Objective: To evaluate the effect of a dietary and exercise intervention on cognition and behaviors among primary school students, and to further explore the mediating role of family support, in order to provide scientific evidence for future effective intervention strategies. Methods: A dietary and exercise intervention program for childhood obesity prevention was carried out in 24 primary schools in Beijing, Changzhi and Urumqi from 2018 to 2019, and 1 392 children in grade four as well as their parents were included. Family support and children s cognition and behaviors were collected through questionnaire. To carry out diet and exercise behavior intervention on the three levels of school, family and individual in the intervention group,and children s dietary and exercise knowledge, eating habits, physical activities, as well as sedentary and screen behaviors were evaluated. The linear mixed model was used to analyze the effect of intervention on children s cognition and behaviors, and the mediation model was used to explore the role of family support. Results: The proportion of children with higher score of dietary and exercise knowledge ( OR= 2.34 , 95%CI =1.71-3.21), eating habits ( OR=2.58, 95%CI =1.75-3.82), and sedentary and screen behaviors ( OR=1.91, 95%CI =1.35-2.68) increased in the intervention group after one year intervention ( P <0.01), compared with the control group, respectively. The intervention also increased the proportion of children s family support in the intervention group compared with the control group ( OR=3.45, 95%CI =2.19-5.45), and the support from children s fathers ( OR=2.70, 95%CI =1.68-4.35), mothers ( OR=3.71, 95%CI =2.28-6.04), paternal grandmothers ( OR=1.65, 95%CI =1.00-2.70), and maternal grandmothers ( OR= 2.14, 95%CI =2.12-2.16) increased significantly ( P <0.05). The mediation analysis showed that family support played a mediating role in association between comprehensive intervention and children s eating habits as well as sedentary and screen behaviors. Conclusion The dietary and exercise intervention effectively promoted children s cognition and behaviors, and family support played an important mediating role.

Objective: To explore the mediation effect of eating behavior in the personality obesity association, so as to provide scientific evidence for preventing childhood obesity in China. Methods: This study investigated 1 271 children in September 2018 among Beijing, Changzhi and Urumuqi. By used NEO five Factor Inventory to assess characteristics of personality and used Children Eating Behavior Questionnaire to measure eating behaviors in children. Five obesity related indicators [body mass index (BMI), BMI Z score, waist circumference, waist to hip ratio and body fat percentage] were derived from physical examination. Results: After adjusting for sex, age and region, the standardization scores of conscientiousness were negatively associated with BMI( B= -0.227 , 95%CI =-0.422--0.031), BMI Z score( B=-0.081, 95%CI =-0.158--0.006), waist circumference( B=-0.720, 95%CI = -1.281--0.159), waist to hip ratio( B=-0.004, 95%CI =-0.007--0.001) and body fat percentage ( B=-0.727, 95%CI = -1.293--0.162)( P <0.05). Results from the mediation analysis showed that the associations between conscientiousness and BMI, BMI Z score, waist circumference, waist to hip ratio and body fat percentage were partly mediated through food responsiveness and emotional eating behaviors; with effects ranged from 27.5%-47.1% and 0.9%-18.0%( P <0.05). Conclusion Conscientiousness is associated with lower risk of childhood obesity and food responsiveness and emotional eating behaviors show mediating effect in the association between childhood personality and obesity. Health education should be carried out in time for children with low conscientiousness in order to prevent the occurrence of obesity in the early stage.

Objective: To analyze the effect of a comprehensive intervention on the accuracy of children s body size perception, so as to provide a theoretical basis for child body size perception improvement. Methods: The participants were selected from a cluster randomized controlled trial (September 2018 to June 2019). A total of 1 287 children in 24 primary schools (clusters) equally distributed among three regions (Beijing, Changzhi and Urumqi) were selected, which included 12 intervention schools (648 students) and 12 control schools (639 students). The accuracy of body size perception was measured by Ma figural stimuli. A linear mixed model was employed to analyze the effect of the comprehensive intervention on the accuracy of children s body size perception. Results: At baseline, the accuracy rate of body size perception among children in the intervention group and the control group was 56.6% and 51.5%, respectively. The underestimation rate was 42.0% and 47.7%, and the overestimation rate was 1.4% and 0.8%. After the intervention, compared with the control group, the inaccuracy rate ( OR=0.50, 95%CI=0.37-0.68, P <0.01) and the underestimation rate in the intervention group decreased ( OR=0.37, 95%CI=0.26-0.54, P <0.01). There was no significant difference in the overestimation rate between the two groups( P =0.51). The results of the stratified analysis showed that the intervention could improve the accuracy of children s body size perception, regardless of their gender, nutritional status, region, or whether or not they were only child( P >0.05). Conclusion The inaccuracy rate of children s body size perception, which mainly involved underestimation was high. A comprehensive intervention can effectively reduce body size underestimation and improve the accuracy of children s body size perception.

Objective: To study the compliance and associated factors of smartphone application (APP) usage in childhood dietary and exercise intervention. Methods: Based on one childhood intervention of diet and exercise in Beijing, Changzhi of Shanxi Province and Urumqi of Xinjiang Province, 694 children (and their primary caregivers) in the intervention group were investigated regarding usage of APP during the intervention. Compliance of APP usage was evaluated by the click times of APP, and Logistic regression models were used to analyze influencing factors of the compliance. Results: The median (inter quartile range) click times of APP in the four modules (information dissemination, behavior monitoring, homework uploading and feedback) were 10 (5，21), 20 (14，26), 7(4，10), 26 (15，53), respectively. Multivariable logistic regression analysis found that compliance of APP usage was higher among subjects in Changzhi region ( OR =1.67，95% CI =1.12-2.48), whose primary caregiver was mother ( OR =1.55，95% CI =1.09-2.22), or whose mother did not work ( OR =0.47， 95% CI =0.31-0.74). Conclusion Compliance of APP usage was generally high in the childhood intervention of diet and exercise. Some factors are associated with compliance of APP usage. Findings of the study provide a scientific basis for better implementation of APP based childhood interventions of diet and exercise in the future.

Objective: To study the relationship between nutrition status and physical fitness in 8-10 year-old children in 3 cities, and to provide a scientific reference for improving physical condition of chidren of pre-school age. Methods: To investigate the weight, height and physical fitness (standing long jump, endurance running, rope skipping in one minute and sit-ups in one minute) of 1 384 children in grade four from 24 primary schools in Beijing, Changzhi, Urumchi in 2018. Evaluated overweight and obesity by using the standard of “Screening for Overweight and Obesity among School-age Children”. Then used mixed linear model to compare the physical fitness of students with different nutritional status and to analyze the relationship between BMI and physical fitness. Results: The prevalence of overweight and obesity were 17.41% and 23.48%, respectively. And the prevalence in boys was both more than that in girls(χ2=9.84，47.68，P<0.01). The increase in BMI of children from the same age and the same gender was related with the decrease in physical fitness by correlation analysis(P<0.05). In comparison method, the performance of the students of normal weight was better than obese students, but the male and female students had got the same results in their physical fitness test(P<0.05). Conclusion There is a negative correlation between nutrition status and physical fitness and the physical fitness in normal weight and obese children are better than the overweight children or obese children.

Objective: To analyze the current situation and needs of primary and secondary school health clinic services, and to provide a reference for strengthening school health service in China. Methods: Investigation provinces were selected according to China s three major economic zones, 1 or 2 survey centers were selected from each province, 16 provinces and 26 survey centers were selected. In each survey centers, six schools from primary and secondary schools, junior high schools and high schools in urban and rural areas were randomly selected as research sites. Each research site randomly selected 10 students in each grade(grade three, four, five from primary schools) to fill in the questionnaire anonymously. A total of 4 661 valid questionnaires were collected. Results: Among the services provided by the school clinics to students, "trauma treatment" "consulting health problems" "physical examination" accounted for 49.4%, 40.5% and 39.0% respectively. Within the past one year, 45.1% students went to the school clinic for consultation or consultation 1-3 times, 6.4% for 4-5 times, and 3.7% for 6 times or more. When students were sick in school, 65.8%(primary school), 64.0%(junior high school), and 54.4%(high school) of them selected to go to the school clinic. When suddenly suffered trauma in school, 78.2%(primary school), 73.2%(junior high school) and 69.6%(high school) of the students went to the school clinic. Conclusion Primary and middle school students have a great demand for school health services, and it is necessary to continue to strengthen the construction of primary and secondary school health clinics.

Objective:To evaluate the efficacy and safety of clip-with-endoloop method during endoscopic submucosal dissection (ESD) in treatment of early gastric angle cancer and precancerous lesions.Methods:A total of 59 patients with early gastric angle cancer or precancerous lesions underwent ESD from January 2018 to December 2018 were randomly divided into the routine ESD group ( n=28) and the clip-with-endoloop group ( n=31). The frequency of supplementary submucosal injection, ESD procedure time, area of the resected specimen, dissection time, submucosal dissection speed, complete resection rate and complications were compared between the two groups. Results:The frequency of supplementary submucosal injection in the clip-with-endoloop group was less than that in the routine ESD group (2.3±1.1 VS 3.7±1.4, t=4.557, P<0.001). There was no significant difference in the area of the resected specimen between the two groups (12.7±2.6 cm 2 VS 11.7±2.7 cm 2,t=1.485, P=0.143). The ESD procedure time (72.4±24.7 min VS 93.6±28.9 min, t=3.043, P=0.004) and dissection time (67.7±23.3 min VS 88.2±28.3 min, t=3.054, P=0.003) in the clip-with-endoloop group were significantly shorter compared with those in the routine ESD group. The submucosal dissection speed in the clip-with-endoloop group was higher than that in the routine ESD group (20.2±3.2 mm 2/min VS 14.3±3.4 mm 2/min, t=6.879, P<0.001). The complete resection rate was 100.0% in the both groups. No perforation or postoperative bleeding occurred in the two groups. The incidence of intraoperative bleeding in the clip-with-endoloop group was lower than that in the routine ESD group [19.4% (6/31) VS 35.7% (10/28), χ2=1.992, P=0.158]. Conclusion:Clip-with-endoloop method makes ESD procedures easier and faster, with a lower possibility of intraoperative bleeding in treatment of early gastric angle cancer.

In recent years,magnetic resonance imaging (MRI) has been widely used in the early diagnosis as well as long-term follow-up study of Alzheimer's disease (AD).The studies were reviewed which applied the structural MRI and arterial spin labeling MRI (ASL-MRI) in AD over the past 20 years,and found more gray matter volume loss in multiple brain structures in individuals with AD spectrum.Among them,medial temporal lobe atrophy and posterior cortical atrophy are the most diagnostic.Meanwhile,cerebral blood flow changes in various brain regions with the progression of the AD.More investigations combining the changes of gray matter volume and cerebral blood flow to explore pathophysiological mechanisms underlying cognitive decline in AD spectrum are necessary in the future.

Objective: To investigate ultrasonographic and magnetic resonance imaging features of pure mucinous adenocarcinoma of breast, and to discuss the diagnose value. Methods: Eighty-eight patients with 92 breast lesions of pure mucinous adenocarcinoma had undergone ultrasonography and MRI. The imaging features were reviewed and the diagnostic values were compared between the two imaging examinations. Results: On ultrasonography, tumors were mostly showed well-defined margins (77.2%), lobulated shape (60.9%), hypoechoic (51.1%), heterogeneous texture (63.0%), posterior echo enhancement (82.6%). Color Doppler imaging showed vascularity in 75% of these lesions.On magnetic resonance imaging, most tumors showed circumscribed mass with lobulated shape. Sixty-four lesions (69.6%) showed hypointensity on T1-wighted images.Hyperintensity and strongly hyperintensity on T2-weighted images were identified in 71 cases and 21 cases, respectively. After contrast, 54 cases showed rim enhancement and the other 38 cases showed heterogeneous enhancement. There was no significant difference in diagnostic accuracy between ultrasonography and MRI (72.8% vs 77.2%, P=0.481). Combined the two imaging examinations, the diagnostic accuracy was higher than that of ultrasonography (84.8% vs 72.8%, P=0.001) and MRI (84.8% vs 77.2%, P=0.016). Conclusions Pure mucinous adenocarcinoma of breast has some typical characteristics in ultrasonography and MRI, combination of the two imaging examinations can improve the diagnostic accuracy.

BACKGROUND:The mechanism underlying Wal erian degeneration fol owing peripheral nerve injury is complex. Immune regulation on Wal erian degeneration is beneficial for early repair of perpheral nerve injury.
OBJECTIVE:To investigate the effects of Tol-like receptor 4 (TLR4) antagonist on Wal erian degeneration and axonal regeneration after early peripheral nerve injury in rats.
METHODS:Fifty male Wistar rats were recruited and randomly divided into treatment group (n=20), model group (n=20) and sham group (n=10). The right sciatic nerves of rats in treatment and model groups were cut and sutured end-to-end, while the sciatic nerves of rats in sham group were only exposed. In the treatment group rats were intravenously injected with 0.15 mg/kg TAK-242 via tail vein 1 hour preoperatively and 7 days postoperatively, and the rats in the other two groups were given intravenous injection of the same volume of normal saline. The sciatic nerves were removed at 24 hours, 3, 4 and 7 days after surgery.
RESULTS AND CONCLUSION:Real-time PCR indicated that the mRNA expressions of interleukin-1βand monocyte chemoattractant-1 were significantly increased in the model group compared with the sham group at 24 hours after surgery (both P<0.001), while the expressions were significantly decreased after TAK-242 injection (both P<0.001). Immunofluorescence showed that compared with the model group, down-regulated expression of CD68+and iba1+cel s appeared in the treatment group at 3 days after surgery (P<0.01, P<0.05). Luxol fast blue staining revealed that demyelination at the sciatic nerve stump appeared in both model and treatment groups at postoperative 7 days, but myelin debris clearance in the treatment group was significantly reduced compared with the model group (P<0.05). Hematoxylin-eosin staining showed that a lot of inflammatory cel s, Schwann cells and regenerated nerve fibers at the sciatic nerve stump were found in the model group, while there were few inflammatory cells, Schwann cel s and regenerated nerve fibers in the treatment group at 7 days after surgery. Immunohistochemistry found that the expression of growth-associated protein-43 in the treatment group was significantly lower than that in the model group at 4 days postoperatively (P<0.05). Besides, compared with the model group, a significantly decreased sciatic functional index was found in the treatment group at 20, 30 and 40 days after surgery (P<0.05). These results show that TLR4 antagonists delay early nerve regeneration in rats after sciatic nerve injury probably by inhibiting the TLR4 signaling pathway.