Objective: To investigate the epidemiological characteristics of hepatitis C in Beilin District, Xi'an City, Shaanxi Province from 2014 to 2023, so as to provide the evidence for optimizing hepatitis C prevention and control strategies. Methods: Data on hepatitis C cases in Beilin District from 2014 to 2023 were collected from the Infection Disease Surveillance System of the China Information System for Disease Control and Prevention. The crude incidence of hepatitis C was calculated, and the standardized incidence was computed using the age composition of the standard population from the Seventh National Population Census in 2020. Descriptive epidemiological methods were employed to analyze the demographic, temporal, and regional distribution characteristics of hepatitis C cases. The average annual percent change (AAPC) was used to analyze the trend in incidence of hepatitis C in Beilin District from 2014 to 2023. Results: From 2014 to 2023, a total of 2 423 hepatitis C cases were reported in Beilin District, with a crude incidence of 35.91/105 and a standardized incidence of 30.63/105. The crude and standardized incidence of hepatitis C in males were higher than in females (41.93/100 000 vs. 28.68/100 000, 36.81/100 000 vs. 22.69/100 000, both P<0.05). From 2014 to 2023, the standardized incidence among total population, males and females showed decreasing trends, with AAPC values of -7.411%, -6.147%, and -9.267%, respectively (all P<0.05). The age group of 50-<60 years had the highest number of reported hepatitis C cases, with 769 cases, accounting for 31.74%. In contrast, the age group of ≥80 years had the highest crude incidence, at 88.84/105. Occupations were predominantly characterized by housework and unemployment, with 892 cases, accounting for 36.81%. Regarding monthly distribution, the higher numbers of cases were reported in May and March, with 242 and 238 cases, respectively. Nanyuanmen Subdistrict, Zhangjiacun Subdistrict, and Wenyi Road Subdistrict ranked the top three in terms of standardized incidence of hepatitis C, with 44.15/100 000, 42.52/100 000, and 39.80/100 000, respectively. Conclusions From 2014 to 2023, the incidence of hepatitis C in Beilin District showed an overall decreasing trend. Males, middle-aged and elderly individuals, and housework or unemployed were key populations for targeted hepatitis C prevention and control. It is recommended to strengthen control measures in high-incidence areas.

Severe intra-abdominal infections are life-threatening conditions and a significant challenge for surgeons. This article presents a case of an elderly patient with a severe intra-abdominal infection complicated by an anastomotic leak. This patient had experienced prolonged sepsis and multiple surgical traumas. Upon admission to our department, exploratory surgery revealed extensive bowel edema and adhesions, an anastomotic leak, and abdominal contamination with infection. In accordance with the principles of damage control surgery, the anastomotic leak was exteriorized, the abdomen was left open, and continuous intra-abdominal lavage with dual-lumen catheters was implemented to effectively control the infection. Negative pressure wound therapy was used to manage the open abdomen, and a negative pressure-assisted drainage device was used to manage the enteroatmospheric fistula. After granulation of the abdominal wound, split-thickness skin grafting was performed. The enteroatmospheric fistula was converted into an enterocutaneous fistula. A 3D-printed stoma baseplate was used to manage the digestive fistula. Concurrently, enhanced parenteral and enteral nutritional support was provided. Six months later, the patient successfully underwent definitive fistula resection and abdominal wall defect repair.

Severe intra-abdominal infections are life-threatening conditions and a significant challenge for surgeons. This article presents a case of an elderly patient with a severe intra-abdominal infection complicated by an anastomotic leak. This patient had experienced prolonged sepsis and multiple surgical traumas. Upon admission to our department, exploratory surgery revealed extensive bowel edema and adhesions, an anastomotic leak, and abdominal contamination with infection. In accordance with the principles of damage control surgery, the anastomotic leak was exteriorized, the abdomen was left open, and continuous intra-abdominal lavage with dual-lumen catheters was implemented to effectively control the infection. Negative pressure wound therapy was used to manage the open abdomen, and a negative pressure-assisted drainage device was used to manage the enteroatmospheric fistula. After granulation of the abdominal wound, split-thickness skin grafting was performed. The enteroatmospheric fistula was converted into an enterocutaneous fistula. A 3D-printed stoma baseplate was used to manage the digestive fistula. Concurrently, enhanced parenteral and enteral nutritional support was provided. Six months later, the patient successfully underwent definitive fistula resection and abdominal wall defect repair.

Objective To investigate the effectiveness and safety of oral olive oil combined with polyethylene glycol electrolyte ( PEG ) on bowel preparation before colonoscopy for chronic constipation patients. Methods A randomized, single-blind, prospective study was conducted on 180 patients with chronic constipation, who underwent colonoscopy at Tangdu Hospital of the Fourth Military Medical University from November 2017 to May 2018. Patients were randomly divided into three groups. Patients in group A took 60 mL olive oil and a piece of crystal sugar at 7:30 pm the day before colonoscopy, followed by 1500 mL PEG at 8:00 pm before the test, and 1500 mL PEG at 5:00 am the day of colonoscopy. Patients in group B took 60 mL olive oil and a piece of crystal sugar after administration of PEG at 8:00 pm the day before colonoscopy, followed by 1500 mL PEG at 5:00 am the day of colonoscopy. The group C was given 1500 mL PEG at 8:00 pm the day before colonoscopy, and another 1500 mL PEG at 5:00 am the day of colonoscopy. We recorded the time of first defecation after taking medication, the number of defecation before sleep, the total number of defecation, the score of Boston bowel preparation scale ( BBPS) of the right, middle and left colon, and the adverse reactions, and compared the data among the three groups. The measurement data was compared using the analysis of variance. After the difference was found, the LSD-t test was used to compare between the two groups. The enumeration data was compared using the Pearsonχ2 test. Results One patient in the group B terminated colonoscopy due to unable to continue cooperation during the examination. Group B and C both excluded one patient because of a large mass found in the descending colon of patients. Finally, there were 60 cases in the group A, 58 in the group B, and 59 in the group C. There was no statistical difference between the three groups in the general resource ( P>0. 05) . The time of first defecation after taking medication for the group A, B and C was (2. 25±2. 32) h, (2. 43±2. 39) h and (3. 36±2. 79) h respectively, with statistical difference (F=3. 36, P=0. 037). The time of first defecation was longer in the group C than that of the group A and B ( P = 0. 016 and P = 0. 046, respectively). The number of defecation before sleep for the group A, B and C was 3. 47±2. 09, 3. 24±1. 76 and 2. 49±1. 58 respectively, with statistical difference (F=4. 65, P=0. 011). The number of defecation before sleep was lesser in the group C than that of the group A and B ( P=0. 004, P=0. 027, respectively) . The total number of defecation for the group A, B and C was 7. 20 ± 2. 67, 6. 81 ± 2. 31 and 5. 64 ± 2. 22 respectively. The difference among the three groups was statistically significant ( F=6. 68, P=0. 002) . For the group A and B, the total number of defecation was both more than that of the group C ( P=0. 001, P=0. 010) . There were no statistical differences among the three groups in the BBPS score of the left and middle colon and the total BBPS score ( all P>0. 05) . The BBPS score of the right colon for the group A, B and C was 2. 03 ± 0. 82, 1. 95 ± 0. 87 and 1. 53 ± 0. 80 respectively, with statistical difference ( F=6. 38, P=0. 002) , and was lower in the group C than that of the group A and B ( P= 0. 001, P= 0. 006, respectively) . Adverse reactions after taking medication including nausea, vomiting, abdominal pain, and bloating were respectively reported in 7, 3, 0 and 3 cases in the group A, 5, 3, 0 and 6 in the group B, and 4, 2, 1 and 4 in the group C, and there was no statistical difference among the three groups (χ2=4. 35, P=0. 824) . Conclusion Administration of olive oil compared with PEG can improve the cleanness of right colon for chronic constipation patients, shorten the time of first defecation after taking medication, and increase the number of defecation before sleep and the total number of defecation during bowel preparation. Taking olive oil before or after PEG at the night before colonoscopy has no significantly effect on bowel preparation and adverse reactions.

OBJECTIVETo study long-term effect on renal function exposed to environmental cadmium.

METHODSStratified random sampling and cluster sampling method of epidemiological investigations were carried out in northern Guangdong province between April, 2011 and August, 2012. A total of 167 residents who lived in high cadmium exposure area for more than 15 years, aged above 40 were selected in exposed group. Moreover, A total of 145 residents who had similar living and economic conditions and lived in local for more than 15 years, aged above 40 were selected in control group. We used health questionnaires and medical examinations in order to acquire their health status. Home-harvested rice and vegetables were collected using quartering method for detection of cadmium level. Urine specimens of residents were collected for detection of cadmium level and creatinine as well as renal dysfunction biomarkers, namely, N-acetyl-beta-D-glucosamidase (NAG), β2-microglobulin (β2-MG), and retinol binding protein(RBP), respectively. The analysis of spearman rank correlation and multiple regression were used to investigate the relationships between age, urinary cadmium levels and renal injury biomarkers.

RESULTSThe cadmium levels in rice and vegetables of exposed group were 0.75 and 0.10 mg/kg, both were significantly higher than 0.07 and 0.01 mg/kg in the control group (Z values were -6.32 and -7.84, all P values < 0.001). The urinary cadmium level of exposed group was 8.29 µg/g · cr, which was higher than that of the control group 2.03 µg/g · cr with significant difference (Z value was -11.39, P < 0.001). After stratified the total population by age, the urinary cadmium level in 40-49 years, 50-59 years and ≥ 60 years subgroups were 7.22, 8.71, and 13.10 µg/g · cr, which both were significantly higher than 1.80, 2.04, and 2.05 µg/g · cr in the control group (Z values were -5.22, -7.41, and -7.14, all P values < 0.001). After stratified the total population by gender, the urinary cadmium level of male and female were 5.12 and 12.36 µg/g · cr, which both were significantly higher than 1.79 and 2.16 µg/g · cr in the control group (Z values were -7.68 and -9.03, all P values < 0.001). Comparing the differences of renal dysfunction biomarkers (NAG, β2-MG, RBP) between two groups. The level of urinary β2-MG and RBP of exposed group were 0.21 and 0.04 µg/g · cr, which were higher than 0.05 and 0.00 µg/g · cr of the control group with significant difference (Z value was -7.08 and -9.65, all P values < 0.001). Pearson correlation analysis showed that NAG, β2-MG and RBP were positively correlated with urinary cadmium and age, the correlation coefficients were 0.57, 0.49, 0.21 and 0.22, 0.26, 0.23 respectively (all P values < 0.001). After adjusting the effect of age, it was appeared that urinary cadmium levels contributed most to the alteration of NAG, β2-MG and RBP, the standardized regression coefficients were 0.57, 0.49 and 0.20 (all P values < 0.001), and suggested that the cadmium body burden was one of the most important factors for renal dysfunction.

CONCLUSIONResidents, who had cadmium contaminated rice and vegetables for a long time, would take the risk of increasing body burden of cadmium and urinary early biomarkers of renal tubular injury that referred to occurrence of renal dysfunction.

Adult ; Aged ; Cadmium ; Creatinine ; Environmental Exposure ; Epidemiologic Studies ; Female ; Food Contamination ; Humans ; Kidney Diseases ; Male ; Middle Aged ; Multivariate Analysis ; Oryza ; Risk ; Time ; Vegetables

Objective To study long-term effect on renal function exposed to environmental cadmium. Methods Stratified random sampling and cluster sampling method of epidemiological investigations were carried out in northern Guangdong province between April, 2011 and August, 2012 . A total of 167 residents who lived in high cadmium exposure area for more than 15 years, aged above 40 were selected in exposed group. Moreover, A total of 145 residents who had similar living and economic conditions and lived in local for more than 15 years, aged above 40 were selected in control group. We used health questionnaires and medical examinations in order to acquire their health status. Home-harvested rice and vegetables were collected using quartering method for detection of cadmium level . Urine specimens of residents were collected for detection of cadmium level and creatinine as well as renal dysfunction biomarkers, namely, N-acetyl-beta-D-glucosamidase(NAG), β2-microglobulin(β2-MG), and retinol binding protein(RBP), respectively. The analysis of spearman rank correlation and multiple regression were used to investigate the relationships between age, urinary cadmium levels and renal injury biomarkers. Results The cadmium levels in rice and vegetables of exposed group were 0.75 and 0.10 mg/kg, both were significantly higher than 0.07 and 0.01 mg/kg in the control group (Z values were-6.32 and-7.84, all P values<0.001). The urinary cadmium level of exposed group was 8.29μg/g·cr, which was higher than that of the control group 2.03μg/g·cr with significant difference(Z value was-11.39, P<0.001). After stratified the total population by age, the urinary cadmium level in 40-49 years, 50-59 years and≥60 years subgroups were 7.22, 8.71, and 13.10μg/g·cr, which both were significantly higher than 1.80, 2.04, and 2.05μg/g·cr in the control group (Z values were-5.22,-7.41, and-7.14, all P values<0.001). After stratified the total population by gender , the urinary cadmium level of male and female were 5.12 and 12.36μg/g · cr, which both were significantly higher than 1.79 and 2.16 μg/g · cr in the control group (Z values were-7.68 and-9.03, all P values<0.001). Comparing the differences of renal dysfunction biomarkers (NAG, β2-MG, RBP) between two groups. The level of urinaryβ2-MG and RBP of exposed group were 0.21 and 0.04μg/g · cr, which were higher than 0.05 and 0.00 μg/g · cr of the control group with significant difference(Z value was-7.08 and-9.65, all P values<0.001). Pearson correlation analysis showed that NAG,β2-MG and RBP were positively correlated with urinary cadmium and age, the correlation coefficients were 0.57,0.49,0.21and 0.22, 0.26, 0.23 respectively (all P values<0.001). After adjusting the effect of age, it was appeared that urinary cadmium levels contributed most to the alteration of NAG, β2-MG and RBP, the standardized regression coefficients were 0.57, 0.49 and 0.20 (all P values<0.001), and suggested that the cadmium body burden was one of the most important factors for renal dysfunction. Conclusion Residents, who had cadmium contaminated rice and vegetables for a long time, would take the risk of increasing body burden of cadmium and urinary early biomarkers of renal tubular injury that referred to occurrence of renal dysfunction.

Objective To study long-term effect on renal function exposed to environmental cadmium. Methods Stratified random sampling and cluster sampling method of epidemiological investigations were carried out in northern Guangdong province between April, 2011 and August, 2012 . A total of 167 residents who lived in high cadmium exposure area for more than 15 years, aged above 40 were selected in exposed group. Moreover, A total of 145 residents who had similar living and economic conditions and lived in local for more than 15 years, aged above 40 were selected in control group. We used health questionnaires and medical examinations in order to acquire their health status. Home-harvested rice and vegetables were collected using quartering method for detection of cadmium level . Urine specimens of residents were collected for detection of cadmium level and creatinine as well as renal dysfunction biomarkers, namely, N-acetyl-beta-D-glucosamidase(NAG), β2-microglobulin(β2-MG), and retinol binding protein(RBP), respectively. The analysis of spearman rank correlation and multiple regression were used to investigate the relationships between age, urinary cadmium levels and renal injury biomarkers. Results The cadmium levels in rice and vegetables of exposed group were 0.75 and 0.10 mg/kg, both were significantly higher than 0.07 and 0.01 mg/kg in the control group (Z values were-6.32 and-7.84, all P values<0.001). The urinary cadmium level of exposed group was 8.29μg/g·cr, which was higher than that of the control group 2.03μg/g·cr with significant difference(Z value was-11.39, P<0.001). After stratified the total population by age, the urinary cadmium level in 40-49 years, 50-59 years and≥60 years subgroups were 7.22, 8.71, and 13.10μg/g·cr, which both were significantly higher than 1.80, 2.04, and 2.05μg/g·cr in the control group (Z values were-5.22,-7.41, and-7.14, all P values<0.001). After stratified the total population by gender , the urinary cadmium level of male and female were 5.12 and 12.36μg/g · cr, which both were significantly higher than 1.79 and 2.16 μg/g · cr in the control group (Z values were-7.68 and-9.03, all P values<0.001). Comparing the differences of renal dysfunction biomarkers (NAG, β2-MG, RBP) between two groups. The level of urinaryβ2-MG and RBP of exposed group were 0.21 and 0.04μg/g · cr, which were higher than 0.05 and 0.00 μg/g · cr of the control group with significant difference(Z value was-7.08 and-9.65, all P values<0.001). Pearson correlation analysis showed that NAG,β2-MG and RBP were positively correlated with urinary cadmium and age, the correlation coefficients were 0.57,0.49,0.21and 0.22, 0.26, 0.23 respectively (all P values<0.001). After adjusting the effect of age, it was appeared that urinary cadmium levels contributed most to the alteration of NAG, β2-MG and RBP, the standardized regression coefficients were 0.57, 0.49 and 0.20 (all P values<0.001), and suggested that the cadmium body burden was one of the most important factors for renal dysfunction. Conclusion Residents, who had cadmium contaminated rice and vegetables for a long time, would take the risk of increasing body burden of cadmium and urinary early biomarkers of renal tubular injury that referred to occurrence of renal dysfunction.

Objective To improve the function of outpatient intravenous admixture services , provide patients better medical services.Methods According to the characteristic of outpatient , the rationality of the operation of outpatient intravenous admixture services was analyzed , combining with the actual situation of our hospital .Results Outpatient intravenous admixture services effi-ciently promoted safe and rational medication , but it had some deficiencies .Conclusion Outpatient intravenous admixture services played a significant role in improving quality of health care .It should be essential to improve and develop the advantages .

AIM: Remnant polyp tissues are often found after polypectomy. In this study, we assessed the outcome and safety of argon plasma coagulation (APC) in the management of colorectal sessile or semipedunculated polyp remnants after polypectomy. METHODS: Sixty-one colorectal polyps of 33 patients underwent polypectomy in Department of Digestion Medicine, Tangdu Hosptial, the Fourth Military Medical University of Chinese PLA from 2004 to 2007. Colorectal polyps type was identified by pathological examination. All polyps were removed under colonoscope with the diathermic snare, and the polyp remnants were destroyed with APC (Erbe, Germany). The power output was initially set at 40-50 W. In case of visibly insufficient coagulation, the output power was increased gradually by 5 W up until the remnants were completely ablated. Follow-up endoscopies were performed 1 and 3 months after the treatment. Pathological examination and APC treatment were performed when the recurrence of polyps was found. RESULTS: ①All 61 colorectal polyps were removed with the diathermic snare and the polyp remnants were destroyed with APC successfully only once. ②During the follow-up averaged 2.4 months, effective destruction of remnant polyp tissue was obtained in 59 polyps (96.7%) in 31 patients (93.9%). Colorectal polyp of two cases relapsed one month after treatment and identified as villous adenoma. ③Final power output was positively correlated with lesion size (r =0.97, P