ObjectivesTo investigate the prevalence of respiratory diseases and lung function of school-age children in Chongqing and to compare them with that of children in 25 years ago and to explore the possible causes of this change.MethodsAccording to the air quality data of Chongqing from 1998 to 2016, the annual variation of air quality days and pollutant concentrations were plotted. 2 126 school-age children in two districts of Chongqing were selected by random cluster sampling for questionnaires. 771 children were randomly selected from the children who completed the questionnaire for pulmonary function tests. The results were compared with that of 25 years ago.ResultsFrom 1998 to 2016, the number of days with good air quality in Chongqing increased annually, and the concentration of SO2 decreased significantly. The main air pollution composition changed from SO2 to PM10 and PM2.5. The prevalence of bronchitis (P<0.05) was higher than that of 25 years ago. After adjusting for confounding factors by multivariate logistic regression, the OR value of bronchitis in children was 1.667 (P<0.05) compared with 25 years ago. After adjusting for age, sex, height and weight by multiple linear regression, the results showed that the subjects' lung function indexes (FVC, FEV1, PEF and FEV3) were lower than that of 25 years ago. In this survey, there were differences in lung function indexes between children with different frequency of eating fruits and dairy products (P<0.05), and those with high frequency consumption were higher than low frequency. In terms of exercise time, subjects exercising ≥1 hour/day had greater FVC and FEV3 values than those exercising <1 hour/day (P<0.05).ConclusionsThe overall air quality in Chongqing has improved from 1998 to 2016; The respiratory health of children has decreased when compared with that of 25 years ago. Changes in the composition of air pollutants may endanger children's respiratory health, and fruit and dairy foods and exercise may be protective factors for children's respiratory health.
ObjectivesTo systematically review the status quo of studies on the influencing factors of early puberty timing.MethodsWe searched VIP, CNKI, CBM, WanFang Data, PubMed, Ovid, Web of Science, EBSCO and The Cochrane Library to collect studies on the influencing factors of early puberty timing published up to November 16th, 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, quantitative analysis and qualitative synthesis methods were used to analyze the studies.ResultsA total of 146 studies were included, among which 74 were case-control studies. The results showed that: the influencing factors on early puberty timing mainly included 10 aspects: obesity, dietary preference and nutritional intake, environmental endocrine disruptors, genetic, social psychologycal stress, social economic status, lifestyle, intrauterine fetal growth, maternal age at menarche and weight, adverse factors during pregnancy.ConclusionsThe current systematic review showed that obesity, genetic, environmental endocrine disruptors, intrauterine fetal growth and early maternal age at menarche may increase the risk of early puberty timing, while other factors remain controversial. While the definition of early puberty timing and related factors have not been unified, most studies focus on females and qualitative data with lack of in-depth analysis. Therefore high quality cohort studies and studies on males are required.
【摘要】 目的 探討顱內原發生殖細胞瘤的臨床特征。方法 收集華西醫院腦外科2000年1月—2009年3月119例顱內原發生殖細胞瘤的臨床資料進行回顧性分析。結果 發病率約占同期顱內腫瘤的 1.1%。男〖DK〗∶女=1.64〖DK〗∶1,平均發病年齡15.4歲。臨床表現主要為顱內高壓癥狀及視力視野改變,分別為61、56例；腫瘤主要來源于松果體區及鞍區；64例患者行放療或放療加化療,隨訪45例。55例患者行手術治療(其中術后行單純放療19例,放療加化療5例),隨訪36例。隨訪時間3~94個月,平均29.7個月。行放療和放化療的患者3、5年生存率明顯高于單純行手術治療的患者。結論 顱內原發生殖細胞瘤多見于兒童及青少年,男性多見,腫瘤大多位于松果體區及鞍區。臨床表現位于松果體區者主要為顱內高壓癥狀等,位于鞍區者主要為視力視野改變、尿崩等。放療聯合化療是主要治療手段。
ObjectiveTo analyze the current status of children's clinical practice guidelines from 2010 to 2021, and to evaluate the quality of evidence-based guidelines for children. MethodsPubMed, EMbase, CNKI, WanFang Data, and VIP databases and relevant domestic and foreign guideline websites were searched to collect Chinese pediatric clinical guidelines from January 1st 2010 to September 13th 2021. Two reviewers independently screened literature, extracted data; 4 reviewers used AGREE Ⅱ to evaluate the quality of the included evidence-based guidelines. ResultsA total of 164 guidelines were included, which involved 65 evidence-based guidelines and 99 non-evidence-based guidelines, 113 western medicine guidelines and 51 traditional Chinese medicine guidelines. The majority of the diseases with high hospitalization burden were covered by those guidelines, including 35 guidelines for respiratory diseases, ranking first among all diseases. However, there was no guideline for pediatric cardiovascular disease in China. The average scores for 65 evidence-based guidelines in 6 individual domains were 65.2%, 49.6%, 59.3%, 68.5%, 23.9% and 83.6%. ConclusionsThe scores for applicability, stakeholder involvement, and rigor of development are low for Chinese guideline for children. There is a lack of pediatric clinical guidelines for circulatory disorders.