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* OBJECTIVE: To examine the associations between (1) various types of physical activity and the risk of back pain incidence, and (2) the influence of substituting sedentary behaviors with physical activities on back pain incidence. * DESIGN: A prospective cohort study. * METHODS: We analyzed UK Biobank data collected from 365 307 participants who were free of back pain at baseline. The exposures were total, light, moderate, and vigorous physical activity, and sedentary behaviors. The outcome was back pain incidence. The main statistical models were the Cox proportional hazard model and the isotemporal substitution model. * RESULTS: In the follow-up time (median, 12.97 years; interquartile range, 12.10-13.71), 25 189 individuals developed back pain. The associations between all types of physical activity and incident back pain were significantly nonlinear (P<.001) among the general population and other subgroups. High physical activity was associated with a decreased risk of back pain compared with no physical activity. The lowest risk occurred in the 1801-to-2400 MET-min/week (metabolic-equivalent minutes per week) subgroup of total physical activity (hazard ratio [HR] = 0.64; 95% CI: 0.59, 0.69), approximately consisting of 1200, 600, and 600 MET-min/week of light, moderate, and vigorous physical activity, respectively. Extremely high vigorous physical activity was related to high risk, specifically in males (HR = 1.13; 95% CI: 1.02, 1.25). Replacing 1 hour/day of sedentary behaviors with an equal time of physical activity reduced the risk of incident back pain by 2% to 8% (P<.05). * CONCLUSION: Physical activity was related to a reduced risk of back pain incidence (except over high vigorous physical activity). Substituting sedentary behaviors with physical activities reduced the risk of future back pain. [ABSTRACT FROM AUTHOR]

Objective: To characterize the inferior adrenal artery (IAA) pulsatility index (PI) in intrauterine growth-restricted (IUGR) fetuses without brain sparing.Methods: Twenty-three IUGR fetuses with a normal Doppler cerebroplacental ratio (CPR) and 23 normal controls were included in this prospective cross-sectional study. The PI of the IAA was recorded using routine transabdominal Doppler ultrasound. The differences in Doppler characteristics, perinatal outcomes, and steroidogenesis in the umbilical vein at birth (adrenocorticotropic hormone [ACTH] and cortisol [F] levels) were compared between the 2 groups. The correlations between IAA-PI and steroidogenesis were assessed in the IUGR group.Results: IAA-PI was significantly lower in IUGR fetuses than in normal controls (0.85 vs 1.18 at first scan, 0.78 vs 0.92 at last scan; both P < 0.001). The plasma F and ACTH levels in IUGR cases were significantly higher than those of the normal controls (18.2 vs 12.4 µg/dL and 280.5 vs 125.6 pg/mL for F and ACTH, respectively; both P < 0.001). There were negative correlations between IAA-PI and plasma F values and between IAA-PI and ACTH values in the IUGR group (r = -0.774 and -0.82 at first scan, r = -0.525 and -0.45 at last scan, respectively; P < 0.001).Conclusion: Increased adrenal gland blood flow with concomitant increases in ACTH and F levels were observed in IUGR fetuses. IAA-PI is useful to assess early blood redistribution and may be beneficial for evaluating the steroidogenic response in high-risk pregnancies. [ABSTRACT FROM AUTHOR]

The article presents a study focusing on identification of a novel missense mutation at the collagenous domain of ectodermal dysplasia (EDA) gene in a Chinese family with X-linked hypohidrotic ectodermal dysplasia (XLHED). The findings of the study include the substitution of a proline with a leucine in EDA protein by mutation, the substitution mutation found only in the affected males and the carrier females with normal phenotypes, and the proline affecting the stability of collagen helix.

Objective: To study the possibility of Chinese visible human (CVH) head datasets as brain atlas for locating the subthalamic nucleus (STN) before deep brain stimulation (DBS) surgery. Methods: Optimal head axial and coronal 3.0T, T2-weighted magnetic resonance images (MRI) of 30 patients were obtained. Cross-sectional head images of four CVH head datasets were chosen to establish an average CVH model. All MRI sequences were registered to the CVH model via fiducials in X-, Y-, and Z-direction, respectively, within the same stereotactic space. The correlations between red nucleus (RN) and fiducials, the accuracy of MRI-to-CVH registration, and the coordinate value differences of RN gravity center between MRI and CVH were tested. Results: The mean gravity center coordinate values and ranges of STN in CVH were measured; The X coordinate value of RN positively correlates with the most anterior point of putamen(PU-A), the lateral edges of putamens (PU-L), and width of the third ventricle, negatively correlated with the patients’ age; The minimal mean errors were when no fiducials were used when locating RN between the MRI and the CVH average model; There were no significant differences of RN in X- and Y-direction between MRI sequences and CVH. Conclusion: CVH head datasets can be used as brain atlas for Chinese STN localization. Moreover, average coordinate values of the gravity center and the ranges of STN in CVH can be considered as references for locating STN. [ABSTRACT FROM AUTHOR]

With Chemically Enhanced Primary Treatment (CEPT) as the short-term process, the capacity of Bailonggang Wastewater Treatment Plant accounts for almost 25% of the total capacity of wastewater treatment in Shanghai, China. However, shortly after this plant was placed in operation in 2004, it was found that the effluent of CEPT couldn't meet the new national discharge criteria. Although the removal of phosphate is almost 80%, chemical oxygen demand (COD) and ammonia nitrogen (NH3-N) in the effluent is frequently found to exceed the standards. The primary goal of this research is to investigate the possibility of optimizing the CEPT to make it meet the discharge criteria before it is upgraded to a secondary treatment. An oxidant is adopted to remove NH3-N, and a high performance polyaluminum chloride (HP-PACl) is synthesized to enhance the removal of COD. It is found that HP-PACl improves the removal of COD, and the oxidant enhances NH3-N removal effectively. However, to meet the requirement of a newly implemented stricter discharge standard, it is necessary to upgrade this CEPT to a secondary treatment. The results of this study provide scientific evidence for the upgrade of the Bailonggang Wastewater Treatment Plant. [ABSTRACT FROM AUTHOR]

Background: The prevalence of Fabry disease (FD) in Chinese patients with hypertrophic cardiomyopathy (HCM) is unclear. We aimed to evaluate the prevalence, clinical characteristics, and outcomes of FD in Chinese patients with HCM., Methods: Of 217 patients with HCM, FD probands were screened by next-generation sequencing at Fuwai Hospital. Medical data from α-galactosidase A activity, electrocardiography, echocardiography, coronary angiography, cardiac magnetic resonance, pathological examination, and follow up was analyzed., Results: Two FD probands were observed (0.93% of patients with HCM), both of which were diagnosed with symptomatic obstructive HCM at 49 years of age. One proband had a GLA mutation (c.887T>C [p.M296T]) with a late-onset cardiac variant, which was characterized by dual ventricular hypertrophy and conduction disease with a permanent pacemaker. The other patient had a GLA mutation (c.758T>C [p.I253T]) with a classic phenotype and dual ventricular hypertrophy, atrioventricular block, renal failure, and recurrent cerebral infarction. Both probands had late gadolinium enhancement mainly in the basal segment of the inferolateral wall. Follow up revealed no exertional symptoms or outflow obstruction after surgical septal myectomy in the two probands, and stable renal function was observed after 6 months of migalastat therapy in the later one. A family study revealed six female carriers and three sudden cardiac deaths., Conclusions: FD is not uncommon in Chinese patients with HCM. Multiple organic involvement, dual ventricular hypertrophy, and conduction disease provide clinical clues for suspected FD, and early genetic screening is necessary. Surgical septal myectomy and migalastat improve the long-term prognosis of patients with FD., (Copyright © 2021. Published by Elsevier Inc.)

It is important for modern hospital management to strengthen medical humanistic care and build a harmonious doctor-patient relationship. Innovative applications of the big data resources of patient experience in modern hospital management facilitate hospital management to realize real-time supervision, dynamic management and scientific decision-making based on patients experiences. It is helping the transformation of hospital management from an administrator's perspective to a patient's perspective, and from experience-driven to data-driven. The technological innovations in hospital management based on patient experience data can assist the optimization and continuous improvement of healthcare quality, therefore help to increase patient satisfaction to the medical services.

Aim: To establish the safety and feasibility of laparoscopic splenectomy (LS) for littoral cell angioma (LCA)., Methods: From September 2003 to November 2013, 27 patients were diagnosed with LCA in our institution. These patients were divided into two groups based on operative procedure: LS (13 cases, Group 1) and open splenectomy (14 cases, Group 2). Data were collected retrospectively by chart review. Comparisons were performed between the two groups in terms of demographic characteristics (sex and age); operative outcomes (operative time, estimated blood loss, transfusion, and conversion); postoperative details (length of postoperative stay and complications); and follow-up outcome., Results: LS was successfully carried out in all patients except one in Group 1, who required conversion to hand-assisted LS because of perisplenic adhesions. The average operative time for patients in Group 1 was significantly shorter than that in Group 2 (127 ± 34 min vs 177 ± 25 min, P = 0.001). The average estimated blood loss in Group 1 was significantly lower than in Group 2 (62 ± 48 mL vs 138 ± 64 mL, P < 0.01). No patient in Group 1 required a blood transfusion, whereas one in Group 2 required a transfusion. Two patients in Group 1 and four in Group 2 suffered from postoperative complications. All the complications were cured by conservative therapy. There were no deaths in our series. All patients were followed up and no recurrence or abdominal metastasis were found., Conclusion: LS for patients with LCA is safe and feasible, with preferable operative outcomes and long-term tumor-free survival.