1.Exploring the Feasibility of Machine Learning to Predict Risk Stratification Within 3 Months in Chest Pain Patients with Suspected NSTE-ACS.
Zhi Chang ZHENG ; Wei YUAN ; Nian WANG ; Bo JIANG ; Chun Peng MA ; Hui AI ; Xiao WANG ; Shao Ping NIE
Biomedical and Environmental Sciences 2023;36(7):625-634
		                        		
		                        			OBJECTIVE:
		                        			We aimed to assess the feasibility and superiority of machine learning (ML) methods to predict the risk of Major Adverse Cardiovascular Events (MACEs) in chest pain patients with NSTE-ACS.
		                        		
		                        			METHODS:
		                        			Enrolled chest pain patients were from two centers, Beijing Anzhen Emergency Chest Pain Center Beijing Bo'ai Hospital, China Rehabilitation Research Center. Five classifiers were used to develop ML models. Accuracy, Precision, Recall, F-Measure and AUC were used to assess the model performance and prediction effect compared with HEART risk scoring system. Ultimately, ML model constructed by Naïve Bayes was employed to predict the occurrence of MACEs.
		                        		
		                        			RESULTS:
		                        			According to learning metrics, ML models constructed by different classifiers were superior over HEART (History, ECG, Age, Risk factors, & Troponin) scoring system when predicting acute myocardial infarction (AMI) and all-cause death. However, according to ROC curves and AUC, ML model constructed by different classifiers performed better than HEART scoring system only in prediction for AMI. Among the five ML algorithms, Linear support vector machine (SVC), Naïve Bayes and Logistic regression classifiers stood out with all Accuracy, Precision, Recall and F-Measure from 0.8 to 1.0 for predicting any event, AMI, revascularization and all-cause death ( vs. HEART ≤ 0.78), with AUC from 0.88 to 0.98 for predicting any event, AMI and revascularization ( vs. HEART ≤ 0.85). ML model developed by Naïve Bayes predicted that suspected acute coronary syndrome (ACS), abnormal electrocardiogram (ECG), elevated hs-cTn I, sex and smoking were risk factors of MACEs.
		                        		
		                        			CONCLUSION
		                        			Compared with HEART risk scoring system, the superiority of ML method was demonstrated when employing Linear SVC classifier, Naïve Bayes and Logistic. ML method could be a promising method to predict MACEs in chest pain patients with NSTE-ACS.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Acute Coronary Syndrome/epidemiology*
		                        			;
		                        		
		                        			Bayes Theorem
		                        			;
		                        		
		                        			Feasibility Studies
		                        			;
		                        		
		                        			Risk Assessment/methods*
		                        			;
		                        		
		                        			Chest Pain/etiology*
		                        			;
		                        		
		                        			Myocardial Infarction/diagnosis*
		                        			
		                        		
		                        	
2.Reinforced radiculoplasty for the treatment of symptomatic sacral Tarlov cysts: A clinical analysis of 71 cases.
Chao WU ; Bin LIU ; Jing Cheng XIE ; Zhen Yu WANG ; Chang Cheng MA ; Jun YANG ; Jian Jun SUN ; Xiao Dong CHEN ; Tao YU ; Guo Zhong LIN ; Yu SI ; Yun Feng HAN ; Su Hua CHEN ; Xiao Liang YIN ; Qian Quan MA ; Mu Tian ZHENG ; Lin ZENG
Journal of Peking University(Health Sciences) 2023;55(1):133-138
		                        		
		                        			OBJECTIVE:
		                        			To investigate the safety and efficacy of reinforced radiculoplasty in the treatment of symptomatic sacral Tarlov cysts (TCs).
		                        		
		                        			METHODS:
		                        			A retrospective analysis was performed on the clinical data and follow-up data of 71 patients with symptomatic sacral TCs who underwent reinforced radiculoplasty in the Neurosurgery Department of Peking University Third Hospital from June 2018 to March 2021. All the operations were performed under neuroelectrophysiological monitoring. Intraoperative cyst exploration, partial resection of the cyst wall, narrowing of the leak, nerve root sleeve radiculoplasty and artificial dural reinforcement were performed. The incidence of postoperative complications and new neurological dysfunction was analyzed. Visual analogue scale (VAS) was used to assess the changes of pain before and after surgery. The Japanese Orthopedics Association (JOA) low back pain score was used to evaluate the changes in nerve function before and after surgery.
		                        		
		                        			RESULTS:
		                        			In the study, 71 patients had 101 TCs, 19 (18.8%) TCs originated from the left S1 nerve, 26 (25.7%) originated from the left S2 nerve, 3 (3.0%) originated from the left S3 nerve, 14 (13.9%) originated from the right S1 nerve, 33 (32.7%) originated from the right S2 nerve, 6 (5.9%) originated from the right S3 nerve, all the TCs underwent reinforced radiculoplasty. Deep infection (1 case), subcutaneous effusion (1 case), fat li-quefaction (1 case) and urinary tract infection (4 cases) were recorded postoperatively. The patients were followed up for 12-43 months (median, 26 months). Two cases had new urinary retention after operation, and the catheter was removed at the end of the first and second months respectively. One case had new fecal weakness, which improved after 3 months. Compared with preoperation, VAS decreased significantly at the last follow-up [median, 6 (4-9) vs. 1 (0-5), Z=-7.272, P < 0.001], JOA score increased significantly [median, 20 (16-25) vs. 27 (18-29), Z=-7.265, P < 0.001]. There were 18 cured cases (25.4%), 41 excellent cases (57.7%), 8 effective cases (11.3%), and 4 invalid cases (5.6%). The total efficiency was 94.4% (67/71). Two (1.98%) cysts recurred.
		                        		
		                        			CONCLUSION
		                        			For patients with symptomatic sacral TCs, reinforced radiculoplasty can significantly improve the pain and nerve function, which is safe and reliable.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Tarlov Cysts/epidemiology*
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Neoplasm Recurrence, Local/complications*
		                        			;
		                        		
		                        			Cysts/surgery*
		                        			;
		                        		
		                        			Pain
		                        			
		                        		
		                        	
3.A follow-up study on the pain changes trend and effects in patients diagnosed with herpes zoster in Beijing City.
Dan ZHAO ; Luo Dan SUO ; Jing Bin PAN ; Xing Hui PENG ; Yan Fei WANG ; Tao ZHOU ; Xiao Mei LI ; Ying MA ; Zi Ang LI ; Xing Huo PANG ; Li LU
Chinese Journal of Preventive Medicine 2023;57(12):2068-2072
		                        		
		                        			
		                        			Objective: To understand the changes in pain and its effects in patients with the diagnosis of herpes zoster. Methods: A total of 3 487 patients diagnosed with herpes zoster (HZ) for the first time at the outpatient department of Miyun District Hospital from January 1, 2017, to December 31, 2019, were included in the study. The information of patients was registered and issued with a record card. Patients were required to record the time of pain and rash by themselves. Telephone follow-up was conducted at 21, 90, 180 and 365 days after the onset of rashes, including hospitalization, location of rash and pain, and the time of start and end. The impact of pain on life was evaluated by the Zoster Brief Pain Inventory (ZBPI). Results: The age of 2 999 HZ patients included in the analysis were (53±16) years old, including 1 377 (45.91%) males and 1 903 (63.45%) patients aged 50 years and older. After 21 days of rash, mild, moderate and severe pain accounted for 20.87% (626 cases), 37.98% (1 139 cases) and 33.81% (1 014 cases), respectively. Only 5.07% (152 cases) had no pain or discomfort, and 2.27% (68 cases) had no pain but discomfort. Most of the pain sites were consistent with the rash sites. The chest and back and waist and abdomen were the most common, accounting for 35.58% (1 067 cases) and 29.18% (875 cases), respectively, followed by the limbs and face and neck, accounting for 16.74% (502 cases) and 16.40% (492 cases), respectively. The M (Q1, Q3) of pain days in the HZ patients was 14 (8, 20) days, and the incidence of post-herpetic neuralgia (PHN) was 6.63% (171/2 580) (excluding 419 patients who refused to visit or lost to visit on 90 days after the onset of rash). The pain score of HZ patients within 21 days after the rash was (5.19±2.73) points, and the pain score of PHN patients was (7.61±2.13) points, which was significantly higher than that of non-PHN patients [(5.04±2.69) points] (P<0.001). Daily activities, emotions, walking ability, work, social interaction, sleep and recreation were affected for 21 days after the rash in HZ patients, ranging from 60.79% to 83.83%, with sleep being the most affected (83.83%). The impact scores of pain and life dimensions in PHN patients ranged from 4.59 to 7.61 points on the ZBPI scale, which were higher than those in non-PHN patients (2.49-5.04) (t values ranged from 8.86 to 11.67, all P values <0.001). Conclusion: The proportion of pain in HZ patients after the diagnosis is high, and the pain is more obvious in patients with PHN and HZ patients aged 50 and older, which has a greater impact on their daily lives.
		                        		
		                        		
		                        		
		                        			Male
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Beijing
		                        			;
		                        		
		                        			Follow-Up Studies
		                        			;
		                        		
		                        			Herpes Zoster/epidemiology*
		                        			;
		                        		
		                        			Pain/epidemiology*
		                        			;
		                        		
		                        			Exanthema
		                        			
		                        		
		                        	
4.A follow-up study on the pain changes trend and effects in patients diagnosed with herpes zoster in Beijing City.
Dan ZHAO ; Luo Dan SUO ; Jing Bin PAN ; Xing Hui PENG ; Yan Fei WANG ; Tao ZHOU ; Xiao Mei LI ; Ying MA ; Zi Ang LI ; Xing Huo PANG ; Li LU
Chinese Journal of Preventive Medicine 2023;57(12):2068-2072
		                        		
		                        			
		                        			Objective: To understand the changes in pain and its effects in patients with the diagnosis of herpes zoster. Methods: A total of 3 487 patients diagnosed with herpes zoster (HZ) for the first time at the outpatient department of Miyun District Hospital from January 1, 2017, to December 31, 2019, were included in the study. The information of patients was registered and issued with a record card. Patients were required to record the time of pain and rash by themselves. Telephone follow-up was conducted at 21, 90, 180 and 365 days after the onset of rashes, including hospitalization, location of rash and pain, and the time of start and end. The impact of pain on life was evaluated by the Zoster Brief Pain Inventory (ZBPI). Results: The age of 2 999 HZ patients included in the analysis were (53±16) years old, including 1 377 (45.91%) males and 1 903 (63.45%) patients aged 50 years and older. After 21 days of rash, mild, moderate and severe pain accounted for 20.87% (626 cases), 37.98% (1 139 cases) and 33.81% (1 014 cases), respectively. Only 5.07% (152 cases) had no pain or discomfort, and 2.27% (68 cases) had no pain but discomfort. Most of the pain sites were consistent with the rash sites. The chest and back and waist and abdomen were the most common, accounting for 35.58% (1 067 cases) and 29.18% (875 cases), respectively, followed by the limbs and face and neck, accounting for 16.74% (502 cases) and 16.40% (492 cases), respectively. The M (Q1, Q3) of pain days in the HZ patients was 14 (8, 20) days, and the incidence of post-herpetic neuralgia (PHN) was 6.63% (171/2 580) (excluding 419 patients who refused to visit or lost to visit on 90 days after the onset of rash). The pain score of HZ patients within 21 days after the rash was (5.19±2.73) points, and the pain score of PHN patients was (7.61±2.13) points, which was significantly higher than that of non-PHN patients [(5.04±2.69) points] (P<0.001). Daily activities, emotions, walking ability, work, social interaction, sleep and recreation were affected for 21 days after the rash in HZ patients, ranging from 60.79% to 83.83%, with sleep being the most affected (83.83%). The impact scores of pain and life dimensions in PHN patients ranged from 4.59 to 7.61 points on the ZBPI scale, which were higher than those in non-PHN patients (2.49-5.04) (t values ranged from 8.86 to 11.67, all P values <0.001). Conclusion: The proportion of pain in HZ patients after the diagnosis is high, and the pain is more obvious in patients with PHN and HZ patients aged 50 and older, which has a greater impact on their daily lives.
		                        		
		                        		
		                        		
		                        			Male
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Beijing
		                        			;
		                        		
		                        			Follow-Up Studies
		                        			;
		                        		
		                        			Herpes Zoster/epidemiology*
		                        			;
		                        		
		                        			Pain/epidemiology*
		                        			;
		                        		
		                        			Exanthema
		                        			
		                        		
		                        	
5.Effects of delayed ureteral stents removal during the COVID-19 pandemic on the quality of life and psychological status of postoperative patients with urinary calculi.
Jin Hui LAI ; Qi WANG ; Jia Xiang JI ; Ming Rui WANG ; Xin Wei TANG ; Ke Xin XU ; Tao XU ; Hao HU
Journal of Peking University(Health Sciences) 2023;55(5):857-864
		                        		
		                        			OBJECTIVE:
		                        			To explore the impacts of delayed ureteral stent removal on the quality of life (QoL) and mental health of urinary calculi postoperative patients due to the corona virus disease 2019(COVID-19) pandemic.
		                        		
		                        			METHODS:
		                        			The demographic and clinical data of patients with ureteral stent placement after urinary endoscopic lithotripsy and returned to Peking University People's Hospital for stent removal from December 2019 to June 2020 were collected. Ureteral stent symptoms questionnaire (USSQ) score and the outcome 20-item self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were collected to estimate the QoL and mental status. The USSQ consisted of 44 questions in 6 domains (including urinary symptom, physical pain, general health, work performance, sexual function, and ureteral stent related infection). For most questions in each domain, its score was a five-point Likert-type scale from 1 to 5, and a small proportion of questions was quantified by 1 to 4 or 1 to 7 scale. SAS and SDS both contained 20 questions used to assess a patient's level of anxiety and depression. Its scoring for each item was on a four-point Likert-type scale from 1 to 4. A total score (ranging from 20 to 80) was the main statistical indicator. The level of clinical anxiety and depression was quantified by using standard scores (total score multiplied by 1.25 to produce integers). And the multi-group structural equation model was constructed by analysis of moment structure (AMOS) analysis.
		                        		
		                        			RESULTS:
		                        			Overall, 71 patients were enrolled for analysis. It was found that the median duration of ureteral stent time differed significantly between the control and delayed groups for 32 (30, 33) d and 94.5 (88, 103) d, respectively. The delayed group resulted in higher scores in the USSQ multidimensional, which included urinary symptoms, general health, work performance and ureteral stent related infections. Anxiety and depression were also significantly serious in the delayed group than in the control group. A longer indwelling time of a ureteral stent could exacerbate the effects of urinary symptoms and physical pain on work performance (P=0.029 < 0.05). Among them, the patients with severe urinary symptoms leading to poor work performance were most significantly affected by prolonged ureteral stent duration time (CR=2.619>1.96).
		                        		
		                        			CONCLUSION
		                        			Patients with delayed ureteral stent removal due to the COVID-19 had resulted in worse QoL and mental status. Stents related symptoms are more severe in patients with higher anxiety and depression degree during COVID-19. To improve the QoL and mental health of patients after urinary calculi surgery during COVID-19, it is still not recommended to prolong the stent duration time or corresponding intervention measures should be taken.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Quality of Life
		                        			;
		                        		
		                        			Pandemics
		                        			;
		                        		
		                        			COVID-19/epidemiology*
		                        			;
		                        		
		                        			Ureter/surgery*
		                        			;
		                        		
		                        			Urinary Calculi
		                        			;
		                        		
		                        			Pain
		                        			;
		                        		
		                        			Ureteral Diseases
		                        			;
		                        		
		                        			Stents
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			;
		                        		
		                        			Ureteral Calculi
		                        			
		                        		
		                        	
6.Comparison on the clinical characteristics of patients with Takotsubo syndrome from China and from Europe/North America.
Qian RAN ; Xia ZHOU ; Ya Zhou SUN ; Xin ZHAO ; Zhang Chi LIU ; Xin LIU ; Chuan QU ; Cui ZHANG ; Jin Jun LIANG ; Bo YANG ; Shaobo SHI
Chinese Journal of Cardiology 2022;50(4):386-394
		                        		
		                        			
		                        			Objective: To summarize the clinical characteristics of patients with Takotsubo syndrome (TTS) from China and compare these features with patients from Europe/North America. Methods: We reviewed case reports published between 1990 and 2020 with the key words of "Takotsubo syndrome" "stress cardiomyopathy" "apical balloon syndrome" and "broken heart syndrome", in Wanfang, CNKI, Pubmed and Web of Science databases, and 1 294 articles were identified, including 128 articles reporting 163 cases in China and 1 166 articles reporting 1 256 cases in Europe/North America. The characteristics of demographics, triggers, symptoms, electrocardiogram, echocardiography, left ventriculogram,coronary angiography, treatment and prognosis were analyzed and compared between Chinese and European/North American cases. Results: A total of 1 294 articles (1 419 cases: 163 from China, 1 256 from Europe/North America) were included in the final analysis. The characteristics of Chinese cases included: (1) demographic:the age was (59.6±16.9) years, which was similar with that of European/North American ((59.7±17.4) years, P=0.90), and female accounting for 78.5% (128/163), which was lower than that of European/North American (85.4% (1 073/1 256), P=0.02). (2) Triggers:mental triggers accounted for 48.5% (79/163), physical triggers accounted for 43.6% (71/163), and no triggers accounted for 7.9% (13/163), respectively. Compared with Europe/North America, the ratio of patients with mental triggers was higher in China, while the ratio of patients with physical triggers and no triggers was lower (P<0.05). (3) Symptoms: chest pain (52.8% (86/163)), chest tightness (35.0% (57/163)), shortness of breath (33.1% (54/163)), dizziness (16.0% (26/163)), sweating (15.3% (25/163)), palpitations (12.3% (20/163)), syncope (9.2% (15/163)) abdominal pain/diarrhea (8.6% (14/163)), hypotension (7.4% (12/163)), and fatigue (1.2% (2/163)) were illustrated in sequence. Compared with patients in Europe/North America, the ratio of patients with chest tightness, dizziness, sweating, palpitations, abdominal pain/diarrhea was higher in Chinese patients, while the ratio of patients with hypotension was lower in Chinese patients (P<0.05). (4) Electrocardiogram: main manifestations were myocardial ischemia symptoms, such as ST-segment elevation (63.8% (104/163)), T wave inversion (46.0% (75/163)), ST-segment depression (8.6% (14/163)). Compared with European/North American, the ratio of patients with ST-segment elevation, T wave inversion, and atrioventricular block was higher in Chinese patients (P<0.05). (5) Echocardiography and imaging:apical dyskinesia (59.5% (97/163)) and apical/left ventricular bulbar dilation (36.2%(59/163)) dominated the echocardiography findings. Compared with European/North American, the ratio of patients with apical dyskinesia, apical/left ventricular bulbar dilation, and mitral regurgitation was higher in Chinese patients, while the ratio of patients with dyskinesia in other parts and left ventricular ejection fraction<50% was lower in Chinese patients (P<0.05). Left ventricular angiography showed 36.2% (59/163) of apical dyskinesia in Chinese patients, which was higher than that reported in European/North American patients, and 38.7% (63/163) of apical/left ventricular bulbar dilation was reported in Chinese patients, which was similar to that reported in European/North American patients. Coronary angiography showed percent of no stenosis or stenosis less than 50% was 87.1% (142/163), which was similar to that reported in European/North American patients (P>0.05). The typical type of TTS accounted for 96.3% (157/163), which was significantly higher than that reported in European/ American patients, while the ratio of basal type and midventricular type was lower (P<0.01). (6) Treatment and prognosis:the applied drugs in China were listed in order as following, β-blockers (41.1% (67/163)), antiplatelet agents (37.4%(61/163)), ACEI/ARB (36.2%(59/163)), anticoagulants (27.0%(44/163)), diuretics (19.6% (32/163)), etc. Compared with Europe/North America, the ratio of antiplatelet agents, anticoagulants, statins, diuretics, and nitrates use was higher in China (P<0.05), while the use of oxygen therapy and IABP was similar (P>0.05). The hospital mortality in China was 5.5% (9/163), during 1-year follow-up the recurrence rate was 3.7% (6/163) and the mortality was 0. The prognosis was similar with that in Europe/North America. Conclusions: Compared with TTS cases in Europe/North America, TTS cases in China also occur usually in middle-aged and elderly women, most of whom have mental/physical triggers and typical imaging manifestations, followed by a low hospital mortality rate and recurrence rate.
		                        		
		                        		
		                        		
		                        			Abdominal Pain/complications*
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Angiotensin Receptor Antagonists
		                        			;
		                        		
		                        			Angiotensin-Converting Enzyme Inhibitors
		                        			;
		                        		
		                        			Anticoagulants
		                        			;
		                        		
		                        			Arrhythmias, Cardiac/complications*
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			Diuretics
		                        			;
		                        		
		                        			Dizziness/complications*
		                        			;
		                        		
		                        			Dyskinesias/complications*
		                        			;
		                        		
		                        			Electrocardiography
		                        			;
		                        		
		                        			Europe/epidemiology*
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hypotension/complications*
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Platelet Aggregation Inhibitors
		                        			;
		                        		
		                        			Stroke Volume
		                        			;
		                        		
		                        			Takotsubo Cardiomyopathy/etiology*
		                        			;
		                        		
		                        			Ventricular Function, Left
		                        			
		                        		
		                        	
7.Upper gastrointestinal ulcer in children: a clinical analysis of 173 cases.
Chinese Journal of Contemporary Pediatrics 2022;24(4):372-376
		                        		
		                        			OBJECTIVES:
		                        			To study the clinical manifestations and gastroscopic characteristics of upper gastrointestinal ulcer in children.
		                        		
		                        			METHODS:
		                        			A retrospective analysis was performed for the children who underwent gastroscopy and were found to have upper gastrointestinal ulcer for the first time at the Endoscopy Center of Shengjing Hospital, China Medical University, from January 2011 to May 2021. According to the cause of the disease, they were divided into primary ulcer group (primary group; n=148) and secondary ulcer group (secondary group; n=25). The clinical data were compared between the two groups.
		                        		
		                        			RESULTS:
		                        			A total of 173 children with upper gastrointestinal ulcer were enrolled, with a male/female ratio of 3.9:1. Compared with girls, boys had significantly higher proportions of duodenal ulcer and primary ulcer (P<0.05). Compared with the children aged below 6 years, the children aged 6-14 years had higher proportions of duodenal ulcer and primary ulcer and lower proportions of giant ulcer and multiple ulcers. Of the 148 children in the primary group, 95 (64.2%) had Helicobacter pylori infection. Abdominal pain was the most common clinical symptom and was observed in 101 children (68.2%). Duodenal ulcer was common and was observed in 115 children (77.7%), followed by gastric ulcer in 25 children (16.9%) and esophageal ulcer in 7 children (4.7%). Multiple ulcers were observed in 32 children (21.6%). Seventy children (47.3%) experienced complications, among which bleeding was the most common complication and was observed in 63 children (43.6%). Of the 25 children in the secondary group, abdominal pain was the most common clinical symptom and was observed in 9 children (36.0%), with a significantly lower incidence rate than the primary group (P<0.05); foreign body in the digestive tract was the most common cause of ulcer and was observed in 17 children (68%), followed by abdominal Henoch-Schönlein purpura in 5 children (20.0%) and Crohn's disease in 3 children (12.0%). The secondary group had a significantly higher proportion of multiple ulcer or giant ulcer than the primary group (P<0.05).
		                        		
		                        			CONCLUSIONS
		                        			Upper gastrointestinal ulcer is more common in boys than girls, and duodenal ulcer and primary ulcer are more common in boys. Children aged 6-14 years often have duodenal ulcer and primary ulcer, and giant ulcer and multiple ulcers are relatively uncommon. Primary ulcer in children has a variety of clinical manifestations, mainly abdominal pain, and duodenal ulcer is relatively common, with bleeding as the main complication. The clinical symptoms and endoscopic manifestations of secondary ulcer are closely associated with the primary causes, and it is more likely to induce huge ulcers and multiple ulcers.
		                        		
		                        		
		                        		
		                        			Abdominal Pain
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Duodenal Ulcer/epidemiology*
		                        			;
		                        		
		                        			Endoscopy, Gastrointestinal/adverse effects*
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Helicobacter Infections/diagnosis*
		                        			;
		                        		
		                        			Helicobacter pylori
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Ulcer
		                        			
		                        		
		                        	
8.Effects of individual factors and labor organization on neck pain in auto assembler.
Kang Kang ZHANG ; Rong Bin SUN ; Jia Bing WU ; Li Hua DING ; Ning XU ; Rui Jie LING
Chinese Journal of Industrial Hygiene and Occupational Diseases 2022;40(9):710-714
		                        		
		                        			
		                        			Objective: To investigate the influence of individual factors and labor organization on the prevalence of neck pain (hereinafter referred to as neck pain) in automotive assemblers, and to provide a basis for enterprises to optimize neck pain interventions. Methods: A cluster random sampling method was taken in January 2021, at an automobile manufacturing plant in Shiyan, 656 assemblers with ≥1.0 years of service were selected, the "Musculoskeletal Disorder Questionnaire" was used to investigate the incidence and influencing factors of neck pain. Pearson χ(2) test or trend χ(2) test was used to compare the data rates. The influencing factors of neck pain were analyzed by multivariate logistic regression. Results: The prevalence rate of neck pain (hereinafter referred to as the prevalence rate of neck pain) of automobile assemblers within one year was 53.94% (342/634) . The prevalence of neck pain in women was higher than that in men (69.1% vs 48.6%, P<0.01) . The prevalence of neck pain was related to length of service, self-assessment of fatigue, working hours per week, working in the same workshop, rest days per shift, and accumulated rest time per shift (P<0.05) . Multivariate logistic regression analysis showed that the risk of neck pain in women was 2.434 times higher than that in men; The risk of neck pain increased by 18.9% for each hour of work per week; Rest during work was a protective factor for neck pain. The number of rest per shift increased and the risk of neck pain decreased (r=0.405, 0.311, 0.302, 95%CI=0.205~0.803, 0.169~0.572, 0.142~0.642, P<0.05) . Conclusion: The annual prevalence of neck pain was higher in automobile assemblers. Enterprises should fully consider the influencing factors such as gender, working hours per week and the number of breaks when arranging production.
		                        		
		                        		
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Musculoskeletal Diseases/epidemiology*
		                        			;
		                        		
		                        			Neck Pain/epidemiology*
		                        			;
		                        		
		                        			Occupational Diseases/epidemiology*
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			
		                        		
		                        	
9.Anesthesia management of athletes' operation in Beijing Olympic Winter Games.
Zhi Yu KANG ; Lei Lei WANG ; Yong Zheng HAN ; Xiang Yang GUO
Journal of Peking University(Health Sciences) 2022;54(4):770-773
		                        		
		                        			
		                        			According to literature reports, the injury rate of the athletes in Olympic Winter Games recent years was as high as 10%-14%. Combined with the background of corona virus disease 2019 (COVID-19), the medical insurance work of the 24th Olympic Winter Games held in Beijing had put forward more complicated requirements and more severe challenges. In order to better optimize anesthesia management, this article summarized the perioperative treatment of athletes in Olympic Winter Games, the safety protection strategy of medical staff under general anesthesia, and the potential impact of peri-operative drugs on athletes. Anesthesiologists, as the core members of the rescue team, should be familiar with the particularity of operative anesthesia of athletes, sum up relevant experience to ensure the safety of perioperative patients. So all kinds of technical measures should be taken in the process of operation to minimize the indoor pollution caused by the patient's cough. For example, all the patients should wear N95 masks from the ward to the operating room, and after the operation, wear the N95 masks back to the ward. Although the International Olympic Committee had banned more than 200 drugs for participants and athletes who had to strictly follow International Olympic Committee requirements during anesthesia, the athletes were no longer participating in this Olympic Winter Games, so opioids (sufentanil and remifentanil) and glucocorticoid (dexamethasone) could be used according to the actual needs of surgery and anesthesia. Five athletes in Yanqing competition area underwent surgical anesthesia in Peking University Third Hospital Yanqing Hospital. All the five patients received general anesthesia, of whom four underwent orthopaedic surgery and one underwent laparoscopic cholecystectomy. General anesthesia with laryngeal mask airway was the first choice in the five patients. And the pain after orthopaedic surgery was severe and nerve block technique could effectively relieve the pain after surgery. Three patients received ultrasound-guided nerve block analgesia, the postoperative analgesia lasted 36 h. After the operation, non-steroidal anti-inflammatory drug (NSAID) was infused intravenously in the ward and all the patients recovered uneventfully. As the core member of the trauma rescue team, anesthesiologists should be familiar with the particularity of the athletes' surgical anesthesia, do a good job in medical security, and summarize relevant experience to ensure the life safety of the perioperative patients.
		                        		
		                        		
		                        		
		                        			Anesthesia/methods*
		                        			;
		                        		
		                        			Anniversaries and Special Events
		                        			;
		                        		
		                        			Athletic Injuries/surgery*
		                        			;
		                        		
		                        			Beijing/epidemiology*
		                        			;
		                        		
		                        			COVID-19/prevention & control*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Pain Management/methods*
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		                        			Sports
		                        			
		                        		
		                        	
10.Quality of life and related factors in patients with interstitial cystitis/bladder pain syndrome.
Jia Wen WANG ; Jing Chao LIU ; Ling Feng MENG ; Wei ZHANG ; Xiao Dong LIU ; Yao Guang ZHANG
Journal of Peking University(Health Sciences) 2021;53(4):653-658
		                        		
		                        			OBJECTIVE:
		                        			To evaluate the quality of life of patients with interstitial cystitis/bladder pain syndrome (IC/BPS), to compare the difference between IC/BPS and overactive bladder (OAB) pain syndrome, and to explore the related factors affecting the quality of life of IC/BPS patients.
		                        		
		                        			METHODS:
		                        			The demographic data of female outpatients with IC/BPS in Beijing Hospital and other medical centers in China were collected. The quality of life of the patients was investigated by multi-angle questionnaires and compared with the data of OAB patients. According to the influence degree of quality of life, the patients with IC/BPS were divided into mild-moderate group and severe group.
		                        		
		                        			RESULTS:
		                        			In this study, 109 patients with IC/BPS were included. The average age was (46.4±14.3) years and the average course of disease was (39.4±51.6) months. Compared with the OAB patients, the patients in IC/BPS group had a longer average course of disease (P=0.008), a lower proportion of the patients of first visit for the disease (P < 0.001), a higher score of the American Urological Association symptom index (AUA-SI) (P < 0.001), a lower body mass index (BMI) ratio (P=0.016), and a lower incidence of constipation (P=0.006). IC/BPS had the greatest impact on family life, followed by social activity. The score of IC/BPS related symptoms on family life was significantly higher than that of the OAB group (P=0.003). The top three symptoms of the IC/BPS patients were pain (45%), frequency (28%) and urgency (17%). The score of quality of life in the IC/BPS patients was significantly higher than that in the OAB patients (P < 0.001). Caffeine intake (P=0.034) and constipation (P=0.003) might be the factors influencing the quality of life of the patients with IC/BPS.
		                        		
		                        			CONCLUSION
		                        			IC/BPS has a great influence on the quality of life of patients. Caffeine intake and constipation may be related factors affecting the quality of life of patients with IC/BPS. Urologists should recommend changes in diet and lifestyle to reduce symptoms and improve the patients' quality of life.
		                        		
		                        		
		                        		
		                        			Adult
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		                        			Cystitis, Interstitial/epidemiology*
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		                        			Female
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		                        			Humans
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		                        			Middle Aged
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		                        			Pain
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		                        			Quality of Life
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		                        			Surveys and Questionnaires
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		                        			Urinary Bladder, Overactive/epidemiology*
		                        			
		                        		
		                        	
            
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