ABSTRACT
Objective To investigate the practical results of three dimensional evaluation model based on preparation-process-outcome in transitional care in patients with breast cancer. Methods A total of 142 cases of patients with breast cancer received postoperative endocrine drugs adjuvant therapy for the first time were randomly divided into transitional care group (n=78) and control group (n=64). Patients in the control group were received routine follow-up care outside the hospital. Patients in transitional care group were accepted transitional care based on three dimensional evaluation model based on preparation-process-outcome, and structure, process and results of the transitional care were evaluated and monitored. After intervention 3, 6 and 12 months, the medication compliances of patients were evaluated. Before the patients discharged and after intervention 3, 6 and 12 months, the qualities of life were assessed. Results After intervention 6 and 12 months, the scores of Chinese Perceived Stress Scale (CPSS) in the transitional care group were (30.4 ± 3.2), (27.9 ± 2.5) points, respectively, and in the control group were (33.7 ± 3.6), (31.5 ± 3.4) points, respectively, the differences were statistically significant (t=5.746, 12.834, P<0.01). After intervention 3, 6 and 12 months, the scores of Self- rating Anxiety Scale (SAS) in the transitional care group were (49.3±3.9), (44.7±3.5), (37.6±2.9) points, respectively, and in the control group were (52.2±4.1), (47.8±3.9), (42.9±4.4) points, respectively, the differences were statistically significant ( t=3.696, 5.304, 9.682, P<0.01). After intervention 3, 6 and 12 months, the values of the medicine possession ratio (MPR) in the transitional care group were (99.1 ± 0.8)％, (98.7 ± 1.1)％, (96.7 ± 1.3)％, respectively, and in the control group were (93.5±3.6)％, (92.3±4.1)％, (87.2±3.8)％, the differences were statistically significant (t=14.524, 13.568, 16.834, P<0.01). After intervention 3, 6 and 12 months, the quality of life score in the transitional care group were (107.6 ± 4.2), (107.1 ± 4.3), (109.7 ± 4.4) points, respectively, and in the control group were (103.6 ± 4.8), (101.4 ± 4.2), (97.5 ± 3.9) points, the differences were statistically significant (t=5.524, 7.967, 18.623, P<0.01). Conclusions From the preparation, process and outcomes of the three dimensions to control the development and implementation of transitional care could improve the recent stress, anxiety and other negative emotions of the patients, improve the medication compliance of patients, and thus contribute to improving the overall quality of life of patients.
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Objective To investigate the prevalence and risk factors of metabolic obesity with normal weight (MON W) in Han nationality adult population,and to identify the cut-off points of body fat percentage (％ BF) by dualenergy X-ray absorptiometry(DXA) for defining MONW.Methods Six hundred and sixty subjects (403 men and 257 women) with body mass index(BMI) ranged from 18.5 to 23.9 kg/m2 were recruited into this study.Waist circumference(WC),blood pressure (BP),BM1,and ％ BF were measured.Serum concentrations of glucose,triglycerides(TG),total cholesterol (TC),high-density lipoprotein-cholesterol (HDL-C),low-density lipoproteincholesterol(LDL-C),serum insulin,and high-sensitivity C-reactive protein (hsCRP) were tested.Those within the highest quartile in the homeostasis model assessment of insulin resistance (HOMA-IR) with a normal BM1 between 18.5 and 23.9 kg/m2 were classified as MONW.Results The prevalence of MONW was 11.34％ for men and 16.34％ for women amongst normal-weight subjects,there was no significant different between men and women in the prevalence(P＞0.05).Multivariable Logistic regression analysis showed that TG(OR =5.92,P=0.001),LDLC (OR =13.65,P =0.009),hsCRP (OR =2.09,P =0.011),WC (OR =2.35,P ＜ 0.01),％ BF (total,OR =3.65,P＜0.01) and ％ BF(abdominal,OR =26.07,P＜0.01) were the risk factors of MONW amongst men.For women,TG (OR =9.12,P＜0.01),LDL-C (OR =2.64,P =0.005),HDL-C (OR =0.020,P＜ 0.01),hsCRP (OR =2.15,P =0.039),WC (OR =1.32,P =0.045),％ BF(total,OR =1.73,P＜0.01) and ％ BF(abdominal,OR =8.43,P＜0.01) were the risk factors of MONW.The cut-off points of ％ BF for diagnosing MONW by ROC were ％ BF≥25％ for men,％ BF ≥35.0％ for women.Conclusion MONW is quite common in Han nationality adult population;.％ BF,WC,hsCRP and lipid profiles were independently associated with MONW ％ BF ≥25 ％ for men,％ BF≥35.0％ for women can be used as reference cut-off.point for diagnosing MONW.
ABSTRACT
Objective To determine the level of ieptin (LEP) and soluable leptin receptor (sLEP-R) in the peripheral blood of rheumatoid arthritis (RA). The change of LEP/sLEP-R in patients with RA and the relationship between LEP/sLEP-R with osteoporosis is also investigated. Methods Sixty-four patients with RA and 60 normal controls were involved. Levels of LEP and sLEP-R were measured by ELISA. Bone mineral density (BMD) of non-dominant forearm, lumbar vertebrae(L_(1～4)) and hip were measured by dual energy X-ray absorptiometry. Results ① Compared with normal controls, the level of LEP in RA increased significantly,but the level of sLEP-R in RA decreased significantly (P<0.01). ② BMD of all detected regions in RA were significantly reduced than those in the normal controls (P<0.01). There was a higher incidence of osteoporosis in patients with RA (35.9%) than in normal controls (15.0%)(P<0.01). ③ There was a positive lineary correlation between age and the level of LEP in the peripheral blood of RA (P<0.01). There was negative lineary correlations between BMD and level of LEP in the peripheral blood of RA (P<0.05). There was a negative lineary correlation between age and level of sLEP-R in the peripheral blood of RA (P<0.01). There was positive lineary correlation between BMD and level of sLEP-R in the peripheral blood of RA (P<0.05). There was no correlations between clinical or laboratory parameters and level of LEP/sLEP-R in the peripheral blood of RA. ④ Analysis of Logistic Regression showed that the level of sLEP-R in the peripheral blood of RA was an independent protective factor for the occurrence of osteoporosis in RA (OR=3.089, P=0.017, 95%CI: 0.017-7.108). Conclusion The level of LEP in RA increases significantly, while the level of sLEP-R decreases significantly. There is a closely correlation between bone metabolism status and the level of LEP or sLEP-R in RA. The level of sLEP-R in the peripheral blood of RA is an independent protective factor for the occurrence of osteoporosis in RA.