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Objective:To investigate epidemiological characteristics of arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province.Methods:A cross-sectional study was conducted. From October 2016 to January 2017, all residents aged over 18 years (except pregnant women) were enrolled from 3 villages in Baiyun Town, Shimen County, Hunan Province by using a cluster-sampling method. Demographic information was collected through a face-to-face questionnaire interview. All residents received skin examination performed by professional dermatologists, and blood, urine, and hair samples were collected for the measurement of arsenic levels. Non-conditional logistic regression analysis was performed to analyze factors associated with arsenic poisoning-related skin lesions.Results:A total of 1 092 eligible residents in the arsenic tailing area were recruited in this study, and 756 (69.2%, 95% CI: 66.5%, 72.0%) presented with arsenic poisoning-related skin lesions, including hyperkeratosis, hypo- or hyper-pigmentation. The median ( Q1, Q3) arsenic levels were 0.31 (0.14, 0.74) μg/g in hair samples ( n = 1 079), 0.84 (0.67, 1.10) μg/L in blood samples ( n =1 091), and 60.31 (41.71, 91.52) μg/L in urine samples ( n =1 092). Multivariable analysis showed that the occurrence of arsenic poisoning-related skin lesions was associated with age, residential location, and occupational arsenic exposure history, but was not associated with gender, ethnicity, education levels, migration history, arsenic levels in hair, blood, or urine. Compared with the group aged 18 - 39 years, the group aged 40 - 59 years and the group aged over 60 years showed significantly higher risks of arsenic poisoning-related skin lesions (adjusted OR = 11.34, 95% CI: 5.98, 21.50, P < 0.001; adjusted OR = 71.82, 95% CI: 35.81, 144.05, P < 0.001, respectively). Compared with the residents in the Wangyangqiao village, residents in the Heshan village and Huangchang village showed significantly higher risks of arsenic poisoning-related skin lesions (adjusted OR = 2.89, 95% CI: 2.05, 4.08, P < 0.001; adjusted OR = 4.13, 95% CI: 1.94, 8.78, P < 0.001, respectively). The risk of arsenic poisoning-related skin lesions was significantly higher in residents with occupational exposure history than in those without (adjusted OR = 1.99, 95% CI: 1.04, 3.83, P = 0.039) . Conclusion:Nearly 70% of the residents presented with arsenic poisoning-related skin lesions in an arsenic tailing area in Hunan Province, and the duration and previous degree of arsenic exposure were associated with the risk of arsenic poisoning-related skin lesions.
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Background Heavy metal emissions from mining and smelting areas are a global problem, and health risks associated with heavy metal contamination of soils are of great concern. The long-term mining of the largest realgar mine in Asia has caused severe arsenic and other metal pollution to the surrounding rivers and soils. Objective To understand the levels of metal contamination and health risks in agricultural soils of villages surrounding the largest realgar mine in Asia, and to lay a good foundation for further necessary pollution control actions and decisions. Methods A field survey was conducted to collect soil samples according to the Technical rules for monitoring of environmental quality of farmland soil (NY/T 395-2012), and then inductively coupled plasma mass spectrometry was used to determine the contents of 28 heavy metals [cadmium (Cd), arsenic (As), lead (Pb), mercury (Hg), chromium (Cr), nickel (Ni), copper (Cu), zinc (Zn), beryllium (Be), selenium (Se), cobalt (Co), antimony (Sb), molybdenum (Mo), vanadium (V), barium (Ba), thallium (Tl), boron (B) , bismuth (Bi), lithium (Li), manganese (Mn), strontium (Sr), calcium (Ca), rubidium (Rb), iron (Fe), magnesium (Mg), aluminum (Al), kalium (K), and titanium (Ti)]. Geoaccumulation index, single factor pollution index, and Nemerow comprehensive index were used to evaluate the degree and characteristics of single metal pollution and combined pollution in soil, respectively. A health risk assessment model was used to evaluate the risks of metals in soil to human health. Results The results of geoaccumulation index calculation revealed that 22 heavy metals were enriched in the soil, and the indexes of target heavy metals from high to low were Cd > Se > Pb >Hg > As > Co> Ni > Cu > Zn > Bi > Sb > Mo > Be> Cr > Ba >V > Li > Sr> Mn> Rb > Ca> Tl . The single factor pollution indexes of 17 heavy metals from high to low were Be > Cd > B > Mo > V > As > Ni > Cu > Pb > Zn > Co > Se > Tl > Ba > Cr > Hg > Sb. The Nemerow comprehensive index indicated all sampling points were graded as severe pollution. The mean of total non-carcinogenic health risk values and the mean of carcinogenic health risk values for the target heavy metals in the area were higher than the threshold (1) and the maximum acceptable risk (1.0×10–4), respectively. The total carcinogenic health risks for adults and children reached 1.1×10–3 and 1.67×10–3, respectively. The mean non-carcinogenic health risk values of As, Co, Cr, and Pb pollution were greater than 1, and the maximum non-cancer risk value of Sb for children was greater than 1. The mean carcinogenic risk values of Ni, As, and Cu exceeded 1.0×10–4 for both adults and children, and the maximum carcinogenic risk values of Be and Cr for children were more than 1.0×10–4. Conclusion The farmland soil around the hugest realgar mine in Asia is contaminated by multiple metals. The study soil is seriously polluted by Cd, Se, Pb, As, Hg, Be, B, Mo, V, Ni, Cu, Pb, Zn, Co, and Ba. The pollution of Ni, As, Cu, Cr, and Be is considered as carcinogenic hazards to health, while the pollution of As, Co, Cr, Pb, and Sb poses non-carcinogenic health risks. Our study findings show that the soil is polluted by Co and Group 1 carcinogen Be, which could cause health risks; although Cr and Sb have not reached severe pollution levels, there are certain health risks and also need attention.
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Objective:To analyze the relationship between plasma uranium concentration and renal injury.Methods:A case-control study was conducted in Hunan province, involving 102 renal injury cases and 102 matched controls. The association between plasma uranium concentration and renal injury was analyzed using conditional logistic regression models, and the dose-response relationship was analyzed through restricted cubic spline regression. The linear regression model and Spearman correlation were used to analyze the association between plasma uranium concentration and renal injury indicators.Results:The median of plasma uranium concentration was 8.94 ng/L in all subjects and 10.19 ng/L in the case group. The plasma uranium may be a risk factor for renal injury, with a dose-response relationship between the both representing nonlinear association ( χ2=5.15, P<0.05). The risk of renal injury was 4.21 times higher in the group exposed to highest uranium concentration than that in the group exposed to lowest uranium concentration. Plasma uranium concentration was closely related to glomerular filtration rate, serum creatinine and β 2-microglobulin ( r=0.211, -0.142, 0.195, P<0.05). Conclusions:The plasma uranium concentration is significantly associated with the renal injury, which may provide epidemiology evidence for the prevention of renal injury.
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Chronic kidney disease (CKD) is suffered progressive loss of kidney function lasting more than 3 months and is classified according to the degree of kidney damage (level of proteinuria) and the decreased glomerular filtration rate (GFR). The most severe form of CKD is end-stage renal disease. The prevalence of CKD is high with fast growth rate and the disease burden has become increasingly serious. CKD has become an important public health problem threatening human health. The etiology of CKD is complex. In addition to genetic factors, environmental factors are an important cause of CKD. With the development of industrialization, environmental metal pollution has become increasingly severe, and its impact on human health has received widespread attention. A large number of studies have shown that metals such as lead, cadmium, and arsenic can accumulate in the kidney, which can cause damage to the structure and function of the kidney, and play an important role in the development of CKD. Therefore, summarizing the epidemiological research progress in the relationship between arsenic, cadmium, lead, and other metal exposures and kidney diseases can provide new ideas for the prevention and control of kidney diseases caused by metal exposure.
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Humanos , Cadmio/toxicidad , Arsénico/toxicidad , Riñón , Insuficiencia Renal Crónica/epidemiología , Fallo Renal CrónicoRESUMEN
Background Exposure to uranium can result in multi-organ toxicity in humans. Some experimental studies have shown that uranium presents a damaging effect on liver, but no relevant population studies have been reported. Objective To investigate a potential association of plasma uranium exposure with liver injury. Methods The inhabitants of two representative areas of heavy metal pollution in northern and southern Hunan were selected as the research subjects. A total of 740 participants were recruited through 1∶1 paired case-control design based on a pre-determined diagnostic criterion for liver injury (defined as two or more anomalies among alanine aminotransferase, aspartate aminotransferase, and total bilirubin in the health examination) and the principle of case-control comparability. Information such as general demographic characteristics and medical history were collected through questionnaires and physical examination. Plasma uranium and liver function were determined by laboratory tests. Spearman correlation was applied to assess the association between plasma uranium concentration and liver injury indexes, and restricted cubic spline model was used to evaluate the dose-response relationship between plasma uranium concentration and liver injury. The participants were divided into four groups from Q1 to Q4 according to the quartile values of plasma uranium concentration of the control group after natural logarithmic transformation (with the Q1 group as the reference group), and the association between plasma uranium concentration and liver injury was evaluated by conditional logistic regression. Results The plasma uranium level in M (P25, P75) of the case group was 10.89 (6.78-18.53) ng·L−1, higher than that in the control group, 9.26 (5.01-14.38) ng·L−1 (P<0.001). The results of Spearman correlation analysis showed that alanine aminotransferase and aspartate aminotransferase were positively correlated with plasma uranium level (rs=0.138, rs=0.167; P<0.001). The restricted cubic spline model showed that the risk of liver injury increased with the increase of plasma uranium concentration (overall effect P<0.001). After adjusting for confounding factors such as gender, age, smoking, alcohol consumption, and prevalence of hypertension and hyperlipidemia, the results of conditional logistic regression analysis showed that the risks of liver injury in the Q2 group, the Q3 group, and the Q4 group were 2.043 (95%CI: 1.135-3.680), 2.246 (95%CI: 1.238-4.075), and 3.536 (95%CI: 1.955-6.397) times higher than that of the Q1 group respectively. Conclusion Plasma uranium exposure is associated with liver injury. This study is the first to provide population-level evidence of such an association.
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The COVID-19 is currently spreading around the world, which has posed significant threats to global health and economy. Convalescent plasma is confirmed effective against the novel corona virus in preliminary studies. In this paper, we first described the therapeutic schedule, antibody detection method, indications, contraindications of the convalescent plasmas, and reported the operability of the treatment by case study.
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BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been identified as the cause of the ongoing worldwide epidemic of Coronavirus Disease 2019 (COVID-19) in China and worldwide. However, there were few studies about the effects of SARS-CoV-2 infection on pregnant women. MethodsIn this retrospective cohort study, we enrolled 31 pregnant women and 35 non-pregnant women from Jan 28 to Feb 28, 2020 to evaluate the effects of SARS-CoV-2 infection during pregnancy. Inflammatory indices were used to assess the severity of COVID-19. Evidence of vertical transmission was determined by laboratory confirmation of SARS-CoV-2 in amniotic fluid, placenta, neonatal throat and anal swab and breastmilk samples. FindingsCompared with non-pregnant women, pregnant women had a significantly lower proportion of fever (54{middle dot}8% vs. 87{middle dot}5%, p= 0.006), a shorter average interval from onset to hospitalization (7{middle dot}80 {+/-}7{middle dot}0d vs. 13{middle dot}2 {+/-} 8{middle dot}2d, p= 0.005), and a higher proportion of severe or critical COVID-19 (32{middle dot}3% vs. 11{middle dot}4%, p=0.039). Neutrophil-to-lymphocyte ratio (NLR) and systematic immune-inflammation-based prognostic index (SII) were significantly higher on admission in severe/critical pneumonia group than moderate pneumonia group. We could not detect the presence of SARS-CoV-2 by RT-PCR in amniotic fluid, placenta, neonatal throat and anal swab and breastmilk samples. InterpretationThe clinical symptoms of COVID-19 in pregnant women were insidious and atypical, compared with those in non-pregnant patients. SII and NLR could be a useful marker to evaluate the severity of COVID-19. There was no evidence of vertical transmission during pregnancy with SARS-CoV-2 infection. FundingNational Natural Science Foundation of China and Research Funds for the Central Universities. Research in contextO_ST_ABSEvidence before this studyC_ST_ABSWe searched PubMed, Embase and Web of science for articles published up to March 1st, 2020, using the keywords ("novel coronavirus" OR "2019 novel coronavirus" OR "2019-nCoV" OR COVID-19 OR SARS-CoV-2) AND (pregnancy OR "maternal infection" OR "fetal infection") AND "Cohort studies". We identified no published cohort studies on pregnant women with the 2019 novel coronavirus disease (COVID-19) infection. Added value of this studyFor this retrospective cohort study, we reviewed clinical records, laboratory findings, and chest CT scans from 31 pregnant women and 35 non-pregnant women from Jan 28 to Feb 28, 2020 to evaluate the effects of SARS-CoV-2 infection during pregnancy. Inflammatory indices were used to assess the severity of COVID-19. Evidence of vertical transmission was determined by laboratory confirmation of SARS-CoV-2 in amniotic fluid, placenta, neonatal throat and anal swab and breastmilk samples. Compared with non-pregnant women, pregnant women had a significantly lower proportion of fever (54{middle dot}8% vs. 87{middle dot}5%, p= 0.006), a shorter average interval from onset to hospitalization (7{middle dot}80 {+/-}7{middle dot}0d vs. 13{middle dot}2 {+/-} 8{middle dot}2d, p= 0.005), and a higher proportion of severe or critical COVID-19 (32{middle dot}3% vs. 11{middle dot}4%, p=0.039). Neutrophil-to-lymphocyte ratio (NLR) and systematic immune-inflammation-based prognostic index (SII) were significantly higher on admission in severe/critical pneumonia group than moderate pneumonia group. Amniotic fluid, placenta, neonatal throat and anal swab and breastmilk samples were tested for SARS-CoV-2 by RT-PCR and all results were negative. Implications of all the available evidenceThe clinical symptoms of COVID-19 in pregnant women were insidious and atypical, compared with those in non-pregnant patients. SII and NLR could be a useful marker to evaluate the severity of COVID-19. There was no evidence of vertical transmission during pregnancy with SARS-CoV-2 infection.
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BackgroundThe 2019 novel coronavirus disease (COVID-19) emerged in Wuhan, Hubei province, China, and was characterized as pandemic by the World Health Organization. Diabetes mellitus is an established risk factor for poor clinical outcomes, but the association of diabetes with the prognosis of COVID-19 have not been reported yet. MethodsIn this cohort study, we retrospectively reviewed 258 consecutive hospitalized COVID-19 patients with or without diabetes at the West Court of Union Hospital of Huazhong University of Science and Technology in Wuhan, China, recruited from January 29 to February 12, 2020. The cases were confirmed by real-time PCR and the demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Prognosis was defined as hospitalization, discharged survivor and death, which was followed up until March 12, 2020. ResultsOf the 258 hospitalized patients (63 with diabetes) with COVID-19, the median age was 64 years (range 23-91), and 138 (53.5%) were male. No significant differences in age and sex were identified between patients with and without diabetes. Common symptoms included fever (82.2%), dry cough (67.1%), polypnea (48.1%), and fatigue (38%). Patients with diabetes had significantly higher leucocyte and neutrophil counts, and higher levels of fasting blood glucose, serum creatinine, urea nitrogen and creatine kinase isoenzyme MB at admission compared with those without diabetes. COVID-19 patients with diabetes were more likely to develop severe or critical disease condition with more complications at presentation, and had higher incidence rates of antibiotic therapy, non-invasive and invasive mechanical ventilation, and death (11.1% vs. 4.1%). Cox proportional hazard model showed that diabetes (adjusted hazard ratio [aHR]=3.64; 95% confidence interval [CI]: 1.09, 12.21) and fasting blood glucose (aHR=1.19; 95% CI: 1.08, 1.31) were associated with the fatality of COVID-19, adjusting for potential confounders. ConclusionsDiabetes mellitus is associated with greater disease severity and a higher risk of mortality in patients with COVID-19. Primary and secondary prevention strategies are needed for COVID-19 patients with diabetes.
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OBJECTIVES@#To evaluate residents' knowledge, attitude and behavior towards coronavirus disease 2019 (COVID-19) in Hunan Province, and to explore the factors influencing behaviors.@*METHODS@#A self-designed questionnaire was used to conduct an online survey for 4 139 Hunan residents. The contents included general population information, residents' knowledge, attitude and practice to COVID-19.@*RESULTS@#Mean scores of knowledge, attitude, and behavior were 29.82±3.16, 6.71±1.12, and 14.93±1.45, respectively. Residents had the highest score of major symptoms of COVID-19 (3.96±0.39), but the lowest was the main transmission routes (3.47±0.89). A total of 22.68% of the residents were very or relatively afraid of the outbreak, but 95.22% of the residents had confidence in defeating COVID-19. In behavior dimension, "handling of suspicious symptoms" had the lowest score (3.58±0.75). The behavior implementation rate of "keep the surfaces of household items clean" (80.50%), "doing more exercise, reasonable diet, working and resting regularly" (84.59%), and "avoid hand contacting with eyes, mouth or nose" (89.51%) were relatively low. Pearson correlation coefficient showed that the knowledge, attitude, and practices score were correlated with each other (knowledge vs behavior: =0.366; knowledge vs attitude: =0.041; attitude vs behavior: =0.100; all <0.05). Multiple linear regression analysis showed that the knowledge, attitude and behavior on COVID-19 were mostly influenced by education background (all <0.05), and the independent factors affecting behavior included knowledge and attitude, gender, permanent residence, education background (all <0.05).@*CONCLUSIONS@#Residents in Hunan Province have a good knowledge, attitude, and behavior to COVID-19. Nevertheless there are still weak links to be improved in all dimensions. It is necessary to strengthen knowledge and behavior of family protection, and care for residents' psychological health, especially persons with low education degree, male and rural residents.
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Humanos , Betacoronavirus , China , Infecciones por Coronavirus , Psicología , Conocimientos, Actitudes y Práctica en Salud , Pandemias , Neumonía Viral , Psicología , Encuestas y CuestionariosRESUMEN
By searching the database of CNKI, Wanfang and PubMed, the prevalence and risk factors of atopic dermatitis, psoriasis, acne, and urticaria were relatively more investigated, which were the skin diseases of more concern in the current epidemiological study of skin diseases. Three national epidemiologic surveys reported that the prevalence of atopic dermatitis increased from 0.69% in 1998, to 3.07% in 2002, and 12.94% in 2014, respectively. The prevalence of psoriasis increased from 0.123% in 1984 to 0.47% in 2009 according to 2 national surveys. The prevalence of acne was 8.1% in a national investigation in 2008. Representative national prevalence data of urticaria is not available. Risk factors for these skin diseases are distinct. Atopic dermatitis, psoriasis, and urticaria are more related to environment and mental stress, while acne is more related to skin type and dietary factors. Owing to the heterogeneities in diagnostic methods used in the dermatoepidemiologic surveys (some of the diagnoses were self-reported) and a lack of follow ups, the reliability of data remained questionable, and the comparability across the surveys was difficult. As a result, it is necessary to conduct population-based cohort studies on skin diseases in China.
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Humanos , Acné Vulgar , Epidemiología , China , Epidemiología , Dermatitis Atópica , Prevalencia , Psoriasis , Epidemiología , Reproducibilidad de los Resultados , Factores de Riesgo , UrticariaRESUMEN
To construct an intelligent assistant diagnosis model based on the clinical images of basal cell carcinoma (BCC) and pigmented nevi in Chinese by using the advanced convolutional neural network (CNN). Methods: Based on the Xiangya Medical Big Data Platform, we constructed a large-scale clinical image dataset of skin diseases according to Chinese ethnicity and the Xiangya Skin Disease Dataset. We evaluated the performance of 5 mainstream CNN models (ResNet50, InceptionV3, InceptionResNetV2, DenseNet121, and Xception) on a subset of BCC and pigmented nevi of this dataset. We also analyzed the basis of the diagnosis results in the form of heatmaps. We compared the optimal CNN classification model with 30 professional dermatologists. Results: The Xiangya Skin Disease Dataset contains 150 223 clinical images with lesion annotations, covering 543 skin diseases, and each image in the dataset contains support for pathological gold standards and the patient's overall medical history. On the test set of 349 BCC and 497 pigmented nevi, the optimal CNN model was Xception, and its classification accuracy can reach 93.5%, of which the area under curve (AUC) values were 0.974 and 0.969, respectively. The results of the heatmap showed that the CNN model can indeed learn the characteristics associated with disease identification. The ability of the Xception model to identify clinical images of BCC and Nevi was basically comparable to that of professional dermatologists. Conclusion: This study is the first assistant diagnosis study for skin tumor based on Chinese ethnic clinical dataset. It proves that CNN model has the ability to distinguish between Chinese ethnicity's BCC and Nevi, and lays a solid foundation for the following application of artificial intelligence in the diagnosis and treatment for skin tumors.
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Humanos , Área Bajo la Curva , Carcinoma Basocelular , Diagnóstico por Imagen , Redes Neurales de la Computación , Nevo Pigmentado , Diagnóstico por Imagen , Neoplasias Cutáneas , Diagnóstico por ImagenRESUMEN
According to the new biopsychosocial medical model,status and burden of diseases should be evaluated comprehensively,and health-related quality of life can be an important measurement index of the burden of diseases.Conventional assessment methods for health-related quality of life include interval-based assessment methods and preference-based assessment methods (health utilities and willingness-to-pay).This review introduces willingness-to-pay,and summarizes its applications in skin diseases.However,at present,only a small quantity of small-scale studies are available on willingness-to-pay,with only a few kinds of skin diseases involved.In the application of health-economic assessment of skin diseases,willingness-to-pay can serve as an approximate index of benefit gains,and be more valuable in practice than health utilities (the index of utility gains).With the increase in health-economic researches on skin diseases,more attention is paid to the willingness-to-pay for skin diseases and other health-economic assessment methods,and large-scale health-economic assessment-related researches are expected to be conducted on more kinds of skin diseases.
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Objective To understand health literacy levels in elderly people aged 60 years and above in Hunan, and explore factors related to health literacy.Methods Hunan residents aged 60 years and above were randomly recruited by the multistage stratified cluster sampling method.A total of 611 elderly people from 13 counties of Hunan were included in the study, which was conducted through questionnaires.Results The median health literacy score for elderly people aged 60 years and above was 51.00 (4-90), and it was lower than that for people under 60 years old, which was 56.00.Single factor analysis found that education level, occupation, number of family members, and household income each had an influence on health literacy scores (H=59.526, 20.609, 17.214, and 50.749, respectively;P=0.000, 0.002, 0.001 and 0.000, respectively).The number of people with basic health literacy accounted for 10.6% (65/611) of the total.Multiple logistic regression analysis found that chronic disease was a factor affecting basic health literacy.Compared with elderly people without chronic diseases, a higher percentage of people with basic health literacy was among elderly people with chronic diseases (OR =1.870, 95% CI: 1.037-3.373).Conclusions The health literacy level is lower in elderly people aged 60 years and above than those under 60 years old in Hunan.Only 10.6% (65/611) of them show basic health literacy.Education level, occupation, number of family members, and household income are the factors related to health literacy.Health education about healthy lifestyle and behavior as well as chronic disease prevention and control should be increased in order to improve the health literacy level in elderly people.
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Objective To promote the standardization of medical practice in China by comparing the discrepancies of diagnosis and medication strategies for benign prostatic hyperplasia (BPH) between urologists and geriatricians.Methods Departments of urology and geriatrics in general hospitals in China were selected through stratified sampling and 145 315 patients who went for the outpatient service in certain days during December 2011 to December 2012 were recruited by cluster.Questionnaires were completed by corresponding doctors and data of patient clinical characteristics as well as diagnostic and therapeutic pattern were collected.Results A total of 142 511 valid questionnaires were collected with 119 426 from urology and 23 085 from geriatrics.The average age of BPH patients was (68.34±8.61) years and the average IPSS was 17.93±4.73.The rates of diagnostic method were IPSS (99.2%),ultrasonic inspection (86.0%),digital rectal examination (DRE) (66.0%) and urine flow rate test (55.2%).The rate of ultrasonic application was lower while the rates of other methods were higher among urologists (P<0.01) ; the rate of DRE among urologists was 2.2 times to that among geriatricians.For patients with moderate or severe symptoms,most urologists (72.1% in moderate patients and 79.9% in severe patients) applied drug-combination strategy and the rate was 2 times to that among geriatricians (P<0.01).In contrast,most geriatricians (59.7% in moderate patients and 56.1% in severe patients) applied single drug to BPH patients.Urologists utilized α-receptor blockers,plant preparations and traditional Chinese medicine more frequently than geriatricians (P<0.01).Conclusions Urologists performed more integrated diagnosis strategy compared with geriatricians.The urologists tended to use 5α-reductase inhibitor combined with α-receptor blocker to treat BPH patients with moderate or severe symptoms,while geriatricians preferred 5α-reductase inhibitor alone.
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OBJECTIVE@#To evaluate the effect of nutrition and food safety education among middle school students in a poverty-stricken county in west China, and to explore the better education model for further education.@*METHODS@#Students of grade 7 to 9 were selected from 4 middle schools in the country through multi-stage cluster sampling for the questionnaire, and the schools were assigned into an intervention group or a control group. After students in the intervention schools completed one year nutrition and food safety education with the textbooks, students were chosen from the same 4 schools to finish the same questionnaire again.@*RESULTS@#A total of 410 students from grade 7 to 9 were selected at the baseline study, and 474 students in the final study. The essential characteristics of the 2 groups were not statistically significant (P>0.05). In the baseline investigation, the differences in the scores on nutrition and food safety knowledge, attitude and practice between the 2 groups were not significant (P>0.05). In the final study, the scores on the knowledge, attitude of nutrition knowledge learning, and dietary habits among students in the intervention group were significantly higher than those in the control group (P0.05).@*CONCLUSION@#Nutrition and food safety education can improve the nutrition and food safety knowledge effectively. The curriculum should be further standardized and different emphases should be set up to different grades to cultivate healthy diet behaviors.
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Humanos , China , Dieta , Inocuidad de los Alimentos , Educación en Salud , Conocimientos, Actitudes y Práctica en Salud , Ciencias de la Nutrición , Educación , Pobreza , Instituciones Académicas , Estudiantes , Encuestas y CuestionariosRESUMEN
Green hospital construction is a new challenge for medical industry after global sustainable development strategy was put forward. The core connotation of green hospital includes green building, green healthcare, patient safety, and doctor-patient harmony. Many countries have established green building evaluation system to deal with energy crisis. Leadership in Energy and Environmental Design (LEED), Green Guide for Health Care (GGHC) in the U.S., and Evaluation System for Green Hospital Building (CSUS/GBC 2-2011) in China have guiding signiifcance for the development of green hospitals in China. The evaluation system of green hospitals home and abroad still focuses on green building, and establishment of suitable synthesis evaluation system of green hospitals in China needs further research.
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Objective To comparing the diagnostic and therapeutic strategies for patients with benign prostatic hyperplasia(BPH) between doctors in general hospitals and community hospitals,and to provide scientific clues for the standardization in medical practice.Methods General and community hospitals in urban China were selected via the stratified sampling.127,325 outpatients in these hospitals from December 2011 to December 2012 were randomly recruited.Results The average age of patients was(67.82±8.62) years.There were significant differences in I-PSS,prostate volume,urinary flow rate(UFR) and result of digital rectal examination(DRE) between patients in general and community hospitals.The rates of diagnostic applications were different between doctors in the two kinds of hospitals except I-PSS.Compared with community hospitals,DRE was more frequently applied while ultrasonic inspection and UFR test were less used in general hospitals in North China.A totally opposite situation was observed in East China as compared with the north.The application rates of DRE and UFR test were lower and ultrasonic inspection rate was higher in community hospitals than in general hospitals in South China.Pharmacotherapy was the most common treatment for BPH patients in both types of hospitals(97.53 %).The rates of drug combinations were statistically different but both were close to 75% in the two types of hospitals.In community hospitals,the percentage of patients receiving watchful waiting with severe symptoms and signs were lower than that of patients receiving watchful waiting with moderate symptoms and signs,but the percentage of patients receiving operation was not significantly increased.On the contrary,the percentage of patients receiving operation with severe symptoms and signs was higher than that of patients receiving operation with moderate symptoms and signs in general hospitals,but the percentage of patients receiving watchful waiting was not decreased.Conclusions Applications of diagnostic methods are significantly different between doctors in general hospitals and community hospitals and vary among regions.Therapeutic strategies are correlated with the severity of obstructive symptoms or signs.The medication strategy is similar between the two types of doctors.
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OBJECTIVE@#To evaluate the rationality and validity of weighted TOPSIS method and weighted RSR method to evaluate drug supervision and supply networks construction in rural areas of Hunan .@*METHODS@#Data of drug network construction in rural Hunan in 2010 were used to establish a comprehensive evaluation model, and weighted TOPSIS and RSR method were applied to this model and the results of which were compared to that of synthetical scored method to examine the validity.@*RESULTS@#A comprehensive evaluation model was established, comprising of 3 primary indices, 8 secondary indices and 56 tertiary ones. The result of weighted RSR method was highly correlated to that of synthetical scored method, yet the result of TOPSIS was less correlated to the formers. All correlations were significant (P<0.01).@*CONCLUSION@#Both weighted RSR and TOPSIS are not perfect methods, but the application of the methods in drug network evaluation is scientific and effective.
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China , Metodologías Computacionales , Técnicas de Apoyo para la Decisión , Honorarios y Precios , Modelos Teóricos , Preparaciones Farmacéuticas , Estándares de Referencia , Servicios de Salud RuralRESUMEN
OBJECTIVE@#To establish a scientific foundation for cosmetic supervision and administration based on the analysis of the sanitary quality of cosmetics in Hunan Province during 2010.@*METHODS@#According to Cosmetic Sanitary Standards (set by the Ministry of Health, People's Republic of China), 150 random samples of cosmetics in Hunan were assayed both for microbial items (including total plate count, fungus and yeast, fecal coliform, staphylococcus aureus, pseudomonas aeruginosa) and chemical items (including 17 kinds of prohibited substances and 14 kinds of restricted substances).@*RESULTS@#The total rate of cosmetics failing to meet the standards was 22.0% of the 150 samples; specific rates for failing perfumes, skin care products (eye cream) and deodorant products were, relatively, 70.6%, 60.00%, and 44.4%. Four kinds of prohibited substances, including diethyl phthalate, acrylamide, asbestos and neodymium, as well as 2 kinds of restricted substances, including triclosan and formaldehyde, were found to exceed standards. None of microbial items exceeded standard levels.@*CONCLUSION@#The sanitary quality control of cosmetics is lax. Administrative departments should not only reinforce their post-production supervision with respect to cosmetics, but also consolidate their control over the process of cosmetic production in order to solve the problem of toxic residues or illegal and intentional adulterations.
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Humanos , China , Cosméticos , Química , Estándares de Referencia , Formaldehído , Ácidos Ftálicos , Control de Calidad , Staphylococcus aureusRESUMEN
Prohibited substances in cosmetics refer to substances which must not be among the raw material ingredients of cosmetic products. These substances are absorbed mostly through skin, as well as via lung and gastrointestinal tract. Polyacrylamide is ubiquitously used in industry and its decomposition residue acrylamide (ACR) easily finds its way into cosmetic products. ACR can either be oxidized to epoxide glycidamide or conjugated with glutathione, hemoglobin or DNA; ultimately it is excreted in urine. ACR causes neurotoxicity, reproductive toxicity and tumors in rodents. Occupational exposure to ACR causes neurotoxicity in humans; however, epidemiological evidence have not unambiguously answered the question of whether ACR exposure can increase cancer risk for humans.