Time trends and disparities of obesity and related national policies and programs in Nepal:a systematic review

Objective Overweight and obesity prevalence has increased in low-income countries.This study systematically reviewed the obesity trend,disparities,and prevention and control efforts in Nepal.Methods We searched PubMed and Google Scholar for articles and reports published between January 1,2004 and December 31,2022.Additional information on National policies and programs related to obesity prevention was retrieved from governmental websites and consultation with relevant experts.Overweight and obesity were defined using the World Health Organization body mass index cut points.Thirty-two studies and reports were included.Results Overall,overweight and obesity rates increased in all groups in Nepal although nationally representative data remained limited.The combined overweight and obesity(OW/OB)and obesity rates in women aged 15-49 years increased from 8.5%to 22.2%and from 0.9%to 5.1%between 2006 and 2016,respectively.OW/OB and obesity rates in men were 17.1%and 2.5%based on data from the 2016 Demographic and Health Survey.OW/OB rate in under-five children increased from 0.6%to 2.8%between 2006 and 2016.Obesity rates for school-age(5-9 years)boys and girls in 2016 were 2.4%and 2.8%,respectively,and were 1.1%and 1.4%for male and female adolescents aged 10-19 years,respectively.OW/OB prevalence was much higher among women,residents in urban areas and central provinces,and in higher socioeconomic status groups.Projected prevalence of OW/OB and obesity for 2030 in adults aged 15-49 was 44.7%and 8.3%,respectively,while it was 2.2%for OW/OB in preschool children.Policies and direct interventions that specifically focused on obesity prevention and control are limited.Conclusions OW/OB prevalence in Nepal has increased during the past 1.8 decades,disproportionately affecting population groups.Existing interventions mostly focused on undernutrition with some indirect implications for obesity prevention.In the future,Nepal needs to develop population-based programs for obesity prevention.

Effects of dezocine on postoperative stress response and immune function in patients with breast cancer

Objective: To investigate the effects of dezocine on postoperative stress response and immune function in patients with breast cancer. Methods: According to random data table method, a total of 80 patients who were scheduled for breast cancer radical surgery from September 2016 to May 2017 were divided into observation group and the control group, 40 cases in each group. The observation group gave intravenous injection of dezocine as an advanced analgesia 15 min before anesthesia induction, the control group given the same amount of sodium chloride injection. The levels of serum inflammatory factors and immune function were measured and compared between the two groups before and after operation. Results: The levels of angiotensin Ⅱ, renin, cortisol, aldosterone, CD3+, CD4+, CD8+and CD4+/CD8+ in the two groups before treatment were not statistically significant. The levels of angiotensin Ⅱ, renin, cortisol, aldosterone in the two groups were increased at first and then decreased, which were significantly higher than those in the same group before operation at 1 d and 3 d;and the levels of angiotensin Ⅱ, renin, cortisol, aldosterone in the observation group were significantly lower than those in the control group after 1 d and 3 d, the difference was statistically significant. The levels of serum CD3+, CD4+ and CD4+/CD8+ in the two groups were decreased at first and then increased, which were significantly lower than those in the same group before operation at 1 d and 3 d;and the observation group levels were significantly higher than those in the control group after 1 d and 3 d, the above indicators were compared with the difference was statistically significant. The levels of serum CD8+ in the two groups were increased at first and decreased subquently, which were significantly higher than those in the same group before operation at 1 d and 3 d and the observation group levels were significantly lower than those in the control group after 1 d and 3 d, the above indicators were compared with the difference was statistically significant. The above indicators have restore to preoperative levels after 5 d. Conclusion: Dezocine can reduce the stress response in patients with perioperative breast cancer, improve the immune function of patients, which has important clinical value, so it is worth promoting.

Effects of dexmedetomidine on inflammatory response and oxidative stress in laparoscopic hysterectomy patients

Objective: To investigate the effect of dexmedetomidine on inflammatory response and oxidative stress in patients with laparoscopic total hysterectomy. Methods: Ninety patients with laparoscopic hysterectomy under general anesthesia were selected in our hospital from January 2015 to December 2016, and randomly divided into control group and observation group, Each group of 45 cases. The observation group was given dexmedetomidine, intravenous pump injection, The control group was given the same amount of saline in the same manner, followed by anesthesia induction. The hemodynamics, inflammatory factors and oxidative stress were monitored before anesthesia (T0), 30 min after the end of pneumoperitoneum (T1), after operation (T2) and at the end of 24 h (T3). Results: Compared with T0, T1, T2 and T3, the observation group of patients with MAP and HR levels were no significant difference;T3, the control group MAP and HR levels were not significantly different;T1 and T2, MAP and HR levels in the control group were significantly increased, And significantly higher than the observation group;Compared with T0, the levels of CRP, TNF-α and IL-1β in patients were significantly increased in T1, T2 and T3, but the levels of CRP, TNF-α and IL-1β in the observation group were significantly lower than those in the control group;Compared with T0, both groups of patients with H2O2 and MDA levels were significantly increased, TAS levels were significantly reduced, the difference was statistically significant, However, the levels of H2O2 and MDA in the observation group were significantly lower than those in the control group, the level of TAS was significantly higher than the control group. Conclusion:Laparoscopic hysterectomy increases the inflammatory response and oxidative stress in patients, while the use of dexmedetomidine can maintain hemodynamic stability in a certain extent, reduce the inflammatory response and reduce oxidative stress injury;it is worth of further clinical application.

Surgical management of newborns with combined tracheoesophageal fistula, esophageal atresia, and duodenal obstruction

To the Editor: The incidence of esophageal atresia (EA) along with tracheoesophageal fistula (TEF) is approximately 1/3000 in newborns.[1] A large population study revealed that 46% of patients with TEF/EA had at least one of the other vertebral, anal, cardiac, tracheal, esophageal, renal, and limb (VACTERL) malformations.[2] Duodenal obstruction has an incidence of 1/7000 live births and can be caused by duodenal atresia (DA) or annular pancreas (AP).[3] AP is an uncommon congenital anomaly, and duodenal obstruction most commonly presents in the infancy or early childhood of patients.[4] The incidence of DA combined with EA varies between 3% and 6%,[5] and DA combined with EA is often associated with significant morbidity and mortality.[6]

Sperm cryopreservation in the human sperm bank:11-year results of the Chinese mainland sperm banking network

To the Editor:Montegazza in 1866 was the first to suggest banks for frozen human semen.[1]In 1981,China's first human sperm bank was successfully established at the CITIC Xiangya Hospital.During the previous four decades,from 1981 to 2020,there were 27 human sperm banks in Chinese mainland.Human sperm banks provide cryopreservation of spermatozoa services for males needing to preserve fertility for an extended period in the Chinese mainland.

Treatment of diabetes with encapsulated pig islets: an update on current developments

The potential use of al ogeneic islet transplantation in curing type 1 diabetes mel itus has been adequately demonstrated, but its large-scale application is limited by the short supply of donor islets and the need for sustained and heavy immunosuppressive therapy. Encapsulation of pig islets was therefore suggested with a view to providing a possible alternative source of islet grafts and avoiding chronic immunosuppression and associated adverse or toxic effects. Nevertheless, several vital elements should be taken into account before this therapy becomes a clinical reality, including cell sources, encapsulation approaches, and implantation sites. This paper provides a comprehensive review of xenotransplantation of encapsulated pig islets for the treatment of type 1 diabetes mel itus, including current re-search findings and suggestions for future studies.

Severe hepatoxicity caused by aspirin overdose： a case report

We report here the rare case of a 61-year-old man with multiple organ dysfunction caused by an aspirin overdose （4 g orally）. The patient presented with a fever that reached 39.2 ℃, a peptic ulcer, and massive upper gastrointestinal bleeding. His blood test results were as follows： white blood cell count, 1.8 × 10^9/L; absolute lymphocytes, 0.4 × 10^9/L; absolute neutrophils, 1.2× 10^9/L; and electrolyte disturbances. A computed tomography （CT） scan showed evidence of bilateral inferior pulmonary infection and acute pancreatitis. Thick dark bile with visible floccule was drawn via a percutaneous transhepatic cholangiodrainage （PTCD）. Klebsiella pneumoniae was detected in microbiological bile tests. Two years later, the patient died of chronic liver failure.

CDC48B facilitates the intercellular trafficking of SHORT-ROOT during radial patterning in roots

CELL DIVISION CONTROL PROTEIN48(CDC48)is essential for membrane fusion,protein degradation,and other cellular processes.Here,we revealed the crucial role of CDC48B in regulating periclinal cell division in roots by analyzing the recessive gen1 mutant.We identified the GEN1 gene through map-based cloning and verified that GEN1 encodes CDC48B.gen1 showed severely inhibited root growth,increased periclinal cell division in the endodermis,defective middle cortex(MC)formation,and altered ground tissue patterning in roots.Consistent with these phenotypes,CYCLIND 6;1(CYCD6;1),a periclinal cell division marker,was upregulated in gen1 compared to Col-0.The ratio of SHR_(pro):SHR-GFP fluorescence in pre-dividing nuclei versus the adjacent stele decreased by 33%in gen1,indicating that the trafficking of SHORT-ROOT(SHR)decreased in gen1 when endodermal cells started to divide.These findings suggest that the loss of function of CDC48B inhibits the intercellular trafficking of SHR from the stele to the endodermis,thereby decreasing SHR accumulation in the endodermis.These findings shed light on the crucial role of CDC48B in regulating periclinal cell division in roots.