Objective: To determine the correlation between obesity related indicators and blood lipid levels among children and adolescents. Methods: A total of 5 812 participants were included. Height, weight, body composition, waist circumference, blood pressure were measured and fasting glucose and blood lipid levels were tested based on a cross sectional survey of children and adolescents 6-17 years in Beijing, 2022-2023. The body mass index (BMI), fat mass index (FMI), body roundness index (BRI) and waist to height ratio (WHtR) were calculated. Linear and Logistic regression were used to analyze the associations between the four obesity indicators (BMI, FMI, BRI, and WHtR) and blood lipids in children and adolescents. The area under the curve (AUC) of the receiver operating characteristic (ROC) was used to evaluate differences in the associations between different obesity indicators with dyslipidemia. Results: Linear regression showed that BMI, FMI, BRI, and WHtR were positively correlated with triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and non high density lipoprotein cholesterol (non HDL-C) levels (boys: β 6-9 years =0.02-0.28, β 10-17 years =0.02-0.37; girls: β 6-9 years =0.02-0.28, β 10-17 years =0.03-0.25), and negatively correlated with the high density lipoprotein cholesterol (HDL-C) level in both genders across age subgroups (boys: β BMI = -0.03, β FMI = -0.04 , β BRI =-0.09, β WHtR =-0.17; girls: β BMI =-0.03, β FMI =-0.04, β BRI =-0.11, β WHtR =-0.20) (all P <0.01). The associations between total cholesterol (TC) and remnant cholesterol (RC) levels with obesity indicators differed significantly by gender and age. The TC level was positively associated with obesity indicators in boys of all ages ( β BMI =0.01, β FMI =0.03, β BRI = 0.08 , and β WHtR =0.16) but only with FMI, BRI, and WHtR in girls 6-9 years of age ( β FMI =0.02, β BRI =0.05, and β WHtR =0.08) (all P <0.05). The RC level had a negative correlation with BRI in boys 10-17 years of age ( β =-0.01) and a positive correlation with BMI in girls 6- 9 years of age ( β =0.00) (all P <0.05). Logistic regression indicated that elevated obesity indicators were significantly associated with higher risks of elevated TG, LDL-C, and non HDL-C levels and a decreased HDL-C level in all gender age stratas (all P <0.01). Only the BMI and FMI in girls 6-9 years of age were significantly related to a high RC ( OR =1.07, 1.07, both P <0.05). ROC analysis revealed that FMI, BRI, and WHtR were more predictive than BMI of elevated TG, LDL-C, and non HDL-C levels. The BMI was superior in predicting a decreased HDL-C level in boys, while no significant difference was detected among indicators in girls. Indeed, all obesity indicators had poor predictive performance for elevated TC, RC, and LDL-C levels in girls (all AUC<0.7). Conclusions Obesity indicators reflecting body fat content and fat distribution are shown to be closely associated with dyslipidemia in children and adolescents with obvious age and gender differences. The FMI, BRI, and WHtR have potential advantages in the early identification of dyslipidemia among children and adolescents compared to the BMI alone.

Objective:To observe the improving effects of Tuina(Chinese therapeutic massage)plus exercise therapy on joint alignment and walking function in children with genu varum(GV).Methods:Sixty-six children with GV were divided into an exercise therapy group and a Tuina plus exercise therapy group using the random number table method,with 33 cases in each group.Both groups received identical exercise therapy,while the Tuina plus exercise therapy group was additionally offered Tuina manipulation treatment.The intervention course lasted 12 weeks in both groups.Before and after the intervention,the three-dimensional gait analysis was adopted to assess the spatiotemporal parameters,kinematics,and kinetic characteristics of lower-limb joints in children with GV.Results:The GV angle was reduced after intervention in the Tuina plus exercise therapy group(P<0.05),but there was no significant change in the exercise therapy group(P>0.05).After treatment,the Tuina plus exercise therapy group demonstrated a notable decrease in the step length,walking speed,peak forefoot adduction angle,and peak ankle inversion moment(P<0.05),suggesting the correction of the ankle joint's compensatory pathological changes.In the exercise therapy group,the foot progression angle(FPA)and gait deviation index(GDI)increased markedly after the intervention(P<0.05),indicating improved overall kinematic function.Conclusion:The combined use of Tuina manipulations and exercise therapy can produce significant effects in correcting the knee joint's torsion,both coronally(GV angle)and horizontally(ankle inversion moment,FPA,and forefoot adduction angle),while exercise therapy alone can markedly improve the overall kinematic parameters(FPA and GDI).

Objective:To analyze the wear rate of each monitoring module of monitoring device during the duration of wearing monitoring device in patients who received monitoring for vital sign,and research the application value of that in clinical treatment and its influence on patients'compliance.Methods:A total of 200 patients with emergency observation who need undergo monitoring for vital sign at Ningbo Medical Center Li Huili Hospital from July to December 2024 were selected.They were divided into a bedside monitoring group and a wearable monitoring group,with 100 patients in each group.The bedside monitoring group used conventional bedside monitoring devices for treatment and monitoring,while the wearable monitoring group used wearable monitoring devices for that.Boxplot was utilized to compare the wear rates of each module of the monitoring devices between the two groups,and to analyze patients'compliance.Results:The median of wear rates of the electrocardiogram(ECG)module and the blood oxygen module were respectively 0.991(0.975,0.999)and 0.928(0.876,0.979)in the wearable monitoring group,which were significantly higher than the 0.846(0.811,0.881)and 0.699(0.641,0.754)of the bedside monitoring group(Z=10.586,5.065,P<0.05).The wear rates of the monitoring devices for monitoring indicators such as heart rate,blood oxygen,perfusion index,respiratory frequency and pulse in the wearable monitoring group were also higher than those in the bedside monitoring group,with statistically significant differences(t=10.586,5.065,5.067,8.731,5.063,P<0.05).However,there was not significant difference in the wear rate of monitoring device for blood pressure between two groups(P>0.05).Conclusion:Wearable monitoring can effectively improve patients'wear rates,and enhance patients'compliance,and prolong monitoring time for patients,and improve treatment outcomes for patients,and ensure the life and health of patients.

Objective:To analyze the changes and significance in clinical cardiac indicators of early cardiac myocardial dysfunction and cardiac substructure dose during conventional radiotherapy for N 2-N 3 non-small cell lung cancer (NSCLC) with mediastinal lymph node metastases. Methods:The data of 34 NSCLC patients with lymph node metastases in regions 4-8 admitted to the Affiliated Cancer Hospital of Guizhou Medical University from June 2022 to August 2023 were observed and analyzed. All patients were treated with volumetric modulated arc therapy with a prescribed dose of 60-70 Gy. Cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were measured at 6 time points: within 1 week before radiotherapy ( t0); when the cumulative radiotherapy dose reaches 20 Gy ( t20), 40 Gy ( t40), 60 Gy ( t60) during radiotherapy; within 1 week after radiotherapy ( tp); 1 month after radiotherapy( tp1). Left ventricular global longitudinal strain (LVGLS) and left atrial global longitudinal strain (LAGLS) were assessed at 4 time points: t0, t40, tp and tp1, respectively. The changes in cardiac indicators at different time points during radiotherapy and their correlation with substructure doses were analyzed using analysis of variance, linear regression analysis, and Pearson correlation. Results:The correlation between cardiac substructure dose and mean heart dose (MHD) in the study cohort in the descending order was as follows: left ventricle ( B=0.43, P<0.001), right ventricle ( B=0.37, P=0.002), left atrium ( B=0.16, P<0.001), and right atrium ( B=0.15, P=0.001). There were significant differences in the changes of LVGLS and LAGLS across different time points ( F=3.13, P=0.029; F=17.18, P<0.001). At 1 month after radiation, LAGLS was significantly decreased compared to pre-radiation levels ( P=0.009), whereas no significant difference was observed in LVGLS ( P=1.000). No significant differences were observed in the changes of cTnT and NT-proBNP across different time points (all P>0.05). Significant correlations were identified between cTnT and right ventricle mean dose at t40 ( r=0.38, P=0.025), as well as between NT-proBNP and right atrium mean dose at t60 and tp ( r=0.54, P=0.001; r=0.41, P=0.016). Conclusions:At present, there is no significant difference between the sensitive serum markers of myocardial injury and LVGLS in detecting early myocardial injury. LAGLS may hold substantial clinical value. There is uncertainty about radiation injury and repair of various cardiac substructures.

Objective:To ascertain the weakness in radiological health technical service in Sicuan province through the assessment of radiological health technical service capability in Sichuan province from 2019 to 2024, and continue to optimize and improve the radiological health service system, and provide assistance to the high-quality development of all kinds of work.Methods:By querying the basic information on institutions by the aid of the Sichuan Provincial Radiation Health Information Management Platform, the information was investigated, collected, collated and analyzed with respect to the qualification, technical service, capability comparison, quality assessment in relation to radiological health technical service institutions in the past 6 years.Results:In the past 6 years, the total number of institutions in Sichuan province has increased from 40 to 48, and the proportion of Grade A institutions has increased from 7.5% to 20.8%. As of the end of 2024, there were 889 professionals and technicians, with an average of 18.8 ± 4.2 per institution. There was a statistically significant difference in the number of professionals and technicians between public and private institutions ( t=-3.48, P<0.05), while there was a statistically significant difference in the number of professionals and technicians between Grade A and Grade B and unclassified institutions ( t=-4.01, P<0.05). There were 1 886 items of equipment, and there was a statistically significant difference ( t=6.58, 10.13, 6.74, P<0.05) in the total number of items of equipment, on-site testing equipment, and laboratory testing equipment between Grade A and Grade B and unclassified institutions. Totally 48 institutions issued 21 026 reports on radiological health tests, with an average of 457.1 ± 6.4 reports per institution and 4 038 reports on radiological health evaluation, with an average of 87.8 ± 5.1 reports per institution. A total of 25 institutions carried out personal dose monitoring, accounting for 78.1%, and completed the personal dose monitoring of 40 058 radiation workers for 5 428 employers. The workload of technical services has been increasing year by year. In the past 6 years, a total of 20 professional and technical training sessions have been sponsored, with approximately 3 500 people trained. A total of 21 rounds of various quality assessments or evaluations were conducted, and the overall pass rate was good and has been increasing year by year. Conclusions:The result of assessment has shown that efficient operation of the Sichuan Provincial Radiological Health Quality Control Center comprehensively promoted the high-quality development of radiological health service, therefore injecting new vitality into the next step towards promoting the provincial radiological health service to a new level.

Objective:To observe the effect of governor vessel(GV)electroacupuncture on potassium chloride cotransport-er 2(KCC2)and γ-Aminobutyric acid type a receptor(GABAAR α 1)and to explore the possible mecha-nism of GV electroacupuncture in improving post-stroke limb spasticity(PSLS).Method:45 male SD rats of SPF grade were randomly selected into the blank group and the sham operation group,with 9 rats in each group.The remaining rats were used to make the middle cerebral artery occlusion model.On the 3rd day after the completion of modeling,the rats with limb spasticity were chosen and random-ly divided into the model group,the electroacupuncture group,and the baclofen group,with 9 rats in each group,following a series of behavioral tests.Acupuncture was provided to the electroacupuncture group at"Da-zhui","Jizhong"and"Houhui",whereas the baclofen group received a baclofen solution by gavage for 7 days.Rats in each group were observed for the changes in nerve function by the symptom score of nerve function defect,and the changes in muscle tension level were evaluated by the modified Ashworth grading score and EMG signal value change.KCC2 and GABAARα1 mRNA and protein in the cerebral cortex of rats were de-tected by qPCR and Western Blot,and changes in chloride ion content were detected with a colorimetric kit.Result:The neurological function defect score,the modified Ashworth grading score,the water content of brain tissue,the volume of cerebral infarction,and the expression of chloride ion content in the model group were all significantly increased compared with the sham operation group at the same time point(P＜0.01),while the EMG signal value,cerebral cortex KCC2 and GABAAR α 1 mRNA and protein were significantly decreased(P＜0.01).Compared with the model group,the nerve function defect score,the modified Ashworth grading score,the water content of brain tissue,the volume of cerebral infarction and the expression of chlo-ride ion content in the electroacupuncture group and the baclofen group were all decreased(P＜0.01),while the EMG signal value and KCC2,with GABAARα1 mRNA and protein expression were all increased(P＜0.01,P＜0.05,respectively);There was no significant difference in all indexes between the GV electroacupuncture group and the baclofen group(P＞0.05).Conclusion:GV electroacupuncture can increase the expression of KCC2,GABAARα1 mRNA,and protein in the cerebral cortex of rats,in order to exert the inhibitory effect of γ-aminobutyric acid,thus improving the symptoms of PSLS.

Objective To investigate the gait characteristics of school-age children with generalised joint hypermobility(GJH).Methods The kinematic and kinetic data of lower extremity joints in 56 children with GJH and 56 healthy children were collected by 3D motion capture system and 3D force plates,and the differences between the two groups were compared and analyzed.Results Kinematics parameters:the mean ankle inversion angle(P=0.000),maximum hip adduction angle(P=0.002)and maximum foot clearance angle(P=0.004)in stance phase decreased in the GJH children group,while the mean foot progression angle(P=0.000),the maximum foot internal rotation angle(P=0.000)in stance phase,and the knee flexion angle(P=0.032)in the middle stance phase increased.Kinetics parameters:the maximum power of knee(P=0.005)and hip(P=0.000)joints and the maximum inversion moment of ankle joints(P=0.009)in stance phase decreased in GJH children group.Temporal and spatial parameters:the step length(P=0.001),walking velocity(P=0.000),and cadence(P=0.000)decreased in GJH children group,while the stance phase percentage(P=0.000),and step width(P=0.000)increased.Conclusions There is a decrease in walking efficiency and balance stability of children with GJH.The line alignment is abnormal in ankle joint.The knee function needs a long-term attention.

Objective:To investigate the efficacy of oral folic acid intervention in lung cancer patients with radiation esophagitis (RE) caused by concurrent chemoradiotherapy.Methods:In this randomized, controlled, single-center clinical trial, a total of 82 patients with stage N 2-N 3 lung cancer including small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) admitted to the Affiliated Cancer Hospital of Guizhou Medical University from June 2022 to October 2023 were prospectively included. All enrolled patients were randomly divided into the experimental group (folic acid group) and control group according to 1 vs. 1 of simple random method, and patients in both groups were required to receive radiation therapy for lung lesions and mediastinal metastatic lymph nodes [≥2 cycles of chemotherapy were completed during the same period of radiotherapy (≥40 Gy / 20 F) or targeted drugs were given simultaneously]. The severity of RE was evaluated using the modified common terminology criteria for adverse events criteria of the National Cancer Institute in both groups weekly at the onset of radiation esophagitis symptoms and thereafter until 1 week after the end of radiotherapy. Conventional treatment of RE was delivered according to the grading criteria of the Radiation Therapy Oncology Group. Patients in the folic acid group were given with folic acid tablets 30 mg/d orally at the beginning of radiotherapy until the end of radiotherapy, while those in the control group did not receive any drug intervention. The onset time, severity and duration of RE, and changes in the severity of esophageal toxicity after conventional treatment were recorded and analyzed. Serum folate value, serum vitamin B 12 value and homocysteine value were measured before and after radiotherapy. For continuous quantitative variables, independent sample t-test or independent sample rank-sum test was used for comparison among different groups. For categorical data, Chi-square test or Fisher's exact probability method was used for comparison among different groups. Results:During the observation period, no grade 4 or above RE was reported between two groups. The incidence of grade 0, 1, 2 and 3 RE in the folic acid and control groups was 10% (4/40) and 5% (2/41), 70% (28/40) and 42% (17/41), 15% (6/40) and 51% (21/41), 5% (2/40) and 2% (1/41), respectively. The differences were not statistically significant between two groups ( P=0.456). However, the incidence of grade 0-1 RE in the folic acid group was significantly higher than that in the control group ( Z=2.72, P=0.006). The median time of RE in the folic acid group and control group was 12 d (range 7-52 d) and 15 d (range 11-56 d) after the start of radiotherapy, respectively, with no statistically significant difference ( χ2=-0.75, P=0.456). However, median duration of the individual's most severe RE was 12 d (range 4-36 d) and 21 d (range 7-38 d) in the folic acid group and control groups, respectively, and the differences were statistically significant ( χ2=2.10, P=0.039). In the folic acid group, the grades of swallowing with pain and dysphagia were significantly declined after folic acid intervention, especially at 2 weeks after the occurrence of RE ( P=0.001, P=0.002). The remission rate of RE after 1 week in the folic acid group was higher than that in the control group, and the difference was statistically significant ( χ2=7.36, P=0.012). Conclusion:Oral intake of folic acid during concurrent chemoradiotherapy for lung cancer cannot reduce the incidence of RE, but it may reduce its severity, shorten the duration of the most severe RE in individuals, and have a certain protective effect.

Objective:To analyze the changes and significance in clinical cardiac indicators of early cardiac myocardial dysfunction and cardiac substructure dose during conventional radiotherapy for N 2-N 3 non-small cell lung cancer (NSCLC) with mediastinal lymph node metastases. Methods:The data of 34 NSCLC patients with lymph node metastases in regions 4-8 admitted to the Affiliated Cancer Hospital of Guizhou Medical University from June 2022 to August 2023 were observed and analyzed. All patients were treated with volumetric modulated arc therapy with a prescribed dose of 60-70 Gy. Cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were measured at 6 time points: within 1 week before radiotherapy ( t0); when the cumulative radiotherapy dose reaches 20 Gy ( t20), 40 Gy ( t40), 60 Gy ( t60) during radiotherapy; within 1 week after radiotherapy ( tp); 1 month after radiotherapy( tp1). Left ventricular global longitudinal strain (LVGLS) and left atrial global longitudinal strain (LAGLS) were assessed at 4 time points: t0, t40, tp and tp1, respectively. The changes in cardiac indicators at different time points during radiotherapy and their correlation with substructure doses were analyzed using analysis of variance, linear regression analysis, and Pearson correlation. Results:The correlation between cardiac substructure dose and mean heart dose (MHD) in the study cohort in the descending order was as follows: left ventricle ( B=0.43, P<0.001), right ventricle ( B=0.37, P=0.002), left atrium ( B=0.16, P<0.001), and right atrium ( B=0.15, P=0.001). There were significant differences in the changes of LVGLS and LAGLS across different time points ( F=3.13, P=0.029; F=17.18, P<0.001). At 1 month after radiation, LAGLS was significantly decreased compared to pre-radiation levels ( P=0.009), whereas no significant difference was observed in LVGLS ( P=1.000). No significant differences were observed in the changes of cTnT and NT-proBNP across different time points (all P>0.05). Significant correlations were identified between cTnT and right ventricle mean dose at t40 ( r=0.38, P=0.025), as well as between NT-proBNP and right atrium mean dose at t60 and tp ( r=0.54, P=0.001; r=0.41, P=0.016). Conclusions:At present, there is no significant difference between the sensitive serum markers of myocardial injury and LVGLS in detecting early myocardial injury. LAGLS may hold substantial clinical value. There is uncertainty about radiation injury and repair of various cardiac substructures.

Objective To develop and validate an early venous thromboembolism(VTE)risk assessment scale for emergency observation patients.Methods ① Based on the characteristics of emergency observation patients,the Delphi expert consultation method and literature review were used to determine scale items and construct a scoring system.②The newly developed VTE scale and its scoring system were analyzed for reliability and validity.③Primary application:collect non acute traumatic observation and rescue patients admitted to Zhejiang Hospital from June 2022 to June 2023 as the research subjects.Patients were divided into survival and non-survival groups based on 28-day outcomes.Differences in VTE scores between the two groups using the new scale,Caprini,and Padua models were compared.The optimal cut-off point was determined using the receiver operator characteristic curve(ROC curve),according to the optimal cut-off value of the new scale score,patients were divided into two groups,and Kaplan-Meier survival curves were used to analyze the 28-day cumulative survival of the two groups of patients.Results ①The preliminary version of the early VTE risk assessment scale for emergency observation patients was developed,comprising 8 items:age,pre examination triage level,underlying diseases,D-dimer levels,activities of daily living(ADL)assessment,coagulation-related indicators,anticoagulants and(or)antiplatelet drugs use,and unhealthy habits.② A total of 121 emergency observation patients were included in the analysis.The test-retest reliability correlation coefficient(R)of the new scale was 0.945(>0.850),split-half reliability was 0.741(>0.700),and Cronbach'sαcoefficient was>0.700.KMO value was 0.715(>0.700),and Bartlett's sphericity test yieldedχ2=167.079,P<0.001,confirming the suitability of the scale for factor analysis.Three factors were identified:basic information,initial assessment,and blood test indicators.Pearson correlation analysis showed the correlation coefficients between the new scale and the Caprini and Padua scores were 0.842 and 0.307,respectively,both P<0.01.③Area under the curve(AUC)of the new scale was 0.566,95%confidence interval(95%CI)was 0.444-0.688,with an optimal diagnostic cut-off value of 13.5 points based on the maximum Youden index.The results of the Kaplan-Meier regression indicated that survival analysis using the 13.5-point cut-off revealed that patients with scores≥13.5 had significantly lower 28-day survival rates than those with scores<13.5(Log-Rank test:χ2=5.609,P=0.018).④The survival group had significantly lower scores than the non-survival group across all scales(new score:10.06±2.84 vs.12.69±3.06,Caprini model:7.22±2.48 vs.9.41±2.64,Padua model:2.91±1.97 vs.4.59±1.07,all P<0.05).Conclusion The early VTE risk assessment scale for emergency observation patients was successfully developed,demonstrating good reliability and validity through statistical analysis.The new scale effectively predicts disease severity and prognosis in emergency observation patients.