Value of Measuring Awake Blood Pressure at Different Time on Predicting Nocturnal Hypertension in Patients With Hypertension / 中国循环杂志

Objectives:The purpose of this cross-sectional study was to determine the predictive value of measuring awake blood pressure(BP)at different time points on nocturnal hypertension by ambulatory blood pressure monitoring(ABPM)device in patients with hypertension. Methods:A total of 204 consecutive hypertensive outpatients seeking medical care at the First Affiliated Hospital of Fujian Medical University from April 2023 to July 2023 were enrolled.We measured office BP and out-office BP.Out-office BP include evening BP,bedtime BP,morning BP and mean morning BP which were measured by ABPM device and BP daily record.Nocturnal hypertension was defined by the mean nocturnal systolic blood pressure≥120 mmHg(1 mmHg=0.133 kPa).ROC curve analyses of different awake blood pressure was established to identify significant correlates to nocturnal hypertension.The serial test was also performed.The value of the two indexes in predicting nocturnal hypertension was compared.The predictors of nocturnal hypertension were evaluated by multivariate analysis. Results:Of the 204 subjects,104(51.0%)had nocturnal hypertension.The repeated measures analysis of variance(ANOVA)showed that mean nighttime systolic BP and bedtime systolic BP were similar(P=0.641).Nocturnal hypertension was present in 75.7%(84/111)of patients with bedtime systolic BP≥120 mmHg,in 94.2%(49/52)of patients with bedtime systolic BP≥135 mmHg and in 88.2%(75/85)of patients with mean morning systolic BP≥135 mmHg.ROC curve analyses showed that the diagnostic accuracy of mean morning systolic BP(AUC 0.903,P＜0.05)for subjects with nocturnal hypertension was significantly superior to that of office systolic BP,evening systolic BP,bedtime systolic BP,morning systolic BP.Multivariate logistic regression analysis revealed that mean morning systolic BP and bedtime systolic BP were significantly associated with a higher risk of nocturnal hypertension(P＜0.05).ROC curve analyses of predicted probability of bedtime systolic BP and mean morning systolic BP showed higher diagnostic accuracy(AUC 0.929,P＜0.05).The serial test showed that nocturnal hypertension was present in 98.0%(49/50)of patients with bedtime systolic BP≥130 mmHg and mean morning systolic BP≥135 mmHg. Conclusions:Mean morning BP and bedtime BP are significant correlates of nocturnal hypertension in patients with hypertension,and combined mean morning BP with bedtime BP showed higher diagnostic accuracy,which might used for predicting nocturnal hypertension with high efficiency.

Nursing experience of a patient with secondary catheter complications caused by cerebrospinal fluid drainage after endovascular aorticrepair / 中国实用护理杂志

Objective To summarize the nursing experience of a patient with secondary catheter complications caused by cerebrospinal fluid drainage after endovascular aorticrepair. Methods A retrospective analysis was made on the clinical situation of a patient who received cerebrospinal fluid drainage afterendovascular aorticrepair in 2017, and the cause of secondary catheter complications, symptoms and signs were identified and nursing. Results After careful observation, mean arterial pressure maintenance, painmanagement, cerebrospinal fluid drainage velocity management, catheter infection risk and control, psychological intervention and exercise rehabilitation, the patient was finally recovered and discharged. Conclusions In order to evaluate the postoperative complications, we should not only focus on the surgery but also on the adverse events caused by cerebrospinal fluid drainage. In addition,we should improve the ability to identify the source of problems, to risk management and to disease assessment.

Value of intracavitary contrast-enhanced ultrasound via abdomen in fistulas difficult to diagnose before operation / 中国医师杂志

Objective To evaluate the value of intra-cavitary contrast-enhanced ultrasound (IC-CEUS) via abdomen in fistulas difficult to diagnose before operation.Methods Clinical data of 12 patients with preoperative clinical suspicion of Crohn's Disease (CD) complications of fistula were enrolled in the study.Colonoscopy,cystoscope,or CT/MR has not confirmed the diagnosis of intra abdominal fistulas.IC-CEUS were performed by locally-injection of contrast agent in abdominal abscess,observing fistula and the relationship with the adjacent organs in CEUS mode.Diagnostic criteria were surgical findings.Results Fistulas in 10 patients were detected by IC-CEUS,including 7 cases of Ileo-mesenteric fistuls,2 cases of il eo-vesical fistulas,and 1 case of colo-vesical fistula.The accuracy rate of IC-CEUS in diagnosis of fistulas difficult to diagnose before operation in Crohn's disease was 83.3％ (10/12).No severe adverse events occurred during and after IC-CEUS procedure.Conclusions Our preliminary study shows that IC-CEUS is feasible in detecting abdominal fistula with high accuracy.It might be used as the alternative imaging tech nique for detecting fistulas when CT and MR are insufficient.

Establishment of rat late brain glioma model and magnetic resonance perfusion weighted imaging / 重庆医学

Objective To explore the application value of 3.0T magnetic resonance perfusion weighted imaging(PWI)in the rat late brain glioma model.Methods C6 glioma cells were injected stereotactically into the right caudate nucleus of 32 Wistar rats.In 3 weeks after inoculation,the conventional MRI and PWI were performed.The relative cerebral blood volume(rCBV)values were recorded and compared with the pathological results.Results The tumor formation in 30 inoculated rats were confirmed by the sub-sequent pathological examination,with the tumor formation rate of 100%.PWI showed that rCBV values of the brain glioma region and the contralateral mirror image brain tissue were 262.61±72.82 and 189.39±57.21,the difference between them was statisti-cally significant(P<0.05).Conclusion The rat late brain glioma model is suitable for the study on the blood volume of brain tumor tissues.

Risk factors of contrast-induced nephropathy in patients with coronary diseases treated with interventional therapy / 现代临床护理

Objective To investigate the risk factors of contrast-induced renal nephropathy(CIN)in patients with coronary disease treated with interventional therapy and summarize the nursing strategies. Methods One hundred and twenly CHD patients treated with PCI were selected.Logistic regression analysis was done to screen out the risk factors of CIN. Result The main risk factors included renal inadequacy,advanced age,diabetes and contrast dosage(all P<0.05). Conclusion Risk assessment before PCI,rational use of contrast and preventive nursing measures are essential for the prevention and reduction of CIN.

Analysis on prognostic influence factors of acute subdural hematoma / 中国基层医药

Objective.To explore the prognostic influence factors of acute subdural hematoma.Methods The clinical data of 114 patients of acute subdural hematoma were analyzed retrospectively,they were divided into good prognosis group(62 patients) and poor prognosis group(52 patients) according to prognosis,analyzed the related factors for the prognosis were gualyzed in two groups.Results The prognosis of acute subdural hematoma with sex,weight was no significant correlation(all P＞0.05),but related with age,GCS score,pupillary changes,brain shift and hematoma volume(all P＜0.05).Conclusion Patient's age,GCS score,pupillary changes,brain shift and hematoma volume were the prognostic influence factors of acute subdural hematoma.

Efficacy and safety of remifemin compared to tibolone for controlling of perimenopausal symptoms / 中华妇产科杂志

rse effect when compared with tibolone.

Effects of raloxifene hydrochloride on bone mineral density, bone metabolism and serum lipids in postmenopausal women: a randomized clinical trial in Beijing / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To determine the effects of raloxifene hydrochloride (RLX) on bone mineral density (BMD), bone metabolism markers and serum lipids in healthy postmenopausal women in Beijing.</p><p><b>METHODS</b>A multicenter, randomized, double-blind, placebo-controlled study was conducted in a total of 204 healthy postmenopausal women (age 59.5 +/- 5.0 years and weight 62.8 +/- 8.7 kg) treated with either RLX 60 mg (n = 102) or placebo (n = 102) daily for 12 months. BMD, serum lipids, and bone markers were measured before and after drug administration.</p><p><b>RESULTS</b>Compared with placebo, RLX produced a significant increase in both total lumbar spine and total hip BMD. For the lumbar spine, percentage increase in total BMD was 2.3% with RLX compared with a decrease of 0.1% with placebo (P < 0.001). Corresponding values for total hip BMD were a 2.5% increase for RLX and a 1.1% increase for placebo (P = 0.011). For biochemical markers of bone metabolism, serum osteocalcin and C-telopeptide, percentage decreases were 27.65% and 24.02% in RLX-treated subjects. Corresponding values in placebo were a 10.64% decrease and a 15.75% increase (RLX compared with placebo, both P < 0.001). For total cholesterol and low-density lipoprotein cholesterol levels, percentage decreases were 6.44% and 34.58% in the RLX-treated group. Corresponding values in placebo-treated patients were a 1.44% increase and a 19.07% decrease (RLX compared with placebo, both P < 0.001). No differences were found for high-density lipoprotein cholesterol or triglyceride levels between the two groups. Only 5 subjects discontinued early owing to an adverse event (3 in the RLX group and 2 in the placebo group).</p><p><b>CONCLUSIONS</b>This study confirms that RLX exerts positive effects on the skeleton, increasing BMD and decreasing biochemical markers of bone metabolism, and has a positive effect on the overall serum lipid profile in postmenopausal women in China.</p>