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Objective To screen the incidence of transient hypertension in conventional hypertensive management population of hypertension and analysis it's related etiology and constituent ratio.Methods People who met the diagnosis of hypertension were selected from inpatient and outpatient of this department.All patients were followed up for 2 months of home blood pressure monitoring,if the patients who were normal when monitoring home blood pressure were included in the trial and symptomatic hypertension was excluded.Results Three hundred of patients met the diagnostic criteria for hypertension,46 cases (15.3％) met the standard of transient hypertension,the etiology and constituent ratio of transient hypertension in the observed cases were as follows:25 cases (54.3％) of anxiety and depression,8 cases (17.4％) of acute cerebrovascular disease,7 cases (15.2％) of sleep disorders,4 cases(8.7％) of a variety of head and face pain,1 (2.2％)case of epilepsy tonic clonus,1 (2.2％)case of vertigo.Conclusion The application of interactive management of home blood pressure measurement is particularly helpful for screening patients with transient hypertension,and it can timely avoid excessive anti-hypertensive treatment.
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Objective To evaluate the clinical significance of improving the goal attainment rate by management of timely feedback of hypertension patients, which is carried out by using existing communication network. Methods Totally 423 hypertension patients who were hospitalized for treatment in Daping Hospital from Jan. 2012 to Jan 2013, the random numbers table was used to randomize the patients into 2 groups: control group (212 cases) and experiment group (211cases), the conventional treatment was used in control group. Besides the conventional treatment measures, the modern way of communication and network information platform was used by patients who timely feed back the blood pressure changing, and implement the cognitive treatment of hypertension at the same time in the experiment group. The Chi square test was used to compare the patient's medication compliance, the attainment rate and so on , the t test was used to compare the blood pressure in two groups of patients after the intervention. Results At the end of the intervention, the difference of heavy salt diet (reduced to 16.59%), regularly drinking (reduced to 13.74%), heavy sugar diet (reduced to 10.43%), abnormal blood lipid (reduced to 19.91%), smoking (reduced to 27.96%), the number of people who have a stable mood (up to 91.47%), body mass index (reduced to 29.38%) and exercise at ordinary times (reduced to 36.02%) were statistically significant (P< 0.05). Hypertension patients compliance increased significantly, of which the medical behavior of 84.83%, compared with 13.21%in the control group, there was statistically significant difference (χ 2=8.54,P< 0.05). And the awareness, treatment, success rate of blood pressure control were 94.79%, 84.36%, 82.94% in experimental group and 50.94%, 40.09%, 27.83% in control group, and the differences were statistically significant (P<0.05). Conclusion Use of the existing information interaction platform in order to strengthen the management of the blood pressure of hypertension patients and related cognitive behavioral intervention, the control of risk factors and treatment compliance have improved significantly. The remote interaction platform used to patients with hypertension management improve the attainment rate of high blood pressure.
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Objective To provide rationales for preventing and treating dyslipidemia by understanding the current status of lipids and related metabolic factors.Methods A total of 2 590 permanent residents aged ≥ 18 years were selected by random cluster sampling from three urbanized communities of Sijiqing Street.And the rate of abnormal lipid metabolism was calculated for different ages and genders.Spearman's correlation analyses were conducted for the levels of total cholesterol (TC),total triglyceride (TG),low density lipoprotein-cholesterol (LDL-C),high density lipoprotein-cholesterol (HDL-C),body mass index (BMI),waist circumference (WC),systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting plasma glucose (FPG),glycated hemoglobin (HbA 1 c) and uric acid (UA) levels.Both x2 test and logisic regression were employed to examine the correlations between dyslipidemia and overweight/obesity,hypertension,hyperglycemia and hyperuricemia.Results ① The total rate of abnormal lipid metabolism was 60.0％ (1 554/2 590) with a standardized rate of 57.2％.High TC rate was 42.9％ (1 111/2 590) with a standardized rate of 40.5％.And the edge incremental rate was 31.7％ (822/ 2 590),the standardized rate 30.5％,the incremental rate 11.2％ (289/2 590) and the standardized rate 10.0％.High TG rate was 33.0％ (855/2 590) with a standardized rate of 30.7％.And the edge incremental rate was 15.3％ (397/2 590),the standardized rate 14.3％,the incremental rate 17.7％ (458/2 590) and the standardized rate 16.4％.High LDL-C rate was 30.4％ (787/2 590) with a standardized rate of 28.4％.And the edge incremental rate was 22.9％ (594/2 590),the standardized rate 21.7％,the incremental rate 7.5％ (193/2 590) and the standardized rate 6.7％.Low HDL-C rate was 12.6％ (327/2 590) with a standardized rate of 12.8％.The rates of high TC,high TG,high LDL-C,low HDL-C and abnormal lipid metabolism among gender showed no statistically significant difference (P ＞ 0.05);② For both males & females,high TC rate,high TG rate,high LDL-C rate and total rate of abnormal lipid metabolism increased with age (P ＜ 0.01) while low HDL-C rate did not change with age (P ＞ 0.05);③Spearman's correlation analysis showed that the levels of TC,TG and LDL-C were positively correlated with BMI,WC,SBP,DBP,FBG,HbA1C and UA (all P ＜0.01) while the level of HDL-C had negative correlations with BMI,WC,SBP,DBP,FBG,HbA1 c,and UA (all P ＜ 0.05);④The total rate of abnormal lipid metabolism and various types of abnormal lipid metabolism increased with a rising level of BMI in the upward trend (trend test P ＜ 0.01),various types of abnormal lipid metabolism rate between different groups (elevated & non-elevated) of blood pressure,glucose and uric acid also were statistically significant (all P ＜ 0.05);⑤ Non-conditional logistic regression analysis showed that,after adjusting for age and gender,overweight or obesity and hypertension were risk factors of high TC and high LDL-C;overweight or obesity,hyperuricemia was a risk factor for low HDL-C;overweight or obesity,hypertension,hyperglycemia and hyperuricemia were risk factors for high TG and total abnormal blood lipid.Conclusions Urbanized community groups have a high rate of dyslipidemia.And abnormal lipid metabolism is affected by overweight or obesity,hypertension,hyperglycemia and hyperuricemia.The target population should be regularly monitored and comprehensively controlled.
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Objective To explore the feasibility of repairing the large area skin and soft tissue defect in thefront upper of tibia by free flap with anastomosis of saphenous vessels.Methods From June,2009 to April,2014,16 cases (10 males and 6 females) of large area skin and soft tissue defect in the front upper of tibia were treatedwith free flap.The ages ranged from 24 to 56 years old,averaged of 34.5 years old.The supportive therapy and repeated debridement combined with VSD,and designed to use free anterolateral thigh flap with anastomosis of saphenous vessels before repairing operation.Results Fourteen patients accorded with preoperative design,in which 2 cases were adopted cross leg flap anastomosis posterior tibia vessels of the healthy side (1 case of saphenous artery diameter too small,and 1 case of saphenous artery long injury degeneration,unsuitable for vascular anastomosis).All 14 flaps survived,expect 2 cases were part-necrosis in the end of the flap,and gradually healed by dressing exchange.Conclusion Reconstruction of large area skin and soft tissue defect in the front upper of tibia with free flap can use anastomosis of saphenous vessels.