Prevalence and risk factors of hypertensive retinopathy in a health-checkup population / 中华健康管理学杂志

Objective:To investigate the prevalence and risk factors of hypertensive retinopathy (HRP) in a non-diabetic population over 30 years old during routine health examinations.Methods:This was a cross-sectional study of a non-diabetic population over 30 years of age. The study was conducted during routine health examinations at the Tongren Hospital, Beijing, from January to December 2020. Fundus photographs were taken, and data including medical history, height, weight, and blood pressure were collected. Routine laboratory examinations were performed. The study population was divided into hypertension, transient hypertension, and non-hypertension groups. The prevalence of HRP was compared among the three groups. OR and 95% CI of HRP risk factors was estimated by binary logistic regression, adjusted for age and gender. Results:The prevalence of HRP was 4.3% in the non-diabetic population over 30 years old. Adjusted for age, gender, and systolic blood pressure, the prevalence of HRP in hypertension and transient hypertension groups, was both higher than in the non-hypertension group [ OR(95% CI) of 3.11(2.25-4.30) and 1.72(1.21-2.45), respectively]. The proportion of grade 1-2 HRP was higher (76.2%). There was no significant difference in the prevalence of grade 3 HRP among the three groups. Adjusted for age and gender, systolic blood pressure and creatinine clearance rate were independent risk factors for HRP in the hypertension group [ OR(95% CI): 1.22(1.01-1.48) and 1.66(1.12-2.46)] and transient hypertension group [ OR(95% CI): 1.48(1.10-2.06) and 1.95(1.03-3.46)]. SBP and DBP were independent risk factors for HRP in the non-hypertension group [ OR(95% CI): 1.68(1.07-2.63) and 1.61(1.06-2.44)]. Conclusions:There was a high prevalence of HRP among the non-diabetic population over the age of 30 and there was still relatively high risk of grade 3 HRP among the normotensive population.

Study on the correlationship between hearing loss and cognitive decline among older adults in Beijing / 中华健康管理学杂志

Objective:To study the correlation between hearing loss and cognitive decline in community-dwelling older adults and to analyze the influencing factors.Methods:Using Pure-tone audiometry, the Hearing Handicap Inventory for the Elderly (HHIE), Mini-Mental State Examination (MMSE), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder, a survey was conducted with 492 community-dwelling older adults aged 60 years and above in Beijing. Age, gender, education level, hearing loss, levels of anxiety and depression, and other factors were used as independent variables, and the MMSE scores were used as dependent variables. Analysis of variance and multiple linear regression were performed.Results:Among the 492 subjects, based on the better ears, 418 (85.0%) had hearing loss and 160 (32.5%) had disabled hearing loss. Factors such as age (β=-0.33, P<0.01), gender (β=0.09, P=0.04), education level (β=0.31, P<0.01), hearing loss (β=-0.11, P=0.02) and marital status (β=0.56, P=0.02) were significantly related to cognitive decline. Gender (β=-0.17, P<0.01) and hearing loss (β=0.08, P=0.02) correlated with anxiety indicators; gender (β=-0.84, P=0.02) and hearing loss (β=0.04, P=0.01) also correlated with depression indicators. Conclusion:Results indicated a correlation between hearing loss and cognitive decline, and between hearing loss and anxiety and depression among community-dwelling older adults in Beijing.

Analysis of the results of hearing screening in physical examination in Beijing / 中华健康管理学杂志

Objective:To investigate the prevalence and characteristics of adult hearing loss.Methods:From March 2018 to November 2019, 8, 439 adult physical examinees were screened for hearing (i.e., 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz pure tone air conduction audiometry), while some were examined for hearing diagnosis (i.e., 250 Hz, 500 Hz, 1, 000 Hz, 2, 000 Hz, 4 000 Hz, and 8 000 Hz pure tone bone air conduction audiometry). Prevalence, location, frequency and type of hearing loss in different age and gender groups were analyzed using SPSS 25.0.Results:The prevalence of hearing loss was 32.2%, which increased with age. The prevalence in males was higher than that of females (40.1% vs. 21.6%). The rate of single frequency damage was higher in male than in female, while the rate of multiple frequency damage was higher in women than in men ( P<0.001). The high frequency (4 000 Hz) damage rate in male was higher than that of females, while the low-middle frequency (500-2 000 Hz) damage rate in females was higher than that of males ( P<0.001). Sensorineural hearing loss accounted for 90.8%, while conductive hearing loss was 3.9%, mixed hearing loss was 5.0%, and others were 0.3%. Conductive hearing loss was mainly concentrated in the younger age group. Conclusion:Physical examination population has a relatively high prevalence of hearing loss. The characteristics of hearing loss differed with age and gender.

The predictor of pathological downgrading after radical prostatectomy in patients with biopsy-proven level 2 of grading groups / 中华泌尿外科杂志

Objective To evaluate the predictors of gleason score pathological downgrading after radical prostatectomy in patients with biopsy-proven level 2 of grading groups (Gleason Score 3 + 4 =7).Methods Data of 252 patients,diagnosed with level 2 of grading groups(Gleason score 3 + 4 =7) prostate cancer by biopsy,with subsequent laparoscopic radical prostatectomy,were retrospectively analyzed.The mean age was 64.3,ranged from 46 to 82 years.The average body mass index (BMI) was 23.2 kg/m2,ranged from 15.2 to 30.4 kg/m2.The median prostate volume,transition zone volume(TZV) and transition zone index(TZI) were 48.9 ml (30.3-73.1 ml),21.4 ml(13.5-31.2 ml) and 0.46％ (0.37％-0.58％),respectively.The median value of tPSA,fPSA and PSAD were 1.53 ng/ml(0.67-3.92 ng/ml),9.65 ng/ml (4.13-18.68 ng/ml) and 0.18 ng/(ml · cm3) [0.09-0.50 ng/ (ml · cm3)],respectively.Clinical T stage was also evaluated,including 153 (60.7％) diagnosed as T1e stage,78 (3 1.0％) diagnosed as T2 stage,and 21 (8.3％) diagnosed as T3 stage.There were 58(23.0％) with extracapsular extension,47 (18.7％) patients with seminal vesicle invasion,and 2(0.8％) with lymph node metastasis.Pathological T stage includes 112 (44.4％) diagnosed as T2 stage,55 (21.8％) diagnosed as T3a stage,35 (13.9％) diagnosed as T3b stage,and 50(19.8％) diagnosed as T4 stage.The patients were assigned Prostate ImagingReporting and Data System version 2 scores of 1,2,3,4,and 5 were 45 (17.9％),36 (14.3％),51 (20.2％),68(27.0％)and 52(20.6％),respectively.The patients were categorized into 2 groups with and without pathological downgrading,including downgrade and no downgrade group.Univariate and multivariate logistic regression analysis were done to determine the predictors of pathological downgrading.Results The patients were categorized into downgrade(n =31) and no downgrade group(n =221) of 252 patients.The pathological downgrading was identified in 31 (12.3％).The tPSA,PSAD and PI-RADS scores in patients with downgrade group which were lower than those in without downgrade group (P ＜ 0.05).The logistic regression analysis revealed PI-RADS score was the independent predictor of downgrading(OR =0.364,95％ CI 0.253-0.522,P ＜ 0.01).The area under the ROC curve of PI-RADS score was 0.810 and the diagnostic value was the best.Conclusions These findings suggested that PI-RADS scores was predictor for pathological downgrading after radical prostatectomy in patients with biopsy-proven level 2 of grading groups,reduced PI-RADS score (PI-RADS score ≤ 3) is correlated with increased pathological downgrading after radical prostatectomy.

Impact of diverse shapes of prostatic apex on positive apical margin rate and biochemical recurrence following laparoscopic radical prostatectomy / 中华外科杂志

Objective@#To explore the effects of various forms of prostatic apex on positive apical margin rate (PAM) and biochemical recurrence (BCR) after laparoscopic radical prostatectomy.@*Methods@#A retrospective analysis of 309 patients (aging (65±6) years) who were experienced laparoscopic radical prostatectomy from January 2010 to December 2016 at the Department of Urology, First Affiliated Hospital of Fujian Medical University. According to the relationship between prostate apex and membrane urethra at the mid-sagittal plane of preoperative MRI, all patients were classified into 4 categories. There were 31 patients for type 1, apex covering both anterior and posterior aspects of membranous urethra, 139 patients for type 2, apex covering anterior side of membranous urethra, 63 patients for type 3, apex covering posterior aspect of membranous urethra, 76 patients for type 4, apex not covering membranous urethra. PAM and BCR after operation were compared between this four groups respectively. The χ2 test was used to compare PAM among the 4 types. Logistic regression analysis were undertaken to analyze the factors affecting PAM. Cox′s proportional hazards regression model was undertaken to identify the variables influencing BCR.@*Results@#There was no significant difference in the 4 groups concerning age, body mass index, prostate volume, preoperative prostate-specific antigen (PSA) value, postoperative Gleason score and pathological stage (P>0.05).The median follow-up time was 32 months (ranged from 12 to 60 months).The data showed that the apical type 3 patients has the highest PAM. There was statistical difference among the 4 groups in PAM (χ2=15.592, P=0.001). Preoperative level of PSA (OR=20.356, 95% CI: 2.440 to 169.810, P=0.005), postoperative Gleason score (OR=4.113, 95% CI: 1.911 to 8.849, P=0.001), pathological stage (OR=3.422, 95% CI: 1.600 to 7.319, P=0.002) and apical type 3 (OR=6.134, 95% CI: 2.196 to 17.132, P=0.001) were independent relactive factors of PAM. Preoperative level of PSA (HR=1.362, 95% CI: 1.006 to 1.843, P=0.045), postoperative Gleason score (HR=1.920, 95% CI: 1.384 to 2.665, P=0.001), pathological stage (HR=1.476, 95% CI: 1.098 to 1.983, P=0.010), PAM (HR=3.497, 95% CI: 2.407 to 5.081, P=0.001)and apical type 3 (HR=1.828, 95% CI: 1.266 to 2.639, P=0.001) were independent prognosis factors of BCR.@*Conclusion@#Prostate apical type 3 could be a significant independent predictor of PAM, and an independent prognosis factor for BCR.

Prevalence and risk factors of diabetic retinopathy in a physical examination population in Beijing / 中华健康管理学杂志

Objective To investigate the prevalence and risk factors of diabetic retinopathy (DR) in a Beijing population during routine medical examinations. Methods This was a cross-sectional study during a routine health examination at the Tongren Hospital of Beijing,from March 2014 to February 2015. Fundus photography was conducted by experienced ophthalmologists.Medical history,height,weight,waist and hip circumference,and blood pressure were recorded.Routine laboratory examinations were performed. Logistic regression models were used to estimate the odds ratio (OR) and 95% confidence interval (CI) of diabetic retinopathy for each risk factor,adjusted for age and gender. Results The prevalence of DR was 7.0% among diabetic individuals.The multivariate analysis showed that disease durations[OR(95% CI),2.1 (1.564-2.752),P<0.001],fasting plasma glucose[1.2(1.093-1.273),P<0.001],body mass index[1.8(1.010-3.100),P=0.046],and triglyceride[0.794(0.638-0.987),P=0.038]were independently associated with DR. The prevalence of diabetes mellitus (DM) and DR significantly increased in populations aged>30 years. Conclusion Fundus photography (nonmydriatic) should be recommended as a routine screening method for people 30 years and elder to effectively prevent occurrence of visual impairment and blindness.

Correlation of dark red tongue and metabolic parameters in health checkup population / 中华健康管理学杂志

Objective To study the metabolic parameters in health checkup people with dark red tongue and light red tongue,with different coating nature,coating color or liguliform,to understand the relationship between dark red tongue and human metabolic state.Methods Clinical data of 2 891 individuals who underwent health checkup in our center between Dec.2013 and Aug.2014 were collected,including body mass index,blood pressure,blood glucose,lipid and uric acid.Tongue diagnosis was made by Chinese Medicine practitioners.Results The dark red tongue was more common in males,it was found in 61.58％ males and 38.42％ females in the dark red tongue group.The average level including body mass index,systolic blood pressure,diastolic blood pressure,blood glucose,total cholesterol,triglyceride,low-density lipoprotein cholesterol and blood uric acid in dark red tongue group were higher than those in light red tongue group (P＜0.01).When the dark red tongue had yellow fur-like or thick and greasy coat,the average level of body mass index,blood glucose,total cholesterol,low-density lipoprotein cholesterol and blood uric acid were higher than those of the normal dark red tongue group,the level of high-density lipoprotein cholesterol was lower than that of the normal dark red tongue group.Conclusions Dark red tongue has homogeneous relations with abnormal metabolic parameters,it may be the external expression of metabolic abnormalities;tongue is the external macro manifestation of human body health state.

Relationship between normal serum uric acid levels and nonalcoholic fatty liver disease among Chinese people with normal body mass index / 中华健康管理学杂志

Objective Serum uric acid (SUA) levels have been identified to be associated with nonalcoholic fatty liver disease (NAFLD) which is often closely linked to obesity. However, few studies have examined the relationship between SUA levels and NAFLD in normal body mass index (BMI) people in whom NAFLD is noted not uncommon. We conducted this study to assess the association of SUA with NAFLD in Chinese normal-BMI people. Methods A total of 2 193 normal-BMI people (1 106 men and 1087 women) who participated in a health check-up were enrolled in this cross-sectional study. NAFLD was defined as a hepatic steatosis examined by liver ultrasonography in the absence of a second cause. Multiple regression analysis was performed to examine the relationship between SUA and NAFLD. Results Compared with people without NAFLD, those with NAFLD had significantly higher level of serum uric acid [males,(339.0±47.6)μmol/L vs.(309.3±53.5)μmol/L, t=3.296, P<0.01;female,(273.6±41.6)μmol/L vs. (243.9 ± 47.6)μmol/L, t=3.178, P<0.01]. Multiple regression analysis revealed that the quartile 3 and 4 of SUA in both sexes had a higher (P<0.05) odds ratio for the presence of NAFLD than the lowest quartile [males,odds ratio:2.508(1.255-3.374)and 3.383(2.058-5.490);females,odds ratio:2.186(1.090-4.384) and 2.420(1.214-4.821),respectively],after adjusting for age, body mass index, blood urea nitrogen, serum creatinine, the liver-function test, metabolic components, high sensitivity C-reactive protein, and smoking status.Conclusions Increased SUA level, even within the normal range, are independently associated with the presence of NAFLD among normal-BMI people.

A correlation study between body mass index and features of tongue manifestation / 国际中医中药杂志

Objective To investigate the correlation between body mass index (BMI) and features of tongue manifestation.Methods A total of 1 655 physical examination individuals were selected,and height and body weight were measured to calculate BMI.Traditional Chinese Medicine tongue inspection was performed,and map of tongue manifestation was photographed by a digital camera.Results Among the 1 655 physical examination individuals,prevalences of normal weight,overweight/obesity and low weight were 50.94％,43.74％ and 5.32％,respectively.The prevalences of individuals had dark red tongue (37.98％ vs.24.56％;x2=40.883,P＜0.001),purplish tongue (5.94％ vs.3.44％;x2=8.133,P=0.017),dark purplish tongue (2.35％ vs.0.59％;x2=10.398,P=0.006),yellow fur (63.95％ vs.58.84％;x2=9.570,P=0.008),thick greasy fur (24.86％ vs.17.20％;x2=18.698,P＜0.001) in the overweight/obesity group were significantly higher than those in the normal weight group,and the prevalence of individuals had exfoliative fur/little fur/less fur in the overweight/obesity group was significantly higher than that in the normal weight group (1.93％ vs.3.91％;x2=6.454,P=0.040).The prevalences of individuals had red or deep red tongue (48.86％ vs.24.72％;x2=24.608,P＜0.001),red dot tongue (7.95％ vs.1.93％;x2=12.254,P=0.002),thin whitish fur (22.73％ vs.9.53％;x2=14.030,P=0.001) in the low weight group were significantly higher than those in the normal weight group.Binary logistic regression analysis showed positive correlation between dark red tongue (OR 1.830,95％ CI 1.515-2.211;P＜0.001),purplish tongue (OR 1.874,95％ CI 1.211-2.901;P=0.005),dark purplish tongue (OR 4.259,95％ CI 1.610-11.266;P=0.003),yellow fur (OR 1.294,95％ CI 1.093-1.531;P=0.003),gray-black fur (OR 6.147,95％ CI 1.816-20.811;P=0.004),thick greasy fur (OR 1.597,95％ CI 1.289-1.978;P＜0.001) and BMI,and negative correlation between pink tongue (OR 0.766,95％ CI 0.637-0.920;P=0.004),red or deep red tongue (OR 0.659,95％ CI 0.549-0.789;P＜0.001),red dot tongue (OR 0.548,95％ CI 0.326-0.921;P=0.023),thin whitish fur (OR 0.695,95％ CI 0.536-0.900;P=0.006),whitish fur (OR 0.821,95％ CI 0.683-0.986;P=0.035) and BMI.Conclusions There is some correlation between BMI and features of tongue manifestation.Abnormal tongue color is mainly dark red tongue in the overweight/obesity individuals,and red or deep red tongue in low weight individuals.Abnormal tongue fur is mainly thick yellow fur.The tongue shape is normal in different body weight groups.

Determination and Analysis of Chromatic Value in Abnormal Red Tongue Tip / 中国中医药信息杂志

Objective To measure the chromatic differences of the tongue tip and tongue side and provide quantitative evidence for tongue color diagnosis. Methods Totally 683 healthy people were recruited, and their tongue photos were taken. Then ICC specific documents were used for the correction of all tongue photos, and chromatic values (L*, a*, b*, C*and h°) of tongue tip and tongue side were obtained for further statistical analysis. CIEDE2000 was used for calculating the color differences. Results The average color difference of tongue tip and tongue side in normal pink tongue was 5.4. When pink tongue has abnormal red tongue tip, the average color difference of tongue tip and tongue side was 10.85. Compared with normal tongue tip, the average color difference of tongue tip and tongue side in abnormal color tongue with abnormal red tongue tip increased from 5.4-7.0 to 11.23. Conclusion Red tongue tip is a sensitive sign indicating abnormal heat in the body. Tongue tip quantitative diagnosis is valuable in the determination of heat sign in TCM preventive treatment of disease, and reveal the diagnosis meaning and scientific connotation of red tongue tip.

Observation and Thinking of Diseased Tongue amongShanghuo(Heatiness) People / 世界科学技术-中医药现代化

This study was aimed to discuss the diagnosis significance of the diseased tongue demonstration in Shanghuo (heatiness) people. Based on 303Shanghuo cases, the relevance of diseased tongue demonstration and inquiry data were analyzed. The results showed that 53.14%Shanghuo cases had at least more than 2Shanghuo inducing causes. The most common inducing cause combinations were pathogenic factors neither endogenous nor exogenous (unbalanced diet, overworked) and internal factors (over stressed, emotional). When there were several Shanghuo causes occurred at the same time, the probability of appearing diseased tongue demonstration increased significantly. There were 29.95%Shanghuo cases occurredShanghuo experience frequently. And in these cases, the probability of appearing diseased tongue demonstration increased significantly. It was concluded that when Shanghuo people had diseased tongue demonstration appeared, it was not merely just“is going to get ill”, but was already suffering from heat syndrome. In traditional Chinese medicine (TCM) physical examination, to effectively differentiate“is going to get ill” and“being ill” was initially important. And the diseased tongue demonstration was a crucial diagnostic basis.

Study on Congenital Constitution Components in Medical Books before Qing Dynasty / 世界科学技术-中医药现代化

This study was aimed to discuss the connotation of congenital constitution in medical books before Qing dynasty. By searching the character Bing as a keyword in the Encyclopedia of Traditional Chinese Medicine (TCM), 6 480 articles were retrieved. Through reading each of the articles, 9 congenital constitution terms were con-cluded. A total of 1 041 valid entries involved in 165 medical books were retrieved. The results showed that congen-ital constitution was affected by parent heredity and region factors. Parent heredity factor includes the influence of both parents and the influence of mother during pregnancy where the influence of both parents includes both parents' habits and conditions when having sex; the influence from the mother includes habits and medication during her pregnancy. Congenital constitution embodiment includes the body's growth and development, body structure and vis-cera, qi and blood, pulse and forefinger blood vessels (of young children), mental state and life span. In three other factors of congenital constitution (i.e. qi and blood, body structure and life span), both body structure and life span depend on the endowment of qi and blood. It was concluded that TCM practitioners before Qing dynasty judged one's congenital constitution through observing the speed of its growth and development, appearance, mental state, strength of visceral functions, condition of its mind, forefinger blood vessels, pulse, susceptible to types of disease and etc. Therefore, body structure is an important factor of congenital constitution judgment. TCM practitioners before Qing dynasty paid attention to the effect on mother to her offspring's health.

"Study on Congenital Constitution Terms Consist of ""Bing"" Before Qing Dynasty" / 世界科学技术-中医药现代化

This study was aimed to investigate the congenital constitution terms consist of Bing and connotation in medical books before Qing dynasty. By searching the character Bing as a keyword in the Encyclopedia of Tradi-tional Chinese Medicine (TCM), 6480 articles were retrieved. Through reading each of the articles, 9 congenital con-stitution terms were concluded. The results showed that Sui dynasty recorded the earliest congenital constitution term. And till the end of Ming dynasty, altogether 9 terms, which were Bing Qi, Bing Zhi, Bing Shou, Bing Fu, Suo Bing, Fu Bing, Qi Bing, Bing Ti and Su Bing, appeared in sequence. The terms appeared with high frequency were Bing Shou ( 33 . 27%) and Bing Fu ( 32 . 99%) . There were 5 congenital constitution relat-ed factors altogether , which were physique , parental heredity , life span , qi and blood as well as region , ap-peared in sequence . And the term appeared with high frequency was physique ( 32.11%) . It was concluded that before Qing dynasty, all congenital constitution terms occurred with the character of Bing (endowment). The usage of different terms to state congenital constitution was intended to describe different associated factors . It reflected the understanding of congenital constitution process. The first known congenital constitution factor was not parental heredity but physique . Qi and blood was the second most appeared factor . This indicated that con-genital constitution does not only involve the structure of the body ( physique ) , but also the function of the body (qi and blood). The investigation about congenital constitution of ancient TCM brings a positive practical signifi-cance for the modern health cognition and health maintenance .

Preparation of alpha-tricalcium phosphate/HA whisker/carboxymethyl chitosan-gelatin composite porous bone cement / 生物医学工程学杂志

In order to investigate the effects of HA whisker and carboxymethyl chitosan-gelatin(CMC-Gel) on the mechanical properties of porous calcium phosphate cement, a series of alpha-tricalcium phosphate (alpha-TCP), HA whisker and L-sodium glutamate porogen with different mass fractions were mixed, and setting liquid was added to them to prepare alpha-TCP/HA whisker composite porous bone cement. Then, the cement was immersed in a series of CMC-Gel solutions which had different weight ratios of CMC to Gel to prepare alpha-TCP/HA whisker/CMC-Gel composite porous bone cement. The compressive strengths and microstructure of cement were characterized by mechanical testing machine and SEM. The results showed that when the mass fraction of HA whisker is 4%, the compressive strength of alpha-TCP/HA whisker composite porous bone cement reaches 2.57MPa, which is 1.81 times that of alpha-TCP bone cement. When the weight ratio of CMC to Gel is 50:50, the compressive strength of alpha-TCP/HA whisker/CMC-Gel composite porous bone cement is 3. 34MPa, which is 2.35 times that of alpha-TCP bone cement, and the toughness of the composite cement is greatly improved as well.

Risk Factors of Fungal Ventilator-associated Pneumonia / 中华医院感染学杂志

OBJECTIVE To investigate the risk factors of fungal ventilator associated pneumonia(FVAP) and the characteristic of pathogenic fungi.METHODS Thirty seven VAP patients were divided into FVAP group and nonfungal ventilator associated pneumonia(NFVAP) group.Risk factors were compared between the two groups and the characteristic of pathogenic fungi was analyzed.RESULTS Compared to the NFVAP group,the FVAP group showed a significant higher rate in systemic usage of glucocorticosteriod and combined application of antibiotics.The cases of FVAP appeared frequently over the period since 7th to 14th days after intubation.Twelve strains of fungi were isolated from the sputum of patients in FVAP group.Ten strains(83.3%) of the isolates belonged to Candida species included(C.albicans 6 strains(50.0%),C.tropicalis 2 strains(16.7%),C.krusei 1 strain(8.3%),and C.parapsilosis 1 strain(8.3%),and 2 strains(16.7%) of the isolates belonged to Aspergillus.CONCLUSIONS The rate of tracheal intubation should be decreased and the time of mechanical ventilation should be shortened to avoid FVAP.Identifying the strains of fungi and their sensitivity are useful to direct the treatment.