Objective:To analyze the causes of out-of-hospital cardiac arrest (OHCA) and the differences in outcomes of pre-hospital first-aid measures and cardiopulmonary resuscitation for different etiologies, improved the success rate of rescue.Methods:A retrospective study was conducted on OHCA patients admitted to Beijing Emergency Medical Centre from January to December 2021. The pre-hospital emergency medical records and rescue results within medical institutions were collected. Compared the basic situation between patients with cardiogenic and non-cardiogenic cardiac arrest, the differences of rescue measures and CPR outcomes between the groups were compared by non-parametric test and χ 2 test. Results:A total of 7 517 patients were included in this study. Cardiogenic arrest patients were older, more underlying diseases (84.2%), and cardiac arrest mainly occurred at home. The cause of non-cardiogenic arrest included disease (85.1%), trauma (2.9%), suicide (5.0%), traffic accidents (1.7%), poisoning (1.1%), and so on. In terms of first-aid measures, after the emergency doctor arrived at the scene, the proportion of first-aid measures used for cardiogenic patients was high (22.3%), and the first aid measures include cardiopulmonary resuscitation, tracheal intubation, defibrillation, oxygen inhalation, injection of adrenaline and use of other drugs. All the proportions of first-aid measures for cardiogenic patients were significantly higher than non-cardiogenic patients (all P<0.001). In terms of clinical outcomes, there were no statistical differences in return of spontaneous circulation ( P=0.072) and 24-hour survival ( P=0.093) between cardiogenic and non-cardiogenic patients. Conclusions:Cardiogenic cardiac arrest was the main cause of OHCA. Cardiogenic arrest patients were more underlying diseases, and older in age, the main clinical feature was onset at home. The comprehensive treatment measures for pre-hospital first-aid cardiac arrest should continue to be strengthened to improve the success rate of rescue for OHCA.

Humans ; Microglia ; Spinal Cord ; Neuralgia ; Hyperalgesia

Objective:To investigate the longitudinal trajectory and influencing factors of cancer-related fatigue (CRF) in breast cancer patients during chemotherapy.Methods:From March 2019 to January 2020, breast cancer patients in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine and Peking Union Medical College Hospital were selected as the research objects to conduct follow-up investigation. The survey tools included general information questionnaire, Cancer-related Fatigue Assessment Scale, International Physical Activity Questionnaire, and the Pittsburgh Sleep Quality Index Scale.Results:A total of 91 patients were included in the study. The incidence of severe CRF at each time point before chemotherapy, 3 weeks after chemotherapy and 6 weeks after chemotherapy were 1.1% (1/91), 8.8% (5/57) and 2.1% (1/48), respectively. The results of the generalized estimation equation showed that the trajectory of the total score CRF firstly increased and then decreased, reaching a peak at 3 weeks after chemotherapy (35.45±13.07), and mild CRF change showed statistical difference ( P<0.05). In addition, BMI and sleep and daytime dysfunction were the influencing factors of the total score of CRF. Disease stage, sleep disturbance and daytime dysfunction were the influencing factors of CRF with different severity. Conclusions:CRF is a prominent problem in breast cancer patients during chemotherapy. Attention should be paid to high-risk individuals with abnormal BMI and daytime function by medical staff.

Objective:To study the epidemic status of drinking tea type endemic fluorosis in Qinghai Province.Methods:In 2019, in counties (cities, districts, referred to as counties) that had the habit of drinking brick tea in 8 cities (prefectures) of Qinghai Province, epidemiological investigation of drinking tea type endemic fluorosis was carried out in villages. Ten households were randomly selected from each village, to investigate the demographic data of each household and the drinking situation of brick tea, residents' drinking water and brick tea samples were collected to determine the fluorine content, and calculate the daily per capita tea fluorine intake. At the same time, skeletal fluorosis was examined in all adults over 25 years old, and dental fluorosis was examined in all children aged 8 to 12 years old in survey sites. The content of fluorine in tea and water was detected by ion selective electrode method; the diagnosis of skeletal fluorosis was based on "Diagnostic Criteria for Endemic Skeletal Fluorosis" (WS 192-2008), the diagnosis of dental fluorosis was based on "Diagnosis of Dental Fluorosis" (WS/T 208-2011).Results:The mean (range) of fluorine of the 3 602 water samples was 0.31 (0.20 - 1.00) mg/L. The geometric mean (range) of fluorine of the 31 067 brick tea samples was 646 (40 - 2 295) mg/kg, the fluorine content of the brick tea ≤300 mg/kg accounted for 7.80% (2 422/31 067) of the total samples. The proportion of drinking Fu brick-tea was 89.97% (27 952/31 067); and the daily per capita tea fluorine intake was 1.93 mg, the daily per capita tea fluorine intake in Guoluo, Yushu and Hainan prefectures were higher than the health standard (3.50 mg). The detection rate of skeletal fluorosis in adults was 0.16% (2 357/1 484 907), Yushu Prefecture was the highest [29.23% (592/2 025)], followed by Guoluo Prefecture, which was 8.21% (771/9 393). The detection rate of dental fluorosis in children was 4.79% (8 076/168 623), Yushu Prefecture was the highest [32.61% (1 562/4 790)].Conclusion:Drinking tea type endemic fluorosis is prevalent in Qinghai Province, with obvious regional characteristics, covering a large population. The disease is relatively popular in Yushu Prefecture and Guoluo Prefecture.

Objective To explore the prevalence state of drinking brick-tea type fluorosis in children in Guoluo Prefecture,Qinghai Province.Methods According to the historical prevalence of drinking tea-type fluorosis in Guoluo Prefecture,in 2017,in 5 counties of Guoluo Prefecture,according to the pastoral area,agricultural area,semi-agricultural and semi-pastoral areas,each township (town) was selected,in each township (town) drawed a natural village in a ward as a survey point.At each survey site,drinking water samples of local residents were collected,and 10 households were selected,tea samples were collected,and dental fluorosis was investigated for children aged 8-12 years old.The mean of fluoride was determined by fluoride ion selective electrode method (GB/T 5750.5-2006,GB 19965-2005),and the dental fluorosis was diagnosed based on "Diagnosis of Dental Fluorosis" (WS/T 208-2011).Results The mean of fluoride in 85 water samples was 0.34 mg/L (0.20-0.77 mg/L),the mean of fluoride in 161 brick-tea samples was 579 mg/kg (110-1 278 mg/kg).The mean of daily fluoride intake of each person was 6.78 mg,among them,73.29％ (118/161) drank brick-tea,the detection rate of dental fluorosis of 2 083 children was 22.85％ (476/2 083),and the index of dental fluorosis was 0.42,the prevalence was weak.Conclusion The prevalence of drinking brick-tea type fluorosis of children in Guoluo Prefecture is less serious.

Objective To understand the epidemic situation of tea-drinking-borne fluorosis among children in Haixi Prefecture of Qinghai Province,and to provide basis for taking pertinent prevention and control measures.Methods In 2017,three townships (towns) were selected from five counties (cities) in Golmud,Delingha,Dulan,Ulan and Tianjun,Haixi,and one village (villages excluding excessive water fluoride) was selected from each township (town) as the investigation site.Fluoride content in drinking water,tea fluoride content and dental fluorosis in children aged 8-12 years were investigated.Water fluoride was determined using "Standard Test Method for Drinking Water" (GB/T 5750.5-2006);brick tea fluoride content was detected using "The Fluoride Content in Brick Tea" (GB 19965-2005);children's dental fluorosis was diagnosed using "Diagnosis of Dental Standard for Fluorosis"(WS/T 208-2011).Results Totally 75 drinking water samples were collected from each county (city).The water fluoride content ranged from 0.35 to 0.41 mg/L,with an average value of 0.37 mg/L,which was lower than the national drinking water fluoride standard of 1.00 mg/L.The fluoride content of 150 brick tea samples ranged from 206.0 to 796.0 mg/kg,with an average value of 629.8 mg/kg.A total of 1 325 children aged 8-12 were examined.The detection rate of dental fluorosis was 13.43％ (178/1 325),the index of dental fluorosis was 0.27,and the overall epidemic intensity was negative.The epidemic intensity in Dulan and Tianjun counties was marginal.There were significant differences in the detection rate of dental fluorosis among children of different ages (x2=35.26,P ＜ 0.05),and dental fluorosis was increased with ages in children.The detection rate of dental fluorosis in boys and girls was 13.31％ (90/676) and 13.56％ (88/649),respectively,with no significant difference (x2 =0.02,P ＞ 0.05).Conclusions There is an epidemic of tea-drinking-borne fluorosis among children in 5 counties (cities) of Haixi Prefecture.Although the epidemic is mild,it should not be ignored.Health education and publicity work for tea-drinking-borne fluorosis should be strengthened.

Antioxidants ; metabolism ; Benzoxepins ; pharmacology ; Cell Line ; Gene Expression Regulation, Enzymologic ; drug effects ; Humans ; Limonins ; pharmacology ; NF-E2-Related Factor 2 ; metabolism ; Oxidoreductases ; biosynthesis

Objective To observe the illness change trend of drinking water type endemic arsenic poisoning in Qinghai Province, comprehensively evaluate the effect of prevention and control measures, in order to provide a scientific basis for timely adjustment of the prevention and control measures. Methods From 2010 to 2013, according to the Drinking Water Type Endemic Arsenic Poisoning Monitoring Programs, 3 villages in 2 counties within Qinghai Province were randomly selected as monitoring sites. The arsenic content in drinking water of residents was measured, water improvement projects in all monitoring villages were investigated; at the same time an investigation of arsenic disease in resident population was conducted, and urinary arsenic content was monitored. Arsenic in drinking water and urine was determined by hydride generation atomic fluorescence spectrometry, and arsenic poisoning was diagnosed using Endemic Arsenic Poisoning Diagnostic Criteria (WS/T 211-2001). Results Of the three water improvement projects, two were water arsenic exceeded the standard, and one was intermittently operated. From 2010 to 2013, the arsenic poisoning detec tion rate in Baoning Village was 27.30% (193/707), 31.90%(245/768), 29.35%(221/753) and 28.22%(219/776); in Kecai Village was 32.62%(107/328), 34.83%(124/356), 31.26%(131/419) and 29.35%(118/402);and in Manimotai Village was 56.58%(43/76), 52.81%(47/89), 45.10%(46/102) and 34.69% (34/98), there was no significant difference statistically of the arsenic poisoning detection rates in the three monitored villages in the 4 years (χ2 =3.09, 0.04, 0.92, all P>0.05). From 2010 to 2013, women arsenic poisoning detection rate was 36.45%(203/557), 40.59%(246/606), 36.12%(225/623) and 34.77%(218/627), respectively;men was 25.27%(140/554), 28.01%(170/607), 26.57%(173/651) and 23.57%(153/649), respectively;women arsenic poisoning detection rates were higher than those of men (χ2 = 16.25, 21.32, 13.49, 19.38, all P < 0.05). Arsenic poisoning detection rate of people younger than 60 years old had a tendency to increase with age. In 2012 and 2013, 105 and 93 urine samples were tested, respectively; urinary arsenic geometric mean was 0.113 and 0.149 mg/L. Conclusions Water improvement projects and water quality are not optimistic, and prevalence of arsenic poisoning is still at a higher level. A sound long-term monitoring program should be established as soon as possible, the management and maintenance of water improvement projects should be strengthened, and the monitoring and prevention work should not be neglected.

Objective To analyze the radiographic characteristics of right hand X-ray film of adult patients with Kaschin-Beck disease (KBD) in Qinghai Province, to understand the most affected locations in adult KBD. Methods According to the criteria of KBD diagnose (WS/T 207-2010), 111 cases of patients were taken X-ray films of right hands. Joint space narrow, joint deformity, subchondral sclerosis, osteophyte, coarse and irregularity of joint, marginal retraction sign and capsule changes were chosen as the descriptive indexes, and these indexes were analyzed with SPSS 17.0. Results A total of 111 cases adult patients with KBD were examined right hand by X-ray, abnormality on X-ray film were 103 cases, the abnormal rate was 92.79%. The most affected fingers were Ⅱ- Ⅳphalanx bones, Ⅱphalanx bones accounted for about 92.23% (95/103), Ⅲ phalanx bones accounted for about 99.03% (102/103), and Ⅳ phalanx bones accounted for about 99.03% (102/103). There was significant difference of the abnormality between th e proximal phalanx and the middle phalanx among the Ⅱ - Ⅳ phalanx bones(χ2=79.33, P<0.05). Abnormal numbers of joint deformity, marginal retraction sign, coarse and irregularity of joint, osteophyte, capsule changes and joint space narrow in the proximal phalanx were 212, 7, 134, 47, 15 and 115 in Ⅱ - Ⅳ proximal phalanx, respectively; while the abnormal numbers of joint deformity, marginal retraction sign, coarse and irregularity of joint, osteophyte, capsule changes and joint space narrow in the middle phalanx were 77, 37, 137, 26, 19 and 126 in Ⅱ - Ⅳmiddle phalanx, respectively. Conclusion The Ⅱ - Ⅳ phalanx bones of right hand are the most affected locations in adult KBD.

Objective One hundred and sixteen cases of pediatric patients with severe heart fail-ure,pneumonia combined application of phentolamine dopamine synthesis with conventional medical treat-ment were compared the clinical efficacy,analyze and judge the feasibility of both combination therapy clini-cal significance and its value.Methods Collected from July 2013 to April 2015 period to the author hospi-tal and diagnosed with pneumonia in children with heart failure in 116 patients.Which were randomly divid-ed into two groups,group A +phentolamine medical treatment with dopamine and B group routine clinical medicine comprehensive treatment.Clinical observation by a number of factors to analyze comparative A,B two groups after the treatment efficacy.Results A significant effect of the treatment group and the number of effective treatments were more than group B and A group of overall response rate (91.38%)than in group B (60.34%);A group invalid proportion treated patients (8.62%)was significantly less in group B (39.66%);A group of children mortality (5.17;Change a group on heart rate and blood pressure had a better than group B;and the difference was greater (P <0.05).A,B two members appeared after treat-ment of mild nasal congestion and mild bloating and other adverse reactions,for Group A after two cases of children with nasal 1% solution of furosemide Ma nasal symptoms disappear;for two cases of group B chil-dren with mild bloating conventional medical treatment after symptoms have been effectively controlled.A, B two groups in terms of adverse events was not significantly (P >0.05)Conclusions A group of overall efficiency significantly higher in group B and body recover faster in children,low mortality,children with severe pneumonia prompted phentolamine and dopamine treatment with heart failure better.