Objective To explore the risk factors causing tetany in patients with hyperventilation syndrome. Meth?ods A total of 103 patients with hyperventilation syndrome treated in our hospital were included in this study. According to whether there was tetany, patients were divided into tetany group and non-tetany group. Values of gender, age, electrolyte, pH and p(CO2) were analysed between two groups. The factors of P<0.1 were engaged in binary Logistic regression. Logistic regression (Forward Wald) was used to analyze the risk factors of tetany in patients with hyperventilation syndrome. Re?sults In 103 patients there were 70 patients with tetany (68%), 33 patients without tetany(32%). The serum K+, serum phos?phorus and p(CO2) values were significantly lower in tetany group than those of non-tetany group (P<0.01), while the pH value was significantly higher in tetany group than those of non-tetany group (P<0.01). There were no significant differences in gen?der, age, serum Na+, serum Cl-, serum calcium (bound calcium and ionized calcium), ionized calcium and serum Mg2+levels be?tween two groups (P>0.05). It was revealed that the younger age, the lower level of the serum K+, serum phosphorus and p(CO2) were the risk factors of tetany through binary Logistic regression analysis. Conclusion The risk factors of tetany in patients with hyperventilation syndrome include younger age, lower level of serum K+and serum phosphorus and reduced p(CO2).

Adenocarcinoma ; metabolism ; pathology ; Adenocarcinoma, Mucinous ; metabolism ; pathology ; Adenocarcinoma, Papillary ; metabolism ; pathology ; Carcinoma, Signet Ring Cell ; metabolism ; pathology ; Follow-Up Studies ; Gene Expression Regulation, Neoplastic ; Humans ; Lymphatic Metastasis ; Neoplasm Invasiveness ; Organic Cation Transport Proteins ; biosynthesis ; genetics ; Organic Cation Transporter 2 ; Osteopontin ; Prognosis ; RNA, Messenger ; biosynthesis ; genetics ; Sialoglycoproteins ; biosynthesis ; genetics ; Stomach Neoplasms ; metabolism ; pathology ; Survival Rate

BACKGROUNDStandardized screening tools for Parkinson syndrome have not been developed for non-western populations. This study aimed to validate the Copiah County questionnaire (CCQ) as a screening instrument in a Chinese rural population.

METHODSAll participants of a previously reported prevalent study were interviewed using CCQ. The participants who answered yes to at least one item on CCQ were defined as positive. The Parkinson's disease (PD) diagnosis was established using United Kingdom Parkinson's disease Brain Bank Clinical diagnosis criteria (UKPDBBC) and served as a gold standard to determine the sensitivity, specificity, and positive and negative predictive values (PPV, NPV) for the questionnaire.

RESULTSAmong 16 130 participants, 2872 (17.8%) were screened positive for CCQ and 13 258 negative (82.2%). Among the 697 participants diagnosed as having Parkinson syndrome, 605 were positive for CCQ, and 92 were negative, leading to a sensitivity of 86.8%. Out of the 15 433 non-Parkinson syndrome participants, 13 166 were negative to CCQ, giving a specificity of 85.3%. Among the 2872 participants screened positive, 605 were diagnosed with Parkinson syndrome, and their PPV was 21.1%. For the 13 258 participants screened negative on CCQ, 92 were diagnosed with Parkinson syndrome and 13 166 did not have Parkinson syndrome, leading to a NPV of 99.3%.

CONCLUSIONSCCQ appeared to have satisfactory statistical parameters to serve as a screening instrument for Parkinson syndrome in this rural Chinese population. Further studies may prove the utility of this short questionnaire in Parkinson syndrome screening among Chinese populations including those residing in rural areas.

Asian Continental Ancestry Group ; Female ; Humans ; Male ; Middle Aged ; Parkinsonian Disorders ; diagnosis ; Rural Health ; Surveys and Questionnaires

BACKGROUNDThe studies of the natural progression of Parkinson's disease (PD) in Chinese populations have been lacking. To address this issue and obtain a preliminary data, we conducted a PD progression assessment in 15 adults with de novo PD from a nutritional intervention trial (NIT) cohort in Lin County China.

METHODSUsing the Copiah County screening questionnaire and United Kingdom Parkinson's Disease Society Brain Bank diagnostic criteria, we surveyed the available NIT cohort members in 2000 and diagnosed 86 patients as PD. In 2010, we resurveyed all PD patients and confirmed definite PD diagnosis in 15 cases with the rest of them being dead (54); having probable (10) PD or vascular Parkinsonism (3); refusing to participate (2); or being away (2). In both surveys, we used Hoehn and Yahr (HY) scale and assessed the disease progression. Unified Parkinson's Disease Rating Scale (UPDRS) was added to the second survey.

RESULTSIn 2010, the average disease duration for 15 definite PD patients was 13.6 ± 7.3 years. Over a 10-year time span, 9 out of 15 patients remained at the same HY stage while the remaining 6 progressed. Rigidity (47% vs. 100%; P = 0.002) and postural instability (7% vs. 47%; P = 0.005) worsened significantly. The mean UPDRS motor scores in 2010 were 39.4 ± 23.7.

CONCLUSIONSOverall worsening of motor function in PD seems to be the rule in this untreated cohort, and their rate of progression seemed to be slower than those reported in the western populations.

Aged ; Aged, 80 and over ; Disease Progression ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease ; pathology ; Severity of Illness Index

OBJECTIVETo analyze the cervical cancer mortality and distribution profiles by areas and population in 2004 - 2005 and the changes in the last 30 years.

METHODSThe demographic information and cervical cancer death data came from the Third National Retrospective Sampling Survey of Death Causes which including 158 sampling areas (including 61 cities and 97 villages; 52 in the east region, 49 in the middle region and 57 in the west region) covered 31 province-level regions in the interior of China by multiple stage stratified clustering sampling. The total number of the samples were 142 660 482 person years (72 970 241 person years in male and 69 690 241 person years in female). The crude and age-specific death rate was calculated. The standardized death rate was calculated by using 5 years interval from the census data of 2000. In addition, the mortality data was compared with the two previous national death surveys in 1970's and 1990's, respectively.

RESULTSIn the sampling region of the third retrospective death causes survey from 2004 to 2005, the crude death rate of cervical cancer was 2.86/100 000 (1995/69 690 241), which accounting for 2.86% (1995/69 667) and ranking 9th of all cancer death causes in female population. The crude death rates of cervical cancer were 2.88/100 000 (1326/46 091 419) and 2.83/100 000 (669/23 598 822) for rural areas and urban areas, respectively, the Chinese population adjusted death rates of rural and urban areas were 2.01/100 000 and 1.67/100 000, respectively. The standardized death rates of cervical cancer in 1973 - 1975 and 1990 - 1992 were 11.10/100 000 and 3.25/100 000, respectively, which accounting for 17.91% and 4.86%, respectively; in 2004 - 2005, the crude death rates increased by age, rose remarkably from the age of 40 and arrived the peak of 20.83/100 000 (82/393 624) at the age of 85. The mortality among 35 - 44 year-old group was higher than those in 1990's. The crude death rates of the middle, west and east areas were 3.41/100 000 (827/24 225 738), 3.25/100 000 (636/19 563 647) and 2.05/100 000 (532/25 900 856), respectively, the Chinese population adjusted death rates of the middle and west areas were about twice that of the east (2.35/100 000 in the middle, 2.38/100 000 in the west, and 1.19/100 000 in the east).

CONCLUSIONThe mortality of cervical cancer was higher in rural areas than that in urban, as well as higher in the middle and west areas than that in east area in the interior of China in 2004 - 2005. Younger trend of cervical cancer death was observed; the mortality of cervical cancer and constituent ratio in the female tumor death continued to decline compared to those in 1973 - 1975 and 1990 - 1992.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cause of Death ; trends ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Health Surveys ; Humans ; Infant ; Infant, Newborn ; Middle Aged ; Neoplasms ; Uterine Cervical Neoplasms ; epidemiology ; mortality ; Young Adult

OBJECTIVETo study the possible association between C-reactive (CRP) and insulin resistance (IR) as well as the pathogenesis of type 2 diabetes macrovascular complication.

METHODSSerum CRP was measured by ultrasensitive immuoturbidimetric, which was determined on type 2 diabetes (T2DM) with or without macrovascular complication (70 and 60 cases respectively) and on normal controls (90 cases). IR was estimated by homeostasis model assessment (HOMA-IR).

RESULTSResults showed that the concentration of CRP was higher in T2DM with or without macrovascular complications than that in the healthy subjects (P < 0.01), while it was higher in diabetic patients with macrovascular complications than that in diabetic patients without macrovascular complications (P < 0.01). In diabetic patients with macrovascular complications, person correlation analysis indicated that there existed positive correlations between CRP and FINS, HOMA-IR, triglyceride (TG) while stepwise linear regression showed that usCRP and HOMA-IR, TG having linear correlation.

CONCLUSIONCRP seemed to play a role in the initiation and progression of atherosclerosis in type 2 diabetes, possibly was by the way of IR.

C-Reactive Protein ; metabolism ; Case-Control Studies ; Diabetes Complications ; blood ; metabolism ; pathology ; Diabetes Mellitus, Type 2 ; complications ; metabolism ; physiopathology ; Female ; Homeostasis ; Homocysteine ; blood ; Humans ; Inflammation Mediators ; metabolism ; Insulin Resistance ; Linear Models ; Male ; Middle Aged

Objective To observe the effects of Qingyuan Shenghua Decoction on cardiovascular indexes and illness severity in sepsis patients after severe bone trauma. Methods Forty-eight sepsis patients after severe bone trauma were randomly divided into control group(22 cases)and treatment group(26 cases). The two groups were given routine treatment of western medicine according to International Guidelines for Management of Severe Sepsis and Septic Shock (2012). Additionally,the treatment group was treated with oral use or intranasal use of Qingyuan Shenghua Decoction, a herbal medicine recipe mainly composed of Radix Astragali, Radix Salviae Miltiorrhizae,Radix Angelicae Sinensis,Radix Paeoniae Rubra,Radix et Rhizoma Rhei,Rhizoma Curcumae, and Flos Carthami. Before and after treatment,we observed the mean arterial pressure(MAP),central venous pressure(CVP), heart rate(HR), arterial blood lactic acid(Lac), central venous blood oxygen saturation (ScvO2),central venous-arterial blood carbon dioxide partial pressure difference (Pcv-aCO2),acute physiology and chronic health evaluation system Ⅱ(APACHE Ⅱ) scores , sequential organ failure assessment (SOFA) scores, and oxygenation index (PaO2/ FiO2) of the two groups. Results With the prolongation of medication time,MAP,CVP,ScvO2,and Pcv-aCO2 of the two groups were increased gradually,and HR and Lac were decreased gradually (P < 0.05 or P < 0.01 compared with those before treatment) . Compared to the control group at the same time period, the treatment group had higher MAP, ScvO2, Pcv-aCO2 and PaO2/FiO2, and had lower HR, Lac, APACHEⅡ scores and SOFA scores 7 days after treatment, the difference being significant(P < 0.05). Conclusion Qingyuan Shenghua Decoction is effective on improving the abnormal hemodynamics and microcirculation, enhancing the efficient utilization of oxygen, protecting the function of multiple viscera,and alleviating the severity of disease in sepsis patients after severe bone trauma.

BACKGROUND AND OBJECTIVEIn China, there has been no established national program for cervical cancer prevention, the screening methods and experiences are especially deficient in the rural areas. The aim of this paper is to evaluate the effects of acetic acid/Lugol's iodine (VIA/VILI) used for screening of cervical cancer and pre-cancerous lesions in a rural area of China by analyzing the large-scale population-based screening data from the demonstration site.

METHODSWomen aged 30-59 years from Xiangyuan County in Shanxi Province were recruited for cervical cancer screening from 2005 to 2007. VIA/VILI was the primary screening method followed by colposcopy if the VIA/VILI was positive. Cervical lesions were diagnosed by directed biopsy under the colposcopy. The VIA/VILI negative women or cervical intraepithelial neoplasia 1 (CIN1) were re-screened using the same procedure in the next year.

RESULTSIn total, 7145 women received the cervical cancer screening, with a participation rate of 74.75%. Their average age was 42.16 years. A total of 1287 women were consecutively screened for three times from 2005 to 2007. The detection rates of CIN2, CIN3 and cervical cancer were 0.70% (9/1287), 1.01% (13/1287) and 0.23% (3/1287) for the first round screening, and were 0.22% (2/976), 0.11% (1/976) and 0% (0/976) for the second round screening, respectively. Only one CIN2 was found in the third round screening. In the years of 2006-2007, 3490 women were screened consecutively twice. The detection rates of CIN2, CIN3 and cervical cancer were 0.26% (9/3490), 0.52% (18/3490) and 0.15% (5/3490) for the first round screening, and 0.40% (14/2943), 0.40% (14/2943) and 0.03% (1/2943) for the second round screening. Likewise, 2 368 women were screened consecutively twice in the years of 2007-2008. The detection rates of CIN2, CIN3 and cervical cancer were 0.55% (13/2368), 0.25% (6/2368) and 0.12% (3/2368) for the first round screening, and 0.42 (10/2040), 0.04% (1/2040) and 0% for the second round screening. The cumulative detection rates for CIN2, CIN3 and cervical cancer were 0.81% (58/7145), 0.74% (53/7145) and 0.17% (12/7145), respectively. And 53.45% (31/58) of CIN2, 68.81% (37/53) of CIN3 and almost all cervical cancers (11/12) were found during the first round screening, except for an early stage cervical cancer (Ia). Only one CIN2 was detected in the third round screening in the same population. The average age of CIN1, CIN2, CIN3 and cervical cancer were 38.65, 40.61, 44.10 and 46.73 years, respectively.

CONCLUSIONSVIA/VILI can be used as an alternative screening method for cervical cancer and high-grade pre-cancerous lesions among the women aged 30-59 years in China's rural areas because of its low cost, easy training for the local health providers, and less depending on facilities. One round screening by VIA/VILI can detect more than a half of CIN2, two-thirds of CIN3 and almost all the cervical cancer in the population, and the detection rates of CIN2/3 can be increased by two consecutive rounds of screening.

Acetic Acid ; Adult ; Carcinoma in Situ ; diagnosis ; Carcinoma, Squamous Cell ; diagnosis ; Cervical Intraepithelial Neoplasia ; diagnosis ; China ; Female ; Follow-Up Studies ; Humans ; Iodides ; Mass Screening ; methods ; Middle Aged ; Rural Population ; Uterine Cervical Neoplasms ; diagnosis

OBJECTIVETo study the value of endocervical curettage (ECC) in the detection of cervical intraepithelial neoplasia (CIN) and cervical cancer, and the necessity of ECC during colposcopic examination.

METHODSIn the high prevalent area of cervical cancer in Shanxi Province, China, a total of 1997 women aged 35 approximately 45 years old were enrolled. Cervical cytology, colposcopy and targeted multiple biopsies, as well as ECC were performed for all women.

RESULTSAmong the 1997 women received ECC, 31 was positive for abnormal histologic changes with a frequency of 1.6%. Of the 31 cases, 9 had low grade squamous intraepithelial lesions (LSIL, 0.5%), 20 had high grade squamous intraepithelial lesions (HSIL, 1.0%), and 2 had squamous-cell carcinoma. No pathologic diagnosis could be made in 131 women because the tissue curretaged was insufficient. The women with positive cytologic findings had higher frequency (5.3%) of abnormal ECC than those with negative cytologic findings (0.3%). There was positive correlation between the frequency of abnormal ECC and the grade of cytolologic findings. Abnormal ECC was present in 9.1% of those with unsatisfactory colposcopy while 1.3% of those with satisfactory colposcopy (P < 0.01). The frequency of abnormal ECC was 0.6% in patients with negative colpocopy, 0.9% in LSIL and 24.1% in HSIL. Frequency of abnormal ECC in women with a negative colposcopy or LSIL was significantly lower than that with HSIL. The positive rate of ECC pathologically verified was 3.3% in LSIL, 22.2% in HSIL and 50.0% in squamous carcinoma, respectively (P < 0.01). Of the 316 patients with positive cytology but negative colposcopy, ECC was abnormal in 8 (2.5%), of which HSIL cytologically verified was in 3.

CONCLUSIONIf cytology or colposcopy shows HSIL or more severe changes, and cytology is positive while colposcopy is unsatisfactory, ECC should be done routinely.

Adult ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; Cervical Intraepithelial Neoplasia ; diagnosis ; pathology ; Cervix Uteri ; pathology ; Colposcopy ; Dilatation and Curettage ; Female ; Humans ; Middle Aged ; Uterine Cervical Neoplasms ; diagnosis ; pathology

OBJECTIVETo determine the association between viral load of high risk human papillomavirus (HR-HPV) and cervical intraepithelial neoplasia (CIN).

METHODSCervical exfoliated cells were collected from 18 186 women aged 17 -59 from six urban areas and eight rural areas when they were screened in the cross-sectional population-based studies from 1999 to 2008. HR-HPV was detected by the Hybrid Capture 2 (hc2) system, and viral load was measured by the ratio of relative light units to standard positive control (RLU/PC). RLU/PC was categorized for analysis into four groups: negative [0, 1.00), low viral load [1.0, 10.00), moderate viral load [10.00, 100.00), and high viral load > or = 100.00. Cervical lesions were diagnosed by biopsies as normal, CIN 1, CIN 2, CIN 3 and squamous cervical cancer (SCC). Association between HR-HPV viral load and CIN was evaluated by unconditional multinomial logistic regression.

RESULTSThe HR-HPV infection rate of the population was 14.51% (2515/17334). 100.00% (29/29) of SCC, 97.63% (206/211) of CIN 3, 93.43% (199/213) of CIN 2, 75.04% (421/561) of CIN 1 and 10.17% (1660/16320) of normal women were positive for HR-HPV DNA. The median RLUs for the HR-HPV positive women with SCC, CIN 3, CIN 2, CIN 1 and normal were 320.85, 158.05, 143.70, 125.34 and 9.64, respectively. There were significant differences among the distributions of viral loads in each lesion (chi2 = 6190.40, P < 0.01). The severity of CIN increased with the viral load (chi2 = 5493.35, P <0.01). Compared with the risks of CINs in HR-HPV negative population, the risks of CINs in low, moderate and high viral loads were increased gradually [OR(95% CI) : CIN 1 : 9.01(6.31 - 12.87), 24.96(18.23 - 34.17) and 68.42(51.40 - 91.08); CIN 2 : 26.44(12.07 - 57.95), 98.53(49.54 - 195.98) and 322.88(168.62 - 618.27); CIN 3+ : 72.89(24.02-221.18); 343.58(121.81-969.09) and >999.99(473.38 - >999.99)], and there were obvious dose-response relationships (chi2trend was 3115.05, 2413.95 and 3098.57, respectively. P< 0.01). In each age group of the HR-HPV positive population,the risks of CIN 2 + in the women with moderate or high viral load were higher than the one with low viral load [OR(95% CI): <35 : 4.71(1.23 - 18.09) and 15.06(4.40 - 51.49); 35 -: 4.01 (1.62 -9.90) and 14.09(6.15 -32.28); 40 - : 3.06(1.52 -6.16) and 7.78(4.05 -14.95); > or =45: 3.50(1.36 -9. 01) and 7.57(3.13 - 18. 30)], and there was a positive correlation between the risk of CIN 2+ and the viral load (chi2trend was 51.33, 66.28, 53.64 and 51.00, respectively. P <0.01). The risk of CIN 2 + was highest among the women aged 40 - with high viral load [OR (95% CI) : 2.02 (1.15 - 3.52)].

CONCLUSIONThere is strong correlation between the HR-HPV viral load and the severity of CIN, and so is the correlation between the HR-HPV viral load and the risk of CIN 2 +. A moderate to high viral load of HR-HPV should be the major risk factor for the cervical cancer and CIN 2 and CIN 3, and there is a higher risk in the women aged 35 or older than the younger ones. Considering both the age and viral load could help the doctors to manage the screening women more effectively.

Adult ; Cervical Intraepithelial Neoplasia ; epidemiology ; pathology ; virology ; Cervix Uteri ; pathology ; virology ; Female ; Humans ; Middle Aged ; Papillomavirus Infections ; epidemiology ; pathology ; virology ; Risk Factors ; Uterine Cervical Neoplasms ; epidemiology ; pathology ; virology ; Viral Load