The development and implementation of training mode for diabetes educators amid normalization stage of novel coronavirus pandemic prevention and control / 中国实用护理杂志

Objective:To develop an program for training diabetes educators amid normalization stage of novel coronavirus pandemic prevention and control, and provide reference for clinical teaching under special circumstances.Methods:From January 2020 to June 2021, The head member of Diabetes Education and Management Committee of Hunan Health Management Association Xiangya Hospital of Central South University, developed and implemented a program based on core competencies of diabetes educators. It included 26 online courses, one to one education demonstration video with 7 themes, one diabetes conversation map and simulation, and three-week clinical practice. From April 2021 to June 2021, 55 health workers participated in the program. Theoretical tests, video feedback and questionnaires were used to evaluate the trainees′ diabetes knowledge, educational skills and satisfaction with the training program.Results:A total of 55 health workers participated in the program. All the participants completed the online courses and passed the quizzes, the theoretical examination score was (92.93 ± 5.28). Fifty-four participants finished the tasks of clinical practice and obtained the certificate of diabetes educator. Their communication skills and strategies of behavior change were significantly improved ( χ2 values were 4.17 -26.34, all P<0.05), and all of them were satisfied with the program. Conclusions:The training mode based on online training is flexible, convenient and effective,which is suitable for stage of novel coronavirus pandemic prevention and control.

Construction and verification of an intelligent measurement model for diabetic foot ulcer / 中南大学学报(医学版)

OBJECTIVES@#The measurement of diabetic foot ulcers is important for the success in diabetic foot ulcer management. At present, it lacks the accurate and convenient measurement tools in clinical. In recent years, artificial intelligence technology has demonstrated the potential application value in the field of image segmentation and recognition. This study aims to construct an intelligent measurement model of diabetic foot ulcers based on the deep learning method, and to conduct preliminary verification.@*METHODS@#The data of 1 042 diabetic foot ulcers clinical samples were collected. The ulcers and color areas were manually labeled, of which 782 were used as the training data set and 260 as the test data set. The Mask RCNN ulcer tissue color semantic segmentation and RetinaNet scale digital scale target detection were used to build a model. The training data set was input into the model and iterated. The test data set was used to verify the intelligent measurement model.@*RESULTS@#This study established an intelligent measurement model of diabetic foot ulcers based on deep learning. The mean average precision@.5 intersection over union (mAP@.5IOU) of the color region segmentation in the training set and the test set were 87.9% and 63.9%, respectively; the mAP@.5IOU of the ruler scale digital detection in the training set and the test set were 96.5% and 83.4%, respectively. Compared with the manual measurement result of the test sample, the average error of the intelligent measurement result was about 3 mm.@*CONCLUSIONS@#The intelligent measurement model has good accuracy and robustness in measuring the diabetic foot ulcers. Future research can further optimize the model with larger-scale data samples.

Psychological status of the staff in a general hospital during the outbreak of coronavirus disease 2019 and its influential factors / 中南大学学报(医学版)

OBJECTIVES@#To understand the psychological status of the staff in a general hospital during the coronavirus disease 2019 and its influential factors, and to provide references for the mental health services to hospital staff.@*METHODS@#Using star platform of questionnaire, the staff in the general hospital were investigated via Depression, Anxiety, Stress Scale (DASS-21), Social Support Rating Scale (SSRS) and Simplified Coping Style Questionnaire (SCSQ). The influential factors were discussed by descriptive analysis, rank sum test, single factor analysis, correlation analysis and multiple factors binary logistic regression analysis.@*RESULTS@#A total of 2 060 valid questionnaires were collected. The negative emotions of nurses and cleaners were the most obvious. The depression scores, anxiety scores and stress scores for nurses and cleaners were 5.06±7.47, 6.36±7.84, 9.75±8.65, and 6.72±8.84, 4.51±6.56, 9.69±9.56, respectively. Multivariate binary logistic regression analysis showed that staff types, education levels, job status, economic situation and concerns on the supplies of protective goods were the main influential factors for depression; staff types, contacting status with infected patients, economic situation, concerns on the supplies of protective goods, history of disease were the main influential factors for anxiety; contacting status with infected patients, economic situation, concerns on the supplies of protective goods were the main influential factors for stress.@*CONCLUSIONS@#There are differences in psychological characteristics among different groups of staff in the general hospital under the outbreak. Thus psychological protection and intervention measures should be formulated according to different groups and work status.

Clinical analysis for patients with diabetic foot among multiple centers in China / 中南大学学报(医学版)

To explore the clinical characteristics, risk factors and factors affecting the severity of the disease in patients with diabetic foot at the current stage through a multi-center cross-sectional survey.
 Methods: Clinical data of 326 patients with diabetic foot (205 males and 121 females) from 13 general hospitals nationwide were collected from October to November 2017 using a unified clinical data collection table. The clinical characteristics were analyzed, and the influential factors for severe diabetic foot were analyzed by logistic regression analysis.
 Results: Among 326 patients with diabetic foot, 68.4% of the patients were more than 60 years old, and 60.1% of the patients received primary or junior high school education; 96.3% of the patients developed Type 2 diabetes; 80.1% of patients had glycated hemoglobin (HbA1c)≥7%; 60.1% of patients suffered dyslipidemia. Improper wearing of footwear (38.5%) is the main cause of diabetic foot. Diabetic neuropathy (76.7%), diabetic retinopathy (62.3%) and lower limb vascular disease (57.4%) were the most common complications. Logistic regression analysis showed that diabetic nephropathy, diabetic lower extremity vascular disease, and HbA1c levels were independent risk factors for severe diabetic foot, and receiving foot care education can be regarded as a protective factor.
 Conclusion: The diabetic foot occurs mostly in male patients, and Type 2 diabetes with older age, lower education level, poor glycemic control and dyslipidemia are the risk factors. Diabetic nephropathy, diabetic lower extremity vascular disease, HbA1c, and receiving foot care education are independent influential factors for the severity of diabetic foot.

Association between two functional SNPs of SCN1A gene and efficacy of carbamazepine monotherapy for focal seizures in Chinese Han epileptic patients / 中南大学学报(医学版)

OBJECTIVE@#To investigate whether single nucleotide polymorphisms (SNPs) of rs2298771 and rs3812718 of the sodium channel α-subunit type 1 (SCN1A) gene affect the efficacy of carbamazepine (CBZ) treatment for seizures in Chinese Han epileptic patients.@*METHODS@#SNP rs2298771 and rs3812718 of the SCN1A gene from 628 patients were genotyped. CBZ monotherapy was administered to the subjects with new-onset partial seizures. The efficacy was defined as the decrease in the number of seizures. Four semi-quantitative levels were used to assess the efficacy: seizure-free (SF), >75% seizure decrease (SD), 50%-75% SD, and <50% SD in the number of seizures compared with patients' initial conditions.@*RESULTS@#After the 12 month treatment with CBZ monotherapy, the rate of SF patients with G allele of the SNP rs2298771 was significantly lower than that in patients with the AA genotype (P=0.003). The heterozygote and homozygote of the G allele at SNP rs2298771 predicted the low SF rate (OR=2.101, 95% CI 1.289-3.425). Marginal significance was observed between the dichotomous efficacy of SF and non-SF in 3 partial seizure types (P=0.028).@*CONCLUSION@#rs2298771 is significantly associated with the efficacy of CBZ monotherapy in Chinese Han epileptic patients.

Effectiveness of systematic self-management education on blood sugar level of patients in the community with type 2 diabetes / 中南大学学报(医学版)

OBJECTIVE@#To explore the effectiveness of systematic self-management education on blood sugar level of patients in the community with type 2 diabetes.@*METHODS@#A total of 248 patients with type 2 diabetes from 10 communities of Changsha were randomized into intervention or control groups in February 2009. The intervention group received systematic self-management education, while the other received routine community education. Before and after intervention, fasting plasma glucose, 2 h postprandial plasma glucose and glycosylated hemoglobin were measured, and evaluated between the 2 groups.@*RESULTS@#Fasting plasma glucose, 2 h postprandial plasma glucose and glycosylated hemoglobin levels of patients with diabetes from the two groups were generally comparable at baseline (P>0.05). After the intervention, these three indicators were all statistically significant between the 2 groups (P0.05), 2 h plasma glucose and glycosylated hemoglobin levels were improved (P<0.01, P<0.05, respectively).@*CONCLUSION@#Systematic self-management education effectively encourages patients with type 2 diabetes to control their blood sugar levels, and deserves further promotion.

Effect of systematic self-management education on quality of life, anxiety and depression of patients with Type 2 diabetes in communities / 中南大学学报(医学版)

OBJECTIVE@#To explore the effect of systematic self-management education on quality of life, anxiety and depression of patients with Type 2 diabetes in communities.@*METHODS@#A total of 248 patients with Type 2 diabetes from 10 communities of Changsha from February 2009 to July 2010 were randomized into an intervention group and a control group. The intervention group received systematic self-management education, while the controls received routine community education. The quality of life, anxiety and depression were measured by adjusted diabetes-specific quality of life scale (A-DQOL), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) respectively.@*RESULTS@#The quality of life, morbidity of anxiety or depression of the intervention and the control group were comparable at the baseline (P>0.05). One and half year later, there was significant difference between the two groups (P<0.01). Compared with the control group, the intervention group got better quality of life (P<0.01), less morbidity of anxiety (8.94% vs. 44.4%, P<0.01) and depression (23.58% vs. 56.00%, P<0.01).@*CONCLUSION@#Systematic self-management education can effectively improve the quality of life, reduce the level of anxiety and depression of patients with Type 2 diabetes in communities, which deserves further generalization.