Objective:It analyzes the flow characteristics and spatial distribution patterns of intra-provincial cross-regional medical patients in Guangdong,while comparing hospitalization cost differences between local and non-local care.Methods:Based on 2022-2023 cross-regional medical data from Guangdong,spatial visualization and descriptive analysis were conducted combined with Mann-Whitney U test to compare the cost burden.Results:Cross-Regional patients in Guangdong primarily flow to Guangzhou,accounting for 77.8％of the total intra-provincial cross-regional hospitalizations.Cross-regional medical expenses were significantly higher than the insured locations,with notable differences in mean total hospitalization costs and personal out-of-pocket payment ratios.Conclusion:Refining pre-approval procedures for cross-regional care,enhancing specialized medical departments in under-resourced regions,and strengthening coordination between healthcare insurance systems and primary healthcare strengthening initiatives are needed to promote balanced medical resource allocation and reduce the cost burden on patients.

Objective:It analyzes the flow characteristics and spatial distribution patterns of intra-provincial cross-regional medical patients in Guangdong,while comparing hospitalization cost differences between local and non-local care.Methods:Based on 2022-2023 cross-regional medical data from Guangdong,spatial visualization and descriptive analysis were conducted combined with Mann-Whitney U test to compare the cost burden.Results:Cross-Regional patients in Guangdong primarily flow to Guangzhou,accounting for 77.8％of the total intra-provincial cross-regional hospitalizations.Cross-regional medical expenses were significantly higher than the insured locations,with notable differences in mean total hospitalization costs and personal out-of-pocket payment ratios.Conclusion:Refining pre-approval procedures for cross-regional care,enhancing specialized medical departments in under-resourced regions,and strengthening coordination between healthcare insurance systems and primary healthcare strengthening initiatives are needed to promote balanced medical resource allocation and reduce the cost burden on patients.

Objective: To systematically evaluate the surgical effect in duct-to-mucosa and invagination groups of pancreaticojejunostomy after pancreaticoduodenectomy. Methods: The Cochrane Library, PubMed, EMbase and CBM data bases were searched to identify randomized controlled trials that compared the postoperative pancreatic fistula, mortality, incidence of complications, delayed gastric emptying, postoperative haemorrhage, infection, reoperate rate, postoperative hospital stay of duct-to-mucosa and invagination for pancreaticcoduodenectomy. Meta-analysis was performed using the software RevMan 5.3. Results: Nine trials with 1 163 patients comparing the duct-to-mucosa group with invagination group were included, the duct-to-mucosa group with 579 patients and the invagination group with 584 patients. The meta-analysis revealed that, compared the duct-to-mucosa group with the invagination group, the rate of postoperative pancreatic fistula was not significantly reduced (RR=1.13, 95%CI: 0.88-1.45, P=0.34), there was no significant difference between the two group. To systematically evaluate the total mortality (RR=0.80, 95%CI: 0.42-1.52, P=0.49), incidence of complications (RR=1.04, 95%CI: 0.88-1.24, P=0.63), delayed gastric emptying (RR=1.26, 95%CI: 0.90-1.76, P=0.18), postoperative haemorrhage (RR=0.86, 95%CI: 0.51-1.44, P=0.57), postoperative infection (RR=1.20, 95%CI: 0.86-1.69, P=0.29), reoperate rate (RR=1.05, 95%CI: 0.62-1.78, P=0.84), postoperative hospital stay (WMD=-1.36, 95%CI: -2.91-0.20, P=0.09) in duct-to-mucosa and invagination groups. There was no significant difference between the two group. Conclusions There was no significant difference of postoperative pancreatic fistul and mortality, incidence of complications, delayed gastric emptying, postoperative haemorrhage, postoperative infection, reoperate rate, postoperative hospital stay in duct-to-mucosa and invagination groups of pancreaticojejunostomy after pancreaticoduodenectomy.

OBJECTIVETo explore the relationship between the occurrence of sub-health and health promotion lifestyle in Guangdong province to provide epidemiological evidences for prevention of sub-health.

METHODSA 1:1 nested case-control study was carried out involving 133 cases from the cohort study paired with 133 control case matched for gender and age.

RESULTSThe univariate conditional logistic regression model showed no significant association of marital status, education level, or body mass index with the occurrence of sub-health, but a significant correlation was found between lifestyle and sub-health with an odd ratio of 5.90 (95% CI: 3.12-11.16, P=0.000). Analysis of the multivariate conditional logistic regression model on the 6 subscales of health promotion lifestyle showed that stress management was significantly correlated with the occurrence of sub-health with an odd ratio of 4.00 (95% CI: 1.54-10.40, P=0.004).

CONCLUSIONA unhealthy lifestyle, especially in terms of stress management, is the major risk factor contributing to the occurrence of sub-health.

Objective To explore the correlation of fatigue with health-promoting lifestyle in the udnergraduate students, so as to provide scientific evidence for the intervention. Methods A cross-section trial was carried out in the undergraduate students from a medical university in Guangzhou. By a self-designed questionnaire, the incidence of fatigue in the undergraduate students was figured out after data processing and statistical analysis. Results A total of 6 100 questionnaires were released, and 5 843 were responded, with a respondent rate being 95.79%. The number of effective questionnaires arrived 5 676. The results showed that the prevalence of fatigue among undergraduate students was 49.6%. The female had a higher risk than the male ( 51.6% vs 45.8%, P<0.01). The prevalence of fatigue in grade 1-3 students was 49.4%, 48.1% and 52.1% , respectively, the difference being insignificant among the three grades (P>0.05). The students with poor level of health-promoting lifestyle had a higher risk of suffering from fatigue (OR=6.647, 95%CI: 4.913-8.993). Conclusion Fatigue is prevalent among the undergraduate students. The incidence of fatigue can be reduced by increasing the level of self-actualization, physical exercise and pressure management.

Objective To investigate the changes of traditional Chinese medical constitution types with menstrual cycle of sub-health state women, thus to explore the affectability of diseases during menstrual cycle. Methods Sub-health State Questionnaire and Menstruation State Questionnaire established in our previous study were used for the epidemiological survey of 330 women outpatients aged 20-45 years admitted by the disease-preventive department of Tianhe District Hospital of Traditional Chinese Medicine. Results In 330 cases, the cases of sub-health state accounted for 64.5%, in which 21.5%had pure sub-health state without any chronic diseases, and 43.0% had sub-health state together with some diseases. The diseases of hyperplasia of mammary glands, vaginitis, cervical spondylosis, hyperlipemia, chronic appendagitis, and uterus myoma had higher morbidity rate in order. At premenstrual phase, constitution types of Qi stagnation, damp heat, and blood stasis had the higher incidences; at menstruation phase, Qi stagnation, blood stasis, and damp heat had the higher incidences; at postmenstrual phase, yang deficiency, Qi deficiency, and damp heat had the higher incidences. Most of the sub-health state women had the complex constitution types, accounting for 93%. Conclusion Traditional Chinese medical constitution types are correlated with menstral cycle of sub-health state women, and show some effects on the affectability and progress of diseases. The investigation results of dynamic changes and the distribution of traditional Chinese medical constitution types during menstrual cycle will supply some evidence for the prevention and treatment of irregular menstruation and sub-health state of the women with Chinese medine.

Objective To explore the relationship between the occurrence of sub-health and health promotion lifestyle in Guangdong province to provide epidemiological evidences for prevention of sub-health. Methods A 1:1 nested case-control study was carried out involving 133 cases from the cohort study paired with 133 control case matched for gender and age. Results The univariate conditional logistic regression model showed no significant association of marital status, education level, or body mass index with the occurrence of sub-health, but a significant correlation was found between lifestyle and sub-health with an odd ratio of 5.90 (95%CI:3.12-11.16, P=0.000). Analysis of the multivariate conditional logistic regression model on the 6 subscales of health promotion lifestyle showed that stress management was significantly correlated with the occurrence of sub-health with an odd ratio of 4.00 (95%CI:1.54-10.40, P=0.004). Conclusion A unhealthy lifestyle, especially in terms of stress management, is the major risk factor contributing to the occurrence of sub-health.

Objective To explore the relationship between the occurrence of sub-health and health promotion lifestyle in Guangdong province to provide epidemiological evidences for prevention of sub-health. Methods A 1:1 nested case-control study was carried out involving 133 cases from the cohort study paired with 133 control case matched for gender and age. Results The univariate conditional logistic regression model showed no significant association of marital status, education level, or body mass index with the occurrence of sub-health, but a significant correlation was found between lifestyle and sub-health with an odd ratio of 5.90 (95%CI:3.12-11.16, P=0.000). Analysis of the multivariate conditional logistic regression model on the 6 subscales of health promotion lifestyle showed that stress management was significantly correlated with the occurrence of sub-health with an odd ratio of 4.00 (95%CI:1.54-10.40, P=0.004). Conclusion A unhealthy lifestyle, especially in terms of stress management, is the major risk factor contributing to the occurrence of sub-health.

Objective To systematically evaluate the postoperative pancreatic fistula rate,overall postoperative morbidity rate,overall postoperative mortality rate and length of stay in external stent group versus no stent group for pancreaticcoduodenectomy.Methods The Cochrane Library,PubMed,Embase and CBM data bases were searched to identify randomized controlled trials that compared the effectiveness of external stent versus no stent for pancreaticcoduodenectany.Meta-analysis was performed using the software RevMan 5.2.Results Four trials with 416 patients comparing external stent with no stent were included,the external stent group with 207 patients and the no stent group with 209 patients.The Meta-analysis revealed that,compared the external stent group with the no stent group,the rate of postoperative pancreatic fistula was significantly reduced in the external stent group [RR =0.57,95％ CI(0.41,0.80),P =0.001],especially for the patinets of pancreatic diameter ≤ 3.0 mm[RR =0.55,95 ％ CI(0.37,0.82),P =0.003] and soft pancreatic [RR =0.67,95 ％ CI(0.45,0.99),P =0.040],the overall postoperative morbidity rate of external stent group versus.no stent group was reduced[RR =0.79,95 ％ CI (0.64,0.98),P =0.030],and length of stay was shortened [WMD =-3.98,95％ CI(-6.42,-1.54),P =0.001].There was no difference between the two groups regarding the postoperative pancreatic fistula rate of diameter ＞ 3.0 mm [RR =0.37,95 ％ CI(0.08,1.83),P =0.220],and the overall postoperative mortality rate [RR =0.86,95 ％ CI(0.28,2.65),P =0.800].Conclusions Exental stent significantly reduced the postoperative pancreatic fistula rate and overall postoperative morbidity rate 、shortened the length of stay,and thus it can be identified as a preferable option for Pancreaticcoduodenectomy.

Objective To investigate the effectiveness of disodium Aidi injection for cancer-related fatigue in nasopharyngeal carcinoma patients of Ⅲ-Ⅳ B stage undergoing radiotherapy and chemotherapy.Methods Eighty nasopharyngeal carcinoma patients of Ⅲ-Ⅳ B stage with fatigue symptoms from December 2011 to May 2012 in our hospital were divided into two groups.All patients received treatment of sequential 3 cycles with platinum-based chemotherapy after concurrent chemoradiation.One group of 40 patients also received intravenous infusion of disodium Aidi injection (experimental group),the other group of 40 patients only received conventional therapy (control group).Brief fatigue inventory (BFI) questionnaires data were collected at baseline,the eighth week and the twentieth week after treatment.The changes of fatigue severity and the occurrence of Ⅲ-Ⅳ degree adverse reactions in the two groups were compared.Results At the eighth week,the improvement in fatigue severity was not significantly different between two groups (x2 =1.758,P =0.32).However,significant improvement in cancer-related fatigue of experimental group was found than that of control group at the twentieth week(x2 =8.12,P =0.005).The Ⅲ-Ⅳ degree adverse reactions of experimental group were significantly lower than that of control group.Conclusion Disodium Aidi injection combined with radiotherapy and chemotherapy can improve the cancer-related fatigue of nasopharyngeal carcinoma patients of Ⅲ-ⅣB stage and it can also reduce the incidence rate of Ⅲ-Ⅳ degree adverse reactions.