ObjectiveTo evaluate the pharmacological effect of Buzhong Yiqitang on brain development in offspring of rats with subclinical hypothyroidism （SCH） during pregnancy and explore its potential mechanism. MethodsForty-eight SPF female SD rats were divided into sham operation group （n=8） and model group （n=40）. The rat model of subclinical hypothyroidism （SCH） was constructed by total thyroidectomy combined with postoperative subcutaneous injection of levothyroxine （L-T₄）. The modeled rats were randomly allocated into model， low-， medium-， and high-dose （5.58， 11.16， 22.32 g∙kg^-1， respectively） Buzhong Yiqitang， and euthyrox （4.5×10^-6 g∙kg^-1） groups， with 8 rats in each group. These rats were co-housed with normal male rats for mating. Drug administration started 2 weeks before pregnancy and continued until delivery. Hematoxylin-eosin staining and Golgi-cox staining were used to observe pathological changes in the hippocampal tissue of offspring rats. Western blot was employed to detect the effects of Buzhong Yiqitang on the protein levels of cytochrome C oxidase subunitⅠ （COX）Ⅰ and COXⅣ in the hippocampal tissue of offspring rats. A colorimetric method was used to measure the mitochondrial adenosine triphosphate （ATP） content in the hippocampal tissue of offspring rats. For in vitro experiments， a hydrogen peroxide （H₂O₂）-induced oxidative damage model was established with rat pheochromocytoma cells （PC12）. Interventions included the DNA methyltransferase inhibitor （SGI-1027）， Buzhong Yiqitang-medicated serum， and euthyrox-medicated serum. The cell counting kit-8 （CCK-8） assay was used to examine the effect of Buzhong Yiqitang on cell proliferation. Immunofluorescence staining was performed to evaluate the effect on tubulin beta 3 class Ⅲ （TUBB3） in PC12 cells. Western blot was employed to assess the effects on the protein levels of DNA methyltransferases （TETs and DNMTs） in PC12 cells. The fluorescent probe 2′，7′-dichlorodihydrofluorescein diacetate （DCFH-DA）， luciferase assay， and JC-1 staining were employed to assess the effects of Buzhong Yiqitang on the levels of reactive oxygen species （ROS） and ATP and the mitochondrial membrane potential in PC12 cells. ResultsCompared with the sham group， the model group showed a reduction in the number of hippocampal neurons， incomplete pyramidal cell bodies， loose arrangement， shortened average dendrite length， decreased dendritic complexity and dendritic spine density， and reduced expression levels of COXⅠ and COXⅣ and content of ATP in the brain tissue （P<0.05， P<0.01）. Compared with the model group， after administration of Buzhong Yiqitang and euthyrox， hippocampal neurons exhibited regular arrangement， complete morphology， extended dendrite， increased dendritic complexity and dendritic spine density， and restored expression levels of COXⅠ and COXⅣ and content of ATP （P<0.05， P<0.01）， with the medium-dose Buzhong Yiqitang group showing the best therapeutic effect. In the PC12 cell model of oxidative damage， Buzhong Yiqitang increased the cell viability （P<0.01）， enhanced neuronal differentiation， down-regulated the expression levels of DNMTs （P<0.05）， up-regulated the expression levels of TETs （P<0.05）， decreased the ROS content （P<0.01）， and restored the ATP content and mitochondrial membrane potential （P<0.01）. ConclusionBuzhong Yiqitang protects brain development in offspring of pregnant rats with SCH. It mainly acts on the oxidative stress and mitochondrial dysfunction resulted from abnormal mtDNA methylation， with DNMTs and TETs as the key proteins for its effects.

BACKGROUND: The mechanisms distinguishing metabolically healthy from unhealthy phenotypes within the same BMI categories remain unclear. This study aimed to investigate the associations between regional fat distribution and metabolically unhealthy phenotypes in Chinese adults across different BMI categories. METHODS: This cross-sectional study involving 11833 Chinese adults aged 20 years and older. Covariance analysis, adjusted for age, compared the percentage of regional fat (trunk, leg, or arm fat divided by whole-body fat) between metabolically healthy and unhealthy participants. Trends in regional fat percentage with the number of metabolic abnormalities were assessed by the Jonckheere-Terpstra test. Odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated by logistic regression models. All analyses were performed separately by sex. RESULTS: In non-obese individuals, metabolically unhealthy participants exhibited higher percent trunk fat and lower percent leg fat compared to healthy participants. Additionally, percent trunk fat increased and percent leg fat decreased with the number of metabolic abnormalities. After adjustment for demographic and lifestyle factors, as well as BMI, higher percent trunk fat was associated with increased odds of being metabolically unhealthy [highest vs. lowest quartile: ORs (95%CI) of 1.64 (1.35, 2.00) for men and 2.00 (1.63, 2.46) for women]. Conversely, compared with the lowest quartile, the ORs (95%CI) of metabolically unhealthy phenotype in the highest quartile for percent arm and leg fat were 0.64 (0.53, 0.78) and 0.60 (0.49, 0.74) for men, and 0.72 (0.56, 0.93) and 0.46 (0.36, 0.59) for women, respectively. Significant interactions between BMI and percentage of trunk and leg fat were observed in both sexes, with stronger associations found in individuals with normal weight and overweight. CONCLUSIONS Trunk fat is associated with a higher risk of metabolically unhealthy phenotype, while leg and arm fat are protective factors. Regional fat distribution assessments are crucial for identifying metabolically unhealthy phenotypes, particularly in non-obese individuals.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Adipose Tissue ; Body Fat Distribution ; Body Mass Index ; China/epidemiology* ; Cross-Sectional Studies ; Health Surveys ; Phenotype

Objective To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.

Objective To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.

Objective To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.

Objective To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.

Objective To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.

Objective To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.

Objective To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.

Objective To construct a quality evaluation index system for emergency triage and form a quality evalua-tion table for application,it provides a reference basis for the supervision of the quality of emergency triage.Methods Based on the Donabedian structural model and referring to the latest released relevant policies and stan-dards,a Delphi method were used to determine the quality evaluation indicators of emergency triage,as well as the scores and evaluation methods of each level of indicators.The convenience sampling method was applied to seven tertiary hospitals in Jiangsu Province to test the reliability and validity of the emergency triage quality evaluation scale and to analyze the application.Results The effective recovery rate of the two rounds of expert correspondence ques-tionnaires was 100％,and the expert authority coefficients were 0.869 and 0.927,respectively,and the resulting emergency triage quality evaluation index system included 3 first-level indexes,12 second-level indexes,and 43 third-level indexes.The Cronbach coefficient of the emergency triage quality evaluation table was 0.719,and the average score of emergency triage quality of the seven hospitals was 93.36 points,which was at a good level.Conclusions The constructed emergency triage quality evaluation index system has good expert recognition,specialty and good reliability and validity,and the contents included are reasonable and clear with feasibility.