[Influence of disposable diaper dependence on emotional behavior and related factors of preschool-aged children]

Objective: To investigate the influence of disposable diaper dependence (DDD) on emotional behavior and related factors of preschool-aged children. Methods: A total of 3 000 preschool-aged children from 16 kindergartens in Zhengzhou of Henan Province from October 2019 to March 2020 were selected and their parents were investigated by using a basic information questionnaire (including usage of disposable diapers), Strengths and Difficulties Questionnaire (SDQ) and Children's Sleep Questionnaire (PSQ). The differences in baseline and clinical data were compared between the DDD children and normal children, and multiple linear regression models were used to analyze the factors associated with emotional behavior in DDD children. Results: A total of 3 000 questionnaires were distributed and 2 775 (92.50%) were valid. The children ranged in age from 3 to 5 years, including 1 438 boys (51.82%) and 1 337 girls (48.18%). There were 98 (3.53%) children in DDD group and 2 677 (96.47%) children in normal group. The proportion of children living in cities in the DDD group was 58.16%, significantly higher than that of 41.84% in the normal children group (P<0.001). The abnormal detection rate of various factors in SDQ in DDD children, from high to low, were hyperactivity (n=14, 14.29%), peer communication problems (n=12, 12.24%), prosocial behavior (n=11, 11.22%), emotional symptoms (n=10, 10.20%) and conduct problems (n=7, 7.14%). The detection rates of abnormal total difficulty scores in DDD group and normal children were 7.14% (7 cases) and 0.78% (21 cases), respectively, with statistically significant differences (P<0.001). The proportions of emotional symptoms and hyperactivity disorder in DDD group were higher than those in normal group, and the differences were statistically significant (P<0.05). The PSQ score of children in DDD group was 3.01±2.02 which was not significantly different from the PSQ score of the normal group (2.71±2.10, P=0.157). The multi-factor analysis showed that caregiver's education level (β=-1.135,95%CI:-1.910 to -0.359), urinary incontinence (β=2.222, 95%CI: 1.105-3.339), fecal incontinence (β=3.833, 95%CI: 2.691-4.975), urinary and fecal incontinence (β=5.522, 95%CI: 4.145-6.899), and recurrent urinary tract infections(β=3.523,95%CI: 1.798-5.248)were the independent influencing factors of emotional behavioral problems in DDD children (P<0.05). Conclusions: Children with DDD are more likely to have emotional behavioral problems than normal children. Caregiver's education level, urinary incontinence and recurrent urinary tract infections were influencing factors of emotional behavioral problems in DDD children.

The Immunologic Profiles of Kawasaki Disease Triggered by Mycoplasma pneumoniae Infection

OBJECTIVE

We compared the immunologic characteristics of mycoplasma pneumoniae-triggered Kawasaki disease (MP-KD) with Kawasaki disease (KD) not associated with mycoplasma pneumoniae (MP), with mycoplasma pneumoniae-triggered Henoch-Schönlein purpura (MP-HSP), and with healthy controls.

METHODS

Complement levels, cellular and humoral immunity were assessed in KD, in MP-KD, in MP-HSP, and in healthy children.

RESULTS

Of 622 children with KD, 74 had MP-KD. Complement C3 and CD4/CD8 ratio were significantly increased in MP-KD compared to KD. C3, C4, and the ratio of CD4/CD8 in the MP-KD group were higher than those in the MP-HSP group. IgA and CD56 were lower in the MP-KD group than the MP-HSP group.

CONCLUSIONS

Both C3 and polyclonal CD4+ T lymphocytes may be activated in the patients with MP-KD.

[Epidemiological investigation and analysis of the effect of using diapers on daytime urinary incontinence on children]

Objective: To investigate the relationship between the incidence of daytime urinary incontinence(DUI)and the usage of diapers. Methods: The stratified sampling method was used to investigate the relationship between the incidence of DUI and the usage of diapers on children from 3 to 10 years old from 30 kindergarten and primary schools in Henan Province, China. The survey was carried out in the way of anonymous questionnaire. Results: A total of 8 560 qualified questionnaires(96.2%) were collected and used for statistical analysis. The overall incidence of DUI was 3.52%. With the age increasing, the incidence of DUI was decreased(χ(2)(trend)=75.690, P<0.001) from 6.06% for 3 years old children to 1.82% for 10 years old children. With the time of usage diapers increased, the rate of urination training was significantly reduced(χ(2)(trend)=84.260, P<0.001), and the incidence of DUI was significantly increased(χ(2)(trend)=18.824, P<0.001). With the increase of using diapers, the incidence of DUI increased (χ(2)(trend)=9.234, P<0.01). With the delay of the starting time of urination training, the incidence of DUI was increasing( χ(2)(trend)=9.775, P<0.01). Logistic regression analysis showed that the increase of time of using diapers(OR=1.017, 95% CI: 1.006-1.027, P<0.01)and the increase of frequency of using diapers(OR=1.290, 95% CI: 1.002-1.025, P<0.05)contribute to DUI significantly. Urination training starts from 0 to 6 months was a protective factor against DUI(OR=0.529, 95% CI: 0.345-0.811, P<0.01). Conclusions: The usage of diapers is the risk factor of DUI. It's better to start urination training earlier to help reduce the incidence of DUI in children.

Treatment for Thoracic Ossification of Posterior Longitudinal Ligament with Posterior Circumferential Decompression

OBJECTIVE

To report the results of the posterior approach for thoracic ossification of posterior longitudinal ligament (TOPLL) by using a special "L" osteotome.

METHODS

The present study enrolled 16 consecutive patients (9 men and 7 women) between May 2009 and September 2013. All patients underwent a posterior circumferential decompression osteotomy and segmental instrumentation with interbody fusion. The mean age at surgery was 57.3 years (range, 37-68 years). Patients' data, clinical manifestation, blood loss, length of surgery, complications, visual analog scale (VAS), Japanese Orthopedic Association (JOA), and Frankel grading system before and after surgery were collected and evaluated, retrospectively.

RESULTS

The average follow-up period was 30 ± 19 months (range, 12-50 months). All patients were successfully treated with posterior compression and segmental instrumentation with interbody fusion. The average operation time was 261.6 ± 51.3 min (range, 190-310 min). The mean blood loss was 980.3 ± 370.5 mL (range, 600-2100 mL). All patients had subjective improvement of motor power and gait. Average preoperative and postoperative JOA scores were 4.2 ± 1.7 and 7.8 ± 2.5 points, respectively. Differences in the overall JOA scores showed significant postoperative improvement. At the last follow-up, all patients improved either by one or two Frankel grades. There was a significant difference between preoperative VAS scores and those 3 months after surgery (P < 0.05). No significant difference was observed between the 3-month and 12-month results (P > 0.05). Cerebrospinal fluid (CSF) leakage occurred in 3 patients. Acute neurological deterioration was encountered postoperatively in 1 patient.

CONCLUSION

Treatment with posterior transpedicular osteotomy and circumferential decompression was found to be safe, effective, reliable, and technically feasible, and keeping the thoracic cavity intact avoids many shortcomings of anterior surgery and results in a satisfactory spinal decompression.

Association of BCL-2 polymorphism with the presence and severity of lumbar disc degeneration in the Chinese Han population

BACKGROUND

Apoptosis is involved in the mechanism of lumbar disc disease (LDD). BCL-2 has been shown to play an anti-apoptosis role. The present study aims to examine the association of -938C > A polymorphism of the BCL-2 gene with the presence and severity of LDD in the Chinese Han population.

METHODS

This study consisted of 325 patients with LDD and 236 normal controls. The grade of disc degeneration was determined according to Schneiderman's classification for MRI. -938C > A polymorphism was determined by "slow-down" polymerase chain reaction (PCR) method.

RESULTS

The genotype frequency of -938C > A polymorphism was consistent with Hardy-Weinberg equilibrium (p = 0.136). Higher frequencies of -938CA and AA genotypes were found in patients with LDD compared with normal controls (p = 0.019). Furthermore, there were higher frequencies of the A allele in LDD patients than in normal controls (p = 0.005). Unconditional logistic regression analysis revealed that -938CA and AA genotypes were significantly associated with the presence of LDD compared with CC genotype (p = 0.041; OR 1.449; 95% CI 1.015 - 2.067 and p = 0.015; OR 2.102; 95% CI 1.158 - 3.813, respectively). The A allele was significantly associated with the susceptibility to LDD compared with the C allele (p = 0.005; OR 1.436; 95% CI 1.113 - 1.851). In addition, -938CA and AA genotypes, as well as the A allele were found to be associated with the risk for higher degenerative grades of LDD compared with the CC genotype and C allele, respectively (p = 0.017 and p = 0.003, respectively).

CONCLUSIONS

The -938C > A polymorphism of BCL-2 may be associated with the presence and severity of LDD in the Chinese Han population.