Relationship between different obesity phenotypes and abnormal blood pressure in children and adolescents in Yinchuan city / 中华实用儿科临床杂志

Objective:To investigate the relationship between different obesity phenotypes and abnormal blood pressure in children and adolescents in Yinchuan city, and to provide appropriate treatment and intervention measures for obese children and adolescents.Methods:The current research design was adopted to facilitate the cluster sampling.A total of 1 047 children and adolescents aged 12 to 18 in Yinchuan were enrolled in this study from September 2017 to September 2018.There were 530 males and 517 females, with an average age of (13.93±1.24) years old.The questionnaire survey, physical examination and laboratory testing were carried out.Statistical analysis was performed by using SPSS 19.0 software.Results:Among the children and adolescents with normal weight, the composition ratio of the metabolically unhealthy normal-weight (MUNW) phenotype was 7.6%.In the obese cases, the composition ratio of the metabolically healthy obesity (MHO) phenotype was 20.2%.The blood pressure of MUNW [systolic pressure SBP: (119±13) mmHg(1 mmHg=0.133 kPa); diastolic pressure(DBP)(74±10) mmHg] and metabolically unhealthy obesity (MUO) [SBP (127±10) mmHg; DBP(74±7) mmHg] phenotypes were significantly higher than those of the metabolically healthy normal-weight (MHNW) phenotype (all P<0.05). The blood pressure of the MUO [SBP(127±10) mmHg; DBP(74±7) mmHg] phenotype was significantly higher than that of the MHO phenotype ( P<0.05). After adjusting for age, gender, and family history of hypertension, MUNW and MUO phenotypes were 5.93 (95% CI: 3.10-11.36) and 11.63 (95% CI: 6.37-21.24) times more likely to develop blood pressure abnormalities than MHNW phenotypes, respectively ( P<0.001). The MHO phenotype was 0.63 (95% CI: 0.08-4.93) times more likely to develop blood pressure abnormalities than the MHNW phenotype ( P=0.66). Conclusions:The MHO phenotype does not increase the risk of abnormal blood pressure, while the MUNW phenotype does.Therefore, it is recommended to identify the MHO phenotype and MUNW phenotype in order to provide appropriate obesity treatment and interventions for children and adolescents.

Mental health status of students with self reported learning disabilities in Beijing / 中国学校卫生

Objective@#Understanding mental health status of students with learning disabilities in Beijing to provide a basis for mental health promotion of students with learning disabilities.@*Methods@#By means of random cluster sampling, 5 787 enrolled students in grade one and grade two of 11 public junior middle schools in Beijing were selected as the survey subjects. A self designed questionnaire was used to investigate the students’ learning disabilities and mental health status through anonymous self filling.@*Results@#About 11.6% students self reported learning disabilities. The proportions of students with learning difficulty in mathematical reasoning and calculation were higher, 44.1% and 40.7% respectively. The reported rate of mental health problems was 38.3%. The top four of the 10 symptoms were obsessive compulsive symptoms, learning pressure, emotional instability and anxiety(2.19±0.77)(2.17±0.99)(2.09±0.90)(2.07±1.08). Compared with students without learning disabilities, students with self reported learning disabilities had poorer mental health status(OR=1.47), and learning disabilities were related to most factors of mental health. Different types of learning disabilities were associated with different mental health factors.@*Conclusion@#Mental health problems of students with learning disabilities are higher than that of students without learning disabilities. It is necessary to strengthen the mental health support for students with learning disabilities and improve their mental health.

Relationship between sutured nucleus echo and serum metal and non-motor symptoms in patients with Parkinson′s disease / 中华神经科杂志

Objective:To explore the relationship between the changes of midbrain raphe nucleus echo and blood trace metals, non-motor symptoms in patients with Parkinson′s disease (PD).Methods:A total of 177 patients with PD were recruited from Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from November 2017 to December 2019. Their non-motor symptoms were assessed by a series of PD-related scales. All subjects completed transcranial color-coded sonography, and were divided into two groups according to the continuity of raphe nucleus echo. The difference of trace metals in peripheral blood and the scores of non-motor symptoms were analyzed.Results:The serum iron level of PD patients in the continuous echo of raphe nucleus group (117 cases; 15.33 （11.30, 18.93） μmol/L) was higher than that of the discontinuous group (60 cases; 12.52 （4.15, 16.00） μmol/L, t=-2.294, P=0.022), so was the scores of Scale for outcomes in PD for Autonomic Symptoms (34.00 （28.00, 39.00） vs31.00 （26.25, 36.00）， t=-2.044, P=0.041). There was no significant difference in the level of serum copper, hemoglobin, ceruloplasmin, and the scores of Movement Disorder Society Unified Parkinson′s Disease Rating Scale, Parkinson′s Disease Sleeping Scale, 39 items Parkinson′s Disease Questionnaire, Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale between the two groups. Conclusion:There was significant difference in serum iron levels and the scores of SCOPA-AUT between the two groups, but no difference in depression, sleep, and daily living ability.

Correlation of substantia nigra hyperecho with essential tremor and Parkinson disease / 中华全科医师杂志

Objective To investigate the correlation of substantia nigra hyperecho with essential tremor (ET) and Parkinson disease (PD).Methods The clinical data of 158 patients with ET or PD who underwent transcranial ultrasonography in Tongji Hospital from March 2016 to March 2018 were retrospectively analyzed.There were 35 patients with ET (ET group),113 patients with PD who had no previous history of ET (PD group),and 10 PD patients with previous history of ET (ET-PD group).And 58 healthy subjects served as controls (control group).The hyperechoic area of substantia nigra in different groups was compared.Results The hyperechoic areas of the substantia nigra were [0 (0,0)]cm2 (control group),[0.27(0,0.41)]cm2 (ET group),[0.33(0.21,0.40)]cm2 (ET-PD group) and [0.35(0.29,0.45)]cm2 (PD group);the differences between control group and ET group,between the ET group and PD group were statistically significant (Z=-5.24,P=0.01;Z=-3.09,P=0.02),and there were no significant difference between the ET group and ET-PD group,between ET-PD group and PD group (Z=-0.98,P=0.32;t=-0.98,P=0.33).The ratio of substantia nigra hyperechoic positive to negative in ET-PD group was 9.00 (9/1),while that in ET group was 0.94 (17/18) (OR=9.53,95％ CI:1.09-83.43,x2=3.91,P=0.04).Conclusion Substantia nigra hyperecho is an objective imaging indicator for patients with ET and PD,and has a certain differential value for their diagnosis.

Value of shear wave elastrography image classification in the diagnosis of breast masses / 中华肿瘤杂志

Objective@#To analyze the image features of shear wave elastrography (SWE) in breast masses, and to evaluate their values in the differentiation of benign and malignant breast lesions.@*Methods@#A total of 361 patients with 403 breast lesions who simultaneously underwent conventional ultrasound and SWE examination from February 2015 to January 2018 were selected. Diagnosis in all patients was confirmed by aspiration biopsy or operative pathology. The SWE images were collected and the elastic images were divided into 5 types. The SWE image features of different breast pathological types were summarized, and their values in benign and malignant breast lesion diagnoses were evaluated.@*Results@#The main features of benign breast lesion were type Ⅰ and Ⅱ, the main features of the malignant lesion were type Ⅳ and Ⅴ, and the proportion of which were 43.6% (71/163), 37.4% (61/163), 22.1% (53/240) and 57.9% (139/240), respectively. Type Ⅲ accounted for a certain proportion in both benign and malignant lesions. The SWE image features of benign and malignant lesions were compared and a significant difference was observed (P<0.001). The type Ⅴ features were mainly observed in invasive ductal carcinoma, invasive lobular carcinoma and other types of invasive carcinoma, while the type Ⅳ features were mostly presented in ductal carcinoma in situ and mucinous carcinoma. Fibroadenoma, fibroadenosis accompanied with fibroadenoma, and fibroadenosis were featured with type Ⅰ. Both intraductal papilloma and benign phyllodes tumor were mostly type Ⅱ, while type Ⅲ and Ⅴ were more common in chronic granulomatous mastitis. When type Ⅰ and typeⅡof breast lesions were classified as benign features while type Ⅳ and Ⅴ were malignant features, the sensitivity and specificity of breast malignant lesion diagnosis were 91.2% and 84.7% by application of SWE combined with breast imaging reporting and data system (BI-RADS). The sensitivity of combined diagnosis was slightly lower than that of conventional ultrasound (P>0.05), but the specificity was significantly higher than conventional ultrasound (P<0.01).@*Conclusion@#The SWE is a simple and effective method. Combination of SWE with conventional ultrasound may improve the diagnostic differentiation of benign and malignant breast lesions.

Impaired Na⁺−K⁺-ATPase signaling in renal proximal tubule contributes to hyperuricemia-induced renal tubular injury

Hyperuricemia contributes to renal inflammation. We aimed to investigate the role of Na⁺–K⁺–ATPase (NKA) in hyperuricemia-induced renal tubular injury. Human primary proximal tubular epithelial cells (PTECs) were incubated with uric acid (UA) at increasing doses or for increasing lengths of time. PTECs were then stimulated by pre-incubation with an NKA α1 expression vector or small interfering RNA before UA (100 μg ml⁻¹, 48 h) stimulation. Hyperuricemic rats were induced by gastric oxonic acid and treated with febuxostat (Feb). ATP levels, the activity of NKA and expression of its α1 subunit, Src, NOD-like receptor pyrin domain-containing protein 3 (NLRP3) and interleukin 1β (IL-1β) were measured both in vitro and in vivo. Beginning at concentrations of 100 μg ml−1, UA started to dose-dependently reduce NKA activity. UA at a concentration of 100 μg ml⁻¹ time-dependently affected the NKA activity, with the maximal increased NKA activity at 24 h, but the activity started to decrease after 48 h. This inhibitory effect of UA on NKA activity at 48 h was in addition to a decrease in NKA α1 expression in the cell membrane, but an increase in lysosomes. This process also involved the subsequent activation of Src kinase and NLRP3, promoting IL-1β processing. In hyperuricemic rats, renal cortex NKA activity and its α1 expression were upregulated at the 7th week and both decreased at the 10th week, accompanied with increased renal cortex expression of Src, NLRP3 and IL-1β. The UA levels were reduced and renal tubular injuries in hyperuricemic rats were alleviated in the Feb group. Our data suggested that the impairment of NKA and its consequent regulation of Src, NLRP3 and IL-1β in the renal proximal tubule contributed to hyperuricemia-induced renal tubular injury.

Application of real-time three-dimensional transthoracic echocardiography in patients with functional mitral regurgitation / 中国医学影像技术

Objective To investigate the structural and functional changes of mitral valve in patients with functional mitral regurgitation (FMR) by real-time three-dimensional transthoracic echocardiography (RT-3D-TTE).Methods RT-3D-TTE were performed on 70 patients with at least moderate mitral regurgitation (FMR group;including 35 cases of ischemic cardiomyopathy [ICM] subgroup and 35 cases of dilated cardiomyopathy [DCM] subgroup) and 30 normal controls (control group).The mitral valve parameters were analyzed by TomTec assessment software to detect dynamic changing pattern of mitral valve size and shape during cardiac systole.The differences of parameters between control group and FMR group were compared.The parameters included mitral annulus structural parameters:Anterior-posterior (AP),anterolateral-posteromedial (AL-PM),sphericity (SPI;SPI=AP/AL-PM),annular circumference (AC),commissural diameter (CD),nonplanarity angle (NPA),annular height (AH),tenting height (TH),tenting volume (TV),three-dimensional annular area (AA3D);dynamic parameters..Maximum annular displacement (ADmax),maximum annular displacement velocity (ADVmax).Results The mitral valve parameters present phasic variation law in FMR group.Compared with control group,AH,ADmax and ADVmaxwere smaller and the other parameters were larger than those in FMR group (all P＜0.05).Compared with control group,AH,ADmax and ADVmax were smaller and the other parameters were larger than those in both ICM subgroup and DCM subgroup (all P＜0.05).Compared with ICM subgroup,AH was smaller in DCM subgroup (P＜0.05),there was no statistical difference in ADmax and ADVmax between ICM subgroup and DCM subgroup (P＞0.05),the rest parameters were greater in DCM group (all P＜0.05).Conclusion RT-3D-TTE can be used to quantitatively assess the structural and functional changes of mitral valve in patients with FMR and provide a reference for the clinical treatment of FMR.

Quantitative assessment of mitral apparatus in patients with acute myocardial infarction after percutaneous coronary intervention by real-time three-dimensional transthoracic echocardiography / 中华超声影像学杂志

Objective To assess the changes of structure and function of the moderate mitral valvular regurgitation before and after percutaneous coronary intervention ( PCI ) by real-time 3-dimensional transthoracic echocardiography ( RT 3D-TTE) . Methods Thirty-two patients with acute myocardial infarction( AMI) and moderate mitral regurgitation were enrolled in the study ,while 30 healthy subjects were selected as the control group . All patients accepted RT 3D-TTE ,the imaging was analyzed offline with TomTec 4D MV-Assessment software . The mitral valve structure and function parameters were measured . All AMI patients were performed RT 3D-TTE at 12 hours before PCI ,1 week and 3 months after PCI . According to whether improved at 3 months after PCI ,patients with moderate mitral regurgitation were dividedintotwogroups:improvementgroupandnoimprovementgroup.Results ①Comparedwiththe control group ,anterior-posterior ( AP) diameter ,anterolateral-posteromedial ( AL-PM ) diameter ,annular circumference(AC) ,commissural diameter(CD) ,three-dimensional annular area(AA3D) ,tenting volume (TV) ,tenting height(TH) ,nonplanarity angle(NPA)of mitral regurgitation group were larger( P <0 .05) , annular height ( AH ) and maximum annular displacement ( ADMax ) ,and maximum annular displacement velocity( ADVMax ) of mitral regurgitation group were smaller( P <0 .05) . ②At three months after PCI ,20 patients with moderate mitral regurgitation were improved ( effective regurgitant orific area < 0 .2 cm2 ) , twelve patients with moderate mitral regurgitation were not improved . Compared with mitral valve parameters before PCI and at one week after PCI ,AP ,AL-PM ,AC ,CD ,AA3D ,and TV in improvement group were discreased at three months after PCI( P < 0 .05) ,AH was increased ( P < 0 .05) . Compared with mitral valve parameters before PCI ,mitral valve structure and function parameters after PCI were not improved ,compared with those in no improvement group ,AP ,AL-PM ,AC ,CD ,and AA3D in improvement group were smaller( P < 0 .05) . ③ By analysis of ROC curves AP ,AL-PM ,AC ,and CD for diagnosing mitral regurgitation had good test effectiveness . Conclusions In patients with acute myocardial infarction and moderate mitral regurgitation ,the mitral annular is not only presented as the size enlargement but also the flattening of its geometric shape and the decrease of its dynamic ,while structure and function parameters of the mitral valve before PCI can predict improvement of mitral regurgitation and provide a reference for the development of clinical programs .

Value of MicroPure imaging of ultrasonography in display of breast calcification: comparison with mammography / 中华超声影像学杂志

Objective To evaluate the value of MicroPure imaging system of ultrasonography in display of breast calcification,and explore its clinical application value.Methods One hundred and forty-one patients underwent by mammography,conventional ultrasound imaging and MicroPure imaging,the mammography results were reference standard,observing the display rate of MicroPure imaging for calcification,and the value of MicroPure imaging in the display of calcification with different shapes on mammography.As the pathologic diagnosis was golden standard,the accuracy of diagnosis of conventional ultrasound,conventional ultrasound combined with MicroPure imaging,conventional ultrasound combined with mammography were evaluated with receiver operating characteristic(ROC) curve.Results The display case of calcifications within breast masses:the specificity of MieroPure imaging was lower than conventional ultrasound(88.14％ vs 100％,P ＜ 0.05),the sensitivity and accuracy were higher than conventional ultrasound(100％ vs 62.79％,93.14％ vs 84.31 ％,P ＜0.05).The display case of microcalcifications within normal breast tissue:the specificity and accuracy of MicroPure software system were lower than conventional ultrasound(9.26％ vs 100％,43.87％ vs 65.96％,P ＜0.05),the sensitivity was higher than conventional ultrasound (100％ vs 20.00％,P ＜0.05).The punctate calcification,amorphous calcification,rough uneven,pleomorphic calcifications on mammography were all hyperechoic spots on MicroPure software system.The area under the ROC curve of the conventional ultrasound,conventional ultrasound combined with MicroPure imaging,conventional ultrasound combined with MicroPure imaging was 0.881,0.858,0.932,respectively.Conclusions MicroPure imaging has some clinical value on microcalcifications within breast masses,which can improve its sensitivity and accuracy.The specificity of MicroPure imaging diagnostic ultrasound imaging of microcalcifications were lower,and it can not distinguish between different shapes of calcifications.Compared with conventional ultrasound,MicroPure imaging system can not improve the accuracy of diagnosis of benign and malignant breast lesions.

Trim family and tumor / 国际肿瘤学杂志

Studies show that some Trim family proteins are associated with tumorigenesis and cancer progression.Trim members are differently expressed in various cancers including lung cancer,hepatocellular carcinoma,colon cancer,stomach cancer and breast cancer.Trim proteins are found to be involved in tumor progess by modulating the expression of tumor associated genes via several signaling pathways such as p53 and NF-κB pathway.Members of Trim family can be used as oncogenes or anti-oncogenes in the biological processes such as tumor cell proliferation,cell differentiation,cell apoptosis and metastasis.

The value of color Doppler ultrasound in diagnosing in-stent restenosis in lower limb artery / 中华医学超声杂志（电子版）

Objective To investigate the value of color Doppler flow imaging(CDFI) in diagnosing lower limb artery in-stent restenosis (ISR), and to provide the evidences for clinical application. Methods Patients with lower limb artery percutaneous transluminal stent insertion in 12 months were enrolled in this study and divided into two groups, CT angiography (CTA) or digital subtraction angiography (DSA) was applied to diagnose ISR, 31 patients with 47 stenting which were diagnosed ISR was named as restenosis group, 63 patients with 89 stenting which were diagnosed no ISR was named as no stenosis group, and 30 normal person was enrolled and named as normal control group. Ultrasonic characteristics and peak systolic blood flow velocity (PSV), systolic blood flow acceleration time (AT) of proximal part, inner stents, distal part were recorded in restenosis group and no stenosis group, then compared with data in normal control group. Regression and receiver operator (ROC) curve were applied to analyse the correlation between PSV and AT. Results PSV of no stenosis group in common femoral artery, femoral artery, superifcial, popliteal artery stent respectively were (146.71±35.59) cm/s, (120.11±25.67) cm/s, (96.44±32.87) cm/s. PSV of normal control group in common femoral artery, femoral artery, superifcial, popliteal artery respective were (119.67±15.34) cm/s, (91.17±15.09) cm/s, (71.13±21.23) cm/s. There was statistically signiifcant difference between the two groups (t=2.457, 2.459, 2.321, all P0.05). PSV of restenosis group in proximal part, restenosis part, distal part respectively were (87.67±23.34) cm/s, (218.17±72.09) cm/s, (54.13±21.23) cm/s. PSV of no stenosis group in proximal part, inner stents, distal part respectively were (91.71±25.59) cm/s, (131.11±45.67) cm/s, (96.44±32.87) cm/s. There was statistically significant difference between restenosis part/inner stents, distal part (t=3.412, 3.511, both P0.05). AT of restenosis group in proximal part, restenosis part, distal part respectively were (98.31±14.09) ms, (109.54±21.03) ms, (158.23±45.21) ms. AT of no stenosis group in proximal part, inner stents, distal part respectively were (84.98±13.77) ms, (86.34±19.36) ms, (83.77±17.05) ms. There was statistically signiifcant difference between restenosis part/inner stents, distal part (t=2.319, 3.610, both P0.05). ROC curve showed that in ISR lower limb artery, PSV>168 cm/s had a sensitivity of 89.4%, speciifcity of 92.1%, the area under the ROC curve was 0.949;AT>127 ms, had a sensitivity of 86.8%, speciifcity of 98.0%, the area under the ROC curve was 0.867. Conclusions CDFI can detect the changes of PSV and AT, ISR can be detected and diagnosed earlier in lower limb artery. By combining PSV>168 cm/s with AT>127 ms, the value of ISR diagnosis can be increased.

The clinical applicated value of high-frequency ultrasound in the diagnosis of isolated calf muscle vein thrombosis / 中华医学超声杂志（电子版）

Objective To explore the clinical value of high-frequency color Doppler ultrasound in the diagnosis of isolated calf muscle vein thrombosis (ICMVT). Methods Sonographic features of 175 patients with isolated calf muscular venous thrombosis were analyzed retrospectively and outcome of anticoagulant therapy in 1, 3, and 6 months was followed up. Diagnosis was established with high-frequency color Doppler ultrasound examination. Results One hundred and seventy-ifve patients presenting with 190 calf muscle vein thrombosis were included. One hundred and iffty-eight cases with 173 calf muscle vein thrombosis were diagnosed by high-frequency color Doppler ultrasound, 7 cases of misdiagnosis, missed diagnosis in 10 cases. The accuracy rate was 91.1%(173/190). Seven cases were misdiagnosed with 1 euroifbromatosis, 1 mixed hemangioma, 5 gastrocnemius hematoma. After diagnosis of ICMVT, all patients prescribed thrombolysis and anticoagulation therapy. High-frequency color Doppler ultrasound for 1, 3, 6 months after treatments revealed partial or complete recanalization without calf deep vein thrombosis. Typical sonographic features included:calf muscle venous lumen dilation, tortuous anechoic lumen or hypoechoic iflling, with tubular or branched shape in the longitudinal view and oval or round shape in the transversal view. Conclusion High-frequency color Doppler ultrasound is an accurate and reliable method in the diagnosis of the isolated calf muscular venous thrombosis.

Analysis of sites for recurrent and metastatic gastric cancer after curative resection and its guidances for the treatment / 肿瘤研究与临床

Objective To investigate the patterns for the recurrent and metastatic gastric cancer after curative resection and to indicate the strategy of treatment. Methods 162 patients who had received radical resection and presented post-operation failure during recent 9 years were analyzed. The failure patterns were confirmed by type-B ultrasonic or CT / MRI imaging. 15 of 34 patients with abdominal dropsy were diagnosed by adenocarcinoma cells in the abdominal dropsy. All superficial lymphadens and abdominal wall metastasis were diagnosed via punctuation. 31 patients with gastric remnant and (or) anastomoses recurrence were diagnosed via biopsy. Results Of 162 patients, 63 presented the recurrence or metastasis in multiple sites,including abdominal lymph node (LN) metastases in 46.9 % (76/162), peritoneum metastases in 21.0 % (34/162),gastric remnant and (or) anastomoses recurrence in 19.1% (31/162), liver metastases in 19.1% (31/162), the incidence rates of other parts were all ＜10 %. Meanwhile, out of 76 patients with abdominal lymph node metastases, 48.7 % (37/76) patients with peri-gastric LNs metastases, 31.6 % (24/76) with peri-pancreatic LNs metastases, 19.7 % (15/76) with para-aortic LNs metastases. The incidence of LN metastases was 57.7 % (56/97) in cancer arising from gastric fundus/cardia and 60.4% (29/48) in gastric body and 64.7 % (11/17) in pylorus antrum. Conclusion The regional failure sites for gastric cancer patients with radical resection were dominantly found in the gastric stump/stoma, the peritoneum and pelvic cavity implantation and abdominal cavity LN metastases, especially in the peri-gastric, peri-pancreatic and/or para-aortic LN metastases. The distant place failure sites were mainly in the liver, lung, brain, spondylus, cervical part LN and mediastinal LN metastases. Therefore, we should take chemotherapy, abdominal cavity chemotherapy and regional radiotherapy to prevent the regional district recurrences and distant metastasis after the gastric cancer patients with radical resection. Radiotherapy fields should focus on the gastric stump/stoma and the peri-gastric, peri-pancreatic and para-aortic LN regions.