Sex differences in cardiovascular health among children aged 6-8 years in Beijing City / 中国学校卫生

Objective@#To explore sex difference in the cardiovascular health (CVH) status of 6-8 year old children in Beijing, so as to inform the early intervention of CVH related lifestyles.@*Methods@#Based on the Beijing Children s Growth and Health Cohort (PROC), baseline physical examination, sequential questionnaire survey, and laboratory tests were conducted among 1 914 grade 1 students. Children s CVH and its subscales (health behaviors and health factors) scores were calculated according to the Life s Essential 8 (LE 8) index and categorized into high, moderate, and low CVH. CVH scores were reported as medians and interquartile ranges; sex differences were compared using the Chi square test and Wilcoxon test.@*Results@#Among the 1 914 participants, the percentages of high, moderate, and low CVH were 35.7%, 63.5%, and 0.8%, respectively, and the percentages of high, moderate, and low health behavior scores were 25.9%, 67.5%, and 6.6%, respectively, with no statistically significant differences between sex ( χ 2=2.30, 0.07, P >0.05). The rates of high, moderate, and low health factor scores for boys and girls were 61.1%, 36.0%, 2.9% and 71.1%, 28.4%, 0.5%, respectively, with a statistically significant sex difference ( χ 2=31.88, P < 0.01). The overall CVH score was 76.0(70.0, 83.0), 76.0(69.0, 82.0) for boys, and 77.0(71.0, 83.0) for girls. Among the health behavior metrics, sleep scores were the best and physical activity scores were the worst[100.0(90.0,100.0), 40.0(20.0, 80.0 )]; among the health factor metrics, blood glucose scores were the best and lipid scores were the worst[100.0(100.0,100.0), 60.0(40.0,100.0)]. In respect to health factors, there were significant gender differences in body mass index, blood lipids, blood sugar, and blood pressure scores ( Z =-6.92, 3.01, -6.60, -2.30, <0.05), but there were no significant gender differences in diet, physical activity, nicotine exposure, or sleep scores with regards to health behaviors ( Z =0.99, 0.88, -0.13, 0.36, P > 0.05 ). Compared to boys, girls in the low and moderate CVH groups had high health factor scores despite low health behavior scores.@*Conclusion@#Most 6 to 8-year-old children in Beijing were found to have relatively good CVH, and optimization of children s CVH status can be achieved by promoting healthier lifestyles and monitoring health factors, especially among boys.

Sex differences in the growth and physical development of Beijing school aged children and adolescents / 中国学校卫生

Objective@#The study aimed to explore sex differences in the growth and physical development of Beijing school-aged children and adolescents.@*Methods@#Data obtained from regular health examinations of 94 122 school-aged children and adolescents aged 6-18 years old were collected from primary and high schools in Shunyi District from 2009 to 2018, and a longitudinal dataset was compiled with complete anthropometric parameters including height, weight, and BMI levels after linkage of individuallevel information. The age-specific growth rate was calculated and a linear mixed-effects model was used to identify sex differences according to chronological or relative age to peak height velocity (PHA).@*Results@#Height, weight, and BMI levels increased with age in both boys and girls. Girls were taller than boys in the 10-11 year-old age group, catch-up growth in height was observed in boys at age 12, whose height surpassed that of girls thereafter. Boys had a higher weight and BMI than girls in all age groups (P<0.01). Sex differences were found in the growth rates of height, weight, and BMI levels(t=-67.56，-47.46，3.22，P<0.01), which was demonstrated by the interaction effect of sex and age in the linear mixed-effects model. The PHA in boys was 12 years old, which was two years later than the PHA in girls. Boys reached peak weight velocity at 12 years old, lagging one year behind girls who reached their peak at 11 years old. The curves of the BMI growth rate with age showed double peaks in boys and the first peak appeared at 10 years, which was one year earlier than girls. The change in weight was highly synchronized in time with the increase in height, after adjusting for the growth rate of weight by PHA. Weight velocity increased with age before the onset of puberty until PHA, and then it declined; boys presented with obvious fat accumulation before the onset of puberty.@*Conclusion@#Sex differences in the growth and physical development of school-aged children and adolescents were persistent and apparent, and the change in weight was highly synchronized in time with the increase in height.

Association between visceral adiposity index and nonalcoholic fatty liver among overweight and obese children in Beijing / 中国学校卫生

Objective@#To examine the association between the visceral adiposity index (VAI) and nonalcoholic fatty liver disease (NAFLD) in the pediatric population in order to improve risk stratification and prevention systems for chronic liver disease.@*Methods@#A total of 510 overweight/obese children aged 6-8 years old were enrolled from the child cohort which was designed to study puberty, obesity, and cardiovascular risk (PROC), and complete data from liver ultrasounds and the VAI were obtained. Used Spearman s rank correlation coefficient, Chi-square tests, and Logistic regression analyses to explore the association between the VAI and NAFLD.@*Results@#The detection rates of NAFLD for boys and girls were 25.9% and 11.1%, respectively. VAI for normal group and the NAFLD group were 0.43(0.31, 0.61) and 0.61(0.44, 0.87) in boys, and 0.74(0.56, 1.07) and 1.08(0.67, 1.51) in girls, respectively. Spearman s correlation coefficient analysis showed that triglycerides(TG), VAI, and the third quintile VAI group were positively correlated with NAFLD in both boys and girls(r=0.19,0.26,0.29;0.16,0.16,1.18,P<0.05), and high-density lipoprotein-cholesterol (HDL-C) was negatively correlated with NAFLD in boys (r=-0.21, P<0.05). With advancing tertiles of VAI, the increasing trend in the NAFLD detection rate was statistically significant in boys and girls(Chi-square for trend were 21.77,7.66, P<0.01). The results of univariate and multivariable Logistic regression showed that, by taking the first tertile of VAI as a reference, the risk of NAFLD among boys was higher in the second tertile (cOR=2.59, 95%CI=1.15-5.86; aOR=2.33, 95%CI=1.01-5.36) and in the third tertile(cOR=5.73, 95%CI=2.62-12.53; aOR=4.87, 95%CI=2.15-11.03), where as the risk among girls was higher in the third tertile(cOR=4.43, 95%CI=1.40-14.00).@*Conclusion@#VAI is positively correlated with pediatric NAFLD. Higher tertiles of VAI were associated with an increased risk of NAFLD in overweight and obese children, which indicates that VAI can be used as an early predictor of NAFLD.

Identifying cardiometabolic risk factors of children, informing policies of stratified interventions / 中国学校卫生

Abstract@#The prevalence of cardiometabolic risk factors at early lifecycle stages is higher than ever before, early identification and stratified intervention are critical to slowing down disease progression and reducing cardiovascular disease risk burden in adulthood. The implementation of stratified interventions to address the co-prevalence of cardiometabolic risk factors can reduce health expenditure and increase social capital. Guided by the policies and characteristics inherent to the growth and development of Chinese children, and nurtured and inspired by prestigious child cohorts around the world, we aim to carry out a precisely measured child cohort study that uses rigorous indicators to assess child health. We wish to produce detailed evidence that can identify cardiometabolic risk factors during childhood, so as to develop early warning and informed stratified intervention strategies, which can thereby reduce the burden of cardiovascular disease in China from childhood to adulthood and improve quality of life.

Cyclin-dependent kinase 8 and its inhibitors in antitumor therapy: research advances / 国际药学研究杂志

Cyclin-dependent kinase 8(CDK8)regulates transcription by binding to mediator complex or phosphorylating transcriptional factors. Recent studies have reported that overexpressed CDK8 leads to the development of colorectal cancer, breast cancer and hematological malignancies by activating Wnt- β- catenin, promoting the transcription of estrogen- inducible genes and inhibiting the expression of super enhancer-associated genes. These studies have indicated that CDK8 is a potential antitumor target. This paper briefly discusses the biological function of CDK8 and the regulatory mechanism of CDK8 on the tumorigenesis and its development, and reviews on the research progress in CDK8 inhibitors, hoping to provide a reference CDK8-targeting cancer therapy.

Prevalence of childhood asthma in China from 2011 to 2018: a Meta-analysis / 中国学校卫生

Objective@#To understand the epidemiological characteristic of the prevalence of aasthma in children in China, and to provide clues for the prevention and treatment of asthma in China.@*Methods@#A systematical literature retrieval on children asthma prevalence from CNKI, WanFang Data, VIP and PubMed databases was performed. Random effects model was used to calculate the combined prevalence of asthma and its 95% confidence interval (CI) with Stata 16.0 software, the subgroup analysis was conducted according to sex, age and region.@*Results@#A total of 26 studies were included, including 213 729 children, 112 169 boys and 101 560 girls. Meta-analysis showed that the combined prevalence of asthma in children aged 14 and under in China was 3.3%(95%CI=2.7%-4.0%). The subgroup analysis showed that the prevalence of asthma in boys was higher than that in girls(Q=11.42, P=0.01). The prevalence of asthma in preschool children aged 4-6 was higher than that in infants aged 0-3 and school children aged 7-14(Q=8.03, P=0.02). And there was no significant discrepancy of the asthma prevalence among children between the north and south(Q=0.72, P>0.05).@*Conclusion@#The prevalence of childhood asthma in China presented an increasing trend. Our findings underscore more efforts to control and prevent asthma among children.

Evaluation of cartilage regeneration by arthroscopy after high tibial osteotomy / 中国骨伤

OBJECTIVE@#To evaluate the cartilage regeneration in the knee joint by arthroscopy after high tibial osteotomy.@*METHODS@#Eleven patients were included in the study who were treated with high tibial osteotomy and underwent microscopy when the internal fixation was unloaded from September 2017 to September 2019. Among them, there were 2 males and 9 females, aged from 55 to 64 years old. The internal and external compartment pictures of the knee were taken before and after surgery of removing the internal fixation and the International Cartilage Repair Society (ICRS) grading systerm was used to evaluate the degree of cartilage damage on the medial and lateral femoralcondyles and tibial plateau. The Westrn Ontarioand Mcmaster Universities osteoarthritis index (WOMAC) and the weight bearing line (WBL) were used to evaluate the function of the knee and the alignment of the lower limb.@*RESULTS@#All 8 patients were followed up for more than 12 months, ranging from 12 to 22 months. The degenerated cartilage of the medial femoral condyle and medial tibial plateau was covered by newly regenerated cartilage. WOMAC score decreased from 102-127 to 41-52 and WBL was improved from 17%-34% to 58%-64%. All incisions healed in stageⅠ, and no complications such as internal fixation rupture and infection occurred during and after the operation.@*CONCLUSION@#High tibial osteotomy can relieve the pain of the knee and the dysfunction by adjusting lower limb alignment, and the degenerated cartilage could be regenerated in the medial femoral condyle and medial tibial plateau.

Intertransverse approach microendoscopic discectomy for far lateral lumbar disc herniation / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical effect of intertransverse approach microendoscopic discectomy for far lateral lumbar disc herniation.</p><p><b>METHODS</b>From February 2005 to February 2010, 73 patients with far lateral lumbar disc herniation were treated with intertransverse approach microendoscopic discectomy. Their clinical data were retrospectively analyzed. There were 41 males and 32 females, aged from 19 to 80 years old with an average of 56.5 years; courses of disease ranged from 1 to 25 months with an average of 4.5 months. The main symptom was low back pain and sciatica, especially the sciatica was seriously. Herniation level was in L3,4 of 9 cases, L4,5 of 49 cases, L5S1 of 15 cases. Preoperative, 2 weeks after operation, final follow-up, conditions of pain relief were assessed by visual analogue scale (VAS); total life quality of patients were evaluated by Oswestry Disability Index (ODI) before operation and last follow-up.</p><p><b>RESULTS</b>All operations were performed successfully, operative time was from 40 to 115 min (mean of 50 min); and blood loss was from 50 to 150 ml (mean of 110 ml). Incision infection had 1 case and incomplete nerve root injury had 1 case. All patients were followed up from 3 to 8 years with an average of 4.5 years. Postoperative VAS and ODI had obviously improved (P < 0.01).</p><p><b>CONCLUSION</b>The technique of intertransverse approach microendoscopic discectomy is a feasible and effective method for far lateral lumbar disc herniation.</p>

Analysis of intraoperative complications of microendoscopic disectomy and corresponding preventive measures / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the reasons of intraoperative complications of microendoscopic disectomy (MED) and corresponding preventive measures.</p><p><b>METHODS</b>From October 2001 to January 2012, the data of 851 patients with lumbar disc herniation underwent MED were retrospectively analyzed. There were 469 males and 382 females with an average age of 42.5 years ranging 16 to 75. Course of disease was from 1 to 18 months with an average of 3 months. The segments of herniated disc including L3,4 of 24 cases, L4,5 of 418 cases and L5S1 of 409 cases . Main symptoms included low back pain with lower extremity radial pain and numbness. Of them,unilateral lower extremity symptom was in 729 cases and bilateral symptom was in 122 cases. There were at least 2 abnormal signs in the four signs which including feeling anormaly, muscle strength anormaly,dysreflexia and muscle atrophy. Distraction test of nerve was positive. CT or MRI findings must coincide with the clinical symptoms and signs. No lumbar instability,spinal stenosis,the upper lumbar disc herniation or combined with cauda equina nerve syndrome were found in 851 patients. The intraoperative complications were recorded and analyzed for the reasons of the intraoperative complication and related prevention measures.</p><p><b>RESULTS</b>According to the Macnab standard,424 cases obstained excellent results, 321 good,106 fair,with excellent and good rate of 87.5%. The result was similar to the traditional open operation. One cases transferred to open operation due to equipment breakdown, case died for myocardial infarction at 11 days after the operation, 2 cases occurred acute epidural hematoma in 1 hour after operation. Injury of dura mate of spinal cord occurred in 28 cases and incidence rate was 3.29%(28/851); traction injury of nerve root occurred in 38 cases and incidence rate was 4.46% (38/851). One case occurred in retroperitoneal hematoma, 2 cases in incomplete cauda equina injury and 2 cases in incomplete nerve root breakage.</p><p><b>CONCLUSION</b>Skilled endoscopic hemostasis techniques,careful and meticulous operation is very important for the prevention of intraoperative complications. Moreover,timely finding and treating the complications was effective measures to prevent the coniplications.</p>