Prevalence of cardiovascular disease in subjects hospitalized due to chronic obstructive pulmonary disease in Beijing from 2000 to 2010

Objectives To investigate the overall prevalence of cardiovascular disease (CVD) in subjects hospitalized for chronic obstructive pulmonary disease (COPD), and explore the prevalence of the major CVD complications and trends in patients with COPD over a 10-year period. Methods Medical records in the PLA General Hospital, Beijing Union Medical College Hospital, and Beijing Hospital from 2000/01/01 to 2010/03/03 were retrospectively reviewed. A total of 4960 patients with COPD were reviewed in the study (3570 males, mean age, 72.2 ± 10.5 years; 1390 females, mean age, 72.0 ± 10.4 years). Results The prevalence of CVD in COPD patients was 51.7%. The three most prevalent CVDs were ischemic heart disease (28.9%), heart failure (19.6%), and arrhythmia (12.6%). During the 10-year study period, the prevalence of various CVDs in COPD patients showed a gradual increasing trend with increasing age. There was higher morbidity due to ischemic heart disease (P < 0.01) in male COPD patients than in the female counterparts. However, heart failure (P < 0.01) and hypertension (P < 0.01) occurred less frequently in male COPD patients than in female COPD patients. Furthermore, the prevalence of ischemic heart disease decreased year by year. In addition to heart failure, various types of CVD complications in COPD patients tended to occur in younger subjects. The prevalence of all major types of CVD in women tended to increase year by year. Conclusions The prevalence of CVD in patients hospitalized for COPD in Beijing was high. Age, sex and CVD trends, as well as life style changes, should be considered when prevention and control strategies are formulated.     

German Network for Early Mobilization: Impact for participants

Professional networks support health care providers in implementing evidence based knowledge. The German Network for Early Mobilization in Intensive Care Units (ICU) was founded in 2011 and serves for more than 300 critical care team members today. The mobilization network is connected to other professional networks and contributed to the development of national guidelines and quality indicators. Several research projects were conducted. Members of the mobilization network perceived benefits for themselves and their workplace. The network increased participants’ knowledge and contributed to quality improvement projects on ICUs. Without having significant resources, this network development may serve as an example for other networks.     

What is the prevalence of inspiratory muscle weakness in preoperative cardiac surgery patients? An observational study

BackgroundIn patients undergoing elective cardiac surgery, the prevalence of inspiratory muscle weakness is not well-understood. This information could guide pre-operative therapy.ObjectivesTo determine the prevalence of inspiratory muscle weakness in preoperative cardiac surgery patients, and describe relationships between pre-operative factors (including maximal inspiratory pressure, MIP) and post-operative pulmonary complications (PPCs).MethodsProspective study of elective cardiac surgery patients. Pre-operative MIP was measured (cmH₂O) and PPC data were extracted from medical records (Melbourne Group Score) while age, height, weight, frailty and physical activity levels were captured via questionnaire. Backwards-stepwise logistic regression was used to describe associations.Results24 participants were recruited (79% male, age 70 ± 10.7, BMI 26.8 ± 4.14). The prevalence of inspiratory muscle weakness (MIP < 60% predicted) was 25% (n = 6). PPCs were associated with body mass index (BMI) (r = 0.464, p = 0.022).ConclusionThe prevalence of pre-operative inspiratory muscle weakness was 25%. BMI may be an important determinant of PPCs in elective cardiac surgery patients.     

支气管增殖性结核1例并文献复习

目的提高对支气管增殖性结核的认识。方法结合1例支气管增殖性结核患者的临床资料和文献复习,详细分析该病的病因、临床表现、诊断、鉴别诊断、治疗及预后。结果该病主要为结核菌感染所致,临床症状无特异性,影像学检查表现各异,支气管镜下表现不易与肿瘤区分,病理学检查主要是干酪样、非干酪样肉芽肿。根据病情不同,可采用药物治疗,支气管镜下介入治疗或手术治疗。结论支气管增殖性结核不易与肿瘤区分,极易误诊,应予重视;支气管镜检查对于此病的诊断、治疗及预后至关重要。     

药学信息检索策略的探讨

通过对药学信息检索步骤的分析,探讨如何根据检索课题选择数据库、确定关键词、制定检索式,以及调整检索策略的方法和技巧,以期为医药学专业人员高效、便捷地检索和获取所需的药学信息提供借鉴与参考。     

H-FABP、NT-proBNP、cTnT和CK-MB在急性心肌梗死早期诊断中的价值比较

目的通过测定心型脂肪酸结合蛋白（H-FABP）、N-末端脑钠肽（NT-proBNP）、肌钙蛋白T（cTnT）和肌酸激酶同工酶（CK-MB）在急性心肌梗死（AMI）患者的早期诊断效率,对几种标志物在AMI早期诊断中的价值进行比较。方法测定84例AMI患者和72例不稳定型心绞痛（UA）患者血浆H-FABP、NT-proBNP、cTnT和CK-MB含量,各组之间进行比较,通过ROC曲线计算4种标志物在AMI早期诊断中的诊断效率、灵敏度、特异度和阴阳性预测值,比较几种标志物对AMI早期诊断价值。结果 AMI组的H-FABP、NT-proBNP、cTnT和CK-MB水平都明显高于UA组,两组比较,差异有统计学意义（P〈0.05）。在AMI诊断上,H-FABP是4种标志物中诊断效率、灵敏度和阴性预测值最高的,cTnT是特异度和阳性预测值最高的,所有标志物诊断效率均具有统计学意义（P〈0.01）。结论在AMI早期诊断上,4种标志物联合检测特别是H-FABP和cTnT联合检测能够明显提高AMI的诊断效率。     

2000～2010年间4960例慢性阻塞性肺病住院患者合并高血压和糖/脂代谢紊乱情况调查

目的研究慢性阻塞性肺病(COPD)住院患者合并高血压和糖/脂代谢紊乱的患病比例、人群分布特征和顺位及与年龄和性别的相关性研究。方法对2000年1月1日~2010年3月20日间解放军总医院、北京协和医院及卫生部北京医院的住院病案数据库进行回顾性现况调查。结果(1)入选患者4960例,男性3570例,女性1390例,平均年龄(72.2±10.4)岁。(2)高血压、糖尿病/糖耐量异常和高脂血症/脂蛋白代谢紊乱合并症患病比例在COPD患者由高到低顺位为高血压病>糖尿病/糖耐量异常>高脂血症/脂蛋白代谢紊乱,分别为40.3%、18.8%和6.9%。且随年龄增长逐渐升高,而合并高脂血症/脂蛋白代谢紊乱的患病比例在≥80岁组却明显下降。(3)女性和男性COPD患者合并高血压的患病比例均随年龄增长而增加,在40~49.9年龄段,不同性别COPD患者合并高血压的患病比例无显著差异(P>0.05);从50岁以上各年龄组,女性COPD患者合并高血压的患病比例均显著高于男性(P<0.05)。(4)男性糖尿病/糖耐量异常的患病比例也呈增龄性改变,但女性在年龄≥80岁后,合并糖尿病/糖耐量异常的患病比例降低(P<0.05)。不同年龄组COPD患者中男女患病比例的差别从60岁以后开始出现,在60~69.9岁、70~79.9岁两个年龄段,女性合并糖尿病/糖耐量异常的患病比例高于男性(P<0.05);≥80岁女性患病比例降低但与男性比较无统计学差异(P>0.05)。(5)男性和女性在≤80岁的COPD患者合并高脂血症/脂蛋白代谢紊乱的患病比例均随年龄增加而升高(P<0.05),且在60~69.9岁、70~79.9岁两个年龄段女性合并高脂血症/脂蛋白代谢紊乱的患病比例高于男性,有统计学意义(P<0.05);在≥80岁组男性和女性的患病比例均降低,但无性别差异(P>0.05)。结论 4960例40岁以上COPD住院患者合并高血压和糖/脂代谢紊乱的患病比例与年龄和性别特点对临床COPD的二级预防提供了明确的靶点。