Objective To analyze the pressure source and effect of comprehensive intervention in type 2 diabetes mellitus patients. Methods 200 diabetes patients were randomized into the observation group and the control group with 100 cases in each group. Comprehensive intervention was introduced into the observation group and the control group underwent routine treatment. The pressure source was investigated after intervention by questionnaires and the results were compared. Results Fearing of serious complications bocame the most common cause of pressure. The scores of Self-rating Depression Scale(SDS)and Self-rating Anxiety Scale(SAS)were lower and the biochemical index was also better in the observation group than those in the control group as well as those before intervention in the observation group(P＜0.05).Conclusion The depression, anxiety status and biochemical index in patients with type 2 diabetes mellitus were effectively controled by corresponding and comprehensive intervention measures according to the sequence order of pressure source.

Objective To investigate diabetes specialist nurse training mode and clinical practice conditions in Shandong Province,explore the main factors influencing clinical practice of diabetes specialist nurses,gradually improve diabetes specialist nurses training and application.Methods A total of 232 nurses with diabetes specialist nurses certificates in Shandong Province were carried out with the questionnaire about geneal information,training model,clinical practice conditions by convenient sampling method.Results Diabetes specialist nurse training mode in Shandong Province had achieved remarkable results.The total scores of practical skills were (54.64 ± 9.46),in which the scores of clinical nursing dimension were (12.99 ± 2.90),at top level.By using multivariate linear regression analysis,achiuement in scientific research,assessment form of clinical nursing and sources of training teachers were the ninfluential factors of clinical practice of diabetes specialist nurses.Conclusions It would play a positive stimulating effect in bringing diabetes nurse specialist into full play if we gave diabetes specialist nurse systematic and standardized training,a good learning and communication platform,and effective support system.

Objective To study the effects of proprioception training on the motor function and ability in the activities of daily living (ADL) of hemiplegic stroke patients. Methods Forty hemiplegic stroke patients were divided into study group and a control group ( n =20 in each).The two groups received conventional rehabilitation treatment and pharmacotherapy,but the study group received additional proprioception training.The Technobody proprioceptive system assessment,the Fugl-Meyer lower limb assessment (FMA),the Berg balance scale (BBS) and the modified Barthel index (MBI) were used to evaluate their proprioceptive ability,lower limb motor function,balance and ADL ability,before and after 4 weeks of treatment. Results After 4 weeks,proprioception,lower limb motor function,balance and ADL ability had all improved significantly in the experimental group.Lower limb motor function,balance and ADL ability had also improved significantly in the control group,but they showed no significant change in their average proprioceptive ability.The improvement in the experimental group was superior to that of the control group in terms of proprioceptive ability,balance and ADL ability. Conclusions Proprioception training can improve the motor function (including the proprioception and balance) and ADL ability of hemiplegic stroke patients.

Objective To examine the impact of diabetic foot patients′ negative emotion on the caregiver′quality of life. Methods Totally 100 pairs of diabetic foot patients and their caregivers were investigated using convenience sampling method. Results The incidence of anxiety, depression of hospitalized patients with diabetic foot was 41.5% (23/200), 44.0% (88/200) respectively. Pearson correlation analysis showed that anxiety score were negatively correlated with caregivers′ quality of life except for mental health dimension, physical pain dimension and the total score of physical health, mental health and the MOS item Short from Health Survey (SF-36) (r=-0.471--0.117, P<0.05), and depression score were negatively correlated with caregivers′ quality of life except for physical pain dimension and the total score of physical health, mental health and SF-36(r=-0.519--0.220, P<0.05). Multiple regression analysis indicated that caregivers educational level, provided support, social support , relationship with patients, self-evaluation of health, live together time with patient, patient care burden, caregivers gender, depression score, patient age, diabetic foot Wagner grade were the influence factors of the caregiver′ quality of life. Conclusions Diabetic foot patients′ negative emotion has an important impact on caregiver′quality of life, we can improve the quality of life of patients and their caregivers by reducing the negative mood of patients with diabetic foot.

Objective: To systematically evaluate the factors affecting diabetic retinopathy (DR) among Chinese adult patients with type 2 diabetes mellitus (T2DM), so as to provide insights into establishment of personalized risk prediction models for DR. Methods: Case-control studies pertaining to factors affecting DR among Chinese adults were retrieved from international and national databases, including CNKI, Wanfang Data, SinoMed, PubMed, Web of Science, Embase and CINAHL from inception to March 31, 2023. A meta-analysis was performed using the software Stata 17.0, and subgroup analysis was performed to explore the source of heterogeneity. Sensitivity analysis was performed using the leave-one-out method, and the publication bias was evaluated using the Egger's test and trim-and-fill method. Results: Totally 4 969 publications were retrieved, and 35 case-control studies were finally enrolled, including 32 high-quality publications (91.43%). The included studies involved 29 228 participants and 10 568 DR patients, and the prevalence of DR was 36.16%. Meta-analysis revealed that age (OR=1.06, 95%CI: 1.00-1.13), duration of T2DM (OR=1.09, 95%CI: 1.08-1.11), systolic blood pressure (OR=1.02, 95%CI: 1.01-1.03), glycated hemoglobin A1c (OR=1.38, 95%CI: 1.26-1.50), fasting blood glucose (OR=1.57, 95%CI: 1.07-2.31), urinary albumin to creatinine ratio (OR=1.50, 95%CI: 1.10-2.04), serum uric acid (OR=1.01, 95%CI: 1.00-1.01), urine microprotein (OR=2.01, 95%CI: 1.96-2.07), triglyceride (OR=1.77, 95%CI: 1.42-2.21), and total cholesterol (OR=1.82, 95%CI: 1.50-2.21) were risk factors for DR, and glomerular filtration rate (OR=0.98, 95%CI: 0.97-0.98) and C-peptide (OR=0.79, 95%CI: 0.68-0.93) were protective factors for DR. Sensitivity analysis of age effects was not robust. Following adjustment for glomerular filtration rate with the trim-and-fill method, there was still a publication bias, and the publication bias of other influencing factors had no impact on pooled effects. Conclusions Age, course of T2DM, systolic blood pressure, glycated hemoglobin A1c, fasting blood glucose, urinary albumin to creatinine ratio, serum uric acid, urine microprotein, triglyceride and total cholesterol were risk factors, and glomerular filtration rate and C-peptide were protective factors for DR among Chinese adults.

Objective To investigate the distribution of circadian typology of patients with type 2 diabetes mellitus (T2DM) and to analyze its consequent impact on glycemic control. Methods From January 2016 to June 2016, a total of 283 T2DM patients were interviewed in this study. Self designed questionnaire, Morningness-Eveningness Questionnaire (MEQ), Pittsburg Sleep Quality Index (PSQI) and Center for Epidemiological Survey-Depression Scale (CES-D) were used to collect information on diabetes history, circadian typology, sleep quality and depression. HbA1c and other biochemical indicators were determined. The glycemic control target was<7%. The 283 T2DM patients were divided into three groups:morning type group, evening type group and neither type group according to MEQ score. Results Of the 283 subjects, 97 (34.3%) were classified as morning type, 42 (14.8%) as evening type, and 144 (50.9%) as neither. Participants with evening type were younger, shorter diabetes duration, more depressive symptoms, higher perceived sleep debt, higher FBG and higher HbA1c than those with morning type. The binary Logistic regression analysis showed that HbAlc≥7%was associated with higher FBG, higher PSQI score, higher sleep debt, lower HDL-C, and lower MEQ scores (OR=0.189-2.904, all P<0.05). Conclusions Evening type was associated with higher HbA1c and poorer glycemic control in T2DM patients compared with morning type and may be one of the risk factors affecting glycemic control.

Objective To investigate the influence of fear of hypoglycemia on the compliance of diabetes patients.Methods A total of 201 diabetes inpatients with hypoglycemia in four first-class hospital of grade three in Ji'nan were selected by convenience sampling method and investigated by General Information Questionnaire,Chinese version of Hypoglycemia Fear Survey Ⅱ-Worry Scale and Diabetes Treatment Compliance Scale.And carrid on the correlation analysis and the multiple linear regression analysis.Results The scores of fear of hypoglycemia was 3-33 points,the median score was 12 points(interquartile range,10-15 points).The score of treatment compliance was 23-55(35.90±5.84)points.Spearman correlation analysis showed that fear of hypoglycemia score were negative correlated with treatment compliance score,drug,diet,exercise dimensions(r=-0.467-0.288),and it was positively correlated with self monitoring dimension(r=0.259),the difference was statistically significant(P＜0.01),it was not associated with periodic inspection dimension.Multiple linear regression analysis showed that the economic income,occupation,whether to participate in health education of diabetes mellitus,glycosylated hemoglobin,fear of hypoglycemia were the influence factors of treatment compliance.Conclusions Diabetes patients'fear of hypoglycemia can influence treatment compliance.medical staff should pay attention to and take effective measures to reduce their fear of hypoglycemia and improve treatment compliance.

Objective: To understand junior high school students’ sexual knowledge, sexual attitudes, sexual behaviors,as well as acess to sexual knowledge and related influencing factors, so as to provide reference for the practice of sexuality education. Methods: Using stratified cluster sampling method, 7 341 junior high school students were selected from Anhui, Fujian, Gansu, Guangxi, Henan, Xinjiang, Yunnan, Zhejiang and Beijing, and self-compiled questionnaires were used. Results: Junior high school students scored (61.71±18.79) in sexual knowledge, with pass rate and excellent rate being 59.02% and 18.53%. The attitudes towards LGBT was (65.44±20.01), the attitudes towards sexual and healthy behaviors was (67.04±49.23), and the attitudes towards sexual relations and behaviors was (70.75±10.46). Students had intimacy needs and sexual behaviors (18.70%), and some had such behaviors as kissing (13.80%), touching sensitive parts (6.70%) and sexual intercourse (2.20%). The results of multivariate Logistic regression analysis showed that students’ sexual knowledge was related to region, grade and school-based sexuality education (OR=2.11,P<0.05). Conclusion Junior high school students have sexual needs and behaviors, but their sexual knowledge is not sufficient; there are differences in sexual knowledge and attitudes of junior high school students across region,grade and gender; schools should promote school-based sexuality education for junior high school students’ sexual health.

Objective:To investigate the status of post-traumatic growth and its afffecting factors in middle-aged and young patients with type 2 diabetes, in order to carry out clinical intervention for reference.Methods:A general data questionnaire, Posttraumatic Growth Inventory, Perceived Social Support Scale, and Connor-Davidson Resilience Scale were used to survey 222 middle-aged and young patients with type 2 diabetes hospitalized from December 2020 to March 2021 in Shandong First Medical University Affiliated Center Hospital, Shandong Provincial Qianfoshan Hospital, Liaocheng People′s Hospital.Results:The total score of Posttraumatic Growth Inventory, Perceived Social Support Scale, and Connor-Davidson Resilience Scale was (45.20 ± 12.90), (42.73 ± 10.16),(51.41 ± 10.60) points in middle-aged and young patients with type 2 diabetes. Regression showed that treatment mode, medical payment mode, social support, and psychological resilience were the main influencing factors of post-traumatic growth levels in middle-aged and young patients with type 2 diabetes ( P<0.05), which could explain 42.3% of the variation. Conclusions:Middle-aged and young patients with type 2 diabetes have grown at low level. Medical staff should concentrate on the positive psychology of patients and improve their level of social support and resilience to promote the production of post-traumatic growth.

Objective To investigate the clinical efficacy of laparoscopic anatomical left hepatectomy by guided middle hepatic vein approach.Methods The clinical data of 21 patients undergone anatomical left hepatectomy from Oct.2015 to Jul.2018 were retrospectively analyzed.Results Among the 21 cases,the primary hepatocellular carcinoma were found in 4 patients (19.1％),the cholangiocarcinoma in 1 patients (4.8％),the giant hepatic hemangioma in 1 patients (4.8％),the hepatolithiasis in 15 patients (71.3％).All 21 patients were operated under laparoscopy and recovered.The operative time was 160-380 min,the average operative time was(248 ± 56)min,the intraoperative blood loss was 100-700 ml.The average blood loss was (250 ± 40)ml,the average length of hospital stay of the patients was 8-14 (10 ± 2)d.Conclusions Laparoscopic anatomical left hepatectomy guided by middle hepatic vein approach is a safe and effective operation.