Computer-assisted three-dimensional individualized extreme liver resection for hepatoblastoma in proximity to the major liver vasculature

BACKGROUND The management of hepatoblastoma(HB)becomes challenging when the tumor remains in close proximity to the major liver vasculature(PMV)even after a full course of neoadjuvant chemotherapy(NAC).In such cases,extreme liver resection can be considered a potential option.AIM To explore whether computer-assisted three-dimensional individualized extreme liver resection is safe and feasible for children with HB who still have PMV after a full course of NAC.METHODS We retrospectively collected data from children with HB who underwent surgical resection at our center from June 2013 to June 2023.We then analyzed the detailed clinical and three-dimensional characteristics of children with HB who still had PMV after a full course of NAC.RESULTS Sixty-seven children diagnosed with HB underwent surgical resection.The age at diagnosis was 21.4±18.8 months,and 40 boys and 27 girls were included.Fifty-nine(88.1%)patients had a single tumor,39(58.2%)of which was located in the right lobe of the liver.A total of 47 patients(70.1%)had PRE-TEXT III or IV.Thirty-nine patients(58.2%)underwent delayed resection.After a full course of NAC,16 patients still had close PMV(within 1 cm in two patients,touching in 11 patients,compressing in four patients,and showing tumor thrombus in three patients).There were 6 patients of tumors in the middle lobe of the liver,and four of those patients exhibited liver anatomy variations.These 16 children underwent extreme liver resection after comprehensive preoperative evaluation.Intraoperative procedures were performed according to the preoperative plan,and the operations were successfully performed.Currently,the 3-year event-free survival of 67 children with HB is 88%.Among the 16 children who underwent extreme liver resection,three experienced recurrence,and one died due to multiple metastases.CONCLUSION Extreme liver resection for HB that is still in close PMV after a full course of NAC is both safe and feasible.This approach not only reduces the necessity for liver transplantation but also results in a favorable prognosis.Individualized three-dimensional surgical planning is beneficial for accurate and complete resection of HB,particularly for assessing vascular involvement,remnant liver volume and anatomical variations.

High formability Mg-Zn-Gd wire facilitates ACL reconstruction via its swift degradation to accelerate intra-tunnel endochondral ossification

After reconstructing the anterior cruciate ligament(ACL),unsatisfactory bone tendon interface healing may often induce tunnel enlargement at the early healing stage.With good biological features and high formability,Magnesium-Zinc-Gadolinium(ZG21)wires are developed to bunch the tendon graft for matching the bone tunnel during transplantation.Microstructure,tensile strength,degradation,and cytotoxicity of ZG21 wire are evaluated.The rabbit model is used for assessing the biological effects of ZG21 wire by Micro-CT,histology,and mechanical test.The SEM/EDS,immunochemistry,and in vitro assessments are performed to investigate the underlying mechanism.Material tests demonstrate the high formability of ZG21 wire as surgical suture.Micro-CT shows ZG21 wire degradation accelerates tunnel bone formation,and histologically with earlier and more fibrocartilage regeneration at the healing interface.The mechanical test shows higher ultimate load in the ZG21 group.The SEM/EDS presents ZG21 wire degradation triggered calcium phosphate(Ca-P)deposition.IHC results demonstrate upregulation of Wnt3a,BMP2,and VEGF at the early phase and TGFβ3 and Type II collagen at the late phase of healing.In vitro tests also confirmed the Ca-P in the metal extract could elevate the expression of Wnt3a,βcatenin,ocn and opn to stimulate osteogenesis.Ex vivo tests of clinical samples indicated suturing with ZG21 wire did not weaken the ultimate loading of human tendon tissue.In conclusion,the ZG21 wire is feasible for tendon graft bunching.Its degradation products accelerated intra-tunnel endochondral ossification at the early healing stage and therefore enhanced bone-tendon interface healing in ACL reconstruction.

Epidemiological Features of Severe Acute Respiratory Syndrome in Beijing Urban and Suburb Areas in 2003

To describe the epidemiologic features of an outbreak of severe acute respiratory syndrome （SARS） in urban and suburb areas in Beijing and to explore their differences between these two areas. Methods Data of SARS cases were collected from daily notification of China Ministry of Health and a database of infectious diseases was established by the Beijing Municipal Center for Disease Prevention and Control （BCDC）. All the data were put into dataset files by Microsoft Exeel-2000 and analyzed with SPSS version 10.0 software. Results The respective urban incidence and mortality rate were 29.06 and 2.21 per 100 000, while the case fatality rate was 7.62%. In contrast, the respective suburb incidence and mortality rate were 10.61 and 0.78 per 100 000, and the case fatality rate was 7.32%. No significant differences were found in demographic characteristics between the urban and suburb areas. Conclusion Beijing urban area suffered a more serious SARS epidemic than the suburb area in 2003.

Comparative study on the anti-tuberculous effect and mechanism of the traditional Chinese medicines NiuBeiXiao He extract and JieHeWan

Background:The traditional Chinese medicine NiuBeiXiaoHe(NBXH)extract and Chinese medicine preparation JieHeWan(JHW)exhibit anti-tuberculosis(TB)effects.The anti-TB effect of NBXH was compared with that of JHW to elucidate the mechanism of action of NBXH.Methods:BALB/c mice aged 6-8 weeks were randomly divided into a normal control group,TB model group,JHW treatment group,and NBXH treatment group.After 3 and 13 weeks of treatment,the therapeutic effect in each group was evaluated by comparing lung histopathology,lung and liver colony counts,the number of spots representing effector T cells secreting IFN-γin an enzyme-linked immunospot assay(ELISPOT),and the levels of Th1,Th2,and Th17 cytokines,which were measured by a cytometric bead array(CBA).Mouse RNA samples were subjected to transcriptome sequencing.Results:After 13 weeks of treatment,the mean histopathological lesion area of the NBXH group was significantly smaller than that of the TB model group(P<0.05).Compared with those in the TB model group,the lung colony counts in the JHW and NBXH groups were significantly decreased(P<0.05),and the IL-2 and IL-4 levels in the NBXH group were significantly increased(P<0.05).NBXH partly restored significant changes in gene expression caused by Mycobacterium tuberculosis(M.tuberculosis)infection.According to GO and KEGG analyses,the changes in biological process(BP),cell composition(CC)and molecular function(MF)terms and in signaling pathways caused by NBXH and JHW treatment were not completely consistent,but they were mainly related to the immune response and inflammatory response in the mouse TB model.Conclusions:NBXH had therapeutic effects similar to those of JHW in improving lung histopathology,reducing lung colony counts,and regulating the levels of cytokines.NBXH restored significant changes in gene expression and repaired cell damage caused by M.tuberculosis infection by regulating immune-related pathways,which clarified the mechanism of action of NBXH.

Coastal protection using building with nature concept:A case study from Chongming Dongtan Shoal,China

With climate change and rising sea levels,the coastal zone’s flood risk is deteriorating.Previous researches have shown a gradually degrading capacity of traditional hard engineering structures(e.g.,seawall,dikes)on flood mitigation due to problems such as land subsidence and insufficient maintenance.To remedy the defects,the"building with nature concept"for coastal protection with saltmarshes was examined by combining field measurements and numerical simulations.The advantages of saltmarsh over traditional seawall on flood protection was demonstrated from the perspective of both flood area mitigation and economic gain,based on scenario simulations.Results show that tidal wetlands are essential in mitigating significant wave heights(Hs)and current velocities even during storm conditions.The storm wave and current velocity reduction ratio(RRw and RRc)by saltmarshes on Chongming Dongtan Shoal(CMDS)during Typhoon 9711 is approximately 11%and 51%,respectively.The wave and current mitigation by Scirpus mariqueter are more efficient than Spartina alterniflora and Phragmites australis during measurements in 2010,which were approximately 0.3 m and 0.2 m/s,0.125 m and 0.155 m/s,0.086 m and 0.128 m/s per kilometer width,respectively.The summer saltmarsh area 54.2 km2 on CMDS protects approximately 32 km^(2)land area behind the seawall from being flooded,equivalent to the seawall heightening of approximately 0.42 m on equivalent flood mitigation.The performance of cost-and-benefit analysis shows a relatively higher(by 3%–7%)net present value(NPV)and a higher(by 1.5 times)benefit-cost ratio(BC)of nature-based solution(i.e.,saltmarsh restoration)compared with traditional hard engineering solution(i.e.,seawall construction).Thus,building seawall with nature,such as a hybrid flood protection measure,should be implemented in the future coastal redesign and maintenance.

Waist Circumference Reference Values for Screening Cardiovascular Risk Factors in Chinese Children and Adolescents

Objectives To explore the optimal threshold values of waist circumference （WC） for detecting cardiovascular （CV） risk factors among Chinese children and adolescents. Methods Association of WC with CV risk factors was studied among 65 898 children aged 7-18 years whose data were pooled from nine previous studies in China. CV risk factors in this study included hypertension （blood pressure above 95 percentile levels）, dyslipidemia （with one or more of the following three indexes： TG ≥ 1.7 mmol/L, TC ≥ 5.18 mmol/L, and HDL-C ≤ 1.04 mmol/L） and elevated glucose level （fasting plasma glucose ≥5.6 mmol/L）. Receive-operating characteristic analysis （ROC） and logistic regression were employed to derive optimal age- and sex-specific waist circumference references for predicting CV risk factors. Results A slight increasing trend of CV risk factors was observed starting from the 75th percentile of waist circumference in the study population, while a remarkable increasing trend occurred from the 90th percentile. The optimal waist circumference thresholds for predicting high blood pressures were at the 75th percentile for both boys and girls, which was at the 90th percentiles for detecting at least two of the above three CV risk factors. In comparison with children with waist circumference below the 75th percentile, the odds ratio of two CV risk factors doubled among children with waist circumference between the 75th and the 90th percentile, and increased by 6 times among children with waist circumference above the 90th percentile. The trend of high blood pressure increasing with waist circumference remained significant after having been stratified by BMI category. Conclusion The 75th and the 90th percentiles of WC are the optimal cut-off points for predicting an increased and a substantially increased risk of CV factors in Chinese children and adolescents, respectively.

FTO Polymorphisms Are Associated with Obesity But Not with Diabetes in East Asian Populations:A Meta-analysis

Objective To clarify the contradictory findings in patients with obesity and type 2 diabetes by meta-analysis. Methods PubMed and Embase were searched for articles published up to March 2009. All studies on the association of FTO polymorphisms with obesity and type 2 diabetes were included. Pooled odds ratio was calculated using the model of fixed or random effects. Sensitivity analysis was performed to evaluate the stability of meta-analytic results. Results Meta-analysis suggested that rs9939609 A allele was more significantly associated with obesity risk than T allele （3 studies / 2 004 cases and 4 544 control subjects）： random effect odds ratio （OR）-1.28, 95%CI=1.05 and 1.55, P heterogeneity =0.05, I^2=66.6%. Similar results were observed in rs8050136 polymorphism （3 studies/2 404 cases and 5 713 control subjects）： fixed effect OR =1.25, 95%CI-1.13, 1.37, Pheterogeneity =0.12, 12=51.9%. However, no significant association was found between genetics and risk of type 2 diabetes after control of potential confounders （at least for BMI） either for rs9939609 （fixed effect OR=1.05, 95% CI 0.97,1.13） or for rs8050136 polymorphism （fixed effect OR -1.07, 95%CI： 0.99, 1.16）. Furthermore, the sensitivity analysis strengthened our confidence in validity of the association. Conclusion FTO polymorphisms are associated with obesity but not with type 2 diabetes in East Asian populations. Further large-scale studies are required to conclusively establish the association.

Reduced Arterial Compliance Associated with Metabolic Syndrome in Chinese Children and Adolescents

Objective To explore the metabolic syndrome and its association with arterial compliance in Chinese children and adolescents. Methods 337 participants aged 6 to 18 years with males accounted for 55.8% were grouped according to their traits of metablic syndrome. Anthropometry, blood pressure, fasting plasma glucose, insulin and serum lipid profile were measured. Homeostasis model was assessed and insulin resistance （HOMA-IR） index was measured and calculated for estimating individual insulin resistance. Arterial compliance was also measured using digital pulse wave analyzing method （Micro medical, London）, and stiffness index was calculated. Results The stiffness index in participants with metablic syndrome was significant higher than that in participants with no riskof metablic syndrome [（7.69±1.63） vs （6.25±0.86） m/s, P〈0.01] and stiffness index and HOMA-IR were progressively increased with the increase of traits of metablic syndrom （P for linear trend 〈0.001）. After gender, age, and pubertal development were adjusted, both traits of metablic syndrome and HOMA-IR were correlated positively with stiffness index （both P〈0.05）. Conclusion The clustering of metablic syndrome was closely associated with risk at increased arterial stiffness in Chinese children and adolescents. It was suggested that arterial compliance assessment of children and adolescents might be an important measure for prevention of cardiovascular diseases.

Prevalence of hypertension and its associations with body composition across Chinese and American children and adolescents

Background The age of onset of hypertension(HTN)is decreasing,and obesity is a significant risk factor.The prevalence and racial disparities in pediatric HTN and the association between body composition and blood pressure are insufficiently studied.This study aimed to evaluate the prevalence of HTN in Chinese and American children and adolescents and to assess the relationship between various body composition indices and HTN.Methods Seven thousand,five hundred and seventy-three Chinese and 6239 American children and adolescents aged 8–18 years from the 2013–2015 China Child and Adolescent Cardiovascular Health study and the 2011–2018 National Health and Nutrition Examination Surveys were analyzed.Blood pressure and body composition(fat and muscle)were measured by trained staff.The crude prevalence and age-standardized prevalence rate(ASPR)of primary HTN and its subtypes[isolated systolic hypertension(ISH)and isolated diastolic hypertension(IDH)]were calculated based on 2017 American Academy of Pediatrics guidelines.Multivariable-adjusted linear regression coefficients and odds ratios(ORs)were calculated to assess the associations of body composition indicators with HTN,ISH and IDH.Results The ASPR of HTN was 18.5%in China(CN)and 4.6%in the United States(US),whereas the obesity prevalence was 7.4%and 18.6%,and the population attributable risk of HTN caused by overweight and obesity was higher in the US than in CN.Increased fat mass,muscle mass and body fat percentage mass were associated with a higher risk of HTN in both countries.The percent of muscle body mass had a protective effect on HTN and ISH in both countries[HTN(CN:OR=0.83,95%CI=0.78–0.88;US:OR=0.72,95%CI=0.64–0.81);ISH(CN:OR=0.87,95%CI=0.80–0.94;US:OR=0.71,95%CI=0.62–0.81)],and the protective effect was more common among children and adolescents with high levels of physical activity.Conclusions The burden of HTN in Chinese children and adolescents was substantial and much greater than that in the US,and the contribution of obesity to HTN was higher in the US than in CN.Augmenting the proportion of muscle mass in body composition has a protective effect against HTN in both populations.Optimizing body composition positively influences blood pressure in children and adolescents,particularly those with high-level physical activity.

Combination of magnesium ions and vitamin C alleviates synovitis and osteophyte formation in osteoarthritis of mice

Introduction:We previously demonstrated that magnesium ions(Mg^(2+))was a novel therapeutic alternative for osteoarthritis(OA)through promoting the hypoxia inducible factor-1α(HIF-1α)-mediated cartilage matrix synthesis.However,oxidative stress can inhibit the expression of HIF-1α,amplify the inflammation that potentially impairs the therapeutic efficacy of Mg^(2+) in OA.Vitamin(VC),a potent antioxidant,may enhance the efficacy of Mg^(2+) in OA treatment.This study aims to investigate the efficacy of combination of Mg^(2+)and VC on alleviating joint destruction and pain in OA.Material and methods:Anterior cruciate ligament transection with partial medial meniscectomy induced mice OA model were randomly received intra-articular injection of either saline,MgCl2(0.5 mol/L),VC(3 mg/ml)or MgCl2(0.5 mol/L)plus VC(3 mg/ml)at week 2 post-operation,twice weekly,for 2 weeks.Joint pain and pathological changes were assessed by gait analysis,histology,western blotting and micro-CT.Results:Mg^(2+) and VC showed additive effects to significantly alleviate the joint destruction and pain.The efficacy of this combined therapy could sustain for 3 months after the last injection.We demonstrated that VC enhanced the promotive effect of Mg^(2+) on HIF-1αexpression in cartilage.Additionally,combination of Mg^(2+) and VC markedly promoted the M2 polarization of macrophages in synovium.Furthermore,combination of Mg^(2+) and VC inhibited osteophyte formation and expressions of pain-related neuropeptides.Conclusions:Intra-articular administration of Mg^(2+)and VC additively alleviates joint destruction and pain in OA.Our current formulation may be a cost-effective alternative treatment for OA.

Timing and secular trend of pubertal development in Beijing girls

Background:Historical research is limited in changes in pubertal development in Chinese girls.We aimed to identify the timing of pubertal characteristics and the secular trend of menarche age among Beijing girls from the 1980s through the 2000s.Methods:Six data sets were analyzed,including the Beijing Child and Adolescent Metabolic Syndrome study in 2004,where 9778 Bejing girls aged 6–18 years were studied.The Fetal Origins of Adult Disease study provided retrospective menarche age from 1940 through 1960.Other four studies were conducted in Beijing to obtain supplementary information to assess secular trend in menarche age.Linear regression method was used to analyze the data.Results:Among Beijing girls in 2004,the median age at menarche was 12.1 years,which was 0.6 years earlier in urban than in rural areas.The median age at Breast Tanner Stage 2 was 9.5±1.2 years,representing 9.4±1.1 years and 9.6±1.2 years for urban and rural girls,respectively.In contrast,the median age at Pubic Hair Tanner Stage 2 was 11.1±1.1 years,representing 10.8±1.1 and 11.4±1.1 years for urban and rural girls,respectively.The menarche age of urban girls decreased by 4.2 months per decade,and that of rural girls by 9.6 months per decade from 1980 to 2004.Conclusions:Urban girls mature earlier than rural girls in Beijing.A secular trend towards earlier menarche was observed between the 1980s and the 2000s.

Design,synthesis and preliminary biological evaluation of brain targeting L-ascorbic acid prodrugs of ibuprofen

Received 4 November 2012 Received in revised form 17 December 2012 Accepted 31 December 2012 Available online 4 February 2013

Collagen fiber anisotropy characterization by polarized photoacoustic imaging for just-in-time quantitative evaluation of burn severity

Just-in-time burn severity assessment plays a vital role in burn treatment and care.However,it is still difficult to quantitatively and promptly evaluate burn severity by existing medical imaging methods via initial burn depth measurement since burn wounds are usually dynamically developed.As an elastic skeleton of skin,the degree of conformational changes of collagen fibers caused by overheating can reflect the burn severity in a timelier manner.Herein,the polarized photoacoustic technique(PPAT)for just-in-time quantitative evaluation of burn severity via collagen fiber anisotropy assessment is proposed.First,phantom experiments demonstrate the ability of PPAT for deep imaging in a transport mean free path and accurately quantify changes in microstructural order by thermal damage.Then,the Pearson correlation coefficient of the PPAT in assessing burn severity is shown to be up to 0.95,validated by burn skin samples.The PPAT provides a just-in-time quantitative strategy for burn severity evaluation.

Noncommunicable chronic disease prevention should start from childhood

Noncommunicable chronic diseases(NCDs),such as cardiovascular disease(CVD),diabetes,cancers,and osteoporosis,are the leading causes of death and health costs.According to the 2020 Report on Chinese Resident’s Chronic Disease and Nutrition,NCDs account for 88.5%of China’s disease burden in 2019,more than all other causes combined.

Characteristics of pediatric inpatients with primary and secondary hypertension

Importance:Extensive population-based studies have explored the prevalence of primary hypertension(HTN)in children and adolescents.However,there is little published data on the characteristics of different types of pediatric HTN and the causes of secondary HTN.Objective:To investigate the characteristics of different types of pediatric HTN and the causes of secondary HTN in a hospital setting.Methods:The study cohort comprised pediatric inpatients(<18 years of age)discharged with a diagnosis of HTN from Beijing Children's Hospital during 2015-2020.Pediatric patients with HTN were allocated to secondary and primary HTN groups on the basis of comprehensive analyses of their diagnoses,family history of HTN,and findings on physical examination,as documented in their medical records.The Mann-Whitney U test,χ^(2) and Fisher's exact test were used to assess differences in characteristics of patients with different HTN types and causes of secondary HTN.Results:Data of 1470 inpatients with HTN from 18 clinical departments were included in the analysis.Among them,458(31.2%)had primary HTN,and 1012(68.8%)had secondary HTN.Compared with patients had primary HTN,children with secondary HTN were younger and had lower body mass indexes and longer lengths of stay.Moreover,children with primary HTN had mostly been managed by the Endocrinology and Cardiology Departments,75.8%of them having obesity-related comorbidities.In contrast,most patients with secondary HTN had been managed by the Nephrology Department,renal diseases being the leading cause of their HTN(46.3%).Interpretation:Secondary HTN is more common than primary HTN in pediatric clinical settings,renal diseases being the leading cause of secondary HTN.

Regeneration of Fe_(2)O_(3)-based high-temperature coal gas desulfurization sorbent in atmosphere with sulfur dioxide

Regeneration of a high-temperature coal gas desulfurization sorbent is a key technology in its industrial applications.A Fe_(2)O_(3)-based high-temperature coal gas desulfurizer was prepared using red mud from steel factory.The influences of regeneration temperature,space velocity and regeneration gas concentration in SO_(2) atmosphere on regeneration performances of the desulfurization sorbent were tested in a fixed bed reactor.The changes of phase and the composition of the Fe_(2)O_(3)-based high-temperature coal gas desulfurization sorbent before and after regeneration were examined by X-ray diffraction(XRD)and X-ray Photoelectron spectroscopy(XPS),and the changes of pore structure were characterized by the mercury intrusion method.The results show that the major products are Fe3O4 and elemental sulfur;the influences of regeneration temperature,space velocity and SO_(2) concentration in inlet on regeneration performances and the changes of pore structure of the desulfurization sorbent before and after regeneration are visible.The desulfurization sorbent cannot be regenerated at 500℃ in SO_(2) atmosphere.Within the range of 600℃-800℃,the time of regeneration becomes shorter,and the regeneration conversion increases as the temperature rises.The time of regeneration also becomes shorter,and the elemental sulfur content of tail gas increases as the SO_(2) concentration in inlet is increased.The increase in space velocity enhances the reactive course;the best VSP is 6000 h^(-1) for regeneration conversion.At 800℃,20 vol-%SO_(2) and 6000 h^(-1),the regeneration conversion can reach nearly to 90%.

Comparison of modified injection molding and conventional machining in biodegradable behavior of perforated cannulated magnesium hip stents

In this study,perforated cannulated magnesium(Mg)hip stents were fabricated via modified Mg injection molding and conventional machining,respectively.Additionally,the stent canal was filled with paraffin to simulate injection of biomaterials.The microstructure,mechanical performance,corrosion behavior,and biocompatibility were comparably studied.Scanning electron microscopy(SEM)and energy dispersive spectroscopy(EDS)showed higher affinity of interstitial element such as oxygen and carbon as consequences of routine molding process.After immersion in SBF,machining stents showed reduced degradation rate and increased deposition of calcium phosphate compared to molding stents.Corrosion resistance was improved via paraffin-filling.Consistently,the hemolysis and in vitro osteoblast cell culture models showed favourable biocompatibility in machining stents compared to molding ones,which was improved by paraffin-filling treatment as well.These results implied that the feasibility of the prepared machining stents as the potential in vivo orthopaedic application where slower degradation is required,which could be enhanced by designing canal-filling injection of biomaterials as well.

Childhood adiposity, adult adiposity, and bone health

Importance:Childhood and adolescence are critical periods for lifelong bone mineral accrual,but few studies have determined the impact of childhood adiposity on adult bone density.Objective:To determine the long-term impact of childhood adiposity on adult areal bone mineral density(aBMD)and the effect of adult adiposity on this relationship.Methods:We conducted a longitudinal study of 1156 adults(56.3%men),for whom skinfold thickness(SFT)had been measured during childhood(6-18 years)and fat mass percentage(FMP)and aBMD were measured during adulthood(29-43 years).Adult aBMD in the lumbar spine(LS),femoral neck(FN),arms,and legs was measured using dual-energy X-ray absorptiometry.The direct effect of childhood SFT and its indirect effect through adult FMP on adult aBMD were estimated using general linear regression and a causal steps approach.Results:Significant positive associations between childhood SFT and adult aBMD were found in the LS in men(β=0.089,P=0.044)and in all the skeletal sites in women.With respect to the adult fat-bone relationship,high adult FMP was associated with low aBMD in most of the sites in men,but with high FN aBMD in women(β=0.144,P=0.002).Moreover,suppressive effects of adult FMP on the associations between childhood SFT and adult aBMD in the LS(-34.8%)and legs(-67.1%)of men,and a positive effect on the FN aBMD in women(17.0%)were identified.Interpretation:Childhood adiposity appears to have a positive long-term effect on adult aBMD,which may be reduced by adiposity in adult men but reinforced by adiposity in adult women.

Can spot urine measurement be a substitute for 24-hour urine measurement to estimate sodium intake in adolescents?

Importance:Several methods have been established in recent decades that allow use of spot urine to estimate dietary sodium intake.However,their accuracies have been controversial in children.Objective:To validate the performance of three commonly used methods-the Kawasaki,Tanaka,and International Cooperative Study on Salt,Other Factors,and Blood Pressure(INTERSALT)methods.Additionally,this study explored the accuracies of the Tanaka and INTERSALT methods by using spot urine samples taken at four separate times.Method:Forty-one adolescents aged 14 to 16 years completed two non-consecutive 24-hour urine collections and their mean values were used as reference data.The second-morning urine was used for assessment with the Kawasaki method;a casual spot urine and spot urine samples taken at four separate times(morning,afternoon,evening,and overnight)were used for assessment with the Tanaka and INTERSALT methods.Results:The mean differences were 1801 mg,542 mg,47 mg,and-31 mg for the Kawasaki,Tanaka,INTERSALT 1(with potassium),and INTERSALT2(without potassium)methods with their required spot urine,respectively.The proportions of relative difference levels within±10%were 4.9%for the Kawasaki method,19.5%for the Tanaka method,36.6%for the INTERSALT 1 method,and 36.6%for the INTERSALT2 method.Interpretation:The INTERSALT method seemed to provide minimally biased estimations of mean population sodium intake with casual spot urine.However,there is a need to be cautious regarding inconsistencies in estimation among different levels of sodium intake.The methods assessed in this study were unable to accurately estimate sodium intake at the individual level.

The impact of body weight trajectory from childhood on chronic inflammation in adulthood: The Bogalusa Heart Study

Importance:The impact of long-term burden of excessive body weight,beginning in childhood,on inflammatory status in adulthood has been poorly described.Objective:To characterize the longitudinal body mass index(BMI)trajectory from childhood and examine its relationship with inflammatory status in adulthood.Methods:We included 1285 adults who had 4-15 repeat measurements of BMI from childhood to adulthood.The area under the curve(AUC)of growth curves was calculated to characterize long-term burden(total AUC)and trends(incremental AUC)of BMI.Results:After adjusting for covariates,higher values of BMI in terms of childhood and adulthood,as well as total and incremental AUC,were strongly associated with elevated levels of adult C-reactive protein(CRP)in the four race-sex groups.There were significant differences in linear and nonlinear curve parameters between the normal and high CRP groups for all race-sex groups(P<0.01).Compared with participants who had consistently low BMI in both childhood and adulthood,participants with high BMI in adulthood had higher CRP levels(P<0.001),irrespective of their childhood BMI status;participants with high BMI in childhood but low BMI in adulthood had similar adult CRP levels.Interpretation:The impact of excessive body weight on inflammation is cumulative and exacerbated over time.The influence of childhood overweight/obesity on inflammatory status in adulthood can be alleviated by reducing adiposity in adulthood.