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Abstract@#In recent years, mental health problems such as anxiety and depression among adolescents in China have attracted attention from all walks of life. Given that adolescence is a transitional and critical period for individual development, mental health affect the developmental opportunities. Therefore, in the review, the effects of environment, psychosocial factors and behavioral patterns on depressive symptoms are analyzed by combining with the characteristics of physical and mental development among adolescents. It is found that early adolescence and even childhood should be the key period for the prevention and intervention of depression. In order to formulate effective interventions and prevention strategies, it is proposed that future research should combine real situation in China with active exploration of protective factors and early predictors of depression.
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Objective@#To explore the relationship between adolescents physical fitness and depressive symptoms, and to provide reference for the early prevention and intervention of depressive symptoms and improvement of physical fitness in Chinese adolescents.@*Methods@#From September to December 2021, a total of 8 102 adolescents were selected by random cluster sampling method in Shanghai, Urumqi, Changsha and Kunming. The Center for Epidemiologic Studies Depression Scale(CES-D) was used to investigate the depressive symptoms, and completed grip strength, standing long jump, 50 m running, modified sitting forward flexion, 20 s repeated traverse, 30 s sit ups, 20 m round trip running (20 m SRT) test. χ 2 test, Goodman Kruskal Gamma and Logistic regression analysis were used to analyze the relationship between physical fitness index(PFI) and depressive symptoms.@*Results@#The overall detection rate of depressive symptoms in adolescents with high level PFI was 23.4%, and the detection rate of low level adolescents was 26.3%, with a statistically significant difference ( χ 2=6.73, P =0.01). There was a significant positive correlation between PFI and depressive symptoms in the high school group ( G=0.09, P <0.05) and the boy group ( G=0.12, P < 0.05 ), and there was no significant association between PFI and depressive symptoms in the junior high school group and the girl group ( P >0.05). After adjusting for gender and age in the Logistic regression model, compared with those with high PFI, the risk of depressive symptoms in those with low PFI was 1.18 times (95% CI =1.05-1.33).@*Conclusion@#There is a correlation between physical fitness and depressive symptoms in adolescents. Adolescents with low PFI are at higher risk of developing depressive symptoms than those with high PFI.
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Objective@#A longitudinal study design was used to explore the effect of perceived discrimination on the psychological adaptation of children relocated to alleviate poverty.@*Methods@#Four hundred twenty six children who were relocated to alleviate poverty were measured three times using a perceived discrimination questionnaire, childhood depression inventory, and the Illinois loneliness questionnaire, the data were analyzed using a cross lag model.@*Results@#Depression and loneliness of children relocated to alleviate poverty had an increasing trend during the three surveys( F=18.79, 8.69, P <0.01). Perceived discrimination was positively correlated with depression and loneliness at the time points for the three surveys( r=0.23~0.55, P <0.01). Cross lag analysis showed that perceived discrimination in the pretest (Tn) significantly predicted posttest (Tn+1) depression ( β=0.16, 0.20, P < 0.01 ) and perceived discrimination at time 2 significantly predicted loneliness ( β=0.25, P <0.01) at time 3.@*Conclusion@#Perceived discrimination was shown to be an important factor affecting the psychological adaptation of children relocated to alleviate poverty.
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Objective@#To explore the correlation between physical activity and nutritional status of Chinese children and adolescents, and to provide references for the healthy development of Chinese adolescents.@*Methods@#According to the six administrative regions of China (East China, Northwest China, North China, Central China, Southwest China and South China), 4 269 children and adolescents aged 7 to 18 were selected by stratified random sampling method. "Physical Activity Level Evaluation Questionnaire" was used to conduct a physical activity survey. Chi square test and non parametric test were used to analyze the physical activity status.@*Results@#The overall detection rate of MVPA insufficiency in children and adolescents with normal BMI were 53.7%, 50.2%, 56.3%, and 52.5% in the wasting group, overweight and obese group, respectively. There was no significant difference in the detection rate of MVPA insufficiency between different nutritional status( χ 2=2.55, P >0.05); but in the 7-9 years old age group, the difference in the detection rate of MVPA insufficiency between different nutritional status were statistically significant( χ 2= 10.35, 8.86, 15.88, P <0.05). There were no significant differences in physical activity intensity and item types under different nutritional status ( P >0.05).@*Conclusion@#There are age differences in the correlation between physical activity and nutritional status of children and adolescents in my country.Therefore, the differences between different groups should be fully considered while formulating intervention policies.
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Objective@#To explore age, gender, and regional differences in physical activity among children and adolescents in China, and to provide a scientific reference for enhancing physical activity promotion.@*Methods@#A total of 4 269 children and adolescents aged 7 to 18 years were selected from six administrative regions of China (East China, Northwest China, North China, Central China, Southwest China and South China) using a stratified random cluster sampling method from September to December 2018. A questionnaire was administered to evaluate the physical activity level of Chinese children and adolescents aged 7 to 18.@*Results@#The overall detection rate of MVPA insufficiency in children and adolescents in China was 53.8%, of which the detection rate of MVPA insufficiency was 50.8% among boys and 57.1% among girls. Gender differences were statistically significant ( χ 2= 17.10 , P <0.05). Among the different age groups, the lowest detection rate of MVPA among 10-12 year olds was 43.6%, whereas the highest rate among 16-18 year olds was 63.0%, with significant differences between gender ( χ 2=4.33, 30.79, P <0.05). The P 50 values of total physical activity(TPA), light intensity physical activity(LPA), moderate intensity physical activity(MPA), vigorous intensity physical activity(VPA), moderate to vigorous physical activity(MVPA) were 92.9,24.3,41.4,7.1 and 55.7 min/d , respectively. The P 50 values of physical exercise, housework activities, entertainment activities and transportation activities were 34.3 , 2.1, 2.3 and 30.0 min/d, respectively, and the difference in age groups was statistically significant( H =95.03, 74.99, 300.26 , 64.16, P <0.05). There was a statistically significant difference in the detection rate of insufficient MVPA among children and adolescents in different regions ( χ 2=83.91, P <0.05). The lowest rate was 44.0% in North China, and the highest was 65.9% in East China.@*Conclusion@#The detection rate of MVPA insufficiency among Chinese children and adolescents firstly decreased and then increased with age. Boys participated in higher levels of physical activity than girls.
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Objective@#To understand the correlation between physical activity (PA) and socioeconomic status (SES) among Chinese children and adolescents, and to provide theoretical basis for physical activity promotion for Chinese children and adolescents.@*Methods@#By using stratified random cluster sampling, a total of 4 269 children and adolescents aged 7 to 18 were selected from six cities in China from September to December 2018. Physical Activity Level Evaluation Questionnaire of Chinese Children and Adolescents Aged 7 to 18 was used to investigate PA and SES, and the height and weight were measured.@*Methods@#In terms of different intensity of PA, the time spent on light intensity physical activity(LPA), moderate intensity physical activity(MPA), moderate to vigorous physical activity(MVPA)and total physical activity(TPA) in low SES group was 28.5(6.9,57.1) min/d, 46.2 (25.7,79.2) min/d, 61.4(34.3,101.9) min/d and 102.9(65.0,145.8)min/d respectively, which was higher than that in middle SES groups [ 21.4 (4.3,50.7), 37.1(18.6,65.7), 50.3(27.1,86.8), 85.7(49.3,127.1) min/d] and high SES groups [24.3( 5.0 ,54.3), 40.0(21.4,69.1), 54.3(32.9,91.4), 89.6(55.7,132.9) min/d]( P <0.01). In terms of different types of PA, the traffic PA [40.0(15.0,68.6) min/d] and entertainment PA[4.3(0,17.1)min/d] accounted the highest proportion in low SES group,while sports PA [36.4(20.7,60.7) min/d] accounted the highest proportion in high SES group( P <0.01).The compliance rates of MVPA in low, middle and high SES groups were 51.1%, 42.5% and 45.2%, respectively, and the differences were statistically significant ( χ 2= 22.02 , P <0.05). After controlling for confounding factors, the detection rate of MVPA in the low SES group was 1.24 times higher than that in the high SES group ( P <0.01).@*Conclusion@#The MVPA and TPA time of children and adolescents with middle SES group were the lowest. Physical activities spent on traffic and entertainment account highest in low SES group, while physical activities spent on sports account highest in high SES group.
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Objective@#To analyze the correlation between physical activity and physical fitness index of children and adolescents in China, so as to provide reference for physical activity and physical fitness promtion of children and adolescents.@*Methods@#In September 12,2018, 4 269 students were selected by cluster sampling in east, northwest, north, central, southwest and South China, the test of standing long jump, grip strength, 50 m running, improved seat forward bend, 30 s sit ups, 20 s cross repeatedly, 20 m round trip running was completed.@*Results@#In comparing the physical fitness index of children and adolescents with different levels of physical activity, the PFI values of the middle and high intensity physical activity (MVPA) groups of boys aged 10-12 and 16-18 years old were (0.46±3.58) (0.75±3.0), the value of PFI of the MVPA group were (-0.69±3.64) (-0.61±2.87), the difference was statistically significant ( t =0.04, 0.57, P >0.05). There was no significant difference in the values of PFI between the four age groups of the girls ( P <0.05). In comparison of physical activity status of children and adolescents in different physical ability grades, the time of MPA, VPA and physical exercise in healthy physical ability group was higher than that in unhealthy physical ability group ( Z =-2.04, -4.93, -7.09, P <0.05). Linear regression analysis showed that there was a positive correlation between daily MVPA, physical exercise and physical fitness index ( P <0.05).@*Conclusion@#Moderate and high intensity physical activity, that is, physical exercise, is positively correlated with physical fitness index. Therefore, it is particularly important for children and adolescents to engage in sufficient moderate and vigorous intensity physical activities.
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@# Objective: To investigate the expression of histone methyltransferase G9a in gastric cancer tissues and its correlation to prognosis, and to observe the effect of G9a inhibitor on the proliferation and apoptosis of gastric cancer cells. Methods: The expression level of G9a in gastric cancer tissues and its correlation to prognosis were analyzed by using the Kaplan-Meier Plotter and Oncomine database. Human gastric cancer cell line SGC-7901 and MKN-45 were selected as study subject. The expression level of G9a protein was detected by Western blotting. The morphological change of gastric cancer cells after the treatment of G9a inhibitor BIX01294 was observed. CCK-8 proliferation experiment and plate colony formation assay were used to examine the proliferation ability and clone formation rate of gastric cancer cells. The changes of cell apoptosis were detected by Annexin-V staining. Results: G9a was highly expressed in gastric cancer tissues (P<0.01), and the high expression of G9a was positively correlated with poor prognosis of gastric cancer patients (P<0.01). After the treatment of BIX01294, the morphology of gastric cancer cells was changed, the volume of gastric cancer cells reduced, the intercellular connections disappeared, and even the apoptotic manifestations appeared, such as the shrinking,, becoming round and cast-off etc. BIX01294 could significantly inhibit the proliferation and colony formation but promote the apoptosis of gastric cancer cells (all P<0.05). Conclusion: Histone methyltransferase G9a was highly expressed in gastric cancer tissues, and its high expression level was positively correlated with poor prognosis. The proliferation of gastric cancer cells was obviously inhibited while the apoptosis was significantly promoted after inhibiting G9a expression.
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AIM:To measure ocular biometric values with sexual and age and determine the relationship between the differences using the Lenstar 900.METHODS:Totally 413 myopes 826 eyes,200 males (400 eyes) and 213 females (426 eyes),were enrolled in this study and were divided into 3 groups:Group Ⅰ (＜ 5 years),Group Ⅱ (5-10 years),Group Ⅲ (＞10 years).Central corneal thickness (CCT),anterior chamber depth (ACD),lens thickness (LT),axial length (AL),white-to-white distance (WWD) and pupil diameter (PD) were measured by Lenstar 900.The differences between age groups and gender groups were compared using the LSD and SNKk methods in variance analysis.Pearson correlation coefficient to assess AL,CCT,ACD,LT,WWD,PD in children and adolescents.RESULTS:There were significant difference in CCT between ages groups (P＜0.05) which increased with the age.There were significant differences both in ACD and AL between sexual groups.With analysis of Person,CCT showed a significantly positive correlation with WWD and PD(r=0.208,0.167;P＜0.05) and ACD showed a significantly positive correlation with AL,WWD,PD(r=0.620,0.238,0.192;P＜0.05).LT showed a significantly negative correlation with ACD,AL and WWD (r=-0.271,-0.186,-0.227;P＜0.05).WWD showed a significantly positive correlation with PD (r=0.273,P＜0.05).CONCLUSION:CCT has gradually thickening trend with ages.Men are more than women in ACD and AL.CCT shows positive correlation with WWD and PD and ACD shows positive correlation with AL,WND,PD.LT shows negative correlation with ACD,AL and WWD.WWD showed positive correlation with PD.
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Objective@#To evaluate the plaque distribution on the fitting surface of fixed implant prostheses which were supported by multi-unit abutment. @*Methods @# 21 patients with maxillary full-arch implant-supported fixed prostheses were collected. Plaque accumulation at the fitting surfaces were evaluated 3 months after restoration, by analyzing the digital photographs recorded by Imag e J 2.1.4.7.@*Results@#The average percentage of area covered with plaque was (46.13 ± 7.23)%. Plaque accumulation on the buccal and palatal area were (41.53 ± 3.08) and (53.76 ± 3.07)% respec⁃ tively, with a significant difference (t = 16.750, P < 0.001). The free area (71.86 ± 2.00) % was significantly higher than the anterior area (48.85 ± 2.09)% (t = 40.445, P < 0.001), andalso the middle area (49.33 ± 0.98)% (t = 47.124 , P < 0.001). The plaque percentage was higher when the distance between the implants was shorter.@*Conclusion@#To Minimize the palatal extension and free area of the prostheses, and to maximize the distances between the implants, were helpful to improve the oral hygiene control. It might be the key to keep a good outcome of the maxillary full-arch implant-supported fixed prostheses.
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Objective To detect the levels of five trace elements in whole blood of patients with Keshan disease(KSD) and dilated cardiomyopathy(DCM) and explore their role in the pathogenesis of KSD.Methods One hundred and four patients with chronic KSD were selected from Keshan diseased areas in Shandong,Sichuan and Inner Mongolia.Thirty patients with DCM were selected from Qilu Hospital of Shandong University,Jinan Central Hospital,The First People's Hospital.Ninety-one healthy people from KSD endemic areas and 39 healthy people from Jinan were selected as endemic healthy controls and non-endemic healthy controls,respectively.Blood samples were collected to determinate the level of selenium (Se),copper (Cu),zinc (Zn),chromium (Cr) and manganese (Mn) with fluorescence method and atomic absorption spectrometry,according to the principle of informed consent.Results The level of Se,Zn and Cr of KSD group[(36.0 + 4.9)μg/L,(22.73 + 4.62)mg/L,(0.56 + 0.17)mg/L] was significantly lower than that of non-endemic healthy controls [(56.4 ± 6.8)lμg/L,(25.35 ± 4.44)mg/L,(0.71 ± 0.17)mg/L,all P ＜ 0.05],but the level of Cu of KSD group[(0.95 ± 0.24)mg/L] was significantly higher than that of non-endemic healthy controls[(0.73 ± 0.13) mg/L,all P ＜ 0.05].The level of Se and Cr of KSD was significantly lower than that of endemic healthy controls[(54.5 ± 5.4)μg/L,(0.87 ± 0.02)mg/L,P ＜ 0.05],and Cu was significantly higher than that of endemic healthy controls[(0.66 ± 0.02)mg/L,P ＜ 0.05].The level of Cu and Zn of KSD was significantly lower than that of DCM [(1.21 ± 0.23)mg/L,(27.09 ± 7.10)mg/L,all P ＜ 0.01].The level of Se and Cr of DCM group[(39.6 ± 3.5)μg/L,(0.58 ± 0.14)mg/L] was significantly lower than that of non-endemic healthy controls(all P ＜ 0.01),but Cu[(1.21 + 0.23)mg/L] was significantly increased (P ＜ 0.01).Compared with non-endemic healthy controls,the level of Se of endemic healthy control group was significantly decreased (P ＜ 0.01),while Cu was significantly increased (P ＜ 0.01).Se,Zn and Cr level of KSD decreased gradually following elevated heart function level,but the level of Cu gradually increased.Conclusions The metabolism of Se,Cr,Cu and Zn is unbalanced in KSD patients,whose Se level is still lower than that of people in non-endemic areas.The change of Se,Cr,Cu and Mn level between KSD and DCM is consistent.
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The burden of maternal mortality (MM) and morbidity is especially high in Asia.However,China has made significant progress in reducing MM over the past two decades,and hence maternal death rate has declined considerably in last decade,To analyze availability and quality of emergency obstetric care (EmOC) received by women at Tongji Hospital,Wuhan,China,this study retrospectively analyzed various pregnancy-related complications at the hospital from 2000 to 2009.Two baseline periods of equal length were used for the comparison of variables.A total of 11 223 obstetric complications leading to MM were identified on a total of 15 730 hospitalizations,either 71.35％ of all activities.No maternal death was recorded.Mean age of women was 29.31 years with a wide range of 14-52 years.About 96.26％ of women had higher levels of schooling,university degrees and above and received the education of secondary school or college.About 3.74％ received primary education at period two (P2) from 2005 to 2009,which was significantly higher than that of period one (P1) from 2000 to 2004 (P＜0.05) (OR:0.586; 95％ CI:0.442 to 0.776).About 65.69％ were employed as skilled or professional workers at P2,which was significantly higher than that of P1 (P＜0.05).About 34.31％ were unskilled workers at P2,which was significantly higher than that of P1 (P＜0.05).Caesarean section was performed for 9,930 women (88.48％) and the percentage of the procedure increased significantly from 19.25％ at P1 to 69.23％ at P2 (P＜0.05).We were led to conclude that,despite the progress,significant gaps in the performance of maternal health services between rural and urban areas remain.However,MM reduction can be achieved in China.Priorities must include,but not limited to the following:secondary healthcare development,health policy and management,strengthening primary healthcare services.
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Objective To study the risk factors of hyperthyroid heart diseases(HHD) by analyzing clinical features of patients in order to provide a scientific basis for prevention and treatment of HHD. Methods Nine hundred and eighty two cases were selected as objective from in-patient data of Thyroid Disease Treatment Centre of Shandong Province. The cases were divided into hyperthyroidism group and HHD group. The variables of etiology,sex, age, duration of disease, TSH, FT3, FT4 and TRAb were analyzed by comparative analysis. The risk factors were analyzed by logistic regression. Results The prevalence of hyperthyroidism complicated hyperthyroid heart disease was 7.7%(76/982), age, duration of diseases, FT3, TRAb in the HHD group were [(51.4 ± 11.5), (6.3 ±2.1) years, 21.6 pmol/L, 71.6 U/L], in hyperthyroidism group were [(37.9 ± 9.8), (2.6 ± 1.3) years, 14.9pmol/L, 49.6 U/L]. The differences were statistically significant(u = 9.93,15.23, T = 44954,48792.5, P ＜ 0.05)between the two groups. The factors of the older, higher FT3 and TRAb, longer duration, Graves disease (OR =1.751,1.470,1.483,1.445,1.234) increased the risk of HHD. Conclusions Graves disease, longer duration, old age, higher FT3 and TRAb are the risk factors of HHD. Timely prevention and control of risk factors is necessary to reduce the incidence of HHD.
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Objective To explore the reliability of relevant electrocardiogram(ECG) indexes in evaluating isoprenaline(ISO)-induced rat acute ischemic myocardial injury and provide reference for future scientific applications of these models. Methods Seventy male Wistar rats were randomly equally assigned to ten groups according to their body weight: 5,10,20,40,80,160,320,640, 1280 and 2560 μg/kg dose groups. All rats were tail intravenously given corresponding doses of saline diluted isoprenaline according to their body weight. Standard limb Ⅰ , Ⅱ, Ⅲ-lead ECG of all rats were recorded before, immediately after and 1,24,and 72 hour after injection, respectively.Changes of heart rate, T-wave amplitude of Ⅱ -lead and Q-T interval were measured. Results Significant differences were found in heart rates, T-wave amplitudes and Q-T intervals at different time points(F = 15.03,11.28,13.64, all P ＜ 0.01 ), while differences among the ten ISO-dose groups were statistically insignificant (F= 1.45, 1.17,1.09, all P ＞ 0.05). No interaction between observation time and ISO dose was observed on heart rates, T-wave amplitudes and Q-T intervals(F= 0.79,0.82,0.59, all P ＞ 0.05). Immediately after injection of ISO, the heart rates were significantly increased compared with that of pre-injection in all groups(all P ＜ 0.05), of which 320 and 640μg/kg dose groups increased most significantly [(550 ± 47), (521 ± 43)times/min]. T-waves decreased significantly compared with that of pre-injection (all P ＜ 0.01 ), and 20 μg/kg dose and above groups decreased particularly evident, and partly inverted. Q-T intervals of rats in each group were significantly shorter than that of pre-injection(all P ＜ 0.01 ), and 320, 640, 1280 μg/kg groups shortened more pronounced[(0.070 ± 0.006),(0.072 ± 0.005), (0.068 ± 0.005)ms]. One hour after injection, the heart rate of rats in each group decreased,except 320 and 640 μg/kg dose groups[(518 ± 43), (487 ± 36)times/min], which were still higher than that of pre-treatment[(450 ± 40), (448 ± 51 )times/min, all P ＜ 0.05], the rest groups no longer had significant differences (all P ＞ 0.05). ECG T-wave in each group was significantly recovered compared with that of instantly medication (all P＜0.05), and 40 μg/kg dose and above groups recovered more than a big margin, but there were still differences compared with that of pre-treatment (P ＜0.05), while T-waves of 40 μg/kg dose and below groups had returned to the level of pre-treatment. Q-T interval in each group had varying degrees of recovery, except 1280 and 2560 μg/kg dose groups[(0.080 ± 0.004), (0.076 ± 0.011 )ms]which were still less than that of pre-treatment[(0.086 ± 0.007),(0.085 ± 0.006)ms, all P ＜ 0.05], other groups had no significant difference compared with that of pre-treatment (all P ＞ 0.05). Twenty-four hours after injection of ISO, the heart rates of 1280 and 2560 μg/kg dose groups [(389 ± 31 ), (398 ± 23)times/min]decreased significantly compared with that of pre-treatment[(427 ± 43), (438 ±26)times/min, all P ＜ 0.05], while other groups had returned to the level of pre-treatment. Seventy-two hours after injection of ISO, the heart rates, T-wave amplitudes and Q-T intervals of all doses groups had returned to the level of pre-treatment (all P ＞ 0.05). Conclusions There has no significant ST segment in the electrocardiogram of rat.Isoprenaline has an exact effect on shortening Q-T interval. T-wave amplitude and Q-T interval can be used as reliable indexes of ECG for assessment of this animal model.
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Objective To investigate the incidence of Keshan disease(KSD) in Shandong province and to supply evidence for scientific control of the disease.Methods According to the scheme of KSD monitoring in Shandong province,the KSD cases were searched in 7 counties,and representative 3 counties and 6 villages were selected as key monitoring sites.In each site,about 420 residents were checked by asking detailed disease history,physical examination,and electrocardiography (ECG) tracings.Suspected cardiac abnormalities were taken chest posteroanterior X-ray film.At the same time,residents hair and food samples were collected to detect selenium levels in internal and external environments,and residents' income and per capita share of grain and other basic information were collected.Results ①Two hundred and fifty-nine medical units were searched,1132 cases of myocardial disease were found out and 638 suspected cases were identified and 142 chronic KSD cases were diagnosed.②In the 6 monitoring sites,2538 residents were surveyed and 91 cases of KSD were detected(of which 77 cases of potential,14 cases of chronic),the detection rate was 3.58％.A total of 2127 residents were traced ECG and the incidence of abnormal ECG was 24.5％ (521/2127),of which ST-T changes,T-wave changes,sinus bradycardia,sinus arrhymia,sinus tachycardia,and atrial premature beats et al were more common.Of the 75 X-ray films,39 cases had enlarged heart(in which 21 of mild,13 of moderate,5 of severe).③A total of 406 hair and grain samples were collected,respectively,and the selenium content of hair was approaching the level of appropriate,and the selenium content of food was still low.The annual per capita incomes of each site were between 3000 - 5900 Yuan,and residents main staple food was flour.Conclusions KSD in Shandong province is in a relatively stable situation.But latent and chronic KSD cases can still be detected.The internal environment selenium levels are elevated since the local living standards and dietary nutrition are improved.
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Objective To measure the serum selenium levels in patient with Keshan disease(KSD)and in healthy controls in Shandong,Sichuan and Inner Mongolia KSD areas,to monitor the long-term dynamic changes of hair and serum selenium levels in Shandong KSD areas,and to provide scientific basis for preventing KSD.Methods A cross-sectional survey was carried out in KSD areas of Shandong,Sichuan and Inner Mongolia in 2009.The research subjects which come from KSD areas were 77 cases and 63 healthy controls from Shandong;35 patients and 36 healthy controls from Sichuan;and 17 patients and 18 healthy controls from Inner Mongolia.Additional 33 healthy people from Jinan city were selected as controls of non-KSD areas.Blood and hair samples were collected and selenium levels were measured by 2,3-diaminonaphthalene fluorescence spectrometry.Retrospective method was used to analyze the hair and serum selenium data collected between 1976 and 2004 in Shandong KSD areas.and these data were eompard with the data of 2009 to observe the long-term dynamic changes.Results ① The serum selenium levels of KSD patients in Shandong and Inner Mongolia were significantly lower than that of healthy subjects of KSD areas[(0.0773±0.0113)vs(0.0895±0.0256),(0.0347±0.0107)vs(0.0469±0.0161),t=3.52,3.87,all P<0.01].No significant difference was found between KSD patients and healthy people in Sichuan[(0.0792±0.0162)vs(0.0774±0.0103),t=0.55,P>0.05].②The serum selenium levels of KSD patients in Shandong,Sichuan and Inner Mongolia KSD areas were lower than that of non-KSD area[(0.0988±0.0231)mg/L,q=6.74,5.83,19.47,all P<0.01].The serum selenium levels of healthy people in Sichuan and Inner Mongoha KSD areas were significantly lower than that of non-KSD area(q=6.68,16.36,all P<0.01).The serum selenium levels of healthy controls in Inner Mongolia were lower than that of in Shandong and Sichuan(q=13.63,14.74,13.62,1.46,all P<0.01).③From 1976 to 2009,the hair and serum selenium levels of Shandong resident were increased 1.68 times(0.343/0.128-1)for hair and 0.98 times(0.091/0.046-1)for serum,respectively.But there was no significant difference between the average growth rate of hair and serum selenium levels(χ2=1.38,P>0.05).Conclusions ①The hair and serum selenium levels of KSD patients are lower than that of healthy controls in non-KSD area.②The serum selenium levels of Shandong,Sichuan and Inner Mongolia are different between KSD patients and healthy controls in the diseased areas.③The hair and serum selenium data of Shandong resident show an upward vend over the past 30 years.We suggest to continue the comprehensive measures of adding selenium in KSD areas.
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Objective Color doppler ultrasonography of chronic Keshan disease (CKD) was evaluated to provide evidences for clinic diagnosis of the disease. Methods From September to Novermber 2009, according to "Diagnostic criteria of Keshan disease" (GB 17021-1997), 64 cases of CKD were randomly sampled from five Keshan diseased districts in Shandong province, Zoucheng, Sishui, Yishui, Wulian, Jvxian, and Pingyi as patient group. Thirty four healthy volunteers being checked up by Shandong Institute for Endemic Diseases Control and Research were put in control group. All the subjects were examined with Color doppler ultrasonography. The indexes of cardiac structure, left ventricular (LV) systolic function and LV diastolic function were measured.Results Left atrial internal diameter, LV end-diastolic internal diameter, LV end-systolic internal diameter, right ventricular diameter, aorta diameter, right atrial transverse diameter, right atrial long diameter and left ventricle mass of the patient group[(35.38 ± 6.89), (61.57 ± 8.61), (45.39 ± 10.29), (17.22 ± 3.79), (28.69 ± 2.81),(38.00 ± 6.05), (42.68 ± 8.65)mm, (283.22 ± 103.12)g] were higher than that of control group[(26.70 ± 3.27),(45.41 ± 4.93), (26.91 ± 4.35), (13.76 ± 2.27), (24.09 ± 2.89), (31.50 ± 3.32), (35.82 ± 3.14) mm, (156.03 ±39.86)g, t = 6.93, 10.09, 9.98, 4.87, 7.64, 5.81, 4.46, 6.90, all P＜ 0.05]. The LV ejection fraction and fractional shortening of the left ventricular of the patient group[(49.25 ± 14.33)%, (26.11 ± 9.17)%] were lower than that of control group[(73.88 ± 4.04)%, (42.88 ± 3.62)%, t = - 9.79, - 10.22, all P＜ 0.05]. Diffuse hypokinetic motion of the left ventricle reduced in 95% (61/64) of CKD patients, and 5% (3/64) of CKD patients had segmental LV dyskinesia. Seventy five per sent(48/64) of the patients accompanied with mitral regurgitation, and 39% (26/64) of these cases accompanied with tricuspid regurgitation. Meaningful Mitral or tricuspid regurgitation was not found out in control group. Conclusions The CKD patients' bore of atrio-ventricular cavity and LV mass are enlarged, and their motion of ventricle is reduced or partly reduced. They have poor heart function. Mitral regurgitation are more than tricuspid regurgitation. Color doppler Ultrasonography is important in diagnosis of chronic Keshan discase.
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Objective To observe the incidence and clinical characteristics of chronic Keshan disease in recent years, and to provide evidence for diagnosis of the disease. Methods From March to August 2009, 163 patients with chronic Keshan disease were chosen from Shandong, Sichuan, Inner Mongolia and Cansu. Of these patients, 62 cases were from Shandong, 34 cases from Sichuan, 37 cases from Inner Mongolia, and 30 cases from Gansu. All of the subjects underwent detailed natural history of the disease, careful physical examination and electrocardiogram (ECG), X-ray chest radiography and cardiac ultrasound examination. The incidence and clinical features were analyzed. Results Adults accounted for 98.8%(161/163) and children for 1.2%(2/163) in 163 cases of chronic Keshan disease, with an average age of 45.8 years. Slow onset accounted for 62.6%(102/163), other types that evolved into chronic-type accounted for 37.4%(61/163). Low blood pressure( 116.5/72.4 mmHg),often with cardiac function grade Ⅱ accounted for 65.6%(107/163). Common symptoms were: palpitation[86.5%(141/163)], asthma [76.7% (125/163)], fatigue[76.1%(124/163)], precordial discomfort [54.6% (89/163)], dizziness[50.3%(82/163)], edema of lower limbs[44.8%(73/163)], and anorexia[38.0%(62/163)]. Common signs were: low-weak first heart sound[66.9%(109/163)], heart enlargement[64.4%(105/163)], apical pulse dispersion[42.3%(69/163)], arrhythmia[40.5%(66/163)], hepatomegalia[39.3%(64/163)], systolic murmur [25.2%(41/163)], and edema[20.9%(34/163)]. Abnormal ECG detection rate was 93.9%(153/163), with common types followed by ST-T changes[ST-T changes, ST segment changes, Tchange, 36.2%(59/163)], ventricular premature [occasional and frequent ventricular premature, 26.4% (43/163)], complete right bundle branch block [25.8% (42/163)], atrial fibrillation[19.0%(31/163)], and atrioventricular conduction block[8.6%( 14/163)]. X-ray results showed that significant and moderate heart enlargement were common, accounting for 73.4%( 105/143), followed by mild enlargement of 25.2%(36/143). Color doppler ultrasound examination results showed that the atrio-ventricular cavity diameter increased, followed by left ventricular end-systolic diameter increased[81.3%(52/64)], left ventricular end-diastolic diameter increased[65.6%(42/64)], left atrial enlargement[51.6%(33/64)], right atrial enlargement [43.8%(28/64)], and right ventricular enlargement[32.8%(21/64)]. Left ventricular wall and interventricular septum thinning accounted for 15.6%( 10/64) and 7.8%(5/64), respectively. Conclusions In recent years, most cases of chronic Keshan disease occur as natural chronic type, and at older age at onset with low blood pressure.Main clinical features of the disease are cardiac enlargement, inadequate tissue perfusion, and venous stasis performance caused by cardiac decompensation. Correct diagnosis of chronic Keshan disease can be made based on these clinical features.
ABSTRACT
<p><b>OBJECTIVE</b>To study the CT axial manifestations of iliolumbar ligament(ILL) and discusses its clinical effects on locating lumbosacral vertebral segments.</p><p><b>METHODS</b>From May 2008 to March 2010, 706 adult patients diagnosed lumbar disc disease were performed with axial scans by single slice helical CT. Among the patients, 436 patients were male and 270 patients were female, ranging in age from 25 to 82 years, the median age was 44 years, 78 cases with lumbosacral transitional vertebrae (LSTV) were verified by X-radiography or fluoroscopy. The morphology, origin and insertion, courses of ILL and the relationship of ligament and spinal segments on axial plane images were used to study. The location method of spinal segments by ILL was compared with the other four location methods on CT.</p><p><b>RESULTS</b>Of the 628 cases with normal lumbosacral segmentations sides of ligament, the main part of ILL originated from L5 transverse processes and terminated at the iliac crest, the morphological characters were divided into two types: double band (71.8%, 451/628) and single band (28.2%, 177/628). The tiny branches from posterior and outside edge of L4, lumbar disc were seen simultaneity in 3 cases. The ILL of 78 cases with LSTV all also originated from L5 transverse processes. Using ILL as a marker of the L5 vertebral level, 78 cases with LSTV were correctly numbered, the accuracy rate was higher than the other location methods, there was statistical significance between the location method by ILL and the location method by iliac crest (P < 0.05).</p><p><b>CONCLUSION</b>The main part of ILL originates from L5 transverse processes, the anatomic location is relatively steady and can be clearly displayed on axial CT, which can be used as a measure in the idenlification of LSTV in clinical practice, it is worthy to be applied widely in basic-level hospitals.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Ilium , Diagnostic Imaging , Ligaments , Diagnostic Imaging , Lumbar Vertebrae , Diagnostic Imaging , Lumbosacral Region , Tomography, X-Ray ComputedABSTRACT
Objective To observe dynamic changes of incidence and epidemic characteristics of Keshan disease(KSD)in Shandong Province from 1960 to 2007,in order to provide scientific basis for prevention and treatment. Methods The data below were collected and analyzed retrospectively.Morbidity and mortality of KSD were reported annually by multi-level prevention and treatment network at the level of province,city,county.township and village; five large-scale epidemiological investigations of KSD were carried out in 1962,1969,1973,1982 at province-scale and in every disease counties too.Results A total of 4228 cases of KSD occurred from 1960 to 2007 and the highest incidence rate was 2.636 per ten thousand(158/599 368)in Shandong Province.Mortality rate of sub-acute KSD was 88.01 percent(492/559)and the five years mortality rate of chronic KSD was 67.91 percent(491/723).Incidence cbanges of KSD among 48 years experienced three stages(the years of the high and low incidence,the years with basicallv controlled incidence)in Shandong Province.The years of high incidence were from 1960 to 1979,when 3969 cases of patients were found.its highest incidence rate being 2.636 per ten thousand(158/599 368).The years of low incidence were from 1980 to 1989,when 200 eases of patients were found,the highest incidence rate being 0.058 per ten thousand(57/9 908 013).In the years from 1990 to 2007 the disease was basically controlled,and only 59 cases of patients were found,with the highest incidence rate of 0.016 per ten thousand(16/9 720 832).KSD onset gradually changed from acute and sub-acute to chronic and potential type.The onset age were gradually from 4-10 vealp8 0ld to 13-25 years old and 20-year-old and above.The disease was sporadically seen around the whole year instead of peaking in March and April.Conclusions The incidence of KSD has experienced the high,the low and controlled stages for the past 48 years in Shandong Province,which has decreased gradually after a m40r prevalence. The onset characteristics evolves with incidence changes.