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Fenqi D, Yupeng L, Qiuju Z, Chao Y, Wenjie S, Tianyi X, Junnan G, Weinan X, Xiufeng J, Junge B, Chenyang J, Hua X, Yien L, Xuefeng B, Yanlong L. Early Postoperative Serum Carcinoembryonic Antigen Is a Stronger Independent Prognostic Factor for Stage II Colorectal Cancer Patients Than T4 Stage and Preoperative CEA. Front Oncol 2022; 11:758509. [PMID: 35087748 PMCID: PMC8786716 DOI: 10.3389/fonc.2021.758509] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 12/20/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Serum carcinoembryonic antigen (CEA) is an important biomarker for diagnosis, prognosis, recurrence, metastasis monitoring, and the evaluation of the effect of chemotherapy in colorectal cancer (CRC). However, few studies have focused on the role of early postoperative CEA in the prognosis of stage II CRC. METHODS Patients with stage II CRC diagnosed between January 2007 and December 2015 were included. Receiver operating characteristic (ROC) curves were used to obtain the cutoff value of early postoperative CEA, CEA ratio and CEA absolute value. The areas under curves (AUCs) were used to estimate the predictive abilities of the CEA and T stage. The stepwise regression method was used to screen the factors included in the Cox regression analysis. Before and after propensity score (PS) - adjusted Cox regression and sensitivity analysis were used to identify the relationship between early postoperative CEA and prognosis. Meta-analysis was performed to verify the results. Kaplan-Meier survival curves were used to estimate the effects of CEA on prognosis. RESULTS We included 1081 eligible patients. ROC curves suggested that the cutoff value of early postoperative CEA was 3.66 ng/ml (P <0.001) and the AUC showed early postoperative CEA was the most significant prognostic marker in stage II CRC (P = 0.0189). The Cox regression and sensitivity analysis before and after adjusting for PS both revealed elevated early postoperative CEA was the strongest independent prognostic factor of OS, DFS, and CSS (P < 0.001). Survival analysis revealed that patients with elevated early postoperative CEA had lower OS (53.62% VS 84.16%), DFS (50.03% VS 86.75%), and CSS (61.77% VS 90.30%) than patients with normal early postoperative CEA (P < 0.001). When the postoperative CEA was positive, the preoperative CEA level showed no significant effect on the patient's prognosis (all P-values were > 0.05). Patients with a CEA ratio ≤0.55 or CEA absolute value ≤-0.98 had a worse prognosis (all P-values were < 0.001). Survival analysis suggested that adjuvant chemotherapy for stage II CRC patients with elevated early postoperative CEA may improve the CSS (P = 0.040). CONCLUSIONS Early postoperative CEA was a better biomarker for prognosis of stage II CRC patients than T stage and preoperative CEA, and has the potential to become a high-risk factor to guide the prognosis and treatment of stage II CRC patients.
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Affiliation(s)
- Du Fenqi
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Liu Yupeng
- Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Zhang Qiuju
- Department of Biostatistics, Public Health School of Harbin Medical University, Harbin, China
| | - Yuan Chao
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Song Wenjie
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xia Tianyi
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Guo Junnan
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xue Weinan
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Jiang Xiufeng
- Department of Anus and Intestine Surgery, The First Hospital of Qiqihar, Qiqihar, China
| | - Bai Junge
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Jia Chenyang
- Department of Epidemiology, Public Health School of Harbin Medical University, Harbin, China
| | - Xi Hua
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Li Yien
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Bai Xuefeng
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Liu Yanlong
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, Harbin, China
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Kataoka M, Hirano Y, Ishii T, Kondo H, Asari M, Ishikawa S, Kataoka A, Fujii T, Shimamura S, Yamaguchi S. Impact of Lymphovascular Invasion in Patients With Stage II Colorectal Cancer: A Propensity Score-matched Study. In Vivo 2021; 35:525-531. [PMID: 33402505 DOI: 10.21873/invivo.12287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND/AIM Whether lymphovascular invasion (LVI) is a high-degree risk factor in stage II colorectal cancer has not been fully clarified, as different results have been reported in the literature. If LVI is a risk factor, postoperative chemotherapy may be recommended. The purpose of this study was to evaluate the impact of lymphovascular invasion on disease recurrence and patient prognosis in conjunction with stage II colorectal cancer (CRC). PATIENTS AND METHODS A total of 636 patients with stage II CRC, each undergoing radical resection between April 2007 and December 2015, were selected for the study. Subjects with or without venous or lymphatic invasion were assigned to positive and negative groups, respectively. We then compared overall survival (OS) and disease-free survival (DFS) using propensity score matching. RESULTS After matching (n=226, each group), OS and DFS were found to be significantly lower (OS: p=0.047; DFS: p=0.004) in patients positive (vs. negative) for venous invasion. However, the same was not true of lymphatic invasion. After matching, positive and negative groups (n=92, each) did not significantly differ in terms of OS (p=0.951) or DFS (p=0.258). CONCLUSION In patients with stage II CRC, venous invasion proved to be a significant high-degree risk factor that may warrant adjuvant chemotherapy.
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Affiliation(s)
- Masahiro Kataoka
- Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yasumitsu Hirano
- Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Toshimasa Ishii
- Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hiroka Kondo
- Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Masahiro Asari
- Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Shintaro Ishikawa
- Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Atsuko Kataoka
- Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Takatsugu Fujii
- Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Satoshi Shimamura
- Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Shigeki Yamaguchi
- Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, Saitama, Japan
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Jiang Y, Huang X, Zhu Y, Wang X, Wu K. [Research progress in osteonecrosis of femoral head following femoral intertrochanteric fractures in adults]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020; 34:1458-1461. [PMID: 33191706 DOI: 10.7507/1002-1892.202002111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To summarize the research progress of osteonecrosis of femoral head (ONFH) following femoral intertrochanteric fractures in adults. Methods Relevant literature at home and abroad was extensively reviewed to summarize the pathogenesis, high-risk factors, and treatment of ONFH after femoral intertrochanteric fracture in adults. Results ONFH after femoral intertrochanteric fracture mostly occurs within 2 years after operation, with a lower incidence. At present, it is believed that comminuted and large displacement fractures caused by high-energy injuries, fracture line close to the base of neck, excessive external rotation deformity, improper intramedullary nail entry points, and rough intraoperative manipulating may injury the deep branch of the medial circumflex femoral artery, causing ONFH. Hip replacement is the main treatment for necrosis, which can achieve good results. Conclusion Addressing the above risks, excessive external rotation, overstretching, and rough manipulating should be avoided. Anatomical reduction should be performed during the operation, the nail entry point should be accurate and avoid repeated drilling and thermally bone necrosis.
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Affiliation(s)
- Yu Jiang
- Department of Orthopedics, the Forth Medical Center of Chinese PLA General Hospital, Beijing, 100048, P.R.China
| | - Xin Huang
- Department of Orthopedics, the Forth Medical Center of Chinese PLA General Hospital, Beijing, 100048, P.R.China
| | - Yingbo Zhu
- Department of Orthopedics, the Forth Medical Center of Chinese PLA General Hospital, Beijing, 100048, P.R.China
| | - Xiaoning Wang
- Department of Orthopedics, the Forth Medical Center of Chinese PLA General Hospital, Beijing, 100048, P.R.China
| | - Kejian Wu
- Department of Orthopedics, the Forth Medical Center of Chinese PLA General Hospital, Beijing, 100048, P.R.China
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Huang LB, Yang TH, Yang L, Yu YY, Wang ZQ, Wang C, Zhou ZG. Clinical efficacy of adjuvant chemotherapy in the treatment of pT4 stage II colorectal cancer with defective mismatch repair status: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e20693. [PMID: 32590743 PMCID: PMC7328979 DOI: 10.1097/md.0000000000020693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The aim of this systematic review and meta-analysis is to assess the efficacy of adjuvant chemotherapy in patients with stage IIB/C CRC and defective mismatch repair (dMMr) status, and to evaluate what is the determinant risk factor for adjuvant chemotherapy in those patients. METHOD A systematic search of PubMed, EMBASE, Web of science, Cochrane Library databases will be performed. All RCTs published in electronic databases from inception to March 19, 2020, with language restricted in English will be included in this review study. Two reviewers will independently perform the Study selection, data extraction, quality assessment, and assessment of risk bias and will be supervised by third party. Outcomes consisted of overall survival, progression-free survival and sufficient information to extract hazard ratios and their 95% confidence intervals and it will be calculated to present the prognostic role of adjuvant chemotherapy in patients with stage IIB/C CRC and dMMR status using Review Manager version 5.3 when there is sufficient available data. RESULTS The results of this systematic review and meta-analysis will be submitted to a peer-reviewed journal for publication. CONCLUSION This study will summarize up-to-date evidence to assess the efficacy of adjuvant chemotherapy in patients with stage IIB/C CRC and dMMR status and provide a scientific and practical suggestions for treatment decision-making. REGISTRATION This protocol has been registered on the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY) with a registration number of INPLASY202050019.
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Wang L, Hirano Y, Heng G, Ishii T, Kondo H, Hara K, Obara N, Asari M, Kato T, Yamaguchi S. Mucinous Adenocarcinoma as a High-risk Factor in Stage II Colorectal Cancer: A Propensity Score-matched Study from Japan. Anticancer Res 2020; 40:1651-1659. [PMID: 32132070 DOI: 10.21873/anticanres.14115] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/01/2020] [Accepted: 02/03/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND/AIM The purpose of this study was to investigate the clinical, pathological, and prognostic differences between adenocarcinoma (ADC) and mucinous adenocarcinoma (MUC) in colorectal cancer (CRC). PATIENTS AND METHODS This was a retrospective study of a Japanese high-volume cancer Center over a 10-year period. From April 2007 to December 2016, a total of 3,296 patients with primary CRC were included in the study. The clinical characteristics of MUC and ADC were compared. Then, propensity score matching was performed according to a 1:2 ratio. Multivariate analysis was used for independent risk factors related to prognosis. The overall survival (OS) and disease-free survival (DFS) of 126 cases of MUC and 256 cases of ADC were studied, as well as the survival rate of each stage. RESULTS MUC accounts for 3.82% of the total CRC. Compared to ADC, MUC is more common in female patients (47.62% vs. 38.77%; p=0.045), with higher carcinoembryonic antigen levels (56.35% vs. 34.95%; p<0.001), more ulcerative and infiltrative types (82.54% vs. 72.93%; p=0.016), higher incidence of perineural infiltration (51.59% vs. 41.04%; p=0.018), deeper infiltration (T3-T4: 90.48% vs. 65.84%; p<0.001), and more advanced cancer (stage III-IV: 59.52% vs. 44.79%; p=0.001). MUC is also more likely to recur (24.6% vs. 14.32%; p=0.001). Regarding the long-term survival rate, the OS (p<0.001) and DFS (p=0.05) is consequently worse. After propensity score matching, multivariate analysis showed that MUC was a common independent risk factor for DFS [odds ratio (OR)=4.277; 95% confidence interval (CI), 0.327-0.97; p=0.039], and also for OS (OR= 6.836; 95% CI, 0.274-0.831; p=0.009). In MUC, OS and DFS were still relatively worse (OS: p=0.017; DFS: p=0.038). However, only significant statistical differences were shown in stage II (OS: p=0.003; DFS: p=0.007). No significant differences were noted in the stages I, III, or IV. CONCLUSION MUC is a high-risk factor for stage II CRC. Adjuvant chemotherapy should be routinely recommended for patients with MUC stage II, and special attention should be paid during their follow-up.
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Affiliation(s)
- Liming Wang
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Yasumitsu Hirano
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Gregory Heng
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Toshimasa Ishii
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Hiroka Kondo
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Kiyoka Hara
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Nao Obara
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Masahiro Asari
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Takuya Kato
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Shigeki Yamaguchi
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
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He XG, Xu FD, Li JF, Wu WS, Liu SJ. [Effect of different antibiotic use strategies on infection in neonates with premature rupture of membranes and high-risk factors for neonatal infection]. Zhongguo Dang Dai Er Ke Za Zhi 2020; 22:310-315. [PMID: 32312367 PMCID: PMC7389693 DOI: 10.7499/j.issn.1008-8830.1910170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 03/16/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To study the effect of different antibiotic use strategies on infection in neonates with premature rupture of membranes and the high-risk factors for neonatal infection. METHODS A retrospective analysis was performed for the clinical data of 223 neonates with premature rupture of membranes. According to the antibiotic use strategies, they were classified into two groups: study group (n=95) and control group (n=128). The neonates in the study group were given antibiotics based on risk assessment and infection screening, and those in the control group were given antibiotics based on risk assessment alone after admission. General status and prognosis were compared between the two groups. According to the presence or absence of infection, the neonates were classified into two groups: infection group (n=32) and non-infection group (n=191). The clinical data were compared between the two groups. A logistic regression model was used to investigate the high-risk factors for infection in neonates with premature rupture of membranes. RESULTS Compared with the control group, the study group had a significantly longer time of premature rupture of membranes, a significantly higher rate of cesarean section, and a significantly lower antibiotic use rate at admission and a significantly lower total antibiotic use rate (P<0.05). The study group also had a significantly higher incidence rate of infection and a significantly lower incidence rate of sepsis (P<0.05). There were no significant differences in the incidence rates of other complications between the two groups (P>0.05). Compared with the non-infection group, the infection group had a significantly lower gestational age, a significantly longer time of premature rupture of membranes, a significantly higher rate of cesarean section, and significantly higher levels of C-reactive protein (CRP) and procalcitonin on admission and during reexamination (P<0.05), with fever as the most common symptom. The logistic regression analysis showed that preterm birth and cesarean section were high-risk factors for infection in neonates with premature rupture of membranes (P<0.05). CONCLUSIONS Strict adherence to the indications for antibiotic use in neonates with premature rupture of membranes does not increase the incidence rate of complications. Neonates with premature rupture of membranes, especially preterm infants and infants delivered by cesarean section, should be closely observed for the change in disease conditions, and infection indices including CRP should be reexamined in case of fever and antibiotics should be used to prevent serious infection.
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Affiliation(s)
- Xiao-Guang He
- Department of Neonatology, Dongguan Children's Hospital, Guangdong Medical University, Dongguan, Guangdong 523325, China.
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He XG, Xu FD, Li JF, Wu WS, Liu SJ. [Effect of different antibiotic use strategies on infection in neonates with premature rupture of membranes and high-risk factors for neonatal infection]. Zhongguo Dang Dai Er Ke Za Zhi 2020; 22:310-315. [PMID: 32312367 PMCID: PMC7389693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 03/16/2020] [Indexed: 11/04/2023]
Abstract
OBJECTIVE To study the effect of different antibiotic use strategies on infection in neonates with premature rupture of membranes and the high-risk factors for neonatal infection. METHODS A retrospective analysis was performed for the clinical data of 223 neonates with premature rupture of membranes. According to the antibiotic use strategies, they were classified into two groups: study group (n=95) and control group (n=128). The neonates in the study group were given antibiotics based on risk assessment and infection screening, and those in the control group were given antibiotics based on risk assessment alone after admission. General status and prognosis were compared between the two groups. According to the presence or absence of infection, the neonates were classified into two groups: infection group (n=32) and non-infection group (n=191). The clinical data were compared between the two groups. A logistic regression model was used to investigate the high-risk factors for infection in neonates with premature rupture of membranes. RESULTS Compared with the control group, the study group had a significantly longer time of premature rupture of membranes, a significantly higher rate of cesarean section, and a significantly lower antibiotic use rate at admission and a significantly lower total antibiotic use rate (P<0.05). The study group also had a significantly higher incidence rate of infection and a significantly lower incidence rate of sepsis (P<0.05). There were no significant differences in the incidence rates of other complications between the two groups (P>0.05). Compared with the non-infection group, the infection group had a significantly lower gestational age, a significantly longer time of premature rupture of membranes, a significantly higher rate of cesarean section, and significantly higher levels of C-reactive protein (CRP) and procalcitonin on admission and during reexamination (P<0.05), with fever as the most common symptom. The logistic regression analysis showed that preterm birth and cesarean section were high-risk factors for infection in neonates with premature rupture of membranes (P<0.05). CONCLUSIONS Strict adherence to the indications for antibiotic use in neonates with premature rupture of membranes does not increase the incidence rate of complications. Neonates with premature rupture of membranes, especially preterm infants and infants delivered by cesarean section, should be closely observed for the change in disease conditions, and infection indices including CRP should be reexamined in case of fever and antibiotics should be used to prevent serious infection.
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Affiliation(s)
- Xiao-Guang He
- Department of Neonatology, Dongguan Children's Hospital, Guangdong Medical University, Dongguan, Guangdong 523325, China.
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Abstract
OBJECTIVE To investigate the prevalence of simple obesity and its risk factors in preschool children in Fuzhou, China. METHODS The physical examination data of 14 kindergartens in Fuzhou, China were collected by stratified cluster random sampling. The detection rate of simple obesity was calculated. The children with normal body weight were selected as the control group by 1:1 case-control method. The risk factors for childhood simple obesity were investigated by self-made questionnaire and multivariate logistic regression analysis. RESULTS A total of 5 767 children aged 3-6 years were enrolled in this study. A total of 289 (5.01%) children with simple obesity were screened out, including 153 with mild obesity and 136 with moderate to severe obesity. The prevalence rate of simple obesity gradually increased with the age of children. The multivariate logistic regression analysis showed that the following factors were independent risk factors for simple obesity: preference for fried food (OR=4.789, P<0.05), caregivers' over-concern about diet (OR=4.620, P<0.05), eating before sleep (OR=4.006, P<0.05), eating fast (OR=3.221, P<0.05), preference for sweets (OR=2.282, P<0.05), high birth weight (OR=2.202, P<0.05), overweight or obesity in father (OR=2.074, P<0.05), overweight or obesity in mother (OR=2.047, P<0.05), more than 1.2 times the food intake at the same age (OR=2.013, P<0.05), watching TV (OR=1.665, P<0.05), and lack of exercise (OR=1.463, P<0.05). CONCLUSIONS The prevalence rate of simple obesity is 5.01% in preschool children in Fuzhou, China. The development of simple obesity is multifactorial. It is suggested that doctors, parents, and teachers should strengthen health education for preschool children, help them develop good living and eating habits, and encourage them to take more exercise, in order to reduce the development of simple obesity.
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Affiliation(s)
- Jing-Min Guo
- Department of Child Health Care, Fujian Provincial Maternity and Children's Hospital/Affiliated Hospital of Fujian Medical University, Fuzhou 350001, China.
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Guo JM, Lin HC, Ou P. [Prevalence of simple obesity and its high-risk factors in preschool children in Fuzhou, China]. Zhongguo Dang Dai Er Ke Za Zhi 2018; 20:943-938. [PMID: 30477626 PMCID: PMC7389030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 09/10/2018] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To investigate the prevalence of simple obesity and its risk factors in preschool children in Fuzhou, China. METHODS The physical examination data of 14 kindergartens in Fuzhou, China were collected by stratified cluster random sampling. The detection rate of simple obesity was calculated. The children with normal body weight were selected as the control group by 1:1 case-control method. The risk factors for childhood simple obesity were investigated by self-made questionnaire and multivariate logistic regression analysis. RESULTS A total of 5 767 children aged 3-6 years were enrolled in this study. A total of 289 (5.01%) children with simple obesity were screened out, including 153 with mild obesity and 136 with moderate to severe obesity. The prevalence rate of simple obesity gradually increased with the age of children. The multivariate logistic regression analysis showed that the following factors were independent risk factors for simple obesity: preference for fried food (OR=4.789, P<0.05), caregivers' over-concern about diet (OR=4.620, P<0.05), eating before sleep (OR=4.006, P<0.05), eating fast (OR=3.221, P<0.05), preference for sweets (OR=2.282, P<0.05), high birth weight (OR=2.202, P<0.05), overweight or obesity in father (OR=2.074, P<0.05), overweight or obesity in mother (OR=2.047, P<0.05), more than 1.2 times the food intake at the same age (OR=2.013, P<0.05), watching TV (OR=1.665, P<0.05), and lack of exercise (OR=1.463, P<0.05). CONCLUSIONS The prevalence rate of simple obesity is 5.01% in preschool children in Fuzhou, China. The development of simple obesity is multifactorial. It is suggested that doctors, parents, and teachers should strengthen health education for preschool children, help them develop good living and eating habits, and encourage them to take more exercise, in order to reduce the development of simple obesity.
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Affiliation(s)
- Jing-Min Guo
- Department of Child Health Care, Fujian Provincial Maternity and Children's Hospital/Affiliated Hospital of Fujian Medical University, Fuzhou 350001, China.
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Chen D, Wang M, Wang X, Ding XW, Ba RH, Mao J. [ High-risk factors and clinical characteristics of massive pulmonary hemorrhage in infants with extremely low birth weight]. Zhongguo Dang Dai Er Ke Za Zhi 2017; 19:54-58. [PMID: 28100323 PMCID: PMC7390125 DOI: 10.7499/j.issn.1008-8830.2017.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 10/14/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To explore the high-risk factors and analyze the clinical characteristics of massive pulmonary hemorrhage (MPH) in infants with extremely low birth weight (ELBW). METHODS Two hundred and eleven ELBW infants were included in this study. Thirty-five ELBW infants who were diagnosed with MPH were labelled as the MPH group, and 176 ELBW infants without pulmonary hemorrhage were labelled as the control group. The differences in clinical characteristics, mortality rate, and incidence of complications between the two groups were analysed. The high-risk factors for MPH were identified by multiple logistic regression analysis. RESULTS The MPH group had significantly lower gestational age, birth weight, and 5-minute Apgar score than the control group (P<0.05). The MPH group had significantly higher rates of neonatal respiratory distress syndrome, patent ductus arteriosus (PDA), early-onset sepsis (EOS), intracranial hemorrhage, pulmonary surfactant utilization, and death compared with the control group (P<0.01). The multiple logistic regression analysis showed that 5-minute Apgar score was a protective factor for MPH (OR=0.666, P<0.05), and that PDA and EOS were risk factors for MPH (OR=3.717, 3.276 respectively; P<0.01). In the infants who were discharged normally, the MPH group had a longer duration of auxiliary ventilation and a higher incidence rate of ventilator-associated pneumonia (VAP) compared with the control group (P<0.05). CONCLUSIONS A higher 5-minute Apgar score is associated a decreased risk for MPH, and the prensence of PDA or EOS is associated an increased risk for MPH in ELBW infants. ELBW infants with MPH have a prolonged mechanical ventilation, a higher mortality, and higher incidence rates of VAP and intracranial hemorrhage compared with those without pulmonary hemorrhage.
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Affiliation(s)
- Dan Chen
- Department of Neonatology, Shengjing Hospital, China Medical University, Shenyang 110004, China.
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