OBJECTIVE To put forward the governance for the development of Chinese materia medica industry by studying the multi-chain docking and integration mechanism based on the investigation and analysis of Polygonati Rhizoma industry in Anhui province. METHODS Based on the theory of multi-chain integration, this research defines the connotation of multi-chain integration, proposes the mechanism of multi-chain integration, and takes Anhui Polygonati Rhizoma industry as a case to sort out the mechanism of inter-chain docking and integration in industrial development, and puts forward the management strategy of industrial development accordingly. RESULTS The precise docking of the industrial chain, value chain, innovation chain, information chain, capital chain and policy chain was explored. Leading enterprises, scientific research units, financial institutions, industry organizations, government departments five inter-chain contact points, docking to promote multi-chain integration. CONCLUSION This research promotes industrial multi-chain integration from five aspects: leading enterprises to promote product development, scientific research institutions to promote innovation, financial departments to increase capital investment, industry organizations to build information exchange platforms, and government departments to increase policy support, for government to promote the development of effective Chinese materia medica industry reference theory instruction value and reality significance.

Objective: To evaluate the effectiveness of a comprehensive intervention for childhood obesity on self-efficacy, weight perception, and stage of behavior change, and to provide a scientific evidence for childhood obesity interventions. Methods: The study was a cluster randomized controlled trial. Twelve primary schools and 1 889 children (aged 7-11 years) from Dongcheng District in Beijing were recruited in September, 2013, and were administered a comprehensive intervention for childhood obesity. Six schools (930) were randomly allocated to the intervention group, and six schools (959) were randomly allocated to the control group. A face-to-face questionnaire survey was carried out, R 4.0.3 software was used to analyze the data, and multiple linear regression model was used to analyze the intervention effect. Results: After the intervention, mean (standard deviation) scores of self-efficacy among children in the intervention and control groups were (4.4±0.9) and (4.2±1.1), respectively. After the intervention, the proportion of children in the intervention group who underestimated or overestimated their body weight was 28.4% and 11.3 %, respectively, while the figures in the control were 37.1% and 6.9%; compared with the control, the risk of underestimating body weight decreased among children in the intervention group( OR=0.64, 95%CI=0.52-0.80, P <0.01), while the risk of weight overestimation increased( OR=1.79, 95%CI=1.26-2.54, P <0.01). After the intervention, the proportion of children in the contemplation or action stage of behaviour change was 65.3% and 83.6%, while the figures in the control group were 59.8% and 69.8 %, respectively; in comparison with the control group, more children in the intervention group were in comtemplation ( OR= 1.28 , 95%CI=1.03-1.59, P =0.02) or action stage of behaviour change( OR=2.59, 95%CI=2.04-3.27, P <0.01). Conclusion The comprehensive intervention for childhood obesity improved self-efficacy, weight perception, and facilitated behavior change, but may increase the risk of weight overestimation.

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 evaluate the cost effectiveness of a school based comprehensive intervention for childhood obesity and to provide scientific basis for formulating and promoting efficient and economic intervention measures for childhood obesity. Methods: In a cluster randomized controlled trial, 12 primary schools (1 889 students from grade 3 to 5) in Dongcheng District in Beijing were selected and randomly assigned to the intervention (6 schools, 930 students) and control group (6 schools, 959 students). Students in the intervention group received a one year school based comprehensive intervention for childhood obesity, including development of school level policies, health education activities, improvement of physical activity, and improvement of healthy diet. A cost analysis method from a social perspective was used to evaluate the implementation costs of the intervention. Cost effectiveness analysis was used by calculating incremental cost effectiveness ratio (ICER) on obesity related knowledge, number of days completing no less than 60 minutes of moderate to vigorous physical activity (MVPA) per week, students consuming sugar sweetened beverage. Results: The material cost and human cost were 46 376.24 yuan and 46 197.32 yuan, respectively. The total cost of the intervention was 92 573.56 yuan and the average cost was 99.54 yuan per student in the intervention group. ICER on obesity related knowledge, number of days completing no less than 60 minutes of MVPA per week, percentage of students consuming sugar sweetened beverage were 52.39%, 71.61% and 2.26%, respectively. Conclusion The school based comprehensive intervention for childhood obesity shows a good cost effectiveness promoting students obesity related knowledge, as well as dietary and physical activity behaviors.

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 analyze the influence of obesity status on the development of cardiometabolic disorders in school-age children.Methods:Information about children's body weight, body height and cardiovascular risk factors were collected in baseline survey in 2017 and follow-up survey in 2019. The school-age children were divided into four groups based on their baseline and follow-up obesity status, i.e. sustained non-obesity group, restored obesity group, newly classified obesity group, and persistent obesity group. Analysis of covariance was used to compare the difference of change in levels of cardiometabolic factors among the four groups. The multivariate logistic regression model was used to analyze the relationship between obesity status and the incidence risk of cardiometabolic disorders.Results:The present study included 11 379 school-age children (boys accounting for 49.6%). During the 2 years, the incidence of obesity was 3.2% (95% CI: 2.9%-3.5%) with the restoration ratio of obesity of 4.4% (95% CI: 4.0%-4.8%). Compared with the sustained non-obesity group, increases in SBP, DBP, TG, LDL-C and non-HDL-C were much higher in newly classified obesity group and persistent obesity group, but lower in restored obesity groups except for DBP (all P<0.05). In addition, the incidence risk of hypertension, high glucose, dyslipidemia and cardiometabolic disorders (≥2 risks) were much higher in newly classified and persistent obese children than in sustained non-obese children. No difference was found in incidence risks of most cardiovascular disorders between restored obese children and sustained non-obese children, except for hypertension and cardiometabolic risks. Conclusion:Both newly classified obesity and persistent obesity increased the incidence risks for multi cardiovascular disorders, while these risks could be reduced when non-obese status restore.

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.

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.