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June 2017, Volume 20, No.17 Abstracts

 Comparison of Community Rehabilitation Based on Differences in Culture Values between China and Australia  ZHANG Zhi-jun1*,LIU Chao-jie2
1.Puhuangyu Community Health Service Center of Fengtai District,Beijing 100075,China
2.School of Psychology and Public Health,La Trobe University,Melbourne 3086,Australia
*Corresponding author:ZHANG Zhi-jun,Attending physician;E-mail:buyishusheng7@126.com
    【Abstract】  There are significant differences in community rehabilitation between China and Australia,in terms of the philosophy and goals of rehabilitation,configuration and functions of human resources,and intervention approaches.These differences are associated with differences in the cultural values and the political,economic and social contexts of the two countries. This article analyzed the strategies and measures of community rehabilitation adopted in Australia and their implications on the development of community rehabilitation services in China.
    【Key words】  Rehabilitation;Community health services;Australia
 
Evaluation of Cognitive Impairment in Patients with Asymptomatic Carotid Stenosis and Its Risk Factors  ZHANG Hua1*,ZHANG Shu-ping1,WANG Xiao-xin2
1.Department of Neurology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China
2.Department of Neurology,Beijing Miyun Hospital,Beijing 101500,China
*Corresponding author:ZHANG Hua,Associate physician;E-mail:zhhuahua@sohu.com
    【Abstract】  Objective  To evaluate the cognitive function in the patients with asymptomatic carotid stenosis(ACS) by event related potentials P300(ERP-P300),mini-mental state examination(MMSE) and Montreal Cognitive Assessment(MoCA),and to explore the risk factors of cognitive impairment.Methods  A total of 179 patients with ACS,who were hospitalized and outpatient in Department of Neurology,Beijing Anzhen Hospital,Capital Medical University in 2015,were selected as the research objects.According to the degree of coronary artery stenosis,subjects were divided into no stenosis group(<30%,n=90),mild to moderate stenosis group(30%-69%,n=49) and severe stenosis group(70%-99%,n=40).The clinical data were collected,and levels of serum homocysteine(Hcy),hypersensitive C-reactive protein(hs-CRP),low density lipoprotein cholesterol(LDL-C),serum uric acid(UA),and FPG were measured.MMSE,MoCA were used to evaluate the cognitive function of patients,and ERP-P300 detection was conducted by the keypoint EMG evoked potentiometer to record the latent period and amplitude,and Fazekas score were used to evaluate degree of white matter lesions.Results  There was significant difference in the detection rate of smoking and hypertension among all the groups(P<0.05).There were no significant differences in scores of ERP-P300 amplitude and MMSE among all the groups(P>0.05).The latent period of ERP-P300,and scores of MoCA and Fazekas were significantly different among all the groups(P<0.05).Among them,the MoCA score in mild to moderate stenosis group was lower than that in no stenosis group,and the MoCA score in severe stenosis group was lower than that in no stenosis group and mild to moderate stenosis group(P<0.05).The latent period of ERP-P300 in mild to moderate stenosis group was longer than that in no stenosis group,and the latent period of ERP-P300 in severe stenosis group was longer than that in no stenosis group and mild to moderate stenosis group(P<0.05).The rate of MMSE in detecting cognitive impairment of patients with ACS was 16.8%(15/89),which was lower than that of MoCA〔43.8%(39/89),χ2=18.892,P<0.001〕.Multivariate Logistic regression analysis showed that hypertension〔OR=2.671,95%CI(1.877,3.609)〕,the prolonged latent period of ERP-P300 〔OR=5.014,95%CI(2.983,8.429)〕,severe carotid artery stenosis 〔OR=3.232,95%CI(1.134,9.208)〕 were risk factors of cognitive impairment of patients with ACS.Conclusion  Cognitive impairment may occur in the early stage of patients with ACS,and it is associated with hypertension and degree of carotid artery stenosis.MoCA and ERP-P300 are sensitive to predicting cognitive impairment of patients with ACS,and can be used as an auxiliary examination means to evaluate cognitive impairment.
    【Key words】  Carotid stenosis;Cognition disorders;Event-related potentials;P300;Risk factors
 
Analgesic Effects of Intra-articular Injection of Ropivacaine Mesylate Alone or Combination with Dezocine,or with Sufentanil,or with Dezocine and Sufentanil after Arthroscopic Knee Surgery  NIU Jing-hui1,QI Qi2,WANG Fei1,LYU Yan-xia3*,WANG Xiu-li3,WANG Qiu-jun3
1.No.1  Department of Joint,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China
2.No.2  Department of Cardiovascular Medicine,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China
3.No.2  Department of Anesthesiology,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China
*Corresponding author:LYU Yan-xia,Professor,Chief physician,Master supervisor;E-mail:lyxshsy@163.com
    【Abstract】  Objective  To evaluate the effect of intra-articular injection of ropivacaine mesylate alone,or combination with dezocine,or with sufentanil,or with dezocine and sufentanil for postoperative analgesia after arthroscopic knee surgery.Methods  One hundred and twenty consecutive patients underwent selective unilateral arthroscopic meniscectomy in the Third Hospital of Hebei Medical University from November 2014 to January 2016 were selected as the participants and divided into 4 groups,group L,group LD,group LF,and group LDF with 30 in each by using the random number table.For postoperative analgesia,group L,group LD,group LF,and group LDF were given intra-articular injection of ropivacaine mesylate 178.8 mg,ropivacaine mesylate 178.8 mg plus dezocine 10 mg,ropivacaine mesylate 178.8 mg plus sufentanil 10 μg,and ropivacaine mesylate 178.8 mg plus dezocine 5 mg plus sufentanil 5 μg,respectively after the surgery but 10 min before releasing the thigh tourniquet.We recorded the Visual Analogue Scale (VAS) scores measured before the surgery in steady and dynamic(bipedal standing,flexing knee at 90°) states and those measured at 2,4 h and at 6,12,and 24 h after the surgery in steady and dynamic states;Bruggrmann Comfort Scale(BCS) scores evaluated before the surgery and at 2,4,6,12 and 24 h after the surgery;Ramsay Sedation Scale (RSS) scores evaluated before the surgery and at 2,4,6,12 and 24 h after the surgery and the calculated appropriate sedation rate(RSS scores of 2-3 points are considered as the appropriate sedation);the time that the patient first required readministration of analgesics;the dosage of the readministered analgesics within 24 h after the surgery;the time required to restore unassisted ambulation;patient satisfaction with analgesia;and situation of postoperative adverse reactions(nausea score,vomiting score,incidences of dizziness,urinary retention,pruritus and respiratory depression and so on).Results  Analgesia method and administration time of analgesics exerted significant interaction effects on steady and dynamic VAS scores and BCS scores(P<0.05).Analgesia method had main effects on steady and dynamic VAS scores and BCS scores(P<0.05).There were no significant differences in the appropriate sedation rates among four groups at 2,4,24 h after surgery(P>0.05).There were significant differences in the appropriate sedation rates among four groups at 6,12 h after surgery(P<0.05).The appropriate sedation rates both at 6 and 12 h after surgery were higher in group LDF than in group L (P<0.05).Four groups displayed remarkable differences in terms of the time that the patient first required readministration of analgesics,the dosage of the readministered analgesics within 24 h after the surgery,the time required to restore unassisted ambulation,patient satisfaction with analgesia,nausea score,vomiting score,incidences of dizziness,and overall incidence of adverse reactions(P<0.05).Conclusion  All the 4 analgesia methods can relieve the pain after arthroscopic knee surgery,but the mixture of 3 drugs injected intra-articularly provides better analgesia effects with less side effects.
    【Key words】  Arthroscopy;Ropivacaine mesylate;Dezocine;Sufentanil;Analgesia
 
Clinical Observation of Cardiopulmonary Exercise Testing in Patients with Chronic Thromboembolic Pulmonary Hypertension  WANG Yong1*,ZHANG Ya-guang2
1.Department of Hypertension,the People′s Hospital of Henan,Zhengzhou 450003,China
2.Henan Medical College,Zhengzhou 451191,China
*Corresponding author:WANG Yong,Associate chief physician;E-mail:wangyong_8888@126.com
    【Abstract】  Objective   To evaluate the application value of cardiopulmonary exercise testing in patients with chronic thromboembolic pulmonary hypertension(CTEPH).Methods  From January 2009 to October 2013,a total of 72 cases with chronic thromboembolic disease admitted in the People′s Hospital of Henan were enrolled.According to whether it caused pulmonary hypertension,the patients were divided into 2 groups:CTEPH group of 45 cases and chronic thrombosis(CPE) group of 27 cases.And 52 patients with normal cardiopulmonary function in the same period were selected as the control group.All the 3 groups underwent cardiopulmonary exercise testing.The differences of cardiopulmonary function parameters among the three groups were compared and the correlation between the amino-terminal brain natriuretic peptide(NT-proBNP) and cardiopulmonary function parameters were analyzed.Results  The plasma concentrations(1 564±1 031)pmol/L of NT-proBNP in the CTEPH group were higher than those in the CPE(595±159)pmol/L and control groups (605±167)pmol/L(both P<0.05).The PetO2,PetCO2,VO2max,VO2/kg,oxygen pulse,anaerobic threshold,VE/VO2,VE/VCO2,VD/VT,VE/VCO2 slope among the 3 groups were compared and the differences were statistically significant(P<0.05).The PetCO2 and VO2/kg in the CPE group were significantly lower than those in the control group.The VE/VO2,VE/VCO2,VD/VT,and VE/VCO2 slope in the CPE group were significantly higher than those in the control group.The PetCO2,VO2max,VO2/kg,oxygen pulse,and anaerobic threshold in the CTEPH group were significantly lower than those in the control and CPE groups.The VE/VO2,VD/VT,and VE/VCO2 slope in the CTEPH group were higher than those in the control and CPE groups.The PetO2,VE/VCO2 in the CTEPH group were higher than those in the control group(P<0.05).Multiple linear regression analysis showed that VO2/kg (β=-0.213,t=-4.436,P<0.001)and the right ventricular internal diameter(β=0.561,t=4.209,P<0.001)were independent influencing factors affecting NT-proBNP levels.Conclusion  Cardiopulmonary exercise testing could objectively and quantitatively evaluate the exercise capacity in patients with CTEPH.
    【Key words】   Pulmonary embolism;Hypertension,pulmonary;Cardiopulmonary exercise testing
 
Relationship between Cardiovascular Reactivity and Competitive Attitude in Xinjiang Uygur Patients with Hypertension  LI Shu-zhen1,2,3,ZHANG Lan1,2*
1.Research Center for Applied Psychology,Shihezi University,Shihezi 832003,China
2.Department of Psychology,Normal College,Shihezi University,Shihezi 832003,China
3.Heze Domestic Science College,Heze 274300,China
*Corresponding author:ZHANG Lan,Professor;E-mail:zhanglan1999@yeah.net
    【Abstract】  Objective   To investigate the correlation between cardiovascular reactivity and competitive attitude in Xinjiang Uygur patients with hypertension based on analyzing their competitive attitude manifestations,in order to improve the health of hypertension patients.Methods  This population-based study was conducted between December 2013 and January 2014.The participants were 140 Uygur villagers from Xinjiang Shihezi County Saybag Village〔61 with hypertension(hypertension group) and 79 without hypertension(non-hypertension group)〕 selected by convenience sampling.A psychological stress test and a Competitive Attitude Scale-Uygur version〔CAS-U,which consists of Healthy Competitive Attitude Subscale(HCAS) and Hypercompetitive Attitude Subscale(HAS)〕 were used to explore the correlation between cardiovascular reactivity and competitive attitude in the patients.The systolic blood pressure(SBP),diastolic blood pressure(DBP) and heart rate(HR) of them at different periods of the test were measured and recorded.Results  There were significant differences in age,body weight,BMI,SBP and DBP measured at baseline period,task recall period,and recovery period between the hypertension group and non-hypertension group(P<0.05).No obvious differences were found between the groups in the aspects of HR measured at baseline period,task recall period and recovery period,scores of HCAS and HAS(P>0.05).Multivariate Logistic regression analysis suggested that BMI was the influencing factor for hypertension〔OR=0.96,95%CI(0.93,0.98),P<0.05〕.Pearson′s correlation coefficient analysis found that the scores of HAS were positively correlated with the fluctuation of HR measured between the baseline period and task recall period(r=0.32,P=0.01).Multiple linear regression analysis demonstrated that hypercompetition was the correlation factor for the fluctuation of HR measured between the baseline period and task recall period(β=2.01,t=2.58,P=0.01).Conclusion  BMI is the influencing factor for hypertension.There is a correlation between hypercompetitive attitude and cardiovascular response indexes.
    【Key words】   Hypertension;Behavioral medicine;Competitive behavior;Stress,psychological;Uygur nationality
 
Influencing Factors of Patients with Acute Kidney Injury Developing Type 3 Cardiorenal Syndrome  ZHAO Feng-qi,ZHOU Rong-bin*
Department of Emergency,Chinese PLA Army General Hospital,the Affiliated Clinical Hospital of Second Military Medical University,Beijing 100700,China
*Corresponding author:ZHOU Rong-bin,Chief physician,Main research:sepsis,cardiopulmonary resuscitation;E-mail:dr_zhourongbin@sina.com
    【Abstract】  Objective  To investigate the risk factors of patients with acute kidney injury(AKI) developing type 3 cardiorenal syndrome (CRS).Methods  The clinical data of 135 patients who had been diagnosed with AKI discharged in Chinese PLA Army General Hospital,the Affiliated Clinical Hospital of Second Military Medical University from 2013 to 2015 were retrospectively analyzed.The patients with AKI were divided into type 3 CRS group(37 patients) and non-type 3 CRS group(98 patients) according to whether they had secondary cardiac injury or not.The general data,laboratory examination indicators,prognosis,treatment,hospital stays and cost of the two groups were collected.Multivariable Logistic regression analysis was used to analyze risk factors of patients with AKI developing type 3 CRS.Results  There were no significant differences in gender,staging of AKI,whether there was disorder of calcium and phosphate,uric acid,whether fibrinogen was normal,prognosis and whether use renal replacement therapy between type 3 CRS group and non-type 3 CRS group(P>0.05).There were significant differences in inducement of AKI,whether there was diastolic dysfunction of left ventricular,whether having history of chronic nephrosis or not,whether cholesterol was normal or not,whether D-double polymer was normal between type 3 CRS group and non-type 3 CRS group(P<0.05).There were no significant differences in mean arterial pressure,hypersensitive C-reactive protein,creatinine,urea nitrogen,glomerular filtration rate,homocysteine level between type 3 CRS group and non-type 3 CRS group (P>0.05).There were significant differences in age,creatinine/urea nitrogen,hospital stays and cost between type 3 CRS group and non-type 3 CRS group(P<0.05).Multivariate Logistic regression analysis showed that age〔OR=1.714,95%CI(1.437,2.094)〕,diastolic dysfunction of left ventricular〔OR=10.331,95%CI (3.129,34.112)〕,history of chronic kidney disease〔OR=13.076,95%CI(2.345,72.911)〕,and increased level of cholesterol〔OR=9.983,95%CI(1.590,62.666)〕 were independent risk factors of patients with AKI developing type 3 CRS.Conclusion  Infected glomerulonephritis and use of nephrotoxic drugs are the two main causes of AKI.Despite advances in medical technology for the treatment of AKI,the incidence of type 3 CRS in patients with AKI is still high and the secondary cardiac injury has extended hospital stays and increased medical costs.Age,diastolic dysfunction of left ventricular,history of chronic kidney disease and increased level of cholesterol are independent risk factors of patients with AKI developing type 3 CRS.
    【Key words】  Acute kidney injury;Cardio-renal syndrome;Root cause analysis
 
Associated Factors of SIRS and Residual Stones after Flexible Ureteroscopic Holmium Laser Lithotripsy for Calyceal Diverticular Stones  WANG Chun-tao,HAO Bin*
Department of Urology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China
*Corresponding author:HAO Bin,Chief physician;E-mail:binhao68@126.com
    【Abstract】  Objective   To investigate the associated factors of systemic inflammatory response syndrome(SIRS) and residual stones after flexible ureteroscopic holmium laser lithotripsy for calyceal diverticular stones.Methods  The 30 participants enrolled in this study were from the Second Affiliated Hospital of Zhengzhou University,they were diagnosed with calyceal diverticular stones between September 2012 and July 2015 by kidney-ureter-bladder(KUB) abdominal radiography combined with intravenous pyelography(IVP) or CT urography(CTU) and treated by flexible ureteroscopic holmium laser lithotripsy.Postoperative SIRS occurred in the participants were observed and recorded.CT plain scanning was performed in all of them at the time of 1,3 months after the surgery for detecting the residual stones in bilateral kidneys.Results  The average intraoperative duration,intraoperative blood loss and postoperative hospital stay was(67.3±21.2)min,(7.0±4.1) ml,(4.1±2.7) days,respectively.Twenty percent of them(6/30) had postoperative SIRS,but no urosepsis and septic shock after receiving the treatment against infection,fluid infusion and other symptomatic treatment.The residual stone rate detected by the CT scanning performed at the time of 1,3 months after the surgery was 20.0%(6/30),and 16.7%(5/30),respectively.Among the participants,the incidence of SIRS was significantly associated with diabetes,intraoperative infection,and infection-related stone fragments(P<0.05),while it was not associated with gender,age,kidney stone size,location and amount,angle between the renal pelvis and calyce(P>0.05);the incidence of postoperative residual stones was substantially associated with kidney stone location and angle between the renal pelvis and calyce(P<0.05),but not with gender,age,kidney stone size and amount,diabetes,intraoperative infection,and infection-related stone fragments(P>0.05).Conclusion  Ureteroscopic holmium laser lithotripsy is one of the safe and effective ways for the treatment of calyceal diverticular stones.For patients with the risk factors for SIRS,attention should be paid to the prevention and treatment of postoperative infection;for those with the risk factors for residual stones,surgical method and management option for residual stones should be selected carefully.
    【Key words】  Kidney calculi;Ureteroscopy;Systemic inflammatory response syndrome;Root cause analysis
 
miR-142-3p Suppresses the Proliferation of Nasopharyngeal Carcinoma Cells and Stem Cells by Targeting CD133  TANG Guo-hui1,ZHANG Zhi-wei2,HUANG Wei-guo2,XIE Yun-jie2,XING Jiao-tao1,HE Xiu-sheng2*
1.Department of Anus and Bowels,Affiliated Nanhua Hospital,University of South China,Hengyang 421002,China
2.Cancer Research Institute,University of South China,Hengyang 421001,China
*Corresponding author:HE Xiu-sheng,Professor;E-mail:hexiusheng@hotmail.com
    【Abstract】  Objective   To investigate whether miR-142-3p can suppress the proliferation and invasion abilities of nasopharyngeal carcinoma cells by targeting CD133,in order to reveal the molecular mechanism that miR-142-3p functions as a tumor suppressor in nasopharyngeal carcinoma.Methods  This study was conducted between July 2015 and September 2016.CD133 mRNA 3′-UTR-luciferase vector was constructed and dual-luciferase reporter gene assay was employed to examine the effect of miR-142-3p on luciferase activity of CD133 mRNA 3′-UTR.Nasopharyngeal carcinoma CNE2 cells were transfected with negative contrast control agent 40 μmol/L,CD133 siRNA 40 μmol/L,and miR-142-3p mimics 40 μmol/L,respectively.Western blotting was performed to detect the expressions of CD133 protein.CNE2 cells in logarithmic growth phase were divided into 4 groups,negative control group(transient transfection of negative contrast control agent 40 μmol/L),positive control group(transient transfection of CD133 siRNA 40 μmol/L),miR-142-3p group(transient transfection of miR-142-3p mimics 40 μmol/L),and combined group〔transient transfection of miR-142-3p mimics 40 μmol/L and pcDNA3.1(+)-CD133 0.8 μg〕.MTS assay and Transwell migration assay were used to detect the proliferation and invasion abilities of CNE2 cells,respectively.Tumorsphere formation assay was employed to detect the sphere-forming ability of CNE2 stem cells.Results  Results of luciferase assay with single-photon detector showed that,the luciferase activity of pCD133-Wt cells with transfection of miR-142-3p was much lower than that of those without〔(0.535±0.035) vs.(0.924±0.107),t=7.924,P=0.022〕.Western blotting identified that,the expression of CD133 differed significantly between negative control group,positive control group,and miR-142-3p group(F=12.44,P<0.05),concretely,the negative control group had higher expression of CD133 than both positive control group,and miR-142-3p group(all P<0.05);obvious differences in the number of CNE2 cells were found among the 4 groups(F=16.78,P<0.05),specifically,negative control group had more CNE2 cells than positive control group,and miR-142-3p group(all P<0.05).Transwell migration assay revealed that,the number of CNE2 cells passing through the matrigel differed significantly among the 4 groups(F=13.19,P<0.05);negative control group had more CNE2 cells passing through the matrigel than positive control group and miR-142-3p group(all P<0.05).Tumorsphere formation assay demonstrated the number of sphere-forming CNE2 stem cells were more in negative control group than those in miR-142-3p group(t=14.92,P<0.05).Conclusion  miR-142-3p suppresses cell proliferation and invasion,and sphere-formation of stem cells by targeting CD133 in nasopharyngeal carcinoma.
    【Key words】   Nasopharyngeal neoplasms;Neoplastic stem cells;Cell proliferation;Cell invasion
 
Immunologic Function in Children with Infectious Mononucleosis and Infected with Epstein-Barr Virus  WANG Ying-chao1*,ZHU Gui-ying1,ZHANG Qiu-tang2,JIANG Lan-jun1,LI Zhuang-zhuang1
1.Department of Pediatrics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China
2.Institute of Hematology,Zhengzhou University,Zhengzhou 450052,China
*Corresponding author:WANG Ying-chao,Associate chief physician,Main research direction:blood and tumor diseases in children;E-mail:yingchaowang152@163.com
    【Abstract】  Objective  To investigate the lymphocyte subset and immunoglobulin features of peripheral blood in children with Epstein-Barr virus(EBV)-associated infectious mononucleosis(IM) and infected with chronic active EBV(CAEBV).Methods  Thirty-four children infected with EBV who received diagnosis and treatment in Department of Pediatrics,the First Affiliated Hospital of Zhengzhou University from May 2010 to May 2016 were selected,and they had underwent the detection of lymphocyte subset and immunoglobulin in peripheral blood.Among them,20 cases in IM group and 14 cases in CAEBV group;20 healthy children after physical examination at the same period were also included as control group.Flow cytometry was used to detect CD+3 T lymphocytes,CD+4 T lymphocytes,CD+8 T lymphocytes,B lymphocytes,and natural killer cell count,and immunoglobulin IgA,IgG and IgM levels were measured by immunological scatting turbidity method.Results  There were significant difference in white blood cell count,lymphocyte count,CD+3 T lymphocyte count,CD+4 T lymphocyte count,CD+8 T lymphocyte count,B lymphocyte count,natural killer cell count of peripheral blood among the three groups(P<0.05).The leukocyte count,lymphocyte count,CD+3 T lymphocyte count and CD+8 T lymphocyte count in peripheral blood in IM group were higher than those in control group,and the B lymphocyte count was lower than that in control group(P<0.05).Lymphocyte count,CD+3 T lymphocyte count,CD+4 T lymphocyte count,CD+8 T lymphocyte count,B lymphocyte count and natural killer cell count in peripheral blood in CAEBV group were lower than those in control group and IM group(P<0.05).The leukocyte count in peripheral blood in CAEBV group was lower than that in IM group(P<0.05).There were significant differences in IgA and IgG among the three groups(P<0.05).IgA and IgG in IM group and CAEBV group were higher than those in control group(P<0.05).Conclusion  The CD+8 T lymphocyte proliferation of children with IM is the main reason of significant increasing of lymphocyte count,lymphocyte of children CAEBV reduces,with reduced T lymphocytes,B lymphocytes,and natural killer cell subsets as the main features.Immunoglobulin IgA and IgG are significantly increased in children with IM and CAEBV.Lymphocyte subsets detection contributes to the diagnosis and differential diagnosis of IM and CAEBV.
    【Key words】  Infectious mononucleosis;Herpesvirus 4,human;T-lymphocyte subsets;Immunoglobulin isotypes
 
Detection Rate of Thyroid Nodules and Thyroid Function in Patients from Community Health Service Center  LUO Jin-bing1,LI Yong-jin1,LU Chang-an1*,ZHAO Rui-quan1,XIA Li-jun1,HAO Shi-wei1,LIU Guo-wei1,GONG Wen-bo1,SONG Fei1,YANG Guang-ran2,YUAN Shen-yuan2
1.Department of General Practice,Tuanjiehu Community Health Service Center,Beijing 100026,China
2.Department of Endocrinology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China
*Corresponding author:LU Chang-an,Attending physician;E-mail:723156383@qq.com
    【Abstract】  Objective   To investigate the detection rate of thyroid nodules and thyroid function in community health service center patients.Methods  The participants enrolled were 488 patients visited Tuanjiehu Community Health Service Center in Chaoyang District,Beijing,and undertook B-mode ultrasonography for the screening of thyroid nodules from March 2015 to June 2016.Two hundred and fifty-six of them also undertook thyroid function test.Results  Among the 488 participants,316 were found with thyroid nodules,with a detection rate of 64.8%.There was no significant difference in the detection rate of thyroid nodules between male and female〔68.2%(45/66)vs.64.2%(271/422),χ2=0.393,P=0.531〕;46.2%(146/488) were found with single thyroid nodule,53.8%(170/488) were found with multiple thyroid nodules.There was no significant difference in the amount distributions of thyroid nodules between male and female(χ2=0.742,P=0.690);There was significant difference in the  amount distributions of thyroid nodules among different age groups(χ2=43.127,P<0.01),the middle-aged group and the elderly group had lower detection rate of no thyroid nodules than the young group,the elderly group had lower detection rate of no thyroid nodules than the middle-aged group(P<0.01);detection rate of single thyroid nodule showed no differences among different age groups(P>0.05);the elderly group had higher detection rate of multiple thyroid nodule than the young group and the middle-aged group(P<0.01).Of the 256 undertaking thyroid function test,90 had no thyroid nodules,76 had single thyroid nodule,and 90 had multiple thyroid nodules.There was no significant difference in T3,T4,FT3 and FT4 levels among the three groups by amount of thyroid nodules(P>0.05);there was significant difference in TSH levels among the three groups(P<0.05),concretely,the multiple thyroid nodules group had lower TSH level than the no thyroid nodules group and the single thyroid nodule group(P<0.05).Conclusion  The detection rate of thyroid nodules in patients from Tuanjiehu Community Health Service Center is high,and it gradually increases with the ageing,especially multiple thyroid nodules,which should be paid attention in clinical practice.
    【Key words】  Thyroid nodule;Thyroid function tests;Community health services
 
Differences in Current Operation Status between the Long-term Care Facilities with Various Durations in Beijing  MA Xiao-wen,DU Jia-min,XIE Hong*
Peking University School of Nursing,Beijing 100191,China
*Corresponding author:XIE Hong,Associate professor;E-mail:xh6959@163.com
    【Abstract】  Objective   To investigate the differences in current operation status between the long-term care facilities with various durations in Beijing,so as to provide references for developing the operation patterns of long-term care facilities suitable for the situation of China,and to provide a theoretical basis for the enacting and formulating of the relative policies.Methods  This questionnaire survey was conducted in the long-term care facilities in Beijing selected by convenience sampling in August 2014.The self-made questionnaire used in the study involved the baseline characteristics of the facilities,status of admission,status of employees,social welfare function,provided medical services and so on.Single factor analysis and multiple Logistic regression were used to investigate the current operation status of the long-term care facilities with various durations.Results  A total of 374 long-term care facilities received the questionnaire survey.Of them,96.5%(361/374) returning responsive questionnaires were selected as the final subjects.Classified by the duration,there were 4 categories in the 361 long-term care facilities:15.8%(57/361) had a duration of ≤5 years,44.6%(161/361) had a duration of 6-15 years,8.6%(31/361) had a duration of 16-20 years,and 31.0%(112/361) had a duration of ≥21 years.The 4 categories of long-term care facilities differed significantly in the location,ownership of the facilities,land ownership,housing property ownership,number of beds,insured bed rate,proportion of nursing beds,per bed covered area in average,construction area of the facilities,and per bed fixed assets(P<0.05).The 4 categories of long-term care facilities were found to have obvious differences in bed occupancy rate,proportion of public residents,proportions of admitted people in age groups of 60 to 69 years,70 to 79 years,80 to 89 years,and 90 years or over,proportion of admitted self-care people,proportion of admitted people without self-care ability,proportions of admitted people from the local towns and districts(counties),from other districts(counties) and provinces(P<0.05).The 4 categories of long-term care facilities had substantial differences in the overall number of staff/number of beds ratio,overall number of nursing assistants/number of beds ratio,status of doctor employment,and status of nurse employment(P<0.05).The 4 categories of long-term care facilities demonstrated differences in terms of whether be the appointed facilities receiving the people without self-care ability living on subsistence allowances,proportions of admitted urban people of "three noes"(no ability to work,no source of income and no statutory supporters) and admitted rural people supported by the five guarantees(food,clothing,medical care,housing and burial expenses were provided by the government),whether offering medical services approved by the health administrative departments,whether affording medical services with the support of nearby medical institutions based on the cooperation agreement,and whether the provided medical services were covered by medical insurance(P<0.05).The multiple Logistic regression analysis found that,in the 4 categories of long-term care facilities,there were distinct differences in bed occupancy rate,status of admission,ownership of the facilities,provided medical services and manpower allocation(P<0.05).Conclusion  Long-term care facilities with various durations have significant differences in bed occupancy rate,status of admission,ownership of the facilities,provided medical services and manpower allocation.Therefore,it is suggested that predicting the development trend and developing the service and management mode of long-term care facilities suitable for China′s national conditions should be based on the current operation status of them.
    【Key words】   Health services for the aged;Healthcare disparities;Long-term care facilities;Duration
 
Relationship between Weight Change and Incidence of Metabolic Syndrome in Guiyang Urban Residents Aged 40 or Over:a 3-year Follow-up Study  YUAN Xin,LI Hong*,SHI Li-xin,ZHANG Qiao,PENG Nian-chun,HU Ying
Department of Endocrinology and Metabolism,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China
*Corresponding author:LI Hong,Chief physician;E-mail:lihong3@medmail.com.cn
    【Abstract】  Background  As weight is strongly related to metabolic syndrome(MS),the association of weight change with the incidence of MS has become one of the focus.Objective  To investigate the association between weight change and the incidence of MS based on a 3-year follow-up study of the community residents.Methods  This study was conducted from 2011 to 2014.The participants enrolled in this study were 5 850 Guiyang urban residents who aged 40 or over and participated in the "Risk Evaluation of Tumor in Patients with Type 2 Diabetes in China:an Epidemiological Study" conducted in 2011.The participants′ height,weight,waist circumference and blood pressure were measured,and the values of fasting plasma glucose(FPG),high-density lipoprotein cholesterol(HDL-C) and triglyceride(TG) of them were measured as well.We measured the above indicators of them again in December 2014 and those with MS were diagnosed.According to the weight changes during the follow-up,the participants were divided into 5 groups,the weight loss(WL) group(loss≥1.0 kg ),weight stable(WS) group(change <1.0 kg),weight gain(WG)-A group(gain 1.0-<2.5 kg),WG-B group(gain 2.5-<5.0 kg),WG-C group(gain ≥5.0 kg).Results  A total of 4 392 participants completed the follow-up,with a lost follow-up rate of 24.92%.Of them,males had a lower incidence of MS than females did〔15.87%(223/1 405) vs.27.18%(812/2 987),χ2=55.293,P<0.05〕.The incidence of MS increased with the increase of weight in each gender(P<0.05).There were significant differences in the changes of BMI,waist circumference and waist-to-height ratio among each group of the males during the follow-up(P<0.05).Significant differences in the changes of BMI,waist circumference,waist-to-height ratio,SBP and DBP were found among each group of the females during the follow-up(P<0.05).After adjusting for baseline age,BMI,waist circumference,SBP,DBP,FPG,HDL-C,and TG levels,multivariate Logistic regression analysis showed that,compared with WS group of males,the WL group had a lower risk of MS 〔OR=0.411,95%CI(0.262,0.645)〕,while those in the WG-B group〔OR=2.735,95%CI(1.664,4.497)〕 and WG-C group〔OR=3.755,95%CI(1.907,7.395)〕 showed a higher risk of MS;compared with the WS group of females,the WL group showed a lower risk of MS〔OR=0.675,95%CI(0.534,0.854)〕,while those in the WG-A group〔OR=1.446,95%CI(1.125,1.859)〕,WG-B group〔OR=1.778,95%CI(1.355,2.331)〕,and WG-C group〔OR=2.801,95%CI(1.975,3.972)〕 showed a higher risk of MS(P<0.05).Conclusion  In Guiyang urban residents who aged 40 or over,females had a higher incidence of MS than males did,and weight gain was the significant risk factor of MS.Weight gain was more closely associated with the incidence of MS in males than in females.
    【Key words】  Metabolic syndrome X;Weight gain;Incidence;Body mass index
 
Reliability and Validity of the Chinese Version of Short Version of Thyroid-specific Patient Reported Outcome(ThyPRO39)  XUE Xia1,XU Xu-juan2*,GU Zhi-feng2,SHEN Yi3,DONG Qing2,ZHOU Jing1,WU Ai-juan2
1.School of Nursing,Nantong University,Nantong 226001,China
2.Affiliated Hospital of Nantong University,Nantong 226001,China
3.School of Public Health,Nantong University,Nantong 226001,China
*Corresponding author:XU Xu-juan,Chief superintendent nurse,Professor;E-mail:2205434494@126.com
    【Abstract】  Objective  To test the reliability and validity of the Chinese version of short version of Thyroid-specific Patient Reported Outcome(ThyPRO39) translated from the original abbreviated version of ThyPRO39 among Chinese patients with benign thyroid disease.Methods  Using a convenience sampling method,230 patients with benign thyroid disorders were recruited from the endocrine outpatient clinics and inpatient units at the Affiliated Hospital of Nantong University from February to April in 2016.The English version of ThyPRO39 was translated into Chinese according to Brislin′s translation model and items were adjusted based on the results of consulting expert committee.After that the Chinese version of ThyPRO39 was developed and filled in by 230 cases of thyroid disorders.The retest was done in a subsample of 30 revisiting patients 2-3 weeks later.According to the total scores of the patients obtained from the questionnaire,27% of the patients with highest scores were set up as the high score group(n=62,≥40 points),and 27% with lowest scores were arranged as the low score group(n=60,≤21 points).And scores of each item were compared between the two groups.The content validity of the scale was evaluated by content validity index(CVI).The construct validity of the scale was evaluated by exploratory factor analysis(EFA).The criterion-related validity of Chinese version of ThyPRO39 was evaluated by SF-36.And the reliability of the scale was assessed by Cronbach′s α coefficient,split-half reliability and retest reliability.Results  There were statistically significant differences in the scores of the 39 items of Chinese version of ThyPRO39 between the high score group and low score group(P<0.05).CVI of the items(I-CVI)ranged 0.830-1.000,and the average CVI of all items(S-CVI) was 0.952.Results of EFA showed that KMO value was 0.867;Bartlett′s test of sphericity was χ2=3 893.300(P<0.01);a total of 10 principal components were extracted,which could interpret 64.435% of the total variance.Pearson correlation analysis showed that the physical symptom,physical,mental,social well-being,appearance dimensions and single QoL item of the Chinese version of ThyPRO39 were negatively correlated with the physical and mental dimensions of SF-36(P<0.01).The Cronbach′s α coefficient and split-half coefficient of the Chinese version of ThyPRO39 was 0.916 and 0.711.The retest 2-3 weeks later indicated that the reliability of the subscales ranged 0.722-0.858(P<0.01).Conclusion  The survey showed that Chinese version of ThyPRO39 has good reliability and validity,which may be useful for measuring the quality of life in Chinese patients with benign thyroid disease.
    【Key words】  Thyroid diseases;Quality of life;Questionnaires;Reliability;Validity
 
Reliability and Validity of Headache Management Self-Efficacy Scale Short-Form of Chinese Version  FAN Fu-ling*,WANG Jing
Department of the Nursing,Teaching and Research Section of Internal Medicine,Luohe Medical College,Luohe 462000,China
*Corresponding author:FAN Fu-ling,Associate professor;E-mail:fanfuling0905@126.com
    【Abstract】  Objective  To translate the Headache Management Self-Efficacy Scale Short-Form(HMES-SF) into Chinese and to evaluate the reliability and validity of HMES-SF.Methods  By convenience sampling method,132 hospitalized patients with headache in neurology department of Luohe Central Hospital from November 2015 to June 2016 were selected as the research subjects.According to the translation mode of the scale,Chinesization and cultural adjustment were conducted to the HMES-SF of English-version,and the HMES-SF of Chinese-version was applied to patients with headache to test its reliability and validity.Results  The average content validity index(CVI) of the HMES-SF of Chinese version was 0.893,and the CVI of items ranged from 0.841 to 1.000.Two common factors were got through factor analysis and were named relieving strategies of headache(3 items) and control strategies of headache(3 items),the factor load of each item on its common factor was greater than 0.400.The Cronbach′s α coefficient of the HMES-SF of Chinese version is 0.829,and the Cronbach′s α coefficients of each dimension were 0.817,0.841 respectively(P<0.01).The split-half reliability coefficient r=0.764(P<0.01);the retest reliability was 0.812(P<0.01),and the retest reliability of each dimension was 0.796 and 0.828 respectively(P<0.01).Conclusion  The HMES-SF of Chinese version has good reliability and validity,and can be used to evaluate the self-efficacy of patients in headache management.
    【Key words】  Headache;Headache Management Self-Efficacy Scale Short-Form;Self efficacy;Reliability;Validity
 
Reliability and Validity of the Chinese Version of Social Capital Questionnaire for Adolescent Students  LIU Li,ZHANG Rui-xue,LIU Kun*
College of Nursing,Jinzhou Medical University,Jinzhou 121000,China
*Corresponding author:LIU Kun,Professor;E-mail:llfluency@sina.cn
    【Abstract】  Objective  To examine the reliability and validity of the translated Chinese version of Social Capital Questionnaire for Adolescent Students(SCQ-AS),and to verify its application in Chinese adolescent students so as to provide a measurement tool for the study of social education for young students.Methods  From April to May 2016,we selected 350 students from Zhangwu County,Liaoning Province as the subjects of this study by using convenient sampling method.The finished Chinese version of SCQ-AS under Chinese cultural context used in this study was finally developed after 2 revisions and improvements of the original Chinese version of SCQ-AS translated by 4 teachers and students of nursing,the first revision and improvement was based upon the suggestions of 2 primary and junior high school English teachers with no medical background,and the second was based on the pre-survey results.With the Chinese version of SCQ-AS,we conducted a formal anonymous survey in the subjects,and a second survey in 60 of whom two weeks later.Results  A total of 334 valid questionnaires were obtained,with a response rate of 95.4%.The results of the surveys showed that the Cronbach′s α,split-half reliability coefficient,and retest reliability coefficient of the questionnaire was 0.829,0.692 and 0.710,respectively(P<0.001).The scores of each item in the Chinese version of SCQ-AS were positively correlated with the total score,r values ranged from 0.458 to 0.715(P<0.05).The Chinese version of SCQ-AS was assessed by 5 nursing experts,and the content validity index was 0.816.Four common factors with eigenvalues >1.000 were extracted by exploratory factor analysis with a cumulative variance contribution rate of 66.369%.Common factor 1 had greater loads on items from 5 to 7,and item 10,while common factor 2 had those on items from 1 to 4,common factor 3 had those on items 8 and 9,and common factor 4 had those on items from 10 to 12.Confirmatory factor analysis showed that χ2/df=1.874,GFI=0.922,CFI=0.937,TLI=0.914,IFI=0.939, RMSEA=0.071,AGFI=0.874,NFI=0.878,which indicated that the fitness of theoretical structure of Chinese version of SCQ-AS was good.Conclusion  Chinese version of SCQ-AS has good reliability and validity,which can be used as a tool for the investigation of social capital of young students in China.
    【Key words】  Mental health;Adolescent;Social Capital Questionnaire for Adolescent Students;Reliability;Validity
 
Starting Time of Continuous Renal Replacement Therapy Based on the Serum Cystatin C Level in Patients with Sepsis-induced Acute Kidney Injury  LI Lin1,HUANG Li2*
1.Graduate School,Guangxi Medical University,Nanning 530021,China
2.Department of Nephrology,the Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,China
*Corresponding author:HUANG Li,Chief physician;E-mail:386079160@qq.com
    【Abstract】  Objective   To evaluate the value of serum Cys C as the indicator of implementing continuous renal replacement therapy(CRRT) in patients with sepsis-induced acute kidney injury(SAKI).Methods  We retrospectively studied the clinical data of 65 patients with SAKI treated in the ICU,the First Affiliated Hospital ,and the Second Affiliated Hospital,Guangxi Medical University from January 2013 to January 2015.Acute physiology and chronic health evaluationⅡ(APACHEⅡ) and sepsis-related organ failure assessment(SOFA) were used to assess the severity of disease.The serum procalcitonin(PCT),creatinine and Cys C levels were measured before the starting of CRRT.According to the duration between Cys C starting to elevate and the starting time of CRRT,these patients were divided into three groups:group A(<48 h,29 cases),group B(48-72 h,17 cases),and group C(>72 h,19 cases).Results  The groups had no significant differences in gender,urine volume,mean arterial pressure(MAP),proportion of patients with mechanical ventilation,proportion of patients with vasoactive drugs treatment,number of failing organs,APACHEⅡscore,SOFA score,PCT,serum creatinine,and Cys C(P>0.05).Significant difference in age existed among the three groups,specifically,the patients in group A were younger than those in group B and C(P<0.05).The in-hospital mortality rate showed no substantial difference among the groups(P>0.05).The rate of renal function recovery differed significantly among the groups(P<0.05),specifically,it was significantly higher in group A than in the other two groups(P<0.016).Multivariate Logistic regression analysis found that,the duration between Cys C starting to elevate and the starting time of CRRT was not significantly associated with the renal function recovery in patients with SAKI〔b=0.113,OR=1.120,95%CI(0.482,2.603)〕.Conclusion  It needs to be further confirmed that starting CRRT treatment in patients with SAKI within 48 h after the elevating of Cys C level could increase the rate of renal function recovery.
    【Key words】  Acute kidney injury;Sepsis;Continuous renal replacement therapy;Cystatin C
 
Efficacy of Cyclic Adenosine Monophosphate Meglumine and Digoxin for Heart Failure and Myocardial Stunning Caused by Sepsis  XU Chun-qi1,2*,SHANG Ya-dong2,CHENG Ren-li2,YOU Jia-cong1,WANG Wei-qiang1
1.Department of General Practice,Suzhou Hospital of Anhui Medical University/Suzhou Municipal Hospital,Suzhou 234000,China
2.Department of Emergency,Suzhou Hospital of Anhui Medical University/Suzhou Municipal Hospital,Suzhou 234000,China
*Corresponding author:XU Chun-qi,Associate chief physician;E-mail:xcq3615@126.com
    【Abstract】  Objective  To investigate the effect of cyclic adenosine monophosphate meglumine and digoxin for heart failure and myocardial stunning caused by sepsis.Methods  Fifty-eight patients with heart failure and myocardial stunning caused by sepsis admitted in Department of Emergency and Department of General Practice,Suzhou Hospital of Anhui Medical University from January 2013 to June 2015 were selected as the participants of this study and divided into the treatment group(n=29) and the control group(n=29) in accordance with the random number table.Based on the conventional treatment,both groups received oral administration of digoxin 0.125 mg,once daily,and the patients in the treatment group additionally received intravenous drip of cyclic adenosine monophosphate meglumine 180 mg and insulin 4 U diluted in 250 ml of glucose 5% solution.The levels of cardiac troponin I(cTn-I),brain natriuretic peptide(BNP),C-reactive protein(CRP),lactate(Lac) and procalcitonin(PCT) in venous blood and(or) arterial blood of both groups of patients were measured before the treatment and at the 7th day after treatment.Acute physiology and chronic health evaluationⅡ(APACHEⅡ) was used to assess the severity of disease.And bedside color Doppler ultrasound was employed to measure the left ventricular ejection fraction(LVEF).Results  There were no statistically significant differences between the two groups in the levels of cTn-I,BNP,CRP,Lac,PCT and APACHEⅡ scores and LVEF before treatment(P>0.05).However,after treatment,the levels of cTn-I ,BNP,CRP,Lac,PCT and APACHEⅡ scores were lower and LVEF was higher in the treatment group when compared with the control group(all P<0.05).The control group had a slightly higher rate of adverse reactions than the treatment group but with no significant difference between the two groups〔44.8%(13/29)vs. 51.1%(15/29),χ2=0.276,P=0.599〕.After two weeks of treatment,it was found that the control group had significantly higher mortality than the treatment group〔34.5%(10/29) vs. 10.3%(3/29),χ2=4.858,P=0.028〕.Conclusion  The treatment of myocardial stunning and heart failure caused by sepsis with cyclic adenosine monophosphate meglumine and digoxin,can significantly reduce the myocardial injury and systemic inflammatory response ,improve the heart function and reduce mortality.
    【Key words】  Sepsis;Myocardial stunning;Heart failure;Cyclic adenosine monophosphate meglumine;Digoxin
 
Reasons of the 34 Cases of MDR-TB Excluded from the Tuberculosis Control Project Supported by Global Fund  ZHANG Lei-lei1,JIN Hua2*,FENG Ju-ying1,WANG Jian-yun3,SONG Qiong1,ZHANG Li1,SUN Zun-yan1
1.Lanzhou Municipal Center for Disease Control,Lanzhou 730020,China
2.Gansu University of Chinese Medicine,Lanzhou 730020,China
3.Pulmonary Hospital of Lanzhou,Lanzhou 730000,China 
*Corresponding author:JIN Hua,Professor,Chief physician,Master supervisor;E-mail:lanzhoujinhua@126.com
    【Abstract】  Objective  To analyze the reasons of the patients with multidrug-resistant tuberculosis(MDR-TB) excluded from the Tuberculosis Control Project supported by Global Fund,so as to provide evidences for the treatment of these patients.Methods  The participants enrolled were 76 cases with MDR-TB selected from 770 suspicious cases in Lanzhou from March 2012 to June 2014.They were divided into included group(n=42) and non-included group(n=34) by the panel of experts based on the baseline characteristics,bacteria culture,results of auxiliary examination,and drug treatment history.The susceptibility to isoniazid(INH,H),rifampicin(RFP,R),ethambutol(EMB,E),streptomycin(SM,S),ofloxacin(OFLX,Ofx),kanamycin(KM,Km),amikacin(AMK,Am),capreomycin(CPM,Cm) was tested by the proportional method.Results  Of the 34 patients in the non-included group,6 were young,19 were middle-aged,and 9 were aged.The age distribution and treatment history differed significantly between the two groups(P<0.05).The 34 patients in the non-included group had 9 kinds of antibiotic resistance combination;17 were only resistant to first-line anti-tuberculosis drugs,the first combination of antibiotic resistance spectrum was H+R+S(8 cases),and the second was H+R(6 cases);other 17 cases were resistant to both first-line and second-line anti-tuberculosis drugs,the first combination of antibiotic resistance spectrum was H+R+S+Ofx(8 cases),and the second was H+R+E+S+Ofx(5 cases).The 34 patients excluded from the Project was due to death(6 cases),refusing to receive that kind of treatment(4 cases),lost to follow up(2 cases),insisting on using the original treatment(2 cases),1 was excluded,detaining(8 cases),aged over 65 and with different chronic basic diseases(5 cases),severe liver or kidney injury or other comorbidities and complications(5 cases),the coming out time of results of antibiotic susceptibility was later than the included time of the Project(1 case).Conclusion  It is necessary to pay great attention to using the second-line anti-tuberculosis drugs in the control and treatment of MDR-TB patients whose treatment was excluded from the Project.Besides,vulnerable population including elderly and detained patients should also be focused on.
    【Key words】  Tuberculosis,multidrug-resistant;Aged;Antitubercular agents;Global fund for MDR-TB
 
Value of Inflammatory Biomarkers in the Preoperative Diagnosis of Perforated Appendicitis  HUA Ke-jun*,HU Xian-jie,ZHANG Xing,CHEN Wen-zhong,WANG Hui,ZHAO Qin-ming
Department of General Surgery,Yinzhou Hospital Affiliated to Medical School of Ningbo University,Ningbo 315040,China
*Corresponding author:HUA Ke-jun,Attending physician;E-mail:survivin2@126.com
    【Abstract】  Objective  To investigate the value of inflammatory biomarkers such as C reactive protein(CRP) and white blood cell count,neutrophil percentage for the preoperative diagnosis of perforated appendicitis.Methods  The participants enrolled were 862 with acute appendicitis(acute attack of chronic appendicitis was included) diagnosed preoperatively and treated by appendectomy(laparoscopic appendectomy was covered) in Yinzhou Hospital Affiliated to Medical School of Ningbo University from 2012 to 2015.Based on the severity of appendicitis,they were divided into perforated group(146 cases) and non-perforated group(716 cases).The data of preoperative CRP,white blood cell count and neutrophil percentage of the participants measured at the same time were collected.The receiver operating characteristic(ROC) curve of the above three biomarkers were drawn for assessing their performance in the diagnosis of perforated appendicitis.Results  The white blood cell count and neutrophil percentage did not differ significantly between the groups(P>0.05).Perforated group had higher CRP than the non-perforated group did(P<0.05).When CRP was greater than 50 mg/L,it provided a sensitivity of 78.8%,and specificity of 90.9% for diagnosing perforated appendicitis.The young and middle-aged in the perforated group had higher CRP levels than those in the non-perforated group(P<0.05).Higher CRP levels were found in the elderly in the perforated group than in those in the non-perforated group(P<0.05).When CRP was greater than 25 mg/L,it provided a sensitivity of 82.4%,and specificity of 81.0% for diagnosing perforated appendicitis in the elderly;when it was over 50 mg/L,its sensitivity and specificity was respectively 80.2% and 89.7% for the diagnosis of perforated appendicitis in the young and middle-aged.Conclusion  White blood cell count and neutrophil percentage cannot accurately predict perforated appendicitis preoperatively,but CRP can be used as a predictor for acute appendicitis accompanied by perforation,and its diagnostic performance is better for the young and middle-aged than the elderly.
    【Key words】  Appendicitis;Perforated appendicitis;C-reactive protein;Leukocyte count
 
Microsurgical Treatment for Parasagittal and Falcine Meningiomas  WANG Xing-hua*,DU Jia-geng
Department of Neurosurgery,Affiliated Hospital of Shandong Academy of Medical Sciences,Jinan 250031,China
*Corresponding author:WANG Xing-hua,Associate chief physician;E-mail:wxh072571@163.com
    【Abstract】  Objective  To explore the key management points and effect of microsurgical treatment of parasagittal and falcine meningiomas.Methods  The clinical data of 46 consecutive patients with parasagittal and falcine meningiomas admitted in Department of Neurosurgery,Affiliated Hospital of Shandong Academy of Medical Sciences from January 2008 to May 2015,were analyzed retrospectively.The tumors located in the anterior 1/3 segment of sagittal sinus and cerebral falx in 13 cases,in the central 1/3 segment in 29 cases,and in posterior 1/3 segment in 4 cases.The tumors originated from the sagittal sinus in 16 cases,originated from the cerebral falx in 22 cases,and involved with both the sagittal sinus and cerebral falx in 8 cases.Microsurgical treatment was performed in all the patients.Results  In terms of Simpson grade of meningioma resection,32 cases received Simpson grade Ⅰ resection of the meningiomas,9 received grade Ⅱ,4 received grade Ⅲ,and 1 received grade Ⅳ.Classified by pathological typing of the meningioma,20 cases had meningothelial meningioma,12 had fibrous meningioma,6 had psammomatous meningioma,4 had angiomatous meningioma,2 had mixed meningioma,and 2 had atypical meningioma.With review to the treatment outcome,no patient died due to operation;myodynamia decrease occurred in 16 cases preoperatively,after surgery,myodynamia was improved in 14 cases,but unchanged in 1 case,and hemiplegia aggravated in 1 case;1-8 year longitudinal follow-up given to 41 cases showed that,seizure stopped after the surgery in 6 of 9 cases with epilepsy,tumors recurred in 3 cases,radiotherapy was performed in 2 cases,and 1 underwent the surgery again.Conclusion  The important factors for enhancing the effect of microsurgery for parasagittal and falcine meningiomas are the following:accurate preoperative imaging diagnosis,proper surgical approach design and intraoperative strategies,well control of bleeding,and careful and meticulous protection and management of the sagittal sinus,draining veins and functional areas of the cerebral cortex.
    【Key words】  Meningioma;Sagittal sinus;Cerebral falx;Microsurgery;Treatment outcome
 
Development and Accuracy Evaluation of the 3G Intelligent Sphygmomanometer for the Elderly  ZHANG Qun1,CAI Dao-zhang2*,WANG Ya-nan3,LI De-long2,DENG Jin-quan4,LIU Li1,DENG Yong-ping5,ZHANG Hua-ying5,FEI Wei-chun6,YANG Shi-sheng6,LI Liang-liang6
1.GCP Development,the Third Affiliated Hospital of Southern Medical University,Guangzhou 510630,China
2.Department of Joint Surgery,the Third Affiliated Hospital of Southern Medical University,Guangzhou 510630,China
3.Medical Department,the Third Affiliated Hospital of Southern Medical University,Guangzhou 510630,China
4.Statistics Office,the Third Affiliated Hospital of Southern Medical University,Guangzhou 510630,China
5.Home for the Aged Guangzhou,Guangzhou 510550,China
6.Beijing M&B Electronic Instruments Co.,Ltd,Beijing 102660,China
*Corresponding author:CAI Dao-zhang,Professor,Chief physician;E-mail:daozhang@medmail.com.cn
    【Abstract】  Objective   To develop a kind of 3G intelligent sphygmomanometer,and evaluate the accuracy of it by comparing its measuring results with those of the mercury sphygmomanometer.Methods  This study was conducted from March to August in 2016.The participants recruited were 50 elderly persons,selected from Home for the Aged Guangzhou,including 22 cases with normal blood pressure,and 28 cases with the history of hypertension.The blood pressure of every participant was measured 3 consecutive times with the interval of 3-5 min,by the specially trained physician by using the mercury sphygmomanometer and 3G intelligent sphygmomanometer,respectively.And then recorded the average of blood pressure measured by mercury sphygmomanometer and 3G intelligent sphygmomanometer.Results  In the participants with normal blood pressure,the systolic blood pressure(SBP),diastolic blood pressure(DBP) measured by the mercury sphygmomanometer was positively correlated with that by 3G intelligent sphygmomanometer(r=0.797,P<0.001;r=0.854,P<0.001),and there was no significant difference in SBP,DBP measured by two kinds of sphygmomanometers(t=-1.320,P=0.201;t=-0.203,P=0.841).Among the participants with the history of hypertension,the SBP,DBP measured by the mercury sphygmomanometer showed a positive correlation with that by 3G intelligent sphygmomanometer(r=0.829,P<0.001;r=0.920,P<0.001),and there was no significant difference in SBP,DBP measured by two kinds of sphygmomanometers(t=0.858,P=0.398;t=0.569,P=0.574).Among all the participants,52.0%(26/50)′s SBP values measured by the mercury sphygmomanometer and 3G intelligent sphygmomanometer differed by <5 mm Hg,74.0%(37/50)′s differed by 10 mm Hg,and 90.0%(45/50)′s by 15 mm Hg;76.0%(38/50)′s DBP values measured by the mercury sphygmomanometer and 3G intelligent sphygmomanometer differed by <5 mm Hg,92.0%(46/50)′s differed by <10 mm Hg and 100.0%(50/50)′s differed by <15 mm Hg.Of the participants with the history of hypertension,the proportion of participants found with SBP≥140 mm Hg by mercury sphygmomanometer was not significantly different from that by 3G intelligent sphygmomanometer〔89.2%(25/28) vs.85.7%(24/28),χ2 <0.01,P>0.05〕;the percentage of participants found with DBP≥90 mm Hg by mercury sphygmomanometer did not differ substantially from that by 3G intelligent sphygmomanometer〔21.4%(6/28) vs.17.8%(5/28),χ2 <0.01,P>0.05〕.Conclusion  For the old people measuring blood pressure and predicting the hypertension,3G intelligent sphygmomanometer has similar accuracy as the mercury sphygmomanometer.
    【Key words】   Sphygmomanometers;3G intelligent sphygmomanometer;Mercury sphygmomanometer;Aged
 
Research Progress of the Related Tools of the Comprehensive Geriatric Assessment  ZHANG Yan1,GU Yan-hong2*
1.Nantong University School of Nursing,Nantong 226000,China
2.Shanghai University of Medicine & Health Sciences,Shanghai 201318,China
*Corresponding author:GU Yan-hong,Chief superintendent nurse,Professor,Master supervisor;E-mail:reddy_gu@163.com
    【Abstract】  Comprehensive geriatric assessment(CGA) is the core technology of geriatric medicine,which has been widely used in clinical practice.There are a wide range of evaluation tools,including comprehensive assessment tools:Older American Resources and Services Multidimensional Functional Assessment Questionnaire(OMFAQ) and EASY-Care Standard questionnaire;comprehensive assessment tools targeting at special older population:Geriatric Assessment in Hematology(GAH) and the Long-term Care-CGA(LTC-CGA).We can use effective screening tools such as Abbreviated Comprehensive Geriatric Assessment(aCGA),Vulnerable Elders Survey(VES-13),Geriatric-8(G-8),Korean Cancer Study Group Geriatric Score(KG-7) to select older people who need a full CGA.The paper reviews the use and research of CGA-related tools.
    【Key words】  Aged;Assessment instrument;Review
 

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