Objective To compare the changes of brain voxel-mirrored homotopic connectivity(VMHC)of patients before and after Tai Chi Chuan training based on functional magnetic resonance imaging(fMRI)technology;To discuss the central effect mechanism of Tai Chi Chuan in treating chronic fatigue syndrome(CFS).Methods A total of 25 CFS patients(experiment group)and 27 healthy individuals(control group)were recruited to undergo a 1-month Tai Chi Chuan intervention.All receive one month of Tai Chi Chuan training.Differences in SF-36 scores and VMHC between CFS patients and HCs were compared.Results Before training,the SF-36 scores in the experimental group were significantly lower than those in the control group(P<0.001),and the VMHC in the bilateral inferior occipital gyrus,paracentral lobule,lingual gyrus,insula and superior temporal gyrus brain areas were weakened.After training,the scores of SF-36 in the experimental group significantly increased(P<0.001),and the VMHC in bilateral inferior occipital gyrus,superior temporal gyrus,anterior cuneiform lobe and paracentral lobule were significantly enhanced.The difference in whole brain VMHC was positively correlated with the difference in energy scores in SF-36(r=0.456,P=0.025);some scores of SF-36 in the control group significantly increased(P<0.05),and no significant changes in VMHC were observed in brain regions.Conclusion Tai Chi Chuan can effectively improve the quality of life of patients with CFS.This change may be related to the enhancement of functional connections in brain regions such as inferior occipital gyrus,superior temporal gyrus,precuneus,paracentral lobule,et al.

Objective:To explore the relationship between puberty timing and cardiovascular metabolic risk factors among primary and secondary students with different genders in Beijing.Methods:Using the method of stratified cluster sampling by urban and rural areas and school sections,3 067 students from 16 primary and secondary schools in Fangshan District of Beijing were selected in October 2012,with ques-tionnaire survey,physical examination and serum laboratory testing.In this study,we controlled for con-founding factors such as school segments,current residence of the family,birth weight,feeding method,only child,highest educational level of parents,and monthly family income,and then the associations between cardiovascular metabolic risk factors and puberty timing among the primary and secondary students was analyzed by multivariate Logistic analysis.To ensure the reliability of the data,this study adopted strict quality control.Results:A total of 3 067 primary and middle school students aged 7 to 16 years were included in this study,including 1 575 boys and 1 492 girls.The prevalence of premature pu-berty was 14.73％among the boys and 12.89％among the girls,respectively.The prevalence of delayed puberty was 9.49％among the boys and 10.99％among the girls,respectively.The detection rates of central obesity,hypertension,hyperglycemia,and dyslipidemia among the primary and secondary students were 35.87％,19.95％,2.54％and 26.31％,respectively.The detection rates of 1 risk fac-tor clustering,2 risk factors clustering and more than 3 risk factors clustering were 29.21％,16.17％and 9.36％,respectively.The difference in the detection rate of cardiovascular and metabolic risk factors in different youth stages was insignificant(P＞0.05),the detection rate of risk factor aggregation of 0 was lower than that of the timely group and delayed group,and the detection rate of risk factors aggrega-tion of 2 was higher than that of the timely group(P＜0.05).After adjusting the effects of learning stage,region,birth weight,feeding patterns,one-child,family income and the parents'educational levels,multivariate Logistic regression analysis showed that,compared with the on-time puberty group,the risk of 1 risk factor clustering,2 risk factors clustering and more than 3 risk factors clustering increased by 1.94 times(95％CI=1.29-2.91),2.97 times(95％CI=1.89-4.67)and 2.02 times(95％CI=1.13-3.63)among the girls;It had not been found that the relationship between puberty timing and car-diovascular risk factor clustering among the boys(P＞0.05).Conclusion:Premature puberty is an inde-pendent risk factor for the clustering of cardiometabolic risk factors in girls,and primary prevention strate-gies should be implemented to reduce the burden of cardiovascular metabolic diseases in the population.

Objective To investigate peripheral blood cell count and characteristics of dyshaematopoiesis of peripheral blood and bone marrow cells in patients with myelodysplastic syndrome(MDS).Methods A total of 40 patients with MDS newly diagnosed in the hospital from January 2015 to December 2022 were selected as the experimental group,while 17 patients with megaloblastic anemia(MA group),11 patients with aplastic a-nemia(AA group),and 24 patients with autoimmune disease(AID group)were selected as the non-MDS group.Blood routine of patients in each group was detected by whole blood cell analyzer Sysmex XN20,and the white blood cell count(WBC),red blood cell count(RBC),hemoglobin(Hb),platelet count(PLT),mean red blood cell volume(MCV)and coefficient of variation of red blood cell distribution width(RDW-CV)of patients in 4 groups were compared and analyzed.Bone marrow and peripheral blood cell morphology in 4 groups were observed and recorded by artificial microscopy.The positive rate of common dyshaematopoiesis of peripheral in 4 groups was compared and analyzed.Results Compared with MA group,RBC and Hb in MDS group were significantly increased(P＜0.05),while MCV was significantly decreased(P＜0.05).Compared with AA group,WBC,MCV,RDW-CV and PLT in MDS group were significantly increased(P＜0.05).Com-pared with AID group,WBC,RBC,Hb and PLT in MDS group were significantly decreased(P＜0.05),while MCV and RDW-CV were significantly increased(P＜0.05).The positive rate of peripheral blood primitive cells in MDS group was significantly higher than that in non-MDS group(P＜0.05).Large red blood cells and polylobulated granulocyte were the main dysplasia types in the peripheral blood of MA group,and the positive rate of dyshematopoietic was significantly higher than that in MDS group(P＜0.05).Compared with the non-MDS group,the positive rates of five types of dyshaematopoiesis in the MDS group were significantly higher than those in the control group(P＜0.05),including increased blasts,decreased or absent cytoplasmic gran-ules,pseudo Pelger neutrophils,binucleated granulocytes and micromegakaryocytes.The positive rates of polylobulation and giant change in granulocytes,giant change,large red cells,basophilic stippling erythrocyte and H-J corpuscle in erythrocytes in MA group were significantly higher than those in MDS group(P＜0.05).Dyshematopoiesis was absent or rare in the bone marrow smears of AA group and AID group.Conclu-sion Specific dyshaematopoiesis combined with peripheral blood cell count is helpful for the diagnosis and differential diagnosis of MDS,and reduces the possibility of misdiagnosis and missed diagnosis.

BACKGROUND: Worldwide, the volume and availability of digestive endoscopy have undergone dramatic development in recent years, with increasing attention on quality assurance. We investigated the utilization and quality of digestive endoscopy in China from 2015 to 2019 and developed a quantitative quality evaluation tool for medical institutions. METHODS: We invited all tertiary/secondary hospitals in Chinese mainland to participate in the survey annually. The questionnaires included the personnel, annual volume, and quality indicators of endoscopy. An endoscopy quality index (EQI) was developed based on recorded quality indicators using principal component analysis to determine the relative weight. RESULTS: From 2015 to 2019, 806, 1412, 2644, 2468, and 2541 hospitals were respectively enrolled in this study. The average annual volume of endoscopy increased from 12,445 to 16,206 (1.30-fold) and from 2938 to 4255 (1.45-fold) in tertiary and secondary hospitals, respectively. The most obvious growth was observed in diagnostic colonoscopy (1.44-fold for all hospitals after standardization). The proportion of early cancer among all esophageal and gastric cancers during diagnostic esophagogastroduodenoscopy increased from 12.3% (55,210/448,861) to 17.7% (85,429/482,647) and from 11.4% (69,411/608,866) to 16.9% (107,192/634,235), respectively. The adenoma detection rate of diagnostic colonoscopy increased from 14.9% (2,118,123/14,215,592) to 19.3% (3,943,203/20,431,104). The EQI model included 12 quality indicators, incorporating 64.9% (7.792/12) of the total variance into one comprehensive index. According to the EQI measurements, the quality of endoscopy was higher in tertiary hospitals and hospitals in developed areas with higher volume or more endoscopists than that in other hospitals. CONCLUSIONS Digestive endoscopy in China has developed considerably in recent years in terms of both volume and quality. The EQI is a promising tool to quantify the quality of endoscopy at different hospitals.
Humans ; Colonoscopy/methods* ; Endoscopy, Gastrointestinal ; Endoscopy, Digestive System/methods* ; Surveys and Questionnaires ; Adenoma ; China

Objective:To evaluate the services, quality and safety of digestive endoscopy in China in 2020.Methods:Data of digestive endoscopy in 2020 collected by the national medical quality information network were included. After data quality evaluation, the basic information of digestive endoscopy centers in different types of hospitals, the diagnosis and treatment of digestive endoscopy, the process and outcome indicators of digestive endoscopy were analyzed and compared.Results:A total of 3 714 hospitals were included in this survey. The digestive endoscopy operations completed by each hospital was 3 562.5 (1 299.75, 8 426.75), the digestive endoscopists was 4 (2, 7), and the endoscopic operations completed per capita per year was 900 (500, 1 452). The detection rate of early gastrointestinal cancer was 17.46% (110 069/630 265). The success rates of cecal intubation under colonoscopy and selective intubation of endoscopic retrograde cholangiopancreatography were 95.43% (6 976 521/7 310 970) and 94.21% (121 666/129 149) respectively. The complete resection rate of endoscopic submucosal dissection was 92.68% (93 536/100 924). The incidence of serious complications related to digestive endoscopic operations [0.05‰ (1 316/26 499 108)] and mortality [0.003‰ (80/26 499 108)] remained at a low level.Conclusion:The quality and safety of digestive endoscopy in China in 2020 is improved, but there are still some problems, such as the shortage of digestive endoscopists, the poor ability of endoscopists in the diagnosis of early gastrointestinal cancer.

Objective:To observe the morphological and hemodynamics changes of aortic segments in mice with angiotensinogen Ⅱ(Ang II) combined with β-aminopropionitrile(BAPN) induced-aortic dissection by color Doppler ultrasound(CDUS).Methods:Twenty male mice of 6-8 weeks old C57BL/6 were randomly divided into two groups: the model group( n=10) was induced by intraperitoneal injection of Ang Ⅱ combined with BAPN to establish mice model with aortic dissection; the control group( n=10) was intraperitoneally injected with normal saline.The body weight, systolic and diastolic blood pressure of the mice were routinely recorded. On the 42th day, CDUS was used to measure the indexes of ascending aorta(AoA), descending thoracic aorta(DAo) and suprarenal aorta(SAo) in both groups, including the inner diameter of the cross section, peak systolic velocity(PSV), the end diastolic velocity(EDV), the resistance index(RI), the pulsatility index(PI), time average mean velocity(TAMV), the heart rate(HR) and the maximal shear rate(SR). Then, the aortas were harvested from the root to the bifurcation of the renal artery. The pathological changes of the aortic wall were observed using hematoxylin-eosin(HE) staining. Results:①There were statistically significant differences in body weight, systolic blood pressure, diastolic blood pressure and heart rate between the model group and the control group(all P<0.05). Compared with the control group(0/10), the incidence of the AoA dissection(8/10) in the model group was obviously higher, the difference was statistically significant( P<0.05); while the incidence of the DAo dissection(4/10) and the SAo dissection(3/10) in the model group was slightly higher, the differences were not statistically significant (all P>0.05). ②Compared with the ascending aorta of the control group, the inner diameter, PSV, EDV, TAMV, PI and SR in the model group were significantly higher(all P<0.05), while RI showed no significant difference between the two groups ( P>0.05). For the descending thoracic aorta, PSV, EDV, TAMV, PI and SR in model group were higher than those of the control group(all P<0.05), however the inner diameter and RI were not significantly different between the two groups (all P>0.05). And for the superior renal aorta, PSV, TAMV, RI, PI and SR in the model group were obviously higher than the control group(all P<0.05), whereas the inner diameter and EDV were not significantly different between the two groups (all P>0.05). ③The HE of the tissue section in the model group showed, the aortas were obviously dilated, irregular, with inhomogeneously thickening wall; the endothelial cell nuclei were slightly stained, and some intima and middle layer ruptured and protruded outward to form dissecting aneurysms. The adventitias were markedly infiltrated with inflammatory cells. Conclusions:Ultrasonography could primarily evaluate the hemodynamic changes of aorta in hypertension with aortic dissection, and the PSV, TAMV, PI and SR of aorta may be important indicators for early predicting the occurrence of aortic dissection in hypertension.

Objective:To identify dietary patterns among children and adolescents aged from 7 to 18 and the associations between these patterns and family characteristics.Methods:A stratified cluster sampling method was used. Data was collected on 2 438 students and their parents through physical examinations and questionnaires. Students were from 16 schools (4 urban primary schools, 4 rural primary schools, 4 urban middle schools, and 4 rural middle schools) in Fangshan district, Beijing. Dietary patterns were derived by factor analysis. Rank sum tests and Pearson correlation analysis were used to analyze the correlations between family characteristics and the scores on dietary patterns. Generalized linear mixed models were used to examine the associations between family characteristics and dietary patterns, for univariate analyses.Results:Two dietary patterns were identified: the risk pattern and the protective pattern. Results from the univariate analyses showed that maternal BMI was associated with the risk pattern ( P=0.011). All factors, including the only-child, parental education level, monthly household income, paternal age at birth and maternal BMI, were related to the protective pattern (all P<0.05) except for the paternal BMI. After adjusting for gender, age, locations of residence (urban-rural) and BMI z-score, children with a lower parental education level and higher monthly household income were more likely to adhere to the risk pattern ( β=-0.10, 95% CI:-0.16- -0.04; β=0.07, 95% CI: 0.02-0.12, respectively). For the protective pattern, the scores were positively associated with parental education level ( β=0.08, 95% CI: 0.02-0.14), monthly household income ( β=0.06, 95% CI: 0.02-0.11) and maternal age at birth ( β=0.02, 95% CI: 0.00-0.03). Children from the one-child families were more likely to adhere to the protective pattern ( β=-0.13, 95% CI: -0.22- -0.03). Conclusions:Differences of dietary behaviors were seen among children and adolescents from families with different characteristics. Protective patterns for children from families with lower parental education, lower monthly household income, lower maternal age at birth or multiple children etc. should be promoted. Risk patterns of children with lower parental educational or higher monthly household income also need to be corrected.

Objective To evaluate the comparability and consistency of two kinds of triglycerides reference methods, one of which is the isotope dilution liquid chromatography-mass spectrometry (LC/MS) in the Cholesterol Reference Method Laboratory Network (CRMLN), the other isthehigh-performance liquid chromatography (HPLC) method for triglyceride detection in China. Methods 52 fresh frozen sera with triglycerides levels among 0.45-4.52 mmol/L were determined by LC/MS and HPLC. After evaluation the precision and accuracy of the two methods,a series of analyses were conducted including plotting to scatter plots and deviation graphs, testing outliers, selecting the best fitting regression models and calculating the regression equations and parameters, and so on. The expected deviation at the level of medical decision of triglycerides and the 95％confidence range were statistically analyzed.Results For HPLC method, the CV of instrument measurement was 0.29％(0％-1.16％), the total CV of samples measurement was 0.54％(0.04％-1.28％), and the average bias of the reference materials was 0.22％(-0.43％-0.68％). ForLC/MSmethod,the CV of instrument measurement was 0.55％(0％-1.68％),the total CV of samples measurement was 0.79％(0％-1.93％), and the average bias of the NIST reference materials was 0.09％(-0.73％-1.29％). No outlier was found from the scatter plots and the statistical analysis and the linear regression was fitted to analyze the results of the two methods. The linear regression parameters of two methods for 52 fresh frozen human sera were as follows:the slope was 0.9988,the standard error of slope was 0.0035, the intercept was 0.0037mmol/L, the standard error of intercept was 0.0030 mmol/L, the standard error of Y-estimate was 0.0236 mmol/L,and the correlation coefficient was 0.9997. Compared with the LC/MS method,the absolute deviation of fresh sera by HPLC method was-0.001 mmol/L (-0.070-0.056 mmol/L), with a relative deviation of 0.13％ (-2.01-2.83％). T-test showed no statistically significant difference between the two methods. The expected deviations at the triglycerides medicine decision level were within the 95％confidence range,and the expected deviations were far less than the allowable error. Conclusions The HPLC method of triglyceridesdetetion has good consistency and comparability with LC/MS method as one of the reference methods of CRMLN. Because of the advantages of HPLC method such as low cost, simplicity,less technical need,and better precision,HPLC method is expected to play an important role in the process of standardization and traceability of serum triglycerides.

Primary nephrotic syndrome(PNS)is a common renal disease in children and the pathogenesis has not been clarified, but it is considered to be related to cellular immune dysfunction.We collected the reported cytokines associated with PNS and reviewed the resources and the involving pathogenesis of the cytokines.We hope to help to clarify the possible pathogenesis of PNS and to develop new treatments for PNS patients.

Objective: To understand the pathogenic composition of hand, foot and mouth disease (HFMD) in Ningxia Hui Autonomous Region (Ningxia) from 2016 to 2017, and analyze the genetic characteristics of the main pathogens enterovirus (EV)-A71 and coxsackievirus (CV)-A16. Methods: Analysis of the result of nucleic acid testing of HFMD in Ningxia from 2016 to 2017 to determine the pathogenic composition of HFMD. The complete VP1 coding region was amplified by RT-PCR and the gene sequence was determined for the enterovirus strains sent to the National HFMD Network Monitoring Laboratory in Ningxia from 2016 to 2017. BLAST analysis confirmed the serotype of the strain, and the phylogenetic tree was constructed respectively by selecting EV-A71 and CV-A16 isolates. Results: The leading pathogens of HFMD in Ningxia of 2016 and 2017 were other EV (397, 43.72%) and EV-A71 (918, 56.18%) respectively, and the dominant pathogens in different months may differ. The pathogenic composition causing HFMD in the past two years has changed from CV-A16 and other EV to EV-A71 and other EV. The isolated EV-A71 strains were C4a evolutionary branch and the isolated CV-A16 strains were B1b evolutionary branch. Conclusions Compared to 2016, in 2017 EV-A71, CV-A16 and other EV changed dynamically. Dynamic monitoring of EV-A71 in Ningxia is of great significance to guide the strategy of using EV-A71 vaccine, concentrating medical resources to strengthen the treatment and reduce the mortality rate of severe HFMD cases.