ABSTRACT
Objective To investigate the outcomes of patients with diabetic retinopathy (DR) in Shanghai communities and the influencing factors.Methods From October 2015 to April 2016,533 type 2 diabetic patients with DR were selected by target sampling and cluster random sampling method from six community health service centers in Shanghai.Patients were followed up for 1 year.The demographic information,physical examination,laboratory tests and eye fundus exam results were documented and the DR was graded.The factors associated with the regression of DR were analyzed.Results Total 478 patients,including 280 females (58.6％) and 198 males (41.4％),were followed up for 1 year.The mean age of patients was (64±7) years and the mean disease duration was (8.85±4.20) years.The original DR lesion was remitted in 35 patients with an improvement rate of 7.3％;while the original DR lesion was aggravated in 29 patients with a progression rate of 6.1％.Ordinal logistic regression analysis revealed that age (OR=0.197,95％CI:0.056-0.699),body mass index (BMI) (OR=0.383,95％CI:0.171-0.856),glycosylated hemoglobin (HbAlc) (OR=0.287,95％CI:0.102-0.803),triglycerides (TG) (OR=0.541,95％CI:0.295-0.991),urinary albumin to creatinine ratio (ACR)(OR=0.218,95％CI:0.066-0.720) were associated with DR in type 2 diabetic patients.Conclusion The regression of DR is closely related to age,BMI,glucose,serum lipids and renal function,so it is suggested that lowering BMI,controlling glucose and serum lipids and maintaining normal kidney function are necessary for preventing the progression and promoting the improvement of DR in diabetic patients.
ABSTRACT
Objective To investigate the clinical characteristics of digestive system cancer during pregnancy and its influence on mother and fetus.Methods Clinical data of 12 pregnant women accompanied with digestive system cancer obtained from the follow-up record of cancer patients between July 2007 and January 2016 in Daqiao Community Health Service Center of Yangpu District,Shanghai,were retrospectively analyzed.Results Delayed treatment,missed diagnosis and misdiagnosis were found in ten of the 12 cases.Eleven cases underwent B-type ultrasound as an early imaging screening method.Eleven patients had advanced cancer,but only two of them were eligible for radical surgery.Five patients could be treated with anti-tumor therapy.Eleven of the 12 patients died within two years after diagnosis,and only one survived over five years.Eight of the twelve embryos or fetuses died and four neonates survived.Conclusions Digestive system cancer during pregnancy has an insidious onset,and the rates of missed diagnosis and misdiagnosis are high,with advanced disease stage at diagnosis and poor prognosis.Knowledge of the digestive system cancer during pregnancy and early diagnosis and treatment capacity should be enhanced so as to reduce the damage to both the pregnant woman and fetus.