Objectives Retrospective analysis of the Tibetan convulsive status epilepticus (CSE) for the aetiology, prognosis and its influencing factors in Tibet area. Methods Through electronic patient record, making “epilepsy”, “status epilepticus ”, “epileptic seizure” as keywords, convulsive status epilepticus patients in the People’s Hospital of Tibet Autonomous Region hospitalized from January 2015 to December 2020 were retrospectively observed, gathering their clinical data and aided examinations furthermore, and the prognoses were returned by telephone, meanwhile the functional status of those patients was assessed by the modified rankin scale. and the causes differ in gender, age, out-of-hospital antiepileptic treatment, family history of epilepsy and history of epilepsy were analyzed. The prognostic factors were analyzed by logistic regression. Results A total of 2 254 hospitalized patients with epilepsy were retrieved, including 331 CSE patients aged 14~84 years, 219 males and 112 females. There were 36 lost calls, 62 CSE deaths (21.01%), and 4 adverse outcomes (non-death)(1.7%).There were statistically significant differences in etiology of CSE in different ages and history of epilepsy (P<0.05), but there were no statistically significant differences in gender, out-of-hospital antiepileptic treatment, progression of refractory status epilepticus and family history of epilepsy. Cerebrovascular disease was the main cause of CSE in people aged 45 and over (54 cases), while the main cause of CSE in people aged under 45 was unknown (104 cases).Among the patients with previous history of epilepsy, the highest proportion was unknown cause [117 cases (48.8%)]; Among patients without a history of epilepsy, cerebrovascular disease [34 cases (37.4)] was the most common cause of CSE. Multivariate logistic regression analysis of prognostic factors of CSE showed that gender, age, GCS and electrolyte disorder had statistically significant effects on the death of CSE patients (P<0.05), while altitude and their duration and other factors had no statistically significant effects on the death of CSE patients (P>0.05). ConclusionsCerebrovascular disease is the leading cause of CSE in people aged 45 and over. Male, advanced age, low GCS score at discharge, and electrolyte disorder were risk factors.
In order to further promote the construction of healthy Tibet, West China Hospital of Sichuan University, which has rich experience in providing assistance to Tibetan areas, has proposed a new model of “136” assistance to Tibet. In this new model, the demand of the assisted hospital is the center. Technology, talent and management as three core elements are starting point. Six special topics were taken as the dimensions, including specialist capacity building, technology popularization, establishment of chronic disease prevention and treatment system, appropriate talent training, hospital management training and model effect evaluation. This paper introduces the structural framework of the model and its application in Tibetan hospitals. It also puts forward the problems existing in the work of assisting Tibet and gives relevant suggestions, aiming to provide a reference for the improvement and perfection of medical aid work in Tibet.
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).
It has always been an important policy of the Chinese government to provide aid and assistance for the development of Tibet. With nearly one-eighth of China’s total land areas and about 0.002% of China’s total population, the Tibet Autonomous Region lags behind the domestic average level in medical education and is in bad need for medical professionals. The West China Center of Medical Sciences (WCCMS) of Sichuan University has managed to introduce US projects to set up the West China–Tibet Telemedical Education System to transmit medical courses in a real-time and interactive way. Based on this system, WCCMS has established a model for assisting the Tibet University Medical College through transmitting medical courses, training their medical faculty, sending WCCMS faculty to work in Tibet and admitting medical teachers and students from Tibet to study and be trained at West China Medical School and Hospital.
ObjectiveTo analyze the types and characteristics of common paroxysmal diseases in order to improve the diagnosis of onset types and to analyze the related factors of epileptic seizures in Tibetan population.Methods510 patients with paroxysmal diseases were enrolled in the Department of Neurology, People's Hospital of Tibet Autonomous Region from June 2013 to December 2018 and the video electroencephalogram (VEEG) data were analyzed.ResultsAmong the 510 patients, there were 35 types of paroxysmal diseases, 335 cases (65.69%) of seizures and 86 cases (16.86%) of psychogenic non-epileptic seizures (PNES). There were significant differences in the incidence of seizures between male and female patients (P<0.05), the incidence of seizures were different at different altitude and the concentration of hemoglobin (P<0.05), the course of seizures was always more than 2 years (P<0.05), and the frequency and age of seizures were higher, but there were no significant difference, and epileptic patients in Tibet were more likely to be young adults (34.51%).ConclusionsThere are many kinds of paroxysmal diseases in Tibetan population, and epileptic seizures are the main type. There was a qualitative relationship between the incidence of epilepsy and altitude. The incidence of epilepsy didn’t increase along with the increase of hemoglobin, and the course of seizures was mostly more than 2 years.
ObjectiveTo compare whether the training process of commissioned training residents from Tibet and non-commissioned training residents have achieved homogenized.MethodsThe training time and operation frequency data of 170 commissioned training residents from Tibet and 96 non-commissioned training residents of grade 2016 during the 19 months from September 2016 to April 2018 were collected. The 25 operational data of 11 departments that are representative and comparable are compared.ResultsThe two types of trainees completed the rotation of 47 different departments within 19 months, of which 45 departments were the departments where both types of students were rotated. Among these 11 departments, the average training time of trainees from Tibet in the Departments of Anesthesiology was lower than that of non-commissioned trainees (Z=–4.543, P<0.001). There were statistically significant differences in 7 of the 25 operating data (P<0.05). The operation number of arterial puncture and ventilator management (Intensive Care Unit); patient treatment (Department of Emergency); arterial puncture, ventilator management and intraoperative monitoring (Department of Anesthesiology) of trainees from Tibet were lower than those of non-commissioned trainees (P<0.05). The operation number of lung and mediastinal examinations (Department of Radiology) of trainees from Tibet was higher than that of non-commissioned trainees (P<0.05).ConclusionsDuring the training of the two types of trainees, the rotation schedule was basically the same, but there were differences in the clinical practice operations. Trainees from Tibet have higher requirements for radiology training. Trainees from Tibet will return to Tibet with independent practice needs, so their requirements of medical imaging skills operation would be higher. Due to language and training time, the critically ill, emergency first aid, and surgical skills of trainees from Tibet are not as good as those of non-commissioned trainees, and they need to gradually strengthen and improve these skills in subsequent trainings.
ObjectiveTo compare the outcomes of kidney transplantation (KT) between Tibetan and Han recipients.MethodsPatients greater than 18 years old, who had received the first ABO-compatible KT between April 2006 and March 2017, were retrospectively included. A propensity score matching (PSM) of Tibetans to Hans was performed by 1∶3 ratio. Survival, renal function and adverse events of the two groups were compared.ResultsOf the 1 820 patients who fit the screening criteria, 123 Tibetans and 357 Hans were included after PSM. The median follow-up time was 48 months. There was no statistically significant difference in death-censored grafts survival (P=0.061) or patients survival (P=0.440) between the two groups. The serum creatinine was higher in Tibetans than that in Hans within one year after KT (P<0.05), and the estimated glomerular filtration rate was lower in Tibetans than that in Hans within 5 years after KT (P<0.05), but no difference thereafter (P>0.05). The incidence of delayed graft function in Tibetan patients after operation was higher than that in Han patients (4.9% vs. 1.4%, P=0.037), but there was no significant difference in the incidence of acute rejection, infection, reoperation, or cancer between the two groups (P>0.05).ConclusionTibetans receiving KT achieve excellent and comparable long-term graft and patient survival to Hans, with similar long-term graft function.
This paper systematically summarizes the practical experience of the 2025 Dingri earthquake emergency medical rescue in Tibet. It analyzes the requirements for earthquake medical rescue under conditions of high-altitude hypoxia, low temperature, and low air pressure. The paper provides a detailed discussion on the strategic layout of earthquake medical rescue at the national level, local government level, and through social participation. It covers the construction of rescue organizational systems, technical systems, material support systems, and information systems. The importance of building rescue teams is emphasized. In high-altitude and cold conditions, rapid response, scientific decision-making, and multi-party collaboration are identified as key elements to enhance rescue efficiency. By optimizing rescue organizational structures, strengthening the development of new equipment, and promoting telemedicine technologies, the precision and effectiveness of medical rescue can be significantly improved, providing important references for future similar disaster rescues.
Tibetan population has been living in Tibet plateau for more than thousands of years ago. Although, the environment is unlikely to be an ideal place for residence. They have evolved genetical and physiological adaptions living in Tibetan highlands. In recent several years, foreign scientists have noticed that lung cancer mortality is reduced at high altitude. Many in vitro and in vivo experiments explored the mechanism of this phenomenon. In this review we discuss the lung cancer incidence and mortally of Tibetan population, as well as the possible underlying mechanism including oxygen level, radiation, inhalable particulate matter, metabolism, hypoxic induced factor pathway and immune system. But, the clinical data as well as basic researches of Tibetan population remain insufficient, which required further investigation.
Objective To investigate the inpatients disease constitution of the Tibet autonomous region people’s hospital, to provide baseline date for further rational drug use analysis. Methods The medical records of inpatients from 2014 to 2015 were collected from hospital information system. Diseases were classified based on international Classification of Diseases Coding (ICD-10). We analyzed the general situation, main discharge diagnosis and single diseases. Distribution of inpatients frequency, constituent ratio, cumulative frequency of diseases were calculated by Microsoft office 2007. Results (1) A total of 19 177 patients were discharged in 2014, sex ratio (male : female) was 1.07 : 1, involving all 21 system disease of ICD-10; 20 970 inpatients were discharged in 2015, the sex ratio was 1.05 : 1, covering 20 system diseases of ICD-10. (2) The constituent ratio of 3 diseases were over 10%: exogenous injury or poisoning, digestive disease and diseases concerning pregnancy, childbirth and puerperium. (3) The constituent ratio of 5 diseases were between 5% to 10%: respiratory diseases, circulatory system disease, the factors influencing health status and health care institutions contact-tumor morphology, genitourinary system disease, and tumor. (4) In 2014, the top of 10 single diseases based on constituent ratio were singletons natural birth, lung infection, chemotherapy, type 2 diabetes, gallstones with chronic cholecystitis, bronchial pneumonia, gall bladder stones, neonatal aspiration pneumonia, high altitude pulmonary edema, premature rupture of membranes; in 2015, the top 10 main single diseases included singletons natural birth, lung infection, tumor chemotherapy, type 2 diabetes, gallstones with chronic cholecystitis, bronchial pneumonia, cholelithiasis, neonatal aspiration pneumonia, cancer maintenance chemotherapy, iron deficiency anemia. Conclusion The inpatients disease composition of the Tibet autonomous region people’s hospital has certain regional specificity.