Objective To assess the acute high altitude sickness (AHAS) and its risk factors among public health emergency responders, so as to provide scientific proof for guaranteeing the safety and health of emergency rescue workers. Methods?The self-administered questionnaire aim at learning AHAS occurrence and its risk factors were distributed to 67 members from 4 teams at different altitudes selected among 35 rescue teams. The AHAS could be diagnosed by a total score of more than or equal to 5 within 3 days since arrival, as in the following detail: 1-3 score could be assigned in accordance with the following symptoms in degrees of the mild, moderate or severe, respectively: headache, nausea or vomiting, lassitude, dizziness and blurred vision, and sleep disorder; and 1 score could be assigned for each of the following symptoms: palpitation, shortness of breath, nosebleed, chest distress, diarrhea, constipation, cyanochroia of the lips, numbness in hands and feet, and dry cough. Results?A total of 54 among 67 (81%) responders completed the questionnaire, among whom 93% were males and the median age was 36 with the scope from 24 to 55, and 63% (34 respondents) developed AHAS. The univariate analysis showed that the altitude of the responders’ original residence (10 score for “lt;100 m” vs. 5.2 score for “gt;1 000 m”, P=0.005), experiences in high altitude areas (10 score for “having not” vs. 6.4 score for “having”, P=0.039), length of stay in an area over 2 000 m altitude before arrival (9.4 score for “≥3 days” vs. 5.7 score for “≤1 day”, P=0.011), luggage weight (9.8 score for “≥25 kg” vs. 5.5 score for “lt;25 kg”, P=0.002) were correlated with AHAS severity. The multivariate linear regression indicated that the lower altitude of the responders’ original residence and the short stay in an area over 2000m altitude before arrival were the factors influencing the severity of AHAS. The linear regression formulation was Y= 2.89 - 0.187 × the altitude of the responders’ original residence (pre 100m) + 2.43 × the length of stay in an area over 2000m altitude before arriving at Yushu (day). Conclusions?The past experiences and the pre-arrival preparation are critical factors of AHAS. Measures should be taken to protect the safety and health of responders dispatched to high altitude areas.
Objective
To investigate the psychological stress level and its influence factors of the motor transport soldiers in Military Station C at high altitude, and provide the data basis for the proper stress management.
Methods
A cluster random sampling was performed on the motor transport soldiers in Military Station C. And SCL-90 were adopted to measure the psychological stress level of the motor transport soldiers while the self-made basic information questionnaire was conducted to collect the information of demographic characteristic, length of military service, driving years. Then the effect of basic information on the psychological stress level was analyzed.
Results
1 692 soldiers in Military Station C were enrolled in this survey. The scores of somatization, depression, psychosis and the total score of the SCL-90 of these soldiers were higher than the norm (allP values<0.001). The scores of interpersonal relationship, depression, terror and stubborn of the only child were higher than those of non-only-child (P=0.034,P=0.039,P=0.025,P=0.002). The scores of interpersonal relationship and anxiety were positively correlated with their education levels (P=0.008,P=0.026). The compulsory servicemen had higher scores of anxiety, terror and psychosis (P<0.001,P=0.026,P=0.001) but lower scores of somatization (P<0.001) compared with the sergeants. Those who suffered from neck discomfort had higher somatization scores (P<0.001).
Conclusion
Some factors involved in psychological stress level of the motor transport soldiers in Military Station C are higher than the norm, suggesting that more attention should be paid to their psychological states by the army administrators and the health management department, especially the only child, new recruits, junior soldiers and those who suffers from somatization discomfort.
Objective To analyze the prevalence rate of chronic obstructive pulmonary disease in people over 40 years old in China plateau (altitude≥1 000 m) in recent years. Methods PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, WanFang Data, VIP databases and Chinese Medical Database were searched, and the articles published between January 1, 2010 and December 5, 2022 were collected. Two reviewers independently reviewed the literature, extracted data, and assessed the risk of bias of included articles. Meta-analysis was performed with Stata 17.1. Results A total of 13 articles were included, with a total sample size of 37 230 people, including 3 697 chronic obstructive pulmonary disease patients. The prevalence rate of chronic obstructive pulmonary disease in people over 40 years old in China plateau was 9.0% [95% confidence interval (0.07, 0.11), P<0.001]. The results of subgroup analysis showed that males (12.4%), smokers (13.4%), 61-70 years old (15.1%), primary school and below (10.3%), low body weight (12.2%) and Yunnan (11.5%) had the highest prevalence rates within the subgroup (P<0.05). Conclusions The prevalence of chronic obstructive pulmonary disease in China plateau is still high. Gender, age, smoking, education level, body mass index and region are still important influencing factors of chronic obstructive pulmonary disease.
【Abstract】 Objective To analyze the correlations between the mt5351G and mt6680C genotypes in mitochondrial DNA ( mtDNA) haplogroup M and susceptibility to high altitude pulmonary edema ( HAPE)among the Hans. Methods Specimens from206 Hans cases of HAPE and 144 matched Hans controls were collected. Then PCR-RFLP method was used to determine haplogroup M and N of mtDNA, and PCR-LDR was used to genotype mt5351G and mt6680C in the haplogroup M in these samples. Results The frequencies of haplogroup Mand N were 49. 0% and 51.0% in the HAPE patients, and 47. 2% and 52. 8% in the controls, respectively, with no significant difference between the HAPE patients and the controls. In the haplogroup M, the genotype of mt6680C and mt5351G frequencies in the HAPE patients were both significantly higher than the controls ( both 12. 0% vs. 1. 5% , P = 0. 016) . Conclusion The existence of mt5351G and mt6680C genotypes in the haplogroup Mis a risk factor for HAPE among the Hans.
Objective To analyze the current situation and demand of emergency and critical care training for medical staff in plateau areas, and to provide a reference for further emergency and critical care training for medical staff in plateau areas. Methods From July 1, 2018 to July 30, 2020, medical staff (including physicians, nursing staff, and other medical staff) from hospitals in various regions of Tibet were surveyed anonymously, to investigate the content and demand of medical staff in plateau areas receiving emergency and critical care training. The content and demand of medical staff from different levels of hospitals receiving emergency and critical care training were further compared. Results A total of 45 questionnaires were distributed in this study, and a total of 43 valid questionnaires were collected, with an effective response rate of 95.6%. The average age of medical staff was (35.67±9.17) years old, with a male to female ratio of 1∶1.5. The proportion of tertiary, secondary, and lower level hospitals to which medical staff belong were 23.3%, 27.9%, and 48.8%, respectively. The number and proportion of medical staff receiving training on chest pain, heart failure, stroke, gastrointestinal bleeding, respiratory failure, metabolic crisis, and sepsis diseases were 25 (58.1%), 25 (58.1%), 24 (55.8%), 23 (53.5%), 20 (46.5%), 14 (32.6%), and 12 (27.9%), respectively. The number and proportion of medical staff who believed that training in the heart failure, respiratory failure, metabolic diseases, stroke, gastrointestinal bleeding, chest pain, and sepsis needed to be strengthened were 38 (88.4%), 36 (83.7%), 35 (81.4%), 34 (79.1%), 34 (79.1%), 33 (76.7%), and 29 (67.4%), respectively. Thirteen medical staff (30.2%) hoped to acquire knowledge and skills through teaching. There were no statistically significant differences in gender, age, job type, professional title, and department type among medical staff from tertiary, secondary, and lower level hospitals participating in the survey (P>0.05). The proportion of medical staff in hospitals below secondary receiving training on chest pain was lower than that in second level hospitals (38.1% vs. 91.7%). The proportion of medical staff in hospitals below secondary receiving training on heart failure was lower than that in secondary and tertiary hospitals (38.1% vs. 75.0% vs. 80.0%). The proportion of medical staff in hospitals below secondary receiving training on respiratory failure was lower than that in tertiary hospitals (28.6% vs. 80.0%). The demand for sepsis training among medical staff in hospitals below secondary was higher than that in tertiary hospitals (85.7% vs. 30.0%). There was no statistically significant difference in the other training contents and demands (P>0.05). Conclusion The content of critical care training for medical staff in plateau areas cannot meet their demands, especially for medical staff in hospitals below secondary. In the future, it is necessary to strengthen training support, allocate advantageous resources to different levels of hospitals, expand the scope of training coverage, and enrich training methods to better improve the ability of medical personnel in plateau areas to diagnose and treat related diseases.
Objective To investigate the safety of thoracic surgery for high-altitude patients in local medical center. MethodsWe retrospectively collected 258 high-altitude patients who received thoracic surgery in West China Hospital, Sichuan University (plain medical center, 54 patients) and People's Hospital of Ganzi Tibetan Autonomous Prefecture (high-altitude medical center, 204 patients) from January 2013 to July 2019. There were 175 males and 83 females with an average age of 43.0±16.8 years. Perioperative indicators, postoperative complications and related risk factors of patients were analyzed. ResultsThe rate of minimally invasive surgery in the high-altitude medical center was statistically lower than that in the plain medical center (11.8% vs. 55.6%, P<0.001). The surgical proportions of tuberculous empyema (41.2% vs. 1.9%, P<0.001) and pulmonary hydatid (15.2% vs. 0.0%, P=0.002) in the high-altitude medical center were statistically higher than those in the plain medical center. There was no statistical difference in perioperative mortality (0.5% vs. 1.9%, P=0.379) or complication rate within 30 days after operation (7.4% vs. 11.1%, P=0.402) between the high-altitude center and the plain medical center. Univariate and multivariate analyses showed that body mass index≥25 kg/m2 (OR=8.647, P<0.001) and esophageal rupture/perforation were independent risk factors for the occurrence of postoperative complications (OR=15.720, P<0.001). ConclusionThoracic surgery in the high-altitude medical center is safe and feasible.
