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August 2017, Volume 20, No.23 Abstracts

 New Viewpoint on 2015-2020 Dietary Guidelines for Americans

DENG Yu-hong

Department of Nutriology,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China

    Abstract  The 2015-2020 Dietary Guidelines for Americans was released in January 2016.This article focused on interpreting the updated content from previous version and compared the updated content with the 2016 Chinese Dietary Guidelines,so as to provide better service for guidance and management of public health.The recommended healthy eating patterns from the American dietary guidelines included healthy American diets,healthy Mediterranean diets and healthy vegetarian diets.It emphasized on more intake from the following food groupvegetables,fruits,whole grains,low-fat dairy products,nuts and seafood.At the meantime,it was recommended to reduce consumption of red meat and processed meat products,sugary beverages,salt and refined carbohydrates.The upper limit for cholesterol was eliminated.These recommendations were basically in line with the Chinese dietary guidelines.The American dietary guidelines also highlighted the importance of the choice of different types of fat instead of limiting total intake and eliminated the simple "low-fat diet" model.The American dietary guidelines underlined the importance of replacing unhealthy food choices with "nutrients dense" foods.It also stressed that all industries should adjust to create a healthy social and ecological environment for residents.This recommendation was worthwhile for Chinese future reference.

    Key words  Diet;Food habits;Guidebooks

 

Status and Management Strategies of Multiple Chronic Conditions in Older Adults

CUI YaoLIU QianQIN Ming-zhao*

Department of Geriatrics,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China

*Corresponding author:QIN Ming-zhao,Master supervisor;E-mailqinmingzhao58@163.com

    Abstract  The older adults often suffer from two or more chronic diseases or geriatric syndromes,and it is named as multiple chronic conditions(MCC)or multimorbidity.The prevalence of MCC is high in older adults,and it greatly increases the complexity of managing disease and the risk of poor prognosis,it also seriously affect the function and quality of life of older adults,and increase the cost of health care.Clinical management of MCC should be patient-centered,integrated and individualized.This review generally described the conceptepidemiologyinfluences of MCCas well as the strategies for clinical management.

    Key words  Comorbidity;Aged;Disease management

 

Prevalence of Comorbidity in Inpatients of Department of General Practice

MA Ke,FENG Mei*,ZHAO Rui-min,QIAO Ai-chun,LI Li-qi

 Department of General PracticeShanxi Academy of Medical Sciences,Shanxi Dayi Hospital,Taiyuan 030032,China

*Corresponding authorFENG MeiChief physicianE-mail1747003708@qq.com

    Abstract  Objective  To investigate the prevalence of comorbidity in inpatients of department of general practice,in order to provide new ideas for the prevention and treatment of comorbidity in such patients.Methods  We enrolled 1 344 cases who received hospitalized treatment in Shanxi Dayi Hospital from November 2011 to June 2014 via the information system of this hospital.We investigated the kinds of diseases occurring in them,and analyzed the association of age,sex,occupation with the kinds of diseases.Results  Of the participants,5.21%70/1 344 had one kind of disease,94.79%1 274/1 344 had comorbidities.Most of the participants had four or more kinds of diseases,specifically,59.30%797/1 344had six kinds of diseases,11.68%157/1 344had five kinds of diseases and 9.38%126/1 344 had four kinds of diseases.The kinds of diseases significantly varied by age,sex and occupationP0.05.Conclusion  The inpatients of department of general practice are found to have a high prevalence of comorbidity and many kinds of diseases,and most of them are the middle-aged and elderly people,including the retired,which indicates that the elderly are prone to comorbidities.Therefore,strengthening health education and delivering targeted medical services for the elderly are of great significance.

    Key words  ComorbidityGeneral practiceCross-sectional studies

 

Countermeasures for Polypharmacy in the Elderly with Comorbidity

XU QianBAI Song*FENG Xiang-jun,CHEN Xiao-shuang

Department of Cadre Healthcare,First Affiliated Hospital of Kunming Medical University,Kunming 650000China

*Corresponding authorBAI Song,Chief physician;E-mailbaisong523@163.com

    Abstract  In the process of organ aging and hypofunction,the kinds of chronic diseases that the elderly suffer from gradually increase,which often leads to the coexistence of many diseases,i.e.,comorbidity.The treatment of a variety of diseases requires polypharmacy,which results in problems in drug safety and other safety issues.At present,the comorbidity and associated polypharmacy in the elderly are becoming commonplace.We introduced the current status of comorbidity and polypharmacy in the elderly,analyzed the causes and likely impact of polypharmacy and put forward the corresponding countermeasures,so as to provide a reference for clinical decision making.

    Key words  Comorbidity;Aged;Polypharmacy

 

1Medication Adherence and Its Influencing Factors of Community Multimorbidity Patients

WANG Jin-ming1,LIN Sheng-qiang2,YANG Yu-ming2,MO Hai-yun1,OU Wei-lin1,OU Wen-sen1,WU Wen-lin1,YANG Zhi-peng1,ZHANG Man1,WANG Jia-ji1*

1.School of Public Health,Guangzhou Medical University,Guangzhou 511436,China

2.Lecong Community Health Service Center in Shunde District of Foshan,Foshan 528315,China

*Corresponding authorWANG Jia-ji,Professor,Master supervisorE-mailwjiaji@163.com

    Abstract  Objective  To investigate the medication adherence of community multimorbidity patients and explore the influencing factorsso as to provide reference for medical staff to formulate appropriate interventions.Methods  Nine hundred and seven patients in Lecong Community Health Service Center in Shunde District of Foshan from May and August 2016 were selected by using random sampling method.We investigated its socio-demographic data and related information of diseases.The Chinese version of the 8-item Morisky Medication Adherence Scale(MMAS-8) was used to survey the medication adherence,the overall health items of SF-36 scale was adopted to assess the self-assessed health status.And the factors associated with multimorbidity in the participants were analyzed.Results  The average MMAS-8 score was(6.4±1.7).495 cases(54.6%) got more than 6 points,412 cases(45.4%) less than or equal to 6.There were no significant differences in medication adherence among the patients with different gender,age,marital status,living conditions,educational attainment,BMI,and medication duration(P 0.05);there were significant differences in medication adherence among the patients with different medical payment methods,working situation,household monthly income per person,numbers of comorbidities,medication types,self-assessed health status(P0.05).Multivariate Logistic regression analysis found that medication adherence was affected substantially by medical payment methodsOR=1.384,95%CI1.161,1.649)〕,working situationOR=0.463,95%CI0.324,0.661)〕,numbers of comorbidities OR=1.771,95%CI1.467,2.137)〕 and self-assessed health statusOR=1.980,95%CI1.517,2.583)〕.Conclusion  Poor medication adherence was found in the multimorbidity patients managed by Shunde Lecong Community Health Service Center of Foshan,which is mainly affected by methods for paying the medical expenses,employment status,increased comorbidities,and poor self-assessed health status.Therefore,it is suggested to give the patients targeted interventions and management based on the above associated factors.

    Key words  ComorbidityCommunity health servicesMedication adherenceRoot cause analysis

 

Effect of Target Intracoronary Injection of Nicorandil for the Prevention of No-reflow Phenomenon during Emergency Percutaneous Coronary Intervention in Patients with Acute ST-segment Elevation Myocardial Infarction

QI Qi1,CHEN Tao1NIU Jing-hui2,JIANG Zhi-an1*

1.No.2  Department of Cardiology,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China

2.No.1  Department of Joint,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China

*Corresponding authorJIANG Zhi-an,Professor,Chief physician,Master supervisorE-maildoctorJiangzhian@163.com

    Abstract  Objective  To investigate the effect of target intracoronary injection of nicorandil for the prevention of no-reflow phenomenon NRP during emergency percutaneous coronary interventionPCI in patients with acute ST-segment elevation myocardial infarctionSTEMI.Methods  The enrolled 105 cases of acute STEMI receiving emergency PCI in the Third Hospital of Hebei Medical University from January 2015 to September 2016 were randomized them into nicorandil group,sodium nitroprusside group and control group with 35 cases in each,and treated with target intracoronary injection of 2 mg nicorandil diluted in 10 ml 0.9% sodium chloride solution,200 μg sodium nitroprusside diluted in 10 ml 0.9% sodium chloride solution,and 10 ml 0.9% sodium chloride solution,respectively,into the place that was 2 mm distant from the target lesion via pre-dilated balloon and pressure pump.The TIMI flow grade of infarct-related artery,corrected TIMI frame count cTFC,TIMI myocardial perfusion grade TMPG before and at the end of PCI,the incidence of NRP during PCI,the ST-segment resolution STR rate at 90 min after PCI were observed.N-terminal pro-brain natriuretic peptide NT-proBNP was measured before and at 1 week after PCI.CK-MB and cTnI were measured before and at every 4 h after PCI,and their peak levels were recorded.Color Doppler echocardiography was used to calculate the wall motion score index WMSI and left ventricular ejection fractionLVEF before and at 1 week after PCI.The incidence of hypotension during PCI and postoperative prognosis were observed.Results  Before PCI,the TIMI flow grade,the proportion of patients with TMPG grade 3,NT-proBNPvalues of CK-MBcTnIWMSI and LVEF did not differ significantly among the three groupsP0.05.After PCI,compared with control group,the value of cTFC and the incidence of NRP in nicorandil group and sodium nitroprusside group were significantly decreased,but the proportion of patients with TMPG grade 3 and the proportion of STR 50% at 90 min after PCI were significantly increased P0.05;compared with the control group,the level of NT-proBNPpeak levels of CK-MBcTnI and WMSI in nicorandil group and sodium nitroprusside group were significantly decreased,but the LVEF was significantly increased P0.05;there were no significant differences in the value of cTFC,the proportion of patients with TMPG grade 3,incidence of NRP,proportion of STR 50% at 90 min after PCI,level of NT-proBNPpeak levels of CK-MBcTnIWMSI and LVEF between the nicorandil group and sodium nitroprusside groupP0.05.The incidence of hypotension in the control group,sodium nitroprusside group and nicorandil group was 9.1%3/33,24.2%8/33 and 0,respectively,which differed significantly among the groups (χ2=10.236,P=0.006;the sodium nitroprusside group had higher incidence of hypotension than the nicorandil groupP0.01;patients with hypotension in both the control group and the sodium nitroprusside group were treated by dopamine.The incidence of MACEs 3 months after PCI was 15.2%5/33,6.1%2/33 and 5.9%2/34 in the control group,sodium nitroprusside group and nicorandil group respectively,which showed no significant differences among the three groups(χ2=2.276P=0.320.Conclusion  For patients with acute STEMI receiving emergency PCI,target intracoronary injection of nicorandil is safe,which can effectively prevent the incidence of NRP during PCI,as well as improve the myocardial perfusion and cardiac function.

    Key words  Myocardial infarctionAngioplasty,balloon,coronaryNo-reflow phenomenonNicorandil

 

Study on the Relationship between Self-reported Sleep Duration and Blood Pressure Control in Hypertensive Patients of Different Ages

DENG Li-qun1,ZUO Hui-juan2,MA Li-ping1*

1.Department of General Practice,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China

2.Beijing Institute of Heart Lung and Blood Vessel Disease,Beijing 100029,China

*Corresponding authorMA Li-ping,Chief physicianAssociate professorE-mailmaliping65@126.com

    Abstract  Objective  To analyze the relationship between self-reported sleep duration and blood pressure control in hypertensive patients of different ages.Methods  Hypertensive patients aged 35-55 years at work and aged 60-69 years with retirement were recruited from the Department of Outpatient of the Beijing Anzhen HospitalCapital Medical University from March to December 2015.General information of the patients were collected,including gender,age,family history of hypertension,whether diagnosing diabetes,whether smoking at present,whether drinking at present,physical activity in the past 1 year,and the average actual sleep duration every night in the past 1 month.Results  A total of 3 038 hypertensive patients aged 35-55 years were collected,with the average sleep duration 7.8±1.1h/d.Among them,the sleep duration in 357 cases11.8% was7 h/d,the sleep duration in 2 252 cases74.1% was 7-8 h/d,the sleep duration in 429 cases14.1% was8 h/d.There were 2 291 hypertensive patients aged 60-69 years,with the average sleep duration 7.6±1.3h/d.Among them,the sleep duration in 468 cases20.4% was7 h/d,the sleep duration in 1 406 cases 61.4% was 7-8 h/d,the sleep duration in 417 cases18.2% was8 h/d.In the 35-55 years old hypertensive patients,there were statistically significant differences in the rate of blood pressure control not up to the standard among different genders,family history,smoking,drinking and average sleep durationP0.05.In the 60-69 years old hypertensive patients,there were statistically significant differences in the rate of blood pressure control not up to the standard among different genders,body mass and physical activitiesP0.05.Multivariate Logistic regression analysis showed that sleep duration 7 h/d was a protective factor for hypertension control reaching the standard in the 35-55 years old patientsP0.05;there was no correlation between sleep duration and hypertension contr


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