

Zhou Yan

About me
Member of the 7th Rehabilitation Professional Committee of the Chinese Society of Rehabilitation Medicine, and Chairman of the 1st Youth Committee of the Geriatric Health Medical Professional Committee of the Hunan Provincial Women Physicians Association.
Proficient in diseases
Specializes in geriatric internal medicine diseases, particularly in the rescue of cardiovascular critical illnesses such as acute coronary syndrome, hypertensive crisis, malignant arrhythmia, acute heart failure, etc.

Voices

Can people with myocarditis drink alcohol?
Myocarditis is an inflammatory disease of the myocardium. Its pathogenesis is due to direct damage to the myocardium caused by viruses, and the interaction of the virus with the body's immune response to both myocardial injury and microvascular damage, which impairs the structure and function of the myocardial tissue. Drinking alcohol affects the myocardium and can also cause damage to it. Therefore, alcohol should not be consumed with myocarditis, as drinking can further aggravate the myocardium, leading to heart failure.

Can elderly people with prostate enlargement experience urinary incontinence?
In the advanced stages of lower urinary tract obstructive diseases caused by prostate enlargement, overflow urinary incontinence can occur. After chronic urinary retention caused by prostate enlargement, if the bladder is extremely full, the pressure inside the bladder can exceed the resistance of the normal urethral sphincter, allowing urine to overflow through the urethra. Additionally, pressure incontinence can also be caused by damage to the external urethral sphincter or to the perineal and urethral areas following prostate surgery due to prostate enlargement.

Is coronary arteriosclerosis serious?
The severity of arterial atherosclerosis is related to the location of the lesion and the narrowing it causes in the coronary arteries. This is because if the blood flow through the coronary arteries is insufficient to meet the metabolic demands of the heart muscle, it can lead to ischemia and hypoxia of the heart muscle, causing angina. Severe and prolonged ischemia can lead to myocardial necrosis, or myocardial infarction. When there is significant narrowing in the coronary artery lumen, for instance more than 50%-75%, the situation can be compensated during rest. However, during exercise or rapid heart rate or emotional excitation, the oxygen demand of the heart muscle increases. This may result in mild or transient myocardial oxygen supply, or an imbalance between supply and demand. Another scenario involves unstable atherosclerotic plaques that rupture, erode, or bleed, leading to platelet aggregation or thrombus formation, causing a rapid worsening of luminal narrowing. This results in a decreased supply of oxygen to heart muscle, leading to acute coronary syndrome, which is very severe. In fact, the degree of coronary artery atherosclerosis is positively correlated with plaque stability, plaque location, and the elasticity of the coronary artery.

Compensatory mechanisms of acute heart failure
There are several compensatory methods for acute heart failure. The first is mechanical ventilation, including non-invasive mechanical ventilation and tracheal intubation. Mechanical ventilation is commonly referred to as assisted breathing with a ventilator. The second is continuous renal replacement therapy, commonly known as total ultrafiltration, which can be used to remove excess fluid and metabolic waste from the body. The third is intra-aortic balloon counterpulsation, which can effectively improve myocardial perfusion, reduce myocardial oxygen consumption, and increase cardiac output. The fourth is extracorporeal membrane oxygenation, commonly known as ECMO, which provides external cardiopulmonary support when the heart cannot maintain systemic perfusion or when the kidneys cannot adequately exchange gases. The fifth is the implantable left ventricular assist device, which can maintain peripheral perfusion during acute heart failure and reduce myocardial oxygen consumption, thus reducing cardiac injury. These five methods can provide compensatory treatment when drug therapy is ineffective for patients with acute heart failure.

What should elderly people do if they have slight urinary incontinence?
Urinary incontinence is relatively common in the elderly. After excluding organic causes of urinary incontinence through examination, we should consider functional causes. This is mainly due to the relaxation of the urethral sphincter, pelvic floor, and the muscles around the urethra, which decreases the urethral pressure. When the abdominal pressure increases, it can cause urinary incontinence. We can improve the muscles of the pelvic floor gradually by undergoing pelvic floor rehabilitation therapy, which increases their strength and improves urinary incontinence. The key to pelvic floor rehabilitation is to provide patients with guidance and exercises for lifting the anus. By persisting in these exercises, the symptoms of urinary incontinence can be alleviated or eliminated.

Is angina pectoris coronary heart disease?
Coronary heart disease refers to the occurrence of atherosclerosis in the coronary arteries, leading to narrowing or blockage of the lumen, causing myocardial ischemia, hypoxia, and necrosis resulting in heart disease. Through different pathological anatomy and pathophysiology, there are five major types, including asymptomatic coronary heart disease, angina pectoris, myocardial infarction, ischemic cardiomyopathy, and sudden death. Angina pectoris is one type of coronary heart disease.

Early symptoms of Parkinson's disease
Parkinson's disease begins inconspicuously and progresses gradually. There are two main categories of symptoms in Parkinson's disease: motor symptoms and non-motor symptoms. In the early stages of the disease, one can appear normal, or may experience motor symptoms like bradykinesia or rigidity, often starting asymmetrically. Symptoms commonly begin on one side of the upper limbs, and less frequently start from the lower limbs, eventually spreading to the limbs on the other side. Non-motor symptoms can occur at various stages of Parkinson's disease, including the pre-motor phase, such as loss of smell, sleep disturbances, constipation, depression, and more.

What should be avoided in the diet for Parkinson's disease?
For patients with Parkinson's disease, we advocate comprehensive treatment and full-course management. Drug treatment is the core treatment method, while surgical treatment can supplement drug therapy. Physical rehabilitation and psychological therapy should also be conducted. What should patients with Parkinson's disease avoid eating? Generally, patients with Parkinson's disease are prone to constipation. Therefore, we should avoid consuming spicy and greasy foods that may lead to constipation, and try to eat vegetables and fruits to keep the bowel movements regular.

What is the best way to exercise for Parkinson's disease?
Patients with Parkinson's disease should undergo comprehensive treatment and full management. Drug treatment is the core treatment plan, but it is also necessary to include physical rehabilitation and psychological therapy. For physical therapy, patients should be encouraged to exercise more, as this can help improve symptoms and slow the progression of the disease. The type and intensity of exercise should be chosen based on the patient's motor symptoms. Tai Chi, jogging, brisk walking, and aerobics are all suitable forms of exercise, and it is advisable to exercise four times a week, with each session lasting about 30 minutes. Evidence has shown that Tai Chi can improve patients' balance disorders, and long-term persistence in exercise can help improve their quality of life.

Triggers of acute heart failure
The triggers of acute heart failure include the following aspects: Respiratory infections are the most common and important trigger, and infective endocarditis is also not uncommon. However, due to its concealed onset, it is easily underdiagnosed. The second is arrhythmia, among which atrial fibrillation is one of the most common arrhythmias in organic heart disease and is also an important factor leading to heart failure. Additionally, rapid arrhythmias can also cause acute heart failure. The third is an increase in blood volume, such as excessive salt intake or excessive or rapid intravenous fluid administration. The fourth is excessive physical exertion or emotional excitement, such as during late pregnancy or childbirth. The fifth aspect is improper treatment, inappropriate use of diuretics or antihypertensive drugs, which can also trigger an episode of acute heart failure. Furthermore, whether it is an exacerbation of existing heart disease or complications with other diseases, such as coronary heart disease with myocardial infarction, rheumatic disease becoming active, or complications with hyperthyroidism or anemia, can all cause acute heart failure.