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OBJECTIVE@#To analyze the current status and evaluate the equity of health human resource allocation for echinococcosis control in Ganzi Tibetan Autonomous Prefecture, Sichuan Province, so as to provide the empirical evidence for optimizing the health human resource allocation for echinococcosis control.@*METHODS@#A questionnaire survey was performed to collect the numbers of health human sources for echinococcosis control, including health workers, healthcare professionals, certified/assistant physicians and registered nurses, per 1 000 permanent residents, per 1 000 m2, per 1 000 residents screened using Bmode ultrasonography and per 1 000 echinococcosis patients in two highly endemic counties and three lowly endemic counties in Ganzi Tibetan Autonomous Prefecture, Sichuan Province from 2016 to 2019. The equity of health human resource allocation for echinococcosis control was evaluated by permanent residents and geographical areas using Lorenz curve and Gini index in Ganzi Tibetan Autonomous Prefecture from 2016 to 2019.@*RESULTS@#The numbers of health workers, healthcare professionals, certified/assistant physicians and registered nurses per 1 000 permanent residents, per 1 000 permanent residents, per 1 000 m2, per 1 000 residents screened using B-mode ultrasonography and per 1 000 echinococcosis patients were 0.99-, 1.06-, 1.78- and 1.88-fold; 3.38-, 3.67-, 6.00- and 6.00-fold; 1.64-, 1.74-, 3.22- and 3.18-fold; and 64.92-, 70.39-, 139.34- and 117.44-fold more in lowly endemic counties than in highly endemic countries in Ganzi Tibetan Autonomous Prefecture, Sichuan Province, 2019. The Gini indexes of health human resource allocation for echinococcosis control were 0.371 to 0.397 by permanent residents and 0.477 to 0.591 by geographical areas in Ganzi Tibetan Autonomous Prefecture from 2016 to 2019, and the Gini indexes (0.469 to 0.730) for allocation of certified/assistant physicians and registered nurses were both higher than those of health workers and healthcare professionals (0.302 to 0.451) by both permanent residents and geographical areas.@*CONCLUSIONS@#The health human resource allocation for echinococcosis control showed general equity by permanent residents and poor equity by geographical areas in Ganzi Tibetan Autonomous Prefecture, Sichuan Province from 2016 to 2019.
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Humans , China/epidemiology , Echinococcosis/epidemiology , Health Personnel , Health Workforce , Resource Allocation , UltrasonographyABSTRACT
Piroxicam has polymorphism. Different crystalline forms can exhibit different physicochemical properties and biological activities. Analysis of the intermolecular interactions is essential to reveal the formation mechanism and differences of polymorphs. In this paper, Hirshfeld surface analysis and semi-empirical methods were used to calculate and analyze the intermolecular interactions in seven polymorphic forms of piroxicam. The results show that the Hirshfeld surface analysis method can clearly and intuitively reveal the intermolecular interactions, among which H…H, O…H/H…O and N…H/H…N interactions account for 95% of the total energy. There are differences in the proportion and distribution of the forces of different crystal forms. The energy calculation shows that the lattice energy of the hydrate is significantly lower than that of the anhydrous forms, and in the specific energy distribution, the contribution of the dispersion force is the most prominent. Further interaction energy analysis was found that within the distance of 3.8 Å from the center of the piroxicam molecule, different crystalline forms of piroxicam molecule have different interaction energies with surrounding molecules.
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Four salts of ticagrelor, ticagrelor-3,5-dinitrobenzoic acid, ticagrelor-pyrazinamide, ticagrelor-D-proline and ticagrelor-L-proline were prepared by solvent suspension and liquid-assisted grinding to improve the solubility of ticagrelor. The compounds were characterized by powder X-ray diffraction, Fourier transform infrared spectroscopy, differential scanning calorimetry, nuclear magnetic resonance spectroscopy, elemental analysis, and the intermolecular salt-bonding forces were analyzed. The equilibrium solubility of salts and pure drug in hydrochloride buffer pH 1.2 and phosphate buffer pH 6.8 were measured by high-performance liquid chromatography. Ticagrelor was salted with 3,5-dinitrobenzoic acid, pyrazinamide, D-proline, L-proline all in a stoichiometric ratio of 1∶1; with the exception of ticagrelor-D-proline, the solubility of the other three salts provided significantly improved solubility in hydrochloride buffer pH 1.2, and the equilibrium solubility of ticagrelor-3,5-dinitrobenzoic acid was increased by approximately 1.7 folds as compared to pure drug. Salt-forming technology is convenient and can improve the solubility of ticagrelor.
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Objective: To study the chemical composition and structure of the secondary metabolites of the endophytic fungus Aspergillus oryzae from Paris polyphylla var. yunnanensis. Methods: A. oryzae was fermented by liquid fermentation. After extraction, it was separated and purified by various chromatography methods. The structure of the compounds was identified according to the physical and chemical properties and spectral data. Results: Four compounds were isolated and their structures were identified as 4-hydroxy-6-[(2S,3S)-3-hydroxybutan-2-yl]-3-methyl-2H-pyran-2-one (1), (R)-4-hydroxy-6-(1-hydroxy-2- methylpropyl)-3- methyl-2H-pyran-2-one (2), flufuran (3) and flufuran methyl ester (4). Conclusion: Compounds 1 and 2 are new α-pyronoids named asper-α-pyranone A and asper-α-pyranone B.
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Sleep disorders are very common non-motor symptoms in Parkinson disease(PD) related to the life quality of patients, mainly including insomnia, arousal disorders, restless legs syndrome(RLS), REM sleep behavior disorder(RBD) and sleep disorders breathing(SDB). In this article, the author discusses the causes and the current state of the diagnosis and management of sleep disorders in PD, aiming to increase clinical doctors' attention to it.
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Objective:To explore effects of exercise training on cardiac function,exercise function and quality of life in pa-tients after percutaneous coronary intervention (PCI).Methods:A total of 150 patients after PCI,who were hospitalized in our hospital from Jan 2014 to Dec 2015,were selected.Patients were randomly and equally divided into routine treat-ment group (received routine treatment and health guidance ) and exercise training group (received moderate intensity exer-cise training based on routine treatment group ),both groups were intervened for 12 weeks.Cardiac function indexes,6min walking distance (6MWD),score of Seattle angina questionnaire (SAQ) and incidence rate of major adverse cardiovascular events (MACE) were observed and compared between two groups before and after intervention.Results:Compared with before intervention,there were significant rise in left ventricular ejection fraction (LVEF) and 6MWD,and significant re-ductions in left ventricular end-diastolic dimension (LVEDd) and NYHA class in exercise training group after 12-week in-tervention,P＜0.01 all;there were significant rise in all dimension scores of SAQ in two groups after intervention,P＜ 0.05 or ＜0.01.Compared with routine treatment group after intervention,there were significant rise in LVEF [ (54.19 ± 7.75)% vs.(60.63 ± 9.28)%],6MWD [ (437.49 ± 21.37) m vs.(453.26 ± 31.76) m] and all dimension scores of SAQ,and significant reductions in LVEDd [ (5.24 ± 0.83) cm vs.(4.72 ± 0.78) cm] and NYHA class [ (1.78 ± 0.72) classes vs.(1.43 ± 0.67) classes] in exercise training group,P＜0.05 or ＜0.01.Incidence rate of MACE of exercise training group was significantly lower than that of routine treatment group (6.67% vs.18.67%),P＝0.027.Conclusion:Exercise training can improve cardiac function,exercise function and quality of life,reduce incidence rate of MACE in pa-tients after PCI,which is worth extending.
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<p><b>OBJECTIVE</b>To introduce the Item Function Analysis(IFA) of Quality of Life- Alzheimer's disease(QOL-AD)Chinese version and to explore the feasibility of its application on Chinese patients with AD.</p><p><b>METHODS</b>Two hundred AD patients were interviewed and assessed by QOL-AD, through the stratified cluster sampling method. Multilog 7.03. was used for Item Function Analysis. Difference scale(a), difficulty scale(b)and Item Characteristic Curve(ICC) of each item of QOL-AD were provided.</p><p><b>RESULTS</b>Different scales of the item 1, 7 were below 0.6, while all the others were above 0.6. As for ICC. The first and last lines for the other items were monotonic in which the two in between were in inverted V-shape, with very steep slopes, except for the item 1 and 7.</p><p><b>CONCLUSION</b>Results form the IFA showed that QOL-AD was applicable to be used in the Chinese patients with AD.</p>
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Aged , Aged, 80 and over , Humans , Alzheimer Disease , Psychology , Asian People , Genetics , Psychometrics , Methods , Quality of LifeABSTRACT
Objective The aim of this study was to introduce the multi-slate Markov model for the prediction of mild cognitive impairment (MCI) to Alzheimer' s disease (AD) and to find out the related factors for AD prevention and early intervention among the elderly.Methods MCI,moderate to severe cognitive impairment,and AD were defined as state 1,2 and 3,respectively.A three-state homogeneous model with discrete states and discrete times from data on six follow-up visits was constructed to explore factors for various progressive stages from MCI to AD.Transition probability and survival curve were made after the model fit assessment.Results At the level of 0.05,data from the multivariate analysis showed that gender (HR=I.23,95％CI:1.12-1.38),age (HR=I.37,95％ CI:1.07-1.72),hypertension (HR=l.54,95％ CI:1.31-2.19) were statistically significant for the transition from state 1 to state 2,while age (HR=0.78,95％ CI:0.69-0.98),education level (HR=1.35,95％ CI:1.09-1.86) and reading (HR=1.20,95％ CI:1.01-1.41 ) were statistically significant for transition from state 2 to state 1,and gender (HR=1.59,95％ CI:1.33-1.89),age (HR=1.33,95％ CI:1.02-1.64),hypertension (HR=l.22,95％ CI:1.11-1.43),diabetes (HR=1.52,95％CI:1.12-2.00),ApoEε4 (HR=1.44,95％CI:1.09-1.68) were statistically significant for transition from state 2 to state 3.Based on the fired model,the three-year transition probabilities during each state at average covariate level were estimated.Conclusion To delay the disease progression of MCI,phase by phase prevention measures could be adopted based on the main factors of each stage.Multi-state Markov model could imitate the natural history of disease and showed great advantage in dynamically evaluating the development of chronic diseases with multi-states and multi-faetors.
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Objective To investigate the current status and influencing factors regarding quality of life among patients with Alzheimer' s disease (AD).Methods Through stratified cluster sampling method,two hundred patients with AD and their caregivers were chosen and interviewed.AD patients were assessed by questionnaires,Montreal Cognitive Assessment,and Quality of LifeAlzheimer' s Disease (QOL-AD),in order to compare the reports from patients and caregivers on QOL-AD and to analyze related influencing factors.Descriptive analysis,paired t-test,analysis of variance (ANOVA),Pearson' s correlation and multiple linear regression were performed using the Statistical Package for Social Science (SPSS).Results The scores of reports from patients (28.78 ±4.30) were lower than that from the caregivers' (30.05 ± 6.05).The difference was statistically significant (t=2.122,P＜0.05) and was positively correlated (r=0.312,P＜0.001).Data from multivariate analysis showed that cognitive level (t=3.465,P=0.001),marriage relationship (t=3.062,P=0.003 ),having public activities (t =2.581,P=0.011 ),personal characters (t =2.254,P =0.026),restricted diet pattern (t=3.614,P＜0.001),regularly drinking tea (t=2.652,P=0.009) and doing housework (t=3.180,P=0.002) were predictive factors.Conclusion Scores from the caregiver' s report on QOL-AD were higher than that from the patients'.Many factors influenced the quality of life on AD patients.Strategies on improving the quality of life among AD patients can be developed based on the findings of this study.
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Objective To explore the determinants of Alzheimer' s disease (AD) patients with depression.Methods The degree of depression on AD patients was assessed by the geriatric depression scale.Improved cumulative logistic regression (ICLR) was used to analyze the determinants of AD patients with depression.Results 196 AD patients were investigated.Among the 196 AD patients,there were 60(30.6％ ) males and 136(69.4％ ) females,at 58-89 years of age (72.3 ± 6.0).Physical activity,diabetes,MoCA,hearing,economic sources and alcohol were related to the degree of depression of AD patients (P＜0.10 ).The difference between “normal” and “mild depression” was smaller than difference between “mild depression” and “severe depression”.Conclusion AD patients with mild depression were the target population for prevention and they were influenced by several factors listed above.
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Objective To introduce the Multi-state Markov model in studying the outcome prediction of mild cognitive impairment (MCI). Methods Based on the intelligence quotient (IQ)changes that reflecting the trends in cognitive function in the patients under follow-up program, we constructed a four states model and used Multi-state Markov model to analyze the patients. Results Among 600 MCI patients, there were 174(29.0%) males and 426(71.0%) females, with age range of 65-90 years-old (average 69.7±6.6). For univariate analysis, gender, age, education level, marital status, smoking, household income, cerebral hemorrhage, hypertension, high cholesterol, diabetes,LDL-C, SBP and DBP were found to be associated with cognitive function. For multivariate analysis,female, older age, cerebral hemorrhage and higher SBP were shown to be the risk factors for transition from the state of cognitive stability to the state of severe deterioration, and their coefficients were 0.762,0.366,0.885, and 0.069, respectively. Age (0.038) could influence the transition from the state of cognitive stability to slight deterioration. Higher education level was shown to be the protective factor for these transitions (-0.219 and-0.297). Transition intensity from the state of cognitive stability to the state of slight and severe deterioration was 1.2 times that of transition to the state of improving. Transition intensity from state of slight deterioration to cognitive stability was 11.4times that of transition to severe deterioration. Conclusion Multi-state Markov model was an effective tool in dealing with longitudinal data.
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<p><b>OBJECTIVE</b>To compare the clinical outcomes between China made sirolimus-eluting stents (SES) and bare metal stents (BMS) implantation in patients with acute myocardial infarction (AMI).</p><p><b>METHODS</b>Consecutive patients with AMI underwent primary percutaneous coronary intervention (PCI) were randomly divided into SES group (n = 87) and BMS group (n = 86). The incidence of major adverse cardiac events (MACE including death, reinfarction, in-stent thrombosis, restenosis rate, target vessel revascularization) up to 6 months post PCI were assessed.</p><p><b>RESULTS</b>Postprocedure vessel patency, enzymatic release, cardiac function, and the incidence of short-term MACE were similar between the two groups (all P > 0.05). Two in-stent thrombosis was diagnosed in the SES group and bare stents group respectively (2.4% vs. 2.3%, P > 0.05). At 6 months, In-stent restenosis rate (4.5% vs. 40.0%, P < 0.01) and the in-segment restenosis rate (6.8% vs. 44.9%, P < 0.01) as well as MACE (8.0% vs. 24.4%, P < 0.01), which is mainly due to a marked reduction in the risk of target vessel revascularization (3.4% vs. 11.6%, P < 0.05) were significantly lower in SES group compared to BMS group.</p><p><b>CONCLUSION</b>The China made SES were not associated with an increased risk of in-stent thrombosis but significantly reduced restenosis rate and MACE at 6 months post primary angioplasty in patients with AMI.</p>