Efficacy and safety of human chorionic gonadotropin combined with human menopausal gonadotropin and a gonadotropin-releasing hormone pump for male adolescents with congenital hypogonadotropic hypogonadism / 中华医学杂志(英文版)

BACKGROUND@#Compared to adult studies, studies which involve the treatment of pediatric congenital hypogonadotropic hypogonadism (CHH) are limited and no universal treatment regimen is available. The aim of this study was to evaluate the feasibility of human chorionic gonadotropin (hCG)/human menopausal gonadotropin (hMG) therapy for treating male adolescents with CHH.@*METHODS@#Male adolescent CHH patients were treated with hCG/hMG (n = 20) or a gonadotropin-releasing hormone (GnRH) pump (n = 21). The treatment was divided into a study phase (0-3 months) and a follow-up phase (3-12 months). The testicular volume (TV), penile length (PL), penis diameter (PD), and sex hormone levels were compared between the two groups. The TV and other indicators between the groups were analyzed using a t-test (equal variance) or a rank sum test (unequal variance).@*RESULTS@#Before treatment, there was no statistical difference between the two groups in terms of the biochemistry, hormones, and other demographic indicators. After 3 months of treatment, the TV of the hCG/hMG and GnRH groups increased to 5.1 ± 2.3 mL and 4.1 ± 1.8 mL, respectively; however, the difference was not statistically significant (P > 0.05, t = 1.394). The PL reached 6.9 ± 1.8 cm and 5.1 ± 1.6 cm (P  0.05, t = 0.314). After 9 to 12 months of treatment, the T level was higher in the hCG/hMG group. Other parameters did not exhibit a statistical difference.@*CONCLUSIONS@#The hCG/hMG regimen is feasible and effective for treating male adolescents with CHH. The initial 3 months of treatment may be a window to optimally observe the strongest effects of therapy. Furthermore, results from the extended time-period showed positive outcomes at the 1-year mark; however, the long-term effectiveness, strengths, and weaknesses of the hCG/hMG regimen require further research.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT02880280; https://clinicaltrials.gov/ct2/show/NCT02880280.

Cosinor-rhythmometry for 24-h urinary sodium, potassium, creatinine excretion in the Chinese adult population / 中华医学杂志(英文版)

BACKGROUND@#The low accuracy of equations predicting 24-h urinary sodium excretion using a single spot urine sample contributed to the misclassification of individual sodium intake levels. The application of single spot urine sample is limited by a lack of representativity of urinary sodium excretion, possibly due to the circadian rhythm in urinary excretion. This study aimed to explore the circadian rhythm, characteristics, and parameters in a healthy young adult Chinese population as a theoretical foundation for developing new approaches.@*METHODS@#Eighty-five participants (mean age 32.4 years) completed the 24-h urine collection by successively collecting each of the single-voided specimens within 24 h. The concentrations of the urinary sodium, potassium, and creatinine for each voided specimen were measured. Cosinor analysis was applied to explore the circadian rhythm of the urinary sodium, potassium, and creatinine excretion. The excretion per hour was computed for analyzing the change over time with repeated-measures analysis of variance and a cubic spline model.@*RESULTS@#The metabolism of urinary sodium, potassium, and creatinine showed different patterns of circadian rhythm, although the urinary sodium excretion showed non-significant parameters in the cosinor model. A significant circadian rhythm of urinary creatinine excretion was observed, while the circadian rhythm of sodium was less significant than that of potassium. The circadian rhythm of urinary sodium and creatinine excretion showed synchronization to some extent, which had a nocturnal peak and fell to the lowest around noon to afternoon. In contrast, the peak of potassium was observed in the morning and dropped to the lowest point in the evening. The hourly urinary excretion followed a similar circadian rhythm.@*CONCLUSION@#It is necessary to consider the circadian rhythm of urinary sodium, potassium, and creatinine excretion in adults while exploring the estimation model for 24-h urinary sodium excretion using spot urine.

Age-dependent changes of total and differential white blood cell counts in children / 中华医学杂志(英文版)

BACKGROUND@#Total and differential white blood cell counts are important for the diagnostic evaluation of suspected diseases. To facilitate the interpretation of total and differential white blood cell counts in pediatric patients, the present study investigated age-dependent changes in total and differential white blood cell counts in healthy reference children.@*METHODS@#Data were obtained from the Pediatric Reference Intervals in China study (PRINCE), which aims to establish and verify pediatric reference intervals for Chinese children based on a nationwide multicenter cross-sectional study from January 2017 to December 2018. Quantile curves were calculated using the generalized additive models for location, shape, and scale method. The 2.5th, 50th, and 97.5th quantile curves were calculated for both total and differential white blood counts. Percents of stacked area charts were used to demonstrate the proportions of differential white blood cells. All statistical analyses were performed using R software.@*RESULTS@#Both 50th and 97.5th quantiles of total white blood cell count and monocyte count were highest at birth, then rapidly decreased in the first 6 months of life; relatively slow reduction continued until 2 years of age. The lymphocyte count was low during infancy and increased to its highest level at 6 months of age; it then exhibited moderate and continuous reduction until approximately 9 years of age. The pattern of neutrophil count changed with age in a manner opposite to that of lymphocyte count. Besides, there were two inter-sections of lymphocyte count and neutrophil count during infancy and at approximately 5 years of age, based on locally weighted regression (LOESS) analysis. There were no apparent age-related changes in eosinophil or basophil counts.@*CONCLUSION@#These data regarding age-related changes in total and differential white blood cell counts can be used to assess the health of pediatric patients and guide clinical decisions.

The optimal cut-off value of waist-to-height ratio for detecting severe central obesity and low body weight adult Chinese population / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the optimal cut-off values of waist-to-height ratio (WHtR) for detecting the severe central obesity and low body weight in adult Chinese population.</p><p><b>METHODS</b>A total of 30 630 participants aged 35-59 years from different areas in mainland China were surveyed for cardiovascular diseases risk factors in two independent cross-sectional studies that carried out in 1992-1994 and 1998, respectively. Indices, such as sensitivity, specificity for hypertension, abnormal glucose, high serum total cholesterol, low serum high density lipoprotein cholesterol and clustering of risk factors (number ≥ 2) were calculated to evaluate the efficacy individual cut-off point of WHtR. The cut-off point value for obvious central obesity was fixed on the point whose specificity of the point was gathered more than 90%. And the cut-off point value to indicate low weight was determined by the percentile distribution of WHtR, at which the 5th percentile of point, both in male and female population. Based on the principle of convenient and practical for use, the optimal cut-off point values of WHtR for low weight and obvious central obesity were determined.</p><p><b>RESULTS</b>The cut-off values of WHtR to detect severe central obesity were 0.54 and 0.57 for men and women, respectively. Additionally, the cut-off points of WHtR for each of the 4 cardiovascular risk factors to evaluate the severity separately ranged from 0.54 to 0.55 in male, and ranged from 0.57 to 0.58 in female. The 5th percentile of WHtR, which was the point value of WHtR to indicate low body weight, was 0.40 in both male and female population.</p><p><b>CONCLUSION</b>Our data suggest that the optimal cut-off value of WHtR for defining severe central obesity and low body weight should be 0.57 and 0.40, respectively.</p>

Contrast and efficacy of waist circumference and waist-to-height ratio in predicting central obesity / 中华流行病学杂志

Objective To study the efficacy of waist circumference (WC) and waist-to-height ratio (WHtR) in predicting central obesity among the Chinese adult population.Methods A total of 30 630 participants aged 35-59 from different areas in mainland China were surveyed for the risk factors of cardiovascular diseases (CVD) in two independent cross-sectional studies that were carried out in 1992-1994 and 1998,respectively.In subgroups with different heights,consistency analysis for central obesity diagnosed by WHtR (≥0.50) and WC (≥85 cm for men,≥80 cm for women) were conducted.Sensitivity and specificity for predicting the clustering of risk factors (number ≥2) would include hypertension,abnormal glucose,high serum total cholesterol and low serum high density lipoprotein cholesterol and they were also calculated to evaluate the efficacy of prediction,with the two indices in the different height subgroups as well.Results The consistency of diagnosis on central obesity by WC and WHtR was good in the whole population (the Kappa value was 0.805 in men and 0.816 in women),but poor (all Kappa values ≤0.6) for those with tall (men's height ≥ 180 cm and women' s height ≥ 170 cm) or with short statures (men' s height ＜ 160 cm,and women's height ＜ 150 cm).Sensitivity in the shorty subgroups and specificity in the tall subgroups appeared poor in both genders,by using WC criteria to predict the clustering of risk factors.However,the sensitivity (ranged from 56.1％ to 64.1％ for men and 64.7％ to 73.2％ for women) and specificity (from 70.0％ to 74.5％ for men,59.2％ to 75.9％ for women) seemed good and stable in all the subgroups as well as in both genders by using the WHtR criteria.Conclusion WC and WHtR could both be applied in predicting the clustering of risk factors of CVD and in evaluating the central obesity in the whole population.With satisfactory efficacy,WHtR seemed to be better than WC in the prediction of central obesity,both in men or women with tall or short statures.

Clinical characteristics of and related treatments on 1004 patients with acute myocardial infarction from March 2004 to March 2007 / 中华流行病学杂志

Objective To study the change of baseline clinical characteristics including prehospital delayed time(PDT),modes of transportation and treatment for patients with acute myocardial infarction (AMI)in the past 3 years.Methods We used the same questionnaire to accurately collect and retrospectively analyze the data regarding clinical characteristics of all 1004 patients with AMI,who consecutively presented to the Emergency Unit and Emergency Intensive Care Unit(EICU)of Beijing Anzhen Hospital from March 12th 2004 to March 11th 2007.According to the time of onset of the disease,all patients were divided into 3 groups:group A(from Mar.12th 2004 tO Mar.11th 2005),group B(Mar.12th 2005 to Mar 11th 2006)and group C(Mar.12th 2006 to Mar.11th 2007).Clinieal characteristics and treatment were compared.Results There were significant differences in the number of patients with histories of stroke,coronary artery disease or smoking among the three groups(P＜0.05).No obvious differences in the median of PDT were found among the three groups(P＞0.05).More patients accepted reperfusive therapy in group C compared to group A(P＜0.05),although the mortality rates of AMI among these 3 years were similar.Conclusion Though more people started to have accepted reperfusion therapy,mortality failed to show an obvious decrease.Subject as how tO shorten the PDT called for further study.

Prehospital delay time and mortality in patients with acute myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To determine the relationship between prehospital delay time (PDT) and other associated factors on mortality in patients with acute myocardial infarction.</p><p><b>METHODS</b>We retrospectively analyzed factors associated with mortality in 580 patients with acute myocardial infarction presented to the Emergency Ward and Emergency Intensive Care Unit (EICU) of Beijing Anzhen Hospital from March 2004 to March 2006 (428 males, average age: 60.7 +/- 12.9 years). The patients were divided to 3 groups according various therapies: thrombolysis, PCI/CABG or symptomatic medication groups.</p><p><b>RESULTS</b>The median PDT was 130 min. Thrombolysis, PCI/CABG and medical therapy were applied in 122 (21.0%), 266 (45.9%) and 192 (33.1%) patients respectively. PDT was significantly longer in patients receiving medical therapy (290.9 min +/- 3.4 min) compared to patients treated with thrombolysis (104.5 min +/- 2.3 min) and PCI/CABG (119.1 min +/- 2.3 min, all P < 0.05). The overall mortality rate was 5.3% (31/580) and all occurred in patients with medical therapy group mostly due to irreversible ventricular fibrillations. Old age (OR = 1.047, P = 0.004), diabetes mellitus (OR = 2.159, P = 0.02) and PDT (OR = 2.159, P = 0.023) are independent predict factors for mortality.</p><p><b>CONCLUSION</b>Coronary Revascularisation by thrombolysis, PCI or CABG early post acute myocardial infarction is the key issue for reducing mortality in patients with acute myocardial infarction.</p>