Chinese Criteria Research Articles

Artificial intelligence based Chinese clinical trials eligibility criteria classification

Subject recruitment is a key component that affects the progress and results of clinical trials, and generally conducted with eligibility criteria (includes inclusion criteria and exclusion criteria). The semantic category analysis of eligibility criteria can help optimizing clinical trials design and building automated patient recruitment system. This study explored the automatic semantic categories classification of Chinese eligibility criteria based on artificial intelligence by academic shared task. We totally collected 38 341 annotated eligibility criteria sentences and predefined 44 semantic categories. A total of 75 teams participated in competition, with 27 teams having submitted system outputs. Based on the results, we found out that most teams adopted mixed models. The mainstream resolution was applying pre-trained language models capable of providing rich semantic representation, which were combined with neural network models and used to fine-tune the models with reference to classifier tasks, and finally improved classification performance could be obtained by ensemble modeling. The best-performing system achieved a macro F1 score of 0.81 by using a pre-trained language model, i.e. bidirectional encoder representations from transformers (BERT) and ensemble modeling. With the error analysis we found out that from the point of data processing steps the data pre-processing and post-processing were very important for classification, while from the point of data volume these categories with less data volume showed lower classification performance. Finally, we hope that this study could provide a valuable dataset and state-of-the-art result for the research of Chinese medical short text classification.

Association of maternal pre-pregnancy low or increased body mass index with adverse pregnancy outcomes

This study investigated the association between pre-pregnancy body mass index (BMI) and adverse pregnancy outcomes among women participated in the National Free Preconception Health Examination Project in Guangdong Province, China, and explored these associations according to maternal age. Pre-pregnancy BMI was classified into underweight (BMI < 18.5 kg/m2), healthy weight (18.5–23.9 kg/m2), overweight (24.0–27.9 kg/m2), and obesity (≥ 28.0 kg/m2) according to Chinese criteria. Outcomes were preterm birth (PTB, delivery before 37 weeks of gestation), large for gestational age (LGA, birthweight above the 90th percentile for gestational age by infants’ sex), small for gestational age (SGA, birthweight below the 10th percentile for gestational age by infants’ sex), primary caesarean delivery, shoulder dystocia or birth injury, and stillbirth. Adjusted incidence risk ratios (aIRR) were calculated for underweight, overweight and obesity, respectively. Compared with healthy weight, underweight was associated with increased risk of PTB (aIRR 1.06, 95%CI 1.04–1.09) and SGA (1.23, 1.22–1.26) but inversely associated with LGA (0.83, 0.82–0.85), primary caesarean delivery (0.88, 0.87–0.90) and stillbirth (0.73, 0.53–0.99). Overweight was associated with increased risk of LGA (1.17, 1.14–1.19), primary caesarean delivery (1.18, 1.16–1.20) and stillbirth (1.44, 1.03–2.06), but inversely associated with SGA (0.92, 0.90–0.95) and shoulder dystocia or birth injury (0.86, 0.79–0.93). Obesity was associated with increased risk of PTB (1.12, 1.05–1.20), LGA (1.32, 1.27–1.37), primary caesarean delivery (1.45, 1.40–1.50), but inversely associated with SGA (0.92, 0.87–0.97). The aIRRs for underweight, overweight and obesity in relation to these adverse pregnancy outcomes ranged from 0.65 to 1.52 according to maternal age. In Chinese population, maternal pre-pregnancy BMI was significantly associated with the risk of adverse pregnancy outcomes and the risk differs according to maternal age. Further investigation is warranted to determine whether and how counselling and interventions for women with low or increased BMI before pregnancy can reduce the risk of adverse pregnancy outcomes.

Prevalence and determinants of potentially inappropriate medications prescribing in elderly patients in Chinese communities

To assess the prevalence and associated risk of potentially inappropriate medications (PIMs) prescribing in community-dwelling elderly patients in China and to examine the most frequently used PIMs. This will provide a reference for the formulation of medication manuals for the community-dwelling elderly and further standardize the use of medications in elderly patients. We conducted a cross-sectional retrospective study from April 1, 2020 to April 30, 2020. Data from elderly patients aged ≥65 years were collected from the Hengjie (N=2,294), Loujiang (N=3,972), and Tongxing communities (N=1,969) in Suzhou. The frequency of PIMs was detected using the 2019 Beers criteria and the 2017 Chinese criteria. Chi-square (for categorical variables), ANOVA (for continuous variables as applicable), and logistic regression were used to describe and identify potential predictors of PIMs. A total of 8,235 elderly patients were examined. Using the Chinese criteria, the prevalence of PIMs was 37.07%, which was slightly higher than that found using the 2019 Beers criteria (32.16%). The most prescribed PIMs were estazolam (21.53%) and insulin (4.60%) based on the Chinese criteria. Logistic regression analysis showed that advanced age, polypharmacy, and comorbid disease of patients were associated with a high risk of PIMs. Furthermore, the educational background and professional title of physicians were also associated with PIMs. Given the high prevalence of PIMs in the Chinese community-dwelling elderly population, the implementation of evidence-based interventions to promote rational clinical drug use could improve their quality of life.

Analysis of animal models of chronic atrophic gastritis based on characteristics of clinical symptoms of traditional Chinese and Western medicine

Based on the characteristics of clinical symptoms of chronic skin ulcers in traditional Chinese and Western medicine, the current animal models of skin ulcers are summarized. This article analyzes the advantages and disadvantages of animal models according to the etiology and pathogenesis of chronic skin ulcers, traditional Chinese and Western medicine diagnostic criteria and observation indicators, and eva-luates the agreement between the existing animal models and the characteristics of clinical syndromes of traditional Chinese and Western medicine for chronic skin ulcers. Through analysis and comparison, it is found that most of the existing modeling methods are single-factor animal models, and there are certain gaps in the physiological and pathological characteristics of chronic skin ulcers caused by clinical multi-factors and interactions. Most of the modeling methods are guided by Western medicine. The lack of pathogenic factors of traditional Chinese medicine(TCM) in the process of modeling. Therefore, this article proposes to establish a reasonable quantification standard for chronic skin ulcer animal models, and to establish a combination model of chronic skin ulcer disease with traditional Chinese and Western medicine as the focus of future animal model research.

Predictive value of live birth rate based on different intrauterine adhesion evaluation systems following TCRA

ObjectiveThe aim of this study was to assess the predictive value of five different intrauterine adhesion (IUA) evaluation systems for live birth rate following transcervical resection of adhesion (TCRA).MethodThis retrospective study included 128 women with IUA who desired for spontaneous conception after TCRA. All the patients were retrospectively scored by the American Fertility Society (AFS) classification, European Society of Gynecological Endoscopy (ESGE) classification, March’s classification (March), Nasr classification (Nasr) and Chinese IUA diagnosis classification criteria (Chinese). The predictive value of these evaluation systems was determined by receiver operating characteristic (ROC) curves and area under a ROC curve (AUC).ResultsThe correlation coefficients of AFS, ESGE, March, Nasr and Chinese classification and the live birth rate were 0.313, 0.313, 0.288, 0.380, and 0.336, respectively. Among women with hypomenorrhea and amenorrhea, as well as women with no infertility, the severities determined by all five evaluation systems were correlated with live birth rate (P < 0.001). All five scoring systems were efficient to predict live birth rate. Among them, Nasr classification showed the highest AUC (0.748) with the best predictive value. Multivariate logistic regression analyses showed that Nasr classification had the highest OR (OR, 6.523; 95% CI, 2.612, 18.263). And, Nasr’s classification system also showed highest sensitivity (81.8%) and negative predictive value (96.7%) when divide the system into mild IUA vs. moderate and severe IUA.ConclusionAFS, ESGE, March, Nasr and Chinese classification were demonstrated to be capable of predicting live birth following TCRA although the predictive capacities might be limited, and Nasr classification showed the highest predictive value of live birth.

Hazard assessment and mitigation of non-seismically fatal landslides in China

Fatal landslides cause severe disasters to human lives and socioeconomic costs in China. In this study, the data non-seismically fatal landslides were collected between 2004 and 2016 in China. The hazard and life risk criteria of these fatal landslides were assessed, and the government's investment and ecological influencing factors for landslide prevention and mitigation were analyzed. There were more fatal landslides in Sichuan, Guizhou, Yunnan, Hunan, and Guangdong provinces. High landslide density value focused on Guizhou, Hunan, and Guangdong province had very high landslide density value, while Gansu held the biggest fatality density value as a result of a few huge fatal landslide events. The Chinese life risk evaluation criterion was higher than those in other countries because there was a greater population density in landslide-prone areas. Nevertheless, the government has invested a great deal of human and financial resources for landslide mitigation over the past 13 years. In total, 244,559 engineering projects were carried out and $15,920.89 million was spent. Thus, a total of 13,603 landslides were successfully predicted and 641,333 persons and $1,372.94 million has been saved. Additionally, the types of land use, afforestation area, and soil erosion management have a positive effect on landslides. However, a trend of reverse increase was presented in fatal landslides. This paper gives a detailed examination of the non-seismically fatal landslide hazard and proves an evaluation of the Chinese government's contribution to landslide mitigation by integrating engineering and ecological measures.

Prevalence, Management, and Associated Factors of Obesity, Hypertension, and Diabetes In Tibetan Population Compared with China Overall

Background: Tibetans’ life expectancy lags behind China’s national average. Obesity and noncommunicable diseases (NCDs) contribute to the health disparity, but NCD patterns among Tibetans are unknown. This systematic review and meta-analysis examined prevalence, management, and associated factors for obesity, hypertension, and diabetes among Tibetans and compared them with China's average. Methods: We systematically searched PubMed and China National Knowledge Infrastructure databases for studies published in English and Chinese between January 2010 and April 2021. Pooled prevalence estimates were calculated using random-effects models. China’s national estimates were from nationally representative surveillance. PRISMA guidelines were followed. Findings: Thirty-nine studies were included for systematic review, among which 37 qualified for meta-analysis, with 115,403 participants. Studies included were geographically diverse in altitude, livelihood, and urban/rural residence. Pooled prevalence estimates were 47·9% (95% CI 38·0-57·8) for overweight/obesity among adults (BMI≥24kg/m 2 ), and 15·4% (13·7-17·2) among children using Chinese criteria, lower than national rates of 51·2% and 19·0%, respectively. The estimate for hypertension (31·4% [27·1-35·7]) exceeded China’s average (27·5%), while diabetes (7·5% [5·2-9·8]) was lower than China’s average (11·9%). Men had higher prevalence estimates of overweight/obesity, hypertension, and diabetes than women. Residents in urban, rural, and Buddhist institutes had monotonically decreased prevalence estimates in both hypertension and diabetes. Awareness, treatment, and control rates for hypertension were lower than China's average. Findings on diabetes management were similar based on limited studies. Urban residence and high altitude were consistent risk factors for hypertension. Limited studies investigated factors associated with diabetes, and none for obesity. Interpretation: Tibetans have a high burden of obesity and hypertension. Further research is required to clarify the low diabetes prevalence found. Representative and longitudinal studies are needed for interventions tailored to the Tibetan population, evidence-based and culturally-sensitive policy development, and health equity. Registration Details: Study protocol was registered with PROSPERO, number CRD42021255694. Funding Information: The study was funded in part by research grants from the National Key Research & Development Program of China (2017YFC0907200 & 2017YFC0907201), Natural Scientific Foundation of China (82103846) and Chinese Nutrition Society (CNS-SCP-2020-40). Declaration of Interests: We declare no conflict of interest.

Method of Setting Exit Advance Guide Signs in Highway Tunnels Based on the Driver’s Eye Movement With Markov Chains

While the number of highway tunnels is increasing, the current Chinese criteria and Uniform Traffic Control Equipment Manual (MUTCD) 2009 guidelines provide no clear method for setting exit advance guide signs in highway tunnels. To solve this problem, this paper proposes separate guide signs, consisting of location and distance signs. Location signs on the tops of tunnels use Chinese characters with a height of 40 cm and a width 20 cm. The distance signs are 62.6 m from the location signs with a character height and width of 1.5 m and a total sign length of 22.5 m. Four schemes were tested, in which the distance sign was on the left or right wall of the tunnel and the vehicle was in the left or right lane. At the “Perception” and “Recognition” stages, the pupil area change rate of the four schemes had a slight difference to no sign but were always less than the 20% threshold line. A Markov chain was employed to analyze the driver's eye movement characteristics to evaluate the effect of separate guide signs. The results are the following. In the left lane, when a distance sign on the left wall of the tunnel appeared, the driver's fixation points were relatively balanced, except in the left area. After the sign disappeared, the driver's fixation points were no different than before, except in the front area. However, when a distance sign appeared on the right wall, 77.84% of the driver's fixation points were concentrated in the front and right areas, which decreased the driving safety. Similar results were obtained in the right lane. Therefore, distance signs should be placed on the left wall of the highway tunnel. This study can forewarn a driver in a tunnel of the exit location and distance and help the driver to exit the highway safely.

Sampling survey report on Chinese physicians' cognition of the guidelines on diagnosis and treatment of colorectal cancer

Objective: To investigate and evaluate the mastery and recognition degree of Chinese clinicians on the 2015 edition of the Chinese Criteria for Diagnosis and Treatment of Colorectal Cancer in order to provide useful suggestions for updating and formulating diagnosis and treatment standards. Methods: Simple random sampling was used to conduct a questionnaire survey in 1500 colorectal cancer-related doctors in general hospitals and cancer hospitals from 115 cities in China. The study included the following guidelines: (1) Chinese Criteria for Diagnosis and Treatment of Colorectal Cancer (2015 edition); (2) Chinese Society of Clinical Oncology Colorectal Cancer Guidelines 2017 (CSCO 2017); (3) National Comprehensive Cancer Network (NCCN) Colon Cancer Guidelines 2017.v1; (4) European Society for Medical Oncology (ESMO) Rectal Cancer Guidelines. The survey was carried out in 2017 and 2019 respectively. In the first phase, the questionnaire included 4 dimensions (guideline cognition, detection and diagnosis, pathology and staging, treatment), and 1500 questionnaires were distributed. In the second phase, the questionnaire contained 3 dimensions (basic information, current treatment status of metastatic colorectal cancer, academic expectations), and 350 questionnaires were distributed. Case (%) was used to indicate the categorical variable data, and chi-square test was used for comparison between groups. P<0.05 indicated that the difference was statistically significant. Results: In the first phase, 1472 valid questionnaires were collected, and the questionnaire efficiency was 98.1% (1472/1500). In the second phase, 337 valid questionnaires were collected, and the questionnaire efficiency was 96.3% (337/350). In the survey of the first phase, doctors had some knowledge and compliance with various guidelines, but the most familiar one was the NCCN guidelines, accounting for 90.7% (1335/1472). In the dimension of detection and diagnosis, the overall correct rate was 64.1% (944/1472). The correct rate of doctors in the first-tier cities was 55.6% (148/266), which was lower than 59.1% (182/308) and 72.9% (369/506) in the second- and the third-tier cities, and the difference was statistically significant (χ(2)=42.140, P<0.001). More than 60.0% (883/1472) of doctors was clear about the specification requirements of the staging evaluation and pathological examination. However, in terms of rectal cancer local staging evaluation, the ratio of doctors who would choose rectal MRI in the first-tier cities was lower than that of those in other tier cities [51.5% (137/266) vs. 65.6% (202/308), 63.2% (320/506) and 61.2% (240/392)], and the difference was statistically significant (χ(2)=41.886, P<0.001). In the dimensions of staging evaluation and pathological examination, there were no statistically significant differences in cognition between general and specialist hospitals (P>0.05). In the treatment dimension, 79.8% (1175/1472) of doctors considered the preoperative treatment as a necessary option for patients with middle and low locally advanced (over cT3) rectal cancer. 46.3% (681/1472) of doctors, including 60.3% (433/718) of surgeons, and 31.4% (225/716) of physicians, had a vague idea that irinotecan could not be used for postoperative adjuvant treatment of colorectal cancer. In the survey of the second phase, 93.8% (316/337) of doctors approved potentially curative systemic (conversion) therapy, and 95.3% (321/337) of doctors followed the clinical guidelines in the treatment of metastatic colorectal cancer. Regarding academic expectations, the clinician's concern for surgery was more practical, and 79.2% (267/337) of doctors wanted to know the best options of conversion therapy for potentially curable metastatic colorectal cancer. In contrast, the clinician's concern for internal medicine was more exploratory, and 80.1% (270/337) of doctors focused on selecting targeted drugs and the sequence of treatment. Conclusions: This investigation has a preliminary understanding of the diagnosis and treatment of colorectal cancer in China. (1) There are many guidelines for doctors' reference, but doctors' understanding of domestic guidelines is not as good as NCCN guidelines. (2) The degree of understanding of the guidelines varies significantly among doctors in different cities. (3) The promotion of guidelines should focus on basic concepts and theories. (4) The detection, diagnosis, and treatment of colorectal cancer should be better trained and promoted. (5) The concept of conversion therapy for metastatic colorectal cancer is highly recognized.

Prevalence of osteoporosis and its spatiotemporal patterns in a community-dwelling Chinese population: a systematic review and meta-analysis of data from 982 563 individuals

BackgroundOsteoporosis is becoming a common skeletal disorder characterised by reduced bone strength that leads to an increased risk for fractures. Despite its increasing prevalence among the Chinese population, osteoporosis remains both underdiagnosed and undertreated. Many observational studies have reported prevalence of osteoporosis in China; however, the estimated prevalence varies within a certain range because of the diverse ways of life and diverse genetic heritage of the populations in different Chinese regions, and few studies have examined the sex-specific prevalence of osteoporosis in China across time. We did a systematic review and meta-analysis to compare the prevalence and temporal trends of osteoporosis in Chinese women and men. MethodsIn accordance with MOOSE and PRISMA, we did literature searches in PubMed, MEDLINE, Embase, the China National Knowledge Infrastructure, and the Chinese WanFang databases for epidemiological studies that reported osteoporosis prevalence in Chinese individuals from their inception to Jan 31, 2020, without language restrictions. Studies were considered eligible if they reported sufficiently detailed results about prevalence of osteoporosis among Chinese individuals aged at least 18 years, and if they used either WHO or Chinese criteria for osteoporosis diagnosis. Studies were excluded if they were reviews, case reports, editorials, guidelines, and other article forms without available full-texts, if they were duplicate papers or evaluating the same sample, and if the studies were done in a population with other specific diseases. We assessed prevalence of osteoporosis using a random-effects model by applying binomial distribution and Freeman-Tukey double arcsine transformation to stabilise the variances, and the pooled Freeman-Tukey prevalence estimates were then back transformed to their original scale for ease of interpretation. We also did a subgroup analysis by sex, age, region, and screening period. FindingsWe identified 129 eligible studies that included 982 563 individuals. The overall prevalence of osteoporosis in China was 20·80% (95% CI 17·95–23·79). Its prevalence was higher in women (23·57%, 18·50–29·04) than in men (12·22%, 7·23–18·29), and in rural (23·06%, 16·80–29·99) than urban regions (20·95%, 17·09–25·09). From 2001–05 to 2016–19, prevalence of osteoporosis progressed steadily from 19·35% (14·86–24·28) to 21·30% (17·17–25·73) in 2006–10 and 22·61 (19·27–26·12) to 23·58% (17·08–30·78) in 2011–15. In terms of temporal stratification, the prevalence increased with age in both sexes, with a greater rise in women from age 50–59 (10·22%) years to 80 years and older (62·24%) than in men of the same age groups (from 5·62% to 30·55%). In terms of regional stratification, the pooled prevalence estimates were higher among Chinese individuals in the south, north, and southwest (prevalence of more than 25%) by a factor of 1·5, compared with their counterparts in the northeast of China. Regional prevalence of osteoporosis ranged from 25·78% (19·79–32·26) in the south, 22·55% (14·32–32·02) in the east, 19·60% (13·25–26·85) in the northwest, and 17·33% (11·23–24·44) in the northeast. InterpretationThis up-to-date meta-analysis provides a comprehensive overview of the burden of osteoporosis among Chinese women and men. Our findings suggest a considerable prevalence of osteoporosis, especially in older Chinese women. Our findings also emphasise the urgent need for control measures and preventive management of osteoporosis because of a rapidly ageing population in China. FundingNational Natural Science Foundation of China (81803329) and China Postdoctoral Science Foundation (2018M631780).

Sex-Related Differences in the Risk of Silicosis Among Chinese Pottery Workers: A Cohort Study.

To investigate the effect of sex on the risk of silicosis and to explore any interaction between cigarette smoking and sex in the development of silicosis. The cohort was selected from eight Chinese pottery factories. Diagnoses of silicosis were based on 1986 Chinese pneumoconiosis Roentgen diagnostic criteria. Data on cigarette smoking were collected by face-to-face interviews in 1989 and 2003. Eight thousand eight hundred and eighty seven dust-exposed workers were included. Men had a 77% higher incidence of silicosis than women. At lower pack-years of smoking, men were 72% more at risk than women. The latency period was found to be longest in female never-smokers and shortest in female ever-smokers. Men had a higher risk of developing silicosis than women. Cigarette smoking increased the risk in both sexes, more so in women.

COVID-19 Epidemic Situation, the Outbreak Peak and Cycle Centered on China's No-Drug Control Actions: A Modeling Study

Background: New characteristics have created significant challenges in non-drug regulation on the 2019 Corona Virus Disease (COVID-19) outbreak while there are few related research articles in recent months. In view of these recent developments, a more comprehensive analysis on the role of non-drug control measures (NDC) will provide a further guide for the work on disease prevention faced with a range of changes. Methods: This paper measures and divides the intensity of the NDC into eleven tiers according to the World Health Organization (WHO) and Chinese emergency classification criteria. The paper then proposes a new model for control-measures-susceptible-exposed-infected-removed-dead (CM-SEIRD), based upon the standard susceptible-exposed-infected-removed (SEIR) model, which parameterizing the new characteristics of COVID-19 infection and NDC. The start time and intensity of implementation of the NDC were taken as variables to obtain the special impact of NDC on the COVID-19 epidemic. The theoretical study on variable discretization and continuity was carried out for the Wuhan model system. Findings: NDC can efficiently minimize deaths, minimize infection risk, and delay the outbreak peak for 1-2 months. The highest outbreak time discussed in this study was around 16-23 days. If NDC can be carried out within the time threshold and intensity level, more than 10% of the total death toll will be reduced, more than 8% of the peak infected number will be reduced, and more than 90% of the population will be able to prevent infection. In contrast to the NDC starting time, the intensity of NDC impacts the outbreak more directly and has a good impact on the overall number of people exposed, sick and dead from the beginning to the end. This study also found that it would take 23 days to clear new cases in the blocked areas based on the strength of Chinese control measures. Interpretation: Despite great pressure due to the new characteristics and situation of the COVID-19 outbreak, at this point, NDC is still the most effective prevention and control step. Different countries and regions need to implement strict NDCs as quickly as possible to contain the outbreak and to promote development and economic growth as soon as possible.Funding Statement: Guangxi University.Declaration of Interests: All authors declare no competing interests.

Resolution of Coronavirus Disease 2019 Infection and Pulmonary Pathology With Nebulized DAS181: A Pilot Study.

Severe acute respiratory syndrome coronavirus 2 infections commonly lead to respiratory failure and potentially fatal systemic inflammation and organ failure. Nebulized DAS181, a host-directed biologics with sialidase activity, is an investigational drug with antiviral activities on parainfluenza and influenza under phase 3 and phase 2 development. The objective of this study (NCT04324489) is to investigate the safety and effects of nebulized DAS181 on hypoxic coronavirus disease 2019 patients. Single-center, prospective, open-label, compassionate use. Renmin Hospital of Wuhan University, Department of Respiratory and Critical Care Medicine and Department of Infectious Diseases. Patients 18 to 70 years old who met Chinese criteria for severe coronavirus disease 2019 pneumonia and required supplemental oxygen but not on mechanical ventilator at screening. Nebulized DAS181 (4.5 mg) twice a day for 10 days. Three male coronavirus disease 2019 hypoxic patients with bilateral lung involvement completed DAS181 treatment for 10 days. By day 14, all achieved return to room air (primary endpoint) and their nasopharyngeal swabs were negative for severe acute respiratory syndrome coronavirus 2. Clinical severity improved from severe coronavirus disease 2019 at baseline to moderate or mild disease by day 5, consistent with rapid reduction of inflammatory cytokines by days 2-3 and radiologic improvement by days 5-10. No DAS181-related adverse events were reported. Inhalation of DAS181 was well tolerated and potential clinical benefit of DAS181 on hypoxic coronavirus disease 2019 is the reduction of supplemental oxygen need. Efficacy and safety, including pharmacokinetics and viral studies of DAS181 in severe, hypoxic coronavirus disease 2019, should be examined by a double-blind, randomized controlled study.

Potential Application of Anti-Müllerian Hormone in Polycystic Ovary Syndrome According to Chinese Classification Criteria: A Retrospective Analysis

Objective: Anti-Mullerian hormone (AMH) expression is elevated in patients with polycystic ovary syndrome (PCOS), however, its clinical significance is not clear. Owing to the strong correlation between AMH and polycystic ovarian morphology (PCOM), some studies believe that AMH alone can be used to diagnose PCOS. The aim of this study was to explore whether AMH can be used to diagnose PCOS and to differentiate the various PCOS subtypes. Methods: This was a retrospective study of 503 patients with PCOS. Patients were divided into eight subtypes based on the presence/absence of hyperandrogenemia (HA), insulin resistance (IR), or obesity (OB). The expression characteristics of AMH in each subtype were analyzed. Due to the small number of patients with subtypes 7 and 8, only patients with subtypes 1–6 were included in the analysis. Results: AMH showed a good positive correlation with PCOM (P = 0.000) and negative correlations with OB (P = 0.000) and IR (P = 0.003). The free testosterone index showed no correlation with AMH (P = 0.803). The percentages of patients with each subtype (excluding subtypes 7–8) and their respective AMH levels were as follows: Type 1 (HA + NIR + OB) 4.77% and 9.12 ng/mL; Type 2 (HA + IR + NOB) 20.68% and 10.34 ng/mL; Type 3 (HA + NIR + NOB) 23.66% and 9.47 ng/mL; Type 4 (HA + IR + OB) 30.82% and 8.32 ng/mL; Type 5 (NHA + NIR + NOB) 11.73% and 10.0 ng/mL; and Type 6 (NHA + IR + NOB) 6.16% and 9.76 ng/mL. The diagnostic rates of AMH (>8.09 ng/mL) and ultrasound for PCOM were 60.10% and 85.60%, respectively, suggesting that AMH did not completely predict PCOM. Conclusions: High AMH levels can be used to evaluate the incidence trend of PCOS. However, due to clinical heterogeneity, accurately evaluating the severity of PCOS and identifying the subtype of PCOS in Chinese patients are difficult. Individualized treatment should be administered based on accurate clinical subtypes and other clinical characteristics.

Association between dynamic obesity and mortality in patients with first-ever ischemic stroke: A hospital-based prospective study.

Although obesity is an established risk factor of primary stroke, the association between obesity and post-stroke mortality remains unclear. The aim of this study was to investigate the association between dynamic obesity status and mortality in survivors of their first stroke in China.Of 775 patients with first-ever ischemic stroke included in a longitudinal study, 754 patients were included in this study and categorized into 4 categories of body mass index (BMI) (underweight, normal weight, overweight, and obese) and 2 categories of waist circumference (WC) (normal WC and abdominal obesity) according to standard Chinese criteria. The mortality information and obesity status were obtained via telephone follow-up every 3 months, beginning in 2010 through 2016. Time-dependent Cox proportional hazards models were used to estimate the unadjusted and adjusted hazard ratios (HRs) for the relationship between all-cause mortality and dynamic obesity status.Of 754 patients, 60.87% were male, and the overall mean age was 61.45 years. After adjusting for possible confounders, significant inverse associations were identified between BMI and WC and all-cause mortality. Compared with those with normal BMI or WC, those with abdominal obesity or overweight had a significantly lower risk of all-cause mortality (HR and 95% confidence intervals [CI]: .521 [.303–.897] and 0.545 [.352–.845], respectively), whereas patients with underweight had the highest risk and those with obesity had lower risk of mortality, though it was not statistically significant (1.241 [.691–2.226] and .486 [.192–1.231], respectively).Overweight and abdominal obesity were paradoxically associated with reduced risk of mortality in patients who survived their first-ever ischemic stroke in China. Future prospective studies must look at evaluating the role of obesity in different stroke subtypes and devise appropriate weight-management strategies for optimal prognoses in secondary prevention in these survivors.

Control of temperature and fume generation by cooking in a residential kitchen by ceiling radiative cooling and fume hood extraction

The heat radiation in a residential kitchen was simulated by CFD (Computational-fluid-dynamics) to evaluate the cooling by a radiant cooling ceiling panel and pollution dispersion by the range hood and the air extraction system. The kitchen has a 2-hobs stove and a fume hood for removing waste heat and fumes. The simulation was validated by measurements in a domestic kitchen in a home in Changsha, China, where summer temperature is generally about 33 °C and often over 35–42°C. The simulation results show that the pollutant concentration in the kitchen during cooking was much lower than the Chinese standard criteria of GB/T18883-2002. A standard turbulence model was used, which indicated satisfactory distribution of temperature and airflow in the kitchen. The indoor airflow velocity was low. The airflow temperature when both hobs were used was slightly higher by 3–4°C than when a single hob was used. The temperature in the kitchen during cooking was about 28 °C, which was a degree lower than the living-room temperature, thus maintaining a comfortable thermal and healthy environment. The radiant cooling in the ceiling was shown to be a significant contributing factor. The ring suction type range hood has a sufficient capacity to remove the kitchen fume contaminants.

Association of Reallocating Time in Different Intensities of Physical Activity with Weight Status Changes among Normal-Weight Chinese Children: A National Prospective Study.

Background: Time spent in different intensity-specific physical activities is codependent, but the substitution effect of different activities on weight status changes in children remains unclear. This study aims to investigate the prospective association between reallocating time in different intensities of physical activity and weight status changes among Chinese children. Methods: A national sample of 15,100 normal-weight children aged 7–18 years (46.7% boys) were recruited in September 2013 and followed up for nine months. Vigorous-intensity physical activity (VPA), moderate-intensity physical activity (MPA), walking, and sedentary time were obtained by International Physical Activity Questionnaire Short Form (IPAQ-SF). Height and weight were objectively measured, by which body mass index (BMI) and BMI z-score were calculated. Weight status was classified by the Chinese criteria for 7- to 18-year-old children. Isotemporal substitution analyses (including single-factor model, partition model, and isotemporal substitution model) were applied to examine the association of time allocation with weight status changes. Results: Each 30 min/day of increase in VPA was favorably associated with a 13.2% reduced risk of incident overweight/obesity in a single-factor model and a 15.6% reduced risk in a partition model. Negative associations were found between VPA, MPA, walking and the risk of being underweight in the single-factor model, but not in the partition model. In substitution models, replacing 30 min/day sedentary time with an equal amount of VPA was favorably associated with a 16.1% reduction of the risk of being overweight/obese. Conclusion: These findings highlight the need for promoting vigorous-intensity physical activity in children.

Study on Process for Recovering Iron Concentrate from Iron-Containing Solid Waste in Mines

In order to recycle valuable elements from solid mine waste, this study took iron-bearing tailings as the research object and involved existing Hanging Vibrating Cone (HVC) concentrator separation technology to explore and determine the most appropriate processing parameters of this equipment for the experiment sample processing. The iron concentrates obtained by the experiment meet the Chinese Steel Industry criterion, within or up to a grade of 61.75 wt.% and the iron element recovery rate of 60.31%. So, a new and feasible way has been found for the reuse of mineral solid waste, which is rich in valuable elements.

The disease burden of childhood asthma in China: a systematic review and meta-analysis.

BackgroundIn China, childhood asthma prevalence showed a remarkable increase in the past decades. An updated epidemiological assessment of childhood asthma in China with a focus on prevalence and time trends is required.MethodsWe systematically searched three main Chinese databases and one English database to identify epidemiological studies of the prevalence of childhood asthma in China. Asthma cases were defined according to one of the five sets of Chinese diagnostic criteria which were established by the Children Respiratory Disease Group. We estimated age- and sex-specific prevalence of asthma using a multilevel mixed-effects logistic regression. We presented the time trends of asthma prevalence between 1990 and 2020 by age, sex and setting (urban vs rural), and also estimated the number of children affected by asthma in 2010.ResultsIn 1990, the prevalence of asthma ranged from 0.13% (95% confidence interval (CI) = 0.10-0.20) in rural girls aged 14 years to 1.34% (95% CI = 1.11-1.67) in urban boys aged five years. In 2010, the overall prevalence of asthma in Chinese children aged 0-14 years was 2.12% (95% CI = 1.83-2.51), corresponding to 5.16 million children living with asthma. Children aged 5-9 years were with the highest prevalence estimate of 2.65% (95% CI = 2.31-3.12) and those aged 10-14 years were with the lowest (1.48%, 95% CI = 1.26-1.78). In 2020, it is expected that this disparity will continue, with the prevalence of asthma being at the lowest level among rural girls aged 14 years (1.11%, 95% CI = 0.82-1.54) and at the highest level among urban boys aged four years (10.27%, 95% CI = 8.61-12.18). Over the 30 years (1990-2020), the prevalence of asthma in children aged 0-14 years has increased in both sexes and settings, which was consistently the lowest in rural girls and the highest in urban boys.ConclusionsThis study shows that childhood asthma has been increasingly prevalent in China. Asthma is more frequent in boys and in rural areas. The detailed and systematic estimates of asthma prevalence in this study constitute the best currently available basis for policymaking, planning, and allocation of health and welfare resources related to the burden of childhood asthma in China.

Association between obesity status and successful aging among older people in China: evidence from CHARLS

BackgroundThe paper aimed to examine the association between obesity status and successful aging among elderly adults in China and further find gender differences in the effect of components of successful aging on obesity status.MethodsThe data came from the follow-up survey(2015) of China Health and Retirement Longitudinal Study (CHARLS) and 4019 dwellers age 60 and over are included. Obesity status were defined by the body mass index (BMI) according to Chinese criteria. Successful aging was defined following Rowe and Kahn’s multidimensional model. Multivariable logistic regression was used to estimate the relationship between obesity status and successful aging.ResultsThe rate of successful aging in men and women was 18.87 and 9.48% respectively. For BMI, the proportion of population with underweight, overweight and obesity in men was 10.29, 23.04 and 29.63% respectively and that in women was 1.40, 11.69 and 9.47%. Men with obesity (OR = 1.587 95% CI 1.087 ~ 2.316) has an positive relationship with successful aging than normal weight men; Women with underweight (OR = 0.197 95% CI 0.058 ~ 0.824) has an negative relationship with successful aging than normal weight women; Meanwhile, no matter men and women, the relationship between obesity status and successful aging were not significant among oldest adults(≥75 years).ConclusionObesity status was significantly association with successful aging in young older adults (60-74 years), and the components of successful aging differently were related with the obesity status of male and female.