Evaluation of the clinical effect of an artificial intelligence-assisted diagnosis and treatment system for neonatal seizures in the real world: a multicenter clinical study protocol / 中国当代儿科杂志

Neonatal seizures are the most common clinical manifestations of critically ill neonates and often suggest serious diseases and complicated etiologies. The precise diagnosis of this disease can optimize the use of anti-seizure medication, reduce hospital costs, and improve the long-term neurodevelopmental outcomes. Currently, a few artificial intelligence-assisted diagnosis and treatment systems have been developed for neonatal seizures, but there is still a lack of high-level evidence for the diagnosis and treatment value in the real world. Based on an artificial intelligence-assisted diagnosis and treatment systems that has been developed for neonatal seizures, this study plans to recruit 370 neonates at a high risk of seizures from 6 neonatal intensive care units (NICUs) in China, in order to evaluate the effect of the system on the diagnosis, treatment, and prognosis of neonatal seizures in neonates with different gestational ages in the NICU. In this study, a diagnostic study protocol is used to evaluate the diagnostic value of the system, and a randomized parallel-controlled trial is designed to evaluate the effect of the system on the treatment and prognosis of neonates at a high risk of seizures. This multicenter prospective study will provide high-level evidence for the clinical application of artificial intelligence-assisted diagnosis and treatment systems for neonatal seizures in the real world.

Folic Acid Supplementation in Chinese Peri-conceptional Population: Results from the SPCC Study / 生物医学与环境科学（英文）

Objective@#To determine the prevalence and determinants of folic acid (FA) supplementation in Chinese couples planning for pregnancy and in women during early pregnancy.@*Methods@#This was a cross-sectional study based on the Shanghai PreConception Cohort (SPCC) study. Data on FA supplementation and socio-demographic features were collected using questionnaires. Couples visiting clinics for pre-pregnancy examination and pregnant women at < 14 gestational weeks were recruited in Shanghai, China, between March 2016 and September 2018.@*Results@#Among the pregnancy planners, 42.4% (4,710/11,099) women and 17.1% (1,377/8,045) men used FA supplements, while 93.4% (14,585/15,615) of the pregnant women used FA supplements. FA supplement use was higher in female pregnancy planners who were older ( : 1.13, 95% : 1.08-1.18), had higher education ( : 1.71, 95% : 1.53-1.92), and were residing in urban districts ( : 1.06, 95% : 1.01-1.11) of FA supplementation; female pregnancy planners with alcohol consumption ( : 0.95, 95% : 0.90-0.99) had lower odds of FA supplementation. In early pregnancy, women with higher educational level ( : 1.04, 95% : 1.03-1.06), who underwent pre-pregnancy examination ( : 1.02, 95% : 1.01-1.03) had higher odds of using an FA supplement; older aged ( : 0.99, 95% : 0.98-0.99), and multigravida ( : 0.97, 95% : 0.96-0.98) had lower odds of FA supplementation.@*Conclusion@#Although the majority of pregnant women took FA supplements, more than half of the women planning for pregnancy did not. Urgent strategies are needed to improve pre-conception FA supplementation.

Construct validity of the Autism Spectrum Rating Scale of the Revised Chinese Version / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the construct validity of the Autism Spectrum Rating Scale of Revised Chinese Version (RC-ASRS).</p><p><b>METHODS</b>Seven hundred and one children aged 6-12 years old were recruited from one primary school in the Minhang District of Shanghai. The parents of the children completed the RC-ASRS questionnaire. Mpuls 6.0 Software was used to conduct the construct validity analysis.</p><p><b>RESULTS</b>A total of 671 questionnaires (95.7%) were retrieved, involving 368 boys (54.8%) and 303 girls (45.2%). The 3 factor structure of the RC-ASRS had better model fitting indices, 0.051 for root mean square error of approximation (RMSEA), 0.889 for comparative fit index (CFI) and 0.884 for Tucker-Lewis index (TLI), compared with the original ASRS, 0.060 for RMSEA, 0.829 for CFI and 0.823 for TLI.</p><p><b>CONCLUSIONS</b>The RC-ASRS may serve as a reliable and valid tool for screening autistic symptoms in China.</p>

The effect of oral alpha-lipoic acid in overweight/obese individuals on brachial-ankle pulse wave velocity and supine blood pressure:a randomized,crossover,double-blind,placebo-controlled trial / 中华流行病学杂志

Objective To investigate the effect of oral alpha-lipoic acid (ALA) supplement on brachial-ankle pulse wave velocity (baPWV),supine systolic blood pressure (SBP) and diastolic blood pressure (DBP) in overweight/obese individuals.An 8-week double-blind,randomized,placebo-controlled and cross-over trial with a 4-week washout between cross-over periods.Methods Sixty-three males and 40 females aged 22-57 years old who met the inclusion criteria as (1) Han ethnicity;(2) 20-60 years old;(3) BMI≥25 kg/m2 and having at least one of the following risk factors:borderline hypertension (130 mm Hg≤SBP＜140 mm Hg and/or 85 mm Hg≤supine DBP＜90 mm Hg),dyslipidemia(fasting total cholesterol≥5.2 mmol/L or HDL-C＜1.04 mmol/L),or impaired fasting glucose (6.1 mmol/L≤fasting glucose＜7.0 mmol/L);(4)Not on any antioxidant gender.Group 1 received 8 weeks ALA (1200 mg/day) followed by 4-week washout period and followed by another 8 weeks placebo;while Group 2 received 8 weeks placebo (1200 mg/day)followed by 4-week washout period,and followed by ALA treatment for 8 weeks.BaPWV and supine blood pressure were measured at the beginning of 1st phase and 2nd phase and at the endpoint of the whole trial.Mixed effect linear regression model was performed to compare the change of baPWV and supine blood pressure between ALA group and placebo group.Results BaPWV decreased -33.03 cm/s ± 130.70 cm/s for ALA group and increased 5.66 cm/s ± 139.89 cm/s for placebo group,supine systolic blood pressure decreased -4.09 mm Hg±9.18 mm Hg for ALA group and -2.32 mm Hg±8.16 mm Hg for placebo group.Supine diastolic blood pressure decreased -1.29 mm Hg ± 6.55 mm Hg for ALA group and -0.48 mm Hg±6.63 mm Hg for placebo group.These three mix-effect models did not show significant effect of ALA treatment after adjustment on baseline values,sex,age,treatment sequence or period.Conclusion The current trial did not provide evidence that oral intake of ALA for 8 weeks had significant effects on lowering baPWV,supine systolic blood pressure or supine diastolic blood pressure.

Waist circumference reference values for screening cardiovascular risk factors in Chinese children and adolescents / 生物医学与环境科学（英文）

<p><b>OBJECTIVES</b>To explore the optimal threshold values of waist circumference (WC) for detecting cardiovascular (CV) risk factors among Chinese children and adolescents.</p><p><b>METHODS</b>Association of WC with CV risk factors was studied among 65,898 children aged 7-18 years whose data were pooled from nine previous studies in China. CV risk factors in this study included hypertension (blood pressure above 95 percentile levels), dyslipidemia (with one or more of the following three indexes: TG > or = 1.7 mmol/L, TC > or = 5.18 mmol/L, and HDL-C < or = 1.04 mmol/L) and elevated glucose level (fasting plasma glucose > or = 5.6 mmol/L). Receive-operating characteristic analysis (ROC) and logistic regression were employed to derive optimal age- and sex-specific waist circumference references for predicting CV risk factors.</p><p><b>RESULTS</b>A slight increasing trend of CV risk factors was observed starting from the 75th percentile of waist circumference in the study population, while a remarkable increasing trend occurred from the 90th percentile. The optimal waist circumference thresholds for predicting high blood pressures were at the 75th percentile for both boys and girls, which was at the 90th percentiles for detecting at least two of the above three CV risk factors. In comparison with children with waist circumference below the 75th percentile, the odds ratio of two CV risk factors doubled among children with waist circumference between the 75th and the 90th percentile, and increased by 6 times among children with waist circumference above the 90th percentile. The trend of high blood pressure increasing with waist circumference remained significant after having been stratified by BMI category.</p><p><b>CONCLUSION</b>The 75th and the 90th percentiles of WC are the optimal cut-off points for predicting an increased and a substantially increased risk of CV factors in Chinese children and adolescents, respectively.</p>

Waist circumference reference values for screening cardiovascular risk factors in Chinese children and adolescents aged 7-18 years / 中华流行病学杂志

Objective To explore the optimal threshold values of waist circumference (WC) in detecting the risk on cardiovascular (CV) among the Chinese children and adolescents. Methods Association of WC and CV risk factors were studied among 65 898 children and adolescents aged 7-18 years whose data were pooled from nine studies carried out in China. Receive-operating characteristic analysis (ROC) and logistic regression were employed to derive optimal age- and sex-specific waist circumference references for predicting the CV risk factors. Results A slight increasing trend of CV risk factors was observed starting from the 75th percentile of waist circumference in the study population, while a remarkable increasing trend occurred from the 90th percentile. The optimal waist circumference thresholds for predicting high blood pressures were at the 75th percentile for both boys and girls, and at the 90th percentiles it could detect at least two of the above three CV risk factors. In comparison with children whose waist circumference was below the 75th percentile, the odds ratio of two CV risk factors doubled among children with waist circumference between 75th and 90th percentile, and increased by 6 times among children with waist circumference above the 90th percentile. The trend of high blood pressure increasing remained significant with waist circumference after having been stratified by BMI category. Conclusion The 75th and the 90th percentile of WC appeared to be the optimal cut-off points for predicting an increased and a substantially increased risk of CV factors in Chinese children and adolescents.

Strontium-89: a desirable therapeutic for bone metastases of prostate cancer / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of strontium-89 (89Sr) in the treatment of painful bone metastases of prostate cancer.</p><p><b>METHODS</b>A total of 116 patients with painful bone metastases of prostate cancer received bilateral orchiectomy and incretion, followed by intravenous injection of 89Sr at the dose of 1.48-2.22 MBq (40-60 microCi)/kg. The clinical effects were evaluated by follow-up analysis.</p><p><b>RESULTS</b>After the 89Sr treatment, appetite and sleep were evidently improved in 33.6% and 56.0% of the patients respectively, the applied dose of anodyne reduced in 61.2%, pain alleviated in 83.6%, with an absolute palliation rate of 24.1%. Pain relief started at 3-21 (10.2 +/- 6.5) days and lasted 3-12 (5.3 +/- 2.2) months. Flare ache occurred in 31.9% of the patients. Compared with pre-treatment, the mean score on Karnofsky's performance status (KPS) was 20.0% higher, and the WBC count decreased to 3.0-3.9 x 10(6)/L in 18.1% of the patients. Whole body bone scintigraphy of 53 followed-up patients showed that 39 (73.6%) of them exhibited an obvious decrease in the number of metastases, 10 (18.9% remained in a stabilized state and only 4 (7.5% deteriorated.</p><p><b>CONCLUSION</b>89Sr, capable of inhibiting bone metastasis, palliating pain and improving the quality of life with few adverse effects, can be used as a desirable therapeutic for painful bone metastases of prostate cancer.</p>

Expression of transcription factor Pokemon in non-small cell lung cancer and its clinical significance / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Transcription factor Pokemon, a central regulation gene of the important tumor suppressor ARF gene, exerted its activity by acting upstream of many tumor-suppressing genes and proto-oncogenes. Its expression in non-small cell lung cancer (NSCLC) and its clinical significance remains unclear. The aim of this study was to investigate the expression of Pokemon in NSCLC and to explore its correlation with the clinical pathological characteristics and its influence on patients' prognosis.</p><p><b>METHODS</b>Fifty-five cases of NSCLC were involved in this study. The expression of Pokemon in the tumor tissue, the corresponding tumor adjacent tissue and the surrounding tissue was detected via reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting, with the aim of investigating the correlation between the expression of Pokemon in tumor tissue of NSCLC and its clinical pathological characteristics. Moreover, a prognostic analysis was carried out based upon the immunohistochemical (IHC) detection of the expression of Pokemon gene in archival tumor specimens (5 years ago) of 62 cases of NSCLC.</p><p><b>RESULTS</b>Statistical significance of the expression of Pokemon mRNA and protein was determined in the tumor tissue, the tumor adjacent tissue and the surrounding tissue (P<0.05). The expression of Pokemon was determined not to be associated with the patients' sex, age, smoking condition, tumor differentiation degree, histology and lymph node metastasis condition. However, its relationship with TNM staging was established (P<0.05). Furthermore, it was shown that the survival rate of patients with negative Pokemon expression was significantly higher than that of those with positive Pokemon expression (P=0.004), therefore, the expression of Pokemon is believed to be an independent factor affecting prognosis (P=0.034).</p><p><b>CONCLUSION</b>Pokemon was over-expressed in NSCLC tissue and the expression of Pokemon might be of clinical significance in non-small cell lung cancer prognostic evaluation.</p>

Variations in the calpain-10 gene are associated with the risk of type 2 diabetes and hypertension in northern Han Chinese population / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Calpain-10 (CAPN10) has been identified as a susceptibility gene in type 2 diabetes mellitus (T2DM) and insulin resistance. The present study aimed to identify the effects of genetic variations in the CAPN10 gene on the development of type 2 diabetes and hypertension in northern Han Chinese population.</p><p><b>METHODS</b>We performed a case-control study and genotyped single nucleotide polymorphism (SNP)-44, -43, -19 and -63 of CAPN10 gene in 1046 subjects from the northern China, including 493 patients with T2DM and hypertension and 553 age- and gender-matched normal healthy controls.</p><p><b>RESULTS</b>Univariate analysis showed that the four polymorphisms were not independently associated with T2DM and hypertension. However, the frequency distributions of SNP-44 allele C (allele 2) (17.89% vs 9.80%, P = 0.0016) and genotype CC (22) (4.21% vs 1.01%, P = 0.0059) in obese patients (body mass index > or = 30 kg/m2) were different from those in non-obese patients. Logistic regression analyses revealed that carriers of the 1112/1221 diplotype had a significantly lower odds ratio for diabetes and hypertension (OR = 0.399, 95% CI, 0.196 - 0.814, P = 0.0115). The 1112/1121 diplotype associated with significantly increased risk of type 2 diabetes in Mexican-American was not associated with the increased risk in Chinese.</p><p><b>CONCLUSION</b>These results suggested that CAPN10 gene variations might play roles in the risk of diabetes and hypertension in northern Han Chinese population.</p>

Study on the body mass index reference norm for defining overweight and obesity in school-age children and adolecents with Uygur and Han ethnic backgrounds in Urumqi / 中华流行病学杂志

<p><b>OBJECTIVE</b>To construct and compare the body mass index (BMI) cutoff points for defining overweight and obesity in school-age children and youths with Uygur and Han ethnic backgrounds in Xinjiang, China.</p><p><b>METHODS</b>A total number of 9146 boys and girls in Urumqi, Xinjiang, aged 7-18 years, were recruited by stratifying and clustering sampling from April to June 2004. Demographic and anthropometric data, including body weight and standing height, were collected. Questionnaires and standard methods were used and BMI was calculated by weight/height2. BMI centile curves with age were drawn according to gender and ethnicity, using LMS software (Tim cole and Huiqi Pan) which were making the centile curves passing through 25 kg/m2 and 30 kg/m2, and 24 kg/m2 and 28 kg/m2 at age of 18 for overweight and obesity respectively.</p><p><b>RESULTS</b>The age and sex specific BMI centile curves were drawn for children with Uygur and Han ethnicities. Data showed that BMI increased with age. The centile of BMI curves, P94.46 and P99.58 for Uygur boys, P92.44 and P99.64 for Uygur girls, P85.05 and P97.26 for Han boys, P90.92 and P99.03 for Han girls, which passing through 25 kg/m2 and 30 kg/m2 by IOTF recommendation at age 18, were constructed. Under the basis of WGOC recommendation, the points that passing through 24 kg/m2 and 28 kg/m2 at age 18 were P90.54 and P98.86 for uygur boys, P86.96 and P98.77 for uygur girls, P78.98 and P94.72 for Han boys, P86.15 and P97.56 for Han girls. The BMI cutoff points for defining overweight and obesity were suggested.</p><p><b>CONCLUSION</b>To the best of our knowledge, the present study established the BMI cutoff points for Uygur ethnic school-aged children and youths for identifying overweight and obesity. There was ethnic difference in the BMI distribution with age. We recommended using the BMI cutoff points proposed by the current study to identify those overweight and obese children in Urumqi.</p>

Common SNPs of APM1 gene are not associated with hypertension or obesity in Chinese population / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate whether the common variants 45T/G and 276G/T in APM1 gene were associated with hypertension combined with obesity (HO) and related clinical features in Chinese Han population.</p><p><b>METHODS</b>A case-control study design was applied. Common polymorphisms of 45T/G and 276G/T were genotyped by PCR product sequencing in 484 cases with HO and 502 controls with normal blood presure and BMI < 25.</p><p><b>RESULTS</b>The genotype and allele frequencies of 45T/G, 276G/T, and haplotype defined by the two variants in cases did not differ from those in controls. The means of blood pressure, BMI and waist-hip ratio did not differ among genotypes of the two polymorphisms and haplotypes. Among lipid profiles, only serum high-density lipoprotein cholesterol (HDL-C) levels were significantly lower in T allele carriers than that in non-T carriers after adjusting possible confounding factors (1.21 vs 1.32 mmol/L, P=0.0001).</p><p><b>CONCLUSION</b>Polymorphisms of 45T/G and 276G/T in APM1 gene are not associated with hypertension or obesity, or their clinical features in Chinese Han population. Common polymorphism of 45T/G might be associated with serum HDL-C levels in Chinese.</p>

Ethnic differences in body mass index and prevalence of obesity in school children of Urumqi City, Xinjiang, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the prevalence of obesity and distribution of body mass index (BMI) in school children of four ethnic groups in Urumqi, Xinjiang, China.</p><p><b>METHODS</b>A total of 55508 school children of Han, Hui, Uygur and Kazak nationalities aged 8-18 years were selected by a cluster sampling from a districts of Urumqi City for anthropometric measurement and demographic survey. Prevalence of obesity and overweight and distribution of body mass index (BMI) by gender, age, and nationality were analyzed and compared. Cutoff points of BMI for defining obesity and overweight were based on the proposal set by the Working Group on Obesity in China (WGOC) to assess age-, gender- and nationality-specific prevalence of obesity and overweight.</p><p><b>RESULTS</b>Prevalence of obesity was 5.34%, 6.78%, 3.39 %, and 1.22% for boys and 2.61%, 1.83%, 1.78%, and 1.40% for girls of Han, Hui, Uygur and Kazak nationalities, respectively. Prevalence of obesity tended to decrease with age overall, whereas that of overweight increased with age in Han children.</p><p><b>CONCLUSIONS</b>Prevalence of obesity in school children in Urumqi varies with their nationalities and is lower than that of an average national level and a level of western countries. Obesity is more prevalent in boys than in girls of Urmuqi overall, which is just the opposite in Kazak children. Han boys and Hui girls have the highest prevalence of obesity and Kazak boys and girls have the lowest ones. Prevalence of obesity decreases with age, but that of overweight shows a different trend.</p>