Objective:To study whether the socio-ecological model based on “student-school-family”three-level strategy is effective in obesity prevention. Methods: A total of 3 175 students aged 7 to 18 from 16 schools (4 urban primary schools, 4 rural primary schools, 4 urban secondary schools and 4 rural secondary schools, of which 2 intervention schools were selected, respectively ) were recruited by strati-fied cluster sampling method. A three-month intervention using “student-school-family” socio-ecological model was conducted through health education and environment improvement. The intervention contents included knowledge on obesity, healthy diet and physical activities. Their anthropometric indexes were recorded. Results:The intervention prevented obesity(OR =1. 12, P <0. 05), and was effective in waist circumference (WC) and waist-hip ratio (WHR) (adjusted difference=0. 63, 0. 02, P<0. 05). WC and WHR were reduced in girls ( adjusted difference=0 . 52 &0 . 02 , P<0 . 05 ) , and obesity was prevented in girls ( OR=1 . 18 , P<0 . 05 ) . WC and WHR were reduced in boys ( adjusted difference=0 . 73 , 0 . 01 , P<0 . 05 ) . WHR were reduced in urban areas ( adjusted difference=0 . 01 , P<0 . 05 ) . WC and WHR were reduced ( adjusted difference=1 . 05 , 0 . 02 , P<0 . 05 ) and obesity was prevented (OR=1. 18, P<0. 05) in rural areas. WHR were reduced (adjusted difference=0. 01, P<0. 05) and obesity was prevented (OR =1. 21, P <0. 05) in primary schools. WHR were reduced in secondary schools (adjusted difference=0. 02, P<0. 05). The intervention effect was better in girls than in boys, in rural areas than in urban areas, and in primary schools than in secondary schools. The overweight and obesity prevalence went down after the intervention (χ2 =11 . 01 , P <0 . 01 ) . Conclusion:Intervention strategy is effective in central obesity indexes such as WC and WHR, and it can be used widely.

Objective To identify the routes and branches of the proper plantar digital nerves(PPDN) in the medial of the great toe and its adjoining relationship among the surrounding fascia tissues and organs,which was expected to provide accurate localization of the nerve impingement and possible relevant of anatomical basis for the treatment of nerve entrapment in clinical utility.Methods From December,2016 to January,2019,a total of 54 formalin fixed feet were collected.Fifty of them were performed conventional anatomical procedure,the other 4 were prepared with sectional anatomical technique.The seats and branches of the PPDN in the medial of the great toe were observed;The width and thickness of the nerve were measured at the first metatarpophalangeal joint(FMPJ),along with its proximal and distal sides 0.5 cm.The origin and origin of fascia were observed by foot dissection.Masson staining was used to observe the tissue changes of the nerves in the FMPJ.Results The PPDN of the medial great toe run between the flexor pollicis longus tendon and the abductor pollicis tendon at the proximal,issued (4.21±0.12) final branches.And governed the sensation of the medial half of the great toe.The width of the nerve at the FMPJ was (3.50±0.09) mm,which was significantly increased compared with that of the near [(1.58±0.04) mm] and far [(1.56± 0.03) mm] from the joint.The difference was statistically significant (P＜0.05);The thickness of the nerve in the proximal segment was (0.83±0.04) mm,and that in the distal segment was (0.82±0.03) mm.Compared with that in the FMPJ [(0.67±0.02) mm],the difference was statistically significant (P＜0.05).A deep fascia was observed on the superficial surface of the PPDN at medial great toe,which was stretched between the tendon sheath of the flexor pollicis longus tendon and the tendon of the abductor pollicis muscle.Masson staining showed obvious proliferation of nerve outer mem brane fibers at the metatarpophalangeal joint,the number of nerve fiber bundles increased,and obvious thickening of nerve fiber bundles and nerve fascia.Conclusion Long-term compression can lead to thickening of the epineurium and perineurium,and the superficial fascia is an important factor of thumb pain and numbness caused by the compression of the PPDN at medial of the great toe.

Objective:To investigate the analgesic effect and quality of awakening of esketamine in patients undergoing laparoscopic total hysterectomy.Methods:100 patients who underwent laparoscopic total hysterectomy in our hospital from Mar. 2021 to Mar. 2023 were selected and randomly divided into the observation group ( n=50) and the control group ( n=50) . The observation group were injected esketamine during the operation, and the control group were injected an equal amount of saline. Anesthesia induction, maintenance and postoperative analgesic medication were kept the same in both groups. The hemodynamic indexes of heart rate (HR) and mean arterial pressure (MAP) of the two groups were monitored at the moment of entering the room (T0) , the moment of saline/exketamine infusion (T1) , the moment of surgical skin incision (T2) , the moment of skin suture (T3) , the moment of tracheal extubation (T4) , and the moment of exiting the operating room (T5) ; The recovery time of spontaneous respiration, the time of awakening and the time of extubation were counted, and the quality score (steward score) of the awakening was calculated. Exercise and resting visual analog scores (VAS scores) at 2 h, 4 h, 6 h and 8 h after surgery for the two groups of patients were recorded; The number of cases using rescue analgesics after surgery, and the number of times using patient’s self-control intravenous analgesia (PCIA) pumps were counted; The number of patients who experienced adverse reactions (nausea and vomiting, respiratory depression, bradycardia, chills, drowsiness) after surgery were recorded and the incidence rate was calculated. The number of patients was counted and the incidence rate was calculated. Results:The differences in the hemodynamic indexes HR and MAP between the two groups at T0, T1, T2 and T3 were not statistically significant (both P>0.05) . Compared with the control group, the observation group had a significant decrease in the hemodynamic indexes HR at T4 and T5 (101.87 times/min vs 91.67 times/min) (91.53 times/min vs 83.13 times/min) (both P<0.05) . There was no statistically significant difference in the exercise and resting VAS scores between the two groups at 2 h postoperatively (both P>0.05) . Compared with the control group, MAP was significantly reduced in the observation group at T4 and T5 (102.43 mmHg vs 90.4 mmHg) (94.13 mmHg vs 85.53 mmHg) (both P<0.05) . The difference in the exercise and resting VAS scores between the two groups was not statistically significant at 2 h postoperatively (both P>0.05) ; The exercise VAS scores of the patients in the control group at 4 h, 6 h, and 8 h postoperatively were 3.50, 4.70, and 4.63, respectively, and the resting VAS scores of the patients in the control group were 3.43, 4.20, and 4.40; The exercise VAS scores of the patients in the observation group were 2.53, 3.70, and 4.30; The resting VAS scores of patients in the observation group were 2.10, 2.47 (both P<0.05) . In the control group, the number of cases of postoperative rescue analgesic use and the number of patients’ postoperative analgesic pump presses were 2.01±0.73 and 5.87±1.25, respectively; In the observation group, the number of cases of postoperative rescue analgesic use and the number of patients using PCIA pump were 0.43±0.41 and 1.88±0.68, respectively; The number of postoperative rescue analgesic use and the number of patients using PCIA pump were 0.43±0.41 and 1.88±0.68, respectively (both P<0.05) . In the control group, the postoperative recovery time of spontaneous breathing, awakening time and extubation time were 5.67min, 18.77min and 7.40min respectively, while the postoperative spontaneous breathing recovery time, awakening time and extubation time of patients in the observation group were 4.70min, 13.33min and 4.18min, respectively (both P<0.05) . The steward score of the control group was 4.33, and the steward score of the observation group was 5.42 ( P<0.05) . There was no statistically significant difference in the number and incidence of postoperative nausea and vomiting, respiratory depression, bradycardia, chills, or somnolence between the two groups (both P>0.05) . Conclusion:Escitalopram can make the hemodynamics of laparoscopic total hysterectomy patients smooth, reduce postoperative pain, improve the quality of awakening, and reduce adverse reactions.

As we all known,lipid metabolism participate in various diseases extensively.Abnormal lipid metabolism may contribute to hepatic adipose infiltration,diabetes,atherosclerosis and so forth.Accordingly,it is urgent to find chemicals that regulate lipid metabolism.A large number of experimental studies have shown that flavonoids in fructus aurantia are the active components of lowering blood lipids.This article will describe the concept,structure and classification of flavonoids.It will also introduce the mechanism of action of flavonoids in lipid metabolism from various diseases such as atherosclerosis,hypertension and type 2 diabetes.

Objective? To investigate the effect and safety of high-flow nasal cannula (HFNC) oxygen therapy for patients after extubation in lung transplantation. Methods? A retrospective study was conducted on 60 hospitalized patients with lung transplant during January 2017 to December 2017 in Wuxi People＇s Hospital. According to the different methods of respiratory support prescribed after extubation, the patients were divided into two groups: observation group (n=28, via HFNC) and control group (n=32, via nasal oxygen tube) . The two groups were compared in terms of the clinical indicators including their blood gas analysis(oxygenation index, lactic acid, partial pressure of carbon dioxide) , viscosity of sputum and comfort, etc. Results? Six hours after extubation and before transferring to other departments, the observation group＇s oxygenation index was(263.70±48.97)and(273.22±43.26)mmHg, which were statistically different from those of the control group with (217.83±77.30)and(229.08±68.64)mmHg respectively (P＜ 0.05). Before transferring to other departments, the partial pressure of carbon dioxide in the observation group was (37.04±8.56)mmHg, lower than the control group with (42.43±6.14)mmHg with a statistical difference (P＜0.05); the viscosity of sputum in the obseration group was lower than the control group with statistical difference (P＜0.05); the patients＇ comfort in the observation group achieved (7.72±1.06)points, higher than the control group＇s (4.39±0.82)points with statistical difference (P＜ 0.05). Conclusions? HFNC oxygen therapy for the patients after extubation in lung transplantation has good effects, is safe and reliable, and can be widely applied in clinical practice.

This study was aimed to investigate the effects of Si-Wu mixture on the secretion of E2 and the expression of CYP19al gene in granulosa cells after cell injury.Ovarian granulosa cells of SD rats were treated with cisplatin (CDDP).And the expression levels of E2 and CYP19a1 were determined by different testing methods.The results showed that the level of E2 induced by radioimmunoassay of the Si-Wu group was significantly higher than that of the CDDP group.Meanwhile,the group which added TGF-β3 protein pathway blocker was lower than others.The results of immunohistochemistry and western blotting showed that the expression level of CYP 19a1 of the Si-Wu group was higher than that of the CDDP group.In the western blotting,the group which added blocker was significantly lower than the non-blocking group.It was concluded that the pharmacological serum of Si-Wu mixture can enhance the level of E2 in CDDP cells through TGF-β3 protein pathway.And the effect is accomplished by the intervention of CYP 19a1.

Objective To investigate the anatomical structure of the first plantar lumbrical muscle in the foot and to measure the relevant data which could provide anatomical basis for repairing thumb and finger defects with the transplantation of toes accompanied with the first lumbrical muscle,and to explore the marphological function of the first lumbrical muscle of the foot.Methods From March,2016 to January,2018,a systematic and detailed dissection of the 50 formalin-fixed feet was performed to observe the exact position of the starting and ending points of the first lumbrical muscle,and a Vernier caloper was used to measure the relevant record data.Results The first lumbrical muscle originates from the medial portion of the flexor digitorum lungus tendon of the second toe,and the length of the ventral muscle was [55.87±8.67(79.30-41.16] mm.There were 2 endpoints in the tendon.The first one was in the medial tubercle of the proximal phalanges.The second one was aponeurosis of the dorsal toe and the tendon was divided into proximal and distal segments with the medial tubercle as the mark point.The length of the proximal segment was [15.34±4.81(5.52-25.18] mm,the width of the proximal segment was [2.31±1.12(3.28-1.21)] mm,the thickness was [0.44±0.14(0.28-0.68)] mm;the length of the distal segment was [11.51±4.06(3.46-14.90)] mm,the width was [6.10±1.44(9.36-3.70)] mm,and the thickness was [0.18±0.09(1.10-0.38)] mm.The length and thickness of the proximal segment was signifantly larger than those of the distal segment (P＜0.05).Conclusion The first lumbrical muscle has the function of maintaining the balance and stability of both the toe and the arch during movement,flexuring the metatarsophalangeal joint,extending the interosseous joint of the extensor phalangeal,adducting the second toe;also the function of preventing the second toe from pronation during foots' movement.

Pediatric medical devices cannot meet the existing medical needs now. In consideration of the difficulty that clinical trials conducted in pediatric population, reasonable extrapolation of adult device data to pediatric population can maximize the use of existing data, as well as reduce unnecessary clinical trials in pediatric populations. It can also help accelerate the development and marketing of pediatric medical devices and ensure the clinical demand of pediatric devices. We analyzed the related guiding principles in America, and explored the extrapolation of medical device data to pediatric population in China from the perspective of medical device technology evaluation, hoping to provide reference in promoting China's data extrapolation.
Child ; China ; Data Collection ; Equipment and Supplies ; Humans ; Technology

Objective:To evaluate the effect of health science popularization in child caregivers by using social media of WeChat and Weibo in China in 2020.Methods:A questionnaire was designed based on the knowledge of children health from January to March 2020, and the public were invited to participate in the survey by visiting the official accounts of WeChat and Weibo of China CDC to analyze the awareness of health related knowledge and the change of daily behaviors in the child caregivers.Results:In the 1 325 child caregivers included in this survey, the awareness rate of chronic disease reexamine was lowest (74.94%), and the awareness rate of quality-oriented education was highest (99.55%). In the 7 questions in the questionnaire, the correct answer rate of the question about the reexamine of chronic disease was <75.00% (below the standard), the correct answer rate to other six questions were all ≥75.00% (above the standard). Logistic regression analysis showed that the education levels of senior high school or technical secondary school, junior college, bachelor's degree, master's degree or above, being worker, business/service personnel, teacher and company employee were the influencing factors for the awareness of the chronic disease related knowledge in child caregivers (all P<0.05). The daily behaviors of child caregivers after acquiring health knowledge were significantly improved (all P<0.001). Conclusions:In the season with high incidence of respiratory diseases, the use of new media platforms, such as WeChat and Weibo, to conduct health education had a good performance, resulting in higher rate of knowledge about healthy parenting and a significant improvement in daily behaviors in child caregivers. The results showed that the health education about the reexamine of chronic diseases in children should be focused on child caregivers with low education level, especially workers, business/service personnel.

Gait deficits and balance disturbances are prevalent clinical features in Parkinson′s disease (PD). There is an increasing body of evidence pointing towards the degeneration of central cholinergic neurons as a crucial factor leading to these disturbances in PD. This paper presents a comprehensive review of the relevant research on the involvement of the central cholinergic system in the mechanisms underlying gait deficits and balance disturbance in PD. The aim is to provide new perspectives and insights for the treatment of gait deficits and balance disturbances in PD.