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Objective:To analyze the prevention and treatment of Kaschin-Beck disease in Fu County, Shaanxi Province, so as to provide basis for consolidating the results of Kaschin-Beck disease prevention and control and the treatment of patients with Kaschin-Beck disease.Methods:The epidemiological investigation of data and clinical data Kaschin-Beck disease from 1954 to 2022 were collected from the Fu County Institute for Endemic Disease Prevention and Control and People's Hospital of Fu County in Shaanxi Province, respectively. The retrospective study was used to investigate the prevention and control of Kaschin-Beck disease in Fu County through the adoption of comprehensive measures such as relocation, grain exchange, water improvement, conversion of farmland to forest and so on.Results:In 1954, there were 6 endemic townships and 127 endemic villages of Kaschin-Beck disease in Fu County, with a total population of 78 781. A total of 16 327 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 20.72%, including 5 434 patients without clinical symptoms. There were 5 850 patients with clinical grade Ⅰ, 3 725 patients with clinical grade Ⅱ and 1 318 patients with clinical grade Ⅲ. In 1975, the first general survey of Kaschin-Beck disease was conducted in the whole county, with a total population of 101 341. A total of 9 575 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 9.45%, including 3 247 cases without clinical symptoms. Among the patients with symptoms, there were 3 704 cases of clinical grade Ⅰ, 2 006 cases of clinical grade Ⅱ and 618 cases of clinical grade Ⅲ. The patients with Kaschin-Beck disease were mainly local residents, accounting for 93.92% (8 993/9 575). In 1997, 27 320 students aged 7 to 16 years in 342 schools of 15 townships were examined and found that there were 169 cases without clinical symptoms with X-ray changes, only 2 cases with clinical grade Ⅰ, and the detection rate decreased to 0.63%. In 1997, Fu County began to encourage relocation and grain exchange to prevent Kaschin-Beck disease. The relocation targets were mainly the seriously ill villages with new cases among children and poor living conditions. By 1999, a total of 100 households and 469 people were relocated, and by 2020, 1 569 households and 5 334 people were relocated. In 1997 and 1998, measures were taken to improve water quality in 43 natural villages in 6 townships, with 1 591 households and 7 375 people benefiting. In 2010, a general survey of Kaschin-Beck disease was conducted in 15 townships of Fu County, with a total population of 135 858, and 3 424 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 2.52%. There were 2 885 cases with clinical symptoms, including 1 584 cases with clinical grade Ⅰ, 1 024 cases with clinical grade Ⅱ and 277 cases with clinical grade Ⅲ. Among them, 32 561 minors under 16 years old were examined, and 49 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 0.15%, and all of them were clinical gradeⅠ patients. In 2014, a total of 73 600 people were surveyed in 170 endemic villages of Fu county, and 2 885 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 3.92%. Compared with 2010, the number of patients with Kaschin-Beck disease increased zero, and there were no underage patients under the age of 16 for 4 consecutive years. By the end of 2016, 666.67 hm 2 of farmland had been converted to forest in Fu County, involving 9 townships (including communities), 33 administrative villages and 1 993 households. In 2018, another general survey of Kaschin-Beck disease was conducted in Fu County, with a total population of 157 362. A total of 2 308 patients were detected by X-ray examination, with a detection rate of 1.47%. Among them, there were 1 270 cases of clinical grade Ⅰ, 870 cases of clinical grade Ⅱ and 168 cases of clinical grade Ⅲ, and there were no patients with Kaschin-Beck disease under 16 years old in the county for 8 consecutive years (2011-2018). In the same year, 22 cases of Kaschin-Beck disease joint replacement were completed in Fu County, and by January 2022, about 60 cases had completed joint replacement. Conclusion:The prevention and control of Kaschin-Beck disease in Fu County has achieved remarkable results through comprehensive measures such as relocation, grain exchange, water improvement and conversion of farmland to forest.
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Objective:To explore the effect of Helicobacter pylori(HP)eradication on development of metachronous gastric cancer(MGC)after endoscopic submucosal dissection(ESD)in elderly patients with early gastric cancer.Methods:From January 2014 to December 2019, 748 early gastric cancer patients aged 60 years or older, receiving ESD in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, were included.According to the situation of HP infection and eradication efficacy within 1 year postoperatively, patients were divided into three groups.The patients with HP infection and successful HP-eradication were enrolled into successful eradication group, those without eradicating or with eradication failure were enrolled into eradication failure group, those with HP negative were enrolled into HP-negative group.And then the occurrence and risk factors of MGC after ESD among the three groups were statistically analyzed.Results:MGC were detected in 58 cases(7.7%)in elderly patients with early gastric cancer after ESD.The median follow-up time was 39 months.The multivariate regression analysis results of MGC showed that no HP-eradication or HP eradication of failure( HR=2.231, 95% CI: 1.054-4.722, P=0.036)and multiple lesions( HR=1.857, 95% CI: 1.076-3.204, P=0.026)were independent risk factors.Non-smoking was a protective factor for the occurrence of MGC( HR=0.409, 95% CI: 0.234-0.716, P=0.002). After adjusting for confounding factors, Cox proportional risk regression analysis showed that the incidence of MGC was significantly higher in group of no HP-eradicating or HP-eradicating of failure than in group of successful HP-eradicating group( χ2=37.877, P<0.001). Conclusions:HP eradication can effectively prevent MGC in elderly patients with early gastric cancer after ESD.Multiple lesions and smoking are independent risk factors for MGC.
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OBJECTIVES@#With the increasing detection rate of lung nodules, the qualitative problem of lung nodules has become one of the key clinical issues. This study aims to evaluate the value of combining dynamic contrast-enhanced (DCE) MRI based on time-resolved imaging with interleaved stochastic trajectories-volume interpolated breath hold examination (TWIST-VIBE) with T1 weighted free-breathing star-volumetric interpolated breath hold examination (T1WI star-VIBE) in identifying benign and malignant lung nodules.@*METHODS@#We retrospectively analyzed 79 adults with undetermined lung nodules before the operation. All nodules of patients included were classified into malignant nodules (n=58) and benign nodules (n=26) based on final diagnosis. The unenhanced T1WI-VIBE, the contrast-enhanced T1WI star-VIBE, and the DCE curve based on TWIST-VIBE were performed. The corresponding qualitative [wash-in time, wash-out time, time to peak (TTP), arrival time (AT), positive enhancement integral (PEI)] and quantitative parameters [volume transfer constant (Ktrans), interstitium-to-plasma rate constant (Kep), and fractional extracellular space volume (Ve)] were evaluated. Besides, the diagnostic efficacy (sensitivity and specificity) of enhanced CT and MRI were compared.@*RESULTS@#There were significant differences in unenhanced T1WI-VIBE hypo-intensity, and type of A, B, C DCE curve type between benign and malignant lung nodules (all P<0.001). Pulmonary malignant nodules had a shorter wash-out time than benign nodules (P=0.001), and the differences of the remaining parameters were not statistically significant (all P>0.05). After T1WI star-VIBE contrast-enhanced MRI, the image quality was further improved. Compared with enhanced CT scan, the sensitivity (82.76% vs 80.50%) and the specificity (69.23% vs 57.10%) based on MRI were higher than that of CT (both P<0.001).@*CONCLUSIONS@#T1WI star-VIBE and dynamic contrast-enhanced MRI based on TWIST-VIBE were helpful to improve the image resolution and provide more information for clinical differentiation between benign and malignant lung nodules.
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Adult , Humans , Retrospective Studies , Magnetic Resonance Imaging , Plasma , Tomography, X-Ray Computed , LungABSTRACT
Objective@#To examine the correlation between frailty and lifestyle factors among middle-aged and elderly populations, so as to provide insights into the management of frailty among middle-aged and elderly populations.@*Methods @#Middle-aged and elderly residents at ages of 45 ot 69 years were recruited using the convenient sampling method from seven townships in Changxing County of Zhejiang Province from 2019 to 2020. The demographic characteristics and lifestyle factors were collected using questionnaires, and the frailty was measured using the Chinese version of Tilburg Frailty Indicator ( TFI ). Factors affecting frailty were identified among middle-aged and elderly populations using the multivariable logistic regression model.@*Results@#A total of 7 170 residents were surveyed, including 2 780 males ( 38.77% ) and 4 390 females ( 61.23% ), which had a median age of 56 (interquartile range, 10) years. The median frailty score was 2 (interquartile range, 3 ) among the study subjects, and the median frailty score was 2 ( interquartile range, 2 ) among residents at ages of 45 to 59 years, and 2 (interquartile range, 3) among residents at ages of 60 to 69 years. The overall detection of frailty was 16.07%, and the detection of frailty was 13.52% among subjects at ages of 45 to 59 years and 21.01% among subjects at ages of 60 to 69 years. Multivariable logistic regression analysis identified physical activity ( OR=0.826, 95%CI: 0.719-0.949 ) and sleep quality ( OR: 3.376-11.493, 95%CI: 2.907-15.808 ) as factors affecting frailty among middle-aged and elderly residents. Following age stratification, physical activity ( OR=0.817, 95%CI: 0.681-0.981 ) and sleep quality ( OR: 3.076-11.566, 95%CI: 2.518-18.216 ) as factors affecting frailty among subjects at ages of 45 to 59 years, while sleep quality ( OR: 3.777-11.827, 95%CI: 3.002-18.547 ) significantly correlated with frailty among residents at ages of 60 to 69 years.@*Conclusion@#Physical activity and sleep quality are associated with the risk of frailty among middle-aged and elderly populations.
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Objective:To construct the rehabilitation strategy of anterior cruciate ligament reconstruction based on the evidenced method and evaluate the effectiveness in clinic.Methods:The rehabilitation strategy was firstly built based on evidenced method. And then 80 patients from Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing University Medical School Affiliated Drum Tower Hospital from January to August, 2019 were randomly and equably sent to experiment group and control group. Patients in experiment group or control group were accepted the evidenced method or regular method as treatment strategy, respectively. The visual analogue scale (VAS), thigh circumference, motion range of knee joint and Lysholm score were recorded before and after surgery.Results:Six papers met the inclusion criterion and were been screen out from 1 535 papers, and then the evidenced rehabilitation strategy of anterior cruciate ligament reconstruction was made. The VAS scores in 12 and 24 h were 1(0-2), 1(1-3) in experiment group and 2(1-3), 3(1-3)in control group, the differences were significant between two groups( Z values were 4.955, 6.489, P<0.001). The motion ranges of knee joint in 2, 4, 6, 12 weeks after operation were (61.6±5.1)°, (85.3±6.6)°, (114.6±5.2)°, (127.6±3.4)° in experiment group and(54.9±4.6)°, (71.0±8.8)°, (105.1±5.9)°, (115.8±4.0) °in control group, the differences were significant between two groups( t values were 6.209-14.138, P<0.001). The Lysholm scores at 6,8,12 weeks after operation were 58.8±3.7, 71.1±3.1, 84.3±3.7 in experiment group and 56.0±3.4, 65.4±4.3, 75.6±3.0 in control group, the differences were significant between two groups( t values were 3.511, 6.867, 11.439, P<0.001). Conclusions:This evidenced rehabilitation strategy of anterior cruciate ligament reconstruction in this study was helpful to alleviating the pain, improving motion range of knee joint after anterior cruciate ligament reconstruction.
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Objective:To explore the effectiveness of blended learning in the clinical teaching of wound care clinic.Methods:Blended learning based on WeChat and offline CBL teaching method was constructed by applying evidence-based nursing. Totally 125 interns from the wound care clinic of our hospital were selected as subjects, among which 62 didn't receive the blended learning (control group), and 63 received the blended learning (observation group). At the end of the two-week practice, the effectiveness of the two teaching methods was compared. The objective evaluation was carried out in the forms of theory test, practice evaluation and comprehensive quality questionnaire combined with online self-test and offline practice. All data were analyzed by SPSS 20.0 statistical software.Results:The scores of theory test, practice evaluation and comprehensive quality assessment in the observation group were all higher than those in the control group ( P<0.001). Conclusion:The blended learning with WeChat as the medium can guide student active learning, consolidate the basic knowledge, improve the efficiency of teaching, stimulate the enthusiasm of practice, and improve the comprehensive quality. It's a clinical teaching method that can be used for reference.
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Chromosomal region maintenance 1 (CRM1) is associated with an adverse prognosis in glioma. We previously reported that CRM1 inhibition suppressed glioma cell proliferation both in vitro and in vivo. In this study, we investigated the role of CRM1 in the migration and invasion of glioma cells. S109, a novel reversible selective inhibitor of CRM1, was used to treat Human glioma U87 and U251 cells. Cell migration and invasion were evaluated by wound-healing and transwell invasion assays. The results showed that S109 significantly inhibited the migration and invasion of U87 and U251 cells. However, mutation of Cys528 in CRM1 abolished the inhibitory activity of S109 in glioma cells. Furthermore, we found that S109 treatment decreased the expression level and activity of MMP2 and reduced the level of phosphorylated STAT3 but not total STAT3. Therefore, the inhibition of migration and invasion induced by S109 may be associated with the downregulation of MMP2 activity and expression, and inactivation of the STAT3 signaling pathway. These results support our previous conclusion that inhibition of CRM1 is an attractive strategy for the treatment of glioma.
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Objective:To evaluate the quality of the final examination paper of the course Introduction to Nursing and analyze the students' performance, so as to provide objective basis for strengthening the course construction and continuously improving the teaching quality. Methods:SPSS 22.0 software was used to analyze the relevant data, descriptive statistics was carried out on the course scores and scores of different knowledge points of 58 nursing undergraduates in a college, and Pearson correlation analysis was used to analyze the relationship between students' examination scores and their usual scores. Based on the classical measurement theory, the difficulty coefficient, differentiation, reliability and validity of final examination papers were measured.Results:The average scores of students' usual performance, examination scores and total scores were 93.66, 67.07 and 75.19. The highest score of examination was 89, the lowest score was 52, the median was 65, the passing rate was 93.10%, and the number of students in 60-69 and 70-79 was 33 and 15 respectively. Among the 20 knowledge points examined, the passing rate of 10 knowledge points was less than 60%, and 5 of them<50%. There was a positive correlation between the test scores and the usual scores ( r=0.973, P<0.001). The difficulty coefficient of the final examination was P=0.329, the discrimination degree D=0.256, and the reliability r=0.734. Conclusion:The final examination are generally in line with the teaching requirements and are of good quality, but the final examination scores of the students are generally low. The students' usual scores are ideal, and their understanding, analysis and comprehensive application of knowledge points are poor.
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Chromosomal region maintenance 1 (CRM1) is associated with an adverse prognosis in glioma. We previously reported that CRM1 inhibition suppressed glioma cell proliferation both in vitro and in vivo. In this study, we investigated the role of CRM1 in the migration and invasion of glioma cells. S109, a novel reversible selective inhibitor of CRM1, was used to treat Human glioma U87 and U251 cells. Cell migration and invasion were evaluated by wound-healing and transwell invasion assays. The results showed that S109 significantly inhibited the migration and invasion of U87 and U251 cells. However, mutation of Cys528 in CRM1 abolished the inhibitory activity of S109 in glioma cells. Furthermore, we found that S109 treatment decreased the expression level and activity of MMP2 and reduced the level of phosphorylated STAT3 but not total STAT3. Therefore, the inhibition of migration and invasion induced by S109 may be associated with the downregulation of MMP2 activity and expression, and inactivation of the STAT3 signaling pathway. These results support our previous conclusion that inhibition of CRM1 is an attractive strategy for the treatment of glioma.
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Objective To investigate the prevalence characteristics for high risk adults of type 2 diabetes in Zhejiang. Methods From June to October in 2010, 19113 local residents aged≥18 years old were selected among 7571 families from fifteen counties in Zhejiang by a four stage stratified-random sampling method. A self-designed questionnaire was completed to collect information on demographic characteristics, risk factors, and physical activity. At the same time, physical examinations including measurements of height, weight, blood pressure, and blood lipid levels were carried out. The high-risk population was determined according to the 2017 edition of China′s Guidelines for the Prevention and Treatment of Type 2 Diabetes. Results Finally, 17437 people completed all the investigation projects. Among them, 14455 people were at high risk of type 2 diabetes [aged (49.3+15.1) years, 6902 men (47.75％) and 7553 women (52.25％)]. The crude prevalence rate of high risk type 2 diabetes was 82.90％(standardized rate:79.26％). A significantly higher prevalence rate of high risk type 2 diabetes was associated with the age group of 45 to 60 years (83.47％), men (84.49％), class 1 rural area (84.59％), primary school education level (87.04％), marital status (84.40％), and average annual family income less than 10000 yuan (all P<0.05). Among the eight high risk factors, the detection rate of ≥40 years old was the highest (78.12％) and the detection rate of history of cardiovascular disease was the lowest (1.54％). The detection rates of overweight/obesity/central obesity, dyslipidemia, hypertension, sedentary lifestyle, pre-diabetes, and family history of type 2 diabetes were 42.86％, 31.28％, 29.98％, 29.18％, 7.28％, and 3.81％, respectively. High risk of type 2 diabetes was dominated by 1 high-risk factor (31.75％) or 2 high-risk factors (31.39％) or 3 high-risk factors (22.13％). The adults with 4 high-risk factors (11.01％) and 5 or more high-risk factors (3.71％) were less in number. The detection rates of all the risk factors and aggregation distribution of various risk factors were significantly different between different genders, age groups, regions and educational levels, marital status, and family per capita annual income. Conclusion The epidemic level of high-risk type 2 diabetes in Zhejiang province is relatively high, and health management of high risk of type 2 diabetes in community should be actively taken as early as possible according to the population distribution characteristics.
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Objective @#To investigate the knowledge,attitude and practice of salt reduction for hypertension prevention among residents in Liandu District of Lishui,and to provide reference for intervention of salt reduction.@*Methods @#Residents aged 18-69 years in two communities and three towns of Liandu District were selected by multistage stratified random sampling method. They were investigated the prevalence of hypertension and knowledge,attitude and practice of salt reduction for hypertension prevention. Logistic regression models were used to analyze the influencing factors for knowledge,attitude and practice of salt reduction for hypertension prevention.@*Results @#Among 1 801 participants,1 509 completed the survey,with a response rate of 83.79%. The prevalence of hypertension was 31.88%. The proportions of the participants who had knowledge, attitude and practice of salt reduction for hypertension prevention were 33.40%,60.70% and 58.58%,respectively. The results of multivariate logistic regression analysis showed that women（OR=1.583,95%CI：1.248-2.008）,hypertension（OR= 1.734,95%CI：1.303-2.308）,30 to 39 years old（OR=0.368,95%CI：0.226-0.597）,junior high school and above education（OR=0.057-0.403,95%CI：0.036-0.577）were the influencing factors for the knowledge of salt reduction for hypertension prevention;women（OR=1.342,95%CI：1.072-1.679）,married（OR=1.582,95%CI：1.167-2.144）,junior or senior high school education（OR=0.235-0.525,95%CI：0.163-0.736）,having the knowledge（OR=2.640,95%CI：2.033-3.430）were the influencing factors for the attitude of salt reduction for hypertension prevention;women（OR=1.632,95%CI：1.304-2.044）,30 to 39 years old（OR=0.494,95%CI：0.346-0.705）,rural residents（OR= 1.617,95%CI：1.276-2.050）,family history of chronic diseases（OR=1.455,95%CI：1.148-1.845）,having the knowledge（OR= 1.396,95%CI：1.084-1.797）,having the attitude（OR=4.059,95%CI：3.203-5.145）were the influencing factor for the practice of salt reduction for hypertension prevention.@*Conclusion @#The residents in Liandu District had low levels of the knowledge,attitude and practice of salt reduction for hypertension prevention. The higher levels of the knowledge and attitude of salt reduction for hypertension prevention,the higher level of the practice.
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Objective @#To evaluate the risk of cardiovascular disease in hypertensive patients managed by communities in Tongxiang in the next 10 years,and to provide evidence for the development of cardiovascular disease prevention strategies. @*Methods@#The information about hypertensive patients managed by communities was collected from Tongxiang resident health records management system. The risk of ischemic cardiovascular disease（ICVD）in the next 10 years was assessed by the Assessment Scale of 10-Year ICVD Risk in Chinese.@*Results@# A total of 27 173 hypertensive patients managed by communities with complete data were recruited,including 11 868 males,accounting for 43.68%,and 15 305 females,accounting for 56.32%. The median（inter-quartile range）of the total scores of 10-year ICVD risk in hypertensive patients was 8.00（3.00）,with 9.00（2.00）in males and 8.00（2.00）in females. The total scores of 10-year ICVD risk in males was significantly higher than those in females（P<0.05）. A total of 8 764 patients had high 10-year ICVD risk,accounting for 32.25%. The proportion of high10-year ICVD risk in females with hypertension was higher than that in males（P<0.05）. The weights of ICVD risk factors in males were 54.58% in age,17.42% in systolic blood pressure,14.27% in smoking,7.77% in body mass index,4.51% in total cholesterol and 1.45% in diabetes;the ones in females were 63.57% in age,14.63% in systolic blood pressure,9.81% in body mass index,6.00% in total cholesterol,5.88% in diabetes and 0.11% in smoking.@*Conclusion @#The ICVD risk of hypertensive patients managed by communities in Tongxiang is higher in the next 10 years. Male patients should focus on the control of blood pressure and smoking,while female patients should focus on the control of blood pressure and body weight.
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Objective @#To explore the positive rates and influencing factors of depression and anxiety among managed diabetic patients in community and to provide evidence for the future mental health intervention.@*Methods@#Random sampling method was used to select the diabetic patients from the local health information platform in Ningbo. The anxiety and depression symptoms of the diabetic patients were evaluated by 9-Item Patient Health Questionnaire（PHQ-9）and 7-Item Generalized Anxiety Disorder Scale（GAD-7）. Logistic regression model was applied to analyzing the influencing factors for anxiety and depression in diabetic patients.@*Results@#A total of 1 032 diabetic patients were enrolled,with a response rate of 91.98%. The positive rate of depression was 9.01% and the positive rate of anxiety was 3.78%. The results of multivariate logistic regression analysis showed that divorced/widowed（OR=3.046,95%CI：1.522-6.100）,having two comorbidities or more（OR=6.723,95%CI：2.495-18.120）and suffering diabetes for more than ten years（OR=2.668,95%CI：1.406-5.062）were the risk factors for depression in diabetic patients,while having a college education or above（OR=0.288,95%CI：0.093-0.893）was the protective factor for depression in diabetic patients;unmarried（OR=13.244,95%CI：1.268-138.377）,having two comorbidities or more（OR=6.979,95%CI：2.164-22.503） and suffering diabetes for more than ten years（OR=3.109,95%CI：1.241-7.787）were the risk factors for anxiety in diabetic patients.@*Conclusion@#Marital status,the number of comorbidity,course of diabetes and education level could affect the occurrence of depression in diabetic patients;marital status,the number of comorbidity and course of diabetes could affect the occurrence of anxiety in diabetic patients.
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Objective@#To investigate the sodium,potassium and blood pressure of adult residents in Liandu District of Lishui,and to provide evidence for salt reduction intervention.@*Methods@#A stratified random sampling method was used to select residents aged 18 to 69 years in Liandu District from December 2016 to February 2017. A questionnaire survey and physical examination were conducted to collect basic information. The 24-hour urine samples were collected to detect sodium and potassium intake.@*Results@#Among 300 participants,the average daily intake of sodium was（10.59±3.90）g,which was higher in men than in women [（11.11±4.33）g vs.（10.08±3.37）g,P<0.05]. There were 274 participants with average daily intake of sodium more than 6 g,accounting for 91.33%. The average daily intake of potassium was（1.67±0.71）g,which was higher in women than in men [（1.77±0.72）g vs.（1.57±0.68）g,P<0.05]. The average daily intakes of potassium were significantly different among different age groups,with participants aged 20 to 29 years the lowest（P<0.05）. There were 217 participants with average daily intake of potassium less than 2 g,accounting for 72.33%. The ratio of sodium to potassium was 4.7±2.2,which was higher in men than in women（5.3±2.7 vs. 4.1±1.4,P<0.05）and decreased with age（P<0.05）. There were 291 participants with the ratio more than 1.87,accounting for 97.00%. The prevalence of hypertension was 31.67%,which was 33.65% in men and 29.80% in women.@*Conclusion@#The residents in Liandu District have high intake of sodium and prevalence of hypertension,yet low intake of potassium.
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Objective@#To learn the current status of injury among community residents in Zhejiang Province,and to provide reference for injury prevention strategy.@*Methods@#A total of 38 005 residents were recuited from 11 counties or districts in Zhejiang Province by multi-stage cluster random sampling. A retrospective questionnaire survey was conducted to collect their injury occurrence from June 1st of 2017 to May 31st of 2018,then analyzed the incidence,mortality and types of injury.@*Results@#Among 38 005 respondents,2 186 injuries occurred,the incidence rate of injury was 5.75%. The incidence rate of injury in males and females were 5.67% and 5.84%,respectively. The incidence rate of injury in rural respondents（6.97%）was higher than that（4.79%）in urban respondents（P<0.05）. Seven respondents died of injury and the mortality rate was 18.42/100 000. The top five types of injury were falls（2.27%）,traffic accidents（1.53%）,animal bites（0.69%）,sharp articles（0.50%）and blunt articles（0.41%）. The lowest incidence rate of injury lay in 15 to 24 years old,and the highest lay in 65 to 74 years old. The incidence rate of injury increased with age（P<0.05）. The first type of injury in respondents aged 15 to 44 years old was traffic accidents,while others was falls.@*Conclusion@#The incidence of injury is higher in rural residents than in urban residents in Zhejiang Province,which increase with age. Falls and traffic accidents are the main threats to residents in Zhejiang Province.
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Objective@#To understand prevalence, control of hypertension and intake of sodium and potassium among residents aged 50-69 years old in Zhejiang Province.@*Methods@#A multi-stage random cluster sampling method was used to select 3 032 residents aged 50-69 years old in Zhejiang Province. The demographic characteristics, prevalence and control of hypertension were collected through a questionnaire survey, and physical measurement was also performed. The stratified random sampling method was used to detect the level of sodium and potassium in the 24 h urine of 676 subjects. The total amount of 24 h urinary sodium ≥102.55 mmol and the ratio of 24 h urinary sodium and potassium content ≥2 were defined as excessive.@*Results@#The prevalence of hypertension (95%CI) was 56.89% (54.39%-59.40%), and the awareness, treatment and control rate of hypertension were 58.25% (55.01%-61.49%), 45.37% (42.10%-48.65%) and 19.75% (17.01%-22.50%), respectively. 78.99% (n=534) of residents had excessive 24 h urinary sodium, and 95.41% (n=360) of residents had excessive ratio of 24 h urinary sodium and potassium.@*Conclusion@#The prevalence of hypertension in residents aged 50-69 years old in Zhejiang Province was at a high level, and the control of hypertension was not satisfactory in 2017. Most of residents have excessive level of sodium intake and the level of sodium and potassium intake was not balanced.
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Objective@#To study the effect of Neiyi-Tongjingling on the content of TGF-β1 and Smad2/3 protein in ectopic endometrium of rats with endometriosis.@*Methods@#Atotal of 42 rats were randomly divided into the sham operation group, model group, high, medium and low dose groups of traditional Chinese medicine and western medicine group with 7 rats in each group. Except for the sham-operated group, the rats in the other groups established EMs models by means of rat autologous intimal transplantation. The drug was administered at the 5th week after the model was established. The western medicine group was given 0.5 mg/kg gestrinone solution twice a week. The high, medium and low dose groups of traditional Chinese medicine were given 49.50 mg/kg, 24.75 mg/kg and 12.38 mg/kg of Neiyi-Tongjingling liquid, respectively. While the model group and sham operation group were given the same volume of normal saline once per day for 4 weeks. The volume of ectopic lesions in each group was observed. The HE staining was used to observe the pathological changes of intima tissue. Immunohistochemical SP method was used to detect the expression of TGF-β1 and Smad2/3 proteins in intima tissue.@*Results@#The volume of ectopic endometrium (57.91 ± 13.10 mm3, 48.93 ± 8.15 mm3, 76.21 ± 17.14 mm3, 57.88 ± 15.98 mm3 vs. 141.58 ± 54.25 mm3) in the western medicine group and the high, medium and low dose group of Chinese medicine were significantly lower than that in the model group (P<0.05). Compared with the model group, the content of TGF-β1 (0.08 ± 0.00, 0.08 ± 0.01, 0.10 ± 0.00 vs. 0.13 ± 0.03) and Smad2/3 (0.09 ± 0.02, 0.08 ± 0.01, 0.10 ± 0.01 vs. 0.12 ± 0.02) in ectopic endometrium tissue of three Chinese medicine groups decreased significantly (P<0.05).@*Conclusions@#The Neiyi-Tongjingling can treat EMs by inhibiting the growth of ectopic endometrium, reducing the volume of ectopic lesions, and reducing the expression of TGF-β1 and Smad2/3 proteins.
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Objective To express HIV-1 capsid p24 antigen in an eukaryotic expression system and to evaluate its antigenicity and potential in the early diagnosis of HIV. Methods The full-length gene of HIV-1 p24 and the signal peptide DRVI gene were amplified by PCR. The signal peptide DRVI preceding the p24 gene was introduced using fusion PCR, and cloned into vector pDRVI1. 0. Two recombinant plas-mids pDRVI-p24 and pDRVI-p24s were constructed and transfected into 293F cells. Expression and secre-tion of p24 protein were detected by SDS-PAGE, Ni-NTA column chromatography and molecular sieve were used to purify p24s protein. The purified protein was identified by Western blot and indirect ELISA using hu-man/mouse HIV-1-positive serum samples. Results The eukaryotic expression system for HIV-1 p24 anti-gen was successfully established with high efficiency. The target protein of interest with the signal peptide DRVI was obviously detected in the supernatants of cell culture. The recombinant protein had good specifici-ty and sensitivity based on the results of serological tests using serum samples of five HIV-1-positive and five HIV-negative mice , 30 HIV-1-positive patients and 50 HIV-1-negative healthy individuals . Conclusions The eukaryotic expression system for HIV-1 p24 antigen was successfully established. The purified HIV-1 p24s antigen had good antigenicity. An indirect ELISA assay with good specificity and sensitivity for the de-tection of HIV-1 was preliminarily constructed and showed great potential for application.
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Objective To analyse the clinical characteristics of patients with acute intermittent porphyria (AIP) in order to improve the understanding and treatment. Methods Patients diagnosed as AIP and admitted to the First Affiliated Hospital of Zhengzhou University were retrospectively enrolled from January 2008 to July 2018. Data of clinical manifestations, causes, laboratory data, treatment and clinical outcome were recorded. Results Among the 50 patients, 41 patients (82%) were aged 20 to 40. The ratio of male and female was 1∶1.8. The most common symptoms were abdominal pain (94.0%), nausea, vomiting (72.0%) and constipation (42.0%). Neuropsychiatric disorders were seen in 72.0% patients, and 30.0% of the patients had dark?coloured urine. Precipitating factors included infections, menstruation, starvation, drugs, alcohol consumption, mental stimulation and so on. Laboratory tests were abnormal for urinary porphobilinogen, liver function, hyponatremia, anaemia and so on. Various mutations of hydroxymethylbilane synthase (HMBS) genes were detected in 16 patients. Management strategies included removal of risk factors, administration of glycogen and symptomatic treatment during acute episode. Most patients were discharged with improved conditions. Conclusions The clinical manifestations of acute intermittent porphyria are complex and diverse. Misdiagnoses or malpractice may be fatal. It is critical to emphasize on its early diagnosis and treatment.
ABSTRACT
The family doctor system is a collection of the rules and operating patterns formed during the interaction between the top design of "universal health coverage" and the "contractual experiment" at primary level. Its optimization and upgrading call for continuous attention to primary policy response. A questionnaire survey was made to medical workers at primary healthcare institutions in Zhejiang,to learn the comments and willingness of participation of family doctors for the contractual service policy. The survey found the poor policy response roots in such constraints as lack of effective connection between top level and primary level,poor incentive design,and delayed supporting policies. In view of upgrading supplier policy response,the authors recommended feasible strategies to optimize policy response, namely priori decision-making,process control,both hard and soft tactics,and parallel efforts for both internal and external sides.