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.
ObjectiveThe purpose of the research is to study the distribution and early warning of electroencephalogram (EEG) in acute mountain sickness (AMS).
MethodsA total of 280 healthy young men were recruited from September 2016 to October 2016. The basic data were collected by the centralized flow method, the general situation of the division of the investigators after the training, the Lewis Lake score, the computer self-rating anxiety scale and depression scale, and the collection of EEG. Follow up in three months.
Results94 of the patients with AMS, morbidity is 33%, 21 (22.34%) of the patients are moderate to severe, 73 (77.66%) are mild, morbidity is 26.67%. The abnormal detection rate of electrogram was 7.9% (22/280), which were mild EEG, normal EEG abnormal rate was 8.6% (16/186), abnormal detection rate of mild AMS was 4.1% (3/73), and the abnormal detection rate was 14.3% (3/21) in the medium / heavy AMS. The latter was significantly different from the previous (P < 0.05). Three months follow-up of this group of patients with 0 case of high altitude disease.
Conclusions The EEG in AMS is mainly a rhythm irregular, unstable, poor amplitude modulation; or two hemisphere volatility difference of more than 50% or slightly increased activity. The result is statistically significant, suggesting that EEG distributions has possible early warning of AMS.
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.
Smart wearable devices play an increasingly important role in physiological monitoring and disease prevention because they are portable, real-time, dynamic and continuous.The popularization of smart wearable devices among people under high-altitude environment would be beneficial for the prevention for heart and brain diseases related to high altitude. The current review comprehensively elucidates the effects of high-altitude environment on the heart and brain of different population and experimental subjects, the characteristics and applications of different types of wearable devices, and the limitations and challenges for their application. By emphasizing their application values, this review provides practical reference information for the prevention of high-altitude disease and the protection of life and health.
Objective To explore the clinical characteristics of patients with combined use of ≥2 kinds of anti-seizure medications in Tibetan plateau. Methods Epilepsy patients who were hospitalized in the People’s Hospital of Tibet Autonomous Region from September 2018 to September 2023 and used ≥2 kinds of anti-seizure medications in combination were selected. Their demographic data such as gender, age, and ethnicity, as well as diagnostic information, medication and other clinical data were collected, and relevant demographic and clinical characteristics were analyzed. In the later stage, telephone follow-up was used to record medication and epileptic seizure control. Results A total of 2295 patients with epilepsy were included, of which 142 (6.2%) met the inclusion criteria, of which 133 (93.7%) were Tibetans. There were more males than females (86 vs. 56, P<0.05), and more minors and young patients than middle-aged and elderly patients (106 vs. 36, P<0.05). 87.3% of the patients underwent magnetic resonance imaging (MRI) or computed tomography (CT), and 71.1% of the patients were abnormal. The main cause of epilepsy was structural etiology (84/142, 59.2%). The most common combination was two drugs (127/142, 89.4%). The largest proportion of combination was sodium valproate and levetiracetam (46/142, 32.4%). After standardized multi-drug combination therapy, the average frequency of epilepsy seizures was significantly reduced compared with the baseline, and the difference was statistically significant (P<0.05). Among the 98 patients aged ≥14 years, 15 cases (15.3%) had drug-refractory epilepsy, 18 cases (18.4%) had seizures controlled by standardized combination medication, 16 cases (16.3%) had seizures controlled by reducing combination medication to a single drug, 5 cases (5.1%) had good control and had stopped medication, 3 cases (3.1%) had frequent epileptic seizures due to poor medication compliance, 15 cases (15.3%) had irregular medication, 17 cases (17.3%) died, and 9 cases (9.2%) were lost. Conclusion The proportion of epilepsy treated with multiple drugs and refractory to drugs was lower than the conclusion of previous studies, and the anti-epileptic effect of multiple drugs was positive. Structural causes (stroke, etc.) are the main causes of epilepsy, and brain parasitic infection is a unique factor of high-altitude epilepsy. Strengthening the standardized use of drugs will help improve the treatment status and prognosis of patients.
【摘要】 目的 探討高原地區腹腔鏡膽囊切除術（laparoscopic cholecystectomy，LC）患者的特點，以便更好地進行圍手術期處理。 方法 對2009年2月-2010年5月收治的長期生活在西藏高原地區的患者（高原組）367例和非高原地區患者（非高原地區組）167例的一般資料、術前診斷、合并癥情況進行回顧性分析，兩組患者性別、年齡及病程比較，差異無統計學意義（Pgt;0.05），有可比性。兩組患者診斷均以膽囊結石為主，其次為膽囊息肉，診斷構成比較，差異無統計學意義（Pgt;0.05）；兩組患者合并癥比較，高原組患者高血壓、冠心病、血紅蛋白增多癥及竇性心動過緩的發生率高于非高原地區組（Plt;0.05）；肺部疾病、肝硬化、糖尿病及腦梗死的發生率兩組患者比較差異無統計學意義（Pgt;0.05）。兩組患者均采用常規LC進行治療，對兩組患者術后臨床結果、并發癥等進行統計學分析。 結果 高原組患者手術中轉開腹率（7.1%）高于非高原地區組（2.4%）患者（Plt;0.05）；高原組患者較非高原地區組患者住院時間長、手術時間長、術中出血量多（Plt;0.05）；術后并發癥比較差異無統計學意義（Pgt;0.05）。 結論 高原地區LC患者宜及時中轉開腹，其圍手術期處理得當將有助于減少術后并發癥的發生。【Abstract】 Objective To explore the characteristics of patients undergoing laparoscopic cholecystectomy in highland area, in order to carry out better perioperative management. Methods We collected and analyzed the general information, preoperative diagnosis and complications of 367 patients living in highland area and 167 patients living in inland between February 2009 and May 2010. There was no significant difference between the two groups in sex, age and course of disease (Pgt;0.05). Cholecystolithiasis was the main disease followed by gallbladder polyps, and there was no difference between them in the kind of diseases (Pgt;0.05). The incidence of hypertension, coronary heart disease, hereditary persistence of fetal hemoglobin and sinus bradycardia was higher in patients in highland area than that in patients in non-highland area (Plt;0.05). There was no significant difference in the incidence of lung disease, liver cirrhosis, diabetes mellitus and cerebral infarction between the two groups (Pgt;0.05). Conventional laparoscopic cholecystectomy was conducted in both two groups. Comparative analysis of treatment outcome and postoperative complications was done. Results The rate of conversion from laparoscopic surgery to laparotomy in Tibetan patients (7.1%) was higher than that in patients in non-highland area (2.4%) (Plt;0.05). Hospitalization time, operation time and blood loss in Tibetan patients were significantly higher than those in patients in non-highland area (Plt;0.05), but there was no significant difference in postoperative complications between the two groups of patients (Pgt;0.05). Conclusions Laparoscopic cholecystectomy for patients in highlardarea should be converted to laparotomy when necessary. Appropriate perioperative management is helpful in reducing the incidence of postoperative complications.
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.
