Objective:To analyze the differences in endoscopic and pathological features in autoimmune gastritis (AIG) patients with and without Helicobacter pylori ( HP) infection, and to explore the effects of HP on the clinical manifestations and disease development in AIG patients. Methods:From January 2022 to April 2024, 174 AIG patients who visited Beijing Hospital and met the 2022 AIG diagnostic criteria established by Japanese Gastroenterological Endoscopy Society were enrolled and divided into the HP-infected group (including current and previous infection, 77 cases) and the HP-unifected group (97 cases). The general clinical data, laboratory examinations endoscopic findings, and pathological characteristics of the two groups were analyzed. Independent sample t-test and chi-square test were used for statistical analyses. Results:The vitamin B 12 level of HP-infected group was higher than that of HP-unifected group ((573.81±460.77) ng/L vs. (411.86±335.00) ng/L), and the difference was statistically significant ( t=-2.57, P=0.011). The average red blood cell volume of HP-infected group was lower than that of HP-unifected group ((87.30±8.86) fL vs. (98.50±49.82) fL), and the difference was statistically significant ( t=2.16, P=0.033). The proportion of intestinal metaplasia in gastric fundus in HP-infected group was lower than that in HP-unifected group (50.6% (39/77) vs. 73.2% (71/97)), and the difference was statistically significant ( χ2=9.38, P=0.002). Conclusion:HP infection in AIG patients may delay the malabsorption of vitamin B 12 and the occurrence of intestinal metaplasia in gastric fundus.

Background The decline of physical activity in the elderly due to aging may increase the risk of sarcopenia. Currently, there is a lack of evidence from large natural populations on the relationship between PA and sarcopenia. Objective To explore the relationship between PA and sarcopenia in the elderly aged 60 years and above in 10 provinces (autonomous regions) of China. Methods Data were retrieved from the 2022—2023 round of the China Development and Nutrition Health Impact Cohort. Personal basic information and PA data were collected by questionnaire survey. Skeletal muscle mass was measured by bio-electrical impedance analysis, muscle strength was measured using a grip dynamometer, and physical performance was reflected by 6-meter walk speed. The Asian Working Group for Sarcopenia (AWGS) 2019 criteria were used to diagnose sarcopenia. Light physical activity (LPA) duration, moderate-to-vigorous physical activity (MVPA) duration, and total physical activity volume were calculated. A total of 3326 residents aged ≥60 years with complete data were selected as the survey participants. Multiple logistic regression models and restricted cubic splines (RCS) were used to assess the association between PA duration/volume and sarcopenia. Results In 10 provinces (autonomous regions) of China, the prevalence of sarcopenia in the elderly aged 60 years and above was 5.5% (95%CI: 4.7%, 6.2%). The logistic regression analysis showed that compared with the elderly reporting 0-7.0 h·week⁻¹ in LPA duration, the risk of sarcopenia in the elderly with LPA duration of >14.0-21.0 h·week⁻¹ was reduced by 51% (OR=0.49, 95%CI: 0.26, 0.96). Compared with the elderly with total physical activity ≥15.0 metabolic equivalent of task (MET)-h·week⁻¹, those with <7.5 MET-h·week⁻¹ had a 2.24-fold increased risk of sarcopenia (OR=2.24, 95%CI: 1.17, 4.29). The RCS results found that LPA duration and total physical activity volume each showed a nonlinear dose-response relationship with the risk of sarcopenia (P_overall<0.05, P_non-linear<0.05). Compared with the elderly with an LPA duration of 0 h· week⁻¹, the risk of sarcopenia in the elderly with an LPA duration of 12.6 h· week⁻¹ was the lowest (OR=0.42, 95%CI: 0.21, 0.83). Compared with the elderly with a total physical activity volume of 15.0 MET-h· week⁻¹, the elderly with a total physical activity volume of 46.0 MET-h· week⁻¹ had the lowest risk of sarcopenia (OR=0.57, 95%CI: 0.38, 0.84). There was no statistically significant association between weekly MVPA duration and the risk of sarcopenia (P>0.05). Conclusion Increasing weekly LPA duration and total physical activity volume would help to reduce the risk of sarcopenia.

Objective:To analyze the differences in endoscopic and pathological features in autoimmune gastritis (AIG) patients with and without Helicobacter pylori ( HP) infection, and to explore the effects of HP on the clinical manifestations and disease development in AIG patients. Methods:From January 2022 to April 2024, 174 AIG patients who visited Beijing Hospital and met the 2022 AIG diagnostic criteria established by Japanese Gastroenterological Endoscopy Society were enrolled and divided into the HP-infected group (including current and previous infection, 77 cases) and the HP-unifected group (97 cases). The general clinical data, laboratory examinations endoscopic findings, and pathological characteristics of the two groups were analyzed. Independent sample t-test and chi-square test were used for statistical analyses. Results:The vitamin B 12 level of HP-infected group was higher than that of HP-unifected group ((573.81±460.77) ng/L vs. (411.86±335.00) ng/L), and the difference was statistically significant ( t=-2.57, P=0.011). The average red blood cell volume of HP-infected group was lower than that of HP-unifected group ((87.30±8.86) fL vs. (98.50±49.82) fL), and the difference was statistically significant ( t=2.16, P=0.033). The proportion of intestinal metaplasia in gastric fundus in HP-infected group was lower than that in HP-unifected group (50.6% (39/77) vs. 73.2% (71/97)), and the difference was statistically significant ( χ2=9.38, P=0.002). Conclusion:HP infection in AIG patients may delay the malabsorption of vitamin B 12 and the occurrence of intestinal metaplasia in gastric fundus.

Objective:To study the effect of cardiac rehabilitation program on recovery of patients after small incision aortic valve replacement.Methods:600 patients who underwent small incision aortic valve replacement in our hospital from January 2015 to January 2020 were retrospectively collected and divided into Cardiac rehabilitation group(CR) and control group by propensity matching analysis. Clinical data of CR group and control group were collected 6 months and 12 months after the beginning of Cardiac rehabilitation program. The primary outcome measures were the peak oxygen uptake(VO 2 Peak) of cardiopulmonary function test and the number of patients attending cardiovascular specialty in tertiary hospitals after the rehabilitation program began. The secondary outcome measures were 6-minute Walk test(6-MWT), psychological evaluation, and assessment of cardiovascular disease risk factors. Results:After 6 months and 12 months of cardiac rehabilitation program, the VO2 peak in CR group was statistically significant compared with the control group, and the 6-MWT index after 12 months was statistically significant.The cardiovascular specialist visits in tertiary hospitals in the two groups were statistically significant. The comparison of psychological self-rating scale and cardiovascular disease risk factors between the two groups was statistically significant after propensity matching analysis.Conclusion:Cardiac rehabilitation has a positive effect on postoperative recovery after small incision aortic valve replacement, and can improve patients’ motor ability.

Objective:To investigate the effect of remote ischemic preconditioning combined with postconditioning (RIPC+ RIPostC) on postoperative delirium (POD) in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods:Eighty patients aged 44-64 years old and scheduled to elective heart valve replacement under CPB in the operating room of our hospital were recruited and divided into control group (group C) and group R according to random number table method, with 40 cases in each group. Patients in group R underwent RIPC 30 minutes before the start of CPB and RIPostC 30 minutes before the end of CPB. The specific treatment measures were as follows: tie an inflatable cuff on the patient' s lower limb, inflate and pressurize until the pressure to 200 mmHg, hold for 5 minutes, and then completely deflate the cuff until the pressure to 0; after 5 minutes, inflate and pressurize again, and repeat for 3 cycles. The cuff was tied to the patient' s lower limb, but no inflation and deflation were performed in group C. Peripheral venous blood was drawn 1 day before operation and 1 day and 3 days after operation, and blood routine was determined. POD was assessed by the intensive care unit (ICU) consciousness disturbance assessment method (CAM-ICU) within 3 days after the operation. Neurocognitive testing was performed preoperatively, at discharge, and 3 months postoperatively, and postoperative cognitive dysfunction (POCD) and dementia (AD) were assessed using the Mini-Mental State Examination Scale (MMSE), with exclusion of preoperative patients with <24 points. Intraoperative and postoperative adverse events including sinus bradycardia or hypotension/hypertension, postoperative infection, etc. were recorded. The length of hospital stay and 90-day mortality were recorded. After 3 months, data related to sleep, quality of life, anxiety and pain were collected using questionnaires.Results:The white blood cell count, neutrophil count and percentage of neutrophils in the two groups at 1 day and 3 days after operation were all higher than those at 1 day before operation, but the indexes in group R was significantly lower than those in group C ( P<0.05). A total of 13 patients (32.5%) in group C developed POD within 3 days after surgery, while 27 patients (67.5%) did not develop POD, and there was a significant difference between the groups ( P<0.05). A total of 5 patients (12.5%) in group R developed POD within 3 days after surgery, and 35 patients (87.5%) did not develop POD. At the 90-day follow-up, there was no difference in the MMSE score compared with the baseline ( P>0.05). A total of 4 patients (10%) developed neurocognitive dysfunction after surgery. There was no difference in the incidence of POCD between the two groups ( P>0.05). The incidence of adverse events such as bradykinesia, hypotension/hypertension, and postoperative infection were similar between the two groups, and there was no significant difference ( P>0.05). During the 90-day follow-up period after surgery, no patient died in either group. There was no significant difference in postoperative hospital stay between the two groups ( P>0.05). Using the EQ-5D questionnaire to evaluate the quality of life of the two groups of patients, the results showed that there was no statistically significant difference between the two groups ( P>0.05). At 3 months after operation, there was no significant difference in sleep quality between the two groups ( P>0.05). Conclusion:RIPC+ RIPostC can reduce the inflammatory response, reduce the incidence of POD and improve the quality of life after operation in patients with heart valve replacement under CPB.

Objective:To explore the newborn birth weight and its influencing factors of polycystic ovary syndrome (PCOS) patients during fresh embryo transfer cycle.Methods:In this retrospective cohort study, the clinical data of 5087 patients with singleton live births who underwent in vitro fertilization and embryo transfer (IVF-ET) in the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2019 were analyzed. The patients were categorized into PCOS group ( n=1095) and non-PCOS group (referred to as control group, n=3992) according to the cause of infertility. The general conditions and birth weight of the two groups were compared, and logistic regression analysis was performed to identify the factors affecting birth weight. Results:For embryo transfer on the 3rd day (day 3, D3), the clinical pregnancy rate [69.0% (1248/1808)] and the implantation rate [49.0% (1742/3555)] in PCOS group were higher than those in control group [59.1% (5661/9572) and 42.0% (7577/18 040), all P<0.001], while the live birth rate [37.0% (670/1810)] was lower than that in control group [49.0% (4697/9585), P<0.001]. For blastocyst transfer on the 5th day (day 5, D5), the implantation rate [63.1% (500/793)] and the live birth rate [54.0% (425/787)] in PCOS group were higher than those of control group [59.0% (1066/1806), P=0.042; 48.0% (876/1825), P=0.013]. The birth weight of the infants [(3 459.76±527.11) g] and the proportion of overweight infants [14.35% (61/425)] in PCOS group of D5 blastocyst transfer were higher than those in control group [(3 391.61±521.38) g, P=0.028; 8.22% (72/876), P<0.001] and PCOS group of D3 embryo transfer [(3 389.24±555.06) g, P=0.018; 9.25% (62/670), P=0.009], but the proportion of low weight infants [2.35% (10/425)] was lower than that in control group of the D5 blastocyst transfer [4.91% (43/876), P=0.029] and PCOS group of D3 embryo transfer [4.78% (32/670), P=0.042]. Logistic regression analysis showed that the level of female body mass index (BMI) affects the birth weight of D5 blastocyst transfer ( OR=1.12, 95% CI=0.052-0.175, P<0.001). Developmental timing of transferred embryos affects birth weight in PCOS patients ( OR=1.52, 95% CI=0.019-0.819, P=0.040). Conclusion:For PCOS patients, choosing D5 blastocyst transfer can obtain a higher rate of live birth and a lower proportion of low birth weight infants. It is recommended that blastocyst transfer be performed for PCOS patients in fresh cycle.

Objective:To explore the newborn birth weight and its influencing factors of polycystic ovary syndrome (PCOS) patients during fresh embryo transfer cycle.Methods:In this retrospective cohort study, the clinical data of 5087 patients with singleton live births who underwent in vitro fertilization and embryo transfer (IVF-ET) in the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2019 were analyzed. The patients were categorized into PCOS group ( n=1095) and non-PCOS group (referred to as control group, n=3992) according to the cause of infertility. The general conditions and birth weight of the two groups were compared, and logistic regression analysis was performed to identify the factors affecting birth weight. Results:For embryo transfer on the 3rd day (day 3, D3), the clinical pregnancy rate [69.0% (1248/1808)] and the implantation rate [49.0% (1742/3555)] in PCOS group were higher than those in control group [59.1% (5661/9572) and 42.0% (7577/18 040), all P<0.001], while the live birth rate [37.0% (670/1810)] was lower than that in control group [49.0% (4697/9585), P<0.001]. For blastocyst transfer on the 5th day (day 5, D5), the implantation rate [63.1% (500/793)] and the live birth rate [54.0% (425/787)] in PCOS group were higher than those of control group [59.0% (1066/1806), P=0.042; 48.0% (876/1825), P=0.013]. The birth weight of the infants [(3 459.76±527.11) g] and the proportion of overweight infants [14.35% (61/425)] in PCOS group of D5 blastocyst transfer were higher than those in control group [(3 391.61±521.38) g, P=0.028; 8.22% (72/876), P<0.001] and PCOS group of D3 embryo transfer [(3 389.24±555.06) g, P=0.018; 9.25% (62/670), P=0.009], but the proportion of low weight infants [2.35% (10/425)] was lower than that in control group of the D5 blastocyst transfer [4.91% (43/876), P=0.029] and PCOS group of D3 embryo transfer [4.78% (32/670), P=0.042]. Logistic regression analysis showed that the level of female body mass index (BMI) affects the birth weight of D5 blastocyst transfer ( OR=1.12, 95% CI=0.052-0.175, P<0.001). Developmental timing of transferred embryos affects birth weight in PCOS patients ( OR=1.52, 95% CI=0.019-0.819, P=0.040). Conclusion:For PCOS patients, choosing D5 blastocyst transfer can obtain a higher rate of live birth and a lower proportion of low birth weight infants. It is recommended that blastocyst transfer be performed for PCOS patients in fresh cycle.

Objective:To investigate the influence of environmental factors on body mass index of children and adolescents in China.Methods:Using data from the China Health and Nutrition Survey, the research object to 7 - 17 years old children and adolescents who participated in 2000, 2006, 2011, and 2015 round of survey with complete data, a total of 6 626 children and adolescents (male 3 473, female 3 153) were investigated under univariate analysis for each environmental factor variable before using Partial Least Square Regression fitting a linear model for further screening. Finally, we fitted a three-level linear mixed-effects model distinct by urban and rural area for analysis.Results:The three-level null model, log likelihood=-17 034.68, χ 2=483.06, P<0.001. Intern-class correlation coefficient ( ICC) showed that community-level was 9.97%, and both community and individual were 39.38%. The three-level model also showed that urban model's urbanization index ( β=-0.05, 95% CI: -0.09--0.01, P<0.05), the park location ( β=-0.88, 95% CI: -1.72 - -0.04, P<0.05), 15 - 17 age group ( β=-1.04, 95% CI:-1.78 - -0.30, P<0.05) were negatively correlated with BMI. The distance to the gym ( β=0.12, 95% CI: 0.02 - 0.22, P<0.05), the number of home TV sets ( β=0.50, 95% CI: 0.08 - 0.92, P<0.05) and the frequency of parents' alarm of fiction TV program contents ( β=1.85, 95% CI: 0.70 - 3.00, P<0.05) were correlated with BMI. Rural urbanization index ( β=-0.04, 95% CI:-0.07 - -0.01, P<0.05). Rural per capita income ( β=-7.29e -4, 95% CI:-1.00e -3 - -6.77e -5, P<0.05), parents' restricted frequency of watching TV ( β=-1.29, 95% CI:-2.36 - -0.21, P<0.05), adipo-energy ratio ( β=-0.03, 95% CI:-0.06 - -1.00e -3, P<0.05) were negatively correlated with the BMI. Factors as the frequency of parents' alarm of fiction TV program contents ( β=3.01, 95% CI: 0.03 - 6.00, P<0.05), the survey time was 2015 ( β=4.83, 95% CI: 1.96 - 7.69, P<0.05) were correlated with BMI. Conclusions:Environmental factors could indirectly influence the change of BMI of children and adolescents to different degrees and various aspects. Urbanization index and rural per capita income had a slight protective effect on increasing BMI of children and adolescents. At the community level, attention should be paid to the setting of activity places around the living environment of children and adolescents. Family members should also guide their children and adolescents to develop nice behavior in watching TV.

Objective:To explore the characteristics of brain structure in patients with long-term withdrawal of methamphetamine-dependence.Methods:A total of 44 patients with withdrawal of methamphetamine-dependent for more than 14 months were recruited,who met the diagnostic criteria for substance dependence in the fifth edition of the American Mental Disorders Diagnostic and Statistical Manual (DSM-Ⅴ),and 40 healthy subjects were used as the control.In addition to the general scale of drug-relevant survey,the subjects received the 3.0T magnetic resonance high-resolution scan.The voxel-based morphometric measurements for the subject's brain gray volume were conducted.Results:There was no significant difference in age,education,smoking and alcohol consumption between the methamphetamine-dependent withdrawal group and the control group (P＞0.05).The volumes for the bilateral cerebellum,the left side of temporal gyrus and the right side of the lingual gyrus in the methamphetamine-dependent withdrawal group were increased than those in the control group.The volumes for the bilateral lingual gyrus and bilateral cuneus in the methamphetamine-dependent withdrawal group were decreased than those in the control group.The volumes of left of cuneus and cerebellum were positively correlated with the duration of abstinence.Conclusion:After long-term abstinence,although the patients still show abnormal brain structure,their behavior and cognitive function is improved.The cerebral nerve structural is recovered from long-term abstinence.

Objective To explore the association between Q-1 and T1 locus polymorphism in ADAM33 gene and chronic obstructive pulmonary disease in Han population in northern Guizhou by detecting Q-1 and T1 locus polymorphism in ADAM33 gene in patients with COPD in the distribution of frequency ,provide a theoretical basis for the prevention and treatment of COPD. Methods Polymerase chain reaction and DNA sequencing tech-nology,electrophoresis separation method were applied to detect Q-1 and T1 locus polymorphism in ADAM33 gene. Results The genotype distribution of Q-1 and T1 locus in the case group and the control group of ADAM33 gene were in accordance with the Hardy-Weinberg equilibrium law and ADAM33 gene Q-1,T1 locus were C and T alleles. There was no significant difference in genotype and allele frequency distribution between the case group with control group,and COPD complicated with chronic respiratory failure(COPD)and hypoxemia(P > 0.05). T1(83 bp,112 bp)at a high probability of two heterozygous in the same samples(18/19),and is located in the encoding region. Conclusion No association was found between Q-1,T1 locus polymorphism in ADAM33 gene and chronic obstructive pulmonary disease in Han population in northern Guizhou.