Advances in evaluation methods of pubertal timing in children / 中国学校卫生

Abstract@#Over the past 40 years, there has been a long term trend of early pubertal onset in children in China. Early pubertal timing is closely associated with mental health and behavioral problems in children, and can even lead to cardiovascular and metabolic diseases, cancers of the endocrine system and abnormalities of the bone and joint system in adulthood. Prompt detection of early pubertal timing in children is important. There are many methods for evaluating pubertal timing, the appropriateness of which is worth exploring. This paper reviews previous literature publications, examines current research progress in evaluation methods of pubertal timing, evaluates their applicability in the study of children and adolescents, and provides a reference for the selection of an evaluation method to assess pubertal timing in children in China.

Chemotherapy-induced oral mucositis induced by low dose methotrexate: a case report and literature review / 口腔疾病防治

Objective@# To investigate the diagnosis and treatment for oral mucositis induced by low-dose methotrexate and to provide a reference for clinicians@*Methods @# A case of severe chemotherapy-induced oral mucositis caused by short-term use of low-dose methotrexate (the maximum cumulative dose within 1 week) was reported and reviewed in combination with the literature.@*Results@# The patient was treated with low-dose methotrexate (2.5 mg orally every other day at weeks 1, 2, and 4; the third week, 2.5 mg each time for 3 consecutive days for twice, with a maximum cumulativedose of 15 mg within a week). After irregular medication for approximately three weeks, the patient gradually developed severe erosion of the lips, pain, difficulty eating, and skin erosion on both legs. Methotrexate was stopped after admission, and local symptomatic treatments such as Kangfuxin solution were given. Recombinant human granulocyte colony-stimulating factor was used systemically when combined with neutropenia. After treatment, the chemotherapy-induced oral mucositis and skin lesions were improved. A literature review shows that chemotherapy-induced oral mucositis is a toxic reaction to high-dose methotrexate, while cases of severe chemotherapy-induced oral mucositis caused by low-dose methotrexate are rare. Studies have found that the more risk factors patients have, such as poor local oral conditions and systemic diseases such as liver and kidney dysfunction and diabetes, the higher the risk of chemotherapy-induced oral mucositis. Clinicians should cooperate with dentists to address oral diseases as much as possible before using chemotherapy drugs. In addition, when ordering patients to take methotrexate, we should pay attention to the patient's general condition and susceptibility factors, standardize the frequency and dose of administration, adopt personalized treatment plans, and give patients detailed medication education to prevent the occurrence of adverse consequences caused by medication errors. If methotrexate poisoning occurs, the drug should be stopped in time, detoxification and active symptomatic and supportive treatment should be given. Basic oral care, cryotherapy, laser therapy, nutritional support and analgesic drugs are common treatments for chemotherapy-induced oral mucositis. Systemic administration of granulocyte colony-stimulating factor may be considered when accompanied by neutropenia.@*Conclusion@# It is necessary to be alert to the occurrence of severe chemotherapy-induced oral mucositis caused by low-dose methotrexate in clinical practice.

Gender differences in the association between health literacy and bully victimization among middle school students / 中国学校卫生

Objective@#To explore the association between middle school students health literacy and bully victimization and associated sex difference, and to provide guidance for bully prevention in adolescents.@*Methods@#During November 2017 to January 2018, 18 900 junior and senior high school students were enrolled from Hefei of Anhui Province, Shenyang of Liaoning Province, Yangjiang of Guangdong Province and Chongqing by multistage cluster sampling. A self rated questionnaires were used to collect demographic information, health literacy, and bully victimization. Group differences by different characteristics and the association between health literacy and bully victimization were analyzed.@*Results@#The detection rates of campus and cyber bullying victimization were 15.8% (2 992/18 900) and 9.1% (1 723/18 900). Boys, junior high school students, students with poor family financial status and few close friends had a detection rate of 28.0%, 18.8%, 23.3%, and 33.6% of school bullying, which are higher than those of the control group ( χ 2=225.64, 148.07, 141.13, 143.49, P <0.01); boys, students with poor household income and few close friends, the detection rates of cyber bullying were 10.9%, 14.4%, and 20.1%, respectively, are higher than the control group ( χ 2=62.96, 112.82, 88.49, P <0.01). Multivariate Logistic regression analysis indicated that students with low overall and dimensions scores of health literacy were more likely to suffer from campus and cyber bullying, except for the dimension of physical activity. In addition, at all levels of health literacy, males are more likely to be bullied than females ( P <0.05).@*Conclusion@#Health literacy of middle school students is related to bully victimization, which is sex specific. Intervention programs of bullying should focus on health literacy enhancement.

Development and application of the Adolescent Mental Health Literacy Assessment Questionnaire among medical undergraduates / 中国学校卫生

Objective@#To develop the Adolescent Mental Health Literacy Assessment Questionnaire (AMHLAQ), and to evaluate its reliability and validity among undergraduates.@*Methods@#On the basis of the definition of mental health literacy (MHL) and the Knowledge, Attitudes and Practices (KAP) theory, this study constructed a total of 36 items consisting of four dimensions, and scores were measured according to a five point Likert type scale. Using a cluster sampling method, a questionnaire survey was conducted among 3 826 freshmen and sophomore students from two medical schools in Anhui Province. The items were screened by performing t tests, Pearson s correlation coefficient analysis and factor analysis. The reliability and validity of the questionnaire were evaluated using indicators including homogeneity reliability, the split half reliability coefficient, and construct validity.@*Results@#Factor analysis revealed that the AMHLAQ consisted of 22 questions grouped into four domains. The variance cumulative contribution rate was 62.213%. The reliability result showed that the Cronbach s alpha coefficient of the total questionnaire was 0.897, the split half reliability was 0.800, the Cronbach s coefficient of each dimension was 0.796 to 0.885, the split half reliability of each dimension was 0.725 to 0.846, and the indicators had a high level of reliability. Confirmatory factor analysis showed that the model fit was good ( χ 2/df =19.319, P <0.01; RMSEA=0.069).@*Conclusion@#AMHLAQ is consistent with the evaluation standard of psychometrics, has good reliability and validity, and can be used to estimate the level of MHL among undergraduates.

Associations between childhood abuse experience,parentchild relationship and non-suicidal self-injury in middle school students / 中国学校卫生

Objective@#The aim of this paper is to understand the associations between childhood abuse experience,parent-child relationship and non-suicidal self-injury (NSSI) in middle school students.@*Methods@#Stratified cluster sampling method was used to select 14 500 middle school students from Shenzhen,Zhengzhou,Nanchang and Guiyang as participants. Questionnaire survey was conducted to collect information on childhood abuse exposure,parent-child relationship and NSSI.@*Results@#The prevalence of NSSI was 14.81%,while it was higher among male students (15.95%) than female students (13.64%) (χ2=15.29,P<0.01). A multivariate Logistic regression models showed that the moderate and high level of childhood abuse (OR=2.23,3.27) and the low level of parents-child relationship (OR=1.80,1.36) were associated with high NSSI detection rate among middle school students (P<0.01). In each group of childhood abuse,low level of father-child relationship was associated with high NSSI detection rate among middle school students (OR=1.36,1.34,1.56,P<0.05). In the group with high level of childhood abuse experience,low level of mother-child relationship was associated with high NSSI detection rate (OR=1.20,P<0.05). Among male students,those with high level of childhood abuse experience,low level of parentchild relationship were associated with high NSSI detection rate (OR=1.46,1.35,P<0.01); regardless of the level of childhood abuse experience,low level of father-daughter relationship was associated with NSSI detection rate (OR=1.64,1.54,1.68,P<0.01) among females.@*Conclusion@#Childhood abuse experience and poor parent-child relationship are associated with NSSI in middle school students, with distinct gender difference. Prevention of childhood abuse and the improvement of parent-child relationship are beneficial to the prevention and control of NSSI.

Relationship between childhood abuse experience and non-suicidal self-injury in middle school students / 中国学校卫生

Objective@#To investigate the relationship between childhood abuse experience and non-suicidal self-injury in middle school students, and gender differences of the relationship.@*Methods@#Stratified cluster sampling method was used to select 14 500 middle school students from Shenzhen, Zhengzhou, Nanchang and Guiyang as participants. Questionnaire survey was conducted to collect information on demographic indicators, childhood abuse experiences and non-suicidal self-injury, etc. Logistic regression was used to analyze the relationship between childhood abuse experience and non-suicidal self-injury, and gender differences.@*Results@#The prevalence of NSSI was 9.5%,while it was higher among male students (10.7%) than female students(8.3%) (χ2=22.77，P<0.01). The rate of NSSI was higher with the increasing exposure of childhood abuse. High levels of multiple forms of childhood abuse had independent effects on NSSI among total samples after controlling for confounding factors (P<0.01). In middle school students with high levels of sexual abuse, emotional neglect and childhood abuse, females versus males had higher risk to have NSSI (P<0.01).@*Conclusion@#Childhood abuse experiences were associated with increased risk of NSSI among middle school students, especially among girls. Groups at highest risk of NSSI in relation to certain types of childhood abuse should be targeted with interventions accordingly.

Relationship between childhood abuse and dating violence perpetration and victimization among medical college students / 中国学校卫生

Objective@#The purpose of the current study was to determinate the prevalence of dating violence perpetration and victimization and to examine its relationship with childhood abuse among medical college students.@*Methods@#Cluster sampling survey was carried out among 3 727 freshmen and sophomores in two medical colleges from Anhui Province. Information with general demographic variables, childhood abuse and dating violence was obtained. Logistic regression was used to identify the relationship of different types of childhood abuse and dating violence after controlled for confounding factors.@*Results@#The rate of dating violence perpetration and victimization was 37.8% and 27.8%, respectively. Female students had higher childhood emotional abuse experience (61.9%) than male students (51.6%), while male students had higher childhood physical and sexual abuse (28.2% and 19.4%) than females (24.3% and 10.5%) (χ2=33.84，6.33，52.97，P<0.01). Results showed that increased dating violence perpetration [OR(95%CI)=1.71(1.48-1.98),1.55(1.33-1.82),1.75(1.43-2.15)]and victimization [OR(95%CI)=1.84(1.43-2.16),1.59(1.34-1.87),1.62(1.32-2.00)](P<0.01) among individuals with physical, emotional and sexual abuse after controlling for confounding variables. No gender difference was found within other groups in the relationship between childhood abuse and dating violence(P>0.05).@*Conclusion@#Childhood abuse experiences are associated with higher risk of dating violence perpetration and victimization among college students. Reducing childhood abuse is beneficial to the prevention and control of dating violence among medical college students.

Association between childhood abuse experiences and smoking behavior among middle school students / 中国学校卫生

Objective@#The aim of this paper is to understand the prevalence of smoking behavior among middle school students and to analyze the impact of childhood abuse experience on smoking behavior of middle school students.@*Methods@#Stratified cluster sampling method was used to select 14 500 middle school students from Shenzhen, Zhengzhou, Nanchang and Guiyang as participants. A multivariate logistic regression model was established to analyze the effects of childhood abuse on smoking behavior among middle school students.@*Results@#The rate of smoking behavior among middle school students was 3.6%, male students (5.8%) were higher than female students (1.4%), senior high school (5.0%) was higher than junior high school (2.3%), and rural (6.0%) was higher than urban (2.8%). The differences were statistically significant(P<0.01). Those exposed to high-level of various types of childhood abuse had a higher rate of smoking behavior than those with low levels. Multivariate Logistic regression models showed that emotional abuse(OR=1.69, 95%CI=1.38-2.07), physical abuse(OR=2.17, 95%CI=1.78-2.64), sexual abuse(OR=2.56, 95%CI=2.10-3.12), emotional neglect(OR=2.27, 95%CI=1.89-2.74), physical neglect (OR=2.21, 95%CI=1.83-2.67) and childhood abuse experience (OR=2.66, 95%CI=2.21-3.21) increased the risk of smoking among middle school students independently(P<0.01).@*Conclusion@#Childhood abuse is closely assoliated with smoking behavior among middle school students. Strengthening the importance and intervention of childhood abuse is beneficial to the prevention and control of smoking behavior among middle school students.

Identification of hepatitis B virus vertical transmission from father to fetus by direct sequencing.

To identify the possibility of hepatitis B virus (HBV) vertical transmission from father to fetus, eight male HBV carriers whose wives were negative for any HBV marker and their eight aborted fetuses who had been infected with HBV in utero, were studied. S gene 451 approximately 660 nucleotide sequence of HBV in 6 cases of father/fetus pairs and C gene 2022 approximately 2321 nucleotide sequence in the other 2 cases of father/fetus pairs were amplified by nested polymerase chain reaction (NPCR), and sequenced. HBV DNA was detected in the semen and spermatid of male HBV carriers. The homologies of HBV sequences between father and fetus were very high. Six father/fetus pairs had the same subtype adw. The sequences of the fragment were identical between father and fetus in 4 cases. Especially in case 3, both father and fetus had the same point mutation, which caused an amino acid substitution at codon 126. The other two cases had point mutations in the fetus at nucleotide positions 491, 494, 546, 581 resulting in amino acid substitution at codons 113, 114, 131, 143. The C gene 2022 approximately 2321 nucleotide sequences in two cases were identical. There were eleven common point mutations between father and fetus, but those mutations did not cause phenotypic changes. Our finding suggested that HBV vertical transmission from father to fetus was present. A HBV carrier father may transmit the virus to his fetus by spermatid.

Sequence analysis of Orientia tsutsugamushi DNA from mites collected in the Xisa archipelago, China.

The genotype of Orientia tsutsugamushi DNA from mites in the Xisa archipelago of China were identified. A natural focus of tsutsugamushi disease in the archipelago was found. The DNA sequence that codes for the 56 kDa protein of O. tsutsugamushi was amplified by nested polymerase chain reaction (N-PCR). The purified positive products were cloned into a pGEM-T vector and sequenced. The DNA sequence was compared with various sequences on the internet for sequence homology. A 507 bp DNA fragment encoding the 56 kDa protein was amplified from the samples. The sequence homology was 85% (Karp strain), 68% (Gilliam strain), 65% (Kato strain), and 67% (Yonchon strain). Orientia tsutsugamushi is carried by the mites of the Xisa archipelago; the main genotype is the Karp strain.