Objective To explore the status of obesity and diet behavior in young and middle-aged people of Jinan and supply reference for controlling overweight and obesity by diet intervention. Methods Stratified sampling method was conducted to investigate 18～59 inhabitants in Jinan. The information about their body height,body weight and diet behavior was collected to further analyze the relationship between the status of obesity and correlated behaviors by the SPSS 11.5 software. Results The prevalence rate of overweight and obesity had a significant difference between young group and middle-aged group(P＜0.01), which was separately 21.56% and 33.46%; the prevalence rate of overweight and obesity in young group had a significant difference between males and females(P＜0.05),but no significant difference in middle-aged group.Compared with the diet behavior problems of normal body weight people, the incidence rate of overweight and obesity was significantly higher(P＜0.01),but no significant difference for the habit of midnight snack.Females paid more attention to reasonable match and the speed of food intake than males.Conclusion Overweight and obesity in young and middle-aged people of Jinan is relatively serious,which is closely correlated with unscientific diet behavior.

Objective To investigate the changes in the levels of motilin in the gastric body in a rat model of incisional pain.Methods Eighty-four healthy male Sprague-Dawley rats,weighing 180-220 g,were randomized into 2 groups (n =42 each):normal saline group (NS group) and incisional pain group (P group).In group P an 1 cm long incision was made in the plantar surface of right hindpaw under sevotlurane anesthesia.Six rats were chosen from each group and paw withdrawal threshold to mechanical stimulation (MWT) and paw withdrawal latency to nociceptive thermal stimulation (TWL) were measured at 24 h before operation (To) and 1,6,24,48 and 72 h after operation (T1-5).Six rats were chosen from each group at T0-5 and sacrificed and the gastric mucosal tissues were prepared for measurement of motilin levels by ELISA.Results Compared with group NS,MWT,TWL and motilin levels were significantly decreased at T1-4 (P ＜ 0.05) and no significant change was found at T0 and T5 in P group (P ＞ 0.05).Compared with the baseline value at To,MWT,TWL and motilin levels were significantly decreased at T1-4,and no significant change was found at T5 in group P (P ＞ 0.05).MWT,TWL and motilin levels were significantly higher at T3-T5 than at T1 in group P (P ＜ 0.05).MWT,TWL and motilin levels were increased gradually at T3-T5 in P group (P ＜ 0.05).The motilin levels were positively correlated with MWT and TWL (r =0.9597 and 0.9231,respectively,P ＜ 0.01) in group P.Conclusion The levels of motilin in the gastric body is significantly decreased in a rat model of incisional pain and the decreasing range is positively corre lated with the degree of incisional pain.

Objective To evaluate the therapeutic effects of noninvasive bi-level positive airway pressure (BiPAP) ventilation after extubation in chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure.Methods Forty-one intubated COPD eases with severe respiratory failure due to pulmonary infection (pneumonia or purulent bronchitis) were involved in the study.At the time of pulmonary infection control (PIC) window,the extubation was conducted and followed by BiPAP ventilation in 21 cases (the experimental group),while the other 20 COPD cases with similar clinical characteristics,as the control group,who continuously received invasive mechanical ventilation after PIC window.Outcomes including the duration of invasive ventilation,the total duration of ventilation support,success rate,the incidence of ventilator associated pneumonia (VAP) and mortality rate were observed and compared between the two groups.Results The two groups had similar clinical characteristics and gas exchange at the time of PIC window (P ＞ 0.05 ).Compared with the control group,the experimental group had shorter duration of invasive mechanical ventilation (6.9±3.0) d vs.(13.1 ±4.3) d,t=5.38,P＜0.001),lower rate of VAP (1/20 vs.8/20,x2 =5.51,P=0.02) andhigher extubation rate (20/21 vs.13/20,x2 =4.19,P =0.04).Conclusion In COPD patients with intubation and mechanical ventilation for respiratory failure,BiPAP ventilation after extubation at the point of PIC window may improve patients' prognosis.

Objective To verify the validity and feasibility of national early warning score (NEWS) in evaluation of death risk in elderly patients with critical illness,in order to find out which scoring method is more suitable for elderly critical illness patients.Methods A prospective case-control study was conducted.The critical illness patients aged over 60 years old with the length of hospital stay over 24 hours,and admitted to Department of Emergency of Qingdao Municipal Hospital from January to December 2015 were enrolled.The clinical data including in emergency and the actual outcome of patients were collected,and the patients were divided into death group and survival group according to 30-day outcome.Patients in the two groups were assessed by using NEWS and risk classification according to the first results of vital signs monitoring.Multivariate logistic regression model was used to analyze the relationship between the NEWS classification and the risk of death in elderly critical ill patients.Results 1 950 emergency elderly patients with critical illness were enrolled,with 78 cases (4.0％) dead within 30 days and 1 872 survived (96.0％).Compared with the survival group,patients in death group were older (years:79.8 ± 10.8 vs.75.3 ± 8.9,t =4.335,P ＜0.001),and had higher acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score (22.9± 4.6 vs.18.2 ± 4.8,t =8.487,P ＜ 0.001),lower Glasgow coma scale (GCS) score (12.2 ± 4.5 vs.13.4 ± 5.2,t =-2.007,P =0.045),higher incidence of respiratory system diseases (29.5％ vs.17.9％,x 2 =12.742,P =0.013),higher NEWS score (11.2 ± 5.5 vs.3.9 ± 2.7,t =22.063,P ＜ 0.001),as well as higher proportion of patients with NEWS classification of high risk and very high risk (65.4％ vs.15.8％,x 2 =263.125,P ＜ 0.001).With the increase of NEWS risk classification,mortality rate was also increased,and the mortality rate in the patients with low,medium,high and very high risk were 0.81％ (9/1 108),3.63％ (18/496),5.83％ (13/223),30.89％ (38/123),respectively,with statistically significant difference (x 2 =179.741,P ＜ 0.001).It was showed by logistic regression analysis that the NEWS score of elderly patients with critical illness were positively correlated with 30-day death.The 30-day death risk of patients with middle risk,high risk and very high risk was 4.600,9.052 and 54.598 folds of the patients with low risk respectively.Conclusion NEWS score can be used to assess the risk of death in emergency elderly patients with critical illness.NEWS risk classification can quantify and classify the risk of death in the elderly patients with critical illness.

Objective To evaluate the changes in the levels of motilin in the duodenum in a rat model of incisional pain.Methods Eighty-four healthy male Sprague-Dawley rats,aged 6-8 months,weighing 180-220 g,were randomized into 2 groups (n =42 each) using a random number table:control group (group C) and incisional pain group (group P).The animals were anesthetized with sevoflurane.In group P,a 1 cm long incision was made in the plantar surface of right hindpaw.Six rats were chosen from each group and mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 24 h before operation (T0) and 1,6,24,48 and 72 h after operation (T1-5).Six rats were chosen from each group at T0-5 and sacrificed and the duodenal mucosal tissue was prepared for measurement of motilin levels by ELISA.Pearson linear correlate analysis was performed between the motilin level and pain threshold at each time point in group P.Results Compared with group C,MWT was significantly decreased,TWL was shortened,and motilin levels were significantly increased at T1-4,and no significant change was found at T0 and T5 in group P.The motilin levels were negatively correlated with MWT (r =-0.8 910) and TWL (r =-0.8 463) in group P.Conclusion Incisional pain can promote the secretion of motilin in the duodenum.

Objective To investigate the injuries caused by cholesterol to the vascular endothelial cells (VECs). Methods Different dosage of cholesterol (6.25,12.5,25.0,50.0 mg/L) was used on human umbilical endothelial cell line,ECV304,respectively. LDH activity,nitric oxide and the nitric oxide synthetase activity in the supernatant of cell culture were detected. The concentration of MCP-1 protein in cell culture was detected by ELISA. Results As compared with the normal control cells,a significant increase of LDH activity was found in the cells treated with 50.0 mg/L cholesterol. The NO level decreased in the cells treated by 25.0 or 50.0 mg/L cholesterol. When treated by cholesterol at dose of 6.25,12.5,25.0 or 50.0 mg/L respectively,the NOS activity was greatly decreased and MCP-1 protein was significantly increased in a dose-dependent manner. Conclusion Cholesterol of high concentration could directly injure the structure and partial function of VECs.

ObjectiveTo assess the diagnostic value of ultrasonography in the diagnosis and pathological classifi cation of appendicitis with pathological results.MethodsThe study included 111 cases who confi rmed by surgery and pathology in the Six Affi liated Hospital of Sun Yat-sen University from June2012 to December 2013. The image characteristics of ultrasonic images performed before surgery were analyzed retrospectively. The cases were divided into five groups based on the pathology: 6 acute simple appendicitis, 45 acute suppurative appendicitis, 15 acute gangrenous appendicitis, 33 chronic appendicitis, and 12 acute attack of chronic appendicitis. The length, width and wall thickness of the appendicitis measured by preoperative ultrasound between various pathological type were compared with Kruskal-Wallis statistical methord, and also used the same method to compared the one which had statistically signifi cance between the fi ve groups. As in the above case, Fisher Exact Test was used to compare the characters′ of ultrasonography included gradations of the appendix, the tube cavity expansion, stercorolith, the appendiceal abscess, mergering lymph node enlargement and the appendix around effusion, if there was statistically signifi cance, the same methord was used to the further comparison between thefi ve groups.ResultsTotally 90 of 111 cases of were reminded appendicitis by preoperative ultrasound, the diagnostic accuracy rate was 81.08%, including acute suppurative appendicitis 91.11% (41/45), acute gangrenous appendicitis 93.33% (14/15), acute simple appendicitis 83.33% (5/6), chronic appendicitis 60.61% (20/33), chronic appendicitis onset acute 83.33% (10/12). There were no statistical differences of preoperative ultrasound measured between various pathological type of appendicitis in length, while the appendix width measured by preoperative ultrasound of acute gangrenous appendicitis was wider than the acute simple group and chronic group, and there were statistically signifi cance between them (P<0.05), in the aspect of wall thickness, the acute suppurative appendicitis and the acute gangrenous appendicitis groups were thicker than the chronic group, and these differences had statistically signifi cance (P<0.05). The stercorolith, lymph node enlargement and the appendiceal abscess in different types of appendicitis had no statistical difference. There were statistically differences (P<0.05) between the acute suppurative goup, acute gangrenous group and the chronic group respectively, both in gradations of the appendix and the tube cavity expansion. Also there were statistically difference (P<0.05) between the acute gangrenous appendicitis group and the chronic group in the aspect of the appendix around effusion.ConclusionsUltrasound is valuable in the diagnosis of appendicitis, especially for acute gangrenous appendicitis and acute purulent appendicitis. The measurement of appendix with wide diameter, wall thickness by ultrasond preoperatively, and the characteristics of the wall layers, lumen expansion degree and the appendix around effusion are valuable in identifying chronic appendicitis, acute suppurative appendicitis, and acute gangrene appendicitis; The ultrasonic measurement of appendix wide diameter could identify acute gangrenous appendicitis and acute simple appendicitis. Ultrasound had limited value in identifying acute suppurative, acute gangrenous appendicitis, acute simple appendicitis, chronic appendicitis, and chronic appendicitis onset acute.

Objective To evaluate the effects of intrathecal low-dose naloxone,morphine and fentanyl on the expression of motilin (MTL) in the spinal cord in rats with incisional pain.Methods Seventy-two healthy male Sprague-Dawley rats,weighing 180-220 g,in which intrathecal catheters were successfully implanted,were randomly divided into 6 groups (n =12 each) using a random number table:normal saline group (NS group),morphine + fentanyl group (MF group),incisional pain group (P group),naloxone + incisional pain group (NP group),morphine + fentanyl + incisional pain group (MFP group),and morphine + fentanyl + naloxone +incisional pain group (MFNP group).Incisional pain was induced by an incision made into the plantar surface of the right hindpaw.At 20 min before induction of incisional pain,the mixture of morphine 5 μg/kg and fentanyl 0.25 μg/kg was injected intrathecally in MF,MFP and MFNP groups,and naloxone 1 ng/kg was given in NP and MFNP groups.Six rats from each group were randomly chosen,and paw withdrawal threshold to mechanical stimulation (PWMT) and paw withdrawal latency to thermal stimuli (PWTL) were measured before intrathecal catheterization (T0,baseline),at 24 h before induction of incisional pain (T1),and at 1,3 and 6 h after induction of incisional pain (T2-4).The left 6 rats from each group were chosen and sacrificed and the spinal cord were removed at 6 h after operation for detection of MTL content in the spinal cord,body of the stomach and duodeum tissues (by ELISA).Results Compared with the baseline value at T0,PWMT was significantly increased at T3,and PWTL was prolonged at T2-4 in MF group,PWMT was decreased and PWTL was shortened at T2-4 in P group and at T3,4 in NP group,PWMT was increased at T2,3 in MFP group,and PWMT was increased and PWTL was prolonged at T2 in MFNP group (P ＜ 0.05).Compared with NS group,MTL contents in spinal cord and body of the stomach were significantly decreased in MF and NP groups,MTL cortent in duodeum was decreased in group MF,while increased in group NP and MTL content in spinal cord was increased,and MTL content in body of the stomach was decreased in P and MFP groups,MTL content in duodeum was increased in group P,while decreased in group MFP(P ＜ 0.05),however,no significant change was found in MTL content in MFNP group (P ＞ 0.05).Conclusion Intrathecal low-dose naloxone combined with morphine and fentanyl can inhibit up-regulation of the expression of MTL in the spinal cord in rats with incisional pain and is involved in the maintenance of stable gastrointestinal motility.

Objective To analyze the normal reference values of the right ventricular volumes and ejection fraction of healthy adults measured by single-beat real-time three-dimensional echocardiography (sRT-3DE).Methods The subjects of this study included three hundred and thirty-four healthy adults,and were divided into 2 groups by gender and 6 groups by age.The sRT-3DE was chosen to measure their right ventricular volumes and ejection fraction.The parameters of right ventricular volumes were standardized by body surface area (BSA)and lean body mass (LBM)to calculate the ranges of their normal value.The correlation between these parameters and genders as well as the physical characteristics (height,weight, body mass index,BSA and LBM)was also clarified.Results Three hundred and thirty-four (96%)of the 348 subjects had been tested.Before standardizing,men had larger right ventricular volumes compared with women,and the differences of the right ventricular end diastolic volume (RVEDV),right ventricular end systolic volume (RVESV)and right ventricle stroke volume (RVSV)were statistically significant(P <0.001 ),but it had no statistical significance in the difference of the right ventricular ejection fraction (RVEF)(P >0.05 ).After standardizing by LBM,the RVEDV,RVESV and RVSV in male group were significantly lower than those in women group (P < 0.001 ).In different age groups,the difference of RVEDV,RVESV,RVSV ,but no RVEF were statistically significant (P < 0.05 ).Positive correlations between the RVEDV,RVESV,RVSV and the BSA,height,weight,body mass index and LBM had been detected,and it showed a negative relation between RVEDV,RVESV,RVSV with age.Noticeably,RVEF had no correlation with them.Conclusions sRT-3DE can provide a preliminary range for normal reference values of right ventricular volumes and RVEF in healthy adults according to gender and age and finds that LBM has certain impact on adult cardiac structure,which offers valuable evidence for the diagnosis of right heart diseases in clinical practices.

Objective To prepare thermosensitive chitosan (CTS) hydrogels containing astragalus polysaccharides (APS)/CTS microshperes (MS), and evaluate its physicochemical properties. Methods The APS/CTS MS (APS-MS) were prepared by spray drying method, and characterized by Scanning Electron Microscopy (SEM) and Laser Granularity Analyzer. Depending on the gelation temperature and gelating time, thermosensitive CTS hydrogels (HG) containing APS-MS (APS-MS-HG) were optimized by signal factor experiments, and the morphological characteristics were observed by SEM. In vitro release behaviors of APS-MS, hydrogels containing APS (APS-HG) and APS-MS-HG in pH 6.8 phosphate buffer were evaluated by dialysis tube method. Results The APS-MS were well dispersed with nearly spherical shapes and slightly wrinkled surfaces. The surface weighted mean D[3,2] of APS-MS was 8.078μm. The optimal APS-MS-HG, APS-MS-HG J, contained 3.012% APS-MS which were agitated with a magnetic stirrer for 3h. Observed by SEM, APS-MS were stayed spherical and dispersed unevenly in HG J, but the porous structure of HG J was disappeared in APS-MS-HG J. The release of APS from APS-MS-HG J was without initial burst release, and the cumulative amount of APS was about 74.75% after 36h. Conclusion Suppressing the phenomenon of sudden release at the first stage of delivery, APS-MS-HG J holds great promise for topical applications as a sustained-release nasal delivery system.