Effect of Body Mass Index on All-cause Mortality and Incidence of Cardiovascular Diseases─Report for Meta-Analysis of Prospective Studies on Optimal Cut-off Points of Body Mass Index in Chinese Adults

Objective To verify the optimal cut-off points for overweight and obesity in Chinese adults based on the relationship of baseline body mass index (BMI) to all-cause mortality, and incidence of cardiovascular diseases from pooled data of Chinese cohorts. Methods The prospective study data of existing cohort studies in China were collected, and the age-adjusted all-cause mortality stratified by BMI were estimated. The similar analysis was repeated after excluding deaths within the first three years of follow-up and after excluding smokers. The incidence of age-adjusted coronary heart disease (CHD) and stroke stratified by BMI were also analyzed. Multiple Cox regression coefficients of BMI for the incidence of CHD and stroke after controlling other risk factors were pooled utilizing the methods of weighting by inverse of variance to reveal whether BMI had independent effect and its strength on the incidence of CHD and stroke. Results The data of 4 cohorts including 76 227 persons, with 745 346 person-years of follow-up were collected and analyzed. The age-adjusted all-cause mortality stratified by BMI showed a U-shaped curve, even after excluding deaths within the first three years of follow-up and excluding smokers. Age-adjusted all-cause mortality increased when BMI was lower than 18.5 and higher than 28. The incidence of CHD and stroke, especially ishemic stroke increased with increasing BMI, this was consistent with parallel increasing of risk factors. Cox regression analysis showed that BMI was an independent risk factor for both CHD and stroke. Each amount of 2 kg/m2 increase in baseline BMI might cause 15.4%, 6.1% and 18.8 % increase in relative risk of CHD, total stroke and ischemic stroke. Reduction of BMI to under 24 might prevent the incidence of CHD by 11% and that of stroke by 15 % for men, and 22 % of both diseases for women. Conclusion BMI ≤18.5, 24-27.9 and ≥28 (kg/m2) is the appropriate cut-off points for underweight, overweight and obesity in Chinese adults.

Discussion on the Prevention and Treatment of COVID-19 Causing Lung Disease and Heart Damage Based on Lei Zhongyi's Theory of Intermingled Phlegm,Blood Stasis and Toxin

Novel coronavirus infection not only damages lung function,but also causes myocardial injury,elevated myocardial enzymes and heart failure,especially for patients with basic heart diseases who develop COVID-19,the first consideration should be the protection of cardiac function.Based on the theory of intermingled phlegm,blood stasis and toxin of heart disease put forward by Master Lei Zhongyi,the dialectical treatment thinking of COVID-19 patients from the concept of damage of phlegm,blood stasis and toxin to the heart were discussed.During the diagnosis,critical stage and recovery period of COVID-19,expectorant and blood-activating agents,heat and detoxification agents can be added to promote lung and asthma,free Bizheng and remove blood stasis,calm the heart and calm the mind,and promote the recovery of cardiopulmonary functions.

Influence of Underlying Diseases and Age on the Association between Obesity and All-Cause Mortality in Post-Middle Age

Background: Studies on the association between obesity and all-cause mortality have found that the degree of obesity is directly proportional to all-cause mortality. In contrast, there have been studies indicating that obese people with underlying diseases have a higher survival rate. We hypothesized that age and underlying diseases lead to such contrasting results. Therefore, we conducted a study to clarify the influence of post-middle age obesity and underlying diseases on all-cause mortality. Methods: This study used data from longitudinal studies in the United States, which conducted follow-up for 19 years on 33,708 participants in different age groups: ≥45, 45 - 64, and ≥65 years. Hazard ratio (HR) was determined using the Cox proportional hazards model to analyze a group consisting of all participants, a group of those with underlying diseases, and a group of those without underlying diseases, considering age, gender, education history, marital status, household income, smoking history, and BMI category as covariates. Results: In the group aged ≥65 without underlying diseases, HR was almost 1 in those with BMI 25 - 35 kg/m2. Further, HR was higher in the 45 - 64 age group without underlying diseases if BMI was >35 kg/m2. However, HR was approximately 1 in the ≥65 age group. Conclusions: The study revealed that among individuals aged ≥65 years without underlying diseases, there was no association between obesity and all-cause mortality. Among individuals without underlying diseases, HR was higher in the 45 - 64 age group with BMI > 35 kg/m2 but was approximately 1 among those aged ≥65 years. Therefore, an interaction based on age was detected. These findings may lead to recommendations regarding the need to modify the advice and education provided to obese individuals in different age groups.

Morbidity and Mortality of Inpatients in the Department of Infectious Diseases of the University Hospital of Bobo-Dioulasso, Burkina Faso

Background: Infectious Diseases are responsible for nearly 17 million annual deaths worldwide. Burkina Faso, like the majority of poor countries, remains vulnerable to infectious diseases. The objective of the present study was to analyze the profile of inpatients, including the mortality and causes of death, in the Infectious Diseases Department of SourôSanou teaching hospital (Bobo-Dioulasso, Burkina Faso). Methods: We carried out a cross-sectional study based on medical records of all inpatients from 2011 to 2015. Results: We included 1169 patients. The gender ratio was 0.8. The age group 30 to 39 was more represented (30.2%) as well as housewives and farmers (73.7%). Over one-thirds of the patients (35.3%) were consulted within an average of 7 days. The most common reason for consultation was fever (65.1%). Around 62.0% of inpatients were infected by the Human Immunodeficiency Virus (HIV). Digestive diseases ranked first (21.8%) followed by nervous system disorders (19.4%) and tuberculosis (17.8%). Overall morbidity rate was 31.3%. About 42% were admitted to the emergency ward while 83.3% already arrived with poor health condition. And 82.1% of deaths occurred on pathological grounds of which 66.7% were related to HIV. Main causes of death included nervous system diseases (28.6%), tuberculosis (21.9%) and gastrointestinal diseases (18.3%). Conclusion: Infectious diseases remain a major public health issue. Further efforts are needed to improve their management in Burkina Faso.

Adverse Effects of Inactivated Foot-and-Mouth Disease Vaccine—Possible Causes Analysis and Countermeasures

Foot-and-mouth disease (FMD) is an infectious and sometimes fatal viral disease that affects cloven-hoofed animals, and Chinese government adopts compulsory immunization measures for FMD. The adverse effects of FMD vaccine to pigs, cattle and goats have been reported increasingly frequent during the spring and autumn seasons when large numbers of farm livestock are vaccinated. The financial losses caused by vaccine adverse effects have been a serious concern for both farmers and primary prevention personnel. There are various causative factors reported to involve into adverse effect of FMD vaccine, including the inappropriate vaccine production, transportation and storage, livestock poor tolerance, and unqualified vaccinating manipulations. Symptomatic treatment and early drug prevention have a certain effect on the adverse effects. To analyze causes and propose countermeasures, in the current study possible reasons during the production and processing procedures of inactivated FMD vaccine were reviewed and corresponding countermeasures were recommended. The review may provide references for better use of vaccine to prevent FMD.

The effects of the environmental factors on Laminaria disease caused by alginic acid decomposing bacteria

-The rot disease of Laminaria occurs often in nurseries of sporeling and commercial cultivation in the sea and results in economic loss greatly. Usually the disease outbreaks accompanied with massive multiplication of alginic acid decomposing bacteria. From the section of the decaying Lamuutria which resulted from the inoculation of alginic acid decomposing bacteria, it was observed that the bacteria invaded the epiderm of the Laminaria surface at first, then entered the ex-odermis, endodermis and pith. In addition, there were a great amount of bacteria in the intercellular region and a lot of free cells of the algae in the decaying areas. The wall of some free cells was decomposed, which led to soft tissue or disintegration. Alginic acid decomposing bacteria are normal epiphytic microorganisms growing on Lamuutria surface. These bacteria do not cause disease at normal environmental conditions. The experiments showed that the unfavourable conditions, e. g. , wounding, overcrowding, high temperature reduced the ability of antibacterial activity and made the algae more susceptible to the pathogens and favoured the multiplication of alginic acid decomposing bacteria and finally led to the disease outbreak. The unfavourable environmental factors which resulted from a variety of reasons were the main cause of the disease.

老年人群骨关节疾病流行特征及其影响因素研究

背景骨关节疾病是老年人群常见、多发的慢性疾病,其与更高的死亡率、更多的致残率、功能状态的下降和较低的生命质量显著相关,产生巨大的疾病负担。目前尚无河南省该病流行情况及其影响因素的研究。目的了解河南省老年人群骨关节疾病流行特征及其影响因素,为其实施精准防控提供科学依据。方法采用多阶段随机整群抽样方法,通过调查问卷、医学体检、实验室检测等方法,获取2018年河南省≥18岁常住居民人口学特征、既往疾病史、身体活动及身体指标等,本研究纳入1055名≥60岁居民为研究对象。运用多因素Logistic回归分析探讨河南省不同特征老年人群骨关节疾病特征及其影响因素。结果2018年河南省老年人群骨关节疾病患病率(加权后)为28.13%(95%CI=28.10%~28.15%)。其中女性、城市、超重或肥胖、中心性肥胖、血脂异常或高脂血症、无吸烟史、有打鼾史、中等强度活动的老年人群骨关节疾病患病率更高(P<0.05)。多因素Logistic回归分析显示,男性(OR=0.717,95%CI=0.550~0.933,P=0.013)是老年人群骨关节疾病的保护因素;超重或肥胖(OR=1.329,95%CI=1.050~1.684,P=0.018)、中心性肥胖(OR=1.305,95%CI=1.047~1.626,P=0.018)是老年人群骨关节疾病的危险因素。结论河南省老年人群骨关节疾病与性别、BMI和中心性肥胖相关,应对老年人群中女性、超重或肥胖和中心性肥胖者开展针对性健康教育及综合干预。

预后营养指数对腹膜透析患者心血管疾病死亡的影响:一项多中心回顾性队列研究

背景心血管疾病(CVD)是腹膜透析(PD)患者死亡的主要原因,而营养不良是PD患者发生CVD及死亡的重要危险因素之一。预后营养指数(PNI)作为一种综合评估患者免疫、炎症和营养状态的指标,因其具有便利性与可靠性等优点,在肿瘤等多种疾病的预后评估中得到了广泛应用。然而,不同时间点的营养状态与PD患者预后之间的关系仍有待进一步探究。目的探讨PD患者首年PNI与CVD死亡之间的关系。方法本研究为多中心、回顾性观察性队列研究,纳入2000-01-01—2019-07-01在南方医科大学南方医院、南方医科大学顺德医院、佛山市第一人民医院以及赣州市人民医院4所中心置管并开始接受PD治疗的1640例PD患者作为研究对象。对患者进行随访,随访截止时间为2021-07-01,终点事件为CVD死亡并记录患者生存时间及具体死亡原因。应用限制性立方条图(RCS)分析PNI与PD患者CVD死亡风险之间的非线性关联;采用Kaplan-Meier法绘制PD患者的生存曲线,绘制PNI预测PD患者CVD死亡的受试者工作特征(ROC)曲线,并根据最佳截断值(cut-off=40.46)将患者分为低PNI组703例与高PNI组937例;采用Log-rank检验和Cox风险回归模型分析探讨PNI对PD患者CVD死亡的影响。结果本研究中位随访时间为30个月,随访期间共148例患者死亡,其中CVD死亡73例(49.32%)。RCS结果表明,PNI与CVD死亡事件呈线性关联(P for Nonlinear=0.655)。ROC曲线显示,PNI预测PD患者CVD死亡的曲线下面积(AUC)为0.717(95%CI=0.659~0.775,P<0.001),灵敏度为74.0%,特异度为58.6%。Kaplan-Meier生存分析结果显示,低PNI组CVD生存率低于高PNI组(χ^(2)=26.685,P<0.001)。多因素Cox风险回归模型分析,校正性别、年龄及CVD病史等混杂因素后,低PNI组仍是CVD死亡的独立预测因素(HR=7.76,95%CI=1.72~35.06,P=0.008),亚组分析结果仍稳健,无明显交互作用。结论PNI降低是PD患者CVD死亡的独立影响因素,PD首年PNI评分在评估PD患者预后有一定的指导意义。

Occurrence of Rice Dry Straight Head Disease and Its Control

[Objective] Cause of disease and control measures of rice dry straight head disease in Chuzhou area was discussed. [Method] Field investigation and comprehensive analysis of the literature were conducted to study the reason of dry straight head disease in Chuzhou area, some common control measures were summarized. [Result] The characteristic of main symptoms included incidence of single plant, incidence of cluster, inclusive incidence between clusters. Sporadic normal rice grains existed in diseased spikes under the incidence of grains. The main pathogenic factors of dry straight head disease were concentration of arsenic or lack of elements, belonging to physiological disease, while the effect of other pathogenic factors could not be excluded. Heavy application of organic fertilizer and crop rotation should be conducted, white soil field should be paid more attention about the changes of disease condition with more wet and dry roasting over fields. Application time of micro fertilizer should be chosen properly, while tillering final stage and pollen formation stage must be adjusted to avoid high temperature, irrigation management should also be improved. [Conclusion] The study could provide reference for preventing rice dry straight head disease.

POSSIBLE HYDROGEOCHEMICAL PRECONDITIONS FOR KASHIN－BECK DISEASE IN TRANSBAIKALIA

In the basin of the Amur River at the territory of Russia, in the northern regions of China and Korea the osteal-articulate disease of people and animals, well known as Kashin-Beck disease is spread. About 20 hypotheses had been suggested for explaining the disease causes. some of them are briefly introduced. The hydrogeochemical researches in Transbaikalia. Russia, showed that natural water of the endemic areas have several features in chemical composition.some of them are considered by existing hypotheses as the causes of the disease.others do not concern the possible etiologic factors of the disease for the present. The author examines these features respectively.

Other Possible Causes of a Well-Publicized Outbreak of <i>Pseudomonas aeruginosa</i>Following Arthroscopy in Texas

Background: Seven patients at a hospital in Houston, TX, were diagnosed during a two-week period in 2009 with joint space infection of pansusceptible P. aeruginosa following arthroscopic procedures of the knee or shoulder. Tosh et al. (2011), who investigated and published the principal report discussing this bacterial outbreak, conclude that its most likely cause was the improper reprocessing of certain reusable, physically-complex, heat-stable arthroscopic instruments used during these arthroscopic procedures. These reusable instruments reportedly remained contaminated with remnant tissue, despite diligent efforts by the hospital to clean their internal structures. This retained bioburden presumably shielded the outbreak’s strain of embedded P. aeruginosa from contact with the pressurized steam, reportedly resulting in ineffective sterilization of these arthroscopic instruments and bacterial transmission. Objectives: First, to clarify which specific sterilization methods, in addition to steam sterilization, Methodist Hospital employed to process its reusable arthroscopic instrumentation at the time of its outbreak, in 2009;second, to evaluate Tosh et al.’s (2011) conclusion that ineffective steam sterilization due to inadequate cleaning was the most likely cause of this hospital’s outbreak;third, to consider whether any other hitherto unrecognized factors could have plausibly contributed to this outbreak;and, fourth, to assess whether any additional recommendations might be warranted to prevent disease transmission following arthroscopic procedures. Methods: The medical literature was reviewed;some of the principles of quality assurance, engineering and a root-cause analysis were employed;and Tosh et al.’s (2011) findings and conclusions were reviewed and compared with those of other published reports that evaluated the risk of disease transmission associated with the steam sterilization of physically-complex, heat-stable, soiled surgical instruments. Results and Conclusion: Reports documenting outbreaks of P. aeruginosa or another vegetative bacterium associated with the steam sterilization of inadequately cleaned surgical or arthroscopic instruments are scant. This finding—coupled with a number of published studies demonstrating the effective steam sterilization of complex instruments contaminated with vegetative bacteria mixed with organic debris, or, in one published series of tests, with resistant bacterial endospores coated with hydraulic fluid—raises for discussion whether Methodist Hospital’s outbreak might have been due to one or more factors other than, or in addition to, that which Tosh et al. (2011) conclude was its most likely cause. An example of such a factor not ruled out by Tosh et al. (2011) findings would be the re-contamination of the implicated arthroscopic instruments after sterilization. The specific methods that Methodist Hospital employed at the time of its outbreak to sterilize some of its arthroscopic instrumentation remain unclear. A number of additional recommendations are provided to prevent disease transmission following arthroscopic procedures.

Trends of Ten Leading Causes of Death in Head and Neck Squamous Cell Carcinoma

Objective:An understanding of the leading causes of death in patients with head and neck squamous cell carcinoma(HNSCC)would be helpful to inform doctors,patients,and healthcare providers on disease management.This study aimed to comprehensively study the leading causes of death in these survivors.

Mortality from chronic liver disease:Recent trends and impact of the COVID-19 pandemic

Prepandemic time trends in mortality from chronic liver disease(CLD)differed according to specific cause of death(decreasing for liver cirrhosis,stable or increasing for liver cancer),etiology(increasing for nonalcoholic fatty liver disease,generally decreasing for other etiologies),and world region(decreasing in areas with the highest burden of hepatitis B virus,increasing in Eastern Europe and other countries).The coronavirus disease 2019(COVID-19)pandemic affected mortality of patients with CLD both directly,with a higher risk for severe illness and death depending on age,stage and etiology of the disease,and indirectly,through social isolation and loss of support,harmful drinking,and difficulties in access to care.Nevertheless,only sparse data are available on variations in CLD as a cause of death during the pandemic.In the USA,in 2020-2021 a growth in mortality was registered for all liver diseases,more marked for alcoholic liver disease,especially among young people aged 25-44 years and in selected ethnic groups.COVID-19 related deaths accounted only for a minor part of the excess.Further data from mortality registers of other countries are warranted,preferably adopting the so-called multiple cause-of-death approach,and extended to deaths attributed to viral hepatitis and liver cancer.

Erratum to “Is Alzheimer’s Disease an Adaptability Disorder? What Role Does Happiness Have in Treatment, Management and Prevention” [World Journal of Neuroscience 5 (2015) 180-188]

A case presentation indicating the importance of “happiness” in childhood causing memory block until the patent presented with probable mixed vascular and neurodegenerative memory loss at 60 years of age is presented to highlight the role of emotional factors in causing the disease. The question of whether Alzheimer’s disease is an adaptability disorder is raised, given the patient blocked out her memory of her childhood experience. The importance of “happiness” as a treatment goal raises issues of advocacy and Guardianship as well as capacity, which is addressed by actual case reference and court action in defence of the patient’s rights to have their wishes respected and observed. Functional mental capacity assessment, using the Functional Mental State Measure (FMSM) gives a greater indication of neuronal reserve than standard cognitive testing, as it helps to unravel the dilemma associated with pure cognitive assessment in Alzheimer’s Disease as well as vascular dementia patients and patients who, despite retained and intact functional capacity and ability to express their wishes, i.e. “best interest”, are “wrongly” placed under Guardianship. A General Systems approach, which recognises functional interaction as optimal and withdrawal or inadequate and/or inappropriate response as not, provides further understanding of the relationship between emotional factors, memory and neurodegenerative (Alzheimer’s) disease.

Is Alzheimer’s Disease an Adaptability Disorder? What Role Does Happiness Have in Treatment, Management and Prevention

A case presentation indicating the importance of “happiness” in childhood causing memory block until the patent presented with probable mixed vascular and neurodegenerative memory loss at 60 years of age is presented to highlight the role of emotional factors in causing the disease. The question of whether Alzheimer’s disease is an adaptability disorder is raised, given the patient blocked out her memory of her childhood experience. The importance of “happiness” as a treatment goal raises issues of advocacy and Guardianship as well as capacity, which is addressed by actual case reference and court action in defence of the patient’s rights to have their wishes respected and observed. Functional mental capacity assessment, using the Functional Mental State Measure (FMSM) gives a greater indication of neuronal reserve than standard cognitive testing, as it helps to unravel the dilemma associated with pure cognitive assessment in Alzheimer’s Disease as well as vascular dementia patients and patients who, despite retained and intact functional capacity and ability to express their wishes, i.e. “best interest”, are “wrongly” placed under Guardianship. Maladaptive responses, to control the change in external environment that are sensed or perceived, and which lead to disorder or to susceptibility to disease, exemplify a General Systems Theory approach, in which appropriate and adequate responses to environmental change, in behavioural terms, by a person, whether independently, or as the recipient or giver, or both, leads to functional interaction and happiness.

The Resolution of the Mysterious Plum Pox Phenomena Caused by Plum Pox Potyvirus

Plum pox potyvirus, also known as Sharka, is a disease of plum, first registered in Bulgaria, 100 years ago. The official scientific opinion is the plum tree should be cut, pulled out of the ground and not to plant anything in that place for five years. The research was directed at plants so the cause was sought in a virus considered to be cancer. However, a single phenomenon that, for instance, there is only a healthy plum tree among the infected ones, that it blossoms on a hill but not at the foot hill, and during the dry and rainy year, contributed to the fact that there are many dilemmas and mystifications in searching for the cause of the disease. New theory proves to be the cause of diseases lies in the soil i.e., in acid rains, that the disease could be cured and it is noncommunicable. At work ＂the resolution of mysterious plum pox phenomena caused by PPV＂ on the concrete examples, there were answers to all questions known to author during the specific period of time （during the war in Bosnia and Herzegovina）.

AN ANALYSIS FOR DEATH CAUSES IN 45 CASES OF LIVER CANCER TREATED WITH TRADITIONAL CHINESE DRUGS

Among the 165 cases of late-stage liver cancer treated in our hospital,65(39.4%)died,with an average survival time of 8.1 months and a median survival time of 7 months.Among the 65 dead patients,45 were treated with traditional Chinese drugs and 20 withwestern medicine.The average survival time was 8.4 months in the former and 7.3months in the latter group.The direct causes of death for the 65 patients were hepaticcoma,severe hemorrhage of the upper digestive tract,Heyd’s syndrome,hepatorrhexis,respiratory failure,cardiac failure,etc.The incidence rates of hemorrhage of the upperdigestive tract and hepatorrhexis in the 45 patients treated with traditional Chinese drugswere obviously lower than those treated with western medicine.

基层老年慢性病患者心血管疾病综合发生风险的影响因素研究

背景心血管疾病是造成我国居民死亡和疾病负担的首要病因,防控形势严峻。心血管疾病风险影响因素管理是预防心血管疾病的重要基础。但目前国内外应用单导联可穿戴心电设备针对基层老年慢性病患者心血管疾病发生风险的影响因素调查研究较少,且在既往研究中也未以整体观对患者包含不同数量风险的变量重要性进行排序。目的分析基层管理的65岁以上老年慢性病患者心血管疾病综合发生风险的影响因素,为基层心血管疾病综合防控提供客观依据及帮助。方法选取2021年12月—2022年9月宁夏回族自治区26家基层医疗卫生机构的3039例65岁以上+高血压、糖尿病、冠心病其中至少1种慢性病的患者为研究对象。依据72 h心电图分析结果划分为正常组632例、风险组2407例。分析两组患者基本资料,确定最佳λ值,绘制模型,采用LASSO回归和多因素Logistic回归分析探讨老年慢性病患者心血管疾病综合风险影响因素;并对影响心血管疾病综合风险及包含不同数量风险的变量排序。结果两组患者年龄、性别、BMI、教育程度、职业、城乡分布、吸烟、运动、冠心病+糖尿病、高血压+冠心病及糖尿病比较,差异均有统计学意义(P<0.05);最佳λ值为0.01568531。LASSO回归和多因素Logistic回归模型分析显示年龄、BMI、城乡分布、吸烟、高血压+冠心病+糖尿病是心血管疾病综合风险的影响因素(P<0.05)。受试者工作特征曲线下面积(AUC)=0.650(95%CI=0.627~0.673,P<0.001)。影响综合风险及不同数量风险种类变量排序前五位的分别为:年龄、BMI、城乡分布、饮茶、运动;年龄、高血压+冠心病、性别、城乡分布、吸烟;年龄、高血压+冠心病、性别、BMI、城乡分布;糖尿病+冠心病、年龄、高血压+冠心病、高血压+冠心病+糖尿病、高血压+糖尿病。结论年龄、BMI、城乡分布、吸烟、高血压合并冠心病及糖尿病是65岁以上+慢性病患者发生心血管疾病风险的影响因素。除年龄外,BMI及生活习惯对心血管疾病综合风险的发生影响较为重要,随着+风险种类数量的增多,慢性病尤其慢性病共病的影响增强。基层医护团队应以单导联可穿戴设备为载体定期对老年慢性病患者进行心血管疾病综合发生风险管理,其不但可高效、低成本的实现心血管疾病发生风险的一级、二级预防及健康管理,并可加速基层医疗服务应加快从不连贯的诊疗服务向全程健康管理的转变。

社区规范管理稳定性冠心病患者运动耐量情况及其影响因素分析

背景稳定性冠心病(SCAD)患者冠状动脉硬化狭窄、斑块破裂形成血栓的风险高,再发心血管事件概率高,是反复住院的重要原因。发达国家通过运动康复为主的心脏康复使得本国心血管疾病的发生率、死亡率、再入院率明显下降,医疗费用降低。目的调查首都医科大学附属复兴医院月坛社区卫生服务中心规范管理SCAD患者运动耐量及其影响因素,为后期社区心脏康复提供科学依据。方法2020年1月,通过整群抽样在首都医科大学附属复兴医院月坛社区卫生服务中心卫生信息系统(CHIS)(医生工作站)选取规范管理、75岁以下SCAD患者980例,采用自行设计问卷[包括一般资料调查表、退伍军人特定活动问卷(VSAQ)等]对其进行调查。依据VSAQ测得的代谢当量(METs)值者分为运动耐量≤7.0 METs组和运动耐量>7.0 METs组,比较不同运动耐量SCAD患者临床资料的差异,采用Logistic回归分析探讨SCAD患者运动耐量的影响因素。结果980例SCAD患者中,运动耐量>7.0 METs者108例(11.0%),5.0~7.0 METs者619例(63.2%),<5.0 METs者253例(25.8%);运动耐量≤7.0METs组SCAD患者的性别、年龄、PCI术接受情况、糖尿病患病情况、血压达标情况、规律运动情况、运动强度水平、每次运动时间与运动耐量>7.0 METs组比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,性别、年龄、是否患有糖尿病、血压控制是否达标、是否规律运动、运动强度是SCAD患者运动耐量的影响因素(P<0.05)。结论SCAD患者有运动意识,但运动耐量整体水平较低(≤7.0 METs),缺乏运动指导,建议通过运动康复,提高运动耐量,从而改善其生活质量。

玉林市第一人民医院2013-2021年住院死亡病例分析

目的分析影响人民生命安全的主要疾病及影响因素,为预防疾病和提高医院医疗质量提供科学依据。方法通过病案管理系统导出广西壮族自治区玉林市第一人民医院2013年1月1日至2021年12月31日的住院患者的信息,采用SPSS 26.0统计软件对住院死亡患者的病案进行回顾性统计分析。结果各年度病死率呈下降趋势,男性病死率高于女性(P<0.05)。死亡年龄平均(56.29±22.97)岁,60~<80岁死亡人数最多;各年龄段死亡患者性别比例:40~<60岁男女死亡比例最高,整体男女死亡比例为2.0∶1.0;随着年龄的增长,病死率不断升高(P<0.05)。前5位死因依次为循环系统疾病、肿瘤、损伤、中毒和外因的某些其他后果及呼吸系统、消化系统疾病;其中循环系统疾病的前3位死因依次为脑出血、心肌梗死、脑梗死,肿瘤的前3位死因依次为肝恶性肿瘤、肺恶性肿瘤、白血病。首要死因:0~<20岁是损伤、中毒和外因的某些其他后果;20~<60岁是肿瘤;≥60岁是循环系统疾病。结论广西壮族自治区玉林市第一人民医院住院患者的病死率逐年下降,病死率具有性别差异和年龄差异,依据死因分析,应加强循环系统疾病、肿瘤、损伤、中毒和外因的某些其他后果及呼吸系统、消化系统疾病的防治工作,提升医院管理,降低住院患者病死率。