Study on related factors and characteristics of multimorbidity of overweight and obesity-related diseases in children in Hunan Province / 中华预防医学杂志

From January 2019 to December 2021, overweight and obese children who visited in health outpatient Center of Hunan Children's Hospital were studied to explore and analyze the rate, related factors and patterns of multimorbidity of overweight and obesity-related diseases in children in Hunan Province. Univariate and multivariate logistic regression models were used to analyze the multimorbidity-related factors of overweight and obesity-related diseases in children. Association rules (apriori algorithm) were used to explore the multimorbidity patterns of overweight and obesity-related diseases in children. A total of 725 overweight and obese children were included in this study. The multimorbidity rate of overweight and obesity-related diseases in children was 46.07% (334/725). Age, waist circumference, the frequency of food consumption such as hamburgers and fries and adding meals before bedtime were multimorbidity-related factors of overweight and obesity-related diseases in children. The multimorbidity associated with nonalcoholic fatty liver disease (NAFLD) was relatively common. The patterns with the top three support degrees were "NAFLD+dyslipidemia","NAFLD+hypertension" and "NAFLD+hyperuricemia". The patterns with the top three confidence and elevation degrees were "Hypertension+dyslipidemia => NAFLD","Hyperuricemia => NAFLD" and "NAFLD+hypertension => dyslipidemia".

A cross-sectional study on the prevalence rate and influencing factors of non-alcoholic fatty liver disease in overweight/obese children / 中国当代儿科杂志

OBJECTIVES@#To investigate the prevalence rate of non-alcoholic fatty liver disease (NAFLD) in overweight/obese children who visit a hospital, and to explore the influencing factors of NAFLD, in order to provide a basis for the prevention of NAFLD in overweight/obese children.@*METHODS@#Overweight/obese children who visited Hunan Children's Hospital from June 2019 to September 2021 were recruited. The prevalence rate of NAFLD was examined. Logistic regression analysis was used to explore the factors influencing the development of NAFLD [non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH)]. Receiver operating characteristic curve analysis was used to evaluate the predictive value of the influencing factors for NAFL and NASH.@*RESULTS@#A total of 844 overweight/obese children aged 6-17 years were enrolled. The prevalence rate of NAFLD in overweight/obese children was 38.2% (322/844), among which the prevalence rates of NAFL and NASH were 28.8% (243/844) and 9.4% (79/844), respectively. Multivariate logistic regression analysis showed that the increase of waist-to-hip ratio (WHR) and low high-density lipoprotein cholesterol (HDL-C) were associated with the development of NAFL and NASH (P<0.05). The receiver operating characteristic curve analysis showed that the combined measurement of WHR and HDL-C had a predictive value for NAFL (area under the curve: 0.653, 95%CI: 0.613-0.694), and for NASH (area under the curve: 0.771, 95%CI: 0.723-0.819).@*CONCLUSIONS@#The prevalence rate of NAFLD in overweight/obese children who visit a hospital is high. WHR and HDL-C are associated with the development of NAFLD and the combined measurement of WHR and HDL-C has a certain value for predicating the development of NAFLD.

Effectiveness of induction therapy with exclusive enteral nutrition in pediatric Crohn's disease / 中国当代儿科杂志

OBJECTIVES@#To evaluate the effectiveness of induction therapy with exclusive enteral nutrition (EEN) in pediatric Crohn's disease (CD).@*METHODS@#A retrospective analysis was performed on the medical data of 62 children with CD who received EEN in Children's Hospital, Zhejiang University School of Medicine, from March 2013 to August 2021. The medical data included general information and height, weight, Pediatric Crohn's Disease Activity Index (PCDAI), Crohn's Disease Endoscopic Index of Severity, C-reactive protein, erythrocyte sedimentation rate, and serum albumin level before treatment and after 8 weeks of treatment. The changes in the above indicators were compared before and after treatment.@*RESULTS@#Among the 62 children with CD, there were 39 boys (63%) and 23 girls (37%), with a mean age of (11.9±3.0) years at diagnosis. Among the 55 children who completed EEN treatment for at least 8 weeks, 48 (87%) achieved clinical remission at week 8. PCDAI at week 8 was significantly lower than that before treatment (P<0.001). Except for 17 children with involvement of the small intestine alone and 3 children with involvement of the colon who did not receive colonoscopy reexamination, the remaining 35 children with involvement of the colon received colonoscopy reexamination after the 8-week EEN treatment. Of the 35 children, 29 (83%) achieved mucosal healing. As for the 48 children who achieved clinical remission at week 8, there were significant improvements in height-for-age Z-score and body mass index-for-age Z-score at week 8 (P<0.01). As for the 7 children who did not achieve clinical remission at week 8, there were no significant changes in height-for-age Z-score and body mass index-for-age Z-score at week 8 (P>0.05).@*CONCLUSIONS@#The 8-week EEN treatment has a good effect on clinical remission and mucosal healing in children with CD. For the children with CD achieving clinical remission, EEN can improve their height and body mass index.

Diagnostic value of MDM2 RNA in situ hybridization in atypical lipomatous tumor/well-differentiated liposarcoma and dedifferentiated liposarcoma / 中华病理学杂志

Objective: To investigate the value of MDM2 RNA in situ hybridization (RNA-ISH) in diagnosing atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) and dedifferentiated liposarcoma (DDL). Methods: A total of 26 ALT/WDL/DDLs diagnosed from March 2017 to May 2019 in West China Hospital, Sichuan University, Chengdu, China and 18 control cases were included. MDM2 RNA-ISH was performed on all samples and compared with the fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) regarding their performance in detecting MDM2. Results: All samples were detected successfully using the three methods. Among 26 ALT/WDL/DDLs, all cases showed MDM2 amplification and positivity for MDM2 RNA-ISH (26/26, 100%). Twenty-four (24/26, 92.3%) of the 26 tested cases were positive for MDM2 IHC while two of them were negative. Eighteen control cases were all negative for MDM2 FISH and RNA-ISH, and 15 (15/18) cases were negative for MDM2 IHC. The sensitivity and specificity of RNA-ISH were both 100%, and those of MDM2 IHC were 92.3% and 83.3%, respectively. Diffuse staining was identified in all MDM2 RNA-ISH positive ALT/WDL/DDLs, but identified in only 8/24 (33.3%) of the MDM2 IHC positive cases. Among the 11 ALT/WDL/DDL samples evaluated on tissue microarray, the positive rate of MDM2 RNA-ISH was 100% with diffuse staining in all cases. The positive rate of MDM2 IHC was 9/11 while only 1 of the 9 cases showed diffuse staining. The result of MDM2 RNA-ISH was identical to that of MDM2 FISH and was overall consistent with that of MDM2 IHC (Kappa=0.763, P<0.001). Conclusions: In ALT/WDL/DDLs, results of MDM2 RNA-ISH are highly consistent with those of FISH. MDM2 RNA-ISH is more sensitive and more specific and has more diffuse positive signals than the IHC. The findings indicate that MDM2 RNA-ISH is highly valuable for the diagnosis and differential diagnosis of ALT/WDL/DDLs.

Predicting Metabolic Syndrome Using Anthropometric Indices among Chinese Adolescents with Different Nutritional Status: A Multicenter Cross-sectional Study / 生物医学与环境科学（英文）

Objective@#To evaluate the predictive performance of anthropometric indices for metabolic syndrome (MetS) among Chinese adolescents with different nutritional status.@*Methods@#We recruited 9,513 adolescents aged 10-18 years from seven provinces in China during September 2014. Anthropometric indices and blood pressure were measured at recruitment, and blood samples were collected for determining fasting plasma glucose and lipid profile. Receiver operating characteristic (ROC) analyses were used to assess the predictive performance of anthropometric indices, including body mass index (BMI) percentile, waist circumference percentile, waist-height ratio, and waist-hip ratio.@*Results@#Overall, the four anthropometric indices showed good accuracy for predicting MetS with areas under ROC curves (AUCs) ranging from 0.86 to 0.94; similar AUCs ranging from 0.73 to 0.99 were observed for participants with normal weight. The performance of all four indices was poor in overweight and obese participants, with AUCs ranging from 0.66 to 0.77 and from 0.60 to 0.67, respectively. Waist circumference showed relatively better performance in all the subgroup analyses.@*Conclusions@#We suggest using anthropometric indices with the cutoff values presented here for predicting MetS in the overall and normal-weight adolescent population, but not in the overweight and obese adolescent population where more specific screening tests are required.

Clinical observation of refined moxibustion for sequelae of pelvic inflammatory disease with / 中国针灸

OBJECTIVE@#To compare the curative effect of refined moxibustion, traditional moxa box moxibustion and Chinese patent medicine on the sequelae of pelvic inflammatory disease with @*METHODS@#A total of 150 patients with sequelae of pelvic inflammatory disease with @*RESULTS@#After treatment, the TCM symptoms, body signs and comprehensive scores of each group were lower than those before treatment (@*CONCLUSION@#Compared with traditional moxa box moxibustion and Chinese patent medicine treatment, refined moxibustion can better improve the symptoms, body signs and quality of life in patients with the sequelae of pelvic inflammatory disease of

Inflammatory bowel disease with growth hormone deficiency in adolescents: an analysis of 4 cases and literature review / 中国当代儿科杂志

Inflammatory bowel disease (IBD) is a chronic recurrent non-specific inflammatory disease in the intestinal tract. About 10%-56% of children with Crohn's disease and about 10% of children with ulcerative colitis have growth retardation. This study reports four adolescents with IBD and growth hormone deficiency who were diagnosed with Crohn's disease. There were three boys and one girl, with an age of 11.0-13.9 years and a disease duration of 11-85 months at diagnosis. The four patients had the involvement of the small intestine only, the colon only, both the small intestine and the upper gastrointestinal tract, and both the small intestine and the colon respectively. The pediatric Crohn's disease activity index ranged from 27.5 to 45 points. All four patients had a height-for-age Z-score (HAZ) of <-2, and the growth hormone provocative test suggested growth hormone deficiency. Of all four patients, two received recombinant human growth hormone combined with infliximab, one received infliximab only, and one received recombinant human growth hormone combined with mercaptopurine. All four patients had an improvement in HAZ after treatment.

Clinical features and prognosis of gastrointestinal injury due to foreign bodies in the upper gastrointestinal tract in children: a retrospective analysis of 217 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical features and prognosis of gastrointestinal injury caused by foreign bodies in the upper gastrointestinal tract in children.</p><p><b>METHODS</b>A retrospective analysis was performed for the clinical data of 217 children who were diagnosed with foreign bodies in the upper gastrointestinal tract complicated by gastrointestinal injury by gastroscopy from January 2011 to December 2016, including clinical features, gastroscopic findings, complications, and prognosis.</p><p><b>RESULTS</b>Among the 217 children, 114 (52.5%) were aged 1-3 years. The most common foreign body was coin (99/217, 45.6%), followed by hard/sharp-edged food (45/217, 20.7%) and metal (35/217, 16.1%). The most common gastrointestinal mucosal injury was ulceration (43.8%), followed by erosion (33.2%). Compared with other foreign bodies, button cells were significantly more likely to cause esophageal perforation (P<0.01). The esophagus was the most commonly injured organ (207/217, 95.4%). Of all the 217 children, 24 (11.1%) experienced infection. The children with perforation caused by foreign bodies had a significantly higher incidence rate of infection than those with ulceration caused by foreign bodies (P=0.003). Of all the 217 children, 204 (94.0%) underwent successful endoscopic removal of foreign bodies. Among these children, 98 were hospitalized due to severe mucosal injury and were given anti-infective therapy, antacids, and supportive care including enteral nutrition through a nasogastric tube and/or parenteral nutrition. Of all the children, 10 left the hospital and were lost to follow-up, and all the other children were improved and discharged.</p><p><b>CONCLUSIONS</b>Most cases of foreign bodies in the upper gastrointestinal tract occur at 1-3 years of age. Coin, hard/sharp-edged food, and metal are the most common foreign bodies. Button cells are more likely to cause esophageal perforation. The incidence rate of secondary infection increases with the increasing severity of gastrointestinal mucosal injury. Children undergoing endoscopic removal of foreign bodies and enteral nutrition through a nasogastric tube tend to have a good prognosis.</p>

Clinical Contrastive Study between Caudal-to-crainal and Medial-to-lateral Approaches for Laparoscopic Right Hemicolectomy / 昆明医科大学学报

Objective To compare the short-term therapeutic effects of the caudal-to-crainal and medial-to-lateral approaches for laparoscopic right hemicolectomy. Method The clinical data of 124 patients underwent laparoscopic right hemicolectomy in the department of gastrointestinal surgery, the First Affiliated Hospital of Kunming Medical Universitiy from,June 2014 to June 2016,were analyzed retrospectively. According the surgical operation, the patients were divided into two groups,caudal-to-crainal group with 48 patients,and medial-to-lateral group with 76 patients. The characteristics, opertation time, volum of blood loss during operation, the number of lymph node dissection, the rate of conversion to laparotomy,postoperative eating time, postoperative ventilation time, postoperative hospital stay time, postoperative complications of the two groups were analyzed to compare the short-term therapeutic effects. Result No significant differences were found in the sexual distinction, age, BMI,the volume blood loss during the operation, the number of lymph node dissection, the rate of conversion to laparotomy, postoperative eating time, postoperative ventilation time, postoperative hospital stay time, postoperative complications between the two groups (P＞0.05).Significant differences were found in the operation time [caudal-to-crainal group vs medial-to-lateral group (123.49 ±14.19 min VS 140.57 ±25.40 min) ] and the blood loss of the operation [caudal-to-crainal group vs medial-to-lateral group (60.63±24.00 ml vs 77.24 ±36.90 ml) ]. Conclusion The caudal-to-crainal approach for laparoscopic right hemicolectomy is more simple, practicable, with less blood loss during the operation and safer, which worth being recommended in right-hemicolectom-surgery.

Association between vitamin D receptor gene polymorphisms and pediatric Crohn's disease in China: a study based on gene sequencing / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the association between TaqI, BsmI, and ApaI polymorphisms of vitamin D receptor (VDR) gene and pediatric Crohn's disease (CD) in China.</p><p><b>METHODS</b>Nineteen children with CD were selected as a case group, and 122 healthy children who underwent physical examination were selected as a control group. Serum 25-hydroxyvitamin D3 [25(OH)D3] levels were measured using ELISA. The TaqI, BsmI, and ApaI polymorphisms of VDR gene were determined by gene sequencing, and the two groups were compared in terms of genotype and allele frequencies.</p><p><b>RESULTS</b>The case group had significantly lower serum 25(OH)D3 levels than the control group (17.3±2.4 ng/mL vs 26.9±2.1 ng/mL; P<0.05). There were no significant differences in the frequencies of genotypes and alleles of TaqI, BsmI, and ApaI polymorphisms between the case and control groups (P>0.05).</p><p><b>CONCLUSIONS</b>Children with CD have low serum 25(OH)D3 levels. TaqI, BsmI, and ApaI polymorphisms of VDR gene may not be associated with susceptibility to CD among the Chinese population.</p>

Analysis of the immunohistochemical subtypes and prognosis of primary diffuse large B cell lymphoma of the central nervous system / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the subtypes of primary diffuse large B cell lymphoma of the central nervous system (CNS DLBCL) and to explore the relationship between the subtype classification and prognosis.</p><p><b>METHODS</b>Immunohistochemical staining was used to determine the expression of CD20, CD3, CD10, Bcl-6, Mum-1, CD5, Bcl-2, Ki-67, FOXP-1, GCET-1, BLIMP-1 and LMO-2 antigens on paraffin-embedded sections of 47 cases. Hans, Choi and Tally subtypes were classified, and univariate and multivariate analyses were used to elucidate the relationship between the subtypes and prognosis.</p><p><b>RESULTS</b>In the 47 cases, the expression of Bcl-2 in the tumor cells was 46.8%, CD10 4.3%, Bcl-6 70.2%, Mum-1 53.2%, GCET-1 36.2%, BLIMP-1 4.3%, FOXP-1 63.8% and LMO-2 19.2%. The positive rate of Ki-67 was 30% to 95%, with a median of 80%, of which 12 cases (25.5%) was > or = 90%. The Hans subtype classification showed 16 cases (34.0%) were of GCB type and 31 cases (66.0%) of non-GCB type. The Choi subtype classification showed 16 cases (34.0%) were of GCB type and 31 cases (66.0%) of ABC type. The Tally subtype classification showed 6 cases (12.8%) were of GCB type and 41 cases (87.2%) of non-GCB type.</p><p><b>CONCLUSIONS</b>The results of this study show that there is no significant correlation between the three subtypes and prognosis. The prognosis is correated with post-operative radiotherapy, chemotherapy and MTX therapy.</p>

Primary gastrointestinal diffuse large B-cell lymphoma: an immunohistochemical and prognostic study of 90 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the immunophenotype and prognostic significance of primary gastrointestinal diffuse large B-cell lymphoma, with reference to Hans, Choi and Tally algorithms.</p><p><b>METHODS</b>The clinicopathologic features and follow-up data in 90 cases of primary gastrointestinal diffuse large B-cell lymphoma were analyzed by Kaplan-Meier method, Log-rank test and Cox regression model. Immunohistochemistry was carried out using EliVision and EnVision methods for CD20, CD3ε, CD10, bcl-6, MUM-1, CD5, bcl-2, GCET1, FOXP1, LMO2, BLIMP1 and Ki-67.</p><p><b>RESULTS</b>The age of patients ranged from 27 to 83 years (mean = 58 years). The male-to-female ratio was 1.31:1. Amongst the 90 cases studied, 64.4% (58/90) involved the stomach and 35.6% (32/90) involved the intestine. The immunohistochemical findings were as follows: 100% positivity for CD20, 0% for CD3ε and CD5, 17.8% (16/90) for CD10, 75.6% (68/90) for bcl-6, 52.2% (47/90) for MUM-1 (cut off was 30%), 43.3% (39/90) for MUM-1 (cut off was 80%), 50.0% (45/90) for GCET1, 45.6% (41/90) for FOXP1, 23.3% (21/90) for LMO2, 42.2% (38/90) for bcl-2 and 8.9% (8/90) for BLIMP1. The Ki-67 index ranged from 20% to 95% (median = 80%). According to Hans algorithm, 51.1% of the cases belonged to germinal center B-cell (GCB) subtype and 48.9% belonged to non-GCB subtype. In contrast, Choi algorithm classified 55.6% cases as GCB subtype and 44.4% as activated B-cell (ABC) subtype. According to Tally algorithm, 34.4% were of GCB subtype and 65.6% of non-GCB subtype. Most of the patients (67.8%, 61/90) received chemotherapy and 68.9% (62/90) underwent surgical resection. The overall 2, 3 and 5-year survival rates were 58.5%, 52.8% and 49.8%, respectively. The overall 2, 3 and 5-year survival rates in the CHOP therapy group were 68.5%, 61.2% and 52.9%, respectively.</p><p><b>CONCLUSIONS</b>There is no significant difference in ratio between the GCB and non-GCB/ABC subtypes by Hans and Choi algorithms. The non-GCB subtype seems to be more prevalent according to Tally algorithm. Although there is no significant difference in survival between GCB and non-GCB/ABC subtypes by the 3 algorithms, GCB subtype tends to show a better survival. In univariate analysis, LDH level, international prognostic index, chemotherapy, surgical resection, B symptoms, number of involved sites and clinical stage are found to have prognostic significance. In multivariate analysis, Choi algorithm, Tally algorithm, chemotherapy, surgical resection, LDH level and clinical stage are independent prognostic factors.</p>

Application of Warthin-Starry stain, immunohistochemistry and transmission electron microscopy in diagnosis of cat scratch disease / 中华病理学杂志

<p><b>OBJECTIVE</b>To evaluate the diagnostic utility of Warthin-Starry silver stain, immunohistochemistry and transmission electron microscopy in the detection of human Bartonella henselae infection and pathologic diagnosis of cat scratch disease (CSD).</p><p><b>METHODS</b>The paraffin-embedded lymph node tissues of 77 histologically-defined cases of cat scratch disease collected during the period from January, 1998 to December, 2008 were retrieved and studied using Warthin-Starry silver stain (WS stain) and mouse monoclonal antibody against Bartonella henselae (BhmAB stain). Five cases rich in bacteria were selected for transmission electron microscopy.</p><p><b>RESULTS</b>Under electron microscope, the organisms Bartonella henselae appeared polymorphic, round, elliptical, short rod or bacilliform shapes, ranged from 0.489 to 1.110 microm by 0.333 to 0.534 microm and often clustered together. Black short rod-shaped bacilli arranged in chains or clumps were demonstrated in 61.0% (47/77) of CSD by WS stain. The organisms were located outside the cells and lie mainly in the necrotic debris, especially near the nodal capsule. In 72.7% (56/77) of the cases, dot-like, granular as well as few linear positive signals were observed using BhmAB immunostain and showed similar localization. Positive results for both stains were identified in 59.7% (46/77) of the cases. When applying both stains together, Bartonella henselae was observed in 74.0% (57/77) of the case. The difference between the results obtained by WS stain and BhmAB immunostain was of statistical significance (P < 0.05).</p><p><b>CONCLUSIONS</b>Bartonella henselae is the causative pathogen of cat scratch disease. WS stain, BhmAB immunostain and transmission electron microscopy are helpful in confirming the histologic diagnosis. Immunostaining using BhmAB can be a better alternative than WS stain in demonstrating the organisms.</p>

Study on the willingness of care and related influencing factors among caregivers of those stranded children under 7 years in Chinese rural areas / 中华流行病学杂志

Objective To explore the willingness of care and related influencing factors among caregivers of those 'left at hometown' children under 7 years in Chinese rural areas.Methods Questionnaires were used to survey caregivers (n=7585) who were identified by multi-stage stratified cluster sampling. Multi-factor ordinal logistic regression analysis was used to screen the influencing factors on the willingness of care among them. Results The percentage on 3.5% respectively in the group with single parent while 19.5%, 71.4% and 9.1% respectively in the group of both parents having left home. Data from the multi-factor ordinal logistic regression analysis showed that factors including the age of the caregiver, annual per capita income for caregivers'families, social connections and the length of children' s mother being absent, amount of fees for living provided by parent/parents, and the child' s age and lifestyle, being the only child or not, and the age of the child when the parent/parents left the residence etc, were related to the willingness of care of the givers. Conclusion Willingness of care calls for attention and urgent improvement.Influencing factors and measures need to be taken when necessary.

Primary lymphoma of breast: a clinicopathologic, immunophenotypic and prognostic study of 21 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathologic and immunophenotypic features of primary breast lymphoma (PBL) and to discuss the diagnosis of the tumor.</p><p><b>METHODS</b>Twenty-one cases of PBL with follow up data were clinically reviewed. The histologic diagnosis of the tumor was based on the updated WHO Classification of tumors of hematopoietic and lymphoid tissues (2008). Immunohistochemistry was performed by SP method and antibodies selected were as follows: CD20, CD3epsilon, CD10, Bcl-6, MUM-1, CD5, Bcl-2, CD23, CD10, cyclin D1, CD43 and Ki67.</p><p><b>RESULTS</b>(1) All 21 patients were female and the median age of patients was 48 years. The right and the left breasts were involved in 11 (52.4%) and 10 patients (47.6%), respectively. According to Ann Arbor staging system, 20 cases were stage I-II (95.2%), and the remaining case was stage IV (4.8%). For the international prognostic index (IPI), 19 cases were score 0-1, and 2 cases were score 2-3. For ECOG score, 19 cases were 0, and the remaining 2 cases were 1. (2) Histologically, all 21 cases (100%) were DLBCL. Immunohistochemically, the frequency of antigen expression was as follows: CD20 (100%), MUM-1 (14/21, 66.7%), bcl-6 (5/21, 23.8%), CD10 (0), bcl-2 (13/21, 61.9%), CD5 (1/21, 4.8%); Ki-67 index: 10 cases (47.6%) were less than 59%, with the expression of seven cases (33.3%) being 60% - 89%, and more than 90% in the remaining four cases (19.1%). The median Ki-67 index was 60%. All the cases were considered non germinal center B-cell-like type of DLBCL. (3) Follow-up data was available in 64% of the cases. One, two and five-year survival rates were 11 cases, 7 cases and 3 cases, respectively.</p><p><b>CONCLUSION</b>All the cases of PBL in the current study were DLBCL, non germinal center B-cell-like type, and a diagnosis of PBL can only be established after excluding breast involvement in systemic lymphoma.</p>

Analysis on influences of guardians on behavior of left-behind children aged 3 to 7 years in countryside / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the influences of guardians on emotion and behavior of rural left-behind children aged 3 to 7 years.</p><p><b>METHODS</b>A self-designed questionnaire of children's condition and Children Strengths and Difficulties Questionnaire (the edition for parents, SDQ) were used to investigate 805 left-behind children aged 3 to 7 years in countryside.</p><p><b>RESULTS</b>The prevalence of difficulty among left-behind children was 3.5%, in male it was 4.1% and in female 2.7%, the difference was not significant (chi(2) = 1.154, P > 0.05) between male and female. The scores of peer communication problems among associate the left-behind children were (2.30 +/- 1.86), which was significantly higher than that (2.09 +/- 1.74) of not left-behind children (P < 0.05). The score of emotion symptom was (2.76 +/- 1.84) and the total score of difficulty was (11.41 +/- 4.77) among left-behind children was significantly higher than those of left-behind children with one parent stayed out (2.29 +/- 1.64) and (10.41 +/- 5.18), were significantly different (t = -2.489 - 2.006, P < 0.05), the score of social behavior (6.39 +/- 2.26) was significantly lower than that of left-behind children with father or mother stayed out (7.34 +/- 2.18, P < 0.001). The score of social behavior of children whose guardians had higher education level (7.02 +/- 2.21) was significantly higher than those with guardians who were illiterate or semiliterate (6.20 +/- 2.44, P < 0.01).</p><p><b>CONCLUSIONS</b>There are evident problems in emotion and behavior among left-behind children with parents staying out. One of parents should stay home to care for children. To improve educational level of guardian will be beneficial to development of physical and mental health among left-behind children.</p>

Clinical and colonoscopic characteristics of pediatric inflammatory bowel disease / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze clinical manifestations, endoscopic and histological features for establishing a diagnosis of pediatric inflammatory bowel disease (IBD).</p><p><b>METHOD</b>Thirty-four inpatients with inflammatory bowel disease (ulcerative colitis/UC/: 24; Crohn's disease/CD/:10) were enrolled into this study. Data of clinical manifestations, laboratory values, endoscopic findings and histopathological features of biopsy material were analyzed.</p><p><b>RESULT</b>Four children had mild/moderate active Crohn's disease. Six had severe active disease. The most common presenting symptom in CD was abdominal pain (80%, 8/10). One child had intestinal perforation; 2 had obstruction. Anal fistula was found in 2 patients. There were 5 mild, 14 moderate and 5 severe diseases in UC group. Diarrhea (23/24, 96%) was the most common symptom. Three children with UC suffered from perianal diseases. One had chronic intussusception. ESR and C reactive protein values were significantly higher in patients with CD compared with patients with UC (chi(2) = 15.938, P < 0.01; chi(2) = 11.184, P < 0.01). The pattern of anatomic involvement in CD was: ileocolic 60%, colon 10% and small bowel 30%. Endoscopically, discontinuous lesions, diverse ulcers, proliferative/regenerative patterns and narrowed bowel lumen were observed. Histologically, lymphocytes aggregation in the lamina propria and submucosa were observed. Non-caseating granulomas were found in 22% cases. Twenty-five percent of patients with UC had pancolitis. Colonoscopy showed diffusely distributed multiple erosions and ulcers in UC cases. Twenty-nine percent of children had pseudopolyps. No mucosal bridge was found. Mucosal biopsies showed chronic inflammatory cells, neutrophils and eosinophils diffusely infiltrated in the lamina propria. Crypt abscess was found in 4 cases.</p><p><b>CONCLUSION</b>The clinical manifestations in pediatric inflammatory bowel disease are nonspecific. Colonoscopic examination and biopsy are valuable in establishing the diagnosis of pediatric ulcerative colitis. It is important for colon involved CD children to have a colonoscopic examination. But the mucosal biopsies were short of specificity. Multi-place and deep biopsy are needed to improve the diagnosis.</p>

Small cell variant of peripheral T-cell lymphoma, not otherwise specified: a clinicopathologic and immunophenotypic analysis / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and differential diagnosis of small cell variant of peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS).</p><p><b>METHODS</b>The clinicopathologic features of 5 cases of small cell variant of PTCL, NOS were retrospectively reviewed, with immunohistochemical study, T-cell receptor (TCR) gene rearrangement analysis and evaluation for Epstein-Barr virus (EBV) status.</p><p><b>RESULTS</b>All the 5 patients were males. The mean age was 52.6 years. The median duration before diagnosis was 1 month. Clinically, 3 patients presented in stage IV and 2 in stage III. Four of them had generalized lymphadenopathy and splenomegaly. Hepatomegaly and massive effusion were found in 1 and 2 cases, respectively. Marrow involvement was detected in 3 of the 4 patients with bone marrow biopsy performed and one of them also accompanied by lymphocytosis. Histologically, the involved lymph nodes showed partial or complete effacement of nodal architecture and replacement by a monomorphous population of small lymphoid cells. Scanty large lymphoid cells were also identified in 4 cases. Increase in number of blood vessels was noticed in two of them as well. Immunohistochemically, the lymphoma cells in all cases expressed two or more of the T-cell markers and CD43. The staining for CD20, TdT, CD56 and granzyme B was negative. CD99 expression was noted in 3 of the 4 cases. The Ki-67 index ranged from 5% to 15%. Clonal TCRgamma gene rearrangement was detected in the 4 cases studied and one of them also showed TCRbeta gene rearrangement. In-situ hybridization for EBV-encoded RNA was negative in the 4 cases studied. Follow up information was available in 3 of the 5 cases. All of the 3 patients died of the disease, with an average survival of 21.7 months.</p><p><b>CONCLUSION</b>Small cell variant of PTCL, NOS represents a rare disease entity which often presents in advanced tumor stage and carries a poor prognosis.</p>

Investigation on dietary nutrients among rural stranded children of 2-7 year olds in China / 中华流行病学杂志

Objective To understand the dietary nutrients among rural stranded children.Methods 2551 children aged 2 to 7, including 1278 stranded children in the rural areas and another 1273 children served as controls were selected, using multistage stratified cluster random sampling. Dietary survey was performed with three-day weighing dietary method and questionnaire on food intake. Data on diet were analyzed and evaluated by the Dietary Reference Intakes (DRIs) recommend by Chinese Nutrition Society, to evaluate the levels on energy and nutrient intake among stranded children in the rural areas. Results The dietary pattern among rural stranded children mainly consisted of grains and vegetables, but the intakes of animal products, fruits, and snacks were significantly less than in the control group. The intakes of three major energy-producing nutrients were below the recommend nutrient intake. Minerals as calcium, zinc, selenium, kalium and vitamins as vitamin A, B1, B2were insufficient.Most of the rural stranded children took nutrients insufficiently, with 50% lack of adequate energy and 80% of protein, 90% of minerals (calcium, zinc etc.) and vitamins (vitamin B1 and vitamin B2 etc.).Sources from high quality protein was insufficient, only consisting 35% of the total protein, but overabundant (over 64 % ) from the plants. The intake of plant-sourced iron was overabundant, accounted for 87%. Conclusion The dietary pattern was unsatisfactory with insufficient intake of energy-sourced proteins and some nutrients. The sources of energy, protein, and iron were mostly obtained from underbalaneed foods. It is necessary to improve the dietary nutrients status among rural stranded children aged 2-7 years.

Using multivariate multilevel model in studying the influential factors of violence among rural high school students in Changsha / 中华流行病学杂志

Objective To provide evidence for setting up violence intervention programs in rural middle schools, through studying the influential factors. Methods Taking variables including emotional, physical and sexual violence in the past year as the multi-dependent variables before multivariate multilevel model logistic regression model was adopted to analyze the correlations among the three kinds of violence and the influential factors. Results Among 3620 respondents, the incidence rates of emotional, physical and sexual violence weres 21.5%, 24.3% and 2.0% respectively. The correlation coefficients between emotional violence vs. physical violence, emotional violence vs. sexual violence, physical violence vs. sexual violence were 0.337,0.133, 0.131 respectively when the random effect of class difference was separated by multivariate multilevel model. There was an internal aggregation of the incidence rate on physical violence in different grades (X2=4.286, P=0.038) and an internal relevant between emotional violence vs. sexual violence (X2=4.239, P=0,039), physical violence vs. sexual violence (X2=4.482, P=0.034). The influential factors on the incidence rates of violence would include:sex, smoking status, family without harmony, tendency of bullying others and the level on self-esteem etc. Conclusion When the random effect of class difference was separated by multivariate multilevel model, the estimated results would be more precise. Other than paying more attention to both individual and family influential factors when taking measures to reduce the incidence rate of violence in high school students, the effect of environment in the class should not be ignored.