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Objective To explore the prevalence rate and related factors of urban and rural residents with hyperuricemia (HUA). Methods A total of 360 subjects in physical examination department of Sanliusan Hospital from January 2020 to January 2023 were selected and divided into urban residents and rural residents according to their permanent residence addresses, and the demographic information, living habits and underlying diseases were collected. Fasting blood glucose (FBG), serum uric acid (SUA), body mass index (BMI) and triglyceride (TG) were measured. The risk factors of HUA were analyzed by logistics regression analysis. Results The incidence rates of HUA in urban and rural residents were 12.18% and 12.88%. There were statistically significant differences in education level, occupation, BMI, sleep time, alcohol drinking, FBG and TG between urban and rural residents (all P24 kg/m2, alcohol drinking and chronic kidney disease were independent risk factors for HUA occurrence among urban residents (all P<0.05). Chronic kidney disease, FBG≥7.0 mmol/L and TG≥2.3 mmol/L were independent risk factors for hyperuricemia occurrence among rural residents (all P<0.05). Conclusion Rural residents should strengthen health education and blood glucose and lipid control, and urban residents should pay more attention to reasonable exercise, control alcohol consumption and reduce HUA occurrence.
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The potential utility of wastewater-based epidemiology as an early warning tool has been explored widely across the globe during the current COVID-19 pandemic. Methods to detect the presence of SARS-CoV-2 RNA in wastewater were developed early in the pandemic, and extensive work has been conducted to evaluate the relationship between viral concentration and COVID-19 case numbers at the catchment areas of sewage treatment works (STWs) over time. However, no attempt has been made to develop a model that predicts wastewater concentration at fine spatio-temporal resolutions covering an entire country, a necessary step towards using wastewater monitoring for the early detection of local outbreaks. We consider weekly averages of flow-normalised viral concentration, reported as the number of SARS-CoV-2 N1 gene copies per litre (gc/L) of wastewater available at 303 STWs over the period between 1 June 2021 and 30 March 2022. We specify a spatially continuous statistical model that quantifies the relationship between weekly viral concentration and a collection of covariates covering socio-demographics, land cover and virus-associated genomic characteristics at STW catchment areas while accounting for spatial and temporal correlation. We evaluate the models predictive performance at the catchment level through 10-fold cross-validation. We predict the weekly viral concentration at the population-weighted centroid of the 32,844 lower super output areas (LSOAs) in England, then aggregate these LSOA predictions to the Lower Tier Local Authority level (LTLA), a geography that is more relevant to public health policy-making. We also use the model outputs to quantify the probability of local changes of direction (increases or decreases) in viral concentration over short periods (e.g. two consecutive weeks). The proposed statistical framework is able to predict SARS-CoV-2 viral concentration in wastewater at high spatio-temporal resolution across England. Additionally, the probabilistic quantification of local changes can be used as an early warning tool for public health surveillance.
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【Objective】 To analyze the application value of transcutaneous electrical acupoint stimulation (TEAS) in treating blood donation-related vasovagal reaction (DRVR). 【Methods】 The donors, experienced DRVR in our No.1 and No.2 mobile blood donation trucks from January 2020 to November 2021, were selected as research subjects and divided into TEAS group and control group, according to different treatment methods.After the occurrence of DRVR, the control group adopted routine treatment methods, such as stoping phlebotomy immediately, laid flat on the back with the feet higher than the head, head tilted to one side, and loosing collar or tight clothes.In case of syncope, acupressure was given to Renzhong and Hegu, pulse and blood pressure were monitored, and blood donors were provided with proper amount of liquid after consciousness recovery.The TEAS group received extra TEAS treatment based on the above methods.According to the symptoms of DRVR, the two groups were sub-divided into non-syncope DRVR and syncope DRVR to observe the effect of different treatments. 【Results】 The total effective rate of TEAS in non-syncope DRVR(97.33%) and syncope DRVR group(97.06%) was higher than those of control group (vs 91.13% and 76.67%)(P<0.05). The changes of blood pressure and heart rate of blood donors before blood donation and after treatment with the two methods in the TEAS group were lower than those in the control group (systolic blood pressure change value 5.24±2.87 mmHg vs 7.42±3.44 mmHg, diastolic blood pressure change value 3.17±2.24 mmHg vs 3.67±2.51mmHg, heart rate change value 2.71±0.35 beats/min vs 3.46±0.49 beats/min), P<0.05. 【Conclusion】 TEAS has better effect than conventional treatments, especially for DRVR with syncope, and can quickly and effectively improve the syncope related symptoms and shorten the recovery time.Moreover, it is safe, non-invasive, simple economic and effective, which deserves application and popularization in mobile blood donation sites.
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Objective To study thyroid function in patients with depression.Methods The average levels of TSH,FT3,FT4 in 5 316 patients with depression were compared with 5 316 healthy controls.The average levels of TSH,FT3,FT4 were compared between male and female patients with depression.The differences of thyroid disease detection rate were compared between elder and group younger group.Results The differences of TSH,FT3,FT4 levels between the depression patients and healthy controls have statistically significant(P<0.05).The differences of TSH,FT3,FT4 levels between the male depression patients and the female depression patients have statistically significant (P< 0.05).The hyperthyroidism prevalence were as follows:6.50 % versus 6.10 % (P>0.05),compared between older and younger depression patients.The subclinical hypothyroidism prevalence 24.30 % versus 9.40 % (P<0.05),compared between older and younger depression patients.The hypothyroidism prevalence 14.30 % versus 2.90% (P<0.05),compared between older and younger depression patients.Conclusion Depression is easily caused by low thyroid hormone levels.Women and elder people with hypothyroidism should more prevent depression.Thyroid hormones can be used as routine screening index of depression,but not specific indicators.
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Objective To study thyroid function in patients with depression.Methods The average levels of TSH,FT3,FT4 in 5 316 patients with depression were compared with 5 316 healthy controls.The average levels of TSH,FT3,FT4 were compared between male and female patients with depression.The differences of thyroid disease detection rate were compared between elder and group younger group.Results The differences of TSH,FT3,FT4 levels between the depression patients and healthy controls have statistically significant(P<0.05).The differences of TSH,FT3,FT4 levels between the male depression patients and the female depression patients have statistically significant (P< 0.05).The hyperthyroidism prevalence were as follows:6.50 % versus 6.10 % (P>0.05),compared between older and younger depression patients.The subclinical hypothyroidism prevalence 24.30 % versus 9.40 % (P<0.05),compared between older and younger depression patients.The hypothyroidism prevalence 14.30 % versus 2.90% (P<0.05),compared between older and younger depression patients.Conclusion Depression is easily caused by low thyroid hormone levels.Women and elder people with hypothyroidism should more prevent depression.Thyroid hormones can be used as routine screening index of depression,but not specific indicators.
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Objective To study the stability of the plasma glucose in sample tubes containing different glycolysis inhibitors and anticoagulants at room temperature for up to 24 h.Methods Venous blood was collected from 20 volunteers.Each donor blood sample was divided into six tubes containing different glycolysis inhibitors and anticoagulants and kept at room temperature.Plasma glucose was measured at 0,2,4,8 and 24 h after collection.The difference of plasma glucose levels for each sample tube was com-pared with different placed time and the difference of plasma glucose levels for the same placed time was compared with different sample tubes.Results The differences of the plasma glucose results of 2 hours after sampling and of instant detecting are statisti-cally significant for each sample tube(P<0.05).The differences of the plasma glucose levels among the three sample tubes contai-ning sodium fluoride are not statistically significant at the same placed time(P>0.05).The differences of the plasma glucose results of 2,4,8,24 h after sampling for each sample tube are not statistically significant(P>0.05).The differences of the plasma glucose results for each sample tube containing sodium iodoacetate are statistically significant at different placed times(P< 0.05).The differences of plasma glucose levels of 0,2,4 hours after sampling for the three sample tubes are no statistically significant(P>0.05)and the differences of plasma glucose levels of 8,24 hours after sampling for the three sample tubes are statistically signifi-cant(P<0.05).The differences of plasma glucose levels for the two glycolytic inhibitors are statistically significant at 4,8,24 hours after sampling(P<0.01)except 2 hours after sampling(P>0.05).Conclusion Tubes containing NaF are more suitable for detec-ting venous plasma glucose within 24 h at room temperature.The type of anticoagulant has no obvious correlation with the ability of glycolytic inhibition.
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BACKGROUND: The time required for patients with acute chest pain to reach a hospital emergency department varies, possibly lowering the diagnostic performance of a general cut-off value for high-sensitivity cardiac troponin T (hs-cTnT) in diagnosing acute myocardial infarction (AMI). The aim of this study was to determine the cut-off values as calculated by receiver operating characteristic (ROC) of hs-cTnT at different times from onset of symptoms to admission, and to evaluate their diagnostic performance. METHODS: Our study included 3096 patients with symptoms suggestive of AMI. These patients were classified according to time from onset of symptoms to admission. The diagnostic accuracy was quantified by the area under the ROC curve (AUC). RESULTS: Of the patients, 1082 (49.3%) were diagnosed as having AMI (317 were non-ST segment elevation myocardial infarction [NSTEMI]). The AUC for hs-cTnT to diagnose AMI was 0.881 at <3 h after symptom onset, 0.940 at 3-6 h after symptom onset, 0.966 at 6-12 h after symptom onset, and 0.974 at >12 h after symptom onset. The threshold as determined by ROC of hs-cTnT was 13.5 ng/L to diagnose AMI at ≤3 h after symptom onset with a sensitivity of 81.8% and a specificity of 80.1%, 17.8 ng/L at 3-6 h after symptom onset with a sensitivity of 94.6% and a specificity of 84.3%, 30.0 ng/L at 6-12 h after symptom onset with a sensitivity of 95.9% and a specificity of 85.5%, and 58.0 ng/L at >12 h after symptom onset with a sensitivity of 92.7% and a specificity of 93.3%. The same observations were performed for the diagnosis of NSTEMI. CONCLUSIONS: The ROC-determined cut-off value of hs-cTnT for AMI or NSTEMI diagnosis gradually increased with time from onset of symptoms to presentation. Using a higher cut-off value by ROC for hs-cTnT will improve its accuracy in diagnosing AMI or NSTEMI patients in late presenters. The higher value will enable physicians to more quickly rule in patients compared to the 99th percentile cut-off, and can rule out patients safely.
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Infarto del Miocardio/diagnóstico , Troponina T/análisis , Enfermedad Aguda , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Curva ROC , Factores de TiempoRESUMEN
<p><b>OBJECTIVE</b>To explore the effect of arterial infusion with methylene blue during total mesorectal excision (TME) for better preservation of pelvic autonomic nerve on urination function and sexual function in male patients with rectal cancer.</p><p><b>METHODS</b>A total of 68 male rectal cancer patients from Zhejiang Xiaoxing People's Hospital and 44 male rectal cancer patients from Guangdong Zhongshan Chenxinghai Hospital between June 2013 and June 2015 were prospectively enrolled. Patients were randomly divided into the trial group receiving arterial infusion with 8 ml of 1% methylene blue and the control group without artery infusion, with 56 cases in each group. All the patients underwent TME. Intra-operational lymph node removal and postoperative urination and sexual function (erection and ejaculation) were compared between two groups.</p><p><b>RESULTS</b>The baseline data of the two groups were not significantly different (all P>0.05). As compared to the control group, the trial group had shorter operation time [(3.28±0.63) hours vs. (4.01±0.94) hours, P<0.01], less blood loss[(92.5±36.4) ml vs. (174.1±61.4) ml, P<0.01], and more lymph nodes harvested per patient (15.8±7.6 vs. 11.9±4.3, P<0.01). One year after operation, classI(, II(, III(, IIII( of urination was observed in 33 cases (58.9%), 15 cases (26.8%), 6 cases (10.7%), 2 cases (3.6%) in the trial group, while 24 (42.9%), 15 (26.8%), 12 (21.4%), 5 (8.9%) in the control group, which indicated that trial group was superior to control group(P<0.05). ClassI(, II(, III( of erection was observed in 36 cases (64.3%), 18 cases (32.1%), 2 cases(3.6%) in the trial group, while 25(44.6%), 23(41.1%), 8(14.3%) in the control group, which indicated that trial group was superior to the control group (P<0.05). ClassI(, II(, III( of ejaculation was found in 36 cases (62.5%), 18 cases (32.1%), 3 cases (5.4%) in the trial group, while 24 (42.9%), 22 (39.3%), 10(17.9%) in the control group, which also indicated that trial group was superior to the control group(P<0.05).</p><p><b>CONCLUSIONS</b>In the treatment of male rectal cancer patients, TME combined with arterial infusion with methylene blue can facilitate the distinction of operation scope, which is beneficial to reduce damages to the pelvic nerve, leading to the protection of urinary function and sexual function. In addition, this procedure can result in shorter operation time, less operational blood loss and more lymph nodes harvested.</p>
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Humanos , Masculino , Procedimientos Quirúrgicos del Sistema Digestivo , Infusiones Intraarteriales , Escisión del Ganglio Linfático , Azul de Metileno , Periodo Posoperatorio , Neoplasias del Recto , Cirugía General , Recto , Cirugía General , MicciónRESUMEN
Objective To research the levels of thyroid hormone in patients with Sheehan′s syndrome .Methods The difference of thyroid‐stimulating hormone(TSH) or free triiodothyronine(fT3 ) or free thyroxine(fT4 ) levels was compared between 100 pa‐tients with sheehan′s syndrome and 100 cases of female healthy controls included in this study .The difference for TSH or fT3 or fT4 levels was compared between before and after treatment in Sheehan′s syndrome patients .The difference of TSH or fT3 or fT4 levels was compared when time from a large bleeding to disease onset below 1 year ,1‐5 years and over 5 years respectively in Shee‐han′s syndrome patients .Results The difference of TSH or fT3 or fT4 levels between patients with Sheehan′s syndrome and female healthy controls had obvious statistical significance .TSH :1 .60(0 .79 -2 .86)mU/L versus 3 .08(1 .97 -5 .08)mU/L ,fT3 :2 .09 (1 .44-3 .69)pmol/L versus 4 .86(4 .49-5 .40)pmol/L ,fT4 :8 .01(3 .45 -12 .64)pmol/L versus 14 .56(13 .63 -16 .11)pmol/L (P<0 .001 for comparisons respectively) .The difference of TSH or fT3 or fT4 levels between before and after treatment had obvi‐ous statistical significance .TSH :1 .60(0 .79-2 .86)mU/L versus 1 .16(0 .57-2 .11)mU/L ,fT3 :2 .09(1 .44-3 .69)pmol/L versus 3 .27(2 .38-4 .11)pmol/L ,fT4 :8 .01(3 .45 -12 .64)pmol/L versus 14 .32(10 .48 -15 .92)pmol/L(P<0 .05 for comparisons re‐spectively) .Time from a large bleeding to disease onset were below 1 year ,1-5 years and over 5 years ,TSH levels were respective‐ly 2 .85(2 .21-3 .51)、1 .82(1 .24-2 .98) and 1 .52(0 .65-2 .64)mU/L(P<0 .05 for comparisons) .The fT3 levels were respective‐ly 3 .74(2 .24-4 .45) ,2 .54(1 .87-3 .32) and 1 .89(1 .13-3 .11)pmol/L(P<0 .05 for comparisons) .The fT4 levels were respec‐tively 12 .21(10 .45-14 .32) ,8 .52(5 .13-12 .34) and 7 .85(3 .12 -10 .12)pmol/L(P<0 .05 for comparisons) .Conclusion TSH could serve as an identifiable index for sheehan′s syndrome and primary hypothyroidism .The time from a large bleeding to the dis‐ease onset is longer ,the anterior pituitary function is more serious .Thyroid hormone should be monitored regularly in order to pre‐vent the happening of hyperthyroidism during the process of the treatment .For postpartum hemorrhage patients ,thyroid hormone should be early detected and combine with the clinical manifestations .They should early diagnose and timely treat in order to pre‐vent the sheehan′s syndrome and its crisis .
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Objective To investigate the diagnostic threshold value and diagnostic performance of high-sensitivity troponin T (hs-cTnT)for elderly patients with acute myocardial infarction(AMI).Methods 835 emergency department patients with chest pain were recruited in the study,then these patients were divided into elderly group (≥65 years old)and control group(<65 years old).Hs-cTnT concrentrations were compared between the two groups;The difference of hs-cTnT concentrations between AMI pa-tients and non-AMI patients were compared in elderly group and control group respectively;The optimal threshold values of the hs-cTnT for acute myocardial infarction were determined by receiver operating characteristic(ROC)curve.Results The hs-cTnT con-centrations of non-AMI patients in elderly group were 18.4(14.5-32.5)ng/L,which were higher than those of non-AMI patients in control group[3.2(3.0-8.2)ng/L],and the difference were statistically significant(P <0.05);The hs-cTnT concentrations of AMI patients in elderly group were 136.1 (51.6 - 384.1 )ng/L,which were higher than those of AMI patients in group 68.5 (25.6-217.1)ng/L,and the difference were statistically significant(P <0.05).According to the ROC curve,the optimal threshold value for AMI diagnosis in elderly group by using hs-cTnT was 32 ng/L,which was higher than that in control group(14 ng/L). The specificity and the positive predictive value of the optimal threshold value determined by ROC were apparently higher than the 99th percentile(P 99 )in elderly group respectively,the difference were statistically significant(P <0.05).Conclusion The hs-cTnT levels were positively related with age.The optimal threshold value of hs-cTnT for AMI(32 ng/L)was higher than the P 99 (14ng/L)in elderly group.
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Objective To study the feasibility and clinical effect of trans umbilical single incision laparoscopic right hemicolectomy for right hemicolon carcinoma.Methods The clinical data of 35 patients with right hemicolon carcinoma were retrospectively analyzed,the 15 cases were received the trans umbilical single incision laparoscopic right hemicolectomy (single incision group) and 20 cases were received laparotomy right hemicolectomy (laparotomy group).The clinical indexes were compared between the 2 groups.Results The length of incision,intraoperative bleeding volume,passage of gas by anus time,feeding time,hospitalized time in single incision group were significantly better than those in laparotomy group [(5.5 ± 0.6) cm vs.(17.6 ± 2.2) cm,(84.0 ± 31.1) ml vs.(155.5 ± 43.1) ml,(2.00 ± 0.76) d vs.(3.75 ± 0.63) d,(5.3 ± 0.6) d vs.(6.5 ± 0.6) d,(9.3 ± 1.4) d vs.(13.5 ± 1.5) d],the operation time in single incision group was significantly longer than that in laparotomy group [(238.4 ± 19.3) min vs.(165.3 ± 25.8) min],there were statistical differences (P < 0.05).There was no statistical difference in number of incision lymph node between the 2 groups (P > 0.05).Postoperative complication in single incision group occurred in 2 cases,postoperative complication in laparotomy group occurred in 3 cases,there was no statistical difference (P >0.05).The follow-up time was 1-55 months,the median follow-up time was 28 months,local recurrence and distant metastasis were found in 2 cases in single incision group,and 4 cases was found in laparotomy group,there was no statistical difference (P > 0.05).Conclusions Single incision laparoscopic right hemicolectomy for right hemicolon carcinoma is safe and feasible,which has the advantages of minimal trauma,aesthetic outlook,less bleeding,quick recovery and short hospitalization time,etc.It can be developed in the hospital which has some basis of laparoscopic surgery.
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Objective To study the surgical strategies and techniques for the correction of congenital kyphoscoliosis with hemivertebra and evaluate the surgical results. Methods From June 2010 to June 2011,there were 6 congenital kyphoscoliostic patients with fully segmented hemivertebra were undergone hemivertebra resection through posterior approach, which included 4 males and 2 females with an average age of 15.7 years. The average Cobb angle of scoliosis was 73.4° (range, 52°~87°), the average Cobb angle of segmental kyphosis was 67.4° (range, 43°~89°) . The highest level of hemivertebrae was T9 and the lowest was L2. The surgical strategies were designed as followed:For the 2 cases without structural compensative curve, the posterior hemiverte-brae resection and short segmental internal fixation were performed. For the 4 cases with structural compensative curve, whose Risser signs were classified into 2-5, the hemivertebrae resection and long segmental internal fixa-tion were performed, and the compensative curve was included in the instrumentation level. Results The opera-tion time was 2.5~4.0 h (average,3.5 hours), the blood loss was 700-2 000 mL (mean,1 367 mL) . Numb-ness happened in one lower extremity postoperatively in 1 patient, and the symptom released in 1 month. The aver-age postoperative Cobb angle in coronal plane was 21.4° (11°~28°) with a correction rate of 67.9%. The aver-age postoperative Cobb angle in sagittal plane was 17.8° (12°~35°) with a correction rate of 75.2%. The fol-low-up period was from 26 months to 36 months (average, 26 months),no pseudoarthrosis,and obvious correc-tion loss either in coronal or sagittal plane was noted. Conclusion Hemivertebra resection and individualized oper-ation way has a good capability of correcting congenital kyphoscoliosis caused by hemivertebra.