Effects of preoperative other diseases on the compications of senile cervical vertebral operation in perioperative period

AIM：To investigate the effects of preoperative other diseases on the complications of senile cerical vertebral operation in perioperative period.METHODS:800 senile cervical vertebral cases were divided into two group:group A included the cases without other comorbidities,and group B included the cases with hypertension,diabetes mellitus,coronary heart disease (GHD) or chronic obstructive pulmonary disease(COPD).We retrospectively analyzed the changes of BP,oxygen saturation (SaO2) and the incidence of cardiac arrhythmia during operation of group A and B.RESULTS:In perioperative period,the incidence of B reduction or rising and cardiac arrhythmia in group B was more than that of group A.Incidence of SaO2 decreasing increases apparently in each stage and incidence of cerebrovascular,pulmonary complications and asphyxia led by incision bleeding increases apparently.CONCLUSION:The hypertension,CHD,diabetes mellitus and COPD were the main reasons of complications of the heart,the cerebral vessels and the lung,kidney and the incision bleeding in perioperative period of senile patients.     

Effects of preoperative other diseases on the complications of senile cervical Tertebral operation in perioperative period

AIM: To investigate the effects of preoperative other diseases on the complications of senile cervical vertebral operation in perioperative period METHODS: 800 senile cervical vertebral cases were divided into two group: group A included the cases without other comorbidilies, and group B included the cases with hypertension, diabetes mellitus, coronary heart disease (CHD) or chronic obstructive pulmonary disease(COPD) . We retrospectively analyzed the changes of BP, oxygen saturation (Sad) and the incidence of cardiac arrhythmia during operation of group A and B. RESULTS: In perioperative period, the incidence of BP reduction or rising and cardiac arrhythmia in group B was more than that of group A. Incidence of SaO2 decreasing increases apparently in each stage and incidence of cerebrovascular, pulmonary complications and asphyxia led by incision bleeding increases apparently. CONCLUSION: The hypertension, CHD, diabetes mellitus and COPD were the main reasons of complications of the heart, the cerebral     

老年糖尿病住院患者感染危险因素分析

INTRODUCTION Incidence of diabetes combined with infection was very high,disease condition was serious,course of disease was long which made treatment very difficult[1- 3].Senile diabetes were more easy to be infected because of bad control effect of blood glucose and decreased immune function and the infection was difficult to control.Corresponding risk factors about senile diabetes combined with infection were analyzed in this article to make timely diagnosis and treatment.     

Small cell lung cancer starting with diabetes mellitus: Two case reports and literature review

BACKGROUND Small-cell lung cancer(SCLC)is a type of fatal tumor that is increasing in prevalence.While these are unpleasant facts to consider,it is vitally important to be informed,and it is important to catch the disease early.Typically,lung cancer does not show severe clinical symptoms in the early stage.Once lung cancer has progressed,patients might present with classical symptoms of respiratory system dysfunction.Thus,the prognosis of SCLC is closely related to the early diagnosis of the disease.Ectopic adrenocorticotropic hormone(ACTH)syndrome(EAS)is related to cancer occurrence,especially for SCLC with the presence of Cushing's syndrome,which is dependent on markedly elevated ACTH and cortisol levels.CASE SUMMARY In the current report,we describe two middle-age patients who were originally diagnosed with diabetes mellitus with no classical symptoms of lung cancer.The patients were eventually diagnosed with SCLC,which was confirmed by bronchoscopic biopsy and histopathology.SCLC-associated diabetes was related to EAS,which was an endogenous ACTH-dependent form of Cushing’s syndrome with elevated ACTH and cortisol levels.Multiple organ metastases were found in Patient 1,while Patient 2 retained good health at 2 years follow-up.EAS symptoms including thyroid dysfunction,hypercortisolism and glucose intolerance were all resolved after anticancer treatment.CONCLUSION In conclusion,SCLC might start with diabetes mellitus and increased cortisol and hypokalemia or other EAS symptoms.These complex clinical features were the most significant factors to deteriorate a patient’s condition.Early diagnosis and treatment from clinicians were essential for the anti-cancer treatment for patients with SCLC.     

肾移植病人的饮食康复治疗

Background:Now renal transplantation is extensively used and recetpted in the clinic for treating chronic renal failure.Nutrition support and diet treatment are necessary for postoperative rehabilitation of patients underwent renal transplantation.Rigid nutrition treatment could prevent and treatment postoperative diabetes mellitus,hypertension and hyperlipemia.Diet control was also necessary for patients receiving immunodepressant.Standards and protocol for diet treatment are unavailable now.The incidence of acute rejection and allograft failure during the first year posttransplantation has been greatly reduced by advances in operative techniques, immunosuppressive agents and our understanding of their toxicities, donor selection and preservation, and donor and patient management. However, life-long immunosuppression is required to prevent the development of chronic rejection. Thus, either chronic rejection or the adverse side effects of chronic immunosuppression limit long-term survival. There is increasing incidence that posttransplant lipoprotein abnormalities may contribute to the development of cardiovascular disease (CVD). CVD is one of the most common causes of morbidity and mortality following renal transplantation. In addition, there is some indirect evidence that posttransplant lipoprotein abnormalities may influence the progression of chronic transplant nephropathy. While there are no intervention trials examining whether antilipemic therapy is beneficial in the prevention of CVD in renal transplant patients, it is reasonable to assume that the benefits of treating hyperlipidemia in renal transplant recipients may be comparable to those found in the general population. Objective:Protocol for diet treatment was determined for patients underwent renal transplantation to reduce renal load,promote recovery of renal function,and decreased the incidence of complications.     

骨质疏松症的预防与康复治疗

INTRODCTION Incidence of osteoporosis is very high in menopausal women and the senile.There weren't satisfying therapeutic method at present and exercises,diet,shinning,drugs were the main basic treatment for osteoporosis which preventive effects were better than therapeutic effects.Scientific exercises plus diet containing high calcium or suitable supplement of calcium is an effective preventive method for osteoporosis.     

上海市郊区绝经后妇女预防骨质疏松行为水平的调查及相关因素分析

Objective To study the osteoporosis prevention activity level and its influence factors of postmenopausal women in Shanghai suburbs area, in order to develop effective intervention programs to provide scientific evidence. Methods The related knowledge questionnaire, self-efficiency table of related food and sports of the osteoporosis, activity quantity table of related food and sports of the osteoporosis were used to do the research on 246 postmenopausal women in Shanghai suburbs area. Results The average mark of related knowledge and self-efficiency was generally not high, which were separately (9.74 ± 6.38) and (43.00 ±14.06). The activity level mark was(17.44 ±4.23), the average mark of food was lower than that of sport activity(t =21.95,P <0. 01); There was active relation(P <0. 01) between osteoporosis prevention activity and the related knowledge/self-efficiency. SAS shows that the knowledge and self-efficiency are the predict factor of the activity. Conclusions According to the characteristics of postmenopausal women in Shanghai suburbs area, community doctors and nurses and the government should take efficient interference measures to improve the knowledge of osteoporosis and self- efficiency, in order to improve their activities.     

老年骨质疏松性骨折的康复治疗

When the senile patients with osteoporosis fracture are hospitalized,fracture is cured by surgical department of orthopedics and osteoporosis is cured by internal department of orthopedics,which is timely and appropriate.Even after union of fracture,the comprehensive treatment is essential for such patients.     

护理干预对老年糖尿病患者自我护理的影响

Objective To investigate influential factors of self-nursing in elderly patients with diabetes mellitus and its intervention strategies. Methods 90 elderly patients with diabetes mellitus in our Outpatient Department were investigated by Diabetes Self-Efficacy Scale (DSES), Diabetes Self-Management Scale (DSMS). Their self-nursing confidence and self-nursing performance were evaluated. The influential factors of their self-nursing were surveyed by a self-designed questionnaire, factors-based nursing was given to them, and their improvement of self-nursing before and after the intervention was compared. Results Self-nursing confidence and performance of elderly patients with diabetes mellitus were obviously improved by health education, psychological guidance and betterment of disease cognition (P ＜ 0. 01 ). Conclusions Self-nursing ability of elderly patients with diabetes mellitus could be improved by individualized health education,psychological guidance and betterment of disease cognition to ameliorate their psychological status and change their deep-rooted concept.     

Rehabilitative treatment of senile osteoporosis fracture

When the senile patients with osteoporosis fracture are hospitalized,fracture is cured by surgical department of orthopedics and osteoporosis is cured by internal department of orthopedics,which is timely and appropriate.Even after union of fracture,the comprehensive treatment is essential for such patients.     

施行糖尿病患者康复教育的临床意义

Background:Diabetes is a kind of chronically permanent disease.Management during hospitalization was insufficient.Now,health education is the important project in diabetes study.Patients' lifestyle ,attitude to condition and previous treatment showed obvious impact on diabetes control.Some investigators indicated patients had less knowledge about diabetes-related matters,and their self-health idea was unobvious.They rarely abided by physicians' demands.So,rehabilitative education is important for diabetes patients. Objective:To observe the therapeutic effect of rehabilitative education on diabetes patients. Unit:Department of Leader Health,Laiwu People's Hospital. Subjects:80 diabetes were recruited during July 1997 to July 2001.Among these patients,46 were males,34 were females aged 12～ 72(mean age:56.5).42 had high school education and others had middle school education. Intervention:Based on education project for diabetes developed by Endocrine Institute of Hunan Medical University,health education was conducted during hospitalization.After admission,《 Elementary knowledge about diabetes prevention and treatment》 was given to patients.Extensive education ways were used for diabetes patients and their family members.Patients can seek tele-medical directions with telephone or letters according to their demands. Patients were evaluated before and after education. Main prognosis indexes:Comprehensive condition for elementary knowledge about diabetes,fasting blood glucose and accordance behavior were evaluated. Result: (1)Elementary knowledge about diabetes was mastered by 26% patients before education and 80% after education.(2)Fasting blood glucose was (8.22± 0.80)mmol/L before education and (6.10± 0.50)mmol/L after education(P< 0.05).Follow-up showed no changes in fasting blood glucose after discharge.(3) Accordance rate of drugs uptake,diet control,activity intensity,detection of blood glucose and urinary glucose was 50% before education and 85% after education. Conclusion:Rehabilitative education can enhance patients' self regulation and self detection ability,delay development of complications.     

干预高血压、高血脂、高黏滞血症对心脑血管疾患发生率的影响

Background:According to American Heart Association's report,death composition of cerebrovascular and cerebrovascular disease was increased to 29％ in 1996,and now 33％ from 25％ in 1992.Now,atherosclerosis seriously endanger human's health.Hypertension,hyperlipemia and hyperviscosity syndrome are main risk factors of cardiovascular and cerebrovascular diseases.There conditions often existed simultaneously in elders.Intervention to these diseases can prevent cardiovascular and cerebrovascular events,which is feasible. Objective:To investigate impact of hypertension,hyperlipemia and hyperviscosity syndrome on incidence of cardiovascular and cereborvascular events. Design:Random,controlled study. Unit:Department of Senile Diseases, Qianfoshan Hospital of Shandong. Subjects:In study group, 52 senile subjects with complete hospitalizing data were recruited from 1995～ 2000.Patients with hypertension,hyperlipemia ,hyperviscosity syndrome were included in the current study.13 subjects asked medical help due to hypertension,25 due to hyperlipemia and 14 due to hyperviscosity syndrome.Sometimes blood pressure of hypertension patients was 140～ 160/90～ 100 mmHg.Patients' mean age was 65.21.Ratio of male to female was 13:1.In control group,50 outpatients were included who had similar diseases those in study group.Mean age was 62.34 and ratio of male to female was 17.33:1. Intervention:In study group,calcium antagonist such as adalatcc, nitrendipine, plendil and/or ASCE inhibitor such as perindopril and captopril were given o.s.Blood pressure was con trolled to normal level.Blood lipid regulating drugs such as pravastatin, ticlopidine,and lipanthy were given for hyperlipemia patients.For patients with hyperviscosity syndrome,enteral aspirin or persantine was given,50～ 75 mg/day.Interval of drugs was 1 day to 2 months.Detailed data was unavailable.Red sage root or its compound form injecto was given i.v.,70 mg/day,pueraria root was given i.v.300～ 500 mg/day;astraglaus root was given 20～ 214 g/day,ginkgo leaf,70 mg/day.10～ 15 days was a disease course.Drugs were given for once in 17 subjects and twice 35 subjects.No subjects received 3 times of therapy.In control group,patients received no described treatment during 5 years.Outpatients' medical records as well as discharge record for inpatients were read to study conditions during five 5 years retrospectively. Main prognosis indexes:Collection point for statistical analysis was determined as begging phase of obervation and end point after 5 years.Cardiovascular events such as heart infarction,cerebrovascular disease such as cerebral infarction,cerebral hemorrhage and TIA were evaluated. Result: Incidence of cardiovascular and cerebrovascular events was markedly lower in study group compared with that in control group.In study group,2 subjects developed acute heart infarction(3.84％ ),11 subejcts developed heart infarction in control group(22.00％ )(P< 0.01).Ischemic cerebrovascular disease occurred in 1 subject(1.92％ ) in study group and 7 in control group(14.00％ ).Amount of cerebral hemorrhage showed no significant decrease in 1 subject (1.92％ )in study group and 3 subjects in control group(6.00％ )(P >0.05). Conclusion:Risk factors of cardiovascular and cerebrovascular disease in elders should be actively intervened to reduce development of cardiovascular and cerebrovascular disease.     

Experience of life nursing to dementia after senile cerebral hemorrhage

Background:The manifestation of senile dementia is irreversible and slowly progressive cognitive decrease.When rehabilitation training is performed,the principle of advancing step by step should be grasped.Objective:To explore the effect of life nursing on dementia after senile cerebral hemorrahge.Unit:Affiliated Hospital to Medical College,Beihua Universiyt.Subjects:50 patients with dementia were investigated including 38 males and 12 females aged 65-78 years old.All patients had cerebrovascular disease and cerebral infarction,lacunar infarction and atrophy were conformed by CT. Internetion:The content included:(1) Enhancement of symptomatic nursing:Kinds of need of patients should be fulfilled.After patients‘ modd got stable,patients were help to resume memory,corresponding questions were asked,inquired repeatedly and induced to help patinents resume memory early.(2)Instruction of disease acknowledge to patients:Administration condition was explained and function exercieses in recovery stage were instructed.Suggestive treatment was adopted to keep healthy mentality and make them take part in rehabilitation process and change their depending mentality.(4)Enhancement of diet nursing:Besides common basal nursing,diet nursing should be taken.Low-salt,low-fat and light diet should be administrated.Non-staple foods selected vegetables,fruits,meat with bone removed.Amount should be limited to polyphagia patients avoiding craputence.Caccagogue was used when constipation appeared.(5)Strenthening of sleep nursing:Patients were told to rest at fixed time,sleep early,wake up early.To patients unable to sleep,sedative drugs was adopted.Because of aderse effect,barbitals should be used carefully and vallium might be used.(6)Enhancement of basal nursing and prevention of complications:Besides basal nursing,patients dependent on others should be helped when walking to avoid accident tumble wound.Condition of disease should be paid attention to.To patients with long rest in bed,bed should be kept neat and clean,often turning over,rubbing pressed site of skin could prevent occurrence of bed sore.Results:After 2 years of follow-up survery,except that 5 cases died for severe pulmonary infection,other 45 cases survived and accompanyed by special person.7 patients were independent and could take part in partial social activities;20 patients were indpendent mostly and could get out bed,but need other‘s help.16 patients need other‘s help in most time;2 patients rested in bed and need other‘s help completely.Conclustion:Life nursing to patients with dementia can improve patients‘ mood and suitability to surroundings and motive coordination.     

心脑血管疾病患者血清同型半胱氨酸检查与血脂检查分析

Objective To investigate the cardiovascular and cerebrovascular diseases, check serum homocysteine compared with the lipids examined. Methods with the hospital over the same period 200 cases of healthy persons(control group)to observe the control group and study group before treatment and after 15 of serum homocysteine and serum lipids were compared. Results In control group and study group before treatment Hcy comparison(P ＜0. 01)significant difference. Control group and study group after treatment compared Hcy (P ＞ 0.05) no significant difference. Blood lipid control group and study group were compared (P ＞ 0.05) no significant difference. Conclusion In this group of patients with cardiovascular disease examination and serum homocysteine blood examination, observation early in the disease was significantly higher Hcy, Hcy after treatment basically reduced to normal levels, while the study group and control group blood lipid no significant difference, compared to no significant difference. Fully illustrated examination of serum homocysteine in patients with cardiovascular and cerebrovascular diseases are the extent of disease and healing guidance, Hcy higher the more severe the illness, a higher probability of complications, in short, check the heart of serum homocysteine and cerebrovascular detected in patients has important significance, is worthy of extensive development and application.     

老年人脑卒中早期康复介入疗效观察

Background:Early rehabilitative inervention is essential for improving quality of life in elders with stroke.32 patients received early rehabilitative intervention.We analyzed effect of early rehabilitative intervention in improving functional recovery,preventing and reducing disability. Objective:To investigate effect of early rehabilitative intervention on nerve function in elders with stroke. Unit:Intraneura Department,Tanghai County Hospital,Hebei Province. Subjects:62 patients(36 males,26 females,aged 60～ 78,mean age:70.4) were recruited from intraneural department during January,1999 ～ January 2000.All patients were confirmed by skull CT.Diagnosis was done according to diagnostic standards issued in 4th national cerebrovascular disease meeting.All patients experienced first onset of cerebrovascular disease.34 patients suffered from brain infarction,28 from brain hemorrhage.All patients were randomly divided into two groups,rehabilitation group(n=32),control group(n=30).There were no obvious differences in disease type,sex and age. Intervention:Two groups received routine drug therapy and nonoperational thrombolysis management.Rehabilitation management was initiated in rehabilitation group 48 hours after stable disease status was obtained.In the early phase,good limbs position training in bed,body position exchanges,limbs and passive movement,shift and turning over were carried out.Anti-resistant movement was performed from distal end of limbs to near end.Patients were helped to sit,stand and walk,once per day,40 min /once. Above movement was performed under direction of staffs.Acupuncture and physical therapy were also conducted. Main prognosis indexes:Fugl-meyer scoring was used to evaluate motor function before treatment and 2 months after treatment.Modified Barthel index was used to evaluate ADL. Results:Fugl-meyer score was (32.7± 23.2)and (66.2± 29.8) in rehabilitation group before and after treatment respectively.For control group,Fugl-meyer score was (31.9± 23.1) and (40.3± 23.2) before and after treatment respectively.ADL score was (28.2± 11.9) and (40.5± 8.7) in rehabilitation group before and after treatment respectively.In control group, ADL score was (27.2± 11.3) and (30.2± 10.3) in rehabilitation group before and after treatment respectively.Before treatment, two groups showed no significant difference in score,while posttreatment difference was significant(P< 0.05). Conclusion:Early rehabilitative management improves physiological function and quality of life in elders with stroke.     

The Differential Effects of Exercise, Brace and Combined Rehabilitation Treatment in Patients with Adolescent Idiopathic Scoliosis

Abstract Objective：To compare the effects of different conservative managements on patients with adolescent idiopathic scoliosis (AIS). Method：One hundred and four AIS patients were recruited for this study. The patients were divided into 3 groups: exercise (E group), brace (B group) and combined rehabilitation treatment (brace treatment combined with exercise, CR group). Radiological parameter were used to assess AIS patients before and after treatment. The Chinese version of scoliosis research society-22(SRS-22) patient questionnaires were filled out by patients after treatment. The SRS-22 scores were compared among management groups. Result：The maximal Cobb angles were smaller in E group than in B group or CR group both before and after treatment. The maximal Cobb angles were significantly smaller after treatment than before treatment in B group and CR group. Function/activity was better in E group than in B group or CR group. Self-image/appearance and satisfaction with management were better in E group and CR group than in B group. There was no significant difference among treatment groups in pain and mental health. Conclusion：Both brace and combined rehabilitation treatment can reduce the spinal curve of AIS patients. Both exercise and combined rehabilitation treatment have positive influence on self-image/appearance and satisfaction with management. We support preference of combined rehabilitation treatment above brace treatment.     

Diet treatment after renal transplantation

Background:Now renal transplantation is extensively used and recetpted in the clinic for treating chronic renal failure.Nutrition support and diet treatment are necessary for postoperative rehabilitation of patients underwent renal transplantation.Rigid nutrition treatment could prevent and treatment postoperative diabetes mellitus,hypertension and hyperlipemia.Diet control was also necessary for patients receiving immunodepressant.Standards and protocol for diet treatment are unavailable now…     

脑电图与经颅多普勒对脑梗死后癫痫的评估价值

INTRODUCTION Cerebrovascualr disease is common disease of senile nerve system, and is also main reason to epilepsy. Handicapping rate of cerebral stroke is high. There was few report on EEG and TCD of epilepsy after stroke.     

2型糖尿病合并冠心病患者的临床特点研究

Objective To investigate the characteristic of type 2 diabetes (T2DM)patients with coronary heart disease(CHD), and provide methods for prevention and treatment for patients who suffer from CHD.Methods The hospitalized patients from December 2006 to June 2010 were divided into three groups. The treatment group contents 46 examples who were T2DM with CHDM. The control group Ⅰ contents 30 examples who were T2DM without CHDM. The control group Ⅱ contents 50 examples who were CHD without T2DM. Compare their ordinary circumstances. The blood sugar, BP, TC, TG, HDL, LDL, HbA1C, C-P, Ins were measured. Insulin sensitive index(ISI)was calculated. Results Three groups have obvious statistical difference in BP, TC, LDL-C, ISI, HbA1C. Diabetic patients with coronary heart disease behave more common with three lesions. Conclusion In the clinical job should strengthen composite observation and treatment because the factors of atherosclerosis in T2DM patients are numerous and complex.     

Prevalence of mild cognitive impairment：a population—based study in elderly veterans

AIM：To explore the prevalence of mild cognitive impairment (MCI) among elderly veterans. METHODS:2 674 veterans (aged 60 years and over) from26 military sanatorium in Shijiazhuang city were evaluated. The Mini-Mental State Examination,Global Deterioration Scale, Activity of Daily Living, Hachinski Ischemic Scale and Hamilton Depression Scale were served as screening tools. RESULTS:The prevalence of total MCI was 8.08% among elderly people. The standardized prevalence of MCI was 6.87% in male and 10.38% in female (P&;lt;0.01). The prevalence of MCI tended to increased with aging (P&;lt;0.01) and decreased with the elevated degree of education (P&;lt;0.05). CONCLUSION:The prevalence of MCI among elderly veterans is lower than that in European and American countries. It should in tensive to monitor the MCI subjects which a high risk Alzheimer disease people. The interventionist treatment for MCI should be turn into the second prevention of the Alzheimer disease.