Objective: To evaluate the accuracy of body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) in screening true obesity among children, so as to provide a scientific basis for precise screening and early prevention and control of childhood obesity. Methods: A total of 1 322 children aged 10-15 years old were surveyed by the Huantai Children Cardiovascular Health Cohort in 2021. Fat mass percentage (FMP) and fat mass index (FMI) were measured by bioelectrical impedance analysis, with FMP or FMI values at or above the age and sex-specific 70th percentiles as the criteria for defining true obesity. BMI, WC and WHtR were used to define general obesity and central obesity. The accuracy of these measures in screening for true obesity was evaluated by calculating the missed diagnosis rate, misdiagnosis rate, area under the curve(AUC) for receiver operating characteristic and Kappa coefficient. Results: Boys had higher BMI [(21.79±4.56) kg/m 2], WC [(76.41±12.53) cm] and WHtR (0.47±0.07) than girls [(20.83±4.13) kg/m 2, (70.69±10.06) cm, (0.45±0.06)] ( t =4.02, 9.19, 6.63), while boys had lower FMP [(18.29±8.35)%] and FMI [(4.35±2.79) kg/m 2] than girls [(24.87±6.51)%, (5.44±2.53) kg/m 2] ( t =-16.10,-7.42) ( P <0.01). Using FMP as a reference standard, the diagnosis error rates of screening for true obesity based on BMI, WC and WHtR were 12.24%, 2.11% and 2.11%, respectively; the diagnosis error rates were 10.88%, 27.28% and 24.33%; the AUC values were 0.88, 0.85 and 0.87; the Kappa coefficients were 0.67, 0.48 and 0.52. Using FMI as a reference standard, rates of BMI, WC and WHtR screening for true obesity were 14.20%, 1.23% and 2.78%; the diagnosis error rates were 4.81%, 20.84% and 18.14 %; the AUC values were 0.90, 0.89 and 0.90; the Kappa coefficients were 0.81, 0.64 and 0.67. Conclusions BMI has a higher diagnosis error rate in screening for true obesity in children, while WC and WHtR have higher diagnosis error rates. It is recommended to promote body fat assessment in clinical practice, so as to achieve more accurate prevention and control of chronic diseases.

Pyran- and furanocoumarins are key representatives of tetrahydropyrans and tetrahydrofurans, respectively, exhibiting diverse physiological and medical bioactivities. However, the biosynthetic mechanisms for their core structures remain poorly understood. Here we combined multiomics analyses of biosynthetic enzymes in Peucedanum praeruptorum and in vitro functional verification and identified two types of key enzymes critical for pyran and furan ring biosynthesis in plants. These included three distinct P. praeruptorum prenyltransferases (PpPT1-3) responsible for the prenylation of the simple coumarin skeleton 7 into linear or angular precursors, and two novel CYP450 cyclases (PpDC and PpOC) crucial for the cyclization of the linear/angular precursors into either tetrahydropyran or tetrahydrofuran scaffolds. Biochemical analyses of cyclases indicated that acid/base-assisted epoxide ring opening contributed to the enzyme-catalyzed tetrahydropyran and tetrahydrofuran ring refactoring. The possible acid/base-assisted catalytic mechanisms of the identified cyclases were theoretically investigated and assessed using site-specific mutagenesis. We identified two possible acidic amino acids Glu303 in PpDC and Asp301 in PpOC as vital in the catalytic process. This study provides new enzymatic tools in the epoxide formation/epoxide-opening mediated cascade reaction and exemplifies how plants become chemically diverse in terms of enzyme function and catalytic process.

Purpose The study aims to investigate the effects of various ages,genders and body mass index(BMI)on amide proton transfer weighted(APTw)in the right kidney of normal Chinese.Materials and Methods A total of 182 healthy volunteers enrolled from September 2021 to February 2022 at Xi'an GaoXin Hospital were prospectively performed.There were 7 groups(11-80 years)according to age per 10 years;2 groups according to gender,male and female;4 groups according to BMI,slim group,normal group,overweight group and obese group.3D-APTw imaging of the right kidney was performed via intermittent breath-holding.The correlation between APT values and age and BMI was analyzed,and the differences in APT values between age groups,different BMI groups and gender were analyzed,respectively.Results A total of 131 cases were finally included.There was a weak positive correlation between APT and age(r=0.325,P<0.001).There were statistical difference in APT values among different age groups(F=3.566,P=0.003),the post-hoc analysis showed that the APT values of 11-20 years[(1.853±0.357)%]old group was significantly lower than those of 41-50 years[(2.387±0.432)%]old group and 51-60 years[(2.336±0.451)%]old group(P<0.05);the APT value of male[1.980(2.320,1.820)%]was significantly lower than that of female[2.284(2.586,1.825)%;Z=2.301,P=0.021].There was a very weak positive correlation between APT and BMI(r=0.181,P=0.039),with statistically different APT values among BMI groups(F=3.265,P=0.024).The results of intra-group analysis showed that APT values in emaciation group were significantly lower than those in normal group,overweight group and obesity group,respectively(all P<0.05).Conclusion The APT value of the right kidney may be correlated with age and BMI,with males lower than females.The effect of age,gender and BMI on APT on the clinical application of 3D-APTw may be considered.

Objective To investigate the value of interleukin(IL)-6 and kidney injury molecule(Kim)-1 in the early prediction of contrast-induced pnephropathy(CIN)after percutaneous coronary intervention(PCI)in patients with coronary heart disease.Methods A total of 730 patients with coronary heart disease who underwent PCI were retrospectively collected,divided into CIN group(n=46)and non-CIN group(n=684),and the medical records of the two groups were compared,and the relationship between Kim-1 and IL-6 of renal injury and CIN was analyzed by binary regression,and the receiver operating characteristic(ROC)curve was used to explore the predictive value of these two markers on CIN after PCI for coronary heart disease.Results There was no significant difference between two groups in terms of preoperative IL-6(P=0.467)and Kim-1(P=0.643),and 48h and 72h after PCI,IL-6 and Kim-1 in CIN group was higher than that in non-CIN group(P＜0.001),and IL-6 and Kim-1 in CIN group was higher than that in before surgery(P＜0.001).48h postoperative IL-6(OR=1.884,P=0.002),48h postoperative Kim-1(OR=1.409,P＜0.001)and 72h postoperative IL-6(OR=1.377,P＜0.001)and 72 hours postoperative Kim-1(OR=1.092,P=0.004)were independent risk factors for CIN.The ROC curve showed that when used as a diagnostic marker for CIN,the area under the curve(AUC)of IL-6(48h),IL-6(72h)were 0.837,0.782,AUC of 48h Kim-1 and 72h Kim-1 were 0.820 and 0.827,respectively.Conclusion IL-6 and Kim-1 are independent risk factors for CIN after PCI for coronary heart disease.IL-6 and Kim-1 were positively correlated with the occurrence of CIN after PCI for coronary heart disease.IL-6 and Kim-1 have good diagnostic sensitivity and specificity for CIN after PCI for coronary heart disease.

ObjectiveTo evaluate the effect of Shengmaisan granules on myocardial fibrosis in chronic heart failure patients with Qi-Yin deficiency syndrome by cardiac magnetic resonance （CMR） imaging and serological indicators. MethodSixty-six chronic heart failure patients with Qi-Yin deficiency syndrome who visited the Affiliated Hospital of Integrated Traditional Chinese and Western Medicine， Nanjing University of Chinese Medicine from October 2021 to January 2023 were selected. The patients were assigned into a control group （33 cases） and an observation group （33 cases） by the minimization random method. Both groups received standardized Western medicine treatment for heart failure. In addition， the control group was treated with placebo granules， and the observation group with Shengmaisan granules for a course of 6 months. The baseline data， clinical efficacy， TCM symptom scores， serological indicators ［high-sensitivity C-reactive protein （hs-CRP）， soluble growth stimulation expressed gene 2 protein （sST2）， pro-collagen Ⅲ N-terminal peptide （PⅢNP）， interleukin （IL）-6， IL-11， transforming growth factor-β₁ （TGF-β₁）］， echocardiography ［Left atrial diameter （LAD）， left ventricular end systolic diameter （LVEDs）， left ventricular end diastolic diameter （LVEDd）］ and CMR indicators ［left ventricular ejection fraction （LVEF）， myocardial extracellular volume fraction （ECV）， and longitudinal relaxation time （T1）］ were compared between the two groups. ResultFinally， 31 patients in the control group and 30 patients in the observation group were included. There was no significant difference in baseline data or indicators between the two groups before treatment. Compared with those before treatment， the scores of TCM symptoms （shortness of breath， fatigue， palpitations， spontaneous or night sweats， thirst/dry throat， feverish feeling in palms and soles， and edema in lower limbs）， total score of TCM symptoms， ECV， T1， inflammation/fibrosis indicators （hs-CRP， sST2， PⅢNP， IL-6， IL-11， and TGF-β₁） in observation group decreased （P<0.05， P<0.01）， and the scores of TCM symptoms （except feverish feeling in palms and soles）， T1， and inflammation/fibrosis indicators in the control group decreased （P<0.05， P<0.01）. After treatment， the observation group had lower scores of TCM symptoms （except feverish feeling in palms and soles and edema in lower limbs）， ECV， T1， and inflammation/fibrosis indicators than the control group （P<0.05， P<0.01）. After treatment， the total response rate in the observation group was 93.33% （28/30）， which was higher than that （80.65%， 25/31） in the control group （Z=2.976， P<0.01）. There was no significant difference in adverse reactions between the two groups during treatment. ConclusionFor patients with chronic heart failure with Qi-Yin deficiency syndrome， Shengmaisan Granules can alleviate the TCM symptoms， reduce inflammation， and inhibit myocardial fibrosis by regulating the TGF-β₁/IL-11 signaling axis.

Objective:To systematically evaluate the correlation of high sensitivity C-reactive protein (hs-CRP) with contrast-induced nephropathy (CIN) in patients following coronary angiography (CAG) or percutaneous coronary intervention (PCI).Methods:PubMed, web of science, CBM, CNKI and Wanfang Data were searched for studies on hs-CRP levels in patients undergoing CAG or PCI patients from the incipience of the database to March 7, 2021. Meta-analysis was performed by RevMan 5.3 and Stata 12.0 software.Results:Fourteen related studies were included involving 11 885 patients undergoing CAG or PCI (1 034 cases with CIN and 10 851 cases without CIN). The results of meta-analysis showed that the level of hs-CRP in CIN group was significantly higher than that in non-CIN group (WMD=3.77,95 %CI:2.80—4.74, P<0.001, I2=93%), patients with higher levels of hs-CRP before CAG or PCI were more likely to develop CIN. Sensitivity analysis shows that the results of this study had good stability. The results of subgroup analysis show that the differences in sample size, study population, geographical location and the definition of CIN were statistically significant. Conclusion:Available evidence shows that high hs-CRP level is a risk factor for CIN in patients undergoing CAG or PCI, large sample trials are still needed to support this conclusion.

Objective:To analyze the distribution and composition characteristics of jellyfish stings in various coastal baths in Qinhuangdao City from 2017 to 2019, and to provide scientific basis for the prevention, control and early warning of jellyfish stings.Methods:Statistics and analysis of the age, gender, time of stings, location of injury, first symptoms, and playing time in the sea at the time of the sting, etc. of people with jellyfish stings in various bathing beaches along the coast of Qinhuangdao from 2017 to 2019 (July to August) were conducted.Results:The number of jellyfish stings in the coastal bathing beaches of Qinhuangdao City in 2017, 2018, and 2019 was decreasing year by year, with 1 890, 492, and 171 cases respectively. Among them, Qianshuiwan Bathing Beach and Dongshan Bathing Beach had more stings (60.90% and 35.08% respectively in 2017, 24.39% and 64.23% respectively in 2018, 16.96% and 16.42% respectively in 2019). There was no significant change in the gender and age distribution of jellyfish stings each year [57.99% males in 2017, with a median age of 13 (8, 31) years old; 63.21% males in 2018, with a median age of 25 (8, 29) years old; and 59.65% males in 2019, with a median age of 12 (7, 31) years old]. Stings were mainly located at the lower limbs (the proportion of lower limb injuries: 46.54% in 2018, 45.61% in 2019), followed by upper limbs (upper arm, elbow, forearm), trunk, etc. The first symptom was mainly pain (89.43% in 2018, 38.29% in 2019), followed by rash (64.43% in 2018, 59.43% in 2019), numbness, blisters, etc. Sting incidents mainly occurred from 13:00 to 17:59 (the proportion of sting incidents in this time period in 2018 and 2019 were 68.09% and 52.63%, respectively).Conclusions:Jellyfish stings in coastal baths in Qinhuangdao City are mainly distributed in Qianshuiwan Baths and Dongshan Baths. The management of these sea areas should be strengthened, and scientific publicity and medical rescue should be strengthened to prevent jellyfish stings in peak hours and related baths.

OBJECTIVE:To investigate the effects of polydatin on protein expression of MMP-9 and TIMP-1 in renal tissue of renal fibrosis model rats,and to investigate the mechanism of delaying renal fibrosis in rats. METHODS:A total of 40 rats were randomly divided into sham operation group(normal saline),model group(normal saline),polydatin group(100 mg/kg)and benazepril group(positive control,5 mg/kg). Except for sham operation group,renal fibrosis rat model was induced by unilateral ureteral obstruction in other groups. 1 h after surgery,each group was given relevant medicine intragastrically,once a day.After 4 weeks of consecutive treatment,the contents of β 2-microglobulin(β 2-MG)and N-acetyl-β-D-glucosaminidase(NAG)in urine, serum contents of BUN and Cr were detected in each group. HE staining was used to observe and score pathological changes of renal tissue in rats. Protein expressions of MMP-9 and TIMP-1 in renal tissue of rats were determined by immunohistochemistry. RESULTS:Compared with sham operation group,the contents of β2-MG and NAG in urine,serum contents of BUN and Cr were increased significantly in model group(P<0.05),and pathological score and protein expressions of MMP-9 and TIMP-1 were also increased significantly(P<0.01). Compared with model group,protein expression of MMP-9 in renal tissue were increased continuously in polydatin group and benazepril group(P<0.01);other indexes were decreased significantly(P<0.05 or P<0.01),and there was no statistical significance in each index between polydatin group and benazepril group(P>0.05). CONCLUSIONS:Polydatin can delay renal fibrosis,the mechanism of which may be associated with up-regulating protein expression of MMP-9,down-regulating protein expression of TIMP-1 and increasing the ratio of MMP-9/TIMP-1.

Objective To understand the enterovirus(EV) pathogenic composition of Coxsackie virus(CV)A6 and A10 causing hand foot and mouth disesse(HFMD) in Guiyang area during 2015 to provide a basis for the prevention and treatment of HFMD in local area.Methods The specific primers were respectively designed according to CVA6 and CVA10 sequence published in GenBank.The fluorescence quantitative RT-PCR method system was established.The gene sequencing method was used for conducting verification.Then this method was used to detect the clinical samples from 607 cases of HFMD.Results A total of 607 samples of suspected HFMD were detected,the overall positive rate was 59.47 ％ (361/607),in which EV71 accounted for 7.25 ％ (44/607),CVA16 for 11.37％(69/607),EV71+CVA16 double positive accounted for 0.16％ (1/607) and other EV for 40.69％ (247/607).The positive samples of CVA6,CVA10 and CVA6+CVA10 detected by the established real time fluorescence RT-PCR were 11 cases,71 cases and 1 case.Conclusion CVA6 and CVA10 are the main pathogens causing new onset HFMD in Guiyang area and the CVA10 monitoring should be strengthened.

OBJECTIVE:To investigate the effects of neoadjunctive chemotherapy(NAC)of docetaxel and epirubicin com-bined with cyclophosphamide on clinical efficacy and tumor markers of breast cancer patients with different molecular types. METH-ODS:A total of 88 female patients with locally advanced breast cancer collected from our hospital during Jan. 2014-Jan. 2016 were divided into Luminal A type(23 cases),Luminal B type(21 cases),basal-like type(11 cases),HER2-over expressing type(18 cases)and normal breast-like type(15 cases)according to molecular type. All patients were given Docetaxel injection+Epirubicin hydrochloride injection+Cyclophosphamide for injection for consecutive 6 cycles(21 d as a cycle). Total response rates and patho-logical complete remission(pCR)rates were compared among breast cancer patients with different molecular types. The expression of serum tumor markers [CEA,CA125,CA153] were compared before and after treatment,and the occurrence of ADR was record-ed. RESULTS:Total response rate of 88 patients was 63.64%,among which that of basal-like breast cancer patients was 72.73%, significantly higher than other molecular types,with statistical significance(P<0.05). There was no statistical significance in total response rates of pairwise molecular type comparison(P>0.05). The pCR rate of 88 patients was 27.27%,and that of basal-like breast cancer patients was the highest(45.45%). There was statistical significance in pCR rates of pairwise molecular type compari-son(P<0.05),except there was no significant difference in pCR rate between HER2-over expressing type and normal breast-like type(P>0.05). Before treatment,there was no statistical significance in the expression of CEA,CA125 and CA153 in breast can-cer patients with different molecular types(P>0.05). After treatment,the expression of CEA,CA125 and CA153 in different mo-lecular types were decreased significantly,with statistical significance(P<0.05). There was no statistical significance in the expres-sion of above markers among different molecular types(P>0.05). There was no statistical significance in the incidence of ADR among different molecular types(P>0.05). CONCLUSIONS:NAC plan of docetaxel and epirubicin combined with cyclophospha-mide can reduce the expression of tumor markers and shows certain therapeutic efficacy for breast cancer patients with different mo-lecular types. Total response rate and pCR rate of basal-like type are better than those of other molecular types,so NAC plan is the preferred treatment for basal-like type breast cancer.