BackgroundBeing overweight and obese are major risk factors for noncommunicable diseases such as cardiovascular diseases. The prevalence of overweight and obesity is high throughout the world and these issues are very serious in the Shunyi District in China. As mobile technologies have rapidly developed, mobile apps such as WeChat are well accepted and have the potential to improve health behaviors.ObjectiveThis study aims to evaluate the effectiveness of a mobile app (WeChat) as an intervention on weight loss behavior.MethodsThis study was conducted among an occupational population from August 2015 to February 2016 in the Shunyi District of Beijing. Before the intervention, the Shunyi District Government released an official document for weight loss to all 134 government agencies and enterprises in Shunyi District. Participants willing to use our official WeChat account were enrolled in a WeChat group and received 6 months of interventions for weight loss; those who were not willing to use the account were in a control group given routine publicity on weight loss.ResultsIn total, 15,310 occupational participants including 3467 participants (22.65%) in the control group and 11,843 participants (77.35%) in the WeChat group were enrolled. Participants in the WeChat group lost more weight (mean 2.09, SD 3.43 kg) than people in the control group (mean 1.78, SD 2.96 kg), and the difference in mean weight loss between the two groups for males was significant based on the stratification of age and educational level. To control for confounding factors and to explore the effects of WeChat on weight loss, the propensity score method with a multinominal logistic regression was utilized. For males, this showed that the WeChat group (with both active and inactive subgroups) had a higher probability of maintaining weight, weight loss from 1 to 2 kg, or weight loss more than 2 kg than the control group. However, the control group had higher probability of weight loss from 0 to 1 kg. Being active in WeChat was likely to be associated with weight loss. The more active participants were in the weight loss program via WeChat, the more weight they lost.ConclusionsThe weight loss intervention campaign based on an official WeChat account focused on an occupation-based population in Shunyi District was effective for males. The more active male participants were in using WeChat, the more weight they lost. There might be no effect or there may even be a negative effect on weight loss for females. Future research should focus on how to improve adherence to the WeChat weight loss interventions, to improve and refine the WeChat content such as developing a variety of materials to attract interest, and to protect personal privacy, especially for females.

ClinicalTrials.gov; No.: NCT02497729; URL: www.clinicaltrials.gov.

ObjectiveTo evaluate the effect of an improved salt-restriction spoon on the attitude of salt-restriction, the using rate of salt-restriction-spoon, the actual salt intake, and 24-hour urinary sodium excretion (24HUNa).DesignA community intervention study.SettingTwo villages in Beijing.Participants403 local adult residents being responsible for home cooking.InterventionParticipants were randomly assigned to the intervention group or the control group. Those in the intervention group were provided with an improved salt-restriction-spoon and health education, and were informed of their actual salt intake and 24HUNa. Not any intervention was given to those in the control group.Main Outcome MeasuresThe scores on the variables of Health Belief Model, the using rate of salt-restriction-spoon, the actual salt intake, and 24HUNa.AnalysisCovariance analyses, Chi-square tests, Student’s t tests, and repeated measures analyses of variance.ResultsAfter 6 months of intervention, the intervention group felt significantly less objective barriers, and got access to significantly more cues to action as compared to the control group. The using rate and the correctly using rate of salt-restriction-spoon were significantly higher in the intervention group. The daily salt intake decreased by 1.42 g in the intervention group and by 0.28 g in the control group, and repeated measures analysis of variance showed significant change over time (F = 7.044, P<0.001) and significant difference between groups by time (F = 2.589, P = 0.041). The 24HUNa decreased by 34.84 mmol in the intervention group and by 33.65 mmol in the control group, and repeated measures analysis of variance showed significant change over time (F = 14.648, P<0.001) without significant difference between groups by time (F = 0.222, P = 0.870).ConclusionsThe intervention effect was acceptable, therefore, the improved salt-restriction-spoon and corresponding health education could be considered as an alternative for salt reduction strategy in China and other countries where salt intake comes mainly from home cooking.

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BackgroundThe two-gram salt-restriction-spoons, which can be used to reduce the salt intake of people, had been handed out for free by the Chinese government to the citizens several years ago, but only a small fraction of residents use such a spoon currently. Since no studies have been conducted to investigate relevant influencing factors, this study was designed to explore the determinants of salt-restriction-spoon using behavior (SRB) in China.MethodsThis cross-sectional study was conducted in Beijing, China. Altogether 269 rural residents and 244 urban residents aged over 18 were selected by convenience sampling method in 2012. Variables measured in a questionnaire designed according to the Health Belief Model (HBM) included socio-demographics, perceived susceptibility, perceived severity, perceived benefits, perceived objective barriers, perceived subjective barriers, self-efficacy, knowledge of hypertension, cues to action, and SRB. Answers to the questionnaire were obtained from all the participants, and 24-hour urine samples were collected to determine the 24-hour urinary sodium excretion (24HUNa). Path analyses were used to explore the determinants of SRB.ResultsApproximately 22.7% and 45.3% of residents used a salt-restriction-spoon everyday in the rural and urban areas, respectively. The average 24HUNa was 211.19±98.39 mmol for rural residents and 109.22±58.18 mmol for urban residents. Path analyses shown that perceived objective barriers, perceived benefits, perceived severity, knowledge and age were related to SRB and 24HUNa for both rural and urban participants, among which perceived objective barrier (β =  − 0.442 and β =  − 0.543, respectively) was the most important determinant.ConclusionImprovement of the current salt-restriction-spoon and education on the right usage of the salt-restriction-spoon, the severity of hypertension, and the benefit of salt reduction are necessary, especially among those who are relatively young but at risk of hypertension, those who have lower education levels, and those who live in the rural areas.

Post-pancreaticoduodenectomy hemorrhage is a life-threatening complication that occurs in 2-10% of patients. The most common location for post-pancreaticoduodenectomy hemorrhage is the gastroduodenal artery stump. Nonetheless, unusual sources of hemorrhage, which are hard to locate, exist. Here, we report a rare postoperative hemorrhage after robotic-assisted pancreatoduodenectomy for pancreatic head cancer. A 67-year-old man presenting with appetite loss, general fatigue and painless jaundice was admitted to our ward. The patient had an elevated level of carbohydrate antigen 19-9 (50 U/mL). Computed tomography scan revealed a 17-mm wide low-density area in the uncinate process of the pancreas. Magnetic resonance cholangiopancreatography showed the dilation of bile and pancreatic ducts. Robotic-assisted pancreaticoduodenectomy was performed on the patient by using the da Vinci Model S Surgical System. On postoperative days 5 and 6, the patient vomited blood, and bloody fluid was observed in the drainage. Emergent gastroscopic examination was performed and revealed a large amount of hematocele in the stomach. On postoperative day 6, emergency operation was undertaken, and the output jejunal loop was found to have intussuscepted in the stomach. This is the first case report of output jejunal loop intussusception in the stomach that consequently caused hemorrhage after robotic-assisted pancreaticoduodenectomy for pancreatic head cancer.

BackgroundHypertension can result in great cardiovascular risk, while medication adherence and blood pressure control of patients were suboptimal. Therefore, we conducted a 12-month clustered randomized controlled trial to evaluate the effectiveness of transtheoretical model (TTM)-based health intervention mode on blood pressure of Chinese newly-diagnosed hypertensive patients.MethodsThis trial was conducted in six primary healthcare centers, Shunyi District, Beijing, China from September 2016 to September 2017. A total of 400 patients were included and randomized, 194 patients in the control group and 206 patients in the intervention group. Patients in the intervention group received TTM-based health intervention and those in the control group received usual care. Multilevel modeling was used to adjust for clustering effect and repeated measurements.ResultsSystolic blood pressure of patient was reduced by 4.534 mm Hg at 3-month follow-up [95% CI (−3.054, −1.403), p = 0.005], 3.982 mm Hg at 6-month follow-up [95% CI (−7.387, −0.577), p = 0.022], and 5.803 mm Hg at 12-month follow-up [95% (−9.716, −1.891), p = 0.004]. Diastolic blood pressure of patient was reduced by 3.383 mm Hg at 3-month follow-up [95% CI (−5.724, −1.042), p = 0.005], 0.330 mm Hg at 6-month follow-up [95% CI (−2.870, 2.210), p = 0.799], and 3.129 mm Hg at 12-month follow-up [95% CI (−6.048, −0.21), p = 0.036]. Medication adherence of patients was improved at all the three time points. For stages of change for taking medication, patients in the intervention group were 8.401-fold more likely to be in a higher stage at 3-month follow-up [95% CI (4.186, 16.862), p &lt; 0.001]. The odds ratio of being in a higher stage was 8.454 at 6-month follow-up [95% CI (3.943, 18.123), p &lt; 0.001] and 19.263 at 12-month follow-up [95% CI (7.979, 46.505), p &lt; 0.001].ConclusionTranstheoretical model-based health intervention might be a promising strategy to improve medication adherence of newly-diagnosed hypertensive patients in community.