OBJECTIVE To investigate the effect of allogeneic decalcified bone graft in the treatment of nonunion in children. METHODS From April 1990 to September 1997, 17 children with nonunion were adopted in this study. Among them, there were 10 boys and 7 girls, the age ranged from 2 to 13 years. The allogeneic decalcified bone graft taken from fresh corpse by aseptic manipulation were used to repair 3 cases of congenital nonunion and 14 cases of acquired nonunion. RESULTS All cases were followed up 2 to 9 years after operation, 9 cases were cured successfully and 7 cases were cured after twice operations. One case of congenital pseudoarthrosis of the tibia was operated twice and there were callus grown half years after the second operation, but reoccurred after one year. Although there were 1.5 cm to 3 cm shortening deformity of extremity including another 2 cases of congenital pseudoarthrosis of the tibia and 5 cases of nonunion caused by chronic osteomyelitis, the function of joint was normal. CONCLUSION Treatment of nonunion in children by allogeneic decalcified bone graft is a valuable technique in clinical practice. It is characterised by high capacity of osteoinduction, low antigenicity, rapid bony union, plentiful source of bone graft and convenient utilization.
Since 1979, nine children had been treated by free fibular graft in our hospital. Five of them were males, and 4 were females, with a mean age of eight years. The average length of the skeletal defects was 7 cm. The average length of the fibula that was removed for reconstruction was 12.3 cm. The blood circulation of the donor bone was re-established by direct anastomosis of one peroneal artery and vein of the transfer with the appropriate artery and vein of the host region. Nine patients had been followed from 1 year to 9 years,avereged 5.5 years. S even grafts which were substituted in the tibia defects took the same shape and caliber as that of the normal tibia with canalization of the marrow cavity . From the roentgenographic examination of the side where the fibular graft was removed, there was definite caudal migration of the upper fibular in 5 cases,averged 5.2mm,while in 7 cases there was cephalic migration of the distal fibular segments,averaged 4.3mm. The breadth of ankle mortise where increased in 7 cases,The tibio-talus angle was averaged 7 degrees,in 3 cases. In 3 of the 9 cases during follow-up,alaterl wedging of the distal tibia epiphysis with lateral tilting of the talus invarably associated with instability of the ankle was evident. We believed that the elevation of the lateral malleolus and latral wedging of the distal tibia epiphysis were responsible for instability of the ankle.
ObjectiveChildhood absence epilepsy (CAE) is a common syndrome of idiopathic generalized epilepsy.However, little is known about the brain structural changes in this type of epilepsy, especially in the default mode network (DMN) regions.Diffusion tensor imaging (DTI) is a noninvasive techniques that can be used to quantitatively explore structural characteristics of brain.This study aims at using the DTI technique to quantify structural abnormalities of DMN nodes in CAE patients.MethodDTI data were obtained in 14 CAE patients and 13 age-and gender-matched healthy controls.The data were analyzed using voxel-based analysis (VBA) and statistically compared between patients and controls.For the regions with significant difference in group comparison, their DTI metrics were further analyzed with clinical symptoms using Pearson's correlation.ResultsPatients showed significant increase of apparent diffusion coefficient (ADC) in left medial prefrontal cortex (MPFC) (P=0.042), while fractional anisotropy (FA) value was significantly decreased in left precuneus (P=0.010).In correlation analysis, ADC value from left MPFC was positively associated with duration of epilepsy.Neither the disease duration nor the seizure frequency showed significant correlation with FA values.ConclusionThe findings indicate that structural impairments exist in DMN regions in children suffering from absence epilepsy.This may contribute to understanding the pathological mechanisms and chronic neurological deficits of this disorder.
Objective To analyze the causal relationship between gut microbiota and childhood asthma based on Mendelian randomization (MR). Methods The human gut microbiota dataset was downloaded from the MiBioGen database, and 196 known bacterial groups (9 phyla, 16 classes, 20 orders, 32 families, and 119 genera) were retained as exposure factors. Single nucleotide polymorphisms (SNPs) that were strongly correlated with exposure factors and independent of each other were selected as effective instrumental variables. A childhood asthma dataset with 3 025 patients and 135 449 controls was downloaded from the genome-wide association studies database as the outcome variable. Two-sample MR analysis was performed using inverse variance weighted, weighted median, MR-Egger, weighted model and simple model methods, respectively. The causal association between gut microbiota and childhood asthma was evaluated by odds ratio (OR). Sensitivity analysis was performed by leave-one-out method. Horizontal pleiotropy was tested by MR-Egger intercept test and MR-PRESSO global test, and Cochran’s Q test was used for heterogeneity. Results A total of 15 out of 196 gut microbiota groups were found to have a causal association (P<0.05) with the risk of childhood asthma, with a total of 181 SNPs included in the analysis. Inverse variance weighted analysis showed that Mollicutes [OR=1.42, 95% confidence interval (CI) (1.10, 1.83), P=0.007], Escherichia-Shigella [OR=1.39, 95%CI (1.02, 1.90), P=0.036], Oxalobacter [OR=1.30, 95%CI (1.10, 1.54), P=0.002], Ruminococcaceae UCG-009 [OR=1.34, 95%CI (1.09, 1.64), P=0.006] and Tenericutes [OR=1.42, 95%CI (1.10, 1.83), P=0.007] were significantly positively correlated with childhood asthma. Actinobacteria [OR=0.76, 95%CI (0.58, 0.99), P=0.042], Bifidobacteriaceae [OR=0.76, 95%CI (0.58, 0.98), P=0.035], Eubacterium nodatum group [OR=0.81, 95%CI (0.70, 0.94), P=0.007], Bifidobacterales [OR=0.76, 95%CI (0.58, 0.98), P=0.035] and Actinobacteria [OR=0.74, 95%CI (0.56, 0.99), P=0.040] were negatively correlated with childhood asthma. In addition, the results of leave-one-out sensitivity analysis were stable, MR-Egger intercept test and MR-PRESSO global test showed no horizontal pleiotropy, and Cochran’s Q test showed no heterogeneity. Conclusions There is a causal relationship between gut microbiota and childhood asthma. Mollicutes, Escherichia-Shigella, Oxalobacter, Ruminococcaceae UCG-009 and Tenericutes may increase the risk of childhood asthma. Actinobacteria, Bifidobacteriaceae, Eubacterium nodatum group, Bifidobacterales and Actinobacteria can reduce the risk of childhood asthma.
Objectives
To systematically review the relationship between indoor decoration and childhood leukemia in China.
Methods
CNKI, WanFang Data, VIP, CBM, PubMed, EMbase and The Cochrane Library databases were electronically searched to obtain case-control studies of the relationships between indoor decoration and childhood leukemia from inception to December 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.
Results
A total of 13 studies involving 1 727 cases and 2 468 controls were included. The results of meta-analysis showed that indoor decoration could increase the risk of childhood leukemia in China (OR=2.69, 95%CI 1.82 to 3.98, P<0.000 01).
Conclusions
The current evidence suggests that indoor decoration is a risk factor for childhood leukemia in Chinese. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
Childhood obesity is a global public health problem that seriously affects the normal growth and development of children. In recent years, a large number of studies have pointed out that the intestinal microbiome is closely related to childhood obesity, and the treatment strategies targeting the intestinal microbiome have a certain improvement effect on childhood obesity. This article elaborates on the establishment and development of intestinal microbiome, intestinal microbiome characteristics, the mechanisms of intestinal microbiome involvement in the occurrence and development of childhood obesity, and potential intervention strategies, so as to provide more ideas for basic and clinical research on childhood obesity.
Abstract From 1980 to 1985, 21 cases of free transplantation of fibula were performed. There were 6 children in this series, and 4 children were followed up for 9 to 12 years (average 10 years). The Xray showed that distal epiphysis of tibia had a normal width at the medial side and gradully tapered toward the lateral side in a "wedgeshaped" apperance. The articular space of the tibiotalar joint inclined to the fibularside. The hight of the talus was higher laterally, leading to eversion deformity of the ankle joint. The medial and lateral malleoli were smaller than normal, and thus the ankle joint mortise became shallow. The trabeculae of the tibia were irregularly arranged. The lateral cortex of the tibia was thicker than that of the medial one. In one case, the bone density of the lateral side of the "wedgeshaped" epiphysis had increased as high as that ofthe cortex with disappearance of trabeculae. The biomechanics of fibular boneand the mechanism of development of disturbance of ankle joint in childhood were analyzed. Close attention should be paid to this disturbance.
Objective To systematically review the effects of various exercise modalities on obese children and adolescents with metabolic syndrome (MetS). MethodsChinese and English databases such as CNKI, WanFang Data, VIP, PubMed and Web of Science were selected to search for RCTs on the effects of exercise on obese children and adolescents with MetS, and the search period was from January 2000 to November 2024. Two researchers independently screened the literature, extracted data and evaluated the risk of bias of the included studies, and net work meta?analysis was performed using Stata 17.0 and RevMan 5.4 software. ResultsA total of 15 RCTs involving 968 obese children and adolescents with MetS were included. The results of reticulated meta?analysis showed that compared with the non?exercise intervention group, aerobic exercise was effective in improving the patients' body mass index (BMI) (SMD=?1.21, 95%CI ?2.31 to ?0.11, P=0.031), total cholesterol (TC) (SMD=?0.44, 95%CI ?0.82 to ?0.05, P=0.028), triglyceride (TG) (SMD=?1.10, 95%CI ?1.98 to ?0.22, P=0.014), fasting blood glucose (FBG) (SMD=?0.70, 95%CI ?1.34 to ?0.07, P=0.030), systolic blood pressure (SBP) (SMD=?1.10, 95%CI ?1.83 to ?0.38, P=0.003), diastolic blood pressure (DBP) (SMD=?0.93, 95%CI ?1.49 to ?0.37, P=0.001). Resistance exercise can effectively improve the HDL cholesterol (SMD=0.55, 95%CI 0.09 to 1.02, P=0.020) and SBP (SMD=?1.16, 95%CI ?2.18 to ?0.14, P=0.025). Aerobic combined with resistance exercise can effectively improve waist circumference (WC) (SMD=?1.09, 95%CI ?1.74 to ?0.44, P=0.001), BMI (SMD=?1.22, 95%CI ?2.32 to ?0.12, P=0.030), HDL (SMD=0.56, 95%CI 0.13 to 1.00, P=0.011), and FBG (SMD=?0.57, 95%CI ?1.13 to ?0.02, P=0.044). The results of cumulative probability ranking showed that aerobic exercise was the most effective in improving TG, TC, FBG and DBP, resistance exercise was the most effective in improving SBP; and aerobic combined with resistance exercise was the most effective in improving WC, BMI and HDL. ConclusionDifferent exercise modes have different improvement effects on various body indexes in obese children and adolescents with MetS. Due to the limitation of the number and quality of included studies, more high quality studies are needed to verify the above conclusions.
ObjectiveTo investigate the medical knowledge and treatment compliance of parents of asthma children in Gaoming District, Foshan City.
MethodOne hundred consecutive parents of asthma children who sought pediatric service in Gaoming People's Hospital from January to December in 2012 were surveyed by the use of Knowledge-Belief-Behavior Questionnaire developed by Capital Research Center of Pediatrics.
ResultsNinety-five of the one hundred questionnaires provided useful data for analysis. Among these parents, 63.18% understood the nature of asthma being hyperactive inflammatory disease of the airways; 78.91% believed it to be controllable by regular treatment; only 21.05% of asthma children under parental guidance received inhaled corticosteroids on a regular basis; 14.74% considered their children fit for physical exercises when stabilized; 22.10% chose inhaled β2 agonists as "relievers" during attacks; 61.05% were concerned about the side effects on growth of inhaled corticosteroids and 48.42% discontinued its use against physician's instruction; 82.11% of asthma children had not been evaluated by Asthma Control Questionnaire.
ConclusionsParents of asthma children in Gaoming District, Foshan City have weak links in the understanding of this condition. Though most believe it to be controllable under regular treatment, the overall compliance is unsatisfactory. Therefore, knowledge of asthma should be propagated at various public fronts in order to better improve the treatment compliance and consequently the disease control, of asthma children.
ObjectiveTo systematically review the relationship between maternal alcoholic consumption during pregnancy and the occurrence of childhood cancer in offspring. MethodsThe PubMed, Embase, Web of Science, Cochrane library, CNKI, WanFang Data, VIP, and CBM databases were electronically searched to obtain related case-control and cohort studies from inception to December 2024. Two reviewers independently screened articles, extracted data and assessed the risk of bias of the included articles. Meta-analysis was performed by using the RevMan 5.4 software. ResultsA total of 18 articles involving 9 childhood tumors' outcome were included. The results of meta-analysis showed that compared with women who never drink alcohol during pregnancy, alcoholic consumption during pregnancy increased the incidence risk of childhood cancer (OR=1.13, 95%CI 1.01 to 1.26, P=0.04). Subgroup analysis showed that alcoholic consumption during pregnancy significantly increased the incidence risk of acute leukemia (OR=1.17, 95%CI 1.06 to 1.30, P=0.002) and acute lymphocytic leukemia (OR=1.23, 95%CI 1.02 to 1.48, P=0.03). ConclusionThe current evidence suggests that alcoholic consumption during pregnancy significantly increases the incidence risk of childhood cancer in offspring, particularly acute leukemia and acute lymphocytic leukemia. Due to the limited quantity and quality of the included articles, more high-quality birth cohort studies are needed to verify the above conclusion.
