AIM:To investigate if non-alcoholic fatty liver disease (NAFLD) is an early mediator for prediction of metabolic syndrome,and if liver B-ultrasound can be used for its diagnosis.METHODS:We classified 861 obese childre...AIM:To investigate if non-alcoholic fatty liver disease (NAFLD) is an early mediator for prediction of metabolic syndrome,and if liver B-ultrasound can be used for its diagnosis.METHODS:We classified 861 obese children (6-16 years old) into three subgroups:group 0 (normal liver in ultrasound and normal transaminases);group 1 (fatty liver in ultrasound and normal transaminases);and group 2 (fatty liver in ultrasound and elevated transaminases).We measured the body mass index,waist and hip circumference,blood pressure,fasting blood glucose,insulin,homeostasis model assessment of insulin resistance (HOMA-IR),whole-body insulin sensitivity index (WBISI),lipid profile and transaminases in all the participants.The risk of developing metabolic syndrome (MS) was assessed according to the degree of liver fatty infiltration based on the B-ultrasound examination.RESULTS:Among the 861 obese children,587 (68.18%) were classified as having NAFLD,and 221 (25.67%) as having MS.The prevalence of MS in NAFLD children (groups 1 and 2) was 37.64% (221/587),which was much higher than that in non-NAFLD group (group 0,12.04%) (P < 0.01).There were significantly higher incidences concerning every component of MS in group 2 compared with group 0 (P < 0.05).The incidence of NAFLD in MS patients was 84.61% (187/221),which was significantly higher than that of hypertension (57.46%,127/221) and glucose metabolic anomalies (22.62%,50/221),and almost equal to the prevalence of dyslipidemia (89.14%,197/221).Based on the B-ultrasound scales,the presence of moderate and severe liver fatty infiltration carried a high risk of hypertension [odds ratio (OR):2.18,95% confidence interval (95% CI):1.27-3.75],dyslipidemia (OR:7.99,95% CI:4.34-14.73),impaired fasting glucose (OR:3.65,95% CI:1.04-12.85),and whole MS (OR:3.77;95% CI:1.90-7.47,P < 0.01).The state of insulin resistance (calculated by HOMA-IR and WBISI) deteriorated as the degree of fatty infiltration increased.CONCLUSION:NAFLD is not only a liver disease,but also an early mediator that reflec展开更多
INTRODUCTION Lung diseases are the most common conditions in newborn infants and children and are also the primary causes of death in children younger than 5 years old.[1] Therefore,accurate and timely diagnosis is ex...INTRODUCTION Lung diseases are the most common conditions in newborn infants and children and are also the primary causes of death in children younger than 5 years old.[1] Therefore,accurate and timely diagnosis is extremely important in order to enable efficient treatment and improve the prognosis of patients with lung diseases.In the past,the diagnosis of lung disease mainly depended on chest radiography （CR） and/or computed tomography （CT）.展开更多
Many countries have adopted higher-valent pediatric combination vaccines to simplify vaccination schedules and minimize health expenditures and social costs.However,China is conservative in the use of pediatric combin...Many countries have adopted higher-valent pediatric combination vaccines to simplify vaccination schedules and minimize health expenditures and social costs.However,China is conservative in the use of pediatric combina-tion vaccines.By reviewing and synthesizing quantitative and qualitative data,in this commentary we identify gaps and challenges to combination vaccine use and make recommendations for promoting use of higher-valent pediatric combination vaccines in China.Challenges are in four dimensions:(1)legislation and regulation,(2)immunization schedule design,(3)vaccine awareness and price,and(4)research and development capacity.To optimize the use of combination vaccines to reduce vaccine-preventable disease burden,we make recommendations that address key challenges:(1)develop policies and regulations to strengthen enforcement of the Vaccine Administration Law and remove regulatory hurdles that hinder combination vaccine research and development,(2)establish an evi-dence-informed policy-making mechanism for combination vaccines,(3)resolve immunization schedule conflicts between monovalent and combination vaccines,and(4)implement effective interventions to increase vaccine awareness and reduce price.展开更多
Atherosclerosis is extremely widespread.Traditionally,it is considered a disease of older people,who most often experience problems with the heart and blood vessels.While much attention from the scientific community h...Atherosclerosis is extremely widespread.Traditionally,it is considered a disease of older people,who most often experience problems with the heart and blood vessels.While much attention from the scientific community has been paid to studying the association between aging and atherosclerosis,as well as its consequences,there is evidence that atherosclerosis occurs at an early age.Atherosclerosis may form both during intrauterine development and in childhood.Nutrition plays an important role in childhood atherosclerosis,along with previous infectious diseases and excess weight of both the child and the mother.In the present review,we examined the development of atherosclerosis and the prerequisites in childhood.展开更多
Childhood-onset obesity has emerged as a major public healthcare challenge across the globe,fueled by an obesogenic environment and influenced by both genetic and epigenetic predispositions.This has led to an exponent...Childhood-onset obesity has emerged as a major public healthcare challenge across the globe,fueled by an obesogenic environment and influenced by both genetic and epigenetic predispositions.This has led to an exponential rise in the incidence of type 2 diabetes mellitus in children and adolescents.The looming wave of diabetes-related complications in early adulthood is anticipated to strain the healthcare budgets in most countries.Unless there is a collective global effort to curb the devastation caused by the situation,the impact is poised to be pro-found.A multifaceted research effort,governmental legislation,and effective social action are crucial in attaining this goal.This article delves into the current epidemiological landscape,explores evidence concerning potential risks and consequences,delves into the pathobiology of childhood obesity,and discusses the latest evidence-based management strategies for diabesity.展开更多
PSYCHIATRISTS DISAGREE profoundly with lawyers,about what we human beings are capable of.The one says we have‘intent’—the other that we do not.They cannot both be right.All non-psychiatrist doctors must perforce ag...PSYCHIATRISTS DISAGREE profoundly with lawyers,about what we human beings are capable of.The one says we have‘intent’—the other that we do not.They cannot both be right.All non-psychiatrist doctors must perforce agree with the lawyers.This paper argues that these harmful discrepancies will continue,until we undo the separate watertight human knowledge silos,which have grown up between legal procedures,general medicine,and psychiatric practice.All three would benefit.Psychiatry in particular,suffers from a grievously narrow view of scientific evidence,one which is open to fundamental criticism.There are radical differences in how the fuzzy concept of‘intent’is regarded in law,in general clinical medicine and in psychiatry.Once‘intent’is accorded its due weight,our understanding of justice,health and sanity is vastly improved,allowing us hugely more optimism.This paper is based on two earlier papers—The Scientific Evidence That‘Intent’Is Vital for Healthcare and Why Quakerism Is More Scientific Than Einstein.These are deployed here,to unpick the unhealthy tangle in which today’s psychiatry now finds itself.Its six sections are—(1)why‘intent’matters in law,in medicine&in psychiatry;(2)scientific quagmires;(3)a working definition for‘madness’;(4)“children are impressionable”;(5)“trust me,I’m a doctor”;and(6)skin heals,why can’t minds?The breakthrough is that verbal fuzziness means that words can mean different things at different times––not that they are 100%meaningless.Only a better understanding of trust,autonomy and consent can open the way to something that is painfully absent from today’s psychiatry––a cure for any and all mental disease.展开更多
基金Supported by Zhejiang Provincial Natural Science Foundation,No.Y2080047funds for Zhejiang Major Medical and Health Science and Technology Program+2 种基金 funds from Ministry of Health,No.WKJ2008-2-026Major Special Zhejiang Provincial Science and Technology Fund,No.2008c03002-1the National Key Technology R&D Program of China,No.2009BAI80B01
文摘AIM:To investigate if non-alcoholic fatty liver disease (NAFLD) is an early mediator for prediction of metabolic syndrome,and if liver B-ultrasound can be used for its diagnosis.METHODS:We classified 861 obese children (6-16 years old) into three subgroups:group 0 (normal liver in ultrasound and normal transaminases);group 1 (fatty liver in ultrasound and normal transaminases);and group 2 (fatty liver in ultrasound and elevated transaminases).We measured the body mass index,waist and hip circumference,blood pressure,fasting blood glucose,insulin,homeostasis model assessment of insulin resistance (HOMA-IR),whole-body insulin sensitivity index (WBISI),lipid profile and transaminases in all the participants.The risk of developing metabolic syndrome (MS) was assessed according to the degree of liver fatty infiltration based on the B-ultrasound examination.RESULTS:Among the 861 obese children,587 (68.18%) were classified as having NAFLD,and 221 (25.67%) as having MS.The prevalence of MS in NAFLD children (groups 1 and 2) was 37.64% (221/587),which was much higher than that in non-NAFLD group (group 0,12.04%) (P < 0.01).There were significantly higher incidences concerning every component of MS in group 2 compared with group 0 (P < 0.05).The incidence of NAFLD in MS patients was 84.61% (187/221),which was significantly higher than that of hypertension (57.46%,127/221) and glucose metabolic anomalies (22.62%,50/221),and almost equal to the prevalence of dyslipidemia (89.14%,197/221).Based on the B-ultrasound scales,the presence of moderate and severe liver fatty infiltration carried a high risk of hypertension [odds ratio (OR):2.18,95% confidence interval (95% CI):1.27-3.75],dyslipidemia (OR:7.99,95% CI:4.34-14.73),impaired fasting glucose (OR:3.65,95% CI:1.04-12.85),and whole MS (OR:3.77;95% CI:1.90-7.47,P < 0.01).The state of insulin resistance (calculated by HOMA-IR and WBISI) deteriorated as the degree of fatty infiltration increased.CONCLUSION:NAFLD is not only a liver disease,but also an early mediator that reflec
文摘INTRODUCTION Lung diseases are the most common conditions in newborn infants and children and are also the primary causes of death in children younger than 5 years old.[1] Therefore,accurate and timely diagnosis is extremely important in order to enable efficient treatment and improve the prognosis of patients with lung diseases.In the past,the diagnosis of lung disease mainly depended on chest radiography （CR） and/or computed tomography （CT）.
文摘Many countries have adopted higher-valent pediatric combination vaccines to simplify vaccination schedules and minimize health expenditures and social costs.However,China is conservative in the use of pediatric combina-tion vaccines.By reviewing and synthesizing quantitative and qualitative data,in this commentary we identify gaps and challenges to combination vaccine use and make recommendations for promoting use of higher-valent pediatric combination vaccines in China.Challenges are in four dimensions:(1)legislation and regulation,(2)immunization schedule design,(3)vaccine awareness and price,and(4)research and development capacity.To optimize the use of combination vaccines to reduce vaccine-preventable disease burden,we make recommendations that address key challenges:(1)develop policies and regulations to strengthen enforcement of the Vaccine Administration Law and remove regulatory hurdles that hinder combination vaccine research and development,(2)establish an evi-dence-informed policy-making mechanism for combination vaccines,(3)resolve immunization schedule conflicts between monovalent and combination vaccines,and(4)implement effective interventions to increase vaccine awareness and reduce price.
基金funded by the Russian Science Foundation(Grant No.23-45-00031).
文摘Atherosclerosis is extremely widespread.Traditionally,it is considered a disease of older people,who most often experience problems with the heart and blood vessels.While much attention from the scientific community has been paid to studying the association between aging and atherosclerosis,as well as its consequences,there is evidence that atherosclerosis occurs at an early age.Atherosclerosis may form both during intrauterine development and in childhood.Nutrition plays an important role in childhood atherosclerosis,along with previous infectious diseases and excess weight of both the child and the mother.In the present review,we examined the development of atherosclerosis and the prerequisites in childhood.
文摘Childhood-onset obesity has emerged as a major public healthcare challenge across the globe,fueled by an obesogenic environment and influenced by both genetic and epigenetic predispositions.This has led to an exponential rise in the incidence of type 2 diabetes mellitus in children and adolescents.The looming wave of diabetes-related complications in early adulthood is anticipated to strain the healthcare budgets in most countries.Unless there is a collective global effort to curb the devastation caused by the situation,the impact is poised to be pro-found.A multifaceted research effort,governmental legislation,and effective social action are crucial in attaining this goal.This article delves into the current epidemiological landscape,explores evidence concerning potential risks and consequences,delves into the pathobiology of childhood obesity,and discusses the latest evidence-based management strategies for diabesity.
文摘PSYCHIATRISTS DISAGREE profoundly with lawyers,about what we human beings are capable of.The one says we have‘intent’—the other that we do not.They cannot both be right.All non-psychiatrist doctors must perforce agree with the lawyers.This paper argues that these harmful discrepancies will continue,until we undo the separate watertight human knowledge silos,which have grown up between legal procedures,general medicine,and psychiatric practice.All three would benefit.Psychiatry in particular,suffers from a grievously narrow view of scientific evidence,one which is open to fundamental criticism.There are radical differences in how the fuzzy concept of‘intent’is regarded in law,in general clinical medicine and in psychiatry.Once‘intent’is accorded its due weight,our understanding of justice,health and sanity is vastly improved,allowing us hugely more optimism.This paper is based on two earlier papers—The Scientific Evidence That‘Intent’Is Vital for Healthcare and Why Quakerism Is More Scientific Than Einstein.These are deployed here,to unpick the unhealthy tangle in which today’s psychiatry now finds itself.Its six sections are—(1)why‘intent’matters in law,in medicine&in psychiatry;(2)scientific quagmires;(3)a working definition for‘madness’;(4)“children are impressionable”;(5)“trust me,I’m a doctor”;and(6)skin heals,why can’t minds?The breakthrough is that verbal fuzziness means that words can mean different things at different times––not that they are 100%meaningless.Only a better understanding of trust,autonomy and consent can open the way to something that is painfully absent from today’s psychiatry––a cure for any and all mental disease.
