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Objective:To investigate prevalence and related factors of overweight and obesity in children aged 6-12 years in Yiwu of Zhejiang Province.Methods:The stratified sampling method was used to perform physical examination and questionnaire survey among 500 children aged 6-12 years from five schools in Yiwu (166 from city-level schools, 168 from district-level schools, and 166 from village-level schools). The number of children at each year of 6-12 years was 54 (10.8%), 66 (13.2%), 70 (14.0%), 69 (13.8%), 83 (16.6%), 79 (15.8%) and 79 (15.9%). The factors that affect the prevalence of overweight and obesity were analyzed.Results:Among 500 school-age children, the detection rates of overweight and obesity were 12.8% (64/500) and 11.6% (58/500), respectively. There were significant differences in the detection rates of overweight and obesity between male and female children (16.1%/9.0%, 15.4%/7.3%), among children whose fathers received different levels of education (primary school and below/junior high school/senior high school and above) (25.0%/13.1%/9.2%, 22.9%/11.2%/9.2%), among children whose mothers received different levels of education (primary school and below/junior high school/senior high school and above) (23.5%/12.9%/10.1%, 19.6%/13.3%/7.7%), among children living in cities versus villages (18.6%/8.8%, 16.7%/8.1%), among children performing exercise for different lengths of time (< 0.5 hours/0.5-1.0 hours/> 1.0-2.0 hours/> 2.0 hours) (21.2%/14.9%/13.1%/3.6%, 19.2%/13.1%/11.9%/3.6%), among children with different sleep time (< 8 hours/8-10 hours/>10 hours) (16.8%/14.2%/6.3%, 15.9%/12.7%/5.6%), among children taking dessert at different frequencies (< 3 days per week/3-5 days per week/> 5 days per week) (5.6%/10.3%/23.4%, 4.9%/9.4%/21.4%), among children taking sugary or carbonated drinks at different frequencies (< 3 days per week/3-5 days per week/> 5 days per week) (6.5%/11.2%/17.1%, 6.5%/9.4%/16.1%), and among children who took extra meals before bed (< 3 days per week /3-5 days per week /> 5 days per week) (15.8%/9.4%/20.3%, 14.3%/8.5%/19.0%) (overweight: χ2 = 5.61, 8.41, 6.74, 10.48, 17.45, 6.74, 22.43; obesity: χ2 = 7.88, 6.28, 6.58, 8.63, 14.76, 6.74, 20.69, all P < 0.05). Multivariate logistic regression analysis showed that boys, unbalanced diet and extra meals before bed are independent risk factors for overweight and obesity in school-age children (all P < 0.05). Sleep time, exercise time and mother's education were protective factors of overweight and obesity (all P < 0.05). Conclusion:The incidences of overweight and obesity among school-age children aged 6-12 years in Yiwu of Zhejiang province are high, and sex, mother's education level, diet, exercise and sleep are the main influential factors of overweight and obesity.
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Objective:To evaluate the clinical value of tissue doppler imaging Tei index in evaluating the degree of myocardial injury, right cardiac function after neonatal asphyxia.Methods:From March 2018 to May 2019, 62 cases of neonatal asphyxia hospitalized in the undergraduate department of Yiwu Central Hospital were classified as asphyxia group.According to Apgar score of birth, they were further divided into 41 cases of mild asphyxia group, 21 cases of severe asphyxia group.And 30 healthy full-term neonates delivered in our Hospital during the same period were selected as normal control group.The Newborn's Tei index, as well as the different severity asphyxia neonatal serum myocardial injury indicators[amino terminal brain natriuretic peptide(NT-proBNP), troponin(cTn-Ⅰ), creatine kinase isoenzyme(CK-MB), lactate dehydrogenase(LDH)], ultrasonic right heart function parameters[right ventricular ejection fraction(RVEF), E, A value and E/A ratio] were compared.Pearson test was used to evaluate the correlation between Tei index, myocardial injury indicators and right cardiac function parameters in neonatal asphyxia cases.Results:The Tei index of the asphyxiation group was (0.38±0.05), which was higher than (0.27±0.04) of the control group ( t=10.521, P<0.05), and the Tei index of the severe asphyxiation group was (0.43±0.06), which was higher than (0.34±0.05) of the mild asphyxiation group ( t=6.264, P<0.05). In neonatal asphyxia cases, the NT-proBNP, cTnI, CK-MB, LDH levels in the severe asphyxia group were (1 164.27±231.64)ng/L, (0.33±0.05)μg/L, (27.11±3.65)U/L, (298.20±37.57)U/L, respectively, which were higher than those in the mild asphyxia group [(590.38±73.91)ng/L, (0.25±0.04)μg/L, (18.36±2.34)U/L, (200.71±24.39)U/L] ( t=14.576, 6.839, 11.463, 12.338, all P<0.05). The ultrasonic RVEF level, E/A ratio in the severe asphyxia group were (52.94±6.10)%, (0.94±0.11), respectively, which were lower than those in the mild asphyxia group [(56.83±5.97)%, (1.02±0.13)] ( t=2.411, 2.547, all P<0.05). Correlation analysis found that Tei index was positively correlated with NT-proBNP, cTn-Ⅰ, CK-MB, LDH levels, and negatively correlated with RVEF level, and positively correlated with E/A ratio in neonatal asphyxia cases( r=0.745, 0.598, 0.703, 0.665, -0.711, -0.692, all P<0.05). Conclusion:Abnormal increasing of Tei index in neonatal asphyxia cases can objectively reflect the extent of myocardial injury and right heart function decline in children.
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Objective To observe the influence state of asarone injection for the pulmonary surfactant proteins and oxygen supply state of newborns with pneumonia. Methods 72 newborns with pneumonia were selected as the study object, and they were randomly divided into control group (36 cases) and observation group (36 cases), the control group were treated with conventional treatment of pneumonia, the observation group were treated with asarone injection on the treatment method of control group, then the pulmonary surfactant protein indexes, oxygenation function indexes and blood gas analysis of two groups before and after the treatment were respectively detected and compared. Results The pulmonary surfactant protein indexes, oxygenation function indexes and blood gas analysis of two groups before the treatment all had no significant differences, while the pulmonary surfactant protein indexes, oxygenation function indexes and blood gas analysis of observation group at first, second and fifth day after the treatment were all significantly better than those of control group, all P<0.05, there were all significant differences. Conclusion The asarone injection can significantly improve the pulmonary surfactant proteins and oxygen supply of newborns with pneumonia, so its application value in the treatment of newborns with pneumonia is higher.
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Objective To investigate the clinical effect of milrinone in the treatment of children with congenital heart disease complicated by severe pneumonia and heart failure. Methods 94 patients with congenital heart disease complicated with severe pneumonia and heart failure in our hospital from March 2014 to February 2016 were selected,and randomly divided into experimental group and routine group,47 cases in each groups. The routine group were treated with conventional treatment, the experimental group in the conventional group received routine treatment based on the same given milrinone treatment. The clinical efficacy, symptom disappearance time and adverse reactions were compared between the two groups. Results The treatment in the experimental group the total efficiency (93.62%) was significantly higher than that of the conventional treatment group with the total effective rate (78.72%), significant difference, statistically significant (P<0.05); the experimental group in children with fever, cough, rales and other symptoms disappeared time is lower than the conventional group, the data had significant difference, has statistical significance (P<0.05); two groups of patients during treatment were not any serious adverse reactions, the adverse reaction condition no difference does not have statistical significance.Conclusion The clinical effect of milrinone in the treatment of children with congenital heart disease complicated by severe pneumonia and heart failure significantly, clinical efficacy, low incidence of adverse reactions, worthy of promotion.
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OBJECTIVE:To evaluate the effects of PDCA cycle management method on clinical application of Fat-soluble vita-min for injection (Ⅱ). METHODS:By retrospective analysis,500 discharge medical records of Fat-soluble vitamin for injection (Ⅱ)were collected from our hospital during Jul.-Aug. in 2015(before intervention),Sep.-Oct. in 2015(after first intervention cy-cle),Nov.-Dec. in 2015(after second intervention cycle),respectively. RESULTS:After 2 PDCA cycles,the proportion Fat-solu-ble vitamin injection (Ⅱ) use without indication decreased from 65.4% to 39.2%;the reasonable rate of drug dosage increased from 53.2% to 97.2%,and that of usage increased from 96.4% to 99.8%;the reasonable rate of medication course increased from 69.6% to 96.6%;the reasonable rate of the clinical application of Fat-soluble vitamin injection (Ⅱ) increased from 18.8% to 56.4%,with statistical significance (P<0.05). CONCLUSIONS:PDCA cycle can effectively promote the clinical reasonable of Fat-soluble vitamin for injection(Ⅱ).
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Objective To investigate serum alpha2-Heremans-Schmid glycoprotein ( AHSG ) level and its relationship with associated clinical parameters in subjects with simple overweight and obesity. Methods Forty-nine subjects with obesity ( OB group) , 176 subjects with overweight ( OW group) , and 327 individuals with normal weight ( NW group) were randomly enrolled. The clinical data were collected and serum levels of AHSG and adiponectin ( APN) were determined by ELISA. The associations of serum AHSG level with other clinical parameters were assessed by Pearson correlation analysis and multiple linear regressive model. Results Serum AHSG levels were higher in OW and OB groups than that in NW group[(276. 30 and 302. 10 vs 241. 60)μg/ml], being especially higher in OB group (P<0. 05 or P<0. 01). Serum AHSG level in NW group was positively associated with fasting plasma glucose, homoeostasis model assessment of insulin resistance index, C-reactive protein (CRP), triglycerides, and free fatty acids ( FFA ) , but negatively associated with age and APN. In OW and OB groups, AHSG was also positively associated with body mass index, waist hip ratio(WHR), and low density lipoprotein cholesterol(P<0. 05 or P<0. 01) except the aforementioned clinical parameters. In multiple linear regression model, AHSG was positively associated with WHR, CRP, and FFA, and was negatively associated with APN ( P<0. 05 or P<0. 01). Conclusion The raised AHSG level in overweight and obese subjects may be a risk factor for obesity-related diseases.
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Objective To investigate the characteristics of hepatitis C viurs (HCV)infection and its genotypes in Yancheng area . Methods A total of 20 185 cases of subjects receiving healthy examination were collected ,and fasting blood levels of serum anti‐HCV were detected .Clinical data of patients with HCV infection were statistically analysed .HCV genotypes and levels of HCV RNA were detected ,and their clinical prognosis was judged by type‐B ultrasonic .Results The total infection rate of HCV was 1 .22% .The infection rate of male was higher than that of female and the infection rate was increased with the elevation of age .The genotype 1b was accounted for 73 .17% .The results of type‐B ultrasonic shown that all patients infected with genotype 6 and 1b/2a HCV only had liver damage .80 .77% of patients infected with genotype 2a HCV had liver damage ,which was higher than that of patients infected with 16 and 3a+3b genotypes .Conclusion Most of HCV infected patients are male ,and the infection rate might be increased with the elevation of age .The prognosis is in various different genotypes of HCV ,which indicates that the prognosis could be evaluated by genotyping .
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From both doctors and patients′different perspectives , this paper analyses the causes of conflict of doctor-patient communication , and from the subjective and the objective , the history and reality , individual and social aspects of light on the restricting factors for good doctor -patient communication , and puts forward strengthe-ning the consciousness of active , rule execution , achieving full coverage , explore ways to standard mode , rich di-verse ways and other countermeasures .
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The association between serum fetuin A and diabetic nephropathy (DN) in patients with type 2 diabetes mellitus(T2DM) was investigated.Serum levels of fetuin-A and adiponectin were measured by ELISA and the clinical data were collected in 101 T2DM patients with normal albuminuria (NA group),87 patients with microalbuminuria (MA group),44 patients with overt albuminuria (OA group),and 130 normal control subjects (NC group).Fetuin-A levels increased progressively from NC,NA,MA,to OA groups,and there were significant differences among groups(P＜0.05 or P＜0.01).Fetuin-A level in patients was positively associated with duration of illness,urinary albumin to creatinine ratio (ACR),fasting blood glucose,2-hour postprandial blood glucose,and C-reactive protein(CRP,P＜0.05 or P＜0.01),but was negatively associated with age and adiponectin (all P＜ 0.01).Multiple stepwise regression analysis indicated that duration of diabetes,fetuin-A,CRP,and adiponectin were independent determinants for ACR (all P ＜ 0.01).Fetuin-A may be involved in the development and pathogenesis of DN by proinflammatory effects and repressing adiponectin production.