Objective To investigate influence factors of childhood essential hypertension and provide scientific evidence for prevention and management of the disease. Methods Relevant studies were searched using PubMed, ISI Web of Knowledge, Ovid, CNKI and VIP from January 2007 to December 2011. STATA 11 was applied for meta-analysis. After heterogeneity analysis, influence factors (OR with 95%CI) were estimated using fixed or random effect models. Sensitivity analyses were used for evaluating the robustness of the results. Publication bias was assessed by Egger’s test and funnel plot. Results A total of 13 studies involving 4 278 cases and 37 230 controls were included. The pooled OR and its 95%CI of different factors associated with hypertension among children were: gender (male) 1.283 (1.063 to 1.549), age 1.013 (0.975 to 1.052), overweight 2.622 (1.985 to 3.464), obesity 3.730 (2.299 to 6.051), waist circumstance 1.060 (1.036 to 1.085), family history 1.189 (0.956 to 1.480), and frequency of physical activities 0.584 (0.460 to 0.742). Conclusion Current results indicate that gender (male), overweight, obesity, waist circumstance are risk factors of hypertension among children, while frequency of physical activities is protective factor.
Objective To understand the prevalence of overweight and obesity and its influence factors in Zhuhai inhabitants. Methods Applying multi-stage cluster random sampling in the three administrative areas of Zhuhai including Xiangzhou, Doumen and Jinwan, A questionnaire-based survey was performed in conjunction of the measurement of height and weight among 961 inhabitants aged 15-69 years. In addition, a multivariate unconditional logistic regression model was employed to analyze the influence factors of overweight and obesity. Results The prevalence and standardized rates of overweight and obesity in the study population were 18.1%, 17.6%, 6.6%, 6.5%, respectively. The standardized rates of overweight and obesity in male and female were 18.4%, 5.8%, 16.5%, 7.2%, respectively. Age, drinking, smoking and regional difference were identified as the 4 risk factors of overweight and obesity, their OR values being 1.028, 1.683, 0.677, 1.404, Plt;0.05, respectively. Conclusion The prevalence of overweight and obesity in Zhuhai’s inhabitants was over the average level of Chinese residents, and overweight and obesity has become a major risk factor influencing the health of Zhuhai’s inhabitants. In view of the influence factors of overweight and obesity, timely and effective prevention and control measures should be taken.
Objective To evaluate the results of operative treatment of acetabular fractures and to investigate its influence factors. Methods The cl inical data were analyzed retrospectively from 82 patients with acetabular fractures treated between September 2004 and June 2009. Of 82 patients, 65 were male and 17 were female, aged 26-72 years (mean, 38 years).Fractures were caused by traffic accident in 62 cases, by crush in 13 cases, and by fall ing from height in 7 cases. The time from injury to admission was 30 minutes to 12 days (median, 7.6 hours) in 70 cases, 12 cases were transferred because poor result after 34-67 days of conservative treatment. According to Judet classification, there were 24 cases of posterior wall fracture, 3 cases of posterior column fracture, 1 case of anterior wall fracture, 2 cases of anterior column fracture, 6 cases of transverse fracture, 16 cases of transverse and posterior wall fracture, 4 cases of posterior column and posterior wall fracture, 5 cases of T-type fracture, 3 cases of anterior and posterior hemitransverse fracture, and 18 cases of complete both-column fracture; 24 cases combined with dislocation of the hip. During operation, Kocher-Langenbeck approach was used in 49 cases, anterior il ioinguinal approach in 19 cases, and the combination of anterior and posterior approaches in 14 cases. Reconstructive plate (74 cases) and hollow lag screw (8 cases) internal fixation were used. The function of the hip was evaluated according to the modified Merled’Aubigne- Postel hip score system postoperatively. According to fracture type, age, lower extremity fracture before operation, qual ity of reduction, timing of surgery, hi p dislocation and time of reduction, operative approach, deep vein thrombosis (DVT), and heterotopic ossification (HO), the patients were divided into the groups and the results were compared. Results Accordancewith the Matta X-ray evaluation criteria, anatomic reduction was achieved in 21 cases, good reduction in 37 cases, fair reduction in 16 cases, and poor reduction in 8 cases, and the excellent and good rate was 71%. All the cases were followed up 12-52 months mean, 34 months). Iatrogenic sciatic nerve injury occurred in 8 cases, infection in 3 cases, HO in 16 cases, DVT in 3 cases, hip posttraumatic arthritis in 12 cases, and avascular necrosis of the femoral head in 9 cases. X-ray examination showed that 80 cases achieved fracture union at 10-24 weeks after operation (mean, 14 weeks) and 2 cases had fracture delayed union at 10 months and 12 months after operation. According to the modified Merled’Aubigne-Postel hip score system, the function of the hip was rated as excellent in 26 cases, good in 32, fair in 20, and poor in 4 at 6 months after operation; the excellent and good rate was 71%. The affecting factors of cl inical results of acetabular fractures were fracture type, age, lower extremity fracture before operation, qual ity of reduction, timing of surgery, hip dislocation and time of reduction (P lt; 0.05). However the operative approach, DVT, and HO were not affecting factor of the acetabular fractures (P gt; 0.05). Conclusion Operative treatment of acetabular fractures has a satisfying therapeutic effect. Fracture type, age, lower extremity fracture before operation, qual ity of reduction, timing of surgery, hip dislocation, and time of reduction are risk factors affecting postoperative results.
Objective To retrospectively analyze the long-term effectiveness of percutaneous laser disc decompression (PLDD) in treatment of cervical spondylosis. Methods Between March 2003 and June 2005, 156 patients with cervical spondylosis were treated with PLDD. There were 74 males and 82 females with an average age of 55.4 years (range, 31-74 years). The disease duration varied from 2 months to 15 years. Fifty-nine patients were classified as cervical spondyloticradiculopathy, 48 as vertebral-artery-type cervical spondylosis, 19 as cervical spondylotic myelopathy, and 30 as mixed type spondylosis. The lesions were located at the levels of C3,4 in 32 discs, C4,5 in 66 discs, C5,6 in 89 discs, and C6,7 in 69 discs, and including 71 one-leve lesion and 85 multi-level lesions. All cases were followed up to study the long-term effectiveness and correlative factors. Results A total of 117 (75%) patients’ symptoms were l ightened or eased up immediately after operation. Discitis occurred in 1 case at 3 days after operation and was cured after 3 weeks of antibiotic use. All patients were followed up 5 years to 7 years and 3 months (5 years and 6 months on average). According to Macnab criteria, the long-term effectiveness was excellent in 60 cases (38.46%), good in 65 cases (41.67%), fair in 19 cases (12.18%), and poor in 12 cases (7.69%); the excellent and good rate was 80.13%. No significant difference was observed in the wedge angels and displacements of the intervertebral discs between before and after operations (P gt; 0.05). Multiple-factors logistic regression showed that the disease duration and patient’s age had obvious relationship with the effectiveness of treatment (P lt; 0.05), while the type of cervical spondylosis, disc protrusion degree, mild cervical instabil ity, and lesion scope had no correlation with the effectiveness of treatment (P gt; 0.05). Conclusion PLDD is safe and effective in treatment of cervical spondylosis with less compl ication. There is no impact on the stabil ity in cervical spinal constructs. The disease duration and patient’s age have obvious impact on the long-term effectiveness of treatment. The type of cervical spondylosis, disc protrusion degree, cervical instabil ity, and lesion scope are not the correlative factors.
Objective To evaluate the results of operative treatment of complex acetabular fractures and to investigate its influence factors. Methods From June 2000 to August 2006, 54 patients with complex acetabular fractures were treated, including 44 males and 10 females aged 20-75 years old (average 39.1 years old). Fractures were due to traffic accidentin 40 cases, fall ing from high places in 8 cases and crush by heavy objects in 6 cases. All cases were fresh and close fractures and the time from injury to operation was 5-72 days. There were 5 cases of posterior column and posterior wall fracture, 25 of transverse and posterior wall fracture, 2 of T-type fracture, and 22 of double column fracture. During operation, Kocker- Lagenbach approach was used in 23 cases, anterior il ioinguinal approach was appl ied for 3 cases and the combination of anterior and posterior approaches was performed on 28 cases. AO reconstructive plate and screw internal fixation were used in all the cases. Results Fifty-two cases were followed up for 12-74 months (average 31.3 months). Anatomical reduction was achieved in 23 cases, satisfactory reduction in 19 cases, poor reduction in 10 cases, and the excellent and good rate reached 80.77%. During operation, 1 case suffered from a tear in the external il iac vein and healed after vein repair; 2 cases had sciatic nerve injury and took mecobalamin as oral administration, one of them fully recovered, and the other had incomplete recovery at 18-month follow-up. At the final follow-up, there were 6 cases of severe heterotopic ossification, one of them received heterotopic bone resection and the rest 5 patients received conservative treatment; there were 9 cases of traumatic osteoarthritis, one of them received total hip replacement and the rest 8 patients received conservative treatment; there were 5 cases of avascular necrosis of the femoral head, two of them received total hip replacement, 1 received no further treatment because the femoral head didn’ t collapse, and the rest 2 patients gave up total hip replacement; 75.00% patients were graded as excellent and good according to the modified Merled’Aubigné-Postel hip score system. Patients’ qual ity of l ife was compared with local population normsmatched for age and sex by using SF-36 scales, their overall score were below the local population norms, and their general health, vital ity, role l imitation due to emotional problems and mental health were comparable to the local population norms. Logistic regression analysis revealed the time to reduce hip dislocation, qual ity of fracture reduction nd traumatic arthritis were independent risk factors affecting postoperative functional outcomes. Conclusion Applying open reduction and internal fixation in the treatment of displaced complex acetabular fractures has a satisfying therapeutic effect. Time to reduce hip dislocation, qual ity of fracture reduction as well as traumatic arthritis are independent risk factors affecting postoperative functional outcomes.
Objective To investigate the preparing procedures for the larger chemically acellular nerve allografts (CANA) and to establish an evaluation criteria and the preparation method.Methods The sciatic nerves ofthe dogs were exposed by a muscle-splitting incision and were isolated free of the underlying fascia. The 50-mm-long segments of the nerve were made. The proximal and distal ends of the nerve segments were labelled and stabilized by pinning the ends to a thin plastic support, and then they were treated according to the following decellularization processes: The nerve segments were rinsed with the distilled water for 9h, transferred in a 3% Triton-100 solution for 12 h, soaked in 7% sodium deoxycholate for 12 h, and washed in the distilled water for 6 h. All the decellularization steps were performed at room temperature. The nerve segments were divided into 5 subgroups. In Group Ⅰ, Group Ⅱ and Group Ⅲ, the nerve segments were decellularized for 2, 3 and 4 times, respectively. In Group Ⅳ and Group Ⅴ, the two ends of the nerve segments were ligated with a silk line and were decellularized for 2 and 3 times, respectively. Each nerve segment was subdivided into 5 portions from the proximal end to the distal end. The degrees of decellularization, activity of Laminin, degrees of demyelination, and integrity of the nerve fiber tube were observed under microscope and were assessed by a scoring system. Results In all the groups the activity of Laminin was present and the degrees of decellularization were complete. As for the demyelination of the nerve segments, the myelin sheath in Groups Ⅰ, Ⅱ and Ⅲ was partially preserved, but it completely disappeared in Groups Ⅳ and Ⅴ. The structure of the nerve fiber tube in Groups Ⅰ and Ⅳ was almost normal. The total score for the degrees of decellularization, demyelination, and structural integrity was the lowest in Group Ⅳ but the quality was the best. Conclusion The degrees of demyelination are not parallel to the times of decellularization processes. In the quality control of CANA, we should consider the following 4 factors: activity of Laminin, degrees of decellularization, demyelination, and structural integrity. For the larger CANA,ligation of the two ends of the nerve segments during the decellularization procedure may be a better method of ensuring the quality of the decellularization.
Objective To study traits and influencing factors of coping styles in the military groups of social emergency responders for special service and provide a theoretical basis for epidemiologic intervention. Methods A cross-sectional survey on coping styles and their influencing variables was carried out among 12 special service companies from Armed Police Forces and Fire Units of Public Security stationed in Chongqing by means of cluster sampling. Then, different coping styles were compared with general military personnel, the types and maturity degree of coping behaviors were evaluated, and major influencing variables were screened. Results Of 396 subjects, 86.36% had field experience in handling emergencies. The population’s average levels of coping styles are significantly higher than the military norm (P≤0.01), and the overall type of coping behaviors is mature. Although the relevance between the performance type and the number of 6 coping styles scores reaching the military masculine norm is significant (Plt;0.001), the Pearson contingency coefficient（c=0.23）represents a relatively limited maturity in coping styles. In view of direction and extent effects of various influencing factors, lack of survival skills, disaccord on self and experience, self-inferiority as well as self-stereotypes are negative factors. In addition to social support, self-flexibility responsibility may be positive factors. Use of social support, disaccord on self and experience, self-confidence and knowledge about danger-avoiding take universal impacts, and other factors take single impact on a certain coping style. Conclusion Coping styles in military groups of social emergency responders for special service are comparatively mature and stable, but there are significantly individual differences and a wide range of influencing factors. So, it is very necessary to advance maturity in coping styles through targeted interventions.
ObjectiveTo observe the effect of health education on hand, foot and mouth disease knowledge of the parents and their psychological status, in order to provide a reference for regulating clinical intervention measures. MethodsBetween October 2011 and February 2013, self-made questionnaire was used to survey the parents of 286 children with hand, foot and mouth disease for their knowledge about the disease. We promoted health education including distributing pamphlets, holding lectures, and carrying out psychological counseling. Then, parents' knowledge and their psychological status were compared before and after the implementation of health education. ResultsAfter health education, parents' suspicion, anxiety, fear, indulgence in children and other negative psychological scores were significantly lower than those before intervention (P<0.05). Their knowledge on the disease was also significantly enhanced (P<0.05). Gender, age and educational background were the main influence factors for health education. ConclusionMulti-form comprehensive health education can enhance parents' knowledge on hand, foot and mouth disease effectively and alleviate various negative psychological situations, which assists them to participate in the treatment work actively, thus greatly promotes early rehabilitation of the child patients.
ObjectiveTo know the life attitude and its influence factors of nursing undergraduates in a school of nursing,so as to provide the theoretical evidence for the exploration of the way of life education. MethodsA cluster sample of 246 nursing undergraduates were asked to complete the survey,who were sampled from grade 2008 to grade 2011 in a University of Sichuan province between Nevember and December 2011.Then we used the way of questionnaire to analyze and research the life attitude and its influence factors of nursing students,and this study mainly used the Life Attitude Scale (LAS) questionnaire which was made by Taiwan scholar Manying Xie. ResultsThe total score of the investigated nursing students'attitude to life was 365.1±43.6,and the total and each level scores were higher than Taiwan college students and the differences were statistically significant (P<0.01).Female students'total score of attitude to life and the existence sense dimension were significantly higher than male students'(P<0.05).The third grade students'score of love and care level had a significant difference with the second grade and the first grade students (P<0.05).Through correlation analysis,nursing students'life attitude and self-rating interpersonal relationship (r=0.256,P=0.000),the situation of families talking about death (r=0.210,P=0.001),whether there was a Dutch act idea (r=0.172,P=0.007),family income (r=0.151,P=0.017),gender (r=0.130,P=0.042) and whether had siblings (r=-0.143,P=0.025) were positively correlated. ConclusionWe should carry out targeted life and death education for nursing students to promote them to establish positive life attitude and value.
ObjectiveTo analyze the influence factors of the stable angina pectoris patients' medication compliance based on health belief model. MethodsFrom January to December, 2013, 107 patients with stable angina pectoris were interviewed using the self-design questionnaires, and multiple stepwise linear regression statistical was used to analyze. ResultsThe influence factors of increasing medication compliance were as follows:"myocardial infarction can lead to death", "patients with stable angina pectoris may suffer a sudden myocardial infarction", "over the past year the number of the angina pectoris", "standard treatment is good for prevention of myocardial infarction", "suffering myocardial infarction, even if not dying, there is no more chance to live", "take medicine on time can get family's praise", and "among the people that I know there are patients who die of myocardial infarction". The partial regression coefficients were 0.245, 0.251, 0.248, 0.099, 0.234, 0.162, 0.095, respectively; while "worry about side effects of the drugs", "can't afford the medicine", the partial regression coefficients were -0.164 and -0.114. ConclusionHealth belief model is helpful for general practitioners to evaluate the effect factors of medication compliance on stable angina pectoris.