To investigate the awareness of cognitive impairment disorders among residents of the Xizang Autonomous Region and its influencing factors, thereby providing a basis for targeted prevention and treatment efforts.

From April to December 2024, a questionnaire survey was conducted among permanent residents aged ≥18 years (residing in the Xizang Autonomous Region for 180 days or more). The survey was primarily conducted online, supplemented by QR code distribution during community medical outreach by healthcare workers. Demographic information and data on awareness of cognitive disorders were collected, and an ordered Logistic regression model was used to analyze influencing factors in the overall population and stratified by occupation.

A total of 327 questionnaires were collected, with 14 excluded (13 for not meeting residency requirements and 1 for self-reported diagnosis of cognitive impairment), leaving 313 valid questionnaires. The average age of respondents was 42.0±11.9 years; 108 (34.5%) were male, and 205 (65.5%) were female. Most respondents were from Lhasa (78.6%, 246/313); 179 (57.2%) were healthcare workers, and 134 (42.8%) were non-healthcare workers. Regarding awareness of cognitive impairment disorders, 7.3% (23/313) were "unaware", 75.7% (237/313) were "partially aware", and 16.9% (53/313) were "well aware".Ordered Logistic regression analysis revealed that education level of high school or below (OR=2.82, 95% CI: 1.18-6.75, P=0.020), non-healthcare workers (OR=4.03, 95% CI: 2.00-8.14, P < 0.001), and no prior contact with cognitive impairment patients (OR=2.95, 95% CI: 1.64-5.32, P < 0.001) were associated with lower disease awareness. Subgroup analysis stratified by occupation showed that education level of high school or below (OR=3.00, 95% CI: 1.10-8.15, P=0.031) and no prior contact with cognitive impairment patients (OR=3.13, 95% CI: 1.14-8.60, P=0.027) were associated with lower awareness among non-healthcare workers, while no prior contact with cognitive impairment patients (OR=3.40, 95% CI: 1.61-7.20, P=0.001) was associated with lower awareness among healthcare workers.

Awareness of cognitive impairment disorders among residents of the Xizang Autonomous Region needs improvement. Educational level, occupation, and prior contact with cognitive impairment patients significantly influence disease awareness. Enhancing overall education levels and using vivid clinical case presentations in health education and public outreach are key strategies to improve public awareness of cognitive impairment disorders.

Objective:This study aimed to clarify the clinical characteristics of children infected with rhinovirus in the context of the Corona Virus Disease 2019 (COVID-19) pandemic and to explore the impact of recent COVID-19 infection history on their clinical features.Methods:Clinical data and laboratory test result of 286 children diagnosed with rhinovirus infection at Hangzhou Children′s Hospital from July 2022 to October 2023 were collected. A retrospective survey was conducted to determine whether all study participants had a history of COVID-19 infection within the 6 months prior to hospitalization.Results:Among the 286 children with rhinovirus infection, 180 (62.94%) had simple rhinovirus infection, while 106 (37.06%) had co-infections with other pathogens; Among the 180 rhinovirus simplex-positive children, 56.67% had wheezing symptoms; among them, 15 cases (15/180, 8.33%) were diagnosed with acute asthma attacks; 7 cases (7/180, 3.88%) were diagnosed with severe pneumonia. Based on whether the children had a history of COVID-19 infection in the 6 months prior to hospitalization, they were divided into a group with previous COVID-19 infection and a group without previous COVID-19 infection. There were no significant differences between the two groups in terms of gender, age of onset, peak fever, incidence of wheezing, incidence of pneumonia, proportion of severe pneumonia, proportion of severe asthma attacks, duration of fever, time to relief of wheezing, length of stay, white blood cell count, eosinophil count, C-reactive protein, procalcitonin, immunoglobulin E, oxygen therapy requirements, and use of intravenous steroids ( P>0.05). Conclusions:A history of COVID-19 infection in the past 6 months does not exacerbate the clinical symptoms of children with rhinovirus infection, nor does it increase the incidence of wheezing.

Objective:To study the clinical application effect of modified nasopharyngeal swab sampling for 2019 novel coronavirus nucleic acid detection.Methods:This study covered the period from January 14 to March 1, 2020.The supine position method and the protective face screen were used to collect nasopharyngeal swabs from February 24 onwards, before which, the nasopharyngeal swabs were collected by sitting position method. All the patients who were diagnosed with suspected/confirmed 2019 novel coronavirus infection were admitted from February 19 with the nasopharyngeal swabs collected outside the hospital before admission. (1) Thirty-four swabbing operators meeting the inclusion criteria of the study were recruited in this retrospective cohort study. They were grouped according to the collection method of nasopharyngeal swabs. Sixteen operators of Wuhan Taikang Tongji Hospital who applied the supine position method and the protective face screen were included in supine position method+ protective face screen group (15 males and 1 female, aged 34-49 years); 18 operators (12 from the First Affiliated Hospital of Army Medical University (the Third Military Medical University), 1 from Wuhan Jiangxia Mobile Cabin Hospital, 5 from the East District of People′s Hospital of Wuhan University) who applied the traditional sitting position method were included in sitting position method group (2 males and 16 females, aged 25-49 years). In supine position method+ protective face screen group, when collecting sample, the patient lay flat and wore a special protective face screen for nasopharyngeal swab sampling, with neck slightly extending and face turning to the opposite side of the operator about 10°. The self-designed questionnaire was used to investigate the cooperation, the incidence of nausea, coughing, sneezing, and struggling of patients evaluated by the operators, the operation time for a single swab sample, the fear of operation and the perceived exposure risk of operators in the two groups. (2) Sixty-five patients (22 males and 43 females, aged 25-91 years) admitted to Wuhan Taikang Tongji Hospital who successively received the sitting position method and supine position method+ protective face screen for nasopharyngeal swabs sampling and with complete nucleic acid detection results were included. The positive rates of nucleic acid detection by the two sampling methods of nasopharyngeal swabs of the patients were statistically analyzed. (3) Forty-one patients who could express their feelings accurately were selected out of those 65 patients (12 males and 29 females, aged 27-83 years). The comfort of patients in the process of sampling by the two methods was investigated. (4) Thirty-four patients (10 males and 24 females, aged 25-83 years) with two or more consecutive negative results of nucleic acid detection of nasopharyngeal swabs by sitting position method were selected from the above 65 patients. The positive rate of nucleic acid detection of nasopharyngeal swab of patients by supine position method+ protective face screen, i. e. negative to positive rate was statistically analyzed. Data were statistically analyzed with t test, Wilcoxon signed rank test, and chi-square test. Results:(1) Compared with those of sitting position method group, the cooperation score of patients evaluated by the operators in supine position method+ protective face screen group was significantly higher ( Z=-4.928, P<0.01), the incidence of nausea, choking cough, sneezing, and struggling of patients evaluated by the operators, and the fear of operation score and the perceived exposure risk score of operators in supine position method+ protective face screen group were significantly lower ( Z=-5.071, -5.046, -4.095, -4.397, -4.174, -5.049, P<0.01), and the operation time for a single swab sample in supine position method+ protective face screen group was significantly longer ( t=223.17, P<0.01). (2) The positive rate of nucleic acid detection of nasopharyngeal swabs by supine position method+ protective face screen was 60.00% (39/65), which was obviously higher than 41.54% (27/65) by sitting position method ( χ2=4.432, P<0.05). (3) The comfort score of the 41 patients during nasopharyngeal swabs sampling by supine position method+ protective face screen was significantly higher than that by sitting position method ( Z=-5.319, P<0.01). (4) Of the 34 patients with two or more consecutive negative results of nucleic acid detection of nasopharyngeal swabs by sitting position method, the rate of negative to positive of nucleic acid detection was 26.47% (9/34) after sampling by supine position method+ protective face screen. Conclusions:Compared with the traditional sitting position method, detection of 2019 novel coronavirus nucleic acids of nasopharyngeal swabs collected by supine method combined with protective face screen is worth promoting, because of its better comfort of patients, low exposure risk for operators, in addition to reducing in the false negative result to some extent, which may help reduce false recurrence of discharged patients.

Objective To analyze the incidence of choledocholithiasis in patients who underwent cholecystectomy in our hospital,and to determine the incidences of recurrent stones and choledocholithiasis combined with cholangitis after treatment for choledocholithiasis.Methods A retrospective study was conducted on 1 152 patients with common bile duct stones treated from January 2013 to July 2017 in our hospital.Results Of the 1152 patients with common bile duct stones,572 patients had a history of cholecystectomy,accounting for 49.65％ of all patients.402 patients had choledocholoithiasis combined with cholecystolithiasis (34.9％ of all patients),278 patients had choledocholithiasis without cholecystolithiasis (24.1％).Choledocholithiasis could occur after cholecystectomy.The time of onset of choledocholithiasis was 5 ～ 10 years after operation in 49.1％ of patients,and 200 of these patients with choledocholithiasis were treated with lithotripsy.There were 110 patients who underwent choledocholithotomy and cholecystectomy,and 90 patients who underwent ERCP and stone removal.There was no significant difference between the 2 groups (P ＞ 0.05).Choledocholithiasis complicated with cholangitis developed in 511 patients (44.3％ of all patients).These included 437 patients with acute mild cholangitis (85.5％) and acute obstructive suppurative cholangitis (14.5％).Recurrent choledocholithiasis combined with acute cholangitis after choledocholithotomy developed in 51 patients,and recurrent choledocholithiasis combined with cholangifts developed after ERCP in 50 patients.There was no significant difference between the two groups (P ＞0.05).Conclusions Choledocholithiasis after cholecystectomy accounted for a high proportion of patients.Recurrent choledocholithiasis could occur after choledocholithotomy.Common bile duct stones were susceptible to develop cholangitis.Thus,common bile duct stones should be treated as soon as possible.

Objective: To evaluate the efficacy and safety of catheter-directed interventional therapy in patients with acute pulmonary embolism(PE). Methods: PE was diagnosed by CT pulmonary angiography(CTPA). After risk stratification, a total of 79 PE patients (age (58.9±14.9) years old)were treated with catheter-directed interventional therapy via pulmonary vessels. The changes of pulmonary hemodynamics were compared before and after treatment. The risk of complications and side effects were observed. Results: The pulmonary artery pressure was changed followed by interventional therapy. The interventional therapy significantly decreased mean pulmonary arterial pressure (mPAP) from (35.3±11.2)mmHg (1 mmHg=0.133 kPa) to (30.0±10.6)mmHg (t=8.803,P<0.05) and the echocardiographic derived right ventricular dimension to left ventricular dimension (RV/LV) ratio from 0.93±0.16 to 0.83±0.15 (t=6.868,P<0.05). The arterial partial pressure of oxygen was increased from (69.0±8.6)mmHg to (75.1±9.9)mmHg (t=8.561,P<0.05) . The oxygen saturation was also increased from (93.9±2.9)% to (95.1±1.9)% at 24 h after the treatment (t=2.621,P<0.05) . Patients were further grouped as high-risk group (n=28) and intermediate risk group (n=51). mPAP and RV/LV ratio were significantly reduced in the two subgroups (all P<0.05) and the range of reduction was more significant in the high-risk group. Five patients experienced minor bleeding complication, 3 patients suffered worsened dispone post procedure and were treated with mechanical ventilation, 1 patient died, and 1 patient developed recurrent PE. Conclusion The catheter-directed interventional therapy improves pulmonary hemodynamics and reduces load of right ventricle both in high-risk or intermediate risk PE patients, this therapy strategy is safe and effective for patients with PE.

Objective: To evaluate the effectiveness and to explore the releated factors of antiretroviral therapy among HIV/AIDS patients in Liangshan Yi Autonomous Prefecture, Sichuan Province. Methods: The method of convenience sampling was adopted in July 2017 to select the research objects who were accepted antiretroviral therapy (ART) over 6 months, older than 18 years and had HIV viral load in 2016, totally 400 cases. A retrospective study was used to collect the data, including social demography, medicine use, information of medical service acquisition, their own behaviors and cognition. 395 questionnaires were effectively recovered. χ² test and logistic regression were performed to examine relationships between factors and effects. Results: All of the 395 respondents were Yi-nationality. The average age of all cases was (39.23±7.52) years old and 223 were male (56.5%). Among 395 cases patients who were detect Viral load in 2016, 221 cases were under the number of 400 copies, thze effective rate of ART was 55.9%. Multivariate analysis showed that HIV/AIDS patients who missed the medication during the antiviral therapy had poor antiviral effects. Compared to those who adhered to medication, the treatment-ineffective OR (95%CI) of the patients missing the medication during the therapy was 7.06 (3.67-13.58); Compared to those who had adverse reactions that affect the therapy, the treatment-ineffective OR (95%CI) of the patients with mild adverse reactions that did not affect the therapy was 0.45 (0.23-0.87); Compared to the patients who used drugs during the treatment, the treatment-ineffective OR (95%CI) value of the antiretroviral therapy effect of non-drug users was 0.39 (0.16-0.91);Compared to the patients who have a correct cognition that insisting on taking medicine correctly can extend their life expectancy as a common person, the treatment-ineffective OR (95%CI) values for those who hold the view that could be prolonged by 10-20 years and not/unknown were 4.18 (1.59-10.99) and 6.64 (2.67-16.53). Conclusion The HIV/AIDS patients who receive ART were less effective in Liangshan, Prefecture. Missings drugs is one of the main influencing factors for the ineffective treatment.

Humans ; Lung Diseases ; Pulmonary Circulation ; Vascular Diseases

OBJECTIVETo assess the safety, feasibility and clinical outcome of laparoscopic radical resection for low rectal cancer with telescopic anastomosis or with colostomy by stapler through transanal resection without abdominal incisions.

METHODSFrom January 2010 to September 2014, 37 patients underwent laparoscopic radical resection for low rectal cancer through transanal resection without abdominal incisions. The tumors were 4-7 cm above the anal verge. On preoperative assessment, 26 cases were T1N0M0 and 11 were T2N0M0.

RESULTSFor all cases, successful surgery was performed. In telescopic anastomosis group, the mean operative time was (178±21) min, with average blood loss of (76±11) ml and (13±7) lymph nodes harvested. Return of bowel function was (3.0±1.2) d and the hospital stay was (12.0±4.2) d without postoperative complications. Patients were followed up for 3-45 months. Twelve months after surgery, 94.6%(35/37) patients achieved anal function Kirwan grade 1, indicating that their anal function returned to normal.

CONCLUSIONSLaparoscopic radical resection for low rectal cancer with telescopic anastomosis or colostomy by stapler through transanal resection without abdominal incisions is safe and feasible. Satisfactory clinical outcome can be achieved mini-invasively.

Anal Canal ; Anastomosis, Surgical ; Colostomy ; Humans ; Laparoscopy ; Lymph Nodes ; Operative Time ; Postoperative Complications ; Rectal Neoplasms ; Safety

Objective To assess the safety, feasibility and clinical outcome of laparoscopic radical resection for low rectal cancer with telescopic anastomosis or with colostomy by stapler through transanal resection without abdominal incisions. Methods From January 2010 to September 2014, 37 patients underwent laparoscopic radical resection for low rectal cancer through transanal resection without abdominal incisions. The tumors were 4-7 cm above the anal verge. On preoperative assessment , 26 cases were T1N0M0 and 11 were T2N0M0. Results For all cases, successful surgery was performed. In telescopic anastomosis group, the mean operative time was (178±21) min, with average blood loss of (76±11) ml and (13±7) lymph nodes harvested. Return of bowel function was (3.0±1.2) d and the hospital stay was (12.0±4.2) d without postoperative complications. Patients were followed up for 3-45 months. Twelve months after surgery, 94.6%(35/37) patients achieved anal function Kirwan grade 1, indicating that their anal function returned to normal. Conclusions Laparoscopic radical resection for low rectal cancer with telescopic anastomosis or colostomy by stapler through transanal resection without abdominal incisions is safe and feasible. Satisfactory clinical outcome can be achieved mini-invasively.

Objective To assess the safety, feasibility and clinical outcome of laparoscopic radical resection for low rectal cancer with telescopic anastomosis or with colostomy by stapler through transanal resection without abdominal incisions. Methods From January 2010 to September 2014, 37 patients underwent laparoscopic radical resection for low rectal cancer through transanal resection without abdominal incisions. The tumors were 4-7 cm above the anal verge. On preoperative assessment , 26 cases were T1N0M0 and 11 were T2N0M0. Results For all cases, successful surgery was performed. In telescopic anastomosis group, the mean operative time was (178±21) min, with average blood loss of (76±11) ml and (13±7) lymph nodes harvested. Return of bowel function was (3.0±1.2) d and the hospital stay was (12.0±4.2) d without postoperative complications. Patients were followed up for 3-45 months. Twelve months after surgery, 94.6%(35/37) patients achieved anal function Kirwan grade 1, indicating that their anal function returned to normal. Conclusions Laparoscopic radical resection for low rectal cancer with telescopic anastomosis or colostomy by stapler through transanal resection without abdominal incisions is safe and feasible. Satisfactory clinical outcome can be achieved mini-invasively.