1.Influence of nursing intervention according to comprehensive geriatric assessment on quality of life in ;aged patients with coronary heart disease
Haihong QU ; Changxiang CHEN ; Airu XU ; Limeng MA ; Yanmin YAO ; Min WEI
Chinese Journal of cardiovascular Rehabilitation Medicine 2014;23(2):209-212
Objective:To explore influence of nursing intervention according to comprehensive geriatric assessment (CGA)on quality of life (QOL)in aged patients With coronary heart disease (CHD).Methods:A total of 96 aged CHD inpatients admitted in department of cardiology from Mar 2012 to Mar 2013 Were enrolled.According to num-ber table method,they Were randomly divided into routine nursing group (n=48,received specific nursing of cardi-ology department)and CGA group (n=48,received nursing intervention according to CGA based on routine nurs-ing).Chinese questionnaire of quality of life in patients With cardiovascular disease (CQQC)Was used to score and compare each dimension of QOL betWeen tWo groups at admission and on 6-month after discharge.Results:Com-pared With routine nursing group after intervention,there Were significant increase in scores of physical strength [(7.35±4.12)scores vs.(10.86±5.06)scores],patient's condition [(4.57±0.85)scores vs. (8.75±4.54) scores],medical condition [(4.72±0.82)scores vs.(5.90±0.40)scores],general living [(3.85±1.45)scores vs. (5.22±1.95)scores],social psychological conditions [(3.67±1.52)scores vs.(8.41±3.22)scores],Working sta-tus [(0.70±0.64)scores vs.(0.97±0.66)scores]and total score of CQQC [(24.86±4.43)scores vs.(40.11± 9.05)scores]in CGA group,P<0.01 or<0.05.Conclusion:Nursing intervention according to comprehensive geri-atric assessment can improve quality of life in aged patients With coronary heart disease.
2.Analysis of clinical and pathological features of 12 cases of Fabry disease
Jie MA ; Jianjun TIAN ; Yubing WEN ; Yan QIN ; Limeng CHEN ; Wenling YE ; Xuemei LI
Basic & Clinical Medicine 2015;(1):90-94
Objective To investigate the clinical and pathological features of Fabry disease in Chinese patients. Methods This retrospective study included all in-patients Fabry disease patients at PUMC Hospital from 2004 to 2014.Results The 12 patients included 10 males and 2 females.The middle age at onset was 10.The most fre-quent symptoms in our group were pain(10/12), angiokeratoma(9/12), renal abnormalities (7/12), hearing loss ( 6/12 ) , hypohidrosis ( 5/12 ) , cardiac abnormalities ( 5/12 ) , cerebrovascular abnormalities ( 3/12 ) and ophthalmological abnormalities ( 3/12 ) .The severe clinical manifestations were more frequently found in males . Electron microscopy plays a very important role in pathological diagnosis of Fabry disease .7 patients were suspec-ted to have family history .5 patients were examined regularly in which 4 cases were stable , and 1 patient re-ceived hemodialysis after 3 years'follow-up.Conclusions Onset of Fabry disease is early, many organs could be involved and patients may have different clinical manifestations.There are great differences in clinical features be-tween male and female patients .
3.Monitoring and analysis of radioactive contamination in Beijing following the Japanese Fukushima nuclear accident
Yun LOU ; Ling WAN ; Yongzhong MA ; Huijuan LI ; Qinghua MENG ; Yuxia KONG ; Weijie ZHU ; Dapeng WU ; Limeng CUI
Chinese Journal of Radiological Medicine and Protection 2012;32(2):129-132
Objective To monitor the levels of radioactive contamination due to the Japanese Fukushima nuclear accident in Beijing,so as to provide scientific technical information for government to draw effective controlling strategy and processing mechanism.Methods The system of nuclear emergency nmonitoring was started,then the radioactive contamination levels of atmosphere,rain water,surface water and vegetables in Beijing were detected according to the relative survey regulations and technology criterions.Results During the period from 15 to 41 d after the accident,obvious radioactive contamination was found in the atmosphere of Beijing.The maximum radioactivity concentration of 131I ( 5.89 mBq/m3 ) was detected at 22 d after the accident.The radioactivity concentrations of 137Cs and 134Cs were surveyed forming their corresponding peaks at 20 d after the accident,but they were one magnitude lower than the peak value of 131I at least.In addition,the gross β radioactivity level in the water of Chao Bai-he river was verified to be in the range of 0.314 - 0.602 Bq/L. Conclusions The radioactive contamination due to Fukushima nuclear accident has not done visible harm to the public health in Beijing,but monitoring should be continued to observe the long-term effect of the accident.
4.Influence of holidays on peritoneal dialysis patients: an observational study
Ying MA ; Lei LEI ; Haiyun WANG ; Zijuan ZHOU ; Yang LI ; Ying WANG ; Wei YANG ; Baoyan HUANG ; Xuemei LI ; Limeng CHEN
Chinese Journal of Clinical Nutrition 2017;25(4):233-239
Objective To observe the clinical parameters, self-management, and compliance in peritoneal dialysis (PD) patients before and during Spring Festival, and to describe holiday syndrome in PD patients.Methods We prospectively observed PD patients with regular follow-up in our center before Chinese Spring Festival (January 8-February 7, 2016) and during Chinese Spring Festival (February 8-March 8, 2016).Demographic and clinical characteristics, self-management, and compliance with its influencing factors were collected by face-to-face method in outpatient care.Results Totally 130 PD patients were enrolled.The average age was (58.5±15.4) years, and women accounted for 53.1%.The primary diagnosis was diabetic kidney disease (32.3%), followed by primary glomerulonephritis (26.2%).Fourteen patients (10.8%) received automated peritoneal dialysis (APD), and most of the remaining patients chose continuous ambulatory peritoneal dialysis (CAPD,73.8%), with a median dialysis age of 34 months.During the 4-week followed-up, the appetite was stable, while the serum phosphate and pre-albumin increased [(1.5±0.4)mmol/L vs.(1.6±0.4)mmol/L, P=0.025;325.3 (272.2,355.1)mmol/L vs.326.0(284.2,376.5)mmol/L, P<0.01, respectively].No difference was observed in edema, dyspnea, and nighttime lying flat.However, the weight elevated significantly [(61.3±13.9)kg vs.(63.4±13.0)kg, P=0.002], with the median peritoneal ultrafiltration volume increased from 783.3 ml to 900.0 ml (P=0.005).During the holiday, the incidences of dialysis-related infections were unchanged, while the incidences of digestive system comorbidities increased significantly (5.4% vs.13.8%, P=0.021).As for the compliance, 8 patients reduced their PD cycles during the holiday, which was more frequent than before holiday (P=0.018).One patient changed his PD pattern, and 6 patients did not follow the medication orders.Demographic characteristics such as gender, age, and marriage conditions were not associated with the compliance.Conclusions Holiday syndrome remarkably affects PD patient''s volume load, metabolism, and compliance.Poor self-management of PD patients during holidays needs further concern.
5.Glycemic variability in hemodialysis patients: implications, characteristics and interventions
Hua ZHENG ; Ying MA ; Limeng CHEN
Chinese Journal of Clinical Nutrition 2018;26(1):54-60
Glycemic variability is an important indicator for glycemic control and an independent risk factor for cardiovascular events and overall mortality in type 2 diabetes.Hemodialysis patients have greater challenge controling glycemic variability because patients of end-stage renal disease generally have more "brittle" glycemic hemostasis and dialysis itself may cause extra disturbance.In this article,we present an overview on the characteristics,cause,potential damage,and intervention of glycemic variability in hemodialysis patients.
6.Application of comprehensive geriatric assessment nursing model on the quality of life in elderly patients with coronary heart disease
Haihong QU ; Changxiang CHEN ; Airu XU ; Limeng MA
Chinese Journal of Modern Nursing 2014;20(20):2485-2488
Objective To explore the effects of the comprehensive geriatric assessment ( CGA) nursing model on the quality of life in elderly patients with coronary heart disease ( CHD ) .Methods A total of 143 cases of hospitalized elderly patients with CHD were randomly divided into two groups , from January 2012 to June 2013 .The control group ( 69 cases ) was given the cardiovascular specialty nursing and the CGA group (74 cases) was given the cardiovascular nursing based on the CGA nursing model .The scores of patients ’ physical strength, illness, medical condition, general life, social psychology, working and interpersonal relationship were surveyed using the questionnaire of quality of life in patients with cardiovascular diseases ( CQQC) when patients first admitted to the hospital and 6 months after discharge .Results In the CGA group , 75.7%patients had two or more kinds of elder problems , within which 67.6% was depression, 66.2% was sleep disorder, 62.2% were hearing disability and 60.8% was visual disability.Before the intervention, the scores of quality of life between groups had no significant differences (P >0.05).After the nursing intervention, the scores of physical strength , illness, medical condition, general life, social psychology, working and interpersonal condition in the CGA group were (10.86 ±5.06), (8.75 ±4.54), (5.90 ±0.40), (5.22 ±1.95), (8.41 ±3.22), (0.97 ±0.66) and (40.11 ±9.05).Those scores in the control group were (7.35 ±4.12), (4.57 ±0.85), (4.72 ±0.82), (3.85 ±1.45), (3.67 ±1.52), (0.70 ±0.64) and (24.86 ±4.43).The differences of scores between groups were significant ( t =4.541, 7.545, 11.137, 4.720, 11.095, 2.470, 12.653, respectively;P <0.05 ).Conclusions Based on the comprehensive evaluation, the CGA nursing model can play a positive role in clinical nursing of elderly CHD patients , and it also can improve the quality of life in elderly patients with CHD .
7.Effect of peritoneal dialysis on glycemic variability in patients with diabetes and its clinical implications
Zijuan ZHOU ; Hua ZHENG ; Wei LI ; Ying MA ; Haiyun WANG ; Fan PING ; Xuemei LI ; Yuxiu LI ; Limeng CHEN
Chinese Journal of Clinical Nutrition 2018;26(5):261-266
Objective To compare glycemic profile between diabetic patients receiving peritoneal dialysis and diabetic patients with normal kidney function, and to investigate the impact of peritoneal dialysis on glycemic control through continuous glucose monitor system ( CGMS). Methods 19 diabetic patients with end-stage renal disease receiving regular peritoneal dialysis (DMPD group) and 8 patients with non-diabetic ne-phropathy receiving regular peritoneal dialysis ( PD group) were randomly selected and matched with 20 diabetic patients with normal kidney function (DM group) based on age, gender and 72 hours mean glucose. CGMS were applied on all patients for 72 hours. Glycemic variability parameters were compared among the three groups. Results Peritoneal transport function was positively correlated with mean glucose, glucose standard deviation and mean amplitude of glycemic excursion. Compared with PD group, multiple variation parameters, such as intraday glycemic standard deviation (P<0. 001), covariant efficiency (P=0. 009) and mean of daily difference (P=0. 043), were significantly lower in DMPD group. Though both DMPD and DM group exhibited profile as trough in wee hours and post-prandial hyperglycemia, DMPD had higher glycemic level in wee hours (P<0. 001). Conclusion Diabetic patients with end-stage renal disease receiving regular peritoneal dialysis have smaller glucose variability than diabetic patients with normal renal function.
8.Situation and enlightenment in an environmental radioactivity and public health perspective seven years after Fukushima nuclear power plant accident
Limeng CUI ; Takamura NOBORU ; Yongzhong MA
Chinese Journal of Radiological Medicine and Protection 2019;39(8):619-623
Since the accident on March 11th 2011 at the Fukushima Daiichi Nuclear Power Station following the Great East Japan Earthquake,huge amount of radionuclide has been released to the surrounding environment.In this study,the environmental monitoring method,γ-ray dose rates,radioactivity in environmental samples,food,wild animals and plants,health situation of residents were summarized.Through summarizing the accident experience of Fukushima Daiichi Nuclear Power Station,this research discussed and analyzed the accident combining with the situation in China.
9.Kimura disease with renal impairment: case series and literature review
Rongrong HU ; Lei ZHANG ; Jie MA ; Cai YUE ; Yubing WEN ; Wei YE ; Wenling YE ; Ke ZHENG ; Yan QIN ; Limeng CHEN ; Xuemei LI
Chinese Journal of Nephrology 2022;38(3):196-202
Objective:To analyze the clinical and pathological characteristics, treatment and prognosis of renal changes in patients with Kimura disease and improve the clinicians′ understanding on renal manifestations of Kimura disease.Methods:The clinical data of Kimura disease patients with definite diagnosis and detailed data in Peking Union Medical College Hospital from January 1980 to August 2020 were retrospectively analyzed. The patients were divided into renal impairment group and non-renal impairment group according to whether the kidney was involved or not and the related clinical data between the two groups were compared. The patients presenting with nephrotic syndrome were followed up.Results:There were 60 patients with Kimura disease confirmed by pathological diagnosis with 48 males. The median age was 33(3, 62) years old, and the median duration was 36(12, 111) months. There were 18 cases complicated with renal injury in 49 patients with complete routine urine and renal function examination and the main manifestations of renal injury were proteinuria and/or microscopic hematuria. There was no significant difference at age, sex and absolute value of eosinophils between the two groups (all P>0.05). Compared with the renal inpairment group, patients in non-renal inpairment group had longer course of disease, higher levels of hypersensitive C-reactive protein and erythrocyte sedimentation rate, and lower median values of total eosinophils and total IgE, but there was no statistically significant difference (all P>0.05). Among the patients with renal involvement, 6 patients met the diagnostic criteria for nephrotic syndrome, and 5 of them completed renal biopsies. The renal pathological diagnosis was membranous nephropathy in 2 cases and minimal change disease in 3 cases, and no interstitial eosinophil infiltration was found in renal biopsy tissues. These patients had a good response to glucocorticoids and/or immunosuppressive therapy, and achieved complete remission of nephrotic syndrome; at the same time, lymphadenopathy caused by Kimura disease could be well controlled. Conclusions:Kimura disease can combine with various renal lesions, and the pathology of nephrotic syndrome can be membranous nephropathy or minimal change nephropathy. After energetic treatment of glucocorticoids and/or immunosuppressive therapy, nephrotic syndrome can be completely relieved, and lymphadenopathy can be well controlled. The relationship between Kimura disease and renal disease needs further study.
10.Survival analysis in automated peritoneal dialysis patients
Xiaoyan PENG ; Haiyun WANG ; Yang LI ; Ying WANG ; Zijuan ZHOU ; Ying MA ; Bingyan LIU ; Wei YANG ; Ying CUI ; Limeng XUEMEI ; Chen LI
Chinese Journal of Nephrology 2017;33(10):738-744
Objectives To compare the clinical characteristics, long - term survival and associated risk factors of automated peritoneal dialysis (APD) patients and continuous ambulatory peritoneal dialysis (CAPD) patients. Methods As a retrospectively study, adult patients started peritoneal dialysis in Peking Union Medical College Hospital (PUMCH) from September 1st, 2002 to September 30th, 2016 were enrolled. Baseline information and dialysis associated parameters were collected. The primary outcome was death and the secondary outcome was technical failure. The risk factors of death were analyzed in APD patients by Cox's regression model. Homochromous gender and age matched CAPD patients were analyzed as control. Results The baseline condition of 69 APD patients were similar to those of 138 CAPD patients. The survival rates of APD patients at 1-year、3-year and 5-year were 95.4%, 88.0% and 73.0% respectively, which were superior to CAPD patients. No significant difference in technical survival was found between APD and CAPD patients. Single-factor Cox's regression analysis showed that all-cause mortality of CAPD patients was 2.2 times higher than that of APD patients (95% CI 1.221-3.837). In the multi-factor Cox regression analysis model, adjusted by age, complications (including cardiovascular disease and diabetes), nPCR and serum creatinine, dialysis modality was not an independent risk factor of dialysis patients. Age (HR=1.077, 95%CI 1.016-1.142, P=0.013), diabetes (HR=3.608, 95%CI 1.117-11.660, P=0.032) and serum albumin (HR=0.890, 95%CI 0.808-0.982, P=0.020) were independently associated with all-cause death of APD patients. Conclusions Dialysis modality was not an independent risk factor for the all-cause mortality of peritoneal dialysis patients. Age, diabetic nephropathy and hypoalbuminemia were independently associated with the death of APD patients.