RESUMEN
Objective To explore the effect of continuing nursing intervention with traditional Chinese medicine (TCM) characteristics on mental state and quality of life of empty nest elderly patients with hypertension, and to provide evidence-based theoretical basis for the development of continuing nursing care for empty nest elderly patients with hypertension. Methods Totally 100 cases of empty nest elderly patients with hypertension were randomly divided into study group and control group by random number method, 50 cases in each group; two groups of patients were given regular nursing according to doctor's instructions to adjust blood pressure drugs and hypertension; control group patients were given routine continuing nursing intervention after discharge; study group patients were given traditional Chinese medicine characteristics on the basis of the control group. Sustained nursing intervention; Self-rating Anxiety Scale (SAS) was used to measure the degree of anxiety at admission, discharge and 6 months after discharge. The rate of blood pressure control reaching the standard at admission, discharge and 6 months after discharge and the clinical effect at discharge and 6 months after discharge were compared between the two groups. SF-36 was used to assess the quality of life of the 2 groups at admission, at the time of discharge and 6 months after discharge. Results There was no significant difference in SAS scores between the two groups at admission and discharge (P>0.05). The SAS score in the study group at 6 months after discharge was (44.65 ± 4.32) points and (46.91 ± 4.56) points in the control group, and there was significant difference (t=2.544, P=0.006). There was no significant difference in the control rates of systolic and diastolic blood pressure between the two groups at admission and discharge (P>0.05). The control rates of systolic blood pressure and diastolic blood pressure in the study group were better than those in the control group at 6 months after discharge (t=4.762,4.336, P = 0.029, 0.037); there was no significant difference in the clinical efficacy between the two groups at discharge (P>0.05), and the clinical efficacy of the study group at 6 months after discharge was better than that of the control group (u=1.997, P=0.046). There was no significant difference in the scores of SF-36 at discharge (P>0.05); the scores of SF-36 at discharge for 6 months in the study group were significantly better than those in the control group (t=4.875-8.975, P=0.000); no cardiovascular and cerebrovascular events occurred in the study group for 6 months, 4 cases of unstable angina pectoris and 4 cases of cerebral infarction occurred in the control group. In 2 cases, the incidence of cardiovascular and cerebrovascular events was 12.00% (6/50). The difference between the two groups was statistically significant ( χ2=4.433, P=0.035). Conclusion Continuous nursing intervention with TCM characteristics can significantly improve the anxiety level of empty nest elderly patients with hypertension, is conducive to the control of blood pressure, improve the clinical efficacy, reduce the incidence of cardiovascular and cerebrovascular events, improve the quality of life of patients, and has the advantages of simplicity, safety and reliability, low cost, and so on. It is worth popularizing and applying.
RESUMEN
Objective@#To explore the effect of continuing nursing intervention with traditional Chinese medicine (TCM) characteristics on mental state and quality of life of empty nest elderly patients with hypertension, and to provide evidence-based theoretical basis for the development of continuing nursing care for empty nest elderly patients with hypertension.@*Methods@#Totally 100 cases of empty nest elderly patients with hypertension were randomly divided into study group and control group by random number method, 50 cases in each group; two groups of patients were given regular nursing according to doctor's instructions to adjust blood pressure drugs and hypertension; control group patients were given routine continuing nursing intervention after discharge; study group patients were given traditional Chinese medicine characteristics on the basis of the control group. Sustained nursing intervention; Self-rating Anxiety Scale (SAS) was used to measure the degree of anxiety at admission, discharge and 6 months after discharge. The rate of blood pressure control reaching the standard at admission, discharge and 6 months after discharge and the clinical effect at discharge and 6 months after discharge were compared between the two groups. SF-36 was used to assess the quality of life of the 2 groups at admission, at the time of discharge and 6 months after discharge.@*Results@#There was no significant difference in SAS scores between the two groups at admission and discharge (P>0.05). The SAS score in the study group at 6 months after discharge was (44.65 ± 4.32) points and (46.91 ± 4.56) points in the control group, and there was significant difference (t=2.544, P=0.006). There was no significant difference in the control rates of systolic and diastolic blood pressure between the two groups at admission and discharge (P>0.05). The control rates of systolic blood pressure and diastolic blood pressure in the study group were better than those in the control group at 6 months after discharge (t=4.762,4.336, P = 0.029, 0.037); there was no significant difference in the clinical efficacy between the two groups at discharge (P>0.05), and the clinical efficacy of the study group at 6 months after discharge was better than that of the control group (u=1.997, P=0.046). There was no significant difference in the scores of SF-36 at discharge (P>0.05); the scores of SF-36 at discharge for 6 months in the study group were significantly better than those in the control group (t=4.875-8.975, P=0.000); no cardiovascular and cerebrovascular events occurred in the study group for 6 months, 4 cases of unstable angina pectoris and 4 cases of cerebral infarction occurred in the control group. In 2 cases, the incidence of cardiovascular and cerebrovascular events was 12.00% (6/50). The difference between the two groups was statistically significant (χ2=4.433, P=0.035).@*Conclusion@#Continuous nursing intervention with TCM characteristics can significantly improve the anxiety level of empty nest elderly patients with hypertension, is conducive to the control of blood pressure, improve the clinical efficacy, reduce the incidence of cardiovascular and cerebrovascular events, improve the quality of life of patients, and has the advantages of simplicity, safety and reliability, low cost, and so on. It is worth popularizing and applying.
RESUMEN
Objective To investigate the relationship between lipid fluctuations of daily diet and insulin resistance in patients with type 2 diabetes mellitus(T2DM) with normal fasting lipid profile. Methods One hundred and ninety?eight cases patients with T2DM who were treated in the Endocrinology Department of the General Hospital of Benxi Iron and Steel Group Corporation from October 2012 to September 2014 were selected. Patients were divided into three groups according to fasting and postprandial 4 h triglyceride( TG4 h) level,the group with normal fasting TG and normal TG4 h with 38 cases,the group with normal fasting TG and rising TG4 h with 78 cases,the group with rising fasting TG and rising TG4 h with 82 cases. The control group was composed of healthy volunteers with 20 cases. The patients followed daily diet habits to eat,blood glucose, insulin and lipid level of fasting and 2 h,4 h after lunch were monitored. Homeostasis model insulin resistance index( HOMA?IR) was used as an index to evaluate insulin resistance,and the correlation analysis was carried out with fasting and dietary intake of postprandial lipid metabolism. Results (1)HbA1c,FPG,HOMA?IR,TG and insulin level in the patients of the group with normal fasting TG and normal TG4 h,the group with normal fasting TG and rising TG4 h,the group with rising fasting TG and rising TG4 h were higher than the control group (HbA1c:(8. 4±1. 9)%,(8. 2±2. 4)%,(7. 8±1. 8)% vs. (4. 3±0. 6)%);FPG:(8. 98±1. 93) mmol/L, (8. 62±1. 33) mmol/L,(8. 28±1. 26) mmol/L vs. (4. 82±0. 63) mmol/L;,HOMA?IR:11. 07±0. 11,6. 98 ±0. 08,3. 83±0. 09 vs. 1. 24±0. 16;TG:0 h TG:(2. 35±1. 85) mmol/L,(1. 60±0. 41) mmol/L,(1. 58±0. 46) mmol/L vs. (0. 82±0. 25) mmol/L;2 h TG:(3. 97±2. 96) mmol/L,(2. 98±1. 49) mmol/L,(1. 83±0. 62) mmol/L vs. (1. 22±0. 31) mmol/L;4 h TG:(4. 24±1. 57) mmol/L,(3. 15±1. 63) mmol/L,(1. 92±0. 53) mmol/L vs. (1. 16±0. 24) mmol/L;insulin(0 h insulin:(26. 51±3. 65) mU/L,(18. 18±6. 24) mU/L,(10. 31 ±2. 38) mU/L vs. (5. 87±1. 62) mU/L;2 h insulin:(59. 15±8. 34) mU/L,(43. 75±9. 83) mU/L,(34. 27 ±1. 61) mU/L vs. (25. 24±1. 98) mU/L;4 h insulin:(51. 22±6. 79) mU/L,(40. 06±7. 51) mU/L,(31. 06 ±1.77) mU/L vs. (13.36±1.37) mU/L;P<0.05). (2)WHR(0.90±0.08 vs.0.72±0.06),HOMA?IR, insulin level of fasting and 2 h,4 h after lunch,TG of 2 h,4 h after lunch in the group with normal fasting TG and rising TG4 h were higher than the group with normal fasting TG and normal TG4 h ( P<0. 05 ) . ( 3 ) BMI ((27. 3±3. 3) kg/m2 vs. (23. 1±1. 5) kg/m2),WHR(0. 96±0. 10 vs. 0. 72±0. 06),HOMA?IR,TG and insulin level of fasting and 2 h,4 h after lunch in the group with rising fasting TG and rising TG4 h were higher than the group with normal fasting TG and normal TG4 h( P<0. 05) . HOMA?IR,TG and insulin level of fasting and 2 h, 4 h after lunch in the group with rising fasting TG and rising TG4 h were higher than the group with normal fasting TG and rising TG4 h( P<0. 05) . ( 4) HOMA?IR was positively correlated with BMI,WHR,and fasting TG levels in the groups with diabetes(r=0. 297,0. 376,0. 326,P<0. 05). HOMA?IR was significantly positively correlated with TG of 2 h,4 h after lunch in the groups with diabetes( r=0. 529,0. 693,P<0. 05) . HOMA?IR was significantly positively correlated with BMI and WHR in the control group(r=0. 617,0. 728,P <0. 05). HOMA?IR was not significantly correlated with fasting and postprandial TG in the control group. Conclusion Postprandial lipid metabolism disorder after daily diet is in some of patients with T2DM with normal fasting lipid profile. Postprandial lipid metabolism disorder after daily diet is significantly positively correlated with insulin resistance in patients with T2DM. Insulin resistance may be one of the pathogenesis of postprandial dyslipidemia in patients with type 2 diabetes.
RESUMEN
To explore the effects of serum insulin on the expression of ChREBP, ACC and FAS in vivo, KKAy mice which were characterized with high levels of both serum insulin and glucose and DIO mice which were characterized with high serum insulin level alone were utilized, separately. The age-matched C57BL/6J mice fed with standard chow were used as normal control (Con). Expressions of hepatic ChREBP, ACC and FAS were detected by Western blotting. As the results, in KKAy mice, a positive correlation between the levels of serum insulin and glucose (r = 0.902, P < 0.000), as well as between the levels of serum insulin and TG (r = 0.732, P < 0.000), was observed. Meanwhile, the expressions of hepatic ChREBP, ACC and FAS increased significantly and accompanied with its hyperinsulinemia and hyperglycemia, separately. In DIO mice, correlation between the levels of serum insulin and TG (r = 0.722, P < 0.001) also showed positive, and the expressions of hepatic ChREBP, ACC and FAS increased significantly and also accompanied with its hyperinsulinemia. However, their blood glucose values were almost normal. These demonstrated that hyperinsulinemia may cause glycolipid metabolic disorders by up-regulating the expression of ChREBP in vivo.
RESUMEN
Tei-Index is a useful echocardiographic parameter for evaluating global cardiac function. Conventionally, a value and b value, which the calculation of Tei index is based on, are measured in different cardiac cycle. Therefore, accuracy of Tei index is damaged by cycle dependent variation, especially in patients with arrhythmia. The newly established Dual Doppler modality allows a synchronous measurement of both a value and b value. This study was aimed to explore the value of Tei index measured by Dual Doppler in cardiac function estimation in patients with hypertension. One hundred and forty patients with hypertension were recuited and divided into three groups according to cardiac function. The a value and b value were generated from the transmitral and transaortic flow spectrum of the same cardiac cyle by Dual Doppler modality. The results showed that Tei index was significantly higher in the cardiac dysfunction group than in the control group. There was a high correlation between Tei index and NYHA cardiac performance. Tei index measured by Dual Doppler modality is a highly reproducible parameter with high sensitivity and specificity for cardiac function estimation, even for patients with arrthymia.
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Ecocardiografía Doppler en Color , Hipertensión , Diagnóstico por Imagen , Disfunción Ventricular Izquierda , Diagnóstico , Función VentricularRESUMEN
OBJECTIVE: In order to study the mechanism of the aqueous humor circulation and its relationship to the glaucoma macroscopically with engineering methods. METHODS: A dynamistic model was presented, which can be used to simulate the situation and the treatment of the primary open angle glaucoma (POAG). The frame of the model was built based on the ophthalmically accepted feedback mechanism between the aqueous humor circulation and the intraocular pressure (IOP). The transfer functions and the parameters were educed from the analysis of physiological theories, the basic elements of hydrodynamics, and the clinical parameters. The relation between the parameters of the system and the episode mechanism of POAG was discussed. A digital method was used to simulate the Challenge test and some medicines' treatment of POAG, and the results were consistent with clinical observations. RESULTS: The results of simulation illuminate that the model can simulate the mechanism of the aqueous humor circulation and the curative mechanism of some medicines under the physiological condition and the pathological condition of the POAG. CONCLUSION: A few parameters which can hardly be captured with clinical method could be obtained from the model. These parameters can be helpful for the diagnosis and prediction of the curative effect.