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 understand the prevalence and disease burden of major chronic diseases in the elderly in China and provide scientific basis for the prevention and control of chronic diseases and for the rational allocation of health resources. Methods: We analyzed the prevalence of chronic diseases in residents aged ≥60 years in China by using national and provincial surveillance data of chronic diseases and related risk factors in China. We conducted the analysis on the burden of chronic diseases in the elderly in China by using the data of global burden of disease. Results: The prevalence rates of hypertension, diabetes and hypercholesterolemia were 58.3%, 19.4% and 10.5% respectively in residents aged ≥60 years in China. Up to 75.8% of the residents aged ≥60 years had at least one chronic disease. The prevalence rate was higher in women than in men, higher in urban area than in rural area. With the increase of age, the prevalence rate of chronic diseases also increased. The top three chronic diseases with heavy disease burden in residents aged ≥70 years were stroke, myocardial infarction, cancer and chronic obstructive pulmonary disease. Conclusion The prevalence of major chronic diseases in the elderly is high with three quarters of the elderly suffering from at least one chronic disease, and the burden of chronic diseases is increasing.

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 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.

Objective To investigate the prevalence and co-prevalence of tobacco use,excessive alcohol use,insufficient intake of vegetable and fruit,physical inactivity,and overweight or obesity in floating population and influencing factors in China,2012.Methods Data from the 2012 China Chronic Disease Risk Factor Survey in Floating Population in China were used.In this survey,48 704 people aged 18-59 years in floating population were selected through stratified multistage clustering sampling in 170 counties and districts from 31 province (autonomous regions and municipalities) and Xinjiang Production and Construction Corps.The gender specific prevalence and co-prevalence of five risk factors were estimated,and the rank sum test was used for result comparison.Results Among the people surveyed,27.4％ had one risk factor,37.1％ had two risk factors,28.5％ had ≥3 risk factors.The prevalence or co-prevalence of risk factors were positively correlated with age (P＜0.05),income level (P＜0.05) and migration time (P＜0.05),and negatively correlated with educational level (P＜0.05).People who were males,in Han ethnic group,engaged in construction and from other provinces were more likely to have more risk factors (P＜0.05).Conclusion The prevalence and co-prevalence of tobacco use,excessive alcohol use,insufficient intake of vegetable and fruit,physical inactivity and overweight or obesity were high in floating population in China,suggesting that it is necessary to strengthen the comprehensive behavior intervention in floating population.

Objective: To understand medical treatment seeking behaviors and its influencing factors in employed floating population in China and provide evidence for the development of health service policies for floating population. Methods: Data were from the national chronic disease and risk factor surveillance (floating population part) in 2012. Floating population were selected through multistage clustering sampling stratified by industries in 170 counties and districts from 31 provinces (autonomous regions, municipality directly under the central government) and Xinjiang Production and Construction Corps in the mainland of China. Information on demographic basic information, health status and health seeking behaviors six months before the investigation were collected through face-to-face questionnaire interview. The people aged 18-59 who had physical discomfort in the past six months was analyzed. After complex weighted analysis, multinomial logistic regression model was used to analyze the health seeking behavior and its influencing factors in the employed floating population. Results: A total of 11 134 suitable people aged 18-59 years were included in the study. The number and proportion of the people seeking medical treatment, having self-treatment and having no treatment were 4 950 (44.5%), 3 880 (34.8%) and 2 304 (20.7%), respectively. Multinomial logistic regression analysis showed that women were 1.275 times (95%CI: 1.100-1.477) more likely to seek medical treatment compared with men. The medical treatment seeking rates of floating population in the eastern, central and western areas were 2.153 times (95%CI: 1.669-2.777), 2.310 times (95%CI:1.777-3.002), 2.177 times (95%CI: 1.695-2.796) higher than that of floating population in northeastern area. In terms of seeking treatment, the proportion of the floating population with annual income of more than 25 000 yuan was 1.255 times (95%CI: 1.088-1.448) higher than that of the floating population with annual income of 25 000 yuan or less than 25 000 yuan. The proportion of the floating population with severe physical discomfort within the past six months was 8.076 times (95%CI: 6.091-10.707) higher than that of the floating population without severe physical discomfort and the proportion of the floating population who participated in medical insurance in both original living places and current living places was 1.566 times (95%CI: 1.250-1.961) higher than that of the floating population who did not participate in medical insurance in two places. The incidence ratio of medical care seeking and self-treatment in new generation of floating population was 1.369 (95%CI: 1.157-1.619) and 1.240 (95%CI: 1.042-1.475) compared with old generation of floating population. Compared with the widowed/divorced/separated, the incidence ratio of medical treatment seeking and self-treatment for the married/cohabited was 1.590 (95%CI: 1.057-2.391) and 1.815 (95%CI: 1.209-2.725). The more severe physical discomfort, the higher level medical institutions they chose (P<0.05). Conclusions The treatment rate in medical institutions of employed floating population was low in China. Gender, generation of floating population, marital status, area, annual income, severity of physical discomfort in past six months and the way to participate in medical insurance were the main factors affecting the medical treatment seeking behaviors of employed floating population.