Objective To investigate the level of empowerment of type 2 diabetic patients and analyze its correlating factors.Methods A total of 302 diabetes patients from a Grade A hospital were investigated with Diabetes Empowerment Scale-Short Form (DES-SF),Diabetes Management Self-efficacy Scale (DMSES) and The Third Version of Diabetes Attitude Scale (DAS-3) from the diabetes management manual.Results The mean score of empowerment is (4.02 ± 0.71) in the patients.They were not very good in dealing with the pressure,overcoming the difficulties in self-management process and making detailed plan to change behaviors.Multivariate stepwise regression analysis showed that the correlating factors of the empowerment in the patients with type 2 diabetes were self-efficacy (β =0.568,P =0.000),diabetes education (β =0.128,P =0.007).Conclusions To strengthen the diabetes education management,promote self-efficacy may increase the empowerment of the patients with type 2 diabetes.

Adolescent ; Adult ; Aged ; DNA Mutational Analysis ; DNA, Viral ; genetics ; Drug Resistance, Viral ; drug effects ; genetics ; Female ; Hepatitis B virus ; drug effects ; genetics ; isolation & purification ; Hepatitis B, Chronic ; genetics ; virology ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo compare the safety of intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rtPA) in ischemic patients under the guidance of CT and multi-mode MRI.

METHODSThe clinical, laboratory, and radiologic data from 113 consecutive hyperacute ischemic patients who received intravenous rtPA therapy from June 2009 to October 2011 was retrospectively reviewed. The rate of hemorrhagic transformation (HT) and the clinical outcome between CT and multi-mode MRI was compared. Etiological subgroups were classified according to Chinese ischemic stroke subclassification (CISS).

RESULTSAmong 113 patients treated with intravenous rtPA, the mean age was 66 ±12 years, 74(65.5%) were man, the pretreatment National Institutes of Health Stroke Scale score (NIHSS) was 12.4 ±6.5, and time from symptom onset to therapy was 259.7 ±131.7 min. Postlytic radiological HT was found in 34 patients (30.1%). Symptomatic ICH occurred in 9 patients (8%). Logistic regression analysis suggested that multi-mode MRI was an independent predictor of reduced risk of HT.

CONCLUSIONThe risk of hemorrhagic complications is lower in patients receiving intravenous thrombolytic therapy with rtPA guided by multi-mode MRI than those guided by CT scan.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Brain Infarction ; drug therapy ; Cerebral Hemorrhage ; chemically induced ; prevention & control ; Female ; Humans ; Logistic Models ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Recombinant Proteins ; administration & dosage ; adverse effects ; therapeutic use ; Retrospective Studies ; Stroke ; drug therapy ; Thrombolytic Therapy ; adverse effects ; Tissue Plasminogen Activator ; administration & dosage ; adverse effects ; therapeutic use ; Tomography, X-Ray Computed ; Young Adult

Objective To compare urodynamic studies (UDS) and perineal sonography for assessing mixed urinary incontinence (MUI) in women. Methods A total of 118 adult females with MUI and 30 controls were enrolled from September, 2010 to December, 2017. Their baseline clinical characteristics were recorded. The MUI patients were divided into stress-predomi-nant (S-MUI, n=51), urge-predominant (U-MUI, n=34) and equal predominance (E-MUI, n=33) according to King's Health Questionnaire. Both UDS and perineal sonography were performed in all the subjects. Tolerability of the two methods was compared. Results For sonography parameters, compared with the controls, S-MUI patients had greater dynamic posterior urethral angle, dynamic angle of urethral inclination, dynamic pubo-urethral distance and descent of bladder neck (P<0.001), U-MUI patients had greater detrusor thickness (P<0.05), and E-MUI patients had greater descent of blad- der neck (P<0.05). For UDS parameters, compared with the controls, S-MUI patients had lower Pure.clos.max and functional urethral length; U-MUI patients had lower Qmax, smaller bladder volume, higher Pdet.open, high-er Pdet.Qmax and higher incidence of detrusor overactivity; and E-MUI patients had higher Pdet.Qmax and low-er Pure.clos.max (P<0.05). All UDS and sonography parameters differed significantly between S-MUI and U-MUI patients. The descent of the bladder neck, dynamic angle of urethral inclination, and dynamic puboure-thral distance were negatively correlated with detrusor pressure at maximal flow and functional urethral length, while detrusor wall thickness was positively correlated with detrusor pressure at maximal flow and functional urethral length. Perineal ultrasound was better tolerated than UDS in 82.3% patients. Conclusion Perineal sonography parameters show good correlation with UDS parameters. Ultrasonography is better tol-erated than UDS and provides additional morphologic data. Perineal sonography could facilitate to diagnose U-MUI.

BACKGROUNDDiabetes management could be improved by diabetes education, through influencing attitudes towards diabetes, knowledge and behaviors of patients. The purpose of this study was to characterize the impact of diabetes education on glycemic control, and to assess the attitude, knowledge and self-care behavior in patients with type 2 diabetes in China.

METHODSThis questionnaire-based survey was conducted in 50 medical centers across China from April to July of 2010. The patients with type 2 diabetes were eligible for the study. The information of glycemic control and diabetes education was collected. The diabetes attitude scale-3 formulae, a questionnaire of diabetes knowledge and Summary of Diabetes Self-care Activities scale were used to assess attitude, knowledge and the self-care of patients, respectively.

RESULTSAmong the 5961 eligible respondents (3233 males; mean age (59.50 ± 12.48) years; mean hemoglobin A1c (HbA1c) (8.27 ± 2.23)%), most patients (79.8%) considered themselves educated on diabetes. Compared with patients without diabetes education, their educated counterparts showed significant lower value of HbA1c, after controlling for age, gender, body mass index and duration of diabetes (P < 0.01). The patients who received diabetes education also performed significant higher scores on attitude, knowledge and self-care than their uneducated counterparts. Patients with lower income or education level tended to have higher glucose levels, and showed lower percentage of patients received diabetic education.

CONCLUSIONSChinese patients with diabetes education achieved better glycemic control than un-educated patients. Our study indicates effort is required to provide professional education to patients, with emphasis on lower income and lower education level populations.

Aged ; Blood Glucose ; metabolism ; China ; Cross-Sectional Studies ; Data Collection ; Diabetes Mellitus, Type 2 ; blood ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Self Care ; Surveys and Questionnaires

OBJECTIVETo investigate the clinical characteristics of and factors related to relapse in chronic hepatitis B (CHB) patients who had previously achieved cessation criteria and had been withdrawn from nucleoside analogues treatment.

METHODSSixty CHB patients who experienced relapse after nucleoside analogues withdrawal based on cessation criteria were enrolled in the study retrospectively. Each patient's data on biochemical, serological and viral characteristics corresponding to baseline (treatment initiation), withdrawal and relapse were collected. COX proportional hazard modeling was used to evaluate the factors related to relapse.

RESULTSThe hepatitis B e antigen (HBeAg)-positive and -negative patients had similar median antiviral treatment times (38 months (range: 24 - 80) vs. 35 months (30 - 60); Z = -1.313, P more than 0.05). For all patients, the median follow-up time was 12 months (2 - 72), during which 49 (81.7%) patients developed virological breakthrough and 17 (28.3%) developed HBeAg recurrence. The patients who experienced virological breakthrough or HBeAg recurrence had significantly higher baseline levels of HBV DNA than those patients who remained disease-free (t = 2.15 and -2.54 respectively; P less than 0.05). The median relapse time of the HBeAg-positive patients was significantly longer than that of the HBeAg-negative patients (14 months (3 - 72) vs. 6 months (3 - 36); Chi-square test = 7.045, P less than 0.01). HBeAg status at baseline was identified as an independent factor associated with relapse (relative risk = 1.937, 95% confidence interval = 1.14-3.28, P less than 0.05).

CONCLUSIONHBeAg-positive and-negative patients showed distinct clinical characteristics of relapse, with the latter being more prone to relapse soon after nucleoside analogues withdrawal. Prolonging the treatment course may be beneficial to HBeAg-negative patients, even if cessation criteria are achieved.

Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; drug therapy ; Humans ; Male ; Middle Aged ; Nucleosides ; therapeutic use ; Recurrence ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo explore the techniques of stereotactic combined amygdalohippocampotomy for management of medial temporal lobe epilepsy (MTLE).

METHODSThe Leksell stereotactic frame was used for all cases, and which almost paralleled the long axis of hippocampus. Stereotactic amygdalohippocampotomy was performed in 23 patients with unilateral medial temporal lobe seizures by using magnetic resonance imaging (MRI) localization for target planning, depth electrode for the electroencephalogram (EEG) monitoring and radiofrequency techniques for lesion production. All procedures were completed under local anesthesia.

RESULTSPre-lesion spikes or polyspike-waves complex were recorded by a depth electrode in the amygdala and hippocampus region in all patients, and the epileptiform discharges disappeared after the amygdalohippocampotomy. The MRI appearance of the lesion areas after 1 - 2 weeks surgical operation showed that mutiple areas of coagulation necrosis corresponding to the lesion sites were surrounded by zones of edema. Twenty-three patients were followed-up to 8 - 32 months with seizure free 43.48% (10/23), and the general efficiency (seizure reduction >or= 50%) was 91.30% (21/23 cases).

CONCLUSIONSStereotactic combined lesions of unilateral amygdala and hippocampus for minimally invasive treatment of MTLE is safe and effective, and it is worth to spread in clinical application.

Adolescent ; Adult ; Amygdala ; surgery ; Child ; Electrodes, Implanted ; Electroencephalography ; Epilepsy, Temporal Lobe ; surgery ; Female ; Follow-Up Studies ; Hippocampus ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Monitoring, Intraoperative ; Radiosurgery ; methods ; Stereotaxic Techniques ; Treatment Outcome

OBJECTIVETo observe the influence of 1.8 GHz microwave (MW) specific absorption rate (SAR, 3 W/kg) on human lymphocytes DNA damage induced by 4 chemical mutagens [mitomycin C (MMC), bleomycin (BLM), methyl methanesulfonate (MMS), and 4-nitroquinoline 1-oxide (4NQO)].

METHODSComet assay in vitro was used to detect human lymphocyte DNA damage induced by 1.8 GHz MW, 4 chemical mutagens, and MW plus 4 chemicals 0 h and 21 h respectively after exposure. The time exposed to MW or mutagens was 2 h or 3 h respectively. The results were showed by tail length (TL) and tail moment (TM).

RESULTSThe difference of DNA damage between MW group and control group was not statistically significant (P > 0.05). DNA damages in MW plus MMC groups and MW plus 4NQO groups were significantly greater than those in the corresponding concentrations of MMC groups and 4NQO groups (P < 0.01 or P < 0.05). However, MW did not enhance DNA damage induced by MMS and BLM (P > 0.05).

CONCLUSIONExposure to 1.8 GHz (SAR, 3 W/kg) microwave may not induce human lymphocyte DNA damage, but could enhance DNA damage induced by MMC and 4NQO.

4-Nitroquinoline-1-oxide ; toxicity ; Adult ; Bleomycin ; toxicity ; Cells, Cultured ; Comet Assay ; DNA ; drug effects ; DNA Damage ; Humans ; Lymphocytes ; drug effects ; radiation effects ; Male ; Methyl Methanesulfonate ; toxicity ; Microwaves ; adverse effects ; Mitomycin ; toxicity ; Mutagens ; toxicity

Objective To probe the technical processes of the suboccipital retrosigmoidal craniotomy with replacement of bone flap and deep muscles incision and suture and its clinical application. Methods The data of 40 patients undergoing suboccipital craniotomy to the cerehello-pontine angle lesions, deep muscles incision and suture in our hospital from May, 2003 to May, 2005 were analyzed retrospectively. Results All the procedures of craniotomy including removal of the bone flap, deep muscles incision and suture were accomplished safely with an average operation time of 40-60 min. Two patients appeared post-operative subcutaneous hydrops without CSF leakage and the majority can move their head freely sixth day after the operation. Conclusion Suboccipital retrosigmoidal craniotomy with replacement of bone flap, and deep muscles incision and suture, being a safe and feasible method, may decrease the happening of postoperative CSF leakage and encephalocele, and accelerate the recover of head movement.

Objective To describe the effects of China diabetes educator training and explore the influencing factors.Methods Totally 314 diabetes educators who graduated from Johnson & Johnson Diabetes Institute(JJDI) from 2007 to 2014 were recruited and investigated via self-designed evaluation form.Results The total score was 76.64±22.24.The top three items with highest scores were performing nurses training (93.36±62.81),form of health education (84.27±23.09) and working responsibility and procedure of diabetes educator (82.07±32.43).The items scored lower than 60 were regular follow-up system(56.16±31.74),publishing health education papers(38.47±47.75) and conducting related researches (26.11±44.00).Multiple linear regression analysis showed that educators who had longer time of working in diabetes department(t=3.515,P=0.001) and whose post were educators(t=3.404,P=0.001) and who were not first line practitioners (t=-2.589,P=0.001) had higher scores.Conclusion The educators' main work in China is focusing on regular health education.Follow-up management and research renovation capacity should be enhanced in the future for educators.