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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. doi:10.3760/cma.j.issn.1671-7368.2011.03.011

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.

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Evaluation of the early prediction score system for multiple organ dysfunction syndrome in the elderly

Qingwu TAN ; Qinghua LI

Chinese Journal of General Practitioners.2011;10(3):175-177. doi:10.3760/cma.j.issn.1671-7368.2011.03.010

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.

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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. doi:10.3760/cma.j.issn.1671-7368.2011.03.025

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.

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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. doi:10.3760/cma.j.issn.1671-7368.2011.03.021

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.

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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. doi:10.3760/cma.j.issn.1671-7368.2011.03.018

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.

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Risk factors of nosocomial infection in intensive care unit

Liming YANG

Chinese Journal of General Practitioners.2011;10(3):191-192. doi:10.3760/cma.j.issn.1671-7368.2011.03.017

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.

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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. doi:10.3760/cma.j.issn.1671-7368.2011.03.008

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.

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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. doi:10.3760/cma.j.issn.1671-7368.2011.03.024

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.

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Clinical application of multi-slice spiral computed tomography imaging with post-processing technology in lamina papyracea fracture

Nuanlin WANG

Chinese Journal of General Practitioners.2011;10(3):205-207. doi:10.3760/cma.j.issn.1671-7368.2011.03.023

This paper aimed at evaluating clinical value of multi-slice spiral computed tomography (MSCT) with post-processing technology in diagnosis for lamina papyracea fracture (LPF). Volume scanning with MSCT was performed for 97 cases with LPF followed by post-processing with axial highresolution reconstruction, coronal multi-planar reformation ( CMPR), coronal maximum intensity projection (CMIP) and volume rendering (VR). Obtained images in the patients with fracture were compared with their primary axial scanning, including 42 with line-type fracture without obvious dislocation, 48 cases with depression fracture with dislocation, and seven cases with non-depression fracture showing dislocation.Twelve of them displayed "two margins sign", seven diagnosed by CMPR and CMIP images and five by VR combined with CMPR. Thirty-nine cases complicated with swelling of the intraocular muscle, 25 with intraorbital fat hernia into the ethmoid sinus, 66 cases with intraorbital air and liquid deposited at the ethmoid sinus, and 15 with retro-bulbar hemorrhage. MSCT with post-processing technology can accurately display direct and indirect signs of LPF which can be further divided into varied types, and is the most effective method in clinical diagnosis.

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Efficacy of dirithromycin and clarithromycin in treatment chronic sinusitis

Jing JIN ; Jun LI ; Linfeng YE ; Xianglei WU

Chinese Journal of General Practitioners.2011;10(3):202-204. doi:10.3760/cma.j.issn.1671-7368.2011.03.022

Fifty four patients with chronic sinusitis (without nasal polyps) were randomly divided into two groups. Thirty patients in experimental group were treated with dirithromycin and 24 patients in control group were treated with clarithromycin. The doses was both 250 mg q. d. and the duration of treatment was 3to 6 months. The VAS scores of subjective symptoms (nasal obstruction, purulent nasal discharge,headache, smell worse ) and Lund-Mackay scores of objective signs (sinus CT ) in both groups were improved significantly compared with the baseline(P ＜0.05), and there were no statistical significances between two groups ( P ＞ 0. 05 ). The curative effect was positively correlated with the duration of treatment.The total effective rates were 73% and 67% and adverse reaction rates 7% and 21% in two groups,respectively (P ＞ 0. 05 ); but the adverse reactions in control group were more serious than those in experimental group. During the six-month follow-up, no recurrence and aggravation were observed. The results suggest that low-dose dirithromycin may be more suitable for long-term treatment of chronic sinusitis.

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