1.Analysis for results of cervical cancer screening among 4006 women at Qiaozi Town, Huairou District, Beijing
Chunling HOU ; Guixiang LI ; Jingjing CHEN
Chinese Journal of General Practitioners 2010;09(8):576-577
In total, 4006 women aged 25 -65 years at Qiaozi Town, Huairou District, Beijing were screened for cervical cancer during April to June, 2009. Results showed that 54. 52% of the women screened suffered from varied gynecological illness, highest in those aged 30 - 34 years ( 80. 90% ) and lowest in those aged 50 -54 years. The top three gynecological morbidity among them were cervicitis (34. 77% ), virginities ( 12. 88% ) and uterine leiomyoma (8. 34% ). Precancerous lesions in 12 women,endometrial cancer in one woman and cervical cancer in one woman were detected by cervical cytological examinations.
2.The influence of different postures on the efficacy of mechanical ventilation in critically ill patients with 2009 H1N1 influenza
Zhigang ZHANG ; Bin SHI ; Bin LI
Chinese Journal of General Practitioners 2010;09(8):551-552
28 patients with acute respiratory distress syndrome caused by 2009 H1N1 influenza were mechanically ventilated for 1 hour in the supine, lateral, semi-supine, lateral prone, and prone position respectively. Changes of heart rate, respiratory parameters and arterial partial pressure of oxygen ( PaO2 )were measured. There were no significant differences ( P > 0. 05 ) of heart rate and mean arterial pressure among these postures. Lateral prone ( P < 0. 05 ) and prone posture ( P < 0. 01 ) , however, can both significantly improve tidal volume, mean airway pressure, PaO2, static lung compliance and oxygenation index. We concluded that mechanical ventilation delivered in the prone position can remarkably improve oxygenation in patients with H1N1 influenza-associated acute lung injury.
3.Effects of continuous positive airway pressure treatment on patients of obstructive sleep apnea syndrome accompanying with asthma
Lijun RUI ; Mei SU ; Xilong ZHANG
Chinese Journal of General Practitioners 2010;09(8):532-535
Objective To investigate effects of continuous positive airway pressure (CPAP)treatment on pulmonary function, frequency of asthmatic attack, and quality of life in patients of moderate to severe obstructive sleep apnea syndrome (OSAS) accompanying with asthma. Methods Twenty-three patients of OSAS accompanying with mild-to-moderate asthma were studied. They were divided into two groups, gastroesophageal reflux ( GER ) group ( n = 9 ) and non-GER group ( n = 14 ), based GER questionnaire score equal to or greater than 12, or less than 12. Pulmonary function tests (PFTs), Epworth sleepy score (ESS), quality of life for obstructive sleep apnea (QOLAp) score, quality of life for asthma (QOLAs) score and polysomnography (PSG) were measured for all the patients before and after four-week CPAP, respectively. Results No significant difference in PFTs was revealed before and after four-week CPAP between the two groups. However, there was significant difference in scores of QOLAp, ESS and QOLAs before and after four-week CPAP treatment, ( 12. 8 ± 2. 8 ) and (4. 6 ± 0. 9), ( 5. 1 ± 0. 7 ) and (6.3 ±0.6), and (4. 1 ±0.5) and (6.3 ±0.5) in GER group, and (13.0 ±2.9) and (4.6 ± 1.1),(4.7±0.5) and (5.6±0.6), and (3.6±0.3) and (5.8 ±0.6) in non-GER group, respectively (P<0. 01 or 0. 05). Frequencies of asthmatic attack and nocturnal asthmatic attack reduced to ( 1.7 ± 1.1 )episodes per week and (0. 7 ± 0. 3) episodes per week after four-week treatment from (2. 9 ± 2. 0) episodes per week and ( 1.4 ± 0. 8) episodes per week before treatment ( P < 0. 05 ) in GER group, but no significant difference was found before and after treatment in non-GER group. Scores of QOLAs increased more significantly in GER group than that in non-GER group ( P < 0. 05 ). Conclusion CPAP treatment can significantly improve quality of life, rather than pulmonary function, in patients of OSAS accompanying with asthma, especially in those with GER symptoms.
4.Cryptogenic organizing pneumonia: a case report and literature review
Zhenshun CHENG ; Jiong YANG ; Yuhui LIN ; Yanqing YE ; Bing LIU ; Han ZHANG
Chinese Journal of General Practitioners 2010;09(7):489-491
We reported a case of cryptogenic organizing pneumonia ( COP) who was admitted to the hospital in July 2008 and reviewed the Chinese literature of COP from 2003 to 2008. The most common symptoms of COP are fever, cough and exertional dyspnea. The imaging characteristics of COP are similar to those of pneumonia, therefore is often misdiagnosed as pneumonia with a high misdiagnosis rate. Lung biopsy is the main method for pathological diagnosis; polypoid growth of granulation tissue was noted within respiratory bronchioles, small airways and alveolar spaces.
5.Hypertension control in communities:analysis of implementation of non-pharmaceutical management
Zengwu WANG ; Linfeng ZHANG ; Xin WANG ; Wen WANG ; Weiwei CHEN ; Manlu ZHU ; Shengshou HU ; Zhenglong LEI ; Lingzhi KONG ; Lisheng HU
Chinese Journal of General Practitioners 2010;09(7):461-465
Objective To assess effectiveness of implementation of non-pharmaceutical treatment in a standardized community-based hypertension management program in China.MethodsA protocol of standardized community-based hypertension management was developed based on current guidelines for prevention and treatment of hypertension in China.Physicians in community health-care service centers at the grassroots across China were trained in a standardized way using this protocol during 2005 to 2008,and then the trainees were required to manage hypertensive patients according to the protocol.Hypertensive patients eligible for criteria of inclusion and under management for more than one year were analyzed to observe changes in their behavioral risk factors,pharmaceutical and non-pharmaceutical treatment,and effectiveness of blood pressure lowering.ResultsBy the end of 2008,a total of 29 411 hypertensive patients had been managed for one year according to the protocol and 20 077 patients with complete data (47.1% for male)with mean age of 61±11 years were eligible for analysis.After standardized management of one year,prevalence of smoking,alcohol drinking and proportion of patients who preferred salty diet decreased from 17.7 percent,18.1 percent and 32.8 percent to 8.9 percent,8.7 percent and 15.8 percent,respectively(P<0.01).Srstolic blood pressure(BP)decreased by 11.6[95%confidence interval(CI)10.8-12.4]mm Hg(1 mm Hg=0.133 kPa),13.7(95%CI 13.3-14.1)mm Hg and 15.2(95%CI14.8-15.6)mmHg in the patients with non-pharmaceutical therapy,pharmaceutical therapy and both,respectively;and diastolic BP decreased by 7.5(95%CI6.9-8.1)mm Hg,8.3(95%CI8.1-8.5)mmHg and 8.0(95%CI7.8-8.2)mm Hg in the three groups,respectively.During the one-year period of management,proportion of the patients with appropriate non-pharmaceutical therapy increased continuously.By the end of one-year management,59.5 percent of smoked patients were required to quit their smoking,55.5 percent of alcohol drinkers were required to limit their drinking,52.3 percent of overweight and obese patients were required to reduce their weight and 47.3 percent of patients with physical exercises less than three times a week were required to increase their regular physical activity.However,certain proportion of the patients with risk factors did not receive appropriate non-pharmaceutical therapy.Conclusion Guideline-oriented hypertension management succeeded in lifestyle changes among the patients,but it is a gradual process to its full implementation.
6.Changes of physical activity status of residents in Beijing Yayuncun community
Wanxiang XIAO ; Feng XIAO ; Yan LI ; Yanlan XIAO ; Yi SONG ; Ruili LI ; Jun MA ; Bowen CHEN
Chinese Journal of General Practitioners 2010;09(7):457-460
Objective To evaluate the changes of physical activity status of residents in Beijing Yayuncun(Asian Games Village)Community.Methods A total of 1765 permanent residents over 15 from 600 families living in Yayuncun Communities since 2000 were selected in this prospective study.Thebaseline survey was carried out with the Questionnaire for Residents of Beijing Typical Community in 2004 and 2005.From 2006 to 2008,same questionnaire was used for the follow-up survey,and 1412 residents were responded to the questionnaire.Results The knowledge levels related to physical exercise of Yayuncun residents elevated(P<0.01).The source of knowledge gain from Olympics Games promotion,specialized community lectures and intemet increase significantly(P<0.01),that from other media decreased(P<0.01).The exercise rate in community was higher than in other sites(P<0.01)and increased significantly (P<0.05);while doing exercise in charged sites decreased(P<0.05).Logistic regression analysis showed that regular physical exercise was related to age,BMI,exercise-related knowledge,exercise sites,attitude for sport facilities and chronological order.Conclusion During the preparation for the Beijing Olympic Games.the status of physical exercise of residents in Yayuncun Community presented the positive trends.
7.Thinking of training for general practitioners and its preliminary practice
Yunjie LIU ; Yanhong WANG ; Jianguo ZHU ; Lin ZHANG
Chinese Journal of General Practitioners 2010;09(7):482-483
For the issues existed in training of general practitioners, with characteristics of community health-care service centers (CHS) and large-scale urban hospitals, a training model of exchange physicians between hospitals and CHSs was formulated. After three-month practice, a general practitioner-specialist technical cooperation group was established. The new model not only promoted construction of a two-way referral system, but also created environmental condition for training community physicians.
8.T lymphocyte sub-populations in malignant and tuberculous pleural effusion or ascites
Baoxin SU ; Qing LI ; Jiafeng NIU ; Jinling WANG ; Shucui LI ; Tianling ZHANG
Chinese Journal of General Practitioners 2010;09(7):470-473
Objective To determine counts of T lymphocyte sub-populations in malignant and tuberculous pleural effusion or ascites and evaluate its significance in difierential diagnosis.Methods T lymphocyte sub-populations in pleural effusion or ascites and peripheral blood were determined in 30 patients with tuberculosis and 31 patients with cancer by flow cytometry.Concentrations of cytokines Th1 and Th2,γ-interferon(IFN-γ),interleukin-12(IL-12)and IL-4 in pleural effusion or ascites were measured by enzyme-linked immunosorbent assay(ELISA).Results Compared to that in peripheral blood,percentage of CD3+ and CD4+ T-celI counts were all higher in both malignant and tuberculous pleural effusion or ascites [(73±6)%and(67±20)%vs.(51±19)%and(48±14)%,P<0.05].Although CD3+T-cells count was higher in tuberculous pleural effusions or ascites,no difference in ratio of CD3+ and CD4+/CD3+ and CD8+ T-cell counts was found between malignant and tuberculous pleural effusions or ascites.However,ratios of IFN-γ and IL-12 to IL-4 were higher in tuberculous pleural effusion or ascites(54±24 and 82±19vs.8±6 and 19±10,t=10.34 and 16.28,respectively,P<0.01).Conclusions CD3+ and CD4+ Tcells can be aggregated in both malignant and tuberculous pleural effusions or ascites,80 nature (tuberculosis or malignancy)of pleural effusion or ascites can not be differentiated by CD4+ and/or CD8+ T-cell counts only,and determination of cytokines Th1 and Th2 can help their differentiation.
9.Relationship between serum brain natriuretic peptide level and short-term prognosis in patients with acute myocardial infarction
Xubo WANG ; Hongtao PAN ; Dozhi SHI ; Dongqing ZHANG ; Jun ZHAO
Chinese Journal of General Practitioners 2010;09(7):466-469
Objective To investigate relationship between serum level of brain natriuretic peptide (BNP)and short-term prognosis in patients with acute myocardial infarction(AMI).Methods Ninetynine patients with AMl with elevated S-T segment in electrocardiogram admitted to the department of cardiology,the Fourth Hospital of Jilin University,Changchun during January to December 2008 were divided into two groups.one with percutaneous transluminal coronary angioplasty(PTCA)or pereutaneous coronary intervention(PCI)(61 eases)and the other without PTCA(38 cases)as controls.Their serum levels of BNP were measured at admission, and one day and seven days after admission,respectively,and their main adverse cardiac events(MACE)were followed-up and recorded for 30 days.Results No significant differenee in serum BNP level between the patients at admission and one day after admission was found(P<0.01).Seven days after admission,serum BNP level in PCI group was significantly lower than that in controls(P<0.01),and occurrence of MACE was significantly lower in PCI group than that in controls(P<0.05).Logistic regression analysis indicated that serum BNP level in PCI group seven days after admission was the uppermost predictor for MACE in patients with AMI in one month after onset(OR=1.026,95%CI 1.014-1.038,P<0.01).Serum BNP level was significantly higher in patients with MACE seven days after admission than that in those without it(P<0.01)during 30-day followup.Conclusion Serum level of BNP seven days after admission is associated with their short-term prognosisfor patients with AMI.
10.An study on significance of clinical scales in diagnosis for pulmonary embolism
Kebin CHENG ; Jinming LIU ; Beilan GAO
Chinese Journal of General Practitioners 2010;09(7):453-456
Objective To assess diagnostic value of Wells and Geneva seales in patients with suspected pulmonary embolism(PE).Methods Clinical data of 958 consecutive cases of suspected PE admitted to Shanghai Pulmonary Hospital form January 1,1995 to January 1,2009,were analyzed retrospectively,and all patients were assessed with Wells and Geneva scales,respectively for likelihood of PE,as compared to those diagnosed by lung imaging Results Three hundred and forty-seven patients with PE were diagnosed with lung imaging as gold standard,sensitivity,specificity,and positive and negative predictive values for Wells scale and Geneva scale in diagnosis for PE were 82.4%,58.1%,52.8%and 85.3%.and 88.8%,55.3%,53.1%and 89.7%,respectively,with positive and negative likelihood ratios.Youden index and crude agreement of 1.97,0.30,0.41 and 0.21,and 1.99,0.20,0.44 and 0.25.respectively.Area under the receiver operating characteristic(ROC) curve of Geneva scale(0.79)was significantly more than that of Wells scale(0.73)(Z=2.25,P<0.05).As compared to Wells scale,sensitivity and specificity for Geneva scale in diagnosis for PE was significantly higher(χ2=7.12 and 6.84,respectively,P<0.05).Conclusions Although there is a considerable gap in accuracy between clinical scales and lung imaging in diagnosis for PE.both Wells and Geneva scales can be used in clinical screening for PE to save unnecessary cost.however,Geneva scale is more practical and accurate than Wells scale,worthwhile to be popularized clinically.