Objective: To study and discuss the application effect of TCM characteristic nursing combined with individualized health education in vertigo multi-specialty integrated diagnosis and treatment platform, and to provide reference basis for clinical research in the future. Methods: From June 2016 to June 2017, 60 patients with vertigo treated by multi-professional integrated diagnosis and treatment platform in our hospital were studied. The subjects of both groups were treated with acupoint application, and were randomly divided into routine group and combined group. There were 30 cases in each group. The routine standardized nursing method was applied to the vertigo multi-specialty integrated diagnosis and treatment platform, and the combined group was applied to the platform based on the routine group, and the application effect of the two groups was compared. Results: The total effective rate of nursing in the observation group was 96.67% (29/30), which was significantly higher than that in the routine group (86.67% (26/30), and the difference was statistically significant (χ²= 4.172, P < 0.05).There was no significant difference in the quality of life score before treatment between the two groups (t = 0.178, P > 0.05), but the score of the observation group was significantly higher than that of the routine group (t = 4.237, P < 0.05), and the quality of life score of the observation group was significantly higher than that of the routine group (t = 4.237, P < 0.05). At the same time, the scores of quality of life after treatment in the two groups were significantly higher than those before treatment (t = 9.239, 5.217, P < 0.05).The nursing satisfaction of the observation group was 96.67% (29/30), which was significantly better than that of the conventional group (83.33% (25/30), and the difference was statistically significant (x = 5.372, P <0.05). After one year of follow-up, the number of recurrences in the observation group was 2, the recurrence rate was 6.67%, the number of recurrences in the conventional group was 6, the recurrence rate was 20.00%, the observation group was superior to the normal group, and the difference was statistically significant (χ²= 5.137, P<0.05). Conclusion In the integrated diagnosis and treatment platform of vertigo, the application of TCM nursing combined with individualized health education can improve the nursing effect, improve the patients' quality of life and nursing satisfaction, and reduce the recurrence rate. To provide new theoretical thinking and clinical methods for improving vertigo patients.

Objective To explore the impact of health management programs on hypertension related to their cost of the hypertensive,so as to provide evidence for related policy-making.Methods Data was from the 2011 China Non-communicable and Chronic Disease Survey Project which was developed in 161 counties (districts) and Xinjiang production and Construction Corps.Information regarding hypertensive patients were collected through a questionnaire.Two-part model was used to analyze the influence from health management scheme.Results This study included 1 1 294 participants who were 35 years old or beyond,with 4 904 (43.42％) males and 6 390 (56.58％) females.The median cost from the outpatient was 100 (30-200) Yuan,and the cost of patients under management program were significantly lower than those without (P＜0.05).Median pharmacy cost appeared as 30 (15-100) Yuan but there was no significant difference noticed between the cost from the managed or unmanaged patients (P＞0.05).Regarding the calculation on the outpatient cost,results showed that the patients under the management program were more likely to practice ‘outpatient-medical-behavior’ (OR=2.50,95％CI:2.26-2.76) with nearly three quarters of the cost from the unmanaged patients.Hypertensive patients from the urban areas were more likely to adopt ‘medical behavior’ (OR=1.31,95％CI:1.18-1.45) which was 1.69 times of the costs from the rural patients.Results of the pharmacy cost showed that the urban hypertension patients were more likely to purchase medicine (OR=1.10,95％CI:1.01-1.20) and was 1.19 times the costs of the rural patients.Conclusion Health management program on hypertension showed preliminary but promising results in reducing the out-patient cost in the treatment of hypertension,thus should be promoted and implemented.

Objective:To develop a risk assessment tool for chemotherapy induced nausea and vomiting after transcatheter arterial chemoembolization in patients with primary liver cancer, and to verify its predictive efficiency, so as to provide reference for risk assessment and nursing intervention of nausea and vomiting in patients with primary liver cancer.Methods:A cross-sectional survey was used. The risk assessment tool was compiled by using literature analysis, Delphi expert consultation and analytic hierarchy process. 153 patients with primary liver cancer who underwent transcatheter arterial chemoembolization in the Department of Intervention, Jiangsu Cancer Hospital from May 2022 to April 2023 were selected for assessment by using convenience sampling method. Receiver operating characteristic curve, sensitivity, specificity and Youden index were used to test the prediction efficiency of risk assessment tools.Results:Among 153 patients, there were 78 males, 75 females, aged (48.44 ± 7.76) years old. The expert positive coefficient of the three rounds of inquiry letters was all 100%, the expert authority coefficient was 0.936, 0.950 and 0.960 respectively, and the Kendall harmony coefficient was 0.490, 0.327 and 0.414 respectively (all P<0.01). The risk assessment tool for chemotherapy induced nausea and vomiting after transcatheter arterial chemoembolization in patients with primary liver cancer included 14 items. The results of prediction efficiency analysis showed that the area under the receiver operating characteristic curve was 0.938 (95% CI 0.903-0.974, P<0.01). When the cut-off score was 56.2, the sensitivity, specificity and Youden index of the risk assessment tool were 0.926, 0.881 and 0.807, which had the best prediction efficiency. Conclusions:The risk assessment tool for chemotherapy induced nausea and vomiting after transcatheter arterial chemoembolization in patients with primary liver cancer has high scientificity, predictive efficiency and practicability, and is suitable for the risk assessment for chemotherapy induced nausea and vomiting after transcatheter arterial chemoembolization in patients with primary liver cancer in China.

Objective: To investigate the prevalence of hypercholesterolemia among Chinese adults in different geographic areas, and to analyze the related factors. Methods: China Chronic and Non-Communicable Disease and Risk Factor Surveillance was conducted in 2013, based on 298 counties/districts in 31 provinces of Chinese mainland. The adults aged 18 years old were randomly selected using multi-stage stratified clustering sampling method. Information on chronic disease and risk factors was collected using face-to-face questionnaire interview and physical measurement. Blood samples were collected by local staffs. Serum total cholesterol (TC) was determined using standard method in a central laboratory. After excluding 565 participants missing key variables and 1 558 participants with abnormal TC values, a total of 174 976 participants were included. Weighted prevalence of hypercholesterolemia was calculated. Hypercholesterolemia related individual or geographic determinants were defined using multilevel logistic regression. Results: The prevalence of hypercholesterolemia in Chinese adults age 18 years old and above was 6.9% (95%CI: 6.4%-7.3%), ranged from 3.0% (95%CI: 2.5%-3.4%) in the northwest of China to 14.2% (95%CI: 12.9%-15.5%) in the south (χ²=183.42, P<0.001). The prevalence of hypercholesterolemia was higher in 6 provinces including Tianjin, Liaoning, Fujian, Guangdong, Guangxi, and Hainan (≥9.0%), but lower in 7 provinces including Shanxi, Shannxi, Gansu, Qinghai, Ningxia, Xinjiang, and Tibet (<3.9%). There was a 1.27 fold variation in hypercholesterolemia prevalence by provincial level, and 72.5% of the geographical variation in hypercholesterolemia prevalence was account for by area-level determinants. With multilevel logistic analysis, the individual risk factors associated with hypercholesterolemia included aging, higher education level or annual household income per capita, regular drinking, too much red meal intake, inactivity, overweight or obesity. For geographic factors, residents living at south China, counties/districts with higher urbanization rates, higher education level or lower standardized death rates were more likely to have hypercholesterolemia (all P<0.05). Conclusion The prevalence of hypercholesterolemia was high in Chinese adults, it was different between regions and related with characteristics of population, individual behaviors and geographical regions.

Objective: To investigate the geographical variation of prediabetes in adults in different regions of China, and to analyze the related factors of prediabetes. Methods: Data was obtained from China Chronic Disease and Related Risk Factor Surveillance in 2013. The surveillance adopted multiple-stage stratified cluster random sampling method, which sampled 177 099 residents aged above 18 years old among 298 surveillance points in 31 provinces of Chinese Mainland. Questionnaire interview was used to obtain demographic variables, personal living style, and socio-economical information. Physical examination was conducted and fasting venous blood sample and (oral glucose tolerance test-2 hours, OGTT-2 h) venous blood sample were obtained from the participants. A total of 171 567 residents aged 18 and above were included in the analysis. The prevalence of prediabetes was analyzed by provinces and by China's geographical regions, after complex weighting. Multilevel logistic models were established to explore the related factors of prediabetes on the area level and individual level. Results: The prevalence of prediabetes among residents aged 18 and above was 16.6% (95%CI: 15.6%-17.6%) in China. The prevalence of prediabetes was the highest (18.3%) in the south China and lowest (13.1%) in the northwest area. The difference of the prevalence in different areas were not statistically significant (P=0.510). If categorized the prevalence of prediabetes into 5 groups by quintile, Hainan, Jilin, Shandong, Anhui, Hunan and Chongqing were in the highest group of prevalence of prediabetes (18.6%-22.7%), and Tibet, Qinghai, Gansu, Ningxia, Guizhou, and Jiangxi were in the lowest group (7.6%-12.6%). The variance of prevalence of prediabetes on the county level (MOR: 1.60 (95%CI:1.53-1.67)) was more diverse than the province level (MOR: 1.21(95%CI:1.08-1.29)) and higher than the street level (1.23 (95%CI:1.14-1.30)). Several factors increased risk of pre-diabetes, including smoking, hazardous drinking and harmful drinking, drinking in the past 30 days, overweight, obesity, central obesity, sugary drink intake, hypertension, high total cholesterol, high triglycerides, high blood low-density lipoprotein cholesterol, low blood high-density lipoprotein cholesterol (all P<0.05). After adjusted the above variables, 92.5% of variance of prediabetes prevalence conld be explained on the provincial level. Conclusion The geographical distribution of prediabetes in adults in China differed by geographic areas, and it significantly varied on the county level. The related variables included demographic variables, personal behavior, and geographic related variables.

Objective: To evaluate the provincial representativeness of China Non-communicable and Chronic Disease Risk Factor Surveillance System, 2013. Methods: The Sixth National Population Census data which was collected by National Bureau of Statistics of People's Republic of China was used to calculate proportion of population who aged 65 and above, mortality rate, the proportion of non-agriculture population, the illiteracy rate and urbanization rate in order to evaluate the surveillance system in each province. The Mann-Whitney U test was used to determine the statistically differences between the surveillance system and corresponding general population. Results: Among the 298 disease surveillance points (DSPs) in China Non-communicable and Chronic Disease Risk Factor Surveillance System, there were 111, 85, and 102 DSPs located in the east, middle, and west area of China, which covering 13.90%, 11.48%, and 12.28% of the total population, respectively. The surveillance system covered 169 million of the population of China, accounting for 12.70% of Chinese population. The number of DSPs by provinces ranges from 6 (Hainan, Qinghai, and Ningxia) to 14 (Shandong, Guangdong and Henan). It indicated that mortality rate (DSP: 0.238%; Province: 0.482%) and the illiteracy rate (DSP: 15.54%; Province: 26.22%) among DSPs in Tibet were significantly lower than the provincial level, on the other hand, the proportion of non-agriculture population among DSPs (40.6%) was significantly higher than the provincial level (18.8%). The urbanization rate among Jiangxi DSPs (43.4%) was significantly lower than the provincial level (59.9%). The proportion of non-agriculture population among Shandong DSPs (32.8%) was significantly higher than the provincial level (24.2%), however, the illiteracy rate among Shandong DSPs (3.86%) was significantly lower than the provincial level (5.25%). Other than the provinces mentioned above, there was no statistical differences (P>0.05) among proportions of population who aged 65 and above, mortality rates, the proportions of non-agriculture population, the illiteracy rates and urbanization rate between provincial surveillance system and corresponding area. Conclusion Other than 3 provinces, in general, China Non-communicable and Chronic Disease Risk Factor Surveillance System had provincial representativeness.

Objective To understand the effects of standardized community-based management of hypertension in urban and rural areas in China and related influencing factors.Methods The study subjects were the hypertension patients aged ≥35 years who were recruited in 2011 from the participants of 2010 national chronic and non-communicable disease surveillance project.The hypertension patients were diagnosed in community health centers or higher level hospitals and included in community based hypertension management project.By face-to-face questionnaire survey and health examination,the information of the subjects' demographic characteristics,risk factors,complications,involvement in community-based management of hypertension,anti-hypertension treatment,blood pressure,body height,waistline and body weight were collected.In this study,Rao-Scott x2 test was used to compare the variations among sub-groups.Taylor series linearization method was used to estimate the prevalence rate.The complex sampling and unconditional multivariate logistics regression analysis was conducted to identify the influencing factors for the control of hypertension.Results A total of 5 120 subjects were recruited in the analysis.The proportion of those receiving management for more than two years was 36.57％,and it was higher in urban area (44.56％) than in nural area (31.79％,P＜0.05);In the past 12 months,6.17％ and 14.46％ of the patients received no blood pressure measurement and drug therapy advice respectively,but there were no significant differences between urban group and rural group (P＞0.05);In the past 12 months,the proportions of the patients receiving diet and physical activity advice were 84.25％ and 84.90％ respectively,and the proportions were higher in urban group than in rural group (P＜0.05);In the past 12 months,the proportions of the subjects receiving tobacco and alcohol use advice were 78.41％ and 77.80％ respectively,and the proportions were higher in rural group than in urban group (P＜0.05).In urban area,the subjects receiving standardized management had lower SBP (142.79 ± 17.39) mmHg,lower DBP (84.26 ± 9.49) mmHg and higher blood pressure control rate (49.77％) than those receiving no standardized management (P＜0.05);while in rural area,no difference was found in BP control between the patients receiving and receiving no standardized management (P＞0.05).In urban area,the influencing factors for BP control among the subjects receiving community based management were educational level,annual income,body weight,hypertension management mode,times of receiving BP measurement,times of receiving antihypertensive medicine advice and receiving physical activity advice;while in rural area,the influencing factors for BP control among the subjects receiving community based management were annual income,body weight,family history of hypertension,antihypertensive medicine awareness,times of receiving antihypertensive medicine advice and receiving diet advice.Conclusion The effects of community-based standardized management of hypertension were better in urban area than in rural area,and the quality of the services of community-based hypertension management was lower in rural area than in urban area.

Objective To investigate the community-based management of diabetes patients aged ≥35 years in China.Methods The subjects from 2013-2014 Chronic Non-communicable Disease and Risk Factor Surveillance in China were used in this study,those who were aged ≥35 years and diagnosed by doctors in hospitals at community level or above were selected through clustering sampling.Questionnaire was used to collect the data of subjects' general information,health status,the treatment and the control of blood glucose.Blood samples were taken from the subjects to detect the fasting blood glucose level and blood glucose level at 2 hours after oral administration of glucosum anhydricum.The subjects were weighted according to complex sampling scheme to calculated the different rates and 95％CI.The Rao-scott x2 test was performed to test the differences in rates between the subgroups.Results The survey indicated that among the 10 056 diabetes patients aged ≥35 years and diagnosed with diabetes,4 609 received management service in communities.After being weighted,the management rate of diabetes patients was 45.0％ (95％ CI:40.8％-49.2％).Females (46.9％,95％CI:42.8％-51.0％) had higher management rate than males (43.0％,95％CI:38.1％-47.9％).The management rate was higher in rural area (50.4％,95％CI:46.3％-54.5％) than in urban area (41.6％,95％CI:35.5％-47.6％).There was a significant age specific difference in the proportion of patients receiving management services (x2=21.0,P＜0.01),the rate of management was highest in the patients aged ≥65 years (49.2％,95％CI:43.6％-54.7％),but lowest in the patients aged 35-44 years (35.2％,95％CI:27.9％-42.4％).The overall standardized management rate of diabetes patients in communities was 16.7％ (95％ CI:13.7％-19.7％).The proportion of urban patients receiving standardized management service (19.7％,95％CI:15.3％-24.1％) was higher than that of rural patients (12.8％,95％ CI:9.8％-15.8％).The overall treatment rate of diabetes patients in communities was 95.8％ (95％CI:94.8％-96.9％).The treatment rate was higher in females (97.0％,95％CI:96.0％-98.0％) than that in males (94.5％,95％CI:92.7％-96.4％).The control rate of blood glucose in diabetes patients receiving management in communities was 34.6％ (95％CI:31.5％-37.6％),and the highest blood glucose control rate was in the patients aged ≥65 years (38.2％,95％ CI:33.4％-43.0％),while the lowest blood glucose control rate was in the patients aged 45-54 years (34.4％,95％CI:26.7％-42.0％).Conclusions Both the standardized management rate and blood glucose control rate were low in the diabetes patients aged ≥35 years in China.It is necessary to strengthen the allocation of medical resources in communities and standardized diabetes management.

Objective To estimate the effect of daily diurnal temperature range (DTR) on mortality in different areas in China.Methods A time series study using the data collected from 66 areas in China was conducted,and Meta-analysis was used to analyze the estimates of associations between DTR and daily mortality.Modifying effects of extremely low and high DTR-mortality relationship by season and socioeconomic status (SES) were also evaluated respectively.Cumulative excess risk (CER) was used as an index to evaluate the effects.Results The information about 1 260 913 registered deaths were collected between 1 January 2006 and 31 December 2011,we found the relationship between extreme DTR and mortality was non-linear in all regions and the exposure-response curve was J-shaped.In central and south areas of China,the result indicated the obvious acute effect of extremely high DTR,and the mortality effect in central area (CER=5.1％,95％CI:2.4％-7.9％) was significant higher than that in south area (CER=4.5％,95％CI:1.7％-7.3％).Regarding to the modification of seasons,the cumulative mortality effect of DTR in cold season (CER=5.8％,95％CI:2.5％-9.2％) was higher than that in hot season (CER=3.1％,95％CI:1.1％-5.1％).Generally,deaths among the elderly (≥75 years) were associated more strongly with extremely high DTR.Conclusions The mortality effects of extremely DTR in different areas and seasons showed different characteristics,that in central area and in cold season it was significantly stronger.After modified by season and SES,DTRs were the greatest threat to vulnerable population,especially to the elderly (≥75 years).Therefore,more attention should be paid to vulnerable groups and protection measures should be taken according to the local and seasonal conditions.

Objective To understand the passive smoking exposure level and related risk awareness in adults in China in 2013.Methods A face-to-face questionnaire survey was conducted in 179 570 adults selected through multistage cluster sampling from Chinese chronic disease and risk factors surveillance sample population (2013) in 302 surveillance sites.The effective sample size was 176 179 adults.After comprehensive weighting of the samples,the passive smoking exposure level and the awareness rate of related risks were analyzed.Results The passive smoking exposure rate was 52.8％ (95％CI:51.2％-54.4％) and the rate decreased with age (x2=515.8,P＜0.000 1).The exposure rate was highest in persons engaged in commercial services (61.6％,95％CI:58.6％-64.5％).The awareness rate of related risks was 67.9％ (95％CI:65.8％-69.9％).The awareness rate was higher in urban area (77.0％,95％CI:75.0％-79.1％) than in rural area (60.0％,95％CI:57.7％-62.4％),in males (69.8％,95％CI:67.8％-71.7％) than in females (65.9％,95％CI:63.7％-68.1％).The awareness rate of three related diseases in urban residents (49.8％,95％CI:47.3％-52.4％) were higher than that in rural residents (37.9％,95％CI:35.4％-40.5％);the awareness rate of passive smoking related lung cancer was highest (88.5％,95％CI:87.5％-89.5％),followed by lung disease in children (70.0％,95％ CI:68.1％-71.9％),the awareness rate of passive smoking related heart disease was lowest (46.8％,95％CI:44.6％-49.1％).Conclusion The passive smoking exposure level is relatively high in adults in China,and the awareness rate of passive smoking exposure risks,especially heart disease,is low.