Objective:To investigate the prevalence and risk factors of the 4 most common functional gastrointestinal disorders (FGID) among school-aged children in Shanghai.Methods:A cross-sectional questionnaire survey was conducted from January to December 2019. Using stratified cluster sampling, 26 097 students in grades 1-12 from Huangpu and Jiading District, Shanghai were enrolled. The questionnaire of pediatric gastrointestinal symptoms-Rome Ⅳ (QPGS-Ⅳ) and the pediatric quality of life inventory (PedsQL) were used to assess the prevalence and health-related quality of life (HRQoL) of functional dyspepsia (FD), irritable bowel syndrome (IBS), functional abdominal pain-not otherwise specified (FAP-NOS), and functional constipation (FC). Multivariate Logistic regression analysis was performed to identify correlations between sociodemographic factors, lifestyle habits, comorbidities and 4 major FGID. A trend chi-square test was used to explore the relationship between HRQoL scores and FGID prevalence.Results:A total of 26 097 valid participants (26 097/27 036, 96.5%) were included in the study, with the age of (10.8±3.1) years and 12 441 cases (47.7%) were female. The prevalence of FC was found to be the highest (5 537 cases, 21.2%), followed by IBS (797 cases, 3.1%), FAP-NOS (267 cases, 1.0%) and FD (218 cases, 0.8%). Multivariate Logistic regression analysis revealed the following findings: junior high school (FD: OR=1.88 (95% CI 1.35-2.61); IBS: OR=1.42 (95% CI 1.18-1.71); FAP-NOS: OR=1.39 (95% CI 1.02-1.90)), senior high school (FD: OR=2.67 (95% CI 1.84-3.86);IBS: OR=2.36 (95% CI 1.93-2.89) ;FAP-NOS: OR=2.20 (95% CI 1.56-3.11)) and frequent respiratory infections (FD: OR=2.15 (95% CI 1.45-3.18); IBS: OR=2.59 (95% CI 2.12-3.16); FAP-NOS: OR=1.49 (95% CI 1.00-2.21)) were common risk factors for FD, IBS and FAP-NOS. Allergic symptoms (FD: OR=2.21 (95% CI 1.56-3.14); IBS: OR=2.30 (95% CI 1.04-1.51); FAP-NOS: OR=2.54 (95% CI 1.85-3.50); FC: OR=1.09 (95% CI 1.01-1.17)) was a common risk factor for FD, IBS, FAP-NOS and FC. Family history of allergy was a risk factor for IBS ( OR=1.41 (95% CI 1.20-1.65)) and FAP-NOS ( OR=1.33 (95% CI 1.01-1.74)). Female exhibited increased risks for FD ( OR=1.49 (95% CI 1.13-1.96)), IBS ( OR=1.50 (95% CI 1.30-1.74)) and FC ( OR=1.10 (95% CI 1.03-1.17)). The presence of dietary bias was associated with of IBS ( OR=1.46 (95% CI 1.26-1.69)) and FC ( OR=1.26 (95% CI 1.19-1.34)); late bedtime ( OR=1.32 (95% CI 1.06-1.64)) and allergen exposure ( OR=1.25 (95% CI 1.04-1.51)) were risk factors for IBS. Insufficient sleep ( OR=1.11 (95% CI 1.02-1.21)), insufficient outdoor time ( OR=1.20 (95% CI 1.01-1.43)) and severe lack of outdoor time ( OR=1.48 (95% CI 1.23-1.76)) were significant risk factors for FC. Pet ownership ( OR=1.39 (95% CI 1.07-1.81)) was a risk factor for FAP-NOS. HRQoL scores were significantly lower in children with FD, IBS, or FAP-NOS compared to non-FGID peers (all P<0.05). χ2 trend test analysis showed that the Pearson correlation coefficients between the prevalence of FD, IBS, FAP-NOS, FC and HRQoL scores were -0.93, -0.93, -0.97 and -0.84, respectively. Conclusions:The prevalence of FGID among school-aged children in Shanghai varies by sub-type. FC was the most prevalence. Junior and senior high school, female sex, allergic symptoms and frequent respiratory infections were major risk factors. Meanwhile, dietary bias, late bedtime, insufficient outdoor time and pet ownership were associated with specific subtypes. The HRQoL is significantly reduced in children with FD, IBS and FAP-NOS.

Objective:To investigate the prevalence and risk factors of the 4 most common functional gastrointestinal disorders (FGID) among school-aged children in Shanghai.Methods:A cross-sectional questionnaire survey was conducted from January to December 2019. Using stratified cluster sampling, 26 097 students in grades 1-12 from Huangpu and Jiading District, Shanghai were enrolled. The questionnaire of pediatric gastrointestinal symptoms-Rome Ⅳ (QPGS-Ⅳ) and the pediatric quality of life inventory (PedsQL) were used to assess the prevalence and health-related quality of life (HRQoL) of functional dyspepsia (FD), irritable bowel syndrome (IBS), functional abdominal pain-not otherwise specified (FAP-NOS), and functional constipation (FC). Multivariate Logistic regression analysis was performed to identify correlations between sociodemographic factors, lifestyle habits, comorbidities and 4 major FGID. A trend chi-square test was used to explore the relationship between HRQoL scores and FGID prevalence.Results:A total of 26 097 valid participants (26 097/27 036, 96.5%) were included in the study, with the age of (10.8±3.1) years and 12 441 cases (47.7%) were female. The prevalence of FC was found to be the highest (5 537 cases, 21.2%), followed by IBS (797 cases, 3.1%), FAP-NOS (267 cases, 1.0%) and FD (218 cases, 0.8%). Multivariate Logistic regression analysis revealed the following findings: junior high school (FD: OR=1.88 (95% CI 1.35-2.61); IBS: OR=1.42 (95% CI 1.18-1.71); FAP-NOS: OR=1.39 (95% CI 1.02-1.90)), senior high school (FD: OR=2.67 (95% CI 1.84-3.86);IBS: OR=2.36 (95% CI 1.93-2.89) ;FAP-NOS: OR=2.20 (95% CI 1.56-3.11)) and frequent respiratory infections (FD: OR=2.15 (95% CI 1.45-3.18); IBS: OR=2.59 (95% CI 2.12-3.16); FAP-NOS: OR=1.49 (95% CI 1.00-2.21)) were common risk factors for FD, IBS and FAP-NOS. Allergic symptoms (FD: OR=2.21 (95% CI 1.56-3.14); IBS: OR=2.30 (95% CI 1.04-1.51); FAP-NOS: OR=2.54 (95% CI 1.85-3.50); FC: OR=1.09 (95% CI 1.01-1.17)) was a common risk factor for FD, IBS, FAP-NOS and FC. Family history of allergy was a risk factor for IBS ( OR=1.41 (95% CI 1.20-1.65)) and FAP-NOS ( OR=1.33 (95% CI 1.01-1.74)). Female exhibited increased risks for FD ( OR=1.49 (95% CI 1.13-1.96)), IBS ( OR=1.50 (95% CI 1.30-1.74)) and FC ( OR=1.10 (95% CI 1.03-1.17)). The presence of dietary bias was associated with of IBS ( OR=1.46 (95% CI 1.26-1.69)) and FC ( OR=1.26 (95% CI 1.19-1.34)); late bedtime ( OR=1.32 (95% CI 1.06-1.64)) and allergen exposure ( OR=1.25 (95% CI 1.04-1.51)) were risk factors for IBS. Insufficient sleep ( OR=1.11 (95% CI 1.02-1.21)), insufficient outdoor time ( OR=1.20 (95% CI 1.01-1.43)) and severe lack of outdoor time ( OR=1.48 (95% CI 1.23-1.76)) were significant risk factors for FC. Pet ownership ( OR=1.39 (95% CI 1.07-1.81)) was a risk factor for FAP-NOS. HRQoL scores were significantly lower in children with FD, IBS, or FAP-NOS compared to non-FGID peers (all P<0.05). χ2 trend test analysis showed that the Pearson correlation coefficients between the prevalence of FD, IBS, FAP-NOS, FC and HRQoL scores were -0.93, -0.93, -0.97 and -0.84, respectively. Conclusions:The prevalence of FGID among school-aged children in Shanghai varies by sub-type. FC was the most prevalence. Junior and senior high school, female sex, allergic symptoms and frequent respiratory infections were major risk factors. Meanwhile, dietary bias, late bedtime, insufficient outdoor time and pet ownership were associated with specific subtypes. The HRQoL is significantly reduced in children with FD, IBS and FAP-NOS.

Objective:To develop an UPLC-MS/MS method for the determination of paeoniflorin, tetramethylpyrazine, nobiletin, paeonol, amygdalin and ligustilide in Gexia-Zhuyu Decoction. Methods:Isocratic elution was carried out with mobile phase consisting of methanol- 4 mM ammonium formate. The separation was performed on Waters XTerra MS C18 (2.1 mm × 50 mm, 3.5 μm), and the mass spectrometer was operated in the positive and negative ionization electrospray (ESI) mode using multiple monitoring (MRM) for analysis of six components. Quantitative analysis by external standard method. The precursor to product ion transitions monitored for paeoniflorin, tetramethylpyrazine, nobiletin, paeonol, amygdalin and ligustilide were m/z 525.0→449.1, 137.1→55.1, 403.0→373.0, 167.2→149.4, 456.5→323.3 and 191.1→91.1, respectively. Results:Paeoniflorin, tetramethylpyrazine, nobiletin, paeonol, amygdalin and ligustilide were all analyzed exactly, the linear ranges were 0.000 2-0.012 8, 0.000 8-0.051 2, 0.000 1-0.006 4, 0.000 2-0.012 8, 0.000 6-0.038 4, 0.000 1- 0.006 4 ng, respectively. The r were 0.999 3, 0.997 5, 0.999 6, 0.992 6, 0.995 5 and 0.999 1, respectively. The recoveries of six analytes ranged from 98.00% to 105.3% and the relative standard deviations ( RSD) were all below 2.47%. Conclusions:This method was sensitive, which could be applied for the determination of paeoniflorin, tetramethylpyrazine, nobiletin, paeonol, amygdalin and ligustilide in Gexia-Zhuyu Decoction.

Objective To observe the effect of Ziyin-Jianghuo formula in treatment of Yin deficiency generating intrinsic heat type of the levels of monoamine neurotransmitters and estrogens in rats, and investigate its intervention in the neuroendocrine system. Methods There were 7 groups, which were sham operation group, model control group, estrogen tablet group, Gengnian capsule group, Ziyin-Jianghuo formula low, medium and high dose groups. Castration was performed by castration (extraction of ovaries) plus hot traditional Chinese medicine. The rats in the treatment group were given the above drugs 24 hours after the last administration of the hot Chinese medicine, once a day for 30 consecutive days. The sham operation group and the model control group were given an equal volume of purified water by simultaneous intragastric administration. The serum estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL) levels,uterine coefficient and monoamine neurotransmitters dopamine (DA), norepinephrine (NE), serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA) content in the hypothalamus were detected after 12 hours of the last treatment. Results Compared with the model group, the levels of serum FSH (4.39 ± 0.22 IU/L, 2.89 ± 0.91 IU/L, 2.84 ± 0.98 IU/L vs. 5.51 ± 0.24 IU/L), LH (14.48 ± 0.24 IU/L, 11.46 ± 0.33 IU/L, 5.28 ± 1.31 IU/L vs. 15.02 ± 0.37 IU/L) in the low, middle and high doses of Ziyin-Jianghuo formula significantly decreased (P<0.05), the levels of serum E2 (39.84 ± 6.08 pmol/L, 48.65 ± 6.77 pmol/L, 64.96 ± 7.97 pmol/L vs. 33.16 ± 4.62 pmol/L) significantly increased (P<0.05). The content of DA, 5-HT, 5-HIAA in the hypothalamus and the 5-HT/NE (0.48 ± 0.02, 0.43 ± 0.03, 0.27 ± 0.02 vs. 0.67 ± 0.02), 5-HIAA/5-HT (1.74 ± 0.09, 1.71 ± 0.10, 1.80 ± 0.17 vs. 2.00 ± 0.10) in the low, middle and high doses of Ziyin-Jianghuo formula significantly decreased ( P<0.05), the content of NE (663.34 ± 9.81 ng/kg, 695.94 ± 10.54 ng/kg, 790.76 ± 16.35 ng/kg vs. 602.95 ± 13.24 ng/kg) in the hypothalamus in the low, middle and high doses of Ziyin-Jianghuo formula significantly increased (P<0.05). The levels of serum PRL (10.16 ± 1.26 μg/L, 7.22 ± 1.26 μg/L vs. 14.80 ± 1.64 μg/L) in the middle and high doses of Ziyin-Jianghuo formula significantly decreased (P<0.05). Conclusions The Ziyin-Jianghuo formula has a significant positive regulation effect on the neuroendocrine system of menopausal Yin deficiency generating intrinsic heat type of rats, and this process is dose-dependent and can improve a series of symptoms caused by autonomic dysfunction.