Objective To investigate the techniques and influence factors for the respiratory navigator echo triggered whole-heart coronary MR angiography(WH-CMRA)and evaluate its application in visualizing coronary arteries and the image quality.Methods Ninety two volunteers were acquired with WH-CMRA at 3 T MR scanner using respiratory navigator-echo gated TFE sequence.Imaging quality was visually graded as 0—Ⅳ grade according to the visual inspection,average length,diameter and sharpness of coronary arteries.The correlation between the imaging quality and respiratory pattern,heart rate and navigator efficiency was analyzed.Results The imaging quality in 92 cases was that 28 were graded as Ⅳ, 53 were graded as Ⅲ,9 were graded as Ⅱ and 2 were graded as Ⅰ.The successful rate of scan was 88% (81/92).The imaging quality is mainly graded as Ⅳ when the heart rate was less than 75 beats per minute (bpm)and the sharpness of vessel was(48?11)%.When heart rate was more than 75 bpm,the image quality was mostly graded as Ⅲ and the sharpness was(33?15)%.The correlation between heart rate and imaging quality score was negative(r=-0.726,P0.05).Conclusion 3 T WH-CMRA technique could facilitated the visualization of whole coronary arteries at free breathing but having indications on heart rate.

OBJECTIVETo explore the growth patterns and simple mathematic models of height and weight of Chinese children.

METHODSThe original data had been obtained from two national representative cross-sectional surveys which were 2005 National Survey of Physical Development of Children (under 7 years of age) and 2005 Chinese National Survey on Students Constitution and Health (6 - 18 years). Reference curves of height and weight of children under 7 years of age was constructed by LMS method, and data of children from 6 to 18 years of age were smoothed by cubic spline function and transformed by modified LMS procedure. Growth velocity was calculated by smoothed values of height and weight. Simple linear model was fitted for children 1 to 10 years of age, for which smoothed height and weight values were used.

RESULTS(1) Birth length of Chinese children was about 50 cm, average length 61 cm, 67 cm, 76 cm and 88 cm at the 3rd, 6th, 12th and 24th month. Height gain was stable from 2 to 10 years of age, average 6 - 7 cm each year. Birth length doubles by 3.5 years, and triples by 12 years. The formula estimating average height of normal children aged 2 - 10 years was, height (cm) = age (yr) x 6.5 + 76 (cm). (2) Birth weight was about 3.3 kg. Growth velocity was at peak about 1.0 - 1.1 kg/mon in the first 3 months, decreased by half and was about 0.5 - 0.6 kg/mon in the second 3 months, and was reduced by a quarter, which was about 0.25 - 0.30 kg/mon, in the last 6 months of the first year. Body mass was up to doubles, triples and quadruple of birth weight at about the 3rd, 12th and 24th month. Average annual gain was about 2 kg and 3 kg from 1 - 6 years and 7 - 10 years, respectively. The estimated formula for children 1 to 6 years of age was weight (kg) = age (yr) x 2 + 8 (kg), but for those 7 - 10 years old, weight (kg) = age (yr) x 3 + 2 (kg).

CONCLUSIONSGrowth patterns of height and weight at the different age stages were summarized for Chinese children, and simple reference data of height and weight velocity from 0 to 18 years and approximate estimation formula from 1 - 10 years was presented for clinical practice.

Adolescent ; Asian Continental Ancestry Group ; Birth Weight ; Body Height ; Body Mass Index ; Body Weight ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Models, Statistical ; Reference Values

Objective To study the body cut-offs of mass index (BMI) for the purpose of screening overweight and obesity for Chinese children and adolescents aged 2-18 years. Methods Based on the BMI growth reference values for Chinese children aged 0-18, using the common methods to establish the BMI cut-offs for screening overweight and obesity. These methods were having the same empirical percentile or Z scores and the BMI value at 18 years consistent with adults.Three sets of BMI cut-offs, including (BMI24, BMI28) , (P85, P95) and (Z1, Z2) , were initially identified. Differences were compared on different cut-off points and prevalence rates of overweight and obesity with different BMI reference, different values and "prevalence" of overweight and obesity based on "2004 Beijing Child and Adolescent Metabolic Syndrome Study ". Cut-offs standards which recommended by the Chinese Working Group on Obesity for Children (WGOC) and by the International Obesity Task Force (IOTF) were also used. Finally the appropriate cut-offs were defined. Results Three sets of BMI cut-offs for screening overweight and obesity for Chinese children and adolescents aged 2-18 years were obtained according to the above mentioned methods for selection. The prevalence rates of overweight and obesity defined by those cut-offs appeared not to be significantly different. Compared with the WGOC, the BMI cut-off points for screening overweight and obesity for both boys and girls from our study were very close to the WGOC', but cut-off points for screening overweight for girls aged 8.5-15.5 y was 0.3-1.0 kg/m2 lower than the WGOC'. Going through the database on screening of "2004 Beijing Children's Metabolic Syndrome Survey ", the prevalence of overweight for girls was about 3.4% higher than using the cut-offs of WGOC. Conclusion Results from this study suggested that the BMI cut-offs passed through the cut-off point of BMI24 and BMI28 at 18 years was appropriate for screening overweight and obesity in Chinese children from 2 to 18 years, and achieved the continuity in age and consistency in screening standard when using the BMI indicator in children and adolescents.

Objective To study the feasibility and clinical values of diffusion tensor tractography (DTT)in the spinal cord at 3.0 T MR.Methods Forty patients with spinal cord compression including cervical cord herniation and cervical spondylosis(30 cases),tumors in spinal canal(9 cases)and old injury in cervical vertebrae(1 cases)and 20 healthy volunteers participated in this study.Single-shot spin- echo echo-planar diffusion tensor sequence for tractography of the spinal cord was performed.The fibers of spinal cord were visualized by using fiber tracking software.Results On the DTT maps,the normal spinal cord was depicted as a fiber tract showing color-encoded cephaloeaudally,which indicated anisotropy in the cephalocaudal direction.By setting two ROI,the main spinal cord fiber tracts,such as corticospinal or spinothalamic tract,were visualized.The tracts from two sides of the brain did not completely cross.It was asymmetric in the number of tracts on the two sides in most normal subjects(8/10).The tracts of all patients with cord compression were seen oppressed or damaged in different degrees.The DrrT in patients with cervical spondylosis and extramedullary-intradural neurolemmoma demonstrated that tracts were oppressed but not damaged.The DTT in one ependymoma showed that tract was markedly compressed and slightly damaged.Conclusion DTT is a promising tool for demonstrating the spinal cord tracts and abnormalities,can provide useful information for the localization of compression and evaluation of the impairment extent on the white matter tracts of the spinal cord.

OBJECTIVETo construct the body mass index (BMI) reference data and curves for Chinese children and adolescents from birth to 18 years of age.

METHODSData from two national representative cross-sectional surveys which were The National Growth Survey of Children under 7 years in the Nine Cities of China in 2005 and The Physical Fitness and Health Surveillance of Chinese School Students in 2005. Height (length was measured for children under 3 years) and weight data of 93,702 urban healthy children from nine cities/provinces used to calculate the BMI. The LMS method was used to smooth the BMI, with estimates of L, M, and S parameters, values of percentile and Z-score curves which were required were calculated, and then standardized growth charts were generated. Adult cut-offs for overweight and obesity at 18 years was used to study the cut-offs for children 2 to 18 years of age.

RESULTSThe smoothed percentiles and Z-scores reference data and curves of BMI-for-age for boys and girls aged 0-18 years were made out respectively. BMI cut-off values for overweight and obesity for children from 2 to 18 years of age were also defined. At 18 years, the BMI values are equivalent to the overweight cut-off (> or =24 kg/m2) and obesity cut-off (> or =28 kg/m2) for Chinese adults. Comparison with the reference of the WHO and 2000 CDC for the United States, there were some difference among them, at the 97th percentile curve there was a big difference between Chinese and U. S. adolescents. On the whole, the China BMI curve for boys was higher than the new WHO curve and lower than 2000 CDC at 97 percentile curve, but the China BMI curve for girls was lowest among the three curves. There was also significant difference between China and Japan BMI values at 97 percentile curve.

CONCLUSIONBMI growth curves are very useful in child growth monitoring and nutritional surveillance, discovering overweight and obesity. The BMI growth charts are recommended for use in pediatric clinic and public health service.

Adolescent ; Body Height ; Body Mass Index ; Body Weight ; Body Weights and Measures ; standards ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Obesity ; epidemiology

OBJECTIVETo construct the height and weight growth charts for Chinese children and adolescents from birth to 18 years for both clinical and preventive health care uses.

METHODSData from two national representative cross-sectional surveys which were The National Growth Survey of Children under 7 years in the Nine Cities of China in 2005 and The Physical Fitness and Health Surveillance of Chinese School Students in 2005. The data from 94,302 urban healthy children were used to set up the database of length/height (length was measured for children under 3 years) and weight. The LMS method was used to smooth the growth curves, with estimates of L, M, and S parameters, values of percentile and Z-score curves which were required were calculated, and then generated standardized growth charts.

RESULTSThe 3rd, 10th, 25th, 50th, 75th, 90th, 97th smoothed percentiles curves and -3, -2, -1, 0, +1, +2, +3 Z-scores curves of weight-for-age, length/height-for-age for boys and girls aged 0-18 years were made out respectively. Comparison with the new WHO growth charts and 2000 CDC growth charts for the United States, the results showed that there was some big difference in weight and height among the three growth charts. For boys under 15 years of age and girls under 13 years of age, the China curves are slightly higher than WHO and CDC curves, but after those ages, the China curves fall behind and the difference became larger as age progresses. At the age of 18 years, the Chinese children are 3.5 cm shorter in boys and 2.5 cm shorter in girls as compared with the U. S. children. The difference in weights are very large for the school children, especially in girls. The weight of Chinese boys was 5.9 kg less than that of the U. S. boys at 18 years, and the difference was much bigger in girls, the weight of U.S. girls between 8 to 18 years was 4.1-20.5 kg more than that of Chinese girls at the same age range.

CONCLUSIONThe new growth charts of height and weight were based on national survey data and therefore are recommended as the China national growth standards for use in pediatric clinics and public health service. Application of the charts will promote child growth monitoring, discovering early growth disorder, and will be useful to diagnosis of diseases and assessment of therapeutic effects.

Adolescent ; Body Height ; Body Mass Index ; Body Weight ; Body Weights and Measures ; standards ; Child ; Child, Preschool ; China ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Reference Standards

Objective: To examine risk factors of simple obesity and their interaction in preschool children in China. Methods: A total of 63 292 preschool children aged 3-7 years selected by cluster random sampling in 9 cities of China, including Beijing, Harbin, Xi'an, Shanghai, Nanjing, Wuhan, Guangzhou, Fuzhou and Kunming, were investigated from June to November in 2016. Based on the BMI-for-age cut off points of overweight and obesity for Chinese children aged 2-18 years, a total of 1 522 obese children (1 006 boys and 516 girls) were screened. By population-based matched case-control design, a normal weight child was randomly selected to match with an obese child by sex, age (difference ≤6 months) and body height (difference ≤5 cm) from the survey area. Conditional logistic regression model was used to analyze association of risk factors with obesity and the interaction of risk factors. Results: ① Univariate conditional logistic regression model showed that 17 risk factors of simple obesity had statistical significance (P<0.001), including high birth weight, cesarean section, gestational diabetes, gestational hypertension, formula feeding in the first 6 months after birth, strong appetite, fast or slow eating speed, low intensity of outdoor activities, daily outdoor activity time <1 hour, daily screen viewing time < 1 hour or ≥2 hours, daily night sleep time <9 hours, mother overweight, father overweight, mother's low educational level, father's low educational level, non-nuclear family structure, and parents not being the primary caregivers of children. ②Multivariate conditional logistic regression model showed that 12 risk factors had statistical significance, including high birth weight (OR=1.83, 95%CI:1.29-2.61, P<0.001), cesarean section (OR=1.22, 95%CI:1.07-1.39, P=0.003), gestational diabetes (OR=4.57, 95%CI:2.13-9.79, P<0.001), mother's low educational level (OR=1.52, 95%CI:1.11-2.07, P=0.008), single parent family (OR=4.79, 95%CI:1.44-15.88, P=0.010), mother overweight (OR=2.58, 95%CI:1.93-3.46, P<0.001), father overweight (OR=2.40, 95%CI:1.86-3.10, P<0.001), strong appetite (OR=7.78, 95%CI:5.38-11.27, P<0.001), fast eating speed (OR=6.59, 95%CI:4.86-8.94, P<0.001), daily outdoor activity time <1 hour (OR=1.42, 95%CI: 1.09-1.85, P=0.009), daily night sleep time <9 hours (OR=1.59, 95%CI: 1.13-2.23, P=0.007), daily screen viewing time ≥2 hours (OR=1.69, 95%CI:1.27-2.24, P<0.001). ③ Interaction of the four groups of risk factors had statistical significance, including interaction between mother overweight and father overweight (OR=5.53, 95%CI: 3.76-8.13, P<0.001), interaction between strong appetite and fast eating speed (OR=54.48, 95%CI: 32.95-90.06, P<0.001), interaction between low intensity of outdoor activity and daily outdoor activity time <1 hour (OR=2.12, 95%CI: 1.29-3.48, P=0.002), interaction between daily night sleep time <9 hours and daily screen viewing time ≥2 hours (OR=2.83, 95%CI: 1.71-4.68, P<0.001). Conclusions: This study identified 12 risk factors of childhood obesity, including high birth weight, cesarean section, gestational diabetes, mother's low educational level, single parent family, mother overweight, father overweight, strong appetite, fast eating speed, daily short outdoor activity time, daily short night sleep time, daily long screen viewing time, and interaction of the four groups of risk factors had statistical significance, including strong interaction between mother overweight and father overweight, interaction between strong appetite and fast eating speed, interaction between low intensity of outdoor activity and daily short outdoor activity time, interaction between daily short night sleep time and daily long screen viewing time.
Adolescent ; Body Mass Index ; Cesarean Section ; Child ; Child, Preschool ; China/epidemiology* ; Cities/epidemiology* ; Female ; Humans ; Male ; Overweight/epidemiology* ; Pediatric Obesity/epidemiology* ; Pregnancy ; Prevalence ; Risk Factors

OBJECTIVETo evaluate the long-term results of combination treatment with Gamma Knife radiosurgery and stereotactic intracavitary brachytherapy for mixed cystic and solid craniopharyngiomas.

METHODSSixty-seven consecutive patients with mixed cystic and solid craniopharyngioma treated by Gamma Knife radiosurgery combined with stereotactic brachytherapy from October 1996 to December 2005 were selected for retrospective analysis. The inclusion criterion was the patients who survived for at least 5 years after combined treatment. There were 39 male and 28 female patients and the mean age was 31.5 years (ranged from 3 to 70 years). The clinical evaluations including neurological, neuro-ophthalmological, and neuro-endocrinological examinations, assessment of comprehensive quality of life and neuroimaging examinations were performed periodically. The actuarial survival rates and the mean survival time were calculated by using Kaplan-Meier product limit method. The rates were compared using the χ(2) test.

RESULTSFollow-up period varied from 60 to 168 months, with an average of 114 months. The tumor response rate gained from combination treatment with Gamma Knife radiosurgery and stereotactic intracavitary brachytherapy for predominantly solid and cystic craniopharyngiomas were 10/12 and 90.9% respectively, and 89.6% in all. Mean survival after combination treatment was (110 ± 9) months. The mean survival of patients with predominantly solid and cystic craniopharyngioma were (97 ± 12) months and (120 ± 14) months and the actuarial 10-year survival rates were 7/12 and 69.1%. There was no statistics difference in tumor response rate and 10-year survival rate between 2 groups of patients with predominantly solid and cystic craniopharyngioma. The actuarial 5-, 6-, 7-, 8-, 9- and 10-year survival rates were 90.5%, 85.7%, 83.3%, 76.4%, 69.4% and 60.0% respectively. The decreased visual acuity had improved in 68.3% at 6 months postoperatively and in 70.0% in long term results. Comprehensive quality of life in long term follow-up of 67 patients was excellent in 28 cases(41.8%), good in 19 cases(28.4%), fair in 17 cases(25.4%) and poor in 3 cases(4.5%), respectively. The side effects that occurred 6 to 12 months after treatment were worsening of visual acuity (4 patients), dysfunction of hypothalam (4 patients) and third nerve palsy was found in 1 patents 5 years after treatment. The rate of complications was 13.4%.

CONCLUSIONCombination treatment with Gamma Knife radiosurgery and stereotactic intracavitary brachytherapy is highly effective and safety in the treatment of mixed cystic and solid craniopharyngiomas.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Combined Modality Therapy ; Craniopharyngioma ; surgery ; Female ; Follow-Up Studies ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Pituitary Neoplasms ; surgery ; Radiosurgery ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the efficacy and safety of olmesartan medoxomil compared with losartan potassium in patients with mild to moderate essential hypertension.

METHODThis is a randomized, double-blind, double-dummy, active-controlled, parallel, multi-center study. After a 2-week placebo run-in period, a total of 287 eligible subjects were randomized at 1:1 ratio to receive olmesartan medoxomil 20 mg or losartan potassium 50 mg, once daily for 8 weeks. The blood pressure was assessed after 4 weeks treatment. If the subject's seating diastolic blood pressure (SeDBP) was still >or=90 mm Hg, the dosage was doubled for another 4 weeks; for those subjects whose SeDBP was <90 mm Hg after 4-week treatment, the initial dosage remained unchanged and the treatment continued until completion of the study.

RESULTS(1) The mean trough reduction in SeDBP from baseline in olmesartan group was significantly greater than that in losartan group after 4 weeks (11.72 mm Hg vs 9.23 mm Hg, P=0.004) and 8 weeks treatment (12.94 mm Hg vs 11.01 mm Hg, P=0.035). (2) The number and percentage of responders in olmesartan group (81, 65.3%) were statistically higher than those (68, 52.7%) in losartan group (P=0.028) after 4 weeks treatment and were similar between the two groups after 8 weeks treatment (P>0.05). (3) Individual and overall trough/peak ratios of DBP and SBP in 24-hour ambulatory blood pressure monitoring were higher in olmesartan group than losartan group. The hypotensive effect of olmesartan was more durable than losartan at 24 hour interval. (4) The incidence of study drug-related adverse events (AEs) in olmesartan group (10.5%) was similar as that in losartan group (13.9%, P>0.05). Most of these AEs were mild and transient.

CONCLUSIONThis study shows that olmesartan medoxomil, at oral dose of 20 mg-40 mg once daily was effective and safe for hypertension treatment and the hypotensive effect was superior to losartan potassium (50 mg-100 mg once daily).

Adolescent ; Adult ; Aged ; Antihypertensive Agents ; administration & dosage ; China ; Double-Blind Method ; Female ; Humans ; Hypertension ; drug therapy ; physiopathology ; Imidazoles ; adverse effects ; therapeutic use ; Losartan ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Olmesartan Medoxomil ; Tetrazoles ; adverse effects ; therapeutic use

This paper, taking the formulation of national drug standards for traditional Chinese medicine (TCM) dispensing granules as a case study, explores the improvement of the formation mechanism of national drug standards, and promotes the reform of streamline administration, delegate powers, and improve regulation and services of national standards management, so as to release the vitality of the research and development of standards of drug manufacturers. After nearly two decades of pilot production of TCM dispensing granules, a large number of researches and discussions have been conducted on the formulation of unified standards of TCM dispensing granules from manufacturing enterprises to national standard administration departments, it was found that this work was difficult on the basis of the original drug standard formation mechanism. The authors tried to improve and innovate the formation mechanism of national drug standards, to provide methods and ideas for the formulation and unification of national standards for TCM dispensing granules, and to provide references for the formulation of other national drug standards.