[Establishment of quality evaluation criteria for out-patient medical records of cancer pain and assessment of its application effect].

Objective: To establish the quality evaluation criteria for out-patient medical records of cancer pain and evaluate the effect of its application. Methods: The evaluation criterion was established based on Delphi method for out-patient medical records of cancer pain in the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University. Firstly, the weight of each evaluation indicator was calculated by the method of Attribute Hierarchical Model in combination with technique for order preference by similarity to solution (AHM-TOPSIS), and out-patient medical records of 50 cancer pain patients (group A, 150 records) received in June 2020 were assessed comprehensively. Secondly, the relative closeness (Ci value) between the writing quality and the ideal solution was calculated, as well as the proportion of evaluation indicators which were lack of standardization. Thirdly, the corresponding countermeasures were adapted based on the results of assessment. Finally, another 50 medical records (156 records) received in October 2021 were re-evaluated by the same method, and the differences of quality of medical record and proportion of each evaluation indicator which was lack of standardization before and after the intervention were compared. Results: A specific criterion which contained integrity of materials required for the medical records, documents of the complaints and medical history of cancer pain, description of the previous medical treatment for cancer pain, regular assessment of cancer pain and its' document, quantitative assessment and its' document, comprehensive assessment and its' document, dynamic assessment and its' document, reasonable of pain medication, reasonable of the drug usage and dosage, reasonable adjustment of the drug variety or dosage, prevention of adverse reactions of analgesic drugs and its' document, evaluation and management of adverse reactions of analgesic drugs and its' document (12 indicators) was established to evaluate the out-patient medical records of cancer pain. The proportion of medical records which Ci≥0.6 was 62.0% (93/150) in group A before the intervention. It was increased to 84.6% (132/156) in group B after the intervention and the difference was statistically significant (P<0.001). Furthermore, the proportions of comprehensive assessment of cancer pain which were lack of standardization, prevention of adverse reaction, quantitative evaluation and dynamic assessment of cancer pain accounted for a higher level, which was 64.0% (96/150), 55.3% (83/150), 54.7% (93/150) and 52.7% (79/150) respectively in group A before the intervention. However, proportions of such records were decreased to 50.6% (79/156), 35.9% (56/156), 32.1% (50/156) and 39.7% (62/156) respectively in group B after the intervention and the differences were statistically significant (all P<0.05). Conclusions: A specific quality evaluation criterion is established based on Delphi method and AHM-TOPSIS for the out-patient medical records of cancer pain. The quality of medical records has been improved in a certain level after adapting comprehensive evaluation and intervention on the out-patient medical records of cancer pain.

[Association between perceived built environment attributes and adults' leisure-time physical activity in four cities of China].

Objective: To explore the associations between perceived built environment attributes and adults' leisure-time physical activity in four cities of China. Methods: Multistage cluster random sampling method was used to select adults aged 25 to 64 in Hangzhou, Suzhou, Chengdu, and Qingdao. Data were collected from June 2017 to July 2018. The perception of the urban built environment was assessed by the neighborhood environment walkability scale-abbreviated (NEWS-A), and the physical activity was assessed by the International Physical Activity Questionnaire. Generalized linear mixed models were used to explore the relationship between the perceived built environment and leisure-time physical activities. Results: A total of 3 789 participants were included in the analysis. After adjusting for potential confounders, better access to public services (OR=1.34, 95%CI: 1.02-1.75) and higher aesthetic quality (OR=1.37, 95%CI: 1.09-1.73) were positively associated with the possibility of engaging in leisure-time physical activity in the past week. Similarly, these two attributes were positively associated with leisure-time walking. Higher scores on the perception of street connectivity were positively associated with leisure-time walking [exp(ß)=1.09, 95%CI: 1.00-1.19]. Higher residential density [exp(ß)=1.000 4, 95%CI:1.000 0-1.000 8], better access to physical activity destinations[exp(ß)=1.09, 95%CI: 1.00-1.19], and better aesthetics [exp(ß)=1.11, 95%CI:1.00-1.22] were associated with higher leisure-time physical activity. Similarly, these three attributes were positively associated with the possibility of meeting the WHO recommendations. Conclusion: Changing some urban built environment attributes may increase leisure-time physical activity.

[Influence of diet and behavior related factors on the peripheral blood triglyceride levels in adults: a cross-sectional study].

Objective: To study the influence of diet and behavior related factors on the peripheral blood triglyceride levels in adults, through a cross-sectional survey. Methods: The current study included 13 434 subjects without histories of major chronic diseases from a population-based cross-sectional survey: the 2010 Metabolic Syndrome Survey in Zhejiang Province. A generalized linear model was used to investigate the influence of diet/behavior-related factors on the peripheral blood triglyceride levels. Results: Mean TG of the sample population appeared as (1.36±1.18) mmol/L. The proportions of elevated TG and marginally elevated TG were 10.3% and 11.0% respectively, with statistically significant difference seen between males and females (χ(2)=44.135, P<0.001). In this sampled population, the daily intake of cooking oil was exceeding the recommendation levels by over 50% while the intake of fruit, milk, nuts and physical exercise were much below the recommendation. There were statistically significant differences between smoking, alcohol-intake, meat, fruit and water intake in male population from this study. However, in females, the intake of aquatic product and physical exercise showed statistically significant differences. After controlling for other variables, factors as age, drinking, staple food and aquatic products showed positive influence on TG, while milk presented negative influence on TG. Through interaction analysis, fruit and meat intake in males and staple food in females showed positive influence on TG, when compared to the reference group. Conclusion: Hyperglyceridemia appeared as one of the major metabolic abnormities in Zhejiang province. Programs on monitoring the alcohol, staple food and meat intake should be priority on intervention, in the communities.

Studying the non-uniform expansion of a stent influenced by the balloon.

Non-uniform expansion of cardiovascular stents, which exists widely in experiments, has a large influence on stent safety, but has seldom been studied in depth until now. In this paper we use a folded balloon with friction to expand a stent through finite element method (FEM), and study how this influences non-uniform expansion of the stent. The simulations were carried out using ABAQUES software. The results show that the stent expands non-uniformly only when the fold and friction are considered together in the FEM model. The extent of non-uniformity during expansion increases with rising friction coefficient values; with the same friction coefficient but different stent locations on the balloon the extent of non-uniform deformation is different. On the other hand, compared to a tri-folded balloon, a six-folded balloon clearly decreases the expansive non-uniformity, which means that by increasing the number of the folded parts of balloon the stent expands more uniformly.