RESUMO
Multiple chronic conditions have become prominent health problems nowadays. There is a positive correlation between the number of chronic diseases and the risk of sleep disorders. Patients with sleep disorders will also be more difficult to control chronic diseases they have. Therefore, more attention should be paid to the sleep problems in patients with multimorbidity. This article discusses the interrelation between multimorbidity and sleep disorders from various dimensions, to provide a new vision for the prevention and treatment of sleep disorders in patients with multimorbidity.
RESUMO
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable common chronic airway disease. As the gatekeeper of health care, general practitioners should play a key roles in prevention and management of COPD; however, the ability of COPD prevention and management is generally limited among general practitioners, so that the training for them is essential. At present there is no unified training program and standard for COPD prevention and management in China, the training contents and methods are various, and the training facilities and capacity are inadequate, particularly in grass-roots institutions, all these restrain the development of effective training. This articles reviews the status quo of COPD prevention and management training for general practitioners at home and abroad, and suggests to construct a network for chronic respiratory diseases management and a training system for primary care health workers to improve the prevention and management of COPD in China.
RESUMO
AIM: To introduce the entry point of clinical pharmacists on developing pharmaceutical care in the department of nephrology to further explore more pharmaceutical care entry point and to better promote rational drug use. METHODS: To summarize the work of the clinical pharmacists participate in the formulation and optimization of anti-infection therapy; participate in the formulation of parenteral nutrition program; conduct medication and adherence education; conduct pharmaceutical monitoring; provide evidence-based medical analysis for the off-label drug use in the department of nephrology by case sharing. RESULTS: Clinical pharmacists provide pharmaceutical care in the department of nephrology. This improves the medication compliance, avoids adverse reactions, optimize therapeutic regimen. CONCLUSION: Developing various pharmaceutical care in the department of nephrology will be safe, effective and economic for drug application.
RESUMO
Objective:To examine the association between baseline serum albumin level and short-term, long-term outcomes in patients with systemic sclerosis associated interstitial lung disease (SSc-ILD).Methods:A total of 259 patients with SSc-ILD who were hospitalized in West China Hospital of Sichuan University from January 2008 to December 2018 were enrolled. The data of serum albumin, demographic characteristics, peripheral blood hemoglobin at admission, and treatment plan were obtained from the hospital information management system, and the survival of the patients were followed up to June 1, 2019. The mean baseline serum albumin of 259 patients was 37.67 g/L, there were 118 patients with serum albumin ≤37.67 g/L (low protein group) and 141 patients with serum albumin>37.67 g/L (high protein group).Results:There were 64 males and 195 females with a mean age of 50.0(41.0, 61.0) years. The follow-up time was 627(61, 1 426) days. Compared to high protein group, the low protein group had higher proportion of male patients [30.5%(36/118) and 19.9%(28/141),χ 2=3.92, P=0.048], and higher levels of the erythrocyte sedimentation rate [45.0(27.0,69.0) vs. 29.0 (19.0,46.0)mm/1 h,χ 2=4.07, P<0.001], neutrophil percentage [71.50(63.35,77.13) vs. 65.60(59.50,72.50)%,χ 2=3.65, P<0.001], platelet [196(140,273) vs. 172(126,240)×10 9/L,χ 2=1.99, P=0.046], nutrophil/lymphocyte ratio [33.85(2.53,5.28) vs. 2.61(1.97,3.83),χ 2=4.57, P<0.001], platelet/lymphocyte ratio [149.0(112.0,216.8) vs. 113.5(72.76,158.8),χ 2=4.98, P<0.001], aspartate aminotransferase [27.0(21.0,39.0) vs. 23.0 (19.5,30.0) IU/L,χ 2=2.93, P=0.003], globulin [31.20(26.90,36.83) vs. 29.50(25.65,32.80) g/L,χ 2=2.28, P=0.023], serum cystatin C[1.14(0.98,1.33) vs. 1.02(0.88,1.16) mg/L,χ 2=3.80, P<0.001], IgA[2 710 (1 965,3 505) vs. 2 460 (1 862,3 105) mg/L,χ 2=2.13, P=0.033], IgG[15.05(12.83,21.08) vs. 13.60(11.53,17.23)g/L,χ 2=3.24, P=0.001], IgE[60.44(24.92,197.99) vs. 34.82(14.72,85.04) kIU/L,χ 2=3.33, P=0.001] and circulating immune complex [0.13(0.08,0.19) vs. 0.10(0.08,0.13)O.D,χ 2=2.60, P=0.009]; and lower levels of hemoglobin [121.5(101.8,132.0) vs. 129.0(119.0,142.0) g/L,χ 2=5.05, P<0.001], albumin [(33.28±3.49) vs.(41.34±2.95) g/L,χ 2=20.17, P<0.001] and IgM[1 320 (932,1 745) vs.1 560(1 170,2 030) mg/L, χ 2=2.63, P=0.009]. The utilization rate of antibiotics was higher in the low protein group (60 vs. 43 cases, χ 2=11.10, P=0.001). The number of patients followed up to 1, 5, and 10 years were 248, 245, and 244, respectively. The 1-year, 5-year, and 10-year cumulative survival rates of patients in low protein group and high protein group were(91.0% vs. 98.4%, χ 2=6.23, P=0.013;87.0% vs. 97.1%, χ 2=6.15, P=0.013; 81.6% vs. 97.1%, χ 2=7.00, P=0.008) respectively. Conclusions:Patients with scleroderma-associated interstitial lung disease have an increased risk of poorer prognosis when serum albumin ≤37.67 g/L.
RESUMO
The incidence of colorectal polyp shows an upward trend, and some types of colorectal polyps, may evolve into colorectal cancer. Dyslipidemia is not only related to the occurrence of cardiovascular diseases, but also related to the occurrence and development of colorectal polyps. Hyperlipidemia can directly or indirectly stimulate the proliferation of colorectal mucosal cells and lead to tumorigenesis. Exploring the factors affecting the occurrence and recurrence of colorectal polyps may be conducive to prevent and manage the disease. General practitioners should pay attention to the high-risk group of colorectal polyps, and timely health education and colonoscopy screening are important measures to prevent its occurrence and further cancer development.
RESUMO
Objective:To survey the knowledge, attitudes, and practice about chronic obstructive pulmonary disease (COPD) among general practitioners in Sichuan province.Methods:From October to November 2020, a questionnaire survey on knowledge, attitudes and practice (KAP) among 104 general practitioners who participated in the training of the comprehensive prevention and control of COPD organized by Sichuan Provincial Health Commission. The content of the questionnaire included the basic information and the KAP status of COPD. The descriptive analysis, Mann-Whitney U test, and Kruskal-Wallis H were used for statistical analysis. Results:A total of 104 questionnaires were distributed and 102 were returned with a response rate of 98.1%. General practitioners with different ages, professional titles, visits of COPD patients each month, and whether or not to refer COPD patients to higher-level hospitals were not significantly different in the scores of knowledge( U=1 276.00, H=0.78, U=1 074.00, U=589.00), attitude( U=1 141.50, H=1.75, U=1 090.00, U=585.00), and practice( U=1 221.00, H=0.31, U=1 163.00, U=499.50) (all P>0.05). In knowledge part the highest correctness rate was "quitting smoking is the most powerful interventions affecting the natural disease course of COPD" (100.0%, 102/102); the lowest was that"the main objective examination for judging the airflow limitation of COPD patients is the lung function test"(5.9%, 6/102). In the part of the attitude, the highest positive rate was "educating patients to quit smoking and avoid exposure to second-hand smoke" (65.7%,67/102); the lowest positive rate was "provide exercise guidance to patients "(43.1%, 44/102) and " be responsible for long-term treatment follow-up" (43.1%, 44/102). In the part of practice, the highest behavioral rate was "when receiving patients with COPD, actively pay attention to the treatment of comorbid diseases" (95.1%, 97/102); the lowest behavioral rate was "when patients with COPD were seen at the clinic, and the patients were advised of the best time to use the inhaler" (65.7%, 67/102). Conclusions:The study indicates that the relevant departments need to increase the intensity of knowledge training for general practitioners in Sichuan province. General practitioners should continuously improve their education, prevention, and treatment ability and implement the primary responsibilities for COPD management.
RESUMO
Department of General practice of West China Hospital of Sichuan University has been commissioned to train general practitioner for Tibet Autonomous Region since 2015. Based on the "demand-oriented and clinical ability training", the established training framework includes four aspects: a rotation plan of general practice theory-clinical practice-community application, the closed-loop mechanism of teaching management system improvement,innovation of training assessment and teaching activities. This article summarizes the practical experience of the commissioned general practice residency training for Tibet to provide reference for the program design.
RESUMO
BACKGROUND:Currently, vertebral compression fractures are the most common osteoporotic fracture in postmenopausal women;however, incidence of refracture has aroused increasing attention due to a lack of standard treatment. OBJECTIVE:To evaluate whether vertebroplasty combined with anti-osteoporosis treatment can reduce refracture rate fol owing osteoporotic vertebral compressive fractures. METHODS:Eighty-nine patients with osteoporotic vertebral compressive fractures undergoing vertebroplasty were divided into control group (n=38) and treatment group (n=51) after making an informed choice about treatment. Chest/lumbar X-ray and bone mineral density determinations were performed through outpatient or inpatient fol ow-up. The spinal stability, bone mineral density and refracture rate of patients in both groups were fol owed up. RESULTS AND CONCLUSION:Seventy-eight patients achieved complete fol ow-up (ranged from 6-39 months, average 26.73 months). There was no significant difference in the spinal stability between both groups (P>0.05), while rare bone trabecula was found in the control group. There was a significant difference in bone mineral density between both groups at postoperative 12, 24, and 36 months (P<0.05). The refracture rate in the treatment group was significantly lower than that in the control group (P<0.05). Our results indicate that anti-osteoporosis treatment can effectively reduce the incidence of refracture after vertebroplasty in patients with osteoporotic vertebral compressive fractures, and this study found satisfactory short-and medium-term clinical outcomes.
RESUMO
BACKGROUND:To grasp the optimal multiplicity of infection (MOI) and the time when stronger fluorescence intensities produce can lay the foundation for tracing observation of human bone marrow mesenchymal stem celsin vivo in animal models. OBJECTIVE:To investigate the feasibility of HIV-1 lentivirus carrying enhanced red fluorescent protein to transfect human bone marrow mesenchymal stem cels. METHODS:Human bone marrow mesenchymal stem cels at passage 4 were divided into blank group and MOI 2, 3, 4 groups. After that, the cels were seeded into 12-wel plates at a density of 5.0×105 , and cultured in 1 mL complete medium for adult bone marrow mesenchymal stem cels containing 1% fetal bovine serum. The infectious titer of lentivirus-carried enhanced red fluorescent protein was adjusted to 1.0×10 11 TU/L. Lentivirus solution 10, 15, 20 μL at MOI=2, 3, 4 were respectively added into the MOI 2, 3, 4 groups, and 10μL PBS was added into the blank group. At 24 and 72 hours after transfection, the expression of red fluorescence was observed under an inverted fluorescence microscope and the transfection efficiency was calculated. RESULTS AND CONCLUSION:Enhanced red fluorescent protein expressed stably in bone marrow mesenchymal stem cels. At 24 hours after transfection, red fluorescence could be seen under the inverted fluorescence microscope and achieved the peak at 72 hours after transfection. Within 21 days after transfection, there were no differences in the number of human bone marrow mesenchymal stem cels between the MOI 2, 3, 4 groups and blank group (P > 0.05). These results show that the HIV-1 lentivirus carrying enhanced red fluorescent protein is feasible to transfect human bone marrow mesenchymal stem cels, with the highest transfection efficiency when the MOI=4, which can express at least for 21 days and have no effects on the proliferative activity of labeled cels.
RESUMO
Objective To summarize overlapping tissue expansion of neck without platysma in repairing maxillofacial and neck scar contracture deformity.Methods Two expanders were buried in the same soft tissue pocket superficially to the platysma in an overlapping pattern,water injection were on schedule,and secondary operation was performed after 4 to 6 weeks.Results 16 cases of maxillofacial and neck scar contracture deformities were treated with overlapping tissue expansion of neck without platysma since 2004.Good results were achieved except one case of expander exposure,but the final resuit was good after suitable treatment.Conclusion The overlapping tissue expansion technique can provide much more expanded tissue and reduce complications compared with the traditional expansion technique,especially using overlapping tissue expansion of neck without platysma for repairing the defects at the maxillofacial and cervical region.
RESUMO
To investigate the nature of syndrome of traditional Chinese medicine by means of pharmacokinetic (PK) method.
RESUMO
Objective To investigate the clinical value of face scar deformity by small-capacity tissue expansion. Methods A small-capacity expander of 10~100 ml was implanted into the hypoderm, and then regular affusion was made with injection pot outside or inside. After expanding for four weeks to eight weeks, the expander was removed and the removing wound surface of scar was repaired with flap. Results After clinical application in 32 cases, there were complications such as infection and expander's exposure occurred in two cases, but the final result was good after suitable treatment. All cases were satisfied with unclear scar after 6 to 36 months’ follow-up. Conclusions Positive cosmetic effect can be received with small-capacity tissue expansion.
RESUMO
0.05).Conclusions After hepatectomy,in rats is associated with an obvious insulin resistance,mainly due to the level of serum insulin was obviously decreased(P
RESUMO
Objective To investigate the effect of glucagon-like peptide-1(GLP-1) in a dose related manner on glucose metabolism after 65% hepatectomy in rats.Methods We determined the serum glucose levels of hepatomized rats at 0,5,10,20,and 30 minutes after an intravenous glucose load(IVGTT,0.5 g/kg glucose) on the first postoperative day,and the changes of blood glucose,serum insulin and glucagon concentrations of hepatomized rats that received the volum load with normal saline or 0.3 nmol/kg GLP-1,0.45 nmol/kg GLP-1 respectively.Blood was drawn for determination of glucose(glucose oxidase),insulin,glucagon,and GLP-1(radioimmunoassay).Results The peak glucose and 30-minute glucose levels and the area under the curve(AUC 0-30) were significantly higher in the hepatomized rats compared to the control rats,which had not undergone any operation and received a same intravenous glucose load(0.5 g/kg glucose with normal saline)(P0.05).Nevertheless the peak glucose and 30-minute glucose levels and AUC 0-30 of the hepatomized rats that received with 0.45 nmol/kg GLP-1 were significantly lower compared to the rats that received the same volum load with normal saline or 0.3 nmol/kg GLP-1 respectively after liver resection.There was an increasing postoperative serum concentration of glucose,insulin,glucagon on the first day,then,the serum glucose concentration was significantly lowered after infusion of GLP-1 in rats undergoing hepatectomy(P