September 2013, Volume 16, No.26 Abstracts

 What Can We Learn from Canadian Experience of General Practitioner System?

TIAN Jiang, JI Xu.Health Human Resources Development Center,Ministry of Health, Beijing 100097,China

Abstract The article reviews the evolution, core concept, and good practices of Canadian General Practitioner System, and provides suggestions to China based on the current status of General Practitioner System in China.

Key words Canada; General Practitioner system; Enlightenment

Clinical Characteristics of Ankylosing Spondylitis with Osteoporosis

LI Xue, WANG Jun-xiang. Department of Nephrology, Affiliated Hospital of Jilin Medical College, Jilin 132000, China

Abstract Objective To study the clinical characteristics and risk factors of osteoporosisOPwith ankylosing spondylitisAS.

Methods A total of 105 AS patients admitted to this hospital from 2010 to 2011 were divided, based on whether combined with OP, into groups ASn=64, AS-OP n=41.The general information, biochemical indicators were compared between 2 groups and their correlation analyzed.Results Patients age and onset age were lower in AS-OP group than AS group, number of involving peripheral joints and CT grading of sacroiliac joint higher, levels of erythrocyte sedimentation rateESR, C-reactive proteinCRP, calciumCahigher, the difference was significantP0.05.In AS group, the maximum T value of BMD was positively correlated with ESRr=0.208, P=0.033, CRPr=0.209, P=0.033, number of involving jointsr=0.341, P=0.000, CT grading of sacroiliac jointr=0.205, P=0.041, not correlated with age,onset age,course of disease, Ca, phosphorusP, alkaline phosphateseALP)(r=-0.003, 0.175, -0.077, -0.166 , respectively; P=0.973, 0.073, 0.433, 0.090, respectively.Conclusion OP patients combined with AS have earlier onset, severer condition, and increased with ESR, CRP, number of arthritic joints, sacroiliac joint CT grading increased, decreased with the increase of age and age of onset.

Key words Spondylitis, ankylosing; Osteoporosis; Bone density

Effect of Combined Intra-articular Injection of Sodium Hyaluronate and Compound Betamethasone on Ankylosing Spondylitis with Coxa Arthropathy

ZHANG Feng-xiao, NING Xiao-ran, ZHENG Gui-min, et al. Department of Rheumatology, Hebei General Hospital, Shijiazhuang 050051, China

Abstract Objective To explore the effect of hip joint injection of sodium hyaluronateSHcombined with compound betamethasone on ankylosing spondylitisASwith coxa arthropathy and on serum levels of tumor necrosis factor α(TNF-α)and interleukin 12IL-12.

Methods A total of 75 patients with AS with coxa arthropathy of hip joint treated in our hospital from January 2010 to June 2012 were included in this study.The patients were randomly divided into two groupstrial group, n=45; And control group, n=30.Besides the routine therapy, the trial group was given sodium hyaluronate combined with compound betamethasone hip joint injection once a week, five timescompound betamethasone were only applied at the first time; While control group was only given compound betamethasone intramuscular injection once in the first week.The whole treatment lasted 6 weeks.Disease activity was evaluated by Bath AS disease activity indexBASDAI, disease function was measured by Bath AS function indexBASFI, hip joint lesions were evaluated by Harris hip scoreHHS, and serum levels of TNF-α and IL-12 were analyzed by enzyme-linked immunosorbent assayELISA.

Results After treatment, BASDAI , BASFI , and the serum levels of TNF-α and IL-12 decreased significantly in both trail group and control groupP0.05, the declining degrees of which in the trial group were higher than those in the control groupP0.05.HHS increased significantly after the treatment compared with that before the treatment in the trial groupP0.01; While in the control group, although HHS increased slightly compared with that before treatment, but the difference was not statistically significantP0.05.Correlation analysis showed that the levels of TNF-α and IL-12 were positively correlatedr=0.4221, P0.001.

Conclusion Hip joint injection of sodium hyaluronate combined with compound betamethasone could inhibit the production of pro-inflammatory cytokines quickly and effectively, control the activities of AS with coxa arthropathy and improve body function, and also effectively release hip joint pain and improve its function.The finding provides a theoretical basis for clinical application of sodium hyaluronate combined with compound betamethasone to treat AS with coxa arthropath. Key words Sodium hyaluronate; Betamethasone; Spondylitis, ankylosing; Osteoarthritis, hip

Treatment Compliance of Patients with Ankylosing Spondylitis and Its Influencing Factors

WU Qing-xiang, QI-Ying, ZHOU Tao, et al. Peking University Shenzhen Hospital, Shenzhen 518036, China

Abstract Objective To understand the treatment compliance of patients with ankylosing spondylitis (AS) and its influencing factors.

Methods Treatment compliance was assessed in 200 AS patients visiting Department of Rheumatism Immunity of this hospital from March 2011 to March 2012,and the reasons for non-compliance analyzed.

Results In 200 AS patients,54 had good compliance (27%),146 had bad or non-compliance (73%).By univariate analysis, there was significant difference in gender, marital status, occupation, family monthly income between patients with good compliance and those with bad or non-compliance(P0.05).By multivariate analysis, gender and occupation entered into the regression equation. The reasons for bad compliance were, in proper order,treatment factors,patients own factors, lack of knowledge, less harmonious doctor-patient relationship, their familys nonsupport.

Conclusion AS patients have bad treatment compliance, which is related to many factors.Medical staff should give them targeted interventions based on their specific circumstances,to improve their compliance.

Key words Spondylitis, ankylosing; Treatment compliance; Influence factors

Significance of Myocardial Injury Markers in Risk Stratification of Acute Coronary Syndrome

YU Yang,MA Jun,PENG Hui, et al. Clinical Laboratory Center,Hospital of Traditional Chinese Medicine, Xinjiang Medical University,Urumqi 830000,China

Abstract Objective To investigate the use of plasma homocysteine(Hcy),high sensitivity-C reactive protein (hs-CRP),heart-type fatty acid binding protein ( H-FABP ),and ischemia modified albumin (IMA) level in risk stratification of acute coronary syndrome (ACS).Methods Eighty-two ACS inpatients in the Department of Cardiology of our hospital between April 2012 and November 2012 were assigned as the study group,and were further divided into three subgroups (low-risk group,medium risk group,and high risk group) according to the Global Registry of Acute Coronary Events (GRACE) risk score.Another 89 controls for health check-up during the same period were also selected.Levels of Hcy,hs-CRP, H-FABP ,and IMA were tested and compared.Results Significant differences were observed among the four groups in Hcy,hs-CRP,H-FABP and IMA levels(P0.05).The three subgroups all had higher levels of Hcy than the control group (P0.05),but no significant difference was found among the subgroups (P0.05).Medium risk group and high risk group had higher hs-CRP levels than the control group (P0.05),but no significant difference was found between the low-risk group and the control group(P0.05).High risk group had higher levels of H-FABP and IMA than the medium risk and low risk group;the medium risk group had higher level of H-FABP and IMA than the low risk group (P0.05).Conclusion Level of Hcy does not increase with the risk of ACS patients.The levels of plasma hs-CRP, H-FABP ,and IMA are positively correlated with the risk of ACS patients and have high clinical value in risk stratification of ACS patients.

Key words Cysteine; C-reactive protein; Fatty acid-binding proteins; Acute coronary syndrome; Risk assessment

End-point Events within Half Year after Diagnosis of Stable Angina Pectoris

FENG Yan,ZHANG Jing-chun,WANG Yi-xin, et al. Department of General Practice, Anzhen Hospital Affiliated to Capital Medical University,Beijing 100029,China

Abstract Objective To retrospectively review the clinical data of patients with stable angina pectoris who had end-point events within half year of diagnosis.

Methods A total of 254 patients who were diagnosed with stable angina using coronary arteriography in our hospital between June 2007 and January 2009 were followed up for half a year. The patients who had end-point events within half year were analyzed for clinical features, cardiovascular risk factors, TCM syndrome types,blood stasis syndrome score,TCM symptom score, and biochemical indices.

Results Altogether 10 patients had end-point events,including 1 primary end-point event and 9 secondary end-point events. Among them,there were 6 males and 4 females; 7 patients were over 65;6 had work overload and high pressure;8 were irritable;6 fond of sweet food;6 fond of salty food;10 had history of hypertension with 8 cases of Grade 3 hypertension;9 had hyperlipidemia;10 had undergone coronary revascularization;7 were assessed as NYHA classification2;8 had blocked coronary artery number2;6 had total length of bracket26 mm.Regarding the TCM syndrome types,10 had Qi deficiency syndrome,8 had blood stasis syndrome,and 6 had phlegm turbidity syndrome. At the start of the study,7 patients had blood stasis syndrome score(median)14,and 6 had TCM symptom score(median)10.The only significant difference in biomedical indices between the start of study and the occurrence of end-point event was hs-CRP level(P0.05).

Conclusion Comprehensive assessment including TCM syndrome types and biochemical indices should be given to patients with stable angina pectoris with special attention to those with cardiovascular risks.

Key words Angina pectoris; End point event; Risk factors; Follow-up studies

Association between Microalbuminuria and Central Arterial Pressure in Patients with Essential Hypertension

YANG Jun, XU Bo, QIN Xiao-wei, et al. Department of Cardiology, Langzhong Peoples Hospital, Nanchong 637400, China

Abstract Objective To investigate the relationship between microalbuminuriaMAUand central aortic pressure in patients with essential hypertensionEP.

Methods A total of 204 EP patients admitted to First Affiliated Hospital of Xinjiang Medical University from September 2009 to November 2012 were divided into groups Apositive MAU, n=95, BMAU negative, n=109.Levels of fasting blood glucoseFBG, blood lipids, renal function, blood coagulation, MAU were detected.Sphygmocor pulse wave analysis system was used to determine central artery related indicators such as central systolic pressureCSP, central pulse pressureCPP, augmentation pressureAP, reflected wave augmentation index, blood pumping time and subendocardial viability ratioSEVR.Their correlation with MAU and influencing factors were analyzed.

Results There was significant difference in hypertension course, family history, fibrinogen, urea, uric acid, SBP, DBP, creatinine level between 2 groupsP0.05.By Pearson correlation analysis, MAU was positively correlated with CSP, CPP, APr=0.32, P0.01; r=0.189, P0.01; r=0.149, P0.05; By multiple regression analysis, CSP, fibrinogen, SBP entered into the regression equation.

Conclusion CSP, CPP, AP, risk factors of MAU, can lead to elevated MAU when they increase.

Key words Hypertension; Albuminuria; Central arterial pressure

Vascular Endothelial Function and Homocysteine Level in Patients with Acute Cerebral Infarction and Its Treatment

DENG Yuan-qiong, LIU Bo-sheng, DENG Yuan-qi, et al. Department of Functions, the Fourth Affiliated Hospital of Nanchang University, Nanchang 330003,China

Abstract Objective To evaluate the vascular endothelial function and homocysteine (Hcy) level in patients with actue cerebral infarction, and explore the effects of folic acid,Vitamin B12 on the prognosis of acute cerebral infarction.

Methods A total of 160 patients with acute cerebral infarction treated in our hospital from January 2011 to October 2012 were included in this study. The patients were divided into two groups based on their blood pressure, namely the Group of 80 patients with normal blood pressure and Group of 80 patients with hypertension.Each group was divided randomly into two subgroups of 40 patients, namely Group with intervention, Group without intervention, Group with intervention, and Group without intervention. And 80 healthy people who came to our hospital for regular physical examination during the same period were recruited as the control group. The inner diameter of brachial artery, carotid intima-media thickness(IMTwere detected by Color Doppler, and brachial artery flow-mediated dilation(FMD) calculated; Serum Hcy level was determined by enzymatic cycling assay, serum nitrogen oxide(NO)by nitrate reductase method, and the serum level of endothelial nitrogen oxide synthase (eNOS) was measured by enzyme-linked immunosorbent assay(ELISA).The degree of neurological deficits was evaluated by the National Institutes of Health Stroke Scale(NIHSS)of the U.S., and the ability of daily living was rated with Barthel Index(BI).

Results The FMD, levels of NO, eNOS were lower in Group with hypertension than those in Group with normal blood pressure, all of which were lower than those in control group.The levels of Hcy and IMT were higher in Group with hypertension than those in Group with normal blood pressure, all of which were higher than those in control group.The comparison among the four test subgroups showed that, compared to the two subgroups without intervention, the two subgroups with intervention has higher levels of NO,eNOS,and BI, and lower levels of the Hcynot between Group with intervention and Group without interventionand NIHSS after 2 weeks and after 12 weeks of the treatment(P0.01).The serum NO levels and serum Hcy levels were negatively correlated in Group with hypertension and Group with normal blood pressure(r=-0.90,-0.79; P0.01).

Conclusion There are vascular endothelial dysfunction and high Hcy hyperlipidemia in patients with acute cerebral infarction,both of which work synergistically in promoting the atherosclerosis process. Folic acid and vitamin B12 can reduce serum Hcy level, enhance the endothelial function, and improve the prognosis of patients with acute cerebral infarction.

Key words Brain infarction; Endothelialium vascular; Cysteine; Folic acid;Vitamin B12

Risk Factors of Elderly Cutaneous Pruritus

LI Dan, DOU Na, MA Su-hui, et al. College of Nursing and Rehabilitation, Hebei United University, Tangshan 063000, China

Abstract Objective To investigate the influencing factors of elderly cutaneous pruritus, to provide a basis for health education and control of patients condition.Methods Stratified random sampling was used to choose 912 over-60-year-old aged residents of Tangshan communities.The self-made general questionnaire, improved pruritus comprehensive assessment scales were used to analyze its influencing factors.Results 1Hot or sea food, bathing times3 times or bathing water temperature50 , use of alkaline bath things, regular consumption of coffee and tea, detergent washing, wearing tight underwear, poor quality of sleep, husband-wife quarrellings, emotional irritability led a high incidence of elderly cutaneous pruritusP0.05.2Taking cutaneous pruritus as dependent variable, hot or sea food, alkaline bath things, coffee, tea, detergent washing, wearing tight underwear, husband-wife quarrellings, emotional irritability as independent variables, all of the above-mentioned factors entered into the regression equation, and the order for influencing degrees of cutaneous pruritus was gainedalkaline bath thingshot or sea foodteaemotional irritabilityhusband-wife quarrellingscoffeetight underweardetergent washing.Conclusion Use of alkaline bath things, hot or sea food, consumption of strong tea or coffee, emotional irritability, wearing tight underwear are risk factors of elderly cutaneous pruritus.Health education should be strengthened to improve their awareness to reduce the incidence of cutaneous pruritus.

Key words Aged; Pruritus; Risk factors

Risk of Viral Hepatitis in Different Regions of China and Its Influencing Factors

TAN Lian-yun.Department of Internal Medicine, Campus Hospital of Suzhou University, Suzhou 234000, China

Abstract Objective To evaluate the risk of viral hepatitis in different regions of China and analyze its influencing factors.Methods The incidence of 4 types of viral hepatitishepatitis A, B, C, Ein 31 provinces of China were analyzed.Results The Northwest China had the highest incidence of hepatitis A, B, and C, while the East China had the highest incidence of hepatitis E.Qinghai Province, Xinjiang Province, and Gansu Province had the highest risk for infecting hepatitis, while Shandong Province, Tianjin Province, and Hunan Province had the lowest.Hepatitis B and C had similar incidence, which might be explained by their resemblance in etiology, mechanism, and routes of transmission.However, hepatitis A and E significantly differed in incidence.Medical advances had shown effects in the prevention and control of hepatitis A, but not for other three types of viral hepatitis.Conclusion There are regional differences in incidence of viral hepatitis in China, which might be related with the etiology, mechanism, and routes of transmission.

Key words Hepatitis, viral, human; Hepatitis viruses; Risk assessment;Correspondence analysis;Factor analysis

Correlation of Recurrent Spontaneous Abortion with PAPP-A in Decidual Tissues

YANG Jun, WANG Hui-ling, HUA Fang-fang.Department of Obstetrics and Gynecology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100, China

Abstract Objective To explore the relationship of recurrent spontaneous abortion (RSA) to pregnancy-associated plasma protein-A (PAPP-A) in decidual tissues.

Methods Thirty-nine RSA patients (RSA group) admitted to


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