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AIM: To explore the prevalence and influencing factors of poor vision among 3 014 primary school students in Wucheng District, Jinhua City, in order to provide evidence for the intervention measures of poor vision.METHODS: Using a cross-sectional study, a self-designed questionnaire was done, including general conditions and influencing factors of vision. The international standard logarithmic visual acuity chart was used for visual acuity detection. The risk factors that were statistically significant among the single factor groups were used as independent variables for multivariate Logistic regression analysis.RESULTS: A total of 1 367 students with poor vision were detected, the detection rate was 45.36%, among which mild poor vision rare was 26.08%; moderate rate was 11.51%; and severe rate was 7.76%. Multivariate Logistic regression analysis showed that senior grades, parental myopia, daily insufficient sleep and outdoor activity, overuse of electronics or computers and no eye exercise were risk factors for poor vision.CONCLUSION: The rate of poor vision among the primary school students was severe, schools should take measures to improve and prevent students' poor vision by increasing outdoor activity time, correcting poor reading and writing posture, and reducing the time spent on electronic products.
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ObjectiveTo retrospectively analyze the effect of modified Shugan Dingji Decoction （疏肝定悸汤） on the occurrence of endpoint events in patients with paroxysmal atrial fibrillation of liver constraint and qi stagnation. MethodsA retrospective cohort study was conducted using the electronic medical record database of Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine to screen and include patients with paroxysmal atrial fibrillation of liver constraint and qi stagnation from January 1st， 2018， to December 31th， 2021. The included patients were divided into an exposure group and a non-exposure group， each consisting of 100 cases， based on whether they received modified Shugan Dingji Decoction. General information of the patients including age， gender， body mass index， duration of illness and comorbidities， medication history， cardiac structure and function indicators such as left atrial diameter， left ventricular end-diastolic diameter， stroke volume and ejection fraction， and the occurrence of endpoint events assessed through 24-hour dynamic electrocardiography or electrocardiogram to determine the recurrence of paroxysmal atrial fibrillation were collected. Kaplan-Meier （K-M） curves and Log-Rank tests were used to conduct survival analysis on the occurrence of endpoint events in the two groups of patients. Univariate and multivariate Cox regression analyses were used to analyze the impact of various factors on entry into endpoint events. Additionally， a safety assessment was performed by comparing liver and kidney function indicators before and after treatment. ResultsIn the non-exposure group， a total of 49 cases （49.0%） experienced endpoint events， while in the exposure group， there were 26 cases （26.0%）. The Log-rank test indicated significant difference between the two groups （χ2=11.211， P=0.001）. Univariate Cox regression analysis showed that age， duration of illness， hypertension， diabetes， chronic heart failure， left atrial diameter， stroke volume， and the use of modified Shugan Dingji Decoction may be the influencing factors for the occurrence of endpoint events in patients with paroxysmal atrial fibrillation of liver constraint and qi stagnation （P＜0.05 or P＜0.01）. Multivariate Cox regression analysis showed that the risk of endpoint events in the exposure group was significantly lower than that in the non-exposure group （P＜0.01）. Patients with a duration of illness ＞12 months had a significantly higher risk of endpoint events compared to those with a duration of illness ≤12 months （P＜0.01）. Patients without concomitant hypertension had a lower risk of endpoint events compared to those with hypertension （P＜0.05）. Patients with left atrial diameter ＞40 mm had significantly higher risk of endpoint events than those with left atrial diameter ≤40 mm （P＜0.01）. There was no statistically significant difference in liver and kidney function indicators between the two groups before and after treatment （P＞0.05）. ConclusionThe use of modified Shugan Dingji Decoction is a protective factor for patients with paroxysmal atrial fibrillation of liver constraint and qi stagnation， which can help to reduce the recurrence and progression of atrial fibrillation. Long duration of illness， concomitant hypertension， and enlarged left atrial diameter are risk factors for patients to experience endpoint events.
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The idea of online purchases is becoming more popular as a result of the development in the fields of information and technology. People now look for alternate options for purchasing because they do not have enough time to directly go to a store to place an order. Nowadays, individuals prefer to make online purchases, use credit or debit cards to pay their utility bills, and have goods delivered to their doorstep at a cheaper and more attractive price. The current study was carried out to assess influencing factors in Karaikudi town and to rank influencing factors with online shopping. Primary data have been collected from 120 respondents in the study area with the help of an interview schedule. Percentage analysis and the ranking method were used to analyse the collected data. The findings of the study reveal that majority of the respondents (55.83%) are male, most of the respondents (35.84%) belong to the age group upto 25, and 34.17% of the respondents purchased clothing through online shopping
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Abstract Objective: To investigate the factors influencing hyperuricemia in children and adolescents and to provide a scientific basis for early prevention and treatment. Methods: A retrospective study (2017-2021) of the prevalence of hyperuricemia in children and adolescents was conducted, and the factors influencing hyperuricemia were analyzed by multifactor logistic regression. Results: The overall prevalence of hyperuricemia in children and adolescents aged 6-17 years in northeast Sichuan Province was 55.12% (8676/15,739), of which 60.68% (5699/9392) in boys and 46.90% (2977/6347) in girls; the prevalence of hyperuricemia from 2017 to 2021 was 52.40% ( 1540/2939), 52.56% (1642/3124), 52.11% (1825/3502), 58.33% (1691/2899), and 60.40% (1978/ 3275), respectively; the prevalence rates of 6-12 years old were 48.92% (864/1766), 50.46% (769/1524), and 52.73% (685/1299), 56.99% (693/1216), 35.46% (444/1252), 46.33% (524/1131), 60.50% (720/1190), and 66.82% (739/1106), 58.95% (652/1106), and 62.17% (761/1106) for 13-17 years old, respectively, 62.17% (761/1224), 63.19% (855/1353), and 61.70% (970/1572), respectively. Logistic regression showed that the prevalence of male (OR = 1.451, 95% CI 1.034 to 2.035, p = 0.031), age (OR = 1.074, 95% CI 1.024 to 1.126, p = 0.003), overweight/obesity (OR = 1.733, 95% CI 1.204~2.494, p = 0.003), blood creatinine (OR = 1.018, 95% CI 1.005~1.031, p = 0.007), triglycerides (OR = 1.450, 95% CI1.065~1.972, p = 0.018), blood calcium (OR = 6.792, 95% CI 1.373~33.594, p = 0.019), and systolic blood pressure (OR = 1.037, 95% CI 1.018~1.057, p < 0.001) were influential factors for the development of hyperuricemia. Conclusion: The prevalence of hyperuricemia was higher in children and adolescents aged 6-17 years in northeastern Sichuan Province, with a higher prevalence in boys than in girls, and the prevalence increased with age.
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OBJECTIVE@#To investigate humanistic practice ability of nurses in a general hospital in Hunan Province and analyze the factors affecting their practices to provide evidence for interventions to improve humanistic practice ability of the nurses.@*METHODS@#A total of 1196 nurses were surveyed using a self-designed questionnaire and a nurse humanistic practice ability assessment scale questionnaire for assessment of their abilities for humanistic care practice, psychological adjustment, interpersonal communication, self-management, ethics and legal practice. Univariate and multivariate analyses were performed for analysis of the factors affecting the practice abilities of the nurses.@*RESULTS@#The total score of humanistic practice ability of the 1196 nurses was 105.69±16.45 (the full score of the scale was 130), and the scores of humanistic care practice ability, psychological adjustment ability, interpersonal communication ability, self-management ability, ethics and legal practice ability were 40.95±6.46, 16.41±2.66, 16.41±2.66, 11.32±2.05 and 12.43±2.00, respectively. Univariate analysis and multiple linear regression analysis showed that gender (P=0.033), age (P < 0.001), department (P=0.015), working years (P < 0.001), professional title (P < 0.001), first academic degree (P < 0.001), highest academic degree (P < 0.001), family location (P=0.010), marital status (P=0.023), number of patients to care for (P=0.022), number of children (P=0.001), previous humanities related training (P < 0.001), training times (P < 0.001), and care received from family members (P < 0.001) and colleagues (P < 0.001) were all the factors affecting humanistic practice ability of the nurses. Among these factors, age, working in department of obstetrics and gynecology and emergency department, professional title, humanities training, and care from family and colleagues explained 20.7% of the variance.@*CONCLUSION@#The humanistic practice ability of nurses in this general hospital is above the average level, but their self-management ability needs to be improved. Intervention measures should be implemented to improve the nurses' humanistic practice ability including more attentions to the key groups and departments, strengthening the training of humanistic practice ability, and improving the promotion assessment system.
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Child , Female , Pregnancy , Humans , Hospitals, General , Emergency Service, Hospital , Multivariate Analysis , Research DesignABSTRACT
OBJECTIVES@#The number of gestational women has been increased in recent years, resulting in more adverse pregnancy outcomes. It is crucial to assess the coagulation function of pregnant women and to intervene in a timely manner. This study aims to analyze the influencing factors on thrombelastography (TEG) and explore the evaluation of TEG for gestational women.@*METHODS@#A retrospective study was conducted on 449 pregnant women who were hospitalized in the obstetrics department in Xiangya Hospital of Central South University from 2018 to 2020. We compared the changes on the TEG parameters among normal pregnant women between different age groups, different ingravidation groups, and different stages of pregnancy groups. The influence on TEG of hypertensive disorders in pregnancy (HDP) and gestational diabetes mellitus (GDM) as well as two diseases synchronization was explored.@*RESULTS@#Compared with the normal second trimester women, the R values and K values of TEG were increased, and α angle, CI values and LY30 values were decreased in third trimester women (all P<0.05). Compared with normal group, the R values and CI values of TEG of the HDP group have significant difference (both P<0.05). There were no significant difference of TEG between the GDM group, the HDP combined with GDM group and the normal group (all P>0.05). Multiple linear regression analysis showed that the influencing factors for R value in TEG were weeks of gestation (P<0.001) and mode of conception (P<0.05), for α angle was weeks of gestation (P<0.05), for MA value was mode of conception (P<0.05), and for CI value was weeks of gestation (P<0.05). The analysis of correlation between TEG with platelet (PLT) and coagulation routines represented that there was a correlation between TEG R values and activated partial thromboplastin time (APTT) (P<0.01), and negative correlation between TEG CI values and APTT (P<0.05). There was a negative correlation between TEG K values and FIB (P<0.05). The correlation of α angle (P<0.05), MA values (P<0.01) and CI values (P<0.05) with FIB were positive respectively.@*CONCLUSIONS@#The TEG parameters of 3 stages of pregnancy were different. The different ingravidation approach has effect on TEG. The TEG parameters were consistent with conventional coagulation indicators. The TEG can be used to screen the coagulation status of gestational women, recognize the abnormalities of coagulation and prevent the severe complication timely.
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Female , Humans , Pregnancy , Thrombelastography/methods , Blood Coagulation Tests/methods , Retrospective Studies , Blood Coagulation , Blood Platelets , Diabetes, Gestational/diagnosisABSTRACT
Multidrug-resistant tuberculosis (MDR-TB) has become one of the major challenges in the global tuberculosis (TB) control.Despite years of efforts on MDR-TB control,the treatment success rates in China have increased slowly,which indicates possible deficiencies in the management of prevention and control work.Therefore,it is necessary to analyze the current status of MDR-TB prevention and treatment based on the patient pathway.This review summarizes the current drop-out situation of MDR-TB patients in the diagnosis and treatment pathway and the factors affecting patients' outcomes in the whole pathway,so as to provide a scientific reference for the prevention and control of MDR-TB.
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Humans , Antitubercular Agents/therapeutic use , Tuberculosis, Multidrug-Resistant/prevention & control , Treatment Outcome , ChinaABSTRACT
Objective:To explore the influencing factors of tuberculosis related health behaviors among college freshmen with health belief model, so as to provide a scientific basis for the intervention of health behaviors among students.Methods:From January to February 2021, the questionnaire survey was conducted among 5 254 college freshmen from 11 universities.The survey included general demographic data, tuberculosis related health behaviors, and tuberculosis related knowledge, disease threat perception and disease policy cognition.The SPSS 23.0 software was used for data analysis, independent sample t-test and one-way ANOVA were used for inter group comparison, and Logistic regression analysis was used to explore the influencing factors of health behavior holding. Results:The total score of tuberculosis related health behaviors among freshmen was 3~12 (11.01±1.10), and the overall holding rate of tuberculosis related health behaviors was higher.Male( B=-0.753, OR(95% CI)=0.471(0.417-0.531)), and tuberculosis history ( B=-1.088, OR(95% CI)=0.337(0.157-0.722)) were risk factors for tuberculosis related health behaviors among freshmen.Birth in city( B=0.117, OR(95% CI)=1.124(0.944-1.338)), father's education level college /undergraduate and above ( B=0.177, OR(95% CI)=1.194(1.024-1.392)), mother's education level high school/secondary school( B=0.356, OR(95% CI)=1.428(1.126-1.810)), college/undergraduate and above( B=0.194, OR(95% CI)=1.214(1.029-1.433)), take the initiative to understand tuberculosis knowledge ( B=0.208, OR(95% CI)=1.231(1.095-1.385)), higher tuberculosis knowledge score ( B=0.088, OR(95% CI)=1.092(1.041-1.145)), higher disease threat perception score ( B=0.082, OR(95% CI)=1.086(1.031-1.144)) and higher disease policy cognition score( B=0.320, OR(95% CI)=1.378(1.265-1.500)) were protective factors for tuberculosis related health behaviors among first-year undergraduates(all P<0.05). Conclusion:The application of health belief model can analyze and explain the influencing factors of tuberculosis-related health behaviors of freshmen, which is helpful to strengthen health education and advocate tuberculosis-related health behaviors.
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Objective:To understand and explore the incidence and influencing factors of malnutrition in patients with inflammatory bowel disease.Methods:This study was a cross-sectional study. Patients with inflammatory bowel disease hospitalized in the Department of Gastroenterology of a tertiary hospital in Shenzhen from March 1 to August 31, 2021 were enrolled. Indicators related to nutrition and clinical outcome were collected, including height, weight, body mass index (BMI), nutritional risk screening (NRS 2002) results, malnutrition diagnosis as per Global Leadership Initiative on Malnutrition (GLIM) criteria and Pittsburgh Sleep Quality Index (PSQI). Chi-square test, t-test and Wilcoxon rank sum test were used as appropriate for univariate analysis, and binary logistic regression analysis was used for multivariate analysis.Results:A total of 188 patients were included in this survey. There were 145 (77.1%) patients with no malnutrition, 38 (20.2%) with moderate malnutrition, and 5 (2.7%) with severe malnutrition according to GLIM criteria. In the subgroup of 47 ulcerative colitis patients, 12 (25.5%) were with moderate malnutrition and 3 (3.4%) were with severe malnutrition. In the subgroup of 141 Crohn's disease patients, 26 (18.4%) were with moderate malnutrition and 2 (1.4%) were with severe malnutrition. When divided by the presence or absence of malnutrition, there were statistically significant differences in age ( t = -2.237, P = 0.026), disease stage ( χ 2 = 22.299, P < 0.001), history of digestive tract resection ( χ 2 = 6.890, P = 0.009), intestinal infection ( χ 2 = 4.010, P = 0.045), gastrointestinal symptoms ( χ 2 =11.884, P = 0.001), hemoglobin ( t = 5.160, P < 0.001), serum albumin ( t = 3.96, P < 0.001), prealbumin ( t = 5.061, P < 0.001) and PSQI scores ( t = -4.744, P < 0.001). Multivariate analysis showed that the stage of disease, history of partial resection of digestive tract, gastrointestinal symptoms, hemoglobin, prealbumin and PSQI scores were the main influencing factors of malnutrition. Conclusions:IBD patients at older age, at active stage, and with history of partial digestive tract resection, intestinal infection, gastrointestinal symptoms, low hemoglobin, low serum albumin, low prealbumin and poor sleep quality are more likely to develop malnutrition. Timely intervention should be carried out to improve the nutritional status of these patients.
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Objective:To investigate the influential factors of the efficacy of tinnitus multivariate integrated sound therapy (T-MIST) in the treatment of subjective tinnitus.Methods:A total of 431 patients with subjective tinnitus who received treatment in The First Affiliated Hospital of Xiamen University from June 2019 to June 2020 were included in this study. A cross-sectional study method was used to conduct refined testing on tinnitus patients using the T-MIST matching platform. The severity of tinnitus patients was evaluated using the Tinnitus handicap inventory scale. SPSS software was used to analyze the factors affecting the effectiveness of the T-MIST for subjective tinnitus based on patients' basic characteristics.Results:Multivariate logistic regression analysis showed that compared with patients with short-term tinnitus, OR (95% CI) was 1.982 (1.033-3.804), P = 0.040, in patients with 3-12 months of disease duration, OR (95% CI) was 2.411 (1.322-4.396), P = 0.004 in patients with > 12 months of disease duration. With the increase in tinnitus handicap inventory score, the efficacy of T-MIST became better [ OR (95% CI) = 1.014 (1.004-1.024), P = 0.007]. The efficacy of T-MIST was better in the hearing compensation-effective patients [ OR (95% CI) = 0.133 (0.081-0.216), P < 0.001]. Conclusion:The course of the disease, tinnitus handicap inventory score, and effective hearing compensation are the influential factors of T-MIST. They can provide evidence for the treatment of subjective tinnitus.
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Objective:To analyze the related factors of neurotoxicity induced by oxaliplatin chemotherapy in patients with colorectal cancer and its prevention and treatment strategies.Methods:A total of 300 patients with colorectal cancer treated with oxaliplatin in Zhejiang Cancer Hospital from January 2018 to December 2020 were randomly selected for baseline collection using the convenience sampling method. The occurrence of oxaliplatin-induced peripheral neurotoxicity (OIPN) was statistically analyzed. The factors that affect the occurrence of OIPN were analyzed using univariate analysis.Results:There was a significant difference in OIPN score between patients of different genders, between patients who had different education levels, between patients who had different occupations, and between patients who lived in different long-term residence places ( t = 7.29, 3.39, 2.53, 18.11, all P < 0.05). There was no significant difference in OIPN score between patients adhering to different religion's beliefs, between patients married and not, between patients who lived with and without members, between patients who paid medical costs and not, and between patients who had a previous history of smoking and not ( t = 3.25, 0.37, 0.69, 2.39, 0.15, all P > 0.05). There was a significant difference in OIPN score between patients with different tumor-node-metastasis stages, between patients who received medication via different administration routes, and between patients who received different times of oxaliplatin administration ( t = 8.40, 3.34, 3.49, all P < 0.05). Conclusion:Medical staff should pay attention to the occurrence of OIPN in patients with colorectal cancer treated with oxaliplatin, focus on the patient's factors related to the disease, and take correct and effective coping strategies promptly to reduce the adverse reactions, improve the quality of life, and ensure the therapeutic effect.
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Objective:To study the prevalence and epidemiological characteristics of adult thyroid nodules in Wuhan City, and to analyze the influencing factors of thyroid nodules, so as to provide basis for prevention and treatment of adult thyroid nodules in Wuhan City.Methods:From 2019 to 2021, two communities or towns were selected from each of the 13 districts in Wuhan City using multi-stage cluster random sampling method. One hundred permanent residents over the age of 16 were selected from each community or town according to the inclusion and exclusion criteria (age and sex ratio balanced), for questionnaire survey, physical examination, urinary iodine test and thyroid ultrasound examination. The influencing factors of thyroid nodules was analyzed using logistic regession and Spearman correlation.Results:A total of 2 578 adults were investigated, including 1 168 men and 1 410 women. The age was (41.79 ± 13.01) years. The prevalence of thyroid nodules was 35.49% (915/2 578). The prevalence of single nodules was 19.16% (494/2 578), which was higher than that of multiple nodules [16.33% (421/2 578), χ 2 = 2 577.00, P < 0.001]. Multivariate logistic regression analysis showed that female ( OR = 2.033, 95% CI: 1.631 - 2.535), older ( OR = 1.404, 95% CI: 1.290 - 1.528), history of thyroid disease ( OR = 1.351, 95% CI: 1.211 - 1.506) and diabetes ( OR = 1.449, 95% CI: 1.083 - 1.938) were independent risk factors for adult thyroid nodules ( P < 0.05). The median urinary iodine of residents in Wuhan City was 185.32 μg/L, at an appropriate level of iodine nutrition, there was no correlation between urinary iodine and thyroid nodules ( r = 0.02, P = 0.391). Conclusions:The prevalence of thyroid nodules of adults in Wuhan City is high. Women, older, a history of thyroid diseases and diabetes are all risk factors for thyroid nodules. No correlation is found between urinary iodine level and thyroid nodules.
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Objective:To explore the medical reference values, distribution characteristics and influencing factors of serum iodine in adults with different thyroid health conditions, and to evaluate the importance of serum iodine in evaluating individual iodine nutrition.Methods:From February 2017 to November 2018, multi-stage stratified cluster sampling was used to select one community and one agricultural (fishing) village in the coastal Yingkou City and the inland areas of Shenyang City of Liaoning Province as survey sites. Cluster sampling of adults over 18 years old who had lived for five years were conducted with questionnaire survey, clinical physical examination and thyroid ultrasound examination. Fasting venous blood samples and one random urine sample were collected from all subjects for serum iodine, thyroid hormone, antibody and urine iodine detection. The 95% medical reference value of serum iodine was established by using the percentage quantile method, and the reference value, distribution characteristics and influencing factors of serum iodine in adults with different thyroid health status were analyzed. The diagnostic value of iodine nutritional indicators in thyroid diseases was evaluated by the receiver operating characteristic (ROC) curve.Results:A total of 2 931 adults were surveyed, with serum iodine levels of 62.1 (53.6, 72.2) μg/L, ranging from 5.6 to 642.3 μg/L; urine iodine was 167.6 (111.2, 244.2) μg/L, and the overall iodine level was at an appropriate level. A total of 1 089 patients with thyroid diseases were examined, with a detection rate of 37.2% (1 089/2 931); among them, there were 597 cases of thyroid nodules, 56 cases of endemic goiter, 42 cases of hypothyroidism, 161 cases of subclinical hypothyroidism, 27 cases of hyperthyroidism, 18 cases of subclinical hyperthyroidism, and 474 cases of autoimmune thyroid disease (AITD). There was a statistically significant difference in the detection of thyroid diseases among adults with different levels of serum iodine (χ 2 = 13.80, P < 0.05). The reference values of serum iodine in normal adults, hypothyroidism (without thyroid hormone intervention), hyperthyroidism (without anti thyroid hormone drug treatment), AITD, endemic goiter, and thyroid nodules were 37.2 - 103.0, 12.5 - 52.8, 49.9 - 163.1, 34.3 - 129.3, 27.3 - 92.8, and 37.9 - 119.5 μg/L, respectively. The ROC curve analysis results showed that the serum iodine area under curve(AUC) of patients with hyperthyroidism, subclinical hyperthyroidism, endemic goiter, thyroid nodules, and AITD were 0.94, 0.61, 0.55, 0.53, and 0.52, respectively. The results of univariate analysis showed that there were statistically significant differences in adult serum iodine levels among different positions, regions, age, education level, occupation, iodine intake, blood pressure, and body mass index ( P < 0.05). Conclusions:There are significant differences in serum iodine levels among adults with different thyroid health conditions, and evaluation standards and systems should be developed separately. Serum iodine is an important indicator for evaluating individual iodine nutrition.
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Due to the cloud-like appearance of the dental surface of dental fluorosis, serious tooth defect may occur, thus affecting the overall beauty of the face. The clinical effect of dental fluorosis is not better than that of normal teeth in the application of repair, which brings some difficulties to the clinicians. The application of porcelain veneers in the restoration of dental fluorosis has been widely concerned by clinicians and researchers due to its advantages of high aesthetics, small amount of tooth tissue abrasion, and good biocompatibility. Therefore, this article comprehensively discusses the application effect and influencing factors of porcelain veneers in the restoration of dental fluorosis, in order to provide some reference for clinical application.
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Objective:To analyze the influencing factors of dental fluorosis of children in the drinking-water-borne endemic fluorosis (referred to as drinking-water-borne fluorosis) areas with qualified drinking water.Methods:In 2020 and 2021, the cluster sampling method was used to select the children aged 8 to 12 years old from the drinking-water-borne fluorisis areas with qualified drinking water in Tianjin City for water and urine fluoride detection, dental fluorosis examination and questionnaire survey, and logistic regression and classification tree model were used to analyze the influencing factors of dental fluorosis in children.Results:A total of 3 795 cases children aged 8 to 12 years old were investigated, and 1 001 cases of dental fluorosis were detected, and the detection rate of dental fluorosis was 26.38% (1 001/3 795). The results of logistic analysis showed that age [odds ratio ( OR) = 1.193, 95% confidence interval ( CI): 1.115 - 1.277], high urinary fluoride (1.84 - 19.40 mg/L, OR = 1.510, 95% CI: 1.169 - 1.952) and the number of permanent residents at home ≥6 ( OR = 1.377, 95% CI: 1.090 - 1.739) were risk factors of dental fluorosis in children; and the mother's with higher education level (college degree or above, OR = 0.664, 95% CI: 0.441 - 0.999), the years of water improvement ≥5 years (5 - < 10 years, OR = 0.193, 95% CI: 0.157 - 0.238; ≥10 years, OR = 0.254, 95% CI: 0.193 - 0.333) were protective factors of dental fluorosis in children. The results of classification tree model analysis showed that the years of water improvement contributed the most to the prevalence of dental fluorosis among children in the drinking-water-borne fluorisis areas with qualified drinking water, followed by age, number of permanent residents at home and urinary fluoride. The area under the receiver operating characteristic curve (AUC) of logistic regression model and classification tree model were 0.730 (95% CI: 0.711 - 0.748) and 0.721 (95% CI: 0.702 - 0.739), respectively, with good fitting effect. Conclusion:The detection rate of children's dental fluorosis in the drinking-water-borne fluorosis areas with qualified drinking water is mainly related to the years of water improvement, age, the number of permanent residents at home and urinary fluoride.
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Objective:To analyze the relationship between dietary composition of residents in endemic fluorosis areas and skeletal fluorosis.Methods:A case-control study was used to analyze the difference of dietary composition between patients with skeletal fluorosis (case group) and residents without skeletal fluorosis (control group). In August 2019, taking the drinking water-borne endemic fluorosis area in Wenshui County, Lvliang City, Shanxi Province as the survey site, a cluster sampling method was adopted to select local residents aged over 18 years old, and a questionnaire survey was conducted by face-to-face interview. The survey contents included gender, age and consumption frequency of various foods. Binary logistic regression was used to analyze the relationship between food consumption frequency and skeletal fluorosis. The diagnosis of skeletal fluorosis was made by using portable digital radiography (DR) to take X-ray films of forearm and lower leg, combining with clinical signs, and according to the Diagnostic Standard for Endemic Skeletal Fluorosis (WS/T 192-2008) to determine.Results:A total of 1 061 subjects were included in this study, including 376 in the case group and 685 in the control group. The age composition of patients in the case group (≤60, > 60 years old: 162, 214 cases) was significantly different from that in the control group (≤60, > 60 years old: 423, 261 cases, χ 2 = 34.52, P < 0.001). There was no statistically significant difference in gender ratio (χ 2 = 1.37, P = 0.251). The proportion of patients in the case group who ate meat and eggs > 1 time/week was lower than that in the control group (χ 2 = 8.06, 5.46, P < 0.05), the proportion of patients who ate milk > 1 time/week was higher than that in the control group (χ 2 = 4.01, P = 0.046), and the proportion of patients who ate seafood ≥1 time/week was lower than that in the control group (χ 2 = 4.16, P = 0.046). The results of binary logistic regression analysis showed that after adjusting for age, sex, and urinary fluoride, the frequency of eating meat, eggs or milk > 1 time/week and the frequency of eating seafood ≥1 time/week were not related to the risk of skeletal fluorosis ( P > 0.05); however, in the group ≤60 years old, the frequency of eating eggs > 1 time/week was associated with the risk of skeletal fluorosis [odds ratio ( OR) = 0.59, 95% confidence interval ( CI): 0.39, 0.88]. Conclusions:The consumption frequency of meat, milk, eggs and seafood is significantly different between the skeletal fluorosis patients and the control people. In the population ≤60 years old, consumption frequency of eggs > 1 time/week may reduce the risk of skeletal fluorosis.
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Objective:To evaluate the effect of comprehensive intervention measures on Yunnan unexplained sudden death (YUSD) in Dali Prefecture, Yunnan Province, and to provide scientific basis for improving the prevention and control measures.Methods:Since 2010, Yunnan Province had implemented comprehensive intervention measures in ward areas according to the etiological pattern of YUSD. In July 2019, 47 families with YUSD were selected as case families and 23 families without YUSD were selected as control families in 31 natural villages of Heqing, Xiangyun, Yunlong, Eryuan, Jianchuan, Binchuan and Nanjian counties of Dali Prefecture. A unified questionnaire was used to investigate the basic information, economic status, dietary structure, and health literacy of the families during the two periods of "the first sudden death case" and "the present".Results:The annual household income of the case families at present (median, 20 492.6 yuan) was significantly higher than that of the first sudden death case (3 883.4 yuan), and the difference was statistically significant ( Z = - 5.27, P < 0.001). At present, rice (76.6%, 36/47) was the main diet of the case families; at the time of the first sudden death case, 23.4% (11/47) of the case families could not eat enough, and there was no such situation in the case families at present. Compared with the time of the first sudden death case, the dietary habits of the case families at present were as follows: the proportion of eating Trogia venenata decreased from 19.0% (39/205) to 0 (0/190), the proportion of eating wild fruit decreased from 17.1% (35/205) to 9.5% (18/190), and the proportion of drinking raw water decreased from 55.1% (113/205) to 42.1% (80/190), and the differences were statistically significant (χ 2 = 22.37, 4.90, 6.86, P < 0.05). Lifestyle and health awareness: the proportion of those who washed their hands before meals and after using the toilet increased from 9.8% (20/205) to 41.6% (79/190), those who did not overwork increased from 16.6% (34/205) to 34.2% (65/190), and those who took good protection when spraying pesticides increased from 7.3% (15/205) to 21.6% (41/190), and the differences were statistically significant (χ 2 = 53.17, 33.94, 16.48, P < 0.001). Toilet habits: the proportion of using outdoor toilet decreased from 75.6% (155/205) to 9.5% (18/190), the difference was statistically significant (χ 2 = 175.21, P < 0.001). When the first sudden death case occurred, the proportions of eating Trogia venenata and using outdoor toilet in the case families were higher than those in the control families (χ 2 = 22.37, 23.70, P < 0.001), the proportions of those who washed their hands before meals and after using the toilet and those who did not overwork in the case families were lower than those in the control families (χ 2 = 7.38, 4.93, P < 0.05). Conclusions:The economic conditions, production and living conditions of YUSD areas in Dali Prefecture have been significantly improved, and the health literacy and health prevention awareness of the population have been greatly improved. Economic conditions and living standard, dietary structure and health literacy may be related factors of YUSD.
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【Objective】 To explore the influencing factors of planned robot-assisted partial nephrectomy (RAPN) converted to radical nephrectomy (RN). 【Methods】 Clinical data and operation records of 488 patients planned for RAPN in our hospital during 2015 and 2020 were retrospectively collected. The patients were divided into converted and unconverted groups, and relevant clinical data of the two groups were compared. The causes and influencing factors for conversion were analyzed. 【Results】 Among the 488 patients, 14 (2.9%) converted to RN. The causes included: ①complicated tumor anatomy and surgical difficulties; ②local advanced renal tumor suspected during operation; ③severe intraoperative hemorrhage. Univariate analysis showed that R. E. N. A. L score (P<0.001), E value (P<0.001), N value (P<0.001), L value (P<0.001), renal hilum position (P<0.001) and T stage (P=0.002) were influencing factors of conversion. 【Conclusion】 Causes for the conversion of RAPN to RN include complicated tumor anatomy, suspected local advanced renal tumor and severe intraoperative hemorrhage. The R. E. N. A. L score, E value, N value, L value, renal hilum position and T stage are influencing factors.
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【Objective】 To explore the efficacy of flexible ureteroscopic lithotripsy (FURL) under local anesthesia (LA) in the treatment of upper urinary tract calculi, and to analyze the risk factors of pain. 【Methods】 Clinical data of 255 patients treated during Apr.2022 and Sep.2022 were reviewed, including visual analogue score (VAS) of pain during ureteroscopy, sheath placement, holmium laser lithotripsy, 1 hour and 8 hours after operation. VAS ≥5 was defined as significant pain. Clinical and follow-up data of the significant pain group and non-significant pain group were analyzed with logistic regression to analyze the risk factors of pain in FURL under LA. 【Results】 Altogether 198 patients (77.6%) successfully completed the operation, and the stone-free rate (SFR) was 89.9% (178/198). The VAS of ureteroscopy was the highest (4.49±1.08), and 73 patients (28.6%) experienced significant pain. Univariate analysis showed that significant pain was associated with gender, previous surgical history, age, body mass index (BMI), education level, and ASA classification (P<0.05). Multivariate analysis showed that male (OR=2.896, 95%CI:1.413-5.933, P=0.040) and BMI≥28 (OR=7.776, 95%CI:2.268-26.657, P=0.001) were independent risk factors of significant pain, while age ≥65 years (OR=0.237, 95%CI:0.083-0.672, P=0.007) and previous surgical history (OR=0.156, 95%CI:0.032-0.754, P=0.021) were the protective factors. 【Conclusion】 It is feasible and effective to treat upper urinary tract calculi with FURL under LA. The presence of significant pain is associated with factors such as gender, age, BMI and previous surgical history.
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【Objective】 To analyze the risk factors of postpartum stress urinary incontinence (SUI) and to establish a nomogram model. 【Methods】 A total of 278 puerpera who gave birth at our hospital during Dec.2018 and Aug.2020 were selected as the modeling group, and 132 puerpera who gave birth during Sep.2020 and Sep.2021 were involved in the verification group. Factors affecting postpartum SUI were identified with univariate and multivariate logistic regression, and a nomogram prediction model was constructed with R software. The predictive effectiveness and discrimination of the model were assessed, and the decision curve analysis (DCA) was drawn to evaluate the clinical application value of the model. 【Results】 A total of 84 cases (30.22%) in the modeling group developed SUI 2 months after delivery. Fetal weight, delivery method, maternal age, mobility (Δhy) and rotation Angle (Δβ) were factors affecting postpartum SUI (P<0.05). Multivariate logistic regression analysis showed that increased fetal weight, normal delivery, increased Δhy, and increased Δβ were independent risk factors of postpartum SUI (P<0.05). The constructed nomogram fitted well. The H-L fit curve of the modeling group and verification group were (χ2=7.514, P=0.312) and (χ2=6.157, P=0.267), respectively. The area under the receiver operating characteristic curve of the modeling group and verification group were 0.815 and 0.760, respectively, indicating high specificity and consistency. DCA indicated that when the high-risk threshold probability of the model was between 0.06-0.80, the nomogram model had a high clinical value. 【Conclusion】 Increased fetal weight, normal delivery, increased Δhy and elevated Δβ are independent risk factors that affect postpartum SUI. The nomogram model constructed has good predictive effectiveness and discrimination, and high clinical application value.