1.Analysis of the diagnostic and therapeutic status of elderly benign prostatic hyperplasia
Tingjun WANG ; Chunxian CHEN ; Zhongxin WANG
Chinese Journal of Geriatrics 2012;31(11):943-946
Objective To evaluate the diagnostic and therapeutic status of elderly benign prostatic hyperplasia (BPH).Methods Totally 188 male elderly in outpatient department from January 2010 to March 2012 were enrolled in this study.Medical history was inquired in detail,and prostatic volumes (PV)were measured by abdominal ultrasound,PV≥ 20ml was diagnosed as BPH.Lower urinary tract symptoms (LUTS) was evaluated by international prostate symptom score (IPSS),prostate specific antigen (PSA) was measured.Age≥62 years,PSA≥1.6 μg/L and PV≥31 ml were considered as higher risk of clinical progression of BPH.We investigated the rate of prevalence,awareness and treatment of BPH.PV,IPSS and PSA were compared among different age groups by ANOVA.Logistic regression analysis was made to show the risk factors of BPH.Results Among 188 male elderly,the prevalence rate of BPH was 48.4%,and the total rate of awareness was 41.5%.The rate of awareness resulting from seeing doctor due to LUTS was 10.6%.PV,IPSS and PSA were increased with ageing.Risk factors contributing to BPH were age,hypertension and diabetes.The treatment rate with drugs of 5a-reductase inhibitor was 47.3 %,however 10 subjects had not been given drugs treatment among 46 patients with higher risk of clinical progression of BPH.Conclusions The prevalence rate of BPH is increased with ageing,the proportion of seeing a doctor with passion is lower because the male elderly have not paid enough attention to LUTS.And doctors have not given drugs intervention to patients with clinical progression BPH in time.We should launch propaganda and education among the elderly patients with hypertension and diabetes and take comprehensive treatment.
2.Placental transfer of epidural levobupivacaine for cesarean section
Hong CHEN ; Yi ZHAO ; Chunxian ZHU
Chinese Journal of Anesthesiology 2008;28(8):740-742
Objective To determine the placental transfer of epidural levobupivacaine for cesarean section. Methods Sixty parturients (ASA ⅠorⅡ) aged 24-35 yr weighing 60-80 kg undergoing elective cesarean section under epidural anesthesia were studied. Epidural anesthesia was performed at L1,2 or L1,3 interspace. The catheter was advanced 3 cm cephalad into the epidural space. A test dose of 0.5% levobupivacaine 5 ml with 1:200 000 epinephrine was injected. If there were no signs of subarachnoid injection in 5 min, 9-12 ml of 0.5% levobupivacaine was administered twice at 5 min interval. Arterial blood samples were taken from the double- clamped umbilical cord segment at delivery for determination of blood pH. Apgar scores at 1 and 5 min after birth were recorded. Blood samples were taken from maternal and umbilical vein for determination of plasma levobupivacaine concentration by high performance liquid chromatography ( HPLC). Results The pH of the umbilical arterial blood was ≥ 7.25. The Apgar scores at 1 and 5 min after birth were ≥ 7.0. The levobupivacaine concentration of maternal and umbilical venous blood was 0.35±0.24 and (0.24 ±0.21) μg/ml respectively at the time of delivery. The ratio of umbilical and maternal venous blood levobupivacaine concentration was 0.7 ± 0.3. Conclusion Epidural levobupivacaine can cross the placenta during cesarean section. The ratio of umbilical and maternal venous blood levobupivacaine concentration is 0.7.
3.Relationship between benign prostatic hyperplasia and urine albumin excretion
Tingjun WANG ; Chunxian CHEN ; Zhongxin WANG
Chinese Journal of Geriatrics 2014;33(2):179-182
Objective To investigate the relationship between benign prostatic hyperplasia (BPH) and urine albumin excretion.Methods A total of 258 male inpatients aged 60 to 70 years were enrolled in this study.According to prostate volume (PV) measured by transrectal ultrasonography,patients were divided into BPH group(PV≥20 ml) and NBPH(non benign prostatic hyperplasia) group(PV<20 ml).Urine albumin and urine creatinine concentrations were measured and urine albumin/creatinine ratio(UACR) was calculated.Fasting blood glucose(FBG) and fasting insulin(FINS) also were measured,insulin resistance index(HOMA-IR) was calculated based on the formula HOMA-IR=ln(FBG × FINS/22.5).The correlation between PV and other indicators were analyzed by Pearson correlation analysis.The risk factors for BPH were analyzed by logistic regression analysis.Results UACR was significantly higher in BPH group than in NBPH group[(163.6± 69.8) mg/g vs.(73.3 ± 55.6) mg/g,t =4.81,P< 0.01],and hypertension duration was longer in BPH group than in NBPH group [(9.2±6.6)years vs.(6.0±3.6)years,t=2.27,P<0.05].The prevalence rate of BPH and PV were increased along with increasing of urine albumin excretion(x2=4.58,F=4.85,respectively,P<0.05 or 0.01).Prostate volume was positively correlated with UACR,HOMA-IR,hypertension duration,body mass index(r=0.248,0.229,0.183,0.157,respectively,all P < 0.05).Logistic regression analysis indicated that UACR,HOMA-IR and hypertension duration were the risk factors for BPH(OR=16.348,1.040,0.166,respectively,all P <0.05).Conclusions BPH is correlated with UACR,which indicates that there is a close relationship between atherosclerosis and BPH.Insulin resistance probably plays an important role in the progression of arteriosclerosis and BPH.
4.Comparison of the effects of general and epidural anesthesia for cesarean section on fetuses
Chunxian ZHU ; Hong CHEN ; Hefeng HUANG
Chinese Journal of Obstetrics and Gynecology 2001;0(04):-
0.05). Conclusions Our prospective study suggests that mode of anesthesia does not influence significantly the outcome of newborn infants delivered by elective cesarean section. It seems that both general and epidural anesthesia can be used in elective term cesarean sections safely.
5.Drug Resistance Analysis in Ureaplasma urealyticum
Xunzhong SHI ; Chunxian LI ; Min CHEN ; Yuanyuan ZHANG ; Chaomei CHEN
Chinese Journal of Nosocomiology 2006;0(03):-
OBJECTIVE To investigate the drug resistance in Ureaplasma urealytium(Uu)from 2005 to 2007 in Ningbo city and guide rational drug administration in clinics.METHODS Twelve kinds of antibiotics sensitivity test in Uu which was isolated in clinics from 2005 to 2007 were analyzed retrospectivly.RESULTS The detection rate of Uu from 2005 to 2007 was 47.25%,52.66% and 61.94%,respectively.Compared with in 2005(19.96%),the resistance increased obviously to erythromycin and roxithromycin(P0.05).CONCLUSIONS Drug resistance of Uu is changing.It is necessary to monitor the local drug resistance of Uu regularly to guide reasonable administration in clinics.
6.Factors affecting postpartum stress urinary incontinence among lying-in women at ages of 35 years and older
Baiyun WANG ; Xiaoyun CHEN ; Chunxian HU ; Qiunan WU
Journal of Preventive Medicine 2022;34(9):959-963
Objective:
To investigate the factors affecting postpartum stress urinary incontinence (PSUI) among lying-in women at ages of 35 years and older, so as to provide insights into PSUI prevention.
Methods:
Lying-in women at ages of 35 years and older receiving postpartum examinations were sampled using a convenient sampling method from Hangzhou Obstetrics and Gynecology Hospital during the period from January 2021 to April 2022. Participants' demographic data, type of delivery, birth weight, diastasis recti abdominis, pelvic floor muscle strength injury, pelvic floor muscle training were collected, and the development of PSUI was evaluated using the International Consultation on Incontinence modular questionnaire. The factors affecting the development of PSUI were identified among lying-in women at ages of 35 years and older using a multivariable logistic regression model.
Results:
A total of 230 questionnaires were allocated, and 226 valid questionnaires were recovered, with an effective recovery rate of 98.26%. The lying-in women had a mean age of (37.30±2.11) years, and 75.66% had a pre-pregnancy body mass index (BMI) of 18.5 to 24.0 kg/m2. There were 29 women with postpartum BMI of 24.0 kg/m2 and greater (12.83%), 201 women with gestational weeks of 37 weeks and greater at delivery (88.94%), 105 women with vaginal delivery (46.46%), 20 women with neonatal birth weights of 4 000 g and higher (8.85%), 149 women with diastasis recti abdominis (65.93%), 154 women with pelvic floor muscle strength injury (68.14%). The prevalence of PSUI was 25.22% among the study subjects. Multivariable logistic regression analysis showed that vaginal delivery (OR=4.061, 95%CI: 2.124-7.763), postpartum BMI of 24 kg/m2 and higher (OR=1.903, 95%CI: 1.275-3.288), neonatal birth weight of 4 000 g and higher (OR=2.108, 95%CI: 1.420-4.135), diastasis recti abdominis (OR=1.487, 95%CI: 1.110-2.169) and pelvic floor muscle strength injury (OR=2.924, 95%CI: 1.726-4.803) were risk factors for PSUI among lying-in women at ages of 35 years and older, and pelvic floor muscle training was a protective factor for PSUI among lying-in women at ages of 35 years and older (OR=0.410, 95%CI: 0.216-0.780).
Conclusions
The development of PSUI correlates with the type of delivery, postpartum BMI, neonatal birth weight, diastasis recti abdominis and pelvic floor muscle strength injury among lying-in women. Reasonable weight control and active pelvic floor muscle training may facilitate the prevention of PSUI.
7.Impact of subclinical hypothyroidism on the outcome of pregnancy
Chunxian LI ; Min CHEN ; Meihong LI ; Minmin SU ; Jing LI
Chinese Journal of Endocrinology and Metabolism 2015;31(11):937-940
Objective To evaluate the impact of subclinical hypothyroidism (SCH) on the outcome of pregnancy and the therapeutic effect of L-T4.Methods A total of 1 786 pregnant women during the first, second, and third trimesters were enrolled for thyroid screening by determining serum free thyroxine (FT4), total thyroxine (TT4), thyrotropin (TSH), and thyroid peroxidase antibody;123 pregnant women with SCH were successfully divided into treated group (n =42) and untreated group (n =81).The treated group was treated by L-T4 based on American Thyroid Association (ATA) 2011 guideline.Collected items include obstetric outcomes and complications.Results (1) Compared to control group, the rate of spontaneous abortion in pregnant women during first trimesters was increased in SCH group (20.99% vs 8.45%, x2 =12.96, P =0.00), with higher incidence of diabetes during second trimester (24.69% vs 10.45%, x2 =14.11, P =0.00).The incidences of hypertension during pregnancy, premature delivery, ablatio placentae, placenta praevia, fetus growth restriction, and low birth weight showed no difference between two groups (all P > 0.05).(2) Compared with the untreated group, the incidences of spontaneous abortion and diabetes were decreased in the treated group (7.14% vs 20.99%, x2 =3.89, P =0.05;9.52% vs 24.69%, x2 =4.05, P =0.04), while the incidences of hypertension, premature delivery, ablatio placentae, placenta praevia, fetus growth restriction, and low birth weight infant accident rate were not different between two groups (all P > 0.05).Conclusions SCH during the frist trimester is a risk factor of spontaneous abortion;SCH during the middle stage of pregnancy is a risk factor of gestational diabetes mellitus.Treatment of SCH with L-T4 may be beneficial.
8.Effect of general nursing intervention on the mental state of patients with breast cancer undergoing chemotherapy
Huimei ZENG ; Chunxian CHEN ; Keru LIN ; Hongxia WANG ; Xiaolan FAN
Modern Clinical Nursing 2014;(4):50-52
Objective To investigate the effect of general nursing intervention on the mental state of the patients with breast cancer undergoing chemotherapy.Methods Forty-eight breast cancer patients undergoing postoperative chemotherapy received nursing general interventions including healthy education,psychological nursing care,pantosomatous,relaxation therapy and rehabilitative exercise. All patients were evaluated by self-rating depression scale (SDS) and depression status inventory (DSI) before and after the general intervention.Result The scores of SDS and DSI after intervention were significantly lower than those before intervention (bothP<0.05).Conclusion The general nursing intervention could significantly improve patients’ psychological state and life quality,promote rehabilitation and improve their quality of life.
9.A primary study of slice optimization of dynamic contrast-enhanced CT scan and its practical application on solitary pulmonary nodules
Liangping LUO ; Chunxian CAI ; Hejia WU ; Jincheng CHEN
Chinese Journal of Radiology 2000;0(12):-
0.05).(2)In 67 cases with pre-and post-image selection and reconstruction in single-slice or twin-slice helical CT,the slice concordance rate in measurement was 20.98% and 97.01%,respectively(?2=80.22,P=0.00).The slice concordance was all accomplished with the same method in multi-slice helical CT in 5 cases.(3)Peak heights and SPN-to-aorta ratios of malignant [(38.48?14.32)HU,(19.64?9.52)% ] and inflammatory SPN [(42.48?11.55)HU,(21.14?7.77)%] were significantly higher than that of benign SPN [(9.52?3.78)HU,(3.41?1.86)%,P0.05).Slice optimization of dynamic contrast-enhanced CT scan improved the diagnostic accuracy of SPN from 78% to 80%.Conclusion No significant efficacy was found in the attenuation between primitive images and reconstructive images with the same slice thickness of homogenous material.Slice concordance of dynamic contrast enhanced spiral CT could reflect objectively the morphological appearance and CT value changes of solitary pulmonary nodules,and may improve the veracity of diagnosis.
10.Relationship among cardioversion,cerebral infarction and NT-proBNP level in patients with heart fail-ure complicated atrial fibrillation
Yuhong ZHAO ; Hongfeng SUN ; Leijun WANG ; Chunxian QIAN ; Aijun CHEN ; Lei SHI ; Kaifeng CHEN ; Jing SUU
Chinese Journal of cardiovascular Rehabilitation Medicine 2015;24(5):498-501
Objective:To explore the relationship among cardioversion ,cerebral infarction (CI) and N terminal pro brain natriuretic peptide (NT‐proBNP) level in patients with heart failure (HF) complicated atrial fibrillation (AF) . Methods :A total of 150 HF + AF patients received intravenous drip of amiodarone for cardioversion therapy .Ac‐cording to cardioversion results ,they were divided into cardioversion group (n=100 ) and non‐cardioversion group (n=50) ,NT‐proBNP level change was observed in two groups before and after cardioversion .According to CI on‐set or not ,patients were divided into CI group (n=20) and non‐CI group (n= 130) ,NT‐proBNP level was com‐pared between two groups before and after onset .Results :Within 48h after administration ,a total of 100 patients (66.67% ) recovered to sinus rhythm .Compared with before cardioversion ,NT‐proBNP level significantly reduced [(967.04 ± 366.16) pg/ml vs .(496.21 ± 142.54) pg/ml] after cardioversion in cardioversion group ,and was signifi‐cantly lower than that of non‐cardioversion group (996.76 ± 351.28) pg/ml , P<0.01 all . In CI group ,compared with small size CI group ,there were significant rise in NT‐proBNP level [ (784.21 ± 231.26) pg/ml vs .(1983.24 ± 32.96) pg/ml ,(3562.19 ± 1468.32) pg/ml] in medium and large size CI group , P< 0.05 or <0.01 .Conclusion:NT‐proBNP level at hospitalization possesses predictive value for drug cardioversion effect in HF + AF patients . NT‐proBNP level is related with CI onset .After acute CI ,the higher NT‐proBNP level is ,the larger infarct size is , the poorer prognosis is .