Prevalence of eating out and its association with overweight and obesity among children and adolescents in Hebei Province / 中国学校卫生

Objective@#To investigate the prevalence and associated factors of eating out among children and adolescents aged 6-17 in Hebei Province, and to explore the association between eating out and overweight/obesity.@*Methods@#Data came from Children and Nurse Nutrition Health Monitoring of China during 2016-2017. Questionnaire surveys and anthropometric measures was conducted among 3 330 children aged 6-17 in 12 survey sites. Multivariate Logistics stepwise regression model was used to analyze the influencing factors of eating out and the relationship between eating out and overweight/obesity.@*Results@#The proportion of eating out was 16.19%, and the rate of overweight and obesity was 29.43%. Multivariate analysis showed that the older children (junior high school students:OR=1.36; high school students:OR=3.57, both P<0.05) and adolescents from highincome families (10 000~<20 000 CNY:OR=1.48; ≥20 000 CNY:OR=2.93, both P<0.05) were more likely to eat out. Children and adolescents living in rural areas (OR=0.20, P<0.01), nononlychild (OR=0.76, P=0.02), day school students (OR=0.21, P<0.01), and the primary caregivers of the elderly (OR=0.69, P=0.03) were less likely to eat out. In addition, eating out was statistically associated with an increased risk of overweight and obesity (OR=1.31, P<0.01).@*Conclusion@#Eating out is common among children and adolescents aged 6-17 in Hebei Province. Residency, age, household income, onechild family, boarding and and eating out behaviors of primary caregivers are associated with eating out among children and adolescents. Eating out may increase the risk of overweight/obesity in children.

Appraisals of the reform of public hospitals by their staff and suggestions / 中华医院管理杂志

Objective To investigate hospital staffs' appraisals on public hospitals reform.Methods 890 medical staffs were randomly investigated by questionnaire,to learn their comments on the implementation of reform measures,public-benefit nature and reform outcomes of the reform,as well as problems found with the government and improvement suggestions,and difficulties encountered in such a reform.Results The hospital staffs' appraisals on the reform tend to be low,as 36.4％ of them hold that the reform is less effective in its outcomes or a mere formality (19.8％).The staff blamed the lack of system breakthrough (67.9％),lack of financial support (61.1％),and insufficient support from the doctors as stakeholders (49.1 ％),for most of the problems of the reform.Conclusion It is suggested to win over support of the medical staff for the reform; to improve the laws and policies related to the reform; and to establish an effective supervision system for public hospitals.

Effect of osthole on ERK/MAPK signaling pathway and the expression of COX-2 mRNA in the spinal dorsal horn of rats with nucleus pulposus-induced inflammatory radicular pain / 中国药理学通报

Aim Toinvestigatetheanalgesiceffectsof epidural osthole application on the mechanical allodyn-ia and the ERK/MAPK signaling pathway and the expression of COX-2 mRNA in the spinal dorsal horn.Methods 125adultmaleSDratswererandomizedin-to five groups( n=25 each) :Blank, Sham, NP, Ost and vehicle. At postoperative day 6, 1mg/rat osthole 50 μl was injected epidurally into group Ost and the same volume of vehicle was given into group vehicle. The mechanical pain threshold was measured by 50%MWT at 1 day before operation and the 3 rd,6 th,7 th, 14 th,21 st day after operation. After the measurement of pain threshold on postoperative day 14 , the L4-6 segment of spinal dorsal horn was removed for determi-nation of the expression of ERK, pERK and COX-2 mRNAbyWesternblotandRT-PCR.Results Com-pared with blank group, the mechanical pain threshold was only down-regulated at day 1 after operation in sham group, the expression of pERK and COX-2 mR-NA in sham group showed no significant difference ( P>0. 05 ); the mechanical pain threshold was signifi-cantly down-regulated after operation in NP, Ost and vehicle groups( P0. 05). The correla-tion analysis on pERK1/2 and COX-2 mRNA revealed the Pearson correlation coefficient was 0 . 878 and 0 . 910 , suggesting a strong positive correlation between pERKandCOX-2mRNA.Conclusions Ostholead-ministrated in the early stage after surgery can alleviate the nucleus pulposus-induced radicular inflammatory pain probably by inhibiting the expression of pERK and COX-2 mRNA in spinal dorsal horn.

Dexmedetomidine versus remifentanil in combination with sevoflurane for gynecological laparoscopy / 中华麻醉学杂志

Objective To compare the efficacy of dexmedetomidine versus remifentanil in combination with sevoflurane for gynecological laparoscopy. Methods Forty ASA Ⅰ or Ⅱ patients aged 18-64 yr with body mass index of 18-30 kg/m2 undergoing gynecological laparoscopy were randomly assigned to one of two groups ( n =20 each): dexmedetomidine group (group D) and remifentanil group (group R). Starting from 5 min before induction of anesthesia, dexmedetomidine was infused at 0.05 μg · kg - 1 · min- 1 in group D and remifentanil at 0.1 μg· kg- 1· min-1 in group R for 10 min, then dexmedetomidine infusion rate was increased to 0. 3 μg· kg-1 · h-1 and remifentanil infusion rate was increased to 0.15 μg· kg-1 · min-1 . Anesthesia was induced with propofol 1.5-2.0 mg/kg and fentanyl 2 μg/kg. Tracheal intubation was facilitated with cis-atracurium 0.15 mg/kg. Anesthesia was maintained with sevoflurane and fentanyl 1 μg/kg and intermittent iv boluses of cis-atracurium. Narcotrend index was maintained at 40-50. Blood sample was taken from external jugular vein for blood gas analysis and determination of serum concentrations of corticosteroid, norepinephrine and epinephrine before administration, at 5 min after intubation, at 10 min of aeroperitoneum and at 5 min after extubation. The pH value and concentrations of lactic acid and glucose were recorded. The time for recovery of spontaneous breathing, eye-opening time, extubation time, orientation time and perioperative side-effects were recorded. Numeric rating scale was used to assess the intensity of pain during 2 h after operation. The analgesics used were also recorded. Results The serum concentrations of norepinephrine and epinephrine were significanfly lower at 10 min of aeroperitoneum, the time for recovery of spontaneous breathing was shorter, eye-opening time longer and the incidence of shivering and nausea and vomiting lower, the percentage of patients requiring rescue opioids lower in group D than in group R ( P ＜ 0.05). Conclusion The efficacy of dexmedetomidine combined with sevoflurane anesthesia is better than remifentanil combined with sevoflurane anesthesia for gynecological laparoscopy.