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Objective@#To explore the association between dietary inflammatory index (DII) and metabolic syndrome (MetS) and its components among children aged 6-14 years in Beijing, so as to provide a reference for preventing MetS.@*Methods@#A cross sectional study was carried out in 2 086 records of 1 832 children from the 2017 and 2019 Nutrition and Health Surveillance in Primary and Secondary school students of Beijing (NHSPSB). Three day consecutive 24 hour dietary recalls combined with weighing household cooking oils and condiments were used to collect dietary intake and calculate DII. MetS was diagnosed according to "Definition and Suggestion on the Metabolic Syndrome of Chinese Children and Adolescent". The Generalized estimating equations (GEEs) models were used to analyze the association between DII and the presence of MetS and its components (abdominal obesity, high triglyceride, low high density lipoprotein cholesterol, hypertension, and hyperglycemia).@*Results@#The mean DII score was (1.64±1.07) for the included children. No significant association was found between DII scores and the likelihood of MetS (per 1 point increment: OR =1.16, 95% CI =0.92-1.48, P >0.05). In terms of the components of MetS, DII scores were positively associated with the odds of high triglyceride (per 1 point increment: OR =1.17, 95% CI =1.01-1.36, P <0.05). There was no statistically significant difference in the association among different age groups ( P >0.05). No significant associations were observed between DII and other MetS components( P >0.05).@*Conclusion@#DII scores may not be correlated with the risk of MetS, but proinflammatory diet might increase the risk of high triglyceride. DII score in childhood should be emphasized to identify and prevent MetS as soon as possible.
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Objective:To investigate the effect of different blood glucose and BMI levels on the outcome of closed biliary surgery in diabetic patients.Methods:Clinical data of 424 diabetes admitted to Shanxi Provincial People’s Hospital for closed biliary tract surgery from Jan. 2018 to Jun. 2019 were retrospectively analyzed. According to the fasting blood glucose and BMI levels, the subjects were divided into hyperglycemia and non-hyperglycemia groups and obesity and non-obesity subgroups. The differences of clinical data among different groups were compared and analyzed. Multiple regression analysis was used to analyze the factors of postoperative infection, length and cost of hospitalization.Results:①Compared with the non-hyperglycemia group, the hyperglycemia group had higher BMI, serum creatinine, blood urea nitrogen, blood glucose monitoring rate, glycated hemoglobin detection rate, postoperative infection rate, ICU occupancy rate, length and cost of hospitalization, and lower albumin level, all P<0.05.②The age, fasting blood glucose, serum creatinine, low density lipoprotein, length and cost of hospitalization in the hyperglycemic obese subgroup were all lower than those in the non-obese subgroup, all P<0.05; and the serum creatinine in the obese subgroup was higher than those in the non-obese subgroup ( P<0.05) . ③Logistic analysis revealed that hyperglycemia was an independent risk factor for postoperative infection. For every 1mmol/L increase in fasting blood glucose, the risk of postoperative infection increased by 1.158 times, and albumin was a protective factor for postoperative infection. ④Multiple linear regression analysis showed that hyperglycemia and hypoalbumin were the important factors affecting the length of hospital stay and the increase of hospital cost, all P<0.05. Conclusions:Hyperglycemia is an independent risk factor for postoperative infection and a risk factor for longer hospital stay and higher costs. Obesity is not associated with postoperative infection or longer hospital stay, except for increased serum. Patients with diabetes undergoing closed biliary system surgery need to improve the detection rate of glycated hemoglobin and blood glucose monitoring rate, manage blood glucose reasonably, and control body weight appropriately.
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Objective:To explore the diagnostic efficiency of CT enterography (CTE) comprehensive score combined with spectral imaging for Crohn's disease (CD) in active phase.Methods:A retrospective analysis was performed on the case data of 87 CD patients who were admitted to the First People's Hospital of Chenzhou from October 2018 to October 2020. According to CD activity index (CDAI), they were divided into active phase group ( n=58) and remission phase group ( n=29). The results of CTE and spectral imaging in both groups were collected. The diagnostic value of CTE comprehensive score combined with spectral imaging for CD in active phase was analyzed. Multiple linear stepwise regression analysis was used to analyze the independent related factors affecting the active phase of CD. Receiver operating characteristic (ROC) curve was used to predict the area under curve (AUC), sensitivity, specificity and cutoff value of CTE comprehensive score combined with energy spectrum imaging (intestinal wall thickness, intestinal wall uniform enhancement and iodine concentration in portal phase) in active phase of CD. Results:The probability of comb sign, intestinal stenosis or expansion and target sign in CTE of patients with active CD was significantly higher than that in patients with remission CD, the probability of fat sign was significantly lower than that in patients with remission CD, and the CTE comprehensive score was significantly higher than that in patients with remission CD ( P<0.05). Multiple linear stepwise regression analysis showed that the thickness of intestinal wall, uniform enhancement of intestinal wall and iodine concentration in portal phase were independent related factors affecting the active phase of CD ( P<0.05). ROC curve analysis showed that AUC of CTE comprehensive score combined with intestinal wall thickness, intestinal wall uniform enhancement and iodine concentration in portal phase for predicting CD in active phase was 0.953, higher than 0.869, 0.907, 0.914 and 0.913 of single index. The cut-off values of CTE comprehensive score, intestinal wall thickness and iodine concentration in portal phase were 6.0 points, 0.89 cm and 2.68 mg/ml, respectively. There was no homogeneous enhancement of intestinal wall in spectral imaging. Conclusions:CTE comprehensive score combined with intestinal wall thickness, intestinal wall enhancement and iodine concentration in portal phase can more accurately determine CD in active phase, which provide a new quantitative diagnostic reference.
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Objective To retrospectively analyze the detection rate, distribution characteristics of hyper-glycemia patients in non-endocrinological departments of first-class hospitals and the related risk factors of hyper-glycemia in ICU patients. Methods 4364 patients with hyperglycemia in non-endocrinology Department of Shanxi People's Hospital admitted from Feb 1, 2017 to Jan 31, 2018 were selected .The detection rate of hyper-glycemia was counted and the distribution characteristics of hyperglycemia were analyzed. The risk factors of hy-perglycemia in ICU patients were analyzed by logistic regression. Results ① General situation : The detection rate of hyperglycemia in non-endocrinological inpatients was 7.57％, with an average age of (60.2±16.14) years and a male-to-female ratio of 1.28:1. ② The detection rate and distribution characteristics of hyperglycemia in the internal medicine department and surgical department: the detection rate of hyperglycemia in internal medicine department was 8.46％; male-to-female ratio was 1.54:1, and the average age was (61.01±13.96) years. The de-tection rate of surgical department was 6.56％,male-to-female ratio was 1.03:1,and the average age was (59.03± 14.14) years. The detection rate of geriatrics in internal medicine department was higher,The detection rate of Neurosurgery in surgical department was higher. ③ Types of hyperglycemia: 2424 cases (55.54％) of diabetes were diagnosed; 757 cases(17.35％) of diabetes were newly diagnosed; 319 cases(7.31％) of stress hyperglycemi-a. ④ The detection rate of OGTT or HbAlC respectively and both indicators in internal medicine were higher than in surgery (χ2=79.68, 197.29, 67.48,all P=0.00). ⑤ Logistic analysis revealed that perioperative period, diabetes and the history of glucocorticoid use were independent factors for the prevalence of hyperglycemia in ICU pa-tients[OR(95％CI)respectively,1.015(1.169～4.265), 2.999 (1.487～6.049), 5.456(2.067-～14.398),all P<0.05]. Conclusions The detection rate of hyperglycemia in tertiary is higher. Perioperative period, diabetes and history of glucocorticoid use are closely related to the prevalence of hyperglycemia in ICU patients.Non-endocrine physi-cians should strengthen the standardized management of hyperglycemia among inpatients.
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Objective@#To retrospectively analyze the detection rate, distribution characteristics of hyperglycemia patients in non-endocrinological departments of first-class hospitals and the related risk factors of hyperglycemia in ICU patients.@*Methods@#4364 patients with hyperglycemia in non-endocrinology Department of Shanxi People’s Hospital admitted from Feb 1, 2017 to Jan 31, 2018 were selected. The detection rate of hyperglycemia was counted and the distribution characteristics of hyperglycemia were analyzed. The risk factors of hyperglycemia in ICU patients were analyzed by logistic regression.@*Results@#① General situation: The detection rate of hyperglycemia in non-endocrinological inpatients was 7.57%, with an average age of (60.2±16.14) years and a male-to-female ratio of 1.28:1. ② The detection rate and distribution characteristics of hyperglycemia in the internal medicine department and surgical department: the detection rate of hyperglycemia in internal medicine department was 8.46%; male-to-female ratio was 1.54:1, and the average age was (61.01±13.96) years. The detection rate of surgical department was 6.56%,male-to-female ratio was 1.03:1, and the average age was (59.03±14.14) years. The detection rate of geriatrics in internal medicine department was higher, The detection rate of Neurosurgery in surgical department was higher. ③ Types of hyperglycemia: 2424 cases (55.54%) of diabetes were diagnosed; 757 cases (17.35%) of diabetes were newly diagnosed; 319 cases (7.31%) of stress hyperglycemia. ④ The detection rate of OGTT or HbAlC respectively and both indicators in internal medicine were higher than in surgery (χ2=79.68, 197.29, 67.48, all P=0.00) . ⑤ Logistic analysis revealed that perioperative period, diabetes and the history of glucocorticoid use were independent factors for the prevalence of hyperglycemia in ICU patients[OR (95%CI) respectively, 1.015 (1.169~4.265) , 2.999 (1.487~6.049) , 5.456 (2.067-~14.398) , all P<0.05].@*Conclusions@#The detection rate of hyperglycemia in tertiary is higher. Perioperative period, diabetes and history of glucocorticoid use are closely related to the prevalence of hyperglycemia in ICU patients. Non-endocrine physicians should strengthen the standardized management of hyperglycemia among inpatients.
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<p><b>OBJECTIVE</b>To survey the knowledge and behaviors of antibiotic use for children among parents in Ningbo and to explore the influencing factors.</p><p><b>METHODS</b>One kindergarten and one primary school were randomly selected in Yinzhou and Beilun District of Ningbo using stratified random cluster sampling method, respectively. A survey on the knowledge and behaviors of antibiotics use for children was conducted with a self-designed questionnaire among parents of children aged 2 to 14 years in the sampled kindergarten and school.</p><p><b>RESULTS</b>The scores of antibiotic use knowledge were 0-4 in 36.6%(1028/2806) of parents. In the past month, 56.6%(556/983) of parents self-medicated their children, including 20.3%(113/556) medicated with antibiotics. In the past year, 48.5%(1361/2806) of parents stored antibiotics for children at home. Multivariate logistic regression analysis showed that mother, and parents with city residence, higher education level, higher household income, medical background, male children and younger children had higher antibiotic use knowledge scores(<0.05 or <0.01); parents with city residence, higher education level and medical background were more likely to store antibiotics at home (all <0.01); parents with city residence and those store antibiotics at home were more likely to self-medicate their children with antibiotics (<0.05 or <0.01).</p><p><b>CONCLUSIONS</b>sPoor knowledge and massive antibiotic missuse for children among parents are of great concern in Ningbo. Tailored health education programs are needed to improve the knowledge and behaviors of rational antibiotic use among parents and reduce storage of antibiotics at home.</p>
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Adolescent , Child , Child, Preschool , Humans , Male , Adolescent Behavior , Anti-Bacterial Agents , Pharmacology , Child Behavior , Cross-Sectional Studies , Parents , Surveys and QuestionnairesABSTRACT
Two hundred and seventy two type 2 diabetes mellitus (T2DM) patients with negative anti-thyroid autoantibody were enrolled in Shanxi Provincial People's Hospital from November 2016 to September 2017.According to serum vitamin D levels,patients were classified as serious deficiency of vitamin D group([25(OH)D]＜25 nmol/L,n=119),vitamin D deficiency group (≥25 ～ ＜50 nmol/L,n=124)and normal vitamin D group (≥ 50 nmol/L,n=29).There were significant differences in total T4(P=0.04),TSH (P＜0.01),parathyroid hormone (P=0.03) among these groups (P＜0.05).After adjusting gender,age,BMI,glycosylated hemoglobin (HbA1c) and duration of diabetes,serum 25(OH)D level was negatively correlated with TSH (r=-0.24,P＜0.05).After adjusting gender,age,BMI,duration of diabetes and serum 25(OH)D level,HbA1c level was negatively correlated with free T3 (r=-0.18,P＜0.01) and TSH (r=-0.20,P＜0.01).Multiple linear regression analysis revealed that TSH was correlated with 25(OH) D (β=-0.224,P＜0.01) and HbA1c (β=-0.206,P＜0.01).In conclusion,the serum vitamin D and HbA1c levels are independently correlated with thyroid function in patients with T2DM.
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Objective To investigate the clinical value of self-made dressing negative pressure drainage technique in the treatment of the four limbs soft tissue trauma.Methods A total of 60 patients with the four limbs soft tissue trauma in our hospital from December 2013 to December 2014 were randomly divided into the observation group and control group.The observation group with 30 cases were treated with the self-made negative pressure drainage technique,and the control group with 30 cases received the conventional treatment.The pain score,wound healing rate,complication rate between two groups were compared.Results The pain score of the observation group was(1.17±0.22),which was lower than(3.17±0.49) of control group,the difference was statistically significant(P<0.05).The wound healing rate of observation group(73.33%) was higher than that of the control group(40%),the difference was statistically significant(P<0.05).The complication rate of observation group(3.33%) was lower than that of control group(23.33%),the difference was statistically significant(P<0.05).Conclusion The self-made dressing negative pressure drainage technique applied to the patients of four limbs soft tissue trauma can reduce the pain,shorten the healing time,and reduce the incidence of complications.
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Objective To explore the CT and MRI performances of primary extragonadal seminoma .Methods The imaging find‐ings of primary extragonadal seminoma in 16 patients proved by histopathology were analyzed retrospectively .The tumor location , size ,contour ,periphery ,density or signal and contrast enhancement patterns were evaluated ,and these were compared with the pathological results .Results The lesions in 16 patients were solitary including the ovoid lesions in 6 and lobulated ones in 10 .They were located in intracranial area in 10 patients ,anterior middle mediastinum in 4 and abdomen in 2 .Mean size of the tumors was(7 .0 ± 5 .6) cm (ranging from 1 .3 cm to 18 .6 cm) .Unenhanced CT in 13 patients showed the soft tissue masses with necrosis in 8 ,stip‐pled calcification in 2 and hemorrhage in 2 .Enhanced CT in 6 patients showed homogeneity in 2 and heterogeneity in 4 ,and the de‐grees of enhancement increased gradually .The plain and enhanced MRI in 10 patients showed iso‐or slight hypointensity on T1WI and slight hyperintensity on T2 WI in 8 lesions ,heterogeneous enhancement in 7 and slight enhancement in one ,peripheral enhance‐ment in 2 due to central hemorrhage .Pathology showed most of the lesions were well‐vascularized with inner cystic change .Tumor stroma was divided by the fibrovascular tissue .Conclusion The imaging findings of primary extragonadal seminoma are not specific , CT ,MRI can demonstrate the invasive extent accurately .
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OBJECTIVE@#To observe the correlation between the threshold of tone burst auditory brain stem response (Tb-ABR) and ASSR (auditory steady-state response) and the threshold of BA (behavioral audiometry). To investigate the accuracy and clinical value of Tb-ABR and ASSR in pediatric hearing assessment.@*METHOD@#From January, 2014 to December, 2014, 76 children (123 ears) recieved hearing examination in the First Affiliated Hospital of Zhengzhou University. They were classified into three groups according to the hearing level: 23 children (46 ears) with normal hearing ability in group A, 27 children (32 ears) with slightly-moderate sensorineural deafness in group B and 26 children (45 ears) with severe-profound sensorineural deafness in group C. Tb-ABR, ASSR, BA in 4 frequencies (0.5, 1.0, 2.0, 4.0 kHz) were tested and the results were statistically analyzed.@*RESULT@#(1) At the 4 frequencies (0.5-4.0 kHz), we obtained 132 thresholds of Tb-ABR, 144 of ASSR, 152of BA. And 166 thresholds were obtained in Tb-ABR+ASSR+BA in total . (2) The thresholds of Tb-ABR, ASSR and those of BA in all 3 groups had linear relations at 0.5-4.0 kHz. The correlation coefficients of group A were 0.76, 0.82, 0.87 and 0.91; 0.52, 0.57, 0.67 and 0.64. Those of Group B were 0.89, 0.95, 0.98 and 0.95; 0.74, 0.82, 0.87 and 0.90. Those of Group C were 0.91, 0.90, 0.92 and 0.89; 0.93, 0.95, 0.95 and 0.91.@*CONCLUSION@#(1) Both ASSR and Tb-ABR can allow reasonably accurate predictions for the pediatric hearing assessment. The correlation between Tb-ABR threshold and BA threshold is higher in normal hearing children and slightly-moderate sensorineural deafness children. The correlation between ASSR threshold and BA threshold is higher in severe-profound sensorineural deafness children. (2) The hearing test combination can evaluate the residual hearing ability for children with severe hearing loss.
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Child , Humans , Audiometry , Auditory Threshold , Evoked Potentials, Auditory, Brain Stem , Hearing , Hearing Loss, Sensorineural , Diagnosis , Hearing TestsABSTRACT
Objective To evaluate puncture technique in thoracic endovascular aortic repair with abdominal aortic aneurysm and assess the feasibility and safety of using a pre-close technique for puncture and closure of femoral access sites. Methods From May 2010 to August 2013, the pre-close technique which involved two 6 F per-close ProGlide devices deployed in the femoral artery before upsizing to a 18-25 F sheath and one or two deployed before upsizing to a 14-16 F sheath were applied to 42 patients with abdominal aortic aneurysm (group A). Forty-seven patients using surgical femoral cutdown from December 2006 to April 2010 were enrolled into group B. The rate of technical success, time from procedure to the aortic delivery, operation time, low limb braking time, local complication, time from procedure to discharge, local vascular diameter after 3 months was evaluated and compared between two groups. Results There was no significant difference in endograft external diameter between two groups ( P>0.05). The rate of technical success was 97.62%(41/42) in group A and 95.74%(45/47) in group B, and there had no significant difference (P>0.05). Time from procedure to the aortic delivery, operation time and time from procedure to discharge in group A were significantly shorter than those in group B: (21.79 ± 5.79) min vs. (41.37 ± 11.79) min, (127.66±37.83) min vs. (157.84±42.71) min, (6.59±1.89) d vs. (9.14±2.57) d, P0.05. Conclusion The puncture technique with per-close ProGlide is safe and effective in percutaneous endovascular aortic repair which can be adopted as an alternative technique of surgical femoral cutdown approach in patients with abdominal aortic aneurysm.
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Objective To better understand and manage the current situation and problems of patent transformation in university affiliated hospital.Methods we conducted the statistical analysis the quantity of patent authorization in the Peking University People's Hospital during 2002-2013,and the status of patent transformation.Results The quantity of patent authorization increased significantly,however the number of patent transformation is small,with low proportion.Meantime,the transformation period is long,with single mode.Conclusions the hospital should be strengthened for all patent life-cycle management,and strengthen the emphasis on the conversion work to build integrated management team,in particular by building technological achievements promotion platform,improve the incentive mechanism to strengthen the franchise use of the work.
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Objective To investigate the correlations between the time of thoracic endovascular aortic repair (TEVAR) and prognosis in patients with type B acute aortic dissection (AADB). Methods The clinical data of 156 AADB patients with TEVAR was retrospectively analyzed and divided into 3 groups according to the time from onset of symptom to TEVAR:less than seven days was deifned as group 1 (G1, n=87), seven days to fourteen days group 2 (G2, n=48);more than fourteen days was group 3 (G3, n=21). The status of aortic reconstruction at three months TEVAR, in-hospital mortalities, mean hospital expense and length of stay were compared among three groups. Results Before TEVAR, there was no signiifcant differences in the ratio of smallest true lumen diameter and largest false lumen diameter amony the three groups (0.47±0.33, 0.42±0.18, 0.47±0.27, respectively, P>0.05). At three months after TEVAR, the ratio of largest true lumen diameter and largest false lumen diameter among the three groups was signiifcantly greater in group 1 (1.76±0.51) than group 2(1.42±0.30) and group 3(1.34±0.34, P < 0.05), when there was no signiifcant difference between the later two groups. Complete aortic reconstruction (8 from group 1 and 4 from group 2) was achieved in 12 patients at 3 months after TAVAR. Eight patients died during hospitalization, 5 from visceral ischemic, 2 from proximal aortic dissection, one patient from sudden death. Compared with G3, the hospital expense of group 1 and group 2 was cut down about ￥20000. Length of stay was signiifcant greater in group 3 than in group 1 and group 2 (P<0.05). Conclusions Early TEVAR for AADB was safe and beneifcial for aortic reconstruct and reducing the hospital expense and length of stay.
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Objective: Through comparing the hospitalization costs of total knee replacement (TKR) in People’s Hospital of Peking University in 2005 and 2010, to investigate the changing status of hospitalization costs on this operation and the impact of clinical pathway ( CP ) on controlling the hospitalization costs during 5 years , and provide references for controlling medical treatment cost reasonably. Methods: The patients are grouped into undergoing unilateral and bilateral TKR. The total hospitalization cost and cost of each category during 5 years are compared, and SAS 9.2 statistic software is applied to deal the data. Results: Compared with 2005, the total cost for TKR in 2010 decreased. All the charging items decreased, except implant material increased, especially the cost of surgery, hospital room, nursing and pharmacy. Specific to one knee replacement group and both knees replacement, the changing trend of cost is coincident with the total cost. Conclusion: The total cost for TKR in 2010 was lower than that of 2005, which might be the result of adopting CP since 2010. Nevertheless, the implant material cost accounted large proportion of hospitalization cost in 2010, and it has obvious increasing trend compared to 2005. This result is related the increasing application of the new edition of Artificial knee joint prosthesis. Controlling implant material cost is the effective method of decreasing medical costs for TKR.
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10.3969/j.issn.1000-3606.2013.06.023
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Objective To explore the changes of CX3CR1 expressions in monocytes from the patients with different types of coronary heart diseases (CHD). Methods The expressions of CX3CR1 in monocytes were measured by direct immunofluorescence associated with flow cytometry (FCM) in 54 patients with stable angina pectoris (SAP) confirmed by coronary arteriography, 61 patients with acute coronary syndrome (ACS), 20 normal individuals and 24 patients with chest pain syndrome (CPS). Gensini score system was utilized to quantitatively assess the coronary lesion in CHD patients. Finally, the correlation of CX3CR1 levels and Gensini scores was analyzed. Results CX3CR1 expressions in monocytes from the CHD patients were markedly higher than those in normal individuals (P