Objective： To study the effect of quercetin given during pregnancy and lactation period of obese rats on weight and expression of insulin-like growth factors-1 (IGF-1) mRNA of the offspring.Methods: In the study, 8 healthy weaning female SD rats were randomly selected to feed the basal diet and as blank control group, and the others were fed with high-fat diet. When the average weight of the high-fat diet rats was 20% as many as the average weight of the control group, we believed the model succeeded. Then the female SD rats were mated and the pregnant rats were randomly divided into 5 groups, 8 rats in each. They were fed with high fat diet during pregnancy and lactation, and the obese pregnant rats were respectively irrigated with 0 mg/kg body weight (high-fat control), 50 mg/kg body weight,100 mg/kg body weight, and 200 mg/kg body weight quercetin. The blank control group was fed with basic diet throughout the experimental period. The birth weight, the weights during the development of d7, d21, d56, and d98, and the expressions of IGF-1 mRNA in livers tissue of the F1 generation were measured.Results: The average birth weight of the F1 generation of high fat diet (HFD) group was significantly higher than that of the blank control group. Decreased offspring birth weight was observed with the intervention of quercetin, which effect remained to the delectation. The quercetin also reduced the expression of IGF-1 mRNA in livers of the F1 generation, and this effect remained to the adulthood. The 200 mg/kg body weight quercetin was most significantly effective.Conclusion: The averaged birth weight of the F1 generation of obese pregnant rats was significantly increased, and quercetin could effectively inhibit the expression of IGF-1 mRNA in livers of F1 generation to decrease cell proliferation and cell differentiation.

Objective：To study the relationship between rs2228314 polymorphism in sterol regulatory element binding protein 2 gene (SREBP2) and obesity, serum lipid levels in children and adolescents. Methods: In our study, 2 030 children and adolescents aged from 7 to 18 years participated. Anthropometric measurements, including height and weight, were performed. Their serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were detected. The matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was used to detect rs2228314 genotypes. Results: The GC/CC genotypes of rs2228314 polymorphisms had lower HDL-C levels than GG genotype ［(0.10±0.35) mmol/L vs. (0.14±0.36) mmol/L, P=0.020］. The rs2228314 polymorphism was associated with the abnormal HDL-C level under the dominant model after adjustment for study samples, sex and age (OR=1.400, 95% CI: 1.027-1.907, P=0.033). The rs2228314 polymorphism was not associated with obesity under the dominant model after adjustment for study samples, sex, age and HDLC level (OR=1.178，95% CI: 0.971-1.430, P=0.096). Conclusion: The GC/CC genotype carriers of SREBP2 rs2228314 polymorphism have higher risk of abnormal HDL-C level than the individuals with GG genotype among children and adolescents.

Objective：To analyze the current situation of age at menarche (AAM) in Chinese ethnic minority girls aged 9-18 years, and compare the AAM with that of Chinese Han girls from the same province or autonomous region. Methods: Probit analyses were used to calculate the AAM in various ethnic minority groups of Chinese girls who participated in 2010 National Physical Fitness and Health Surveillance. The sample size of ethnic minority girls was 31 711, and the ethnic minorities were Mongolian, Hui, Tibetan, Uighur, Miao, Yi, Zhuang, Buyi, Korean, Dong, Yao, Bai, Tujia, Hani, Kazak, Dai, Li, Lisu, Wa, Shui, Dongxiang, Naxi, Kirgiz, Tu, Qiang and Sala. The local Han girls to compare with the AAM were also surveyed in 2010 National Physical Fitness and Health Surveillance. Results: In the 13-year-old group, the percentage of menarche in Sala was the lowest (32.17%), while that in Korean was the highest (93.23%). At the age of 18, 99.60% ethnic minority girls appeared menstruating. The AAM of the top 3 ethnic minority groups were Korean (11.79 years), Mongolian (12.44 years) and Zhuang (12.52 years); and the last 3 ethnic minority groups were Dongxiang (14.36 years), Sala (14.32 years) and Shui (14.02 years). The AAM in Korean was 0.93 years earlier than that of the Han girls from Jilin province; the AAM in Mongolian was 0.14 years earlier than that of the Han girls from Neimenggu autonomous region; the AAM in Naxi and Qiang was close to that of the Han girls in the same province (region) (P>0.05); and the AAM in Hui, Uighur, Miao, Yi, Zhuang, Buyi, Dong, Yao, Bai, Tujia, Hani, Kazak, Dai, Li, Lisu, Wa, Shui, Dongxiang, Kirgiz, Tu, and Sala was later than that of the Han girls in the same province (region). The cluster analysis indicated that the 26 ethnic minority groups could be classified as three groups: Korean were classified into the earlier age group of AAM; Dongxiang, Sala, Uighur, Yi and Shui belonged to the later age group of AAM; and the other 20 ethnic minority groups were into the middle age group of AAM. Conclusion: There was a large variation among different ethnic minority groups in China. The AAM was earlier in Korean, and Mongolian, compared with the local Han girls, and the AAM in other ethnic minority groups was the same or later compared with the local Han girls.

Objective：To study the relationship between dietary vitamin A intake and plasma vitamin A concentration, and establish the theoretical basis for dietary intake predicting vitamin A nutritional status. Methods: By using cluster sampling, 492 children aged 2-7 years in kindergartens in Banan district of Chongqing were selected. A crosssectional nutrition and health survey was conducted, including the clinical examination, anthropometry, laboratory test and dietary survey. Results: Among the children surveyed, 229 were boys, and 263 girls, the mean age was (4.54±0.87) years, height (107.50±7.20) cm, and weight (18.42±3.41) kg, the mean value of plasma vitamin A was (1.04±0.30) μmol/L. The prevalence of marginal vitamin A deficiency (MVAD) was 43.5%. No cases of severe clinical vitamin A deficiency were found (plasma vitamin A≤0.35 μmol/L). Clinical examination found no conjunctiva, corneaor skin abnormalities, and no Bitot’s spots. Prevalence of the last two weeks colds were 27.4% (135/492), no diarrhea and other gastrointestinal or digestive diseases were found. The proportion of insufficient dietary vitamin A intake (<600 μg RE/d) was as high as 50.0%. By using correlation analysis, plasma retinol concentrations were related to dietary vitamin A intake (r=0.162, P<0.001), and to dietary energy intake (r=0.107, P=0.017). After adjustment for the effects of other non-dietary factors on vitamin A deficiency, the multivariate logistic regression showed that vitamin A-rich foods of liver intake=0 g/d (OR=1.95, 95% CI: 1.05-3.61, P=0.034), vitamin A-rich fruits intake=0 g/d (OR=1.55, 95% CI: 1.03-2.33, P=0.034), vitamin A-rich vegetables intake<200 g/d (OR=3.47, 95% CI: 1.37-8.75, P=0.009) were important risk factors of vitamin A deficiency. But we had not found the correlation between the intake of meat, eggs and milk and vitamin A deficiency. Conclusion: Dietary factors may be the major risk factor of vitamin A deficiency in the three kindergartens. The dietary vitamin A intakes are significantly related to plasma retinol concentrations, and the vitamin Arich foods intakes can predict the body’s vitamin A nutritional status.

Objective：To explore the feasibility of screening for major fetal heart disease by training sonographers in township or county level hospitals. Methods: Training of B ultrasound scan for congenital heart defects was given to the sonographers from one county hospital, and thirteen township hospitals (or the district hospitals), and training of fetal echocardiography was given to sonographers from four city/county hospitals. The trained sonographers who had passed the examinations and had obtained qualifications after six months of independent practice began to screen fetal congenital heart defects. To evaluate the effectiveness, sensitivity and specificity of screening was calculated by using the diagnosis of expert neonatal/fetal echocardiographers as the gold standard. Results: A total of 3 425 fetuses received one fetal B ultrasound screening, one fetal echocardiography and one neonatal echocardiography from April 1, 2004 to December 31, 2005. One hundred and sixtyfive B ultrasound screening images (4.9%) from township hospitals and fifty-six fetal echocardiography images (1.7%) from county or city centers couldn’t be reviewed because of poor quality. The sensitivity of fetal B ultrasound screening in the township and county hospitals was 30% and 0, and the specificity 93.3% and 99.9%, respectively. Nine fetuses with a major congenital heart disease were eventually found by the trained sonographers, and two cases were misdiagnosed and two unnoticed. The total sensitivity and specificity of fetal echocardiography were 81.8% and 99.9%, respectively. The sensitivity in the county and city hospitals was 66.7% and 100%, respectively. The specificity in the county and city hospitals was 99.9% and 100%, respectively. Conclusion: Under the current circumstances, township hospitals are unable to perform effective fetal cardiac screening. Screening on fetal congenital heart disease is suggested to be taken by trained sonographers in county and city level medical centers.

Objective：To investigate the status of blood mineral content of children aged 3 to 12 years in Chinese cities and countryside and explore the possible related influencing factors. Methods: The multistage stratified cluster random sampling was used to select one kindergarten and one primary school in seven cities (Beijing and Guangzhou and so on) and two towns randomly. Firstly, we selected one bottom class, middle class, top class in one kindergarten and one second grade and fifth grade in one primary school randomly. Then all of the healthful students of these classes were investigated and the blood mineral content of calcium, magnesium, lead, iron, copper, and zinc were detected. Results: In the research, 1 842 students were investigated. The means of calcium, magnesium, lead, iron, copper, and zinc were in the standard range. The blood lead content of the boys was higher than that of the girls. The blood mineral content of different ages had statistical significance. The blood calcium and blood copper contents of the preschool children were higher than those of the school children. However, the school children had significantly higher blood lead, iron, and zinc contents in comparison with those of the preschool children. The incidences of iron deficiency and zinc deficiency were 35.5% and 39.6%, respectively. The incidence of iron deficiency and zinc deficiency of different ages had statistical significance, and with the age increasing, the incidence showed a decreasing trend. The incidences of iron deficiency and zinc deficiency of children whose age was more than or equal to 3 years and less than 4 years were up to 47.1% and 64.6%, respectively. The incidence of iron deficiency of the children in the countryside area was significantly higher than those in the first-tier cities. However, the incidence of zinc deficiency of the children in the countryside area was significantly lower than those in the first-tier cities and second-tier cities. Conclusion: The status of iron deficiency and zinc deficiency of children aged 3 to 12 years in Chinese cities and countryside were still serious. We should pay more attention to the nutrition interventional research on iron and zinc.

Objective： To evaluate the accuracy of parents’ perception of whether their child is a picky eater and the specific food category the children avoideating according to the food frequency questionnaire.Methods: This research selected 1 663 infants aged 4-36 months receiving non-diary complimentary food from maternal, infants, nutrition and growth study (MING Study) in 8 Chinese cities in which a combination of systematic cluster random sampling and purposive sampling was used. The general information, dietary status and picky eating status were collected through a self-designed questionnaire from the caregiver of the children. According to the parents’ perception, the children were classified into picky/non-picky groups or avoid/non-avoid to a specific food category groups. Mann-Whitney U test was used to compare between the groups.Results: The reported percentage of picky eaters increased from 7.37% in 4-6 months old infants to 36.20% in 25-36 months old infants. Most picky infants in 4-6 months and 7-12 months old infants avoided eating dairy food (25% and 24%); while most picky toddlers aged 13-24 months and 25-36 months avoided eating vegetables (26.92% and 47.46%). The infants aged 4-6 months and 7-12 months who were perceived as picky by their parents took more kinds of food (8 and 19.5 kinds) than those who were not (6 and 18 kinds), while the picky toddlers aged 13-24 months and 25-36 months took fewer kinds of food (28.5 and 34 kinds for picky eaters, 31 and 37 kinds for non-picky eaters). The parents of infants aged 4-6 months judged correctly in every category of food without any statistical significance; the parents of 7-12 months old infants judged correctly only in dairy food and eggs with statistical significance; those of 13-24 months old infants judged correctly in every food category except for vegetables with statistically significant difference in the category of eggs; those of 25-36 months old toddlers misjudged in dairy, beans and grains with no statistically significant difference in every category.Conclusion: Parents tend to misjudge their children’s picky eating behavior before the first 12 months of the child, and tend to make a more accurate perception after the 12^th month.

Objective：To study the concentrations of fine particulate matters and ultrafine particles and influenced factors during winter in an area of Beijing. Methods: Real-ime monitoring of particles’ mass and number concentrations were conducted in an area of Beijing from February 7^th to 27^th, 2013. At the same time, the meteorological data were also collected from the Beijing meteorological website. Differences of the particles’ mass and number concentrations during different periods were analyzed using Mann-hitney U test. Meanwhile, the influenced factors were also analyzed. Results: The mean concentrations of fine particulate matters and ultrafine particles were (157.2±142.8) μg/m³ and (25 018±9 309) particles/cm³, respectively. The particles’ number and mass concentrations in haze days were 1.27 times and 2.91 times higher than those in non-aze days, respectively. The mass concentrations of fine particulate matters in the self-onitoring site were higher than those in the nearest central monitoring sites, and the hourly-verage concentrations of particles were significantly consistent with those at the commuter times. Meanwhile, the setting off of fireworks/firecrackers during the Spring Festival could lead to short-term increases of the particles’ number and mass concentrations. When the wind speed was low and the related humidity was high, the concentrations of particulate matters were relatively high, and the mass concentrations of fine particulate matters were lagged about 1-2 d. Conclusion: The level of the particulate matters in this area was high. Heavy traffic, setting off of fireworks/firecrackers and meteorological factors may be some of the main factors affecting the concentrations of the particulate matters in this area. Among those factors, the effect of setting off of fireworks/firecrackers didn’t last long and the effect of the meteorological factors had a hysteresis effect.

Objective：To compare the effect of TiO₂ nanoparticles on antioxidant function and element content of liver and kidney tissues in young and adult rats. Methods: Forty-ight SD male rats, half in 4-eek (youth) old and half in 9-eek (adult) old rats, were randomly divided into 8 groups, which were exposed to TiO₂ nanoparticles ［(75±15) nm, anatase］ through intragastric administration at 0, 10, 50 and 200 mg/kg body weight every day for 30 days. The liver and kidney tissues were collected for antioxidant function and element content analysis. Results: 200 mg/kg TiO₂ nanoparticles exposure significantly increased the liver total superoxide dismutase (T-OD) activity and the kidney reduced glutathione (GSH)/oxidized glutathione (GSSG) ratios in young rats, and significantly decreased the liver Mo, Co, Mn and P contents and the kidney Rb and Na contents in young rats. 200 mg/kg TiO₂ nanoparticles exposure significantly increased GSH/GSSG ratios and Rb contents and decreased Na contents in the liver of adult rats. No significantly difference was found in antioxidant indexes and elements content in the kidney of adult rats between three experimental groups and control group. Conclusion: TiO₂ nanoparticles can enhance the antioxidant capacity and decrease the elements content in rat liver and kidney tissues. The liver is the more sensitive target organ and the young animals are more susceptible to TiO₂ nanoparticles toxicity by the oral routes.

Objective：To make an assessment on the genotoxicity caused by black carbon (BC) and ozonized black carbon (O₃-BC). Methods: In this study, 74 healthy male ICR mice ［weighed (28±1.5) g］ were randomly divided into 7 groups, including one phosphate buffer solution (PBS) control group and six particles exposed groups by intratracheal instillation with either BC or O₃-BC at the doses of 50, 100, 200 μg/mouse, respectively. There were 12 mice in the groups of 200 μg/mouse and 10 mice in others. The mice were sacrificed 24 h after four intratrachealinstillations. The activities of catalase (CAT) in serum and the levels of malondialdehyde (MDA) in lung tissue homogenate were measured. As the DNA damage mark, 8-hydroxyguanosine (8-OHdG) in urine and serum were quantified with ELISA method. Micronucleus test was used for potential genotoxicity of BC and O₃-BC. Hematoxylin and eosin staining was used to stain lung paraffin section. Results: The mice were in good condition during instillation, and the liver coefficient of the test groups was significantly lower than that of the control group (P<0.05). The activities of CAT in serum significantly increased in the 100 μg/mouse and 200 μg/mouse groups after being exposed to these two kinds of particles. The micronucleus rate in allthe BC and O₃-BC exposed groups increased (P<0.05), but there was no statistically significant difference among the groups in the levels of 8-OHdG in serum and urine and MDA in lung tissue homogenate. Inflammatory response was found in the lung tissue under the microscope after exposure to BC and O₃-BC. Conclusion: Intratracheal instillation of BC and O₃-BC induced increasing of oxidative stress and genetic damage in mice. But there was no significant difference b

Objective：To describe the clinical characteristics, overall survival as well as to evaluate the prognostic factors in Chinese diffuse large B cell lymphoma (DLBCL) patients.Methods: DLBCL patients who were initially diagnosed and treated in Peking University Cancer Hospital from January 1995 to December 2008 were identified and analyzed,retrospectively.The 5-year OS rates were estimated with Kaplan-Meier.Log-rank test was used to compare the survival curves of the different groups. The multivariate analysis of prognostic factors was conducted with Cox regression model, which included all statistically significant prognostic factors in the univariate analyses.Results: A total of 525 DLBCL patients were included in this retrospective analysis, of whom, 294 were male and 231 female (male∶ female=1.27∶1). The median age at the initial diagnosis was 55 (range 16-90) years, and 37.0% (n=194) were 60 years and above. Regarding the clinical staging at the initial diagnosis, 54 patients (10.3%) were diagnosed as Stage Ⅰ of the disease, 152 (28.9%) as Stage Ⅱ, 117 (22.3%) as Stage Ⅲ and 202 (38.5%) as Stage Ⅳ. The ‘B symptoms’ and increased serum LDH were presented in 206 (39.2%) and 192 (36.6%) patients, respectively. A total of 197 (37.5%) patients were treated with rituximab (R). The survival follow-up continued till 31 January 2014 with a median follow-up time of 77.5 (range: 0-205) months. A total of 267 patients (50.9%) died during the follow-up period. The medial overall survival (OS) time was 84 months, and 5-year OS rate was 52.3%. There were six statistically significant prognostic factors that were identified in both univariate and multivariate analyses: gender, Ann Arbor stage, B symptom, serum LDH, age at initial diagnosis and rituximab treatment. The relative risk (RR) of these prognostic factors in the multivariate analyses were: age >60 years / ≤60 years=1.380 (95%CI 1.078-1.765), male / female=1.315 (95%CI 1.025-1.687), stage Ⅲ/stage Ⅰ=3.034(95%CI 1.667-5.522), stage Ⅳ/Ⅰ=3.748(95%CI 2.102-6.681), with B symptoms/without B symptoms=1.278(95%CI 0.999-1.636),serum LDH increased/LDH not increased=1.351(95%CI 1.057-1.726), without R treatment / with R treatment=1.543(95%CI 1.182-2.015).Compared with the IPI, age >50 years/≤50 years was a statistically significant factor in both univariate and multivariate analyses RR=1.478 (95%CI 1.148-1. 902）, P=0.002.Conclusion:Six factors were related to DLBCL survival: gender, Ann Arbor stage, B symptom, serum LDH, age at initial diagnosis and rituximab treatment. Compared with the IPI, several specific factors may predict a poor prognosis in Chinese DLBCL patients: male, age>50 years and the presence of ‘B symptoms’. But this result is not conclusive until these factors are further tested.

Objective：To examine the potential influence factors of abdominal aortic aneurysm (AAA). Methods: A 1∶2 pair-matched, case-control study was conducted from July 2011 to December 2012. A pair was composed of one AAA patient recruited from the Vascular Surgery Department, Chinese PLA General Hospital and two gender- and age-matched non-AAA subjects, one from the same hospital and the other from the community in Fangshan District in Beijing. Demographic data, medical history and the lifestyle of each subject were collected. Moreover, all the participants underwent abdominal ultrasound or computed tomography (CT) and peripheral venous blood samples were obtained. Results: There were 155 case/control pairs. The multivariate conditional logistic regression model confirmed that suffering from hypertension conferred a 1.98-fold (95%CI 1.12-3.18) increased likelihood of AAA. Smoking was a strong independent risk factor of AAA, with odds ratios (95% confidence intervals) of 5.23 (2.44-11.23). Dyslipidemia(OR=2.61,95%CI 1.45-4.70), a higher level of serum hs-CRP (OR=2.43,95%CI 1.37-4.31) and homocysteine (OR=2.73,95%CI 1.61-4.65) were all associated with AAA. Conclusion: Hypertension and smoking are the risk factors of AAA. Dyslipidemia, hsCRP and Hcy are associated with AAA.

Objective：To systematically evaluate the incidence of liver injury in multii-drug resistant tuberculosis (MDR-TB) patients with the treatment of second-line anti-TB drugs. Methods: Medline (January 1, 1966 to March 1, 2014), Embase (January 1, 1974 to March 1, 2014) and the Cochrane library (January 1, 1993 to March 1, 2014) with four Chinese databases including VIP (January 1, 1989 to March 1, 2014), CBMDisc (January 1, 1978 to March 1, 2014), CNKI (January 1, 1994 to March 1, 2014)and Wanfang (January 1, 1998 to March 1, 2014), were systematically searched with the keywords including “Tuberculosis”, “multidrug-resistant”, “MDR-TB”, “side effect”, “adverse”, “safety” and “tolerability” for the follow-up studies of MDR-TB patients with liver injury during the treatment of second-line anti-TB drugs. The relevant information was extracted and the data were analyzed using the random-effects model. Subgroup and sensitivity analyses were performed based on the diagnostic criteria, study population, study design, history of anti-TB treatment and treatment length. Results: A total of 26 articles with 3 875 MDR-TB patients were included, of which 373 patients developed liver injury, and the weighed combined incidence of liver injury was 7.7%（95%CI：5.5%-10.8%）. There was some heterogeneity among the studies. Subgroup analyses showed that the incidence of liver injury was higher in groups with treatment length≥18 months and non-Asian populations, but there was no significant difference between the groups (P>0.05). Among the 26 articles, only nine of them reported the diagnostic criteria of liver injury, while the criteria were not uniform. Conclusion: The incidence of liver injury during the treatment of second-line anti-TB drug in MDR-TB patients was high, and the diagnostic criteria were not uniform. We should pay attention to the prevention and treatment of liver injury, and develop standard diagnostic criteria for it.

Objective：To establish the control charts for early warning of diarrhea based on the syndromic surveillance data from enteric clinic in Beijing. Methods: The outpatient data from enteric clinic of a Grade Three General hospital in Haidian district, Beijing from April 1 to Oct. 31, 2009 and from May 1 to Nov.10, 2010 were collected, according to the moving average method, the baseline calculated, the value of probability α and  μα, the early warning value based on the formula “w=X_j+μ_αS_j” calculated and the early warning control charts drew at last. Results: According to the harmfulness, the severity and controllability of diarrheal diseases, the value of probability α was determined as 0.01, then μ_α (unilateral) as 2, based on the early warning value, the control charts of diarrheal diseases, bacillary dysentery and other infectious diarrhea were established. Conclusion: The enteric clinic requires to further collect baseline data to evaluate and continuously adjust the established control charts for the best early warning model in accordance with the enteric clinic.

Objective：To evaluate the association between brachial-ankle pulse wave velocity (baPWV) and metabolic syndrome (MetS) among the Chinese elderly and the gender difference. Methods: We conducted a population-based cross-sectional study in a representative urban area of Beijing, China. A sample of 2 102 community elderly (848 males, and 1 254 females) aged 60 to 95 years were included in the study. MetS was defined according to the 2009 harmonizing definition. Results: The prevalence of MetS was 59.1% (50.1% in males and 65.2% in females, P<0.001). The baPWV value was between 8.2 to 45.6 (20.0±4.4) m/s, and showed an increasing trend with age (P<0.001). The partial correlation showed baPWV was positively associated with BMI (r=0.076, P=0.037), systolic blood pressure (r=0.380, P<0.001), diastolic blood pressure (r=0.276, P<0.001), triglyceride (r=0.040, P=0.046), fasting blood glucose (r=0.140, P<0.001), 2-hour post-meal blood glucose (r=0.121, P<0.001), and negatively associated with HDL-C (r=-0.128, P=0.048). There was a strong association between baPWV and prevalence of MetS and its component number in females but not in males. Compared with the lowest quartile of baPWV, the adjusted ORs were 1.22(95%CI 0.83-1.79), 1.32(95%CI 0.90-1.93), 1.46(95%CI 1.00-2.14) in males and 1.28(95%CI 0.93-1.77), 1.55(95%CI 1.12-2.16), 1.86(95%CI 1.32-2.61) in females for the second, third and top quartiles. Conclusion: The prevalence of MetS increases substantially with increasing levels of baPWV among the Chinese elderly, especially in females.

Objective：
To investigate the use of antibacterial agents for emergency patients with acute upper respiratory infections in tertiary hospitals in Beijing.
Methods: We used the medical claim data for urban workers in 10 tertiary hospitals in Beijing from Oct. 2010 to Sep. 2012. Medical records of emergency patients with acute upper respiratory tract infections had been selected as the study sample. The proportions of antibacterial prescriptions and categories of antibacterial drugs were described and analyzed.Results: This study included 135 979 visitors (male: 42.7%; mean age: 43.6±16.2 years). The average antibacterial prescription rate was 71.2% (95%CI 71.0%-71.5%), of which the single kind use was 80.0% (95%CI 79.7%-80.2%). Among acute upper respiratory tract infections, the antibacterial prescription rate for acute tonsillitis visits was highest (85.1%, 95%CI 84.5%-85.6%), followed by acute laryngitis and bronchitis (81.69%, 95%CI 80.4%-82.8%), acute pharyngitis (81.4%, 95%CI 77.7%-85.0%), acute sinusitis (77.0%, 95%CI 74.6%-79.4%), acute nasopharyngitis (74.3%, 95%CI 73.7%-75.0%), and common cold (67.6%, 95%CI 67.3%-67.9%). Compared with the female group, the antibacterial prescription rate for the male was higher (73.2%, 95%CI 72.8%-73.6% vs. 69.7%, 95%CI 69.4%-70.0%). Compared with the <60 years age cases, the antibacterial prescription rate for the ≥60 years cases was higher (72.1%, 95%CI 71.8%-72.3% vs. 66.8%, 95%CI 66.2%-67.5%). In the visitors who used antibacterial drugs, the average percentage of injection use was 50.6% (95%CI 50.3%-50.9%). The top antibacterial drugs in the list of varieties were the second generation cephalosporins (28.4%), followed by the third generation cephalosporins (21.7%), fluoroquinolones (21.0%) and macrolides (17.6%). Conclusion: The antibacterial prescription rate for acute upper respiratory tract infections in the general hospitals in Beijing is high, and the second generation cephalosporins, third generation cephalosporins, fluoroquinolones and macrolides take the lead in the total antibacterial drugs.

Objective： To investigate the behavior of tobacco use among migrants in construction sites and explore the associated factors. Methods: A total of 652 migrants in 10 construction sites were selected in Xi’an and Tongchuan. Chi-square and logistic regression were used to analyze the influencing factors of tobacco use. Results: The average age of the migrants in the construction site was (38.23±10.61), and males occupied 82.7% (535/647) of the total. The current smoking rate of the migrants was 55.8% (364/652), with 64.3% (344/535) in males and 14.3% (16/112) in females. 82.5% (329/399) smokers wanted to quit smoke, however only 52.7%(210/399) had tried quitting smoking in action, and 8.8%(35/399) quitted smoking successfully. Multivariable regression indicated that the migrants who were at lower age, and sick within 2 weeks, had perceived not difficult to stop smoking and who disagree with the benefits of smoking were more likely to try to quit smoking. Conclusion: Migrants in construction sites show their characteristics of old age, low level of health literacy, maledomination, high smoking rate and high intention of quitting smoking. Tobacco control projects should be implemented in construction sites to promote the translation of smoking quitting intention into action.

Objective：To study the impact of primary care oriented outpatient benefits package design of outpatient services coverage and ladder reimbursement of county, town and village levels in the new rural cooperative medical system (NRCMs) on hypertension outpatient services utilization. Methods: The panel data of treatment and control groups in 2009 and 2011 before and after the policy reform were drawn from the household survey data of the innovative payment system project. The difference in difference (DID) method was used for data analysis. The outcome indicators included the utilization of outpatient services of patients with self-reported hypertension and their main treatment locations. Results: The primary care oriented outpatient benefit package design in the NRCMs reduced the probability of no treatment in the latest three months of hypertension by 10.2 percent points. Meanwhile, it increased the probability of choosing village clinic as the preferred location by 15.7 percent points. Conclusion: Primary care oriented outpatient benefits package design lead patients with hypertension to use the nearest outpatient services at low risk of disease.

Objective：To verify the association between social determinants and the quality of life (QoL) among the elderly in Beijing. Methods:A questionnaire household survey was conducted and 1 685 over 60 dwellers in Beijing were interviewed. The EQ-5D scale was used to measure the elderly’s QoL and Time Trade-off model was used to calculate the EQ-5D index. Multiple linear regression and Logistic regression were employed to analyze the association between social determinants and the QoL. Results: There was no statistical significant difference in the QoL between the urban and the rural residents (P>0.05). The elderly with higher education level and income or married tended to have higher overall QoL scoresand better performance of five dimensions of the QoL (P<0.05). Conclusion: More policies should be focused on the elderly with lower social determinants in both urban and rural areas in Beijing.

Objective：To investigate the correlation between anthropometric indices and arteriosclerosis detection indicators in the middle-aged and the elderly. Methods: A cross-sectional descriptive study was made of 1 626 individuals (diabetics patients 23.37%, hypertensive subjects 39.48% and healthy individuals 37.15%), aged 45 to 90 years ［mean age: (61.60±10.22) years)］ in Shijingshan District, Beijing. Their measurements: body mass index (BMI), waist circumference (WC), and waist to height ratio (WHtR). Arterial stiffness was assessed according to brachial-ankle pulse wave velocity (baPWV), intima-media thickness (IMT), augmentation index (AI) and ankle-brachial index (ABI), which were measured by noninvasive detectors and equipment. The correlations between the various indicators were analyzed. Results: The percentages of the hypertensive and diabetic groups of central obesity (male WC>85 cm, female WC>80 cm or WHtR>0.5) and of general obesity (BMI>28 kg/m²) were significantly higher than those of the healthy group (P<0.01). The difference between the two disease groups was not significant (P>0.05). There was a moderate positive correlation between the measures of abdominal obesity (WHtR and WC) and the general obesity indicators (BMI) (r=0.710 and 0.716). In the healthy group, WC and WHtR showed positive correlation with baPWV, IMT and ABI, and negative correlation with AI₇₅. BMI showed positive correlation with IMT and negative correlation with AI₇₅, and no correlation with baPWV and ABI. There was negative correlation between BMI and baPWV in the diabetic group. In the hypertension group, we found negative correlation between BMI and baPWV, maximum IMT, AI₇₅, and also between WC and AI₇₅. The simple regression straight line of baPWV versus the anthropometric parameters showed that the regression equations were y=0.949+1.379 x (baPWV vs. WHtR, R²=0.046, P＜0.001) and y=1.133+0.006x (baPWV vs. WC, R²=0.027, P＜0.001), respectively. baPWV and BMI did not have a linear relationship (P=0.62). Conclusion: WHtR and WC are superior to BMI indices in predicting arteriosclerosis. Anthropometric measurements for central obesity are good predictors of cardiovascular risk.

Objective：To study the influence of r-tPA and urokinase in curative effect and thrombolysis time on patients with acute and severe pulmonary embolism after interventional thrombectomy. Methods: After reviewing and analyzing the clinical data of 19 acute and severe pulmonary embolism patients, we classified them into two groups in accordance with the application of r-tPA and urokinase to compare the changes of their heart rate, blood pressure, pulmonary arterial pressure, arterial partial pressure of oxygen and hemachrome before and after thrombolysis, as well as the thrombolysis effect time the two groups took. Results: The heart rate, blood pressure, pulmonary arterial pressure, arterial partial pressure of oxygen of the patients in both groups gained remarkable improvement after operation (P<0.05); the pulmonary arterial pressure of the r-tPA patient group dropped but not significantly compared with that before operation (P>0.05); the pulmonary arterial pressure of the urokinase patient group dropped significantly compared with that study before operation (P<0.05); the hemachrome of both patient groups did not significantly drop after operation (P>0.05); the thrombolysis effect time by adopting rtPA was remarkably shorter than that caused in thrombolysis by adopting urokinase (P<0.05). Conclusion: Both r-tPA and urokinase are effective in interventional thrombolysis for acute and severe pulmonary embolism. However, r-tPA could significantly shorten the time caused in thrombolysis without increasing any bleeding risk.

Objective：To explore the hepatocyte insulin sensitivity of intrauterine growth retardation (IUGR) rats and establish an insulin resistance cell model in vitro. Methods: An IUGR animal model was established by protein malnutrition during the mother pregnancy. On 60 d and 90 d after birth, the offspring rats were fasted for 12 hours and then their angular vein blood was collected to measure the fasting plasma glucose and fasting serum insulin level, then the insulin resistance index (HOMA-IR) and insulin sensitivity index (ISI) were calculated. The insulin sensitivity was evaluated by HOMA-IR and ISI. Primary hepatocytes from each group were respectively isolated by two-step perfusion with collagenase and were defined as normal hepatocytes group and IUGR hepatocytes group. The normal hepatocyte group was divided into two groups: control group and insulin induction group. Insulin induction group was established by primary cultures of normal hepatocyte incubated with varying dilutions of insulin. CCK-8 was used to detect the viability of the cultured hepatocytes. Glucose oxidase-peroxidase method kit was used to measure glucose consumption of the hepatocytes. Results: HOMA-IR was significantly higher in IUGR rats than in the normal rats at the age of 60 days (t=-17.02, P<0.05) and 90 days (t=-12.52, P<0.05). ISI was significantly lower than in the normal rats aged 60 days (t=5.61, P<0.05) and 90 days (t=12.42, P<0.05). There were no significant differences in hepatocyte viability among the control group, IUGR group and insulin induction group after incubation of 48 h on day 60 (F=1.34, P=0.29) and day 90 (F=0.22, P=0.81). The glucose consumption of the IUGR group and insulin induction group were significantly decreased compared with the control group on day 60 (F=9.28, P=0.002) and day 90 (F=56.60, P<0.001), while there was no significant difference between the IUGR group and insulin induction group (P=0.08, P=0.10). Conclusion: The insulin sensitivity of hepatocytes of IUGR rats decreased from adolescence to adulthood. High-dilution insulin may induce insulin resistance cell model in vitro.

Objective： To analyze the predilection of metastasis at levels Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ for oral and maxillary squamous cell carcinoma on different primary sites. Methods: A retrospective review was conducted of the records of 1 233 patients (1 340 necks) from January 2000 to December 2011 with squamous cell carcinoma simultaneously underwent primary tumor resection and neck dissection in Department of Oral and Maxillary Surgery, Peking University School and Hospital of Stomatology. The topography of positive neck node was recorded, and the calculation was performed for the metastasis rate of levels Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ based on the primary site, respectively. Results: There were 557 necks with positive node (41.57%), and the metastasis rate for level Ⅰ, Ⅱ, Ⅲ, Ⅳ, and Ⅴ were 27.61%, 22.91%, 9.18%, 4.99%, 3.24%, respectively. Those in level Ⅲ were at high risk for metastasis from carcinoma of tongue and the floor of mouth. The positive rate in level Ⅱ was more than that in level Ⅰ for tongue carcinoma, but for inferior gingiva carcinoma, bucca carcinoma, upper gingiva carcinoma, palatine carcinoma, maxillary sinuse carcinoma, intraosseous carcinoma of mandibular, the positive node was more likely to happen at level Ⅰ compared with level Ⅱ. Conclusion: Most metastases happen in levels Ⅰ-Ⅲ for patients with oral and maxillary squamous cell carcinoma, but the predilection of metastasis in level Ⅰ, Ⅱ or Ⅲ is varied with the primary sites.

Objective：To investigate the marginal microleakage after cavity preparation by Er:YAG laser and conventional bur applying different adhesive systems, conditioning surface with acid etching or not. Methods: In the study, 50 primary teeth were divided into 5 groups. (1) Bur+etch-and-rinse system, (2) Bur+self-etching system， (3) Er:YAG laser+etch-and-rinse system, (4) Er:YAG laser+self-etching system, (5) Er:YAG laser+none-etched.  The class V cavities were all filled with composite resin. The microleakage tests were performed, observed and scored under stereomicroscope. Results: Bur+etchand-rinse group had higher microleakage than Er:YAG laser+etch-and-rinse group, and Bur+self-etching group had higher microleakage than Er:YAG laser+self-etching group（P<0.05）. There was no difference between Er:YAG laser+etch-and-rinse group and Er:YAG laser+self-etching group, while they had significantly lower microleakage than that of Er:YAG+none-etched group. Conclusion: Composite resin restoration showed less marginal microleakage when all-in-one self-etch system was used after irradiation by Er:YAG laser on primary teeth.

Objective：To investigate the prevalence and significance of IgG-anti-cyclic citrullinated peptides (CCP) antibody in PSS patients. Methods: A total of 120 patients diagnosed with PSS were investigated in the first affiliated hospital of Baotou Medical College from March 2006 to December 2009. IgG-anti-CCP antibody was assayed by enzyme-linked immunosorbent assay (ELISA), also anti-Sjögren’s syndrome type A (SSA) and Sjögren’s syndrome type B (SSB) antibody were assayed by immunoblotting. Erythrocyte sedimentation rate (ESR) was assayed by westergren in serum, and C reactive protein (CRP), IgA, IgM, IgG and IgM-RF were detected by immune turbidimetric. At the same time, clinical symptoms and involvement of important organs were observed. Following up the patients above 3 years, the primary Sjögren’s syndrome (PSS) patients who had progressed to rheumatoid arthritis (RA) were evaluated. Results: The positive rate of anti-CCP antibody in the PSS patients was 19.17%; After 3 years, more patients who were positive for anti-CCP antibody had progressed to RA (χ²=5.015，P=0.022) than the patients in negative group; The patients in anti-CCP antibody positive group were more prone to joint involvement (χ²=8.058，P<0.05), more swollen joints (U=152.00，P<0.05) and longer morning stiffness (U=100.00，P<0.05) than the patients with negative anti-CCP antibody, but the involvement of vital organs in the two groups had no significant difference (χ²=0.208，0.099，0.000 and 0.122，P>0.05); The positive rate of anti-SSA and SSB antibody in anti-CCP antibody positive group and negative group had no significant difference (χ²=0.008 and 0.56，P>0.05); Multiple linear regression showed that the level of anti-CCP antibody was positively correlated with IgMRF levels in the PSS patients (B=0.61, 95%CI=0.36-0.86, P<0.05), but had no significant correlation with ESR, CRP, IgA, IgM and IgG levels (P>0.05).There were no significant differences in the level of ESR, CRP, IgA, IgM and IgG between anti-CCP antibody positive group and negative group (P>0.05), but the level of IgM-RF in anti-CCP antibody positive group was significantly higher than that in the negative group (U=623.50, P<0.05).Conclusion: Positive rate of IgG-anti-CCP antibody in PSS is 19.17%, also it is associated with joint involvement and more prone to progressing to RA.

Objective：To establish and evaluate a newly established method of enzyme-linked immunosorbent assay (ELISA) for measuring human autoantibody to folate receptor (FR). Methods: Folate receptor was extracted and purified from healthy woman placenta tissues. The protein was coated on 96-well plates. Goat monoclonal antibody was used as detecting antibody to set up the indirect ELISA procedure. The sensitivity, precision and linearity of the method were evaluated. Further, the method was compared with the ELISA method with commercialized bovine folate binding protein (FBP) by determining autoantibody levels in 24 individuals. Results: The measuring range of the standard curve was from 6.25×10^-4 to 8×10^-2 (the IgG concentration of pooled plasma from healthy donors was defined as 1). The lowest detectable level was 3.13×10^-4. The intra- and inter-assay coefficients of variations were 2.74%-8.07% and 4.16%-8.23%, respectively. Linearity test results were considered within acceptable limits. The data from FBP-ELISA and FR-ELISA were highly correlated (r=0.954, P<0.001); The value from FR-ELISA was higher by 14% than that from FBP-ELISA. Conclusion: The ELISA method for measuring human autoantibody IgG to folate receptor was successfully established using human FR as coating protein. The method is sensitive and repeatable and can be used in large-scale population study.

To summarize the experience of managing substernal goiter by totally endoscopic procedure and evaluate the curative effect, we analysed eight patients diagnosed as substernal goiter type Ⅰ and treated with totally endoscopic technique via central routing approach during March 2011 to June 2013 in Beijing Shijitan Hospital retrospectively. The feasibility, safety and curative effect of this surgical technique were estimated. All the cases were successfully operated with the totally endoscopic procedure, and the pathological result showed that 6 were goiter and the other 2 were minimal papillary carcinoma. None of the patients suffered from any complication, and the median follow up time was 6 months (1-28 months). The totally endoscopic technique is a feasible, safe and cosmic one for managing substernal goiter type Ⅰ.