Problems in the theory teaching of general practice course for eight-year program of clinical medi-cal students / 中华医学教育探索杂志

Objective To explore the effect and method of the theory teaching of general practice course for eight-year program of clinical medical students. Methods The course of General Medicine was set up for 87 students from two grades in their fourth school year. All of them attended a closed-book exami-nation when they finished the lectures. The satisfaction rates, necessity and the suggestion of teaching and assessment were collected from the questionnaire. Results The examination results of the two grade students were (80.92±7.26) and (83.76±5.75); The satisfaction rate was 40.2％ (35/87); Necessity of the courses was between 3.6 to 4.1 (5-point-Likert-scale). The way of teaching method students chose was dif-ferent by course content. Conclusion The theory teaching of general practice course for eight-year program of clinical medical students needs more reform from curriculum designing, teaching methods, faculty train-ing and evaluation methods.

Relationship between prostatic hyperplasia and serum 25-hydroxy vitamin D level in elderly men / 中华老年医学杂志

Objective To explore the relationship between serum 25-hydroxy vitamin D level and prostatic hyperplasia in elderly men.Methods Totally 95 male patients aged over 60 years were included.Blood pressure,body weight,body height,body mass index (BMI) were measured and calculated.Venous blood samples were obtained to determine fasting serum levels of 25-hydroxy vitamin D3 and blood glucose (FBG),total cholesterol (TC),triglycerides (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),calcium and prostate specific antigen (PSA),total prostate volume(PV) and annual prostate growth rate were measured and calculated by ultrasound.Results The serum 25 (OH) D3 levels were varied from 12.1 nmol/L to 83.9 nmol/L,with an average of (35.5±15.2) nmol/L in elderly male patients.PV growth rate were significantly lower in elderly men with 25 (OH) D3 ＞ 50 nmol/L than in elderly men with 25 (OH) D3≤50nmol/L[(31.5± 6.0) mlvs.(39.9 ± 14.5) ml,(0.4± 0.2) ml/yvs.(0.5 ± 0.4) ml/y,P＜0.001 or 0.01].PV was negatively correlated with serum 25-hydroxy vitamin D3 level (r=-0.207,P＜0.05),and positively correlated with BMI and PSA (r=0.297,0.958,P＜0.05 or and P＜0.001).While annual prostate growth rate was positively correlated with BMI and PSA (r=0.316,0.464,P＜0.01 or ＜0.001),and positively correlated with serum 25-hydroxy vitamin D3 level,but the difference was not statistically significant (P＞0.05).Conclusions Low serum 25-hydroxy vitamin D3 level may play a role in the pathogenesis of prostatic hyperplasia.

Association between bone mineral density and left ventricular mass index in elderly men / 中华老年医学杂志

Objective To investigate the association between bone mineral density (BMD) and left ventricular mass index (LVMI) in elderly men in Beijing.Methods Totally 370 elderly men with an average age of (76.6±9.3) years from the departments of gerontology were included.BMD,echocardiography measurements as well as blood chemistry were analyzed.LVMI was obtained by echocardiography.All the subjects were divided into two groups:non-LVH group (n=231) and LVH group (n =139).Differences in quantitative variables were tested by independent-sample t test.Multiple stepwise linear regression analysis were performed to identify determinants of LVMI.Results The serum creatinine concentration was significantly higher in LVH group than in non-LVH group [(97.1±43.0) μmol/L,(88.2±21.1) μmol/L (P＜0.05)].Compared with non-LVH group,LVH group showed that the lumbar spine BMD (L1-L4) were significantly lower[L1:(0.90±0.16) g/cm2 vs.(0.95±0.21) g/cm2,P=0.05; L2:(0.95±0.17) g/cm2 vs.(1.01±0.20) g/cm2,P＜0.01 ; L3:(0.99±0.19) g/cm2 vs.(1.06±0.28) g/cm2,P＜0.01] as well as the lumbar spine totalBMD [(0.97±0.18) g/cm2 vs.(1.03-1-0.26) g/cm2,P＜0.05].The femur BMD was lower in theLVH group than in non-LVH group [trochiter:(0.64±0.11) g/cm2 vs.(0.67±0.17) g/cm2,P＜0.05; inter area:(1.00±0.17) g/cm2 vs.(1.05±0.22) g/cm2,P＜0.05].Multiple stepwise linear regression analysis demonstrated that BMI (r=0.27,P＜0.01),the lumbar spine BMD (r=-0.20,P＜0.01),age (r=0.16,P＜0.05),serum creatinine (r=0.15,P＜0.05) were independently correlated with LVMI.Conclusions In elderly men in Beijing,the lumbar spine BMD is an independent correlative factor for LVMI.

The association between insulin resistance and prostatic hyperplasia / 中华老年医学杂志

Objective To evaluate the relationship between insulin resistance and benign prostatic hyperplasia (BPH).Methods Totally 150 male patient from the Department of Geriatrics in Peking University Hospital were included in this study.Blood pressure,body weight,body height,body mass index (BMI) were measured and calculated.Biochemical analyses including serum fasting levels of insulin(FINS),glucose,total cholesterol,triglycerides,low-density lipoprotein cholesterol,high density lipoprotein cholesterol,and prostate-specific antigen (PSA) were performed.Total prostate volume (PV) were measured by ultrasound.Results PV and annual prostate growth rate were more increased in insulin resistance group(40 cases) compared with insulin sensitivity group(110 cases) (t=2.91,3.71 respectively,both P＜0.01).Along with the levels of FINS,HOMA-IR and PSA were increased,the prostate volume was enhanced (t=-3.02,-2.88,-2.84 respectively;all P ＜0.05).PV was positively correlated with insulin resistance,serum fasting insulin and PSA (r=0.16,0.16,0.35;all P＜0.05),while annual prostate growth rate was positively related with insulin resistance,serum fasting insulin,PSA and BMI (r =0.22,0.21,0.24,0.19 ; all P ＜ 0.05).Conclusions Insulin resistance and fasting insulin plays roles in the pathogenesis of prostatic hyperplasia.

Study of left atrial diameters and prothrombotic state in senile patients with hypertension and atrial fibrillation / 中华老年医学杂志

Objective To explore the relationship between left atrial diameters (LAD) and prothrombotic state in senile patients with hypertension (HT) and atrial fibrillation (AF). Mcthods Totally 105 patients with cssential hypertension were divided into 65 patients with atrial fibrillation and 40 cases without atrial fibrillation,and then patients with atrial fibrillation were subgrouped into paroxysmal and persistent atrial fibrillation groups.30 healthy people without hypertension and atrial fibrillation were used as control group.LAD was determined by M type ultrasound cardiogram.Fibrinogen (Fg),D-Dimer(D-Dimer),von willebrand (vwF) and haematocrit (HCT) were also measured as prothrombotic state and compared among the groups. Results In groups of HT with AF versus HT without AF versus control,LAD[(43.56 ± 6.72) mm vs.(36.28 ± 5.83) mm vs.(31.63±4.32)mm],Fg[(4.24±0.59)g/L vs.(3.09 ±0.49)g/L vs.(2.80± 0.46)g/L],D-Dimer [(0.43±0.13)mg/L vs.(0.28±0.]0)mg/L vs.(0.18±0.08)mg/L],vwF[(290.44±29.02)％ vs.(101.32±21.36)％ vs.(84.15±20.26) ％],HCT[(0.46±±0.07)vs.(0.37±0.05)vs.(0.34±0.03)]were significantly higher in HT patients with atrial fibrillation than those without atrial fibrillation and control ( all P＜ 0.05),and there were differences in LAD and D-Dimet (P＜＜0.05),but not in Fg,vwF and HCT (all P＞0.05) between patients without atrial fibrillation and control.LAD[(46.75±7.32)mm vs.(40.82±6.21)mm],Fg [(4.68±0.65)g/L vs.(3.85±0.53)g/L],D-Dimer [(0.48±0.16)mg/L vs.(0.40±0.12)mg/L],vwF [(384.96±29.75)％ vs.(209.43±28.63)％] and HCT [(0.49±0.08)vs.(0.43±0.06)] in persistent atrial fibrillation group were increased than those in paroxysmal atrial fibrillation group ( P ＜ 0.05 ).Fg ( r =0.683 ),D-Dimer ( r =0.735 ),vwF ( r=0.763) and HCT(r=0.759)were corrclated with LAD (all P＜0.01). Conclusions Increased LADmight he one of the elevated risks of atrial fibrillation and a higher prothrombotic state is increasing with larger LAD in senile hypertension.

Relationship between metabolic syndrome and benign prostatic hyperplasia / 中华老年医学杂志

ObjectiveTo evaluate the relationship between metabolic syndrome (MS) and benign prostatic hyperplasia (BPH).MethodsTotally 101 male patients with MS and 117 male patients without MS were enrolled from September 2008 to January 2010 in the department of geriatrics of Peking University People's Hospital.The MS diagnosis was made according to the criteria by Chinese Diabetes Society (2004).Blood pressure,body weight,body height,body mass index (BMI) were measured and calculated.Biochemical analyses including serum fasting blood glucose (FBG),total cholesterol ( TC),triglycerides (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),and prostate-specific antigen (PSA) were performed.Total prostate volume (PV) were measured by ultrasound.ResultsPV in patients with MS[(39.7±21.1)m1] was significantly larger than in patients without MS[(30.7±9.3)ml] (P＜ 0.05).There was no difference in PSA level between groups (P＞ 0.05).PV were positively correlated with BMI(r=0.27,P=0.019),hypertension duration(r=0.37,P=0.01),PSA(r=0.51,P=0.001),FBG(r=0.24,P=0.013) and systolic blood pressure(SBP)(r=0.20,P=0.047),but negatively correlated with HDL-C ( r = - 0.24,P = 0.013 ).Conclusions BMI,hypertension duration,PSA,FBG,SBP,and lower HDL-C may play roles in the pathogenesis of prostatic hvperplasia.

Association between T245G polymorphisms in the osteoprotegerin gene and bone mineral density in elderly individuals / 中国组织工程研究

BACKGROUND: As a primary clinical predictor of fracture risk, bone mineral density (BMD) is partly genetically determined. Osteoprotegerin (OPG) is one important candidate gene in the pathogenesis of osteoporosis. OBJECTIVE: To investigate the association between T245G polymorphisms in the OPG gene and BMD. METHODS: A total of 281 elderly men and postmenopausal women, 182 males and 99 females, who received routine examinations at Peking University People's Hospital between September 2008 and April 2010 were included in this study. T245G polymorphisms in the OPG gene was detected by polymerase chain reaction-restriction fragment length polymorphism together with DNA sequencing. The BMD of the lumbar spine, Ward's triangle, and forearrm was determined by dual energy X-ray absorptiometry. Clinical variables and biochemical measurements were collected simultaneously. The association between T245G polymorphisms and each detection index was analyzed using analysis of variance. RESULTS AND CONCLUSION: The distribution of T245G genotype (alleles T, G) had no difference in elderly men or postmenopausal women (P > 0.05). The GG genotype and TG genotype had higher lumbar spine BMD and TT genotype had lower lumbar spine BMD (P < 0.05). There was no difference in BMD of the Ward's triangle or forearm among different genotypes (P > 0.05). Association between T245G polymorphism and BMD was not found in postmenopausal women. These findings indicate that OPG gene is related to lumbar spine BMD in elderly men.

Relationship of serum uric acid with carotid atherosclerosis in the elderly / 中华全科医师杂志

Objective To investigate correlation between serum level of uric acid (SUA) and carotid atherosclerosis in the elderly. Methods A group of 113 elder subjects were examined by high-frequency Doppler ultrasound to measure their intima-media thickness (IMT) of carotid artery and severity of atherosclerotic plaque formation. Blood levels of biochemical factors such as SUA, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood sugar (FBS), creatinine (Cr) were determined, as well as 24h urine level of albumin (UALB). Correlation between SUA, IMT and the plaque was analyzed.Results SUA in quartile positively correlated with increasing IMT and severity of plaque in the elderly. SUA correlated with IMT of carotid artery, independent from age, gender, TC, TG, HDL-C, LDL-C and Cr, and correlated with severity of plaque adjusted for age, gender, history of hypertension, TC, TG, HDL-C, LDL-C, Cr, FBS and logarithm of UALB.Conclusions Level of SUA positively correlated with IMT, and increased level of SUA was a risk factor for carotid plaque, independent from other cardiovascular risk factors and renal impairment indicators, such as age, gender, history of hypertension,blood lipid level, Cr, etc.

The relationship between the urine albumin excretion rate, the growth factors and bone density in elderly male patients with type 2 diabetes mellitus / 中华老年医学杂志

Objective To observe the relationship between urine albumin excretion rate (UAE), growth factors and the bone mineral density (BMD) in elderly patients with type 2 diabetes mellitus. Methods Fourteen controls and 51 elderly male patients with diabetes divided into three groups: normal albuminuria(UAE

Evaluation for the Efficacy of Taizhian in Treatment of Primary Hyperlipidemia in Aged Patients / 中国医师杂志

Objective To study the efficacy and safety of Taizhian in treatment of aged patients with primary hyperlipidemia.Methods Sixty patients with hyperlipidemia were divided into two groups.Taizhian and simvastatin of 10mg/d group have 30 patients (group A),simultaneously were given simvastatin 10mg before sleep and Taizhian three pills,po,tid for 8wk;30 patients (group B) were given simvastatim 20mg,before sleep for 8 wk.By using full-anutomatic biochemical analytic instrument to measure all lipidemia markers.Results In these two groups,the levels of TC,TG,LDL-C,AI decreased and HDL-C increased(P0 05).In the two groups the adverse reaction were mild.Conclustions Taizhian and simvastatin of 10mg/d are so effective in treatment hyperlipidemia as simvastatin of 20mg/d,while the former can decrease the adverse reaction.