Oral absorption and effect of macromolecules in traditional Chinese medicine: a new perspective and research mode of phase structure / 中国中药杂志

Protein polypeptides and polysaccharides, the indispensable macromolecular active components in traditional Chinese medicine, are widely found in Chinese medicine decoction after the decoction of traditional Chinese medicine. However, through oral administration, these macromolecules are digested by the stomach and intestine and thus fail to be absorbed in prototype. This is inconsistent with the actual clinical efficacy of Chinese medicine decoction. According to modern research, new phase structures and effects of the macromolecules emerge during the decoction of traditional Chinese medicine, but the phase change law caused by the interaction among the components of traditional Chinese medicine and the relationship between phase structure and effect are still unclear. Thus, this study reviewed the oral absorption of macromolecular components of traditional Chinese medicine, analyzed the internal relationship of the form of macromolecules in traditional Chinese medicine with the absorption and effect based on phase structure, and summarized the research mode of oral absorption and effect of macromolecules in traditional Chinese medicine with phase structures as the core, providing new ideas and methods for future research.

Application value of enhanced recovery after surgery in the radical distal gastrectomy / 中国现代普通外科进展

Objective:To evaluate the safety and feasibility of enhanced recovery after surgery (ERAS) in the Radical Distal Gastrectomy.Methods:The clinical data of 52 patients who underwent radica distal gastrectomy surgery from Jan 2016 to Jan 2017 were collected,and divided into the ERAS group and the control group.Results:(1) Operation condition:the operative time,volume of intraoperative blood loss,number of patients with conversion to open surgery showed no statistically significant difference between the 2 groups (P＞0.05).(2)postoperative clinical indexes:time for initial anus exhaust,time for initial liquid diet intake,time for out-of-bed activity,time of urinary catheter removal,duration of hospital stay of patients without complications days in the ERAS group and days in the control group,respectively,have been with statistically significant differences between the 2 groups(P＜0.05).But the time to initial defecation,time of abdominal drainage-tube removal and the number of postoperative complications during hospitalization between the 2 group had no statistically difference(P＞0.05).(3)Postoperative complications:at the first days and the third days after operation,WBC,CRP and IL-6 in ERAS group were lower than thoese in the control group,the differences were statistically significant.Conclusion:The perioperative ERAS program in distal gastrectomy is safe and effective and should be popularized.

Application of enhanced recovery after surgery in total laparoscopic uncut Roux-en-Y gastrojejunostomy / 中国现代普通外科进展

Objective:To evaluate the safety and feasibility of enhanced recovery after surgery (ERAS) in total laparoscopic Uncut Roux-en-Y gastrojejunostomy after distal gastrectomy.Methods:The clinical data of 42 patients who were divided into ERAS group (n=20) and control group (n=22) were collected.Observation indicators included operation condition,postoperative clinical indexes and postoperative serum stress indexes.Measurement data with normal distribution were presented as-x±s and analyzed by T test.Count data were analyzed by the chi-square test.Results:The operative time,volume of intraoperative blood loss and number of patients with conversion to open surgery shown no statistically significant difference between the 2 groups(P＞0.05).Postoperative clinical indexes:time for initial anus exhaust,time for initial liquid diet intake,time for out-of-bed activity,duration of hoSpital stay of patients without complications in the ERAS group were lower than in the control group,with statistically significant differences between the 2 groups (P＜0.05).But the time to initial defecation,time of abdominal drainage-tube removal and the early postoperative complications between the 2 group had no statistically difference(P＞0.05). Postoperative complications:at the first days and the third days after operation,WBC,CRP and I L-6 in ERAS group were lower than in the control group,the differences were statistically significant (P＜0.05).Conclusion:The perioperative ERAS program in total laparoscopic Uncut Roux-en-Y gastrojejunostomy after distal gastrectomy is safe and effective and should be popularized,meanwhile,it can also reduce duration of hospital stay and improve the comfortable degree and satisfaction of patients.

Association between abdominal obesity and blood pressure among 7 to 10 years old Chinese children / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the association between abdominal obesity and blood pressure among 7-10 years old Chinese children.</p><p><b>METHODS</b>A total of 40 495 children aged 7-10 years with complete height, weight, waist circumference and blood pressure data were chosen from the data of 2010 Chinese National Survey on Students Constitution and Health. Based on the "Reference Norms for Screening Overweight and Obesity in Chinese Children and Adolescents" developed by Working Group Obesity in China (WGOC) and the waist to height ratio reference value for children (WHtR ≤ 0.46) , the children were divided into 4 body types (normal weight, simple abdominal obesity, combined obesity and other types). High blood pressure was defined as the systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) higher than the P 95 blood pressure value of 2010 national student of the same gender and age. The prevalence of simple abdominal obesity, combined obesity and high blood pressure were described. Three groups (with 2165 children in each) of children with normal weight, simple abdominal obesity, combined obesity respectively were selected from the chosen ones matched by gender, age (within ± 0.5 years old) and height (within ± 0.3 cm) at the ratio of 1: 1: 1. The value of blood pressure and prevalence of high blood pressure were described.χ(2) test, analysis of variance and multilevel models were used to analyze the relationship between obesity and blood pressure.</p><p><b>RESULTS</b>A total of 40 475 children were selected from the database, including 20 175 boys and 20 320 girls. The prevalence of simple abdominal obesity was 6.36% (2576/40 495), the prevalence of boys and girls was 7.41% (1494/20 175) and 5.32% (1082/20 320) respectively. The prevalence of combined obesity was 16.33% (6611/40 495), the prevalence of boys and girls was 21.30% (4298/20 175) and 11.38% (2313/20 320) respectively. There were statistical differences in the body type distribution of both boys and girls (χ(2) = 869.01, P < 0.01). The prevalence of high blood pressure was 9.62% (3896/40 495), the prevalence of boys (10.05% (2028/20 175)) was higher than girls (9.19% (1868/20 320)) (χ(2) = 8.59, P < 0.01). The value of SBP and DBP among combined obesity group (boys: (103.8 ± 11.3), (64.7 ± 10.1) mm Hg (1 mm Hg = 0.133 kPa); girls: (102.9 ± 12.1), (64.5 ± 10.0) mm Hg) > simple abdominal obesity group (boys: (99.5 ± 11.2), (61.6 ± 9.9) mm Hg; girls: (99.6 ± 11.4), (62.6 ± 9.3) mm Hg)> normal weight group (boys: (97.4 ± 10.8), (60.5 ± 9.4) mm Hg; girls: (97.2 ± 10.8), (60.8 ± 9.4) mm Hg), and the differences were statistical significant (Fboys: 113.22, 62.05; Fgirls: 54.19, 32.31, P < 0.01). According to the results of multilevel model, among boys, compared with the normal weight group, the SBP of combined obesity group and simple abdominal obesity group was 6.0 and 1.8 mm Hg higher respectively (Wald χ(2): 17.55, 204.94, P < 0.01); the DBP was 4.0 and 0.9 mm Hg higher respectively (Wald χ(2): 6.37, 114.05, P < 0.05). Among girls, the SBP was 5.0 and 2.1 mm Hg higher respectively (Wald χ(2):16.47, 92.52, P < 0.01); the DBP was 3.5 and 1.6 mm Hg higher respectively (Wald χ(2): 12.29, 57.52, P < 0.01). Comparing with normal group, the risk of high SBP among boys with simple abdominal obesity was higher (OR = 1.48; 95%CI: 1.06-2.06), and both the boys (SBP: OR = 3.06; 95%CI: 2.28-4.11) ; DBP: OR = 2.72; 95%CI: 1.99-3.72) and girls (SBP: OR = 2.48; 95%CI: 1.75-3.53; DBP: OR = 2.64; 95%CI: 1.82-3.93) in combined obesity group had a higher risk of high SBP and high DBP.</p><p><b>CONCLUSION</b>Simple abdominal obesity is associated with the increasing of blood pressure in children, and combined obesity has a closer ties than simple abdominal obesity.</p>

Association between physical development and spermatorrhea during puberty among boys aged 11 to 15 years in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the association between spermatorrhea and physical development during puberty for boys aged 11 to 15 years old in China.</p><p><b>METHODS</b>The height, weight, chest circumference, waist circumference, hip circumference and the station of spermatorrhea of boys aged 11-15 years old were selected from the data of 2010 National Survey on Students Constitution and Health. Body mass index (BMI) and waist to height ratio were calculated. After 1: 1 random matching in every 0.1 year of age, 6880 boys (3440 with spermatorrhea and 3440 without spermatorrhea) were included in our study. t-test was used to analyze differences in anthropometry measurements between boys with spermatorrhea and boys without spermatorrhea in each age group. Multilevel model was used to analyze the relationship between anthropometry measurements and spermatorrhea.</p><p><b>RESULTS</b>A total of 6880 boys were put in this research. Heights of boys with spermatorrhea aged 11 to 15 years old were (150.96 ± 8.01), (159.46 ± 8.03), (163.76 ± 7.43), (167.03 ± 7.12) and (169.50 ± 6.64) cm, respectively, while heights of boys without spermatorrhea aged 11 to 15 were (147.38 ± 6.54), (153.55 ± 8.68), (160.35 ± 8.66), (164.44 ± 7.98) and (167.98 ± 7.80) cm, respectively. The differences were significant (t values were 3.70, 9.96, 10.76, 8.26, and 3.21 respectively with all P values < 0.01).</p><p><b>RESULTS</b>of multilevel analysis showed that the differences of weight were the largest from 11 to 13 years old, boys with spermatorrhea having a 4.20, 7.23 and 3.93 kg (Waldχ(2) values were 13.11, 70.73 and 72.93 respectively, all P values < 0.01) larger weight than boys without spermatorrhea, respectively. Differences of height were the largest from 14 to 15 years old, boys with spermatorrhea having a 2.81 and 1.99 cm (Waldχ(2) values were 87.80 and 19.54, P < 0.01) larger height than boys without spermatorrhea. The trends of the differences between boys with spermatorrhea and boys without spermatorrhea (β value) with age were parabolic on weight, BMI, height, chest circumference, waist circumference, hip circumference and waist to height ratio. The β values reached maximum at 12 years old, which were 7.23 kg, 1.64 kg/m(2), 5.55 cm, 4.40 cm, 4.63 cm, 4.94 cm, and 0.015, respectively. The β values reached minimum at 15 years old, which were -0.39 kg, -0.56 kg/m(2), 1.99 cm, -0.57 cm, -1.59 cm, -0.42 cm and -0.015, respectively.</p><p><b>CONCLUSION</b>There is an association between spermatorrhea and physical development among boys aged 11 to 15 years in China , which has a parabolic trend with age.</p>

Analysis of influencing factors on physical endurance of Chinese primary and middle school students aged 10 to 17 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the influencing factors on physical endurance among Chinese primary and middle school students aged 10-17.</p><p><b>METHODS</b>Data was used from "2010 National Physical Fitness and Health Surveillance", from which 68 458 primary and middle school students with complete information were selected. Good physical endurance was defined as endurance running time ≤ P 25 of same gender and age, poor physical endurance as ≥ P 75 of same gender and age. Difference of endurance running time in different physical endurance groups was compared; chi-square test, logistic regression and multiple level model were used to analyze influence of region, BMI, diet, exercise and exercise willingness on physical endurance.</p><p><b>RESULTS</b>There were 34 293 (50.0%) students of good physical endurance and 34 219 (50.0%) ones of poor physical endurance in 68 458 subjects. Percentage of good physical endurance was 53.8% (18 285/33 996) in rural students, higher than urban ones (46.3% (15 954/34 462)) (χ(2) = 384.16, P < 0.01). Percentage of good physical endurance was 12.2% (448/3660) in obese students, lower than normal (55.2% (28 183/51 028)), overweight (29.3% (2012/6874)) and emaciated ones (52.1% (3596/6896)) (χ(2) = 3840.08, P < 0.01). Percentage of good physical endurance was 52.5% (25 534/48 679) in students having breakfast everyday, higher than ones never having breakfast or 1-2 times per week (41.3% (3209/7768))(χ(2) = 438.31, P < 0.01). Percentage of good physical endurance was 51.7% (11 580/22 379) in students having milk everyday, slightly higher than ones never or sometimes having milk (49.2% (22 659/46 079)) (χ(2) = 39.84, P < 0.01). Percentage of good physical endurance was 55.3% (18 961/34 314) in students with adequate physical education class, higher than ones with inadequate class (44.7% (15 278/34 144)) (χ(2) = 756.41, P < 0.01). Percentage of good physical endurance was 58.6% (9484/16 195) in students with one hour exercise or more per day, higher than ones with less than one hour exercise (47.4% (24 755/52 263)) (χ(2) = 619.82, P < 0.01). Percentage of good physical endurance was 60.1% (19 287/32 118) in students who were "very willing" to take part in endurance running, higher than "generally willing" ones (45.4% (10 569/23 272)) and "not willing" ones (33.5% (4383/13 068)) (χ(2) = 2909.61, P < 0.01). Multiple level analysis revealed that risk of poor physical endurance was lower in rural students (OR = 0.80, 95%CI: 0.77-0.82) than urban ones. Risk in emaciated students (OR = 1.11, 95%CI: 1.05-1.17), overweight students (OR = 2.69, 95%CI: 2.55-2.85) and obese students (OR = 7.71, 95%CI: 6.97-8.52) was higher than normal ones. Concerning diet, risk of poor physical endurance in students never having breakfast or once to twice per week was highest (OR = 1.20, 95%CI: 1.13-1.26), followed by students having breakfast three to five times per week (OR = 1.13, 95%CI: 1.08-1.18); risk in students having one bag of milk per day was higher (OR = 1.09, 95%CI: 1.02-1.17) than ones having two bags. Concerning exercise, risk of poor physical endurance in students with inadequate physical education class (OR = 1.20, 95%CI: 1.13-1.26) and less than one hour exercise per day (OR = 1.34, 95%CI: 1.29-1.40) was higher than ones with adequate physical education class and one hour exercise or more respectively. Risk of poor physical endurance in students who were "generally willing" (OR = 1.67, 95%CI: 1.61-1.73) and "not willing" (OR = 2.72, 95%CI: 2.60-2.85) to take part in endurance running was higher than "very willing" ones.</p><p><b>CONCLUSION</b>Urban and rural residence, BMI, breakfast, milk, physical education class, exercise time and exercise willingness were related to primary and middle school students'physical endurance.</p>

Association between early menarche and physical fitness among adolescent girls in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the association between early menarche and physical fitness among adolescent girls in China.</p><p><b>METHODS</b>Research material was selected from the data of "2010 National Physical Fitness and Health Survey". Probability unit regression method was used to calculate the age of 10th percentile at menarche and menarche age before the 10th percentile was defined as early menarche(9.0-11.6 years old). A total of 1072 girls with early menarche were selected. Each girl with early menarche was matched with one girl from the same urban or rural locations who hadn't achieved menarche with the age difference less than 0.1 years. A total of 1072 girls without menarche were selected. Indicators of physical fitness included 50 m running, standing broad jump, 50 m×8 shuttle running and sit-ups. Differences of physical fitness between early menarche and without menarche were analyzed using t test stratified by age and urban/rural area. The multilevel models of single dependent variable and multiple dependent variables were used to analyze association between early menarche and physical fitness.</p><p><b>RESULTS</b>A total of 2144 students were put in this research. Among girls (11.0-11.6 years old) in urban areas, 50 m running, standing broad jump and sit-ups was (9.78 ± 0.85) s, (153.81 ± 18.59) cm, and 27.79 ± 10.25, respectively for those with early menarche, while in girls without menarche was (10.01 ± 0.90) s, (149.71 ± 18.72) cm and 26.28 ± 10.11, respectively. There were significant differences between two groups on all above variables (t values were 4.02, 3.43 and 2.31, respectively with all P values <0.01). Among girls in rural, 50 m×8 shuttle-running and sit-ups was (125.22 ± 15.57) s and 24.96 ± 8.97 for those with early menarche, while it was (120.92 ± 13.06) s and 22.96 ± 9.83 for those without menarche. There were significant differences between two groups on both variables(t values were 3.89 and 2.77 with both P values < 0.01). In addition, 50 m×8 shuttle-running in girls (10.0-10.9 years old) with early menarche was (128.52 ± 15.74) s and it was (123.89 ± 13.50) s in girls without menarche. The difference was significant (t = 2.14, P < 0.05). The multilevel analysis showed that 50 m running, standing broad jump and sit-ups in girls with early menarche was 0.12 s, 3.14 cm and 1.11 higher than girls without menarche (Waldχ(2) values were 4.00, 6.22 and 4.07, respectively with all P values < 0.05). But 50 m×8 shuttle-running in girls with early menarche was 1.95 s less than girls without menarche (Waldχ(2) = 3.96, P < 0.05).</p><p><b>CONCLUSION</b>Early menarche may be associated with higher speed fitness, leg power and muscle power and lower physical stamina.</p>

Clinical characteristics and treatment analysis of primary breast lymphoma: 49 cases report / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the morbidity, clinical characteristics, diagnosis, metastasis, treatment and prognosis of primary breast lymphoma (PBL).</p><p><b>METHODS</b>From January 1960 to August 2007, 49 cases with PBL were treated among 22811 cases of breast malignancy and 7337 cases of malignant lymphoma. The clinical data of these 49 patients, included gender, age, pathologic type, breast X ray and B ultrasound examination results, involved lymph nodes and organs, treatment, survival time, were retrospectively analyzed.</p><p><b>RESULTS</b>From 1960 to 2007, the incidence rate of PBL in Tianjin Municipality was 59/10 millions; in details, the incidence rate of PBL for every 10 years was 2/10 millions, 3/10 millions, 0, 13/10 millions and 32/10 millions, respectively. According to circle graph of age, PBL occurred frequently in female aged 30 to 59 years. Most of this group of PBL was non-Hodgkin lymphoma (48 cases). No typical characteristics was found with the examination of breast X ray, B ultrasound and frozen section pathology. Bone marrow (9 cases), lung (7 cases), meninges (4 cases) and ovary (4 cases) were frequently involved organs. The overall 5-year survival rate was 6.1% for the group. The prognosis in patients with radical mastectomy combined chemotherapy was much better than that in patient received super to local mastectomy plus chemotherapy or simple tumor resection plus chemotherapy (5-year survival rates were 21.4%, 0, 0, respectively).</p><p><b>CONCLUSIONS</b>PBL is a kind of rare lymphoma with incidence increasing sharply in the past few decades. The clinical manifestation is atypical. Diagnosis of PBL should adopt histological examination. Radical mastectomy combined chemotherapy could bring better prognosis, but the prognosis is still poor.</p>