Objective To describe the clinical and imaging manifestations of patients with synovitis acne pustulosis hyperostosis osteomyelitis (SAPHO) syndrome,and to analyze the diagnostic importance of different clinical and imaging manifestations for SAPHO syndrome. Methods Seventeen patients (7 males and 10 females) with SAPHO syndrome were recruited in this study.Age ranged from 36 to 67 years with a mean age of (48 ± 8) years. All patients fulfilled the diagnostic criteria of Benhamou. Serum HLA B27 antigen records were reviewed for all patients. Imaging data of the abnormal bone sites were collected by conventional radiograph in all patients,CT in 13 patients as well as MR in 3 patients.Average time to take for a definite diagnosis of the syndrome was 3.7 years (ranged from O.5 to 13 years).Results Serum HLA B27 antigen was positive in all patients. Both skin and bone abnornalities were found in all patients.Ten patients had skin palmoplantar pustulosis and two patients had acne. Involving sites of bone and joints include sacroiliac joints,anterior chest and limbs.Sacroiliac joints were asymmetrically involved with imaging features in all patients.Eight patients exhibited anterior chest wall involvement. Five patients had osteomyelitis at limbs. For all images of 17 patients,CT was superior to conventional radiography in detecting abnormal changes of bone erosion and soft tissue swelling.MR imaging was able to depict edema changes that was not detectable by CT and radiography.Conclusion SAPHO syndrome is a rare disease,but for patients with skin and bone-joint abnormalities,especially with skin palmoplantar pustulosis,acne as well as with imaging features at the sacroiliac joint and anterior chest wall,SAPHO syndrome should be taken into a diagnostic consideration.

Objective:To investigate the clinical efficacy of Huangqin decoction combined with western medicine in the treatment of pediatric ulcerative colitis. Methods:A total of 100 children with ulcerative colitis who received treatment at the Longyou People's Hospital from January 2020 to January 2022 were included in this case-control study. They were divided into a control group ( n = 50) and an observation group ( n = 50) according to different treatment methods. Children in the control group were treated with routine western medicine, while those in the observation group were treated with routine western medicine plus Huangqin decoction. Both groups of children were treated for 14 days. The two groups of children were compared in terms of traditional Chinese medicine syndrome score, clinical efficacy, inflammatory factor levels, intestinal mucosal improvement score, and incidence of adverse reactions. Results:After treatment, the level of decrease in traditional Chinese medicine syndrome score in the observation group was significantly greater than that in the control group ( P < 0.05). The total response rate in the observation group was 98% (49/50), which was significantly higher than that in the control group [82% (41/50), χ2 = 7.11, P < 0.05]. The levels of tumor necrosis factor α, interleukin-6, and C-reactive protein in the observation group were (12.83 ± 4.53) ng/L, (8.55 ± 1.44) ng/L, and (6.35 ± 0.99) mg/L, respectively, which were significantly lower than those in the control group [(24.41 ± 5.38) ng/L, (13.14 ± 1.51) ng/L, (10.03 ± 1.05) mg/L, t = 13.21, 7.52, 5.15, all P < 0.05]. The improvement scores for ulcer, congestion, erosion, and edema in the observation group were (1.43 ± 0.20) points, (1.24 ± 0.27) points, (1.36 ± 0.34) points, and (1.02 ± 0.21) points, respectively, which were significantly better than those in the control group [(2.48 ± 0.52) points, (2.19 ± 0.37) points, (2.45 ± 0.32) points, and (2.35 ± 0.40) points, t = 5.12, 4.52, 3.73, 4.84, all P < 0.05]. The incidence of adverse reactions in the observation group was 4% (2/50), which was significantly lower than that in the control group [18% (9/50), χ2 = 5.01, P < 0.05]. Conclusion:The combination of Huangqin decoction and western medicine for the treatment of pediatric ulcerative colitis can effectively decrease traditional Chinese medicine symptom score and intestinal mucosal score, with a low incidence of adverse reactions, good clinical effect, and high safety.

Objective:To investigate the clinical efficacy of Danggui Shaoyao powder combined with folic acid tablets in the treatment of chronic atrophic gastritis. Methods:A total of 90 patients with chronic atrophic gastritis who were treated at Longyou Branch, Sir Run Run Shaw Hospital, Zhejiang University from March 2021 to March 2022 were included in this study. They were randomly divided into a control group and an experimental group, with 45 patients per group. The control group was treated with folic acid tablets, while the experimental group was treated with Danggui Shaoyao powder combined with folic acid tablets. Before and after treatment, traditional Chinese medicine syndrome scores, gastroscopy and pathology scores, and inflammatory factor levels were compared between the two groups. Clinical efficacy was compared between the two groups. Results:The amplitudes of decreases in traditional Chinese medicine syndrome score in the experimental group [acid reflux (0.57 ± 0.19) points and epigastric pain (0.84 ± 1.36) points] were significantly greater than those in the control group [acid reflux (1.46 ± 0.39) points, epigastric pain (1.52 ± 1.41) points, t = 4.86, 6.52, both P < 0.05]. Inflammatory factor levels in the experimental group [tumor necrosis factor-α (1.03 ± 0.11) μg/L, interleukin-6 (8.15 ± 1.42) ng/L, C-reactive protein (6.55 ± 0.98) mg/L] were significantly lower than those in the control group [tumor necrosis factor-α (1.73 ± 0.14) μg/L, interleukin-6 (12.24 ± 1.48) ng/L, C-reactive protein (10.23 ± 1.03) mg/L, t = 4.52, 7.66, 6.95, all P < 0.05]. The gastroscopy and pathological scores in the experimental group [intestinal metaplasia (0.78 ± 0.35) points, dysplasia (0.30 ± 0.10) points] were significantly lower than those in the control group [intestinal metaplasia (1.31 ± 0.38) points, dysplasia (0.68 ± 0.12) points, t = 4.13, 3.85, both P < 0.05]. The overall response rate in the experimental group was 93.33% (42/45), which was significantly higher than 77.78% (35/45) in the control group ( χ2 = 4.40, P < 0.05). Conclusion:Danggui Shaoyao powder combined with folic acid tablets in the treatment of chronic atrophic gastritis can effectively improve traditional Chinese medicine syndromes, reduce the level of inflammatory factors, and have a good clinical effect.

Objective:To estimate physical activity level in residents in Suzhou and explore the association between community environment and physical activity level in local residents.Methods:Through multistage stratified random sampling, residents aged 25-64 years in Suzhou were surveyed by face-to face interview in 2017. Physical activity levels were assessed by the international physical activity questionnaire-long version (IPAQ-L). Perceptions of community environment were assessed by Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A).Results:Among the local residents surveyed in Suzhou,the median of weekly total physical activity level was 3 610.42 MET-min/w. The level of occupational physical activity was higher than that of transportation, household and leisure-time related physical activity levels. After controlling for socio-demographic factors, public service access was negatively associated with the overall physical activity level ( OR=0.522,95% CI:0.329-0.830), land-use mix-diversity was negatively associated with the level of occupational physical activity level ( OR=0.701,95% CI: 0.492-0.999), infrastructure of walk and cycle ways was positively associated with occupational physical activity level ( OR=1.603,95% CI:1.004-2.559); traffic hazards were negatively associated with the transportation physical activity level ( OR=0.642,95% CI: 0.416-0.990); residential building density was positively associated with leisure-time physical activity level ( OR=1.001,95% CI: 1.000-1.002), and the perceptions level of community environment were positively associated with the occupational, transportation, household and overall physical activity levels ( OR=1.889,95% CI: 1.176-3.033; OR=1.671,95% CI: 1.120-2.495; OR=1.775,95% CI: 1.143-2.756; OR=1.593,95% CI: 1.079-2.350). Conclusion:Improving infrastructure of walk and cycle ways and beautifying community environment play an important role in increasing the physical activity level of the residents.

Objective:To explore the associations between perceived built environment attributes and adults’ leisure-time physical activity in four cities of China.Methods:Multistage cluster random sampling method was used to select adults aged 25 to 64 in Hangzhou, Suzhou, Chengdu, and Qingdao. Data were collected from June 2017 to July 2018. The perception of the urban built environment was assessed by the neighborhood environment walkability scale-abbreviated (NEWS-A), and the physical activity was assessed by the International Physical Activity Questionnaire. Generalized linear mixed models were used to explore the relationship between the perceived built environment and leisure-time physical activities.Results:A total of 3 789 participants were included in the analysis. After adjusting for potential confounders, better access to public services ( OR=1.34, 95% CI: 1.02-1.75) and higher aesthetic quality ( OR=1.37, 95% CI: 1.09-1.73) were positively associated with the possibility of engaging in leisure-time physical activity in the past week. Similarly, these two attributes were positively associated with leisure-time walking. Higher scores on the perception of street connectivity were positively associated with leisure-time walking [ exp( β)=1.09, 95% CI: 1.00-1.19]. Higher residential density [ exp( β)=1.000 4, 95% CI:1.000 0-1.000 8], better access to physical activity destinations[ exp( β)=1.09, 95% CI: 1.00-1.19], and better aesthetics [ exp( β)=1.11, 95% CI:1.00-1.22] were associated with higher leisure-time physical activity. Similarly, these three attributes were positively associated with the possibility of meeting the WHO recommendations. Conclusion:Changing some urban built environment attributes may increase leisure-time physical activity.

Background::Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods::A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson’s correlation, multiple linear regression, and analyses of covariance.Results::All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. Conclusions::The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.