Objective To investigate how to improve safety of insulin injection in type 2 diabetes patients by“insulin pen”through the rotating insulin weekly abdominal injection card. Method All the inpatients with type 2 diabetes in the Department of 3rd Internal Medicine from January to September, 2013 were enrolled in this study. Insulin Injection Card group was composed of 66 type 2 diabetes patients who were admitted from June to September, while control group was composed of 62 type 2 diabetes patients admitted from January to April. The difference between Insulin Injection Card group and control group was that the former group used the rotating insulin abdominal injection card weekly which was designed by ourselves, while the control group patients did not use the card. Every participant of both groups was evaluated at 2 weeks of treatment by percentage of patients having absence of Safety standard of insulin injection, and at the end of 3 months of treatment by percentage of patients attaining the therapeutic targets and incidence of adverse events. Result Compared with the control group, patients in Insulin Injection Card group had lower proportion of absence of Safety standard for insulin injection. The scores of rotation injection site in the two groups was 0.59±0.14 and 2.67±0.21(P<0.01). The rate of FPG target achievement of patients in Insulin Injection Card group (84.9%) was higher than that of the control group (61.3%)(P<0.01), the rate of HbA1c target achievement of patients in Insulin Injection Card group (78.8%) was higher than that of the control group (56.5%)(P<0.01). Patients in Insulin Injection Card group had lower incidence of local adverse events (1.5%) compared with the control group (12.9%)(P<0.05). Conclusion Use of the rotating insulin weekly abdominal injection card that was designed by the diabetes health management Quality Control Group in our department showed good effect in achieving therapeutic targets (including HBA1C) and decreasing safety standard deficiency of insulin injection and adverse events.

Objective To survey the basic situation of trainees, the career awareness, the requirement for training, the problems in training, and the selection to the training institutions for the health management specialist trainees. Method Using the cluster sampling method, the trainees from two health management specialist training institutions in Hunan Province were randomly selected from Oct. 2012 to Jun. 2014, a total of 543 trainees were recruited from tertiary health management specialist trainees of 12 periods training a questionnaire survey was conducted. Result Totally 474 valid questionnaires were received, the effective rate was 87.3%. The trainees were mainly from college or undergraduate settings (366, 77.2%), medical professionals (430, 90.7%). The main purpose of the training was to improve their knowledge and technique. Students' demands in the theory content for health management training mainly included the health monitoring (396, 83.5%), health education and health promotion (384, 81.0%), health risk assessment and risk management (382, 80.6%), health intervention plan formulation, implementation and evaluation (360, 75.9%). Demand for practical skills was mainly for health monitoring (426, 89.9%), health risk assessment (424, 89.5%), health interventions (410, 86.5%), health plan formulation, implementation and evaluation (402, 84.8%), health management in the application of specific people (398, 84.0%), etc. At the same time, most of the students considered that for teaching arrangement equal attention to theory and practice should be paid (320, 67.5%). Conclusion Health management specialist training is still in its infancy in China;establishment and improvement of the relevant policies about health management system and forming a complete standard set of health management specialist training system are imminent.

Objective To explore the relationship between lipids profile and body composition in the young and middle?aged adults. Method The relationship between body composition and lipids profile was examined in 642 adults (21-60 years, 178 male, 464 female). According to the result of body composition assessment, they were assigned to three groups: Normal (N, n=272), Obesity (O, n=245), Sarcopenic Obesity (SO, n=125). The lipids profile among three groups and its related factors were analyzed. Results In groups N, O and SO, the levels of total cholesterol (TC), triglycerides (TG), low density lipoprotein?cholesterol (LDL?C) increased gradually (P<0.01), and the high density lipoprotein?cholesterol (HDL?C) level decreased gradually (P<0.01). In a multiple logistic regression analysis, the odds ratio for high levels of TC, TG, LDL?C and low level of HDL?C risk increased gradually in groups N, O and SO [compared to group N, the odds ratio of the four kinds of dyslipidemia in group O were 2.617 (1.117-6.132), 3.549 (1.481-8.503), 4.618 (1.288-16.564), 1.222 (0.529-2.822), respectively, and in group SO were 5.915 (2.512-13.926), 10.430 (4.400-24.722), 9.522 (2.637-34.388) , 4.253 (1.957-9.242) , respectively]. After adjusting for age, sex, waist?to?hip ratio and visceral fat area, the odds ratio for high level of TG risk still increased gradually in group N, O and SO [compared to group N, the odds ratio of group O was 3.565 (1.319-9.632), and of group SO was 8.173 (2.685-24.881)]. Moreover, the odds ratio for high TC and low HDL?C levels of group SO were higher than those of group N [compared to group N, the odds ratio in group SO were 5.658 (1.871-17.111), 6.823 (2.119-21.969) respectively]. With stepwise multivariate logistic regression analysis, for male, the related factors for high levels of TC, TG and low level of HDL?C were high percentage of body fat;sarcopenia, sarcopenia obesity;sarcopenia, respectively. For female, the related factors for high levels of TC, TG and LDL?C were sarcopenia, aging;high percrntage of body fat, aging;sarcopenia, aging, respectively. Conclusion SO was the main risk factor for dyslipidemia in young and middle?aged adults, even more severe than obesity alone and sarcopenia was the risk factor of high TG, low HDL?C levels for male;and the risk factor of high TC, high LDL?C levels for female.

Objective To investigate prevalence of nutritional status of children and adolescents of school age in the poor region with many ethnic groups of Western regions of China. Methods In September 2006, we performed a health check?up for 2 475 students of a primary school and a middle school from many ethnic groups in Rongshui, Guangxi; 1 163 boys (46.99%) and 1 362 girls (53.01%) participated in this study, including 4 main ethnic groups: Han (848 participants, 34.26%), Miao (736 participants, 29.74%), Zhuang (415 participants, 16.77%) and Dong (341 participants, 13.78%), and prevalence of obesity and malnutrition for the population were surveyed. Results The prevalence rates of overweight among male and female children/adolescents of school age were 3.01%and 3.66%, respectively;and the prevalence rates of obesity were 1.55%and 0.76%, respectively. In 4 main ethnic groups of Han, Miao, Zhuang and Dong, the prevalence rates of overweight were 2.59%, 4.76%, 2.89% and 2.93%, respectively; while the prevalence rates of obesity were 1.89%, 0.27%, 0.96%and 1.17%, respectively. The prevalence rates of malnutrition among male and female children/adolescents of school age were 5.59%and 3.35%, respectively;while the prevalence rates of malnutrition in 4 main ethnic groups of Han, Miao, Zhuang and Dong were 6.96%, 2.17%, 5.54% and 2.64%, respectively. Conclusion The prevalence rates of overweight and obesity of children and adolescents of school age in Rongshui were relatively low, while the prevalence rates of malnutrition is similar to the average level of China.

Objective To investigate the health knowledge and behaviors related to traditional Chinese medicine (TCM) among the elderly of communities in national TCM health education pilot area of Zhejiang province and provide reference for TCM health education. Methods A survey about the health knowledge and behaviors status related to TCM was made among 600 elderly people in Gongshu District. The survey included demographic characteristics, health knowledge of TCM and health behaviors related to TCM. The univariate and multivariate analyses were used for analyzing the health knowledge and behavior status and influencing factors of the elderly. Results The awareness rate of knowledge about TCM health knowledge in elderly was 94.7%, the qualified rate of TCM behaviors was only 31.6%. It showed that the qualified TCM behaviors among the elders were significantly different in those of different economic status and physical exercise situation (χ2=6.606, 10.243, P=0.037, 0.001). The results of logistic regression model showed that the protective factors of qualified TCM behaviors were 60-year old and good physical exercise (OR=1.836, 2.249) and the risk factor was moderate economic status (OR=0.539). Conclusion The awareness rate of TCM health knowledge in Gongshu District was high, but the qualified rate of TCM behaviors was low. The age, economic status and physical exercise situation are the influencing factors of TCM behaviors.

Objective To analyze the relationship between baseline serum γ?glutamyltransferase (GGT) and risk of the metabolic syndrome (MS). Method A total of 4 935 adults from health checkup population in Shenzhen were enrolled into a 10?year follow?up study, of these adults 81.84%were male and 18.16% were female, the average age was 60.54 ± 10.38 years.The follow?up outcome measure was the occurrence of MS. The proportional hazards model was adopted to calculate the hazard ratios (HR) and 95%confidence intervals (95%CI) to analyze the association of GGT with the development of MS. Reslut The mean follow up period was 5.0 ± 2.9 years, and there were 24 713 person?years of follow?up, and 1 689 subjects developed MS. During the follow?up, the cumulative incidence and incidence density of MS were 34.22%and 68.34/1 000 person?years, respectively. For both genders, the association between GGT and MS presented dose?response relationship trend (male: M?C χ2=32.78, P<0.001; female: M?C χ2=18.80, P<0.001). After adjusting for age, gender, body mass index, systolic blood pressure, diastolic blood pressure, high?density lipoprotein cholesterol, low?density lipoprotein cholesterol, triglycerides, uric acid and fasting blood glucose in Cox regression model, the HR for MS in quartiles 3 and 4 level of GGT was 1.45 (95%CI:1.08-1.85) and 1.52 (95%CI:1.15-1.99), respectively. Conclusion The GGT level could be an important risk factor and predictor for the development of MS.

Objective Neutrophil/lymphocyte ratio (NLR) is an easy-to-analyze inflammation biomarker but few studies have assessed the relationship between NLR and type 2 diabetes. In order to evaluate how NLR is related to type 2 diabetes, we designed a large scale cross?sectional study in an adult population. Method A cross?sectional study (including 49 861 men and 40 376 women) was conducted on participants recruited from the Health Management Center of Tianjin Medical University General Hospital in Tianjin, China. Measurements of neutrophil and lymphocyte counts, fasting blood glucose and other potential confounding factors were performed. Type 2 diabetes was defined according to the criteria of American Diabetes Association. Adjusted logistic regression models were used to assess relationships between NLR quintiles and type 2 diabetes. Result In the final multivariate models, the odds ratios (95% confidence interval) for T2D across NLR quintiles were 1.00 (Reference), 1.19 (1.05, 1.35), 1.33 (1.17, 1.50), 1.28 (1.13, 1.44) and 1.34 (1.19, 1.51) (P for trend<0.000 1), in men. Similar relationships were also observed in women. Conclusion This study demonstrated that NLR was related to the prevalence of type 2 diabetes in men and women, and suggesting that NLR may be an efficient and accurate prognostic biomarker for type 2 diabetes.

Objective Neutrophil/lymphocyte ratio (NLR) is a simple and reliable inflammation biomarker but few studies have assessed the relationship between NLR and hypertension in Chinese population. In order to evaluate how NLR is related to the incidence of hypertension, we designed a large scale prospective cohort study in an adult population. Method Participants were recruited from Tianjin Medical University's General Hospital?Health Management Centre. Hypertension?free subjects (men, 13 638;women,15 212) were followed up for a median of 2.7 years. Adjusted Cox proportional hazards regression models were used to assess relationships between the quintiles of NLR and the incidence of hypertension. Result During the follow-up period, 1 348 subjects in men and 476 subjects in women developed hypertension. The hazard ratios of hypertension incidence were evaluated in increasing NLR quintiles both in men and women. In the final multivariate models, the hazard ratios (95% confidence interval) for hypertension across NLR quintiles were 1.00 (Reference), 1.05 (0.87, 1.26), 1.02 (0.85, 1.22), 1.07 (0.90, 1.29) and 1.22 (1.03, 1.45) (P for trend=0.01), in men;1.00 (Reference), 1.11 (0.82, 1.49), 0.79 (0.58, 1.08), 1.13 (0.85, 1.52) and 1.25 (0.94, 1.66) (P for trend=0.07), in women, respectively. Conclusion This study showed that the elevated NLR levels were significantly related to an increased risk of developing hypertension in men, but not in women.

Objective To evaluate the impacts of self-management on quality of life of patients with chronic obstructive pulmonary disease (COPD) in community. Method A total of 130 patients with COPD from selected 3 neighbourhood residential committees in Longhua community were randomized into intervention group (65 cases) and control group (65 cases). The control group was treated with conventional health education, the intervention group was treated with self-management education program. Both groups were evaluated by the Chinese version of the chronic disease self-management study measures and SF-36 profile before and after the 6 months intervention. Result After 6 months, the scores of the chronic disease self-management study in the control group were holistic health (3.52 ± 0.64), symptom (18.86 ± 3.06), shortness of breath (3.92 ± 1.74), somatic function (8.15 ± 0.51) and impact on life (22.21 ± 7.14), while the scores in the intervention group were holistic health (2.43±0.43), symptom (15.68±3.66), shortness of breath (2.06 ± 1.30), somatic function (5.73 ± 1.08) and impact on life (16.43 ± 5.17) , and the differences were statistically significant (P<0.01). Compared with the control group, the dimensions and total score of quality of life of the intervention group were (52.41±7.90 vs. 71.63±8.11, P<0.01). Conclusion The effective self-management could improve symptoms, the ability of self-management and their quality of life.

Objective To evaluate whether an intervention with a health promotion program can reduce prevalence of the health risk factors of non-communicable chronic diseases (NCD) and improve the knowledge awareness of NCD prevention of employees from a security corporation in Beijing selected by the study team. Methods A cross-sectional study was conducted by selecting 157 employees of a security corporation in Beijing, and a quasi-experiment method and a self-developed Questionnaire of Intervention for Health Risk Factors were used. Based on the results of the distribution of risk factors for NCD and the focus-group discussion, one year health promotion program intervention was performed. According to the comparison of prevalence of risk factors between baselines and after intervention of the studied employees, the intervention effectiveness was evaluated. Results After the health intervention, rate of reported unhealthy diet reduced from 75.0%to 56.8%, which showed statistically significant (?2=8.53, P<0.05);rate of reported less physical activity reduced from 35.5%to 17.4%, with statistical significance (?2=19.60, P<0.05);rate of reported cigarette smoking reduced from 16.8%to 11.6%with statistically significance. There was no statistically significant reduction in the rate of the other health risk factors (P>0.05). The median value of health knowledge awareness of the studied employees was significantly improved from 10.20 to 11.33(S=-2 545, P<0.05) and awareness of recommended daily intake of dietary salt increased significantly from 46.20%to 67.09%after intervention (χ2=17.85, P<0.05). Conclusion The non-communicable chronic diseases intervention program can reduce the health risk factors and improve health knowledge awareness of the studied population.