The predictive value of extra pulmonary multiple factors including creatine kinase-isoenzyme MB in prognosis of patients with acute paraquat poisoning / 中华急诊医学杂志

Objective To investigate the predictive value of extra pulmonary multiple factors including creatine kinase-isoenzyme MB (CK-MB) for the prognosis of patients with acute paraquat poisoning.Methods A retrospectively analysis were conducted on 641 patients who were treated at the First Affiliated Hospital of Zhengzhou University due to oral paraquat poisoning from October 2002 to April 2017.The observation end point was that the patients died from paraquat poisoning within 3 months after admission or were still alive within 3 months after paraquat poisoning.The patients' data were retrieved,including general information,the dose of poison,urinary paraquat concentration,arterial blood gas analysis,alanine transaminase (ALT),total bilirubin (TBIL),uric acid (UA),aspartate transaminase (AST),creatine kinase (CK),CK-MB,B type natriuretic peptide (BNP),lactic dehydrogenase (LDH),high sensitivity troponin T (hsTnT),C-reaction protein (CRP) and procaicitonin (PCT).According to the patient's prognosis within 3 months,the patients were divided into a survival group and a non-survival group.The above indicators were compared between the two groups and the diagnostic value of CK-MB for acute paraquat poisoning was analyzed according to the receiver operating characteristics (ROC) curve.Collect the last arterial blood gas analysis,and laboratory test results were analyzed by binary logistic regression analysis to determine the risk factors for death in patients with acute paraquat poisoning.Results Among the 641 patients with acute paraquat poisoning,315 (49.1％) patients survived and 326 (50.9％) died.Compared with the survival group,patients in the non-survival groupthere were older,had a shorter hospital stay,and had a higher oral paraquat dose and urinary paraquat concentration;Lac,TBIL,UA,AST,CK,CK-MB,BNP,LDH,CRP and PCT were higher,while blood gas analysis index were lower in the non-survival group (P＜0.05).Binary logistic regression analysis showed that the dose of paraquat,CK-MB and AST were closely related to the prognosis of patients with acute paraquat poisoning.The optimal cut-off value of ingestion dose,the first urinary paraquat concentration on admission and CK-MB in predicting the prognosis of patients with acute paraquat poisoning were 7 g (AUC=0.918,sensitivity 80.6％,specificity 87.5％,Yoden index 0.681,P＜0.01),5.16 μg/mL (AUC=0.879,sensitivity 93.8％,specificity 70.1％,Yoden index 0.639,P＜0.01),and 18.2 U/L (AUC=0.846,sensitivity 83.9％,specificity 71.9％,Yoden index 0.558,P＜0.01),respectively.Binary logistic regression analysis of the last biochemical indicators of paraquat poisoning showed that the dose of poison,the last CK-MB,the last SCr,urinary paraquat concentration,and the last blood Na+ were closely related to the prognosis of patients with acute paraquat poisoning.Among them,the last CK-MB＞18.05 U/L often indicated poor prognosis (AUC=0.808,sensitivity 79.7％,specificity 65.8％,Yoden index 0.455,P＜0.01).Conclusions In the treatment of patients with acute paraquat poisoning,there are significant differences in extra pulmonary factors such as heart,liver,kidney,electrolytes and inflammatory markers in patients with different prognosis,so the monitoring and follow-up should be improved,in addition to focusing on the presence and treatment of pulmonary fibrosis.In particular,CK-MB is an independent risk factor for the prognosis of acute paraquat poisoning.In the late stage of poisoning,CK-MB,SCr,and blood Na+ have a strong predictive value for the prognosis of the patients,and we should pay attention to the regular follow-up of the above mentioned laboratory items.

Relationship between urinary cadmium and type 2 diabetes mellitus in adults / 中华流行病学杂志

Objective To explore the relationship between environmental factors as urinary cadmium and type 2 diabetes mellitus (DM) in adults.Methods Case-control study was adopted,including 166 cases and 427 controls.General characteristics of the subjects were collected by a structured questionnaire.FPG,biochemical indexes and urinary cadmium (UCd) were detected respectively,while UCd was corrected with creatinine.Unconditioned logistic regression model was applied to analyze the relationship between UCd and DM.Results Levels of UCd appeared higher in cases with the following characteristics as:having primary school education (P=0.016),being female (P=0.013),being non-smokers (P=0.014) or non-alcoholic (P=0.025),and with BMI＞25.00 kg/m2 (P=0.040,P=0.025) than those appeared in the control group.Same results were shown in the 60-69 years (P=0.024) old group.Data from the unconditional logistic regression analysis showed that family history of DM (OR=3.19,95％ CI:1.45-7.03),education status (OR=1.50,95％CI:1.08-2.08) and UCd (OR=1.61,95％CI:1.08-2.41) were influencing factors on DM.Conclusion A close association between UCd and DM was noticed.UCd appeared a risk factor on DM that called for setting up related prevention program to reduce the exposure of Cd and to control the risk on DM.

Relationship between urinary cadmium and type 2 diabetes mellitus in adults / 中华流行病学杂志

Objective To explore the relationship between environmental factors as urinary cadmium and type 2 diabetes mellitus (DM) in adults.Methods Case-control study was adopted,including 166 cases and 427 controls.General characteristics of the subjects were collected by a structured questionnaire.FPG,biochemical indexes and urinary cadmium (UCd) were detected respectively,while UCd was corrected with creatinine.Unconditioned logistic regression model was applied to analyze the relationship between UCd and DM.Results Levels of UCd appeared higher in cases with the following characteristics as:having primary school education (P=0.016),being female (P=0.013),being non-smokers (P=0.014) or non-alcoholic (P=0.025),and with BMI＞25.00 kg/m2 (P=0.040,P=0.025) than those appeared in the control group.Same results were shown in the 60-69 years (P=0.024) old group.Data from the unconditional logistic regression analysis showed that family history of DM (OR=3.19,95％ CI:1.45-7.03),education status (OR=1.50,95％CI:1.08-2.08) and UCd (OR=1.61,95％CI:1.08-2.41) were influencing factors on DM.Conclusion A close association between UCd and DM was noticed.UCd appeared a risk factor on DM that called for setting up related prevention program to reduce the exposure of Cd and to control the risk on DM.

Multiple factors analysis and case-control study on high-frequency ultrasound for diagnosing thyroid nodules / 国际检验医学杂志

Objective To adopt the high-frequency ultrasound to conduct the diagnostic analysis for multiple factors of thyroid nodules and the case-control study to provide the reliable method for accurately diagnosing thyroid nodules.Methods The question-naire survey was performed on the residents in a region by using the overall random sampling method.The thyroid high-frequency ultrasound examination and the urine iodine value detection were conducted;the individuals with the positive thyroid nodules by high-frequency ultrasound and the individuals without thyroid nodules lesions were divided into the two groups according to the age,gender,occupation and urban-rural matching,400 cases in each group.The two groups were performed the case-control study;the study results were performed the single factor and multiple factors Logistic regression analysis.Results The combination of the single factor and multiple factors analysis showed that the protective factors were correlated with the patient annual income,the higher the income,the lower the probability suffering from thyroid nodules,the individuals with smoking history had the higher probability suffering from thyroid nodules,the detection and analysis showed that the urinary iodine value in the individuals with low prevalence rate of thyroid nodules was generally 100-190 μg/L (P <0.05).Conclusion Conducting the single factor and mul-tiple factors comparative analysis on the patients with thyroid nodules by the high-frequency ultrasound finds that the diet habit and the use amount of iodine have a certain correlation with the occurrence rate of thyroid nodules,the urinary iodine value affects the occurrence rate of thyroid nodules.The high-frequency ultrasound plays a role in the diagnosis of thyroid nodules and can be taken as the promotion application for the diagnosis of thyroid nodules in clinic.

Analysis of the effect factors about postoperative mechanical ventilation time in 217 children with congenital heart diseases / 重庆医学

Objective To analyze the multiple factors affecting the postoperative mechanical ventilation supporting time of chil-dren with congenital heart diseases ,and to preferably master the offline period and offer intervention techniques about shortening mechanical ventilation supporting time and improving efficacy .Methods A total of 217 with congenital heart diseases in 2012 from January to October were retrospectively studied to seek the factor affecting the duration of ventilation .The factors including the age ,weight ,cardiopulmonary bypass time(CBP) ,aortic cross-clamping time(ACC) ,preoperative albumin ,preoperative pulmonary infection ,preoperative pulmonary artery pressure ,postoperative complications were analyzed by the stepwise Logistic regression . Results The ventilation supporting time was 0 .5 -312 .0 h ,average(28 .42 ± 2 .99)h .Multivariate stepwise Logistic analysis showed that the postoperative complications ,preoperative pulmonary infection and CPB were mechanical ventilation use time of the main influence factors .Conclusion Postoperative complications ,preoperative pulmonary infection and CPB are the main influencing factors of mechanical ventilation supporting time .

Compreensão dos idosos sobre os fatores que influenciam no envelhecimento saudável / The elderly comprehension about de factors that influence on a healthy aging

O objetivo deste estudo é investigar a compreensão dos idosos sobre quais fatores influenciam no Envelhecimento Saudável. O instrumento utilizado foi uma entrevista com 2 questões abertas e 21 questões fechadas. Foram entrevistados 30 idosos participantes de grupos de atividade física (90% mulheres), sendo a média de idade desses de 68,7+7,9 anos. Nas questões abertas, obtiveram-se oito elementos para os aspectos biológico e social, e sete para o aspecto psicológico, demonstrando que não houve a valorização de um único aspecto por parte dos idosos. Nas questões fechadas, a maioria dos idosos manifestou altos níveis de satisfação com a saúde geral. Deste modo, através da análise dos resultados pode-se concluir, na percepção dos idosos estudados, que para obter um Envelhecimento Saudável é necessário um equilíbrio ou uma combinação de múltiplos fatores, sejam de ordem biológica, psicológica ou social.

The aim of this study is to investigate the elderly comprehension about which factors influence on healthy aging. The instrument used was an interview based on two opened questions and twenty one closed questions. We interviewed 30 elderly physical activity groups participants (90% women), with average ages between 68,7+7,9 years old. In the opened questions, it was obtained eight elements to the biological and social aspects, and seven to the psychological aspect. It means that not only one aspect was considered by the elderly, but also many others. In the closed questions, most of the elderly demonstrated high levels of satisfaction with health in general. Therefore, through the analysis of the results, it was possible to conclude, in the perception of the studied elderly, that to get a healthy aging is necessary a balance or a combination of multiples factors related to biological, psychological or social aspects.

Related factors of tic disorders among schoolchildren in Daxing district of Beijing:a cose-control study / 中国心理卫生杂志

Objective:To understand the related factors of tic disorders(TD) and early intervention among schoolchildren.Methods:Using stratified-cluster random sampling techniques,4,020 children were selected from 61,836 schoolchildren in Daxing district of Beijing.Totally 4,020 children and their parents were asked to fill in a self-designed questionnaire covering both motor and vocal tics and general information.A three-stage procedure was used:screening,interview and clinical investigation.A total of 3,813 children were investigated successfully.The children who were reported with tic symptoms as well as those who were reported by their teachers or classmates were surveyed according to the TD criteria in Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition(DSM-Ⅳ).Eighty-six TD children were investigated respectively about the related factors of TD,and 86 healthy children matched in age,sex and grade were selected as controls.Telephone interview was carried out to find the doubtful TD cases in family members.Those people identified as having tics underwent a semistructured interview to determine whether they had TD according to DSM-Ⅳ criteria.Related risk factors of TD were investigated according to self-designed formulary medical history sheet. Results:Positive TD inheritance family history(7.0%),abdominal delivery style(36.0%),carbonate drink(10.5%),obesity(14.0%) and psychological stress were risk factors of TD(P<0.05).The multivariate analysis of variance indicated that inheritance family history,delivery style,dwelling environment,carbonate drink,parent-child relation,hobby,underachieve,self-care ability were closely related to the high incidence of TD (P<0.05).Conclusion:The occurrence of tic disorders may be related to multiple interacted factors.Early intervention is most important.

Impact of diabetes mellitus on in-hospital death of patients with acute myocardial infarction / 中华急诊医学杂志

Objective To evaluate the clinical characteristics and in-hospital mortality of acute myocardial infarction patients (AMI) with diabetes mellitus (DM) and to analyze the risk factors of in-hospital mortality of AMI. Method A total of 1023 patients with diagnosis of AMI complicated with or without DM admitted between 2000 and 2004 were analyzed to find out the clinical characteristics, in-hospital complications and mortality. Of them, 164 (16.03%) were complicated with DM. The data were analyzed by using Mann-Whitney U or chi-square test. The multivariate logistic regression analysis was used to find out the risk factors of in-hospital mortality of patient with AMI. Results In comparison with non-DM patients, the females were predominant in number over males in the DM patient cohort (42.2% vs. 28.9%, P < 0.05), the incidence of hypertension (71.7% vs. 41.6%, P < 0.01) and rate of angina (57.3% vs. 48.3%, P < 0.06). The admission time of DM patients was delayed rather than that of non-DM patients. Coronary angiography revealed that the rate of three-vessel in-volved was higher in DM patients than in non-DM patients (48.4% vs. 25.4%, P < 0.05. During hospital stay, AMI patients with DM presented mar frequently with arrhythmias, pulmonary edema (18.9% vs. 10.5%, P <0.01) and increase in in-hospital mortality (17.7% vs. 9.2%, P < 0.01) compared with non-DM patients. Di-uretics (43.9% vs. 32%, P <0.01) and digitalis (27.4% vs. 16.8%, P <0.01) were more frequently used in DM patients rather than in non-DM patients. Compared to medication, primary coronary intervention (PCI) with placement of intra-vascular stent significantly decreased the mortality of DM patients (χ~2 = 4.536, P < 0.05).Logistic regression analysis showed DM was an independent risk factor for in-hospital mortality (OR = 2.109;95% CI:1.229-3.619). Conclusions AMI patients with DM exhibit more risk factors for in-hospital complications and higher mortality than those without DM.DM is an independent risk factor for in-hospital mortality of patients with AMI.

Side-to-side Asymmetry in Trigeminal Neuralgia-Multiple Factors Theory- / Oral Science International

The right side was affected in 61% of reported cases and the left side was affected in 39% of approximately 30,000 patients with trigeminal neuralgia (TN) affected on only one side. Side-to-side asymmetry of neurovascular compression in healthy persons cannot account for side-to-side asymmetry in TN. Size asymmetry and shape asymmetry of the rotundum and ovale foramens may account for the higher incidence of TN on the right side. This paper proposes a multiple factors theory: the summation of multiple factors reaches a critical level at which TN occurs. It is rational that entrapment of the maxillary and mandibular nerves when they cross the ovale and rotundum foramens is one of the factors which cause TN. The multiple factors theory can account for a TN patient without neurovascular compression and a healthy person with neurovascular compression.

Side-to-side Asymmetry in Trigeminal Neuralgia / Oral Science International

The right side was affected in 61% of reported cases and the left side was affected in 39% of approximately 30,000 patients with trigeminal neuralgia (TN) affected on only one side. Side-to-side asymmetry of neurovascular compression in healthy persons cannot account for side-to-side asymmetry in TN. Size asymmetry and shape asymmetry of the rotundum and ovale foramens may account for the higher incidence of TN on the right side. This paper proposes a multiple factors theory: the summation of multiple factors reaches a critical level at which TN occurs. It is rational that entrapment of the maxillary and mandibular nerves when they cross the ovale and rotundum foramens is one of the factors which cause TN. The multiple factors theory can account for a TN patient without neurovascular compression and a healthy person with neurovascular compression.

Analysis on characters of serf-consistency and congruence of air force pilots and its influential factors / 中华行为医学与脑科学杂志

AIM Analyze on characters of self-consistency and congruence of air force pilots and its in-fluential factors,so as to provide a background for counseling and psychotherapy.Methords Altogether 428 air force pilots were evaluated in our sanatorium using Self Consistency and Congruence Scale,Life Events Scale,Per-ceived Social Support Scale,Social Avoidance and Distress Scale,Trait Coping Styles Questionnaire,Eysenck Per-senality Questionnaire for Adults and Symptom Checklist 90.Results Self-inconsistent and incongruent and self stiffness of air force pilots were lower than that of army force (-13.10≤t≤-2.45,P<0.05) ;but self flexibil-ity was higher (5.11≤t≤11.98,P<0.01) ;the correlation between self-inconsistent and incongruent and the neuroticism of EPQ was good (0.406≤r≤0.529,P<0.001) ;the correlation between self-inconsistent and in-congruent and all the factors of perceived social support were goed(0.212≤r≤0.377,P<0.01) ;the correlation between it and negative family events was good (r=0.445,P<0.01) ;the correlation between self-inconsistent and incongruent as well as self stiffness and negative coping style was good (r=0.595,0.434,P<0.01);also and social distress was also good(r=0.456,P<0.01);then the result of the multiple factors analysis revealed that : the first reason that affect the self-inconsistent and incongruent of air pilots was negative life events β=0.53;and the second reason was mentality ill health β=0.40.Conclusion The self-consistency and congruence of air force pilots can be improved by replying the negative life events and enhancing mentality health.

Health and environment in the context of urbanization

This paper introduces a series of research projects designed to fulfill the societal role of environmental health studies by investigating (1) the dynamic and complex relationships between environmental conditions and (2) health in an urban setting. Research in this first category has revealed the existence of the combined influence of multiple physical environmental factors on health and its mechanisms. In the second category, there have been a number of studies of the integrated influence of social environmental factors on health employing an aggregate modeling of multiple determinants of health and studies of individual topics related to social determinants of health. These research projects have contributed to the formulation of specific remedies and the development of comprehensive health policies. Participatory approaches have been used to enhance capacity building opportunities and to ensure that research results reflect the actual conditions in urban societies. Healthy Cities projects and programs have been developed in close collaboration with this type of research. Urban societies have become interdependent and share the same issues globally. Further research into the relationships between health and the environment in the context of urbanization will expand the base of evidence applicable to the complex realities in modern societies.

Health and Environment in the Context of Urbanization

This paper introduces a series of research projects designed to fulfill the societal role of environmental health studies by investigating (1) the dynamic and complex relationships between environmental conditions and (2) health in an urban setting. Research in this first category has revealed the existence of the combined influence of multiple physical environmental factors on health and its mechanisms. In the second category, there have been a number of studies of the integrated influence of social environmental factors on health employing an aggregate modeling of multiple determinants of health and studies of individual topics related to social determinants of health. These research projects have contributed to the formulation of specific remedies and the development of comprehensive health policies. Participatory approaches have been used to enhance capacity building opportunities and to ensure that research results reflect the actual conditions in urban societies. Healthy Cities projects and programs have been developed in close collaboration with this type of research. Urban societies have become interdependent and share the same issues globally. Further research into the relationships between health and the environment in the context of urbanization will expand the base of evidence applicable to the complex realities in modern societies.

Effects of Tail-suspension,Noise and Combination of Two Stresses on Immune Function of Rats / 航天医学与医学工程

Objective To investigate the effect of tail-suspension,noise stress and combination of them on immune function in rats.Methods The rats were divided into four different groups,A: control;B: noise stress(2 h);C: tail-suspension(30?,21 d);D: tail-suspension added noise stress.The body weight,thymus weight and spleen weight,circulating leukocytes and its distribution,T lymphocyte subpopulations(with flow cytometry) and NO level in serum(with Griess method) of rats were determined after exposed to 21 d tail-suspension,2 h noise stress and combination of them.Results Compared with group A,the body weight were significantly decreased(P

Multiple Factors on Fatal Outcome Following Head Injury

The causative factors were analyzed clinicostatically on 113 patients who were dead among 1591 head injured patients during recent 3 years from March, 1983. The conclusions are as follows: 1) The mortality ratio of male to female is 2.9 to 1 and especially 3rd to 5th decade is the most prevalent age group(64 cases, 56.6%). 2) The most common mode of injury is motor vehicle accident(71 cases, 62.8%), followed by fall down and struck on the head in the order of frequency. 3) The 60 cases(53.1%) are in the category of lower GCS(Glasgow Coma Scale) score( or = 8) and longer survival time.