Objective To discuss the recent effect of professional instruction on patients with type 2 diabetes mellitus. Methods 200 patients with type 2 diabetes mellitus were divided into the observation group and the control group. The observation group received professional instruction while the control group only got doctors'simple advice about the characteristic, results and attentions of diabetes mellitus. Various in dices were determined before and 3 months after intervention and patients compliance was evaluated 3 months after intervention. Results The indices such as blood glucose,glycosylated hemoglobin, urine trace protein, blood lipid, weight index, blood pressue and waistline were different between the two groups(P＜0.05) after intervention although no difference was seen between them before intervention(P＞0.05).The patients compliance in the observation was better compared with the control group(P＜0.01). Conclusion Application of professional instruction proved to be an effective method to alleviate the symptoms of patients with type 2 diabetes mellitus.

Objective:To know about the prevalence rates of depression and anxiety and its related factors a-mong human immunodeficiency virus (HIV)-infected men who have sex with men (MSM)in China.Methods:Under the help of MSM group,totally 600 HIV-infected MSM were recruited by snowballing sample among HIV-positive MSM,and 541 effective electronic questionnaire were received.Participants completed self-made question-naire of HIV-positive MSM healthy condition which included social demographic and health behavior et al.The Center for Epidemiologic Studies Depression Scale(CES-D)and Self-Rating Anxiety Scale (SAS)were used to survey the condition of depression (CES-D score ≥16)and anxiety (SAS score ≥50)respectively.Results:The percentage of having depression and anxiety symptoms was 44.7% (242 /541)and 25.1% (136 /541)respective-ly.Multiple unconditioned logistic regression analysis showed that the risk of having depressive symptoms included considered suicide in the past year (OR =3.31,95%CI:1.73 -5.34),nondisclosure their HIV infection to male primary sexual partners (OR =0.47,95%CI:0.30 -0.73),discrimination experience (OR =1.19,95%CI:1.11 -1.29).Compared with monthly income of 1500 yuan or less,participants who earned >5000 yuan monthly were less likely to have depressive symptoms (OR =0.34,95%CI:0.17 -0.71).Factors associated with anxiety symp-toms included considered suicide in the past year (OR =2.43,95%CI:1.40 -4.21),accepted antiviral therapy (OR=1.74,95%CI:1.06 ~2.84),discrimination experience (OR =1.12,95%CI:1.05 ~1.20).Participants earned >5000 yuan monthly (OR =0.44,95%CI:0.20 ~0.94)could decrease the risk of having anxiety symptom compared with whose monthly income of 1500 yuan or less.Conclusion:The prevalence rate of depression and anxiety symp-tom among HIV-infected MSM is high and need more attention.It may be helpful to call for the strategy of promo-ting mental health on decreasing social discrimination,communicating with sexual partners,and improving their eco-nomic status.

Objective To evaluate the efficacy and safety of domestic human recombinant FSH (rhFSH) in women with anovulation of WHO groupⅡ. Methods A randomized, blind, parallel-controlled, non-inferiority and multicenter study was performed. A total of 534 admitted to 13 hospitals from May 2008 to August 2009. There were 531 women with ovulatory disorder was included in the statistical analysis, were randomly divided into test group (domestic rhFSH, n=352) and control group (imported rhFSH, n=179). Percentage of cycle with mature follicle, ovulation rate, clinical pregnancy rate, multiple pregnancy rate, ovarian hyperstimulation syndrome (OHSS) and adverse events were observed. Results No statistical significant differences (P>0.05) were observed between the two groups in terms of the efficiency on mature follicle [91.8%(323/352) versus 88.8%(159/179)], ovulation rate [91.3%(295/323) verus 90.6%(144/159)], clinical pregnancy rate [19.2%(62/323) verus 18.2%(29/159)], the number of the follicles<14 mm, the level of serum LH and progesterone, the thickness of endometrium on the day of hCG administration. The number of follicle≥18 mm and 14 mm≤follicle<18 mm and the level of serum estradiol on the day of hCG in the test group were significantly higher than those in the control group (P<0.05). The number of days of rhFSH administration in the test group was significantly less than that in the control group [(9.8±2.2) versus (11.4± 0.6) days, P<0.05], the dosage of rhFSH was significantly lower than that in the control group [(879 ± 419) versus (1 043 ± 663) U, P<0.05]. The multiple pregnancy rate in the test group was significantly higher than that in the control group [21% (13/62) versu 10% (3/29), P<0.05]. The incidence of OHSS and adverse events were similar between the two groups (P>0.05), and no other adverse events were observed in test group during treatment. Conclusion Ovarian stimulation with domestic rhFSH is effective, safe and economical in women with anovulation of WHO groupⅡ.

Objective To investigate a more pedect method for a nice outward appearance of a reconstructed thumb.Methods A free one-stage plasty second toe transfer for thumb reconstruction by interchanging the whole skin-nail flap from the great toe with another one from the second toe.Results There were 12 cases in this group,following-up 6-9 months in 8 cases,7 cases was excellent and 1 cases was good.The reconstructed thumb got a nice looking and more normal function while no blight to the great toe occurred.Conclusion It is an effective new procedure in ameliorating outward appearance of the reconstructed thumb by transferring the free moulded second toe.

OBJECTIVEA certain fraction of patients failed palliative treatment of 153Sm- ethylenediaminetetramethy lenephosphate (153Sm-EDTMP) for painful skeletal metastases were reviewd. A comparative analysis was designed to identify the factors related to therapeutic response.

METHODSFrom a 3-year multi-center clinical trial, 51 cases were collected who did not respond to an intravenous injection of 153Sm-EDTMP at a dosage of 0.5-1.5 mCi/kg. The therapeutic efficacy was evaluated via changes of symptoms, general condition, consumption of analgesics, sum of effect product, and Karnofsky scores. The age, sex, history of treatment, tumor type, location of bony involvement, uptake ratio and number of metastases, and doses used by the patients were compared to those of the responders.

RESULTSIn 51 non-responders, 43 were male, 34 suffered from lung cancer, 41 had bone lesions in the vertebrae, 39 in the pelvis, and 24 had metastases in the lower extremities. Sex distribution, tumor type and location of the lesion differed significantly between responders and non-responders. No other factor showed differences between the two groups. Though patients of younger age, and lesions with lower uptake of radiopharmaceutical seemed to fail the treatment more easily as observed clinically, this was not confirmed by statistical analysis.

CONCLUSIONThe sex of the patients, certain types of primary tumors and metastases to lower parts of the body were found to influence the patients' response to a single dose of 153Sm-EDTMP palliation. Further exploration of a better way to determine dosage and predict response for each individual case is needed.

Adult ; Aged ; Aged, 80 and over ; Analgesics, Non-Narcotic ; therapeutic use ; Bone Neoplasms ; physiopathology ; radiotherapy ; secondary ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Organometallic Compounds ; therapeutic use ; Organophosphorus Compounds ; therapeutic use ; Palliative Care

Objective To describe the prevalence rates of smoking,quitting and passive smoking in different populations on their status of education,occupation and geographic distribution.Methods A total of 13 408 residents aged 15-69 from 45 counties through stratified multi-stage cluster sampling from Zhejiang province were selected and surveyed,using questionnaires.Data from 13 326 subjects were used for analysis.Indicators as smoking,current smoking,and secondhand smoke exposure,etc.,were calculated by weight on age proportions from the 2010 census.Results Among the adults aged 15 years and older,there were an estimated number of 12.90 million (29.59％) smokers,with 9.99 million (22.92％) current smokers,8.45 million (19.38％) daily current smokers.The prevalence rates of smoking were 41.18％ for men,3.69％ for women,with 45-54 year-old group the highest (51.66％) for men while the group of 65-69 year-olds was the highest (4.62％) in women.The overall rate of quitting was 22.56％.40.19％ of the smokers had thought about quitting,with the main means as self-restriction (87.59％) in conducting the behavior of smoking cessation.Among those non-smokers at age 15 or older,it was estimated that 67.90％ (22.77 million) of them had been exposed to secondhand smoke.SHS exposure was the highest in the indoor workplace (62.84％),among all the venues.Knowledge on tobacco among residents seemed to be relatively poor,with only 31.52％ of the population were aware that smoking could cause serious three diseases (stoke,heart disease,and lung cancer).34.04％ of the population were aware that secondhand smoking could cause all the three diseases (heart disease,lung disease,and lung cancer).Conclusion Current prevalence of smoking in males in Zhejiang province remained at a high level,indicating that the publicity programs on the knowledge of smoking tobacco was not strong enough and the task of control smoking should be taken more arduously.

Objective To explore the effects of a psychological nursing programme based on acceptance and commitment therapy on patients with end-stage cancer.Methods The convenience sampling method was adopted to select 120 patients with end-stage cancer who were hospitalized in the radiotherapy department of a tertiary A maternity and general hospital in Yuncheng from June 2021 to December 2022 as the research subjects.The Research Randomizer was used to divide them into an experimental group and a control group,with 60 cases in each group.The experimental group adopted the psychological nursing programme based on acceptance and commitment therapy,and the control group received the routine psychological nursing.The differences of psychological resilience,psychological pain,experiential avoidance level and quality of life before and after intervention were compared between the 2 groups.Results 57 cases in the experimental group and 58 cases in the control group completed the study.The scores of the 10-item Connor-Davidson Resilience Scale were(35.14±4.76)points in the experimental group and(33.17±2.97)points in the control group,and the difference between the 2 groups was statistically significant(t=2.664,P=0.009).After intervention,the scores of the Distress Thermometer in experimental group and control group were(4.14±1.88)points and(5.69±2.13)points,and the difference between the 2 groups was statistically significant(t=-4.138,P＜0.001).The scores of the Acceptance and Action Questionnaire-Ⅱwere(16.19±3.80)points in the experimental group and(23.93±2.46)points in the control group,and the difference between the 2 groups was statistically significant(t=-13.002,P＜0.001).The EORTC QLQ-C30 score in the experimental group was(117.00±8.50)points,and that in the control group was(101.45±11.88)points,and the difference between the 2 groups was statistically significant(t=8.066,P＜0.001).Conclusion The psychological nursing programme based on acceptance and commitment therapy can effectively reduce the level of psychological pain and experiential avoidance,improve psychological resilience and improve the quality of life of patients.

OBJECTIVETo understand the coverage of HIV related intervention and antiviral treatment among HIV-positive men who have sex with men (MSM) and to examine factors of initiating antiretroviral treatment.

METHODSA total of 501 HIV-positive MSM were recruited by "snowballing" sampling in Chengdu (160), Chongqing (168) and Guangzhou (173) from January to June, 2013. Participants who were older than18 years, had sex with men, HIV-infected, were living in these 3 cities when survey was conducted were eligible for subjects of this survey. The data were collected by computer assisted survey, including social demography, the coverage of HIV related follow-up intervention and ART, related knowledge level, sexual behaviors in the last 6 months, as well as notification to sexual partners and family. We analyzed the influence factors for initiating ART by Multiple Unconditioned Logistic Regression.

RESULTSAmong 501 HIV-positive MSM, the ratio of CD4 counting and HIV viral load testing were 90.8% (455) and 19.4% (97), respectively. The percentage of the latest CD4 counting not more than 350 per µl was 33.0% (150/455). The coverage of initiated ART among the participants who met the qualification was 56.0% (84/150). The multivariable Logistic regression analysis showed that the possibility of not on ART among participants who were migrants increased to 5.21(2.33-11.66) times of the local residents and the possibility among participants who were diagnosed STD in the last year increased to 2.70(1.12-6.55) times of those who were not infected STD, the possibility of not on ART among participants who had sex with male occasional or commercial partner in the last 6 months increased to 2.16(1.03-4.50) times of those who hadn't, and the possibility among participants who had anal sex with condom use in the past 6 months increased to 2.68(1.10-6.50) times of those who couldn't insist using condom.

CONCLUSIONThere were low coverage of series of HIV/AIDS related intervention services among HIV-positive MSM in Chengdu, Chongqi and Guangzhou. Migrants, had sex with male occasional or commercial partner, had anal sex with condom use in the past 6 months, not infected STD in the last year may be the independent risk factors for HIV-positive MSM to not initiating ART.

Anti-Retroviral Agents ; therapeutic use ; CD4 Lymphocyte Count ; China ; Cities ; Condoms ; Demography ; Emigrants and Immigrants ; Follow-Up Studies ; HIV Infections ; drug therapy ; epidemiology ; Health Knowledge, Attitudes, Practice ; Homosexuality, Male ; Humans ; Logistic Models ; Male ; Risk Factors ; Risk-Taking ; Safe Sex ; Sexual Behavior ; Sexual Partners ; Surveys and Questionnaires

OBJECTIVETo investigate the status of HIV disclosure to primary partners and to explore the correlates of HIV disclosure among HIV-infected men who have sex with men (MSM) in Guangzhou, Chongqing and Chengdu.

METHODSThis survey was conducted in Chengdu, Chongqing and Guangzhou by using "snowballing" sample from December, 2012 to May, 2013. Participants who were eighteen years old or elder, HIV-infected, had sex with men and lived in three cities when the survey was conducted were eligible for subjects of this survey. Primary partners and disclosure status of participants were investigated. Multiple Unconditioned Logistic Regression analysis was used to analyze the influence factors associated with HIV disclosure.Of 600 participants, 541 were excluded because of logical problem or incomplete items in questionnaire and the effective response rate was 90.2%.

RESULTSOf the 541 HIV-positive MSM participants, the mean age was (30.2 ± 7.7) years old, 78.2% (423/541) of the participants had male primary partners.Of the 423 participants who had male primary partner, 10.9% (46/423) had wife, 58.9% (249/423) had one primary partner, and 41.1% (174/423) had two or more. The proportion of HIV disclosure to all male primary sexual partners and wife was 41.8% (177/423) and 4.5% (19/423) respectively, 20.3% (86/423) of them disclosure to some of male primary partners and 37.8% (160/423) not disclosure to any male primary partners. Participants who had HIV-positive male partners in the past 6 months (accounting for 35.2% (149/423)) were more likely to disclose HIV infection to their primary sexual partners (70.5% (105/149)) than those who had non-HIV-positive sexual partners (26.3% (72/274)) (χ(2) = 77.46, P < 0.01). Participants who had male unknown HIV-status sexual partners in the past 6 months(accounting for 52.7% (223/423)) were less likely to disclosure HIV infection to primary sexual partners (22.4% (50/223) ) than those who had already known HIV-status sexual partners (63.5% (127/200)) (χ(2) = 73.11, P < 0.01). The possibility of HIV disclosure to primary sexual partner among participants who had HIV-positive sexual partner increase to 6.36 (3.75-10.80) times of those who had HIV -negative partners, and the possibility among participants who had sexual partners of unknown HIV status decreased to 0.44 (0.25-0.76) times of those who had sexual partners of already known HIV status. Compared with having non-anal sex behaviors with male primary partner, the possibility of HIV disclosure to primary sexual partner decreased to 0.46 (0.22-0.95) times among participants who had anal sex behavior with male primary partners.

CONCLUSIONThere were low proportion of HIV disclosure to primary sexual partners among HIV-infected MSM in Guangzhou, Chongqing and Chengdu.HIV disclosure to primary sexual partners may be associated with characteristics of their sexual partners, and participants who had HIV-positive male partners were more likely to disclose HIV infection to their primary sexual partners.

Adult ; China ; Cities ; Disclosure ; HIV Infections ; Homosexuality, Male ; Humans ; Male ; Sexual Behavior ; Sexual Partners

Objective:To evaluate the prognostic value of sepsis-induced coagulopathy (SIC) in patients with sepsis.Methods:From January 2019 to December 2021, patients with sepsis admitted to the Intensive Care Unit of our hospital were retrospectively classified into the SIC group and non-SIC group according to SIC diagnostic criteria. The baseline clinical data, severity score, total length of hospital stay, length of ICU stay and 28-day survival were compared between the two groups. Kaplan-Meier was used to compare the 28-day survival of patients with sepsis between the two groups. Cox proportional hazard regression model was employed to analyze the risk factors of prognosis in patients with sepsis.Results:Totally 274 patients with sepsis were included in the analysis, including 139 patients in the SIC group and 135 patients in the non-SIC group. The two groups were compared in the perspectives of the Platelet count (PLT), prothrombin time (PT) , procalcitonin (PCT), D dimer, hematocrit, red blood cell distribution width, hemoglobin, acute kidney injury (AKI), the use of continuous renal replacement treatment (CRRT), the use of vasoactive drugs, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHEⅡ) score were compared between the two groups and the difference were statistically different (all P<0.05). Kaplan-Meier analysis showed that the 28-day mortality rate in the SIC group was significantly higher than that in the non-SIC group (32.4% vs. 14.1%, P<0.05). COX proportional hazard model showed that SIC score ( HR= 2.17, 95% CI: 1.15-3.91, P<0.05), APACHEⅡ score ( HR= 1.13, 95% CI: 1.09-1.17, P<0.05) and the use of vasoactive drugs ( HR=3.66, 95% CI: 1.53-8.75, P<0.05) were independent influencing factors for 28-day death in patients with sepsis. Conclusions:Patients with sepsis and SIC have more severe disease and increased mortality risk. SIC score exhibits good clinical value in predicting the prognosis of patients with sepsis.