Treatment of Diabetic Retinopathy with Blood Stasis， Collateral Obstruction， and Qi and Yin Deficiency Syndrome with Tongluo Mingmu Capsules： A Randomized， Double-blind， and Multi-center Phase Ⅲ Clinical Trial / 中国实验方剂学杂志

ObjectiveTo evaluate the clinical efficacy and safety of Tongluo Mingmu capsules in the treatment of diabetic retinopathy with blood stasis， collateral obstruction， and Qi and Yin deficiency syndrome. MethodA randomized， double-blind， positive-control， and multi-center clinical trial design method was used. 416 patients with diabetic retinopathy with blood stasis， collateral obstruction， and Qi and Yin deficiency syndrome in four test centers were included （the ratio of the treatment group to the control group was 3∶1）. On the basis of standardized hypoglycemic treatment， the treatment group was given both four Tongluo Mingmu capsules and two Calcium Dobesilate capsule agents three times a day， while the control group were given both two Calcium Dobesilate capsules and four Tongluo Mingmu capsule agents three times a day. The course of treatment was 12 weeks. The curative effect of Tongluo Mingmu capsules was evaluated by comparing the comprehensive curative effect of diabetic retinopathy， traditional Chinese medicine（TCM） syndrome score， corrected visual acuity， fundus changes， fundus fluorescence angiography， and other curative effect indexes before and after treatment in the two groups. At the same time， general examination， laboratory examination， and adverse events were performed to evaluate the safety of the drug. ResultThe baseline demographic data and disease characteristics of the treatment group and the control group were balanced and comparable， with the difference not statistically significant. After 12 weeks of treatment， the total effective rate of the comprehensive curative effect of diabetic retinopathy in the treatment group （61.0%， 189/310） was better than that in the control group （44.1%， 45/102）， and the difference was statistically significant （χ2=8.880， P<0.01）. The total effective rate of TCM syndromes in the treatment group （88.4%， 259/293） was better than that in the control group （69.9%， 65/93）， and the difference was statistically significant （χ2=17.927， P<0.01）. The disappearance rate of dry eyes （χ2=8.305）， dull complexion （χ2=4.053）， lassitude （χ2=10.267）， shortness of breath （χ2=8.494）， and dry stool （χ2=8.657） in the treatment group was higher than that in the control group， and the difference between the groups was statistically significant （P<0.05， P<0.01）. In terms of improving corrected visual acuity （χ2=8.382）， fundus changes （χ2=6.026） ， the treatment group was significantly better than the control group （P<0.05）. During the trial， the incidence of adverse events in the treatment group and the control group was 1.3% and 2.9%， respectively. There was no significant difference between the two groups. In addition， there were no serious adverse events and adverse events leading to withdrawal in both groups. ConclusionTongluo Mingmu capsules can improve the comprehensive curative effect of diabetic retinopathy and enhance the efficacy of TCM syndromes， visual acuity， fundus changes， and fundus fluorescein angiography， with great safety. Therefore， it can provide a new alternative therapeutic drug for patients with diabetic retinopathy.

Walnut-shell moxibustion for dry eye symptoms: a randomized controlled trial / 中国针灸

OBJECTIVE@#To evaluate the effects of walnut-shell moxibusiton on dry eye symptoms.@*METHODS@#A total of 67 patients with dry eye symptoms were randomized into a walnut moxibustion group and a sodium hyaluronate eye drops group.@*METHODS@#In the walnut moxibustion group, the walnut moxibustion was used, once every two days, 3 times a week, for 4 weeks totally. In the sodium hyaluronate eye drops group, sodium hyaluronate eye drops were selected, 4 times a day, one drop instilled in each eye each time, for 4 weeks totally. At the baseline (before treatment) and in 4 weeks of treatment, the score of the ocular surface disease index (OSDI), the score of visual analogous scale (VAS) for eye symptoms, the tear film break-up time (BUT), the cornea fluorescent pigmentation (FL) and SchirmerⅠ(SchⅠ) were evaluated. In 1-month follow-up after treatment termination, the changes of OSDI and VAS scores were evaluated in the two groups.@*RESULTS@#In 4 weeks of treatment and the follow-up, OSDI scores were reduced as compared with those before treatment in the two groups (0.05). In 4 weeks of treatment and the follow-up, VAS scores were reduced as compared with those before treatment in the two groups (all 0.05). The differences were not significant in the above indexes between the two groups (all >0.05). There was no obvious adverse reaction in the two groups.@*CONCLUSION@#The walnut-shell moxibustion is available likely for the subjective symptoms in the patients with dry eye syndrome and contributes to the tear film stabilization. The therapeutic effects need to be further evaluated with the adequate sample size in the randomized controlled trial.

Adhibition of Misoprostol Combined with Palace Cavity Attraction Tube in the Treatment of Painless Abor-tion after Cesarean Section / 中国药房

OBJECTIVE:To study the adhibition of misoprostol combined with palace cavity attraction tube in the treatment of painless abortion after cesarean section. METHODS:214 patients who received painless abortion after cesarean section were ran-domly divided into group A(71 case),group B(71 case)and group C(72 case). After all patients were given conventional intrave-nous anesthesia,Group A was given misoprostol 0.6 mg for oral administration in preoperative 2 h. Group B was given Misoprostol tablet 0.2 mg abrasive powder put in posterior fornix in preoperative 3 h. Group C did not give any drugs. All the groups used dis-posable suction curettage tube. The efficacies of sedation and cervical dilatation,operation time,intraoperative blood loss,recovery time,dosage of propofol and incidences of complications and adverse reactions in the 3 groups were observed. RESULTS:The op-eration time,intraoperative blood loss in group A were lower than group B and lower than group C,the differences were statistical-ly significant(P0.05). The total effective rates of sedation and cervical dilatation in group A and B were significantly higher than group C,and the difference was statistical-ly significant(P0.05). The incidence of compli-cations in group A was lower than group B and lower than group C,and the difference was statistically significant (P0.05). CONCLUSIONS:The efficien-cy and safety of misoprostol for oral administration or medicated vaginal suppository combined with palace cavity attraction tube in the treatment of painless abortion after cesarean section is similar,but oral administration can reduce the dosage of anesthetics,op-eration time and smaller intraoperative blood loss volume.

Effect of high myopia on 24-hour intraocular pressure in patients with primary open-angle glaucoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>As intraocular pressure (IOP) and IOP fluctuation are known risk factors for glaucoma, it is important to understand the effects of high myopia on these ocular parameters. The aim of this study was to investigate if primary open-angle glaucoma (POAG) patients with high myopia exhibit higher IOP and greater IOP fluctuations at resting conditions over 24 hours.</p><p><b>METHODS</b>We designed a prospective control clinical study. Eighty-two eyes of 82 high-tension Chinese POAG patients only on prostaglandin analogue locally were divided into 3 groups according to various myopic grades (< -6.0 D, n = 27 and between -0.76 and -5.99 D, n = 33) or without myopia (-0.75 to 0.75 D, n = 22). Single time IOP at 10 am, mean corrected 24-hour IOP, mean corrected night IOP, 24-hour IOP fluctuation and IOPs of 10 am, 2 pm, 6 pm, 10 pm, 2 am, 6 am and 8 am were measured.</p><p><b>RESULTS</b>The IOP was higher in POAG patients with high myopia over those POAG alone in three ways: the elevated IOP value was 0.65 mmHg measured in single time IOP at 10 am, 0.84 mmHg in mean corrected 24-hour IOP, 0.97 mmHg in mean corrected night IOP. The 24-hour IOP fluctuation was lower in the two myopia groups than in non-myopia group. Further, using repeated measurement analysis of variance, there was no statistical significance among groups regarding the IOPs at the seven time points (P = 0.77) and there was no interaction between groups and time points (P = 0.71), but the difference of IOPs at the seven time points in same group was statistically significant (P = 0.01).</p><p><b>CONCLUSION</b>High-tension POAG patients with high myopia, even on pharmacological glaucoma therapy, still have higher IOP, but 24-hour IOP fluctuation at resting conditions was lower in these patients.</p>

Association of adiponectin gene polymorphism with obesity in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the distribution characteristics of adiponectin gene +45 single nucleotide polymorphisms (SNP) in Chinese children, and to determine the role of adiponectin gene +45 polymorphisms in the pathogenesis of childhood obesity.</p><p><b>METHODS</b>A total of 147 Chinese obese and 118 healthy children were randomly selected and enrolled to identify adiponectin gene SNP+45 polymorphism by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. Plasma adiponectin levels were determined using ELISA. Waist circumference (WC), waist to hip ratio (WHR), percentage of body fat (%BF), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), serum triglycerides (TG), total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), plasma fasting insulin (FINS), and homeostasis model assessment of insulin resistance (HOMA-IR) were measured.</p><p><b>RESULTS</b>The allelic frequency of adiponectin gene SNP+45 in children with obesity and healthy controls were 40.5% and 25.4%, respectively. There were significant differences in the distribution of genotypes and the allelic frequency between the two groups (P<0.05). The plasma adiponectin levels were significantly higher, in contrast, %BF, HOMA-IR, TC and LDL-C levels were significantly lower in obese children with TT genotype than those in obese children with TG or GG genotype.</p><p><b>CONCLUSIONS</b>The adiponectin gene SNP+45 polymorphism may be associated with pathogenesis of obesity in children. T→G variance may be associated an increased risk of childhood obesity and result in a decreased level of adiponectin.</p>

Polymorphisms of matrix metalloproteinase-2 C735T and -9 C1562T are associated with stroke and its subtype large artery atherosclerotic stroke, but not associated with the prognosis in patients with ischemic stroke / 国际脑血管病杂志

Objective To investigate the association between matrix metalloproteinase (MMP) -2 C735T and MMP-9 C1562T polymorphisms and TOAST subtypes, the outcome in patients with stroke. Methods A total of 232 patients with ischemic stroke were divided into large artery atherosclerosis (LAA, n =37), cardioembolism (CE, n =31), small artery occlusion (SAO, n =65) stroke, stroke of other demonstrated etiology (SOE, n =2), and stroke of undemonstrated etiology (SUE, n =97) according to TOAST criteria. A total of 235 healthy subjects in the outpatient served as control. Genetic polymorphisms of MMP-2 C735T and MMP-9 C1562T were identified by polymerase chain reaction-restriction fragment length polymorphism.The outcome of patients was evaluated with Barthel Index (BI) at day 21 and 90 after stroke.Results The frequencies of MMp-2 735CC genotype and C allele in the ischemic stroke group (CC genotype: 63.36％ vs. 54.04％,x2 =4. 182, P=0.014; C allele: 79.31％vs. 74.04％,x2 =3. 936, P =0. 047 ) and its LAA subtype ( CC genotype: 78. 37％ vs. 54. 04％, x2 =7. 740, P =0. 005; C allele: 87. 83％ vs. 74. 04％, x2 =6. 655, P =0. 01 ) were significantly higher than those in the control group. The frequencies of MMP-9 1562CT +TT genotype and T allele in the ischemic stroke group (CT +TT genotypes: 21.98％ vs. 13. 19％,x2 =6. 233, P=0.013; T allele: 11.64％ vs. 7. 02％ ,x2 =5. 891, P =0. 015)and its LAA subtype(CT +TT genotypes: 32. 43％ vs. 13. 19％ ,x2 =8. 892, P =0. 003; T allele: 20. 27％ vs. 13.19％ ,x2 =13. 950, P =0. 000). Multivariate logistic regression analysis indicated that risk of ischemic stroke and its LAA subtype with MMP-2 735CC genotype (ischemic stroke: odds ratio [OR]1.099, 95％ confidence interval [CI] 1.038-1.260, P =0.028; LAA: OR 1.360, 95％ CI 1. 167-5. 774, P =0. 009) and with MMP-9 1562TT genotype (ischemic stroke: OR 9. 409,95％ CI 1. 154-76. 722, P =0. 036; LAA: OR 8. 962, 95％ CI 1. 380-58. 218, P =0. 022)increased significantly. There were no significant correlation between the different genotypes of MMP-2 and MMP-9 and the outcome of ischemic stroke. Conclusions Polymorphisms of MMP-2 C735T and -9 C1562Tare associated with ischemic stroke and its subtype large artery atherosclerotic stroke, but not associated with the outcome in patients with ischemic stroke

Application of methylene blue in sentinel lymph node biopsy in breast conservative therapy of breast cancer / 中国基层医药

Objective To explore the clinical value of methylene blue in sentinel lymph node biopsy ( SLNB) in breast conservative therapy of breast cancer. Methods 55 patients performed sentinel lymph node biopsy( SLNB)in were analyzed,with breast conservative therapy of breast cancer in clinical stage Ⅰ-Ⅱ. The mapping procedures and SLNB were performed using subareolar injection of Methylene blue dye,followed by the axillary lymph node dissection(ALND). All of the SLN and ALN were evaluated pathologically after the operations. Results Among 55 cases ,52 cases were checked out sentinel lymph node and the positive rate was 95% (52/55). The axillary status was 100% accurately predicted by SLNs;Sensitivity in this group was 93% (52/55) ;False negative rate was 5% (1/20);False positive rate was 0. Conclusion Methylene blue dye is a reliable method for sentinel lymph node biopsy. SLNB is a simple and safe technic, which helps to reveal the state of the axillary lymph nodes.

Basic characteristics and functional outcomes of 3123 consecutive patients in Chengdu stroke registry / 中华神经科杂志

Objective To analyze basic data and outcomes in Chengdu Stroke Registry.Methods The stroke patients consecutively admitted to Department of Neurology,West China Hospital,Sichuan University since March 1,2002 were prospectively registered.The baseline demographic,risk factors,treatment,and outcome data was recorded with standardized stroke register form by trained specialists.The patients were followed up at seven days,one,three,six months and one year after onset of the stroke for death and disability.Results A total of 3123 consecutive patients were registered between March 1,2002 and August 31,2006,of which 65.5％ came from urban areas and 34.5％ from rural areas.The age was (63.05 ± 17.98) years old and male accounted for 60.3％.Ninety-seven percent (3028/3123) of patients completed CT or MRI scanning during hospitalization.A total of 1804 patients were included between March 2002 and September 2004,of which ischemic stroke accounted for 62.1％ (1120/1804),intracranial hemorrhage 28.4％ (513/1804),subarachnoid hemorrhage 4.0％ (72/1804) and TIA 5.5％ (99/1804).The median NIHSS score on admission was 8(3-15) points in patients with cerebral hemorrhage,and 5(2-10) points in patients with ischemic stroke.Compared with the patients with intracranial hemorrhage,patients with ischemic stroke more frequently had a history of diabetes (OR =2.427,95％ CI 1.811- 3.253,P=0.000),atrial fibrillation (OR=6.121,95％ CI3.535-10.60,P=0.000),coronary heart disease (OR=4.144,95％ CI 2.944-5.832,P =0.000) and TIA (OR=4.342,95％ CI 1.726-10.92,P =0.001 ),and less alcohol consumption ( OR =0.740,95％ CI 0.611-0.896,P =0.002 ).The proportion of in-hospital treatments were thrombolysis 0.9％,anti-platelet therapy 83.0％,mannitol 23.5％,neuroprotective agents (citicoline) 68.1％,and Chinese herbal medicine 89.7％.Case fatality rate was 10.7％ and 13.9％ respectively at 7 days and one month for patients with intracranial hemorrhage,3.0％ and 5.2％ respectively for ischemic stroke.Death or disability was 40.4％,40.3％ and 38.9％ in patients with intracranial hemorrhage and 37.1％,35.0％ and 33.4％ for ischemic stroke at the end of 3,6,12 months respectively.Conclusions Our stroke registry is featured with the largest sample,and the longest period of consecutively registration.It provides an important platform for clinical investigation of stroke.Our study suggested case fatality and disability is lower in this group than in other ethics.Above features should be considered in design of future clinical trials in China.

Switch of substrate specificity of hyperthermophilic acylaminoacyl peptidase by combination of protein and solvent engineering

The inherent evolvability of promiscuous enzymes endows them with great potential to be artificially evolved for novel functions. Previously, we succeeded in transforming a promiscuous acylaminoacyl peptidase (apAAP) from the hyperthermophilic archaeon Aeropyrum pernix K1 into a specific carboxylesterase by making a single mutation. In order to fulfill the urgent requirement of thermostable lipolytic enzymes, in this paper we describe how the substrate preference of apAAP can be further changed from p-nitrophenyl caprylate (pNP-C8) to p-nitrophenyl laurate (pNP-C12) by protein and solvent engineering. After one round of directed evolution and subsequent saturation mutagenesis at selected residues in the active site, three variants with enhanced activity towards pNP-C12 were identified. Additionally, a combined mutant W474V/F488G/R526V/T560W was generated, which had the highest catalytic efficiency (k (cat)/K (m)) for pNP-C12, about 71-fold higher than the wild type. Its activity was further increased by solvent engineering, resulting in an activity enhancement of 280-fold compared with the wild type in the presence of 30% DMSO. The structural basis for the improved activity was studied by substrate docking and molecular dynamics simulation. It was revealed that W474V and F488G mutations caused a significant change in the geometry of the active center, which may facilitate binding and subsequent hydrolysis of bulky substrates. In conclusion, the combination of protein and solvent engineering may be an effective approach to improve the activities of promiscuous enzymes and could be used to create naturally rare hyperthermophilic enzymes.

Clinical study on electrical plum-blossom needle for treatment of amblyopia in children / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To comparatively study the clinical effect of electrical plum-blossom needle on ametropic amblyopia and anisometropic amblyopia.</p><p><b>METHODS</b>Sixty children (107 eyes) with ametropic amblyopia or anisometropic amblyopia were randomly assigned to two groups at their first visit on the basis of optometry. They had never received any treatment before. Patients in one group were treated with electrical plum-blossom needle (as the treatment group) and those in the other group were treated with physical comprehensive therapy (as the control group). The 1-month clinical effect was observed.</p><p><b>RESULTS</b>The 1-month total effective rate was 79.6% (43/54) in the treatment group and 58.5% (31/53) in the control group. Statistical significance was shown in clinical effect after statistical management. The electrical plum-blossom needle showed better effect than the comprehensive therapy.</p><p><b>CONCLUSION</b>The electrical plum-blossom needle for treatment of amblyopia in children could initiate faster with good compliance. Its short-term effect was definite with no side effect.</p>

Fractalkine and its receptor CX3 CR1 and cerebrovascular diseases / 国际脑血管病杂志

Fractalkine is a new member of chemokine family, which exists in membrane-boundd form and soluble form. It has both adhesion molecular and chemokine activities. CX3 CR1 is its specific receptor. Both of them were expressed in many diseases of the nervous system. At present, fractalkine and its receptor CX3CR1 polymorphism and the research of cerebrovascular diseases mainly involve in the risk factors for cerebrovascular diseases, cerebral ischemia-reperfusion and bone marrow stem cell transplantion, which are expected to become a new target for clinical treatment.

Prevention and treatment of cerebral vasospasm with free radical scavengers after subarachnoid hemorrhage / 国际脑血管病杂志

Cerebral vasospasm is a common complication after subarachnoid hemorrhage, and its pathophysiological mechanism is poorly understood. A growing body of research suggests that free radicals play an important role in inducing cerebral vasospasm. In recent years, the research about free radical scavengers in the prevention and treatment of cerebral vasospasm after subarachnoid hemorrhage is continuing to increase, This article reviews the roles of many types of free radical scavengers in the prevention and treatment of cerebral vasospasm after subarachnoid hemorrhage.

Early intensive blood pressure reduction in acute cerebral hemorrhage / 国际脑血管病杂志

There are more prognostic factors affecting the patients with cerebral hemorrhage, including bleeding volume, bleeding site, cause of bleeding, and blood pressure regulation during acute phase. Among them, the regulation of blood pressure during acute phase is a man-controlled important factor. However, the ideal blood pressure level has not yet to he determined at present. Therefore, more clinical trials are needed to determine the exact time window of blood pressure management in patients with intracerebral hemorrhage during acute phase and the range of blood pressure control.

Effect of qiming granule on retinal blood circulation of diabetic retinopathy: a multicenter clinical trial / 中国结合医学杂志

<p><b>OBJECTIVE</b>To objectively assess the effect of Qiming Granule in the treatment of diabetic retinopathy (DR) by fluorescence fundus angiography (FFA).</p><p><b>METHODS</b>In a multi-center, randomized, parallel controlled clinical trial, patients with DR were randomly assigned to the control group (calcium dobesilate capsule) and the test group (Qiming Granule). Changes in the retinal blood circulation time were recorded by FFA after 3 months of medication.</p><p><b>RESULTS</b>Significant reduction was observed in the retinal arterio-venous circulation time (AVCT) in both groups (P<0.01), the value was 7.635+/-3.149 s before treatment and 5.165 +/-3.382 s after treatment in the treated group, and 7.737+/-3.413 s and 5.313+/-3.472 s in the control group respectively. Qiming Granule also reduced the arm-to-retinal circulation time (ARCT, P<0.05). The value was 17.867+/-3.872 s before treatment and 15.643+/-4.648 s after treatment in the treated group, and 17.217+/-3.833 s and 16.312+/-3.613 s in the control group (P>0.05) respectively. The ARCT in the tested group was reduced, with a statistically significant difference post-medication (P<0.01).</p><p><b>CONCLUSION</b>As a Chinese medicine complex prescription, Qiming Granule may alleviate retinal hypoxia and ischemia by increasing retinal blood flow and improving the blood circulation.</p>

Plasma levels of adiponectin and tumor necrosis factor-alpha in children with obesity / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To examine plasma adiponectin (ADPN) and tumor necrosis factor-alpha (TNF-alpha) levels and their correlation in children with obesity in order to investigate the roles of both in the development of childhood obesity.</p><p><b>METHODS</b>One hundred and forty-seven children with obesity and 118 normal children who were randomly sampled from five primary schools from the Kaifu District in Changsha were enrolled. Physical shape indexes, including height, weight, waist circumference, hip circumference, and waist to hip ratio (WHR) were measured. Body mass index (BMI) was calculated. Blood pressure was measured. Percentage of body fat (%BF) was measured with dual energy X-ray absorptiometry. Plasmal levels of ADPN and TNF-alpha were detected using ABC-ELISA. Blood concentrations of triglycerides (TG), total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C) were measured by automatic biochemistry analyzer. Fasting blood glucose level was measured by glucose oxidase method. Fasting blood insulin level was assayed by radioimmunity. Homeostasis model assessment for insulin resistance (HOMA-IR) was performed.</p><p><b>RESULTS</b>Plasma ADPN levels in obese children significantly decreased compared with those in normal children (8.12+/-2.54 mg/L vs 12.22+/-4.68 mg/L; p<0.05), and had a negative correlation with plasma TNF-alpha levels, BMI, WHR and HOMA-IR (p<0.01), and with %BF, fasting insulin, systolic blood pressure and TG (p<0.05). Plasma TNF-alpha levels in obese children significantly increased compared to normal children (171.38+/-34.33 ng/L vs 91.07+/-21.60 ng/L; p<0.01) and positively correlated with BMI, WHR, %BF, fasting insulin, HOMA-IR, TG and systolic blood pressure (p<0.01), and negatively with HDL (p<0.05). Multiple stepwise regression analysis showed that ADPN, BMI and TNF-alpha were main influential factors for %BF (R2=0.926, p<0.01). There was a significant interaction between ADPN and TNF-alpha (p<0.05).</p><p><b>CONCLUSIONS</b>Plasma ADPN levels decreased and plasma TNF-alpha levels increased in children with obesity and both were main influential factors for %BF in children. There was an interaction between ADPN and TNF-alpha, suggesting that they both participate in the development of childhood obesity.</p>

Tumor necrosis factor-α and cerebral ischemia-reperfusion injury / 国际脑血管病杂志

As an important inflammatory cytokine, tumor necrosis factor-α (TNT-α) plays an important role in the process of cerebral ischemia-reperfusion. The discussion of the dynamic changes, the mechanism of neurotoxicity and antagonizing the therapeutic effect of TNF-α in the process of cerebral ischemia-reperfusion injury will provide theoretical basis for the treatment of cerebrovascular diseases.

Serum leptin level and its association with bone mineral density in obese children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate serum leptin level and its relationship with bone mineral density in obese children from Changsha City.</p><p><b>METHODS</b>One hundred and nineteen obese children and 103 normal children aged 7 to 12 years from five primary schools of Changsha City were enrolled. Obesity was assessed based on the body mass index (BMI). Dual energy X-ray absorptiometry (DEXA) was used to determine bone mineral density (BMD) and body composition. Serum leptin level was measured using enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>The obesity group had higher height, weight, BMI, waist circumference and waist to hip ratio (WHR) compared with the normal group (p<0.01). BMD, bone mineral content (BMC), lean mass (LM), fat mass (FM), percentage of body fat (%BF) and leptin concentration in the obesity group were significantly higher than those in the normal group (p<0.01). Serum leptin level was positively correlated with BMD, BMC, LM and FM (r=0.528-0.903, p<0.01). Multiple stepwise regression analysis indicated that BMI and %BF were independent influencing factors for serum leptin level.</p><p><b>CONCLUSIONS</b>Obese children have higher serum leptin level. Serum leptin concentration is significantly correlated with BMD and body composition. BMI and %BF are independent influencing factors for serum leptin level in children.</p>

Analysis of epidemiological characteristics of 11 142 injuries / 中华疾病控制杂志

Objective To study the characteristics of injuries in patients,and provide basic evidence for injury prevention and control.Methods 3 hospitals were sampled by stratified sampling,and the data of all injured patients visiting the 3 hospitals in 2006～2007 were analyzed.Results 11 142 injured patients were collected.The ratio of male to female was 1.81∶1.The average age was 34.56?16.Injured patients were mainly peasants(40.04%) and students(20.62%).Most injuries occurred at home and highway,and at 9～10AM and 3～4PM.The cause of injuries were fall(32.12%),traffic accidents(20.33%) blunt force(16.60%),and animal attacks(11.67%).Unintentionally injured patients accounted for 87.70% of all cases.Conclusions The occupation injury,traffic injury and injury to young adolescents are seriously endangering the health of peasants and students.

Obesity and its influencing factors in primary school students from Kaifu District of Changsha City / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the prevalence of obesity and the influencing factors for obesity in primary school students from Kaifu District of Changsha City.</p><p><b>METHODS</b>A total of 4 140 students aged 7 to 12 years sampled randomly from Kaifu District of Changsha City were enrolled. Obesity was identified based on the body mass index (BMI). The influencing factors for obesity were investigated by non-logistic regression analysis.</p><p><b>RESULTS</b>The prevalence of overweight and obesity were 9.76% and 7.39% respectively, and the prevalence of obesity in boys and girls were 9.37% and 5.13% respectively (P<0.05). The obese children had significantly higher BMI, waist circumference (WC), waist to hip ratio(WHR), percentage of body fat (%BF), systolic blood pressure, and serum triglyceride (TG) and low density lipoprotein-cholesterol (LDL-C) levels but significantly lower serum high density lipoprotein-cholesterol (HDL-C) level compared with the children with normal weight. BMI, %BF, WC and WHR were all positively correlated to serum levels of TG and LDL-C in obese children. Binge overeating, increased television viewing time, fast speed of eating and increased consumption of fried foods are all risk factors for the development of obesity. Preference for physical activity and sufficient physical activity were protective factors for obesity.</p><p><b>CONCLUSIONS</b>The prevalence of obesity of primary school students from Kaifu District of Changsha City is high in China. The development of childhood obesity is associated with poor eating behaviors, less physical activity and increased television viewing time. The control of childhood obesity may be beneficial to early prevention of some adult chronic diseases.</p>

Assessment on intrapulmonary shunting in liver transplantation candidates using contrast-enhanced echocardiography / 中国组织工程研究

BACKGROUND: Intrapulmonary vascular abnormalities result in the right-to-left shunting and severe hypoxemia in liver transplantation candidates. Currently, a convenient, sensitive and effective method is absent to screen the intrapulmonary vascular dilatations.OBJECTIVE: To evaluate the role of contrast-enhanced echocardiography on clinical diagnosis of intrapulmonary shunting in liver transplantation candidates.DESIGN, TIME AND SETTING: The experiment, prospective controlled observation based on cases, was performed at the Hepatology Unit of the 458 Hospital of PLA (Guangzhou, Guangdong, China) from February 2004 to February 2006.PARTICIPANTS: Twenty-four consecutive liver transplantation candidates were recruited from the Hepatology Unit of the 458Hospital of PLA.METHODS: Routine examination was conducted under the condition without any regimen of vascular dilatation drugs.Contrast-enhanced echocardiography was applied to detect the prevalence of right-to-left shunting in the patients with end-stage liver disease. The microvesicle of the left ventricle in patients was qualitatively assessed by a score from 1+ to 3+. Accordingly, all patients were divided into two groups: intrapulmonary shunting and non-intrapulmonary shunting.MAIN OUTCOME MEASURES: The prevalence of right-to-left shunting and clinical characteristics of liver transplantation candidates were determined.RESULTS: Ten (41.7%) of 24 patients with positive contrast-enhanced echocardiography were proved to develop the intrapulmonary right-to-left shunting, including 6 for l+ and 4 for 2+ by left ventricle abnormality, which emerged after 6-10 cardiac cycles of right ventricle abnormality. There were no significant differences in age, gender, arterial blood gas analysis and liver function tests between the two groups (P > 0.05). Echocardiography results demonstrated that, the upper digestive tract hemorrhage,spleen thickness that indicated portal hypertension, pulmonary artery systolic pressure and Tei index were significandy higher in the patients of intrapulmonary shunting than in those of non-intrapulmonary shunting (P<0.05-0.01 ).CONCLUSION: Intrapulmonary vascular dilatation occurs frequently in liver transplantation candidates associated with intrapulmonary shunting but without hypoxemia. Contrast-enhanced echocardiography is a sensitive and non-invasive method for the early diagnosis of intrapulmonary vascular dilatation. The pathogenic cause is portal hypertension. Tel index can be used as an important parameter for evaluating right ventricular function in patients of intrapulmonary vascular dilatation.