1.Analysis of knowledge, attitude, behavior, and practice and the influencing factors of pneumococcal vaccination in type 2 diabetes mellitus patients
Xueli YUAN ; Rui WANG ; Ying FU ; Kui XIE ; Wenqing NI ; Jian XU
Chinese Journal of Health Management 2019;13(1):46-50
Objective This study aimed to analyze the knowledge, attitude, behavior, and practice of pneumococcal vaccination in type 2 diabetes mellitus patients. Methods From January to March 2018, 3000 patients with type 2 diabetes mellitus were randomly selected from patients with type 2 diabetes registered and managed in community health service centers to participate in a questionnaire survey, using multi-stage cluster random sampling. The questionnaire included basic information, pneumococcal vaccine awareness, and pneumococcal vaccination status and inoculation intention, 2896 valid questionnaires were collected. The chi-squared test and multivariate logistic regression analysis were used to analyze the knowledge, attitude, behavior, and practice and influencing factors of pneumococcal vaccination. Results Of all the patients, 1267 (43.75%) patients with type 2 diabetes were willing to receive pneumococcal vaccination, and 23 (0.79%) patients with type 2 diabetes were vaccinated against pneumococcal, 1295(44.72%) patients with type 2 diabetes believed that patients with chronic diseases were susceptible to pneumococcal. Eight hundred seventy-seven (30.38%) patients believed that pneumococcal vaccination for chronic disease patients could reduce the risk of outpatient, hospitalization and death. Seven hundred ninety-nine (27.59%) patients believed that diabetic patients were the primary recipients of the pneumococcal vaccine. Multivariate logistic regression analysis showed that retired patients; those who thought that patients with chronic diseases were susceptible to pneumonia; those who thought that pneumococcal vaccination could reduce the risk of needing outpatient care, hospitalization, and death;and those who thought that diabetes was the priority of pneumococcal vaccination were more willing to receive pneumococcal vaccination (OR=1.442, 0.764, 1.494, 1.713, P all<0.05). Conclusion Patients with type 2 diabetes in Shenzhen have lower pneumococcal vaccine awareness, inoculation intention, and vaccination rates. Health education on the prevention of diabetes complications and pneumococcal vaccination should be promoted.
2. Effect of lifestyle intervention among high risk group of chronic diseases in Shenzhen Futian district
Min LIU ; Wenqing NI ; Jian XU ; Jianwei XU ; Ning JI ; Yamin BAI
Chinese Journal of Preventive Medicine 2018;52(4):396-401
Objective:
To evaluate the effect of lifestyle intervention among high risk group of chronic diseases in Shenzhen Futian district.
Methods:
12 out of 115 communities were randomly selected in Futian district of Shenzhen city from October to November, 2013, and 1 923 cases were screened by multiple ways as high risk groups of chronic diseases. High risk groups of chronic diseases were divided into intervention group (1 338 cases, from five residential communities and three villages within city) and control group (585 cases, from four residential communities). The intervention group received group based health education activities as well as lifestyle intervention. The intervention group was provided with health management which was mainly lifestyle intervention. No intervention was implemented in the control group. All participants were followed up over two years. 1 563 participants (1 002 in intervention group and 561 in control group) were followed up from October to November, 2015. The changes of lifestyle related outcome indicators were analyzed to examine the effect of intervention.
Results:
In the intervention group, 21.8% (219 persons) in high risk groups of chronic diseases became healthy individuals and 15.2% (152 persons) became patients with chronic diseases. In the control group, 9.6% (54 persons) in high risk groups of chronic diseases became healthy individuals and 20.5% (115 persons) became patients with chronic diseases. The outcome of the intervention group was better than that of the control group and the difference was statistically significant (χ2=-5.67,
3. Cost-effectiveness analysis of comprehensive community intervention and health management of patients with dyslipidemia in Shenzhen
Zhipeng ZHUO ; Jin XIE ; Xueli YUAN ; Wenqing NI ; Hongshan CHI ; Jinping SONG ; Hui YANG ; Jian XU
Chinese Journal of Health Management 2018;12(4):313-318
Objective:
To evaluate the cost-effectiveness of intervention and management of the patients with dyslipidemia in some districts in Shenzhen and provide health economic basis for prevention and control of dyslipidemia.
Methods:
We conducted a comprehensive community intervention among patients for dyslipidemia management, enrolling 204 cases of dyslipidemia in the intervention group and 200 cases in the control group through multi-stage cluster random sampling. We collected baseline and intervention data, such as the cost of institutional intervention (labor costs, office expenses, material expenses, loss of low-value consumables, service costs, and depreciation of fixed assets), patient costs (direct and indirect medical costs), effect indicators (lipid control rate, lipid improvement rate, and lipid exacerbation rate) to analyze cost-effectiveness.
Results:
After 12 months of the comprehensive community intervention, the total cost for the intervention group was 1 321.62 yuan per capita; the cost per patient was 973.33 yuan; and per capita institutional cost was 348.29 yuan. Total cholesterol, triglyceide, and high-density lipoprotein cholesterol of intervention group decreased by 0.43 mmol/L, 0.16 mmol/L, and 0.42 mmol/L, respectively, after the intervention, and there was a significant difference before and after the intervention (
4.Prognostic analysis of definitive three-dimensional radiotherapy for non-surgically resectable esophageal squamous cell carcinoma:a multi-center retrospective study ( 3JECROG R-01)
Xin WANG ; Lan WANG ; Junqiang CHEN ; Wencheng ZHANG ; Xiaomin WANG ; Xiaolin GE ; Wenbin SHEN ; Miaomiao HU ; Qianqian YUAN ; Yonggang XU ; Chongli HAO ; Zhiguo ZHOU ; Shuai QIE ; Na LU ; Qingsong PANG ; Yidian ZHAO ; Xinchen SUN ; Kaixian ZHANG ; Gaofeng LI ; Ling LI ; Xueying QIAO ; Miaoling LIU ; Yadi WANG ; Lei DENG ; Wenqing WANG ; Nan BI ; Tao ZHANG ; Wei DENG ; Chen LI ; Wenjie NI ; Xiao CHANG ; Weiming HAN ; Zongmei ZHOU ; Jun LIANG ; Qinfu FENG ; Lvhua WANG ; Dongfu CHEN ; Jima LY ; Shuchai ZHU ; Chun HAN ; Zefen XIAO
Chinese Journal of Radiation Oncology 2018;27(11):959-964
Objective To evaluate the survival and prognostic factors of esophageal cancer treated with definitive ( chemo ) radiotherapy by applying novel radiation techniques including three-dimensional conformal radiotherapy (3DCRT) or intensity-modulated radiotherapy (IMRT). Methods Clinical data of 2762 patients with non-operated esophageal squamous cell carcinoma who underwent definitive ( chemo ) radiotherapy from 2002 to 2016 in 10 hospitals were retrospectively analyzed.The prognostic factors were also identified and analyzed. Results The median follow-up time was 60. 8 months. The 1-, 2-, 3-and 5-year overall survival (OS) of all patients was 71. 4%,48. 9%,39. 3%,and 30. 9%,respectively.The 1-,2-,3-and 5-year progression-free survival (PFS) was 59.5%,41.5%,35.2%,and 30%,respectively.The median survival was 23 months.The median time to progression was 17. 2 months.Multivariate analysis demonstrated that age, primary tumor location, clinical stage, tumor target volume, EQD2 and treatment mode were the independent prognostic factors for OS.Primary tumor location,clinical stage,tumor target volume and EQD2 were the independent prognostic factors for PFS. Conclusions In this first large-scale multi-center retrospective analysis of definitive ( chemo) radiotherapy for esophageal squamous cell carcinoma in China, the 5-year OS of patients with esophageal squamous cell carcinoma is significantly improved by 3DCRT, IMRT combined with chemotherapy drugs. However, the findings remain to be validated by prospective clinical trials with high-level medical evidence.
5. Study on safety of adjuvant radiotherapy concurrent with weekly chemotherapy for stage ⅡB-ⅣA esophageal carcinoma after radical resection
Wenjie NI ; Shufei YU ; Jinsong YANG ; Wencheng ZHANG ; Zongmei ZHOU ; Hongxing ZHANG ; Dongfu CHEN ; Qinfu FENG ; Jima LYU ; Jun LIANG ; Xiaozhen WANG ; Xin WANG ; Lei DENG ; Wenqing WANG ; Tao ZHANG ; Nan BI ; Zefen XIAO
Chinese Journal of Oncology 2019;41(6):415-420
Objective:
To evaluate the tolerability and short-term efficacy of chemo-radiotherapy in 125 patients with stage ⅡB-ⅣA esophageal carcinoma after radical resection.
Methods:
We retrospectively evaluated the rate of completion, toxicity and survival of patients undergoing adjuvant concurrent chemo-radiotherapy after radical resection of esophageal carcinoma from January 2004 to December 2014 in our institution. The survival rate was determined by the Kaplan-Meier method and analyzed using the log-rank test. Multivariate prognostic analysis was performed using the Cox proportional hazard model.
Results:
122 patients received more than 50 Gy dose (97.6%). A total of 52 patients received more than 5 weeks chemo-radiotherapy (41.6%), while 73 patients underwent only 1-4 weeks (58.4%). The median following up was 48.4 months. 8 patients lost follow up (6.4%). The 1-year and 3-year overall survival rate were 91.6% and 57.0%, respectively, with a median survival time of 64.4 months. The 1-year and 3-year disease free survival rate were 73.2% and 54.3%, respectively, with a median disease free survival time of 59.1 months. The most common acute complications associated with chemo-radiotherapy were myelosuppression, radiation esophagitis and radiation dermatitis, the majority of which were Grade 1-2. Of the 125 patients, there were 59 cases of recurrence, including 23 cases with local regional recurrence, 26 cases with hematogenous metastasis, and 8 cases with mixed recurrence. Univariate analysis showed that the numbers of concurrent chemotherapy was associated with the overall survival (
6. The value of the planned neoadjuvant radiotherapy or chemoradiotherapy for the non-radical resection of esophageal squamous cell carcinoma
Wenjie NI ; Wei DENG ; Zefen XIAO ; Zongmei ZHOU ; Xin WANG ; Dongfu CHEN ; Qinfu FENG ; Jun LIANG ; Jima LYU ; Nan BI ; Lei DENG ; Tao ZHANG ; Wenqing WANG ; Qi XUE ; Shugeng GAO ; Juwei MU ; Yousheng MAO ; Dali WANG ; Jun ZHAO ; Yushun GAO ; Jinfeng HUANG ; Fengwei TAN ; Liang ZHAO ; Fang LYU ; Guochao ZHANG
Chinese Journal of Oncology 2019;41(4):295-302
Objective:
The role of planned neoadjuvant radiotherapy or chemoradiotherapy in the non-radical resection of esophageal squamous cell carcinoma was unclear. The study aimed to evaluate their therapeutic effect and analyze the prognostic factors.
Methods:
We retrospectively analyzed the clinical data of locally advanced esophageal squamous cell carcinoma who received neoadjuvant radio therapy (33 patients) and concurrent chemoradiotherapy (119 patients) from January 2004 to December 2016 in our single-institution database.The survival rates were calculated by Kaplan-Meier method. The prognostic factors were analyzed by using Log rank test and Cox proportional hazards model.
Results:
The median follow-up was 29.8 months. One hundred and one patients survived more than 3 years. The rates of overall survival (OS) and disease-free survival (DFS) at 3 years were 63.9% and 55.6%, respectively.The rates of complete, partial and minimal pathological response of the primary tumor were 50.3%, 38.4%, 11.3%, the corresponding 3-year OS were 75.5%, 57.4%, 27.3% (