ABSTRACT
Objective To evaluate the effectiveness of intensive lifestyle intervention on rural residents with metabolic syndrome (MS) . Methods A total of 253 patients with MS selected from cross-sectional survey were divided into intensive lifestyle intervention and conventional management group incomplete randomly. Aimed to control weight, patients in the intervention group were treated with dietary control and exercise guidance. Besides, their compliances were assessed. In conventional management group, patients were disposed according to chronic disease management specification. Anthropometric measurements and biochemical markers detection were carried out in both groups at baseline and at the end of 6 months. Results These main anthropometric measurements and biochemical markers have no significant difference between the intervention group and conventional management group at the baseline (P>0.05) . After 6 months intensive lifestyle modification, the prevalence of MS did not significantly differ between the two groups: it was 67.14% in the intervention group and 60.95% in the conventional management group (P>0.05) .In the intervention group, the body weight, BMI and the waist circumference were decreased by 3.11 kg, 1.50 kg/m2, 4.29 cm, respectively, and 1.23 kg, 0.47 kg/m2, 1.22 cm in the conventional management group. The changes were significantly larger in the intervention group than in the conventional management group (P<0.01) .Uric acid, triglyceride were decreased by 14.30 μmol/L, 0.01 mmol/L, respectively, in the intervention group and in the conventional management group they were increased by 18.17 μmol/L and 0.41 mmol/L conversely. While the high density lipoprotein cholesterol was increased by 0.02 mmol/L, it was decreased by 0.10 mmol/L in the conventional management group (P<0.01) . Body weight and BMI decreased by 3.93kg and 1.40 kg/m2 in the high compliance group, compared to low compliance group, there was statistically difference with regard to this change between the two groups (P<0.05) . While the body fat% was decreased by 2.27%, and it was increased by 1.01% in the conventional management group (P<0.05) . Conclusion For rural residents, the beneficial effects of intensive lifestyle intervention are improving metabolic risk factors. The compliance is the main factor of the effects of intervention.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the risk factors of pregnancy termination at second and third trimester in women with scarred uterus and placenta previa.</p><p><b>METHODS</b>Clinical data of 24 pregnant women of second and third trimester with a scarred uterus and placenta previa,who requested termination in Women's Hospital Zhejiang University School of Medicine from July 2009 to June 2014, were retrospectively analyzed. The method of mifepristone combined with ethacridine lactate was adopted for all cases. Mifepristone combined with ethacridine lactate and uterine artery embolization were routinely given for patients with complete placenta previa. Cesarean section was performed for patients who failed to delivery or underwent massive vaginal bleeding before delivery. Age, gestational weeks, gravidity and parity, times of previous cesarean section, the interval from previous operation, the position and the type of placenta previa, placenta accretet, the indication and method of termination, postpartum hemorrhage, successful rate of labor induction, placental retention ratio and uterus rupture were documented.</p><p><b>RESULTS</b>The successful rate of labor induction was 83.3%. The analysis showed that age, gestational weeks, gravidity and parity and times of previous cesarean section were not risk factors for failed labor induction, however the interval time from previous operation was related to induction failure (P<0.05). Patients with previous cesarean section ≥ 13 years were more likely to require cesarean section than those <13 years (P<0.05). The placenta adhered to the antetheca of the uterus or placenta accrete increased risk to have cesarean section. There were no significant differences in postpartum hemorrhage, the successful rate of labor induction, placental retention ratio and the rate of uterine rupture between patients with uterine artery embolization and those without.</p><p><b>CONCLUSION</b>The labor induction would be feasible for women with a scarred uterus and placenta previa in second and third-trimester pregnancy. The previous operation ≥ 13 years, the antetheca placenta or placenta accrete might increase the incidence of labor induction, while the uterine artery embolization would rise the successful rate of labor induction.</p>