The Impact of Home Cardiac Rehabilitation on Quality of Life and Psychological Well-Being in Patients with Coronary Heart Disease: A Randomized Controlled Study.

BACKGROUND Percutaneous coronary intervention (PCI), a therapeutic approach to coronary heart disease, significantly alleviates symptoms of coronary heart disease (CHD) and substantially improves quality of life. This study aimed to investigate the effect of home cardiac rehabilitation (HCR) on patients after PCI. MATERIAL AND METHODS We randomly divided 106 patients after PCI into an Intervention group (n=52) and a Control group (n=53). Left ventricular ejection fraction (LVEF), blood pressure, blood glucose, and low-density lipoprotein were measured in both groups before hospital discharge and after 3 months of engaging in the intervention. Patients were assessed using the short-form health survey (SF-12) scale and Hospital Anxiety and Depression Scale (HADS) scale. RESULTS After 3 months of HCR intervention, SF-12 scores of patients in the Intervention group were significantly higher compared to patients in the Control group (physical component summary (PCS): 47.46±9.86 vs 43.28±8.21; and Mental Component Summary (MCS): 50.68±9.82 vs 48.26±9.69) (P.

Prevention of catheter tip malposition with an ultrasound-guided finger-pressure method to block the internal jugular vein during PICC placement: a meta-analysis.

Introduction: Peripherally inserted central catheters (PICC) are a type of deep venipuncture, for which the catheter tip malposition rate is high. Aim: To examine the feasibility of preventing catheter tip malposition during PICC placement using an ultrasound-guided finger-pressure method to block the internal jugular vein. Material and methods: We conducted a double-blinded randomized controlled trial (RCT) at a tertiary public hospital in Hubei province, China. A total of 600 patients were recruited and randomly allocated to the ultrasound-guided finger compression method (UGFCM) and traditional partial head method (TPHM) group (n = 300/group). Incidence of catheter tip malposition was assessed as the primary outcome of the study. A systematic literature review and meta-analysis was performed. We searched MEDLINE, EMBASE, Cochrane Library, China-National Knowledge Infrastructure, and Chinese Biomedicine Database and performed publication bias and sensitivity analyses on 10 extracted studies. Results: There were no significant differences in baseline demographic and clinical characteristics between the two groups (p > 0.05). Overall incidence of catheter tip malposition was significantly lower in the UGFCM and TPHM group (1.67% vs. 10.3%) and particularly the incidence of malposition in the internal jugular vein (1% vs. 9%). In the meta-analysis of 10 eligible studies, with 1263 cases using the UGFCM method while 1261 adopted the TPHM method, the results showed that the incidence of catheter tip malposition was significantly lower in the group using the UGFCM method (OR = 0.17, 95% CI: 0.11-0.27, p < 0.01), which is in line with the results of our RCT study. Conclusions: This study may add valuable evidence on adopting the finger-pressure method for blocking neck veins to reduce the incidence of catheter tip malposition, particularly in the internal jugular vein.

Genotypic and Epidemiological Trends of Acute Gastroenteritis Associated with Noroviruses in China from 2006 to 2016.

There are periodical norovirus-associated acute gastroenteritis outbreaks around the world. This study aimed to analyze the molecular and epidemiological features of norovirus infections in China during 2006-2016. We extracted epidemiological data from 132 norovirus outbreaks and the norovirus genotyping for 1291 sequences in China over the past ten years. A total of 132 norovirus outbreaks (8133 cases) were reported in China, where the east and south regions were most affected [47.7% (63/132)]. The highest number of outbreaks occurred in 2015. A seasonal pattern has been observed, with a peak from November to the following March. Most of the outbreaks occurred in middle and primary schools, accounting for 28.8% (38/132), and 28.0% (37/132) of outbreaks, respectively. The dominant age group was 10 to 19 years old, responsible for 75.7% (933/1232) of cases. Generally, the dominant genotypes was GII, for 81.9% (1058/1291) of sequences. G II.4 was the predominant genotype in China from 2004 to 2014. However, the GII.17 became more prevalent starting in 2014. Norovirus-associated acute gastroenteritis increased sharply in recent years caused by the emergence of GII.17, but epidemiological features have not changed during 2006-2016. Vigilant surveillance should be strengthened to promptly detect any variation.

[Retrospective analysis of clinical and epidemiological characteristics of hand-foot-and-mouth disease deceased cases in Zhejiang Province].

OBJECTIVE: To understand the clinical and epidemiological characteristics of hand-foot-and-mouth disease (HFMD) deceased cases. METHOD: Information of demographics, diagnosis and treatment, clinical symptoms and signs, laboratory test results, and epidemiological contact history of 72 HFMD cases who died between May 2008 and September 2011, in Zhejiang Province, were collected and analyzed. RESULT: The average age of the 72 cases was 1.8 years, 45 were males, accounting for 62.5%, 63 (87.5%) of the cases were scattered children. Eighteen counties reported 2 or more deaths, accounting for 46.1% (18/39) among the counties where the deaths were reported. The deaths occurred mainly in April to August, the peak occurred in May and June. Fever (98.4%, 63/64) and rash (95.1%, 58/61) were the most common symptoms, but the rash was not obvious at the first diagnosis. Fever occurred before the rash (79.0%, 49/62), persisted for 4 days in average. Vomiting (71.9%, 46/64), dyspnea (65.6%, 42/64), cyanosis (53.1%, 34/64) and impaired consciousness (51.6%, 33/64) were often seen among the cases; 53.1% (34/64) cases went to see the doctor on the first day, but 82.5%(52/63)cases were misdiagnosed. Time to diagnosis of HFMD was in average 3 days. About 3 to 4 days after the onset, the disease deteriorated sharply, deaths occurred within 1 day after admission in 78.9%(45/57)of the deceased cases; 85.0% (34/40) cases had high white blood cells level, mainly neutrophils increased, the ratio of neutrophil was more than 70% in 55.6% (15/27) of cases. Enterovirus 71 (EV71) infection was found in 93.3% (56/60) cases, the deceased cases often died of pulmonary hemorrhage (42.9%, 21/49) and encephalitis (34.7%, 17/49). The sanitary conditions of the cases' family were poor (65.5%, 36/55), but 73.3% (33/45) cases had no exposure history. CONCLUSION: The HFMD deceased cases were mostly younger aged boys, scattered children, nonlocal-residents, and had poor sanitation. They were often infected with EV71, had high fever but had no typical rash, no clear exposure history, they had increased leukocyte, and were often misdiagnosed. Three or 4 days after onset, the disease deteriorated abruptly, most cases died within 1 week after onset. To decrease the HFMD mortality, early detection of severe cases should be stressed, and relative measures should be taken. The guardian should be aware of having good sanitary situation and healthy habits.

[Community-based study on disease burden of diarrhea in Zhejiang province].

OBJECTIVE: To study the status on economic burden of diarrhea in Zhejiang province so as to provide evidence for allocation of health resource as well as decision-making on health issues. METHODS: Multi-phases stratified random cluster sampling was used to select samples in the population. Data was collected on the incidence of diarrhea in the last two weeks as well as on the related cost due to medical care etc. RESULTS: The overall incidence (person per year) of diarrhea was 0.26, with 0.29 in the rural and 0.22 in the urban areas respectively. The incidence of diarrhea in children less than 5 was 0.66 (person per year), higher than in any of the age groups. The average direct cost of medical treatment was 69.23 Yuan with average direct cost of non-medical care was 8.29 Yuan for every person, while the indirect cost was 48.43 Yuan. In conclusion, the average disease burden of diarrhea in the province was 1.697 billion Yuan per year, which accounted for 1 per thousand of the GDP, with 1.217 billion Yuan in rural area and 0.480 billion Yuan in the urban areas respectively. The direct cost of medical care was 0.886 billion Yuan (52.21%) and the direct cost due to non-medical care was 0.124 billion Yuan (7.31%). The indirect cost appeared to be 0.480 billion Yuan (40.48%). Factors that affecting the cost would relate to: severity of diarrhea, medical insurance, location of residential area, age and education background of the patients, etc. CONCLUSION: Programs on diarrhea prevention and control should be strengthened to reduce the economic burden caused by this disease while special attention should be paid to those children who are under 5 years of age and living in the rural areas.

[Effect of hypokalemia on glucose metabolism in primary hyperaldosteronism].

OBJECTIVE: To investigate the effect of potassium deficiency on glucose and insulin metabolism in primary hyperaldosteronism, including aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA). METHODS: Totally 178 patients who were diagnosed as primary hyperaldosteronism (103 patients with APA and 75 with IHA) were divided into hypokalemia group and normal potassium group according to their serum potassium levels. All patients received 3 hours of oral glucose tolerance test and aldosterone test to observe the relationship among glucose, insulin and serum potassium. RESULTS: Area under curve of serum potassium, area under curve of plasma insulin, and fasting serum insulin were significantly lower in the hypokalemia group than in the normal potassium group (P <0. 05, P <0. 01); area under curve of glucose and aldosterone level were significantly higher in the hypokalemia group than in the normal potassium group ( P < 0. 05 ) . The prevalence of metabolic syndrome was significantly higher in IHA than in APA (57. 3% vs 38. 8% ; P < 0. 05). CONCLUSION: Hypokalemia may play an important role in inhibiting insulin secretion in primary hyperaldosteronism.

[Puberty development of the healthy adolescent girls of Daqing city, Heilongjiang province].

OBJECTIVE: To investigate the process of puberty development of healthy adolescent girls in Northern China. METHODS: 288 adolescent girls of Daqing city, Heilongjiang province, aged 5 to 16, were studied and followed up yearly for four years. The height, weight, fat percentage, second sex characteristics, and the blood levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E(2)) were examined. RESULTS: The mean age of puberty onset of these healthy adolescent girls was 8.5 years +/- 1.1 years. The blood levels of FSH, LH and E(2) were 0.2 mIU/L, 1.1 mIU/L and 0.06 nmol/L respectively (the 95 percentiles were 2.5 mIU/L, 2.3 mIU/L and 0.12 nmol/L respectively). Their mean age of menarche was 12.4 years +/- 1.2 years. The mean age of breast development was 8.8 years +/- 1.1 years. CONCLUSION: The girls in Northern China begin their puberty development at younger ages than reported before.