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Objective@#To investigate the prevalence and risk factors of diabetic peripheral neuropathy in type 2 diabetic patients under community management programs.@*Methods@#A cross-sectional study was conducted on T2DM patients in eight communities in Wuhan and Changshu cities. Data would included questionnaire, body measurement, blood testing and clinical examination. The criterion of diabetic peripheral neuropathy was under the combination of symptoms with five physical examinations. Binary logistic regression model was used to analyze the influential factors.@*Results@#The overall prevalence of peripheral neuropathy was 71.2% among the diabetic patients who were managed in primary care health services in the two cities. The binary logistic regression method identified older age (≥60 years, OR=2.39, 95%CI:1.95-2.94), longer diabetic duration (≥10 years, OR=1.25, 95%CI: 1.02-1.54), and worse postprandial glucose control (2 h postprandial plasma glucose >10.0 mmol/L: OR=1.65, 95%CI:1.33-2.04) (all P<0.05) as risk factors for the presence of diabetic peripheral neuropathy, while higher education level was protective factor (compared to patients with education levels of primary school or below, OR=0.52, 95%CI: 0.41-0.66; OR=0.59, 95%CI: 0.44-0.79; OR=0.64, 95%CI: 0.44-0.94 for those with education levels of junior high school, senior high school, and college, respectively).@*Conclusions@#High rates of diabetic peripheral neuropathy among T2DM patients suggested the urgent need for early screening and standardized management at the community levels. It is necessary to promote appropriate screening techniques and methods to identify the peripheral neuropathy, in the primary health service institutions.
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Objective@#To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants.@*Methods@#The general clinical data of preterm infants with gestational age 24-36+ 6 weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed.@*Results@#The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ2=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ2=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ2=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ2=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ2=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis.@*Conclusions@#HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.
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Objective To study the clinical effect of zinc gluconate combined with tetralogy of viable bifidobacterium tablets in the treatment of infantile autumn diarrhea .Methods 76 children with diarrhea in Lishui Hospital of Traditional Chinese Medicine from September to November in 2014 and from September to November in 2015 were selected as research subjects .All patients were randomly divided into control group ( n=38 ) and observa-tion group(n=38) by registration order.The control group was given tetralogy of viable bifidobacterium tablets ,while the observation group was given zinc gluconate combined with tetralogy of viable bifidobacterium tablets .The disappea-ring time of disease and the clinical symptoms after treatment for 72 h were compared between the two groups . Results The disappearing time of fever in the observation groupwas (28.81 ±5.72) h,which in the control group was (41.67 ±7.91)h,the difference was statistically significant between the two groups (t=10.358,P=0.011).The disappearing time of abdominal distension in the observation group was (40.28 ±7.96)h,which in the control group was (52.35 ±11.54)h,the difference was statistically significant between the two groups (t=7.334,P=0.021).The disappearing time of emesis in the observation groupwas (35.71 ±10.37)h,which in the control group was (50.66 ± 12.89)h,the difference was statistically significant between the two groups (t=9.214,P=0.017).The total effective rate of the observation group was 97.37％,which was higher than 81.58％ of the control group (χ2 =15.240,P<0.05 ) .In addition ,no complication was observed during the treatment .Conclusion The combination therapy of zinc gluconate and tetralogy of viable bifidobacterium tablets for infantile autumn diarrhea has high efficacy ,less adverse reaction,short therapy time ,and it has clinical value .
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Objective To explore the prevalence and possible risk factors of depressive /anxious symptoms of patients with digestive disease .Methods Totally 245 patients with digestive diseases were recruited consecutively .Face-to-face interview and the hospital anxiety and depression scale ( HADS) ,self-rating anxiety scale ( SAS) and self-rating depression scale ( SDS) were employed to collect the clinical data .The non-condition logistic regression was performed to analyze the data .Results The prevalence of depression and anxiety in patients with organic diseases in digestive system was 36.3%.Among them,the higher incidence of depression and anxiety symptoms were digestive system tumors , peptic ulcer , acute pancreatitis and cirrhosis .The educational degree was correlated with simple depression,pure anxiety,depression complicated with anxiety (χ2 =8.781,P=0.013;χ2 =7.976,P=0.018;χ2 =15.807,P=0.003),the degree of high school or above was a protective factor ,the OR values were 0.347, 0.373,0.301.The gender was also correlated with depression ,anxiety,depression complicated with anxiety (χ2 =4.343,P=0.031;χ2 =1.056,P=0.017;χ2 =2.382,P=0.03),female was the risk factor of mental illness ,the OR values were 2.72,2.438,2.671.The age was correlated with depression ,depression complicated with anxiety (χ2 =9.872,P=0.002;χ2 =15.710,P=0.031),the age of over 40 years old was the risk factor of mental illness ,the OR values were 5.137,5.731.The occupation was correlated with depression (χ2 =6.017,P=0.017),the non-physical labor was the risk factors of depression , the OR value was 2.752.Conclusion There is a higher prevalence of depression and anxious symptoms in patients with digestive organic diseases .Female,senior high school or lower ,older than 40 years,and non-manual work are the risk factors of these symptoms .
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Objective To explore the safety and efficacy of intrathecal administration of adipose stem cells de-rived from bioactive secretome (ASCBS)in treatment of whiter matter injury (WMI)in the preterm infants. Methods Sixty - three cases of WMI were recruited according to the uniform standards from multiple medical centers and they were divided into 3 gestational age (GA)subgroups,which were 21 cases in group A (GA 24 - 28 + 6 ),20 cases in group B (GA 29 - 32 + 6 ),and 22 cases in group C (GA 33 - 36 + 6 ). The patients were randomly divided into treatment groups and control groups by tossing coins. The treatment groups received lumbar puncture followed with ASCBS intra-thecal injection once daily for 3 consecutive days. Follow - up study included Neonatal Behavioral Neurological Assess-ment (NBNA)at term - equivalent age and neurodevelopment at corrected age of 6 - month. Neurodevelopment was assessed by using the Bayley Scales of Infant Development and Peabody Developmental Motor Scale. The survival rates, NBNA scores,mental development index (MDI),psychomotor develop index (PDI),total motor development quotient, gross motor development quotient and fine motor development among each subgroup were compared. Results Sixty -three cases were recruited,including 31 in the treatment group and 32 in the control group. Only 1 case in the treatment groups lost in the follow - up. No clinical side effects were found in the treatment groups. There was no significant diffe-rence in the survival rate and complication in the preterms in all subgroups of the treatment group and control group (all P > 0. 05). The gross and total motor development quotient in the treatment group A was higher than that in the control group A(gross motor development quotient:98. 330 ± 6. 282 in treatment group A,90. 330 ± 3. 777 in control group A, P = 0. 040;total motor development quotient:97. 330 ± 4. 803 in treatment group A,91. 000 ± 4. 472 in control group A,P = 0. 023). The rest findings showed no significant difference between groups. Conclusion The treatment of WMI in preterm infants with ASCBS is safe and can promote the motor development of preterm infants with GA in 24 - 28 weeks.
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Cerebral microbleeds (CMBs) are a key biomarker of cerebral small vessel disease on magnetic resonance imaging,They have potential clinical relevance to future stroke risk.Therefore,the detection of CMBs has important clinical significance for various cerebrovascular disease phenotypes.This article briefly summarizes the detection method of CMBs,mainly investigating the clinical significance of CMBs in general population and in patients with ischemic stroke,cerebral hemorrhage,vascular cognitive impairment,cerebral amyloid angiopathy,and leukoaraiosis.