Differences in nutrient and energy contents of commonly consumed dishes prepared in restaurants v. at home in Hunan Province, China.

OBJECTIVE: Eating away from home is associated with poor diet quality, in part due to less healthy food choices and larger portions. However, few studies account for the potential additional contribution of differences in food composition between restaurant- and home-prepared dishes. The present study aimed to investigate differences in nutrients of dishes prepared in restaurants v. at home. DESIGN: Eight commonly consumed dishes were collected in twenty of each of the following types of locations: small and large restaurants, and urban and rural households. In addition, two fast-food items were collected from ten KFC, McDonald's and food stalls. Five samples per dish were randomly pooled from every location. Nutrients were analysed and energy was calculated in composite samples. Differences in nutrients of dishes by preparation location were determined. SETTING: Hunan Province, China. SUBJECTS: Na, K, protein, total fat, fatty acids, carbohydrate and energy in dishes. RESULTS: On average, both the absolute and relative fat contents, SFA and Na:K ratio were higher in dishes prepared in restaurants than households (P < 0·05). Protein was 15 % higher in animal food-based dishes prepared in households than restaurants (P<0·05). Quantile regression models found that, at the 90th quantile, restaurant preparation was consistently negatively associated with protein and positively associated with the percentage of energy from fat in all dishes. Moreover, restaurant preparation also positively influenced the SFA content in dishes, except at the highest quantiles. CONCLUSIONS: These findings suggest that compared with home preparation, dishes prepared in restaurants in China may differ in concentrations of total fat, SFA, protein and Na:K ratio, which may further contribute, beyond food choices, to less healthy nutrient intakes linked to eating away from home.

Recent urbanization in China is correlated with a Westernized microbiome encoding increased virulence and antibiotic resistance genes.

BACKGROUND: Urbanization is associated with an increased risk for a number of diseases, including obesity, diabetes, and cancer, which all also show associations with the microbiome. While microbial community composition has been shown to vary across continents and in traditional versus Westernized societies, few studies have examined urban-rural differences in neighboring communities within a single country undergoing rapid urbanization. In this study, we compared the gut microbiome, plasma metabolome, dietary habits, and health biomarkers of rural and urban people from a single Chinese province. RESULTS: We identified significant differences in the microbiota and microbiota-related plasma metabolites in rural versus recently urban subjects from the Hunan province of China. Microbes with higher relative abundance in Chinese urban samples have been associated with disease in other studies and were substantially more prevalent in the Human Microbiome Project cohort of American subjects. Furthermore, using whole metagenome sequencing, we found that urbanization was associated with a loss of microbial diversity and changes in the relative abundances of Viruses, Archaea, and Bacteria. Gene diversity, however, increased with urbanization, along with the proportion of reads associated with antibiotic resistance and virulence, which were strongly correlated with the presence of Escherichia and Shigella. CONCLUSIONS: Our data suggest that urbanization has produced convergent evolution of the gut microbial composition in American and urban Chinese populations, resulting in similar compositional patterns of abundant microbes through similar lifestyles on different continents, including a loss of potentially beneficial bacteria and an increase in potentially harmful genes via increased relative abundance of Escherichia and Shigella.

[Study on developing a Brief Version of Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB-SF)].

OBJECTIVE: To develop a brief version scale with good validity and reliability to evaluate self-management knowledge, attitude and behavior (KAB) of diabetes patients in a shorter time. METHODS: 20 authority experts who specialized in the field of diabetes clinical and non-communicable disease self-management, and familiar with the relevant content of diabetes self-management were selected. Face to face and Email consultation methods were applied in two rounds delphi expert consultations to choose items from the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB, total scale, 98 items). In the first round of expert consultation, experts were asked to select the core items from every dimension and score the extent of familiarity and basis of judgment. In the second round of expert consultation, the significance of the core items which were selected by experts in first round, were graded. The items which entered into the brief scale were determined by harmonious condition of expert opinions. RESULTS: Two rounds of consultation reclaimed 16 and 15 responses respectively, Positive coefficients of experts were 80% and 94% respectively, and both authoritative coefficients were 0.90. In the first round of consultation, experts selected 44.3 ± 6.2 items on average, 42 items were selected according to the integrity of the scale for measuring dimension and content at last. In the second round of consultation, experts thought that the 42 items could measure the important contents of each dimension comprehensive and representative, the item importance scores of knowledge, attitude, and behavior subscale were 8.42 ± 1.17, 8.61 ± 1.24, 8.61 ± 1.02 respectively, and the coordination coefficients of the three subscale were 0.36, 0.20, 0.49 (χ(2) were 89.74, 11.13, 96.03, P<0.05). The total coordination coefficient was 0.38 (χ(2) =199.36, P<0.001), which indicated the concentration of experts(')opinion was acceptable, showed the brief scale with good face validity and content validity. CONCLUSION: The brief scale could evaluate Diabetes Self-management KAB Scale rapidly and relatively comprehensive in groups or individuals diabetes with good face validity and content validity.

[Submental island pedicled flap combination with bio-membrane for reconstructing the piercing palate defects].

OBJECTIVE: To evaluate the clinical outcomes of submental island pedicled flap (SIPF) combination with bio-membrane in reconstructing palate defects after maxillofacial or palatal neoplasm resection. METHODS: There were 12 patients with squamous cell carcinoma and one patient with adenoid cystic carcinoma. The clinical stages of tumours were II in two patients, III in four patients, IV in six patients (UICC 2002), and one patient with adenoid cystic carcinoma no staged. SIPFs were designed and created, and the tissue sides of the SIPFs were covered with bio-membrane to reconstruct the oral and the nasal sides of the defects respectively. Speech and swallowing functions and opening mouth were evaluated 6 months postoperatively. RESULTS: All flaps survived and no serious complications occurred. Ten patients achieved normal speech, two had intelligible speech, and one was with slurred speech; Nine patients resumed a solid diet, three with a soft diet, and one on a liquid diet. Eight patients recovered normal mouth opening, four emerged minor limitation of mouth opening, and one had serious limitation of mouth opening. CONCLUSIONS: SIPF combined with bio-membrane is a safe, simple, and reliable method for reconstruction of piercing palate defect following neoplasm ablation, with satisfactory oral functions.

[Dietary patterns of urban residents from 1982 to 2012 in Hunan].

OBJECTIVE: To determine the change in the dietary patterns of Hunan urban residents from 1982 to 2012. METHODS: A 24 hour dietary recall method was used for 3 consecutive days to collect information on food intake, and the condiment intake was collected by weighting method. RESULTS: Rice products and potato consumption were 449.0 g per person per day and 44.0 g per person per day in 1982, and dropped to 150.0 g per person per day and 9.0 g per person per day in 2012. In 2012, vegetable (277.1 g per person per day), fruits (47.8 g per person per day), milk and dairy products (16.6 g per person per day) consumption were still insufficient. Fat (59.3 g per person per day) and salt (10.1 g per person per day) consumption was still high. CONCLUSIONS: : The dietary quality of urban residents in Hunan has been greatly improved, but is still seriously imbalanced. To consume more fruits, milk and dairy products and reduce fat and salt intake are very important.

[Clinical research on the simultaneous surgical treatment of craniomaxillofacial fracture combined with other injuries].

OBJECTIVE: This study aimed to compare the treatment effects of simultaneous surgical treatment and stage operation for patients with craniomaxillofacial fracture combined with other injuries. METHODS: Fifty patients with maxillofacial fractures combined with other injuries were chosen and divided into simultaneous (28 patients) and staging (22 patients) operation groups. In simultaneous operation group, maxillofacial fracture reduction, internal fixation, and other parts of the surgery were simultaneously operated by relevant departments jointly. In the staging operation group, maxillofacial fracture reduction and internal fixation were performed after treatment of other injuries. Data on the treatment efficacy and associated injuries of the two groups were statistically analyzed. RESULTS: In the simultaneous operation group, 26 patients had good occluding relation, the maximum mouth opening was (34.5 +/- 3.7) mm, the symmetry and shape of hard tissues recovered well, and the bone plate of one patient was removed because of internal fixation infection. In the staging operation group, 14 patients had good occluding relation, the maximum mouth opening was (28.5 +/- 3.5) mm, the symmetry and shape of hard tissues poorly recovered, and the bone plates of 5 patients were removed because of internal fixation infection. Statistical significance was determined among occluding relation, maximum mouth opening, postoperative complications, and length of stay of the two groups (P< 0.05). Treatment of the simultaneous operation group was more effective than that of the staging operation group. CONCLUSION: When a patient's condition is relatively stable, simultaneous surgical treatment of multiple specialties should be conducted to treat craniomaxillofacial fracture combined with other injuries.

[Submental island flap for repair of oral defects after radical resection of early-stage oral squamous cell carcinoma].

OBJECTIVE: To evaluate the effectiveness of the submental island flap for repair of oral defects after radical resection of early-stage oral squamous cell carcinoma (OSCC). METHODS: Between February 2010 and August 2011, 15 cases of early-stage OSCC were treated. Of 15 cases, 9 were male and 6 were female, aged from 48 to 71 years (mean, 63 years). The disease duration was 28-73 days (mean, 35 days). Primary lesions included tongue (3 cases), buccal mucosa (8 cases), retromolar area (2 cases), and floor of mouth mucosa (2 cases). According to TNM classification of International Union Against Cancer (UICC, 2002) of oral cancer and oropharyngeal cancer, 2 cases were classified as T1N0M0 and 13 cases as T2N0M0. The results of the pathologic type were high differentiated squamous cell carcinoma in 11 cases and moderately differentiated squamous cell carcinoma in 4 cases. The defect after resection of the lesion ranged from 5 cm x 3 cm to 8 cm x 6 cm. All the cases underwent radical resection of the primary lesion and immediate reconstruction with submental island flap except 1 case with radial forearm free flap because of no definite venous drainage. The sizes of the submental island flap varied from 6 cm x 4 cm to 9 cm x 6 cm. RESULTS: Operation time ranged from 4 hours and 30 minutes to 7 hours and 10 minutes (mean, 5 hours and 53 minutes) in 14 cases undergoing repair with submental island flap. All the flaps survived completely in 13 cases except 1 case having superficial necrosis of the flap, which was cured after conservative treatment. Temporary marginal mandibular nerve palsy occurred in 1 case, and was cured after 3 months; submandibular effusion was observed in 3 cases, and was cured after expectant treatment. The follow-up period ranged from 8 to 15 months (mean, 10.5 months) in 14 cases undergoing repair with submental island flap. Hair growth was seen on the flap and became sparse after 3 months in 2 male cases. The appearance of the face, opening mouth, swallowing, and speech were recovered well in 14 cases, and the donor site had no obvious scar. The follow-up period was 13 months in 1 case undergoing repair with radical free forearm flap, and the appearance and function were recovered well. No local recurrence was found during follow-up. CONCLUSION: The submental island flap has reliable blood supply, and could be harvested simply and rapidly. It can be used to repair oral defects in patients with early-stage OSCC after radical resection.

[Analysis on the changing trend of mortality rate and spectrum regarding causes of death in the last recent 30 years in Hunan province].

OBJECTIVE: To investigate the changing trend of mortality and the spectrum regarding causes of death in the population of Hunan, and to analyze the health-related major diseases. METHODS: With retrospective study method, a sample survey on causes of death and the related information was carried out from 2004 to 2005 among the residents in Hunan province. Results were compared with the data from a retrospective survey on causes of death in Hunan during 1973-1975 and 1990-1992, respectively. RESULTS: The crude mortality rates and the standardized mortality ratios (SMR) of the residents in Hunan were 901.59/100 000 and 865.14/100 000 during the period of 1973-1975 while 588.64/100 000 and 537.42/100 000 during the period of 1990-1992, and 608.27/100 000 and 413.67/100 000 during the period of 2004-2005, respectively. During the past 30 years, the SMR of the residents in Hunan decreased by 52.18% and the descending range from the rural areas was more than that of the urban areas, and higher in females than in males. The death proportion of infectious diseases, maternal and perinatal diseases, nutritional deficiencies decreased significantly (P<0.01), but the death proportion of chronic non-communicable diseases increased significantly (P<0.01). The changing ranges of the former two proportions were both larger in the rural areas than those in the urban areas. The highest proportions of deaths due to injury and poisoning during the past 30 years were both seen in the 5 year olds, followed by the age groups of 25 year olds (P<0.01). During the period of 2004-2005, the death proportion of all the infectious diseases, maternal/perinatal diseases and nutritional deficiencies was 8.01% altogether, and those of chronic non-communicable diseases, injury and poisoning were 80.66% and 11.33%, respectively. During the past 30 years, the SMR of the three kinds of diseases all significantly decreased, more significantly seen in infectious diseases, maternal and perinatal diseases, and nutritional deficiencies but less in chronic non-communicable diseases. Among the death cases of chronic non-communicable diseases, the SMR of cerebrovascular disease, malignant tumor, and heart disease showed an increasing tendency and the sequences of them had been advanced to the first, the second, and the fourth in the death ranking during the period of 2004-2005, respectively. CONCLUSION: The SMRs of the residents in the urban and rural areas from Hunan province showed a declining tendency. Cardiovascular, cerebrovascular diseases and malignant tumors had become the important diseases affecting the health of the people, while injury and poisoning had otherwise topped the causes of death among children and adolescents in Hunan province.

[Development and application of a three-dimensional craniomaxillofacial measurement instrument].

OBJECTIVE: To evaluate the clinical application effect of a three-dimensional craniomaxillofacial measurement instrument. METHODS: A three-dimensional craniomaxillofacial measurement instrument was developed. Twelve patients of unilateral fracture of zygoma complex were treated with the help of the three-dimensional craniomaxillofacial measurement instrument. RESULTS: The therapeutic effects of twelve patients were satisfactory with the three-dimensional craniomaxillofacial measurement instrument. No complication occurred, such as infection, injury of nerves and veins. CONCLUSION: Three-dimensional craniomaxillofacial measurement instrument can exactly measure craniomaxillofacial hard tissue, and has adjuvant effect to restore and fix the fracture of unilateral zygoma complex.