慢性心力衰竭患者生活质量及干预措施研究进展

慢性心力衰竭(chronic hear failure,CHF)是一种极为复杂的临床综合征,是各种心脏病发展的最终阶段,严重危害患者及家属的生命安全和心理健康。生活质量能较全面评价生活优劣。近年来对影响心力衰竭患者生活质量的因素及干预措施不断涌现。文章结合循证医学证据和国内外最新研究,对慢性心力衰竭的生活质量及干预措施研究进展作一综述。     

Lipid abnormalities in chronic renal failure

Lipid abnormalities remain to be a major cause of early mortality in patients with chronic renal failure (CRF). In present study, 114 (one hundred fourteen) CRF patients without any additional cause of dyslipidemia were divided into groups on the basis of etiologies of CRF. Blood samples from each group were analyzed for total cholesterol, triglyceride and HDL cholesterol along with blood urea nitrogen and serum creatinine. 25 healthy individuals without any obvious disease were taken as control. Patients from all the groups showed a marked hypertriglyceridemia of 232 (SD±77) mg/dl (P<0.001) as compared to control. Levels of HDL cholesterol were found to be significantly low 20 (±11) mg/dl (p<0.001) in all the groups. LDL cholesterol showed an increase 104 (±30) mg/dl as compared to control group which is not statistically significant. Present study reveals that, CRF patients show an uniform dyslipidemia irrespective of etiologies leading to CRF. This dyslipidemia is also independent of serum creatinine levels. Although, these lipid abnormalities may not solely cause mortality in CRF patients, they may act as modulators in accelerating atherogenesis which in turn cause early mortality in CRF patients.     

Study of sEGF level in chronic atrophic gastritis with either Chinese traditional medicine or western medicine

This study was aimed to investigate the level of sEGF in CAG with different therapies of either Chinese traditional medicine or western medicine. Patients were divided into spleen-reinforcingⅠ, spleen-reinforcing Ⅱ,dampness-resolving and western medicine group by Differentiation Syndrome. Healthy volunteers acted as controls. The sEGF was investigated before and after treatment. The level of sEGF in CAG was higher than that in control group(P<0.01). In patients of spleen-reinforcingⅠgroup and spleen-reinforcing Ⅱgroup, the symptoms and pathological manifestations were improved dramatically (P<0.01) and sEGF dropped markedly after treatment(P<0.01 and P<0.05).The level of sEGF in the dampness-resolving group increased after treatment (P<0.05). But the level of sEGF in the western-medicine group dropped a little after treatment (P>0.05). The inflammation of gastric mucosa may cause the elevation of sEGF in CAG reflectively. After being effectively treated with Chinese traditional medicine, the symptoms of CAG improved simultaneously with the return of sEGF. SEGF is a sensitive index to prognosis of CAG.     

浅谈中医防治慢性前列腺炎

慢性前列腺炎中医属于＂淋证＂、＂尿浊＂等范畴。其病因主要为湿热下注。中医辨证分为湿热蕴结型、肝气郁滞型、瘀血阻滞型、脾肾阳虚型、肾阴亏虚型。外治法有针刺疗法、灸法、按摩法、坐浴疗法、中药煎汤保留灌肠。慢性前列腺炎应未病先防,中医辨证论治效果良好。     

Tai Ji Quan as an exercise modality to prevent and manage cardiovascular disease: A review

BackgroundRegular exercise is beneficial for adults with cardiovascular disease (CVD) and CVD risk factors. Tai Ji Quan is popular among older adults and may offer additional exercise options. The present article aims to review the scientific literature published within the past decade on Tai Ji Quan as an exercise modality to prevent and manage CVD.MethodsAn electronic literature search of four databases (PubMed, CINAHL, PsycINFO, and AMED) was conducted from April 2003 through March 2013. Studies that examined Tai Ji Quan, were published in English, and specified a target study population of participants with a known CVD condition (e.g., coronary artery disease, chronic heart failure, or stroke) or studies conducted among participants with a CVD risk factor (e.g., hypertension, dyslipidemia, or impaired glucose metabolism) were included.ResultsA total of 20 studies met the inclusion criteria: 11 randomized clinical trials, seven quasi-experimental studies and two cross-sectional studies. The effect of Tai Ji Quan was examined on more than 20 different study variables among persons with coronary artery disease (n = 5 studies), chronic heart failure (n = 5 studies), stroke (n = 4 studies), and CVD risk factors (n = 6 studies). These studies were conducted primarily in Asia (n = 9, 45%) or the United States (n = 8, 40%). Overall, participants enrolled in Tai Ji Quan had better outcomes, though mixed results were reported.ConclusionCollectively, these studies indicate that Tai Ji Quan is a safe form of exercise to prevent and manage CVD. Further research is needed with more rigorous study designs, larger sample sizes, adequate Tai Ji Quan exercise doses, and carefully chosen outcome measures that assess the mechanisms as well as the effects of Tai Ji Quan, before widespread recommendations can be made.     

Adverse childhood experiences,chronic diseases,and risky health behaviors in Saudi Arabian adults: A pilot study

Adverse childhood experiences (ACEs) have been linked with risky health behaviors and the development of chronic diseases in adulthood. This study examined associations between ACEs, chronic diseases, and risky behaviors in adults living in Riyadh, Saudi Arabia in 2012 using the ACE International Questionnaire (ACE-IQ). A cross-sectional design was used, and adults who were at least 18 years of age were eligible to participate. ACEs event scores were measured for neglect, household dysfunction, abuse (physical, sexual, and emotional), and peer and community violence. The ACE-IQ was supplemented with questions on risky health behaviors, chronic diseases, and mood. A total of 931 subjects completed the questionnaire (a completion rate of 88%); 57% of the sample was female, 90% was younger than 45 years, 86% had at least a college education, 80% were Saudi nationals, and 58% were married. One-third of the participants (32%) had been exposed to 4 or more ACEs, and 10%, 17%, and 23% had been exposed to 3, 2, or 1 ACEs respectively. Only 18% did not have an ACE. The prevalence of risky health behaviors ranged between 4% and 22%. The prevalence of self-reported chronic diseases ranged between 6% and 17%. Being exposed to 4 or more ACEs increased the risk of having chronic diseases by 2–11 fold, and increased risky health behaviors by 8–21 fold. The findings of this study will contribute to the planning and development of programs to prevent child maltreatment and to alleviate the burden of chronic diseases in adults.     

老年慢性肺心病伴发急性心肌梗死的分析

目的探讨老年慢性肺心病伴发急性心肌梗死(AMI)的临床特点.方法对66例老年慢性肺心病伴发AMI的病人(A组)进行分析,并与老年单纯冠心病AMI152例(B组)作比较.结果A组疼痛发生率(45.4%)显著低于B组(83.9%)(p＜0.01),A组急性左心衰、心源性休克发生率显著高于B组,分别为53.1%与25.0%,48.4%与21.7%(p＜0.05),A组病死率(42.4%)显著高于B组(15.7%),肺心病对其伴发AMI的发生部位无影响.结论对老年肺心病患者突然发生的急性左心衰和/或心源性休克应高度警惕伴发AMI的可能.     

大鼠慢性萎缩性胃炎模型的建立

目的 :建立稳定、价廉、实用的慢性萎缩性胃炎动物模型。方法 :采用 2 %水杨酸钠和30 %酒精混合溶液灌胃 ,并结合劳累、饥饱失常等多因素方法刺激Wistar大鼠胃粘膜 8周。结果 :CAG模型组大鼠较正常对照组大鼠体重明显减轻、胃粘膜腺体萎缩、炎细胞浸润 ,壁细胞数量减少且部分呈空泡样变性 ,停止作用 4周后仍无恢复。结论 :多因素联合作用 8周能建立良好的大鼠慢性萎缩性胃炎模型 ,且稳定性好。     

Pathways to Children’s Academic Performance and Prosocial Behaviour: Roles of physical health status,environmental, family,and child factors

The objective of this article is to examine the pathways by which children’s physical health status, environmental, family, and child factors affect children’s academic performance and prosocial behaviour, using a theoretically‐based and empirically‐based model of competence development. The model proposes that 3 types of relational processes, dealing with opportunity, support, and skill development through participation, lead to competence. Structural equation modelling was performed on cross‐sectional, parent‐report data for approximately 10,000 Canadian children aged 6–11 years from the 1994–95 National Longitudinal Survey of Children and Youth. The analyses controlled for family socioeconomic status and child’s age and sex, and included 3 groups of children (those with activity‐limiting conditions, non‐activity‐limiting conditions, or no health problems). There was little evidence that children with chronic conditions were at direct risk for poorer outcomes. Children with activity‐limiting conditions were at increased indirect risk for academic difficulties through the role played by cognitive functioning. Cognitive functioning and hyperactivity/inattention difficulties were the major predictors of academic performance. Recreational participation and behavioural functioning were the main predictors of prosocial behaviour. The pathways in the model also indicated the importance of family functioning, social support to parents, and neighbourhood cohesion. In conclusion, the findings indicate the utility of the model of competence development in understanding the pathways and processes by which various factors affect children’s academic and social outcomes.     

Bardet–Biedl Syndrome: A Rare Cause of Chronic Kidney Disease

Bardet-Biedl syndrome (BBS) is a rare autosomal recessive condition characterized by retinitis pigmentosa, postaxial polydactyly, central obesity, and renal involvement. Renal failure is the commonest cause of death. We report a case of BBS with chronic kidney disease (CKD) at younger age (17 year) from India. This diagnosis should be considered in patients with renal disease and the characteristic phenotype of retinitis pigmentosa, postaxial polydactyly and central obesity. These patients should undergo regular monitoring of renal function test to early diagnosis and treatment of CKD to prevent morbidity and mortality. Renal transplantation is a viable option of renal replacement therapy in these patients. These findings are valuable for comparing phenotype of BBS patients with CKD from various national and international centers.