Estimating risk of stroke in elderly people by use of Framingham Stroke Risk Profile / 上海预防医学

Objective To explore the application of Framingham Stroke Risk Profile in elderly people. Methods A total of 5 148 people aged 55 years and older who received physical examination in a community were enrolled.Information of their healthy status and risk factors were collected by interview using a questionnaire.Height, weight, waist circumference (WC), and blood pressure as well as fasting plasma glucose ( FPG) , and serum lipid were measured. Results The average 10-year probabilities of stroke in elderly people were 9.79% in men and 6.20% in women ( P <0.05).Besides aging factor, higher risk probability in men might be related to their higher proportions of smoking and atrial fibrillation. In addition to blood pressure and FPG which were variables associated with risk profile, WC/height ratio ( WHR) and serum triglyceride level were associated with increased risk of stroke estimated by stroke risk profile (OR=1.598, 95%CI:1.371~1.864;OR=1.487, 95%CI:1.225~1.783), respectively. Conclusion Besides factors which had been included by risk profile, it is important to pay attention to weight control and triglyceride level.For elderly male, to quit smoking is an important measure that decreases their risk of stroke.

Achievement of ABC goals and thrir association with serum creatinine and urea nitrogen among community middle aged and elderly diabetics / 上海预防医学

Objective To investigate the achievement of HbAlc ( A) ,blood pressure ( B) ,and LDL-C ( C) control goals of diabetes and explore their association with indices of renal function among diabetics in community. Methods A total of 388 diabetes patients aged 45 years and older were enrolled who received physical examination in a community.In addition to blood pressure (BP),were measured fasting blood glucose,glycated hemoglobin ( HbAlc) ,serum lipid,creatinine,and urea nitrogen. Results In this investigation only 1.8%of diabetes patients achieved ABC goals.And 34.0% achieved none of the three and 45.9%reached only one of the three.In the 388 diabetes patients,54.6%had HbAlc<7%,25.0%LDL-C <2.6 mmol/L,and 8.2% BP<130/80 mmHg.The levels of serum creatinine and urea nitrogen were elevated with age and not found to have association with the achievement of ABC goals. Conclusion Poor achievement of ABC goals was among diabetics in community.The effective control of blood pressure and LDL contributes to improvement of comprehensive control levels for diabetics.

Application of umbilical venous catheter combined with peripherally inserted central catheter in very low birth weight infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the application of umbilical venous catheter (UVC) combined with peripherally inserted central catheter (PICC) in very low birth weight infants (VLBWIs).</p><p><b>METHODS</b>A retrospective analysis was performed on the VLBWIs in the neonatal intensive care unit who received UVC combined with PICC (catheter group, n=63) or did not receive the catheter treatment (non-catheter group, n=38) to compare the differences in nosocomial infection, weight gain, and length of hospital stay between the two groups.</p><p><b>RESULTS</b>The rate of nosocomial infection was 17% in the catheter group and 24% in the non-catheter group (P>0.05). Compared with the non-catheter group, the catheter group had a significantly higher weight gain (11.7±2.0 g/kg•d vs 10.6±2.3 g/kg•d; P<0.05) and a significantly shorter length of hospital stay (40±11 days vs 45±14 days; P<0.05). There was no significant difference in the incidence of complications between the two groups.</p><p><b>CONCLUSIONS</b>Compared with those not receiving catheter treatment, the VLBWIs receiving UVC combined with PICC have a markedly higher weight gain and a markedly shorter length of hospital stay and show a declining trend in the rate of nosocomial infection.</p>

High-risk factors for parenteral nutrition-associated cholestasis in very low birth weight infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the high-risk factors for parenteral nutrition-associated cholestasis (PNAC), which is the most common complication of parenteral nutrition for infants, in very low birth weight infants (VLBWIs).</p><p><b>METHODS</b>Retrospective analysis was performed on the clinical and laboratory data of 204 VLBWIs who received parenteral nutrition for over 2 weeks in the neonatal intensive care unit from August 2006 to December 2011. The infants'liver function was evaluated periodically before and after Parenteral nutrition. Univariate analysis and multivariate analysis were performed in the observation (PNAC) and control (without PNAC) groups.</p><p><b>RESULTS</b>PNAC occurred in 46 (22.5%) of the 204 VLBWIs. Univariate analysis showed that continuous positive airway pressure (CPAP) ventilation, respiration failure, respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) were significantly increased in the observation group compared with the control group. The observation group had lower birth weights, longer duration of ventilation, later breast feeding beginning, longer duration of fasting, longer duration of parenteral nutrition, and higher cumulated amino acid and lipid emulsion intake. Logistic regression analysis revealed that duration of fasting was a high-risk factor for PNAC (OR=1.115, 95%CI: 1.031-1.207).</p><p><b>CONCLUSIONS</b>Many risk factors are associated with PNAC. Early enteral nutrition and short duration of parenteral nutrition are helpful in preventing the incidence of PNAC in VLBWIs.</p>

Using repeated measurement of 'analysis of variance' on hypertension patients to evaluate the self-management program in the communities / 中华流行病学杂志

Objective To explore the application of repeated measurement‘analysis of variance'(ANOVA)in evaluating the effectiveness of 'community-based hypertension self-management program'.Methods A community-based parallel controlled trial was conducted among 3 communities.169 patients in intervention group took part in the course on hypertension self-management program once a week and 204 patients in control group received routine hypertension management services.Data collected through questionnaire at baseline and 6 months,12 months after intervention and were compared through repeated ANOVA measurement.Results Subjects in the intervention group showed statistical significance and linear trends in health self-evaluation,distress,in lOW spirit,self-efficacy in managing symptoms(SEMS),self-efficacy to managing diseases in general(SEMDG),systolic blood pressure(SBP)and diastolic blood pressure(DBP)over time by univariate test of repeated measurement ANOVA.The score of SEMS increased from 6.84±2.53 at baseline to 8.20±1.44 at 12 months after intervention while SEMDG from 7.28±2.45 to 8.89±1.05,and SBP decreased from 137.66±7.30 inln Hg(1 mm Hg=0.133 kPa)to 130.41±7.71 mm Hg.DBP decreased from 84.13±6.70 mm Hg to 81.04±5.98 mm Hg respectively.Only tow spirit and SBP changed over time were seen in the control group.Self-evaluation,distress,in low spirit,caused by diseases,SEMS,SEMDG and SBP were statistically different between control and intervention groups,and the effect of interaction between groups and time span were statmtically significanton indicators as self-evaluation,low spirit,self-efficacy in managing symptoms,seLf-efficacy tO manage diseases and sBP etc,by multivariate test of repeated measurement ANOVA. Conclusion Repeated measurement ANOVA not only could be used to analyze group-effect,but could also explain the effect and the interaction among groups and time,to make the results more reliable.The self-management approach could improve the health status and self-efficacy of the patients,so as to reduce the blood pressure.Our result showed that it was effective for hypertensive patients to be on the chronic diseases selfmanagement program.

Study on the prevalence of arthritis and relevant factors in Shanghai / 中华流行病学杂志

<p><b>OBJECTIVE</b>This study aimed to understand the prevalence rate, epidemiological characteristics and relevant factors of arthritis in Shanghai.</p><p><b>METHODS</b>A sample of 7 575 residents aged 15 years and above was drawn from 6 communities under multiple stage cluster sampling. A household survey with questionnaire was carried out to differentiate both undiagnosed patients and those with definite arthritis. Those who had not been diagnosed before were asked to carry further clinical examinations by a rheumatologist.</p><p><b>RESULTS</b>The prevalence rate of arthritis was 6.11%, including osteoarthritis (OA) 4.18%, rheumatoid arthritis (RA) 0.52%, gout 0.28%, ankylosing spondylitis (AS) 0.28%, rheumatic arthritis 0.49% and other types arthritis 0.82%. Arthritis was significantly related to cardiovascular disease, pulmonary disease and gastrointestinal disease. Age, female and obesity might serve as risk factors for arthritis. Physical labors and living in rural area might have protecting effects.</p><p><b>CONCLUSION</b>Elderly and female seemed to be at high risk for arthritis. Weight control and more exercise should be encouraged to reduce the risks. For arthritis patients, treatment to other chronic diseases should not be ignored.</p>