OBJECTIVE:Although wearable electronic devices have demonstrated potential utility as intervention tools to enhance physical activity,comprehensive evaluations of their specific effects on the healthy adolescent population remain scarce.Consequently,this article aims to systematically explore and summarize the impact of interventions based on wearable electronic devices on the physical activity and sedentary behavior of healthy adolescents,thereby providing more precise and reliable evidence-based support for public health practices. METHODS:Randomized controlled trials assessing the effects of wearable electronic device-based interventions on the physical activity and sedentary behavior of healthy adolescents were retrieved from databases including Web of Science,PubMed,Scopus,The Cochrane Library,and EBSCO.Meta-analysis was conducted using Review Manager 5.4 and Stata 17,evaluating the effects of interventions on physical activity and sedentary behavior through the standardized mean difference.To ensure the robustness of the research findings,a Leave-One-Out sensitivity analysis was conducted,and subgroup analyses were carried out to explore the potential influence of different factors on the results.The review protocol was registered with the International Prospective Register of Systematic Reviews(CRD42023406645). RESULTS:(1)Twelve publications were ultimately included,consisting of three randomized controlled trials and nine cluster-randomized controlled trials,involving a total of 4 933 healthy adolescents.(2)Meta-analysis results revealed that interventions based on wearable electronic devices had a positive effect on moderate to vigorous physical activity[standardized mean difference(SMD)=0.10;95%confidence interval(CI):0.04 to 0.17;P<0.05).However,the interventions did not significantly improve low-intensity physical activity(SMD=-0.15;95%CI:-0.32 to 0.02;P>0.05),daily step count(SMD=0.13;95%CI:-0.65 to 0.91;P>0.05),and sedentary behavior(SMD=0.00;95%CI:-0.09 to 0.09;P>0.05).(3)Subgroup analyses indicated that short-term interventions(≤12 weeks)(SMD=0.11;95%CI:0.03 to 0.18;P=0.008),studies using pedometers worn at the waist or hip(SMD=0.10;95%CI:0.04 to 0.17;P=0.002),and experiments registered at clinical trial centers(SMD=0.11;95%CI:0.04 to 0.17;P=0.001)had a more significant effect on enhancing daily moderate to vigorous physical activity. CONCLUSION:The current evidence suggests that interventions based on wearable electronic devices possess certain advantages in enhancing the daily moderate-to-vigorous physical activity of healthy adolescents.It is recommended that interventions not exceeding 12 weeks and utilizing pedometers positioned at the waist or hip may yield more favorable results.However,the effects of these interventions on daily step count,low-intensity physical activity,and sedentary behavior exhibit some limitations.Consequently,future investigations necessitate higher-quality,larger-scale randomized controlled trials for further validation.

Background::Dilated cardiomyopathy (DCM) has a high mortality rate and is the most common indication for heart transplantation. Our study sought to develop a multiparametric nomogram to assess individualized all-cause mortality or heart transplantation (ACM/HTx) risk in DCM patients.Methods::The present study is a retrospective cohort study. The demographic, clinical, blood test, and cardiac magnetic resonance imaging (CMRI) data of DCM patients in the tertiary center (Fuwai Hospital) were collected. The primary endpoint was ACM/HTx. The least absolute shrinkage and selection operator (LASSO) Cox regression model was applied for variable selection. Multivariable Cox regression was used to develop a nomogram. The concordance index (C-index), area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA) were used to evaluate the performance of the nomogram.Results::A total of 218 patients were included in the present study. They were randomly divided into a training cohort and a validation cohort. The nomogram was established based on eight variables, including mid-wall late gadolinium enhancement, systolic blood pressure, diastolic blood pressure, left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-diastolic volume index, free triiodothyronine, and N-terminal pro-B type natriuretic peptide. The AUCs regarding 1-year, 3-year, and 5-year ACM/HTx events were 0.859, 0.831, and 0.840 in the training cohort and 0.770, 0.789, and 0.819 in the validation cohort, respectively. The calibration curve and DCA showed good accuracy and clinical utility of the nomogram.Conclusions::We established and validated a circulating biomarker- and CMRI-based nomogram that could provide a personalized prediction of ACM/HTx for DCM patients, which might help risk stratification and decision-making in clinical practice.

Objective:To assess the association between body mass index (BMI) and major adverse cardiovascular and cerebrovascular events (MACCE) among patients with acute coronary syndrome (ACS).Methods:This was a multicenter prospective cohort study, which was based on the Improving Care for Cardiovascular Disease in China (CCC) project. The hospitalized patients with ACS aged between 18 and 80 years, registered in CCC project from November 1, 2014 to December 31, 2019 were included. The included patients were categorized into four groups based on their BMI at the time of admission: underweight (BMI<18.5 kg/m 2), normal weight (BMI between 18.5 and 24.9 kg/m 2), overweight (BMI between 25.0 and 29.9 kg/m 2), and obese (BMI≥30.0 kg/m 2). Multivariate logistic regression models was used to analyze the relationship between BMI and the risk of in-hospital MACCE. Results:A total of 71 681 ACS inpatients were included in the study. The age was (63.4±14.7) years, and 26.5% (18 979/71 681) were female. And the incidence of MACCE for the underweight, normal weight, overweight, and obese groups were 14.9% (322/2 154), 9.5% (3 997/41 960), 7.9% (1 908/24 140) and 7.0% (240/3 427), respectively ( P<0.001). Multivariate logistic regression analysis showed a higher incidence of MACCE in the underweight group compared to the normal weight group ( OR=1.30, 95% CI 1.13-1.49, P<0.001), while the overweight and obese groups exhibited no statistically significant difference in the incidence of MACCE compared to the normal weight group (both P>0.05). Conclusion:ACS patients with BMI below normal have a higher risk of in-hospital MACCE, suggesting that BMI may be an indicator for evaluating short-term prognosis in ACS patients.

Objective To investigate the injury mechanisms of three-year-old child occupants by reconstructing a real traffic accident.Methods A traffic accident case from the CIREN database was reconstructed using a vehicle finite element model and a three-year-old child occupant injury bionic model(TUST IBMs 3YO-O).The Δv,mass of the vehicle,and deformation energy were comprehensively analyzed to calculate the collision velocity of the vehicle.This accident was simulated to present injuries to a child occupant,and the injury mechanisms were analyzed in depth.Results The TUST IBMs 3YO-O fully reconstructed the injuries of the child occupant in this case.The kinematic and biomechanical responses of the children's heads differed.The biomechanical response of the internal tissues and organs in the chest cavity showed no injury,however,the result ant chest acceleration at 3 ms reached 54 g,which exceeded the threshold.Conclusions In the future,it will be necessary to adopt biomechanical parameters for occupant safety evaluations.The application of human biomechanical models with high biofidelity to reconstruct occupant injuries in traffic accidents can not only be used to observe the kinematic responses of the occupant in the accident and analyze the injury mechanisms in depth,but also to provide references for virtual testing,as well as for the research and development of child occupant protection devices and the formulation of safety regulations.

【Objective】 To investigate the safety, feasibility and clinical efficacy of modified anterior robot-assisted laparoscopic radical prostatectomy (RALRP) with preservation of Retzius space. 【Methods】 The clinical data of 10 patients who underwent RALRP using the modified anterior approach to preserve the Retzius space in our hospital during June 2021 and March 2022 were retrospectively analyzed, including the preoperative, intraoperative, postoperative and follow-up data. 【Results】 All operations were successful without conversion to open surgery. The average operation time (robotic arm operation time) was (98.6±47.7) min, blood loss (105.0±57.3) mL, postoperative drainage tube indwelling time (5.3±1.3) d, postoperative urinary catheter indwelling time (7.2±0.8) d, and postoperative hospital stay (9.2±2.2) d. Urinary continence was achieved immediately after removal of the urinary catheter in 6 patients, 2 patients recovered 2 weeks after extubation, and 2 patients recovered 3 months after extubation. Postoperative pathology showed pT2a stage in 1 case, pT2b stage in 2 cases, and pT2c stage in 7 cases; Gleason score was 6-7 points; all postoperative resection margins were negative. During the follow-up of 3-12 months, no tumor recurrence was observed, and no patient was readmitted due to surgical complications. 【Conclusion】 RALRP with modified anterior approach to preserve the Retzius space is safe and feasible, with no serious complications during and after surgery, and the early postoperative urinary continence effect is comparable to that of the posterior approach.

BACKGROUND: We have recently developed a new Coronary Artery Tree description and Lesion EvaluaTion (CatLet) angiographic scoring system. Our preliminary studies have demonstrated its superiority over the the Synergy between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery (SYNTAX) score with respect to outcome predictions for acute myocardial infarction (AMI) patients. The current study hypothesized that the residual CatLet (rCatLet) score predicts clinical outcomes for AMI patients and that a combination with the three clinical variables (CVs)-age, creatinine, and ejection fraction, will enhance its predicting values. METHODS: The rCatLet score was calculated retrospectively in 308 consecutively enrolled patients with AMI. Primary endpoint, major adverse cardiac or cerebrovascular events (MACCE) including all-cause mortality, non-fatal AMI, transient ischemic attack/stroke, and ischemia-driven repeat revascularization, was stratified according to rCatLet score tertiles: rCatLet_low ≤3, rCatLet_mid 4-11, and rCatLet_top ≥12, respectively. Cross-validation confirmed a reasonably good agreement between the observed and predicted risks. RESULTS: Of 308 patients analyzed, the rates of MACCE, all-cause death, and cardiac death were 20.8%, 18.2%, and 15.3%, respectively. Kaplan-Meier curves for all endpoints showed increasing outcome events with the increasing tertiles of the rCatLet score, with P values <0.001 on trend test. For MACCE, all-cause death, and cardiac death, the area under the curves (AUCs) of the rCatLet score were 0.70 (95% confidence intervals [CI]: 0.63-0.78), 0.69 (95% CI: 0.61-0.77), and 0.71 (95% CI: 0.63-0.79), respectively; the AUCs of the CVs-adjusted rCatLet score models were 0.83 (95% CI: 0.78-0.89), 0.87 (95% CI: 0.82-0.92), and 0.89 (95% CI: 0.84-0.94), respectively. The performance of CVs-adjusted rCatLet score was significantly better than the stand-alone rCatLet score in terms of outcome predictions. CONCLUSION: The rCatLet score has a predicting value for clinical outcomes for AMI patients and the incorporation of the three CVs into the rCatLet score will enhance its predicting ability. TRIAL REGISTRATION http://www.chictr.org.cn , ChiCTR-POC-17013536.
Humans ; Coronary Artery Disease/complications* ; Death ; Myocardial Infarction/etiology* ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Treatment Outcome

Alzheimer's disease (AD) is associated with the impairment of white matter (WM) tracts. The current study aimed to verify the utility of WM as the neuroimaging marker of AD with multisite diffusion tensor imaging datasets [321 patients with AD, 265 patients with mild cognitive impairment (MCI), 279 normal controls (NC)], a unified pipeline, and independent site cross-validation. Automated fiber quantification was used to extract diffusion profiles along tracts. Random-effects meta-analyses showed a reproducible degeneration pattern in which fractional anisotropy significantly decreased in the AD and MCI groups compared with NC. Machine learning models using tract-based features showed good generalizability among independent site cross-validation. The diffusion metrics of the altered regions and the AD probability predicted by the models were highly correlated with cognitive ability in the AD and MCI groups. We highlighted the reproducibility and generalizability of the degeneration pattern of WM tracts in AD.
Humans ; White Matter/diagnostic imaging* ; Diffusion Tensor Imaging/methods* ; Alzheimer Disease/complications* ; Reproducibility of Results ; Cognition ; Cognitive Dysfunction/complications* ; Brain/diagnostic imaging*

Objective:To explore the clinical effectiveness of hemostatic bandage on wound safety and comfort after transradial coronary angiography and/or interventional therapy.Methods:This was a experimental study. A total of 400 consecutive patients who underwent transradial coronary angiography and/or interventional therapy in the Department of Cardiology, Peking University Third Hospital from July to October 2022 were enrolled and randomly divided into the hemostatic bandage group and the hemostatic balloon compressor group by the envelope method with 200 cases in each group. The hemostatic bandage group and the hemostatic balloon compressor group were treated with hemostatic bandage and hemostatic balloon compressor as transradial artery hemostatic device, respectively, to observe and compare postoperative hemostatic effect, hemostat use time, complication rate, postoperative pain, the degree of numbness in the finger on the operated side and wristband comfort between the two groups.Results:The hemostatic success rate was 98.5% (197/200) and 99.0% (198/200) in the hemostatic bandage and the hemostatic balloon compressor group, respectively, with no statistical difference ( χ2=0.20, P>0.05). The hemostat use time in the hemostatic bandage group and the hemostatic balloon compressor group was (6.23 ± 0.47) h and (17.01 ± 7.74) h, respectively, and the difference was statistically significant ( t=-19.66, P<0.01). The incidence of complications in the hemostatic bandage group and the hemostatic balloon compressor group was 13.5%(27/200) and 29.5%(59/200), respectively, and the difference was statistically significant ( χ2=8.01, P<0.05). Among the complications, swelling occurred in 21 individuals of the hemostatic bandage group and 54 individuals of the hemostatic balloon compressor group with statistically significant differences ( U=16 689.50, P<0.01). Besides, the hemostatic bandage group was significantly better than the hemostatic balloon compressor group with statistically significant differences in wound pain at immediate postoperative ( U=13 669.50, P<0.01), in finger numbness at immediate postoperative and 1-hour postoperative (immediate postoperative: U=17 838.00, P<0.05; 1-hour postoperative: U=13 342.50, P<0.01), in comfort at immediate postoperative, 4-hours, 8-hours and 12-hour postoperative(immediate postoperative: U=9 966.50, P<0.01; 4-hour postoperative: U=12 851, P<0.01; 8-hour postoperative: U=14 900, P<0.01; 12-hour postoperative: U=15 920, P<0.01). Conclusions:The hemostatic bandage shows better hemostatic effect, shorter compression time, lower complication rate, less wound pain, less numbness of the finger on the operation side, and higher comfort of the wrist band compared to hemostatic balloon compressor after transradial coronary angiography and/or interventional therapy, which is worthy of clinical promotion.

Objective:To analyze the incidence of liver function injury in patients infected with 2019-nCoV omicron variant and its influencing factors.Methods:The clinical data and laboratory findings of 897 COVID-19 patients infected with omicron variant in Zhejiang province from February 23 to July 14, 2022 were retrospectively analyzed. Patients were divide into liver function injury group ( n=243) and non-liver function injury group ( n=654) based on liver function indicators. The clinical characteristics and laboratory tests were compared between the two groups, and influencing factors of liver function injury were analyzed. SPSS 26.0 statistical software was used for data analysis. Results:The incidence of liver injury in this series was 27.09% (243/897). The median age of patients in liver injury group was older, the body mass index (BMI) was higher( Z=-6.237 and -2.166, both P<0.05), the proportions of patients with hypertension and diabetes, and with severe clinical classification were higher ( χ2=17.087, 27.509 and 12.945, all P<0.01) ; the proportion of vaccinated patients was lower ( χ2=17.766, P<0.01) than those in non-liver injury group. The levels of platelet, hemoglobin, albumin and potassium in liver injury group were lower than those in non-liver injury group ( Z=-4.631, -2.368, -10.593 and -2.141, all P<0.05), while serum ALT, AST, γ-GT, urea nitrogen, glucose and hs-CRP levels were higher than those in the non-liver injury group ( Z=-7.451, -8.663, -4.410, -3.824, -3.278 and -3.884, all P<0.01). Multivariate Logistic regression analysis showed that age ( OR=2.580, 95% CI 1.429-4.657, P=0.002), history of diabetes ( OR=3.650, 95% CI 1.698-7.849, P=0.001), and decreased hemoglobin ( OR=1.993, 95% CI 1.066-3.726, P=0.031) and increased hs-CRP ( OR=1.797, 95% CI 1.283-2.517, P=0.001) were risk factors associated with liver function injury, while vaccination ( OR=0.499, 95% CI 0.312-0.798, P=0.004) was the protective factor for liver function. Conclusion:Liver function injury is frequently observed in COVID-19 patients infected with omicron variant, which is linked to age, underlying disease, and elevated inflammatory markers; while vaccination can lower the risk of liver injury in infected patients.

Corona virus disease 2019 （COVID-19） has led to more than 500 million cases， including 6.19 million deaths. Mutated strains of SARS-CoV-2 （alpha， beta， gamma， delta and omicron） have successively emerged. Currently the omicron variant is gradually replacing the delta variant， driving a surge of cases in most countries including China， posing a great challenge to the prevention and treatment of COVID-19. In the face of the severe pandemic situation， a large number of non-medical volunteers are fighting on the front lines of the war against the pandemic and are vulnerable to exposure due to lack of professional knowledge. This paper introduces the routine skills training of volunteers and emergency response， aiming to provide behavioral guidance for non-medical volunteers in designated isolation facilities.