March 2013, Volume 16, No.8 Abstracts
HUANG Kai, DU Xue-ping, SUN Yan-ge.Fuxing Hospital Affiliated to Capital Medical University, Beijing 100038, China
【Abstract】 With the increase of aging population and residents′life expectancy, osteoporosis, affecting the life and health of community residents for its high incidence, morbidity, mortality, is becoming a public health problem.Early screening can find high risk group of osteoporosis to realize early diagnosis and treatment to achieve the goal of prevention and decrease of osteoporosis and related fractures.This paper reviews the necessity of community osteoporosis screening, progress in screening technology and some recommendations in promotion of community applications.
【Key words】 Osteoporosis; Diagnostic techniques and procedures; Community health services; Public health administration
Use of Health Belief Model and Self-efficacy Theory in Community Chronic Disease Management：Take Primary Osteoporosis as Example
DENG Wei, XIA Chang-chun.Department of Biostatistics and Social Medicine, School of Publish Health, Fudan University; Public Health Security Key Laboratory of the Ministry of Education, Shanghai 200032, China
【Abstract】 This article takes primary osteoporosis as example to explore the application of health belief model and self-efficacy theory in community chronic diseases management.Patients of primary osteoporosis diagnosed at a community health center in Shanghai were surveyed on their cognition, behavior, health belief and self-efficiency.Community chronic disease management needs to be further improved besides the application of health belief model.
【Key words】 Health belief model; Self-efficacy; Community healthy services; Community comprehensive management; Intervention; Osteoporosis
Effects of Community Comprehensive Management on Cognition and Behavior of Patients with Primary Osteoporosis
LU Xia-fang, XIA Chang-chun, WANG Zhi-qian, et al.Community Health Center of Pengpu New Estate, Zhabei District, Shanghai 200435, China
【Abstract】 Objective To evaluate the effects of community comprehensive management on cognition and behavior of patients with primary osteoporosis.Methods A total of 226 patients (＞55 years old,female) of primary osteoporosis identified at our community health center were divided into the intervention group and the control group (n=113 for each group) in September 2009.Patients in the control group were given routine medication,and patients in the intervention group were given routine medication plus community comprehensive management.The scores of primary osteoporosis scale(POS),diet and lifestyle change scale (DLCS),exercise self-efficacy scale(ESS),and exercise behavior scale (EBS) of patients in the two groups before and after the intervention were recorded.The community doctors and patients in the intervention group were interviewed after the intervention.
Results Scores of each of the four dimensions and the total score of POS were not significantly different between the two groups before the intervention(P＞0.05),while difference was observed in scores regarding healthcare knowledge and risk factors,as well as the total score after the intervention（P＜0.05）.No significant difference was observed between patients of the two groups in DLCS scores (except for direct sunshine for 4 times a week or more） before the intervention（P＞0.05）,while difference was observed in regular fishes and shrimps intake,dark green vegetables intake,sun bath,and calcium medication after the intervention（P＜0.05）.No significant difference was observed between patients of the two groups in ESS scores (except for physical environment factors) before the intervention（P＞0.05）,while difference was observed in score of physical environment factors as well as the total score after the intervention（P＜0.05）.Significant difference was observed in scores of regular exercise of the past year and consistent exercise for more than 3 months of the EBS between the two groups after the intervention （P＜0.05）.The completion rate of the intervention group was 93.8%.
Conclusion Community comprehensive management of primary osteoporosis can improve patients′ cognition of the disease and encourage them to adopt healthy behaviors.
【Key words】 Community healthy services; Community comprehensive management; Osteoporosis; Cognition; Behavior; Intervention
Effect of Community Comprehensive Management on Primary Osteoporosis
SHEN Wei, XIA Chang-chun, FANG Ya-bei, et al.Community Health Center of Pengpu New Estate, Zhabei District, Shanghai 200435, China
【Abstract】 Objective To evaluate the effect of community comprehensive management of primary osteoporosis.
Methods A total of 226 patients (＞55 years old,female) of primary osteoporosis identified at our community health center were divided into the intervention group and the control group (n=113 for each group) in September 2009.Patients in the control group were given routine medication,while patients in the intervention group were given community comprehensive management in addition to routine medication.Bone mineral density (T value),score of Visual Analogue Scale (VAS),score of Simple Quality of Life Scale (SF-36),and incidence of bone fracture during the study of patients in the two groups were recorded.
Results Before the intervention,no significant difference was observed between the two groups in T value,VAS average score and score at the worst condition,SF-36 total score,or score on body pain (P＞0.05).After one year of intervention, differences were observed in all the above parameters except SF-36 total score(P＜0.01).There was no significant difference in the incidence of bone fracture between the two groups(P=0.2990).
Conclusion For the primary osteoporosis patients,community comprehensive management can help with disease control,relieve pains,and improve quality of life.
【Key words】 Community healthy services; Community comprehensive management; Osteoporosis; Bone density; Intervention
Serum Antibodies of Helicobacter Pylori Affecting Eradication Efficacy of Esomeprazole Quadruple Therapy
CUI Mei-hua, YANG You-peng, YUE Lin, et al. Department of Gastroenterology, Aerospace Center Hospital, Beijing 100049, China
【Abstract】 Objective To observe the influence of serum antibodies of Helicobacter pylori（H.pylori）on the eradication efficacy of esomeprazole quadruple therapy.Methods Patients with gastroduodenal diseases admitted from August 2010 to November 2011 were enrolled in this study and a total of 107 patients with chronic gastritis and peptic ulcer were consistent with the inclusive criteria.Protein chips were used to detect the antibody repertoire of serum H.pylori including IgG antibodies of urease（Ure）, cytotoxin-associated protein（CagA）, vacuolating cytotoxin（VacA）, heat shock protein 60（Hsp60）, nitroreductase（RdxA）.Esomeprazole quadruple therapy was used to perform H.pylori eradication and 13C-breath test to judge the effect of H.pylori eradication 4 weeks after treatment.Results Overall H.pylori eradication rate was 86.0%（92/107）. H.pylori eradication rate was higher in peptic ulcer patients than in chronic gastritis patients（92.7% vs.78.8%, P=0.039）, and higher in anti-CagA-positive patients than in anti-CagA-negative group（90.7% vs.75.0%, P=0.033）.There was no significant difference in H.pylori eradication rate between different patients of sex, age, anti-VacA, anti-Hsp60 or anti-RdxA（P＞0.05）.Multivariate analysis revealed that eradication effects were related with disease types〔OR=0.162, 95%CI（0.034, 0.764）, P=0.021〕and anti-CagA status〔OR=0.219, 95%CI（0.057, 0.837）, P=0.026〕.Conclusion Esomeprazole quadruple therapy is with satisfaction in the eradication of H.pylori; Type of disease and anti-CagA status are independent factors affecting H.pylori eradication efficacy.
【Key words】 Helicobacter pylori; Antibodies; Influencing factors; Quadruple therapy
Clinical Efficacy of Donepezil in the Treatment of Senile Dementia
YANG Hong,ZHU De-sheng.Department of Neurology,Shanghai Yangpu Geriatric Hospital,Shanghai 200090,China
【Abstract】 Objective To evaluate the clinical efficacy of Donepezil in the treatment of senile dementia.
Methods A total of 106 senile dementia patients admitted to our hospital were randomly divided into treatment group (n=53) and control group (n=53).The two groups were both given primary treatment,and the treatment group was given additional Donepezil treatment.Clinical symptoms,physical signs,MMSE score and ADL score were compared between the two groups before treatment,three months and two years after treatment.
Results Among the 106 senile dementia patients,44 cases were male (41.5%) and 62 cases were female (58.5%); the patients were aged from 60 to 90,and 82 cases were from 60 to 75 (77.3%) and 24 cases were from 76 to 90 (22.7%); 73 cases were under college degree (68.87%) and 33 cases were college degree or above (31.13%); 72 cases had Alzheimer′s disease (AD) (67.9%),23 cases had vascular dementia (VaD) (21.7%) and 11 cases had other dementia (10.4%).92 cases were followed up and 14 cases lost following up during the two-year follow up.The MMSE score and ADL score before treatment and on three-month following up between the two groups showed no statistically significant difference(P＞0.05),but showed statistically significant differences on two-year following up(P＜0.05).Both groups had adverse effects and were improved after symptomatic treatment.The incidence of adverse effect between the two groups showed no statistically significant difference(χ2=1.38,P＞0.05).
Conclusion Donepezil is safe and effective treatment for senile dementia with little adverse reaction.Donepezil may be regarded as one of best treatments for senile dementia.
【Key words】 Dementia; Alzheimer disease; Dementia, vascular; Follow-up studies
Risk Factors of Progression of Untreated Lesions in Patients with 3-Vessel Coronary Disease
ZHANG Yan-yan, CHE Jing-jin.Department of Cardiology,the Second Hospital of Tianjin Medical University,Tianjin 300211,China
【Abstract】 Objective To investigate the risk factors of progression of untreated lesions in patients with three-vessel coronary disease.Methods A total of 108 patients diagnosed by coronary angiography as 3-vessel coronary disease and given stent implantation and reexamination coronary arteriongraphy (CA) after 6~36 months from January 2009 to June 2012 were divided into groups A (n=74,with progression of lesions),B (n=34,without progression).Serum total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (LDL-C),low density lipoprotein cholesterol (LDL-C),very low density lipoprotein cholesterol (VLDL-C) were detected before PCI and reexamination.The formula was used to calculate non-HDL-C.Results There was significant difference in TC and non-HDL-C levels between 2 groups before PCI (P＜0.05),and in TC,LDL-C,VLDL-C,non-HDL-C before CA reexamination (P＜0.05).By Logistic regression analysis,the independent risk factors of lesion progression were non-HDL-C in CA reexamination,history of diabetes,first hospitalization due to acute myocardial infarction (AMI).Conclusion The level of non-HDL-C,history of diabetes and first hospitalization due to AMI are independent risk factors of untreated lesion progression in patients with 3-vessel coronary disease.Attention should be paid to the control of non-HDL-C.
【Key words】 Non high density lipoprotein-chlesterol; Coronary artery disease; Diabetes mellitus; Myocardial infarction; Three lesions
Effectiveness of the Combination of Schuell Excitation Therapy and Hyperbaric Oxygenation Therapy within Different Time Windows in Treating Patients with Motor Aphasia
DING Xu-feng, DU Yu-ling, YU Lan, et al.Department of TCM, Jinshan Hospital Affiliated to Fudan University, Shanghai 201508, China
【Abstract】 Objective To evaluate the effectiveness of the combination of Schuell excitation therapy and hyperbaric oxygenation therapy in treating patients with motor aphasia caused by acute ischemic stroke.
Methods Totally 105 patients with motor aphasia who were treated in our hospital from August 2008 to September 2011 were equally divided into five groups using the random number table：normal control group, early treatment group Ⅰ （the rehabilitation time window＜24 h）, early treatment groupⅡ（24 h≤time window＜7 d）, early treatment group Ⅲ （7 d≤time window＜14 d）, and late treatment group（time window ≥14 d）.The normal control group treated with routine treatment and Schuell excitation therapy, whereas the four treatment groups treated with Schuell excitation therapy, hyperbaric oxygenation therapy, and routine treatment.The severity of aphasia was assessed after treatment.
Results The total score and the scores of retelling, speaking, and reading were significantly improved after treatment in all these groups（P＜0.05）.There were significant differences in early treatment group Ⅰ, Ⅱ, Ⅲ and late treatment groups when comparised to the normal control group（P＜0.05）.Compared with the late treatment group, the early treatment group Ⅰ had significantly better total score of aphasia and score of retelling（P＜0.05）.
Conclusion The combination of Schuell excitation therapy and hyperbaric oxygenation therapy is effective and safe in improving motor aphasia and reducing disability.Early（＜24 h）intervention can achieve better prognosis.
【Key words】 Brain infarction;Schuell excitation therapy; Hyperbaric oxygenation; Aphasia, motor; Time-window
Efficacy of Flupentixol and Melitracen Tablets Combined with Dexzopiclone in the Treatment of Chronic Tension-type Headache with Depression, Anxiety and Insomnia
LI Ying-jie,LI Ya-nan, GUO Ying-jun, et al.251 Hospital of PLA, Zhangjiakou 075000, China
【Abstract】 Objective To investigate the efficacy and safety of flupentixol and melitracen tablets combined with dexzopiclone in the treatment of chronic tension-type headache（CTH）with depression,anxiety and insomnia.
Methods 100 CTH patients with depression,anxiety and insomnia admitted to neurology department of our hospital from February 2011 to November 2011 were randomly divided into combination group (treated by flupentixol and melitracen tablets combined with dexzopiclone) and single group (treated only by flupentixol and melitracen tablets) with each group 50 cases,and the treatment course was 8 weeks.Visual analog score (VAS),Hamilton depression rating scale (HAMD),Hamilton anxiety rating scale (HAMA) and Pittsburg sleep quality index scale(PSQI) were used to assess the efficiency and treatment emergent symptom scale (TESS) and laboratory results after 8-week treatment were used to assess safety.Results The scores of VAS,HAMD,HAMA and PSQI between the two groups at different times before and after treatment all showed statistically significant differences(P＜0.05).The scores of VAS,HAMD and HAMA in single group after two weeks treatment showed statistically significant differences compared with before treatment(P＜0.05),and the scores of VAS,HAMD,HAMA and PSQI after eight weeks treatment showed statistically significant differences compared with before treatment (P＜0.05).The scores of VAS,HAMD,HAMA and PSQI in combination group after two weeks treatment and eight weeks treatment all showed statistically significant differences compared with before treatment(P＜0.05).The scores of VAS,HAMD,HAMA and PSQI in the two groups after eight weeks treatment all showed statistically significant differences compared with after two weeks treatment(P＜0.05).The scores of VAS,HAMD,HAMA and PSQI in combination group showed no statistically significant difference compared with single group before treatment(P＞0.05).The scores of HAMA and PSQI in combination group showed statistically significant differences compared with single group after two weeks treatment (P＜0.05).The score of PSQI in combination group showed statistically significant difference compared with single group after eight weeks treatment(P＜0.05).The scores of TESS in the two groups after two weeks treatment〔(3.23±1.36) vs (3.11±1.42)〕 showed no statistically significant difference compared with after eight weeks treatment〔(3.96±1.31) vs (3.94±1.44)〕(t=0.43,P=0.68;t=0.07, P=0.94).Routine urine and blood test,functions of liver and kidney,blood pressure and electrocardiogram showed no abnormalities before and after treatment.
Conclusion The combination of Deanxi and dexzopiclone is effective for CTH with depression,anxiety and insomnia,and it can quickly improve sleep quality and reduce anxiety with good tolerance and no obvious adverse effect.
【Key words】 Tension-type headache; Depression; Anxiety; Sleep initiation and maintenance disorders; Flupentixol and melitracen tablets; Dexzopiclone
Extended Care for Patients with Chronic Obstructive Pulmonary Disease
LIU Hong, LI Xia, ZHAO Ai-li, et al.Department of Respiratory, the Third Affiliated Hospitael of Qiqihaer Medical College, Qiqihaer 161000, China
【Abstract】 Objective To observe the effect of extended care for patients with chronic obstructive pulmonary disease（COPD）.
Methods A total of 63 COPD patients were divided randomly into groups study (n=33) and control (n=30).Group study were given extended care after discharge, control group given conventional follow-up.The results of 6-minute walking test after 1 month were compared in two group.Clinical parameters, function indexes, cost indicators and satisfaction were evaluated 1 month after discharge.
Results By results of 6-minute walking test, there was significant difference between 2 groups in SBP（t=2.419, P=0.026）, heart rate（t=2.530, P=0.021）, SPO2（t=-2.346, P=0.031）, total walking distance（t=-3.423, P=0.003）, Borg score（t=4.067, P=0.004）.By CSES scores, there was difference in total score（t=3.545, P=0.002）, labile mood（t=3.221, P=0.003）, physical activity（t=3.256, P=0.002）, ambient temperature（t=2.997, P=0.004）between 2 groups.There was difference in clinic revisit rate（χ2=6.995, P=0.010）, re-hospitalization rate （χ2=7.580, P=0.009）, service method（χ2=7.295, P=0.009）, aid