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Objective:To explore the effects of different time of skin-to-skin contact on physical/mental status and breastfeeding in cesarean section parturient, so as to provide reference for promoting breastfeeding.Methods:A total of 87 cesarean section parturient and children were collected from Taihe Hospital of Traditional Chinese Medicine from February 2021 to February 2022 as research objects by convenient sampling method. They were divided into A group, B group and C group by random digits table method, each group were 29 cases. Skin-to-skin contact was carried out in the three groups while the parturient was awake, A group contact time were 30 min, B group were 60 min, C group were 90 min. The intervention effect was assessed by Short Form McGill Pain Questionnaire, Visual Analogue Scale for Anxiety (VAS-A), Infant Brestfeeding Assessment Tool (IBFAT) as well as breast feeding related indicators.Results:Finally, 81 parturient were included, with 27, 28, and 26 cases in A group, B group, and C group. The scores of visual analogous scale, pain grading index, presents pain intensity, VAS-A were (6.74 ± 1.48), (19.33 ± 2.02), (4.48 ± 1.16), (5.22 ± 1.05) points in A group and (6.93 ± 1.41), (20.11 ± 2.50), (4.93 ± 1.56), (5.46 ± 1.04) points in B group, lower than in C group (7.69 ± 1.19), (22.08 ± 2.31), (5.73 ± 1.08), (6.31 ± 1.57) points, the differences were statistically significant ( t values were 2.05-4.36, all P<0.05). The successful rate of first breastfeeding and the rate of exclusive breastfeeding at 42 d after delivery were 55.6%(15/27), 59.3%(16/27) in A group, lower than in B group 82.1%(23/28), 85.7%(24/28) and in C group 88.5%(23/26), 88.5%(23/26), the differences were statistically significant ( χ2 values were 4.55-7.07, all P<0.05). The lactation start time, duration of first breastfeeding and IBFAT total scores were (17.04 ± 3.98) h, (10.44 ± 3.03) min, (4.74 ± 1.64) points in A group, lower than in B group and C group (19.22 ± 3.12) h, (12.36 ± 3.18) min, (7.07 ± 1.78) points and (16.69 ± 3.97) h, (13.62 ± 2.38) min, (7.58 ± 1.40) points, the differences were statistically significant ( t values were 2.45-5.25, all P<0.05). Conclusions:Skin-to-skin contact for 60 min can promote breastfeeding and alleviate anxiety and pain degree of cesarean section parturient.
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Objective:To dynamically monitor the prevalence and trend of dental fluorosis in children in Shandong Province, and to evaluate the prevention and control measures for drinking water-borne endemic fluorosis (referred to as drinking water-borne fluorosis), and to provide scientific basis for the next step.Methods:Totally 40 counties (cities, districts) were selected as project counties (cities, districts) from drinking water-borne fluorosis areas in Shandong Province in 2018, and all counties (cities, districts) were selected in 2019 and 2020, to investigate the situation of water improvement, detect water fluoride content, and investigate the prevalence of dental fluorosis in children aged 8 - 12 years.Results:From 2018 to 2020, the detection rates of dental fluorosis in children aged 8 - 12 years were 10.30% (503/4 884), 8.94% (25 895/289 539) and 8.66% (24 061/277 689), respectively, with statistically significant differences (χ 2 = 27.10, P < 0.001), and the dental fluorosis indexes were 0.21, 0.18 and 0.17, respectively. The total detection rates of dental fluorosis in children of different age groups in the 3 years were 7.26% (6 590/90 775), 7.97% (9 303/116 680), 9.29% (12 167/130 915), 9.29% (12 238/131 670) and 9.95% (10 161/102 072), the differences were statistically significant (χ 2 = 615.71, P < 0.001). In the 3 years, the total detection rate of dental fluorosis was 8.93% (28 101/314 737) in boys and 8.69% (22 358/257 375) in girls, the difference was statistically significant (χ 2 = 10.27, P = 0.001). In 2018 and 2019, the detection rates of dental fluorosis of children aged 8 - 12 years in water fluoride qualified villages [5.74% (235/4 095) and 7.98% (20 200/253 082)] were significantly lower than those in villages with excessive water fluoride [33.97% (268/789) and 15.62% (5 695/36 457), χ 2 = 570.61, 2 283.76, P < 0.001]. Conclusions:The prevalence of dental fluorosis among children aged 8 - 12 years has been effectively controlled, and remarkable results have been achieved in prevention and treatment of drinking water-borne fluorosis in Shandong Province. However, the detection rate of dental fluorosis among children in a few endemic villages is high, so it is necessary to continue to strengthen the monitoring of fluoride content in drinking water and the condition of dental fluorosis among children.
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Objective:To investigate the relationship between iodine nutrition level and thyroid disease.Methods:Totally 299 patients with thyroid disease who were treated at Shandong Provincial Institute for Endemic Disease Prevention and Control from 2016 to 2018 were selected as case group which was further divided into Graves' disease group (GD group, 137 patients), chronic lymphocytic thyroiditis group (HT group, 90 patients) and thyroid nodule group (72 patients). At the same time, 75 healthy people with no history of thyroid disease, normal thyroid color ultrasound and thyroid function were selected as control group. Morning urine was collected and urinary iodine was detected by arsenic cerium catalytic spectrophotometry. Fasting venous blood was extracted, and serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid globulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) were detected by electrochemiluminescence method. Results:The difference of median urinary iodine in the 4 groups was statistically significant ( H = 42.530, P < 0.05). The medians urinary iodine in GD and HT groups (326.79, 341.91 μg/L) were higher than those of thyroid nodule group and control group (235.01, 187.32 μg/L, P < 0.05). The levels of TSH, FT 3 and FT 4 in GD group were compared with those of control group, and the differences were statistically significant ( P < 0.05). The positive rates of TgAb and TPOAb in HT group were significantly higher than those in GD, thyroid nodule and control groups, and the positive rates of TgAb and TPOAb in GD group were higher than those in thyroid nodule and control groups ( P < 0.05). Conclusions:GD and HT patients have excessive iodine nutrition, and high iodine intake may lead to the occurrence of these thyroid diseases (GD and HT). Thyroid function test combined with laboratory urinary iodine test can be used to diagnose thyroid diseases simply and quickly.
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Objective:To master the current situation of prevention and control of drinking water-borne endemic fluorosis in Shandong Province, and to provide basic data for control and evaluation of drinking water-borne endemic fluorosis.Methods:From June to December 2019, in accordance with the requirements of the "National Drinking Water-Borne Fluorosis Monitoring Program (2019 Edition)" and "Shandong Province Drinking Water-Borne Fluorosis Monitoring Program (2019 Edition)", cross-sectional survey method was used to monitor the operation of the water supply projects, the fluorine content in drinking water, and the condition of children with dental fluorosis in all the disease affected villages of the drinking water-borne endemic fluorosis counties (cities, districts) in 16 cities of Shandong Province. Water fluorine was detected by "Standard Examination Methods for Drinking Water-Nonmetal Parameters" (GB/T 5750.5-2006), and in accordance with the "Standards for Drinking Water Quality" (GB 5749-2006), the water fluorine content was judged to be qualified or not. The examination and determination of dental fluorosis in children adopted "Diagnosis of Dental Fluorosis" (WS/T 208-2011), and the detection rate of dental fluorosis was calculated, the detection rates of dental fluorosis were compared between water improvement villages and villages without water improvement, qualified water fluorine and unqualified water fluorine villages.Results:There were 9 475 drinking water-borne endemic fluorosis villages in 105 counties (cities, districts) in Shandong Province, of which 9 370 were water improvement villages, and the water improvement rate was 98.89%. Among all the water improvement villages, there were 9 318 projects in normal operation, 45 intermittent projects and 7 scrapped projects. Among all the drinking water-borne endemic fluorosis villages, 8 254 villages were qualified in water fluorine, and the qualified rate of water fluorine was 87.11% (8 254/9 475); among water improvement villages, 8 210 villages were qualified in water fluorine, and the qualified rate of water fluorine was 87.62% (8 210/9 370); among the villages without water improvement, 44 villages were qualified in water fluorine, and the qualified rate of water fluorine was 41.90% (44/105). The qualified rate of water fluorine in water improvement village was significantly higher than that in villages without water improvement (χ 2 = 193.31, P < 0.05). The detection rates of dental fluorosis in children in water improvement villages and villages without water improvement were 8.92% (25 624/287 405) and 12.70% (271/2 134), respectively, and the detection rate of dental fluorosis in children in villages without water improvement was higher than that in water improvement villages (χ 2 = 37.23, P < 0.05). The detection rates of dental fluorosis in children in qualified water fluorine and unqualified water fluorine villages were 7.98% (20 200/253 082) and 15.62% (5 695/36 457), respectively, and the detection rate of dental fluorosis in children in unqualified water fluorine villages was higher than that in qualified water fluorine villages (χ 2 = 2 283.76, P < 0.05). Conclusions:Water improvement and fluorine reduction measures have been implemented in most drinking water-borne endemic fluorosis villages in Shandong Province, the detection rate of dental fluorosis in children in water improvement villages is lower than that in villages without water improvement. However, attention should be paid to the situation of water fluorine exceeding the standard and later management and maintenance to prevent the rebound of the disease.
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Chronic kidney disease (CKD) is an important public health problem due to its poor prognosis and high medical costs.The cardiac damage is the leading cause of death in patients with CKD.The early detection of left ventricular systolic dysfunction in CKD patients may help for evaluating CKD patients' condition and prognosis.Compared with traditional echocardiography,new technology 3 dimensional speckle tracking imaging (3D-STI) is able to quantify left ventricular systolic function accurately and noninvasively.The application progresses of 3D-STI in assessment of left ventricular systolic function in patients with CKD were reviewed in this article.
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Objective To summarize and analyze the epidemiological and clinical characteristics of patients with subacute thyroiditis (SAT),so as to provide a basis for prevention and treatment of the disease.Methods The epidemiological and clinical datas of 121 SAT patients,who were treated at the Shandong Provincial Institute for Endemic Disease Prevention and Control in 2015,were collected.The SAT patient's age,sex,lived in urban or rural areas,occupation and time of onset distributions were analyzed retrospectively.According to the clinical manifestations,the SAT patients were divided into types Ⅰ (mild/nodule type),Ⅱ (medium/normal),Ⅲ (severe/hyperthyroidism),and Ⅳ (delay),and clinical manifestations,auxiliary examination findings,treatment and outcome were summarized.Results Average age of the 121 cases of SAT patients was 41.36 years old,the youngest was 10 years old and the oldest was 76 years old.Most of the patients were 30-＜ 50 years old,which was accounted for 55.37％ (67/121).Most of the patients were female,which was accounted for 90.08％ (109/121).Most of the patients lived in rural areas,which was accounted for 59.50％ (72/121).Majority of the SAT patients were farmers,which was accounted for 43.80％ (53/121).Most onset of the disease was in November,accounted for 19.83％ (24/121),and the least was in June,accounted for 2.48％ (3/121),the peak of the incidence of SAT lied in autumn,and it was sporadic in the rest of the year.From the clinical classification,the mild type (61) and the medium type (46) were the largest part,a total of 107 cases,accounted for 88.43％ (107/121);while the severe type had 5 cases,accounted for 4.13％ (5/121);the delay type had 9 cases,accounted for 7.44％ (9/121).The clinical manifestations were as follows:anterior neck discomfort was 109 cases,accounted for 90.08％ (109/121);sore throat was 93 cases,accounted for 76.86％ (93/121).Auxiliary examination findings were as follows:thyroid iodine taken rate reduced in 121 cases,accounted for 100.00％ (121/121);thyroid nodule 96 cases,accounted for 79.34％ (96/ 121);total number of white blood cells increased in 52 cases,accounted for 42.98％ (52/121);neutrophil increased in 61 cases,accounted for 50.41％ (61/121);blood sedimentation significantly speed up in 49 cases,accounted for 40.50％ (49/121).All of the 121 patients were cured.Conclusions Majority of the patients are female,young aduhs and farmers.The peak of the incidence of SAT lies in autumn.The proportion of mild,medium type is the highest,we suggest this disease should be early diagnosis and treatment.
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Objective To evaluate the clinical efficacy of Jianpi pill in the treatment of leucocytopenia induced by anti -thyroid drug.Methods According to the digital table,195 Graves hyperthyroidism patients with leucocytopenia induced by anti -thyroid drug were randomly divided into the observation group(100 cases)and the control group(95 cases).The observation group was given Jianpi pill treatment,while the control group adopted the combination therapy of batilol tablets,leucogen tablets,vitamin B4 tablets.The facial color,whether or not limb weak-ness,whether or not palpitations after strenuous exercise in the two groups were observed.The number of white blood cells and the number of neutrophils in the two groups were observed.3 months later,the curative effect of the two groups was determined according to the degree of cure.Results The total effective rates of the control group and the observation group were 52.63% and 85.00% respectively,the difference was statistically significant between the two groups(χ2 =23.96,P 0.05).The incidence rates of dry mouth,hyperactive bowel sounds and liver damage,constipation and diarrhea in the control group were 4.21%,2.10% and 1.05% respectively,and the incidence rates of dry mouth,hyperactive bowel sounds and liver damage in the observation group were 3.00% and 1.00% respectively,there was no significant difference in adverse reactions between the two groups(P >0.05).Conclusion The curative effect of Jianpi pill in the treatment of Graves hyperthyroidism patients with leucocytopenia induced by anti -thyroid drug is sure,and it is superior to the combination therapy of batilol tablets,leucogen tablets,vitamin B4 tablets.
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Objective:To observe the clinical efficacy and safety of alteplase combined with butylphthalide in the patients with a-cute ischemic stroke. Methods:Totally 108 cases of acute ischemic stroke patients in our hospital were selected and randomly divided into the experimental group and the control group with 54 ones in each. The two groups were both given such treatments as blood sugar control, blood lipid control, blood pressure control and the other conventional treatment, and the control group was given alteplase for thrombolysis treatment additionally, while the experimental group was given butylphthalide sodium chloride injection combined with al-teplase additionally. Both groups were treated for 14 days. The clinical effect, NIHSS score, daily life ability score and the adverse re-actions in the two groups were observed and compared. Results: The total effective rate in the experimental group was 94. 4%, and that was 81. 5% in the control group, and the difference was statistically significant (P<0. 05). The NIHSS score was reduced signifi-cantly(P<0. 05),and the life ability based on Barthel index score increased significantly (P<0. 05) in the two group after the 7-and 14-day treatment,and the improvement of the experimental group was significantly better than that of the control group with statistically significant differences (P<0. 05). There was no significant difference in the incidence of cerebral hemorrhage and the total adverse re-actions between the groups (P > 0.05). Conclusion: In the treatment of acute ischemic stroke, alteplase combined with bu-tylphthalide is safe and effective, and can effectively improve the neurological function and the ability of daily life, which is worthy of clinical application.
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Objective:To observe the clinical efficacy and safety of alteplase combined with butylphthalide in the patients with a-cute ischemic stroke. Methods:Totally 108 cases of acute ischemic stroke patients in our hospital were selected and randomly divided into the experimental group and the control group with 54 ones in each. The two groups were both given such treatments as blood sugar control, blood lipid control, blood pressure control and the other conventional treatment, and the control group was given alteplase for thrombolysis treatment additionally, while the experimental group was given butylphthalide sodium chloride injection combined with al-teplase additionally. Both groups were treated for 14 days. The clinical effect, NIHSS score, daily life ability score and the adverse re-actions in the two groups were observed and compared. Results: The total effective rate in the experimental group was 94. 4%, and that was 81. 5% in the control group, and the difference was statistically significant (P<0. 05). The NIHSS score was reduced signifi-cantly(P<0. 05),and the life ability based on Barthel index score increased significantly (P<0. 05) in the two group after the 7-and 14-day treatment,and the improvement of the experimental group was significantly better than that of the control group with statistically significant differences (P<0. 05). There was no significant difference in the incidence of cerebral hemorrhage and the total adverse re-actions between the groups (P > 0.05). Conclusion: In the treatment of acute ischemic stroke, alteplase combined with bu-tylphthalide is safe and effective, and can effectively improve the neurological function and the ability of daily life, which is worthy of clinical application.
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Objective To evaluate the therapeutic efficacy of YunKe and prednisone on moderate and severe thyroid associated ophthalmopathy(TAO).Methods 1 08 hyperthyroidism patients with moderately severe TAO were randomly divided into YunKe group,hormone group and the control group.All of the patients were given anti -thyroid medication(ATD)treatment.By thyroid hormone level upper limit every times higher than normal for a sulfhydryl imidazole 5mg/day to calculate daily dosage,based on thyroid hormone level adjusted a sulfhydryl imidazole dose every two weeks,make thyroid hormone levels in the normal range.YunKe set:intravenous push note YunKe per day A +B agent four groups (including cloud 20mg),each treatment medicine for five days in A row,interval of 25 days to the next period of treatment,medication six procedures.Hormone group:oral prednisone for 6 months,monthly dose in the order 1 mg·kg -1 ·d -1 ,0.75mg·kg -1 ·d -1 ,0.5mg·kg -1 ·d -1 ,0.25mg·kg -1 ·d -1 ,0.1 25mg·kg -1 ·d -1 , 0.062 5mg·kg -1 ·d -1 ,1 time a day,took at 8 o'clock in the morning.The control group treated ATD.Before and 6 months after treatment,all of the patients were checked the TNF -αand TRab,CT scan to measure degree of exophthalmus.Six months after treatment,respectively,on the basis of TAO classification (NOSPECS)and TNF -α, TRab level changes to determine the efficacy of treatment.Data entry Excel 2003 statistical software,used SPSS 1 9.0 statistical software to analyze data.Non parametric tests of three groups of data with Kruskal Wallis test.Not matching the two independent samples nonparametric test with the Mann -Whitney test,with P <0.05 for the difference was statistically significant.Results The markedly effective rate,effective rate and ineffective rate of YunKe group were 36.1 %,47.2% and 1 6.7% respectively,which of the hormone group were 20.0%,37.1 % and 42.9%,which of the control group were 1 3.9%,22.2% and 63.9%.The efficacy among the three groups had statistically significant differences (Kruskal -Wallis χ2 =1 0.736,P =0.005 ).The lighter exophthalmos,tge curative effect was better (Mann -Whitney Z =-4.599,P <0.001 ).The changes of TNF alpha,TRab levels among the three groups had significant differences(YunKe group,the TNF alpha,TRab levels markedly reduced 75.0% and 80.6%,respectively, which of the hormone group were 37.1 % and 34.3%,which of the control group were 1 9.4% and 27.8%,TNF χ2 =23.527,P <0.001 ;TRab χ2 =23.831 ,P <0.001 ).Conclusion The therapeutic efficacy of YunKeon TAO is better than prednisone,but the long -term effect deserves more investigation.
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Objective To summarize and analyze the epidemiological and clinical characteristics of patients with subacute thyroiditis(SAT),so as to provide a basis for prevention and treatment.Methods The epidemiological and clinical data of 1 865 patients with SAT,who were treated in the Shandong Institute of Prevention and Control for Endemic Disease in 2015-2006,were collected.The SAT patients' sex,age,urban and rural areas,occupation and time of onset distributions,summary onset clinical manifestations,laboratory findings,treatment and outcome were analyzed retrospectively.Results The average age of the 1 865 patients with SAT was 42.16 years old,the youngest was 9 years old,and the oldest was 74 years old.Most of the patients were 21-50 years old,which was accounted for 62.36％ (1 163/1 865),and most of the patients were female,which was accounted for 83.70％ (1 561/1 865).Most of the patients lived in rural areas,which was accounted for 60.54％ (1 129/1 865).Most patients were onset in January,accounted for 20.48％ (382/1 865),and the least in July,accounted for 1.77％ (33/1865).For the clinical classification,the moderate type and the light type were the largest part with 1 716 cases,accounted for 92.01％,while the severe type was 149 cases,accounted for 7.99％.The clinical manifestations were as follows:the neck discomfort in 1 701 cases,accounted for 91.21％;neck pain,sore throat and palpitate in 1 439 cases,1 351 cases and 1 341 cases,accounted for 77.16％,72.44％ and 71.90％,respectively.Laboratory test results were as following:1 865 cases of thyroid 131I absorption rate reduced(100％);1 396 cases of thyroid nodules increased(74.85％);532 cases of FT3 and FT4 significantly increased,while TSH significandy decreased (28.53 ％);949 cases of FT3 and FT4 increased,while TSH decreased (50.88％);53 cases of FT3 and FT4 decreased,while TSH increased (2.84％);331 cases of FT3,FT4 and TSH in the normal range(17.75％).The thyroid 13I absorption rate significantly increased and thyroid nodules significantly reduced with treatment,the difference was statistically significant (t =-34.93,133.2,all P ＜ 0.001).1 813 patients were cured,while 52 cases arised hypothyroidism.Conclusion Majority of SAT patients are young women.The peak of the incidence of SAT lies in autumn and winter.The proportion of the moderate type is the highest.Early diagnosis and treatment is the key to improve the prognosis of patients with SAT.
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This study aimed to investigate antimicrobial susceptibility of hospital acquired Burkholderia cepacia infection in Shanxi [China] during August 2009 and December 2012. To characterize an emerging nocosomial infection. The medical records of 112 patients that were tested positive for B. cepacia were retrospectively analyzed. The K-B disk diffusion method was used to determine the drug susceptibility of the isolated strains. A hundred and fifty strains of B. cepacia were isolated from 112 patients. The sensitivity rates of B. cepacia to meropenem, imipenem, cotrimoxazole, minocycline and ceftazidime were 65.7%, 14.3%, 76.0%, 68.1% and 74.1%, respectively. All patients suffered from more than two underlying diseases, 89 [79.5%] from another bacterial infection and 92 [82.1%] with indwelling catheter. All patients were given antibiotics, including 62 patients that received carbapenem antibiotics. The average duration of hospitalization before detection of B. cepacia was 31+/-24 days, after which 65 patients [58.0%] improved, 22 [19.0%] died, 8 [7.1%] quit the therapy, and 17 [15.2%] were discharged after full recovery. The prevalence of hospital acquired B. cepacia infection and drug-resistance in the hospital is reported and risk factor exploration requires further study
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Objective To reveal inpatient service utilization and medical burden in disease-caused poor rural families,for policy references.Methods By means of convenience sampling method,face-toface interview was made to inpatients from such families in Miyi County of Sichuan Province,Binhai County of Jiangsu Province and Xingtai County of Hebei Province.Results Totally 453 effective questionnaires were collected,with an effective rate of 96.7％.Respondents feature low income and fund raising capability,while 75.3％ of them pay their inpatient costs out-of-pocket,17.7％ pay with loans from others and 7.1％ pay by financial assistance from relatives;but they tend to go to higher level hospitals and have higher financial burdens for diseases.Conclusions Rural hospitalization resources should be optimized and integrated,levels of the New Rural Cooperative Medical System be improved,the catastrophic health care system be perfected and the health insurance coverage be gradually expanded for the low-income and marginalized population.
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<p><b>PURPOSE</b>To explore the impact of subtropical maritime monsoon climate on the frequency of ambulance use for trauma patients in a coastal region in China.</p><p><b>METHOD</b>Statistical analysis of data on ambulance use from the 120 Emergency Command Center in Shantou City, Guangdong Province, from January to December 2012 as well as daily meteorological data from a Shantou observatory was performed to determine how climatic factors (seasons, time, and weather) affect the frequency of ambulance use for trauma patients.</p><p><b>RESULTS</b>The daily ambulance use for trauma patients differed between spring and summer or autumn (p<0.05), between sunny and rainy days (p<0.05), and between cloudy and lightly or moderately rainy days (p<0.05).We found a linear correlation between daily maximum temperature and daily ambulance use for trauma patients (R² =0.103, p<0.05). In addition, there was significant difference in ambulance use between good and bad weather (p<0.05).</p><p><b>CONCLUSION</b>Frequency of ambulance use for trauma patients is affected by the subtropical maritime monsoon climate in the coastal region. Better weather contributes to increased daily frequency of ambulance use, which is the highest in autumn and lowest in spring.</p>