2.Application of three diagnostic criteria for metabolic syndrome among the elderly in urban community of Beijing
Xin GAO ; Xiaoguang WU ; Zhe TANG ; Fangkun GAO
Chinese Journal of Geriatrics 2012;31(3):248-250
Objective To compare the application of three diagnostic criteria for metabolic syndrome(MS) among the elderly in community. Methods 773 elderly people in the community were diagnosed for MS by the Chinese Medical Association Diabetes Society (CDS),International Diabetes Federation (IDF) and revised National Cholesterol Education Prongram-Adult Treatment Panel(ATP Ⅲ* ) criteria,respectively.The diagnosis accordance rates were compared among the different diagnostic criteria. Results The MS prevalence rates in the elderly were 32.5% (251/773),53.4% (413/773) and 47.2% (365/773) according to CDS,IDF and ATP Ⅲ* criteria,respectively and there were significant difference among the criteria (Q=173.10,P<0.01 ).The MS prevalence was higher in women than in men especially by IDF [57.3% (284/487)vs.45.1% (129/286),x2=12.64,P<0.01]and ATPⅢ* criteria [53.0%(258/487)vs. 37.4% (107/286),x2=17.52,P<0.01].The coincidences in the diagnosis of MS were 88.6% (Kappa=0.773,P<0.01)using IDF and ATPⅢ * definitions,75.7% using CDS and ATPⅢ *,and 73.7% using CDS and IDF.Conclusions The agreement in the diagnosis of MS using IDF and ATPⅢ* definitions is higher than using CDS and IDF or ATPⅢ * definitions.
3.Clinical analysis of 11 cases of sub-acute arsenic poisoning
Juan YUAN ; Yan LAI ; Chuntao HUANG ; Lei HUANG ; Fangkun TANG ; Lun HONG ; Yimei YANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2020;38(12):921-924
Objective:To investigate the clinical manifestations, treatments and prognosis of subacute arsenic poisoning.Methods:In January 2020, a retrospective analysis was carried out on 11 patients hospitalized with subacute arsenic poisoning caused by arsenic contaminated drinking water. We observed manifestations, treatments and prognosis.Results:The main clinical presentations of subacute arsenic poisoningin were gastroenteritis in early phase, some of them had other organ damage, such as skin, blood, liver, kidney, cardiovascular and so on. The later phase was mainly peripheral nervous system damage. The treatment was mainly to chelate arsenic, protect target organs and treat toxic peripheral neuropathy. Most were significantly recoveried, but the recovery of severe toxic peripheral neuropathy was tardy.Conclusion:Acute gastroenteritis is the mainly early manifestation of subacute arsenic poisoning caused by digestive tract, and toxic peripheral neuropathy in the later phase. The prognosis is good, but the recovery of severe toxic peripheral neuropathy is tardy.
4.Clinical analysis of 11 cases of sub-acute arsenic poisoning
Juan YUAN ; Yan LAI ; Chuntao HUANG ; Lei HUANG ; Fangkun TANG ; Lun HONG ; Yimei YANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2020;38(12):921-924
Objective:To investigate the clinical manifestations, treatments and prognosis of subacute arsenic poisoning.Methods:In January 2020, a retrospective analysis was carried out on 11 patients hospitalized with subacute arsenic poisoning caused by arsenic contaminated drinking water. We observed manifestations, treatments and prognosis.Results:The main clinical presentations of subacute arsenic poisoningin were gastroenteritis in early phase, some of them had other organ damage, such as skin, blood, liver, kidney, cardiovascular and so on. The later phase was mainly peripheral nervous system damage. The treatment was mainly to chelate arsenic, protect target organs and treat toxic peripheral neuropathy. Most were significantly recoveried, but the recovery of severe toxic peripheral neuropathy was tardy.Conclusion:Acute gastroenteritis is the mainly early manifestation of subacute arsenic poisoning caused by digestive tract, and toxic peripheral neuropathy in the later phase. The prognosis is good, but the recovery of severe toxic peripheral neuropathy is tardy.
5.Delphi method investigation and research on the revision of Diagnosis of Occupational Arsenic Poisoning (GBZ 83-2013)
Juan YUAN ; Yan LAI ; Lei HUANG ; Chuntao HUANG ; Fangkun TANG ; Yimei YANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2024;42(9):679-683
Objective:To explore the expert opinions on the revision of the Diagnosis of Occupational Arsenic Poisoning (GBZ 83-2013) .Methods:In March 2023, the improved Delphi expert consultation method was adopted, in the first round of consultation, a pre-survey was conducted on 20 experts, and the questionnaire was improved according to the experts' opinions. Then, a second round of expert consultation questionnaire was formed to conduct a questionnaire survey and consultation of 50 experts engaged in occupational disease diagnosis and related work. The feedback of experts was collected and analyzed.Results:The average score for the scientificity and progressiveness of the main technical content of the original standard was 3.33, and the average score for the rationality and operability of the main technical content of the original standard was 3.25. The importance of individual indicators with specific connotations were ranged from 4.20 to 4.45, with coefficients of variation <0.25, and the experts' opinions were relatively concentrated. The experts have provided feedback indicating that the original standard had issues such as lack of continuity in diagnostic gradation, the need to integrate biomarkers with urinary and hair arsenic levels, a scarcity of objective diagnostic indicators, the removal of exposure response from the main text, and a low level of consistency in standard usage. These issues need to be revised urgently.Conclusion:The Diagnosis of Occupational Arsenic Poisoning (GBZ 83-2013) should be revised based on experts' feedback and suggestions to meet the current real demand for occupational arsenic poisoning diagnosis.
6.Delphi method investigation and research on the revision of Diagnosis of Occupational Arsenic Poisoning (GBZ 83-2013)
Juan YUAN ; Yan LAI ; Lei HUANG ; Chuntao HUANG ; Fangkun TANG ; Yimei YANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2024;42(9):679-683
Objective:To explore the expert opinions on the revision of the Diagnosis of Occupational Arsenic Poisoning (GBZ 83-2013) .Methods:In March 2023, the improved Delphi expert consultation method was adopted, in the first round of consultation, a pre-survey was conducted on 20 experts, and the questionnaire was improved according to the experts' opinions. Then, a second round of expert consultation questionnaire was formed to conduct a questionnaire survey and consultation of 50 experts engaged in occupational disease diagnosis and related work. The feedback of experts was collected and analyzed.Results:The average score for the scientificity and progressiveness of the main technical content of the original standard was 3.33, and the average score for the rationality and operability of the main technical content of the original standard was 3.25. The importance of individual indicators with specific connotations were ranged from 4.20 to 4.45, with coefficients of variation <0.25, and the experts' opinions were relatively concentrated. The experts have provided feedback indicating that the original standard had issues such as lack of continuity in diagnostic gradation, the need to integrate biomarkers with urinary and hair arsenic levels, a scarcity of objective diagnostic indicators, the removal of exposure response from the main text, and a low level of consistency in standard usage. These issues need to be revised urgently.Conclusion:The Diagnosis of Occupational Arsenic Poisoning (GBZ 83-2013) should be revised based on experts' feedback and suggestions to meet the current real demand for occupational arsenic poisoning diagnosis.
7. Clinical analysis on 2 cases of acute thallium poisoning with combined treatment using blood purification and sodium dimercaptosulfonate
Juan YUAN ; Yan LAI ; Lei HUANG ; Fangkun TANG ; Yunhua ZHANG ; Lun HONG ; Chuntao HUANG
China Occupational Medicine 2018;45(03):347-354
OBJECTIVE: To investigate the clinical features,treatment methods and prognosis of acute thallium poisoning.METHODS: The clinical data of 2 cases of acute thallium poisoning were analyzed retrospectively to observe its clinical features,therapeutic effect of blood purification and sodium dimercaptosulfonate,and prognosis.RESULTS: The typical triads of clinical features of the two cases of acute thallium poisoning were gastroenteritis,polyneuropathy and alopecia.Before treatment,the blood thallium level was 200.6 and 712.7 μg/L and the urine thallium level was 5 206.4 and 11050.2 μg/24 h respectively.After the combined treatment using blood purification and sodium dimercaptosulfonate,the blood thallium decreased to 31.6 and 14.6 μg/L and the urine thallium decreased to 175.2 and 265.3 μg/24 h.The two patients had a good prognosis.The result of re-examination showed that blood thallium was 7.9 and 0.6 μg/L and the urine thallium was 31.5 and 5.5 μg/24 h respectively in 2 and 5 months later.CONCLUSION: The combined treatment using blood purification and sodium dimercaptosulfonate is effective for acute thallium poisoning therapy.