ABSTRACT
Objective To investigate the characteristics of five hormone levels of hypertension in patients with essential hypertension,and explore the correlation between them and essential hypertension.Methods The clinical data of 1 731 patients with essential hypertension and 305 healthy people in General Hospital of Heilongjiang Province Land Reclamation Bureau from April 2018 to March 2019 were analyzed retrospectively.The levels of renin,angiotension Ⅱ (AT Ⅱ),aldosterone,adrenocorticotropic hormone (ACTH) and cortisol were measured by magnetic particle chemiluminescence,and the ratio of aldosterone to renin (ADRR) was calculated.Results The renin,AT Ⅱ,aldosterone,ACTH,cortisol and ADRR in patients with essential hypertension were significantly higher than those in healthy controls:(13.58 ± 9.78) ng/L vs.(9.20 ± 2.12) ng/L,(181.06 ± 89.82) ng/L vs.(133.49 ± 5.47) ng/L,(174.96 ± 103.14) ng/L vs.(136.04 ± 15.48) ng/L,(76.39 ± 61.43) ng/L vs.(26.98 ± 5.10) ng/L,(176.4 ± 88.8) μg/L vs.(145.1 ± 18.9) μg/L and 27.71 ± 18.37 vs.15.18 ± 1.77,and there were statistical differences (P＜0.01).The renin and AT Ⅱ in male patients with essential hypertension (904 cases) were significantly higher than those in female patients with essential hypertension (827 cases):(16.04 ± 10.67) ng/L vs.(10.34 ± 8.59) ng/L and (194.28 ± 96.22) ng/L vs.(166.37 ± 83.42) ng/L,the aldosterone was significantly lower than that in female patients with essential hypertension:(166.31 ± 101.91) ng/L vs.(184.68 ± 104.37) ng/L,and there were statistical differences (P＜0.01 or ＜0.05);there were no statistical difference in ACTH,cortisol and ADRR (P＞0.05).The renin and AT Ⅱ in patients aged 51 to 60 years (610 cases) and ＞60 years (572 cases) were significantly lower than those in patients aged ＜ 50 years (549 cases):(12.67 ± 10.76),(12.43 ± 8.29) ng/L vs.(16.05 ± 10.29) ng/L and (172.62 ± 81.63),(166.04 ± 79.09) ng/L vs.(208.94 ± 108.75) ng/L,and there were statistical differences (P＜0.05 or ＜0.01);there were no statistical difference in aldosterone,ACTH,cortisol and ADRR (P＞0.05).Multivariate linear regression analysis result showed that renin and AT Ⅱ were negatively correlated with systolic blood pressure and diastolic blood pressure (P＜0.01 or ＜0.05),and aldosterone,ACTH and cortisol were positively correlated with systolic blood pressure and diastolic blood pressure (P＜0.05 or ＜0.01).Conclusions Renin and AT Ⅱ are negatively correlated with systolic blood pressure and diastolic blood pressure;aldosterone,and ACTH and cortisol are positively correlated with systolic blood pressure and diastolic blood pressure.The five hormone levels of hypertension can reflect the function of renin-angiotension-aldosterone (RAAS) system and hypothalamus pituitary adrenocortical axis (HPA axis),which are the influencing factors of essential hypertension.
ABSTRACT
Objective@#To evaluate the clinical value of four items of thrombosis detection, including thrombin-antithrombin complex (TAT), α2-plasmin inhibitor-plasmin complex (PIC), thrombomodulin (TM) and tissue plasminogen activator-inhibitor complex (t-PAIC), combined with D-dimer (D-D) and fibrin degradation products (FDP) in venous thrombosis in patients with malignant tumor.@*Methods@#A total of 904 patients with malignant tumor from October 2017 to March 2019 in General Hospital of Heilongjiang Province Land Reclamation Bureau were selected (malignant tumor group), and 200 healthy physical examination patients were selected as healthy control group. Among 904 patients with malignant tumor, 92 patients had venous thrombosis (thrombosis group), and 812 patients had not venous thrombosis (non-thrombosis group). The TAT, PIC, TM, t-PAIC, FDP and D-D were detected. The relationship between TAT, PIC, TM, t-PAIC, D-D, FDP and venous thrombosis was analyzed by binary Logistic regression. The receiver operating characteristic (ROC) curve was used to determine the diagnostic performance of each index, and the maximum value of the Youden index was the optimal cut-off value.@*Results@#The TAT, PIC, TM, t-PAIC, D-D and FDP in malignant tumor group were significantly higher than those in healthy control group, and there were statistical differences (P<0.01). The TAT, PIC, TM, t-PAIC, D-D and FDP in thrombosis group were significantly higher than those in non-thrombosis group: 20.20 (12.30, 59.45) μg/L vs. 8.60 (4.87, 15.15) μg/L, 1.23 (0.69, 2.84) mg/L vs. 0.70 (0.37, 1.45) mg/L, 14.55 (8.12, 21.10) kU/L vs. 10.05 (7.975, 13.90) kU/L, 10.20 (7.30, 15.17) μg/L vs. 7.40 (5.20, 12.65) μg/L, 3.42 (1.38, 7.07) μg/L vs. 1.69 (0.53, 4.64) μg/L, 6.41 (3.21, 17.05) mg/L vs. 5.15 (2.26, 10.01) mg/L, and there were statistical differences (P<0.01 or <0.05). Binary Logistic regression analysis result showed that TAT, PIC, TM, t-PAIC, D-D and FDP were correlated with venous thrombosis in patients with malignant tumor (OR = 1.277, 1.209, 1.107, 1.089, 1.260, 1.078 and 0.002; P<0.01 or <0.05). ROC curve result showed that the optimal cut-off values of TAT, PIC, TM, t-PAIC, D-D and FDP in the diagnosis of venous thrombosis in patients with malignant tumor were 24.450 μg/L, 2.624 mg/L, 17.750 kU/L, 13.250 μg/L, 5.290 μg/L and 22.435 mg/L; and the area under curve (AUC) were 0.788, 0.659, 0.621, 0.597, 0.626 and 0.598, respectively. The AUC of TAT + PIC + TM + t-PAIC and TAT + PIC + TM + t-PAIC + D-D + FDP in the diagnosis of venous thrombosis in patients with malignant tumor were significantly higher than D-D + FDP (0.808 and 0.796 vs. 0.633). Ninety patients with TAT>24.450 μg/L or PIC>2.624 mg/L were selected. Fourty-five cases of them were injected with low molecular weight heparin (experimental group) for 6 weeks, and another 45 cases were not treated with low molecular weight heparin (control group). Both groups were followed up for 1 year. The incidence of venous thrombosis in the experimental group was significantly lower than that in control group: 2.22% (1/45) vs. 15.56% (7/45), the survival time was significantly longer than that in control group: (10.6 ± 3.1) months vs. (8.5 ± 2.8) months, and there were statistical differences (P<0.05), and no bleeding occurred in experimental group.@*Conclusions@#Four items of thrombosis detection combined with D-D and FDP is better than single detection. It is the best non-invasive method to detect venous thrombosis. It can predict the possibility of venous thrombosis in patients with malignant tumor at an early stage, and help patients actively use preventing drug, determine the best and most reasonable treatment time, improve the prognosis of patients, and prolong survival time.
ABSTRACT
Objective To study clinical and laboratory features of children with brucellosis and to provide a theoretical basis for clinical diagnosis and treatment.Methods Using the retrospective analysis method,the clinical diagnosed information of child patients with brucellosis from January 2013 to January 2016 in Heilongjiang Agricultural Reclamation Bureau General Hospital were selected to analysis the general characteristics,clinical symptoms and laboratory examination results.At the same time,follow the case control method,dadult brucellosis laboratory results were selected,and the laboratory examination results were compared between child and adult patients.Results The children of ＞ 12-15 years of age had the highest incidence in 65 cases of brucellosis,and the rate was 47.7％ (31/65).Clinical symptoms were fever and joint pain,which accounted for 83.1％ (54/65) and 84.6％ (55/65),respectively.The mean values of γ-glutamyl transpeptadase (γ-GT),α-hydroxybutyric dehydrogenase (HBDH),creatine kinase isoenzyme (CK-MB) and lactate dehydrogenase (LDH) were compared between child brucellosis and adult brucellosis,and the differences were statistically significant [(30.66 ± 27.05) vs (82.80 ± 36.34) U/L,(287.40 ± 35.02) vs (180.08 ± 40.90)U/L,(20.88 ± 13.01) vs (11.70 ± 4.13)U/L,(328.69 ± 37.86) vs (217.88 ± 45.67)U/L,t =-4.243,3.396,3.756,3.135,all P ＜ 0.05].After treatment,the test results of children with aspartate transaminase (AST),alanine aminotransferase (ALT),γ-GT,total protein (TP),albumin (ALB),HBDH,CK-MB and LDH were compared with those of before the treatment,the differences were statistically significant [(56.95 ± 29.50) vs (23.00 ± 12.26) U/L,(57.60 ± 35.65) vs (23.94 ± 13.38) U/L,(30.66 ± 27.05) vs (18.45 ± 12.62) U/L,(63.77 ± 5.51) vs (67.42 ± 3.50) g/L,(39.15 ± 3.89) vs (43.06 ± 3.11) g/L,(287.40 ± 35.02) vs (139.23 ± 51.70) U/L,(20.88 ± 13.01) vs (11.61 ± 10.26) U/L,(328.69 ± 37.86) vs (187.77 ± 42.32) U/L,t =4.848,2.717,2.182,-5.442,-13.752,6.989,4.749,5.993,all P ＜ 0.05].Conclusions Liver and heart of children with brucellosis are injured.By monitoring the changes of myocardial enzymes,medicines for children might be cautiously used in clinical trial,and myocardial damages of children with brucellosis can be protected and prevented.
ABSTRACT
Objective To evaluate the effect of health education on the compliance and health status of epileptic patients after discharge. Methods A total of 88 patients with epilepsy were selected and divided into control group (January to June in 2014) and experimental group (July to December in 2014)with 44 patients each.During hospitalization,the patients in control group were given routine health education,discharge guidance,on the basis of the control group,the patients in experimental group were added health education after discharge. The health status were evaluated at the time of admission and discharge(1 days before discharge)and 1,3,6 and 12 months after discharge.The medication compliance and clinical efficacy of the two groups were evaluated at 12 months after discharge. Results The medication compliance at 12 months after discharge was 97.73%(43/44)in experimental group and 63.64% (28/44)in control group,and there was significant difference(x2=15.92,P<0.01).The total effective rate was 84.09%(37/44)in experimental group and 40.91%(18/44)in control group,and there was significant difference (x2=12.31, P<0.01). Repeated measurement of variance analysis showed that there was no significant difference between two groups of self testing health score during hospitalization (P>0.05), there were significant differences in the health status at 1, 3, 6, 12 months after discharge between two groups, treatment effect, time effect, interaction effect (F =57.50, 5.69, 8.35, P<0.01). Conclusions Health education after discharge can improve the medication compliance, health status and clinical efficacy of patients with epilepsy and promote their rehabilitation.
ABSTRACT
Objective To investigate the effects of solution focused approach on the hope level of patients with epilepsy. Methods A total of 83 patients with epilepsy were randomly divided into the observation group and the control group, 42 cases in the observation group, 41 cases in the control group. The control group was given traditional nursing care, the observation group was given nursing intervention based on solution focused approach. Two groups were surveyed with Herth Hope Index (HHI), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) before and after the intervention. Results Before the intervention, HHI of the observation group and the control group scored 24.95 ± 1.92 and 24.56 ± 3.23 respectively. After intervention the scores increased to 28.85 ± 1.81 and 25.31 ± 3.35. After intervention, HHI and each dimension of the observation group scored higher than those before intervention and the control group, the difference was statistically significant (t=-4.75, 5.84, P 0.05). After intervention SAS scores the observation group and the control group were 41.65 ± 6.22 and 49.72 ± 5.86, SDS scores were 44.57 ± 5.83 and 49.73 ± 6.24, there was significant difference between 2 groups (t=5.67, 3.20, P < 0.01). Intra group comparison of the observation showed that there was significant difference in SAS and SDS scores before and after the intervention (t=10.27, 5.36, P < 0.01). Intra group comparison of the control group also showed statistical difference in SAS and SDS scores (t=4.65, 2.17, P<0.05 or 0.01). Conclusions The solution focused approach can improve the psychological status of patients with epilepsy, improve the level of hope, promote the rehabilitation of patients.
ABSTRACT
Objective To investigate the effect of (the transtheoretical model of change,TTM) on the level of self-esteem in children with epilepsy (EP). Methods 65 cases of EP were divided into intervention group with 31 cases and control group with 34 cases by random number table. The two groups were treated with anti EP drug treatment and nursing, the use of the change stage and the Self- Esteem Scale (SES) for the baseline assessment, the intervention group according to the assessment results to develop individual TTM intervention measures, the control group received general health education and psychological care, for a period of 6 months. Two groups of patients were followed up for 6 months after hospital discharge, and the distribution of the changes in the changes of the patients and the change of self-esteem scores were analyzed. Results Before the intervention, two groups in the intention stage, preparation stage, operation stage and maintenance stage self-esteem score comparison, the difference was not statistically significant (P>0.05);6 months after the intervention, the change of phase of self-esteem, the intervention group respectively were (22.61+2.88) points, (22.78+1.56) points, (24.03+1.5) points, (24.39+1.60) points, in the control group were (21.15+2.44) points, (21.39+2.21) points, (22.26+2.33) points, (22.01+2.31) points, with significant differences between the two groups (t=1.12-3.38, P<0.01). Two groups from the former intention phase to maintain the stage of change in the number of children were increased, the intervention group was better than the control group, the difference was statistically significant (χ2=15.00, P<0.01). Conclusions Using TTM as the guidance can improve the self-esteem of children with EP.
ABSTRACT
Objective To investigate the differents of rapid enzyme-linked immunosorbent assay(IELISA) and the traditional serological methods in diagnosis of human brucellosis.Methods Brucella antibody was detected by IELISA,rose bangel plate test (RBPT),standard agglutination test (SAT),Coomb's test and cysteine test of serological methods in 430 confirmed and suspected patients and 300 healthy controls during the same period.The consistency was analyzed between IELISA and other tests.Results Positive rates of patients were significandy higher than those in healthy controls (IELISA:83.49％ vs.0;RBPT:86.97％ vs.0;SAT:76.27％ vs.0;Coomb's:65.58％ vs.0.02％;and cysteine test:67.91％ vs.0,x2 =535.05,412.47,437.66,339.22,489.49,all P ＜ 0.01).Positive consistency rates between IELISA and other tests were 87.19％,79.39％,71.59％ and 76.60％,the highest was between IELISA and RBPT,the lowest was between IELISA and Coomb's.Conclusions Brucella antibody is detected conveniently,quickly,and accurately by the joint application of RBPT and IEHSA,which provides important technical support for prevention and control of brucellosis.It is worthy of application extensively.
ABSTRACT
Objective To analyze the diagnostic value of fluorescence polarization assay (FPA) for human brucellosis.Methods From April 2013 to August 2014,240 positive sera of brucella patients were collected as case group and 287 normal sera as control group in Heilongjiang Agricultural Reclamation Bureau General Hospital.Four milliliters of venous blood were withdrawn for separation of serum.Fluorescence polarization assay was used and the consistency,sensitivity and specificity were compared with those of four classical serological methods,including rose bengal plate agglutination test (RBPT),standard tube agglutination test (SAT),Coomb's test and cysteine test.Results The results of FPA were complied with those of the four conventional serological methods,Kappa ≥ 0.75.The sensitivity of FPA (89.17％) was higher than that of RBPT (87.08％),SAT (85.00％),Coomb's (74.17％) and cysteine test (75.83％).The specificity of FPA (94.08％) was higher than that of RBPT (89.90％) and Coomb's (81.53％),but lower than that of SAT (98.95％) and cysteine test (99.30％).Conclusion FPA can be used as a laboratory diagnostic method for human brucellosis,which is worthy to be widely used.
ABSTRACT
Objective To investigate the relationship of plasma homocysteine with the genotype distribution of MTHFR and MTRR among Chinese Han women in Xiangtan. Methods MTHFR C677T, A1298C and MTRR A66G geno?typing was analyzed to detect the distribution of gene polymorphisms among 1 701 women from Xiangtan city then the data were compared with the rest of the Han women in Zibo, Zhengzhou, Yantai, Zhenjiang, Songzi, Huizhou, Qionghai. Plasma Hcy levels from 110 patients were measured and analyzed the correlation with gene polymorphisms. Results The frequency of MTHFR C677T genotype and allele frequencies in Xiangtan is 12.6%which is higher than Huizhou (10.9%) and Qionghai (6.1%) but lower than Zibo (43.6%), Zhengzhou (36.8%), Yantai (32.2%), Zhenjiang (21.8%) with statistically significant dif?ference (P<0.05). There is no significant different in MTHFR C677T between Xiangtan and Songzi. The frequency of MTH?FR A1298C genotype and allele frequencies in Xiangtan is 4.8%which is lower than Qionghai(7.1%)but higher than Zibo (1.4%),Zhengzhou(2.4%), Yantai(1.8%), Zhenjiang(3.5%)and Songzi(2.6%)with statistically significant difference. The frenquency of MTRR A66G genotype and allele frequencies in Xiangtan is 6.8%which is higher than Zibo (4.8%) but lower than Qionghai (9.3%) with statistically signifcant difference. Plasma Hcy concentration correlate with MTHFR C677T, Hcy concentration in TT population is higher than that in CT and CC population(μmol/L:8.52±2.01 vs 5.94±1.47 vs 5.71± 0.18);Plasma Hcy concentration also correlate with MTHFR A1298C and Hcy concentration in CC population is higher than AA and AC population(μmol/L:9.83 ± 2.26 vs 6.35 ± 2.13 vs 5.55 ± 1.75);Plasma Hcy concentration does not correlate with MTRR A66G. Conclusion The gene polymorphism of MTHFR C677T, A1298C and MTRR A66G among the Han women in Xiangtan was statistically different from other selected regions of China. Mutation in MTHFR C 677T and A1298C were associated with elevated plasma levels of Hcy.
ABSTRACT
Objective To study the correlation between the hope levels and medical coping modes of maintenance bemedialysis(MHD) patients.Methods 118 hemodialysis patients were sampled from a hospital in Fuzhou city in October,2007.A survey was conducted among these patients by questionnaires.And the col-lected data were analyzed with SPSSll.5.Results 98.3% of surveyed patients got a mediate or high-level in hope level.Compared to common patients,MHD patients got a higher score both in wriggly and subdued coping modes,and a lower score in facing mode.The choice of coping modes was affected by the hope levels of MHD patients.Conclusions Pafients with higher hope level tend to adopt wriggly and facing coping modes,while those with lower hope level generally take subdued coping mode.The nurses should help MHD patients seek supports from others in order to increase their hope level and promote them to adopt effective coping modes,in doing 80,it Can promote their mental healthy and improve their qu~ty of life.
ABSTRACT
Objective This study aimed to discuss the different assessment of pain among medical and nursing staff and cancer patients and supply reference for proper analgesic precept for clinical application and nursing measures. Methods We collected the assessment of psychological pain and physiological pain by 55 hospitalization cancer patients, 40 physicians in-charge and 55 nurses in-charge in one week by Johnson inventory. The assessment results were compared and at the same time the relevant problems of the attitude to cancer pain by patients was also investigated. Results Improper recognition existed in cancer pain treatment by most cancer patients. The physiological pain was higher than the psychological pain assessed by both patients and nurses (P<0.05). But the pain assessment by patients was higher than that by the nurses (P<0.05). The assessment of psychological pain was higher than the physiological pain by doctors and both aspects were lower than those by patients, but no statistical difference was seen (P>0.05). The assessment by doctors was more accurate than that by nurses. Conclusions Routine establishment of pain assessment inventory for patients could instruct patients how to record the degree of their pain. We should strengthen the standard training about pain management knowledge and give timely communication with patients' cancer pain.
ABSTRACT
BACKGROUND: Twenty-four hours dynamic electroencephalogram (EEG)is to prolong the time of scanning on the basis of routine EEG to monitor electrical activity of brain in various states, by which, the detectable rate of epilepsy is much improved in children.OBJECTIVE: To probe into the evaluation of 24 hours dynamic EEG monitoring on paroxysmal cerebral disorder in children in epileptic and suspected epileptic patients.DESIGN: Case analysis.SETTING: Department of Neurological Internal Medicine of Second Affiliated Hospital of Jiangxi Medical College.PARTICIPANTS: Totally 151 cases of paroxysmal cerebral disorder were employed, diagnosed in clinic and from the inpatients in Department of Neurological Internal Medicine of Second Affiliated Hospital of Jiangxi Medical College from July 2001 to October 2004, of which, 99 cases were male, 52 cases female, aged varied from 3 month to 14 years. According to clinical diagnosis, two groups were divided, named epileptic group (85 cases) and suspeeted epileptic group (66 cases). Of 151 eases, 39 cases received EEG examination, 21 cases CT scanning examination and 3 cases MRI examination.METHODS: All of participants were inquired medical history in detail,received physical examination in Neurological Department and 24 hours dynamic EEG monitoring [those were determined as epileptic discharge if during the monitoring, it was present spike wave, sharp wave, spike and ware complex, burst high-amplitude slow wave, high-arrhythmic wave,neonatal single rhythmic burst wave and hyperventilation early breakthrough or limitative burst slow wave. Those were determined as non-specific abnormality if it was present abnormal background wave, occipital paroxysmal slow wave of childhood, extreme spindle wave of sleep stage,neonatal diffusive transient sharp wave and occasional non-classic sharpslow complex.]. In addition, the results of routine EEG, CT or MRI examinations were collected.epileptiform discharge of paroxysmal disorder in children during 24 hours of abnormal rate and epileptiform discharge of paroxysmal disorder in children during 24 hours dynamic EEG monitoring with the results of routine EEG, CT or MRI examinations.dynamic EEG monitoring, of 151 cases, abnormality was present in 122cases, of which, 97 cases had epileptiform discharge. The epileptiform discharge rate in epileptic group was higher remarkably in suspected epileptic tic group, epileptiform discharge in dynamic EEG was mainly in unilateral hemisphere or dominant in limitative unilateral side and bilateral cerebral hemisphere. In suspected epileptic group, the detectable rate of epileptiEpileptiform discharge was predominated in sleep period (74%, 72/92), of peared clinic seizure in epileptic group, of which, the detectable rate epileptiform discharge was 93% (13/14), higher remarkably than suspected epileptic group [25 cases of clinic seizure, epileptiform discharge decases received routine EEG examination, of which, 19 cases were present non-specific abnormality and 7 cases had epileptiform discharge; in dynamic EEG examination, 5 cases were present non-specific abnormality and 29 cases had epileptiform discharge. In comparison, non-specific abnormality was dominant in routine EEG and epileptiform discharge was predominated in dynamic EEG.CONCLUSION: Twenty-four hours dynamic EEG examination results in remarkable high detectable rate of epileptiform discharge in diagnosis of paroxysmal disorder in children and determines discharge location and time, indicating fully the advantage of dynamic EEG in evaluation of paroxysmal cerebral disorder in children.
ABSTRACT
There were three kinds of styles of human sexual ethics in human history, which were styles of deified sexual ethics,of evil and instrumental sexual ethics,and of hedonic sexual ethics. These ethical thought has brought benefit to mankind , but caused unhealthy consequence in theory and practice. We must confirm and establish principles on human sexual ethics by human essences . Only thus can individual and nature, individual and others, individual and society, individual and itself nature (the human body and soul) be developed harmoniously.