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Objective@#To analysis of the effect of strengthening management of dyslipidemia in community based on family doctor contracting service.@*Methods@#In December 2014, 1267 cases patients with dyslipidemia aged over 18 years were selected from three community health service centers in Hangzhou, including 645 in intervention group (311 males and 334 females) and 622 in control group (307 males and 315 females). In the intervention group, the management of dyslipidemia in community was strengthened by graded follow-up and personalized diagnosis and treatment based on the contracted services of family doctors, while the control group adopted the general management of dyslipidemia in the community. After 12 months of intervention, the changes of lifestyle (smoking, drinking, body mass index, waist circumference), regularly taking lipid-regulating drugs, blood lipid, blood pressure, blood sugar levels and their control rates were compared by χ2 test or t test before and after intervention between the intervention group and the control group. Non-conditional logistic regression analysis was used to analyze the influencing factors of blood lipid attainment.@*Results@#Before intervention, there were no significant differences in gender, age, cardiovascular risk stratification, the levels of lipid and other metabolic indicators, lipid compliance rate between intervention group and control group (P> 0.05). After intervention, the intervention group improved in drinking, overweight,obesity, abdominal obesity, and the rate of regularly taking lipid-regulating drugs increased,compared with the control group, the difference was statistically significant (χ2=5.923,4.765,8.587,5.341, 5.654; all P<0.05). The levels of total cholesterol, triglyceride, low density lipoprotein cholesterol, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose, glycosylated hemoglobinin the intervention group were lower than those in the control group, the differences were statistically significant (t=-4.987,-3.207, -6.280, -3.339, -2.466, -4.052, -5.012, -2.865, -2.450; all P<0.05), while the HDL-C level in the intervention group was higher than that in the control group (t=2.294; P<0.05). The control rate of blood lipids, the control rate of blood pressure, and the combined control rates of blood lipid, blood pressure and blood sugar in the intervention group were higher than those in the control group, the differences were all significant (χ2=31.262,4.818,17.245; all P<0.05). Unconditional logistic regression analysis showed that family doctor contracted services (OR=1.961, 95%CI: 1.485-2.589), gender (OR=0.662, 95%CI: 0.471-0.930), smoking (OR=0.498, 95%CI: 0.332-0.745), obesity (OR=0.570, 95%CI: 0.359-0.904), hypertension (OR=0.353, 95%CI: 0.259-0.480), diabetes mellitus (OR=0.340, 95%CI: 0.239-0.483) was the influencing factor of blood lipid reaching the target (all P<0.05).@*Conclusion@#Intensive management of dyslipidemia in community based on family doctor's contracting service is helpful to improve the management effect of dyslipidemia.
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Objective@#To understand the dyslipidemia rate and trend of blood lipid level in an urban community in Hangzhou.@*Methods@#A total of 1 485 urban community residents aged 24 years or older who had participated in health checkup over 6 years, from 2011-2016, were selected by random cluster sampling. Fasting blood Triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C) levels were measured in all subjects. A χ2 test was used to analyze the dyslipidemia rate trend, and an ANOVA of repeated measurement was conducted to observe the blood lipid level changes.@*Results@#From 2011 to 2016, the total abnormal rates of blood lipids in 1 485 residents were 33.2% (493/1 485), 30.5% (453/1 485), 30.4% (452/1 485), 26.5% (394/1 485), 26.3% (391/1 485), and 25.1% (373/1 485), respectively, which showed a declining trend year-by-year (χ2=36.051, P<0.01). Among these results, however, the high TG rate did not significantly differ from year-to-year (χ2=10.081, P>0.05). The TG, TC, LDL-C, and HDL-C levels statistically differed over the 6 years (F=4.876, 33.033, 170.254, 58.442, respectively, all P<0.01). LDL-C was the highest in 2011 [(3.02±0.29) mmol/L] and the lowest in 2016 [(2.72±0.71) mmol/L], while HDL-C was the highest in 2016 (1.44±0.33 mmol/L) and the lowest in 2011 [(1.35±0.30) mmol/L]. Time-sex group interaction effect analysis: TC and HDL-C levels showed different trends over time between men and women (F=2.556, 4.982, respectively, all P<0.05), and the TC level in the male group was significantly lower than in the female group, since 2012. Interaction effect of time age group: TC and LDL-C levels showed different trends between age groups over time, and the declining trend of TC and LDL-C in the elderly group was more significant than in the young or middle age group (F=10.328, 3.085, respectively, all P<0.01).@*Conclusions@#The community population showed an overall improvement in blood lipid levels; however, there was no significant improvement in high TG levels. It is necessary to continue monitoring blood lipid levels in the community, especially to strengthen the prevention and control of high TG levels.
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Objective To analysis the clinical and gene mutation characteristics of hereditary fructose intolerance (HFI). Methods The clinical features and the results of gene testing in the child with HFI and her parents were analyzed retrospectively. Gene sequencing was carried out by high-throughput sequencing and validated by Sanger sequencing. Results The 4-year-3-month old girl had recurrent hypoglycemia episodes and growth retardation. When the condition was stable, the levels of lactic acid and urine micro protein were slightly higher, and the levels of thyroid hormone, cortisol, glycosylated hemoglobin, insulin and C peptide were normal.EEG showed epileptiform activity.Gene sequencing revealed the presence of aldolase B gene(ALDOB) compound heterozygous mutations, a novel splicing mutations (c.325-1G>A) in intron 3 and a frameshift mutation (c. 865delC;p.L289fs*10) in exon 8. Her father carries a frameshift mutation, and her mother carries a splicing mutation. Conclusion The diagnosis of HFI caused by ALDOB mutation can be confirmed by high-throughput sequencing technology.
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Objective:To analyze the mistakes in the application of tuina therapy in the rehabilitation of stroke,in order to elevate the clinical effects in the treatment of stroke by tuina.Methods:The issues are found out by searching and analyzing the relevant articles on tuina treatment of stroke.Results:In the tuina treatment of stroke,mistakes exist in the intervening time of the treatment,in the emphasis of tuina with negligence of rehabilitation,in the assessment of therapeutic effects,in the selection of the manual techniques and acupoints,and in the negligence of health education.Conclusion:In the tuina treatment of stroke,it is advisable to start treatment in the early stages,use the manual techniques in different phases,to cooperate with rehabilitation at the proper time and to emphasize health education,in order to avoid or reduce the occurrence of misuse syndrome,and eliminate the appearance of disuse syndrome,for displaying the unique advantage of tuina therapy fully and promoting the innovation and development of TCM rehabilitative techniques.
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<p><b>OBJECTIVE</b>To verify the efficacy and safety of post-marketed fleabane injection combined with Dengzhan Shengmai capsules in the treatment of ischemic stroke (IS).</p><p><b>METHOD</b>A multicentre, prospective, practical, randomized controlled study was carried out to compare the efficacy and safety of Dengzhan group (n = 343) and western medicine group (n = 335), appling "clinical study central stochastic system". The treatment of Dengzhan group is using fleabane injection in acute stage and Dengzhan Shengmai capsules in convalescence. The primary indexes of effect evaluation are the important outcome events in 360 days' follow-up, including mortality, recurrence, disability and quality of life to reflect the effect of clinical study. The indexes of safety evaluation involve laboratory examination results and incidence of adverse events.</p><p><b>RESULT</b>After 360 days' follow-up, 4 people died of IS in Dengzhan group, and the mortality rate of which is 1.17%, while 16 died in Western medicine group (WM group), and the mortality rate is 4.78%, suggesting that the mortality rate of Dengzhan group is significantly lower than WM group (P<0.05). Eleven cases recurred in Dengzhan group, and the recurrence rate of which is 3.21%, while 12 recurred in WM group, and the recurrence rate is 3.59%, indicating that the recurrence rate of Dengzhan group is slightly lower than WM group. The disability rate of Dengzhan group is 39.53%, among which the rate of severely disabled cases are 1.49%, while the disability rate of WM group is 40.13%, among which the rate of severely disabled cases are 3.13%, suggesting that the disability rate of Dengzhan group is lower and the severity of disability is also lighter than WM group. In the field of quality of life, the activity ability and the upper limb function store of stroke patients in Dengzhan group improved far much better than WM group (P<0.05). Analysis of safety suggested that, adverse events occurred in 11 cases in Dengzhan group, among which 4 cases is related with the drug treatment, the incidence of adverse events of which is 1.17%, and the main manifestations involve fever and chilling, rash, nausea, dizziness, palpitation, etc. which were all appeared after the treatment of fleabane injection, and disappeared 1 to 2 days after drug withdrawal. 13 cases occurred abnormal liver function and 2 cases abnormal kidney function in Dengzhan group. According to the judgment of clinical physicians, 3 case of ALT abnormality is possibly related to the treatment, the others are all unrelated with the treatment.</p><p><b>CONCLUSION</b>Fleabane injection and Dengzhan Shengmai capsules are all safe and effective TCM in the treatment of ischemic stroke.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Brain Ischemia , Drug Therapy , Capsules , Drug-Related Side Effects and Adverse Reactions , Drugs, Chinese Herbal , Therapeutic Uses , Erigeron , Injections , Product Surveillance, Postmarketing , Prospective Studies , Stroke , Drug TherapyABSTRACT
<p><b>OBJECTIVE</b>To study the effect and safety of Kudiezi injection on patients with acute ischemic stroke.</p><p><b>METHOD</b>Seven hundreds patients were divided into two groups by central randomization system. The study group, 346 cases, was treated with kudiezi injection plus traditional Chinese medicine (TCM) synthesis rehabilitation project, and the control group, 354 cases, was treated with synthetic rehabilitation project. The patients were treated for 10 to 21 days. Before treatment and at the 7th, 14th and 21th day of treatment, the indexes include NIHSS used for evaluating the neurological deficit degree and the motor function score (Fugl-Meyer) for evaluating motor function were observed. The safety index is defined by adverse observation event and laboratory test. The incidence of adverse events and laboratory tests results were observed before and after treatment at the same time.</p><p><b>RESULT</b>Application of generalized estimating equation model, we found that as the treatment time, NIHSS score and FMI score of the two groups showed a trend of improvement. And at the 14th days and 21th days of treatment, compared to the control group the treatment group showed significant statistical difference on the impact of NIHSS and FMI (P<0.05). No serious adverse events were observed.</p><p><b>CONCLUSION</b>Kudiezi injection plus TCM rehabilitation project of ischemic stroke showed some superiority to western medicine rehabilitation program on improving the neurological deficit and motor function. Kudiezi injection is safe and effective in the treatment of acute ischemic stroke.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Brain Ischemia , Drug Therapy , Drug-Related Side Effects and Adverse Reactions , Drugs, Chinese Herbal , Therapeutic Uses , Injections , Medicine, Chinese Traditional , Product Surveillance, Postmarketing , Stroke , Drug TherapyABSTRACT
Objective To study the effects on tissue CT number caused by scan protocols.Methods The phantom was repeatedly scanned in different protocols by changing only one of parameters,such as X-ray tube voltage,mAs and recon kernel,while other parameters were ketp unchanged.The CT number of different materials in phantom were measured and analyzed.Results The CT numbers of tissues changed remarkably with the tube voltage and had different relativity for different tissues.The CT numbers had positive correlation with kV for such maierials as polyethyle,lexan,perspex,but for teflon the correlation was negative.The mAs and recon kernel had no effects on CT number.Conclusions The CT number of tissue changes with scanning X-ray tube voltage,so the setting of scan parameters should be taken into account in image diagnosis and radiotherapy.
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<p><b>OBJECTIVE</b>To study the triterpenoid saponins in Hemsleya chensnsis.</p><p><b>METHOD</b>The chemical constituents were isolated and purified by various chromatographic methods and their structures were elucidated on the basis of spectral analysis.</p><p><b>RESULT</b>Seven known triterpenoid saponins were isolated from the root of H. chensnsis and were identified as 3-O-beta-D-glucuropyranosyl-oleanol-icacid (1), 3-O-beta-D-glucopyra-noside-oleanolicacid-28-O-beta-D-glucopyranoside (2), 3-O-(6'-methylester)-beta-D-glucuropyranosyl olea- nolic acid-28-O-alpha-L-arabinopyranoside (3), 3-O-(6'-methylester)-beta-D- glucuropyranosyl- oleanolic acid-28-O-beta-D-mannupyranoside (4), 3-O-(6'-ethyl ester)-beta-D-glucuropyranosyl oleanolic acid-28-O-beta-D- glucopyranoside (5), 3-O-alpha-L-arabinopyranoside-(1-->3) -beta-D-glucuropyranosyl- oleanolic acid-28-O-beta-D-glucopyranoside (6), 3-O-beta-D-glucu-ropyranosyl-oleanolic acid-28-O-beta-D-glucopyra-noside-(1-->6)-beta-D-glucopyranoside (7).</p><p><b>CONCLUSION</b>Compounds 1-7 were isolated from this plant for the first time.</p>
Subject(s)
Cucurbitaceae , Chemistry , Drugs, Chinese Herbal , Pharmacology , Mitragyna , Chemistry , Molecular Structure , Plant Extracts , Pharmacology , Plant Roots , Chemistry , Saponins , ChemistryABSTRACT
<p><b>OBJECTIVE</b>To report a true hermaphroditism due to a teragametic chimerism and to discuss the pathogenesis of tetragametic chimerism.</p><p><b>METHODS</b>Chromosomal analysis and fluorescence in situ hybridization(FISH) were carried out on the lymphocytes from the blood and on the fibroblasts from the cultured skin and on fibroblasts from two different kinds of gonadal tissues of the patient with ambiguous genitalia respectively. Blood groups, human leukocyte antigen (HLA) haplotyping and 77 short tandem repeat (STR) microsatellite markers were tested. The two kinds of tissues in the gonad were detected by histopathological examination. Blood groups, HLA haplotying and 77 STR microsatellite markers parents of the patient's were also analyzed.</p><p><b>RESULTS</b>Either 46,XX or 46,XY karyotype was found in the lymphocytes of the blood and in the fibroblasts of the cultured skin and of the two different kinds of gonadal tissues. Two X chromosome-specific signals or one X and one Y signal were detected in each interphase nucleus by FISH from the lymphocytes of the blood and the fibroblasts of three different tissue cultures. The karyotype of the 46,XY cell line predominated in all cultures except the cultured-fibroblasts from yellow gonadal tissues. STR marker analysis, ABO grouping and HLA study from the patient were identified a single haplotype in the patient from the mother and two different haplotypes from the father. Two kinds of tissues in the gonad were observed by histopathological examination. The yellow tissue was ovary and the white one was testis.</p><p><b>CONCLUSIONS</b>Histopathological examination and chromosomal analysis combined with FISH are very useful methods for the diagnosis of true hermaphroditism. Blood typing, HLA and short tandem repeat microsatellite markers afford strong evidence for confirming tetragametic chimerism. The mechanism of tetragametic chimerism in true hermaphroditism can be explained by a parthenogenetic division of a haploid nucleu into two identical gametes, followed by fertilization with both X and Y spermatozoa and then developed into an organism.</p>