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    15 June 2018, Volume 21 Issue 17
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    Monographic Research
    The Interpretation of 2018 Diabetes UK Evidence-based Nutrition Guideline for the Prevention and Management of Diabetes　#br#
    CHENG Gai-ping1，LI She-yu2，HU Wen1*
    2018, 21(17):  2017-2021.  DOI: 10.12114/j.issn.1007-9572.2018.00.011
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    Diabetes UK updated the Evidence-based Nutrition Guidelines for the Prevention and Management of Diabetes on March 2018，by its previous version of 2011.The current version provided comprehensive recommendations based on the daily dishes instead of nutrients，including diabetes education and prevention，management of cardiovascular disease risks，management of diabetic complications and associated issues （eg.comorbidities，nutrition support，nutrition during pregnancy and lactation，eating disorders，micronutrients，food supplements，functional foods，commercial food for diabetes and nutritive and non-nutritive sweeteners）.We are interpreting the selected recommendations from the guideline for Chinese general practitioners along with the latest Chinese nutrition guidelines of diabetes.
    Effect of Gradual Transition from Low-carbohydrate Diet to High-nutrient-dense Diet Pattern on Weight Loss　
    DENG Yu-hong*，ZENG Ting，LI Yu-ling，YE Xiao-fang，LIAO Yu-mei，MA Kai-en
    2018, 21(17):  2022-2025.  DOI: 10.3969/j.issn.1007-9572.2018.00.160
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    Background　Practical，effective，and long-term adherence dietary interventions are urgently needed in overweight and obese patients in order to achieve long-term weight control.Objective　To evaluate the effect of the weight loss diet pattern of gradual transition from low-carbohydrate diet to high-nutrient-dense diet in 1-6 months.Methods　We enrolled 145 overweight and obese outpatients who received treatment from Department of Clinical Nutrition，the Second Affiliated Hospital of Guangzhou Medical University during June 2015 to January 2017.The interventions given to them were as follows：carbohydrate intake was limited to 50 g /d in the 1st month，and thereafter the carbohydrate intake gradually increased.Carbohydrate intake was increased to 110 g/d in the 3rd month.Energy intake level for the first 3 months was designed to be 500 kcal/d reduction based on recommended energy consumption calculated by initial resting metabolic rate and activities level.In the 1st and 2nd months of intervention，substitute food was provided instead of conventional staple food.From the 4th to 6th months of intervention，there was no limit for the intake of calories and carbohydrates and education of “high-nutrient-dense foods pagoda” was implemented based on low refined carbohydrate diet.Body weight was measured and recorded at the end of the 1st，3rd，6th months of intervention.Results　Of the participants，93.8%（136/145） completed the 1st month of intervention，their mean body weight decreased by （3.77±1.76） kg compared with before the intervention（tpaired=10.61，P< 0.01），with a success rate of weight loss of 38.2% （52/136）；the success rate of weight loss for all the participants was 35.8%（52/145）．Totaled 74.5%（108/145） of the participants completed the first 3 months of intervention，their mean body weight decreased by （6.67±3.50） kg compared with before the intervention （tpaired= 10.89，P<0.01），with a success rate of weight loss of 80.5%（87/108）；the success rate of weight loss for all the participants was 60.0%（87/145）．A total of 67.6%（98/145） of the participants completed the whole 6-month intervention，their mean body weight decreased by （7.85±4.12） kg compared with before the intervention （tpaired = 4.77，P<0.01），with a success rate of weight loss of 85.7%（84/98）；the success rate of weight loss for all the participants was 57.9%（84/145）．Conclusion　The pattern of gradual transition from low-carbohydrate diet to high-nutrient-dense diet is effective and feasible，which deserves further clinical application.
    Overseas Research on the Effect of Dietary Factors on Diabetes　#br#
    LIU Ya-fang1，LIU Lin1，AI Si-rui1，DU Li-kun2*
    2018, 21(17):  2026-2029.  DOI: 10.3969/j.issn.1007-9572.2018.00.111
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    Diet plays a vital role in the diabetes incidence and glycemic control.Numerous researches reveal that high-carbohydrate and high-fat（HCHF） diet has an important impact on the incidence of T1DM and T2DM as well as glycemic control.Therefore，the control of HCHF diet can contribute to the control of glycemic level.Blood glucose is influenced directly by the high proportion of carbohydrate intake in the total amount of calories，eating red meat，eating processed meat and drinking soft drink.In contrast，vegetarian diet is conducive to reducing the incidence of diabetes，and Mediterranean diet including milk，olive oil and fish is also beneficial to the prevention and control of diabetes.The studies concerning the relationship between diet and diabetes have been reviewed systematically，in order to guide diabetic patients to have a reasonable diet.

    Overseas Research on the Effect of Dietary Factors on Diabetes　
    LIU Ya-fang1，LIU Lin1，AI Si-rui1，DU Li-kun2*
    2018, 21(17):  2026-2029.  DOI: 10.3969/j.issn.1007-9572.2018.00.111
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    Diet plays a vital role in the diabetes incidence and glycemic control.Numerous researches reveal that high-carbohydrate and high-fat（HCHF） diet has an important impact on the incidence of T1DM and T2DM as well as glycemic control.Therefore，the control of HCHF diet can contribute to the control of glycemic level.Blood glucose is influenced directly by the high proportion of carbohydrate intake in the total amount of calories，eating red meat，eating processed meat and drinking soft drink.In contrast，vegetarian diet is conducive to reducing the incidence of diabetes，and Mediterranean diet including milk，olive oil and fish is also beneficial to the prevention and control of diabetes.The studies concerning the relationship between diet and diabetes have been reviewed systematically，in order to guide diabetic patients to have a reasonable diet.

    Development and Validation of the Comprehensive Scientific Research Performance Assessment System for Community Health Centers　
    LIU Rui1，WANG Zhao-xin2，3，LU Yuan2，3，BO Xiao-jie3，WANG Chun-xu3，CHEN Ning3，LIU Na-na3，GONG Xin3，XU Kang-jie3，PAN Ying2，3，SHI Jian-wei2，3，YU De-hua2，3*
    2018, 21(17):  2030-2034.  DOI: 10.12114/j.issn.1007-9572.2018.00.008
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    Objective　The development of scientific research performance in China's community health centers（CHCs） is in the initial phase.Moreover，there is lack of corresponding effective assessment systems.We aimed to develop a comprehensive scientific research performance assessment system for domestic CHCs，providing a reference for relative studies and assessments.Methods　This study was conducted from March to December 2015.We determined the indicators in the comprehensive scientific research performance assessment system for CHCs based on systematic review of relative studies and Delphi expert consultation，and determined their weights by using analytic hierarchy process.Then，the validation of the assessment system was performed in 11 CHCs of Yangpu Hospital of Tongji University.Results　Our assessment system consisted of 3 dimensions（scientific research input，scientific research output and scientific research management） and 23 indictors.The weighted consensus index for the indicators was less than 0.10.The validation and sensitivity analysis of the assessment system showed that，the ranking of 8 CHCs by the experts' objective assessment and by our study group using the assessment system（subjective ranking） differed less than 2.Conclusion　The sensitivity and effectiveness of this assessment system proved its good feasibility.However，quality control and dynamic feedback are needed during large-scale data collection and analysis，so as to better support the development of scientific research performance in CHCs.
     
    Scientific Research Performance Ranking for Community Health Centers in China （2016）　
    WANG Zhao-xin1，2，LIU Rui3，LU Yuan1，2，BO Xiao-jie2，WANG Chun-xu2，CHEN Ning2，LIU Na-na2，GONG Xin2，XU Kang-jie2，PAN Ying1，2，YU De-hua1，2，SHI Jian-wei1，2*
    2018, 21(17):  2034-2037.  DOI: 10.12114/j.issn.1007-9572.2018.00.014
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    Objective　To develop a scientific research performance ranking for community health centers（CHCs） in China 2016 using the comprehensive scientific research performance assessment system for CHCs.Methods　We conducted this study between December 2015 and March 2016.We collected the data concerning scientific research performance of CHCs in China via a survey among CHCs with electronic questionnaire issued by the community health associations of all levels.Then，based on the survey results assessed by the comprehensive scientific research performance assessment system for CHCs，we ranked the CHCs according to the scientific research performance（including three dimensions of scientific research input，scientific research output and scientific research management）.Results　31 CHCs obtained the top 30 rankings in the scientific research performance ranking for CHCs in China 2016，which were geographically distributed in Shanghai（20），Beijing（6），Dongguan（1），Shenzhen（1），Hangzhou（1），Ningbo（1），Chengdu（1）.Conclusion　Our study provides an objective and reasonable reference for comprehensive assessment of the scientific research performance and for the improvement of the scientific research performance of CHCs.
    Scientific Research Performance Ranking for Community Health Centers in China （2018） and the Prospect Development　
    BO Xiao-jie1，LU Yuan1，2，LIU Rui3，WANG Chun-xu1，CHEN Ning1，LIU Na-na1，GONG Xin1，XU Kang-jie1，PAN Ying1，2，YU De-hua1，2，SHI Jian-wei1，2，WANG Zhao-xin1，2*
    2018, 21(17):  2038-2042.  DOI: 10.12114/j.issn.1007-9572.2018.00.005
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    Objective　To develop the scientific research performance ranking for community health centers（CHCs） in China （2018），with referring to the assessment system for scientific research performance of community health centers，and based on this，to evaluate the development of scientific research performance of community health organizations in China.Methods　From December 2017 to March 2018，we conducted a survey with a electronic questionnaire for obtaining the data concerning scientific research input，scientific research output and scientific research management in CHCs using a assessment system through health commissions and community health associations.500 CHCs in 27 provinces of China，participated voluntarily or being recommended to participate by the local health commission.Then，based on the survey results，we developed the scientific research performance ranking for CHSs in China （2018）.Results　31 CHCs achieved the top 30 rankings in the scientific research performance ranking for CHSs in China （2018），which are geographically distributed in Shanghai（21），Beijing（6），Hangzhou（1），Dongguan（1），Xiamen（1），Chongqing（1），respectively.Compared with the CHCs included in the scientific research performance ranking for CHSs in China （2016），the maximum value and mean value for the assessment indictors for scientific research performance of the CHCs have increased to a certain extent，in particular，Shanghai Pudong New Area Liuzao Community Health Center，Hangzhou Jianggan District Kaixuan Street Community Health Center and Shanghai Jiading District Malu Town Community Health Center were found with the largest improvements.Conclusion　The scientific research performance of CHCs in China has been improved continuously in recent years，showing great potential for development.Moreover，with the development of scientific research performance of CHCs，the corresponding assessment system is being examined and improved continuously，playing an ever-growing role in guiding the scientific research.
     
    Influencing Factors of Carotid Atheromatous Plaque Formation：a Case-control Study　
    GUO Xiao-bin1*，WANG Peng2，TAO Li-yuan3，WU Hua2
    2018, 21(17):  2043-2047.  DOI: 10.3969/j.issn.1007-9572.2018.00.214
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    Objective　To investigate the influencing factors of carotid atheromatous plaque（CAP） formation.　Methods　The enrolled 372 participants were part of the individuals undergoing medical examination in Peking University Third Hospital from April to December 2016.We collected their clinical data，common carotid artery intima-media thickness（IMT）detected by color Doppler flow imaging〔110 were found with CAP （CAP group） and 262 without （non-CAP group）〕and measurement results of complement C1q and biochemical parameters.A multivariate Logistic regression analysis was performed to analyze the influencing factors of CAP formation.Results　Two groups had significant differences in the distribution of sex，age，smoking，regular exercise，history of hypertension and diabetes，use of antihypertensive drugs，lipid-lowering drugs and hypoglycemic agents，levels of systolic and diastolic blood pressure，body mass index，complement C1q，alanine aminotransferase，aspartate aminotransferase，urea nitrogen，uric acid，creatinine （Cr），triglyceride （TG），fasting blood glucose，high-density lipoprotein cholesterol，C-reactive protein，glycosylated hemoglobin，and homocysteine （P<0.05）.There was no correlation between bilateral IMT and complement C1q levels （rs=-0.14，P=0.052）.Multivariate Logistic regression analysis showed that age〔OR=1.11，95%CI （1.07，1.16）〕，regular exercise〔OR=2.88，95%CI （1.37，6.22）〕，use of hypoglycemic agents〔OR=0.15，95%CI （0.03，0.59）〕，diastolic blood pressure〔OR=1.05，95%CI （1.02，1.09）〕，Cr〔OR=1.03，95%CI （1.00，1.06）〕，and TG〔OR=1.49，95%CI （1.01，2.22）〕were the influencing factors of CAP formation （P<0.05）.Conclusion　CAP formation was found to be correlated with age，regular exercise，use of hypoglycemic agents，levels of blood pressure and blood lipid.This result provides an important reference for clinical prevention of CAP formation.
     
    Relationship between Serum Thyroid Hormone Level and Coronary Collateral Circulation in Patients with Coronary Artery Chronic Total Occlusion　
    QIN Xing-han，DING Tong-bin，LIU Shi-chao，JIA Xing-tai，YAN Qiong-wen，JIAN Li-guo*
    2018, 21(17):  2048-2053.  DOI: 10.3969/j.issn.1007-9572.2018.00.124
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    Objective　To investigate the relationship between serum thyroid hormone（TH） level and formation of the coronary collateral circulation（CCC） in patients with coronary artery chronic total occlusion（CTO）.Methods　Study subjects consisted of 86 patients who underwent coronary angiography and were confirmed to have at least one major coronary artery CTO in Department of Cardiovascular Medicine，the Second Affiliated Hospital of Zhengzhou University from 2015-09-01 to 2017-02-28.The patients were divided into the poor CCC group（n=23） and good CCC group（n=63） according to the Cohen-Rentrop method.General information，left ventricular ejection fraction（LVEF），routine blood tests，thyroid stimulating hormone（TSH） level，free triiodothyronine（FT3） level，free thyroxine（FT4） level，and subclinical hypothyroidism（SCH） were analyzed.Results　The poor CCC group had a higher proportion of patients with diabetes，hyperlipidemia and smoking than the good CCC group，TSH level and SCH were also higher in the poor CCC group than in the good CCC group，FT3 and FT4 levels in the poor CCC group were lower than those in the good CCC group（χ2=6.192，χ2=6.031，χ2=6.720，Z=-2.410，χ2=4.976，Z=-3.586，Z=-2.802，P<0.05，respectively）．Multivariate Logistic regression model 1 showed that diabetes 〔OR=0.255，95%CI（0.066，0.981）〕，smoking 〔OR=0.136，95%CI（0.030，0.620）〕，and SCH 〔OR=0.048，95%CI（0.007，0.327）〕 were independent risk factors for poor CCC formation（P<0.05）．Multivariate Logistic regression model 2 showed that diabetes 〔OR=0.142，95%CI（0.027，0.761）〕，smoking 〔OR=0.128，95%CI（0.019，0.861）〕，TSH 〔OR=1.955，95%CI（1.247，3.066）〕，and FT3 〔OR=0.170，95%CI（0.043，0.671）〕 were independent risk factors for poor CCC formation（P<0.05）．Conclusion　Diabetes mellitus，smoking，SCH，TSH，and FT3 are risk factors for the formation of poor CCC in patients with coronary artery CTO.This study provides new evidence for the secondary prevention of coronary heart disease，and a potential strategy for preventing the progression of coronary heart disease.
     
    Clinical Efficacy and Prognostic Factors for Local Advanced Cervical Cancer Patients Treated with Concurrent Chemoradiotherapy　
    XIONG Hui，LIU Ping，ZOU Wen，HU Chun-hong*
    2018, 21(17):  2053-2058.  DOI: 10.3969/j.issn.1007-9572.2017.00.235
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    Objective　To investigate the clinical efficacy as well as toxicity and side effects of simple radiotherapy and concurrent chemoradiotherapy（CCRT） for local advanced cervical cancer and analyze the influence of different factors on the prognosis.Methods　A total of 125 cases with local advanced cervical cancer from September 2008 to December 2013 with a confirmed pathologic diagnosis who underwent chemoradiotherapy in the Cancer Center at the Second Xiangya Hospital of Central South University were selected.Based on different treatment methods，the patients were classified into radiotherapy（n=27，21.6%） and CCRT（n=98，78.4%） groups.The overall survival（OS） for each patient was recorded at follow-up March 1，2016.The survival curve was drawn with the Kaplan-Meier method and a Log-rank test was performed.A multivariate Cox proportional hazards regression model was applied to analyze the prognostic factors.Results　The general 1-，3-，and 5-year survival rates of the 125 patients were 89.6%，74.4%，and 71.2%，respectively.The difference of 1-，3-，and 5-year survival rates between the radiotherapy and CCRT groups was statistically significant（P<0.05）．The incidence rates of patients with bone marrow suppression，gastrointestinal reactions，rectal reactions，genitourinary reactions，vaginal inflammation，pelvic fluid，radiation enteritis，radiation cystitis，and lower limb venous thrombosis did not exhibit significant differences between the two groups（P>0.05）．The results of the Log-rank test showed that there were significant differences in the total OS of patients with local advanced cervical cancer by comparing FIGO clinical stage，pretreatment hemoglobin level，total duration of radiotherapy，and different treatment methods（P<0.05）．Multivariate Cox hazards regression analysis illustrated that FIGO clinical stage〔HR=0.329，95%CI（0.106，0.770）〕，pretreatment hemoglobin level〔HR=0.937，95%CI（0.925，0.984）〕，total duration of radiotherapy〔HR=1.081，95%CI（1.022，1.095）〕，and treatment methods 〔HR=0.203，95%CI（0.072，0.574）〕exhibited regression correlations with the total OS of patients with local advanced cervical cancer（P<0.05）．Conclusion　Compared with radiotherapy treatment of patients with local advanced cervical cancer，the CCRT have obvious effects.FIGO clinical stage，pretreatment hemoglobin level，total duration of radiotherapy，and treatment methods are important prognostic factors for treatment of patients with local advanced cervical cancer.
    Long-term Safety and Efficacy of Bare Metal Stent Implantation in Patients with Acute Coronary Syndromes　
    LIU Rui-fang1，XU Fang-xing1，ZHOU Yu-jie1，LIU Tong-ku2*，XU Li-hua2，GU Ming2，DING Fu-xiang2，MA Hong-yan2，ZHAO Dong-ming2，SUN Feng2
    2018, 21(17):  2059-2063.  DOI: 10.3969/j.issn.1007-9572.2018.00.198
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    Objectives　To investigate the long-term efficacy and safety of baremetal stent （BMS） implantation in patients with acute coronary syndrome （ACS）．Methods　A total of 491 ACS patients who underwent BMS implantation at the Affiliated Hospital of Beihua University between 2000 and 2005，for whom complete follow-up data were available，were enrolled in this study.Percutaneous coronary intervention was performed to implant the BMS.The following primary endpoints were recorded by the hospital：coronary angiography follow-up，outpatient follow-up，or telephone follow-up.Results　The average follow-up time was （95±39） months.During the follow-up period，there were 171 cases of major cardiac adverse events （MACE）．The incidence of MACE was 34.83%，and the average annual MACE rate was 4.38%.There were 68 death cases （13.85%）；71 cases （14.46%） of target lesion revascularization；28 cases （5.70%） of target vessel revascularization；0 cases of late stent thrombosis（LST） and very late stent thrombosis（VLST）；2 cases （0.41%） of heart failure；and 2 cases （0.41%） of coronary artery bypass graft.In-stent restenosis occurred in 106 cases （21.59%）；stent segment restenosis developed in 60 cases （12.22%）；and both types of restenosis occurred in 127 cases （25.87%）．Conclusion　The incidence of MACE，LST and VLST were lower in patients with ACS who underwent BMS implantation；the treatment thus has a favorable safety profile.

    Blood Pressure Response to Sudden Drops in Temperature and the Effect of Ear Acupoint Massage on Reducing Its Response　#br#
    SHU Shi-bin，GAN Lei-juan，XU Bo-wen，CHEN Jia-han，ANGSAER?Yeerken，LIU Yu，WU Qian，ZHU He*
    2018, 21(17):  2064-2067.  DOI: 10.3969/j.issn.1007-9572.2018.00.203
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    Objective　To investigate the blood pressure response to sudden drops in temperature，and to explore the effect of ear acupoint massage on reducing this kind of response.Methods　One hundred Han college students were enrolled from School of Medicine，Shihezi University during December 2016 to February 2017 and equally divided into intervention group and non-intervention group based on the random number table（50 cases for each group）.After the measurement of MAP in a heated room with a temperature of 15 ℃，students in the intervention group first received 5-minute ear acupoint massage，measured MAP again，after that，they walked calmly to the outdoor environment with a temperature of -5 ℃，then MAP was measured immediately and at 5 minutes later；those in the non-intervention group walked calmly to three types of cold outdoor environments （-5 ℃，-10℃，-15 ℃），respectively，and MAP was measured immediately and at 5 minutes later respectively under these three conditions.Results　For those in the non-intervention group，both the MAP measured immediately and 5 minutes later after they exposed to the three cold environments increased gradually with the decrease of temperature（P<0.05）.To be specific，the MAP measured immediately after they exposed to the environment with a temperature of -5 ℃ was significantly higher than the baseline MAP 〔 （85±3） mm Hg〕 （tpaired=3.14，P<0.05），but it was similar to the baseline MAP 5 minutes later（tpaired=0.97，P>0.05）.However，when they exposed to the environment with a temperature of -10 ℃，both the MAP measured immediately and 5 minutes later were all significantly higher than the baseline MAP （tpaired=7.07，2.21，P<0.05）.The same status occurred when they exposed to the environment with a temperature of -15℃（tpaired=12.41，13.76，P<0.05）.For those in the intervention group，the MAP measured following the ear acupoint massage was much lower than the baseline MAP〔（77±4） mm Hg vs. （85±3）mm Hg〕（tpaired=4.23，P<0.05）.In the environment with a temperature of -5 ℃，the MAP measured immediately for the intervention group was （83±1）mm Hg，which was much lower than the intervention group's （86±2）mm Hg （t=2.20，P<0.05），but it increased to（84±1）mm Hg 5 minutes later （tpaired=-13.01，P<0.05）.Conclusion　Sudden drops in temperature can increase MAP，but ear acupoint massage can reduce such fluctuations.

    Risk Factors of Acute Chorioamnionitis and Funisitis in Pregnant Women Carrying Group B Streptococcus：a Case-control Study　
    LU Chang1，JIANG Hai-li2，WANG Xin2*，JIA Chen-yang2，WANG Xiao-xin2，ZOU Li-ying2
    2018, 21(17):  2068-2071.  DOI: 10.3969/j.issn.1007-9572.2018.00.197
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    Objective　To investigate the risk factors of acute chorioamnionitis and funisitis in pregnant women carrying group B streptococcus （GBS） and undergoing vaginal delivery.Methods　129 full-term pregnant women who carried GBS and underwent vaginal delivery were enrolled from Bejing Obstetrics and Gynecology Hospital，Capital Medical University from June 2014 to January 2015.By reviewing the medical records，we collected their baseline characteristics and data concerning delivery.Furthermore，based on the pathological examination results，we assigned 27 with acute chorioamnionitis or funisitis and 102 without to the case group and control group，respectively.Results　Multivariate Logistic regression analysis showed that amniotomy 〔OR=5.106，95%CI（1.535，16.987）〕，total duration of labor 〔OR=1.098，95%CI（1.013，1.191）〕，and neonatal birth weight 〔OR=1.002，95%CI（1.000，1.003）〕were risk factors for having acute chorioamnionitis and funisitis（P<0.05）.Conclusion　For full-term pregnant women with GBS and vaginal delivery，appropriately shortening the total duration of labor and reducing the possibilities of amniotomy could decrease the risk of acute chorioamnionitis and funisitis.

    Localization of Upper Airway Obstruction in Male OSAHS Patients：a Comparative Study of Fibre Nasopharyngoscopy and Magnetic Resonance Imaging　#br#
    FENG Guo-fei，WANG Han-qing*，ZHUGE Pan，YOU Hui-hua
    2018, 21(17):  2072-2076.  DOI: 10.3969/j.issn.1007-9572.2017.00.188
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    Objective　To investigate the results of upper airway parameters and localization of upper airway obstruction in males with varying degrees of obstructive sleep apnea hypopnea syndrome（OSAHS） detected by fibre nasopharyngoscopy（FN） versus magnetic resonance imaging（MRI），and based on this，to analyze the correlation and consistency of the two methods for the localization of upper airway obstruction in these patients.Methods　We enrolled 93 OSAHS patients who received treatment in Department of Otolaryngology，Head and Neck Surgery，Jinhua Central Hospital from May 2014 to December 2015，including 32 with mild OSAHS（mild group），31 with moderate OSAHS（moderate group），and 30 with severe OSAHS（severe group）．The collapse degree of the hinder parts of the soft palate，the tongue and epiglottis was measured with FN.The cross-sectional area，left-right dimension and front-back dimension of the hinder part and thickness of pharyngeal wall of the soft palate，the tongue and the epiglottis were measured by MRI.SPSS 15.0 statistical software was applied to analyze the measurement results of the two methods.Results　The collapse degree，cross-sectional area，left-right dimension and front-back dimension of the hinder part of the soft palate，the tongue and epiglottis，and the lateral wall thickness of the epiglottis differed significantly between the three groups（P<0.05）．Pearson correlation analysis found that，the collapse degree and the cross-sectional area of hinder part of epiglottis were positively correlated in the mild group（r=0.53，P=0.002），while they were negatively correlated in the moderate group（r=-0.53，P=0.002）．The results of localization of upper airway obstruction by FN were consistency with MRI（Kappa=0.390，P=0.007）．Conclusion　Both FN and MRI can detect the airway soft tissue compliance and anatomical features in patients with varying degrees of OSAHS，but for the localization of upper airway obstruction，they have no correlation and consistency.Therefore，in order to comprehensively assess the upper airway obstruction in these patients，these two methods can be used together.
     
    Expression of TAp63 Gene in Bone Marrow Mononuclear Cells Derived from Childhood Leukemia and Its Clinical Significance　
    PAN Yang-qiong1，CHEN Hao2，SONG Chun-lan1，CHENG Yi-bing1*
    2018, 21(17):  2077-2081.  DOI: 10.3969/j.issn.1007-9572.2017.00.243
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    Objective　To investigate the expression of TAp63 gene in bone marrow mononuclear cells in children with acute leukemia（AL） and its clinical significance.Methods　The AL group included 104 relapsed or treatment-naive children with AL who were admitted to the Third Affiliated Hospital of Zhengzhou University and Zhengzhou Children's Hospital between June 2015 and June 2016.The group included 80 patients with acute lymphoblastic leukemia（ALL） 〔61 cases of acute B lymphoblastic leukemia（B-ALL） and 19 cases of acute T lymphoblastic leukemia（T-ALL）〕，and 24 with acute non-lymphocytic leukemia（ANLL）．There were 90 incipient cases（18 high-risk cases and 72 low-risk cases） and 14 recurrent cases in the AL group.The control group was composed of 36 children with non-malignant hematological diseases who were admitted to the Third Affiliated Hospital of Zhengzhou University and Zhengzhou Children's Hospital during the same period.Semi-quantitative reverse transcription-polymerase chain reaction（RT-PCR） was used to detect the expression of TAp63 gene in the different groups.Results　In the AL group，86（82.7%） of 104 children had positive expression of TAp63 gene，and the TAp63 mRNA relative expression was（0.61±0.19）．In the control group，there were no patients with positive expression of TAp63 gene.There was no significant difference in the positive expression rate of TAp63 gene between ALL children and ANLL children（P>0.05）；however，the TAp63 mRNA relative expression was significantly higher in ALL children than in ANLL children（P<0.05）．The positive expression rate of TAp63 gene did not differ significantly between incipient cases and relapsed cases（P>0.05）；however，TAp63 mRNA relative expression was higher in relapsed cases than in incipient cases（P<0.05）．B-ALL children had a higher positive expression rate of TAp63 gene and TAp63 mRNA relative expression than T-ALL children（P<0.05）．There was no significant difference in the positive expression rate of TAp63 gene between high-risk cases and low-risk cases in incipient children（P>0.05），whereas the TAp63 mRNA relative expression was higher in high-risk children than in low-risk incipient children（P<0.05）．There was no significant difference in positive expression rate of TAp63 gene between children with and without complete remission（CR）（P>0.05），whereas the TAp63 mRNA relative expression was higher in children without CR（P<0.05）．Conclusion　Overexpression of the TAp63 gene may contribute to the pathogenesis and progression of childhood acute leukemia.TAp63 gene is a potential biomarker to monitor the efficacy of chemotherapy.Patients with high expression of TAp63 gene have a higher risk of relapse；the protein may be a promising prognostic factor for AL in children.
    Effectiveness Prediction of Community-based Hypertension Management in China：an Analysis based on Risk Prediction Models　
    ZHANG Yan-chun1，2，LIU Fang1*，PU Lin3，QIN Jiang-mei1，Kim Sweeny2
    2018, 21(17):  2082-2085.  DOI: 10.3969/j.issn.1007-9572.2018.00.230
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    Objective　To analyze the effectiveness of community-based hypertension management after 2009 under the investment of the public health service equalization（PHSE） program in China.Methods　 The data stemmed from the China Health and Nutrition Survey（1991，1993，1997，2000，2004，2006，2009，2011）.A sample of 10 242 participated，and 9 553 who positively responded to the survey were included in the final analysis，including 1 025 with a confirmed diagnosis of hypertension 〔1 007 of whom aged 35-84（317 were under control but other 690 were not） 〕.Trend and isometric analyses were performed to predict the effectiveness of community-based hypertension management in 2013.The risk for 10-year risk of cardiovascular and cerebrovascular diseases and ratio of people with this kind of risk were calculated，so that，long-term（10-year） effectiveness of hypertension management in China was analyzed.Results　In 2013，after the social，economic factors and health services developing factors were adjusted，the predicted number of people with awareness of hypertension，people receiving antihypertensive treatment，and those with controlled hypertension was 39 132 883，32 610 735 and28 697 447，respectively.The weighted 10-year risk of fatal and non-fatal cardiovascular and cerebrovascular diseases for people with controlled hypertension and those with uncontrolled hypertension was 6.34%，16.34%，respectively，indicating that this risk in those with controlled hypertension was lowered by 10 percentage points by hypertension control interventions.The predicted number of people with cardiovascular and cerebrovascular diseases developed from controlled and uncontrolled hypertension in 10 years was 1 819 275，4 689 995，respectively，showing that the cases of such diseases among those with controlled hypertension were decreased by 2 870 720 by hypertension control interventions.Conclusion　The PHSE program contributed to the improvement of hypertension awareness，treatment and control in China.It lowered hypertensive population's 10-year risk of developing into fatal or non-fatal cardiovascular and cerebrovascular diseases.Further emphasis needs to be focused on comprehensive interventions for chronic disease patients.The study improved the evaluation of hypertension intervention in primary care，providing an evidence for long-term economic evaluations of the PHSE program in China.
     
    Effect of Missionary Education of Self-monitoring Blood Pressure among Community-dwelling Hypertensive Patients　
    SU Jin，XU Li-ping*，DING Hong-juan，GUO Fei-na
    2018, 21(17):  2087-2090.  DOI: 10.3969/j.issn.1007-9572.2018.00.021
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    Objective　To explore the effect of missionary education of self-monitoring blood pressure among community-dwelling hypertensive patients.Methods　This study was carried out from September 2016 to June 2017，all the enrolled hypertensive patients were from communities governed by Xuhui District Fenglin Neighborhood Committee and received contractual hypertension management services by using convenient sampling，including 120 cases from Wannan community who voluntarily received antihypertensive drug treatment，conventional community-based management combined with missionary education of self-monitoring blood pressure（intervention group） and 120 from other 3 communities（Donger，Ximu and Jinxie） who voluntarily received only antihypertensive drug treatment and conventional community-based management（control group）．Community-dwelling hypertensive patients' awareness of standardized using electronic sphygmomanometer questionnaire was used to assess the awareness of standardized using electronic sphygmomanometer.And standardized using electronic sphygmomanometer assessment scale was adopted to evaluate the status of using electronic sphygmomanometer.Results　8 weeks after receiving intervention，the awareness rates of diagnostic threshold of hypertension，precautions for blood pressure measurement，selection of position for blood pressure measurement，position of the arm during blood pressure measurement in sitting position，correct placement of the cuff，tightness of the cuff，frequency of blood pressure measurement，time of blood pressure measurement，selection of electronic sphygmomanometer，and other matters needing attention in the intervention group increased significantly compared with before intervention（P<0.05），and they were much higher than those of the control group（P<0.05）．At each of the 4 measurement times after intervention（1，2，4，8 weeks after intervention），the intervention group achieved much higher scores in standardized measurement of blood pressure by using electronic sphygmomanometer compared with before intervention，as well as the control group（P<0.05）．Conclusion　By missionary education of self-monitoring blood pressure，community-dwelling hypertensive patients（even all of them） could know the correct way for measuring blood pressure，the accuracy of patients' self-measurement of blood pressure could be increased，patients' self-management of blood pressure could be enhanced，efficiency of hypertension management from a family doctor team could be improved，by which the blood pressure monitoring could reach the standard.This education way of self-monitoring blood pressure offers a reference for community-based chronic disease management.
     
    Reliability and Validity of the Revised Chinese Version of Benefit Finding Scale in Family Caregivers of Cancer Patients
    BIAN Jing1，ZHANG Lan-feng2*，LIU Zhun-zhun3，NI Tong-wei4，LI Yun-yun1
    2018, 21(17):  2091-2096.  DOI: 10.3969/j.issn.1007-9572.2018.00.222
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    Objective　To revise the Chinese version of Benefit Finding Scale （BFS-C） and to evaluate its reliability and validity in family caregivers of cancer patients.Methods　We developed a revised Chinese version of Benefit Finding Scale （BFS-RC） by revising the BFS-C.Then，we conducted a survey in a convenience sample of 420 family caregivers of cancer patients receiving treatment in Nantong Tumor Hospital from January to September 2017 with the demographic questionnaire and the BFS-RC.Four weeks later，we carried out another survey in a random sample of 30 of the 420 participants with the BFS-RC for retesting its reliability.After that，we implemented item analysis，content validity analysis，exploratory factor analysis，reliability analysis as well as confirmatory factor analysis of the BFS-RC.Results　The BFS-RC includes five factors （acceptance，family relationship，personal growth，social relations and health behaviors） covering 22 items.The results of exploratory factor analysis showed that KMO=0.899，Bartlett 's χ2 =2 876.943，df=231（P<0.01），and the 5 common factors explained 69.903 % of the total variance.The results of confirmatory factor analysis showed that root mean square residual （RMR）=0.032，root mean square error of approximation （RMSEA）=0.033，incremental fit index （IFI）=0.984，tacker-lewis index （TLI）=0.980，comparative fit index （CFI）=0.983，parsimonious goodness-of-fit index （PGFI） =0.703，parsimonious normed fit index （PNFI）=0.778，and parsimonious comparative fit index （PCFI）=0.834.The reliability analysis showed that Cronbach's α of the BFS-RC and its 5 factors of acceptance，family relationship，personal growth，social relations and health behaviors was 0.933，0.905，0.856，0.886，0.841 and 0.889，respectively.The test-retest reliability of the BFS-RC was 0.884.Conclusion　With good reliability and validity，the BFS-RC can be used as a tool for evaluating the benefit finding of the family caregivers of Chinese cancer patients.
     
    Development，Validity and Reliability of Demands Scale of Women of Advanced Maternal Age during Their Second Pregnancy　
    LIANG Juan1，LIN Zheng2*，XU Hong1，SUN Hai-yan1，ZHOU Zi-xia1
    2018, 21(17):  2097-2100.  DOI: 10.3969/j.issn.1007-9572.2018.00.038
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    Objective　To develop and evaluate the validity and reliability of the Demands Scale of Women of Advanced Maternal Age during Their Second Pregnancy（DSWAMATSP）．Methods　From July to December 2016，convenience sampling was employed to recruit 260 women of advanced maternal age during their second pregnancy who underwent antenatal examination at the outpatient department of a tertiary grade A hospital in Yancheng，China.Based on Maslow's hierarchy of needs，results of the interviews of these women and Delphi expert consultation，we developed the initial DSWAMATSP.Critical value and correlation coefficient were adopted to choose suited items.Cronbach's α was adopted to evaluate the reliability of the scale，and content validity and exploratory factor analysis were conducted to evaluate the validity of the scale.Results　The initial scale consisted of 7 dimensions and 57 items.Nine items were deleted based on the results of Delphi expert consultation and 3 items whose item-to-dimension correlation coefficients were less than 0.400 were excluded.The final scale contains 45 items in 7 fields.The Cronbach's α was 0.933 for the total scale and 0.799 to 0.937 for its subscales.Factor analysis revealed 7 common factors，accounting for 64.08% of the total variance，loading for each factor was over 0.400.The content validity index was 0.866 for the total scale.Conclusion　The DSWAMATSP is reliable and can be used as a tool for evaluating the needs of women of advanced maternal age during their second pregnancy.
    Healthcare-seeking Behavior among Pregnant and Parturient Women from Medical Institutions of Guangzhou：a Decision Tree-based Analysis
    LIU Gui-hao1，YANG Yun-bin2*，GENG Qing-shan1*，XUE Yun-lian1
    2018, 21(17):  2101-2105.  DOI: 10.3969/j.issn.1007-9572.2018.00.210
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    Objective　To investigate the characteristics of healthcare-seeking behavior among pregnant and parturient women from medical institutions in Guangzhou，providing a reference for guiding such populations to seek healthcare in a scientific way and for the development of hierarchical medical system.Methods　We conducted a survey in 675 randomly selected pregnant and parturient women seeking healthcare in a stratified and typical case sample consisting of a primary hospital （Guangzhou Zengcheng District Xintang Hospital，changed to secondary hospital now），a secondary hospital （Zengcheng District Maternal and Child Care Hospital） and a tertiary hospital （Sun Yat-sen Memorial Hospital Sun Yat-sen University） during May to September 2016 with a self-developed questionnaire based on the Andersen healthcare utilization model.A decision tree-based analysis of the survey results was performed to determine the associated factors for pregnant and parturient women seeking healthcare in the chosen hospital.Results　The number of participants seeking healthcare in the primary hospital，secondary hospital and tertiary hospital was 207 （30.7%），219 （32.4%），249 （36.9%），respectively.The level of hospital selected for obtaining healthcare differed significantly by age，home-to-hospital distance，waiting time for receiving healthcare，annual household net disposable income per capita，history and number of antenatal examination，number of pregnancy，history of abortion，number of live births，history of premarital checkup，history of pregnancy loss，and level of satisfaction with healthcare（P<0.05）．Furthermore，the level of hospital selected for early antenatal registration varied obviously according to medical cost（low or not），quality of care（excellent or not） and home-to-hospital distance（short or not） （P<0.05）．Decision tree analysis found that，the accuracy of No.1 decision tree model for predicting the selected primary hospital was much higher compared with predicting the selected secondary hospital （χ2=111.023，P<0.001）；Both No.2 and No.3 decision tree models had much higher overall predictive accuracy than No.1 decision tree model（P<0.05）．In terms of the causes for choosing the hospital for obtaining healthcare（including early antenatal registration），analysis with No.1 decision tree model demonstrated that those selecting the primary or secondary hospital was mainly due to short waiting time for receiving healthcare and low medical cost，analysis with No.2 decision tree model showed that those choosing the secondary or tertiary hospital was mainly out of annual household net disposable income per capita，number of antenatal examination，number of pregnancy and short home-to-hospital distance，and analysis with No.3 decision tree model presented that those choosing the primary or tertiary hospital was mainly for annual household net disposable income per capita，number of pregnancy，number of live births，and short home-to-hospital distance.Conclusion　Policy guidance of the implementation of hierarchical medical system should be strengthened.Pregnant and parturient women without any adverse factors should be guided to seek healthcare in primary or secondary medical institutions.Those choosing tertiary medical institutions just because of high household income should be guided for choosing medical institutions more reasonably.In addition，the importance of undergoing regular prenatal care should be reinforced for pregnant and parturient women seeking healthcare in primary or secondary medical institutions.
     
    Prevalence and Associated Factors of Hip Joint Disease in Yellow River Beach Areas in Henan Province　
    LIANG Sen1，ZHANG Shi-jie2，ZHANG Yu-hua1*，DIAO Yun-chan3，CHEN Zhi-min4
    2018, 21(17):  2106-2100.  DOI: 10.3969/j.issn.1007-9572.2018.00.079
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    Objective　To investigate the prevalence of hip joint disease and its associated factors in Yellow River beach areas in Henan province，providing a basis for prevention and treatment of this disease.Methods　We conducted this survey from May to June 2016.The enrolled participants were 374 701 permanent residents in Taiqian county，Henan province attending general hip joint disease screening.The suspected hip joint disease cases found by physical examination were diagnosed by following imaging examination.Those were diagnosed with hip joint disease in the past，were assigned to the case group，and sex-，age- and number-matched residents without hip joint disease who lived adjacent to the place of hip joint disease cases were assigned to the control group.We used a self-designed questionnaire to collect their data such as demographic characteristics，smoking habit，drinking habit，hormone treatment status，medical history and family history of hip joint disease.Results　Of the participants，there were 2 587 cases of hip joint disease（including 836 newly diagnosed cases and 1 751 diagnosed in the past；1 107 males and 1 480 females），with a crude prevalence of 6.90‰；the crude prevalence of hip joint disease was 5.67‰ for males，8.24‰ for females，7.51‰ for age group of 0-14 years，4.89‰ for age group of 15-59 years，and 14.81‰ for age group of ≥60 years；the two major types of diseases were developmental dysplasia of the hip〔45.46%（1 176/2 587）〕 and femoral head necrosis 〔43.53%（1 126/2 587）〕.Multivariate Logistic regression analysis showed that total household income 〔2 500-4 999 yuan per month：OR=0.564，95%CI（0.374，0.848）；5 000-9 999 yuan per month：OR=0.688，95%CI（0.517，0.914）；≥10 000 yuan per month：OR=0.671，95%CI（0.554，0.813）〕，hormone treatment 〔OR=15.684，95%CI（8.361，29.421）〕，traumatic femoral neck fracture 〔OR=59.970，95%CI（14.679，245.012）〕 and family history of hip joint disease 〔OR=10.499，95%CI（4.491，24.539）〕 were the associated factors for the residents with hip joint disease（P<0.05）.Conclusion　The prevalence of hip joint disease in Taiqian county is high，and the two major types are developmental dysplasia of the hip and femoral head necrosis.Low total household income，hormone treatment，trauma femoral neck fracture and family history of hip joint disease are the risk factors for hip joint disease.
     
    Mechanical Analysis of Carotid Artery Vulnerable Plaque in Patients with Hypertension Complicated with Cerebral Infarction　
    KAN Yan-min*，WANG Yi-hua，MA Lin，AN Ming-hua，SUN Yu-wei
    2018, 21(17):  2111-2115.  DOI: 10.3969/j.issn.1007-9572.2018.00.097
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    Objective　To observe the predilection site and acoustic characteristics of carotid artery vulnerable plaques in hypertension complicated with cerebral infarction patients and to explore the value of velocity vector imaging（VVI） technology to detect the stress and strain of plaques.Methods　98 patients in hypertension complicated with carotid artery atherosclerotic plaques with cerebral infarction（as case group） and 70 patients in hypertension associated with carotid artery atherosclerotic plaques（as control group） were chosen from May 2016 to June 2017 in North China University of Science and Technology Affiliated Hospital.The location of the vulnerable plaques were observed by two-dimensional ultrasound，and the main mechanical parameters of carotid arterial wall and plaques including velocity，strain and strain rate were detected by VVI technology.Results　There were 88 cases（52.4%） of carotid bifurcation plaques of patients of two groups，mainly to vulnerable plaques.And the incidence of vulnerable plaques of the common carotid artery was 17.8%（30/168），and the extracranial segment of internal carotid artery was 29.8%（50/168）．In the case group，50 cases（51.0%） had hypoechoic plaques，48 cases（49.0%） had heterogeneous plaques.And in the control group，38 cases（54.3%） had hypoechoic plaques，32 cases（45.7%） had heterogeneous plaques.There were no significant difference in the distributions of the hypoechoic plaques and the heterogeneous plaques between two groups（P>0.05）．The velocity，plaque strain and strain rate in the proximal intimal surface，proximal shoulder，the top of plaques，distal shoulder and distal intimal surface of the hypoechoic plaques and the heterogeneous plaques in case group were higher than those in control group（P<0.05）．Conclusion　The stability of carotid artery vulnerable plaques in hypertension complicated with cerebral infarction patients is worse than that in patients with hypertension，and the mechanical changes of carotid arterial plaques by VVI technology can provide an objective basis for early prevention and treatment of hypertension and for reducing recurrence rate of cerebral infarction.
     
    Diagnostic and Treatment Analysis of Adnexal Torsion in Adolescent Patients　
    XU Xin-xin，ZHOU Zhi-yang，WU Xue-qing*
    2018, 21(17):  2116-2120.  DOI: 10.3969/j.issn.1007-9572.2017.00.253
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    Objective　To investigate the clinical features，diagnosis，treatment，and pathology of adnexal torsion in adolescent patients.Methods　This study involved a total of 32 adolescent patients，aged 10-18 years，who had adnexal torsion and treated in the First Affiliated Hospital of Wenzhou Medical University between January 2006 and October 2016.For each patient，we retrospectively analyzed general information，clinical features，laboratory tests，diagnosis and treatment data.Results　Symptoms mainly presented as abdominal pain，nausea and vomiting.In some cases，there was an increase in white blood cells，neutrophils and tumor biomarkers.Ultrasound and computed tomography（CT） examination revealed a pelvic mass or suggested adnexal torsion.In terms of treatment，30 cases underwent laparoscopic surgery.Of these，12 cases received laparoscopic ipsilateral adnexectomy，10 cases received laparoscopic cyst removal surgery，and 8 cases received laparoscopic ipsilateral salpingectomy.Two cases underwent conventional laparotomy.Postoperative pathology included mature teratoma，ovarian cyst，ovarian crown cyst，and ovarian mucinous cystadenoma.Patients were further divided into a <3 days group and a ≥3 days group based on the interval between the first onset of symptoms and admission.There were no significant differences between the two groups in terms of age，torsional side，incidence of abdominal pain，nausea or vomiting，white blood cell count，neutrophil count，the proportion of patients in whom significant blood flow signals were not detected，length of stay，obvious necrosis and adhesion of the torsion part，torsion turns，the diameter of torsional mass or the duration of operation time（P>0.05，for all parameters）．The preoperative neutrophil/lymphocyte ratio（NLR），and the rate of torsion diagnosis before surgery were higher in the <3 days group compared with the ≥3 days group（P<0.05）．Conclusion　The symptoms and laboratory tests of adolescent adnexal torsion are non-specific.Ultrasound and CT have certain diagnostic value.However，some patients may be misdiagnosed which delays treatment.In suspected cases，extensive examinations should be carried out，along with diagnosis and treatment，as early as possible in order to minimize the negative impact of the disease.
     
    Precise Medical Care Analysis for Two Children with Genic Mutation　
    YAO Xian-hua
    2018, 21(17):  2120-2123.  DOI: 10.3969/j.issn.1007-9572.2018.00.215
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    We discussed the important role of gene detection in the field of rehabilitation medicine by enumerating 2 children with genic mutation，and concluded that clinical use of genetic testing technology can improve the diagnostic accuracy，and contribute to treatment as well as prognosis evaluation.Therefore，we suggested that genetic testing can be performed when necessary based on the comprehensive analysis of the patient's clinical symptoms，signs and laboratory findings，in order to make an accurate diagnosis，deliver precise medical care and evaluate the prognosis for such patients，
    Research Progress about Risk Factors for Benign and Malignant Solitary Pulmonary Nodules　
    ZHENG Li-qin1，LIN Qun-ying2*
    2018, 21(17):  2124-2129.  DOI: 10.3969/j.issn.1007-9572.2017.00.242
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    Progress in computed tomography（CT） imaging technology has led to a significant increase in the detection rate of solitary pulmonary nodules.Although health awareness is improving，the early signs of pulmonary nodules are becoming more difficult to identify due to the effects of many factors.If pulmonary nodules can be fully evaluated as benign or malignant at the early stage，this would have a positive effect.This article summarizes and reviews the diagnostic value of related factors such as age，gender，serum tumor markers，CT imaging features，smoking history，and previous tumor history in patients with benign and malignant solitary pulmonary nodules.
    Influencing Factors of Low Back Pain during Pregnancy and Its Rehabilitation Treatment　
    WANG Min-jia*，LIAO Yuan-peng
    2018, 21(17):  2130-2133.  DOI: 10.3969/j.issn.1007-9572.2017.00.160
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    Low back pain during pregnancy is at the top of the list of pregnancy symptoms and its prevalence rates is as high as 50% to 80%.Current clinical treatments of low back pain during pregnancy are poor and lack of professional guidance in China，which results in the negative attitude towards the treatments among the majority of patients with decreased ability in daily life and work.Through reviewing domestic and foreign literatures，this paper aims to observe current situation of treatments and effective rehabilitation treatments of low back pain during pregnancy and to discover its influencing factors and prevalence in order to provide reference and ideas for clinical treatments of low back pain during pregnancy.

    Clinical Application and Research Progress of Lung Ultrasound for Adult Pneumonia　#br#
    ZHANG Li-tao
    2018, 21(17):  2134-2137.  DOI: 10.3969/j.issn.1007-9572.2017.00.263
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    Pneumonia is a major health and economic problem，with considerably high morbidity and mortality.The accurate diagnosis and timely treatment of patients can improve its prognosis.Adult pneumonia can be accurately diagnosed by lung ultrasound（LUS），which is comparable with X-ray examination for specificity and sensitivity.LUS can also be employed to assess the effect of treatment for pneumonia.The most important criterion for the diagnosis of pneumonia via LUS is the presence of air bronchograms in the hypoechoic region on the sonogram，as well as pleural effusions in the basal section of the lung.LUS has the advantages of convenience，effectiveness，low cost and being free of radiation risk，and can be clinically applied as an important measure in the diagnosis of pneumonia.
    Recent Advances in the Relationship between NLRP3 Inflammasome and Atherosclerosis　
    CHI Tian-he，SUN Jing-wu*，KANG Wen，WU Yu-hui，DU Qing，JIANG Shuang-qiang
    2018, 21(17):  2138-2142.  DOI: 10.3969/j.issn.1007-9572.2018.00.058
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    NLRP3 inflammasome is a polyprotein complex formed by the activation of pattern recognition receptor.Activated NLRP3 inflammasome can transform pro-caspase-1 into active caspase-1，which promotes the maturation and secretion of IL-1β and IL-18，and then triggers the inflammatory response of the body.Atherosclerosis is the basis of the pathogenesis of cardiocerebral vascular disease，which is a serious threat to human health.Recent studies show that atherosclerosis is a chronic inflammatory reactive disease，inflammasome plays a key role in the inflammatory response of atherosclerosis，and NLRP3 inflammasome is closely related to the formation of atherosclerosis.This article reviews the activation mechanism of NLRP3 inflammasome and its relationship with atherosclerosis.

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