Relationship between high body mass index and irritable bowel syndrome in Chinese adolescents / 临床儿科杂志

ObjectivesTo explore the impact of high body mass index (BMI) on irritable bowel syndrome (IBS) in Chinese adolescents.MethodsThe students were randomly selected from middle school and high school. They completed the epidemiological questionnaire of IBS and had their height, body mass measured.ResultsIn total, 1173 students were recruited, including 700 middle school students and 473 high school students. The incidence of overweight/obesity was 30.52%. The incidence of overweight/obesity was not significantly different between boys (28.40%) and girls (32.65%) (P=0.114), and there was not significantly different between students from middle school (30.57%) and high school (30.44%) (P=0.963). Two hundreds and twenty-one students suffered from IBS and the incidence of IBS was 18.84% with no significant gender difference. The incidence of IBS was significantly higher in students from middle school (13.43%) than those from high school (26.85%) (P<0.001). The incidence of IBS was not statistically significant be-tween overweight/obese students (22.07%) and normal weight students (17.42%) (P=0.061). The distribution of IBS subtypes had no statistical significance between overweight/obese and normal weight students (χ2=0.91,P=0.823). ConclusionsOverweight/obesity and IBS were extremely prevalent in Chinese adolescents, but the correlation be-tween them remains to be confirmed.

Teaching and discussion evidence-based medicine by students of different academic program / 中华医学教育探索杂志

The medical students, Shanghai Jiaotong University School of medical from 5- year,7-year, 8-year to general of academic, received evidence-based medicine (EBM) education. The students' background and attitudes about EBM were different. Teaching EBM should pay attention to the relationship of EBM and basic courses, especially for deferent students. Teaching EBM should transform from imparting basic knowledge to learning skills on their own initiative.

An epidemiologicai investigation of irritable bowel syndrome in Shanghai Songjiang communities / 中华消化杂志

Objective To explore the prevalence,subtype,distribution characteristics and risk factors of IBS met ROME Ⅲ criteria in local adult residents of Shanghai Songjiang area.Methods With multi-stage,stratified cluster random sampling method,from April to May in 2010,residents of45 shanghai Songjiang communities were interviewed by questionnaire survey.IBS diagnosis was based on Rome Ⅲ criteria,and the subtypes were according to Bristol stool scale.Self-rating anxiety scale (SAS),self-rating depression scale (SDS) and Athens insomnia scale (AIS) were also simultaneously finished. Results There were 7648 individuals who completed the survey with qualified questionnaires; the efficient rate was 90％. The sample size accounted about 1.62％ of total population in Shanghai Songjiang area.Total 970 patients were detected,who met the Rome Ⅲ criteria,of those 492 males and 478 females.The adjusted prevalence of IBS was 13.1％,13.8％ in males and 12.7％ in females.The ratio of male to female was 1 ∶ 0.92.There was no significant difference in detection rate between males and females (P＞0.05).The prevalence was highest in the 18 to 29 years age group (18.2％,P=0.000).IBS unsubtyped (IBS-U) was the most common type in patients who met the Rome Ⅲ criteria (45.3 ％),IBS with diarrhea (IBS-D) type was more common in male (27.0％) and IBS with constipation (IBS-C) was more common in female (19.5％).The IBS prevalence of obesity group (x2 =4.046,P=0.044),higher education group (x2=31.210,P=0.000),mental group (x2 =8.409,P =0.015),unmarried group(x2 =26.933,P =0.000) and no abdominal surgery history group(x2 =5.894,P=0.015) was higher than that of control group.The risk of IBS prevalence in those who had the history of gastrointestinal infection,abdominal surgery,taking antibiotics or analgesics increased by 5.105,3.388,2.949 and 2.811 times respectively(P=0.000).Multivariate analysis indicated that the risk of IBS prevalence was increased by 1.69 times if took more spicy food,however high-protein diet was a protective factor (OR=0.900,P=0.000).Anxiety (OR=2.452,P=0.000) and insomnia (OR=1.923,P=0.000) were also risk factors of IBS.Conclusion IBS is a common and frequently occurring disease in Shanghai Songjiang community.The history of gastrointestinal infection,abdominal surgery,taking antibiotics or analgesics,intake of more spicy food,anxiety and insomnia may be risk factors of IBS.

Awareness of diagnostic criteria for irritable bowel syndrome in physicians in Shanghai / 中华全科医师杂志

Objective To investigate physicians' awareness of diagnostic criteria for irritable bowel syndrome (IBS). Methods Questionnaire was used to investigate awareness of diagnostic criteria for IBS among 782 physicians in 34 hospitals in Shanghai during August 2008. Results Overall, 82. 7 percent (647/782) of physicians surveyed thought they knew or partly knew diagnostic criteria for IBS. More than 70. 0 percent of physicians knew Rome criteria, but less than 25.0 percent knew other criteria. Awareness of current Rome criteria, whether mental symptoms included in it, and its time frame differed significantly among physicians in varied specialties (P ＜ 0. 01 ). Gastroenterologists had more knowledge about Rome criteria than other specialists, but most physicians, including gastroenterologists, did not fully understand its applicability. Conclusions Although gastroenterologists knew more about diagnostic criteria for IBS, their knowledge still needed to be perfected and updated. Awareness of diagnostic criteria for IBS was poor in nongastroenterological physicians and general practitioners knew it to certain extent.

Association of sleep quality with irritable bowel syndrome in community / 中华消化杂志

Objective To investigate the association of sleep quality with prevalence of irritable bowel syndrome (IBS) in communities of Shanghai.Methods A survey on prevalence of IBS in communities of Jiangqiao County,Jiading District of Shanghai was conducted using a stratified,randomized cluster-sampling method.A total of 11 569 questionnaires was collected.The IBS was diagnosed according to Rome Ⅲ criteria,and Athens Insomnia Scale (ALS) was used for selfassessment.The relationship between sleep quality and IBS was analyzed.Results The prevalence of insomnia was 21.00% in community groups,33.02% in IBS patients and 18.74% in non-IBS patients.The incidence of insomnia was significant higher in IBS group than non-IBS group (P =0.004,OR = 2.14,95 % CI:1.92- 2.39).Among IBS patients,the incidence of insomnia was higher in females than in males (37.24% vs 28.41%,P = 0.000).A logistic analysis for psychological contributing factors in IBS revealed that insomnia might be one of the risk factors for IBS (OR= 2.11,95% CI:1.89-2.36).Conclusion IBS patients have poor sleep quality,especially in females.

Design of questionnaire on factors for diagnosis of irritable bowel syndrom for physicians / 上海交通大学学报（医学版）

Objective To design a questionnaire on factors that affect diagnosis of irritable bowel syndrome for physicians, and determine the retest reliability. Methods The questionnaire was completed after literature review, and 9 experts were invited to revise the questionnaire. Thirty-four physicians filled the questionnaire for pre-test and did it again for re-test 4 weeks later. Kappa value of each question of the questionnaire was calculated. Results Content validity and face validity were assured by experts. Kappa values were over 0.61 in all items, which achieved substantial level. Conclusion The questionnaire designed has fairly good reliability and validity, and can be used in investigation of irritable bowel syndrome for physicians.

An epidemiologic study of functional dyspepsia in Chinese adolescents / 中华消化杂志

Objective To analyze the clinical presentation of functional dyspepsia in Chinese ado lescents.Methods A stratified,randomized study by cluster sampling was employed,which recruited 51 956 students from high and primary schools in six provinces and two cities.All students were requested to fill in a questionnaire.Functional dyspepsia was diagnosed according to Rome Ⅱ criteria.Results Among 51 956 students,10 174 were diagnosed as functional dyspepsia(accounted for 19.58%).Heart burn,hiccup and air swallowing to terminate hiccup were major symptoms of functional dyspepsia.The upper abdominal distention,epigastric pain,anorexia and insomnia were common in boys than girls with no significance(P＞0.05).The belching,early satiety,fatigue and anxiety were significantly higher in girls than boys.Conclusions Functional dyspepsia is a common disorder among the adolescents.Educa-tion and psychotherapy are important in the treatment of students with functional dyspepsia.

The evaluation of diagnostic criteria for irritable bowel syndrome / 中华消化杂志

Objective To assess the diagnostic value of Manning's criteria, Rome Ⅰ criteria and Rome Ⅱ criteria in Chinese patients of irritable bowel syndrome. Methods 724 subjects were enrolled from the outpatient department of gastroenterology and the physical examination center of Xinhua hospital. Self designed questionnaire, routine physical examination and selective accessory diagnostic procedures were undergone in all subjects including 402 cases of irritable bowel syndrome,134 cases of non ulcer dyspepsia,90 cases of ulcerative colitis and 98 healthy controls. According to Manning criteria, Rome Ⅰcriteria and Rome Ⅱcriteria, the sensitivity, specificity, positive likelihood and negative predictive value(PV), positive likelihood and negative likelihood were calculated separately. Results The sensitivity and specificity of Manning's criteria, Rome Ⅰ criteria and Rome Ⅱcriteria were 96.02% (95%CI:95.06%-100.0%), 77.36% (75.31%-79.41%), 68.41% (66.14%-70.68%) and 47.51% (44.78%-50.23%), 73.29%(70.87%- 75.70 %) 83.23% (81.19%-85.27%),respectively. The positive PV and negative PV were 69.55%, 78.33% , 83.59% and 90.53%, 72.17%, 67.85%, respectively.The positive likelihood and negative likelihood were 1.83 , 2.90 , 4.07 and 0.08, 0.31, 0.38, respectively. Conclusion Irritable bowel syndrome could be positively diagnosed by taking an appropriate history and questionnaires,Rome Ⅱ criteria had higher validity in diagnosis of irritable bowel syndrome.