Objective:To explore the effectiveness of digital health management in the management of community patients with essential hypertension comorbid with somatization symptom disorder.Methods:This was an intervention-controlled study. Patients with essential hypertension comorbid with somatization symptom disorder who visited the outpatient clinic of Jiangwan Town Community Health Service Center in Hongkou District, Shanghai from January to December 2022 were enrolled. Based on the time of initial diagnosis, patients were divided into a digital health management group (initial diagnosis from January to June 2022) and a control group (initial diagnosis from July to December 2022). Baseline clinical data were collected. The control group received conventional interventions, while the digital health management group utilized the Health Cloud APP 5.3.11 platform for online digital health management without altering the original medication regimen. The intervention lasted for 24 weeks. Before and after the intervention, the Somatization Symptom Scale (SSS), 9-item Patient Health Questionnaire (PHQ-9), and 7-item Generalized Anxiety Disorder Scale (GAD-7) were used to assess somatization symptoms, depression, and anxiety, respectively. The reduction rate in SSS scores was calculated, and blood pressure and heart rate were measured. The evaluation criteria for somatization symptom intervention effectiveness were as follows: at the endpoint of the intervention, SSS ≤29 or a reduction rate of SSS ≥ 75% was considered "cured"; a reduction rate of 50% to <75% was considered "markedly effective"; a reduction rate of 25% to <50% was considered "effective"; and a reduction rate of <25% was considered "ineffective".The overall effectiveness rate=(number of cured patients + number of markedly effective patients + number of effective patients)/total number of patients × 100%.Results:A total of 62 patients in the digital health management group and 65 patients in the control group were included in the final analysis. The mean age of the digital health management group was (50.5±3.5) years, with 30 males (48.4%), while the mean age of the control group was (50.2±3.2) years, with 31 males (47.7%). There were no statistically significant differences in the age or gender distribution between the two groups (both P>0.05). Before the intervention, there were no significant differences between the two groups in SSS sub-item scores, total SSS scores, PHQ-9 scores, GAD-7 scores, blood pressure, or heart rate (all P>0.05). After 24 weeks of intervention, all scores decreased in both groups, and did blood pressure and heart rate (all P<0.05). The differences in SSS sub-item scores, total SSS scores, PHQ-9 scores, GAD-7 scores, blood pressure, and heart rate before and after the intervention were greater in the digital health management group than in the control group (all P<0.05). The proportion of patients with effective intervention for somatization symptom was higher in the digital health management group than in the control group (57 cases (91.9%) vs. 38 cases (58.5%), P<0.001). Conclusion:Digital health management can improve somatization symptom disorder, blood pressure, and heart rate in patients with hypertension.

Objective:To explore the effectiveness of digital health management in the management of community patients with essential hypertension comorbid with somatization symptom disorder.Methods:This was an intervention-controlled study. Patients with essential hypertension comorbid with somatization symptom disorder who visited the outpatient clinic of Jiangwan Town Community Health Service Center in Hongkou District, Shanghai from January to December 2022 were enrolled. Based on the time of initial diagnosis, patients were divided into a digital health management group (initial diagnosis from January to June 2022) and a control group (initial diagnosis from July to December 2022). Baseline clinical data were collected. The control group received conventional interventions, while the digital health management group utilized the Health Cloud APP 5.3.11 platform for online digital health management without altering the original medication regimen. The intervention lasted for 24 weeks. Before and after the intervention, the Somatization Symptom Scale (SSS), 9-item Patient Health Questionnaire (PHQ-9), and 7-item Generalized Anxiety Disorder Scale (GAD-7) were used to assess somatization symptoms, depression, and anxiety, respectively. The reduction rate in SSS scores was calculated, and blood pressure and heart rate were measured. The evaluation criteria for somatization symptom intervention effectiveness were as follows: at the endpoint of the intervention, SSS ≤29 or a reduction rate of SSS ≥ 75% was considered "cured"; a reduction rate of 50% to <75% was considered "markedly effective"; a reduction rate of 25% to <50% was considered "effective"; and a reduction rate of <25% was considered "ineffective".The overall effectiveness rate=(number of cured patients + number of markedly effective patients + number of effective patients)/total number of patients × 100%.Results:A total of 62 patients in the digital health management group and 65 patients in the control group were included in the final analysis. The mean age of the digital health management group was (50.5±3.5) years, with 30 males (48.4%), while the mean age of the control group was (50.2±3.2) years, with 31 males (47.7%). There were no statistically significant differences in the age or gender distribution between the two groups (both P>0.05). Before the intervention, there were no significant differences between the two groups in SSS sub-item scores, total SSS scores, PHQ-9 scores, GAD-7 scores, blood pressure, or heart rate (all P>0.05). After 24 weeks of intervention, all scores decreased in both groups, and did blood pressure and heart rate (all P<0.05). The differences in SSS sub-item scores, total SSS scores, PHQ-9 scores, GAD-7 scores, blood pressure, and heart rate before and after the intervention were greater in the digital health management group than in the control group (all P<0.05). The proportion of patients with effective intervention for somatization symptom was higher in the digital health management group than in the control group (57 cases (91.9%) vs. 38 cases (58.5%), P<0.001). Conclusion:Digital health management can improve somatization symptom disorder, blood pressure, and heart rate in patients with hypertension.

Teaching clinics represent a unique form of outpatient training of resident physicians and serve as a crucial instrument and core component of standardized training of general practice residents. This article reviews the common model and innovations of teaching clinics of general practice in China, and analyzes their reported effectiveness in enhancing the capabilities of consultation of resident physicians, the teaching capabilities of general practice trainers, as well as satisfaction levels of involved participants. It outlines the challenges encountered in implementing teaching clinics, including inadequate teaching facilities and equipment, incomplete incentive system for teaching, difficulties in patient recruitment, and weaknesses in the teaching capabilities of trainers. To address these challenges, this article proposes corresponding strategies based on realistic needs, including the improvement of facilities and equipment in teaching clinics, the establishment of incentive systems for teaching clinics, the expansion of patient recruitment channels for teaching clinics, and the enhancement of training for trainers' teaching capabilities. This is envisaged to provide both theoretical bases and practical guidance for the effective execution and standardized development of teaching clinics in general practice residency training bases.

Objective:To determine the inhibitory effect of Rupixiao ( RPX) granule on mammary gland hyperplasia ( HMG) in rabbits and explore the possible mechanism to provide reference for clinical medication. Methods:Rabbit model of mammary hyperpla-sia was established by estradiol benzoate and progesterone. Xiaoyao pills and tamoxifen were used as the positive control, and the RPX granule group was respectively at low, medium and high dose (0. 525,1. 05,2. 1 g·kg-1). Each group was with intragastric adminis-tration for 30 days. The levels of E2 , PROG, FSH, LH and PRL in serum and the expression of VEGF in the homogenate tissue were determined by an Elisa method. The breast tissue of rabbits in each group was withdrawn to observe the structure changes after Hema-toxylin-eosin staining ( HE) . Results:Ovarian preservation-benzoic acid, estradiol combined with progesterone could be used to estab-lish mammary gland hyperplasia in rabbits. RPX granule could significantly decrease the serum levels of E2 and PRL (P<0. 01)and increase that of PROG (P<0. 01 or P<0. 001). The results of pathological section showed that the breast structure in RPX granule high dose group could be restored to the level of the blank control group, which showed its therapeutic effect on HMG was better than that of tamoxifen and Xiaoyao pills. The expression of VEGF in each treatment group significantly decreased compared with that in the model group by the Elisa reagent (P<0. 001). Conclusion:RPX granule has good efficacy in HMG rabbits. The inhibitory effects of RPX granule on HMG in rabbits maybe related to the inhibition of VEGF in rabbit breast tissues, and the inhibition of RPX granule was similar to that of tamoxifen and Xiaoyao pills.

OBJECTIVETo investigate the different outcomes by dexamethasone in adults immune thrombocytopenia purpura (ITP) with different types of platelet specific-autoantibodies.

METHODSA total of 185 ITP were enrolled, 61 males and 124 females, with a median age of 42 (18-83) years, including 117 newly diagnosed, 35 persistent, and 33 chronic cases. All the patients received the dexamethasone at an initial dose of 40 mg per day for 4 days and a low dose of 5-10 mg for 3-4 weeks. The platelet specific-autoantibodies were identified by the modified monoclonal antibody-specific immobilization of platelet antigen (MAIPA) assay.

RESULTSAmong the IgG positive patients, the response rates in anti-GPIIb/IIIa antibody, anti-GPIbα antibody, both antibody positive, and both antibody negative were 87.5%, 50.0%, 68.0%, and 72.3% (χ²=11.489, P<0.05), respectively. Among the IgM positive patients, the response rates in the four groups were 82.1%, 71.4%, 61.9%, and 68.9% (χ²=2.719, P=0.437), respectively. Among the GPIbα antibody positive patients, the response rates in IgG alone, IgM alone, both positive, and both negative were 52.4%, 59.1%, 76.1%, and 77.9% (χ²=10.811, P<0.05), respectively. Among the GPIIb/IIIa antibody positive patients, the response rates in the four groups were 73.3%, 71.0%, 78.6%, and 66.3% (χ²=1.374, P=0.719), respectively.

CONCLUSIONITP patients with GPIbα-IgG antibody have worse response to dexamethasone treatment.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal ; Autoantibodies ; Blood Platelets ; Dexamethasone ; Female ; Humans ; Male ; Middle Aged ; Platelet Glycoprotein GPIIb-IIIa Complex ; Purpura, Thrombocytopenic, Idiopathic ; Young Adult

OBJECTIVE: The purpose of the present study was to investigate the prevalence of hearing loss by studying the current status of hearing loss, risk factors of hearing loss, exposure level of noise, and everyday habit of hearing in a group of university students, so as to provide information for hearing loss prevention in university students. METHOD: According to the purposive sampling method, 642 freshmen students participated in the study. Pure tone audiometry, and exposure level of noise scale were performed in all participants. RESULT: (1) According to the hearing loss criterion of WHO/PDH97.3, high frequency hearing loss, and noise induced threshold shifts, the hearing loss prevalence was 0.36%, 20.91% and 6.73%, respectively. (2) Multivariant Logistic regression analysis of high-frequency hearing loss indicated that traffic noise exposure and ear infection were risk factor of high frequency hearing loss. CONCLUSION There is a high prevalence of high frequency hearing loss in university students (20.91%), which was high related with traffic noise exposure and ear infection.
Audiometry, Pure-Tone ; Cross-Sectional Studies ; Hearing Loss, High-Frequency ; epidemiology ; Humans ; Noise ; adverse effects ; Prevalence ; Risk Factors ; Students ; Universities