Objective:To investigate and analyse the current status of screening and management of diabetic kidney disease (DKD) in six provinces and cities in China.Methods:The qualitative research method of focus group interview was adopted, based on the semi-structured interview outline, the clinical medical and disease control personnel in Tianjin, Chongqing, Gansu, Hubei, Heilongjiang, and Guangdong were interviewed. The interview transcripts were analyzed using thematic analysis, and MAXQDA analysis software was used for data management and analysis.Results:A total of 6 interviews were conducted with 49 interviewees. Forty respondents (81.6%) claimed that DKD screening was critical; 53.1% think that it was not easy for patients to obtain DKD screening services; 40.8%, 26.5% and 14.3% of the people believed that the technology of DKD screening services was moderate, simple or very simple, respectively. Of the respondents,16.3% thought that the cost of DKD screening service was relatively expensive, while 83.7% thought that the cost was inexpensive; 75.5% of the respondents believed that the patients could receive early DKD screening service. The factors of fully implementing medical reform policies, changing concepts and actively serving patients, and integrating external resources in medical and health institutions at all levels and of all types were conducive to the development of DKD screening and management services. The lack of technology and personnel for DKD screening services at the grassroots level, the lack of trust in the service capabilities of grassroots medical institutions by patients, the low level of patient awareness, and the novel coronavirus infection epidemic had an adverse impact on the development of DKD screening and management services.Conclusion:The screening and management services for DKD are relatively limited in China, and there is a significant fragmentation in the management and care of diabetes and DKD.

Objective:To evaluate the therapeutic efficacy of interposition urethroplasty on glandular hypospadias and severe penile curvature.Methods:A total of 9 cases of congenital glandular hypospadias and 2 cases of congenital severe penile curvature (>30°) treated with the interposition urethroplasty technique in the Shenzhen Children′s Hospital from November 2008 to December 2019 were retrospectively analyzed.The mean age of initial surgery was 40 (25-109) months.Two cases were surgically treated with one-staged interposition urethroplasty and the remaining were treated with two-staged interposition urethroplasty.They were followed up for 8 months to 12 years, including the penile morphology, urination, urethrocutaneous fistula, urethral stricture and uroflowmetry.Continuous variables were presented as ± s deviation, Student′s t-test was used for comparison between groups. Results:The median length of interposition urethra was 3.2 (2.2-4.2) cm.The cosmetic appearance of penis was good without residual chordee, urethral stricture or urethral diverticulum in all patients.Two cases had urethrocutaneous fistula(one-staged repair and two-staged repair were performed in one case respectively), which were successfully repaired by re-operation.The maximum of uroflowmetry in patients at 3 months [(8.3±1.0) mL/s] and 6 months [(6.7±1.9) mL/s] after surgery was significantly lower than that of children in healthy control group [(10.5±3.7) mL/s] ( t=3.221, 3.864, all P<0.05). However, there was no significant difference in 1-year maximum of uroflowmetry postoperatively between surgically treated patients [(10.5±3.7) mL/s] and healthy control group ( P>0.05). Conclusions:Interposition urethroplasty is an effective and safe treatment for glandular hypospadias and/or severe penile curvature in children.

Objective:To analyze the changes in self-efficacy and its influencing factors in type 2 diabetic patients after community-based self-management group intervention.Methods:From August to November 2014, a 3-month community-based self-management intervention study of type 2 diabetes patients was implemented in Fangshan District, Beijing. 510 patients were recruited through posters, household inquiries and telephone notification and then were randomly divided into intervention group (260 patients) and control group (250 patients). Finally, 500 patients completed the study, including 259 in the intervention group and 241 in the control group. Self-efficacy score was measured through face-to-face interview at different time points, including pre-intervention, post-intervention, 2 years after the intervention and 5 years after the intervention, respectively. A two-level random coefficient model was fitted to analyze the long-term trend of self-efficacy and its relationship with group intervention.Results:Individual-level educational attainment, disease duration as well as their treatment plans had a positive correlation with self-efficacy of type 2 diabetic patients while gender and age did not affect their self-efficacy. Patients with junior middle school education, senior high school education and university and above education had 4.66 ( P<0.05), 6.40 ( P<0.05) and 11.02 ( P<0.05) points higher than those with primary education, respectively. The self-efficacy of diabetic patients increased by 0.23 ( P<0.05) for each additional course year. The effect of treatment plan on self-efficacy was mainly reflected in the self-efficacy of taking medication or insulin injection as prescribed and blood glucose monitoring. After controlling for the confounding factors, i.e., gender, age, disease duration, educational attainment, and treatment plan, self-efficacy scores at the post-intervention increased in both groups compared to those at the pre-intervention. The intervention group had 7.95 points higher than the control group ( P<0.05). After the intervention, the self-efficacy scores of both groups decreased year by year while the intervention group declined faster, with 5.41 points ( P<0.05) at 2 years after the intervention and 8.94 points ( P<0.05) at 5 years after the intervention. Conclusion:Community-based self-management group intervention could improve the self-efficacy of type 2 diabetic patients while the self-efficacy decreases year by year in the absence of follow-up intervention.

Objective:To analyze the changes in self-efficacy and its influencing factors in type 2 diabetic patients after community-based self-management group intervention.Methods:From August to November 2014, a 3-month community-based self-management intervention study of type 2 diabetes patients was implemented in Fangshan District, Beijing. 510 patients were recruited through posters, household inquiries and telephone notification and then were randomly divided into intervention group (260 patients) and control group (250 patients). Finally, 500 patients completed the study, including 259 in the intervention group and 241 in the control group. Self-efficacy score was measured through face-to-face interview at different time points, including pre-intervention, post-intervention, 2 years after the intervention and 5 years after the intervention, respectively. A two-level random coefficient model was fitted to analyze the long-term trend of self-efficacy and its relationship with group intervention.Results:Individual-level educational attainment, disease duration as well as their treatment plans had a positive correlation with self-efficacy of type 2 diabetic patients while gender and age did not affect their self-efficacy. Patients with junior middle school education, senior high school education and university and above education had 4.66 ( P<0.05), 6.40 ( P<0.05) and 11.02 ( P<0.05) points higher than those with primary education, respectively. The self-efficacy of diabetic patients increased by 0.23 ( P<0.05) for each additional course year. The effect of treatment plan on self-efficacy was mainly reflected in the self-efficacy of taking medication or insulin injection as prescribed and blood glucose monitoring. After controlling for the confounding factors, i.e., gender, age, disease duration, educational attainment, and treatment plan, self-efficacy scores at the post-intervention increased in both groups compared to those at the pre-intervention. The intervention group had 7.95 points higher than the control group ( P<0.05). After the intervention, the self-efficacy scores of both groups decreased year by year while the intervention group declined faster, with 5.41 points ( P<0.05) at 2 years after the intervention and 8.94 points ( P<0.05) at 5 years after the intervention. Conclusion:Community-based self-management group intervention could improve the self-efficacy of type 2 diabetic patients while the self-efficacy decreases year by year in the absence of follow-up intervention.

OBJECTIVE：To stud y the mass spec trometry fragmentation regularity and establish rapid identification method of macrocyclic polyamine alkaloids from Tripterygium wilfordii. METHODS ：The determination was performed on Hypersil GOLDTM C18 column with 0.1％ formic acid solution （A）-methanol（B）as mobile phase （gradient elution ）at the flow rate of 0.25 mL/min. The column temperature was 40 ℃，and sample size was 2 μL. The mass spectrometric condition included ESI，positive ion mode ， breakdown voltage of 100 V，collision energy of 35 eV，and scanning range of m/z 100-2 000. UPLC-Q-TOF-MS/MS combined with PeakView 1.2 software were used to analyze mass spectrum of 4 macrocyclic polyamine alkaloids control as celafurine ， celabenzine，celacarfurin，celacinnine and total extract of T. wilfordii ，and summarized the mass fragmentation regularity of alkaloids. According to retention time ，accurate molecular weight and secondary mass fragment ion information ，referring to the above mass spectrometry fragmentation regularity ，macrocyclic polyamine alkaloids in the total extract of T. wilfordii were quickly identified，and whether it was a new compound was determined by consulting Scifinder database and literature comparison. RESULTS：There were three characteristic cleavage fragments of macrocyclic polyamine alkaloids ，i.e. m/z 160.11（base peak ），m/z 188.10 and m/z 100.07 in positive ion mode. According to the precise molecular weight and mass spectrometry fragmentation regularity，10 macrocyclic polyamine alkaloids were identified rapidly ，and compound 1-6，8 were 2-phenyl-1，5，9-triazacy- clotridecan-4-one， 9-acetyl-2-phenyl-1，5，9-triazacyclotridecan-4-one， 9-nicotinoyl-2-phenyl-1， 5， 9-triazacyclotridecan-4-one， celafurine，celabenzine，celacarfurine，celacinnine，respectively. Compounds 3，7，9 and 10 might be new compounds. CONCLUSIONS：The macrocyclic polyamine alkaloids canform three common characteristic fragment ions ，m/z 160.11（base peak ），m/z 188.10 and m/z 100.07，which can be used for the rapid identification of these active components.

Objective:To analyze the mortality level and trend of chronic and non-communicable diseases (NCDs) among elderly residents aged 65 and over in China from 2004 to 2018, and predict the age-standardized mortality rate of NCDs from 2019 to 2023.Methods:Data on resident death was collected from the National Mortality Surveillance data set and used to analyze the unstandardized mortality rates, age-standardized mortality rates, composition ratios and changing trends of NCDs among different genders, urban and rural areas, and geographical regions in China during 2004 to 2018. The age-standardized mortality rates were calculated based on the Year 2010 Population Census of China. The Joinpoint Regression Models were fitted by the weighted least squares method. The average annual percent change (AAPC) and its 95% confidence interval for the entire time period were calculated. Log-linear models were used to predict age-standardized mortality rates.Results:From 2004 to 2018, the age-standardized mortality rates of NCDs decreased from 4 697.05 per 100 000 to 3 555.35 per 100 000, with an average annual decline of 2.0% (95% CI: -2.7%- -1.3%). The age-standardized mortality rates among different genders, urban and rural areas, and regions showed a downward trend. The age-standardized mortality rates of eastern region (AAPC = -2.1%, 95% CI: -2.8%- -1.3%) and central region (AAPC = -2.8%, 95% CI: -3.4%- -2.1%) fell faster than that of western region (AAPC = -0.8%, 95% CI: -1.8%-0.2%). The proportion of deaths caused by NCDs increased from 89.82% to 91.41%, with an average annual increase of 0.1% (95% CI: 0.1%-0.2%). Expected to 2023, the age-standardized mortality rates for male (3 906.23 per 100 000) will be significantly higher than female's (2 708.43 per 100 000); and that in rural areas (3 283.20 per 100 000) will be approximately equal to that in urban areas (3 250.01 per 100 000); the gap of age-standardized mortality rate between the western (3 782.48 per 100 000), eastern (3 037.01 per 100 000), and central region (3 249.24 per 100 000) will be further increased. Conclusion:From 2004 to 2018, age-standardized mortality rates of NCDs of the elderly residents in China showed a downward trend, and the proportion of deaths of NCDs showed an upward trend. Male and the western region elderly residents should be the key population for prevention and control of chronic diseases in the future.

Objective:To evaluate the quality of the National Demonstration Area for Comprehensive Prevention and Control of NCDs (referred to as "the Demonstration Area").Methods:Based on the evaluation scores of the Demonstration Area field survey from 2017 to 2019, we counted the scores of each indicator, comparing the scores among indicators and regions. x± s was used to describe the scores. The 95% CI of the score was used to test the statistical difference among regions. Each score was converted into a hundred-mark system to compare the scores among indicators. Results:Of 236 Demonstration Areas, the total score was 83.5. The scores of the first-level indicator listed from high to low appeared as Integrating System of NCD Prevention and Control (92.8), Policy Perfection (90.3), Building Supportive Environment for NCD Prevention and Control (88.4), Implementation of Health Education and Health Promotion (87.4), Whole-course Management of NCDs (78.1), Innovation and Guidance (76.5), Surveillance and Evaluation (75.1). Total scores were higher in the east (259.2±18.8) comparing to the middle (243.2±15.2) or the west (245.4±19.7) regions.Conclusions:Substantial variations on the quality in the Demonstration Area existed across different regions in China. These disparities are important to the government when developing health policies and allocating resources. Whole-course Management of NCDs, Surveillance and Evaluation, and Innovation and Guidance in the Demonstration Area also needs to be improved.

Objective:To discuss the diagnostic methods, clinical features and treatment options of bronchogenic cysts.Methods:A total of 86 patients with bronchogenic cysts and 5 patients with esophageal cysts and esophageal cysts were selected from January 2011 to May 2020 in the Affiliated Tumor Hospital of Harbin Medical University. There were 37 males and 49 females with bronchogenic cysts, aged 23 to 70(49.27±10.70)years old. According to the location of the disease, the patients were divided into mediastinal type(65 cases, 75.6%); intrapulmonary type(21 cases, 24.4%); bronchogenic cyst originating from the esophagus(9 cases, 10.5%).Results:The preoperative diagnosis coincidence rate was 9.3% in 8 cases. The rate of thoracoscopic surgery(59.3% in 51 cases), compared with the indwelling time of thoracic drainage tube after thoracotomy[(3.80±1.25) days vs.(4.97±1.54)days, P<0.001] and hospital stay[(7.08±1.75) days vs.(9.60±2.58)days, P<0.001] significantly shortened. 65 cases(71.4%, 65/91) were successfully followed up, with a median follow-up time of 34(2-111) months, and no recurrence was found. Conclusion:Bronchial cysts have no characteristic clinical manifestations, and it is difficult to make a clear diagnosis before surgery. Chest MRI has a great advantage in the diagnosis of cysts. For most cases, thoracoscopic surgery can achieve better clinical treatment results and has minimally invasive advantages. It is difficult to distinguish between bronchogenic cysts that originated in the esophagus and esophageal cysts, and there is no significant difference in clinical characteristics.

Objective: To evaluate the effect of a community-based intervention supporting type 2 diabetes mellitus patients in their self-management of the disease. Methods: This research was a randomized controlled trial conducted in communities in Fangshan District, Beijing, China. Adult patients with type 2 diabetes from 17 communities in 4 sub-district of Fangshan District were randomly assigned to either the intervention or control group. Participants in the intervention group participated in a three-month group-based diabetes self-management intervention service. Data were collected both in intervention and control group at baseline and after the intervention to evaluate the effect of the intervention. A questionnaire survey was completed by all participants to collect their demographic information, diabetes related health behaviors and skills. A physical examination and lab testing including height, weight, blood pressure, and waist circumference as well as HbA1c, fasting blood glucose, lipid profile were conducted before and after the intervention. Results: A total of 500 valid questionnaires were received, including 259 in the intervention group and 241 in the control group. Patients in the intervention group who learned how to conduct the self-monitoring of blood glucose increased from 56.76% (n=147) to 87.26% (n=226) after the intervention, higher than that of control group (63.07%, n=152) (P<0.001). 69.50% (n=180) patients in intervention group had blood glucose monitor at home, which was 60.62% (n=157) prior to the intervention and higher than that of control group (57.68%, n=139) (P=0.004). After the intervention, 3.09% (n=8) patients in intervention group ceased to take medicine by themselves, which was 16.22% (n=42) before the intervention, while the control group was 8.30% (n=20) after the intervention (P=0.009). Patients in the intervention group made significant improvements in implementing self monitoring on blood glucose (SMBG), which was increased from one day per week to 2 days per week, and foot self-examination, which increased from 2 days per week to 7 days per week. The body weight of patients in the intervention group reduced 1.62 kg on average after the intervention, while it increased 0.88 kg in the control group. Similar improvement was found in waist circumstance between the intervention and control group (-0.83 cm vs -0.16 m). There was a significant reduction on body weight and waist circumstance in the intervention group (P<0.05). Conclusion The group activities focusing on people with type 2 diabetes resulted in improvement in their lifestyle and self management behaviors, as well as their body weight and waist circumstance.

Objective To evaluate the effect of a community?based intervention supporting type 2 diabetes mellitus patients in their self?management of the disease. Methods This research was a randomized controlled trial conducted in communities in Fangshan District, Beijing, China. Adult patients with type 2 diabetes from 17 communities in 4 sub?district of Fangshan District were randomly assigned to either the intervention or control group. Participants in the intervention group participated in a three?month group?based diabetes self?management intervention service. Data were collected both in intervention and control group at baseline and after the intervention to evaluate the effect of the intervention. A questionnaire survey was completed by all participants to collect their demographic information, diabetes related health behaviors and skills. A physical examination and lab testing including height, weight, blood pressure, and waist circumference as well as HbA1c, fasting blood glucose, lipid profile were conducted before and after the intervention. Results A total of 500 valid questionnaires were received, including 259 in the intervention group and 241 in the control group. Patients in the intervention group who learned how to conduct the self?monitoring of blood glucose increased from 56.76% (n=147) to 87.26% (n=226) after the intervention, higher than that of control group (63.07%, n=152) (P<0.001). 69.50%(n=180) patients in intervention group had blood glucose monitor at home, which was 60.62% (n=157) prior to the intervention and higher than that of control group (57.68%, n=139) (P=0.004). After the intervention, 3.09% (n=8) patients in intervention group ceased to take medicine by themselves, which was 16.22% (n=42) before the intervention, while the control group was 8.30% (n=20) after the intervention (P=0.009). Patients in the intervention group made significant improvements in implementing self monitoring on blood glucose (SMBG), which was increased from one day per week to 2 days per week, and foot self?examination, which increased from 2 days per week to 7 days per week. The body weight of patients in the intervention group reduced 1.62 kg on average after the intervention, while it increased 0.88 kg in the control group. Similar improvement was found in waist circumstance between the intervention and control group (-0.83 cm vs-0.16 m). There was a significant reduction on body weight and waist circumstance in the intervention group (P<0.05). Conclusion The group activities focusing on people with type 2 diabetes resulted in improvement in their lifestyle and self management behaviors, as well as their body weight and waist circumstance.