BACKGROUND Unintended pregnancy occurs when an individual or couple conceives without planning or desire,which can potentially affect a child’s physical,mental,and social well-being.This can then lead to long-term so...BACKGROUND Unintended pregnancy occurs when an individual or couple conceives without planning or desire,which can potentially affect a child’s physical,mental,and social well-being.This can then lead to long-term socioeconomic challenges for families and communities.Although its impact on child growth and development is a pressing concern,research remains limited particularly in multicenter settings.AIM To examine the long-term consequences of unintended pregnancy on the critical years of early childhood growth and development.METHODS This analytical observational study employed a case-control design and was conducted in research centers across Indonesia,encompassing those located in Central Java,Lampung,Bali,and West Nusa Tenggara.A total of 700 children aged≤5 years with histories of intended or unintended pregnancies participated.Data collection involved structured interviews and direct anthropometric and developmental assessments.Data analyses were conducted using multivariate statistics and partial least squares structural equation modeling.RESULTS Unintended pregnancy was found to have a statistically significant effect on both child growth(t=8.178;P<0.001)and child development(t=25.688;P<0.001).Key growth problems identified included underweight,undernutrition,abnormal head circumference,and stunting.Developmental challenges prominently associated with unintended pregnancy included behavioral and emotional disorders,autism spectrum disorder,attentiondeficit/hyperactivity disorder,social and motor skill deficits,as well as visual and hearing impairments.CONCLUSION Unintended pregnancy significantly affects child growth and development,underscoring the need for early intervention,quality prenatal care,and strengthened family planning policies.展开更多
Community-acquired pneumonia(CAP) is one of the leading causes of morbidity and mortality in children worldwide.In this study,we aimed to describe the aetiology of viral infection of pediatric CAP in Chinese mainland....Community-acquired pneumonia(CAP) is one of the leading causes of morbidity and mortality in children worldwide.In this study,we aimed to describe the aetiology of viral infection of pediatric CAP in Chinese mainland.During November2014 to June 2016,the prospective study was conducted in 13 hospitals.The hospitalized children under 18 years old who met the criteria for CAP were enrolled.The throat swabs or nasopharyngeal aspirates(NPAs) were collected which were then screened 18 respiratory viruses using multiplex PCR assay.Viral pathogens were present in 56.6%(1539/2721) of the enrolled cases,with the detection rate of single virus in 39.8% of the cases and multiple viruses in 16.8% of the cases.The most frequently detected virus was respiratory syncytial virus(RSV)(15.2%,414/2721).The highest detection rate of virus was in <6-month-age group(70.7%,292/413).RSV,human metapneumovirus(HMPV),human parainfluenza viruses(HPIVs) and influenza B virus(Flu B) showed the similar prevalence patterns both in north and south China,but HPIVs,Flu A,human bocavirus(HBoV),human adenovirus(HAdV) and human coronaviruses(HCoVs) showed the distinct circulating patterns in north and south China.Human enterovirus/human rhinovirus(HEV/HRV)(27.6%,27/98),HBoV(18.4%,18/98),RSV(16.3%,16/98) and HMPV(14.3%,14/98) were the most commonly detected viruses in severe pneumonia cases with single virus infection.In conclusion,viral pathogens are frequently detected in pediatric CAP cases and may therefore play a vital role in the aetiology of CAP.RSV was the most important virus in hospitalized children with CAP in Chinese mainland.展开更多
Background:Undernutrition poses a major threat for the growth and development of children in remote island regions of Bangladesh.Methods:This study investigated the prevalence and risk predictors of undernutrition amo...Background:Undernutrition poses a major threat for the growth and development of children in remote island regions of Bangladesh.Methods:This study investigated the prevalence and risk predictors of undernutrition among children under five in the island regions of Bangladesh.A cross‐sectional study was conducted in 13 unions across two islands,with a random sample of 549 children.Results:Descriptive analyses showed that underweight(Z‐score<−2),wasting(Z‐score<−2),and stunting(Z‐score<−2)were prevalent,with rates of 36.80%,24.60%,and 47.20%,respectively.Significant predictors of underweight included a history of diarrhea(AOR=2.24,p<0.001),acute respiratory infection(ARI)(AOR=1.84,p<0.01),anemic caregivers(AOR=1.52,p<0.05),and belonging to day labor families(AOR=0.29,p<0.01).Childhood wasting was significantly associated with partial vaccination(AOR=2.84,p<0.001),large family size(AOR=1.79,p<0.05),higher birth order(AOR=0.58,p<0.05),diarrhea(AOR=3.09,p<0.001),anemic mothers(AOR=1.89,p<0.05),primary(AOR=3.35,p<0.05)and secondary(AOR=4.11,p<0.01)maternal education,and fathers working abroad(AOR=0.42,p<0.05)or as daily laborers(AOR=0.17,p<0.001).Stunting was more common among children with partial vaccination,diarrhea,and ARI,and less common among those with a history of fever or those from day laborer families.Conclusion:Overall,undernutrition among children in the island areas of Bangladesh is influenced by multiple factors,necessitating a multisectoral approach to improve their nutritional status.展开更多
We investigated the psychological effects of nail treatments on children living in child welfare facilities.We performed a single nail treatment on children living in child welfare facilities.As a result,we found that...We investigated the psychological effects of nail treatments on children living in child welfare facilities.We performed a single nail treatment on children living in child welfare facilities.As a result,we found that feelings of“energy”,“relaxation”,and“comfort”tended to increase more strongly after the treatment than before.Furthermore,these feelings increased even more after the nail treatment.The effects of nail treatments were unrelated to gender or previous nail experience.Furthermore,nail treatments increased communication and interaction with facility staff and other children residing in the facility,promoting self-expression,and,as a result,increasing a sense of accomplishment,acceptance from others,and self-esteem.This suggests that positive emotions persisted even after nail treatments,leading to positive changes in daily life.展开更多
With the widespread adoption of smartphones,parental phubbing behaviors have become increasingly prevalent,potentially affecting preschool children’s development.Current research primarily focuses on adolescent popul...With the widespread adoption of smartphones,parental phubbing behaviors have become increasingly prevalent,potentially affecting preschool children’s development.Current research primarily focuses on adolescent populations,while the mechanisms through which parental phubbing and authoritarian parenting style influence preschool children’s behavioral problems within the Chinese cultural context remain to be explored.Our investigation seeks to examine the factors contributing to behavioral difficulties among children of preschool age and provide theoretical guidance for prevention.Methods In our research,we utilized a convenience sampling approach to collect data from parents whose children(n=612)were between 3 and 7 years of age.The questionnaire distribution was facilitated via the Wenjuanxing online survey platform.Research instruments included the Parental Phubbing Scale,Parent-Child Relationship Scale,Authoritarian Parenting Style Scale,and Conners Child Behavior Rating Scale.For analytical procedures,we employed SPSS 24.0 to generate descriptive statistics and correlation analysis.Chain mediation effects were examined via Process macro,while significance assessment of the mediating effects relied on the Bootstrap method for constructing 95%confidence intervals.Results A statistically significant positive association was observed between parental phubbing and behavioral problems exhibited by children(r=0.251,p<0.001).Parental phubbing exhibited a significant direct effect on children’s behavioral problems(β=0.088,p<0.001).Analysis of sequential mediation demonstrated that authoritarian parenting style together with parent-child conflict functioned as significant intermediary variables in the relationship between parental phubbing and children’s problem behaviors(β=0.163,p<0.001),with these indirect pathways constituting 64.94%of the total effect.Conclusion Parental phubbing significantly contributes to behavioral problems in preschool children.Parents should monitor their media use,improve their parenting approach,and enhance parent-child relationships to reduce behavioral problems in preschool children.展开更多
The Realgar-Indigo Naturalis formula(RIF)is a proprietary Chinese medicine,which is one of the important drugs in the treatment of pediatric acute promyelocytic leukemia(APL).However,the dose of RIF in clinical applic...The Realgar-Indigo Naturalis formula(RIF)is a proprietary Chinese medicine,which is one of the important drugs in the treatment of pediatric acute promyelocytic leukemia(APL).However,the dose of RIF in clinical application is not uniform and the long-term effectiveness and safety of combining RIF with all-trans retinoic acid(ATRA)in a larger population of pediatric APL patients remains undocumented.We conducted a multicenter single-arm clinical trial(ChiCTR-OIC-16010014)in China.Individuals newly diagnosed with APL were treated with CCCG-APL-2017 protocol which is based on RIF and ATRA in consolidation.The event-free survival(EFS)and overall survival(OS)outcomes were evaluated.We recruited 200 patients diagnosed with APL.The six-year OS rate was 100%in the low-risk(LR)group and 97.6%in the high-risk(HR)group.The six-year EFS rate was 98.3%in the LR group and 97.6%in the HR group.Plasma levels of arsenic remained stable after the administration of RIF at a dosage of 60 mg/kg/d for seven days and returned to baseline levels within fourteen days after discontinuation of RIF administration,which is consistent with a concentration of 135 mg/d/kg.Furthermore,controlling white blood cells(WBC)to maintain levels at or below 30×10^(9)/L during induction therapy can decrease the incidence of induced differentiation syndrome(DS)or alleviate its symptoms.Our study demonstrated that the CCCG-APL-2017 protocol,which combines RIF with ATRA,is both effective and safe in treating children with APL.展开更多
This study examined the positive changes that water-based nail treatments can bring to emotions and behavior in children who do not attend school and use a place for school-refusing children.Children who do not attend...This study examined the positive changes that water-based nail treatments can bring to emotions and behavior in children who do not attend school and use a place for school-refusing children.Children who do not attend school and use a place for school-refusing children were given water-based nail treatments about once a week for three months.In addition,the parents of these children were asked to respond to questions about their children’s daily activities.The results showed that natural communication through nail treatments significantly increased positive emotions.However,continued nail treatments did not reduce the children’s problem behaviors.Some children returned to school,while others continued not attending school.Increased frequency of visits and number of treatments confirmed the promotion of communication.It was suggested that building positive relationships with family and supporters is important for achieving sustained effects from nail treatments.This study showed that nail treatments are a useful tool for promoting positive emotions,self-acceptance,and social skills,and may contribute to the emotional growth and social interest of children who do not attend school.展开更多
BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in ...BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.展开更多
Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines stil...Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines still recommend the use of antidepressants,especially specific serotonin re-uptake inhibitors.Previous studies have suggested that antidepressants have little therapeutic effect but many side effects,such as switching to mania,suicide,and non-suicidal self injury(NSSI),in the treatment of child and adolescent depression.In the process of developing guidelines,drug recommendations should not only focus on impro-ving symptoms,but they should also consider potential side effects.This review discusses the serious side effects of antidepressants,including switching to mania,suicide,and NSSI.展开更多
BACKGROUND Antibiotic resistance is a key factor influencing the treatment outcomes of Helicobacter pylori(H.pylori)infection.The antibiotic resistance spectrum of H.pylori varies in different regions.We investigated ...BACKGROUND Antibiotic resistance is a key factor influencing the treatment outcomes of Helicobacter pylori(H.pylori)infection.The antibiotic resistance spectrum of H.pylori varies in different regions.We investigated the current status of antibiotic resistance of H.pylori in Hunan Province and analyzed the factors related to such resistance to provide strategies for the accurate clinical treatment of H.pylori infection.AIM To understand the antibiotic resistance of H.pylori in Hunan Province and provide guidance for the clinical treatment of H.pylori infection.METHODS This study selected patients who underwent gastroscopy in five hospitals in Hunan Province from April 2022 to April 2023.The sensitivity of H.pylori to clarithromycin,levofloxacin,metronidazole,amoxicillin,furazolidone,and tetracycline was detected using the Agar dilution method.RESULTS H.pylori strains from a total of 566 patients were isolated and identified.The resistance rates of H.pylori strains to clarithromycin,levofloxacin,metronidazole,amoxicillin,furazolidone,and tetracycline were 49.2%,37.8%,76.1%,2.3%,1.4%,and 0.7%,respectively.The resistance rates to clarithromycin,levofloxacin,and metronidazole were high in the four regions of Hunan Province,and the overall resistance rates in central Hunan Province were higher than those in other regions.The resistance rates of H.pylori strains to clarithromycin and levofloxacin were significantly different among the different age groups(P<0.05),with the elderly group having a higher resistance rate than the young group.The resistance rate of H.pylori strains to clarithromycin was greater in patients with atrophic gastritis,and the resistance rate to levofloxacin was the lowest in patients with peptic ulcers.CONCLUSION The resistance rate of H.pylori to amoxicillin,clarithromycin,and metronidazole is high in Hunan Province.Age,stomach disease,and H.pylori reinfection may affect the antibiotic resistance of H.pylori.展开更多
OBJECTIVE:To investigate the difference in gut microbiota between population with damp-heat constitution(DHC)and balanced constitution(BC).METHODS:A multi-centered cross-sectional casecontrol study was conducted,which...OBJECTIVE:To investigate the difference in gut microbiota between population with damp-heat constitution(DHC)and balanced constitution(BC).METHODS:A multi-centered cross-sectional casecontrol study was conducted,which included 249 participants with damp-heat constitution or balanced constitution.Baseline information of participants was collected,and stool samples were collected for gut microbiota analysis.Principal coordinate analysis,linear discriminant analysis effect size analysis,receiver operating characteristic,random forest model,and phylogenetic investigation of communities by reconstruction of unobserved states methods were used to reveal the relationship between gut microbiota and the damp-heat constitution.RESULTS:Compared to those in the BC group,the richness and diversity of the microbiota,specifically those of several short-chain fatty acid producing genera such as Barnesiella,Coprobacter,and Butyricimonas,were significantly decreased in the DHC group.Regarding biological functions,flavonoid biosynthesis,propanoate metabolism,and nucleotide sugar metabolism were suppressed,while arachidonic acid metabolism and glutathione metabolism were enriched in the DHC group.Finally,a classifier based on the microbiota was constructed to discriminate between the DHC and BC populations.CONCLUSION:The gut microbiota of the DHC population exhibits significantly reduced diversity and is closely related to inflammation,metabolic disorders,and liver steatosis,which is consistent with clinical observations,thus serving as a potential diagnostic tool for traditional Chinese medicine constitution discrimination.展开更多
Objective To investigate the growth parameters of children with phenylketonuria and assess the impact of a phenylalanine-restricted diet on their physical development.Methods The study involved 39 children diagnosed w...Objective To investigate the growth parameters of children with phenylketonuria and assess the impact of a phenylalanine-restricted diet on their physical development.Methods The study involved 39 children diagnosed with phenylketonuria through newborn screening at the Central Child Teaching Hospital,Baghdad,Iraq.Data were collected during scheduled monthly check-ups,including phenylalanine levels,diet compliance,and anthropometric measurements.The children were divided into two groups based on their phenylalanine levels during the 3-year follow up period:well-controlled group(average phenylalanine level of less than 360μmol/L,with no single reading exceeding 600μmol/L;n=14)and poorly-controlled group(one or more phenylalanine readings above 600μmol/L during the follow-up period;n=25).Results The mean height readings for all time points(at birth and 3,6,9,12,15,18,21,24 and 36 months of age)were higher in the well-controlled group than the poorly-controlled group,however,only at 3 months of age the difference was statistically significant.Height Z-scores revealed a clearer pattern:although the poorly controlled group had higher height Z-scores at birth(P=0.001),the well-controlled group showed significantly higher height Z-scores at 3,6,12,15,18,24,and 36 months(P<0.05).The well-controlled group exhibited significantly higher mean weight measurements compared to the poorly-controlled group at 3,6,9,15,18 months and 21 months(P<0.05).From 6 to 36 months,the well-controlled group consistently had significantly higher weight Z-scores than the poorly controlled group(P<0.05).The well-controlled group showed more favorable height and weight Z-score distributions at 36 months of age compared to the poorly-controlled group,but the differences were not statistically significant(P>0.05).Both groups had height and weight Z-scores within the normal range at 36 months of age.Conclusions The children with phenylketonuria who receive good dietary control show better improvements in growth parameters compared to those with poor dietary control,however,both groups maintain height and weight Z-scores within the normal range,indicating generally adequate physical development across the cohort.展开更多
BACKGROUND Epidemiological surveys indicate an increasing incidence of type 2 diabetes mellitus(T2DM)among children and adolescents worldwide.Due to rapid disease progression,severe long-term cardiorenal complications...BACKGROUND Epidemiological surveys indicate an increasing incidence of type 2 diabetes mellitus(T2DM)among children and adolescents worldwide.Due to rapid disease progression,severe long-term cardiorenal complications,a lack of effective treatment strategies,and substantial socioeconomic burdens,it has become an urgent public health issue that requires management and resolution.Adolescent T2DM differs from adult T2DM.Despite a significant increase in our understanding of youth-onset T2DM over the past two decades,the related review and evidence-based content remain limited.AIM To visualize the hotspots and trends in pediatric and adolescent T2DM research and to forecast their future research themes.METHODS This study utilized the terms“children”,“adolescents”,and“type 2 diabetes”,retrieving relevant articles published between 1983 and 2023 from three citation databases within the Web of Science Core Collection(SCI,SSCI,ESCI).Utilizing CiteSpace and VoSviewer software,we analyze and visually represent the annual output of literature,countries involved,and participating institutions.This allows us to predict trends in this research field.Our analysis encompasses co-cited authors,journal overlays,citation overlays,time-zone views,keyword analysis,and reference analysis,etc.RESULTS A total of 9210 articles were included,and the annual publication volume in this field showed a steady growth trend.The United States had the highest number of publications and the highest H-index.The United States also had the most research institutions and the strongest research capacity.The global hot journals were primarily diabetes professional journals but also included journals related to nutrition,endocrinology,and metabolism.Keyword analysis showed that research related to endothelial dysfunction,exposure risk,cardiac metabolic risk,changes in gut microbiota,the impact on comorbidities and outcomes,etc.,were emerging keywords.They have maintained their popularity in this field,suggesting that these areas have garnered significant research interest in recent years.CONCLUSION Pediatric and adolescent T2DM is increasingly drawing global attention,with genes,behaviors,environmental factors,and multisystemic interventions potentially emerging as future research hot spots.展开更多
Background: Pancreatic cancer is one of the most lethal malignancies, with postoperative recurrence severely affecting patient survival and prognosis. This study aims to develop and validate a clinical prediction mode...Background: Pancreatic cancer is one of the most lethal malignancies, with postoperative recurrence severely affecting patient survival and prognosis. This study aims to develop and validate a clinical prediction model for postoperative recurrence in pancreatic cancer patients, incorporating multiple preoperative, intraoperative, and postoperative factors to assist clinical decision-making. Methods: A retrospective study was conducted on 216 patients who underwent surgical treatment for pancreatic malignancy at the First Affiliated Hospital of Chongqing Medical University between January 2015 and January 2023. An independent external validation cohort of 76 patients from the Second Affiliated Hospital of Chongqing Medical University was used to validate the model. Seven independent risk factors for postoperative recurrence were identified through univariate and multivariate Cox regression analyses. The model’s performance was evaluated using the concordance index (C-index) and ROC curves, and its accuracy and clinical value were assessed using calibration curves and decision curve analysis (DCA). Results: The predictive model demonstrated good discriminatory power, with a C-index of 0.72 in the training cohort and 0.66 in the validation cohort. The ROC curves for predicting recurrence at 3, 6, and 12 months postoperatively showed AUC values ranging from 0.72 to 0.83, indicating strong predictive value. Calibration curves and DCA confirmed the model’s accuracy and clinical utility. Conclusion: This study successfully developed and validated a clinical prediction model that incorporates seven independent risk factors for postoperative recurrence in pancreatic cancer. The model provides a useful tool for predicting recurrence risk, aiding in the identification of high-risk patients, and informing clinical decision-making.展开更多
Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent compl...Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent complete obstruction (apnea). Our aim is to study the role of adeno-tonsillectomy in the management of OSAHS in children. Methodology: This was a prospective descriptive study conducted in the ENT-Head and Neck Surgery department of Ignace Deen National Hospital over a six-month period. We included in our study all patients aged 0 to 15 years, presenting with OSAHS of ENT etiology and who had undergone tonsillectomy/adenoidectomy. Results: The frequency of OSAHS was 13%. The mean age of our patients was 5.1 ± 3.8 years. There was a predominance of males (69.6%) with a sex ratio of 2.28. Snoring (98.6%), nasal obstruction (97.1%), and mouth breathing (96.6%) were the main reasons for consultation. Adeno-tonsillectomy (45.4%) was the primary surgical intervention. Almost all children (99.0%) had a simple postoperative course. Conclusion: OSAHS is a condition with a multifactorial etiology. Adeno-tonsillectomy remains the first-line surgical treatment to prevent severe complications and relieve the patient. Multidisciplinary collaboration is essential in the management of OSAHS.展开更多
Domestic accidents (DA) are common in children and responsible for high morbidity and mortality in developed countries. Objective: This work aimed to describe the epidemiological profile of AD in children aged 0 to 15...Domestic accidents (DA) are common in children and responsible for high morbidity and mortality in developed countries. Objective: This work aimed to describe the epidemiological profile of AD in children aged 0 to 15 years in Libreville. Materials and Methods: All children aged 0 to 15 years who were victims of unintentional trauma occurring at home or in its immediate surroundings were included. We studied the mother’s age, family situation, socioeconomic level, type of housing, age and sex of the child, characteristics of AD and their management. Results: The majority of mothers lived in an intermediate dwelling (80.6%). They were married (37.1%), middle managers (58.2%) and of average socioeconomic level (60.5%). The average age of the mothers was 39.9 ± 11.4 years. Families with more than three children were most exposed (39.2%) to the occurrence of AD. The average age of the children was 6.5 ± 3.3 years with a male predominance. The sex ratio was 1.8. The most common ADs were falls (34.7%), followed by cuts (22.3%) and burns (17.7%). Wounds (54.4%), followed by burns (33%) and fractures (5.1%) were the main types of injuries. The upper limbs were the most affected body part (33.9%) followed by the lower limbs (30.1%) and the head (27.3%). The yard was the preferred location for ADs to occur (51.1%), and particularly during the holiday period (48.4%). The risk factors related to the occurrence of AD were age, socioeconomic level, number of children and type of housing. Care was provided at home in 51.9% of cases. Conclusion: The occurrence of AD in children is not negligible;hence the need to implement preventive measures to minimize their frequency.展开更多
文摘BACKGROUND Unintended pregnancy occurs when an individual or couple conceives without planning or desire,which can potentially affect a child’s physical,mental,and social well-being.This can then lead to long-term socioeconomic challenges for families and communities.Although its impact on child growth and development is a pressing concern,research remains limited particularly in multicenter settings.AIM To examine the long-term consequences of unintended pregnancy on the critical years of early childhood growth and development.METHODS This analytical observational study employed a case-control design and was conducted in research centers across Indonesia,encompassing those located in Central Java,Lampung,Bali,and West Nusa Tenggara.A total of 700 children aged≤5 years with histories of intended or unintended pregnancies participated.Data collection involved structured interviews and direct anthropometric and developmental assessments.Data analyses were conducted using multivariate statistics and partial least squares structural equation modeling.RESULTS Unintended pregnancy was found to have a statistically significant effect on both child growth(t=8.178;P<0.001)and child development(t=25.688;P<0.001).Key growth problems identified included underweight,undernutrition,abnormal head circumference,and stunting.Developmental challenges prominently associated with unintended pregnancy included behavioral and emotional disorders,autism spectrum disorder,attentiondeficit/hyperactivity disorder,social and motor skill deficits,as well as visual and hearing impairments.CONCLUSION Unintended pregnancy significantly affects child growth and development,underscoring the need for early intervention,quality prenatal care,and strengthened family planning policies.
基金This study was supported by National Science and Technology Supported Projects(grant number:2013BAI09B11)the National Major Science&Technology Project for Control and Prevention of Major Infectious Diseases in China(grant number:2018ZX10201002-008-008,2017ZX10103004-004)。
文摘Community-acquired pneumonia(CAP) is one of the leading causes of morbidity and mortality in children worldwide.In this study,we aimed to describe the aetiology of viral infection of pediatric CAP in Chinese mainland.During November2014 to June 2016,the prospective study was conducted in 13 hospitals.The hospitalized children under 18 years old who met the criteria for CAP were enrolled.The throat swabs or nasopharyngeal aspirates(NPAs) were collected which were then screened 18 respiratory viruses using multiplex PCR assay.Viral pathogens were present in 56.6%(1539/2721) of the enrolled cases,with the detection rate of single virus in 39.8% of the cases and multiple viruses in 16.8% of the cases.The most frequently detected virus was respiratory syncytial virus(RSV)(15.2%,414/2721).The highest detection rate of virus was in <6-month-age group(70.7%,292/413).RSV,human metapneumovirus(HMPV),human parainfluenza viruses(HPIVs) and influenza B virus(Flu B) showed the similar prevalence patterns both in north and south China,but HPIVs,Flu A,human bocavirus(HBoV),human adenovirus(HAdV) and human coronaviruses(HCoVs) showed the distinct circulating patterns in north and south China.Human enterovirus/human rhinovirus(HEV/HRV)(27.6%,27/98),HBoV(18.4%,18/98),RSV(16.3%,16/98) and HMPV(14.3%,14/98) were the most commonly detected viruses in severe pneumonia cases with single virus infection.In conclusion,viral pathogens are frequently detected in pediatric CAP cases and may therefore play a vital role in the aetiology of CAP.RSV was the most important virus in hospitalized children with CAP in Chinese mainland.
文摘Background:Undernutrition poses a major threat for the growth and development of children in remote island regions of Bangladesh.Methods:This study investigated the prevalence and risk predictors of undernutrition among children under five in the island regions of Bangladesh.A cross‐sectional study was conducted in 13 unions across two islands,with a random sample of 549 children.Results:Descriptive analyses showed that underweight(Z‐score<−2),wasting(Z‐score<−2),and stunting(Z‐score<−2)were prevalent,with rates of 36.80%,24.60%,and 47.20%,respectively.Significant predictors of underweight included a history of diarrhea(AOR=2.24,p<0.001),acute respiratory infection(ARI)(AOR=1.84,p<0.01),anemic caregivers(AOR=1.52,p<0.05),and belonging to day labor families(AOR=0.29,p<0.01).Childhood wasting was significantly associated with partial vaccination(AOR=2.84,p<0.001),large family size(AOR=1.79,p<0.05),higher birth order(AOR=0.58,p<0.05),diarrhea(AOR=3.09,p<0.001),anemic mothers(AOR=1.89,p<0.05),primary(AOR=3.35,p<0.05)and secondary(AOR=4.11,p<0.01)maternal education,and fathers working abroad(AOR=0.42,p<0.05)or as daily laborers(AOR=0.17,p<0.001).Stunting was more common among children with partial vaccination,diarrhea,and ARI,and less common among those with a history of fever or those from day laborer families.Conclusion:Overall,undernutrition among children in the island areas of Bangladesh is influenced by multiple factors,necessitating a multisectoral approach to improve their nutritional status.
基金This study received a research grant from the Hoyu Science Foundation in 2023.
文摘We investigated the psychological effects of nail treatments on children living in child welfare facilities.We performed a single nail treatment on children living in child welfare facilities.As a result,we found that feelings of“energy”,“relaxation”,and“comfort”tended to increase more strongly after the treatment than before.Furthermore,these feelings increased even more after the nail treatment.The effects of nail treatments were unrelated to gender or previous nail experience.Furthermore,nail treatments increased communication and interaction with facility staff and other children residing in the facility,promoting self-expression,and,as a result,increasing a sense of accomplishment,acceptance from others,and self-esteem.This suggests that positive emotions persisted even after nail treatments,leading to positive changes in daily life.
文摘With the widespread adoption of smartphones,parental phubbing behaviors have become increasingly prevalent,potentially affecting preschool children’s development.Current research primarily focuses on adolescent populations,while the mechanisms through which parental phubbing and authoritarian parenting style influence preschool children’s behavioral problems within the Chinese cultural context remain to be explored.Our investigation seeks to examine the factors contributing to behavioral difficulties among children of preschool age and provide theoretical guidance for prevention.Methods In our research,we utilized a convenience sampling approach to collect data from parents whose children(n=612)were between 3 and 7 years of age.The questionnaire distribution was facilitated via the Wenjuanxing online survey platform.Research instruments included the Parental Phubbing Scale,Parent-Child Relationship Scale,Authoritarian Parenting Style Scale,and Conners Child Behavior Rating Scale.For analytical procedures,we employed SPSS 24.0 to generate descriptive statistics and correlation analysis.Chain mediation effects were examined via Process macro,while significance assessment of the mediating effects relied on the Bootstrap method for constructing 95%confidence intervals.Results A statistically significant positive association was observed between parental phubbing and behavioral problems exhibited by children(r=0.251,p<0.001).Parental phubbing exhibited a significant direct effect on children’s behavioral problems(β=0.088,p<0.001).Analysis of sequential mediation demonstrated that authoritarian parenting style together with parent-child conflict functioned as significant intermediary variables in the relationship between parental phubbing and children’s problem behaviors(β=0.163,p<0.001),with these indirect pathways constituting 64.94%of the total effect.Conclusion Parental phubbing significantly contributes to behavioral problems in preschool children.Parents should monitor their media use,improve their parenting approach,and enhance parent-child relationships to reduce behavioral problems in preschool children.
基金supported by National Key Research and Development Program of China(2021YFE0106900)the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(2021-I2M-1-041,2021-I2M-1-001)the National Natural Science Foundation of China(82270144).
文摘The Realgar-Indigo Naturalis formula(RIF)is a proprietary Chinese medicine,which is one of the important drugs in the treatment of pediatric acute promyelocytic leukemia(APL).However,the dose of RIF in clinical application is not uniform and the long-term effectiveness and safety of combining RIF with all-trans retinoic acid(ATRA)in a larger population of pediatric APL patients remains undocumented.We conducted a multicenter single-arm clinical trial(ChiCTR-OIC-16010014)in China.Individuals newly diagnosed with APL were treated with CCCG-APL-2017 protocol which is based on RIF and ATRA in consolidation.The event-free survival(EFS)and overall survival(OS)outcomes were evaluated.We recruited 200 patients diagnosed with APL.The six-year OS rate was 100%in the low-risk(LR)group and 97.6%in the high-risk(HR)group.The six-year EFS rate was 98.3%in the LR group and 97.6%in the HR group.Plasma levels of arsenic remained stable after the administration of RIF at a dosage of 60 mg/kg/d for seven days and returned to baseline levels within fourteen days after discontinuation of RIF administration,which is consistent with a concentration of 135 mg/d/kg.Furthermore,controlling white blood cells(WBC)to maintain levels at or below 30×10^(9)/L during induction therapy can decrease the incidence of induced differentiation syndrome(DS)or alleviate its symptoms.Our study demonstrated that the CCCG-APL-2017 protocol,which combines RIF with ATRA,is both effective and safe in treating children with APL.
基金supported by a research grant from the Hoyu Science Foundation in 2023.
文摘This study examined the positive changes that water-based nail treatments can bring to emotions and behavior in children who do not attend school and use a place for school-refusing children.Children who do not attend school and use a place for school-refusing children were given water-based nail treatments about once a week for three months.In addition,the parents of these children were asked to respond to questions about their children’s daily activities.The results showed that natural communication through nail treatments significantly increased positive emotions.However,continued nail treatments did not reduce the children’s problem behaviors.Some children returned to school,while others continued not attending school.Increased frequency of visits and number of treatments confirmed the promotion of communication.It was suggested that building positive relationships with family and supporters is important for achieving sustained effects from nail treatments.This study showed that nail treatments are a useful tool for promoting positive emotions,self-acceptance,and social skills,and may contribute to the emotional growth and social interest of children who do not attend school.
文摘BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.
文摘Antidepressants are the main drugs used to treat depression,but they have not been shown to be effective in the treatment of child and adolescent depression.However,many adolescent depression treatment guidelines still recommend the use of antidepressants,especially specific serotonin re-uptake inhibitors.Previous studies have suggested that antidepressants have little therapeutic effect but many side effects,such as switching to mania,suicide,and non-suicidal self injury(NSSI),in the treatment of child and adolescent depression.In the process of developing guidelines,drug recommendations should not only focus on impro-ving symptoms,but they should also consider potential side effects.This review discusses the serious side effects of antidepressants,including switching to mania,suicide,and NSSI.
基金Supported by the National Natural Science Foundation of China,No.82270594the Independent Exploration and Innovation Project of Central South University,No.2024ZZTS0966.
文摘BACKGROUND Antibiotic resistance is a key factor influencing the treatment outcomes of Helicobacter pylori(H.pylori)infection.The antibiotic resistance spectrum of H.pylori varies in different regions.We investigated the current status of antibiotic resistance of H.pylori in Hunan Province and analyzed the factors related to such resistance to provide strategies for the accurate clinical treatment of H.pylori infection.AIM To understand the antibiotic resistance of H.pylori in Hunan Province and provide guidance for the clinical treatment of H.pylori infection.METHODS This study selected patients who underwent gastroscopy in five hospitals in Hunan Province from April 2022 to April 2023.The sensitivity of H.pylori to clarithromycin,levofloxacin,metronidazole,amoxicillin,furazolidone,and tetracycline was detected using the Agar dilution method.RESULTS H.pylori strains from a total of 566 patients were isolated and identified.The resistance rates of H.pylori strains to clarithromycin,levofloxacin,metronidazole,amoxicillin,furazolidone,and tetracycline were 49.2%,37.8%,76.1%,2.3%,1.4%,and 0.7%,respectively.The resistance rates to clarithromycin,levofloxacin,and metronidazole were high in the four regions of Hunan Province,and the overall resistance rates in central Hunan Province were higher than those in other regions.The resistance rates of H.pylori strains to clarithromycin and levofloxacin were significantly different among the different age groups(P<0.05),with the elderly group having a higher resistance rate than the young group.The resistance rate of H.pylori strains to clarithromycin was greater in patients with atrophic gastritis,and the resistance rate to levofloxacin was the lowest in patients with peptic ulcers.CONCLUSION The resistance rate of H.pylori to amoxicillin,clarithromycin,and metronidazole is high in Hunan Province.Age,stomach disease,and H.pylori reinfection may affect the antibiotic resistance of H.pylori.
基金National Nonprofit Institute Research Grant for the Institute of Basic Theory for Chinese Medicine,China Academy of Chinese Medical Sciences:Mechanism of Regulating Phlegm-Dampness Constitution to Prevent Metabolic Diseases based on Gut Microbiota-host DNA Methylation(No.YZ-202151)。
文摘OBJECTIVE:To investigate the difference in gut microbiota between population with damp-heat constitution(DHC)and balanced constitution(BC).METHODS:A multi-centered cross-sectional casecontrol study was conducted,which included 249 participants with damp-heat constitution or balanced constitution.Baseline information of participants was collected,and stool samples were collected for gut microbiota analysis.Principal coordinate analysis,linear discriminant analysis effect size analysis,receiver operating characteristic,random forest model,and phylogenetic investigation of communities by reconstruction of unobserved states methods were used to reveal the relationship between gut microbiota and the damp-heat constitution.RESULTS:Compared to those in the BC group,the richness and diversity of the microbiota,specifically those of several short-chain fatty acid producing genera such as Barnesiella,Coprobacter,and Butyricimonas,were significantly decreased in the DHC group.Regarding biological functions,flavonoid biosynthesis,propanoate metabolism,and nucleotide sugar metabolism were suppressed,while arachidonic acid metabolism and glutathione metabolism were enriched in the DHC group.Finally,a classifier based on the microbiota was constructed to discriminate between the DHC and BC populations.CONCLUSION:The gut microbiota of the DHC population exhibits significantly reduced diversity and is closely related to inflammation,metabolic disorders,and liver steatosis,which is consistent with clinical observations,thus serving as a potential diagnostic tool for traditional Chinese medicine constitution discrimination.
文摘Objective To investigate the growth parameters of children with phenylketonuria and assess the impact of a phenylalanine-restricted diet on their physical development.Methods The study involved 39 children diagnosed with phenylketonuria through newborn screening at the Central Child Teaching Hospital,Baghdad,Iraq.Data were collected during scheduled monthly check-ups,including phenylalanine levels,diet compliance,and anthropometric measurements.The children were divided into two groups based on their phenylalanine levels during the 3-year follow up period:well-controlled group(average phenylalanine level of less than 360μmol/L,with no single reading exceeding 600μmol/L;n=14)and poorly-controlled group(one or more phenylalanine readings above 600μmol/L during the follow-up period;n=25).Results The mean height readings for all time points(at birth and 3,6,9,12,15,18,21,24 and 36 months of age)were higher in the well-controlled group than the poorly-controlled group,however,only at 3 months of age the difference was statistically significant.Height Z-scores revealed a clearer pattern:although the poorly controlled group had higher height Z-scores at birth(P=0.001),the well-controlled group showed significantly higher height Z-scores at 3,6,12,15,18,24,and 36 months(P<0.05).The well-controlled group exhibited significantly higher mean weight measurements compared to the poorly-controlled group at 3,6,9,15,18 months and 21 months(P<0.05).From 6 to 36 months,the well-controlled group consistently had significantly higher weight Z-scores than the poorly controlled group(P<0.05).The well-controlled group showed more favorable height and weight Z-score distributions at 36 months of age compared to the poorly-controlled group,but the differences were not statistically significant(P>0.05).Both groups had height and weight Z-scores within the normal range at 36 months of age.Conclusions The children with phenylketonuria who receive good dietary control show better improvements in growth parameters compared to those with poor dietary control,however,both groups maintain height and weight Z-scores within the normal range,indicating generally adequate physical development across the cohort.
基金Supported by the National Natural Science Foundation of China,No.82105018 and No.81903950.
文摘BACKGROUND Epidemiological surveys indicate an increasing incidence of type 2 diabetes mellitus(T2DM)among children and adolescents worldwide.Due to rapid disease progression,severe long-term cardiorenal complications,a lack of effective treatment strategies,and substantial socioeconomic burdens,it has become an urgent public health issue that requires management and resolution.Adolescent T2DM differs from adult T2DM.Despite a significant increase in our understanding of youth-onset T2DM over the past two decades,the related review and evidence-based content remain limited.AIM To visualize the hotspots and trends in pediatric and adolescent T2DM research and to forecast their future research themes.METHODS This study utilized the terms“children”,“adolescents”,and“type 2 diabetes”,retrieving relevant articles published between 1983 and 2023 from three citation databases within the Web of Science Core Collection(SCI,SSCI,ESCI).Utilizing CiteSpace and VoSviewer software,we analyze and visually represent the annual output of literature,countries involved,and participating institutions.This allows us to predict trends in this research field.Our analysis encompasses co-cited authors,journal overlays,citation overlays,time-zone views,keyword analysis,and reference analysis,etc.RESULTS A total of 9210 articles were included,and the annual publication volume in this field showed a steady growth trend.The United States had the highest number of publications and the highest H-index.The United States also had the most research institutions and the strongest research capacity.The global hot journals were primarily diabetes professional journals but also included journals related to nutrition,endocrinology,and metabolism.Keyword analysis showed that research related to endothelial dysfunction,exposure risk,cardiac metabolic risk,changes in gut microbiota,the impact on comorbidities and outcomes,etc.,were emerging keywords.They have maintained their popularity in this field,suggesting that these areas have garnered significant research interest in recent years.CONCLUSION Pediatric and adolescent T2DM is increasingly drawing global attention,with genes,behaviors,environmental factors,and multisystemic interventions potentially emerging as future research hot spots.
文摘Background: Pancreatic cancer is one of the most lethal malignancies, with postoperative recurrence severely affecting patient survival and prognosis. This study aims to develop and validate a clinical prediction model for postoperative recurrence in pancreatic cancer patients, incorporating multiple preoperative, intraoperative, and postoperative factors to assist clinical decision-making. Methods: A retrospective study was conducted on 216 patients who underwent surgical treatment for pancreatic malignancy at the First Affiliated Hospital of Chongqing Medical University between January 2015 and January 2023. An independent external validation cohort of 76 patients from the Second Affiliated Hospital of Chongqing Medical University was used to validate the model. Seven independent risk factors for postoperative recurrence were identified through univariate and multivariate Cox regression analyses. The model’s performance was evaluated using the concordance index (C-index) and ROC curves, and its accuracy and clinical value were assessed using calibration curves and decision curve analysis (DCA). Results: The predictive model demonstrated good discriminatory power, with a C-index of 0.72 in the training cohort and 0.66 in the validation cohort. The ROC curves for predicting recurrence at 3, 6, and 12 months postoperatively showed AUC values ranging from 0.72 to 0.83, indicating strong predictive value. Calibration curves and DCA confirmed the model’s accuracy and clinical utility. Conclusion: This study successfully developed and validated a clinical prediction model that incorporates seven independent risk factors for postoperative recurrence in pancreatic cancer. The model provides a useful tool for predicting recurrence risk, aiding in the identification of high-risk patients, and informing clinical decision-making.
文摘Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent complete obstruction (apnea). Our aim is to study the role of adeno-tonsillectomy in the management of OSAHS in children. Methodology: This was a prospective descriptive study conducted in the ENT-Head and Neck Surgery department of Ignace Deen National Hospital over a six-month period. We included in our study all patients aged 0 to 15 years, presenting with OSAHS of ENT etiology and who had undergone tonsillectomy/adenoidectomy. Results: The frequency of OSAHS was 13%. The mean age of our patients was 5.1 ± 3.8 years. There was a predominance of males (69.6%) with a sex ratio of 2.28. Snoring (98.6%), nasal obstruction (97.1%), and mouth breathing (96.6%) were the main reasons for consultation. Adeno-tonsillectomy (45.4%) was the primary surgical intervention. Almost all children (99.0%) had a simple postoperative course. Conclusion: OSAHS is a condition with a multifactorial etiology. Adeno-tonsillectomy remains the first-line surgical treatment to prevent severe complications and relieve the patient. Multidisciplinary collaboration is essential in the management of OSAHS.
文摘Domestic accidents (DA) are common in children and responsible for high morbidity and mortality in developed countries. Objective: This work aimed to describe the epidemiological profile of AD in children aged 0 to 15 years in Libreville. Materials and Methods: All children aged 0 to 15 years who were victims of unintentional trauma occurring at home or in its immediate surroundings were included. We studied the mother’s age, family situation, socioeconomic level, type of housing, age and sex of the child, characteristics of AD and their management. Results: The majority of mothers lived in an intermediate dwelling (80.6%). They were married (37.1%), middle managers (58.2%) and of average socioeconomic level (60.5%). The average age of the mothers was 39.9 ± 11.4 years. Families with more than three children were most exposed (39.2%) to the occurrence of AD. The average age of the children was 6.5 ± 3.3 years with a male predominance. The sex ratio was 1.8. The most common ADs were falls (34.7%), followed by cuts (22.3%) and burns (17.7%). Wounds (54.4%), followed by burns (33%) and fractures (5.1%) were the main types of injuries. The upper limbs were the most affected body part (33.9%) followed by the lower limbs (30.1%) and the head (27.3%). The yard was the preferred location for ADs to occur (51.1%), and particularly during the holiday period (48.4%). The risk factors related to the occurrence of AD were age, socioeconomic level, number of children and type of housing. Care was provided at home in 51.9% of cases. Conclusion: The occurrence of AD in children is not negligible;hence the need to implement preventive measures to minimize their frequency.
