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Objective@#To understand the toxicological indexes and indexes factors of drinking water in rural schools in Yunnan Province during 2017-2020, so as to provide scientific basis for ensuring drinking water safety, and targeted intervention in rural schools. @*Methods@#The end water of 456，399，391，387 rural primary and secondary school drinking water supply projects in 129 counties in Yunnan Province was collected from 2017 to 2020, 11 toxicological indexes were analyzed and evaluated.@*Results@#The overall compliance rate of drinking water toxicological indexes in rural primary and secondary schools in Yunnan Province was 99.32 %; The top three indexes exceeding the standard were nitrate nitrogen(0.31%), chloroform (0.15%) and cadmium(0.09%). The difference of compliance rate by year was statistically significant( χ 2=11.04, P <0.05); No difference in compliance rate was found between dry and wet seasons( χ 2=0.05, P >0.05); The rate of the surface water meeting the standard was higher than that of the groundwater( χ 2=9.62, P <0.05). There was no significant difference in the compliance rate between the treated and untreated projects( χ 2=1.55, P >0.05); The daily water supply scale was less than 500 m 3, and the rate of reaching the standard was lower than that of daily water supply is greater than 500 m 3( χ 2=4.27, P <0.05).@*Conclusion@#The overall percentage of the toxicological indexes in drinking water exceeding the standard in rural primary and secondary schools in Yunnan Province is low. Nitrate nitrogen, chloroform and cadmium should be considered as the prioritirized pollutants of drinking water in rural schools of Yunnan Province.
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OBJECTIVE@#To evaluate the efficacy of black cohosh extracts (BCE) in improving the low estrogen status induced by postoperative gonadotropin-releasing hormone agonist (GnRHa) in patients with endometriosis.@*METHODS@#Randomized clinical controlled trial about the improvement of low estrogen status caused by GnRHa with the treatment of BCE in patients with endometriosis after laparoscopic surgery were retrieved from Medline (Ovid), PubMed, Cochrane Library, CNKI, CBMdisc, Wanfang and VIP databases before January 2020, and meta-analysis of included studies was performed by Revman 5.3 software.@*RESULTS@#Seven randomized controlled trials involving 745 patients were included in this study. Meta-analysis results showed that the addition of BCE did not alter hormone levels of patients, including serum estradiol levels [ =1.24, 95% (-4.58, 7.08), >0.05] and luteinizing hormone levels [ =-0.02, 95% (-0.15, 0.11), >0.05]. BCE effectively improved the perimenopausal symptoms induced by low estrogen status:improving hectic fever and sweating [ =0.1, 95% (0.02, 0.47), < 0.01], reducing the occurrence of insomnia symptoms [ =0.23, 95% (0.13, 0.39), < 0.01], improving fatigue [ =0.09, 95% (0.04, 0.20), < 0.01], reducing the occurrence of vaginal dryness [ =0.04, 95% (0.01, 0.30), < 0.01]. BCE affected Kupperman's menopausal index (KMI) score 12 weeks after the surgery [ =-11.50, 95% (-20.09, -2.90), < 0.01] and KMI score 24 weeks after the surgery [ =-23.68, 95% (-39.66, -7.69), < 0.01].@*CONCLUSIONS@#The limited evidence so far indicates that BCE could efficiently improve perimenopausal symptoms cause by low estrogen status of the patients recieved GnRHa treatment after surgery for endometriosis, but does not alter hormone levels of patients.
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Female , Humans , Cimicifuga , Endometriosis , Estrogens , Plant ExtractsABSTRACT
Objective@#To explore the association of the glycosylated hemoglobin (HbA1c) level at admission with 90 days functional outcome in patients with spontaneous intracerebral hemorrhage (ICH).@*Methods@#Patients admitted to the Department of Neurology, Tongji Hospital from January to December 2017 were prospectively and continuously enrolled in this study. Clinical data were collected at admission and functional outcomes 90 days after ICH were assessed by using the modified RANKIN scale. Univariate and multivariate conditional logistic regression models were constructed. Patients were divided into four groups according to the quartile of HbA1c values. The median value of HbA1c in each group was taken as the substitute value and P for trend was calculated. The logistic regression model was fitted by restricted cubic splines to investigate the association between HbA1c level and outcome of ICH.@*Results@#A total of 345 patients with ICH were enrolled, including 214 with favorable outcomes and 131 with poor outcomes (99 severe disability cases and 32 deaths). The risk of poor 90 days outcomes was significantly associated with HbA1c level at admission indicated by multivariate logistic regression analysis, and the P for trend test was <0.001 (middle-level group vs. low-level group: OR=2.33, 95%CI: 1.07-5.07; high-level group vs. low-level group: OR=2.52, 95%CI: 1.12-5.64; extremely high-level group vs. low-level group: OR=6.80, 95%CI: 3.01-15.34). Results from the restricted cubic spline showed that there was a linear correlation between HbA1c level at admission and poor 90 days outcomes of ICH (χ2=14.81, P<0.001; non- linear test: P=0.118). Compared with patients with HbA1c level of 6.5%, the risk of poor outcomes in patients with HbA1c level of <6.5% decreased linearly with the decrease in HbA1c level at admission, and the risk in patients with HbA1c level >6.5% was higher but not significantly.@*Conclusion@#There was correlation between high HbA1c level at admission and 90 days poor outcome of ICH. High HbA1c level is an independent prediction indicator for ICH.
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Objective To study the nurse-patient communication procedures among nursing interns. Method Totally 334 nursing interns were involved in the survey using the basic questionnaire and the nurse-patient communication procedure scale. Result The average score of the communication skills was 22 . 91 ± 2 . 13 , with the dimensions of communication preparation (0.97 ± 0.07), information collection (0.88 ± 0.13), information sending (0.90 ± 0.12), respecting patients (0.91 ± 0.18), ending communication (0.98 ± 0.08). Conclusions The nurse-patient communication skills of the nursing interns were at a relatively high level. They could conduct the effective communication according to the communication procedures in the sequence of communication preparation, information collection, information sending, respect patients and ending communication. But they are weak in the procedures of information collection and information sending. Therefore, some special trains, such as case analysis, can be done to improve the ability in these procedures.
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BACKGROUND:It has a certain difficulty in the clinical treatment of distal humeral fractures in elderly people. According to the particularity of elderly patients, during clinical treatment of senile distal humeral fracture, conservative treatment or the metal implant internal fixation remains controversial. OBJECTIVE:To explore the feasibility and effectiveness of metal implants for the repair of senile distal humeral fractures. METHODS:A total of 35 hospitalized elderly patients with distal humeral fracture in Beijing Renhe Hospital from September 2008 to September 2013 were studied. 19 cases were given titanium implant fixation (experimental group), 16 cases were given conventional conservative treatment (control group). RESULTS AND CONCLUSION:Total y 35 patients were fol owed up. In the experimental group, elbow joint function was excel ent in eight cases and good in four cases, with total excel ent and good rate of 63%. The excel ent and good rate was significantly higher in the experimental group than in the control group (31%;P<0.05). In the experimental group, three patients suffered from infection of incisional wound, and two patients experienced sensory anesthesia of ulnar nerve innervation area. They had recovered after symptomatic treatment. No nonunion of fracture or loosening of fixator appeared. These suggest that metal implant for senile distal humeral fracture obtained good outcomes, and showed feasibility and effectiveness.
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@#Objective To investigate the principal indicators of self-care ability in activities of daily living for the persons with physical disability. Methods Persons with physical disability were asked to select the top 3 items out of 27 items of activities of daily living in 3 levels. Results A total of 1960 questionnaires were send out, and 1862 were returned. For all the subjects, the items related with personal hygiene, such as toileting, self-cleaning and bathing, were selected 899 times (16.1%). The items related with personal health, as visiting community clinics and community exercising, were selected 570 times (10.2%). The items related with social interaction, as making a telephone and chatting, were selected 500 times (9.0%). For the persons with physical disability of first grade, the major items most selected were eating, entertaining, self-cleaning and transferring; and self-cleaning and housework for those of second grade; self-cleaning, community activities and housework for those of third grade; and community and interaction for those of fourth grade. Conclusion The persons with physical disability mostly focused on the activities related with personal hygiene, health and social interaction, and varied with the severity of disability, from self-cleaning to housework and social participation.
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Objective To explore the effect of Laparoscopy-assisted radical pull-out operation for Hirschsprung disease.Methods The clinical data of 12 patients with Hirschsprung disease admitted to our hospital in the last 2 years were retrospectively reviewed.Results The surgical procedures of 12 cases were successfully performed by laparoscopy,including 6 cases of common segment,4 cases of short segment,and 2 cases of long segment type.All the operations were completed with laparoscopy in 80-130 min(mean 100 min).There was very little bleeding during the procedure and no obvious scar.There were no complications.Conclusions Laparoscopy-assisted radical pull-out operation for Hirschsprung disease is feasible and effective.
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Objective To study the methods for diagnosis and treatment of insulinoma.Methods The clinical data of 120 patients with insulinoma who had been admitted to our hospital in the last 40 years were retrospectively reviewed.Results Fasting blood glucose values were less than 2.75 mmol/L in all the patients.Fasting serum insulin values in 75 patients were higher than 25 ?U/mL,and the average was (65 ?6.0)?U/mL.Before operation,tumor was detected in 2 of 60 patients by ultrasound scan,and in 10 of 50 by CT. Among 18 patients who had intra-operative B-ultrasound examination, 16 positive cases were verified by intraoperative exploration; and one case the tumor was not palpable but was found by intraoperative B-ultrasound examination.The operations included enucleation of insulinoma(70 patients),insulinoma resection and distal resection of the pancreas(44),distal resection of the pancreas(4),and biopsy(2).The low blood glucose symptoms disappeared after the first operation in 111 of the 112 patients who had benign tumor.One case with benign tumor was cured by a second operation.Twenty patients developed pancreatic fistula after tumor enacleation, of them,14 healed uneventfully after drainage,5 were cured by operation,and 1 died of peritoneal infection.Conclusions Preoperative localization of insulinomas is difficult. Intraoperative exploration and ultrasound scan are the chief methods for the localization of insulinoma.Enucleation of insulinoma should be selected for benign tumor. Resections of the pancreatic body and tail is required for large,deep or multiple tumors.