ObjectiveTo investigate the risk factors,characteristics and prognosis in Tibetan patients with venous thromboembolism. MethodsTibetan patients with VTE from plateau area,admitted in West China Hospital from January 2010 to December 2012,were recruited in the study. The VTE diagnosis was confirmed by CT pulmonary angiogram (CTPA) or vascular ultrasound examination. Risk factors,clinical symptoms,signs and laboratory tests were retrospectively investigated and follow-up by telephone interview was conducted. Results31 Tibetan VTE patients with 16 males and 15 females were included. The investigation of risk factors revealed that 15 patients suffered from obese(48.3%),10 patients suffered from highly viscous hyperlipidemia(32.3%). The most common clinical symptom was dyspnea(29%),followed by chest pain(19.4%),hemoptysis(16.1%) and cough(12.9%). The common signs were lower extremity edema(73.3%) and lung rale(36.7%). All the patients received anticoagulation therapy,and inferior vena caval filters were implanted in 2 patients. In two years' follow-up after discharge,2 patients died of tumor,2 died of pulmonary embolism,6 patients suffered from chronic embolization syndrome with lower extremity edema or pain,1 patient suffered from pulmonary hypertension after embolization,and thrombus in 20 patients disappeared or recanalized. ConclusionTibetans long-termly reside in high altitude areas with the eating habits of high-fat diet,which may increase the incidence of acquired risk factors such as viscous hyperlipidemia and obesity. There are no specific clinical symptoms and signs among Tibetan VTE patients,with dyspnea as the most common symptom and lower extremity edema as the most common sign. Patients with risk factors which can be eliminated in a short term have better prognosis.
Objective To analyze clinical characteristics and treatment experience of 143 tibetan victims of China Yushu earthquake, so as to provide reference for emergency preparation for earthquake disasters. Methods A retrospective study from April 16th to April 22th, 2010 was designed. A total of 143 injured Tibetans (74 men, 69 women) of the magnitude 7.1 Yushu earthquake were included in this study. Data from victims was collected retrospectively as follows: age, gender, cause of injury, place and time of rescue, chief complaint, primary diagnosis, onsite treatment, transfer, psychological crisis intervention and so on. Results The 143 tibetan victims contained 67 fracture cases (4 open fracture, 63 closed fracture), 5 joint dislocation cases and 3 neural injury cases. 62 victims with fracture were treated by Tibetan-Chinese therapy combined with external fixation, 5 victims were operated with emergency surgery, 6 victims refused to the surgical debridement and suture, and no dead case reported. All patients were given 3 to 11 psychological intervention treatments. As to the aspect of the wounded transferring, 48 cases among 54 supposed evacuating victims were transferred to Xinin hospitals, and the other six refused to be transferred and kept staying in the original place for treatment. Conclusion The clinical characteristics of the tibetan victims are outstanding. The medical rescue for disaster in ethnic region should be appropriate for features of disaster areas.Both the individualized remedy and early psychological intervention are regarded as the important measures for improving the general level of earthquake medical rescue in ethnic regions.
Objective To primarily test the reliability and validity of the Kashin-Beck Disease (KBD) affected big joints function assessing system for adult Tibetans in Rangtang County. Method From June to July 2009, 142 KBD patients were investigated with the function assessing system in Rangtang County of Ngawa. Cronbach’s α coefficient was calculated to estimate internal consistency reliability. Pearson’s r for the correlation of the items with the total score of the scale was computed to test the internal validity. Principal component factor analysis with varimax rotation analysis was conducted to explore construct validity. Result Both the response and complete rates of the scale were 100%. The time for completing the scale was 7.8±3.4 minutes. Cronbach’s α was 0.857, which revealed satisfactory internal consistency reliability. Pearson correlation analysis revealed significant correlation between the scores of each item and the total score of the scale (Plt;0.05). Pearson’s r value of each item was more than 0.4, only except the items of “sitting with legs crossed” and “standing at attention”. The principal factor analysis extracted three latent factors explaining 68.1% of the variation together. The latent factors weights of the items were over 0.4 except the items of “standing at attention”, "taking food” and “wiping after defecation”. Conclusion The reliability and validity of KBD affected big joints function assessing system for adult Tibetans in Rangtang County was good in this primary test, the function assessing system has to be widely applied and further assessed among Tibetans suffered with KBD, in order to provide a standard evaluation criterion in KBD integrate control.
It has always been an important policy of the Chinese government to provide aid and assistance for the development of Tibet. With nearly one-eighth of China’s total land areas and about 0.002% of China’s total population, the Tibet Autonomous Region lags behind the domestic average level in medical education and is in bad need for medical professionals. The West China Center of Medical Sciences (WCCMS) of Sichuan University has managed to introduce US projects to set up the West China–Tibet Telemedical Education System to transmit medical courses in a real-time and interactive way. Based on this system, WCCMS has established a model for assisting the Tibet University Medical College through transmitting medical courses, training their medical faculty, sending WCCMS faculty to work in Tibet and admitting medical teachers and students from Tibet to study and be trained at West China Medical School and Hospital.
Objective Certificate Compound Zangyao Dadui for Cirrhosis of liver had unique curative effect. Method This randomized controlled study examined in 100 patients with established cirrhosis, with comparison with the effects of a combined therapy with Gantaile and hepatic growth factor (HGF). The patients in the treatment group (n=50) received Compound Zangyao Dadui, 2 grams and three times daily for three month, and the control group (n=50) with Combination of Gantailei and HGF, for the same period. Results The cure rate, improvement rate, ineffective rate, and total effective rate in the treatment group were 70% (35/50), 20% (10/50), 10% (5/50), and 90%, respectively, while they were 30% (15/50), 30% (15/50), 40% (20/50), and 60%, respectively, in the control group 0. The difference in the total effective rate between the two groups is statistically significant (Plt;0.01).
ObjectiveTo explore the application of PDCA cycle in the examination of medical quality of Tibetan area hospitals. MethodsIn the October 2014, PDCA cycle theory was introduced into the examination of Tibetan hospital medical quality. We collected quality problems existing in the medical activities actively, analyzed the reason and influencing factors and made corresponding plans. Then we implemented the plans and measures strictly, surveyed the results, found out and analyzed the problems, summarized the results of the examination, and turned the unsolved problems to the next PDCA circulation. Continuous follow-up was performed until the results were satisfactory. Based on Sichuan Province Secondary Comprehensive Hospital Evaluation Standard, we analyzed the medical quality of the hospital before PDCA application (July to September 2014) and after PDCA application (October to December 2014). ResultsThe incidence of medical nursing documents writing defects decreased from 12.4% to 5.9%. Hospital infection management defect rate declined from 13.5% to 5.3% and drug safety management defect rate declined from 11.8% to 2.5%, and all the differences were statistically significant (P<0.05). ConclusionPDCA cycle in the Tibetan hospital for medical quality examination has greatly improved the medical quality of Tibetan hospitals.
ObjectiveTo investigate the situation of tuberculosis (TB) infection in primary and middle school students and to provide scientific basis for TB prevention and control in Nyingchi. MethodsPrimary and middle school students in Nyingchi were investigated from 2006 to 2008 using a questionnaire, and purified protein derivative (PPD) tests were carried out among the sampling students. Data analysis was conducted by SPSS 13.0. ResultsIn 3 987 included primary and middle students, the positive, strongly positive and overall positive rates of PPD were 11.4%, 5.1%, 16.5%, respectively. Five patients with TB were found in the investigation, and the prevalence was 125.4 per 100 000. The positive and strongly positive rates were 11.3% and 4.4% in male, 11.5% and 5.7% in female, respectively. The positive and strongly positive rates were 6.9% and 3.9% in primary school students, 18.8%, 7.1% in middle school students, respectively. Both the positive rate and strongly positive rate in middle school students were higher than those in primary school students (P < 0.05). The positive rates in town, village and floating population were 16.5%, 9.5%, 8.9%, respectively, and their strongly positive rates were 6.1%, 4.8%, 1.4%, respectively. Both the positive rate and strongly positive rate in town were higher than those in village and floating population (P < 0.05). The strongly positive rates in Tibetan, the Han nationality and other ethnic minorities were 5.2%, 4.0%, 6.0%, respectively. The strongly positive rates in Tibetan and other ethnic minorities were higher than those in the Han nationality (P < 0.05). ConclusionThe infection and prevalence rate of TB of primary and middle school students in Nyingchi are fairly high. TB prevention and control for the high-risk populations should be strengthened in primary and middle schools in Nyingchi.
ObjectiveTo explore and discuss the risk factors of early onset coronary heart disease in Tibetan residents. MethodsWe selected Tibetan residents with coronary heart disease who were hospitalized in the Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region between January 2011 and May 2013, and then divided them into two groups by age (early onset and late onset coronary heart disease groups). Univariate analysis was performed between two groups by gender, family history, smoking, drinking, hypertension, diabetes, levels of blood lipid, respectively. The factors with significant differences were extracted for logistic regression. Data analysis was performed using SPSS 16.0 software. ResultsA total of 64 Tibetan residents with coronary heart disease were included, of which, 22 cases were in the early onset groups and 42 cases the late onset group. The results of univariate analysis showed that, significant differences were found in gender, family history, and levels of HDL-C and LDL-C (all P < 0.05). Besides, the results of logistic regression showed that, family history (OR=3.374, P < 0.05), high triglycerides level (OR=2.369, P < 0.05), low HDL-C level (OR=0.014, P < 0.05) and high level of LDL-C (OR=3.008, P < 0.05) were independent risk factors of early onset coronary heart disease in Tibetan residents. ConclusionPositive family history, high triglycerides level, low HDL-C level and high level of LDL-C are independent risk factors of early onset coronary heart disease in Tibetan residents.
ObjectiveTo investigate the association between local population's lifestyle and the morbidity of cerebral stroke in Ganzi Tibetan state, so as to provided references for preventing stroke in the local region. MethodsA representative population sample (including residents, farmers and herdsmen) of Kangding, Dege, Ganzi, Litang and Batang county was selected through randomized cluster sampling from September 2010 to June 2012. Data including lifestyle, housing conditions and stroke status were collected using a questionnaire. Then statistic analysis was performed using SPSS 19.0 software. ResultsA total of 7 038 cases were investigated, of which 125 cases with cerebral stroke were found. The morbidity of stroke was 1 923/100 000. Smoking, alcohol drinking, excessive intake of salt and overweight were positively associated with the risk of cerebral stroke, while appropriate physical exercise was negatively associated with cerebral stroke. Housing conditions and height above sea level were not obviously associated with cerebral stroke. ConclusionThe prevalence of cerebral stroke is high in Ganzi Tibetan state, which is related to special local population's lifestyle. It is very important to reinforce the work for the prevention and control of stroke.
ObjectiveTo evaluate the diagnostic value of interferon-gamma release assay (TB-IGRA) for tuberculosis in the Tibetan. MethodsFrom January 2014 to December 2014, suspected Tibetan tuberculosis patients were enrolled from AVIC 363 Hospital and underwent TB-IGRA test. All patients were also underwent smear test for Mycobacteria. The diagnostic value of TB-IGRA test for Tibetan TB patients was analyzed. ResultsA total of 77 suspected Tibetan tuberculosis patients were included. According to the diagnostic criteria, of the 77 suspected patients, 50 were diagnosed as TB patients, and 27 were diagnosed as not-TB patients. The sensitivity and specificity of TB-IGRA test was 86% and 81.5%. While the sensitivity and specificity of smear test were 22% and 100%, respectively. ConclusionThe TB-IGRA test is superior to smear test, and is the fast and sensitivity test for diagnosing Tibetan TB patients.