ObjectiveTo systematically review the association between chronotype and quality of life in adolescents. MethodsPubMed, EMbase, Cochrane Library, Web of Science, CBM, WBM, VIP, WanFang Data and CNKI databases were electronically searched to collect studies on the association between chronotype and quality of life in adolescents from inception to April 21, 2022. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. A qualitative systematic review was then performed. ResultsA total of 7 studies were included. The results of systematic review suggested that the association between chronotype and quality of life in adolescents was statistically significant. Moreover, chronotype completely affected quality of life via insomnia symptoms, sleep related irrational cognition and general self-efficacy. ConclusionCurrent evidence shows that chronotype is associated with quality of life in adolescents. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To explore the association between behavioral, emotional problems and life events among adolescents, and to determine which factors of life events correlate most highly with the behavioral, emotional problems. Method A total of 1 325 adolescents were investigated with Youth Self-Report (YSR) of Achenbach’s behavior checklist and Adolescent Self-Rating Life Events Checklist (ASLEC), and the data were analyzed with canonical correlation analysis. Results Canonical correlation was statistically significant. The correlation coefficients of the first pair of canonical variables in the male and female group were 0.631 3 and 0.621 1, respectively, and the cumulative proportion of the first two pairs of canonical variables was above 0.95. In the first pair of canonical variables, the loadings of anxious/depressed, interpersonal sensitivity and study pressure were higher, while in the second pair, withdrawal and punishment were the most important factors. Conclusions The effects of life events on emotional problems mainly contributed to interpersonal sensitivity and study pressure.
The incidence of obesity and type 2 diabetes mellitus (T2DM) in adolescents has been rapidly increasing over the past two decades due to dramatic changes in dietary structure and physical activity. The incidence of diabetic retinopathy (DR), a serious vision-threatening complication of diabetes, is also increasing yearly in the adolescent population with T2DM. Due to the insidious onset of retinal diseases in the early stages, regular screening is important for the timely diagnosis of DR. However, there are still problems such as low attention of the population and insufficient screening rate. In the future, we should strengthen the health education of the adolescent population and optimize the control of risk factors such as blood glucose and blood pressure. At the same time, appropriate screening strategies should be actively developed, and the use of telemedicine and emerging technologies should be promoted for early detection of treatable lesions to improve patient prognosis.
ObjectiveTo identify the prevalence of distal adding-on phenomenon after posterior selective fusion in type Lenke 1A idiopathic scoliosis, to analyze its risk factors so as to find the reasonable choice for lowest instrumented vertebra (LIV). MethodsA retrospective study was made on the clinical data of 43 patients with type Lenke 1A idiopathic scoliosis undergoing posterior selection fusion with pedicle screw instrumentation between July 2011 and December 2015. There were 15 males and 28 females, aged 12-18 years (mean, 16 years). The preoperative Cobb angle was (50.1±11.3)°. The anteroposterior and lateral radiographs were taken at preoperation, immediate after operation, and last follow-up to measure the radiographic parameters. Forty-three patients were divided into adding-on group and control group according to whether or not the occurrence of distal adding-on phenomenon on anteroposterior radiographs of the spine at last follow-up. All the factors that maybe cause distsal adding-on were evaluated by statistical analysis. ResultsThe patients were followed up 12-50 months (mean, 26.5 months). At last follow-up, distal adding-on was observed in 10 of 43 patients (23.3%), including 2 males (13.3%) and 8 females (28.6%). Univariate analyses showed following several factors associated with adding-on:preoperative lumbar flexibility, preoperative pelvic tilt in coronal plane, preoperative LIV+1 deviation from center sacral vertical line, L4 subtype, the difference between LIV and last touching vertebra (LTV) (LIV-LTV), the difference between LIV and lower end vertebra (LEV) (LIV-LEV), and the difference between LIV and stable vertebra (SV) (LIV-SV). The risk factors above were brought into Logistic regression model, the results showed that preoperative LIV+1 deviation (deviation>10 mm, odds ratio=10.812, P=0.026), LIV-LTV (LIV-LTV<1, odds ratio=9.017, P=0.04), and L4 subtype (1A-R, odds ratio=9.744, P=0.047) were significantly associated with adding-on. ConclusionPreoperative LIV+1 deviation of >10 mm, L4 subtype (1A-R) and LIV-LTV of <1 are independent predictive factors of adding-on after surgery. As high risk of adding-on was closely related with the incorrect fusion level, it plays an important role for surgeons to decide the level of the fusion before surgery thoroughly. The LIV should be extended at least to LTV+1 to avoid adding-on phenomenon.
ObjectiveTo explore the effect of a new rehabilitation intervention model based on International Classification of Functioning, Disability and Healthy (ICF) concept in perioperative treatment on patients with adolescent idiopathic scoliosis (AIS).MethodsFrom June 2017 to January 2019, AIS patients with Cobb angle below 80° were randomly divided into experimental group and control group by the method of randomized block design. The patients in the control group received routine perioperative rehabilitation intervention, while the patients in the experimental group received rehabilitation mode intervention based on ICF concept. The therapeutic effect of the two groups including functional and activity dimensions was observed.ResultsA total of 40 patients were included, with 20 in each group. Two patients withdrew the control group. On the fourth day after surgery, the total score of Modified Barthel Index (50.55±8.87 vs. 18.99±5.63; t=13.264, P<0.001) and Scoliosis Research Society-22 (SRS-22) (3.68±0.13 vs. 3.27±0.11; t=10.355, P<0.001) in the experimental group were all better than those in the control group. In the SRS-22 scores, statistically significant differences in comparison of function (2.79±0.29 vs. 1.90±0.48; t=6.884, P<0.001), and self image (3.91±0.27 vs. 3.38±0.32; t=5.539, P<0.001) between the two groups were found. There was no statistically significant difference in pain indicators and muscle strength between the two groups in the two postoperative evaluations (P>0.05). ConclusionsThe treatment based on the concept of ICF can improve the daily living ability in the short term with the safe and acceptable premise. The concept of stimulating patient autonomy, improving patient independence, and promoting social treatment, may improve the overall state of the patients.
Objective To explore the effect of arthroscopy in diagnosis and treatment of osteochondritis dissecans of elbow joint in adolescent. Methods From May 2003 to February 2006, 11 patients with osteochondritis dissecans of elbowjoint were diagnosed and treated with arthroscopy. There were 6 males and 5 females, aging from 13 to 19 years. The left joints were involved in 4 cases and right joints in 7 cases. Seven patients had obvious history of injury. The interval of injury and operation was from 7 months to 12 years. The score of VAS was 80±10, the range of flexion and extend of joint 80±10°, the range of rotation of joint 100±5° preoperatively. The brachial plexus anesthesia, the elbow hung to traction, soft spot, interna and extrapathway were given to explore and debride elbow joint and remove corpus liberum. Results All patients recovered daily life and work 7 to 12 dayspostoperatively. There were no complications of blood vessel and nerve injuries. Eleven cases were followed up for 6 to 18 months (mean 12-5 months). The results wereexcellent in 7 and good in 4 according to HSS scoring system. At the final followup, the score of VAS was 32±15, showing statistically significant difference when compared with preoperation (Plt;0.05). The range of flexion and extend of joint was 110±10°，the range of rotation of joint was 120±5° postoperatively, showing statistically significant differences when compared with preoperation (Plt;0.05). Conclusion The elbow arthroscopy might be a reliable methodto diagnose and treat osteochondritis dissecans of elbow joint in adolescent with minor trauma，quick recovery，significant improving function and less complications.
Objective To explore the effectiveness of arthroscopic medial retinaculum pl ication (MRP) for recurrent patellar dislocation in adolescents. Methods Between March 2000 and October 2007, 30 adolescent patients with recurrent patellar dislocation underwent arthroscopic MRP, and 28 of them (12 left knees and 16 right knees) completed thefinal follow-up and were enrolled. There were 5 males and 23 females with an average age of 14.7 years (range, 12-19 years). The dislocation duration was 4 to 39 months with an average of 18.8 months. All patients experienced 2-4 episodes of dislocation. Before operation, all the patients showed positive apprehension test; the degree of lateral patellar translation was (2.9 ± 0.7)° and there was no hardness termination in lateral translation. The International Knee Documentation Committee (IKDC), Lysholm, Kujala, and Tegner scores were 47.7 ± 3.7, 52.6 ± 4.9, 66.7 ± 5.9, and 3.1 ± 1.3, respectively. All patients underwent arthroscopic MRP procedure. Results All incisions healed by first intention without compl ication. All the patients were followed up 2-7 years (4.8 years on average). During the follow-up, more and more patients showed positive apprehension test, and at 24 months of follow-up, 12 patients showed positive apprehension test; less and less patients had hardness termination in lateral translation, only 3 patients at 24 months of follow-up; the degree of lateral patellar translation increased, (2.3 ± 1.1)° at 24 months of follow-up. There were significant differences in positive apprehension test and hardness termination between preoperation and 24 months of follow-up (P lt; 0.05). Moreover, 6 patients suffered from redislocation, and 23 patients experienced patella instabil ity. The IKDC, Lysholm, Kujala, and Tegner scores at 24 months of follow-up were 62.5 ± 6.2, 70.7 ± 5.1, 76.6 ± 4.8, and 3.9 ± 0.7, respectively, showing significant differences when compared with preoperative scores (P lt; 0.05). CT examination showed that the congruence angle, lateral patellar angle, and patellar tilt angle were recovered to normal level after operation immediately, however, the final patellar position at 24 months of follow-up was not significantly betterthan that before surgery (P gt; 0.05). There was significant difference in the lateral patellar displacement between preoperation and 24 months of follow-up (P lt; 0.05). Conclusion Arthroscopic MRP is not rel iable for maintaining the corrected position of the patella for recurrent patellar dislocation in adolescents, though functional improvements are significant.
ObjectiveTo systematically review the association between chronotype and depressive symptoms among adolescents. MethodsCNKI, VIP, WanFang Data, PubMed, ScienceDirect and Web of Science databases were electronically searched to collect studies on the association between adolescent chronotype and depressive symptoms from inception to January 17th, 2022. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 16.0 software. ResultsA total of 12 studies were included. The results of meta-analysis showed that there was an association between chronotype and depressive symptoms (Fisher’s Z=−0.19, 95%CI −0.21 to −0.17, P<0.001). ConclusionCurrent evidence shows that evening-type chronotype may be a risk factor for depressive symptoms among adolescents. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo observe the clinical features of retinal arterial occlusion (RAO) in youth.MethodsThis is a retrospective case review. Nine patients (9 eyes) with RAO were enrolled in this study. There were 6 males (6 eyes) and 3 females (3 eyes). The average age was (14.22±3.93) years. The best-corrected visual acuity (BCVA), indirect ophthalmoscopy, fundus color photography and fundus fluorescein angiography were performed. All patients underwent systemic evaluation including blood routine, erythrocyte sedimentation rate, blood lipids, vasculitis screening, homocysteine level, antiphospholipid antibody, blood coagulation, neck vascular ultrasound, and cardiac color ultrasound and electrocardiogram examination. All patients received oxygen therapy, blood medications and symptomatic treatment. Meanwhile, the patients with autoimmune diseases were received systemic glucocorticoid therapy. The follow-up was ranged from 6 to 12 months. The visual acuity and fundus change before and after treatment were compared.Resultsamong 9 patients, one patient had systemic lupus erythematosus, one patient had congenital heart disease, one patient had hypergammaglobulinemia, and carotid artery color ultrasonography showed that the internal carotid artery vessels faltered in 2 cases. The BCVA was 0.01 - 0.12. Among 9 eyes, there were 5 eyes (55.6%) with retinal branch artery occlusion (BRAO), 2 eyes (22.2%) with central retinal artery occlusion (CRAO), 2 eyes (22.2%) with ciliary retinal artery occlusion (CLAO). CRAO eyes showed positive RAPD (relative afferent pupillary defect), fine retinal artery and the corresponding vein, pale white retinal edema in posterior area and macular cherry-red spot. BRAO eyes manifested as inferior temporal artery occlusion and pale white retinal edema around them. CLAO eyes showed temporal ligulate grey-white retinal edema. At the last follow-up, BCVA improved and retinal vessels returned to normal in 7 eyes (77.8%); BCVA unchanged and no improvement in fundus in 2 eyes (22.2%).ConclusionAdolescent RAO is mostly partial occlusion, the prognosis is generally good after early active treatment.
ObjectiveTo systematically review the relationship between polycyclic aromatic hydrocarbons (PAHs) and emotion and behaviors in children and adolescents. MethodsThe PubMed, EBSCO, Web of Science, CBM, VIP, WanFang Data, OVFT, Proquest Psychological database and CNKI databases were electronically searched to collect studies on the relationship between PAHs and emotion and behaviors in children and adolescents from inception to October 20, 2022. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. A qualitative systematic review was then performed. ResultsA total of six cohort studies were included, five studies involving maternal exposure during pregnancy, found that maternal exposure to PAHs during pregnancy was associated with an increase in childhood anxiety/depression syndrome, attention problems, social withdrawal, social competence, social problems, orientation/regulation, withdrawal behaviors, and autism-related behaviors. Another study of exposure in school-age children found that PAHs exposure was associated with poorer attention performance in school. Results of other emotional behaviors were inconsistent, or no association was found. ConclusionCurrent evidence shows that PAHs have certain effects on emotional behaviors of children and adolescents. Due to the limited quality and quantity of the included studies, more high-quality cohort studies are required to verify above conclusion.