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Objective:To study the effect of Compound Duzhong Jiangu Granules on joint function, quality of life and inflammatory factors in patients with Kashin-Beck disease.Methods:By group design, 135 patients with Kashin-Beck disease in Chongxin County, Pingliang City, Gansu Province, were selected and divided into intervention group (100 cases treated with Compound Duzhong Jiangu Granules, 12 g/bag, 1 bag/time, 3 times/day, treatment for 1 month) and control group (35 cases treated with ibuprofen, 0.3 g/capsule, 1 capsule/time, 2 times/day, treatment for 2 weeks) according to the randomized, single-blind principle. The changes of joint dysfunction index score, joint function improvement rate, total scores of Kashin-Beck disease quality of life (KBDQOL) and scores of each dimension were analyzed before treatment, 1 month and 3 months after treatment. The serum levels of interleukin-6 (IL-6), nuclear factor κB (NFκB)-p65, inducible nitric oxide synthase (NOS2), nitric oxide (NO), and prostaglandin E2 (PGE2) were detected by enzyme-linked immunosorbent assay before treatment and 1 month after treatment.Results:The total scores of joint dysfunction index of the intervention group and the control group 1 month after treatment and 3 months after treatment were lower than those before treatment, but 3 months after treatment was higher than 1 month after treatment ( P < 0.001). One month after treatment, the total effective rates of joint function improvement in the intervention group and the control group were 68.00% (68/100) and 54.55% (18/33), respectively; 3 months after treatment, the total effective rates of the intervention group and the control group were 36.00% (36/100) and 39.39%(13/33), respectively. The total scores and scores of each dimension of KBDQOL were not significant for the main effect of the group ( P > 0.05), but significant for the main effect at the time point ( P < 0.05), and there was no interactive effect ( P > 0.05). There were significant differences in the scores of social support and mental status dimensions in the intervention group at different time points ( P < 0.001). And in the intervention group, the total score, the scores of physical function, activity limitation, economy and overall health dimensions were statistically significant between before treatment and 1 month after treatment, 1 month after treatment and 3 months after treatment( P < 0.05); however, there was no significant difference between before treatment and 3 months after treatment ( P > 0.05). One month after treatment, the serum PGE2 levels of both groups were decreased ( P < 0.05), and there was no difference in other inflammatory factors at different groups and time points ( P > 0.05). Conclusion:Compound Duzhong Jiangu Granules can effectively inhibit the inflammatory reaction of patients with Kashin-Beck disease, promote the improvement of joint function and improve the quality of life in various aspects.
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Objective:To investigate the clinical characteristics and causes of death of chronic Keshan disease cases.Methods:A retrospective analysis was conducted on the last clinical data of 39 death cases of chronic Keshan disease who were repeatedly hospitalized in Jingchuan County People's Hospital from March 2016 to August 2020 before their death, including gender, age, course of disease, clinical symptoms and signs, chest X-ray, electrocardiogram, cardiac echocardiography, causes of death, etc., and analysis was made on the clinical characteristics related to the death of chronic Keshan disease cases.Results:Among the 39 death cases of chronic Keshan disease, 27 cases (69.2%) were male and 12 cases (30.8%) were female. The age was (62.64 ± 8.63) years old, and the median course of disease was 5 years. Dyspnea [37 cases (94.9%)] and edema [33 cases (84.6%)] were the main clinical symptoms. All cases had varying degrees of cardiac enlargement, pulmonary congestion signs, and abnormal changes in electrocardiogram. Among the causes of death, 18 cases (46.2%) were sudden cardiac death, 11 cases (28.2%) were heart failure, 5 cases (12.8%) were cardiogenic shock, and 3 cases (7.7%) were heart failure combined with cardiogenic shock, and 2 cases (5.1%) had other causes.Conclusion:Dyspnea and edema are the main clinical characteristics of death cases of chronic Keshan disease, sudden cardiac death, heart failure and cardiogenic shock are the three common causes of death.
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Objective:To evaluate the reliability and validity of Chinese version of Minnesota Living with Heart Failure Questionnaire (MLHFQ) scale among patients with chronic Keshan disease.Methods:The patients with chronic Keshan disease diagnosed in Keshan disease area of Gansu Province from August 2018 to April 2020 were selected as the survey subjects to analyze the reliability and validity of the Chinese version of MLHFQ scale in evaluating the quality of life of patients with chronic Keshan disease. To evaluate the reliability of MLHFQ scale, the Cronbach's α coefficient was used, and when the Cronbach's α coefficient > 0.8 indicated that the consistency reliability of the scale was good. Kaider-Meyer-Olkin(KMO) statistic and Barlett's sphericity test were used to evaluate whether the scale was suitable for factor analysis (applicable when KMO > 0.6 and Barlett's sphericity test P < 0.05). The principal component analysis and maximum variance method of exploratory factor analysis were used to extract common factors, and the structural validity of the scale was evaluated. The discrimination validity of the scale was evaluated by New York Heart Association (NYHA) cardiac function classification and analysis of variance. Pearson correlation analysis was used to evaluate the content validity of the scale. Results:A total of 333 questionnaires were collected, of which 329 were valid. There were 180 males and 149 females, aged (59.52 ± 9.26) years. The Cronbach's α coefficient of the Chinese version of MLHFQ scale was 0.95 ( > 0.8). Among them, the Cronbach's α coefficients in the physical domain, emotional domain and other domains were 0.93, 0.91 and 0.86, respectively ( > 0.8). The KMO value of the Chinese version of MLHFQ scale was 0.95 ( > 0.6), and Barlett's sphericity test rejected the hypothesis (χ 2 = 5 222.01, P < 0.05). Principal component analysis and maximum variance method were used to extract 3 common factors, which were named kinetic energy of life, physical condition and emotional condition, respectively. The cumulative contribution rate of principal components was 66.22% ( > 50%). Compared with patients with NYHA cardiac function grade Ⅱ and patients with grade Ⅲ and Ⅳ, there were significant differences in the physical domain, other domain and total score ( P < 0.001). The Pearson correlation coefficients between the physical, emotional, and other domains and their respective items ranged from 0.74 to 0.88, 0.78 to 0.90, and 0.56 to 0.80, respectively, and the correlation coefficients between each item and its domain were all > 0.5 ( P < 0.001). Conclusion:The Chinese version of MLHFQ scale has good reliability and validity in patients with chronic Keshan disease in Gansu Province, and can be used to evaluate the quality of life of patients with chronic Keshan disease.
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Objective:To evaluate the reliability and validity of the Chinese version of concise health status questionnaire (SF-36 scale) in evaluating the quality of life of patients with chronic Keshan disease, and to provide a scientific basis for studying the quality of life and the evaluation of treatment and rehabilitation of this population.Methods:In the August 2017, using cluster random sampling method, 175 patients with chronic Keshan disease treated by self-management of family beds in Pingliang City, Gansu Province in 2017 were selected as survey subjects, and demographic and disease data were collected. The Chinese version of SF-36 scale was used to investigate the quality of life. Split-half reliability and Cronbach's α coefficient were used to evaluate the reliability of the SF-36 scale; the factor analysis, correlation and differences between groups were used to evaluate the validity of the SF-36 scale.Results:The split-half reliability value of SF-36 scale was 0.916, and the Cronbach's α coefficient was 0.869. Factor analysis extracted 3 common factors from 8 dimensions of SF-36 scale, and the cumulative contribution rate of the 3 common factors to the total variance was 72.08%. In addition to the correlation coefficient ( r) between Role-Emotional and Bodily Pain dimension, the r value between total score and the scores of each dimension, and the scores of each dimension of SF-36 scale were 0.140 - 0.769. Except for the Bodily Pain dimension, there were statistically significant differences in the scores of Physiological Functioning, Role-Physical, General Health, Vitality, Social Functioning, Role-Emotional, and Mental Health dimension of the quality of life of patients with different grades of cardiac function ( F = 4.66, 10.73, 6.77, 14.61, 5.58, 9.57, 7.10, P < 0.05). Conclusion:The Chinese version of SF-36 scale has good reliability and validity in evaluating the quality of life of patients with chronic Keshan disease, and can be used to evaluate the quality of life of the patients.
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Objective:By investigating the cognitive level and influencing factors of heart failure knowledge in patients with chronic Keshan disease, so as to provide reference for improving the cognitive level of disease-related knowledge of the patients with Keshan disease in the targeted manner.Methods:In 2019, 100 patients with chronic Keshan disease were selected in Jingchuan County, Gansu Province. A questionnaire survey was conducted using the heart failure knowledge questionnaire to conduct correlation and regression analysis on the cognitive level of patients' heart failure knowledge and influencing factors.Results:Patients' average score of the heart failure knowledge level was (6.18 ± 2.72) points, and the scoring accuracy rate was 41.20%. The Spearman correlation analysis indicated that heart failure knowledge level was associated with annual family income ( r = 0.363, P < 0.01), the hospitalization times due to heart failure ( r = 0.304, P < 0.01), and the number of family members ( r = 0.240, P < 0.05). The results of multiple linear regression showed that the cognitive level of heart failure knowledge in male patients was higher than that in female patients ( P < 0.05). The more hospitalization times ( P < 0.05) and the more family members ( P < 0.05) were, the higher the cognitive level of heart failure knowledge was. Conclusions:The cognitive level of heart failure knowledge of patients with chronic Keshan disease is generally low. Medical staff should actively make use of the patient's hospitalization time for health education, and pay attention to the health education of family members of the patients.
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Objective:To evaluate the effect of self-management treatment for patients with chronic Keshan disease in Gansu Province.Methods:From March to June 2018, 243 patients with chronic Keshan disease who were treated by self-management treatment outside the hospital in 7 Keshan disease counties in Gansu Province were selected as the survey subjects, and their general demographic and clinical data were collected. At the same time, the survey subjects were given a 6-month self-management treatment, and the self-management scale was used to evaluate the patients' self-management behavior before treatment and 6 months after treatment. The higher the score, the better the patients' self-management behavior. The influencing factors of self-management scale were analyzed by multiple linear regression analysis.Results:Excluding incomplete data, a total of 158 patients with chronic Keshan disease were included in this survey, including 96 males and 62 females. Compared with patients before self-management treatment, the patients' cardiac function classification and work ability improved significantly after 6 months of self-management treatment ( Z = - 4.685, - 5.934, P < 0.05); cardiothoracic ratio decreased (0.61 ± 0.08 vs 0.63 ± 0.09, t = 5.175, P < 0.05); in the cardiac color Doppler ultrasound indexes, left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were increased (0.41 ± 0.11 vs 0.36 ± 0.07, 0.21 ± 0.07 vs 0.18 ± 0.05, t = - 6.504, - 5.391, P < 0.05); the total score of the self-management scale was increased [(53.86 ± 9.29) scores vs (51.46 ± 10.50) scores, t = - 3.696, P < 0.05]. Further analysis of the efficacy of the patients' cardiac function classification showed that the patients' medication compliance was positively correlated with the efficacy of the cardiac function classification ( r = 0.243, P < 0.05). The result of multiple linear regression analysis showed that education level and efficacy of the cardiac function classification were influencing factors of the self-management scale for patients with chronic Keshan disease ( t = 2.466, 2.635, P < 0.05). Conclusion:The self-management treatment for patients with chronic Keshan disease can effectively improve heart function and improve self-management behavior.
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Objective:Analyze the monitoring results of drinking water-type endemic fluorosis in Gansu Province, understand the epidemic situation of endemic fluorosis and the operation of water improvement projects, combined with the comprehensive evaluation of water improvement measures, to provide data support and scientific suggestions for making prevention and control measures and strategies of endemic fluorosis.Methods:A simple random sampling method was adopted; six surveillance cites in Gansu Province were selected from 2014 to 2017, including Zhangye, Wuwei, Linxia, Tianshui, Pingliang and Qingyang. In addition, three epidemic villages were selected as fixed monitoring villages in each city. The operation situation of water improvement projects and the fluoride content in drinking water were determined, and the dental fluorosis of children aged 8 to 12 was diagnosed.Results:There was no significant difference in water fluoride from 2014 to 2017 ( H = 1.397, P > 0.05), the normal operation rates of water improvement projects were 84.63% - 100.00%, and the water fluoride of all the water improvement projects in villages with water changed was up to the standard in 2017. In 2017, the average value of water fluoride in 3 of the 4 villages without water improvement exceeded the standard. A total of 4 901 children aged 8 to 12 were investigated, the dental fluorosis prevalence rate of whole children was 38.93% (1 908/4 901), and the dental fluorosis index was 0.64, showing a mild prevalence of dental fluorosis. In 2014 - 2017, the dental fluorosis prevalence rates of children were 29.47% (262/889), 47.24% (735/1 556), 46.60% (700/1 502) and 22.12% (211/954), respectively. Conclusions:The water improvement projects in Gansu Province run well, and the water fluoride exceeds the standard in some areas without water improvement. The detection rate of dental fluorosis of children shows a downward trend year by year, and the condition of fluorosis is effectively controlled. It is suggested to strengthen the operation monitoring and later maintenance of the water improvement projects, implement the water improvement projects in the villages without water improvement as soon as possible, and solve the problem of excessive fluoride content in drinking water of residents in the villages without water improvement.
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Objective:To evaluate the quality of life of patients with chronic Keshan disease, and to explore related influencing factors, in order to provide a theoretical basis for improving the quality of life of patients with chronic Keshan disease.Methods:According to the standard of "Diagnosis of Keshan Disease" (WS/T 210-2011), 110 patients with chronic Keshan disease treated in the Jingchuan People's Hospital, Pingliang City, Gansu Province were selected as the research subjects, and demographic and disease data of the patients were collected by questionnaire survey; the quality of life of patients was assessed by the Minnesota living with heart failure questionnaire (MLHFQ); and correlation analysis was used to analyze and explore the influencing factors of patients' MLHFQ score.Results:Among the 110 patients with chronic Keshan disease, 66 were males and 44 were females, aged (60.93 ± 8.22) years; the education level was mainly junior high school or below, accounting for 92.73% (102/110); average annual family income was 20 700 yuan; the cardio-thoracic ratio of the patient was 0.64 ± 0.09; the ejection fraction (EF) was (36.71 ± 7.55)%; the labor ability classification was mainly based on simple activities, accounting for 60.91% (67/110); and the cardiac function classification was mainly Grade Ⅲ, accounting for 67.27% (74/110). The total MLHFQ scores of chronic Keshan patients were (69.17 ± 16.14) points, and the scores of physical, emotional and other fields were (26.32 ± 6.70), (15.86 ± 4.96) and (26.94 ± 6.10) points, respectively. The total MLHFQ scores had statistically significant differences among patients with different education level, cardio-thoracic ratio, EF, labor ability classification, cardiac function classification and annual family income ( F=7.121, 6.236, 4.515, 3.427, 5.418, Z=2.346 , P < 0.05). The results of correlation analysis showed that educational level and labor ability classification were negatively correlated with scores in physical field and other fields ( r=- 0.302, - 0.206, - 0.343, - 0.285, P < 0.01), and annual family income was negatively correlated with scores in emotional field ( r=- 0.263, P < 0.01). The cardiac function classification was positively correlated with scores in physical and other fields ( r=0.233, 0.210, P < 0.05). Conclusions:The quality of life of patients with chronic Keshan disease is poor. The quality of life of patients is affected by their educational level, annual family income, labor ability classification, cardiac function classification, etc.
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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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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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Keshan disease (KD) is a unique endemic cardiomyopathy of unknown origin in China.According to the state of heart function and the pathogenesis,KD is divided into four types:acute,sub-acute,chronic and latent.Chronic KD comes on slowly,and the clinical manifestation is chronic cardiac insufficiency.Chronic patients often have poor treatment outcomes,with high mortality and disability.This article summarizes the nonpharmacological treatment of heart failure in chronic KD in order to provide a basis for clinical treatment.
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Objective To analyze the difference of echocardiography in patients with chronic Keshan disease (CKD) at different altitudes areas,explore the effects of altitude on the structure and functional of right heart in CKD patients,and provide a reference for imaging diagnosis of CKD.Methods According to the three step distribution of the terrain in China,30 cases of CKD patients in the first step (altitude ＞ 4 000 m) of Tibet autonomous region were randomly selected as the Tibetan plateau group.In the second step (altitude:1 000-2 000 m),31 cases were randomly selected in Gansu Province as the Loess plateau group.In the third step (altitude ＜ 500 m),42 cases were randomly selected in Shandong Province as the plain group.Echocardiography was used to analyze the morphology,hemodynamics and function of right heart.Results Right atrial transverse diameter (RATD),right ventricular transverse diameter (RVTD),right ventricular lateral wall thickness (RVWT) and main pulmonary artery diameter (MPAD) of the Tibetan plateau group,the Loess plateau group and the plain group (mm:49.75 ± 8.40,45.64 ± 7.63,43.56 ± 7.34;50.89 ± 7.13,46.56 ± 5.62,43.27 ± 6.01;4.75 ± 1.02,3.53 ± 0.61,3.37 ± 0.51;32.87 ± 3.62,28.93 ± 2.12,28.44 ± 2.71) were significant differences among the three groups (F =5.36,12.91,37.08,23.33,P ＜ 0.01).The above indexes of the Tibetan plateau group were higher than those of the Loess plateau group and the plain group (P ＜ 0.05).RVTD of Loess plateau group was higher than that of plain group (P ＜ 0.05).The fractional area change [FAC,(24.85 ± 2.75)％,(26.26 ± 3.42)％,(26.73 ± 3.14)％],tricuspid annular plane systolic excursion [TAPSE,(12.87 ± 1.12),(14.59 ± 1.63),(14.13 ± 1.31) mm] of the Tibetan plateau group,the Loess plateau group and the plain group were significant differences among the three groups (F =3.36,13.47,P ＜ 0.05 or ＜ 0.01);the above indexes of the Tibetan plateau group were lower than those of the Loess plateau group and the plain group (P ＜ 0.05).Tei index (0.87 ± 0.18,0.78 ± 0.16,0.71 ± 0.14),tricuspid flap diastolic maximum filling speed/tricuspid annulus early diastolic peak velocity (E/E',9.48 ± 1.22,8.64 ± 0.91,8.12 ± 1.13),systolic pulmonary artery pressure [SPAP,(49.58 ± 11.76),(44.35 ± 11.41),(42.67 ± 12.13) mmHg,1 mmHg =0.133 kPa] of the Tibetan plateau group,the Loess plateau group and the plain group were significant differences among the three groups (F =12.89,13.99,3.12,P ＜ 0.01 or ＜ 0.05);the Tei index and E/E'of the Tibetan plateau group were higher than those of the Loess plateau group and the plain group (P ＜ 0.05).Tei index,E/E'of the Loess plateau group were higher than those of the plain group (P ＜ 0.05).Conclusions The right heart structure and function of CKD patients are affected by the altitude of their residence.With the increase of altitude,the right heart is enlarged,the right ventricular systolic and diastolic functions are decreased,and SPAP is increased in CKD patients.
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Keshan disease is an endemic cardiomyopathy of unclear cause.The major clinical manifestations are cardiac dysfunction and arrhythmia.Based on time course of onset and cardiac function of a suffering patient,Keshan disease is generally classified into four types:acute,sub-acute,chronic and latent types.This article elaborates on the pharmacological mechanisms and dosages of drug treatment for heart failure:diuretics,neurohormonal antagonists,ivabradine,positive inotropic drugs,vasodilators,etc,in order to provide basis for clinical treatment of chronic Keshan disease.
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Objective To evaluate the efficacy of telephone interviews on the quality of life of patients with chronic Keshan disease.Methods Totally 120 cases of chronic Keshan disease patients with chronic heart failure and NYHA classification of Ⅱ-Ⅳ were enrolled among the 181 patients with chronic Keshan disease,which confirmed by case search in Heshui County and Zhengning County in Qingyang City,Gansu Province in 2015,general demographic and clinical data were collected.According to the principle of random number table grouping,these 120 patients were randomly divided into a intervention group (n =60) and a control group (n =60).Both groups were given the conventional therapy and encouraged to inquiry or given regular outpatient medical follow-up.The patients in the intervention group received telephone interviews regularly for 6 months,with a interview frequency once a week in the first month,once every two weeks in the second and third months and once a month in the fourth,the fifth and the sixth months,with about 15 to 20 minutes interviews each time.Meanwhile there was no telephone interviews in the control group.At the begining of study,and after 3 months and 6 months of study,quality of life scores were scored according to the Minnesota Heart Insufficiency Scale (MLHFQ).The scores included total quality of life,physical field scores,emotional field scores,and other field scores.The lower the score,the higher the quality of life.Results After 3 months of telephone interviews,the emotional domain score of the intervention group (10.16 ± 4.58) was lower than that of the control group (13.10 ± 5.37,P ＜ 0.05).After 6 months of telephone interviews,the patients in the intervention group (35.60 ± 16.07,6.67 ± 4.01,13.16 ± 4.13) had significantly better quality of life than those in the control group (57.19 ± 14.97,12.43 ± 5.29,18.94 ± 6.68),with lower total points of life quality,emotion area and other area scores.The differences between the two groups were statistically significant (P ＜ 0.05).Conclusions Telephone interviews may promote the quality of life for patients with chronic Keshan disease.It is an effective way in enhancing the ability of chronic Keshan disease management.
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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,.
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Objective To study the correlation between patellar stability and keen clinical manifestation in adults with Kaschin-Beck disease (KBD).Methods Through a cross-sectional study in September 2016,one hundred and forty-three adult patients with KBD were asked to accept a digital radiographic X-ray (DR) which included positive and lateral slices of knee joint and axis slice of patellar.Meanwhile,every patient must undergo a Lysholm function evaluation for knee joint and morphological measurement on the DR film which included Insall index,lateral patellofemoral angle,sulcus angle,congruence angle,lateral migrating ratio of patella,and patellofemoral index.Then,the regression equation was built and the correlation analysis was made with multiple linear regression test.Results One hundred and forty-three patients' average scores of Insall index,lateral patellofemoral angle,sulcus angle,congruence angle,lateral migrating ratio of patella,patellofemoral index and Lysholm score were 1.10 ± 0.17,(14.49 ± 1.47)°,(138.08 ± 3.86)°,(11.55 ± 2.17)°,(1.34 ± 0.13)％,1.18 ±0.10,and (62.96 ± 6.11) scores.By multiple linear regression test,Insall index (X1),congruence angle (X4),lateral migrating ratio of patella (X5),and patellofemoral index (X6) were selected to enter into the equation;while,lateral patellofemoral angle and sulcus angle were rejected.The multiple linear regression equation was as follows:Y =17.529 + 15.232X5 + 0.950X4 + 15.957X6-4.224X1.The adjusted determination coefficient (R2) of the equation was 0.559.Those indexes which were selected to enter into the equation were ranked from big to small based on the impact on Lysholm as follow:congruence angle,lateral migrating ratio of patella,patellofemoral index,and Insall index.Among them,Lysholm score had a negative correlation with Insall index.Through variance analysis,F valve was 46.642,and P ＜ 0.05,which meant the fitted equation had statistical significance.Conclusion There is significant correlation between the patellar stability and knee Lysholm scoring in adult with KBD,which is reflected with the following parameters from big to small in turn:patellofemoral index,lateral migrating ratio of patella,congruence angle and Insall index.
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Objective To grasp the epidemic features of Kaschin-Beck disease in different ecotypic areas in Gansu Province,in order to provide ecological basis for Kashin-Beck disease control.Methods Totally 37 counties with Kashin-Beck disease were divided into four ecological areas,villages with historical serious condition in township and townships with historical serious condition in county were investigated.Clinical examination and Xray of right hand of all 7-12-year-old children in the villages were carried out,while investigation of prevention and control measures was performed.Results Among 27 966 children from four ecological areas,the clinical detection rate was 0.05％ (14/27 966) and the X-ray positive rate was 1.26％ (353/27 966),metaphyseal rate was 1.25％ (350/27 966),bone-side positive rate was 0.01％ (3/27 966) and no case of epiphyseal and carpal were discovered.The clinical detection rate in children in the four ecological areas was not statistically significant (x2() =7.757,P ＞0.05),the Loess Plateau-gully region of Longdong [0.09％ (10/11 604)] ＞ the Anyon area of Qinling of Longnan [0.04％ (3/7 969)] ＞ Alpine grassland meadow area of Gannan [0.02％ (1/4 021)] ＞ the Loess Plateau-hills region of Longzhong [0 (0/4 372)].The detected rate of X-ray in four ecological areas was statistically significant (x2 =18.133,P ＜ 0.05),the Anyon area of Qinling of Longnan [1.49％ (119/7 969)] ＞ the Loess Plateau-gully region of Longdong [1.41％ (164/11 604)] ＞ the Loess Plateau-hills region of Longzhong [0.89％ (39/4 372)] ＞ Alpine grassland meadow area of Gannan [0.77％ (31/4 021)].Comprehensive prevention and control measures on Kaschin-Beck disease were different in different ecotypic areas.Relocation,long-distance education and selenium supplement measures had not been implemented in the four ecological areas.Conclusion The epidemic situation of Kaschin-Beck disease is different in different ecotypic areas in Gansu Province,which maybe related to ecological environment,but is under a state of control.
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Objective To explore the relationship between prevalence of Kashin-Beck disease (KBD) and ecological environment, and to broaden the perspective of KBD etiology. Methods In 37 counties of KBD areas in Gansu Province, information about the ecological environment and implementation situation of control measures (altitude, temperature, rainfall, evapo ration, frost free period, annual sunshine hours, population density, per capita income, the proportion of staple food, returning farmland to forest, to forestry and replant crops) and X-ray detection rate of KBD of 7-12-year-old children in 2012 - 2014 was collected. Using four quantile regression method, the regression model was introduced to analyze the 11 ecological factors which related to the pathogenesis of KBD. The effect of three points on X-ray detection rate of KBD was estimated. Results The X-ray detection rate of KBD was independent of altitude, temperature, evaporation, population density, per capita income and cash crops, and was dependent of rainfall, frost free period, annual sunshine hours, the staple food purchase ratio, and returning farmland to forest and grassland. No matter where in any place numbered, the higher rainfall (measure value:0.003 3 to 0.006 4), the longer frost free period (measure value: 0.029 2 to 0.043 8), the longer annual sunshine hours (measure value:0.001 6 to 0.001 8), and the higher staple food purchase ratio (measure value:0.019 7 to 0.027 6), the higher risk of X-ray detection rate of KBD; the higher returning farmland to forest and to grassland, the lower risk of X-ray detection rate of KBD (measure value: - 0.037 2 to - 0.013 3). Conclusion The X-ray detection rate of KBD is closely related to local ecological environment.
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Objective To evaluate the correlation between osteophytes size and lower limb alignment in the knees of patients with Kaschin-Beck disease (KBD).Methods A total of 300 clinically diagnosed patients with KBD were X-rayed on knee-joints which ranged from the distal half of femur to proximal half of tibia.Meanwhile some related parameters in the X film with the anteroposterior position (including osteophytes length,femorotibial angle,femorotibial joint space ratio of inner side to outer side) were measured by DICOM 2.0,a software of medical graphic measuring,then followed by calculating the osteophyte spur index.The association between femorotibial angle,femorotibial joint space ratio and osteophytes spur index was evaluated by Pearson correlation test.Results The average of femorotibial angle of all the tested knee-joints was (165.97 ± 4.02)°,which positively correlated with both the osteophyte spur index of the medial femoral condyle [(6.54 ± 3.12)％,correlation coefficient (r) =0.524,P＜0.01] and the osteophyte spur index of medial tibil plateau [(7.14 ± 3.40)％,r =0.578,P ＜0.01].The femorotibial joint space ratio was 0.61 ± 0.13,which positively correlated with both the osteophyte spur index of medial femoral condyle (r =0.531,P ＜0.01) and that of the medial tibil plateau (r =0.563,P ＜0.01).Conclusions The results of this study indicate that there is a positive correlation between lower limb alignment and osteophyte size of both the medial femoral condyle and the medial tibial plateau.This finding may be evidenced by the fact that the changes of lower limb biomechanics may contribute to formation and development of osteophytes in the kneejoint.
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Objective To observe the condition of Keshan disease (KSD) in Gansu Province in order to provide a scientific basis for prevention and control of the disease. Methods In 2011, according to “The national Keshan Disease Monitoring Program (trial edition)”, based on searching of KSD cases, 12 villages of 12 towns in 6 counties of Gansu Province, were selected as surveillance sites. All the residents in surveillance sites were clinically examined and given 12-lead ECG tracings; suspected cases were taken anterior chest X-rays in the distance of 2 meters, while staple food and life conditions of the residents were surveyed. Diagnosis of KSD was based on“Keshan Disease Diagnostic Criteria”(WS/T 210-2011). Results Among investigated 5 484 residents, the incidence of abnormal electrocardiogram was 15.41%. Of the 196 X-ray films, 61 cases had enlarged heart(in which 22 of mild, 21 of moderate and 18 of severe). Two hundred and forty-three cases of KSD were detected, the general detection rate was 4.43%, in which 31 cases of chronic, the detection rate was 0.56%; 212 cases of potential, the detection rate was 3.87%. In all cases, 47 cases were under the age of 30, including 46 cases of potential and 1 case of chronic. The major abnormal electrocardiogram change of KSD cases was ST-T changes[22.68%(71/313)], followed by complete right bundle branch block[16.29%(51/313)], low voltage[12.46%(39/313)], and left anterior fascicular block[6.71%(21/313)]. Per-capita annual income in surveillance site was 1 763 Yuan;and the major staple food was flour, accounted for 87%, and the staple food rice accounted for 5%. Conclusion The detection rate of KSD in Gansu Province is mainly to potential, and there is a cosiderable portion of patients under the age of 30;monitoring and investigation should also be strengthened in the younger age of KSD cases detected village.