1.Investigation on dietary structure,nutrition and health status in military elderly cadres
Ying CAI ; Cailian WU ; Haijuan ZENG
Medical Journal of Chinese People's Liberation Army 2001;0(10):-
Objective To investigate the dietary structure,nutrition and health status of elderly military cadres.Methods Questionnaire,dietary investigation and physical examination were performed in elderly cadres in Hangzhou Sanitarium in 1992,2002 and 2008(520,720 and 643 cases,respectively).The dietary structure,nutrition and health status were analyzed systematically.Results The intake of cereals dropped,and also the dried legumes.The intake of meats and aquatic products was significantly increased,and the intake of all the vegetables,fruits,dairy products,nuts and vegetable oils was rapidly increased too.The intake of pickles was decreased.The intake of salt and soy sauce showed a insignificant tendency of change.The intake of food supplying energy and protein had exceeded the recommended nutrient intake(RNI).The intake of niacin,vitamin E and Fe was increased gradually and reached the standard of RNI.Vitamin B1 intake also reached that of RNI.Vitamin C intake was increased rapidly,and reached 176.0?23.5mg/d in 2008.Zinc intake was not enough in 1992,while reached the standard of RNI in 2002 and 2008.Selenium intake reached RNI in 2008.With the increasing of milk consumption,calcium intake had greatly improved.There was also an increase in the proportion of energy from fat,which reached 37% in 2008.The health status of military old cadres had greatly improved.The prevalence of digestive diseases and hyperosteogeny decreased significantly by years,while the cardiovascular and cerebrovascular diseases increased.Conclusions The nutrition status and the quality of average diet in military elderly cadres have improved obviously,while the intake of fat,cholesterol and sodium is excessive.As a result,overweight,obesity and hypertension are prevalent.Propagation of nutrition knowledge and nutrition intervention should be emphasized.
2.Human errors in medical practice and the prevention
Dachun ZHOU ; Xiaonin CHEN ; Cailian ZHAO ; Xiujun CAI
Chinese Journal of Hospital Administration 2009;25(4):231-234
Human errors are errors found in planning or implementation, and those found in medical practice are often major causes of mishaps.To name a few, wrong-site surgery, medication error, wrong treatment, and inadvertent equipment operation.Errors of this category can be prevented by learning from experiences and achievement worldwide.Preventive measures include those taken in human aspect and system aspect, reinforced education and training, process optimization, and hardware redesign.These measures can be aided by multiple safety steps in risky technical operations, in an effort to break the accident chain.For example, pre-operative surgical site marking, multi-department co-operated patient identification, bar-coded medication delivery, read-back during verbal communication, and observation of clinical pathway.Continuous quality improvement may be achieved when both the management and staff see medical errors in the correct sense, and frontline staff are willing to report their errors.
3.Effectiveness of fibrosis-4 versus aspartate aminotransferase-to-platelet ratio index in evaluating liver fibrosis degree in patients with chronic HBV infection
Xiaoting LI ; Bobin HU ; Hongyu LIU ; Chao JIN ; Cailian CAI ; Keshan WANG ; Yanchun WEI ; Jianning JIANG ; Minghua SU
Journal of Clinical Hepatology 2024;40(12):2424-2429
ObjectiveTo investigate the performance of fibrosis-4 (FIB-4) versus aspartate aminotransferase-to-platelet ratio index (APRI) in predicting advanced liver fibrosis and disease progression in patients with chronic HBV infection. MethodsA total of 497 patients with chronic HBV infection who underwent liver biopsy in The First Affiliated Hospital of Guangxi Medical University from February 2013 to December 2022 were enrolled, among whom 404 were enrolled in a retrospective study and 75 were enrolled in a prospective study. Related indicators were collected, including demographic features (sex and age), biochemical indices (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]), and platelet count, and FIB-4 and APRI were calculated. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups; the chi-square test was used for comparison of categorical data between groups. The area under the ROC curve (AUC) was used to assess the ability of APRI and FIB-4 in evaluating liver fibrosis degree and disease progression in patients with chronic HBV infection. ResultsIn the retrospective analysis, compared with the FIB-4<2.67 group, the FIB-4≥2.67 group had a significantly higher proportion of the patients who were diagnosed with liver cirrhosis or hepatocellular carcinoma (66.19% vs 47.54%, χ²=12.75, P<0.001). The medians of FIB-4 and APRI increased significantly with liver fibrosis degree from F0 to F4 (H=42.5 and 35.9, both P<0.001). As for the fibrosis stage of F0-F4, the median of FIB-4 was significantly higher than that of APRI in the patients with the same fibrosis stage (H=59.71, P<0.001). FIB-4 and APRI had a similar AUC for predicting stage F3 fibrosis (0.67 vs 0.65, Z=0.71, P=0.480), while FIB-4 had a higher AUC for predicting stage F4 fibrosis than APRI (0.72 vs 0.64, Z=10.50, P<0.001). In the prospective study cohort, FIB-4 and APRI showed an increasing trend over time in predicting disease progression (chronic hepatitis B to liver cirrhosis), with an AUC of 0.718 (95% confidence interval [CI]: 0.476 — 0.760) and 0.555 (95%CI: 0.408 — 0.703), respectively, and FIB-4 had a significantly higher accuracy than APRI in predicting disease progression (χ2=12.44, P<0.001). ConclusionFIB-4 and APRI can be used to evaluate advanced liver fibrosis (F3 and F4) and predict disease progression, and FIB-4 is superior to APRI in certain aspects.