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Objective:To explore the association between mild cognitive impairment(MCI)and the risk of all-cause death among community middle-aged and older adults, and to provide evidence for early identification of high-risk populations.Methods:From September to November 2011, the residents aged 55 years and middle-aged and older in five urban communities were selected as the research objects by typical sampling method.The baseline survey of general information questionnaire, Mini-Mental State Examination(MMSE), activity of daily Living Scale(ADL), Geriatric Depression Scale(SDS)was carried out and the physical examination was performed.Mild cognitive impairment at the time of enrollment was the exposure factor.In 2017, 2019 and 2021, Deaths were followed up through home visits and search for death surveillance information systems.COX regression model was used to analyze the influencing factors for death.Results:A total of 1046 participants completed the follow-up and were included in the study.The baseline age was(66.4±6.6)years, and 199(19.0%)of them met the criteria for MCI.The average follow-up time was 112±16 months.During the follow-up period, 106 deaths were observed.The mortality rate was higher in participants with MCI(40 deaths, 21.1%)than those without MCI [(66 deaths, 10.1%), χ2=26.80, P<0.001)]. Participants with MCI had a shorter median survival time than those without MCI[(108.0±1.5) vs.(113.0±0.5)months, χlog-rank2=28.02, P<0.001]using the Kaplan-Meier method.Controlling for gender, age, and ethnicity, the Cox regression model revealed that MCI is associated with an increased risk of all-cause death( HR=1.98, 95% CI: 1.30-3.02, P=0.023). Conclusions:Mild cognitive impairment is an independent risk factor for all-cause death among community older adults.Early identification and intervention of MCI may have potential value in preventing premature death and prolonging life in middle-aged and older adults.
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Myocardial infarction (MI) has the characteristics of high mortality rate, strong suddenness and invisibility. There are problems such as the delayed diagnosis, misdiagnosis and missed diagnosis in clinical practice. Electrocardiogram (ECG) examination is the simplest and fastest way to diagnose MI. The research on MI intelligent auxiliary diagnosis based on ECG is of great significance. On the basis of the pathophysiological mechanism of MI and characteristic changes in ECG, feature point extraction and morphology recognition of ECG, along with intelligent auxiliary diagnosis method of MI based on machine learning and deep learning are all summarized. The models, datasets, the number of ECG, the number of leads, input modes, evaluation methods and effects of different methods are compared. Finally, future research directions and development trends are pointed out, including data enhancement of MI, feature points and dynamic features extraction of ECG, the generalization and clinical interpretability of models, which are expected to provide references for researchers in related fields of MI intelligent auxiliary diagnosis.
Subject(s)
Humans , Electrocardiography , Myocardial Infarction/diagnosis , Recognition, Psychology摘要
Objective:To report the design,field investigation and main findings of mental health survey in Ningxia Hui Autonomous Region,and to provide valid data for mental disorder prevention.Methods:According to the design of China Mental Health Survey,a cross-sectional study was conducted in 5 390 eligible participants se-lected by multi-stage sampling.The Composite International Diagnostic Interview was used to complete computer assisted personal interview.According to the diagnostic criterion of the Diagnostic and Statistical Manual of Mental Disorder,Fourth Edition(DSM-Ⅳ),the 12-month prevalence and lifetime prevalence were calculated using post-stratification weighting.Results:In 4 085 respondents interviewed in the survey,the 12-month prevalence rate of any mental disorder was 9.4％,and the lifetime prevalence was rate 15.1％.The prevalence rate in rural areas was higher than that in urban areas(10.9％vs 7.9％,P＜0.01).The prevalence rates of anxiety disorder and mood disorder in the female were higher than those in the male(5.3％vs.2.9％,4.9％vs.3.3％,Ps＜0.05),while the prevalence rates of substanceuse disorder and impulse-control disorder were higher in the male than those in the fe-male(2.5％vs.0.2％,2.3％vs.1.5％,Ps＜0.05).The 12-month prevalence rate of any mental disorder showed a decreasing trend with age growth.Among those who met any mental disorder's criteria,93.4％never sought help,and 57.5％of the help seekers didn't receive any effective help.Conclusion:Mental disorders have become an important public health problem in Ningxia,prevention and control measures should be taken accordingly.
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Objective:To investigate the prevalence of anxiety disorder and its distribution,and related factors in adults in Ningxia community.Methods:Using the method of China Mental Health Survey,anxiety disorder was investigated with the Composite International Diagnostic Interview,and related factors were analyzed.Twelve-month prevalence and life-time prevalence and their distributions were calculated according to DSM-Ⅳ criteria.Results:A total of 4 085 respondents were interviewed in the survey.The 12-month prevalence rate of any anxiety disorder was 4.2％,and the lifetime prevalence rate was 5.6％.The 12-month prevalence rates of social phobia,special phobia and generalized anxiety disorder were higher in women than in men(P＜0.05).The prevalence of special phobia and any anxiety disorder in rural area was higher than that in urban area.Logistic regression model revealed that fe-male(OR=1.86,95％CI:1.32-2.64)had higher prevalence risk of anxiety disorder,and individuals with somat-ic pain had higher risk of anxiety disorder than those without(P＜0.05).Conclusion:Anxiety disorder is prevalent in Ningxia.It suggests that strengthening somatic pain community mental health service is necessary to develop tar-geted intervention programs among the high-risk population.
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Objective:To explore the prevalence of mood disorders and utilization of health services inadults in the Ningxia Hui Autonomous Region,thus providing the scientific basis for disease prevention and control.Methods:Using Composite International Diagnostic Interview with the criteria of the Diagnostic and Statis-tical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ),the first survey on mood disorders was carried out by multiple stage sampling.The Rao-Scott x2 test was used to compare the prevalence rate of mood disorders in popula-tions with different characteristics.Results:The 12-month prevalence rate of mood disorder was 4.0％,while life-time prevalence rate of mood disorder was 7.4％.The 12-month prevalence rate was higher in female than male(4.9 vs.3.3％),and the 12-month prevalence rate in rural area was higher than that in urban area(5.0％vs.3.0％)(Ps＜0.05).The 12-month prevalence rate of bipolar Ⅰ disorder decreased with age growth(P＜0.001),and the 12-month prevalence rate of any mood disorder and major depressive disorder decreased with the increase of education level(Ps＜0.05).Among those who met any mood disorder's criteria,92.6％never sought help,45.8％of the help secekers didn't receive any effective help.Conclusion:The prevalence of mood disorder in Ningxia adults is relatively high,but the utilization of mental health services is very low.Females,rural residents,and persons with low education level are the key groups for the prevention of mood disorder.
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Objective:To investigate the prevalence of alcohol use disorder in adult residents in Ningxia and related factors,and to provide scientific evidence for intervention.Methods:In this cross-sectional study,multi-stage sampling was administrated.According to the diagnostic criterion of the Diagnostic and Statistical Manual of Mental Disorder,Fourth Edition(DSM-Ⅳ),face-to-face interview in household was carried out using Composite Interna-tional Diagnostic Interview in Ningxia Hui Autonomous Region.The prevalence of alcohol use disorder and the re-lated factors were analyzed.Results:In 4 085 residents who completed the survey,the 12-month prevalence of alco-hol use disorder was 1.2％,and the life-time prevalence rate was 3.5％.The twelve-month prevalence rates of alco-hol abuse and alcohol dependence were 1.1％and 0.6％,respectively,and the life-time prevalence rates of them were 2.8％and 1.2％,respectively.Comparing with control population,male(OR=10.84,95％CI:2.88-40.87),age groups of 18 to 29 years old(OR=3.67,95％CI:1.27-10.59),30 to 39 years old(OR=5.12,95％CI:1.98-13.24),and 40 to 49 years old(OR=3.82,95％CI:1.45-10.06),secondary school(OR=3.07,95％CI:1.22-7.75),high school or above(OR=3.13,95％CI:1.21-8.12),smoking(OR=3.00,95％CI:1.34-6.70)and body pain(OR=1.88,95％CI:1.05-3.36)were risk factors of alcohol use disorder.Conclusions:The prevalence of alcohol use disorder in different populations distribute dissimilarly in Ningxia.Males,middle-aged and young people,smokers,and those with physical pain should be key objects of intervention for alcohol use disorders.
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BACKGROUND@#Few studies have specifically addressed quality of life issues for elderly hospice patients. The purpose of this study is to explore various factors and service patterns of the quality of life of end-of-life care for the elderly.@*METHODS@#We collect the data and make small-scale exploratory study via semi-structured individual interviews. Data were collected from the family of 2 elderly cancer patients receiving hospice services, and the data were analyzed qualitatively.@*RESULTS@#After investigation, we found that elderly people in hospice care, regardless of age, are suffering from physical and psychological pain and do not want to spend the rest of their lives in the hospital, but want to die in their own homes.@*CONCLUSIONS@#Both hospitalization and in-home care can improve resource utilization, and the key is to find various factors affecting the quality of life. Improving the quality of life is what patients and their families need most.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , China , Health Personnel , Psychology , Hospice Care , Psychology , Neoplasms , Therapeutics , Patients , Psychology , Quality of Health Care , Social Work摘要
Objective To discuss the treatment program and experience of " 4P" theory in the treatment of severe infection wounds of perineum.Methods Retrospective analysis of 123 cases of severe infection wounds of perineum in our hospital from March 2016 to February 2018.Following the "4P" theory (T wound debridement-preparation,I prevention and treatment of infection-protection,M dry-wet balanceprogress,E wound edge management-promotion),personalized treatment program was implemented to ensure the normal physiological activities of patients while closing the wound and promoting wound healing.Results There was no death and no serious complications.All the patients were discharged from the hospital after the wound healed well.Wound healing time was (10.37 ±3.25)days.The follow-up time was 2 to 10 months,the median follow-up was 6 months.The recurrence occurred in 3 case and chronic pain in 5 cases during the follow-up.Conclusions According to the main factors affecting wound healing,"4P Theory" can protect the wound to the maximum extent and is safe and effective in the treatment of severe infection of perineal wound.
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Objective To explore the application of 3D printing templates for titanium plate contouring (TrPC) in pelvic ring surgery.Methods From May 2016 to June 2018,12 patients with pelvic ring injury were treated by internal fixation with 24 titanium plates at Department of Orthopedics and Trauma,Sanshui People's Hospital.After solid digital models of the damaged pelves of the patients were reconstructed from their CT images via software,the hollowed ones were created with the wall thickness of 1.2 mm.After the models of damaged pelves were restored to be intact,the templates for titanium plate contouring were designed based on the area of fixation and manufactured via a stereo lithography apparatus.The total manufacturing time and material consumption of 3D printing TTPC were recorded and compared with those of 3D printing solid and hollow models.Before operation,the titanium plates were contoured according to the templates.The time for preoperative shaping the plate and the time for intraoperative preparing the plate before installation were recorded.After operation,all patients underwent CT scan again for reconstruction of 3D models of the postoperative pelves which were compared with their corresponding preoperative ones in the software.Matta criteria were used to evaluate the pelvic reduction and Majeed criteria to evaluate the functional recovery 6 months after operation.Results All patients were followed up for 6 to 28 months (average,16.3 months).The total manufacturing time and material consumption of 3D printing a TTPC were significantly less than those of 3D printing a solid or hollow model (P ＜ 0.05).The time for preoperative shaping the plate was 12.8 ± 4.1 minutes and the time for intraoperative preparing the plate was 1.4 ± 1.1 minutes.The average deviation between the preoperative 3D models and the postoperative ones was 1.4 ± 1.1 mm.According to the Matta criteria for pelvic reduction,6 cases were excellent,4 good and 2 satisfactory.According to the Majeed criteria,the pelvic functions were excellent in 7 cases,good in 4,and fair in one.Conclusion Application of 3D printing TTPC in the surgery for pelvic ring injury is advantageous in lowering the costs of 3D printing and reducing the intraoperative time for contouring the titanium plate,leading to satisfactory outcomes.
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Objective To evaluate the effects of medical social workers on the service efficiency and patient satisfaction in general practice outpatient service . Methods A randomized controlled intervention study was conducted at general practice department of Shanxi Dayi Hospital in June 2017.Three hundred and thirty patients were randomly selected and assigned into two groups : 159 patients received intervention with medical social work service package ( intervention group ) and 163 patients served as controls.The service package included advising service , counseling service, accompanying service, comfort service, intervention guidance service , etc.The average time per visit and patient satisfaction were compared between two groups and the effectiveness of intervention was evaluated by interview of doctors .Results There were no statistically significant differences in gender , age, occupation and insurance categories between the two groups (P ＞0.05).The average time per visit patients in the intervention and control groups were 18 (15,22) min and 21 (15,25) min, respectively (Z＝2.364, P＝0.018).The highest degree of patient satisfaction in the control group was the attitude of doctors (36/40, 90.0%), and the lowest was in the setting of consulting room (20/40, 50.0%).The highest degree of satisfaction in the intervention group was the "comfortable with doctors" (40/40, 100.0%), followed by the affinity nature of social workers ( 38/40, 95.0%), and the lowest was the environmental satisfaction index ( 32/40, 80.0%).The satisfaction of comfortableness with doctors , clinic environment and consultation process in intervention group [(40/40,100.0%)、(32/40,80.0%)、(37/40,92.5%)] was higher than that in control group [(29/40,72.5%)、(20/40,50.0%)、(30/40,75.0%)] (χ2＝12.754, 7.912, 4.501, P＜0.05).Conclusion Intervention provided by medical social workers can improve the efficiency of general practice outpatient service and improve the satisfaction of patients .
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Objective To investigate the mutations of BRCA genes in sporadic high grade serous ovarian cancer (HGSOC) and study its clinical significance. Methods Sixty-eight patients between January 2015 and January 2016 from the Affiliated Cancer Hospital of Zhengzhou University were collected who were based on pathological diagnosis of ovarian cancer and had no reported family history, and all patients firstly hospitalized were untreated in other hospitals before. (1)The BRCA genes were detected by next-generation sequencing (NGS) method. (2)The serum tumor markers included carcinoembryonic antigen (CEA), CA125, CA199, and human epididymis protein 4 (HE4) were detected by the chemiluminescence methods, and their correlation was analyzed by Pearson linear correlation. Descriptive statistics and comparisons were performed using two-tailed t-tests, Pearson′s chi square test, Fisher′s exact tests or logistic regression analysis as appropriate to research the clinicopathologic features associated with BRCA mutations, including age, International Federation of Gynecology and Obstetrics(FIGO)stage, platinum-based chemotherapy sensitivity, distant metastases, serum tumor markers (STM). Results (1) Fifteen cases (22%, 15/68) BRCA mutations were identified (BRCA1: 11 cases; BRCA2: 4 cases), and four novel mutations were observed. (2) The levels of CEA, CA199, and HE4 were lower in BRCA mutations compared to that in control group, while no significant differences were found (P>0.05), but the level of CA125 was much higher in BRCA mutation group than that in controls (t=-3.536,P=0.003). Further linear regression analysis found that there was a significant linear correlation between CA125 and HE4 group (r=0.494,P0.05), while significant differences were found in CA125 and sensitivity to platinum-based chemotherapy between the patients with BRCA mutation and wild type (P<0.05). The multiple factors analysis showed that the high level of CA125 was a independent risk factor of BRCA mutations in sporadic HGSOC (P=0.007). Conclusion The combination of CA125 with BRCA have great clinical significance, the mutation of BRCA gene could guild the clinical chemotherapy regiments.
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Objective To study plasmid-mediated transfer,plasmid replicon typing,and genetic environment of blaNDM-1 gene in Enterobacteraerogenes(E.aerogenes).Methods E.aerogenes HN-NDM0711 was used as the subject of this research,the transferable properties of plasmid were analyzed by conjugation testing,conjugant was performed stability testing,plasmid type was determined by PCR-based replicon typing (PBRT),downstream and upstream of blaNDM-1 were sequenced using chromosome walking method,genetic context was analyzed by BLASTN and BALSTP,as well as annotated using Vector NTI 11.5.1 software,sequence pipeline graph was made,the sequence was submitted to Genbank through software Banklt.Results The conjugation testing of E.aerogenes pHN-NDM0711 was positive,after positive conjugant was conducted 4-day passage,minimal inhibitory concentrations (MICs) of imipenem and meropenem to all the cloned strains didn't change,blaNDM-1 were all positive.The replicon type was IncA/C;blaNDM-1 gene was localized between ISAba14 and IS91,at upstream of the blaNDM-1,class 1 integron and Tn3 transposon were identified,class 1 integron contained a new mosaic structure of a drug-resistant resistance gene cassette.Conclusion E.aerogenes pHN-NDM071 1,bearing blaNDM-1 gene in IncA/C plasmid,derived from gene recombination under different antimicrobial selection pressure.Antimicrobial use in clinical,industrial and agricultural area should be strictly controlled,so as to reduce the emergence of such bacteria.
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Objective To investigate the relationship between single nucleotide polymorphism (SNP) of BARD 1 gene and BRCA1 gene in epithelial ovarian cancer (EOC).Methods Nineteen EOC patients with BRCA1 gene mutation and 50 EOC cases without BRCA1 gene mutation between January 2016 and October 2016 were collected,and all EOC were diagnosed by pathological method.BARD1 gene variants were detected by next generation sequencing (NGS).The SNP of BARD1 gene was analyzed by Pearson linear correlation.Logistic regression analysis was used to research the clinicopathologic features and BRCA1 gene mutation associated with BARD1 gene SNP.Pearson's chi-square test was used to analyze the association between BARD1 gene Val507Met,Arg378Ser and Pro24Ser with different clinicopathologic features and BRCA1 gene mutation risk.Results (1) Eight BARD1 gene variants were found in 69 ovarian cancer patients,in which Val507Met,Arg378Ser and Pro24Ser were common variants,and the rate of mutation were all 54％ (37/69).(2) There was a significant linear correlation among Val507Met,Arg378Ser and Pro24Ser (all P＜0.01).(3) Obvious differences were found in Val507Met,Arg378Ser and Pro24Ser of BARD1 gene between BRCA1+ and BRCA1 (all P＜0.05).(4) No differences were found between BARD1 gene Val507Met,Arg378Ser and Pro24Ser and the clinicopathologic features (all P＞0.05),while obvious differences were found in BRCA1 gene mutation compared to the controls group.The risk of BRCA1 mutation in Val507Met and Arg378Ser were more evident in subjects with negative family history,positive menopause history,negative tubal ligation,onset age (≤60 years old) and sensitivity to platinum-based chemotherapy in EOC (all P＜0.05),while Pro24Ser was only more evident in positive menopause history of EOC (P＜0.05).Conclusions BARD1 Val507Met,Arg378Ser and Pro24Ser are the common genotypes,which are associated with BRCA1 mutation in EOC.The family history,menopause history,tubal ligation,onset age and sensitivity to platinum-based chemotherapy have effects on BARD1 SNP in the risk of BRCA1 gene mutation.
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Objective To explore the relationships among post traumatic stress disorder(PTSD),gratitude and posttraumatic growth (PTG) for terminal cancer patients.Methods Totally 119 advanced cancer patients were investigated with the self-demographic questionnaire,posttraumatic growth inventory (PTGI),the PTSD cheeklist-civilian version (PCL-C) and the Gratitude Questionnaire-6 (GQ-6).Results For terminal cancer patients,the total score of PCL-C was 34.02±12.49.The scores on re-experience,avoidance/numbness,hypervigilance were 9.79±3.78,13.85±5.68,10.36±3.80.The total score of gratitude was 29.37±7.48.The total score of PTG was 51.34± 13.57.The scores of life appreciation,personal relationship and self-strength were 8.00± 2.99,21.18± 5.84,22.16± 6.10.The total scores of PTG were significantly statistical significance among different PTSD groups(F=16.267,P＜0.01)and gratitude groups(F=43.674,P＜0.0 1).The total scores of PCL-C (r=-0.694,P＜0.01),re-experience (r=-0.664,P＜0.01),avoidance/numbness (r=-0.671,P＜0.01),hypervigilance (r=0.753,P＜0.01) and gratitude(r=-0.611,P＜0.01) were all correlated with PTG.The total score of PCL-C and gratitude could explain 66.6％ variation of PTG.For the relationship between PTSD and PTG,the moderation effect of gratitude was not significant (P ＞0.05).Conclusion The gratitude and PTSD were important influence factors for terminal cancer patients' PTG,while the moderation effect of gratitude was not significant,so in clinical intervention we should pay more attentions to the actual effects of gratitude,and we should not pursuit gratitude education blindly.
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Objective To investigate the conceptual feasibility and biomechanical advantages of our self-designed screw hole filler for a lateral bamboo-raft-type titanium locking plate in a digital model of proximal tibial fracture using linear statics finite element analysis.Methods A nut-type screw hole filler was designed.Four different idealized finite element models of proximal tibial fracture fixed by a lateral bamboo-raft-type anatomic locking plate were established on the basis of three-dimensional CT reconstruction and digital orthopedic techniques.The first one was assembled with the filler and stabilized fibula,the second with stabilized fibula but without the filler,the third with the filler and unstabilized fibula,and the fourth with unstabilized fibula but without the filler.Linear statics finite element analyses were conducted for the 4 models under the same 26 groups of loads.The 4 models were compared in terms of maximum relative displacement on fracture surface,average relative displacement on fracture surface,maximum Von Mises stress of internal fixation,maximum contact stress on fracture surface,maximum contact stress between plate and tibial surface,maximum contact pressure on fracture surface,and maximum contact pressure between plate and tibial surface.Outcomes of the analyses for the 4 models were harvested and treated with Wilcoxon Signed Ranks Test.Results There were significant differences between using filler and not using filler in maximum relative displacement on fracture surface,average relative displacement on fracture surface,maximum Von Mises stress of internal fixation and maximum contact pressure between plate and tibial surface (P ＜ 0.05),but no significant difference was found in maximum contact pressure on fracture surface (P ＞ 0.05).The model assembled with the filler and unstabilized fibula led to the greatest improvement in maximum Von Mises stress of internal fixation (P ＜ 0.05).Conclusions Since use of nut-type screw hole filler may increase the contact pressure between plate and bone surface,reduce the maximum Von Mises stress of internal fixation,the maximum displacement of the whole model,and the relative and average displacements on fracture surface,but has insignificant effect on the contact pressure on fracture surface,it improves the biomechanical performance of internal fixation.The filler deserves further study.
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Objective To analyze the monitoring results of iodized salt in Guyuan of Ningxia,and to provide a basis to prevent and control iodine deficiency disorders.Method Descriptive epidemiological method was used to analysis the data of iodized salt from 2008 to 2014,the differences of the qualified rate of iodized salt and the consumption rate of qualified iodized salt in different years were compared longitudinally.Results From 2008 to 2014,the residents iodized salt qualified rate was 96.95％ (9 918/10 230),ranged from 96.03％ to 97.93％ in Guyuan,qualified rate of iodized salt in different years was significantly different (x2 =18.24,P ＜ 0.05);The consumption rate of qualified iodized salt was 96.22％ (9 918/10 308),ranged from 95.18％ to 97.59％,there was significant difference among different years (x2 =38.99,P ＜ 0.05);The median iodine concentration in salt was 31.4 mg/kg,and ranged from 26.2 to 34.9 mg/kg.Conclusions The qualified rate of iodized salt and the consumption rate of qualified iodized salt are kept at a high level.The current iodine content of salt is enough to prevent and control iodine deficiency disorders.
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Objective@#To explore the risk factors of diabetic foot ulcer (DFU) in diabetic patients of Uyghur nationality and Han nationality in the Xinjiang Uygur Autonomous Region.@*Methods@#Clinical data of 640 diabetic patients admitted to our ward from January 2015 to November 2016, conforming to the study criteria, were retrospectively analyzed. Patients were divided into DFU group (n=403) and non-DFU group (n=237) according to whether DFU occurred or not. The data of gender, age, nationality, body mass index (BMI), smoking, drinking, binge eating, triglyceride (TG), total cholesterol (TC), and high-density lipoprotein (HDL) of patients between two groups were compared with chi-square test and t test. Indexes with statistically significant differences between two groups were selected, and they were processed with non-conditional multivariate logistic regression analysis to screen the independent risk factors of DFU. The possible risk factors of DFU of patients of Uyghur nationality and Han nationality were further processed with non-conditional multivariate logistic regression analysis respectively to screen the independent risk factors of DFU of patients of Uyghur nationality and Han nationality.@*Results@#(1) There were no statistically significant differences in gender, age, TC, and HDL of patients between two groups (with χ2=0.149, t values respectively 1.163, 1.033, and 1.026, P values above 0.05). There were statistically significant differences in nationality, BMI, smoking, drinking, binge eating, and TG of patients between two groups (with χ2 values from 4.778 to 13.694, t values respectively 4.703 and 4.237, P<0.05 or P<0.01). (2) Nationality, BMI, smoking, drinking, binge eating, and TG were the independent risk factors of DFU(with odds ratios respectively 1.488, 1.527, 1.736, 1.738, 1.382, and 1.648, 95% confidence intervals respectively 1.315-3.175, 1.488-4.393, 1.834-4.675, 1.474-2.695, 1.342-4.678, and 1.105-6.747, P values below 0.05). (3) Smoking, drinking, binge eating, and TG were the independent risk factors of DFU in diabetic patients of Uyghur nationality (with odds ratios respectively 1.673, 1.387, 1.328, and 1.486, 95% confidence intervals respectively 1.384-1.765, 1.414-1.659, 1.423-1.687, and 1.150-1.670, P values below 0.05). BMI, smoking, and drinking were the independent risk factors of DFU in diabetic patients of Han nationality (with odds ratios respectively 2.442, 1.604, and 1.251, 95% confidence intervals respectively 2.223-2.699, 1.268-2.028, and 1.164-1.344, P<0.05 or P<0.01).@*Conclusions@#Smoking, drinking, binge eating, and TG were the independent risk factors of DFU in diabetic patients of Uyghur nationality. BMI, smoking, and drinking were the independent risk factors of DFU in diabetic patients of Han nationality.
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Objective To investigate the clinical efficacy of buttress plating for patients with posterior pilon fracture.Methods From April 2012 to January 2015,12 patients with posterior pilon fracture of the distal tibia were treated in our hospital.They were 7 men and 5 women,30 to 56 years of age (average,41.2 years).According to the CT classification by Haraguchi et al.,5 cases belonged to type I,3 to type Ⅱ and 4 to type Ⅲ.All the patients underwent open reduction and internal fixation with buttress plate via either a posterolateral approach or a dual posterolateral-posteromedial approach.All the patients were available for follow-up.The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the visual analogue scale (VAS).The radiological evaluation was performed using the osteoarthritis-score (OA-score).Results The patients obtained an average follow-up of 21.2 months (range,from 12 to 30 months).Bone fractures united after an average of 15 weeks (range,from 13 to 19 weeks).The time for full weight walking averaged 16 weeks,ranging from 15 to 23 weeks.The ankle plantar flexion ranged from 36° to 42° (average,40.4°);the ankle dorsal extension ranged from 38° to 44° (average,42.6°).At the final follow-ups,the AOFAS scores ranged from 82 to 97 (average,88.2);the OA-score ranged from 0.6 to 0.8 (average,0.71);the VAS scores during rest,active motion and weight-bearing walking ranged from 0.5 to 0.8 (average,0.66),from 0.6 to 0.9 (average,0.82) and from 1.2 to 1.8 (average,1.41),respectively.No fracture malunion,implant loosening,pain or stiffness of the affected ankle was observed at the final follow-ups.Conclusion Buttress plating for posterior pilon fractures can lead to satisfactory clinical outcomes,because it ensures rigid fixation which in turn enables earlier postoperative mobilization.
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Objective To investigate the current status of prevalence and its relative factors of non-alcoholic fatty liver disease (NAFLD) in the elderly in urban community in Ningxia province and to compare the differences in prevalence of NAFLD between Han and Hui ethnicities.Methods 1046 residents aged 55 years and over from five communities were selected.Questionnaire survey and clinical examination were conducted in all subjects.Fasting vein blood samples were collected.The serum total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol were detected.Results There were 1043 subjects with average age of (66.41 6.65) years finishing the whole examination,including 696 (66.7％) Han and 347 (33.3％) Hui people.The total prevalence of NAFLD was 27.0％ (286/1043),and there was a significant difference in the prevalence [23.4％ (94 cases) vs.29.9％ (192 cases),x2 =5.18,P=0.023]between male and female,but no difference between Han and Hui ethnicities [28.2％ (98 cases) vs.27.0％ (188 cases) x2 =0.17,P=0.675].Logistic regression showed that age(OR=0.96,95％ CI:0.94-0.99),BMI(OR=1.31,95％ CI:1.24-1.38),TG(OR=1.71,95％ CI:1.47-1.98),central obesity (CO)(OR=5.20,95％CI:2.21-12.23) were the factors correlating with NAFLD.Conclusions The prevalence of NAFLD in Hui elderly people was is similar to that in Han elderly people.The elderly people with overweight,central obesity and high serum level of triglyceride and high level TG have higher risk for NAFLD.
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BACKGROUND:As a conventional internal fixation method, anatomic plate has some shortcomings. Recently locking plate has been widely used in treatment of Pilon fracture. How to effective reconstruct articular facet at the distal tibia and to reduce soft tissue damage have attracted increasing attentions. OBJECTIVE:To compare the curative effect of locking compression plate versus anatomic plate internal fixation in treatment of Pilon fracture. METHODS:A retrospective analysis was performed among 72 patients of Ruedi-Al gower II and III Pilon fracture, who were selected from Sanshui People’s Hospital of Foshan between January 2010 and August 2014. The involved patients were randomly divided into two groups:36 patients of observation group were treated with locking compression plate internal fixation, and 36 patients of control group were given anatomic plate internal fixation. The average operation time, postoperative recovery time, postoperative complications, curative effect and postoperative fracture situation were compared between the two groups. RESULTS AND CONCLUSION:The average operation time and the average postoperative recovery time of observation group were significantly better than that of control group (P0.05). Compared with the anatomic plate internal fixation, locking compression plate internal fixation can shorten the operation time and postoperative recovery time, reduce the incidence of delayed healing and nonunion after internal fixation, and improve clinical curative effect in treatment of Pilon fracture.