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BACKGROUND: Patients with nasogastric tube (NTG) nutrition after discharge still need to be transferred to community hospitals for continued care. Effective health education is conducive to raising the level of knowledge of caregivers to promote the rehabilitation of patients. METHODS: Clinical data of 65 caregivers of stroke patients in Putuo Hospital affiliated to Shanghai University of Traditional Chinese Medicine from June 2020 to December 2020 were retrospectively analyzed. These caregivers were divided into an observation group (33 cases, hospital-community-family education model) and a control group (32 cases, routine nursing health education). We used questionnaires to assess the knowledge, attitudes, and practice levels of caregivers before and after education, and recorded the occurrence of complications in patients within 12 weeks. RESULTS: The scores of the knowledge questionnaire and practice questionnaire of caregivers in the observation group were higher than those in the control group at 2, 4 and 12 weeks after intervention (P<0.05). The scores of caregivers' attitudes questionnaire were higher in the observation group than in the control group at 4 and 12 weeks after intervention (P<0.05). But 2 weeks after intervention, there was no significant difference between the two groups (P>0.05). Within 12 weeks after intervention, the probability of complications in observation group was lower than that in the control group (P<0.05). Logistic regression analysis showed that the hospital-community-family health education helped the outcome. CONCLUSION: For the main caregivers of NTG nutrition patients, the implementation of a hospital-community-family health education model based on regional medical consortium can improve the level of knowledge, attitude and practice of caregivers' NTG nutrition skills and reduce complications in patients.
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Objective To investigate the correlation between the incidence of type 2 diabetes mellitus (T2DM) with hypertension and the levels of some elements in serum, and to provide a more scientific and reasonable basis for the control of T2DM. Methods A total of 1 024 T2DM patients admitted to a top three hospital in Urumqi from March 2015 to May 2016 were selected. Patients with T2DM were divided into T2DM with hypertension group and T2DM without hypertension group according to the presence or absence of hypertension. Various elements levels in the serum were analyzed. The correlation between serum levels and the incidence of hypertension with T2DM was analyzed, and the related risk factors were explored by using logistic regression. Results Among 1 024 T2DM patients, 627 patients had hypertension, accounting for 61.20%, while 397 patients had no hypertension, accounting for 38.80%. There was a positive correlation between serum sodium and magnesium levels with T2DM in hypertension (P<0.05). The increase of serum sodium level and the decrease of magnesium level were the risk factors of T2DM with hypertension. This result suggested that the difference of serum levels of various elements may play a role in the occurrence and the development of T2DM. Conclusions Serum sodium and magnesium levels were positively correlated with the incidence of T2DM with hypertension. The increase of serum sodium level and the decrease of magnesium level were influencing factors of the incidence of T2DM with hypertension. This study suggests that the serum levels of sodium and magnesium play a role in the occurrence and development of T2DM.
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BACKGROUND: Previous studies have shown that hypertension is an important factor contributing to the occurrence and progression of diabetic kidney damage. However, the relationship between the patterns of blood pressure (BP) trajectory and kidney damage in the diabetic population remains unclear. This prospective study investigated the effect of long-term systolic BP (SBP) trajectory on kidney damage in the diabetic population based on an 8-year follow-up community-based cohort. METHODS: This study included 4556 diabetic participants among 101,510 participants. BP, estimated glomerular filtration rate (eGFR), and urinary protein were measured every 2 years from 2006 to 2014. SBP trajectory was identified by the censored normal modeling. Five discrete SBP trajectories were identified according to SBP range and the changing pattern over time. Kidney damage was evaluated through eGFR and urinary protein value. A multivariate logistic regression model was used to analyze the influence of different SBP trajectory groups on kidney damage. RESULTS: We identified five discrete SBP trajectories: low-stable group (n = 864), moderate-stable group (n = 1980), moderate increasing group (n = 609), elevated decreasing group, (n = 679), and elevated stable group (n = 424). The detection rate of kidney damage in the low-stable group (SBP: 118-124 mmHg) was the lowest among the five groups. The detection rate of each kidney damage index was higher in the elevated stable group (SBP: 159-172 mmHg) compared with the low-stable group. For details, the gap was 4.14 (11.6% vs. 2.8%) in eGFR <60 ml·min-1·1.73 m-2 and 3.66 (17.2% vs. 4.7%), 3.38 (25.0% vs. 7.4%), and 1.8 (10.6% vs. 5.9%) times in positive urinary protein, eGFR <60 ml·min-1·1.73 m-2 and/or positive urinary protein, and eGFR decline ≥30%, respectively (P < 0.01). CONCLUSION: An elevated stable SBP trajectory is an independent risk factor for kidney damage in the diabetic population.
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Blood Pressure/physiology , Asian People , Female , Glomerular Filtration Rate/physiology , Humans , Hypertension/physiopathology , Logistic Models , Male , Prospective Studies , Risk FactorsABSTRACT
Objective To investigate whether brachial-ankle pulse wave velocity(baPWV),independently and jointly with the level of body mass index(BMI),affect the risk of incident diabetes with hypertension. Methods The effects of baPWV and BMI level on incident diabetes with hypertension were evaluated using Kaplan-Meier curves (log-rank test) and multi logistical regression models after adjustment for various confounding factors. Results A total of 2 222 participants were recruited in this study. Higher baPWV (Q4) was associated with a greater risk of incident diabetes with hypertension simultaneously compared with baPWV in the lower quartiles(Q1-Q3),with HR 4.16(95% CI 2.14,8.09)in the crude model,2.52(95% CI 1.10,5.78) in modelI,and 2.45(95% CI 1.05, 5.70)in modelⅡ.The highest risk of diabetes with hypertension simultaneously was in the group with high baPWV and BMI≥25 kg/m2,with HR 11.50(95% CI 4.5,29.9)in the crude model,4.20(95% CI 1.4,13.1)in modelI,and 4.30(95% CI 1.4,13.3) in modelⅡ. Conclusions The joint effect of baPWV and BMI level on incident diabetes with hypertension simultaneously is a better predictor than their independent effect. The risk of incident diabetes with hypertension markedly increases in the subjects with BMI≥25 kg/m2and higher baPWV.
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<p><b>Background</b>Previous studies have shown that hypertension is an important factor contributing to the occurrence and progression of diabetic kidney damage. However, the relationship between the patterns of blood pressure (BP) trajectory and kidney damage in the diabetic population remains unclear. This prospective study investigated the effect of long-term systolic BP (SBP) trajectory on kidney damage in the diabetic population based on an 8-year follow-up community-based cohort.</p><p><b>Methods</b>This study included 4556 diabetic participants among 101,510 participants. BP, estimated glomerular filtration rate (eGFR), and urinary protein were measured every 2 years from 2006 to 2014. SBP trajectory was identified by the censored normal modeling. Five discrete SBP trajectories were identified according to SBP range and the changing pattern over time. Kidney damage was evaluated through eGFR and urinary protein value. A multivariate logistic regression model was used to analyze the influence of different SBP trajectory groups on kidney damage.</p><p><b>Results</b>We identified five discrete SBP trajectories: low-stable group (n = 864), moderate-stable group (n = 1980), moderate increasing group (n = 609), elevated decreasing group, (n = 679), and elevated stable group (n = 424). The detection rate of kidney damage in the low-stable group (SBP: 118-124 mmHg) was the lowest among the five groups. The detection rate of each kidney damage index was higher in the elevated stable group (SBP: 159-172 mmHg) compared with the low-stable group. For details, the gap was 4.14 (11.6% vs. 2.8%) in eGFR <60 ml·min·1.73 m and 3.66 (17.2% vs. 4.7%), 3.38 (25.0% vs. 7.4%), and 1.8 (10.6% vs. 5.9%) times in positive urinary protein, eGFR <60 ml·min·1.73 m and/or positive urinary protein, and eGFR decline ≥30%, respectively (P < 0.01).</p><p><b>Conclusion</b>An elevated stable SBP trajectory is an independent risk factor for kidney damage in the diabetic population.</p>
Subject(s)
Female , Humans , Male , Asian People , Blood Pressure , Physiology , Glomerular Filtration Rate , Physiology , Hypertension , Logistic Models , Prospective Studies , Risk FactorsABSTRACT
AIM: Circulatory GDF-15, angiotensin II (Ang-II) and GDF-15 mRNA expression levels were examined in three groups, in other words, control (n = 25), Type 2 diabetes (T2DM; n = 25) and Type 2 diabetes with hypertension (T2DM_HTN; n = 36). RESULTS: T2DM and T2DM_HTN subjects had significantly (p < 0.05) higher GDF-15 and Ang-II levels compared with control subjects. Significant positive correlation was found between Ang-II and GDF-15 levels. GDF-15 mRNA expression from blood cells was significantly elevated in T2DM_HTN (p < 0.05) but not in T2DM subjects. GDF-15 mRNA expression was significantly elevated in Ang-II-treated (50 nM) THP-1 (p < 0.001) and H9C2 (p < 0.05) cells but not altered after high glucose treatment. CONCLUSION: Collectively, our data suggest that higher levels of GDF-15 is associated with increased Ang-II levels in diabetic patients with concurrent hypertension.
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Objective To investigate the influence of the diabetes with hypertension on glucose and lipid metabolism as well as renal function. Methods 310 diabetic inpatients were divided into hypertension group (n=150) and non-hypertension group (n=160). The levels of plasma glucose, insulin, C-peptide, lipid and creatine, as well as microalbuminuria were measured. The results were statistically analyzed. Results Compared with non-hypertension group, in hypertension group the plasma levels of fasting glucose and postprandial glucose significantly increased (P
