ObjectiveTo investigate the status quo of emergency resources in all township hospitals in a county of Aba Autonomous Region. MethodWe set up a uniform electronic version questionnaire between April 15th and 18th, 2015. The leaders of township hospitals filled in their information and uploaded the data including emergency medical services, human resources, medical device and technology application situation. Then, the data were statistically analyzed. ResultsFor these township hospitals, the service population was 2 206.05±846.95, the service radius was (25.5±14.3) km. The number of registered doctors per 1 000 people of resident population was 1.52, the number of registered nurses per 1 000 people of resident population was 0.47, and the number of hospital beds per 1 000 people of resident population was 1.69. The staff in all township hospitals included 74 doctors and 23 nurses. The constitution of positional titles and academic qualifications of doctors and nurses in these township hospitals was not significantly different (P>0.05). All township hospitals had a total of six ambulances, one of which was ambulance for rescue and monitoring, and the others were ordinary ambulances. The devices equipped in the ambulances and hospitals were not sufficient, and most doctors and nurses could only perform surrounding vein puncture, and debridement and suture surgery. They could not recue critically ill patients alone. ConclusionsFor these township hospitals, the service radius is too long, the number of doctors and nurses is too small, and the ability of service is insufficient. In order to meet the demand of emergency resources in ethnic areas as far as possible, we should increase investment and promote medical devices, increase the number of doctors and nurses, improve the personnel structure, and strengthen professional training.
ObjectiveTo analyze the clinical characteristics and epidemiological characteristics of patients with coronavirus disease 2019 treated early in Jiangxi province.MethodsFour-night patients with coronavirus disease 2019 treated in this hospital from January 21st to 27th, 2020 were included in this study. The epidemiological and clinical data of patients after admission were collected, and laboratory tests such as blood routine, urine routine, stool routine, liver and kidney function, electrolytes, myocardial enzymes, erythrocyte sedimentation (ESR), C-reactive protein (CRP), calcitonin, coagulation, T cell subset and Chest CT were reviewed. The clinical results of common and severe/critically ill patients were compared.ResultsOf the 49 patients, 40 were common and 9 were severe/critical. Fourty-six patients had a clear history of contact with Wuhan or other areas of Hubei. The sex ratio was 2.06∶1, and the average age was 42.9 years. The symptoms were mainly fever (78.7%), cough (38.8%), and fatigue (18.4%). 28.6% (14 cases) of patients had hypertension and diabetes. Serum lymphocyte count and calcium concentration of the patients were decreased, but lactate dehydrogenase, ESR, CRP and serum amyloid A were increased in these patients. T lymphocyte subsets (CD3+, CD4+, CD8+) decreased significantly in these patients. Forty-seven patients (95.9%) had single or scattered patchy ground glass density shadows on the chest CT. Compared with common patients, the patients with severe/critical patients were older (P=0.023), hospitalized later (P=0.002), and had higher comorbidities (P=0.017). ESR (P=0.001）, CRP (P=0.010) and the serum amyloid A (P=0.040) increased significantly, while CD3+ (P<0.001), CD4+ (P=0.012), CD8+ (P=0.006) decreased significantly in severe/critical patients.ConclusionsThe patients with coronavirus disease 2019 in Jiangxi province are commonly imported from Wuhan. Severe/critical patients are older, hospitalized later, and have more medical complications and more severe systemic inflammatory reactions than common patients.
Objective To explore the characteristics of diagnosis and treatment for the rectal cancer in the young patients （≤40 years）．Methods The domestic and abroad literatures about the research on the progress of rectal cancer in the young patients were reviewed, the clinical data of patients with rectal cancer were compared between the young patients and the other age patients, the characteristics of diagnosis and treatment for the rectal cancer in the young patients were summarized．Results The onsets of the young patients with rectal cancer were related to the diet，lifestyle, and genetic factors．Compared with the older patients, more later stage, higher percentage of poor differentiation, earlier lymph node metastasis were found in the young patients with rectal cancer．Rectal cancer of the young patients was often misdiagnosed and with a poor prognosis．Currently，surgery assisted with neoadjuvant therapy was generally acknowledged as a better method．Conclusions It has specificity in epidemiology, pathology, treatment, prognosis, and so on for rectal cancer in the young patients, but surgery needs further research．
ObjectiveTo study the epidemiologic characteristics of primary liver cancer (PLC). MethodsThe literatures about regional distribution and etiologic epidemiology of PLC were reviewed. Results PLC was mainly distributed on caostland in the south-east of China. The main cause of PLC was hepatitis B virus, aflatoxin and contamination of drinking water. Otherwise, PLS was also related with lack of some trace element, sex horemones, genealogy cause and so on.Conclusion The genesis of PLC was by multiple factors.
Objective To study the risk factors for contralateral breast cancer (CBC) in women after regular treatment of the primary breast cancer. Methods Between January 1997 to December 2002, the clinical data of 340 breast cancer patients at our institution were retrospectively analyzed. In all the patients a detailed analysis was carried out with respect to age, operation type, radiation therapy technique and dose, the use of chemotherapy or hormone therapy, and other clinicopathologic characteristics. The KaplanMeier method was used to estimate the actuarial rate of CBC. The Cox proportional hazard regression model was used to estimate the relative risk factors of CBC. Results Fourteen cases were diagnosed to be CBC, thus overall incidence of CBC was 4.1%. Ten-year CBC incidence (2.7%) was higher than 5-year incidence of CBC (1.4%). Univariate analysis showed that the risk factors of CBC at 5-year and 10-year included: ≤45 years old, medullary carcinoma, family history of breast cancer and being taken without endocrine therapy (P＜0.05), while chemotherapy and radiotherapy were not risk factors of CBC (P＞0.05). Mutivariate analysis showed that ≤ 45 years old and being internal breast radiotherapy were independent risk factors of CBC at 5-year and 10-year (P＜0.05). Conclusions CBC may occur in these primary breast cancer patients with age ≤45 years old, medullary carcinoma, family history of breast cancer. In order to reduce the incidence of CBC, endocrine therapy rather than internal breast radiotherapy should be performed in early breast cancer patients.
ObjectiveTo systematically review the epidemiological characteristics and economic burden of traumatic spinal cord injury (SCI) in China.MethodsPubMed, EMbase, WanFang Data, VIP and CNKI databases were electronically searched to collect studies of the epidemiological characteristics and economic burden of SCI in China from January 1st, 1978 to August 30th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 32 studies were included. The results of meta-analysis showed that: the prevalence of SCI in China was 37 persons per million per year (95%CI 21 to 53), with the average age ranged from 34.7 to 54.4 years. Men had a higher risk of SCI than Women. Motor vehicle collisions (MVCs) and falls were the two main causes of SCI. The neurological injury levels were varied, ASIA grade A was the most common and grade E was the least.ConclusionCurrent evidence shows that there is a high prevalence of SCI in China with heavy social and medical burden. The main reason of SCI is motor vehicle collisions and falls. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion.
Acute kidney injury (AKI) is characterized by a rapid decrease in renal function caused by different etiologies and can involve multiple organs and systems. AKI is a potentially reversible disease. However, it can also progress to chronic kidney disease (CKD) without proper treatment. The concept of acute kidney disease (AKD) is recently recommended as a derivative between AKI and CKD. At present, AKI still lacks specific drug treatment; therefore prevention and early diagnosis are crucial in AKI management. Due to the heterogeneity of the pathogenesis, the epidemiological features of AKI vary across nations and regions, so the strategies for prevention and control are different. This papers reports new progress of epidemiological features of AKI in different countries, so as to provide reference for assessing the disease burden and formulating public health policies.
ObjectivesTo systematically review the epidemiological characteristics of mild cognitive impairment (MCI) in Chinese elderly population.MethodsPubMed, EMbase, The Cochrane Library, CNKI, VIP, WanFang Data and CBM databases were electronically searched to collect studies on the epidemiological characteristics of mild cognitive impairment in the elderly in China from inception to May 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 25 studies involving 56 720 patients were included. The results of meta-analysis showed that the prevalence of MCI in Chinese elderly population was 14% (95%CI 12% to 17%), in which 12.1% (95%CI 9.7% to 14.5%) was male and 14.8% (95%CI 12.5% to 17.2%) was female. The prevalence of MCI was 8% (95%CI 6.0% to 10.1%) in the elderly aged 60 to 69, 13.1% (95%CI 10.6% to 15.6%) in the elderly aged 70 to 79 and 23.4% (95%CI 18.3% to 28.6%) in the elderly aged above 80. The prevalence of MCI was 23% (95%CI 18.3% to 27.6%) in the elderly who were illiterate, 15.2% (95%CI 11.2% to 19.2%) among the elderly with a primary education and 9.8% (95%CI 7.1% to 12.6%) among the elderly with an education above junior high school. The prevalence of MCI was 9.9% (95%CI 5.5% to 14.2%) in urban areas, and 16.7% (95%CI 11.2% to 22.2%) in rural areas. The prevalence of MCI was 12.1% (95%CI 7.7% to 16.5%) in married individuals and 17.1% (95%CI 13.9% to 20.2%) in single individuals. The prevalence of MCI was 15.4% (95%CI 11.4% to 19.4%) in northern China, 14.1% (95%CI 11.1% to 17.2%) in eastern China, 5.4% (95%CI 3.9% to 6.9%) in northeast China, 13% (95%CI 6.2% to 19.8%) in Central-south China, 11.7% (95%CI 10.2% to 13.2%) in the southwest China and 17.4% (95%CI 2.5% to 32.3%) in northwest China. By using the diagnostic criteria proposed by Petersen, the prevalence of MCI was 15.2% (95%CI 11.8% to 18.7%), and was 12.4% (95%CI 9.4% to 15.4%) using the criteria of the DSM-Ⅳ.ConclusionsThe prevalence of MCI is high in China, and varies with gender, age, education, location, marital status, region and diagnostic criteria.
Objective To investigate the prevalence of high myopia，the prevalence and risk factors of high myopia associated with chorioretinopathy in residents aged 60 years or over in Beixinjing community, Shanghai, China.Methods A cluster stratified random sampling method was used to screen 4153 people aged 60 and over in Beixinjing community. There were 3851participants in total with a 9273% response rate. Participants were invited to complete a questionnaire and received a comprehensive eye examination including visual acuity, refraction, slitlamp microscopic examination, direct ophthalmoscopy and fundus photography and so on. Spherical equivalent (SE) was used to determine the degree of refractive errors. The diagnosis of high myopic chorioretinopathy was made if SEgt;-6.00 D and myopic chorioretinal atrophy lesions were presented such as posterior scleral staphyloma, lacquer cracks, Fuchs spot and myopic arc spots. The degree of visual acuity impairment was determined according to the World Health Organization (WHO) classification as low vision (the best corrected visual acuity ge; 0.05, but lt;0.3) or blindness (the best corrected visual acuity lt;0.05).Results There were 207/3851(5.37%) high myopia patients, in which 183/207 (88.40%) patients were associated with myopic chorioretinopathy. The prevalence of myopic chorioretinopathy decreased while age increased (chi;2=19.21, Plt;0.01), but statistically there was no gender difference （chi;2=1.83, Pgt;0.05）. Logistic regression analysis showed that there were significant differences in the prevalence of high myopia between people with different age, educational levels and family history （chi;2=19.21，32.08，960.68；Plt;0.01）.There were 29 cases of bilateral blindness, 96 cases of unilateral blindness,104 cases of bilateral low vision and 562 cases of unilateral low vision in those participants. In 183 cases of high myopic chorioretinopathy patients, 111（60.65 %）cases had an obvious visual impairment, including 3448% (10 cases) of bilateral blindness, 1146% (11 cases) of unilateral blindness, 2981% (31 cases)of bilateral low vision and 1050% (59 cases) of unilateral low vision.Conclusions The prevalence of high myopia of residents aged ge;60 years in Beixinjing community, Shanghai,China is relatively high. Age, education level and family history are the most important factors affecting the occurrence of chorioretinopathy in high myopia patients.
ObjectivesTo systematically review the epidemiological characteristics of frailty in Chinese elderly population.MethodsPubMed, EMbase, Web of Science, CNKI, VIP and WanFang Data databases were electronically searched to collect studies on the epidemiological characteristics of frailty in China from January, 1978 to December, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, and then, meta-analysis was performed by using OpenMetaanalyst software.ResultsA total of 29 studies, involving 64 306 patients were included. The results of meta-analysis showed that: the prevalence of frailty in Chinese community was 12.8% (95%CI 0.105 to 0.152), in Chinese hospital was 22.6% (95%CI 0.130 to 0.270), and in nursing home was 44.3% (95% CI 0.222 to 0.664). In the subgroup analysis by gender: male prevalence in community was 9.2% (95%CI 0.074 to 0.110), female was 12.9% (95%CI 0.100 to 0.157). Prevalence of male in hospital was 23.3% (95%CI 0.124 to 0.342), Prevalence of female was 17.9% (95%CI 0.122 to 0.237). In the subgroup analysis by region: the prevalence of frailty in north China was 13.4% (95%CI 0.093 to 0.175), in east China was 13.6% (95%CI 0.083 to 0.189), and in Taiwan province and HongKong was 9.8% (95% CI 0.078 to 0.199). In the subgroup analysis by age: the prevalence of frailty among the elderly aged 65 to 74 was 12.2% (95%CI 0.037 to 0.206), and 33.2% (95%CI 0.136 to 0.527) among the elderly aged 75 to 84, and 46.8% (95%CI 0.117 to 0.820) among the elderly aged above 85. For investigation based on time periods, the prevalence of frailty was 9.1% (95%CI 0.078 to 0.104) from 2003 to 2010, and 14.4% (95%CI 0.111 to 0.177) from 2011 to 2018.ConclusionsThe prevalence of frailty in China is high. Economic underdevelopment is higher in more developed regions. The prevalence in hospital population is higher than that in community population. The prevalence of female in community and rural is higher than male. The higher ages has higher prevalence. The prevalence of frailty from 2011 to 2018 is higher than from 2003 to 2010. As no uniform screening tools exist, the results of this study requires further validations by high quality research.