Kidney damage is common in patients with diabetes mellitus (DM).However,whether the type of kidney damage can be reliably diagnosed using clinical data alone remains unclear.Predictive factors for diabetic nephropathy (DN) outcomes are also poorly understood.In this study,the clinical manifestations of 111 cases of biopsy-proven DN were described,and the clinical and pathological parameters of patients with different DN outcomes were compared.Results showed that long DM duration (＞ 10 years in 32.4％ of patients),severe proteinuria (62.2％),and renal dysfunction (estimated glomerular filtration rate [eGFR] ＜ 60 mL/(min-1.73 m2)) (52.3％) did not accurately indicate whether the condition of these patients progressed to DN.Hematuria (48.6％) failed to specify either DN or nondiabetic renal disease.Diabetic retinopathy (78.4％) was a crucial complication in patients with DN.Kaplan-Meier analysis revealed that the renal survival of 53 patients who were diagnosed with DN and were followed up was not significantly associated with glomerular classification (P ＞ 0.05).Cox's regression analysis demonstrated that renal survival time was significantly influenced by sex (β=1.394,P =0.038),hematuria (β =0.036,P =0.029),and eGFR (β =-0.039,P =0.002) but was not significantly affected by age,24 h urinary protein excretion,or glomerular classification (P ＞ 0.05).In conclusion,the clinical characteristics of DN vary,and renal biopsy is necessary to determine renal damage patterns.Sex,hematuria,and the eGFR may affect DN outcomes,whereas the glomerular classification may not.

Objective:To explore the association of weight loss with diabetes remission after metabolic surgery in patients with type 2 diabetes mellitus(T2DM) for 10 years and more.Methods:Data of T2DM patients with obesity who underwent metabolic surgery in the General Surgery Department & Obesity and Metabolic Disease Center of China-Japan Friendship Hospital from November 2017 to June 2021 were retrospectively collected and analyzed. Remission of diabetes was defined as glycated hemoglobin (HbA1c) < 6.5% or fasting blood glucose < 7.0 mmol/L after discontinuing anti-diabetic medication for more than 3 months. The patients were followed up and divided into two groups according to whether the percentage total weight loss (%TWL) was ≥ 20% or not. The age, sex, body mass index (BMI), fasting C-peptide, and HBA1c were compared between the two groups.Results:Among 65 (28 males and 37 females) patients with T2DM for ≥ 10 years , 50 (76.9%) achieved diabetes remission after a median of 12-month follow-up. 6.2%, 41.5% , 38.5% and 13.8% of the patients achieved %TWL < 10%, 10~20%, 20~30% and ≥ 30% , respectively. The diabetes remission rates were 50%, 63.0%, 92.0% and 88.9%, respectively. Compared with the %TWL < 20% group, the preoperative weight [(95.5±18.8) kg vs (85.5±11.0) kg, P = 0.012] and BMI [(34.4±6.0) vs (30.9±3.3) , P = 0.006] were significantly higher in the %TWL ≥ 20% group, and diabetes remission rates was aslo significantly higher in the %TWL ≥ 20% group (91.2% vs 61.3%, P = 0.010) . After adjusting for age, preoperative BMI, fasting C-peptide and duration of T2DM, Cox multivariate regression analysis showed that %TWL ≥ 20% was independently associated with diabetic remission after metabolic surgery in patients with T2DM for ≥ 10 years (HR = 1.99, 95% CI: 1.03 to 3.83, P = 0.04). Conclusions:More than 70% of patients with T2DM for ≥ 10 years could achieve diabetes remission after metabolic surgery. %TWL ≥ 20% may be one independent factor of diabetes remission in patients with long-duration T2DM.

Objective:The purpose of this study is to use the next-generation sequencing (NGS) technology platform to detect the methylation rate of phosphatase and tensin homolog deleted on chromosome ten ( PTEN) promoter region in hepatocellular carcinoma (HCC) tissue samples, and to analyze the clinical significance of its correlation with the prognosis of patients receiving sorafenib treatment. Methods:The 52 pairs of tumor tissue and para-cancerous tissue samples from HCC patients treated with sorafenib alone, which were collected and preserved in the Liver Tumor Diagnosis and Research Center of the former 302 Hospital of the People′s Liberation Army by the National Natural Science Foundation of China Youth Project with the project batch number 81702986 in 2018, were extracted total DNA from the samples. Then the DNA samples were treated with bisulfite and specific primers were designed to amplify the PTEN promoter region. Finally, the amplified products were analyzed by second-generation sequencing. In the analysis of clinical significance of PTEN methylation, log-rank statistical analysis was used to calculate whether there was a statistical difference in survival between the patient groups. Results:The methylation rate of PTEN promoter region in tumor tissues (29.17%±9.58%) was significantly higher than that in paracancer tissues (4.17%±2.86%)( t=19.970, P<0.05). At the same time, in HCC tissues, the methylation rate of the PTEN promoter region is negatively correlated with its expression ( F=47.270, P<0.000 1; Y=-1 800× X+38.03), and the PTEN methylation rate is negatively correlated with the prognosis of patients receiving the molecularly targeted drug Sorafenib (χ2=4.313, P<0.05). Conclusion:This study successfully established a new method for detecting methylation in the promoter region of PTEN, and the methylation rate of PTEN can be used as one of the targets of HCC diagnosis and targeted therapy.

Objective:The purpose of this study is to use the next-generation sequencing (NGS) technology platform to detect the methylation rate of phosphatase and tensin homolog deleted on chromosome ten ( PTEN) promoter region in hepatocellular carcinoma (HCC) tissue samples, and to analyze the clinical significance of its correlation with the prognosis of patients receiving sorafenib treatment. Methods:The 52 pairs of tumor tissue and para-cancerous tissue samples from HCC patients treated with sorafenib alone, which were collected and preserved in the Liver Tumor Diagnosis and Research Center of the former 302 Hospital of the People′s Liberation Army by the National Natural Science Foundation of China Youth Project with the project batch number 81702986 in 2018, were extracted total DNA from the samples. Then the DNA samples were treated with bisulfite and specific primers were designed to amplify the PTEN promoter region. Finally, the amplified products were analyzed by second-generation sequencing. In the analysis of clinical significance of PTEN methylation, log-rank statistical analysis was used to calculate whether there was a statistical difference in survival between the patient groups. Results:The methylation rate of PTEN promoter region in tumor tissues (29.17%±9.58%) was significantly higher than that in paracancer tissues (4.17%±2.86%)( t=19.970, P<0.05). At the same time, in HCC tissues, the methylation rate of the PTEN promoter region is negatively correlated with its expression ( F=47.270, P<0.000 1; Y=-1 800× X+38.03), and the PTEN methylation rate is negatively correlated with the prognosis of patients receiving the molecularly targeted drug Sorafenib (χ2=4.313, P<0.05). Conclusion:This study successfully established a new method for detecting methylation in the promoter region of PTEN, and the methylation rate of PTEN can be used as one of the targets of HCC diagnosis and targeted therapy.

Objective:To investigate the postoperative changes in levels of 25-hydroxy vitamin D (25-[OH]D], parathyroid hormone (PTH) and other relevant biomarkers in obese patients receiving metabolic surgery and analyze the dynamic changes in relevant biomarkers in the short term (after 3-6 months) and the long term (after 12-24 months).Methods:A total of 96 obese patients who underwent metabolic surgery and received follow-up examinations from January 2018 to January 2020 were included. Baseline and postoperative data were collected, including anthropometric data (height, weight, neck circumference, waistline and hipline) and laboratory test results (fasting glucose, glycated hemoglobin, 25-[OH)D, PTH, serum calcium and serum phosphorus). Body mass index (BMI) and waist-hip ratio were calculated. The anthropometric data were analyzed by repeated measures analysis of variance and laboratory data were compared between groups using t test and Kruskal-Wallis test. Results:96 patients (33 males and 63 females) were included, of whom 49 were complicated with diabetes. Prior to surgery, 79 (79.17%) of the patients had 25-(OH)D deficiency (< 20 μg/L), 16 (16.67%) had 25-(OH)D insufficiency (≥ 20 μg/L and < 30 μg/L) and 23 (23.96%) had high PTH levels (> 70 ng/L). After the surgery, 25-(OH)D level was transiently increased in the short term ( P = 0.01) but declined thereafter in the long term ( P < 0.01) to levels lower than baseline ( P = 0.023). Long-term PTH level was higher than baseline ( P = 0.012), with 11 patients showing PTH levels higher than normal (> 70 ng/L). Serum phosphorus level was increased in both the short term and the long term ( P < 0.01). Conclusions:Obese patients have 25-(OH)D deficiency/insufficiency before metabolic surgery and experience further decrease in the long term after surgery, despite a transient increase. Secondary increase in PTH level occurs in some of the patients after surgery. Long-term nutritional supplements and comprehensive nutritional management play important roles in postoperative management of obese patient.

Objective: To establish the norm of the Physical Activity afterschool Questionnaire for Preschooler(P-PAQ) in urban areas of China, so as to provide a basis for graded guidance from the family perspective and to improve children s physical activity levels. Methods: From October 2020 to January 2021, 6 267 children aged 3-6 years old were recruited from 40 kindergartens in eight cities across six major administrative regions by stratified cluster sampling, and the P-PAQ initially developed by the researchers of this study were completed by the primary caregivers. The questionnaire was administered to collect data relating to the amount of physical activity undertaken by the preschoolers, and the norm was determined by quartiles. Data relating to parental concepts of sports and parental behavior were assessed by calculating mean scores in order to establish the norm. Results: Among preschoolers in urban areas, the M(P 25 ，P 75 ) of total physical activity time (min/day), moderate-to-vigorous physical activity time (min/day), outdoor time (min/day) and screen time (min/day) on school days outside kindergarten and on weekends were 84 (54,120), 22 (8,40), 12 (0,24) and 18 (6,30), and 170 (115,240), 60 (30,95), 90 (35,120) and 30 (20,60), respectively. When the score of parents sports concept and behavior (total score of 40) were≥34, 29-<34, 24-<29, <24, it was defined as four levels about above medium, medium, lower medium and lower, respectively. And for two dimensions，when the score of parental sports concept were ≥19, 17-<19, 15-<17, <15，and the score of parental behaviors were ≥16, 12-<16, 8-<12, <8, it was defined as four levels about upper medium, medium, lower medium and lower, respectively. Conclusion The norm of extracurricular activities among preschool children in Chinese cities has good representativeness and appropriate threshold values, which could provide a valuable reference for early assessment, as well as guidance in relation to out-of-school physical activity behaviors among children aged 3-6 years old.

OBJECTIVETo understand the infantile nocturnal sleep-wake pattern developmental trajectory with Actiwatch, which would benefit the clinical assessment of infantile sleep.

METHODThis study was a longitudinal study conducted between 7 Oct, 2009-30 Oct, 2011 in 10 hospitals of 9 cities of China ( Beijing, Xi'an, Qingdao, Wuhan, Changsha, Chongqing, Huzhou, Xiamen and Liuzhou). Actiwatch was used to track the sleep-wake pattern development trajectory of healthy infants in the first year of life in the home setting. Participating infants were followed up at 10th day and 28th day during the first month, and then monthly from the second to the sixth month after birth, and then at ninth and twelve months of age respectively. Meanwhile, infantile sleep was observed continuously for about 60 hours at each visit. According to the characteristics of repeated measurement data of this study, two-level random effect model was adopted to analyze the trend of infantile nocturnal sleep-wake parameters changing with age, and the gender difference.

RESULTA total of 473 healthy infants were included in this study, among whom 246 (52.0%) were boys, and 227 (48.0%) were girls; 355 (75.1%) infants completed the whole year follow-up survey. With infants' age increasing, the latency of infants' nighttime sleep onset decreased from 66.8 minutes on 10th day to 15.5-18.7 minutes at 6-12 months of age. The number of night wakes also decreased with age, while uninterrupted sleep periods lengthened with age. On the 10th day, there were 3.0 times of nightwaking on average, and the longest continuous sleeping interval lasted for 227.6 minutes on average. At 12-month of age, infants could sleep continuously for 350.9 minutes at most on average, while the number of nightwaking decreased to 1.6 times per night on average. Generally, nighttime sleep efficiency increased from 66.3% on the 10th day to 86.3% at 12-month of age. The differences of sleep-wake patterns between boys and girls presented as boys' nocturnal longest uninterrupted sleep period was 19 minutes shorter(266.6 vs. 285.6 min), and the average nighttime sleep efficiency was 2.2% lower (74.2% vs. 76.4%) compared with girls respectively. And the differences of sleep efficiency between boys and girls reduced gradually along with the growth.

CONCLUSIONDuring the first 6 months after birth, infantile sleep-wake pattern undergo obvious change. The capability of sleep-onset and uninterrupted sleep improved with age, and the sleep efficiency increased.

China ; Female ; Humans ; Infant ; Infant, Newborn ; Longitudinal Studies ; Male ; Sleep ; physiology ; Surveys and Questionnaires

Birth cohort is an important platform to study the effect of early-life exposure on health outcome, but large cohorts to investigate the effect of preconception exposure, especially paternal exposure, on reproductive health and birth outcome are limited. The Preconception Reproductive Health and Birth Outcome Cohort (PREBIC) is a prospective birth cohort study which pays equal attention to the contribution of environmental, psychological, behavioral as well as other factors to reproductive health and adverse birth outcomes in both men and women in Chongqing, China. PREBIC started in 2019 and plans to recruit 20 800 reproductive-age couples with child-bearing willingness. Followed up was conducted to understand the conception status of the women within two years. Women in pregnancy would be visited at first, second, third trimesters and after delivery. The offspring would be monitored until 2 years old to understand the incidences of preterm birth, low birth weight, birth defects, neurodevelopmental disorders and other outcomes. Related information and biospecimen collections (including semen, peripheral blood, urine, placenta, umbilical cord, cord blood and oral swab) were scheduled in each period. By January 2022, PREBIC had recruited 8 698 participants from all 38 districts in Chongqing. The goal of PREBIC is to establish one of the largest prospective preconception birth cohorts covering both men and women, which might provide a unique insight to understand the effects of the full reproductive cycle on reproductive health and adverse outcomes, with especial emphasis on preconception exposures.

Objective:To establish the norm of the Chinese version of Karitane Parenting Confidence Scale (KPCS) in urban areas of China.Methods:From August to December 2017, the parents of 2 216 children (<36 months old) were selected from 15 cities (Beijing, Lianyungang, Hangzhou, Chengdu, Xi′an, Guangzhou, Changsha, Jinan, Guiyang, Ningbo, Dalian, Qinhuangdao, Maanshan, Chongqing and Wuhan) in 14 provinces by stratified random sampling. The general demographic characteristics and parents′ parenting confidence were collected by a self-made questionnaire and KPCS Chinese version. The percentile norm was established. P 3, P10 and P 25 were used as the criteria to define the degree of lack of parenting confidence. Results:The age of mothers was (30.67±4.29). The age of the father was (32.50±4.99) years old. There were 726 (32.76%), 759 (34.25%) and 731 (32.99%) infants in 6-12, 12-23 and 24-35 months old groups. The total scores of P 50, P 25, P 10 and P 3 of KPCS (Chinese version) of infant parents in urban areas in China were 41, 38, 33, and 29 respectively. When the scores of parents were 34-37, 30-33, and ≤ 29, they were judged as mild, moderate, and severe lack of parenting confidence. There was no significant difference in the Chinese version of KPCS between parents of different age groups and parents of different gender (χ2=3.53, P=0.171; χ2=1.41, P=0.236). Each factor score≤ P 3 is defined as the boundary score, and the corresponding boundary scores of "parenting" "support" and "competence" were 13, 9, and 5 respectively. Conclusion:The Chinese version of KPCS can be used to assess the parenting confidence of infants in urban areas of China. It can used as one of the bases for scientific and objective evaluation of the parenting status of families.

Objective:To establish the norm of the Chinese version of Karitane Parenting Confidence Scale (KPCS) in urban areas of China.Methods:From August to December 2017, the parents of 2 216 children (<36 months old) were selected from 15 cities (Beijing, Lianyungang, Hangzhou, Chengdu, Xi′an, Guangzhou, Changsha, Jinan, Guiyang, Ningbo, Dalian, Qinhuangdao, Maanshan, Chongqing and Wuhan) in 14 provinces by stratified random sampling. The general demographic characteristics and parents′ parenting confidence were collected by a self-made questionnaire and KPCS Chinese version. The percentile norm was established. P 3, P10 and P 25 were used as the criteria to define the degree of lack of parenting confidence. Results:The age of mothers was (30.67±4.29). The age of the father was (32.50±4.99) years old. There were 726 (32.76%), 759 (34.25%) and 731 (32.99%) infants in 6-12, 12-23 and 24-35 months old groups. The total scores of P 50, P 25, P 10 and P 3 of KPCS (Chinese version) of infant parents in urban areas in China were 41, 38, 33, and 29 respectively. When the scores of parents were 34-37, 30-33, and ≤ 29, they were judged as mild, moderate, and severe lack of parenting confidence. There was no significant difference in the Chinese version of KPCS between parents of different age groups and parents of different gender (χ2=3.53, P=0.171; χ2=1.41, P=0.236). Each factor score≤ P 3 is defined as the boundary score, and the corresponding boundary scores of "parenting" "support" and "competence" were 13, 9, and 5 respectively. Conclusion:The Chinese version of KPCS can be used to assess the parenting confidence of infants in urban areas of China. It can used as one of the bases for scientific and objective evaluation of the parenting status of families.