ObjectiveTo investigate the risk factors,characteristics and prognosis in Tibetan patients with venous thromboembolism. MethodsTibetan patients with VTE from plateau area,admitted in West China Hospital from January 2010 to December 2012,were recruited in the study. The VTE diagnosis was confirmed by CT pulmonary angiogram (CTPA) or vascular ultrasound examination. Risk factors,clinical symptoms,signs and laboratory tests were retrospectively investigated and follow-up by telephone interview was conducted. Results31 Tibetan VTE patients with 16 males and 15 females were included. The investigation of risk factors revealed that 15 patients suffered from obese(48.3%),10 patients suffered from highly viscous hyperlipidemia(32.3%). The most common clinical symptom was dyspnea(29%),followed by chest pain(19.4%),hemoptysis(16.1%) and cough(12.9%). The common signs were lower extremity edema(73.3%) and lung rale(36.7%). All the patients received anticoagulation therapy,and inferior vena caval filters were implanted in 2 patients. In two years' follow-up after discharge,2 patients died of tumor,2 died of pulmonary embolism,6 patients suffered from chronic embolization syndrome with lower extremity edema or pain,1 patient suffered from pulmonary hypertension after embolization,and thrombus in 20 patients disappeared or recanalized. ConclusionTibetans long-termly reside in high altitude areas with the eating habits of high-fat diet,which may increase the incidence of acquired risk factors such as viscous hyperlipidemia and obesity. There are no specific clinical symptoms and signs among Tibetan VTE patients,with dyspnea as the most common symptom and lower extremity edema as the most common sign. Patients with risk factors which can be eliminated in a short term have better prognosis.
Objective To analyze clinical characteristics and treatment experience of 143 tibetan victims of China Yushu earthquake, so as to provide reference for emergency preparation for earthquake disasters. Methods A retrospective study from April 16th to April 22th, 2010 was designed. A total of 143 injured Tibetans (74 men, 69 women) of the magnitude 7.1 Yushu earthquake were included in this study. Data from victims was collected retrospectively as follows: age, gender, cause of injury, place and time of rescue, chief complaint, primary diagnosis, onsite treatment, transfer, psychological crisis intervention and so on. Results The 143 tibetan victims contained 67 fracture cases (4 open fracture, 63 closed fracture), 5 joint dislocation cases and 3 neural injury cases. 62 victims with fracture were treated by Tibetan-Chinese therapy combined with external fixation, 5 victims were operated with emergency surgery, 6 victims refused to the surgical debridement and suture, and no dead case reported. All patients were given 3 to 11 psychological intervention treatments. As to the aspect of the wounded transferring, 48 cases among 54 supposed evacuating victims were transferred to Xinin hospitals, and the other six refused to be transferred and kept staying in the original place for treatment. Conclusion The clinical characteristics of the tibetan victims are outstanding. The medical rescue for disaster in ethnic region should be appropriate for features of disaster areas.Both the individualized remedy and early psychological intervention are regarded as the important measures for improving the general level of earthquake medical rescue in ethnic regions.
Objective To primarily test the reliability and validity of the Kashin-Beck Disease (KBD) affected big joints function assessing system for adult Tibetans in Rangtang County. Method From June to July 2009, 142 KBD patients were investigated with the function assessing system in Rangtang County of Ngawa. Cronbach’s α coefficient was calculated to estimate internal consistency reliability. Pearson’s r for the correlation of the items with the total score of the scale was computed to test the internal validity. Principal component factor analysis with varimax rotation analysis was conducted to explore construct validity. Result Both the response and complete rates of the scale were 100%. The time for completing the scale was 7.8±3.4 minutes. Cronbach’s α was 0.857, which revealed satisfactory internal consistency reliability. Pearson correlation analysis revealed significant correlation between the scores of each item and the total score of the scale (Plt;0.05). Pearson’s r value of each item was more than 0.4, only except the items of “sitting with legs crossed” and “standing at attention”. The principal factor analysis extracted three latent factors explaining 68.1% of the variation together. The latent factors weights of the items were over 0.4 except the items of “standing at attention”, "taking food” and “wiping after defecation”. Conclusion The reliability and validity of KBD affected big joints function assessing system for adult Tibetans in Rangtang County was good in this primary test, the function assessing system has to be widely applied and further assessed among Tibetans suffered with KBD, in order to provide a standard evaluation criterion in KBD integrate control.
Objective Certificate Compound Zangyao Dadui for Cirrhosis of liver had unique curative effect. Method This randomized controlled study examined in 100 patients with established cirrhosis, with comparison with the effects of a combined therapy with Gantaile and hepatic growth factor (HGF). The patients in the treatment group (n=50) received Compound Zangyao Dadui, 2 grams and three times daily for three month, and the control group (n=50) with Combination of Gantailei and HGF, for the same period. Results The cure rate, improvement rate, ineffective rate, and total effective rate in the treatment group were 70% (35/50), 20% (10/50), 10% (5/50), and 90%, respectively, while they were 30% (15/50), 30% (15/50), 40% (20/50), and 60%, respectively, in the control group 0. The difference in the total effective rate between the two groups is statistically significant (Plt;0.01).
ObjectiveTo explore the application of PDCA cycle in the examination of medical quality of Tibetan area hospitals. MethodsIn the October 2014, PDCA cycle theory was introduced into the examination of Tibetan hospital medical quality. We collected quality problems existing in the medical activities actively, analyzed the reason and influencing factors and made corresponding plans. Then we implemented the plans and measures strictly, surveyed the results, found out and analyzed the problems, summarized the results of the examination, and turned the unsolved problems to the next PDCA circulation. Continuous follow-up was performed until the results were satisfactory. Based on Sichuan Province Secondary Comprehensive Hospital Evaluation Standard, we analyzed the medical quality of the hospital before PDCA application (July to September 2014) and after PDCA application (October to December 2014). ResultsThe incidence of medical nursing documents writing defects decreased from 12.4% to 5.9%. Hospital infection management defect rate declined from 13.5% to 5.3% and drug safety management defect rate declined from 11.8% to 2.5%, and all the differences were statistically significant (P<0.05). ConclusionPDCA cycle in the Tibetan hospital for medical quality examination has greatly improved the medical quality of Tibetan hospitals.
ObjectiveTo explore and discuss the risk factors of early onset coronary heart disease in Tibetan residents. MethodsWe selected Tibetan residents with coronary heart disease who were hospitalized in the Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region between January 2011 and May 2013, and then divided them into two groups by age (early onset and late onset coronary heart disease groups). Univariate analysis was performed between two groups by gender, family history, smoking, drinking, hypertension, diabetes, levels of blood lipid, respectively. The factors with significant differences were extracted for logistic regression. Data analysis was performed using SPSS 16.0 software. ResultsA total of 64 Tibetan residents with coronary heart disease were included, of which, 22 cases were in the early onset groups and 42 cases the late onset group. The results of univariate analysis showed that, significant differences were found in gender, family history, and levels of HDL-C and LDL-C (all P < 0.05). Besides, the results of logistic regression showed that, family history (OR=3.374, P < 0.05), high triglycerides level (OR=2.369, P < 0.05), low HDL-C level (OR=0.014, P < 0.05) and high level of LDL-C (OR=3.008, P < 0.05) were independent risk factors of early onset coronary heart disease in Tibetan residents. ConclusionPositive family history, high triglycerides level, low HDL-C level and high level of LDL-C are independent risk factors of early onset coronary heart disease in Tibetan residents.
ObjectiveTo investigate the association between local population's lifestyle and the morbidity of cerebral stroke in Ganzi Tibetan state, so as to provided references for preventing stroke in the local region. MethodsA representative population sample (including residents, farmers and herdsmen) of Kangding, Dege, Ganzi, Litang and Batang county was selected through randomized cluster sampling from September 2010 to June 2012. Data including lifestyle, housing conditions and stroke status were collected using a questionnaire. Then statistic analysis was performed using SPSS 19.0 software. ResultsA total of 7 038 cases were investigated, of which 125 cases with cerebral stroke were found. The morbidity of stroke was 1 923/100 000. Smoking, alcohol drinking, excessive intake of salt and overweight were positively associated with the risk of cerebral stroke, while appropriate physical exercise was negatively associated with cerebral stroke. Housing conditions and height above sea level were not obviously associated with cerebral stroke. ConclusionThe prevalence of cerebral stroke is high in Ganzi Tibetan state, which is related to special local population's lifestyle. It is very important to reinforce the work for the prevention and control of stroke.
ObjectiveTo evaluate the diagnostic value of interferon-gamma release assay (TB-IGRA) for tuberculosis in the Tibetan. MethodsFrom January 2014 to December 2014, suspected Tibetan tuberculosis patients were enrolled from AVIC 363 Hospital and underwent TB-IGRA test. All patients were also underwent smear test for Mycobacteria. The diagnostic value of TB-IGRA test for Tibetan TB patients was analyzed. ResultsA total of 77 suspected Tibetan tuberculosis patients were included. According to the diagnostic criteria, of the 77 suspected patients, 50 were diagnosed as TB patients, and 27 were diagnosed as not-TB patients. The sensitivity and specificity of TB-IGRA test was 86% and 81.5%. While the sensitivity and specificity of smear test were 22% and 100%, respectively. ConclusionThe TB-IGRA test is superior to smear test, and is the fast and sensitivity test for diagnosing Tibetan TB patients.
Objective To explore the relationship between obesity and the three targets including blood pressure, glucose, and lipid. Methods A total of 181 adult Tibetans who underwent physical examination between March and September 2015 at Xigaze People's Hospital were enrolled in this study. Their obesity degrees were assessed with body mass index (BMI) and waist circumference (WC) respectively. The levels of blood pressure, glucose, and lipid were compared at the different levels of BMI or WC. Results The incidence of systematic obesity and central obesity in these adults were 57.5% and 79.0%, respectively. Compared the overweight group with the normal BMI group, the systolic pressure and diastolic pressure of the former were 9.26 mm Hg (1 mm Hg=0.133 kPa) [95% confidence interval (CI) (3.46, 15.07) mm Hg, P=0.002] and 7.76 mm Hg [95%CI (3.96, 11.57) mm Hg, P<0.001] higher, respectively. Similarly, the systolic pressure and diastolic pressure of the central obesity group were 8.24 mm Hg [95%CI (1.03, 15.46) mm Hg,P=0.026] and 6.79 mm Hg [95%CI (2.03, 11.55) mm Hg, P=0.006] higher than those in the normal WC group, respectively. For the normal WC or normal BMI subjects, the detection rate of dyslipidemia reached up to 50.0% and 52.6%. Conclusions With the increase of BMI/WC values, the level of blood pressure rises. Even though WC or BMI is normal, the detection rate of dyslipidemia is high.
Objective To observe the changes and influencing factors on pulse oxygen saturation and hemoglobin in Tibetan residents of 4 200 meters above sea level. Methods The health examination data of the Tibetan village residents were collected in Rerong Country, Shannan Prefecture of Tibet autonomous region from January 4 to February 4, 2012. And the information of pulse oxygen saturation was recorded at the same time. The residents were categorized by sex, age and smoking history to observe the difference in each group. Results The clinical data of 234 healthy Tibetan residents were collected with average age of (37.9±13.9) years old, and 97 were male (41.5%). There were no difference in pulse oxygen saturation [(86.1±3.4)% and (86.0±4.7)%, P=0.784) between male and female residents, and heart rate of the male was less than that of the female [(77.9±9.8) bpm and (81.1±12.1) bpm, P=0.036], while the hemoglobin content was higher in male residents [(164.5±15.4) g/L and (139.1±19.2) g/L, P=0.000). With the increase of age, especially in the group older than 60 years, the pulse oxygen saturation significantly decreased (P=0.003), while hemoglobin content showed a gradual increase trend (P=0.000). And in the group which smoking history more than 20 pack-years, the pulse oxygen saturation was lesser than the other groups, and the hemoglobin content increased (P=0.000). Conclusions The pulse oxygen saturation level of Tibetan residents of 4 200 meters above sea level is negatively correlated with age and smoking history, and the level of hemoglobin is positively correlated with age and smoking history. In resting state, there is no significant difference in heart rate between the groups divided by ages.