Objective To investigate and analyze the employment status and related influencing factors of maintenance hemodialysis (MHD) patients. Methods MHD patients from four hemodialysis centers in Beijing between January 2020 and January 2021 were selected. The baseline data and clinical data of patients with long dialysis interval were collected. An anxiety and depression survey was conducted on the patient. Results A total of 108 MHD patients were included. Among them, 41 patients were working and 67 patients were not working. Among the 41 patients at work, there were 3 workers, 1 farmer, 14 company employees, 6 public institution employees, 11 self-employed, 5 freelancer and 1 other. Among the 67 patients who did not work, 8 patients had the ability to work but did not work. Body mass index was an independent influencing factor for employment in MHD patients [odds ratio=1.135, 95% confidence interval (1.017, 1.266), P=0.024]. Conclusion The nutritional status of MHD patients should be taken seriously to improve their employment rate.
Objective To assess the effectiveness of intensive versus routine education on diabetes mellitus for preventing diabetic foot ulcer. Methods We electronically searched CENTRAL (Issue 1, 2013), PubMed (1978-2013), EMbase (1978-2013), VIP (1989-2013) and WanFang Data (1980-2013), hand-searched correlated proceedings and retrieved the references of included studies, for the randomized controlled trials on intensive versus routine education on diabetes mellitus for preventing diabetic foot ulcer all over the world. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results Twelve trials involving 1 841 patients were finally included. The results of meta-analysis showed that: a) the incidence of diabetic foot ulcer in the intensive education group was lower than the routine group, with a significant difference (RR=0.51, 95%CI 0.30 to 0.84, P=0.008); b) two groups were alike in the amputation rate, with no significant difference (OR=0.54, 95%CI 0.17 to 1.67, P=0.28); and c) the score of knowledge on diabetes mellitus was higher in the intensive education group than in the routine education group, with a significant difference (MD=7.32, 95%CI 3.57 to 11.06, P=0.000 1). Conclusion Current evidence shows that: compared with routine education, intensive education could reduce the incidence of diabetic foot ulcer effectively. However, the above conclusion should be verified by conducting more high quality studies.
Objective To assess the effectiveness and safety of biphasic insulin aspart 30 given three times a day in the management of type 2 diabetes. Methods Such databases as CENTRAL, MEDLINE, PubMed and CNKI were searched on computer; additionally, the relevant conference proceedings from associations like American Diabetes Association, and the references of all selected literatures were also hand-searched. The randomized controlled trials (RCTs) on biphasic insulin aspart 30 given three times a day in treating type 2 diabetes were screened according to inclusive and exclusive criteria, without concerning the limitation of languages and blind methods. After data extraction and quality evaluation, Meta-analysis was performed by using RevMan 4.2 software. Results Ten trials involving 1 415 patients were included. The sub-group analysis showed that compared with the group of given biphasic insulin aspart 30 twice a day (the bid group), the group of given biphasic insulin aspart 30 three times a day (the tid group) was superior in decreasing HbAlc (Plt;0.000 01). Compared with the group of thrice preprandial injection of Novolin R plus one injection of Novolin N at bedtime (the qid group), Meta-analysis showed that, a) As to the average fasting glucose levels: the tid group was not superior to the qid group (P=0.65); b) As to the average 2-hour postprandial glucose levels: the tid group was superior to the qid group (P=0.0003); c) As to the therapeutic time: the tid group was not superior to the qid group (P=0.38); d) As to the insulin doses: the tid group was superior to the qid group (P=0.000 1); e) As to the insulin costs: the tid group was inferior to the qid group (P=0.02); and e) As to the incidence of hypoglycaemia: the tid group was superior to the qid group (P=0.000 2). Compared with the oral antidiabetic drugs, the results of Meta-analyses showed: the tid group was superior in decreasing HbAlc (P=0.001). Conclusion The limited current evidence shows that biphasic insulin aspart 30 given three times a day, as a simple insulin intensified scheme, is safe and effective for type 2 diabetes, and is worth recommending in clinic. However, all these findings should be further confirmed with more large sample and well-designed RCTs.
Objective To evaluate the analgesic effect of intra-articular ropivacaine with lidocaine. Methods A double-blind randomized controlled trial was conducted. Ninety patients receiving selective knee arthroscopy were randomized into three groups of 30 patients. At the end of the operation, before the release of the tourniquet, an intra-articular injection was administered to each patient through arthroscope, in accordance with their random allocation: 0.9% normal saline (normal saline group); 100 mg ropivacaine (ropivacaine alone group) and 100 mg ropivacaine and 100 mg 2% lidocaine (ropivacaine with lidocaine group). Pain intensity was assessed after the operation using the 100-mm visual-analog scale (VAS), and the amount of supplemental analgesics used within the following 24 hours were recorded. Results The VAS scores of 2 hours postoperatively at rest, and 1, 2, 4, and 8 hours postoperatively at motion, were significantly higher in the normal saline group than in ropivacaine alone group (Plt;0.05). The VAS scores 0.5, 1 and 2 hours postoperatively at rest, and at the awaking moment, 0.5, 1, 4, 8, and 24 hours postoperatively at motion, were significantly higher in the normal saline group than in ropivacaine with lidocaine group (Plt;0.05). Conclusion Intra-articular ropivacaine can reduce a patient’s pain after operation. The combination of lidocaine with intra-articular ropivacaine can reduce the patient’s pain severity immediately after the operation and achieve an early analgesic effect.
【摘要】 目的 了解成都市综合医院门诊患者抑郁障碍和焦虑障碍的患病率及门诊医生的识别率。 方法 2007年4-5月应用医院焦虑抑郁量表（Hospital Anxiety and Depression Scale，HADS）、患者健康问卷（Patient Health Questionnaire 15-Item，PHQ-15）对在四川大学华西医院和华西第二医院神经内科、消化内科、妇科和心血管内科门诊就诊的685例患者进行筛查。HADS≥8分者进入精神科访谈，由精神科医生使用国际神经精神科简式访谈问卷进行诊断。 结果 综合医院门诊患者抑郁障碍校正后的现患率和终身患病率分别为19.26%和22.32%，焦虑障碍校正后的现患率和终身患病率分别为9.16%和9.63%。各科患病率不同，科室间患病率的差异有统计学意义。门诊医生的识别率为10.57%。 结论 成都市综合医院门诊患者抑郁障碍和焦虑障碍的患病率较高，识别率有待提高。【Abstract】 Objective To investigate the prevalence of depressive disorders and (or) anxiety disorders and physicians’ detection rate of these disorders in general hospitals in Chengdu. Methods From April to May, 2007, a hospital-based cross-sectional survey was conducted in neurology, gastrointestinal, gynecology and vasculocardiology departments in West China Hospital and West China Second Hospital. Outpatients were screened by using Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire 15-Item (PHQ-15). Psychiatrists interviewed subjects whose score of HADS were 8 and above and made diagnoses by using Mini International Neuropsychiatric Interview (MINI) according to the criteria of Diagnostic and Statistical Manual of Mental Health Disorders 4th Edition (DSM-IV). Results The adjusted current and lifetime prevalence of depressive disorders were 19.26% and 22.32%, respectively, and those of anxiety disorders were 9.16% and 9.63%, respectively. The prevalence of depressive disorders and/or anxiety disorders among four departments had statistically significant difference. The detection rate of these disorders by outpatient physicians was 10.57%. Conclusion Prevalence of depressive disorders and anxiety disorders among outpatients in West China Hospital and West China Women and Children Hospital is high, and the rate of physicians’ detection needs to be improved.
【摘要】 目的 评估四川省精神科专科医师培训基地带教师资培训效果、培训方式及提出建议。 方法 对2009年10月和2010年11月的两次培训均参加的59名带教师资采用自制评估表进行评估，其中男37名，女22名；年龄（39±9）岁。采用SPSS 13.0统计软件进行统计分析。 结果 参与培训带教师资对培训的效果总体评价，好22名，占37.29%，很好18名，占30.51%；对培训方式的总体评价，好25名，占42.37%，很好20名，占33.91%；参训教师各个方面较培训前均有显著提高。 结论 开展短期方式多样的集中培训可能是提高带教师资水平的一种快速途径。应该建立师资准入制度考核标准和标准培训内容，从而建立起一支高素质的精神专科医师培训的带教师资，保障精神专科医师培训的质量和顺利进行。【Abstract】 Objective To assess the results and styles of training process for faculty doctors in psychiatric specialist training center of Sichuan Province, and put forward suggestions. Methods We evaluated 59 psychiatric specialist training faculty doctors, including 37 males and 22 females aged (39±9) years old by giving out a self-made questionnaire. Factor analysis was done by adopting SPSS 13.0. Results Evaluation of the training results showed good in 22 doctors (37.29%), and very good in 18 doctors (30.51%); Evaluation of the training style showed good in 25 doctors (42.37%) and very good in 20 doctors (33.91%). After training, the faculty doctors got more progress than before in every aspects. Conclusions Short-term training with various training styles may be a quick way for faculty doctors in psychiatric specialist training center to increase their teaching ability. The standard enrollment criteria, standard training contents and standard exam criteria should be established. Through this, a high-quality faculty doctors in psychiatric specialist training center will be set up, which is very important in ensuring the quality and success of training for psychiatric specialist doctors.
目的:了解成都市3~6岁学龄前儿童超重、单纯性肥胖发展趋势和干预效果,以寻求更有效的干预措施。方法:自2000~2007年对成都市五城区所有一类托幼园所3~6岁儿童进行调查,对其超重、肥胖发生、发展动态趋势进行分析研究,并设重点干预点进行连续干预监测。参照WHO标准,应用身高别体重法评价儿童超重和肥胖。结果:2000~2005年中,成都市学龄前儿童超重、单纯性肥胖发生率显著升高(2000年为6.50%、2.14%;2005年为9.57%,4.39%,Plt;0.001);通过对托幼园所实施肥胖干预后,2005~2007年儿童超重、单纯性肥胖检出率处于稳定控制状态(2007年为9.13%,4.17%,Pgt;0.05)。2005~2007年对本市15所托幼机构实施重点干预后,儿童超重、肥胖检出率为8.51%,3.26%,明显降低(Plt;0.05),而一般干预点,超重、肥胖发生率明显升高(10.42%,5.12%,Plt;0.05)。结论:学龄前儿童超重、单纯性肥胖呈上升趋势,有效的干预措施能控制超重和肥胖发生率。
Objective To compare the analgesic efficiency and safety of subacromial bursa continued ropivacaine analgesia with patient-controlled intravenous analgesia for arthroscopic rotator cuff repair. Methods A total of 64 patients undergoing rotator cuff repair surgery between October 2013 and February 2015 were randomly divided into the subacromial bursa group (JFX group, 32 cases) and the patient-controlled intravenous analgesia group (JM group, 32 cases). At the end of surgery, a catheter was inserted into the subacromial bursa of the patients in JFX group under arthroscopic visualisation and fixed properly, and analgesia pump was connected after surgery; in JM group, analgesia pump was connected to the vein channel after surgery. The pain Visual Analogue Scale (VAS) (motion and rest) scores 1 hour and 12, 24, 48, 72 hours after surgery, adverse reactions, use of analgesic pump, number of additional analgesia and patients satisfaction were recorded. Results There were no differences between the two groups in the number of additional analgesia, patients satisfaction, additional use of antiemetic drugs, motion and rest VAS scores 1 hour and 12, 72 hours after surgery, and the incidence of moderate-severe pain (VAS≥4) at each time point (P>0.05). The motion and rest VAS scores 24, 48 hours after surgery in JFX group were lower than those in JM group, the analgesia times and the incidence of nausea and vomiting in JFX group were lower than those in JM group, and the differences were statistically significant (P<0.05). Conclusion Efficiency of subacromial bursa infiltration of ropivacaine sustained analgesic is slightly better than that of patient-controlled intravenous analgesia, with lower incidence of adverse reactions.
Cardiac rehabilitation can safely and effectively improve the quality of patient's life and reduce readmission rate and mortality after cardiac surgery. Early cardiac rehabilitation after cardiac surgery is an indispensable part of cardiac rehabilitation. It can speed up the recovery of patient's exercise endurance, prevention of postoperative complications, shorten the time of returning to the family, increase the confidence of sustained rehabilitation, and lay foundation and set rehabilitation targets for the later stage of cardiac rehabilitation. This paper reviews the development history of early cardiac rehabilitation after cardiac surgery, and summarizes the current status, problems and outlook of rehabilitation management in China.
Objective To investigate the expression of miR-92a in breast cancer tissues and whether it can influence the migration and invasion ability of breast cancer cells through kruppel-like factor 4 (KLF4). Methods ① The expressions of miR-92a and KLF4 mRNA in cancer tissues and adjacent tissues were detected by qRT-PCR in 122 breast cancer patients who were operated in our hospital from May 2017 to October 2019. ② The expression of miR-92a in MCF-7 breast cancer cells was up-regulated or knocked out. Cell survival rate was detected by MTT assay, cell migration ability was detected by scratch assay, cell invasion ability was detected by Transwell assay, and the relative expression levels of KLF4, E-cadherin (E-cad), and N-cadherin (N-cad) proteins were detected by Western blotting. ③ The targeting relationship between miR-92a and KLF4 was detected by dual luciferase reporter gene assay. Results ① The relative expression levels of miR-92a and KLF4 mRNA in cancer tissues were higher than those in adjacent tissues (P<0.05). ② The up-regulation of miR-92a expression had no effect on the survival rate of MCF-7 breast cancer cells, but the migration and invasion ability of cells were enhanced (P<0.05). The knockdown of miR-92a expression decreased the survival rate of MCF-7 breast cancer cells and the ability of cell migration and invasion (P<0.05). ③ The miR-92a and KLF4 had a direct targeting relationship, up-regulation of miR-92a expression increased the relative expression levels of KLF4 and N-cad proteins, while decreased the relative expression level of E-cad protein (P<0.05). After knockout of miR-92a expression, the relative expression levels of KLF4 and N-cad proteins were decreased, while the relative expression level of E-cad protein was increased (P<0.05). Conclusion The miR-92a is highly expressed in breast cancer cells, and knockout of miR-92a expression can inhibit KLF4 signaling pathway and reduce the migration and invasion ability of breast cancer cells.