Objective:To investigate the association between metabolically healthy obesity(MHO) and atherosclerosis risk among Chinese community population aged 40 or older.Methods:A total of 9 525 participants without cardiovascular diseases (3 621 men and 5 904 women) from Jiading community in Shanghai were enrolled to complete questionnaires, undergo extensive physical examination including brachial-ankle pulse wave velocity (baPWV) and blood pressure (BP) assessment, and laboratory screening. According to body mass index (BMI) and metabolic status, these participants were categorized into 4 groups including metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), MHO, and metabolically unhealthy obese (MUO). High baPWV was defined as baPWV>1 400 mm/s, and high pulse pressure (PP) was defined as PP above fourth quartile of the population. Multivariate logistic regression model was conducted to explore the relationship between MHO and high baPWV as well as high PP after adjusting for confounders. Results:After multivariable adjustment, such as sex, age, current smoking, current drinking, and education, logistic regression analysis showed that MHO was significantly correlated with high baPWV ( OR=1.18, 95% CI 1.02-1.37) and high PP ( OR=1.72, 95% CI 1.43-2.08) in comparison with MHNO. Otherwise, both MUNO and MUO subjects were at higher risk for suffering from high baPWV (MUNO: OR=3.02, 95% CI 2.60-3.50; MUO: OR=3.26, 95% CI 2.87-3.70) and high PP (MUNO: OR=2.56, 95% CI 2.17-3.02; MUO: OR=3.49, 95% CI 3.01-4.06). Conclusion:On the basis of Chinese community population, there was a pronounced correlation between the MHO phenotype and the increased risk of developing atherosclerosis.

Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.

Objective:To investigate the correlation between exposure to famine in early life and later risk of type 2 diabetes in adulthood.Methods:A cluster sampling method was used to include 8 868 residents who were lived in the Jiading community of Shanghai during the Great Famine from 1959 to 1962 in China. Subjects were divided into non-exposed group, fetal exposure group, childhood exposure group, and adolescent exposure group. Logistic regression model was used to analyze the relationship between famine exposure in early life and the risk of type 2 diabetes in adulthood. Results:Famine exposure during childhood and adolescent both increased the risk of developing type 2 diabetes in adulthood in women. No significant correlation was observed in men. In subjects with less physical activity and lower education level, the risk of developing type 2 diabetes mellitus in adulthood was significantly higher in the famine-exposed group than that of non-exposed groupand the interactions were statistically significant.Conclusion:Early life famine exposure increases the risk of developing type 2 diabetes in adults, especially in women.

OBJECTIVE：To observe therapeutic efficacy and safe ty of Huhuang burn liniment on the prevention and treatment of radiation dermatitis patients with nasopharyngeal carcinoma （NPC）. METHODS ：Totally 129 NPC patients were collected from our hospital during Aug. 2018-Feb. 2020. They were numbered according to the order of radiotherapy ，the ones with odd number were included into observation group （65 cases）and the ones with even number into control group （64 cases）. Both groups received routine radiotherapy and skin nursing. Control group were evenly smeared with Shirun shaoshang cream in the radiation field during radiotherapy ，and observation group were smeared with Huhuang burn liniment. The smearing area should be 1 cm beyond the edge of radiation field ，3 times a day until the end of stage 1 radiotherapy（33-38 times in total ）. The skin lesions of the two groups were observed ；the appearance time and healing time of skin lesion ，RTOG score and NRS score were recorded. The levels of serum cytokines （TNF-α，IL-6，IL-8 and IL- 10）were detected in 2 groups at 0，15th and 30th time of radiotherapy. The occurrence of ADR was recorded in 2 groups during treatment. RESULTS ：The appearance time of skin lesion in observation group was significantly longer than control group ；the healing time of skin lesion in observation group was significantly shorter than control group （P＜0.01）. RTOG grading of radiodermatitis in the two groups was mainly grade 1，but no grade 3 or 4 was found. There was no significant difference in the proportion of patients with differen RTOG grades （P＞0.05）. The highest NRS score of control group and observation group were 3 and 2 points respectively ，and the proportions of patients with 0-3 points in the two groups were statistically significant （P＜0.05）. There was no significant difference in serum cytokine levels between @qq.com 2 groups at 0 time of radiotherapy （P＞0.05）. The serum cytokine levels of 2 groups were increased significantly at 15th @qq.com time of radiotherapy ， but t he observation group was significantly lower than control group at the same period （P＜0.05 or P＜0.01）. At 30th time of radiotherapy ，the cytokine levels of 2 groups decreased significantly ，compared with 15th time of radiotherapy ，the observation group was significantly lower than the control group at the same period （P＜0.05 or P＜0.01）；the levels of TNF-α，IL-6 and IL- 10 in control group as well as the level of IL- 6 in observation group were significantly higher than the same group at 0 time of radiotherapy （P＜0.05 or P＜0.01）. There was no ADR such as allergy ，rash，smear site infection in the two groups during the treatment. CONCLUSIONS ：Huhuang burn liniment has a good effect of preventing and treating radiation dermatitis of NPC patients ，delays the occurrence of skin lesion，shortens the healing time of skin lesion ，relieves pain and reduces the level of serum cytokines with good safety.

The association between serum uric acid and the risk of incident diabetes in Chinese adults remains unknown. This study aimed to investigate this association in a community-dwelling population aged ≥ 40 years in Shanghai, China. Oral glucose tole3rance test was conducted during baseline and follow-up visits. Relative risk regression was utilized to examine the associations between baseline gender-specific serum uric acid levels and incident diabetes risk. A total of 613 (10.3%) incident diabetes cases were identified during the follow-up visit after 4.5 years. Fasting plasma glucose, postload glucose, and glycated hemoglobin A1c during the follow-up visit progressively increased across the sex-specific quartiles of serum uric acid (all Ps < 0.05). The incidence rate of diabetes increased across the quartiles of serum uric acid (7.43%, 8.77%, 11.47%, and 13.43%). Multivariate adjusted regression analysis revealed that individuals in the highest quartile had 1.36-fold increased risk of diabetes compared with those in the lowest quartile of serum uric acid (odds ratio (95% confidence interval) = 1.36 (1.06-1.73)). Stratified analysis indicated that the association was only observed in women. Accordingly, serum uric acid was associated with the increased risk of incident diabetes among middle-aged and elderly Chinese women.
Adult ; Aged ; China/epidemiology* ; Diabetes Mellitus/epidemiology* ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Uric Acid

OBJECTIVE： To establish the method for content determination of eugenol in Syzygium aromaticum oil dropping pills， and to optimize the preparation technology. METHODS： The content of eugenol in S. aromaticum oil dropping pills was determined by UV spectrophotometry. Based on single factor test， using the percentage of drugs in total amount， liquid temperature， falling distance of condensate， liquid drop distance as factors， taking the roundness， weight and hardness difference and comprehensive score as factors， L9（34） orthogonal design test was adopted to optimize the preparation process. RESULTS： The linear range of eugenol was 15.15-45.45 μg/mL（r＝0.999 6）； RSDs of precision， stability and reproducibility tests were all lower than 1％； the recoveries were 97.41％-100.59％（RSD＝1.35％， n＝6）. The optimal preparation technology included that the percentage of drugs in total amount was 5％； liquid temperature was 80 ℃； falling distance of condensate was 13 cm； liquid drop distance was 6 cm. The dropping pills had smooth appearance， good roundness and moderate hardness； the average content of engenol was 4.073％（RSD＝0.35％，n＝6）. CONCLUSIONS： The established method is simple， and can be used for the content determination of eugenol in S. aromaticum oil dropping pills. The optimal preparation technology is stable and feasible.

Objective To investigate the relationship between the serum levels of retinol-binding protein 4(RBP4),blood lipid level and glycemic control in patients with chronic schizophrenia complicated with type 2 diabetes.Methods The levels of glycated hemoglobin (HbA1c),fasting plasma glucose (FPG),cholesterol (TC),triglycerides (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),apolipoproteinA1 (Apo A1),apolipoprotein B(Apo B),apolipoprotein E(Apo E),lipoprotein(a)[Lp (a)],free fatty acid(FFA),RBP4,fasting insulin (FINS) were determined in 96 patients with chronic schizo-phrenia complicated with type 2 diabetes (schizophrenia group) and 50 healthy subjects (healthy control group),the insulin resistance index (HOMA IR)was calculated.The patients were divided into HbA1c<7.0% group and HbA1c≥7.0% group according to the results of the HbA1c,and the results were statistically analyzed.Results In the HbA1c<7.0% group,the levels of HbA1c,FPG,TG,Apo B,Apo E,Lp(a),RBP4 were significantly higher than those in the healthy control group,the levels of serum Apo A1 and HDL-C was lower than those in the healthy control group (P<0.05).In the HbA1c≥7.0% group,the levels of HbA1c, Body mass index (BMI),FPG,TG,Apo E,FFA,RBP4,FINS,HOMA-IR were significantly higher than those in the HbA1c<7.0% group and the healthy control group,the levels of TC,Apo B,Lp(a)were significantly higher than the healthy control group and the levels of serum Apo A 1 and HDL-C were lower than those in the healthy control group (P<0.05).Single factor Logistic regression analysis showed that BMI,TG,Apo E, FFA,RBP4,FINS and HOMA-IR were risk factors for poor control of blood glucose in type 2 diabetes pa-tients with chronic schizophrenia.Conclusion The levels of RBP4 and blood lipid in patients with chronic schizophrenia complicated with type 2 diabetes may be related to the poor control of blood sugar level.

Objective To investigate the association between levels of serum alanine aminotransferase (ALT) and the risks of cardiovascular disease in Chinese. Methods A survey of 10 375 subjects aged 40 or older in Jiading District of Shanghai was performed using cluster sampling. All the subjects were recruited to undergo questionnaire interview, anthropometric measurements, and fasting blood sampling. A total of 8 877 participants were included in the final analyses, including 5 664 females and 3 213 males. The mean age of individuals was ( 58.68 ± 9.22)yearsinmenand(57.65±8.93)yearsinwomen(P＜0.01).10-yearriskforafirsthardatherosclerotic cardiovascular diseases (ASCVD) event was calculated. Results Increased ALT levels were associated with more unfavorable cardiovascular risk profiles and 10-year risk for ASCVD. Increased ALT levels were associated with the prevalence of diabetes mellitus in female participants, while in male participants the prevalence of diabetes mellitus appeared as a U-distribution. The prevalence of hypertension and hyperlipidemia were 66.04%, 52.74%and 64.49%, 47.63% respectively. Increased serum ALT was associated with higher prevalence of 10-year risk for ASCVD. As compared with participants in the first ALT quartile, the risks of 10-year risk for ASCVD were increased by 148%(OR＝2.48, 95%CI 1.78-3.45) and 139%(OR＝2.39, 95%CI 1.78-3.19), respectively in male and female participants. As compared with participants in the first ALT quartile, higher prevalence of 10-year risk for ASCVD were increased by 96%(OR＝1.96, 95%CI 1.30-2.95), while there was no significantly statistical difference in men. Conclusion A high-normal serum ALT level was significantly associated with an increased risk of the cardiovascular disease in middle-aged and elderly Chinese.

Objective To investigate the association of age at menarche with the risks of diabetes and metabolic syndrome ( MS) in adulthood in Shanghai community postmenopausal women. Methods A total of 10375 residents over 40 years in Jiading, Shanghai were identified by a cluster sampling method. After taking standardized questionnaire surveys, physical examinations, and biochemical parameters testing, we gathered their lifestyle and medicine information. A total of 4723 postmenopausal women were enrolled in the study. The population was divided into three groups according to age at menarche, and their risks of MS and diabetes in various groups were compared. Results After multivariate adjustment, postmenopausal women with a menarche age<15 years had a 29％increased risk of diabetes(95％CI 1.03-1.61) and a 45％ increased risk of MS(95％ CI 1.20-1.76) in adulthood, compared with those with menarcheal age at 15-18 years. Among the five components of MS, earlier age of menarche was associated with higher risks of hypertriglyceridemia, low high density lipoprotein-cholesterol, and central obesity. Conclusions In Shanghai Jiading community postmenopausal women, age at menarche is associated with the risk of diabetes and MS, independent of the body mass index in adulthood.

Objective To establish a detection technique for H.pylori(HP) infection in Mongolian gerbils using nested PCR technique.Methods H.pylori was cultured in vitro and inoculated into Mongolian gerbils.At the 10th week after infection, the HP in the gastric juice of Mongolian gerbil was detected by conventional PCR assay and the gastric juice, gastric mucosa, duodenal contents and colon stool were examined by nested PCR.Rapid urease test and ELISA were used to analyze the accuracy of the nested PCR assay.All of the PCR products were verified by sequencing.Results The positive rate of gastric juice detected by conventional PCR was 30%, while the positive rates of gastric juice, gastric mucosa, duodenal contents and colon stool detected by nested PCR were 100%, 100%, 90%, and 10%, respectively.The positive detection rates of rapid urease test and serum ELISA were 100% and 0%, respectively.Comparing the results of different methods, both the positive rates of gastric juice and gastric mucosa detected by nested PCR and the detection rate of rapid urease test were 100%, but the results of conventional PCR detection of gastric juice, the nested PCR detection result of stool in colon and of serum ELISA assay were lower than other methods.Conclusions Due to its high accuracy and sensitivity, the nested PCR assay of gastric juice can be used for the long-time detection of H.pylori infection in Mongolian gerbils, especially useful in the experiments of prevention and treatment of H.pylori infection.