RESUMEN
Over the past decade, remarkable progress has been made in prevention and control of endemic diseases in China through implementation of the 12th and the 13th Five-Year National Plans for Prevention and Control of Endemic Diseases and the Three-Year Action Plan for Special Prevention and Control of Endemic Diseases. Based on the latest monitoring data of endemic diseases and the evaluation results of the control and elimination of endemic diseases of the 13th Five-Year Plan, this paper analyzed current main problems in prevention and control of endemic diseases in China, focusing on implementation of prevention and control measures for iodine deficiency disorders, endemic fluorosis, and endemic arsenicosis, as well as the treatment and management of patients. Accordingly, corresponding countermeasures and suggestions are put forward from three aspects, including prevention and control mechanism, implementation of prevention and control measures, and scientific research, so as to provide scientific basis for the country and various regions to consolidate the achievements of prevention and control of endemic diseases and accurately implement the prevention and control measures of endemic diseases.
RESUMEN
Objective:To explore the pupil size distribution of the Chinese myopic population under different mesopic conditions, and to analyze the possible influencing factors.Methods:A cross-sectional study was conducted.Two hundred and fourteen myopic patients (428 eyes) who underwent refractive surgery in Tianjin Eye Hospital from December 2018 to April 2019 were randomly selected.The patients were 17 to 45 years old, with an average age of (22.62±4.88) years old.The patients were divided into astigmatism <-1.5 D group (372 eyes) and astigmatism ≥-1.5 D group (56 eyes) according to their astigmatism measurements.The low mesopic pupil size (LMPS) (0.2 lx) was measured with the infrared Colvard pupillometer, and the high mesopic pupil size (HMPS) (6-12 lx) was obtained through the anterior Pentacam segment analyzer.The pupil size was compared between both eyes, different sexes and different astigmatism measurements.The relationship between pupil size and possible influencing factors, such as age, sex, spherical equivalent, spherical diopter, cylinder diopter, axis, mean keratometry(Km), and central cornea thickness was analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Tianjin Eye Hospital (No.201912). Written informed consent was obtained from each subject or their guardians.Results:The pupil sizes measured by the Colvard pupillometer and Pentacam were (6.806±0.776)mm and (3.312±0.540)mm, respectively.The pupil size of male subjects was (6.692±0.754)mm, which was larger than (6.668±0.792)mm of females, showing a statistically significant difference ( t=2.935, P=0.004). Under the high mesopic condition, the pupil size of astigmatism ≥-1.5 D group was lower than that of astigmatism <-1.5 D group, with a statistically significant difference ( t=2.611, P=0.009). Under the low mesopic condition, pupil size was negatively correlated with age and Km ( r=-0.213, -0.210; both at P<0.001). Under the high mesopic condition, pupil size was weakly positively correlated with cylinder power ( r=0.124, P=0.010) and was weakly negatively correlated with Km ( r=-0.142, P=0.003). The multiple linear regression analysis revealed that the LMPS=0.659×HMPS-0.019×age-0.084×Km+ 8.662.About 28% of pupil size under low mesopic conditions could be predicted by Pentacam.LMPS of ≤7 mm could be better predicted when the results were below 3.6 mm. Conclusions:Age and corneal curvature are influencing factors of mesopic pupil size.Older people with steep curvature have a smaller pupil.At high mesopic conditions, astigmatism affects pupil size.Pentacam measurements can predict LMPS to some degree but are not a substitute for dark-adapted pupil diameter.
RESUMEN
Objective:To analyze the occurrence of early hypotony after the intravitreal injection of anti-vascular endothelial growth factor (VEGF) and its risk factors.Methods:A case-control study was performed.One hundred and twenty-seven eyes of 127 patients with fundus vascular disease who received intravitreal injections of anti-VEGF drugs were enrolled in Henan Provincial People's Hospital from January 2020 to January 2022.Of the 127 patients, there were 71 males and 56 females, with an average age of (61.85±11.53) years and a mean intraocular pressure of (15.28±3.71)mmHg (1 mmHg=0.133 kPa). All subjects were intravitreally injected with 0.05 ml of anti-VEGF drugs, including 56 cases receiving ranibizumab, 38 cases receiving conbercept and 33 cases receiving aflibercept.The intraocular pressure was measured with a non-contact tonometer at 30 minutes, 1 hour and 2 hours after the injection.The cases were grouped as hypotony group or non-hypotony group according to the intraocular pressure of subjects was less than 10 mmHg or not.The differences in sex, age, distribution of left eye and right eye, disease type, intraocular pressure before injection, injection frequency, lens status, drug type, injection timing, injection site, with or without high myopia, with or without a history of glaucoma or ocular hypertension, and with or without a history of vitreoretinal surgery were analyzed to investigate the factors with a P-value <0.05, which were used as the independent variable and the occurrence of hypotony as the dependent variable in logistic regression analysis to explore the risk factors for hypotony.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEEC-2022-42). Results:Hopotony occurred in 8 eyes within 2 hours after the injection.There were significant differences in intraocular pressure at different time points before and after injection between the hypotony and non-hypotony groups ( Fgroup=62.177, P<0.001; Ftime=25.128, P<0.001). The intraocular pressure of the hypotony group at 30 minutes, 1 hour and 2 hours after injection were lower than before injection, and the intraocular pressure of the non-hypotony group was higher at 30 minutes after injection than before injection (all at P<0.05). The average reduction of intraocular pressure of the hypotony group was 7.88, 7.63 and 7.23 mmHg at 30 minutes, 1 hour and 2 hours after the injection, and the intraocular pressure returned to baseline level at 1 day after injection.There was no significant difference in sex, distribution of left and right eyes, disease type, pre-injection intraocular pressure, injection frequency, lens status, drug type, injection timing, injection site, with or without a history of high myopia and with or without a history of glaucoma or ocular hypertension between the two groups.There were significant differences in age and with or without a history of vitreoretinal surgery between the two groups ( t=8.265, P<0.001; χ2=6.907, P=0.035). Multivariate logistic regression analysis showed younger patients and having a history of vitreoretinal surgery were the risk factors for early hypotony after anti-VEGF intravitreal injection (odds ratio=88.563, P<0.001; odds ratio=20.991, P=0.009). Conclusions:Patients with younger age and having a history of vitreoretinal surgery are susceptible to early hypotony after anti-VEGF intravitreal injection.
RESUMEN
OBJECTIVE To investigate the effect of ropivacaine combined with dexmedetomidine on postoperative analgesia in women undergoing cesarean section， and to explore the feasibility of the opioid-free analgesia mode after cesarean section under spinal-epidural anesthesia. METHODS Totally 80 women undergoing cesarean section were randomly divided into observation group （ropivacaine combined with dexmedetomidine for analgesia） and control group （ropivacaine combined with opioid drug sufentanil for analgesia） ， with 40 cases in each group. The exercise and rest score in visual analogue scale （VAS） within 48 hours after operation， the use of analgesia pump （the time of first analgesia pump pressing， the times of analgesia pump pressing within 24 hours and 48 hours after operation）， the time of block （the onset time of spinal anesthesia sensory block， the time to the highest level of spinal anesthesia sensory block， the time of sensory recovery and the time of movement recovery） ， the time of prognosis （the time of gastrointestinal ventilation recovery， the time of getting out of bed and the hospitalization time）， and the incidence of adverse events were compared in 2 groups. RESULTS Finally， 64 parturients （32 in the observation group and 32 in the control group） were involved in the analysis. Compared with the control group， the recovery time of sensation and movement were significantly prolonged， the ventilation time was significantly shortened， and the incidence of nausea， vomiting and abdominal distension was significantly decreased in the observation group （P＜0.05） . There was no significant difference in the other indexes between the two groups （P＞0.05）. CONCLUSIONS Ropivacaine combined with dexmedetomidine under spinal-epidural anesthesia could provide similar analgesic effect as combined with opioids drug sufentanil， shorten the time of gastrointestinal ventilation recovery， and reduce the incidence of nausea，vomiting and abdominal distension， with no increased risk of low blood pressure or urinary retention.
RESUMEN
Since the 18th National Congress of the Communist Party of China (CPC), the CPC Central Committee and the State Council have paid great attention to the prevention and control of endemic diseases. Through the implementation of the prevention and control measures of endemic diseases, especially the implementation of the "Six Major Actions" to tackle key problems in "three years' project", all kinds of diseases have met the relevant requirements. The prevention and control of endemic diseases in China has achieved remarkable results and made historic achievements. However, risk challenges remain. At present, there are still some problems in the management and treatment of patients with iodine deficiency disorders, water-borne iodine excess goiter, drinking water-borne endemic fluorosis and drinking tea-borne endemic fluorosis in China, which need to be solved by strengthening the prevention and control efforts.
RESUMEN
The standardization of endemic diseases in China has made steady progress during the "13th Five-Year Plan" period. This article mainly summarized the current endemic diseases standard system, analyzed the major problems existed in the current endemic diseases standard, and introduced the key tasks of the "14th Five-Year Plan" of the endemic diseases standard in China. During the "14th Five-Year Plan" period, the work of endemic diseases standardization will be carried out in a targeted manner in accordance with the requirements of the "Planning of Health Standardization during the ′14th Five-Year Plan′ Period" of the National Health Commission, to establish an endemic diseases standard system suitable for China's economic and social development, to help eradicate poverty and consolidate and implement the rural revitalization strategy, promote the full realization of the goal of eliminating endemic diseases in the "Healthy China Action (2019-2030)".
RESUMEN
Objective:To study the relationship and the role of leptin in children with biliary atresia and hepatic fibrosis to provide a treatment basis for these patients.Methods:The clinical data of children with biliary atresia or congenital biliary dilatation (CBD) who underwent surgical treatment at the Department of General Surgery of Tianjin Children's Hospital from August 2019 to August 2021 were retrospectively analyzed. Of 31 children included in this study, there were 14 males and 17 females, with age of 60 (30, 63) d. Children with biliary atresia served as the study group ( n=26) and children with CBD served as the control group ( n=5). Leptin protein, α-smooth muscleactin (α-SMA) and phosphorylation of extracellular-regulated protein kinase 1/2 (p-ERK1/2) in liver tissues were detectd by immunohistochemistry (IHC). The expression level of leptin mRNA in liver tissues were detected by quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). Results:The average optical density values of leptin protein, α-SMA protein and p-ERK1/2 protein in the liver tissues of children in the study group were significantly higher than the control group ( P<0.05). The expression levels of leptin, α-SMA and p-ERK1/2 in liver tissues of children with biliary atresia significantly increased with increase in fibrosis degree ( P<0.05). The expression level of leptin in liver tissues of children with biliary atresia was positively correlated with the liver fibrosis grade ( rs=0.876), α-SMA ( r=0.723) and p-ERK1/2 ( r=0.725) ( P<0.01). The results of qRT-PCR showed that the content of leptin mRNA in liver tissues of children with biliary atresia was significantly higher than that of children with CBD ( P<0.05). Conclusion:Expressions of leptin increased with aggravation of degrees of hepatic fibrosis in biliary atresia. Leptin may be involved in activation of HSCs through the ERK1/2 signaling pathway in the process of hepatic fibrosis due to biliary atresia.
RESUMEN
Objective To observe the efficacy and safety of rifabutin and furazolidone included triple regimen and minocycline plus furazolidone included quadruple regimen in eradicating refractory H.pylori infection.Methods A total of 146 patients who failed (≥ two times) to treat H.pylori with standard antiH.pylori therapy were selected and divided into esomeprazole,rifabutin and furazolidone treatment group (ERF group,n =74) and esomeprazole,minocycline,furazolidone and bismuth potassium citrate group (EMFB group,n =72).The duration of treatment were both 10 days.Liver and renal functions were examined within three days after therapy.13C or 14 C-urease breath test was performed one month after the medication withdrawal.The patients were followed up once every two weeks during the treatment period.The medication and adverse reactions were recorded in detail.The compliance and rates of adverse events in two groups were compared and analyzed.The eradication rates of the two groups and subgroups were compared by intention-to-treat (ITT) and per-protocol (PP) analyses.The cost-effectiveness of the two groups was evaluated with cost effectiveness analysis (CEA).The cost/effectiveness (C/E) ratio was calculated by PP.Chi-square test and t test were used for statistical analysis.Results There was no significant difference in complicance between ERF group and EMFB group (90.5％ vs.90.3％,P ＞0.05).There was no significant difference in H.pylori eradication rate between ERF group and EMFB group analyzed by ITT (82.4％ vs.84.7％,P ＞0.05).Analyzed by PP,there were no significant differences in H.pylori eradication rate between ERF group and EMFB group (91.0％ vs.93.8％),between male subgroup and female subgroup of ERF group (87.9％ vs.94.1％),between subgroup with age less than 60 years and subgroup with age over 60 years of ERF group (89.7％ vs.92.9％),between male subgroup and female subgroup of EMFB group (89.7％ vs.97.2％) and between subgroup with age less than 60 years and subgroup with age over 60 years of EMFB group (93.6％ vs.94.4％) (all P ＞ 0.05).There were no statistically significant differences in the rate of adverse events between ERF group and EMFB group (20.3％ vs.22.2％),between male subgroup and female subgroup of ERF group (25.0％ vs.15.8％),between subgroup with age less than 60 years and subgroup with age over 60 years of ERF group (26.2％ vs.12.5％),between male subgroup and female subgroup of EMFB group (19.4％ vs.24.4％) and between subgroup with age less than 60 years and subgroup with age over 60 years of EMFB group (24.5％ vs.15.8％)(all P ＞ 0.05).Fixed daily cost,total cost and C/E of ERF group was RMB 59.0 yuan,RMB 590.5 yuan and 648.9,respectively;and the eradication rate was 91.0％ (61/67).Fixed daily cost,total cost and C/E of EMFB group was RMB 32.9 yuan,RMB 329.1 yuan and 350.9,respectively;and the eradication rate was 93.8％ (61/65).Conclusions Rifabutin and furazolidone included triple regimen and minocycline plus furazolidone included quadruple regimen both have good efficacy,safety and compliance in the eradication of refractory H.pylori infection,and the latter is better.
RESUMEN
Objective@#To observe the efficacy and safety of rifabutin and furazolidone included triple regimen and minocycline plus furazolidone included quadruple regimen in eradicating refractory H. pylori infection.@*Methods@#A total of 146 patients who failed (≥two times) to treat H. pylori with standard anti-H.pylori therapy were selected and divided into esomeprazole, rifabutin and furazolidone treatment group (ERF group, n=74) and esomeprazole, minocycline, furazolidone and bismuth potassium citrate group (EMFB group, n=72). The duration of treatment were both 10 days. Liver and renal functions were examined within three days after therapy. 13C or 14C-urease breath test was performed one month after the medication withdrawal. The patients were followed up once every two weeks during the treatment period. The medication and adverse reactions were recorded in detail. The compliance and rates of adverse events in two groups were compared and analyzed. The eradication rates of the two groups and subgroups were compared by intention-to-treat (ITT) and per-protocol (PP) analyses. The cost-effectiveness of the two groups was evaluated with cost effectiveness analysis (CEA). The cost/effectiveness (C/E) ratio was calculated by PP. Chi-square test and t test were used for statistical analysis.@*Results@#There was no significant difference in complicance between ERF group and EMFB group (90.5% vs. 90.3%, P>0.05). There was no significant difference in H. pylori eradication rate between ERF group and EMFB group analyzed by ITT (82.4% vs. 84.7%, P>0.05). Analyzed by PP, there were no significant differences in H. pylori eradication rate between ERF group and EMFB group (91.0% vs. 93.8%), between male subgroup and female subgroup of ERF group (87.9% vs. 94.1%), between subgroup with age less than 60 years and subgroup with age over 60 years of ERF group (89.7% vs. 92.9%), between male subgroup and female subgroup of EMFB group (89.7% vs. 97.2%) and between subgroup with age less than 60 years and subgroup with age over 60 years of EMFB group (93.6% vs. 94.4%) (all P>0.05). There were no statistically significant differences in the rate of adverse events between ERF group and EMFB group (20.3% vs. 22.2%), between male subgroup and female subgroup of ERF group (25.0% vs. 15.8%), between subgroup with age less than 60 years and subgroup with age over 60 years of ERF group (26.2% vs. 12.5%), between male subgroup and female subgroup of EMFB group (19.4% vs. 24.4%) and between subgroup with age less than 60 years and subgroup with age over 60 years of EMFB group (24.5% vs. 15.8%) (all P>0.05). Fixed daily cost, total cost and C/E of ERF group was RMB 59.0 yuan, RMB 590.5 yuan and 648.9, respectively; and the eradication rate was 91.0%(61/67). Fixed daily cost, total cost and C/E of EMFB group was RMB 32.9 yuan, RMB 329.1 yuan and 350.9, respectively; and the eradication rate was 93.8%(61/65).@*Conclusions@#Rifabutin and furazolidone included triple regimen and minocycline plus furazolidone included quadruple regimen both have good efficacy, safety and compliance in the eradication of refractory H. pylori infection, and the latter is better.
RESUMEN
The resistance rate of Helicobacter pylori (Hp) to antimicrobial drugs increases year by year, which is the key factor for the decreased Hp eradication rate. Formulating an empirical regimen for Hp eradication based on an understanding of the dynamic epidemiology of antimicrobial resistance of Hp in the region will improve the eradication rate of Hp efficiently. The resistance rates of Hp to antimicrobial drugs are diversified in different geographic regions, population and time. This article reviewed the resistance rates of Hp to seven currently most frequently used antimicrobial drugs.
RESUMEN
<p><b>OBJECTIVE</b>To study the characteristics of blood flow in common hepatic tumors by 256-slice spiral CT whole-liver perfusion imaging.</p><p><b>METHODS</b>Seventy-one patients with hepatic tumors were examined retrospectively by 256-slice spiral CT whole-liver perfusion. Among them, twenty-seven cases were of primary hepatic cancer, twenty-four cases of hepatic hemangioma, and twenty cases of hepatic metastases.Regions of interest (ROIs) were placed in the tumor parenchyma (Area A), peritumoral hepatic parenchyma (Area B), and normal hepatic parenchyma (Area C), respectively. The time density curves (TDC) were drawn, and perfusion parameters including hepatic arterial perfusion(HAP), portal venous perfusion(PVP), total liver perfusion(TLP) and hepatic erfusion index(HPI) were obtained. The values of ROIs were measured, and the perfusion parameters in the areas A, B, C of different hepatic tumors were statistically analyzed.</p><p><b>RESULTS</b>The values of HAP, PVP, HPI in the tumor parenchyma of primary hepatic carcinoma were (20.00 ± 11.41)ml · min(-1) · 100 ml(-1,) (32.31 ± 21.06)ml · min(-1) · 100 ml(-1,) (52.31 ± 30.55)ml · min(-1) · 100 ml(-1,) and (39.67 ± 11.19)%, showing significant difference as compared with those in peritumoral hepatic parenchyma and in normal hepatic parenchyma(P<0.05). The values of HAP, TLP, and HPI in the tumor parenchyma of hepatic hemangioma were (40.39 ± 29.23)ml · min(-1) · 100 ml(-1,) (132.72 ± 132.65) ml · min(-1) · 100 ml(-1,) and (35.51 ± 15.12)%, were significantly different as compared with those in the peritumoral hepatic parenchyma and in normal hepatic parenchyma(P<0.05). The values of HAP, PVP, HPI in the tumor parenchyma of hepatic metastases were (17.43 ± 12.27)ml · min(-1) · 100 ml(-1,) (36.19 ± 34.99) ml · min(-1) · 100 ml(-1,) and (37.86 ± 14.49)%, significantly different as compared normal hepatic parenchyma (P<0.05). The HAP, PVP, and TLP of tumor tissue and the PVP and HPI of peritumoral tissue in different hepatic tumors were statistically significantly different (P<0.05).</p><p><b>CONCLUSIONS</b>The multi-slice spiral CT whole-liver perfusion has certain value in the diagnosis of common hepatic tumors. Perfusion parameters in different areas of common hepatic tumors have their own hemodynamic characteristics.</p>
Asunto(s)
Humanos , Carcinoma Hepatocelular , Diagnóstico por Imagen , Hemangioma , Diagnóstico por Imagen , Arteria Hepática , Diagnóstico por Imagen , Fisiología , Hígado , Neoplasias Hepáticas , Diagnóstico por Imagen , Imagen de Perfusión , Vena Porta , Diagnóstico por Imagen , Fisiología , Flujo Sanguíneo Regional , Estudios Retrospectivos , Tomografía Computarizada EspiralRESUMEN
Objective To discuss the blood flow charateristics of normal Couinaud’s hepatic segments by using whole-liver perfu-sion with multi-slice spiral computed tomography (MSCT).Methods 73 patients underwent whole-liver perfusion enhanced CT scans for detection of gastric or pancreas cancer,and some were excluded including metastatic liver tumors in 7,multiple liver cysts (>3 cm in diameter)in 6,cirrhosis in 6,liver operation or splenecormy in 3,intra-hepatic bile duct dilation in 1,and excessive motion artifacts in 4.The final 46 patients with normal liver were included,and the perfusion parameters of liver segments were measured for estimating blood-dynamics condition.Results The hepatic arterial perfusion (HAP)in segment 3 was significantly higher than that in segment 6,7 and 8 (P <0.05),and the HAP in segment 4 was significantly higher than that in segment 7 (P <0.05).The hepatic perfusion index (HPI)in segment 3 was significantly higher than that in segment 7 (P <0.05).All normal liver were classi-fied into two groups (group A:<60 years,group B:≥60 years),and no significant correlation between age groups was found.How-ever,the perfusion parameter values in group A were higher than those in group B.No significant correlation was found between gen-ders.Conclusion Our results suggest that differences exist in normal hepatic parenchyma between liver segments.MSCT whole-liver perfusion imaging can more comprehensively response hemodynamic changes in liver,and provids the imaging basis for clinical evaluation of liver disease.
RESUMEN
Objective To investigate the clinical application value of selective arterial embolization in the treatment of iatrogenic hemorrhage.Methods 32 cases with iatrogenic hemorrhage were retrospectively analyzed.The location and feature of bleeding were identified by selective percutaneous artery angioraphy,and then super-selective interventional embolization were performed.The embolic agents inclued gelfoam medical line,steel coils or polyvinyl alcohol (PVA)particles.Results In 32 patients,26 cases with active bleeding signs were found by angiography,they mainly presented contrast medium overflow,6 cases with pseudo-aneurysms,1 case with ar-teriovenous fistula.All patients underwent interventional embolization successfully.Only 1 case underwent twice procedure because of rehaemorrhagia on the 8 days after embolization.Follow-up for a month after arterial embolization,25 cases had no severe compli-cations,1 case died by multiple organ failure.In 6 negative cases,3 cases died by hemorrhagic shock,3 cases stopped hemorrhage after medical treatment.Conclusion Selective angiography is a safe and effective measure for the treatment of iatrogenic hemor-rhage.