The Relationship between Fat Mass Percentage and Glucose Metabolism in Children and Adolescents: A Systematic Review and Meta-Analysis

To assess the relationship between fat mass percentage (FMP) and glucose metabolism in children aged 0–18 years we performed a systematic review of the literature on Medline/PubMed, SinoMed, Embase and Cochrane Library using the PRISMA 2020 guidelines up to 12 October 2021 for observational studies that assessed the relationship of FMP and glucose metabolism. Twenty studies with 18,576 individuals were included in the meta-analysis. The results showed that FMP was significantly associated with fasting plasma glucose (FPG) (r = 0.08, 95% confidence interval (CI): 0.04–0.13, p < 0.001), fasting plasma insulin (INS) (r = 0.48, 95% CI: 0.37–0.57, p < 0.001), and homeostasis model assessment (HOMA)- insulin resistance (IR) (r = 0.44, 95% CI: 0.33–0.53, p < 0.001). The subgroup analysis according to country or overweight and obesity indicated that these associations remained significant between FMP and INS or HOMA-IR. Our results demonstrated that there is a positive relationship between FMP and FPG. Moreover, subgroup analysis according to country or overweight and obesity indicated that FMP is significantly associated with INS and HOMA-IR. This is the first known systematic review and meta-analysis to determine the associations of FMP with glucose metabolism in children and adolescents.     

孕妇新型冠状病毒肺炎及疫苗的流行病学研究进展

新型冠状病毒肺炎（COVID-19）是一种由新型冠状病毒（新冠病毒）引起的急性呼吸道传染性疾病。由于妊娠期间的生理变化,孕妇易感COVID-19,尤其是新冠病毒变异株流行期间,孕妇不良妊娠结局的发生风险可能更高。目前尚缺乏孕妇接种新冠病毒疫苗（新冠疫苗）的随机临床试验证据,各国关于孕妇接种新冠疫苗的推荐存在差异,这给孕妇COVID-19的防控带来了一定挑战。本文回顾了国内外妊娠期感染新冠病毒的重要研究进展,论述了妊娠期患COVID-19对孕妇、胎儿及婴儿的危害,以及真实世界研究中妊娠期接种新冠疫苗的有效性和安全性等,以期为今后开展孕妇相关研究,制定防控措施提供参考。     

可乐定对原代培养大鼠皮质神经元氧糖剥夺损伤的保护作用

目的：研究可乐定对原代培养大鼠皮质神经元氧糖剥夺( OGD)损伤的保护作用。方法取培养8 d的皮质神经元,分为正常对照组、模型对照组、可乐定(1.0,3.0,10.0μmol·L-1)预处理组。神经元氧糖剥脱损伤模型通过化学性缺氧、孵育液缺糖的方法建立。神经元损伤程度采用噻唑蓝( MTT)染色法和检测乳酸脱氢酶( LDH)的释放量来进行评价,观察预给予可乐定(1.0,3.0,10.0μmol·L-1)对神经元损伤的保护作用。结果显微镜下,正常对照组细胞密集,胞体饱满,边缘光滑,有较强折光性;神经元存活率(100.00±32.12)％,LDH释放比率(100.00±37.51)％。模型对照组细胞核固缩,细胞膜不完整,折光性差,MTT染色吸光度值明显降低,神经元存活率(53.61±7.62)％,LDH释放量显著增加,释放率为(166.07±9.65)％。可乐定(1.0,3.0,10μmol·L-1)预处理可明显逆转ODG损伤所致细胞形态的改变,剂量依耐性升高MTT染色吸光度值,神经元存活率分别为(67.53±10.54)％,(71.50±9.79)％和(87.48±5.29)％,同时可明显降低LDH的释放量,释放率分别为(136.45±25.72)％,(130.92±24.94)％和(121.63±32.68)％。结论可乐定对原代培养大鼠皮质神经元ODG损伤具有良好的保护作用。     

前部缺血性视神经病变诊断要点探讨

目的：报告19例22眼前部缺血性视神经病变的多种临床表现，探讨本病诊断要点。方法：应用眼底血管荧光造影和静态定量视野检查的方法，探讨多种改变形式。结果：视盘荧光充盈延缓和视盘荧光充盈缺损为造影主要表现；半盲，象限盲或扇形视野缺损为视野主要改变。结论：本病我发于50岁以上老年患者，其诊断主要依据较有特点的发病史，眼底血管荧光造影和视野改变特点来判断。及时诊断与治疗有利于本病的恢复。     

1072例Ⅱ型糖尿病治疗方式的分析

统计分析１０７２例住院Ⅱ型糖尿病患者的治疗方式。结果显示，病程５年以内者单纯饮食治疗占２６．９８％，口服降糖药治疗占６２．７０％，胰岛素治疗占１０．３２％。病程长于１４年者，单纯饮食治疗占９．２４％，口服降糖药治疗占５５．９８％，胰岛素治疗占３４．７８％。病程５年以内的治疗方式与国外有关资料基本相似，病程长于１４年者胰岛素治疗的比例明显低于国外。     

生物电阻抗法和双能X线吸收法测量7~ 17岁儿童青少年体成分的一致性评价

目的评价生物电阻抗法(BIA)与双能X线吸收法(DXA)测量7~17岁儿童青少年体成分的一致性。方法对1431名儿童进行BIA和DXA检测。采用组内相关系数(ICC)和Bland-Altman分析评价方法间所测去脂体重和脂肪量的一致性。Bland-Altman分析在对数变换的数据中进行。结果男、女生中BIA与DXA所测去脂体重的ICC分别为0.986和0.974,脂肪量的ICC则分别为0.854和0.926。男生中BIA与DXA的去脂体重比值均值及一致性界限(LoA)分别为1.04和0.95~1.14,女生中则为1.02和0.90~1.15。男、女生中去脂体重的LoA范围均随年龄增长而变窄。男、女生中两种方法的脂肪量比值LoA范围均较宽,分别为0.40~1.27和0.48~1.48。此外,男、女生中均可看到各成分的比值LoA范围随BMI等级增高而变窄。结论BIA所测去脂体重与DXA的一致性良好,但BIA测量脂肪量的误差较大。肥胖儿童的BIA与DXA一致性优于消瘦和正常体重儿童。     

儿童与成人脑干星形细胞瘤临床特点及手术疗效比较

目的比较病理级别相同的儿童和成人脑干星形细胞瘤病人的临床特点和手术疗效的差异。方法回顾性分析40例病理级别相同(WHO分级Ⅱ级)的脑干星形细胞瘤病人的临床资料,包括儿童组10例,成人组30例。比较两组的一般资料和手术疗效差异,并采用Kaplan-Meier法分析两组术后1年生存率。结果肿瘤侵犯脑神经数目,在儿童组和成人组组间的差异具有统计学意义(P=0.017);病人性别、MRI显示肿瘤有无强化、肿瘤部位、大小、切除程度,入院时的日常生活质量评分(KPS)及出现症状至手术时间等方面,两组间差异均无统计学意义。生存分析显示:儿童组平均生存16.5个月,术后1年生存率为55.6%,成人组平均生存35.2个月,术后1年生存率为83.3%;成人组脑干星形细胞瘤预后优于儿童组(P=0.005)。结论病理级别相同的成人和儿童脑干星形细胞瘤,成人预后好于儿童;与成人比较,儿童脑干星形细胞瘤浸润生长明显。     

The germinomas arising from the basal ganglia and thalamus

Objective To introduce the features of germinomas arising from the basal ganglia (BG) and thalamus. Method Retrospective analysis was done with the clinical cases of germinomas in BG and thalamus from 1996 to 2000. The data included the symptoms, signs, neuroimaging findings, treatment, and outcomes. Result Fourteen cases were included, only one female was included. The main symptoms are disorder of numbness and weakness in limbs. Neuroimaging showed no or mild peritumor high signal in T2 weighted imaging of magnetic resonance, accompanied with cyst, calcification or bleeding. Total gross resection was obtained in nine cases, subtotal resection in four. Follow-up data were available in 11 cases with average of 56 months. Eight cases underwent only postoperative radiotherapy, one underwent only chemotherapy, and two underwent both. One case died of complication 6 months after chemotherapy, the rest lived good life. Conclusion Germinoma in BG and thalamus predominate in a boy. The neuroimaging features are very informative for diagnosis. Surgical resection should not be the first choice although it is has lesser complications. The long-term outcome is favorable.