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Objective To provide an comprehensive evaluation of the correlation between sleep apnea hypopnea syn?drome (SAHS) and nonalcoholic fatty liver disease (NAFLD). Methods The various case-control studies on the relation?ship between SAHS and NAFLD were retrieved from all kinds of large-scale databases at home and abroad (including Web of science, EMbase, Pubmed, Springer Link, EBSCO Databases, CNKI, CQVIP, Wanfang Data). The quality evaluation of in?cluded studies was made by two independent researchers. RevMan 5.1 and stata 12.0 software were used for meta-analysis. Results A total of 11 qualified documents were included in this study. Meta analysis showed that the relative risk of NAFLD was increased in SAHS patients than non-SAHS patients (RR=2.82, 95%CI:2.03-3.92, P<0.01). The serum ala?nine aminotransferase (ALT) increased in SAHS patients (SMD=0.53, 95% CI:0.02-1.05, P < 0.05). Compared with non-SAHS patients, the apnea-hypopnea index (AHI) was significantly higher in SAHS patients combined with severe NAFLD than those combined with mild NAFLD (SMD=1.42, 95%CI:0.12-2.72, P < 0.05). Conclusion The risk of NAFLD in?creases in SAHS patients. The severity of NAFLD is relatively higher with the severity of intermittent hypoxia.
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Objective To study the effects of health management on blood pressure and lifestyle of hypertensive outpatients.Methods A total of 319 hypertensive outpatients were randomly assigned to the control group (n =160) or the health management group (n =159).Pharmacologic therapy was given to the control group,while in the health management group,intensive health management combined with pharmacologic therapy was conducted.Blood pressure,height,body weight (BW),total cholesterol (TC),and fasting blood glucose (FBG) of the participants were measured and compared at baseline and 12 months.Results There were no significant differences of clinical characteristics between two groups at baseline.After 12 months' intervention,more significant decrease of systolic blood pressure and diastolic blood pressure was found in the health management group (t values were 2.701 and 2.306,respectively;both P ＜ 0.05).There were statistically significant differences of body mass index (BMI) and serum TC levels between the control and the health management group (t values were 2.111 and 2.227,respectively ;P ＜ 0.05).After the intervention,two groups showed no significant difference in current cigarette smoking (x2=2.787,P ＞ 0.05).The participants in the health management group showed improved physical exercises,diet,and adherence to treatment at the end of the observation (x2 values were 59.459,52.018,6.321 and 5.392,respectively; all P ＜ 0.05).Conclusion Compared with pharmacologic therapy,health management combined with pharmacologic therapy could significantly improve clinical parameters and life style of hypertensive patients.
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ObjectiveTo study the effects of health management on elderly patients with metabolic syndrome and lower extremity arterial disease.Methods A total of 118 metabolic syndrome( MS ) patients with ankle-brachial index (ABI) ＜ 0.9 and no intermittent claudication were randomly assigned to the control group( n =60,receiving pharmacologic therapy ) or health management group ( n =58,receiving intensive health management + pharmacologic therapy).Blood pressure,ABI,total cholesterol (TC),and fasting blood glucose(FBS) were tested before and 12 after the intervention.Results Clinical data were comparable between the two groups at baseline.After 12-months' intervention,systolic blood pressure(SBP) and FBS in both groups were significantly decreased,especially in the health management group[SBP:(141 ± 10)mm Hg(1 mm Hg=0.133 kPa) vs(146±11) mm Hg,t =2.581,P=0.011; FBS:(5.32 ±1.33) mmol/L vs ( 5.92 ± 1.61 ) mmol/L,t =2.231,P =0.028].TC ( 5.51 ± 0.51 ) mmol/L vs ( 5.11 ± 0.49 ) mmol/L,(t=4.307,P=0.000) and ABI(0.77 ±0.17 vs 0.84 ±0.19,t=2.091,P=0.039) of the health management group were significantly improved at 12 months.Patients in the health management group also showed higher SF-36 scores than those in the control group( physical functioning:72.2 ± 12.4 vs 65.2 ±20.1,t =2.268,P =0.025 ; emotion:73.9 ± 18.0 vs 65.6 ± 21.1,t =2.295,P =0.023 ; mental health:63.9 ± 13.3vs 58.3 ± 12.5,t =2.358,P =0.020 ).Conclusion Compared with medication,health management and pharmacologic therapy could significantly improve clinical parameters and quality of life of elderly MS patients combined with peripheral arterial disease.
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Objective To study the effects of health management on cardiovascular events in the elderly patients with hypertension. Methods A total of 182 elderly patients with hypertension were randomly assigned to the control group (n = 61 ), pharmacologic therapy group (n = 61 ) or health management group ( n = 60). Serum biomarkers, brachial-ankle pulse wave velocity ( baPWV ), and blood pressure were tested at baseline and after intervention. Results There were no differences between the 2 groups in clinical characteristics at baseline. The average following-up period was (21 ± 7 ) months. The improvement of systolic blood pressure ( t = 3.915, P = 0. 000 ), pulse pressure ( t = 3. 966, P = 0. 000), and baPWV ( t = 3. 093, P = 0. 002) in the health management group was more significant than the control group;the systolic blood pressure ( t = 2. 008, P= 0. 046 ) was bitterly improved than the pharmacologic therapy group. The accumulative survival rate of the health management group (96. 7% ) was higher than the control group (83.6%; x2 =5. 921 ,P =0. 015) ,similar to the pharmacologic therapy group (93.3%; x2 =2. 821,P=0.091 ). Decreased systolic blood pressure, diastolic blood pressure, pulse pressure and baPWV were protective factors. After adjusted by age and gender,the improvement of systolic blood pressure was found to be an independent protective factors ( RR = 0. 75, P ＜ 0. 05 ). Conclusion Health management in elderly patients with hypertension could more significantly reduce the risk of cardiovascular diseases.
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BACKGROUND: Post-stroke depression(PSD) is the most common emotional change after stroke. It has high morbidity, which also seriously affects the near and long term functional prognosis of the patients and affects the quality of life (QOL) of the patients during convalescence.OBJECTIVE: To investigate the impacts of integrated rehabilitative therapy on post-stroke depression and ability of daily life(ADL) through interventional therapy in patients with post-stroke depression.DESIGN: A randomized controlled study with the patients as subjects basedon diagnosis.SETTING: Department of cadre in a university hospital.PARTICIPANTS: Sixty cases including 34 males and 26 females hospitalized in the Department of Cadre of the General Hospital Affiliated to Tianjing Medical University between October 2001 and March 2002 were randomly divided into rehabilitation group( n = 30) and control group( n = 30).INTERVENTIONS: Patients of rehabilitation group received both routine medication and integrated rehabilitative therapy (cinesiotherapy + psychotherapy) while the patients of control group only received routine medication(decompression, improving cerebral circulation and symptomatic therapy) . Barthel index(BI) and Hamilton rating scale for depression(HAMD)were used to assess the patients at admission, the 3rd month and the 6th month during the course of the disease.MAIN OUTCOME MEASURES: BI and HAMD score at the 3rd and 6thmonth in patients of rehabilitation group and control group.RESULTS: BI at 3rd month or 6th month was (68.0 ± 2.9) or (70.0 ± 3.5)in patients of rehabilitation group, which was significantly higher than (62.0±3.3) at 3rd month and (65.0±3.8) at 6th month in patients of control group( P ＜ 0. 001, 0. 01) . HAMD score at 3rd month or 6th month was(8.9 ±4.9) or(8.7 ±5.1) in patients of rehabilitation group, which was significantly lower than(15.2 ±5.6) at 3rd month or(14. 9 ±8. 1) at 6th month in patients of control group ( P ＜ 0.05).CONCLUSION: Integrated rehabilitative therapy can effectively improve the ADL of patients with post-stroke depression and relieve depression.
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Objective To analyze the therapeutic effect of rehabilitation intervention for patients with post-stroke depression. Methods Sixty patients with post-stroke depression were divided randomly into a rehabilitation group(n=30) and a control group(n=30). Those in the former group were intervened with comprehensive rehabilitation programs (mainly the exercise and psychotherapy), while those in the later group only the ordinary medical drugs. 3～6 months later, therapeutic effect was assessed according to the recorded Barthel index and the HAMD scores, and a comparison was carried out between the two groups. Results In comparison with the control group, the therapeutic effect was significantly better in the rehabilitation group, as shown by significant increase of Barthel index scores at 3 months (P
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0.05). While serum pregesterone, hCG levels in inevitable group were (33.1?19.6) nmol/L, (10.3?3.2) kU/L respectively. Compared with normal early pregnancy and threatened abortion group, the levels of serum pregesterone and hCG reduced significantly ( P