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Objective@#To investigate the self-care activities and their influencing factors among young and middle-aged patients with type 2 diabetes mellitus ( T2DM ), so as to provide the basis for the care management of T2DM.@*Methods@#T2DM patients at ages of 18 to 59 years that were admitted to Department of Endocrinology, Hangzhou First People's Hospital Affiliated to Medical School of Zhejiang University were selected using the convenient sampling method from January to August 2021, and the demographic data were collected using questionnaires, including gender, age and educational levels. The self-care level was measured using the Summary of Diabetes Self-Care Activities ( SDSCA ) was used to assess self-management behaviors, and the social support level was evaluated using the Social Support Rating Scale ( SSRS ), while the coping modes were assessed using the Medical Coping Modes Questionnaire ( MCMQ ). Factors affecting the self-care activities were identified among young and middle-aged patients with T2DM using multivariable linear regression analysis.@*Results@#The 342 respondents included 185 men ( 54.07% ) and 157 women (45.93% ), and had a mean age of ( 43.76±3.82 ) years. The total score of self-care activities was ( 94.22±18.74 ), and the overall scoring rate was 72.48%, including 63 cases with high scores ( 18.42% ), 208 cases with moderate scores ( 60.82% ) and 71 cases with low scores ( 20.76% ). Multivariable linear regression analysis identified gender ( women, β'=0.213 ), educational level ( high school/technical secondary school, β'=0.187; diploma and above, β'=0.411 ), household monthly income per capita (5 000 Yuan and higher, β'=0.390), course of disease ( >5 years, β'=0.340 ), history of receiving health education targeting diabetes ( β'=0.411 ), coping mode ( avoidance, β'=0.195; confronce, β'=0.367 ) and social support level ( general, β'=0.206; high, β'=0.383 ) as factors affecting self-care activities among young and middle-aged patients with T2DM.@*Conclusions@#The overall self-care activities at a moderate level among young and middle-aged patients with T2DM, which are associated with gender, educational level, economic income, course of disease, health education targeting diabetes, coping mode and social support level.
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Objective:To explore application value of dance movement therapy in the chemotherapy of young and middle-aged patients with breast cancer, so as to provide reference for rehabilitation nursing.Methods:By convenient sampling method, 90 young and middle-aged female breast cancer patients during chemotherapy from June 2020 to June 2021 in Renmin Hospital of Wuhan University were enrolled in the present study. They were assiged to experimental group and control group with 45 cases in each group according to the enrolled ward. The control group received routine nursing and the experimental group received 4 cycles of dance movement therapy. Before and after intervention, the effects were assessed by Cancer Fatigue Scale (CFS) and Patient-Generated Subjective Global Assessment (PG-SGA) as well as biochemical nutrition indexes.Results:After intervention, the physical fatigue score, emotional fatigue score, cognitive fatigue score and total CFS score were (8.29 ± 3.58), (7.74 ± 1.68), (5.57 ± 1.11), (21.59 ± 4.41) points in the experimental group, which were significantly lower than (9.86 ± 3.49), (8.95 ± 2.62), (6.27 ± 1.70), (25.09 ± 4.33) points in the control group ( t values were 2.07-3.71, all P<0.05). After intervention, the PG-SGA score was (2.81 ± 0.71) points in the experimental group, which was significantly lower than (3.29 ± 1.15) points in the control group ( t=2.37, P<0.05). Conclusions:Dance movement therapy can alleviate the cancer related fatigue and promote nutritional status of young and middle-aged female breast cancer patients with chemotherapy.
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Objective:To explore the effects of stepped-care intervention on disease adaptation and medical coping among young and middle-aged patients undergoing early stage of peritoneal dialysis.Methods:Totally, 72 young and middle-aged patients undergoing early stage of peritoneal dialysis from January 2018 to December 2019 in the Affiliated Hospital of Guilin Medical College were divided into experimental group and control group according to drawing lots methods, each group contained 36 cases. The control group received routine nursing, while patients in the experimental group were given stepped-care intervention for 6 times. Before and after intervention, the effects was assessed by Self-report Pychosocial Adjustment to Illness Scale (PAIS-SR) and Medical Coping Modes Questionnaire (MCMQ), respectively.Results:After intervention, the health care scores, ability to work scores, family relationship scores, communication scores, entertainment scores, psychological condition scores and total PAIS-SR scores were 7.88±1.53, 9.12±1.30, 6.62±1.10, 6.74±1.31, 6.44±1.80, 8.29±1.83, 50.35±4.26 in the experimental group, significantly lower than those in the control group 8.70±1.33, 10.06±1.90, 7.61±1.66, 7.73±1.86, 7.48±2.15, 9.45±1.60, 56.58±5.04 ( t values were 2.317-5.464, P<0.01 or 0.05). the MCMQ scores in facing were 12.97±2.44 in the experimental group, significantly higher than that in the control group 11.58±2.33; the avoidance and yielding scores were 16.41±1.46, 13.44±1.83 in the experimental group, significantly lower than those in the control group (17.76±1.52, 14.73±2.36), the differences were statistically significant ( t values were 2.389, 3.696, 2.496, P<0.05). Conclusions:Stepped-care intervention can improve the ability of disease adaptation and promote the positive transformation of young and middle-aged patients undergoing early stage of peritoneal dialysis.
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Objective:To classify the symptom characteristics of young and middle-aged peritoneal dialysis patients and to explore the differences of demographic functional status and social function of patients with different symptom categories.Methods:A total of 179 peritoneal dialysis patients from 3 peritoneal dialysis centers in Shanghai were investigated from December 2019 to August 2020 by General Information Questionnaire, Peritoneal Dialysis Symptom Distress Scale. Latent class analysis was used to classify young and middle-aged peritoneal dialysis patients according to symptom characteristics. Multiple Logistic regression was used to explore the differences of demographic and disease characteristics of different categories of patients.Results:Peritoneal dialysis patients could be divided into three potential categories according to symptom characteristics ( P<0.05). According to the conditional probability of each category, they were named "low symptom group" (111 cases,62.0%), "high psychological-moderate physical symptom group" (22 cases, 12.3%), "high symptom group" (46 cases,25.7%). There were differences in working status ( OR=0.029, P<0.01), education level ( OR=152.799, P<0.01), duration ( OR=81.307, P<0.05), diabetic nephropathy ( OR=80.619, P<0.01) and CCI score ( OR=91.188, P<0.01) distribution among different potential categories of young and middle-aged peritoneal dialysis patients. Conclusions:There are three types of potential symptoms in young and middle-aged patients undergoing peritoneal dialysis. In clinical practice, medical staff should focus on the psychological status of young and middle-aged patients with low educational background and early stage of dialysis, and encourage them to return to work; at the same time, they should regularly evaluate the symptom burden of patients with diabetic nephropathy and high complication index peritoneal dialysis patients, in order to provide targeted intervention measures to prevent the progression of the disease.
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Objective:To investigate the status and influencing factors of health-promoting lifestyle in young and middle-aged people with high normal blood pressure, so as to provide the basis for primary prevention about hypertension.Methods:From July to December 2020, a convenience sampling method was used to select 280 cases of young and middle-aged people with high normal blood pressure in the First Affiliated Hospital of Wenzhou Medical University were investigated by self-administered general information questionnaire,and Health Promotion Lifestyle Profile Ⅱ(HPLP-Ⅱ).Results:The HPLP-Ⅱ total score in the young and middle-aged with high normal blood pressure was 146.79 ± 29.57. Multiple linear regression analysis showed that different occupation,income, family history of hypertension and learning-willingness were the influencing factors of their health-promoting lifestyle( P<0.05). Conclusions:The health-promoting lifestyle among the young and middle-aged with high normal blood pressure is at a medium level, health care providers should strengthen guidance to improve their health-promoting lifestyle through health education and other ways for individuals without stable employment, poor income level, no family history of hypertension and lack in willingness to learn.
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Objective@#To analyze the level of resilience and its influencing factors in the young and middle-aged patients with type 2 diabetes mellitus ( T2DM ), so as to provide reference for optimizing mental interventions for the patients.@*Methods@#The young and middle-aged patients with T2DM from September 2019 to September 2020 in Hangzhou First People's Hospital, affiliated to the Medical School of Zhejiang University, were selected as the subjects, the general information questionnaire, Perceived Social Support Scale ( PSSS ) , Conner-Davidson Resilience Scale ( CD-RISC ), Diabetes Distress Scale (DDS) and Diabetes Management Self-efficacy Scale ( DMSES ) were used to investigate, the multivariate linear regression model was used to analyze the influencing factors for resilience in young and middle-aged patients with T2DM.@*Results@#A total of 250 questionnaires were distributed and 238 valid questionnaires were recovered. The effective recovery rate was 95.20%. Among 238 patients, 142 cases ( 59.66% ) were males and 96 cases ( 40.34% ) were females; 168 cases ( 70.59% ) were 45-59 years old. The CD-RISC score was 70.49±12.81, PSSS score was 63.70±10.90, DDS score was 2.14±0.87, and DMSES score was 130.22±38.49. The results of multivariate regression analysis indicated that educational level, average monthly family income, fasting blood glucose, self-efficacy, social support and diabetes distress were the influencing factors for resilience of young and middle-aged patients with T2DM ( P<0.05 ).@*Conclusion@#The level of mental resilience in young and middle-aged patients with T2DM is mainly related to the level of education, monthly family income, blood glucose control, diabetes distress, self-efficacy and social support.
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Objective: To investigate the association between smoking and the severity of coronary lesions among young and middle-aged female patients with acute coronary syndrome (ACS). Methods: Data of this study were derived from the Improving Care for Cardiovascular Disease in China (CCC)-ACS project, a collaborative study of the Chinese Society of Cardiology and the American Heart Association. Since 2014, the CCC-ACS project consecutively enrolled inpatients with ACS, systematically collected their clinical data and evaluated medical quality of these patients from 158 tertiary hospitals and 82 secondary hospitals across China. This study enrolled female patients less than 60 years old with initial ACS, who received coronary angiography in CCC-ACS project. Patients were divided into two groups according to smoking status. A multivariate logistic regression analysis was used to analyze the association between smoking and the severity of coronary lesions among young and middle-aged female patients with ACS. Results: A total of 2 863 female patients younger than 60 years old with initial ACS, who received coronary angiography, were enrolled. Among them, 12% (340 cases) was smokers. Proportion of patients younger than 45 years old was higher (13.2% (45/340) vs. 8.5% (215/2 523), P<0.01) and prevalence of hypertension (59.4% (202/340) vs. 66.7% (1 683/2 523), P<0.01) and diabetes (39.4% (134/340) vs. 44.2% (1 116/2 523), P=0.09) was lower in smoker group than in non-smoker group. However, prevalence of ST-elevation myocardial infarction (66.8% (227/340) vs. 53.7% (1 354/2 523), P<0.01), coronary multi-vessel lesions (39.1% (133/340) vs. 32.6% (822/2 523), P<0.01) and severe stenosis in either single-vessel (56.2% (109/194) vs. 46.1% (706/1 530), P<0.01) or multi-vessel (63.2% (84/133) vs. 58.2% (478/822), P=0.29) was significantly higher in smoker group than in non-smoker group. Multivariate logistic regression analyses showed that after adjusting for age, hypertension, diabetes, elevated low-density lipoprotein cholesterol, lower high-density lipoprotein cholesterol, elevated triglyceride, renal insufficiency, family history of coronary heart disease and types of ACS, smokers faced a higher risk of coronary multi-vessel lesions, coronary multi-vessel severe lesions and coronary severe lesions with the odds ratios and 95% confidence interval of 1.41 (1.11-1.79), 1.40 (1.10-1.78) and 1.78 (1.11-2.87), compared with non-smokers. Conclusions: Smoking is significantly associated with an increased risk of extensive and severe coronary lesions among young and middle-aged female patients with ACS. This study provides crucial evidence for further understanding the harms of smoking and the need to strengthen the tobacco control education and smoking cessation guidance for young and middle-aged women.
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Acute Coronary Syndrome , Adult , China , Coronary Angiography , Female , Humans , Middle Aged , Risk Factors , SmokingABSTRACT
Objective @#To explore the potential association between particular living habits and recurrent aphthous ulcers (RAU), and provide some references for RAU prevention among the young and middle⁃aged. @*Methods@#The mul⁃ tistage random sampling method was adopted to select 850 young and middle⁃aged people in Nanjing. The disease sta⁃ tus and living habits of young and middle⁃aged people with RAU in Nanjing were investigated by a questionnaire, and the influencing factors were analyzed by univariate and multivariate logistic regression analysis.@*Results@# The preva⁃ lence of RAU was 20.5% among 799 individuals, including 357 men and 442 women. The risk of RAU at medium and low stress levels was 0.533 times and 0.419 times that at high stress levels, respectively (P < 0.05), indicating that high stress was an independent risk factor for RAU. The risk of RAU in patients with low exercise levels was 1.513 times that in patients with high exercise levels (P < 0.05), indicating that high exercise levels were a protective factor for RAU. There were no statistically significant differences in age, sex, smoking, drinking or bedtime (P > 0.05). @*Conclu⁃ sion@#Multivariate logistic regression showed that mental stress and physical activity were independent influencing fac⁃ tors for the development of RAU. The living habits of RAU patients and RAU susceptible populations should be treated with corresponding interventions to prevent RAU.
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@#AIM: To describe microRNAs(miRNAs)expression pattern in infant and cataract human lens, analyzing the possible difference to assess their function in transparent human lens and cataract formation. <p>METHODS: The different ages of miRNAs in lens were extracted and samples were divided into four groups: infant lens group(lens from non-ophthalmopathy infant), congenital cataract group(lens from cataract infant), young and middle-aged group(lens from young cataract patients)and senile group(lens from age-related cataract patients). The expression of the 10 miRNAs was detected in the four groups using stem-loop RT-PCR respectively.<p>RESULTS: In normal infant's lens, the expression of miR-184 was the highest. Compared with the normal infant's lens tissue, the miR-184 and miR-182 in congenital cataract patients increased, the miR-124 and miR-204 decreased. Compared with the children's lens with cataract, the expression of miR-204, 124 and let-7d in young and middle-aged cataract patients increased, while the expression of miR-184, 183 and let-7a decreased. In the lens of senile cataract patients, all of the 10 miRNAs changed. The expression of miR-182, 204, 124 increased, while miR-184, 181b, 183, 125b, let-7a/b/d decreased.<p>CONCLUSION: There are significant differences in the expression of miRNA in the lens of children and cataract patients of different ages. Some miRNAs are related to the normal morphology, function and certain pathological conditions of the lens. This study provided a theoretical basis of further study on the role of miRNAs in maintaining the normal function of the young children's lens and the formation of cataracts at different ages.
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@#Objective To investigate the predictive value of volatile organic compounds (VOCs) on pulmonary nodules in people aged less than 50 years. Methods The 147 patients with pulmonary nodules and aged less than 50 years who were treated in the Department of Thoracic Surgery of Sichuan Cancer Hospital from August 1, 2019 to January 15, 2020 were divided into a lung cancer group and a lung benign disease group. The lung cancer group included 36 males and 68 females, with the age of 27-49 (43.54±5.73) years. The benign lung disease group included 23 males and 20 females, with the age of 22-49 (42.49±6.83) years. Clinical data and exhaled breath samples were collected prospectively from the two groups. Exhaled breath VOCs were analyzed by gas chromatography mass spectrometry. Binary logistic regression analysis was used to select variables and establish a prediction model. The sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve of the prediction model were calculated. Results There were statistically significant differences in sex (P=0.034), smoking history (P=0.047), cyclopentane (P=0.002), 3-methyl pentane (P=0.043) and ethylbenzene (P=0.009) between the two groups. The sensitivity, specificity and area under the ROC curve of the prediction model with gender, cyclopentane, 3-methyl pentane, ethylbenzene and N,N-dimethylformamide as variables were 80.8%, 60.5% and 0.781, respectively. Conclusion The combination of VOCs and clinical characteristics has a certain predictive value for the benign and malignant pulmonary nodules in people aged less than 50 years.
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Objective To compare the blood lipid levels of different brachial-ankle pulse wave velocity (baPWV) in young and middle-aged people with normal blood pressure and to explore the related factors affecting baPWV.Methods From January 2014 to December 2017,the clinical data of one thousand two hundred and sixty-eight middle-aged and young people with normal blood pressure who underwent physical examination in Dongying People's Hospital were retrospectively analyzed.Using baPWV＜ 1 400 cm/s as the standard of normal arterial stiffness,the patients were divided into normal arterial stiffness group (normal group,1 128 cases),abnormal arterial stiffness group (abnormal group,baPWV ≥ 1 400 cm/s,140 cases).The blood lipid indexes of the two groups were analyzed and compared.Logistic regression analysis was used for multivariate analysis and linear correlation analysis was used for linear correlation analysis.Pearson correlation analysis was used.Results Compared with the normal group,TC ((4.99 ± 1.10) mmol/L vs.(4.48 ± 1.03) mmoL/L,t =5.830),TG ((1.62 ± 0.27) mmol/L vs.(1.49 ± 0.23) mmol/L,t=5.102),LDL-C[(3.25±0.23) mmol/L vs.(3.11±0.16) mmol/L,t =4.712),Apo B((0.96 ±0.07) g/L vs.(0.87±0.08) g/L,t =4.297)in abnormal group all increased,and HDL-C((1.15±0.09) mmol/L vs.(1.27±0.07) mmol/L,t =4.712) decreased,and the differences were statistically significant (P＜0.05).Smoking,high FPG,high LDL-C,high Apo B,low HDL-C were the independent factors affecting baPWV abnormality (P＜ 0.05).TC,TG,LDL-C,Apo B and baPWV in abnormal group were positively correlated(P＜0.05),and HDL-C and baPWV were negatively correlated(P＜0.05).There was a linear regression relationship between LDL-C,Apo B and baPWV (P＜0.05).Conclusion The increase of LDL-C and Apo B are closely related to early arterial disease in the low-risk populations of normotensive young and middle-aged people,even the risk of blood lipid may already exist within the normal range.
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Objective To evaluate the relevant knowledge level and compliance of young and middle-aged hypertensive patients,and explore the association of them. Method A total of 276 young and middle-aged hypertensive patients were surveyed using a hypertension knowledge level scale and treatment compliance questionnaire. Results The average score of young and middle-aged hypertensive patients on relevant knowledge was (62.55 ± 17.79). From different dimensions, the hypertensive patients got the highest score in the knowledge of their lifestyle,while they got the lowest score in their knowledge for complication.The average score of young and middle-aged hypertensive patients on treatment compliance was (71.53±9.87).From different dimensions,the hypertensive patients got the highest score in medication adherence,while they got the lowest score in exercise and pressure-relieving compliance.It showed that medication and drug compliance knowledge of middle-aged hypertensive patients was closely associated with treatment compliance(r=0.648, P<0.001)). Conclusions Both knowledge level and treatment compliance of young and middle-aged hypertensive patients should be improved.We should strengthen the population of knowledge about hypertension among young and middle-aged patients,especially the guidance of drug knowledge to improve their compliance.
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Objective To explore the relationship between blood lipid levels and cerebrovascular hemodynamic indices (CVHI) in a young and middle?aged population, and to identify reference values for early warning of stroke. Method Between June 2015 and June 2016, a total of 6 252 young and middle?aged patients were assessed for cerebrovascular function in The Health Management Center of Affiliated Hospital of Guizhou Medical University. Patients were divided into abnormal and normal blood lipid groups. Differences in CVHI indicators and scores between the groups were determined, and factors influencing CVHI indices were compared using multivariate logistic regression analysis. Results Mean (Vmean), maximum (Vmax), and minimum blood flow velocity (Vmin) and cumulative scores for CVHI indices in the abnormal blood lipid group were significantly lower than in the normal blood lipid group (P<0.001). However, pulse wave velocity, characteristic impedance, peripheral vascular resistance, dynamic resistance, critical pressure, and differences between diastolic blood pressure and critical pressure were greater than those in the normal blood lipid group (P<0.001). Multivariate logistic regression analysis indicated that a high triglyceride level, overweight or obesity, high systolic blood pressure, high diastolic blood pressure, and age were risk factors for low CVHI scores, with odds ratios (95% confidence intervals) of 1.455 (1.195- 1.771), 2.271 (1.782-2.895), 5.967 (4.557-7.815), 4.251 (3.349-5.396), 2.560 (1.993-3.287), and 1.448 (1.189-1.763). Conclusion Abnormal blood lipid levels can lead to abnormal cerebrovascular function in young and middle?aged population; elevated triglyceride level was an independent risk factor for impaired cerebrovascular function.
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Objective To investigate the characteristics of cognitive impairment and its influential factors in young and middle-aged hospitalized patients with T2DM.Methods Totally 140 young and middle-aged T2DM patients were recruited in 4 hospitals using convenience sampling method and were evaluated by Montreal Cognitive Assessment Scale (MoCA).Results The prevalence of cognitive impairment in 140 young and middle-aged T2DM patients in this study was 37.9％.The delayed memory (85.0％) was most common,followed by language(73.6％),and impaired visuospatial and executive function(50.7％).Attention,abstraction,and orientation were rarely affected,and naming was not impaired.Logistic regression showed that older individuals,women,poor blood glucose control could be important independent risk factors for cognitive impairment in young and middle-aged T2DM patients.Conclusion The prevalence of cognitive impairment in young and middle-aged T2DM patients was relatively high,and the delayed recall was mostly common.The older individuals,women,poor blood glucose control are associated with cognitive impairment.
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Objective To investigate the blood pressure variability(BPV) and circadian rhythms in young and middle-aged people with H-type hypertension.Methods The ambulatory blood pressure monitoring data from 89 young and middle-aged patients with mild-to-moderate hypertension were retrospectively analyzed.All cases were divided into the H-type hypertension group (n=56) and non-H-type hypertension group(n=33) according to plasma homocysteine(Hcy) level.Blood pressure in different time periods(including 24hSBP/24hDBP,dSBP/dDBP,nSBP/nDBP,mSBP/mDBP,mnSBP/mnDBP),variability(including 24hSBPV/24hDBPV,dSBPV/dDBPV,nSBPV/nDBPV,mSBPV/mDBPV,mnSBPV/mnDBPV),day and night average heart rate,dipper ratio of SBP/DBP and morning blood pressure surge were compared between the two group.Results 24hSBP,dSBP,nSBP and mSBP in the H-type hypertension group were significantly higher than those in the non-H-type hypertension group,while 24hDBP,dDBP,nDBP and mDBP were significantly lower than those in the non-H-type group,the differences were statistically significant(P＜0.01).24hSBPV,24hDBPV,dSBPV,nDBPV and mSBPV had statistically significantly difference between the H-type hypertension group and non-H-type hypertension group(P＜0.05).The dipper ratio of SBP and mean MBPS in the H-type hypertension group were significantly higher than those in the non-H-type hypertension group(P＜0.01).Conclusion Blood pressure variability is increased within a certain range in young and middle-aged patients with H-type hypertension,which is correlated to circadian rhythm changes.
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Objective To investigate the status of sub-health in young and middle-aged intellectuals in Guangxi,and to provide a reference basis for improving the health status of young and middle-aged intellectuals. Method Convenient random sampling was used to select 3862 young and middle-aged intellectuals in Guangxi and the sub-health measurement scale version 1.0 (SHMS V1.0) was used to analyze the mental sub-health status. Results The total scores was (59.53±10.48) points and the score of SHMS V1.0 in the physical subscale, psychological subscale, social subscale were (59.27±13.39),(56.26±10.39),(63.49±11.92) points.The difference of the young and middle-aged intellectuals of age, occupation, gender, marriage,dwelling,work day time, breakfast, sleeping time, exercise, smoking and drinking were statistically significant (P<0.05). Conclusions The physical and psychological sub-health status of the young and middle-aged intellectuals in Guangxi is not unsatisfactory.Puting forward the nursing strategy of installing information exchange platform , forming a good living habits , creating a good atmosphere to improve the psychological sub-health status of the young and middle-aged intellectuals are of great importance.
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Objective To investigate the correlation between resilience and coping styles in young and middle-aged female breast cancer patients. Methods A total of 296 young and middle-aged female breast cancer patients from August 2016 to February 2017 were investigated by the general information questionnaire, Connor-Davidson Resilience Scale and Medical Coping Modes Questionnaire. Results The total scores of Connor-Davidson Resilience Scale was(61.51±16.26)points;the confrontation coping was (20.37 ± 2.99) points, there was no difference with the norm, while the avoidance and resignation coping was(16.58±2.46),(11.79±1.54)points,which was higher than the norm(14.56±3.00),(9.20±3.12) points,there was significant difference(t=8.606,12.149,P<0.05). Scores of resilience and its sub-scales were correlated with confrontation coping(r=0.216-0.249,P<0.05)and resignation coping(r=-0.314--0.166,P<0.05),but there was no significant correlation with the score of avoidance dimension(P>0.05). Conclusions Close correlation exists between resilience and coping styles in young and middle-aged female breast cancer patients.It is suggested to assessment and guide patients′coping styles appropriately for better resilience and psychological status.
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Objective To explore the distribution and drug resistance of extended-spectrum beta-lactamase (ESBLs)producing Klebsiella pneumoniae in elderly and young and middle-aged patients,and provide reference for rational use of antibiotics for clinicians.Methods Specimens of elderly (≥ 60 years old) and young and middle-aged (18-59 years old) patients who with various clinical infection in Shengjing Hospital of China Medical University from January 2016 to December 2016 were collected as the research object.ESBLs-producing Klebsiella pneumoniae was isolated from 125 patients (60 elderly patients and 65 young and middle-aged patients).The preliminary screening and phenotypic confirmatory test of ESBLs were carried according to the method which was recommended by American Clinical and Laboratory Standards Institute.The drug resistance of ESBLs-producing Klebsiella pneumoniae was analysed and the resuh of the two groups were compared.Results The specimens of ESBLs-producing Klebsiella pneumoniae strains of elderly patients were mainly from urine (36.67％),sputum (33.33％) and whole blood (11.67％);the specimens of young and middle-aged patients were also mainly from urine (24.62％),sputum(24.62％) and whole blood (15.38％).There was statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the specimens secretions between the elderly patients and the young and middle-aged patients(P ＜0.05).There was no statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the specimens of urine,sputum,whole blood,bile,pus,drain,cerebrospinal fluid,ascitic fluid and catheter between the elderly patients and the young and middle-aged patients (P ＞ 0.05).ESBLs-producing Klebsiella pneumoniae strains of elderly patients were mainly isolated from department of respiration (20.00％,12/60) and department of urinary surgery (18.33％,11/60);the ESBLs-producing Klebsiella pneumoniae strains of young and middle-aged patients were mainly isolated from department of intensive care (16.92％,11/65) and department of neurosurgery (16.92％,11/65).There was statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the department of respiration and obstetrics and gynecology between elderly patients and young and middle-aged patients(P ＜ 0.05);there was no statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the department of urinary surgery,general surgery,intensive care,neurosurgery,rheumatoid immunology,invasive technology,oncology,digestion,infection,kidney,orthopaedics,rehabilitation,hematology,neurology and other department between elderly patients and young and middle-aged patients(P ＞ 0.05).The drug resistance rates of ESBLs-producing Klebsiella pneumoniae to beta-lactam antibiotic in elderly and young and middle-aged patients were more than 90.00％;the drug resistance rates of ESBLs-producing Klebsiella pneumoniae to carbapenems were nearly 0.00％ in elderly and young and middle-aged patients.There was significant difference in the drug resistance rates of ESBLs-producing Klebsiella pneumoniae to ceftazidime and gentamicin between elderly patients and young and middle-aged patients(P ＜ 0.05);there was no significant difference in the drug resistance rate of ESBLs-producing Klebsiella pneumoniae to another antibiotic between elderly patients and young and middle-aged patients (P ＞ 0.05).Conclusion Both elderly and the young and middle-aged patients can be infected with ESBLs-producing Klebsiella pneumoniae.There was no significant difference in the distribution of ESBLs-producing Klebsiella pneumoniae in most clinical departments (except respiratory and obstetrics and gynecology).The most effective antimicrobial drugs at present for the treatment of ESBLs-producing Klebsiella pneumoniae was carbapenems.There is no significant difference in the drug resistance rates of ESBLs-producing Klebsiella pneumoniae to common antibiotics between elderly patients and young and middle-aged patients.Clinicians should rationally use antibiotics according to the results of susceptibility tests.
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The continuing education system at the Peking University Health Science Center for vis-iting scholars (Research program for young and middle-aged doctors) is a relatively advanced and compre-hensive medical continuing education system in China, among which, the tutorial system is a good method to guide the visiting scholars of continuing education. On this basis we conducted scholars learning effect questionnaire survey and combined with the feedback results, discussed the advantages and disadvantages of the current educational system of visiting scholars in China, and put forward some concrete suggestions on the development of the continuing education in China.
ABSTRACT
Objective To analyze the prevalence characteristics of fatty liver in young and middle-aged people,and to explore the risk factors of the disease,so as to provide clinical evidence for the prevention and treatment of fatty liver.Methods In 756 young and middle-aged healthy subjects with age≤50 years old,there were 197 fatty liver cases were diagnosed by ultrasonic test during 2015 year.The prevalence of different characteristics in young and middle-aged fatty liver was analyzed,the difference of blood biochemical index between fatty liver and non fatty liver group was compared,and risk factors of fatty liver was explored by binary logistic regression model.Results The total prevalence rate of fatty liver in young and middle-aged people was 26.1%(197/756),among which 33.1% (119/359) were male and 19.6%(78/397) were female,the prevalence rate of male was significantly higher than that of female(χ2=17.833,P<0.05).The prevalence rate of fatty liver increased with age(χ2=33.296,P<0.05),which in 40-50 years old was 37.1%(111/299) and significantly higher than that in 20 years-(15.0%)(24/160) and 30 years-(20.9%)(62/297).Logistic regression analysis on influencing factors of fatty liver prevalence showed that age,sex,body mass index(BMI),drinking,diabetes and fasting blood glucose(FPG),triglyceride(TG),total cholesterol(TC) were closely related to fatty liver(P<0.05),overweight,obesity,drinking,diabetes increased the risk of fatty liver disease.Biochemical indicators(FPG,TG,TC) in fatty liver group were higher than those in non fatty liver group((7.09±1.47) mmol/L vs.(5.14±1.71) mmol/L,(5.98±1.23) mmol/L vs.(4.95±1.42) mmol/L,(2.03±0.45) mmol/L vs.(1.23±0.67) mmol/L,t=271.905,98.866,278.255;P<0.05).Conclusion The prevalence rate of fatty liver in young and middle-aged people is high,and controlling body weight,give up drinking,active treating diabetes,reducing blood glucose and blood lipids can effectively decrease the prevalence of fatty liver in young and middle-aged people.