Objective To explore the number variation trend of inpatients with traumatic brain injury (TBI) in high altitude and plain areas. Methods The first page information in medical records of TBI patients, who were admitted to military hospitals from 2001 to 2007, was searched and extracted from the Chinese Trauma Database. Two military hospitals in high altitude area and another two in the same hospital level in plain area were selected. Then, the number variation trend of TBI inpatients in those two areas was compared. Results In high altitude area, the proportion of male patients and their median inpatient days were higher, while the age, proportion of Han patients and surgery rate were lower than those in plain area (all Plt;0.001). During 2001-2007, there were 9 141 TBI patients discharged from the four hospitals, and the average annual growth rate was 13.15%. In high altitude area, the average annual growth rate of discharged inpatients was 24.00%, while in plain area, it was just 7.09%. The 4 common categories of TBI were intracranial injury, open wound of the head, neck and trunk, skull fracture, and other injuries. Conclusion Compared with the plain area, there are significant differences in the demographics, hospital stay and surgery of inpatients in high altitude area. The average annual growth rate of TBI inpatients discharged from hospitals in high altitude area is faster than that in plain area, to which should be paid attention by relevant departments.
Objective To observe the incidence of retinopathy of prematurity (ROP) at different altitudes in Yunnan Province. MethodsA retrospective case-control study. From July 1, 2010 to June 30, 2019, 1 352 premature infants (Kunming group) and 579 premature (Dehong group) infants who received ROP screening in the Neonatology Department of Kunming Maternal and Child Health Hospital and the Neonatology Department of Dehong Dai and Jingpo Autonomous Prefecture People's Hospital were included in the study. A wide field digital retinal imaging system combined with binocular indirect ophthalmoscope and scleral oppressor was used for fundus examination. Inspection results were recorded according to the international ROP classification. The incidence of ROP in recent 10 years was retrospectively analyzed. Independent sample t test was used for comparison between groups. ResultsAmong the 1 352 preterm infants in Kunming group, 716 were males and 636 were females. The birth weight was (1 765.75±357.64) g; gestational age of birth were (32.51±2.07) weeks. The altitude of the residence was (1 920±30) m. Among 579 premature infants in Dehong group, 302 were males and 277 were females. The birth weight was (1 762.54±401.73) g; gestational age of birth were (32.10±2.36) weeks. The altitude of the residence was (920±80) m. There was no significant difference in sex composition ratio (χ2=0.10, P=0.75) and birth weight (t=0.17, P=0.87) between the two groups (P≥0.05). Gestational age and elevation of residence were compared, and the difference was statistically significant (t=3.82, 35.15; P<0.01). ROP was detected in 72 cases 144 eyes (5.32%, 72/1 352) in Kunming group and 55 cases 110 eyes (9.5%, 55/579) in Dehong group. Both cases were binocular. There was significant difference in the detection rate of ROP between the two groups (χ2=11.49, P<0.01). ROP stages 1 to 3 in Kunming and Dehong groups were 128 (88.89%, 128/144), 6 (4.17%, 6/144), 6 (4.17%, 6/144) eyes and 18 (16.36%, 18/110), 66 (60.00%, 66/110), 22 (20.00%, 22/110) eyes. The acute ROP (A-ROP) was 4 (2.78, 4/144) and 4 (3.63%, 4/110) eyes in Kunming and Dehong groups, respectively. There were significant differences in the detection rates of ROP in stages 1 to 3 between the two groups (χ2=11.26, 66.48, 15.86, 0.76; P<0.05). There was no significant difference in the detection rate of A-ROP (χ2=0.76, P>0.05). ConclusionThe detection rate of ROP in high altitude area of Yunnan Province is significantly lower than that in low altitude area.
Objective To explore the feasibility and safety of daytime laparoscopic cholecystectomy in high-altitude areas. Methods Clinical data of patients with gallstones undergoing laparoscopic cholecystectomy admitted to Qinghai Red Cross Hospital between January and December 2023 were retrospectively collected. Patients were divided into daytime surgery group and routine surgery group according to their hospitalization method. The gender, age, ethnicity, American Society of Anesthesiologists classification, comorbidities, postoperative pain, postoperative indwelling drainage tube, postoperative nausea and vomiting, overall satisfaction, length of hospital stay, and hospitalization costs of the two groups of patients were compared. Results A total of 95 patients who underwent daytime surgery and 186 patients who underwent routine surgery were included. There was no statistically significant difference in gender, age, comorbidities, or American Society of Anesthesiologists classification between the two groups of patients (P>0.05). The proportion of Han patients in the daytime surgery group was higher than that in the routine surgery group (69.5% vs. 34.4%, P<0.05). All patients successfully completed the surgery without any serious complication. There was no statistically significant difference in postoperative indwelling drainage tube, postoperative nausea and vomiting, postoperative pain, or overall satisfaction between the two groups of patients (P>0.05). The length of hospital stay [(1.03±0.17) vs. (5.30±1.53) d] and hospitalization expenses [(8104.97±660.65) vs. (8947.82±746.19) yuan] in the daytime surgery group were lower than those in the routine surgery group (P<0.05). Conclusion Daytime laparoscopic cholecystectomy is safe and feasible for patients in high-altitude areas without comorbidities or with stable control of comorbidities, and is beneficial for reducing the medical burden on patients.