Sleep Duration and Factors Related to Sleep Loss in 3-14-Year-Old Children in Beijing: A Cross-Sectional Survey / 中华医学杂志(英文版)

Background@#It is known that short sleep duration adversely affects children's behavior and physical development. This study aimed to investigate the status of sleep duration in 3-14-year-old children in Beijing and explore the related factors of sleep loss with them.@*Methods@#In this study, a cross-sectional study of random stratified cluster sampling was conducted on 3-14-year-old children and adolescents in Beijing. According to the proportion of children in each district and school, the final cohort included a total of 11 kindergartens, 7 primary schools, and 8 junior high schools from 7 districts of Beijing. Children of sampled classes were included, and their parents were invited to fill a series of questionnaires including the simplified Chinese version of Pediatric Sleep Questionnaire, Sleep Questionnaire Scale, and Hong Kong-Children Sleep Questionnaire about the performance of the last 6 months.@*Results@#Out of the total 11,420 questionnaires, 9198 questionnaires were valid and effective with the response rate of 80.54%. The age of the investigated children was 8.8 ± 3.8 years, including 4736 males and 4462 females. The daily sleep duration of children in Beijing was 9.7 ± 0.7 h. The prevalence of sleep loss (<9 h/day) of children in Beijing was 11.8%. The daily sleep duration of children aged <6, 6 ≤ age <11, and ≥11 years was 9.7 ± 0.6 h, 9.6 ± 0.6 h, and 9.5 ± 0.8 h, respectively. The sleep duration reduced significantly in children aged ≥11 years as compared to younger children in Beijing which was mainly contributed by the variation tendency of sleep duration on weekdays. The multivariate logistic regression analysis identified factors associated with sleep loss (P < 0.05): male (odds ratio [OR] = 1.32, 95% confidence interval [CI]: 1.15-1.51), age ≥11 years (OR = 2.37, 95% CI: 1.92-2.93), overweight (OR = 1.34, 95% CI: 1.17-1.54), family history of snoring (OR = 1.35, 95% CI: 1.13-1.61) and activities before bedtime with watching TV (OR = 1.24, 95% CI: 1.08-1.43), sports (OR = 1.22, 95% CI: 1.01-1.48), playing cellphone (OR = 1.91, 95% CI: 1.31-2.73) and surfing the Internet (OR = 1.27, 95% CI: 1.06-1.52) and among them age ≥11 years and playing cellphone before bedtime had greater impact on children's short sleep duration than that of other factors.@*Conclusions@#Sleep loss was common among 3-14-year-old children in Beijing. Sleep duration decreased with age, especially among children over 11 years old. Factors associated with sleep loss covered sociodemographic characteristics, family sleep habits and routine activities before bedtime, and among those variables, age ≥11 years and playing with cellphones before bedtime had a greater impact on sleep duration, indicating that existing sleep loss in 3-14-year-old children could be, at least partly, improved by paying more attention to children aged of 11 years or entering Grade 5 and Grade 6 and to children with a family history of snoring; by reducing the use of electronic products before bedtime, especially cellphones; by managing weight and keeping fit; and by improving the bedtime routine.

Clinical analysis of 81 cases of pulmonary cryptococcosis / 中华外科杂志

<p><b>OBJECTIVE</b>To clarify the clinical feature, diagnosis and therapy of the pulmonary cryptococcosis (PC).</p><p><b>METHODS</b>A retrospective study of cases with PC who were diagnosed by pathological examinations between January 1996 and December 2010 was conducted. Eighty-one cases were enrolled in the study (58 male and 23 female patients; mean age of (51±11) years). Forty-one cases were asymptomatic at the time of diagnosis. There were single pulmonary lesions in 50 cases, and multiple lesions in 31 cases. Fourteen lesions (17.3%) were located in left upper lobe, 27 (33.3%) in left lower lobe, 21 (25.9%) in right upper lobe, 3 (3.7%) in right middle lobe, 28 (34.6%) in right lower lobe, and 3 (3.7%) diffusely involved bilateral lungs. The tumors ranged from 0.8 to 10.0 cm in diameter with a mean of (2.9±1.8) cm. All the cases were misdiagnosis prior to the surgical resection, and histologically confirmed by postoperative pathological specimens.</p><p><b>RESULTS</b>All the cases received surgical treatment including complete resection in 69 cases, and palliative resection in 12 cases. Resections were performed by means of video-assisted thoracoscopy in 31 cases and thoracotomy in 50 cases. Surgical resections included pulmonary wedge excisions in 42 cases, and lobectomies in 39 cases. After histological confirmation, 63 cases (77.8%) were treated with antifungal agents, which consisted of fluconazole in 38 cases, itraconazole in 18 cases, amphotericin B in 6 cases, and flucytosine in 4 cases. There were no intraoperative death, but two cases died for cryptococcal meningoencephalitis in the postoperative period. Operative morbidity occurred in 7 (8.6%) cases. The median follow-up was 42.5 months (6 to 84 months). There were 2 local relapses of PC, and 9 cases with complications of anti-fungal agents.</p><p><b>CONCLUSIONS</b>The clinical manifestations of PC are mild and non-specific, with no characteristic radiographic manifestations. Surgical resection is usually indicated for definite diagnosis and treatment. Antifungal drug therapy is indispensable even after complete resection.</p>

Surgery treatment for pulmonary sclerosing hemangioma / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological features and surgical treatment of pulmonary sclerosing hemangioma (PSH).</p><p><b>METHODS</b>Clinic data of PSH patients admitted by surgical resection from January 1985 to December 2010 was analyzed retrospectively. One hundred and sixty-five patients were enrolled in the study. There were 27 male and 138 female patients with a mean age of (48 ± 13) years. Seventy-nine patients were asymptomatic at the time of diagnosis. Eighty-nine tumors arose in the right lung (27 in right upper lobe, 24 in right middle lobe, 34 in right lower lobe, 2 in right upper lobe with invasion of right middle lobe, 1 in right middle lobe with invasion of right lower lobe, and 1 case with multiple lobe lesions), 75 in the left (33 in left upper lobe, 42 in left lower lobe), and 1 in the bilateral. There were huge mass lesions in 2 cases, endobronchial lesions in 2 cases, and multiple lesions in 6 cases. The mean size of the lesion was (2.6 ± 0.9) cm (ranging from 0.9 to 10.0 cm). Forty-eight cases (29.1%) were misdiagnosed as malignancies preoperatively, and 41 cases (24.8%) were misdiagnosed intraoperatively.</p><p><b>RESULTS</b>Resections were performed by means of video-assisted thoracoscopy (n = 53) and thoracotomy (n = 112). Surgical resection included pulmonary wedge excision in 61 patients, lobectomy in 89 patients, right bilobectomy in 5 patients, anatomic segmentectomy in 2 patient, enucleation in 6 patients, and synchronous bilateral pulmonary wedge resection in 1 patient. Operative mortality and morbidity occurred in 0 and 2 (4.3%) patients, respectively. Mean follow-up was 34.7 months (ranging from 6 to 62 months). There was no local recurrence or death from PSH.</p><p><b>CONCLUSIONS</b>PSH is a rare benign lung tumor. It is difficult to make accurate diagnosis preoperatively, and sometimes even intraoperative frozen sections can't differentiate it from malignant tumors. Surgical resection is usually indicated for definite diagnosis and treatment. Partial resection is a sufficient treatment in view of uncommon tumor recurrence. Thoracoscopic surgery is recommended for PSH.</p>

Effect of surgery on delayed inhaled foreign body: a case report / 中华医学杂志(英文版)

The occurrence of foreign body is uncommon in youths and adults. We report here a case of 16-year-old boy who inhaled a foreign body which was overlooked for 6 months. The patient suffered productive cough and received antibiotic treatment for 10 days. But the symptoms did not improve. Chest radiography and CT scan revealed a 1-cm-long needle-like foreign object in the right inferior lobar bronchus. Wedge resection of lung was finally performed because of severe hemorrhage caused by prior bronchoscopy.

Inhibitory effect of adenovirus-mediated endostatin gene transfer on transplanted lung carcinoma in mice / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the effect of adenovirus-mediated endostatin gene transfer on transplanted lung cancer in mice and its mechanism of action.</p><p><b>METHODS</b>Transplant tumor model was induced by subcutaneous inoculation of 2 x 10(6) Lewis lung cancer (LLC) cells into the back of C57BL/6 mice. The mice were treated by intratumoral injection of 2 x 10(9) pfu Ad-mEndostatin. The expression of endostatin in situ and its maintaining time were detected by immunohistochemistry and Western Blot, respectively. The endostatin level in serum was determined by ELISA . The inhibition of tumor growth and changes of survival were recorded and the microvessel density (MVD) was determined by histochemical stainingwith CD31 and CD105 antibodies. The tumor apoptosis was observed by electron microscopy.</p><p><b>RESULTS</b>In comparison with controls, intratumoral injection of Ad-mEndostatin significantly inhibited the tumor growth and metastasis, and prolonged the survival rate of mice (P < 0.05). Strong positive expression of mEndostatin was seen in the tumor tissue after injection of Ad-mEndostatin, immunhistochemically ostained by mouse endostatin monoclonal antibody, while the control groups showed only very low expression or absence. Serum endostatin concentration was 1540 +/- 560 ng/ml at the second week of administration, the expression of endostatin diminished a month later. The microvessel density (MVD)) decreased from 42.4 +/- 4.8 to 10.5 +/- 3.2 per x 200 magnificetion microscopic field by CD10 staining and from 68.5 +/- 4.5 to 37.5 +/- 4.6 by CD31 staining, respectively (P < 0.05). More apoptotic tumor cells were seen under the transmission electron microscope.</p><p><b>CONCLUSION</b>Endostatin gene therapy mediated by adenoviral vector efficiently induces expression of endostatin in vivo, and inhibits the growth and metastasis of tumor. It is concluded that its action is targeted to tumor neovasculature and the mechanism is inhibition of tumor angiogenesis.</p>

Analysis of the Pulmonary Function in Patients with Cervical Spinal Cord Injury / 中国康复理论与实践

@#ObjectiveTo investigate the features of pulmonary function and influencing factors in patients with cervical spinal cord injury (SCI).MethodsThe pulmonary function data of 48 patients with cervical SCI were analyzed. The correlations between the percent predicted values of vital capacity (VC), maximal voluntary ventilation (MVV), forced expiratory volume of 1st second (FEV1) and V75 (expressed as VC%, MVV%, FEV1%, V75%) and ASIA motor/sensory scores were analyzed. Then, four multiple linear regressions were run to use VC, MVV, FEV1, V75 as an independent variable respectively.ResultsThe percent predicted values of the pulmonary function (VC%, MVV%, FEV1%, V75%) in patients with cervical SCI obviously decreased, which suggested that these patients had a restrictive ventilation disorder. There were significant positive correlations between VC%、FEV1%、V75% and ASIA motor scores (by bivariate correlation tests), no significant correlations between any of pulmonary function parameters and the ASIA sensory scores. Of four linear regression models, the height showed as a protecting factor in 3 linear regression models and weight did in the other one respectively. Of parameters associated with SCI, just ASIA motor scores showed as a protecting factor in 3 linear regression models, no sensory scores or duration appeared in any linear regression models.ConclusionBesides the height and weight, the ASIA motor score is a main factor influencing the pulmonary function.

Experimental study of degradable chitin long fiber reinforced polycaprolactone for reconstruction of chest wall defects / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the application of a novel degradable biomaterial as a chest wall prosthesis and provide valuable scientific basis for clinical application.</p><p><b>METHODS</b>Preparation of chitin long fiber reinforced polycaprolactone (PCL) by means of melt blending and modeling. Full-thickness chest wall defects of 10 cm x 8 cm was created in 10 dogs and then repaired with long chitin fiber reinforced PCL artificial rib in 8 dogs (tested group) and Marlex mesh in 2 dogs (control group). It was dynamically observed that the situation of the implanted chest wall prosthesis and the progress of the regeneration of the chest wall tissue postoperatively.</p><p><b>RESULTS</b>No operative and perioperative deaths were observed in all experimental dogs. In tested group, slight paradoxical respiration occurred in 2 dogs and could not be seen in 2 weeks. No chest wall subsidence and infection occurred. New bone tissue obviously regenerated around both resection ends of the ribs and integrated tightly with artificial ribs. In control group, there were evidently paradoxical respiration and chest wall subsidence. Marlex mesh folded and was enveloped by fibrous tissue.</p><p><b>CONCLUSION</b>Degradable chitin long fiber reinforced PCL can provide effective support to chest walls and is a practicable material for chest wall reconstruction.</p>

Efficacy of tonsillectomy and adenoidectomy in Asian childhood obstructive sleep apnea/hypopnea syndrome: a case control study / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of tonsillectomy and adenoidectomy (T & A) in Asian childhood obstructive sleep apnea/hypopnea syndrome (OSAHS).</p><p><b>METHODS</b>The medical data of the OSAHS patients in the Sleep Center of the Duchess Kent Children's Habilitation Institute from May 1999 to May 2003 were retrospectively reviewed. OSAHS was diagnosed according to the abnormal sleep monitoring results. The clinical outcomes were followed up and compared between the Operation and Non-operation groups (Control) in OSAHS children with adenotonsillar hypertrophy (ATH). Sleep endoscopy was performed for those who had residual OSAHS for the purpose of detecting the underlying causes.</p><p><b>RESULTS</b>Sixty-one patients were diagnosed with OSAHS. Among the OSAHS patients, 39 were associated with ATH, and 25 of the 39 patients underwent T & A. The desaturation dip rate and minimum saturation in the Operation group were significantly improved after T & A. Six out of 25 (24%) patients in the Operation group had residual OSAHS whereas 11 out of the 13 (85%) patients in the Control group had unchanged or worsening clinical symptoms (OR=15.4, 95%CI 2.7- 87.5). Residual OSAHS after surgery were attributable to obesity, achondroplasia, upper airway structure anomaly and airway dynamic problems.</p><p><b>CONCLUSIONS</b>T & A was effective in the majority of Asian childhood OSAHS associated with ATH. Upper airway structure or dynamic abnormalities can result in residual OSAHS in parts of children. Further investigation is required to detect the underlying problems.</p>

Experimental study on the reconstruction of circumferential tracheal defects with novel prosthesis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of using new tracheal prosthesis made of biomaterials to replace extensive circumferential tracheal defects in mongrel dogs.</p><p><b>METHODS</b>Three types of tracheal prostheses were developed, whose basic skeleton of tubular mesh was knitted with polypropylene monofilament and poly (lactic-co-glycolic acid) fiber. The inner side of type-I tubular mesh was first coated with polyurethane solution and then with collagen. The exterior of type-I was then immobilized with collagen-hydroxyapatite composites. In contrast, the internal and external walls of type-II were coated with polyurethane solution, which produced a prosthesis similar to a nonporous one, while type-III was coated only with collagen solution. Surgical resection and replacement of a segment of the cervical trachea was performed in 16 adult mongrel dogs. The efficacy of the implanted prosthesis periodically evaluated postoperatively.</p><p><b>RESULTS</b>In group A, only one died from prosthetic dehiscence, another from anastomotic leakage, and the others had uneventful postoperative courses. The implanted prosthesis was completely incorporated with the recipient trachea, where different length of reepithelialization occurred on the luminal surface of the reconstructed trachea. Macroscopic examination showed scattered and different sizes of neo-ossification surrounding the implanted prosthesis. The prosthesis was roentgenopaque when exposed to routine X rays. In contrast, a relatively high number of complications occurred postoperatively in group B and C.</p><p><b>CONCLUSION</b>Type-I tracheal prosthesis may be used effectively for long-segment circumferential tracheal replacement, and appears very promising for clinical application, with further improvements in promoting the epithelialization.</p>

Experimental study on a novel esophageal prosthesis made of composite biomaterials / 中华外科杂志

<p><b>OBJECTIVE</b>To design and develop a novel esophageal prosthesis by selecting appropriate biomaterials, developing special manufacturing techniques, and investigating the feasibility of replacement of cervical esophagus in mongrel dogs.</p><p><b>METHODS</b>In accordance with the requirements of ideal esophageal substitutes, we designed a new type of esophageal prostheses. The inner stent were made with polyurethane of medical grade, and the outer surface of the prosthesis was coated with collagen-chitosan sponge. The silicone tube was used as a control. Thirteen adult mongrel dogs that were divided into two groups were used to establish the experimental models.</p><p><b>RESULTS</b>In the experimental group (n = 8), the esophageal prostheses were completely incorporated with the native esophagus and adherent to the surrounding host connective tissues. Epithelial linings of varying degrees were formed on the luminal surface, and complete epithelization was seen in 1 month postoperatively. The granulation at the sites of the anastomosis in this group was less significant than that of the control group. One dog has been surviving for 12 months up to now without any complications. In the control group (n = 5), esophageal epithelial was not observed on the luminal surface, constriction of the regenerated esophagus progressed and all the dogs died within 2 months after operation.</p><p><b>CONCLUSION</b>These observations suggest that this esophageal prosthesis made of composite biomaterials has high biocompatibility and potential for long-segment esophageal reconstruction, which is promising for the clinical repair of esophageal defects.</p>

Replacing dog cervical esophagus with polyurethane stent covered with collagen-chitosan sponge / 第二军医大学学报

Objective: To replace esophageal defects with artificially composed biodegradable materials and non-biodegradable materials. Met hods: A two-layered tube consisting of a collagen-chitosan sponge and an inner polyurethane stent was used to replace 5 cm esophageal segmental defect s in 15 dogs. The inner polyurethane stent was removed endoscopically at weekly intervals from 2 or 4 weeks. Results: Partial regeneration of es ophageal epithelia was observed in 5 dogs at week 2, and progressing constricti on occurred and the dogs became unable to swallow within 1 month. In the 10 dog s that the polyurethane stent was removed at week 4, regenerated esophageal tiss ue successfully replaced the defects, and complete epithelization was observed 1 month after surgery. Complete regeneration of esophageal mucosa structures, inc luding mucosal smooth muscle and mucosal glands were observed 3 months after surgery, and partial regeneration of esophageal muscle tissue was also observed 6 months after surgery. Conclusion: Our artificial prosthesis i n reconstruction of the cervical esophagus segment in dogs is feasible. Through temporary polyurethane tube, collagen-chitosan sponge provides a three-dimensi onal structure suitable for the regeneration and sufficient degradation time for the complete regeneration of esophagus.

Replacing dog cervical esophagus with polyurethane stent covered with collagen-chitosan sponge / 第二军医大学学报

Objective: To replace esophageal defects with artificially composed biodegradable materials and non-biodegradable materials. Met hods: A two-layered tube consisting of a collagen-chitosan sponge and an inner polyurethane stent was used to replace 5 cm esophageal segmental defect s in 15 dogs. The inner polyurethane stent was removed endoscopically at weekly intervals from 2 or 4 weeks. Results: Partial regeneration of es ophageal epithelia was observed in 5 dogs at week 2, and progressing constricti on occurred and the dogs became unable to swallow within 1 month. In the 10 dog s that the polyurethane stent was removed at week 4, regenerated esophageal tiss ue successfully replaced the defects, and complete epithelization was observed 1 month after surgery. Complete regeneration of esophageal mucosa structures, inc luding mucosal smooth muscle and mucosal glands were observed 3 months after surgery, and partial regeneration of esophageal muscle tissue was also observed 6 months after surgery. Conclusion: Our artificial prosthesis i n reconstruction of the cervical esophagus segment in dogs is feasible. Through temporary polyurethane tube, collagen-chitosan sponge provides a three-dimensi onal structure suitable for the regeneration and sufficient degradation time for the complete regeneration of esophagus.