Objective: To assess the effects of Socioeconomic status on the dietary quality of children and adolescents, and to provide the reference for improving primary students’ dietary quality. Methods: A total of 2 496 students from 16 schools (4 urban primary schools, 4 rural primary schools, 4 urban middle schools, and 4 rural middle schools) in Fangshan District, Beijing, were included using a stratified cluster random sampling method. Information on 7-day intake of cereals, vegetables, fruits, meat and dairy was collected using questionnaires and dietary quality was graded according to the Dietary Guidelines for Chinese Residents (2016). Results: The dietary quality for urban children and adolescents was better than that for rural ones. Compared with rural children, their urban peers had higher scores for intake of vegetables, fruits, and dairy (all were P<0.01), but lower scores for intake of meat (P=0.01). For children with parental education level of senior high school, the dietary scores were higher in urban areas (P<0.05), whereas no urban-rural disparity was found for children with higher educated parents (junior college or above, P=0.17). In children with monthly household income less than 5 000 yuan, the urban dietary scores were higher than that of rural areas (P<0.01), whereas in the group above 5 000 yuan, the difference between urban and rural areas was no longer statistically significant(P>0.05). The multi-factor analysis showed that living in urban areas, being girls, being younger, with higher educated parents and with higher monthly household income were protective factors for dietary quality. However, the effect of household income on dietary quality differed between urban and rural areas (P<0.05). Conclusion In the process of dietary guidance and intervention, children with relatively low socio-economic level should be given a priority to provide appropriate nutrition education and welfare policies.

Hemostatic materials are essential for the treatment of trauma patients with massive blood loss in battlefields and disaster environments. According to the site and severity of trauma, different types of hemostatic materials need to be used to stop bleeding urgently. At present, first-aid hemostatic materials for bleeding on body surface wounds, extremities and junctions have been well applied. However, in the case of deep bleeding wounds in the thoracic and abdominal cavity and internal organs and even non-compressible hemostasis, there are still no ideal hemostatic materials in early emergency treatment. In this review, the authors elaborate the classification and mechanism of hemostatic materials and their application in trauma first aid, so as to provide references for the use of hemostatic materials in first aid.

Objective: To analyze and compare the changes of cardiac structure and function in patients with borderline pulmonary hypertension. Methods: Echocardiographic data of 617 outpatients from February to October 2018 in Peking University People′s Hospital were retrospectively analyzed. According to the estimated mean pulmonary artery pressure (mPAP), the patients were divided into normal group (mPAP<19 mmHg), borderline group (19 mmHg≤mPAP<25 mmHg) and elevated group (mPAP≥25 mmHg). Results: ①Compared with normal group，the patients were older in borderline group and elevated group[(39.2±10.1)years old vs (46.5±13.5)years old vs (51.8±14.2)years old，all P<0.001] and the proportions of male were relatively lower (69.9% vs 58.9% vs 54.4%，all P<0.01). The incidences of smoking，drinking and cardiovascular complications increased significantly. ②Compared with normal group，the left atrium[(30.2±8.2)ml/m² vs (34.5±9.7)ml/m²，P<0.001]，left ventricle[(57.4±11.6)ml/m² vs (60.6±12.5)ml/m²，P<0.01]and right atrium[(19.5±5.9)ml/m² vs (22.6±7.0)ml/m²，P<0.001] were enlarged in borderline group.Left ventricular global long-axis strain (GLS_LV) increased[(-20.1±2.5)% vs (-21.1±3.1)%，P<0.001]，but the long-axis strain in the middle segment of right ventricular free wall (GLS_RVFWmid) decreased[(-31.4±6.6)%对(-27.2±8.8)%，P<0.001] in borderline group.Meanwhile，left ventricular diastolic function was impaired. ③Age，sex，right atrial volume，right ventricular area，RV-S′，GLS_LV，GLS_RVFWmid and mitral valve E/e′ were independent risk factors for mPAP elevation. Conclusions Early changes of cardiac structure and function exist in the patients with borderline pulmonary hypertension. Echocardiography is critical for the early diagnosis and follow-up monitoring of pulmonary hypertension.

Objective To analyze and compare the classification of left atrial size by different echocardiographic measurements based on the latest large sample of normal Chinese adults'echocardiographic data . Methods The echocardiography data of 1067 unselected adult outpatients were retrospectively analyzed . The outpatients were divided into normal or enlarged groups according to the left atrialantero-posteriordiameter(LAD)andleftatrialvolume(LAV),respectively.Results ①LADand LAV enlargement were found in 299 (28 .0％ ) patients and 449 (42 .1％ ) patients of the total population , respectively . ②There was a good positive linear correlation between LAD and LAV ( r = 0 .642 , P =0 .000) ,but the agreement for the classification of left atrial size by LAD and LAV was not ideal ( Kappa =0 .392 , P = 0 .000) . The majority of the patients ( 74 .6％ ) with abnormal LAD had abnormal LAV . Conversely ,among the patients with abnormal LAV ( 50 .3％ ) had normal LAD . ③ The sensitivity and specificity of judging left atrial enlargement were 76 .8％ and 66 .8％ for LAD>3 .7 cm in male ,and 74 .9％and 70 .6％ for LAD>3 .4 cm in female ,respectively . The sensitivity and specificity of judging severely left atrial enlargement were 75 .5％ and 78 .7％ for LAD>4 .0 cm in male ,and 84 .2％ and 75 .8％ for LAD>3 .7 cm in female ,respectively . Conclusions The agreement of the classification of left atrial size by LAD and LAV is limited . LAD-based assessment may result in an underestimation of left atrial size . When LAD is larger than 4 .0 cm for male or 3 .7 cm for female ,the accuracy of LAD in the diagnosis of left atrial enlargement is better .

Objective:To evaluate the efficacy of holographic image technology in robot-assisted laparoscopic radical prostatectomy (RARP).Methods:The clinical data of 34 patients with prostate cancer who underwent RARP in our hospital during October 2020 and December 2020 was analyzed retrospectively. The average age of the patients was 67.8 (52-78) years. The mean BMI was 25.8 (18.0-32.3) kg/m 2. The median level of PSA before surgery was 13.4 (2-149) ng/ml. Median prostate volume was 31.7 (9.5-159.1) ml. EAU risk groups for biochemical recurrence of localised and locally advanced prostate cancer were list as below: 5 cases of low-risk, 7 cases of medium-risk, 22 cases of high-risk. There were 9, 16, 9 cases with the ASA score of 1, 2, 3 point, respectively. Preoperative Gleason score of 34 patients were list as below: 9 cases in score ≤6 group, 15 cases in score=7 group, 10 cases in score ≥8 group. For clinical stage before the surgery, 13 cases ≤T 2a stage, 1 case in T 2b stage, 20 cases ≥T 2c stage. The engineers established holographic images of 34 patients based on multiparametric magnetic resonance imaging (mpMRI) and the reports before the operation. Surgeons can obtain the size and location of tumors, surrounding neurovascular bundles visually by revolving, assembling, disassembling and concealing images, which was helpful for pre-surgery planning. By manipulating the holographic images extracorporeally, surgeons can discriminate Internal sphincter of urinary bladder and vesicoprostatic muscle, neurovascular bundles, membranous part, seminal vesicle easily, which improves the operation accuracy. Results:All 34 cases underwent operation successfully without transferring to open surgery. The median operative time was 157.5 (95-276) min with an estimated blood loss of 50 (20-300) ml. The median drainage removal time was 2 d and median hospitalization time was 3.5 d, respectively. The catheters were removed within an average time of 20.5 d. For postoperative Gleason score, there were 2 cases in score ≤6 group, 16 cases in score =7 group, 8 cases in score ≥8 group and 8 cases can’t make a score. For clinical stage after the surgery, 10 cases were ≤T 2a stage, 1 case was T 2b stage, 23 cases were ≥cT 2c stage. 22 cases underwent pelvic lymph node dissection, including a patient with right iliac fossa lymph node metastasis. There were 2 cases with positive surgical margin and 3 cases with Clavien-DindoⅠcomplications. The rate of 1-month and 3-month urinary continence were 47.1% and79.4%, respectively, 8 cases recovered erectile function after 3 month. Conclusions:Holographic image technology can promote cancer dissection completely, achieve urinary continence early and reduce perioperative complications tremendously. The technology is the "intraoperative security" for the accurate surgical treatment of prostate cancer.

The heparin polysaccharide nanoparticles block the interaction between heparan sulfate/S protein and inhibit the infection of both wild-type SARS-CoV-2 pseudovirus and the mutated strains through pulmonary delivery.Image 1.

BACKGROUND: The presence of fibrosis is a criterion for subtype classification in the newly updated hypersensitivity pneumonitis (HP) guidelines. The present study aimed to summarize differences in clinical characteristics and prognosis of non-fibrotic hypersensitivity pneumonitis (NFHP) and fibrotic hypersensitivity pneumonitis (FHP) and explore factors associated with the presence of fibrosis. METHODS: In this prospective cohort study, patients diagnosed with HP through a multidisciplinary discussion were enrolled. Collected data included demographic and clinical characteristics, laboratory findings, and radiologic and histopathological features. Logistic regression analyses were performed to explore factors related to the presence of fibrosis. RESULTS: A total of 202 patients with HP were enrolled, including 87 (43.1%) NFHP patients and 115 (56.9%) FHP patients. Patients with FHP were older and more frequently presented with dyspnea, crackles, and digital clubbing than patients with NFHP. Serum levels of carcinoembryonic antigen, carbohydrate antigen 125, carbohydrate antigen 153, gastrin-releasing peptide precursor, squamous cell carcinoma antigen, and antigen cytokeratin 21-1, and count of bronchoalveolar lavage (BAL) eosinophils were higher in the FHP group than in the NFHP group. BAL lymphocytosis was present in both groups, but less pronounced in the FHP group. Multivariable regression analyses revealed that older age, <20% of lymphocyte in BAL, and ≥1.75% of eosinophil in BAL were risk factors for the development of FHP. Twelve patients developed adverse outcomes, with a median survival time of 12.5 months, all of whom had FHP. CONCLUSIONS Older age, <20% of lymphocyte in BAL, and ≥1.75% of eosinophil in BAL were risk factors associated with the development of FHP. Prognosis of patients with NFHP was better than that of patients with FHP. These results may provide insights into the mechanisms of fibrosis in HP.
Humans ; Bronchoalveolar Lavage Fluid ; Prospective Studies ; Alveolitis, Extrinsic Allergic/diagnosis* ; Fibrosis ; Carbohydrates