Chinese Journal of General Practitioners

Objective To evaluate the pattern of energy metabolism and nutrients intake in patients with chronic viral hepatitis and posthepatitic cirrhosis to effectively direct their nutrition therapy.Methods Resting energy expenditure (REE) was measured with open-circuit indirect Jorimetry in 60 patients with chronic viral hepatitis and 60 patients with posthepatitic cirrhosis.Their normal basal energy expenditure (BEE) was predicted by Harris-Benedict equation and energy intake (EI) was determined by diet recall. Correlation between REE and indicators for nutrition assessment was analyzed.Results REE was (77± 21) kJ·kg~(-1)·d~(-1) in 60 patients with pusthepatitic cirrhosis,significantly lower than BEE[(95±16) kJ· kg~(-1)·d~(-1)(P0.01),and their EI was (102±33) kJ·kg~(-1)·d~(-1),1.42±0.61 times as REE,in which protein intake (PROI) was (0.84±0.31) g·kg~(-1)·d~(-1),0.85±0.52 times as resting protein expenditure (PROE) [(1.11±0.42) g·kg~(-1)·d~(-1)],indicating a negative nitrogen balance (-6.29± 4.62).In patients with chronic viral hepatitis,REE was (93±18) kJ·kg~(-1)·d~(-1),as compared to BEE of (98±8) kJ·kg~(-1)·d~(-1),P0.05,and their EI was (127±34) kJ·kg~(-1)·d~(-1),1.41±0.43 times as REE,in which PROI was (1.02±0.29) g·kg~(-1)·d~(-1),1.31±0.61 times as PROE (0.87±0.34) g·kg~(-1)·d~(-1),also indicating a negative nitrogen balance (-2.02±4.07).REE,EI and intake of three nutrients,serum level of albumin and prealbumin (PA) and body weight significantly decreased in patients with posthepatitic cirrhosis,as compared to those in patients with chronic viral hepatitis (P0.01), indicating a severely negative nitrogen balance (P0.01).In patients with posthepatitic cirrhosis,their EI positively correlated to REE/BEE (P0.05),and PA reversely correlated to protein oxidation rate (P0.05).Conclusions Hypometablosim of energy was found in patients with posthepatitic cirrhosis. Negative nitrogen balance was a common issue in patients with posthepatitic cirrhosis and chronic viral hepatitis.Early prevention of malnutrition in patients with chronic liver diseases could improve their prognosis in long term.

Wang Xin

Zhonghua quanke yishi zazhi

Energy metabolism in patients with chronic viral hepatitis and posthepatitic cirrhosis

慢性病毒性肝炎和肝炎后肝硬化患者的能量代谢

Objective To compare the changes in serum levels of high sensitive C-reactive protein (hs-CRP)and uric acid(UA)before and after atorvastatin treatment for the patients with both essential hypertension and hypercholesterolemia,and to evaluate its effects on blood pressure and left ventricular remodeling.Methods One hundred and twenty-six hypertensive patients complicated with hypercholesterolemia were randomized into group A with amlodipine 10 mg/d(n = 65)and group B with amlodipine 10 mg/d plus atorvastatin 20 mg/d(n = 61),for three months continuously.Serum levels of total cholesterol(TC),low-density lipoprotein-cholesterol(LDL-C),high-density lipoprotein-cholesterol (HDL-C),triglyeerides(TG),hs-CRP and UA,as well as blood pressure,were determined for both groups before and after treatment.Left ventricular posterior wall thickness(LPWT)and interventricular septum thickness(IVST)were measured by echocardiography and left ventricle mass index(LVMI)was calculated.Results Serum levels of TC,LDL-C,HDL-C,TG,hs-CRP and UA decreased significantly in gr6up B after three-month treatment with atorvastatin,while serum level of HDL-C increased significantly. And,systolic and diastolic blood pressure reduced in both groups,but significantly lower in group B than those in group A,after treatment(P0.05).As compared with that before treatment,LVMI in both groups decreased significantly,but significantly lower in group B than that in group A(P0.05).Conclusions Atorvastatin can decrease serum levels of hs-CRP and UA,remarkedly reduce blood pressure and reverse left ventricle hypertrophy in patients with essential hypertension complicated with hypercholesterolemia. Atorvastatin possibly ameliorated inflammation,improve blood vessel endothelial function,reduced arterial blood pressure and inhibited cardiac hypertrophy in the left ventricle,all of which then affected the progress of left ventricular remodeling in hypertensives.

Zhang Chun

Effects of atorvastatin on blood pressure and left ventricular remodeling in patients with both essential hypertension and hypercholesterolemia

阿托伐他汀对原发性高血压合并高胆固醇血症患者血压及左心室重构的影响

Objective To study the prevalence of common infections with soil-borne intestinal nematodes amongst kindergarten children aged 3 to 6 years in Hangzhou,Zhejiang Province to provide evidence for determination of the priority of disease prevention and control.Methods Totally,1667 preschool children were selected from 14 kindergartens of Classes A,B and C in east,middle and west Hangzhou.Perianal skin Scotch Tape(a short strip of sealing cellophane pressure-sensitive tape)specimens were collected for detection of eggs of Enterobius vermicularis,and stool specimens for eggs of Ascaris lumbricoides,Ancylostoma duodenale and Trichuris trichiura by Kato-Katz method and saturated brine floatation,as well as questionnaire interview,for all the children.Results Two hundred and sixteen of 1667 children examined were found infected with common soil-borne intestinal nematodes,with an overall prevalence of 12.96%,4.44% for Enterobius vermicularis,8.28% for Ascaris lumbricoides,0.54% for Trichuris trichiura and 0.24% for Ancylostoma duodenale.Prevalence of infection of common intestinal nematodes was 7.31% in children of the Class A kindergartens,12.60% of Class B,and 21.47% of Class C,with statistically significant difference(χ~2 = 49.95,P0.001).Conclusions Overall prevalence of infection with common intestinal nematodes in children aged 3 to 6 years was 12.96% at kindergartens of Hangzhou,which was associated with its classes.More importance should be attached to the prevention and control of intestinal nematode infection in the kindergartens of Class C with poor environmental and sanitary facilities.

Yang Zhen-xing

Prevalence of infections with soil-borne intestinal nematodes amongst kindergarten children in Hangzhou

杭州幼儿园儿童土壤传播肠道线虫感染的流行情况

Objective To study the effects of cooking practice education on their status of nutrient intake and blood glucose control in patients with type 2 diabetes mellitus (T2DM) over 60 years old.Methods Four-hour cooking practice education lecture was offered per month for 57 patients with T2DM over 60-year old based on balance diet and food exchange list,with features including requiring patients joining the lecture with their family members together,demonstration of raw and fresh dietary materials and cooked food,choice of food to eat by the patients themselves according to their own dietary regimen.Sixty patients with T2DM who were only educated by outpatient department of nutrition for 35 minutes were selected as control.After twelve months of education,indices such as scores of awareness of knowledge of food exchange list,status of nutrient intake and blood glucose control,and so on,were compared between the two groups to evaluate the effects of cooking practice education.Results After 12- month education,score of knowledge of food exchange list in the experiment group increased significantly,as compared to that in the control group.Intake of energy [(6304±826) kJ] and fat [(46±6) g] decreased significantly in the experimental group [(6921±860) kJ and (63±9) g,respectively],and fasting blood glucose [(7.1±0.8) mmol/L],postprandial blood glucose [(11.2±1.1) mmol/L] and glycosylated hemoglobin A1c [(6.2±0.5)%] were decreased significantly,as compared to those in the control group [(7.8±0.9) mmol/L,(12.4±1.2) mmol/L,and (6.5±0.7)%)],respectively.Conclusions Cooking practice education is effective to correctly use diet regimen and improve status of nutrient intake and control of blood glucoses for over-60-year patients with T2DM.

Cheng Hua

Effects of cooking practice education for diabetics aged over 60 on their nutrient intake and blood glucose control

60岁以上糖尿病患者烹饪实践教育对其营养摄入及血糖控制的影响

Objective To study sleeping conditions and relevant factors for insomnia in the elderly people aged 60 years and over in the community of Shanghai,China.Methods A cross-sectional study on sleeping condition by questionnaire was conducted among 2789 elderly people aged 60 years and over during July to October 2005 in seven neighborhood committees of Jing'an District,Shanghai,China,with cluster sampling.Results Totally,2304 elderly people completed the study questionnaire with a response rate of 82.61%.Prevalence of insomnia was 14.84% (342/2304) in the elderly.Logistic regression analysis showed that age increasing (OR=1.02),female (OR=2.20),drinking before sleeping (OR=2.98), room light (OR=3.89),noise (OR=1.95),diabetes (OR=1.82),hypertension (OR=1.49),stroke (OR=1.65),osteoporosis (OR=1.76) and number of afflicted chronic diseases (OR=1.43) all were risk factors for insomnia in the elderly (P0.05).Conclusion Prevalence of insomnia was higher in the elderly aged 60 years and over of Shanghai community,which maybe associated with their age,gender, sleeping habit,environment and some chronic diseases.

Zhu Shan-zhu

An investigation on sleeping conditions and factors related to insomnia in the elderly aged 60 years and over in Shanghai community

上海社区60岁及以上老年人睡眠状况及相关失眠因素的调查

Objective: To study the experience of frontline medical workers in COVID-19 quarantine points Methods: Purposive sampling method was employed and 12 frontline medical workers in COVID-19 points of Zhaoyuan City were selected for semi-structured and in-depth interview Colaizzi's seven-step analysis method was adopted to analyze and categorize the data Results: The real experience of frontline medical workers in quarantine points were classified into five themes: professional mission and pride, inadequate initial response in dealing with public health emergencies (shortage of personal protective equipment,inadequate preparation of medical workers and imperfect settings of quarantine points), having some negative emotions (worrying about being infected and feeling fearful for family members), facing complex and diverse working difficulties (repugnance and diversified demands of people quarantined, heavy workload, discomfort from personal protective equipment and occupational exposure), and gaining support and appreciation (getting support from epidemic control and prevention departments as well as medical systems and winning appreciation from people quarantined) Conclusions: The frontline medical workers are lack of experience in dealing with public health emergencies and have some psychological and working pressure Administrative department should further complete the emergency plan of centralized isolation medical observation, strengthen the contingency management of public health emergencies, attach importance to the mental health of medical workers, optimize management methods and establish flexible work schedules © 2021 Chinese Medical Association

Cuicui Lu

Hui Zhao

Huiyue Zhang

Wen Zhang

Xuemei Zhao

Experience of frontline medical workers in COVID-19 quarantine points: a qualitative study

COVID-19隔离点一线医务人员的经验：一项定性研究

Objective: To understand the coronavirus disease 2019(COVID-19)prevention and control work and the problems and difficulties faced by non-government primary medical institutions in China during the epidemic period Methods: A survey on the coronavirus disease 2019(COVID-19)prevention and control work of non-government primary medical institutions was conducted on April 14 to 21, 2020 with the self-designed questionnaire The questionnaire contained three parts: the first part was basic information of medical staff in non-government primary medical institutions, including position and institutional information;the second part was the status quo of non-government primary medical institutions participating in the prevention and control of COVID-19, including the specific work and difficulties faced by the responders during the epidemic period;and the third part was the prevention and control effect of COVID-19 in the responders' institutions, including whether there were confirmed cases and infected medical staff An online invitation was issued among the members of General Practice Branch of Chinese Non-government Medical Institution Association The invited participants included the heads, general practitioners and other medical personnel of the non-government primary medical institutions the invited participants voluntarily scanned the online two-dimensional code to fill in Results: A total of 761 individuals in primary health institutions from 20 provinces, municipalities and autonomous regions in China participated in the survey There were 290 (38 1%) men and 471 (61 9%) women with age of 40(32, 48) years;83 0% (632/761) had worked for more than 5 years;33 8% (257/761) owned primary professional titles and 33 0% (251/761) owned intermediate titles Among all participants 28 5% (217/761) were general practitioners, 26 9% (205/761) were institutions/department managers, 14 6% (111/761) were specialists and 40 3% (307/761) were other related personnel A total of 549 institutions continued to operate during the epidemic period and 96 5% (530/549) participated in the work related to the prevention and control of the epidemic, including prescreening and triage, health consultation, follow-up of suspected patients, donation, quarantine of suspected cases, follow-up of close contacts/discharged patients, diagnosis and treatment of patients with new coronavirus pneumonia 44 7% (340/761) of respondents participated in the epidemic prevention as front-line staff and directly contacted patients/suspected patients, and 63 1% (480/761) participated in the epidemic prevention work of primary medical institutions, including clinical outpatient service, prescreening triage and screening The working sites were not limited to the institutions, but also other sites including high-speed railway station The 97 8% (744/761) responders expressed their willingness to participate in epidemic prevention work under the unified leadership and command of the state The 63 9% (486/761) of the responders were worried about the lack of protective equipments and measures, and 90 4% (688/761) respondents showed that they needed medical supplies (protective equipment: masks, goggles, protective gowns, etc ) Conclusion: The participation of non-government primary medical institutions and their staff in COVID-19 infection prevention and control is a key component of the epidemic prevention process © 2021 Chinese Medical Association

X. Yang

Z. Qi

H. Pang

Y. Gu

C. Chi

Prevention and control of novel coronavirus pneumonia in non-government primary medical institutions

非政府基层医疗机构新型冠状病毒肺炎的预防与控制

S. Zhu

Facing the challenge of COVID-19 epidemic, achieving the goal of health for all

面对新冠肺炎疫情挑战，实现全民健康目标

Objective: To analyze the status of prevention and control of COVID-19 in primary care institutions at the early stage of the epidemic Methods: Thirty healthcare professionals from various places of China were recruited in the study from 6thto 16th February 2020 through WeChat platform advertising and by purposive sampling method They were general practitioners (GPs), administrators, and other specialists, all of whom were involved in the prevention and control of COVID-19 Personal interview and focus group discussion were conducted online The topic guide was as follows: (1) Introduction of the work that primary healthcare professionals carried out during the outbreak of COVID-19 (2) Difficulties and challenges that healthcare professionals encountered (3) Opinions on the prevention and control of COVID-19 (4) Advices on future outbreak of similar epidemics or disease NVivo 12 software system was used to code and classify the interview content, and thematic framework analysis was used to sort out and analyze the data and extract the interview themes Results: Six themes were extracted: (1) The community hospital leaders led the work in time but job distribution and prevention procedures were insufficient;and the workload of GPs was heavy (2) Primary care settings had carried out pre-screening and triage;while outpatient clinic continued to provide health care service for local residents, especially stressing online service and consultation to reduce the population mobility (3) GPs should make full use of technical advantages and participate in joint prevention and control (4) GPs offered various health education to residents to improve their awareness of self-protection (5) GPs lacked professional skills and needed more related training, while the current training were still insufficient (6) There were not enough supplies and GPs had increasing worries about the infection risks Conclusions: GPs play an important role in effectively curbing the spread of the epidemic It is suggested that the setting of triage and fever clinic in primary care institutions need to be readjusted;and the training of prevention and control knowledge and skill for GPs need to be strengthened in the future © 2021 Chinese Medical Association

Y. Liu

M. Yao

Prevention and control of novel coronavirus infections in primary care institutions at early stage of the epidemic: a qualitative study

新型冠状病毒感染在疫情早期基层医疗机构的防控:一项定性研究

Objective: To analyze Traditional Chinese Medicine(TCM) prescriptions in COVID-19 patients in Shanghai area Methods: Two hundred and forty patients were enrolled in the study, including 19 mild cases, 199 moderate cases, 16 severe case and 6 critical cases The COVID-19 formula in Shanghai area was extracted and input in TCM Inheritance platform Data association method such as software association rules,improved mutual information method,complex system entropy clustering,unsupervised entropy hierarchical clustering were used to analyze the frequency,herb flavor and meridian, combination rule and core combination of different types of Chinese herbs in the treatment of COVID-19 in Shanghai area Results: According to the frequency analysis of 240 prescriptions of Chinese medicine,194 herbs were found The COVID-19 formula herbs were all cold, the frequency of use in mild, moderate, severe and critical cases was [46 02%(104/226), 46 31%(1 230/2 656), 37 06%(146/394), 39 24%(31/79)] The flavor was mainly and the frequency of use in 4 types of disease were [36 53%(122/332), 37 33%(1 445/3 857), 35 96%(205/564), 33 62%(39/113)] Scutellaria was the most frequently used TCM of bitter and cold The drugs used were mainly lung,stomach and spleen meridians By comparing the formulas between mild and moderate cases,herb combinations with the highest frequency were all scutellaria glycyrrhiza and tangerine glycyrrhiza The formulas for 19 mild cases were collected,and 197 drug combinations were counted, and 125 Chinese medicine association rules,including 13 Chinese herbs The formulas were extracted in 199 moderate cases of COVID-19, a total of 92 drug combinations and 38 Chinese medicine association rules were collected,including 19 Chinese herbs In 16 severe cases, a total of 62 drug combination models and 46 Chinese medicine association rules were collected,including 17 Chinese herbs For the 6 critical cases,80 Chinese medicine prescriptions were combined,and 10 Chinese medicine association rules, including 12 Chinese herbs Conclusions: The herbal prescriptions of COVID-19 in Shanghai are characterized by clearing away heat and resolving dampness By analyzing prescription rules with complex system entropy clustering, association compatibility ideas of different types of traditional Chinese medicine are found to be different among four types of COVID-19 cases Analyzing the connection rules in formulas, by using the theory of TCM and pharmacology of traditional Chinese medical formula in different COVID-19 patients may be helpful for general practitioners © 2021 Chinese Medical Association

Publication Information	Publisher: Chinese Medical Journals Publishing House Co.Ltd，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2020，Proportion of original research papers: 0.00%，Self Citation Rate:N.A.， Gold OA Rate: 0.00%

Chinese Journal of General Practitioners

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