Benzodiazepines in complex biological matrices:Recent updates on pretreatment and detection methods / 药物分析学报

Benzodiazepines(BDZs)are used in clinics for anxiolysis,anticonvulsants,sedative hypnosis,and muscle relaxation.They have high consumptions worldwide because of their easy availability and potential addiction.They are often used for suicide or criminal practices such as abduction and drug-facilitated sexual assault.The pharmacological effects of using small doses of BDZs and their detections from complex biological matrices are challenging.Efficient pretreatment methods followed by accurate and sensitive detections are necessary.Herein,pretreatment methods for the extraction,enrichment,and preconcentration of BDZs as well as the strategies for their screening,identification,and quantitation developed in the past five years have been reviewed.Moreover,recent advances in various methods are summarized.Characteristics and advantages of each method are encompassed.Future directions of the pretreatment and detection methods for BDZs are also reviewed.

Effects of long working hours exposure on occupational stress and depression symptoms in couriers in Zhejiang Province / 中华劳动卫生职业病杂志

Objective: To understand the current situation of long working hours exposure of couriers in Zhejiang Province, and to analyze the influence of long working hours exposure levels on their occupational stress and depression symptoms, and provide a basis for promoting the physical and mental health of couriers. Methods: From September to December 2021 , 1159 couriers from Zhejiang Express Transport Companies were selected as respondents by cluster sampling, and their basic information were collected. The occupational stress and depression symptoms of the couriers were assessed using the Core Occupational Stress Scale (COSS) and the Patient Health Questionnaire-9 (PHQ-9). The effects of long work hours (>48 h per week) on the occupational stress and depression symptoms of the couriers were analyzed. Results: The average age of 1159 courier in Zhejiang Province was (33.24±8.42) years, the average weekly working hours were (63.21±18.77) h, and 75.15% (871/1159) were long-term workers. The detection rates of occupational stress and depression symptoms in courier were 32.44% (376/1159) and 32.53% (377/1159), respectively. There were significant differences in the detection rates of occupational stress and depression symptoms among couriers with different ages, educational background, marital status, monthly average income, length of service, position or post, shift status, drinking status, and average weekly working hours (P <0.05). The adjusted logistic regression analysis showed that, after adjusting for the influence of confounding factors such as age, educational background, marital status, monthly average income, length of service, position or post, shift status and drinking status, compared with the weekly working hours ≤48 h, weekly working hours of 63-77 h, 78-92 h, ≥93 h were the risk factors for occupational stress (OR=1.547, 95%CI: 1.019-2.350; OR=1.886, 95%CI: 1.184-3.006; OR=2.338, 95%CI: 1.188-4.062) and depression symptoms (OR=1.897, 95%CI: 1.258-2.860; OR=2.041, 95%CI: 1.290-3.230; OR=4.978, 95%CI: 2.551-9.715) of couriers (P<0.05) . Conclusion: Long working hours could increase the risk of occupational stress and depression symptoms among couriers. It is necessary to arrange working hours reasonably to reduce the occurrence of occupational stress and depression symptoms of couriers.

Clinical analysis of 11 cases of pregnancy with aortic dissection / 中华妇产科杂志

Objective: To investigate the treatment and maternal and fetal outcomes of pregnant women with aortic dissection (AD). Methods: The clinical data of 11 pregnant women with AD treated at the First Affiliated Hospital of Air Force Military Medical University from January 1st, 2011 to August 1st, 2022 were collected, and their clinical characteristics, treatment plans and maternal and fetal outcomes were analyzed retrospectively. Results: (1) Clinical characteristics: the age of onset of 11 pregnant women with AD was (30±5) years old, and the week of pregnancy of onset was (31.4±8.0) weeks. Clinical manifestations: the main symptoms were sudden onset of chest and back pain or low back pain. Type of AD: 8 cases of Stanford type A, and 3 cases of type B. The aortic width was (42±11) mm. Diagnostic methods: the diagnosis of AD was confirmed by transthoracic echocardiography (TTE), computed tomography angiography (CTA) or enhanced CT examination, among which 4 cases were confirmed by CTA examination, 4 cases by TTE examination, and 3 cases by enhanced CT examination. Laboratory results: white blood cell count was (15.4±8.7) ×109/L, neutrophil count was (13.5±8.5) ×109/L, the median D-dimer level was 2.7 mg/L (2.1-9.2 mg/L), and the median fibrin degradation products level was 12.0 mg/L (5.4-36.1 mg/L). (2) Treatments: all 11 patients were admitted to hospital in emergency. Before operation, the departments of cardiac surgery, obstetrics, pediatrics and anesthesiology cooperated to develop individualized treatment plan. Aortic surgery was performed in 11 pregnant women with AD. In 6 of them, pregnancy termination was performed at the same time as aortic surgery, and aortic surgery was performed after cesarean section. Four cases of pregnancy termination and aortic operation were performed by stages, including aortic operation after cesarean section in 2 cases, and cesarean section after aortic operation in 2 cases. One case (12+6 weeks of gestation) had spontaneous abortion on the day after aortic surgery. The gestational age of the 11 patients on pregnancy termination was (32.9±7.4) weeks. Aorta surgical methods: 7 patients received under extracorporeal circulation ascending aorta replacement ± aortic valve replacement ± coronary artery transplantation (or coronary artery bypass transplantation)± left and right coronary Cabrol + total arch replacement (or aortic arch replacement)± stent implantation, 1 patient received under extracorporeal circulation aortic root replacement, and 3 patients underwent aortic endoluminal isolation. (3) Maternal and fetal outcomes: among the 11 pregnant women with AD, 9 (9/11) survived, 2 (2/11) died with lower limb ischemia before the onset of the disease. A total of 10 newborns were born in 9 pregnant women after delivery (1 of them was twins), and the 2 cases were spontaneous abortion after aortic surgery in the first trimester (12+6 weeks) and fetal death after hysterotomy in the second trimester (26+3 weeks), respectively. Among the 10 surviving neonates, 3 were full-term infants and 7 were premature infants. The birth weight of newborn was (2 651±784) g. Respiratory distress syndrome was found in 6 cases. The newborns were followed up for (5.6±3.6) years after birth, and the infants developed well during the follow-up period. Conclusions: Pregnancy complicated with AD is dangerous, and chest and back pain is the main clinical manifestation of this disease. With early identification and selection of appropriate diagnostic methods, multidisciplinary diagnosis and treatment, mother and children could obtain good outcomes.

Bear bile powder attenuates senecionine-induced hepatic sinusoidal obstruction syndrome in mice / 中国天然药物

Hepatic sinusoidal obstruction syndrome (HSOS) via exposure to pyrrolizidine alkaloids (PAs) is with high mortality and there is no effective treatment in clinics. Bear bile powder (BBP) is a famous traditional animal drug for curing a variety of hepatobiliary diseases such as cholestasis, inflammation, and fibrosis. Here, we aim to evaluate the protective effect of BBP against HSOS induced by senecionine, a highly hepatotoxic PA compound. Our results showed that BBP treatment protected mice from senecionine-induced HSOS dose-dependently, which was evident by improved liver histology including reduced infiltration of inflammatory cells and collagen positive cells, alleviated intrahepatic hemorrhage and hepatic sinusoidal endothelial cells, as well as decreased conventional serum liver function indicators. In addition, BBP treatment lowered matrix metalloproteinase 9 and pyrrole-protein adducts, two well-known markers positively associated with the severity of PA-induced HSOS. Further investigation showed that BBP treatment prevents the development of liver fibrosis by decreasing transforming growth factor beta and downstream fibrotic molecules. BBP treatment also alleviated senecionine-induced liver inflammation and lowered the pro-inflammatory cytokines, in which tauroursodeoxycholic acid played an important role. What's more, BBP treatment also decreased the accumulation of hydrophobic bile acids, such as cholic acid, taurocholic acid, glycocholic acid, as well. We concluded that BBP attenuates senecionine-induced HSOS in mice by repairing the bile acids homeostasis, preventing liver fibrosis, and alleviating liver inflammation. Our present study helps to pave the way to therapeutic approaches of the treatment of PA-induced liver injury in clinics.

Effect of Danggui Shaoyaosan on TLR4/MyD88/JNK Signaling Pathway on Rats with Nonalcoholic Fatty Liver Disease / 中国实验方剂学杂志

Objective:To explore<italic> </italic>the efficacy and mechanism of Danggui Shaoyaosan on rats of nonalcoholic fatty liver disease （NAFLD）. Method:Sixrty SPF SD male rats were randomly divided into normal group， model group，essentiale （0.144 g·kg^-1） and low， middle and high-dose of Danggui Shaoyaosan groups （2.44， 4.88， 9.76 g·kg^-1）. High fat diet were fed to bulid the NAFLD model， and each treatment group was given corresponding drugs at the same time. After 8 weeks， the serum and liver tissue were collected to detect the contents or activities of total cholesterol （TC）， triglyceride （TG）， alanine aminotransferase （ALT）， aspartic acid aminotransferase （AST）， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>） and interleukin-10 （IL-10） in serum， the contents of TC， TG and free fatty acid （FFA） in liver tissue， Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR） and Western blot were used to observe the gene and protein expressions of Toll-like receptor 4 （TLR4）， myeloid different factory 88 （MyD88） and c-Jun n-terminal kinase （JNK） and the protein expression of phosphorylation JNK（p-JNK） in liver tissue. Hematoxylin-eosin （HE） staining and Oil red staining to observe the pathological morphological changes of liver. Result:Compared with control group， the contents or activities of TC， TG， ALT， AST and TNF-<italic>α</italic> in serum， the contents of TC， TG and FFA in liver and the gene and protein expressions of TLR4， MyD88， JNK， and the protein expression of p-JNK in liver tissue of model group were distinctly increased （<italic>P</italic><0.01）， the content of IL-10 was significantly decreased （<italic>P</italic><0.01）. Compared with model group， the contents or activities of TC， TG， ALT， AST and TNF-<italic>α</italic> in serum， the contents of TC， TG and FFA in liver and the mRNA and protein expressions of TLR4， MyD88 and JNK， and the protein expression of p-JNK in liver tissue of Danggui Shaoyaosan groups were significantly reduced （<italic>P</italic><0.05，<italic>P</italic><0.01）， the content of IL-10 in serum of Danggui Shaoyaosan groups was distinctly increased（<italic>P</italic><0.05，<italic>P</italic><0.01）， HE staining and Oil red staining show that the degree of liver steatosis was alleviated obviously by Danggui Shaoyaosan. Conclusion:Danggui Shaoyaosan has a better treatment on NAFLD by inhibiting TLR4/MyD88/JNK pathway and alleviating the inflammation response.

Feasibility and safety of right ventricular endomyocardial biopsy via the right internal jugular vein approach / 中华心血管病杂志

Objective: To evaluate the feasibility and safety of right ventricular endomyocardial biopsy (EMB) via the right internal jugular vein approach. Methods: It was a retrospective and descriptive study. A total of 272 patients, who underwent right ventricular EMB from December 2014 to June 2020 in Fuwai Hospital and Peking Union Medical College Hospital were enrolled. The preliminary diagnosis included suspected myocarditis, myocardiopathy, unexplained heart failure etc after exclusion of coronary heart disease. Clinical characteristics including age, sex, height, weight, NYHA functional class, NT-proBNP, chest radiography, echocardiography, and hemodynamics parameters were collected at baseline. EMB was performed via right internal jugular vein approach under the biplane fluoroscopic guidance. Success rate was calculated in this study. Complications related to operation were recorded according the following definitions. Major complications included death, urgent cardiac surgery, advanced cardiac life support, pericardiocentesis in cardiac tamponade, permanent complete atrioventricular block requiring permanent pacing etc. Minor complications included pericardial effusion without pericardiocentesis, temporary (lasting less than 24 hours) or permanent right bundle-branch block, temporary Mobitz type Ⅱ atrioventricular block (AV block) with AV conduction 2∶1 requiring medical treatment with atropine, or additive temporary pacing, non-sustained ventricular tachycardia with long runs of more than 10 ventricular complexes, and an episode of atrial fibrillation lasting less than 12 hours or cardioversion of atrial fibrillation. Other complications included tricuspid anterior chorda rupture and new onset tricuspid regurgitation after EMB. Results: In this study, right ventricular EMB were performed successfully in 270 patients, the total success rate was 99.3% (270/272), and EMB were failed in 2 (0.7%) patients. Age of the enrolled patients was (42.7±16.9) years, and there were 164 (60.3%) males. Major complication including cardiac tamponade requiring pericardiocentesis occurred in 2 (0.7%) patients. Minor complications such as small amount pericardial effusion occurred in 18 (6.6%) patients, tricuspid anterior chorda rupture occurred in 1 (0.4%) patient. No patient died, or requiring permanent pacing, or requiring emergency cardiac surgery. The complication rate was 9.3% (13/140), 7.8% (7/90), and 2.4% (1/42) in operators with 1, 2, and 3 years' experience. Conclusions: EMB via the right jugular vein approach under fluoroscopic guidance is a simple, safe and feasible procedure. The complication rates decrease significantly with increasing operator experience.

Effect of Plantaginis Semen on Inflammatory Cytokines and mRNA and Protein Expressions of AQP4 in Colon Tissue of Diarrhea Rats / 中国实验方剂学杂志

Objective:To observe Plantaginis Semen's mechanism in treating diarrhea by observing the effect on inflammatory factors in serum and mRNA and protein expressions of aquaporin4 (AQP4) in colon tissue of diarrhea rats. Method:Senne Folium was orally administered to duplicate diarrhea rats. Sixty male SD rats were randomly divided into normal group, model group, hydrochlorothiazide group (9 mg·kg-1), and low, middle, and high-dose Plantaginis Semen groups (0.95, 1.9, 3.8 g·kg-1). Senne Folium (20 mL·kg-1) was intragastrically administered in 5 groups in the morning, except for normal group that was orally given the same dose of distilled water. In the afternoon, each treatment group was orally given the corresponding drugs, while normal group and model group were orally given the same dose of distilled water. The loose stool rate, average degree of loose stool, and diarrhea index were compared according to fecal traits and stool times after 14 days of treatment. The serum and colon tissue were collected to detect the contents of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) in serum. Hematoxylin-eosin (HE) staining was used to observe the pathological morphological changes of colon tissue, and quantiative Real-time fluorescent quantitative polymerase chain reaction (Real-time PCR) and Western blot were used to detect the mRNA and protein expressions of AQP4 in colon tissue. Result:In the model group, the loose stool rate, average degree of loose stool, and diarrhea index were significantly increased (P<0.01), apoptosis and necrosis were observed in the epidermal cells of colonic mucosa, telangiectasia and congestion in lamina propria were obvious, and a few neutrophils were infiltrated, and the contents of TNF-α, IL-6 and CRP in serum increased (P<0.05, P<0.01), the mRNA and protein expressions of AQP4 significantly decreased (P<0.01). Compared with the model group, the loose stool rate, average degree of loose stool, and diarrhea index were significantly decreased in low, middle, and high-dose Plantaginis Semen groups (P<0.01), the apoptosis and necrosis of epidermal cells, telangiectasia and hyperemia and neutrophil infiltration in colonic mucosa were obviously improved, and the contents of TNF-α and CRP in serum significantly decreased (P<0.05, P<0.01), the mRNA and protein expressions of AQP4 increased （P<0.05, P<0.01）. Conclusion:Plantaginis Semen has a better antidiarrheal effect, and its mechanism may be related to inhibition of inflammatory reaction, repair of pathological damage of colonic mucosa, up-regulation of AQP4 expression and promotion of water and fluid metabolism.

Optimization of Technology of Moslae Herba Processed with Ginger Juice and Analysis of Its Volatile Components by HS-GC-MS / 中国实验方剂学杂志

Objective:To optimize the processing technology of Moslae Herba processed with ginger juice, and to explore the changes of its volatile components in processing process. Method:The volatile components in Moslae Herba, ginger juice and Moslae Herba processed with ginger juice were extracted by steam distillation. Volatile components in these products were analyzed by HS-GC-MS and identified by NIST 11 standard mass spectra library. Gas chromatographic conditions were as following:HP-5MS elastic quartz capillary column(0.25 mm×30 m, 0.25 μm), helium as the carrier gas, flow rate of 1.0 mL·min-1, injector temperature at 250℃, sample quantity of 0.2 μL, split ratio of 50:1, temperature program for initial temperature at 40℃, up to 60℃ with the heating rate at 5℃·min-1, keep 2 min, up to 160℃ with the heating rate at 5℃·min-1, keep 3 min, finally rise to 250℃ with the heating rate at 25℃·min-1, keep it for 2 min and finish, mass spectrometry conditions were as following:electron impact ionization(EI), electron collision energy of 70 eV, ion source temperature at 230℃, the interface temperature at 280℃, quadrupole temperature at 150℃, no delay of solvent, electronic multiplier voltage at 2.188 kV, taking full scan mode, scanning range of m/z 35-550.Taking frying time, solid-liquid ratio and moistening time as factors, orthogonal test was adopted to optimize the processing technology with the comprehensive score of relative contents of thymol and carvacrol, number of volatile components and extracting amount of volatile oil as index. Result:A total of 27 volatile components were detected in Moslae Herba. There were 81 volatile components in Zingiberis Rhizoma Recens. The processed products of orthogonal test(No. 1-9) had 31, 38, 29, 35, 38, 33, 34, 22 and 26 volatile components, respectively. Extracting amount of volatile oil was in the order of Moslae Herba processed with ginger juice > Zingiberis Rhizoma Recens > Moslae Herba. The best processing technology was as following:moistening Moslae Herba with equal volume of ginger juice for 6 h, stir-frying for 8 min. Conclusion:Processing has certain impact on the extracting amount of volatile oil in Moslae Herba and the types of volatile components. This optimized technology is stable and feasible, which can provide experimental data for the quality evaluation of processed products of Moslae Herba, and lay a foundation for clarifying its processing mechanism.

Comparison of Effect of Fine Powder and Ultrafine Powder of Dendrobium nobile Stem on Intestinal Transporters of Rats / 中国实验方剂学杂志

Objective:To compare the contents of alkaloids from fine and ultrafine powder of Dendrobium nobile stem in rat plasma,and investigate the effect of D. nobile stem with different particle sizes on gene expression of intestinal transporters. Method:Rats were randomly divided into the blank group,fine powder group of D. nobile stem(0.25 g·kg-1) and ultrafine powder group of D. nobile stem(0.25 g·kg-1).The rats were gavaged every 6 h for 5 days.The samples of rat plasma and small intestine were collected.The plasma samples were detected with UPLC-MS.The chromatography separation was performed on a Hypersil Gold C18 column(2.1 mm×150 mm,1.9 μm) with acetonitrile-0.1%formic acid solution as mobile phase for gradient elution.Electrospray ionization (ESI) was applied and operated in positive ion mode.The mRNA expression of multidrug resistance protein 1(MDR1),oligopeptide transporter protein 1(PEPT1),organic cation transporter protein 2(OCT2),breast cancer resistance protein 1(BCRP1),monocarboxylate transport protein 1(MCT1) and multidrug resistance related protein 2(MRP2) in small intestine were quantified by real time fluorescence quantitative polymerase chain reaction. Result:After intragastric administration of fine and ultrafine powder of D. nobile stem,dendrobine,mubironine B and dendramine could be detected in rat plasma.The contents of dendrobine and dendramine in the ultrafine powder group were significantly higher than that in the fine powder group(PD. nobile stem(PPD. nobile stem(PConclusion:Compared with the fine powder group of D. nobile stem,the plasma concentrations of dendrobine and dendramine in the ultrafine powder group are significantly increased,it may be related to the intestinal transporters of MDR1 and BCRP1.These results can provide experimental basis for selecting particle size of D. nobile stem.

Effect of Jiedu Hugan Decoction on Protein Expression of MIP-2 and MIP-1β in Rats with Drug-induced Liver Injury / 中国实验方剂学杂志

Objective: To observe the effect and mechanism of Jiedu Hugan decoction on drug-induced liver injury in rats by detecting serum liver function, serum biomarkers, inflammatory factors, macrophage inflammatory protein-2 (MIP-2) and macrophage inflammatory protein-1β (MIP-1β). Method: The rat model of drug-induced liver injury was induced by acetaminophen (1 g·kg-1) orally once daily for 30 days. The sixty male adult Wistar rats were divided into five groups, control group,model group,administered silybin group(44.1 mg·kg-1), Jiedu Hugan decoction high, medium and low dose groups (63,31.5,15.75 g·kg-1), normal group and model group were given normal saline gavage, and the other groups were given corresponding liquid gavage for 30 days. After the experiment, the abdominal aorta separation take blood serum aspartate amino transferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), direct bilirubin (DBIL), malate dehydrogenase (MDH), enzyme for oxygen p1 (PON1) and glutamate dehydrogenase (GLDH), arginine (ARG), purine nucleotide phosphorylase (PNP), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) content. Pathological morphological changes of liver tissues were observed by hematoxylin-eosin (HE) staining. The protein expression of MIP-1β was observed by immunohistochemistry. The protein expression of MIP-2 was observed by single fluorescence immunohistochemistry, and the contents of TNF-α and IL-6 in liver homogenate were detected by enzyme-linked immunosorbent assay (ELISA). Result: Compared with normal group, levels of AST, ALT, DBIL, PON1, ARG, GLDH, MDH, PNP and TNF-α in model group were significantly increased (PPPPα in liver injury rats(PPβ protein expression, detoxification protect liver soup effect of the optimal dose group, the pathological morphology of liver cell dosage group were with different degree of protection. Conclusion: The effect of Jiedu Hugan decoction in medium dose group is better, and its mechanism may affect the chemotaxis of neutrophils induced by MIP-2 and MIP-1β by reducing the content of TNF-α, thus inhibiting the release of inflammatory factors and preventing inflammation.

A cross-sectional survey of the relationship between eating habits and childhood obesity:based on a cohort study of school children in Minhang District of Shanghai / 复旦学报（医学版）

Objective To investigate the relationship between eating habits and childhood obesity by the method of cross-sectional survey in order to provide scientific basis for the prevention and intervention of childhood obesity.Methods We enrolled first-year students in Minhang District of Shanghai who participated in physical examination in 2014.Information was obtained from standardized face to face interviews of their parents or guardians with detailed questions on demographic characteristics,dietary habit,food preference,physical activity,sleep time and so on.Odds ratio (OR) and 95％ CI were calculated by unconditional Logistic regression models.Results Finally,5 752 students were enrolled in the study.The rate of obesity was 15.16％ (boys:18.35％;girls:11.83％) and the rate of over weight was 14.31％ (boys.:15.15％;girls:13.43％).Meat-based diet (OR=1.58,95％ CI:1.32-1.91),skipping breakfast (OR =1.87,95％ CI:1.01-3.46),eating too much caffeine-containing food (OR =1.66,95％ CI:1.09-2.51) and eating fast (OR:3.32-14.95) were associated with an increased risk of childhood obesity.Plant-based diet (OR =0.51,95％ CI:0.35-0.74) and choosy in food (OR:0.38-0.64) were associated with a decreased risk of childhood obesity.Besides,we found that children who preferred meat (OR =2.11,95％CI:1.42-3.14) and cured food (OR =1.42,95％ CI:1.05-1.92) had a higher risk of obesity.Conclusions Our results support the association between eating habits and childhood obesity.

Prevalence and incidence of anemia among school students aged 6-11 years old in Minhang District of Shanghai / 复旦学报（医学版）

Objective To analyze the epidemic features of anemia among students aged 6-11 years old in Minghang District,to provide basis for the control and prevention strategies of anemia among school students.Methods Surveillance on hemoglobin concentration was conducted among 42 872 students aged from 6 to 11 years old between 2012 and 2015.All data analyses were completed by SPSS 18.0 statistical software.Results The prevalence rate of anemia among school students 6-11 years old was 5.05％ (95％CI:4.84-5.26).The prevalence rate of anemia among girls was 5.28％,which was significantly higher than that 4.84％ among boys (x2 =4.24,P =0.037).Six-year-old boys and girls were most susceptible to anemia.Compared to students in Hope Schools,public school students are more vulnerable to anemia (boys:OR =2.37,95 ％ CI:2.03-2.76;girls:OR =2.08,95 ％ CI:1.74 -2.49).Overweight and obese students had a lower risk of anemia than average students (boys:OR =0.65,95 ％ CI:0.55-0.76;girls:OR =0.75,95 ％ CI:0.61-0.92).The three-year cumulative incidence of anemia was 12.80％ (95 ％CI:12.49-13.12).The cumulative incidence among girls was 14.52％,which was significantly higher than that of 11.28％ among boys (x2 =100.26,P＜0.001).Six-year-old boys have the highest three-year cumulative risk among all students,while 10-11-year-old girls have the highest three-year cumulative incidence.The risk of anemia in Hope School was found highest in all schools (boys:RR =1.93,95％CI:1.72-2.16;girls:RR =1.20,95 ％CI:1.04-1.39).Overweight and obesity were considered protective factors to anemia (boys:RR =0.75,95％CI:0.67-0.84;girls:RR =0.77,95％CI:0.68-0.88).The primary and recurrent detection rates of anemia were 14.58％ and 2.54％.The anemia among students was mainly detected during the first examination despite the differences in ages,schools and nutrition conditions (P ＜ 0.05).Conclusions The prevalence of anemia among primary school students in Minhang District is at a mild level.Control measures should be adopted,including monitoring of hemoglobin in all school children and adolescents,taking individual intervention measures based on results,promoting the health education for adolescent girls and parents of school children,and paying special attention to Hope School and students with recurrent and continuous anemia.

Research of malnutrition epidemiologic trend among students aged 6-18 years from 2010 to 2016 in Minhang District of Shanghai / 复旦学报（医学版）

Objective To analyze malnutrition epidemiologic trend among students aged 6-18 years from 2010 to 2016 in Minhang district of Shanghai,and to provide reference for malnutrition prevention and treatment.Methods Physical examination data from healthy monitoring schools in Minhang District from 2010 to 2016 were used to screened out the malnutrition of students aged 6-18 years via National standard 2014 and analyzed the different type of malnutrition in different population.Results During the period of 2010 to 2016,malnutrition rate of students demonstrated a fluctuated trend.Malnutrition rate in 2010 was 4.0％ and 4.4％ in 2016.The major type of malnutrition is wasting with a proportion more than 88％ during these years.Rate of wasting increased from 3.5％ to 7.8％ in boys aged 13-18 years old and from 1.3％ to 3.9％ in girls aged 13-18 years old.Conclusions The malnutrition of students in Minhang District is under control,while the screening rate of wasting increased in students aged 13-18 years old.Intensified intervention of prevention and treatment should be administrated and integrated with obesity control in Minhang District of Shanghai.

A cross-sectional survey of the relationship between eating habits and childhood obesity:based on a cohort study of school children in Minhang District of Shanghai / 复旦学报（医学版）

Objective To investigate the relationship between eating habits and childhood obesity by the method of cross-sectional survey in order to provide scientific basis for the prevention and intervention of childhood obesity.Methods We enrolled first-year students in Minhang District of Shanghai who participated in physical examination in 2014.Information was obtained from standardized face to face interviews of their parents or guardians with detailed questions on demographic characteristics,dietary habit,food preference,physical activity,sleep time and so on.Odds ratio (OR) and 95％ CI were calculated by unconditional Logistic regression models.Results Finally,5 752 students were enrolled in the study.The rate of obesity was 15.16％ (boys:18.35％;girls:11.83％) and the rate of over weight was 14.31％ (boys.:15.15％;girls:13.43％).Meat-based diet (OR=1.58,95％ CI:1.32-1.91),skipping breakfast (OR =1.87,95％ CI:1.01-3.46),eating too much caffeine-containing food (OR =1.66,95％ CI:1.09-2.51) and eating fast (OR:3.32-14.95) were associated with an increased risk of childhood obesity.Plant-based diet (OR =0.51,95％ CI:0.35-0.74) and choosy in food (OR:0.38-0.64) were associated with a decreased risk of childhood obesity.Besides,we found that children who preferred meat (OR =2.11,95％CI:1.42-3.14) and cured food (OR =1.42,95％ CI:1.05-1.92) had a higher risk of obesity.Conclusions Our results support the association between eating habits and childhood obesity.

Prevalence and incidence of anemia among school students aged 6-11 years old in Minhang District of Shanghai / 复旦学报（医学版）

Objective To analyze the epidemic features of anemia among students aged 6-11 years old in Minghang District,to provide basis for the control and prevention strategies of anemia among school students.Methods Surveillance on hemoglobin concentration was conducted among 42 872 students aged from 6 to 11 years old between 2012 and 2015.All data analyses were completed by SPSS 18.0 statistical software.Results The prevalence rate of anemia among school students 6-11 years old was 5.05％ (95％CI:4.84-5.26).The prevalence rate of anemia among girls was 5.28％,which was significantly higher than that 4.84％ among boys (x2 =4.24,P =0.037).Six-year-old boys and girls were most susceptible to anemia.Compared to students in Hope Schools,public school students are more vulnerable to anemia (boys:OR =2.37,95 ％ CI:2.03-2.76;girls:OR =2.08,95 ％ CI:1.74 -2.49).Overweight and obese students had a lower risk of anemia than average students (boys:OR =0.65,95 ％ CI:0.55-0.76;girls:OR =0.75,95 ％ CI:0.61-0.92).The three-year cumulative incidence of anemia was 12.80％ (95 ％CI:12.49-13.12).The cumulative incidence among girls was 14.52％,which was significantly higher than that of 11.28％ among boys (x2 =100.26,P＜0.001).Six-year-old boys have the highest three-year cumulative risk among all students,while 10-11-year-old girls have the highest three-year cumulative incidence.The risk of anemia in Hope School was found highest in all schools (boys:RR =1.93,95％CI:1.72-2.16;girls:RR =1.20,95 ％CI:1.04-1.39).Overweight and obesity were considered protective factors to anemia (boys:RR =0.75,95％CI:0.67-0.84;girls:RR =0.77,95％CI:0.68-0.88).The primary and recurrent detection rates of anemia were 14.58％ and 2.54％.The anemia among students was mainly detected during the first examination despite the differences in ages,schools and nutrition conditions (P ＜ 0.05).Conclusions The prevalence of anemia among primary school students in Minhang District is at a mild level.Control measures should be adopted,including monitoring of hemoglobin in all school children and adolescents,taking individual intervention measures based on results,promoting the health education for adolescent girls and parents of school children,and paying special attention to Hope School and students with recurrent and continuous anemia.

Research of malnutrition epidemiologic trend among students aged 6-18 years from 2010 to 2016 in Minhang District of Shanghai / 复旦学报（医学版）

Objective To analyze malnutrition epidemiologic trend among students aged 6-18 years from 2010 to 2016 in Minhang district of Shanghai,and to provide reference for malnutrition prevention and treatment.Methods Physical examination data from healthy monitoring schools in Minhang District from 2010 to 2016 were used to screened out the malnutrition of students aged 6-18 years via National standard 2014 and analyzed the different type of malnutrition in different population.Results During the period of 2010 to 2016,malnutrition rate of students demonstrated a fluctuated trend.Malnutrition rate in 2010 was 4.0％ and 4.4％ in 2016.The major type of malnutrition is wasting with a proportion more than 88％ during these years.Rate of wasting increased from 3.5％ to 7.8％ in boys aged 13-18 years old and from 1.3％ to 3.9％ in girls aged 13-18 years old.Conclusions The malnutrition of students in Minhang District is under control,while the screening rate of wasting increased in students aged 13-18 years old.Intensified intervention of prevention and treatment should be administrated and integrated with obesity control in Minhang District of Shanghai.

Recent Developments in the Use of Intralesional Injections Keloid Treatment

Keloid scars are often considered aesthetically unattractive and frustrating problems that occur following injuries. They cause functional and cosmetic deformities, displeasure, itching, pain, and psychological stress and possibly affect joint movement. The combination of these factors ultimately results in a compromised quality of life and diminished functional performance. Various methods have been implemented to improve keloid scars using both surgical and non-surgical approaches. However, it has proven to be a challenge to identify a universal treatment that can deliver optimal results for all types of scars. Through a PubMed search, we explored most of the literature that is available about the intralesional injection treatment of hypertrophic scars and keloids and highlights both current (corticosteroid, 5-fluorouracil, bleomycin, interferon, cryotherapy and verapamil) and future treatments (interleukin-10 and botulinum toxin type A). The reference lists of retrieved articles were also analysed. Information was gathered about the mechanism of each injection treatment, its benefits and associated adverse reactions, and possible strategies to address adverse reactions to provide reliable guidelines for determining the optimal treatment for particular types of keloid scars. This article will benefit practitioners by outlining evidence-based treatment strategies using intralesional injections for patients with hypertrophic scars and keloids.

Adipofascial Anterolateral Thigh Flap Safety: Applications and Complications

BACKGROUND: A thinned anterolateral thigh (ALT) flap is often harvested to achieve optimal skin resurfacing. Several techniques have been described to thin an ALT flap including an adipocutaneous flap, an adipofascial flap and delayed debulking. METHODS: By systematically reviewing all of the available literature in English and French, the present manuscript attempts to identify the common surgical indications, complications and donor site morbidity of the adipofascial variant of the ALT flap. The studies were identified by performing a systematic search on Medline, Ovid, EMBASE, the Cochrane Database of Systematic Reviews, Current Contents, PubMed, Google, and Google Scholar. RESULTS: The study selection process was adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and 15 articles were identified using the study inclusion criteria. These articles were then reviewed for author name(s), year of publication, flap dimensions and thickness following defatting, perforator type, type of transfer, complications, thinning technique, number of cases with a particular area of application and donor site morbidity. CONCLUSIONS: The adipofascial variant of the ALT flap provides tissue to fill large defects and improve pliability. Its strong and safe blood supply permits adequate immediate or delayed debulking without vascular complications. The presence of the deep fascia makes it possible to prevent sagging by suspending and fixing the flap for functional reconstructive purposes (e.g., the intraoral cavity). Donor site morbidity is minimal, and thigh deformities can be reduced through immediate direct closure or liposuction and direct closure. A safe blood supply was confirmed by the rate of secondary flap debulking.

Identification of chemical constituents of volatile oil in coastal glehnia root / 第二军医大学学报

Objective To identify the chemical constituents of volatile oil from the Chinese traditional medicine coastal glehnia root and to compare the differences between coastal glehnia root of different locations. Methods A total of 16 batches of the coastal glehnia root were collected from several major production areas from September 2012 to March 2013, and then they were ground into powder. The volatile oil was extracted from the powder samples using the methods described in Chinese Pharmacopoeia Appendix. Gas chromatography-mass spectometry (GC-MS) was used to get the spectra of volatile oil of each sample and NIST 11. 0 database was used to identify the chemical constituents of coastal glehnia root. Results and Conclusion From 16 batches of 48 coastal glehnia root volatile oil samples, we identified 12 common components. The 12 common chemical constituents can serve as the characteristic composition of volatile oil of the coastal glehnia root, and falcarinol is the major main chemical constituent. The three batches collected from Hebei province had fewer chemical components and lower contents. We also found that the coastal glehnia root samples with root bark had more volatile oil components and higher contents than the samples without bark; moreover, eicosapentaenoic acid was only found in the samples with root bark. Peeling the bark may reduce the contents of some volatile oils such as eicosapentaenoic acid, which may affect the medicinal activity of the coastal glehnia root.

Analysis of retinal nerve fiber layer thickness and macular thickness in unaffected female carrier of Leber hereditary optic neuropathy / 中华实验眼科杂志

Background Researches documented that retinal nerve fiber layer thickness (RNFLT) in unaffected carriers of Leber hereditary optic neuropathy (LHON) becomes thickened in different quadrants to different degrees.But the change of their macular thickness is still unclear.Objective This study was to clarify RNFLT and macular thickness by optical coherence tomography (OCT) in unaffected female carriers of LHON families.Methods Five female LHON patients (5 eyes) from 5 LHON families,eighteen unaffected female carriers (18eyes) from 18 LHON families and twenty-five age-matched healthy female controls (25 eyes) were included in this study.The patients and genetic carriers were diagnosed in PLA General Hospital from 2011 September to 2012 October.Regular ocular examination were performed followed by OCT measurement of retinas.The Optic Disc Cube 200×200 and Macular Cube 200×200 protocols were used during the OCT measurement.Average (360°) RNFLT,RNFLT at four quadrantic sections,cube average macular thickness and macular thickness of nine Early Treatment Diabetic Retinopathy Study (ETDRS) sub-areas were compared among the LHON genetic carriers,LHON patients and normal controls.Results Compared to the normal control group,significant reduced values were seen in temporal,superior,nasal and inferior side of sub-area macular thickness in the LHON female carriers (P=0.022,0.046,0.024,0.008).In addition,but no significant differences were found in cube average thickness,central subarea macular thickness,temporal,superior,nasal and inferior side of lateral sub-area macular thickness,average RNFLT,and temporal,superior,nasal and inferior quadrant RNFLT between the LHON female carriers and normal controls (P=0.102,0.051,0.238,0.663,0.1 10,0.104,0.419,0.371,0.158,0.063,0.563).Compared to the unaffected female carrier group,female patients showed significant reductions in cube average macular thickness,temporal,superior,nasal and inferior side of sub-area macular thickness,temporal,superior,nasal and inferior side of lateral sub-area mac ular thickness,average R NFLT and temporal,superior,and inferior quadrant RNFLT (P =0.000,0.000,0.000,0.007,0.002,0.002,0.000,0.000,0.040,0.000,0.016,0.000,0.000) except for the central subarea macular thickness and nasal quadrant RNFLT (P=0.388,0.580).Conclusions Unaffected LHON female carriers show a normal peripapillary RNFLT,but the macular thickness at medial sub-area is thinner.This first report offers an information of macular structure change in unaffected LHON female carriers,which suggest that macular damage appears prior to RNFLT change.