Objective: To analyze the relationship between body mass index(BMI) during pre pregnancy, maternal lipid levels during early pregnancy and childhood overweight and obesity, as well as the mediating role of maternal lipid levels during early pregnancy in pre pregnancy BMI and childhood overweight and obesity, providing scientific evidence for developing obesity prevention strategies in preschool children. Methods: Using data from Peking University Birth Cohort in Tongzhou (PKUBC-T) collected between June 2018 and September 2022, the study included 1 292 mother-child pairs. Participants were stratified into two groups based on children s BMI Z scores at age 3: an overweight/obesity risk group (BMI Z >1, n =173) and a non overweight/obesity risk group (BMI Z ≤1, n =1 119).Multivariate Logistic regression was conducted to analyze the associations between pre pregnancy BMI, maternal lipid levels[total cholesterol(TC),triglyceride（TG）,high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),TC/HDL-C,TG/HDL-C,LDL-C/HDL-C] during early pregnancy and childhood overweight and obesity. The mediating effect of maternal lipid levels during early pregnancy on pre pregnancy BMI and childhood overweight and obesity was further explored. Results: There were statistically significant differences in pregnancy BMI levels, early pregnancy blood LDL-C ,TC/HDL-C,LDL-C/HDL-C levels between the overweight and obesity risk group and the non overweight and obesity risk group ( χ 2/Z =19.01, 2.48, 2.48, 2.71, all P <0.05). Multivariate Logistic regression analysis showed that pre pregnancy BMI, LDL-C, TC/HDL-C and LDL-C/HDL-C in early pregnancy were significantly associated with childhood overweight and obesity ( OR =1.09, 1.42, 1.49, 1.60, all P <0.05). LDL-C, TC/HDL-C and LDL-C/HDL-C in early pregnancy played a significant mediating role on pre pregnancy BMI and childhood obesity and the mediating effects accounted for 7.3%, 10.2%, 23.5% of the total effects, respectively (all P <0.05). Conclusions Maternal hyperlipidemia during early pregnancy partially mediated the association between pre pregnancy obesity and childhood obesity. Both pre pregnancy obesity and maternal hyperlipidemia during early pregnancy are risk factors for obesity in preschool children.

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable common chronic airway disease. As the gatekeeper of health care, general practitioners should play a key roles in prevention and management of COPD; however, the ability of COPD prevention and management is generally limited among general practitioners, so that the training for them is essential. At present there is no unified training program and standard for COPD prevention and management in China, the training contents and methods are various, and the training facilities and capacity are inadequate, particularly in grass-roots institutions, all these restrain the development of effective training. This articles reviews the status quo of COPD prevention and management training for general practitioners at home and abroad, and suggests to construct a network for chronic respiratory diseases management and a training system for primary care health workers to improve the prevention and management of COPD in China.

Objective:To comprehensively understand the operational status and existing problems of the neurosurgery professional training bases for standardized residency training in Guangdong Province.Methods:According to the scoring rules of "Standardized Residency Training Evaluation Indicators—Surgery (Neurosurgery) Professional Base" formulated by the Post-Graduation Medical Education Neurosurgery Professional Committee of the Chinese Medical Doctor Association, 28 training bases were supervised and evaluated. The scoring results of the supervision of 28 neurosurgery training bases were collected, and the training bases were divided into two categories according to the traditional teaching history, 6 affiliated hospitals of traditional medical schools and 22 non-traditional affiliated/teaching hospitals. GraphPad 5.0 software was used for statistical analysis of the 14 core indicators, and t-test, variance analysis and Chi-square test were used for analysis. Results:The results showed that there was a statistically significant difference in the compliance rate of 14 core indicators between traditional teaching hospitals and non-traditional teaching hospitals ( P = 0.003), skill operation and type and number of surgeries ( P = 0.041) and student rotation plan ( P = 0.012). The differences were also statistically significant. Conclusion:This study reveals that the comprehensive management ability of training bases in traditional teaching hospitals is significantly better than that in non-traditional teaching hospitals. Additionally, it's suggested to strengthen the construction of professional bases, enhance the institutionalized management of bases, and thus realize the homogenization training of neurosurgery residents.

【Objective】 To obtain the quality information of von Willebrand factor (vWF) in coagulation factor Ⅷ (FⅧ) concentrates in China. 【Methods】 FⅧ concentrates produced by 7 domestic blood product manufactures and 1 foreign manufacture were collected, then FⅧ and vWF contained in FⅧ concentrates were evaluated. 【Results】 The activity loss of vWF was more than 25% in 2 of the 7 domestic FⅧ concentrates. The ratio of vWF activity to FⅧ activity in FⅧ concentrates from different domestic manufactures was significantly different (P<0.05). The ratio in FⅧ concentrates prepared by C, D, F manufacturer was greater than 1, which was similar to that in willate^@ approved abroad for the treatment of vWD. The ratio in FⅧ concentrates prepared by E manufacturer was greater than 0.7 and less than 1, and by A, B, G manufacturers was less than 0.5. In addition, the specific activities of FⅧ and vWF were significantly different among different FⅧ concentrates in China (P<0.05), and the specific activities of FⅧ and vWF were much lower than that of willate^@. 【Conclusion】 The variation of vWF quality between domestic FⅧ concentrates and willate^@ is mainly due to the different in vWF content. After the comprehensive consideration of various indicators, the FⅧ concentrates made by C and D manufacturers may be used in the treatment of vWD.

Objective: Screen the pathogenic genes of a pedigree with clinical manifestation of familial dilated cardiomyopathy in Inner Mongolia. Methods: A total of 3 patients with dilated cardiomyopathy and 20 family members from the same family were examined in Ordos Central Hospital in Inner Mongolia from October, 2003 to August, 2017. Data on medical history, physical examinations, electrocardiograms, and echocardiography were obtained. 5 ml peripheral blood was sampled for per person. Chip Capture Sequencing technology was used to capture all the exons and splice sites of the genes that associated with hereditary cardiomyopathy and hereditary arrhythmia. The mutations in these genes were detected by high-throughput sequencing. All suspected pathogenic loci identified by high-throughput sequencing were verified by Sanger sequencing used for mutation detection. One hundred and fifty gender, age and race matched healthy people were included as the control group. Results: Pathogenic gene variations were detected in 3 symptomatic family members and 1 carrier from the pedigree. Five pathogenic gene variations were identified in the proband (Ⅱ1), a pSer236Gly and a pArg215Cys variation in the MYBPC3 gene, a pGln90Arg variation in the DSP gene, and pAsn2912Asp and pGlu2910Val variation in the DMD gene. One pathogenic variation was detected in Ⅲ3, which was a pArg215Cys variation in the MYBPC3 gene. Two pathogenic variations were detected in Ⅲ7, a pSer236Gly variation in the MYBPC3 gene and a pGln90Arg variation in the DSP gene. Two pathogenic variations were detected in the Ⅳ7, a pSer236Gly variation in the MYBPC3 gene and a pGln90Arg variation in the DSP gene. No gene variation loci were detected in the other family members and the control group. Conclusion MYBPC3 gene, DSP gene and DMD gene variations are present in the familial dilated cardiomyopathy pedigree from Inner Mongolia, and these variations may be related with familial dilated cardiomyopathy.

Military flying labor hygiene is a discipline that focuses on influences of special flight environment and labor condition on human body and related prevent measures, with the core of flight fatigue. Health information and technique training can help flight surgeons to enhance professional competency and improve the prevention and recovery of military flying fatigue. The course construction of teaching system in this study included survey of demand, arrangement of content, identification of strategy, determination of evaluation, and feedback of results. Meanwhile, the textbook compilation, cultivation of teaching team and construction of laboratory were also needed. After a 4-year practice, a formal teaching system has been established and its teaching effectiveness has basically fulfilled the professional requirement for flight surgeons.

Objective To investigate the etiology,clinical manifestations,imaging finding,pathology and treatment of primary bladder schwannoma.Methods A case of bladder schwannoma was reported and discussed in the literature.A 64-year-old male patient with painless gross hematuria for 4 months was admitted on October 5,2016.Enhanced computed tomography (CT) showed left anterior bladder wall lesions with mildly enhancement.Preoperative diagnosis was bladder cancer.The patient underwent transurethral resection of bladder tumor (TURBT).During surgery,a 3 cm × 3 cm polypoid soft tissue was found in the left side of bladder,which convex to the bladder with smooth surface and wide base.Results The bladder neoplasm was resected successfully.The intraoperative bleeding was about 100 ml.Postoperative pathology showed a large number of myloid spindle cells with immunohistochemical S-100 (+),considering source of mesenchymal tissue.No recurrence was noticed during the 3 months' follow-up.Retrieving domestic and foreign literature,we found 17 cases with bladder schwannoma from 1993 to 2016.Bladder schwannoma occurs in the age of 40-69 years old.There is no relationship with the agenda.It is often seen in the top or the side wall of the bladder with single growth and rare malignant.The clinical manifestations was mainly painless gross hematuria,CT and magnetic resonance imaging(MR) showed less specificity than other solid tumors of the bladder,which is difficult to identify.Partial cystectomy or TURBT is the main strategy.Postoperative pathology is the gold standard for diagnosis.The immunohistochemical stainings often showed S-100(+).Conclusions Bladder schwannoma is extremely rare in benign bladder tumor,and it could easily be misdiagnosed.The diagnosis should be performed by histopathological examination.Because it will become malignant,it is suggested that the positive treatment should be done.Treatment methods have not been clearly defined,and the effect of surgical resection is good.

Objective To assess the relationship between plaque burden (PB) and area strain (AS) by intravascular ultrasonic elastography (IVUSE).Methods Forty purebred New Zealand rabbits were fed with a high-cholesterol diet.And the abdominal aorta endothelium was balloon-injured after 2 weeks.At the end of the 12th week,2 plaques with moderate echo from each rabbit were chosen for in situ imaging,and 2 consecutive frames near the end-diastole images in situ were used to construct an IVUS elastogram.Cross-sectional external elastic membrane area (EEMare),lumen area (Lumenarea),plaque area (PA),PB,external elastic membrane volume (EEMvolume),lumen volume (Lumenvolume),plaque volume (PV),plaque volume burden (PVB),maximal plaque thickness (Tmax) and minimal plaque thickness (Tmin),eccentric index (EI),remodeling index (RI) and AS were measured and calculated,respectively.According to the PB,the plaques were divided into low PB group (PB≤40 ％) and high PB group (PB＞ 40 ％).The differences of all above parameters between the two groups were compared,and the relationship between the plaque morphological and mechanical parameters were analyzed.Results PA,PV,PB,PVB,Tmin,Tmax,Lumenarea,Lumenvolume and EI were different between the 2 groups (all P＜0.01).On stepwise multiple regression analysis,the regression equation were built,(Y)=-6.921+10.430X1 +12.207X2((Y):AS,X1:EI,X2:PB,R2 =0.272,P＜0.001).After eliminating the effect of EI on the AS,the lower PB group had obviously smaller AS than higher PB group (P =0.010).Conclusion The PB has effect on plaque mechanical stability.The plaques with higher burden are more vulnerable than those with lower burden.

Objective:To investigate the changes of gene or protein expression and activity of matrix metalloprotein9 (MMP9) and tissue inhibitor ofmetalloproteinasel (TIMP1) in the carotid artery (CA) of 4 wk hindlimb unweighted rat.Methods:A 4 weeks(wk) hindlimb unweighted (HU) rat model was used to simulate the effect of weightlessness on the cardiovascular system.Transmission electron microscopy was used to detect the content of ECM.Reverse transcriptase polymerase chain reaction(RT-PCR) was conducted to measure the mRNA content MMP and TIMP1.Immunohistochemistry and Western blot technique were used to measure the protein abundance.Gelatin zymography was carried out to detect the activity of MMP9.Results:Compared to the control group (CON),the area of ECM was enhanced (P＜0.05) and the content of collage fiber was increased (P＜0.05) in the CA of HU rats;moreover,HU did not affect the mRNA expression of MMP9,but significantly reduced the protein content (P＜0.05) or enzymatic activity (P＜0.05).Accordingly,the mRNA or protein expression of TIMP1 in the CA was significantly increased by HU (P＜0.05).Conclusion:Simulated weightlessness caused imbalance between MMP and TIMP1 expression,which might contribute to the ECM aggregation and stiffness of CA.

Objective This study aimed to assess the efficiency and purification of the Trace DNA extraction with a quantified method for the magnetic bead-based DNA extraction as performed on the Tecan Automated systems with TE-MAGS magnetic separator. Methods Serial dilutions of standard commercial DNA 9947A were used with the total DNA contents, 0.1ng, 0.2ng,0.3ng, 0.4ng,0.5ng, 0.6ng, 0.7ng, 0.8ng, 0.9ng,1ng,diluted progressively and a 1ng DNA (standard commercial DNA 9947A) admixed with 6 common DNA-PCR inhibitors were extracted on the Automated systems and then performed via Fluorogenic probe quantitative PCR and STR genotype for the quantification analysis of recovery and purification. Results The recovery rate of standard 9947A DNA diluted with 0.1~1ng was 38.92~60.01%, and 0.3ng and more DNA could observed the full STR profiles. For the different PCR inhibitors, above 94.5% of bile acid, collagen and urea were efficient removal during the purification process, and the hemoglobin, melanin and humic acid removal efficiency were about 97.5%, 97.85%, 82.14%, respectively.Conclusion Our results suggested that The TE-MAGS magnetic bead-based DNA extraction was suitable for the extraction of trace DNA with high recovery efficiency and purification ability.