Objective To identify easily confused Chinese herbal pieces by micro-macroscopical identification method,and study its application value in quality acceptance of Chinese herbal pieces in medical institutions.Methods Using the method of micro-macroscopical identification,with the help of related instruments,the microscopic characteristics of 10 groups of 31 kinds of Chinese herbal pieces,which were easy to be confused and could not be observed by naked eye and ordinary magnifying glass,were analyzed and summarized according to the classification of different medicinal parts,such as flowers,fruits,seeds,whole grass,roots and rhizomes,stems,and others,and pictures were taken to save them.Results The micro-characters of 10 groups of 31 easily confused Chinese herbal medicines,including Eriocauli flos,Eriocaulon sexangulare,Eriocaulon australe,Aurantii fructus,Citrus changshan-huyou,Chaenomelis fructus,Chaenomeles cathayensis,Perillae fructus,Perillae fructus(Physalis alba),Perillae fructus(Wild),Astragali complanati semen,Astragalus chinensis,Selaginellae herba,Selaginella pulvinata,Selaginella moellendorfii,Selaginella doederleinii,Selaginella uncinata,Lysimachiae herba,Lysimachia hemsleyana,Desmodium styracifolium,Dryopteris crassirhizoma,Woodwardia japonica,Brainea insignis,root of Valvate actinidia,Actinidia arguta,Tripterygium wilfordii,root of Romanet grape,Trogopterus dung,Bat dung,Hare dung and Silkworm sand were observed.The various traditional Chinese medicines possessed unique identification characteristics.Flower-based medicines could be studied for their color,tissue structure,and surface features such as texture and trichomes.Fruit-based medicines could be studied for their fruit peel structure,color,degree of development,and outer characteristics such as cuticle layer and wax.Seed-based medicines could be studied for their morphology,size,color,and texture.Whole plant-based medicines could be studied for leaf length-to-width ratio,widest point,surface characteristics,and splitting situation,as well as stem trichomes and stomata.Root-based medicines,rhizome-based medicines,and stem-based medicines could be studied for their bark,wood structure,and the morphology and arrangement of vascular bundles or ducts.Other kinds of medicines could be studied from their sources,and these unique micro-characteristic identification features could be easily discovered with the help of a microscope.Conclusion Compared with the traditional characteristic identification,micro-macroscopical identification is more capable of improving the accuracy of Chinese herbal pieces identification,which is economical,practical,simple and intuitive,and can be popularized as a commonly used identification method of herbal medicines in medical institutions,and it is a feasible solution to realize the rapid inspection of herbal medicines.

Objective: To investigate the longitudinal association of plasma Irisin concentrations with changes in blood pressure (BP) levels among children,and to assess the moderating effect of physical activity (PA) or sedentary behavior (SB) on the relationship between Irisin levels and BP. Methods: Based on a cohort study, a cluster sampling method was used to select 3 651 school aged children from five schools in Guangzhou in 2017 at the baseline survey and follow up in 2019. Both at baseline and during follow up, PA and SB were assessed by validated questionnaires, and BP levels were measured by an electronic sphygmomanometer. A final sample of 521 children were enrolled based on the PA and SB at baseline. Plasma Irisin concentrations were measured by ELISA at baseline. Logistic regression analysis was recruited for exploring the associations of plasma Irisin concentrations with changes in BP. Moderating effects of PA and SB on the relationship between Irisin concentrations and BP were estimated using stratified analysis. Results: Logistic regression analysis indicated that there was no significant association between Irisin concentrations and changes in BP levels among children ( OR =0.98, P >0.05). After stratification for SB, Irisin levels in the low SB subgroup were inversely associated with changes in diastolic blood pressure ( OR=0.87, 95%CI=0.77-0.98, P =0.02). In addition, SB level had a moderating effect on the relationship between Irisin levels and the DBP changes ( P =0.01). Conclusion Increased Irisin concentration is associated with the decrease of DBP level among low SB children. Furthermore, SB level shows moderating role in the relationship between Irisin concentrations and changes in DBP levels.

Objective: To investigate the association of parental weight related knowledge, attitude and practice (KAP) with abdominal obesity among primary and middle school students and to provide evidence for related intervention measures. Methods: In September 2013, the multistage random sampling method was used to select 17 307 primary and secondary school students with normal waist circumference in seven provinces/municipalities in China. After nine month follow up, 14 118 students aged 6-18 years were included in the final analysis. Questionnaires were used to assess parental weight related KAP, and students’ waist circumference was measured objectively at baseline and follow up. Multiple linear regression and multivariate Logistic regression were conducted to analyze the relationship between parents’ KAP with the change of students waist circumference and abdominal obesity, respectively. Results: The nine month cumulative incidence of pre and abdominal obesity among students was 6.67% and 0.85%, respectively. The scoring rates of parents knowledge, attitude and practice were 80.17%, 78.17%, 50.50%, respectively. The score of parents weight related attitude was inversely associated with the changes of waist circumference ( β=-0.18, 95%CI = -0.26- -0.10) and cumulative incidence of pre and abdominal obesity ( OR=0.90, 95%CI =0.82-0.98)( P <0.05). Conclusion Parental positive and correct weight related attitude is inversely associated with the incidence of abdominal obesity among children and adolescents. Interventions targeting establishing parents correct beliefs may be an effective way to prevent abdominal obesity in children and adolescents.

Objective To evaluate the effect and mechanism of cysteine rich protein 61, namely CCN family member 1(CCN1) on the survival of adipose tissues in rats after autologous fat grafting. Methods At 1 week after the establishment of autologous fat grafting rat models, all animals were randomly divided into the CCN1 group (n=20) and control group (n=20). The survival of fat grafts, the morphology of fat graft tissues, the proportion of active adipocytes and the number of new blood vessels of rats were statistically compared between two groups. The levels of differential expressed messenger ribonucleic acid (mRNA) in the fat graft tissues of rats were compared between two groups by high-throughput sequencing and subsequently subject to cluster analysis. The expression levels of related proinflammatory cytokines of fat graft tissues of rats were statistically compared between two groups. Results The weight retention rate of adipose tissues in the CCN1 group was significantly higher than that in the control group (P < 0.05). In the CCN1 group, the integrity of adipocytes was considerably higher, the degree of vesiculation and vacuolation, the degree of inflammatory cell aggregation and the degree of fibrosis were significantly lower than those in the control group (all P < 0.000 1). Immunofluorescence staining demonstrated that the proportion of active adipocytes with uniform morphology was higher in the CCN1 group, whereas the proportion of active adipocytes was lower and the cells were observed in different sizes accompanied by vesiculation in the control group. Compared with the control group, the quantity of new blood vessels was significantly higher, and the expression levels of platelet derived growth factor (PDGF) and fibroblast growth factor (FGF) mRNA were remarkably higher in the CCN1 group (all P < 0.05). High-throughput sequencing analysis showed that the data at the transcriptome levels significantly differed between two groups. In the CCN1 group, the gene expression levels of cell surface markers, inflammatory cytokines and chemokines related to M1 macrophages tended to decline. Real-time fluorescent quantitative polymerase chain reaction (RT-qPCR) revealed that the mRNA expression levels of interleukin (IL)-8, IL-1 and Toll-like receptor (TLR) 2 in the CCN1 group were significantly lower than those in the control group (P < 0.01-0.05). Conclusions During autologous fat grafting, supplement of exogenous CCN1 may effectively promote the neovascularization of adipose tissues and improve the survival rate of fat graft probably by mediating the transformation of macrophages into M2 phenotype via down-regulating the TLR2 expression level.

Objective: To investigate the associations of moderate to vigorous intensity physical activity (MVPA) and screen time (ST) with emotional and behavioral problems in children and to provide evidence for related intervention measures. Methods: In March 2017, a total of 4 922 children aged 6-12 years from 5 primary schools in Guangzhou were enrolled using stratified random cluster sampling method. Questionnaires were used to assess children s socio demographic information, MVPA, ST and emotional and behavioral problems. The associations of MVPA and ST with behavioral problems were explored by using generalized linear mixed models. Results: Students with MVPA≥60 min per day accounted for 37.5%, and with ST≤2 h per day accounted for 87.7%. Children who were physically active showed lower scores for total difficulties, hyperactivity, and peer problems and higher score for prosocial than inactive peers( t =2.80, 2.47, 2.56, -1.97, all P <0.05). Also, children who spent less than 2 h ST per day reported lower scores for total difficulties, emotional symptoms, conduct problems, hyperactivity, and peer problems and higher score for prosocial compared to those with high ST( t =3.18, 3.35, 3.70, 3.80, -3.21, 4.97, all P <0.05). Children who met neither MVPA nor ST recommendations had significantly increased risks of total difficulties( OR=1.73, 95%CI =1.12-2.68), conduct problems( OR=1.45, 95%CI =1.02-2.05), peer problems( OR=1.93, 95%CI =1.11-3.36), and prosocial ( OR=1.55, 95%CI =1.08-2.23) than those who met both. Conclusion MVPA and ST are independently related to children s emotional and behavioral problems, and the risks of emotional and behavioral problems increased in children with insufficient MVPA and longer ST.

Objective: To investigate the association between sedentary bouts and cardiovascular disease (CVD) risk factors, and to provide a reference for controlling and reducing the incidence of CVD in children. Methods: Cluster random sampling was used to select 356 students from five primary schools in Guangzhou. Sedentary behavior and physical activity were assessed using ActiGraph GT3X accelerometers, which were worn for 7 consecutive days. According to the sedentary bout duration of each participant, sedentary time was classified into categories of 1-<5, 5-<10, 10-<15, 15-<20 and ≥20 min bouts. Physical examinations were carried out to identify cardiometabolic risk factors. Multivariate linear regression was performed to analyze the relationship between sedentary bouts and CVD risk factors. Results: After adjusting for confounding factors, the time accumulated in sedentary bouts of 5-<10, 10-<15, 15-<20 min in duration were positively associated with higher cardiometabolic risk scores ( B =1.24， 2.01 ，2.40), negatively associated with lower HDL ( B =-0.13，-0.21，-0.27). The time accumulated in sedentary bouts of 1-<5, 5-<10 , 10-<15, 15-<20 min in duration were positively associated with BMI levels ( B =1.07，1.89，2.86，3.65), and waist circumference ( B =2.79，4.81，8.04，10.14)( P <0.05). Conclusion These results suggested that sedentary bouts of 5-<20 min were associated with an unfavorable cardiometabolic risk profile. Our finding suggests no more than 20 min accumulated sedentary time for children.

Objective: To examine the association of sedentary behaviors with visual acuity among primary school children, and to provide a reference basis for the prevention and control of poor vision. Methods: Using stratified random cluster sampling method, a total of 4 969 students in grade 1-4 were selected from 5 primary schools in Guangzhou in 2017, and then were followed up in 2019. A validated questionnaire was used to collect data on children s sedentary behaviors, including doing homework, watching TV, playing computer/video games, and taking the bus/car between home and school. Visual acuity was measured in the baseline and the follow up using a 5 m standard logarithmic visual acuity chart. Multiple linear regression and Logistic regression were conducted to analyze the relationship between sedentary behaviors and visual changes. Results: The two year cumulative incidence of poor vision was 48.74%. Homework time was inversely associated with visual acuity of left eye( β=-0.012, 95%CI =-0.023- -0.002 ). Homework time was positively correlated with poor vision( OR =1.16, 95% CI =1.05-1.27). However, total sedentary time, screen time and bus/car time were not statistically associated with changes in visual acuity( P >0.05). Conclusion Increased homework time was associated with poorer vision in primary school students. Interventions to reduce the academic burden should be taken.

Objective: To investigate the associations between early life factors and the incidence of overweight and obesity and to provide a reference for childhood overweight and obesity prevention. Methods: A total of 5 172 children aged 6-11 years from 5 primary schools in Guangzhou were enrolled using stratified random cluster sampling method. After two years follow up, 3 315 children were included in the final analysis. Questionnaire was used to collect children s early life factors. Height and weight were measured objectively at baseline and follow up. Results: The incidence of overweight and obesity was 8.7% in children. After adjustment for confounders, results from the Logistic regression analysis showed that maternal pre pregnancy underweight was negatively associated with the incidence of childhood overweight and obesity( OR=0.54, 95%CI =0.38-0.76)( P <0.05). While excessive gestational weight gain during pregnancy( OR=1.55, 95%CI =1.14-2.10) and caesarean section ( OR=1.30, 95%CI =1.00-1.68) were positively associated with the incidence of childhood overweight and obesity( P <0.05). Conclusion Both excess gestational weight gain and caesarean section would increase the risk of the overweight and obesity of their offspring, while maternal pre pregnancy underweight would reduce the risk of childhood overweight and obesity.

Objective:To explore the progress of small shadow and the change of lung function in pneumoconiosis with positive autoantibody, so as to provide basis for clinical treatment of pneumoconiosis.Methods:A total of 756 patients were admitted to the pneumoconiosis department of the Guangzhou Occupational Disease Prevention Hospital from January 1, 2013 to June 1, 2019. The patients with combined infection were excluded. According to whether the autoantibody was positive, they were divided into positive group and negative group, 25 cases in each group. Follow-up observation of X-ray chest radiographs, chest CT, forced expiratory volume in one second (FEV 1) and forced expired flow at 50% of FVC (MEF 50) of pneumoconiosis patients for 5 years, to analyze the influence of positive autoantibody on the morphology of X-ray chest film, the pneumoconiosis promotion in 5 years and lung function. Results:There were 22 males and 3 females in the autoantibody positive group, aged 53.14±10.51 years. In the autoantibody negative group, there were 23 males and 2 females, aged 53.88±8.10 years. During the 5-year observation period, there was no significant difference of small shadow shape, pneumoconiosis stage, and the pneumoconiosis promotion in 5 years between the autoantibody positive group and the autoantibody negative group ( P>0.05). However, the increment of small shadow area in the autoantibody positive group was higher than that in the autoantibody negative group ( P<0.05). FEV 1 and MEF 50 of the autoantibody positive group were significantly lower than those of the autoantibody negative group in the fourth and third years, respectively ( P<0.05). Positive autoantibody was negatively correlated with FEV 1 and MEF 50 ( P<0.05). Conclusion:The positive autoantibody can't promote the progress of X-ray, but show more small shadows on chest CT; the positive autoantibody may aggravate the decline of lung function.

To analyze the clinical data of a case of acute emamectin·chlorfenapyr poisoning in Guangzhou 12th People's Hospital in 2019. The patient developed high fever and night sweats, and gradually became unconscious. The patient died after 5 days of treatment. The toxicity and mortality of emamectin·chlorfenapyr were high. For acute poisoning patients, in addition to conventional symptomatic treatment, early blood purification treatment should be actively carried out.