Objective To investigate the association between the Chinese visceral adiposity index (CVAI) and diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension among elderly people in Hebei Province. Methods In 2020, a stratified multi-stage random sampling was used to conduct questionnaire survey, physical examination and laboratory detection among permanent residents of 10 monitoring sites in Hebei Province. Logistic regression was used to analyze the association between CVAI and diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension. The area under the ROC curve (AUC) was used to evaluate the predictive value of CVAI for diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension. Results The detection rates of diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension were 19.8%, 74.6%, 78.2%, and 16.2%, respectively. Multivariate logistic regression analysis showed that compared with the lowest quartile of CVAI group Q1, the OR (95% CI) of diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension in the highest quartile Q4 group were 3.55 (2.58~4.89), 2.52 (1.92~3.31), 3.09 (2.31~4.12), and 4.92 (3.40~7.12), respectively. The ROC curve results showed that CVAI had the best predictive value in the diagnosis of diabetes with hypertension, and the optimized critical values in males and females were 128.54 and 141.88, respectively. Conclusion The detection rates of diabetes mellitus and hypertension are high in the elderly population in Hebei Province. CVAI is positively associated with the risk of diabetes mellitus, hypertension, diabetes mellitus or hypertension, and diabetes with hypertension among the elderly in Hebei. CVAI has the strongest prediction ability for diabetes with hypertension.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

Objective:To explore the clinical effects of intramuscular injection of oryzanol for 5 and 10 days in the treatment of menopausal syndrome.Methods:This study adopts a case-control study method.Twenty patients with menopausal syndrome admitted to Peking Union Medical College Hospital from July 2021 to March 2022 were selected and randomly divided into a control group and an observation group using a random number table method, with 10 patients in each group. The control group was given intramuscular injection of oryzanol once a day for 5 consecutive days on the basis of routine health education; On the basis of routine health education, the observation group was given intramuscular injection of oryzanol once a day for 10 consecutive days. Two groups of patients completed a total of 6 visits before treatment and on days 5, 10, 30, 60, and 90 of treatment. Baseline survey was conducted to record the basic information of patients, including demography data, menstruation, past history, surgical history, drug allergy and the main symptoms of climacteric syndrome, and the baseline hormone level of patients was detected. Compare the menopausal symptoms by modified K-score, Pittsburgh sleep quality index (PSQI) score, menopausal specific quality of life (MENQOL) score, post treatment injection site pain by visual analog score (VAS), and observe adverse reactions during treatment between the two groups of patients at each visit time point.The measurement data conforming to the normal distribution is expressed in xˉ± s. The comparison between the two groups is performed by t test, and the change trend of the two groups at each time point is compared by repeated measurement analysis of variance; The measurement data that do not conform to the normal distribution are represented by M( Q1, Q3), and the Kruskal Wallis test is used for comparison between groups; Counting data is represented by examples(%), Fisher's exact probability method is used for inter group comparison, and Wilcoxon rank sum test is used for rank data comparison. Results:The body mass of the control group was higher than that of the observation group [(62.50±11.88) kg vs (52.90±4.28) kg, t=2.40, P=0.027]. There was no statistical difference between the two groups in other demography data and previous history, sex hormone levels, menopausal symptoms, and menstrual conditions (all P>0.05). Compared with the baseline, the modified K-score, PSQI score, and MENQOL vascular dilation and contraction, psychological state, physiological state, and sexual life scores of the two groups of patients on the 5th, 10th, 30th, 60th, and 90th day of treatment were significantly reduced, and showed a gradually decreasing trend with the extension of observation time (the values in Group F were 36.37, 12.40, 18.69, 24.73, 40.77, and 18.39, respectively, P<0.001), but there was no statistically significant difference between the groups (all P>0.05). After treatment, the VAS score of the control group was 1 point in 2 cases, 2 points in 4 cases, and 3 points in 4 cases; The VAS score of the observation group was 1 in 4 cases, 2 in 3 cases, and 3, 5, and 6 in 1 case each. There was no statistically significant difference in VAS scores between the two groups ( Z=0.43, P=0.664), and no adverse events or serious adverse events were observed during the treatment period. Conclusions:Intramuscular injection of oryzanol injection for 5 and 10 days can improve menopausal symptoms, improve sleep quality and overall quality of life in patients with menopausal syndrome, and the overall effect is similar.

OBJECTIVE: Cassiae Semen (CS, Juemingzi in Chinese) has been used for thousands of years in ancient Chinese history for relieving constipation, improving liver function as well as preventing myopia. Here we aimed to elucidate the anti-steatosis effect and underlying mechanism of CS against non-alcoholic fatty liver disease (NAFLD). METHODS: High-performance liquid chromatography (HPLC) was used to identify the major components of CS water extract. Mice were fed with a high-fat and sugar-water (HFSW) diet to induce hepatic steatosis and then treated with CS. The anti-NAFLD effect was determined by measuring serum biomarkers and histopathology staining. Additionally, the effects of CS on cell viability and lipid metabolism in oleic acid and palmitic acid (OAPA)-treated HepG2 cells were measured. The expression of essential genes and proteins involved in lipid metabolism and autophagy signalings were measured to uncover the underlying mechanism. RESULTS: Five compounds, including aurantio-obtusin, rubrofusarin gentiobioside, cassiaside C, emodin and rhein were simultaneously identified in CS extract. CS not only improved the diet-induced hepatic steatosis in vivo, as indicated by decreased number and size of lipid droplets, hepatic and serum triglycerides (TG) levels, but also markedly attenuated the OAPA-induced lipid accumulation in hepatocytes. These lipid-lowering effects induced by CS were largely dependent on the inhibition of fatty acid synthase (FASN) and the activation of autophagy-related signaling, including AMP-activated protein kinase (AMPK), light chain 3-II (LC3-II)/ LC3-1 and autophagy-related gene5 (ATG5). CONCLUSION Our study suggested that CS effectively protected liver steatosis via decreasing FASN-related fatty acid synthesis and activating AMPK-mediated autophagy, which might become a promising therapeutic strategy for relieving NAFLD.

ObjectiveTo investigate the effect of supplemented Buyang Huanwutang on kidney tissue， nuclear factor-κB （NF-κB） pathway， and fibrosis factors in diabetic kidney disease （DKD） mice. MethodA total of 24 db/db mice （11-12 weeks old） were randomized into the model group （equivalent volume of distilled water， once/day， 8 weeks）， supplemented Buyang Huanwutang group （16.0 g·kg^-1， once/day， 8 weeks）， and irbesartan group （13.5 mg·kg^-1， once/day， 8 weeks） after adaptive feeding for 1 week and positive urinary protein monitoring， with 8 in each group. Another 8 db/m mice （11-12 weeks old） were included in the normal group （equivalent volume of distilled water， once/day， 8 weeks）. Then samples were collected， and the levels of fasting blood glucose （FBG）， total cholesterol （TC）， triglyceride （TG）， blood urea nitrogen （BUN）， serum creatinine （SCr）， and urinary microalbumin （mALB） were detected. The mRNA expression of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and monocyte chemoattractant protein-1 （MCP-1） was determined by real-time polymerase chain reaction （Real-time PCR）. The expression of nuclear factor-κB （NF-κB）， NF-κB inhibitor α （IκBα）， phosphorylated IκBα （p-IκBα）， transforming growth factor-β₁ （TGF-β₁）， α-smooth muscle actin （α-SMA）， and fibronectin （FN） in kidney tissue was measured by Western blot. The expression of NF-κB in renal tissue was detected by immunofluorescence. The pathological changes of kidney were observed under light microscope. ResultCompared with the normal group， the model group showed glomerular hypertrophy， increase in extracellular matrix， thickening of basement membrane， small cystic lumen， interstitial inflammatory cell infiltration， and some interstitial fibrosis （P<0.01）. Moreover， the model group had higher content of FBG， mALB， TC， TG， BUN， and SCr （P<0.01）， higher expression of inflammatory factors TNF-α， IL-1β， and MCP-1， and fibrosis-related proteins TGF-β₁， α-SMA， and FN （P<0.01）， and stronger activation of NF-κB pathway in renal tissue （P<0.01） than the normal group. Compared with the model group， supplemented Buyang Huanwutang alleviated the pathological injury in kidney （P<0.01）， decreased the content of mALB， TC， and TG， the content of BUN and SCr （P<0.01）， and the content of TNF-α， IL-1β， and MCP-1 （P<0.05， P<0.01）， and inhibited the activation of NF-κB pathway and the expression of fibrosis factors in renal tissue （P<0.05， P<0.01）， but had no significant effect on blood glucose level. ConclusionBy inhibiting NF-κB pathway and the expression of fibrosis factors in renal tissue， supplemented Buyang Huanwutang can exert anti-inflammatory and anti-fibrosis effect and alleviate the pathological damage in kidney tissue， thereby protecting the kidney.

Objective:To explore the significance of 99Tc m-sulfur colloid lymphoscintigraphy in the diagnosis of lower limb lymphedema after gynecological tumor surgery. Methods:The clinical data of patients with lower limb lymphedema after gynecological tumor surgery in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from May 2015 to October 2019 were retrospectively analyzed. 99Tc m-sulfur colloid lymphoscintigraphy was performed in all patients. The results of lymphatic vessel imaging, lymph node imaging and their combination in the diagnosis of lower limb lymphedema were analyzed. The diagnostic efficacy of lymphatic vessel imaging alone, lymph node imaging alone and their combination was evaluated by the receiver operating characteristic (ROC) curve and the area under the curve (AUC), and the Youden index, sensitivity and specificity were calculated. Results:Among the 100 lower limbs of 50 patients, 56 limbs had lymphedema and 44 limbs had no obvious edema. When diagnosis was based on abnormal lymphatic vessel imaging alone, among 56 lower limbs with lymphedema, lower limbs lymphatic vessel imaging was positive in 38 (67.9%) and negative in 18 (32.1%); among 44 lower limbs without obvious edema, lower limbs lymphatic vessel imaging was positive in 6 (13.6%) and negative in 38 (86.4%); the sensitivity was 67.9%, the specificity was 86.4%, and the Youden index was 0.543. When diagnosis was based on abnormal lymph node imaging alone, among 56 lower limbs with lymphedema, lower limbs lymph node imaging was positive in 42 (75.0%) and negative in 14 (25.0%); among 44 lower limbs without obvious edema, lower limbs lymph node imaging was positive in 13 (29.5%) and negative in 31 (70.5%); the sensitivity was 75.0%, the specificity was 70.5%, and the Youden index was 0.455. When diagnosis was based on the combination of lymphatic vessel imaging and lymph node imaging, among 56 lower limbs with lymphedema, lymphatic vessel imaging and lymph node imaging were positive in 48 (85.7%) and negative in 8 (14.3%); among 44 lower limbs without obvious edema, lymphatic vessel imaging and lymph node imaging were positive in 14 (31.8%) and negative in 30 (68.2%); the sensitivity was 85.7%, the specificity was 68.2%, and the Youden index was 0.539. The AUC for the combined diagnosis of lymphatic vessel imaging and lymph node imaging was 0.781, the AUC for the diagnosis of abnormal lymphatic vessel imaging was 0.771, and the AUC for the diagnosis of abnormal lymph node imaging was 0.739 (all P < 0.01). Conclusions:99Tc m-sulfur colloid lymphoscintigraphy is of great help in the diagnosis of lower limb lymphedema after operation of gynecological tumors. The combination of lymph node imaging and lymphatic vessel imaging is more effective in the diagnosis of lower limb lymphedema.

Background::Compared with human leukocyte antigen (HLA)-matched sibling donor (MSD) transplantation, it remains unclear whether haploidentical donor (HID) transplantation has a superior graft-versus-leukemia (GVL) effect for Philadelphia-negative (Ph-) high-risk B-cell acute lymphoblastic leukemia (B-ALL). This study aimed to compare the GVL effect between HID and MSD transplantation for Ph- high-risk B-ALL.Methods::This study population came from two prospective multicenter trials (NCT01883180, NCT02673008). Immunosuppressant withdrawal and prophylactic or pre-emptive donor lymphocyte infusion (DLI) were administered in patients without active graft-versus-host disease (GVHD) to prevent relapse. All patients with measurable residual disease (MRD) positivity posttransplantation (post-MRD+) or non-remission (NR) pre-transplantation received prophylactic/pre-emptive interventions. The primary endpoint was the incidence of post-MRD+.Results::A total of 335 patients with Ph- high-risk B-ALL were enrolled, including 145 and 190, respectively, in the HID and MSD groups. The 3-year cumulative incidence of post-MRD+ was 27.2% (95% confidence interval [CI]: 20.2%-34.7%) and 42.6% (35.5%-49.6%) in the HID and MSD groups (P = 0.003), respectively. A total of 156 patients received DLI, including 60 (41.4%) and 96 (50.5%), respectively, in the HID and MSD groups ( P= 0.096). The 3-year cumulative incidence of relapse was 18.6% (95% CI: 12.7%-25.4%) and 25.9% (19.9%-32.3%; P = 0.116) in the two groups, respectively. The 3-year overall survival (OS) was 67.4% (95% CI: 59.1%-74.4%) and 61.6% (54.2%-68.1%; P = 0.382), leukemia-free survival (LFS) was 63.4% (95% CI: 55.0%-70.7%) and 58.2% (50.8%-64.9%; P= 0.429), and GVHD-free/relapse-free survival (GRFS) was 51.7% (95% CI: 43.3%-59.5%) and 37.8% (30.9%-44.6%; P= 0.041), respectively, in the HID and MSD groups. Conclusion::HID transplantation has a lower incidence of post-MRD+ than MSD transplantation, suggesting that HID transplantation might have a superior GVL effect than MSD transplantation for Ph- high-risk B-ALL patients.Trial registration::ClinicalTrials.gov: NCT01883180, NCT02673008.

Objective:To investigate the effect of attention and interpretation therapy on sleep dysfunction and quality of life in perimenopausal syndrome patients.Methods:From August 2018 to January 2020, a total of 76 patients with perimenopausal syndrome were divided into experimental group (38 cases) and control group (38 cases) according to the random number table method. Two groups recieved routine therapy and nursing care, on the basis of this, the experimental group was given attention and interpretation therapy for 10 weeks. Before intervention and after 10 weeks of intervention, the effects were assessed by Pittsburgh Sleep Quality Index (PSQI) and Menopause-Specific Quality of Life (MENQOL), respectively.Results:There was no significant difference in the score of PSQI, MENQOL before intervention between the two groups ( P>0.05). After intervention, the sleep quality, sleep duration, sleep efficiency scores and total PSQI scores were 0.79±0.10, 1.48±0.23, 1.11±0.22, 9.70±0.59; in addition, the vasomotor symptoms, psychological symptoms, somatic symptoms and total MENQOL scores were 3.06±0.81, 2.06±0.81, 2.50±0.51, 2.63±0.39 in the experimental group, significanlty lower than those in the control group (1.03±0.22, 1.85±0.33, 1.25±0.28, 10.59±0.66, 3.69±0.95, 2.83±0.77, 2.92±0.94, 3.18±0.53), the differences were statistically significant ( t values were 2.306-6.021, P<0.05). Conclusions:Attention and interpretation therapy can effectively alliviate sleep dysfunction and improve quality of life of perimenopausal syndrome patients.

Objective:To investigate the prevention effect of nurse-led peer support system on the postpartum posttraumatic stress disorder of primipara.Methods:A total of 74 cases of primipara were randomly divided into experimental group ( n=37) and control group ( n=37). The control group received routine nursing. The experimental group received nurse-led peer support intervention. The postpartum depression and postpartum posttraumatic stress disorder was assessed by using Edinburgh postnatal depression scale (EPDS) and impact of event scale-revised (IES-R) before and after intervention. Results:Before intervention, the socre of EPDS and IES-R was no statistical difference between experimental group and control group ( P>0.05). After intervention, the scores of EPDS and IES-R were significantly decreased in the experiment group [(5.41 ± 0.49) pionts, (16.56 ± 1.36) pionts] compared to the control group [(16.56 ± 1.36) pionts, (19.01 ± 1.98) pionts], the difference was statistically significant ( P<0.05). Conclusion:Nurse-led peer support system can alliviate postpartum depression and posttraumatic stress disorder status and promote the psychological health of primipara.

Objective:To investigate the prevalence of pre-diabetes mellitus (PDM) and the impact of occupation-related factors on PDM, among workers from a steel company in Tangshan city, Hebei province.Methods:Clustering sampling method was used to select a steel company and to carry out occupational health-related physical checkup programs for eligible workers who had working in this company for longer than one year. The study began in February and ended up in June, 2017. Workers who were with FPG level as ≤6.9 mmol/L, and free from diabetes, were selected as the subjects for this study. Questionnaires were used and physical examinations and FPG testing conducted.Results:The total number of subjects in this study was 4 173, of which 2 648 appeared as pre-diabetic, with the prevalence rate as 63.4 %. Increase of the PDM prevalence was in parallel with the length of service, among the workers. The risk for the pre-diabetes in those who worked more than 8 hours per day was 1.696 times higher than those who worked less than or equal to 8 h/d (95 %CI:1.517-1.937). Compared with those workers without exposures to heat, noise or carbon monoxides, the proportion of pre-diabetes appeared higher in workers exposed to heat, noise or CO with OR=1.782 (95 %CI: 1.205-2.636), 1.815 (95 %CI: 1.209-2.794) and 1.653 (95 %CI: 1.158-2.361), respectively. Risks for those who were exposed to heat or noise were higher than those who were free from exposure to any occupational hazards ( OR=2.098, 95 %CI: 1.296-3.397). Prevalence rates of pre-diabetes in those who were exposed to heat, noise or CO, were higher than that those who were not. Conclusion:Working hours and exposures to heat, noise or CO appeared as influential factors on PDM.