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1.
Chinese Journal of Digestive Surgery ; (12): 414-418, 2023.
Article in Chinese | WPRIM | ID: wpr-990656

ABSTRACT

Objective:To investigate the application value of mixed reality technology in surgical conversation of laparoscopy radical resection of gastric cancer.Methods:The prospective randomized controlled study was conducted. There were 80 family members of patients with gastric cancer who were admitted to Nanfang Hospital of Southern Medical University from June 2021 to December 2022 being selected as subjects. All patients underwent laparoscopic radical resection of gastric cancer. Based on random number table, all subjects were allocated into the control group and the experiment group. Subjects in the control group performed routine surgical conversation and subjects in the experiment group performed surgical conversation based on mixed reality technology. Observation indicators: (1) baseline data of the subjects; (2) anxiety assessment of the subjects. Measurement data with normal distribution were represented as Mean± SD, and the independent sample t test was used for inter-group comparison. Repeated measurement data were analyzed using the repeated ANOVA. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the Wilcoxon rank sum test. Results:(1) Baseline data of the subjects. A total of 80 subjects were selected for eligibility, including 40 subjects in the control group and 40 subjects in the experi-ment group. There were 44 males and 36 females, aged (40±9)years. The gender (male, female), age, education background (primary school education, middle school education, high school education, junior college education, undergraduate education, postgraduate education) were 23, 17, (39±9)years, 1, 3, 9, 16, 9, 2 in subjects of the control group, versus 25, 15, (42±10)years, 0, 8, 6, 11, 14, 1 in subjects of the experiment group, showing no significant difference in the above indicators between the two groups ( χ2=0.20, t=?1.64, Z=?0.10, P>0.05). (2) Anxiety assessment of the subjects. The scores of self-rating Anxiety Scale (SAS) and Hospital Anxiety Scale (HADS) before surgical conversation, after surgical conversation, after surgery were 41±10 and 26±5, 49±11 and 32±3, 40±13 and 15±8 in subjects of the control group, versus 44±9 and 23±3, 66±16 and 28±6, 34±14 and 8±3 in subjects of the experiment group, showing significant differences in the above indicators between the two groups ( FSAS组间=8.83, FSAS时间=40.41, FSAS交互=12.21, FHADS组间=32.42, FHADS时间=321.28, FHADS交互=6.15, P<0.05). Conclusion:Compared with traditional surgical conversation, mixed reality technology based surgical conversation can relieve the postoperative conxiety of subjects.

2.
Chinese Journal of Practical Nursing ; (36): 1376-1382, 2023.
Article in Chinese | WPRIM | ID: wpr-990346

ABSTRACT

Objective:To develop the rehabilitation needs questionnaire for stroke patients, so as to provide a tool for medical staff to implement continuous rehabilitation services.Methods:Based on the conceptual framework of the International Classification of Function, Disability and Health, and on the basis of literature review and qualitative research, the questionnaire items were preliminatively established after two rounds of Delphi expert consultation, and 130 stroke patients admitted to the Department of Neurology and Rehabilitation of the First Hospital of Shanxi Medical University from April to December 2021 were selected to test the reliability and validity of the questionnaire. And 200 stroke patients were selected for confirmatory factor analysis to form a formal scale.Results:Exploratory factor analysis extracted a total of 4 common factors: physiological function rehabilitation needs, social rehabilitation environmental support needs, emotional/psychological support needs, rehabilitation knowledge/information needs. After project analysis and 3 exploratory factor analysis, a final questionnaire containing 16 items was formed.The Cronbach α of the questionnaire was 0.935, with a broken half reliability of 0.824. The fitting index of confirmatory factor analysis was within the standard range. The χ2/ df was 2.979, the incremental fitting index was 0.907, the comparative fitting index was 0.906, and the root mean square error of approximation was 0.100. Conclusions:The reliability and validity of the rehabilitation needs questionnaire for stroke patients are good, which can preliminarily assess the rehabilitation needs of stroke patients.

3.
Chinese Medical Journal ; (24): 2316-2323, 2023.
Article in English | WPRIM | ID: wpr-1007636

ABSTRACT

BACKGROUND@#Existing evidence suggests that fruit consumption is a significant influencing factor for chronic obstructive pulmonary disease (COPD), but this is unclear in the Chinese population. We examined the association of fresh fruit consumption with the risk of COPD-related hospitalization and death in a nationwide, population-based prospective cohort from China.@*METHODS@#Between 2004 and 2008, the China Kadoorie Biobank recruited >0.5 million adults aged 30 to 79 years from ten diverse regions across China. After excluding individuals diagnosed with major chronic diseases and prevalent COPD, the prospective analysis included 421,428 participants. Cox regression was used to calculate the hazard ratios (HRs) for the association between fresh fruit consumption and risk of COPD-related hospitalization and death, with adjustment for established and potential confounders.@*RESULTS@#During a mean follow-up of 10.9 years, 11,292 COPD hospitalization events and deaths were documented, with an overall incidence rate of 2.47/1000 person-years. Participants who consumed fresh fruit daily had a 22% lower risk of COPD-related hospitalization and death compared with non-consumers (HR = 0.78, 95% confidence interval [CI]: 0.71-0.87). The inverse association between fresh fruit consumption and COPD-related hospitalization and death was stronger among non-current smokers and participants with normal body mass index (BMI) (18.5 kg/m 2 ≤ BMI < 24.0 kg/m 2 ); the corresponding HRs for daily fresh fruit consumption were 0.78 (95% CI: 0.68-0.89) and 0.69 (95% CI: 0.59-0.79) compared with their counterparts, respectively.@*CONCLUSIONS@#High-frequency fruit consumption was associated with a lower risk of COPD in Chinese adults. Increasing fruit consumption, together with cigarette cessation and weight control, should be considered in the prevention and management of COPD.

4.
Chinese Medical Journal ; (24): 2476-2483, 2023.
Article in English | WPRIM | ID: wpr-1007571

ABSTRACT

BACKGROUND@#Several studies have reported that polygenic risk scores (PRSs) can enhance risk prediction of coronary artery disease (CAD) in European populations. However, research on this topic is far from sufficient in non-European countries, including China. We aimed to evaluate the potential of PRS for predicting CAD for primary prevention in the Chinese population.@*METHODS@#Participants with genome-wide genotypic data from the China Kadoorie Biobank were divided into training ( n = 28,490) and testing sets ( n = 72,150). Ten previously developed PRSs were evaluated, and new ones were developed using clumping and thresholding or LDpred method. The PRS showing the strongest association with CAD in the training set was selected to further evaluate its effects on improving the traditional CAD risk-prediction model in the testing set. Genetic risk was computed by summing the product of the weights and allele dosages across genome-wide single-nucleotide polymorphisms. Prediction of the 10-year first CAD events was assessed using hazard ratios (HRs) and measures of model discrimination, calibration, and net reclassification improvement (NRI). Hard CAD (nonfatal I21-I23 and fatal I20-I25) and soft CAD (all fatal or nonfatal I20-I25) were analyzed separately.@*RESULTS@#In the testing set, 1214 hard and 7201 soft CAD cases were documented during a mean follow-up of 11.2 years. The HR per standard deviation of the optimal PRS was 1.26 (95% CI:1.19-1.33) for hard CAD. Based on a traditional CAD risk prediction model containing only non-laboratory-based information, the addition of PRS for hard CAD increased Harrell's C index by 0.001 (-0.001 to 0.003) in women and 0.003 (0.001 to 0.005) in men. Among the different high-risk thresholds ranging from 1% to 10%, the highest categorical NRI was 3.2% (95% CI: 0.4-6.0%) at a high-risk threshold of 10.0% in women. The association of the PRS with soft CAD was much weaker than with hard CAD, leading to minimal or no improvement in the soft CAD model.@*CONCLUSIONS@#In this Chinese population sample, the current PRSs minimally changed risk discrimination and offered little improvement in risk stratification for soft CAD. Therefore, this may not be suitable for promoting genetic screening in the general Chinese population to improve CAD risk prediction.


Subject(s)
Male , Humans , Female , Coronary Artery Disease/genetics , Biological Specimen Banks , East Asian People , Risk Assessment/methods , Genetic Predisposition to Disease/genetics , Risk Factors , Genome-Wide Association Study
5.
Chinese Medical Journal ; (24): 1929-1936, 2023.
Article in English | WPRIM | ID: wpr-980989

ABSTRACT

BACKGROUND@#Severe liver disease (SLD), including cirrhosis and liver cancer, constitutes a major disease burden in China. We aimed to examine the association of genetic and healthy lifestyle factors with the incidence and prognosis of SLD.@*METHODS@#The study population included 504,009 participants from the prospective China Kadoorie Biobank aged 30-79 years. The individuals were from 10 diverse areas in China without a history of cancer or liver disease at baseline. Cox regression was used to estimate adjusted hazard ratios (HRs) for incident SLD and death after SLD diagnosis associated with healthy lifestyle factors (smoking, alcohol, physical activity, and central adiposity). Additionally, the contribution of genetic risk for hepatitis B virus (HBV, assessed by genetic variants in major histocompatibility complex, class II, DP/DQ [ HLA - DP / DQ ] genes) was also estimated.@*RESULTS@#Compared with those with 0-1 healthy lifestyle factor, participants with 2, 3, and 4 factors had 12% (HR 0.88 [95% confidence interval [CI] 0.85, 0.92]), 26% (HR 0.74 [95%CI: 0.69, 0.79]), and 44% (HR 0.56 [95%CI: 0.48, 0.65]) lower risks of SLD, respectively. Inverse associations were observed among participants with both low and high genetic risks (HR per 1-point increase 0.83 [95%CI: 0.74, 0.94] and 0.91 [95%CI: 0.82, 1.02], respectively; Pinteraction = 0.51), although with a non-significant trend among those with a high genetic risk. Inverse associations were also observed between healthy lifestyle factors and liver biomarkers regardless of the genetic risk. Despite the limited power, healthy lifestyle factors were associated with a lower risk of death after incident SLD among participants with a low genetic risk (HR 0.59 [95%CI: 0.37, 0.96]).@*CONCLUSIONS@#Lifestyle modification may be beneficial in terms of lowering the risk of SLD regardless of the genetic risk. Moreover, it is also important for improving the prognosis of SLD in individuals with a low genetic risk. Future studies are warranted to examine the impact of healthy lifestyles on SLD prognosis, particularly among individuals with a high genetic risk.


Subject(s)
Humans , Prospective Studies , Incidence , East Asian People , Healthy Lifestyle , Risk Factors , Liver Neoplasms , Prognosis , China/epidemiology
6.
Chinese Medical Journal ; (24): 141-149, 2023.
Article in English | WPRIM | ID: wpr-970034

ABSTRACT

BACKGROUND@#Evidence on the relations of the American Heart Association's ideal cardiovascular health (ICH) with mortality in Asians is sparse, and the interaction between behavioral and medical metrics remained unclear. We aimed to fill the gaps.@*METHODS@#A total of 198,164 participants without cancer and cardiovascular disease (CVD) were included from the China Kadoorie Biobank study (2004-2018), Dongfeng-Tongji cohort (2008-2018), and Kailuan study (2006-2019). Four behaviors (i.e., smoking, physical activity, diet, body mass index) and three medical factors (i.e., blood pressure, blood glucose, and blood lipid) were classified into poor, intermediate, and ideal levels (0, 1, and 2 points), which constituted 8-point behavioral, 6-point medical, and 14-point ICH scores. Results of Cox regression from three cohorts were pooled using random-effects models of meta-analysis.@*RESULTS@#During about 2 million person-years, 20,176 deaths were recorded. After controlling for demographic characteristics and alcohol drinking, hazard ratios (95% confidence intervals) comparing ICH scores of 10-14 vs. 0-6 were 0.52 (0.41-0.67), 0.44 (0.37-0.53), 0.54 (0.45-0.66), and 0.86 (0.64-1.14) for all-cause, CVD, respiratory, and cancer mortality. A higher behavioral or medical score was independently associated with lower all-cause and CVD mortality among the total population and populations with different levels of behavioral or medical health equally, and no interaction was observed.@*CONCLUSIONS@#ICH was associated with lower all-cause, CVD, and respiratory mortality among Chinese adults. Both behavioral and medical health should be improved to prevent premature deaths.


Subject(s)
Adult , Humans , Cardiovascular Diseases/prevention & control , East Asian People , Prospective Studies , Risk Factors , Smoking
7.
Chinese Medical Journal ; (24): 648-657, 2022.
Article in English | WPRIM | ID: wpr-927544

ABSTRACT

BACKGROUND@#Few studies have assessed the relationship between multimorbidity patterns and mortality risk in the Chinese population. We aimed to identify multimorbidity patterns and examined the associations of multimorbidity patterns and the number of chronic diseases with the risk of mortality among Chinese middle-aged and older adults.@*METHODS@#We used data from the China Kadoorie Biobank and included 512,723 participants aged 30 to 79 years. Multimorbidity was defined as the presence of two or more of the 15 chronic diseases collected by self-report or physical examination at baseline. Multimorbidity patterns were identified using hierarchical cluster analysis. Cox regression was used to estimate the associations of multimorbidity patterns and the number of chronic diseases with all-cause and cause-specific mortality.@*RESULTS@#Overall, 15.8% of participants had multimorbidity. The prevalence of multimorbidity increased with age and was higher in urban than rural participants. Four multimorbidity patterns were identified, including cardiometabolic multimorbidity (diabetes, coronary heart disease, stroke, and hypertension), respiratory multimorbidity (tuberculosis, asthma, and chronic obstructive pulmonary disease), gastrointestinal and hepatorenal multimorbidity (gallstone disease, chronic kidney disease, cirrhosis, peptic ulcer, and cancer), and mental and arthritis multimorbidity (neurasthenia, psychiatric disorder, and rheumatoid arthritis). During a median of 10.8 years of follow-up, 49,371 deaths occurred. Compared with participants without multimorbidity, cardiometabolic multimorbidity (hazard ratios [HR] = 2.20, 95% confidence intervals [CI]: 2.14 - 2.26) and respiratory multimorbidity (HR = 2.13, 95% CI:1.97 - 2.31) demonstrated relatively higher risks of mortality, followed by gastrointestinal and hepatorenal multimorbidity (HR = 1.33, 95% CI:1.22 - 1.46). The mortality risk increased by 36% (HR = 1.36, 95% CI: 1.35 - 1.37) with every additional disease.@*CONCLUSION@#Cardiometabolic multimorbidity and respiratory multimorbidity posed the highest threat on mortality risk and deserved particular attention in Chinese adults.


Subject(s)
Aged , Humans , Middle Aged , Arthritis, Rheumatoid , Asian People , China/epidemiology , Hypertension , Multimorbidity
8.
Chinese Journal of Digestive Surgery ; (12): 1185-1190, 2022.
Article in Chinese | WPRIM | ID: wpr-955233

ABSTRACT

The etiology of diaphragmatic hernia in adults is mainly congenital and traumatic, its overall incidence in adults is low, and adult diaphragmatic hernia is easily misdiagnosed and missed diagnosis because of lacking specificity in clinical presentation. There is no clinical guidelines or consensus for the diagnosis and treatment of diaphragmatic hernia in adults. The authors inquire into the diagnosis and treatment of diaphragmatic hernia in adults by summarizing relevant litera-tures and combining with clinical practice, and recommend that multi-slice spiral computed tomo-graphy should be promptly refined for suspected cases, especially focusing on sagittal images. The symptomatic patients should be repaired promptly, with a preference for laparoscopic surgery, and mesh augmentation is recommended in those with larger defects.

9.
Chinese Journal of Infectious Diseases ; (12): 274-278, 2020.
Article in Chinese | WPRIM | ID: wpr-867611

ABSTRACT

Objective:To analyze the epidemiological characteristics of children with hand, foot, and mouth disease (HFMD) and herpetic angina (HA) in Wenzhou City and the influence of meteorological factors on the pathogenesis, and to provide basis for early warning and disease prevention.Methods:A total of 62 809 children diagnosed with HFMD and 56 005 with HA in the 2nd Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University during 2012 to 2017 were enrolled. The meteorological factors during 2012 to 2017 were collected monthly. The data were analyzed using Spearman rank correlation and multivariant linear stepwise regression model.Results:The number of cases of HFMD and HA began to rise in the spring, and decreased after reaching the peak from May to July. Then there was a secondary peak from September to December, and the incidence decreased significantly in winter. Univariate correlation analysis showed that the effects of different meteorological factors on HFMD and HA were basically the same. Multivariant linear stepwise regression analysis showed that there was a positive correlation between monthly mean temperature (X) and the number of HFMD cases. The regression equation was Y=-161.450+ 53.828X ( F=22.250, P<0.01). Monthly mean relative humidity (X 1) and temperature (X 2) were positively associated with the number of HA cases. The regression equation was Y=-3 521.196+ 46.814X 1+ 41.762X 2 ( F=18.351, P<0.01). Conclusions:The trends of onset time of HFMD and HA are similar. The meteorological factors are closely related to HFMD and HA, and their incidence trends are significantly affected by meteorological changes.

10.
Journal of Stroke ; : 175-183, 2019.
Article in English | WPRIM | ID: wpr-766249

ABSTRACT

BACKGROUND AND PURPOSE: Both genetic factors and smoking are associated with ischemic stroke (IS) risk. However, little is known about the potential interaction of these factors. We aimed to assess whether smoking and a positive family history interact to increase the risk of IS. METHODS: The nationwide prospective study recruited 210,000 men and 300,000 women in 2004 to 2008 at ages 30 to 79 years. During 9.7 years of follow-up, we documented 16,923 and 20,656 incident IS cases in men and women without major chronic diseases at baseline, respectively. Multivariable Cox regression models were used to examine associations between family history and IS. Likelihood ratio tests were used to test the smoking-family history interactions on IS. RESULTS: About 67.8% (n=135,168) of men ever smoked regularly compared with 2.7% (n=7,775) of women. Among men, a significant interaction between family history and smoking on IS was observed (P for interaction=0.03), with more pronounced association between family history and IS among ever-regular smokers (hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.16 to 1.27) than among never-smokers (HR, 1.11; 95% CI, 1.01 to 1.23). The association between family history and IS among ex-smokers after more than 10 years of cessation (HR, 1.01; 95% CI, 0.85 to 1.20) appeared similar to that among never-smokers. Among women, a similar but not significant interaction between family history and smoking on IS was observed. Ever-regular smokers who had a family history of stroke had the highest risk of IS. CONCLUSIONS: Among Chinese men, the association of family history with IS was accentuated by smoking, and such accentuation tended to be lowered by cessation.


Subject(s)
Female , Humans , Male , Asian People , Chronic Disease , Cohort Studies , Family Health , Follow-Up Studies , Gene-Environment Interaction , Prospective Studies , Smoke , Smoking , Stroke , Nicotiana
11.
Chinese Journal of Microbiology and Immunology ; (12): 583-590, 2019.
Article in Chinese | WPRIM | ID: wpr-756240

ABSTRACT

Objective To investigate the distribution and drug resistance of carbapenem-resistant Enterobacteriaceae ( CRE) isolated from children in China. Methods CRE strains were collected in 10 ter-tiary children's hospitals of China from January 1, 2016 to December 31, 2017. Antimicrobial susceptibility of the clinical strains was detected with disk diffusion method ( KB method) and automated method. The re-sults were analyzed according to the Clinical and Laboratory Standards Institute ( CLSI) Standards published in 2017. WHONET 5. 6 software was used to retrospectively analyze the distribution characteristics and drug resistance of these strains. Results A total of 3065 CRE clinical strains were isolated from children with an overall prevalence of 7. 7% and among them, 13. 5% were isolated in neonatal group and 5. 8% in non-neo-natal group. The detection rate of CRE in 2017 was higher than that in 2016 (9. 7% vs 5. 7%). Among the 3065 CRE strains, there were 1912 strains of Klebsiella pneumoniae (62. 0%), 667 strains of Escherichia coli (22. 0%), 206 strains of Enterobacter cloacae (7. 0%), 56 strains of Klebsiella aerogenes (1. 8%) and 47 strains of Serratia marcescens (1. 5%). Most of the strains were isolate in neonatology departments including neonatal intensive care units (NICU) and intensive care units (ICU), accounting for 44. 8% and 19. 7%, respectively. Respiratory tract (61. 8%), urine (19. 4%) and blood (5. 7%) specimens were the main sources of CRE isolates. Results of antimicrobial susceptibility test showed that the CRE strains were highly resistant to carbapenem antibiotics such as imipenem, meropenem and ertapenem, as well as penicillins and most cephalosporins (79. 6%-100%), especially those isolated in the neonatal group (P<0. 05). Children had relatively low resistance rates to aminoglycosides such as amikacin (19. 7%) and fos-fomycin (11. 9%), fluoroquinolones such as levofloxacin (37. 7%) and ciprofloxacin (43. 3%), and tige-cycline (3. 8%). Currently, no polymyxin B-resistant strains were isolated. Conclusions The prevalence of common CRE strains in children in 2017 was higher than that in 2016, especially in newborns. Drug re-sistance in CRE strains isolated from neonates to common antibiotics was more severe, suggesting that great attention should be paid to it and timely measures should also be taken.

12.
Chinese Journal of Pediatrics ; (12): 355-362, 2019.
Article in Chinese | WPRIM | ID: wpr-810590

ABSTRACT

Objective@#To understand clinical characteristics of children with pneumococcal meningitis (PM) in China and to analyze the drug sensitivity of Streptococcus pneumoniae isolates and associated impacts on death and sequelae.@*Methods@#The clinical data, follow-up results and antimicrobial sensitivity of isolated strains of 155 children (including 98 males and 57 females, age ranged from 2 months to 15 years) with PM in 10 tertiary-grade A class hospitals of Infectious Diseases Surveillance of Pediatrics (ISPED) from 2013 to 2017 were collected and analyzed retrospectively. Patients were divided into different groups according to the following standards: ≤1 year old group,>1-3 years old group and >3 years old group according to age; death group and non-death group according to the death within 30 days after PM diagnosis; complication group and non-complication group according to the abnormal cranial imaging diagnosis; sequelae group and no-sequelae group according to the follow-up results. Bonfereoni chi-square segmentation and Kruskal-Wallis H test were used for statistical analysis.@*Results@#There were 64 cases (41.3%) in the ≤1 year old group, 39 cases in the >1-3 years old group (25.2%), and 52 cases (33.5%) in the >3 years old group. The most common clinical manifestation was fever (151 cases, 97.4%). The mortality was 16.8% (26/155) during hospitalization. The neurological complication rate was 49.7% (77/155) during hospitalization, including the most common complication, subdural effusion and (or) empyema in 50 cases (32.3%) and hearing impairment in 6 cases. During follow-up after discharge, no death was found and focal neurological deficits were found in 47 cases (30.3%), including the frequent neurological sequelae: cognitive and mental retardation of different degree in 22 cases and hearing impairment in 14 cases (9.0%). The rate of cure and improvement on discharge was 74.8% (116/155) and the lost to follow-up rate was 8.4% (13/155). The proportions of died cases, neurological complications during hospitalization and proportions of peripheral white blood cell count <12 × 109/L before admission in ≤1 year old group were significantly higher than those in >3 years old group (25.0% (16/64) vs. 5.8% (3/52), 75.0% (48/64) vs. 25.0% (13/52), 48.4% (31/64) vs. 15.4% (8/52), χ2=7.747, 28.767, 14.044; P=0.005, 0.000, 0.000). The proportions of headache, vomiting, neck resistance and high risk factors of purulent meningitis in >3 years old group were significantly higher than those in ≤ 1 year old group (67.3%(35/52) vs. 1.6%(1/64), 80.8% (42/52) vs. 48.4% (31/64), 69.2% (36/52) vs. 37.5% (24/64), 55.8% (29/52) vs. 14.1%(9/64), χ2=57.940, 12.856, 11.568, 22.656; P=0.000, 0.000, 0.001, 0.000). Streptococcus pneumoniae isolates were completely sensitive to vancomycin (100.0%, 152/152), linezolid (100.0%, 126/126), moxifloxacin (100.0%, 93/93) and ofloxacin (100.0%,41/41); highly sensitive to levofloxacin (99.3%, 142/143) and ertapenem (84.6%, 66/78); moderately sensitive to ceftriaxone (48.4%, 45/93), cefotaxime (40.0%, 44/110) and meropenem (38.0%, 38/100); less sensitive to penicillin (19.6%, 27/138) and erythromycin (4.2%, 5/120). The proportions of non-sensitive strains of penicillin (21/21) and meropenem (17/18) in the death group were significantly higher than those (90/117, 45/82) in the survived group(χ2=4.648 and 9.808, P=0.031 and 0.002).@*Conclusions@#The children′s PM is mainly found in infants under 3 years old in China. Death and neurological complications are more common in PM children under 1 year old. The clinical manifestations and peripheral blood inflammatory markers of PM patients under 1 year old are not typical. Fever is the most common clinical manifestation and subdural effusion and (or) empyema is the most common complication. Long-term hearing impairment is common in PM and the follow-up time must be prolonged. The dead PM cases had high in sensitive rates to penicillin and meropenem.

13.
Chinese Journal of School Health ; (12): 34-38, 2019.
Article in Chinese | WPRIM | ID: wpr-819350

ABSTRACT

Objective@#This study aims to explore factors associated with parental mediation of children’s vision care and digital technology use.@*Methods@#By using a probabilityproportionate sampling method, a total of 3 249 parents of junior primary school students completed the selfadministered questionnaire in second semester of 2018 from Taipei and Pingtung. @*Results@#Parents had moderate scores in children’s vision care beliefs, selfefficacy and parental mediation. Children spent an average of 7 hours on digital technology use per week. Multiple regression analysis results showed that parents who had intact family, not providing children with personal digital technology devices, spent less time in digital technology devices, and had higher levels of vision care beliefs, higher mediation efficacy, and more cues to action were more likely to have higher levels of vision care mediation behaviors. Whereas children who were at senior grades, low household income, from nonintact families, owned personal digital technology devices, whose parents spent more time using digital technology devices and implementing low levels of parental mediation were more likely to spend more time using digital technology devices.@*Conclusion@#Schools and communities could provide more parental training and parentchild colearning opportunities to enhance parental mediation of children’s vision care behavior and reduce excessive digital technology use.

14.
Chinese Journal of Digestive Surgery ; (12): 387-393, 2019.
Article in Chinese | WPRIM | ID: wpr-743987

ABSTRACT

Objective To explore the application value of the extra-glissonian pedicle transection approach guided by arantius' ligament in laparoscopic left hemihepatectomy.Methods The retrospective cohort study was conducted.The clinical data of 57 patients who underwent laparoscopic left hemihepatectomy in the First Affiliated Hospital of Fujian Medical University from January 2015 to January 2018 were collected.There were 18 males and 39 females,aged from 29 to 75 years,with an average age of 57 years.Of the 57 patients,22 undergoing the laparoscopic left hemihepatectomy with extra-glissonian pedicle transection approach guided by arantius' ligament and 35 undergoing laparoscopic left hemihepatectomy with regular intra-glissonian pedicle transection approach were allocated into the extra-glissonian transection group and intra-glissonian transection group,respectively.Observation indicators:(1) intraoperative situations and postoperative short-term outcomes;(2) postoperative complications;(3) follow-up.Patients were followed up by outpatient examination and telephone interview to investigate postoperative recurrence of diseases up to June 2018.Measurement data with normal distribution were represented as Mean±SD and comparison between groups was analyzed using the t test.Count data were described as absolute number or percentage and comparison between groups was analyzed using the chi-square test.Results (1) Intraoperative situations and postoperative short-term outcomes:the operation time,dissection time of left hepatic pedicle,volume of intraoperative blood loss were (123± 37) minutes,(14± 5) minutes,(337± 169) mL in the extra-glissonian transection group and (148± 27) minutes,(22± 3) minutes,(495±203) mL in the intra-glissonian transection group,respectively,showing statistically significant differences between the two groups (t =2.992,7.733,3.045,P<0.05).Cases with intraoperative blood transfusion,time of gastrointestinal recovery,time for postoperative drainage-tube removal,duration of postoperative hospital stay were 1,(1.8±0.9)days,(3.2±0.9)days,(8.2± 1.7)days in the extra-glissonian transection group and 4,(2.0± 0.8)days,(3.6±0.8)days,(10.0±4.0)days in the intra-glissonian transection group,respectively,showing no statistically significant difference between the two groups (x2 =0.171,t=1.304,1.857,1.622,P>0.05).There was no uncontrolled hemorrhage or air embolism in the two groups.(2) Postoperative complications:3 patients had complications of Clavien-Dindo classification Ⅰ in the extra-glissonian transection group including 1 of pulmonary infection,1 of abdominal infection,1 of incisional infection and 7 had complications in the intraglissonian transection group including 2 of pulmonary infection,2 of liver sectional effusion,1 of subphrenic abscess,1 of biliary leakage,1 of incisional infection,showing no statistically significant difference between the two groups (x2=0.066,P>0.05).Patients with postoperative complications were cured and discharged after symptomatic treatment.There was no perioperative death in the two groups.(3) Follow-up:57 patients were followed up for 5-41 months,with a median time of 23 months.Two and 1 patients had tumor recurrence and hepatolithiasis recurrence in the intra-glissonian transection group,without recurrence of hepatic hemangioma or cholangiocarcinoma.Five patients had tumor recurrence in the intra-glissonian transection group,without recurrence of hepatic hemangioma,hepatolithiasis or cholangiocarcinoma.The disease recurrence rate was 13.6% (3/22) and 14.3%(5/35) in the extra-glissonian transection group and intra-glissonian transection group,respectively,showing no statistically significant difference between the two groups (x2 =0.104,P>0.05).Conclusions Extraglissonian pedicle transection approach guided by arantius' ligament in laparoscopic left hemihepatectomy is feasible and effective,which can control hepatic blood inflow of left liver,simplify the surgery procedure and shorten dissection time of left pedicle,in order to save operation time and reduce volume of intraoperative blood loss.

15.
Chinese Journal of Experimental and Clinical Virology ; (6): 17-20, 2018.
Article in Chinese | WPRIM | ID: wpr-805902

ABSTRACT

Objective@#To investigate the relationship between the EBV-induced liver injury and caspase-3/6 in children.@*Methods@#Data of 249 patients seen from July 2016 to June 2017 who got infection with EBV were collected in second affiliated hospital of Wenzhou Medical University and the patients were divided into two groups; 168 patients who were diagnosed with hepatitis were selected for abnormal liver function group, laboratory tests were performed in acute phase and convalescent phase. Meanwhile the 81 patients, whose liver function were normal were selected for normal liver function group. Two ml of blood plasma was collected from each patient from both groups at the beginning and after a week’s treatment of the abnormal liver function group. The patients were aged from 1 to 14 years. The abnormal liver function group was further divided into four groups: young children (1-3 years old), preschool children (4-6 years old), school children (7-10 years old), teenagers (10-14 years old). Firstly, we recorded their alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), gamma glutamyl transpeptidase (GGT) and direct bilirubin (DBIL), then by the use of enzyme linked immunosorbent assay (ELISA) we measured the protein level of caspase-3 and caspase-6.@*Results@#In the group of abnormal liver function group, in the acute phase of the teenagers the level of ALT, caspase-3 and caspase-6 are improved significantly(927.2±82.5 vs. 158.5±41.4, P<0.001, 169.8±52.8 vs. 91.5±10.1, P<0.001, P<0.05, 82.2± 2.6, P<0.001, 965.8±31.5, P<0.001, 184.8±14.3, P<0.001), while the AST, TBLL, GGT and DBLL had no significant difference.@*Conclusions@#In the process of EBV-induced liver injury, there was a linear correlation between the increase of caspase-3/6 and ALT in the acute stage, suggesting that EBV-induced liver injury is closely related to caspase-3/6.

16.
Chinese Journal of Pediatrics ; (12): 582-586, 2018.
Article in Chinese | WPRIM | ID: wpr-810082

ABSTRACT

Objective@#To describe the clinical characteristics of pneumococcal infections and drug resistance of Streptococcus pneumoniae isolates from children's hospitals, which would provide reference for preventing and treating pneumococcal diseases.@*Methods@#This was a prevalence survey. In this study, the age, specimen type, monthly distribution characteristics, and antimicrobial resistance of Streptococcus pneumoniae isolates from 9 children's hospitals in China were investigated between January 1, 2016 and December 31, 2016. The WHONET 5.6 software was used to analyze the antibiotic susceptibility of Streptococcus pneumoniae. The comparison of rates was performed by Chi-square test.@*Results@#A total of 6 200 isolates of streptococcus pneumoniae were obtained, namely, 95.1% (5 876/6 177) from the respiratory tract specimens, 2.2% (136/6 177) from blood specimens and 0.4% (24/6 177) from cerebrospinal fluid specimens. The isolates were mainly from children older than 1 and younger than 5 years (54.7%, 3 381/6 185) . Most of strains (33.2%, 1 184/3 563) were isolated in November, December and January. Streptococcus pneumoniae isolates were completely sensitive to vancomycin (100.0%, 6 189/6 189) , linezolid (100.0%, 6 030/6 030) , moxifloxacin (100.0%, 3 064/3 064) , highly sensitive to levofloxacin (99.8%, 5 528/5 540), ertapenem (98.8%, 3 024/3 061) and lowly sensitive to erythromycin (1.7%, 102/6 016), clindamycin (3.7%, 116/3 136), and tetracycline (5%, 244/4 877), respectively. According to the parenteral susceptibility breakpoints for non-meningitis isolates, the sensitivity of Streptocococus pneumoniae to penicillin from children's hospital of Chongqing Medical University (49.3%, 892/1 809) was significantly lower than those of other hospitals (χ2=1 268.161, P<0.05) .@*Conclusions@#Streptococcus pneumoniae is mainly isolated from respiratory tract, from children older than 1 and younger than 5 years and during November to January in tertiary children's hospital of China. The Streptococcus pneumoniae from children is highly sensitive to vancomycin, linezolid, moxifloxacin, levofloxacin. There are also significant differences in the sensitivity of penicillin for Streptococcus pneumoniae from different hospitals.

17.
Chinese Journal of Pediatrics ; (12): 29-33, 2018.
Article in Chinese | WPRIM | ID: wpr-809762

ABSTRACT

Objective@#To analyze the antimicrobial resistance profile in Chinese children.@*Methods@#This was a prevalence survey. From January 1 through December 31, 2016, the isolates were collected from 10 tertiary children hospitals in China. Antimicrobial susceptibility testing was carried out by routine laboratory methods. The penicillin susceptibility of streptococcus pneumonia and Meropenem susceptibility of gram-negative bacteria were detected by E-test and disk diffusion method respectively. Antimicrobial susceptibility results were interpreted according to the criteria of Clinical and Laboratory Standards Institute (CLSI) Guideline 2016. The data of antimicrobial susceptibility testing of isolates from either the different patients (neonatal group and non-neonatal group) or various sources were analyzed by WHONET 5.6 software.@*Results@#A total of 56 241 isolates were collected, of which 41.5% (23 328 isolates) were gram-positive organisms and 58.5% (32 886 isolates) gram-negative organisms. The five leading pathogens were Escherichia coli (7 995/56 214, 14.2%), Straphylococcus aureus (6 468/56 214, 11.5%), Streptococcus pneumonia (6 225/56 214, 11.1%), Haemophilus influenza (5 435/56 214, 9.7%) and Klebsiella pneumonia (4 523/56 214, 8.0%). The Meropenem resistance rates of Klebsiella pneumonia, Enterobacter cloacae, Escherichia coil, Pseudomonas aeruginosa, Acinetobacter baumonia isolates were 27.4% (326/1 189) , 8.1% (29/358) , 2.0% (27/1 362) , 19.5% (34/174) , 49.7% (230/463) in neonatal group and 15.4% (512/3 327) , 4.8% (40/841) , 2.3% (151/6 564) , 13.7% (252/1 840) , and 53.4% (860/1 611) in non-neonatal group. The Methicillin-resistant Staphylococcus aureus (MRSA) rates of neonatal group and non-neonatal group were 46.2% (649/1 404) and 33.3% (1 668/5 010) . The penicillin non-susceptible rates of Streptococcus pneumonia in the two groups were 17.6% (6/34) and 18.2% (1 121/6 158) respectively. The β-lactamase positive rates of Haemophilus pneumonia isolates in the neonatal group and non-neonatal groups were 33.8% (47/139) and 44.4% (2 345/5 282) respectively.@*Conclusion@#This investigation highlights the worrisome trend of antimicrobial resistance in children, especially among neonatal patients in China.

18.
Journal of Stroke ; : 247-257, 2018.
Article in English | WPRIM | ID: wpr-714415

ABSTRACT

BACKGROUND AND PURPOSE: Self-rated health (SRH) is a consistent and strong predictor of all-cause and cardiovascular mortality in various populations. However, the associations between SRH measures and risk of first-ever or recurrent stroke were rarely explored. We thus aim to prospectively investigate the associations between SRH measures and risk of total and subtypes of stroke in Chinese population. METHODS: A total of 494,113 participants from the China Kadoorie Biobank without prior heart diseases or cancer (486,541 without stroke and 7,572 with stroke) were followed from baseline (2004 to 2008) until December 31, 2013. General and age-comparative SRH were obtained from baseline questionnaires. First-ever stroke or recurrent events were ascertained through linkage to disease registry system and health insurance data. RESULTS: We identified 27,662 first-ever stroke and 2,909 recurrent events during an average of 7.0 years of follow-up. Compared with excellent general SRH, the hazard ratios (HRs) and 95% confidence intervals (CIs) for first-ever stroke associated with good, fair, and poor general SRH were 1.04 (1.00 to 1.08), 1.19 (1.15 to 1.23), and 1.49 (1.42 to 1.56) in the multivariate model, respectively. Compared with better age-comparative SRH, the HRs (95% CIs) of same and worse age-comparative SRH were 1.13 (1.10 to 1.17) and 1.51 (1.45 to 1.58), respectively. The relations of SRH measures with ischemic stroke, hemorrhagic stroke, and recurrent stroke were similar to that with total first-ever stroke. However, the magnitude of associations was much stronger for fatal stroke than for non-fatal stroke. CONCLUSIONS: This large-scale prospective cohort suggests that self-perceived health status is associated with incident stroke, regardless of stroke subtype.


Subject(s)
Adult , Humans , Asian People , China , Cohort Studies , Follow-Up Studies , Heart Diseases , Insurance, Health , Mortality , Prospective Studies , Stroke
19.
Chinese Journal of Infectious Diseases ; (12): 101-106, 2018.
Article in Chinese | WPRIM | ID: wpr-707222

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Objective To evaluate the curative effect of recombinant human Interferon α2b (rhIFN α2b) spray in hand,foot and mouth disease (HMFD).Methods In total,313 HMFD children were enrolled from Beijing Ditan Hospital affiliated to Capital Medical University,Tianjing Second People's Hospital,Hebei Children's Hospital,the Second Hospital affiliated to Wenzhou Medical College,Kunming Maternal and Child Health Hospital and Guiyang Public Health Treatment Center from March,2015 to February,2017.They were divided into rhIFN α2b group (148 cases) and ribavirin group (165 cases).The children in rhIFN α2b group were given with the rhIFN α2b spray,and those in ribavirin group were given with the ribavirin spray.Meanwhile,the children were given unified standard interventions for basic treatment.The curative effect and safety between two groups was compared.The t test was used for intergroup comparison and the Wilcoxon rank test was used for non-normal quantitative data.Results At the end of the follow-up period,all kids reached the recovery level,with 144 cases in the rhIFN α2b group and 164 cases in the ribavirin group.Fever,herpes and rashes all disappeared with 7-day follow-up.The total efficiency of the rhIFN α2b group measured at the 72h after treatment was 74.15%,which showed significant differences compared with the ribavirin group with 49.09 % efficiency (Z=4.44,P<0.01).As the secondary outcome measures,the complete disappearance time of fever and the immediate disappearance time of fever in the rhIFN α2b group were significantly shorter than those in the ribavirin group ([27.03±21.99] vs [33.21±26.71],t=-2.13;[23.56±13.96] vs [28.51±18.84],t=-2.07,both P<0.05).The appetite improvement and the disappearance times of oral herpes and rashes in the rhIFN α2b group were shorter than those in the ribavirin group,with significant differences (x2 =4.94,3.17 and 3.55,respectively,all P=0.000).No adverse event in both groups.Conclusions rhIFN α2b spray treatment in HMFD is proved significantly effective,particularly,it can evidently relieve fever symptoms and promote the disappearance of oral herpes symptoms,and no adverse event is observed throughout the study,which indicates a good safety of the rhIFN α2b spray.Clinical trial registration Chinese Clinical Trial Registry,ChiCTR-OIN-17013182.

20.
Chinese Journal of Clinical Nutrition ; (6): 40-46, 2017.
Article in Chinese | WPRIM | ID: wpr-515421

ABSTRACT

Objective To investigate the clinical features,magnetic resonance imaging (MRI),treatment,and follow-up of patients with glutaric aciduria type Ⅰ (GA-1).Methods Four pediatric patients with GA-1 diagnosed in our hospital were included in this study.They were treated with special diets and carnitine supplements.MRI and tandem mass spectrometry (MS/MS) were performed,and the mental development indices were measured.Results GA-1 was confirmed 2 months,13 months,4 months,and 7 months after birth.Seizure had been observed before the disease diagnosis in three patients and disappeared after treatment.In all four patients,T2-weighted brain MRI showed frontotemporal atrophy or hypoplasia and enlarged subarachnoid space in the sylvian fissures and anterior to the temporal lobes.Diffusion weighted imaging revealed high-density lesions over both the putamen and globus pallidus.The patients were followed up for 4 to 5 years.Plasma amino acids and acylcamitine profile were monitored every 3-5 months.The mean C5DC level and C5DC/C8 were kept the higher limits of the normal ranges,especially in case 3.During the follow-up,the body weight was at-2 SD-0 and the height at-1 SD-0.Intellectual development test showed that case 1 and case 4 had mildly abnormal intelligence,whereas case 2 and case 3 had extremely severe intellectual disability.Gene test confirmed the presence of gene mutations in all four cases,including IVS10-2A > C homozygous mutation in cases 1,3,and 4 and [IVS10-2A > C] + [c.245G >c(p.Arg82Pro)] hybrid mutation in case 2.Two female children were smoothly enrolled by local kindergarten,while two male children were unable to walk alone due to delayed motor development and spastic paralysis.Conclusions The phenotype of GA-1 patients is not remarkably correlated with its genotype correlation.Newborn screening is essential for identifying GA-1 patients.

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