Risk factors of incomplete thrombosis in the false lumen after endovascular treatment of extensive acute type B aortic dissection.

OBJECTIVE: This study evaluated the risk factors of incomplete thrombosis in the false lumen after thoracic endovascular aortic repair (TEVAR) in patients with extensive acute type B aortic dissection. METHODS: This was a retrospective study at Zhongda Hospital and Henan Provincial People's Hospital, China. Between January 2005 and May 2008, patients with acute type B dissection who underwent TEVAR at two centers were reviewed and 124 who met the following criteria were included in this study: (1) dissection involving the aorta below the level of the celiac artery, (2) completely patent false lumen at the time of intervention, and (3) complete initial diagnostic computed tomography (CT) scans and all follow-up CT scans available. Exclusion criteria were (1) aortic dissection secondary to trauma, (2) intramural hematoma, and (3) Marfan patients. The main outcome measures were demographics, comorbidity profiles, technical details of procedures, anatomic characteristics of dissection, and false lumen status of thrombosis during follow-up. Ordinal regression analysis was performed with variables that reached P < .20 on univariate analysis to investigate independent risk factors of incomplete thrombosis in the false lumen. RESULTS: Univariate analysis showed that the age at TEVAR, hypertension, maximum diameter of the abdominal aorta and false lumen at the abdominal level, re-entry tears, and visceral branches that arose partially or totally from the false lumen had a P < .20. Further analysis with an ordinal regression model showed that the visceral branches that arose partially or totally from the false lumen (odds ratio [OR], 10.054; P < .001), re-entry tears (OR, 30.661; P < .001), and maximum diameter of the false lumen on the abdominal aorta (OR, 1.265; P = .004) were the significant risk factors of incomplete thrombosis in the false lumen after TEVAR. CONCLUSIONS: Visceral branches that arose partially or totally from the false lumen, re-entry tears, and maximum diameter of the false lumen on the abdominal aorta were the risk factors of incomplete thrombosis in the false lumen after TEVAR in extensive acute type B dissection.

[Study on the relationship between childhood non-intentional injury and socio-economic status in Jiangxi province].

OBJECTIVE: To understand the relationship between childhood non-intentional injury and socio-economic status (SES) in Jiangxi province. METHODS: Nearly 100 000 households were selected by PPS sampling method, in Jiangxi province. All children aged 0 - 17 years in selected households were surveyed using an 'injury questionnaire'. SES was calculated under the World Bank method. RESULTS: 98 335 children were surveyed and the identified number of non-intentional injury cases was 5429 and with 52 fatal cases. The morbidity was 5.52% and mortality was 52.88/100 000. The mortality of children with higher SES was lower than that of other groups but without statistical significance. The morbidity of moderate injury increased with the increasing SES, also without statistical significance. However, the morbidity of severe injury in male children decreased with the increasing SES. Rates of moderate injury morbidities of fall and road traffic injury also increased with the increasing SES. Moderate injury morbidity caused by animals decreased with the increasing SES. Severe injury morbidity of fall decreased with the increasing SES. CONCLUSION: The morbidity of injury in children was affected by the SES and the relationship between injury and SES varied along with the results of different types of injuries.

[Study on traffic induced injuries in children aged 0-17 years in Jiangxi province].

OBJECTIVE: To explore the morbidity, mortality, and disease burden of traffic injury in children aged 0-17 years so as to develop a related strategy on prevention. METHODS: 100,000 households were selected by PPS sampling method in Jiangxi province. All children aged 0-17 years in selected households were interviewed by trained interviewers using a standardized 'traffic injury questionnaire'. RESULTS: The overall mortality and fatality rates of traffic injury were 10.17/100,000 and 1.36% respectively while the traffic injury morbidity in children of 0-17 years old was 7.40 per thousand. Morbidity in males was 8.29 per thousand compared to 6.26 per thousand in females. Severe cases accounted for 1.79 per thousand of the total but those living in urban area appeared to be 0.93 per thousand compared to 1.88 per thousand in the rural area, with statistical significance. Pedestrian and cyclists related injuries accounted for 80.48% of all the injured children. The average medical cost per case was 1369.57 Yuan with an average of 3.63 days of hospitalization. The average days of missing school/working was 8.79. CONCLUSION: The morbidity and mortality among male children were higher than those among female children. The morbidity of severe traffic injury cases in children living in rural area was higher than that of children living in urban area. The disease burden of traffic injury in Jiangxi province was heavy and the development of relative intervention strategy seemed urgent in Jiangxi province.

[Epidemiological study on injuries among children in Beijing].

OBJECTIVE: To explore the morbidity, burdens caused and risk factors of injuries among children and to provide information for policy making on prevention. METHODS: By PPS sampling method, we selected 28 000 households in Beijing and using a questionnaire developed by UNICEF, TASC and China CDC. RESULTS: The morbidity of child injury in Beijing was 2.25%, higher than that of adults (1.56%) with 6-9 year group the highest (2.83% ). The morbidity of boys was 3.04% higher than that of girls (1.37%). Among the 7 death cases, 3 were caused by injury(2 RTA, 1 drowning). The three leading causes of injuries were fall, animal bite and road traffic accident in children. Among children aged 0-5 years, fall, animal and burn/machine injuries were the leading causes. Among children aged 0-5 years, the leading causes were hurt by animals, fall and RTA with the leading causes as fall, sprain and RTA. The average medical cost of injury cases was 1617.57 Yuan. There were 3500 children (injured orphan) whose parents were injured leading to death or disability in Beijing in 2003. CONCLUSION: Injury was the leading cause of child deaths in Beijing with children of 6-9 years old having the highest morbidity with RTA the most severe type of injuries in Beijing which affects both children and their parents.

[A questionnaire investigation on the way of delivery and its related factors in 415 women at child bearing age in one hospital].

OBJECTIVE: To understand the changing trend on the way of delivery since 1970s and its related factors that influencing the attitude of choice on Cesarean section (C-section) in women at child-bearing age. METHODS: A face-to-face interview was conducted anonymously in pregnant and lying-in women visited at the out-patient department of Gynecology and Obstetrics, Tiantan Hospital of Beijing. Totally, 415 women at child-bearing age, with a history of previous birth were interviewed on date, place and way of delivery of last birth, as well as on information that could have had impact on the choice of C-section. RESULTS: The average rate of C-section in Tiantan Hospital had been 29% since the year of 2000, much higher than that during 1970s, 1980s and 1990s (chi(2) = 22.81, P = 0.001) which showed an increasing trend. Rate of C-section among lying-in women with native Beijing origin was 25.0%, significantly higher than 9.6% (chi(2) = 21.96, P = 0.000 002) that in the migrants. Lying-in women with education level of high school or above had higher chance to choose C-section than those with lower level of education (chi(2) = 43.64, P < 0.000 01). Workers, managerial staff or clerks had more chance to choose C-section than those with other occupations (chi(2) = 20.07, P = 0.01). As reported by the interviewees, 93% (70/75) of C-section in the hospital were performed and recommended by obstetricians. CONCLUSION: Rate of C-section in the hospital showed an increasing trend which suggested that intervention with health education be carried out for both pregnant women and obstetricians.