基于微信平台的脑卒中高危人群健康管理效果分析

目的 探讨微信平台+健康管理对脑卒中高危人群的应用效果,为脑卒中开展干预提供参考。方法 2018年6 月至2019 年6 月在江西省脑卒中高危人群院外筛查干预信息平台采用随机抽样的方法抽取宜春市彬江、高城和灵泉3 个社区的脑卒中高危人群400 例,随机分为对照组（n=200）与试验组（n=200）,试验组实施基于微信平台的健康管理模式,对照组由基层项目医院实施管理,比较两组管理12 个月后的脑卒中相关知识知晓情况、行为生活方式、体格检查结果、临床相关指标及预后结局。结果 试验组脑卒中相关知识知晓率、不良行为生活方式改变率均高于对照组（P＜0.01）,而临床相关指标：血压、糖化血红蛋白、低密度脂蛋白胆固醇、体质量指数均低于对照组（P＜0.01）;预后结局：血压、血糖正常率高于对照组（P＜0.01）,脑卒中发病率（0.50%）低于对照组（3.50%）,但差异无统计学意义（P＞0.05）。结论 试验组脑卒中高危人群实施基于微信平台的健康管理模式后,提高脑卒中相关知识知晓率,减少脑卒中暴露因素,改善临床相关指标,一定程度上减少脑卒中发病风险。     

护理干预对社区高危人群健康的影响

目的 探讨护理干预对社区高危人群(BMI≥25)健康的影响.方法 对136名高危人群随机分为对照组(68名)和观察组(68名),对照组行常规健康教育、观察组采用常规健康教育与针对性护理干预.两组均使用自行设计的调查表进行整体调查并评估干预效果.结果 干预后,观察组人群健康意识和健康行为显著优于对照组;观察组每日有效运动热量消耗增多、有效运动次数增加,有效运动时间显著增加,BMI和腰围显著降低,两组比较有显著性差异(均P＜0.05).结论 综合干预能提高人群对健康知识的知晓率和健康行为的形成率,可以促使他们长期坚持有效运动,降低BMI、腰围,达到降低有害风险的目的.     

“治未病”的体质辨识治疗对心血管疾病高危人群的临床效果

目的 探讨心血管疾病高危人群采用“治未病”的体质辨识治疗的临床效果。方法 选取2021年6月至2022年6月杭州市中医院筛查出的108例心血管疾病高危人群为研究对象，采用随机数字表法将其分为对照组和研究组，每组各54例。对照组给予常规生活干预，研究组在常规生活干预基础上采用“治未病”的体质辨识治疗；比较两组研究对象干预前、干预3个月的体质量指数（body mass index，BMI）、腰围、血压、血脂、空腹血糖水平及生活质量。结果 干预3个月，两组研究对象的BMI、腰围、收缩压、舒张压、总胆固醇、三酰甘油、空腹血糖水平均显著低于本组干预前，生活质量评分均显著高于本组干预前（P<0.05）；研究组研究对象的BMI、腰围、收缩压、舒张压、总胆固醇、三酰甘油、空腹血糖水平均显著低于对照组，生活质量评分均显著高于对照组（P<0.05）。结论 心血管疾病高危人群采用“治未病”的体质辨识治疗能有效调节其BMI、腰围、血压、血脂和血糖水平，提高其生活质量。     

耳穴贴压干预社区糖尿病高危人群体重效果观察

目的:探讨耳穴贴压对社区糖尿病高危人群体重的影响。方法:将60例社区糖尿病高危人群随机分为观察组和对照组,对照组采用饮食疗法、运动疗法和健康教育的干预措施,观察组采用同样的干预措施并加用耳穴贴压同期治疗3个月,观察两组患者治疗前、治疗3个月后体重、腰围、腰臀比的变化。结果:观察组患者体重指数、腰围和腰臀比均明显低于对照组,组间差异显著(P0.05)。结论:耳穴贴压能够显著降低糖尿病高危人群的体重,且操作简便安全,有较好的临床应用及推广价值。     

综合干预对肥胖2型糖尿病胰岛素抵抗的影响

目的:探讨综合干预对肥胖2型糖尿病胰岛素抵抗的影响。方法:将160例肥胖2型糖尿病的患者随机分为综合干预组与对照组各80例,综合干预组采用个体化饮食、运动与健康教育等干预手段,对照组采用一般常规护理。比较2组入组时及3、6个月后的血糖、血脂、血压、腰围(WC)、体重指数(BMI)、胰岛素抵抗指数。结果:综合干预组与对照组患者的空腹血糖、餐后血糖、糖化血红蛋白、血脂、体重指数均有下降(P<0.05),干预组下降幅度更明显(P<0.01)。结论:个体化综合干预可以有效改善肥胖2型糖尿病患者的血糖和血脂,减轻胰岛素抵抗。     

长沙市糖调节受损居民强化生活方式干预效果观察

目的 :观察强化生活方式干预对长沙市糖调节受损人群的效果。方法 :对长沙市2610名社区居民健康普查中筛选出的100例IGR患者,随机分为强化生活方式干预组和对照组,接受6个月的强化生活方式干预,在研究开始和结束对所有研究对象进行体格检查(包括身高、体重、腰围、臀围、血压)和生化指标(包括FPG、OGTT2hPG、血脂四项(TC、TG、H-LDL,L-LDL)、尿酸)。结果 :与对照组比较,干预组患者BMI值、腰/臀比、血压、FPG、OGTT2hPG、TC、TG、L-LDL、尿酸水平明显下降。HDL-C水平升高不明显。对照组的糖尿病6个月累积发病率为10%,而干预组未发现糖尿病。对照组6个月累积血糖转变为正常率为4%,低于干预组(18%)。结论 :强化生活方式干预可以改善长沙市居民的代谢相关指标,降低糖尿病发病风险,促进向正常血糖转化。     

微信平台在中青年糖尿病患者健康教育中的作用

目的　运用微信健康教育平台，提高中青年糖尿病患者自我管理水平。方法　以2013年12月1日至2014年6月30日间到我院内分泌科首诊的120名中青年糖尿病患者为研究对象，随机分为微信组和对照组（59例 vs. 61例）。对照组按就诊时医师指导自行用药、控制饮食、锻炼，并监测血糖；微信干预组在对照组基础上，由微信教育小组通过微信平台定期向患者发送微信，指导其饮食、运动及用药等，及时解决患者微信反馈问题，共干预6个月。采用两独立样本t检验比较微信干预3个月及6个月后，两组患者自我管理能力及血糖、血压等指标变化。结果　干预3个月后，微信组自我管理能力得分（15.3±2.35 vs. 11.46±3.25）和空腹血糖（7.23±0.69 vs. 8.40±0.99）、餐后2h血糖（9.76±1.28 vs. 11.41±1.73）、糖化血红蛋白（7.46±0.59 vs. 8.06±1.00）、收缩压（126.56±10.24 vs. 130.39±10.44）、舒张压得分（75.41±7.73 vs. 79.88±9.48）优于对照组。微信干预6个月与干预3个月比较，患者自我管理能力得分（19.53±2.62 vs. 15.3±2.35）进一步提高，其空腹血糖（6.62±0.70 vs. 7.23±0.69）、餐后2h血糖（9.00±0.85 vs. 9.76±1.28）、糖化血红蛋白（6.92±0.72 vs. 7.46±0.59）、收缩压（123.05±8.82 vs. 126.56±10.24）、舒张压（72.27±5.97 vs. 75.41±7.73）持续改善。结论　微信平台干预作为一种新型健康教育形式，可显著提高糖尿病患者自我管理能力和血糖、血压控制，在中青年糖尿病患者代谢控制方面优势突出，值得推广。     

糖尿病的社区全人群的防治及研究

目的 :研究并制订社区全人群的糖尿病的规范化管理及防治模式,评价社区干预成效,从而能够有效的预防及控制糖尿病。方法:对分管社区随机选取糖尿病患者40例,高危人群40例,健康人群40例,除糖尿病组实施一般糖尿病治疗外,各组均开展随访、干预、评估等社区健康管理防治工作,通过分析比较空腹及餐后血糖水平,糖化血红蛋白水平等指标,评价全人群社区综合防治策略的成效。结果:各组对糖尿病知识较干预前均有了显著提升;健康人群及高危人群组共新确诊糖尿病1例,糖耐量减低2例,糖尿病组空腹血糖、餐后2 h血糖、糖化血红蛋白水平均较干预前改善明显,比较差异具有显著性(P0.05或P0.01)。结论:基于健康教育及行为指导的社区综合干预措施能有效提高全人群对糖尿病的认知,改善自身行为习惯,提高生活质量,从而有效的预防及控制糖尿病。     

基于信息化平台的社区人群糖尿病干预模式的构建和评价

目的 以社区糖尿病前期人群为对象,以充分利用社会资源为目标,构建经济、适用的糖尿病行为干预新型模式.方法 通过系统分析和德尔菲法建立针对糖尿病前期人群的行为干预项目;根据流行病学实验的方法,在重庆主城区慢病控制试点社区开展干预试验.将522例糖尿病前期患者随机分为试验组和对照组,根据“知-信-行”的行为干预理论,试验组对象在接受社区常规健康管理服务的基础上,增加新型行为干预项目,同时接受定期社区现场活动和信息化平台交流活动;对照组对象只接受常规社区健康管理.干预实施后,定期观察试验组对象行为变化情况;半年后比较两组的行为执行情况、糖尿病的发病率、身体测量指标和实验室检测指标的变化情况.结果 从干预试验实施后的第4 ～ 24周,试验组各健康行为改变率均有不同程度的增加;半年后,试验组与对照组相比,除穴位按摩和以步代车行为外,所有要求健康行为执行强度和行为养成比例显著增加;试验组的糖尿病发病率为4.51％,对照组的糖尿病发病率为7.58％,两组糖尿病发病率差异无统计学意义(P＞0.05);与对照组相比,试验组BMI降低显著,但其他指标,如腰围、血压、血糖和糖化血红蛋白等变化差异无统计学意义(P＞0.05).结论 在现有社区慢病管理的基础上构建的糖尿病新型行为干预模式,从多个环节促进被干预者行为改变,有助于试验对象建立健康行为,提高研究对象的依从性,其在短期内已显示出降低体质量指数的效果.     

高校社区糖尿病高危人群健康教育效果观察

目的:探讨糖尿病健康教育在高校糖尿病高危人群的效果及其对临床治疗的指导意义。方法:选取华南地区某高校职工中具有糖尿病高危因素的教师30例,进行6个月的饮食干预、运动疗法、心理干预和糖尿病健康教育,测定并比较健康教育前后高危因素者的血糖水平、血脂水平、体重变化情况。结果:健康教育后受试者的体重、血压和血脂水平明显低于对照组,经统计学处理有显著差异性(P<0.05)。结论:高校社区开展糖尿病健康教育对有效降低糖尿病的危险因素有重要意义。     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.     

Development Is A High Level Inheritance for China Time-honored Brand Products

<正>As culture is the soul of a nation,the three books,"History of Chinese Philosophy,""History of Chinese Culture"and"History of Chinese Science and Technology"have demonstrated the superiority of our great Chinese culture,and its significant impact in the field of international culture.Both core value and practical value of the Chinese culture are very clear,reflected in the views of universe,nature,life,health,disease,and therapy and related considerations,concepts,and technical methods.