成人哮喘生命质量询问表制定与初步应用分析

５１名成年哮喘病人参加哮喘生命质量询问表原始表的项目筛选，结果发现在原始表的七个因子９７条项目中，选择各项目的病例数和该项目受哮喘的影响程度明显不同，频度或评分高的项目主要分布于哮喘症状、对刺激原的反应、活动受限和心理功能状态等因子中。活动受限因子的评分与性别、年龄和用药情况均有关，其它部分因子则仅仅与年龄、性别或用药情况三项中一项有关。根据筛选结果制定ＡＱＬＯ初表，包项五项因子３５条项目，采用七分制评定。

温针治疗神经根型颈椎病疗效观察

目的采用麦吉疼痛询问量表(McGill Pain Questionnaire, MPQ)观察陆氏温针治疗神经根型颈椎病的临床疗效。方法采用随机、对照的研究方法,将患者随机分为针刺组、温针组和温针补泻组。3组均选择风池、天柱、大杼、列缺作为针刺穴位,隔日治疗1次。比较各组患者的临床疗效及治疗前、治疗中期、治疗结束及治疗随访1个月后的MPQ评分,主要观察Mc Gill总评分、PRI评分、VAS评分和PPI评分。结果针刺组、温针组和温针补泻组的总有效率分别为85.3%、94.3%和97.1%,温针补泻组优于针刺组(P<0.05)。3组McGill总评分、PRI评分、PRI情感项评分、VAS评分和PPI评分治疗后各时间点与治疗前比较,均显著减低(P<0.05);3组PRI感觉项评分治疗结束和随访1个月后与治疗前比较均显著降低(P<0.05)。在降低Mc Gill总评分、PRI评分、PRI感觉项评分和PPI评分方面,温针补泻组优于温针组和针刺组(P<0.05);在降低PRI情感项评分、VAS评分方面,温针补泻组、温针组优于针刺组(P<0.05)。结论单纯针刺、温针、温针结合补泻手法治疗神经根型颈椎病均有一定疗效,温针结合补泻手法的整体疗效更好。

生活事件评分方法作为心理症状学指标的比较研究

生活事件调查表(LES)的七种评分方法,对其以简要症状询问表(BSI)测定时,何种方法作为心理症状学指标最为优越作了比较研究。除根据个人正性生活事件评分方法外,其他六种方法都与症状学有显著相关性。而以个人负性生活事件评分较之其他评分方法作为指标显得更为优异。从这些结果可得出以下结论:(1)

How to improve patient satisfaction during midazolam sedation for gastrointestinal endoscopy?

To determine the procedure-related factors that affect sedation satisfaction and to make a suggestion to improve it.METHODSWe prospectively enrolled a total of 456 patients who underwent outpatient endoscopy procedures with midazolam sedation between March 2014 and August 2014. All patients completed both pre- and post-endoscopy questionnaires about sedation expectations and satisfaction.RESULTSThe study cohort included 167 (36.6%) patients who underwent esophagogastroduodenoscopy (EGD), 167 (36.6%) who underwent colonoscopy, and 122 (26.8%) who underwent a combined procedure (EGD and colonoscopy). Over 80% of all patients were satisfied with sedation using midazolam. In univariate and multivariate analyses, total procedure time in the EGD group, younger age (≤ 50 years), and longer colonoscopy withdrawal time in the colonoscopy group were related to decreased satisfaction with sedation. However, in active monitoring and intervention group, there was no decrease in grade of satisfaction despite longer procedure time due to more procedures during colonoscopy. Younger age (≤ 50 years), longer inter-procedure time gap, and colonoscopy withdrawal time were related to decreased satisfaction in the combined EGD and colonoscopy group.CONCLUSIONMidazolam is still a safe and effective sedative for gastrointestinal endoscopy. Satisfaction with sedation depends on several factors including age (≤ 50 years) and procedure time duration. To improve patient satisfaction with sedation, active monitoring of sedation status by the endoscopist should be considered for patients who require long procedure time.

Validation of Veterans Specific Activity Questionnaire to assess exercise tolerance of Chinese elderly with coronary heart disease

Objective The Veterans Specific Activity Questionnaire （VSAQ） has been used to assess exercise tolerance. Nevertheless, there is no val- idated Chinese version. The aim of this study is to determine whether a questionnaire-based method using the Chinese version of VSAQ （the modified VSAQ） is a practical tool to assess exercise tolerance of Chinese elderly with coronary heart disease. Methods One hundred thirty consecutive elderly patients who were diagnosed with coronary heart disease （CHD） （mean age 68.9 -4- 6.0 years） referred for treadmill exercise testing （TET） for clinical reasons were included in the study. They were asked to complete a questionnaire for clinical characteristics information on age, sex, history, exercise habits, medications, the original VSAQ and the modified VSAQ. We investigated the relationship between exer- cise tolerance in metabolic equivalents （METs） estimated by VSAQ and that obtained by TET. Results The METs by the original VSAQ and the modified VSAQ did not difference significantly （P = 0.528）. The modified VSAQ scores were significantly correlated with the METs oh- mined by TET （r = 0.819, 95% CI： 0.7534）.873, P 〈 0.01）, and the scores of original VSAQ also correlated with the METs by TET （r = 0.804, 95% CI： 0.7454）.854, P 〈 0.01）. The Bland-Altman graph analysis showed few values outside the limits of agrcement, suggesting good precision between the METs estimated by questionnaire and the METs obtained by TET. Conclusions The Chinese version of the VSAQ confirmed its validity and equivalence to the original version, especially when evaluating individuals with coronary heart disease and older adults. The results showed that the VSAQ is a valuable tool to assess the exercise tolerance.

KING GEORGE ISLAND GIS (KGIS) PROJECT OF WGGGI——A STATE OF THE ART

The presentation contains information on existing geodetic data for King George Island obtained from the questionnaires distributed among the members of the WGGGI.

Estimation of quality of life in Cypriot patients with inflammatory bowel disease

AIMTo investigate the health-related quality of life (HRQoL) of patients suffering with idiopathic inflammatory bowel disease (IBD).METHODSThe Greek validated version of the Short Inflammatory Bowel Disease Questionnaire was used for evaluating the quality of life of IBD patients. The questionnaire was distributed to 100 consecutive patients suffering from IBD and presenting for a clinic appointment at the endoscopy unit of Larnaca General Hospital during the period from October to November 2012. The criteria for participating in this study were constituted by the documented diagnosis of either ulcerative colitis (UC) or Crohn&#x02019;s disease (CD) after endoscopy and histologic examination at least 6 months before the study, adult patients (18 years old or older), the capability of verbal communication and the patient&#x02019;s written consent for attending this study. The majority of the questionnaires were completed by a nurse practitioner who specializes in IBD patient care.RESULTSRegarding the physical dimension in patients with UC, males scored significantly higher than females (4.2 vs 3.4, P = 0.023). Higher scores were also observed in UC patients younger than 35 or older than 50 years (4.0 and 4.2 vs 3.2, respectively, P = 0.021). The psychological dimension revealed similar results in patients with UC, with males, and older ages scoring higher (5.0 vs 3.0, P = 0.01 and 4.7 vs 2.7, P &#x0003c; 0.5, respectively), whereas regarding CD higher scores were observed in married compared to unmarried (3.83 vs 2.33, P = 0.042). No statistical differences in any parameters in the social dimension were observed. Regarding the treatment of, patients with CD, overall higher scores were observed when treated with biological factors compared to standard therapy in all dimensions but with statistical significant difference in the social dimension (5.00 vs 3.25, P = 0.045).CONCLUSIONThe study reveals a negative impact of IBD on HRQoL. Increased risks are age and gender in patients with UC and family status in patients with CD.

出院后跟进护理对COPD稳定期病人生活质量的影响

[目的]探析院后跟进护理对慢性阻塞性肺疾病(COPD)稳定期病人生活质量的影响。[方法]抽取2015年3月-2016年3月我科收治的COPD病人86例,随机分为观察组46例和对照组40例。对照组实施常规出院指导,观察组出院后给予院后跟进护理干预。对比两组病人出院后生活质量。[结果]观察组病人出院后6个月生活质量、CAT评分、FEV_1%pred、FEV_1/FVC评分明显优于对照组,差异有统计学意义(P<0.01)。[结论]根据病人不同康复阶段,制订有针对性的院后跟进护理方案,可以提高病人的生活质量。

An Efficient Algorithm for Skyline Queries in Cloud Computing Environments

Skyline query processing has recently received a lot of attention in database and data mining communities. However, most existing algorithms consider how to efficiently process skyline queries from base tables. Obviously, when the data size and the number of skyline queries increase, the time cost of skyline queries will increase exponentially, which will seriously influence the query efficiency. Motivated by the above, in this paper, we consider improving the query efficiency via skyline views and propose a cost-based algorithm(abbr. CA) to efficiently select the optimal set of skyline views for storage. The CA algorithm mainly includes two phases:(i) reduce the skyline views selection to the minimum steiner tree problem and obtain the approximate optimal set AOS of skyline views, and(ii) adjust AOS and produce the final optimal set FOS of skyline views based on the simulated annealing. Moreover, in order to improve the extendibility of the CA algorithm, we implement it based on the map/reduce distributed computation model in cloud computing environments. The detailed theoretical analyses and extensive experiments demonstrate that the CA algorithm is both efficient and effective.

我国南方腰痛和膝痛患病率低于北方:汕头COPCORD研究报告

目的验证20世纪80年代中国-国际抗风湿联盟(ILAR-China)调查所见,我国南方腰痛(LP)、膝痛(KP)患病率低于北方的结果,并且探讨相关危险因素。方法用社区控制风湿病规划(COPCORD)第Ⅰ、Ⅱ期询问表,对澄海市区16岁以上居民2040名进行调查。有风湿症状者进行体检,疑似关节炎者进行X线和实验室检查。结果风湿痛总患病率为18.1%;KP7.5%,其中55%为膝骨关节炎;LP患病率11.5%,其中69%为腰椎骨关节炎。平房居民KP患病率为5.6%,LP7.9%;而楼房居民KP9.1%,LP16.2%。KP、LP患病率均低于北京所见。结论我国南方KP和LP患病率明显低于北方,推测与气候因素有关。楼房居民KP、LP患病率高于平房居民,可能和人体功率学有关。

Evaluation of a risk factor scoring model in screening for undiagnosed diabetes in China population

Objective:To develop a risk scoring model for screening for undiagnosed type 2 diabetes in Chinese population.Methods:A total of 5348 subjects from two districts of Jinan City,Shandong Province,China were enrolled.Group A (2985) included individuals from east of the city and Group B (2363) from west of the city.Screening questionnaires and a standard oral glucose tolerance test (OGTT) were completed by all subjects.Based on the stepwise logistic regression analysis of Group A,variables were selected to establish the risk scoring model.The validity and effectiveness of this model were evaluated in Group B.Results:Based on stepwise logistic regression analysis performed with data of Group A,variables including age,body mass index (BMI),waist-to-hip ratio (WHR),systolic pressure,diastolic pressure,heart rate,family history of diabetes,and history of high glucose were accepted into the risk scoring model.The risk for having diabetes increased along with aggregate scores.When Youden index was closest to 1,the optimal cutoff value was set up at 51.At this point,the diabetes risk scoring model could identify diabetes patients with a sensitivity of 83.3% and a specificity of 66.5%,making the positive predictive value 12.83% and negative predictive value 98.53%.We compared our model with the Finnish and Danish model and concluded that our model has superior validity in Chinese population.Conclusions:Our diabetes risk scoring model has satisfactory sensitivity and specificity for identifying undiagnosed diabetes in our population,which might be a simple and practical tool suitable for massive diabetes screening.

Current recognition and management of intra-abdominal hypertension and abdominal compartment syndrome among tertiary Chinese intensive care physicians

This survey was designed to clarify the current understanding and clinical management of intra-abdominal hypertension （IAH）/abdominal compartment syndrome （ACS） among intensive care physicians in tertiary Chinese hospitals. A postal twenty-question questionnaire was sent to 141 physicians in different intensive care units （ICUs）. A total of 108 （76.6%） questionnaires were returned. Among these, three quarters worked in combined medical-surgical ICUs and nearly 80% had primary training in internal or emergency medicine. Average ICU beds, annual admission, ICU length of stay, acute physiology and chronic health evaluation （APACHE）II score, and mortality were 18.2 beds, 764.5 cases, 8.3 d, 19.4, and 21.1%, respectively. Of the respondents, 30.6% never measured intra-abdominal pressure （IAP）. Although the vast majority of the ICUs adopted the exclusively transvesicular method, the over- whelming majority （88.0%） only measured lAP when there was a clinical suspicion of IAH/ACS and only 29.3% measured either often or routinely. Moreover, 84.0% used the wrong priming saline volume while 88.0% zeroed at reference points which were not in consistence with the standard method for lAP monitoring recommended by the World Society of Abdominal Compartment Syndrome. ACS was suspected mainly when there was a distended ab- domen （92%）, worsening oliguria （80%）, and increased ventilatory support requirement （68%）. Common causes for IAH/ACS were ＂third-spacing from massive volume resuscitation in different settings＂ （88%）, ＂intra-abdominal bleeding＂, and ＂liver failure with ascites＂ （52% for both）. Though 60% respondents would recommend surgical decompression when the lAP exceeded 25 mmHg, accompanied by signs of organ dysfunction, nearly three quarters of re- spondents preferred diuresis and dialysis. A total of 68% of respondents would recommend paracentesis in the treatment for ACS. In conclusion, urgent systematic education is absolutely necessary for most intensive care physicians in China to help to establish clear diagnostic criteria and appropriate management for these common, but life-threatening, diseases.

Application of Traditional Chinese Medicine in medical practice：a survey of community residents in Beijing,China

OBJECTIVE:To investigate how community residents in Beijing understood and used Traditional Chinese Medicine(TCM) in their medical practice.METHODS:This was a cross-sectional study conducted on 3410 community residents from four large communities of Tongzhou district in Beijng,China.A validated, self-administered questionnaire comprised of three sections was used to gather the data.A systematic sampling procedure was applied to recruit the community residents.RESULTS:A total of 3410 participants completed the questionnaire survey.It showed that in highly educated residents, 33.4%(170) knew of the names of 3-10 Chinese herbals, 35.8%(182) knew of names of 3-10 traditional Chinese patent drug.Among all the respondent residents, 80.7%(2753)believed that TCM herbal therapy and TCM non-drug treatments were effective in disease treatment, health enhancement, 85.7%(2923) had taken traditional Chinese patent drug in their life,56.8%(1937) of residents had used herbal decoction, 40.0%(1365) had received non-drug treatment of TCM, such as acupuncture, massage, cupping, auricular acupuncture.Among the elderly residents, 11.4%(98) often used Chinese patent drug and 9.8%(85) often used herbal decoction.In addition, 70.8%(2415) of residents were willing to accept knowledge and information on TCM for health enhancement and disease prevention, such as medicated diet, medicinal tea, Tai Chi and Qi Gong, although 82.8%(2825) of residents had never used them.CONCLUSION:Chinese patent drug and herbal decoction are widely used in the communities in Beijing, and there existed a possible close correlation between high educational level and better understanding of TCM.Age and occupation also correlated with the attitude to TCM therapies.The characteristics of the residents should be considered seriously in the course of promoting the understanding and application of TCM.

Chertsey Outcome Score for Trauma： Development and validation of a new unifying patient reported outcome measure for orthopaedic trauma

Purpose： Lately there is an increasing tendency of using Patient Reported Outcome Measures （PROMs） as a final indicator of the outcome of many surgical treatments in orthopaedics and in other medical specialties. Currently there are many outcome scores in orthopaedics and most of them are site specific. In the contrary there is a lack of trauma specific outcome scores. Methods： We have designed a new PROM especially for orthopaedic trauma patients, in order to measure in what extent the patients manage to return to their pre-injury state. This score uses as baseline the preinjury status of the patient and has the aim to determine the percentage of rehabilitation after treatment for any injury. Results： A total of 60 Chertsey Outcome Score for Trauma （COST） questionnaires were gathered in our outpatients department. The participants were 57% male （aged 46.81 years ± 18.5 years） and the questionnaires collected at mean 10 months post-injury. A Cronbach＇s Alpha value of 0.89 was identified for the whole construct. The three dimensions of the scale had good internal consistency as well （Cronbach＇s Alpha test values 0.74, 0.84 and 0.81 for symptoms, function and mental status respectively）. Strong/moderate correlation （Spearman＇s Rho test 0.43-0.65） was observed between the respective physical/mental dimensions of the COST and SF-12v2 questionnaires. Conclusion： There is a need among the orthopaedic trauma society for a specific PROM of trauma. COST is a useful and easy to use tool for every trauma surgeon.