ObjectivesTo investigate the prevalence of respiratory diseases and lung function of school-age children in Chongqing and to compare them with that of children in 25 years ago and to explore the possible causes of this change.MethodsAccording to the air quality data of Chongqing from 1998 to 2016, the annual variation of air quality days and pollutant concentrations were plotted. 2 126 school-age children in two districts of Chongqing were selected by random cluster sampling for questionnaires. 771 children were randomly selected from the children who completed the questionnaire for pulmonary function tests. The results were compared with that of 25 years ago.ResultsFrom 1998 to 2016, the number of days with good air quality in Chongqing increased annually, and the concentration of SO2 decreased significantly. The main air pollution composition changed from SO2 to PM10 and PM2.5. The prevalence of bronchitis (P<0.05) was higher than that of 25 years ago. After adjusting for confounding factors by multivariate logistic regression, the OR value of bronchitis in children was 1.667 (P<0.05) compared with 25 years ago. After adjusting for age, sex, height and weight by multiple linear regression, the results showed that the subjects' lung function indexes (FVC, FEV1, PEF and FEV3) were lower than that of 25 years ago. In this survey, there were differences in lung function indexes between children with different frequency of eating fruits and dairy products (P<0.05), and those with high frequency consumption were higher than low frequency. In terms of exercise time, subjects exercising ≥1 hour/day had greater FVC and FEV3 values than those exercising <1 hour/day (P<0.05).ConclusionsThe overall air quality in Chongqing has improved from 1998 to 2016; The respiratory health of children has decreased when compared with that of 25 years ago. Changes in the composition of air pollutants may endanger children's respiratory health, and fruit and dairy foods and exercise may be protective factors for children's respiratory health.
ObjectivesTo systematically review the association between pubertal development progression and emotional and behavioral problems.MethodsVIP, CNKI, CBM, WanFang Data, PubMed, Web of Science and EBSCO databases were electronically searched to collect studies on the relationship between pubertal tempo or trajectory and emotional and behavioral problems from inception to December 31st, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Qualitative methods were then used to analyze the data.ResultsA total of 14 cohort studies were included. The results showed that depression was the most studied emotional problem, and 2 of the 3 studies found a significant association between faster pubertal tempo and more depressive symptoms in juvenile males. However, no association was found in 3 of the 4 studies on juvenile females. The content of behavioral problems of included studies was broad, including internalizing and externalizing problems, substance abuse, attention problem, self-control, first-sexual experience, delinquency, conduct disorder, peer relationship, etc. However, few studies on the same behaviors, and the relationship between behavioral problems was unclear.ConclusionsThe faster pubertal tempo may be associated with depression in juvenile males. The association between pubertal tempo and behavioral problems in males and females remain to be determined by more studies.
ObjectiveTo identify the effects of transition to siblinghood (TTS) on the firstborn children’s emotions and behaviors, and to define the time of TTS.MethodsCBM, VIP, CNKI, WanFang Data, PubMed, Web of Science and EBSCO were electronically searched to collect studies on the emotional and behavioral characteristics of firstborn children in TTS from inception to December 31st, 2019. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies. Then, qualitative methods were used to analyze the studies.ResultsA total of 13 studies involving 980 children were included. 12 behavioral related studies explored self-behavior of the firstborn children during TTS, 3 studies focused on the interaction behavior between the firstborn children and their parents, the firstborn children and the second children. The systematic reviews found that TTS showed both positive and negative effects on the behavioral characteristics of firstborn children, primarily the negative effects. Firstborn children’s anxiety, confrontation and attachment showed 3 different patterns over time, respectively. Two studies showed the increase of negative emotions of firstborn children during TTS. The time range of TTS was mainly concentrated in the third trimester to 12 months after the birth of the second child.ConclusionsThe current evidence shows that TTS primarily increases the negative emotions and behaviors of firstborn children, and the behaviors of firstborn children changes over time. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Objective To investigate the prevalence and predisposing factors of gastroesophageal reflux（GER）in patients with chronic obstructive pulmonary disease（COPD）and its impacts on the frequency of COPD exacerbations.Methods 50 patients with acute exacerbation of COPD were enrolled in the study.All patients filled a modified version of clinically validated standardized Mayo Clinic GER questionnaire.Pulmonary function tests（PFT），body mass index（BMI），serum albumin，and medications were recorded.The patients were divided in to GER group（13 patients with GER symptoms longer than one year and diagnosed GER by gastroscope） and non-GER group（37 patients without GER symptoms）.Results There were no significant differences in the BMI，serum albumin，use of inhaled steroids and theophylline between the two groups.Forced expiratory volume in one second as a percentage of the predicted value（FEV1%pred）（37% vs 38.3%，P=0.608.），residual volume % predicted（123.4 % vs 137.8%，P=0.222），and residual volume to total lung capacity（139.4% vs 141.5%，P=0.798） were not significantly different between the two groups.The number of COPD exacerbations per year was significantly higher in patients with GER compared to patients without GER（4.5 vs 1.3，P=0.006）.Conclusions The severity of airflow obstruction and the hyperinflation is unlikely to contribute to the development of GER.Patients with GER experience significantly more exacerbations per year when compared to patients without GER，suggesting more highlight warrant in treatment of GER in COPD patients.