Objective To investigate the current situation of self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes mellitus (T2DM) in Sichuan province, and to analyze the influencing factors of SMBG, so as to provide evidence for improving the level of SMBG. Methods By the convenience sampling method, 410 patients with T2DM for more than 1 year were selected from 17 hospitals and community health service centers in 7 cities across Sichuan province, and their SMBG was investigated with a questionnaire. Results Among 410 eligible patients, the average frequency of SMBG was 7.3 times per month. There were 268 patients (65.4%) performed SMBG less than 4 times per month, 94 (22.9%) performed 4-15 times per month, 29 (7.1%) performed 6-29 times per month, and 19 (4.6%) performed over 30 times per month. Just 234 patients (57.1%) monitored the HbA1c in the past 6 months. FPG, 2-hour PPG and HbA1c were negatively correlated with the frequency of SMBG. The influencing factors of SMBG were insulin treatment and education. Conlusion The SMBG status in D2TM patients is relatively poor in Sichuan province, and the compliance of SMBG is expected to be improved by enhancing diabetic education.
Objective To systematically review literature on the influencing factors related to adolescent sub-health problems. Methods We electronically searched the following four databases including CBM, VIP, CNKI and WanFang Data to collect Chinese literature on adolescent sub-health status and problems in China published before May 2012. Two reviewers independently screened literature, extracted data, and cross checked records. Then qualitative analysis was applied. Results According to the inclusion and exclusion criteria, 41 cross-sectional studies were included. The results of qualitative analysis showed that the influencing factors of adolescent sub-health could be classified into four categories including social factors, family factors, school factors, and interpersonal relationships. The main ones were social support, employment pressure, family economic conditions, learning burden, unhealthy habits, etc. Conclusions There are many influencing factors of adolescent sub-health with interaction. Due to the limitation of the included studies, more prospective cohort studies are needed to provide high quality evidence.
Objective Through the analysis of hospital costs of 16 866 cases of patients with lung cancer in Sichuan Province, in oder to find the main influencing factors of hospital costs of patients with lung cancer, and to provide references for reducing the hospital costs of patients with lung cancer. Methods We selected information of in-patients with lung cancer in 6 hospitals in Sichuan province from January 2008 to December 2011 based on full consideration into the local economic levels geographics distribution of different regions in Sichuan province. Then we extracted baseline data, hospitalization data and costs, and then analysis on relevant influencing factors was performed using single factor analysis of variance and multiple stepwise regression analysis. Results A total of 16 918 cases are chosen, of which, 16 866 were effective for further analysis. The results of statistical analysis showed that, the cost of western medicine accounted for the most of the average of the total hospital costs (50.79%) , followed by the cost of diagnosis and treatment (40.79%). The reuslts of multiple stepwise regression analysis showed that, the top three factors influencing hospital costs most included hospital stay, operation, and regions. Conclusion Facing daily increasing costs of hospital costs of lung cancer, effectively reducing drug expenses of patients could be a breakthrough. We could ultimately reduce the hospital costs of patients with lung cancer as well as the the economic burden of patients and society, by strengthening hospital management, shortening hospital stay, and rationally regulating drug use.
Objective To identify the factors which influence the effectiveness of clinical evaluation of undergraduate nursing students. Methods A self-made questionnaire was used in face-to-face interviews with 158 clinical teachers of undergraduate nursing students in four teaching hospitals in Sichuan. Results The main factors that influence the effectiveness of clinical evaluation of undergraduate nursing students included: clinical environment, duration of evaluation, degree of familiarity with the evaluation criteria of clinical teachers, and evaluation methods used by clinical teachers. The less important factors included: “halo-effect” of teachers to students, relationship between teachers and students, attitude towards evaluation and emotional status of clinical teachers. Conclusion It is of great importance to improve the clinical environment, provide enough time for clinical teachers to evaluate, cultivate and improve clinical teachers’ evaluation and competence, and establish a good relationship between teachers and students.This should improve the accuracy, objectivity and fairness of undergraduate nursing students’ clinical evaluation.
【Abstract】 Objective To analyze the influencing factors of no-reflow phenomenon after reperfusion in patients with chronic limb ischemia associated with acute thrombosis. Methods Between January 2009 and December 2010, 59 patients (67 limbs) with chronic limb ischemia associated with acute thrombosis were treated. According to whether the no-reflow phenomenon occurred or not, the patients were divided into no-reflow group (19 patients, 21 limbs) and reflow group (40 patients, 46 limbs). Logistic regression was used to analyze the roles of ischemia time, ischemia extent, smoking, hypertension, cardiovascular and cerebrovascular disease, diabetes, surgical procedure, platelet count, fibrinogen (FBG), prostaglandin I2 (PGI2), and thromboxane A2 (TXA2) on no-reflow phenomenon after reperfusion. Results The results of the logistic regression analysis indicated that ischemia time (OR=7.196; 95%CI: 1.679-27.960), ischemia extent (OR=5.116; 95%CI: 1.399-109.338), smoking (OR=6.893; 95%CI: 3.704-2 291.003), diabetes (OR=3.864; 95%CI: 1.009-421.702), PGI2 (OR=7.985; 95%CI: 1.001-1.043), and TXA2 (OR=7.643; 95%CI: 1.011-1.065) were the high risk factors of no-reflow phenomenon. The levels of TXA2 and FBG in no-reflow group were significantly increased and the level of PGI2 was decreased, showing significant differences when compared with the reflow group (P lt; 0.05). However, no significant difference was found in the platelet count between 2 groups (P gt; 0.05). Conclusion Ischemia extent and ischemia time are the main influencing factors of no-reflow phenomenon after reperfusion in patients with chronic limb ischemia associated with acute thrombosis, and the patients combined with smoking or diabetes are high risk population of the no-reflow phenomenon. Postoperative patients with no-reflow phenomenon are at a hypercoagulable state in vivo, in which prostacyclin plays an important role.
Objective To investigate the influencing factors of the hi p functional recovery after Pi pkin fracture surgery. Methods The cl inical data were retrospectively analysed, from 37 patients with Pi pkin fracture between May 2002 and February 2009. There were 32 males and 5 females, aged 26 to 98 years (median, 43 years). The causes of injury were traffic accident in 31 cases, a fall ing in 4 cases, and fall ing from height in 2 cases. The time from injury to operation was 1-28 days (mean, 8.6 days). According to the Pi pkin classification criteria, there were 23 cases of type II, 8 cases of type III, and 6 cases of type IV. Open reduction and internal fixation (ORIF) were performed in 27 cases, total hip arthroplasty (THA) in 10 cases.The relationships between gender, age, time from injury to surgery, type of fracture, treatment way and the hip functionalrecovery were analysed statistically. Results All patients achieved heal ing of incision by first intention, no infection anddeep venous thrombosis occurred. All patients were followed up 10 to 94 months with an average of 40.5 months. Bonefusion was observed at 5-11 months (mean, 8.9 months) in patients undergoing ORIF by X-ray examination; no prostheticloosening or subsidence occurred in patients undergoing THA. At last follow-up, Oxford Hip Score (OHS) was 16-58 points(mean, 37.2 points); the results were excellent in 12 cases, good in 13 cases, fair in 2 cases, and poor in 10 cases. The univarible analysis showed that the type of fracture and treatment way significantly affected the hip functional recovery (P lt; 0.05). The multivarible analysis showed that the type of fracture and treatment way had no significant effect on the hip functional recovery (P gt; 0.05). Conclusion Type and treatment way of Pi pkin fracture may affect postoperative hi p function recovery, so appropriate treatment should be selected based on fracture type to ensure the restoration of joint function.
Objective To investigate the causes of the vacuum seal ing drainage (VSD) compl ications during treatment of extremity wounds. Methods Between February 2005 and February 2010, 174 patients with skin and soft tissue defect of extremities were treated with VSD. Among them, 12 patients (6.9%) had compl ications and the cl inical data were analyzed retrospectively. There were 7 males and 5 females aged from 17 to 65 years (mean, 36.1 years). Injury was caused bytraffic accident in 8 cases, and by machine extrusion in 4 cases. The locations were forearm in 3 cases, upper arm in 2 cases, thigh and calf in 1 case, calf in 4 cases, and foot in 2 cases. The size of defect ranged from 10 cm × 7 cm to 90 cm × 40 cm. The time from injury to hospital ization was 3-8 hours (mean, 4.2 hours). Results At 1 day postoperatively, moderate to severe anemia and hypokalemia occurred in 6 cases, and the hemoglobin value increased to 100 g/L and the electrolyte disorder was rectified after blood transfusion and fluid infusion. At 2 days, 2 patients had local skin allergic symptoms, and local rash disappeared after oral administration of Clarityne. At 3 days, 2 patients complained pain and the pain was released after the suction pressure was decreased by 50%; 2 patients had infection and received VSD demol ition, debridement and draining, and anti-infection treatment. Tissue necrosis occurred in 1 case at 4 days and pressure ulcer in 1 case at 5 days, VSD was immediately changed and wound was repaired by spl it thickness skin graft or local flap. Conclusion Compl ications associated with VSD therapy for the wounds of the extremities are not very common. Most causes are related to the location of wound, the technique of the operators, and the conditions of the patients.
Objective To investigate the donor-site compl ications of the anterolateral thigh flap and its influencing factors. Methods Between July 1988 and July 2007, 427 patients were treated with anterolateral thigh flap. Among them, 33 patients had postoperative donor-site compl ications and their cl inical data were analyzed retrospectively. There were 21 malesand 12 females aged 14-47 years old (average 32.7 years old). The size of the wound defect ranged from 16 cm × 7 cm to 28 cm × 13 cm. The area of the flap harvested during operation ranged from 16 cm × 7 cm to 30 cm × 13 cm. The donor sites were treated by direct suture in 7 cases; free spl it-thickness skin graft in 23 cases, and reverse superficial epigastric artery flap repair in 3 cases. The size of graft in the donor site ranged from 10 cm × 5 cm to 18 cm × 8 cm. The occurrence of short-term (within 4 weeks) and long-term (over 6 months) compl ications were analyzed. Results All patients were followed up for 8-54 months (average 21 months). There were 26 patients (78.8%) with short-term and long-term compl ications and 7 patients (21.2%) with long-term compl ications. The short-term compl ications included skin graft necrosis in 23 cases (69.7%), wound infection in 17 cases (51.5%), and muscle necrosis in 2 cases (6.1%). The long-term compl ications included non-heal ing wounds in 21 cases (63.6%), serious scar in 28 cases (84.8%), discomfort in 25 cases (75.8%), and dysfunction of the quadriceps femoris in 16 cases (48.5%). Conclusion The occurrence of anterolateral thigh flap donor-site compl ications is related to the anatomical structure of the anterolateral thigh region, the surgical procedure, and the patient’s physique.
Objective To understand the adult male’s acceptance of circumcision and its influencing factors in Chongqing, so as to provide scientific evidences for developing male circumcision extension programs and health education materials. Methods The circumcision acceptance of adult males from 18 to 45 years old in Chongqing was investigated by using multistage stratified cluster sampling method. Results Among 1 502 subjects, 661 males persisted in their willingness to do circumcision, and the operation acceptance rate was 44.01%; the acceptance rate in the 18-30 age group was higher than that in the 31-45 age group; the higher the education level, the higher the acceptance of the circumcision; and workers and businessmen had greater willingness to accept than farmers. The multivariate logistic regression analysis showed that the positive factors affecting acceptance rate were “being aware that the circumcision is suitable for phimosis and redundant prepuce” (OR=21.01, 95%CI 14.21 to 31.06), “being told by friends who had circumcision before” (OR=1.65, 95%CI 1.25 to 2.19), and “being realized on the risk of phimosis and redundant prepuce” (OR=1.43, 95%CI 1.01 to 2.02); while the negative factors were “being worried about the surgical complications” (OR=0.69, 95%CI 0.50 to 0.95) and “being afraid of the ridicule from people around” (OR=0.63, 95%CI 0.40 to 0.99). Conclusion The willingness rate of adult males to accept circumcision was low in Chongqing; the publicity and education should be strengthened, and the good social atmosphere should be built for increasing the willingness rate of accepting circumcision.
Objective To investigate the basic condition and psychological health status of children in rural areas of Xibaipo town in Hebei province, learn the psychological problems of the leftover children and their influencing factors, and provide scientific basis for the school and family education for the leftover children. Methods A questionnaire survey was performed on 446 middle and primary school students in Xibaipo town, and the self-designed questionnaire was applied to collect the basic condition, family condition and psychological health status of the children. EpiData 3.0 and SPSS 17.0 were used to perform data entry and data analyses, respectively. Results The survey displayed that the leftover children accounted for 43.5% of the total number of students. The negative emotion of leftover children was significantly ber than that of non-leftover children (χ2=12.484, Plt;0.001), especially for children with both parents living far away. The main factors affecting children’s emotion were their academic performance and whether they were left behind by their parents. Conclusion The psychological health status of the leftover children is poorer than that of non-leftover children, especially for children with both parents working outside and mothers working outside. Being left over and the academic performance are the factors affecting children’s mental condition. More attention should be paid to the physical and mental development of leftover children and vigorous efforts should be exerted to formulate corresponding policies and take countermeasures so as to promote healthy growth of children.