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AIM: To explore a more convenient and accurate method for evaluating the anterior chamber angle width based on the Van Herick method.METHODS:A total of 58 patients(69 eyes)with age-related cataract who visited our hospital between January and December 2021 were included. They were divided into the chamber angle width ≥1/2 corneal thickness(CT)group(44 eyes of 37 cases)and <1/2CT group(25 eyes of 21 cases)according to the Van Herick method. The central anterior chamber depths and the peripheral anterior chamber angle degrees were measured by ultrasound biomicroscopy.RESULTS: There were statistically significant differences in central anterior chamber depth between the two groups(2.64±0.27 mm vs. 2.23±0.29 mm, P<0.01), and the differences of chamber angle degrees of quadrants of superior, temporal, inferior and nasal compared between two groups were all statistically significant(P<0.01). The difference of chamber angle degrees of quadrants of superior and inferior in chamber angle width ≥1/2CT group was not statistically significant(P>0.05), while the differences of chamber angle degrees of other quadrants were all statistically significant(P<0.05). The differences of chamber angle degrees of quadrants of superior and nasal, temporal and the chamber angle degrees of quadrants of inferior and temporal were all statistically significant in chamber angle width <1/2CT group(P<0.05).CONCLUSION: In the overall evaluation of the anterior chamber angle, it would be more simple, fast and accurate when evaluating the temporal chamber angle width and inferior quadrant of chamber angle width by using the Van Herick method under silt lamp.
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Acute coronary syndromes (ACS) are clinical syndromes caused by the instability or rupture of coronary atheromatous plaques. The development and treatment of ACS are closely related to some ocular manifestations. Hypertensive retinopathy, retinal arteriovenous occlusion, diabetes retinopathy, and age-related macular degeneration are associated with a high risk of ACS. Retinal vascular occlusion may be a potential postoperative complication of the percutaneous coronary intervention for ACS. Ocular parameters such as the retinal vascular diameter and density, the blood flow velocity of the ophthalmic artery, and the choroidal thickness are expected to be markers for assessing or predicting the risk of ACS, which are of important value for the prevention of cardiovascular events such as ACS.
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Objective:To compare the application effect among Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scale, Medical Outcomes Study 36-item Short Form (SF-36) scale and "Assessment for Therapeutic Efficacy on Kashin-Beck Disease" (WS/T 79-2011) standard in the evaluation of therapeutic effect of patients with Kashin-Beck disease, which could provide basis for the treatment evaluation of patients with Kashin-Beck disease.Methods:A total of 213 patients with Kashin-Beck disease in Gansu Province were investigated. WOMAC scale, SF-36 scale and standard of WS/T 79-2011 were used to analyze the quality of life of patients before and after treatment. The reliability, construct validity, content validity, discriminant validity of WOMAC and SF-36 scales were compared. Correlation between WOMAC, SF-36 scales and standard of WS/T 79-2011 were evaluated.Results:Both WOMAC and SF-36 scales had good construct validity and content validity (construct validity showed WOMAC and SF-36 scales contained 1 and 2 common factors, respectively; content validity showed WOMAC and SF-36 scales contained 3 and 8 common factors, respectively). The reliability and discriminant validity of WOMAC scale were better than those of SF-36 seale (reliability showed WOMAC reliability coefficient ≥0.934, the reliability coefficient of SF-36 scale was ranged from 0.386 to 0.999. Discriminant validity showed there were differences in 3 dimensions of the WOMAC scale before and after treatment, while there were differences in 6 out of 8 dimensions of the SF-36 scale). The correlation coefficients between WOMAC scale and standard of WS/T 79-2011 ranged from 0.175 to 0.437, the correlation coefficients between SF-36 scale and standard of WS/T 79-2011 ranged from - 0.434 to - 0.099 ( P < 0.05). Conclusion:The reliability, discriminant validity and correlation with the standard of WS/T 79-2011 of WOMAC scale are better than those of SF-36 scale in efficacy evaluation of patients with Kashin-Beck disease.
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Objective:To study the effect of Compound Duzhong Jiangu Granules on joint function, quality of life and inflammatory factors in patients with Kashin-Beck disease.Methods:By group design, 135 patients with Kashin-Beck disease in Chongxin County, Pingliang City, Gansu Province, were selected and divided into intervention group (100 cases treated with Compound Duzhong Jiangu Granules, 12 g/bag, 1 bag/time, 3 times/day, treatment for 1 month) and control group (35 cases treated with ibuprofen, 0.3 g/capsule, 1 capsule/time, 2 times/day, treatment for 2 weeks) according to the randomized, single-blind principle. The changes of joint dysfunction index score, joint function improvement rate, total scores of Kashin-Beck disease quality of life (KBDQOL) and scores of each dimension were analyzed before treatment, 1 month and 3 months after treatment. The serum levels of interleukin-6 (IL-6), nuclear factor κB (NFκB)-p65, inducible nitric oxide synthase (NOS2), nitric oxide (NO), and prostaglandin E2 (PGE2) were detected by enzyme-linked immunosorbent assay before treatment and 1 month after treatment.Results:The total scores of joint dysfunction index of the intervention group and the control group 1 month after treatment and 3 months after treatment were lower than those before treatment, but 3 months after treatment was higher than 1 month after treatment ( P < 0.001). One month after treatment, the total effective rates of joint function improvement in the intervention group and the control group were 68.00% (68/100) and 54.55% (18/33), respectively; 3 months after treatment, the total effective rates of the intervention group and the control group were 36.00% (36/100) and 39.39%(13/33), respectively. The total scores and scores of each dimension of KBDQOL were not significant for the main effect of the group ( P > 0.05), but significant for the main effect at the time point ( P < 0.05), and there was no interactive effect ( P > 0.05). There were significant differences in the scores of social support and mental status dimensions in the intervention group at different time points ( P < 0.001). And in the intervention group, the total score, the scores of physical function, activity limitation, economy and overall health dimensions were statistically significant between before treatment and 1 month after treatment, 1 month after treatment and 3 months after treatment( P < 0.05); however, there was no significant difference between before treatment and 3 months after treatment ( P > 0.05). One month after treatment, the serum PGE2 levels of both groups were decreased ( P < 0.05), and there was no difference in other inflammatory factors at different groups and time points ( P > 0.05). Conclusion:Compound Duzhong Jiangu Granules can effectively inhibit the inflammatory reaction of patients with Kashin-Beck disease, promote the improvement of joint function and improve the quality of life in various aspects.
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Objective:To analyze the characteristics of thyroid diameter and volume of children aged 8 - 10 years in Gansu Province, and to provide a basis for standardizing B-ultrasound examination of children's thyroid volume and establishing a normal reference value of children's thyroid volume.Methods:The data of thyroid volume by B-ultrasound and urinary iodine determination of children aged 8 - 10 years in Gansu Province were from Institute of Endemic Disease, Gansu Center for Disease Control and Prevention. Based on the measured data of thyroid B-ultrasound of 8 - 10 years children in Gansu Province, the characteristics and relationship between thyroid diameter and volume were analyzed by nonparametric test.Results:The medians of urinary iodine of 8, 9, 10 years children ( n = 500, 503, 496) were 166.62, 167.16 and 178.78 μg/L, respectively. The length, width, thickness and volume of the left and right lobes of the thyroid in children were skewed distribution. There was a positive correlation between the left and right diameters (length, width and thickness) and between left and right thyroid volumes ( r = 0.76, 0.85, 0.72, 0.88, P < 0.001). There was no significant difference in the six diameter lines and volume values of thyroid between genders ( P > 0.05), but there was significant difference between ages ( P < 0.001). The means thyroid volume of 8, 9 and 10 years children were 2.6, 2.9 and 3.2 ml, respectively, the medians were 2.5, 2.7 and 3.0 ml, respectively, and the 97th percentile ( P97) were 4.4, 4.9 and 6.5 ml, respectively. The thyroid volume of 10 years group was higher than the current national standard (6.0 ml). The median ranges of thyroid volume of children aged 8, 9 and 10 years at the county level were from 1.8 ml to 4.1 ml, from 1.8 ml to 4.3 ml and from 1.9 ml to 4.4 ml, respectively. There was significant difference in thyroid volume of children at the county level in all age groups ( P < 0.05). Conclusions:Compared with the national standard, the P97 value of thyroid volume of children aged 8 - 10 years in Gansu Province is slightly different. The reference value of thyroid volume should be formulated according to age, and a unified reference value can be used for different genders at the same age.
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Objective:To investigate and analyze the living conditions of patients with Kaschin-Beck disease in Gansu Province, and to provide scientific basis for accurate treatment of the patients.Methods:From 2018 to 2019, case investigation, clinical examination and X-ray examination of patients with Kaschin-Beck disease were carried out in the Kaschin-Beck disease area of Gansu Province. The contents of the survey included basic information of the patients, clinical diagnosis classification, disease information, surgery and drug treatment, etc.Results:A total of 23 909 patients with Kaschin-Beck disease were diagnosed in 37 counties (districts) of 7 cities (states). The patients with grade Ⅰ, grade Ⅱ and grade Ⅲ accounted for 64.04% (15 312 cases), 26.12% (6 244 cases) and 9.84% (2 353 cases), respectively; 90.74% (21 694 cases) of the patients were over 50 years old, Han nationality was 97.15% (23 228 cases), and peasants were 99.25% (23 729 cases). The patients mainly had multiple joint thickening and deformation (89.30%, 21 350 cases) and pain (87.04%, 20 810 cases). Joint thickening and deformation and pain were more common in finger joint, knee joint and ankle joint. The thickening and deformation of the three joints accounted for 89.97% (21 512 cases), 78.18% (18 692 cases) and 63.81% (15 257 cases), respectively; pain accounted for 80.66% (19 285 cases), 78.75% (18 828 cases) and 64.50% (15 422 cases), respectively; 83.83% (20 044 cases) had joint rest pain, 82.63% (19 757 cases) had joint movement pain and 76.03% (18 177 cases) had joint morning stiffness. Surgical treatment was completed in 1.97% (470 cases). Long-term drug treatment (more than 6 months in the whole year) accounted for 47.78% (11 424 cases); the annual cost of drug treatment was mainly less than 500 yuan, accounting for 57.72% (13 800 cases).Conclusions:The quality of life of patients with Kaschin-Beck disease in Gansu Province is low. We should pay more attention to adult patients with Kaschin-beck disease and strengthen management and treatment.
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Objective:To explore the status of kinesiophobia in patients with heart failure during discharge transition period, and analyze its changing trend and influencing factors.Methods:The189 patients with heart failure treated in Henan Provincial People′s Hospital from February 2020 to April 2021 were conveniently selected as the research objects. The general situation questionnaire, the Tampa Scale for Kinesiophobia Heart, the Self-efficacy for Exercise Scale and the Control Attitudes Scale-Revised were used to investigate the patients 2-3 days before leaving the hospital, 1 month and 4 months after discharge.Results:The score of patients′ kinesiophobia deteriorated slightly from 2-3 days before discharge (48.62 ± 11.26) to 1 month after discharge (49.03 ± 11.24), and decreased with the extension of the transition time to 4 months after discharge (47.86 ± 11.11). The overall trend of improvement was statistically significant ( F = 17.92, P<0.01). The score of perceived disease control also showed the same change pattern, 2-3 days before discharge (27.34 ± 7.40), 1 month after discharge (26.18 ± 7.39), 4 months after discharge (27.76 ± 7.38), the difference was statistically significant ( F = 38.41, P<0.01). The score of the exercise self-efficacy of 4 months after discharge (35.63 ± 11.51) was higher than (34.00 ± 11.88) of 2-3 days before discharge and (34.20 ± 11.69) of 1 month after discharge ( F = 12.33, P<0.01). The generalized estimation equation showed that exercise self-efficacy ( B = -0.255, P<0.01) and perceived disease control ( B = -0.439, P<0.01) were protective factors of kinesiophobia in patients with heart failure. Path analysis showed that perceived disease control could not only directly predict patients′ kinesiophobia ( β = -0.461, P<0.01), but also indirectly affect patients′ kinesiophobia by acting on exercise self-efficacy (mediating effect = -0.21, 95% CI -0.293 - -0.136). The mediating effect accounted for 31% of the total effect. Conclusions:The kinesiophobia, perceived disease control and exercise self-efficacy in patients with heart failure during discharge transition were dynamic. Perceived disease control could not only directly predict patients′ kinesiophobia, but also indirectly affect it by acting on exercise self-efficacy. Nursing staff can develop nursing interventions based on perceived disease control or exercise self-efficacy to reducethe level of kinesiophobia inheart failure patients.
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Objective:To observe the changes of optic disc structure in patients with high myopia and the correlation with the morphological markers of the fundus.Methods:A retrospective study. From July 2018 to January 2020, 90 patients (155 eyes) diagnosed as high myopia in Department of Ophthalmology of Beijing Friendship Hospital affiliated to Capital Medical University were included in the study. Among them, there were 31 males (52 eyes) and 59 females (103 eyes), with age of 57.1±14.2 years old and axial length (AL) of 28.5±2.6 mm. According to the classification of myopic macular degeneration, patients were divided into 4 groups based on forms and degree of lesions, including non-pathological myopia group, mild traction lesions group, severe traction lesions group and neovascular lesions group, 35, 58, 41, 21 eyes, respectively. The digitized fundus photographs and an Image J system were used to measure the horizontal, vertical, maximal, and minimal diameter of the optic disc, the horizontal and vertical diameter of the parapapillary δ zone and γ zone, ovality index, distance between the most superior point of the temporal superior arterial arcade and most inferior point of the temporal inferior arterial arcade (VDA), angle between the temporal arterial arcade and optic disc (angle kappa), distance between the optic disc center and the fovea (DFD), angle between the horizontal disc axis and the disc-fovea line (DFA). The correlation between the diameter of the optic disc and other parameters was analyzed. Univariate and multivariate analysis were used to compare differences between groups.Results:The horizontal diameter of the optic disc was positively correlated with the horizontal diameter of the δ zone ( r=0.300, P<0.001), Kappa angle ( r=0.260, P=0.003), and elliptic index ( r=0.650, P<0.001); it was negatively correlated with DFD ( r=-0.190, P=0.030). Optic disc vertical diameter and optic disc horizontal diameter ( r=0.280), δ-zone horizontal diameter ( r=0.330) and vertical diameter ( r=0.460), γ-zone horizontal diameter ( r=0.430) and vertical diameter ( r=0.390), DFD ( r=0.390) was positively correlated ( P<0.001); it was negatively correlated with DFA ( r=-0.210, P=0.001) and Kappa angle ( r=-0.210, P=0.004). Compared with the non-pathological myopia group, there were statistically significant differences in the horizontal and vertical diameters of the optic disc in the severe traction disease group ( P<0.05). Among them, the horizontal diameter difference did not depend on the eye axis and age difference; the vertical diameter difference was caused by the eye axis difference. Compared with the non-pathological myopia group, the difference in the horizontal diameter of the optic disc in the neovascular disease group was statistically significant ( P<0.05), and did not depend on the difference in the axis and age; the difference in the vertical diameter of the optic disc was not statistically significant ( P>0.05). Conclusion:The morphology of optic disc was related to several fundus morphological markers, which was differentiated according to the age, AL and the degree of disease in patients with high myopia.
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Objective:To describe the characterization of ocular changes secondary to hemophagocytic lymphohistiocytosis (HLH).Methods:The clinical data of 5 patients with HLH complicated with ocular involvement treated in Beijing Friendship Hospital Affiliated to Capital Medical University from September 2020 to May 2021 were retrospectively analyzed, the patients′ systemic examination and treatment were sorted out, and the ocular examination results were analyzed. The relevant literatures on ocular involvement of HLH patients were searched in China National Knowledge Infrastructure (CNKI), Pubmed, WOS, Embase and Medicine databases to summarize the characteristic manifestations of ocular involvement of HLH.Results:Of the 5 patients, 1 had primary HLH, 3 were Epstein-Barr virus-associated HLH (EBV-HLH), and 1 had diffuse large B-cell lymphoma-associated HLH. 4 patients showed unilateral or bilateral focal retinal hemorrhage and exudates. 1 male patient performed bilateral retinal pigment epithelial detachment. The literature search results showed that a total of 1 paper on ocular involvement in HLH patients was retrieved from the Chinese database and 11 papers were retrieved from the foreign database. HLH mainly involved the optic nerve, retina and choroid.Conclusions:The ocular involvement of HLH is easy to be missed or misdiagnosed because of its occult onset and complex and diverse clinical manifestations. Early examination and effective treatment may save vision and avoid missing the opportunity of systemic treatment.
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Objective:To study the iodine nutritional status and thyroid function of adult males in iodine nutrition appropriate rural areas of Gansu Province.Methods:In 2017, Liangzhou District and Linze County of Gansu Province with suitable children iodine nutrition were selected as the study areas and 52 males aged 20 - 49 years old were investigated in each study area. One random urine sample was collected to determine urinary iodine. Fasting blood samples were collected to determine serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT 3), free thyroxin (FT 4), thyroglobulin antibody (TgAb) and thyroid microsomal antibody (TMAb). At the same time, thyroid examination was performed by B-ultrasound. Results:The median urinary iodine of adult males in Liangzhou District and Linze County was 180.2 and 161.0 μg/L, respectively, and the difference was statistically significant ( P < 0.05). There was no goiter in adult males in Liangzhou District and Linze County. The serum TSH (median), FT 3 and FT 4 (mean value) of adult males in Liangzhou District and Linze County were 1.85, 1.61 mU/L, 5.19, 5.16 pmol/L and 16.58, 16.30 pmol/L, respectively. There were no significant differences between the two areas ( P > 0.05). The overall abnormal rate of thyroid function in the two areas was 6.7% (7/104), mainly subclinical hypothyroidism (6/7). The incidences of thyroid dysfunction in Liangzhou District and Linze County were 5.8% (3/52) and 7.7% (4/52), respectively, with no statistical difference between the two areas ( P > 0.05). The total positive rate of antibody was 12.5% (13/104). The positive rates of antibody in Liangzhou District and Linze County were 13.5% (7/52) and 11.5% (6/52), respectively, with no statistical difference between the two areas ( P > 0.05). Both TgAb and TMAb were positive in 9/13 of antibody positive persons, of which the proportion of antibody positive persons in Liangzhou District and Linze County were 7/7 and 2/6, respectively. The 11/13 of the total antibody positive persons were simple antibody positive without thyroid hormone and TSH abnormalities. Conclusion:The iodine nutrition of adult males in iodine nutrition appropriate rural areas of Gansu Province is suitable, but there is a potential risk of thyroid disease in this population, which should be paid attention to and checked regularly.
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Objective:To investigate the iodine nutritional status of population in Gansu Province, and to provide a scientific basis for policy adjustment of relevant departments.Methods:In 2019, a cross-sectional survey was conducted in 87 monitoring units in 86 counties (districts and cities) of 14 cities (prefectures) in Gansu Province for iodine deficiency disorders (IDD). Instant urine samples and salt samples of children aged 8 to 10 years and pregnant women were collected for detection of urinary iodine and salt iodine. B-ultrasound was used to check the thyroid volume of children in 40 monitoring units.Results:A total of 17 772 children aged 8 to 10 years were investigated. The median urinary iodine (MUI) of children was 197.4 μg/L, the MUI of 14 cities (prefectures) ranged from 160.6 to 233.4 μg/L. There were statistically significant differences in MUI among children of different genders and ages ( P < 0.001). Totally 8 269 children were examined by B-ultrasound, the children's goiter rate was 1.4% (118/8 269). There were statistically significant differences in the thyroid volume among children of different genders and ages ( P < 0.05). A total of 8 605 pregnant women were investigated. The MUI of pregnant women was 178.6 μg/L, and the MUI of 14 cities (prefectures) ranged from 156.5 to 275.0 μg/L. There was no statistical significant difference in MUI among pregnant women in different pregnancies ( P > 0.05). A total of 26 377 samples of salt consumed by children and pregnant women were detected. The median salt iodine was 24.71 mg/kg. The coverage rate of iodized salt and the consumption rate of qualified iodized salt were 99.44% and 93.59%, respectively. Twenty-three counties (districts and cities) failed to meet the elimination standard of IDD in the single indicator. Conclusions:IDD is in a state of continuous elimination in Gansu Province; iodized salt supervision needs to be further strengthened; there is an imbalance of control measures between regions.
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Objective:To master the epidemic trend of Kashin-Beck disease (KBD) in Gansu Province and provide a scientific basis for prevention and treatment of KBD.Methods:All children aged 7 - 12 or 16 years old were selected as the survey subjects in 37 KBD districts and counties in Gansu Province, clinical and X-ray monitoring results of KBD in children from 2004 to 2018 were collected to analyze the epidemic trend of the disease.Results:From 2004 to 2018, a total of 97 190 children were examined clinically and 94 180 X-ray films were taken in Gansu Province. Four hundred and twenty-eight clinical positive cases were detected, with a detection rate of 0.44%. There were 649 X-ray positive cases, and the detection rate was 0.69%. There were 435 metaphyseal positive cases, the detection rate was 0.46%. There were 214 positive cases of bone end, and the detection rate was 0.23%. The clinical positive rate was the highest (7.17%, 58/809) in 2004, followed by 2007 (4.60%, 51/1 109) and 2005 (4.48%, 187/4 173), and the positive rate in other years was less than 3%. The positive rate of X-ray was the highest (9.59%, 58/605) in 2004, followed by 2005 (5.10%, 213/4 173), 2008 (3.66%, 45/1 228) and 2006 (3.04%, 125/4 107), the positive rate of other years was less than 3%.Conclusions:The clinical positive rate and X-ray positive rate of KBD in children in Gansu Province are decreased rapidly and then maintain a low fluctuation. The effect of comprehensive prevention and control measures is remarkable.
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Objective:To evaluate the reliability and validity of the Chinese version of concise health status questionnaire (SF-36 scale) in evaluating the quality of life of patients with chronic Keshan disease, and to provide a scientific basis for studying the quality of life and the evaluation of treatment and rehabilitation of this population.Methods:In the August 2017, using cluster random sampling method, 175 patients with chronic Keshan disease treated by self-management of family beds in Pingliang City, Gansu Province in 2017 were selected as survey subjects, and demographic and disease data were collected. The Chinese version of SF-36 scale was used to investigate the quality of life. Split-half reliability and Cronbach's α coefficient were used to evaluate the reliability of the SF-36 scale; the factor analysis, correlation and differences between groups were used to evaluate the validity of the SF-36 scale.Results:The split-half reliability value of SF-36 scale was 0.916, and the Cronbach's α coefficient was 0.869. Factor analysis extracted 3 common factors from 8 dimensions of SF-36 scale, and the cumulative contribution rate of the 3 common factors to the total variance was 72.08%. In addition to the correlation coefficient ( r) between Role-Emotional and Bodily Pain dimension, the r value between total score and the scores of each dimension, and the scores of each dimension of SF-36 scale were 0.140 - 0.769. Except for the Bodily Pain dimension, there were statistically significant differences in the scores of Physiological Functioning, Role-Physical, General Health, Vitality, Social Functioning, Role-Emotional, and Mental Health dimension of the quality of life of patients with different grades of cardiac function ( F = 4.66, 10.73, 6.77, 14.61, 5.58, 9.57, 7.10, P < 0.05). Conclusion:The Chinese version of SF-36 scale has good reliability and validity in evaluating the quality of life of patients with chronic Keshan disease, and can be used to evaluate the quality of life of the patients.
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Objective:To observe the morphological characteristics of retinal vessels in patients with ischemic stroke, and to preliminary analyze the correlation between retinal vascular morphological parameters and ischemic stroke.Methods:A retrospective study. From May 2015 to May 2017, 73 patients with ischemic stroke (ischemic stroke group) confirmed by examination at the Beijing Friendship Hospital, Capital Medical University were included in this study. In addition, 146 patients were included in the control group. A total of 146 patients with acute stroke who were excluded by head CT and/or magnetic resonance imaging were selected as the control group. Fundus images of patients were collected by nonmydriatic fundus camera. Retinal vascular parameters were measured by artificial intelligence fundus image analysis system, included retinal artery and vein caliber as well as vascular curvature, branching angle, fractal dimension, and density. The morphological characteristics of retinal vessels were compared between the control and ischemic stroke groups, and correlation between the retinal vascular parameters and ischemic stroke was analyzed using binary logistic regression.Results:Compared with the control group, the ischemic stroke group had thinner retinal artery caliber, smaller retinal vascular fractal dimension, and lower retinal vascular density; moreover, these differences were statistically significant ( t=3.232, 3.502, 3.280; P<0.05). Vascular fractal dimension [odds ratio ( OR)=0.291, 95% confidence interval ( CI) 0.160-0.528] and retinal artery caliber ( OR=0.924, 95% CI 0.870-0.981) were strongly correlated with ischemic stroke ( P<0.01). Conclusion:Compared with the control group, the retinal artery caliber, fractal dimension and retinal vascular density in ischemic stroke group are smaller; decreased retinal artery caliber and fractal dimension are correlated with ischemic stroke.
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Objective:To learn about the current situation and growth and decline trend of Keshan disease in Gansu Province, so as to provide scientific basis for key prevention and control of Keshan disease.Methods:In 2019, the cross-sectional survey method was used to carry out case search in all diseased townships (towns) in 28 diseased counties (districts) of Gansu Province. The situation data of the disease areas were collected under the jurisdiction of counties (districts), and suspected cardiomyopathy cases were investigated by village doctors in the whole township (town) with the village as the unit. Suspected cases were diagnosed according to "Diagnosis of Keshan Disease" (WS/T 210-2011).Results:No Keshan disease cases were detected in the disease affected 8 counties (districts) of Gansu Province, and chronic and latent Keshan disease cases were detected in the remaining 20 counties (districts), and no cases of acute or subacute Keshan disease were found. There were 668 cases of Keshan disease, including 509 cases of chronic Keshan disease, 159 cases of latent Keshan disease; and 1 new case of chronic Keshan disease was found, the annual incidence rate was 0.10/10 000 (1/96 449). The specific ratios of male and female patients were 1.33 ∶ 1.00 (291 ∶ 218) and 1.01 ∶ 1.00 (80 ∶ 79) in chronic and latent Keshan disease; the age of chronic and latent Keshan disease was mainly > 50 - 60 years old, accounting for 36.94% (188/509) and 42.14% (67/159), respectively, followed by the > 60 - 70 years old, accounting for 36.15% (184/509) and 25.79% (41/159), respectively.Conclusion:Keshan disease is in a stable low incidence situation in Gansu Province, but there are still new cases, so the continuity of disease monitoring should be maintained.
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Objective:To evaluate the reliability and validity of Chinese version of Minnesota Living with Heart Failure Questionnaire (MLHFQ) scale among patients with chronic Keshan disease.Methods:The patients with chronic Keshan disease diagnosed in Keshan disease area of Gansu Province from August 2018 to April 2020 were selected as the survey subjects to analyze the reliability and validity of the Chinese version of MLHFQ scale in evaluating the quality of life of patients with chronic Keshan disease. To evaluate the reliability of MLHFQ scale, the Cronbach's α coefficient was used, and when the Cronbach's α coefficient > 0.8 indicated that the consistency reliability of the scale was good. Kaider-Meyer-Olkin(KMO) statistic and Barlett's sphericity test were used to evaluate whether the scale was suitable for factor analysis (applicable when KMO > 0.6 and Barlett's sphericity test P < 0.05). The principal component analysis and maximum variance method of exploratory factor analysis were used to extract common factors, and the structural validity of the scale was evaluated. The discrimination validity of the scale was evaluated by New York Heart Association (NYHA) cardiac function classification and analysis of variance. Pearson correlation analysis was used to evaluate the content validity of the scale. Results:A total of 333 questionnaires were collected, of which 329 were valid. There were 180 males and 149 females, aged (59.52 ± 9.26) years. The Cronbach's α coefficient of the Chinese version of MLHFQ scale was 0.95 ( > 0.8). Among them, the Cronbach's α coefficients in the physical domain, emotional domain and other domains were 0.93, 0.91 and 0.86, respectively ( > 0.8). The KMO value of the Chinese version of MLHFQ scale was 0.95 ( > 0.6), and Barlett's sphericity test rejected the hypothesis (χ 2 = 5 222.01, P < 0.05). Principal component analysis and maximum variance method were used to extract 3 common factors, which were named kinetic energy of life, physical condition and emotional condition, respectively. The cumulative contribution rate of principal components was 66.22% ( > 50%). Compared with patients with NYHA cardiac function grade Ⅱ and patients with grade Ⅲ and Ⅳ, there were significant differences in the physical domain, other domain and total score ( P < 0.001). The Pearson correlation coefficients between the physical, emotional, and other domains and their respective items ranged from 0.74 to 0.88, 0.78 to 0.90, and 0.56 to 0.80, respectively, and the correlation coefficients between each item and its domain were all > 0.5 ( P < 0.001). Conclusion:The Chinese version of MLHFQ scale has good reliability and validity in patients with chronic Keshan disease in Gansu Province, and can be used to evaluate the quality of life of patients with chronic Keshan disease.
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Objective:To observe the morphological characteristics of internal carotid artery (ICA) siphon and ophthalmic artery (OA) in patients with non-arteritic anterior ischemic optic neuropathy (NAION) based on CT angiography (CTA) three-dimensional reconstruction of ICA siphon and OA models.Methods:A retrospective cohort study. From January 2017 to January 2019, 26 patients with 31 eyes (NAION group) who were diagnosed with NAION by ophthalmic examination at Beijing Friendship Hospital, Capital Medical Universitywere included in the study. Among them, there were 11 males with 13 eyes, and 15 females with 18 eyes; the age was 67.52±6.30 years old. Nineteen eyes of 19 non-affected contralateral eyes were selected as the contralateral eye group. Among them, there were 9 males with 9 eyes and 10 females with 10 eyes; the age was 65.95±5.66 years old. Twenty-six eyes of 26 age- and sex-matched subjects with normal fundus examination during the same period were selected as the normal control group. All subjects underwent best corrected visual acuity (BCVA), intraocular pressure, fundus photography and CTA examination. The data obtained from CT scans were reconstructed by 3D model, and the anatomical morphology of ICA siphon was divided into U-shape, V-shape, C-shape and S-shape; the diameter of ICA siphon portion and the diameter at the beginning of OA were measured. One-way analysis of variance was used to compare the diameter of the OA at the beginning of the OA and the diameter of the ICA siphon between the three groups of eyes.Results:The diameters at the beginning of OA in the NAION group, the contralateral eye group, and the normal control group were 1.17±0.20, 1.34±0.17, and 1.39±0.15 mm, respectively, and the differences among the three groups were statistically significant ( F=12.325, P<0.05); there was no significant difference between the contralateral eye group and the normal control group ( P=0.310). In the NAION group, the anatomical morphology of the ICA siphon was U-shaped and V-shaped in 20 (64.52%) and 8 (25.81%) eyes respectively, and S and C-shaped in 3 eyes (9.67%); in the contralateral eye group, in the control group, the ICA siphon shape of the eyes examined was U-shaped and V-shaped, and S-shaped and C-shaped were rare. The diameters of the ICA siphons in the NAION group, the contralateral eye group, and the normal control group were 3.50±0.69, 3.22±0.59, and 3.55±0.54 mm, respectively. There was no significant difference between the three groups ( F=1.860, P=0.163). Conclusion:U-shaped and V-shaped ICA siphons are more common in NAION-affected eyes; the diameter of the starting point of OA is significantly reduced.
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Objective:To evaluate the efficacy and safety of enteral extended biliary stenting for biliary stricture.Methods:A multicenter retrospective cohort study was conducted on data of 550 patients with obstructive jaundice due to extrahepatic bile duct stricture between February 2006 and April 2020. Patients were assigned to conventional group (undergoing conventional biliary stent placement) and extended group (undergoing enteral extended biliary stent placement). Propensity score was used to match the basic data of patients of the two groups. Then the stent patency time, bilirubin difference before and after 1 week operation, incidence of complications and hospital stay were compared between the two groups.Results:Among the 550 patients, clinical data of 20 cases were missing and 35 failed to be followed up. Finally, 326 patients were enrolled to the study after propensity score matching with 163 cases in each group. The patency time of extended group was 111.0 (82.0, 192.0) days, which was longer than that of conventional group with patency time of 93.0 (70.0, 141.8) days ( Z=3.260, P=0.001). Total bilirubin difference value of pre-operation and post-operation was less in extended group [51.2 (26.0, 114.7) μmol/L VS 46.0 (13.9, 81.1) μmol/L, Z=2.095, P=0.036]. The rate of early adverse events [4.3% (7/163) VS 3.7% (6/163), P=0.079] and median in-patient days (10.0 days VS 10.0 days, P=0.379) were similar in the two groups. Conclusion:Enteral extended biliary stent is effective and safe for treatment of biliary stricture, which can prolong the patency time without increasing postoperative complications and hospital stay.
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Objective:By investigating the cognitive level and influencing factors of heart failure knowledge in patients with chronic Keshan disease, so as to provide reference for improving the cognitive level of disease-related knowledge of the patients with Keshan disease in the targeted manner.Methods:In 2019, 100 patients with chronic Keshan disease were selected in Jingchuan County, Gansu Province. A questionnaire survey was conducted using the heart failure knowledge questionnaire to conduct correlation and regression analysis on the cognitive level of patients' heart failure knowledge and influencing factors.Results:Patients' average score of the heart failure knowledge level was (6.18 ± 2.72) points, and the scoring accuracy rate was 41.20%. The Spearman correlation analysis indicated that heart failure knowledge level was associated with annual family income ( r = 0.363, P < 0.01), the hospitalization times due to heart failure ( r = 0.304, P < 0.01), and the number of family members ( r = 0.240, P < 0.05). The results of multiple linear regression showed that the cognitive level of heart failure knowledge in male patients was higher than that in female patients ( P < 0.05). The more hospitalization times ( P < 0.05) and the more family members ( P < 0.05) were, the higher the cognitive level of heart failure knowledge was. Conclusions:The cognitive level of heart failure knowledge of patients with chronic Keshan disease is generally low. Medical staff should actively make use of the patient's hospitalization time for health education, and pay attention to the health education of family members of the patients.
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Objective:To investigate the application and problems existing in the implementation of the standard of "Assessment for Therapeutic Efficacy of Kashin-Beck Disease" (WS/T 79-2011, referred to as new standard), and to provide technical basis and suggestions for further improving the standard.Methods:In 2019, a questionnaire survey was conducted and analyzed in Sichuan, Shaanxi, Qinghai and Gansu provinces and Tibet Autonomous Region on basic information, standard implementation, publicity, training and application of scoring method of joint dysfunction index of Kashin-Beck disease prevention and control technicians.Results:One hundred and thirty-four questionnaires were distributed in this survey and 132 valid questionnaires were recovered, of which 88.64% (117/132) of Kashin-Beck disease prevention and control technicians received training in the new standard and 89.39% (118/132) used the new standard; 78.03% (103/132) thought that the standard terms were clear and easy to master; 71.97% (95/132) thought it was simple, convenient and easy to operate; 49.24% (65/132) thought that the standard evaluation results were consistent with the actual improvement of patients, and 50.75% (67/132) thought that it was generally consistent; 72.73% (96/132) thought that the design was scientific, reasonable and feasible. When using the scoring method of joint dysfunction index, more than 90% of the technicians thought that the five index terms of "joint rest pain", "joint movement pain", "morning stiffness", "maximum walking distance" and "limb activity ability" were easy to understand and ask questions. When patients with Kashin-Beck disease were investigated, the constituent ratios of easy to understand the five index terms were 96.21% (127/132), 83.33% (110/132), 90.15% (119/132), 78.79%(104/132), 90.15%(119/132) and the constituent ratios of easy to answer were 95.45% (126/132), 83.33% (110/132), 89.39% (118/132), 75.00% (99/132) and 89.39% (118/132), respectively.Conclusions:The new standard terms are clear, the design is scientific and reasonable, the operation is convenient and the feasibility is strong. The evaluation results are basically consistent with the actual improvement of patients. It is suggested to add objective evaluation indexes to the scoring method of joint dysfunction index.