1.Analysis on drug treatment protocols of out-patients with hypertension
Chinese Journal of General Practitioners 2011;10(2):120-121
The antihypertensive treatment protocols of 4102 patients from the database of Changbai Community Health Service Center of Shanghai Yangpu District were analyzed.Patients with irregular drug treatment were excluded in the study.In 4102 hypertensive patients,45.6% took calcium channel blockers (CCB),16.0% took angiotensin converting enzyme inhibitors ( ACEI),3.6% took AT1-receptor blocker (ARB),9.0% took β-adrenergic receptor blockers,4.7% took diuretics and 21.1% took compound preparation.68% patients were in single-drug protocol,29.3% in two-drug,2.6% in three-drug and 0.1% in four-drug.In patients with two-drug protocol,75.8% was based on CCB; three-drug or four-drug protocols were also based on the combination of CCB.The results indicate that the treatment protocol for hypertensive patients in our community health service center basically meets the requirements of International Society of Hypertension Treatment Guidelines,but the proportion of the single drug use seems to be high,more combination of antihypertensive drug use should by proposed.
2.Vision impairment and eye diseases in the elderly: a report from a community health center
Chinese Journal of General Practitioners 2011;10(2):122-123
The dada of 987 out-patients aged 60 or over,who visited Bajiao Community Health Center of Beijing Shijingshan District from January 2006 to December 2009,were retrospectively analyzed.The results revealed that there was no gender difference in the prevalence of low vision and blindness ( χ2 =2.719,P = 0.606); the severity of low vision and blindness was correlated with the age of patients ( χ2 =138.389,P = 0.000); cataract was the main cause of low vision and blindness,accounting for 49.6%(62/125) of low vision and 64.3% (36/56) of blindness.
3.Relationship between peripheral artery disease and metabolic syndrome among Kazakh adults lived in Xinjiang Yili prefecture
Xiao PENG ; Yitong MA ; Yining YANG ; Fen LIU ; Zhenyan FU ; Xiang XIE
Chinese Journal of General Practitioners 2011;10(3):178-182
Objective To investigate prevalence and risk factors of peripheral artery disease (PAD), metabolic syndrome (MS) and peripheral artery disease complicated with metabolic syndrome among Kazakh adults lived in Xinjiang Yili prefecture. Methods Four-stage cluster sampling method was used to select adults aged 35 years and over for the study from six cities and prefectures of Xinjiang. All the participants were interviewed with questionnaire to collect their demographic characteristics. Physical checksup and blood biochemical measurements were performed for all of them, as well as blood pressure was measured in their lower legs and arms to calculate ankle brachial pressure index ( ABPI), a ratio of the blood pressure in the lower legs to that in the arms. Only data of Kazakh adults in Yili prefecture were analyzed in this paper, including prevalence and risk factors for PAD and MS, as well as their relationship.The patients with PAD were divided into two groups, one complicated with MS and the other without it Logistic regression analysis was used to identify potential risk factors for PAD and MS and their combination.Results A total of 1365 adult Kazakh people were surveyed. Prevalence of MS was 23.7 percent, 30.4 percent for men and 19.0 percent for women, respectively, and that of PAD was 9. 4 percent, 7.0 percent for men and 11.0 percent for women, respectively. Mean age in patients of PAD complicated with MS was older than that in those without MS (t=-5.348, P<0.01). Risk of PAD complicated with MS in Kazakh people associated with gender ( men), age, systolic pressure, diastolic pressure and blood glucose level.(P<0.05). Conclusions Both prevalence of PAD and MS are significantly higher among Kazakh people in Yili prefecture of Xinjiang, and increase with age. Prevalence of PAD is significantly higher in those with MS than that in those without MS. Risk factors of PAD complicated with MS include gender(men), age,systolic pressure, diastolic pressure and blood glucose level.
4.Evaluation of the early prediction score system for multiple organ dysfunction syndrome in the elderly
Chinese Journal of General Practitioners 2011;10(3):175-177
Objective To evaluate the early prediction score system for multiple organ dysfunction syndrome in the elderly (MODSE) induced by pulmonary infection. Methods A total of 316 patients with pulmonary infection aged over 60 were admitted from 2007 Jun to 2009 Jun. All patients were scored by the early prediction score system for MODSE and then classified as high-risk group and non high-risk group. χ2 test was used to analyze the difference in morbidity of MODSE between high-risk group and non high-risk group. Receiver operating characteristic (ROC) curve was drawn, and the area under the curve, sensitivity and specificity was calculated. Results The morbidity of MODSE in high-risk group was higher than that in non high-risk group(χ2=87.569,P<0.01).The area under the ROC curve was 0.864(P<0.01).The sensitivity and specificity of the early prediction score system of MODSE were 84.2% and 72. 1%, respectively. Conclusion The early prediction score system for MODSE can be used to predict MODSE induced by pulmonary infection and to screen for the high risk population.
5.Relationship between total sermn bilirubin and carotid atherosclerosis in type 2 diabetes mellitus
Yao XU ; Tao LIU ; Jie MING ; Yao WANG ; Wensong ZHAI ; Qiuhe JI
Chinese Journal of General Practitioners 2011;10(3):209-211
Ultrasonography examinations were performed for carotid atherosclerosis in 548 patients with type 2 diabetes mellitus (T2DM). Blood glucose, glycosylated hemoglobin, total serum bilirubin, uric acid, total cholesterol ( TC ), triglycerides ( TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL) were measured. Total serum bilirubin level in T2DM patients without carotid atherosclerosis was (13.0±7. 1 )μmol/L, while that was (10. 9 ± 4. 9 )μmol/L in patients with carotid atherosclerosis (P <0. 01 ). The logistic analysis showed that total serum bilirubin level was negatively related to the presence of carotid atherosclerosis ( P < 0. 05 ), which indicated that higher level of total serum bilirubin might be a protective factor for macroangiopathy in T2DM.
6.Hirayama disease: a report of two cases and literature review
Xingyong CHEN ; Mingfeng CHEN ; Ruiling ZHOU
Chinese Journal of General Practitioners 2011;10(3):200-202
To analyze clinical, neuro-electrophysiologocal, imaging and pathological characteristics of Hirayama disease (HD) and review its relevant literatures to improve its diagnosis. Clinical data of two HD cases admitted to Fujian Provincial Hospital, Fuzhou during 2005 to 2008 were analyzed with literatures review. HD occurred more in males, often onset at their adolescence with muscular weakness and atrophy in one or two upper limbs, but without sensory dysfunction or pyramidal signs. Neuro-electrophysiology showed neurogenic abnormality in the body areas dominated by the 4th cervical vertebra to the 1 st thoracic vertebral (C4-T1) spinal nerves in all the patients. Magnetic resonance imaging (MRI) showed slight atrophy of the lower cervical spinal cord at routine position and its compression and forward displacement to varied extent at flexion position, with posterior epidural capsular space widening, crescent or striped high signal, and voids of vessels in some patients. Enhancement magnetic resonance scanning showed crescent sign enhanced in some patients. Biopsies of the inflicted muscles appeared slight neurogenic abnormality in some cases, and normal in other cases. HD is rarely seen clinically, but it can usually be diagnosed according to its symptoms, neuro-electrophysiology and MRI.
7.Serum melatonin levels and expression of inducible nitric oxide synthase mRNA in leucocytes of elderly diabetic patients
Aiqing LIN ; Minglong LI ; Dong SUN ; Dexia WANG
Chinese Journal of General Practitioners 2011;10(3):192-194
Seventy newly diagnosed diabetic patients were enrolled in the study, including 37patients aged over 60 (elderly-onset diabetes, EOD group) and 33 patients under 60 (adult-onset diabetes,AOD group) ; 30 elderly healthy subjects served as controls. Serum melatonin levels were determined with ELISA and the expression of inducible nitric oxide synthase (iNOS) mRNA in peripheral blood leucocytes (PBL) was detected by reverse transcription polymerase chain reaction (RT-PCR). The results showed that serum melatonin levels were significantly lower in EOD group than those in control group [ (6. 6 ± 1.3 )ng/L vs. (7.7 ± 1.4) ng/L, P <0. 01 ], the expression of iNOS mRNA was significantly higher than that in AOD group [ (36 ± 3 )% vs. (30 ± 4)%, P < 0. 01 ]; and i NOS mRNA was not detected in control group.Logistic regression analysis indicated that decreased serum melatonin levels and up-regulated iNOS mRNA might be independent risk factors for diabetes mellitus in the elderly.
8.Risk factors of nosocomial infection in intensive care unit
Chinese Journal of General Practitioners 2011;10(3):191-192
The clinical data of 195 patients in intensive care unit (ICU) were retrospectively analyzed. The total nosocomial infection rate was 15.5% in this group of patients; respiratory tract was the predominant site of infection (71.0%); the most common infection microorganism was Gram-negative bacteria (65. 1% ) ,the top two pathogens were Escherichia (32. 6% ) and Staphylococcus ( 11.6% ). The risk factors of nosocomial infection in ICU were female sex, high age, invasive mechanical ventilation, long hospitalization in ICU, multiple organ dysfunction syndrome (MODS), etc.
9.Correlates of treatment compliance in infertile patients with polycystic ovary syndrome
Saijiao LI ; Jing YANG ; Aiyan HE ; Tailang YIN ; Wangming XU ; Yujie ZOU
Chinese Journal of General Practitioners 2011;10(3):166-170
Objective To investigate factors that correlated to compliance of treatment in infertile patients with polycystic ovary syndrome (PCOS) to provide basis for clinical treatment, specialist consultation and health education. Methods Compliance was assessed by a questionnaire designed by reference to Morisky-Green test and therapeutic principles for PCOS. Interviews were performed in 128 infertile patients with PCOS in Renmin Hospital of Wuhan University, Wuhan, Hubei in China during March 2009 to September 2010. Data were analyzed with logistic regression. Results Logistic regression analysis revealed that a total of 41 (34.2% ) of 120 participants investigated showed good compliance. Factors that might significantly (P < 0.05 ) correlate compliance of treatment included body mass index (BMI) of the patients ( OR = 2.426, 95% CI = 1.428 - 4.121 ), length of their marriage ( OR = 0.398, 95% CI =0.225 - 0.704) and their concerns for adverse drug reactions ( OR= 0.216, 95% CI = 0.067 - 0.694).Conclusions Patients with obesity, shorter length of marriage and concerns for adverse drug reactions show lower compliance. Publicity and intervention to those patients should be strengthened in clinics to improve their treatment compliance in patients with PCOS.
10.Analysis of 41 cases with functional dyspepsia complicated by psychological disorders
Qibin JIA ; Li LI ; Ying YIN ; Yujing FAN ; Yu LAN
Chinese Journal of General Practitioners 2011;10(3):207-209
In our gastroenterology clinic from Jun. 2008 to Jan. 2009, 20. 9% (277/1320) patients were diagnosed with functional dyspepsia (FD) and 14. 8% (41/277) of them with psychological problems according to Minnesota Multiphasic Personality Inventory (MMPI). In those with psychological disorders,92.7% were found with somatization, 60. 9% with depression and anxiety, 97.6% with abdominal pain,75.6% with bloating, 63.4% with early fullness and 36. 6% with nausea. More than 80% patients with anxiety and depression complained irritability, worry, fatigue, poor concentration, memory loss and insomni.a. After 4 weeks of psychological consultation and anti-depression treatment, 5 patients had significant improvement, 31 had improvement and 3 had no response. The overall response rate was 87. 8%.In summary,there is a high prevalence of depression and anxiety in population with FD. Hypochondria and somatization are common among these patients. Psychological consultation with anxiolytic drugs may have good therapeutic effects.