Objective To compare the efficacy of α1 adrenergic receptor blocker,5α-reductase inhibitor or combination therapy in benign prostatic hyperplasia (BPH),and to explore the application of multi-level statistical model in assessment of BPH treatments.Methods Pragmatic clinical trials (PCT) design was used.BPH patients received drug therapy including α-adrenergic receptor blocker,5α reductase inhibitor,and combination therapy were followed up for 4 years.Multilevel statistical model was used to compare the scores of international prostate symtom score(IPSS) and BPH qality of life scale(QLS) among the 3 therapeutic regimens.Results The intra class correlation coefficients of I-PSS and BPH-QLS were 0.6136 and 0.6946 respectively,which indicated that both data were hierarchical structured.During the follow-up period,scores of IPSS and BPH-QLS were improved along with the drug therapy in 3 regimens.There was curve relationship between treatment time and IPSS and BPH-QLS scores in 3 regimens (all P＜0.05),and there was no significant differences in the trend of curves between the 3 regimens (P＞0.05).Conclusions For BPH patients with moderate symptoms bothering the quality of life,α-adrenergic receptor blocker,5α-reductase inhibitor,or combination therapy are significantly effective in reducing symptoms and improving quality of life.There are no efficacy differences among the 3 drug therapy during the 4-years follow-up.Compared with traditional analysis,multilevel statistical model is a more suitable and precise method for assessment of BPH treatments.

Objective To comparing the diagnostic and therapeutic strategies for patients with benign prostatic hyperplasia(BPH) between doctors in general hospitals and community hospitals,and to provide scientific clues for the standardization in medical practice.Methods General and community hospitals in urban China were selected via the stratified sampling.127,325 outpatients in these hospitals from December 2011 to December 2012 were randomly recruited.Results The average age of patients was(67.82±8.62) years.There were significant differences in I-PSS,prostate volume,urinary flow rate(UFR) and result of digital rectal examination(DRE) between patients in general and community hospitals.The rates of diagnostic applications were different between doctors in the two kinds of hospitals except I-PSS.Compared with community hospitals,DRE was more frequently applied while ultrasonic inspection and UFR test were less used in general hospitals in North China.A totally opposite situation was observed in East China as compared with the north.The application rates of DRE and UFR test were lower and ultrasonic inspection rate was higher in community hospitals than in general hospitals in South China.Pharmacotherapy was the most common treatment for BPH patients in both types of hospitals(97.53 ％).The rates of drug combinations were statistically different but both were close to 75％ in the two types of hospitals.In community hospitals,the percentage of patients receiving watchful waiting with severe symptoms and signs were lower than that of patients receiving watchful waiting with moderate symptoms and signs,but the percentage of patients receiving operation was not significantly increased.On the contrary,the percentage of patients receiving operation with severe symptoms and signs was higher than that of patients receiving operation with moderate symptoms and signs in general hospitals,but the percentage of patients receiving watchful waiting was not decreased.Conclusions Applications of diagnostic methods are significantly different between doctors in general hospitals and community hospitals and vary among regions.Therapeutic strategies are correlated with the severity of obstructive symptoms or signs.The medication strategy is similar between the two types of doctors.

Objective To promote the standardization of medical practice in China by comparing the discrepancies of diagnosis and medication strategies for benign prostatic hyperplasia (BPH) between urologists and geriatricians.Methods Departments of urology and geriatrics in general hospitals in China were selected through stratified sampling and 145 315 patients who went for the outpatient service in certain days during December 2011 to December 2012 were recruited by cluster.Questionnaires were completed by corresponding doctors and data of patient clinical characteristics as well as diagnostic and therapeutic pattern were collected.Results A total of 142 511 valid questionnaires were collected with 119 426 from urology and 23 085 from geriatrics.The average age of BPH patients was (68.34±8.61) years and the average IPSS was 17.93±4.73.The rates of diagnostic method were IPSS (99.2％),ultrasonic inspection (86.0％),digital rectal examination (DRE) (66.0％) and urine flow rate test (55.2％).The rate of ultrasonic application was lower while the rates of other methods were higher among urologists (P＜0.01) ; the rate of DRE among urologists was 2.2 times to that among geriatricians.For patients with moderate or severe symptoms,most urologists (72.1％ in moderate patients and 79.9％ in severe patients) applied drug-combination strategy and the rate was 2 times to that among geriatricians (P＜0.01).In contrast,most geriatricians (59.7％ in moderate patients and 56.1％ in severe patients) applied single drug to BPH patients.Urologists utilized α-receptor blockers,plant preparations and traditional Chinese medicine more frequently than geriatricians (P＜0.01).Conclusions Urologists performed more integrated diagnosis strategy compared with geriatricians.The urologists tended to use 5α-reductase inhibitor combined with α-receptor blocker to treat BPH patients with moderate or severe symptoms,while geriatricians preferred 5α-reductase inhibitor alone.

We retrospectively analyzed the clinical manifestations,treatments and prognosis of infective endocarditis (IE)associated with renal lesions in children.There were 23 confirmed IE cases who were admitted to the Capital Institutes of Pediatrics from 1992 to 2012.There were 6 cases (26％) with renal lesions.Renal lesions included asymptonatic microscopic hematuria(1 case),asymptomatic proteinuria (1 case) and acute nephritic syndrome (4 cases).There were 3 cases of acute renal injury (AKI) resulted from nephritis accompanied with acute heart failure.The serum level of C3 was lower in patients with renal lesions than patients without renal lesions (P ＜ 0.05),but the clinical manifestations,physical signs and other laboratory findings were the same.Patients of both groups were treated with antibiotics.All patients were recovered and discharged.The average hospital days were (39.2-± 15.2)days for patients with renal lesions and (34.9-± 19.2) days for patients without renal lesions (P ＞ 0.05).Renal lesions secondary to IE are relatively common in IE patients in children.Most of renal lesions can be improved by effective antibiotics.Prognosis of those patients accompanying with AKI is bad.

Objective:To investigate the association patterns of chronic disease-relevant risk factors for the adults in Haidian District.Methods:Data for chronic disease-relevant risk factors for 3 219 adults in Haidian District in 2014 were collected and analyzed.SPSS 18.0 was used for statistical description and logistic regression.SPSS Modeler 14.1 was used to explore the association among the chronic disease-relevant risk factors.Results:Among men,5 patterns of chronic disease-relevant risk factors were identified,which suggested that heavy drinking,inadequate intake of fruit and vegetables,and physical inactivity were associated with smoking while inadequate intake of fruit and vegetables and smoking were associated with physical inactivity.Among women,one pattern of chronic disease-relevant risk factor was identified,which suggested that inadequate intake of fruit and vegetables was associated with physical inactivity.Conclusion:Chronic disease-relevant risk factors are intercorrelated among the adults in Haidian District.Information on patterns of chronic disease-relevant risk factors could assist interventions targeting multiple behaviors simultaneously.

Objective:To establish an evaluation index system for Hunan Medical Science and Technology Award.Methods:Based on the literature review and expert demonstration, combined with the previous review experiences of Hunan Medical Science and Technology Award, a review system framework was initially developed. Delphi method was used for expert consultation, outcome analysis were also adopted for the modification and reconstruction of this index system.Results:The standard evaluating system was set up with four first-level indicators, fifteen second-level indicators and their scoring standards.Conclusions:The evaluation index system established has the characteristics of scientific, systematic, pertinent, practical, simple and operable, also provides a reference and basis for scientific, objective and accurate evaluation of Medical Science and Technology Awards.

Objective:To test the practicality and effectiveness of Evaluation system of Hunan Medical Science and Technology Awards by empirical data.Methods:The empirical data of this paper is based on the 48 award-winning projects of the 2018 Hunan Medical Science and Technology Award. The actual evaluation process was simulated and peer experts were invited to grade the researching samples by index system to collect measured data. Use AMOS and SPSS as tools to test the reliability, validity and the correlation of the Evaluation system.Results:The internal consistency reliability of Cronbach α is 0.820, which shows this evaluation system with good reliability; sample data of confirmatory factor analysis matches the theoretical model, which shows this evaluation system with good validity; The results of analysis of variance showed that the differences among the three winning groups were statistically significant( P<0.05); The correlation coefficient of spearman rank correlation analysis is 0.335( P<0.05), which shows the positive correlation between the theoretical results and the actual evaluation results. Conclusions:The evaluation system of Hunan Medical Science and Technology Awards performs well and possesses strong applicability and practicality. The higher the score of the project measured by this indicator, the higher the quality of the project, and the higher the order of rewards that can actually be obtained. It could be used as an objective reference for the evaluation of Hunan Medical Science and Technology Award.

Content validity is the degree to which an instrument has an appropriate sample of items for the construct being measured and is an important procedure in scale development. Content validity index (CVI) is the most widely used index in quantitative evaluation. There are 2 kinds of CVI: I-CVI and S-CVI. A method to compute a modified kappa statistic (K*) can be used to adjust I-CVI for chance agreement. S-CVI/UA and S-CVI/Ave are both scale level CVI with different formulas. Researchers recommend that a scale with excellent content validity should be composed of I-CVIs of 0.78 or higher and S-CVI/UA and S-CVI/Ave of 0.8 and 0.9 or higher, respectively. The characteristics and qualifications of the experts, process and main results of content validity evaluation should be reported in scale-related manuscript.
Data Collection ; Humans ; Psychometrics ; methods ; Reproducibility of Results ; Surveys and Questionnaires ; standards

Our primary health care institution began to implement national essential medicine system in 2009. In past fi ve years, the goal of national essential medicine system has been initially achieved. For examples, medicine price is steadily reducing, the quality of medical services is improving and residents' satisfaction is substantial increasing every year. However, at the same time, we also found some urgent problems needed to be solved. For examples, the range of national essential medicine is limited, which is difficult to guarantee the quality of essential medication. In addition, how to compensate the primary health care institution is still a question.
China ; Health Services Needs and Demand ; Primary Health Care ; organization & administration

OBJECTIVE: To establish a scientific foundation for cosmetic supervision and administration based on the analysis of the sanitary quality of cosmetics in Hunan Province during 2010. METHODS: According to Cosmetic Sanitary Standards (set by the Ministry of Health, People's Republic of China), 150 random samples of cosmetics in Hunan were assayed both for microbial items (including total plate count, fungus and yeast, fecal coliform, staphylococcus aureus, pseudomonas aeruginosa) and chemical items (including 17 kinds of prohibited substances and 14 kinds of restricted substances). RESULTS: The total rate of cosmetics failing to meet the standards was 22.0% of the 150 samples; specific rates for failing perfumes, skin care products (eye cream) and deodorant products were, relatively, 70.6%, 60.00%, and 44.4%. Four kinds of prohibited substances, including diethyl phthalate, acrylamide, asbestos and neodymium, as well as 2 kinds of restricted substances, including triclosan and formaldehyde, were found to exceed standards. None of microbial items exceeded standard levels. CONCLUSION The sanitary quality control of cosmetics is lax. Administrative departments should not only reinforce their post-production supervision with respect to cosmetics, but also consolidate their control over the process of cosmetic production in order to solve the problem of toxic residues or illegal and intentional adulterations.
China ; Cosmetics ; analysis ; chemistry ; standards ; Formaldehyde ; isolation & purification ; Humans ; Phthalic Acids ; isolation & purification ; Quality Control ; Staphylococcus aureus ; isolation & purification