Humans ; COVID-19 ; SARS-CoV-2

Objective To analyze the relationship between follow-up service, personal characteristics, lifestyle and blood sugar management of diabetic patients in Gansu Province, and put forward scientific suggestions on influencing blood sugar management of diabetic patients. Methods Based on the data of the 6th National Health Service Questionnaire, 273 subjects were included. Chi-square test and unconditional logistic regression were used to analyze the blood glucose control and its influencing factors of diabetic patients. Results A total of 39.56% patients' blood sugar status was well controlled. 76.92% patients signed up for family doctor service, and 77.66% patients took hypoglycemic drugs according to the law of doctor's advice. There were significant differences in blood sugar control among patients in different regions, educational levels and occupational types (P <0.05) , logistic regression analysis showed that Hui patients (OR=0.21), doctors without family contract (OR=2.86) and patients taking hypoglycemic drugs intermittently (OR = 6.58). Conclusion The blood sugar control rate of diabetic patients in Gansu is low, and the nationality, contracted family doctors and medication plan affect the blood sugar control level of patients. In order to ensure the high efficiency of follow-up treatment, the related follow-up services provided by primary medical institutions, it is necessary to provide self-management programs that meet the individual characteristics and meet the needs of the disease.

Health service is an important part of the integrated development of the Yangtze River Delta. Taking the cooperation practice between Shanghai Tenth People′s Hospital and Suzhou Yinshanhu Hospital as an example, this article introduced the multi-agent cooperation mode of the loose medical alliance including the government, urban hospitals and cross provincial grassroots medical institutions. Among them, the local government provided policy, fund guarantee and guidance, the urban hospital exported management ideas, medicine talents and technologies, and the primary hospital conducted dual training by inviting in and going out to achieve double growth. Through the high gap cooperation between tertiary hospital and primary hospital, Yinshanhu hospital had been comprehensively developed. The loose medical alliance with multi subject coordination and cross region could give full play to the advantages of the loose healthcare alliance mode, achieve multi-win, and have reference significance for promoting the regional integration of medical and health services in the Yangtze River Delta.

Objective:The study investigated and analyzed the health-related quality of life of diabetes patients in Gansu province before and after the healthcare reform and its influencing factors, so as to provide scientific evidence to improve the health-related quality of life of diabetes patients.Methods:The study used data of the fourth and sixth national health service household survey in Gansu province before (2008) and after (2018) medical reform separately, and EQ-5D health utility index was calculated on the basis of Chinese time frade-off values for EuroQol Five-Dimensions Questionnaire Utility Value scoring system.Results:Compared with the period before the healthcare reform, the five dimensions of EQ-5D for residents, aged 15 and above in Gansu, changed significantly after the healthcare reform: action capability improved by 8.08% (27.43% vs. 19.35%), self-care improved by 16.16% (26.55% vs. 10.39%), normal activity improved by 8.97% (28.32% vs. 19.35%), pain/discomfort worsened by 1.38% (38.05% vs. 39.43%), anxiety/depression worsened by 1.83% (16.81% vs. 18.64%), and the EQ-VAS score increased by 3.36 (60.53 vs. 63.89). The health utility index increased by 0.04 (0.83 vs. 0.87). Multivariate regression analysis results showed that the dimension influence factors were not completely consistent, on the whole, the health-related quality of life of diabetes patients with older age, lower education level, no physical exercise and multi chronic diseases was worse ( P<0.05), and multiple chronic disease had the most serious effect on the health of patients with diabetes. The health-related quality of life of diabetes patients with the medical insurance in urban area and after the new medical reform was higher ( P<0.05). Conclusion:The new healthcare reform has active influence on the health-related quality of life of diabetes patients in Gansu province, health care providers and policy makers should pay attention to the impacts of multi prechronic diseases on the health-related quality of life of diabetes patients and the mental health of patients with diabetes.

Objective To investigate the social function and influencing factors of rectal cancer patients with permanent colostomy.Methods A total of 126 cases of rectal cancer patients with permanent colostomy in the First Bethune Hospital of Jilin University from August 2015 to July 2016 were selected using convenient sampling. General Information Questionnaire,Social Disability Screening Schedule (SDSS),Social Support Rating Scale (SSRS) and Simplified Coping Style Questionnaire were used to investigate the patients.Results The total score of social function in rectal cancer patients with permanent colostomy was (3.83±2.51),and the incidence rate of social function disability was 80.16%. Multiple regression result showed the utilization degree of social support,the self-care level of colostomy,the negative coping style,educational level and chemotherapy were main influencing factors of social function (P<0.05).Conclusions The incidence rate of social function defects in rectal cancer patients with permanent colostomy is high,and the social function is negative. In clinical nursing work,it is necessary to take individual nursing measures based on the influencing factors to improve the social function of patients.

OBJECTIVETo investigate the risk factors of Budd-Chiari syndrome (B-CS) complicated with hepatocellular carcinoma (HCC).

METHODSThe clinical data of 30 patients with B-CS complicated with HCC treated in the First Affiliated Hospital of Zhengzhou University from December 2012 to November 2014 were analyzed retrospectively, 106 another patients were selected randomly as control group in the same term. Gender, age, medical history, type of B-CS, hemoglobin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, Child-Pugh classification, portal vein diameter, HBV infection and drinking history were recorded and analyzed between the two groups. Univariate analysis and unconditional Logistic regression model were performed to screen corresponding risk factors. Area under curve (AUC) was calculated according to receiver operator characteristic (ROC) curve to evaluate the diagnostic value of each indicator.

RESULTSUnivariate analysis showed that there were no statistical differences in gender (χ² =0.001), age (t=0.317), medical history (t=-0.906), type of B-CS (χ² =2.894), ALT (t=-1.581), Child-Pugh classification (Z=-0.777), HBV infection (χ² =0.016) and drinking history (χ² =0.285) between the two groups (all P > 0.05), but the hemoglobin (t=3.370) and albumin (t=2.152) in HCC group were lower and AST (t=-2.425) and portal vein diameter (t=-2.554) were higher than that in the other group, and the differences were statistically significant (all P <0.05). The results of unconditional Logistic regression model analysis indicated that hemoglobin, AST and portal vein diameter were independent risk factors of B-CS complicated with HCC (OR=0.972, 1.015, 1.206; P=0.004, 0.022, 0.012). ROC curve analysis indicated that the AUC of AST, hemoglobin and portal vein diameter was 0.704, 0.324 and 0.624, the predicate value was, in order, AST, portal vein diameter, hemoglobin.

CONCLUSIONHemoglobin, AST and portal vein diameter are independent risk factors of B-CS complicated with HCC.

Area Under Curve ; Aspartate Aminotransferases ; metabolism ; Budd-Chiari Syndrome ; complications ; Carcinoma, Hepatocellular ; complications ; Case-Control Studies ; Child ; Hemoglobins ; analysis ; Humans ; Liver Neoplasms ; complications ; Logistic Models ; Portal Vein ; pathology ; ROC Curve ; Retrospective Studies ; Risk Factors

Objective To invetigate the correlation between Kawasaki disease (KD) and mycoplasma pneumomiae (MP). Methods The medical records of 84 children diagnosed as KD in our hospital from March 2012 to February 2014 were retrospectively analyzed, and according to whether with mycoplasma infection or not ,they were divided into observation group and control group. The observation group included 43 cases with mycoplasma infection, and the control group in-cluded 41 KD patients without MP infection. White blood cell count (WBC), high sensitive C reactive protein (CRP), erythrocyte sedimentation rate (ESR), hemoglobin (HB), platelet count (PLT) were detected and analyzed in two groups. Patients of the two groups were compared in whether the existence of coronary artery lesions. Results Patients of the observation group without coronary artery injury accounted for 34.9%(15/43), significantly lower than that of the con trol group 58.5%(24/41), and the observation group with coronary lesions accounted for 65.1%(28/43), significantly higher than that of the control group 41.5%(17/41). The differences were statistically significant (P<0.05); CRP of the observation group was (68.9±14.7) mg/L, significantly higher than that of the control group (52.8±8.2) mg/L, and ESR of the observation group was (42.6 ±15.9) mm/h, significantly higher than that of the control group (21.6 ±6.1) mm/h. The differences were statistically significant (P<0.05). Conclusion MP is one of the causes of KD and has positive corre-lation with coronary artery injury of patients. The injury and inflammation reaction mediated by autoimmune reaction caused by MP is an important way to KD.

Objective To explore the molecular and cytogenetic abnormalities in multiple myeloma (MM).Methods The la-boratory data of bone marrow smears were retrospectively analyzed in 61 patients of MM.24 hours short-term culture of bone marrow and R banding technology were performed in 31 patients.Among these patients,10 cases were selected for de-tecting the IgH gene expression by the interval FISH method.Results The proportions of myeloma cells were 0.19~0.94 in bone marrow smears of 61 patients.In 31 patients,25 patients had enough metaphases for analysis,in which 19 cases (71.3%)had abnormal clones,8q24,11q13,13q14 and 17p13 were important structural abnormalities,where 14q32 rear-rangement was the most characteristic abnormal structure,6 patients were detected IgH gene rearrangement.Conclusion Bone marrow smear combined with other laboratory examinations could make the diagnosis of MM,chromosomal abnormali-ties may help to explore the pathogenesis of MM,and provide a theoretical basis for the early diagnosis,treatment and prog-nosis of this disease.

Objective In order to examine the value of the combination of carotid artery ultrasound and Transcrani-al Doppler (TCD) in the evaluation of carotid artery stenosis stenting. Methods Seventy-one carotid stenosis cases con-firmed by digital subtraction angiography (DSA) who had cerebral ischemia symptoms and received stent implantation were reviewed. Carotid artery ultrasound and TCD were adopted to measure the vessel diameter, peak systolic velocity (PSV) of the narrow segment, PSV and pulsatility index (PI) of ipsilateral middle cerebral artery (MCA) before and after the treatment of intravascular stents, and a comparison analysis was made. Results Carotid stent implantation significant-ly improved the inner diameter, PSV of the narrow part, PSV and PI of the MCA on the stenotic side. Inner diameter of the narrow part was 3.13±0.83, 4.77±0.51 and 4.64±0.52 mm at before, one week and one year after the implantation, re-spectively (P<0.05). The PSV of the narrow part was 190.69±113.65, 86.15±30.52 and 90.28±29.79 cm/s at before, one week and one year after the implantation, respectively(P<0.05).PSV of the MCA on the stenotic side was 77.68±14.66, 115.62±22.32 and 108.89±20.29 cm/s at before, one week and one year after the implantation, respectively(P<0.05). PI of the MCA on the stenotic side was 0.81±0.01, 1.07±0.01 and 1.06±0.02 at before, one week and one year after the implantation, respectively (P<0.05). Conclusions The present study demonstrates that the combination of carotid artery ultrasound and TCD can quantitatively detect the vascular structural and hemodynamic improvements following the endo-vascular stenting, indicating that the combination of carotid artery ultrasound and TCD can be used for the accurate as-sessment and follow up of carotid artery stenting treatment.

Objective To explore the reason of serious interference red blood cell(RBC)parameters in blood routine test and correct method.Methods 30 cases of patients whose results of blood routine RBC parameters obviously abnormal ,According to the interference factors were divided into four groups:cold agglutination (7 cases),severe hemolysis(13 cases),high triglycerides (8 cases),high white blood cell(WBC)(2 例).Take appropriate corrective action for processing respectively.The difference of red blood cell parameters were compared with t test.Results To analysis of interference factors and take appropriate corrective meas-ures,RBC parameters could be more close to the real results.Conclusion We should pay attention to the changes of the RBC pa-rameters,analysis of interference factors,and to take appropriate measures to correct,in order to avoid clinical misdiagnosis and mi-stherapy.