research advances in neonatal cerebral sinovenous thrombosis / 中国当代儿科杂志

Neonatal cerebral sinovenous thrombosis (CSVT) is a cerebrovascular disease with a seriously underestimated incidence rate. Due to a lack of specific clinical manifestations and the low sensitivity of conventional imaging examinations, it has long been considered a rare disease in neonates. In recent years, the development of magnetic resonance technology has improved the diagnostic rate of CSVT. This article reviews the research advances in intracranial venous anatomy of neonates and clinical manifestations, imaging features, treatment, and prognosis of CSVT and deep venous thrombosis, in order to improve the understanding and to make correct diagnosis and treatment of neonatal CSVT.

Physical Fitness for Children from Special Education Schools Based on ICF / 中国康复理论与实践

Objective To explore the functional status and influencing factors of physical fitness of children with intellectual and developmental disabilities enrolled in special education, and to establish framework of physical fitness for analysis of physical fitness and exercise intervention using International Classification of Functioning, Disability and Health (ICF). Methods Based on the ICF apporach, we analyzed the functional status and physical fitness characteristics and influencing factors of students in special education schools, and developed a function-based physical fitness intervention program for children with intellectual and developmental disabilities with reference to the requirements of WHO Guidelines on Physical Activity and Sedentary Behavior (2020). Results A systematic analysis of the overall functional status of children with intellectual and developmental disabilities based on ICF, especially intellectual functions, activities and environmental factors related to intellectual disability, was conducted and discussed in the context of related motor functions and physical fitness. A physical activity program was developed based on the ICF and with reference to WHO Guidelines on Physical Activity and Sedentary Behavior (Children and Adolescents), and related adaptive support strategies were proposed. Conclusion The overall functional status of children with intellectual and developmental disabilities has been analyzed in body functioning (both intellectual and motor), activity and participation, and environmental factors. Based on WHO Guidelines on Physical Activity and Sedentary Behavior and the ICF framework, a physical activity program for physical fitness with adaptive and supportive teaching and training methods, has been developed for children with intellectual and developmental disabilities.

Physical Fitness for Children from Special Education Schools Based on ICF / 中国康复理论与实践

Objective To explore the functional status and influencing factors of physical fitness of children with intellectual and developmental disabilities enrolled in special education, and to establish framework of physical fitness for analysis of physical fitness and exercise intervention using International Classification of Functioning, Disability and Health (ICF). Methods Based on the ICF apporach, we analyzed the functional status and physical fitness characteristics and influencing factors of students in special education schools, and developed a function-based physical fitness intervention program for children with intellectual and developmental disabilities with reference to the requirements of WHO Guidelines on Physical Activity and Sedentary Behavior (2020). Results A systematic analysis of the overall functional status of children with intellectual and developmental disabilities based on ICF, especially intellectual functions, activities and environmental factors related to intellectual disability, was conducted and discussed in the context of related motor functions and physical fitness. A physical activity program was developed based on the ICF and with reference to WHO Guidelines on Physical Activity and Sedentary Behavior (Children and Adolescents), and related adaptive support strategies were proposed. Conclusion The overall functional status of children with intellectual and developmental disabilities has been analyzed in body functioning (both intellectual and motor), activity and participation, and environmental factors. Based on WHO Guidelines on Physical Activity and Sedentary Behavior and the ICF framework, a physical activity program for physical fitness with adaptive and supportive teaching and training methods, has been developed for children with intellectual and developmental disabilities.

Differential expression of circular RNA in patients with white matter hyperintensity and cognitive impairment / 中南大学学报(医学版)

OBJECTIVES@#White matter hyperintensity (WMH) is an important factor leading to cognitive impairment, and the mechanism has not been clarified. In recent years, studies have found that circular RNA (circRNA) has differential expression in cerebrovascular diseases. This study aims to analyze the expression profile of circRNA in peripheral blood mononuclear cell (PBMC) of patients with WMH with cognitive impairment, to screen the differentially expressed circRNA, and to explore the possible role of circRNA in WMH with cognitive impairment.@*METHODS@#CircRNA microarray was used to detect the circRNA expression profile of PBMC in patients with WMH with cognitive impairment, and in patients with WMH without cognitive impairment as well as in normal controls (3 cases each, male to female ratio of 2꞉1). The differentially expressed circRNA in patients with WMH with cognitive impairment was screened. The screening criteria for differentially expressed circRNA was fold change (FC) ≥2.0 (|log@*RESULTS@#Compared with the control group, there were 5 significantly up-regulated circRNA and 3 down-regulated circRNA in the WMH with cognitive impairment group; 8 circRNA were significantly up-regulated and 2 were down-regulated in the WMH without cognitive impairment group. When compared with the WMH with cognitive impairment group, no co-differentially expressed circRNA was found in WMH without cognitive impairment group and control group. Compared with the control group, the expression of hsa_circ_0092222 was up-regulated and the expressions of hsa_circ_0000662 and hsa_circ_0083773 were down-regulated in the WMH with cognitive impairment group and the WMH without cognitive impairment group, and there was no significant difference between the 2 groups (all @*CONCLUSIONS@#The circRNA expression profile of patients with WMH is changed significantly. The differentially expressed circRNA may be the cause of WMH; Hsa_circ_0092222, hsa_circ_0000662, and hsa_circ_0083773 may regulate the expression of target genes by targeting adsorption of the target miRNA, leading to brain white matter damage through Janus kinase 2 (JAK2)/signal transducers and activators of transcription (STAT3) signal pathway and Wnt signal pathway.There is no significant difference in circRNA expression profile between WMH with or without cognitive impairment. Cognitive impairment in patients with WMH may have other reasons.

Clinical analysis of early-onset group B Streptococcus infection induced purulent meningitis in newborns / 中国小儿急救医学

Objective:To explore the value of magnetic resonance imaging(MRI) in clinical diagnosis and prognosis by comparing the clinical features of early-onset group B Streptococcus(GBS)-induced purulent meningitis and the performance of head MRI.Methods:A retrospective analysis was performed on the clinical characteristics and MRI features of 16 neonates with early-onset GBS induced purulent meningitis admitted to Shengjing Hospital of China Medical University from January 2013 to December 2017.Results:Among the 16 neonates with early-onset GBS induced purulent meningitis, there were three cases showing specific neurological symptoms, including varying degrees of convulsions and/or changes in muscle tone.There were two cases showing the general infection manifestations such as lethargy, refusal of milk, low response, and only two cases had fever.Eleven cases of neonates with purulent meningitis had a head MRI examination.There were three cases of brain edema of different degrees, and one of which had ventricular ependymitis; Seven cases had white matter damage, and two cases of which complicated with ventricular hemorrhage.And one case had cerebral infarction.A total of 11 cases were improved or cured clinically, four cases gave up treatment due to serious complications, and one case died in hospital.Conclusion:The incidence of early-onset GBS-induced purulent meningitis is high and the prognosis is poor.The neurological pathological changes of the brain can be found through MRI examination, which provides an objective basis for the diagnosis, treatment and prognosis.

Analysis of gut microbiota change in colorectal adenomatous polyps patients by 16S rRNA sequencing / 中华检验医学杂志

Objective@#To explore the characteristics of gut microbiota change in colorectal adenomatous polyps (CAP), which has been considered as precancerous lesion for colorectal cancer.@*Methods@#Thirty patients with colon adenomatous polyps (CAP group) and thirty healthy individuals without adenomatous polyps (HC group) who underwent colonoscopy at the First Affiliated Hospital of Kunming Medical University from November 2017 to April 2018 were randomly collected. The biopsy mucosae were collected by endoscopic electrocoagulation, and DNA was extracted to amplify 16S rRNA V3-V4 region, followed high-throughput sequencing with Illumina MiSeq platform. The experimental results were analyzed using Wilcoxon test.@*Results@#The alpha diversity of CAP patients was higher than that of healthy controls (Chao & Ace P<0.01). A decreased abundance of Bacteroidetes (FC=0.38) was observed at phylum level(P<0.05). At genus level, the abundances of Bacteroides (FC=0.32) , Escherichia (FC=0.57) , Ruminococcus (FC=0.42) , Blautia (FC=0.27) , and Dorea (FC=0.57) were decreased (P<0.05), but those of Pseudomonas(FC=2.43), Lactococcus(FC=2.84), Geobacillus(FC=2.07), and Acinetibacter(FC=2.36) were increased in CAP patients (P<0.05).@*Conclusions@#Compared with healthy volunteers, there are significant differences in the abundance and diversity of the adenoma tissue in CAP patients, indicating that there is an imbalance of gut microbiota in the adenomatous polyps. The imbalance of intestinal microenvironment may contribute to the occurrence and development of CAP.

Analysis of gut microbiota change in colorectal adenomatous polyps patients by 16S rRNA sequencing / 中华检验医学杂志

Objective:To explore the characteristics of gut microbiota change in colorectal adenomatous polyps (CAP), which has been considered as precancerous lesion for colorectal cancer.Methods:Thirty patients with colon adenomatous polyps (CAP group) and thirty healthy individuals without adenomatous polyps (HC group) who underwent colonoscopy at the First Affiliated Hospital of Kunming Medical University from November 2017 to April 2018 were randomly collected. The biopsy mucosae were collected by endoscopic electrocoagulation, and DNA was extracted to amplify 16S rRNA V3-V4 region, followed high-throughput sequencing with Illumina MiSeq platform. The experimental results were analyzed using Wilcoxon test.Results:The alpha diversity of CAP patients was higher than that of healthy controls (Chao & Ace P<0.01). A decreased abundance of Bacteroidetes (FC=0.38) was observed at phylum level( P<0.05). At genus level, the abundances of Bacteroides (FC=0.32) , Escherichia (FC=0.57) , Ruminococcus (FC=0.42) , Blautia (FC=0.27) , and Dorea (FC=0.57) were decreased ( P<0.05), but those of Pseudomonas(FC=2.43), Lactococcus(FC=2.84), Geobacillus(FC=2.07), and Acinetibacter(FC=2.36) were increased in CAP patients ( P<0.05). Conclusions:Compared with healthy volunteers, there are significant differences in the abundance and diversity of the adenoma tissue in CAP patients, indicating that there is an imbalance of gut microbiota in the adenomatous polyps. The imbalance of intestinal microenvironment may contribute to the occurrence and development of CAP.

Analysis and prediction of clinical features of different prognosis of neonates with group B streptococcal infection / 中国小儿急救医学

Objective To analyze the risk factors leading to poor prognosis and to explore the pre-dictive value of related indicators by comparing the clinical features of different prognosis of neonates infected with Group B Streptococcus (GBS). Methods A retrospective study was performed on the clinical data of 56 neonates with GBS infection in blood culture admitted to Shengjing Hospital of China Medical University from January 2013 to December 2017. According to the clinical outcomes,the neonates were divided into sur-vival group (n＝37) and death group (n＝19). The clinical characteristics and laboratory results between the two groups were analyzed and compared. Results The gestational age and age of onset in the death group were younger than those in the survival group,the differences were statistically significant (P<0. 05). The C-reactive protein and cerebrospinal fluid leukocyte count and protein in the death group were higher than those in the survival group,and the differences were statistically significant (P<0. 05). Logistic regression multivariate analysis found that gestational age was an independent risk factor for the death of neonates infec-ted with GBS(OR＝7. 56,95%CI:1. 536~37. 209). The area under the ROC curve for cerebrospinal fluid protein and white blood cell levels predicting death in children was 0. 733 ( P <0. 05 ) and 0. 723 ( P <0. 05),respectively,and the cerebrospinal fluid protein threshold was 1. 305 g/L,the threshold value of white blood cells was 1 947×106/L. Conclusion The gestational age of children with GBS infection has a very close relationship with the prognosis; cerebrospinal fluid protein and white blood cell levels have predictive value for the risk of death in children.

Clinical features and outcomes of neonatal necrotizing enterocolitis / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features of neonatal necrotizing enterocolitis (NEC) and risk factors for poor outcomes.@*METHODS@#A retrospective analysis was performed for the clinical data of 121 preterm infants diagnosed with NEC. According to the treatment method, they were divided into a non-surgical group (n=66) and a surgical group (n=55). According to the outcome, they were divided into a survival group (n=76) and a death group (n=45). Clinical features were compared between these groups. Risk factors for poor outcomes were analyzed by multivariate logistic regression analysis.@*RESULTS@#Compared with the non-surgical group, the surgical group had significantly lower corrected gestational age, minimum platelet count, and incidence rate of bloody stool at the onset of NEC (P<0.05). The maximum C-reactive protein (CRP) and mortality rate in the surgical group were significantly higher than those in the non-surgical group (P<0.05). Compared with the survival group, the death group had significantly lower gestational age at birth, birth weight, proportion of small-for-gestational-age infants, and corrected gestational age, body weight and minimum platelet count at the onset of NEC (P<0.05). The incidence of patent ductus arteriosus, rate of use of ibuprofen, maximum CRP and rate of surgical treatment in the death group were significantly higher than those in the survival group (P<0.05). The multivariate logistic regression analysis showed that ibuprofen treatment was a risk factor for death in infants with NEC (OR=9.149, P<0.05).@*CONCLUSIONS@#Ibuprofen treatment increases the risk for death in preterm infants with NEC.

Characteristics of Physical Fitness for Students from Special Education Schools in Beijing / 中国康复理论与实践

Objective:To explore the physical fitness of students from special education schools in Beijing. Methods:From September to December, 2016, 810 students aged seven to 15 years from 19 special education schools in Beijing were tested with physical fitness test. Results:There were significant differences in height, mass and vital capacity among students of different ages (F > 8.273, P < 0.001), which increased with age, but were lower than that of normal students. Gender and age had significant effects on height, mass and vital capacity (P < 0.01). Level of disability had significant effects on height and vital capacity (P < 0.01), while no effect on body mass (P > 0.05). There were significant differences in 50-meter running, sandbag throwing, 30 seconds sit-ups, 6/9 minutes running/walking, one-leg standing and sit & reach among students of different ages (F > 3.571, P < 0.001). Most of the items increased with age, but were lower than that of normal students. Gender, age and level of disability had significant effects on 50-meter running, sandbag throwing, 30 seconds sit-ups, 6/9 minutes running/walking, one-leg standing and sit & reach (P < 0.05). Conclusion:There are significant differences in body morphology, function and physical fitness among students of different ages, and the differences increase with age, but they are worse than the normal students as a whole. Gender, age and level of disability have a significant effect on body morphology, function and physical fitness among students of different ages.

Influence of menopause status on breast fibrograndular tissue and background parenchymal enhancement / 复旦学报（医学版）

Objective To evaluate the influence of menopause status on breast fibrograndular tissue (FGT),background parenchymal enhancement volume ratio (BPEv) and intensity ratio (BPEI) by breast MR image automatic quantitative analysis.Methods From 14 033 consecutive patients who underwent breast MR in our center from 2009 to 2012,we randomly selected 101 normal cases (47cases of premenopausal and 54 cases of postmenopausal).Premenopausal status was subclassified into four groups (8 cases in the 1st week and 13 cases in the 2nd,3rd and 4th week,respectively) based on the menstrual cycle.We evaluated FGT,BPEv and BPEI at early (2 minutes),medium (4 minutes) and late (6 minutes) enhanced time phases of breast MRI for quantitative assessment.The FGT,BPEv and BPEI in premenopausal and postmenopausal women were compared using the Mann-Whitney U test.Comparison of each menstrual cycle was made using the Kruskal-Wallis test.Results The FGT,BPEv and middle-late BPEI of postmenopausal women were significantly lower than that of premenopausal women (P＜0.05).The maximum BPEI was in the 1st week,the minimum in the 2nd week in premenopausal women (P＜0.05).The FGT and BPEv in the 1st week were the highest among the 4 weeks,but there was no significant difference.Conclusions The FGT,BPEv and BPEI were significantly decreased after menopause.The optimal time of breast MR examination is in the 2nd week of menstrual cycle.

Influencing factors for bronchopulmonary dysplasia in VLBWI and ELBWI / 国际儿科学杂志

Objective To explore causes and clinical factors associated with bronchopulmonary dyspla-sia( BPD) in very low birth weight infant ( VLBWI) and extremely low birth weight infant( ELBWI) . Methods A retrospective analysis was performed on the clinical data of VLBWI and ELBWI,whose birth weight less than1200g and diagnosed BPD in NICU of Shengjing Hospital between Jan. 1st 2010 and Dec. 31st 2014. No-BPD infants with the same birth weight and during the same period were selected as the control group. Results One handred and twenty-eight cases met the criteria of BPD,whose mean gestational age(GA) was (28. 6 ± 1. 8)weeks. Other 121cases were no-BPD,and mean GA was (30. 8 ± 1. 8)weeks. Maternal hypertension during pregnancy,gestational age,birth weight,small for age infant were lower in BPD group than those in no-BPD group. Prenatal infection,premature rupture of membrances≥18h,cesarean delivery,male,Apgar 1min≤3,intra-partum recovery,alveolar surface active substances,mechanical ventilation and the time,oxygen time were higher in BPD group than those in no-BPD group. Logistic regression analysis indicated that low gestational age( OR=1. 014,P<0. 05),male(OR=2. 771,P<0. 05),duration of invasive mechanical ventilation(OR=1. 014,P<0. 05),duration of CPAP(OR=1. 008,P<0. 05)lead to BPD. Multiple logistic regression model showed that Apgar 1min≤3(95％CI:1. 274～14. 017,χ2 = 5. 550,P=0. 018,OR=4. 226),duration of invasive mechanical ventilation(95％CI:1. 001 ～1. 004,χ2 =10. 410,P =0. 001,OR =1. 003),PDA surgery(95％CI:1. 345 ～129. 693,χ2 =4. 904,P=0. 027,OR=13. 210) were the independent risk factors for the moderate-severe BPD. Conclusion Our study showed that low GA,male,long duration of mechanical ventilation were risk factors of the development of BPD. Apgar 1min≤3,duration of mechanical ventilation,PDA surgery were related with moderate-severe BPD.

Research progress in drug therapy for bronchopulmonary dysplasia in preterm infants / 中国当代儿科杂志

Bronchopulmonary dysplasia (BPD) is the most common long-term complication in surviving extremely preterm infants. This may lead to pulmonary hypertension, increase late neonatal mortality, and cause abnormal neural development. There is still controversy over the efficacy, as well as advantages and disadvantages, of drug therapy for BPD in preterm infants. This article reviews the research progress in the drug therapy for BPD.

Correlation between magnetic resonance imaging score and clinical grading in neonatal hypoxic-ischemic encephalopathy / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the correlation between magnetic resonance imaging (MRI) score and clinical grading in neonatal hypoxic-ischemic encephalopathy (HIE).</p><p><b>METHODS</b>Clinical grading was performed for 61 neonates with HIE according to the HIE clinical grading standard. The modified MRI scoring system was used to determine the injury scores on different MRI sequences. The correlation between HIE imaging score and clinical severity was analyzed.</p><p><b>RESULTS</b>The MRI score in neonates with moderate HIE was significantly lower than that in those with severe HIE (P<0.01). Neonates aged 0-7 days had the highest correlation coefficient between diffusion weighted imaging (DWI) score and total MRI score (r>0.9), and neonates aged >7 days had the highest correlation coefficient between T1-weighted imaging score and total MRI score (r=0.963). Brain MRI showed injuries in the basal ganglia/thalamus+brainstem and even the whole brain in neonates with severe HIE, while the neonates with moderate HIE had injuries in the cerebral watershed, with little involvement of the brainstem (P<0.01).</p><p><b>CONCLUSIONS</b>There is a good correlation between the MRI scoring system and clinical grading in neonatal HIE, suggesting the system can help with the clinical diagnosis and grading of HIE.</p>

Design and implementation of big data ad-hoc queries and statistics subsystem for miliary electronic health records / 军事医学

Objective To improve the analysis efficiency and interactive experience of the Military Electronic Health Records System(MEHRS)and to realize quick response of ad-hoc queries and statistics in the MEHRS with big data columnar storage and processing technologies.Methods We carried out requirement analysis and functional design of the ad-hoc queries and statistics subsystem of the MEHRS,proposed a three-tier architecture which included the archive storage layer,statistical pretreatment layer and statistical application layer.After the selection and evaluation of big data processing technologies,CarbonData columnar storage was used to store preprocessed data and executed statistics with Spark SQL on the basis of medical business data modeling and preprocessing.Results Five testing tasks were executed on two million archives in the following two subsystems:one with modeless and non-preprocessed MongoDB storage,the other with modeled and preprocessed CarbonData storage.The latter could finish these tasks within seconds and was dozens of times more efficient than the former statistically.Conclusion This study designs and implements a big data technology proposal that satisfies the quick response of ad-hoc queries and statistics in the MEHRS, providing powerful and flexible technical support for big data statistical analysis.