Objective To learn the disease status and living conditions of Kaschin-Beck disease (KBD) patients and implementation of related control measures in Aba Autonomous Prefecture,Sichuan Province.Methods A total of 26 KBD villages and 12 non-KBD villages nearby were selected in Aba Autonomous Prefecture with stratified cluster sampling method in the year of 2009 to 2011.One thousand three hundred and forty-seven KBD patients from KBD villages and 447 residents from non-KBD villages were interviewed with a self-designed questionnaire.The investigation includes:①General demographic characteristics such as name,gender,age,educational level,family income,marital status and so on.②The basic information about KBD patients including the time and location of diagnosis,treatment,hand X ray diagnosis taken or not and suffering from dental fluorosis and skeletal fluorosis.③The basic living habits such as drinking water,staple food sources,staple food types,grain storage places,tea-drinking habits and so on.Results A total of 522 (38.8％,522/1 347) KBD patients and 12 (2.7％,12/447) controls were confirmed that their parents were KBD patients.The vast majority of KBD patients (99.0％,1 334/1 347) were diagnosed in county of Chinese Center for Disease Control and Prevention or county level hospitals within 2-5 years after onset of the disease and 97.6％ of them (1 314/1 347) treated their disease by taking painkillers,sodium selenite or vitamin E.Most KBD patients had suffered from dental fluorosis (66.3％,893/1 347) and skeletal fluorosis (59.9％,807/1 347).Both the KBD patients and the controls mainly drank river water and 96.7％ of them (1 716/1 774) took locally grown food,93.5％ of them (1 660/1 775) took barley and corn as staple food in the past (before the year of 2004).But now (from the year of 2004 until now) they mainly drink tap water and 96.9％ of them (1 727/1 783) take commodity grain or two kinds of source food,98.4％ of them (1 765/1 794)changed their staple food to rice and flour.94.1％ of KBD patients (1 267/1 347) used to drink tea.Conclusions The measures of changing water and grain are well implemented in Aba Autonomous Prefecture.The government should improve the overall local KBD disease status and the quality of life of KBD patients by taking health promotion and prevention in key families,strengthening the local medical security system and targeted treatment combined with specific local conditions.

Objective To explore the application value of endoscopic ultrasonography (EUS) in the diagnosis of suspected obstructive jaundice in acute biliary pancreatitis and its effect on treatment outcomes. Methods Clinical data were retrospectively collected in 96 patients with acute biliary pancreatitis (ABP) who were suspected obstructive jaundice. Patients were divided into early EUS scanning group (EES) and delay EUS scanning group (DES). Clinical treatment results and test results were compared between the two groups. Results The diagnosis sensitivity, specificity, accuracy, positive predictive value and negative predictive value of EUS were 96.43 %, 82.5 %, 90.63 %, 88.52 % and 96.29 %. Early EUS scan with 72 h could identify the etiology of ABP and subsequent treatment based on the EUS can easily decrease the white blood cell count, percentage of neutrophils, total bilirubin and serum amylase (P < 0.05). The pain relief rate in EEI group after 1 week treatment was significantly higher than that in the DES group (87.50 % vs 66.67 %, P = 0.027) and average length of hospitalization was shorter [(12.70 ±2.10) d vs (14.10 ± 3.00) d, P = 0.006]. Delay EUS scan were likely to have higher white blood cell count and total bilirubin, meanwhile seemed to increase the organ failure rate and necrotic infection of the pancreas. Conclusion ABP with suspected obstructive jaundice should be considered to have endoscopy intervention. Results of EUS are the basis for treatment decision, which can avoid the unnecessary endoscopy treatment.

Objective To assess the progress of control and elimination of iodine deficiency disorders (IDD) in Aba Prefecture,Sichuan Province,in order to make classified and refined strategy in prevention and control of the disease.Methods According to the project of "Assessment on Endemic Disease of the Twelfth Five Years Project in Sichuan Province",the last assessment was carried out.From March to June 2015,the management indicators were graded in 13 counties (cities) of Aba Prefecture,1 township (town) was chosen according to the east,west,south,north,and centre of 5 directions of each county (city),4 administrative villages were chosen in each township (town),salt samples from 15 households were collected in each administrative village,and the content of salt iodine was tested based on the arbitration law (GB/T 13025.7-1999).One primary school was chosen in each township (town),urine samples of 40 children aged 8-10 (half males and half females) were collected,arsenic cerium catalytic spectrophotometry (WS/T 107-2006) was used to test the content of urinary iodine;and palpation method was used to check goiter.Urine samples of 20 pregnant women were collected in the selected township (town),and the content of urinary iodine was determined;at the same time,of the pregnant women who had been checked urinary iodine levels,10 individuals were selected to conduct a questionnaire survey to understand the health education of pregnant women.Results The average score of management indicators was 92.A total of 3 941 salt samples were collected,the median of salt iodine was 28.8 mg/kg,the consumption rate of qualified iodized salt was 96.6％ (3 806/3 941),and the rate of iodized salt was 99.6％ (3 927/3 941).A total of 2 866 urine samples of children were tested,the median of urinary iodine was 160.0 μg/L,and ＜ 50 μg/L was 4.6％ (131/2 866);the thyroid enlargement rate was 0.7％ (19/2 819).A total of 1 143 urine samples of pregnant women were tested,the median of urinary iodine was 188.3 μg/L,and ＜ 150 μg/L was 27.9％ (319/1 143);a total of 650 questionnaires were collected,awareness of pregnant women's health education was 78.3％ (1 527/1 950).Conclusion Aba Prefecture continues to eliminate IDD,and the iodine nutrition status of the population is better,but it is necessary to further strengthen supervision on iodized salt market and health education.

Objective: To investigate the clinical effect of modified Graeb criteria score and Glasgow coma score (GCS) in individualized treatment of intraventricular hemorrhage. Methods: 113 patients with intraventricular hemorrhage admitted to the department of neurosurgery of Second Affiliated Hospital of Guangxi Medical University from June 2014 to February 2018 were enrolled, and they were divided into 13-15, 9-12, and 3-8 groups according to GCS score at admission, and modified Graeb criteria score was classified as grade Ⅰ, Ⅱ and Ⅲ at the same time. In GCS 9-12 and 3-8 groups, patients with modified Graeb criteria score grade Ⅲ were treated with bilateral extra ventricular drainage, patients with modified Graeb criteria score grade Ⅱ were treated with bilateral extra ventricular drainage or lumbar cistern drainage (GCS 9-12 group was more prior to lumbar cistern drainage, 3-8 group was given priority to extra ventricular drainage), and patients with modified Graeb criteria score grade Ⅰ were treated conservatively. In GCS 13-15 group, bilateral extra ventricular cerebral drainage or lumbar cistern drainage was performed if the modified Graeb criteria score grade was Ⅲ, lumbar cistern drainage or conservative treatment was performed if the modified Graeb criteria score grade was Ⅱ, and conservative treatment was performed if the modified Graeb criteria score grade was Ⅰ. The changes in GCS score at 1 month after individualized treatment and the favourable prognosis rate at 6 months after treatment were observed [favourable prognosis was defined as Glasgow outcome score (GOS) Ⅳ-Ⅴ] as well as the basic clearance time of intraventricular hematomas, and the occurrence of complications such as intracranial infection, pulmonary infection and hydrocephalus were recorded. Results: 113 patients with intraventricular hemorrhage were enrolled in the final analysis, including 39 patients in GCS 13-15 group, 27 in 9-12 group, and 47 in 3-8 group; 21 patients with the first grade of modified Graeb criteria score, 42 with the second grade and 50 with the third grade. At 1 month after individualized treatment, the GCS scores in GCS 13-15 and 9-12 groups were significantly higher than those at admission (14.8±0.2 vs. 13.7±0.8, 13.1±1.7 vs. 10.7±1.1, both P < 0.05). When comparing the GCS score of the same patient at admission with that of 1 month after treatment, the GCS scores of the three groups were significantly improved, indicating that the consciousness of patients with different coma levels at admission had been significantly improved after individualized treatment. The basic clearance time of intracerebroventricular hematomas in patients with the second grade of modified Graeb criteria score was (7.0±2.8) days, in patients with the third grade was (6.1±2.0) days. At 6 months after individualized treatment, among 113 patients, GOS score was grade Ⅰ in 7 patients (6.2%), grade Ⅱ in 13 patients (11.5%), grade Ⅲ in 28 patients (24.8%), grade Ⅳ in 27 patients (23.9%), and grade Ⅴ in 38 patients (33.6%), with the favourable prognosis rate of 57.5% (65/113). Among 113 patients, intracranial infection occurred in 5 patients (4.4%), pulmonary infection in 22 patients (19.5%), hydrocephalus in 2 patients (1.8%) and rebleeding in 4 patients (3.5%). In 83 patients with lumbar cistern drainage, 1 patient had post-drainage infection (1.2%), 3 patients had plugging (3.6%), 6 patients had accidental drop of drainage tube (7.2%), and none of them had occipital macroforamen hernia after drainage. Seven of the 113 patients died including 2 patients died of cerebral hernia caused by rebleeding, 5 patients died of severe pneumonia or automatic discharge from hospital. Conclusion The combination of modified Graeb criteria score and GCS score can individualize treatment for patients with intraventricular hemorrhage and effectively improve the prognosis of patients with intraventricular hemorrhage.

OBJECTIVE: To investigate the clinical effect of modified Graeb criteria score and Glasgow coma score (GCS) in individualized treatment of intraventricular hemorrhage. METHODS: 113 patients with intraventricular hemorrhage admitted to the department of neurosurgery of Second Affiliated Hospital of Guangxi Medical University from June 2014 to February 2018 were enrolled, and they were divided into 13-15, 9-12, and 3-8 groups according to GCS score at admission, and modified Graeb criteria score was classified as grade I, II and III at the same time. In GCS 9-12 and 3-8 groups, patients with modified Graeb criteria score grade III were treated with bilateral extra ventricular drainage, patients with modified Graeb criteria score grade II were treated with bilateral extra ventricular drainage or lumbar cistern drainage (GCS 9-12 group was more prior to lumbar cistern drainage, 3-8 group was given priority to extra ventricular drainage), and patients with modified Graeb criteria score grade I were treated conservatively. In GCS 13-15 group, bilateral extra ventricular cerebral drainage or lumbar cistern drainage was performed if the modified Graeb criteria score grade was III, lumbar cistern drainage or conservative treatment was performed if the modified Graeb criteria score grade was II, and conservative treatment was performed if the modified Graeb criteria score grade was I. The changes in GCS score at 1 month after individualized treatment and the favourable prognosis rate at 6 months after treatment were observed [favourable prognosis was defined as Glasgow outcome score (GOS) IV-V] as well as the basic clearance time of intraventricular hematomas, and the occurrence of complications such as intracranial infection, pulmonary infection and hydrocephalus were recorded. RESULTS: 113 patients with intraventricular hemorrhage were enrolled in the final analysis, including 39 patients in GCS 13-15 group, 27 in 9-12 group, and 47 in 3-8 group; 21 patients with the first grade of modified Graeb criteria score, 42 with the second grade and 50 with the third grade. At 1 month after individualized treatment, the GCS scores in GCS 13-15 and 9-12 groups were significantly higher than those at admission (14.8±0.2 vs. 13.7±0.8, 13.1±1.7 vs. 10.7±1.1, both P < 0.05). When comparing the GCS score of the same patient at admission with that of 1 month after treatment, the GCS scores of the three groups were significantly improved, indicating that the consciousness of patients with different coma levels at admission had been significantly improved after individualized treatment. The basic clearance time of intracerebroventricular hematomas in patients with the second grade of modified Graeb criteria score was (7.0±2.8) days, in patients with the third grade was (6.1±2.0) days. At 6 months after individualized treatment, among 113 patients, GOS score was grade I in 7 patients (6.2%), grade II in 13 patients (11.5%), grade III in 28 patients (24.8%), grade IV in 27 patients (23.9%), and grade V in 38 patients (33.6%), with the favourable prognosis rate of 57.5% (65/113). Among 113 patients, intracranial infection occurred in 5 patients (4.4%), pulmonary infection in 22 patients (19.5%), hydrocephalus in 2 patients (1.8%) and rebleeding in 4 patients (3.5%). In 83 patients with lumbar cistern drainage, 1 patient had post-drainage infection (1.2%), 3 patients had plugging (3.6%), 6 patients had accidental drop of drainage tube (7.2%), and none of them had occipital macroforamen hernia after drainage. Seven of the 113 patients died including 2 patients died of cerebral hernia caused by rebleeding, 5 patients died of severe pneumonia or automatic discharge from hospital. CONCLUSIONS The combination of modified Graeb criteria score and GCS score can individualize treatment for patients with intraventricular hemorrhage and effectively improve the prognosis of patients with intraventricular hemorrhage.
Cerebral Hemorrhage ; China ; Glasgow Coma Scale ; Humans ; Hydrocephalus ; Prognosis ; Retrospective Studies ; Treatment Outcome

Objective To study the superiority of severe multiple trauma treatment model based on damage control strategy. Methods In the intergrated injury first-aid mode, the intensive care unit-guided damage control strategy was used to treat severe multiple trauma. Results A total of 789 severe multiple damage patients were treated with damage control strategies in our hospital from December 2018 to December 2018. Sixty-nine patients died and the survival rate was 91.25％. Conclusions The intensive care unit-guided trauma control strategy has a satisfactory clinical effect in the treatment of patients with severe multiple trauma.

Tongji hospital provides disciplinary development oriented information services , including disciplinary information resources construction , lectures on medical information literacy , discipline information push service and information analysis service .The corresponding interaction and supervision mechanism has been established to ensure service quality .Such services constitute vital information support for first-class disciplines development by such means as information resources availability , talents training , discipline development and scientific decision-making.It also provides a service platform for improvement of hospital discipline reputation satisfactorily .