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Objective:To compare the clinical application of aspirin and low molecular weight heparin in pulmonary lobectomy after percutaneous coronary intervention(PCI), and to explore the effect of aspirin monotherapy in anti-platelet therapy.Methods:From January 2018 to December 2019, the clinical data of 48 patients with coronary atherosclerotic heart disease(coronary heart disease) who underwent lobectomy in the Thoracic Surgery Department of Beijing Anzhen Hospital within 12 months after PCI were retrospectively analyzed. There were 37 males and 11 females. The age ranged from 41 to 76(67.6±10.4) years. There were 22 cases with hypertension, 18 cases with diabetes and 2 cases with cerebrovascular disease. Iliac artery stents were inserted in 2 cases and vertebral artery stents in 1 case. Preoperative atrial fibrillation in 2 cases. There were 46 patients with gradeⅠand 2 patients with gradeⅡcardiac function(NYHA). According to the preoperative antiplatelet treatment, the patients were divided into aspirin group(25 cases) and low molecular weight heparin group(LMWH group, 23 cases). In the aspirin group, clopidogrel or ticagrelor was stopped 5 days before lobectomy, and aspirin single drug antiplatelet therapy was used, orally 100 mg every day until the morning of operation. In the LMWH group, aspirin, clopidogrel or ticagrelor were stopped 7 days before surgery, and 0.6 ml LMWH calcium was injected subcutaneously, once every 12 hours, and stopped 12 hours before surgery. Perioperative clinical data of the two groups were recorded and analyzed, and major adverse cardiac event(MACE) and bleeding events were observed.Results:There was no death in all groups. MACE and bleeding occurred in 1 case respectively in LMWH group. There were no significant differences between the two groups in length of hospital stay, duration of operation, diameter of lesion, total postoperative thoracic drainage and retention time of thoracic drainage tube( P>0.05). The intraoperative blood loss and chest drainage in the aspirin group were significantly lower than those in the LMWH group in the first 3 days after surgery, with statistical significance( P<0.05). Conclusion:The incidence of MACE increases after lobectomy for coronary heart disease within 12 months after PCI, and aspirin monotherapy is safe and effective in antiplatelet therapy.
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Objective:To systematically analyze the clinical features of severe fever with thrombocytopenia syndrome (SFTS) and to provide evidence for the prevention and treatment of SFTS.Methods:Relevant studies of SFTS from six databases, including China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP, PubMed, Cochrane Library and Embase from January 2009 to May 2019 were systematically searched and identified. The literatures were screened and the data of patients′ epidemiology, clinical manifestations, laboratory examinations and prognosis were obtained. Revman 5.2 software was used for meta analysis.Results:Sixty-eight Chinese literatures and fourteen English literatures encompassing 6 780 patients with SFTS were included in the final analysis. Of these patients, 845 cases (12.46%) died. SFTS mostly occurred in mountainous and hilly areas, and farmers (3 637 cases) were the usual victims. The onset season was mostly in summer and the peak was from May to August each year. There were 1 434 patients had a clear history of tick bites, and 21 cases were human-to-human transmitted.There were 6 071 cases (89.54%) presented with fever, 5 407 cases (79.75%) presented with fatigue, 3 140 cases (46.31%) presented with muscle soreness, and 2 300 cases (33.92%) presented with chills.Using random effects model for meta analysis, the levels of creatine kinase (CK) (mean difference ( MD)=500.40, 95% confidence interval ( CI) 380.51-620.28, P<0.01) and lactic acid dehydrogenase (LDH)( MD=442.81, 95% CI 152.85-732.78, P=0.003) in severe patients were both higher than those in mild patients, and the difference were both statistically significant. The risk of death increased in patients aged>60 years( MD=8.19, 95% CI 4.03-12.36, P<0.01). The levels of CK( MD=530.92, 95% CI 29.27-1 032.56, P=0.040), LDH( MD=609.28, 95% CI 80.25-1 138.31, P=0.020), urea nitrogen ( MD=4.67, 95% CI 3.05-6.30, P<0.01) and creatinine ( MD=43.05, 95% CI 23.49-62.62, P<0.01) of patients in the death group were all higher than those in the survival group. The differences were all statistically significant. Conclusions:During the course of SFTS, the patients may show impaired blood system, heart, liver and kidney functions with high mortality. Clinicians should timely monitor the changes of blood routine, myocardial enzyme spectrum, liver and kidney functions and other indicators, so as to find cardiovascular and other system complications as early as possible. Timely treatment could not only reduce liver, heart and other organ injuries, but also reduce mortality.
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Objective To sum up the measures for nursing the patients with laparoscopic gastrectomy-induced anastomotic leakage treated by open center vacuum aspiration. Method We retrospectively reviewed the histories of 22 patients with laparoscopic gastrectomy-induced anastomotic leakage to look into the nursing measures to look into the management of open vacuum aspiration , observation of the drainage, leakage care, mental care. Results The time for open center vacuum aspiration was between 10 to 17 days, averaged (15.63 ± 3.22)d. The hospital stay was between 13 to 23 days, averaged (17.21 ± 5.47)d. No complications were observed. Conclusions The nursing measures for managing the anastomotic leakage can be effective in improving the effect of peritoneal irrigation. The mental care can be effective for the reduction of patients′pains so as to promote the heal of the leakages.
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Objective To explore the relationship between osteoporosis and serum total type Ⅰ amino terminal extension of the peptide,vitamin D3 and smoking index in the patients with chronic obstructive pulmonary disease (COPD).Methods One hundred and fifty patients with COPD (test group) and 150 healthy people (control group) were selected.The total type Ⅰ amino terminal extension of the peptide was measured by electrochemical luminescence,and enzyme-linked immunoassay was adopted to determine the vitamin D3.The 150 patients with COPD were divided into slight group (45 cases),moderate group (52 cases) and severe group (53 cases) according to the severity of COPD.In 150 patients with COPD,120 patients with smoking were divided into 3 groups according to smoking index:A group smoking index ＜ 360,36 cases;B group smoking index 360-400,34 cases;and C group smoking index 401-560,50 cases.The levels of serum total type Ⅰ amino terminal extension of the peptide and vitamin D3 were compared and correlation was analyzed.Results The vitamin D3 and the total type Ⅰ amino terminal extension of the peptide levels in test group were significandy lower than those in control group:(35.37 ± 12.11) mg/L vs.(45.88 ± 12.55) mg/L and (38.16 ± 11.12) mg/L vs.(45.23 ± 12.33) mg/L,and there were statistical differences (t =2.74 and 4.64,P＜ 0.01).The levels of vitamin D3 and the total type Ⅰ amino terminal extension of the peptide in slight,moderate and severe group were decreased in turn,and the levels of total type Ⅰ amino terminal extension of the peptide and the vitamin D3 were positively associated with the severity of COPD (r =0.185 and 0.257,P ＜ 0.05).The levels of vitamin D3 and total type Ⅰ amino terminal extension of the peptide in A,B and C group were decreased in turn,and the levels of total type Ⅰ amino terminal extension of the peptide and the vitamin D3 were positively associated with smoking index (r =0.159 and 0.172,P ＜ 0.05).Conclusion COPD patients are easier to suffer from osteoporosis compared with healthy population,and the serum vitamin D3 and total type Ⅰ amino terminal extension of the peptide can forecast the osteoporosis in COPD patients.
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Objective To observe the efficacy of lowering blood pressures and TCM syndrome on the mild to moderate hypertension via the treatment of auricular syndrome differentiation combined with magnetic point application;To provide reference for clinical treatment of hypertension by non-pharmaceutical therapy. Methods Totally 260 patients with mild to moderate hypertension were randomly divided into control group and treatment group, 130 cases for each. The control group was given Norvasc by conventional oral dosage, and the treatment group was given auricular syndrome differentiation and Yongquan (KI1) magnetic point application additionally. SBP, DBP and TCM syndrome scores of the two groups were observed before and after treatment to evaluate the antihypertensive efficacy and TCM syndrome efficacy. The side effects were also observed. Results After treatment, SBP of the two groups decreased significantly (P0.05). DBP of the treatment group decreased significantly (P0.05). TCM syndrome of treatment group improved significantly compared with the control group (P<0.05). The total effective rate of TCM syndromes in treatment group was better than the control group (P<0.05), without side effects. Conclusion Auricular syndrome differentiation combined with magnetic point application can not only significantly improve the TCM syndrome of patients with mild to moderate hypertension, but also has synergistic hypotensive efficacy and high safety.
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<p><b>OBJECTIVE</b>To investigate the outcomes and relative risk factors in subjects with impaired fasting glucose in Inner Mongolia, China.</p><p><b>METHOD</b>A total number of 32 villages in Kezuohou Banner and Naiman areas in Inner Mongolia were selected as the baseline surveys study fields from 2002 to 2003. Patients with IFG (5.6 mmol/L≤FPG<7.0 mmol/L) but without history of diabetes were selected as the study subjects. A follow-up study was conducted in 2013. Multinomial logistic regression analysis was used to evaluate the correlated factors.</p><p><b>RESULTS</b>There were 384 patients with IFG recruited in the study. Out of them, 150 (39.1%) progressed to normoglycaemia, 174 (45.3%) remained as IFG, and 60 (15.6%) developed into type 2 diabetes mellitus. Through adjustment multivariately, patients that returning to the status of normoglycaemia were significantly associated under the function of TG (OR = 0.692, 95%CI:0.502-0.952, P < 0.05)and those developed to diabetes were significantly associated with factors as age(OR = 1.052, 95%CI:1.014-1.090, P < 0.05) or obesity (OR = 2.924, 95% CI:1.353-6.320, P < 0.05).</p><p><b>CONCLUSION</b>15.6% of the IFG patients developed diabetes mellitus among the Inner Mongolian population. Elevated TG was an inhibition factor for patients returning to normoglycaemia while both age and abdominal obesity were risk factors for the development of diabetes in the Inner Mongolian population.</p>
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Humans , Blood Glucose , China , Epidemiology , Diabetes Mellitus, Type 2 , Epidemiology , Fasting , Blood , Follow-Up Studies , Obesity , Epidemiology , Prediabetic State , Epidemiology , Risk FactorsABSTRACT
Objective To investigate the outcomes and relative risk factors in subjects with impaired fasting glucose in Inner Mongolia,China.Method A total number of 32 villages in Kezuohou Banner and Naiman areas in Inner Mongolia were selected as the baseline surveys study fields from 2002 to 2003.Patients with IFG(5.6 mmol/L≤FPG＜7.0 mmol/L) but without history of diabetes were selected as the study subjects.A follow-up study was conducted in 2013.Multinomial logistic regression analysis was used to evaluate the correlated factors.Results There were 384 patients with IFG recruited in the study.Out of them,150 (39.1％) progressed to normoglycaemia,174 (45.3％) remained as IFG,and 60 (15.6％) developed into type 2 diabetes mellitus.Through adjustment multivariately,patients that returning to the status of normoglycaemia were significantly associated under the function of TG (OR=0.692,95％CI:0.502-0.952,P＜0.05) and those developed to diabetes were significantly associated with factors as age (OR=1.052,95％CI:1.014-1.090,P＜ 0.05) or obesity (OR=2.924,95％ CI:1.353-6.320,P＜0.05).Conclusion 15.6％ of the IFG patients developed diabetes mellitus among the Inner Mongolian population.Elevated TG was an inhibition factor for patients returning to normoglycaemia while both age and abdominal obesity were risk factors for the development of diabetes in the Inner Mongolian population.
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Objective To investigate the outcomes and relative risk factors in subjects with impaired fasting glucose in Inner Mongolia,China.Method A total number of 32 villages in Kezuohou Banner and Naiman areas in Inner Mongolia were selected as the baseline surveys study fields from 2002 to 2003.Patients with IFG(5.6 mmol/L≤FPG＜7.0 mmol/L) but without history of diabetes were selected as the study subjects.A follow-up study was conducted in 2013.Multinomial logistic regression analysis was used to evaluate the correlated factors.Results There were 384 patients with IFG recruited in the study.Out of them,150 (39.1％) progressed to normoglycaemia,174 (45.3％) remained as IFG,and 60 (15.6％) developed into type 2 diabetes mellitus.Through adjustment multivariately,patients that returning to the status of normoglycaemia were significantly associated under the function of TG (OR=0.692,95％CI:0.502-0.952,P＜0.05) and those developed to diabetes were significantly associated with factors as age (OR=1.052,95％CI:1.014-1.090,P＜ 0.05) or obesity (OR=2.924,95％ CI:1.353-6.320,P＜0.05).Conclusion 15.6％ of the IFG patients developed diabetes mellitus among the Inner Mongolian population.Elevated TG was an inhibition factor for patients returning to normoglycaemia while both age and abdominal obesity were risk factors for the development of diabetes in the Inner Mongolian population.
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Objective To investigate the relationship between neutrophil ratio/blood glucose and short outcome among patients with acute ischemic stroke admitted to hospitals.Methods A total of 2 265 acute ischemic stroke patients in four hospitals in Shandong province were included in this study.Through access to patients' files,data on demographic,lifestyle,medical history,family history and laboratory findings were collected from all participants at admission.Endpoint of the study was defined as poor short-term prognosis of acute cerebral infarction (NIHSS≥5) at discharge or death during hospitalization.Subjects of this study were divided into four groups:normal neutrophil ratio with normal blood glucose (NN/NG) ;normal neutrophil ratio with high blood glucose (NN/IG) ;high neutrophil ratio with normal blood glucose (IN/NG) and high neutrophil ratio with high blood glucose (IN/IG).Non-conditional logistic regression analysis was used to evaluate the association between blood glucose/neutrophil ratio and the short outcome of acute ischemic stroke.Results Neutrophil ratio and the level of blood glucose in patients with study endpoints were both higher than those without the study endpoints,and the difference was statistically significant (all P＜0.05). After multivariate adjustment,when compared to NN/NG group,the ORs (95％ CI) of NN/IG,IN/NG and IN/IG group were 1.356 (0.942-1.953),1.879 (1.113-3.171) and 2.210 (1.477-3.307),respectively.Conclusion Neutrophil ratio at admission was an independent risk factor of poor short outcome in patients with acute ischemic stroke.IN/IG group was considered at a highest risk in general population.Neutrophil ratio/glucose was valuable in predicting the incidence of poor short outcome in acute ischemic stroke patients.
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Objective To explore the effect on immunologic function of gastric carcinoma patients after operation by transposition of a transverse colon segment as a gastric reservoir following total gastrectomy.Methods A prospective,randomized,double-blind clinical trial was performed.One hundred and sixty-seven gastric carcinoma patients were divided into control group and research group in terms of balanced random groups.We reconstructed digestive tract with conventional Schlatter esophagojejunostomy and Roux-enY esophagojejunostomy in control group,while we reconstructed digestive tract with transposition of a transverse colon segment as a gastric reservoir in rcsearch group.the changes of T cell subset,IL-2,immunologic function of red blood cell,acute inflammatory mediator were analyzed in the patients respectively at the first day before operation,at the first day after operation,at the ninth day after operation.Postoperative fatality rate was also detected in two groups.Results Compared with control group,The changes of T cell subset,IL-2 had no significant differences in research group at the first day after operation (P ＞ 0.05).chaplet Meanwhile,the changes of C3b receptor chaplet rate and immunocomplex receptor rate had no significant differences in rcscarch group compared with control group at the first day after operation (P ＞ 0.05).There were no obvious differences for acute inflammatory mediators between two groups at the first day after operation (P＞0.05).At the ninth day after operation,the levels of CD4+ (44.68 ±5.92)％ in control group were obviously lower than those (48.75 ± 6.24)％ in research group (P ＜ 0.05).However,the percentage of CD8 + T cells (27.21 ± 3.07) ％ in control group was significantly higher than that (24.26 ±2.39) ％ in research group (P ＜ 0.05).The levels of IL-2 in control group and research group were (1.49 ± 0.32) μg/L and (1.67 ± 0.35) μg/L,with obvious differences between two groups (P ＜ 0.05).At the ninth day after operation,C3b receptor chaplet rate (39.27 ± 6.88) ％ in research group was markedly higher than that (30.25 ± 6.65) ％ in control group (P ＜ 0.05).The levels of IL-6 in control group were (125.51 ± 18.24) pg/mL,while the levels of IL-6 in research group were(87.34 ± 12.88) pg/mL,with obvious differences (P ＜ 0.05).There was no significant difference for postoperative fatality rate between two groups (P ＞ 0.05).Conclusions The transposition of a transverse colon segment as a gastric reservoir is a safely new mode in the reconstruction of alimentary.It is positive to improve immunologic function for gastric carcinoma patients after operation.
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OBJECTIVE@#To explore the influence of hypoxemia on the hearing of children with childhood obstructive sleep apnea-hypopnea syndrome (OSAHS).@*METHOD@#Auditory brainstem response (ABR) and distortion-product otoacoustic emission (DPOAE) was recorded in 68 ears and 60 ears respectively of children suffering from OSAHS with "A" tympanogram. Meanwhile, ABR and DPOAE was also recorded in 30 controls of children with "A" tympanogram.@*RESULT@#There was no statistical difference between the mild OSAHS group and the control group in the latency of wave I, III and V, the interval between wave I and III, III and V, I and V. There was significant difference between the moderate and severe OSAHS group and the control group in the delayed latency of wave I. There was significant difference between the mild OSAHS group and the control group in the amplitudes of DPOAE at 8 kHz. There was significant difference between the moderate and severe OSAHS group and the control group in the amplitudes of DPOAE at 6 kHz and 8 kHz.@*CONCLUSION@#Cochlear function was affected when AHI > or = 10/h. ABR and DPOAE could be used to detect the early damagement of auditory function in childhood OSAHS.
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Adolescent , Child , Child, Preschool , Female , Humans , Male , Evoked Potentials, Auditory, Brain Stem , Otoacoustic Emissions, Spontaneous , Sleep Apnea, ObstructiveABSTRACT
OBJECTIVE@#To investigate the clinical presentation, diagnosis and therapy of syphilis with sensorineural deafness.@*METHOD@#Three patients of syphilis with sensorineural deafness were analyzed including the clinical manifestation, serum and therapy response.@*RESULT@#Three patients of syphilis with sensorineural deafness: 2 cases with rapid plasma reagin (RPR) and treponema pallidum particle agglutination (TPPA) positive, 1 case with RPR negative and TPPA positive; 2 cases had been diagnosed with syphilis and treated once; 2 cases with sudden sensorineural deafness and tinnitus, 1 case with tinnitus and high-frequency hearing loss. All cases hadn't another identified cause of the hearing loss or tinnitus. Their hearing loss level weren't improved after therapy.@*CONCLUSION@#Sudden hearing loss or nervous tinnitus may be the clinical manifestations of syphilis with sensorineural deafness. It is easy to miss diagnosis in clinical work. Some lab examinations were necessary to diagnose the cases with the etiology unknown of hearing loss, tinnitus or nystagmic.
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Adult , Female , Humans , Male , Middle Aged , Hearing Loss, Sensorineural , Microbiology , Retrospective Studies , SyphilisABSTRACT
BACKGROUND: Abnormal lipid metabolism is one of the risk factors in patients with ischemic cerebral disorders, and is correlated with the changes of lecithin cholesterol acyltransferase activity.OBJECTIVE: To observe the relationship between the changes of lecithin cholesterol acyltransferase activity and lipid content in red blood cell membrane.DESIGN: A case-control study(experimental group with control as standard level).SETTING: Department of clinical laboratory, emergency room and department of neurology of a hospital affiliated to a medical college of a university.PARTICIPANTS: Totally 105 inpatients and outpatients with cerebrovascular diseases were selected from the Department of Neurology, Affiliated Hospital of Medical College of Qingdao University, from March 2002 to December 2003. They accorded with the Diagnostic Criteria set at the Second National Conference on Cerebrovascular Diseases. A total of 42 patients with cerebral arteriosclerosis and 63 patients with cerebral infarction were selected as patients group consisting of 67 males and 38 females. Another 65 healthy people receiving physical examination in the hospital, 36 males and 29 females, were selected as control group.METHODS: Venous blood of 8 mL was drawn from the participants on an empty stomach. We assayed the activity of lecithin cholesterol acyltransferase,high density lipoprotein cholesterol, low density lipoprotein cholesterol,apolipoprotein A1 and apolipoprotein B. Red blood cell membrane cholesterol was determined by phthalyl aldehyde-acetometry and red blood cell membrane phospholipid was determined by chemical quantitative analysis.MAIN OUTCOME MEASURES: Changes of lecithin cholesterol acyltransferase activity and lipid content in red blood cell membrane in patients group and control group.RESULTS: According to intention analysis, all the 105 patients in patients group and 65 patients in control group entered the results analysis. Activity of lecithin cholesterol acyltransferase: Activity changes in cerebral arteriosclerosis group and cerebral infarction group were obvious lower than those in control group[(2.14±0.72) kat/L, (2.06±0.80) kat/L, and(2.61± 0. 74) kat/L, P ＜ 0.01 ] . Level of high density lipoprotein cholesterol and apolipoprotein A1: The level in cerebral arteriosclerosis group and cerebral infarction group was obvious lower than that in control group[ (1.32±0.33) mmol/L, (1.37±0.33) g/L, (1.28±0.33) mmol/L; (1.27±0.31) g/L, (1.60±0.43) mmol/L, (1.60±0.43) g/L, t=2.72 to 5.01, P ＜ 0.01 ]. Content of low density lipoprotein cholesterol and red blood cell membrane-cholesterol: The content in cerebral arteriosclerosis group and cerebral infarction group was obvious higher than that in control group [ (2.94 ± 0. 82) mmol/L, (0.63 ±0.05) mmol/g, (3.02 ±0.79) mmol/L;(0.60 ±0.07) mmol/g, (2.56 ±0. 58) mmol/L, (0.57 ±0.05) mmol/g, P ＜ 0. 01 ] . Moreover, the activity of lecithin cholesterol acyltransferase was positively correlated with high density lipoprotein cholesterol and apolipoprotein A1(r=0.247, P ＜0.05; r=0.303, P ＜0.01), but was negatively correlated with low density lipoprotein cholesterol and red blood cell membrane cholesterol(r= -0.212, P ＜0.05;r= -0.346, P ＜0.01).CONCLUSION: In patients with ischemic cerebral disorders, the major change of plasma lipid is the decrease of lecithin cholesterol acyltransferase,but it is not secondary to cerebral infarction. The activity of lecithin cholesterol acyltransferase is positively correlated with high density lipoprotein cholesterol and apolipoprotein A1, but is negatively correlated with low density lipoprotein cholesterol and red blood cell membrane cholesterol.
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Objective The reliability of the RUS-CHN of The Standards of Skeletal Maturity of Hand and Wrist for Chinese-China 05 and the TW_3-C Carpal methods was studied and the effects of readers' experience on the measured skeletal age were determined.Methods Under the conditions that readers were blinded to the age and sex of the children,the hand and wrist radiographs of 75 children(skeletal age from 3 to 18 years) were independently read by 11 readers using RUS-CHN method and the radiographs of 46 children(skeletal age from 3 to 13.5 years) were analyzed by 6 readers using TW_3-C Carpal method.The radiographs were re-read by the same readers 20 days later.The percentage agreement in the ratings and the differences of skeletal age in the rereading were used to evaluate the reliability.Results It was found that(a) intraobserver percentage agreement of ratings were 63.4% to 82.2% for RUS-CHN and 65.6% to 83.2% for TW_3-C Carpal respectively,the intraobserver 95% confidence limits for a single reading were ?0.40 year to ?0.76 year for RUS-CHN and ?0.38 year to(?0.71) year for TW_3-C Carpal respectively;(b) interobserver percentage agreement of ratings were 61.3% to 77.3% for RUS-CHN and 77.4% to 88.0% for TW_3-C Carpal respectively;interobserver 95% confidence limits for a single reading were ?0.42 year to ?0.96 year for RUS-CHN and ?0.42 year to ?0.78 year for TW_3-C Carpal respectively.Conclusion The present findings suggest that the reliability of skeletal age assessment between readers is significantly different and that the reliability levels of the experienced and relative experienced readers is higher,which can be obtained for few nonexperienced readers through training of assessment of skeletal age.The assessments of skeletal age are unreliability for the majority of non-experienced readers,so that the further training for them is needed.
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Objective The existing standards of skeletal development for Chinese were revised in this study due to the accelerated growth and development of Chinese children in the past 20 years.Methods Seventeen thousand and four hundred and one (17,401) healthy children of Han nationality (8,685 boys, 8,716 girls), aged 0～20 years, from cities of Shanghai, Guangzhou, Wenzhou, Dalian and Shijiazhuang were served as the sample for standardization. The radiographs were evaluated by a single observer using TW3 method. Furthermore, the new skeletal maturity events were chosen in 4, 5, 6, 7 stages of first metacarpal, proximal and middle phalanges, as well as in 5, 7 stages of radius and 5 stage of ulna in accordance to TW3-RUS. As a result, each stage was divided into two new stages. The fusion stages of radius and ulna were divided to 4 phases. The skeletal maturity scoring was computed by “scaling of categorized attributes” to minimize the overall disagreement between the different bones totaled over the standardizing sample. The new method is called RUS-CHN. The means and standard deviations of maturity score transformed by logarithm in each age group were calculated, and were fitted by quadratic and linear functions of age, respectively.Results The percentile standards of TW_3-C RUS, TW_3-C Carpal, RUS-CHN skeletal maturity scores were established. The revised standards are designated as “The Standards of Skeletal Maturity of Hand and Wrist for Chinese of Han Nationality-China 05”. Ages of the complete maturity of TW_3-C RUS, TW_3-C Carpal and RUS-CHN standards are 16, 13.5 and 18 years in boys and 15, 11.5 and 17 years in girls, respectively. In the verified sample of 2,438 children (1,301 boys, 1,137 girls), aged 1～19 years, the differences between skeletal age and chronological age of all age groups were mostly 0.0～0.3 year in TW_3-C RUS, TW_3-C Carpal and RUS-CHN skeletal maturity standards.Conclusion “The Standards of Skeletal Maturity of Hand and Wrist for Chinese of Han Nationality-China 05” are applicable to contemporary Chinese children.
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Objective The determination of skeletal maturity is an important measure for selecting sports talent. The characteristics of skeletal development of hand and wrist in Chinese children were investigated in order to compare with overseas experiences. Methods The subjects were 16035 children, aged 2～18 years. The skeletal maturity of hand and wrist of the subjects was estimated by TW3 method and was compared with that of European, European North American and Japanese children. Results In comparison with European and American children, Chinese and Japanese children showed a similar patterns of skeletal maturation. The TW3-RUS skeletal maturity of Chinese children was retarded by 0.3～0.6 year in boys at the age of 8～12 and was very close to European and American in girls at the age of 5～10. Older than 12 years of age in boys and 10 years of age in girls, the TW3-RUS skeletal maturity of Chinese children accelerated and became advanced by 1.1～1.6 years in boys, by 1.2 years in girls. As compared with European and American children, the TW3-carpal maturity delayed by 0.3～0.6 year in Chinese boys at the age of 3～10 and by 0.2～0.4 year in Chinese girls at the age of 2～5. The TW3-carpal maturation accelerated after age of 10 in boys and age of 5 in girls. The age of complete maturity in all carpals was advanced by 1.4 year in boys and girls. Conclusion As compared with European and American children in 1970s-1990s, the delay of skeletal development of hand and wrist in Chinese children was not obvious in childhood, and the extent of advanced skeletal maturity and the age of advanced complete maturity of Chinese children are more evidently.
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Objective Due to the accelerated growth of Chinese children, the secular trend of accelerated skeletal development was observed in this study in order to provide the evidence for using the standards of skeletal maturity in reason.Methods The subjects were the children from two skeletal development surveys in 1980s and 2000s. The appearance age and fusion age of ossification centers in hand and wrist were calculated using the probit regression analysis, and the skeletal ages of children from the survey in 2000s were estimated by CHN method. The CHN skeletal ages were compared with calendar ages. Results Compared with the children in 1960s, the appearance ages and fusion ages of the ossification centers were all advanced in children in 1980s. Compared with the children in 1980s, the metacarpals and phalanges of children in 2000s were advanced by 0.5-1.0 year at age of appearance of ossification centers and 1.0 year in boys and 1.0-1.5 years in girls at the ages of fusion ossification centers. The ages of complete ossification of radius and ulna in children in 2000s were advanced by 0.4 year in boys and 0.3 year in girls. The differences between CHN skeletal age and chronological age of all age groups in 2000s were 0.3-1.1 year in boys and 0.2-1.0 year in girls. Conclusions In the last 40 years, the secular trend of accelerated skeletal development was presented in Chinese children. It should be cautious to estimate the contemporary Chinese children when using the skeletal norms of 1960s or 1980s.