1.Comparison of blood pressure control in community hypertensive patients with different management methods
Mei ZHU ; Junling GAO ; Guiqin JIN ; Jianying ZHENG ; Qin HUANG ; Jueying CHEN ; Zhigang PAN
Chinese Journal of General Practitioners 2015;14(1):15-19
Objective To compare blood pressure control in community hypertensive patients with different management methods.Methods Two neighborhood committees in a community of Pudong were selected as study area using cluster sampling method.A total of 5 166 residents aged ≥35 y were screened for blood pressure; the subjects with high blood pressure and had antihypertensive medication in last 6 months were included,and patients with secondary hypertension was excluded.The patients who entered community hypertension management program and got medication from community were included in community group; those who did not enter in community management program and/or not get medication from community were included in non-community group.Self-designed questionnaire was used for investigation.The medication compliance,awareness of hypertension risk factors and high blood pressure control were compared between two groups.Results Among 5 166 residents 4 763 were surveyed for hypertension with a response rate of 92.2% and hypertension prevalence rate of 23.2% (1 105/4 763).Among 1 012 patients with drug treatment for more than 6 months,there were 878 cases in community (86.8%) and 134 cases (13.2%) in non-community group.There were no significant differences in gender,age,education,working condition between community group and non-community group (P > 0.05).44.3% (389/878) patients in community group had a history of high blood pressure > 10 y and that was 56.7% (76/134) in non-community group (P =0.011) ; 28.6% (251/878) patients in community group were at high risk for risk stratification and that in non-community group was 47.8% (64/134) (P <0.001).The awareness of hypertension risk factors in community group and non-community group was 83.9% and 95.5%,respectively (P < 0.001).The medication compliance and blood pressure control rates in two groups were 93.2 % and 84.3 % (P < 0.001),68.6% and 51.5 %,respectively (P < 0.001).Conclusion The outcomes of hypertension management in terms of medication compliance and blood pressure control in community group are better than those in non-community group.
2.Effect of ventilation with different positive end-expiratory pressures on intracranial pressure in patients undergoing gynecological laparoscopic surgery
Yujuan WU ; Yang ZHANG ; Jueying ZHENG ; Keshi YAN ; Ke LUO ; Xue DONG ; Ju GAO
Chinese Journal of Anesthesiology 2018;38(10):1230-1233
Objective To evaluate the effect of ventilation with different positive end-expiratory pressures (PEEPs) on intracranial pressure in the patients undergoing gynecological laparoscopic surgery.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 25-55 yr,with body mass index of 18-27 kg/m2,scheduled for elective gynecological endoscopic surgery,were divided into 3 groups (n=20 each) using a random number table method:routine ventilation group (group A),4 cmH2O PEEP group (group B) and 8 cmH2O PEEP group (group C).The patients were mechanically ventilated with PEEP 4 or 8 cmH2O at 5 min of head-down tilt after start of pneumoperitoneum in group B and group C.The patients were mechanically ventilated in volume-controlled mode,with tidal volume 7 ml/kg,inspired oxygen concentration 50% and inspiratory/expiratory ratio 1 ∶ 2.Blood samples were collected from the radial artery for measurement of PaCO2 and PaO2 at 5 min after tracheal intubation (T0),5,15 and 30 min of head-down tilt (T1-3),and 5 min of the supine position after the end of pneumoperitoneum (T4).The peak airway pressure (Ppeak) was recorded,dynamic pulmonary compliance (Cdyn)was calculated,and optic nerve sheath diameter was measured using an ultrasonic apparatus at T0-4.Cognitive function was assessed at 1 day before surgery and 7 days after surgery using Mini-Mental State Examination.Results Compared with group A,Ppeak was significantly increased at T1-4,and PaO2 was increased at T2 in group B,and Ppeak and PaO2 were increased at T1-4,and Cdyn was increased at T1,2 in group C (P<0.05).Compared with group B,Ppeak was significantly increased at T4,and Cdyn was increased at T2 in group C (P<0.05).There was no significant difference in optic nerve sheath diameter or Mini-Mental State Examination score at each time point among three groups (P>0.05).No patients developed cognitive dysfunction at 7 days after surgery in three groups.Conclusion Ventilation with different PEEPs causes no increase in intracranial pressure of the patients undergoing gynecological laparoscopic surgery.