Objective:To test the validity and reliability of Chinese version of Psycho-Educational Profile (C-PEP) for children with autism in order to develop an assessment tool suitable for Chinese autistic children.Methods:A sample of 438 children who were diagnosed as autism according to the Diagnostic and Statisti-cal Manual of Mental Disorders,Fourth Edition (DSM-IV)criteria and aged from 2 to 11 coming from four differ-ent medical or educational rehabilitation agencies of Beijing,Wuhan,Shenzhen and Changchun were selected.488 Children with 2 to 7 years old were sampled from ordinary kindergartens.This study examined the validity and reli-ability of C-PEP using autism sample.Construct validity was tested with the C-PEP by inter-subscale Pearson corre-lations and confirmative factor analysis.Criterion-related validity was tested with the Peabody Picture and Vocabula-ry Test (PPVT),Combined Raven Test (CRT),Adaptive Behavior Scale (ABS),Childhood Autism Rating Scale (CARS)and the age as criteria.Discriminate validity was obtained by comparing the differences between the typi-cal and autism samples with the total scores of C-PEP.Internal consistency and rater reliability of C-PEP were ex-amined by Cronbach α,ANOVA of rater variation and intra-class correlation coefficients.Results:The inter-sub-scale correlations of C-PEP were medium relevance,the subscale and domain correlations were relatively high.Confirmative factor analysis indicated a relatively high fitting index between the model and sample da-ta.Regarding the concurrent validity of the C-PEP,the development total score was significantly correlated with the Raven's IQ,PPVT IQ,and ADQ scores,pathological behavior total score was positively related to the CARS score.T test results showed that children with autism were significantly behind the typical children at all age lev-els.Results also revealed that the internal consistency based on coefficient alpha and the intra-class correlation coef-ficients of raters for all subtests of C-PEP were reliable.Conclusion:It suggests that the Chinese version of Psycho-Educational Profile (C-PEP)is of good validity and reliability,and it could be used as an effective tool for measur-ing children with autism.

Objective To analyze the situation of health-risk behaviors of the students in specialty medical science college of Yunnan and its relationship with negative life events, and provide scientific evidence for lowering the occurrence rate of health-risk behaviors. Methods The stratified randomised cluster-sampling method was used to select 576 students of specialty medical science college, and the occurrence rate of health-risk behaviors and life events conditions were estimated by Youth Health-Risk Behavior Questionnaire and Adolescents Self-Rating Life Events Checklist. Descriptive statistic analysis, Chi-square test and Logistic regression analysis was used to analyze the data. Results Among the students of specialty medical science college in Yunnan, the rate of smoking was 3.1%,the rate of drinking was 4.9%,the rate of food refusal was 39.6%, the rate of fighting was 13.5%,the rate of obsessed with the internet was 26.4%, and the rate of substance abuse was 3.1%. There were significant differences between the students of different genders (P<0.05) or specialities (P<0.05) . Logistic regression analysis showed total score of negative life events had positive influence on drinking (OR=1.017,P<0.05), food refusal (OR=1.018,P<0.05), fighting (OR=1.021,P<0.05), obsessed with the internet (OR=1.025, P<0.05), substance abuse (OR=1.025, P<0.05) . The factor of interpersonal relationship had positive influence on drinking (OR=1.162,P<0.05), food refusal (OR=1.102,P<0.05), substance abuse (OR=1.260, P<0.05) . The factor of punished had positive influence on fighting (OR=1.144, P<0.05), and had negative influence on drinking (OR=0.891, P<0.05) . The factor of study pressure had positive influence on fighting (OR=1.143, P<0.05), and the factor of loss had negative influence on fighting (OR=1.144, P<0.05) . Conclusion Negative life events are influencing factors for health-risk behaviors of the students in specialty medical science college of Yunnan, and there is difference on the way that the factor of life events influencing health-risk behaviors.

Objective:To evaluate the relationship between postoperative delirium and preoperative frailty in elderly patients undergoing non-cardiac surgery.Methods:Elderly patients undergoing non-cardiac surgery at our hospital from March 2019 to July 2022 were collected and their age, comorbidities, gender, smoking history, type of surgery, preoperative albumin, duration of surgery, duration of anesthesia, postoperative hypotension, educational level, nutritional status, American Society of Anesthesiologists (ASA) Physical Status classification, postoperative admission to ICU or not, intraoperative bleeding and preoperative frailty status were collected. The patients were divided into delirium group and non-delirium group according to whether postoperative delirium occurred. The risk factors for postoperative delirium were analyzed by multivariate logistic regression analysis, and the receiver operating characteristic curve was drawn to analyze the value of risk factors in predicting postoperative delirium.Results:There were 74 cases in delirium group and 321 cases in non-delirium group, and the incidence of postoperative delirium was 18.7%. There were statistically significant differences in terms of age ≥70 yr, education level of junior high school and below, poor nutritional status, ASA Physical Status classification Ⅲ, postoperative admission to ICU, proportion of frailty and intraoperative bleeding volume between delirium group and non-delirium group ( P<0.05). The results of logistic regression analysis showed that age, educational level, nutritional status, ASA Physical Status classification, intraoperative bleeding and frailty were all independent risk factors for delirium ( P<0.05). The area under the receiver operating characteristic curve of preoperative frailty predicting postoperative delirium was 0.672 (95% confidence interval 0.605-0.740). Conclusions:Preoperative frailty is an independent risk factor for postoperative delirium in elderly patients undergoing noncardiac surgery, which can predict the occurrence of postoperative delirium to some extent.

OBJECTIVETo assess the effects of hormone replacement therapy (HRT) on platelet activation in postmenopausal women compared with premenopausal women.

METHODSThe expressions of CD41 and CD62P in fifteen postmenopausal women before and after HRT were detected using flow cytometry (FCM), with fifteen premenopausal women with a mean age of 47 years as controls.

RESULTSThe expressions of CD41 and CD62P in postmenopausal women were higher than those in the control group. CD62P(%), CD62P(I) and CD41 were reduced from 36.40 +/- 5.9, 37.75 +/- 5.8, and 470.11 +/- 74.0 to 27.97 +/- 5.6, 26.64 +/- 4.9, and 303.23 +/- 72.8 after six months of HRT (P < 0.05).

CONCLUSIONSPlatelet activation in postmenopausal women was higher than in premenopausal women and was reduced significantly after six months of HRT. HRT may have a favorable effect on reduction of platelet activity.

Adult ; Female ; Hormone Replacement Therapy ; Humans ; Middle Aged ; Platelet Activation ; drug effects ; Postmenopause ; physiology

Objective:To assess the prevalence of metabolic syndrome(MS) and its relationship with hyperuricemia(HUA) in perimenopausal women in Anning city, Yunnan province.Methods:This is a cross-sectional survey. In May 2021, a multi-stage stratified sampling method was used to collect demographics and clinical data [ethnicity, living community, height, weight, waist circumference, blood pressure, fasting plasma glucose, triglycerides(TG), serum uric acid, high density lipoprotein-cholesterol(HDL-C), alanine transaminase(ALT), etc] in a total of 6 721 perimenopausal women aged 45-60 years.Results:A total of 6 721 perimenopausal women were included in this study. The prevalences of MS and HUA were 14.05%(95% CI 13.22%-14.88%) and 6.46%(95% CI 5.88%-7.07%), respectively. The average age, HDL-C, urea, direct bilirubin, and albumin levels in the perimenstrual HUA population were lower than those in the non-HUA population while the levels of TG, ALT, heart rate, body mass index(BMI), and creatinine were higher(all P<0.05). The prevalence of HUA in perimenopausal women with ethnic minorities and family history of chronic diseases was higher than that in Han nationality and without family history of chronic diseases. The prevalence of MS in perimenopausal women was increased with the increase of serum uric acid( Z=-15.313 8, P<0.001). Multivariate logistic regression model showed that HUA was positively correlated with MS( OR=1.526, 95% CI 1.192-1.954) after adjusting for covariates such as BMI and ethnicity, and the incidence of MS in perimenopausal women in HUA group was 1.526 folds higher than that in non-hyperuricemia group. Conclusion:HUA is highly positively correlated with MS in perimenopausal women. The management of uric acid level in perimenopausal women should be strengthened.

OBJECTIVETo describe a hospital outbreak of severe acute respiratory syndrome (SARS) and summarize its clinical features and therapeutic approaches.

METHODSThe outbreak started with a SARS patient from the community, and a total of 96 people (76 women and 20 men, mean age (29.5 +/- 10.3) years, 93.8% of whom were health care workers) who had exposure to this source patient became infected in a short time. Clinical data in this cohort were collected prospectively as they were identified.

RESULTS(1) The incubation period ranged from 1 to 20 (mean: 5.9 +/- 3.5) days. The duration of hospitalization was (17.2 +/- 8.0) days. (2) The initial temperature was (38.3 +/- 0.6) degrees C, while the highest was (39.2 +/- 0.6) degrees C (P < 0.001), with fever duration of (9.0 +/- 4.2) days. (3) Other most common symptoms included fatigue (93.8%), cough (85.4%), mild sputum production (66.7%), chills (55.2%), headache (39.6%), general malaise (35.4%) and myalgia (21.9%). (4) The radiographic changes were predominantly bilateral in the middle or lower lung zones. The number of affected lung fields was 1.2 +/- 0.8 on presentation, which increased to 2.9 +/- 1.4 after admission (P < 0.001). The interval from the beginning of fever to the onset of abnormal chest radiographs was (3.5 +/- 2.3) days, which increased in size, extent, and severity to the maximum (6.7 +/- 3.5) days later. The time before the lung opacities were basically absorbed was (14.9 +/- 7.8) days. (5) Leukopenia was observed in 67.7% of this cohort. The time between the onset of fever and leukopenia was (4.4 +/- 2.3) days, with the lowest white blood cell count of (2.80 +/- 0.72) x 10(9)/L. (6) The lowest arterial oxygen saturation was (94.8 +/- 3.1)% with supplementary oxygen. (7) Antibiotical therapies included tetracyclines (91.0%), aminoglycosides (83.3%), quinolones (79.2%); 18.8% of the patients received a combination of tetracyclines and aminoglycosides, while 11.5% received a combination of tetracyclines and quinolones, and 63.5% received a combination of tetracyclines, aminoglycosides and quinolones. Vancomycin was used in 13.5% of the patients. (8) 68.8% of the patients were treated with methylprednisolones for a mean interval of (4.9 +/- 2.4) days. The initial dose was (67.3 +/- 28.2) mg/d and the maximal dose was (82.4 +/- 30.5) mg/d. (9) Human gamma-globulin, interferon-alpha, antiviral drugs (oral ribavirin or oseltamivir) were used respectively in 68.6%, 46.9% and 92.7% of the patients. (10) Ninety-five patients (99.0%) had a complete clinical recovery, and only 1 patient (1.0%) died.

CONCLUSIONSSARS appears to be quickly infectious and potentially lethal among health care workers, characterized by acute onset and rapid progression, and mostly bilateral lung involvement on chest radiographs. Proper administration of glucocorticosteroids seems to be of some benefits. Antibiotics, human gamma-globulin, interferon-alpha, and antiviral drugs, although empirically, might be useful to shorten the clinical course.

Adult ; China ; epidemiology ; Cross Infection ; diagnosis ; epidemiology ; therapy ; Disease Outbreaks ; Female ; Humans ; Male ; Severe Acute Respiratory Syndrome ; diagnosis ; epidemiology ; therapy

OBJECTIVETo identify valid measures for preventing outbreaks of severe acute respiratory syndrome (SARS) among protected healthcare workers in isolation units.

METHODSArchitectural factors, admitted SARS cases and infection of healthcare workers in different isolation wards between January 30 and March 30, 2003 were analyzed.

RESULTSFour types of isolation wards were analyzed, including the ward where the thirty-first bed was located on the twelfth floor, the laminar flow ward in the Intensive Care Unit where the tenth bed was located on the fifteenth floor, the ward where the twenty-seventh bed was located on the thirteenth floor of the Lingnan Building, and thirty wards on the fourteenth to eighteenth floors of the Zhongshan Building. The ratios (m(2)/m(3)) of the area of the ventilation windows to the volume of the rooms were 0, 0, 1:95 and 1:40, respectively. Numbers of SARS cases in the wards mentioned above were 1, 1, 1 and 96, respectively. Total times of hospitalization were 43, 168, 110 and 1272 hours, respectively. The infection rates of the healthcare workers in the areas mentioned above were 73.2%, 32.1%, 27.5% and 1.7%, respectively. The difference in the infection rates was of statistical significance.

CONCLUSIONSIsolating SARS cases in wards with good ventilation could reduce the viral load of the ward and might be the key to preventing outbreaks of SARS among healthcare workers along with strict personal protection measures in isolation units.

Adult ; Disease Outbreaks ; prevention & control ; Facility Design and Construction ; Female ; Hospital Units ; Humans ; Infectious Disease Transmission, Patient-to-Professional ; prevention & control ; Male ; Middle Aged ; Patient Isolation ; Severe Acute Respiratory Syndrome ; prevention & control ; Ventilation

Objective To study the influencing factors of primary hypertension by investigating its prevalence in elderly patients of Deang nationality.Methods Nine hundred and thirty-nine elderly patients of Deang nationality were divided into hypertension group (n =353),prehypertension group (n=377) and control group (n=209).Their physical examination data were recorded and their blood pressure was measured.Results The detection rate of hypertension was significantly lower in elderly patients of Deang nationality than in those of the other nationalities in our country with their age ≥60 years (37.6％ vs 49.0％,P＜0.05).The detection rate of hypertension,isolated systolic hypertension and prehypertension increased with the increasing age (P＜0.05).Multivariate logistic regression analysis showed a cross interaction between economic level and alcohol drinking (P＜0.05) and a positive correlation of BMI,age,gender,divorce or widow,smonking,high salt diet with hypertension (P＜0.05).Conclusion The detection rate of hypertension is lower in elderly patients of Deang nationality than in those of the other nationalities in our country.Economic level,alcohol drinking,BMI,age,gender,divorce or widow,smoking,high salt and fat diet are the major risk factors for hypertension.However,regular eating of vegetables can reduce the risk of hypertension.

Objective:To evaluate the test-retest reliability of MRI criteria in the 2019 Bosniak classification of cystic renal masses (CRMs) and to analyze the impact of lesions′ property, size and readers′ experience on the test-retest reliability.Methods:From January 2009 to June 2019, 207 patients with 207 CRMs were included in this retrospective study. All of them underwent renal MRI and surgical-pathologic examination. According to Bosniak classification, version 2019, all CRMs were independently classified twice by eight radiologists with different levels of experience. All radiologists were blinded to the pathology of the lesions. By using intraclass correlation coefficient (ICC), test-retest reliability was evaluated for all CRMs and for subgroups with different pathological properties (benign and malignant) and different sizes (≤40 mm and>40 mm). The test-retest reliability of 4 senior readers (≥10 years of experience) and 4 junior readers (<10 years of experience) were evaluated respectively. The comparison of ICC was performed using Z test. Results:The 207 CRMs included 111 benign lesions (83 benign cysts, 28 benign tumors) and 96 malignant tumors. There were 87 lesions with maximum diameter ≤40 mm and 120 with maximum diameter>40 mm. The test-retest reliability (ICC) of each reader for all lesions was 0.776-0.888, the overall ICC was 0.848 (95%CI 0.821-0.872). The ICCs of senior and junior readers were 0.853 (95%CI 0.824-0.880) and 0.843 (95%CI 0.811-0.871) respectively, without significant difference between the two groups ( Z=0.85, P=0.374). The ICC of all readers was 0.827 for benign lesions and 0.654 for malignant lesions, showing significant difference ( Z=2.80, P=0.005). The ICC was 0.770 for lesions ≤40 mm and 0.876 for lesions>40 mm, which was significantly different ( Z=-2.36, P=0.018). For CRM subgroups with different pathological properties and different sizes, there was no significant difference in test-retest reliability between senior and junior readers (all P>0.05). Conclusion:The test-retest reliability of MRI criteria in the 2019 Bosniak classification of CRMs is excellent and unaffected by readers′ experience. The reliabilities are not consistent among CRMs of different pathological properties and different sizes, but all reached the level of good and above.

Objective: To determine the optimal dose of dexmedetomidine required to prevent nausea and vomiting when used for postoperative analgesia after gynecological laparoscopic surgery. Methods: A total of 135 patients, aged 18-60 yr, weighing 52-80 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective gynecological laparoscopic surgery, were divided into 3 groups (n=45 each) using a random number table method: control group (group C), dexmedetomidine 1 μg/kg group (group D₁) and dexmedetomidine 2 μg/kg group (group D₂). Immediately after anesthesia induction, dexmedetomidine 0.4 μg·kg^-1·h^-1 was injected intravenously until 30 min before the end of surgery in all the patients.When the patient was fully awake at the end of surgery, the tracheal tube was removed, and patients were sent to postanesthesia care unit and received patient-controlled intravenous analgesia (PCIA). The PCIA solution contained sufentanil 1.2 μg/kg and dezocine 20 mg in 100 ml of 0.9% normal saline.The PCIA pump was set up with a 0.5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 2 ml/h.Dexmedetomidine 1 and 2 μg/kg were added to PCIA solution in group D₁ and group D₂, respectively.The occurrence of nausea and vomiting was recorded in postanesthesia care unit stay period (P₁) and in 0-12 h (P₂), 12-24 h (P₃), 24-36 h (P₄) and 36-48 h (P₅) periods after patients returned to the ward.Ramsay sedation score was recorded at 12, 24, 36 and 48 h after patients returned to the ward.When visual analogue scale score >3, patients were told to press PCIA.Patients were followed up for 48 h after surgery, and patients′ satisfaction, pressing times of PCIA and occurrence of pruritus, respiratory depression, bradycardia and dizziness were recorded. Results: Compared with group C, the incidence of nausea was significantly decreased in P₂ period, and the pressing times of PCIA were reduced in P_{2, 3} period in D₁ and D₂ groups (P<0.05). There was no significant difference in Ramsay sedation score at each time point, patients′ satisfaction and incidence of bradycardia among the three groups (P>0.05). No patients developed pruritus, respiratory depression or dizziness in the three groups. Conclusion The optimal dose of dexmedetomidine required to prevent nausea and vomiting is 1 μg/kg when used for postoperative analgesia after gynecological laparoscopic surgery.