东莞地区青、中年慢性病患者用药依从性及影响因素调查

目的本调查旨在探讨东莞地区青、中年慢性病患者用药依从性情况,并分析影响其用药依从性的因素,为该地区青、中年慢性病患者用药管理提供有效的参考依据。方法2022年1月至2022年12月通过问卷调查的方式对该地区青、中年慢性病患者采用方便抽样法进行横断面调查,并对问卷相关结果进行统计分析。结果本次纳入研究的青、中年慢性病患者共5206人,其中Morisky量表平均得分为(1.81±1.48)分,用药依从性高的仅占27.01%;K10量表平均得分为(18.23±5.89)分,大部分患者的心理健康状况都在较好以上。年龄50~59岁患者Morisky量表得分低于18~29岁患者;文化程度为小学的患者Morisky量表得分低于文化程度为大专以上的患者;无医保患者Morisky量表得分低于有医保患者;医疗服务态度对Morisky量表得分具有显著主效应(F=83.072,P<0.001),就医便利程度对Morisky量表得分具有显著主效应(F=10.185,P<0.001)。结论该地区青、中年患者用药依从性较低,且与年龄、文化程度、参与医保情况、心理健康状况、医疗服务态度以及就医便利程度等多种因素相关联,应根据这些因素的特点,采取有效的干预措施,以增强该群体用药依从性。

Changing patterns of colorectal cancer in China over a period of 20 years

AIM： To determine whether any changes have occurred on the patterns of colorectal cancer in China. METHODS： Data from 21 Chinese articles published from 1980 to 1999, were used to analyze the time trend of colorectal cancer according to the patients＇age at diagnosis, sex, the site of the tumor, stage, and the pathology. RESULTS： From 1980s to 1990s, the mean age of the colorectal cancer patients has increased. The percentage of the female patients rose. The distribution of colorectal carcinoma shows a predominance of rectal cancer. However, the proportion of proximal colon cancer （induding transverse and ascending colon） increased significantly accompanied by a decline in the percentage of rectal cancer. Similarity in the percentage of distal colon cancer between two decades was revealed. In the 1990s, statistically more Stage B patients were found than those in 1980s. In addition, databases show a significant decrease in the Stage D cases. The proportion of adenocarcinoma increased, but the mucinous adenocarcinoma decreased during two decades. CONCLUSION： These findings indicate that the pattern of colorectal cancer in China has been changing. Especially, a proximal shift due to the increasing proportion of ascending and transverse colon cancer has occurred in China.

Clinicopathologic characteristics of gastric carcinoma in elderly patients: A comparison with young patients

AIM:To examine the clinicopathologic features of elderly patients with gastric carcinoma and to investigate the relationship between prognosis and age.METHODS: We reviewed the hospital records of 2 014patients with gastric carcinoma retrospectively to compare the clinicopathologic findings in elderly (age ＞70 years) and young (age ＜36 years) patients during the period from 1986 to 2000 in a tertiary referral center in Gwangju, Korea. Overall survival was the main outcome measure.RESULTS: Of the 2 014 patients, 194 (9.6%) were in the elderly group and 137 (6.8%) were in the young group.The elderly and young patients had similar distributions with respect to depth of invasion, nodal involvement, hepatic metastasis, peritoneal dissemination, tumor stage at the initial diagnosis, and type of surgery. Synchronous multiple carcinomas were found in 14/194 (7.2%) of the elderly group and 4/137 (2.9%) of the young group (P＜0.05). Using the Borrmann classification, type Ⅳ was more frequent in the young patients than in the elderly patients (P＜0.05).Significantly more elderly patients had a well or moderately differentiated histology, and more young patients had a poorly differentiated histology and signet ring cell carcinoma (P＜0.001). The 5-year survival rates of elderly and young patients did not differ statistically (52.8% vs 46.5%,P = 0.5290). Multivariate analysis showed that the histologic type, nodal involvement and operative curability were significant prognostic factors, and age itself was not an independent prognostic factor of survival for elderly gastric carcinoma patients.CONCLUSION: Elderly patients with gastric carcinoma do not have a worse prognosis than young patients. The important prognostic factor is whether the patients undergo a curative resection.

Increasing prevalence of advanced colonic polyps in young patients undergoing colonoscopy in a referral academic hospital in Hong Kong

AIM： To investigate the distribution and frequency of advanced polyps over eight years.METHODS：6424 colonoscopies were reviewea aunng the study period 1998 to 2005. The study period was subdivided into period I ： 1998 to 2001 and period 11： 2002-2005. RESULTS： 1856 polyps （33% advanced polyps） and 328 CRCs were detected. The mean ages of the patients with advanced polyps and cancer were 69.2 ± 12.0 and 71.6± 13.8 years, respectively. Advanced polyps were mainly lerc sided （59.5%）. Advanced polyps were found in patients ≤60 years from 17.7% in period Ⅰto 26.3% in period Ⅱ（P 〈 0.05）, especially in male subjects ≤60 years （21.6% vs 31.6%, P 〈 0.05）. Advanced tubuloviUous polyps rose from 21.5% in period I to 29.5% in period Ⅱ （P 〈 0.05）. Whereas cancers in male patients ≤ 60 years were similar in both periods： 23.2% vs 16.5% （P 〉 0.05）.CONCLUSION： Advanced polyps increased significantly in the younger male group in the most recent period and there seems to be a shiE towards a proximal location.

Performance comparison of permafrost models in Wudaoliang Basin,Qinghai-Tibet Plateau,China

Knowledge of the spatial distribution of permafrost and the effects of climate on ground temperature are important for land use and infrastructure development on the Qinghai-Tibet Plateau(QTP). Different permafrost models have been developed to simulate the ground temperature and active layer thickness(ALT). In this study, Temperature at Top of Permafrost(TTOP) model, Kudryavtsev model and modified Stefan solution were evaluated against detailed field measurements at four distinct field sites in the Wudaoliang Basin to better understand the applicability of permafrost models. Field data from 2012 to 2014 showed that there were notable differences in observed ground temperatures and ALTs within and among the sites. The TTOP model is relatively simple, however, when driven by averaged input values, it produced more accurate permafrost surface temperature(Tps) than the Kudryavtsev model. The modified Stefan solution resulted in a satisfactory accuracy of 90%, which was better than the Kudryavtsev model for estimating ALTs. The modified Stefan solution had the potential of being applied to climate-change studies in the future. Furthermore, additional field investigations over longer periods focusing on hydrology, which has significant influence on permafrost thaw, are necessary. These efforts should employ advanced measurement techniques to obtain adequate and extensive local parameters that will help improve model accuracy.

Height and weight are correlated with lumbar spinal bone mineral contents and densities in Chinese adolescents with early ankylosing spondylitis

Objective: To explore the possible factors influencing lumbar spinal bone mineral contents and bone mineral densities in Chinese adolescents with early ankylosing spondylitis(AS). Methods: Thirty-one male Chinese adolescent outpatients with early AS were included and compared with 31 age-matched male controls. Age (year), height (cm), total body weight (kg) together with body mass index (BMI, kg/m 2) of all subjects and disease duration (month), BASMI, BASFI, BASDAI, SASSS as well as ESR (mm/h) of AS patients were obtained. Lumbar 2-4 bone mineral content (L 2-4BMC, g) and lumbar 2-4 areal bone mineral density (L 2-4 BMD, g/cm 2) were evaluated using dual-energy X-ray absorptiometry (DEXA) with Lunar DPX-IQ device and lumbar 2-4 volumetric bone mineral apparent density (L 2-4 BMAD, g/cm 3) was subsequently calculated. Correlation and multiple regression analyses were performed. Results: Compared with 31 age-matched male controls, AS patients had significantly lower L 2-4BMD [(0.984±0.142) g/cm 2 vs (1.055±0.137) g/cm 2, P=0.049] and L 2-4BMAD [(0.1527±0.0173) g/cm 3 vs (0.1630±0.0195) g/cm 3, P=0.032]. In AS patients, multiple regression analysis identified that only the factor of height was significantly correlated with L 2-4BMC (R=0.673, P=0.000) and the factor of weight had predominant influences on L 2-4BMD (R=0.620, P=0.000) as well as L 2-4BMAD (R=0.510, P=0.003). Conclusion: The young patients with early AS had marked reduction in lumbar spine bone mineral densities, which indicated an important primary event leading to osteoporosis. Positive effects of height and weight on lumbar spine bone mass and densities could expectantly make favorable contributions to early prevention of AS associated bone loss and subsequent osteoporosis.

100 CASES OF INTRACTABLE MIGRAINE TREATED BY ACUPUNCTURE AND CUPPING

The author has treated 100 cases ofintractable migraine by acupuncture andcupping with satisfactory therapeutic results,as reported as follows.Clinical Data There were 100 cases in this series,including 38 males and 62 females. 8

Juvenile Myasthenia Laryngis Treated by Acupuncture and TCM Medication

Myasthenia laryngis, or laryngoparalysis, oftenoccurs in juvenile teachers, actors or actresses, andmusical school students.

Comparative Analysis on Juvenile Moral Education between China and America

In the 21st Century of the increasing living standards, the social demand for talents with various aspects of ability is becoming higher and higher. The families, study and society of generations after 70s and 80s pay more attention to cultivating their own children＇s comprehensive development. Juvenile moral education is an important part of the contemporary juvenile education. Juvenile moral education is worthy of being paid attention to. On one hand, it is because the juvenile education is in the most basic and critical stage of the whole education stage, which is in the stage of the biggest influence of education development; on the other hand, it is because the young people are active and curious by nature, which will cause the difficulty of moral education to increase in the education process. Various countries and regions in the world have their own unique cultures and adjustments,and these different cultures affect the residents of different countries and regions with different living habits, ways of thinking and behaviors; thus forming different cultural differences. This paper, by taking the juvenile moral education between China and America as the research object, aims at analyzing the Chinese and Western cultural difference in juvenile moral education representation and transmission, aiming at from point to area,promoting the communication and development of juvenile moral education.

Treatment of Urticaria with Cupping at Back-Shu Points——A Report of 40 Cases

Urticaria is a common and frequently encountered disease, which is mainly manifested by extreme pruritus and lumpish eruption of the skin. Acute urticaria with a short disease course can be cured, while the chronic one with repeated attacks is a lingering disorder. In the past few years, 40 cases of urticaria were treated by cupping at the back-shu points of the five zang-organs and Geshu (BL 17). Another 20 cases in the control group were treated with Fang Feng Tong Sheng Wan (防风通圣丸Miraculous Pills of Ledebouriella) and chlorpheniramine maleate. The therapeutic effect in the treatment group was significantly superior to that in the control group. The results are reported as follows.

Attributional Styles in Adolescents with Transfusion-dependent Thalassemia

This study focused on the way that Adolescents with Transfusion- dependent thalassemia explained negative or positive events in their life （Attributional Styles）. It is defined by three dimensions describing the cognitive appraisal of the events： internal-external, stable-unstable, and global-specific. With cross-sectional research design, the observations consist of 102 adolescents （48 males, 54 females） who diagnosed with Transfusion-dependent thalassemia （more than 50 times for blood transfusions） completed the measure of Attributional Styles and Anxiety Questionnaires. The correlations in the predicted directions among variables examine with Pearson product-moment correlation coefficients, t-test, and One-way ANOVA to ascertain a significant between the group differences on attributional factors and levels of anxiety symptoms. The results show that Adolescent samples with higher levels of anxiety revealed statistically significant relationship among three negative attributional dimensions （overall composite F = 4.5, p 〈 0.05; negative composite F = 4.99, p 〈 0.01; negative-internality F = 4.99 p 〈 0.01; negative-stability F = 3.42, p 〈 0.05 and negative-globality F = 3.77, p 〈 0.05）. In addition, significant age- group differences were found for the total negative-globality （t = 2.05, p 〈 0.05） and negative- globality （t = -2.22, p 〈 0.05）. These data are consistent with the reformulated learned helplessness model of depression. In finding, the individuals who attribute negative life events to internal, stable, and global causes will be more vulnerable to anxiety than those who make external, unstable, and specific attributions. Most interestingly, those adolescents more than 17 years evidence more negative-globality attfibutional style than group less than 16 years, and female adolescents may influence this pattern. These results suggest that targeting Adolescents with Transfusion-dependent thalassemia may be important for improving aspect of coping on psychological adjustment to their chronic illness.

One Hundred Cases of Sciatica Treated by Surrounding Puncture

From 1989 to 1995,the authors used the methodof surrounding puncture to treat 100 cases of sciaticaand obtained satisfactory therapeutic results asreported in the following.General DataIn the treatment group,of 100 cases,43 weremale and 57 female with the ages ranging from 15 to26 years,averaging 38 years.The duration of diseasewas from 3 days to 1.5 years,averaging 25 days.Ofthem,76 cases were spinal cord type and 24 nerveroot type;29 cases were diagnosed after CT examand 71 by lateral lumbar vertebra X-ray.

Some Psychosocial Problems of Adolescents in Some Ghanaian Senior High Schools

This research investigated whether there was a significant relationship between the problems of loneliness, inferiority, and identity confusion. Also, to test whether there was a significant relationship between problems of adolescents and their ages and sexes and to ascertain whether there will be a significant difference in sex with regards to these problems, 240 adolescent students from four Senior High Schools were sampled as respondents for the study. Correlations and t-test were used for analyses by employing Statistical Package for Social Sciences （SPSS） version 16. From the results, it appeared that there were highly significant positive correlations existing between the problems. This suggests that the more an adolescent experiences a problem, the higher will he/she experience another problem. Also, it appeared that among the three problems, inferiority had a significant relationship with sex whereas all the problems had a positive significant relationship with age. This suggests that the older an adolescent is, the more severe will he/she experience a problem. Finally, girls tend to experience inferiority more than their male counterparts. This finding also suggested that although problems of adolescents may differ with regards to sex, they are not isolated and therefore multi-factorial in nature.

Palynomorph assemblages from the Fenghuoshan Group,southern Qinghai,China:their age and palaeoenvironmental significance

The varicoloured Fenghuoshan Group occurs widely in the Qiangtang-Hoh Xil region of the northern Qinghai-Xizang Plateau. Few fossils have been found to date in this sedimentary succession because lithological conditions are not conducive to their preservation. As a result, there has been a long-term disagreement among geologists about its age. Despite a few lists of fossil names in individual publi- cations, no detailed research on the palaeontology, including palynology, has been reported previously. In this study, we recovered many pollen grains and spores from two samples that were collected on the northern slope of Fenghuo Moun- tain. They indicate an age no younger than Maastrichtian for the upper part of the Fenghuoshan Group. It is considered likely that the entire Fenghuoshan Group represents deposi- tion between the late Early Cretaceous （possibly Albian） and the Maastrichtian. The palynoflora consists mainly of angio- sperm pollen, gymnosperm pollen and fern and bryophyte spores being subordinate. Pollen grains referable to the Ephedrales and the Taxaceae-Cupressaceae groups dominate the assemblage, implying a warm, arid climate and subtropical forest-shrub vegetation at the time of deposition.

Effect of a Traditional Chinese Medicine combined therapy on adolescent idiopathic scoliosis:a randomized controlled trial

OBJECTIVE:To evaluate the effectiveness of a combined Traditional Chinese Medicine(TCM) therapy versus conventional treatment on adolescent idiopathic scoliosis.METHODS:One hundred twenty outpatients with mild and moderate adolescent idiopathic scoliosis were randomly divided into a TCM group(TCMG)and a brace group(CG).TCMG patients underwent Daoyin,Tuina,and acupotomology therapies.CG patients were treated with a Milwaukee brace.Each patient's Cobb angle was measured after 12 and 24 months of treatment,and pulmonary function was determined after 12 months of treatment.Average electromyogram(AEMG) ratio of the surface electromyogram was measured after 6 and 12 months of treatment and followed-up after 18 and 24 months.RESULTS:The Cobb angle significantly decreased in both groups after 12 months of treatment compared with before treatment(P< 0.05).The percentages of original Cobb angle in TCMG and CG were51.4%and 47.8%(P > 0.05) after 12 months and62.5%and 34.7%(P < 0.05) after 24 months,respectively.Pulmonary function significantly improved after 12 months in TCMG(P < 0.05) but significantly decreased in CG(P < 0.05).The AEMG ratio was significantly lower(P < 0.01) and tended to remain at1 after stopping treatment in TCMG,but increased in CG(P<0.05).CONCLUSION:TCM combined therapy can prevent the progression of scoliosis.The AEMG ratio is a promising index that could replace radiography in the evaluation of treatment effect and progression in scoliosis.