OBJECTIVE To establish a interview outline design process and quality control evaluation method based on grounded theory， providing ideas for qualitative research interview outline design in medical fields. METHODS A literature review was conducted to understand the current research status； a preliminary interview outline was developed around the research content. The triangulation method， group evaluation， expert review and pre-interview were adopted to execute the interview outline and conduct quality control. The evaluation indicators and target values were formulated （an average score for the overall quality evaluation of all indicators ≥4.5， and an average score for individual indicators ≥4.00） to evaluate the effect of the interview outline. Taking the research on the mechanism of physicians’ prescribing behavior under the background of Diagnosis Related Groups （DRGs） payment as an example， the methodological contents of above interview outline were applied in practical research. RESULTS The interview outline included basic information and interview questions. The interview questions were divided into three parts：influencing factors survey， promoting and hindering factors of standardizing physician prescription behavior， and communication， with a total of 12 questions. After being reviewed by members of the research group， experts review and pre- interview， a total of 9 people participated in the quality control evaluation of the interview outline. The overall evaluation score was 4.94 （＞4.50）， and the average score of each indicator was greater than 4.00， indicating that the quality of the outline met the requirements for the interview and could be used for the formal interview. CONCLUSIONS The established interview outline design and quality control method based on grounded theory provides ideas for the qualitative research interview outline design in the medical field， and lays the foundation for further using grounded theory to study the influencing factors and mechanisms of physician prescription behavior under the DRG background.

OBJECTIVE: To observe the skin surface microcirculation of acupoints of conception vessel, governor vessel and thoroughfare vessel in patients with primary dysmenorrhea using laser speckle contrast imaging (LSCI), and provide acupoint selection basis of acupuncture-moxibustion for primary dysmenorrhea. METHODS: Ninety-nine healthy female college students with regular menstrual cycles (normal group) and 94 female college students with primary dysmenorrhea (dysmenorrhea group) were recruited. Before menstrual period, on the first day of menstruation, and on the third day after menstruation, LSCI was used to observe the surface microcirculation at the abdominal acupoints of conception vessel, i. e. Yinjiao (CV 7), Qihai (CV 6), Shimen (CV 5), Guanyuan (CV 4), Zhongji (CV 3) and Qugou (CV 2), acupoints of thoroughfare vessel, i. e. Huangshu (KI 16), Zhongzhu (KI 15), Siman (KI 14), Qixue (KI 13), Dahe (KI 12), Henggu (KI 11) and acupoints of lumbosacral region of governor vessel, i. e. Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3), Yaoshu (GV 2) as well as two non-acupoints. RESULTS: Before menstrual period, there was no significant difference in the surface blood perfusion of the acupoints between the dysmenorrhea group and the normal group (P>0.05). On the first day of menstruation, the surface blood perfusion of Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3) and right Huangshu (KI 16) in the dysmenorrhea group was higher than that in the normal group (P<0.05, P<0.01). On the third day after menstruation, the surface blood perfusion of the right Henggu (KI 11) in the dysmenorrhea group was lower than that in the normal group (P<0.05). CONCLUSION In patients with primary dysmenorrhea, on the first day of menstruation, the surface blood perfusion of Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3) of governor vessel, and the right Huangshu (KI 16) of thoroughfare vessel is increased, while on the third day after menstruation, the surface blood perfusion of the right Henggu (KI 11) of thoroughfare vessel is decreased. These findings might provide a basis for acupoint selection in the acupuncture-moxibustion treatment of primary dysmenorrhea.
Humans ; Female ; Microcirculation ; Dysmenorrhea/therapy* ; Menstrual Cycle ; Acupuncture Points ; Acupuncture Therapy

BACKGROUND: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in adults with type 2 diabetes (T2D). The aim of this study was to determine the CV risk in Chinese patients with T2D based on the 2019 European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD) guidelines on diabetes, pre-diabetes, and CV diseases. METHODS: A total of 25,411 patients with T2D, who participated in the study of China Cardiometabolic Registries 3B study, were included in our analysis. We assessed the proportions of patients in each CV risk category according to 2019 ESC/EASD guidelines. RESULTS: Based on the 2019 ESC/EASD guidelines, 16,663 (65.6%), 1895 (7.5%), and 152 (0.6%) of patients were included in "very high risk," "high risk," and "moderate risk" categories, respectively. The proportions of patients in each category varied based on age, sex, body mass index, and duration. While 58.7% (9786/16,663) of elderly patients were classified to "very high risk" group, 89.6% (3732/4165) of patients with obesity were divided into "very high risk" group. Almost all patients with a duration of diabetes >10 years had "very high risk" or "high risk." However, 6701 (26.4%) of Chinese T2D patients, who had shorter duration, and one or two risk factors, could not be included in any category (the "unclear risk" category). CONCLUSIONS In China, most patients with T2D have "very high" or "high" CV risk based on 2019 ESC/EASD guidelines. However, the risk of patients in "unclear risk" group needs to be further classified.
Adult ; Aged ; Cardiovascular Diseases/epidemiology* ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; Heart Disease Risk Factors ; Humans ; Risk Factors

Objective: To determine health risk behaviors and cluster patterns among adolescents from four minorities in rural of Wuling mountainous area, and to provide a reference for health education for adolescents in ethnic minority areas. Methods: Totally 4 162 teenagers from 8 rural middle schools of Xiangxi Tujia and Miao Autonomous Prefecture, Dong Autonomous County of Tongdao, Huaihua, Bai Minority Village of Sangzhi County, Zhangjiajie, were selected with multi-stage stratified random cluster sampling and surveyed with a questionnaire to collect information on health risk behaviors from September to October, 2018. Cluster patterns of health risk behaviors were analyzed by sex by two-step cluster method. Results: The occurrence rates of the behaviors of the adolescents from four minorities of smoking, drinking, walking violations, unsafe swimming, fighting, suicide idea, feeling lonely constantly, frequent sleeplessness, depression, internet addiction were 18.9%, 31.0%, 49.6%, 32.3%, 28.6%, 18.3%, 16.3%, 12.4%, 16.3%, 6.7% respectively, among which the highest occurrence rates were Tujia teenagers’ fight(31.4%), Miao teenagers’ unsafe swimming(45.1%), Dong teenagers’ drinking(34.8%), Bai teenagers’ walking violation(52.9%). And the differences were statistically significant(P<0.05). Among the lowest risk group, there were 322 male students (16.4%) and 496 female students (22.5%); Among the moderate low group, there were 377 male students (19.3%) and 536 female students (24.3%); Among the implicit behavior high risk group, there were 518 male students (26.5%) and 758 female students(34.4%);Among the explicit behavior high risk group, there were 741 male students (37.8%) and 414 female students(18.8%). 23.1% of teenagers engaged in four or more types of health risk behaviors, with male higher than that of female(χ2=183.52, P<0.01), and the rate of Miao teenagers (28.2%) was the highest. Conclusion Health risk behaviors among minority adolescents in Wuling rural areas are prevalent and varied in ethnicity. Clustering of explicit risk behaviors in boys and implicit risk behaviors in girls were obvious. The hierarchical guidance and comprehensive intervention should be carried out on the basis of the characteristics of different minority teenagers’ health risk behaviors.

Objective To investigate causes of abdominal distension in patients with invasive mechanical ventilation,and to explore the related nursing strategies.Methods Totals of 142 patients withinvasive mechanical ventilation who were treated in a class Ⅲ grade A hospital in Changsha from October 2015 to October 2016 were enrolled in the study. Retrospective analysis was used to investigate the reasons for concurrent abdominal distension based on the medical records.Results Approximately 34.5% (49/142) patients had concurrent abdominal distension. The univariate analysis showed that the influencing factors included:invasive mechanical ventilation time,blood potassium concentration,cuff pressure,and RASS sedative score (P<0.05). Multivariable Logistic regression suggested that the risk factors for concurrent abdominal distension included long invasive mechanical ventilation time (≥96 h) and RASS score. High cuff pressure (≥25 cmH2O) was protective factors against abdominal distension.Conclusions The incidence of abdominal distension is relatively higher in patients with invasive mechanical ventilation,which affects their ventilation effect. The related treatment and nursing care should be focused on the influencing factors to reduce the risk of abdominal distension.

Objective To evaluate the perioperative period safety of improved transurethral plasma kinetic enucleation of prostate (TUPKEP) in high-risk benign prostatic hyperplasia (BPH) patients with coronary heart disease (CHD).Methods One hundred and twenty-eight BPH patients were selected,24 patients had CHD (with CHD group),among whom 10 patients were given transurethral vapor-resection of prostate (TUVP),and 14 patients were given improved TUPKEP; 104 patients didn't have CHD,among whom 22 patients were given TUVP,and 82 patients were given improved TUPKEP.The serum endothelin (ET)-1 was measured by specific radioimmunoassay at preoperative 2 h and postoperative 1,2,6 d,and complication was observed.Results All the patients were cured by operation,and left hospital smoothly.There were no statistical differences in the preoperative 2 h serum ET-1 in with CHD group and without CHD group (including all TUVP patients and improved TUPKEP patients) (P ＞ 0.05).The postoperative 1 and 2 d serum ET-1 levels of TUVP patients were significantly higher than those of improved TUPKEP patients,in with CHD group:(114.09 ± 15.33) ng/L vs.(94.77 ± 12.14) ng/L and (99.67 ± 9.87) ng/L vs.(88.21 ± 9.55) ng/L; in without CHD group:(70.21 ± 12.44) ng/L vs.(53.67 ± 9.02) ng/L and (61.18 ± 9.52) ng/L vs.(48.54 ± 9.15) ng/L,and there were statistical differences (P ＜ 0.05).There were no statistical differences in postoperative 6 d serum ET-1 in TUVP patients and improved TURKEP patients (P ＞ 0.05).In with CHD group,5 patients had ischemic ST-T change in the early postoperative period,and 3 patients had angina pectoris.They all were promptly treated,and the events were controlled.Serious complications did not present such as acute myocardial infarction (AMI),acute heart failure and sudden cardiac death,etc.Conclusions The postoperative BPH patients have vascular endothelial injury catholically,especially the high-risk patients with CHD.Furthermore,it might be one of the causes of the postoperative adverse cardiovascular events.Compared with TUVP,improved TUPKEP has a minor impact on vascular endothelial function,and it can reduce the postoperative adverse cardiovascular events in the BPH patients with CHD.Improved TUPKEP is a relatively safer surgical method for high-risk BPH with CHD.

Objective:To experimentally intervene safe injection by medical staff in basic-level hospitals and observe the recent and long-term effect atfer the intervention and to provide practical measures to improve safe injection. Methods:We used random sampling methods to set up groups in county hospitals and township hospitals of Hunan Province, and offered lectures, delivered safe injection guide, brochure and on-site guidance in the experimental group. We surveyed the 2 groups atfer the intervention at 1 month and 6 months to compare the effect of unsafe injection behaviors and safe injection behaviors. Results:One month after the intervention, the unsafe injection rate in the experimental group decreased from 27.8%to 21.7%, while in the control group injection the unsafe injection rate rose from 26.0%to 27.9%, with signiifcant difference (P<0.01). Six months atfer the intervention, the unsafe injection rate in the experimental group declined to 18.4%while the unsafe injection rate in the control group also dropped to 22.4%, with signiifcant difference (P<0.01). Unsafe injection rate was decreased in the experimental group at different intervention points, with signiifcant difference (P<0.01). The safe injection behavior scores in the experimental group were higher than those in the control group after the intervention of 1 month and 6 month intervention (P<0.01);the experimental group got higher scores atfer the intervention (P<0.01). Conclusion:Training of safe injection, distribution of safe injection guide, and comprehensive intervention model can significantly change the primary care practitioners’ behaviors in unsafe injections and it is worth promoting.

Objective To characterize the baseline status of Chinese diabetic patients based on data derived from Chinese cohort from SOLVETM study.Methods Patients with type 2 diabetes initiating basal insulin detemir at the decision of the physician were eligible for the study.Data on demographics,medical history,glycemic profile and treatment regimen at baseline were collected by physicians.Results A total of 3272 patients [female 42％,male 58％,mean age (56.2 ± 10.8) years] were included in the study.Their BMI was (25.3 ± 3.3) kg/m2.The duration of diabetes was 4.0 (0.1-27.0) years,and the duration of treatment with oral antidiabetic drugs (OADs) was 3.0(0.0-20.2) years.The proportions of subjects with diabetic macro-and micro-vascular complications were 15.8％ (515 cases) and 27.1％ (866 cases),respectively.The hemoglobin Al c (HbAl c) at baseline was (8.33 ± 1.70) ％,and the fasting blood glucose (FPG) was (9.5 ± 2.6) mmol/L.Conclusions A large proportion of patients with type 2 diabetes remain in poor glycemic control,and the prevalence of diabetic complications is high,which requires optimal therapeutic strategy for the patients with suboptimal glycemic control.

OBJECTIVETo investigate the composition and resistance of main pathogens isolated form Lower respiratory tract in coalminer's pneumoconiosis patients complicated with infection to provide the basis for clinical treatment.

METHODCoalminer's pneumoconiosis patients complicated with infection during 2009 to 2010 were divided into mechanical ventilation group and non mechanical ventilation group. Specimens were obtained from lower respiratory tract by fibrobronchoscopy with protected specimen brush in patients of both groups to perform isolation, culture, identification and susceptibility test of pathogen.

RESULTTotal 111 patients were enrolled, 36 of them in mechanical ventilation group and 75 patients in non mechanical ventilation group. The pathogenic bacteria detection rate of patients in mechanical ventilation group was significantly higher than that of patients in non mechanical ventilation group (88.9% vs. 46.7%, P < 0.01). In non mechanical ventilation group, Mycobacterium tuberculosis was detected in 3 patients, and 27 strains of G- bacilli, 3 strains of G+ coccus, and 2 strains of fungus; and 26 strains of G- bacilli, 3 strains of G+ coccus, and 3 strains of fungus were detected in mechanical ventilation group. There was no significant difference in term of strains between the two groups (P > 0.05). Rate of resistance to main antibiotics of patients in mechanical ventilation group was higher than that of patients in non mechanical ventilation group.

CONCLUSIONResistance of pathogenic bacteria isolated from lower respiratory tract was severe in coalminer's pneumoconiosis patients complicated with infection, which was higher in patients treated with mechanical ventilation than patients without mechanical ventilation. Mycobacterium tuberculosis and fungal infection and increasing resistance prompted that clinicians must attach importance to rational drug use and keep to monitoring bacterial resistance.

Aged ; Aged, 80 and over ; Anthracosis ; microbiology ; Drug Resistance, Bacterial ; Humans ; Male ; Middle Aged ; Mycobacterium tuberculosis ; drug effects ; isolation & purification ; Respiration, Artificial ; adverse effects ; Respiratory Tract Infections ; microbiology

Objective To study the effect and possible mechanism of Apelin in candate on the pain behavior of rat. Methods Tail flick latency(TFL)of rat was taken as pain threshold and radiant heat as nociceptive stimulus. Microinjected Apelin into rat's caudate to observe the effect of Apelin on modulating of pain in CNS and then to study the interaction between Apelin and morphine in modulation of pain.And the contents of cAMP and cGMP in candate tissue and blood plasma were detected.Results Compared with control groups,the pain threshold of rat decreased when Apelin Was injected into caudate alone.Injected 0.5μl Apelin of 10~(-4) moL/L into rat caudate 10 min later,the pain threshold of rat Was reduced(-9.22±1.26)%and 40 min later(-16.95±1.46)%compared with normal saline group(-0.32±1.2)%,(0.17±0.80)%),and it had statistical significance(P<0.01).The contents of cAMP in caudate Was(14.08±2.25)nmol/g and blood plasma(19.94± 4.43)nmol/L compared with normal saline(133.05±20.41)nmol/g,(38.66±6.73)nmol/L,and they had statistical significance(P<0.01).Conclusions Apelin can facilitate the pain behavior of rat induced by radiant heat stimulus and consequently plays a hyperalgesia role in CNS.Apelin may have interaction with morphine and display its hyperalgesia effect through the intracellular second messenger cAMP.