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Objective:To investigate the correlation of illness uncertainty with anxiety and depression in perioperative patients with early gastric cancer.Methods:A cross-sectional survey was conducted among 107 patients with early gastric cancer who were admitted in Department of Gastroenterology of a Class A tertiary hospital in Beijing from April 2020 to August 2021. The demographic data questionnaire was used for survey, and the psychological status of patients was evaluated with Mishel′s Uncertainties in Illness Scales (MUIS), self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Spearman correlation analysis was used to explore the correlation of disease uncertainty with anxiety and depression in patients with early gastric cancer.Results:The illness uncertainty in patients with early gastric cancer was at a moderate level (93.2±14.0). The total scores on the SAS and SDS were (46.5±9.7) and (47.7±10.2), respectively. And the incidence rate of anxiety and depression was 34.6% (37/107) and 31.8% (34/107) respectively. The illness uncertainty of patients with early gastric cancer was positively correlated with anxiety and depression ( r=0.40,0.31,all P<0.05). Conclusion:Some patients with early gastric cancer have illness uncertainty, anxiety and depression, and the illness uncertainty is related to anxiety and depression.
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Objective:To explore the association between weight change from age 20 to middle age and diabetes risk.Methods:A total of 10 104 residents over 40 years old were recruited in Guangzhou. The final analysis data set is a cohort of 6 272 patients from the REACTION study. Quartile of weight changes from age 20 to middle-age was used as an independent variable to explore its association with newly diagnosed diabetes. Simple and multivariable logistic regression analysis were used to calculate OR and 95% CI. Results:The prevalence of newly diagnosed diabetes in study cohort was 15.7%. Weight changes from age 20 to middle-age was significantly higher in diabetes group( P<0.001). Logistic regression analysis found in general population and overweight people [24.0≤body mass index(BMI)<28.0 kg/m 2], after adjusting for gender, age, educational level, family history of diabetes, drinking, SBP, waist circumference, cholesterol, high-density lipoprotein-cholesterol(HDL-C), TG, ALT, AST, the risk of diabetes increased in line with the magnitude of weight change( P=0.081). While in group of lean, normal and obese adult, no significant association has been found. Conclusion:The risk of diabetes increased with weight change in general population and overweight people, indicating that weight change in adults after age of 20 was positively associated with diabetes. It is suggested the importance of weight management in the prevention of dialetes.
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Objective To explore the effect of the utilization of National Basic Public Health Service (NBPHS) on the regular medication behavior and glycemic control of patients aged 35 and over with type 2 diabetes, and to provide support for the health management practice of type 2 diabetes patients in China. Methods Based on the multi-stage stratified sampling method, a questionnaire survey was conducted in 10 community health service centers or township health centers in Zhejiang Province, Shanxi Province and Chongqing City in China from November to December 2019. The data of socio-demographic characteristics, utilization of NBPHS in the last year, regular medication in the last six months and glycemic control were collected. The effect of NBPHS utilization on the regular medication rate and glycemic control rate of type 2 diabetes patients was analyzed by logistic regression. Sensitivity analysis was carried out using the multilevel logistic method and the total score calculation method for basic public health services in different countries. Results A total of 1 527 patients with type 2 diabetes aged 35 and over were recruited, 41.00% were male, 66.08% were aged 65 years old and above, and 39.64% were ill for 10 years and over. The survey showed that the regular medication rate was 89.26%, the glycemic control rate was 65.23%, and the score on utilization of NBPHS was 11.83±2.246 (range 0-15). With the more utilization of NBPHS, regular medication rate in patients with type 2 diabetes increased (χ2trend=4.816, P2trend=0.080, P>0.05). The multivariate regression analysis showed that secondary school and above (OR=2.20), longer duration of disease (OR5-9 years=1.62, OR10 year and above=3.92) and higher utilization score of NBPHS (ORQ3=2.01) were protective factors for the regular medication. Compared with the local household registration population, the local resident population (OR=0.54) was a risk factor for regular medication. Unmarried or divorced or widowed (OR=0.61) and longer course of disease (OR10 year and above=0.60) were risk factors for satisfactory glycemic control, while increased monthly income per household (OR2000-5000 yuan=1.52, ORMore than 5000 yuan=1.76) was a protective factor for satisfactory glycemic control. Conclusion The utilization of NBPHS has promoted the regular medication rate of patients with type 2 diabetes, and the higher utilization takes better effect. Emphasis should be paid on patients with low education level, non-local household registration, short course of disease, and no partner. At the same time, it is necessary to strengthen the utilization of NBPHS to promote the change of their health awareness and health behavior..
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Objective@#To study the effects of endoscopic submucosal dissection(ESD) on long-term quality of life (QOL) and gastric function of patients with distal early gastric cancer (EGC), compared with those of surgery.@*Methods@#Patients with EGC who received ESD or surgical resection in Peking Union Medical College Hospital over 1 year ago were selected to be followed up. QLQ-C30, SF-36, EQ-5D and dyspeptic symptom rating scale were used to evaluate QOL. Five-hour gastric emptying rate was used to evaluate distal gastric function. Electronic gastroscopy was used to observe whether the anastomotic stoma was stenotic. According to the age at resection, 1 to 1 matching was performed between the distal 1/3 gastric ESD (EP) group and the distal subtotal gastrectomy (SP) group, and then the QOL and gastric function between the two groups were compared.@*Results@#Twenty-five patients were included in group EP and group SP respectively. According to QLQ-C30, the scores of cognitive function were 83.3 (83.3, 83.3) in group EP and 83.3 (83.3, 100.0) in group SP (P=0.056). The proportion of patients with symptoms (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea and financial difficulties) between the two groups were not statistically different. There was no statistical difference in the scores of EQ-5D and SF-36 between the two groups. According to dyspeptic symptom rating scale, 56.0% patients in group EPhad burning sensation, but only 28.0% in group SP had this symptom (P=0.054). 20.0% of patients in group SPreported nausea, while only 4.0% in group EP had this symptom (P=0.084). Gastric emptying results showed that the proportion of patients with abnormal 5-hour gastric emptying rate was 31.8% in group EP, while there was no abnormal emptying in group SP (P=0.003). Gastroscopy results showed that one patient in group EP had pyloric stenosis, but 5-hour gastric emptying rate was normal. All anastomotic stomas in group Sp were unobstructed.@*Conclusion@#ESD and surgical resection for distal EGC show similar long-term effects on QOL of patients. But the long-term gastric emptying function may decrease after distal gastric ESD.
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Objective To study the effects of endoscopic submucosal dissection(ESD) on long-term quality of life ( QOL) and gastric function of patients with distal early gastric cancer ( EGC) , compared with those of surgery. Methods Patients with EGC who received ESD or surgical resection in Peking Union Medical College Hospital over 1 year ago were selected to be followed up. QLQ-C30, SF-36, EQ-5D and dyspeptic symptom rating scale were used to evaluate QOL. Five-hour gastric emptying rate was used to evaluate distal gastric function. Electronic gastroscopy was used to observe whether the anastomotic stoma was stenotic. According to the age at resection, 1 to 1 matching was performed between the distal 1/3 gastric ESD ( EP ) group and the distal subtotal gastrectomy ( SP ) group, and then the QOL and gastric function between the two groups were compared. Results Twenty-five patients were included in group EP and group SP respectively. According to QLQ-C30, the scores of cognitive function were 83. 3 (83. 3, 83. 3) in group EP and 83. 3 (83. 3, 100. 0) in group SP(P=0. 056). The proportion of patients with symptoms (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea and financial difficulties) between the two groups were not statistically different. There was no statistical difference in the scores of EQ-5D and SF-36 between the two groups. According to dyspeptic symptom rating scale, 56. 0％patients in group EPhad burning sensation, but only 28.0％ in group SP had this symptom (P=0.054).20. 0％ of patients in group SP reported nausea, while only 4. 0％ in group EP had this symptom ( P=0. 084) . Gastric emptying results showed that the proportion of patients with abnormal 5-hour gastric emptying rate was 31. 8％ in group EP, while there was no abnormal emptying in group SP(P=0. 003). Gastroscopy results showed that one patient in group EP had pyloric stenosis, but 5-hour gastric emptying rate was normal. All anastomotic stomas in group Sp were unobstructed. Conclusion ESD and surgical resection for distal EGC show similar long-term effects on QOL of patients. But the long-term gastric emptying function may decrease after distal gastric ESD.
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Objective:To evaluate the accuracy of parents ’ perception of whether their child is a picky eater and the specific food category the children avoideating according to the food frequency question-naire.Methods:This research selected 1 663 infants aged 4-36 months receiving non-diary complimen-tary food from maternal, infants, nutrition and growth study (MING Study) in 8 Chinese cities in which a combination of systematic cluster random sampling and purposive sampling was used .The general infor-mation, dietary status and picky eating status were collected through a self-designed questionnaire from the caregiver of the children .According to the parents ’ perception , the children were classified into picky/non-picky groups or avoid/non-avoid to a specific food category groups .Mann-Whitney U test was used to compare between the groups .Results: The reported percentage of picky eaters increased from 7.37%in 4-6 months old infants to 36.20%in 25-36 months old infants .Most picky infants in 4-6 months and 7-12 months old infants avoided eating dairy food ( 25% and 24%); while most picky toddlers aged 13-24 months and 25-36 months avoided eating vegetables (26.92% and 47.46%). The infants aged 4-6 months and 7-12 months who were perceived as picky by their parents took more kinds of food (8 and 19.5 kinds) than those who were not (6 and 18 kinds), while the picky toddlers aged 13-24 months and 25-36 months took fewer kinds of food (28.5 and 34 kinds for picky eaters, 31 and 37 kinds for non-picky eaters ) .The parents of infants aged 4-6 months judged correctly in every category of food without any statistical significance;the parents of 7-12 months old infants judged cor-rectly only in dairy food and eggs with statistical significance;those of 13-24 months old infants judged correctly in every food category except for vegetables with statistically significant difference in the category of eggs;those of 25-36 months old toddlers misjudged in dairy , beans and grains with no statistically significant difference in every category .Conclusion: Parents tend to misjudge their children ’ s picky eating behavior before the first 12 months of the child , and tend to make a more accurate perception after the 12th month.
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<p><b>BACKGROUND</b>Infancy is a critical period of growth and physiological development, in which breast milk is the best source of nutrients. Compared to western countries, research on breast milk of Chinese population are limited. Thus, it is necessary to measure breast milk energy and macronutrient concentrations of healthy urban Chinese mothers at different lactation stages, to expand the database of milk composition of Chinese population, and to examine whether dietary or other maternal factors can affect the levels of macronutrients in breast milk.</p><p><b>METHODS</b>Breast milk of full expression of one side breast from 436 urban Chinese lactating mothers at 5-11 days, 12-30 days, 31-60 days, 61-120 days, and 121-240 days postpartum was obtained at 9:00 a.m. to 11:00 a.m. Total energy, lactose, protein, and fat contents were measured. 24-hour dietary recall was surveyed, and maternal nutrient intakes were analyzed.</p><p><b>RESULTS</b>Milk composition changed over the course of lactation and large individual variations were documented. The concentrations were 61.3 kcal/dl for total energy, 7.1 g/dl for lactose, 0.9 g/dl for protein, and 3.4 g/dl for fat in mature milk. Stage of lactation was a strong factor affecting milk composition. Minimal evidence was found for associations between maternal current dietary intake and milk macronutrient concentration, consistently with prior research. Maternal body mass index (BMI) was positively associated with milk fat content, to a greater extent than did dietary intake. All other maternal characteristics were not significant for milk composition.</p><p><b>CONCLUSION</b>These findings suggest that milk composition is generally weakly associated with maternal factors except for stage of lactation, and is likely to be more susceptible to long-term maternal nutritional status than short-term dietary fluctuation.</p>