Objective: To verify the applicability of the theory of planned behavior(TPB) in the physical exercise behaviors of rural adolescents in Sichuan Province, and to explore the possible influencing factors of physical exercise behaviors, and to provide a theoretical basis for further effective intervention measures. Methods: A total of 2 302 students were selected from grade seven and grade ten of two rural middle schools in Zizhong, Sichuan Province. The survey was conducted with a structured questionnaire. Using TPB as the research framework and basis, the structural equation model was constructed for analysis. Results: Lack of physical exercise was 1 527(66.3%).Physical exercise behavior was statistically different among schools, grades(t=-7.40，-2.90，10.90,P<0.05)， and genders. Based on TPB, the structural equation model was established and corrected to obtain the revised model, and the fitting index GFI=0.93, CFI=0.94, NFI=0.94, TLI=0.93, IFI=0.94,RMSEA=0.07, indicating the model fitted good. Exercise intention directly affected exercise behaviors. The standardized effect was 0.45(95%CI=0.39-0.52). Subjective norms and perceived power were the main two mediators of the relationship between value evaluation and exercise intention. The standardized effect values were 0.66(95%CI=0.57-0.73), 0.23(95%CI=0.16-0.93)(P<0.01). Conclusion There is serious lack of physical exercise in rural adolescents in Sichuan Province. TPB has a good applicability for physical exercise in rural adolescents in Sichuan Province. Subjective norm is the most important factors to promote exercise intentions.

Objective: To observe the disease type and the changes of symptom load during treatment of patients with Ph chromosome/BCR-ABL fusion gene negative myeloproliferative neoplasm (MPN). Methods: A total of 84 patients with MPN diagnosed from May 2017 to January 2019 in People′s Hospital of Longhua District of Shenzhen were selected, and were divided into polycythemia vera (PV) group, essential thrombocyhemia (ET) group, and myelofibrosis (PMF) group according to their subtypes, with 28 cases in each group. The scores of MPN-SAF-TSS were compared among the three groups. Besides, the scores of the scale (myeloproliferative neoplasm symptom assessment form total symptom score, MPN-SAF-TSS) in different treatment periods (at the time of the visit, when the disease progressed, when the disease was stable, when the clinical improvement was made, when the partial remission was completed, at the time of remission and recurrence) were also compared. Results: At the time of initial diagnosis, there were significant differences in the incidences of symptom burdens among the three groups of MPN patients with abdominal fullness (χ²=6.095, P=0.047), abdominal discomfort (χ²=7.342, P=0.025), poor mobility (χ²=13.029, P=0.001), inattention (χ²=6.099, P=0.047), pruritus (χ²=6.956, P=0.031), bone pain (χ²=7.807, P=0.020), fever (χ²=8.000, P=0.018) and weight loss (χ²=27.340, P<0.001). The incidences of poor mobility (85.71%, 24/28), inattention (67.86%, 19/28) and weight loss (82.14%, 23/28) in PMF group were significantly higher than those in PV group [42.86% (12/28), 39.29% (11/28), 35.71% (10/28)] and ET group [46.43% (13/28), 39.29% (11/28), 14.29% (4/28)] (all P<0.05). The incidences of abdominal discomfort (75.00%, 21/28) and bone pain (60.71%, 17/28) in PMF group were higher than those in PV group [39.29% (11/28), 25.00% (7/28)] (both P<0.05). The incidences of abdominal fullness (89.29%, 25/28) and fever (42.86%, 12/28) in PMF group were higher than those in ET group [60.71% (17/28), 10.71% (3/28)] (both P<0.05). The incidence of pruritus in PV group (71.43%, 20/28) was higher than that in ET group (42.86%, 12/28) and PMF group (39.29%, 11/28) (both P<0.05). Symptom load scores of patients with fatigue (χ²=368.594, P<0.001), abdominal fullness (χ²=261.312, P<0.001), abdominal discomfort (χ²=195.629, P<0.001), poor mobility (χ²=217.862, P<0.001), lack of concentration (χ²=280.664, P<0.001), night sweats (χ²=239.650, P<0.001), pruritus (χ²=254.418, P<0.001), bone pain (χ²=180.291, P<0.001), fever (χ²=231.613, P<0.001) and weight loss (χ²=227.831, P<0.001) were significantly different during different therapeutic periods. The fatigue symptom load score was higher when the disease progressed than that at the time of the visit (P<0.05), and the symptom score of abdominal fullness was lower than that at the time of visit (P<0.05). Symptom load scores of weakness and pruritus when the condition was stable was lower than those when the disease progressed (both P<0.05). When the clinical improvement was made, symptom load scores of weakness, abdominal discomfort, inattention, night sweats, weight loss were lower than those when the disease was stable (all P<0.05). Symptom load scores of abdominal fullness, poor mobility, inattention, night sweats and pruritus in partial remission period decreased compared to temporary improvement period (all P<0.05). Compared to the partial remission period, the symptom load scores of weakness, abdominal fullness, night sweats, pruritus, bone pain and weight loss in complete remission period were lower (all P<0.05). At last, symptom load scores of weakness, abdominal fullness, abdominal discomfort, poor mobility, inattention, night sweats, pruritus, bone pain, fever and weight loss in recurrence period were higher than those in complete remission period (all P<0.05). Conclusion There are several differences in the main clinical symptoms among patients with different MPN subtypes, and there are significant changes in the main clinical symptoms as the disease progresses or turns around.

Objective To investigate the prevalence of nutritional risk,undernutrition and nutritional support among elderly inpatients with coronary heart disease in 11 tertiary A hospitals in China.Methods Records of elderly patients under the age of 90 with coronary heart disease were collected between March 2012 and May 2012 from 11 tertiary A hospitals in China following the direction of diagnosis related group of Beijing government.Results A total of 1 279 consecutive cases were recruited with the average age 74 years old (65-89).The total nutritional risk prevalence was 28.14％ (360/1 279).The prevalence of nutritional risk and nutritional risk score ≥ 5 increased with age.The prevalence of nutritional risk (12.88％ vs.30.08％ vs.42.28％) and nutritional risk scored ≥5 (10.86％ vs.18.61％ vs.27.78％)increased with age.Judging from BMI,most patients were overweight or obese (BMI ≥ 24 kg/m2),accounting for 53.0％ of the total,and prevalence of nutritional risk in this subgroup was 15.12％ (96/635).The prevalence of nutritional risk in patients with normal BMI was 34.24％.The prevalence of undernutrition defined as BMI＜ 18.5 kg/m2 was 4.25％ (51/1 279),among which patients with score ≥ 5 account for 64.7％ (33/51).The prevalence of undernutrition defined as nutritional impairment score =3 was 7.58％ (97/1 279).In patients with nutritional risk,57 were administrated nutrition support (16.6％);in patients without nutritional risk,21 received nutrition support,mostly parenteral nutrition (16 cases,76.2％).In patients with nutritional risk [(79.46± 7.19) years vs.(76.40± 6.16) years],there were statistically significant difference between those who received nutrition support and those who did not in terms of age and the ratio of patients with nutritional risk scored≥5 (35.1％ vs.17.1％) (P =0.001,P=0.002).Conclusions The prevalence of nutritional risk in patients with coronary heart disease was high.The prevalence of undernutrition was low.Prevalence of overweight and obese was high,but there was still nutritional risk in this group of patients.The patients who received nutrition support were older and had high nutritional impairment score,but the indication is not rationale.

Objective To investigate the effect of oral nutritional supplementation on the nutritional status and quality of life in patients with gastric cancer after operation.Methods In this prospective,single blind,randomized,controlled clinical study,25 postoperative patients with gastric cancer received neoadjuvant chemotherapy in outpatient clinic were enrolled.All patients received dietary guidance.In the intervention group,in addition to standard diet,oral nutritional supplements with 2 090 kJ/d of Intacted Protein Enteral Nutrition Powder were added,which lasted 90 days.The changes of body mass,body mass index(BMI),hemoglobin,prealbumin,albumin,gastrointestinal function score,and life quality score 30,60,and 90 days after discharge were recorded.Patients on standard diets were used as the control group.Results In the intervention group,the body mass increased by(0.66 ±1.47)kg 60 d after discharge and(-0.90±1.82)kg on 90 d after discharge,which were [60 d:(-5.13±1.79)kg,90 d:(-9.56±2.44)kg] in the control group,and the difference was statistically significant(P=0.027,P=0.015).The BMI of intervention group increased by(0.20 ±0.55)kg/m2 on 60 d and(-0.32±0.55)kg/m2 on 90 d after discharge,which were(-2.06±0.67)kg/m2 on 60d and(-3.21± 0.73)kg/m2 on 90 d in the control group(P=0.014,P=0.003).There was no significant difference in terms of serum albumin,prealbumin and other laboratory indicators.Intestinal functional status and quality of life also showed no significant difference between these two groups.ConclusionOral nutrition supplementation can reduce the body mass loss and improve the nutritional status in patients with gastric cancer during chemotherapy after operation.

Objective Long-chain triacylglycerol (LCT) by three producers,each mixed with the same medium-chain triacylglycerol (MCT),were compared with the brand MCT/LCT in causing focal necrosis of hepatocytes in beagle dogs (a bioequivalence evaluation).Methods 21 beagle dogs (male,0.7-1.5 years old,10-15 kg) were used in this study.According to the sources of the LCT,the animals were divided into Group A (LCT made in China),Group B (LCT made in Japan),Group C (LCT made in Germany),and the control group (the brand 10％ MCT/LCT).Central venous port was placed via the lumber vein of the animals under general anesthesia.After 2 weeks of rehabilitation,MCT/LCT was administered through this port for 28 days at 9 g/ (kg · d) [while the routine dose used clinically was 1 g/ (kg · d)].The laboratory indexes and the pathomorphism of the liver and kidney were studied single blindly.Results Laboratory tests,including liver and kidney function,blood coagulation function and lipid metabolism,did not identify differences among emulsions with different sources of LCT.Liver biopsy at day 28 showed no focal necrosis in Group C and the control group;there was minor damage in Group B;and Group A had obvious liver necrosis.and the pathological findings of other organs are similar.No significant difference was observed in biopsies of other organs.Conclusions Emulsions with different sources of LCT varied in their damage to the liver.Generics with LCT of higher quality were equivalent to the brand MCT/LCT in terms of safety.

Objective To evaluate a relationship between the nutritional risk and nutritional support in elderly hospitalized patients (aged ≥ 65 years) with gastrointestinal cancer,and to analyze the relationship between nutrition support and clinical outcomes.Methods Elderly hospitalized patients with gastrointestinal cancer were recruited from September 2009 to November 2011.Patients were screened using Nutritional Risk Screening 2002 (NRS 2002) on admission.Data were collected on the application of nutrition support,including complication rate,length of hospital stay and medical care costs.Results In 592 recruited patients,the malnutrition rate was 14.0％ (83/592) and the rate of a validated nutrition risk was 43.7％ (259/592).79.2％ of patients with nutritional risk received nutritional support while 62.2％of non-risk patients received nutritional support.The case numbers of paraenteral nutrition (PN),enteral nutrition(EN) and paraenteral nutrition + enteral nutrition(PN + EN) were 141,64 and 49 respectively,with the PN:EN ratio of 2.2 ∶ 1.The rate of postoperative complications,lengths of hospital stay and medical care cost were higher in patients with nutritional risk than without nutritional risk[complications 39.8 ％ (103/259) vs.20.4 ％ (68/333),lengths of hospital stay (17.1±4.8) d vs.(12.6±3.6) d,medical care cost(62 191.5 ±4 251.2) RMB vs.(46 792.3±3 115.4) RMB,x2 =26.55 or t=13.03,50.84 respectively,all P＜ 0.01].The average of the rate of postoperative complication [36.8 ％ (75/205) vs.45.9％ (20/44),x2 =19.38,P＜0.01],length of hospital stay [(15.6±3.5) d vs.(18.1±5.4) d,(12.1±4.8) d vs.(15.6±3.5) d,P＜0.05 or 0.01] and medical care cost[62843.3±3491.7) RMB vs.(68925.1± 4633.2) RMB,(53410.5±1954.3) RMBvs.(59857.3±3221.6) RMB,allP＜0.05 or0.01] were lower or shorter in elderly gastric cancer or colorectal cancer patients with nutritional support than in patients without nutritional support.Conclusions A considerable numbers of elderly hospitalized patients with gastrointestinal cancer are at nutritional risk.There is significant relationship between the nutritional risk and clinical outcome.Nutritional support for elderly hospitalized patients with nutritional risk may improve the clinical outcome.

ObjectiveTo study the feasibility and technique in liver transplantation (LT) in an adult with situs inversus (SI) and reviewed the medical literature on this subject.MethodsA 45-year-old male with complete SI,suffered from progressive hepatic failure secondary to hepatolithiasis,obstructive jaundice,portal hypertension and liver cirrhosis.He underwent liver transplantation in July 2004.His anatomy was studied by preoperative CT scan and three-dimensional liver reconstruction imaging and angiography.LT was performed using the modified piggyback technique.The donor right liver was rotated 45 degree to the left,making the donor left liver pointing to the left paracolic sulcus and the donor right liver was in the recipient hepatic fossa.The donor suprahepatic vena cava was anastomosed end-to-side to the recipient vena cava,and the infrahepatic vena cava was closed by oversewing.ResultThe patient recovered uneventfully.His liver function was stable during a follow-up of 75 months.ConclusionLT in patients with SI is safe and feasible.Exact determination of the anatomy,comprehensive preoperative planning,and good technique in liver transplantation play important roles in LT for patients with SI.

Objective To investigate the diagnosis and treatment of septic shock and multiple organ dysfunction syndrome (MODS) following transrectal ultrasound-guided prostate biopsy (TRUSPB). Methods We reported two cases,45 and 46 years old,of septic shock and MODS after TRUSPB from June 1996 to May 2011.10 cases like these two cases in literatures were acquired (3 cases in Chinese and 7 cases in English) from 1991 to 2011,and the causes of severe infections following transrectal prostate biopsy and its prophylactic procedures were discussed as well. Results The two cases,suffered postoperative septic shock and MODS 16 -40 h after being smoothly performed TRUSPB.One patient died four days after surgery and the other improved after five days antibiotic treatment.All the 12 cases had abrupt onsets and deteriorated rapidly,2 cases died and 1 case was performed amputation due to double lower limb gangrene,resulted in high mortality and morbidity.There are many risk factors,such as repeated puncture (4/12),diabetes (3/12),chronic infections (3/12) and used immune suppression (1/12),et al; blood culture was positive in 9 case and E.coli bacteria was the main bacteria(8/9),besides,half of them were multi-drug resistant (4/8) and other 2 cases were ESBLs ( + ) or 1 case was quinolone-resistant repectively.9 cases recovered after actively controlled infection using carbapenem and other treatment. Conclusions Transrectal ultrasound-guided prostate biopsy could cause serious complications such as septic shock,to which more attentions should be paid.Preoperative use of carbapenem should be recommended for patients with repeating biopsy or other risk factors.

Objective To evaluate the effects of a carbohydrate-electrolyte solution on serum glucose, pancreas islet function and inflammatory response in elderly patients after abdominal operation.Methods It was a prospective, randomized, double-blinded and controlled trial. Totally 40 elderly patients after abdominal operation who met the defined criteria were enrolled. The subjects in study group were administered with 1000 ml carbohydrate-electrolyte solution intravenously in consecutive three days since 1st or 2nd postoperative day. Control group was administered with 1000 ml of 10% glucose on the same method. The changes of serum glucose, insulin, C-peptide and inflammatory response cytokine (IL-6, TNF-α, CRP) were detected before and after injection.Systemic inflammatory response syndrome (SIRS) was observed.Results All the 40 patients completed the study according to the study protocol. The incremental rate of serum glucose was significantly lower in study group than in control group on the 2nd and 3rd day after administration [(4.40±2.58) mmol/L vs. (14.97±3.44) mmol/L, t=2.984, P=0.008; (2.70± 1.55) mmol/L vs. (8.11± 2.60) mmol/L, t= 5.659, P= 0.000]. The changes of insulin and C-peptide of two group were similar before and after operation. The levels of IL-6 and TNF-α were significantly lower in study group than in control group on the 3rd day after administration[IL-6: (21.76±10.40) ng/Lvs. (50.17±35.24) ng/L, t=-2.447, P=0.034; TNF-α:(23.92±14.89) ng/L vs. (51.48±42.81) ng/L, t=-2.268, P=0.043]. In study group, 6 cases experienced SIRS and 4 cases had infective complications, but in control group the numbers were 8 and 6 respectively.Conclusions Appropriate application of carbohydrate-electrolyte solution intravenously has relatively mild effects on serum glucose and inflammatory response cytokine in elderly patients after abdominal operation, it decreases incidence of SIRS and maybe decrease infective complications.

ObjectiveTo investigate the prevalence of nutritional risk and malnutrition among hospitalized elderly abdominal surgical patients with malignant tumors.MethodsTotally 269 elderly patents ( ≥ 65 years) with malignant tumor who were hospitalized in our department of abdominal surgery from December 2009 to November 2010 were consecutively enrolled.Nutritional Risk Screening 2002 ( NRS 2002 ) was performed on the next morning after admission.Body mass index (BMI) lower than 18.5 kg/m2 was considered as malnutrition.Results The NRS 2002 was completed in all the 269 enrolled patients.The overall prevalence of malnutrition was 30.1％ (81/269) ; more specifically,37.5％ (21/56) among geriatric patients ( ≥80 years) and 17.6％ (43/245) among the other age groups (P =0.001 ).The overall rate of nutrition risk was 38.3％ (103/269) ; more specifically,57.1％ (32/56) among the geriatric patients and 29.3％ (72/245) among the other age groups (P ＜0.001 ).The rate of nutrition risk in patients with pancreas cancer was 58.3％,which was higher than other elderly patients; on the contrary,and the rate of nutrition risk in the patients with colorectal cancer was relatively lower.ConclusionThe rates of nutrition risk and malnutrition in hospitalized elderly abdominal surgical patients ( ≥ 65years) with malignant tumor are relatively higher than other age groups,especially among the geriatric patients.