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June 2020, Volume 23,No17 Abstracts(B)

Survey on Knowledge about Thyroid Nodules and Differentiated Thyroid Cancer among General Practitioners in Pudong New Area of Shanghai TANG Huiyun,ZHANG Tao*,SHA Jingjing,WANG Haiwen,BAO Yan,HUANG Ying
Department of General Medicine,Jinyang Community Health Service Center,Pudong New Area,Shanghai 200136,China
*Corresponding author: ZHANG Tao,Chief physician;E-mail: songdp201206@126.com
【Abstract】 Background At present,the prevalence of thyroid nodules in China is 20% to 76%,which has become the second most common disease of the endocrine system.Early detection,early diagnosis and early treatment are effective measures to prevent and treat thyroid tumors,and family doctors play a major role in it.However,there are still many shortcomings in the management of thyroid diseases in community health service centers.Objective Through study of the knowledge about thyroid nodules and Differentiated thyroid carcinoma(DTC) among General practitioners in Pudong New Area of Shanghai,to find the shortcomings in order to propose improvement methods to promote the hierarchical diagnosis and treatment of thyroid diseases.Methods From 20th December 2017 to 10th January,2018,according to the urban-rural division of Pudong New Area in Shanghai,through cluster sampling method,randomly selected three community health service centers by computer from urban areas,suburban areas and suburbs according to the urban-rural division of Pudong New Area in Shanghai,and the survey included general information,assessment of benign and malignant thyroid nodules,preoperative and postoperative management of thyroid nodules,treatment and management of thyrotropic hormone(TSH) inhibition after DTC,and self-assessment of thyroid disease management ability of general.Results A total of 309 questionnaires were distributed,and 307(99.4%) of them were recovered.In the evaluation of general practitioners' understanding of the evaluation methods of benign and malignant thyroid nodules,the differences were statistically significant in the understanding of CT scan,magnetic resonance imaging,2-fluoro-2-deoxyd-glucose positron emission tomography,TSH,and thyroid globulin among general practitioners with different professional titles and educational backgrounds(P<0.05).The differences were statistically significant in the degree of understanding of serum calcitonin among general practitioners with different professional titles(P<0.05).In the evaluation of general practitioners' understanding of preoperative and postoperative management of thyroid nodules,the differences were statistically significant in the understanding of general practitioners with different titles on preoperative follow-up time,indications of fine needle aspiration biopsy,postoperative TSH inhibition therapy and left thyroxine replacement therapy(P<0.05).The differences were statistically significant(P<0.05)in the understanding degree of general practitioners with different educational backgrounds on the preoperative follow-up time of thyroid nodules and understanding of indications and contraindication of 131I treatment.In the evaluation of general practitioners' understanding of TSH inhibition treatment and management after DTC,the differences were statistically significant among general practitioners with different titles in their understanding of the preferred oral preparation L-T4,L-T4 taking method,L-T4 dose adjustment and TSH level monitoring(P<0.05).General practitioners with different education backgrounds had statistically significant differences in their understanding of L-T4 dose adjustment and heart monitoring(P<0.05).The understanding score of general practitioners on the benign and malignant evaluation methods of thyroid nodules was(19.1±6.9),the understanding score of preoperative and postoperative management of thyroid nodules was(14.0±7.2),and the understanding score of TSH inhibition treatment and management after DTC was(13.7±8.4).The general practitioners with different educational backgrounds and professional titles had statistically significant differences in the understanding scores of these three parts and the total scores(P<0.05).Moreover,the self-evaluation of thyroid disease management ability of general practitioners with different professional titles and educational backgrounds was statistically significant(P<0.05).Conclusion GPs in Shanghai's Pudong New District relatively lack in the knowledge of thyroid nodule and DTC,especially in patients with thyroid nodule preoperative and postoperative treatment referral follow-up management,DTC patients postoperative TSH suppression therapy and management.Moreover,GPs lack confidence in the management of thyroid diseases,and it is necessary for GPs to strengthen learning and clinical training.
【Key words】 Thyroid nodules;General practitioners;Questionnaire survey;Differentiated thyroid carcinoma;Awareness rate;Classification treatment
 
Prevalence of Chronic Kidney Disease among the Elderly in Changning District of Shanghai from 2012 to 2016 HUANG Yanping1,RU Qianying1,ZHANG Danhuan1,FAN Chenhao2,MAO Peiju1*
1.Department of Geriatrics,Shanghai Tongren Hospital,Shanghai 200336,China
2.Department of Information,Shanghai Tongren Hospital,Shanghai 200336,China
*Corresponding author: MAO Peiju,Chief physician;E-mail: maopeijv@126.com
【Abstract】 Background The CPC Changning District Committee and the People's Government of Changning District have always attached great importance to the well-being of the elderly,with a focus on the support for happy aging.providing a free annual physical examination for adults aged 65 years and over.When the chronic kidney disease(CKD) develops to uremia,the final stage of CKD,although dialysis and kidney transplantation can prolong the life span,which also result in greatly reduced quality of life,and increased medical costs and other inconveniences.So it is of great significance to early detect CKD,and delay the progression of CKD to uremia by giving timely intervention in early or mid-term stage in this group.Objective To investigate and compare the prevalence of CKD in older adults from Shanghai's Changning District in 5 consecutive years(2012—2016).Methods Adults(≥65 years old) undergoing the free annual health check up in Changning District of Shanghai in 5 consecutive years were enrolled,including 28 361 in 2012,23 745 in 2013,24 864 in 2014,25 405 in 2015,and 24 584 in 2016.They received a survey covering general demographic data(name,sex,date of birth,place of residence and other information),laboratory markers(serum creatinine,routine urinalysis results,etc.),and stage of CKD based on estimated glomerular filtration rate(eGFR).Annual prevalence of CKD and percentages of CKD stages 1-5 were compared.Unconditional Logistic regression(stepwise regression) was used to ermine the associations of sex and age with CKD.Results The prevalence of CKD during 2012—2016 was 16.22%(4 601/28 361),15.13%(3 592/23 745),14.54%
(3 614/24 864),9.81%(2 493/25 405) and 12.39%(3 047/24 584),respectively.Annual CKD stages distribution differed significantly during this period(LR=24 700.47,P<0.001).Sex ratio varied obviously between those with CKD and those without in 2012,2014 and 2016(P<0.05).CKD adults had greater mean age than non-CKD adults in each year of this period(P<0.05).Logistic regression analysis found that the prevalence of CKD in females was 1.536,1.426,1.392,1.351 and 1.509 times higher than that in males from 2012 to 2016,respectively.The prevalence of CKD grew by 1.103,1.104,1.100,1.104 and 1.103 times,respectively,for every additional year of age from 2012 to 2016(P<0.05).Conclusion The prevalence of CKD in older adults from Shanghai's Changning District was high during the period.Although the 5-year annul prevalence showed a downward trend,female and older age are associated with higher risk of CKD.
【Key words】 Nephrosis;Chronic kidney disease;Aged;Prevalence;Data collection;Shanghai
 
Early Screening of Childhood Autism by the Parent in the Community LUO Mingjin,SONG Haidong*,LIU Jian
Hangzhou Seventh People's Hospital /Mental Health Center Zhejiang University School of Medicine,Hangzhou 310013,China
*Corresponding author: SONG Haidong,Associate chief physician;E-mail: drsonghaidong@163.com
【Abstract】 Background A large number of studies show that if autism children are detected and intervened earlier,their prognosis will be better.Although early screening of childhood autism has not been delivered in domestic community health institutions,early screening of childhood autism by the parent can be used as an effective remedy in the community.Objective To analyze the implementation status and associated factors of early screening of childhood autism by the parent in the community,to explore an early screening mode for the disease appropriately conducted in the community.Methods By use of cluster sampling,we recruited 5 306 infants aged >12-36 months from three subdistricts(towns)of West Lake District,and four subdistricts(towns)of Yuhang District,Hangzhou,from July to October 2016.We surveyed their parents for collecting the child's demographic data,and the parents'autism knowledge with a self-developed scale,and for obtaining the parents' evaluation results of autism of the child using the Communication and Symbolic Behavior Scales Developmental Profile(CSBS-DP),and the Modified Checklist for Autism in Toddlers(M-CHAT),and analyzed the associated factors for childhood autism.Results A total of 5 105 valid questionnaires were collected with an effective recovery rate of 96.21%。The prevalence of autism spectrum disorders(ASD)in infants aged 12-18 months was 12.49%(169/1 353).Male infants,premature infants,and infants whose parents knowing little autism knowledge had lower mean scores of CSBS-DP(P<0.05).The CSBS-DP score was correlated with the age of infants negatively(r=-0.360,P< 0.001).The prevalence of ASD in those aged 18-36 months was 5.76%(216/3 752).The M-CHAT score was positively correlated with birth weight(r=0.042,P=0.012)and negatively correlated with parents' autism knowledge score(r=-0.081,P=0.003).Conclusion The prevalence of ASD in infants aged >12-36 months screened by the parent is 7.54%,which is associated with parents' autism knowledge.It is important to implement early screening of childhood autism by the parent in the community,but improvements need to be carried out further.
【Key words】 Autism;Community;Early screening;Children

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