Association between awareness of smoking-related evidence and smoking cessation treatments provided by hospital chest physicians in Guangzhou, China: a multi-institutional cross-sectional survey / 中华流行病学杂志

<p><b>OBJECTIVE</b>Factors associated with smoking cessation interventions initiated by hospital chest physicians in China had not been studied. We examined if the physicians' awareness of emerging evidence regarding negative effects of smoking was associated with the initiation of smoking cessation.</p><p><b>METHODS</b>A cluster randomized cross-sectional survey was conducted from July 2011 to August 2011 in hospital-based chest physicians (n = 354) in Guangzhou, China.</p><p><b>RESULTS</b>Of those who responded (n = 354, 92.2%), 63.8% were aware of emerging evidence regarding negative effects of smoking and 64.5% initiated smoking cessation programs with their patients who smoked. Regarding the related awareness on smoking differed across physicians depending on their affiliation to evidence hospitals(χ(2) = 54.7, P > 0.001), i.e., primary (44.9%), secondary (55.1%)and tertiary hospitals (87.0%)was further supported by the related odds ratio (OR = 1.732, 95%CI:1.072-2.797, P < 0.05). Smoking status of physicians was related to their practice on smoking cessation, supported by the odds ratio (OR = 4.251, 95% CI:1.460-12.380, P = 0.008). Smoking cessation practice by physicians also depended on their affiliated hospitals. Physicians working at primary and secondary hospitals were less aware of the fact that smoking could reduce patients' responsiveness to inhaled corticosteroids than those working at the tertiary hospitals(χ(2) = 37.9, P > 0.001). Furthermore, these physicians would less frequently prescribed medication related to smoking cessation(χ(2) = 137.71, P < 0.001).</p><p><b>CONCLUSION</b>Physicians who were better aware of the health hazards of smoking might more actively provide smoking cessation advice in their clinics. The awareness might correlate with the hospital levels they worked and the smoking status while the the advice they provided might correlate with their educational background, job title, department affiliation and smoking status, but not with the level of hospitals.</p>

A clinical report of highly pathogenic avian influenza A (H_5N_1) / 中华急诊医学杂志

Objective To study the clinical features and prevention means of the infection caused by the highly dathogenic avian influenza A(H_5N_1).Method The clinical data which were confirmed to be an H_5N_1 infected case were analyzed retrospectively.Results The patient,16-year-old male,had no unambi guous history of direct contact with diseased or dead poultry before the onset of the disease.After the onset of the disease,chest X-ray showed flake shadow of the right lower lung quickly spread to the whole lung,associated with mediastinum,subcutaneous emphysema,acute respiratory distress syndrome(ARDS)was occurred on the fifth day.Mechanical ventilation is the primary measure in the comprehensive treatment.On the sixth day,Chinese Center for Disease Control and Prevention detected the pharyngeal specimen of the patient by RT - PCR,Real- time PCR method and suggested positive for the A/H5/N1 virus nucleic acid andis01ated the avian flu(H_5N_1) virus.The disease course was 10 days from onset of illness to death.Conclusions Human infection by the highly pathogenic avian influenza A(H_5N_1)is a deadly infectious disease.If the lesions is widespread and associated with ARDS,prognosis is poor.