OBJECTIVETo study the Chinese medicine (CM) syndrome features of ulcerative colitis (UC) by using fluorescence intensity (the ratio of green to red, G/R ratio) of auto fluorescence imaging, thus providing objective evidences for the CM syndrome typing of UC.

METHODSTotally 49 patients were recruited. They were typed as Dachang damp-heat syndrome (19 cases), Pi-Wei qi deficiency syndrome (30 cases), and the healthy control group (21 cases) on the bases of mucosal morphology of white light endoscopy (WLE) and the G/R ratio of AFI.

RESULTSCompared with the healthy control group (1.227 +/- 0.137), the G/R ratio in Dachang damp-heat syndrome (0.915 +/- 0.114) and Pi-Wei qi deficiency syndrome (1.147 +/- 0.137) decreased with statistical difference (P < 0.05, P < 0.01). Of them, it was lower in Dachang damp-heat syndrome group (P < 0.01). The case number was mainly dominated in moderate endoscopic index (EI) (11 cases) and severe EI (5 cases) in Dachang damp-heat syndrome group. The case number was mainly dominated in the remission phase (17 cases) and mild EI (7 cases) in Pi-Wei qi deficiency syndrome group. The G/R ratio of the remission phase was higher than that of the active phase (1.220 vs. 0.963, P < 0.01). There was statistical difference in the G/R ratio of the mild EI (1.044), the moderate EI (0.967), and the severe EI (0.830) (P < 0.01).

CONCLUSIONSThe inflammation degree of Dachang damp-heat syndrome was more severe than that of Pi-Wei qi deficiency syndrome. AFI could better reflect the inflammation degree of UC.

Aged ; Case-Control Studies ; Colitis, Ulcerative ; diagnosis ; pathology ; Endoscopy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Optical Imaging ; Yang Deficiency ; diagnosis ; Yin Deficiency ; diagnosis

Objective: To investigate the effect of maternal passive smoking during pregnancy and girls’ overweight /obesity on the age at menarche(AAM), and to provide a reference for improving healthy development of children and adolescents. Methods: Based on the school entrance physical examination in 2016, a cross-section study was conducted by convenient sampling method, in a total of 2 722 students of 7th grade, from 26 middle schools in urban areas of Guangzhou. Multivariate logistic regression model was used to investigate the relationship between maternal passive smoking during pregnancy and girls’ overweight /obesity and AAM. A four-way decomposition method was used to explore the mediated effect of girls’ overweight/obesity on the relationship between maternal passive smoking during pregnancy and AAM. Results: The proportion of girls who had menstruate was 90.82%(2 472/2 722). The median AAM was 12.00 years old, with an early menarche rate of 34.91%(863/2 472). Compared with girls whose mother hadn’t passive smoking during pregnancy, the risk of early AAM in girls with mother passive smoking during pregnancy≤3 days/week increased by 32%(OR=1.32, 95%CI=1.06-1.65), the risk in girls with maternal passive smoking during pregnancy>3 days/week increased by 58%(OR=1.58, 95%CI=1.21-2.07). Multivariate Logistic regression analysis showed that, overweight or obesity girls had a 77% higher risk of early AAM than non-overweight/obesity girls(OR=1.77, 95%CI=1.36-2.31). The four-way decomposition analysis showed 79.60% of early AAM risk could be accounted by maternal passive smoking during pregnancy(P<0.01). Conclusion Girls’ overweight/obesity and maternal passive smoking during pregnancy were associated with early menarche. The effect on daughters’ age at menarche is mainly in a direct effect manner of maternal passive smoking during pregnancy.

: To investigate the current status of milk and dairy product intake of primary and middle school students in Guangzhou and to explore the influencing factors, to provide the basis for promoting the consumption of milk and dairy products for students. Methods: Questionnaire survey was conducted among 7 948 students selected from 3 primary schools and 3 middle schools in Guangzhou. The contents included general information, average amount of the intake of milk and dairy products (including pure milk, yoghurt, milk powder, cheese and other dairy products). Using χ2 test and multivariate Logistic regression to analyze the influencing factors of students’ milk and dairy product intake. Results: About 76.12% of all participants reported milk and dairy products intake<7 times/week, 78.88% reported milk and dairy products intake<300 g/d and the median of milk and dairy products was 178.57 g/d. In the multiple Logistic regression model, girls and high school students were more likely to consume milk and dairy products insufficiently, with the OR of 1.42 (95%CI=1.26-1.60), 1.86 (95%CI=1.51-2.28) respectively. The students with father’s education level being college degree or above (OR= 0.75, 95%CI=0.59-0.94), mother’s education level being high school or above (high school:OR=0.75, 95%CI=0.61-0.93, college degree or above:OR=0.58, 95%CI=0.46-0.72) and annual household income ≥200 000 (OR=0.77,95%CI=0.64-0.92) were more likely to consume sufficient milk and dairy products. Conclusion Consumption of milk and dairy products among primary and middle school students in Guangzhou was high but not meet the recommended amount,should be strengthened. Health and nutritional education for students and their parents,especially girls and senior students,should be strengthened to promote the milk and dairy products consumption.

Objective: To explore the influence of birthweight and delivery mode on overweight/obesity and abdominal obesity in primary school students, and to provide evidence for childhood obesity prevention. Methods: After physical examination, questionnaire survey was conducted among 3 361 students and their parents from 3 primary schools in Guangzhou selected through stratified clustering sampling. Information about birthweight and delivery mode was collected. Logistic regression model was used to analyze the association of birthweight and delivery mode with overweight/obesity and abdominal obesity. The multiplicative interaction term and the Delta method was used to explore the potential interaction. Results: The prevalence rate of overweight and obesity for primary school students was 21.33%, and the rate of abdominal obesity was 12.08%. Multivariate Logistic regression analysis showed that delivery by cesarean section was associated with 44% increased risk of overweight/obesity(OR=1.44, 95%CI=1.16-1.80), as compared to vaginal delivery. Higher birthweight was linked to increased risk of overweight/obesity(OR=1.62, 95%CI=1.09-2.42). There was no significant association of birth weight and delivery mode with abdominal obesity in multivariate analysis(P>0.05). Additionally, a positive additive interaction was seen between delivery mode and parental obesity for students risk of overweight/obesity(RERI=0.33, 95%CI=0.02-0.65), as well as for the risk of abdominal obesity(RERI=0.39, 95%CI=0.12-0.65). Conclusion Cesarean section delivery and higher birthweight are linked to increased risk of overweight and obesity in primary school students. The synergistic effect of cesarean section and parental obesity may increase the risk of childhood obesity.

Objective: To understand the relationship between screen time and dietary behaviors among urban middle school students in Guangzhou, and to provide scientific evidence for improving students’ health. Methods: Based on the regular medical examinations for elementary and middle school students in Guangzhou, a total of 12 357 middle school students (grade 7 and grade 10) were investigated by using a cross-sectional study. The physical indicators and daily routine were collected by physical examination and questionnaire survey. Multiple Logistic regression analysis was used to explore the association between screen time and dietary behaviors among students. Results: The proportion of excessive screen time was 18.80% (2 323). There was no significant difference between boys (18.52%, 1 165/6 292) and girls (19.09%, 1 158/6 065) (χ2=0.67, P>0.05). Logistic regression results showed that excessive screen time was negatively associated with consumption of vegetables and fruits, with the aORs of 0.50 (95%CI=0.42-0.58) and 0.64 (95%CI=0.58-0.70) respectively, and positively associated with consumption of fried food (OR=1.90, 95%CI=1.70-2.09), western fast food (OR=1.90, 95%CI=1.65-2.19), sweets (OR=1.36, 95%CI=1.25-1.49) and sugar-sweetened beverage (OR=1.70, 95%CI=1.57-1.84). Conclusion Excessive screen time was associated with unhealthy dietary behaviors among middle school students in Guangzhou. Intervention should be tailored to screen time as well as dietary behaviors.

Objective:To investigate the correlation of isokinetic thigh muscle asymmetry with gait asymmetry at one year after anterior cruciate ligament (ACL) reconstruction.Methods:A retrospective case series analysis was made on 25 patients treated by ACL reconstruction in Third Hospital of Peking University from January 2014 to January 2019. All the subjects were male, aged 17-47 years [(29.4±5.2)years]. Standard rehabilitation treatment procedures were conducted after surgery. The isokinetic muscle strength of the thigh was collected at one year after operation to evaluate knee extensor and flexor concentric strength at 60°/s, 180°/s and 300°/s, and knee extensor and flexor eccentric strength at 60°/s. The maximum concentric and eccentric strength of the knee extensor and flexor were analysed between the injured and intact side. The three-dimensional motion information and ground reaction force was collected during the stance phase of gait, and knee kinematic and kinetic parameters were calculated by inverse dynamics analysis, including the peak flexion moment, peak extension moment, first and second peak adduction moment, peak external and internal rotation moment, peak flexion angle, peak extension angle during the terminal stance phase, flexion angle at heel strike, peak abduction angle, and peak external rotation angle during terminal stance phase. Spearman correlation analysis was used to study the correlation between limb symmetry index (LSI) of isokinetic muscle strength and LSI of gait parameters.Results:One year after ACL reconstruction, the maximum concentric strength of the knee extensor and flexor at 60°/s, 180°/s and 300°/s and maximum eccentric strength of the knee flexor and extensor at 60°/s on the injured side were significantly lower than those on the normal side (all P<0.01). Compared with the intact side, the peak knee extension moment on the injured side was significantly lower during the stance phase of gait ( P<0.01), and the extension angle was insufficient during the terminal stance phase ( P<0.01). There were no significant differences between the injured and intact side in terms of peak flexion moment, first and second peak adduction moment, peak external and internal rotation moment, peak flexion angle, flexion angle at heel strike, peak abduction angle, and peak external rotation angle during terminal stance phase (all P>0.05). One year after ACL reconstruction, Spearman correlation analysis during gait stance phase showed that the LSI of 60°/s concentric strength of the isokinetic knee extensor was significantly related to LSI of peak internal rotation moment ( R=0.42, P<0.05), the LSI of 180°/s concentric strength of the isokinetic knee extensor was significantly related to LSI of peak flexion moment ( R=0.45, P<0.05), the LSI of 180°/s concentric strength of the isokinetic knee flexor was significantly correlated with LSI of peak flexion angle ( R=0.46, P<0.05), the LSI of 300°/s concentric strength of the isokinetic knee extensor was significantly correlated with LSI of peak knee flexion angle ( R=0.42, P<0.05), and the LSI of 60°/s eccentric strength of the isokinetic flexor was significantly correlated with LSI of peak knee flexion angle ( R=0.54, P<0.01). Conclusions:For patients following ACL reconstruction at one year postoperatively, a significant correlation of isokinetic thigh extensor strength asymmetry with peak knee flexion and rotation moment and peak knee flexion angle, and that of isokinetic thigh flexor strength asymmetry with peak knee flexion angle are observed during the stance phase of gait, which suggests that patients with ACL reconstruction still need systematic rehabilitation training one year postoperatively to improve muscle strength and motor function so as to reduce the risk of ACL reinjury and secondary injury.

OBJECTIVE: To measure the electroencephalography (EEG) of the patients with anterior cruciate ligament (ACL) rupture when performing joint position perception movement task, to compare the differences between the ACL rupture side and the unaffected side, to identify the EEG change in the power spectrum caused by the ACL rupture, and to provide evidence for the diagnosis, treatment and rehabi-litation for ACL injury as well as knee instability. METHODS: Sixteen male patients, selected from the Department of Sports Medicine, Peking University Third Hospital from November 2014 to April 2015, with only ACL rupture on one side used isokinetic muscle strength testing equipment were enrolled in the study to perform unilateral active knee joint positional movement and passive knee joint positional movement tasks. EEG was recorded to compare between the affected and unaffected limb of ACL rupture patients when doing single leg movement tasks, including passive knee joint position test and active knee joint position sensation test. The target position of the active knee joint position movement task and the passive knee joint position movement task was 30 degrees of knee flexion. RESULTS: During the passive knee joint position test, there was no significant difference in EEG power spectrum of Delta[F (1, 15)=0.003, P=0.957, η_P² =0.001], Theta[F (1, 15)=0.002, P=0.962, η_P² < 0.001], Alpha[F (1, 15)=0.002, P=0.966, η_P² =0.001], Beta[F (1, 15)=0.008, P=0.929, η_P² =0.001] at Fz, Cz, and Pz between the affected and unaffected limbs in the ACL patients. During the active knee joint position movement task, the EEG power spectrum of Delta, Theta, Alpha, Beta at Fz and Cz location, on the affected side was significant higher than on the unaffected side. CONCLUSION This study compared the differences between the ACL rupture side and the unaffected side during active knee position movement task and passive knee position movement task, and identifyied the EEG changes in the power spectrum caused by the ACL rupture, It was found that the central changes caused by unilateral ACL rupture still existed during contralateral (unaffected) side movement. The EEG power spectrum of the affected side during active exercise was significantly higher than that of the unaffected side This study provides new electrophysiological evidence for the study of ACL injury.
Anterior Cruciate Ligament ; Anterior Cruciate Ligament Injuries ; Electroencephalography ; Humans ; Knee Joint ; Male ; Perception ; Rupture

OBJECTIVE: To analyze characteristics and related factors of the plantar pressure during the level walking and single leg standing in the chronic ankle instability (CAI) individuals. METHODS: From April 2019, 75 CAI individuals and 40 healthy individuals were enrolled in this study. Both of the static and dynamic plantar pressure were measured during six times level walking and three times single leg standing testing. The data including peak force, time to peak force in various foot contact areas and the time to boundary (TTB) and velocity of center of pressure (COP) were measured and compared between the affected side and the unaffected side and between the CAI cases and the healthy individuals. The correlations between the plantar pressure and the gender, Beighton score, affected side and body mass index (BMI) were analyzed. RESULTS: The characteristics of plantar pressure distribution in the CAI individuals included: (1) During the level walking, the affected side showed the similar pressure contribution as the unaffected side (P>0.05). While compared with healthy individuals, there was a significantly higher peak force in the 5th metatarsal area (t=-3.86, P=0.03) of the affected side, lower peak force in the 1st (t=2.99, P=0.02), 2nd metatarsal head areas (t=2.09, P=0.01) of the affected side, medial hindfoot areas of both sides (affected, t=2.33, P=0.01; unaffected, t=3.74, P=0.02) and toes areass of both sides (affected, t=2.23, P=0.01; unaffected, t=3.28, P=0.02) and a delay to peak force in the 4th metatarsal head area (t=3.33, P=0.01) of the affected side. (2) During the single leg standing, the CAI individuals showed significantly worse balance control in the anterior/posterior direction (P < 0.05) and lateral/medial direction (P < 0.05) compared with the healthy controls, and the affected side had more severe balance control deficit in the lateral/medial direction (P < 0.05). (3) The women (P < 0.05) and the individuals with higher Beighton scores (P < 0.05) showed worse balance control deficit in the lateral/medial direction. CONCLUSION CAI individuals showed significantly a more lateral shifted plantar distribution during the level walking compared with the healthy individuals and the tendency was worse on the affected sides, and showed worse balance control in the anterior/posterior direction and lateral/medial direction during the single leg standing. The women and those with generalized ligament laxity showed significantly worse balance control.
Ankle ; Ankle Joint ; Case-Control Studies ; Female ; Foot ; Humans ; Joint Instability

OBJECTIVE: To explore the stress distribution characteristics of the graft after anterior cruciate ligament (ACL) reconstruction, so as to provide theoretical reference for the surgical plan of ACL reconstruction. METHODS: Based on 3D MRI and CT images, finite element models of the uninjured knee joint and knee joint after ACL reconstruction were established in this study. The uninjured knee model included femur, tibia, fibula, medial collateral ligament, lateral collateral ligament, ACL and posterior cruciate ligament. The ACL reconstruction knee model included femur, tibia, fibula, medial collateral ligament, lateral collateral ligament, ACL graft and posterior cruciate ligament. Linear elastic material properties were used for both the uninjured and ACL reconstruction models. The elastic modulus of bone tissue was set as 17 GPa and Poisson' s ratio was 0.36. The material properties of ligament tissue and graft were set as elastic modulus 390 MPa and Poisson's ratio 0.4. The femur was fixed as the boundary condition, and the tibia anterior tension of 134 N was applied as the loading condition. The stress states of the ACL of the intact joint and the ACL graft after reconstruction were solved and analyzed, including tension, pressure, shear force and von Mises stress. RESULTS: The maximum compressive stress (6.34 MPa), von Mises stress (5.9 MPa) and shear stress (1.83 MPa) of the reconstructed ACL graft were all at the anterior femoral end. It was consistent with the position of maximum compressive stress (8.77 MPa), von Mises stress (8.88 MPa) and shear stress (3.44 MPa) in the ACL of the intact knee joint. The maximum tensile stress of the graft also appeared at the femoral end, but at the posterior side, which was consistent with the position of the maximum tensile stress of ACL of the uninjured knee joint. More-over, the maximum tensile stress of the graft was only 0.88 MPa, which was less than 2.56 MPa of ACL of the uninjured knee joint. CONCLUSION The maximum compressive stress, von Mises stress and shear stress of the ACL graft are located in the anterior femoral end, and the maximum tensile stress is located in the posterior femoral end, which is consistent with the position of the maximum tensile stress of the ACL of the uninjured knee joint. The anterior part of ACL and the graft bore higher stresses than the posterior part, which is consistent with the biomechanical characteristics of ACL.
Anterior Cruciate Ligament Injuries/surgery* ; Anterior Cruciate Ligament Reconstruction ; Biomechanical Phenomena ; Femur/surgery* ; Finite Element Analysis ; Humans ; Knee Joint/surgery* ; Tibia/surgery*