OBJECTIVES: The aim of this study was to evaluate the disease burden of prostate cancer (PC) and assess key influencing factors associated with the disease expenditures of PC in the United States. METHODS: The total deaths, incidence, prevalence, and disability-adjusted life-years of PC were obtained from the Global Burden of Disease Study 2019. The Medical Expenditure Panel Survey was used to estimate healthcare expenditures and productivity loss and to investigate patterns of payment and use of healthcare resources in the United States. A multivariable logistic regression model was conducted to identify key factors influencing expenditures. RESULTS: For patients aged 50 and older, the burden for all age groups showed a modest increase over the 6-year period. Annual medical expenditures were estimated to range from US$24.8 billion to US$39.2 billion from 2014 to 2019. The annual loss in productivity for patients was approximately US$1,200. The top 3 major components of medical costs were hospital inpatient stays, prescription medicines, and office-based visits. Medicare was the largest source of payments for survivors. In terms of drug consumption, genitourinary tract agents (57.0%) and antineoplastics (18.6%) were the main therapeutic drugs. High medical expenditures were positively associated with age (p=0.005), having private health insurance (p=0.016), more comorbidities, not currently smoking (p=0.001), and patient self-perception of fair/poor health status (p<0.001). CONCLUSIONS From 2014 to 2019, the national real-world data of PC revealed that the disease burden in the United States continued to increase, which was partly related to patient characteristics.

Humans ; Asthma/drug therapy* ; Biological Therapy

【Objective】 To explore the role and value of applied muscle tension (AMT) in preventing vasovagal nerve reaction (VVR) in blood donors. 【Methods】 A total of 2 992 people, susceptible to suffer VVR from May 2020 to may 2022, were randomly divided into control group (1406 cases) and observation group (1 586 cases). The control group was not given AMT intervention, while the observation group received AMT intervention at different periods during blood donation. The changes of systolic blood pressure, diastolic blood pressure, heart rate and psychological state of anxiety (self-rating anxiety scale, SAS) of blood donors were monitored in the two groups at each period to compare the occurrence of VVR. 【Results】 There were no statistically significant differences in blood pressure and heart rate between the two groups before blood donation (P>0.05). The parameters were relatively stable in observation group during and after donation, but significantly different from that of the controls(P>0.05). SAS score was similar in two groups before blood donation(P>0.05), while decreased in observation group during and after donation in comparison with the controls(P<0.05). The incidence of VVR in the observation group was 3.09%, which was significantly lower than that in the control group (7.97%)(P<0.05). The incidence of VVR was 2.18% after AMT exercise during blood donation. 【Conclusion】 AMT intervention in different periods of blood donation can significantly reduce the occurrence of VVR.

Objective:To explore the teaching effect of 12-lead electrocardiogram (ECG) interpretation based on self-drawing method.Methods:This study recruited 489 students from 10 classes of clinical medicine major of Shandong Medical College as research objects. They were divided into control group and experimental group. Theoretical teaching and traditional practical training were adopted to the control group while theoretical teaching and self-drawing method were adopted to the experimental group. The ECG test scores, the number of students with excellent performance and the ECG scores of the final exam were compared between the two groups. Questionnaires were issued to assess the effect of different teaching methods on students. SPSS 25.0 was used for t test and chi-square test. Results:Compared with the experimental group, the results of the ECG special test, the number of excellent students and the ECG scores of the final exam in the control group all decreased, and the difference was statistically significant ( P<0.01). The results of the questionnaire showed that the experimental group had higher mastery of ECG abnormal patterns, learning initiative, self-confidence and better satisfaction with the overall teaching of ECG ( P<0.01). Conclusion:The practical training based on self-drawing method can improve ECG interpretation skills, learning initiative and self-confidence of students, which has achieved good teaching effect.

Objective:To explore the effect of programmatic follow-up of joint nutrition team on the follow-up management of type 2 diabetes mellitus patients and to provide a basis for clinical practice.Methods:Using the convenient sampling method, a total of 144 patients with type 2 diabetes mellitus who were treated at the Diabetes Specialist Follow-up Clinic of the First Affiliated Hospital of Xinjiang Medical University from March 2016 to December 2017 were selected, and the programmatic follow-up of joint nutrition team was used for prospective observation. After the completion of 2-year follow-up, the changes in obesity, blood glucose, blood lipids and self-care activities of patients at baseline, 12th month and 24th month were compared using repeated measurements analysis of variance.Results:In the end, 141 patients completed the 2-year follow-up. Of the 141 patients, body mass index (BMI) was (21.73±1.89) kg/m 2, waistline was (77.57±1.68) cm, waist-to-hip ratio was (0.87±0.04) , fasting blood glucose was (5.14±0.92) mmol/L, glycosylated hemoglobin was (5.27±0.73) %, total cholesterol was (3.92±1.67) mmol/L, triglycerides was (1.94±0.68) mmol/L and low density lipoprotein was (1.04±0.31) mmol/L at the 24th month. The differences were statistically significant ( F=32.629, 5.556, 5.640, 89.734, 122.451, 43.373, 74.888, 35.887; P<0.05) among the 24th month, the 12th month and the baseline of the above indicators. At the 24 months, scores of diet, exercise, blood glucose monitoring and foot care in diabetic self-management behavior scale were respectively (20.33±3.09) , (11.13±1.54) , (11.78±1.99) and (10.42±1.91) . Compared with baseline and the 12th month, scores increased, and the differences were statistically significant ( F=25.276, 72.250, 74.503, 37.928; P<0.01) . Conclusions:The programmatic follow-up of joint nutrition team can improve indexes related to obesity, blood glucose and blood lipids in patients with type 2 diabetes mellitus and improve self-management ability of patients.

Objective:To explore the effect of precision nutrition therapy on the dietary pattern and appetite of patients with type 2 diabetes mellitus (T2DM) .Methods:From September 2018 to September 2019, convenience sampling method was used to select 155 patients with T2DM discharged from the Endocrinology Department of the First Affiliated Hospital of Xinjiang Medical University. All patients were randomly divided into control group (73 cases) and experimental group (82 cases) . Control group received routine nutritional intervention. Based on routine follow-up intervention, experimental group established a patient's personalized data model according to the medical artificial intelligence system for precise nutritional treatment, including the establishment of diabetes diet management prescriptions and intelligent diet intervention. The Dietary Pattern Questionnaire and the Simplified Nutritional Appetite Questionnaire (SNAQ) were used to compare the changes in dietary patterns and appetite before and after intervention between two groups.Results:After three months of intervention, the proportion of patients with reasonable protein, fat, and carbohydrate intake in two groups was higher than that before intervention, and that of experimental group was higher than that of control group, and the difference was statistically significant ( P<0.05) . After three months of intervention, the score of SNAQ of experimental group and control group was (13.20±1.54) and (10.32±1.25) respectively, and the difference was statistically significant ( t=-12.838, P<0.05) . Conclusions:The establishment of a big data model based on a medical artificial intelligence system for precise nutritional therapy can regulate the dietary behavior of patients with T2DM and increase their appetite.

Objective:To explore the effect of exercise prescription intervention with multidisciplinary support on elderly patients with diabetes mellitus accompanied by sarcopenia.Methods:Using the convenient sampling method, a total of 84 patients with diabetes mellitus accompanied by sarcopenia over 60 years old were selected from 6 community health service centers that had long-term cooperation with the First Affiliated Hospital of Xinjiang Medical University from January 2018 to September 2019. They were randomly divided into the observation group and the control group, with 41 cases in each group. The control group received routine nursing management, while the observation group implemented exercise prescription intervention with multidisciplinary support on the basis of the control group, and the intervention period was 12 weeks. The differences in laboratory indexes, limb motor function and Diabetes Specific Quality of Life Scale (DSQL) scores were compared between the two groups.Results:After intervention, glycosylated hemoglobin (5.38±0.67) % and DSQL score (76.35±5.48) of patients in the observation group were lower than those of the control group, and the differences were statistically significant ( t=-9.964, -5.113; P<0.05) . After intervention, serum albumin (35.81±1.86) g/L and limb motor function score (88.94±7.02) of patients in the observation group were higher than those in the control group, and the differences were statistically significant ( t=5.860, 2.501; P<0.05) . Conclusions:Exercise prescription intervention with multidisciplinary support can help elderly patients with diabetes mellitus accompanied by sarcopenia to improve their blood sugar control, quality of life and skeletal muscle quality and function.

Objective:To explore the effect of remote blood glucose management led by specialist nurses on blood glucose, self-management ability and quality of life of type 2 diabetic patients during home rehabilitation.Methods:From January to December 2019, convenience sampling was used to select 218 patients with type 2 diabetes in the First Affiliated Hospital of Xinjiang Medical University. According to the random number table method, the patients were divided into the observation group and the control group, each with 109 cases. The control group conducted conventional blood glucose management, and the observation group implemented remote blood glucose management led by specialist nurses for a total of three months of observation. Both were observed for 3 months. The self-management behavior and quality of life of the two groups of patients before and after the intervention were evaluated with the Diabetes Self-Management Behavior Scale (SDSCA) and the Diabetes Quality of Life Specific Scale (DSQL), and the blood glucose indicators of the two groups before and after the intervention were compared.Results:All 218 cases cooperated to complete all the research contents, and there was no dropout case. After the intervention, the fasting blood glucose, two hours postprandial blood glucose, glycosylated hemoglobin and DSQL score of the observation group were lower than those of the control group, and the SDSCA score was higher than that of the control group. The differences were all statistically significant ( P<0.05) . Conclusions:Compared with conventional blood glucose management, the remote blood glucose management led by specialist nurses can more effectively control the blood glucose of patients with type 2 diabetes, improve the patients' self-management ability and quality of life, and overall increase the management efficiency of patients during home rehabilitation.

Objective:To explore the effects of time-based nursing mode on acceptance and action, healthy empowerment cognition in patients with newly diagnosed type 2 diabetes mellitus (T2DM) .Methods:Using convenience sampling method, a total of 129 patients with newly diagnosed T2DM who were diagnosed and hospitalized in the Department of Endocrinology of the First Affiliated Hospital of Xinjiang Medical University were selected from January to December 2018. According to the admission time of patients, the 62 cases who were admitted in odd month were included in the routine nursing group, and the 67 cases who were admitted in even month were included in the time-based nursing group. Patients in the routine nursing group received routine nursing for patients with diabetes, while based on the routine nursing and the principle of "do the right thing at the right time", patients in the time-based nursing group received health education, exercise management and retrospective guidance in three time areas from 9∶00 to 11∶00, 16∶00 to 17∶00 and 19∶00 to 21∶00. The degree of acceptance and action, healthy empowerment cognition was investigated and compared between two groups on admission and discharge by Chinese version of Acceptance and Action Diabetes Questionnaire (AADQ) and Health Empowerment Scale.Results:There was no significant difference in Chinese version of AADQ score on admission between the two groups ( P>0.05) ; on discharge, the Chinese version of AADQ score in two groups were reduced than those on admission, and the AADQ score in the time-based nursing group was lower than that in the routine nursing group, and the differences were statistical ( P<0.01) . The differences were not statistically significant on the score of Health Empowerment Scale on admission between two groups ( P>0.05) ; compared with that at admission, the score of the time-based nursing group increased, and the difference was statistically significant ( P<0.01) ; at discharge, the scores of each dimension of Health Empowerment Scale in the time-based nursing group were higher than those in the routine nursing group, the differences were statistical ( P<0.01) . Conclusions:Time-based nursing mode can improve the levels of acceptance and action, healthy empowerment cognition in patients with newly diagnosed T2DM, and improve the acceptance degree of the disease and self-consciousness.

Objective To investigate the vitamin B 12 status of vegetarians in Shanghai.Methods A total of 282 adult vegetarians and 282 omnivores matching by gender and age were recruited in Shanghai.Their dietary intakes were collected.The serum concentrations of vitamin B12,folate and homocysteine were tested.The red blood cell,hematocrit value,mean corpuscular volume and mean erythrocyte width were also examined.Results The daily average intake of dietary vitamin B12 was (0.46± 1.01) μg/d in vegetarians and only (0.1±0.46) μg/d in vegans,which was lower than that of omnivores [(3.91±6.92) μg/d,F=50.57,P＜0.01].137 omnivores and 274 vegetarians had less dietary vitamin B12 level than recommended nutrient intake (RNI) and the difference was statistically significant (x2 =114.77,P＜ 0.01).54.26％ of vegetarians,68.92％ vegans,49.04％ ovo-lacto vegetarians and 15.60％ omnivores had hyperhomocysteinemia and the differences between vegetarians and omnivores were statistically significant (all P＜0.01).After adjusting the confounding factors the hematocrit value was higher in vegetarians,vegans and ovo-lacto vegetarians than in omnivores (27.42％± 18.32％,28.73％± 18.19％,26.95％± 18.38％ vs.8.96％± 16.59％,P＜0.01).Vegans had lower red blood cell counts and higher hematocrit value and mean corpuscular volume than omnivores.Conclusion Vitamin B12 deficiency combined with an elevated level of homocysteine and red blood cell volume growth are common but serious issue in vegetarians,especially in vegans.