ObjectiveTo review the current epidemiological status and trends of overweight and obesity globally and in China, and to analyze its hazards, causes, and prevention strategies. MethodsRecent global and Chinese studies and reports on obesity epidemiology were retrieved. Data from the latest World Obesity Federation’s reports and authoritative national statistics were comprehensively analyzed. ResultsThe prevalence of overweight and obesity was rising worldwide. About 43% of adults were overweight and 16% of adults were obese globally. There were an estimated 2.5 billion adults with overweight (BMI ≥25 kg/m2), including 0.89 billion with obesity (BMI≥30 kg/m2). The overweight rate in youth aged 5–19 increased from 8% in 1990 to 20% in 2022. In China, over half of adults were overweight or obese, totaling over 402 million and ranking first in the world; the overweight/obesity rate in children and adolescents approached 20%. Gaps between urban and rural obesity had narrowed in China, and males and northern regions had higher rates than females and southern regions. Obesity greatly increased the risk of type 2 diabetes, cardiovascular diseases, and other chronic diseases. ConclusionsBoth globally and in China, obesity has become a serious epidemic challenge. Strengthened prevention and control strategies are urgently needed, including comprehensive treatment based on healthy lifestyle intervention, drugs, endoscopy, weight loss surgery, etc, adoption of new weight management therapies and supportive policies are also needed. Special attention should be paid to preventing childhood obesity to curb the rising trend and reduce the associated health burden.
目的评价胆道镜和十二指肠镜在治疗T管拔除后胆瘘中的应用价值。方法对我院2000年5月至2004年12月期间9例采用胆道镜或十二指肠镜下鼻胆管引流（ENBD）治疗T管拔除后胆瘘患者的资料进行回顾性分析。结果本组病例采用胆道镜和十二指肠镜治疗均获成功，无并发症。结论胆道镜和十二指肠镜治疗T管拔除后胆瘘临床疗效可靠，有推广价值。
Objective To formulate an individualized evidence-based treatment for a patient with severe obesity. Methods According to the PICO (patient intervention comparison outcome) principle, the evidence was collected and critically assessed after the clinical issues were put forwarded. The patient’s preference was also taken into account in the decision making process. Results Nine clinical guidelines, eight systematic reviews or meta-analyses and three randomized controlled trials (RCTs) were included. According to the data from the included studies and patient’s special condition, a reasonable surgical treatment regime was made to reduce the weight, relieve all kinds of complications and improve the life quality which were all regarded as the expected target. After one year’s follow-up, the patient’s weight reduced by 20 kg, and some obesity-related co-morbidities such as sleep apnea syndrome and hyperlipoidemia were also improved significantly. Conclusion The laparoscopic adjustable gastric band is an effective operation for severely obese individuals. This procedure can not only achieve weight loss, but also improve some obesity-related co-morbidities.
目的 观察内给氧治疗重症急性胰腺炎的临床效果。方法 对2005年2月至2009年3月期间收治的55例重症急性胰腺炎患者采用非手术治疗，在给予奥曲肽或施他宁、抗生素及基础性支持治疗的基础上，按入院时间先后分为2组，试验组(n=28)给予注射用内给氧治疗1周，对照组(n=27)未用内给氧。结果 试验组动脉血氧分压在应用内给氧治疗前为(53.8±8.1) mm Hg，治疗后为(87.9±9.5) mm Hg； 血氧饱和度治疗前为（81.1±7.4）%，治疗后为（93.2±6.7）%； 治愈病例中血淀粉酶降至正常的时间，试验组平均为(29.4±7.2) h，对照组平均为(162.1±46.8) h； 死于急性呼吸窘迫综合征者试验组为0（0/28），对照组为14.8%（4/27）; 上述指标差异均有统计学意义（P＜0.05）。结论 内给氧配合基础性治疗对重症急性胰腺炎有较好疗效，实用性较强。
ObjectiveTo explore whether positive end-expiratiory pressure (PEEP) guided by the esophageal balloon manometry is better than the ARDS Network standard of care recommendations during treating traumatic acute respiratory distress syndrome (ARDS) patients with mechanical ventilation. MethodsTwelve traumatic ARDS patients selected from September 2013 to March 2015 in ICU of Xiamen No. 3 Hospital were administrated esophageal balloor catheter and underwent mechanical ventilation with PEEP adjusted according to measurements of esophageal pressure and the ARDS Network standard of care recommendations simultaneously. According to the selection method of PEEP, the patients were divided into two groups:the esophageal pressure guided group and the ARDS Network recommendations guided group (the control group). The changes of peak inspiratory pressure, esophageal pressure, transpulmonary end-expiratory pressure, transpulmonary end-inpiratory pressure, lung compliance at 0 h, 24 h, 48 h, 72 h following different PEEP treatments were observed and compared between two groups of patients. ResultsA mean PEEP in the esophageal pressure guided group of (10.98±4.36)cm H2O was significantly higher than the control group of (7.13±2.21)cm H2O (P<0.01). The transpulmonary end-expiratory pressure was significantly higher in the esophageal pressure guided group (0.71±0.62)cm H2O than the control group (-2.29±3.49) cm H2O. And all of the mean transpulmonary end-expiratory pressure remained above zero in the esophageal pressure guided group, whereas in the control group 73% patients remained negative (P<0.01). ConclusionsEsophageal pressure method adjusts PEEP for traumatic ARDS patients with mechanical ventilation through estimating pleural pressure so as to calculate transpulmonary pressure. It can identify traumatic ARDS patients who would benefit from the high PEEP, adjust PEEP individually and meet patients' need more satisfactorily.
On December 11, 2023, the American Diabetes Association (ADA) promulgated the Standards of Care in Diabetes (2024). For a long time, the ADA promulgated the Standards of Care in Diabetes had been regarded as the international guide in the field of diabetes, which has a great reference value for the diagnosis and treatment of diabetes in various countries. The new standard continues to emphasize the transformation of the diagnosis and treatment model from the glucose reduction to the patients, highlighting the importance of reasonable control of glucose, weight management, and improvement of cardiac and renal prognosis as the comprehensive management of diabetes patients, meanwhile continues to affirm the advantages of new hypoglycemic drugs such as glucagon like peptide-1 receptor agonist and metabolic surgery in the comprehensive management of type 2 diabetes mellitus.
Objective To investigate the curative effect of peritoneal drainage tube fixation with titanium clamp in 210 patients during laparoscopic operations. Methods The clinical data of 210 patients with peritoneal drainage fixation via titanium clamp during laparoscopic operations in this hospital were analyzed retrospectively. Results In 210 patients, drainage tube placement lasted for 5-20 d with an average of 8.5 d. No complications such as drainage tube drifting, position changing or obstructed drainage occurred, and all the patients were successfully extubated. Conclusion During laparoscopic operations, the method that drainage tube fixed with titanium clamp is simple with reliable drainage results, affirmed curative efficacy and obviously decreased operative complications, which is worthy of clinical practice and generalization.