Objective:To analyze the relationship among self-efficacy, family support and diabetes self-management behavior in rural patients with type 2 diabetes mellitus, and to explore the mediating role of self-efficacy between self-management behavior and family support in rural patients with type 2 diabetes mellitus.Methods:From June to July 2023, Jingde county in southern Anhui, Jinzhai county in central Anhui, and Mengcheng county in northern Anhui were selected by multistage stratified cluster random sampling method as investigation sites. A total of 258 patients with type 2 diabetes mellitus were investigated by face-to-face survey. The questionnaire included general situation survey from, the summary of diabetes self-care activities measure, the self-efficacy for diabetes and diabetes family behavior checklist. SPSS 25.0 and AMOS 26.0 softwares were used for descriptive analysis, correlation analysis, common method bias test and mediation analysis.Results:The self-management behavior score of rural patients with type 2 diabetes mellitus was(2.15±0.96).The self-efficacy score was(28.50±7.02).The family support score was(29.37±9.45).Self-efficacy and family support were positively correlated with self-management behavior( r=0.390, 0.333, both P<0.01), and family support was positively correlated with self-efficacy( r=0.511, P<0.01). Self-efficacy played a partial mediating role between self-management behavior and family support in rural patients with type 2 diabetes, and the mediating effect accounted for 45.2%(0.147/0.325) of the total effect. Conclusion:Family support not only has direct influence on self-management behavior of rural patients with diabetes mellitus, but also has indirect influence on self-management behavior by improving self-efficacy.

Objective:To analyze the relationship among self-efficacy, family support and diabetes self-management behavior in rural patients with type 2 diabetes mellitus, and to explore the mediating role of self-efficacy between self-management behavior and family support in rural patients with type 2 diabetes mellitus.Methods:From June to July 2023, Jingde county in southern Anhui, Jinzhai county in central Anhui, and Mengcheng county in northern Anhui were selected by multistage stratified cluster random sampling method as investigation sites. A total of 258 patients with type 2 diabetes mellitus were investigated by face-to-face survey. The questionnaire included general situation survey from, the summary of diabetes self-care activities measure, the self-efficacy for diabetes and diabetes family behavior checklist. SPSS 25.0 and AMOS 26.0 softwares were used for descriptive analysis, correlation analysis, common method bias test and mediation analysis.Results:The self-management behavior score of rural patients with type 2 diabetes mellitus was(2.15±0.96).The self-efficacy score was(28.50±7.02).The family support score was(29.37±9.45).Self-efficacy and family support were positively correlated with self-management behavior( r=0.390, 0.333, both P<0.01), and family support was positively correlated with self-efficacy( r=0.511, P<0.01). Self-efficacy played a partial mediating role between self-management behavior and family support in rural patients with type 2 diabetes, and the mediating effect accounted for 45.2%(0.147/0.325) of the total effect. Conclusion:Family support not only has direct influence on self-management behavior of rural patients with diabetes mellitus, but also has indirect influence on self-management behavior by improving self-efficacy.

Objective To clarify the clinical significance of visit-to-visit variability in blood pressure (BP) of stage 3-4 chronic kidney disease (CKD) patients with hypertension.Methods One hundred and fifty-two cases of stage 3-4 CKD patients with hypertension were enrolled in the study.Variability in BP was defined as the standard deviation (SD) in BP.For each patient,SD and mean BP from BP measurements were calculated at all the visits.Correlations between the decline in estimated glomerular filtration rate (eGFR) and SD in BP were analyzed by multivariable regression.Results Visit-to-visit variability in BP was significantly associated with renal function decline (P ＜ 0.05),in addition,baseline eGFR,baseline albuminuria and mean SBP during follow-up were significantly associated with renal function decline as well (all P ＜ 0.05).The percentage of CCBs used in low SD of the SBP group was higher than that in high SD of the SBP (76.1％ vs 58.2％,P ＜ 0.05).Conclusion Visit-to-visit variability in BP is significantly associated with renal function decline.Drugs which can decrease the variability of blood pressure should be the first choice in the treatment of hypertension.

Objective To evaluate the effect of cardiovascular disease (CVD) on the healthcare costs associated with chronic kidney disease (CKD).Methods A total of 96 patients with stage 3-4 CKD treated at CKD clinic of Beijing Friendship Hospital,Capital Medical University were enrolled in the study.Their mean age was (61.6±9.5) years including 65 male and 31 female patients.A retrospective analysis of clinical material and health claims between January 2010 and October 2010 was conducted.Firstly,patients were grouped according to median CKD-associated healthcare cost and clinical characteristics were compared between two groups.Secondly,patients were stratified into three categories based on CVD prevalence (with acute cardiovascular events,with CVD but no acute events,and without CVD),and CKD-associated healthcare costs were assessed among the groups.Finally,the potential factors influencing CKD-associated healthcare costs were evaluated by optimal scaling regression analysis.Results During January to October in 2010,median CKD-associated healthcare costs was 13960.5 yuan (interquartile range 10226.5,19667.2 yuan).In the group with higher healthcare costs,more females,greater urine albumin-creatinine ratio,more emergency observations and/or hospitalizations caused by acute cardiovascular events,higher diabetes mellitus prevalence and calcium-phosphorus products,and lower eGFR and hemoglobin levels were found (P＜0.05,respectively).In contrast,the total prevalence of CVD was not significantly different between the groups (P=0.386).When grouping by CVD prevalence,significant differences of CKD-associated healthcare costs were observed only between patients with acute cardiovascular events and the other two groups (P＜0.01,respectively).The median healthcare cost of the former was approximately twice as higher as that of the other two groups,and the maximal cost was also found in the acute-cardiovascular-event group.For the optimal scaling regression analysis,both emergency observations and/or hospitalizations caused by acute cardiovascular events and diabetes mellitus entered the equation,and standardized coefficients were -0.538 and -0.217 respectively (P＜0.01 and P＜0.05).Conclusions Emergency observations and/or hospitalizations caused by acute cardiovascular events are important factors inducing high CKD-associated healthcare costs in patients with stage 3-4 CKD.Therefore,the prevention of acute cardiovascular events may be favorable to reduce CKD-associated healthcare costs.Larger and longer-time perspective studies are required to confirm it.In addition,diabetes mellitus also influences CKD-associated healthcare costs.

Objective To elucidate the biocompatibility differences of 4 dialyzers with different membranes in maintenance hemodialysis (MHD)patients. Methods A total of 60 MHD patients were enrolled in the prospective,randomized,control,cohort study.In baseline,synthetic polysulfone(PS)membrane dialyzer was used in all the patients for at least 3 months.Then the patients were randomly divided into three groups:ployethersulfone(PES)membrane group,cellulose triacetate (CTA)membrane group,and synthetic polymethylmethacrylate(PMMA)membrane group.Study duration was 6 months.No dialyzer was reused.The biocompatibility markers were detected repeatedly at different time points and compared with each other in different dialyzer groups. Results The blood levels of high sensitive C reactive protein,interleukin-1β and interleukin-13 were not significantly different among different groups on every time point.However,the blood complements levels and WBC count were significantly different among four kinds of dialyzer.When the dialyzers changed from PS to PMMA membrane,C3a levels and WBC count changed significantly(P＜0.05).Moreover,the change of C5a level was significantly different between PES group and PMMA group on month 3(P＜0.05). Conclusion There are some differences of biocompatibiliy among different dialyzer membranes.