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Objective To explore the clinical effect of clinical observation of supplemented wendan decoction combined with Western medicine in treating insomnia accompanied by anxiety and depression in phlegm-heat internal disturbance syndrome.Methods A total of 120 cases of insomnia with anxiety and depression comorbiditis with phlegm heat disturbance syndrome were randomly divided into control group and treatment group,60 cases in each group.The control group was given escitalopram oxalate tablet combined with dexzopiclonone tablet,and the observation group was given added Wendan decoction on the basis of the control group.Both groups were treated continuously for 6 weeks.Polysomnography monitoring parameters and heart rate variability were compared between the two groups during baseline period and visit 2(baseline period+3 months).Scale scores of the two groups were compared during baseline period,visit 1(baseline period+6 weeks)and visit 2.The content of heart rate variability includes:time domain analysis(standard deviation of normal interval(SDNN),square root of the square sum of the mean of the difference between adjacent normal interval(RMSSD)and frequency domain analysis(LF,HF,LF/HF).The scale scores included the Pittsburgh Sleep Quality Index(PSQI)and Insomnia Severity Index(ISI)to assess sleep status,and the Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Self-assessment Scale for Depression(PHQ-9)and Generalized Anxiety Disorder Scale(GAD-7)to assess anxiety and depression status.Results(1)Polysomnography monitoring:the wake time of observation group was significantly shorter than that of control group,the number of awakenings was significantly less than that of control group,and the percentage of N3 and REM was significantly higher than these of control group(P＜0.05).(2)Heart rate variability:RMSSD and HF values in the observation group were significantly higher than those in the control group,and LF/HF values were significantly lower than those in the control group(P＜0.05).(3)In terms of sleep:during the interview,PSQI total score,sleep quality,hypnotic drugs and daytime dysfunction in the observation group were significantly lower than those in the control group(P＜0.05);At the 3 months,the sleep quality,hypnotic drugs and daytime dysfunction in the observation group were significantly lower than those in the control group(P＜0.05).In terms of emotion:HAMA,HAMD and GAD-7 scores were significantly lower than those of control group at 6 weeks(P＜0.05);At the 3 months,HAMA and GAD-7 scores were significantly lower than those of control group(P＜0.05).Conclusion Supplemented Wendan decoction combined with western medicine can obviously optimize the sleep structure of insomnia patients with anxiety and depressionof phlegm-heat disturbance syndrome,improve sleep continuity and deepen sleep depth,and improve parasympathetic functional activities,contribute to sympathetic parasympathetic balance,can improve insomniaand depression symptoms recently,and significantly improve anxiety symptoms in the short term,with good safety.
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Objective@#We used polysomnography (PSG) monitoring and neuropsychological scales to explore the characteristics of coronavirus disease-2019 (COVID-19) patients diagnosed with post-traumatic stress disorder (PTSD) in Wuhan, two years after the onset of the COVID-19 pandemic. @*Methods@#A total of 42 patients in the Sleep Medicine Center were diagnosed with insomnia between December 2021 and May 2022; they were divided into the PTSD group (patients with PTSD diagnosed with insomnia after COVID-19 infection) and the non-PTSD group (patients with insomnia without PTSD). A healthy control group was simultaneously included. @*Results@#The PTSD group was more significant than the non-PTSD group in partial manifestations of sleep disorders, neuropsychological clinical symptoms, and partial PSG data. Patients with different COVID-19 subtypes showed significant differences in the course of disease, sleep disorders, neuropsychological clinical symptoms, relevant scale scores, and PSG data analysis. @*Conclusion@#The emotional anxiety and depression of COVID-19 patients diagnosed with PTSD two years after the COVID-19 pandemic in Wuhan are more significant, and will not be self-alleviated with the passage of time. It is necessary to continue to pay attention to the PTSD symptoms and sleep psychology of COVID-19 infected patients, and take appropriate measures. Patients with severe and critical COVID-19 have more severe sleep and mental disorders, and there is a significant correlation between the duration of the disease and the severity of mental and mental disorders and sleep disorders after recovery.
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Objective To evaluate the predictive value of serum carbohydrate antigen 50(CA50),tumor specific growth factor(TSGF),and tissue polypeptide antigen(TPA)levels for sensitivity to radiochemotherapy in patients with middle-and advanced-stage breast cancer using a nomogram model.Methods Eighty-two patients with middle-and advanced-stage breast cancer were selected as the study sub-jects.All patients received paclitaxel chemotherapy combined with radiotherapy and were divided into sensitive(n= 57)and insensitive(n= 25)groups according to the Response Evaluation Criteria in Solid Tumors.The general information of the patients,serum expression of CA50,TSGF,and TPA,and their differences before and after treatment were recorded.A nomogram model was constructed,and cali-bration curves,receiver operating characteristic(ROC)curves,and decision curves were used to evaluate the predictive power and clinical utility of the nomogram model.Results Significant differences were observed in tumor diameter,vascular invasion,TNM stage,lymph node metastasis,and degree of differentiation between the two groups(P＜0.05).Compared to those in the sensitive group,the serum expression of CA50,TSGF,and TPA after treatment was higher,and the difference in CA50,TSGF,and TPA was smaller in the insensitive group(P＜0.05).Three predictive variables were identified in the LASSO regression:differences in CA50,TSGF,and TPA.The logistic regression results showed that differences in CA50,TSGF,and TPA influenced sensitivity to radiochemotherapy in middle-and advanced-stage breast cancer(P＜0.05).A nomogram model was constructed using differences in CA50,TSGF,and TPA.Calibration,ROC,and decision curves showed the model's good predictive accuracy and clinical utility.Conclusion Serum expression of CA50,TSGF,and TPA is high in patients with middle-and advanced-stage breast cancer who are insensitive to radiochemotherapy,and differences in CA50,TSGF,and TPA affect their sensitivity to radiochemotherapy.The nomogram model had good predictive value and clinical utility.
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Objective:To compare the application effect among Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scale, Medical Outcomes Study 36-item Short Form (SF-36) scale and "Assessment for Therapeutic Efficacy on Kashin-Beck Disease" (WS/T 79-2011) standard in the evaluation of therapeutic effect of patients with Kashin-Beck disease, which could provide basis for the treatment evaluation of patients with Kashin-Beck disease.Methods:A total of 213 patients with Kashin-Beck disease in Gansu Province were investigated. WOMAC scale, SF-36 scale and standard of WS/T 79-2011 were used to analyze the quality of life of patients before and after treatment. The reliability, construct validity, content validity, discriminant validity of WOMAC and SF-36 scales were compared. Correlation between WOMAC, SF-36 scales and standard of WS/T 79-2011 were evaluated.Results:Both WOMAC and SF-36 scales had good construct validity and content validity (construct validity showed WOMAC and SF-36 scales contained 1 and 2 common factors, respectively; content validity showed WOMAC and SF-36 scales contained 3 and 8 common factors, respectively). The reliability and discriminant validity of WOMAC scale were better than those of SF-36 seale (reliability showed WOMAC reliability coefficient ≥0.934, the reliability coefficient of SF-36 scale was ranged from 0.386 to 0.999. Discriminant validity showed there were differences in 3 dimensions of the WOMAC scale before and after treatment, while there were differences in 6 out of 8 dimensions of the SF-36 scale). The correlation coefficients between WOMAC scale and standard of WS/T 79-2011 ranged from 0.175 to 0.437, the correlation coefficients between SF-36 scale and standard of WS/T 79-2011 ranged from - 0.434 to - 0.099 ( P < 0.05). Conclusion:The reliability, discriminant validity and correlation with the standard of WS/T 79-2011 of WOMAC scale are better than those of SF-36 scale in efficacy evaluation of patients with Kashin-Beck disease.
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Objective:To investigate the value of common clinical symptoms and signs of knee joint, elbow joint and lumbar spine in clinical diagnosis of endemic skeletal fluorosis.Methods:From August to October 2020, a cross-sectional survey of skeletal fluorosis was conducted in 8 administrative villages in Gaotai County and 5 administrative villages in Gaolan County, which were serious areas of drinking-water-borne endemic fluorosis in Gansu Province. Individuals aged ≥25 years old, residing for more than 1 year, and exhibiting symptoms and signs of the motor system in the affected villages were selected as the survey subjects. According to the X-ray diagnostic criteria in the "Diagnostic Standard for Endemic Skeletal Fluorosis" (WS/T 192-2021), they were divided into skeletal fluorosis group and non skeletal fluorosis group. The basic information of the two groups was collected, and orthopedic examination and digital radiography (DR) were performed. Multivariate logistic regression model was used to fit the effects of knee joint, elbow joint and lumbar spine related symptoms and signs on the diagnosis of skeletal fluorosis. Receiver operating characteristic (ROC) curve was drawn to evaluate the predictive effectiveness of the model for skeletal fluorosis, and Kappa test was used to evaluate the consistency between the model and X-ray diagnosis (the gold standard for diagnosis of skeletal fluorosis). Results:A total of 970 subjects were included in the investigation, including 501 in the skeletal fluorosis group and 469 in the non skeletal fluorosis group. Multivariate logistic regression analysis showed that elbow joint flexion and extension range of motion (ROM) decreased by ≥45° [odds ratio ( OR) = 2.73, 95% confidence interval ( CI): 2.00 - 3.72], elbow joint rotation ROM decreased by ≥30° ( OR = 3.34, 95% CI: 1.96 - 5.68), ulnar nerve injury symptoms ( OR = 3.77, 95% CI: 3.21 - 4.42), intermittent claudication ( OR = 2.72, 95% CI: 1.48 - 4.99), and positive straight leg elevation test ( OR = 1.69, 95% CI: 1.09 - 2.61) had certain impact on the diagnosis of skeletal fluorosis. The area under the ROC curve was 0.88, and the model had a good predictive ability for the diagnosis of skeletal fluorosis. After Kappa test, the Kappa value was 0.61, which suggested that the prediction of skeletal fluorosis by this model was in good agreement with X-ray diagnosis. Conclusions:Elbow joint flexion and extension limitation, elbow joint rotation limitation, ulnar nerve injury, intermittent claudication, and positive straight leg elevation test have certain diagnostic value for skeletal fluorosis. The combined diagnosis of these signs has good predictive ability for skeletal fluorosis.
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Objective:To investigate the epidemiological situation of drinking water-type endemic fluorosis in Gansu Province, and scientifically evaluate the effectiveness of water improvement and fluoride reduction projects in preventing and controlling the disease.Methods:The drinking water-type endemic fluorosis areas in Gansu Province were divided into five regions according to different ecological types: the Longzhong Loess Plateau Hilly Area in central Gansu, the Longdong Loess Plateau Gully Area in eastern Gansu, the Longnan Qinling Zhongshan Canyon Area in southern Gansu, the Gobi area of the Hexi Desert, and the Alpine Grassland Meadow Area in southern Gansu. In 2021, a survey was conducted on the basic situation, running situation of the water improvement and fluoride reduction projects, fluoride content in drinking water(fluorine ion-selective electrode), and the prevalence of dental fluorosis (Dean) among children aged 8 to 12 in all drinking water-type endemic fluorosis villages in the five regions. The pertinent assessments were executed in accordance with national guidelines such as the "Standards for Drinking Water Quality" (GB 5749-2006) and "Diagnosis of Dental Fluorosis" (WS/T 208-2011).Results:A total of 2 000 villages in drinking water-type endemic fluorosis areas were monitored, among which 1 999 villages had implemented water improvement and fluoride reduction projects, with a coverage rate of 99.95% (1 999/2 000). All water improvement and fluoride reduction projects were operating normally, with no intermittent operation or scrapping. A total of 34 616 children aged 8 to 12 were investigated for dental fluorosis. The detection rate of dental fluorosis was 4.18% (1 448/34 616), and the dental fluorosis index was 0.09. There was a statistically significant difference in the detection rate of dental fluorosis among children of different ages (χ 2 = 69.77, P < 0.001). The difference in the detection rate of dental fluorosis among children of different ecological types of areas was statistically significant (χ 2 = 775.11, P < 0.001). The dental fluorosis index of children aged 8 - 12 was significantly correlated with the historical water fluoride level ( r = 0.29, P = 0.042). The water improvement time in the Gobi area of the Hexi Desert was significantly correlated with the detection rate of dental fluorosis in local children ( r = - 0.48, P = 0.023). Conclusions:In 2021, the prevention and control of drinking water-type endemic fluorosis in all villages in Gansu Province has reached the national control standards. However, due to the different ecological characteristics and changes in water source distribution in different ecological types of areas, it is still necessary to further strengthen the monitoring of the condition of drinking water-type endemic fluorosis in all the affected villages and consolidate the existing prevention and control achievements.
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Objective:To master the epidemic trend of Kashin-Beck disease (KBD) in Gansu Province and provide a scientific basis for prevention and treatment of KBD.Methods:All children aged 7 - 12 or 16 years old were selected as the survey subjects in 37 KBD districts and counties in Gansu Province, clinical and X-ray monitoring results of KBD in children from 2004 to 2018 were collected to analyze the epidemic trend of the disease.Results:From 2004 to 2018, a total of 97 190 children were examined clinically and 94 180 X-ray films were taken in Gansu Province. Four hundred and twenty-eight clinical positive cases were detected, with a detection rate of 0.44%. There were 649 X-ray positive cases, and the detection rate was 0.69%. There were 435 metaphyseal positive cases, the detection rate was 0.46%. There were 214 positive cases of bone end, and the detection rate was 0.23%. The clinical positive rate was the highest (7.17%, 58/809) in 2004, followed by 2007 (4.60%, 51/1 109) and 2005 (4.48%, 187/4 173), and the positive rate in other years was less than 3%. The positive rate of X-ray was the highest (9.59%, 58/605) in 2004, followed by 2005 (5.10%, 213/4 173), 2008 (3.66%, 45/1 228) and 2006 (3.04%, 125/4 107), the positive rate of other years was less than 3%.Conclusions:The clinical positive rate and X-ray positive rate of KBD in children in Gansu Province are decreased rapidly and then maintain a low fluctuation. The effect of comprehensive prevention and control measures is remarkable.
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Objective:To investigate and analyze the living conditions of patients with Kaschin-Beck disease in Gansu Province, and to provide scientific basis for accurate treatment of the patients.Methods:From 2018 to 2019, case investigation, clinical examination and X-ray examination of patients with Kaschin-Beck disease were carried out in the Kaschin-Beck disease area of Gansu Province. The contents of the survey included basic information of the patients, clinical diagnosis classification, disease information, surgery and drug treatment, etc.Results:A total of 23 909 patients with Kaschin-Beck disease were diagnosed in 37 counties (districts) of 7 cities (states). The patients with grade Ⅰ, grade Ⅱ and grade Ⅲ accounted for 64.04% (15 312 cases), 26.12% (6 244 cases) and 9.84% (2 353 cases), respectively; 90.74% (21 694 cases) of the patients were over 50 years old, Han nationality was 97.15% (23 228 cases), and peasants were 99.25% (23 729 cases). The patients mainly had multiple joint thickening and deformation (89.30%, 21 350 cases) and pain (87.04%, 20 810 cases). Joint thickening and deformation and pain were more common in finger joint, knee joint and ankle joint. The thickening and deformation of the three joints accounted for 89.97% (21 512 cases), 78.18% (18 692 cases) and 63.81% (15 257 cases), respectively; pain accounted for 80.66% (19 285 cases), 78.75% (18 828 cases) and 64.50% (15 422 cases), respectively; 83.83% (20 044 cases) had joint rest pain, 82.63% (19 757 cases) had joint movement pain and 76.03% (18 177 cases) had joint morning stiffness. Surgical treatment was completed in 1.97% (470 cases). Long-term drug treatment (more than 6 months in the whole year) accounted for 47.78% (11 424 cases); the annual cost of drug treatment was mainly less than 500 yuan, accounting for 57.72% (13 800 cases).Conclusions:The quality of life of patients with Kaschin-Beck disease in Gansu Province is low. We should pay more attention to adult patients with Kaschin-beck disease and strengthen management and treatment.
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Objective:To analyze the epidemic range of tea-drinking-borne endemic fluorosis in Gansu Province and accurately grasp the information of tea-drinking-borne endemic fluorosis patients, so as to provide basis for popularizing low fluorine brick tea and carrying out patient rescue and treatment.Methods:From 2019 to 2020, 12 counties (cities) in Gansu Province with a history of drinking brick tea were selected as the survey points according to the "Investigation Plan of Endemic Fluorosis of Tea Drinking Type in China in 2019" and the relevant information in Gansu Province. A cross-sectional survey was conducted in all villages with the habit of drinking brick tea (including the investigation of the fluoride content in drinking water, tea, the fluoride intake of the population, the dental fluorosis and urinary fluoride content of children aged 8 to 12, and the skeletal fluorosis and urinary fluoride content of adults), and the survey results were analyzed.Results:The survey covered 125 townships in 12 counties (cities), with 8 625 households in 860 villages. One thousand six hundred and seventy-two drinking water samples were collected, and the fluoride content in water ranged from 0.01 to 1.81 mg/L. Six villages with fluoride content > 1.0 mg/L were screened. A total of 3 664 tea samples were collected, the average fluorine content of brick tea was 481.33 mg/kg, and the fluorine content ranged from 31.88 to 1 643.40 mg/kg. There were 1 076 tea samples with fluorine content less than 300 mg/kg, and the qualified rate of fluorine content in brick tea was 29.37% (1 076/3 664). Among the 12 counties (cities), 92 townships and 496 villages were still drinking brick tea. The drinking rate of brick tea in villages was 57.67% (496/860), and the annual per capita consumption of brick tea was 1.21 kg. The average daily intake of tea fluoride in adults was 1.57 mg/d. In Maqu County, Aksai County, Tianzhu County and Sunan County, the daily intake of tea fluoride of adults in 31 villages of 13 townships was more than 3.5 mg, involving 5 272 households and 15 272 people. Sixty-five patients with dental fluorosis were found in the above 31 villages. The detection rate of dental fluorosis was 3.50% (65/1 856), mainly in very mild and mild cases. Urine samples were collected from 326 children. The median of urinary fluoride was 1.44 mg/L. The clinical investigation of skeletal fluorosis was carried out in 2 189 adults. X-ray examination of bones and joints was performed in 123 patients with definite clinical symptoms and/or signs of skeletal fluorosis. Seven cases of skeletal fluorosis were positive, the detection rate was 0.32% (7/2 189). Urine samples were collected from 83 adults. The median of urinary fluoride was 1.83 mg/L. Two villages with moderate disease were identified as Yehuwan Village in Anyuan Town of Tianzhu County and Nannigou Village in Zhuaxixiulong Town. Four villages in the mild diseased areas were identified as Daiqian Village in Zhuaxixiulong Town, Xiding Village in Dahonggou Town, Tuta Village in Danma Township of Tianzhu County and Annanba Village in Akeqi Township of Akesai County.Conclusion:Most of the endemic areas of tea-drinking-borne endemic fluorosis in Gansu Province have been under control, but the risk of tea fluoride exposure still exists in some areas, so it is urgent to take targeted prevention and control measures.
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Objective:To comprehensively investigate the epidemic scope, geographic features and threatened population of tea drinking type endemic fluorosis in Gansu Province.Methods:From June 2019 to December 2020, according to the "2019 Investigation Plan on the Epidemic Situation of Tea Drinking Type Endemic Fluorosis" and the relevant information about the living habits of residents in cities (prefectures) in Gansu Province, 12 counties (cities) in 4 cities (prefectures) of Gannan, Wuwei, Jiuquan and Zhangye, which had the habit of drinking border-sale tea, were selected as the survey sites. The survey contents included temperature, altitude, the number of townships (towns), the number of administrative villages (residents' committees, referred to as villages), the total population under its jurisdiction, ethnic composition, production methods, drinking condition of border-sale tea, fluoride content of tea, etc. The fluoride content of tea was tested according to "The Fluoride Content of Brick Tea" (GB 19965-2005), and the evaluation of whether the fluoride content exceeded the standard (> 300 mg/kg) was carried out.Results:The annual average temperature of the survey sites ranged from 0.2 to 12.7 ℃, except for Zhouqu County, the annual average temperature of the other 11 counties (cities) was < 10 °C; the average altitude ranged from 1 200 to 4 874 m, and there were 6 counties (Maqu, Tianzhu, Subei, Sunan, Aksay and Luqu) with an altitude > 3 000 m. The total population of the 12 counties (cities) was 1 051 843, of which 492 597 (46.83%) were ethnic minorities who had the habit of drinking border-sale tea; among them, there were 474 620 Tibetans, 10 152 Yugurs, 4 660 Mongolians and 3 165 Kazaks. In 860 villages of 125 townships (towns), a survey was conducted on drinking condition of border-sale tea, and the survey rate was 79.48% (860/1 082); the drinking border-sale tea rates of villages and families were 57.67% (496/860) and 42.41% (3 658/8 625), respectively. From the perspective of production methods, the drinking border-sale tea rates of villages and families in the pastoral counties such as Aksay, Subei, Maqu, Luqu and Sunan, as well as in the semi-agricultural and semi-pastoral county of Tianzhu, were all > 95%. A total of 3 664 tea samples were tested, with an average fluoride content of 481.33 mg/kg. There were 2 588 tea samples with a fluoride content > 300 mg/kg, accounting for 70.63% (2 588/3 664).Conclusions:There are still a large number of populations who drink border-sale tea in Gansu Province, mainly distributes in the low-temperature and high-altitude pastoral counties such as Aksay, Subei, Maqu, Luqu and Sunan. The ethnic group most threatened by tea drinking type endemic fluorosis is Tibetans.
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Objective:To explore the effect of repetitive transcranial magnetic stimulation(rTMS) combined with cognitive behavioral therapy for insomnia(CBT-I)for menopausal women with insomnia.Methods:A total of 76 menopausal women with insomnia who were hospitalized from April 2020 to October 2021 were enrolled.Then they were randomly divided into observation group and control group, with 38 cases in each group.Both observation group and control group were treated with CBT-I. Meanwhile, the patients in observation group were treated with low-frequency repetitive rTMS, on the contrary, the patients in control group were treated with sham rTMS.The intervention lasted for 4 weeks.Insomnia severity index (ISI), Pittsburgh sleep quality index (PSQI) and polysomnography (PSG) were all recorded at baseline and 4 weeks after intervention, as well as adverse events. Data was analyzed by SPSS 22.0 software. Data which was normally distributed, was compared by independent t-test and paired t-test. Results:(1)The scores of ISI (16.39±4.03, 15.66±4.89) and the PSQI(14.97±2.70, 14.11±3.60) in observation group and control group at baseline were not significantly different( t=-0.716, -1.190, both P>0.05). After treatment, the ISI and PSQI scores of the observation group (10.08±3.65, 9.58±1.73)were lower than those of the control group (12.82±4.47, 12.13±2.32), and the differences were statistically significant ( t=2.926, 5.440, both P<0.05). (2) After treatment, all sleep parameters were significantly improved from baseline in observation group (all P<0.05). Sleep efficiency, wake time during sleep, and number of awakenings were significantly improved from baseline in control group(all P<0.05). Compared with control group((70.38±12.99)%, (17.39±11.75)%, (13.98±6.35)%), the observation group reported a greater statistically improvement in sleep efficiency, N3% and REM%((79.52±9.31)%, (22.80±6.05)%, (18.78±6.68)%, respectively)( t=-3.526, -2.524, -3.212, all P<0.05). Neither group had serious adverse effects. Conclusion:The rTMS combined with CBT-I can significantly improve the sleep quality in menopausal women with insomnia. With its high safety rTMS combined with CBT-I may be a recommended non-drug therapy among menopausal women with insomnia.
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Objective:To investigate the application and problems existing in the implementation of the standard of "Assessment for Therapeutic Efficacy of Kashin-Beck Disease" (WS/T 79-2011, referred to as new standard), and to provide technical basis and suggestions for further improving the standard.Methods:In 2019, a questionnaire survey was conducted and analyzed in Sichuan, Shaanxi, Qinghai and Gansu provinces and Tibet Autonomous Region on basic information, standard implementation, publicity, training and application of scoring method of joint dysfunction index of Kashin-Beck disease prevention and control technicians.Results:One hundred and thirty-four questionnaires were distributed in this survey and 132 valid questionnaires were recovered, of which 88.64% (117/132) of Kashin-Beck disease prevention and control technicians received training in the new standard and 89.39% (118/132) used the new standard; 78.03% (103/132) thought that the standard terms were clear and easy to master; 71.97% (95/132) thought it was simple, convenient and easy to operate; 49.24% (65/132) thought that the standard evaluation results were consistent with the actual improvement of patients, and 50.75% (67/132) thought that it was generally consistent; 72.73% (96/132) thought that the design was scientific, reasonable and feasible. When using the scoring method of joint dysfunction index, more than 90% of the technicians thought that the five index terms of "joint rest pain", "joint movement pain", "morning stiffness", "maximum walking distance" and "limb activity ability" were easy to understand and ask questions. When patients with Kashin-Beck disease were investigated, the constituent ratios of easy to understand the five index terms were 96.21% (127/132), 83.33% (110/132), 90.15% (119/132), 78.79%(104/132), 90.15%(119/132) and the constituent ratios of easy to answer were 95.45% (126/132), 83.33% (110/132), 89.39% (118/132), 75.00% (99/132) and 89.39% (118/132), respectively.Conclusions:The new standard terms are clear, the design is scientific and reasonable, the operation is convenient and the feasibility is strong. The evaluation results are basically consistent with the actual improvement of patients. It is suggested to add objective evaluation indexes to the scoring method of joint dysfunction index.
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Objective:To study the radiation dose rate and effective dose in ambient environment due to 125I seed implantation in the treatment of the patients suffering abdominal and pelvic tumors, so as to provide reference for occupational protection of different groups. Methods:Within 24 hours after operation, the radiation dose rate to 42 patients with abdominal and pelvic tumor with 125I seed implantation was monitored by using pocket dosimeter. The relationships between the total activity in the implanted particles and the measured dose rate, as well as between the implanted depth and the dose rate under the standard activity, were obtained by curve fitting. According to the formula, the relationship between the dose rate and the warning time was calculated. Results:The dose rates at 30 cm, 50 cm and 100 cm of vertical particle implantation site were (6.92±2.87), (4.10±1.62) and (1.30±0.48) μSv/h, respectively ( χ2=73.71, P<0.05). The dose rates on the left and right sides were (0.378±0.156) and (0.384±0.153) μSv/h at 30 cm, (0.170±0.089) and (0.17±0.086) μSv/h at 50 cm, (0.039 ±0.014) and (0.043±0.017) μSv/h at 100 cm, respectively ( χ2=76.19, 76.33, P<0.05). There was a linear relationship between the dose rate at the vertical particle implantation site and the total activity in the implanted particles, and between the dose rate and the implantation depth under the standard activity. The relationship between the warning time and the dose rate to adults in the same bed, co-workers, minors in the same bed and pregnant women were as follows: t ( d)=-106.616+ 83.779ln D( t), t ( d)=26.556+ 85.933ln D ( t), t( d)=3.088+ 85.017ln D( t). Conclusions:After 125I seed implantation, the radiation dose in the ambient environment is low, ensuring the radiation safety; and the measured dose rate decreases with the decrease in the total activity in the implanted particle and the increase in the implantation depth; at the same time, the warning time for different groups is calculated according to the measured dose rate or the total activity in the implanted particle and the depth of the implanted particle, so as to carry out individualized protection.
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Objective:To explore the effect of health education on drinking-water-borne endemic fluorosis in Gansu Province, and provide evidence for further development of health education measures.Methods:In 2011-2013, 2016 and 2017, using prospective method, 16-19 drinking-water-borne endemic fluorosis counties (cities, districts) were selected as project counties in Gansu Province each year, and 3 townships (towns) were selected in each project county. To carry out public health education activities on prevention and treatment of drinking-water-borne endemic fluorosis, school health education activities were carried out in the classes of grade 4-6 in the central primary school; 3 administrative villages were selected in each township (town) to carry out community health education activities. Before and after the health education activities, questionnaire surveys on health education of drinking-water-borne endemic fluorosis prevention knowledge were conducted among 30-50 students of grade 5 in the central primary school and 15-30 housewives lived near the schools in each township (town). Comparative analysis of the effects of health education activities was carried out.Results:The total awareness rates of prevention and treatment of drinking-water-borne endemic fluorosis in students of grade 5 and housewives were 89.55% (28 164/31 452) and 86.61% (14 976/17 292) after the intervention, respectively, which were significantly higher than those before the intervention [53.40% (16 518/30 933) and 51.88% (8 925/17 202)], and the differences were statistically significant (χ 2=1 586.16, 4 886.16, P < 0.05). Among the primary school students and housewives, the knowledge awareness rates of prevention and treatment of drinking-water-borne endemic fluorosis were increased by 36.15% and 34.73%, respectively. Conclusions:After implementation of drinking-water-borne endemic fluorosis health education intervention, the awareness rates of prevention and treatment knowledge in primary school students and housewives in Gansu Province are significantly increased. However, there are still weakness such as shortage of primary health education staff and insufficient investment in work funds, which means we can further expand the scope of health education.
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Objective:To spread the knowledge of Keshan disease prevention and control, enhance the awareness of disease prevention among the population in the diseased areas, and provide the basis for formulating scientific intervention strategies for health education of Keshan disease.Methods:From October 2017 to April 2018, 10 counties (districts) with Keshan disease were selected as project counties(districts) in Gansu Province, and 3 towns were selected in each project county (district). To carry out Keshan disease health education activities in grade 4 - 6 of each township (town) central primary school, 3 villages were selected in each township to carry out community health education activities. We carried out 6-month propaganda on knowledge of Keshan disease prevention and control among pupils and residents, distributed health education materials and held lectures. Before and after the intervention, we conducted a questionnaire survey on health education among the target population (residents under 50 and primary school students in Grade 5), evaluated the improvement level of knowledge about keshan disease, and made statistical analysis.Results:Four hundred and fifty residents were investigated pre intervention and 451 residents post intervention, the awareness rate of Keshan disease prevention and control knowledge among residents in the diseased areas increased from 45.4% (2 041/4 500) before intervention to 79.5% (3 584/4 510) after intervention (χ 2 = 1 115.9, P < 0.05). Nine hundred and forty-eight pupils were investigated before intervention and 906 pupils (primary school students in Grade 5) after intervention, the awareness rate of Keshan disease prevention and control knowledge among pupils increased from 50.8% (4 818/9 480) before intervention to 84.2% (7 631/9 060) after intervention (χ 2 = 2 343.3, P < 0.05). Conclusion:The comprehensive intervention mainly based on health education can significantly improve the awareness rate of prevention and treatment knowledge of Keshan disease among primary school students and residents, and improve their bad life style, which is of great significance to the prevention and treatment of Keshan disease.
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This study aimed to evaluate the efficacy of Chinese herbal medicine (CHM) in patients with severe/critical coronavirus disease 2019 (COVID-19). In this retrospective study, data were collected from 662 patients with severe/critical COVID-19 who were admitted to a designated hospital to treat patients with severe COVID-19 in Wuhan before March 20, 2020. All patients were divided into an exposed group (CHM users) and a control group (non-users). After propensity score matching in a 1:1 ratio, 156 CHM users were matched by propensity score to 156 non-users. No significant differences in seven baseline clinical variables were found between the two groups of patients. All-cause mortality was reported in 13 CHM users who died and 36 non-users who died. After multivariate adjustment, the mortality risk of CHM users was reduced by 82.2% (odds ratio 0.178, 95% CI 0.076-0.418; P < 0.001) compared with the non-users. Secondly, age (odds ratio 1.053, 95% CI 1.023-1.084; P < 0.001) and the proportion of severe/critical patients (odds ratio 0.063, 95% CI 0.028-0.143; P < 0.001) were the risk factors of mortality. These results show that the use of CHM may reduce the mortality of patients with severe/critical COVID-19.
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Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Edad , COVID-19/terapia , China , Medicamentos Herbarios Chinos/uso terapéutico , Medicina Tradicional China , Oportunidad Relativa , Puntaje de Propensión , Estudios Retrospectivos , Tasa de SupervivenciaRESUMEN
Objective To summarize and analyze the clinical features and diagnosis and treatment methods of patients with restless leg syndrome (RLS) mainly characterized by abdominal symptoms, and provide the basis for improving the correct diagnosis and treatment rate of RLS. MethodsThree patients, admitted to and completed routine laboratory examination (blood analysis, blood biochemistry, serum iron, serum ferritin, etc.), imaging, electroencephalogram, and electromyography in our hospital from August 2018 to April 2019, were chosen in our study. Polysomnography monitor was used to record the patient's sleep process for 12 h. Sleep and psychological status were evaluated by Pittsburgh Sleep Quality Index (PSQI), RLS Self-rating Depression Scale (IRLS), Epworth Sleeping Scale (ESS), RLS-quality of life (RLS-QoL), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD).Results General examination, physical examination of nervous system, imaging, electroencephalogram, electromyography and routine biochemical examination showed no obvious abnormalities in the three patients. Serum iron decreased in two patients. Polysomnography results indicated that the sleep efficiency of the three patients was obviously decreased, the sleep latency was prolonged, the time of awakening during sleep and the times of awakenings were increased; and the sleep structure was disordered; rapid eye movement sleep was significantly reduced. Meanwhile, all three patients had moderate and severe PLM events. Excessive sleepiness in the daytime was noted; the quality of life was affected about one month, and the severity was severe; all three patients had severe anxiety without evident depression. The condition of three patients with pramipexole hydrochloric acid after treatment were significantly improved.Conclusion s RLS subtype with abdominal symptoms as chief complaint is relatively rare in clinical practice. If patients have abdominal pain and discomfort during sleep at night and can exclude organic diseases of the digestive system, the possibility of RLS should be considered. A good therapeutic effect can be obtained by using dopa receptor agonist such as pramipexole.
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Objective To investigate the characteristics of neuropsychological factors in patients with persistent postural-perceptual dizziness(PPPD) and provide the basis for the psychosomatic comprehen-sive treatment. Methods Cartel Personality Test (16PF),Symptom Checklist 90 ( SCL-90),HAMA,HD-MD,SAS and SDS were used to evaluate personality and mental state in patients with PPPD(PPPD group,n=65) and control group(n=63). Dizziness handicap inventory(DHI) was used to evaluate the degree of ver-tigo. The correlation analysis was carried out between the DHI scores and 16-PF,SCL-90 factor scores. Re-sults (1)16PF factor scores:the factor scores of assertiveness(8. 50±1. 84),excitability (6. 59±1. 73), boldness (7. 46±1. 78),sensitivity (7. 25±1. 79),doubtfulness (6. 55±1. 74),fantasy(6. 20±1. 60),anxie-ty(7. 67±1. 61) and tension(6. 81±1. 67) in PPPD group were higher than those in the control group,and the differences were statistically significant ( all P<0. 05). The gregariousness (4. 38± 1. 65), intelligence (4. 51±1. 67),stability (3. 51±1. 75),independence (4. 39±1. 56) and self-discipline (4. 70±1. 82) fac-tor scores in PPPD group were lower than those in the control group,and the differences were statistically sig-nificant (all P<0. 05). ( 2) SCL-90 factor scores:the factor scores of somatization ( 1. 62 ± 0. 40),anxiety (1. 64±0. 56),interpersonal sensitivity ( 1. 79 ± 0. 42),terrifying ( 1. 71 ± 0. 53),total points ( 150. 77 ± 21. 60),total average score (1. 62±0. 51) in PPPD group were higher than those in control group (all P< 0. 05). There were no differences in obsessive-compulsive (1. 50±0. 55),depression (1. 45±0. 44),hostility (1. 69±0. 60),paranoia (1. 76±0. 53),somatization (1. 42±0. 49) and psychotic ( 1. 29±0. 35) between PPPD group and the control group (all P>0. 05). ( 3) The factor scores of HAMA( 9. 08±1. 77) and SAS (37. 88±2. 96)in patients with PPPD were higher than that in the control group,and the differences were statistically significant (all P<0. 05). There was no significant difference in HAMD (6. 19±2. 82) and SDS (36. 36±4. 71) scores between PPPD group and control group (all P>0. 05). (4)The DHI scores were posi-tively correlated with assertiveness,sensitivity,tension and doubtfulness factors of 16PF. The DHI scores were positively correlated with somatization,interpersonal sensitivity,anxiety and terrifying factors of SCL-90. Con-clusion Patients with persistent postural-perceptual dizziness suffer from personality changes,mental disor-ders and anxiety disorder.
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Objective@#To investigate the characteristics of neuropsychological factors in patients with persistent postural-perceptual dizziness(PPPD) and provide the basis for the psychosomatic comprehensive treatment.@*Methods@#Cartel Personality Test (16PF), Symptom Checklist 90 (SCL-90), HAMA, HDMD, SAS and SDS were used to evaluate personality and mental state in patients with PPPD(PPPD group, n=65) and control group(n=63). Dizziness handicap inventory(DHI) was used to evaluate the degree of vertigo.The correlation analysis was carried out between the DHI scores and 16-PF, SCL-90 factor scores.@*Results@#(1)16PF factor scores: the factor scores of assertiveness(8.50±1.84), excitability (6.59±1.73), boldness (7.46±1.78), sensitivity (7.25±1.79), doubtfulness (6.55±1.74), fantasy(6.20±1.60), anxiety(7.67±1.61) and tension(6.81±1.67)in PPPD group were higher than those in the control group, and the differences were statistically significant (all P<0.05). The gregariousness (4.38±1.65), intelligence (4.51±1.67), stability (3.51±1.75), independence (4.39±1.56) and self-discipline (4.70±1.82) factor scores in PPPD group were lower than those in the control group, and the differences were statistically significant (all P<0.05). (2)SCL-90 factor scores: the factor scores of somatization(1.62±0.40), anxiety (1.64±0.56), interpersonal sensitivity (1.79±0.42), terrifying(1.71±0.53), total points(150.77±21.60), total average score (1.62±0.51) in PPPD group were higher than those in control group (all P<0.05). There were no differences in obsessive-compulsive (1.50±0.55), depression (1.45±0.44), hostility (1.69±0.60), paranoia (1.76±0.53), somatization (1.42±0.49) and psychotic (1.29±0.35) between PPPD group and the control group (all P>0.05). (3)The factor scores of HAMA(9.08±1.77) and SAS(37.88±2.96)in patients with PPPD were higher than that in the control group, and the differences were statistically significant (all P<0.05). There was no significant difference in HAMD (6.19±2.82) and SDS (36.36±4.71) scores between PPPD group and control group (all P>0.05). (4)The DHI scores were positively correlated with assertiveness, sensitivity, tension and doubtfulness factors of 16PF.The DHI scores were positively correlated with somatization, interpersonal sensitivity, anxiety and terrifying factors of SCL-90.@*Conclusion@#Patients with persistent postural-perceptual dizziness suffer from personality changes, mental disorders and anxiety disorder.
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Objective To study the correlation between knee biomechanics and clinical manifestation in adults with Kaschin-Beck disease(KBD). Methods Three hundred and eighty-nine digital radiographic X-ray (DR)anteroposterior keen films of adult KBD patients diagnosed at the Center for Disease Control and Prevention of Gansu Province from Sep 2012 to Sep 2016 were taken as subjects of observation and were retrospectively reviewed. Every patient must undergo a WOMAC function evaluation for knee joint and biomechanic angle measure for the lower limbs on the DR film which included femur angle, tibial angle, femur-tibial angle and joint space angle, Insall-Salvati index (LT/LP), and LT/HI index. Then, the regression equation was built and the correlation analysis was made with multiple linear regression test. Results Three hundred and eighty-nine patients' average scores of femur angle(X1),tibial angle(X2),joint space angle(X3),femur-tibial angle(X4),LT/LP index(X5),LT/HI index (X6) and WOMAC evaluation were (76.32 ± 2.05)°, (110.65 ± 4.68)°, (4.73 ± 0.91)°, (137.56 ± 2.29)°, 0.98 ± 0.12, 1.73 ± 0.11, and (61.35 ± 7.68) scores. By multiple linear regression test, femur angle, tibial angle, femur-tibial angle,LT/LP index, and LT/HI index were selected to enter into the equation; while, joint space angle was rejected. The multiple linear regression equation was as follows: Y = - 77.307 - 6.327X6+ 1.360X1+ 1.310X5+ 0.331X4-0.147X2.The adjusted determination coefficient (R2) of the equation was 0.958. Through variance analysis, the fitted equation had statistical significance (F = 1 790.391, P < 0.05). Through two- tailed significance test, the above-mentioned 5 indexes that were adopted to enter this question were in significant correlation with WOMAC scores(P<0.05).Conclusion There is a significant correlation between knee biomechanic angle and WOMAC scoring in adults with KBD,which is reflected with the following parameters from big to small in turn:femur angle,tibial angle, LT/LP index,femur-tibial angle,LT/HI index,.