The first national epidemiologic survey of obesity of children 0-7 years old in urban area in China was conducted in 1986. A sampling size was 167,065 of eight main cities representing North, Middle and South of China (The cities are: Beijin, Harbin, Xian, Nanjing, Shanghai, Wuhan, Fuzhou and Kunming). The definiton of obesity is that the weight for height of children is more than 20% of the weight for height of relatively well-nourished reference population of China. The prevalence is 0.9% (boy 0.93%, girl 0.90%). The geographical contribution of prevalence is 1.76% in North, 0.89% in Middle, 0.42% in South. The criteria period of obesity is 0-3 months and 4-5 years after birth.Bottle feeding, early introducing solid food (1-2 months after birth), early weaning and overfeeding are "obesiogenic" feeding pattern. Overeating much meat and less fruit and less activity in room are"obesiogenic"life pattern.It is estimated that the resourse of obese children will mainly" come from low income family in future. Parents' attitude plays an important role in aspect of overfeeding of obese children.The factor of spoiling children can not be ignored in etiology of obesity in childhood. The Chinese traditional social custom and cultural philosophy such as children's activity always being limited can result in higher prevalence of severe obesity in boys.Under the situation of economic, cultural and child health care service in China, now, the birth weight is not a good indicator of obesity in late life. Obesity in preschool children is not associated with hypertension.The author indicated that obesity has become a health problem of children in China. Attention should be focused on the popular health education on nutrition knowledge and changing the unresonable feeding pattern and life style.

From January 1977 to December 1988, 279 cases of esophageal carcinoma were proved to be stage Ⅰ andⅡ A after operation. Within 5 years of the operation, 103 cases have failed. The failure was closely related to TNM stages. The regional and esophageal bed failure were obviously related to the site of the original lesion. Twelve of these 279 patients recieved postoperative radiotherapy. The incidence of intra-portal recurrence was lower in those who received postoperative radiotherapy than those who did not, although hematogenous metastasis was similar in these two groups. The 5-year survival rate with no evidence of cancer was higher in patients who received postoperative irradiation.

The prognosis is very poor for the patients with advanced esophageal cancer proved by explored operation.There was not concurrent for the value of radiotherapy after explored operation.A series of 104 patients with explored operation alone and 155 patients with radiotherapy before or after explored operation were analyzed to evaluation the value of postoperetive radiotherapy. The results showed: (1) Postoperative radiotherapy was effective for the patients with advanced esophageal cancer after explored operation.The average survival/mean survival and 1～5 years survival were higher in the patients with postoperative radiotherapy than in those of operation alone. (2) ≥6000cGy groupe was better than

Objective To investigate the clinical effect of hyper-fractionated three-dimensional conformal radiotherapy (3DCRT) combined with transcatheter arterial chemeembolization (TACE) for heating patients with inoperable primary liver cancer.Methods One hundred and two patients with inoperable advanced primary liver cancer were divided by random digits table method into control group with 49 cases treated with TACE and observation group with 53 cases treated with hyper-fractionated 3DCRT combined with TACE.The short-term efficacy,adverse reaction and survival rate of the 1st,2nd and 3rd year and serum alpha-fetoprotein (AFP) expression after treatment in two groups were observed.Results The complete remission rate,progress rate and total efficiency were 17.0％ (9/53),11.3％ (6/53),73.6％ ( 39/53 ) in observation group,2.0％( 1/49 ),28.6％ (14/49),51.0％(25/49 ) in control group.There were significant differences between two groups (P ＜ 0.05).There was no statistical significance in adverse reactions between two groups ( P ＞ 0.05 ).The survival rates of the 1 st,2nd and 3rd year in control group were 51.0％ ( 25/49 ),28.6％(14/49),14.3％(7/49),the median survival time was 15 months;while those in observation groupwere 71.7％(38/53),52.8％(28/53),39.6％(21/53) and 20 months.The survival rates of the 2nd and 3rd year in observation group were significantly higher than those in control group respectively (P ＜0.05 or ＜0.01 ).The rate of patients with no obvious serum AFP protein change between observation group [ 9.8％(4/41) ] and control group [ 31.6％(12/38) ] had statistical significance (P ＜ 0.05).Conclusion Hyper-fractionated 3DCRT combined with TACE for treating patients with inoperable primary liver cancer has good clinical efficacy,it is worthy of clinical practice.

[Objective] To investigate the effects of airway dysbacteriosis on the development of murine atlergic airway diseases (AAD).[Methods] Female C57BL/6 mice were neubulized with Vancomycin for 10 days and then were sacrificed.The bacterial population in bronchoalveolar lavage fluid (BALF) were evaluated using 16S rRNA high-throughput sequencing technology,exploriug the method of establishing an airway dysbacteriosis mouse model.After the mouse model was established successfully,airway dysbacteriosis mouse models were established by the same method,and based on that,the mice were sensitized and challenged with ovalbumin (OVA) to induce airway allergic inflammation.The frequency of nasal rubbing behaviors per mice was counted;the total cell number and eosinophil relative abundance in BALF were evaluated;the lung tissue inflammation and goblet cell metaplasia were assessed according to histopathological features;and the IgE level in serum,IFN-γ,IL-4 and IL-5 levels in BALF,and IL-33 levels in serum,BALF and intestine tissue were measured by ELISA.[Results] Nebulization of Vancomycin increased Bradyrhizobium,Sphingopyxis,Cupriavidus,Pelomonas,and decreased Akkermansia and Prevotella_6 in airway,inducing significant airway dysbacteriosis.Using the animal model,further study found that airway dysbacteriosis exacerbated OVA-induced airway allergic inflammation,including increased nasal rubbing frequency,higher serun IgE level,more total cell count especially eosinophil infiltration,more serious lung tissue inflammation and goblet cell metaplasia.Additionally,compared to OVA group,mice in Dysbacteriosis and OVA group had significantly increased level of Th2 cytokine IL-4 and IL-5,and significantly decreased Thl cytokine IFN-γin BALF,which revealed that mice in Dysbacteriosis and OVA group had mote remarkable Thl/Th2 imbalance.Furthermore,IL-33 level showed a significant increase in BALF,but didn't change in serum or intestine tissue in Dysbacteriosis and OVA group compared to OVA group.Indicating that airway dysbacteriosis may only affect the local production of IL-33.[Conclusions] An airway dysbacteriosis mouse model was established by Vancomycin nebulization successfully.Airway dysbacteriosis may activate innate lymphoid cells (ILC) and Th2 cell by inducing local IL-33 secreting,which leads to the imbalance of Th1/Th2,and in turn promotes the development of AAD.

Portal hypertension (PHT), as a disease with high incidence all over the world, badly affects the patients' health. The research on hemodynamics plays an important role in exploring the pathogenesis of PHT, assessing the risk of hemorrhage induced by the complications, selecting the scheme and time of surgical operations as well as evaluating the curative effects of medication. In this article, the main factors in the pathogeny of PHT are reviewed and the surgical treatments are discussed from the hemodynamic viewpoint. Then some recent results in the hemodynamic research of PHT are summarized. In addition, main ideas are put forward as to establishing a new global biomechanical model of PHT.
Animals ; Hemodynamics ; Humans ; Hypertension, Portal ; etiology ; physiopathology ; surgery ; Models, Cardiovascular

The paper reviewed the history and characteristics of the public hospital reform in China. Based on the theories of corporate governance, it made analysis and comments on existing roadblocks and reform attempts in such hospitals, proposing a public hospital governance model in line with the general reforms made in China's healthcare system sector.

Objective To investigate the effect and underlying mechanisms of G-protein-coupled receptor 39(GPR39)activation on neuroinflammation and brain injury after experimental intracerebral hemorrhage in mice.Methods Mouse model of intracerebral hemorrhage(ICH)was established by intracerebral injection of autologous blood.A total of 176 male C57/BL6 mice were randomly divided into 8 groups:Sham group(n=42),ICH group(n=34),ICH+Vehicle group(n=32),ICH+TC-G 1008 group(n=44),ICH+GPR39 siRNA group(n=6),ICH+Scramble siRNA group(n=6),ICH+TC-G 1008+666-15 group(n=6),and ICH+TC-G 1008+Vehicle 2 group(n=6).GPR39-specific agonist TC-G 1008 was administered via oral gavage at 1 and 25 h post-ICH modeling.Additionally,GPR39 siRNA and cAMP response element binding protein(CREB)inhibitor 666-15 were intracerebroventricularly injected 24 h before induction of ICH to inhibit the expression levels of GPR39 and p-CREB.At 48 h after ICH,modified Garcia test,forelimb placement test and corner turn test were used to evaluate the short-term neurological deficits in mice.Brain water content was determined by wet/dry method.Immunofluorescence assay was performed to detect the co-localization of GPR39 in neurons and microglia in the brain tissue surrounding the hematoma,as well as the expression of NOD-like receptor thermal protein domain associated protein 3(NLRP3)in neurons.ELISA was employed to measure IL-1β,TNF-α and myeloperoxidase(MPO)levels in peri-hematoma tissue.TUNEL staining was performed to quantify apoptotic neurons around the hematoma.Nissl staining was utilized to evaluate neuronal damage.Western blotting was conducted to detect the expression of GPR39,p-CREB,CREB,NLRP3,Cleaved caspase-1(C-caspase-1),and gasdermin-D protein(GSDMD)in peri-hematoma brain tissue.Results GPR39 expression peaked at 48 h post-ICH in mice(P＜0.05),and it was expressed in both neurons and microglia.Activation of GPR39 by TC-G 1008(24 mg/kg)significantly improved the modified Garcia score,and increased success rate of left forelimb placement and the number of left turns(P＜0.05).Brain edema in the ipsilateral basal ganglia(BG)and cortex(CX)was significantly reduced(P＜0.05).The numbers of apoptotic and damaged neurons around the hematoma were obviously decreased(P＜0.05).The expression of pyroptosis-related molecules,including NLRP3,C-caspase-1 and GSDMD and the levels of inflammation-related factors,including IL-1β,TNF-α and MPO were notably decreased(P＜0.05).However,knockdown of GPR39 and downregulation of p-CREB expression significantly increased the expression of pyroptosis related molecules and inflammatory-related factors in peri-hematoma brain tissue post-ICH in mice(P＜0.05).Conclusion GPR39 activation may inhibit neuroinflammation and brain injury after ICH in mice partly through the CREB signaling pathway.Therefore,GPR39 may be a potential therapeutic target for mitigating neuroinflammation and brain damage after ICH.

OBJECTIVETo evaluate the clinical value of prophylactic radiotherapy for esophageal carcinoma after curative operation.

METHODS495 esophageal squamous cell cancer patients who had undergone radical resection were randomized by the envelope method into a surgery alone group (S, 275) and a surgery plus radiotherapy group (S + R, 220). Radiation treatment was started 3 - 4 weeks after operation. The portals encompassed the whole mediastinum and bilateral supraclavicular areas. A mid-plane dose of 50 approximately 60 Gy in 20 approximately 30 fractions over 5 approximately 6 weeks was delivered.

RESULTS1. Survival rate: the overall 5-year survival rate was 39.4%. Those of S alone and S + R groups were 37.1% and 41.3% (P = 0.447 4). The 5-year survival rate for Stage III patients were 13.1% in S alone group and 35.1% in R + S group (P = 0.002 7), 2. Pattern of failure: The incidence of local recurrence intra-thoracic lymph node metastasis, anastomotic recurrence and extra-thoracic lymph node metastasis in S + R group (16.2%, 0.5% and 3.1%) were lower than those (25.9%, 5.8% and 13.2%) (P < 0.05) in S alone group and 3.

COMPLICATIONSthe anastomotic stricture frequencies were similar in the two groups (S 1.8%; S + R 4.1%).

CONCLUSION1. Prophylactic radiotherapy is able to improve the survival rate of stage III patients treated by radical resection, 2. Postoperative radiotherapy is able to reduce the incidence of failure by recurrence in the intra-thoracic lymph nodes and anastomotic recurrence to where radiation therapy had been given, 3. Postoperative radiotherapy does not increase the incidence of anastomotic stricture.

Adult ; Aged ; Carcinoma, Squamous Cell ; mortality ; radiotherapy ; secondary ; surgery ; Combined Modality Therapy ; Esophageal Neoplasms ; mortality ; pathology ; radiotherapy ; surgery ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Postoperative Care ; Survival Rate

Objective To evaluate the effect of Levosimendan on the prognosis in patients with severe coronary heart disease after operation.Methods A total of 485 severe coronary disease patients undergoing coronary artery bypass grafting from Teda International Cardiovascular Hospital and the Cardiac Surgery Department of the First Affiliated Hospital of China Medical University from May 2014 to June 2016 were enrolled.Of them,45 cases receiving Levosimendan postoperatively were assigned to the Levosimendan group,and according to propensity score matching,another 45 cases were selected as the control group in this study.Clinical data before treatment had no difference between the groups (P ＞ 0.1).Postoperative prognosis was compared between the two groups.Results There were significant differences in heart rate,mean arterial pressure,central venous pressure,cardiac output and other hemodynamic parameters between the two groups 48h after operation.The heart ultrasound results showed that the left ventricular ejection fraction(IVEF) was increased [(0.53±0.12) ％vs.(0.46±0.09)％,t =2.594,P=0.002],the postoperative ventilation time was reduced [(46.8±11.3) h vs.(58.5±16.3) h,t=-2.031,P=0.045]and the onset of bowel sounds became early [(16.5±5.9) h vs.(18.7±10.1) h,t =1.592,P=0.039]in the levosimendan group than in the control group 48h after operation.The incidences of new-onset acute kidney injury(20 ％ and 40 ％,x2 =6.702,P =0.018),new-onset postoperative atrial fibrillation (15.6％ and 44.4％,x2 =6.156,P =0.023) and perioperative myocardial infarction(11.1 ％ and 33.3％,x2 =6.429,P =0.021) had significant differences between the two groups(P＜0.05),but there was no difference in ICU retention time,1-month mortality after operation,malignant arrhythmia incidence and auxiliary equipment use (P ＞ 0.05).Conclusions Levosimendan can improve the early prognosis of severe coronary disease patients undergoing coronary artery bypass grafting and reduce the occurrence of postoperative organ dysfunction.