AIM: To optimize the technical parameters of total arasaponin'S purification with macroporous resin. METHODS: Conditions for the elution were studies under the conditio n of the content of total arasaponin. RESULTS: The purity of total arasaponin was up to 83.3% after d riing the part of 70% ethanolic elution. CONCLUSION: The method was a good purification for total arasaponi n.

Objective: To investigate the effect of different organ metastases on clinical prognosis in patients with small cell lung cancer (SCLC). Methods: A total of 10 347 SCLC patients with distant metastases (M1) obtained from the surveillance, epidemiology, and end results (SEER) database between 2010 and 2013 were enrolled in this study. The median duration of follow-up was 4 months and the median age was 67 years. According to metastatic sites, the patients were divided into six groups: bone metastasis group, brain metastasis group, liver metastasis group, lung metastasis group, none group (no metastasis found in the bone, brain, liver or lung) and multi-organ metastasis (MOM) group (2 or more organ metastases found in the bone, brain, liver or lung). The effects of different organ metastases on clinical prognosis in SCLC patients were analyzed. Results: MOM was the most common pathway of metastasis, accounting for 32.8% (3 396/10 347), followed by liver metastasis (19.0%, 1 971/10 347), brain metastasis (12.1%, 1 251/10 347) and bone metastasis (10.0%, 1 033/10 347). The mortality rates associated with bone, brain, liver and lung metastases and MOM were 77.2% (797/1 033), 74.1% (927/1 251), 82.4% (1 625/1 971), 73.4% (504/687), and 81.6% (2 770/3 396), respectively. Compared with the none group, the MOM and liver metastasis groups had higher hazard ratio (HR) (95% confdence interval [CI] of 1.80 (1.66-1.96) and 1.69 (1.54-1.85), respectively, followed by bone and brain metastasis groups with HR (95% CI) of 1.24 (1.12-1.39) and 1.28 (1.16-1.42) (all P<0.001). Lung metastasis group had a lowest HR (95% CI) of 1.07 (0.95-1.21) (P = 0.27). Conclusion: MOM and liver metastases are associated with the worst prognosis and the highest mortality in SCLC patients, followed by bone, brain and lung metastases. Therefore, for the SCLC patients with distant metastasis, different treatments should be carried out according to involved organs, and treatment should be strengthened in patients with liver metastasis and MOM.

Objective To investigate the association of circulating HER-2 level with metabolic syndrome in middle-aged and elderly population. Methods We conducted a population-based cross-sectional study with 687 participants aged 40 years or older from a community in Chongming District, Shanghai, China. Serum HER-2 levels were measured using ELISA. Metabolic syndrome was defined according to the updated National Cholesterol Education Program Adutt Treatment Panel III (NCEP ATP III) criteria for Asian-Americans. Results After adjusting for other influencing factors, we found that the participants with metabolic syndrome (n=370) had significantly higher HER-2 level compared with the control group (n=317) ([12. 4 ± 2. 3] ng/mL vs [8. 2 ± 1. 6] ng/mL, P<0. 001). The serum HER-2 level increased (P<0. 001) with the accumulation of the metabolic syndrome components. After adjusting for potential risk factors, multiple logistic regression analysis showed that the highest quartile of serum HER-2 was associated with increased risk of metabolic syndrome, with a fully adjusted odds ratio (OR) of 1. 35 (95' confidence interval [CI] - 1. 14-2. 31), P<0. 001). Conclusion Serum HER-2 is independently associated with metabolic syndrome in middle-aged and elderly Chinese in this study.

Hospital Information Systems ; Humans ; Medical Records Systems, Computerized

Objective: To understand the longitudinal changes of refractive errors in adolescent myopia screening in the suburb of Shanghai, and to provide reference for targeted measures of myopia prevention and intervention. Methods: By using the cluster sampling method, 1 346 students were selected from two primary schools in a town in the suburb of Shanghai. Physical development indicators and refractive examination parameters of non ciliary muscle paralysis, and uncorrected visual acuity in 2017 and 2020 were collected from the Shanghai adolescent refractive development file. Longitudinal change of spherical equivalent (SE) refractive were assessed. A linear regression model was used to examine the relationship between the rate of SE change with characteristics of the students. Results: The average annual incidence of myopia was 16.36%, and the SE degrees of the left and right eyes of myopia students decreased by 225 degrees for three years. Girls (right eye Z=-4.33; left eye Z=-3.75, P<0.01), newly-onset myopia and persistent myopia (right eye Z=634.45; left eye Z=638.85, P<0.01) was a key for the rapid progress of refractive power. Conclusion The proportion of students with severe low vision is relatively high, and the apparent shifts toward more hyperopia in myopia students call for effective prevention and control programs based on changes in refractive to slow the progression of adolescent myopia.

Objective: To investigate the prevalence of metabolic syndrome in adults in Shanghai Chongming area and to analyze the relationship between metabolic syndrome and chronic kidney disease. Methods: A total of 7 679 residents aged 30 years and over in Chongming District of Shanghai were randomly sampled and investigated by questionnaires, physical examinations, and laboratory examinations. The metabolic syndrome was diagnosed by the diagnostic criteria of metabolic syndrome according to the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes in 2017. According to the criteria of the International Society of Nephrology Working Group on Improving the Overall Prognosis of Kidney Diseases, estimated glomerular filration rate (eGFR)<60 ml·min^-1·(1.73 m²)^-1 was diagnosed as chronic kidney disease. Results: The prevalence of metabolic syndrome was 38.61% in the total population. The prevalence of metabolic syndrome was 47.06% in males and 34.71% in females. Urinary albumin-creatinine ratio (ACR), eGFR, age, smoking, waist circumference, blood glucose, blood pressure, high density lipoprotein-cholesterol and triglyceride in metabolic syndrome group were significantly higher than those in non- metabolic syndrome group. With the increase of metabolic components, eGFR decreased, and ACR increased. According to logistic regression analysis, age, male, hyperglycemia, hypertension, hypertriglyceride were risk factors for eGFR. Male, hypertension, hyperglycemia, hypertriglyceride, central obesity, smoking history, lower education level were risk factors for ACR. Conclusion The number of metabolic components is related to renal damage. Male, hypertension, hyperglycemia, hypertriglyceride are risk factors for early renal damage.

OBJECTIVETo study the value of high-frequency ultrasound in the diagnosis of duchenne muscular dystrophy diseases (DMD) in children.

METHODSEight children with DMD were enrolled as DMD group and 10 healthy children as the control group. The echogenicity of the rectus femoris muscle and the gap between the gastrocnemius and soleus muscles in the two groups were detected by high-frequency ultrasound.

RESULTSCompared with the control group, rectus femoris and gastrocnemius muscles in the DMD group showed increased echogenicity and their muscle fibers were arranged irregularly, and the gap between the gastrocnemius and soleus muscles became wilder (P<0.01).

CONCLUSIONSHigh-frequency ultrasound is valuable in the diagnosis of DMD.

Objective To assess the psychometric potential of the Montreal Cognitive Assessment Scale-Beijing (MoCA-BJ) as a screening instrument for mild cognitive impairment (MCI) in older adults in Wuhan communities of central China. Methods MoCA-BJ and Mini-Mental State Examination (MMSE) were adopted to assess the MCI of 381 older adults from 13 communities in Wuhan in 2015. Confirmatory factor analysis was conducted to evaluate the construct validity of MoCA-BJ, and the relationship between all aspects of cognitive function and MoCA different dimensions. Results MoCA-BJ had acceptable reliability (w=0.76), and MoCA-BJ and MMSE estimation results were highly correlated (r=0.73, P＜0.01). By comparing three measurement models through confirmatory factor analysis, we found that the MoCA-BJ scale had two factors (F1: visual space executive function, F2: memory-based other cognitive functions) in model 3, fit degree of which was higher than model 1 by one factor, and there was a statistically significant difference in the number of factors between model 1 and model 3 (χ2dif=8.73,P＜0.01). Conclusions The MoCA-BJ has two underlying factors that respectively represent two highly correlated but distinct factors, cognition and visual-spatial. Uninformative items should be revised with culturally sensitive items and the cut-off point for mild impairment should also be altered.

ObjectiveTo describe the incidence and distribution characteristics of congenital heart disease in newborns， and to analyze the trend of the notification rate from 2009 to 2018 in Chongming District， Shanghai. MethodsBased on the shanghai birth defects surveillance system， newborns delivered in all medical institutions in Chongming District from 2009 to 2018 were examined for congenital heart disease at birth and followed up to 42 days. The notification rate and trends of various congenital heart diseases were described. ResultsThere were 548 cases of neonatal congenital heart disease in Chongming District from 2009 to 2018， and the notification rate was 20.11‰ （95%CI： 18.47‰-21.85‰）， with statistically significant differences between years during the study period （Z=10.616， P<0.001）. The four most common types of congenital heart disease were patent ductus arteriosus （313， 11.49%）， patent foramen ovale （312， 11.45%）， atrial septal defect （88， 3.64%） and ventricular septal defect （73， 2.68%）. Majority of the congenital heart disease cases were patent ductus arteriosus and patent foramen ovale that could be further closed during growth and development. Isolated patent ductus arteriosus and isolated patent foramen ovale accounted for 18.61% and 23.18% respectively of the total cases. ConclusionThe notification rate of congenital heart disease in Chongming District shows a trend of fluctuating decline followed by an increase. Community follow-up and outcome tracking should be strengthened for children with congenital heart disease， especially those with patent ductus arteriosus or patent foramen ovale.

ObjectiveThis research focused on examining the distinctive characteristics of nutrient intake and dietary patterns among long-lived elderly individuals. Additionally， the study was aimed to explore the specific dietary components that may impact the skeletal muscle mass in this particular group. MethodsThis study was conducted in the Chongming area of Shanghai， China. A total of 206 long-lived elderly individuals aged 90 or above were recruited. The 3-day 24-hour dietary recall method was used to collect dietary information and general demographic data through face-to-face interviews with professional nutritionists. The skeletal muscle mass index（SMI） was measured by bioelectrical impedance analysis（BIA）， and low skeletal muscle mass was diagnosed based on the 2019 Asian Working Group for Sarcopenia criteria. T-test analysis， chi-square test， and logistic regression were used to analyze the relationship between dietary nutrient intake and skeletal muscle mass. ResultsIn terms of food intake categories， compared with the long-lived elderly people with normal muscle mass， the intake of cereals containing miscellaneous beans and vegetables in the long-lived elderly people with low muscle mass was significantly lower（P<0.05）. In terms of the nutrient intake， compared with the long-lived elderly people with normal muscle mass， the intake of total energy， carbohydrate， dietary fiber， vitamin D， folic acid， phosphorus， potassium， magnesium， iron， and manganese in the long-lived elderly people with low muscle mass was significantly lower（P<0.05）. After continuous adjustment for the covariates， multivariate logistic regression analysis found that the intake levels of folic acid and dietary fiber were important factors influencing skeletal muscle mass， Individuals with lower intake levels of folic acid and dietary fiber are at a higher risk of low muscle mass in long-lived elderly individuals ［OR_{folic acid T1}， _{dietary fiber T1} （95%CI）： 2.90 （1.11‒7.61）； 4.09 （1.53‒10.91）］. ConclusionThe consumption of cereals that include a variety of beans and vegetables was noticeably lower in the long-lived elderly individuals with lower muscle mass when compared to those with normal muscle mass. Furthermore， low levels of folic acid and dietary fiber intake are associated with an increased risk of low skeletal muscle mass.