Objective:To investigate the prevalence and risk factors of overweight and obesity among Chinese children aged 3-18 years from 11 provinces, antonomous regions, or municipalities.Methods:This national cross-sectional community health survey utilized a multistage stratified cluster-random sampling method to recruit 193 997 nationally representative participants from 11 provinces, autonomous regions, or municipalities between January 2017 and December 2019. All participants underwent physical examinations, and their caregivers completed questionnaires assessing participants′ dietary, lifestyle, familial, and perinatal information. Multilevel multinomial logistic regression models were employed to identify the potential risk factors.Results:The cohort comprised 193 997 children (102 178 boys, 91 819 girls),aged (10±4) years. Overall prevalence rates were 30 574(15.8%)overweight children and 17 217(8.9%) obesity children. Boys exhibited higher overweight and obesity rates than girls (17.0% (17 368/102 178) vs. 14.4% (13 206/102 178), 11.3% (11 553/91 819) vs. 6.2% (5 664/91 819), χ2=249.12,1 578.69,both P<0.001). The detection rates of obesity in Tanner stage 2 and 3 were the highest in boys and girls, with 13.4%(2 231/16 665) and 8.6%(880/10 221) respectively. Risk factors for obesity included parental overweight (paternal OR=2.34 and maternal OR=2.29), annual household income of 100 000-200 000 yuan (compared with<100 000 yuan, OR=1.04), higher paternal education (compared with below high school,high school and a college education OR=1.09,1.14), birth weight >4.0 kg (≤5 and>5 years old OR=1.74, 1.44,respectively), and western food consumption≥1 time/month (compared with<1, 1-2, 3-4,>4 times/month OR=1.36, 1.30, 1.67(≤5 years), 1.19, 1.16, 1.15 (>5 years), respectively) (all P<0.05). Conversely, coarse grain intake≥1 times/week (compared with<1 times/week, every day, 3-4, 1-2 times/week OR=0.74, 0.80, 0.71 (≤5 years), 0.75, 0.87, 0.90(>5 years), respectively, all P<0.05) was associated with reduced obesity risk. Conclusions:Obesity epidemiology in children demonstrates significant heterogeneity across age, gender, geographic regions, and pubertal stages. It is necessary to establish a personalized prevention and control strategy.

BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

Objective To compare the gut fungal composition between gout patients and healthy individuals through high-throughput sequencing of ribosomal DNA internal transcribed spacer 1(ITS1).Methods Gout patients and healthy volunteers who visited our hospital from January 2023 to December 2024 were enrolled in this study.Then based on established medical guidelines,the gout patients were categorized into 3 groups:Group H(asymptomatic hyperuricemia,n=14),Group G(acute gouty arthritis,n=14),and Group I(intercritical period of gouty arthritis,n=15),and the healthy individuals were assigned into Group N(n=9).Fecal samples were collected from all the participants to undergo ITS1 sequencing analysis.The differences in diversity and composition of gut mycobiome,and FunGuild-derived fungal functions and nutritional status were compared among the 4 groups,and the correlation between the gut mycobiome and clinical indicators was analyzed.Results There were no significant differences in baseline features such as gender,age,glomerular filtration rate(GFR),and levels of serum creatinine(SCr)and serum urea among Group N and other gout groups,but obvious differences were observed in body mass index(BMI),erythrocyte sedimentation rate,and levels of C-reactive protein(CRP),serum uric acid(SUA),and IL-1β and IL-6(P<0.05).In terms of gut fungal diversity,ITS1 analysis showed there were no statistical differences in α-diversity or the principal coordinate analysis(PCoA)of β-diversity among the groups.However,as gout progressed,significant changes were observed in β-diversity indices,indicating a shift in the gut fungal community composition with disease advancement(P<0.05).The phyla Ascomycota,Basidiomycota,and Mucoromycotina were the dominant fungal phyla in all groups.Compared with the other 3 gout groups,the abundance of Pichia was significantly increased in Group N(P<0.05),that of Saccharomyces was in Group H(P<0.05),and that of Starmerella was in Group G(P<0.05).Correlation analysis between the gut mycobiome and clinical indices indicated that the relative abundance of Starmerella was significantly positively correlated with IL-1β(P<0.01)and IL-6(P<0.05).The relative abundance of Pichia was significantly positively correlated with IL-1β and IL-6 levels(P<0.05),and negatively correlated with serum urea level(P<0.05),and the relative abundance of Saccharomyces was negatively correlated with IL-1β and IL-6 levels(P<0.05).Conclusion There exist significant alterations in both the diversity and composition of gut fungi among patients with gout at various stages.Notably,the fluctuations in the relative abundance of Starmerella,Pichia and Saccharomyces appear to correlate with key clinical indicators.

Objective To observe the value of changes of neutrophil-to-lymphocyte ratio(NLR)before and after the first interventional treatment of hepatocellular carcinoma(HCC)for predicting patient's overall survival(OS).Methods Totally 92 HCC patients who underwent the first time TACE or TACE+hepatic artery infusion chemotherapy(HAIC)were retrospectively enrolled.The patients were divided into NLR ratio(NLRR)＜1.29 group(n=54)and≥1.29 group(n=38)based on the ratio of NLR after to before treatment,also ΔNLR＜0.87 group(n=60)and≥0.87 group(n=32)based on the difference of NLR after and before treatment.Clinical data were compared between groups,survival analysis was performed,and the value of NLRR and ΔNLR for predicting OS were analyzed.Results No significant difference of clinical data was found between NLRR＜1.29 and≥1.29 groups,nor between ΔNLR＜0.87 and≥0.87 groups(all P＞0.05).The median OS of 92 patients was 30.90 months,which in NLRR＜1.29 group(55.10 months)was longer than that in NLRR≥1.29 group(22.30 months,P=0.005),while in ΔNLR＜0.87 group(55.10 months)was longer than that in ΔNLR≥0.87 group(14.20 months,P=0.003).Cox regression analysis showed that the maximum diameter of tumor≥5 cm,distant metastasis,ascites,NLRR≥1.29 and ΔNLR≥0.87 were all independent risk factors of OS(all P＜0.05).Taken 1.29 and 0.87 as the best cut-off value,respectively,the area under the curve of NLRR and ΔNLR for predicting OS was 0.620 and 0.610,respectively.Conclusion NLRR and ΔNLR were helpful for predicting OS of HCC patient after the first interventional treatment.

Objective To observe the value of changes of neutrophil-to-lymphocyte ratio(NLR)before and after the first interventional treatment of hepatocellular carcinoma(HCC)for predicting patient's overall survival(OS).Methods Totally 92 HCC patients who underwent the first time TACE or TACE+hepatic artery infusion chemotherapy(HAIC)were retrospectively enrolled.The patients were divided into NLR ratio(NLRR)＜1.29 group(n=54)and≥1.29 group(n=38)based on the ratio of NLR after to before treatment,also ΔNLR＜0.87 group(n=60)and≥0.87 group(n=32)based on the difference of NLR after and before treatment.Clinical data were compared between groups,survival analysis was performed,and the value of NLRR and ΔNLR for predicting OS were analyzed.Results No significant difference of clinical data was found between NLRR＜1.29 and≥1.29 groups,nor between ΔNLR＜0.87 and≥0.87 groups(all P＞0.05).The median OS of 92 patients was 30.90 months,which in NLRR＜1.29 group(55.10 months)was longer than that in NLRR≥1.29 group(22.30 months,P=0.005),while in ΔNLR＜0.87 group(55.10 months)was longer than that in ΔNLR≥0.87 group(14.20 months,P=0.003).Cox regression analysis showed that the maximum diameter of tumor≥5 cm,distant metastasis,ascites,NLRR≥1.29 and ΔNLR≥0.87 were all independent risk factors of OS(all P＜0.05).Taken 1.29 and 0.87 as the best cut-off value,respectively,the area under the curve of NLRR and ΔNLR for predicting OS was 0.620 and 0.610,respectively.Conclusion NLRR and ΔNLR were helpful for predicting OS of HCC patient after the first interventional treatment.

Objective:To investigate the prevalence and risk factors of overweight and obesity among Chinese children aged 3-18 years from 11 provinces, antonomous regions, or municipalities.Methods:This national cross-sectional community health survey utilized a multistage stratified cluster-random sampling method to recruit 193 997 nationally representative participants from 11 provinces, autonomous regions, or municipalities between January 2017 and December 2019. All participants underwent physical examinations, and their caregivers completed questionnaires assessing participants′ dietary, lifestyle, familial, and perinatal information. Multilevel multinomial logistic regression models were employed to identify the potential risk factors.Results:The cohort comprised 193 997 children (102 178 boys, 91 819 girls),aged (10±4) years. Overall prevalence rates were 30 574(15.8%)overweight children and 17 217(8.9%) obesity children. Boys exhibited higher overweight and obesity rates than girls (17.0% (17 368/102 178) vs. 14.4% (13 206/102 178), 11.3% (11 553/91 819) vs. 6.2% (5 664/91 819), χ2=249.12,1 578.69,both P<0.001). The detection rates of obesity in Tanner stage 2 and 3 were the highest in boys and girls, with 13.4%(2 231/16 665) and 8.6%(880/10 221) respectively. Risk factors for obesity included parental overweight (paternal OR=2.34 and maternal OR=2.29), annual household income of 100 000-200 000 yuan (compared with<100 000 yuan, OR=1.04), higher paternal education (compared with below high school,high school and a college education OR=1.09,1.14), birth weight >4.0 kg (≤5 and>5 years old OR=1.74, 1.44,respectively), and western food consumption≥1 time/month (compared with<1, 1-2, 3-4,>4 times/month OR=1.36, 1.30, 1.67(≤5 years), 1.19, 1.16, 1.15 (>5 years), respectively) (all P<0.05). Conversely, coarse grain intake≥1 times/week (compared with<1 times/week, every day, 3-4, 1-2 times/week OR=0.74, 0.80, 0.71 (≤5 years), 0.75, 0.87, 0.90(>5 years), respectively, all P<0.05) was associated with reduced obesity risk. Conclusions:Obesity epidemiology in children demonstrates significant heterogeneity across age, gender, geographic regions, and pubertal stages. It is necessary to establish a personalized prevention and control strategy.

Objective:To investigate the clinical characteristics and management status of children with Turner syndrome (TS) in China.Methods:As a cross-sectional study, 1 089 TS patients were included in the database of the National Collaborative Alliance for the Diagnosis and Treatment of Turner Syndrome from August 2019 to November 2023. Clinical characteristics (growth development, sexual development, organ anomalies, etc.), karyotypes, auxiliary examinations, and treatments were collected and analyzed.Results:Among the 1 089 TS cases, 809 were recorded karyotypes. The karyotype distribution was as follows: 45, X in 317 cases (39.2%), X chromosome structural variants (including partial deletions of p or q arm, ring chromosome, and marker chromosome) in 89 cases (11.0%), 45, X/46, XX mosaicism in 158 cases (19.5%), mosaicism with X chromosome structural variants in 209 cases (25.8%), and presence of Y chromosome material in 36 cases (4.4%). Among the 824 TS cases, the age of diagnosis was 9.7(6.4, 12.2) years, with a height standard deviation score (HtSDS) of -3.1±1.2. Five hundred and fifty three cases underwent growth hormone (GH) stimulation test, and 352 cases (63.7%) had GH peak values <10 μg/L and 75.9% (577/760) had low IGF1 levels, with IGF1 SDS ≤-2 accounting for 38.2% (290 cases). Among 471 cases aged ≥8 years, 132 cases (28.0%) showed spontaneous sexual development (mean bone age (11.0±1.7) years), 10 cases had spontaneous menarche (mean bone age (12.0±2.2) years), and 2 cases had regular menstrual cycles. Common physical features included cubitus valgus (311 cases (28.5%)), neck webbing (188 cases (17.2%)), low posterior hairline (185 cases (17.0%)), shield chest (153 cases (14.0%)), high arched palate (127 cases (11.6%)), short fourth metacarpal (43 cases (3.9%)), and spinal abnormalities (38 cases (3.5%)). Congenital cardiovascular and urogenital anomalies occurred in 91 cases (19.4%) and 66 cases (12.0%)respectively. Abdominal ultrasound in 33 cases (7.2%) indicated fatty liver, hepatomegaly, intrahepatic bile duct stones, and splenomegaly. Among 23 cases undergoing oral glucose tolerance test (OGTT) test, 2 were diagnosed with diabetes mellitus and 4 with impaired glucose tolerance. Following diagnosis, 669 cases (80.7%) received rhGH treatment at a chronological age of (9±4) years and bone age of (8.3±3.2) years. Additionally, 112 cases (19.4%) received sex hormone replacement therapy starting at the age of (14±4) years and bone age of (12.6±1.2) years.Conclusions:The karyotypes of 45, X and mosaicism were most common in Chinese children with TS. The clinical manifestations were mainly short stature and gonadal dysplasia. However, a few TS children could be in the normal range of height, and some cases among those aged of ≥8 years old had spontaneous sexual development. Some exhibited physical features, congenital cardiovascular and urogenital anomalies, and dysfunction of the hypothalamic-pituitary-IGF1 axis. Moreover, a few of them developed impaired glucose tolerance and diabetes mellitus. Following diagnosis, most of the patients received rhGH treatment, and a few of them received sex hormone replacement therapy.

Objective The characteristics of the time-scheduled appointment late arrival of outpatients in thoracic surgery at West China Hospital Sichuan University were analyzed.Methods A total of 9 378 cases of thoracic surgery patients were extracted from the HIS system of West China Hospital of Sichuan University in 2019.The normal patients were used as the control group,and the late patients were analyzed by SPSS 24.0 software.Results Age,gender,place of origin,type of consultation,consultation time,appointment method,expert level,and consultation time were the influencing factors of lateness,and the differences were statistically significant(P＜0.05).The lateness rate of patients is highest on Monday,reaching 34.6%,the lateness rate is highest between＞08:30-09:00 every morning,reaching 78.1%,and the lateness rate is highest between＞13:00-13:30 in the afternoon,reaching 65.7%.Conclusion Patients who are late for medical appointments have certain characteristics.Therefore,solutions need to be proposed based on relevant characteristics to improve patients'compliance with medical appointments within the appointment time period.

Objective:To investigate the diagnostic value of serum Aspergillus fumigatus immunoglobulin G (IgG), bronchoalveolar lavage fluid (BALF) galactomannan antigen test (GM test) and combined detection of the two methods in chronic pulmonary aspergillosis (CPA). Methods:A total of 310 patients with suspected CPA who were hospitalized in Wuhan Pulmonary Hospital from January 2020 to December 2022 were screened. BALF-GM test and serum Aspergillus fumigatus IgG were detected. According to the inclusion and exclusion criteria, 151 confirmed or clinically diagnosed CPA patients were enrolled and 60 non-CPA cases were included as controls. The underlying diseases, clinical symptoms and imaging findings of the two groups were analyzed using case-control study. Statistical comparison was performed by chi-square test. The efficacies of BALF-GM test, serum Aspergillus fumigatus IgG test, and their combined detection for CPA were analyzed by receiver operating characteristic curve. Results:There were 130 confirmed cases and 21 clinically diagnosed cases among 151 patients with CPA, including 106 males (70.2%) with age of (54.6±15.5) years. The age of 60 non-CPA patients was (53.6±17.8) years, including 42 males (70.0%). The proportions of pulmonary tuberculosis, bronchiectasis and chronic obstructive pulmonary disease, and the incidence of hemoptysis in CPA group were 79.47%(120/151), 86.09%(130/151), 26.49%(40/151) and 43.71%(66/151), respectively, which were all higher than those in non-CPA group (10.00%(6/60), 25.00%(15/60), 8.33%(5/60) and 11.67%(7/60), respectively), and the differences were statistically significant ( χ2=86.14, 74.56, 8.44 and 19.48, respectively, all P<0.05). The proportion of interstitial lung disease in non-CPA group was 28.33%(17/60), which was higher than that in CPA group (2.65%, 4/151), and the difference was statistically significant ( χ2=31.61, P<0.001). The common imaging findings of CPA patients were pulmonary cavity (70.86%, 107/151), cavity inclusions (41.72%, 63/151) and lung damage (33.77%, 51/151). The specificity and sensitivity of serum Aspergillus fumigatus IgG for CPA diagnosis were 81.7% and 68.9%, respectively, and the area under the curve (AUC) was 0.753 (95% confidence interval (95% CI) 0.681 to 0.825, P< 0.001). The specificity and sensitivity of BALF-GM test were 76.7% and 67.5%, respectively, and the AUC was 0.724 (95% CI 0.649 to 0.800, P<0.001). The specificity and sensitivity of the two methods in series combined detection were 95.0% and 44.4%, respectively, and those of the two methods in parallel detection were 60.3% and 94.5%, respectively. The AUC of the combined diagnosis of CPA by the two methods was 0.843 (95% CI 0.783 to 0.903, P<0.001). Conclusions:Serum Aspergillus fumigatus IgG combined with BALF-GM test has a good diagnostic efficacy for CPA. The detection of serum Aspergillus fumigatus IgG is non-invasive and highly specific, which is beneficial to the early diagnosis and treatment of CPA.

Objective To investigate the effect of oral fish oil on wound healing and related indexes in patients with diabetic foot ulcer(DFU).Methods A randomized,double-blind,placebo-controlled design was used to recruit 68 patients with DFU aged 18-80 years old in the hospital,and the baseline clinical data of the patients were collected.The patients were randomly divided into experimental group(32 cases,fish oil soft capsule,3 g/d)and control group(33 cases,corn oil soft capsule,3 g/d)by random number generated by Ex-cel,and the intervention lasted for 12 weeks.The primary endpoints included the proportion of complete wound healing and healing area≥50%.The secondary endpoints included wound area,healing time,inflamma-tion index,glucose metabolism index,nutrition related index and wound reinfection.Additionally,the influen-cing factors of wound healing were analyzed.Results After intervention,the proportion of complete wound healing and healing area≥50%in the experimental group was significantly higher than that in the control group(P=0.007,0.039).In the subjects with complete wound healing,the mean healing time in the experi-mental group was shorter than that in the control group,but the difference was not statistically significant(P=0.132).The reduction area of wound area in the experimental group was significantly larger than that in the control group(P=0.045).The decrease of interleukin(IL)-6 and IL-8 in the experimental group was significantly higher than that in the control group(P<0.05).There was no significant difference in the reduc-tion of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),neutrophil-to-lymphocyte ratio(NLR),glycated hemoglobin A1c(HbA1c)and platelet-to-lymphocyte ratio(PLR)between the two groups(P>0.05).The improvement of prealbumin(PA)in the experimental group was higher than that in the control group,but the difference was not statistically significant(P>0.05).Multivariate logistic regression analysis showed that oral fish oil intervention(OR=6.771,95%CI:1.787-25.652),HbA1c(OR=4.149,95%CI:1.026-16.770)and ulcer type(OR=4.319,95%CI:1.026-18.173)were the influencing factors of wound healing(P<0.05).Conclusion Oral fish oil promotes wound healing in patients with DFU,which may be re-lated to improving the level of chronic inflammation in the body.