Objective:To establish and assess the quality control and improvement system for metabolic and bariatric surgery in Beijing.Methods:Based on relevant documents from the National Health Commission and the Beijing Municipal Health Commission,and referencing the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) by the American Society for Metabolic and Bariatric Surgery,a quality control system was developed under the Beijing Quality Control and Improvement Center of Metabolic and Bariatric Surgery. The system incorporated on-site evaluations,data registration,and specialized training. From May to December 2023,on-site assessments were conducted at 21 hospitals in Beijing performing bariatric surgery,evaluating personnel qualifications,infrastructure,clinical workflows,and postoperative follow-up. A quality control database was created to collect real-time surgical data,and training was provided for data entry and professional skills. Assessment results were classified as excellent,qualified,or needing improvement,with rectification suggestions offered and follow-up visits conducted to track progress.Results:All 21 hospitals achieved a 100% compliance rate for surgical indications, 16 (76.2%) met standardized surgical operation criteria,and 14 (66.7%) had standardized postoperative management. However,only 5 (23.8%) achieved a 12-month postoperative follow-up rate of ≥60%,and 4 (19.1%) had established specialized databases. Key challenges included insufficient specialized staffing (19.1%), lack of multidisciplinary collaboration (47.6%), inadequate equipment (57.1%), and low follow-up rates (57.1%). The database collected data from over 2 000 patients across 111 fields. After rectification, specialized database coverage rose to 61.9% (13 hospitals). Multi-level training programs developed backbone physicians and specialized nurses,significantly addressing the shortage of specialized personnel.Conclusion:The quality control system established in this study,through the integration of on-site evaluation,data registration,and specialized training,effectively enhances the standardization of surgical practices and data management capabilities.

Objective:To establish and assess the quality control and improvement system for metabolic and bariatric surgery in Beijing.Methods:Based on relevant documents from the National Health Commission and the Beijing Municipal Health Commission,and referencing the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) by the American Society for Metabolic and Bariatric Surgery,a quality control system was developed under the Beijing Quality Control and Improvement Center of Metabolic and Bariatric Surgery. The system incorporated on-site evaluations,data registration,and specialized training. From May to December 2023,on-site assessments were conducted at 21 hospitals in Beijing performing bariatric surgery,evaluating personnel qualifications,infrastructure,clinical workflows,and postoperative follow-up. A quality control database was created to collect real-time surgical data,and training was provided for data entry and professional skills. Assessment results were classified as excellent,qualified,or needing improvement,with rectification suggestions offered and follow-up visits conducted to track progress.Results:All 21 hospitals achieved a 100% compliance rate for surgical indications, 16 (76.2%) met standardized surgical operation criteria,and 14 (66.7%) had standardized postoperative management. However,only 5 (23.8%) achieved a 12-month postoperative follow-up rate of ≥60%,and 4 (19.1%) had established specialized databases. Key challenges included insufficient specialized staffing (19.1%), lack of multidisciplinary collaboration (47.6%), inadequate equipment (57.1%), and low follow-up rates (57.1%). The database collected data from over 2 000 patients across 111 fields. After rectification, specialized database coverage rose to 61.9% (13 hospitals). Multi-level training programs developed backbone physicians and specialized nurses,significantly addressing the shortage of specialized personnel.Conclusion:The quality control system established in this study,through the integration of on-site evaluation,data registration,and specialized training,effectively enhances the standardization of surgical practices and data management capabilities.

Objective: To analyze the influence of atmospheric particulate matters (PM_2.5 and PM₁₀) on low-birth-weight (LBW) infants at different periods of gestation. Methods: We conducted a systematic literature search for 2 471 articles related to particulate matter and LBW published from January 1st 2000 to January 1st 2016 using the PubMed, Cochrane Library, Web of Science, Science Direct, Chinese Web of Knowledge, Wanfang and Weipu, and the keywords were" air pollution" , "adverse birth outcomes" , "adverse pregnancy outcomes" , "low birth weight/LBW" . According to criteria, 27 literatures were selected and included. Metafor package of the R 3.1.1 Software was used to check the heterogeneity and merge the effect value of the selected literatures, and sensitivity analysis and publication bias were detected and adjusted. Results: A total of 2 471 studies selected form the databases, 27 enrolled in this analysis according to the inclusion and exclusion criteria. Each 10 μg/m³ increase in PM_2.5 was associated with combined OR values of 1st trimester, 2nd trimester, 3rd trimester and entire gestation at 1.02(95% CI: 0.87-1.19), 1.03 (95% CI: 0.91-1.16) , 1.07 (95%CI: 1.04-1.11) and 1.09 (95%CI: 1.04-1.15), respectively. And 10 μg/m³ increase in PM₁₀ was associated with combined OR values of 1st trimester, 2nd trimester, 3rd trimester and entire gestation at 1.66 (95%CI: 1.06-2.61), 1.58 (95%CI:1.28-1.95) , 1.38 (95%CI: 1.23-1.56) and 1.04 (95%CI: 0.99-1.09), respectively. After adjusting the bias of publication, each 10 μg/m³ increase in PM_2.5 was associated with the risk of low birth weight at 1.11 (95%CI: 1.02-1.21). Conclusion This meta analysis supports an adverse impact of maternal exposure to particulate air pollution on low birth weight, varying in effects by exposure period.

Objective To determine the association between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) and early neurological deterioration (END) in patients with acute ischemic stroke (AIS).Methods Two hundred and fifty-five AIS patients diagnosed by MR imaging were recruited between January 2011 and July 2015.The levels of serum Lp-PLA2 and high-sensitivity C-reactive protein (hs-CRP) were assessed right after hospitalization.END was defined as any increase in National Institutes of Health Stroke Scale (NIHSS) scores ≥ 2 in the first 72 h after stroke onset,and the patients were accordingly divided into END group and non-END group.Risk factors associated with END and their clinical data were analyzed by Logistic regression analysis.Results END was observed in 72 of the 255 patients (28.23％).The percentage of female (58.3％ vs.31.3％),smoking ratio (58.3％ vs.31.3％),diabetes mellitus ratio (73.6％ vs.16.9％),prior stroke ratio (44.4％ vs.25.1％),NHISS scores (8 [3] vs.3 [2]),serum Lp-PLA2 level (230.31 ±75.57 μg/L vs.87.60±28.45 μg/L) and hs-CRP level (20.08±8.05 mg/L vs.6.73±3.48 mg/L) in the END group were significantly higher than those in the non-END group (P＜0.05).Multiple Logistic regression analyses indicated that END was positively associated with diabetes mellitus (OR=4.903,95％CI:1.363-17.695,P=0.015),Lp-PLA2 level (OR=1.032,95％CI:1.013-1.043,P=0.000) and hs-CRP level (OR=1.229,95％CI:1.087-1.391,P=0.001) in patients with acute ischemic stroke.Conclusion Serum Lp-PLA2 may predict END in Chinese patients with acute ischemic stroke.

Objective To analyze the temperature modification effect on acute mortality due to particulate air pollution. Methods Daily non-accidental mortality, cardiovascular mortality, and respiratory mortality data were obtained from Jiang'an District Center for Disease Control and Prevention. Daily meteorological data on mean temperature and relative humidity were collected from China Meteorological Data Sharing Service System. The daily concentration of particulate matter was collected from Wuhan Environmental Monitoring center. By using the stratified time-series models, we analyzed effects of particulate air pollution on mortality under different temperature zone from 2002 to 2010, meanwhile comparing the difference of age, gender and educational level, in Wuhan city of China. Results High temperature (daily average temperature>33.4℃) obviously enhanced the effect of PM10 on mortality. With 10 μg/m3 increase in PM10 concentrations, non-accidental, cardiovascular, and respiratory mortality increased 2.95%(95%CI:1.68%-4.24%), 3.58%(95%CI:1.72%-5.49%), and 5.07%(95%CI:2.03%-9.51%) respectively. However, low temperature (daily average temperature <-0.21 ℃) enhanced PM10 effect on respiratory mortality with 3.31%(95%CI: 0.07%-6.64%)increase. At high temperature, PM10 had significantly stronger effect on non-accidental mortality of female aged over 65 and people with high educational level groups. With an increase of 10 μg/m3, daily non-accidental mortality increased 4.27% (95%CI:2.45%-6.12%), 3.38% (95%CI:1.93%-4.86%) and 3.47% (95%CI:1.79%-5.18%), respectively. Whereas people with low educational level were more susceptible to low temperature. A 10μg/m3 increase in PM10 was associated with 2.11%(95%CI:0.20%-4.04%)for non-accidental mortality. Conclusions Temperature factor can modify the association between the PM10 level and cause-specific mortality. Moreover, the differences were apparent after considering the age, gender and education groups.

Objective To evaluate the association between cold spells and nonaccidental mortality from 2001 to 2011 in the Jiang'an District of Wuhan, China. Methods We collected mortality data for December 2001 to 2010 and January to March 2002 to 2011 in the study area. According to the International Classification of Diseases, we stratified the mortality data into three cause-specific categories:nonaccidental mortality, cardiovascular mortality, and respiratory mortality. We also obtained meteorological data (from the China Meteorological Administration) and ambient pollution data (from the Wuhan Environmental Monitoring Center) during the same periods. In the present study, a cold spell was defined as 5 or more consecutive days with daily average temperatures below the 5th percentile of daily mean temperatures (2.58℃) from January to December in 2001-2011. A distributed lag nonlinear model (DLNM) was applied to assess the acute effect of cold spells on daily nonaccidental mortality. Results During the study period, the total number of nonaccidental deaths was 17 119, including 9 403 (75.5%) among individuals aged over 65 years; 7 968 (46.5%) people died of cardiovascular disease. According to this definition, there were a total of 13 cold spell events and 111 days of duration in Wuhan during the study period. Study days were divided into three periods: non-cold spell days, 2008 cold spell days, and cold spell days in other years. Average daily mean temperatures of the above three periods were(8.2±4.5),(-0.7±1.4), and(0.8±1.2)℃, respectively, corresponding to average daily deaths of 14.0 ± 4.2, 18.2 ± 4.5, and 14.9 ± 4.9 for nonaccidental mortality. After adjusting for long-term trends, seasonal trends, weekdays, holidays, and relative humidity, analysis by the DLNM revealed that cold spells were associated with increased mortality risk, with a cumulative relative risk (RR) of 1.56 (95%CI:1.36-1.79) at lag 0-27 days in 2008, higher than that in other years with 1.23 (95%CI:1.08-1.41). Cold spells were not significantly associated with respiratory mortality and people under 65 years of age;however, during the 2008 cold spell RR increased to 1.96 (95%CI:1.62-2.37) and 1.67 (95%CI: 1.43-1.95) for cardiovascular mortality and older adults (≥65 years old), respectively;both males and females had high mortality risk, with RRs of 1.60 (95%CI:1.33-1.92) and 1.50 (95%CI: 1.23-1.84), respectively. The association between cold spells and mortality remained nearly unchanged with and without adjustment for ambient pollutants (PM10, SO2, and NO2) in the DLNMs. Conclusion In Wuhan, both the 2008 cold spell and cold spells in other years were significantly associated with increased nonaccidental mortality. People with cardiovascular disease and elderly adults may be more susceptible to the impact of cold spells on mortality.

Objective To analyze the temperature modification effect on acute mortality due to particulate air pollution. Methods Daily non-accidental mortality, cardiovascular mortality, and respiratory mortality data were obtained from Jiang'an District Center for Disease Control and Prevention. Daily meteorological data on mean temperature and relative humidity were collected from China Meteorological Data Sharing Service System. The daily concentration of particulate matter was collected from Wuhan Environmental Monitoring center. By using the stratified time-series models, we analyzed effects of particulate air pollution on mortality under different temperature zone from 2002 to 2010, meanwhile comparing the difference of age, gender and educational level, in Wuhan city of China. Results High temperature (daily average temperature>33.4℃) obviously enhanced the effect of PM10 on mortality. With 10 μg/m3 increase in PM10 concentrations, non-accidental, cardiovascular, and respiratory mortality increased 2.95%(95%CI:1.68%-4.24%), 3.58%(95%CI:1.72%-5.49%), and 5.07%(95%CI:2.03%-9.51%) respectively. However, low temperature (daily average temperature <-0.21 ℃) enhanced PM10 effect on respiratory mortality with 3.31%(95%CI: 0.07%-6.64%)increase. At high temperature, PM10 had significantly stronger effect on non-accidental mortality of female aged over 65 and people with high educational level groups. With an increase of 10 μg/m3, daily non-accidental mortality increased 4.27% (95%CI:2.45%-6.12%), 3.38% (95%CI:1.93%-4.86%) and 3.47% (95%CI:1.79%-5.18%), respectively. Whereas people with low educational level were more susceptible to low temperature. A 10μg/m3 increase in PM10 was associated with 2.11%(95%CI:0.20%-4.04%)for non-accidental mortality. Conclusions Temperature factor can modify the association between the PM10 level and cause-specific mortality. Moreover, the differences were apparent after considering the age, gender and education groups.

Objective To evaluate the association between cold spells and nonaccidental mortality from 2001 to 2011 in the Jiang'an District of Wuhan, China. Methods We collected mortality data for December 2001 to 2010 and January to March 2002 to 2011 in the study area. According to the International Classification of Diseases, we stratified the mortality data into three cause-specific categories:nonaccidental mortality, cardiovascular mortality, and respiratory mortality. We also obtained meteorological data (from the China Meteorological Administration) and ambient pollution data (from the Wuhan Environmental Monitoring Center) during the same periods. In the present study, a cold spell was defined as 5 or more consecutive days with daily average temperatures below the 5th percentile of daily mean temperatures (2.58℃) from January to December in 2001-2011. A distributed lag nonlinear model (DLNM) was applied to assess the acute effect of cold spells on daily nonaccidental mortality. Results During the study period, the total number of nonaccidental deaths was 17 119, including 9 403 (75.5%) among individuals aged over 65 years; 7 968 (46.5%) people died of cardiovascular disease. According to this definition, there were a total of 13 cold spell events and 111 days of duration in Wuhan during the study period. Study days were divided into three periods: non-cold spell days, 2008 cold spell days, and cold spell days in other years. Average daily mean temperatures of the above three periods were(8.2±4.5),(-0.7±1.4), and(0.8±1.2)℃, respectively, corresponding to average daily deaths of 14.0 ± 4.2, 18.2 ± 4.5, and 14.9 ± 4.9 for nonaccidental mortality. After adjusting for long-term trends, seasonal trends, weekdays, holidays, and relative humidity, analysis by the DLNM revealed that cold spells were associated with increased mortality risk, with a cumulative relative risk (RR) of 1.56 (95%CI:1.36-1.79) at lag 0-27 days in 2008, higher than that in other years with 1.23 (95%CI:1.08-1.41). Cold spells were not significantly associated with respiratory mortality and people under 65 years of age;however, during the 2008 cold spell RR increased to 1.96 (95%CI:1.62-2.37) and 1.67 (95%CI: 1.43-1.95) for cardiovascular mortality and older adults (≥65 years old), respectively;both males and females had high mortality risk, with RRs of 1.60 (95%CI:1.33-1.92) and 1.50 (95%CI: 1.23-1.84), respectively. The association between cold spells and mortality remained nearly unchanged with and without adjustment for ambient pollutants (PM10, SO2, and NO2) in the DLNMs. Conclusion In Wuhan, both the 2008 cold spell and cold spells in other years were significantly associated with increased nonaccidental mortality. People with cardiovascular disease and elderly adults may be more susceptible to the impact of cold spells on mortality.

Objective:To investigate the correlation between plasma homocysteine (Hcy) concentration and transient ischemic attack (TIA) and traditional vascular risk factors.Methods:The plasma Hcy concentrations of 112 patients with TIA and 62 controls were measured by fluorescenee polarization immunoassay.Hcy concentrations and related risk factors were analyzed.Results:The risk of TIA was increased significantly in plasma Hcy concentration 10.0 to 14.9 μmol/L group(OR=2.450,95% CI 1.091 to 5.502) and≥15.0 μmol/L group(OR=5.169,95% CI 2.096 to 12.746) compared with plasma Hcy concentration＜10.0 μmol/L group.Using TIA as the dependent wariable,various vascular risk factors (including plasma Hcy concentration) as the independent variable,logistic regression was analyzed.The result showed that the risk of TIA was increased significantly in plasma Hcy concentration＞10.0 μmol/L group compared with plasma Hcy concentration＜10.0 μmol/L group(OR=3.150,95% CI 1.380 to 7.192).Conclusions:Plasma Hcy concentration is an independent risk factor for TIA.

OBJECTIVETo study the clinical effect of acupoint stimulating control (ASC) in treating obsessive compulsive neurosis.

METHODSThe comparative study was conducted in 65 patients with obsessive compulsive neurosis, they were divided into two groups, the 33 patients in the control group treated with chlorimipramine and the 32 in the tested group treated with ASC. The therapeutic efficacy and adverse reaction were assessed according to the standard for clinical efficacy evaluation by Yale-Brown scale for obsession (Y-BOCS)and adverse reaction scale.

RESULTSThe curative rate and markedly effective rate in the control group was 24.2% (8/33) and 27.3% (19/33), which in the tested group was 37.5% (12/32) and 34.4% (11/32) respectively. Significant difference was shown in comparison of Y-BOCS score between the two groups from the end of the 4th week of treatment (P < 0.05), indicating the efficacy in the tested group was better than that in the control group. Moreover, the occurrence of adverse reaction was higher in the control group than that in the tested group.

CONCLUSIONASC is a treatment with good effect, less adverse reaction and favourable safety superior to the treatment by chlorimipramine.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Behavior Control ; methods ; Behavior Therapy ; Clomipramine ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Obsessive-Compulsive Disorder ; therapy ; Psychiatric Status Rating Scales ; Transcutaneous Electric Nerve Stimulation ; methods