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Objective@#To investigate the effect of pediatric early warning score(PEWS) on the evaluation of severity of emergency children admitted to pediatric intensive care unit(PICU).@*Methods@#A total of 1 069 cases hospitalized through emergency room into PICU in Guiyang Children′s Hospital, from January to December in 2017 were analyzed, and the PEWS was recorded for the first time in emergency room and PICU, while receiver operating curve was used to analyze the efficacy of PEWS to diagnose the children, who were at risk of clinical deterioration and required transfer to the PICU, which included the sensitivity, specificity, Youden index.The diagnostic value of PEWS in asse-ssing the severity of disease in critically ill children was explored.@*Results@#The 1 069 severe cases of PICU ranged from 1 month to 13 years and 8 months, and PEWS score was (4.6±0.8) scores in the emergency room, and (5.1±0.5) scores in the PICU, so there were significant differences of the PEWS score between the death group [(8.0±0.5) scores] and the survival group [(4.8±0.8) scores] in the emergency room and PICU(all P<0.05). The PEWS score of the respiratory, nervous, circulatory and digestive system groups in PICU was (5.8±0.5) scores, while other systemic diseases (blood, kidney, poisoning, and so on) PEWS score was(4.2±0.5) scores; which showed significant differences between 2 groups(t=4.60, P<0.05). In PICU, the score of PEWS was greater than or equal to 4.7, which was the demarcation point to distinguish the critical condition and predict the death risk of the patient.@*Conclusions@#PEWS is of great significance for assessing the children sent to PICU.Patients with mainly respiratory, circulatory, neurological, and digestive system diseases have higher PEWS scores.The PEWS score of other system diseases is significantly reduced.It is suggested that PEWS is not able to reflect the disease of such a system and needs to be taken seriously.
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Objective To explore the association between waist-to-height ratio (WHtR) and dyslipidemia in Chinese adults and to find out an optimal threshold of WHtR for predicting dyslipidemia.Methods A total of 221 270 adults from 4 health checkup centers nationwide were selected by using cluster random sampling method.Height,body weight,waist circumference (WC),total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol(LDL-C) were measured.Body mass index (BMI) and WHtR were then calculated.The area under the receiver operating characteristic curve(AUC) was analyzed and optimal cutoffs were estimated by maximizing the sums of sensitivity and specificity.Results WHtR showed the largest AUCs in the participants with higher TC,TG and LDL-C,followed by increased WC and BMI.In male and female,the optimal thresholds of WHtR,WC and BMI for predicting dyslipidemia were 0.49-0.50 and 0.47-0.49,83-85and 73-76 cm,and 24-25 and 22-23 kg/m2,respectively.Conclusion WHtR may be superior to WC and BMI for predicting dyslipidemia,and an unisex cutoff of 0.5 should be recommended.
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Objective To explore the detection rate and major risk factors of nodular thyroid diseases among adults.Methods A total of 35 495 adults who carried out health checkup during January 1st,2009 and December 31th,2010 in our center were assessed for the occurance of nodular thyroid diseases and the size and number of thyroid nodules by age and gender.Chi-square test,rank sum test and Chi-square trend test were used for data analysis.Results The total detection rate of nodular thyroid diseases was 33.87％ (female vs male:41.76％ vs 29.68％).The prevalence of single thyroid nodule was decreased with age,as opposed to multi-thyroid nodules.Single thyroid nodule was more commonly seen in males,which was reversed in multi-thyroid nodules.Small,middle and large thyroid nodules were found in 77.49％,18.19％ and 4.32％ males or 72.57％,21.59％ and 5.84％ females,respectively.Moreover,thyroid cancer was detected in 0.4‰ of those with nodular thyroid diseases.Conclusions The detection rate of nodular thyroid diseases among adult health checkup receivers was higher,which calls on the needs of intensive monitor and effective prevention of the condition.
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BACKGROUND: Mild cognitive impairment (MCI) in elderly people is becoming increasingly a new hot spot for the clinical study of Alzheimer disease at present, and it is still unknown how many cases of MCI will convert into Alzheimer disease. OBJECTIVE: To analyze the incidence rate of mild cognitive impairment and the conversion rates into dementia and Alzheimer disease among elderly people.DESIGN: A prospective cohort study based on diagnosis. SETTING: Second Department of Cadre's Ward, Bethune International Peace Hospital of Chinese PLA.PARTICIPANTS: The subjects were 216 MCI patients and 2 302 subjects with normal cognition selected in the baseline investigation to the retired cadres aged 60 years and above, in 26 military cadres' sanatoriums of Shijiazhuang city between August and September 2001.METHODS: The MCI diagnosis was according to the MCI diagnostic standard in Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-Ⅳ), and the diagnosis of dementia was according to the standard in DSM-Ⅳ revised by American Psychiatric Association. Alzheimer disease was diagnosed according to the standards of National Institute of Neurological and Communicative Disorders and Stroke/the Alzheimer Disease and Related Disorders Association (NINCDS-ADRDA). All the 216 MCIpatients and 2 302 subjects with normal cognition were enrolled in the 3-year cohort study. MAIN OUTCOME MEASURES: The incidences of MCI among subjects with normal cognition; the annual conversion rates into Alzheimer disease in MCI patients and subjects with normal cognition; the relative risks (RR) and 95% confidence interval (95% CI) of MCI and normal cognition developing into Alzheimer disease. RESULTS: The MCI group and normal cognition group were followed up once every year for 3 years. Of the 216 MCI patients, 7 died, and 209 were followed up actually, and the follow-up rate was 96.8%. Of the 2 302 subjects with normal cognition, 36 died, and 2 266 were followed up actually,and the follow-up rate was 98.4%. ① In the elderly subjects with normal cognition, the annual incidence of MCI was 4.8%, and those of dementia and Alzheimer disease were 1.3% and 0.8 respectively. ② The annual in cidence rates of dementia and Alzheimer disease in MCI patients were 8.1% and 5.6% respectively, which were insignificantly different between males and females (P ＞ 0.05). ③ The incidence rates of dementia and Alzheimer disease showed a descending trend with the elevation of educational level in both the MCI patients (trend x2 =5.57, P=0.02; trend x2 =4.92, P=0.03) and the subjects with normal cognition (trend x2 =23.1, P＜ 0.001; trend x2 =18.0, P ＜ 0.001). ④ The annual incidence rates of dementia and Alzheimer disease showed an ascending trend with aging in both the MCI patients (trend x2 =14.6, P ＜ 0.01; trend x2 =13.9, P ＜ 0.01) and the subjects with normal cognition (trend x2 =32.3, P ＜ 0.01; trend x2=23.8, P ＜ 0.01). ⑤ The relative risks of the conversion into dementia and Alz heimer disease in MCI patients were 6.4 and 7.4 times as many as those in the subjects with normal cognition.CONCLUSION: The risks of conversion into dementia and Alzheimer disease in elderly MCI patients are far higher than those in elderly people with normal cognition. It should be reinforced to monitor elderly MCI patients, who are the of high risk group of dementia.
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Objective To explore the prevalence of mild cognitive impairment (MCI) among elderly veterans. Methods 2 674 veterans ( aged 60 years and over) from 26 military sanatorium in Shijiazhuang city were studied. The Mini-Mental State Examination, Global Deterioration Scale, Activity of Daily Living, Hachinski Ischemic Scale and Hamilton Depression Scale were served as screening tools. Results The prevalence of total MCI was 8 08% in elderly people. The standardized prevalence of MCI was 6 87% in male and 10 38% in female (P