Anticoagulation status and adherence in patients with atrial fibrillation hospitalized for ACS and the impact on 1-year prognosis: a multicenter cohort study / 中华心血管病杂志

Objective: For patients with atrial fibrillation (AF) complicated with acute coronary syndrome (ACS), both anticoagulant and antiplatelet therapy should be applied, but the use of anticoagulation therapy is still poor in these patients in China. The purpose of this study was to explore the status and adherence of antithrombotic therapy in AF patients with ACS and the impact on 1 year clinical outcomes. Methods: Patients with AF hospitalized for ACS were retrospectively included from 6 tertiary hospitals in China between July 2015 and December 2020. According to the use of anticoagulant drugs at discharge, patients were divided into two groups: anticoagulant treatment group and non-anticoagulant treatment group. Logistic regression model was used to analyze the main factors influencing the use of anticoagulant drugs in patients with atrial fibrillation complicated with ACS. Major adverse cardiac events (MACEs) were defined as all-cause death, non-fatal myocardial infarction or coronary revascularization, and ischemic stroke and Bleeding Academic Research Consortium (BARC) 3 bleeding events were also collected at 1 year after discharge. After propensity score matching, Cox proportional hazards models and Kaplan-Meier analysis were used to evaluate the effect of anticoagulant treatment and non-anticoagulant treatment on 1-year prognosis. The patients were divided into different groups according to whether anticoagulation was performed at discharge and follow-up, and the sensitivity of the results was analyzed. Results: A total of 664 patients were enrolled, and 273 (41.1%) were treated with anticoagulant therapy, of whom 84 (30.8%) received triple antithrombotic therapy, 91 (33.3%) received double antithrombotic therapy (single antiplatelet combined with anticoagulant), and 98 (35.9%) received single anticoagulant therapy. Three hundred and ninety-one (58.9%) patients were treated with antiplatelet therapy, including 253 (64.7%) with dual antiplatelet therapy and 138 (35.3%) with single antiplatelet therapy. After 1∶1 propensity score matching between the anticoagulant group and the non-anticoagulant group, a total of 218 pairs were matched. Multivariate logistic regression analysis showed that history of diabetes, HAS-BLED score≥3, and percutaneous coronary intervention were predictors of the absence of anticoagulant therapy, while history of ischemic stroke and persistent atrial fibrillation were predictors of anticoagulant therapy. At 1-year follow-up, 218 patients (79.9%) in the anticoagulant group continued to receive anticoagulant therapy, and 333 patients (85.2%) in the antiplatelet group continued to receive antiplatelet therapy. At 1-year follow-up, 36 MACEs events (13.2%) occurred in the anticoagulant group, and 81 MACEs events (20.7%) in the non-anticoagulant group. HR values and confidence intervals were calculated by Cox proportional risk model. Patients in the non-anticoagulant group faced a higher risk of MACEs (HR=1.802, 95%CI 1.112-2.921, P=0.017), and the risk of bleeding events was similar between the two group (HR=0.825,95%CI 0.397-1.715, P=0.607). Conclusions: History of diabetes, HAS-BLED score≥3, and percutaneous coronary intervention are independent factors for the absence of anticoagulant therapy in patients with AF complicated with ACS. The incidence of MACEs, death and myocardial infarction is lower in the anticoagulant group, and the incidence of bleeding events is similar between the two groups. The risk of bleeding and ischemia/thrombosis should be dynamically assessed during follow-up and antithrombotic regiments should be adjusted accordingly.

Quality evaluation of Cnidii Fructus in commodity grade based on theory of "quality evaluation through morphological identification" / 中国中药杂志

From the perspective of market classification of Cnidii Fructus, this paper revealed the scientific connotation of evaluating the quality grade of Cnidii Fructus by its appearance traits. Thirty batches of Cnidii Fructus in different grades were selected as the research objects. The canonical correlation analysis and principal component analysis(PCA) were used to explore the measurement values of 15 appearance traits and intrinsic content indexes. The results of correlation analysis showed that except the aspect ratio, the 5 appearance trait indexes(length, width, 1 000-grain weight, broken grain weight proportion, and chroma) and 9 internal content indexes(the content of moisture, total ash, acid insoluble ash, osthole, imperatorin, 5-methoxy psoralen, isopimpinellin, xanthotoxin, and xanthotol) showed significant correlation to varying degrees. In addition, there was a significant positive correlation between the first typical variable U_1 composed of appearance traits and the first typical variable V_1 composed of internal content indexes(CR_1=0.963, P<0.01). The results of PCA showed that the classification results of appearance traits for 30 batches of Cnidii Fructus were consistent with the actual information of the samples. Under the same analysis conditions, 30 batches of Cnidii Fructus were reclassified by 9 groups of internal content indexes, and the analysis results were consistent. From the classification standard of the appearance traits of the system study, the statistical results of 6 appearance traits of Cnidii Fructus showed a correlation with grades. There was a good correlation between the appearance and the internal content of Cnidii Fructus, and the appearance quality effectively predicted the level of the internal content. There is a certain scientific basis for the quality classification of Cnidii Fructus by main appearance traits. Appearance classification can replace quality grading to realize the "quality evaluation through morphological identification" of Cnidii Fructus.

Fatal Balamuthia mandrillaris infection with red plaques on the nasal dorsum as the first presentation

Abstract Balamuthia mandrillaris infection is a rare infectious disease around the world, with high rates of morbidity and mortality. Its early and correct diagnosis is a big challenge for us, and without it the delay in starting effective treatment can lead to the development of encephalitis. This is a report of a case of Balamuthia mandrillaris infection in a Chinese boy, with red plaques on the nasal dorsum as the first presentation, who finally developed into fatal encephalitis. The authors have reviewed the related literature and share the special skin features in order to favor the early diagnosis of the disease and increase the chances of survival.

Role of Cytoglobin in Ferroptosis Regulation / 中国生物化学与分子生物学报

Ferroptosis is a recently reported iron-dependent cell death, which is induced by the broken of cellular redox homeostasis and characterized by high level of lipid peroxide. More and more studies have indicated the importance of ferroptosis during disease development and prevention. As a member of globin family, cytoglobin (CYGB), also known as stellate cell activating protein (STAP), can bind to oxygen for its transportation. Moreover, CYGB contains two cysteins within its amino acid sequence and could form the S-S bond when there has change of cellular redox which will result in downstream signaling alternation. Furthermore, CYGB has nitric oxygen dioxygenase activity to scavenge excessive nitric oxygen and prevent the production of ONOO

Triple-negative breast cancer cells respond to T cells severely at the alternative splicing layer

BACKGROUND: Cross talk of tumor­immune cells at the gene expression level has been an area of intense research. However, it is largely unknown at the alternative splicing level which has been found to play important roles in the tumor­immune microenvironment. RESULTS: Here, we re-exploited one transcriptomic dataset to gain insight into tumor­immune interactions from the point of AS level. Our results showed that the AS profiles of triple-negative breast cancer cells co-cultured with activated T cells were significantly changed but not Estrogen receptor positive cells. We further suggested that the alteration in AS profiles in triple-negative breast cancer cells was largely caused by activated T cells rather than paracrine factors from activated T cells. Biological pathway analyses showed that translation initiation and tRNA aminoacylation pathways were most disturbed with T cell treatment. We also established an approach largely based on the AS factor­AS events associations and identified LSM7, an alternative splicing factor, may be responsible for the major altered events. CONCLUSIONS: Our study reveals the notable differences of response to T cells among breast cancer types which may facilitate the development or improvement of tumor immunotherapy.

Quality Regionalization of Angelica sinensis in Genuine Producing Area / 中国实验方剂学杂志

Objective:To study on the quality regionalization of <italic>Angelica sinensis</italic>，in order to guide the rational cultivation of <italic>A. sinensis</italic>. Method:Through visits and field surveys，a total of 857 batches of <italic>A. sinensis</italic> were collected from different counties of Dingxi，relevant geographic information such as longitude，latitude，altitude of each sampling point were obtained by using the global positioning system（GPS），the content of 8 indexes in <italic>A. sinensis </italic>was detected by UPLC， and based on national ecological environment factor data，the suitability analysis of the quality of <italic>A. sinensis</italic> was performed by using MaxEnt，ArcGIS，SPSS. Result:The suitable areas of <italic>A. sinens </italic>were concentrated in central and southern Dingxi. In the suitable areas，the content of ferulic acid，coniferyl ferulate，senkyunolide H decreased from south to north，the content of chlorogenic acid decreased from north to south，the content of senkyunolide A，senkyunolide I decreased from east to west，the distribution regularity of butenyl phthalide was not strong，the highest-content areas were in western Min county，Qingyuan town of Qingyuan county，Shangwan Township and Huichuan town. The content of ligustilide was consistent in the suitable area，and the highest content were in the middle of Weiyuan county and the northern Tongwei county. The results showed that it had a higher index components and comprehensive quality in Min county，Zhang county，southern Weiyuan county and northern Tongwei county. Conclusion:In this study，the quality suitability areas of <italic>A. sinensis</italic> in Dingxi were graded. The chemical components and the quality suitability zoning maps were generated. The findings could provide references for the comprehensive utilization of <italic>A. sinensis</italic>，the selection and construction of high-quality <italic>A. sinensis</italic> raw material base，and the scientific guidance for the production and regional development of <italic>A. sinensis</italic> in Dingxi.

Quantitative analysis of total content differentiation and driving factors of phenolic acids in Angelicae Sinensis Radix of Gansu Dao-di herbs from perspective of geographical space / 中国中药杂志

Dao-di herbs, produced in a specific region and screened through long-term clinical application, is characterized by high stable quality, good efficacy, and high popularity. With favorable climate conditions, Gansu gives birth to the Dao-di herbs Angelicae Sinensis Radix which is widely used in clinical practice, and multiple regions in Gansu, with similar ecological environment produce Angelicae Sinensis Radix. In this study, the spatial correlation and difference of phenolic acid content in Angelicae Sinensis Radix from Dao-di producing areas, emerging producing areas, and emerging planting areas in Gansu were analyzed based on ArcGIS to explore the "quality(chemical type)" characteristics of genuine Angelicae Sinensis Radix. Moreover, spatial distribution law and main driving factors of the total phenolic acid content in Angelicae Sinensis Radix in Gansu were analyzed based on geodetecctor. This study is expected to lay a basis for Dao-di research and production regionalization of Angelicae Sinensis Radix.

Cognitive and willngness to EV71 vacci natior among parents for children in Dongming District of Pudong / 中国学校卫生

Objective@#To understand cognition and willingness of EV71 vaccination among parents of children, so as to provide scientific basis for vaccination.@*Methods@#A cross-sectional survey (census) was adopted. A questionnaire survey was conducted among parents of 2 783 preschool children from 12 kindergartens to analyze the parents’ cognition towards EV71 vaccine and willingness of vaccination of EV71 vaccine.@*Results@#Among the 2 783 parents surveyed, 1 843 heard of EV71 vaccine. The parents’ awareness rate of EV71 vaccine was 51.9%. The main source of EV71 vaccinerelated information was obtained through hospitals(n=887), followed by schools(n=752). 1 014 received EV71 vaccine. The main reason of EV71 vaccination was that vaccine was believed to be effective in preventing hand,foot and mouth disease(HFMD) (76.1%), while the main reason for unwillingness for vaccination was lack of knowledge(31.7%). And 2 478 considered that EV71 vaccine should be included in planned immunization. Multivariate Logistic regression analysis showed that children in public schools(OR=0.72, 95%CI=0.59-0.89), mothers from urban residents(OR=0.76, 95%CI=0.64-0.90), parents lack of EV71 vaccine awareness(OR=0.42,95%CI=0.35-0.49), and perceived high price of EV71 vaccine (OR=0.66, 95%CI=0.47-0.92) had a low vaccination rate. Higher EV71 vaccination rate was related to children’ status as baby class (OR=2.55,95%CI=1.18-5.52),bottom class (OR=2.24,95%CI=1.54-3.24) and middle class(OR=1.51, 95%CI=1.05-2.15)(P<0.05).@*Conclusion@#EV71 vaccination in preschool children in our jurisdiction was relatively high. School type, mother’s household registration, children’s grade and the parental percption of EV71 vaccine price are the main factors influencing EV71 vaccine vaccination in preschool children.

Characteristics of neutrophil extracellular traps in patients with periodontitis and gingivitis

Abstract We sought to compare the characteristics and clinical significance of neutrophil extracellular traps in gingival samples from patients with periodontitis and those with gingivitis. The clinical indexes of gingival samples from patients with periodontitis and gingivitis were measured; the expression of TNF-alpha and IL-8 was measured by real-time fluorescent quantitative PCR; and the expression of TLR-8 and MMP-9 was measured by western blotting assays. Chemotaxis, phagocytosis and phagocytic activity of neutrophils were measured. Compared with the healthy group, the expression of TNF-α and IL-8 in the periodontitis group and the gingivitis group increased significantly (p < 0.05), and TNF-α in the gingivitis group was significantly lower than that in the healthy group (p < 0.05). The expression of IL-8 in the periodontitis group was significantly higher than that in the periodontitis group (p < 0.05). Furthermore, the expression of TLR-8 and MMP-9 in the periodontitis group was different from that in the gingivitis group and the healthy group, and the expression of TLR-8 and MMP-9 in the gingivitis group was significantly different from that in the healthy group (p < 0.05). In addition, the neutrophil mobility index in healthy people was 3.02 ± 0.53, that in the periodontitis group was 2.21 ± 0.13, and that in the gingivitis group was 2.31 ± 0.12. In conclusion, the chemotaxis of neutrophils in gingival samples of patients with periodontitis and gingivitis was decreased, the phagocytotic ability and activity of neutrophils were reduced, and the release of the extracellular trap-releasing inducible factors TNF-alpha and IL-8 also declined.

Changrui enema inhibits inflammation-induced angiogenesis in acute radiation proctitis by regulating NF-κB and VEGF

Abstract Purpose Changrui enema, a traditional Chinese medicine prescription, is used as a supplementary treatment for acute radiation proctitis (ARP). Herein we explored the inhibition effects of Changrui enema on NF-κB and VEGF in ARP mice. Methods A total of 120 C57BL/6 mice were divided randomly into normal mice group, ARP mice group, western medicine enema group (dexamethasone combined with gentamicin), and Changrui enema group. ARP mice were established by pelvic local irradiation. The expression of IL-1β, NF-κB, VEGF, AQP1, AQP3, p-ERK1/2 and p-JNK was determined by immunohistochemistry or western blot. Results The study firstly found that Changrui enema alleviated ARP mice. The expression of IL-1β, NF-κB, VEGF, AQP1 and p-ERK1/2 was increased in ARP mice, and was reserved by Changrui enema. However, the expression of AQP3 and p-JNK was decreased in ARP mice, and was up-regulated by Changrui enema. Conclusions Changrui enema is an effective treatment with fewer side effects for ARP. The mechanism of Changrui enema may be related to the inhibition of inflammation-induced angiogenesis. Changrui enema inhibits IL-1β and NF-κB expression as well as VEGF expression. Interestingly, AQP1 promotes angiogenesis, while AQP3 inhibits inflammation. Changrui enema probably inhibits AQP1 expression by down-regulating p-ERK1/2, and improves AQP3 expression by up-regulating p-JNK.

A Two-DNA Methylation Signature to Improve Prognosis Prediction of Clear Cell Renal Cell Carcinoma

PURPOSE: Effective biomarkers and models are needed to improve the prognostic prospects of clear cell renal cell carcinoma (ccRCC). The purpose of this work was to identify DNA methylation biomarkers and to evaluate the utility of DNA methylation analysis for ccRCC prognosis. MATERIALS AND METHODS: An overview of genome-wide methylation of ccRCC tissues derived from The Cancer Genome Atlas (TCGA) database was download for analysis. DNA methylation signatures were identified using Cox regression methods. The potential clinical significance of methylation biomarkers acting as a novel prognostic markers was analyzed using the Kaplan-Meier method and receiver operating characteristic (ROC) curves. RESULTS: This study analyzed data for 215 patients with information on 23171 DNA methylation sites and identified a two-DNA methylation signature (cg18034859, cg24199834) with the help of a step-wise multivariable Cox regression model. The area under the curve of ROCs for the two-DNA methylation signature was 0.819. The study samples were stratified into low- and high-risk classifications based on an optimal threshold, and the two groups showed markedly different survival rates. Moreover, the two-DNA methylation marker was suitable for patients of varying ages, sex, stages (I and IV), and histologic grade (G2). CONCLUSION: The two-DNA methylation signature was deemed to be a potential novel prognostic biomarker of use in increasing the accuracy of predicting overall survival of ccRCC patients.

Mori Cortex extract ameliorates nonalcoholic fatty liver disease (NAFLD) and insulin resistance in high-fat-diet/streptozotocin-induced type 2 diabetes in rats / 中国天然药物

Nonalcoholic fatty liver disease (NAFLD) and type 2 Diabetes Mellitus (T2DM) are highly prevalent diseases and are closely associated, with NAFLD being present in the majority of T2DM patients. In Asian traditional medicine, Mori Cortex is widely used for the treatment of diabetes and hyperlipidemia. However, whether it has a therapeutic effect on T2DM associated with NAFLD is still unknown. The present study showed that the oral treatment with Mori Cortex extract (MCE; 10 g·kg·d) lowered the blood lipid levels and reversed insulin resistance (IR) in high fat-diet/streptozotocin-induced type 2 diabetes in rats. The expression levels of sterol receptor element-binding protein-1c (SREBP-1c) and carbohydrate-responsive element binding protein (ChREBP), which are involved in steatosis in NAFLD rats, were measured in the liver samples. MCE decreased the protein and mRNA expression levels of SREBP-1c and ChREBP. In conclusion, down-regulation of SREBP-1c and ChREBP might contribute to the protective effect of MCE on hepatic injury and IR in the rats with T2DM associated with NAFLD.

Mori Cortex extract ameliorates nonalcoholic fatty liver disease (NAFLD) and insulin resistance in high-fat-diet/streptozotocin-induced type 2 diabetes in rats / 中国天然药物

Nonalcoholic fatty liver disease (NAFLD) and type 2 Diabetes Mellitus (T2DM) are highly prevalent diseases and are closely associated, with NAFLD being present in the majority of T2DM patients. In Asian traditional medicine, Mori Cortex is widely used for the treatment of diabetes and hyperlipidemia. However, whether it has a therapeutic effect on T2DM associated with NAFLD is still unknown. The present study showed that the oral treatment with Mori Cortex extract (MCE; 10 g·kg·d) lowered the blood lipid levels and reversed insulin resistance (IR) in high fat-diet/streptozotocin-induced type 2 diabetes in rats. The expression levels of sterol receptor element-binding protein-1c (SREBP-1c) and carbohydrate-responsive element binding protein (ChREBP), which are involved in steatosis in NAFLD rats, were measured in the liver samples. MCE decreased the protein and mRNA expression levels of SREBP-1c and ChREBP. In conclusion, down-regulation of SREBP-1c and ChREBP might contribute to the protective effect of MCE on hepatic injury and IR in the rats with T2DM associated with NAFLD.

Investigation of irrational drug use in elderly patients and analysis of influence factors of potentially inap-propriate medications andinfluence factors analysis of potential inappropriate medication in geriatric patients in senile people / 医学研究生学报

Objective The proportion of multiple drugs and the irrational use of drugs increased significantly in the elderly patients (over 80 years). This study aimed to investigate the occurrence of potentially inappropriate medication (PIM) and analyzed the possible reasons related to PIM in elderly patients. Methods In this study,918 cases from Cadre Ward I of Research Center for Geriatrics of Nanjing General Hospital of Nanjing Military Region were selected from January to December in 2016. According to the Beers Criteria (Version 2015),we evaluated PIM in four subtypes,type 1 that is not related to the state of disease in elderly patients, type 2 that is related to the state of disease in elderly patients,type 3 which should be used carefully,and type 4 which is the inappropriate combination of non-anti-infective Drugs. The PIM influence factors were analyzed by logistic regression analysis. Results There are 521 cases (56.75%) of type 1 PIM. The first 3 drugs are Short and medium acting benzodiazepams,PPI and long acting benzodiazepams. There are 206 cases (22.4%) of type 2 PIM. The first 2 drugs are drugs associated with insomnia (oral hyperemia, stimulants, theo-phylline and caffeine) and drugs associated with dementia or cognitive impairment (anti-cholinergic drugs and H2 receptor antago-nists). There are 834 cases (90.85%) of type 3 PIM,which should be used carefully and 45 cases(4.90%) of type 4 PIM.45 cases (4.90%) of non-anti-infective drugs should be avoid or reduced as much as possible in consideration of renal function. The number of combined drug use(OR=5.331,95% CI:3.549-8.009),the age(OR=1.171,95% CI:1.093-1.249),the Chalson's comorbidity index (OR=1.964,95% CI:1.477-2.450) are risk factors of PIM. Conclusion The incidence of potentially inappropriate use of drugs is high among the elderly patients. Reducing the number of combined drugs is an important measure to avoid the occurrence of PIM in elderly patients.

Simultaneous Determination of 5 Components in Lianqiao Baidu Pill by HPLC / 中国药房

OBJECTIVE:To establish a method for the simultaneous determination of chlorogenic acid,paeoniflorin,ferulic ac-id,berberine hydrochloride and baicalin in Lianqiao baidu pill. METHODS:HPLC was performed on the column of Agilent Eclipse XDB-C18 with mobile phase of 0.5% phosphoric acid(triethylamine adjusted to pH 3.0)-methanol(gradient elution)at a flow rate of 1.0 ml/min,the column temperature was 30 ℃,the detection wavelength was 230 nm(for paeoniflorin and berberine hydrochlo-ride),324 nm(for chlorogenic acid and ferulic acid)and 278 nm(for baicalin),and the injection volume was 5 μl. RESULTS:The linear range was 1.884-30.144 μg/ml for chlorogenic acid(r=0.999 9),0.392-6.272 μg/ml for paeoniflorin(r=0.999 7), 0.102-1.632 μg/ml for ferulic acid(r=0.999 7),1.326-21.216 μg/ml for berberine hydrochloride(r=0.999 8) and 1.95-31.2 μg/ml for baicalin(r=0.999 9),respectively;RSDs of precision,stability and reproducibility tests were lower than 2.0%;recoveries were 99.58%-102.47%(RSD=0.93%,n=9),99.21%-102.18%(RSD=0.90%,n=9),98.28%-101.23%(RSD=0.86%,n=9), 99.66%-101.84%(RSD=0.82%,n=9)and 99.18%-101.05%(RSD=0.62%,n=9). CONCLUSIONS:The method is accurate,re-liable,simple and fast,and can be used for the simultaneous determination of chlorogenic acid,paeoniflorin,ferulic acid,berber-ine hydrochloride and baicalin Lianqiao baidu pill.

Computed tomography imaging of early coronary artery lesions in stable individuals with multiple cardiovascular risk factors

OBJECTIVES: To investigate the prevalence, extent, severity, and features of coronary artery lesions in stable patients with multiple cardiovascular risk factors. METHODS: Seventy-seven patients with more than 3 cardiovascular risk factors were suspected of having coronary artery disease. Patients with high-risk factors and 39 controls with no risk factors were enrolled in the study. The related risk factors included hypertension, impaired glucose tolerance, dyslipidemia, smoking history, and overweight. The characteristics of coronary lesions were identified and evaluated by 64-slice coronary computed tomography angiography. RESULTS: The incidence of coronary atherosclerosis was higher in the high-risk group than in the no-risk group. The involved branches of the coronary artery, the diffusivity of the lesion, the degree of stenosis, and the nature of the plaques were significantly more severe in the high-risk group compared with the no-risk group (all p < 0.05). CONCLUSION: Among stable individuals with high-risk factors, early coronary artery lesions are common and severe. Computed tomography has promising value for the early screening of coronary lesions. .

Determination of 23-Acetate Alisol B in Longdan Xiegan Honey Pills by HPLC / 中国药师

Objective:To establish a method for the determination of 23-acetate alisol B in Longdan Xiegan honey pills by HPLC. Methods:The analysis was performed on a Waters Symmetry C18 (250 mm × 4. 6 mm,5μm) column with the mobile phase of acetonitrile-0. 1% phosphoric acid (62 ∶ 38). The flow rate was 1. 0 ml·min-1, the column temperature was 35℃ and the detection wavelength was set at 208nm. Results: The linear range of 23-acetyl alisol B was 19. 999 5- 1 999. 9500 ng(r =0. 999 9), and the average recovery was 95. 56%(RSD = 0. 7%, n = 6). Conclusion: The method is simple, rapid and accurate, and can be used to control the quality of Longdan Xiegan honey pills with good repeatability and recovery.

Comparison of bioelectrical impedance analysis, body mass index and waist circumference in evaluating growth and development of children / 中华实用儿科临床杂志

Objective To compare body mass index(BMI),bioelectrical impedance analysis(BIA) and waist circumference(WC) for the assessment of the growth and development of the children,and to explore the accuracy of BIA and WC for the assessment of the growth and development of the children.Methods Children were surveyed in Department of Child Health Care of Nanjing Children's Hospital from Aug.2011 to Aug.2012.BIA was used to measure body fat,skeletal muscles and bone minerals of these children,and WC was measured by meterstick.According to BMI and body fat parameters,the study subjects were classified into lower weight,normal weight,overweight and obese groups.According to the WC,the subjects were divided into the normal group and the abnormal group.Results There were 2313 children in this survey,1528 boys of them,median age 7.7 years old(ranged from 3.0 to 16.8 years old),and 785 girls of all the children,median age 7.2 years old(ranged from 3.0 to 17.5 years old).Bone mineral content of skeletal muscles increased with age in boys and girls(P ＜0.001).According to BMI,there were 484(20.9％) obese children and 266(11.5％) lower weight children;according to the BIA,there were 663(28.7％) obese children and 481 (20.8 ％) lower weight children; according to the WC,there were 597 (25.8 ％) abnormal children.The sensitivity and specificity of WC and BIA were both higher in the evaluation of overweight and obesity status.When overweight and obesity were analyzed by BIA as well as WC,girls showed a higher specificity,while the boys showed a higher sensitivity.The sensitivity of BMI was higher than BIA in evaluating weight loss.Conclusions BIA as a commonly used indicator is reliable for population census,and it is more desirable if the measurement of WC is done at the same time.The high sensitivity of BIA makes it more suitable for screening overweight and obesity of children.

Surgical treatment of cervicothoracic junction spinal tuberculosis via combined anterior and posterior approaches in children / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cervicothoracic junction spinal tuberculosis (CJST) in children is uncommon, especially when accompanied by a huge abscess. However, its consequences can be severe. Because of the special anatomic location of the cervicothoracic junction, surgical treatment is difficult and rarely reported. The aim of this clinical study was to assess the effectiveness of combined anterior and posterior approaches for focal debridement, decompression, allografting and anterior instrumentation in the treatment of CJST in children.</p><p><b>METHODS</b>Ten pediatric CJST patients underwent focal debridement and cord decompression through combined anterior and posterior approaches. Then an appropriate allograft and titanium plate were applied to reconstruct the spine. The patients were asked to wear head-neck-chest braces for six months and received regular anti-tubercular drugs therapy for 12 months.</p><p><b>RESULTS</b>The patients were followed-up for an average of 26 months (range, 15-32 months). There was no recurrent tuberculous infection. The bone grafts incorporated well and the instrumentation was stable. Cervical and thoracic kyphosis was successfully corrected from 40° (range, 30-52°) before the operation to 18° (range, 12-26°) post-operation. Neurological function was improved in all patients.</p><p><b>CONCLUSIONS</b>Combined anterior and posterior approaches for focal debridement, decompression, bone allografting and anterior instrumentation provided an effective means of treatment in children of CJST with a huge abscess in the posterior part of the vertebral body.</p>