1.Performance of body mass index, waist circumference and waist-to-height ratio in screening true obesity in children
FANG Qihuan, WANG Yuedong, ZHAO Min, YANG Lili, XI Bo
Chinese Journal of School Health 2025;46(3):421-425
Objective:
To evaluate the accuracy of body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) in screening true obesity among children, so as to provide a scientific basis for precise screening and early prevention and control of childhood obesity.
Methods:
A total of 1 322 children aged 10-15 years old were surveyed by the Huantai Children Cardiovascular Health Cohort in 2021. Fat mass percentage (FMP) and fat mass index (FMI) were measured by bioelectrical impedance analysis, with FMP or FMI values at or above the age and sex-specific 70th percentiles as the criteria for defining true obesity. BMI, WC and WHtR were used to define general obesity and central obesity. The accuracy of these measures in screening for true obesity was evaluated by calculating the missed diagnosis rate, misdiagnosis rate, area under the curve(AUC) for receiver operating characteristic and Kappa coefficient.
Results:
Boys had higher BMI [(21.79±4.56) kg/m 2], WC [(76.41±12.53) cm] and WHtR (0.47±0.07) than girls [(20.83±4.13) kg/m 2, (70.69±10.06) cm, (0.45±0.06)] ( t =4.02, 9.19, 6.63), while boys had lower FMP [(18.29±8.35)%] and FMI [(4.35±2.79) kg/m 2] than girls [(24.87±6.51)%, (5.44±2.53) kg/m 2] ( t =-16.10,-7.42) ( P <0.01). Using FMP as a reference standard, the diagnosis error rates of screening for true obesity based on BMI, WC and WHtR were 12.24%, 2.11% and 2.11%, respectively; the diagnosis error rates were 10.88%, 27.28% and 24.33%; the AUC values were 0.88, 0.85 and 0.87; the Kappa coefficients were 0.67, 0.48 and 0.52. Using FMI as a reference standard, rates of BMI, WC and WHtR screening for true obesity were 14.20%, 1.23% and 2.78%; the diagnosis error rates were 4.81%, 20.84% and 18.14 %; the AUC values were 0.90, 0.89 and 0.90; the Kappa coefficients were 0.81, 0.64 and 0.67.
Conclusions
BMI has a higher diagnosis error rate in screening for true obesity in children, while WC and WHtR have higher diagnosis error rates. It is recommended to promote body fat assessment in clinical practice, so as to achieve more accurate prevention and control of chronic diseases.
2.Herbal Textual Research on Euphorbiae Pekinensis Radix and Knoxiae Radix in Famous Classical Formulas
Xiaoxuan CUI ; Kaizhi WU ; Wuwei MENG ; Yapeng WANG ; Wenyue LI ; Cheng FENG ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):282-294
This article systematically analyzes the historical evolution of the name, origin, medicinal parts, processing and other aspects of Euphorbiae Pekinensis Radix(EPR) by referring to the herbal medicine, medical books, prescription books and other documents of the past dynasties, combined with the relevant modern research materials, so as to provide a basis for the development and utilization of famous classical formulas containing this herbal medicine. According to research, EPR was first recorded in the Shennong Bencaojing in the name of Daji, and it is the correct name of the herbal medicine in all dynasties, there are also other aliases such as Qiongju, Hongya Daji, and Xiamaxian. The dried roots of Euphorbia pekinensis from Euphorbiaceae was the mainstream of the past dynasties. Before the Ming dynasty, the above ground parts of E. pekinensis were used as Zeqi in herbal works. However, since LI Shizhen in the Ming dynasty proposed that the origin of Zeqi should be E. helioscopia, the aerial part of EPR is no longer used as medicine. Since modern times, the roots of Knoxia valerianoides has been used as EPR, and has become the mainstream of commodities, which should be corrected. Throughout history, it has been recorded that the main producing areas were Jiangsu, Anhui, Zhejiang, Shanxi and other regions, while modern botanical survey have shown that EPR is a widespread species distributed throughout the country. In ancient times, the harvesting time of EPR was mostly the twelfth lunar month, while in modern time, it is more common to harvest in autumn and winter. The main processing methods of EPR in ancient times were vinegar processing, wine processing, and stir frying, while in modern times, it is uniformly vinegar processing. In the medicinal properties and clinical aspects, the records are basically consistent throughout history, mainly characterized by bitter taste, cold and toxic nature. Its main efficacy is expelling water retention and reducing swelling. Based on the textual research, it is suggested to choose the dried roots of E. pekinensis when famous classical formulas containing EPR, processing method can be based on the original specified prescription requirements, if the processing method is not clear, it is recommended to use vinegar-processed products as medicine.
3.Features of HBV RNA level in different stages of the natural history of chronic hepatitis B virus infection and its correlation with HBV DNA and HBsAg
Han GAO ; Juanli WU ; Yushuang ZHANG ; Yiheng ZHANG ; Lei WANG ; Tao LI ; Lixin ZHANG
Journal of Clinical Hepatology 2025;41(4):637-642
ObjectiveTo investigate the features of serum HBV RNA in different stages of the natural history of chronic hepatitis B virus (HBV) infection without antiviral treatment, as well as its correlation with serum HBV DNA and HBsAg. MethodsA total of 306 treatment-naïve patients with chronic HBV infection who attended Department of Infections Diseases and Hepatoloty, the Second Hospital of Shandong University from January 2023 to June 2024 were divided into six groups based on the different stages of natural history, i.e., HBeAg-positive chronic HBV infection group with 29 patients, HBeAg-positive chronic hepatitis B (CHB) group with 107 patients, HBeAg-negative chronic HBV infection group with 18 patients, HBeAg-negative CHB group with 60 patients, HBeAg-positive indeterminate-phase chronic HBV infection group with 7 patients, and HBeAg-negative indeterminate-phase chronic HBV infection group with 85 patients. Real-time isothermal RNA amplification was used to measure serum high-sensitivity HBV RNA. The Kruskal-Wallis H test was used for comparison between multiple groups of continuous data, while the Mann-Whitney U test was used for comparison between two groups. The Spearman method was used to investigate the correlation of HBV RNA with HBV DNA and HBsAg. ResultsThe HBeAg-positive chronic HBV infection group showed the highest level of serum HBV RNA [7.5 (7.4 — 7.9) log10 copies/mL], followed by the HBeAg-positive CHB group [7.4 (6.4 — 7.9) log10 copies/mL], the HBeAg-negative CHB group [4.5 (3.0 — 5.7) log10 copies/mL], and the HBeAg-negative chronic HBV infection group [1.0 (1.0 — 2.0) log10 copies/mL]; the HBeAg-positive indeterminate-phase chronic HBV infection group had a serum HBV RNA level of 3.9 (3.7 — 5.7) log10 copies/mL, and the HBeAg-negative indeterminate-phase chronic HBV infection group had a serum HBV RNA level of 2.0 (1.0 — 3.0) log10 copies/mL; there was a significant difference in serum HBV RNA level between the six groups (H=830.770, P<0.001). There was a significant difference in HBV RNA level between the HBeAg-positive chronic HBV infection group and all the other groups except the HBeAg-positive CHB group (all P<0.001). In the 306 patients with HBV infection, HBV RNA was strongly correlated with HBV DNA (r=0.92, P<0.001) and was moderately correlated with HBsAg (r=0.67, P<0.001). The correlation between serum HBV RNA and HBsAg in HBeAg-positive patients (r=0.61, P<0.001) was stronger than that in HBeAg-negative patients (r=0.31, P<0.001). For the patients with HBeAg-positive chronic HBV infection, the male patients with ALT>30 U/L and the female patients with ALT>19 U/L had a significantly lower serum HBV RNA level than the male patients with ALT≤30 U/L and the female patients with ALT≤19 U/L (P<0.001), and there was no significant difference in serum HBV RNA level between the latter group of patients and the HBeAg-positive CHB group (P>0.05). ConclusionIn patients with chronic HBV infection who do not receive antiviral therapy, there is a difference in serum HBV RNA level in different stages of natural history, and serum HBV RNA level has the strongest correlation with HBV DNA and a relatively weak correlation with HBsAg. In patients with HBeAg-positive chronic HBV infection, serum HBV RNA level in male patients with ALT>30 U/L and female patients with ALT>19 U/L are in the transition stage between HBeAg-positive chronic HBV infection and HBeAg-positive CHB.
4.Modern Medicine Insights into Strengthening the Spleen and Resolving Dampness for Treating Spleen Deficiency with Dyslipidemia Based on the Theory of "the Spleen Governs the Dispersion of Essence"
Shijia LIU ; Yiguo WANG ; Qiming ZHANG
Journal of Traditional Chinese Medicine 2025;66(10):981-986
The traditional theory of "the spleen governs the dispersion of essence" refers to the spleen's pivotal role in distributing refined nutrients throughout the body. In traditional Chinese medicine (TCM), lipids are categorized under "gaozhi (膏脂)", and their transportation and metabolism via apolipoproteins are believed to be closely related to the spleen's dispersing function. The liver, which synthesizes apolipoproteins, is functionally linked to the spleen system in TCM. Impaired dispersion of essence by the spleen and disrupted transportation of gaozhi constitute the pathological mechanism of dyslipidemia due to spleen deficiency. Strengthening the spleen and resolving dampness is the core therapeutic principle. From the perspective of modern medicine, this may involve promoting hepatic functional recovery related to lipid metabolism, thereby enhancing lipid processing and reducing the levels of abnormally accumulated lipids in the bloodstream.
5.Placebo Design Methodology for Clinical Trials of Pastes for Acupoint Application
Xinyan YANG ; Bingyu PU ; Meng WANG ; Jian WANG
Journal of Traditional Chinese Medicine 2025;66(10):1011-1016
Reasonable and standardised placebo setting for acupoint application pastes is a key factor for clinical trials to verify the safety and effectiveness of acupoint application. By sorting out the current design status of placebo in the allocation concealment and blind design, paste components, paste location, paste duration in the current clinical trials of acupoint application pastes, it is proposed that there are problems such as low application rate of blinding and non-standardised reporting, insufficient standardisation of placebo settings and lack of systematic research, and lack of uniform standards of the placebo evaluation method. Based on the action mechanism of acupoint application, the idea of setting placebo for acupoint application paste is proposed in terms of replacing the application material, controlling the physicochemical effect produced by transdermal absorption of drugs, and setting the permeability of placebo, in order to enrich the methodological content of the placebo setting for acupoint application, and providing more scientific and reliable clinical evidence of acupoint application.
6.Methods and Strategies Employed in Compatibility and Formulation of New Chinese Medicinal Material Resources
Wenhua MING ; Qingqing LI ; Caifeng LI ; Yeran WANG ; Lan WANG ; Yanwen LI ; Zhiyong LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):248-256
Chinese medicinal materials serve as the material foundation of traditional Chinese medicine (TCM) culture. The sustainable development of Chinese medicinal material resources is a focal point in the modernization of TCM. With the increasing scarcity of Chinese medicinal material resources, the expansion of new Chinese medicinal material resources has become a crucial means for the sustainable utilization of these resources. New Chinese medicinal material resources refer to natural resources that have been newly discovered or developed, possessing potential medicinal value or healthcare functions, which fall outside the traditional application scope of herbal medicines. These resources have not yet been widely recognized or applied within the framework of traditional TCM theory. They specifically include artificial substitutes for endangered medicinal materials, new medicinal parts of medicinal plants, medicinal materials with expanded clinical applications, and foreign medicinal resources. The rational compatability and formulation of new Chinese medicinal material resources are essential pathways for integrating them into the TCM system. Due to the weak foundational research on new Chinese medicinal material resources in China, the characteristics of these resources that align with the TCM theory are not yet fully understood, posing numerous constraints on formulating prescriptions based on the traditional compatibility principles of TCM. This paper integrates the traditional formulation theory of TCM with modern data integration methods, proposing four formulation models for new TCM resources: synergistic compatibility, substitutive compatibility, symptom-based compatibility, and efficacy semantic compatibility. These models provide new insights for the application of new Chinese medicinal material resources, not only facilitating their rational use in clinical practice but also offering theoretical support for the development and compatibility research of these resources.
7.Methods and Strategies Employed in Compatibility and Formulation of New Chinese Medicinal Material Resources
Wenhua MING ; Qingqing LI ; Caifeng LI ; Yeran WANG ; Lan WANG ; Yanwen LI ; Zhiyong LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):248-256
Chinese medicinal materials serve as the material foundation of traditional Chinese medicine (TCM) culture. The sustainable development of Chinese medicinal material resources is a focal point in the modernization of TCM. With the increasing scarcity of Chinese medicinal material resources, the expansion of new Chinese medicinal material resources has become a crucial means for the sustainable utilization of these resources. New Chinese medicinal material resources refer to natural resources that have been newly discovered or developed, possessing potential medicinal value or healthcare functions, which fall outside the traditional application scope of herbal medicines. These resources have not yet been widely recognized or applied within the framework of traditional TCM theory. They specifically include artificial substitutes for endangered medicinal materials, new medicinal parts of medicinal plants, medicinal materials with expanded clinical applications, and foreign medicinal resources. The rational compatability and formulation of new Chinese medicinal material resources are essential pathways for integrating them into the TCM system. Due to the weak foundational research on new Chinese medicinal material resources in China, the characteristics of these resources that align with the TCM theory are not yet fully understood, posing numerous constraints on formulating prescriptions based on the traditional compatibility principles of TCM. This paper integrates the traditional formulation theory of TCM with modern data integration methods, proposing four formulation models for new TCM resources: synergistic compatibility, substitutive compatibility, symptom-based compatibility, and efficacy semantic compatibility. These models provide new insights for the application of new Chinese medicinal material resources, not only facilitating their rational use in clinical practice but also offering theoretical support for the development and compatibility research of these resources.
8.Experimental validation of the accuracy of reported dose-length product values in different CT scanner models
Bin YANG ; Shicai ZHANG ; Xiankai HUO ; Zhenhe LIU ; Pengcheng WANG
Chinese Journal of Radiological Health 2025;34(2):155-160
Objective To evaluate the accuracy of dose-length product (DLP) values in CT dose reports by comparing them with the DLP values measured using a pencil-type ionization chamber. Methods Experiments were conducted using four CT scanners with different detector row numbers from two manufacturers (A and B), along with a head phantom and a pencil-type ionization chamber. Other scanning parameters were fixed, while pairwise combinations of kV and mAs were tested. The DLP values were measured under various scanning conditions using the pencil-type ionization chamber (DLPmeasured) and the corresponding DLP values in CT dose reports were recorded (DLPreported). All data were subjected to statistical analysis. Results Differences were observed between DLPreported and DLPmeasured values. The smallest mean absolute value of ΔDLP was approximately 2.526 mGy·cm observed on the 40-row CT scanner of manufacturer A. There was a difference between the ΔDLPs of the four CT scanners. Both DLPreported and DLPmeasured exhibited a linear relationship with mAs. Conclusion The percentage errors between DLPreported and DLPmeasured values for all four CT scanners were within the national standard tolerance of 15%. DLP values in CT dose reports can serve as a reference for assessing patient radiation dose during scanning. However, for radiation dose-related research, data measured using dosimetric instruments such as pencil-type ionization chamber are recommended.
9.Simulation analysis of the protective performance of barium sulfate mortar against positron nuclide γ-rays
Zhiqiang XU ; Huaixin NI ; Jiwu GENG ; Lichun LI ; Zaoqin ZHANG ; Shibiao SU ; Meixia WANG ; Ming LIU
Chinese Journal of Radiological Health 2025;34(2):209-213
Objective To obtain the protective performance parameters of barium sulfate mortar against positron nuclide γ-rays, provide reference data for precise shielding calculations, and guide the design, evaluation, and construction of radiation shielding. Methods The FLUKA program was used to build a model for simulating the dose equivalent rate variation around points of interest under the irradiation of the most commonly used positron nuclide 18F with changes in the thicknesses of lead and barium sulfate mortar. The transmission curves of lead and barium sulfate mortar were fitted, and the half-value layer (HVL) and lead equivalence of barium sulfate mortar were calculated based on the fitted curves. Results The ambient dose equivalent rate coefficient of positron nuclide 18F was 1.339 4×10−1 μSv·m2/MBq·h and the HVL for lead was 4.037 mm, with deviations of 0.043% and 1.53% compared to the values provided in the AAPM Report No. 108, respectively. The HVLs for γ-rays produced by 18F, using barium sulfate mortar with apparent densities of 4.20, 4.00, and 3.90 g/cm3 mixed with 35.2-grade cement in a 4∶1 mass ratio, were 2.914, 2.969, and 3.079 cm, respectively. The lead equivalences were
10.Analysis of peripheral blood genetic material damage in children with vascular malformations after interventional procedures
Yuelong SHI ; Ying PANG ; Zhanchun GUO ; Ya MA ; Yingmin CHEN ; Xiaoshan WANG ; Rui CHEN
Chinese Journal of Radiological Health 2025;34(2):149-154
Objective To observe changes in genetic material in the peripheral blood of pediatric patients with vascular malformations after interventional procedures. Methods A total of 108 children with vascular malformations who underwent interventional procedures at Shandong University Affiliated Children’s Hospital between February 2021 and January 2024 were selected as the research subjects. Clinical data and peripheral venous blood samples before and after the interventional procedures were collected from the children. Two biological indicators, γ-H2AX and peripheral blood lymphocyte chromosomal aberration (CA), were used to determine the levels of genetic material damage in children with vascular malformations before and after interventional procedures. Results The median age of the children was 7 years and the median body weight was 27 kg. The median dose-area product (DAP) was 24.20 Gy·cm2 and the median DAP/kg was 1.04 Gy·cm2/kg. The incidence rates of both γ-H2AX foci and CA in children with vascular malformations significantly increased after the interventional procedures (Z = 5.924, P < 0.001; Z = 8.515, P < 0.001). The incidence of postoperative CA in 7 children were significantly higher than that in others, approaching or exceeding 4%. The incidence rates of postoperative γ-H2AX foci and CA in children with DAP/kg ≥ 1 Gy·cm2/kg were significantly higher than those in children with DAP/kg < 1 Gy·cm2/kg (U = 7.586, P = 0.031; U = 6.835, P = 0.009). No significant differences were observed in the incidence rates of postoperative γ-H2AX foci and CA among subgroups based on age, body weight, or surgical site. A positive correlation was observed between the difference in the incidence rates of γ-H2AX foci before and after the procedure and DAP/kg (R = 0.493, P = 0.027). Conclusion Ionizing radiation exposure during interventional procedures can increase peripheral blood genetic material damage levels in children with vascular malformations, and the damage levels show a correlation with the radiation dose, with some children being abnormally sensitive. Further research is needed to explore the influencing factors for genetic material damage in children with vascular malformations after interventional procedures, which is of great significance for reducing long-term cancer risks and achieving personalized treatment strategies.


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