1.Risk factors for peritoneal dialysis-related peritonitis in type 2 diabetes mellitus patients complicated with renal anemia and establishment of prediction model
Haosen WANG ; Changhao ZHU ; Leilei MA ; Ge TANG
Chinese Journal of Nosocomiology 2025;35(21):3260-3265
OBJECTIVE To explore the risk factors for peritoneal dialysis-associated peritonitis(PDAP)in the type 2 diabetes mellitus patients complicated with renal anemia and construct the risk prediction model so as to provide references for clinical diagnosis and treatment of PDAP.METHODS A total of 142 type 2 diabetes mellitus patients who were complicated with renal anemia and underwent peritoneal dialysis in nephrology department of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from Jan.2017 to Dec.2023 were recrui-ted as the research subjects and were divided into the peritonitis group with 68 cases and the non-peritonitis group with 74 cases according to the status of complication with PDAP.The related data were collected,the univariate a-nalysis and binary logistic regression analysis were performed,the risk prediction model was established,and the obtained model was visualized for further analysis.RESULTS The univariate analysis showed that the age and lev-els of glycosylated hemoglobin,triglyceride and fibrinogen were higher in the peritonitis group than in the non-per-itonitis group;the levels of serum potassium,serum iron and total iron binding capacity of the peritonitis group were lower than those of the non-peritonitis group,and there were significant differences(all P<0.05).The bina-ry logistic regression analysis indicated that glycosylated hemoglobin no less than 7.00%(OR=4.047,95%CI:1.663 to 9.847,P=0.002),no less than 60 years of age(OR=2.181,95%CI:1.039 to 4.578,P=0.039),triglyc-eride greater than 1.47 mmol/L(OR=2.393,95%CI:1.140 to 5.026,P=0.021)and serum iron less than 7.90μmol/L(OR=2.582,95%CI:1.188 to 5.608,P=0.017)were the risk factors for the PDAP in the type 2 diabe-tes mellitus patients complicated with renal anemia.CONCLUSIONS The glycosylated hemoglobin no less than 7.00%,no less than 60 years of age,triglyceride greater than 1.47 mmol/L and serum iron less than 7.90 μmol/L are the risk factors for PDAP in the type 2 diabetes mellitus patients complicated with renal anemia.The risk pre-diction model can be established based on the above factors,and the intervention measures should be actively taken so as to reduce the risk of PDAP and improve the quality of life.
2.Risk factors for peritoneal dialysis-related peritonitis in type 2 diabetes mellitus patients complicated with renal anemia and establishment of prediction model
Haosen WANG ; Changhao ZHU ; Leilei MA ; Ge TANG
Chinese Journal of Nosocomiology 2025;35(21):3260-3265
OBJECTIVE To explore the risk factors for peritoneal dialysis-associated peritonitis(PDAP)in the type 2 diabetes mellitus patients complicated with renal anemia and construct the risk prediction model so as to provide references for clinical diagnosis and treatment of PDAP.METHODS A total of 142 type 2 diabetes mellitus patients who were complicated with renal anemia and underwent peritoneal dialysis in nephrology department of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from Jan.2017 to Dec.2023 were recrui-ted as the research subjects and were divided into the peritonitis group with 68 cases and the non-peritonitis group with 74 cases according to the status of complication with PDAP.The related data were collected,the univariate a-nalysis and binary logistic regression analysis were performed,the risk prediction model was established,and the obtained model was visualized for further analysis.RESULTS The univariate analysis showed that the age and lev-els of glycosylated hemoglobin,triglyceride and fibrinogen were higher in the peritonitis group than in the non-per-itonitis group;the levels of serum potassium,serum iron and total iron binding capacity of the peritonitis group were lower than those of the non-peritonitis group,and there were significant differences(all P<0.05).The bina-ry logistic regression analysis indicated that glycosylated hemoglobin no less than 7.00%(OR=4.047,95%CI:1.663 to 9.847,P=0.002),no less than 60 years of age(OR=2.181,95%CI:1.039 to 4.578,P=0.039),triglyc-eride greater than 1.47 mmol/L(OR=2.393,95%CI:1.140 to 5.026,P=0.021)and serum iron less than 7.90μmol/L(OR=2.582,95%CI:1.188 to 5.608,P=0.017)were the risk factors for the PDAP in the type 2 diabe-tes mellitus patients complicated with renal anemia.CONCLUSIONS The glycosylated hemoglobin no less than 7.00%,no less than 60 years of age,triglyceride greater than 1.47 mmol/L and serum iron less than 7.90 μmol/L are the risk factors for PDAP in the type 2 diabetes mellitus patients complicated with renal anemia.The risk pre-diction model can be established based on the above factors,and the intervention measures should be actively taken so as to reduce the risk of PDAP and improve the quality of life.
3.The development, reform and implications of purchasing community care services in the Unit-ed Kingdom
Hanxiang GONG ; Zehua FENG ; Haosen TANG ; Baoling WU ; Zhenni LUO ; Shanshan FENG
Chinese Journal of Health Policy 2017;10(1):64-69
The United Kingdom is the longest-serving community in the welfare states, and has been serving for more than sixty years so far. The construction of community care service supply model in the United Kingdom is deeply influenced by the neo-liberalism and neo-managerialism, which dominated the reform and development of pur-chasing community care services. Presently, China is actively promoting the government to purchase pension services of public health care combined with the long-term care, especially policy and determination of community-based de-velopment of an elders' service model. Based on the purchased services experience of the United Kingdom combined with the situation in China, this paper puts forward some suggestions such as the repositioning the role of the govern-ment, actively supporting the development of civil service organizations and perfecting the legal system of care serv-ices to be purchased, supporting the development of proposals to reduce the burden on the government and enhance the efficiency of care services through improving their quality.

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