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July 2017, Volume 20, No.20 Abstracts

 Role of Early Cardiac Rehabilitation in Cardiovascular Disease Discipline Development
JIANG Cheng-jian,GUO Hang-yuan*,CHI Ju-fang
Shaoxing People′s Hospital,Shaoxing Hospital of Zhejiang University,Shaoxing 312000,China
*Corresponding author:GUO Hang-yuan,Professor,Doctoral supervisor;Email:ghangyuan@hotmail.com
    【Abstract】  The incidence and mortality of cardiovascular disease are increasing year by year.A growing body of evidence suggests that cardiac rehabilitation and prevention is a method with good cost-effectiveness ratio for reducing cardiovascular morbidity and mortality.We elaborated the concept,theoretical basis and research trend of cardiac rehabilitation,effects of cardiac rehabilitation on cardiac function and long-term prognosis,and recent developments in cardiac rehabilitation models,as well as highlighted the role of early cardiac rehabilitation in cardiovascular disease discipline development based on the status of domestic cardiac rehabilitation development.
    【Key words】  Rehabilitation;Heart diseases;Prognosis
 
Management and Services for Cardiac Rehabilitation
CHI Ju-fang*,GUO Hang-yuan,LIN Hui
Shaoxing People′s Hospital,Shaoxing Hospital of Zhejiang University,Shaoxing 312000,China
*Corresponding author:CHI Ju-fang,Chief physician;Email:jf_chi@163.com
    【Abstract】  Cardiac rehabilitation is a comprehensive and long-term program of exercise,aiming to reduce the physiological and psychological effects due to cardiovascular diseases,reduce the risk for recurrent cardiovascular events or sudden death,control cardiac symptoms,stabilize or reverse the atherosclerotic process,which in turn assist the selected patients to adjust to society.Although the benefits of cardiac rehabilitation for cardiovascular diseases have been proved,it is undertaken by dismal proportion of clinically eligible cardiac patients.We reviewed the history of cardiac rehabilitation,summarized the current domestic innovated models of cardiac rehabilitation and analyzed the challenges and opportunities of future cardiac rehabilitation,in order to promote the effective management and comprehensive services delivery for cardiac rehabilitation,which could be of great benefit to more patients.
    【Key words】  Rehabilitation;Heart diseases;Management;Service
 
Clinical Value of Different Cardiac Rehabilitation Programs Applied to Patients with Acute Myocardial Infarction Early after Percutaneous Coronary Intervention
JIANG Cheng-jian,PAN Sun-lei,CHI Ju-fang,ZHOU Chang-zuan,LIN Hui,MENG Li-ping,ZHAI Xiao-ya,GUO Yan,GUO Hang-yuan*
Shaoxing People′s Hospital,Shaoxing Hospital of Zhejiang University,Shaoxing 312000,China
*Corresponding author:GUO Hang-yuan,Professor,Doctoral supervisor;E-mail:ghangyuan@hotmail.com
    【Abstract】  Objective  To investigate the clinical value and impact of cardiac rehabilitation programs applied to patients with acute myocardial infarction(AMI) early after percutaneous coronary intervention(PCI).Methods  The enrolled participants were 90 cases of AMI who received PCI in Shaoxing People′s Hospital from January 2014 to May 2016.They were randomized into traditional routine group,traditional strengthening group and new optimization group with 30 cases in each.The cardiac rehabilitation program for traditional routine group was developed based on the rehabilitation program applied to patients one week after emergency PCI included in 2006 Chinese Cardiac Rehabilitation Programs after PCI,mainly consisting of simple forms of exercise such like walking.Both the traditional strengthening group and new optimization group received the cardiac rehabilitation program developed based on the rehabilitation program applied to patients after selective PCI included in 2006 Chinese Cardiac Rehabilitation Programs after PCI.In addition,the new optimization group received the early-applied,personalized and accurate cardiac rehabilitation program developed in accordance with the latest concepts in cardiac rehabilitation received by Avans University,UMC St RAdboud,Queen Elizabeth Hospital and other hospitals in Hong Kong.The traditional strengthening group and new optimization group had greater basal activities and total activities than the traditional routine group.The intervention period for all the groups was six months.Color Doppler echocardiography was performed in the groups immediately after PCI(before the cardiac rehabilitation intervention) and six months after the starting of cardiac rehabilitation program(after the cardiac rehabilitation intervention),respectively for measuring the left ventricular ejection fraction(LVEF),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV) and wall motion score index(WMSI).Levels of serum tumor necrosis factor-alpha(TNFα),nitric oxide(NO),endothelin 1(ET1) and soluble vascular cell adhesion molecule 1(sVCAM1) were measured before and after the cardiac rehabilitation intervention.The incidences of malignant arrhythmia,angina pectoris,heart failure and sudden death during the cardiac rehabilitation were observed.Results  No significant differences in LVEF,LVESV,LVEDV,WMSI,TNFα,NO,ET1 and sVCAM1 levels were found among the three groups before the cardiac rehabilitation(P>0.05).After the cardiac rehabilitation intervention,the WMSI was lower in the traditional strengthening group than that in the routine traditional group,LVEF was higher in the new optimization group than that in the routine traditional group and traditional strengthening group,WMSI was lower in the new optimization group than that in the routine traditional group and traditional strengthening group(P<0.05).LVEF was higher after the cardiac rehabilitation intervention than that before the cardiac rehabilitation intervention in the three groups(P<0.05).After the cardiac rehabilitation intervention,the levels of TNFα,ET1 and sVCAM1 were lower in the traditional strengthening group than those in the routine traditional group,the level of NO was higher in the traditional strengthening group than that in the routine traditional group,the levels of TNFα,ET1 and sVCAM1 were lower in the new optimization group than those in the routine traditional group and traditional strengthening group,the level of NO was higher in the new optimization group than that in the routine traditional group and traditional strengthening group(P<0.05).The levels of TNFα,ET1 and sVCAM1 were lower,but the level of NO was higher after the cardiac rehabilitation intervention than that before the cardiac rehabilitation intervention in the three groups(P<0.05).During the cardiac rehabilitation intervention,the incidence of malignant arrhythmia differed significantly among the three groups(P<0.05); three groups had similar incidences of angina pectoris and heart failure(P>0.05); no sudden death occurred in all groups.Conclusion  Cardiac rehabilitation training applied to patients with AMI early after PCI can obviously improve the cardiac function and prognosis.The humanitarian cardiac rehabilitation program based on personal conditions used in the new optimization group can achieve the optimal effect of rehabilitation,which can also protect the cardiac function to the utmost and improve the prognosis tangibly.
    【Key words】  Myocardial infarction;Rehabilitation;Angioplasty,balloon,coronary
 
Evaluation of the Effect and Safety of Early Rehabilitation in Patients with Cardiac Pacemaker Implantation
GUO Ying,GUO Hang-yuan*,SUN Yong,YU Yu,WU Wei-fang,XU Fen-juan,LYU Qiao-xia
Department of Cardiology,Shaoxing People′s Hospital,Shaoxing Hospital of Zhejiang University,Shaoxing 312000,China
*Corresponding author:GUO Hang-yuan,Professor,Doctoral supervisor;Email:ghangyuan@hotmail.com
    【Abstract】  Objective  To investigate the effect of early rehabilitation on quality of life,shoulder joint complications and electrode dislocation events in patients with cardiac pacemaker implantation.Methods  From 2013 to 2015,a total of 220 patients accepted permanent pacemaker implantation in Department of Cardiology,Shaoxing People′s Hospital were selected as study subjects.The patients were numbered according to the order of hospitalization time,the even numbers were early rehabilitation group(n=110),the odd numbers were traditional treatment group(n=110).The patients in the traditional treatment group received routine rehabilitation program.The patients in early rehabilitation group were carried out the rehabilitation intervention by special personnel in accordance with different procedures and step-by-step functional exercise.After 12 h,the patients could get out of bed and exercise.After two weeks and 3 months postoperatively,the patients′ quality of life was evaluated by SF36,the patients′ possible shoulder pain and motion disturbances were assessed by shoulder pain and disability index(SPADI),the electrode dislocation events were evaluated by X radiography.Results  The scores of physical functioning,role-physical,bodily pain,general health,vitality,social functioning,role-emotional,mental health, physical component summary and mental component summary in the early rehabilitation group were higher than those in the traditional treatment group after two weeks postoperatively(P<0.05). The scores of physical functioning,role-physical,bodily pain,general health, social functioning,role-emotional,mental health, physical component summary and mental component summary in the early rehabilitation group were higher than those in the traditional treatment group after three months postoperatively(P<0.05).There was no significant difference in SPADI between the two groups after two weeks postoperatively(P>0.05).The SPADI of the early rehabilitation group was lower than that of the traditional treatment group after three months postoperatively(P<0.05).There were no significant differences between the two groups in the incidence of electrode dislocation after two weeks and three months postoperatively(P>0.05).Conclusion  Compared with traditional treatment,early rehabilitation intervention 6 h after pacemaker implantation is more beneficial to improve the patients′ quality of life,reduce shoulder pain and joint movement disorder,and does not increase the incidence of electrode dislocation events.
    【Key words】  Pacemaker,artificial;Rehabilitation;Quality of life;Postoperative complications
 
Level of Angiotensin Converting Enzyme in Patients with Pneumoconiosis Complicated with Hypertension
WU Xiao-yuan*,HUANG Jia-wen,FAN Chun-yue
Department of Inpatient,Guangdong Prevention and Treatment Center for Occupational Diseases,Guangzhou 510300,China
*Corresponding author:WU Xiao-yuan,Attending physician;Email:wuxy924@163.com
    【Abstract】  Objective  To investigate the difference of serum angiotensin converting enzyme(ACE) level between patients with pneumoconiosis whether complicated with hypertension.Methods  A total of 300 cases of pneumoconiosis patients admitted to the Guangdong Prevention and Treatment Center for Occupational Diseases were selected as study subjects from 2008 to 2015.The subjects were divided into pneumoconiosis combined with hypertension group(37 cases) and  pneumoconiosis group(263 cases) according to whether hypertension was combined.The fasting venous blood of the patients was collected and the level of ACE was measured.Results  The level of ACE in patients with pneumoconiosis was(124.75±75.45) U/L,which was higher than the upper limit of reference range (100.00 U/L),and the difference was statistically significant(t=5.635,P<0.05).Among them,ACE increased in 138 cases(46.0%).The age of pneumoconiosis combined with hypertension group was higher than that of pneumoconiosis group(P<0.05).The ACE levels between the two groups were compared,and there was no statistically significant difference(P>0.05).Linear regression analysis showed that there was no correlation between ACE level and gender,age,heart rate,systolic blood pressure,diastolic blood pressure,stage of pneumoconiosis and fasting blood glucose in patients with pneumoconiosis(P>0.05).Conclusion  The level of ACE in pneumoconiosis patients is generally high,and there is no difference in ACE levels between the pneumoconiosis patients with or without hypertension.
    【Key words】  Pneumoconiosis;Hypertension;Angiotensin converting enzyme
 
Relationship between Polymorphisms of Angiotensin Ⅱ Type 1 Receptor and Antihypertensive Responses of Telmisartan
GONG Hong-tao,DU Feng-he,CHEN Bu-xing*
Department of Cardiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100050,China
*Corresponding author:CHEN Bu-xing,Chief physician;Email:chbux@126.com
    【Abstract】  Objective   This study aims to investigate the relationship between the polymorphism of angiotensin Ⅱ type 1 receptor(AT1R) and the antihypertensive efficacy of telmisartan.Methods  From June 2005 to January 2007,one hundred and forty-eight patients with mild-to-moderate primary hypertension were selected.All the patients accepted monotherapy of telmisartan for 8 weeks,blood pressure was measured 1-2 times/week.The AT1R genes 1166A/C,-810A/T and -521C/T polymorphism of the patients were analyzed by polymerase chain reaction (PCR).Some biochemical indexes such as alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(Cr),blood urea nitrogen(BUN),uric acid(UA),fasting plasma glucose (FPG),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDLC),high density lipoprotein cholesterol(HDLC),blood sodium,blood potassium,blood chloride,angiotensin Ⅱ(AngⅡ) were also measured at the same time.Results  The body mass index(BMI),heart rate(HR),ALT,AST,Cr,BUN,UA,FPG,TC,TG,LDLC,HDLC,blood sodium,blood potassium and blood chlorine levels were compared before and after treatment,the differences were all not statistically significant(P>0.05).The AngⅡ level of the patients before and after treatment were compared,the difference was statistically significant(P<0.05).The systolic blood pressure before and after treatment,systolic blood pressure drop,diastolic blood pressure before and after treatment,diastolic blood pressure drop between AT1R gene 1166 A/C AA genotype and AC genotype,-810A/T AA genotype and AT genotype and TT genotype were compared,there were no significant differences(P>0.05).The systolic blood pressure before and after treatment,systolic blood pressure drop,diastolic blood pressure before and after treatment between AT1R gene -521C/T CC genotype and CT+TT genotype were compared,there were no significant differences(P>0.05).The diastolic blood pressure drop was compared,there was a statistically significant difference(P<0.05).Multiple linear regression analysis showed that UA,-521C/T,AngⅡ before treatment and diastolic blood pressure before treatment were the influencing factors of diastolic blood pressure drop(P<0.05).Conclusion  The -521C/T polymorphism of AT1R gene can independently predict the individual difference in patients′ response to telmisartan.
    【Key words】   Hypertension;Receptor,angiotensin,type 1;Polymorphism,single nucleotide;Angiotensin Ⅱ type 1 receptor blockers
 
Effect of Positive Airway Pressure Ventilation on the Cardiac Function and Vascular Endothelial Function in Patients with Obstructive Sleep Apnea Hypopnea Syndrome
XIN Tu-ye
No.3 Department of Respiratory Medicine,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China
    【Abstract】  Objective  To evaluate the effect of positive airway pressure ventilation on the cardiac function and vascular endothelial function in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) .Methods  A retrospective analysis was conducted on the data of 58 patients with OSAHS treated in the First Affiliated Hospital of Xinjiang Medical University from January 2013 to January 2016.All of them received 12-week positive airway pressure ventilation treatment,and after that,the treatment was stopped,and the conditions of them were observed for a week.The levels of markers associated with breathing during sleep,cardiac function and vascular endothelial function were measured before the treatment,at the 6th,12th weeks after treatment,and 1st week after stopping the treatment.Results  Compared with before the treatment,the oxygen saturation(SpO2),percentage of total sleep time(TST) with SpO2 below 89%,Epworth Sleepiness Scale(ESS) score,systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),central aortic reflective wave pressure augmentation index,radial artery pulse wave conduction velocity(PWV),systemic vascular resistance(SVR),pulmonary vascular resistance(PVR)in the OSAHS patients changed significantly(P<0.05),specifically,the levels of SBP,DBP,MAP,radial artery PWV,SVR and PVR measured at the 6th weeks after treatment were significantly lower than those measured before the treatment;the SpO2 measured at the 12th weeks after treatment was significantly increased while percentage of TST with SpO2 below 89%,ESS score,SBP,DBP,MAP,central aortic reflective wave pressure augmentation index,radial artery PWV,SVR and PVR were significantly lower than those measured before the treatment(P<0.05).However,after stopping the treatment for 1 week,the values of these markers were not significantly different from those measured before the treatment(P>0.05).Conclusion  For OSAHS patients,12-week positive airway pressure ventilation treatment can reduce the arterial pressure,improve the levels of markers associated with breathing during sleep and vascular endothelial function,but the treatment response will be disappeared soon after stopping the treatment for 1 week.
    【Key words】  Sleep apnea,obstructive;Continuous positive airway pressure;Ventricular function;Endothelium,vascular
 
Associated Factors of Static Balance Ability in Patients with Knee Osteoarthritis
WANG Xiao-ling1,2,3*,CHEN Feng4,5*,WANG Yong4,5,ZHONG Cai-hong4,5,DENG Xing-lan1,LIU Qiao-ling1,XIE Rong-fu1
1.School of Rehabilitation Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou 350122,China
2.Fujian Provincial Institute of Rehabilitation Industry,Fuzhou 350122,China
3.Fujian Key Laboratory of Rehabilitation Technology,Fuzhou 350122,China
4.Fujian Sports Science Research Institute,Fuzhou 350003,China
5.Key Laboratory of Motor Function Assessment,General Administration of Sport of China,Fuzhou 350003,China
*Corresponding authors:WANG Xiao-Ling,Associate professor;Email:535286728@qq.com
CHEN Feng,Researcher;Email:cncf666@126.com
    【Abstract】  Objective  To investigate the correlation of course of knee osteoarthritis(KOA),body mass index(BMI),degree of pain,scores of Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) with the static balance ability in patients with KOA.Methods  From January to October 2016,50 participants were recruited for this study,including KOA community residents and KOA outpatients of the Third People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine.The status of knee pain was assessed by Visual Analogue Scale(VAS),knee joint function was assessed by WOMAC,and static balance ability in both eyes-open and eyes-closed conditions was assessed by ProKin 254P system.Results  The course of KOA was found to be positively correlated with the values of balance parameters of SD of ap,SD of la,AS of ap,AS of la,Area,Length in eyes-open condition(P<0.05).BMI was positively associated with the values of static balance parameters of the SD of la,Area under eyes-closed condition(P<0.05).VAS scores were positively correlated with the static balance parameter of C.O.P(y)(P<0.05),but negatively correlated with Romberg length(P<0.05) under eyes-open condition.There was a positive correlation between static balance parameter of C.O.P(y) and WOMAC function subscale scores under eyes-closed condition(P<0.05).Conclusion  The poor static balance ability in KOA patients is associated with prolonged course of KOA,increased BMI and pain,reduced function ability,and the patient′s static balance ability has a greater reliance on vision.
    【Key words】  Osteoarthritis,knee;Postural balance;Body mass index;Arthralgia;Knee joint function
 
Therapeutic Efficiency of Tegafur,Gimeracil and Oteracil Potassium for Metastatic Breast Cancer Resistant to Capecitabine
WANG Shao-min*,YE Meng,NI Shu-min
Department of Medical Oncology,the Affiliated Hospital of School of Medicine of Ningbo University,Ningbo 315020,China
*Corresponding author:WANG Shao-min,Associate chief physician;Email:wangshaomin2000@163.com
    【Abstract】  Objective   The purpose of this study is to analyze retrospectively the therapeutic efficiency and safety of tegafur,gimeracil and oteracil potassium monotherapy in patients with metastatic breast cancer resistant to capecitabine monotherapy.Methods  We retrospectively ananlyzed the clinical data of 22 cases of patients with metastatic breast cancer in the Department of Medical Oncology,the Affiliated Hospital of School of Medicine Ningbo University between November 2011 and May 2015.All patients accepted capecitabine monotherapy,then they all accepted tegafur,gimeracil and oteracil potassium monotherapy after resistant to capecitabine until tumor progression,intolerable side effects and toxicity or refusal of treatment.The therapeutic efficiency of tegafur,gimeracil and oteracil potassium was evaluated according to the Response Evaluation Criteria in Solid Tumors(RECIST),and then the time to progression and overall survival were observed.The pain score and CA153 value were also recorded.Side effects and toxicities were assessed according to the common terminology criteria for adverse events(CTCAE v4.02) issued by the National Cancer Institute.Results  Five patients had partial remission,12 had stable disease,and 5 had disease progress in 22 patients with capecitabine-resistant metastatic breast cancer after tegafur,gimeracil and oteracil potassium treatment.Objective response rate was 22.7%(5/22),clinical benefit response was 77.3%(17/22).Median time to progression was 113 days(22-218 days),median overall survival was 20.2 months(3.8-38.2 momths).A total of 15 patients complained of pain before tegafur,gimeracil and oteracil potassium therapy.Pain relief happened in 10 cases without the increase of analgesic drugs dosage after therapy.Compared with the CA153 value on the beginning of tegafur,gimeracil and oteracil potassium therapy,the lowest CA153 value in the course of therapy decreased signifcantly〔(174.8±67.4)U/ml vs.(102.8±69.7)U/ml,t=4.174,P=0.001〕.The toxic side effects of tegafur,gimeracil and oteracil potassium were well tolerated,and major adverse reactions included anorexia〔59.1%(13/22)〕,nauseas〔50.0%(11/22)〕,fatigue〔45.5%(10/22)〕,neutropenia〔45.5%(10/22)〕,anemia〔40.9%(9/22)〕,diarrhea〔36.4%(8/22)〕,hand-foot syndrome〔27.3%(6/22)〕,transaminase elevation〔22.7%(5/22)〕 and vomiting〔18.2%(4/22)〕et al.Most adverse reactions were Grade Ⅰ-Ⅱ adverse events,Grade Ⅲ adverse events only occurred in 3 cases.Conclusion  Tegafur,gimeracil and oteracil potassium monotherapy is effective and well-tolerated in patients with metastatic breast cancer resistant to capecitabine monotherapy.So tegafur,gimeracil and oteracil potassium monotherapy is a selective regime treatment for patients with metastatic breast cancer after they were resistant to capecitabine monotherapy.
    【Key words】  Breast neoplasms;Tegafur,gimeracil and oteracil potassium;Capecitabine;Antineoplastic combined chemotherapy protocols
 
Correlation of Serum Vitamin E,Carotene β and Vitamin A Levels with the Mortality in Primary Liver Cancer Treated with Radical Hepatic Carcinectomy
ZHANG Xiao-li1,LIU Jia2,MA Yu-fang1*,WANG Ji-hong1,LUO Li-qiong1
1.Department of Oncology,Tianyou Hospital Affiliated to Wuhan University of Science & Technology,Wuhan 430000,China
2.Department of Clinical Laboratory,Tianyou Hospital Affiliated to Wuhan University of Science & Technology,Wuhan 430000,China
*Corresponding author:MA Yu-fang,Chief physician,Main research in tumor chemotherapy;Email:mayufang2016@sina.com
    【Abstract】  Objective   To estimate the correlation of 3 kinds of serum vitamin(E,carotene β and A) levels involved in oxidative stress injury with the mortality in primary liver cancer patients with radical hepatic carcinectomy.Methods  The participants enrolled in this study were 198 consecutive primary liver cancer patients treated by radical hepatic carcinectomy in Tianyou Hospital Affiliated to Wuhan University of Science & Technology from January 2010 to January 2013.Based on the survival status found at the end of 3-year follow-up period,they were divided into the survival group(n=101) and death group(n=97).The serum vitamin(E,carotene β and A) levels and oxidative stress markers〔total anti-oxidative status(TAS),total oxidative status(TOS) and oxidative stress index(OSI)〕 of the participants were measured at 1,and 3 months after the surgery and the difference between the two measured values of the above items(△VitE,△Vitcarotene β,△VitA,△TOS,△TAS and △OSI) were calculated.Results  Compared with the survival group,the death group had lower serum vitamin E values measured at the time of 3 months after the surgery,less △VitE,less △VitA(P<0.05).The TAS measured at the time of 3 months after the surgery was lower,△TAS and △TOS and △OSI values were all less,but TOS and OSI measured at the time of 3 months after the surgery were higher in the death group than in the survival group(P<0.05).For predicting the postoperative 3-year mortality,the AUC value of serum vitamin E measured at the time of 3 months after surgery was 0.798〔95%CI(0.716,0.894)〕,and that of △VitE was 0.894〔95%CI(0.735,0.934)〕.In all the participants,a positive correlation existed between serum vitamin E and TAS measured at the time of 3 months after surgery(r=0.521,P<0.05),while a negative correlation existed between serum vitamin E and mortality(r=-0.611,P<0.05),and a negative correlation was found between serum vitamin E measured at the time of 3 months after surgery and mortality(r=-0.653,P<0.05).Multivariate Logistic regression analysis found that,the independent influencing factors for postoperative 3-year mortality in the participants were serum vitamin E value measured at the time of 3 months after surgery >10.1 μmol/L〔OR=0.78,95%CI(0.40,0.98),P<0.05〕 and △VitE >0.6 μmol/L〔OR=0.89,95%CI(0.49,0.99),P<0.05〕.Conclusion  The serum vitamin E value measured at the time of 3 months after surgery may be a potential predictor for the postoperative 3-year mortality in primary liver cancer patients with radical hepatic carcinectomy.
    【Key words】  Liver neoplasms;Vitamin E;Beta carotene; Vitamin A;Mortality
 
Follow-up Study of Sleep Monitoring in Patients with Untreated Obstructive Sleep Apnea Hypopnea Syndrome
ZHENG Hong-fei1,ZHANG Qing1*,PANG Gui-fen1,YANG Lin-ying1,HE Quan-ying2
1.Department of Respiration,Affiliated Hospital of Chengde Medical College,Chengde 067000,China
2.Department of Respiration,People′s Hospital,Peking University,Beijing 100044,China
*Corresponding author:ZHANG Qing,Chief physician;Email:zhangqing0668@sina.com
    【Abstract】  Objective  To analyze the changes of sleep monitoring during 7-year follow-up in patients with untreated obstructive sleep apnea hypopnea syndrome(OSAHS).Methods  OSAHS paients were screened by the OSAHS epidemiological survey in community population of Chengde City in 2002.In 2009,99 patients with complete follow-up and without surgery,ventilator and other treatment were enrolled as study subjects.According to the baseline age,the patients were divided into middle aged group(age <60 years old,n=63) and the elderly group(age≥60 years old,n=36).The main clinical manifestations of patients,with or without hypertension,coronary heart disease,cerebrovascular disease,diabetes were recorded.Sleep monitoring was performed in 2002 and 2009,respectively.And Epworth sleepiness evaluation(ESS) was used to assess the degree of daytime sleepiness.Results  The incidence of suppress wake in elderly group was significantly lower than that in middle aged group,and the incidence of hypertension,coronary heart disease,cerebrovascular disease and diabetes in elderly group were higher than those in the middle aged group(P<0.05).Among the 41 patients with mild OSAHS in the middle aged group in 2002,21 cases progressed to moderate OSAHS and 2 progressed to severe.Among the 13 patients with moderate OSAHS,6 cases progressed to severe.Among the 10 patients with mild OSAHS in the elderly group in 2002,3 cases progressed to moderate OSAHS.Among the 12 patients with moderate OSAHS,3 cases progressed to severe.In 2009,the body mass index(BMI),apnea hypopnea index(AHI) and ESS score of the middle aged group were higher than those in 2002,and L SaO2 was lower than that in 2002(P<0.05).There were no significant differences in BMI,AHI and ESS score between the 2002 and 2009 in the elderly group(P>0.05),L SaO2 in 2009 was lower than that in 2002(P<0.05).The changes of L SaO2 and AHI in middle aged group during 7 years were higher than those in elderly group(P<0.05).Conclusion  The degree of sleep disorders gradually increases with age increasing in untreated middle aged OSAHS patients.The progress trend of sleep disorders in untreated elderly OSAHS patients slows down with prolonged course of sleep disorders,but the cardiovascular and cerebrovascular and other complications obviously increased.
    【Key words】  Sleep apnea,obstructive;Apnea hypopnea index;Course of disease;Middle aged;Aged;Follow-up studies
 
Clinical Characteristics and Pregnancy Outcome of Re-birth Pregnant Women
CHENG Xian-ying1*,QIAN Lin-hua2,CHENG Li3,MENG Ang-ang4
1.Department of Obstetrics and Gynaecology,Zhejiang Hospital,Hangzhou 310013,China
2.Department of Obstetrics and Gynaecology,Women′s Hospital School of Medicine Zhejiang University,Hangzhou 310008,China
3.Department of Obstetrics and Gynaecology,Hangzhou Xixi Hospital,Hangzhou 310028,China
4.Department of Obstetrics and Gynaecology,Zhejiang University International Hospital,Shulan(Hangzhou) Hospital,Hangzhou 310022,China
*Corresponding author:CHENG Xian-ying,Attending physician;Email:13491159@qq.com
    【Abstract】  Background  The structure of re-birth pregnant women has changed after "comprehensive two-children policy ",which brings new challenge in the perinatal medical field.In order to improve the level of perinatal health care and safeguard mother-to-child safety,the clinical features and pregnancy outcomes of re-birth pregnant were summarized in this paper.Objective  To explore the clinical features and pregnancy outcome of re-birth pregnant women.Methods  Three hundred and seventy-two cases of re-birth pregnant women in Women′s Hospital School of Medicine Zhejiang University,were selected as the study group in March 2016,and 300 cases of non-re-birth pregnant women in the same period were selected as the control group.The medical records of the two groups of pregnant women were consulted,and the basic conditions,pregnancy complications,obstetric complications,postpartum complications,and perinatal complications were collected.Results  There were significant differences between the two groups in age,gestational age,abortion,education,conception and rate of non-invasive prenatal gene detection and amniocentesis(P<0.05).There were no significant differences in the incidence of placental abruption,oligohydramnios,fetal growth restriction,intrahepatic cholestasis of pregnancy,fetal distress and premature rupture of membranes(P>0.05).The incidence of hypertensive disorder complicating pregnancy,gestational diabetes mellitus,placenta previa,placenta accreta,hydramnios and premature birth in the study group were higher than those in the control group(P<0.05).There was no significant difference in the incidence of puerperal infection between the two groups(P>0.05).The incidence of vaginal delivery was lower in the study group than in the control group,the incidence of postpartum hemorrhage and postpartum anemia in the study group were higher than those of the control group(P<0.05).There were no significant differences between the two groups in the incidence of low birth weight infants,NRDS and fetal death(P>0.05).The incidence of macrosomia,neonatal asphyxia,neonatal hypoglycemia and neonatal malformation in the study group were higher than those in the control group(P<0.05).Conclusion  The re-birth pregnant women are older,most associate with secondary infertility and need reproduction assisted,and the rate of pregnancy complications,obstetric complications,cesarean section increase,and macrosomia,neonatal asphyxia,neonatal malformations and other adverse perinatal outcomes increase too.
    【Key words】  Pregnancy time;Pregnancy complications;Pregnancy outcome
 
Mechanism of Action of Advanced Glycation End Products in the Regulation of Smooth Muscle Cells Calcification
HE Hu-qiang,ZENG Hong,SUN Xiao-lei,ZHANG Lei,WANG Wei-ming,XU Xiong-fei,HE Yan-zheng,LIU Yong*
Department of Vascular Surgery,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China
*Corresponding author:LIU Yong,Chief physician;Email:lyong74@163.com
    【Abstract】  Objective  To investigate the mechanism of action of advanced glycation end products(AGEs) in regulating the receptor of AGEs(RAGE) for promoting calcification of human femoral arterial smooth muscle cells.Methods  This study was carried out between January 2014 and March 2015.The tunica media of femoral artery was cut into tissue blocks of 1-2 mm in length for adherent culture.We selected the cultured smooth muscle cells of 3-8 generation for the experiment and divided them into 4 groups for further culture,group A with DMEM culture medium;group B using DMEM+10 mmol/L βsodium phosphate;group C using DMEM+10 mmol/L βsodium phosphate+AGEs 20 mg/L;and group D with DMEM+10 mmol/L β-sodium phosphate+AGEs 40 mg/L.Cells in each group were intervened for 96 hours.Three pairs of random RAGE siRNA were synthesized,and  used to transfect the smooth muscle cells of group C with a concentration of 50 nmol/L.The efficacy of siRNA was measured 24 h later.The sequences with high transfection efficiency were selected for experiment.The calcium deposition in smooth muscle cells were observed by Von Kossa staining before and after RAGE-specific siRNA transfection.The expression levels of RAGE,βcatenin,and osteoprotegerin(OPG) were detected by Western blotting.Results  In the non-transfected cells,there was no calcified plaque in group A,while group B showed obvious calcification plaques;in groups C and D,the number of cytoplasm and nucleus of the smooth muscle cells in red increased and calcified plaques increased significantly.After RAGE-specific siRNA transfection,the number of cytoplasm and nucleus of the smooth muscle cells in red in group C was decreased compared with that before transfection,and the formation of calcified plaque was inhibited.Before RAGE-specific siRNA transfection,the expression levels of RAGE,βcatenin,and OPG in smooth muscle cells differed significantly among the groups(P<0.05),specifically,the expression levels of RAGE,βcatenin,and OPG in smooth muscle cells were higher in group C than in  group B,and they were higher in group D than in groups B  and C(P<0.05).The expressions of RAGE,βcatenin,and OPG in smooth muscle cells in group C were lower after RAGE-specific siRNA transfection compared with those before transfection(P<0.01).Conclusion  AGEs mediate smooth muscle cells calcification by regulating RAGE,the mechanism may be that RAGE activates the Wnt/ βcatenin signaling pathway and by which the expression level of βcatenin downstream protein OPG is increased.
    【Key words】  Diabetes mellitus;Vascular calcification;Advanced glycation end products;Osteoprotegerin
 
Bibliometric Analysis of Mobile Health in China from 2005 to 2015
WANG Yi-rong1,ZHANG Rong-yu2,HE Zhi-hui2,MA Shu-wen3,LIU Yao-sai4,LIU Shang-qi1,WANG Qian1,HE Qun2,5*
1.Zhujiang Hospital of Southern Medical University,Guangzhou 510280,China
2.Guangdong Provincial Center for Disease Control and Prevention,Guangdong Provincial Institute of Public Health,Guangzhou 511430,China
3.Guangzhou DAAN Clinical Laboratory Ctr Co LTD,Guangzhou 510670,China
4.The Fifth Affiliated Hospital of Southern Medical University,Guangzhou 510900,China
5.School of Public Health and Tropical Medicine,Southern Medical University,Guangzhou 510515,China
*Corresponding author:HE Qun,Chief physician;Email:heq@gdiph.org.cn
    【Abstract】  Objective   To investigate the development of mobile health in China by studying the published articles about it.Methods  Using bibliometrics,we analyzed and studied the articles about mobile health in China included in CNKI databases between 2005 and 2015 from the aspects of number,key words,source journals and research institutions.Results  A total of 461 related articles were retrieved and the number of articles showed an increasing trend year by year.The growth rate of number of articles was low from 2005 to 2009,but it has increased rapidly since 2010.If sorted in accordance with the frequency of use from more to less,32 key words were used 10 or more times in the articles.Three kinds of topics were found to be covered by the included articles based on the meaning of key words,research on mobile health technology,research on the application of mobile health technology,and assessment of the mobile health technology.In the light of the development trend of research hotspots,the number of articles with these 3 topics will be similar gradually.Five or more articles were published in each of the 15 of the totaled 197 source journals,and the number of articles published in the 15 amounted to 199,accounting for 43.17% of the total (199/461).Universities and affiliated hospitals were the main research institutions.Conclusion  Mobile health has become a hot issue in academic research,but the related research institutions are not grouped and the quality of related articles are not satisfactory.
    【Key words】   Mobile health;China;Bibliometrics
 
Bibliometric Analysis of Chinese and Foreign Literatures on Mother-to-child Transmission of HIV from 1995 to 2014
QIN Shou-xue1*,SHI Rong-guang1,NONG Yan-li2,TAN Yan-ping1,CHENG Yu-qing3
1.Guigang Maternal and Child Health Care Hospital,Guigang 537100,China
2.Guiping Maternal and Child Health Care Hospital,Guiping 537200,China
3.Pingnan County Maternal and Child Health Care Hospital,Pingnan 537300,China
*Corresponding author:QIN Shou-xue,Attending physician;Email:1946985651@qq.com
    【Abstract】  Objective  To preliminary analysis the research status and development direction of the mother-to-child transmission of HIV from 1995 to 2014 both at home and abroad,and to reveal the characteristics and rules of the studies on the mother-to-child transmission of HIV at home and abroad.Methods  From April to June 2016,the global literatures were retrieved by the reference database of Web of Science of SCI,and the Chinese literatures were retrieved by the web edition of Chinese biomedical literature database(CBM Web).The distribution of the publishing year,region,institution,journal,author and keywords of the literatures was statistically analyzed by bibliometrics method.Results  The amount of foreign and Chinese literatures was 3 348 and 1 041 respectively.On the whole,the quantity of foreign literature was in a steady decline,and the quantity of Chinese literature was in a wave-like growth.Foreign literature focused on studying on the field of basic medicine,epidemiology and pharmacy,while Chinese literature focused on researching in the field of diagnostics,gynecology,epidemiology and public health management.The number of published papers,total citation frequency,average citation frequency per paper,citation frequency of publishing institutions,impact factor of journal,and citation frequency of authors of Chinese literatures were all lagged behind the foreign literatures.Conclusion  The mother-to-child transmission of HIV has attracted extensive attention of researchers both at home and abroad,the quantity of literatures has developed rapidly in recent years,but there is unbalanced development in different countries and regions,and the quality of Chinese literature still needs to be improved.
    【Key words】  Acquired immunodeficiency syndrome;Infectious disease transmission,vertical;Bibliometrics
 
Investigation of Reference Ranges of Urine Gonadotropin in Preschool Children in Community
HANG Biao1,HANG Yin1,MA Ya-ping2,XIA Bing-yang2,HUANG Min1,LI Nan-nan2,YUE Chun-xiao1,ZHANG Xiao-ying1,GONG Da-wei1,ZHOU Han-yang1,XU Zhuang-jian2*
1.The Community Health Service Center of Hudai Town in Binhu District,Wuxi 214161,China
2.Affiliated Hospital of Jiangnan University,the Fourth People′s Hospital of Wuxi,Wuxi 214062,China
*Corresponding author:XU Zhuang-jian,Professor;Email:xxx1959xzj@126.com
    【Abstract】  Objective   It aimed to establish normal reference ranges of urine luteinizing hormone(ULH) and urine follicle-stimulating hormone(UFSH) in preschool children(3-7 years old).And the characteristics of gender and age were investigated.Methods  From May to July in 2015,the preschool children(3-7 years old) in Hudai community of Binhu district,Wuxi city,Jiangsu province were enrolled as subjects.According to the standards of growth and development from World Health Orgnization(WHO) in 2006,the height for age Z-score,weight for age Z-score and BMI for age Z-score were calculated.Three indicators all in -2SD-2SD were regarded as meeting the physical development criteria of the study.The bladder was drained before going to bed,the first morning urine were collected.The urine retention time was recorded.ULH and UFSH were detected by immunochemical chemiluminescence.Creatinine(Cr) was simultaneously detected.Results  There were 1 105 children in line with inclusion criteria and their urine specimens were collected correctly.Among them,90 were 3 years old,390 were 4 years old,373 were 5 years old,and 252 were 6-7 years old.The detection rates of ULH in male and female were 5.30%(31/585) and 11.54%(60/520),respectively.And the detection rates of UFSH were 99.83%(584/585) and 99.04%(515/520),respectively.There were significant differences in the ULH and UFSH levels between male and female(Z=-3.755,P<0.001;Z =-19.644,P<0.001).There were significant differences in the UFSH levels among different age female(P<0.05).The UFSH levels in female of 5 years old or 6-7 years old were lower than those of female in 3 years old and 4 years old,respectively(P<0.05).In 1 105 preschool children,-2SD<HAZ≤0(long-term poor nutritional status) were 409 cases,0<HAZ<2SD(long-term good nutritional status)were 696 cases.There were no significant differences in ULH levels and UFSH levels between long-term poor nutritional status children and long-term good nutritional status children(Z=-1.018,P=0.309;Z=-1.114,P=0.265).In 1 105 cases of preschool children,-2SD<WAZ≤0(short-term poor nutritional status) were 484 cases,0<WAZ<2SD(short-term good nutritional status) were 621 cases.There was no significant difference in ULH concentration between short-term poor nutritional status children and short-term good nutritional status children(Z=-0.472,P=0.637).There was a significant difference in UFSH concentration between short-term poor nutritional status children and short-term good nutritional status children(Z=-1.991,P=0.046).Conclusion  The detection rate of ULH in preschool children was low.ULH and UFSH reference ranges were of gender and age characteristics.The UFSH in preschool female declined gradually with the increasing of age,and the trends declined slowly between 6 years old and 7 years old.UFSH could increase in children with short-term poor nutritional status,but long-term nutritional status did not affect UFSH.
    【Key words】   Child,preschool;Gonadotrophs;Urine;Luteinizing hormone;Follicle stimulating hormone;Community
 
Impact of Personal-level Social Capital on the Quality of Life among People Living with HIV/AIDS in Nanchang
HUANG Ling1,CHEN Fei-yu2,LAN Gui-lian3,XU Qun-ying4,YUAN Zhao-kang1*
1.Department of Health Statistics,School of Public Health,Nanchang University,Nanchang 330000,China
2.Dongxiang Center for Disease Control and Prevention,Fuzhou 331800,China
3.Department of Gastroenterology,the First Affiliated Hospital of Nanchang University,Nanchang 330000,China
4.Department of Nutrition and Food Hygiene,School of Public Health,Nanchang University,Nanchang 330000,China
*Corresponding author:YUAN Zhao-kang,Professor;Email:yuanzhaokang@126.com
    【Abstract】  Objective   To investigate the status of personal-level social capital and its impact on the physical and mental health among people living with HIV/AIDS(PLWHA) in Nanchang,in order to provide reference for improving the quality of life of PLWHA.Methods  A cross-sectional survey was done in Nanchang Donghu Center for Disease Control and Prevention and Nanchang Qingyunpu Center for Disease Control and Prevention from January to June,2015,based on the sample of PLWHA diagnosed with HIV/AIDS and registered in the two institutions.The self-developed socio-demographic questionnaire was used to collect the baseline characteristics of the PLWHA,including gender,age,place of residence,marital status,educational attainment,monthly income,occupation,route of HIV infection,HIV-status disclosure and CD+4 T cell count.Personal Social Capital Scale(PSCS) was used to measure the personal-level social capital and MOS-HIV was used to evaluate the quality of life in PLWHA.Results  This study was conducted with the total enrollment of 230 PLWHA for full interview,and 97.8% of them(225/230) returning responsive questionnaires were selected as the final participants.The scores of bonding social capital,bridging social capital and total social capital of the PLWHA were(14.1±3.4),(9.5±3.4) and(23.6±5.6) respectively,all of them were lower than those of the normals(P<0.05).The scores of physical health and mental health were(51.9±7.0) and(49.3±6.6) respectively,among the participants.Multivariate linear regression analysis showed that,of the items of PSCS,the belief in network members,support and help of network members,resources owned by network members,resources owned by groups were the correlation factors for physical health of the PLWHA(P<0.05);number of network members,daily contact with network members,the belief in network members,resources owned by network members had significant effects on the mental health of the PLWHA(P<0.05).Conclusion  The PLWHA in Nanchang have unsatisfactory personal-level social capital.Bonding social capital has a significant impact on their quality of life.
    【Key words】  Acquired immunodeficiency syndrome ;Social capital;Quality of life;Root cause analysis
 
A Comparison Study on the Management Effect of Community Type 2 Diabetic Patients with Different Visiting Models
FAN Ai-qing1,SU Qi2,HOU Jin3,PAN Zhi-gang4*
1.Lingqiao Community Health Severice Center of Pudong New Area,Shanghai 200137,China
2.Liuzao Community Health Severice Center of Pudong New Area,Shanghai 201322,China
3.Datuan Community Health Severice Center of Pudong New Area,Shanghai 201311,China
4.Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032,China
*Corresponding author:PAN Zhi-gang,Chief physician;Email:137166678@qq.com
    【Abstract】  Objective  To explore the current situation of community first-seen and classification treatment of type 2 diabetic patients in Shanghai Pudong suburban community,and to compare the management effects of type 2 diabetic patients with different visiting models.Methods  From October 2014 to October 2016,type 2 diabetic patients enrolled in the list of management objects of the Shanghai Pudong New Area Center for Disease Control and Prevention in 2014 were selected.The patients were type 2 diabetic patients with fixed visit service (496 cases of fixed visit group)in Shanghai Pudong central suburban community and type 2 diabetic patients with free visit (464 cases of free visit group),respectively.The general situation of two groups patients were compared.The medication compliance,times of hospitalization,and glycosylated hemoglobin (HbA1c) compliance rate and physical health score〔evaluation with the Diabetic Control Symptom Scale (CSSD70)〕 were investigated.Results  The medication compliance rate and HbA1c compliance rate in the fixed visit group were higher than those in the free visit group,and the time of hospitalization was less than that in the free visit group (P<0.05).There were no statistically significant differences in the living habits,treatment,survival skills,treatment goals,disease knowledge scores and total scores between the two groups(P>0.05);the score of conscious symptoms in fixed visit group was higher than that in free visit group (P<0.05).Conclusion  The orderly visit,referral mode management and management effect of type 2 diabetic patients in fixed visit group i.e.community first visit are obviously better than those in free visit group,which can improve the patients′ medication compliance,reduce the times of hospitalization and improve the HbA1c compliance rate.
    【Key words】  Diabetes mellitus,type 2;Community health services;Case management;General practitioner
 
Case-based Learning about Individualized Treatment and Integrated Management of Type 2 Diabetes Mellitus
KONG Yu-xia1,2,ZHENG Jia-tang1,2,DONG Ai-mei1,2,3*
1.Department of General Practice,Peking University First Hospital,Beijing 100034,China
2.School of General Practice,Peking University Health Science Center,Beijing 100191,China
3.Department of Endocrinology,Peking University First Hospital,Beijing 100034,China
*Corresponding author:DONG Ai-mei,Associate chief physician;Email:dongaimei1975@sina.com
    【Abstract】  Diabetes is a common chronic non-communicable disease.General practitioners(GPs) should be equipped with the capabilities of standardized diagnosis and treatment that correspond to guidelines and they can provide personalized treatment and integrated management services based on the patient′s own conditions.Case-based learning is an important way for improving the capabilities of GPs.We comprehensively investigated the personalized treatment and integrated management for type 2 diabetes mellitus on the grounds of a representative newly-diagnosed type 2 diabetes mellitus case as well as the guidelines for the prevention and treatment of the disease with a view to improving the capabilities of clinical diagnosis and treatment of GPs by broadening their ways of thinking.
    【Key words】  Diabetes mellitus,type 2;General practitioner;Individualized medicine
 
Misdiagnosis Analysis of Atypical Pulmonary Sarcoidosis Based on CT Manifestations
YANG Kai-yan,GAO Shuai,JIANG Tao*,LIANG Lu,PENG Peng
Department of Radiology,Beijing Chaoyang Hospital,Affiliated to Capital Medical University,Beijing 100020,China
*Corresponding author:JIANG Tao,Professor,Doctoral supervisor;Email:jiangtao@bjcyh.com
    【Abstract】  Objective  To analyze the atypical CT manifestations of misdiagnosed pulmonary sarcoidosis,and improve the diagnosis level of CT on pulmonary sarcoidosis.Methods  From January 2012 to August 2015,24 cases of pulmonary sarcoidosis misdiagnosed by CT,then confirmed by pathology,met the clinical diagnostic criteria and accepted treatment were selected as subjects in Beijing Chaoyang Hospital,Affiliated to Capital Medical University.The clinic manifestations,the laboratory data and CT characteristics of the 24 cases were retrospectively analyzed.Results  In 24 pulmonary sarcoidosis cases,23(95.8%) presented different respiratory symptoms(cough,expectoration,chest tightness,dyspnea and pectoralgia);8(33.3%)complicated with the systemic nonspecific symptoms(fever,weakness,loss of the weight)simultaneously;4(16.7%)complicated with the extra-pulmonary manifestations(cutaneous erythema nodosum,pain of bilateral hip,nervous deafness);1(4.2%)was asymptomatic.The erythrocyte sedimentation rate elevated in 47.6%(10/21)of cases,and C reaction protein elevated in 52.3%(11/21)of cases,the positive rate of tuberculin test(PPD)was 1/9 , ratio of CD4/CD8 in bronchoalveolar lavage fluid(BALF)increased in 8/18.CT findings:in 12 cases(50.0%) of atypical manifestations of lymph node enlargement,mediastinal and unilateral hilar lymph node enlargement in 5 cases(20.8%),mediastinal lymph node enlargement alone in 5 cases(20.8%),no lymph node enlargement in 2 cases(8.3%);lymph node fusion in 8 cases(33.3%).The atypical pulmonary manifestations:ground glass density in 10 cases(41.7%),miliary nodules in 7 cases(29.2%),linear reticular opacities in 6 cases(25.0%),tree-in-bud opacities in 5 cases(20.8%),nodule and mass opacities in 4 cases(16.7%).Pleural lesions in 10 cases(41.7%),including pleural thickening,calcification and pleural fluid in 2 cases(8.3%).The misdiagnosed diseases on CT included 5 cases(20.8%) of tuberculosis,4 cases(16.7%) of lymphoma,4 cases(16.7%) of pulmonary interstitial fibrosis,3 cases(12.5%) of pulmonary infection,2 cases(8.3%) of mediastinal mass,2 cases(8.3%) of pulmonary metastases,2 cases(8.3%) of lung cancer,and 2 cases(8.3%) of interstitial pneumonia.Conclusion  The atypical manifestations of pulmonary sarcoidosis at CT are diversified and nonspecific.It is of great significance for the diagnosis and treatment of pulmonary sarcoidosis to fully understand the atypical CT manifestations of the disease and combine with the clinical comprehensive analysis.
    【Key words】  Sarcoidosis,pulmonary;Tomography,X-ray computed;Diagnostic errors
 
Head-shaking Test in the Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo
QIAN Shu-xia,BAO Yi-xin,ZHANG Xiao-ling,GUAN Qiao-bing,WANG Yan-ping*
Department of Neurology,the Second Affiliated Hospital of Jiaxing University,Jiaxing 314000,China
*Corresponding author:WANG Yan-ping,Associate chief physician;Email:ypwang93@163.com
    【Abstract】  Objective  To investigate the result of head-shaking test in horizontal semicircular canal benign paroxysmal positional vertigo(HCBPPV).Methods  Fifty-six patients with HCBPPV including 35 geotropic types and 21 apogeotropic types,visited the Vertigo Clinic of the Second Affiliated Hospital of Jiaxing University or hospitalized in the hospital from January to November in 2015 were enrolled in this study.The side with relatively strong nystagmus in roll test was judged as affected side in geotropic type HCBPPV of patients,and the side with relatively weak nystagmus was judged as affected side in apogeotropic type.All of the patients performed head-shaking test.The method of head-shaking test was as follows:the patient shakes his/her head left to right at the range of 30° in horizontal direction with 3 Hz frequency for 30 times while sitting.Examiners observed with naked eyes for 1 min and recorded head-shaking nystamus and the direction.Results  Of the 56 patients,19 showed head-shaking test positive after head-shaking test,and it was more common in apogeotropic type than in geotropic type〔71.4%(15/21) vs.11.4%(4/35),P<0.05〕.Of the 15 patients with head-shaking test positive in apogeotropic type,14 showed healthy side and 1 affected side,whereas of the 4 patients with head-shaking test positive in geotropic type,2 showed healthy side and 2 affected side.Conclusion  Nystagmus induced by head-shaking is common and most contralesional in apogeotropic HCBPPV,while it is rare and contralesional or ipsilesional in geotropic HCBPPV.
    【Key words】  Vertigo;Benign paroxysmal positional vertigo;Head-shaking test;Nystagmus
 
Research Progress of Clinical Trials for the Treatment of Diabetic Nephropathy
XU Zhuo,TU Xiao-wen*,CAO Hai-li
Department of Nephrology,the General Hospital of the PLA Rocket Force,Beijing 100088,China
*Corresponding author:TU Xiao-wen,Associate chief physician;Email:xiaowentu@126.com
    【Abstract】  Diabetic nephropathy(DN) is one of the common complications of diabetes mellitus that threatens human health severely.Although existing interventions such as inhibition of the renin-angiotensin system(RAS),lowering hypertension and hyperglycemia have been shown to slow the progression of DN,no treatments are directed at its pathogenesis effectively.Some patients may still progress to end-stage renal disease(ESRD) ultimately.In order to offer more clinical options for DN management,we summarized the recent findings demonstrated in randomized controlled clinical trials.
    【Key words】  Diabetic nephropathy;Clinical trial;Review
 
Application and Research Progress of Psychomotor Therapy in Psychiatric Rehabilitation
ZHANG Rui-xing1,LI Li2,Michel Probst3,Uschi Germer4,GENG Yao-guo5*
1.School of Nursing,Zhengzhou University,Zhengzhou 450001,China
2.Psychiatric Center,Ninth Hospital of Zhengzhou,Zhengzhou 450053,China
3.Faculty of Kinesiology and Rehabilitation Sciences,KU.Leuven,Leuven 30033,Belgium
4.Heilpraxis PMT Center,Hamburg 21149,German
5.Department of Education,Zhengzhou University,Zhengzhou 450001,China
*Corresponding author:GENG Yao-guo,Professor;Email:gengyg@zzu.edu.cn
    【Abstract】  Psychomotor therapy(PMT) is a kind of therapy which combineds physical movement and the mental improvement.It have been testified to be an effective,low-cost,no adverse reactions and easily operated mental rehabilitation method.PMT have been increasingly widely integrated into the overall treatment plan in the rehabilitation of patients with mental disorders in the developed countries.The conception,function,mechanism,clinical application and the research progress of PMT are introduced in this article in order to provide some references for the work of psychiatric rehabilitation in China.
    【Key words】  Mental disorders;Psychomotor therapy;Rehabilitation;Exercise therapy
 
Research Progress of Cardiovascular Complications of Leber′ Hereditary Optic Neuropathy
GUO Hao1,YUAN Yong2,GUO Li3*
1.Department of Cardiology,Calmette International Hospital,Kunming Medical University,Kunming 650011,China
2.Department of Emergency Surgery,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China
3.Department of Radiology,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China
*Corresponding author:GUO Li,Associate chief physician;Email:guolidoc@163.com
    【Abstract】  Leber′ hereditary optic neuropathy (LHON) is one of the most typical and common mitochondrial hereditary diseases.Mitochondrial diseases often affect multiple tissues and organs needing high-energy metabolism,especially the nervous system,then the cardiac muscle,skeletal muscle and so on.With the constantly intensive studies on cardiovascular complications of LHON,there have been related reports on the cardiovascular abnormalities such as affection of the nervous system of heart,myocardial lesions and vascular lesions.The affection of different organ and tissue and the diverse phenotypes of LHON suggest that we should conduct cardiovascular examination to patients with LHON,and at the same time indicate the complexity of mitochondrial DNA mutations.
    【Key words】  Optic atrophy,hereditary,Leber;DNA,mitochondrial;Cardiovascular system;Complication
 
Effect of a New Type of Three-piece Safety Appliance for Restraining the Activities Applied to the Restless Patients
XU Yan*,ZHAO Bei,CAI Li
Department of Neurology,the First People′s Hospital of Lianyungang,Lianyungang 222002,China
*Corresponding author:XU Yan,Co-chief superintendent nurse;Email:xuyan6509@163.com
    【Abstract】  Objective  To explore the effect of a new type of three-piece safety appliance for restraining the activities applied to the restless patients.Methods  This study was carried out between two sample groups,the control group(66 restless patients who admitted in the ICU of Department of Neurology,the First People′s Hospital of Lianyungang and received the traditional safety appliance for restraining the activities between July and December 2015),and the experimental group(61 restless patients who admitted in the ICU of Department of Neurology of the same hospital and received a new type of three-piece safety appliance for restraining the activities between February and July 2016).We compared the incidences of unplanned extubation(UE),skin damage,rate of sedatives administration,and family satisfaction with the restraining during the period of using safety appliance between the two groups.Results  The total number of indwelling catheters was 164 in the control group,and 179 in the experimental group,the number of indwelling catheters extubated unplannedly was 18(10.98%)in the control group,and 4(2.23%)in the experimental group.The incidence of UE in the experimental group was significantly lower than that in the control group(χ2=10.894,P=0.001).The incidence of skin damage was lower in the experimental group than in the control group〔11.48%(7/61) vs.39.39%(26/66),χ2=12.848,P<0.001〕.The experimental group had lower rate of sedatives administration than the control group did〔19.67%(12/61)vs. 40.91%(27/66),χ2=6.719,P=0.012〕.The experimental group showed higher level of family satisfaction with the restraining than the control group〔85.25%(52/61)vs. 40.91%(27/66),χ2=26.506,P<0.001〕.Conclusion  The application of the new three-piece safety appliance

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