A Case Report of Multidisciplinary Diagnosis and Treatment of a Patient with Tuberous Sclerosis Complex and Multi-Organ Involvement / 罕见病研究

Tuberous sclerosis complex(TSC)is a rare genetic disease that can lead to benign dysplasia in multiple organs such as the skin, brain, eyes, oral cavity, heart, lungs, kidneys, liver, and bones. Its main symptoms include epilepsy, intellectual disabilities, skin depigmentation, and facial angiofibromas, whilst incidence is approximately 1 in 10 000 to 1 in 6000 newborns. This case presents a middle-aged woman who initially manifested with epilepsy and nodular depigmentation. Later, she developed a lower abdominal mass, elevated creatinine, and severe anemia. Based on clinical features and whole exome sequencing, the primary diagnosis was confirmed as TSC. Laboratory and imaging examinations revealed that the lower abdominal mass originated from the uterus. CT-guided biopsy pathology and surgical pathology suggested a combination of leiomyoma and abscess. With the involvement of multiple organs and various complications beyond the main diagnosis, the diagnostic and therapeutic process for this patient highlights the importance of rigorous clinical thinking and multidisciplinary collaboration in the diagnosis and treatment of rare and challenging diseases.

A Case Report of Multidisciplinary Diagnosis and Treatment of a Patient with Tuberous Sclerosis Complex and Multi-Organ Involvement / 罕见病研究

Tuberous sclerosis complex(TSC)is a rare genetic disease that can lead to benign dysplasia in multiple organs such as the skin, brain, eyes, oral cavity, heart, lungs, kidneys, liver, and bones. Its main symptoms include epilepsy, intellectual disabilities, skin depigmentation, and facial angiofibromas, whilst incidence is approximately 1 in 10 000 to 1 in 6000 newborns. This case presents a middle-aged woman who initially manifested with epilepsy and nodular depigmentation. Later, she developed a lower abdominal mass, elevated creatinine, and severe anemia. Based on clinical features and whole exome sequencing, the primary diagnosis was confirmed as TSC. Laboratory and imaging examinations revealed that the lower abdominal mass originated from the uterus. CT-guided biopsy pathology and surgical pathology suggested a combination of leiomyoma and abscess. With the involvement of multiple organs and various complications beyond the main diagnosis, the diagnostic and therapeutic process for this patient highlights the importance of rigorous clinical thinking and multidisciplinary collaboration in the diagnosis and treatment of rare and challenging diseases.

Clinical application of adjustable traction skin stretchers in repair of wounds at the lower leg, foot and ankle / 中华创伤骨科杂志

Objective:To evaluate the clinical effects of adjustable traction skin stretchers used in repair of wounds at the lower leg, foot and ankle.Methods:A retrospective study was performed to analyze the clinical data of 56 patients who had been treated for skin defects at the lower leg, foot and ankle from August 2016 to September 2022 at The First Affiliated Hospital of Zhengzhou University, Honghui Hospital, Affiliated to Xi'an Jiaotong University Medical College, The First Affiliated Hospital of Henan Polytechnic University, and Yunnan Zhongde Orthopedic Hospital. There were 35 males and 21 females, aged (39.9±18.7) years. There were 43 traumatic wounds, 3 burns, 6 inflammatory wounds, 3 relief incisions due to osteofascial compartment syndrome, and 1 scar. The areas of skin defect ranged from 2.5 cm × 2.0 cm to 20.0 cm × 10.0 cm. The duration of wounds was (8.6±7.8) d. All the wounds were repaired with adjustable traction skin stretchers. The row-hook type of skin stretchers was used in 28 cases, the single-rod type in 20 cases, the single-rod type combined with an external fixator in 5 cases, and a combination of the row-hook type and the single-rod type in 3 cases.The time for wound traction closure, color of wound skin margin, skin swelling around the wound, functional recovery of affected limb and complications were recorded.Results:The time from skin stretching to wound closure was (7.8±3.8) d in the 56 patients. The color of wound skin edge after stretching was normal in 16 cases, dark red in 38 cases, and dark in 2 cases; the skin swelling around the wound was degree 1 in 21 cases, degree 2 in 33 cases, and degree 3 in 2 cases. The 56 patients were followed up for (8.9±4.1) months. Primary wound closure was achieved in 48 patients, and secondary wound closure in 8 patients after repair with an autologous skin graft. Partial skin necrosis occurred due to tension blisters after skin stretching in 2 patients, one of whom was repaired with an autologous skin graft and the other of whom by dressing change. Deep bone infection recurred in 2 patients whose wounds healed after their bone defects were repaired using Ilizarov technique of bone transfer. In the 56 patients, the muscle strength of the lower extremity beyond the wound was recovered to normal, and the range of motion of the joints adjacent to the wound also recovered to normal.Conclusion:In repair of wounds at the lower leg, foot and ankle, adjustable traction skin stretchers can lead to fine clinical effects and limited complications, because the stretchers can control the tension of skin digitally and precisely.

A YAP/TAZ-CD54 axis is required for CXCR2-CD44- tumor-specific neutrophils to suppress gastric cancer

As an important part of tumor microenvironment, neutrophils are poorly understood due to their spatiotemporal heterogeneity in tumorigenesis. Here we defined, at single-cell resolution, CD44-CXCR2- neutrophils as tumor-specific neutrophils (tsNeus) in both mouse and human gastric cancer (GC). We uncovered a Hippo regulon in neutrophils with unique YAP signature genes (e.g., ICAM1, CD14, EGR1) distinct from those identified in epithelial and/or cancer cells. Importantly, knockout of YAP/TAZ in neutrophils impaired their differentiation into CD54+ tsNeus and reduced their antitumor activity, leading to accelerated GC progression. Moreover, the relative amounts of CD54+ tsNeus were found to be negatively associated with GC progression and positively associated with patient survival. Interestingly, GC patients receiving neoadjuvant chemotherapy had increased numbers of CD54+ tsNeus. Furthermore, pharmacologically enhancing YAP activity selectively activated neutrophils to suppress refractory GC, with no significant inflammation-related side effects. Thus, our work characterized tumor-specific neutrophils in GC and revealed an essential role of YAP/TAZ-CD54 axis in tsNeus, opening a new possibility to develop neutrophil-based antitumor therapeutics.

Bioequivalence of amlodipine besylate tablets in Chinese healthy subjects / 中国临床药理学与治疗学

AIM: To evaluate the bioequivalence of two kinds of amlodipine besylate tablets in Chinese healthy subjects under fasting and fed conditions. METHODS: Twenty-four healthy subjects were enrolled, and a random, open, single-dose, two preparations, two sequences and double-crossover design was used to give the test or reference preparations under fasting and postprandial conditions. The concentration of metformin in plasma was detected by LC-MS/MS, and the main pharmacokinetic parameters were calculated to evaluate the bioequivalence. RESULTS: In fasting state, the mean of C

Application of teach-back method on blood glucosed and compliance for patients′ gestational diabetes mellitus / 中国实用护理杂志

Objective@#To explore the effects of teach-back on health education for patients′ gestational diabetes mellitus.@*Methods@#A total of 90 pregnant women with gestational diabetes mellitus from obstetrics outpatient were recruited and randomly assigned to either case or control group. The case and control groups received the same treatment and health education, the only difference was teach-back method in the case group,to compare blood glucose, compliance and outcome of pregnancy.@*Results@#After the intervention, fasting blood glucose (FPG), 2h postprandial blood glucose (2h-ppg) and glycosylated hemoglobin (HbA1c) in the case group were respectively (4.75±0.30) mmol/L, (5.69±0.74) mmol/L, (5.15±0.28)%, control group were respectively (5.01±0.30) mmol/L, (6.15±0.70) mmol/L, (5.68±0.33)%. The difference was statistically between the two groups (t=-4.631、-3.019、-8.020, P<0.05 or 0.01). The treatment compliance rate, gestational hypertension, hyperhydramnios, cesarean section and macrosomia rate in the case group were respectively 93.2% (41/44), 6.8% (3/44), 11.4% (5/44), 13.6% (6/44), 2.3% (1/44), control group were respectively 81.4% (35/43), 23.3% (10/43), 30.2% (13/43), 32.6% (14/43), 14.0% (6/43), the difference was statistically between the two groups (U=570.000, χ2=4.398-5.775, P<0.01 or 0.05).@*Conclusion@#Teach-back method is methodis a good health method and to reduce glucose level and improve Compliance of therapy. It is worthy of promotion.

Application of teach-back method on blood glucosed and compliance for patients′ gestational diabetes mellitus / 中国实用护理杂志

Objective To explore the effects of teach-back on health education for patients′gestational diabetes mellitus. Methods A total of 90 pregnant women with gestational diabetes mellitus from obstetrics outpatient were recruited and randomly assigned to either case or control group. The case and control groups received the same treatment and health education, the only difference was teach-back method in the case group,to compare blood glucose, compliance and outcome of pregnancy. Results After the intervention, fasting blood glucose (FPG), 2h postprandial blood glucose (2h- ppg) and glycosylated hemoglobin (HbA1c) in the case group were respectively (4.75 ± 0.30) mmol/L, (5.69 ± 0.74) mmol/L, (5.15±0.28)%,control group were respectively (5.01±0.30) mmol/L, (6.15±0.70) mmol/L, (5.68± 0.33)% . The difference was statistically between the two groups (t=-4.631、-3.019、-8.020, P<0.05 or 0.01). The treatment compliance rate, gestational hypertension, hyperhydramnios, cesarean section and macrosomia rate in the case group were respectively 93.2% (41/44), 6.8% (3/44), 11.4% (5/44), 13.6% (6/44), 2.3% (1/44),control group were respectively 81.4% (35/43), 23.3% (10/43), 30.2% (13/43), 32.6% (14/43), 14.0% (6/43),the difference was statistically between the two groups ( U=570.000, χ2 =4.398-5.775, P<0.01 or 0.05). Conclusion Teach-back method is methodis a good health method and to reduce glucose level and improve Compliance of therapy. It is worthy of promotion.

Changing trends in etiologies of hospitalized patients with liver disease during 2006 -2014 / 中华肝脏病杂志

Objective@#To analyze the changing trends in etiologies of hospitalized patients with liver disease and provide clinical basis for the formulation of medical policy.@*Methods@#Patients who were hospitalized in the Department of Infectious Diseases from 2006 to 2014 were selected as the research subjects. Data of patients with liver diseases were retrospectively analyzed to determine the proportion of main causes of infection, the proportion of different viral infections in viral hepatitis, and the changing trends in proportion of hepatitis B in different age groups. Kruskal-Wallis test was used for statistical analysis.@*Results@#During 9 consecutive years, the overall proportion of inpatients with liver disease decreased continuously, but the number of patients increased. The top five etiologies of liver diseases were viral hepatitis, drug-induced liver disease, autoimmune liver disease, alcoholic and non-alcoholic fatty liver disease. The proportion of viral hepatitis decreased gradually, and the proportion of drug-induced liver disease and autoimmune liver disease increased markedly. Among viral hepatitis patients, hepatitis B, hepatitis C and hepatitis E were in the top three, with hepatitis B stabilized at around 70%, and the proportion of hepatitis C showed an upward trend. The hospitalization time of hepatitis B patients was gradually shortened, the difference was statistically significant (χ 2 = 205.31, P < 0.001), and the hepatitis B patients were mainly distributed in age groups 31-40, 41-50, and 51-60, the total proportion was above 60%. The difference between the different years of the same age group was not evident, but the proportion of hepatitis B patients decreased gradually in the 14-23 –year- old age group, the difference was statistically significant (χ 2 = 19.51, P = 0.01).@*Conclusion@#Liver disease still holds a principal position in the distribution of infectious diseases, and especially the cause of non-infectious liver disease require sufficient attention and concern. The use of hepatitis B vaccine has effectively diminished the infection rate, but the prevention and control of chronic hepatitis B infection is still facing challenges.

Correlation between single nucleotide polymorphisms of ERα gene and bone loss associated with aromatase inhibitors in postmenopausal women with breast cancer / 实用肿瘤学杂志

Objective The aim of this study was to explore the correlation between postoperative aromatase inhibitor(AIs) -based bone metabolism and ERα gene rs9340799,rs2234693 single nucleotide polymorphisms(SNPs)in breast cancer.Methods One hundred and sixty-six breast cancer patients who underwent AIs treatment(≤2 years)were enrolled and hospitalized in our hospital from October 2015 to April 2017.The ERα gene rs9340799 and rs2234693 sites were sequenced and compared subtype of lumbar spine and femur,bone mineral density BMD value and the relationship between BMD value and T value.Results The BMD of lumbar spine in patients with ERα gene rs9340799 was significantly different when compared to those of A/A,A/G and G/G(P<0.01).The BMD of lumbar spine in patients with A/A and A/G genotypes were significantly higher than those in G/G genotypes(P<0.05).The BMD of lumbar spine in patients with ERα gene rs2234693 was significantly different when compared to those of T/T,T/C and C/C(P<0.01). The BMD of lumbar spine in patients with T/T and C/T genotypes were significantly higher than those in C/C genotypes(P<0.05). However,there was no difference in femoral BMD,lumbar spine,and femur T between the 2 subtypes of patients with genotypes(P>0.05).Conclusion Aromatase inhibitor-related bone loss(AIBL)may be related to ERα gene phenotype.In ERα gene rs9340799 and rs2234693 loci,C and G alleles may be susceptible genes for aromatase inhibitor-related bone loss(AIBL).

Correlation between Knowledge on Cardiovascular Disease Prevention and Cardiovascular Health in Community Elderly / 中国康复理论与实践

@#Objective To analyze the relationship between knowledge on cardiovascular disease prevention and ideal cardiovascular health behaviors and factors in community elderly. Methods From December, 2015 to May, 2016, totally 400 elderly in communities with-out overt cardiovascular disease were conveniently sampled. The level of knowledge on cardiovascular disease prevention was measured by self-designed cardiovascular disease prevention questionnaire. And each of the ideal cardiovascular health components was collected. Re-sults A total of 390 responses were valid. 13.85%community elderly were with high level of the knowledge. There were significant differ-ences in the distribution of cardiovascular health indexes among various leves of the knowledge groups (χ2>9.974, P<0.05), except choles-terol (P>0.05). The level of the knowledge was positively correlated with the scores of cardiovascular health behaviors and health factors (r>0.354, P<0.01). The cardiovascular health score, health behaviors score, health factors score and number of ideal cardiovascular health in-dexes were significantly different among various levels of the knowledge groups (F>8.961, P<0.001). Conclusion The level of knowledge on cardiovascular disease prevention was positively correlated with cardiovascular health behavior and health factors. The scores of cardio-vascular health score, health behaviors score and health factors increased with the improvement of knowledge on cardiovascular disease pre-vention.

Correlation between Body Mass Index and Frailty for Community Aged People in Zhengzhou, Henan, China / 中国康复理论与实践

Objective To explore the relationship between body mass index (BMI) and frailty among community aged people. Methods A total of 1571 aged people in two communities in Zhengzhou, Henan, China were recruited by convenience sampling method. They were divided into normal group, overweight group and obesity group according to BMI, and were assessed with Fried Frailty Criteria. Results The rates of overweight and obesity were 38.6%and 10.9%, respectively. There was significant difference in the level of frailty among dif-ferent groups (χ2=86.659, P<0.001). Multivariate Logistic regression analysis showed that overweight and obesity were independent risk fac-tors of pre-frailty (P<0.05), and obesity was the independent risk factor of frailty (P<0.05). Conclusion The prevalence of overweight and obesity was higher in community aged people in Zhengzhou, and normal BMI was important to postpone the process of frailty.

Current Status of Exercise Rehabilitation of Frailty for Elderly (review) / 中国康复理论与实践

At present, the suitable sports rehabilitation methods for frail old people mainly include endurance training, resistance train-ing and comprehensive functional training, while comprehensive functional training includes aerobic exercise and anaerobic exercise, and is suitable for the frail elderly to do exercise at home, which is more conducive to further large-scale promotion. In addition, long-term low and medium intensity exercise can improve the balance ability of the elderly, prevent them from fall, improve the physiological function, and ef-fectively regulate muscle potential;while, the high intensity exercise has greater risk for older people. This article introduced the types and effects of exercise in order to provide reference basis for frail old people in China.

Meta analysis on comparison between radiotherapy combined with temozolomide and single radiotherapy in glioblastoma / 重庆医学

Objective To evaluate the efficacy and safety of radiotherapy combined with concurrent and then adjuvant temozolomide in the patient with glioblastoma.Methods The databases of PubMed,Cochrane library,Medline and OVID were retrieved according to the Cochrane systematical assessment method.The included literatures were performed the quality evaluation and the meta analysis was performed after extracting the data.Results The summary of comparison between temozolomide group and radiotherapy group in the included studies showed that the 12-month overall survival rate[RR 1.22,95 ％ CI(1.01,1.47),P=0.04]and 24-month overall survival rate[RR 2.65,95 ％ CI(1.53,4.40),P＜0.01]had statistically significant differences;the 12-month pregrossion free survival rate[RR 2.59,95 ％CI(1.53,4.40),P=0.000 4] and 24-month pregrossion free survival rate[RR 6.77,95 ％ CI (2.82,16.26),P＜ 0.01] also showed statistically significant difference.The results of adverse reaction events revealed that the hematological toxic reactions in the temozolomide group had statistical difference between the concurrent therapy period and radiotherapy period [RR 3.21,95％CI(1.89,5.46),P＜0.01];which in the temozolomide group had statistical difference between the concurrent period and adjuvant period [RR 0.48,95 ％ CI(0.36,0.65),P＜0.01);but the non-hematological toxic reaction had no statistical difference[RR 1.11,95％CI(0.72,1.70),P=0.64].Conclusion Radiotherapy combined with concurrent and then adjuvant temozolomide therapy improves the overall and progression free survival period in the patient with glioblastoma,the higher occurrence rate of hematologic toxic reactions is correlated with temozolomide treatment drugs.

Language Functional Changes after Ischemic Stroke / 中国医学科学院学报

Language function after ischemic stroke remains controversial. Lesion location was thought to be the main determinant of aphasia. However,some studies have shown inconsistencies between clinical manifestations and imaging findings,thus challenging the classic anatomy of aphasia. In addition,language reorganization after ischemic stroke is poorly understood,especially the role of the non-dominant hemispheric homologous language area plays in the rehabilitation of aphasia. In this review,by focusing on the localization of language functional area and the role of non-dominant hemispheric homologous language area in the rehabilitation of aphasia,we try to elucidate the functional changes after ischemic stroke and provide theoretical basis for its rehabilitation.

Advances in Resistance Training for Chronic Heart Failure-related Sarcopenia (review) / 中国康复理论与实践

Sarcopenia is common in chronic heart failure. The pathogenesis of chronic heart failure-related sarcopenia is complex and diverse. Resistance training, as the main intervention for chronic heart failure-related sarcopenia, is widely applicated as effective and safe therapy.

Anterior cervical decompression with double-way connection intervertebral fusion device implantation for type Ⅱ or type H a Hangman fracture / 中华创伤杂志

Objective To analyze the clinical effect of anterior cervical decompression with double-way connection intervertebral fusion device (ROI-C) implantation for type Ⅱ or type Ⅱ a Hangman fracture.Methods A retrospective study was made on 14 patients with type Ⅱ or type Ⅱ a Hangman fracture treated with anterior cervical ROI-C implantation between February 2011 and March 2014.The patients (11 males and 3 females) were aged between 22 and 46 years (mean,26.4 years).Nine patients sustained traffic injury,4 fall injury and 1 crash injury.Nine patients were classified as type Ⅱ and 5 type Ⅱ a according to the Levine-Edwards classification.All were completed cervical anteroposterior and lateral X-ray,CT scan,three-dimensional CT reconstruction and MRI examination after adnission.American Spinal Injury Association (ASIA) grade E was noted in all before operation.Clinical posttraumatic neck score,visual analogue scale (VAS) as well as angle deformity and displacement of the axis were recorded before operation and at the latest follow-up.Results All patients were operated successfully.Mean operation time was 61 min(range,45-116 min).There were no injuries of superior laryngeal nerve,hypoglossal nerve,throat wall and vessel during operation.Laryngeal edema,dysphagia,paralysis of tongue,hematoma and wound infection were not observed after operation.Mean period of follow-up was 24.2 months (range,4-32 months).All segments and fracture sites showed solid fusion after 3 months.No cages became subsided or displaced,no discs collapsed,and no malunion occurred at the latest follow-up.Data of preoperation and latest follow-up differed significantly with respect to clinical posttraumatic neck score[(53.1 ±7.2) points vs.(91.1 ±5.0)points],VAS[3.38(2.43,4.33)points vs.0.58(0,1.29) points],axis displacement[(4.0 ± 1.5) mm vs.(1.3 ± 1.2) mm],and angle deformityoftheaxis[(9.2±4.7)° vs.(2.1 ±1.9)°] (P＜O.05 or O.01).Conclusion Anterior cervical surgery with ROI-C implantation for type Ⅱ or type Ⅱa Hangman fracture provides good fusion rate and satisfactory clinical effect.

Risk Assessment of Cardiovascular Disease in Perimenopausal Women in Community / 中国康复理论与实践

Objective To investigate the cardiovascular risk factors in perimenopausal women and evaluate the risk for cardiovascular disease. Methods A total of 692 perimenopausal women permanent residents in a community of Zhengzhou from September, 2014 to May, 2015 were selected using multi-stage random sampling. Their age, blood pressure, body weight, smoking history, history of diabetes and fast-ing blood glucose, blood lipid and other information were collected. They were assessed with The National 10-Year Risk Assessment for Ischemic Cardiovascular Disease (ICVD). Results Prevalence of the cardiovascular risk factors screened for were as follow:hypertension 14.3%, dyslipidemia 32.1%, overweight or obesity 59.2%, type 2 diabetes mellitus 7.9%, smoking 0.6%. The absolute risk for ICVD in the next 10 years averaged as (2.01 ± 3.04)%, and increased with age. The incidence of high blood pressure, high total cholesterol, smoking, as well as the level of risk for ICVD were different among various age groups. Conclusion The cardiovascular factors are not controlled ideal-ly in the perimenopausal women, and result in high risk of cardiovascular disease, which need a set of intervention as their risk stratification.

Comparison in prognosis of hospital-acquired pneumonia due to methicillin-resistant and methicillin-sensitive Staphylococcus aureus：analysis of propensity score matching / 中国感染控制杂志

Objective To study whether methicillin-resistant Staphylococcus aureus (MRSA)will increase the burden of patients with hospital-acquired pneumonia (HAP).Methods Patients with Staphylococcus aureus HAP in a hospital between January 1 ,2013 and November 31 ,2014 were selected,patients with MRSA HAP were as case group,patients with methicillin-sensitive Staphylococcus aureus (MSSA)HAP were as control group,propen-sity score matching (PSM)analysis were conducted to compare the prognosis of MRSA HAP and MSSA HAP (length of hospital stay, duration from infection to discharge, mortality, total therapeutic cost ). Results APACHE II score in case group was higher than control group before PSM was conducted,length of hos-pital stay and duration from infection to discharge were both longer than control group (40[20,94]d vs 28[21 ,53] d;19[10,46]d vs 17[8,29]d,respectively,both P 0.05 ),data were balanced and comparable;there were no significant difference in length of hospital stay between two groups (28[21 ,52]d vs 28[21 ,53]d),duration from in-fection to discharge (15[9,25]d vs17[8,29]d),mortality(10.87% vs 15.22%),and total therapeutic cost (121 013.5[80 747.21 ,176 200]yuan vs 119 911 .2[66 994.08,241 184.7]yuan)(all P >0.05).Conclusion APACHE II score is an important factor affecting prognosis;after balancing this factor,there is no difference in the prognosis of patients with MRSA and MSSA HAP,MRSA HAP can not increase the burden of disease.

Awareness of hand hygiene knowledge and compliance status in Chinese hospitals / 中国感染控制杂志

Objective To understand the status of awareness of hand hygiene(HH)knowledge and compliance among health care workers (HCWs)in China,and provide scientific basis for further improvement of HH practice. Methods A multi-centre retrospective survey on awareness of HH knowledge and compliance was conducted in 200 nationwide hospitals in 2015.Results The awareness rates of HH methods and HH indications among HCWs were 86.5% and 82.5% respectively;cleaning staff had the lowest awareness rate of HH indications(69.9%),followed by the other interns and advanced-study students (70.2%),as well as medical technicians (79.8%);attendants had the lowest awareness rate of HH methods(76.9%),followed by advanced-study students and interns(81.0%),and cleaning staff (82.4%);HH knowledge awareness rate among HCWs in secondary hospitals was lower than tertia-ry hospitals,and the district-level hospitals had the lowest awareness rate of HH.HH compliance rate and correct rate were 70.1% and 74.9% respectively;the interns and advanced-study students were at a low level of compliance and correct rates (61.4% and 60.9% respectively);the municipal hospitals had the lowest compliance and correct rates,non-teaching hospitals were lower than teaching hospitals.Conclusion HH in primary hospitals is weak,HH of interns,advanced-study students,as well as attendants and cleaning staffs are not enough,HH management should be strengthened,awareness and compliance of HH should be improved.

Association between body mass index and othercardiovascular risk factors in middle-aged population / 实用医学杂志

Objective To explore the association between body mass index and blood pressure , blood glucose, blood lipids and the 10-year risk of ischemic cardiovascular disease (ICVD) among the middle-aged population and to provide theoretical evidence to prevent cardiovascular disease among overweight and obese mid-dle-aged population in the community. Methods A total of 1,628 middle-aged residents having health examina-tions in Hangdong and Nanguan Community Health Service Center in Guancheng District of Zhenghzou City from September 2014 to September 2015 were selected as subjects and were divided into three groups: normal group , overweight group, and obesity group according the size of the body mass index. The relationship among BMI , blood pressure, blood glucose, blood lipids and the 10-year risk of ICVD was explored. Results The preva-lence of overweight and obesity in the population was 47.97% and 15.72% respectively. There was significant dif-ference in body mass index , systolic blood pressure , fasting blood glucose , blood lipids and the distribution of the 10-year risk for ICVD (all P < 0.05). The incidence of hypertension, hyperglycosemia and hyperlipidemia increased with the increase of BMI (all P < 0.05). Multivariate logistic regression analysis showed that over-weight and obesity were independent risk factors of hypertension , hyperglycosemia and hyperlipidemia (OR =2.144, 1.911, 2.028). Conclusions The prevalence of overweight and obesity among middle-aged population is high in Guancheng District of Zhengzhou City. Overweight and obesity co-exit with other cardiovascular risk factors. Normal BMI is important to reduce the level of risk for CVD and the 10-year risk of ICVD.