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Objective To assess the screening and intervention techniques for resistant hypertension in the community.Methods Random sampling method was used to recruit 1 171 hypertensive patients from two communities in Hangzhou and Zhuji cities of Zhejiang province form October 2015 to september 2016.Among them,97 patients with resistant hypertension were identified with the Three-steps-flow screening method and the individualized intervention was given.The standardized treatment and lifestyle changes were compared before and after intervention.Results Among 97 patients with resistant hypertension,7 cases of pseudo resistant hypertension were detected;there were 2 cases with thyroid disease history,48 cases with snoring history and 1 case with sleep apnea syndrome.The life style intervention and standardized medication guidance were given to 90 patients with resistant hypertension according to the individual risk factors.After one year of intervention,the results showed that the rate of normalized blood pressure was 83.5％ (75/90) and the rate of standardized medication increased from 14.4％(13/90) to 90.0％ (81/90),the rate of medication compliance increased from 46.7％(42/90) to 95.6％(86/90),the blood pressure control rate increased from 12.2％(11/90) to 77.8％(70/90),and the average systolic blood pressure and diastolic blood pressure levels were decreased by 20.4 mmHg (1 mmHg=0.133 kPa) and 15.5 mmHg.The life style of patients with resistant hypertension was remarkably changed,56.7％(51/90) of patients took exercise regularly,high salt/high calorie diet decreased from 37.8％(34/90) to 11.1％(10/90),the proportion of the obese went down to 16.7％(15/90).Conclusion With the application of resistant hypertension screening and intervention,there are remarkable improvement in blood pressure control and life style changes for patients with resistant hypertension in the community.
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Objective To analyze risk factors and complication characteristics of healthcare-associated infection (HAI)in patients with lung cancer,and provide evidence for the formulation of HAI management strategy. Methods HAI-related articles were retrieved from China Biology Medicine (CBM),China National Knowledge Infrastructure (CNKI),Wanfang database,Vip database,PubMed,and Embase,all data were conducted Meta-analysis.Results A total of 19 articles involving 8 069 hospitalized patients with lung cancer (1 280 had HAI)were included.Meta-analysis on combined values of medical factors for HAI were as follows:OR(95%CI )of anti-tumor therapy(radiotherapy and chemotherapy),number of chemotherapy (≥ 2 times ),antimicrobial prophylaxis, immunosuppressant therapy,and invasive operation were 3.13 (1 .82,5.39),9.20 (3.04,27.87),3.23 (1 .77, 5.91),2.00(1 .56,2.57),and 2.28(1 .81 ,2.88),respectively;Meta-analysis on combined values of complication factors for HAI were as follows:OR (95% CI )of pulmonary diseases,chronic obstructive pulmonary disease (COPD),diabetes,renal dysfunction,malnutrition,hypoalbuminemia,neutropenia,and leukopenia were 2.65 (1 .74,4.02),2.40 (1 .76,3.27),2.25 (1 .85,2.73 ),2.56 (1 .18,5.52),5.51 (1 .70,17.89),2.05 (1 .56, 2.70),3.38(1 .40,8.18),and 2.10 (1 .22,3.62),respectively.Conclusion HAI-related factors of medical treat-ment and complications in patients with lung cancer are diversity,risk factors for HAI in patients with lung cancer are anti-tumor therapy,immunosuppressant therapy,antimicrobial prophylaxis,invasive operation,pulmonary dis-eases,COPD,diabetes,renal dysfunction,malnutrition,hypoalbuminemia,neutropenia,and leucopenia.
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Objective To explore the correlation between the epicaridal adipose tissue (EAT)volume and the SNYTAX score in patients with coronary artery diseases and to evaluate its clinical value.Methods Epicardial fat volume of 102 patients with coronary heart disease in our hospital were measured on dual-source CT angiography images,SNYTAX scores were calculated,and level of blood lipids,blood glucose (Glu),blood pressure,renal functional parameters and body mass index(BMI)were collected.Depending on SNYTAX scores,patients were divided into three groups (mild 0-22,moderate 23-32 and severe>33).The difference of EAT volume between groups and correlation with other indicators were analyzed.With indictors statistical significant in one-factor analysis,multi-ple regression equation was constructed to evaluate the risk factors of coronary artery diseases,particularly correlation between EAT volume and SNYTAX score.Results EAT,TC,TG,HDL,HbALc,GLu and BMI were significant different between three groups. Pearson regression showed that EAT,TC,GLu and BMI were independently risk factor in relation to the value of SNYTAX.Among them,standardized regressive coefficient of the EAT volume was the highest (β=0.52).Conclusion EAT volume is significantly positively correlated with the SNYTAX score in coronary heart disease,which can be as an effective predictor for its severity and prognosis.
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Objective To provide the evidences for the management strategies of ventilator-associated pneumonia (VAP) in neonates,we systematically reviewed all related studies and analyzed the high-risk primary disease and medical factors of VAP in neonates.Methods We retrieved all related studies in CNKI,Wanfang,VIP,CBM,Pubmed and Embase and evaluated their quality by Newcastle-Ottawa Scale and analyzed all data by qualitative and Meta-analysis.Results There were 12 case-control studies with higher methodological quality and involving 1 994 neonates and with 708 VAP patients.Six studies involving 872 neonates were included,the odds ratio of respiratory distress syndrome(OR=2.81) and malnutrition(OR=5.18) had significant differences between VAP and non-VAP group.Seven studies involving 1 110 neonates were included and the odds ratio of patients with corticosteroids (OR=3.12),central inhibitors (OR=2.31),antacids (OR=4.35) and Gamma globulin with large doses (OR=2.35) had significant differences between VAP group and non VAP.Four studies involving 554 neonates were included and the odds ratio of patients with closed chest drainage (OR=1.81)and umbilical vein catheterization (OR=9.19) had significant differences between VAP group and non VAP.Six studies involving 1 139 neonates were included and the odds ratio of patients with parenteral nutrition (OR=1.82)and blood transfusions (OR=2.49) had significant differences between VAP group and non VAP.Conclusions Our study confirms that the respiratory distress syndrome and malnutrition corticosteroids,central inhibitors,antacids,Gamma globulin with large doses,closed chest drainage,umbilical vein catheterization,parenteral nutrition and blood transfusions are important risk and early-warning factors.
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<p><b>OBJECTIVE</b>To investigate the role ofCD4+CD25+ T regulatory (Treg) cells, T helper (Th)17cells and interleukin (IL)-6 in the progression of hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) and determine their value as prognostic markers.</p><p><b>METHODS</b>The Chinese National Knowledge Infrastructure (CNKI), WanFang, Chinese Scientific Journals (VIP), PubMed, Embase and Web of Science databases were searched for English language case-control studies on the relationship between regulatory T lymphocytes and ACLF.The quality of included studies was assessed using the Newcastle-Ottawa scale. The meta-analysis was designed according to the PICOS approach recommended by the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. RevMan software, version 5.1, was used to perform the meta-analysis.</p><p><b>RESULTS</b>Nine case-cohort studies were selected for inclusion in the metaanalysis.The results of the meta-analyses showed that the level of CD4+CD25+ Treg cells was not significantly different between patients with HBV-related ACLF and patients with chronic hepatitis B (CHB) (mean difference (MD)=0.59, 95% confidence interval (CI)-1.68, 2.85, P=0.61) nor between patients with HBVrelated ACLF and healthy controls (MD=1.12, 95% CI:-1.42, 3.66, P=0.39). Thus, it appears that ACLF patients do not have a higher level of CD4+CD25+ Treg cells than CHB patients or healthy controls. However, the ACLF patients did appear to have a significantly higher level of Th17 cells than both the CHB patients (MD=1.73, 95% CI:0.21, 3.26, P=0.03) and the healthy controls (MD=1.62, 95% CI:(0.52, 2.72, P=0.004). In addition, the ACLF patients also had significantly higher level than both the CHB patients (MD=11.69, 95%CI:1.98, 21.40, P=0.02) and the healthy controls (MD=13.17, 95% CI:1.38, 24.95, P=0.03).</p><p><b>CONCLUSION</b>CD4+CD25+ Treg cells may be an important protective factor in the progression and prognosis of HBV-related ACLF, while Thl7 cells and IL-6 may be risk factors for further progression and worsened prognosis.</p>
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Humans , Acute-On-Chronic Liver Failure , Diagnosis , Allergy and Immunology , CD8-Positive T-Lymphocytes , Case-Control Studies , Disease Progression , Hepatitis B virus , Hepatitis B, Chronic , Interleukin-6 , Allergy and Immunology , Prognosis , T-Lymphocytes, Regulatory , Allergy and Immunology , Th17 Cells , Allergy and ImmunologyABSTRACT
Objective To investigate on out the deformity in the elderly of longevous area and the characteristics of the regions in Yunnan Province. Methods According to the forth census information, using multistage sample typical survey to the 18 counties (cities) with centenarians over 1/100 000. The deformity types of people aged 60 and over and the deformity rate of various age groups and its distribution were investigated. Results Among the 6 477 people aged 60 and over investigated, a total of 1 928 people were in deformity, the deformity rate was 29 8%. The elder the people, the higher the deformity rate was. The highest deformity rate was in Kunming and Chuxiong prefectures. The audition deformity was highest among all types of deformity in elder people. The occurrence of fracture was highest in Miao Nation in Honghe prefecture, reaching 18.1%. About 14 % of the centenarian people sufferred from dementia. Conclusions Effective control in blood pressure and osteoporosis are important method to protect the elder people and to promote the level of quality of life of the elderly.
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Objective To understand the blood pressure level of the aged in longevous area of Yunnan Province. Methods According to the forth census information,typical multistaged sample-survey was used for 15 counties (cities) with centenarians over 1/100 000 and the 3 counties (cities) with centenarians under 1/100 000. The blood pressure of people aged 60 and over were measured and the investigation questionnaire was filled in. Results The overall level of the blood pressure was systolic pressure (130.8?24.6) mm Hg and diastolic pressure (81.7?14.6) mm Hg. The systolic pressure increased in slow slope with the age growing, ranged 126.2-137.6 mm Hg, and higher in male than in female. The diastolic pressure was not affected by age growing. The difference of blood pressure in nationality was mainly affected by the latitude and the elevation. Conclusions With the age increasing, the blood pressure level of the aged people gradually increases.
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0.05). Conclusion Tianma Gouteng Decoction can reverse left ventricular hypertrophy and myocardial fibrosis,and its mechanism may be related to the inhibition of TGF-? 1 expression in cardiac muscle tissue.
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Objective To investigate the effect of Tianma Gouteng Decoction on myocardial fibrosis in renovascular hypertensive rat (RHR). Methods RHR models were established by occlusion of renal artery with artery forceps. The collagen concentration and the contents of collagen type I,III were measured. Meanwhile, the weight of heart and left ventricle was determined. Results (1)Both Tianma Gouteng Decoction and Captopril could reduce the left ventricle weight index (LVI) and collagen contents (P