ObjectiveTo investigate the epidemiological characteristics of patients in the emergency observation room of Beijing Shijitan Hospital during the last 5 years, to enhance the local and regional construction of education discipline and improve the quality of medical services.MethodsA retrospective study was carried out on selected patients admitted to the emergency observation room of the Capital Medical University Affiliated Beijing Shijitan Hospital between January 1st 2014 and December 31st 2018. Statistical analysis was performed to identify associated epidemiological features in these patients.ResultsAmong the 19 518 patients admitted to the emergency observation room, 49.08% were males and 50.92% were females, with a male to female ratio of 1:1.04. The 46-65 age group had the lowest proportion of females of 47.28%, while this proportion reached to 55.38% in the over-80 age group, which was higher than that in the 46-65 and 66-80 age groups, showing statistical significance (P<0.05). During the last 5 years, 59.66% of the patients were aged above 65; the proportion of over 65 years old patients admitted to the emergency observation room of the hospital each year was 53.86%, 53.19%, 57.00%, 65.40%, and 68.79%, respectively, showing an increasing trend (P=0.011). Among the patients diagnosed, 24.20% had respiratory system diseases, 23.67% had circulation system diseases, 14.47% had digestive system diseases, 12.75% had neurological system diseases, and 7.08% had endocrine system diseases. According to the primary diagnosis, the top 10 most predominant diseases were bacterial pneumonia (14.72%), acute and chronic heart failure (7.86%), hypertension (5.00%), arrhythmia (4.02%), coronary atherosclerotic heart disease (3.92%), chronic obstructive pulmonary disease (3.01%), cerebrovascular disease (2.68%), gastrointestinal hemorrhage (2.66%), acute diabetes (2.43%), and celiac infection (1.73%), which accounted for 48.02% of the total patients admitted. In the winters (December to February) of these 5 years, the total number of patients admitted was 6 145, which contributed to 31.48% of the total admission number, and hence making winter the season with the highest number of patients seeking for medical services.ConclusionsAccording to the spectrum of the disease features, there is a need to enhance the training of specialty and emergency clinics associated with respiratory, circulation, neurological, digestive, and endocrine diseases. Special attention should be paid for treatment and health care targeted at old-aged patients. During winter, the peak hospital visiting time, appropriate medical care service, which addresses the plan of working time, should be provided in order to optimize diagnosis and treatment processes.
Objective To study the prevalence and risk factors of chronic obstructive pulmonary disease ( COPD) and provide reliable data for COPD prevention and management. Methods By cluster-random-sampling survey, the residents aged 40 yrs or older in a community in South Bank District of Chongqing were investigated.The post-bronchodilator FEV1 /FVC lt; 0. 7 was defined as COPD. Those individuals with FEV1 /FVC lower than 0. 7 would received history inquiry, X-ray of chest and ECG to exclude other disease that could impair pulmonary function. Results 1518 residents were enrolled( 517 male and 1001 female) . The prevalence of COPD was 12. 78% ( male 23. 02% and female 7. 49% ) . The major risk factors were cigarettes smoke( OR: 2. 88, 95% CI:2. 118-3. 928) and indoor cooking smoke( OR: 1. 98, 95% CI: 1. 685-3. 317) . There were 22.06% smokers were diagnosed as COPD. Only 9. 30% patients had known themselves disease condition about chronic bronchitis,emphysema or COPD. Conclusion The prevalence of COPD in Chongqing city is significant higher than average level of the whole country and the patients have poor knowledge about the disease.
Objective To analyze the epidemiological features of clavicle fractures.Methods A total of 363 cases of clavicle fractures were treated from February 1993 to November 2002, their case history data were reviewed and evaluated by epidemiological method.Results Out of 363 cases, there were 269 males and 94 females, aged from new born to 96 years. The locations of fractures were on left side in 159 cases and on right side in 204 cases. Neonatal clavicle fracture occurred in the case of delivery (0.28%). The causes of disease for adult clavicle fractures were traffic injury (52.1%) and daily falling injury(31.1%). There were232 cases of simple fractures and 131 cases of comminuted fractures. The fracture positions included inner(6 cases), middle(328 cases) and outer parts(29 cases). Multiinjuries occurred in 78 cases, the rib fractures concomitant with clavicle fractures were the commonest(31 cases).Conclusion The clavicle fractures are the common injury. Of them, traffic injury and daily falling injury arethe most common. The rib fractures are always accompanied with clavicle fractures.The main position of fracture is on the middle part.
Objective To investigate the etiological and clinical characteristics of the outbreak of hand-foot-mouth disease (HFMD) in Chengdu in 2008. Methods A retrospective analysis was conducted to investigate 482 children with hand-foot-mouth disease in Chengdu from January to December 2008 in terms of epidemiology and clinical characteristics. Results Among the 482 children, 76.14% of the cases were infants, and male children numbered more than female ones. The proportion in the urban area was higher than that in the rural area. May to July was the peak epidemic period. Skin rash and fever were major clinical manifestations. Three cases were diagnosed as viral encephalitis. Conclusion The incidence of hand-foot-mouth disease is related to age and season. Effective prevention measures and isolated treatment are critical for prevention and therapy.
Objective To explore the characteristics of diagnosis and treatment for the rectal cancer in the young patients (≤40 years).Methods The domestic and abroad literatures about the research on the progress of rectal cancer in the young patients were reviewed, the clinical data of patients with rectal cancer were compared between the young patients and the other age patients, the characteristics of diagnosis and treatment for the rectal cancer in the young patients were summarized.Results The onsets of the young patients with rectal cancer were related to the diet,lifestyle, and genetic factors.Compared with the older patients, more later stage, higher percentage of poor differentiation, earlier lymph node metastasis were found in the young patients with rectal cancer.Rectal cancer of the young patients was often misdiagnosed and with a poor prognosis.Currently,surgery assisted with neoadjuvant therapy was generally acknowledged as a better method.Conclusions It has specificity in epidemiology, pathology, treatment, prognosis, and so on for rectal cancer in the young patients, but surgery needs further research.
【Abstract】 Objective To survey the prevalence and risk factors of chronic obstructive pulmonary disease ( COPD) , and establish database for community intervention of COPD.Methods A cluster-randomsampling survey was carried out. The population aged over 40 years old in eight communities of Chengdu were investigated from August 2007 to August 2009 using the standard protocol and questionnaire. The spirometry was performed for each participant. Results A total of 4315 residents were enrolled in this survey and 3687 case reports were analyzed, including 1529 males and 2148 females, with an average age of 60. 35 ±13. 21 years old. Total prevalence of COPD was 9. 6% . The prevalence of COPD in the males was significantly higher than that in the females ( 14. 0% vs. 6. 4%, P lt;0. 01) . The prevalence of COPD increased with the age. The major risk factors were cigarettes smoking ( OR = 3. 012, 95% CI 2. 390-3. 797, P lt; 0. 01) and indoor cooking smoking ( OR = 2. 546, 95% CI 1. 734-3. 425, P lt; 0. 01) . Conclusion The prevalence of COPD in Chengdu city is significantly higher than average level of the whole country, which warrant moreattention to better prevention and treatment of COPD in communities.
Objective To study the risk factors for contralateral breast cancer (CBC) in women after regular treatment of the primary breast cancer. Methods Between January 1997 to December 2002, the clinical data of 340 breast cancer patients at our institution were retrospectively analyzed. In all the patients a detailed analysis was carried out with respect to age, operation type, radiation therapy technique and dose, the use of chemotherapy or hormone therapy, and other clinicopathologic characteristics. The KaplanMeier method was used to estimate the actuarial rate of CBC. The Cox proportional hazard regression model was used to estimate the relative risk factors of CBC. Results Fourteen cases were diagnosed to be CBC, thus overall incidence of CBC was 4.1%. Ten-year CBC incidence (2.7%) was higher than 5-year incidence of CBC (1.4%). Univariate analysis showed that the risk factors of CBC at 5-year and 10-year included: ≤45 years old, medullary carcinoma, family history of breast cancer and being taken without endocrine therapy (P<0.05), while chemotherapy and radiotherapy were not risk factors of CBC (P>0.05). Mutivariate analysis showed that ≤ 45 years old and being internal breast radiotherapy were independent risk factors of CBC at 5-year and 10-year (P<0.05). Conclusions CBC may occur in these primary breast cancer patients with age ≤45 years old, medullary carcinoma, family history of breast cancer. In order to reduce the incidence of CBC, endocrine therapy rather than internal breast radiotherapy should be performed in early breast cancer patients.
ObjectiveTo explore the epidemiological and clinical features of hepatic hemangioma. MethodsThe clinical data of patients with hepatic hemangioma who were diagnosed in the First Affiliated Hospital of Guangxi Medical University from 2003 to 2011 were retrospectively analyzed, and then analyzed the epidemiological and clinical characteristics of hepatic hemangioma. ResultsEight hundreds and eighteen patients with hepatic hemangioma were included in the study.Among them, 398 cases (48.7%) were male, 420 cases (51.3%) were female, and there were no significant differences in constitute of gender for each year (χ2=9.912, P=0.271), but there were significant differences in constitute of gender between different age groups (χ2=18.791, P=0.000 1), male patients were more than female in the group of aged over 60 years old.There was no special clinical manifestations of hepatic hemangioma.There were 75 patients (9.2%) combined autoimmune diseases in this group.The size of hepatic hemangioma ranged from 0.5-39.0 cm, the median diameter was 3.0 cm.There were significant differences between different gender, the tumor size of female patients were larger than male's (P < 0.05).The tumor happened mostly in the right hepatic lobe (57.2%), and there were no significant differences of the tumor location in different gender (P > 0.05).Hepatic hemangioma with a single lesion was most common (70.0%), and the right lobe lesions were more common than the left lobe lesions in single lesion group, multiple lesions in double lobes were most common in multiple lesion group. ConclusionsHepatic hemangioma has a certain distribution pattern in gender, age, size, position, and so on, further research in prevention and controlled strategy need to be carried out in the future.At the same time, more in-depth research in the related factors participated in occurrence and development of hepatic hemangioma also need to be carried out, especially for the relationship between gender, age, autoimmune diseases, and hepatic hemangioma, which is worthy to be discussed.
Vaccine-associated uveitis (VAU) usually refers to a rare adverse reaction that occurs after vaccination. The clinical manifestations of VAU are most often anterior with mild symptoms and responded promptly to topical corticosteroids. However, more severe forms of posterior and panuveitis may also occur, such as multiple evanescent white dot syndrome, Vogt-Koyanagi-Harada syndrome, and acute posterior multifocal placoid pigment epitheliopathy. The pathogenesis of VAU is still unclear. Currently, it mainly includes vaccine Shoenfeld syndrome, type Ⅲ hypersensitivity reaction caused by immune complex deposition, direct infection with live attenuated vaccine, and molecular mimicry theory. VAU is self-limiting, and most patients heal without treatment. In the future, it is recommended to ask all patients with uveitis about their recent vaccination history in the clinic. For patients with inactivated vaccine or recombinant/subunit vaccination history, the possibility of developing Shoenfeld syndrome should be considered, and the history, signs and symptoms related to autoimmune diseases should be carefully looked for.
Stroke is a severe disease with high incidence, high recurrence, high disability, and high mortality rates. China has the highest prevalence of stroke in the world, where it is a leading cause of death and disability for adults. There is a struggling way to prevent and control stroke to reduce the disease burden. This review summarizes the temporal trends and characteristics of stroke in China, with an aim to provide baseline reference for stroke prevention and treatment in China. There was an increase in the incidence and prevalence of stroke in China in the past 15 years. The incidence, prevalence, mortality, and disability-adjusted life years of stroke in China were higher than those in developed countries such as the United Kingdom, the United States, and Japan. High-quality studies and standardized diagnosis and treatment are needed to overcome challenges in stroke prevention and treatment in China.