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According to different epochs and development needs, a series of practices on environmental health and sanitary engineering were carried out, which played significant roles in promoting national economic and social developments and protecting the public health. This paper reviewed the main achievements in the past 70 years infields of patriotic health campaign, water sanitation and toilet improvement in rural areas, surveillance and investigation, health standard system, sanitary engineering equipment, stove improvement etc., and then proposed several prospects in the future.
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Objective To report epidemiological data on neonatal pain collected from a geographi-cally defined region,and analyze its influencing factors. Methods We prospectively collected data on all painful procedures from the first 3 days of admission from 106 premature by using self-made questionnaire. Results One hundred and six premature infants experienced 8 167 first-attempt procedures during the first 3 days of admission,26 painful procedures per premature per day. The top seven were respectively plaster re-moval 1 661(20. 3%),nasal aspiration 1 416(17. 3%),blood sugar testing 982(12. 0%),foil removal 833 (10. 2%),intravenous cannula 806(9. 9%),removal of intravenous line 803(9. 8%),arterial puncture 696 (8.5%); 640(7.8%)supplemental attempts were performed. Arterial puncture 274(42.8%)and intrave-nous cannula 235 (36. 7%) were the top two painful procedures easily failed. Non-invasive ventilation,me-chanical ventilation,neonatal respiratory distress syndrome and low weight were the risk factors of painful procedures. Conclusion In neonatal intensive care unit,large number of painful procedures are performed in the first 3 days of admission. Healthcare providers should develop individualized measures to promote the man-agement of premature pain.
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Objective To observe the recurrence rate of colorectal adenoma and to explore its correlations to obesity and body weight changes.Methods A total of 1 236 cases of patients with colorectal adenoma admitted to our hospital from 2010 to 2012 were selected.Among them,913 cases of patients who had completed the 2-years follow-up were recruited in this study.According to body mass index (BMI),patients were divided into three gorups:normal weight group (BMI＜24 kg/m2),overweight group (BMI:24-＜28 kg/m2) and obesity group (BMI≥28 kg/m2).Colonoscopy was defined as the end-point performed after 2-years follow-up,and the body weights were remeasured.The correlations of recurrence rate of colorectal adenoma to patients' basal body mass and body weight change were analysed.Results A total of 361 patients (39.5％) suffered from recurrent colorectal adenoma.The recurrence rates of colorectal adenoma in the normal weight group,overweight group and obesity group were 34.5 ％,41.0％ and 41.9 ％,respectively;the recurrence rates in the overweight group and obesity group were higher than that in the normal weight group,there were statistically significant differences (P＜0.05).However,There was no significant difference in the recurrence rate of colorectal adenoma between patients with body weight changes of 2.5 kg or more and those with body weight changes less than 2.5 kg(P＞0.05).Conclusion The recurrence of colorectal adenoma is associated with obesity,but changes in body weight in the short term (two years) have no significant effect on the recurrence rate.
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Objective To observe the recurrence rate of colorectal adenoma and to explore its correlations to obesity and body weight changes.Methods A total of 1 236 cases of patients with colorectal adenoma admitted to our hospital from 2010 to 2012 were selected.Among them,913 cases of patients who had completed the 2-years follow-up were recruited in this study.According to body mass index (BMI),patients were divided into three gorups:normal weight group (BMI＜24 kg/m2),overweight group (BMI:24-＜28 kg/m2) and obesity group (BMI≥28 kg/m2).Colonoscopy was defined as the end-point performed after 2-years follow-up,and the body weights were remeasured.The correlations of recurrence rate of colorectal adenoma to patients' basal body mass and body weight change were analysed.Results A total of 361 patients (39.5％) suffered from recurrent colorectal adenoma.The recurrence rates of colorectal adenoma in the normal weight group,overweight group and obesity group were 34.5 ％,41.0％ and 41.9 ％,respectively;the recurrence rates in the overweight group and obesity group were higher than that in the normal weight group,there were statistically significant differences (P＜0.05).However,There was no significant difference in the recurrence rate of colorectal adenoma between patients with body weight changes of 2.5 kg or more and those with body weight changes less than 2.5 kg(P＞0.05).Conclusion The recurrence of colorectal adenoma is associated with obesity,but changes in body weight in the short term (two years) have no significant effect on the recurrence rate.
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Objective To analyze mRNA expression of silent information regulator 6 (SIRT6) gene in the blood of population with family history of longevity in Bama county of Guangxi and to explore its association with SIRT6 gene polymorphism and its protein Methods One hundred and thirty-seven people (aged 30 ~ 106, 70 males, 67 females, 6.57% Han nationality, 93.43% Zhuang and Yao nationalities) with family history of longevity (long-lived family history group), and 91 people (aged 22~89, 51 males, 40 females, all Zhuang and Yao nationalities) without family history of longevity were recruited in the study (non-long-lived family history group). Real-time fluorescence quantitative RT-PCR was used to detect mRNA expression of SIRT6 gene in two groups. Results SIRT6 mRNA expression of total and femals in long-lived family history group were higher than those in non-long-lived family history group (P0.05). Conclusion The expression of mRNA in SIRT6 gene may be associated with familial aggregation of longevity in Bama County of Guangxi and high expression of mRNA of SIRT6 in G allele carriers contributes to longevity.
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This paper summarized practices and experiences of other countries in coordinated care delivery system building,and described the care delivery systems used in various healthcare fundraising patterns.It is found that most countries have defined duties and service coverage of healthcare institutions at all the levels and measures to ensure rational patient flow.In the end,the paper concluded found experiences of these countries and inspirations for China.
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Authors described the patterns,core measures and mechanisms of coordinated care delivery in the localities and analyzed initial outcomes of this practice.It is found that such practice has optimized distribution of regional healthcare resources,implemented first visit to primary institutions, and the care delivery to separate emergency from outpatient service.In addition,the paper analyzed problems found in localities in terms of policy,public hospitals and primary institutions,and proposed elements required for coordinated care delivery system to succeed,such as enhanced policy support, enhanced multi-departmental coordination,and public hospital reform to explore feasible approaches.
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OBJECTIVE: To present our experience of manipulation under general anesthesia for treating postoperative hip joint stiffness in children.METHODS: 193 children (226 hips) with postoperative joint stiffness were retrospectively studied at the Department of Pediatric Orthopaedics, Shengjing Hospital, China Medical University from January 1978 to December 2005, comprising 53 males and 140 females, aged 1-14 years old. 226 hips with postoperative stiffness from open reduction of developmental dysplasia of the hip (DDH) (155 cases with 188 hips) and capsulotomy for hip sepsis or tuberculosis (38 cases with 38 hips) were retrospectively reviewed. All patients laid on the surgical table supinately under general anesthesia. The assistant fixed the pelvic with palms. The operator manipulated the hip joint with 3 steps: flexed hip joint slowly and gently to 110°-120° or more; then abducted and externally rotated hip joint; adducted and internally rotated the hip. Then 3-step passive manipulation was repeated for once at least. As soon as the patient waked from general anesthesia, Continuous passive motion was applied for the affected hip with the range of motion increasing daily for 1-2 weeks. They were followed averagely 15 months (6-24 months) to evaluate the promoted range of motion in flextion-extension and adduction-abdduction.RESULTS: 186 hips (82.3%) succeeded in manipulation in addition to 34 failure hips (15%) and 6 hips (2.7%) with femoral neck fracture. The successful rate, promoted range of motion in group of ≤6-year-old and group of ≤12-month-duration from primary surgery were significantly higher, femoral neck fracture rate was less than those in group of >6 years of age and group of >12-month-duration from primary surgery.CONCLUSION: Passive manipulation under general anesthesia is a safe, uninvasive and effective method in treating postoperative hip stiffness in children. Younger age (≤6 years) and less duration from the primary surgery (≤12 months) would yield better result.
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AIM:Spondylolisthesis is a common spinal disease for adults but rarely found in children.In this study,the treatment effect of spondylolisthesis in 7 children with posterior pedicle screw system after 1 year was explored.METHODS:①Eight children patients with spondylolisthesis treated in Shengjing Hospital of China Medical University between January 1996 and December 2006 were selected including 4 males and 4 females.The average age was 12.25 years(range,8-14 years).According to Meyerding classification,7 cases were of stage Ⅰand one of Ⅳ.②Texas Scottish Rite Hospital(TSRH) posterior pedicle screw system was provided by Wego Ortho Co.,Ltd.,GB1Z type,titanium,No.200511028009.Of the 8 cases,4 were treated by TSRH posterior pedicle screw system,3 were treated via a Wiltse paraspinal approach with autogenous bone graft placed between the transverse processes of L5 and sacral ala in situ fusion,and 1 was not treated by operation.The informed consent of treatment was obtained from the patients.③The changes in the spinal radioactive imaging before and after operation,and the material and host biocompatibility were observed.RESULTS:①Seven of 8 cases were followed up.The mean time of follow-up was 56.6 months with a range from 13 to 111 months.②Three of 4 cases treated by TSRH were vertebral completely reduction with the stability of instrumentation about 75%(3/4),and the other one was partly reduction(about 85%).One person developed the progress again in the X-ray films at three weeks after operation.Three cases treated by Wiltse paraspinal approach with autogenous bone graft placed between the transverse processes of L5 and sacral ala in situ fusion healed well without the recurrence of lumbosacral spondylolisthesis and nonunion.CONCLUSION:TSRH is an efficient and safety option for the treatment of spondylolisthesis in children.
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[Objective] This study examined the distribution and the expression of platelet-derived growth factor-A (PDGF-A) in the ligamentum teres of children with developmental dislocation of the hip (DDH) and normal persons in order to investigate the roles of PDGF-A in hip joint laxity. [Methods]There were six pairs of joint laxity of children with DDH and normal children (control group) matched to gender and age. Immunohistochemistry (SP method) method was used to detect the location and distribution of the PDGF-A in the ligamentum teres,and to semi-quantify their content.Semiquantitative RT-PCR method was used to detect the PDGF-A in the ligamentum teres at mRNA level. The quantitative analysis of the PDGF-A was performed by professional image software and the results were analyzed with standard statistical methods.[Results]High density expression was observed in the synovial layer with fibroblast regularly arranged parallel to the joint surface in the ligamentum teres. PDGF-A distribution was decreased in the fibrous layer of the ligamentum teres. There were significant differences in the percentage of positive fibroblast and gray-scale density in the fibrous layer between DDH group and control group (P
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[Objective] To study the relationship between arthrochalasis and developmental dislocation of hip(DDH).[Methods]One hundred and seventy-six patients with DDH treated from Jaunary 2006 to December 2006 in the Shengjing Hospital of China Medical University were evaluated retrospectively.The average age was 3.54 years old(range,from 6 months to 15 years),with 153 females and 23 males.Eighty-four patients had both,58 left and 34 right.Totally 192 normal children were controls,and the average age was 3.67 years old(range,from 4 months to 15 years).The diagnosis of DDH was depended on clinical manifestations,radiography and ultrasonography.The criteria of arthrochalasia were the standards proposed by Wynne Davies.SPSS version 10.0 for Windows was used to perform statistical analysis.?2 test and spearman test was conducted for obtained data.A P
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BACKGROUND: Encopresis after operation for congenital.ectopic anus can cause psychological, physiological and social ability disorders.OBJECTIVE: To treat the children with encopresis with biofeedback training so as to improve the function of post-operative defecation.DESIGN: A self-controlled trial.SETTING: Department of Pediatric Surgery, Second Clinical College of China Medical University.PARTICIPANTS: Totally 20 cases of encopresis after treatment with operation for ectopic anus,were recruited from the Department of Pediatric Surgery, Second Clinical College of China Medical University, between January 1998 and October 2004. Among them, there were 4 cases of complete encopresis, 7 cases of loose encopresis and 9 cases of blotch. All the cases were followed up. There were 9 cases of ectopic anus in the middle and lower parts, and 11 cases of ectopic anus at the high part.METHODS: The objective measuring methods of biofeedback training such as anorectal pressure and anus sphincter electromyography were used to train the patients with postoperative encopresis. After one-month self-directed training in anus contraction and defecation habit, the children received proper biofeedback training. ① Biofeedback training to strengthen the muscles around the anus twice per day. The portable biofeedback-training machine was taken home after the children patients could automically contract the muscles around the anus 3 weeks later. ② Biofeedback training to improve rectal sensitivity and coordination of anus sphincter, and repeated training in expanding saccus. A normal defecation reflex was established. Anus sphincter presented reflex contraction to prevent encopresis once the rectum expanded. ③ Defecation training was performed for 30 minutes after meals every day. ④ Electrostimulation combined with biofeedback training was performed for 10 minutes twice a day for 3 or 4 consecutive weeks.MAIN OUTCOME MEASURES: ① The maximum contraction anal pressure, vector volume, and electromyographic amplitude of external sphincter of anus; ② positive rate of anorectal contraction reflex of the children patients before and after training.RESULTS: According to actual treatment analysis, all the 20 children patients entered the result analysis. ① In middle and lower parts groups, the maximum contraction anal pressure increased from (11.87±5.61) kPa before training to (24.88±16.58) kPa after training; in high part group, they increased from (5.76±3.84)kPa to (18.18±13.71) kPa (P＜ 0.05). ② In middle and lower parts groups, the vector volume increased from (139.17±130.02) cm (cm Hg)2 to 608.10±131.06 cm·(cmHg)2, whereas in high group it increased from (117.01±74.35) cm(cm Hg)2 to (452.17±69.43) cm(cm Hg)2 (P＜ 0.05). ③ In middle and lower parts groups, the electromyographic amplitude of external sphincter of anus increased from (152.20±37.42) μV to (324.12±67.78) μV; in high part group, it rose from (114.08±51.41)μV to (266.18±49.38)μV (P ＜ 0.05). ④ The positive rate of anorectal contraction reflex improved from pretraining 55％ (11/20) to post-training 90％ (18/20).CONCLUSION: After biofeedback training, the maximum contraction anal pressure, anorectal sensitivity and the coordination of anus external sphincter, defecation habit, and contractibility of external sphincter of anus were all improved obviously, especially in those with ectopic anus in the middle or lower parts. Anus external sphincter function can be improved to the uttermost so as to cure encopresis.