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Objective:To investigate the relationship between cardiometabolic index (CMI) and hyperuricemia (HUA) in the health examination population.Methods:It was a cross-sectional study. A total of 21 720 individuals who received health examinations in Xiangya hospital, Central South University between 2020 and 2021 were recruited in this study. Multivariate logistic regression analysis was used to determine the independent correlation between CMI and HUA, and stratified analysis was applied to check whether there were population differences. Then the predictive value of CMI for hyperuricemia in the health examination population was evaluated with the area under the receiver operator characteristic (ROC) curve.Results:Among the 21 720 subjects, 4 418 (20.34%) were detected with HUA. In the HUA group, the body mass index (BMI), waist-to-hip ratio, CMI, total cholesterol, triglyceride, systolic blood pressure, diastolic blood pressure, fasting blood glucose, 2-hour postprandial blood glucose, and blood creatinine levels were all significantly higher than those in the normal uric acid group, while high-density lipoprotein and epidermal growth factor receptor (eGFR) were significantly lower (all P<0.05). Multiple logistic regression analysis showed that after adjusting for relevant factors, CMI was significantly positively correlated with HUA ( OR=1.16, 95% CI: 1.129-1.192); and with the increase of CMI, the risk of HUA increased gradually. Stratified analysis and interaction test according to gender, age, BMI, hypertension, abnormal blood glucose and glomerular filtration rate indicated that CMI was positively associated with the occurrence of HUA in all populations. Compared with that in people with abnormal blood glucose, the correlation between CMI and HUA was more obvious in people with normal blood glucose. The area under the ROC curve (AUC) for CMI to predict HUA was 0.723(95% CI: 0.715-0.731), with a specificity of 0.636 and a sensitivity of 0.698, and the cut-point was 0.693. Conclusion:There was a significant positive correlation between CMI and HUA in the health examination population, which has good predictive value for HUA.
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Objective:To understand the relationship between lipid accumulation product (LAP) and hyperuricemia in physical examination population.Methods:This was a cross-sectional study. The analysis was based on baseline data from a retrospective cohort study. Total of 44 294 people who received physical examination in the Health Management Center of Xiangya Hospital of Central South University from January to December 2012 were selected as subjects with whole-group sampling method. All the subjects aged ≥18 years with complete study variables. The minimum waist circumference of the subjects was calculated to determine the criteria for calculating LAP in those population. With LAP as the observed variable and hyperuricemia as the outcome variable, LAP was divided into four groups according to the interquartile interval (Q 1-Q 4 groups): group Q 1<10.56 cm·mmol/L, 10.56 cm·mmol/L≤Q 2<20.79 cm·mmol/L, 20.79 cm·mmol/L≤Q 3<38.94 cm·mmol/L, Q 4≥38.94 cm·mmol/L. Five models were constructed with logistic regression analysis. No confounding factors was adjusted in Model 1, model 2 was adjusted for age and gender; and model 3 was further adjusted for body mass index, hypertension, hyperlipidemia, creatinine and glomerular filtration rate; model 4 was further adjusted education level, occupation, health insurance, smoking, drinking, diet scores and physical exercise; model 5 was further adjusted the family history of gout, diabetes and hypertension. And the relationship between different LAP levels and hyperuricemia was analyzed. Results:In this study, the minimum waist circumference in the physical examination population was 58 cm and 53 cm for men and women, respectively. The total incidence of hyperuricemia was 13.4% in this population, 5.94% for women and 19.40% for men. When the confounding factors were not adjusted (model 1), the risk of hyperuricemia in women′s LAP Q 2 to Q 4 groups was 1.76 times (95% CI: 1.42-2.17), 5.08 times (95% CI: 4.20-6.14) and 12.58 times (95% CI: 10.43-15.18), and it was 1.68 times (95% CI: 1.43-1.96), 2.74 times (95% CI: 2.36-3.18), and 5.32 times (95% CI: 4.62-6.14) in men, respectively. After gender stratification and adjustment for confounding factors (model 5), the risk still existed, compared with that in Q 1 group of LAP, the risk of hyperuricemia in women in Q 4 group was 8.28 times higher (95% CI: 2.50-27.38) and 3.31 times higher in men (95% CI: 1.57-6.95). Conclusion:The risk of hyperuricemia in health examination population increases with LAP, especially in women.
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Objective:To explore the role of active screening in the diagnosis and treatment of early lung cancer, and give health management recommendations.Methods:A retrospective study was conducted to collect lung cancer patients who had complete population sociology, clinical information, pathology and imaging characteristics in the Thoracic Surgery in Xiangya Hospital of Central South University from 2016 to 2019. According to different diagnostic modes, they were divided into an active screening group (1082 cases) and a passive case finding group (974 cases), to analyze their differences in demographic sociological, clinical information, pathology and imaging characteristics, and to discuss the key points of population management in the active screening group.Results:From 2016 to 2019, the proportion of lung cancer patients in the active screening group increased from 36.1% to 54.2%, and the proportion of patients found to have lung cancer by CT examination in the active screening group increased from 82.2% to 96.8%. Compared with the passive case finding group, the active screening group had a higher proportion of women, non-smokers, patients with precursor glandular lesions and adenocarcinoma, patients in stage 0 and stage I, patients with lesion diameter (d)≤1 cm and 1<d≤2 cm, patients with sublobectomy and lymph node sampling (46.9% vs 32.9%, 59.2% vs 43.8%, 4.0% vs 2.1%, 80.5% vs 56.8%, 4.0% vs 2.1%, 72.0% vs 56.8%, 14.5% vs 7.6%, 42.5% vs 33.3%, 6.3% vs 2.9%, 2.4% vs 1.0%, respectively, all P<0.05). Conclusion:Active screening is helpful to find early lung cancer, and the health management and physical examination center should pay attention to the management of such physical examination population.
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Objective:To establish a model C-GALAD for detecting hepatocellular carcinoma (HCC) from the chronic liver disease and healthy people based on the serum markers.Methods:A clinical cohort including 229 hepatocellular carcinoma patients, 2 317 patients with chronic liver disease and 982 healthy people, was retrospectively collected from eight hospitals or physical examination institutions from April 2018 to October 2020. The data were divided into a training set and a testing set by stratified sampling with a 6∶4 ratio. A predictive model was established on the training set using a logistic backward regression method and validated on the testing set. In addition, clinical data from March to July 2021 in Beijing You′ an Hospital affiliated to Capital Medical University, including 84 patients with liver cancer and 204 patients with chronic liver disease collected were used for external independent validation of the model. The receiver operating characteristic curve (ROC) area under curve (AUC), the sensitivity and the specificity were used to evaluate the effectiveness of the model.Results:Through the logistic backward regression method, the seven signatures including age, gender, alpha-fetoprotein (AFP), alpha-fetoprotein alloplasm-3 ratio (AFP-L3%), des-gamma-carboxyprothrombin(DCP), platelet (PLT) and total bilirubin (TBIL) were selected as risk factors in the detection model. The area under the ROC curve (AUC) of the model on the testing set was 0.954, with an 88.04% sensitivity and a 94.85% specificity, and the AUC of model on the external independent validation set was 0.943, with an 89.29% sensitivity and a 90.2% specificity, which were better than other published models.Conclusion:The C-GALAD Ⅱ model can accurately predict the risk of hepatocellular carcinoma occurrence, and thus provide a trustworthy diagnosis method of hepatocellular carcinoma.
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Objective:To investigate the relationship between waist circumference and hyperuricemia in occupational population in Changsha city.Methods:Based on a retrospective cohort design, a total of 1 197 employees from 70 organizations who received 4 or more years of continuous physical examinations in Xiangya hospital from January 1, 2014 to December 31, 2018 were included in this study. The physical examination data of the year 2014 were set as baseline data, while the data between January 1, 2015 and December 31, 2018 were used as follow-up data. According to interquartile range of the waist circumference, the subjects was divided into four groups: the first quartile ( Q1),<77 cm for men and <68 cm for women; the second quartile ( Q2), 77 cm ≤ and<82 cm for men, 68 cm ≤ and <73 cm for women; the third quartile ( Q3), 82 cm ≤ and <87 cm for men, 73 cm ≤and <78 cm for women; the fourth quartile ( Q4), ≥87 cm for men, ≥78 cm for women. Among them, Q1 was set as the control group, and Q2, Q3 and Q4 as the exposed groups. Three models were established for the total population, men and women, respectively. The confounding factors were not adjusted in model Ⅰ. The model Ⅱ was adjusted for age, gender and body mass index (the male or female population were not adjusted for sex). Confounders including age, gender, body mass index, hypertension, fasting glucose, blood creatinine, triacylglycerol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol were adjusted for model Ⅲ. Cox regression analysis was used to compare the hazard ratio ( HR), adjusted hazardratio (a HR) and their 95% CIs for the development of hyperuricemia in the subjects with different waist circumference over the 4 years. Results:Total of 1 197 subjects were followed-up for (2.05±1.18) years and 2 448 person-years. A total of 208 cases of hyperuricemia were identified in the total population during the 4 years (45 women/163 men), with a cumulative incidence of 17.4% (6.4% in women/33.3% in men) and an incidence density of 84.9/1 000 person-years (31.8/1 000 person-years in women, 157.6/1 000 person-years in men). And 626, 609, 629, and 584 person-years were followed-up in the 4 groups, respectively; with 15, 30, 59, and 104 cases of hyperuricemia occurred during 4 years, respectively. The cumulative incidence rates of hyperuricemia in the 4 yearswas 5.5%, 9.2%, 20.8% and 32.8%, respectively; and the incidence densities was 24.0/1 000 person-years, 49.3/1 000 person-years, 93.8/1 000 person-years and 178.1/1 000 person-years, respectively. Compared with that in the Q1 group, the risk of hyperuricemia was increased in the Q4 group, with a HR (95% CI) of 2.70 (1.81 to 4.04), P<0.05. After adjusted for confounding factors in the total population, the a HR (95% CI) of hyperuricemia was 2.12 (1.39 to 3.24), P<0.05. This risk remained when stratified by gender and adjusted for confounding factors. Compared with the Q1 group, the a HR (95% CI) of hyperuricemia in the Q4 group was 1.91 (1.18 to 3.09) for the male population and 2.93 (1.14 to 7.56) for the female population, respectively (both P<0.05). Conclusion:Among the occupational population, the risk of hyperuricemia increases with increase of waist circumference.
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Objective:To investigate the correlation between hyperuricemia and hypertension in hospital employees.Methods:A cohort was constructed from staff participating health checkups at the Xiangya Hospital of Central South University, baseline health examinations and questionnaires were conducted from February 1, 2011, to January 29, 2012; 502 participants were excluded according to the nadir criteria, and 3 525 participants were followed-up from February 1, 2012, to December 31, 2018, according to the results of annual employee checkups. The participants were divided into the normal uric acid (3 232 cases) and hyperuricemia groups (293 cases) according to the baseline examination results. The presence of hyperuricemia was used as an observation index and occurrence of hypertension within 7 years was used as an outcome indicator. Age, sex, body mass index, creatinine, LDL cholesterol, triacylglycerol, HDL cholesterol, fasting glucose, marriage, education, job position, smoking, alcohol consumption, and exercise status were used as confounding factors to construct five Cox regression models and calculate their HR values, adjusted HR values, and 95% CI to analyze the relationship between hyperuricemia and the occurrence of hypertension in the overall population and female and male populations. Results:The follow-up of the study participants was conducted for a period of (6.19±1.25) years, with a total of 21 831 person-years of follow-up. The 7-year cumulative prevalence of hypertension was 16.5% in the total population, 12.5% in the female population, 30.1% in the male population, 14.1% in the normal uric acid group, and 42.0% in the hyperuricemia group. The prevalence density of hypertension was 26.6, 19.6, 53.8, and 22.4 per 1 000 person-years in the total, female, male, and normouricemic groups, respectively. Without adjusting for any confounding variables, the risk of hypertension was higher in the total population, female population, and male population in the hyperuricemia group than in the normal uric acid group [ HR=3.86, 5.69, 1.60, (95% CI: 3.17-4.72, 4.36-7.43, 1.18-2.16)] (all P<0.05); after gradually adjusting for confounders, this correlation was only manifested in the female population [adjusted HR=1.91 (95% CI: 1.08-3.36)] (all P<0.05), and the difference was not statistically significant in the male population ( P>0.05). Conclusion:Among female hospital employees, hyperuricemia is an independent risk factor for the development of hypertension.
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Objective:To investigate the relationship between advanced glycation end products (AGEs) in the lens and type 2 diabetes mellitus.Methods:226 subjects were recruited between August 14 to September 14, 2018 from the Endocrinology Department of Central South University Xiangya Hospital, the Third Hospital of Changsha City, and the Fourth Hospital of Changsha City. The OGTT test, combined with clinical indicators, were used as the gold standard. Subjects were screened for type 2 diabetes using both the lens AGE fluorescence assay and the gold standard. Drawing the receiver operating characteristic (ROC) curve, we calculated the area under the curve (AUC) and its 95% CI and calculated the AGE for the diagnosis of type 2 diabetes. Sensitivity, specificity, Youden index, Kappa value, and its 95% CI, and the optimal cut-off value were determined according to the Youden index. Taking diabetes as the outcome indicator and AGE as the binary indicator, three logistic regression models were constructed. Stratified by age and sub-center, the differences between fasting blood glucose and 2 h postprandial blood glucose were compared between the AGE-negative and AGE-positive groups to determine the relationship between AGE and diabetes. Results:The area under the ROC curve was 0.86(95% CI: 0.81-0.91). According to the Youden index, the optimal cut-off point for AGE was 0.24. At this time, the sensitivity was 82.86(95% CI: 77.81-87.91), the specificity was 77.06(95% CI: 71.43-82.7), the Youden index was 59.92(95% CI: 53.36-66.49), the Kappa value was 79.62(95% CI: 74.22-85.02). Except for the 20-39-year-old group, the fasting blood glucose and 2 h postprandial blood glucose of the AGE-positive group in different age groups, different sub-centers, and the general population were higher than those of the AGE-negative group (all P<0.05). After adjusting for the confounding effects of age, gender, and sub-center (model 3), the relative risk of diabetes in the AGE-positive group was 11.75 times higher than the AGE-negative group (95% CI: 5.61-24.60), all with P<0.001. Conclusion:There was a high correlation between AGE in the lens and the risk of type 2 diabetes. When the cut-off point of AGE is 0.24, it had high sensitivity and specificity and could be used as a practical tool for early screening of type 2 diabetes.
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After years of exploration, Central South University has comprehensively reformed and upgraded the curriculum in both horizontal and vertical integration, including optimizing and constructing a basic clinical core curriculum system with organ system integration as the main line, utilizing the advantages of comprehensive universities to further advance the cross-teaching reform of science, engineering, arts and medicine, strengthening pre-medical education with the goal of early exposure to medicine, promoting the reform of early contact clinical integrated teaching according to the concept of "early, multiple and repeated clinical practice", and accelerating the integration of clinical skills training courses with the support of clinical skills simulation teaching. After the integration, the faculty team has gradually matured and the teaching quality has been significantly improved, which has strengthened the students' medical thinking and overall literacy.
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Objective:To investigate the correlation between serum uric acid level and hyperglycemia.Methods:A medical examination cohort of the staff of our hospital was constructed. From February 1 st, 2011, to December 31 st, 2011, 3 937 staff members without hyperglycemia were selected, and baseline data were collected through a questionnaire survey, physical examination, measurement of blood lipid and blood glucose, assessment of kidney function, and other laboratory tests. The subjects were followed up during the annual physical examination for 7 years, from January 1 st, 2012, to December 31 st, 2018. They were divided into four groups according to serum uric acid level: uric acid<360 μmol/L, 360≤uric acid<420 μmol/L, 420≤uric acid<480 μmol/L, and uric acid≥ 480 μmol/L. With the occurrence of hyperglycemia as the outcome indicator; uric acid level as the observation index; uric acid<360 μmol/L as the control group; and gender, age, body mass index, smoking, hypertension, dyslipidemia as confounding factors, Cox regression was performed before and after adjusting confounding factors to analyze the relationship between different uric acid levels and the incidence of hyperglycemia in the entire sample, in the male staff, and in the female staff. Results:The 7-year cumulative incidence of hyperglycemia in the four groups were 15.7%, 34.0%, 38.8%, and 43.8%, respectively ( Z=148.94, P<0.01). In the male staff, the 7-year cumulative incidence rates in the four groups were 23.4%, 29.9%, 34.7%, and 35.8%, respectively ( Z=11.17, P<0.01). In the female staff, the 7-year cumulative incidence rates in the four groups were 14.2%, 42.5%, 52.2%, and 65.0%, respectively ( Z=141.84, P<0.01. After adjusting for gender, age, body mass index, smoking, hypertension, and dyslipidemia, the risk of hyperglycemia in the 360≤uric acid<420 μmol/L, 420≤uric acid<480 μmol/L, and uric acid≥ 480 μmol/L groups were 1.73 (1.39-2.15), 1.86 (1.42-2.45), and 1.95 (1.34-2.85) times higher than that in the control group (all P<0.05). Among female staff, the risk of hyperglycemia in the 360≤uric acid<420 μmol/L, 420≤uric acid<480 μmol/L, and uric acid≥ 480 μmol/L groups were 2.18 (1.62-2.94), 3.41 (2.24-5.20), and 3.02 (1.69-5.40) times, respectively, and were also higher than those in the control group (all P<0.01). Conclusion:With the increase of serum uric acid level, the risk of hyperglycemia in medical staff increases, which is mainly manifested in female staff.
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Objective:To investigate the correlation between hyperhomocysteinemia (HCA) and hyperuricemia (HUA).Methods:A total of 8 465 individuals who received a medical examination at the Xiangya Hospital Health Management Center of Central South University were selected as research subjects from January to June 2018. The multi-factor binary Logic regression method was adopted and four different models. The ratio ( OR) and its 95% trusted interval ( CI) between Hhcy group and normal control group were analyzed. Results:Compared to the normal control group, the OR(95% CI) of the probability of HUA in the Hhcy population was 3.272 (95% CI: 2.839 to 3.771, P<0.001) without correcting other factors; After correcting the influence of age and gender, the OR (95% CI) of the Hhcy population with HUA probability was 2.111 (95% CI: 1.811-2.461, P<0.001); After correcting age, gender, Body Mass Index (BMI), blood pressure, fasting blood sugar, triglycerin, low-density lipoprotein, and high-density lipoprotein, the OR(95% CI) of the Hhcy population with HUA probability was 2.163 (95% CI: 1.845 to 2.535, P<0.001); After correcting age, sex, BMI, blood pressure, fasting blood sugar, triglycerin, low-density lipoprotein, high-density lipoprotein, drinking, smoking, exercise time, and exercise intensity, the OR (95% CI) of the Hhcy population had a HUA probability of 2.209(95% CI: 1.845 to 2.646, P<0.001). Conclusion:The cross-sectional study confirmed that Hhcy was positively correlated with HUA. Reducing homocysteine levels may be a new approach to the health management of HUA.
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Objective:To investigate the correlation between serum uric acid level and non-alcoholic liver disease (NAFLD).Methods:A medical examination cohort of our hospital′s staff was constructed. From February 1, 2012 to January 29, 2013, a total of 3, 479 staff without NAFLD were selected as research subjects, and baseline data were collected through a questionnaire survey, physical examination, abdominal ultrasound examination, blood lipid, blood glucose, liver and kidney function, and other laboratory tests. From February 1, 2013 to December 31, 2018, the patients were followed up during the annual physical examination for six years. The serum uric acid level was used as the observation index and divided into four groups from A to D according to the quartile. With the occurrence of NAFLD as the outcome indicator; the four groups of uric acid as the observation indicator; and age, body mass index, hyperlipidemia, hyperglycemia, hypertension, creatinine, and alanine aminotrans ferase as confounding factors; four Cox regression analysis models were constructed to explore the relationship between groups of different blood uric acid levels and NAFLD. Stratified by gender, three Cox regression analysis models were constructed to investigate the relationship between blood uric acid level grouping and NAFLD between different genders.Results:The six-year cumulative incidence of NAFLD in groups A, B, C, and D was 1.2%, 3.1%, 4.9%, and 12%, respectively (χ 2=114.710, P<0.05). Among the female workers, the six-year cumulative incidence rates in groups A, B, C, and D were 1.0%, 2.9%, 4.1% and 10.9%, respectively (χ 2=71.241, P<0.05). The incidence risk of NAFLD in groups B, C, and D was 2.04 (1.01-4.11), 2.24 (1.13-4.44), and 3.89 (1.94-7.80) times that of group A, P<0.05, respectively. The incidence risk of NAFLD in groups B, C, and D was 2.21 (1.02-4.77), 2.39 (1.10-5.19), and 4.49 (1.99-10.15) times that of group A, all P<0.05, respectively. Conclusion:The risk of NAFLD increased with the increase of serum uric acid level, and this trend was mainly manifested in female employees.
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Objective To explore the effect of PDCA [plan (P), design (D), check (C), act (A)] cycle on primary cardiopulmonary resuscitation (CPR) training for medical assistants in hospitals. Methods PDCA cycle was used to enhance continuous quality improvement (CQI) of team members to carry out brain storming to find out the root causes of the training difficulty, and directing to the 3 main root causes: lack of emergency rescue consciousness, without systematic training system and improper education procedure, it was proposed to arrange 3 great strategies: emergency rescue knowledge training, design of systematic training system and proper arrangement of training process. The changes of medical assistants' subjective willingness to perform the first aid, the accurate rates of answering questions on CPR location, frequency, depth, ratio of compression to breathing and awareness degree of CPR before and after training were observed. Results After training, the medical assistants' subjective willingness to perform the first aid was higher than that before training [91.7% (121/132) vs. 2.3% (3/132), P＜0.05]. The accurate answer rates on questions concerning CPR basic knowledge, such as location, frequency, depth and compression-breathing ratio had been greatly improved after training compared with those before training [location: 65.2% (86/132) vs. 4.5% (6/132), frequency: 40.2% (53/132) vs. 0 (0/132), depth: 90.2% (119/132) vs. 0 (0/132), compression-breathing ratio: 84.8% (112/132) vs. 1.5% (2/132 ), all P＜0.05]. After training, the percentage of medical assistants having very familiar awareness degree of CPR was significantly higher than that before training [65.2% (86/132) vs. 3.0% (4/132), P＜0.05]. Conclusion Via CPR training PDCA cycle, not only the efficiency of CPR training management is greatly improved, but also the training effect of participants is significantly elevated.
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To analyze the incidence and imaging characteristics of pulmonary nodules in a unit staff. Methods: Low-dose spiral CT (LDCT) scan were performed in 1 372 staffs ≥45 years old in a certain unit during the physical examination. The clinical and imaging data were collected to analyze the detection rate, imaging characteristics, and postoperative pathological conditions of pulmonary nodules. Results: The total detection rate for pulmonary nodules was 30.39% (417/1 372). The detected nodules were mainly single (227 cases), solid (343 cases), 0.05). Compared with the Lung-RADS category 3 nodules, the proportions of nodules in subsolid state, with irregular shape, lobulation sign, and vascular penetration in the Lung-RADS category 4 were increased (all P<0.05). Among them, 11 patients received surgical therapy, including 10 women. Postoperative pathology confirmed lung adenocarcinoma in 9 patients (2.16%), including 8 women, all non-smokers. Conclusion: The nodules in subsolid state with vascular penetration, irregular shape and lobulation sign tend to be malignant. Lung cancer screening with low-dose spiral CT in female non-smokers should be emphasized.
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Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Detecção Precoce de Câncer , Neoplasias Pulmonares , Diagnóstico por Imagem , Tomografia Computadorizada Espiral , Tomografia Computadorizada por Raios XRESUMO
Objeetive To explore the relationship between metabolic syndrome and benign prostatic hyperplasia in health management.Methods A total of 5 721 patients of prostate hyperplasia was collected and divided into two groups according to metabolic syndrome.The height, weight, body mass index (BMI), and arterial blood pressure were measured.The serum PSA, cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), postprandial blood glucose, uric acid (UA) prostate specific antigen (PSA), and free prostate specific antigen (fPSA) were monitored.The volume of prostate was measured with ultrasound.The difference was analyzed between two groups of metabolic syndrome components and the volume of prostate.The correlation between various indicators of metabolic syndrome and prostate hyperplasia and prostate volume were analyzed.Health intervention was made to observe the changes of prostate volume and symptoms in the patients with metabolic syndrome for one year.Results BMI, TG, TC, BG, prostate volume, and serum PSA were higher in the patients with metabolic syndrome than in the control group.There was significant correlation between hyperlipidemia, benign prostatic hyperplasia and diagnosis of hypertension.Prostate volume was positively correlated with obesity, hypertension, high-density lipoprotein and metabolic syndrome.After health intervention, the indicators of metabolic syndrome decreased, and the symptoms of benign prostatic hyperplasia were relieved.Conclusions Reduced obesity, hypertension, low highdensity lipoprotein and the metabolic syndrome and prostate volume were positively related.Metabolic syndrome and prostatic hyperplasia exists certain relationship.The metabolic syndrome health interventions will be necessary to manage the health of prostate hyperplasia, thus delays the occurrence and development of prostate hyperplasia disease.
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Medical simulation teaching is an emerging and developing teaching method in our coun-try. At present, the simulation teaching centers are developing rapidly in higher education institutions, but how to improve the effectiveness in the operation of the centers is still a subject that needs to be discussed. Based on our own experience, this paper analyzes the related factors in developing medical simulation teach-ing centers, making summary and demonstrations from aspects of team building, teacher training, docking needs, staffing and so on, so as to provide references and suggestions for the construction of medical simu-lation center higher education institutions.
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Objective To investigate the relationship between hyperlipidemia and hyperuricemia.Methods From February 1,2012 to May 31,2017,a physical examination queue for serving and retired employees in Xiangya Hospital was established.As the survey's baseline,height,weight,waist circumference,blood lipids,blood pressure,blood glucose,creatinine,and serum uric acid were collected.The normal group was the control group,and the dyslipidemia group was the exposure group.The occurrence of hyperuricemia was investigated during follow-up.A multivariate Cox proportional hazards regression model was used to analyze hyperlipidemia.Four different clinical types (hypercholesterolemia,hypertriglyceridemia,mixed hyperlipidemia,and low high-density lipoprotein hyperlipidemia) and hyperuricemia had an incidence of hazard ratio (HR) and confidence interval (95％CI).Results A total of 1 553 people entered the follow-up cohort.A total of 5 297 patients were followed up for an average of 3.4 years.Three hundred and ninety-four cases of hyperuricemia were collected.The density of hyperuricemia was 744/10 000 years.The hyperuricemia group was followed up for 2 509 years,with hyperuricemia occurring in 142 cases,and hyperuricemia in the hyperlipidemia group of 566/million years.The hypercholesterolemia,high triglyceride,mixed hyperlipidemia,and low-density lipoprotein groups were followed up for 1 431,403,580,92 years,respectively,and high uric acid occurred respectively.In 105,64,72 and 11 cases,the incidence of disease was 734/million years,1 588/million years,1 241/million years,1 196/million years;the difference was statistically significant (P＜ 0.01).Hyperlipidemia and its four clinical types,hypercholesterolemia,hypertriglyceridemia,mixed hyperlipidemia,and hypodic lipoproteinemia,were associated with hyperuricemia.HR (95％CI) was 1.971 (1.604-2.421),1.441 (1.120-1.855),3.103 (2.309-4.169),2.434 (1.833-3.233),2.336,respectively.(1.265-4.316),P＜ 0.01;after adjusting the influence of age,sex,body mass index,hypertension,hyperglycemia,and hyper creatinine,HR (95％CI) was 1.885 (1.533-2.317),1.450 (1.127-1.866),2.881 (2.141-3.876),2.118 (1.588-2.825),2.451 (1.326-4.528) P＜0.01.Conclusions Hyperlipidemia and its four different clinical types (hypercholesterolemia,hypertriglyceridemia,mixed hyperlipidemia,and low-density lipoproteinemia) are all associated with the onset of hyperuricemia.
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Objective To analyze the factors which influence the treatment compliance of hypertensive patients in health management. Methods Data of 6 325 hypertensive patients who received physical examination in our department were collected; 4 132 male cases and 2 193 female were included, their ages ranged from 28 to 84 years old;the average age was 61.2 ± 5.8 years. The patients of the health intervention group were randomly divided into 3 groups (group 1, group 2 and group 3). They were provided with regular health management (including weight management, catering management, sports management, medication management and monitoring of blood pressure), respectively, given different frequency of telephone follow-up (1 time per 2 months, 1 time per month, and 1 time per month), evaluating treatment compliance. All the results were analyzed and compared respectively according to the level of education, age and mental status. Data of 1 892 hypertensive patients who received outpatient services were enrolled as the control group. Among them, 4 132 were male and 2 193 were female, aged 28-84 years old, average (61.2 ± 5.8) years old. They received the traditional outpatient follow-up (outpatient service review and health education), their treatment compliance, timely correcting unhealthy lifestyle and medication method and self-testing blood pressure were evaluated. ANOVA and chi square test were used to analyze the treatment compliances and blood pressure control rates of the two groups. Result Compared with the control group, health intervention for hypertension patients could significantly improve the treatment compliance and blood pressure control rate(64.8%vs. 41.3%, 56.7%vs. 29.6%;χ2=2.827,1.382;P=0.032,0.007). Comparing the results of telephone follow-up frequency, the treatment compliance and blood pressure control rate of the 3 intervention groups were higher than those of the two other groups(77.3%vs. 65.4%, 51.7%,χ2=3.414,P=0.041;69.6% vs. 57.3%, 43.2%,χ2=2.763,P=0.028). The treatment compliance of patients with high education level was significantly higher than that of patients with low education level(68.7% vs. 59.1%, 46.4%,χ2=3.257,P=0.037;60.1%vs. 47.2%,32.8%,χ2=1.234,P=0.009). And the treatment compliance of patients with good mental state was significantly higher than that of patients with anxiety(Intervention group1:64.3%vs. 55.1%,41.9%,31.0%,χ2=2.257, P=0.016;59.4%vs.46.1%,20.9%,21.8%,χ2=3.34 5 P=0.021;Intervention group2:75.5%vs. 64.3%,51.8%,41.2%,χ2=2.932, P=0.030;68.3%vs.57.1%,39.2%, 32.1%,χ2=2.382, P=0.032;Intervention group3:86.5% vs.73.2%,62.6%,52.4%,χ2=2.435, P=0.026;75.2% vs. 68.0%,51.7%,43.3%,χ2=3.251, P=0.036). Conclusion More frequently follow-up can improve the treatment compliance and control rate of blood pressure in hypertensive patients;education, age and psychological condition are factors influencing treatment compliance in hypertensive patients.
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〔Abstract〕 The paper elaborates the definition of Biobank and the significance of constructing Biobank standardized system, through comparison of Biobank development process and experiences between China and abroad, it analyzes the existing problems and reasons of Biobank standardized system construction in China, puts forward corresponding advices.
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Objective To investigate the relationship between infection of Helicobacter pylori (HP) and early renal damage in type 2 diabetes.Methods Materials of 223 customer cases who received physical examination in our department were collected and analyzed.They were divided into two groups:HP positive group and HP negative group according to the HP infection.The basic information,blood lipid,lipoprotein,albuminuria of 24 hours,fibrinogen,C-reactive protein,erythrocyte sedimentation rate,and blood urea nitrogen and creatinine were compared between two groups,respectively.Results There was no significant difference in basic information,blood glucose,glycosylated hemoglobin and blood lipid (P ＞ 0.05).The results of lipoprotein,albuminuria of 24 hours,fibrinogen,C-reactive protein,and erythrocyte sedimentation rate in HP positive group were higher than those in HP negative group (P ＜ 0.05).Conclusions The infection of Helicobacter pylori played a part in the early renal damage of type 2 diabetes.
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Objective To explore the effect ofα-phenyl-N-tert-butylinitrone (PBN) on expression of nerve growth factor (NGF) in se-rum and spinal cord tissue in rats after spinal cord injury (SCI). Methods 174 female Sprague-Dawley rats were randomly assigned to fol-lowing groups:normal control group (n=54), normal saline control group (NS group, n=60, intrathecally injected normal saline 15 μl), and PBN group (n=60, intrathecally injected PBN, 3 mg, 15 μl). The model was established with New York University blow device (150 kDyne, 1 s dwell time). PBN was intrathecally injected into the damaged areas 30 min after operation, then once a day for 7 days. The Basso-Beattie-Bresnahan (BBB) Locomotor Rating Scale was used to assess the rats 3 days and 1 day before, and 1 day, 5 days, 10 days, 15 days, 20 days, 25 days, 30 days and 35 days after SCI. NGF in the injured spinal cord tissue and serum was measured 1 h, 12 h, 24 h, 48 h, 3 days, 7 days, 14 days and 21 days after SCI. Results NGF increased in serum but not in spinal cord. The ratio of NGF/total protein in serum rose and peaked 48 h after SCI, and the ratio was higher in NS group (0.92%±0.02%) than in PBN group (0.77%±0.05%) (P=0.021). BBB scores in-creased from the 9th day, and PBN group improved better than NS group (P<0.01). Conclusion PBN could reduce the expression of NGF in the SCI rats, and promote the recovery of neurol function.