RESUMO
OBJECTIVE@#This study aimed to examine the trends in stroke mortality among young and middle-aged adults in China.@*METHODS@#Data were obtained from the China national vital registration system. Significant changes in mortality were assessed by Joinpoint regression. Age-period-cohort analysis was used to explain the reasons for the changes. Future mortality and counts were predicted by the Bayesian age-period-cohort model.@*RESULTS@#Between 2002 and 2019, a total of 6,253,951 stroke mortality in young and middle-aged adults were recorded. The age-adjusted mortality rates (AAMRs) of women showed a downward trend. The annual percent changes (APC) were -3.5% (-5.2%, -1.7%) for urban women and -2.8% (-3.7%, -1.9%) for rural women. By contrast, the AAMRs per 100,000 for rural men aged 25-44 years continued to rise from 9.40 to 15.46. The AAMRS for urban men aged 25-44 years and urban and rural men aged 45-64 years did not change significantly. Between 2020 and 2030, the projected stroke deaths are 1,423,584 in men and 401,712 in women.@*CONCLUSION@#Significant sex and age disparities in the trends of stroke mortality among young and middle-aged adults were identified in China. Targeted health policy measures are needed to address the burden of stroke in the young generation, especially for rural men, with a focus on the prevention and management of high risk factors.
Assuntos
Pessoa de Meia-Idade , Masculino , Adulto , Humanos , Feminino , Teorema de Bayes , População Urbana , Acidente Vascular Cerebral/epidemiologia , Estudos de Coortes , China/epidemiologia , MortalidadeRESUMO
BACKGROUND@#Areal bone mineral density (aBMD) applied for osteoporosis diagnosis unavoidably results in the missingdiagnosis in patients with large bones and misdiagnosis in those with small bones. Therefore, we try to find a new adjusted index of bone mineral content (BMC) to make up shortcomings of aBMD in osteoporosis diagnosis.@*METHODS@#In this multi-center epidemiological study, BMC and aBMD of lumbar spines (n = 5510) and proximal femurs (n = 4710) were measured with dual energy X-ray absorptiometry (DXA). We analyzed the correlation between the bone mass and body weight in all subjects including four age groups (50 years). And then the body weight was used for standardizing BMC (named wBMC) and applied for the epidemiological analysis of osteoporosis.@*RESULTS@#The correlation of body weight and BMC is 0.839 to 0.931 of lumbar vertebra 1-4 (L1-4), and 0.71 to 0.95 of femoral neck in different age groups. When aBMD was applied for diagnosing osteoporosis, the prevalence was 7.55%, 16.39%, and 25.83% in patients with a high, intermediate, and low body weight respectively. However, the prevalence was 21.8%, 18.03%, and 11.64% by wBMC applied for diagnosing osteoporosis. Moreover, the prevalence of osteoporosis increased by 3.76% by wBMC with the body weight increased by 5 kg. The prevalence decreased by 1.94% when the body weight decreased by 5 kg.@*CONCLUSIONS@#wBMC can reduce the missed diagnosis in patients with large body weight and reduce misdiagnosis in those with small body weight. Including children, wBMC may be feasible for osteoporosis diagnosis individuals at any age.
Assuntos
Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Absorciometria de Fóton , Fatores Etários , Peso Corporal , Fisiologia , Densidade Óssea , Fisiologia , Colo do Fêmur , Diagnóstico por Imagem , Metabolismo , Vértebras Lombares , Diagnóstico por Imagem , Metabolismo , Osteoporose , Diagnóstico por Imagem , Metabolismo , PrevalênciaRESUMO
AIM To explore the effects of Shexiang Wulong Pills (Moschus Artifactus,Aconiti Radix Cocta,Pheretima,etc.) drug serum on the expression levels of miR-146a,miR-130 and miR-223 in peripheral blood mononuclear cells (PBMCs) of patients with rheumatoid arthritis (RA).METHODS PBMCs were extracted from blood of 30 cases of RA patients,cells were divided into three groups,blank control group,serum-free groupand Shexiang Wulong Pills drug serum group.After 48 hours,total RNA was extracted,then the expression levels of three miRs were detected by RT-PCR.RESULTS Compared with the serum-free group,the expression levels of miR-146a,miR-130 and miR-223 in the Shexiang Wulong Pills drug serum group were significantly decreased (P < 0.01).CONCLUSION Shexiang Wulong Pills can inhibit inflammation in RA patients by down-regulating the expression levels of miR-223,miR-130 and miR-146a in PBMCs.
RESUMO
Objective To analyze the risk factors affecting the safe running and efficiency of large medical equipment and to put forward countermeasures for prevention and control.Methods The risk factors affecting large medical equipment were analyzed and evaluated comprehensively,and risk control measures were determined and executed to enhance medical safety and equipment efficiency.Results The measures made the availability rate of large medical equipment being 100.0%,perfectness ratio being 98.5%,accident rate being 0% and idleness rate being 0%.Conclusion The introduction of risk control in the management of large-scale medical equipment can improve the personnel awareness to prevent risk,enhance medical quality and equipment efficiency,and protect the vital interests of the patients.
RESUMO
Objective To analyze the risk factors affecting the safe running and efficiency of large medical equipment and to put forward countermeasures for prevention and control.Methods The risk factors affecting large medical equipment were analyzed and evaluated comprehensively,and risk control measures were determined and executed to enhance medical safety and equipment efficiency.Results The measures made the availability rate of large medical equipment being 100.0%,perfectness ratio being 98.5%,accident rate being 0% and idleness rate being 0%.Conclusion The introduction of risk control in the management of large-scale medical equipment can improve the personnel awareness to prevent risk,enhance medical quality and equipment efficiency,and protect the vital interests of the patients.
RESUMO
Erectile dysfunction (ED) is a common male disease. Some related studies show that the prevalence of ED is nearly 52% in men aged 40 to 70 years and is increasing among younger males. Hypoxia is now considered to be an independent risk factor for ED and the mechanisms of hypoxia inducing ED are varied and complicated. Recently, an idea in penile rehabilitation has attracted much attention, which aims at improving erectile function by increasing oxygen supply to the cavernosum and reducing tissue fibrosis and apoptosis. The approaches to achieve non-sexual penile erection by increasing oxygen supply to the cavernosum, such as behavior therapy, medication, vacuum constriction device, and intracavernous injection, can simulate normal sexual erection and help patients with penile rehabilitation. This review focuses on the strategies for non-sexual penile erection in penile rehabilitation.
Assuntos
Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Disfunção Erétil , Epidemiologia , Reabilitação , Hipóxia , Terapêutica , Oxigênio , Ereção Peniana , Pênis , Fatores de RiscoRESUMO
<p><b>OBJECTIVE</b>To explore associations between levels of total cholesterol (TC), triglyceride (TG) and incidence of ischemic and hemorrhagic strokes in populations.</p><p><b>METHODS</b>Baseline investigations on stroke-related risk factors and physical examinations were performed in 10 093 (> 35 years) stroke-free urban community residents from 5 cities in China during May to July in 1987, follow-up investigations on stroke events were made during 1998 to 2000. The hazard ratios and 95% confidence intervals (CI) of ischemic and hemorrhagic strokes in middle, high tertiles of baseline TC or TG levels were compared with low baseline tertile residents using the Cox regression model.</p><p><b>RESULTS</b>There were 491 first strokes during the 8-years cohort follow-up. Compared with the low tertile, risk of ischemic stroke in the middle and high tertiles of TC level was increased by 61% (HR: 1.61, 95%CI: 1.14-2.27) and 58% (HR: 1.58, 95%CI: 1.12-2.22) after adjustments for DBP, age, sex and other variables in the Cox proportional hazards model. Compared with the low tertile, risk of ischemic stroke in the high tertile of TG level was increased by 43% (HR: 1.43, 95%CI: 1.02-2.00). However, risk of hemorrhagic stroke in the middle and high tertiles of TC level decreased by 12% (HR: 0.88, 95%CI: 0.64-1.22) and 33% (HR: 0.67, 95%CI: 0.48-0.95) compared with the low tertile.</p><p><b>CONCLUSIONS</b>Elevated serum TC and TG are independent risk factors for risk of ischemic stroke. However, low TC was related with increased risk of hemorrhagic stroke.</p>
Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , China , Epidemiologia , Colesterol , Sangue , HDL-Colesterol , Sangue , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral , Sangue , Epidemiologia , Triglicerídeos , SangueRESUMO
<p><b>OBJECTIVE</b>To compare the efficacy and safety of intravenous levosimendan and dobutamine in patients with decompensated heart failure refractory to conventional medications.</p><p><b>METHODS</b>Patients were recruited into this multicentre, randomised, positive-controlled and parallel-group study to receive either levosimendan or dobutamine therapy. In the levosimendan group, an initial loading dose of levosimendan of 12 microg x kg was infused over 10 min, followed by a continuous infusion of 0.1 microg x kg(-1) x min(-1) for 1 h and then 0.2 microg x kg(-1) x min(-1) for 23 h. In the control group, dobutamine was infused for 1 h at an initial dose of 2 microg x kg(-1) x min(-1) without a loading dose, followed by a continuous infusion of 4 microg x kg(-1) x min(-1) for 23 h. Hemodynamic responses at 24 h were evaluated by echocardiography (in both groups) and Swan-Gans catheter (in the levosimendan group). Clinical assessment was performed to evaluate efficacy and safety of the medications.</p><p><b>RESULTS</b>A total of 225 patients from 12 medical centers were evaluated; 119 assigned to levosimendan and 106 assigned to dobutamine group. The effectiveness rate was 31.9% (38 patients) in the levosimendan group and 17.9% (19 patients) in the dobutamine group (P < 0.01). At 24 h, left ventricular ejection fraction (LVEF) was improved by 6. 4% in the levosimendan group, compared with 4.6% in the dobutamine group (P > 0.05). Stroke volume (SV) was increased by 11.1 ml in the levosimendan group and 2.8 ml in the dobutamine group respectively (P < 0.05). Dyspnea and clinical manifestations improvements were more significant in levosimendan therapy group compared to dobutamine group. There were less adverse effects including hypokalemia, hypotension and ventricular premature beats in the levosimendan group than in the dobutamine group (P < 0.05).</p><p><b>CONCLUSION</b>Levosimendan was well tolerated and superior to dobutamine for patients with decompensated heart failure refractory to conventional medications.</p>
Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cardiotônicos , Usos Terapêuticos , Dobutamina , Usos Terapêuticos , Insuficiência Cardíaca , Tratamento Farmacológico , Hidrazonas , Usos Terapêuticos , Injeções Intravenosas , Piridazinas , Usos Terapêuticos , Resultado do TratamentoRESUMO
<p><b>OBJECTIVE</b>To analyze the prevalence and onset of age of stroke in Chinese adults aged 35 years old and above.</p><p><b>METHODS</b>Data from the 2002 National Nutrition and Health Survey was used to analyze the prevalence of stroke by age, sex, regions, and the differences of onset of age of stroke among the alive patients.</p><p><b>RESULT</b>Standardized prevalence of stroke in Chinese adults aged 35 years old and above was 1111.5 per 100,000, 1258.9 per 100,000 in male which was higher than female (959.3 per 100,000). The prevalence of stroke in urban (1544.8 per 100.000) was higher than that in rural (758.1 per 100,000). The standardized prevalence of stroke in the north (1479.3 per 100,000) was significantly higher than that in the south (719.6 per 100,000). The standardized prevalence of stroke in eastern, central and western region was 1469.0 per 100,000, 1085.4 per 100,000, 614.9 per 100,000, respectively. It is estimated that there were 5.627 million patients with stroke aged 35 years old and above in China in 2002. The age at onset of stroke in the alive patients was skewed distribution. Median was 60 years old. The first incidence of stroke within 60-age group accounted for 32.4%. The age at onset of stroke was no significantly different between male (60 years old, chi(2) = 0.00, P > 0.05) and female (60 years old). The median of the age at onset of stroke (61 years old) in urban was higher than that in rural (58 years old, chi(2) = 17.34, P < 0.01). The median in eastern region was higher than that in central and western regions (57 years old, chi(2) = 12.92, P < 0.01).</p><p><b>CONCLUSION</b>The prevalence of stroke was significant different by sex and regions. Among the alive patients, more than half of their first incidence of stroke were before the age of sixties.</p>
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Idade de Início , China , Epidemiologia , Incidência , Prevalência , Acidente Vascular Cerebral , EpidemiologiaRESUMO
<p><b>OBJECTIVE</b>To investigate the correlation between 18F-FDG standard uptake value (SUV) and expression of GLUT1, MVD and Ki67 in non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Thirty-three patients with non-small cell lung cancer received preoperative 18F-FDG PET-CT examination and underwent surgery. The expression of GLUT1, MVD and Ki67 were detected by immunohistochemstry. The correlation between the SUV of 18F-FDG PET-CT and the immunohistochemical results of the three above mentioned parameters was analyzed.</p><p><b>RESULTS</b>Of the 33 NSCLC patients, 21 were in stage I, 4 in stage II and 8 in stage IIIa. Positive expression of GLUT1 was found in 22 cases (66.7%, 12 adenocarcinomas and 10 squamous cell carcinomas), and negative expression in 11 cases (10 adenocarcinomas and 1 squamous cell carcinoma). Twenty-four patients (72.7%) showed positive expression of Ki67 (13 adenocarcinomas and 11 squamous cell carcinomas), and other 9 (adenocarcinomas) had negative expression. The positive expression rate of CD34 in this series was 100.0% with a mean MVD of 12.6 +/- 2.9.</p><p><b>CONCLUSION</b>SUV of 18F-FDG PET-CT is linearly correlated with the expression of GLUT1, but not with the expression of Ki67 or MVD. The expression of GLUT1, Ki67 and CD34 is not correlated with tumor size and lymph node metastasis.</p>
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adenocarcinoma , Diagnóstico por Imagem , Metabolismo , Patologia , Antígenos CD34 , Metabolismo , Carcinoma Pulmonar de Células não Pequenas , Diagnóstico por Imagem , Metabolismo , Patologia , Carcinoma de Células Escamosas , Metabolismo , Patologia , Fluordesoxiglucose F18 , Farmacocinética , Transportador de Glucose Tipo 1 , Metabolismo , Antígeno Ki-67 , Metabolismo , Neoplasias Pulmonares , Diagnóstico por Imagem , Metabolismo , Patologia , Metástase Linfática , Microvasos , Diagnóstico por Imagem , Estadiamento de Neoplasias , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Farmacocinética , Tomografia Computadorizada por Raios X , Carga TumoralRESUMO
<p><b>OBJECTIVE</b>To observe whether the community-based management for patients with hypertension can reduce the incidence of stroke.</p><p><b>METHODS</b>Sample of this study included 36 863 people aged 35 years or more who came from a cohort consisting three communities from Tiantan Hospital, Puren Hospital and the Gymnasium Road Hospital in Beijing, based on the surveys on the Integrated Community Intervention Measures of Cerebro-vascular Diseases. Some patients with hypertension in this cohort were followed up and under management. First-ever stroke was considered as the end-point event.</p><p><b>RESULTS</b>In both groups diagnosed as borderline hypertension or definite hypertension group, the rates of management and control showed an annual increase. The management rate for women was higher, but the control rate was lower (P < 0.05) than that for men. In the third year of this study, the control rate was nearly 18%. With the qualification of control rate, the risk factors of overall stroke, ischemic stroke or hemorrhagic stroke reduced gradually, and the qualification of control rate showed more effects on hemorrhagic stroke. The qualification of control rate in the three years could cause the risk factors of total stroke, ischemic stroke or hemorrhagic stroke to reduce by 25.7%, 19.1%, 27.4%, respectively. When comparing with blood pressure level at < 160/95 mm Hg (1 mm Hg = 0.133 kPa), the level of < 140/90 mm Hg could reduce the risk factors as: 12.3% to total stroke, 12.8% to ischemic stroke and 14.9% to hemorrhagic stroke.</p><p><b>CONCLUSION</b>Programs as long-term followed-up and management for patients with hypertension, and control the blood pressure at low level etc. could significantly reduce the incidence of stroke.</p>
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , China , Epidemiologia , Hipertensão , Epidemiologia , Acidente Vascular Cerebral , EpidemiologiaRESUMO
<p><b>OBJECTIVE</b>To evaluate the effect of a long-term community-based intervention program on risk factors of stroke among people with different risk factors.</p><p><b>METHODS</b>In 1987,2 geographically separated communities with 10 000 registered residents of each, were selected as either intervention or control communities in Beijing and Changsha. A cohort containing 2700 subjects at the age of 35 years or older,and free of stroke were sampled from each community. The baseline survey was conducted to screen the subjects at high risk for intervention and there were 5319 and 5506 subjects enrolled in intervention and control cohorts,respectively. Then,a program for controlling the risk factors of stroke was initiated in the intervention cohort and health education was provided to the whole intervention community. A follow-up survey was conducted in 1999. The information on incidence and mortality of stroke was collected.</p><p><b>RESULTS</b>Comparing with the control cohort, the risk of incidence and mortality of stroke decreased by 22 % ( HR = 0.78,95 % CI:0. 66-0.92) and 73 % (HR = 0.27,95 % CI:0. 17-0.42) in intervention cohort. The risks of stroke were lower in intervention cohort than in control cohort among almost all of the sub-groups with or without risk factors of stroke except for being male,current smokers and current alcohol drinkers. The risk of death caused by stroke decreased significantly in those with or without the risk factors of stroke.</p><p><b>CONCLUSION</b>The long-term community intervention on the risk factors of stroke could effectively reduce the risk of incidence and mortality of stroke among people with or without the risk factors of stroke. More attention should be paid to the males and those who smoke or drink alcohol.</p>
Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos de Coortes , Serviços de Saúde Comunitária , Educação em Saúde , Pesquisa sobre Serviços de Saúde , Incidência , Fatores de Risco , Acidente Vascular Cerebral , Epidemiologia , MortalidadeRESUMO
<p><b>OBJECTIVE</b>To investigate the diagnosis,treatment and requirement of epilepsy patients in some urban communities in China, and to provide the evidence of searching for effective treatment and management on epilepsy under the China's context.</p><p><b>METHODS</b>A face-to-face survey were conducted in 3 urban communities in Shanghai, Beijing and Changsha, respectively. The questions in the questionniare were general information, hospital visit, treatment, the level and way of getting on the knowledge of epilepsy, as well as the current obstacles and needs.</p><p><b>RESULTS</b>Most of the patients selected the regular hospitals (90.8%) and the departments (92.3%) for their epielspy diagnosis and treatment. They used AEDs modo dictu (77.4%), and had controlled the seizures quite well (82.6%). A small part of patients still could not deeply understand the basic knowledge on epilepsy (13.5%). They ignored to follow up the drug concentration (45.8%) in blood and the blood biocheminstry indicators (43.9%). Some patients went to private clinics (12.9%) and used lay people remedies (7.7%). Longtime waiting (36.8%), inconvenient traffic (23.2%), and high expenses (22.6%) were the main problems influencing the timely treatment. The main obstacles of the patients were employment (47.2%), marriage (29.9%), psychological conditions (44.4%) and interpersonal relationship (29.9%). The main requirements were the effectiveness (87.0%) and cheap AEDs (40.9%) as well as the convenience of hospital visit (37.0%).</p><p><b>CONCLUSION</b>It is very important to emphasize knowledge and publicity/education on epilepsy as well as the psychological treatment according to the requirements of patients.</p>
Assuntos
Humanos , Anticonvulsivantes , Usos Terapêuticos , China , Coleta de Dados , Epilepsia , Diagnóstico , Terapêutica , Necessidades e Demandas de Serviços de Saúde , Hospitais , Cooperação do Paciente , Saúde da População UrbanaRESUMO
Objective To find out the prevalence rate of epilepsy,its treatment gap and quality of life of epilepsy patients in rural areas of Tibet Autonomous Region (TAR).Methods Cluster sampling was adopted to conduct a door-to-door epidemiological survey among 14 822 rural population in Gangka town, Zhaxigang and Quzika village located in Medrogongka and Markham counties of TAR.The quality of life was measured by the 31-item quality of life in epilepsy inventory (QOLIE-31).Results Thirty-seven epilepsy patients were diagnosed as convulsive epileptic patients,and the prevalence was 0.25%.Thirty-five patients (94.59%) were diagnosed as active epilepsy,with a prevalence rate of 0.24%.Only one patient took standard Western Medicine within a week before the survey,and the treatment gap of the active epilepsy was 97.1%.The average QOLIE-31 total score was 42.15?17.63,and the lowest subcomponent score was 22.59?20.31 for seizure worry with the highest subcomponent score 85.83?18.59 for medication effects. Age,occupation,education,economic status,age at epilepsy onset and seizure frequency were significantly correlated with low QOLIE-31 scores (P
RESUMO
<p><b>OBJECTIVE</b>To observe the bone specimen of SANFH (steroid-induced avascular necrosis of femoral head) and the effect of Gufuhuo decoction on local apoptosis of SANFH.</p><p><b>METHOD</b>Model rabbits of necrosis of femoral head, made by intragluteal injection with prednisone acetate, were killed after 6 weeks to study the apoptosis by means of TUNEL.</p><p><b>RESULT</b>A great number of faded osteocytes and osteoblasts existed in specimen of SANFH. There was significant difference in apoptosis indexes between model and control group, Gufuhuo decoction and Xianlinggubao group (P < 0.05).</p><p><b>CONCLUSION</b>In the course of SANFH, the necrosis results from the interaction of apoptosis and necrosis of steroid-induced osteocytes and osteoblasts. Gufuhuo decoction has some effects on improving apoptosis and necrosis of SANFH.</p>
Assuntos
Animais , Feminino , Masculino , Coelhos , Apoptose , Combinação de Medicamentos , Medicamentos de Ervas Chinesas , Farmacologia , Necrose da Cabeça do Fêmur , Patologia , Marcação In Situ das Extremidades Cortadas , Sanguessugas , Química , Materia Medica , Farmacologia , Osteoblastos , Patologia , Osteócitos , Patologia , Plantas Medicinais , Química , Prednisona , Distribuição AleatóriaRESUMO
<p><b>OBJECTIVE</b>To design and manufacture a reliable spine phantom used in the cross calibration and quality control of dual X-ray absorptiometry (DXA).</p><p><b>METHODS</b>A hydroxyapatite quality control phantom was designed and made through three steps: solid water, bone phantom material and integration, then evaluated the phantom on four different types of DXA machines made by LUNAR company.</p><p><b>RESULTS</b>Among the four DXA densitometers, the Expert fan beam densitometer had the biggest accuracy errors of bone mineral density (BMD), bone mineral content(BMC) and area values while the other three one narrow fan beam (Prodigy) and two pencil beam densitometers-had small errors. Of the three indexes measured by all the machines, BMD error was the smallest (-15.4%-11.5%), with the Prodigy's BMD was most outstanding. BMD errors at the higher density ends were small, tend to be positive values while the errors at the lower ends were big, tend to be negative. In cross calibration, giving consideration to the differences between the both ends, it is better to use the regression equation to correct. The base line of precision error derived by scanning the phantom once a day for consecutive 25 days was better than that derived by scanning the phantom 25 times consecutively on the same day. As to precision error, the coefficient of variation (CV) of scanning-25 times-a day was the smallest (0.0043) while the CV of 12 adults measurements was the biggest (0.0078).</p><p><b>CONCLUSIONS</b>This phantom can be used in the quality control and cross-calibration of different types of DXA machines.</p>
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Absorciometria de Fóton , Materiais Biocompatíveis , Densidade Óssea , Calibragem , Durapatita , Modelos Anatômicos , Coluna VertebralRESUMO
<p><b>OBJECTIVE</b>To evaluate the community-based intervention on reduction of hypertension and stroke in different age groups and subtypes hypertension.</p><p><b>METHODS</b>In 6 cities, 2 geographically separated communities with a registered population about 10 000 of each were selected as either intervention or control communities. A cohort containing 2 700 subjects, 35 years or older, and free of stroke were sampled from each community. The baseline survey was conducted to screen the subjects for intervention. In each city, a program for control of hypertension, heart diseases and diabetes was initiated in the intervention cohort and health education was provided to the whole intervention community. A follow-up survey was conducted 3 years later.</p><p><b>RESULTS</b>Within 3 years, the prevalence of hypertension increased in both intervention and control cohorts, as well as in the middle and elderly cohorts, especially in the middle aged in control group. Among hypertensives in the intervention cohort, the rates of awareness, treatment and control of hypertension got improved. The incidence of stroke was 29% lower (HR = 0.71, 95% CI: 0.58 - 0.87) and mortality of stroke was 40% lower (HR = 0.60, 95% CI: 0.42 - 0.86) in the intervention cohort than the control cohort. The intervention was most effective in reduction of stroke for those with isolated systolic hypertension and combined systolic and diastolic hypertension (All P < 0.05). Meanwhile, all-cause mortality was 11% lower (HR = 0.89, 95% CI: 0.78 - 0.99) in the intervention cohort than in the control cohort.</p><p><b>CONCLUSION</b>The community-based intervention was effective in controlling the development of hypertension and stroke, while the elderly people benefit more than the middle aged people from the intervention.</p>
Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , China , Epidemiologia , Estudos de Coortes , Serviços de Saúde Comunitária , Seguimentos , Conhecimentos, Atitudes e Prática em Saúde , Hipertensão , Incidência , Programas de Rastreamento , Fatores de Risco , Acidente Vascular Cerebral , Epidemiologia , Mortalidade , Saúde da População UrbanaRESUMO
<p><b>OBJECTIVE</b>To evaluate the effects of community intervention on risk factors of cerebrovascular disease.</p><p><b>METHODS</b>With cluster sampling, 2,586 and 2,723 women and men aged 35 to 74 were selected randomly as intervention cohort and control cohort, respectively, from about 300 thousand community population in Beijing, Shanghai and Changsha, during 1997 to 2000. Their blood pressure, levels of blood lipid, body mass index (BMI) were measured and status of smoking and alcohol consumption were surveyed as indices of evaluation. Health education for smoking quit, alcohol consumption restriction and reinforced treatment for diabetic and hypertensive patients were implemented in the intervention communities. And, 2,544 and 2,533 persons in the two cohorts responded three years after intervention, and then all the indices mentioned above were measure again for them.</p><p><b>RESULTS</b>Average reduction in systolic blood pressure by 3.21 mm Hg and serum level of total cholesterol by 0.58 mmol/L was achieved in intervention cohort after intervention, but with 0.48 mmol/L increase in triglyceride. Average blood levels of both high density lipoprotein-cholesterol (HDL-C) and glucose increased in the two cohorts after intervention, but with 0.30 mmol/L net increase of blood glucose in control cohort. There was no significant difference in average increase of HDL-C between the two cohorts. BMI increased by 0.56 in control cohort, and no significant change in intervention cohort. Proportion of smoking decreased by 5.4% in men and 2.4% in women of intervention cohort, and no change in control cohort.</p><p><b>CONCLUSION</b>Level of risk factors for cerebrovascular disease reduced significantly with community intervention.</p>
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Consumo de Bebidas Alcoólicas , Índice de Massa Corporal , Transtornos Cerebrovasculares , Estudos de Coortes , Serviços de Saúde Comunitária , Hiperlipidemias , Dietoterapia , Hipertensão , Lipídeos , Sangue , Fatores de Risco , Estudos de Amostragem , Fumar , Saúde da População UrbanaRESUMO
<p><b>OBJECTIVE</b>To probe the of Gufuhuotang effect on hemorheology and lipid metabolism of hormonal necrosis of femoral head.</p><p><b>METHOD</b>32 male rabbits of New Zealand were divided at random into pathological pattern group, normal control group, low-dosage of Gufuhuotang group and high-dosage group; models of osteocyte necrosis of head of femur were made with intragluteal injection of hydroprednisone acetate; the rabbits were observed weekly and killed 6 weeks later and HE pathological section was made to observe hemorheology index and blood-liquid content, and then analysis and comparison were made.</p><p><b>RESULT</b>Gufuhuotang could obviously decrease total blood low-shear viscosity, plasma viscosity, hemacocrit, serum cholesterol and triglyceride contents; under light microscope empty bone lacunas of femoral head were less, fat cells of medullary cavity were less and relatively small, and bone trabecula was sparse with no break.</p><p><b>CONCLUSION</b>Gufuhuotang has a distinct preventive and curative effect on rabbits' hormonal necrosis of femoral head.</p>
Assuntos
Animais , Masculino , Coelhos , Combinação de Medicamentos , Medicamentos de Ervas Chinesas , Usos Terapêuticos , Necrose da Cabeça do Fêmur , Sangue , Hemorreologia , Lipídeos , Sangue , Plantas Medicinais , Química , Prednisona , Distribuição AleatóriaRESUMO
Objective To evaluate the change of treatment gap of epilepsy after intervention in rural areas of China.Method Six months after being stopped from the intervention project in 2004,using the same method as the first survey at the baseline,a door-to-door epidemiological survey was conducted again in 5 rural areas where the intervention measures had been carried out for about 3 years.Results Three hundred and twenty cases of epilepsy were diagnosed in the total sample population,yielding a prevalence rate of 0.62% and the prevalence of active epilepsy 0.44%.The prevalence and the active prevalence of epilepsy in the survey in 2000 were 0.70% and 0.46% respectively.Of the people with epilepsy,39.1% were treated regularly which increased about 14% than that in the baseline survey (24.8%).The treatment gap for active epilepsy was 49.8%,which decreased by 12.8% than that in the first survey (62.6%). Conclusion The treatment gap of epilepsy in the demonstration areas has decreased remarkably,proving that the intervention measures used in the study are effective and feasible in rural areas of China.