Objective To study the breast augmentantion by a large amount of auto fat granule injection. Methods The author selected the fat patients who wanted both breast augmentation and liposection. Large amount of auto fat granule, the fat suspended solution, was obtained from patient's abdomen or buttocks and thighs. The fat suspended solution had been washed by normal saline solution repeatedly, in order to get rid of blood, serum and liquefied fat. Then the auto fat granule solution was injected into breast glands and their underneath and behind pectoral majority muscle. The quantity of fat suspended solution injected was 150～305 ml in each side of breast. Total of 21 cases had been performed by auto fat granule solution injection in our department from Oct.1997 to April 2001. Results Breast augmentation by auto fat granule solution injection were successful and positive, without any complications. The results were satisfied both from patients and surgeons. It showed that the contouring of breast were improved and more chubbiness than that before operation. Conclusions The auto fat granule injection for the breast augmentation is an effective and practical method. It can also be used to inject into the other parts of the body to fill in soft tissue defects.

ObjectiveTo analyze the mortality data of children under 5 years in Chongming District， Shanghai， and to analyze the main causes of death of children under 5 years， so as to provide scientific basis for reducing the mortality of children under 5 years in Chongming District. MethodsData of children under 5 years in Chongming District from 2011 to 2020 were collected from the Maternal and Child Health Information System of Chongming District， Shanghai. The mortality rate and main causes of death of children under 5 years in Chongming District were analyzed retrospectively. ResultsFrom 2011 to 2020， the average mortality rate of children under 5 years in Chongming District was 6.51‰， and the overall trend was stable. The mortality rate of children under 5 years with non-local household registration （11.44‰） was significantly higher than that of children under 5 years of age with local household registration （4.88‰） （P<0.05）. The main causes of death for children under 5 years were accidental deaths （drowning， accidental asphyxia， traffic accidents）， while the main causes of death for infants were congenital heart disease， premature birth or low birth weight， congenital abnormalities， birth asphyxia and pneumonia. ConclusionIt is necessary to strengthen safety education for children and their guardians and strengthen safety management for children who are not registered in this city. Departments of obstetrics and gynecology and the departments of pediatrics should be expanded， and prenatal examination should be strenthened for high risk or elderly parturient women to further reduce the death rate of children under 5 years old.

ObjectiveTo investigate the prevalence of dental caries among preschool children in Chongming District， Shanghai， and to analyze the related factors influencing dental caries in preschool children in Chongming District， in order to provide references and suggestions for the prevention of dental caries in preschool children in Chongming District. MethodsFrom January to April 2022， 939 preschool children from 5 kindergartens in Chongming District of Shanghai were selected as the research objects through random cluster sampling. The dental caries prevalence rate and related risk factors of dental caries in preschool children were studied through oral examinations and questionnaire surveys. ResultsThe prevalence rate of dental caries among the 939 preschool children was 45.69%. The prevalence of dental caries in preschool children was not related to gender but increased with age （P<0.001）. Risk factors for dental caries in children included consuming desserts between meals or before bedtime （OR=3.049， P<0.001）， consuming sugared milk （OR=2.389， P=0.027）， presence of dental caries in caregivers （OR=1.888， P<0.001）， age （OR=1.758， P<0.001）， regular consumption of certain beverages by children （OR=1.250， P=0.029）， and the frequency of snack consumption （OR=1.191， P=0.034）. ConclusionTo reduce the incidence of dental caries in preschool children， it is recommended that caregivers undergo oral health examinations and dental caries treatment to reduce the transmission of cariogenic bacteria. Additionally， reducing the frequency of children’s consumption of snacks， sugary drinks， and dairy products， and avoiding unhealthy eating habits such as consuming desserts before bedtime are advised. It is also important to educate children on proper toothbrushing methods to ensure the effectiveness of toothbrushing and to encourage them to develop good oral hygiene habits.

ObjectiveTo study the epidemiological characteristics of deaths due to pneumoconiosis and its complications in order to improve the prevention and management of pneumoconiosis. MethodsThe pneumoconiosis deaths who died during 1959‒2019 in Chongming District of Shanghai were investigated and analyzed retrospectively by the descriptive epidemiological methods. The correlation of the age of onset and the course of disease was analyzed by Spearman rank correlation，as well as the duration of dust exposure and the course of disease in pneumoconiosis patients. ResultsFrom 1959 to 2019， there were 226 pneumoconiosis deaths， 223 males （98.67%）. The mortality of silicosis was the highest （82.07%）. The age of onset of pneumoconiosis was negatively correlated with the course of disease （r_s=-0.596，P<0.001）.There was no correlation between the duration of dust exposure and the course of disease in pneumoconiosis patients （r_s=-0.107，P=0.109）.There were statistically significant differences in mortality among groups in different types and stages of pneumoconiosis（χ²=59.250，27.666，both P<0.05）. The mortality increased with the increase of stage of pneumoconiosis. The mortality of pneumoconiosis was significantly different in 1959‒1979， 1980‒1989， 1990‒1999， 2000‒2009 and 2010‒2019 （χ²=29.750， P<0.05）. The top three causes of death in pneumoconiosis cases were respiratory diseases， malignant tumor and cardiovascular and cerebrovascular diseases.ConclusionIt is suggested to further strengthen the health monitoring and management of pneumoconiosis patients，control lung and chronic respiratory diseases to delay the life expectancy and improve quality of life of pneumoconiosis patients.

OBJECTIVE： To analyze the application of antibiotics in 18 community health service centers in Shanghai Chongming district， and to further strengthen rational use of antibiotics. METHODS： By retrospective analysis， statistical analysis was made on the monitoring data of antibiotic use and 21 600 prescriptions reported by 18 community health service centers in Chongming district of Shanghai from Jan. 2016 to Dec. 2018 in respect of antibiotics use， top 5 antibiotics in the list of DDDs， prescription analysis， etc. RESULTS： From 2016 to 2018， the average annual total income of medical treatment， drugs and antibiotics of 18 community health service centers in Chongming district of Shanghai were 490 499 000 yuan， 427 231 500 yuan and 41 602 900 yuan respectively. Annual average incomes of outpatient and inpatient antibiotics were 35 435 700 and 6 262 100 yuan. Annual consumption amount of antibiotics were 2 129 627.71 and 70 829.51 DDD. The proportion of antibiotics was 9.76％. Annual antibiotics use density （AUD） was 29.41 DDD. Compound annual growth rate （CAGR） was negative for antibiotics ratio （－3.27％）， outpatient antibiotics consumption amount （－18.40％）， antibiotics consumption amount for outpatient per time      （－17.83％）， inpatient antibiotics consumption amourt （－1.25％） and AUD （－0.98％）. The dosage form of top 5 antibiotics in the list of DDDs within 3 years were oral preparation， among which cefuroxime， cefaclor， levofloxacin and cefpropene were all ranked in the top five in three years. In 21 600 prescriptions， average number of drug per prescriptions was 1.99， the average amount of prescription was 120 yuan， and the number of antibiotics types used accounted for 8.24％ of total drug types； 15.43％ of the prescriptions used antibiotics， the average amount of the prescriptions containing antibiotics was 114.46 yuan， and the total amount of antibiotics accounted for 8.24％ of the total amount of the prescriptions. CONCLUSIONS： The rational use of antibiotics in Chongming community health service center has been continuously improved， and can provide reference for drug management of primary hospitals.

Objective To analyze the the incidence of sedation-related adverse events occurring during percutaneous microwave ablation(PMWA)under deep sedation,and to identify the risk factors for hypoxemia,hypertension and body movement response.Methods The clinical data of 506 patients with liver cancer,who received PMWA under deep sedation at the First Affiliated Hospital of Nanjing Medical University of China between December 2018 and December 2022,were retrospectively analyzed.The sedation-related adverse events including hypoxemia,hypertension and body movement response were recorded.Univariate analysis and multivariate logistic regression analysis were used to assess the risk factors for hypoxemia,hypertension and body movement response.Results After excluding 20 patients whose clinical data were incomplete,the final study sample consisted of 486 patients.After deep sedation,hypotension occurred in 5 patients(1％),and the incidences of hypoxemia,hypertension and body movement response were 13.8％,13.2％and 25.5％respectively.No patient required urgent endotracheal intubation and no cardiovascular complications occurred.The body movement response did not increase the complications of PMWA.Multivariate analysis revealed that age ≥65 years(OR=1.034,P=0.033),BMI＞30 kg/m2(OR=1.865,P=0.039),and Child-Pugh grade B/C(OR=1.113,P=0.046)were the risk factors for hypoxemia.The ablation zone contacting the parietal peritoneum(OR=2.536,P＜0.01),ablation zone contacting the diaphragm(OR=1.795,P=0.001),and ablation zone contacting the adrenal gland(OR=1.581,P＜0.01)were the risk factors for hypertension.The ablation zone contacted the parietal peritoneum(OR=2.831,P＜0.01)and ablation zone contacted the diaphragm(OR=2.213,P=0.026)were the risk factors for body movement response.Conclusion For the treatment of liver cancer,PMWA under deep sedation is clinically safe and effective.The age ≥ 65 years,BMI＞30kg/m2,and Child-Pugh grade B/C are the risk factors for hypoxemia.The ablation zone contacting the parietal peritoneum,the diaphragm or the adrenal gland are the risk factors for hypertension.The ablation zone contacting the parietal peritoneum or the diaphragm are the risk factors for body movement response.(J Intervent Radiol,2023,32:1202-1206)

Objective To investigate the clinical significance and level changes of uric acid(UA)/albumin(ALB)ratio(UAR)in patients with chronic kidney disease(CKD)complicated with coronary heart disease(CHD).Methods A total of 175 patients with CKD were divided into the simple CKD group(control group,n=94)and the CKD complicated with CHD group(experimental group,n=81).The differences of blood routine,blood lipid,renal function and UAR were compared between the two groups.The influencing factors of CKD complicated with CHD were analyzed by binary Logistic regression.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of each index for CKD complicated with CHD.Results There were no significant differences in white blood cell count(WBC),monocytes(Mon),total cholesterol(TC),total triglyceride(TG),high-density lipoprotein(HDL-C)and low-density lipoprotein(LDL-C)between the two groups.The levels of neutrophils(Neu),red cell distribution width variation coefficient(RDW-CV),blood urea nitrogen(BUN),creatinine(Cr),UA and UAR levels were higher in the experimental group than those in the control group(R＜0.05).The levels of lymphocyte(Lym),red blood cell count(RBC),mean corpuscular hemoglobin concentration(MCHC),platelet(PLT),estimated glomerular filtration rate(eGFR)and albumin(Alb)were lower in the experimental group than those in the control group(R＜0.05).Logistic regression analysis showed that lower levels of RBC and MCHC,and higher levels of UAR were independent risk factors for CKD complicated with CHD.ROC curve showed that the area under the UAR curve was the largest in RBC,MCHC and UAR detection,which was 0.912(95%CI:0.870-0.953),the sensitivity was 90.10%,the specificity was 77.70%,the Yoden index was 0.678 and the cutoff value was 10.935.The AUC of combined detection of RBC,MCHC and UAR was 0.987(95%CI:0.974-0.999),the sensitivity was 93.80%and the specificity was 97.90%.Conclusion The increased serum UAR level in patients with CKD is a predictor of CHD.The combined detection of UAR,RBC and MCHC has higher prediction efficiency.

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 investigate the status, characteristics of population distribution and trends of chronic obstructive pulmonary disease (COPD) deaths among the registered residents in Chongming District, Shanghai from 2002 to 2022, and to provide a scientific basis for precise prevention and control of COPD. MethodsCOPD death data were obtained from the Shanghai Chongming District Death Surveillance System, and indicators such as crude mortality rate, standardized mortality rate, mortality rate by age group, and probability of premature death were calculated for the registered residents with COPD. Joinpoint 5.0.2 software was adopted to analyze the annual percent change (APC) and average annual percent change (AAPC), followed by an analysis of trend changes. ResultsFrom 2002 to 2022, the average annual crude mortality rate and average annual standardized mortality rate of COPD among the residents of Chongming District were 73.49/100 000 and 34.00/100 000, respectively, and both were higher in males than those in females. The crude mortality rate of COPD among the residents aged ≤69 years in Chongming District was 6.78/100 000, followed by 218.28/100 000 in the age group of ≥70 years and 1 042.77/100 000 in the age group of ≥80 years, respectively. The standardized mortality rates for the whole population (AAPC=-9.75%), males (AAPC=-9.06%) , and females (AAPC=-12.25%) all showed a downward trend (all P<0.001). In addition, there was a decreasing trend in the crude mortality rates for the residents aged ≤69 years (AAPC=-7.51%), aged ≥70 years (AAPC=-9.89%), and aged ≥80 years (AAPC=-8.85%) (all P<0.001). Furthermore, the probability of premature death of COPD decreased from 1.45% in 2002 to 0.08% in 2022. ConclusionThe mortality rate and probability of early premature death of COPD among the registered residents in Chongming District, Shanghai from 2002 to 2022 show a downward trend, and the mortality rate of declining in males is slower than that in females. The elderly with advanced age account for the highest number of deaths. Therefore, targeted intervention measures should be taken for key groups to reduce the mortality rate of COPD.

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.