1.Analysis of Chinese elderly health policies based on policy tools
SONG Junqing ; ZHAO Yuming ; SHI Wenhui
Journal of Preventive Medicine 2023;35(8):721-725
Objective:
To analyze Chinese elderly health policy documents from 2018 to 2022 based on policy tools, so as to provide insights into improving elderly health policies and promoting healthy aging.
Methods:
Elderly health policy documents were retrieved from “the magic weapon of Peking University”, the policy document database of the State Council and portal websites of relevant ministries and commissions using keywords “elderly”, “aging” and “elderly health”. The documents were encoded using content analysis and keywords were extracted. A two-dimensional analysis framework was constructed based on Rothwell and Zegveld's classification framework and dimension theory, and the use of policy tools was analyzed.
Results:
Totally 57 Chinese elderly health policy documents were collected from 2018 to 2022, including 44 notices, 7 opinions, one rule, one regulation, one law, one announcement, one letter and one joint declaration. There were 37 documents (64.91%) issued by National Health Commission and its departments and offices. The high-frequency keywords in the documents included “medical and healthcare institutions”, “elderly health”, “rehabilitation/nursing”, “community/grassroots/rural”, “pilot”, “traditional Chinese medicine”, “propaganda” and “standardization”. There were 413 document codes, and the supply-, environment- and demand-side policy tools accounted for 52.54%, 31.72% and 15.74%, respectively. Public health and medical services (19.61%) and science popularization (7.99%) were the most commonly used supply-side policy tools, law/regulations and administration systems (7.99%) was the most commonly used environment-side policy tools, while pilot/demonstration projects (5.33%) was the most commonly used demand-side policy tools. The external and internal indicators of the system dimensions accounted for 48.18% and 51.82%, and political system (17.19%) and technical system (16.46%) were the two most commonly used external indicators, while service system (35.60%) was the most commonly used internal indicator.
Conclusions
Chinese elderly health policies focused on supply-side policies from 2018 to 2022, such as public health and medical services. The use of demand-side policy tools is recommended to be increased and the internal composition of supply- and environment-side policy tools are recommended to be optimized.
2.Investigation of Ascending Aortic Distensibility and Risk Factors in Pre-hypertension Patients
Zhibiao ZHAO ; Bo LIU ; Junqing XU ; Zuhua ZHOU ; Chongfu JIA
Chinese Circulation Journal 2017;32(3):237-240
Objective: To explore the features of ascending aortic distensibility (AAD) and risk factors in pre-hypertension (PHT) patients. Methods: A total of 206 participants who received retrospective ECG-triggered coronary CTA by physical check-up or by clinically suspected coronary artery disease (CTA) were enrolled. The participants were divided into 2 groups: Control group, the subjects with normal blood pressure,n=85 and Pre-hypertension group,n=121. A 128 slice dual-source CT scanner was used and the image was automatically reconstructed at every 5% absolute phases in entire R-R interval. The beginning of left coronary artery plane was deifned as the reference and 25 mm above the reference plane was deifned as interested region. ADD value was calculated. Results: Compared with Control group, Pre-hypertension group had decreased AAD,P<0.01 and similar normalized cross-sectional area (Ss),P>0.05; ADD value was similar among different gender and blood lipid levels. Correlation analysis presented that AAD was negatively related to age (r=-0.69,P=0.001), systolic blood pressure (r=-0.37,P=0.001), pulse pressure(r=-0.43,P=0.001) and glycosylated hemoglobin (r=-0.43,P<0.05). Age and systolic blood pressure were the independent risk factors for AAD decline (standardized β=-0.66,P=0.001) and (standardized β=-0.44,P=0.001). Conclusion: Without additional contrast media consumption and radiation dosage, retrospective ECG-triggered coronary CTA may detect AAD changes with risk factors at the early stage in pre-hypertension patients which is helpful to distinguish the high risk individuals.
3.Clinical analysis of relapse factors and prevention for peptic ulcer patients
Junqing LUO ; Zexing DUAN ; Weiqiang LI ; Zhi ZHAO
Journal of Chinese Physician 2014;(4):501-503
Objective To investigate the relapse factors and its control strategy for peptic ulcer patients .Methods A total of 160 cases of peptic ulcer patients who visited our hospital from Jan 2011 to Aug 2013 was retrospectively analyzed .The recurred pa-tients were assigned as the experimental group , and the others as the control group .The relapse factors for peptic ulcer were observed . Results Among 160 peptic ulcers , there were 46 cases with recurrence with a relapse rate of 28.8%.Single factor logistic regression analysis showed that smoking, drinking, the spring and autumn season, h.pylori (Hp) infection, non-steroid anti-inflammatory drugs (NSAIDs), mental factor, and male were the risk factors for recurrence of peptic ulcer .Further multivariable logistic regression analy-sis showed that smoking, drinking, mental factors, history taking NSAIDs, and Hp infection were also the risk factors for recurrence of peptic ulcer .Conclusions Smoking and alcoholism history , meatal factors , history of taking NSAIDs , and Hp infection were the in-dependent risk factors of recurrence of peptic ulcer , intervention of these risk factor might reduce ulcer recurrence .
4.Reflections on Teaching of Medical Imaging Equipment Science
Haitao ZHAO ; Jun LU ; Ting ZHU ; Ying LIU ; Junqing XU ; Yali GE
Chinese Medical Equipment Journal 2003;0(10):-
The medical imaging equipment science is one of the rapidly development science in the medical domain. Based on the characteristics of Medical Imaging Equipment Science, this paper discusses the reflections from the aspects of teachers, teaching contents, teaching schemes and practice teaching.
5.Off-pump percutaneous pulmonary valve implantation in pigs
Junqing ZHOU ; Desheng WEI ; Chu ZHANG ; Zhonghua CHEN ; Jianxing LU ; Zhenhua ZHAO
Chinese Journal of Thoracic and Cardiovascular Surgery 2011;27(12):742-745
Objective The purpose of this study was to investigate the preparation of a pulmonary self-expanding valved stent and the percutaneous implantation of a valved stent in the pulmonary valve position without cardiopulmonary bypass.Methods A bovine jugular valve conduit was trimmed to remove the extraneous materials to reduce profile,and then was sutured onto nitinol stents to form a pulmonary self-expanding valved stent.In vitro,it was tested by a pulsatile mock loop system.Through a 24F delivery system,the valved stents were deployed in the pulmonary valve position of 8 pigs,and then in vivo assessment with echocardiography and a postmortem examination were carried out.Results The pulmonary self-expanding valved stent has an inner diameter of (21.9 ± 1.6) mm,an outer diameter of (24.6 ± 1.5 ) mm,a length of (27.9 ± 4.3 )mm,and an effective orifice area of ( 1.8 ±0.2) cm2.7 of the 8 valved stents were exactly deployed in the native pulmonary valve position,1 valved stent failed.The transvalvular pressure gradient was (7.9 ± 3.3 ) mm Hg by catheter measurement,(9.3 ±4.1 ) mm Hg by Doppler echocardiography.The angiography showed no migration,no regurgitation and no paravalvular leak.The echocartiography showed all the new valves opened and closed well with 2 cases of mild regurgitation.Postmortem examination confirmed the valved stent straddled the pulmonary annuli without migration,the native valve was locked between the stent and arterial wall.Conclusion The acute study demonstrates that the self-expanding valved stent can be successfully implanted in the pulmonary position by a catheter delivery system and function well.Percutaneous pulmonary valve implantation without cardiopulmonary bypass is feasible and has a wide clinical perspective.
6.Family cognitive training for patients with vascular cognitive impairment
Junqing ZHAO ; Xiaohong QIU ; Yuan XUE ; Lifang CHE ; Liyun GUO ; Yufen WANG
Chinese Journal of Physical Medicine and Rehabilitation 2014;36(6):413-415
Objective To observe the effects of family cognitive training on patients with vascular cognitive impairment but without dementia.Methods Sixty patients with non-dementia type vascular cognitive impairment were divided at random into a group which received family cognitive training (30 cases) and a control group (30 cases).The 2 groups all took routine drugs and exercise.The family cognitive training group received cognitive training additionally.Before treatment and after 1 and 6 months of treatment,all of the patients of both groups were assessed using the mini-mental state examination (MMSE),the Montreal cognitive assessment (MoCA) and the modified Barthel index (MBI).Results After 1 month of treatment there was no significant difference between the 2 groups in any of the assessments.After6 months the scores on each item of the MMSE,MoCA and MBI had improved significantly more in the family cognitive training group than in the control group.Conclusion Family cognitive training is effective in treating non-dementia type vascular cognitive impairment.It can delay disease progression and improve cognitive function and ability in the activities of daily living.
7.COX2-PGI2/TXA2 signal pathway involved in protective mechanism of PDTC pretreatment against global cerebral ischemia reperfusion rat hippocampus injury
Jia WANG ; Junqing YANG ; Lijuan YU ; Bin YANG ; Lei ZHAO ; Qingsong JIANG
Chinese Pharmacological Bulletin 2014;(6):782-786
Aim To investigate the effects and mecha-nism of nuclear factor-κ B inhibitor, PDTC, on global cerebral ischemia reperfusion ( GCIR ) rat hippocam-pus. Methods Forty-eight adult male Sprague-Daw-ley rats were randomly divided into one control group receiving sham operation and three experimental groups all receiving global cerebral ischemia for 20 min. In PDTC 100 mg·kg-1 group ( P100 ) and PDTC 200 mg ·kg-1 group ( P200 ) , PDTC 100 mg · kg-1 or PDTC 200 mg·kg-1 was injected ip one hour before ischemi-a respectively. Spatial learning and memory function of rats were tested using Morris water maze. HE staining was employed to observe pathological changes of hipp-ocampal neurons. Expression of COX2 was measured by Western blot, and the content of PGI2 and TXA2 in
rat hippocampus was detected by enzyme-linked immu-nosorbent assay. Results A significant increase of es-cape latency was observed in GCIR group compared to the sham operation group(P<0.05). PDTC 100 mg· kg-1 and PDTC 200 mg · kg-1 significantly reduced escape latency ( P <0.05 ) and histopathological injury in CA1 region of hippocampus. PDTC 100 mg · kg-1 and PDTC 200 mg · kg-1 also reduced COX2 expres-sion, PGI2 content, TXA2 content and PGI2/TXA2 . Conclusion Pretreatment with PDTC can protect hip-pocampus from GCIR injury through inhibition of COX2 expression and PGI2/TXA2 .
8.The analysis of sexuality situation and the influencing factors in 1 732 migrants of Chongqing
Rui ZHAO ; Yuyan LI ; Qi TONG ; Chuanning YU ; Ying ZHOU ; Honglei JI ; Jun LIU ; Yiran LI ; Junqing WU
Chongqing Medicine 2016;45(11):1534-1538
Objective To analyze the sexuality situation and the influencing factors of 1 732 cases of migrants in Chongqing , and provide the scientific basis for improving the sexual health of migrants and the service level of the relevant departments .Meth‐ods The multi stage random cluster sampling method was used to select the subjects .A total of 1 732 married and unmarried mi‐grants who had sexuality were included into the structured questionnaire survey .The SAS9 .3 software was use to statistical analy‐sis .The χ2 test and Ordinal regression analysis and Logistic regression analysis were use to univariate and multivariate analysis .Re‐sults The communication frequency of sexuality of male migrants was higher than the females ,OR=1 .53(95% CI:1 .24-1 .89);young people had the high communication frequency of sexuality ;the frequency of low education groups lower than higher .The fre‐quency of subjects worked in Hong Kong ,Taiwan ,overseas‐funded enterprises are higher than other workplace .The sexual life fre‐quency of male migrants is higher than the female ,OR=1 .84(95% CI:1 .40-2 .42);the sexual life frequency of low age group was higher than high age group ,the frequency of sexual life in factory workers was lower than the Hong Kong ,Taiwan ,overseas‐funded enterprises workers .Compared with the subjects who communicate the sexuality issues often ,the frequency of sexual depression and suppression was higher in the migrants who communicate general and rarely ,the OR was 2 .75 (95% CI:1 .71 -4 .41) and 2 .60 (95% CI:1 .45-4 .66) .Conclusion Male ,younger ,highly educated migrants have a high sexual issues communication frequency . The age and the workplace was the most important factor of the frequency of sexual life .Ease the work pressure and increase the communication of sexual issues will help to relax the sexual depression and depression .
9.Effects of nimodipine and fructose-1,6-diphosphate on cerebral damage in carbon monoxide poisoning mice.
Junqing YANG ; Xiaohui ZHAO ; Qixin ZHOU ; Qingsong JIANG
Chinese Medical Journal 2003;116(12):1911-1915
OBJECTIVETo study the dose- and time-dependent protective effects and the synergistic effects of nimodipine (NMDP) and fructose-1,6-diphosphate (FDP) against cerebral damage induced by acute carbon monoxide (CO) poisoning in mice.
METHODSMale mice were exposed to CO 170 mL/kg, i.p. After CO intraperitonealy exposure, mortality of mice, change in memory function estimated by passive avoidance test, the pathomorphologic observation of brain tissue slices, as well as changes of activities of monoamine oxidase (MAO)-B and Ca(2+)-Mg(2+)-ATPase in cerebral tissue were studied. In dose-dependent protective effect study, NMDP (10.6, 5.3, 2.7 mg/kg) and FDP (2.6, 1.3, 0.67 g/kg) was injected ip, respectively 15 min after CO exposure. To study the time-effect relationship of drugs, NMDP (5.3 mg/kg) and FDP (1.3 g/kg) were administered ip respectively 15 minutes, 45 minutes and 120 minutes after CO exposure. The combination of NMDP (2.7 mg/kg) and FDP (0.67 g/kg) was administered ip15 minutes, 45 min and 120 minutes after CO exposure to study the synergism of the two drugs.
RESULTSEither NMDP (10.6, 5.3 mg/kg) or FDP (2.6, 1.3 g/kg) administered ip within 15 minutes after CO exposure significantly decreased the impairment of memory function and mortality rate induced by CO, inhibited the decrease of Ca(2+)-Mg(2+)-ATPase activity, blunted the rising of MAO-B activity and prevented the delayed hippocampal neuronal death in poisoning mice. To our surprise, the combined use of NMDP (2.7 mg/kg) and FDP (0.67 g/kg) within 15 minutes after CO exposure had similar effects to that in NMDP (10.6, 5.3 mg/kg) and FDP (2.6, 1.3 g/kg).
CONCLUSIONSThese results suggest that the impairment of CO on brain can be attenuated if NMDP or FDP are administered sufficiently and quickly as soon as possible after CO exposure and there exists a synergism of FDP and NMDP against CO poisoning damage.
Animals ; Brain Damage, Chronic ; prevention & control ; Calcium Channel Blockers ; therapeutic use ; Carbon Monoxide Poisoning ; prevention & control ; Dose-Response Relationship, Drug ; Drug Synergism ; Fructosediphosphates ; therapeutic use ; Male ; Mice ; Neuroprotective Agents ; therapeutic use ; Nimodipine ; therapeutic use ; Time Factors
10.Application of continuous monitoring of intracranial pressure and brain oxygen partial pressure in the treatment of patients with severe craniocerebral injury
Zhong WANG ; Ruijian ZHANG ; Zhitong HAN ; Junqing WANG ; Rile WU ; Weiping ZHAO ; Xiaojun ZHANG ; Jingang BAO ; Weiran YANG ; Zhilong ZHANG
Chinese Critical Care Medicine 2021;33(4):449-454
Objective:To investigate the effects of continuous monitoring intracranial pressure (ICP) and brain oxygen partial pressure (PbtO 2) on the prognosis of patients with severe craniocerebral injury. Methods:A prospective randomized controlled trial was conducted. Seventy patients with severe craniocerebral injury with a Glasgow coma score (GCS) 4-8 admitted to the neurosurgical intensive care unit (NICU) of the People's Hospital of Inner Mongolia Autonomous Region from January 2017 to May 2020 were enrolled, and they were divided into ICP monitoring group and ICP+PbtO 2 monitoring group by random number table. Patients in ICP monitoring group received ICP monitoring and were given traditional treatment of controlling ICP and cerebral perfusion pressure (CPP), the therapeutic target was ICP < 20 mmHg (1 mmHg = 0.133 kPa) and CPP > 60 mmHg. Patients in ICP+PbtO 2 monitoring group were given ICP and PbtO 2 monitoring at the same time, and oxygen flow was adjusted on the basis of controlling ICP and CPP to maintain the PbtO 2 > 20 mmHg, and the therapeutic target of ICP and CPP was the same as the ICP monitoring group. ICP and PbtO 2 values were recorded during monitoring in the two groups, the results of CPP, GCS and arterial blood gas analysis were recorded, and the prognosis at 3 months and 6 months after injury was compared by Glasgow outcome scale (GOS) score between the two groups. GOS score > 3 was considered as good prognosis. Kaplan-Meier survival curve was drawn, and the 3-month and 6-month cumulative survival rates of the two groups were analyzed. Linear regression analysis was used to further evaluate the relationship between PbtO 2 and GOS score. Results:Finally, a total of 70 patients with severe craniocerebral injury were enrolled in the analysis, 34 patients received ICP combined with PbtO 2 monitoring and guided therapy, and 36 patients received ICP monitoring alone. The average ICP of ICP+PbtO 2 monitoring group was significantly lower than that of ICP monitoring group (mmHg: 13.4±3.2 vs. 18.2±8.3, P < 0.01). Although the CPP in both groups was great than 60 mmHg, the average CPP of ICP+PbtO 2 monitoring group was significantly higher than that of ICP monitoring group (mmHg: 82.1±10.5 vs. 74.5±11.6, P < 0.01). No significant difference was found in average GCS score or arterial partial pressure of carbon dioxide (PaCO 2) between the ICP+PbtO 2 monitoring group and ICP monitoring group [GCS score: 5.3±2.3 vs. 5.2±2.2, PaCO 2 (mmHg): 33.5±4.8 vs. 32.6±5.2, both P > 0.05]. The average arterial partial pressure of oxygen (PaO 2) of ICP+PbtO 2 monitoring group was obviously higher than that of ICP monitoring group (mmHg: 228.4±93.6 vs. 167.3±81.2, P < 0.01). Compared with the ICP monitoring group, the good outcome rates of 3 months and 6 months after injury in the ICP+PbtO 2 monitoring group were significantly higher (3 months: 67.6% vs. 38.9%, 6 months: 70.6% vs. 41.7%, both P < 0.05). Kaplan-Meier survival curve showed that the 3-month and 6-month cumulative survival rates of ICP+PbtO 2 monitoring group were significantly higher than those of ICP monitoring group (3 months: 85.3% vs. 61.1%, Log-Rank test: χ2 = 5.171, P = 0.023; 6 months: 79.4% vs. 55.6%, Log-Rank test: χ2 = 4.511, P = 0.034). Linear regression analysis showed that PbtO 2 was significantly correlated with GOS score at 3 months and 6 months after injury in patients with severe craniocerebral injury ( r values were 0.951 and 0.933, both P < 0.01). Conclusions:PbtO 2 compared with ICP monitoring guiding therapy is valuable in improving the prognosis of patients with severe craniocerebral injury. It can improve the prognosis at 3-6 months after injury.