奇正青鹏膏剂加推拿加美式脊柱矫正治疗腰椎间盘突出156例

美式正背或推拿加正奇青鹏膏剂治疗腰椎间盘突出症有显著的疗效,用传统的学说来解释,其作用机理为椎间盘突出物的还钠复位,解除了对神经的机构压迫而取得很好的疗效.     

Predictive Values of Body Mass Index and Waist Circumference for Risk Factors of Certain Related Diseases in Chinese Adults - Study on Optimal Cut-off Points of Body Mass Index and Waist Circumference in Chinese Adults

The body mass index of Chinese population is lower than that of the Westerncountries, however, the trends of mean body mass index and prevalence of overweight inadults have increased significantly in recent 15 years[1]. Overweight and obesity areclosely r…     

Meal consumption patterns and anthropometric measurements in adolescents from a low socioeconomic neighborhood in the metropolitan area of Rio de Janeiro, Brazil

We investigated the association between meal consumption and anthropometric measurements in a probabilistic sample of 528 12–18-year-old adolescents assessed in a population-based cross-sectional study developed in the Rio de Janeiro Metropolitan Area, Brazil. A score ranging from zero to nine according to the frequency of meal consumption (breakfast, lunch and dinner) assessed meal patterns which were defined as satisfactory or unsatisfactory. Nutritional status was defined by the sex- and age-specific body mass index cut-offs. Underweight was observed in 5.7% of the adolescents (8.6% boys, 2.5% girls) and overweight in 20.9%. The omission of breakfast was observed in 4.5% of the boys and 12.4% of the girls. Unsatisfactory meal consumption pattern was more frequent among girls (38.7% vs. 29.2%), and among teenagers over 15 years of age (40.0% vs. 25.4%). Boys with unsatisfactory patterns of meal consumption presented higher means of BMI and of waist and hip circumferences than the ones with satisfactory patterns. The higher values of anthropometric measurement observed among adolescents with an unsatisfactory meal pattern indicate that they may be at risk for overweight or obesity.     

沈阳128例男性肥胖和骨密度的关系

目的 研究肥胖与骨密度(BMD)之间的关系,探讨不同的肥胖程度对我国沈阳地区中老年人群骨密度的影响,同时研究代谢综合征(MS)与骨密度之间的关系.方法 收集来我院的128例体检男性,运用双能X线骨密度仪测量受检者的骨密度,根据腰臀比(WHR)和腰围(WC)分别分组,比较不同肥胖程度患者的骨密度情况,分析腰臀比、腰围两者与骨密度的关系.结果 根据腰臀比分组,中老年男性各组骨密度没有差异;根据腰围分组,仅有WC>100 cm的受检者,其L_1的BMD明显高于WC<90 cm时的BMD.多元逐步回归分析示除L_3的BMD外,各项骨密度与腰围呈正相关;左右股骨颈及左全身的BMD与年龄呈负相关;仅左股骨颈和L_(2-4)的骨密度与腰臀比呈负相关.3个代谢综合征成分组和代谢综合征组,L_1的BMD高于无代谢综合征成分的BMD.结论 腰围可能是评价中心型肥胖和骨密度之间关系的较佳指标.适当治疗代谢综合征患者的肥胖,可避免骨量的丢失,预防骨质疏松症.     

Waist Circumference Provides an Indication of Numerous Cardiometabolic Risk Factors in Adults With Cerebral Palsy

Objective

To report the prevalence of cardiometabolic risk factors in a cohort of adults with cerebral palsy (CP) and to investigate the ability of anthropometric measures to predict these factors.

Design

Cross-sectional study.

Setting

Testing took place in a laboratory setting.

Participants

Adults with CP (N=55; mean age, 37.5±13.3y; Gross Motor Function Classification System levels, I–V) participated in this study.

Interventions

Not applicable.

Main Outcome Measures

Total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, insulin, and C-reactive protein levels were measured from a fasting venous blood sample. Insulin resistance was calculated using the Homeostasis Model Assessment (HOMA-IR) index. Blood pressure, body mass index (BMI), waist circumference (WC), waist-hip ratio, and waist-height ratio were also measured. The metabolic syndrome (MetS) was defined according to the 2009 Joint Interim Statement.

Results

The prevalence of the MetS was 20.5% in ambulatory adults and 28.6% in nonambulatory adults. BMI was associated with HOMA-IR only (β=.451; P<.01). WC was associated with HOMA-IR (β=.480; P<.01), triglycerides (β=.450; P<.01), and systolic blood pressure (β=.352; P<.05). Receiver operating characteristic curve analysis revealed that WC provided the best indication of hypertensive blood pressure, dyslipidemia, HOMA-IR, and the presence of multiple risk factors (area under the curve, .713–.763).

Conclusions

A high prevalence of the MetS was observed in this relatively young sample of adults with CP. WC was a better indicator of a number of risk factors than was BMI and presents as a clinically useful method of screening for cardiometabolic risk among adults with CP.     

两种不同麻醉方法在高龄患者经尿道前列腺电切术的临床分析

目的:探讨和分析两种不同麻醉方法在高龄患者经尿道前列腺电切术的临床应用效果。方法:选取经尿道前列腺电切术的高龄患者60例,将其随机分为观察组(O组)和对照组(C组)。O组患者实施腰-硬联合麻醉,C组患者实施全身麻醉,对两组患者麻醉过程中血压、心率等情况进行观察记录,并比较两种麻醉方法术后镇痛效果和术后并发症情况。结果:O组围术期视觉模拟评分法(VAS)评分、血压、心率值明显优于对照组(P<0.05);O组发生肺部并发症、低氧血症等不良反应低于C组(P<0.05);O组手术后MMSE评分在1 h、3 h均高于C组(P<0.05)。结论:对于行经尿道前列腺电切术的高龄患者,给予腰-硬联合麻醉具有安全性高、效果确切、可靠性好等优点,值得临床推广及应用。     

深圳市正常高值血压及高血压影响因素分析

目的了解正常高值血压及高血压人群血脂、血糖、腰围水平对血压的影响因素,加强对高血压尤其是正常高值血压的防治。方法采用多阶段随机整群抽样的方法,在深圳市抽取73个社区,在每个社区中随机抽取120户居民,最终共8 601人进入研究。对研究对象进行问卷调查、人体测量、血液生化检测和膳食调查四部分调查。结果血压正常者、正常高值血压者和高血压者各占65.77%,19.79%和14.44%。高血压组腰围、BMI值、总胆固醇、甘油三酯和空腹血糖值均最大,正常高值血压组次之,正常血压组均最小。多因素Logistic回归分析结果显示高血压及正常高值血压有相同的影响因素,均为性别、年龄、腰围、空腹血糖、低密度脂蛋白、甘油三酯、BMI。结论血脂、血糖、腰围与血压关系密切,正常高值血压人群的健康状况值得关注。     

低浓度盐酸罗哌卡因腰-硬联合麻醉在膝关节镜手术中的应用价值

目的分析低浓度盐酸罗哌卡因行腰-硬联合麻醉在膝关节镜手术中的应用价值。方法随机将60例拟行关节镜手术的患者随机分为A、B两组,每组30例患者,两组均采用腰-硬联合麻醉。A组麻醉药物给予浓度为0.5%的盐酸罗哌卡因,B组麻醉药物给予浓度为0.25%的盐酸罗哌卡因,对两组的麻醉效果及麻醉安全性进行分析。结果两组感觉阻滞起效时间、感觉阻滞维持时间、平面固定时间、运动阻滞起效时间、运动阻滞维持时间及达到BromageⅠ级、Ⅱ级及Ⅲ级的时间比较,差异无统计学意义（P〉0.05）;B组术后感觉及运动阻滞恢复时间均明显优于A组（P〈0.05）。两组麻醉前HR、SBP及DBP比较未见统计学意义（P〉0.05）,自患者接受麻醉5 min开始至手术结束时A组患者HR、SBP及DBP均较麻醉前明显下降（P〈0.05）,而B组患者则较麻醉前无明显改变（P〉0.05）;B组患者麻醉中不良反应发生率明显低于A组（P〈0.05）。结论膝关节镜手术中应用低浓度盐酸罗哌卡因行腰-硬联合麻醉有较好的麻醉效果,且可降低麻醉不良反应发生率。     

Waist Circumference Distribution of Chinese School-age Children and Adolescents

Background Waist circumference （WC）, a proxy measure of central body fat, is a better predictor than overall body fat for cardiovascular risk factors in both adults and children. WC cutoffs have been established in many countries, but the national WC reference has not been developed in China. Objective To study the distribution of WC in a representative group of Chinese children for establishing Chinese WC cutoff points. Methods Cross-sectional data obtained from 15 mainland provinces and Hong Kong were collected. There were 160 225 children and adolescents aged 7-18 years old in total. The subjects were divided into five regional groups namely costal city, other city, noah rural, south rural, and Hong Kong, for analyzing the distribution of WC. Results A large variation in WC distribution was found among the five groups for both sexes. Coastal city group had the highest P85 WC values consistently from the early school ages to 18-year-old compared with other groups. In contrast, south rural group had P85 values consistently lagged behind not only the city groups but also the north rural group. Hong Kong group had a high P85 WC at early ages, but because of the smaller increments of WC during adolescence, the P85 curve was gradually exceeded by the north rural groups. Catch-up trend was found in the two rural groups since the peak of puberty. These disparities were caused by not only socioeconomic and urban-rural factors but also north-south differences. Because of the regional variation of WC, a ＂gradient＂ prevalence of central obesity was prospected among these groups. Comparisons of WC distributions between the Chinese and the U.S.A or Netherlands demonstrated the necessary of setting up China＇s own WC cutoffs. Sex and age-specific percentiles were obtained and smoothed by using LMS method. Conclusion The data obtained from this study could be used to develop national WC cutoff points for Chinese children and adolescents.     

Obesity and symptoms and quality of life indicators of individuals with disabilities

BackgroundHealth risks of obesity are well known, but effects of obesity on health-related quality of life (HRQOL) have not been well-studied in people with physical disabilities.Objective/hypothesisWe examined the association between obesity and HRQOL in people with disabilities relative to the general US population. We hypothesized (a) overall, individuals with disabilities will report worse HRQOL than the general US population and (b) obese individuals with disabilities will report worse HRQOL than non-obese individuals.MethodsIndividuals with muscular dystrophy, multiple sclerosis, post-polio syndrome, and spinal cord injury (N = 1849) completed Patient Reported Outcomes Measurement Information System (PROMIS) measures of fatigue, pain interference, physical and social function, depression, sleep disturbance, and sleep-related impairment. Participants were classified as obese or non-obese based on self-reported weight and height (BMI) and/or waist circumference (WC). PROMIS T-scores were compared to norms and between obesity groups.ResultsMean BMI was 26.4 kg/m² with 23.4% classified as obese. Mean WC was 37.5 inches (males) and 34.0 inches (females); 26.4% reported abdominal obesity. Based on BMI and/or WC, 33.3% (n = 616) were classified obese. Compared to PROMIS norms, obese individuals reported worse HRQOL on all domains (p < 0.0001). Compared to non-obese individuals, obese individuals reported worse functioning on all domains except depression (p < 0.01). Obese individuals with MS and MD reported worse outcomes than non-obese counterparts.ConclusionsObesity in people with physical disabilities is associated with poorer HRQOL. More research is needed to inform clinicians in identifying obese patients and helping them achieve healthy weight, reduce symptom burden, and improve QOL.