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Objective@#To understand the relationships between video time, exercise time and the mental sub-health of Chinese adolescents, and to assist the development of Chinese adolescents’ mental health.@*Methods@#In this study, 16 545 adolescents aged 13-22 years in six administrative regions of China were surveyed using an adolescent sub-health multi-dimensional assessment questionnaire (MSQA), and daily physical exercise time, video screen time and other indicators were recorded. Binary Logistic regression analysis was used to understand adolescents’ mental sub-health and the correlation between video time and exercise time.@*Results@#Detection rate of mental sub-health status in adolescents with video time ≤2 h/d was lower than that of adolescents with video time >2 h/d(19.1%，22.1%), and the detection rate of adolescents with exercise time ≤60 min/d(22.1%，17.7%) was higher than that of adolescents with exercise time >60 min/d. These differences were statistically significant (χ2=14.47, 6.97, P<0.05). Binary Logistic regression analysis showed that the risk of mental sub-health status for Chinese adolescents whose screen time was more than 2 h/d was 1.20 times that of those with screen time ≤2 h/d, and the difference was statistically significant (P<0.01). The risk of mental sub-health for students whose exercise time was > 60 min/d was 0.86 times that of students who exercised ≤ 60 min/d, and the difference was statistically significant (P<0.05).@*Conclusion@#Screen time >2 h/d and exercise time <60 min/d were negative factors leading to mental sub-health symptoms in Chinese adolescents.It is proposed to jointly promote the healthy adolescent development through health education,as well as positive family and social environment.
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Background: With analyzing the incongruent phenomenon of electrical active and cerebral blood flow in brain death determination and screening the related factors, offer correct explanations and countermeasure to ensure the successful implementation of donation after brain death.Methods: Relevant clinical data of potential brain death organ donors were prospectively collected between June 2018 and May 2019. The related parameters of neurological examination, laboratory examination and neuroimaging examination during the period of brain death determination were dynamically recorded. Separation phenomenon was used as grouping factors to screen the factors related to separation phenomena through univariate and multivariate analysis.Results: According to the inclusion criteria, 127 patients were included in the study. Among 22 patients (17.3%) with incongruent phenomenon, 17 (77.3%) had electrical silence earlier than cerebral blood flow arrest, and 9 (22.7%) had cerebral blood flow arrest earlier than electrical silence. Univariate and multivariate analysis showed that age <14 years (OR=6.25, 95%CI 1.21-32.22, p=0.028), SBP≥140 mmHg (OR=7.43, 95%CI 1.62-33.99, p=0.010), primary brainstem injury (OR=15.89, 95%CI 3.04-82.93, p=0.006), spontaneous respiratory arrest time ≤72 hours (OR=11.96, 95%CI 1.59-89.78, p=0.009) and decompression craniotomy(unilateral or bilateral) (OR=16.28, 95%CI 2.25-117.73, p=0.001) were associated with separation phenomenon..Conclusions: Separation phenomenon is a common during the confirmation test of brain death determination in China, and should be correctly recognized. To adopt corresponding measures according to risk factors is useful for successful implementation of donation after brain death.
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Background: This study was designed to build a Nomogarm prediction model of spontaneous respiratory arrest (SRA) in nerocritical patients within 72 hours after brain injury for early identification of potential brain death organ donors.Methods: From October 2017 to May 2019, the neurocritical patients admitted to the First Affiliated Hospital of Sun Yat-sen University, were enrolled. The occurrence of SRA within 72 hours after brain injury was regarded as the time interest point and grouping factor, factors associated with SRA were screened by univariate and multivariate analysis, and then the Nomogarm prediction model was developed. Finally, the Nomogarm prediction model was tested in the validation set.Results: In training set, univariate and multivariate analysis showed that the midline shift (OR=4.56, 95% 1.87-19.21), absent of ambient cistern (OR=4.83, 95% 1.35-16.34), cough reflex absence (OR=3.82, 95% 1.15-12.42), intraventricular hemorrhage (OR=3.16, 95% 1.53-14.52) and serum Na+<125mmol/L (OR=3.06, 95% 1.53-13.44) were associated with SRA within 72 hours. In the training set and validation set, the predicted C index of SRA rate within 72 hours was 0.81 (95% CI 0.76-0.85) and 0.80 (95% CI 0.75-0.83), respectively. Further statistical analysis showed that 140 points, 160 points and 170 points were dangerous cut-off points, of which 140 points, 160 points and 170 points were 30.1%, 65.6% and 93.4% associated with SRA within 72 hours, respectively.Conclusions: Nomogram prediction model based on brain injury assessment parameters can predict the time of SRA in neurocritical patients, and can be used for early identification of potential brain death organ donors.
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Objective@#To understand the mental sub-health status of Chinese adolescents and its correlation with muscle strength index, and to provide information for relevant research in mental health and muscle strength development of Chinese adolescents.@*Methods@#A total of 16 545 adolescents aged 13-22 year-old in six administrative regions of China were administered with the Adolescent Sub-Health Multidimensional Assessment Questionnaire (MSQA). Muscle strength indicatros were tested and its relations with mental sub-health were analyzed.@*Results@#The detection rates of Chinese adolescents emotional problems, character problems, social adjustment difficulties, and mental sub-health status were 25.5%, 25.0%, 16.0%, and 19.7%, respectively. The detection rates of mental sub-health status of adolescents in the group of muscle index <P25, P25-P75, >P75 were 30.3%, 19.0%, and 10.4%, respectively, and the difference was statistically significant(χ2=522.03, P<0.01). Logistic regression analysis showed that junior high school(OR=2.55), high school(OR=2.27), male students(OR=1.15), muscle index <P25 (OR=3.81), P25-P75 (OR=2.03) group were positively correlated with mental sub-health(P<0.01).@*Conclusion@#There is a correlation between the mental sub-health of Chinese adolescents and the muscle strength index. The higher the muscle strength index, the lower detection rate of mental sub-health.
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Rhabdomyolysis is a common complication among brain death donors, affecting the number of organ donations and the quality of donor kidneys. Case report: Male, 17 years old, admitted to the hospital due to a car accident. Subsequently, brown urine appeared, blood myoglobin increased significantly, urine output decreased, and renal function impaired. Treatments including fluid replacement, alkalization of urine, plasma exchange and bedside CRRT were given. The patient's renal function recovered, and the organs were successfully acquired. The renal function recovered well after transplantation. Conclusion: Attention should be paid to rhabdomyolysis. Early diagnosis and treatment of patients with brain death could improve donation success rate and the recovery of postoperative renal function.
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The incidence of Pneumocystis pneumonia is increasing in immunosuppressive patients. How to diagnose and treat Pneumocystis pneumonia in the early stage has become an important issue for clinicians. The development of Next-generation Sequencing (NGS) provides technical support for the diagnosis of Pneumocystis pneumonia. Case report: A 14-year-old male patient was diagnosed with T lymphoblastoma and treated with chemotherapy. After chemotherapy, the patient developed bone marrow suppression and was complicated with severe pneumonia. He was given endotracheal intubation and ventilator assisted respiration. Samples of patients' alveolar lavage fluid were obtained, and Next-generation Sequencing (NGS) was used for diagnosis, confirming the pathogen as Pneumocystis jiroveci, which was treated by TMP/SMX. The patient's condition gradually improved, and was finally removed from ventilator and endotracheal tube. Pneumocystis jiroveci is a common opportunistic pathogen in immunosuppressive patients, and Next-generation Sequencing (NGS) can be used for rapid diagnosis of Pneumocystis pneumonia, thus improving the clinical therapeutic effect.
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Objective@#To analyze and compare the correlation between body mass index (BMI) and cardiopulmonary fitness of children and adolescents aged 7 to 18 years in China and Japan, and to provide important reference for healthy development promotion of children and adolescents in China.@*Methods@#A total of 9 594 children and adolescents aged 7-18 years in China and Japan were selected and examined for height, weight and 20 meters shuttle run test (20mSRT), 4 800 of whom were randomly selected and included for analysis. Independent sample t test was used to compare the differences of BMI and 20mSRT between Chinese and Japanese children and adolescents of different sex and age. Logistic regression was used to compare the odds ratio of high cardiopulmonary fitness among children and adolescents of different nutritional status. Pearson correlation and linear regression were used to analyze the correlation between BMI and 20mSRT.@*Results@#Odds ratios of high cardiopulmonary fitness were 0.57, 0.52 and 0.33 in wasting, overweight and obese children and adolescents in China, and 0.49, 0.36 and 0.16 in Japan, respectively, with significant differences(P<0.05). The BMI-Z scores of Chinese and Japanese children and adolescents ranged from - 2.72 to 8.76. There were significant differences in 20mSRT-z between different BMI-Z groups(P<0.05). The 20mSRT-z score of Chinese and Japanese children and adolescents initially increased with BMI-Z score and then decreased with the increase of BMI-z score. With the decrease of BMI-Z score, 20mSRT performance in Chinese boys decreased significantly.@*Conclusion@#Compared with the normal weight peers in China and Japan, the proportion of wasting, overweight and obese children and adolescents with high cardiopulmonary fitness is lower. The BMI-Z score and 20mSRT-z score shows a general inverted "U-shaped" trend. The effect of wasting on cardiopulmonary fitness is greater in Chinese boys.