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Recent effect of warfarin anticoagulant therapy for 130 elderly cases after heart biological valve replacement in Yunnan-Guizhou plateau

Yinqiang LIU ; Jie TAO ; Baihui YANG ; Jianmin XIA ; Xueyu ZHANG ; Guimin ZHANG

The Journal of Practical Medicine.2014;(9):1490-1492. doi:10.3969/j.issn.1006-5725.2014.09.048

Objective To investigate the reasonable anticoagulant therapy for patients over sixty five years old in Yunnan-Guizhou plateau after heart biological valve replacement , and study the standard of reasonable anticoagulant therapy. Methods We collected the recent cases by retrospective way . Low-intensity anticoagulation standard INR (1.5~2.5) was used on 130 patients over sixty five years old. The warfarin dose and anticoagulation INR values in different surgery operation were compared when the patients reached the stable anticoagulation status. The frequency of INR values and warfarin dosage were studied. The differences between the patients with high risk factors and the ordinary patients without the high risk factors in INR values and warfarin dosage were investigated. Results The INR values and warfarin doses showed no significant difference (P > 0.05) in different operation groups when they reached stable anticoagulation status. The INR values was 1.94 ± 0.50 and the daily warfarin dose was (2.45 ± 0.82)mg/d. No significant differences in INR values and warfarin doses were found between the high-risk group and the general group (P>0.05) in steady-state. During follow-up, both the incidence rate of thrombosis and general bleeding were 0.77%. Conclusion The precent study showed that the low-intensity anticoagulation INR values (1.5~2.5) can be the standard of reasonable anticoagulation in Yunnan-Guizhou plateau after heart biological valve replacement with satisfactory anticoagulant effect.

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The intervention effects of prevention and treatment modes of hypertension in people living in agricultural and pastoral areas

Nanfang LI ; Ling ZHOU ; Jing HONG ; Feiya ZU ; Delian ZHANG ; Hongmei WANG ; Xiaoguang YAO ; Lei WANG

The Journal of Practical Medicine.2014;(9):1486-1489. doi:10.3969/j.issn.1006-5725.2014.09.047

Objective To explore an effective mode for the prevention and control of hypertension in agricultural and pastoral areas in Xinjiang by comparing the effect of mode A with that of B in blood pressure-lowering treatment. Methods 1445 patients with hypertension in agricultural and pastoral areas were included in this study. They voluntarily received mode A or B blood pressure-lowering treatment. The changes in heart rate , blood pressure, lipid, and glucose, and the incidences of cardiovascular and cerebrovascular events and adverse events were noted;and the effect of modes A and B was compared. Results 87.07%of the patients chose mode A group, while 12.93%chose mode B. The rate of pressure control was 70.71%in mode A group and 68.75%in mode B group , with no significant statistical difference (P>0.05). In 12th month of treatment, the decreased level of systolic pressure was (19.09 ± 20.33)mmHg in the group with mode A and (14.14 ± 17.85) mmHg in the group with mode B, showing a significant statistical difference between the two groups (P=0.047); and the declined level of diastolic pressure was (11.17 ± 13.23)mmHg and (8.17 ± 11.17) mmHg, respectively, with no significant statistical difference. Conclusion Mode A blood pressure-lowering treatment can effectively control blood pressure in hypertensive patients living in agricultural and pastoral areas in Xinjiang.

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Clinical evaluation of two gene diagnostic techniques for the detection of drug resistance of Mycobacterium tuberculosis

Juan ZHANG ; Bingqi SUN ; Jiao SUN ; Xiuhua SUN

The Journal of Practical Medicine.2014;(9):1482-1485. doi:10.3969/j.issn.1006-5725.2014.09.045

Objective To evaluate the effect of probe melting curve analysis and gene chips on detecting drug resistance of Mycobacterium tuberculosis against isoniazid and rifampicin. Methods Drug resistance was detected by gene chip and probe melting curve analysis in 46 cases of patients with sputum smear positive specimens, with L-J culture as the gold standard. Results In all the 46 cases, the detection of drug resistance genes against isoniazid was performed by probe melting curve analysis and gene chips, achieving the coincidences of 91.3% and 80.43% with those by L-J culture, respectively. The detection of drug resistance genes in 38 cases administered with rifampicin was conducted as well by the two techniques, achieving the coincidences of 84%and 89.4% with those by L-J culture. There were no significant differences between the two methods (P > 0.05). Conclusion The gene chip direct detection and probe melting curve analysis are of high value in diagnosis of tuberculosis, and they can be regarded as a diagnosis method of choice for tuberculosis. Both have the priorities of timesaving, high sensitivity and specificity.

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Effects of amiodarone on rapid heart rate atrial fibrillation in elder patients with acute myocardial infarction

Baoliang GUO ; Xiaona LI

The Journal of Practical Medicine.2014;(9):1476-1478. doi:10.3969/j.issn.1006-5725.2014.09.043

Objective To explore the effects of amiodarone on rapid ventrile rate atrial fibrillation (Af) in elder patients with acute myocardial infarction (AMI). Methods Besides the injection, an oral amiodarone was given to 96 elder patients,observing the condition of converting and maintaining of atrial fibrillation,ventricular rate controlling, blood pressure changing,mortality in 30 days and negative effects in 96 elder patients with AMI and Af. Results Eighty-two cases (84.4%) restore sinus rhythm, the cardioversion rate is 85.4%(P<0.01). 8 cases failed to cardioversion, 6 cases died . The ventricular rate were significantly lowered than before the treatment (P<0.01). All cases appeared no significant changes in blood pressure (P>0.05). Conclusion In AMI, vein plus oral application amiodarone treat the fast ventricular rate is effective and safety for patients with Af.

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Value of the dual phase 18F-FDG PET/CT in the diagnosis of recurrent and metastatic bladder cancer after surgery

Hongsheng LI ; Hubin WU ; Qiaoyu WANG ; Yanjiang HAN ; Quanshi WANG

The Journal of Practical Medicine.2014;(9):1450-1453. doi:10.3969/j.issn.1006-5725.2014.09.034

Objective To investigate the clinical value of dual phase 18F-FDG PET/CT in the diagnosis of recurrent and metastatic bladder cancer after surgery. Methods The imaging data from 84 patients underwent the dual phase 18F-FDG PET/CT after surgery with known histories of bladder cancer were analyzed. Among the 84 patients, 16 had symptoms of recurrence, 24 had symptoms of metastasis and 44 didn′t have any symptom. The median interval time between the primary tumor resection and the PET/CT scan was 11.5 months (0.5 ~ 240 months). According to the PET/CT imaging procedures, all patients underwent whole body PET/CT scan at 60 minutes after IV injection of 18F-FDG. Additional delayed pelvic PET/CT images were acquired after forced diuresis by using oral 40 mg furosemide. The 18F-FDG PET/CT findings were compared with histopathologic examination results and (or) the clinical follow-up. All patients were followed up for more than six months. Results Results of detecting recurrence and metastasis of bladder cancer showed that the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of the dual phase FDG PET/CT imaging protocol were 91.7%(22/24), 95.0%(57/60), 94.0%(79/84), 88.0%(22/25), 96.6%(57/59) and 90.0%(27/30), 96.3%(52/54), 94.0%(79/84), 93.1%(27/29), 94.5%(52/55), respectively. Conclusion Dual phase FDG PET/CT can be used to detect the recurrence and metastasis with high accuracy, contributing to the restaging and follow-up in bladder cancer after surgery.

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Clinical efficacy of CPAP for obstructive sleep apnea hypopnea syndrome in elderly patients

Rui SUN

The Journal of Practical Medicine.2014;(9):1427-1429. doi:10.3969/j.issn.1006-5725.2014.09.026

Objective To compare the efficacy of continuous positive airway pressure (CPAP) with that of surgical treatment for obstructive sleep apnea-hypopnea syndrome (OSAHS) in elderly patients. Methods Seventy patients with OSAHS were divided into a study group and a control group according to different treatment methods. The study group received CPAP, while the control group underwent surgical treatment. One month after treatment, apnea-hypopnea index (AHI), lowest oxygen saturation (LSaO2), ESS scale value, coagulation factors, and platelet count were measured in both groups. Results AHI and LSaO2 were lower and ESS scale value was higher in the study group than in the control group, but with no significant differences (P>0.05). After treatment, all the indexes of coagulation factors were increased in the control group, but only plasma clotting factorⅡactivity had a significant statistical difference (P<0.05); (FⅡ: C) and (FⅧ: C) were significantly lower in the study group than in the control group (P<0.05); platelet count significantly increased in the control group (P<0.05), but markedly declined in the study group (P<0.05). Conclusions Both CPAP and surgical treatment have a better effiacy for obstructive sleep apnea-hypopnea syndrome. CPAP can more effectively improve coagulation function and lower the risks of complications.

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Correlation factors of hospital stay and hospitalization costs among AIS patients

Yu WAN ; Jun ZHANG

The Journal of Practical Medicine.2014;(9):1420-1423. doi:10.3969/j.issn.1006-5725.2014.09.024

Objective To explore the correlation factors of hospital stay and hospitalization costs among patients with acute ischemia stroke (AIS). Methods The clinical data of the patients with first diagnosis of AIS at Peking University Third Hospital in China from January 1 , 2012 to December 31 , 2012 were retrospectively analyzed to investigate the correlation factors of hospital stay and hospitalization costs using univariate analysis and multiple regression analysis. Results The study involved 496 patients, with a mean age of 63.38 years (range:26~88 years). Multivariate regression analysis showed the significant impact factors for LOS were age, pneumonia, the total score on NIHSS, medication for secondary prevention and stroke subtype. The significant impact factors for cost of hospital stay were payment method, stroke subtype, age, the total score on NIHSS and medication for secondary prevention. Conclusions Age, pneumonia, the total score on NIHSS, stroke treatment and its subtypes are the significant impact factors affecting hospital stay. Payment method, stroke subtype, age, the total score on NIHSS and medication for secondary prevention are the significant impact factors affecting costs of hospitalization.

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Association between human papilloma virus late 1 protein and high risk human papilloma virus persistent infection in cervical intraepithelial neoplasia

Li LIU ; Yumei CHEN ; Qingyuan ZHANG

The Journal of Practical Medicine.2014;(9):1417-1419. doi:10.3969/j.issn.1006-5725.2014.09.023

Objective To investigate the possibility of human papillomavirus late 1 (HPV-L1) protein detection in predicting the prognosis of cervical intraepithelial neoplasia (CIN). Methods (1)Through immunocytochemical method to detect expression of HPV-L1 protein in diagnosis of CIN before treatment. (2) Through hybridization and gene chip technology to detect expression of high-risk human papilloma virus (HR-HPV) in diagnosis of CIN after treatment for twelve months. Results (1) Comparing the three treatment methods in CIN patients, HR-HPV infection sustained no significant difference (P > 0.05). (2) The positive expression rate of HPV-L1 protein was 75.00% in CINⅠand 36.13%in CINⅡ~Ⅲbefore treatment, with statistically significant (P<0.05). (3) Persistent infection rate of HR-HPV was 5.97%in HPV-L1 positive expression group after treatment for twelve months and 19%in HPV-L1 negative expression group. The difference between the two was statistically significant (P<0.05). (4) The expression of HPV-L1 capsid protein before treatment had a negative relationship with HR-HPV persistent infection after 12 months of treatment. Conclusion Detection of HPV-L1 protein before treatment can predict the prognosis of CIN which had been treated.

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Correlation between the severity of subcortical ischemic lesions and vascular cognitive impairment in encephalorrhagia patients

Weijun ZHOU

The Journal of Practical Medicine.2014;(9):1414-1416. doi:10.3969/j.issn.1006-5725.2014.09.022

Objective To investigate the correlation between the severity of subcortical ischemic lesions and vascular cognitive impairment in encephalorrhagia patients. Methods One hundred and twenty-four encephalorrhagia patients were enrolled into two groups, the normal cognition group (60 cases, without cognitive impairment) and the cognitive impairment group (64 cases, with vascular cognitive impairment). Parameters of the lesion diameters, various lesion locations, white matter lesions severity and NIHSS scale score, modified Bathel index score were compared between these two groups. The correlations between the above indexes and the vascular cognitive impairment degree were analyzed by Logistic regression proceduress. Results Compared to the normal cognition group, the indexes of lesion number of frontal area and basal ganglia, lesion diameters, white-matter severity and NIHSS scale score of cognitive impairment group were higher (P<0.05, respectively), and the modified Bathel index score was lower (P<0.05), but the lesion number in temporal, parieto-occipital and infratentorial area were not changed (P>0.05, respectively) in the cognitive impairment group. Result of Logistic regression analysis showed a positive correlation between the severity of white-matter and the degree of vascular cognitive impairment (OR =4.705, P=0.009). Conclusion The severity of white-matter can effectively assess the degree of vascular cognitive impairment of encephalorrhagia patients.

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Association study between glycosylated hemoglobin and acute myocardial infarction in youth

Yunyun WANG ; Tong LI ; Yingwu LIU ; Bojiang LIU

The Journal of Practical Medicine.2014;(9):1411-1414. doi:10.3969/j.issn.1006-5725.2014.09.021

Objective To explore the association between HbA1c and acute myocardial infarction(AMI) in youth. Methods Seventy-two AMI patients (≤44y) diagnosed during the period from January in 2009 to August in 2012 were enrolled and 79 young age-matched adults without coronary artery disease at the same period were enrolled to be control group. The relationship between HbA1c, fasting blood-glucose(FBG) and AMI was explored. Results (1)Compared with the control group,the plasma FBG and HbA1C value were significantly higher(P<0.05) in AMI group. (2)Logistic regression analysis showed that HbA1c is the independent risk factor for AMI in youth. (3)In AMI group, the HbA1c level in single vessel disease had remarkable difference with that in double vessel disease and triple vessel disease(P<0.05). Conclusions Increasing HbA1c level is the independent risk factor for AMI in youth,and positively correlated with the degree of coronary artery lesions. Primary intervention of glycometabolism abnormality possibly becomes the new opinion for prevention and cure of AMI.

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