Diabetes, hypertension, and dyslipidemia, collectively referred to the " Three Highs, " represent increasingly prevalent metabolic risk factors in China. Many individuals experience all three conditions concurrently, significantly heightening the risk of cardiovascular disease and mortality. Although the National Metabolic Management Center(MMC) has been established for over eight years and has its unique features, the awareness, treatment, and control rates of these diseases in China remain low, and the efficiency of community management is insufficient. According to the previous two editions of management guidelines and the most recent domestic and international diagnostic and treatment guidelines, this paper conducts an in-depth analysis of the operational experience and management strategies of the MMC. Its aim is to improve the efficiency of grassroots MMC mode management for " Three Highs" patients and ensure that patients receive more standardized management.

Diabetes, hypertension, and dyslipidemia, collectively referred to the " Three Highs, " represent increasingly prevalent metabolic risk factors in China. Many individuals experience all three conditions concurrently, significantly heightening the risk of cardiovascular disease and mortality. Although the National Metabolic Management Center(MMC) has been established for over eight years and has its unique features, the awareness, treatment, and control rates of these diseases in China remain low, and the efficiency of community management is insufficient. According to the previous two editions of management guidelines and the most recent domestic and international diagnostic and treatment guidelines, this paper conducts an in-depth analysis of the operational experience and management strategies of the MMC. Its aim is to improve the efficiency of grassroots MMC mode management for " Three Highs" patients and ensure that patients receive more standardized management.

Objective:To investigate the effect of pelvic packing on the control of intractable postpartum hemorrhage after emergency perinatal hysterectomy (EPH).Methods:Eleven cases with complete clinical data of pelvic packing due to failure of hemostasis after EPH were collected to evaluate the outcome, complications, hospital stay of pregnant women, and to analyze the factors affecting the effect of pelvic packing. The cases included patients who were admitted to the Third Affiliated Hospital of Guangzhou Medical University after pelvic packing treatment in the other hospital due to continuous bleeding after EPH or who were referred to our hospital for pelvic packing treatment due to continuous bleeding after EPH from January 2014 to August 2021.Results:The median gestational week of 11 pregnant women was 38.3 weeks(38.0-39.9 weeks) , and the methods of termination of pregnancy were cesarean section in 7 cases (7/11) and vaginal delivery in 4 cases (4/11). The median time between postpartum hemorrhage and pelvic tamponade was 10 hours (5-57 hours), the median amount of bleeding was 8 500 ml(4 800-15 600 ml) , the median number of pelvic tamponade was 3 pieces (2-7 pieces), and the median retention time of gauze pad was 6.0 days (3.0-6.0 days). The median frequency of laparotomy in this pregnancy was 3 times (2-3 times), with a maximum of 4 among the 11 cases, the first pelvic packing was successful in hemostasis in 9 cases, and the final successful treatment in all of the 11 cases. All parturients had hemorrhagic shock (11/11) and disseminated intravascular coagulation (11/11) before pelvic packing. Other common complications were multiple organ dysfunction syndrome (9/11), cardiac arrest (4/11), deep vein thrombosis (3/11), septic shock (3/11), and intestinal obstruction (1/11). All parturients took out the gauze after the coagulation function returned to normal and there was no active bleeding. The recovery time of coagulation function in 11 cases was 3 days (3-5 days), the retention time of gauze pad was 6 days (3-6 days), the median length of stay in intensive care unit was 14 days (11-26 days), and the median total length of stay was 22 days (16-49 days).Conclusions:Pelvic packing could be used as a temporary strategy for intractable postpartum hemorrhage after EPH, which provides a key time for injury control resuscitation for patients with unstable vital signs. This technology provides an opportunity for referral to superior medical institutions and further treatment.

Objective: To investigate the use of diabetes medications and their effects on the community diabetic patients in Shanghai, China, and provide the evidence for the use of antidiabetic drugs in diabetic patients in the region. Methods: The data were from a database of a 2018 Survey on Community Diabetes Mellitus in Shanghai, China. There were 4 612 subjects included in this cross-sectional study in 2018. According to the use of antidiabetic drugs, the population was divided into untreated group, single drug group, double drugs combination group and multi-drugs combination group, to compare the fasting blood glucose, glycosylated hemoglobin, BMI and prevalence of diabetic complications in different groups. Results: About 70.9% of the 4 612 patients used hypoglycemic agents, 34.8% used metformin, 35.1% used sulfonylureas, 22.9% used alpha glycosidase inhibitors, and 13.8% used insulin. The prevalence of diabetic nephropathy, retinopathy, neuropathy, stroke, and diabetic foot was higher in the combination than in the untreated and single-drug users (P<0.01). Only 41.3% subjects had HbA_1C<7%. The fasting blood glucose and HbA_1C values were lower in the untreated group than in other three medication groups, and the rate of the HbA_1C reaching target in the untreated group was higher than the other medication groups (P<0.01). As the types of drug increased, HbA_1C was less likely to reach the target (P<0.01). There were 42.2% of patients with BMI<24 kg/m², and there was no significant difference in the proportion of BMI reaching target among the four groups (P>0.05). Conclusion The most common used antidiabetic drugs in diabetic patients in Shanghai are metformin, sulfonylureas, α-glycosides inbibitor, and insulin. The blood glucose control in diabetic patients in Shanghai community is not good enough. Patients with a longer duration of diabetes, a lower rate of HbA_1C at goal, and a higher prevalence of diabetic complications may be more prone to use multiple hypoglycemic drugs.

Objective To investigate the status of health promotion,influencing factors,and health promotion level of cancer patients with PICC during tube indwelling period.Methods A total of 125 PICC cancer patients were investigated by using general information questionnaire and Health Promoting Lifestyle Scale (HPLP-Ⅱ R) according to convenience sampling.Results The average score of health promotion lifestyle in cancer patients was(100.70 ± 18.42)scores during PICC,and the overall level was at the middle level.There was a negative correlation between health promotion behavior and age in cancer patients during PICC detention (P ＜ 0.01),and positively correlated with education,family income and catheterization days (P ＜ 0.05).Multivariate analysis showed that age,education level,diagnosis and catheterization days were influencing factor of health promotion behavior level of cancer patients during PICC indwelling.Conclusion The health promotion behavior of cancer patients during PICC stay is in general level.In clinical nursing work,these patients with elder age,low education level and short timne of catheterization should be paid much attention,so as to improve their health promoting behavior.

Objective To investigate the status of health promotion,influencing factors,and health promotion level of cancer patients with PICC during tube indwelling period.Methods A total of 125 PICC cancer patients were investigated by using general information questionnaire and Health Promoting Lifestyle Scale (HPLP-Ⅱ R) according to convenience sampling.Results The average score of health promotion lifestyle in cancer patients was(100.70 ± 18.42)scores during PICC,and the overall level was at the middle level.There was a negative correlation between health promotion behavior and age in cancer patients during PICC detention (P ＜ 0.01),and positively correlated with education,family income and catheterization days (P ＜ 0.05).Multivariate analysis showed that age,education level,diagnosis and catheterization days were influencing factor of health promotion behavior level of cancer patients during PICC indwelling.Conclusion The health promotion behavior of cancer patients during PICC stay is in general level.In clinical nursing work,these patients with elder age,low education level and short timne of catheterization should be paid much attention,so as to improve their health promoting behavior.

The aim of this study is to explore the tissue distribution of PEGylated puerarin in acute myocardial ischemia model rats. Healthy male SD rats were randomly divided into two groups (30 each). Both were given PEGylated puerarin at a dose of 488 mg x kg(-1). After 5 min of medication, one group was normal rats, another group with acute myocardial ischemia was established by peritoneal injection of 50 mg x kg(-1) isoprenaline. After administration, the animals were executed at 30, 60, 90, 120, 150 and 180 min, then heart, liver, spleen, lung, kidney were extracted. The content of puerarin in organ tissue was determined by HPLC. The results showed that the AUC of tissue distribution of PEGylated puerarin in normal rats was liver > kidney > heart ≈ spleen > lung > brain. While the AUC of tissue distribution of PEGylated puerarin in acute myocardial ischemia model rats was liver ≈ heart > kidney > lung ≈ spleen > brain. AUC(heart) of PEGylated puerarin in acute myocardial ischemia model rats was 1.7 times than that of the normal rats, and there was significant difference (P < 0.05). Thus, PEGylated puerarin had a good heart-targeting property in early myocardial infarction area, drugs could accumulate in the ischemic myocardium. It provided important information for further study and clinic use of PEGylated puerarin.

Objective To observe the clinical efficacy of external -rou te microsurgery for retinal detachment (RD). Methods In 36 patie nts (36 eyes) with single rhegmatogenous RD, the silica gel piece and/or bucklin g bands were preplaced, and drainage of subretinal fluid, retinal cryotherapy, e xamination of locating the holes, and intraocular injection of gas were performe d under surgical microscope. The surgical effects were compared with those of ot her simultaneous 37 patients with rhegmatogenous RD who underwent surgery under binocular indirect ophthalmscope. Results The simultaneous int raoperative observation of the fundus details and the sclera through the microsc ope was excellent in all cases. Under the surgical microscope, the reaction of r etinal cryotherapy was clearly visible without any serious surgical sequela. The observation of reaction of retinal cryotherapy and the orientation of the holes were not affected by mild opacity of the refractive media. Retinal reattachment was achieved in 31 eyes after the primary surgery and in 3 eyes after the secon dary surgery, with the final rate of reattachment of 94%. The best-corrected vi sual acuity was