Objective To investigate the occurrence situation and related influencing factors of obesity among children aged 6-17 years old in Chengde City.Methods The random sampling method was adopted to extract 16 811 children from 10 primary and middle schools in urban and rural areas of this city.The physical examinations were carried out.The incidence rates of over weight and obesity in different ages,sexes and areas were calculated.The risk factors for childhood obesity were preliminarily screened through questionnaire.And the Logistic regression analysis was conducted for further analyzing the risk factors for childhood obesity.Results Among 16 811 sampled children,the overweight rate was 13.09％ and the obesity rate was 12.1％.The overweight rate and obesity rate in boys were higher than those in girls;which had no statistically significant difference between urban and rural areas(P＞0.05);the incidence rates of overweight and obesity in adolescence were higher than those in preadolescence.The multivariate Logistic regression analysis showed that parental overweight,like to drink sugary drinks and watching television for long time might be the risk factors for childhood obesity.Conclusion The overweight rate and obesity rate among children aged 6-17 years old in this city are higher.Reasonable diet,correct life style and increasing exercise can partially reduce the incidence of children obesity.

Objective To investigate the curative effect of modified Yanghe decoction on pulmonary interstitial fibrosis.Methods In this study,62 patients suffering fiom pulmonary interstitial fibrosis were randomly divided into 2 groups with the use of the Random Number Table method.31 cases in the treatment group were treated with modified Yanghe decoction,while 31 cases in the control group were treated with prednisone,40 mg/d (produced by Zhejiang Xianju Pharmaceutical Factory).The dosages of prednisone were gradually reduced a month later.The changes and improvement in symptoms,pulmonary function,chest CT,etc were observed and analyzed after three month.Results The study showed that the total?effective?rates of the treatment group and control group were 83.9％ (26/31) and 58.1％ (18/31) respectively,and the difference had statistical significance (P=0.031,P＜0.05).The integrals of gasping,breathlessness,cough and Velcros Rale of the treatment group before the treatment were (3.1 ± 2.61),(4.1 ± 1.53),(1.38 ± 1.02),(1.56 ±2.34)respectively while those of the control group were (2.83±2.34),(3.90±1.67),(1.28±1.24),(1.61±2.14) respectively.The after-treatment integrals of the treatment group were (1.1 ± 1.06),(1.52± 1.40),(0.36±0.71),(0.65±0.67)respectively while those of the control group were(1.2± 1.33),(2.15±1.31),(0.41±0.70),(0.78 ± 0.30)respectively.Compwered with their symptoms before the treatment,there was obviousimprovement in the symptoms of both groups after the treatment,(P＜0.05),but the difference in these aspects between the two groups had no statistical significance (P＞0.05).Before the treatment,the total lung capacity,vital capacity,diffusion function,arterial oxygen pressure of the treatment group were (69.80±21.7) ％,(73.16±16.38) ％,(51.46± 16.42) ％,(69.70± 10.74) mm Hg (1 mm Hg=0.133 kPa) respectively while those of the control group were(77.52 ± 15.96)％,(74.57 ± 20.73)％,(55.68 ± 17.27)％,(64.86 ± 11.40)mm Hg respectively.After the treatment,the total lung capacity,vital capacity,mass function,arterial oxygen pressure of the treatment group were (82.31±21.65)％,(83.66±17.32)％,(62.34±17.96)％,(83.51±9.37)mm Hg respectively while those of the control group were (85.06± 16.10) ％,(85.72± 20.40) ％,(68.32± 20.16) ％,(79.61 ±9.41)mm Hg respectively.Compwered with their symptoms before the treatment,there was obvious improvement in the symptoms of both groups after the treatment (P＜0.05),but the difference in these aspects between the two groups had no statistical significance (P＞0.05).Conclusion Modified Yanghe decoction can be effectively applied in the prevention and treatment of pulmonary interstitial fibrosis.

OBJECTIVE:To reduce the error rate of inventory in the automated pharmacy of our hospital. METHODS:Activi-ties were designed and implemented by the management method of quality control circles(QCC)-PDCA(Plan,Do,Check and Ac-tion)cycle. The reasons for the errors of inventory in the automated pharmacy were analyzed to investigate and implement counter-measures. Visible and invisible achievements were evaluated,and then standardized processes were made. RESULTS:The errors of inventory in the automated pharmacy mainly included those of drug dispensing,drug shelving,drug return sheet,automatic medi-cine dispensing machine and system. In view of the above reasons,relevant standards were formulated and performed,including the process of warehouse-out check and shelving of drugs,drug dispensing process for the automated pharmacy,the process of sec-ondary check,etc. After the implementation of the activities,the error rate of inventory in the automated pharmacy reduced from 9.17% to 3.77%,which was visible achievement;and the above-mentioned standardized processes could ensure continuous run-ning of PDCA cycle. The practice,sense of responsibility,communication and coordination of management members in PDCA cy-cle namely invisible achievements were improved to some extent. CONCLUSIONS:The management method of QCC-PDCA cycle is feasible in reduction of the error rate of inventory in the automated pharmacy,which can provide a reference for automated phar-macy management.

BACKGROUND:The risk of lower-extremity deep venous thrombosis was high in patients with the osteoporotic hip fracture. The aged age and hip fracture surgery are major risk factors for thrombosis. No study concerned the critical point in time course to the lower extremity deep venous thrombosis in the osteoporotic hip fracture patients.
OBJECTIVE:To analyze the incidence of the perioperative deep venous thrombosis of lower extremity limb at different time slots in senile osteoporotic intertrochanteric fracture patients repaired by proximal femoral nail antirotation fixation.
METHODS:From June 2012 to January 2016, 220 cases diagnosed as osteoporotic intertrochanteric fracture and performed closed reduction and proximal femoral nail antirotation fixation were selected from the Department of Orthopedics, the Affiliated Hospital of Chengde Medical Col ege in China. Based on administered low-molecular-weight heparins (LMWH) or not after trauma, there were two groups:LMWH group and the non-LMWH group. Vascular Doppler ultrasound was conducted at 1, 3 and 5 days after trauma, more than 5 days after trauma, 2, 5, 7 and 14 days after surgery. The total number of cases and incidence of thrombosis were recorded and compared between the two groups. The number of cases and the incidence of new thrombosis were recorded at different time points in both groups. Frequency distribution table was used to analyze the time of suffering thrombosis after injury and surgery.
RESULTS AND CONCLUSION:(1) Among 220 cases, 18 cases in the LMWH group (n=154) affected thrombosis, with an incidence of 12%, and 15 cases in the non-LMWH group (n=66) experienced deep vein thrombosis, with an incidence of 23%. Significant differences in the incidence of thrombosis were detected between the two groups (P=0.041). (2) Peak time of thrombus was 3 days before injury and 1 day after surgery in both groups. (3) Results suggested that the incidence of deep vein thrombosis was high in proximal femoral nail antirotation fixation for intertrochanteric fracture. The peak time of deep vein thrombosis was 3 days before injury and 1 day after surgery. The prevention of deep vein thrombosis should begin from injury. Prophylactic anticoagulation after injury can dramatical y decrease the incidence of deep vein thrombosis.

BACKGROUND: Lower extremity deep venous thrombosis is commonly seen after hip arthroplasty. The time of thrombosis after arthroplasty in senile patients with osteoporotic femoral neck fractures is little reported.OBJECTIVE: To investigate the time of perioperative lower extremity deep venous thrombosis in senile patients with osteoporotic femoral neck fractures undergoing hip arthroplasty. METHODS: The data of 178 patients with femoral neck fractures undergoing hip arthroplasty were analyzed, and were then allocated to anticoagulant and non-anticoagulant groups according to the preoperative use of low-molecular-weight heparins or not. Doppler ultrasonography of both lower extremity arteries was conducted at 1, 3, 5 and 5-7 days after injury, and 2, 5, 7 and 14 days postoperatively to monitor the lower extremity deep venous thrombosis, and the number and incidence of thrombosis in the two groups were recorded at different time points. The time of thrombosis occurred frequently after injury and surgery was determined through drawing the frequency distribution table and line chart.RESULTS AND CONCLUSION: (1) The incidence of thrombosis showed significant difference between anticoagulant (n=6, 8%) and non-anticoagulant (n=22, 21%)) groups (P < 0.05). (2) Thrombosis frequently occurred at 3 days after injury and 1 day postoperatively. (3) These results suggest that the thrombosis in patients with femoral neck fractures frequently occurs at 1-3 days after injury and 1 day after replacement. Additionally, active prevention measures after injury can significantly reduce the incidence of lower extremity venous thrombosis.

Objective:To explore the association of the total gestational weight gain (GWG) and GWG in different trimesters with adverse pregnancy outcomes during the second pregnancy in women with history of gestational diabetes mellitus (GDM).Methods:This retrospective cohort study recruited 441 singleton pregnant women with a history of GDM who gave birth at Beijing Obstetrics and Gynecology Hospital of Capital Medical University from January 2017 to December 2018 as the GDM history group. Another 1 637 singleton pregnant women without a history of GDM who gave birth at the same period were selected through the mechanical sampling method as the control group. Independent sample t-test and Chi-square test were used to compare the differences in general conditions, GWG and perinatal outcomes between the two groups. Based on the Institute of Medicine guidelines for GWG, the subjects were further divided into three subgroups: inadequate GWG, adequate GWG and excessive GWG groups. Multivariate logistic regression analysis was used to compare the pregnancy outcome in women with the same GWG in different periods of pregnancy between the two groups. Results:(1) Women with GDM history had lower GWG before and after oral glucose tolerance test (OGTT) and the whole pregnancy than those without [(6.3±3.3) vs (7.9±3.7) kg, (4.8±2.6) vs (5.6± 2.6) kg, (11.8±4.6) vs (14.4± 4.6) kg; t=8.074, 5.183, 10.277; all P<0.001]. The incidence of GDM, gestational hypertension, and large for gestational age (LGA) in the GDM history group were higher than those in the control group [46.5% (205/441) vs 18.1% (296/1 637), 8.4% (37/441) vs 5.4% (88/1 637), 12.9% (57/441) vs 9.7% (158/1 637); χ2=153.181, 5.583, 4.013; all P<0.05]. (2) Before OGTT: pregnant women with GDM history of different GWG categories had a higher risk of developing GDM [ OR and 95% CI for inadequate, adequate and excessive GWG were 4.02 (2.35-6.88), 3.92 (2.65-5.79) and 3.33 (2.11-5.25), respectively, all P<0.001]. Except for women with inadequate GWG, pregnancy with a history of GDM also had a higher risk of preeclampsia [ OR and 95% CI were 3.62 (1.47-9.23) and 2.22 (1.07-5.57) for adequate and excessive GWG, respectively, both P<0.05]. After OGTT: pregnant women with GDM history of different GWG categories had a higher risk of developing GDM [ OR and 95% CI for inadequate, adequate and excessive GWG were 2.48 (1.60-3.84), 4.63 (2.92-7.35) and 4.22 (2.73-6.51), respectively, all P<0.001]. Pregnant women with a history of GDM with excessive GWG had an increased risk of preeclampsia ( OR=2.46, 95% CI: 1.10-5.51, P<0.05). During pregnancy: pregnant women with GDM history of different GWG categories had a higher risk of developing GDM [ OR and 95% CI were 3.02(2.00-4.59), 4.08(2.76-6.04) and 2.66(1.54-4.59) for inadequate, adequate and excessive GWG, respectively, all P<0.001]. Women with GDM history had an increased risk of large for gestational age (LGA) in those with inadequate GWG and postpartum hemorrhage in those with excessive GWG [ OR and 95% CI were 1.94 (1.09-4.21) and 2.93 (1.31-6.55), respectively, both P<0.05]. Conclusions:The total GWG and GWG in different periods during the second pregnancy in women with a history of GDM are lower than those without, but with a higher risk of adverse outcomes. Even in women with the same range of GWG, GDM history still increases the risk of adverse pregnancy outcomes.

Objective To observe the influence of phentolamine on N terminal B-type natriuretic peptide precursor(NT-proBNP),blood gas analysis,hypersensitive c-reactive protein and plasma D-dimer in patients with chronic cor pulmonale Methods One hundred and one cases patients with chronic cor pulmonale were randomly divided into two groups,51 patients in the treatment group,50 patients in the control group.All patients were treated with normal anti-infection,eliminating phlegm to smooth wheezing antithrombotic for one week,as the same time patients in the treatment group were treated with phentolamine for one week.Through observed the treatment effect of phentolamine to chronic cor pulmonale,the level of NT-proBNP,blood gas analysis,hypersensitive c-reactive protein and plasma D-dimer in patients with chronic cor pulmonale before and after the treatment were analyzed.Results Compared with before treatment,the levels of NT-proBNP,PCO2,hypersensitive c-reactive protein,plasma D dimer were lower than after one week in two groups,while the level of PO2 was higher.Treatment group:NT-proBNP (1 712.76±572.32) ng/L vs.(271.59±163.05) ng/L,t=20.42,P<0.05,PCO2 (66.34±5.81) mmHg vs.(52.58±5.82) mmHg,t=16.46,P<0.05,PO2 (59.28±6.13) mmHg vs.(73.64±6.10) mmHg,t=23.02,P<0.05,hypersensitive c-reactive protein 86.0(28.0) mg/L vs.23.0(12.0) mg/L,Z=-6.22,P<0.05 mg/L,plasma D-dimer (4 953.37±1 654.09) μg/L vs.(1 847.90±838.66) μg/L,t=17.11,P<0.05.Control group:NT-proBNP (1 527.24±658.70) ng/L vs.(612.58±357.59) ng/L,t=14.52,P<0.05,PCO2 (65.41±5.23) mmHg vs.(56.46±5.65) mmHg,t=13.04,P<0.05,PO2(60.57±5.84) mmHg vs.(67.21±5.19) mmHg,t=-10.06,P<0.05,hypersensitive c-reactive protein 79.0(29.0) mg/L vs.43.0(20.0) mg/L,Z=-6.16,,P<0.05,plasma D-dimer (4 408.02±1 682.83) μg/L vs.(2 598.28±1 242.73) μg/L,t=12.15,P<0.05.But the levels of NT-proBNP,PCO2,hypersensitive c-reactive protein and plasma D-dimer reduced significantly,the level of PO2 increased more significantly in treatment group(t(z)=-6.19,-3.39,-7.16,-3.56,5.70,all P<0.05).Conclusion Phentolamine can reduce the level of NT-proBNP,PCO2,hypersensitive c-reactive protein and plasma D-dimer and increased the level of PO2 in patients with chronic cor pulmonale.Phentolamine combined with routine treatment can improve the clinical efficacy of patients with chronic cor pulmonale.

Objective To investigate the correlations of serum levels of NOD-like receptor family CARD domain containing 3(NLRC3)and extracellular matrix protein 1(ECM1)with the develop-ment of acute respiratory distress syndrome(ARDS)in patients with sepsis.Methods A total of 133 patients with sepsis were enrolled in sepsis group,and 80 healthy individuals during the same pe-riod were included in control group.The sepsis group was further divided into ARDS group(52 cases)and non-ARDS group(81 cases)based on the presence or absence of ARDS.Serum levels of NLRC3 and ECM1 expression were measured using enzyme-linked immunosorbent assays(ELISA).Multivari-ate Logistic regression analysis was used to identify factors associated with the development of ARDS in sepsis patients.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of serum NLRC3 and ECM1 levels for ARDS in sepsis patients.Results Compared with the control group,the sepsis group had significantly lower serum NLRC3 level and higher ECM1 level(P＜0.05).The incidence of ARDS in the 133 sepsis patients was 39.10％(52/133).Com-pared with the non-ARDS group,the ARDS group had significantly lower serum NLRC3 level and higher ECM1 level(P＜0.05).Independent risk factors for the development of ARDS in sepsis pa-tients were increased Sequential Organ Failure Assessment(SOFA)score,elevated blood lactate level and increased ECM1 level,while increased NLRC3 level was an independent protective factor(P＜0.05).The area under the curve for the combined prediction of serum NLRC3 and ECM1 expres-sion in sepsis patients with ARDS was 0.887,which was greater than 0.811 and 0.792 predicted by serum NLRC3 and ECM1 expression alone(P＜0.05).Conclusion Decreased serum NLRC3 lev-el and increased ECM1 level are closely associated with the development of ARDS in sepsis patients.The combined assessment of serum NLRC3 and ECM1 level has a high predictive value for ARDS in sepsis patients.

Objective:To investigate the effect of miR-425-5p on glucagon-like peptide-1(GLP-1) secretion in intestinal L cells induced by lipopolysaccharide(LPS), and to explore its mechanism.Methods:GLUTag cells of intestinal L cell line were incubated with LPS to determine the levels of miR-425-5p and GLP-1. Cell viability was determined by MTT assay, and cell apoptosis was detected by flow cytometry. Quantitative real time-PCR and western blot were performed to determine the expressions of miR-425-5p, phosphatase and tensin homology(PTEN), proglucagon, and GLP-1. Activity of Wnt/β-catenin signaling pathway was determined by detecting TOP/FOP ratio. Interaction among miR-425-5p, PTEN, and β-catenin was analyzed using luciferase activity assay and chromatin immunoprecipitation(ChIP)assay.Results:In GLUTag cells, with the elevation of LPS concentration, the expression of miR-425-5p and the apoptosis rate were increased, while the level of active GLP-1 and the cell viability were decreased. MiR-425-5p was involved in the regulation of LPS on GLP-1 secretion and intestinal L cell viability. Inhibition of miR-425-5p reduced the mRNA expression of proglucagon and the TOP/FOP ratio, increased PTEN protein level, and inhibited cell viability. In LPS-treated GLUTag cells, miR-425-5p increased the level of β-catenin by targeting PTEN, and β-catenin acted as a cis-acting element to induce the transcription of proglucagon and promote the secretion of GLP-1.Conclusion:In LPS-induced intestinal L cells, miR-425-5p promotes the expression of GLP-1 by targeting PTEN to modulate β-catenin.

Objective To investigate the correlations of serum levels of NOD-like receptor family CARD domain containing 3(NLRC3)and extracellular matrix protein 1(ECM1)with the develop-ment of acute respiratory distress syndrome(ARDS)in patients with sepsis.Methods A total of 133 patients with sepsis were enrolled in sepsis group,and 80 healthy individuals during the same pe-riod were included in control group.The sepsis group was further divided into ARDS group(52 cases)and non-ARDS group(81 cases)based on the presence or absence of ARDS.Serum levels of NLRC3 and ECM1 expression were measured using enzyme-linked immunosorbent assays(ELISA).Multivari-ate Logistic regression analysis was used to identify factors associated with the development of ARDS in sepsis patients.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of serum NLRC3 and ECM1 levels for ARDS in sepsis patients.Results Compared with the control group,the sepsis group had significantly lower serum NLRC3 level and higher ECM1 level(P＜0.05).The incidence of ARDS in the 133 sepsis patients was 39.10％(52/133).Com-pared with the non-ARDS group,the ARDS group had significantly lower serum NLRC3 level and higher ECM1 level(P＜0.05).Independent risk factors for the development of ARDS in sepsis pa-tients were increased Sequential Organ Failure Assessment(SOFA)score,elevated blood lactate level and increased ECM1 level,while increased NLRC3 level was an independent protective factor(P＜0.05).The area under the curve for the combined prediction of serum NLRC3 and ECM1 expres-sion in sepsis patients with ARDS was 0.887,which was greater than 0.811 and 0.792 predicted by serum NLRC3 and ECM1 expression alone(P＜0.05).Conclusion Decreased serum NLRC3 lev-el and increased ECM1 level are closely associated with the development of ARDS in sepsis patients.The combined assessment of serum NLRC3 and ECM1 level has a high predictive value for ARDS in sepsis patients.