2022年北京冬奥会定点医院医疗卫生保障实践

2022年北京冬奥会是全球瞩目的盛事，如何有效提升延庆赛区定点医院医疗卫生保障能力是冬奥会筹办过程中需要解决的重大课题。文章系统总结延庆赛区冬奥定点医院医疗保障特点、主要做法和经验，旨在为今后大型赛事定点医院的医疗保障提供参考。     

Assessment of the knowledge,attitudes, and practices among UNRWA health staff in Jordan concerning mental health programme pre-implementation: a cross-sectional study

Background

Mental health is a major public health priority, particularly among refugees worldwide. The United Nations Relief and Works Agency for Palestine Refugees (UNRWA) started to integrate mental health and psychosocial support (MHPSS) into its primary health-care services in Jordan in late 2017. This baseline study aimed to assess the knowledge, attitudes, practices, and perceived barriers among UNRWA health staff regarding the implementation of the MHPSS programme.

Nasopharyngeal Carcinoma (NPC) Risk Factors: A Systematic Review and Meta-Analysis of the Association with Lifestyle,Diets, Socioeconomic and Sociodemographic in Asian Region

Objective: Risk factors of nasopharyngeal carcinoma (NPC) have been linked with diets, life style and viral infections. NPC is more rampant in Asian populations than non-Asian countries. Our study aims to assess the validity of the suggestions provided by multiple case control studies demonstrating that salted fish consumption, smoking and alcohol consumption are associated with the risk of NPC in Asia. Methods: Search for related literature on salted fish, smoking and alcohol consumption were performed via Science Direct, PubMed databases and Google Scholar. Articles included in this study were from 2009 to 2017, with specific focus on salted fish, smoking and alcohol consumption as risk factors of NPC. This study excluded all articles published prior to 2009 and articles involving other cancers. Data were extracted independently by two different researchers and harmonized. Meta-analysis was conducted on the obtained data, by using R package Meta to create funnel and forest plots. Results: The meta-analysis revealed that salted fish, smoking and alcohol consumption were significantly associated to NPC risk with random effect model score showing OR of 1.41 at 95% confidence interval (CI) of 1.13-1.75 (P<0.01), OR of 1.89 at 95 % CI of 1.49 – 2.38, and OR: 1.42 at 95 % CI of 1.23 – 1.65 respectively. Our results also revealed significant association of salted meat, salted vegetables, house type, wood dust exposure associated with NPC risk with p values less than 0.05. Conclusion: This study proposes that salted fish intake, smoking and alcohol consumption might be linked to NPC risk in Asians. Further studies are necessary to ascertain the molecular mechanisms and clarify if the associated path that could function as therapeutic target.     

Characteristics and outcomes of in-hospital cardiac arrest in adults hospitalized with acute coronary syndrome in China

AimsThis retrospective study aims to analyze and explore the clinical characteristics, risk factors, and in-hospital outcomes - including return of spontaneous circulation (ROSC) and survival to discharge - of hospitalized patients admitted with acute coronary syndrome (ACS) suffering cardiac arrest.MethodsACS patients admitted to three tertiary hospitals in Fujian, China, were evaluated retrospectively from January 1, 2012 to December 30, 2016. Data were collected, based on the Utstein Style, for all cases of attempted resuscitation for IHCA. We analyzed patient characteristics, pre-event variables, event variables, and the main outcomes, including ROSC and survival to discharge, and identified the influencing factors on the outcomes.ResultsThe total number of ACS admissions across the three hospitals during this study period was 21,337. Among these admissions, 320 ACS patients experienced IHCA (incidence: 1.50%); 134 (41.9%) patients experienced ROSC; and 68 (21.2%) survived to discharge. The findings indicated that four factors were associated with ROSC, including age <70 years-old, shockable rhythm, duration of resuscitation (≤15 min and 16–30 min), and PCI. Five factors were associated with survival to discharge, including age <70 years-old, shockable rhythm, the duration of resuscitation (≤15 min and 16–30 min), Killip ≤ II, and CCI ≤ 2.ConclusionYounger age, shockable rhythm, and shorter duration of resuscitation were all factors demonstrated to be a predictor of ROSC and survival to hospital discharge.     

Suppression of puerarin on polymethylmethacrylate-induced lesion of peri-implant by inhibiting NF-κB activation in vitro and in vivo

Puerarin (PR), a natural isoflavone isolated from Chinese traditional plant pueraria lobata, has attracted considerable attention due to its important biological and pharmacological activities. However, its effects on lesion of peri-implant and related mechanism of action are still not clear, which require further investigation. In this study, we evaluated the effects of PR on polymethylmethacrylate (PMMA)-induced lesion of peri-implant in vitro and in vivo, and explored its possible mechanism of action. Our results indicated that PR could inhibit PMMA-induced osteoclastogenesis in RAW264.7 cells with a dose-dependent manner in vitro and effectively down-regulate mRNA and protein expressions of matrix metalloprotein 9 (MMP-9), tumor necrosis factor (TNF)-α, interleukin (IL)-6, and receptor activator of nuclear factor (NF)-κB (RANK), primarily via the suppression of NF-κB signaling. Furthermore, we found that PMMA induction could directly cause the phosphorylation of IκB and significantly promote the nuclear translocation of p65 in RAW264.7 cells. In other words, PR was able to dose-dependently attenuate the PMMA-induced nuclear translocation of p65 in RAW264.7 cells. In vivo, PR was observed to attenuate PMMA-induced osteoclastogenesis, osteolysis, mRNA expressions of receptor activator of nuclear factor (NF)-κB ligand (RANKL) and RANK, as well as protein levels of MMP-9, TNF-α, IL-6, and p65 in a murine calvarial osteolysis model. These findings suggested that PR might be a potential therapeutic drug to lesion of peri-implant, and provided new insights for understanding its possible mechanism.     

Different Cosmetic Habits Can Affect the Biophysical Profile of Facial Skin: A Study of Korean and Chinese Women

BackgroundPrevious studies on the age-, climate, and skin care habit-related changes of biophysical parameters have mainly focused on Caucasians, and studies on Asians are in paucity.ObjectiveThis study was aimed to investigate the variations of cutaneous biophysical parameters in Chinese and Korean women (northeast Asians) and to assess the association between those parameters and age, climate, and cosmetic habits.MethodsA cross-sectional study included 361 healthy Chinese and Korean women between 18 and 49 years of age in 4 cities (Guangzhou, Nanjing, and Shijiazhuang in China, and Suwon in Korea). We measured skin surface temperature, hydration, transepidermal water loss (TEWL), sebum, elasticity, skin pore, wrinkle, and skin tone (brightness) using non-invasive instruments. Demographic profiles and cosmetic habits were assessed using a questionnaire.ResultsSkin elasticity and tone decreased, and pore size and wrinkle increased with age. Subjects in Suwon (Korean) showed higher hydration level, lower TEWL and lower sebum, less severe wrinkle and brighter skin than those in the 3 cities in China. After adjusting for age and region, using sunscreen everyday, wearing base makeup daily, and using moisturizers improved hydration, TEWL, and elasticity significantly.ConclusionWomen in Suwon (Korea) were found to have a better profile of biophysical parameters than women in the 3 Chinese cities, which might be attributed to cosmetic habits, besides age and climatic factors. The fact that appropriate cosmetic habits are associated with favorable skin biophysical parameters underscores the importance of daily skin care routine in preserving skin functions.     

A systematic review of the benefits of occupation-based intervention for patients with upper extremity musculoskeletal disorders

Study DesignSystematic review of intervention studies (level 3a).IntroductionOccupation-based intervention (OBI) uses daily activities as a treatment modality. Its growing use with patients diagnosed with upper extremity musculoskeletal disorders (UE MSK) has driven interest in its supporting body of evidence.Purpose of the StudyThe purpose of this study was to locate, appraise, and summarize current evidence of the effectiveness of OBI in treating patients with UE MSK.MethodsSearches of PubMed, CINAHL, the Cochrane Register for Controlled Trials, and PEDro databases were conducted using predetermined keywords. Studies included in this systematic review described the use of OBI in UE MSK. Two examiners independently reviewed and assessed the quality of each study using the PEDro scale.ResultsResults of the database searches yielded 991 studies, 13 of which were deemed eligible to include in this review (6 randomized controlled trials, 4 pretreatment/post-treatment cohort or case series studies, and 3 single case reports). Quality of the studies varied, with 4 rated poor, 2 moderate, and 4 excellent. Overall, individuals receiving OBI showed superior benefits in patient-reported, performance, and physical measures assessing the upper extremity.DiscussionFindings of this review provide preliminary evidence for the use of OBI with patients with UE MSK, however, generalizability of the evidence was compromised due to heterogeneity in study subjects as well as conceptualization, dosage, and delivery of OBI.ConclusionsThe existing literature reflects promising trends in the use of OBI, underscoring its utility as a treatment option for UE MSK-related impairment, limitations, and restrictions. Nonetheless, scientific evidence concerning the effectiveness of OBI needs to be improved by conducting high-quality studies that clearly conceptualize this intervention and heighten understanding of its role in hand therapy practice.     

Therapeutic effects of topical 0.03% Tacrolimus ointment in children with refractory vernal keratoconjunctivitis in Middle East

ObjectiveThe purpose of this paper is to review the efficacy and safety profile in children treated with topical 0.03% Tacrolimus ointment for vernal keratoconjunctivitis in Middle East and to propose a treatment posology. According to recent studies, a complex non-IgE dependent mechanism plays a relevant role in the pathogenesis of vernal keratoconjunctivitis. Numerous cells and mediators have been found in the serum, conjunctiva and tears of patients with Vernal keratoconjunctivitis.DesignThis case series included 10 patients from a single centre, pediatric department of a tertiary hospital with active symptomatic vernal keratoconjunctivitis. All the patients had proliferative lesions and corneal involvement despite conventional medications, including topical steroids. All other medications, systemic and topical: steroids, antihistamines and cyclosporine, were unsuccessful. Patients were treated with topical 0.03% Tacrolimus ointment twice daily for 8 weeks and then once a day for the next two month followed by thrice a week for two months. The changes in symptoms and signs after treatment were evaluated, also the development of possible complications was assessed.ResultsThe results showed a significant reduction in signs and symptoms after 4 weeks of the treatment. Clinical resolution of giant papillae and corneal lesions were seen within eight weeks and no additional drug was required during that period, except tear substitutes. Treatment was continued for period of two months and then slowly reduced.ConclusionThe use of 0.03% Tacrolimus ointment is safe and effective in children refractory to conventional treatment of vernal keratoconjunctivitis even in high temperature climate as Middle East. Due to the effectiveness of the treatment, the dosage used may be proposed for conventional use.