Objective To explore the effects of pulmonary rehabilitation training on respiratory function,muscle strength,muscle mass,exercise endurance in patients with chronic obstructive pulmonary disease(COPD)and sarcopenia.Methods A total of 100 patients with COPD and sarcopenia admitted to Taixing People's Hospital from June 2022 to June 2023 were selected as the research subjects.These patients were randomly divided into control group and observation group by the envelope method,with 50 patients in each group.The patients in the control group were given conventional COPD treatment,and the patients in the observation group were given conventional COPD treatment combined with pulmonary rehabilitation training,and all patients were treated for 6 months.The pulmonary function[forced vital capacity(FVC),forced expiratory volume in the one second(FEV1),and FEV1/FVC ratio]of patients in the two groups was evaluated by spirometer at admission,4 weeks,12 weeks,and 6 months of training.The COPD assessment test(CAT)questionnaire and the modified Medical Research Council dyspnea scale(mMRC)score were used to evaluate the degree of dyspnea of patients in the two groups.The skeletal muscle index(SMI)of patients in the two groups was measured by bioelectrical impedance analyzer,the handgrip strength(HGS)of patients in the two groups was measured by electronic handgrip dynamometer,and the exercise tolerance of patients in the two groups was evaluated by 6-minute walk test.Patients who needed to be re-hospitalized during the study period filled in the re-hospitalization registration form,and the re-hospitalization rate was calculated.Results There was no statistically significant difference in FVC,FEV,,and FEV1/FVC ratio of patients between the two groups at admission(P＞0.05);the FVC,FEV1,and FEV1/FVC ratio of patients at 4 weeks,12 weeks,and 6 months of training were significantly high-er than those at admission in the control group and the observation group(P＜0.05);after 4 weeks,12 weeks,and 6 months of training,the FVC,FEV1,and FEV1/FVC ratio of patients in the observation group were significantly higher than those in the control group(P＜0.05).There was no statistically significant difference in CAT and mMRC scores of patients between the two groups at admission(P＞0.05);the CAT and mMRC scores of patients at 4 weeks,12 weeks,and 6 months of training were significantly lower than those at admission in the control group and the observation group(P＜0.05);after 4 weeks,12 weeks,and 6 months of training,the CAT and mMRC scores of patients in the observation group were significantly lower than those in the control group(P＜0.05).There was no significant difference in SMI and HGS levels of patients between the two groups at admission(P＞0.05);the SMI and HGS levels of patients at 4 weeks,12 weeks and 6 months of training were significantly higher than those at admission in the control group and the observation group(P＜0.05);after 4 weeks,12 weeks and 6 months of training,the SMI and HGS levels of patients in the observation group were significantly higher than those in the control group(P＜0.05).There was no significant difference in the 6-minute walking distance between the two groups at admission(P＞0.05);the 6-minute walking distances of patients at 4 weeks,12 weeks and 6 months of training were significantly higher than those at admission in the control group and the observation group(P＜0.05);after 4 weeks,12 weeks and 6 months of training,the 6-minute walking distance of patients in the observation group was significantly higher than that in the control group(P＜0.05).The re-hospitalization rate of patients in the observation group and the control group was 14％(7/50)and 32％(16/50),respectively;the re-hospitalization rate of patients in the observation group was significantly lower than that in the control group(x2=4.574,P＜0.05).Conclusion Pulmonary rehabilitation training can effectively improve the respiratory function of patients with COPD and sarcopenia,reduce their degree of dyspnea,enhance muscle strength,muscle mass and exercise tolerance,and reduce the re-hospitalization rate.

Objective: To evaluate the effectiveness of a comprehensive intervention for childhood obesity on self-efficacy, weight perception, and stage of behavior change, and to provide a scientific evidence for childhood obesity interventions. Methods: The study was a cluster randomized controlled trial. Twelve primary schools and 1 889 children (aged 7-11 years) from Dongcheng District in Beijing were recruited in September, 2013, and were administered a comprehensive intervention for childhood obesity. Six schools (930) were randomly allocated to the intervention group, and six schools (959) were randomly allocated to the control group. A face-to-face questionnaire survey was carried out, R 4.0.3 software was used to analyze the data, and multiple linear regression model was used to analyze the intervention effect. Results: After the intervention, mean (standard deviation) scores of self-efficacy among children in the intervention and control groups were (4.4±0.9) and (4.2±1.1), respectively. After the intervention, the proportion of children in the intervention group who underestimated or overestimated their body weight was 28.4% and 11.3 %, respectively, while the figures in the control were 37.1% and 6.9%; compared with the control, the risk of underestimating body weight decreased among children in the intervention group( OR=0.64, 95%CI=0.52-0.80, P <0.01), while the risk of weight overestimation increased( OR=1.79, 95%CI=1.26-2.54, P <0.01). After the intervention, the proportion of children in the contemplation or action stage of behaviour change was 65.3% and 83.6%, while the figures in the control group were 59.8% and 69.8 %, respectively; in comparison with the control group, more children in the intervention group were in comtemplation ( OR= 1.28 , 95%CI=1.03-1.59, P =0.02) or action stage of behaviour change( OR=2.59, 95%CI=2.04-3.27, P <0.01). Conclusion The comprehensive intervention for childhood obesity improved self-efficacy, weight perception, and facilitated behavior change, but may increase the risk of weight overestimation.

Objective: To evaluate the effect of a dietary and exercise intervention on cognition and behaviors among primary school students, and to further explore the mediating role of family support, in order to provide scientific evidence for future effective intervention strategies. Methods: A dietary and exercise intervention program for childhood obesity prevention was carried out in 24 primary schools in Beijing, Changzhi and Urumqi from 2018 to 2019, and 1 392 children in grade four as well as their parents were included. Family support and children s cognition and behaviors were collected through questionnaire. To carry out diet and exercise behavior intervention on the three levels of school, family and individual in the intervention group,and children s dietary and exercise knowledge, eating habits, physical activities, as well as sedentary and screen behaviors were evaluated. The linear mixed model was used to analyze the effect of intervention on children s cognition and behaviors, and the mediation model was used to explore the role of family support. Results: The proportion of children with higher score of dietary and exercise knowledge ( OR= 2.34 , 95%CI =1.71-3.21), eating habits ( OR=2.58, 95%CI =1.75-3.82), and sedentary and screen behaviors ( OR=1.91, 95%CI =1.35-2.68) increased in the intervention group after one year intervention ( P <0.01), compared with the control group, respectively. The intervention also increased the proportion of children s family support in the intervention group compared with the control group ( OR=3.45, 95%CI =2.19-5.45), and the support from children s fathers ( OR=2.70, 95%CI =1.68-4.35), mothers ( OR=3.71, 95%CI =2.28-6.04), paternal grandmothers ( OR=1.65, 95%CI =1.00-2.70), and maternal grandmothers ( OR= 2.14, 95%CI =2.12-2.16) increased significantly ( P <0.05). The mediation analysis showed that family support played a mediating role in association between comprehensive intervention and children s eating habits as well as sedentary and screen behaviors. Conclusion The dietary and exercise intervention effectively promoted children s cognition and behaviors, and family support played an important mediating role.

Objective: To evaluate the cost effectiveness of a school based comprehensive intervention for childhood obesity and to provide scientific basis for formulating and promoting efficient and economic intervention measures for childhood obesity. Methods: In a cluster randomized controlled trial, 12 primary schools (1 889 students from grade 3 to 5) in Dongcheng District in Beijing were selected and randomly assigned to the intervention (6 schools, 930 students) and control group (6 schools, 959 students). Students in the intervention group received a one year school based comprehensive intervention for childhood obesity, including development of school level policies, health education activities, improvement of physical activity, and improvement of healthy diet. A cost analysis method from a social perspective was used to evaluate the implementation costs of the intervention. Cost effectiveness analysis was used by calculating incremental cost effectiveness ratio (ICER) on obesity related knowledge, number of days completing no less than 60 minutes of moderate to vigorous physical activity (MVPA) per week, students consuming sugar sweetened beverage. Results: The material cost and human cost were 46 376.24 yuan and 46 197.32 yuan, respectively. The total cost of the intervention was 92 573.56 yuan and the average cost was 99.54 yuan per student in the intervention group. ICER on obesity related knowledge, number of days completing no less than 60 minutes of MVPA per week, percentage of students consuming sugar sweetened beverage were 52.39%, 71.61% and 2.26%, respectively. Conclusion The school based comprehensive intervention for childhood obesity shows a good cost effectiveness promoting students obesity related knowledge, as well as dietary and physical activity behaviors.

Objective: To explore the mediation effect of eating behavior in the personality obesity association, so as to provide scientific evidence for preventing childhood obesity in China. Methods: This study investigated 1 271 children in September 2018 among Beijing, Changzhi and Urumuqi. By used NEO five Factor Inventory to assess characteristics of personality and used Children Eating Behavior Questionnaire to measure eating behaviors in children. Five obesity related indicators [body mass index (BMI), BMI Z score, waist circumference, waist to hip ratio and body fat percentage] were derived from physical examination. Results: After adjusting for sex, age and region, the standardization scores of conscientiousness were negatively associated with BMI( B= -0.227 , 95%CI =-0.422--0.031), BMI Z score( B=-0.081, 95%CI =-0.158--0.006), waist circumference( B=-0.720, 95%CI = -1.281--0.159), waist to hip ratio( B=-0.004, 95%CI =-0.007--0.001) and body fat percentage ( B=-0.727, 95%CI = -1.293--0.162)( P <0.05). Results from the mediation analysis showed that the associations between conscientiousness and BMI, BMI Z score, waist circumference, waist to hip ratio and body fat percentage were partly mediated through food responsiveness and emotional eating behaviors; with effects ranged from 27.5%-47.1% and 0.9%-18.0%( P <0.05). Conclusion Conscientiousness is associated with lower risk of childhood obesity and food responsiveness and emotional eating behaviors show mediating effect in the association between childhood personality and obesity. Health education should be carried out in time for children with low conscientiousness in order to prevent the occurrence of obesity in the early stage.

Objective: To analyze the effect of a comprehensive intervention on the accuracy of children s body size perception, so as to provide a theoretical basis for child body size perception improvement. Methods: The participants were selected from a cluster randomized controlled trial (September 2018 to June 2019). A total of 1 287 children in 24 primary schools (clusters) equally distributed among three regions (Beijing, Changzhi and Urumqi) were selected, which included 12 intervention schools (648 students) and 12 control schools (639 students). The accuracy of body size perception was measured by Ma figural stimuli. A linear mixed model was employed to analyze the effect of the comprehensive intervention on the accuracy of children s body size perception. Results: At baseline, the accuracy rate of body size perception among children in the intervention group and the control group was 56.6% and 51.5%, respectively. The underestimation rate was 42.0% and 47.7%, and the overestimation rate was 1.4% and 0.8%. After the intervention, compared with the control group, the inaccuracy rate ( OR=0.50, 95%CI=0.37-0.68, P <0.01) and the underestimation rate in the intervention group decreased ( OR=0.37, 95%CI=0.26-0.54, P <0.01). There was no significant difference in the overestimation rate between the two groups( P =0.51). The results of the stratified analysis showed that the intervention could improve the accuracy of children s body size perception, regardless of their gender, nutritional status, region, or whether or not they were only child( P >0.05). Conclusion The inaccuracy rate of children s body size perception, which mainly involved underestimation was high. A comprehensive intervention can effectively reduce body size underestimation and improve the accuracy of children s body size perception.

Objective: To study the compliance and associated factors of smartphone application (APP) usage in childhood dietary and exercise intervention. Methods: Based on one childhood intervention of diet and exercise in Beijing, Changzhi of Shanxi Province and Urumqi of Xinjiang Province, 694 children (and their primary caregivers) in the intervention group were investigated regarding usage of APP during the intervention. Compliance of APP usage was evaluated by the click times of APP, and Logistic regression models were used to analyze influencing factors of the compliance. Results: The median (inter quartile range) click times of APP in the four modules (information dissemination, behavior monitoring, homework uploading and feedback) were 10 (5，21), 20 (14，26), 7(4，10), 26 (15，53), respectively. Multivariable logistic regression analysis found that compliance of APP usage was higher among subjects in Changzhi region ( OR =1.67，95% CI =1.12-2.48), whose primary caregiver was mother ( OR =1.55，95% CI =1.09-2.22), or whose mother did not work ( OR =0.47， 95% CI =0.31-0.74). Conclusion Compliance of APP usage was generally high in the childhood intervention of diet and exercise. Some factors are associated with compliance of APP usage. Findings of the study provide a scientific basis for better implementation of APP based childhood interventions of diet and exercise in the future.

Objective: To study the relationship between nutrition status and physical fitness in 8-10 year-old children in 3 cities, and to provide a scientific reference for improving physical condition of chidren of pre-school age. Methods: To investigate the weight, height and physical fitness (standing long jump, endurance running, rope skipping in one minute and sit-ups in one minute) of 1 384 children in grade four from 24 primary schools in Beijing, Changzhi, Urumchi in 2018. Evaluated overweight and obesity by using the standard of “Screening for Overweight and Obesity among School-age Children”. Then used mixed linear model to compare the physical fitness of students with different nutritional status and to analyze the relationship between BMI and physical fitness. Results: The prevalence of overweight and obesity were 17.41% and 23.48%, respectively. And the prevalence in boys was both more than that in girls(χ2=9.84，47.68，P<0.01). The increase in BMI of children from the same age and the same gender was related with the decrease in physical fitness by correlation analysis(P<0.05). In comparison method, the performance of the students of normal weight was better than obese students, but the male and female students had got the same results in their physical fitness test(P<0.05). Conclusion There is a negative correlation between nutrition status and physical fitness and the physical fitness in normal weight and obese children are better than the overweight children or obese children.

Objective To develop a new method for describe features of inflow of left ventricle(LV) from color Doppler image by color singular value,and evaluat the value of color singular value in assessment of diastolic dysfunction. Methods Patients with diastolic dysfunction of LV including myocardial infarction (n = 37), angina( n = 35), cardiomyopathy( n = 45) and hypertension ( n =46) were selected and 30 healthy cases as control. CV and AV from color singular value of LV inflow was displayed and calculated automatically by an analyzing system developed in our laboratory. Results Compared with that of control (CV:2.40 0.22 and AV: -0.25 0.05), the absolute value of CV(1.67-1.90 in average)and AV( - 0. 11～-0. 20 in average) from color singular value were decreased significantly( P <0. 001) in groupsof myocardial infarction, angina, cardiomyopathy and hypertension. Conclusions Singular value can be applied to detect color differences in LV inflow from color Doppler signals. Changes of singular value within the diastolic inflow under pathological conditions may reflect the diastolic dysfunction of LV.

BACKGROUND: Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been widely used on clinic; however, there are still few reports addressing rhBMP-2-induced osteogenesis in intervertebral disc.OBJECTIVE: To verify the effect of rhBMP-2 to induce interbody fusion in rabbits.DESIGN, TIME AND SETTING: Randomized controlled animal study and multi-level evaluation, which was performed in Affiliated Hospital of Medical College of Qingdao University from February to July 2007.MATERIALS: 24 adult New-Zealand rabbits weighing 3.5-4.5 kg were used to expose L4-5 and L5-6 intervertebral disc; rhBMP-2 (1 mg/ampoule, purity≥95%) was provided by Beijing Bailingke Biological Products Co., Ltd.METHODS: 24 rabbits were randomly divided into experimental group and control group with 12 rabbits for each. In the experimental group, saline (20 μL, containing 200 μg rhBMP-2) was injected into nucleus pulposus of L4-5 intervertebral disc; equivalent saline was inserted into nucleus pulposus of L5-6 intervertebral disc as controls. Rabbits in the control group were injected with saline (20 μL) into nucleus pulposus of L4-5 intervertebral disc.MAIN OUTCOME MEASURES: Morphological changes of injected segments were observed by hand-feeling check together with histological and imaging tests at 10, 30, 60, and 90 days postoperatively.RESULTS: 24 rabbits were included in the final analysis. ①In the experimental group, the motion range of L4-5 segment was not limited at 10 days postoperatively, and lightly limited at 30 days, but severely limited at 60 days postoperatively; L4-5 segment was fixed tightly at 90 days postoperatively. Moreover, motion range of L5-6,segment and articular motion range in the control group were not changed remarkably. ② L4-5 interbedy space was narrowed at 10 days or even disappeared at 90 days postoperatively, and then osteogenesis fusion was formed. Transmittance of intervertebral space in the L5-6 segment and in the control group was not changed obviously. ③ Nucleus pulposus was gradually shrunk at 10 days postoperatively; partial cartilage endplate transformed into mature woven bone, and collagen fiber structure of annulus fibrosus gradually disappeared at 90 days postoperatively. A lot of mesenchymal cells were aggregated surrounding annulus fibrosus at 10 and 30 days postoperatively. Moreover, mature woven bone was formed in annulus fibrosus near to cartilage endplate at 90 days postoperatively. However, histological and morphological changes were not found in the control group at those four time points.CONCLUSION: rhBMP-2 can induce intervertebral disc osteogenesis so as to achieve interbody fusion.