Objective: To explore the trajectory of the development of permanent caries in 12- to 16-year-old students in Liuyang and to provide a reference for the prevention and management of caries. Methods: Primary and secondary school students who were registered within the Liuyang jurisdiction were screened for caries from September to November by the Liuyang Center for Disease Control and Prevention. A total of 7 297 students between the ages of 12 and 16 years with complete permanent dentition caries monitoring records and traceable deciduous dentition caries monitoring records were selected from 2013 to 2019, and a zero-inflated negative binomial-latent class growth model (ZINB-LCGM) was established to describe the trajectory of the development of individual caries using the decayed missing filled teeth (DMFT) indicators. Results: DMFT of 12- to 16-year-old students in Liuyang were mainly decayed teeth (DT), with the majority occurring in the first permanent molar. According to the ZINB-LCGM model, the students were classified into three latent categories, "slow growth pattern" (28.55%), "rapid growth pattern" (6.59%), and "stable pattern" (64.86%), which followed different nonlinear caries growth trajectories. Females with deciduous teeth caries were more likely to have trajectories showing a “rapid growth pattern” and a “slow growth pattern”. There were significant differences in the trajectories between men and women, as well as between those with and without primary dentition caries. Conclusion The trajectory of the development of caries in 12-16-year-old students shows heterogeneity in terms of different developmental patterns of latent categories, suggesting that females with deciduous dental caries should receive more attention.

The causes for male sexual orientation are complicated, which have not yet been clarified. Recent years have witnessed fruitful progress in the field of biology, while the impact of environment has received little attention. Adverse childhood experiences (ACEs), identified as a special environment in the early stage of development, can affect the individual phenotype by DNA methylation. Given the relationships among male sexual orientation, ACEs, and DNA methylation, as well as based on the existing theory, this article proposes the model "ACEs-DNA methylation-male sexual orientation"from the perspective of environment and epigenetics, aiming to provide a theoretical basis for future research.
Adverse Childhood Experiences ; Child ; DNA Methylation ; Female ; Humans ; Male ; Sexual Behavior

OBJECTIVES: To analyze the cost-effectiveness of the Morse Fall Scale by clinical big data for nurses in the prevention of falls in hospitalized patients. METHODS: A total of 59 358 hospitalized patients, who came from the Third Xiangya Hospital of Central South University in 1 year before nurses were trained by the Morse Fall Scale, served as a control, including 26 862 males and 32 496 females. While the 66 203 hospitalized patients served as an observation group in 1 year after nurses were trained by the Morse Fall Scale, including 29 881 males and 36 322 females. The time spent by clinical nurses in the fall-risk assessment and the fall number were recorded in the 2 groups, and the relationship was analyzed between the Morse Fall Scale assessment and the clinical ending along with the labor cost of nursing. The cost-effectiveness was analyzed. In addition, the incidence of fall in the observation group was compared between the falling high-risk patients and the non-high-risk patients. RESULTS: The Morse Fall Scale showed that the incidences of fall in the observation group and the control group were 3.39/100 000 and 3.82/100 000,respectively, there was no significant difference between the 2 groups ( CONCLUSIONS The evaluation of the Morse Fall Scale has a certain effect, but it is limited in the prevention of falls in adult hospitalized patients, and the cost-effectiveness analysis is not good. It is recommended to implement the intervention measures for high-risk patients after the assessment, which may improve the management level and efficiency of fall prevention.
Adult ; Cost-Benefit Analysis ; Female ; Humans ; Incidence ; Inpatients ; Male ; Risk Assessment

Objective:To explore the influential factors for hospitalization costs regarding the final phase of malignant tumor patients in Shanghai,and to explore the relevant policy for reasonable control of hospitalization costs.Methods:A total of 10 065 patients with malignant tumors were enrolled in this study.The multiple linear regression analysis was used to seek the determinants for hospitalization cost of malignant tumor patients during the final phase.Results:The median length of hospital stay was 43 days for the patients,with an average age of (70.73±12.87) years.Among them 61.66％ of hospitalized patients were male and the median hospitalization cost of malignancy was 55 447.84 yuan.Hospitalization cost showed the linear regression relationship with type of health care,hospital level,hospital types,tumor types,length of hospital stay,surgery,age,gender,and time from hospital admission to death.Conclusion:Proximity to death in malignant tumor patients is an important factor for the hospitalization cost.Medical resources should be allocated rationally,and the comprehensive measures should be taken to control the cost reasonably.

Objective:To analyze the prevalence and influential factors for asthma among adults in Chinese.Methods:Chinese residents aged ≥ 18 years in 12 regions were enrolled to estimate the prevalence of asthma in adults with different characteristics.Multivariate logistic regression analysis were adopted to determine the influential factors for asthma based on the China Health and Nutrition Survey in 2009 and 2011.Results:The prevalence of asthma was 1.25％ (95％CI 1.06％ to 1.43％) among the entire adult population in China.There were significant differences in terms of age,gender,regions,city and countryside,smoking,body mass index (BMI),education levels,marriage and subjective wellbeing (SWB)(all P＜0.05).Compared with normal people,the risk of asthma complicated with hypertension,diabetes,myocardial infarction and stroke was significantly increased (P＜0.01).The multiple logistic regression analysis showed that the influential factors for asthma included age (OR=1.042,95％CI 1.032 to 1.053),gender (male OR=1.533,95％CI 1.080 to 2.167),regions (Beijing OR=2.470,95％CI 1.155 to 5.308),urban area (OR=1.355,95％CI 1.026 to 1.786),BMI (OR=1.021,95％CI 1.000 to 1.037),smoking (OR=1.428,95％CI 1.028 to 1.989),drinking (OR=0.711,95％CI 0.976),education level (OR=0.964,95％CI 0.930 to 0.999),poor short-term health status (OR=5.295,95％CI 4.055 to 6.934),well-being (lowest OR=2.219,95％CI 1.272 to 3.887),playing games (OR=2.732,95％CI 1.023 to 6.088) and watching TV (OR=1.695,95％CI 1.036 to 2.941).Conclusion:Adult asthma is associated with multiple factors including age,gender,lifestyle,social environment,etc.

Background:Gross target volume of primary tumor (GTV?P) is very important for the prognosis prediction of patients with nasopharyngeal carcinoma (NPC), but it is unknown whether the same is true for locally advanced NPC patients treated with intensity?modulated radiotherapy (IMRT). This study aimed to clarify the prognostic value of tumor volume for patient with locally advanced NPC receiving IMRT and to ifnd a suitable cut?off value of GTV?P for prognosis prediction. Methods:Clinical data of 358 patients with locally advanced NPC who received IMRT were reviewed. Receiver oper?ating characteristic (ROC) curves were used to identify the cut?off values of GTV?P for the prediction of different end?points [overall survival (OS), local relapse?free survival (LRFS), distant metastasis?free survival (DMFS), and disease?free survival (DFS)] and to test the prognostic value of GTV?P when compared with that of the American Joint Committee on Cancer T staging system. Results:The 358 patients with locally advanced NPC were divided into two groups by the cut?off value of GTV?P as determined using ROC curves: 219 (61.2%) patients with GTV?P≤46.4mL and 139 (38.8%) with GTV?P>46.4mL. The 3?year OS, LRFS, DMFS, and DFS rates were all higher in patients with GTV?P≤46.4mL than in those with GTV?P>46.4mL (allP<0.05). Multivariate analysis indicated that GTV?P>46.4mL was an independent unfavorable prognostic factor for patient survival. The ROC curve veriifed that the predictive ability of GTV?P was superior to that of T category (P<0.001). The cut?off values of GTV?P for the prediction of OS, LRFS, DMFS, and DFS were 46.4, 57.9, 75.4 and 46.4mL, respectively. Conclusion:In patients with locally advanced NPC, GTV?P>46.4mL is an independent unfavorable prognostic indi?cator for survival after IMRT, with a prognostic value superior to that of T category.

Objective Multimedia materials were introduced,basing on internet platform,in health education of hip arthroplasty patients,so as to create more standards,comprehensive and systematic health education service for them.The application effects would be explored.Methods From March to August 201 3, patients with hip arthroplasty in Department of Orthopedics,Xiangya Hospital Central South University,were selected by cluster sampling.The participants in this prospective cohort study were divided into control group and experimental group according to the time of surgeries.The patients of control group took traditional health education,while in the experimental group,information platform about health education was established and made to the cloud,so that oral,written and multi-media video education could be carried out.Then,behavior compliance and satisfaction degree of patients in the two groups were investigated and compared, and intervention effects were evaluated.Results Behavior compliance and satisfaction degree of health education of patients in the experiment group were higher than that in the control group (P <0.05).Specialized subject and functional exercise showed more improvement in behavior compliance.Conclusions The new mode of health education basing on the internet platform is effective to improve the behavior compliance and satisfaction in total hip arthroplasty patients,which has an obvious guidance for specialized subject and functional exercises,so it is worthy of clinical promotion.

OBJECTIVE: To establish the evaluation index system for equalization of basic public health services and to test its value in practice. METHODS: We developed the index system through expert scored evaluation and then chose a city in Hunan for the research object. The sources of data and the methods of collection for each indicator were identified. The reliability and validity of index system was tested. The methods of AHP (analytic hierarchy process) and TOPSIS (technique for order preference by similarity to an ideal solution) were applied to comprehensively evaluate the public health services among nine counties in the city. RESULTS: The Cronbach's alpha coefficient, which described reliability test result on evaluation index system for equalization of basic public health services, was 0.750. The cumulative contribution rate reached 89.32% after validity test with extraction of 5 common factors through factor-analysis. The sorting results from AHP or TOPSIS method are very close except two districts. CONCLUSION Evaluation index system for equalization of basic public health services established in this study is in good validity and reliability, which can be objectively applied to analyze the current status of basic public health services.
China ; Health Services ; standards ; Health Services Research ; Public Health ; Reproducibility of Results ; Surveys and Questionnaires

OBJECTIVE: To evaluate the efficacy of health education on patients with hip replacement based on the Internet, and to establish a new health education model through modern technology. METHODS: A total of 300 patients with hip replacement from March to August, 2015 were enrolled in this study. The participants were divided into a control group and an experimental group according to months surgeries performed. Traditional education was applied in the control group while the multimedia source material plus the Internet platform of Joint Registration System were applied in the experimental group. Levels of anxiety, degree of satisfaction, and postoperative complications were analyzed. RESULTS: The levels of knowledge, attitude and behavior compliance in the patients of the experimental group were significantly improved, while the levels of postoperative anxiety were decreased compared with those in the control group (P<0.05). CONCLUSION Education based on the Internet platform of Joint Registration System and the computer video could improve patients' knowledge, attitude, and behavior, which is worthy of clinical spread.
Anxiety ; Arthroplasty, Replacement, Hip ; Humans ; Internet ; Multimedia ; Patient Compliance ; Patient Education as Topic

OBJECTIVE: To investigate the risk factors for type 2 diabetes complicated with hypertension in adult residents in Liuyang, Hunan Province, P. R. China.
 METHODS: The residents aged at or over 18 were selected through a method of multi-stage cluster random sampling from 10 towns in Liuyang. Questionnaires, physical measurements and laboratory tests were conducted. Type 2 diabetes complicated with hypertension were served as an experimental group, while simple diabetes, non-diabetes and non-hypertension (healthy control), or non-complication and healthy group (simple hypertension, simple diabetes, and healthy group) were served as control group, respectively. Three kinds of logistic regression model were used to analyze the risk factors for type 2 diabetes complicated with hypertension.
 RESULTS: A total of 5 669 residents were included in the analysis, and the response rate was 97.74%. The results showed that the prevalence of type 2 diabetes complicated with hypertension of residents at or over 18 years old in Liuyang was 2.6% (95%CI: 2.2%, 3.1%). Logistic regression analyses demonstrated that for people at or over 60 years old, obesity and abnormal triglyceride were the independent risk factors for type 2 diabetes complicated with hypertension.
 CONCLUSION Aging, obesity and abnormal triglyceride can increase the risk of type 2 diabetes complicated with hypertension in adult residents in Liuyang.
Adult ; Aging ; China ; epidemiology ; Diabetes Mellitus, Type 2 ; complications ; epidemiology ; Humans ; Hypertension ; complications ; epidemiology ; Logistic Models ; Obesity ; epidemiology ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Triglycerides ; blood