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Screening and evaluating the diseases responding specifically to traditional Chinese medicine （TCM） will help to highlight the advantages of TCM treatment， and the evaluation method should be standardized with consideration to the unique characteristics of the diseases. The incidence of Sjögren's Syndrome （SS） is increasing year by year， while the pathogenesis of this disease remains unclear. Modern therapies for this disease include biological agents and immunosuppressants， which generally have unsatisfactory efficacy. The TCM treatment of SS focuses on the harmony of the physical and mental health. The Rheumatology Branch of the China Association of Chinese Medicine organizes experts in TCM， Western medicine， and evidence-based medicine to form working groups. Delphi method and bibliometric method were used for analysis， and SS was selected as a disease responding specifically to TCM. Furthermore， the evaluation system was established for this disease， and the consensus regarding this disease was reached after seminar discussion. This paper summarized the whole process of the evaluation of the advantages of TCM treatment of SS. First， because TCM atomization is widely used in clinical practice and enriches TCM administration methods， this therapy is included after other non-drug therapies were taken as characteristic therapies. Second， the evaluation indicators of therapeutic effect should be determined with consideration to international acceptance and the current research status. Third， the expression method should be accurate， standardized， and objective， highlight the natural advantages of TCM， and avoid arbitrary extension. This paper provides a reference for clinicians to explore other diseases responding specifically to TCM.
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Objective To explore the effect of temperature on the risk of hand-foot-and-mouth disease (HFMD) and population susceptibility. Methods The data of HFMD cases in Chengdu from January 1, 2016 to October 31, 2022 were collected, and local meteorological data during the same period were also collected. Distributional lag nonlinear models were developed. The relative risk (RR) of morbidity at different temperatures and different lags was calculated. Differences in the relative risk levels of different populations were analyzed and compared. Results A total of 263 776 cases of HFDM were reported in Chengdu during the study period. The distribution of HFMD was periodic. For the overall population, the short-term average temperature and RR showed a “U”-shaped relationship. When the lag time was 0-7 days, the cumulative RR was 1.59 (95%CI: 1.18-2.14) at the average temperature of -0.5℃ and 2.16 (95%CI: 1.60-2.91) at the average temperature of 34.5℃. The RR values under high and low temperatures decreased with increasing lag period. When the lag time was extended, the average temperature and RR showed an inverted “U”-shaped relationship, with higher RR at moderate temperatures and increasing as the lag period increased. The results of the subgroups showed that the RR of onset among scattered children was higher at high and low temperatures. Conclusion The risk effect of temperature on the onset of HFMD in different populations is variable and changes with the lag period, and the prevention and control measures should be adjusted in a timely and targeted manner.
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Objective: To analyze the current status of work-related musculoskeletal disorders (WMSDs), work fatigue and musculoskeletal pain in Chinese occupational population, and to study the relationship between work fatigue and musculoskeletal pain and WMSDs. Methods: A total of 66 961 employees from 323 enterprises in 15 key industries in China were selected as the study subjects using stratified cluster sampling method. The incidence of WMSDs in the past year was investigated using the Chinese version of the Musculoskeletal Disorders Questionnaire, and the work fatigue and musculoskeletal pain were investigated using Borg 6-20 Rating of Perceived Exertion Scale and visual analogue scale. The data were standardized using the age composition data of 18 to 60 years from the seventh national population census. Results: The standardized annual incidence of WMSDs was higher in the front-line workers than that in the administrative and other supportive staff (38.82% vs 36.30%). The detection rates of work fatigue and musculoskeletal pain in the study subjects were 44.54% and 63.08%, respectively. The result of S-curve fitting showed that the risk of WMSDs increased with the level of work fatigue (P<0.01). Among the front-line workers, the average of monthly fatigue frequency in the neck, shoulder, lower back, upper back, wrist/hand, foot and ankle, knee, leg, and elbow were higher in the group with WMSDs compared to those without WMSDs (all P<0.01). The pain degree of musculoskeletal pain was higher in all nine sites in the fatigued group than in the no-fatigue group (all P<0.01). The standardized detection rate of musculoskeletal pain was higher in the fatigued group than in the non-fatigued group (80.38% vs 25.71%). The work fatigue was moderate and positively correlated with musculoskeletal pain in all seven sites except the lower back and elbow, with Kendall Tau-b correlation coefficients ranging from 0.423 to 0.546 (all P<0.01). Conclusion: There is a good correlation between work fatigue and local musculoskeletal pain, work fatigue and WMSDs in Chinese occupational population. Implementing ergonomic interventions to control the development of work fatigue can be an effective measure for preventing WMSDs.
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Background Prolonged awkward postures during occupational activities can lead to excessive musculoskeletal load on the wrist of workers and symptoms such as wrist pain or discomfort. Objective To survey the prevalence of wrist pain among workers in 10 key industries and analyze its correlation with wrist working postures. Methods By using stratified cluster sampling method, workers from 10 key industries, such as footwear manufacturing industry, shipbuilding manufacturing industry, and automobile manufacturing industry, were selected from seven regions in North China, East China, Central China, South China, Southwest China, Northwest China, and Northeast China. The demographic information, wrist working postures, pain in wrist of the workers were collected through a cross-sectional survey. Pearson χ2 test was used to compare prevalence by selected factors, trend χ2 test for between group comparison, and unconditional logistic regression models for the association of wrist working postures with wrist pain. Results There were 64052 workers enrolled in this survey, and 56286 provided valid questionnaires (the effective rate was 87.8%). According to the survey, the prevalence of wrist pain was 23.3% (13112/56286), and the industries with higher prevalences were footwear manufacturing (27.1%, 1927/7106), automobile manufacturing (24.9%, 5378/21560), and shipbuilding and related equipment manufacturing (24.4%, 850/3488) industries. Finger pinching (OR=2.09, 95%CI: 1.95-2.24), frequent wrist bending (OR=2.03, 95%CI: 1.92-2.15), fixed wrist bending (OR=1.77, 95%CI: 1.69-1.85), wrist on hard edge (OR=1.34, 95%CI: 1.28-1.40), and arms over shoulders (OR=1.11, 95%CI: 1.05-1.17) increased the risk of reporting wrist pain. Conclusion Awkward postures are related to wrist pain among workers in selected 10 key industries. The related factors are wrist on hard edge, frequent wrist bending, finger pinching, fixed wrist bending, and arms over shoulders.
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Objective:To study the effect of occupational X-ray exposure on non-cancer diseases of radiation workers.Methods:The medical X-ray workers in Chongqing mumicipality were surved in 1980. In 2020, the previous 91 medical institutions distributed across 41 districts and counties of Chongqing continued to be selected as the survyed units, including 53 grade-A top-class hospitals. Using the method of prospective cohort study, the fifth follow-up survey was conducted for Chongqing′s medical X-ray workers and the control groups in 1980 with respect to their personal information, occupational radiation exposure, disease history and others. The incidence rate, relative risk ( RR) and 95% confidence interval of diseases in each system were analyzed. Results:There were 937 individuals in this cohort. So far, 359 cases of non-cancer diseases had been counted. Compared with the control group, the relative risk RR of cardiovascular system, ophthalmology and other unclassified diseases in the exposure group were 1.50, 2.03 and 2.64 ( χ2=5.97, 3.97, 4.25, P <0.05) , respectively. The adjusted confounding factors showed that the RR of the incidence rate of cardiovascular, ophthalmic and digestive diseases in the female exposure group was generally higher than that in the control group ( RR=2.33, 2.59, 7.55; χ2= 7.28, 4.17, 8.64, P < 0.05) , respectively. The RR of the incidence rate of cardiovascular and ophthalmic diseases in exposure group was generally higher than that in the control group among 25-29 year-old workers ( RR=2.26, 5.07; χ2 =8.22, 4.91, P < 0.05) , respectively. For compasion between the the accumulated dose groups, the incidence rate of cardiovascular system, ophthalmology and digestive system diseases in the exposure group was generally higher than that in the control group ( RR=1.86, 2.91, 3.59; χ2= 9.83, 8.21, 5.58, P < 0.05) , respectively. Conclusions:The non-cancer risk of X-ray workers exposed to long-term occupational exposure was increased, among which the risk of cardiovascular system, digestive system, ophthalmic diseases and others might be related to the occupational exposure.
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Legg-Calvé-Perthes disease (LCPD) is an idiopathic necrosis of the femoral head in childhood, the deformities of the femoral head occurring in the progress of disease could result in osteoarthritis. Treatment can be surgical or nonsurgical, but the timing and indications remain unclear. Understanding of the prognostic factors of LCPD is helpful to predict the outcome and guide the clinical management. This study reviewed the literatures about the prognosis of LCPD since 2000, the prognostic factors were summarized from three categoriesas general factors, disease factors and intervention factors. The general factors were the characteristic information of patient that can be obtained at the first time clinically. The age of onset is the most definite prognostic factor, the younger the age, the better the prognosis, and 6-8 years is an important watershed. Disease factors refer to the disease characteristic information obtained through evaluation. The modified Waldenstr?m stage of the disease needs to be confirmed first, early treatment can ensure better prognosis. Then the severity was evaluated, including the involvement of necrosis, morphological changes and extrusion of the femoral head. The more severe the disease, the worse the prognosis. Most predicters, such as Catterall grading and Herring lateral column typing, have to be used in late-stage of LCPD. The degree of femoral head perfusion evaluated in enhanced MRI or DWI-MRI is an early predictor of LCPD, but it is still in the preliminary exploratory. Intervention factors are the effects of different methods of treatment on prognosis, including the comparison of surgery or non-surgery, different non-surgical and different surgical methods. The determination of surgical or non-surgical treatment mainly depends on the age of onset and severity of disease, and the younger and milder cases tend to be non-surgical treatment, but the specific indications are still controversial.
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Objective:Course of evolution observed relatively early Perthes disease in children surgically treated and conservative, explore the significance of early surgical treatment of Perthes disease.Methods:From January 1997 to December 2017, 632 children with Perthes disease were admitted. According to the inclusion and exclusion criteria, a total of 67 children were included in this study. Surgical group: 35 cases, 32 males and 3 females, age ranged from 7.0 to 11.8 years, with an average 8.3±1.0 years old, 21 cases on the left side and 14 cases on the right side. Conservative group: 32 cases, 24 males and 8 females, age ranged from 7.1 to 12.0 years old, with an average of 8.4±1.4 years old, 22 cases on the left side and 10 cases on the right side. The pelvic orthosis and frog position were taken every 3 months, and the evolution of Perthes disease was evaluated by referring to the modified Waldenstr?m staging. In the series of observations, no modified Waldenstr?m IIb stage was found to skip the fragmentation stage. After the healing period, the pelvic orthosis and frog position were evaluated according to the Stulburg classification results, and the ratio of the width of the metaphyseal end of the affected side to the contralateral side and the height of the femoral head epiphysis were measured.Results:The time required to enter stage IIIa, surgical group: range from 0.1 to 1.5 years, with an average of 0.58±0.33 years, conservative group: range from 0.4 to 1.8 years, with an average of 0.96±0.30 years, it takes both to enter the repair phase The time difference was statistically significant ( t=5.259, P<0.05); children whose disease course skipped the fragmentation stage, surgical group: 11 cases (31%), conservative group: 5 cases (16%), the difference is statistically significant ( χ2=22.626, P<0.05). The ratio of the affected side to the uninfected side of the metaphysis: surgical group: range 101%-123%, with an average of 108.0%±6.0%. Conservative group: range 101%-148%, with an average of 115.8%±11.2%. The difference in the ratio between the affected side and the healthy side of the metaphysis was statistically significant ( t=3.450, P<0.05). The ratio of the affected side to the healthy side of the height of the femoral head epiphysis: surgical group: range 61%-96%, with an average of 82.5%±8.2%. Conservative group: range 33%-92%, with an average of 74.7%±1.3%. There was a statistically significant difference in the ratio of the height of the femoral head epiphysis between the affected side and the healthy side ( t=2.921, P<0.05). Stulberg classification, surgical group: Type I hip joints 29 hips, Type II hip joints 6 hips, Type III hips 0 hips; conservative group: Type I hips 16 hips, Type II hips 10 hips, Type III hips 6 hips. There was a statistically significant difference in the Stulberg classification after the two entered stage IV ( Z=3.386, P<0.05). Conclusion:Early surgery changed the natural evolution of Perthes disease. Early surgical treatment shortens the fragmentation period of Perthes disease, so that it enters the repair phase ear-lier, and has the opportunity to skip the late fragmentation period and change its natural course. After healing, the morphological change of the proximal femur is closer to normal.
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Objective:To analyze the risk factors of avascular necrosis (AVN) after closed reduction and spcia casting in treating developmental dysplaisa of the hip (DDH).Methods:The patients with DDH who received closed reduction in our department from January 2016 to December 2017 were retrospectively reviewed. The inclusion criteria included aged at reduction ≥6 months, achieving successful reduction, having complete data with more than 2 years follow-up. A total of 48 cases with 54 hips were included in the present study. Among them, there were 2 males and 46 females, 41 unilateral hips and 13 bilateral hips. The mean age at closed reduction was 16.4±3.8 months (range 6-24 months). The mean follow-up duration was 2.9±1.8 years (range 2.3-4.1 years). Closed reduction was conducted under general anesthesia followed with a spcia cast immobilization. The abduction angle of the cast was recorded. The stability of reduction was evaluated by Ramsey safety zone. The maximum abduction and re-dislocation abduction were recorded. The quality of reduction was evaluated by the medial gap and femoral head coverage on intraoperative arthrography and post-reduction MRI. AVN was diagnosed according to Salter criteria. The risk factors of AVN were analyzed by univariate and binary logistic regression analysis.Results:AVN occurred in 12 hips (22.2%) of 54 hips. International Hip Dysplasia Institute (IHDI) grade and the difference between maximum abduction and cast abduction (Max-Cast abduction) were related to the occurrence of AVN in univariate analysis. The incidence of AVN in hips of IHDI grade 4 (42.9%, 9/21) was significantly higher than that in hips of IHDI grade 3 (9.7%, 3/31) (χ 2=6.007, P=0.018). However, the hips of IHDI grade 3 and 2 (0%, 0/2) presented a similar incidence of AVN (χ 2=0.000, P=1.000). The Max-Cast abduction was -0.7°±5.9° in the AVN group and 6.1°±7.6° in the AVN group ( t=2.125, P=0.038). Finally, IHDI grade ( OR=8.256, P=0.015) and Max-Cast abduction ( OR=0.832, P=0.047) were both independent factors of AVN in multivariate analysis. Conclusion:Most of the hips with AVN are IHDI grade 4 after closed reduction for DDH. The abduction angle in a spica cast could not be significantly related to the occurrence of AVN. However, the risk of AVN might be increased when the cast abduction is close to or beyond the maximum abduction. Safe abduction in the cast should be 5 to 10 degrees less than maximum abduction at least.
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Objective:Comparing with the external fixator technique, investigate the clinical effect of fixator-assisted plating technique for treatment distal femoral valgus deformity in adolescent.Methods:A retrospective analysis of the relevant data of 22 patients (25 limbs) with acute correction of distal femoral valgus deformities from July 2015 to June 2019, according to the difference of the final fixation, they were divided two groups. The fixator-assisted plating group, including 8 patients (9 limbs), 5 boys and 3 girls, 5 left and 2 right, 1 bilateral, the physis were closed in 4 cases and opened in 4 cases, age 14.04±1.99 years (11.7-18 years). The external fixator group, including 14 patients (16 limbs), 6 boys and 8 girls, 8 left and 4 right, 2 bilateral, the physis were closed in 9 cases and opened in 5 cases, age 13.33±1.88 years (10.1-16.5 years). Measuring the mechanical axis deviation (MAD) and the mechanical lateral distal femur angle (mLDFA) in full length standing AP view X-ray of the lower limb pre and post operation. Recording the changed of limb length discrepancy (LLD) before and after surgery and the knee range of motion at 6 weeks, 3 months, 6 months and the last follow up post operation. The Kolcaba comfort status scale was used to evaluate the comfort of two groups at 2 weeks, 6 weeks, 3 months, 6 months and the last follow up. Meanwhile recorded the healing time of osteotomy sites and the complications.Results:The difference in general information between the two groups was not statistically significant. The fixator-assisted plating group followed up mean 26 months (range, 12-40 months), the healing time were 4.00±0.66 months, the mLDFA mean 73.33°±4.12° before surgery and 87.89°±1.69° after surgery and there was significant difference ( t=10.582, P<0.05). The external fixator group followed up mean 36 months (range, 22-42 months), the healing time were 4.00±0.66 months, the mLDFA mean 73.31°±3.95° before surgery and 87.31°±1.54° after surgery and there was significant difference ( t=14.118, P<0.05). The MAD were in the normal range in all patients after surgery, and there were no significant difference about healing time of the osteotomy sites and postoperative mLDFA between the two groups ( t=1.514, P=0.150; t=0.845, P=0.411). Comparing with the knee function, the fixator-assisted plating group was better at 6 weeks, 3 months, 6 months after surgery but there was no difference at the last follow up. Also, the fixator-assisted plating group felt more comfortable at 2 weeks, 6 weeks, 3 months, 6 months and there was no difference at the last follow up. All the patients with external fixator have mild pin sites infection and there were no obvious complications in patients with plate. Conclusion:The fixator-assisted plating technique can accurately correct the valgus deformity with satisfactory healing of the osteotomy in distal femoral compare with the external fixator technique, but the patients feel more comfortable and the knee joint function recovers faster and no risk of pin site infection, the clinical results was satisfactory with fewer complication.
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Objective To analyze the characteristics and changing trend of injury death among elderly residents aged 65 and above in Chongqing from 2013 to 2017, and to provide a basis for formulating intervention strategies for elderly injuries. Methods Based on monitoring data of death causes of permanent residents in Chongqing from 2013 to 2017, the injury death cases of elderly residents aged 65 and above were extracted, and the mortality rate and sequence were calculated. The standard mortality rate was calculated based on the standard population composition of the sixth national population census in 2010. The Joinpoint Regression Program 4.2 software was used to analyze the death trend. Results From 2013 to 2017, the average annual crude injury mortality rate of Chongqing residents aged 65 and above was 140.89/100 000, and the standardized mortality rate was 12.57/100 000. The crude death rate of male elderly residents was higher than that of female residents in the same year (P <0.001), and the injury mortality rate increased with the age of the elderly (P <0.001). The injury mortality rate of female and all elderly residents, and elderly residents in the 75- and 85-year-old groups showed an upward trend (P<0.05). Falls, road traffic injuries, suicide, other accidental injuries and drowning were the top five causes of injury death in Chongqing, accounting for 93.16% of the total injury deaths. In the past five years, the fall mortality of elderly residents in Chongqing showed an upward trend (P < 0.05). Falling was the first cause of injury death for elderly aged 70 and above in Chongqing. The crude rate of death of elderly residents aged 85 and over was 313.52 /100 000. Conclusion The injury mortality and fall mortality of elderly residents aged 65 and above in Chongqing showed a rising trend in the past five years. It is urgent to take measures to prevent injury and falls for seniors in Chongqing.
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Objective@#To investigate the reproducibility of the femoral head perfusion index by enhanced MRI and the predictive value of the Herring lateral pillar classification after the progression of early stage of Perthes disease (X-ray modified Waldenström stage Ia, Ib, IIa) to stage IIb.@*Methods@#From October 2016 to November 2018, a total of 30 children with early stage of Perthes disease were enrolled, including 29 males and 1 female, aged 7.5±1.0 years (range 6.3 to 9.5 years). All patients were evolved by unilateral with left 24 cases and 6 cases on the right side. There were 1 case in stage Ia, 16 cases in stage Ib and 13 cases in stage IIa. At the initial evaluation, X-ray films and enhanced MRI were performed. Three observers measured the femoral head perfusion index on the enhanced MRI. The ratio of the pixels in the affected ossified nucleus perfusion area to the pixels in the contralateral femoral skull nucleus was recorded. A total of 30 cases were measured with repeated evaluation at intervals of 1 to 2 weeks. The second measurement was independent of the first measurement results. The average of the two measurements was regarded as the final measurement results. At 3 months follow-up, anteroposterior and Lauenstein frog-lateral radiographs were taken. The follow-up duration was end at the stage IIb progression. The Herring lateral pillar of the femoral head was determined on the X-ray films. The differences in the early MRI femoral head perfusion index were compared between the different lateral column types.@*Results@#The ICC values of the femoral head perfusion index between the three observers were 0.876. The ICC values measured by the 1/3 perfusion index of the lateral femoral head were 0.729. The ICC values of the femoral head perfusion index measured by the same observer at different times were 0.932. The ICC values measured by the 1/3 perfusion index of the lateral femoral head were 0.805. A total of 30 children were followed to stage IIb at 6.49±5.12 months (range 2.3 to 22.1 months). There were 13 cases of type A and type B and 17 cases of type C. The sputum perfusion index of type A and type B was 59.77%±17.12% (range 25%-85%), and that of group C was 13.47%±10.65% (range 2%-23%). The difference between groups was statistically significant (t=8.563, P=0.000). The 1/3 perfusion index of the lateral femoral head of the A and B groups was 75.62%±15.03% (range 50%-95%), while the C type was 22.24%±12.28% (range 5%-45%) with significant difference (t=10.621, P=0.000).@*Conclusion@#The measurement of femoral head perfusion index on enhanced MRI has almost perfect agreement between and within observers across multiple rounds of study. In children with early Perthes disease, enhanced MRI has predictive effect on the Herring lateral pillar classification after progression to stage IIb.
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Objective@#To investigate the current status of social security among pneumoconiosis patients from two areas of Chongqing, China with different economic levels from 2006 to 2018, and to provide a reference for the development of security policy for pneumoconiosis patients.@*Methods@#The current status of social security was analyzed for pneumoconiosis patients from A and B counties of Chongqing who were diagnosed from 2006 to 2018, and a comparative analysis was performed.@*Results@#From 2006 to 2017, there was a significant increase in the number of newly diagnosed pneumoconiosis patients in A county, while the number of newly diagnosed pneumoconiosis patients remained relatively stable in B county. As of May 2018, there were 5738 pneumoconiosis patients in A county and 4155 pneumoconiosis patients in B county. Among the 5738 pneumoconiosis patients in A county, 5335 (93%) had employers, and among these patients, 2729 (47.6%) received one-time compensation from occupational injury insurance, and currently 1884 (32.8%) were covered by the insurance. Among the 4155 pneumoconiosis patients in B county, 2482 (59.7%) received one-time compensation from occupational injury insurance, and currently 3062 (73.7%) were covered by the insurance. The social security rate of pneumoconiosis patients was 71.0% in A county and 81.4% in B county, and there was a significant difference in the distribution of social security among pneumoconiosis patients between the two counties (χ2=4704.9, P<0.01) .@*Conclusion@#Strict implementation of social security policies for pneumoconiosis patients by local governments is the key to solving social assistance for pneumoconiosis patients and improving their quality of life and social security level.
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Objective@#To investigate the living conditions, insurance coverage, and assistance of pneumoconiosis patients diagnosed in Chongqing from May 2006 to May 2018.@*Methods@#A cross-sectional survey was conducted in July 2018, and 40 890 pneumoconiosis patients from occupational diseases report management agency were obtained. 34 625 cases meeting the inclusion criteria were investigated, and descriptive statistical analysis was performed on the data.@*Results@#There were 34 625 cases of pneumoconiosis patients alive in Chongqing, and 22730 (65.6%) had participated in work-related injury insurance, 6 308 (18.2%) had participated in basic medical insurance for urban employees which were still effective. 27 056 (78.1%) had participated in cooperative insurance for urban and rural residents which were still effective. 4 393 (12.7%) received assistance for the residents in need in urban and rural areas. 5827 (16.8%) benefited the policy of "Xiangyu Railway". There were 7 961 cases (2.4%) whose work-related injury insurance had expired did not get one-off compensation, and did not receive any assistance.@*Conclusion@#Most of the patients with pneumoconiosis in Chongqing obtained protection in terms of work-related injury insurance, medical insurance, civil assistance and poverty alleviation to a certain extent, but the strength of the guarantee is not enough. Patients with pneumoconiosis might suffer from poverty caused by illness. It is recommended to improve the system of work-related injury insurance benefits, establish special funds for pneumoconiosis patients, strengthen health education and health promotion for pneumoconiosis patients, and strengthen the management of pneumoconiosis patients.
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Objective@#To analyze the prevalence of pneumoconiosis and civil aid and medical care among Xiangyang-Chongqing railway construction workers in Chongqing from 2011 to 2018, so as to provide scientific basis for prevention and control of pneumoconiosis.@*Methods@#The Chongqing database of Xiangyang-Chongqing railway construction workers cases from 2011 to 2018 were subjected to systematic collected. SPSS 18.0 was adopted for statistical description and analysis.@*Results@#From 2011 to 2018, a total of 7031 silicosis cases were diagnosed, and 5827 cases were existed, including 4056 cases of stage I, 1491 cases of stage II, and 280 cases of stage III. The cases were concentrated in the area along the southwest to northeast of Chongqing. The diagnosis age of silicosis patients was mainly 60~64 years old (69.73%) . Most silicosis cases were the drill workers and the stone workers. The exposure time of silicosis patients was short and concentrated in 3 years. The 5827 cases of pneumoconiosis in the Xiangyang-Chongqing railway were all treated with special civil aid and medical care for pneumoconiosis in the Xiangyang-Chongqing railway.@*Conclusion@#The prevalence of silicosis among workers who participated in Xiangyang-Chongqing railway construction remained serious. Civil aid and medical care covers all silicosis patients. Occupational health surveillance for silicosis and assistance should be carried out in these workers.
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Objective@#To analyze the prevalence of pneumoconiosis and assistance guarantee of the migrant workers of the district in Chongqing from 2006 to 2017, so as to provide scientific basis for prevention and control of pneumoconiosis of the migrant workers.@*Methods@#The database of new pneumoconiosis cases of the migrant workers and assistance guarantee of the district in Chongqing from 2006 to 2017 were subjected to systematic arrangement. SPSS 18.0 was adopted for statistical description and analysis.@*Results@#From 2006 to 2017 a total of 2188 new cases of pneumoconiosis were diagnosed, including I (917, 41.91%) , II (1003, 45.84%) , III (268, 12.25%) . Most of new cases of pneumoconiosis were silicosis. The median length of seniority was 6 years. The mean diagnostic age was 44.25. Significant difference was found in diagnosis age between different stages (F=3.161, P=0.043) . 98.77% of migrant workers had no units. There were 5.07% of migrant workers who took out industrial injury insurance, 14.58% receiving civil aid, 31.12% receiving aid from poverty alleviation, and 93.46% participating medical insurance.@*Conclusion@#The prevalence of pneumoconiosis of the migrant workers of the district in Chongqing was serious. The prevention and control of pneumoconiosis should be enhanced to reduce the harm of pneumoconiosis of the migrant workers in Chongqing.
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Objective To investigate the effect of early adequate enteral nutrition (EN) on diaphragmatic thickness and prognosis of mechanical ventilation (MV) patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) by ultrasound. Methods Sixty-two MV patients with AECOPD and feasible to receive early EN were admitted to the Department of Intensive Care Unit (ICU) of Wenling Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from April 2017 to March 2018, and they were divided into an observation group and a control group according to random number table, 31 cases in each group. Besides conventional treatment, both groups started EN (EN) within 2 days, in the observation group, the EN was adequately treated, and the target calories were gradually reached within 3 days; in the control group, nourishing feeding was given, and the target calories were gradually reached after 7 days. Ultrasound was used to measure the diaphragmatic end-expiratory muscle thickness (DTee) and end-inspiratory muscle thickness (DTei) before and after treatment for 3 days, 7 days, and the diaphragmatic thickening fraction (DTF) were calculated; in addition, the MV time, ICU time of stay, 14-day success rate of off-line and incidence of ventilator associated pneumonia (VAP) were compared between the two groups. Results There were no statistical significant differences in the comparisons of age, arterial blood gas analysis and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score etc general status, and the parameters of DTee, DTei and DTF between the two groups before treatment (all P > 0.05). No statistical significant differences in DTee were found after treatment for 3 days, 7 days and after off-line in the comparisons between the two groups (mm: 3 days was 2.69±0.12 vs. 2.68±0.15, 7 days was 2.70±0.14 vs. 2.70±0.13, off-line was 2.71±0.15 vs. 2.70±0.10, all P > 0.05); while the DTei of the two groups were decreased after treatment for 3 days of treatment, the difference between the two groups being not statistically significant (mm: 3.27±0.13 vs. 3.26±0.12, P > 0.05), but the levels of DTei in the two groups were significantly increased after treatment for 7 days and after off-line, the differences between the two groups being statistically significant (7 days: 27.26±5.25 vs. 28.74±6.39, off-line: 34.19±4.78 vs. 30.10±2.90, both P < 0.01). There was no significant difference in MV time and ICU time of stay between the two groups [MV time (days): 7.8±1.0 vs. 8.5±1.2, ICU time of stay (days): 11.4±2.6 vs. 12.1±2.8, both P > 0.05], the 14-day success rate of off-line and incidence of VAP were similar in the two groups, and the difference were not statistically significant [14-day success rate off-line: 77.42% (24/31) vs. 70.98% (22/31), incidence of VAP: 6.45% (2/31) vs. 9.68% (3/31), both P > 0.05]. Conclusion The early adequate EN therapy can improve diaphragmatic function and prognosis in MV patients with AECOPD.
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BACKGROUND@#The study aimed to explore whether sugary beverage consumption is a key mediator of late chronotype, sleep duration, and weight increase in college students in China.@*METHODS@#The cross-sectional study was conducted in four universities using a sample of 800 undergraduate students recruited by cluster sampling. A self-reported questionnaire was given out to collect information, including the characteristic of social demography, state of physical exercise and sugary beverage intake, the types of chronotype, and psychological conditions. Then, two structural equation models (SEMs) were constructed to test the mediating effect of sugary beverage consumption.@*RESULTS@#The significant indirect effect of sugary beverage consumption was found between chronotype and BMI (effect = - 0.03, SE = 0.01, 95% CI [- 0.05, - 0.02]) and between sleep duration and BMI (effect = - 0.12, SE = 0.05, 95% CI [- 0.16, - 0.09]). In addition, physical exercise and psychological condition also play mediating effects between chronotype and BMI (effect = - 0.04, SE = 0.01, 95% CI [- 0.06, - 0.01] and effect = - 0.03, SE = 0.02, 95% CI [- 0.05, - 0.01]), but their mediating effect was not found between sleep duration and BMI.@*CONCLUSION@#Preventive measures should be taken to decrease student's sugary beverage consumption, improve physical exercise, and increase individual well-being to avoid the harmful effects of eveningness. Moreover, the issue of short sleep duration among college students may be further investigated in future research.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Beverages , Body Weight , China , Circadian Rhythm , Cross-Sectional Studies , Feeding Behavior , Sleep , Students , Sugars , UniversitiesABSTRACT
Objective@#To analyze the epidemiological characteristics and the harmfulness situation of pneumoconiosis notified in Chongqing from 2011 to 2015, so as to provide scientific basis for prevention and control of pneumoconiosis.@*Methods@#The Chongqing database of new cases of pneumoconiosis reported from 2011 to 2015 was subjected to systematic arrangement. SPSS 18.0 was adopted for statistical description and trend test.@*Results@#From 2011 to 2015 a total of 24903 new cases of pneumoconiosis were diagnosed, including I (16 294 cases, 65.43%), II (6 520 cases, 26.18%), III (2 089 cases, 8.39%). Of all patients, 98.93% were cases of coal-workers' pneumoconiosis and silicosis. 13 383 (53.74%) were coal-workers' pneumoconiosis cases, and 11 253 (45.19%) were silicosis cases. The pneumoconiosis cases were distributed mainly in Fengjie County (3 329 cases, 13.37%), Yongchuan District (2 849 cases, 11.44%), and Chengkou County (2 584 cases, 10.38%). Most cases were centered in mining industry (17 575 cases, 70.57%) and construction industry (6 613 cases, 26.56%). The median lengths of service at the onsets of new cases of pneumoconiosis, silicosis, coal-workers' pneumoconiosis were 7.0, 3.0, and 16.0 years, respectively. The median age at the onset of pneumoconiosis was shortened from 2011 to 2015. The median ages at the onsets of new cases of pneumoconiosis, silicosis, coal-workers' pneumoconiosis were 53.0, 62.0, and 49.0 years, respectively.@*Conclusion@#The research results showed obvious diseases, regions and industries distribution. The median length of service at the onset of pneumoconiosis was on the low side, and a shortening trend showed in age at the onset of pneumoconiosis. Based on the epidemiological characteristics of pneumoconiosis, the prevention and control of pneumoconiosis should be enhanced in key industries such as mining industry and construction industry.
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Objective To explore the practicability and safety of the application of Percutaneous Vertebroplasty puncture (PVP) needle as a saw guide in the Total En-bloc Spondylectomy (TES) of thoracic and lumbar tumor through single posterior approach.Methods From June 2017 to March 2018,four patients with thoracic and lumbar vertebral neoplasms were analyzed retrospectively.They included 2 males and 2 females,which aged 50-77 years with an average age of 63.75 years.There were 1 case of Tomita 5 grade T7 lymphoma,1 case of Tomita 3 grade T5 metastasis of lung cancer,1 case of Tomita 5 grade T9 metastasis of prostate cancer and 1 case of Tomita 4 grade L2 metastasis of renal cancer.The PVP needle combined with the modified "3-step" method was applied in TES for 4 cases through posterior approach.The operative time and intraoperative blood loss were recorded.The integrity of excised vertebra and postoperative complications were observed.The visual analogue score (VAS) was evaluated to assess the pain improvement.The ASIA classification was evaluated for the assessment of neurological function of thoracic vertebral tumor cases and the muscle strength grades was evaluated for the assessment of neurological function of lumbar vertebral tumor cases.Results In all 4 cases,the vertebra was removed entirely.The average operation time was 4.9 h (4.0-6.5 h)and average blood loss was 3 200 ml (800-9 000 ml).No pachymeninx injury,cerebrospinal fluid leakage,iatrogenic spinal cord injury or vascular injury occurred.During the surgery,the saw-cutting plane is firmly located in the intervertebral disc and no slippage of the cutting plane was observed.Postoperatively,the pain was significantly alleviated.The VAS score decreased to average 1.75 points (1-2 points) after surgery,average reduction of 5.75 points (5-7 points).The neurological deficit was not aggravated in all patients.The neurological improvement of one grade was observed in 3 patients.Two cases of thoracic vertebral tumor had a grade of ASIA classification improved from grade B to grade C.One case of lumbar vertebral tumor had a grade of lower limb muscle strength improved from grade 3 to grade 4.No recurrence of tumor was observed at average 8.1 months (3.5-12 months) followup and 1 case of bone metastasis of lung cancer had intermittent intercostal neuralgia.Conclusion It is feasible and safe to apply PVP puncture needle as a saw guide in TES of thoracic and lumbar tumor through single posterior approach,on the basis of this,the "3-step" intervertebral disc truncation technique is developed,which has good practicability and high safety.
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Objective To compare the difference of X-ray film and MRI in evaluating the degree of early femoral head protrusion of Perthes disease.Methods Data of 38 cases with unilateral modified Waldenstr(o)m necrosis and fragmentation stage from January 2005 to August 2016 were retrospectively analyzed.There were 35 males and 3 females with an average age of 7.2±1.4 years old.There are 21 cases at lefi side,and 17 at right side.14 cases were at necrosis stage,with an average age of 6.9±1.5 years.While 24 cases were at fragmentation stage,with an average age of 7.4±1.4 years old.Both side X-ray films and MRI femoral head extrusion index (X-ray:femoral head bony protruding acetabular part of the outer edge of the bones/femoral skull margin maximum diameter× 100％;MRI:outer edge of bony cartilage protrudes the part of the rim of the acetabular cartilage/the maximum transverse diameter of the cartilage of the femoral head× 100％) were collected.Results The femoral head extrusion index of healthy side was measured on X-ray films and showed an average value of 11.6％±8.2％,and the mean value of affected side was 19.3％±9.8％.The difference between the two sides was statistically significant (t=1 1.550,P=0.000).The femoral head extrusion index of the healthy side was measured on MRI and showed an average value of 20.1％±5.5％,and the mean value of affected side was 27.8％±5.8％.The difference between the two sides was statistically significant (t=5.172,P=0.000).The mean femoral head extrusion index of affected side in necrosis stage of X-ray film was 16.3％± 10.2％,but there were no significant difference compared with the healthy side (13.0％±9.0％) (t=0.369,P=0.719).The mean value of extrusion index of affected side in fragmentation stage was 21.3％±8.8％,while there was 10.8％±1.6％ at the healthy side.The difference was statistically significant (t=4.756,P=0.000).The mean extrusion index of affected side of necrosis stage in MRI was 27.9％± 19.6％,and there was significant difference compared with the healthy side (21.6％± 1.4％) (t=2.651,P=0.018).The mean extrusion index of affected side of disintegration period was 27.8％±5.4％,which was significantly lower than that of healthy side (19.6％± 1.1％).There was statistical significance (t=4.622,P=0.000).There were 17 cases (70.8％) and 22 cases (91.7％) of MRI showed positive sign,and the difference had no statistically significance (P=0.137).Conclusion No significant increasement in femoral head extrusion was observed on the X-ray at necrosis stage in Perthes disease,while MRI showed prominent femoral head extrusion at the acetabular rim.MRI evaluation for evaluating early femoral head extrusion of Perthes disease has better clinical significance.