Objective To discuss how to use the core elements of international classification of functioning,disability and health(ICF) as a guide in stroke operation treatment to develop targeted,effective therapy plan and rehabilitation goals,establish individualized treatment of rehabilitation,and to observe the effect of limb movement function in stroke patients. Methods Sixty cases patients with stroke and aged from 40 to 65 years old were selected. The body function and structure of all stroke patients were marked by comprehensive evaluation scores of The National Institutes of Health Stroke Scale ( NIHSS ) and Fugl?Meyer assessment. And then they were randomly divided into two groups,30 cases in each group. The observation group used the Chinese version of brief ICF Core Sets for evaluation, and set individualized treatment according to the results of the assessment;The control group, according to the conventional rehabilitation process, involved in training routine physical therapy. Again 8 weeks after treatment for patients with evaluation,the assessment results was compared with the results of the first assessment. Results Before treatment, the NIHSS, Fugl?Meyer assessment and Chinese version of brief ICF core elements scale scores for the observation group were 7. 95±2. 37,34. 5±4. 0 and 82. 15±17. 96,for the control group were 7. 58±2. 25,34. 8±4. 0 and 81. 55±18. 78. After treatment,the above three rating scale scores, for the observation group were improved to 4. 78 ± 1. 63, 56. 3 ± 4. 2, 60. 45 ±11. 04,for the control group were improved to 5. 13±1. 75,48. 1±3. 8,73. 56±16. 89. The two groups were significantly improved ( observation group:t=4. 94, 15. 51, 18. 59, P<0. 05;control group:t=3. 17, 14. 66, 12. 33,P<0. 05). After treatment,compared with the control group of three rating scale scores(5. 13±1. 75,48. 1
±3. 8 and 73. 56±16. 89),the observation group(4. 78±1. 63,56. 3±4. 2 and 60. 45±11. 04) improved more apparently(t=3. 15,14. 54,15. 45,P<0. 05) . Conclusion Guided by the idea of ICF and scale,with the demand of the patients as the center,to develop personalized physical therapy,can achieve more productive and more targeted rehabilitation goals.

Objective To observe the therapeutic effect of acupoint injection with nucleotide plus conventional western medicine treatment for moderate and severe chronic obstructive pulmonary disease (COPD).Methods Sixty patients confirmed as moderate and severe COPD were evenly randomized into treatment group and control group.The treatment group was given conventional western medicine treatment and injection with nucleotide on bilateral Dingchuan points,and the control group was given conventional western medicine treatment alone.The treatment lasted for one year.The frequency of COPD acute onset and hospitalization times within one year were recorded.Meanwhile,the severity of dyspnea was evaluated with Medical Research Council (MRC) dyspnea scale scoring.Results (1)The frequency of COPD acute onset and hospitalization times within one year in the treatment group were lowered,and the differences were significant compared with those in the control group (P ＜ 0.05 or P ＜ 0.01).(2) After treatment,MRC dyspnea scale scores in the treatment group were improved (P ＜ 0.05 compared with those before treatment),but the improvement of the scores was insignificant in the control group(P ＞ 0.05).The intergroup comparison showed that the effect on improving MRC dyspnea scale scores in the treatment group was superior to that in the control group (P ＜ 0.05),indicating that the severity of dyspnea was much improved in the treatment group as compared with the control group.Conclusion Acupoint injection with nucleotide is effective on enhancing the therapeutic effect of conventional western medicine treatment for moderate and severe COPD.

Objective To evaluate the association between serum HDL-C and the risk of cardiovascular diseases(CHD) in subjects aged 35-64 years. Methods A prospective study was carried out in 11 provinces from 1992 to 2002. The association of baseline HDL-C level and cardiovascular disease occurrence was analyzed in 30384 subjects aged 35-64 years using Cox multivariate proportional hazards regression. Results (1) Compared with the group of HDL-C≥1.56 mmol/L, multivariate-adjusted relative risk of ischemic cardiovascular disease(ICVD), including CHD and ischemic stroke increased continuously with decreased HDL-C level. (2)HDL-C level had different impact on different types of CVD.Positive association was observed between HDL-C level and the risk of ischemic stroke,but the relationship between HDL-C level and the risk of hemorrhagic stroke was indefinite. Compared with the group with HDL-C≥1.56 mmol/L,the risk of CHD of the group with HDL-C≤1.03 mmol/L increased by 45%(RR=1.45,P＜0.05)and that of ischemic stroke increased by 53%(RR=1.53,P＜0.01).(3)6.4% of ICVD,7.2% of the acute CHD and 7.3% of the acute stroke was attributable to low serum high density lipoprotein cholesterol. Conclusions Starting from HDL-C≥1.56 mmol/L, the risk of ICVD increasescontinuously with decreased HDL-C level. Comprehensive intervention for multiple risk factor clustering should be strengthened to reduce theoverall risk of CVD.

Objective To explore the 15-years change in fasting TG level and the accumulative incidence of type 2 diabetes mellitus (T2DM) from 1992 to 2007,and to assess the association between the change in TG level and the accumulative onset risk of T2DM.Methods A total of 11 387 subjects aged 35-64 years were recruited from 6 provinces in China in the baseline survey in 1992,and were followed-up for cardiovascular disease till 2007.In 2007,9184 subjects were successfully followed-up and 5966 subjects entered into the second examination.Totally 5408 participants,who were free of diabetes at baseline and had complete information for both check ups,were included in this analysis.Fasting TG levels were categorized into three groups:＜ 1.70 mmol/L,1.70-2.25 mmol/L and ≥2.26 mmol/L.The association between 15-years change in TG level and the accumulative onset risk of T2DM was assessed by logistic regression analysis.Results In 1992,the mean level of TG was 1.49 mmol/L in male and 1.26 mmol/L in female.During the 15 years,TG levels increased by 0.25 mmol/L and 0.53 mmol/L in male and female,respectively.The prevalence of elevated TG ( ＜ 1.70 mmol/L) increased from 23.4％ in 1992 to 39.0％ in 2007.The 15-year accumulative incidence of diabetes was 13.9％ in male and 11.8％ in female.The incidence rates were 10.5％,16.2％ and 26.6％ for TG levels of ＜ 1.70 mmol/L,1.70-2.25 mmol/L and ≥2.26 mmol/L,respectively.Multivariate logistic regression analysis showed that the baseline TG level was significantly associated with the onset risk of diabetes after adjustment for other cardiovascular risk factors.At any given baseline TG level,the onset risk of diabetes increased with the TG levels in the second examination in 2007.After adjusting other risk factors,participants with the highest categories of both baseline and follow-up TG levels had 2.1 folds higher accumulative onset risk of diabetes ( RR =3.39,95％CI 2.49-4.61 ) than those with the lowest categories of both baseline and follow-up TG levels.Conclusion Baseline TG level is independently associated with diabetes onset risk,and the change of TG level in a 15-year interval predicts the onset risk of diabetes beyond the baseline TG level.

Objective To analyze the distribution of multiple risk factors for hospitalized patients with acute coronary syndromes (ACS) and explore the status and determinants of drug usage recommended by the guideline.Methods This was a multi-center cross-sectional study in 34 hospitals from 22 provinces in China.About ninety ACS patients were consecutively enrolled from each hospital since April 15,2012 according to a standard protocol.Totally,3 253 patients with complete data were analyzed in this study.Results (1) The average age of male patients with ACS was lower than that of female patients (60.4 years vs 66.2 years,P ＜0.01).Nearly 60％ of ACS patients were under the age of 65 years.Early onset of ACS accounted for one-third of male (＜ 55 years of age) and two-fifthes of female patients (＜ 65 years old).(2) Among the four ACS major risk factors (hypertension,hyperlipidemia,smoking and diabetes),hypertension was with the highest prevalence (68.4％).More than 90％ of ACS patients had at least one risk factor and about two-thirds of them had at least two.(3) As for the application of evidence-based drugs,the top one was aspirin with 95.3％ of ACS patients reseiving it.The second was statins (90.1％).Angiotensin converting enzyme inhibitors (ACEI) or angiotension Ⅱ receptor blocker(ARB) was the lowest (53.6％).Multivariable analysis indicated that,in contrast to that in ACS patients without percutaneous coronary intervention(PCI),the drug usage rates were increased by more than 30％ for ACEI or ARB and β receptor blockers,by more than 50％ for statins,and by 4-7 times for antiplatelet agents among ACS patients with PCI.Conclusions In China,more than 90％ of hospitalized patients with ACS carried at least one major risk factor.There is still room for improving in the application of drugs recommended by the guidelines,especially for ACS patients without PCI.

Objective To evaluate the current status of aspirin for primary prevention in hypertensive outpatients in China,and the gap between aspirin use and guidelines.Methods This was a multi-center cross-sectional study and carried out in hypertensive patients from 46 hospitals of twenty two cities in China from June to December in 2009.At least 100 essential hypertensive outpatients were consecutively recruited from each participant hospitals according to the consistent inclusion criteria.The patients underwent physical examinations and biochemical analyses,and answered questionnaires.Based on the relevant guidelines,the risk assessment of cardiovascular disease (CVD) is a prerequisite for the proper use of aspirin in primary prevention.Results A total of 5 206 hypertensive outpatients were included.Among them,1 324 (25.4％) were with a history of CVD.Among those with no history of CVD,2 705 patients (69.7％) were at high risk of CVD,and the aspirin utilization rate for primary prevention was 29.2％,with 32.2％ patients at high risk and 22.4％ patients at low-medium risk of CVD,respectively.In the application of aspirin for CVD primary prevention,the inappropriate aspirin use rate in patients at lowmedium risk was 23.3％.Conclusions The proportion of subjects at high risk for CVD is high in hypertensive outpatients suggesting a wide range of application space for aspirin.There exists underutilization for high risk and overutilization for low-medium risk patients in current aspirin primary prevention application.

Objective To study the prevalence of hypertension in a Beijing urban population aged 6074 years and to analyze the characteristics of hypertension distribution. Methods A(cross-sectional) study was carried out in the population consisting of 1175 people,and data of blood pressure,glucose,lipid and obesity were analyzed. Results (1) The age-adjusted prevalence of hypertension was 60.5% in the Beijing elderly population.About two thirds of the hypertensive cases were taking prescribed medication(60.9%).Only one quarter of hypertension was controlled successfully(23.4%).(2)Compared with 60-64 age group,the prevalences of hypertension of 70-74 age group was increased by 30.3% in man and by 32.1% in women.(3) The prevalence of isolated systolic hypertension in the elderly was 25.0%,accounting for 42.3% of hypertension in the elderly population.(4) Eighty-six percent of all elder hypertensive patients had one and more cardiovascular risk factor and more in addition to hypertension itself. Conclusions High blood pressure is a popular disease of cardiovascular disorders in Beijing elderly population.Isolated systolic hypertension is the main hypertension subtype in the elderly.Most of the elderly hypertension patients combine other cardiovascular disease risk factors.

This study was aimed to evaluate the effect of region of interest (ROI) on measurement of apparent diffusion coefficient (ADC) obtained in diffusion-weighted (DW) MR sequences between spinal tuberculosis and malignancy, selecting the more reasonable and effective measurement of ADC value. We collected the conventional MR sequences and diffusion-weighted imaging data of thirty-two patients with spinal tuberculosis or malignancy confirmed clinically and pathologically from August 2009 to June 2010. Using the conventional MRI as a guide, the signal intensity (SI) and ADC value were calculated by selecting single ROI and the same area multi-ROI within whole lesion at the largest slice of lesion respectively. Using ADC value defined by receiver operating characteristic (ROC) curve analysis as threshold, the sensitivity, specificity, and accuracy of ADC value for diagnosing spinal tuberculosis were compared. The results showed that the mean of ADC value at signal ROI was lower than that at the multi-ROI. There was no significant difference between the ADC value of single ROI and multi-ROI. The ADC values from spinal tuberculosis and spinal malignancy obtained in single ROI or multi-ROI showed significant differences. The sensitivity, specificity, and accuracy of ADC value for differentiating tuberculosis from neoplastic infiltration at signal ROI is lower than that at the multi-ROI. In conclusion, the ADC acquired multi-ROI can describe preferablywater molecular diffusion and is more useful in differentiating spinal tuberculosis from malignant bone marrow lesions.
Adult ; Algorithms ; Diagnosis, Differential ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Humans ; Image Interpretation, Computer-Assisted ; Male ; Middle Aged ; Spinal Neoplasms ; diagnosis ; Tuberculosis, Spinal ; diagnosis

Based on Moens-Korteweg model & hydrostatic principle, a simple calibration method by changing vertical distance between heart and radial artery is proposed in this paper. Using hydrostatic pressure to change arterial pressure and pulse wave transmit time, consequently obtain several sets of cardiovascular parameters and finally build up relationship between blood pressure and pulse wave transmit time. Clinical tests have been carried with different age and gender for long and short time monitoring. The comparison results with Sphygmomanometer OMRON EW3152 show its promising accuracy and coincidence feature in blood pressure measurement.
Blood Pressure Determination ; instrumentation ; methods ; Blood Pressure Monitors ; Calibration ; Equipment Design

Objectives To explore the characteristics of status and different populations of prehospital death associated with acute coronary events among young adults in Beijing.Methods Data of acute coronary events of hospitalization or death were obtained from the Hospital Discharge Information System from Beijing Public Health Information Center and Death Register System from Beijing Center for Disease Control in Beijing.The total case fatality rate of acute coronary events and proportion of prehospital coronary heart disease (CHD) death were compared upon gender,area,occupation and marital status among people aged between 25-45 years old.Results A total of 3489 cases were identified during 2007 to 2009 with acute coronary events ( male:3183,female:306),with a mean age of (40.5 ± 4.3 ) years old.The 3-years' overall mortality was 26.0％,with female's higher than male's (51.0％ vs 23.6 ％,P ＜ 0.05 ) ; and it was higher in rural area than in urban areas (28.9％ vs 22.9％,P ＜0.05).Ninety-five percent of death due to acute coronary events occurred prehospital,with the proportion of 95.2％ in male and 94.2％ in female. Among the people with different occupations, self-employed people had the highest rate of prehospital death.Majority of prehospital deaths (64.8％ ) occurred at home.Conclusion More than 90％ of deaths caused by acute coronary events among young adults aged between 25-45 years old occurred before been admitted into hospital,and the site of prehospital deaths was mainly at home.