Objective Meta-analysis was used to summarize the current status of medication adherence in patients with type 2 diabetes mellitus and to clarify the characteristics of people with low medication adherence.Methods Relevant literatures were searched in Pubmed,Cochrane Library,Web of Science,Embase,CINAHL,CBM,China National Knowledge Infrastructure,Wanfang Data,and VIP.Two researchers conducted literature screening,data extraction and quality evaluation.Stata 16.0 software was used for subgroup analysis,sensitivity analysis,offset analysis.Results A total of 42 papers were included,and the overall medication adherence of middle-aged and elderly type 2 diabetes patients ranged from 18.37%-96.53%.The medication adherence was higher among those with high education level(63%),married(61%),not living alone(50%),monthly income>3000 RMB/month(64%),having medical insurance(49%),good psychological status(61%),no chronic co-morbidities(66%),having knowledge about the disease(53%),taking≤3 types of medication(58%),convenient access to medical care(58%),and good doctor-patient relationship(50%).Conclusion The medication adherence of patients with type 2 diabetes mellitus varies greatly among different subgroups.In the future,the specific influencing factors should be further explored to formulate targeted policies and intervention measures to improve patients'medication adherence and improve their health and quality of life.

Objective To systematically evaluate the efficacy and acceptability of non-pharmaceutical intervention(NPI)for depression in patients with mild cognitive impairment(MCI).Methods Randomized controlled trials of NPI in treatment of depression patients with MCI published in PubMed,Embase,Web of Science,CINAHL,Cochrane Library,CNKI,Wanfang Data,VIP and CBM databases were searched from self-built databases to January 6,2024,and performed a network Meta-analysis using Stata 14.0 software.Results A total of 55 literatures were included,involving 10 NPIs.According to the surface under the cumulative ranking curve(SUCRA),the top 3 curative effects were cognitive behavioral therapy(CBT),Chinese traditional sport(CTS)and art therapy,the top 3 acceptability were CBT,CTS,and health education.Conclusion CBT and CTS may be effective and acceptable NPI for improving depression in patients with MCI,and individualized interventions can be tailored to the patient's situation to achieve the best results.

Objective To evaluate the influencing factors of loneliness in older adults.Methods Embase,Cochrane Library,PubMed,Web of Science,VIP,CNKI,Wanfang data and SinoMed were searched for research studies on loneliness in older adults from the establishment of the database to February 2024,and performed Meta-analysis using Stata 14.0 software.Results A total of 32 studies involving 46 439 lonely older adults were included,and 19 influencing factors were extracted.The result of Meta-analysis showed that being female,having low literacy,having chronic diseases,having poor health self-assessment,having depression,having fewer social activities,having poor economic status,having low social support,having poor marital status,having fewer social contacts,and living alone were the influencing factors of loneliness among older adults(P＜0.05).Conclusions There are a number of influencing factors that contribute to loneliness in older adults,which can be targeted for interventions to improve mental health issues in older adults.

Objective: To investigate the association between parenting style and sleep problems among school aged children with autism spectrum disorder (ASD). Methods: A total of 98 children with ASD aged 6-10 years old and 98 age and gender matched typically developing (TD) children from mainstream schools were recruited. Parenting style and sleep problems were measured via Parent Behavior Inventory (PBI) and Children s Sleep Habits Questionnaire(CSHQ), respectively. The symptom severity and intelligence level were also evaluated. Generalized linear model was used to analyze the relationship between parenting style and sleep problems. Results: There was no statistically significant difference in the parenting style of the two groups of children( P > 0.05 ); weekend sleep time of children with ASD was significantly shorter than that of the TD group [(9.1±0.7)(9.5±0.8)h, P < 0.01 ], and the score of sleep onset delay was significantly higher than that of the TD group[(1.8±0.7)(1.5±0.7), P <0.01]. However, there was no statistically significant difference in the incidence of total sleep problems and various problems between the two groups of children( P >0.05). The parental support/engagement of children with ASD was negatively associated with the total score of sleep problems( β=-2.68, 95%CI =-4.88--0.47), bedtime resistance ( β=-1.65, 95%CI =-2.54--0.77) and sleep anxiety( β=-1.01, 95%CI =-1.70--0.32). The parental hostility/coercion was positively correlated with score of daytime sleepiness( β=1.41, 95%CI =0.53-2.29)( P <0.05). Conclusion Parenting style of support/engagement is associated with lower sleep problems in children with ASD, while hostile/coercion is associated with higher sleep problems. It should be improve parental style to reduce the sleep problems in children with ASD.

Objective: To investigate the associations between early life exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM 2.5 ) and the risk of autism spectrum disorder (ASD) among school aged children. Methods: A total of 165 children with ASD and 165 age and gender matched typical development (TD) children were recruited. Children s basic information were obtained via questionnaires, and the severity of ASD symptoms was assessed with Social Responsiveness Scale (SRS). Early life PM 2.5 exposure (preconception, entire pregnancy, and the first two years after birth) were extracted from the Tracking Air Pollution in China (TAP) datasets. Conditional Logistic regression and generalized linear model were used to evaluate the associations of early life exposure to PM 2.5 with the risk and the ASD severity symptoms, respectively. Results: The PM 2.5 exposure of ASD group during preconception[(55.08±9.34)μg/m 3], entire pregnancy[(50.44±8.71)μg/m 3], the first year after birth [(45.04± 8.25 )μg/m 3] and the second year after birth [(40.19±7.12)μg/m 3] were significant higher than those in TD children [(47.66± 7.63 , 44.19±7.16, 38.95±6.07, 35.76±5.65)μg/m 3]( t =7.94, 7.13, 7.70, 6.32, P <0.05). After adjusting for potential confounding, each increase of 1 μg/m 3 in PM 2.5 was associated with higher risk of ASD during preconception ( OR=1.21, 95%CI =1.13-1.29), entire pregnancy( OR=1.18, 95%CI =1.11-1.26), the first year after birth ( OR=1.30, 95%CI =1.18-1.43) and the second year after birth ( OR=1.29, 95%CI =1.17-1.42). No similar results were observed regarding the analyses of SRS total and sub scale scores( P >0.05). Conclusion Early life exposure to PM 2.5 is relate to the risk of ASD, these findings indicated that more attention should be paid to ambient PM pollution in the early life prevention and control of ASD.

Objective:To explore the application effect of the "4M1E" comprehensive management mode (man, machine, material, method, environment) in ultrasonic examination, and to provide reference for the health management center of hospitals to formulate reform measures to improve the quality and efficiency of ultrasonic examination.Methods:By adoping a non-randomized controlled research, a total of 400 clients who underwent physical examination in the Health Management Center of Zhujiang Hospital, Southern Medical University were selected as subjects by convenience sampling method. Among them, 200 clients who underwent physical examination from August to October 2021 were selected as the control group to implement routine physical examination mode, another 200 clients who underwent physical examination from August to October 2022 were selected as the experimental group to implement the "4M1E" comprehensive management mode. The ultrasonic examination time, passing rate, bladder filling, pre-examination knowledge score and satisfaction of the two groups were compared.Results:The ultrasonic examination time of experimental group was (9.54 ± 3.25) min, lower than (12.33 ± 5.07) min of control group, and the difference was statistically significant ( t=6.53, P<0.05). The passing rates of ultrasonic examination at 1 time, 2 times and 3 times in the experimental group were 86.0% (172/200), 12.0% (24/200) and 2.0% (4/200), respectively, which were better than 73.5% (147/200), 20.5% (41/200) and 6.0% (12/200) in the control group with statistical significance ( χ2=10.05, P<0.05); the proportions of overfilling, proper filling and poor filling in the experimental group were 1.0% (2/200), 86.0% (172/200) and 13.0% (26/200), respectively, which were better than 2.0% (4/200), 70.0% (140/200) and 28.0% (56/200) in the control group, the differences of two groups were statistically significant ( χ2=14.93, P<0.05). Pre-examination knowledge score of experimental group (8.16 ± 1.43) was higher than that of control group (6.19 ± 1.94) points, and the difference was statistically significant ( t=-11.48, P<0.05). The overall satisfaction score of the experimental group (20.55 ± 2.46) was higher than that of the control group (18.45 ± 2.86). The differences was statistically significant ( t=-7.87, P<0.05). Conclusions:The "4M1E" comprehensive management mode can make physical examination clients fully prepare for the examination, reduce the time of ultrasonic examination, complete the examination efficiently, and comprehensively improve the sense of experience and satisfaction.

Objective:The standardized medical device clinical trials in China began in a short time, and the quality of trials needs to be improved.This article intends to explore possible ways for the improvement of quality management of the medical device clinical trials.Methods:Through working practice and literature review, analyze the current status of medical device clinical trials and in vitro diagnostic reagent in China; put forward targeted improved measures for the quality management system; as well as verify its feasibility through practice.Results:This article summarizes three factors that limit the improvement of the quality of medical device clinical trials, including the insufficient research and development strength of sponsors, the limited professional level of research teams, and the differences in verification and drugs, based on the risk-based quality management concepts, puts forward improved measures from three aspects, which including building risk-based quality certification system, making full use of electronic information systems to ensure the trial quality, and strengthening training of clinical trial capacity of researchers, and verifies the feasibility of these measures via the practical experience of our hospital since 2016.Conclusions:The application of risk-based quality management system, electronic information system and clinical trial capacity training can improve the management quality for medical device clinical trial centers.

Objective:To investigate the cognition and knowledge of cardiopulmonary resuscitation (CPR) among primary school students in Guangzhou and to explore the intervention effect of CPR training.Methods:A total of 238 students from a primary school in Guangzhou were selected as the research subjects from April 22 to 26, 2019. In March 2019 (before the training) , a self-made questionnaire was used to conduct a knowledge survey on CPR, and the training methods and contents of CPR were formulated according to the survey results. Knowledge survey was carried out again on the day after every training, and the training effect was evaluated.Results:Before the training, the correct answer rates of 221 elementary school students to the questions about compression only without artificial respiration, emergency call, external chest compression position, compression speed and compression depth were 6.3%, 95.0%, 89.6%, 24.4%, and 24.0%, respectively. After the training, the correct answer rates of 233 primary school students were 59.2%, 99.6%, 99.6%, 63.5% and 70.0%, respectively. The correct rates after training were higher than those before training, and the differences were statistically significant ( P<0.05) . Before and after the training, there was no statistically significant difference in the proportion of students who thought it necessary to learn CPR and were willing to perform CPR on strangers ( P>0.05) . Conclusions:The knowledge and skills of cardiopulmonary resuscitation of primary school students in Guangzhou without cardiopulmonary resuscitation training are low. It is recommended that schools and education departments at all levels pay attention to the promotion and training of first aid skills, formulate training programs suitable for the physical and mental characteristics of primary school students and improve students' self-help and mutual rescue capabilities.

Objective To explore the effects of virtual reality (VR) on skill retention and retraining time of cardiopulmonary resuscitation (CPR) among medical students.Methods From May to November 2018, we selected students majored in clinical medicine of two classes in a medical university of Guangdong Province by convenience sampling. All of them were randomly divided into two groups taking class as the unit, 30 cases in each group with CPR training by VR and scenario simulation respectively. Examination scores of CPR skills were carried out at the end of training, one and six months after training to compare achievements between two groups. Results At the end of training and one month after training, the examination scores of CPR skills of students in the VR group were (95.426±4.296) and (92.326±7.753) respectively higher than those in the scenario simulation group (t=8.204, 4.797;P<0.05). Six months after training, there was no statistical difference in the examination score between the VR group (87.054±10.323) and the scenario simulation group (81.550±9.241), (t=2.176,P>0.05).Conclusions VR training is propitious to maintain students' CPR skills and to extend the retraining time of skills which provides a new method for medical education.

Objective To investigate the level about illness perception in patients with coronary heart disease. Methods From July to De-cember, 2015, 198 inpatients with coronary heart disease who were admitted into hospitals twice or more were enrolled. They were assessed with Illness Perception Questionnaire-Revised (IPQ-R). Results The score of common symptoms was (4.55±1.64). The symptoms, for exam-ple, chest pains, uncomfortable feeling in chest, cold sweat, flustered and breathlessness were most frequently experienced and most often identified. For the illness perception part, the scores on subscales of treatment control and consequences were higher than 3, which was the neutral point. For the cause dimension part, the highest scores was (3.38 ± 0.90) in diet or eating habits, followed by (3.38 ± 0.89) in aging. Among these factors, immune factors had the highest mean score, followed by stress factor. Conclusion The level of illness perception in pa-tients with coronary heart disease was in the middle level, and individual differences were obvious. The awareness of the disease and the in-tervention of the patient should be strengthened.