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Objective:To observe the clinical efficacy of plan-do-check-Act(PDCA)cycle management model combined with pulsed tooth punch applied in maintenance period of the patients with moderate to severe periodontitis,and to provide the theoretical basis for application of the PDCA cycle management model in the periodontitis patients.Methods:A total of 50 patients with moderate to severe periodontitis were selected based on predefined inclusion,exclusion,and elimination criteria.The patients were randomly divided into experiment group(n=25)and control group(n=25).The patients in experiment group underwent maintenance care with pulsed tooth punch in combination with the BASS brushing technique,while the patients in control group maintained oral hygiene with the BASS brushing technique alone.The patients in both two groups were managed with the PDCA cycle management model.The patients were asked to return for follow-up visits at 2,4,8,and 12 weeks of self-care,and the personalized corrections and guidance were provided based on the plaque accumulation.The clinical periodontal parameters,including plaque index(PLI),probing depth(PD),and bleeding index(BI),at 4 and 12 weeks of self-care,as well as the levels of tumor necrosis factor-α(TNF-α)and interleukin-17(IL-17)in the gingival crevicular fluid of the patients in two groups were observed and recorded.Results:After 4 and 12 weeks of self-care,compared with control group,the PLI,PD,and BI of the patients in experiment group were significantly decreased(P<0.01);compared with baseline,the PLI,PD,and BI of the patients in both two groups at 4 and 12 weeks of self-care were increased(P<0.05 or P<0.01);Compared with 4 weeks of self-care,the PLI,PD,and BI of the patients at 12 weeks of self-care were increased(P<0.01).After 4 and 12 weeks of self-care,compared with control group,the levels of TNF-α and IL-17 in gingival crevicular fluid of the patients in experiment group were significantly decreased(P<0.01);compared with baseline,the levels of TNF-α and IL-17 in gingival crevicular fluid of the patients in two groups at 4 and 12 weeks of self-care were increased(P<0.01).Conclusion:The use of pulsed tooth punch under the PDCA cycle management model can significantly decrease the PLI,PD,BI,and the levels of inflammatory factors in gingival crevicular fluid of the patients with moderate to severe periodontitis,and inhibit the plaque formation and control the gingival inflammation,benefite the maintenance of efficacy of the patients with moderate to severe periodontitis.
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Comprehensive improvement in course teaching quality is an important link in deepening the reform of undergraduate education and teaching. Since 2018, West China Medical School, Sichuan University, has implemented the collective lesson preparation system of "two meetings, seven decisions, and three preparation sessions" for undergraduate clinical courses, thereby effectively implementing subject cooperation, organizational guidance, and resource integration among clinical teachers and determining the key elements of the course through "teaching, learning, and exam preparations" before class. In the process of course operation, the concept of quality control based on plan-do-check-act cycle is deeply integrated with the collective lesson preparation system, and active implementation of the whole-process quality control loop of planning (plan), organization and implementation (do), inspection of results (check), and treatment and improvement (action) has effectively improved the teaching quality of undergraduate clinical courses.
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Objective To explore the strategy of constructing a scientific management system for antibiotics in a tertiary hospital,and to provide reference to strengthen the management and rational use of antibiotic.Methods Using PDCA management tools to build a scientifically effective antimicrobial drug management system.Evaluation of management quality of antimicrobial stewardship was constructed by 14 indicators of 5 dimensions.The entropy weight TOPSIS method was used to comprehensively evaluate and analyze the changes in various indicators after the implementation of PDCA improvement.Results Based on the entropy weight TOPSIS analysis,the management quality of antibiotics in 2018 was the lowest with the Ci value 0.313 5,and the management quality of antibiotics in 2022 was the highest with the Ci value 0.747 4.The evaluation of antimicrobial stewardship was divided into five dimensions:for the evaluation of antibiotics use density,the Ci value in 2017 was highest;for the evaluation of antibiotics usage rate,the Ci value in 2021 was the highest;for the evaluation of the submission rate before use of antibiotics,the Ci value in 2022 was the highest;for the evaluation of preventive medication for type I incisions,the Ci value was highest in 2022;the evaluation of the cost dimension of antibiotics for hospitalized patients showed the highest Ci value in 2022.The application of PDCA method for antibiotics management had shown an overall improvement trend.Conclusion Based on PDCA method,collaboration through multiple departments for antibiotics management had achieved significant results.The entropy weight TOPSIS method can be used to evaluate the effectiveness of antibiotics management,to provide reference for the direction of hospital antibiotics control and policy formulation.
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Welding operations are widely present in the manufacturing production process, involving a large number of occupational groups, and are the key occupations where work injuries and occupational diseases occur in China. For different welding processes and welding materials, the content and focus of occupational health monitoring are different. At present, the item of occupational health examination in welding operation is in poor consistency with the on-site exposure of occupational hazard factors, and it is mainly concentrated in the stage of disease development, which can not reflect the early health damage caused by welding dust exposure in time. The emergence of biomarkers of welding dust can make up for this defect. Therefore, it is of great significance to describe the current situation of occupational health monitoring of welding dust and summarize the research progress of related biomarkers for the early prevention of diseases caused by welding dust and the practice of occupational health monitoring.
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Occupational Health , Welding , Occupational Exposure/analysis , Dust/analysis , Biomarkers , Air Pollutants, Occupational/analysisABSTRACT
INTRODUCTION@#MyDiagnostick is an atrial fibrillation (AF) screening tool that has been validated in the Caucasian population in the primary care setting.@*METHODS@#In our study, we compared MyDiagnostick with manual pulse check for AF screening in the community setting.@*RESULTS@#In our cohort of 671 candidates from a multi-ethnic Asian population, AF prevalence was found to be 1.78%. Of 12 candidates, 6 (50.0%) had a previous history of AF and another 6 (50.0%) were newly diagnosed with AF. Candidates found to have AF during the screening were older (72.0 ± 11.7 years vs. 56.0 ± 13.0 years, P < 0.0001) and had a higher CHADSVASC risk score (2.9 ± 1.5 vs. 1.5 ± 1.1, P = 0.0001). MyDiagnostick had a sensitivity of 100.0% and a specificity of 96.2%. In comparison, manual pulse check had a sensitivity of 83.3% and a specificity of 98.9%.@*CONCLUSION@#MyDiagnostick is a simple AF screening device that can be reliably used by non-specialist professionals in the community setting. Its sensitivity and specificity are comparable and validated across various studies performed in different population cohorts.
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Humans , Atrial Fibrillation/diagnosis , Heart Rate , Sensitivity and Specificity , Risk Factors , Electrocardiography , Mass ScreeningABSTRACT
Objective To study the iodine nutrition status and analyze the detection of thyroid nodules and its related influencing factors in 450 health check-up residents in Chengdu area and to provide evidence for the prevention of thyroid nodules. Methods A total of 450 residents who underwent health check-up in the Western Theater General Hospital from January 2019 to January 2022 were selected as the research subjects. The gender, age, weight and other basic conditions of the subjects were investigated, and their urinary iodine levels and occurrence of thyroid nodules were examined. Univariate and multivariate methods were used to analyze the influencing factors of occurrence of thyroid nodules. Results The overall urinary iodine level of the 450 health check-up people in Chengdu area was (96.89 -212.38) μg/L, with an average of (164.86±42.58) μg/L. The urinary iodine level of males was significantly higher than that of females (P60 years old (P60 years old , people in rural areas and people with history of diabetes mellitus in the thyroid nodule group were higher than that in the non-thyroid nodule group, and thyroid stimulating hormone (TSH), thyroglobulin antibody (TGAb) and anti-thyroid peroxidase antibody (TPOAb) were higher than those in the non-thyroid nodule group (P60 years old, history of diabetes mellitus and high levels of TGAb and TPOAb were risk factors for the occurrence of thyroid nodules (P<0.05). Conclusion The overall iodine nutrition level of 450 health check-up people in Chengdu is in the appropriate range, and the detection rate of thyroid nodules is high. It is necessary to strengthen the examination of thyroid nodules in key populations (women , history of diabetes mellitus, the elderly, etc.), and provide early detection and active intervention to prevent the occurrence and progression of thyroid nodules.
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Objective To compare and validate the efficiency of four models predicting the malignancy of solitary pulmonary nodules (SPN). Methods Patients diagnosed with SPN during health check-up were selected as the research subjects. Risk assessment was conducted using four predictive models. Outcomes were obtained through prospective follow-up. Statistical description and univariate analysis were performed for all risk factors of the four models. ROC curve was applied to compare the efficiency of the four predictive models. Results A total of 479 cases were included in this study. Among these patients, 82 were diagnosed with lung tumor, and the malignant rate was 17.12%. Age, nodule diameter, smoking, family history of tumor, history of extrapulmonary tumor ≥5 years, upper lobe site, unclear boundary, and spiculation rates were higher in the malignancy group than those in the benign group (P < 0.05). The efficiency of Brock model was the best. Its AUC was 0.833, sensitivity was 80.49%, and specificity was 74.31%. Its Youden index, positive likelihood ratio, positive predictive value, and negative predictive value were the highest, and its negative likelihood ratio was the lowest. The AUC, sensitivity, and specificity of Mayo model were 0.815, 81.71%, and 67.51%, respectively; those of PKUPH model were 0.754, 69.51%, and 73.55%, respectively; and those of VA model were 0.738, 68.29%, and 67.55%, respectively. Conclusion The Brock model might be the most appropriate predictive model for the risk assessment of SPN among the health check-up population, and the VA model is the worst. The combination of Brock, Mayo, and PKUPH models requires further study.
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Objective:To analyze the relevant factors affecting the frequency and behavior of health check-up among the population of medical examinees.Methods:From January to June 2022, 491 health examinees who had health check-ups at the Second Affiliated Hospital of Shandong First Medical University were included.Basic information of the check-up population and their needs for check-up services (form of check-up, content of check-up, cost of check-up, form of feedback on check-up results, and needs for check-up providers) were obtained based on a questionnaire survey.According to the frequency of previous medical check-up, the examinees were divided into never-check-up group (frequency of check-up was 0, n=45), the irregular check-up group (the interval between two physical examinations >1 year, n=49) and the regular check-up group (frequency of check-up=1 year, n=347). The frequency of previous medical check-up was used as the dependent variable, and the age, gender, education level, income, form of medical check-up and cost of medical check-up were used as independent variables to analyse the relevant factors affecting the frequency of their medical check-ups.The above count data were analyzed by one-way analysis using chi-square test, and the count data with statistically significant differences in one-way analysis were analyzed by binary logistic regression.The statistical software was SPSS 21.0. Results:The study included 491 medical examinees, of which 9.16%(45/491) were in the never-check-up group, 20.16%(99/491) in the irregular check-up group and 70.68%(347/491) in the regular check-up group. The impact of demography characteristics of physical examinees on the frequency of health check-up, and there were statistically significant differences in the frequency of health check-up in terms of gender, job, education, and income ( χ2=21.826, 157.113, 104.764, 45.486, all P<0.05). The understanding of health check-up and the attention paid to one's own health were influencing factors that affected the frequency of health check-up. There were statistically significant differences in the frequency of health check-up in necessity of health check-up, attention to one's own health, health check-up forms, health check-up institutions, health check-up price and health check-up contents ( χ2=9.277, 25.863188.239, 59.115, 39.250, 28.314, all P<0.05). Logistic regression analysis showed gender, job type, monthly income, necessity of health check-up, concerns for items of check-up, forms and institutions of check-up were influencing factor of health check-up frequency(all P<0.05). Conclusion:The health check-up behavior of the population and the frequency of regular medical check-ups are influenced by the factors such as gender, education, occupation, income, form of medical check-up, price of medical check-up, choice of medical check-up institution and the degree of concern for one’s own health. The popularisation of health check-ups for special groups such as men, low-income people, low literacy and insufficient awareness of the importance of one’s own health will help improve the overall health awareness of the population.
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Objective To establish hemolysis-icterus-lipemia(HIL)alert indices and allowable ranges of sample volume check in CS5100 and CN6000 automated coagulation analyzers.Methods The samples of interference substances were prepared by using the interference reagent kit or obtained through artificial freeze and suction.Twenty-one samples with various concentrations of interference substances were used to evaluate repeatability of HIL indices,and 206 such samples were used to evaluate the consistency of HIL indi-ces between two different instrument systems.A total of 425 specimens were collected to evaluate the concentration distribution of inter-fering substances with various HIL indices,and 378 specimens were used to evaluate the consistency of HIL indices between manual assessment and instrumental operation.Six coagulation screening tests were analyzed parallelly for the samples prepared with the artifi-cial interference before and after,and the HIL indices were recorded.The differences between the paired samples with different concen-trations of interference substances were compared,and the HIL alert indices in different detection intervals of each test were deter-mined.Ten tubes of samples with standard volume±10％lower and upper limits were prepared using distilled water to establish the al-lowable range of volume check for each instrument,and 2 933 samples were used to validate the established ranges.Results The re-peatabilities of the HIL indices in the two systems were favorable,and the consistency between the two systems was fine(Kappa values were 0.969,0.978 and 0.991,respectively,P=0.000).The consistency between instrumental and manual assessment for the evalua-tion of hemolytic samples was just average level(Kappa values were 0.421 to 0.702,P＜0.001).The consistency for jaundice samples between instrumental and manual assessment was poor(Kappa values were 0.023 to 0.267),except the P=0.258 between the operator 1 and instrument,all the other operators were remaining P＜0.001.The consistency between instrumental and manual assessment for chyle samples was better(Kappa values 0.559 to 0.838,P＜0.001).The HIL alert indices varied with different intervals of detection for each test.The APTT H alert index was significantly lower than that measured in other tests when ordinary heparin was used in anti-co-agulation monitoring.The allowable ranges of volume check in 5 coagulation analyzers were 41.0 to 55.5 mm,44.3 to 58.4 mm,41.3 to 56.2 mm,58.3 to 72.5 mm and 59.2 to 73.3 mm respectively.Conclusion The HIL alert indices and allowable range of volume check were determined preliminarily for coagulation screening tests in various detection intervals of two different systems in our laboratory,which provided the basis for achieving intelligent management of pre-analytical quality control.
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Introduction@#Type 1 diabetes mellitus (T1DM) is an autoimmune disorder that requires a lifelong treatment regimen which may affect psychosocial development.@*Objective@#To identify behavioural and emotional problems in children and adolescents with T1DM.@*Methodology@#A cross-sectional study using the Child Behaviour Check List (CBCL) was conducted among all T1DM patients receiving treatment at the Paediatric Endocrine Unit, Hospital Tunku Azizah Kuala Lumpur, Malaysia.@*Results@#Forty T1DM patients were included. The mean age of the participants was 12.4 years (SD=2.69), with 52.5% males, and 75% Malay. The average duration of illness was 4.8 years, 9 were pre-pubertal, while mean HbA1c was 9.4%. Thirty-five percent of the respondents had parent-reported internalizing problems and 17.5% had parent-reported externalizing problems. Those >12 years old had more internalizing problems (p=0.004) compared to those ≤12 years old. The differences were in the anxious/depressed syndrome subscale (p=0.001) and withdrawn/depressed syndrome subscale (p=0.015). There were no statistically significant differences in the 3 main global scores by gender, glycaemic control, duration of illness and pubertal status by univariate analysis.@*Conclusion@#T1DM patients >12 years old were at higher risk of developing psychosocial difficulties. This highlighted the benefit of screening of behavioural and emotional issues in children and adolescents with T1DM.
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Diabetes Mellitus, Type 1ABSTRACT
Objective To understand the quality status of salt iodine monitoring results at the county level and checking results at the city level from 2017 to 2021 in Suzhou，and to provide a scientific basis for the development of iodine deficiency disease（IDD）prevention and control strategies and measures. Methods During the past five years, Suzhou CDC randomly selected 15 samples of 300 monitored salt samples from each county/district CDC each year for spot checks. The data were processed by comparative analysis of relative error and grouped data t test. Results In the conformity of iodized salt and non-iodized salt, the sample monitoring results of some counties/districts were non-iodized salt, while the city-level test results were iodized salt. In the conformity of iodized salt and seaweed iodized salt (or enhanced salt), the sample monitoring results of county/district level were iodized salt, while the test results at the city level were seaweed iodized salt (or enhanced salt). The non-conformity was relatively concentrated in some county/district laboratories, and the total amount of non-conformity tended to increase year by year. The total number of samples with relative error of >20% between the county/district and city-level results was the least in 2021, with 6, and the most in 2018, with 25. The number of samples with relative error of >30% between the county/district and city-level results was the least in 2017 being 0, while there were 12 samples in 2018, fluctuating within a small range in the past three years. The t-test results of grouped data showed that the average value of the checking results at the city level was generally higher than the monitoring results at the county level. There were 21 pairs of data with no statistical significance (P>0.05) and 29 pairs of data with statistical significance (P<0.05) between the results at the county/district level and at the city level. Among them, there were 7 counties/districts whose sample monitoring results were not significantly different from the city-level test results in 2020, while there were 9 counties/districts whose monitoring results were statistically different from the city-level test results in 2021. Conclusion The data analysis results show that the monitoring data of iodized salt in Suzhou is basically reliable and accurate, but there still exist some problems. Therefore, in the future work it is necessary to strengthen the monitoring system of IDD, increase training efforts, continuously monitor and check the quality of iodized salt to provide a scientific basis for effective prevention and control of IDD.
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Objective: Municipal National Health Insurance (NHI) in Nagasaki Prefecture in Japan struggles with poor attendance of health check-ups, which was only 39.6% in 2018. This study aimed to evaluate factors that encourage healthy behaviors, including opting for health check-ups, and the characteristics of middle-aged and older individuals who did not undergo health check-ups.Materials and Methods: This cross-sectional study, using a self-administered questionnaire, was conducted in August 2020 in three municipalities of Nagasaki Prefecture. In addition to questions regarding sociodemographic information, such as sex, age, educational status, self-rated economic status, and family structure, the questionnaire included questions on daily lifestyle habits such as alcohol intake and exercise, current medical treatment, self-rated health, and information related to health check-ups. Of the 18,710 questionnaires distributed in the three municipalities, 8,756 (46.8%) were collected by the end of December 2020, of which 7,840 were valid for analysis. The compliance rate for health check-ups was obtained from the Public Health and Welfare Bureau of Nagasaki Prefecture. Statistical analyses were performed according to two age groups: 40−59 and 60−74 years.Results: Among the respondents who did not undergo health check-ups in the year prior to this study, “lack of time” and being “too bothersome” were the most popular reasons for not attending health check-ups. “Living alone” and “low self-rated economic status” were negative factors for receiving health check-ups regardless of age group.Conclusions: Vulnerable middle-aged and older persons, such as those living alone and with low economic status, were less likely to undergo health check-ups. Emphasis on home visits by public health nurses may also be needed to increase awareness of individual health conditions, especially for people living alone and those who are socioeconomically disadvantaged.
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The Safety Committee, Clinical Information Department, Japan Society of Acupuncture and Moxibustion (JSAM) held a workshop at their 72nd Annual Meeting in Kobe titled "Forgotten Needles: Present Conditions and Measures."In the workshop, the following information was offered by the three committees, and a question and answer session was conducted with the audience afterward. 1. Patient's affection for forgotten needles: analysis of a contribution to Twitter 2. The present conditions and measure plans of forgotten needles: based on the present conditions of Kansai University of Health Sciences 3. Forgotten needles at the Suzuka University of Medical Science: the real condition of prevention of outbreak We performed a thorough cross- and/or double-check to prevent forgotten needles. The reports suggested various ideas as check methods, and the results of the study helped the practice from the next day.
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Background: The least attention is given to the real heroes of the hospital is the Class 4 workers are associated with a lot of duties of lifting and transferring patients and are at risk of work-related musculoskeletal disorders (WMSDs). Aim and Objectives: The aim of the study was to find the prevalence of WMSDs in 9 body regions among Class 4 workers of tertiary care hospitals and ergonomics assessment of their exposure to risk factors for the development of WMSDs. Materials and Methods: This cross-sectional study was conducted among 148 Class 4 workers (male: 99; female: 49 Age: >23 years) from tertiary care hospitals. A structured questionnaire comprises demographic questions, Nordic Musculoskeletal Questionnaire-Extended for WMSDs assessment in nine body parts and quick exposure check (QEC) method for ergonomic assessment, and new job stress scale for assessing job-related stress. The prevalence of WMSDs for each body region was determined. Results: Respondents’ mean age was 31.3 years (SD = 9). Point prevalence for WMSDs was high in regions like the lower back (43.8%), followed by the knee (40.8%), and shoulder (34.4%). Among 49 female respondents, 25 reported lower back pain (51%), and 20 reported neck pain (41.6%). Among 99 male respondents, 25 reported lower back pain (25.5%) while 22 reported knee pain (22.2%). QEC assessment showed that level of exposure to WMSDs risk was high among 50% of the study population. Conclusion: The lower back and knee were the most affected areas among Class 4 workers. Moreover, QEC findings warned the level of exposure to WMSDs risks is high.
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Background: Self-treatment is recognized as one of the global public health issues. Geographical distance, constrained financial resources, and lack of awareness are the main barriers for people in remote areas to access health care. Self-treatment may also have risky consequences such as side effects and antibiotic resistance. It is assumed that the rate of self-treatment is high in the unreachable hilly tribal areas because of the geographical factor. Aim and Objective: The primary objective of the present study is to find out the prevalence and reason of self-medication, and the sources of drug information. The secondary objective is to assess the awareness of routine medical check-up among the tribal population of the hilly areas of the Koraput district of Odisha. Materials and Methods: A retrospective study was conducted after receiving clearance from the Institutional Ethical Committee, SLN MCH, Koraput. The study was conducted from February 2022 in some hilly villages near Koraput, which is a typical mountainous commune with the terrain divided by many mountains. Simple random sampling was done using computer software for selecting participants (sample size: 200). The participants were contacted and our interviewer visited door-to-door for face-to-face interviews. The research team developed a structured questionnaire to use in the face-to-face interviews. The questionnaire included questions about demographic characteristics, access to medical facilities, frequency of routine medical check-ups in the past 12 months, health information sources, and distance to the nearest health facility. A series of questions regarding self-treatment practices were also asked: Whether they had purchased any medication without prescription in the past 3 months, what the symptoms were, and what kind of medicines they bought, and the reasons they bought the medicines on their own. Results: The study found that prevalence of self-medication was 92 (46%, C.I. 95%). The majority of residents had self-medication when they suffered from common cold and cough (16% of participants), fever (8%), diarrhea (6%), body pain or myalgia (8%), and allergy (2%). The most prevalent groups of drugs used were antipyretics such as paracetamol (36%), antibiotics (30%), antihistamines (14%), and analgesics such as diclofenac and nimesulide (26%). The most common reason for choosing a local practitioner or private pharmacist and health worker was the subjects’ proximity to them. Of the self-medicated population in our study, 62% procured medicines from local practitioners, chemists, or health workers residing in their villages or nearby villages. Conclusion: Rational use of drugs requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time and at the lowest cost to them and their community. Self-medication unfortunately does not follow the standard, scientific, and rational criteria. Due to self-medication quality of medicine, scientific, and rational procurement, rational prescription is always questionable.
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Follicular lymphoma is an indolent malignant tumor originating from lymph nodes and lymphoid tissues, which may affect the patients' quality of survival due to the recurrence and progression. In recent years, with the deepening understand of the molecular biology and signaling pathways, many new targeted drugs for follicular lymphoma have been discovered, such as monoclonal antibodies, checkpoint inhibitors, epigenetic regulation related targeted therapies and signaling pathway inhibitors. In this review, the new progress of immunotherapy for follicular lymphoma is summarized briefly.
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Humans , Antineoplastic Agents/pharmacology , Epigenesis, Genetic , Immunologic Factors/therapeutic use , Immunotherapy , Lymphoma, Follicular/drug therapyABSTRACT
BACKGROUND@#Cancer prevention is a crucial challenge in preventive medicine. Several studies have suggested that voluntary health check-ups and recommendations from health professionals are associated with increased participation in cancer screening. In Japan, it is recommended that individuals aged 40-74 years should undergo annual health check-ups; however, the compliance to this recommendation is approximately <50%. According to the national survey, individuals who do not undergo annual health check-ups are at a higher risk for cancer. However, to the best of our knowledge, no previous study has investigated the association between the use of health check-ups and the incidence rate of cancer. We hypothesised that not undergoing periodic health check-ups and/or less use of outpatient medical services are predictors for advanced cancer.@*METHODS@#To explore the relationship between health check-up or outpatient service utilisation and cancer incidence, this retrospective cohort study used data at two time points-baseline in 2014 and endpoint in 2017-from the National Health Insurance (NHI) claims and cancer registry. A multivariable logistic regression analysis was performed to investigate whether cancer diagnosis was associated with health check-up or outpatient service utilisation.@*RESULTS@#A total of 72,171 participants were included in the analysis. The results of the multivariable logistic regression showed that individuals who skipped health check-ups had a higher risk of cancer diagnosis (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.04-1.40). Moreover, not undergoing health check-ups increased the risk of advanced-stage cancer (OR, 1.78; 95% CI, 1.29-2.44). Furthermore, increased rate of outpatient service utilisation was negatively associated with advanced cancer diagnosis.@*CONCLUSIONS@#This is the first study reporting that not undergoing health check-ups is a predictor of cancer diagnosis and advanced cancer stage. Primary prevention strategies for NHI members who do not undergo health check-ups must be reassessed. Moreover, future research should examine secondary prevention strategies, such as health education and recommendations from health professionals to facilitate adequate utilisation of preventive health services.
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Adult , Aged , Humans , Middle Aged , Logistic Models , Neoplasms/epidemiology , Odds Ratio , Preventive Health Services , Retrospective StudiesABSTRACT
ObjectiveTo understand the state of low vision and blindness and vision parameters of the elderly in a town in the suburbs of Shanghai， and analyze the factors that affect the weakened vision of the elderly. MethodsA total of 5 243 community residents who participated in a community physical examination in Sijing Town of Songjiang District of Shanghai were selected as the subjects. Their eyesight was examined for low vision and blindness using the international standard visual acuity chart. At the same time， medical vision examinations were carried out on the subjects， including eye acuity， spherical degree， axial position， horizontal corneal curvature， vertical corneal curvature and cylinder degree. ResultsThe increase in age has an impact on the incidence of low vision and blindness in the elderly community in Sijing Town， with an increased proportion of monocular low vision （χ2=112.545， P<0.05）， binocular low vision （χ2=21.006， P<0.05） and monocular blindness （χ2=9.418， P<0.05）. P<0.05）， a significant downward trend of cylindrical power （F=20.358， P<0.05） and a significant upward trend of spherical power （F=50.274， P<0.05）， axial position （F=7.934， P<0.05） and corneal curvature vertical data （F=7.351， P<0.05）. ConclusionThe incidence of low vision and blindness among elderly community residents in Sijing Town is related to the increase of age. Systematic visual inspection is helpful for early detection and treatment of low vision and blindness among elderly residents in the community.
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In recent decades, immune checkpoint inhibitors (ICIs) have ushered in a new era in oncology treatment. Despite the remarkable efficacy of ICIs, there are still many patients who do not benefit from immunotherapy alone. Combination therapy is currently the main research direction in China and abroad. Metformin can enhance the number and function of T cells, affect macrophage polarization, promote natural killer cell activation and regulate immune checkpoint expression. A large number of preclinical and clinical studies are exploring the efficacy and safety of ICIs in combination with metformin in different tumors.
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Objective:To explore the clinical and CT imaging features of immune checkpoint inhibitor-associated pneumonia (CIP) and to improve the early diagnostic ability of CIP.Methods:From June 1, 2020 to October 31, 2021, the clinical data and chest CT images of 2 067 patients with advanced malignant tumor treated with immune checkpoint inhibitor (ICI) in the First Medical Center, Chinese PLA General Hospital were retrospectively analyzed. Patients with CIP were enrolled according to the guidelines for CIP diagnosis, and the incidence, time from the start of medication to the onset of CIP, medication cycle, imaging features, imaging patterns, CT grade and outcomes were analyzed. χ 2 test was used to compare the incidence of CIP in patients with or without basic lung disease. Results:Among 2 067 patients with malignant tumors treated with ICI, 67 patients developed CIP, the incidence of CIP was 3.2%. The incidence of CIP was significantly different between 386 patients with basic lung disease (7.00%, 27/386) and 1 681 patients without basic lung disease (2.4%, 40/1 681) (χ 2=21.32, P<0.001). The time from the start of medication to the onset of CIP was 7-367 d (median 52 days), and the duration of medication was 1-12 cycles (median 2 cycles). The imaging features of CIP presented as ground glass opacities in 54 cases (80.6%), solid nodules in 26 cases (38.8%), consolidations in 25 cases (37.3%) and irregular reticular opacities in 24 cases (35.8%). The main radiologic pattern was organizing pneumonia (OP, 34 cases, 50.7%), and followed by diffuse alveolar damage (DAD) pattern (14 cases, 20.9%). According to CT grading, there were 26 cases in low risk grade, 17 cases in moderate risk grade and 24 cases in high risk grade. Of 43 low-and medium-risk grade cases, 25 were OP pattern, accounting for 58.1%, and among 24 high-risk grade patients, 13 were DAD pattern, accounting for 54.2%. Forty-three of the 52 patients were initially untreated, of which 23 patients progressed, 17 had lesion shrinkage, and 3 had resolution, and relapsed in 8 cases after resolution or drug withdrawal. Conclusions:The imaging manifestations of CIP are mainly ground glass opacities, nodules, consolidations, and irregular reticular opacities. The radiologic patterns are mainly OP and DAD. OP is the most common pattern in low-moderate risk grade CIP and DAD is the most common pattern in high risk grade CIP. Patients with basic lung disease are more likely to get CIP.