Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-05-21 Cooperative journals: 《中国全科医学》
Abstract： Background Pharmacotherapy is the cornerstone of primary and secondary prevention of atherosclerotic cardiovascular diseases（ASCVD），but the values and preferences of community patients for pharmacotherapy remain unclear. Objective To understand the values and preferences surrounding pharmacotherapy among community patients at risk of or undergoing treatment for ASCVD，which would help clarify the individualized treatment burden and provide patient centered clinical practice. Methods This study employed a sequential exploratory mixed-methods design. Firstly，we recruited eligible patients in West China Hospital of Sichuan University and Yulin Community Health Service Center in Wuhou District，Chengdu City from November 2021 to January 2022. for a focus group discussion，aiming to collect qualitative insights into their experience，values，and preferences for medication use. The software MAXQDA 2020 was used to support qualitative data analysis，and Colaizzi's seven-step approach was further used to identify themes. After completing the qualitative phase，a questionnaire was designed based on the emergent themes to further quantitatively analyze the values and preferences regarding pharmacotherapy. Results Four themes emerged from the qualitative data，including knowledge and use of medications，barriers of medication use，facilitators of medication use，and need for medical services. A total of 186 valid questionnaires were collected in the quantitative study（response rate of 93.5%）. The quantitative data showed a commonality in missed dose and confirmed the existence of social stigma and treatment burden in this group of participants. Although preferences in medication use were highly heterogeneous，participants generally preferred taking fewer medications with less frequency，and were less likely to use injectable medications. Conclusion The study suggests that it may be appropriate to increase the use of compound preparations，and make treatment plans in accordance with patients' daily lives and work to reduce the treatment burden of pharmacotherapy. In addition，we should be active in managing the misconceptions and improper practices in pharmacotherapy in order to improve patients' medication adherence.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-05-14 Cooperative journals: 《中国全科医学》
Abstract： The innovative integration of treatment and prevention is pivotal for enhancing the healthcare system and advancing Healthy China. Guided by a focus on preventive health policies，it fosters collaboration between treatment and preventive services，ensuring seamless linkage across health promotion，prevention，treatment，rehabilitation，and end-of#2;life care. Conceptually，this shift involves transitioning from unidirectional intervention to comprehensive health management，from provider-driven to participatory decision-making，and from transient doctor-patient relationships to sustained accountability relationships. Structurally，it emphasizes coordination between medical and public health systems，collaboration among healthcare institutions，and multi-stakeholder governance. Institutionally，it optimizes evaluation，financing，remuneration，and talent development systems while leveraging intelligent means for integration and promoting interoperability across personnel，resources，and information.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-05-10 Cooperative journals: 《中国全科医学》
Abstract： Background The key task in China's medical and health field during the "14th Five-Year Plan" period is to realize treatment-prevention integration and innovate the mechanism of treatment-prevention integration. Objective This paper analyzes the implementation mechanism of treatment-prevention integration under the background of integrated service system construction，and provides reference for exploring the path of medical and prevention integration adapting to the strategy of “Healthy China”. Methods Taking 2018 as the time node，relevant literature was searched on CNKI and Wanfang data knowledge service platform with keywords of "treatment-prevention integration"，"medical and prevention coordination"，"combination of prevention and treatment" and literatures on case policies，measures and implementation effects of integrated service systems such as medical alliance. Finally，18 literatures and 15 cases were selected. Based on the rainbow model，system integration，organizational integration，professional integration，service integration，functional integration and normative integration were determined as condition variables from macro，meso and micro levels and supporting factors，and the effect of treatment-prevention integration was determined as result variable. QCA was adopted to explore the implementation mechanism of medical and preventive integration under the background of integrated service system construction. Results There were four configuration paths that could effectively improve the effect of treatment-prevention integration，and the four paths were in line with the multi-layer integrated path and the medium-micro integrated path respectively. The following results were obtained：（1）It was more effective to carry out treatment-prevention integration relying on the integrated service system，and there are multiple paths that can effectively improve the effect of treatment-prevention integration under the integrated service system；（2）Service integration plays a fundamental role in improving the effect of medical and preventive integration；（3）The setting of relevant policy indicators for improving the system integration，professional integration and functional integration of treatment-prevention integration is not perfect. Conclusion （1）Relying on the construction of integrated service system to promote the improvement of treatment-prevention integration effect；（2）Give full play to the basic guarantee role of service integration；（3）Make reference to the successful experience of multi-level integration cases，set policy indicators at macro，meso and micro levels in a balanced manner，and improve the integration of system integration，professional integration and supporting elements.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-05-10 Cooperative journals: 《中国全科医学》
Abstract： As an important direction of China's medical and health system reform，medical and prevention integration is of great significance to meet the all-round health needs of the people，and how to establish a scientific and effective medical and prevention integration model is a top priority. Using literature analysis and other methods to collect data，the implementation status and dilemma of China's medical and prevention integration policy were reviewed，and the influencing factors of medical and prevention integration policy implementation were analyzed based on the six dimensions of the Horn-mitt model. On this basis，it is proposed to refine policy objectives，clarify policy implementation standards，increase resource supply，enrich policy implementation methods，explore common interests of medical and defense institutions，improve "coordination mechanisms"，and actively guide policy implementers to carry out medical and prevention integration services. It aims to provide reference significance for the high-quality improvement of medical and prevention integration services in the future.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-05-08
Abstract： Background Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by multiple symmetrical erosive arthritis. IgG glycosylation has been shown to play a role in various immune processes and has been associated with the onset and progression of RA. Objective To systematically review the relationship between IgG glycosylation and RA, and offer insights for the development of RA preventive strategies. Methods We conducted a systematic review for researches on the association between IgG glycosylation and RA in PubMed, Web of Science, CNKI, Wanfang Database, and Weipu Database as of May 1, 2024. The quality of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework. Results A total of 469 relevant studies were identified, and 45 studies were included in this systematic review. The exposure factors in these studies were IgG glycosylation levels, and the outcomes included preclinical RA, RA transition, early RA, established RA, RA activity levels, RA remission, and RA during pregnancy. The results of GRADE indicated that most of the evidence provided was of low to moderate quality (88.9%). Conclusion This systematic review revealed that IgG glycosylation and its derived structures were associated with RA and demonstrated predictive capabilities in identifying RA and evaluating the therapeutic outcomes in RA treatment. However, for more precise conclusions, future research should prioritize high-quality, large-scale randomized controlled trials.
Peer Review Status:
Awaiting Review
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics Subjects: Statistics >> Biomedical Statistics submitted time 2024-05-06
Abstract： 【Abstract】 Extremely unbalanced data here refers to datasets where the values of independent or dependent variables exhibit severe imbalances in proportions, such as extremely unbalanced case-control ratios, very low disease incidence rates, heavily censored survival data, and low-frequency or rare genetic variants. In such scenarios, test statistics in classical statistical methods, such as logistic regression and Cox proportional hazards models, may deviate from normality or chi-square assumptions, leading to difficulties in controlling type I errors. With the increasing availability and exploration of resources from large-scale population cohorts in whole-genome association studies, there is a growing demand for efficient and accurate statistical approaches to handle extremely unbalanced data in independent and non-independent samples. To address this need, this paper provides a systematic methodological overview. Firstly, it derives test statistics from classical statistical methods. Secondly, it elucidates the impact of extremely unbalanced data on the distribution of test statistics. Thirdly, it introduces two widely used methods for correcting statistics in genome-wide association studies: Firth correction and saddlepoint approximation methods. Finally, it briefly introduces commonly used software for extremely unbalanced genomic data. This paper provides theoretical references and application recommendations for the statistical analysis of extremely unbalanced data.
Peer Review Status:Awaiting Review
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-04-15 Cooperative journals: 《中国全科医学》
Abstract： Background The prevalence of pelvic floor dysfunction in postmenopausal women is progressively increasing，leading to a significant impact on both their physical and mental well-being due to stress urinary incontinence. Objective This study investigates the impact of menopausal hormone therapy（MHT）in conjunction with Kegel exercises on pelvic floor structure and clinical symptoms in individuals experiencing mild to moderate stress urinary incontinence（SUI）. Methods A total of 75 patients with menopausal syndrome accompanied by mild to moderate SUI who visited the Menopause Clinic at Beijing Shijitan Hospital in 2022 were selected. They were allocated into the MHT group and the control group in a 2∶1 ratio using a random number table method，and the MHT group was further randomly divided into subgroups receiving Tibolone and estrogen and progestogen therapy（EPT）in a 1∶1 ratio. Both the control group and the MHT group underwent pelvic floor muscle training（PFMT），commonly referred to as Kegel exercises，for 15-30 minutes per session，2-3 times daily，and 2-3 times weekly，over a continuous period of 12 months. The control group received KunTai capsules orally in combination with PFMT，with 4 capsules taken per dose，3 times a day，for 12 months. The MHT group received menopausal hormone therapy in conjunction with PFMT. The EPT subgroups include continuous combined estrogen-progestin therapy（1 mg estradiol valerate + 10 mg dydrogesterone，once daily），continuous sequential estrogen-progestin therapy（femoston 12 courses），and the Tibolone subgroup takes tibolone orally，all of which were administered continuously for 12 months. The study examined serum estradiol（E2）and follicle-stimulating hormone（FSH）levels within and between groups and subgroups before and after treatment. In addition，measurements were obtained for urethral rotation angle（URA），bladder detrusor thickness（BDT），posterior vesicourethral angle（PVUA），levator hiatus area（LHA），urinary incontinence quantification，urinary incontinence score，clinical efficacy，as well as changes in the modified Kupperman Menopausal Index（KMI）score，and the modified oxford staging（MOS）. Results Upon completion of the study，7 participants from the MHT group were lost to follow-up（5 in the Tibolone subgroup and 2 in the EPT subgroup），with 3 participants from the control group also lost to follow-up. In the end，a total of 65 participants were included. After 1 year of treatment，there were no statistically significant differences in FSH，E2，and MOS between the MHT group and the control group（P>0.05）. After 1 year of treatment，there were no statistically significant differences in PUVA，BDT，and URA between the MHT group and the control group（P>0.05）.However，the LHA of the MHT group was significantly lower than that of the control group（P=0.028）. After 1 year of treatment，there were no statistically significant differences in PUVA，BDT，URA，and LHA between the EPT and Tibolone subgroups（P>0.05）. Statistically significant differences were found in the comparison of clinical efficacy between the control group and the MHT group（P=0.010）. Conversely，no statistically significant differences were observed in the comparison of clinical efficacy between the EPT and Tibolone subgroups（P=0.724）. After 1 year of treatment，the MHT group showed lower urinary incontinence quantity，urinary incontinence score，and KMI score compared to the control group（P<0.05）. Before and after the treatment，there were no statistically significant differences in urinary incontinence quantity，urinary incontinence score，and KMI score between the EPT and Tibolone subgroups（P>0.05）. Conclusion The combination of MHT with PFMT yields a positive effect on the pelvic floor structure and markedly alleviates symptoms of urinary incontinence. Nevertheless，there is no significant differences between EPT and Tibolone in the improvement of pelvic floor structure and alleviation of clinical symptoms in patients.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-04-15 Cooperative journals: 《中国全科医学》
Abstract： The Screening Tool of Older Person's Potentially Inappropriate Prescriptions（STOPP）and the Screening Tool to Alert to Right Treatment（START）were initially developed by a panel of experts from Cork University Hospital，Ireland in 2008，and underwent a second update in 2015. Since their inception，these criteria have played a pivotal role in identifying potentially inappropriate medication use in the elderly，enhancing oversight of medication misuse in older individuals，and reducing adverse drug events among the elderly. In 2023，the third edition of the STOPP/START criteria was released，providing updated and more practical evidence-based guidance. Building upon the second edition，this iteration includes the addition，revision，and removal of certain criteria，resulting in a total of 190 new standards for potentially inappropriate medication use. This latest version incorporates the most recent research findings and clinical evidence related to appropriate medication use in older adults. We provide a detailed analysis of the STOPP/START criteria （version 3），offering valuable insights for the updating and refinement of potentially inappropriate medication criteria in our country. Furthermore，it presents recommendations for future research in this field.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-04-15 Cooperative journals: 《中国全科医学》
Abstract： Background Low back pain（LBP）in middle-aged and elderly adults has become a significant public health issue worldwide. Physical activity and sleep are two core components of the 24-hour lifecycle，and maintaining adequate physical activity and good sleep are crucial for health，both of which are associated with LBP. Objective To investigate the prevalence of LBP in middle-aged and elderly adults in China，analyze the independent and combined effects of physical activity and sleep on its occurrence，and provide scientific evidence for behavioral health. Methods Based on the 2018 China Health and Retirement Longitudinal Study，participants without demographic，physical activity，sleep，and LBP data were excluded. A total of 13 496 eligible individuals aged 45 to 69 were included，and their demographic and behavioral information was collected. Binary logistic regression and multiple linear regression were used to examine the relationship between physical activity，sleep duration，and LBP，and a mediation model was constructed to analyze the mediating effect of sleep duration on the association between physical activity and LBP. Results The prevalence of LBP among the 13，496 participants was 39.0%（n=5 269）.Inadequate sleep（<7 hours）was reported by 57.1%（n=7 704）of middle-aged and elderly adults in China，with 11.6%（n=1561）engaging in mild physical activity and 88.4%（n=11 935）engaging in moderate to high-intensity physical activity. The multicollinearity diagnosis results for confounding variables（e.g.，gender，age，alcohol consumption，and smoking） showed that all variance inflation factors were less than 5，indicating no collinearity. Regression analysis revealed a positive correlation between physical activity and LBP（β=0.120，P<0.05），a negative correlation between sleep duration and LBP（β=-0.220，P<0.01），and a negative correlation between physical activity and sleep duration（β=-0.081，P<0.05）. The mediation analysis of categorical variables indicated Z=2.223>1.96，and the path from physical activity to LBP was not significant（β=0.105，P>0.05），suggesting a complete mediating effect of sleep duration on the association between physical activity and LBP. Conclusion Over one-third of middle-aged and elderly adults in China suffer from LBP. Higher levels of physical activity or shorter sleep duration are associated with increased risk of LBP. Sleep duration plays a complete mediating role in the association between physical activity and LBP，where the increased risk of LBP associated with high-intensity physical activity is completely transmitted through reduced sleep duration. Adequate sleep duration plays an important role in reducing the risk of LBP associated with high-intensity physical activity. This study suggests that older adults should adjust their exercise intensity according to their own conditions and maintain adequate sleep duration to reduce the risk of LBP.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-04-01
Abstract： Objective To explore the intervention effect of Lentinan (LNT) on liver lipid deposition induced by sodium arsenite (SA) in C57BL/6 mice. Methods The experiment was divided into four groups (8 mice/group): control group, SA exposure group, LNT intervention+SA exposure group, LNT control group. C57BL/6 mice were exposed by SA (SA dissolved in deionized water, drinking water exposure 10.0 mg/L, 8 weeks) and LNT intervention treatment (1.0 mg/kg, intramuscular injection, once every other day, 8 weeks). After the experiment, liver tissue samples were collected and the characteristics of liver lipid deposition were observed by oil red O staining of liver tissue sections. The levels of triglyceride (TG) and adiponectin (APN) in the liver tissue of mice were detected by enzyme-linked immunosorbent assay (ELISA), and the statistical differences between the groups were analyzed by analysis of variance (ANOVA) and least significant difference (LSD). Results Compared with control group, SA exposure mice showed that lipid deposition in liver tissues, decreased APN level, and increased TG level (P<0.05). Compared with SA exposure group, LNT intervention+SA exposure group showed that the reduced degree of liver lipid deposition, the increased level of APN, and the decreased level of TG (P<0.05). For LNT control group, similar to the control group, the liver tissue morphology was normal, and the levels of APN and TG had no statistical difference compared with the control group (P>0.05). Conclusion SA-induced liver lipid deposition in C57BL/6 mice may be related to the down-regulation of APN level. LNT intervention can increase APN level to antagonize SA-induced liver lipid deposition in C57BL/6 mice.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-04-01 Cooperative journals: 《中国全科医学》
Abstract： Background Hypertension is a major risk factor for cardiovascular disease. Antihypertensive drug therapy should not only consider the characteristics of the patient's blood pressure but also the patient's comorbid conditions. Currently，there is a lack of research on the medication status and influencing factors of hypertensive patients based on family doctor services. Objective To investigate the current medication status of hypertensive patients who purchased family doctor contract services in Jieshou City，Anhui Province，to describe the association between patient medication behavior and patient characteristics，to explore the influencing factors of medication adjustment，and to analyze the rationality of medication use in primary hypertensive patients. Methods Using cluster sampling，from July to August 2021，48 administrative villages were randomly selected from Jieshou City，Anhui. Data on patient characteristics and medication were collected through face-to-face interviews using a self-made questionnaire. According to the "National Guidelines for the Prevention and Management of Hypertension at the Primary Level（2020 Edition）"，the antihypertensive drugs mentioned by patients in the questionnaire were divided into five categories：category A includes angiotensin-converting enzyme inhibitors（ACEIs）and angiotensin receptor blockers（ARBs），category B includes beta-blockers，category C includes calcium channel blockers（CCBs），category D includes diuretics，and category E includes single-pill combination drugs. Blood pressure data uploaded by patients over the past year were obtained from the backend of iFLYTEK's intelligent voice blood pressure monitor to analyze the medication behavior of patients with different characteristics. Multivariate Logistic regression analysis was used to explore the influencing factors of medication adjustment in hypertensive patients. In this study，"combination medication" refers to taking a combination drug or two or more antihypertensive drugs，and "medication adjustment" refers to patients previously taking other antihypertensive drugs. Results A total of 3，005 hypertensive patients were included in this study，including 1 291 males（43.0%）and 1 714 females（57.0%），with an average age of（65.5±9.8）years. The medication rate of hypertension was 79.1%，and the rate of combination medication was 40.2%. Among the 2 376 patients taking antihypertensive drugs，the rates of different types of antihypertensive drugs from high to low were（some patients had combination medication）：category E（39.6%），category C（35.1%），category D（20.3%），category A（20.1%），and category B（3.7%）；the most frequently taken antihypertensive drug was compound lisinopril（33.7%）. For patients with an average annual blood pressure ≥ 160/100 mmHg，12.2% and 4.9% still did not take antihypertensive drugs. Patients' combination medication mainly involved category E antihypertensive drugs. For patients with an average annual "diastolic pressure ≥ 100 mmHg" and "with complications"，the rates of adjusted category A and C antihypertensive drugs increased relatively more；for patients with an average annual "systolic pressure ≥ 160 mmHg" and "without complications"，the rate of adjusted category E antihypertensive drugs increased relatively more. Multivariate Logistic regression results showed that longer duration of medication（OR=1.042，95%CI=1.031-1.053，P<0.001），education level above junior high school（OR=1.488，95%CI=1.195-1.853，P<0.001），combined hyperlipidemia（OR=1.267，95%CI=1.052-1.525，P=0.013），combined cardiovascular complications（OR=1.394，95%CI=1.166-1.667，P<0.001），and combined cerebrovascular complications（OR=1.258，95%CI=1.040-1.522，P=0.018）were promoting factors for medication adjustment in patients，while advanced age（OR=0.980，95%CI=0.971-0.990，P<0.001）was an inhibiting factor for medication adjustment. Conclusion The medication rate among rural hypertensive patients in Jieshou City is high，mainly involving category E and C antihypertensive drugs. The use of various antihypertensive drugs by primary care physicians is generally reasonable，but the management of medication，especially the application of combination medication strategies for patients with secondary hypertension and those with complications，needs to be improved.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-04-01 Cooperative journals: 《中国全科医学》
Abstract： Background The prevalence of allergic diseases is rapidly increasing among the global population，affecting 10%-40% of people worldwide. Allergic diseases often begin in childhood. So far， data for analyzing the trends in the incidence of pediatric allergic diseases in China over the past decade are scant. This study aims to provide an epidemiological support for the prevention and management of pediatric allergic diseases in China by mining electronic medical record data from a single-center institution. Objective To analyze the annual proportion and trend of outpatient visits for allergic diseases among children aged 0-18 years in the Beijing Children's Hospital，Capital Medical University from 2014 to 2021. Methods A retrospective analysis of outpatient electronic medical records from the hospital information system of Beijing Children's Hospital，Capital Medical University from 2014 to 2021 was conducted to examine the annual proportional composition and changes in the trend changes of allergic diseases. The gender- and age-based proportions of different allergic diseases including eczema，urticaria，allergic rhinitis，bronchial asthma，allergic cough，allergic conjunctivitis，food allergies，drug allergies，pollen allergy，and anaphylaxis were calculated. The trend of changes in the proportion of allergic diseases with stable annual composition ranking in the top 10 was further analyzed. Results From 2014 to 2021，there were a total of 1 231 890 outpatient visits for pediatric allergic diseases in our center. After excluding missing data，a total of 1 231 863 eligible cases were included，involving 727 082（59.0%）boys and 504 781（41.0%）girls. The majority of children visited for allergic diseases were under the age of 3 years（46.9%）. There were significant differences in the gender and age among children visited for allergic diseases（P<0.05）.Non-IgE mediated allergic diseases，such as henoch-schoenlein purpura，bronchitis，and respiratory tract infections were excluded，and the remaining 1 208 265 cases included in the disease spectrum analysis. From 2014 to 2017，the top 5 allergic diseases visited in the outpatient department were eczema，urticaria，allergic rhinitis，bronchial asthma，and allergic cough. From 2018 to 2021， allergic rhinitis，eczema，urticaria，allergic conjunctivitis，and bronchial asthma ranked the top 5. The trend analysis for an annual proportion of pediatric allergic diseases showed that the ratios of allergic rhinitis，allergic conjunctivitis，and food allergies among all allergic diseases from 2014 to 2021 showed an increasing trend，with peak ratios of 45.4%，11.1% and 2.8%，respectively. The ratios of urticaria，eczema，and bronchial asthma showed a decreasing trend，with peak ratios of 46.5%，24.9% and 11.3%，respectively. Conclusion From 2016 to 2021，the proportion of outpatient visits for pediatric allergic diseases in Beijing Children's Hospital，Capital Medical University showed an upward trend. Between 2014 and 2021，the annual proportions of allergic rhinitis，allergic conjunctivitis，and food allergies exhibited an increasing trend，while the annual proportions of eczema，urticaria，and bronchial asthma demonstrated a decreasing trend.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-04-01 Cooperative journals: 《中国全科医学》
SU Jin
SHOU Juan
GU Wenqin
YI Chuntao
XU Liping
CHENG Lili
DING Hongjuan
ZHOU Peng
WU Yinghua
QIN Jie
XUE Bin
WEI Baichuan
WANG Qian
PENG Yan
CHENG Yimin
YANG Lan
WEI Yangyang
WANG Lei
QI Jinlin
SHAO Ying
Abstract： Background With the gradual deepening of the comprehensive reform of community health services，the prevention and control of single diseases for the entire population in the community is also constantly being optimized，However，there is still a lack of appropriate evaluation methods in the community to reflect its prevention and control effectiveness evaluation. Objective By analyzing and exploring the cost effect of the existing whole-population prevention and control measures of osteoporosis in Fenglin community，from2016 to 2022，this paper answers the initial results and possible problems of the whole population prevention and control of single disease in the community. Methods This study conducted a cost-effectiveness analysis on 4293 community residents who received osteoporosis prevention and treatment in Fenglin Community from 2016 to 2022. Divide the research object into three states based on bone density values: healthy，low bone mass，and osteoporosis，and construct a Markov model to analyze the influencing factors of different state transitions. And based on the predicted values of the Markov model combined with quality adjusted life years （QALY），the increment of quality adjusted life years（QALY） is calculated. All costs invested in prevention and control work from 2016 to 2022 are counted，and the effectiveness of prevention and control is evaluated by the cost/quality adjusted life year increment ratio. Quality adjusted life years （QALY）are obtained by calculating the health utility value and expected life determined through literature search. Results The total cost of osteoporosis prevention and treatment in Fenglin community was 33，814，102.15 yuan. The total quality-adjusted life years of 4293 community osteoporosis prevention and treatment population were 77098.2889 at the first diagnosis，the average per capita was 17.959，and the standard deviation was 9.34. At the second diagnosis，the total quality-adjusted life years were 79616.9361，the mean per capita was 18.546，the standard deviation was 9.342，and the difference between the two diagnoses was 2，518.6472. The incremental cost-effectiveness ratio （ICER） is 2，132.9070 yuan /QALY，and the incremental cost#2;effectiveness ratio （ICER） is less than 1 times （66，965.10 yuan） per capita GDP，indicating that the intervention scheme is fully cost-effective. Conclusion This study combined Markov model and quality-adjusted life years （QALY） to make a preliminary evaluation of the prevention and treatment effect of osteoporosis in Fenglin community. The results showed that the intervention program of osteoporosis prevention and treatment in Fenglin community was worth investing， and provided a certain basis for the accurate prevention and treatment decision of osteoporosis in the future.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-03-28 Cooperative journals: 《中国全科医学》
Abstract： Traditional Chinese Medicine（TCM） is an important part of Chinese traditional culture. It's also an important health resource，economic resource，technological resource，cultural resource and ecological resource in our country.The international development of TCM is an important part of the inheritance and innovation of TCM. In the global Traditional Medicine system，Indian Traditional Medicine is the most influential. Development status，international development strategies and impact of Indian Traditional Medicine are greatly comparable with those of TCM. From the perspective of international development，this paper compared TCM and Indian Traditional Medicine from seven aspects：service delivery，health workforce，production capacity of traditional medicines，financial allocation for health system and health insurance policy，health governance，product export situation and target markets，international development and influence. It aimed to learn from the successful experience of the international development of Indian Traditional Medicine，and provide reference for the international development of TCM. In order to actively promote the international development of TCM，make important contributions to deepening the cultural identity of TCM overseas and promote the participation of TCM in global health governance.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-03-27 Cooperative journals: 《中国全科医学》
Abstract： Background Acute Myocardial Infarction（AMI） remains one of the leading threats to global public health. Despite available reperfusion therapies，major adverse cardio-cerebral events（MACCEs） associated with AMI continue to be a leading cause of death worldwide. This is particularly true for patients with AMI and concomitant diabetes mellitus，where coronary artery disease is more complex and severe，making early detection and prognosis of long-term outcomes for these patients challenging. Therefore，the identification of simple and accessible laboratory markers could facilitate the prediction of postpercutaneous coronary intervention（PCI） MACCEs in patients with type 2 diabetes mellitus（T2DM） and AMI. Objective To investigate the predictive value of the serum C-reactive protein（CRP）/Albumin（Alb） ratio（CAR） for long-term MACCEs following PCI in patients with T2DM and AMI. Methods A total of 1 683 patients with T2DM and AMI treated at the Cardiovascular Department of Ningxia Medical University General Hospital between 2014 and 2019 were enrolled. General clinical data and test results were collected for these patients. Follow-ups were conducted via telephone or outpatient visits，with a median follow-up period of 5.6 years. MACCEs were defined as all-cause mortality，non-fatal myocardial infarction，recurrent unstable angina，non-fatal stroke，new-onset heart failure，or rehospitalization for worsening heart failure，and revascularization. Patients were divided into the MACCEs group（508 cases） and the non-MACCEs group（1 175 cases） based on the occurrence of major adverse cardiovascular events during the follow-up period. Univariate and multivariate logistic regression analyses were performed to identify factors influencing MACCEs in patients with T2DM and AMI. Kaplan-Meier survival curves were plotted，and the Log-rank test was used for comparisons. Receiver operating characteristic（ROC） curve analysis assessed the predictive efficacy of CAR for long-term MACCEs in patients with T2DM and AMI，while the net reclassification improvement （NRI）and integrated discrimination improvement（IDI） indices evaluated the improvement in prognostic assessment provided by CAR. Results Among the 1 683 patients，508 （30.18%） experienced MACCEs. Multivariate logistic regression analysis indicated that hypertension ［OR（95%CI）=1.994（1.142-3.483）］，length of coronary stent implanted ［OR（95%CI）=1.031（1.002-1.062）］，CRP［OR（95%CI）=0.950（0.915-0.986）］，Alb［OR（95%CI）=0.933（0.880-0.989）］，and CAR［OR（95%CI）=5.582（1.705-18.277）］ were significant predictors of post-PCI MACCEs in patients with T2DM and AMI（P<0.05）. Based on the median CAR level（0.86），patients were divided into two groups：CAR<0.86 and CAR ≥ 0.86. The log-rank test showed that the incidence of MACCEs was significantly higher in the CAR ≥ 0.86 group compared to the CAR<0.86 group（52.68% vs. 22.92%；χ2 =65.65，P<0.001）. The ROC curve indicated that the area under the curve（AUC） for CAR in predicting MACCEs was 0.728（95%CI=0.702-0.754），with an optimal cut-off value of 0.576，sensitivity of 0.617，and specificity of 0.747. Compared to baseline models，CAR significantly improved the prediction of adverse cardiocerebral events［C-index=0.149，P<0.01；NRI=0.377（0.067，0.597），P<0.05；IDI=0.166（0.025，0.257），P<0.05］. Conclusion CAR is an effective predictive marker for the risk of long-term MACCEs in patients with T2DM and AMI following PCI.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-03-26 Cooperative journals: 《中国全科医学》
Abstract： Background Obstructive pulmonary disease（COPD）is a major chronic disease，and airway remodeling is an important pathological mechanism. Bufei Yishen formula and effective-component compatibility of Bufei Yishen formula Ⅲ（ECC-BYF Ⅲ）are effective for COPD treatment. ECC-BYF Ⅲ significantly improves airway remodeling of COPD model rats，however，the components compatibility remains to be revealed. Objective To evaluate the effect of ECC-BYF Ⅲ and components compatibility in treating airway remodeling of COPD based on the COPD rat model. Methods The components of ECC-BYF Ⅲ were divided into four categories：Buqi，Bushen，Huatan，and Huoxue. The four categories were divide into different groups according to the method of mathematical permutation. The animal experiment were performed during May to September in 2018. 216 SD rats were randomly divided into normal，model，ECC-BYF Ⅲ，different components compatibility and aminophylline groups，and 12 rats in each model. From week 1 to week 8，rat model of COPD in stable phase was established by cigarette smoke exposure combined with repeated bacterial infections. The rats were orally gavaged with corresponding drugs from week 9 to week 16. Hematoxylin eosin（HE）staining technique was used to observe the changes of bronchial wall and airway smooth muscle. Enzyme linked immunosorbent assay（ELISA）was used to detect the levels of matrix metalloprotein 12（MMP-12），basic fibroblast growth factor（bFGF）in serum and levels of collagen（COL）-1，COL-3，and MMP-12 in bronchoalveolar lavage fluid（BALF）. Region（R）value comprehensive evaluation method was used to evaluate the effect of different component compatibility on airway remodeling in COPD rats. Results ECC-BYF Ⅲ，different components compatibility and aminophylline weakened the thickness of airway wall，when compared to model group. ECC-BYF Ⅲ，Buqi Huatan，Fuzheng Huatan，Fuzheng Huoxue，Buqi Quxie and aminophylline significantly decreased the number of airway smooth muscle hyperplasia（P<0.05）. When compared to model group，the level of bFGF in serum decreased in ECC-BYF Ⅲ，Bushen，Buqi Huatan，Buqi Huoxue，Bushen Huatan，and Bushen Huoxue groups. The level of MMP-12 in serum decreased ECC-BYF Ⅲ，Fuzheng groups. The levels of MMP-12，COL-1 in BALF decreased in ECC-BYF Ⅲ，different components compatibility and aminophylline groups. The level of COL-3 in BALF decreased in ECC-BYF Ⅲ，Bushen，Huatan，Huoxue，Fuzheng，Buqi Huatan，Buqi Huoxue，Bushen Huoxue，Fuzheng Huatan，Buqi Quxie，Bushen Quxie，and aminophylline groups（P<0.05）. The results of R-value comprehensive evaluation about airway wall thickness，airway smooth muscle hyperplasia，indicators related to airway remodeling in serum and BALF in COPD rats showed that the components compatibility，except for Huatan，Quxie，ECC-BYF Ⅲ，other components compatibility and aminophylline improved the airway remodeling of COPD rats（P<0.05）. Buqi Quxie，Fuzheng Huatan，and Buqi Huoxue showed better effects in improving airway remodeling in COPD rats. Conclusion ECC-BYF Ⅲ and its components compatibility showed different effects on airway remodeling in COPD rats. Buqi Quxie，Fuzheng Huatan，Buqi Huoxie（containing ginsenoside Rh1，astragaloside）showed better effects.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-03-26 Cooperative journals: 《中国全科医学》
Abstract： Background In outpatient clinics, physicians serve as the primary providers of medical treatment activities; their positive attitudes and effective patient-physician communication methods are essential for guaranteeing high quality healthcare services. Objective To compare the outpatient doctor's emotional state and completion of communication details between outpatient doctor's experiential communication and GLTC communication. To provide a reference for improving a doctor's communication skills and emotional state in the future. Methods From July 2021 to January 2022，24 outpatient doctors from 6 departments in 4 tertiary general hospitals in Nanjing，Jiangsu Province were randomly selected as the research objects. Outpatient doctor-patient communication scenes meeting the criteria were selected as observation scenes. All of the included outpatient doctors in the same cohort underwent an individual experiential communication program first（recorded as the experiential group）. Next，they received training on the outpatient GLTC doctor-patient communication program. Finally，the doctors conducted outpatient GLTC communication one week later（recorded as the GLTC group）. The experiential group and the GLTC group were compared in terms of the Brief Profile of Mood States（BPOMS）score before and after communication as well as the completion rate of communication details. Results The fatigue dimension score of BPOMS after communication was higher than that before communication in the experiential group（P<0.05）；After communication，The fatigue and confusion dimension score of BPOMS in the GLTC group were lower than the experiential group（P<0.05）；the completion rate of communication details in the GLTC group such as kind gaze（reception），polite language（reception），smile（reception），not easily interrupting patients，timely nodding response，appeasement，informing the necessity，patience（experimental examination），consulting patients' opinions，patience（diagnosis and communication），popular explanation，language comfort，friendly attitude，getting up（ending and explaining），kind gaze（ending and explaining）），polite language（ending and explanation），smile（ending and explanation）was higher than the experiential group（P<0.05）. Conclusion Compared with experiential communication，GLTC communication is more capable of improving doctors' emotional state and relieving doctors' fatigue. At the same time，the completion rate of the corresponding communication details is improved，but there is still room for improvement in the completion rate of some communication details.
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-03-26 Cooperative journals: 《中国全科医学》
Abstract： Background The level and quality of diagnosis and treatment of Helicobacter pylori（Hp）infections in Shanghai's community health service Institutions is unclear，and there is a lack of systematic evaluation and monitoring. Objective To understand the current status of diagnosis，treatment and management of Helicobacter pylori（Hp）infection in community health centers in Shanghai，to evaluate the quality of diagnosis and treatment，and to explore the problems and improvement measures. Method A questionnaire was distributed to a total of 249 community health centers in 16 administrative districts of Shanghai and 3 875 general practitioners（GPs）working in the community health centers from May to June 2022 to investigate the standardization of prescriptions for the eradication of Hp infections in the community health centers，the detection of Hp infections，the provision of drugs for the eradication of Hp infections，the management of Hp infections，the difficulties of Hp infections in the treatment of Hp infections，as well as the knowledge of community-based GPs on the diagnosis and treatment of Hp infections. Result The result of the prescription eradication program for Hp infection in primary health care facilities in Shanghai was only 32.0 percent correct. The proportion of health service centers with the ability to conduct Hp infection testing in primary healthcare institutions in Shanghai is high，nearly 80%. Most of the community health service centers were able to equip the basic medicines needed for the eradication of Hp，but the rate of bismuth equipment was low，54.6%. The rate of Hp diagnosis and treatment standard supervision was 80.0%. The demand for the training of standardized diagnosis and treatment of Hp infections was high，accounting for 66.7%. The main difficulties in Hp infection diagnosis and treatment were incomplete drug provision，insufficient doctor's diagnosis and treatment ability and insufficient equipment. Community general practitioners do not have enough basic knowledge about the diagnosis and treatment of Hp infection. Conclusion The capacity to conduct Hp testing needs to be further strengthened in primary care organizations in Shanghai，especially in remote community health service centers，including the purchase of more Hp-related testing equipment and reagents，and the completion of related medications needed for the eradication of Hp. In addition，it is necessary to further strengthen the standardized diagnosis and treatment training of Hp infection for community health centers，improve the diagnosis and treatment ability of general practitioners on Hp infection，and at the same time，strengthen the supervision of Hp diagnosis and treatment standardization，so as to further improve the diagnosis and treatment ability of community general practitioners on Hp infection.
Subjects: Psychology >> Applied Psychology Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-03-17
Abstract： HPV vaccination is an effective way to prevent and treat cervical cancer, but the vaccination situation in our country is not optimistic, and many young people hesitate to vaccinate HPV vaccine. Research has shown that information persuasion is an effective means to increase vaccination rates. This study will focus on the content of persuasion information and explore the relationship between influencing factors and individual personality characteristics. To this end, we recruited 284 subjects online to conduct a questionnaire survey and analyzed the data using ANOVA. The results show that there are significant differences in the persuasive effect of information containing different influencing factors. It is necessary to select more effective influencing factors to produce the persuasive effect of promoting vaccination, and the big five personality characteristics of individuals will have a significant impact on the persuasive effect of information. This study can provide scientific basis and guidance for the promotion of vaccination, and has important theoretical and practical value for promoting public health.
Peer Review Status:Awaiting Review
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-03-12 Cooperative journals: 《中国全科医学》
Abstract： Atrial fibrillation（AF）is among the most prevalent types of arrhythmia，leading to severe complications such as heart failure and stroke，thus increasing rates of mortality and disability. Silent AF，which lacks clinical symptoms and has irregular onset，tends to have a low diagnosis rate and often experiences delays in receiving standardized treatments，resulting in negative clinical outcomes. Recent clinical studies highlight the significant benefits of wearable devices in the screening and management of silent AF. In this article，we review the clinical outcomes，cost-effectiveness，challenges and future application prospects of wearable devices in the detection and management of silent AF based on relevant domestic and international literature of recent years to provide more evidence-based support for its further applications.
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