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Acute coronary syndrome(ACS)is a common type of acute and critical disease in Coronary Heart Disease(CHD).It is characterized by multiple and severe symptoms and rapid progression of the disease,which seriously threatens the life safety of patients.In this paper,the relevant studies on symptom cluster of patients with ACS were systematically searched at home and abroad,and the composition of symptom cluster,symptom assessment tools,symptom cluster establishment methods,influencing factors and intervention methods were reviewed,in order to provide references for nurses to manage ACS symptom cluster.
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Objective To investigate the radioactivity levels of gross α and gross β in foods around Zhangzhou nuclear power plant, China before operation. Methods Forty-nine samples from 33 kinds of foods in 5 categories of daily food around Zhangzhou nuclear power plant were collected, pretreated, dried, and ashed. The radioactivity levels of gross α and gross β were measured by the low-background α and β measuring instrument. The atomic absorption technique was employed to measure the level of potassium (K), and the radioactivity level of gross β (subtracting 40K) was calculated with K concentrations in different foods consulted from the nutritional dietary system. Results The radioactivity levels of gross α in vegetables and fruits, grain, poultry and livestock, aquatic products, and tea around Zhangzhou nuclear power plant were < minimum detectable level (MDL)-7.97, < MDL-6.82, < MDL, < MDL-20.76, and 11.90-23.08 Bq/kg, respectively; the radioactivity levels of gross β were 34.56-122.81, 13.05-188.96, 56.00-108.34, 17.86-169.01, and 123.74-171.63 Bq/kg, respectively; the radioactivity levels of gross β (subtracting 40K) were not detected (ND)-14.27, ND-27.86, ND-48.72, ND-45.85, and 6.69-13.79 Bq/kg, respectively. Conclusion The radioactivity of gross α and gross β in foods around Zhangzhou nuclear power plant before operation is basically at the same level as that in other areas of China.
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Patients with chronic obstructive pulmonary disease have the disease phenomenon of fear of exercise because of dyspnea, which can accelerate the body degradation rate, weaken muscle strength, reverse increase dyspnea, and delay the recovery of the disease. As a result, this article examines the theoretical underpinnings and specific measures of dyspnea belief intervention programs for chronic obstructive pulmonary disease patients at home and abroad, summarizes the limitations of previous studies, and makes pertinent recommendations in an effort to serve as a guide for early patient prevention and the development of scientific and feasible intervention programs.
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ObjectiveTo understand the current status of human immunodeficiency virus （HIV）， Treponema pallidum （TP）， hepatitis C virus （HCV） and hepatitis B virus （HBV） infections among patients undergoing screening tests in a specialized cancer hospital in South China， and to analyze the completion of further testing for confirmation， so as to provide a reference for management of common infectious diseases and prevention of nosocomial infections. MethodsWe analyzed the positive rates of HIV antigen/antibody combination assay （HIV-comb）， TP antibody （anti-TP）， HCV antibody （anti-HCV） and hepatitis B surface antigen （HBsAg） among the outpatients and inpatients who underwent the screening tests in 2022. Then we examined the percentage of those patients with seropositivity for further confirmation. ResultsIn patients who underwent the screening tests， the positive rate， percentage of patients for further confirmation test and overall prevalence for HIV-comb were were 0.07%， 100% and 0.06%， respectively； for Anti-PT 1.99%， 100% and 0.51%， respectively. Positive rate of anti-HCV was 0.90% and 26.61% of patients completed further HCV RNA quantitative assay， in 26.44% of whom， HCV RNA levels were above the detection limit. Positive rate of HBsAg was 21.06% and 54.40% of patients completed further HBV DNA quantitative assay， in 51.60% of whom， HBV DNA levels were above the detection limit. As for the nucleic acid testing among the suspected hepatitis patients， we found smaller coverage in outpatients than in inpatients and larger coverage in liver cancer patients than in other patients. ConclusionsCompared with general population， patients in this specialized cancer hospital had similar infection levels of HIV and syphilis， and 100% of them completed further confirmation testing. Hepatitis C and hepatitis B infections were at a relatively high level， but which could not accurately reflect the level of virus replication due to insufficient coverage of nucleic acid testing. Specialized cancer hospitals should prompt medical staff to attach more importance to screening and further confirmation of common infectious diseases among tumor patients. While offering anti-cancer treatment， hospitals should also actively refer the confirmed cases with infectious diseases to designated or general hospitals for a better outcome and quality of medical services.
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Background/Aims@#Previous studies have shown that diet and physical activity can influence constipation. However, the combined effect of diet and physical activity on constipation remains unclear. @*Methods@#Constipation was defined based on stool consistency and frequency, while overall diet quality was assessed using Healthy Eating Index (HEI)-2015 scores. Participants were categorized into low (metabolic equivalent [MET]-min/wk < 500) and high physical activitygroups (MET-min/wk ≥ 500). The association between diet and constipation across physical activity groups was analyzed using surveylogistic regression and restricted cubic splines. @*Results@#Higher HEI-2015 scores were associated with reduced constipation risk in the high physical activity group when constipation was defined by stool consistency (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97-0.99). However, in the low physical activity group, increased HEI-2015 scores did not significantly affect constipation risk (OR, 1.01; 95% CI, 0.97-1.05). Similar results were found when constipation was defined based on stool frequency. In the high physical activity group, increased HEI-2015 scores were significantly associated with a reduced constipation risk (OR, 0.96; 95% CI, 0.94-0.98). Conversely, in the low physical activity group, increased HEI-2015 scores did not affect the risk of constipation (OR, 0.96; 95% CI, 0.90-1.03). @*Conclusions@#Our findings suggest that a higher HEI-2015 score is negatively associated with constipation among individuals with high physical activity levels but not among those with low physical activity levels. This association was consistent when different definitions of constipation were used. These results highlight the importance of combining healthy diet with regular physical activity to alleviate constipation.
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Objective To explore the mechanism of Wumei pill on ulcerative colitis(UC)in mice based on the anti oxidative stress pathway of nuclear factor erythroid 2-related factor 2(Nrf2)/antioxidant response element(ARE).Methods Seventy SPF male C57BL/6 mice were randomly divided into the control group,the UC group,the mesalazine group(MES group,0.82 g/kg MES),the low dose Wumei pill group(WMW-L group,5 g/kg crude drug),the middle dose Wumei pill group(WMW-M group,10 g/kg crude drug),the high dose Wumei pill group(WMW-H group,20 g/kg crude drug)and the high dose Wumei pills+Nrf2 inhibitor ML-385 group(WMW-H+ML-385 group,Wumei pills crude drug 20 g/kg+20 mg/kg ML-385),with 10 rats in each group.The disease activity index(DAI)score and colonic mucosa injury score were performed in mice after the last administration.Pathological changes of colonic mucosa in mice were observed by HE staining.The levels of interleukin(IL)-1β,tumor necrosis factor-α(TNF-α)and IL-6 in serum and colon tissue of mice were measured by enzyme-linked immunosorbent assay(ELISA).The content of malondialdehyde(MDA)in serum and colon tissue of mice was determined by thiobarbituric acid colorimetry(TBA).The activity of superoxide dismutase(SOD)in serum and colon tissue of mice was measured by xanthine oxidase method.The activity of glutathione peroxidase(GSH-px)in serum and colon tissue of mice was determined by direct method with dithiodinitrobenzoic acid(DTNB).The positive expression of Nrf2 in colon tissue of mice was observed by immunohistochemistry.The expression of heme oxygenase-1(HO-1)and NAD(P)H:quinone oxidoreductase-1(NQO1)proteins in colon tissue of mice were detected by Western blot assay.Results Compared with the control group,the DAI score,colonic mucosa injury score,colonic histopathology score,levels of IL-1β,TNF-α,IL-6 and MDA in serum and colonic tissue,and expression levels of Nrf2,HO-1 and NQO1 protein in colonic tissue of mice were increased in the UC group,levels of SOD and GSH-px in serum and colon tissue decreased(P＜0.05),the colon mucosa of mice was seriously damaged.Compared with the UC group,changes of corresponding indexes were contrary to the above in the MES group,the WMW-M group and the WMW-H group.However,the expression levels of Nrf2,HO-1 and NQO1 proteins in colon tissue were increased(P＜0.05),and the damage of colon mucosa in mice was alleviated.Changes of the above indexes were dose-dependent in the WMW-L group,the WMW-M group and the WMW-H group.There were no significant differences in the above indexes between the WMW-H group and the MES group.ML-385 attenuated the improvement effect of high dose Wumei pill on colon mucosa injury.Conclusion Wumei pill may alleviate the colon mucosal damage of UC mice by activating Nrf2/ARE antioxidant stress pathway.
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Objective Toexplore a path to improving surgical operation statistical indexes during the expansion of multi-campus hospitals.Methods In this study we selected the data from the medical records of two surgical departments(A1 and A2)from two campuses of a hospital in the first half of 2023,following by analyzing patients'general information,fourth-level surgical procedures,non-fourth-level surgical procedures,and disease types to identify the reasons for the discrepancies in the in-dicators between the two departments and make suggestions for improvement.Results The A2 department in the branch hospital performed significantly more laparoscopic procedures than the A1 department in the home hospital(P<0.01).Moreover,the prevalence of the patients diagnosed with chemotherapy and malignant melanoma in the A2 department was significantly higher than in the A1 department(P<0.01),impacting the surgical rate indicator for the branch area.Conclusion A systematic anal-ysis of medical record data can effectively pinpoint the reasons for indicator discrepancies among different campuses within the same surgical departments of a hospital.Implementing outpatient-specific disease management and encouraging admission of com-plex and critically ill patients can effectively enhance the surgical rate as well as the fourth-level surgical rate in a department.It is suggested for the home hospital and its branches to set a respective indicator management target as long as the gap in the factors influencing the surgical rate indicators is unbridgeable between the campuses.
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Objective:To investigate the status of participation in treatment and nursing decision-making in patients with chronic obstructive pulmonary disease (COPD), and analyze its influencing factors.Methods:A cross-sectional survey was conducted on 230 COPD patients hospitalized in the Affiliated Hospital of Hangzhou Normal University from October 2021 to May 2022 by using the general situation questionnaire, questionnaire of patients′ decision-making regarding treatment and care, Patient Doctor Relationship Questionnaire, 13-Item Version, Nursing-Patient Relationship Trust Scale and Chronic Obstructive Pulmonary Disease knowledge Questionnaire, Logistic regression was used to analyze the influencing factors of patients′ participation in treatment and nursing decision-making.Results:The participation attitude score of COPD patients′ treatment decision-making was (1.93 ± 0.55) points, the participation degree score of COPD patients′ treatment decision-making was (2.29 ± 0.46) points, the participation attitude score of COPD patients′nursing decision-making was (1.84 ± 0.42) points, and the participation degree score of COPD patients′ nursing decision-making was (2.03 ± 0.35) points. Gender, education level, occupation or occupation before retirement, the number of hospitalizations due to acute exacerbation of COPD in the past year, modified medical research council, doctor-patient relationship, and nurse-patient relationship were the influencing factors for patients to participate in treatment and nursing decision-making ( OR values were 0.070 to 18.368, all P<0.05). Conclusions:The participation attitude of COPD patients in treatment and nursing decision-making is negative and the degree of participation is low. Medical staff should correctly assess the reasons for the low participation of patients, and take targeted individualized measures to support patients to actively participate in treatment and nursing decision-making.
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Objective:To summarize the best evidence of physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD).Methods:According to the 6S evidence model, BMJ Best Practice, UpToDate, Joanna Briggs Institute (JBI) database, National Guideline Clearinghouse (NGC), National Institute for Health and Clinical Excellence (NICE) network, Scottish Intercollegiate Guidelines Network (SIGN), Guidelines International Network (GIN), New Zealand Guideline Group (NZGG) network, Registered Nurses′ Association of Ontario (RNAO) network, Medlive, PubMed, Web of Science, Cochrane Library, CNKI, Wanfang Knowledge Data Service Platform, VIP database and Chinese Biomedical Database and European Respiratory Society/American Thoracic Society were searched systematically to obtain guidelines, expert consensus, best practice information book, clinical decision-making, recommended practice, and systematic review on PA management in patients with COPD. The data retrieval time was from the establishment of the databases to April 30, 2022. Two researchers with evidence-based medicine background evaluated the quality and extracted evidence of the included literature.Results:A total of 19 articles were selected including 4 guidelines, 2 clinical decision, 9 systematic reviews, 3 expert consensus and 1 randomized controlled trial. Finally, 33 pieces of best evidence were formed from 10 themes, namely pre-exercise assessment, exercise prescription, exercise style, time, intensity, PA location, safety and effectiveness of PA, intervention strategies, effect evaluation and quality control.Conclusions:This study summarizes the best evidence of PA in patients with COPD. Health professionals should choose and apply the best evidence with consideration of the clinical situation and patient preference.
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Objective:To investigate the differences in applicability of both the portable high-purity germanium (HPGe) γ spectrometer and the portable lanthanum bromide (LaBr) γ spectrometer for measuring thyroid 131I activity and internal exposure monitoring for radiation workers. Method:Both DETECTIVE-DX100-KT portable HPGe γ spectrometer and InSpector 1000 portable LaBr γ spectrometer were used to measure the 131I content in thyroid of radiation workers for comparison of the measuring result, minimum detectable activity (MDA) and corresponding annual committed effective doses between two types of spectrometers. Results:The detection rate of 131I in thyroid of radiation workers was 67.7% for HPGe γ spectrometer and 26.2% for LaBr γ spectrometer, respectively. The MDA was 12.26-14.74 Bq (measuring time: 3-5 min) for HPGe γ spectrometer and 56.56-80.37 Bq for LaBr γ spectrometer (measuring time: 2-4 min). The annual committed effective dose corresponding to MDA was 0.07-0.08 mSv (3-5 min) for HPGe and 0.31-0.45 mSv (2-4 min) for LaBr, respectively, in the case of using chronic continuous intake mode and 7 d monitoring period. Conclusions:The minimum detectable activity (MDA) of the two types of portable spectrometers could meet the requirements specified in GBZ 129-2016 Specifications for individual monitoring of occupational internal exposure for thyroid monitoring equipment. The two types of spectrometers could be used for routine monitoring of internal contamination. The difference between the monitoring result of LaBr γ and HPGe γ spectrometers might be due to such factors as large uncertainty in short measuring time and low activity concentrations, incomplete identical of distance between probe and neck, probe angle setting, different response of equipment to the environment, background deduction method.
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Neurocognitive impairment is a group of clinical syndromes characterized by impaired cognitive function and decreased motor ability. Non-pharmacological interventions such as physical exercise have advantages in the treatment of patients with neurocognitive impairment. Multicomponent exercise is a combination of various physical exercises, including strength training, endurance training, balance training and flexibility training, that can improve gait, balance and cardiopulmonary function by increasing muscle mass, strength and endurance in people with neurocognitive impairment, while also reducing the risk of falls in elders. This article reviews the benefits of multicomponent exercise for patients with neurocognitive impairment and its evaluation methods; also describes 4 intervention programs and their clinical application, to provide evidence for clinical practice and promote the application of multicomponent exercise in patients with neurocognitive impairment.
الموضوعات
Aged , Humans , Accidental Falls , Cognition , Exercise/physiology , Gait , Resistance Trainingالملخص
Occupational contact dermatitis is the most common occupational skin disease. It has a high incidence among healthcare workers, especially nurses. It has an impact on work and life. This paper reviews the research progress, risk factors, intervention measures, evaluation indicators of nurses′ hand occupational contact dermatitis, and provides references for the future researches.
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Objective:To translate the English version and cross-cultural adaptation of Readiness for Return-To-Work Scale (RRTW) into Chinese and tested the reliability and validity of the Chinese version of RRTW in young and middle-aged stroke patients.Methods:RRTW was translated into Chinese with standard translation-retroversion. From August to December 2020, 235 stroke patients in the First Affiliated Hospital, College of Medicine, Zhejiang University were recruited by convenient sampling. The scale was tested by the reliability and validity.Results:The Chinese version of RRTW for stroke was composed of two parts: The first part was divided into four dimensions, with a total of 13 entries; For the unworked stroke population, the second part was divided into two dimensions, with a total of nine entries for the reworked stroke population. The content validity index (CVI) for each item was from 0.875 to 1.000. The total CVI for all items was 0.994. The Pearson correlation coefficient between dimension and scale was from 0.523 to 0.876. Four common factors were obtained from the first part and the cumulative contribution rate was 62.563%. Two common factors were obtained from the second part and the cumulative contribution rate was 49.908%. The Cronbach α coefficient in the first part was 0.760 and in the second part was 0.693.Conclusions:The Chinese version of RRTW for stroke patients has good reliability and validity, which can be used to assess the readiness level of stroke patients to return to work in Chinese society.
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Objective:To explore the assessment methodology for internal dose to workers exposed to 131I radionuclide. Methods:Workers were chosen in a 131I radiopharmaceutial manufacturer and a nuclear medicine department in a hospital using 131I to treat hyperthyroidism and thyroid cancer. A portable high purity germanium (HPGe) gamma spectrometer was used to measure the content of 131I in the thyroid for 4 consecutive times in a period of 7 d. The internal dose was estimated combining with the work rotation mode for workers dealing with 131I. Results:When the monitoring month was used as a typical month to estimate the internal dose, the annual committed effective dose was 0.09-1.93 mSv for the production staff engaged in the repackaging of 131I radiopharmaceuticals in the surveyed enterprise, and 0.06-0.58 mSv for the nuclear medicine staff in the surveyed hospital. After adjusting the monitoring result of the current monitoring period based on the rotation mode, the annual committed effective dose was estimated to be 0.06-1.22 mSv for radiopharmaceutical production workers and 0.03-0.15 mSv for nuclear medicine workers, respectively. Conclusions:In the assessment of internal dose to radiation workers exposed to 131I, using a single time measurement result to estimate the annual dose would lead to a larger error. In the case of continuous monitoring, the result of subsequent monitoring periods should be corrected according to the result of previous monitoring periods. In order to accurately estimate the internal dose of workers exposed to 131I, it is necessary to take full account of the 131I exposure pattern, time and frequency and the internal contamination route. For workers who may be exposed to 131I with potential internal dose greater than 1 mSv/year, a 14 day-routine monitoring period was appropriate.
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Objective To investigation the radioactivity level of 90Sr in tea leaves within and outside 30 km range of Ningde nuclear power plant. Methods The tea leaves within and outside the 30 km range of Ningde Nuclear Power Plant were collected from 2013 to 2018. According to“Radiochemical analysis of strontium-90 in water and ash of biological samples” (HJ 815—2016), the separation and analysis of 90Sr-90Y were carried outusing the method of di (2-ethylhexyl) phosphate (HDEHP) chromatography. Results During the period of 2013-2018, the radioactivity concentrations of 90Sr in the tea leaves within the range of 30 km around the Ningde nuclear power plant were 0.486～13.29 Bq/kg and that of 90Sr in the tea leaves outside the range of 30 km around the nuclear power station were 1.021～17.19 Bq/kg. Conclusion During the six years of operation in Ningde Nuclear Power Plant, there was no increase in the radioactivity level of 90Sr in the tea leaves around the nuclear power plant.
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Objective:To develop an UPLC-MS/MS method for the simultaneous determination of baicalin, berberine, glycyrrhizic acid and puerarin in Gegen-Huangqin-Huanglian Decoction. Methods:Isocratic elution was carried out with mobile phase consisting of acetonitrile - 4 mmol/L ammonium formate. The separation was performed on ACE Excel 3 C18 (2.1 mm × 100 mm, 3 μm), and the mass spectrometer was operated in the positive and negative ionization electrospray (ESI) mode using multiple monitoring (MRM) for analysis of four components. External standard method was used for fix quantity. The precursor to product ion transitions monitored for baicalin, berberine, glycyrrhizic acid and puerarin were m/z 447.0→271.0, 336.2→320.2, 821.4→350.9 and 415.2→294.9, respectively. Results:Baicalin, berberine, glycyrrhizic acid and puerarin were all analyzed exactly, the linear ranges were 0.002-0.080, 0.002-0.080, 0.001-0.040, 0.002-0.080 ng, respectively. The r were 0.998 3, 0.999 4, 0.997 9 and 0.999 5, respectively. The recoveries of four analytes ranged from 98.75% to 100.86% and the relative standard deviations were all below 0.74%. Conclusions:UPLC-MS/MS method is sensitive, accuate with rapid speed, which could be used for the determination of baicalin, berberine, glycyrrhizic acid and puerarin in Gegen-Huangqin-Huanglian Decoction.
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Objective:The purpose of this study was to conduct a Meta-analysis to assess the influence of physical therapy and respiratory muscle training on rehabilitation of patients with stable chronic obstructive pulmonary disease. To provide a basis for better rehabilitation exercise for patients, families, communities and hospitals.Methods:According to the literature search strategy, the relative literatures of randomized controlled trials (RCTS) of physical therapy and respiratory muscle training on rehabilitation of patients with chronic obstructive pulmonary disease were searched in Cochrane Library、MEDLINE、Embase、CINAHL、CBM、Wan Fang、CNKI and VIP from January 1990 to October 2017. Languages are limited to Chinese and English.The literatures were screened according to the predefined inclusion and exclusion criteria by two people . Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 were used to assess the quality of articles. The data were analyzed by Revman5.3.Results:A total of 7 articles were finally included, among of these 5 of which were written in English , Others were written in Chinese .They included 7 studies of randomized controlled trial and 267 patients with chronic obstructive pulmonary disease .7 studies show that treadmill exercise and respiratory muscle exercise are the most common rehabilitation methods.7 articles result of Meta-analysis showed that there were statistical differences between physical therapy and respiratory muscle training and other therapies in 6MWD、mMRC and FEV 1%;More research is needed on the impact of other outcome measures. Conclusions:Physical therapy and respiratory muscle training is a reliable way of rehabilitation, it to the stabilization of COPD patients FEV 1 % of expected value, activity ability, the influence of the degree of difficulty in breathing has a positive role.It is not stable for the positive effect of FVC and FEV 1 .However, the effects of other outcome measures were not determined.
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Objective:To analyze the monitoring situation of iodized salt in Nanchang City after implementation of the new iodized salt standard, in order to provide a basis for formulating prevention and control strategy to iodine deficiency disorders.Methods:From 2013 to 2015, according to "Jiangxi Province Surveillance Pilot Scheme of Iodine Deficiency Disorders (2012)", 9 counties (districts) were selected for surveillance of iodized salt, every county (district) was divided into 5 sampling areas according to the east, west, south, north, and middle positions, and 1 township (street) was selected from each area, 4 administrative villages (neighborhood committees) were selected from each township (street), and 15 samples of household salt were sampled from each administrative village (neighborhood committee). From 2016 to 2018, according to "National Surveillance Pilot Scheme of Iodine Deficiency Disorders (2016)", some counties (districts) were divided into 5 sampling areas according to the east, west, south, north, and middle positions, and 1 township (street) was selected from each area, 1 elementary school was selected from each township (street), 40 non-boarding students aged 8 to 10 (aged balanced, half male and female) were selected from each elementary school, and salt samples from students' homes were collected and in each township (street) salt samples were collected from 20 pregnant women's homes. The remaining counties (districts) were sampled in accordance with "Jiangxi Province Surveillance Pilot Scheme of Iodine Deficiency Disorders (2012)". The iodine content of salt samples was detected, and the coverage rate, qualified rate and consumption rate of qualified iodized salt were calculated.Results:From 2013 to 2018, the coverage rate of iodized salt, the qualified rate of iodized salt and the consumption rate of qualified iodized salt were 99.52% (16 122/16 200), 95.83% (15 449/16 122) and 95.36% (15 449/16 200), respectively, and the median salt iodine was 23.50 mg/kg; the coverage rate of iodized salt in 2018 was the lowest [98.63% (2 663/2 700)], and the difference was statistically significant between different years (χ 2 = 97.856, P < 0.05); the qualified rate of iodized salt and the consumption rate of qualified iodized salt were both the lowest in 2016, which were 93.93% (2 509/2 671) and 92.93% (2 509/2 700) , respectively. There were significant differences in the qualified rate of iodized salt and the consumption rate of qualified iodized salt between different years (χ 2 = 65.090, 81.053, P < 0.05); the non-iodized salt rate in 2018 was the highest [1.37% (37/2 700)], and the difference was statistically significant between different years (χ 2 = 97.856, P < 0.05). From 2013 to 2018, the range of salt iodine content was 0.00 - 64.67 mg/kg. The coverage rate of iodized salt in Qingyunpu District and Nanchang County was both 100% (1 800/1 800), in Donghu District was the lowest [98.06% (1 765/1 800)]. There was significant difference in coverage rate of iodized salt among different counties (districts, χ 2 = 131.247, P < 0.05). The qualified rate of iodized salt in Qingyunpu District was the highest [99.11% (1 784/1 800) ], and in Xihu District was the lowest [93.16% (1 674/1 797)]. There was significant difference in qualified rate of iodized salt among different counties (districts, χ 2 = 127.257, P < 0.05). The consumption rate of qualified iodized salt in Qingyunpu District was the highest [99.11% (1 784/1 800) ], and in Xihu District was the lowest [93.00% (1 674/1 800)]. There were significant differences in the consumption rate of qualified iodized salt among different counties (districts, χ 2 = 123.784, P < 0.05). Conclusion:The coverage rate of iodized salt and the consumption rate of qualified iodized salt in Nanchang City from 2013 to 2018 are generally stable, meeting the requirements of iodized salt index in iodine deficiency disorders elimination standard.
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Objective:To analyze the relationship between antithrombin Ⅲ(AT-Ⅲ) activity and survival, bleeding and thrombosis complications in patients with acute-on-chronic liver failure (ACLF), and to explore the prediction value of AT-Ⅲ activity in the prognosis of ACLF patients.Methods:The clinical data of 130 hospitalized patients with ACLF were retrospectively collected in Wuxi No.5 People′s Hospital from January 1, 2013 to April 1, 2019. The liver function, international normalized ratio (INR), and 90-day survival rate were detected. The AT-Ⅲ activity values at admission, week two, week four, and week eight of hospitalization were recorded, and the occurrences of fecal occult blood and femoral vein thrombosis were also recorded. The measurement data were compared by t test, analysis of variance, or rank sum test, and the categorical data were compared by chi-square test. The risk factors affecting the survival of ACLF patients were analyzed by Cox regression. The survival analysis was performed using the Kaplan-Meier method. Results:At the end of 90-day follow-up of 130 patients, 56 patients died, 20 patients (15.38%) were fecal occult blood positive and 15 (11.54%) had femoral vein thrombosis. The baseline AT-Ⅲ activity in the death group was lower than that in the survival group ((17.89±13.68)% vs (36.03±11.96)%), and the difference was statistically significant ( t=-8.045, P<0.01). The baseline AT-Ⅲ activities in fecal occult blood positive and negative patients were (18.26±11.52)% and (25.06±10.97)%, respectively, and in femoral vein thrombosis and non-thrombotic patients were (17.55±10.33)% and (32.48±11.88)%, respectively. The differences were both statistically significant ( t=8.746 and 8.090, respectively, both P<0.01). Through dynamic monitoring of AT-Ⅲ, the AT-Ⅲ activity showed a downward trend in the death group, while that showed an upward trend in the survival group, but the differences were not statistically significant ( F=0.282 and 0.401, respectively, both P>0.05). The Cox regression analysis suggested INR (odds ratio ( OR)=1.364, 95% confidence interval ( CI) 1.078-1.726, P=0.010) and AT-Ⅲ activity ( OR=0.930, 95% CI 0.906-0.954, P<0.01) were the independent factors affecting the survival of patients with ACLF. The area under the receiver operator characteristic curve of the AT-Ⅲ activity for predicting 90-day survival outcome of the patient was 0.706 (95% CI 0.773-0.952, P<0.01), and the cut-off value was 25%. Patients with AT-Ⅲ activity ≥ 25% had a higher survival rate than those with AT-Ⅲ activity <25% ( χ2=58.20, P<0.01). Conclusions:AT-Ⅲ activity is associated with fecal occult blood positive and femoral vein thrombosis in ACLF patients. The AT-Ⅲ activity is an independent influencing factor for predicting the prognosis of ACLF patients. Patients with AT-Ⅲ activity less than 25% have the higher mortality rate.
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Objective:To ascertain the basic situation of radiotherapy in Fujian in 2016.Methods:Based on the unified questionnaire, the types and quantity of radiotherapy and its corollary equipment, the number of radiotherapy staff and the work for quality control were surveyed in the radiotherapy units in the whole province, and the data on patients undergoing radiotherapy and other types of patients were collected from 26 hospitals. The total number of radiotherapy patients in the whole province was estimated by the correlation analysis and multiple linear regression analysis.Results:Radiotherapy was performed in a total of 32 hospitals in Fujian province in 2016. Among them, there were 62 sets of radiotherapy equipment, 33 sets of the simulators, 57 sets of treatment planning systems and 762 workers. The total number of 15 156 radiotherapy patients in 26 hospital were available for the survey. Multiple linear regression models showed that the frequency of application of medical electron accelerator was positively correlated with number of outpatients, emergency patients and inpatients, number of radiotherapy staff, number of electron accelerators ( r=0.311, 0.893, 0.956, P<0.05). Meanwhile, the frequency of aterloading brachytherapy was positively correlated with number of outpatients, emergency patients and inpatients, number of radiotherapy staff, number of aterloading brachytherapy units ( r=0.307, 0.966, 0.988, P<0.05). The frequency of radiotherapy was 0.54 patients per 1 000 population in Fujian in 2016. The delivered dose calibration of accelerators was performed in all hospitals involved in line with the relevant regulations, but the number of quality control equipment for radiotherapy was insufficient, such as the QA beam checker or well-type ionization chamber. Conclusions:In recent years, the rapid development of radiotherapy has been seen in Fujian province. The radiotherapy management should focus on standardenized and improved quality control and regulation in future.