Objective:To investigate the correlation between fat distribution and the composite indices of femoral neck strength in obese postmenopausal women.Methods:A total of 293 postmenopausal women with non-low body weight were selected, laboratory tests, body composition analyzer test and double-energy X-ray absorptiometry scan were performed. Based on the body mass index(BMI), they were divided into three groups, the normal BMI group(18.5 kg/m 2≤BMI<24.0 kg/m 2, n=91), the overweight group(24.0 kg/m 2≤BMI<28.0 kg/m 2, n=115), and the obese group(BMI≥28.0 kg/m 2, n=87). The measurement results were analyzed. Results:In the obese group, bone mineral density(BMD) of all sites was higher than that in the normal BMI group and overweight group( P<0.005), compression strength index(CSI), bending strength index(BSI), and impact strength index(ISI) were significantly lower than those in the normal BMI group( P<0.001, P=0.008, P=0.001). In the obese group, waist circumference, waist-hip ratio, total fat mass, appendicular fat mass, and trunk fat mass were risk factors for CSI, BSI and ISI independent of age, fasting blood glucose, and BMI( P<0.05). Visceral fat grade and Chinese visceral adiposity fat index were the risk factors for CSI, BSI, and ISI( P<0.05). Conclusion:The composite indices of femoral neck strength decreased in obese postmenopausal women, and both subcutaneous fat and visceral fat were negatively associated with the composite indices of femoral neck strength.

Objective To design and construct a syndrome differentiation knowledge graph that integrates TCM facial color diagnosis information;To explore the hidden relationships between the knowledge.Methods The literature data came from ancient classics,textbooks,as well as standard literature related to inspection included in the CNKI,VIP and Wanfang Data from the establishment of the databases to December 31,2022.The clinical data was sourced from 30 elderly individuals who underwent TCM health examinations at the Community Health Service Center in Jiading Industrial Zone,Shanghai in September 2022.Facial image acquisition was performed using TFDA-1 digital tongue and facial diagnostic instrument.By following the steps of knowledge extraction,knowledge fusion and quality assessment to construct a graph,and with the assistance of TCM experts for interpretation,using Access 2019 to integrate qualitative textual data and quantitative objective image digital information,a syndrome differentiation knowledge graph integrating TCM facial diagnosis was designed and completed in the Neo4j graph database.In addition,a method was designed to shift facial diagnosis knowledge from qualitative to quantitative.Results There were a total of 194 nodes under 8 entity term types and 12 entity term labels,as well as 361 relationships under 13 semantic relationships in knowledge graph.The Neo4j graph database provided a visualized TCM facial color diagnosis and differentiation,which could be queried and fed back using Cypher language.Conclusion The knowledge graph constructed based on the theory of TCM facial color diagnosis visually shows the complex correlation between facial color diagnosis and syndrome differentiation diagnosis,with a knowledge representation model that forms qualitative data of image features → semantic relationships → syndrome differentiation diagnosis forms.

Objective:To explore the changes of bone turnover markers and geometric parameters of hip bone in overweight postmenopausal women with metabolic syndrome(MS), as well as the influence of MS components. To analyze the association of these factors with the risk of fracture.Methods:A total of 505 overweight postmenopausal female patients who underwent health check-up in Lianhu Community Service Center, Danyang City, Jiangsu Province from January to December 2017 were selected. According to the MS diagnostic criteria of the International Diabetes Federation(2009), the patients were divided into MS group( n=331)and non-MS group( n=174). Blood samples were collected to determine the level of procollagen type 1 N-terminal propeptide(P1NP)and carboxy-terminal cross-linked telopeptide of type 1 collagen(CTX). Bone mineral density and hip bone geometry parameters were tested with dual-energy X-ray absorptiometry and hip structural analysis software. Results:The incidence of osteoporotic fracture and hip fracture in MS group was significantly higher than that in non-MS group(21.1% vs 13.8%, 4.8% vs 1. 1%, P<0.05). However, the bone mineral density of lumbar vertebra 1-4, femoral neck, and total hip in MS group was significantly higher than that in non-MS group, which remained after adjusting for age( P<0.05), but the difference disappeared after further adjustment for body mass index( P>0.05). The P1NP, CTX, femur strength index(FSI), section modulus(SM), and cross-sectional area(CSA)of MS group were significantly lower than those of non-MS group, the buckling ration(BR)was significantly higher than that in non-MS group, and the differences were still statistically significant after adjusting for age and body mass index( P<0.05). There was no significant difference in bone mineral density of lumbar vertebra 1-4, femoral neck, total hip, P1NP, and CTX between fracture group and non-fracture group in patients with MS. But FSI, SM, cross-sectional moment of inertia(CSMI), and CSA were significantly lower, BR was significantly higher( P<0.05) and femur strength decreased in patients with fracture. Regression analysis showed that high BR was an independent risk factor for fracture risk, while high FSI, SM, CSMI, and CSA were protective factors. Multivariate linear regression analysis showed that wasit circumference, diastolic blood pressure, and fasting plasma glucose were the main MS components affecting bone mineral density, bone turnover indexes, and hip bone geometry parameters. Conclusions:Overweight postmenopausal MS patients had decreased bone turnover rate, femoral strength, and relatively poor bone quality. Hip bone geometry parameters can be used as one of the methods to assess fracture risk in MS patients. Waist circumference, diastolic blood pressure, and fasting blood glucose are the important MS components affecting bone mass and bone quality.

Objective:To analyze the epidemiological characteristics of Mycoplasma pneumoniae (MP) infection and its genotyping in children with community-acquired pneumonia (CAP), as well as macrolide resistance and gene mutation genotyping, in order to provide evidence for the prevention and treatment of Mycoplasma pneumoniae pneumonia (MPP) in children.Methods:MP positive cases in 620 hospitalized children at Maternal and Child Health Hospital of Sanshui District, Foshan City with CAP were detected.P1-RFLP genotyping was performed for the MP positive cases.The distribution of the MP positive, type Ⅰ and type Ⅱ in different years and different genders, ages as well as seasons were analyzed.The mutations of macrolide resistance genes in MP were detected.The differences of A2063G and A2064G mutations of the drug-resistant mutant gene in each year, gender, age and season were analyzed.Results:Among 620 children with CAP, 198 were MP positive, and the infection rate was 31.94%.There was little difference among the years.The infection rate was higher in female than that in male.The infection rate gradually increased with the increase of age, and the highest infection rates were found in pre-school age and school age.The infection rates in summer and autumn were significantly higher than those in spring and winter.Among 198 children, P1-RFLP classification showed that 157 (79.29%) cases were P1-Ⅰ and 41 (20.71%) cases were P1-Ⅱ.There was no significant difference in the distribution of type Ⅰ and type Ⅱ in each year, gender, age as well as season.A total of 143 cases were tested for mutation of macrolide resistance gene, in 125 of them, MP gene mutation resulted in drug resistance, and the overall drug resistance rate was 87.41%.MP gene mutation led to drug resistance in 125 children, 66 (52.80%) cases had A2063G mutation and 53 (42.40%) cases had A2064G mutation.There was no significant difference between two types in each year, gender, age and season.Conclusion:MP infection rate of CAP among children in our hospital is 31.94%, and is more common in femal, and the infection rates are highest in pre-school age and school age, with summer and autumn as the season of high incidence.The P1-RFLP typing showes no significant differences among the years, genders, ages and seasons.The drug resistance gene mutation among children is high.Time, gender, age and season does not affect drug resistance gene mutation.

Objective:To explore the risk of hip fracture, changes of composite indices of femoral neck strength and its influential factors in non-low-weight postmenopausal women with type 2 diabetes mellitus(T2DM).Methods:A total of 626 non-low-weight postmenopausal women were selected and divided into type 2 diabetes group, pre-diabetic group, and non-diabetic group according to the diagnostic criteria of the American Diabetes Association in 2010. Each participant completed the questionnaire, physical examination, laboratory examination, and Dual-energy X-ray absorptiometry(DXA) examination.Results:Hip fracture rate in T2DM group was significantly higher than that in non-diabetic group(3.4% vs 0.7%, P<0.05), while no significant difference was observed between pre-diabetic group and non-diabetic group(1.1% vs 0.7%, P>0.05). Bone mineral density(BMD) of lumbar spine 1-4, femoral neck, and total hip was comparable between T2DM group and non-diabetic group or pre-diabetic group and non-diabetic group, respectively( P>0.05). The composite indices of femoral neck strength in T2DM group was significantly lower than that in non-diabetic group( P<0.05), but there was no significant difference between pre-diabetic group and non-diabetic group( P>0.05). Regression analysis showed that age and body mass index were the main influential factors of the femoral neck bone mineral density and the composite indices of femoral neck strength( P<0.05). Conclusion:The composite indices of femoral neck strength could be used as one of the markers to evaluate the risk of hip fracture in type 2 diabetic patients.

Objective:To investigate the types of non-tumor diseases in patients with cancer, and to explore the effects of those dis-eases on the diagnosis and treatment of cancer patients. Methods:We collected the medical records of cancer patients from January 2013 to December 2017 in Peking University Cancer Hospital, and screened for non-tumor diseases. The clinical records of the patients in this group were analyzed retrospectively, and the effects of those diseases on the diagnosis and treatment of tumors were dis-cussed. Results:Of the 1,323 cases of inter-hospital consultation, 1,153 cases of non-tumor disease (87.2％) were selected. There were 773 men (67.0％) and 380 women (33.0％) included. The median age was 62 (14-90) years. The primary tumor types included lung can-cer, gastric cancer, lymphoma, colorectal cancer, esophageal cancer, breast cancer, malignant melanoma, liver cancer, cholangiocarci-noma/gallbladder cancer, pancreatic cancer, and other tumors. Non-neoplastic diseases included cardiovascular disease in 356 cases (30.9％), respiratory system disease (17.0％) in 196 cases, digestive system disease in 107 cases (9.3％), skin and venereal diseases in 81 cases (7.0％), nervous system lesions (6.4％) in 74 cases, urinary system disease in 72 cases (6.2％), blood disease in 70 cases (6.1％), en-docrine and metabolic diseases in 47 cases (4.1％), autoimmune disease in 23 cases (2.0％), and other diseases (11.0％) in 127 cases. Impact on tumor diagnosis and treatment was as follows:direct, 771 cases (66.9％);no influence, 313 cases (27.1％);and uncertain, 69 cases (6.0％). Conclusions:Cardiovascular disease is a major non-tumor disease associated with cancer. Non-neoplastic diseases are important factors affecting the diagnosis and treatment plans of cancer.

Background and objective Radiotherapy combined with chemotherapy or molecular targeted therapy remains the standard of treatment for brain metastases from non-small cell lung cancer (NSCLC). hTe aim of this study is to determine if the deferral of brain radiotherapy impacts patient outcomes.Methods Between May 2003 and December 2015, a total of 198 patients with brain metastases from NSCLC who received both brain radiotherapy and systemic therapy (chemo-therapy or targeted therapy) were identiifed. hTe rate of grade 3-4 adverse reactions related to chemotherapy and radiotherapy had no signiifcant difference between two groups. 127 patients received concurrent brain radiotherapy and systemic therapy, and 71 patients received deferred brain radiotherapy after at least two cycles of chemotherapy or targeted therapy. Disease speciifc-graded prognostic assessment was similar in early radiotherapy group and deferred radiotherapy group.Results Me-dian overall survival (OS) was longer in early radiotherapy group compared to deferred radiotherapy group (17.9 monthsvs 12.6 months;P=0.038). Progression free survival (PFS) was also improved in patients receiving early radiotherapy compared to those receiving deferred radiotherapy (4.0 monthsvs 3.0 months;P<0.01). Receiving tyrosine kinase inhibitor (TKI) therapy atfer the diagnosis of brain metastases as any line therapy improved the OS (20.0 monthsvs 10.7 months;P<0.01), whereas receiving TKI as ifrst line therapy did not (17.9 monthsvs 15.2 months;P=0.289).Conclusion Our study suggests that the use of deferred brain radiotherapy may resulted in inferior OS in patients with NSCLC who develop brain metastases. A prospec-tive multi-central randomized study is imminently needed.

This study was aimed to explore the relationship between atrophic lung disease and modern medicine diseases through the study of experiences of modern famous doctors of traditional Chinese medicine (TCM) in the treatment of atrophic lung disease. Literatures which met the inclusion criteria were retrieved from the existing Lung Disease Database of Modern Famous Doctors of Chinese Medicineand Lung Disease Database of Journals for the establishment ofLiterature Research Database of Experience of Modern Famous Doctors of Chinese Medicine in Treating Atrophic Lung Disease. The SPSS 19.0 software was used in the statistical analysis. The results showed that atrophic lung disease can be interstitial lung disease, atelectasis, pneumonia, primary bronchogenic carcinoma, bronchiectasis, tuberculosis, chronic bronchitis and pneumothorax in modern medicine. Among them, interstitial lung disease was the most common one. It was concluded that atrophic lung disease can be the outcome of many types of lung diseases. The relationship between atrophic lung disease and modern medicine diseases should require further studies by experts to confirm.

Objective To understand the abnormal status of alanine aminotransferase (ALT),fasting blood glucose (GLU),to-tal cholesterol (TC)and triglyceride (TG)in urban and rural residents,to provide the basis for making the effective prevention measures,health education and health promotion to community work more targeted and effective.Methods The data of physical ex-amination results of 4 042 residents were analyzed retrospectively,the levels and abnormal rates of ALT,TG,TC,GLU were com-pared between different gender and age.Results Among 4 042 residents,the abnormal rate of male was significant higher than that of female,but the abnormal rates of TG,TC of female were significant higher than those of male(P <0.05).The highest rates of ALT,TG,TC,GLU in male were in 20-<40 years old,40-<60 years old,60-<80 years old,≥80 years old.The highest rates of ALT,TG,TC,GLU in female were in 0-<20 years old,60 -<80 years old,≥ 80 years old,≥80years old.Conclusion The health status of urban and rural residents is not optimistic,the community intervention,health guidance should be strengthened to prevent and control the occurrence and development of diseases and improve the health level of urban and rural residents.

Background and objective Chemotherapy is a highly effcient primary treatment for extensive-stage small cell lung cancer (ES-SCLC). However, patients receiving such treatment are prone to develop drug resistance. Local treatment is palliative and thus can alleviate the local symptoms and improve quality of life, but limited evidence is available for prolonging survival. Hence, this study evaluated the role of local treatment in chemotherapy of patients with ES-SCLC. Methods A total of 302 ES-SCLC cases were enrolled in this retrospective study. Prognostic factors were analyzed by Kaplan-Meier and Cox multivariate proportional hazards model. Results Median progression-free survival (PFS) and median survival time (MST) of the patients were 4.4 and 10.4 months, respectively. 1-, 2-, and 3-year survival rates were 37.8%, 10.2%and 4.4%, correspondingly. hTe MST of the primary tumor radiotherapy plus chemotherapy group was 14.3 months, whereas that of the chemotherapy group was 8.2 months (P<0.01). hTe MSTs of multiple-site, single-site, and non-metastasis local treatments were 18.7, 12.3 and 8.9 months, respectively (P<0.01). hTe MSTs of initiative, passive, and non-metastasis local treatments were 16.0, 10.9 and 9.4 months, correspondingly (P<0.01). hTe MSTs of patients with prophylactic cranial irradiation (PCI) and those without PCI were 19.8 and 9.9 months, respectively (P<0.01). Primary tumor radiotherapy, metastasis local treat-ment, and PCI were independent prognostic factors for ES-SCLC. Conclusion Primary tumor radiotherapy, metastasis local treatment, and PCI can signiifcantly improve survival in patients with ES-SCLC.