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Objective This study aims to determine the effects of a health management program based on WeChat platform on a hypertensive population aged under 45. Methods 1 128 hypertensive patients aged between 18 and 44 received a health examination from January 2016 to December 2016 and they were divided into intervention (n=561) and control (n=567)groups. The two groups were followed up after 1 year, and initially both the intervention group (n=521) and the control group (n=510) completed a lifestyle questionnaire, and their systolic blood pressure, diastolic blood pressure, triglyceride (TG), total cholesterol (TC), high density lipoprotein‐cholesterol (HDL‐C), low density lipoprotein‐cholesterol (LDL‐C), body mass index (BMI), and pulse wave velocity (PWV) were recorded. For the control group, lifestyle health management programs were conducted. For the intervention group, a learning platform was arranged on WeChat, which uploaded questionnaires, and provided medical information to create electronic health records. The group gained hypertension‐related knowledge, dynamically monitored blood pressure and lifestyle, and participated in interactive question‐and‐answer sessions. Both groups were followed up after a year, and their systolic pressure, diastolic blood pressure, TG, TC, HDL‐C, LDL‐C, BMI, and PWV levels were measured. The changes in their daily exercise time, vegetable intake, sleep time, weekly blood pressure reading, smoking, and salt intake were recorded. Results The mean age of the WeChat intervention group was 33.1 (+10.6) years, which had 319 males (61.2%), and the mean age of the control group was 32.8 (+10.2) years, with 307 males (60.1%). No difference of clinical data was found between the two groups at baseline. The systolic and diastolic blood pressure of the intervention group, (142.4±10.4) mmHg (1 mmHg=0.133 kPa) (85.1±8.2) mmHg was significantly lower than that of the control group (149.6±10.1) mmHg, (92.3±9.1) mmHg (t=3.67, 2.33, P<0.05) at the end of the first year of follow‐up. The TG, TC, LDL‐C, BMI, and PWV levels of the intervention group [(1.6±0.6) mmol/L, (4.4±0.7) mmol/L, (2.8± 0.4 ) mmol/L, (23.9±4.2) kg/m2, (11.3±3.7) m/s respectively] were significantly lower than those of the control group [(1.8±0.7) mmol/L, (5.0±0.8) mmol/L, (3.3±0.5) mmol/L, (25.9±4.5) kg/m2, (15.8± 4.8) m/s, respectively] (t=6.63, 7.24, 4.96, 5.68, 9.25, all P<0.05). The HDL‐C level of the intervention group (1.8±0.7) mmol/L was significantly higher than that of the control group (1.4±0.4) mmol/L(t=8.14, P<0.05). After 1 year of intervention, daily exercise time [(40.5±12.2)min/d, (20.8±9.2) min/d)], vegetable intake [(423.6±145.8) g/d, (204.8±79.3) g/d)], sleeping time [(6.3±2.2) h/d, (5.9±1.7) h/d)], and weekly monitoring of blood pressure (23.4%, 8.1%) showed an increase with statistical significance (t =2.36, 1.95, 9.07, χ2=46.31, P<0.05), while smoking (14.4%, 21.9%) and high‐salt diet (20.2%, 30.5%) decreased showing statistical significance ( χ 2=‐9.83, -14.27, P<0.05). The daily exercise time [(22.9±11.3)min/d, (21.7±9.5)min/d], vegetable intake [(211.8±85.4) g/d, (198.5±81.4) g/d], sleeping time [(5.9±1.8) h/d,(5.8±1.9) h/d], weekly monitoring of blood pressure (9.2%, 8.6%), smoking(18.9%, 19.8%), and high‐salt diet (28.8%, 30.2%) were not significantly different in the control group at the one‐year follow‐up (t=0.14, 0.26, 0.31, χ2=0.11, 0.16, 0.23, all P>0.05). Conclusions The health management program based on WeChat platform can improve diet, exercise compliance, and lifestyle, and effectively reduce blood pressure and blood lipid levels for a hypertensive population under the age of 45.
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Objective To study the relationship between serum homocysteine (Hey) level and firstever cardiocerebral vascular events in elderly hypertension-free population.Methods A total of 6124 hypertension-free patients aged 60-80 years admitted to our hospital for physical examination were randomly divided into control group (n=4122) with their Hcy≤13 μmol/L and experimental group (n=2002) with their Hcy＞13 μmol/L.Their serum Hcy levels were measured.The patients were followed up for 3 years,during which the incidence of first-ever cardiocerebral vascular events was recorded every 6 months and compared.Results No significant difference was found in sex,age,smoking,BMI,SBP,DBP,FBG and LDL-C between the two groups (P＞0.05).The serum Hcy level was significantly higher in experimental group than in control group (29.68±12.87 μmol/L vs 8.12 ± 4.36 μmol/L,P =0.001).The incidence of cardiocerebral vascular events,cerebral infarction and non-lethal myocardial infarction was significantly higher in experimental group than in control group at the end of 3-year follow-up period (18.8％ vs 10.2％,P=0.001;9.0％ vs 4.6％,P=0.025;5.8％ vs 3.0％,P=0.034).Multivariate Cox harzards regression analysis showed that serum Hcy level was an independent risk factor for first-ever cardiocerebral vascular events in elderly hypertension-free population (β=0.78,95 ％ CI:1.76-4.12,P =0.003).Conclusion Elevated serum Hcy level is a risk factor for first-ever cardiocerebral vascular events,especially for cerebral and myocardial infarction in elderly hypertension-free population.
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Objective To investigate the correlation between uric acid level and increase of carotid intima-media thickness (IMT) in the elderly.Methods Clinical data of elderly and middleaged people who took health physical examination from Jan.2013 to Dec.2014 in a 3A-level hospital in Beijing were collected.The elderly people were divided into IMT normal group and plaque group.Logistic regression and linear regression were used to analyze the related factors for IMT thickening and uric acid level.Results The occurrence rate of hyperuricemia had a significant difference between the elderly group and the middle-aged group (P＜0.01).There were significant differences in uric acid level [(350.6±89.6) μmol/L vs.(359.6±86.6) μmol/L, t=5.19, P＜0.05].Body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), blood urea,cholesterol, high density lipoprotein levels between the IMT normal group and plaque group were [(25.3±3.6)kg/m2 vs.(25.8±3.5) kg/m2, (115.9±13.8) mmHg vs.(126.8±16.9) mmHg, (74.6±11.3) mmHg vs.(77.8±12.1) mmHg, (4.9±0.9) mmol/L vs.(5.0±1.0) mmol/L,(1.2±0.3) mmol/L vs.(1.2±0.3) mmol/L, all P＜0.01].Multi factor correlation analysis showed that the IMT thickening was correlated with gender, SBP, low density lipoprotein, blood glucose,while had no correlation with uric acid level.Blood uric acid level was related with gender, smoking, BMI, triglycerides, blood glucose, C-reactive protein, high-density lipoprotein.Conclusions Blood uric acid level, BMI, blood pressure and lipids are increased in the plaque group as compared with the IMT normal group.However, blood uric acid level can not be used as an independent risk factor for IMT lesions.
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Objective] To observe the clinical effect of“eliminating the accumulative stagnation and heat with pressing and kneading manipulation”treatment efficacy of children with functional constipation. [Method] Randomly divide 60 cases into control group and treatment group, 30 cases in each;the control one took conventional pediatric tuina method; the treatment one took “eliminating the accumulative stagnation and heat with pressing and kneading manipulation”method. Compare their effects after three courses. [Result] After three courses treatment, in treatment group, 20 cases had marked effect, 8 effective, 2 void, total effective rate 93.33%;in control group, they were respectively 10,12,8 and 73.33%. The comparison of total effective rates had difference of statistical significance(P<0.05). [Conclusion] The method of “eliminating the accumulative stagnation and heat with pressing and kneading manipulation”has better curative effect than the conventional pediatric tuina method. And it is very simple to manipulate, and worthy of being popularized.
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Objective To explore the clinical effect and safety of high frequency oscillatory ventilation (HFOV) combined thoracic close drainage for the treatment of mechanical ventilated neonates with pneumothorax.Methods Twenty-two neonates were enrolled in this study,who needed mechanical ventilation diagnosed with neonatal pneumothorax and received treatment of HFOV combined thoracic close drainage from Jan.2012 and Jun.2014 in the People's Hospital of Dongguan.We recorded blood gas analysis and parameters of breathing machine before using HFOV and 2,12,24,48 hours after using HFOV respectively.Results There were significant differences between HFOV before use (0) and 2,12,24,48 hours after using HFOV in terms of blood pH value,arterial partial pressure of oxygen(PaO2),partial pressure of arterial carbon dioxide (PaCO2),oxygenation index (OI),the inspired oxygen concentration (FiO2),mean airway pressure (MAP) (F =6.606,17.760,8.387,17.242,25.185; P ＜ 0.05).Compared with before using HFOV combined thoracic close drainage,PaO2 was significantly increased from (51.25 ± 13.16) mmHg to (62.60 ± 15.95) mmHg.PaCO2 was significantly dropped from (63.57 ± 13.81) mmHg to (54.02 ± 11.58) mmHg and OI was dropped sharply from (16.57 ± 9.09) to (11.28 ± 4.67) at 2 hours after using HFOV combined thoracic close drainage (P ＜ 0.05).FiO2 significantly decreased from (0.76 ± 0.15) to (0.60 ± 0.13),as well as MAP from (9.91 ± 1.44) cm H2 Oto (8.50 ± 1.68) cm H2O.Furthermore,pH was significantly improved from (7.24 ± 0.15) to (7.34 ±0.10) at 12 hours later(P ＜0.05).PH,PaO2,PaCO2 were roughly back to normal at 48 hours after treatment.The main complications were intraventricular hemorrhage (2 cases),subarachnoid hemorrhage (2 cases),ventilator associated pneumonia (1 case) and pulmonary hemorrhage (1 case) (not during the time of HFOV treatment).Conclusion HFOV combined thoracic close drainage for the treatment of neonates with pneumothorax is safety and effective methods.
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<p><b>OBJECTIVE</b>To explore the incidence and genotypes of glucose-6-phosphate dehydrogenase (G6PD) gene mutations among infertile patients in Shenzhen.</p><p><b>METHODS</b>DNA samples from 851 infertile patients were tested for 25 G6PD gene mutation sites using a multiplex SNaPshot assay.</p><p><b>RESULTS</b>The incidence of G6PD gene mutations among infertile patients in Shenzhen was 17.63%. Male and female abnormal rates were 15.13% and 20.09% respectively. Most of the female abnormal cases were heterozygotes. Mutations involved 11 haplotypes in 10 sites. 1311C> T/IVS-11 93T> C was the most common mutation, accounting for 72.00% (108/150) abnormal cases. Forty three cases of missense mutations were detected, including 19 cases of 1376G> T, 9 cases of 1388G> A, 5 cases of 95A> G and 871G> A/1311C> T/IVS-11 93T> C, 1 case of 202G> A, 835A> T, 1360C> T, 1376G> T and 392G> T/1311C> T/IVS-11 93T> C.</p><p><b>CONCLUSION</b>The incidence of G6PD gene mutations among infertile patients in Shenzhen was high and the mutation types were various. Therefore, the G6PD deficiency genetic screening should be performed prior to assisted reproduction. This investigated results provided valuable basic data for genetic counseling, preimplantation genetic diagnosis and prenatal diagnosis.</p>
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Female , Humans , Male , Asian People , Genetics , China , Epidemiology , DNA Mutational Analysis , Gene Frequency , Genotype , Glucosephosphate Dehydrogenase , Genetics , Haplotypes , Incidence , Infertility, Female , Ethnology , Genetics , Infertility, Male , Ethnology , Genetics , MutationABSTRACT
Objective To assess the impacts of management of psychological health on metabolic indictors in community residents.Methods A total of 300 health check-up adults from one single community were randomly assigned to the control group (receiving routine health management,n =150) and the study group (receiving psychological health management,n =150).Blood pressure (BP),fasting plasma glucose (FPG),total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C) and life style were evaluated and compared at baseline and 1-year follow-up.Results No difference of clinical data was found between the two groups at baseline.After 1-year intervention,current sigarette smoking,BP,FPG,TC,TG and LDL-C of the study group were significantly decreased when compared with the control group (x2 =7.54,t =6.43,5.38,5.89,6.15,4.36,6.69,5.47 ; all P ＜ 0.05).Compliance to and satisfaction with health management were significantly improved in the study group (x2 =9.13,12.35,11.96,10.98,9.95 ; all P ＜ 0.05).Conclusion Management of psychological health may be effective in improving healthy life style,patients' satisfaction and cardiovascular metabolism in community residents.
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Objective To investigate the effects of health management on risk factors of cardiovascular diseases in community residents.Methods A total of 208 adults from one single community who visited our health check-up center were randomly assigned to the control group(receiving routine consultation,n =104)and health management group(receiving health management intervention,n =104).At 1-year follow-up,fasting blood glucose(FBG),lipid profiles,and blood pressure(BP)were measured and risk factors of cardiovascular were surveyed.t or x2 test was used for data analysis.Results No difference of clinical data was found between the two groups at baseline.Follow-up results indicated that absolute risk of cardiovascular diseases,number of risk factors,health satisfaction,sick leave,daily vegetables intake and physical exercise,and BP were significantly improved in the health management group.Ten-year absolute risk of cardiovascular diseases(0.8 ± 0.4 vs 1.3 ± 0.5),number of risk factors(172 vs 283),and sick leave per year(118 d vs 264 d)were significantly decreased in the health management group when compared to the control group(all P ＜ 0.05).Furthermore,health satisfaction(83.7％(87/104)vs 52.9％(55/104)),and daily vegetables intake(520.5 g vs 348.3 g)and physical exercise(1.2 h vs 0.3h)were significantly improved in the health management group(all P ＜ 0.05).Conclusion Health management may be effective in decreasing risk factors of cardiovascular diseases in community residents.
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Background and Objective Previous study showed tenecteplase and alteplaxe were equovalent for 30-day mortality in the treatment of acute myocardial infarction. The purpose of this open-label, randomized, multi-center, angiographic trial was to assess the efficacy and safety of tenecteplase compared with alteplase in Chinese patients with acute myocardial infarction. Methods We recruited patients with acute ST-elevation myocardial infarction presenting within 6 hours of symptom onset from October, 2002 to March,2004, in 5 hospitals in Beijing. After giving informed consent, patients were randomly assigned a single-bolus injection of tenecteplase (30-50 mg according to body weight) or front loaded alteplase (100 mg), and underwent coronary angiography at 90 min after starting the study drug. All patients received aspirin and heparin (target activated partial thromboplastin time 50-70 s). The primary efficacy end point was the rate of TIMI grade 3 flow at 90 minutes. Other efficacy end points included TIMI grade 2/3 flow at 90 minutes. Safety end points included all stroke, intracranial hemorrhage (ICH), moderate/severe hemorrhage (except for ICH), all-cause mortality at 30-days, and major non-fatal cardiac events at 30 days. Results Overall 110 patients were eligible for statistical analysis, with 58 patients assigned to receive tenecteplase and 52 patients to alteplase. Tenecteplase produced a rate of TIMI grade 3 flow at 90 minutes after the start of thrombolysis(68.4%) similar to that of alteplase (66.7%, P=1.0); the rates of TIMI grade 2 or 3 were similar for patients treated with tenecteplase versus alteplase (89.5% versus 80.4%, respectively, P=0.278). At 30 days, rates for all strokes were similar for the two groups (5.17% for tenecteplase and 1.92% for alteplase, P=0.62); rates of ICH were 3.45% and 1.92% (tenecteplase and rt-PA,P=1.00) respectively. The rate of moderate/severe hemorrhage was 8.62% with tenecteplase and 5.77% with alteplase (P=0.72); total mortality was almost identical in the two groups (13.8% versus 9.6%, respectively, P=0.565) while the rates of non-fatal cardiac complications were 10.35% and 11.54% (tenecteplase and alteplase, P=1.0). Conclusions The efficacy of a single-bolus, weightadjusted tenecteplase fibrinolytic regimen is equivalent to front-loaded alteplase in terms of the rates of TIMI grade 3 flow, and TIMI 2 or 3 flow, but the 30-day mortality and ICH in both groups was so high that the use of tenecteplase is not permitted in China. These negative safety results might be due to the high rate of percutaneous coronary intervention (PCI) and high dose of bolus heparin and suboptimal concomitant medical therapy during hospitalization, so further studies are needed to confirm the safety for tenecteplase in Chinese patients.
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Objective To compare the effects of aspirin and warfarin in the elderly patients with chronic nonvalve atrial fibrillation.Methods 431 elderly patients with chronic non-valvalar atrial fibrillation were randomly divided into two groups: group A received aspirin; group B received warfarin.After patients were treated with aspirin or warfarin for two years,the incidence rate of stroke and hemorrhage rate were counted. Results Aspirin was as effective as warfarin in preventing stroke in patients age 65 to 75 years old without risk factor,and warfarin was more effective than aspirin in preventing stroke in patients (≥75) and all patients with risk factors. Warfarin and aspirin had low incidence rate of bleeding. Conclusion For the patients aged 65 to 75 years old have no risk factors, they should be treated with aspirin in preventing stroke .For the older patients older than 75 years old and patients have risk factors, they should be treated with warfarin,which is more efficient than asprin in preventing stroke.
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<p><b>OBJECTIVE</b>To analyse the effects of different therapies on coronary artery disease (CAD).</p><p><b>METHODS</b>A total of 1055 patients who suffered from CAD diagnosed by coronary angiography were divided into three groups, namely pure drug therapy, percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) groups. Follow up was carried out from March to May in 2001, and the major adverse cardiac events (MACEs) including death, no-lethal myocardial infarction (MI) and revascularization were observed. In long-term observation, angina reoccurred, and their improvement was evaluated. The short-term period was defined as the duration of 30 days after discharge, and the long term period was defined as the duration from 30 days after discharge.</p><p><b>RESULTS</b>In the long-term period, the recurrences of angina both in PCI group and CABG group were lower than pure drug group (P 0.018, 0.002 respectively). No differences about long-term endpoint events were observed among these three groups (P > 0.05). Forty-two patients suffering from left main coronary disease were intervened by the three therapies, and there was no death or MI both in PCI and CABG groups, three patients died and suffered from AMI in pure drug therapy group (P = 0.015). In the short-term period, mortality in CABG group (5.77%) was higher than those in the other two groups (1.91% for PCI, and 1.40% for medical therapy, P = 0.002), and no obvious difference observed in the latter two groups. No significance was concluded about the recent MI among this three groups (P = 0.357). There were no differences on revascularization in these three groups.</p><p><b>CONCLUSIONS</b>Percutaneous coronary interventions can not only reduce the attack of angina but also improve the life quality of patients, however it can not improve the long-term existence but left main CAD.</p>