简介：Assessmentofchildandadolescentpsychiatricdisorders(Figure1)focusesonfourkeyquestions.

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简介：AbstractEtiology of adolescent idiopathic scoliosis (AIS), a complicated three-dimensional spinal deformity with early-onset, receives continuous attention but remains unclear. To gain an insight into AIS pathogenesis, this review searched PubMed database up to June 2019, using key words or medical subject headings terms including "adolescent idiopathic scoliosis," "scoliosis," "pathogenesis," "etiology," "genetics," "mesenchymal stem cells," and their combinations, summarized existing literatures and categorized the theories or hypothesis into nine aspects. These aspects include bone marrow mesenchymal stem cell studies, genetic studies, tissue analysis, spine biomechanics measurements, neurologic analysis, hormone studies, biochemical analysis, environmental factor analysis, and lifestyle explorations. These categories could be a guidance for further etiology or treatment researches to gain inspiration.

简介：OnMarch13th,2011,theReleaseof2010SurveyReportonAdolescentHealthyPersonalityProjectandCeremonyfortheFoundationofYouthVolunteerUnionwereheldinBeijing.Thesurveyreportrevealsthatstudyitselforgettinghighmarksarethefundamentalelementsforprimarystudentsfeelinghappyandproud.26.3%oftheparentsdonotofferhelp

简介：AbstractFrostbite in Southwestern China has been overlooked due to its low incidence, relatively mild temperature and lack of literature published before. However, it needs to be further studied for religious diversity and distinct geomorphology. In this article, we reported an 18-year-old Tibetan girl who suffered from blizzard attack during pilgrimage. Her feet and several fingers showed mummified gangrene upon physical examination with poor movement. She was diagnosed with 3rd to 4th degree of frostbite. The girl was given oral ibuprofen, debridement and other regular treatment daily, but she was eventually amputated due to insufficient thrombolytic management in primary hospital, delayed informing consent in the referral hospital and ethnic conflict between religion and guidelines. This case enriched the experience of managing complex frostbite in Tibetan population and alarms that efforts should be integrated to protect pilgrims and mountaineers in the Tibetan region.

简介：Background:Lately,physicalactivity(PA)inyounggirlshasbeenfrequentlydiscussed,thuswewereinterestedtoexaminewhetheramentaltraininginterventioncanincreasethelevelofPAinyounggirls.Methods:Asampleof56girlsaged15.4±0.3years(mean±SD)wasassignedtoeithertheinterventionorcontrolgroup.Wethenconducteda6-weekmentalimagerytrainingprogramonyoungfemaleparticipants.PAwasevaluatedwithobjectiveaccelerometermonitors.Physicalself-conceptwasalsoassessedinallparticipants.Results:Youngfemales'PAincreasedafteracourseofmentaltrainingcomparedtofemaleparticipantsincontrolgroup.Furthermore,physicalself-conceptimprovedrelatedtomentaltrainingprogram.Conclusion:ExerciseimagerymaybeaneffectivemethodofPAincreasebesidespsychologicalenhancementinyounggirls.

简介：AbstractPurpose:In the surgical treatment of paediatric forearm fractures, plate-screw and titanium elastic nails are used. During the transformation of ligamento-osseous structures from adolescence form into adult form, more stable fixation is required. The aim of this study was to evaluate the results of locked intramedullary nail fixation in adolescent forearm fractures.Methods:A retrospective examination was made on 36 adolescent patients who underwent surgery with locked intramedullary nail fixation due to a forearm fracture. The included patients were in the adolescent age group (12-17 years), did not meet conservative follow-up criteria and had unstable fractures (>10° angulation and <50% cortex continuity after plaster casting). Patients were excluded from the study if they were aged >18 years or <12 years, had Gustilo-Anderson type 2/3 open fractures, multi-trauma, history of physeal injuries or could not be contacted during follow-up. Patients’ age, gender, body mass index, affected side, and the pronation and supination values during follow-up were noted. Functional evaluation of the patients was performed with disabilities of the arm, shoulder and hand score and the surgical outcomes were evaluated according to the Price criteria. The time to union, infection during follow-up, re-fracture and vascular nerve damage were also examined. Data were analyzed using SPSS 22 Windows package program software.Results:The patients comprised 30 males and 6 females (ratio, 5:1) with a mean age of (14.7 ± 2.1) years (range, 12-18 years). According to the Price criteria, the results of 33 patients were excellent, 3 were good and there were no moderate or poor cases. The mean disabilities of the arm, shoulder and hand score was 11.2 ± 6.1 (range, 4-28). The mean time to union was (8.7 ± 2.2) weeks (range, 6-14 weeks), while patients aged >15 years had prolonged time to union ([11.1 ± 1.8] weeks). There were no non-unions, re-fractures or infections. No complications were observed during implant removal. None of the patients had sensorial radial nerve injury or tendon damage.Conclusion:The locked intramedullary nailing technique, which is minimally invasive and provides biological fixation, was found to be successful and safe in the treatment of adolescent forearm fractures.

简介：ZouYan,female,researcher,majoringinevidence-basedmedicine,graduatedfromWestChinaSchoolofMedicine,SichuanUniversityandgainedadegreeofMedicalDoctor.Shehadbeenengagedinclinicalworkofobstetricsandgynecologyfortenyears.Currently,sheworksasHeadofWomenClinicalLaboratoryintheScientificResearchInstituteofNationalHealthandFamilyPlanningCommission,andamasterinstructorofDepartmentofObstetricsandGynecologyinPekingUnionMedicalCollege.

简介：Anationallyrepresentativesampleof1640Chineseurbanadolescents(meanage=14.5years)andtheirparentsandteachersweresurveyedtoexaminetheassociationsbetweenrelationshipswithteachersandparentsandadolescents'developmentaloutcomessuchasacademicperformance,psychologicalwell-being,altruisticbehaviors,andmisconduct.Resultsshowedthatthequalityofadolescents'relationshipswithteacherswashighlycorrelatedwithadolescentoutcomes,inmostcasesmoresothanforrelationshipswithparents.Furthermore,suchassociationswerethesameacrossbothgendersandthreegradelevels.ThesefindingssuggestthatteachersmayplayanespeciallysignificantroleinChineseadolescentdevelopment.Thisstudyaddstothesmallbutgrowingliteratureontheimportanceofteachersaswellasothernon-parentaladultsinadolescentpsychosocialdevelopment.

简介：AbstractImportance:Hypervirulent variants of Klebsiella pneumoniae (hvKp) are capable of causing life-threatening pyogenic liver abscesses (PLAs), but hvKp caused PLAs was seldom reported in pediatric populations. Hence, there is an urgent need to raise our awareness of this phenomenon in pediatric populations.Objective:This study aimed to report the clinical characteristics of hvKp that caused fatal PLA complicated by bacteremia in an adolescent and further identify the microbiological and genomic features of the causative strain.Methods:A 14-year-old boy with diabetes mellitus was admitted to our hospital with a diagnosis of PLA complicated by bacteremia. A hypermucoviscous hvKp strain, KPN_19-106, was isolated from the drainage fluid present within the liver abscess cavity and blood. The hypermucoviscosity phenotype of the causative strain was determined by string test. Its virulence was measured using serum resistance assay and Galleria mellonella larvae-killing assay. Antimicrobial susceptibility was determined by broth microdilution method. Genetic information was obtained by whole-genome sequencing and bioinformatics analysis.Results:KPN_19-106 belonged to sequence type 380 and serotype K2 and exhibited stronger serum resistance and higher in vivo lethality than the well-characterized hvKp NTUH-K2044 strain. Although KPN_19-106 is susceptible to most antibiotics, no sign of improvement was observed during treatment with such drugs. Whole-genome sequencing revealed that the isolate had integrated multiple mobile genetic elements related to virulence.Interpretation:Antibiotic-susceptible hvKp can cause fatal PLA complicated by bacteremia in adolescents, with no improvement during antimicrobial therapy. The causative strain in this case had integrated multiple virulence genes and thus exhibited higher virulence both in vitro and in vivo when compared with NTUH-K2044.

简介：AbstractBackground:Finding an optimal treatment strategy for adolescent idiopathic scoliosis (AIS) patients remains challenging because of its intrinsic complexity. For mild to moderate scoliosis patients with lower skeletal growth potential (Risser 3-5), most clinicians agree with observation treatment; however, the curve progression that occurs during puberty, the adolescent period, and even in adulthood, remains a challenging issue for clinicians. The aim of the study is to investigate the efficacy of Schroth exercise in AIS patients with lower skeletal growth potential (Risser 3-5) and moderate scoliosis (Cobb angle 20°-40°).Methods:From 2015 to 2017, data of 64 patients diagnosed with AIS in Peking University Third Hospital were reviewed. Forty-three patients underwent Schroth exercise were classified as Schroth group, and 21 patients underwent observation were classified as observation group. Outcomes were measured by health-related quality of life (HRQOL) and radiographic parameters. HRQOL was assessed using the visual analog scale (VAS) scores for back, Scoliosis Research Society-22 (SRS-22) patient questionnaire. Radiographic spinopelvic parameters were obtained from anteroposterior and lateral X-rays. The pre-treatment and post-treatment HRQOL and radiographic parameters were tested to validate Schroth exercise efficacy. The inter-rater reliability of the radiographic parameters was tested using the interclass correlation coefficient (ICC). The paired t test was used to examine HRQOL and radiographic parameters. Clinical relevance between C2-C7 sagittal vertical axis (SVA) and thoracic kyphosis was analyzed using Spearman correlation.Results:In Schroth group, VAS back score, SRS-22 pain, and SRS-22 self-image domain were significantly improved from pre-treatment 3.0 ± 0.8, 3.6 ± 0.5, and 3.5 ± 0.7 to post-treatment 1.6 ± 0.6 (t = 5.578, P = 0.013), 4.0 ± 0.3 (t = -3.918, P = 0.001), and 3.7 ± 0.4 (t = -6.468, P < 0.001), respectively. No significant improvements of SRS-22 function domain (t = -2.825, P = 0.088) and mental health domain (t = -3.174, P = 0.061) were observed. The mean Cobb angle decreased from 28.9 ± 5.5° to 26.3 ± 5.2° at the final follow-up, despite no statistical significance was observed (t = 1.853, P = 0.102). The mean C2-C7 SVA value decreased from 21.7 ± 8.4 mm to 17.0 ± 8.0 mm (t = -1.224 P = 0.049) and mean T1 tilt decreased from 4.9 ± 4.2 ° to 3.5 ± 3.1° (t = 2.913, P = 0.011). No significant improvement of radiographic parameters and HRQOL were observed in observation group.Conclusions:For AIS patients with a Risser 3-5 and a Cobb angle 20°-40°, Schroth exercises improved HRQOL and halted curve progression during the follow-up period. Both cervical spine alignment and shoulder balance were also significantly improved after Schroth exercises. We recommend Schroth exercises for patients with AIS.

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简介：Background:Animpactofregularphysicalactivity(RPA)ontheabdominalmusclesmaybesignificantwhencomparingvarioussymptomaticgroups.However,thereislackcomprehensiveinformationinthisfield.Theobjectiveofthisstudywastoassessthelateralabdominalwallatrestandduringabdominaldrawing-inmanoeuvreinadolescentphysicallyactivegirlsindifferentbodypositions.Methods:Onehundredandforty-fourfemalestudents,13–17yearsofage,participatedinthestudy.Participantsweredividedinto2groupsbasedonaphysicalactivity(PA)statement.Measurementsofthethicknessoftheabdominalmusclesatrestandduringabdominaldrawing-inmanoeuvreweremadeinthesupineandstandingpositionsbyultrasoundimaging.Results:Comparedtothecontrolgroup,activitiesoftheobliquusinternusandtransversusabdominismuscleswerehigherintheregularPAgroupby8.9%(95%CI:3.1–14.7)and36%(95%CI:19.1–47.5),respectively.IntheRPAgroup,thetransversusabdominispreferentialactivationratiowasgreaterby0.03(95%CI:0.01–0.04),andthecontractionratiowasgreaterbyameanvalueof0.35(95%CI:0.18–0.46).Conclusion:RPAdoesnothaveanyeffectontherestingthicknessoftheabdominalmusclesinthesupineandstandingpositions.GirlsperformingRPAhaveagreaterabilitytoperformanindependentactivationandgreatercontractionsofthetransversusabdominis.

简介：Background:Giventhelowlevelsofphysicalactivity(PA)amongadolescentgirlsintheUS,thereisaneedtoidentifytoolstomotivateincreasedPA.AlthoughthereislimitedevidencethatadolescentstransferPAfromonecontexttoanother,exergames(i.e.,videogamesthatrequiregrossmotoractivity)mayactasagatewaytopromoteoverallPAoutsidegameplay.Thepurposeofthisstudywastoexaminepotentialtransfereffects(i.e.,influencesonexternalbehaviorsandpsychologicalconstructs)ofa12-weekexergaminginterventiononadolescentgirls’PA,screentime,andself-efficacytowardPA,aswellastheintrinsicmotivationofexergaming.Methods:Participantswere37girlsaged14–18years(65%AfricanAmerican,35%white)whowereoverweightorobese(bodymassindex≥85thpercentile)andwererecruitedfromthecommunityviaschool,physicians,newsmedia,andsocialmediawebsites.Adolescentswererandomlyassignedtoa12-weekgroupexergamingintervention(thirty-six60minsessionsofgroup-baseddanceexergaminginaresearchlaboratoryusingKinectforXbox360(MicrosoftCorporation,Redmond,WA,USA))ortoano-treatmentcontrolgroup.OutcomevariablesincludedobjectivelymeasuredPA(total)andself-reportedleisure-timePA(discretionarytimeonly)1weekbeforevs.1weekaftertheintervention;selectedtypeandintensityofPAwhenplacedinagymsettingfor30min('cardiofreechoice');screentime;self-efficacytowardPA;andintrinsicmotivationtowardexergaming.Results:Attendanceattheexergamingsessionswashigh(80%).Comparedwiththecontrolgroup,theinterventiongroupself-reportedanincreaseinPA(p=0.035)andfewerhourswatchingtelevisionorvideos(p=0.01)aftertheintervention,buttherewerenosignificantdifferencesinsedentary,light,moderate,orvigorousPAmeasuredbyaccelerometry.Theinterventiongroupsignificantlyimprovedself-efficacytowardPA(p=0.028).Theinterventiongrouphighlyratedintrinsicmotivationtowardexergaming.Conclusi

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简介：AbstractPurpose:Previous studies usually examine the associations between psychological distresses and quality of life (QOL) with a variable-centred approach, while little is known about the effect of the individual variance in time-varying changes of psychological distresses on QOL. Therefore, this study aimed to examine whether individual variance in psychological distresses during the early phases post-earthquake would develop different QOL’s levels among adolescent survivors 10-year after the Wenchuan earthquake.Methods:Data were extracted from the Wenchuan Earthquake Adolescent Health Cohort Study. The current study included 744 adolescent survivors who effectively completed surveys at 6 months, 24 months, and 10 years after the earthquake. Self-report questionnaires were administered to collect information on socio-demographic characteristics, earthquake exposure, life events, anxiety symptoms, depressive symptoms, posttraumatic stress symptoms (PTSS), and QOL. Data were analysed using hierarchical multiple regression.Results:Trajectories of psychological distresses were classified as follow: resistance (anxiety 40.73%; depression 54.70%; PTSS 74.46%), recovery (anxiety 17.20%; depression 9.27%; PTSS 10.35%), delayed dysfunction (anxiety 10.35%; depression 18.15%; PTSS 6.18%), and chronicity (anxiety 31.72%; depression 17.88%; PTSS 9.01%). After controlling covariates, hierarchical multiple regression only revealed that the anxiety trajectory with delayed dysfunction remained significantly predictive for four domains of QOL (physical health, psychological health, social relationships, and environment).Conclusion:The current study highlights the importance of focusing on the variations in trajectories of anxiety symptoms among disaster survivors and providing individualized mental health services to improve survivors’ QOL.