Objective To explore the clinical manifestation of systemic lupus erythematosus (SLE) complicated with Pneumocystis carinii pneumonia (PCP).Methods Retrospective analysis of the clinical data of two cases of SLE complicated with PCP.Results The two patients were both aged 31 years and have had SLE disease for 4 and 7 years respectively.Both had lupus nephritis and were previously treated with high dose corticosteroid and cyclophosphadmide.Both patients had ceased immunosuppressive drug treatment for 6 and 12 months respectively at the time of diagnosis of PCP infection.Both patients presented with acute fever with dry cough,shortness of breath at rest,progressive hypoxia and diffuse reticular shadows on chest X ray. Pneumocystis carinii were identified in the bronchoalveolar lavage fluid (BAF) in both cases.SMZ was used to treat the PCP infection.The first patient recovered with improvement in her clinical well being and chest X ray appearance,while the second failed to respond and eventually succumbed.Conclusion One should be alert to the occurrence of PCP when patients with SLE present with rapidly progressive hypoxemia and type I respiratory failure.The mortality rate is high in SLE patients complicated with PCP and early diagnosis and treatment are the key to improving survial in these patients.Recurrence of PCP is common and adequate duration of treatment is essential.

This study investigated the effect of prolonged walking with load carriage on body posture, muscle fatigue, heart rate and blood pressure of the tested subjects. Ten healthy volunteers performed 30 min walking trials on treadmill (speed = 1.1 m/s) with different backpack loads [0% body weight (BW), 10% BW, 15% BW and 20% BW]. The change of body posture, muscle fatigue, heart rate and blood pressure before and after walking and the recovery of muscle fatigue during the rest time (0, 5, 10 and 15 min) were collected using the Bortec AMT-8 and the NDI Optotrak Certus. Results showed that the forward trunk and head angle, muscle fatigue, heart rate and blood pressure increased with the increasing backpack loads and bearing time. With the 20% BW load, the forward angle, muscle fatigue and systolic pressure were significantly higher than with lighter weights. No significantly increased heart rate and diastolic pressure were found. Decreased muscle fatigue was found after removing the backpack in each load trial. But the recovery of the person with 20% BW load was slower than that of 0% BW, 10% BW and 15% BW. These findings indicated that the upper limit of backpack loads for college-aged students should be between 15% BW and 20% BW according to muscle fatigue and forward angle. It is suggested that backpack loads should be restricted to no more than 15% BW for walks of up to 30 min duration to avoid irreversible muscle fatigue.
Blood Pressure ; Body Weight ; Exercise Test ; Healthy Volunteers ; Heart Rate ; Humans ; Muscle Fatigue ; Posture ; Walking ; physiology ; Weight-Bearing

Nonalcoholic fatty liver disease (NAFLD) is a typical chronic liver disease closely associated with gut dysbiosis, and dietary factor may be the most important driving factor affecting the composition and function of intestinal bacteria. Based on the concept of enterotype, this article summarizes the effect of diet on enterotype-related gut microbiota in NAFLD, including Firmicutes/Bacteroidetes ratio, Bacteroides, Prevotella, Ruminococcus, Proteobacteria, Actinobacteria, and other bacteria. It is pointed out that improving diet to regulate gut microbiota is one of the important strategies for the prevention and treatment of NAFLD and has a good prospect, which needs further mechanism and clinical research.

Objective To describe the prevalence of tobacco use among teenagers in different populations by sex and grades at school,and to provide evidence for the development of smoking control and health promotion programs.Methods A total of 4 797 teenagers selected from 36 schools through stratified multi-stage cluster sampling in Zhejiang province and were surveyed by using a questionnaire with 3 886 eligible ones for analysis.Indicators as tried smoking,current smoking,and secondhand smoke exposure,etc.,were calculated by weight on age proportions from the numbers of juniors in Zhejiang province.Results Prevalence rates of tried smoking and current smoking among teenagers were 10.91％ and 2.07％,respectively.7.72％ of the juniors were susceptible to future tobacco use.The prevalence rates of tried smoking were 15.65％ for boys and 5.58％ for girls,12.13％ in rural and 9.24％ in urban areas.Students from the 9th grade showed the highest rate (15.15％) while the 7th graders appeared the lowest level of susceptibility to future tobacco use (5.22％).The highest level of current smoking was seen in the group of "weekly allowance more than 30 Yuan,from parents"(4.07％).The prevalence of secondhand exposure to smoke in outdoor and indoor places,public transport,or at home were 57.60％,54.45％,46.97％,and 43.16％,respectively,among the teenagers.3 071 juniors (77.33％) saw the smoking scenes in the past 30 days but only 1 367 juniors (28.30％) were aware of the basic knowledge on tobaccos in class,in the past 12 months.Conclusions There were juniors who tried to smoke or were current smokers.The rate of secondhand exposure to smoking was high.A large number of the juniors were lack of education on knowledge related to tobacco control,in the classroom.It was important to promote and publicize the knowledge on tobacco so as to reduce the number of teenagers who were susceptible to future tobacco use.

Objective To describe the prevalence rates of smoking,quitting and passive smoking in different populations on their status of education,occupation and geographic distribution.Methods A total of 13 408 residents aged 15-69 from 45 counties through stratified multi-stage cluster sampling from Zhejiang province were selected and surveyed,using questionnaires.Data from 13 326 subjects were used for analysis.Indicators as smoking,current smoking,and secondhand smoke exposure,etc.,were calculated by weight on age proportions from the 2010 census.Results Among the adults aged 15 years and older,there were an estimated number of 12.90 million (29.59％) smokers,with 9.99 million (22.92％) current smokers,8.45 million (19.38％) daily current smokers.The prevalence rates of smoking were 41.18％ for men,3.69％ for women,with 45-54 year-old group the highest (51.66％) for men while the group of 65-69 year-olds was the highest (4.62％) in women.The overall rate of quitting was 22.56％.40.19％ of the smokers had thought about quitting,with the main means as self-restriction (87.59％) in conducting the behavior of smoking cessation.Among those non-smokers at age 15 or older,it was estimated that 67.90％ (22.77 million) of them had been exposed to secondhand smoke.SHS exposure was the highest in the indoor workplace (62.84％),among all the venues.Knowledge on tobacco among residents seemed to be relatively poor,with only 31.52％ of the population were aware that smoking could cause serious three diseases (stoke,heart disease,and lung cancer).34.04％ of the population were aware that secondhand smoking could cause all the three diseases (heart disease,lung disease,and lung cancer).Conclusion Current prevalence of smoking in males in Zhejiang province remained at a high level,indicating that the publicity programs on the knowledge of smoking tobacco was not strong enough and the task of control smoking should be taken more arduously.

Objective:To explore the effect of unplanned removal of elastic bandages on patients after transfemoral artery puncture digital subtraction angiography (DSA) .Methods:The cluster sampling method was used to select 1 051 patients who underwent DSA examination by femoral artery puncture in the Second Ward of Department of Neurology in the First Medical Center of Chinese PLA General Hospital from January to December 2019. According to whether unplanned removal of elastic bandage occurred after operation, they were divided into the control group (943 cases) and the observation group (108 cases) . Patients in the control group received routine care after neurological intervention, and the elastic bandage was removed after lying still for 24 hours. In the observation group, the bandage was removed before being in bed for 24 hours after the operation. The reasons included the patients' strong request to go to the toilet to defecate after the operation, the need to go out for examination, severe skin allergies, poor patient compliance and random limb movement at the puncture side. The incidence of postoperative complications such as bleeding and congestion at the puncture site and the comfort level of the patients were compared between the two groups.Results:There was no statistically significant difference in the incidence of complications such as blood oozing and congestion at the puncture site in patients between the two groups ( P>0.05) . The incidence of lower back pain in the observation group was lower than that in the control group, and the quality of sleep was better than that of the control group, and the differences were statistically significant ( P<0.05) . There was no statistically significant difference in the incidence of postoperative dysuria in patients between the two groups ( P>0.05) . Conclusions:After transfemoral artery puncture DSA, the removal of elastic bandages for less than 24 hours in bed will not increase the incidence of postoperative complications. At the same time, it can alleviate lower back pain of patients, improve their sleep quality and increase their comfort.

Objective Through analyzing the surveillance data on typhoid fever and paratyphoid fever in 2015 to understand the related epidemiological features and most possible clustering areas of high incidence.Methods Individual data was collected from the passive surveillance program and analyzed by descriptive statistic method.Characteristics on seasonal,regional and distribution of the diseases were described.Spatial-temporal clustering characteristics were estimated,under the retrospective space-time method.Results A total of 8 850 typhoid fever cases were reported from the surveillance system,with incidence rate as 0.65/100 000.The number of paratyphoid fever cases was 2 794,with incidence rate as 0.21/100 000.Both cases of typhoid fever and paratyphoid fever occurred all year round,with high epidemic season from May to October.Most cases involved farmers (39.68％),children (15.89％) and students (12.01％).Children under 5 years showed the highest incidence rate.Retrospective space-time analysis for provinces with high incidence rates would include Yurnan,Guangxi,Guizhou,Hunan and Guangdong,indicating the first and second class clusters were mainly distributed near the bordering adjacent districts and counties among the provinces.Conclusion In 2015,the prevalence rates of typhoid fever and paratyphoid fever were low,however with regional high prevalence areas.Cross regional transmission existed among provinces with high incidence rates which might be responsible for the clusters to appear in these areas.