Gender differences in metabolic syndrome and its components in southern china using a healthy lifestyle index: a cross-sectional study.

BACKGROUND: Lifestyle changes are important for the prevention and management of metabolic syndrome (MetS), but studies that focus on gender differences in the lifestyle risk factors of MetS are limited in China. This research aimed to generate a healthy lifestyle index (HLI) to assess the behavioral risk factors of MetS and its components, and to explore the gender differences in HLI score and other influencing factors of MetS. METHODS: A convenience sample of 532 outpatients were recruited from a general hospital in Changsha, China. The general information and HLI scores [including physical activity (PA), diet, smoking, alcohol use, and body mass index (BMI)] of the subjects were collected through questionnaires, and each patient's height, weight, waist circumference, and other physical signs were measured. Logistic regression analysis was used to analyze the risk factors of MetS and its components. RESULTS: The prevalence of MetS was 33.3% for the whole sample (46.3% in males and 23.3% in females). The risk of MetS increased with age, smoking, unhealthy diet, and BMI in males and with age and BMI in females. Our logistic regression analysis showed that lower HLI (male: OR = 0.838,95%CI = 0.757-0.929; female: OR = 0.752, 95%CI = 0.645-0.876) and older age (male: OR = 2.899, 95%CI = 1.446-5.812; female: OR = 4.430, 95%CI = 1.640-11.969) were independent risk factors of MetS, for both sexes. CONCLUSION: Low levels of HLI and older ages were independent risk factors of MetS in both males and females. The association between aging and MetS risk was stronger in females, while the association between unhealthy lifestyles and MetS risk was stronger in males. Our findings reinforced the expected gender differences in MetS prevalence and its risk factors, which has implications for the future development of gender-specific MetS prevention and intervention programs.

Knowledge, attitudes, and practice of Endocrinology healthcare workers regarding screening for pre-ulcerative diabetic foot lesions.

OBJECTIVE: To investigate knowledge, attitude and practice of screening pre-ulcerative lesions among endocrinology healthcare workers. METHODS: A new questionnaire was developed and distributed online and 1004 valid questionnaires were returned. T-test, ANOVA, Pearson correlation analysis, and multiple linear regression were used for statistical analysis. RESULTS: A total of 1100 questionnaires were returned, and 96 were excluded. The scores of endocrinology healthcare workers' knowledge, attitude, and practice for screening for pre-ulcerative lesions were 45.46 ± 16.26, 92.11 ± 10.50, and 72.27 ± 17.63 respectively. 60.2% participants had been trained to screen for pre-ulcerative lesions, but 39.8% had not been trained. 31.8% of healthcare professionals claimed that their hospital did not have a screening project for pre-ulcer diabetic foot lesions. Positive relationships were found between knowledge and practice and between attitude and practice. Multiple linear regression analysis showed that: level II hospital and tertiary hospital were the main factors influencing the knowledge scores; Undergraduate and participating in relevant training were the main factors influencing the attitude scores; participating in relevant training, hospital conducts relevant projects, and patient cooperation, and working hours were the main factors influencing the practice score. CONCLUSIONS: Endocrinology healthcare workers need more knowledge regarding pre-ulcerative lesions, and their screening practices need to be strengthened. Increased education and training for pre-ulcerative lesion screening should be implemented among healthcare workers in endocrinology departments.

Construction and verification of an intelligent measurement model for diabetic foot ulcer. / ä¸€ç§ç³–å°¿ç— è¶³æºƒç–¡æ™ºèƒ½æµ‹é‡æ¨¡åž‹çš„æž„å»ºä¸ŽéªŒè¯.

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. / 2019å† çŠ¶ç— æ¯’ç— ç–«æƒ æœŸé—´æŸç»¼åˆåŒ»é™¢å‘˜å·¥çš„å¿ƒç†çŠ¶æ€åŠå ¶å½±å“å› ç´ .

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.

Adsorption characteristics of nitrite on natural filter medium: Kinetic, equilibrium, and site energy distribution studies.

Nitrite is one of the world's major contaminants in drinking water resources, and granular anthracite is often used as filter medium in water treatment. In this study, the adsorption characteristics of nitrite on granular anthracite under various temperatures were investigated through adsorption kinetic, isotherm models, and site energy distribution theory. The adsorption of nitrite on granular anthracite was an endothermic reaction, while intraparticle diffusion was not the only rate control step. The adsorption could be well described by using pseudo-second-order and Langmuir-Freundlich equations. The adsorption capacity was 402.51 mg NO2--N kg-1 at 298 K, which could be significantly improved to 1380.1 mg NO2--N kg-1 when the temperature reached 308 K. Furthermore, nitrite ions first occupied the high-energy adsorption sites and then diffused to the low-energy adsorption sites on granular anthracite. There were more sites, including high-energy sites and low-energy sites, for nitrite adsorption at 308 K. Besides, the thickness of the boundary layer increased with the adsorption capacity improved at a higher temperature, and nitrite ions were adsorbed mainly through chemical mechanisms. Moreover, the neutral pH was helpful for the adsorption. The presence of co-existing ions could limit the adsorption and the effect followed the order of PO43- > CO32- > SO42- > NO3- > Cl-. The saturated anthracite could be effectively regenerated by 0.2 mol L-1 HCl solution. Therefore, the granular anthracite used as filter medium also has a possible application as a nitrite scavenger at the same time.

[Clinical analysis for patients with diabetic foot among multiple centers in China].

OBJECTIVE: 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.

Analysis of Long Non-Coding RNA Expression of Lymphatic Endothelial Cells in Response to Type 2 Diabetes.

BACKGROUND: Recent evidence has indicated that long non-coding RNA (lncRNA) is involved in the pathogenesis of type 2 diabetes, but nothing is known about lncRNA expression changes of lymphatic endothelial cells in response to type 2 diabetes. METHODS: The GSE38396 dataset was downloaded from the Gene Expression Omnibus database and the probe sets of Human Gnome U133 Plus2.0 microarray were annotated for lncRNA. Differentially expressed lncRNAs between diabetic and non-diabetic lymphatic endothelial cells were calculated. RESULTS: Compared with lymphatic endothelial cells in non-diabetic patients, 31 lncRNAs were down-regulated and 79 lncRNAs were up-regualted in lymphatic endothelial cells of type 2 diabetic patients. Several known lncRNAs were found, such as H19, GAS5, UCA1, CRNDE, GAS5, and LINC00312. Co-expression network of differentially expressed lncRNAs and mRNAs were constructed. Based on genomic regions of these lncRNAs, we found that binding sites of MAF and TCF3 were enriched and these lncRNAs may be related to insulin reporter signaling pathway and response to insulin stimulus. CONCLUSIONS: In a word, we found a set of lncRNAs were differentially expressed in lymphatic endothelial cells in response to type 2 diabetes and these lncRNAs may be involved in the pathogenesis of diabetes-related complications.

[Analysis of Endocrine Disruptor: Triphenyltin Chloride with Raman Spectroscopy].

Triphenyltin Chloride (TPhT) is one of the only two kinds of metal compounds known in the endocrine disruptors. TPhT is widely used in industry, agriculture and transportation fields, which can cause great impact on soil, marine and inland freshwater environment. This experiment collects the Raman signal of TPhT standard powders by applying laser confocal Raman spectroscopy to explore the feasibility of the method and to acquire optimized parameters. In this paper, we combined the application of laser confocal Raman spectroscopy with TPhT physical property. Due to different functional groups of TPhT molecules shows different vibration modes, the Raman spectra was divided into three wavenumber areas(1 500~3 200, 900~1 500 and 100~900 cm-1) to attribute and analyze their assignments of the Raman peaks, obtaining the characteristics of TPhT vibration modes and the corresponding characteristic peaks. Finally, a standard Raman spectra library was established with the spectral range between 100~3 200 cm-1. The results showed that the Raman spectra with high signal-to-noise ratio can be obtained in a short time when the laser power options decayed to 0.5% of the original power (500 mW) after 10s exposure and 2 times integration. Strong Raman signals observed in the Raman spectroscopy at 212, 332, 657, 997 and 1 577 cm-1 could be used as the characteristic peaks of TPhT in Raman detection. Otherwise, the co-occurrence of the Raman peaks at 657 and 997 cm-1 can be considered as the presence of TPhT in complex environmental samples. Experimental results are given to identify the presence of TPhT. The results would be used to identify the presence of TPhT residual in real environmental samples, which provide a theoretical basis and data base on Raman spectroscopy.

Residents health risk of Pb, Cd and Cu exposure to street dust based on different particle sizes around zinc smelting plant, Northeast of China.

The residents health risk of Pb, Cd and Cu exposure to street dust with different particle sizes (<100 and <63 µm) near Huludao Zinc Plant (HZP) was investigated in this study. The average concentrations of Pb, Cd and Cu in the <100-µm and <63-µm dust were 1,559, 178.5, 917.9 and 2,099, 198.4, 1,038 mg kg(-1), respectively. It showed that smaller particles tended to contain higher element concentrations. Metals in dust around HZP decreased gradually from the zinc smelter to west and east directions. There was significantly positive correlation among Pb, Cd and Cu in street dust with different particle sizes. The contents of Pb, Cd and Cu in dust increased with decreasing pH or increasing organic matter. Non-carcinogenic health risk assessment showed that the health index (HI) for children and adult exposed to <63-µm particles were higher than exposed to <100-µm particles, which indicated that smaller particles tend to have higher non-carcinogenic health risk. Non-carcinogenic risk of Pb was the highest in both particle sizes, followed by Cd and Cu. HI for Pb and Cd in both particle sizes for children had exceeded the acceptable value, indicated that children living around HZP were experiencing the non-carcinogenic health risk from Pb and Cd exposure to street dust.

Association between two functional SNPs of SCN1A gene and efficacy of carbamazepine monotherapy for focal seizures in Chinese Han epileptic patients.

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 silver and iodine dressings on wound healing: a systematic review and meta-analysis.

OBJECTIVE: To evaluate the effects of silver and iodine dressings on healing time, healing rate, exudate amount, pain and anti-infective efficacy. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Databases including PubMed, Cochrane Library, Embase, Web of Science and CINAHL were surveyed up to May 2024. ELIGIBILITY CRITERIA: Randomised controlled trials comparing silver and iodine dressings on wound healing in humans. DATA EXTRACTION AND SYNTHESIS: Evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Data extraction was done independently by two reviewers, with the risk of bias assessed using the Cochrane tool. Narrative synthesis was performed to evaluate the effects of silver and iodine dressings on healing time, healing rate, pain, exudate amount and anti-infective efficacy. Meta-analysis using Review Manager V.5.4 calculated standardised mean differences for healing time and relative risks for rate to quantify the impacts of the treatments. RESULTS: 17 studies (18 articles) were included. The meta-analysis indicated that silver dressings significantly reduced healing time compared with iodine dressings (SMD=-0.95, 95% CI -1.62 to -0.28, I2=92%, p=0.005, moderate-quality evidence), with no significant difference in enhancing healing rate (RR=1.29, 95% CI 0.90 to 1.85, I2=91%, p=0.16, low-quality evidence). Based on low-quality evidence, for exudate amount (3/17), 66.7% (2/3) of the studies favoured silver dressings over iodine in reducing exudate volume. For pain (7/17), 57.1% (4/7) of the studies reported no significant difference between silver and iodine dressings, while 42.9% (3/7) studies indicated superior pain relief with silver dressings. For anti-infective efficacy (11/13), 54.5% (6/11) of the studies showed equivalence between silver and iodine dressings, while 36.4% (4/11) suggested greater antibacterial efficacy for silver. CONCLUSION: Silver dressings, demonstrating a comparable healing rate to iodine dressings, significantly reduce healing time, suggesting their potential as a superior adjunct in wound care. PROSPERO REGISTRATION NUMBER: CRD42020199602.

Development and Validation of the Healthcare-Seeking Intention Questionnaire in Patients with Diabetic High-Risk Foot.

Objective: Timely screening and intervention can prevent the development of the diabetic foot. However, delayed visits to the clinic are common among diabetic foot patients. The study aimed to develop and validate a questionnaire to assess healthcare-seeking behavior among patients with diabetic high-risk foot. Methods: The questionnaire of healthcare-seeking intention for patients with diabetic high-risk foot was developed in two phases: (1) Developing the questionnaire: 1) questionnaire items were formulated after literature review, group discussion and semi-qualitative interview; 2) a two-round modified Delphi method was to examine the content validity and the degree of consistency in questionnaire items; 3) conducting pre-survey to revise the questionnaire items. (2) Assessing the internal reliability and construct validity. Results: The final questionnaire consisted of five main themes and 28 items with a five-point rating. Cronbach's alpha coefficients for the five dimensions were respectively 0.937 (relevant knowledge of diabetic foot), 0.669 (attitudes toward seeking care), 0.896 (social support for seeking care), 0.621 (efficacy in coping with foot symptoms), 0.871 (intention to seek care). The Scale-level Content Validity Index of the five parts was 1.00, 0.80, 1.00, 1.00, and 1.00, respectively. The Kaiser-Meyer-Olkin values for each dimension was greater than 0.7, and the p-value for Bartlett's test of sphericity was less than 0.05. Conclusion: This questionnaire showed good validity, internal consistency, and reliability. It provided a potentially useful instrument to evaluate healthcare-seeking intention among patients with diabetic high-risk foot.

Enhanced adsorption of phosphate by rice straw-based biochar prepared via metal impregnation and bio-template technology.

Phosphate removal from water through green, highly efficient technologies has received much attention. Biochar is an effective adsorbent for phosphate removal. However, adsorption capacity of phosphate on pristine rice straw-based biochar was not optimistic due to low anion exchange capacity. In this study, Fe-modified, Mg-modified and MgFe-modified rice straw-based biochar (Fe-BC, Mg-BC and MgFe-BC) were prepared by combining metal impregnation and biological template methods to improve the adsorption capacity of phosphate. The surface characteristics of biochar and the adsorption behavior of phosphate on biochar were investigated. The modified biochar had the specific surface area of 17.910-39.336 m2/g, and their surfaces were rich in a large number of functional groups and metal oxides. Phosphate release was observed on pristine rice straw-based biochar without metal impregnation. The maximum adsorption capacities of phosphate on MgFe-BC, Mg-BC and Fe-BC at 298 K were 6.93, 5.75 and 0.23 mg/g, respectively. Adsorption was a spontaneous endothermic process, while chemical adsorption dominated and electrostatic attraction and pores filling existed simultaneously. Based on the site energy distribution theory study, the standard deviation of MgFe-BC decreased from 6.96 to 4.64 kJ/mol with temperature increasing, which proved that the higher the temperature would cause the lower heterogeneity. Moreover, the effects of pH, humic acid, co-existing ions and ionic strength on phosphate adsorption of MgFe-BC were also discussed. MgFe-BC with fine pores and efficient adsorption sites is an ideal adsorbent for phosphate removal from water.

Application of a Diabetic Foot Smart APP in the measurement of diabetic foot ulcers.

AIMS: In the early stage, we developed an intelligent measurement APP for diabetic foot ulcers, named Diabetic Foot Smart APP. This study aimed to validate the APP in the measurement of ulcer area for diabetic foot ulcer (DFU). METHODS: We selected 150 DFU images to measure the ulcer areas using three assessment tools: the Smart APP software package, the ruler method, and the gold standard Image J software, and compared the measurement results and measurement time of the three tools. The intra-rater and inter-rater reliability were described by Pearson correlation coefficient, intra-group correlation coefficient, and coefficient of variation. RESULTS: The Image J software showed a median ulcer area of 4.02 cm2, with a mean measurement time of 66.37 ± 7.95 s. The ruler method showed a median ulcer area of 5.14 cm2, with a mean measurement time of 171.47 ± 46.43 s. The APP software showed a median ulcer area of 3.70 cm2, with a mean measurement time of 38.25 ± 6.81 s. There were significant differences between the ruler method and the golden standard Image J software (Z = -4.123, p < 0.05), but no significant difference between the APP software and the Image J software (Z = 1.103, p > 0.05). The APP software also showed good inter-rater reliability and intra-rater reliability, with both reaching 0.99. CONCLUSION: The Diabetic Foot Smart APP is a fast and reliable measurement tool with high measurement accuracy that can be easily used in clinical practice for the measurement of ulcer areas of DFU. TRIAL REGISTRATION: Chinese clinical trial registration number: ChiCTR2100047210.

Smart diabetic foot ulcer scoring system.

Current assessment methods for diabetic foot ulcers (DFUs) lack objectivity and consistency, posing a significant risk to diabetes patients, including the potential for amputations, highlighting the urgent need for improved diagnostic tools and care standards in the field. To address this issue, the objective of this study was to develop and evaluate the Smart Diabetic Foot Ulcer Scoring System, ScoreDFUNet, which incorporates artificial intelligence (AI) and image analysis techniques, aiming to enhance the precision and consistency of diabetic foot ulcer assessment. ScoreDFUNet demonstrates precise categorization of DFU images into "ulcer," "infection," "normal," and "gangrene" areas, achieving a noteworthy accuracy rate of 95.34% on the test set, with elevated levels of precision, recall, and F1 scores. Comparative evaluations with dermatologists affirm that our algorithm consistently surpasses the performance of junior and mid-level dermatologists, closely matching the assessments of senior dermatologists, and rigorous analyses including Bland-Altman plots and significance testing validate the robustness and reliability of our algorithm. This innovative AI system presents a valuable tool for healthcare professionals and can significantly improve the care standards in the field of diabetic foot ulcer assessment.

The changes in iron ions concentration and organic matter composition during the surface microlayer membrane formation process in freshwater.

The surface microlayer membrane (SMM) is a complex and unique water body ecosystem. The SMM has a significant effect on water quality and the water ecological system. However, despite the long-lasting interest in the SMM formation process and its environmental effect mechanism in freshwater, studies on it are still scarce. This paper studied the changes in iron ions concentration and organic matter composition during the SMM formation process. Our results revealed that the iron ions enriched in the SMM, at a concentration of up to 8.02 µg/mL, exist in the form of Fe3+. The main organic matter is polysaccharides and proteins in the SMM. Additionally, the microbial community structure revealed that the changes in iron ion morphology in water and the SMM was a significant association with the presence of Aeromonas and Zoogloea. The rapid enrichment process of iron ions and organic matter in the aquatic surface microlayer is involved in the rapid formation of early SMM. Obviously, these findings provide new insights and a basis for the SMM of freshwater.

Screening behaviors for diabetic foot risk and their influencing factors among general practitioners: a cross-sectional study in Changsha, China.

BACKGROUND: Diabetic foot is a serious complication of diabetes with a high disability and mortality rate, which can be prevented by early screening. General practitioners play an essential role in diabetic foot risk screening, yet the screening behaviors of general practitioners have rarely been studied in primary care settings. This study aimed to investigate foot risk screening behaviors and analyze their influencing factors among general practitioners. METHODS: A cross-sectional study was conducted among 844 general practitioners from 78 community health centers in Changsha, China. A self-designed and validated questionnaire was used to assess the general practitioner's cognition, attitude, and behaviors on performing diabetic foot risk screening. Multivariate linear regression was conducted to investigate the influencing factors of risk screening behaviors. RESULTS: The average score of diabetic foot risk screening behaviors among the general practitioners was 61.53 ± 14.69, and 271 (32.1%) always or frequently performed foot risk screening for diabetic patients. Higher training frequency (ß = 3.197, p < 0.001), higher screening cognition (ß = 2.947, p < 0.001), and more positive screening attitude (ß = 4.564, p < 0.001) were associated with more diabetic foot risk screening behaviors, while limited time and energy (ß=-5.184, p < 0.001) and lack of screening tools (ß=-6.226, p < 0.001) were associated with fewer diabetic foot screening behaviors. CONCLUSION: The score of risk screening behaviors for the diabetic foot of general practitioners in Changsha was at a medium level. General practitioners' diabetic foot risk screening behaviors may be improved through strengthening training on relevant guidelines and evidence-based screening techniques, improving cognition and attitude towards foot risk screening among general practitioners, provision of more general practitioners or nurse practitioners, and user-friendly screening tools.

Comprehensive analysis of the association of SCN1A gene polymorphisms with the retention rate of carbamazepine following monotherapy for new-onset focal seizures in the Chinese Han population.

The aim of the present study was to investigate whether single nucleotide polymorphisms (SNPs) in the sodium channel a subunit type 1 (SCN1A) gene affect the retention rate of carbamazepine (CBZ) used to treat seizures in Chinese Han patients with epilepsy. In total, 448 patients were genotyped for SNPs selected in the SCN1A gene. The tag SNPs were selected using Haploview version 4.2 software (http://www.broad.mit.edu/haploview/haploview, accessed 18 Sept 2009). Monotherapy with CBZ was administered to patients with new-onset focal seizures. In the present study, the retention rate of CBZ was defined as the percentage of patients with epilepsy who had continued with CBZ treatment in the preceding 3 months. Potential confounding variables were analysed to evaluate the risk factors for non-retention. When adjusted for potential confounding factors (e.g. age, sex, body mass index, seizure type etc.), the presence of the A allele of SNP rs3812718 predicted non-retention (P = 0.015; odds ratio (OR) = 3.122; 95% confidence interval (CI) = 1.823-4.893). Beyond 12 months of treatment in those that continued with CBZ (retention cohort), analysis of covariance indicated that the maintenance dose (P = 0.025) and serum CBZ levels (P = 0.021) were significantly higher in carriers of the rs3812718 AA genotype than in those with the GG genotype. The results of the present study indicate that the rs3812718 SNP in the SCN1A gene is significantly associated with the retention rate of CBZ monotherapy in Chinese Han patients with focal epilepsy.

[Effectiveness of systematic self-management education on blood sugar level of patients in the community with type 2 diabetes].

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 (P<0.01, P<0.05, P<0.01, respectively). After intervention, blood sugar levels in the intervention group were obviously improved (P<0.01), while in the control group, fasting plasma glucose was not statistically improved (P>0.05), 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.

Health Economic Indicators in Patients With Diabetic Foot: Outpatient Multidisciplinary Management.

The purpose of this study is to investigate the influence of an outpatient multidisciplinary diagnosis and treatment model on the health economic indices of diabetic foot patients. We included 142 diabetic foot patients who received treatment in 2 target hospitals from January to April 2018 in this prospective cohort study. According to their exposure factors, the patients were divided into a MDT group and a control group, with 71 patients in each group. The patients' baseline data were collected. The follow-up period was 12 months; all patients were followed up to April 30, 2019. Health economic indicators were collected when the patients were discharged from the hospital. The prognosis of each group was followed every month. If a wound healed, a major amputation occurred, or the patient died within 12 months, the follow-up was stopped. A total of 129 patients were followed, and their baseline data were comparable. During the follow-up period, the healing rate of the 2 groups was significantly different (P = .034). The healing rate of Wagner grade 4 patients was significantly better than Wagner grade 2 and grade 3 patients (P = .001). Health economic indicators demonstrated significant differences in bed waiting time (P = .038), transfer time (P = .001), surgery waiting time (P = .003), length of hospital stay (P = .047), and hospitalization expenses (P = .011). In conclusion, an outpatient multidisciplinary diagnosis and treatment model for diabetic foot can support cost-effective patient management.