RESUMEN
Objective: To investigate whether residual dental follicles in the alveolar socket after extraction of impacted mandibular third molars affect the periodontal health of adjacent mandibular second molars, in order to provide clinical reference for the management of residual dental follicles after third molar extraction. Methods: A total of 82 patients who underwent bilateral impacted mandibular third molar extraction at the Department of Oral Surgery, School and Hospital of Stomatology Wuhan University, from November 1, 2020, to November 30, 2022, were included in the study. Using a self-controlled method, each patient's bilateral mandibular third molars were randomly divided into two groups: Group A underwent third molar extraction with thorough removal of residual dental follicle tissue, while Group B underwent third molar extraction without any treatment of the remaining dental follicle tissue. Operation time and adverse reactions were recorded. Clinical and radiographic examinations were performed at 6-month follow-up to evaluate the periodontal parameters and alveolar bone height of the bilateral mandibular second molars, and differences between the two groups were compared. Results: All patients had successful bilateral mandibular third molar extractions, and no serious complications occurred intraoperatively or postoperatively. There were no statistically significant differences in surgical time, postoperative pain, or facial swelling between the two groups (P>0.05). At the 6-month follow-up, the probing depth on the distal aspect of the mandibular second molars in Group A [2.67 (2.00, 3.67) mm] was significantly less than that in Group B [4.00 (3.00, 5.00) mm] (Z=-6.55, P<0.001). The clinical attachment loss on the distal aspect of the mandibular second molars in Group A [1.00 (0.00, 3.00) mm] was less than that in Group B [3.00 (2.00, 5.00) mm] (Z=-5.99, P<0.001). The distance from the alveolar crest to the cementoenamel junction on the distal aspect of the mandibular second molars in Group A [(1.86±1.34) mm] was less than that in Group B [(3.04±1.89) mm] (t=6.87,P<0.001). In patients aged≥20 years, the probability of recovery of alveolar bone height to normal level on the distal aspect of the mandibular second molars in Group A [42.3% (11/26)] was significantly higher than that in Group B [0 (0/26)] (P<0.01), while there was no statistically significant difference between Group A [63.3% (19/30)] and Group B [46.7% (14/20)] in patients aged<20 years (P>0.05). Conclusions: Residual dental follicles in the alveolar socket after extraction of impacted mandibular third molars adversely affect the periodontal health of adjacent teeth. Thorough removal of residual dental follicles during impacted mandibular third molar extraction is beneficial for the postoperative recovery of alveolar bone height of the distal aspect of the mandibular second molars, especially in patients aged≥20 years.
RESUMEN
Public health and social measures (PHSMs) are one of the most important measures in the prevention and control of COVID-19 and have also been effective in suppressing the spread of influenza viruses, but their effectiveness has not been fully investigated. This study aimed to review the progress of research on the impact of PHSMs on influenza during the COVID-19 pandemic based on the latest evidence of the effectiveness of various PHSMs in controlling transmission of influenza viruses, to provide scientific evidence for optimizing influenza prevention and control strategies.
Asunto(s)
COVID-19 , Gripe Humana , Pandemias , Salud Pública , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Gripe Humana/epidemiología , Gripe Humana/prevención & controlRESUMEN
In recent years, the high temperature and heatwaves have seriously affected the health of Chinese residents, and there is an important need for public health protection guidelines for high temperature and heatwaves in China. The National Bureau of Disease Control and Prevention has organized experts to fully investigate the evidence from epidemiological research on the health of populations in high temperature and heatwaves globally and in China, analyze the health hazards and protection needs of different populations, and put forward practical and effective individual protection measures and health recommendations. For this reason, the "Guideline for Public Health Protection against High Temperature and Heatwaves" (referred to as the "Guideline") was officially issued in June 2023. This article interprets the background and significance of the Guideline, the principles of compilation, the main considerations, the main contents, the implementations and promotions and other aspects, to improve the understanding of the content of the Guideline and strengthen the publicity and implementations.
Asunto(s)
Guías como Asunto , Calor , Salud Pública , Humanos , ChinaRESUMEN
Objective: To evaluated the safety and feasibility of dissection of lymph nodes posterior to right recurrent laryngeal nerve (â ¥B compartment) in endoscopic thyroidectomy through gasless axillary posterior approach. Methods: A total of 350 cases with right lobe papillary thyroid carcinoma (PTC) who underwent endoscopic lobectomy, isthmusectomy and central compartment neck dissection via gasless axillary posterior approach based at the Department of General Surgery, Nanfang Hospital, Southern Medical University from June 2020 to December 2022 were retrospectively analyzed. Summarize the clinical, pathological characteristics, and postoperative complications of the patients. SPSS 25.0 was used for statistical analysis of the data. Results: All 350 patients underwent endoscopic surgery successfully, with no conversion to open surgery. There were 303 females and 47 males, with an average age of (36.3±9.2) years. Of those, 287 patients were in pT1a stage, 62 in pT1b stage, and one patient in pT2 stage. There was no T3 or T4 stage patient. The mean numbers of yielded lymph nodes in right central compartment and â ¥B compartment were 8.11±4.65 (range, 1-31) and 2.62±1.86 (range, 1-12), respectively. â ¥B compartment metastasis was detected in 52 (14.86%) of 350 patients. The incidence of transient recurrent laryngeal nerve injury was 0.86%(3/350). Postoperative hematoma occurred in three patients (0.86%). Conclusion: The dissection of â ¥B compartment in endoscopic thyroidectomy through gasless axillary posterior approach is safe and feasible in selected PTC patients.
Asunto(s)
Nervio Laríngeo Recurrente , Neoplasias de la Tiroides , Femenino , Masculino , Humanos , Adulto , Persona de Mediana Edad , Estudios Retrospectivos , Tiroidectomía , Ganglios Linfáticos , Cáncer Papilar Tiroideo/cirugía , Neoplasias de la Tiroides/cirugíaRESUMEN
OBJECTIVE: This study aimed to analyze and explore the effect of Plan-Do-Check-Act (PDCA) cycle management combined with detailed management on postoperative deep venous thrombosis in patients undergoing hip replacement surgery. PATIENTS AND METHODS: Patients who underwent hip replacement surgery in our hospital between November 2021 and April 2023 were recruited for the study. After screening, patients who met all the inclusion criteria were assessed for eligibility. Finally, 80 adults were enrolled. All patients were assigned into observation and control groups (1:1) according to the sequence of admission, i.e., patients admitted between November 2021 and August 2022 were the control group, and patients admitted between September 2022 and April 2023 were the observation group. RESULTS: The intraoperative blood loss and hospital stay in the observation group were significantly less than those in the control group (p<0.05). After the intervention, the levels of plasma prothrombin time (PT), thrombin time (TT), and thromboplastin time (APTT) in the observation group were higher than those in the control group, and the DD level was lower than that in the control group (p<0.05). There was one patient in the observation group who developed deep venous thrombosis after the operation, and the incidence was 2.50%. The rate was significantly lower than that of the control group (p<0.05). The hip joint function score of the observation group was higher than that of the control group, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale score was lower than that of the control group (p<0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (p<0.05). CONCLUSIONS: PDCA cycle management plus detailed management in patients with hip replacement surgery yields a favorable clinical outcome, which can effectively prevent postoperative deep vein thrombosis, and improve surgical indicators and postoperative coagulation function. Also, it reduces the incidence of adverse reactions in patients and facilitates recovery. It has a beneficial impact on the prognosis of patients and deserves promotion.
Asunto(s)
Artroplastia de Reemplazo de Cadera , Trombosis de la Vena , Humanos , Trombosis de la Vena/etiología , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/terapia , Complicaciones Posoperatorias/etiología , Tiempo de Protrombina , Coagulación Sanguínea , Artroplastia de Reemplazo de Cadera/efectos adversosRESUMEN
Talaromycosis marneffei has been increasing in recent years. Our understanding of this disease has gradually deepened through extensive basic and clinical research, but there are still many limitations. In this article, by incorporating the latest research advancements, we discuss important issues in managing Talaromycosis marneffei trends, aiming to guide effective prevention and control of the disease, improving public health, and reducing the healthcare burden.
Asunto(s)
Micosis , Talaromyces , Humanos , Micosis/prevención & control , Micosis/tratamiento farmacológicoRESUMEN
Formaldehyde, as an important pollutant in indoor air, has always been of great concern. In the newly issued "Standards for indoor air quality (GB/T 18883-2022)", the standard limit of formaldehyde has been restricted to 0.08 mg/m3. In order to better promote the implementation and application of this new standard, this study reviewed and interpreted the relevant technical content for determining the standard limit, including the indoor concentration and human exposure levels of formaldehyde, the health effects of formaldehyde, and the derivation of safety reference values. It also proposed prospect for the future development and revision of quality standards for formaldehyde in indoor air.
Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire Interior , Contaminantes Ambientales , Humanos , Contaminantes Atmosféricos/análisis , Formaldehído/análisis , ChinaRESUMEN
Benzene, as a major indoor pollutant, has received widespread attention. In order to better control indoor benzene pollution and protect people's health, the limit value of benzene in the"Standards for indoor air quality (GB/T 18883-2022)'' was reduced from 0.11 mg/m3 to 0.03 mg/m3. This study reviewed and discussed the relevant technical contents of the determination of benzene limit value, including the exposure status of benzene, health effects, and derivation of the limit value. It also proposed prospects for the future direction of formulating indoor air benzene standards.
Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire Interior , Contaminantes Ambientales , Humanos , Contaminación del Aire Interior/prevención & control , Benceno/análisis , Contaminantes Atmosféricos/análisis , China , Monitoreo del AmbienteRESUMEN
There are clear indoor air pollution sources of trichloroethylene and tetrachloroethylene. A large number of epidemiological evidence has confirmed their carcinogenic toxicity and non-carcinogenic toxicity. Several countries and international organizations have paid attention to indoor air trichloroethylene and tetrachloroethylene. It has been also assessed that there should be certain potential health risk of indoor air trichloroethylene and tetrachloroethylene in China. Based on the latest research results of health risk assessment of indoor air trichloroethylene and tetrachloroethylene, the "Standards for indoor air quality (GB/T 18883-2022)" added trichloroethylene and tetrachloroethylene as indicators. The index limit of trichloroethylene is 6 µg/m3 for an 8-hour average concentration. The index limit of tetrachloroethylene is 120 µg/m3 for an 8-hour average concentration. The technical contents related to the determination of the standard limits of trichloroethylene and tetrachloroethylene in indoor air were analyzed and discussed, including the sources, the exposure, the health effects, the determination of the limit values, and the recommendations for standard implementation. It also proposed recommendations for the implementation of"Standards for indoor air quality (GB/T 18883-2022)".
Asunto(s)
Contaminación del Aire Interior , Tetracloroetileno , Tricloroetileno , Humanos , Tetracloroetileno/análisis , Tricloroetileno/análisis , ChinaRESUMEN
The pollution and health effects of indoor inhalable particulate matter (PM10) and fine particulate matter (PM2.5) are increasingly receiving public attention. The"Standards for indoor air quality (GB/T 18883-2022)"has revised the standard limit for PM10 and added the standard limit for PM2.5. This study analyzed and interpreted the relevant technical contents of the revision of the standard limits for two indicators, including the exposure status, health effects, and the basis for the determination of the limit value. It also proposed prospects for the future development and revision of standard limits for indoor particulate matters.
Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire Interior , Contaminación del Aire , Humanos , Material Particulado/análisis , Contaminantes Atmosféricos/análisis , Tamaño de la Partícula , Monitoreo del Ambiente , ChinaRESUMEN
Objective: To investigate the efficacy of strategies for minimizing small bowel resection during surgery for pelvic radiation-induced terminal small intestinal stenosis in preventing postoperative complications such as anastomotic leakage and short bowel syndrome. Methods: This was a retrospective cohort study. There are two subtypes of chronic radiation enteritis (CRE) with combined intestinal stenosis and intestinal obstruction: (1) Type I: terminal ileal lesions with a normal ileal segment of 2-20 cm between the ileal lesion and ileocecal junction; and (2) Type II: the lesion is located in the small bowel at a distance from the ileocecal region, usually accompanied by extensive damage to the bowel segments outside the lesion. The indications for minimal bowel resection are as follows: (1) diagnosis of Type I small bowel CRE; (2) absence of radiological evidence of rectosigmoid damage; and (3) absence of colonic obstruction. The contraindications are: (1) stenotic, penetrating lesions of the distal cecum; (2) emergency surgery; (3) recurrence of malignant tumor or history of radiotherapy for recurrent malignant tumor; (4) interval between radiotherapy and surgery <6 months; and (5) history of preoperative small bowel resection or abdominal chemotherapy. Case data of 40 patients with Type I CRE who met the above criteria and had undergone minimal bowel resection between April 2017 and December 2019 were retrospectively analyzed (minimal bowel resection group; including 13 patients from Jinling Hospital, 16 from the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, and 11 from the Affiliated Hospital of Xuzhou Medical University). Forty patients with Type I CRE who had undergone resection of intestinal stenosis lesions and the ileocecal region between October 2015 and March 2017 were included as historical controls (conventional resection group; all from Jinling Hospital). The specific strategy for minimal bowel resection was one-stage partial ileal resection+ileo anastomosis+protective small bowel stoma. In contrast, conventional resection comprised ileocecal resection+ileocecal-ascending colon anastomosis. Postoperative complications, intraoperative and postoperative recovery, and changes in postoperative quality of life were analyzed in both groups. The severity of postoperative complications was assessed by Clavien-Dindo and the Comprehensive Complication Index (CCI). Karnofsky performance scores (KPS) were used to evaluate the quality of life of patients in the two groups preoperatively and postoperatively. The higher the KPS score, the better the quality of life. Results: Baseline patient characteristics did not differ significantly between the two groups (P>0.05). Compared with the conventional resection group, the length of small bowel resected in the minimal bowel resection group (51 [20-200] cm vs. 91 [60-200] cm, Z=5.653, P<0.001), duration of postoperative total enteral nutrition [9 (3-18) days vs. 12 (4-50) days, Z=2.172, P=0.030], and duration of postoperative hospital stay [17 (9-24) days vs 29 (13-57) days, Z=6.424, P<0.001] were shorter; all of these differences are statistically significant. The overall incidence of postoperative complications was lower in the minimal bowel resection group than in the conventional resection group [20.0% (8/40) vs. 70.0% (28/40), χ2=19.967, P<0.001], These comprised short bowel syndrome [5.0% (2/40) vs. 25.0% (10/40), χ2=6.274, P=0.012], anastomotic leakage or fistula [2.5% (1/40) vs. 22.5% (9/40), χ2=7.314, P=0.014], and pleural effusion [7.5% (3/40) vs. 25.0% (10/40), χ2=4.500, P=0.034], all of which occurred less often in the minimal bowel resection than conventional resection group. The CCI index was also lower in the minimal bowel resection group than in the conventional resection group [CCI>40: 2.5% (1/40) vs. 12.5% (5/40), Z=18.451, P<0.001]. KPS scores were higher in the minimal bowel resection group 1 and 3 months postoperatively than they had been 1 day preoperatively (79.9±4.7 vs. 75.3±4.1, 86.2±4.8 vs. 75.3±4.1, both P<0.05). In the minimal bowel resection group, seven patients were satisfied with their current quality of life and refused to undergo stoma reduction at follow-up and one deferred stoma reduction because of rectal bleeding. The remaining 32 patients underwent stoma reduction 3 to 12 months after surgery, 26 of whom underwent ileo-cecal anastomosis. The remaining six underwent resection of the stoma and anastomosis of the ileum to the ascending colon. Conclusions: The strategy of minimal small bowel resection in patients with radiation-induced bowel injuries reduces the length of resected small bowel, decreases the risk and severity of postoperative complications, and is associated with a better prognosis and quality of life than conventional resection.
Asunto(s)
Enteritis , Enfermedades Inflamatorias del Intestino , Obstrucción Intestinal , Laparoscopía , Neoplasias , Síndrome del Intestino Corto , Humanos , Estudios Retrospectivos , Fuga Anastomótica/cirugía , Síndrome del Intestino Corto/complicaciones , Calidad de Vida , Constricción Patológica/cirugía , China , Obstrucción Intestinal/etiología , Complicaciones Posoperatorias , Recto , Neoplasias/complicaciones , Laparoscopía/efectos adversosRESUMEN
Objective: To investigate the efficacy and safety of dexithabine (DAC) combined with HAAG regimen [harringtonine (HHT), cytarabine (Ara-C), aclarubicin (Acla) and recombinant human granulocyte colony stimulating factor (G-CSF)] in the treatment of acute myeloid leukemia (AML). Methods: The clinical data of 89 AML patients in People's Hospital Affiliated to Shandong First Medical University from January 2019 to January 2021 were retrospectively analyzed. The patients were divided into observation group (n=48) and control group (n=41) according to the treatment plan. The observation group included 25 males and 23 females, aged (44.4±9.3) years old, and was treated with DAC combined with HAAG. The control group included 24 males and 17 females, aged (42.2±10.1) years old, and was treated with DAC regimen. After 3 cycles of treatment, the treatment efficacy of the two groups was judged, including complete remission, partial remission and no remission. The level of serum P-glycoprotein (P-gp) in the two groups was detected by direct immunofluorescence-labeled monoclonal antibody flow cytometry. The enzyme-linked immunosorbent assay was used to detect the level of soluble urokinase-type plasminogen activator receptor (suPAR). Meanwhile, the incidence of adverse reactions such as digestive tract reaction, liver and kidney dysfunction, hemorrhage and infection during treatment were recorded. Results: After 3 cycles of treatment, the observation group had complete remission, partial remission and no remission in 10 cases, 21 cases and 17 cases, respectively, and the control group had 3 cases, 11 cases and 27 cases, respectively. The overall efficacy of the observation group was better than that of the control group (Z=-2.919, P=0.004). The levels of serum P-gp and suPAR in the observation group were (5.2±1.8) % and (464.4±103.4) ng/L, respectively, which were significantly lower than those in the control group [(8.8±1.9) % and (660.6±110.4) ng/L, respectively] (both P<0.05). During the treatment, the incidence of digestive tract reaction, liver and kidney dysfunction, hemorrhage and infection in the observation group was 29.2% (14/48), 22.9% (11/48), 16.7% (8/48) and 33.3% (16/48), respectively, while in the control group was 26.8% (11/41), 21.9% (9/41), 14.6% (6/41) and 24.4% (10/41), respectively, with no statistically significant difference (all P>0.05). Conclusions: The overall efficacy of DAC combined with HAAG in the treatment of AML is better than that of DAC alone. Moreover, the incidence of adverse reactions in DAC combined with HAAG is similar to that of DAC alone, with a high safety profile.
Asunto(s)
Leucemia Mieloide Aguda , Receptores del Activador de Plasminógeno Tipo Uroquinasa , Masculino , Femenino , Humanos , Adulto , Persona de Mediana Edad , Decitabina/uso terapéutico , Receptores del Activador de Plasminógeno Tipo Uroquinasa/uso terapéutico , Estudios Retrospectivos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Citarabina/uso terapéutico , Leucemia Mieloide Aguda/tratamiento farmacológico , Resultado del Tratamiento , Factor Estimulante de Colonias de Granulocitos/uso terapéutico , RecurrenciaRESUMEN
Objective: To explore the relationship between metabolic score for insulin resistance (METS-IR) and chronic kidney disease (CKD) and albuminuria in the Chinese population. Methods: This cross-sectional study was conducted from January to December 2018 among residents aged 20 to 70 years in ten regions of eight provinces in China; all residents had lived in their region for more than 5 years. Various parameters were measured, included fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin (HbA1c), blood lipids, renal function, urinary albumin/creatinine ratio (UACR), etc. Data of 5 060 subjects meeting the criteria were included in the study. CKD was defined as estimated glomerular filtration rate (eGFR)<60 ml·min-1·1.73 m-2 or UACR≥30 mg/g. Albuminuria was defined as UACR≥30 mg/g. METS-IR was calculated and categorized into quartiles: Q1, METS-IR≤32.19; Q2, METS-IR 32.20-37.10; Q3, METS-IR 37.11-42.58; and Q4, METS-IR>42.58. The correlation between METS-IR and CKD and albuminuria was analyzed by binary logistic regression, and subgroup analyses were performed. Results: There were 1 266, 1 266, 1 265, and 1 263 participants included in Q1-Q4 groups, respectively. With the increase of METS-IR quartile, various parameters increased, including age, fasting blood glucose, HbA1c, triglycerides, serum uric acid, waist circumference, body mass index, and systolic and diastolic blood pressure, and the proportion of males also increased (all P<0.05). The proportion of patients with CKD and albuminuria increased significantly with the increase in interquartile range (Q) of METS-IR (all P<0.05). Logistic regression analysis showed that for every 1-unit increment of METS-IR, the risk of CKD and albuminuria were both increased by 2% [for both: odds ratio (OR)=1.02, 95% confidence interval (CI) 1.01-1.03]. Compared with the lowest METS-IR group (Q1), the ORs for CKD and albuminuria in the highest METS-IR group (Q4) were 1.57 (95%CI 1.17-2.10) and 1.46 (95%CI 1.09-1.96), respectively. In the subgroup analyses, increased METS-IR was significantly associated with CKD and albuminuria among women (CKD: OR=1.62, 95%CI 1.14-2.31; albuminuria: OR=1.53, 95%CI 1.07-2.18), individuals with HbA1c<7% (OR=1.64, 95%CI 1.21-2.23; OR=1.55, 95%CI 1.14-2.11), individuals with eGFR≥90 ml·min-1·1.73 m-2 (OR=1.78, 95%CI 1.27-2.49; OR=1.80, 95%CI 1.28-2.53), and the Chinese Han population (OR=1.56, 95%CI 1.13-2.17; OR=1.41, 95%CI 1.01-1.96). Conclusions: METS-IR is significantly associated with CKD and albuminuria in a Chinese population. Furthermore, the higher the METS-IR, the higher the risk of CKD and albuminuria.
Asunto(s)
Resistencia a la Insulina , Insuficiencia Renal Crónica , Masculino , Humanos , Femenino , Albuminuria , Glucemia , Estudios Transversales , Ácido Úrico , Pueblos del Este de Asia , Tasa de Filtración GlomerularRESUMEN
Objective: To investigate the current situation of cell phone use and sleep quality among college students, establish a sleep quality trajectory model and explore the influence of cell phone use on the sleep quality trajectory. Methods: Based on data from the College Student Behavior and Health Cohort Study 2019-2020, a latent class growth modeling was used to establish a sleep quality trajectory model among college students. The baseline influencing factors of sleep quality trajectories among college students were analyzed by χ2 test, and the effects of cell phone use on sleep quality trajectories were analyzed by binary logistic regression. Results: A total of 1 092 college students were included in the analysis. The detection rates of cell phone use and poor sleep quality were 24.5% and 13.3%. Latent class growth model identified two groups of sleep quality trend trajactories: an improved sleep quality group (86.0%) and a decreased sleep quality group (14.0%). The result of binary logistic regression showed that the cell phone use was a risk factor of sleep quality trajectories. Conclusion: The cell phone use during college period could increase the risk of poor sleep quality. Targeted intervention measures about cell phone use should be adopted to improve the sleep quality among college students.
Asunto(s)
Uso del Teléfono Celular , Teléfono Celular , Trastornos del Inicio y del Mantenimiento del Sueño , Humanos , Calidad del Sueño , Estudios de Cohortes , Encuestas y Cuestionarios , Estudiantes , SueñoRESUMEN
Objective: To analyze the clinical features and risk factors of herpes zoster and the risk factors of postherpetic neuralgia (PHN). Methods: A total of 2 840 patients diagnosed with herpes zoster in Peking University People's Hospital from January 2021 to April 2022 were included. The patients with herpes zoster were aged (59±16), and of which 1 314 (46.3%) patients were male. The patients were divided into PHN group and non-PHN group according to whether the patients with herpes zoster developed PHN. And there were 442 (15.6%) patients developed PHN aged (68±12), and of which 189 (42.8%) were male. The information and medical history of PHN group and non-PHN group were collected. The information of the use of glucocorticoids, immunosuppressive agents, biological agents and targeted medicine within 2 months before herpes zoster occurred, history of surgery within 6 months before herpes zoster occurred, and the duration of PHN were collected. Logistic regression analysis was used to analyze the risk factors of PHN. Results: Out of 2 840 patients, 2 056 (72.4%) with herpes zoster aged 50 years and above. Intercostal nerves was mostly involved in patients with herpes zoster, with a total of 1 532(53.9%). Hypertension (465 cases, 16.4%) accounted for the highest number of patients with chronic diseases, followed by diabetes (337 cases, 11.9%) and coronary heart disease (283 cases, 10.0%). Rheumatoid arthritis (41 cases, 1.4%) accounted for the highest number of patients with connective tissue diseases, followed by Sjogren's syndrome (31 cases, 1.1%), systemic lupus erythematosus (28 cases, 1.0%). Logistic regression analysis showed that age≥50 years old (OR: 4.581; 95%CI: 3.131-6.705),lesion on the upper limb and shoulder (OR: 1.858; 95%CI: 1.129-3.059), hypertension (OR: 1.963; 95%CI: 1.513-2.546) and immunosuppressive treatments (OR: 2.170; 95%CI: 1.254-3.753) were independent risk factors for PHN (all P<0.05). Conclusions: Herpes zoster mostly occurs in people aged 50 and above, and mainly affected intercostal nerves. The most common complications are hypertension and rheumatoid arthritis. Age≥50, lesion on upper limbs and shoulders, hypertension, and immunosuppressive treatments may be independent risk factors of PHN.
Asunto(s)
Artritis Reumatoide , Herpes Zóster , Hipertensión , Neuralgia Posherpética , Humanos , Masculino , Persona de Mediana Edad , Femenino , Neuralgia Posherpética/complicaciones , Herpes Zóster/complicaciones , Herpesvirus Humano 3 , Factores de Riesgo , Hipertensión/complicaciones , Artritis Reumatoide/complicacionesRESUMEN
Objective: To evaluate the recognition of acute respiratory infection (ARI) by a pretrained model based on electronic medical records (EMRs). Methods: 38 581 EMRs were obtained from Chongqing University Three Gorges Hospital in December 2021. Bidirectional encoder representation from transformers (BERT) pretrained model was used to identify ARI in EMRs. The results of medical professionals were considered as the gold standard to calculate the sensitivity, specificity, Kappa value, and area under the curve of the receiver operating characteristic (AUC). Results: There were 3 817 EMRs in the test set, with 1 200 ARIs. A total of 1 205 cases were determined as ARI by the model, with a sensitivity of 92.67% (1 112/1 200) and a specificity of 96.45% (2 524/2 617). The model identified ARI with similar accuracy in males and females (AUCs 0.95 and 0.94, respectively), and was more accurate in identifying ARI cases in those aged less than 18 than in adults 18-59 and adults 60 and older (AUCs 0.94, 0.89 and 0.94, respectively). The current model had a better identification of ARIs in outpatient patients than that in hospitalized patients, with AUCs of 0.74 and 0.95, respectively. Conclusion: The use of the BERT pretrained model based on EMRs has a good performance in the recognition of ARI cases, especially for the outpatients and juveniles. It shows a great potential to be applied to the monitoring of ARI cases in medical institutions.
Asunto(s)
Registros Electrónicos de Salud , Infecciones del Sistema Respiratorio , Adulto , Masculino , Femenino , Humanos , Infecciones del Sistema Respiratorio/diagnóstico , Pacientes AmbulatoriosRESUMEN
With the global climate change process is accelerating, China is facing great challenges. It is urgent to carry out scientific study, aiming at the major needs of health adaptation action to climate change under the 'double carbon' target. This special issue on Climate Change and Health highlights and reports on China's latest scientific findings in this field. The health risks of non-optimal temperature, drought, ultraviolet radiation and other meteorological factors and cold spells in China are clarified, and the research methods of health risk early warning of heat waves are summarized. Future researches need to further elucidate the scientific evidence of the impact of meteorological factors and extreme weather events on population health in China systematically. Focus on innovating and developing technical methods and tools such as health risk early warning models. Accelerate the transformation and application of relevant scientific and technological achievements in China. To provide scientific and technological support for the health adaptation action to climate change under the 'double carbon' goal.
Asunto(s)
Carbono , Cambio Climático , Humanos , Rayos Ultravioleta , Objetivos , ChinaRESUMEN
Objective: To estimate the excess mortality attributed to non-optimal ambient temperature in China. Methods: Mortality data and meteorological data from 239 counties in 2013-2018 were collected to simulate the quantitative exposure-response relationship between the temperature and mortality using distributed lag nonlinear models for time series studies. Then the number of non-optimal-temperature-related excess deaths was assessed and the spatial distribution was explored. Results: There were averagely (12±8) cases of all-cause deaths per day per county from 2013 to 2018. The average daily temperature was (14.98±10.31)â, and the daily average relative humidity was (68.79±17.25)%. The daily average O3 concentration was (58.95±34.96) µg/m³, and the daily average PM2.5 concentration was (54.97±45.56) µg/m³. The exposure-response curve between daily average temperature and all-cause mortality showed a "U" shape, and the theoretical minimum mortality temperature (MMT) corresponding to the minimum number of deaths was 21.60 â. When the temperature was higher than MMT, the heat-related health effect increased with the temperature rising. When the temperature was lower than MMT, the cold-related effect increased with the temperature decreasing. The attributable fraction (AF) of death caused by non-optimal temperature was 8.76% (95%CI: 8.07%-9.10%), and the AF of death caused by cold effect and heat effect was 7.21% (95%CI: 6.51%-7.57%) and 1.55% (95%CI: 1.46%-1.61%), respectively. The excess deaths from non-optimal temperature in 2015 were 519 122, 72.98% of which could be attributed to low temperature. The number of excess deaths caused by non-optimal temperature mainly showed a decreasing trend from the east to the west, relatively high (117 522) in East China. Heilongjiang Province (in Northeast China) had the most excess deaths (26 924) caused by low temperature, and Guangdong Province(in South China) had the most excess deaths (27 763) caused by high temperature. Conclusion: The non-optimal temperature has a significant impact on health and causes a considerable burden of disease in China with obvious spatial heterogeneity.
Asunto(s)
Costo de Enfermedad , Humanos , China/epidemiología , Material Particulado/análisis , TemperaturaRESUMEN
Objective: To analyze the North-South difference of the relationship between cold spells and mortality risk of cardiovascular diseases in China. Methods: The time series analysis method was used to collect the daily counts of cardiovascular mortality data, meteorological data and PM2.5 concentration in the cold season (November to March of the following year) from January 1, 2013 to December 31, 2018 in 280 districts and counties in China. The non-constrained distributed lag linear model was used to analyze the relationship between cold spells and mortality risk of cardiovascular diseases and its North-South difference in China. Results: From 2013 to 2018, the mean of daily average temperature of the cold season in 280 districts and counties was 5.4 â. The mean of daily average relative humidity was 64.4%, and the mean of daily average PM2.5 concentration was 73.7 µg/m3. The average cold spell days in each county was 11.7 days per year,the mean of daily average temperature on cold spell days was (-2.4±6.7) â, and M (Q1, Q3) was -1.5 (-5.1, 1.1) â. The average of daily number of cardiovascular disease deaths in each county/district was (6±5) cases, and M (Q1, Q3) was 5 (2, 8) cases. The percentage change (95%CI) in the South was 4.94% (3.69%, 6.20%) (lag 0 d), higher than that in the North [the percentage change (95%CI) was 1.49% (1.14%-1.84%) (lag 0-7 d)]. In the North, the mortality risk of ≥75 years old was relatively low among three age groups, with a percentage change (95%CI) about 1.63% (1.33%-1.93%) (lag 0-21 d). In the South, the mortality risk of ≥ 75 years old was relatively high among three age groups, with a percentage change (95%CI) about 5.18% (3.78%-6.59%) (lag 0 d). Conclusion: The mortality risk of cardiovascular diseases caused by cold spells in the South is higher than that in the North of China, and the risk peak occurs earlier in the South.
Asunto(s)
Enfermedades Cardiovasculares , Humanos , Anciano , Frío , Temperatura , China/epidemiología , Material Particulado/análisis , MortalidadRESUMEN
Global warming has caused frequent heat waves worldwide. In order to respond to heat waves and enhance the public's protection abilities, Europe, the United States and other countries have extensively carried out research on heat-health early warning, and initially achieved good health benefits based on a heat-health early warning system. However, the research on heat-health early warning is still limited in China, especially on health risks at the population level. Based on evidence-based thinking, our study combs the research progress of heat-health early warning from four aspects: early warning indicators, early warning models, early warning thresholds, and early warning ranks, and clarifies the key points of the construction of heat-health early warning models and rank schemes, in order to provide early warning technology for the rapid development of national heat-heath early warning in China.