Bowel preparation protocol for hospitalized patients ages 50 years or older:A randomized controlled trial

BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires long-term and regular colonoscopies.Uncomfortable bowel preparation is the main reason preventing patients from undergoing regular colonoscopies.The standard bowel preparation regimen of 4-L polyethylene glycol(PEG)is effective but poorly tolerated.AIM To investigate an effective and comfortable bowel preparation regimen for hospitalized patients≥50 years in age.METHODS Patients were randomly assigned to group 1(2-L PEG+30-mL lactulose+a lowresidue diet)or group 2(4-L PEG).Adequate bowel preparation was defined as a Boston bowel preparation scale(BBPS)score of≥6,with a score of≥2 for each segment.Non-inferiority was prespecified with a margin of 10%.Additionally,the degree of comfort was assessed based on the comfort questionnaire.RESULTS The proportion of patients with a BBPS score of≥6 in group 1 was not significantly different from that in group 2,as demonstrated by intention-to-treat(91.2%vs 91.0%,P=0.953)and per-protocol(91.8%vs 91.0%,P=0.802)analyses.Furthermore,in patients≥75 years in age,the proportion of BBPS scores of≥6 in group 1 was not significantly different from that in group 2(90.9%vs 97.0%,P=0.716).Group 1 had higher comfort scores(8.85±1.162 vs 7.59±1.735,P<0.001),longer sleep duration(6.86±1.204 h vs 5.80±1.730 h,P<0.001),and fewer awakenings(1.42±1.183 vs 2.04±1.835,P=0.026)than group 2.CONCLUSION For hospitalized patients≥50 years in age,the bowel preparation regimen comprising 2-L PEG+30-mL lactulose+a low-residue diet produced a cleanse that was as effective as the 4-L PEG regimen and even provided better comfort.

Review of Two Years of Surgical Activities of the General Surgery Department of the Reference Health Center of Commune I of Bamako Mali

The objectives of this work were to evaluate the surgical activities carried out in the general surgery department of the Reference Health Center of Commune I of Bamako, to describe the sociodemographic characteristics of the operated patients, to determine the main pathologies encountered and to evaluate qualitatively the result of the treatment. In order to improve performance, and the quality of care, and to identify common pathologies in the surgical department, we undertook a retrospective study on surgical activities from January 2009 to December 2010. At the end of this study, out of 474 men and 187 women (equal sex ratio 2.53);we were able to determine the frequency of surgical pathologies. Farmers, housewives and pupils/students were the most represented with 25.9% respectively;20% and 13.3%. The most frequently observed pathologies were wall hernia (44.8%), prostate adenoma (12%) and acute appendicitis (10.5%). The average length of hospitalization was 3.43 days. Infectious complications affected 25 patients (3.8% of cases) and a death rate of 0.45% (i.e. 3 patients). The average cost of care was 53,500 FCFA. Indeed, the reality of surgical practice in health centers was not the same because of the level of skills of practicing surgeons.

Effects of Different Planting Years on Physicochemical Properties and Enzyme Activities in Soil of Rice-Cherry Tomato Rotation

Crop rotation periodicity has always been one of the research focuses currently. In this study, the physicochemical properties, nutrient contents and enzyme activities were investigated in soils from rice-cherry tomato rotation for one year (1a), three years (3a), five years (5a), seven years (7a) and ten years (10a), respectively. The major objective was to analyze the optimal rotation years of rice-cherry tomato from soil perspective, so as to provide theoretical basis for effectively avoiding continuous cropping obstacles of cherry tomato via studying the response characteristics of soil physicochemical properties, nutrient contents and enzyme activities to planting years of rice-cherry tomato rotation system. The results were as follows: 1) Soil pH value was increased year by year during 1a to 5a, reached the highest value 5.32 at 5a. However, soil acidity was sharply enhanced during 7a to 10a (P P •kg-1 at 5a. 3) The content of soil available phosphorus was increased year by year with increasing of crop rotation years, and increased by 110% to 173% during 3a to 10a (P P P < 0.05). In conclusion, long-term single rotation pattern of rice-cherry tomato would aggravate soil acidification, prompt soil nutrient imbalance and reduce soil enzyme activity. 5a to 7a would be the appropriate rotation period for rice-cherry tomato, or else it would reduce soil quality, resulting in a new continuous cropping obstacle of cherry tomato.

Improving the Use of Insecticide-Treated Nets among Children under Five Years Old in Benin, West Africa

Background: In Benin, malaria represents the first cause of consultation and hospitalization (48% for children under 5 years old) in health units. It also accounts for 23.1% of deaths recorded in health facilities (MoH, 2019). Between the two main components of vector control adopted by Benin government, the mass distribution campaigns of Insecticide-Treated Nets (ITNs) remained the only proven cost-effective way to rapidly achieve high and equitable coverage (WHO, 2017). After the fourth mass distribution campaign conducted in 2017, the Demographic and Health Survey (DHS) data indicated that the percentage of children who slept under an ITN has increased from 20% in 2006 to 70% in 2011-2012 and to 76% in 2017-2018 while the incidence of malaria (tested positive) is increasing rapidly among children under 5 years old, growing from 36.5% in 2009 to 28.8% in 2012 and then to 51.4% in 2019. This study aims to understand this contrast by identifying the origin of the increase in ITN use over time among children under five years old and the factors which determine this use. Methods: Data from the Demographic and Health Survey (DHS) conducted in Benin respectively in 2006 and in 20018 were used during the analysis, which covered 13,445 children under five years old from 2006 DHS and 12,255 children from 2017-2018 DHS. Firstly, the data were analyzed using decomposition method to highlight the origin of the increase of ITN use over time among children under five years old. Secondly, the chi-square test analysis estimated the association between ITN use and some characteristics (wealth index, maternal or caregiver education level and child age). Finally, the logistic regression model was used to identify the main factors, which influence the net use over the study period. Results: This study shows that the improvement of basic conditions is the main origin of behavior change in the use of ITNs among children under five years old. This improvement of the basic conditions consists of making ITNs available in households and informing household members about the benefits of ITN use. So, the free ITN distribution campaigns, routine distribution, awareness campaigns about the benefits of ITN use are the strategies, which increase the household capacities and knowledge, allowing household members to make their children sleep under net. The analysis also shows that region of residence, wealth index of household, household size, religion, and child age continue to determine the ITN use among children under age 5 years old and MNCP will integrate the factors in malaria prevention strategies in order to achieve universal use of ITNs. Conclusions: Although, sleeping under ITN behavior has indeed spread among children under 5 years old, policymakers and other stakeholders should design strategies to maintain and improve the current level of ITN use to reach the collective protection threshold (80% according to WHO). Therefore, to address the challenges of universal use of ITN, the study recommends expanding the routine distribution system to private sector health centers;discussing issues related to health service utilization (particularly ITN use) within a consultation framework at the communal level. In addition, collecting qualitative and quantitative data in the Oueme region will allow better understanding of all aspects of the ITN use gap among children under 5 years.

The Prevalence and Risk Factors Associated with Otitis Media in Children under Five Years of Age in Mogadishu, Somalia: A Hospital-Based Cross-Sectional Study

Background: Otitis media (OM) is highly prevalent and is one of the most important causes of preventable hearing loss in developing countries and it may have long-term impacts on the children. Several hospital-based cross-sectional studies have been conducted in East African countries to assess the prevalence of OM;however, no similar studies have been conducted in Somalia. Therefore, we conducted a hospital-based cross-sectional study to identify the prevalence and the underlying risk factors of OM among children under the age of five in Mogadishu, Somalia. Methodology: A hospital-based cross-sectional study was conducted from July 2022 to November 2022 at three main hospitals in Mogadishu, Somalia. A total of 384 children aged less than 5 years were included. Parents of these children were interviewed with a questionnaire and a clinical examination was performed for each child. The Statistical Package for Social Sciences, SPSS (Version 22, IBM, Inc.), was used for the statistical analysis. Result: The prevalence of otitis media among the 384 children recruited was 31.25% (120/384). Otitis media was significantly associated with age less than one year (P = 0.006), malnutrition (P Conclusion: In summary, the present study found that otitis media was highly prevalent (31.25%) in Mogadishu, Somalia. The majority of the affected children were younger than one year. Age of the child, malnutrition, upper respiratory tract infections, feeding in lying position, and dripping something into a child’s ear were found to significantly increase the risk of developing otitis media in children. In contrast, breastfeeding for more than one year has been found to reduce the risk of developing otitis media in children.

Wells评分、Geneva评分和YEARS法对疑似肺栓塞住院患者诊断价值的对比研究

目的探讨Wells评分、Geneva评分和YEARS法对疑似肺栓塞(PE)住院患者的诊断价值。方法回顾性分析2017年1月至2020年6月因胸痛、呼吸困难和咯血于湖南省人民医院住院治疗的946例疑似PE患者。记录所有入组患者病史、临床表现和辅助检查结果等指标。入组患者均接受Wells评分、Geneva评分和YEARS法评估。以CT肺血管造影(CTPA)为标准,分析3种评分诊断PE的灵敏度、特异度、准确度和Youden指数,同时将3组评分结果与CTPA结果进行一致性分析,并绘制受试者工作特征曲线(ROC),计算曲线下面积(AUC),评估3种评分系统诊断PE价值。结果 946例患者中CTPA确诊为PE患者257例(27.2%)。Wells评分、 Geneva评分、YEARS法诊断PE灵敏度分别为88.72%、75.88%、93.00%,特异度分别为35.37%、59.36%、25.11%,准确度分别为50.11%、63.85%、43.55%,Youden指数分别为0.24、0.35、0.18。Wells评分、Geneva评分、YEARS法与CTPA的Kappa值分别为0.16、0.28、0.11。3种评分准确度两两比较差异均有显著统计学意义(P<0.01)。Wells评分、Geneva评分、YEARS法诊断PE的AUC分别为0.622±0.019、0.676±0.019、0.591±0.020,其中Geneva评分AUC最大,与Wells评分、YEARS法差异均有统计学意义(P<0.0167),Wells评分与YEARS法差异无统计学意义(P>0.0167)。结论 3种评分对疑似PE住院患者均有一定的诊断价值,Geneva评分整体诊断价值最高,Wells评分和YEARS法诊断均不理想。

Wells评分和YEARS法对肺栓塞诊断价值的比较

目的:探讨深静脉血栓可能性评分(Wells评分)和简便诊断处理可疑肺栓塞(YEARS法)对肺栓塞患者的诊断价值,应用受试者工作特征(ROC)曲线对比Wells评分和YEARS法诊断肺栓塞的曲线下面积(AUC),以期发现更适用于临床的肺栓塞评分方法。方法:选取因疑似肺栓塞的住院患者139例,其中临床确诊肺栓塞患者48例,收集所有入选患者的病史、临床表现和辅助检查等结果,所有入选研究对象均进行Wells评分和YEARS法评估,将肺动脉血管造影(CTPA)作为诊断的金标准,应用SPSS 22.0统计软件分析2组患者Wells评分和YEARS法诊断肺栓塞的灵敏度、特异度、误诊率、漏诊率和准确度,并对Wells评分、YEARS法和CTPA的结果进行一致性分析,进一步绘制Wells评分和YEARS算法诊断肺栓塞的ROC曲线,计算并比较AUC。结果:与YEARS法比较,Wells评分对肺栓塞诊断的特异度和准确度明显升高(P<0.05),误诊率明显降低(P=0.037),而灵敏度和漏诊率差异无统计学意义(P>0.05)。Wells评分与CTPA的Kappa值为0.45,一致性强度为中度;YEARS法与CTPA的Kappa值为0.22,一致性强度尚可;Wells评分与YEARS法的Kappa值为0.11,一致性较差。Wells评分方法诊断肺栓塞的AUC为0.753±0.044 (P<0.01),YEARS法诊断肺栓塞的AUC为0.585±0.049 (P=0.101)。结论:Wells评分在肺栓塞诊断评估方面总体上优于YEARS法。

A Colour TV Documentary Memorable Years——The seven years the Pughs spent in the hydroelectric plant of China

The documentary film is narrated by the first person.

可疑肺栓塞诊断新策略--YEARS评分

肺栓塞是一种误诊率、漏诊率极高的常见肺血管病,早期识别、早期诊治对改善患者预后至关重要。肺动脉造影是确诊肺栓塞的“金标准”,因其昂贵、有创、有辐射暴露风险,在临床已经逐渐被CT肺血管造影取代。但可疑肺栓塞的患者如果未经有效评估,可能导致过度检查及不必要的医疗资源浪费,也增加了患者辐射暴露的风险。为了有效筛查可疑肺栓塞,目前有多种评分模型对可疑肺栓塞进行评估,但传统评分法相对较复杂,不易在临床工作广泛推广使用。YEARS评分是近年来针对可疑肺栓塞进行评估的新型评分模型,其是一种简单、快速的评估肺栓塞可能性的工具,可以安全有效排除可疑肺栓塞患者,该评分标准更为简便,易于记忆和临床推广。但因目前其临床应用研究有限,有待进一步在临床验证该评分的诊断价值。本文就YEARS评分的临床研究做一综述,以期为肺栓塞的诊断提供新思路、新方法。

The ostracod assemblages and their environmental significance in the Chen Co area, southern Tibet in recent 1400 years

The CC1 core, with a length of 216 cm, was drilled in the west part of the Chen Co (Lake) in southern Tibet Plateau. The 210Pb and 137Cs measurement indicated that it was a consecutive sedimentary sequence since ca. 1400 years. The ostracoda and their assemblages under the level of 1 cm samples’ cutting interval were finished for this core to reveal the past environmental changes in the lake area. A total of 15 species of ostracods belonging to 7 genera in the core sediments had been identified. According to the ostracod distributions, abundances and preservations in the core, seven ostracod assemblages had been distinguished. The ostracod assemblages and their ecological features, together with the sediments dating decision were used to infer the past ca. 1400 years environmental changes of the Chen Co environmental evolutions in three stages, which had responded to the Medieval Ages Warm-period (MAW), the Little Ice Age (LIA) and modern warm period. The results show that the changes of the Chen Co environment had been mainly influenced by the climatic variations. The trend of the lake level fluctuations had been accorded with that of climatic variation during the past 1400 years.

The Interdecadal Variation Characteristics of Arctic Sea Ice Cover-ENSO-East Asian Monsoon and Their Interrelationshipat Quasi-Four Years Time Scale

Interdecadal and quasi-four years variation characterstics of Arctic sea for cover, ENSO and East Asian monsoon index(EAMI) are analyzed based on Singular Spectrum Analys. (SSA), lead-lag correlation and EOF for the past four decades. Results show that the Arctic sea for cover decreased in the early 1970s, several years earlier than that of global SSTA increase in the mid 1970s, which indicates that recent warming over the Northern Hemisphere firstly begins in the Arctic region in the 1970s. Great change of the East Asian monsoon intensity from stronger to weaker in summer (from weaker to stronger in winter) took place in the mid 1970s response to the abrupt modulation of SSTA particularly in the tropical eastern Pacific.Focus on the quasi-four years oscillation,close relationship is found among the sea ice cover, ENSO and EAMI based on lead-lag correlation. In which, the correlation coefficient reaches its maximum when the index of NINO3 SSTA variation takes 6 and 9 months lead of the western Pacific subtropical high and sea for cover index in Section-Ⅲ. Their interaction can be explained in the framework of asymmetric Walker circulation anomaly and Western Pacific Northern Pole (WPN) teleconnection pattern in the context of quasi-four years oscillation.

20 years'development of super rice in China--The 20th anniversary of the super rice in China

Rice(Oryza sativa L.)is originated from Asia and more than 90%of rice is produced in Asia.As the most important cereal crop in the world,rice is the staple food for over 1/3global population,while this proportion is over 60%in Asia(Wan 2010).In order to maintain the most important role that rice has played in Asian agriculture and ensure

Association between fundamental motor skills and physical activity in the early years:A systematic review and meta-analysis

Background:Physical activity(PA)in the early years is associated with a range of positive health outcomes.Fundamental motor skill(FMS)competence is associated with PA and is theorized to be driven by PA in the early years and vice versa in mid to late childhood.However,to date,no studies have meta-analyzed the association between PA and FMS in the early years.Methods:Six electronic databases were searched for articles published up to April 2019.Cross-sectional and longitudinal studies were included if they targeted children(ages 3-6 year)as the population of the study and assessed the association between objectively measured PA and FMS.Total FMS,total physical activity(TPA),and moderate-to-vigorous physical activity(MVPA)data were meta-analyzed using a random effects model.Results:We identified 24,815 titles and abstracts.In total,19 studies met the inclusion criteria,including 14 cross-sectional and 4 longitudinal studies,as well as 1 study with cross-sectional and longitudinal analysis.There was a significant but small positive association between FMS and MVPA(r=0.20,95%confidence interval(CI):0.13-0.26)and TPA(r=0.20,95%CI:0.12-0.28).Findings from longitudinal studies revealed that PA drives FMS in early childhood.Mediation was explored in 1 study,which found that perceived motor competence did not mediate the association between FMS and PA.Conclusion:Using a meta-analysis,this study is the first to show a positive association between FMS,MVPA,and TPA in the early years of childhood,suggesting that the association begins at an early age.Limited evidence from longitudinal studies supports the theory that PA drives FMS in the early years of childhood.More evidence is needed from large studies to track PA and FMS until mid to late childhood and to explore the mediators of this association.

National Nutrition and Health Systematic Survey for Children 0–17 Years of Age in China

The main purpose of the National Nutrition and Health Systematic Survey for children 0-17 years of age in China(CNHSC)was to collect basic data on the nutrition,development,and health status for children in different regions across China using evidence-based,reliable,and cost-effective approaches.Children and their parents or guardians from seven regions(south,southwest,north,northwest,eastern,central,and northeast China)in China were recruited.A multi-stage stratified randomized sampling method was used.Two provinces were randomly sampled from each of the seven regions,from which one urban district and one rural country were also randomly sampled,resulting in a total of 28 survey counties/districts.Dietary surveys,health examinations,laboratory testing,and questionnaires were used to collect dietary intake,nutritional status,child development,and health status information.Nutrition,health,and lifestyle assessment of children and their parents was determined using the Knowledge Attitude Practice(KAP)survey.Greater than 100,000 children(38,000 children<6 years of age and 66,000 children6-17 years of age)completed the survey.The survey provided comprehensive data on child nutrition and health status for future studies and will serve as the basis for an integrated nutrition and health improvement strategies proposal for children in China.

标准法、AADD、YEARS、PERC及PEGeD对慢性阻塞性肺疾病并疑诊肺栓塞患者的预测价值比较

目的探讨标准法、AADD(age-adjusted D-dimer)、YEARS、PERC(pulmonary embolism rule-out criteria)及PEGeD(pulmonary embolism graduated d-Dimer)5种肺栓塞风险评估方法,对住院慢性阻塞性肺疾病急性加重期(AECOPD)并疑诊PE患者的预测价值。方法纳入116例因AECOPD住院并疑诊PE患者。以CTPA和/或V/Q的阳性结果作为确诊PE的金标准,使用标准法、AADD、YEARS、PERC及PEGeD5种方法对入组患者进行评估,比较上述评估方法的预测价值。结果116例住院AECOPD疑诊PE患者中确诊PE者共45例,确诊率为38.8%。标准法、AADD、YEARS、PEGeD对住院AECOPD疑诊PE患者的灵敏度、阳性预测值、阳性似然比、特异度、阴性预测值、阴性似然比、Youden指数分别为:(93.3%、45.2%、1.30、28.2%、87.0%、0.24、0.22)、(66.7%、71.4%、3.94、83.1%、79.7%、0.40、0.50)、(60.0%、77.1%、5.33、88.7%、77.8%、0.45、0.49)、(81.6%、70.2%、3.71、76.1%、91.5%、0.15、0.58)。PERC的灵敏度、阳性预测值分别为:(100%、100%)。PEGeD对于住院AECOPD疑诊PE患者的真阳性率、阴性预测值高,总体预测价值明显优于其余四种方法。结论PEGeD在上述5种方法中最适合住院AECOPD患者进行PE预测。

Characteristics of Long-term Nonprogressors and Viremia Controllers Infected with HIV-1 via Contaminated Blood Donations or Transfusions Conducted 20 Years Earlier

To characterize long‐term nonprogressors(LTNPs)and viremia controllers(VCs),infected with HIV‐1 through contaminated blood donation or transfusion between 1992 and 1996 in Henan,China.LTNPs and VCs were defined by CD4+T lymphocyte(CD4)count and viral load(VL).Of29,294 patients infected with HIV‐1 via contaminated blood donation or transfusion that had conducted for more than 20 years,92 were LTNPs/VCs.There were 70 LTNPs(0.24%),43

Prevalence of diarrhea and associated risk factors among children under-five years of age in Eastern Ethiopia: A cross-sectional study

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.

DEBRIS FLOW STUDIES IN CHINA IN THE LAST 30 YEARS

By summarizing the results of debris flow studies in China and integating with the knowledge and experience gained by the authors in their research work, thes paper makes a review and outlook on debris flow studies in China in the last 30 years. Corresponding opinions and suggestions are proposed in view of the circumstances and disasters in China.

Analysis of Climate Change in the Coastal Zone of Eastern China, against the Background of Global Climate Change over the Last Fifty Years: Case Study of Shandong Peninsula, China

The climate change in Shandong Peninsula, China was analyzed in this paper by the non-parametric Mann-Kendall test, Accumulated Difference Curve and Order Cluster Analysis methods, based upon the datas of annual mean, maximum and minimum temperature and annual precipitation, precipitation from June to September over the past 50 years. Results obtained showed a number of observations: 1) The annual mean temperature of Shandong Peninsula showed a significant increasing trend, with a distinct abrupt change point detected around 1990, during the past 5 decades. The warming of the Peninsula over the last 50 years was due mainly to the significant increase of annual minimum temperature. The annual maximum temperature demonstrated a mixed trend of decreasing and increasing, but was statistically insignificant, and no abrupt change was detected;2) The annual precipitation exhibited a decreasing trend during the past 5 decades, with an abrupt change detected around 1980 at most stations;but there was an earlier transition point at 1966, at a few stations. The reduction in precipitation, from June to September, was responsible mainly for the decrease of annual precipitation. Besides, the proportion of the June-September precipitation in the year declined slightly over the last 50 years;3) In comparison, the temperature evolution in Shandong Peninsula was basically consistent with most parts of China, but warmed at a faster rate over the same period;the decreasing trend of precipitation was more significant compared with the other climate zones of China. Within the Peninsula, the abrupt change of temperature and precipitation in the Southeast was earlier than that in the Northwest;the reduction of precipitation was larger in the Southeast while the increase of temperature was more significant in the Northwest. This research was of great importance to understand the climate change and its environmental effects in the coastal zone.

A Nine Years' Summing-up Report of TEDA's Development (1986 - 1994 )

Since 1986. a brand-new modern industrial city, full of vigor and vitality, has been towering aloftrapidly in what used to be salt marsh in the western part of Bohai Bay of China. With an annual out-put value of RMB ? 14 billion. it has become one of the most lively and energetic areas of Tianjin andeven throughout the country for opening to the outside world and for developing exportoriented econo-