BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses met...BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.展开更多
Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Method...Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Methods:In this study,602 patients with maintenance hemodialysis and continuous ambulatory peritoneal dialysis were enrolled from December 2020 to December 2022 in our hospital,and their medical records were collected and summarized.The main contents included the patient’s gender,age,primary disease,dialysis duration,dialysis method,the use of erythropoietic stimulating agents(ESA),intravenous iron,and laboratory tests.A Hb index exceeding 110 g/L was set as the standard for the prevalence of anemia.Results:The rate of anemia in patients undergoing blood purification was 83%.The proportion of ESA use was 84.1%,and the proportion of iron use was 76.7%,of which the proportion of intravenous iron used was 17.0%,and the proportion of folic acid used was 28.3%.Conclusion:The incidence of anemia in MHD patients was relatively high,with a low proportion of patients reaching the standard Hb levels.Risk factors include albumin(ALB)levels,iron storage,white blood cells,C-reactive protein,cholesterol,etc.Nutritional support,iron supplementation,and prevention of micro-inflammatory reactions can effectively promote the improvement of Hb indicators in dialysis patients to prevent anemia.展开更多
BACKGROUND Patients with inflammatory bowel diseases(IBDs)generally have poor knowledge,attitude,and practice of their disease,while the data from China are lacking.AIM To address this knowledge disparity among Chines...BACKGROUND Patients with inflammatory bowel diseases(IBDs)generally have poor knowledge,attitude,and practice of their disease,while the data from China are lacking.AIM To address this knowledge disparity among Chinese patients with IBD.METHODS This web-based,cross-sectional study was conducted on a cohort of IBD patients who visited the Second Affiliated Hospital of Wenzhou Medical University between December 2022 and February 2023.Their socio-demographic information and the knowledge,attitude,and practice scores were collected and estimated using a self-designed questionnaire.Pearson’s correlation analysis was used to determine the pairwise correlations among knowledge,attitude,and practice scores.A multivariate logistic regression analysis was further performed to determine the independent factors associated with their knowledge,attitude,and practice scores.RESULTS A total of 353 patients(224 males)with IBD completed the questionnaires.The mean knowledge,attitude,and practice scores were 10.05±3.46(possible range:0-14),41.58±5.23(possible range:0-56),44.20±7.39(possible range:0-56),respectively,indicating good knowledge,positive attitude,and proactive practice toward IBD.Pearson’s correlation analysis showed that the knowledge score had significant positive correlations with the attitude score(r=0.371,P<0.001)and practice score(r=0.100,P<0.001).The attitude score had a significant positive correlation with the practice score(r=0.452,P<0.001).Moreover,multivariate logistic regression analysis showed that aged 30-40 years[odds ratio(OR)=4.06,95%confidence interval(CI):1.04-15.82,P=0.043],middle school education(OR=3.98,95%CI:1.29-12.33,P=0.017),high school/technical secondary school education(OR=14.06,95%CI:3.92-50.38,P<0.001),and junior college/bachelor’s degree and above education(OR=15.20,95%CI:4.15-55.650,P<0.001)were independently associated with good knowledge.The higher knowledge score was independently associated with a positive attitude(OR=1.23,95%CI:1.11-1.36,P<0.001).The higher attitude score was independently associated with proactive practice(OR=1.20,95%CI:1.11-1.30,P<0.001).CONCLUSION Chinese patients with IBD might have good knowledge,a positive attitude,and proactive practice toward their disease.However,a small number of specific items require education.展开更多
Background:Depression and anxiety are highly prevalent among adolescents and have multiple negative effects on their physical and mental health.While exercise can reduce the symptoms of depression and anxiety,the rela...Background:Depression and anxiety are highly prevalent among adolescents and have multiple negative effects on their physical and mental health.While exercise can reduce the symptoms of depression and anxiety,the rela-tionship between mental disorders among American university students has been rarely reported.Accordingly,this study aimed to explore the association between exercise,depression and anxiety among American university students in the 2018–2019 academic year.Methods:In this cross-sectional study,the association between exercise,depression and anxiety was investigated in a large representative sample of American university students.In the 2018–2019 academic year,university students aged 18+years old from 79 institutions participated in this school-based study.The questionnaire included measurements of demographic characteristics,exercise,and validated screen instructions for depression(PHQ-9)and anxiety(GAD-7).The multivariable logistic regression model was applied to explore the association between exercise,depression and anxiety.Results:A total of 62026 indivi-duals(31.9%males)participated in this survey,and the prevalence of exercising at least 5 h each day was 24.6%.The prevalence of depression and anxiety was 25.7%and 22.3%,respectively.In the multivariable logistic regres-sion model,compared to exercise at least 5 h daily,participants whose exercise less than 1 h daily(OR=1.31[1.29,1.33],p<0.05),2 to 3 h daily(OR=1.13[1.11,1.15],p<0.05),3 to 4 h daily(OR=1.04[1.02,1.06],p<0.05),were correlated with greater odds of depression,while exercise less than 1 h daily(OR=1.23[1.21,1.25],p<0.05),2 to 3 h daily(OR=1.10[1.08,1.12],p<0.05)were significantly correlated with great-er odds of anxiety.Conclusion:Higher levels of exercise are associated with lower risk of depression and anxiety among American university students.Community and school interventions should focus on increasing exercise participation in university populations to promote both physical and mental health.展开更多
Objective The popularization of gastroenteroscopy and the introduction of comfortable medical care have further promoted the growth of people's demand,especially the demand for painless endoscopy.This cross-sectio...Objective The popularization of gastroenteroscopy and the introduction of comfortable medical care have further promoted the growth of people's demand,especially the demand for painless endoscopy.This cross-sectional study aims to investigate the current situation and change in county people's demand for endoscopy to promote the development of endoscopy centers in county hospitals in southeast China.Methods From October to December 2021,patients and their family members who came to the Gastroenterology Department in Suichang County People's Hospital of Zhejiang Province were randomly selected to complete the questionnaire.A total of 838 valid questionnaires were collected.Additionally,the original software data of the Endoscopy Center were sampled and retrieved(from October to December every year from 2018 to 2021)for statistical analysis of real-world data.Those who would choose painless endoscopy the next time in the valid questionnaires were included in the painless endoscopy group,while those who would choose ordinary endoscopy the next time were included in the ordinary endoscopy group.Results The stepwise forward binary logistic regression model analysis showed that,patients with“secondhand smoke exposure”were more willing to choose painless endoscopy(OR=1.459,95%CI:1.050-2.028,p=0.025).However,patients with an education level of“primary and below”and“junior high school”,and patients who are suffering from“currently experiencing abdominal distension”,were more willing to choose ordinary endoscopy(OR=0.270,95%CI:0.149-0.488,p<0.001;OR=0.528,95%CI:0.330-0.845,p=0.008;OR=0.536,95%CI:0.334-0.861,p=0.010).Patients with previous experience in painless endoscopy tended to choose painless endoscopy the next time,while patients with previous experience in ordinary endoscopy tended to choose ordinary endoscopy the next time(χ^(2)=140.97,p<0.001).From 2018 to 2021,the proportion of painless endoscopy has increased yearly(p<0.001).Most patients indicated that they would“regularly review gastroenteroscopy”(477/838,56.9%).Conclusions With Suichang County of Zhejiang Province as the representative,the demand for painless endoscopy for people's gastrointestinal cancer detection in southeast China has been increasing yearly.The development of endoscopy centers in county-level hospitals can basically meet the demand growth.Meanwhile,advanced concepts such as comfortable medical care and regular follow-up are gradually popularized at the grassroots level in southeast China.展开更多
Objective:This study aimed to estimate the prevalence and determinants of Internet addiction among medical students at the Faculty of Medicine and Pharmacy of Casablanca,Morocco.Methods:This was a cross-sectional stud...Objective:This study aimed to estimate the prevalence and determinants of Internet addiction among medical students at the Faculty of Medicine and Pharmacy of Casablanca,Morocco.Methods:This was a cross-sectional study conducted among students at the Faculty of Medicine and Pharmacy in Casablanca between October and March 2020.An online questionnaire was administered to students to collect data and internet addiction was assessed by the Young questionnaire.A score threshold≥50 was adopted to define addiction.Univariate and multivariate logistic regression analyses were used to identify factors associated with internet addiction.Results:Out of a total of 4093 FMPC students enrolled in the 2020-2021 academic year,506 agreed to participate in this study,including 303 females and 203 males.The mean addiction score assessed on the Young scale was(49.08±16.11).The prevalence of Internet addiction was 44.5%(225/506,95% CI:40% to 49%).Multiple regression analysis showed that being older than 20 years(OR=0.17,95% CI:0.40 to 0.64),being female(OR=1.70,95% CI:1.04 to 2.78),being in the dissertation year(6th year)(OR=5.17,95% CI:2.23 to 11.44),having a history of psychiatric consultation(OR=2.64,95% CI:1.34 to 5.21),having divorced parents(OR=2.64,95% CI:1.05 to 5.87),use of sleeping medication(OR=2.9,95% CI:1.05 to 3.70),sleep disorders(OR=2.06,95% CI:1.25 to 3.79),sleep deprivation(OR=2.26,95% CI:1.39 to 3.65),excessive daytime sleepiness(OR=5.39,95% CI:2.19 to 13.24),anxiety disorders(OR=1.47,95% CI:1.18 to 2.30),duration of internet connection(>4 h)(OR=11.43,95% CI:4.85 to 27.66),and having frequent conflicts with parents(OR=2.37,95% CI:1.49 to 3.79)and friends(OR=0.26,95% CI:0.11 to 0.65)were independently associated with internet addiction.Conclusion:The prevalence of Internet addiction among medical students in Casablanca remains high.Targeted action on the determinants would be of great value in prevention.展开更多
Background: Occupational health is an important consideration, especially for people that work in an environment with pollutants. Gasoline attendants are individuals that work in filling stations. They are constantly ...Background: Occupational health is an important consideration, especially for people that work in an environment with pollutants. Gasoline attendants are individuals that work in filling stations. They are constantly exposed to gasoline fumes and automobile engine products from vehicle exhaust. This increases the risk of acute and chronic respiratory diseases and carcinogenesis among them. The risk of health complications tends to increase with the duration of exposure. The study aimed to determine the proportion of gasoline attendants with lung function impairment. Methods and Materials: Two hundred and eight eligible participants were recruited for this study. A cross-sectional analytical study was carried out in Esan West local government area of Edo state, Nigeria. The study was carried out for a period of six months from December 2015 to May 2016. A questionnaire was used to obtain information on demographic characteristics, work history, mode of exposure and duration of exposure to petrol fumes. Lung function was assessed using a DTspiro spirometer (Model POP 10. Serial no 110843-005);also the anthropometric parameters of the respondent were measured. Statistical analysis was done using IBM SPSS version 20.0. Frequency and percentages were used to present categorical data. The mean and standard deviation of continuous variables were calculated and compared using the student’s t-test. The criteria of significant association were assumed for a p-value less than 0.05. Results: A total of one hundred and forty petrol pump attendants and one hundred and forty controls participated in this study. The mean age for petrol pump attendants was 24 ± 3.1 years and 23 ± 2.8 years for the control group. There were no significant differences in the gender distribution and anthropometric parameters as observed in this study. The lung impairment pattern observed in this study was obstructive in twelve (8.6%) gasoline pump attendants and restrictive pattern in thirty-nine (27.9%) gasoline pump attendants, while only four (2.9%) had an obstructive pattern and twelve (8.6%) had a restrictive pattern of lung impairment among the control group. This implies that a restrictive pattern was predominant. This study also observed that there was an increase in the number of gasoline pump attendants with declined lung function compared to the control group. Conclusion: Restrictive pattern of lung impairment was more predominant than the obstructive pattern among gasoline pump attendants. As a result, public health interventions should be instituted among these individuals, especially in developing countries.展开更多
Background: Protein kinase B (AKT/PKB) family is frequently amplified in ovarian cancer (OC). To the greatest of our knowledge, there is a lack of published reports about the amplification of the genes belonging to th...Background: Protein kinase B (AKT/PKB) family is frequently amplified in ovarian cancer (OC). To the greatest of our knowledge, there is a lack of published reports about the amplification of the genes belonging to the AKT family among Sudanese women with OC. The present study was conducted to detect the AKT1 gene amplification and its association with tumour types, grades, and ages among Sudanese women with OC, bearing in mind the ethnic variation. Methods: This institution-based study included 79 cases of women diagnosed with ovarian cancer (OC) at Omdurman Maternity Hospital in the period 2013-2018. Formalin-fixed, paraffin-embedded (FFPE) tissue sections were used to extract RNA. AKT1 gene amplification was assessed using quantitative real-time PCR. Results: The mean age (±SD) of included women was 49.29 (±13.612). The amplification of AKT1 gene was observed in 18/79 (22.8%) of OC women, with a high frequency in women with undifferentiated 1/2 (50%), clear cell 2/6 (33.3%), mucinous 3/11 (27.3%), endometrioid 3/17 (17.6%), and serous carcinomas 5/30 OC (16.7%). High frequency was seen in women with low (26.3%;n = 10/28) rather than in higher (19.5%;n = 8/33) grade carcinoma, and in older (25.8%;n = 8/23) rather than younger (18.2%;n = 2/9) women. No significant association between AKT1 gene amplification and tumour types, grades, and ages of women was observed (Fisher’s Exact test: p = 0.405, 0.593 and 0.851, respectively). Conclusion: AKT1 gene amplification arises in around one-fifth of Sudanese women with ovarian cancer (OC). It is seen more in undifferentiated, clear cell, and mucinous tumours types, and more frequently in low tumour grade and older women, but not to a statistically significant level. These outcomes sustenance previous studies suggesting that activated AKT genes have a vital role in OC progression and may offer a plan for targeted therapy and prognostic evaluation.展开更多
Background:To examine the correlation between the dietary mineral intake and the nutritional status of patients suffering from malignan-cies.Methods:This multi-center cross-sectional study included a total of 866 pati...Background:To examine the correlation between the dietary mineral intake and the nutritional status of patients suffering from malignan-cies.Methods:This multi-center cross-sectional study included a total of 866 patients with malignant tumors recruited from seven hospitals throughout China.The information of socio-demographic characteristics and biochemical indicators were obtained from electronic medical records of inpatients.Dietary data were collected using a 3-day 24-hour dietary recall questionnaire.The intake of energy,dietary calcium(Ca),phosphorus(P),potassium(K),sodium(Na),magnesium(Mg),iron(Fe),zinc(Zn),selenium(Se),copper(Cu)and manganese(Mn)were estimated according to the Chinese Food Composition Tables standard edition.The weight and height of patients were measured,and the body mass index(BMI)was calculated.Nutritional risk and malnutrition were assessed by the Nutritional Screening 2002(NRS 2002)and Global Leadership Initiative on Malnutrition(GLIM)diagnostic criteria.We used a multivariable logistic regression model to estimate the asso-ciations between dietary minerals and malnutrition.Results:The patients had an average age of 61.98(±15.49)years,and 40.6%(n=352)were female.Slightly less than half(44.5%)of the patients were at nutritional risk(NRS 2002≥3),and 32.7%were diagnosed with malnutrition(using the GUM criteria).Univariate analy-ses revealed that there was a statistically significant relationship between dietary mineral intake and the occurrence of nutritional risk(P<0.001).After adjusting the collinearity,we found that higher levels of P,Mn and Se intake were negatively associated with nutritional risk as-sessed by the NRS 2002 score.Moderate intake of Ca and high intake of Zn might also decrease the nutritional risk(Ca:OR,0.53,95%CI,0.32-0.88;Zn:OR,0.36,95%CI,0.19-0.68).However,no significant relationships were observed between any dietary mineral intake and malnutrition identified by the GUM criteria.Conclusions:Dietary minerals,especially P,Se,and Mn,may have a protective effect on the occurrence of nutritional risk in patients with malignant tumors.In addition,patients should maintain appropriate levels of Ca and Zn.展开更多
Background: Occupational health is an important consideration, especially for people that work in an environment with pollutants. Gasoline attendants are individuals that work in filling stations. They are constantly ...Background: Occupational health is an important consideration, especially for people that work in an environment with pollutants. Gasoline attendants are individuals that work in filling stations. They are constantly exposed to gasoline fumes and automobile engine products from vehicle exhaust. This increases the risk of acute and chronic respiratory diseases and carcinogenesis among them. The risk of health complications tends to increase with the duration of exposure. The study aimed to determine the proportion of gasoline attendants with lung function impairment. Methods and Materials: Two hundred and eight eligible participants were recruited for this study. A cross-sectional analytical study was carried out in Esan West local government area of Edo state, Nigeria. The study was carried out for a period of six months from December 2015 to May 2016. A questionnaire was used to obtain information on demographic characteristics, work history, mode of exposure and duration of exposure to petrol fumes. Lung function was assessed using a DTspiro spirometer (Model POP 10. Serial no 110843-005);also the anthropometric parameters of the respondent were measured. Statistical analysis was done using IBM SPSS version 20.0. Frequency and percentages were used to present categorical data. The mean and standard deviation of continuous variables were calculated and compared using the student’s t-test. The criteria of significant association were assumed for a p-value less than 0.05. Results: A total of one hundred and forty petrol pump attendants and one hundred and forty controls participated in this study. The mean age for petrol pump attendants was 24 ± 3.1 years and 23 ± 2.8 years for the control group. There were no significant differences in the gender distribution and anthropometric parameters as observed in this study. The lung impairment pattern observed in this study was obstructive in twelve (8.6%) gasoline pump attendants and restrictive pattern in thirty-nine (27.9%) gasoline pump attendants, while only four (2.9%) had an obstructive pattern and twelve (8.6%) had a restrictive pattern of lung impairment among the control group. This implies that a restrictive pattern was predominant. This study also observed that there was an increase in the number of gasoline pump attendants with declined lung function compared to the control group. Conclusion: Restrictive pattern of lung impairment was more predominant than the obstructive pattern among gasoline pump attendants. As a result, public health interventions should be instituted among these individuals, especially in developing countries.展开更多
BACKGROUND Neuropathy is a common complication of diabetes mellitus resulting from direct damage by hyperglycemia to the nerves and/or ischemia by microvascular injury to the endoneurial vessels which supply the nerve...BACKGROUND Neuropathy is a common complication of diabetes mellitus resulting from direct damage by hyperglycemia to the nerves and/or ischemia by microvascular injury to the endoneurial vessels which supply the nerves. Median nerve is one of the peripheral nerves commonly affected in diabetic neuropathy. The median nerve size has been studied in non-Nigerian diabetic populations. In attempt to contribute to existing literature, a study in a Nigerian population is needed.AIM To evaluate the cross-sectional area(CSA) of the median nerve using B-mode ultrasonography(USS) and the presence of peripheral neuropathy(PN) in a cohort of adult diabetic Nigerians.METHODS Demographic and anthropometric data of 85 adult diabetes mellitus(DM) and 85 age-and sex-matched apparently healthy control(HC) subjects were taken. A complete physical examination was performed on all study subjects to determine the presence of PN and modified Michigan Neuropathy Screening Instrument(MNSI) was used to grade its severity. Venous blood was taken from the study subjects for fasting lipid profile(FLP), fasting blood glucose(FBG) and glycated haemoglobin(HbA1 c) while their MN CSA was evaluated at a point 5 cm proximal to(5 cmCATL) and at the carpal tunnel(CATL) by high-resolution Bmode USS. Data was analysed using SPSS version 22.RESULTS The mean MN CSA was significantly thicker in DM subjects compared to the HC at 5 cmCATL(P < 0.01) and at the CATL(P < 0.01) on both sides. The presence of diabetic peripheral neuropathy(DPN) further increased the MN CSA at the CATL(P < 0.05) but not at 5 cmCATL(P > 0.05). However, the severity of DPN had no additional effect on MN CSA 5 cm proximal to and at the CATL. There was no significant association between MN CSA and duration of DM and glycemic control.CONCLUSION Thickening of the MN CSA at 5 cmCATL and CATL is seen in DM. Presence of DPN is associated with worse thickening of the MN CSA at the CATL but not at5 cmCATL. Severity of DPN, duration of DM, and glycemic control had no additional effect on the MN CSA.展开更多
Summary:Nurses'work-related fatigue has been recognized as a threat to nurse health and patient safety.The aim of this study was to assess the prevalence of fatigue among first-line nurses combating with COVID-19 ...Summary:Nurses'work-related fatigue has been recognized as a threat to nurse health and patient safety.The aim of this study was to assess the prevalence of fatigue among first-line nurses combating with COVID-19 in Wuhan,China,and to analyze its influencing factors on fatigue.A multi-center,descriptive,cross-sectional design with a convenience sample was used.The statistical population consisted of the first-line nurses in 7 tertiary general hospitals from March 3,2020 to March 10,2020 in Wuhan of China.A total of 2667 samples from 2768 contacted participants completed the investgation,with a response rate of 96.35%.Social-demographic questionnaire,work-related questionnaire,Fatigue Scale-14,Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Chinese Perceived Stress Scale were used to conduct online survey.The descriptive statistic of nurses'social-demographic characteristics was conducted,and the related variables of work,anxiety,depression,perceived stress and fatigue were analyzed by Z-tests,nonparametric test and Pearson's correlation analysis.The significant factors which resulted in nurses'fatigue were further analyzed by multiple linear regression analysis.The median score for the first-line nurses'fatigue in Wuhan was 4(2,8).The median score of physical and mental fatigue of them was 3(1,6)and 1(0,3)respectively.According to the scoring criteria,35.06%nurses(w=935)of all participants were in the fatigue status,their median score of fatigue was 10(8,11),and the median score of physical and mental fatigue of them was 7(5,8)and 3(2,4)respectively.Multiple linear regression analysis revealed the participants in the risk groups of anxiety,depression and perceived stress had higher scores on physical and mental fatigue and the statistically significant positive correlation was observed between the variables and nurses'fatigue,the frequency of exercise and nurses'fatigue had a statistically significant negative correlation,and average daily working hours had a significantly positive correlation with nurses'fatigue,and the frequency of weekly night shift had a low positive correlation with nurses'fatigue(P<0.01).There was a moderate level of fatigue among the first-line nurses fighting against COVID-19 pandemic in Wuhan,China.Government and health authorities need to formulate and take effective intervention strategies according to the relevant risk factors,and undertake preventive measures aimed at reducing health hazards due to increased work-related fatigue among first-line nurses,and to enhance their health status and provide a safe occupational environment worldwide.Promoting both medical and nursing safety while combating with the pandemic currently is warranted.展开更多
Objective To investigate whether ABO blood groups is associated with the severity of coronary artery disease(CAD). Methods Between January 2015 and December 2017, 1425 first diagnosed CAD patients confirmed by selecti...Objective To investigate whether ABO blood groups is associated with the severity of coronary artery disease(CAD). Methods Between January 2015 and December 2017, 1425 first diagnosed CAD patients confirmed by selective coronary angiography were recruited into this cross-sectional study, and their baseline characteristics, ABO blood groups, Gensini score were collected. Multiple linear regression analysis was performed to test the association between the severity of CAD and ABO blood groups. Results The Gensini score was significantly higher in the blood group A than in the non-A groups(41.2 ± 32 vs. 38 ± 27;P = 0.026). After adjusting for age, male, smoking, family history of CAD, hypertension, diabetes mellitus and hypercholesterolemia, multivariate linear regression indicated that blood group A was associated with the severity of CAD(β= 3.298, 95% CI: 0.91–6.505, P = 0.044). In diabetes group, A blood type was also associated with increased Gensini score(P = 0.02) after adjusting for age, male, family history of CAD, hypercholesterolemia, smoking and hypertension. Conclusion In this cross-sectional study, the data indicated that blood group A was an independent risk factor of severity of CAD in Chinese population and Chinese patients with type 2 diabetes.展开更多
Advances in medical imaging with current cross-section modalities enable non-invasive characterization of adrenal lesions. Computed tomography (CT) provides characterization with its non-contrast and wash-out features...Advances in medical imaging with current cross-section modalities enable non-invasive characterization of adrenal lesions. Computed tomography (CT) provides characterization with its non-contrast and wash-out features. Magnetic resonance imaging (MRI) is helpful in further characterization using chemical shift imaging (CSI) and MR spectroscopy. For differentiating between benign and malignant masses, positron emission tomography (PET) imaging is useful with its qualitative analysis, as well as its ability to detect the presence of extra-adrenal metastases in cancer patients. The workup for an indeterminate adrenal mass includes evaluation with a non-contrast CT. If a lesion is less than 10 Hounsfield Units on a non-contrast CT, it is a benign lipid-rich adenoma and no further work-up is required. For the indeterminate adrenal masses, a lipid-poor adenoma can be differentiated from a metastasis utilizing CT wash-out features. Also, MRI is beneficial with CSI and MR spectroscopy. If a mass remains indeterminate, PET imaging may be of use, in which benign lesions demonstrate low or no fluorodeoxyglucose activity. In the few cases in which adrenal lesions remain indeterminate, surgical sampling such as percutaneous biopsy can be performed.展开更多
Background:Since the trauma knowledge of trauma providers correlates with the outcomes of injured patients,this study aims to assess the socio-demographic characteristics and levels of trauma knowledge of trainees in ...Background:Since the trauma knowledge of trauma providers correlates with the outcomes of injured patients,this study aims to assess the socio-demographic characteristics and levels of trauma knowledge of trainees in the China trauma care training(CTCT)program in addition to their post-course test results to provide support for the development of trauma care training programs and trauma systems in China.Methods:A cross-sectional study was conducted by collecting demographic information,hospital-related information and trauma knowledge of the trainees from 19 regions in China.All participants were assessed by questionnaires collecting the socio-demographic data,the trauma care knowledge levels and the information of the hospitals.Results:There were 955 males(78.9%)and 256 females(21.1%)enrolled.Among them,854 were physicians(70.5%),357 were registered nurses(29.5%).In addition,64 of them also played an administrative role in the hospitals(5.3%).The score of the trainees who were members of the emergency department staff(72.59±14.13)was the highest among the scores of all the personnel surveyed,followed by those of the trainees from the intensive care unit(ICU)(71.17±12.72),trauma surgery department(67.26±13.81),orthopedics department(70.36±14.48),general surgery department(69.91±14.79)and other departments(69.93±16.91),P=0.031.The score of the professors(73.09±15.05)was higher than those of the associate professors(72.40±14.71),lecturers(70.07±14.25)and teaching assistants(67.58±15.16),P<0.0001.The score of the individuals who attended experts’trauma lectures(72.22±14.45)was higher than that of individuals who did not attend the lectures(69.33±15.17),P=0.001.The mean scores before and after the training were 71.02±14.82 and 84.24±13.77,respectively,P<0.001.The mean score of trauma knowledge after the training of trainees from different provinces and with different educational backgrounds was higher than that before the training,with a statistically significant difference(P<0.05).Conclusions:The level of trauma knowledge of trauma care providers was associated with their department,professional position and previous participation in related academic conferences.Trauma care experience and participation in academic lectures and training program including CTCT may effectively improve individuals’level of trauma knowledge.展开更多
Kidney stones are a common urinary system condition that can progress to kidney disease.Previous studies on the association between tea consumption and kidney stones are inconsistent.A cross‐sectional study to invest...Kidney stones are a common urinary system condition that can progress to kidney disease.Previous studies on the association between tea consumption and kidney stones are inconsistent.A cross‐sectional study to investigate the association between tea consumption and kidney stones was conducted from 2013 to 2014 and recruited 9,078northern Chinese adults.A total of 8,807participants were included in the final analysis.展开更多
Diarrhea remains a major cause of mortality in children under 5 years of age in Sub-Saharan countries in Africa. Risk factors for diarrhea vary by context and have important implications for developing appropriate str...Diarrhea remains a major cause of mortality in children under 5 years of age in Sub-Saharan countries in Africa. Risk factors for diarrhea vary by context and have important implications for developing appropriate strategies to reduce the burden of the disease. The objective of this study was to assess the prevalence of diarrhea and associated risk factors among children un-der 5 years of age in Kersa district, located in Eastern Ethiopia. A community-based cross-sectional study was conducted among 1456 randomly selected households with at least one child under 5 years of age. A questionnaire and an observational check list were used for col-lecting information on socio-economic charac-teristics, environmental hygiene and behavioral practices, and occurrence of diarrhea among children under 5 years of age. Logistic regres-sion was used to calculate the adjusted odds ratio of 95% confidence interval. The two-week prevalence of diarrhea among children under 5 years of age was 22.5% (95% CI: 20.3-24.6). Improper refuse disposal practices (OR = 2.22, 95% CI: 1.20-4.03), lack of hand washing facilities (OR = 1.92, 95%CI: 1.29-2.86), living in rural area (OR = 1.81, 95% CI: 1.12-3.31), the presence of two or more siblings in a household (OR = 1.74, 95% CI: 1.33-2.28), and age of the child (OR= 2.25, 95% CI;1.5-3.36) were the major risk factors for diarrhea. This study demonstrated that diarrhea morbidity was relatively high among children under 5 years of age residing in Eastern Ethiopia. Efforts to reduce childhood diarrhea should focus on improving household sanitation, personal hygiene, and child birth spacing.展开更多
Background:The constitutional theory is an important aspect of Tibetan medicine,however a quantitative measurement tool for constitution identification still does not exist.The objective of this study is to evaluate t...Background:The constitutional theory is an important aspect of Tibetan medicine,however a quantitative measurement tool for constitution identification still does not exist.The objective of this study is to evaluate the reliability and validity of a Tibetan medicine constitution scale(TMCS)that consists of three sub-scales and 31 items.Methods:From June to July 2019,622 people from the general population in Beijing,China,aged 18 to 60 were investigated.We employed Cronbach’s alpha(α),split-half reliability,and test-retest reliability to determine the reliability of the scale.The content validity and contract validity of the TMCS were evaluated using factor analysis and correlation analysis based on Tibetan medicine theory.The items were screened according to the reliability test results.Results:After the items were screened,22 items remained in the scale.The Cronbach’s alpha value for the internal consistency reliability of the TMCS was 0.754(95%confidence interval(CI):0.700–0.761).The correlation coefficient for the two-week test-retest of the total score was 0.726(95%CI:0.571–0.834).The split-half coefficient was 0.689(95%CI:0.640–0.734).The scale can be explained by eight potential factors,including morphological structure,physiological function,personality,adaptability,etc.The body mass index was negatively correlated with the score of the sub-rlung scale(r=−0.376),slightly positively correlated with the sub-mkhris pa scale(r=0.099),and positively correlated with the sub-bad kan scale(r=0.362).Conclusion:The TMCS is a reliable and valid instrument that can be used to assess the body constitution of the general population in Beijing,China.Future studies are needed to explore the differences in biological characteristics among the constitutional types and the association between constitution and disease.展开更多
Background:This study aimed to determine the prevalence and predictive factors of prolonged grief disorder(PGD)among those bereaved by the Wenchuan earthquake in Southwestern China seven years after the event.Methods:...Background:This study aimed to determine the prevalence and predictive factors of prolonged grief disorder(PGD)among those bereaved by the Wenchuan earthquake in Southwestern China seven years after the event.Methods:A cross-sectional survey based on census tracts was conducted on the bereaved earthquake survivors.Responses to the questionnaire regarding PGD and its potential associated factors were obtained either through face-to-face or telephone interview.PGD was screened by a validated Chinese version of the PGD questionnaire-13(PG-13).Bivariate and multivariate regression analyses were used to determine the prevalence and associated risk factors of PGD.Results:A total of 1464 bereaved earthquake survivors,with a response rate of 97.6%,were included in the study.Of the 1464 respondents studied,124(8.47%)were diagnosed with PGD.Multivariate regression analysis demonstrated that PGD in the bereaved earthquake individuals was significantly associated with several factors,including age,economic burden,close kinship with the deceased,and living with the deceased before the loss.Wenchuan earthquake bereaved aged 41e60 years were more likely to develop PGD compared to those aged younger than 40 or older than 60(OR=2.075,95%CI=1.297e3.319).Those who had a close kinship with the deceased had a higher tendency to develop PGD(OR=5.144,95%CI=2.716e9.740).The odds of PGD among the earthquake bereaved with economic burdens were higher relative to those who did not experience an economic burden(OR=8.123,95%CI=2.657e24.831).Those who living with the deceased before loss also had a higher tendency to develop PGD(OR=0.179,95%CI=0.053e0.602).Conclusions:This study revealed that a significantly high proportion(8.47%)of the Wenchuan earthquake-bereaved remain grieving seven years after the event.Those diagnosed with PGD should receive appropriate interventions from clinical psychologists.The risk factors identified in this study are crucial for the early screening and prevention of PGD in future nursing and psycho-clinical practices.展开更多
Early drinking is considered to result in making tolerant of alcohol consumption and a higher prevalence of alcohol related disorders in the later. We focused generational impacts on drinking rate among high school st...Early drinking is considered to result in making tolerant of alcohol consumption and a higher prevalence of alcohol related disorders in the later. We focused generational impacts on drinking rate among high school students based on multiple nationwide data. The surveys were nationwide, cross-sectional random sampling surveys given every 4 years from the Japanese Youth Tobacco and Alcohol Surveys, 1996 to 2008. Participants were male 53,925 high school students from 7th grade to 11th grade. We divided to the three follow-up groups every 4 years from 1996 to 2004 for male junior high school students in 7th grades and the end periods were 4 years later in 11th grades. Outcome measures in this study were life time drinking, current drinking within 30 days and weekly drinking. All drinking rates decreased each at 7th and at 11th grade. The increments in these drinking rates from 7th grade to 11th grade in males decreased gradually in recent follow-up groups. Generational impacts should be considered by using follow-up groups to study drinking behaviors among students.展开更多
基金Supported by Suzhou Municipal Science and Technology Program of China,No.SKJY2021012.
文摘BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.
文摘Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Methods:In this study,602 patients with maintenance hemodialysis and continuous ambulatory peritoneal dialysis were enrolled from December 2020 to December 2022 in our hospital,and their medical records were collected and summarized.The main contents included the patient’s gender,age,primary disease,dialysis duration,dialysis method,the use of erythropoietic stimulating agents(ESA),intravenous iron,and laboratory tests.A Hb index exceeding 110 g/L was set as the standard for the prevalence of anemia.Results:The rate of anemia in patients undergoing blood purification was 83%.The proportion of ESA use was 84.1%,and the proportion of iron use was 76.7%,of which the proportion of intravenous iron used was 17.0%,and the proportion of folic acid used was 28.3%.Conclusion:The incidence of anemia in MHD patients was relatively high,with a low proportion of patients reaching the standard Hb levels.Risk factors include albumin(ALB)levels,iron storage,white blood cells,C-reactive protein,cholesterol,etc.Nutritional support,iron supplementation,and prevention of micro-inflammatory reactions can effectively promote the improvement of Hb indicators in dialysis patients to prevent anemia.
基金Supported by Wenzhou Science and Technology Bureau,No.Y20220031.
文摘BACKGROUND Patients with inflammatory bowel diseases(IBDs)generally have poor knowledge,attitude,and practice of their disease,while the data from China are lacking.AIM To address this knowledge disparity among Chinese patients with IBD.METHODS This web-based,cross-sectional study was conducted on a cohort of IBD patients who visited the Second Affiliated Hospital of Wenzhou Medical University between December 2022 and February 2023.Their socio-demographic information and the knowledge,attitude,and practice scores were collected and estimated using a self-designed questionnaire.Pearson’s correlation analysis was used to determine the pairwise correlations among knowledge,attitude,and practice scores.A multivariate logistic regression analysis was further performed to determine the independent factors associated with their knowledge,attitude,and practice scores.RESULTS A total of 353 patients(224 males)with IBD completed the questionnaires.The mean knowledge,attitude,and practice scores were 10.05±3.46(possible range:0-14),41.58±5.23(possible range:0-56),44.20±7.39(possible range:0-56),respectively,indicating good knowledge,positive attitude,and proactive practice toward IBD.Pearson’s correlation analysis showed that the knowledge score had significant positive correlations with the attitude score(r=0.371,P<0.001)and practice score(r=0.100,P<0.001).The attitude score had a significant positive correlation with the practice score(r=0.452,P<0.001).Moreover,multivariate logistic regression analysis showed that aged 30-40 years[odds ratio(OR)=4.06,95%confidence interval(CI):1.04-15.82,P=0.043],middle school education(OR=3.98,95%CI:1.29-12.33,P=0.017),high school/technical secondary school education(OR=14.06,95%CI:3.92-50.38,P<0.001),and junior college/bachelor’s degree and above education(OR=15.20,95%CI:4.15-55.650,P<0.001)were independently associated with good knowledge.The higher knowledge score was independently associated with a positive attitude(OR=1.23,95%CI:1.11-1.36,P<0.001).The higher attitude score was independently associated with proactive practice(OR=1.20,95%CI:1.11-1.30,P<0.001).CONCLUSION Chinese patients with IBD might have good knowledge,a positive attitude,and proactive practice toward their disease.However,a small number of specific items require education.
文摘Background:Depression and anxiety are highly prevalent among adolescents and have multiple negative effects on their physical and mental health.While exercise can reduce the symptoms of depression and anxiety,the rela-tionship between mental disorders among American university students has been rarely reported.Accordingly,this study aimed to explore the association between exercise,depression and anxiety among American university students in the 2018–2019 academic year.Methods:In this cross-sectional study,the association between exercise,depression and anxiety was investigated in a large representative sample of American university students.In the 2018–2019 academic year,university students aged 18+years old from 79 institutions participated in this school-based study.The questionnaire included measurements of demographic characteristics,exercise,and validated screen instructions for depression(PHQ-9)and anxiety(GAD-7).The multivariable logistic regression model was applied to explore the association between exercise,depression and anxiety.Results:A total of 62026 indivi-duals(31.9%males)participated in this survey,and the prevalence of exercising at least 5 h each day was 24.6%.The prevalence of depression and anxiety was 25.7%and 22.3%,respectively.In the multivariable logistic regres-sion model,compared to exercise at least 5 h daily,participants whose exercise less than 1 h daily(OR=1.31[1.29,1.33],p<0.05),2 to 3 h daily(OR=1.13[1.11,1.15],p<0.05),3 to 4 h daily(OR=1.04[1.02,1.06],p<0.05),were correlated with greater odds of depression,while exercise less than 1 h daily(OR=1.23[1.21,1.25],p<0.05),2 to 3 h daily(OR=1.10[1.08,1.12],p<0.05)were significantly correlated with great-er odds of anxiety.Conclusion:Higher levels of exercise are associated with lower risk of depression and anxiety among American university students.Community and school interventions should focus on increasing exercise participation in university populations to promote both physical and mental health.
基金supported by the National Natural Science Foundation of China(82073160).
文摘Objective The popularization of gastroenteroscopy and the introduction of comfortable medical care have further promoted the growth of people's demand,especially the demand for painless endoscopy.This cross-sectional study aims to investigate the current situation and change in county people's demand for endoscopy to promote the development of endoscopy centers in county hospitals in southeast China.Methods From October to December 2021,patients and their family members who came to the Gastroenterology Department in Suichang County People's Hospital of Zhejiang Province were randomly selected to complete the questionnaire.A total of 838 valid questionnaires were collected.Additionally,the original software data of the Endoscopy Center were sampled and retrieved(from October to December every year from 2018 to 2021)for statistical analysis of real-world data.Those who would choose painless endoscopy the next time in the valid questionnaires were included in the painless endoscopy group,while those who would choose ordinary endoscopy the next time were included in the ordinary endoscopy group.Results The stepwise forward binary logistic regression model analysis showed that,patients with“secondhand smoke exposure”were more willing to choose painless endoscopy(OR=1.459,95%CI:1.050-2.028,p=0.025).However,patients with an education level of“primary and below”and“junior high school”,and patients who are suffering from“currently experiencing abdominal distension”,were more willing to choose ordinary endoscopy(OR=0.270,95%CI:0.149-0.488,p<0.001;OR=0.528,95%CI:0.330-0.845,p=0.008;OR=0.536,95%CI:0.334-0.861,p=0.010).Patients with previous experience in painless endoscopy tended to choose painless endoscopy the next time,while patients with previous experience in ordinary endoscopy tended to choose ordinary endoscopy the next time(χ^(2)=140.97,p<0.001).From 2018 to 2021,the proportion of painless endoscopy has increased yearly(p<0.001).Most patients indicated that they would“regularly review gastroenteroscopy”(477/838,56.9%).Conclusions With Suichang County of Zhejiang Province as the representative,the demand for painless endoscopy for people's gastrointestinal cancer detection in southeast China has been increasing yearly.The development of endoscopy centers in county-level hospitals can basically meet the demand growth.Meanwhile,advanced concepts such as comfortable medical care and regular follow-up are gradually popularized at the grassroots level in southeast China.
文摘Objective:This study aimed to estimate the prevalence and determinants of Internet addiction among medical students at the Faculty of Medicine and Pharmacy of Casablanca,Morocco.Methods:This was a cross-sectional study conducted among students at the Faculty of Medicine and Pharmacy in Casablanca between October and March 2020.An online questionnaire was administered to students to collect data and internet addiction was assessed by the Young questionnaire.A score threshold≥50 was adopted to define addiction.Univariate and multivariate logistic regression analyses were used to identify factors associated with internet addiction.Results:Out of a total of 4093 FMPC students enrolled in the 2020-2021 academic year,506 agreed to participate in this study,including 303 females and 203 males.The mean addiction score assessed on the Young scale was(49.08±16.11).The prevalence of Internet addiction was 44.5%(225/506,95% CI:40% to 49%).Multiple regression analysis showed that being older than 20 years(OR=0.17,95% CI:0.40 to 0.64),being female(OR=1.70,95% CI:1.04 to 2.78),being in the dissertation year(6th year)(OR=5.17,95% CI:2.23 to 11.44),having a history of psychiatric consultation(OR=2.64,95% CI:1.34 to 5.21),having divorced parents(OR=2.64,95% CI:1.05 to 5.87),use of sleeping medication(OR=2.9,95% CI:1.05 to 3.70),sleep disorders(OR=2.06,95% CI:1.25 to 3.79),sleep deprivation(OR=2.26,95% CI:1.39 to 3.65),excessive daytime sleepiness(OR=5.39,95% CI:2.19 to 13.24),anxiety disorders(OR=1.47,95% CI:1.18 to 2.30),duration of internet connection(>4 h)(OR=11.43,95% CI:4.85 to 27.66),and having frequent conflicts with parents(OR=2.37,95% CI:1.49 to 3.79)and friends(OR=0.26,95% CI:0.11 to 0.65)were independently associated with internet addiction.Conclusion:The prevalence of Internet addiction among medical students in Casablanca remains high.Targeted action on the determinants would be of great value in prevention.
文摘Background: Occupational health is an important consideration, especially for people that work in an environment with pollutants. Gasoline attendants are individuals that work in filling stations. They are constantly exposed to gasoline fumes and automobile engine products from vehicle exhaust. This increases the risk of acute and chronic respiratory diseases and carcinogenesis among them. The risk of health complications tends to increase with the duration of exposure. The study aimed to determine the proportion of gasoline attendants with lung function impairment. Methods and Materials: Two hundred and eight eligible participants were recruited for this study. A cross-sectional analytical study was carried out in Esan West local government area of Edo state, Nigeria. The study was carried out for a period of six months from December 2015 to May 2016. A questionnaire was used to obtain information on demographic characteristics, work history, mode of exposure and duration of exposure to petrol fumes. Lung function was assessed using a DTspiro spirometer (Model POP 10. Serial no 110843-005);also the anthropometric parameters of the respondent were measured. Statistical analysis was done using IBM SPSS version 20.0. Frequency and percentages were used to present categorical data. The mean and standard deviation of continuous variables were calculated and compared using the student’s t-test. The criteria of significant association were assumed for a p-value less than 0.05. Results: A total of one hundred and forty petrol pump attendants and one hundred and forty controls participated in this study. The mean age for petrol pump attendants was 24 ± 3.1 years and 23 ± 2.8 years for the control group. There were no significant differences in the gender distribution and anthropometric parameters as observed in this study. The lung impairment pattern observed in this study was obstructive in twelve (8.6%) gasoline pump attendants and restrictive pattern in thirty-nine (27.9%) gasoline pump attendants, while only four (2.9%) had an obstructive pattern and twelve (8.6%) had a restrictive pattern of lung impairment among the control group. This implies that a restrictive pattern was predominant. This study also observed that there was an increase in the number of gasoline pump attendants with declined lung function compared to the control group. Conclusion: Restrictive pattern of lung impairment was more predominant than the obstructive pattern among gasoline pump attendants. As a result, public health interventions should be instituted among these individuals, especially in developing countries.
文摘Background: Protein kinase B (AKT/PKB) family is frequently amplified in ovarian cancer (OC). To the greatest of our knowledge, there is a lack of published reports about the amplification of the genes belonging to the AKT family among Sudanese women with OC. The present study was conducted to detect the AKT1 gene amplification and its association with tumour types, grades, and ages among Sudanese women with OC, bearing in mind the ethnic variation. Methods: This institution-based study included 79 cases of women diagnosed with ovarian cancer (OC) at Omdurman Maternity Hospital in the period 2013-2018. Formalin-fixed, paraffin-embedded (FFPE) tissue sections were used to extract RNA. AKT1 gene amplification was assessed using quantitative real-time PCR. Results: The mean age (±SD) of included women was 49.29 (±13.612). The amplification of AKT1 gene was observed in 18/79 (22.8%) of OC women, with a high frequency in women with undifferentiated 1/2 (50%), clear cell 2/6 (33.3%), mucinous 3/11 (27.3%), endometrioid 3/17 (17.6%), and serous carcinomas 5/30 OC (16.7%). High frequency was seen in women with low (26.3%;n = 10/28) rather than in higher (19.5%;n = 8/33) grade carcinoma, and in older (25.8%;n = 8/23) rather than younger (18.2%;n = 2/9) women. No significant association between AKT1 gene amplification and tumour types, grades, and ages of women was observed (Fisher’s Exact test: p = 0.405, 0.593 and 0.851, respectively). Conclusion: AKT1 gene amplification arises in around one-fifth of Sudanese women with ovarian cancer (OC). It is seen more in undifferentiated, clear cell, and mucinous tumours types, and more frequently in low tumour grade and older women, but not to a statistically significant level. These outcomes sustenance previous studies suggesting that activated AKT genes have a vital role in OC progression and may offer a plan for targeted therapy and prognostic evaluation.
基金supported by the Spark Program from The First Hospital of Hebei Medical University(No.XH202316)the Innovation Funding Program for postgraduate students of Hebei Medical University(No.22034100684).
文摘Background:To examine the correlation between the dietary mineral intake and the nutritional status of patients suffering from malignan-cies.Methods:This multi-center cross-sectional study included a total of 866 patients with malignant tumors recruited from seven hospitals throughout China.The information of socio-demographic characteristics and biochemical indicators were obtained from electronic medical records of inpatients.Dietary data were collected using a 3-day 24-hour dietary recall questionnaire.The intake of energy,dietary calcium(Ca),phosphorus(P),potassium(K),sodium(Na),magnesium(Mg),iron(Fe),zinc(Zn),selenium(Se),copper(Cu)and manganese(Mn)were estimated according to the Chinese Food Composition Tables standard edition.The weight and height of patients were measured,and the body mass index(BMI)was calculated.Nutritional risk and malnutrition were assessed by the Nutritional Screening 2002(NRS 2002)and Global Leadership Initiative on Malnutrition(GLIM)diagnostic criteria.We used a multivariable logistic regression model to estimate the asso-ciations between dietary minerals and malnutrition.Results:The patients had an average age of 61.98(±15.49)years,and 40.6%(n=352)were female.Slightly less than half(44.5%)of the patients were at nutritional risk(NRS 2002≥3),and 32.7%were diagnosed with malnutrition(using the GUM criteria).Univariate analy-ses revealed that there was a statistically significant relationship between dietary mineral intake and the occurrence of nutritional risk(P<0.001).After adjusting the collinearity,we found that higher levels of P,Mn and Se intake were negatively associated with nutritional risk as-sessed by the NRS 2002 score.Moderate intake of Ca and high intake of Zn might also decrease the nutritional risk(Ca:OR,0.53,95%CI,0.32-0.88;Zn:OR,0.36,95%CI,0.19-0.68).However,no significant relationships were observed between any dietary mineral intake and malnutrition identified by the GUM criteria.Conclusions:Dietary minerals,especially P,Se,and Mn,may have a protective effect on the occurrence of nutritional risk in patients with malignant tumors.In addition,patients should maintain appropriate levels of Ca and Zn.
文摘Background: Occupational health is an important consideration, especially for people that work in an environment with pollutants. Gasoline attendants are individuals that work in filling stations. They are constantly exposed to gasoline fumes and automobile engine products from vehicle exhaust. This increases the risk of acute and chronic respiratory diseases and carcinogenesis among them. The risk of health complications tends to increase with the duration of exposure. The study aimed to determine the proportion of gasoline attendants with lung function impairment. Methods and Materials: Two hundred and eight eligible participants were recruited for this study. A cross-sectional analytical study was carried out in Esan West local government area of Edo state, Nigeria. The study was carried out for a period of six months from December 2015 to May 2016. A questionnaire was used to obtain information on demographic characteristics, work history, mode of exposure and duration of exposure to petrol fumes. Lung function was assessed using a DTspiro spirometer (Model POP 10. Serial no 110843-005);also the anthropometric parameters of the respondent were measured. Statistical analysis was done using IBM SPSS version 20.0. Frequency and percentages were used to present categorical data. The mean and standard deviation of continuous variables were calculated and compared using the student’s t-test. The criteria of significant association were assumed for a p-value less than 0.05. Results: A total of one hundred and forty petrol pump attendants and one hundred and forty controls participated in this study. The mean age for petrol pump attendants was 24 ± 3.1 years and 23 ± 2.8 years for the control group. There were no significant differences in the gender distribution and anthropometric parameters as observed in this study. The lung impairment pattern observed in this study was obstructive in twelve (8.6%) gasoline pump attendants and restrictive pattern in thirty-nine (27.9%) gasoline pump attendants, while only four (2.9%) had an obstructive pattern and twelve (8.6%) had a restrictive pattern of lung impairment among the control group. This implies that a restrictive pattern was predominant. This study also observed that there was an increase in the number of gasoline pump attendants with declined lung function compared to the control group. Conclusion: Restrictive pattern of lung impairment was more predominant than the obstructive pattern among gasoline pump attendants. As a result, public health interventions should be instituted among these individuals, especially in developing countries.
文摘BACKGROUND Neuropathy is a common complication of diabetes mellitus resulting from direct damage by hyperglycemia to the nerves and/or ischemia by microvascular injury to the endoneurial vessels which supply the nerves. Median nerve is one of the peripheral nerves commonly affected in diabetic neuropathy. The median nerve size has been studied in non-Nigerian diabetic populations. In attempt to contribute to existing literature, a study in a Nigerian population is needed.AIM To evaluate the cross-sectional area(CSA) of the median nerve using B-mode ultrasonography(USS) and the presence of peripheral neuropathy(PN) in a cohort of adult diabetic Nigerians.METHODS Demographic and anthropometric data of 85 adult diabetes mellitus(DM) and 85 age-and sex-matched apparently healthy control(HC) subjects were taken. A complete physical examination was performed on all study subjects to determine the presence of PN and modified Michigan Neuropathy Screening Instrument(MNSI) was used to grade its severity. Venous blood was taken from the study subjects for fasting lipid profile(FLP), fasting blood glucose(FBG) and glycated haemoglobin(HbA1 c) while their MN CSA was evaluated at a point 5 cm proximal to(5 cmCATL) and at the carpal tunnel(CATL) by high-resolution Bmode USS. Data was analysed using SPSS version 22.RESULTS The mean MN CSA was significantly thicker in DM subjects compared to the HC at 5 cmCATL(P < 0.01) and at the CATL(P < 0.01) on both sides. The presence of diabetic peripheral neuropathy(DPN) further increased the MN CSA at the CATL(P < 0.05) but not at 5 cmCATL(P > 0.05). However, the severity of DPN had no additional effect on MN CSA 5 cm proximal to and at the CATL. There was no significant association between MN CSA and duration of DM and glycemic control.CONCLUSION Thickening of the MN CSA at 5 cmCATL and CATL is seen in DM. Presence of DPN is associated with worse thickening of the MN CSA at the CATL but not at5 cmCATL. Severity of DPN, duration of DM, and glycemic control had no additional effect on the MN CSA.
文摘Summary:Nurses'work-related fatigue has been recognized as a threat to nurse health and patient safety.The aim of this study was to assess the prevalence of fatigue among first-line nurses combating with COVID-19 in Wuhan,China,and to analyze its influencing factors on fatigue.A multi-center,descriptive,cross-sectional design with a convenience sample was used.The statistical population consisted of the first-line nurses in 7 tertiary general hospitals from March 3,2020 to March 10,2020 in Wuhan of China.A total of 2667 samples from 2768 contacted participants completed the investgation,with a response rate of 96.35%.Social-demographic questionnaire,work-related questionnaire,Fatigue Scale-14,Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Chinese Perceived Stress Scale were used to conduct online survey.The descriptive statistic of nurses'social-demographic characteristics was conducted,and the related variables of work,anxiety,depression,perceived stress and fatigue were analyzed by Z-tests,nonparametric test and Pearson's correlation analysis.The significant factors which resulted in nurses'fatigue were further analyzed by multiple linear regression analysis.The median score for the first-line nurses'fatigue in Wuhan was 4(2,8).The median score of physical and mental fatigue of them was 3(1,6)and 1(0,3)respectively.According to the scoring criteria,35.06%nurses(w=935)of all participants were in the fatigue status,their median score of fatigue was 10(8,11),and the median score of physical and mental fatigue of them was 7(5,8)and 3(2,4)respectively.Multiple linear regression analysis revealed the participants in the risk groups of anxiety,depression and perceived stress had higher scores on physical and mental fatigue and the statistically significant positive correlation was observed between the variables and nurses'fatigue,the frequency of exercise and nurses'fatigue had a statistically significant negative correlation,and average daily working hours had a significantly positive correlation with nurses'fatigue,and the frequency of weekly night shift had a low positive correlation with nurses'fatigue(P<0.01).There was a moderate level of fatigue among the first-line nurses fighting against COVID-19 pandemic in Wuhan,China.Government and health authorities need to formulate and take effective intervention strategies according to the relevant risk factors,and undertake preventive measures aimed at reducing health hazards due to increased work-related fatigue among first-line nurses,and to enhance their health status and provide a safe occupational environment worldwide.Promoting both medical and nursing safety while combating with the pandemic currently is warranted.
基金supported by grants from Clinical Vascular Grant in Chinese Physicians—VG
文摘Objective To investigate whether ABO blood groups is associated with the severity of coronary artery disease(CAD). Methods Between January 2015 and December 2017, 1425 first diagnosed CAD patients confirmed by selective coronary angiography were recruited into this cross-sectional study, and their baseline characteristics, ABO blood groups, Gensini score were collected. Multiple linear regression analysis was performed to test the association between the severity of CAD and ABO blood groups. Results The Gensini score was significantly higher in the blood group A than in the non-A groups(41.2 ± 32 vs. 38 ± 27;P = 0.026). After adjusting for age, male, smoking, family history of CAD, hypertension, diabetes mellitus and hypercholesterolemia, multivariate linear regression indicated that blood group A was associated with the severity of CAD(β= 3.298, 95% CI: 0.91–6.505, P = 0.044). In diabetes group, A blood type was also associated with increased Gensini score(P = 0.02) after adjusting for age, male, family history of CAD, hypercholesterolemia, smoking and hypertension. Conclusion In this cross-sectional study, the data indicated that blood group A was an independent risk factor of severity of CAD in Chinese population and Chinese patients with type 2 diabetes.
文摘Advances in medical imaging with current cross-section modalities enable non-invasive characterization of adrenal lesions. Computed tomography (CT) provides characterization with its non-contrast and wash-out features. Magnetic resonance imaging (MRI) is helpful in further characterization using chemical shift imaging (CSI) and MR spectroscopy. For differentiating between benign and malignant masses, positron emission tomography (PET) imaging is useful with its qualitative analysis, as well as its ability to detect the presence of extra-adrenal metastases in cancer patients. The workup for an indeterminate adrenal mass includes evaluation with a non-contrast CT. If a lesion is less than 10 Hounsfield Units on a non-contrast CT, it is a benign lipid-rich adenoma and no further work-up is required. For the indeterminate adrenal masses, a lipid-poor adenoma can be differentiated from a metastasis utilizing CT wash-out features. Also, MRI is beneficial with CSI and MR spectroscopy. If a mass remains indeterminate, PET imaging may be of use, in which benign lesions demonstrate low or no fluorodeoxyglucose activity. In the few cases in which adrenal lesions remain indeterminate, surgical sampling such as percutaneous biopsy can be performed.
基金support by grants from the“Chongqing Science and Technology Benefiting project”(cstc2016kjhmpt1001)research project from the State Key Laboratory of Trauma,Burns and Combined Injury(SKLZZ201603)。
文摘Background:Since the trauma knowledge of trauma providers correlates with the outcomes of injured patients,this study aims to assess the socio-demographic characteristics and levels of trauma knowledge of trainees in the China trauma care training(CTCT)program in addition to their post-course test results to provide support for the development of trauma care training programs and trauma systems in China.Methods:A cross-sectional study was conducted by collecting demographic information,hospital-related information and trauma knowledge of the trainees from 19 regions in China.All participants were assessed by questionnaires collecting the socio-demographic data,the trauma care knowledge levels and the information of the hospitals.Results:There were 955 males(78.9%)and 256 females(21.1%)enrolled.Among them,854 were physicians(70.5%),357 were registered nurses(29.5%).In addition,64 of them also played an administrative role in the hospitals(5.3%).The score of the trainees who were members of the emergency department staff(72.59±14.13)was the highest among the scores of all the personnel surveyed,followed by those of the trainees from the intensive care unit(ICU)(71.17±12.72),trauma surgery department(67.26±13.81),orthopedics department(70.36±14.48),general surgery department(69.91±14.79)and other departments(69.93±16.91),P=0.031.The score of the professors(73.09±15.05)was higher than those of the associate professors(72.40±14.71),lecturers(70.07±14.25)and teaching assistants(67.58±15.16),P<0.0001.The score of the individuals who attended experts’trauma lectures(72.22±14.45)was higher than that of individuals who did not attend the lectures(69.33±15.17),P=0.001.The mean scores before and after the training were 71.02±14.82 and 84.24±13.77,respectively,P<0.001.The mean score of trauma knowledge after the training of trainees from different provinces and with different educational backgrounds was higher than that before the training,with a statistically significant difference(P<0.05).Conclusions:The level of trauma knowledge of trauma care providers was associated with their department,professional position and previous participation in related academic conferences.Trauma care experience and participation in academic lectures and training program including CTCT may effectively improve individuals’level of trauma knowledge.
基金supported by the Medical Science and Technology Project of Zhejiang Province[2014KYA231]
文摘Kidney stones are a common urinary system condition that can progress to kidney disease.Previous studies on the association between tea consumption and kidney stones are inconsistent.A cross‐sectional study to investigate the association between tea consumption and kidney stones was conducted from 2013 to 2014 and recruited 9,078northern Chinese adults.A total of 8,807participants were included in the final analysis.
文摘Diarrhea remains a major cause of mortality in children under 5 years of age in Sub-Saharan countries in Africa. Risk factors for diarrhea vary by context and have important implications for developing appropriate strategies to reduce the burden of the disease. The objective of this study was to assess the prevalence of diarrhea and associated risk factors among children un-der 5 years of age in Kersa district, located in Eastern Ethiopia. A community-based cross-sectional study was conducted among 1456 randomly selected households with at least one child under 5 years of age. A questionnaire and an observational check list were used for col-lecting information on socio-economic charac-teristics, environmental hygiene and behavioral practices, and occurrence of diarrhea among children under 5 years of age. Logistic regres-sion was used to calculate the adjusted odds ratio of 95% confidence interval. The two-week prevalence of diarrhea among children under 5 years of age was 22.5% (95% CI: 20.3-24.6). Improper refuse disposal practices (OR = 2.22, 95% CI: 1.20-4.03), lack of hand washing facilities (OR = 1.92, 95%CI: 1.29-2.86), living in rural area (OR = 1.81, 95% CI: 1.12-3.31), the presence of two or more siblings in a household (OR = 1.74, 95% CI: 1.33-2.28), and age of the child (OR= 2.25, 95% CI;1.5-3.36) were the major risk factors for diarrhea. This study demonstrated that diarrhea morbidity was relatively high among children under 5 years of age residing in Eastern Ethiopia. Efforts to reduce childhood diarrhea should focus on improving household sanitation, personal hygiene, and child birth spacing.
基金This work was supported by the National Natural Science Foundation of China(No.81704197).
文摘Background:The constitutional theory is an important aspect of Tibetan medicine,however a quantitative measurement tool for constitution identification still does not exist.The objective of this study is to evaluate the reliability and validity of a Tibetan medicine constitution scale(TMCS)that consists of three sub-scales and 31 items.Methods:From June to July 2019,622 people from the general population in Beijing,China,aged 18 to 60 were investigated.We employed Cronbach’s alpha(α),split-half reliability,and test-retest reliability to determine the reliability of the scale.The content validity and contract validity of the TMCS were evaluated using factor analysis and correlation analysis based on Tibetan medicine theory.The items were screened according to the reliability test results.Results:After the items were screened,22 items remained in the scale.The Cronbach’s alpha value for the internal consistency reliability of the TMCS was 0.754(95%confidence interval(CI):0.700–0.761).The correlation coefficient for the two-week test-retest of the total score was 0.726(95%CI:0.571–0.834).The split-half coefficient was 0.689(95%CI:0.640–0.734).The scale can be explained by eight potential factors,including morphological structure,physiological function,personality,adaptability,etc.The body mass index was negatively correlated with the score of the sub-rlung scale(r=−0.376),slightly positively correlated with the sub-mkhris pa scale(r=0.099),and positively correlated with the sub-bad kan scale(r=0.362).Conclusion:The TMCS is a reliable and valid instrument that can be used to assess the body constitution of the general population in Beijing,China.Future studies are needed to explore the differences in biological characteristics among the constitutional types and the association between constitution and disease.
基金This work was supported by funding from the Chengdu University of Traditional Chinese Medicine(Grant no:RWQN1410).
文摘Background:This study aimed to determine the prevalence and predictive factors of prolonged grief disorder(PGD)among those bereaved by the Wenchuan earthquake in Southwestern China seven years after the event.Methods:A cross-sectional survey based on census tracts was conducted on the bereaved earthquake survivors.Responses to the questionnaire regarding PGD and its potential associated factors were obtained either through face-to-face or telephone interview.PGD was screened by a validated Chinese version of the PGD questionnaire-13(PG-13).Bivariate and multivariate regression analyses were used to determine the prevalence and associated risk factors of PGD.Results:A total of 1464 bereaved earthquake survivors,with a response rate of 97.6%,were included in the study.Of the 1464 respondents studied,124(8.47%)were diagnosed with PGD.Multivariate regression analysis demonstrated that PGD in the bereaved earthquake individuals was significantly associated with several factors,including age,economic burden,close kinship with the deceased,and living with the deceased before the loss.Wenchuan earthquake bereaved aged 41e60 years were more likely to develop PGD compared to those aged younger than 40 or older than 60(OR=2.075,95%CI=1.297e3.319).Those who had a close kinship with the deceased had a higher tendency to develop PGD(OR=5.144,95%CI=2.716e9.740).The odds of PGD among the earthquake bereaved with economic burdens were higher relative to those who did not experience an economic burden(OR=8.123,95%CI=2.657e24.831).Those who living with the deceased before loss also had a higher tendency to develop PGD(OR=0.179,95%CI=0.053e0.602).Conclusions:This study revealed that a significantly high proportion(8.47%)of the Wenchuan earthquake-bereaved remain grieving seven years after the event.Those diagnosed with PGD should receive appropriate interventions from clinical psychologists.The risk factors identified in this study are crucial for the early screening and prevention of PGD in future nursing and psycho-clinical practices.
文摘Early drinking is considered to result in making tolerant of alcohol consumption and a higher prevalence of alcohol related disorders in the later. We focused generational impacts on drinking rate among high school students based on multiple nationwide data. The surveys were nationwide, cross-sectional random sampling surveys given every 4 years from the Japanese Youth Tobacco and Alcohol Surveys, 1996 to 2008. Participants were male 53,925 high school students from 7th grade to 11th grade. We divided to the three follow-up groups every 4 years from 1996 to 2004 for male junior high school students in 7th grades and the end periods were 4 years later in 11th grades. Outcome measures in this study were life time drinking, current drinking within 30 days and weekly drinking. All drinking rates decreased each at 7th and at 11th grade. The increments in these drinking rates from 7th grade to 11th grade in males decreased gradually in recent follow-up groups. Generational impacts should be considered by using follow-up groups to study drinking behaviors among students.
