Objective To explore the related risk factors of non-alcoholic fatty liver disease (NAFLD) in Uygurs population of Xinjiang area.Methods A total of 966 Uygurs individuals undergoing physical examination in the First Affiliated Hospital and physical examination center of Xinjiang Medical University were collected and performed the questionnaire investigation,blood biochemical detection and B-type ultrasound examination;the subjects were divided into the NAFLD group (569 cases) and non-NAFLD group (397 cases) according to the physical examination situation.The NAFLD group was performed the correlation analysis of risk factors according to the body mass index (BMI) and waist to height ratio (WHtR) stratification.Results BMI and WHtR had statistical difference between the two groups(P＜0.05);overweight(OR =2.527,P＜0.05) and obesity(OR=1.938,P＜0.05) were the risk factors of NAFLD.The multivariate Logistic regression analysis showed that BMI,fasting plasma glucose (FPG) and triacylglycerol (TG) were associated with NAFLD(P＜0.05) and the risk factors of NAFLD.Conclusion BMI,WHtR,FPG and TG are the risk factors of NAFLD,and have a certain clinical significance in the evaluation and prediction of NAFLD high risk population.

Objective To assess the awareness and knowledge about chronic obstructive pulmonary disease ( COPD ) among community general practitioners and general practice residency trainees in Shanghai.Methods Questionnaire was designed and used to investigate the knowledge of COPD among 59 general practitioners from 10 community health centres and 75 general practice trainees in Shanghai from July to September 2012.Results Of the 134 respondents, 49 were male and 85 were female with average age of (30.4 ±8.0) years.In the self-evaluation of “the knowledge about COPD”, “the diagnosis of COPD”,“the differential diagnosis of COPD and asthma”, “the interpretation of lung function report”, “aerosol using method”, “method about absorption apparatus”, “the side effects of bronchodilator”, “COPD rehabilitation” and “long term oxygen therapy, the rates of knowledge mastery were 61.9% ( 83/134 ) , 81.3%(108/133), 83.6% (112/134), 59.0% (79/134), 83.6% (93/134), 35.8% (48/134), 61.2%( 82/134 ) , 56.7% ( 76/134 ) and 61.2% ( 72/134 ) .Except interpretation of “lung function report”, the sores of all items in self-evaluation of the community general practitioners were higher than those of residency trainees ( all P<0.01 ) .Among the COPD related questions, the hightest accuracy rate was 93.3%(125/134) ( smoking cessation can attenuate the declined lung function) and the lowest accrurcy rate was 16.4% ( 22/134 ) ( the differential diagnosis of COPD and asthma ) .Compared with the general practice residents, community general practitioners got lower scores in question “how differentiate COPD from asthma” (6.8%vs.24.0%,χ2 =7.136, P=0.008) and got higher scores in question“the treatment of moderate COPD” (55.9%vs.30.7%,χ2 =8.655, P=0.003).More than half [56.7%(76/134)] of respondents thought that“it is necessary to develop COPD screening in community”, and 20.1%(27/134) thought that“absolutely necessary”.Conclusion The awareness and knowledge about COPD among the community general practitioners and general practice residency trainees are not satisfectory. The future training should focus on the risk factors, the differential diagnosis and treatment of COPD.

Objective To evaluate the effectiveness of mini clinical evaluation exercise (miniCEX) in community rotation of general practice residency training.Methods Forty nine general practice residency trainees,who participated in community rotation during July 2012 to July 2014 in 3 community teaching bases,were randomly divided into two groups:25 trainees in intervention group received conventional teaching and additional 2 rounds of mini-CEX in one month,and 24 trainees received conventional teaching only.The changes of self-evaluation scores of clinical competence after the community rotation were evaluated.Focus group discussions of 8 trainees and 8 teachers from intervention group were also adopted in January to February 2013 to assess the effectiveness of mini-CEX.Results Three trainees withdrew in the study and the interventional group completed 232 mini-CEXs.The self-evaluation scores of clinical competence were elevated in all items in interventional group after community rotation (from 7.03 ± 0.68 to 7.30 ±0.77 in medical history,from 7.00 ± 0.83 to 7.18 ± 0.88 in physical examination,from 7.42 ± 1.20 to 7.52 ± 0.76 in humanistic qualities,from 6.79 ± 0.82 to 7.12 ± 0.70 in clinical judgment,from 6.85 ± 1.06 to 7.18 ± 0.81 in counseling skills,from 6.85 ± 1.15 to 7.12 ± 0.96 in organization,from 7.09 ±0.81 to 7.33 ±0.69 in overall competence),while in control group,scores of humanistic qualities (from 7.74 ± 0.89 to 7.60 ± 0.97),clinical judgment (from 6.94 ± 0.77 to 6.77 ± 1.10) and organization/efficiency (from 6.94 ± 0.96 to 6.80 ± 0.76) were declined.Mter adjusting self-evaluation score before rotation,the increased scores in clinical judgment(7.12 ±0.70 vs.6.77 ± 1.10,F =4.339,P =0.042) and organization (7.12 ± 0.96 vs.6.80 ± 0.76,F =4.336,P =0.042) of intervention group were significantly higher than those of control group.In focus group discussions both trainees and teachers recognized that mini-CEX would enhance clinical competence,be more comprehensive in assessing and adaptable in training program than former rotation tests.The major concerns of using mini-CEX were subjective rating process,non-unified rating standards and insufficient teaching ability.Conclusions Application of mini-CEX in community rotation of general practice residency training can enhance clinical competency of trainees.

Objective To investigate the supporting policies of assistant general practioner training program (3 + 2 mode) in Shanghai.Methods Total 53 subjects were involved in 15 in-depth interviews and 5 focus group discussions held from October 2012 to October 2013,including 8 graduates from the specialty of country doctor of Shanghai Institute of Health Sciences,12 country doctors,2 leaders of 3 + 2 mode training hospital,5 leaders of rural community health centers,3 leaders of Shanghai Institute of Health Sciences,9 leaders of Commission of Health and Family Planning in Shanghai suburbs,3 leaders of Shanghai Municipal Commission of Health and Family Planning,1 leader of National Health and Family Planning Commission.Results Three leaders of Shanghai Municipal Commission of Health and Family Planning admitted the training program involved multiple departments and there were no unified supporting policies,2 leaders of Commission of Health and Family Planning in Shanghai suburbs thought the enrollment amount should be appropriately controlled.The exploration of social person (non-formal employees)mode was encouraged by the leaders of Shanghai Municipal Commission of Health and Family Planning.Leaders of rural community health centers strongly recommended to increase the selection and withdrawal mechanism to ensure the quality of students and training.Three leaders of rural Commission of Health and Family suggested to enroll student from other provinces.Leaders of rural community health centers and Shanghai Municipal Commission of Health and Family Planning agreed that qualifying as assistant general practioner was an important target of training which should be obtained before graduation.All 3 + 2 mood trainees had a strong expectation to get a bachelor degree at the same time of completing the training.Leaders of Shanghai Municipal Commission of Health and Family Planning and 3 + 2 mode training hospitals proposed to pay attention to the construction of training base and teacher training.About one third of the 3 + 2 mood trainees,graduates from the specialty of country doctor of Shanghai Institute of Health Sciences and country doctors hoped to get more space for development.Leaders of rural community health centers and Shanghai Municipal Commission of Health and Family Planning considered that the qualification of assistant general practioner should be the minimal recruitment for recruitment of new medical personel.Leaders of Shanghai Institute of Health Sciences and 3 + 2 mode training hospital suggested the relevant departments to support the new country doctors in terms of income,promotion policies and so on.Conclusions The supporting policies of the pilot 3 + 2 training in Shanghai are imperfect.It can be improved from organization,management,training implementation and career development.Effective support policies can help to generalize the 3 + 2 training.

In line with the worldwide trend in population aging, China has stepped into an aging society since 2000. The outstanding features of aging, including a large proportion of the older population, rapid growth, dramatic expansion of the oldest-old, and uneven aging distribution, have put China in a unique position. Besides, older population is expanding in parallel with the escalating burden of disease, high prevalence of disability, and low social involvement. However, China is not prepared to solve these problems in terms of the economy, awareness, geriatric care system, geriatric team, social security, or age-friendly environment. From the perspective of public health, we summarized the major challenges and proposed the following policy recommendations: (1) strengthening the top-level design and building a "government-leading, multi-sectoral-cooperating, and society-participating" pattern; (2) enhancing health services by implementing the "comprehensive health" strategy; (3) developing home and community care, coordinately enhance institutional care, promote integration of medical and care systems, and establish a multidimensional tailored care system; (4) optimizing geriatric the supporting system, included the construction of geriatric team and the long-term care insurance system; and (5) establishing a physical and socially age-friendly environment.

Cytochrome P450 enzyme 1A1 (CYP 1A1) is one of the main members of CYP1A subfamily, which participates in metabolizing and activating a variety of indirect carcinogens. CYP1A1 can induce carcinogenesis by participating in activating exogenous compounds to produce intermediates or active metabolites that bind to specific biomolecules. CYP1A1 plays a critical role in the metabolic activation of benzo(a)pyrene e ［B(a)P］, and plays a key role in activating the toxic and carcinogenic effects of B(a)P. CYP1A1 involves in the metabolic activation of 7,12-dimethyl benzanthracene and 2-amino-1-methyl-6-phenylimidazo［4,5-b］pyridine (PhIP), and plays an important role in PhIP-induced genotoxicity. CYP1A1 is the main enzyme to metabolize and activate 7H-dibenzo［c,g］carbazole (DBC), a key factor in the carcinogenic effect of DBC. CYP1A1 is also associated with metabolic activation of indirect carcinogens such as aflatoxin B1, 3-nitrobenzene, and naphthalene. Inhibition of the catalytic activity of CYP1A1 can decrease the CYP1A1-mediated activity of carcinogens, thus playing a role in the prevention and treatment of malignant tumors.

OBJECTIVELuteolin, a flavone, has considerable neuroprotective effects by its anti-oxidative mechanism. However, it is still unclear whether luteolin can protect neurons against oxygen-glucose deprivation/reperfusion (OGD/R) induced injury.

METHODAfter 2 hours oxygen-glucose deprivation and 24 hours reperfusion treatment in primary cultured hippocampal neurons, the neuron viability, survival rate and apoptosis rate were evaluated by MTT assay, lactate dehydrogenase (LDH) leakage assay and Hoechst staining, respectively. The activity of Na+/K+ -ATPase was examined in cultured neurons or in the hippocampus of SD rats treated by 10 minutes global cerebral ischemia and followed 24 hours reperfusion.

RESULTTreatment by OGD/R markedly reduced neuronal viability, increased LDH leakage rate and increased apoptosis rate. Application of luteolin (10-100 micromol x L(-1)) during OGD inhibited OGD/R induced neuron injury and apoptosis in a dose-dependent manner. Compared to the control group or OGP/R-treated neurons, the activity of Na+/K+ -ATPase was significantly suppressed in global ischemia/reperfusion group or OGD/R-treated neurons. Application of luteolin during ischemia or OGD preserved the Na+/K+ -ATPase activity. Furthermore, inhibition of Na+/K+ -ATPase with ouabain attenuated the protective effect afforded by luteolin.

CONCLUSIONThe data provide the evidence that luteolin has neuroprotective effect against OGD/R induced injury and the protective effect may be associated with its ability to improve Na+/K+ -ATPase activity after OGD/R.

Animals ; Antioxidants ; pharmacology ; Apoptosis ; drug effects ; Cell Hypoxia ; Glucose ; metabolism ; Luteolin ; pharmacology ; Neurons ; drug effects ; enzymology ; metabolism ; pathology ; Neuroprotective Agents ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; enzymology ; metabolism ; pathology ; prevention & control ; Sodium-Potassium-Exchanging ATPase ; metabolism

Microneedling is a simple, safe, effective, minimally invasive, and economical treatment technique with a wide range of indications. Studies in China and other countries have showed that microneedling plays a role in the treatment of androgenetic alopecia. Compared with traditional therapies, combined microneedling has better therapeutic efficacy, shorter treatment course and a better safety profile. This review summarizes the therapeutic efficacy, mechanisms of action and safety of combined microneedling, and describes prospective trends in the treatment of androgenetic alopecia with combined microneedling based on recent relevant Chinese and international literature.

Objective:To examine the distribution features of angiotensin converting enzyme ( ACE) gene I/D polymorphisms and their correlation with left ventricular hypertrophy (LVH) in children and adolescents with essential hypertension. Methods:This was a case-control study.One hundred and forty-four children and adolescents who were diagnosed with essential hypertension but received no treatment at the Department of Cardiology, Children′s Hospital, Capital Institute of Pediatrics from January 2022 to April 2023 were recruited. ACE gene polymorphisms were detected using the polymerase chain reaction-restriction fragment length polymorphism method.Patients were divided into the DD+ DI genotype group and the II genotype group according to the dominant model, and the differences in gene frequencies, genotype frequencies, clinical data, and plasma renin-angiotensin-aldosterone system (RAAS) levels were compared between the two groups.In addition, according to the echocardiographic findings, patients were divided into the LVH and non-LVH groups.The risk factors of LVH were analyzed using the multivariate Logistic regression model.The correlation of ACE gene I/D polymorphisms with LVH in children and adolescents with essential hypertension was evaluated using the Spearman analysis.The correlation between plasma RAAS levels and LVH was assessed using the partial correlation analysis. Results:The frequencies of DD, DI and II genotypes in 144 patients were 11.1%, 50.7% and 38.2%, respectively.The frequency of the D and I allele was 36.5%(105/288) and 63.5%(183/288) respectively.Patients in the DD+ DI genotype group (89 cases) were older than those in the II genotype group (55 cases) ( Z=-2.308, P=0.021), and there was no statistically significant difference between the two groups in gender and height (all P>0.05).The incidence of LVH in the DD+ DI genotype group was higher than that in the II genotype group, with a statistically significant difference ( χ2=5.230, P=0.022).Renin activity in RAAS levels was positively correlated with left ventricular mass index and relative wall thickness ( r=0.276, 0.247; P=0.002, 0.006).Multivariate Logistic regression analysis showed that both DD+ DI genotype ( OR=5.678, 95% CI: 1.623-19.872) and body mass index (BMI) ( OR=1.124, 95% CI: 1.024-1.233) were risk factors for the development of LVH in children and adolescents with essential hypertension (all P<0.05). Conclusions:ACE gene I/D polymorphisms are strongly associated with LVH.DD+ DI genotype and BMI are independent risk factors for the development of LVH in children and adolescents with essential hypertension.

Objective? To investigate the occurrence and influencing factors of falls in elderly patients with knee osteoarthritis (KOA), and provide scientific reference for the prevention of falls in elderly patients with KOA. Methods? Using convenience sampling method, 104 elderly patients diagnosed as KOA in orthopaedic wards of four ClassⅢ Grade A hospitals in Hangzhou from November 2017 to August 2018 were selected as subjects. General Information Questionnaire, Morse Fall Scale(MFS)and the Barthel Index(BI)for Activities of Daily Living (ADL) were applied in the investigation. Single factor analysis and multiple factor Logistic regression were used to analyze the influencing factors of falls in elderly KOA patients. Results? A total of 104 questionnaires were sent out in this study, and 95 valid questionnaires were recovered, yielding an effective recovery rate of 91.35%. The incidence of falls in elderly KOA patients was 45.26% (43/95), of which 62.79% (27/43) had fallen twice or more. There were significant differences in knee injury history, staircase climbing and falls among elderly KOA patients (P＜ 0.05). There were significant differences in the risk of falls between elderly KOA patients in "whether taking drugs", "whether using walking aids", "status of self-care ability", and "age" (P＜ 0.05). Logistic regression analysis showed that history of knee injury, frequent staircase climbing and use of walking aids were the influencing factors of falls in elderly KOA patients (OR=4.028, 25.569, 3.191; P＜ 0.05). Conclusions? In view of the influencing factors of falls in elderly KOA patients, individualized nursing measures should be taken to strengthen falls risk assessment, carry out fall prevention related education and improve patients' social support, which will help to reduce the incidence of falls and further improve patients' quality of life.