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Effect of India buead and coix seed powder on phlegm-dampness constitution dyslipidemia in population studies

Chinese Journal of Health Management.2016;10(5):386-389. doi:10.3760/cma.j.issn.1674-0815.2016.05.010

Objective To explore the anomalous effects of India buead and coix seed powder on phlegm-dampness constitution dyslipidemia through population-based intervention studies. Methods According to the experimental results of the model group with dyslipidemia, the phlegm-dampness population meeting the inclusion criteria were chosen as the samples for the randomized controlled trial, who were divided into test meal (21 males and 39 females) and blank control (23 males and 37 females) groups with 60 cases in each, aged 18 to 65 y and the total of 120 cases completed the study. Statistical analyses were performed with SPSS 18.0 statistical software. The self comparison wass conducted by the method of paired-sample t test and the comparison between groups was conducted by using independent sample t test. The categorical statistics were described as frequency and compared throughc2 test, P<0.05 was considered as statistically significant. Without changing the original way of life, the meal group having taken the India buead and coix seed powder was compared independently and with the control group for TC, TG, HDL-C and LDL-C to detect the trends and degrees of the level changes. Meanwhile, according to efficacy tests and standards, the changes in the level of TC, TG and HDL-C have been evaluated and the efficiency and total effective rates of all the variables have been calculated. Results After the intervention, there was a declining tendency in each variable, 8.9%in TC, 21.4%in TG, and 27.2%in LDL-C, except for an increase of 0.13 mmol/L in HDL. There were significant differences in the variables before and after the intervention (P<0.05 in each). As for the test meal group after the intervention, the effectiveness of TC has been obtained in 25 cases and inefficacy in 35 cases, with efficiency of 41.7%;the effectiveness of TG has been shown in 53 cases and inefficacy in 7 cases, with efficiency of 88.3%;the effectiveness of HDL-C has been gained in26 cases and inefficacy in 34 cases, with efficiency of 43.3%; and the total effective rate was 57.8%. Conclusions There are significant changes and improvements in TC, TG, HDL-C and LDL-C in the test meal group after the intervention with the powder, which demonstrate that the powder is effective in the reduction of TG for animals with dyslipidemia and populations with phlegm-dampness constitution.

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Analysis of factors influencing treatment compliance of hypertensive patients in health management

Baoxiang WANG ; Shaohui LIU ; Qiongmei FU ; Ying TAN ; Hong SUN ; Shifang PENG

Chinese Journal of Health Management.2016;10(5):355-360. doi:10.3760/cma.j.issn.1674-0815.2016.05.004

Objective To analyze the factors which influence the treatment compliance of hypertensive patients in health management. Methods Data of 6 325 hypertensive patients who received physical examination in our department were collected; 4 132 male cases and 2 193 female were included, their ages ranged from 28 to 84 years old;the average age was 61.2 ± 5.8 years. The patients of the health intervention group were randomly divided into 3 groups (group 1, group 2 and group 3). They were provided with regular health management (including weight management, catering management, sports management, medication management and monitoring of blood pressure), respectively, given different frequency of telephone follow-up (1 time per 2 months, 1 time per month, and 1 time per month), evaluating treatment compliance. All the results were analyzed and compared respectively according to the level of education, age and mental status. Data of 1 892 hypertensive patients who received outpatient services were enrolled as the control group. Among them, 4 132 were male and 2 193 were female, aged 28-84 years old, average (61.2 ± 5.8) years old. They received the traditional outpatient follow-up (outpatient service review and health education), their treatment compliance, timely correcting unhealthy lifestyle and medication method and self-testing blood pressure were evaluated. ANOVA and chi square test were used to analyze the treatment compliances and blood pressure control rates of the two groups. Result Compared with the control group, health intervention for hypertension patients could significantly improve the treatment compliance and blood pressure control rate(64.8%vs. 41.3%, 56.7%vs. 29.6%;χ2=2.827,1.382;P=0.032,0.007). Comparing the results of telephone follow-up frequency, the treatment compliance and blood pressure control rate of the 3 intervention groups were higher than those of the two other groups(77.3%vs. 65.4%, 51.7%,χ2=3.414,P=0.041;69.6% vs. 57.3%, 43.2%,χ2=2.763,P=0.028). The treatment compliance of patients with high education level was significantly higher than that of patients with low education level(68.7% vs. 59.1%, 46.4%,χ2=3.257,P=0.037;60.1%vs. 47.2%,32.8%,χ2=1.234,P=0.009). And the treatment compliance of patients with good mental state was significantly higher than that of patients with anxiety(Intervention group1:64.3%vs. 55.1%,41.9%,31.0%,χ2=2.257, P=0.016;59.4%vs.46.1%,20.9%,21.8%,χ2=3.34 5 P=0.021;Intervention group2:75.5%vs. 64.3%,51.8%,41.2%,χ2=2.932, P=0.030;68.3%vs.57.1%,39.2%, 32.1%,χ2=2.382, P=0.032;Intervention group3:86.5% vs.73.2%,62.6%,52.4%,χ2=2.435, P=0.026;75.2% vs. 68.0%,51.7%,43.3%,χ2=3.251, P=0.036). Conclusion More frequently follow-up can improve the treatment compliance and control rate of blood pressure in hypertensive patients;education, age and psychological condition are factors influencing treatment compliance in hypertensive patients.

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Research on the application value of stepped screening on hypertension with self-report health measurement questionnaire

Pingting YANG ; Xin HUANG ; Yaqin WANG ; Xia CAO ; Liuxin WU ; Zhiheng CHEN

Chinese Journal of Health Management.2016;10(5):349-354. doi:10.3760/cma.j.issn.1674-0815.2016.05.003

Objective To explore the application value of stepped screening on hypertension with self-report health measurement questionnaire by comparing the accuracy of the different levels of screening. Methods A total of 6 715 subjects with hypertension (average age of 53.47 ± 11.07 years) were selected from those who completed the physical examination in the department of health management in the Third Xiangya Hospital of Central South University for questionnaire survey, routine inspection and special inspection for hypertension. And the patients were divided into four groups based on their hypertension risk levels: the questionnaire survey group, routine inspection group, questionnaire + routine inspection group and questionnaire+routine inspection+special inspection group. The results were compared respectively to calculate the sensitivity, specificity, positive predictive value and coincidence rate of single inspection and joint inspection. Results Nearly 90.00%of the subjects had hypertension associated with the risk factors, while 20.83% of the subjects had hypertension associated with other clinical diseases (the highest percentage was seen in hypertension with diabetes as 14.88%). According to the guidelines of stratification, 3.41% of the patients were at low risk, 23.78% at moderate risk, 47.85% at high risk, and 24.96% at extremely high risk. Sensitivity and specificity of routine inspection were 95.56%and 45.51%in judgment of moderate risk, which became 100.00%and 45.51%after addition of questionnaire survey;as a result, thesensitivity increased. Sensitivity and specificity of routine inspection were 15.03%and 96.28%in judgment of high risk, which became 30.03% and 99.14% after addition of questionnaire survey; as a result, the sensitivity doubled. Sensitivity and specificity of routine inspection were 15.03%and 100.00%in judgment of extremely high risk, and the sensitivity increased to 94.45%after addition of questionnaire survey, while the specificity remained unchanged. Conclusion Addition of questionnaire on the basis of routine physical examination could greatly increase the detection rate of hypertension patients at different risk levels, and increase the sensitivity as well as specificity for detection of moderate risk, high risk and extremely high risk. Therefore, health information and data acquired from the questionnaire and data obtained from the medical inspection equipment are equally important and suggest health management (physical examination) institutions to take questionnaire as a necessary and primary screening in physical examination and chronic disease screening.

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Effect of doctor-patient interaction based on information platform on hypertensive patients management in community

Quanhou LI ; Fang LIU ; Aie CHEN ; Bo CAO ; Weiling YANG ; Huanhuan MA ; Wei ZHANG ; Qing GU

Chinese Journal of Health Management.2016;10(5):343-348. doi:10.3760/cma.j.issn.1674-0815.2016.05.002

Objective To explore the effect of doctor-patient interaction based on information platform on hypertensive patients' self-efficacy and treatment compliance in community. Methods A convenience sampling method was used, and 280 patients with hypertension in Huaxin community health service centre were included. Patients were divided into interactive group (89 cases) and control group (191 cases) according to their wishes. Control group received a regular follow-up at community clinics, while interactive group participated in the doctor-patient interaction based on information platform at the same time of regular community clinic visit for 3 months. All patients were investigated using Self-efficacy Assessment Scale for Hypertensives and Treatment Compliance Questionnaire before and after intervention, which was used for effectiveness analysis. Results Before intervention, two groups showed no significant difference in self-efficacy (t=1.635,P>0.05), but there was significant difference in treatment compliance [interactive group:8.00(5.00) vs. control group:10.00(3.00)] (Z=4.409,P<0.05). After the intervention, two groups showed no significant difference in treatment compliance (Z=0.784,P>0.05), but there was significant difference in self-efficacy (interactive group:34.42 ± 4.49 vs. control group:32.63 ± 5.53) (t=2.867, P<0.01), which in interactive group was higher. Before and after the intervention, self-efficacy and the treatment compliance had significantly increased in interactive group (P<0.05). while not significantlyincreased in control group (P>0.05). Before intervention, there was a significant positive correlation between the total score of self-efficacy and treatment compliance(r=0.500, P<0.001), drug therapy compliance (r=0.327, P<0.001) and Non-drug treatment compliance (r=0.469, P<0.001) in two groups, while there was lower positive correlation after intervention. Conclusion The doctor-patient interaction project of community hypertension supervision based on informatization platform is effective on the improvement of self-efficacy and the treatment compliance through the enhanced doctor-patient communication, particularly in promoting the role of self-efficacy to accelerate the improvement of health behaviors, compliance behavior and treatment compliance.

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To explore the necessity of carrying out standardized training of general practitioners in psychiatry and psychology

Li ZHOU ; Yonghai BAI ; Jianjun ZHOU ; Yejing WANG ; Fangfang PU

Chinese Journal of Health Management.2016;10(5):406-410. doi:10.3760/cma.j.issn.1674-0815.2016.05.016

The psychiatric problem has become a global public health issue. The model of mental health service advocate that“Treatment of disease occurred in the hospital, but rehabilitation and management in the community”. This brings great challenge to the community health service center. By comparing the domestic and foreign mental health service system, this paper discusses the necessity of carrying out the standardized training of general practitioners in psychiatry and psychology.

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Investigation and analysis of mental health of clinicians in a hospital in Xinjiang

Yuling WANG ; Hua GAO ; Xinling YANG

Chinese Journal of Health Management.2016;10(5):382-385. doi:10.3760/cma.j.issn.1674-0815.2016.05.009

Objective To analyse the mental health status of doctors in the First Affiliated Hospital of Xinjiang Medical University. Methods The 673 doctors in different clinic character in the First Affiliated Hospital of Xinjiang Medical University were investigated by questionnaire and symptom checklist-90(SCL-90),and estimate the results through F-test and t-test . Results Doctors in SCL-90 in addition to interpersonal relationships(1.59±0.49, t=-1.02,P>0.05) and the rest of the factors:somatization (1.48 ± 0.55, t=2.32), force(1.75 ± 0.43, t=2.34),depress(1.67 ± 0.44,t=3.00), anxiety(1.55 ± 0.57, t=3,71), hostility(1.76±0.47,t=5.65),horrible(1.48±0.32,t=6.35),stubborn(1.65±0.39, t=4.04),insanity(1.43±0.46, t=3.39)are higher than the national norm, there is statistical difference (P<0.05). In different gender groups, in addition to the somatization and forced, female doctors other project factors were higher than male doctors, including interpersonal relationships(1.62 ± 0.37, 1.56 ± 0.41), hostility factor(1.79 ± 0.38, 1.73 ± 0.43) differences were statistically significant (t=2.15, t=2.07, P均<0.05). In different professional title ,Doctors with primary professional title in addition to the body of the rest are higher than the title doctor. Anxiety factor differences have statistical significance in different groups (F=2.73, P<0.05). In different department , Emergency department and pediatric clinicians in addition to depression, anxiety and other factors of points were higher than those of physicians and surgeons, the difference in interpersonal relationship factors have statistical significance in different groups (F=4.54, P<0.05). Conclusion The scores aboutdoctors, SCL-90 in the First Affiliated Hospital of Xinjiang Medical University in addition to interpersonal relationships, the rest of the factors are higher than the national norm ,showing that clinic doctors were in psy chological sub health state, especially in female doctors, primary professional title dortors and Emergency department and pediatric clinicians.

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Investigation on awareness of perimenopausal hormone replacement therapy among a part of the medical care personnel in Guiyang

Lan MO ; Limei RAN ; Yu CAO ; Chunwei WU ; Jie ZHAN ; Jue SONG ; Lu SHEN ; Yuanzhi HUANG ; Yue FANG

Chinese Journal of Health Management.2016;10(5):377-381. doi:10.3760/cma.j.issn.1674-0815.2016.05.008

Objective To study the awareness of perimenopausal hormone replacement therapy (HRT) among a part of the medical care personnel in Guiyang . Methods A survey was conducted among 500 medical staff members in 4 hospitals of Guiyang by cluster random sampling using questionnaire about HRT. Results The survey showed that 74.6% (373/500) medical staff thought that the hormone replacement therapy was necessary to perimenopausal women; 96.7% (87/90) of obstetrics and gynecology doctors believed that it was necessary for perimenopausal women to use HRT,which was significantly higher than the doctors of other specialties 68.6% (166/242) and the nurses group 71.4% (120/168) (χ2=28.509, 23.537, P<0.01). Only 5.8%(29/500) of the medical personnel were willing to recommend HRT. In light of the attitude for recommending HRT, the obstetricians and gynecologists group was more significantly higher than the other specialties doctors group (χ2=86.781, P<0.01). Conclusion The knowledge of hormone replacement therapy in part of Guiyang medical personnel is not sufficient;the recommending rate of HRT was low;the side effects of HRT was still a concern. There are differences between obstetrics and gynecology doctors and doctors other specialties and nurses in HRT knowledge.

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Prevalence of dyslipidemia and the risk factors analysis of 39 980 subjects in Urumqi

Bo LIU ; Hua YAO ; Jing ZHOU ; Jihong CHEN ; Shuxia WANG ; Huicai WANG ; Yushan WANG

Chinese Journal of Health Management.2016;10(5):371-376. doi:10.3760/cma.j.issn.1674-0815.2016.05.007

Objective To analyze the prevalence of dyslipidemia and the risk factors of 39 980 subjects in Urumqi and to explore the characteristics of dyslipidemia's risk factors. Methods The following parameters of the subjects were determined: total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), body mass index (BMI), waist circumference, systolic blood pressure, diastolic blood pressure, blood sugar, and uric acid. The prevalence of dyslipidemia of different gender or age and risk factors for dyslipidemia were analyzed. Results Dyslipidemia total detection rate was 55.15%, the rate in male (66.03%) was significantly higher than in women (41.72%) (χ2=2 360.034, P<0.001);and in the men the various types of dyslipidemia detection rate was higher than those in the female, the TC (χ2=66.860, P<0.001) and TG (χ2=2 756.572, P<0.001), LDL-C (χ2=258.636, P<0.001), HDL-C (χ2=2 714.685, P<0.001) were significantly higher in men than in women; the detection rate of dyslipidemiaincreased with age, and then decreased gradually in the age group 50-59 years after the peak, the (high total cholesterol (χ2=2 529.462, P<0.001), hypertriglyceridemia (χ2=1 389.313, P<0.001) high LDL-C (χ2=1 552.074, P<0.001), low HDL-C (χ2=97.279, P<0.001) of all age groups the dyslipidemia detection rate differences were statistically significant. Risk factors of dyslipidemia: Logistic regression analyses showed that male gender (OR=1.681;95%CI:1.337-1.928), age (OR=1.299;95%CI:1.270-1.330), high diastolic blood pressure (OR=1.248;95%CI:1.145-1.361), high waist circumference(OR=1.895;95%CI:1.638-1.956), high uric acid(OR=1.200;95%CI:1.094-1.317), high blood glucose(OR=1.366;95%CI:1.229-1.517), high TG(OR=4.043;95%CI:3.770-4.335), high LDL-C(OR=40.148;95%CI:37.341-43.166), low HDL-C ( OR=1.982;95%CI:1.432-2.511) were closely correlated with the high TC; male ( OR=1.956;95%CI:1.853-2.066), high age(OR=1.060;95%CI:1.040-1.080), high BMI(OR=2.097;95%CI:1.968-2.235), high diastolic blood pressure(OR=1.512;95%CI:1.411-1.620), high waist circumference(OR=1.397;95%CI:1.313-1.478), high uric acid(OR=2.146;95%CI:1.995-2.308), high blood glucose(OR=1.498;95%CI:1.375-1.631), high TC(OR=4.030;95%CI:3.821-4.250), low HDL-C(OR=4.003;95%CI:3.764-4.258) were closely correlated with the high TG. Conclusion The prevalence of dyslipidemia is high in Urumqi area. Improving prevention knowledge, attention to life style, regular physical examination, abnormal condition in time, are important to prevent and reduce the occurrence of vascular diseases.

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Complement C3 and simple fatty liver disease and nonalcoholic steatohepatitis in an adult population

Yeqing GU ; Chunlei LI ; Yang XIA ; Qing ZHANG ; Kaijun NIU

Chinese Journal of Health Management.2016;10(5):366-370. doi:10.3760/cma.j.issn.1674-0815.2016.05.006

Objective To explore the association between complement C3 and the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Methods A total of 2 799 health check-up participants were recruited from Tianjin Medical University General Hospital-Health Management Centre. Serum C3 levels were measured using immunoturbidimetry method and simple fatty liver disease and nonalcoholic steatohepatitis were diagnosed by liver ultrasonography and serum alanine aminotransferase concentration. Multiple logistic regression analysis was used to examine the association between quartiles of serum C3 levels and the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Results After adjusting for covariates, the odds ratios (95% confidence interval) of simple fatty liver disease and nonalcoholic steatohepatitis for increasing quartiles of C3 were: 1.00 (reference), 2.15 (1.55, 3.01), 3.28 (2.35, 4.6) and 4.31 (3.11, 6.02); and 1.00 (reference), 4.54 (1.68, 15.91), 7.81 (3.02, 26.67) and 14.91 (5.94, 50.14) (both P for trend<0.000 1), respectively. Conclusions The study found that the elevated C3 levels were significantly associated with the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Further study is needed to clarify whether C3 has a predictive value for the occurrence of nonalcoholic fatty liver disease.

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Utility of different body composition for the predicting myocardial ischemia in the type 2 diabetes mellitus (T2DM) patients

Lei JIANG ; Xianbo ZHANG ; Mingxiao SUN ; Dongni YU ; Lijuan WANG ; Shanshan REN ; Bo CHENG ; Jing WANG ; Xinmiao CHANG

Chinese Journal of Health Management.2016;10(5):361-365. doi:10.3760/cma.j.issn.1674-0815.2016.05.005

Objective To explore the utility of different body composition for the prediction of myocardial ischemia in exercise in type 2 diabetes mellitus (T2DM) patients. Methods T2DM outpatients were selected from Jul. 2013 to Nov. 2014 (male 83, female 57) to measure body composition and clinical biochemical parameters, and divided them into two groups according to treadmill exercise testing results. Group A cases were positive (27 patients) and Group B cases were negative (113 patients). SPSS19.0 was used to make statistical analysis. Results (1) The age, gender, diabetes mellitus (DM) duration, medical history of hypertension and dyslipidemia, body mass index (BMI), waist circumference, the waist-hip fat ratio of the two groups had no significant difference (P>0.05). (2) The fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C) between the two groups had no significant difference. Compared with group B, the low density lipoprotein cholesterol (LDL-C) of group A [(2.48 ± 0.75) mmol/L vs. (2.81 ± 0.77) mmol/L, t=2.009, P<0.05] decreased significantly. (3) Overall body fat percentage, skeletal muscle weight of the two groups had no significant difference. Compared with group B, the waist-hip fat ratio (0.93±0.06 vs. 0.88±0.08, t=-2.790, P<0.01) andvisceral fat area [(99.47 ± 32.84) cm2 vs. (81.10 ± 25.47) cm2, t=-2.822, P<0.01] of group A increased significantly, while this difference mainly existed in male patients visceral fat area [(100.99±39.33) cm2 vs. (79.91 ± 27.09) cm2, t=-2.231, P<0.05], and waist-hip fat ratio was different in female patients of the two groups (0.91±0.06 vs. 0.85±0.09, t=-2.043, P<0.05) . Conclusion Abdominal obesity, especially visceral fat accumulation had close correlation with myocardial ischemia in exercise in T2DM patients. Waist-hip fat ratio and visceral fat area may be more effective indicators of myocardial ischemia in exercise in T 2DM patients than BMI.

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