1.New-onset constipation after stroke: incidence, risk factors and impact on the prognosis of stroke
Yongjing SU ; Zhenlu ZHANG ; Xiaoyan ZHANG ; Jianling TAN ; Jinsheng ZENG
Chinese Journal of Nervous and Mental Diseases 2006;32(4):300-305
Background Constipation is a common complication after stroke, and the results investigated overseas showed the incidence was about 30% ~60%. The difference of results is so significant because the time investigated and the diagnosis criterion used are different. There are less relative report about risk factors of constipation and no report about the impact of constipation on pragnosis. The study is to investigate the incidence and risk factors of new-onset constipation after stroke in the patients with acute stroke and to evaluate the impact of new-onset constipation occurrence on the prognosis in the patients.Methods A prospective cohort study of new-onset constipation was performed to investigate 154 cases of acute stroke patients who were hospitalized from December 2003 to October 2004 in the department of neurology, the first Affiliated Hospital of Sun Yat-sen University. We recorded the demographics, medical history,stroke severity and medication used. National Institutes of Health Stroke Scale (NIHSS), Barthel Index (BI)and Modified Rankin Scale (MRS) were evaluated in the 1st week and 4th week after stroke to evaluate the neurological function and ability of an independent life. BI and MRS were recorded at the 12th week after stroke.Patients were then followed for the development of stroke, the event such as recurrence or death. Constipation was defined by Rome Ⅱ criteria.Results The incidence of new-onset constipation after stroke within 4 weeks was 55. 31%, and the highest risk was within seven days after onset of stroke. Cox regression showed that the incidence of constipation occurrence was strongly related to neurological functional status of patients in the 1st week assessed by BI and the transform of surrounding for defecation. In the 4th week and 12th week after stroke, the rates of poor prognosis in patients with constipation in middling state were both higher than patients without constipation, and the difference was statistically significant respectively(P < 0. 01 ;P = 0. 012).Conclusions The new-onset constipation occurrence in acute stroke is very common and its main risk factor is functional status assessed by Barthel Index at the 1st week after onset and the transform of surrounding for defecation. The results indicate that the new-onset constipation occurrence after stroke has negative effects on the outcome of partial stroke patients.
2.Quality of life of discharged senile patients with chronic diseases and influencial factors
Tianwen HUANG ; Li PENG ; Yunjuan TAN ; Yuantao HAO ; Yongjing SU ; Xiaoyan ZHANG ; Shifeng DENG ; Yan XIAO
Modern Clinical Nursing 2014;(1):12-16
Objective To investigate the quality of life of patients with chronic diseases as well as the influencing factors. Method Two hundred and fifty five elderly patients with chronic disease from 3 hospitals in Guangzhou involved in the survey by adopting WHO quality of life-old(WHO OQOL-OLD)to investigate the quality of life and influencial factors.Results The quality of life of the elderly patients was in middle level.In the dimension of Past,Present and Future Activities,the quality of life was statistically different between the patients with different chronic diseases(P<0.05);In the dimension of Autonomy and Death&Dying, the quality of life was statistically different between those with and without cerebrovascular diseaseor(all P<0.05);In the dimensions of Autonomy,Social Participation,Death and Dying and Intimacy,the quality of life was statistically different between those needing care and no care after discharge(all P<0.05).Conclusions The quality of life of the elderly patients with chronic diseases is in middle level.The influencing factors for the quality of life include contracting multiple diseases,needing care after discharge and cerebrovascular diseases.At discharge,nurses should regulate instructions for them for the purpose of improving their autonomy,social participation and adaptability after discharge. Thus,their quality of life can be improved.
3.Upregulation of CD147/MMP-9 pathway attenuates early left ventricular remodeling in rats with spontaneous hypertension
Wanxing ZHOU ; Bowei LI ; Xiaorong YANG ; Yuliang ZHOU ; Yongjing TAN ; Congcong YUAN ; Yulan SONG ; Xiao CHEN ; Wei ZHANG
The Journal of Practical Medicine 2015;(8):1229-1233
Objective To investigate the effects of CD147/MMP-9 pathway on early left ventricular remodeling Methods 30 healthy eight-week male SHR were divided into 3 groups (n = 10 for each group). SHR group received tail vein injections of normal saline weekly; CD147 group received CD147 of 600 ng·kg-1 weekly; and CD147+DOX group received CD147 of 600 ng/kg weekly and intragastric administration of DOX ( doxycycline ) of 30 mg/kg daily . 10 healthy eight-week male Wistar-Kyoto rats (WKY group) were treated as SHR group. Echocardiography, myocardial sections microscopy examination (HE and VG stain), and Western blot (for assessing levels of MMP-9, TIMP-1, CD147, and collagen I and Ⅲin myocardial tissues) were performed on day 56. Left ventricular weight index (LVWI)was measured and calculated. Collagen volume fractions (CVF) were obtained by image analysis. Results As compared with WKY group , levels of CD147 , MMP-9 , and MMP-9/TIMP-1 were lower but TIMP-1 and collagenⅠand Ⅲ were significantly higher in SHR group. The abundance of CD147 and MMP-9 protein and the ratio of MMP-9/TIMP-1 were obviously increased in CD147 group than in SHR group (P < 0.05). Levels of CD147, MMP-9, and MMP-9/TIMP-1 did no differ between CD147+DOX group and CD147 group. LVWI and contents of collagenⅠand Ⅲ were obviously declined in CD147 group as compare with SHR group. Cardiomyocyte hypertrophy , partial myocardial fibre rupture , myocyte dissolution and fuzzy myocardial fibre boundaries , more abundant of collagen fibers, and higher CVF were found in SHR group. Cardiac fibrosis was significantly improved after CD147 intervention, but the action was suppressed as DOX was administrated simultaneously. Conclusions Early ventricular remodeling may be involved in the inhibition of CD147/MMP-9 pathway in SHR. Input of CD147 to upregulate the pathway can improve the remodeling.