Experimental study on pharmacodynamics of Su Bei Zhi Ke granules (SBZKG) for acute tracheobronchitis / 中国临床药理学与治疗学

AIM: To observe the effect of Su Bei Zhi Ke granules (SBZKG) on acute tracheobronchitis (Syndrome of Wind-cold Attacking Lung). METHODS: Mouse ear swelling experiment and mouse abdominal capillary permeability experiment was used to observe its anti-inflammatory effect. Cough test in mice induced by ammonia water, and phlegm test in rats were used to observe the expectorant and antitussive effects of phenol red test in mice. We used the mortality rate experiment of infected mice to observe its antibacterial and antiviral effects. RESULTS: Compared with the contral group, the large and medium dose groups of SBZKG both reduced mouse auricle swelling (P<0.05) and increased swelling inhibition rate, reducing mouse abdominal capillary permeability (P<0.05, P<0.01). SBZKG can increase the phenol red sputum output in the respiratory tract of mice (P<0.01), prolong the cough incubation period of mice, reduce the number of coughs in mice (P<0.05, P<0.01), and increase the sputum output in rats (P<0.05, P<0.01). SBZKG can reduce the mortality rate of mice infected with bacteria and viruses. CONCLUSION: SBZKG has certain anti-inflammatory, antitussive, expectorant, antibacterial and antiviral effects, and has certain therapeutic effects on acute tracheobronchitis.

Trastornos respiratorios del sueño en Insuficiencia Cardíaca con fracción de eyección reducida

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Introduction: Sleep-disordered breathing (SDB) are highly prevalent in patients with heart failure (HF). The presence of obstructive sleep apnea syndrome (OSA) determines a worse prognosis in these patients. There are questionnaires aimed at evaluating the probability of OSA, although none have been validated in patients with HF. The primary objective of this study was to establish the prevalence of SDB in a cohort of patients with HF and reduced ejection fraction (HFrEF) from the Multidisciplinary HF Unit (UMIC). As a secondary objective, to evaluate the usefulness of the Stop-Bang, Berlin, and 2ABN3M questionnaires for TRS screening in these patients. Methodology: Cross-sectional, observational study, including the active cohort of the UMIC, over 18 years with HFrEF, clinically stable and informed consent. Patients with cognitive, neurological or hearing impairment with limitations when conducting the interview were excluded. Patients with other limiting or uncontrolled sleep disorders, continuous home oxygen therapy requirements, did not enter the study. Berlin, Stop-Bang, and 2ABN3M questionnaires were administered, classifying the population into high-risk, intermediate-risk, and low-risk groups of presenting SDB. All patients underwent outpatient respiratory polygraphy (RP). Descriptive statistics were used to characterize demographic variables, measures of central tendency and dispersion. SPSS statistical software was used. Results: 387 patients were included, 248 men (64.1%), mean age was 63.5 ± 0.6 years. The etiology of HF was ischemic in 41.6% of patients. The body mass index was 29.3 ± 0.3 kg/m2. LVEF was 34.2 ± 0.5, pro-BNP 1233.8 ± 137.6 pg/ml. The results of the questionnaires showed that 52.1% (198) presented a high risk of SDB according to the Berlin questionnaire. With Stop-Bang, 35.9% (139) were high risk, 42.1% (163) intermediate risk, and the remaining 22% (85) low risk. With the 2ABN3M score, 62% (240) were high risk. A total of 156 respiratory polygraphs (40.3% of the population) were performed. The cut-off point to define the presence of sleep apnea was considered to be an AHI >15. 58.3% (91) of the patients presented TRS. Of these, 95% presented obstructive apnea and 5% central apnea with periodic Cheyne-Stokes breathing. A high percentage (26%) presented AHI greater than 30. The sensitivity of the Berlin and Stop-Bang questionnaires was 75.8% and 91.2%, respectively, with a specificity of 53.8% and 24.6%. Regarding the 2ABN3M score, a sensitivity of 71.4% and a specificity of 44.6% were observed. Conclusions: The prevalence of sleep-disordered breathing in patients with HFrEF was high in our cohort and obstructive apnea predominated. Given the high sensitivity (91.2%) of the Stop-Bang questionnaire found in our study, it could be useful as a screening tool for TRS in this type of patient. The importance of investigating this pathology whose clinical presentation can be non-specific and remain underdiagnosed is highlighted.

Introdução: Os distúrbios respiratórios do sono (DRS) são altamente prevalentes em pacientes com insuficiência cardíaca (IC). A presença da síndrome da apneia obstrutiva do sono (SAOS) determina pior prognóstico nesses pacientes. Existem questionários destinados a avaliar a probabilidade de AOS, porém nenhum foi validado em pacientes com IC. O objetivo primário deste estudo foi estabelecer a prevalência de DRS em uma coorte de pacientes com IC e fração de ejeção reduzida (ICFEr) da Unidade Multidisciplinar de IC (UMIC). Como objetivo secundário, avaliar a utilidade dos questionários Stop-Bang, Berlin e 2ABN3M para triagem de SRT nesses pacientes. Metodologia: Estudo transversal, observacional, inclui a coorte ativa da UMIC, maiores de 18 anos com ICFEr, clinicamente estável e consentimento informado. Foram excluídos pacientes com deficiência cognitiva, neurológica ou auditiva com limitações na realização da entrevista. Pacientes com outros distúrbios do sono limitantes ou descontrolados, requisitos de oxigenoterapia domiciliar contínua, não entraram no estudo. Os questionários Berlin, Stop-Bang e 2ABN3M foram aplicados, classificando a população em grupos de alto risco, risco intermediário e baixo risco de apresentar DRS. Todos os pacientes foram submetidos à poligrafia respiratória (PR) ambulatorial. A estatística descritiva foi utilizada para caracterizar as variáveis ​​demográficas, medidas de tendência central e dispersão. Foi utilizado o software estatístico SPSS. Resultados: foram incluídos 387 pacientes, 248 homens (64,1%), com idade média de 63,5 ± 0,6 anos. A etiologia da IC foi isquêmica em 41,6% dos pacientes. O índice de massa corporal foi de 29,3 ± 0,3 kg/m2. FEVE foi de 34,2 ± 0,5, pro-BNP 1233,8 ± 137,6 pg/ml. Os resultados dos questionários mostraram que 52,1% (198) apresentaram alto risco de DRS de acordo com o questionário de Berlim. Com Stop-Bang, 35,9% (139) eram de alto risco, 42,1% (163) de risco intermediário e os restantes 22% (85) de baixo risco. Com a pontuação 2ABN3M, 62% (240) eram de alto risco. Foram realizados 156 polígrafos respiratórios (40,3% da população). O ponto de corte para definir a presença de apneia do sono foi considerado um IAH >15. 58,3% (91) dos pacientes apresentaram SRT. Destes, 95% apresentavam apnéia obstrutiva e 5% apnéia central com respiração Cheyne-Stokes periódica. Uma alta porcentagem (26%) apresentou IAH maior que 30. A sensibilidade dos questionários Berlin e Stop-Bang foi de 75,8% e 91,2%, respectivamente, com especificidade de 53,8% e 24,6%. Em relação ao escore 2ABN3M, observou-se sensibilidade de 71,4% e especificidade de 44,6%. Conclusões: A prevalência de distúrbios respiratórios do sono em pacientes com ICFEr foi alta em nossa coorte, com predominância de apneias obstrutivas. Dada a alta sensibilidade (91,2%) do questionário Stop-Bang encontrado em nosso estudo, ele pode ser útil como uma ferramenta de triagem para ERT nesse tipo de paciente. Ressalta-se a importância da investigação dessa patologia cuja apresentação clínica pode ser inespecífica e permanecer subdiagnosticada.

Application of capsulorhexis-chop forceps assisted prechop technique in hard cataract phacoemulsification / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the advantages of capsulorhexis-chop forceps assisted prechop(CCFP)technique in hard cataract phacoemulsification.METHODS: Prospective study. A total of 100 cases(100 eyes)with age-related grade IV hard cataract were included and randomly divided into 2 groups according to random number table, with 50 patients(50 eyes)in CCFP technique group(group A)and 50 cases(50 eyes)in stop-and-chop technique group(group B). The corneal endothelial cell count before and after operation, intraoperative US time, postoperative corneal endothelial cell loss rate, corneal edema grade at 1 and 7d and best corrected visual acuity(BCVA)were compared and statistically analyzed.RESULTS: The mean US time of group A was lower than that of group B [26.66(16, 40)s vs. 36.12(23, 46)s; Z=-5.56, P&#x003C;0.01]. The mean corneal endothelial cell count in group A was higher than that in group B at 3mo after operation(2308.12±368.18cell/mm2 vs. 2104.06±379.87cell/mm2; t=2.728, P=0.008), and the loss rate of corneal endothelial cells in group A was lower than that in group B at 3mo after operation [10%(8%, 12%)vs. 17%(14%, 20%); Z=13.231, P&#x003C;0.01]. The number of eyes with corneal edema of grade 0, 1, 2, 3 and 4 on 1d after surgery was 0, 23, 21, 6 and 0 in group A, respectively, while it was 0, 9, 26, 15 and 0 respectively in group B. Corneal edema in group A was less than that in group B(Z=10.514, P=0.005). The BCVA of group A was better than that of group B at 1d after operation, and there was significant difference in the number of eyes with different BCVA grades between the two groups(Z=7.176, P=0.029). There was no significant difference in the number of eyes with different grades of BCVA between the two groups at 3mo after surgery(Z=2.377, P=0.372).CONCLUSION: Compared with the stop-and-chop technique, CCFP technique uses less ultrasonic energy, has less damage to corneal endothelial cells and is suitable for hard cataract surgery.

Effects of different hemostasis methods in laparoscopic ovarian cyst surgery on postoperative pain and sex hormone levels / 中华内分泌外科杂志

Objective:To study the effect of different hemostasis methods on postoperative pain and sex hormone levels in patients undergoing laparoscopic ovarian cystectomy.Methods:A total of 118 patients with ovarian cysts admitted to our hospital from Jun. 2018.6 to Aug. 2020 were collected and grouped by digital table method into electrocoagulation hemostasis group (59 cases, electrocoagulation hemostasis) and suture hemostasis group (59 cases, suture hemostasis). Pain at time points, serum inflammatory factors and sex hormone levels in the two groups were measured, and the incidence of complications was counted 12 weeks after surgery.Results:The VAS scores of suture hemostasis group at 6, 12 and 24 h after operation (3.33±0.93, 3.63±1.02, 3.01±0.94) were significantly lower than those of the electrocoagulation hemostasis group (4.16±1.05, 4.61±1.17, 3.72±1.05) ; there was no significant difference in serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels between the preoperative suture hemostasis group and the electrocoagulation hemostasis group. The serum levels of IL-6 and TNF-α in the group (37.64±4.82ng/L, 39.67±4.71ng/L) were lower than those in the electrocoagulation hemostasis group (45.96±5.25ng/L, 48.96±5.14ng/L) ( P<0.05) .) ; there was no significant difference in serum follicle-stimulating hormone (FSH), estradiol (E 2) or luteinizing hormone (LH) levels between preoperative electrocoagulation hemostasis group and suture hemostasis group ( P>0.05) ; There was no significant difference in the three indexes in the suture hemostasis group 3 months after operation compared with those before treatment ( P>0.05). The serum FSH and LH [ (6.59±0.91) mIU/ml, (5.24±0.77) mIU/ml] in the suture hemostasis group were lower than those in the electrocoagulation hemostasis group [ (7.39±1.02) mIU/m, (5.97±0.89) mIU/m], E 2 in suture hemostasis group [ (51.08±6.09) pg/ml] was higher than that in electrocoagulation hemostasis group [ (46.88±5.59) pg/ml] ( P<0.05). In terms of the complication rate at 3 months after operation, the suture hemostasis group (32.20%) was significantly lower than electrocoagulation hemostasis (13.56%) ( P<0.05). After 1 year of follow-up, the pregnancy success rate of the suture hemostasis group (72.88%) was significantly higher than that of the electrocoagulation hemostasis group (52.54%) ( P<0.05). There was no significant difference in pregnancy outcomes ( P>0.05) . Conclusions:Suture hemostasis in patients undergoing laparoscopic ovarian cystectomy is beneficial to relieve postoperative pain, improve postoperative inflammatory response, protect their ovarian function, avoid complications such as abnormal ovulation and excessive menstrual flow, and improve the success rate of pregnancy. The overall application effect is better than electrocoagulation hemostasis.

Near-infrared spectroscopy-based study of the effects of gaming addiction disorders on brain cognitive control functions / 国际生物医学工程杂志

Objective:To explore the effects of game addiction disorders on brain cognitive control functions based on near-infrared spectroscopy.Methods:Thirteen subjects were screened according to the Online Game Addiction (OGA) Scale. The experimental paradigm was the stop-signal task. The relative concentration levels of oxyhemoglobin (HbO 2) and deoxyhemoglobin (Hb) in the prefrontal region of the brain during cognitive activity were collected using near-infrared spectroscopy to assess the cognitive control function of the subjects. Results:The game-addicted patients had lower keystroke accuracy in the stop-signal task than healthy subjects, and the difference was statistically significant ( P<0.05). Compared to healthy subjects, game-addicted patients had less activation in prefrontal areas and showed uncontrolled behavior and brain activity. Conclusions:Game addiction disorders impair brain cognitive control, which in turn triggers a weakening of cognitive control. The results of this study provide a reference for the prevention and treatment of game addiction.

Establishment and evaluation of a risk prediction model for severe obstructive sleep apnea / 西安交通大学学报(医学版)

【Objective】 To construct a prediction model of severe obstructive sleep apnea (OSA) risk in the general population by using nomogram in order to explore the independent risk factors of severe OSA and guide the early diagnosis and treatment. 【Methods】 We retrospectively enrolled patients who had been diagnosed by polysomnography and divided them into training and validation sets at the ratio of 7∶3. Patients were divided into severe OSA group and non-severe OSA group according to apnea hypopnea index (AHI)>30. Variables entering the model were identified by least absolute shrinkage and selection operator regression model (Lasso), and logistic regression (LR) method. Then, multivariable logistic regression analysis was used to establish the nomogram, and the area under the receiver operating characteristic curve (AUC) was used to evaluate the discriminative properties of the nomogram model. Finally, we conducted decision curve analysis (DCA) of nomogram model, STOP-Bang questionnaire and Berlin questionnaire to assess clinical utility. 【Results】 Through single factor and multiple factor logistic regression analyses, the independent risk factors for severe OSA were screened out, including moderate and severe sleepiness, family history of hypertension, history of smoking, drinking, snoring, history of suffocation, sedentary lifestyle, male, age, body mass index (BMI), waist and neck circumference. Lasso logistic regression identified smoke, suffocation time, snoring time, waistline, Epworth sleepiness scale (ESS) and BMI as predictive factors for inclusion in the nomogram. The AUC of the model was 0.795 [95% confidence interval (CI): 0.769-0.820] . Hosmer-Lemeshow test indicated that the model was well calibrated (χ2=3.942, P=0.862). The DCA results on the visual basis confirmed that the nomogram had superior overall net benefits within a wide, practical threshold probability range which displayed the nomogram was higher than that of STOP-Bang questionnaire and Berlin questionnaire, which is clinically useful. The Clinical Impact Curve (CIC) analysis showed the clinical effectiveness of the prediction model when the threshold probability was greater than 82% of the predicted score probability value. The prediction model determined that the high-risk population with severe OSA was highly matched with the actual population with severe OSA, which confirmed the high clinical effectiveness of the prediction model. 【Conclusion】 The model performed better than STOP-Bang questionnaire and Berlin questionnaire in predicting severe OSA and can be applied to screening. And it can be helpful to the early diagnosis and treatment of OSA in order to reduce social burden.

Efeito dos padrões alimentares no tratamento e prevenção da hipertensão arterial: uma atualização / Effect of dietary patterns on the treatment and prevention of high blood pressure: an update

A hipertensão arterial (HA) é uma condição clínica caracterizada por elevação sustentada dos níveis pressóricos maior ou igual a 140 e/ou 90 mmHg. As diretrizes atuais têm apontado cada vez mais estudos que verificam a influência dos diferentes padrões alimentares e seus efeitos benéficos no controle da HA, como: Dietary Approach to Stop Hypertension (DASH) que preconiza o consumo de frutas, hortaliças, fibras, minerais e laticínios com baixos teores de gordura; DASH-Sodium a qual combina três níveis diferentes de ingestão de sódio; Dieta Mediterrânea (MedDiet) caracterizada pela ingestão reduzida de carne vermelha e processada, ovos, doces e bebidas açucaradas, somada ao consumo moderado de peixes, vinho tinto e laticínios com baixo teor de gordura e alta ingestão de azeite de oliva; Plant based cujo escopo é consumir principalmente proteínas de origem vegetal, com um padrão alimentar rico em fibras, que inclua cereais integrais, frutas, legumes, leguminosas e nozes, com uma ingestão regular de peixes e frutos do mar, laticínios com baixo teor de gordura. Todas essas intervenções mostraram benefícios nos níveis pressóricos, porém a DASH é o padrão alimentar mais frequentemente recomendado e com maior nível de evidência para a prevenção primária e o controle da HA (AU).

Arterial hypertension (AH) is a clinical condition characterized by a sustained increase in blood pressure levels higher than or equal to 140 and or 90 mmHg. Present guidelines have increasingly pointed to studies that show the influence of different dietary patterns and their beneficial effects on the control of AH, just as: Dietary Approach to Stop Hypertension (DASH), which advocates the consumption of fruits, vegetables, fiber, minerals and dairy products low in fat; DASH-Sodium which associate three different levels of sodium intake; Mediterranean Diet (MedDiet) characterized by reduced intake of red and processed meat, eggs, sweets, and sugary drinks, besides, moderate consumption of fish, red wine and low-fat dairy products and high intake of olive oil; Plant-based whose scope is to consume mainly plant-based proteins, with a dietary pattern rich in fiber, which includes whole grains, fruits, vegetables, legumes, and nuts, with a regular intake of fish and seafood, low-fat dairy products. All these interventions showed benefits in blood pressure levels, however DASH is the most frequently recommended dietary pattern with the highest level of evidence for primary prevention and AH control (AU).

Obstructive sleep apnea in surgical patients and its relationship with difficult intubation: two years of experience from a single center

Abstract Background and objectives: In this study, we aimed to determine the risk of obstructive sleep apnea (OSA) in patients undergoing elective surgery and its relationship with difficult intubation (DI). Methods: This prospective, descriptive, cross-sectional study was conducted between December 2018 and February 2020 in the anesthesiology and reanimation service of a training and research hospital. The study included patients who were ASA I-II, 18 years of age, and older who underwent elective surgery under general anesthesia. A form regarding the baseline characteristics of the participants as well as STOP-Bang score, Mallampati, and Cormack-Lehane classification was used to collect the data. Results: The study included 307 patients. It was determined that 64.2% of patients had a high risk of OSA. The presence of DI (determined by repeated attempts at intubation) was 28.6% in the high-risk OSA group, while there was no DI in the low-risk OSA group. A statistically significant difference was found between the groups in terms of OSA risk according to the presence of DI according to repeated attempts, Cormack-Lehane classification, and Mallampati classification (p < 0.001). Conclusion: Due to the high rate of DI in patients with a high risk of OSA, the security of the airway in these patients is endangered. Early clinical recognition of OSA can help in designing a safer care plan.

Exploration of Centralized Purchasing Management Platform for Research Reagent Supplies Based on One-stop Service / 中国医疗器械杂志

OBJECTIVE@#The national requirements for the fund management of scientific research projects are becoming more stringent, so that it is convenient to carry out scientific research work and can strengthen the regulation of scientific research reagent procurement, so this study explores the standardization of the whole process of the procurement of scientific research reagent supplies in hospitals and new modes of management.@*METHODS@#By exploring the implementation of the centralized procurement management platform, we engage in full process supervision before, during, and after the event.@*RESULTS@#Introduction of centralized procurement management platform for scientific research reagent supplies can normalize the procurement process, ensure the quality of procurement and improve the procurement efficiency on the basis of ensuring the quality of scientific research.@*CONCLUSIONS@#The new model of centralized procurement of full process management based on one-stop service for scientific research reagent supplies is an important part of improving the fine scale management of public hospitals, and it is of great significance in improving the level of scientific research in China and avoiding scientific research corruption.

Evaluación de riesgo de apnea obstructiva del sueño y de la adherencia al tratamiento farmacológico en pacientes con hipertensión arterial / Risk assessment of obstructive sleep apnea and adherence to pharmacological treatment in patients with arterial hypertension

Introducción:existe una sospecha sobre la relación bidireccional entre la apnea obstructiva del sueño (AOS) y la hipertensión arterial (HTA). Ambas ejercen una acción sinérgica sobre desenlaces cardiovasculares porlo quees trascendente ponderar la prevalencia de riesgo para AOS en los hipertensos. En este último grupo también hemos investigado la tasa de adherencia a los fármacos prescritos. Metodología:mediante un estudio de casos y controles y con la aplicación del cuestionario STOP-BANG se han discriminado las categorías de riesgo para apnea de sueño en las dos cohortes. Para el análisis de la adherencia a fármacos antihipertensivos se utilizó el cuestionario abreviado de Morisky. Resultados:se incluyeron a 590 individuos (295 casos y 295 controles. Se observó alto riesgo para AOS en el grupo de hipertensos (36,6%) comparado con el 14,2% del grupo control. Por otro lado, el sexo masculino OR 7,77 (IC95% 4,33-13,84), la obesidad OR 5,03 (IC95% 3,11-8,13) y la HTA OR 4,31 (IC95% 2,64-7,03) se ponderan significativos en un modelo de ajuste logístico aquí estudiado. El 61,69% de los hipertensos refería adherencia al tratamiento farmacológico prescrito. Discusión:el tamizaje de AOS es factible con un cuestionario aplicable en la práctica clínica diaria. De la probabilidad clínica pre-test hay que partir hacia métodos diagnósticos específicos para el diagnóstico de AOS, enfatizando casos de HTA resistente, HTA nocturna y HTA enmascarada. Se deberían realizar estudios locales que nos ayuden a comprender las causas de la falta de adherencia a fármacos antihipertensivos en una fracción importante de los individuos con HTA

Introduction:there is a suspicion about the bidirectional relationship between obstructive sleep apnea (OSA) and arterial hypertension (AHT). Both have a synergistic action on cardiovascular outcomes, so it is important to assess the prevalence of risk for OSA in hypertensive patients. In this last group we have also investigated the rate of adherence to prescribed drugs.Metodology:through a case-control study and with the application of the STOP-BANG questionnaire, the risk categories for sleep apnea in the two cohorts have been discriminated. For the analysis of adherence to antihypertensive drugs, the abbreviated Morisky questionnaire was used. Results:590 individuals were included (295 cases and 295 controls. A high risk for OSA was observed in the hypertensive group (36.6%) compared to 14.2% in the control group. On the other hand, the male sex OR 7.77 (95%CI 4.33-13.84), obesity OR 5.03 (95%CI 3.11-8.13) and hypertensionOR4.31(95%CI 2.64-7.03) they areweighted significant in a logistic adjustment model studied here.61.69% of hypertensive patients reported adherence to the prescribed pharmacological treatment.Discussion:OSA screening is feasible with a questionnaire applicable in daily clinical practice. From the pre-test clinical probability, specific diagnostic methods for the diagnosis of OSA must be started, emphasizing cases of resistant AHT, nocturnal AHT, andmasked AHT. Local studies should be carried out to help us understand the causes of non-adherence to antihypertensive drugs in a significant fraction of individuals with AHT

Uso de psicofármacos y riesgo de apnea del sueño en pacientes internados en hospital general / Psychotropic drugs and obstructive sleep apnea risk use in hospitalized medical patients

RESUMEN: Se realizó un estudio descriptivo observacional, de corte transversal, con el objetivo de identificar la asociación del consumo de psicofármacos y el aumento del riesgo de padecer apnea obstructiva del sueño (A.O.S.), en pacientes internados y bajo tratamiento con psicofármacos en Hospital General (Hospital Pasteur, Montevideo, Uruguay) durante julio-septiembre de 2019. Se aplicó el cuestionario STOP BANG, hallándose riesgo elevado de A.O.S en el 59,4% de la muestra, del cual 75,6% corresponde al sexo masculino y el 24,4% corresponde al sexo femenino. El riesgo elevado para A.O.S fue: 54,3% para pacientes en tratamiento con un solo psicofármaco y 71,4% con dos. El grupo de antipsicóticos fue el que se asoció con mayor frecuencia al riesgo elevado de A.O.S.

SUMMARY A cross-sectional study was conducted with the objective of identifying the link between psychotropic medications and an increased risk of suffering from obstructive sleep apnea (OSA) in patients under treatment with psychotropic medication who were hospitalized in General Hospital (Hospital Pasteur, Montevideo, Uruguay) during the July-September 2019 period. The STOP BANG questionnaire was applied, elevated risk of OSA was found in 59.4% of the sample, of which 75.6% were male, while 24.4% were female. The elevated risk of OSA was: 54.4% for patients under treatment with a single psychotropic medication and 71.4% for patients under treatment with two psychotropic medications. Antipsychotics were the most frequently group of psychotropic drugs linked to an elevated OSA risk.

To assess the risk of obstructive sleep apnea in type 2 diabetes mellitus patients in a tertiary care center in Eastern India

Background: Obstructive sleep apnea (OSA) and type 2 diabetes mellitus have a major health impact because of their high prevalence worldwide. Obesity is a common risk factor for both OSA and type 2 diabetes mellitus in middle-aged persons. Aim: This study was conducted to assess the risk of OSA in type 2 diabetes mellitus patients. Materials and Methods: A cross-sectional study was performed at the tertiary care center of Veer Surendra Sai Institute of Medical Sciences and Research, Burla, Odisha, India. Type 2 diabetic patients were evaluated to assess the risk of OSA using the STOP-BANG sleep apnea questionnaire (consisting of eight questions). Results: Of the 150 type 2 diabetic patients, 53.8% had low risk, 28.6% had intermediate risk, and 17.6% had a severe risk for OSA based on questionnaires. Patients with comorbid conditions like hypertension (odds ratio 1.5) and obesity (odds ratio 1.06) have a high risk of OSA. There was a significant relationship between the type of medication and the risk of developing OSA (P < 0.05) in diabetic patients. The patients taking both insulin and oral drugs have a high-risk OSA as compared to those taking only insulin or only oral drugs. Conclusion: The prevalence of OSA is much higher in diabetics than in the general population, the risk is increasing with comorbid conditions like obesity and hypertension, patients who are receiving both oral hypoglycemic drugs and insulin. The screening of OSA among diabetic patients is necessary to identify those at high risk and manage this problem, which may remain undiagnosed in many patients.

Development and Utilization of "One-Stop Finance Service" forRelief Fund for Hemophilia Patients / 罕见病研究

The economic burden of medication for hemophilia patients is heavy. Charitable donation is a key way to supplement relief funds for the patients. In order to explore the appropriate and efficient usage of the relief funds, Nanfang Hospital was one of the earliest ones that launched the "one-stop finance service" of relief funds. The practice and experience of the service have been widely referred to and applied in other places, and achieved good results. This article reviews the practice and cases, and discusses the significance in reducing the burden of patients and in improving the efficiency of hemophilia relief.

Building capacity in reducing population dietary sodium intake in the Americas / Creación de capacidad para reducir la ingesta de sodio en los alimentos a nivel de la población en la Región de las Américas / Desenvolvimento de capacidade para a redução da ingestão alimentar de sódio pela população das Américas

ABSTRACT Objective. To present some resources developed as part of the technical support of the Pan American Health Organization (PAHO) to Member States to reduce population dietary sodium intake, and to discuss the main challenges and opportunities to accelerate action toward sodium intake reduction in the Americas. Methods. Sources of information include a mapping of salt reduction policies conducted in 2019, reports from working group meetings, interviews conducted in 2020 and 2021 in seven countries, and technical documents developed around the Updated PAHO Regional Sodium Reduction Targets. Results. These tools show that, despite progress, challenges to succeed in this agenda persist. Priority given to sodium reduction is low in most countries, with insufficient resource allocation. There is a lack of intersectoral coordinated action, and a systemic approach to food systems is commonly missing. Surveillance mechanisms of sodium intake are insufficient, and industry interference in policy processes is commonly identified, undermining policy progress and success. There are also important regional opportunities to address these challenges. These include common ground for future collaborations by updating, strengthening, and complementing these existing tools, and technical and financial support for data generation. Conclusions. PAHO is committed to continue to support countries in the process of promoting, implementing, and monitoring cost-effective sodium reduction interventions. One key policy priority in this agenda is the adoption of the Updated PAHO Regional Sodium Reduction Targets with a mandatory approach, together with the comprehensive and complementary implementation of other strategies. Strong political will and commitment of countries will be critical to translate goals into concrete achievements in the Americas.

RESUMEN Objetivo. Presentar algunos recursos elaborados como parte del apoyo técnico brindado por la Organización Panamericana de la Salud (OPS) a los Estados Miembros para reducir la ingesta de sodio en los alimentos a nivel de la población y abordar los principales desafíos y oportunidades para acelerar las medidas de reducción de la ingesta de sodio en la Región de las Américas. Métodos. Entre las fuentes de información se encontraron un mapeo de las políticas de reducción de la sal realizado en el 2019, varios informes de reuniones de grupos de trabajo, entrevistas realizadas en siete países entre el 2020 y el 2021, y documentos técnicos acerca de las metas regionales actualizadas de la OPS para la reducción del sodio. Resultados. Estas herramientas muestran que, a pesar de los avances, persisten los desafíos en el logro de esta agenda. La prioridad dada a la reducción del sodio en la mayoría de los países es baja y la asignación de recursos es insuficiente. No hay coordinación intersectorial y por lo general no se adopta un enfoque sistémico para los sistemas alimentarios. Los mecanismos de vigilancia de la ingesta de sodio son insuficientes y es común que haya interferencia de la industria en los procesos que siguen las políticas, lo que socava su progreso y éxito. Hay importantes oportunidades regionales para abordar estos desafíos, como un terreno común para futuras colaboraciones mediante la actualización, el fortalecimiento y la complementación de las herramientas existentes, y el apoyo técnico y financiero para la generación de datos. Conclusiones. La OPS mantiene su compromiso de seguir apoyando a los países en el proceso de promoción, ejecución y seguimiento de intervenciones costo-eficaces para la reducción del sodio. Una prioridad política clave en esta agenda es la adopción con carácter obligatorio de las metas regionales actualizadas de la OPS para la reducción del sodio, junto a la ejecución integral y complementaria de otras estrategias. Una fuerte voluntad política y el compromiso de los países serán fundamentales para traducir estos objetivos en logros concretos en la Región de las Américas.

RESUMO Objetivo. Apresentar alguns recursos desenvolvidos como parte do apoio técnico da Organização Pan-Americana da Saúde (OPAS) aos Estados Membros para reduzir a ingestão alimentar de sódio pela população e discutir os principais desafios e oportunidades para acelerar as ações em prol da redução da ingestão de sódio nas Américas. Métodos. As fontes de informação incluem um mapeamento das políticas de redução de sal realizado em 2019, relatórios de reuniões do grupo de trabalho, entrevistas realizadas em 2020 e 2021 em sete países e documentos técnicos relativos às Metas regionais atualizadas da OPAS para a redução do sódio. Resultados. Essas ferramentas mostram que, apesar dos progressos, os desafios para o êxito dessa agenda persistem. Na maioria dos países, a prioridade dada à redução do sódio é baixa, com alocação insuficiente de recursos. Não há ação coordenada intersetorial e, em geral, nem abordagem sistêmica dos sistemas alimentares. Os mecanismos de vigilância da ingestão de sódio são insuficientes e é comum haver interferência da indústria nos processos políticos, o que prejudica o avanço e o êxito das políticas. Há também importantes oportunidades regionais para enfrentar esses desafios, como um consenso para futuras colaborações por meio da atualização, do fortalecimento e da complementação das ferramentas existentes, além de apoio técnico e financeiro para a geração de dados. Conclusões. A OPAS está empenhada em continuar apoiando os países no processo de promoção, implementação e monitoramento de intervenções de redução do sódio com boa relação custo-benefício. Uma prioridade política decisiva nessa agenda é a adoção das Metas regionais atualizadas da OPAS para a redução do sódio, com aplicação obrigatória, associada à implementação ampla e complementar de outras estratégias. A firmeza de vontade e o compromisso político dos países será crucial para materializar os objetivos nas Américas.

Efeitos do sal de ervas sobre a pressão arterial e a excreção de sódio urinário de pessoas com hipertensão / Effects of herbal salt on blood pressure and urinary sodium excretion in people with hypertension

A presente pesquisa teve por objetivo analisar os efeitos da substituição do sal de cozinha por sal de ervas sobre os valores de pressão arterial e excreção de sódio urinário de pessoas com hipertensão arterial. Trata-se de um estudo de abordagem quantitativa e delineamento quasi-experimental, tipo "cross-over", com amostra de hipertensos cadastrados em três unidades públicas de saúde de um município do estado de Mato Grosso. A coleta de dados foi realizada no período de maio de 2020 a maio de 2022. Por meio de entrevista, foi aplicado o questionário para identificação das variáveis sociodemográficas e o "Questionário de Adesão a Medicamentos - Qualiaids" (QAM-Q). Posteriormente, foi realizada a avaliação antropométrica e a medida casual da pressão arterial. A pesquisa foi dividida em três etapas: Etapa 1 - os participantes permaneceram em uso habitual do sal de cozinha, durante sete dias; Etapa 2 - os participantes fizeram uso exclusivo de cinco gramas de sal por dia, durante 10 dias; Etapa 3 - os participantes usaram exclusivamente o sal de ervas para o preparo das refeições, durante 10 dias. Em todas as etapas, foi realizada a Monitorização Residencial da Pressão Arterial (MRPA) e a dosagem de sódio urinário. As análises descritivas foram realizadas por meio do pacote estatístico IBM Statistical Package for Social Science - SPSS®, versão 25.0. O teste ANOVA foi utilizado para comparações entre as médias pareadas. Os resultados foram expressos como valores médios, desvio padrão (dp), mínimo, máximo e mediana. Para diferença estatística foi considerado p<0,05. Participaram do estudo 24 indivíduos, com idade média de 63,2 ± 10 anos, a maioria mulheres (54,2%), que convivem com companheiro (70,8%), de cor da pele autodeclarada branca (54,2%), com média de 7,6 anos de estudo e aposentados (45,8%). Em relação às variáveis clínicas, houve predomínio de participantes com pressão arterial ótima (45,8%), na categoria sobrepeso (45,8%), com risco cardiovascular elevado segundo relação cintura-estatura (87,5%) e risco muito elevado de acordo com a medida da circunferência da cintura (54,1%); 62,5% se mostraram aderentes ao tratamento. Na comparação entre as três etapas, observou-se redução significante nos valores de Pressão Arterial Sistólica (p=0,003) e Pressão Arterial Diastólica (p=0,001), sem diferença nas variáveis consumo de sal (p=0,66) e excreção de sódio urinário (p=0,66). Ainda que o uso do sal de ervas seja uma estratégia não medicamentosa interessante e inovadora para o controle da pressão arterial, os participantes não aderiram de forma expressiva à intervenção proposta. De qualquer forma, salienta-se que a monitorização do consumo de sódio é primordial para a avaliação do uso do sal pela população, tendo em vista a implementação de medidas visando a redução da pressão arterial e a prevenção de eventos cardiovasculares

The present research aimed to analyze the effects of replacing table salt with herbal salt on blood pressure values and urinary sodium excretion in people with hypertension. This study has a quantitative approach and quasi-experimental design, "cross-over" type, with a sample of hypertensive patients registered in three public health units in a municipality in the state of Mato Grosso. Data collection was carried out from May 2020 to May 2022. Through an interview, the questionnaire to identify sociodemographic variables and the "Medication Adherence Questionnaire - Qualiaids" (QAM-Q) were applied. Subsequently, anthropometric assessment and casual blood pressure measurements were performed. The research was divided into three stages: Stage 1 - the participants kept the usual use of table salt for seven days; Stage 2 - participants made exclusive use of five grams of salt per day for ten days; Stage 3 - participants used only herbal salt to prepare meals for 10 days. Residential blood pressure monitoring and urinary sodium measurement were performed at all stages. Descriptive analyzes were performed using the IBM Statistical Package for Social Science - SPSS® program, version 25.0. The One Way test was used for comparisons between the paired mean values. Results were expressed as mean values, standard deviation (sd), minimum, maximum, and median. For statistical difference, p<0.05 was considered. Participated in the research 24 individuals, with a mean age of 63.2 ± 10 years, most of them was women (54.2%), who live with a partner (70.8%), self-declared white skin color (54.2%), with an average of 7.6 years of formal education and retired (45.8%). Regarding clinical variables, it was observed a predominance of participants with optimal blood pressure (45.8%), in the overweight category (45.8%), with high cardiovascular risk according to the waist-to-height ratio (87.5%), and very high risk according to waist circumference measurement (54.1%), 62.5% were adherent to the treatment. When comparing the three stages, there was a significant reduction in the values of systolic blood pressure (p=0.003) and diastolic blood pressure (p=0.001), with no difference in the variables salt consumption (p=0.66) and urinary sodium excretion (p=0.66). Although the use of herbal salt is an interesting and innovative non-drug strategy for blood pressure control, participants did not significantly adhere to the proposed intervention. Nevertheless, it should be noted that the monitoring of sodium consumption is essential for the evaluation of the use of salt by the population and to implement measures aimed at reducing blood pressure and preventing cardiovascular events

Autocuidado para hipertensos: desenvolvimento de um e-book como material educativo / Self-care to hipertensives: development of an e-book as an educative material

Objetivo: apresentar o desenvolvimento do material educativo intitulado "Auto-cuidado para Hipertensos: um guia para cuidar da sua saúde". Métodos: este material foi desenvolvido com base nas orientações para construção de materiais de orientação para o cuidado em saúde, teve como ponto de partida o estudo multicêntrico: "Efetividade de uma estratégia NUtricional para controle PRESSórico em pacientes com hipertensão arterial sistêmica usuários do Sistema Único de Saúde: estudo NUPRESS". Para a elaboração do material foi feito um levantamento bibliográfico. Em seguida, foi realizada a escrita dos temas abordados em forma de capítulos e, por último, foi montada a parte gráfica. Quando finalizado, o e-book foi enviado a 10 juízes que o avaliaram e validaram conforme a sua organização, estilo da escrita, aparência e apelo do material. Foram aceitas as sugestões dos juízes e realizadas as alterações. Resultados: os juízes (n=10), com média de idade de 43,7±17,6 anos e sendo 70% do sexo feminino, avaliaram em sua maioria, com concordância que o conteúdo do e-book possuía boa organização e aparência. Já os domínios de estilo de escrita e apelo foram os que apresentaram menor percentual de concordância entre os juízes, embora tenham obtido uma aprovação de 83,3% em cada dimensão. Conclusões: o e-book desenvolvido pode ser utilizado tanto por profissionais da saúde quanto por pessoas com hipertensão com o propósito de educação sobre a doença, saúde e autocuidado. O material tem linguagem objetiva e de fácil compreendimento, sem usar termos técnicos, além disso foram utilizados recursos gráficos para cativar e facilitar a leitura.

Aims: to present the development of the educational material entitled: "Autocuidado para Hipertensos: um guia para cuidar da sua saúde". Methods: this material was developed based on the guidelines for the construction of orientation materials for health care, taking as its starting point the multicenter study: "Effectiveness of a NUTRITION strategy for PRESSURE control in patients with systemic arterial hypertension users of the Unified Health System: NUPRESS study". For the elaboration of the material, a bibliographical surveywas made, then the themes were written in chapters, and finally, the graphic part was assembled. When finished, the e-book was sent to 10 judges who evaluated and validated it according to its organization, writing style, appearance, and appeal. The judges' suggestions were accepted, and the changes were made. Results: the judges (n=10), with a mean age of 43.7±17. 6 years and wich 70% were female, mostly agreed that the E-book content had good organization and appearance. The domains of writing style and appeal, on the other hand, presented the lowest percentage of agreement among the judges, although they obtained 83.3% approval in each dimension. Conclusions: the e-book developed can be used both by health professionals and people with hypertension for the purpose of education about the disease, health and self-care. The material has an objective and easy-to-understand language, without using technical terms, and graphic resources were used to captivate and facilitate reading.

"One-stop" left atrial appendage clipping combined with transcatheter aortic valve replacement for patients with atrial fibrillation and aortic valve disease / 中国胸心血管外科临床杂志

@#Objective    To summarize the experience and efficacy of "one-stop" left atrial appendage clipping (LAAC) combined with transcatheter aortic valve replacement (TAVR) for patients with atrial fibrillation (AF) and aortic valve disease. Methods     From April 2018 to March 2021, 16 patients with AF and severe aortic valve disease underwent "one-stop" LAAC and TAVR in our department. All patients had long-standing persistent AF. There were 10 males and 6 females with an average age of 77.2±6.2 years. CHA2DS2-VASc score was 4.4±0.8 points, and HAS-BLED score was 3.5±0.7 points. Results    All patients successfully underwent "one-stop" LAAC combined with TAVR. There was no death during perioperative and follow-up periods. The length of the left atrial appendage base measured during the operation was 37.8±3.5 mm. The types of atrial appendage clip were 35 mm (n=3), 40 mm (n=8) and 45 mm (n=5). The time required for clipping the left atrial appendage (from skin cutting to skin suturing) was 25.7±3.8 min. There was no stroke or bleeding of important organs during the perioperative period. The average hospital stay was 6.8±2.0 d. The follow-up time was 19.6±10.1 months, during which there was no patient of cerebral hemorrhage or cerebral infarction. During the administration of warfarin, 2 patients had subcutaneous ecchymosis and 1 patient had gingival bleeding. Conclusion    "One-stop" LAAC combined with TAVR can be safely and effectively used to treat AF and aortic valve disease patients with high risk of thromboembolism and anticoagulant bleeding. The early and middle-term curative effect is satisfactory.

Establishment and application of the one-stop multi-mode stroke rescue platform / 中华医院管理杂志

Stroke rescue features strong time sensitivity and high complexity. Minimizing the time of consumption in pre-hospital and in-hospital stroke rescue is key to improve stroke rescue efficiency and reduce the disability rate. In December 2017, a tertiary hospital launched the construction of a one-stop stroke rescue platform. This platform was centered on " multi-mode image fusion operating room" , operating as a one-stop rescue mode integrating emergency admission, imaging examination, intravenous thrombolytic therapy, mechanical thrombolytic therapy, postoperative evaluation, and so on. The seamless convergence workflow of pre-hospital, in-hospital and post-hospital could effectively optimize the physical rescue pathway. In order to ensure the efficient and orderly operation of the platform, the hospital adopted such measures as multidisciplinary integration, pre-hospital and in-hospital integration construction, and regional stroke care network. Since its operation in September 2019, the platform has treated more than 1 000 patients by December 2021. The application of the platform had effectively improved the efficiency of stroke rescue, led the development of regional stroke rescue system, and provided the reference for raising the stroke rescue capacity and management level in China.

Application of NoSAS score, STOP-BANG Questionnaire and Epworth sleepiness scale in evaluating obstructive sleep apnea risk in patients with respiratory disease / 国际生物医学工程杂志

Objective:To compare the value of NoSAS score, STOP-BANG questionnaire (SBQ) and Epworth Sleepiness Scale (ESS) in assessing the risk of obstructive sleep apnea hypopnea syndrome (OSAHS) in patients with respiratory disease (RD).Methods:The clinical data, NoSAS, SBQ and ESS scores of 190 patients who underwent overnight polysomnography (PSG) were collected. According to the receiver operating characteristic (ROC) curve, with different apnea-hypopnea index (AHI) as the judgment cutoff, the sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratio (DOR) and accuracy of the three scales were compared.Results:With AHI ≥5 times/h as the cutoff, the area under the ROC curve (AUC) of NoSAS and SBQ were 0.833 and 0.729, respectively, indicating that both have predictive value for mild OSAHS. Among them, NoSAS had a larger DOR value (16.150), indicating that NoSAS had the higher accuracy in assessing the risk of mild OSAHS. When AHI>15 times/h was used as the cutoff, the AUC value of NoSAS was 0.704, indicating that it has predictive value for moderate OSAHS. When AHI>30 times/h was used as the cutoff, the AUC value (0.706) and DOR value (6.527) of SBQ were high, indicating that it has predictive value and good accuracy for severe OSAHS. The SBQ is more sensitive than NoSAS and ESS when evaluating patients at high risk for OSAHS ( SBQ≥3). Conclusions:When evaluating the risk of mild and moderate OSAHS in RD patients, NoSAS is better than SBQ and ESS, and when evaluating severe OSAHS, SBQ is better than NoSAS and ESS. In clinical work, appropriate predictive tools should be selected according to the actual situation to assess the risk of OSAHS, so as to formulate and implement early intervention plans based on the assessment results.

Correlation between dietary approaches to stop hypertension pattern and central obesity affected by PM2.5 exposure / 环境与职业医学

Background There is a lack of evidence on whether exposure to PM2.5 and its constituents would affect the relationship between the dietary approaches to stop hypertension (DASH) and central obesity. Objective To investigate the effect of exposure to PM2.5 and its constituents on the correlation between the DASH dietary pattern and the prevalence of central obesity. Methods The data were obtained from the baseline survey of the "Xinjiang Multi-Ethnic Natural Population Cohort Construction and Health Follow-Up Study" in Urumqi. A DASH score was calculated according to intake frequency of 8 food groups, and summed from intake frequency of recommended food groups scored from 1 to 5 from low to high, and intake frequency of restricted food groups scored from 1 to 5 from high to low. A higher DASH score indicates better compliance with the DASH dietary pattern. We estimated exposure using satellite-derived PM2.5 and a chemical transport model (GEOS-Chem) for its constituents, including organic carbon (OC), black carbon (BC), sulfate (SO42−), nitrate (NO3−), ammonium (NH4+), and soil dust. Central obesity was defined by waist circumference: ≥90 cm for men or ≥85 cm for women according to Criteria of weight for adults (WS/T 428—2013). A logistic regression model was used to analyze the effects of the DASH dietary pattern as well as PM2.5 and its constituents on central obesity, and a stratified analysis was used to explore the effects of PM2.5 and its constituents on the association between the DASH dietary pattern and central obesity. Results The study included 9 565 urban residents, aged (62.30±9.42) years, with a central obesity prevalence rate of 60.75%. After adjusting for selected confounders, the DASH score Q5 group had a 17.5% lower risk of central obesity than the Q1 group (OR=0.825, 95%CI: 0.720-0.947). PM2.5 and its constituents OC, BC, SO42−, NH4+, and soil dust were positively associated with the prevalence of central obesity, but no association was observed between constituent NO3− exposure and central obesity. The stratified analysis revealed that the prevalence of central obesity was reduced in the DASH score Q5 group in participants exposed to low concentrations of PM2.5 and its constituents NO3−, NH4+, and soil dust, while the protective effect of the DASH pattern on central obesity disappeared in subjects exposed to high concentrations of PM2.5 and its constituents NO3−, NH4+, and soil dust. Conclusion Exposure to PM2.5 and its constituents NO3−, NH4+, and soil dust could attenuate the protective effect of the DASH pattern on central obesity.