Chinese Journal of General Practitioners

Objective To study changes in levels of tumor necrosis factor-α (TNF-α) and soluble TNF receptor 55 and 75 (sTNF-R55 and sTNF-R75) in induced sputum and plasma in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) before and after treatment.Methods Levels of TNF-α,TNF-R55 and sTNF-R75 in induced sputum and plasma,as well as pulmonary function, were examined for 48 patients with AECOPD before and after treatment and 28 voluntary healthy controls. Results Levels of TNF-α,sTNF-R55 and sTNFR75 in patients with AECOPD in induced sputum and plasma either before or after treatment were all significantly higher than those in healthy controls.Levels of TNF-α in sputum and plasma significantly decreased after treatment,as compared to those before treatment (0.82±0.34) μg/L vs (0.48±0.27) μg/L,P0.001,and (0.82±0.35) μg/L vs (0.60±0.46) μg/L,P0.01,respectively.Levels of sTNF-R55 and sTNF-R75 increased after treatment in both kinds of specimens.But,levels of sTNF-R55 and sTNF-R75 in plasma did not correlate with their pulmonary function (P0.05),and levels of those in induced sputum positively correlated with their pulmonary function (P0.05),while TNF-α levels in induced sputum correlated negatively with their forced expiratory volume at the first second (FEV_1) and FEV_1 percentage,P=0.000.Conclusions Acute exacerbation of COPD may be correlated to systematic and local imbalance of inflammatory and anti- inflammatory mediators.Local inflammatory reactions,rather than systematic one,seem to be closely related to airflow limitation in patients with COPD.

HE Yun-peng

Zhonghua quanke yishi zazhi

Levels of tumor necrosis factor(TNF)α and soluble TNF-R55, 75 in plasma and induced sputum in patients with acute exacerbations of chronic obstructive pulmonary disease

慢性阻塞性肺疾病急性加重患者血浆及诱导痰中肿瘤坏死因子(TNF)α和可溶性TNF-R55、75的水平

Objective To determine serum osteocalcin concentration in patients with rheumatoid arthritis (RA) and study the role of osteocalcin in bone metabolism.Methods Serum concentration of osteocalcin was determined by radioimmunoassay both in 32 patients with RA and 15 healthy controls. Erythrocyte sedimentation rate (ESR) and serum activity of alkaline phosphatase (ALP) were also determined.Results Serum osteocalcin concentration was significantly lower in patients with RA than that in the controls (P0.001).No significant difference in serum concentration of osteocalcin between women aged less than 50 years and those aged equal to or more than 50 years in both groups was found (P0.05). There was no significantly linear correlation between serum osteocalcin and ESR,ALP and duration of disease course in patients with RA (P0.05).There was a significant positive correlation between serum osteocalcin and ESR in female patients with RA aged less than 50 years (P0.05).Conclusions Serum osteocalcin concentration significantly decreased in patients with RA,suggesting reduced osteoblastic activity and rate of bone turnover.There is no correlation between serum osteocalcin and ESR,ALP or the disease course.

Zhao Li-juan

Serum osteocalcin in patients with rheumatoid arthritis

类风湿性关节炎患者血清骨钙素水平

Objective To investigate and analyze the clinical features of Chinese patients with undifferentiated spondyloarthropathy(USpA),and to assess the value of European Spondyloarthropathy Study Group(ESSG)and Amor criteria in diagnosing USpA.Methods Diagnosis of spondyloarthropathy for patients recruited in the study was established by experienced rheumatologists based on their clinical data.USpA was diagnosed for the patients who did not meet the criteria for any definite subset of spondyloarthropathy.Then,all clinical data,including relevant parameters in ESSG and Amor criteria,were collected by trained rheumatologists.Results In total,there were 112 USpA patients recruited into the study,with a male to female ratio of 1.67:1 and an average age of 31 years old.The spine was the site of onset most frequently involved(44.2%),then the buttocks(37.2%),tendon(e.g.heel tendinitis, 9.3%),peripheral joints(arthritis 3.5%),groin(1.2%),and others(4.6%)followed.Axial joints were involved during the course of disease in 83.9% of the patients.Only two cases with iritis/uveitis and one case with heart conduction system involvement could be seen among them.Conclusions In Chinese patients,main clinical features of USpA were inflammatory low back pain.Both MRI for sacroiliac joint and blood determination of HLA-B27 played an important role in early diagnosis of USpA.ESSG and Amor criteria showed rather high application value in diagnosing USpA in Chinese patients,especially combining with MRI of sacroiliac joints.

Wei Qiu-jing

A preliminary investigation on patients with undifferentiated spondyloarthropathy in a Chinese population

中国人群中未分化脊柱关节病患者的初步调查

Objective To study the clinical value of portable echocardiography system in diagnosis for acute paroxysmal dyspnea.Methods Clinical data of 81 patients with acute paroxysmal dyspnea recorded by a portable echocardiography apparatus at their bedside were retrospectively analyzed,and compared to those of 45 patients by conventional echocardiography.Results The 2D images in portable echocardiograph were similar to those of conventional echocardiograph.Diagnosis could be established in 74 (91.4%),corrected in six (7.4%) and not confirmed only in one (1.2%) of 81 patients with acute paroxysmal dyspnea by portable echocardiography system.And,portable echocardiography system could be used to diagnose pericardial effusion and to monitor perieardial puncturing and draining at bedside. Conclusions Portable echocardiography systems can provide rapid,accurate and valuable information on diagnosis and treatment for acute paroxysmal dyspnea,and make its clinical intervention accurate,scientific and effective,bringing echocardiography performed at bedside possible.

Wang Le-min

Clinical application of portable echocardiography system in acute paroxysmal dyspnea

便携式超声心动图系统在急性阵发性呼吸困难中的临床应用

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

杭州市幼儿园儿童土壤传播肠道线虫感染的流行情况

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防控

S. Zhu

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

应对新冠疫情挑战，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

涉及主题	医学内科学生物病理心理学内分泌学外科精神科放射科化学遗传学生物化学护理部免疫学心脏病学数学经济
出版信息	出版商: Chinese Medical Journals Publishing House Co.Ltd，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 2020，原创研究文献占比: 0.00%，自引率:N.A.， Gold OA占比: 0.00%

Chinese Journal of General Practitioners

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