Steroids and dihydroisocoumarin glycosides from Xylaria sp. by the one strain many compounds strategy and their bioactivities / 中国天然药物

The fungus Xylaria sp. KYJ-15 was isolated from Illigera celebica. Based on the one strain many compounds (OSMAC) strategy, the strain was fermented on potato and rice solid media, respectively. As a result, two novel steroids, xylarsteroids A (1) and B (2), which are the first examples of C28-steroid with an unusual β- and γ-lactone ring, respectively, along with two new dihydroisocoumarin glycosides, xylarglycosides A (3) and B (4), were identified. Their structures were elucidated by spectroscopic methods, X-ray diffraction and electronic circular dichroism (ECD) experiments. All isolated compounds were evaluated for cytotoxicity, DPPH radical scavenging activity, acetylcholinesterase inhibitory and antimicrobial effect. Compound 1 exhibited potent AChE inhibitory activity with an IC50 value of 2.61 ± 0.05 μmol·L-1. The β-lactone ring unit of 1 is critical for its AChE inhibitory activity. The finding was further confirmed through exploring the interaction of 1 with AChE by molecular docking. In addition, both compounds 1 and 2 exhibited obvious antibacterial activity against Bacillus subtilis with a minimum inhibitory concentration (MIC) of 2 μg·mL-1. Compounds 3 and 4 exhibited antibacterial activities against Staphylococcus aureus with MICs of 4 and 2 μg·mL-1, respectively, which also exhibited DPPH radical scavenging activity comparable to the positive control with IC50 values of 9.2 ± 0.03 and 13.3 ± 0.01 μmol·L-1, respectively.

Development and application syndromic surveillance and early warning system in border area in Yunnan Province / 中华流行病学杂志

Objective: To establish a dynamic syndromic surveillance system in the border areas of Yunnan Province based on information technology, evaluate its effectiveness and timeliness in the response to common communicable disease epidemics and improve the communicable disease prevention and control in border areas. Methods: Three border counties were selected for full coverage as study areas, and dynamic surveillance for 14 symptoms and 6 syndromes were conducted in medical institutions, the daily collection of information about students' school absence in primary schools and febrile illness in inbound people at border ports were conducted in these counties from January 2016 to February 2018 to establish an early warning system based on mobile phone and computer platform for a field experimental study. Results: With syndromes of rash, influenza-like illness and the numbers of primary school absence, the most common communicable disease events, such as hand foot and mouth disease, influenza and chickenpox, can be identified 1-5 days in advance by using EARS-3C and Kulldorff time-space scanning models with high sensitivity and specificity. The system is easy to use with strong security and feasibility. All the information and the warning alerts are released in the form of interactive charts and visual maps, which can facilitate the timely response. Conclusions: This system is highly effective and easy to operate in the detection of possible outbreaks of common communicable diseases in border areas in real time, so the timely and effective intervention can be conducted to reduce the risk of local and cross-border communicable disease outbreaks. It has practical application value.

Association between physical exercise and non-alcoholic fatty liver disease in people infected with hepatitis B virus / 中华流行病学杂志

Objective: To investigate the association between physical exercise and non-alcoholic fatty liver disease (NAFLD) in people infected with HBV. Methods: The information about the 3 813 participants infected with HBV, including the prevalence of NAFLD, prevalence of physical exercise and other covariates, were collected from the National Science and Technology Major Project of China during 2016-2020. The logistic regression model was used to evaluate the association between physical exercise and NAFLD in HBV infected patients, and subgroup analysis was performed to identify the effect modifiers. Results: A total of 2 259 HBV infected participants were included in the final analysis and 454 (20.10%) had NAFLD. After adjusting for covariates, we found that moderate physical exercise was a protective factor for NAFLD (OR=0.66, 95%CI: 0.46-0.94). Subgroup analysis suggested that the protective effect of moderate physical exercise on NAFLD might be stronger in women (OR=0.61, 95%CI: 0.36-1.01), those <45 years old (OR=0.24, 95%CI: 0.06-0.80), those who had low education level (OR=0.16, 95%CI: 0.04-0.49), those who had low annual income (OR=0.39, 95%CI: 0.16-0.89 for <30 000 yuan RMB; OR=0.64, 95%CI: 0.40-1.00 for 30 000-80 000 yuan RMB), those who had hypertension (OR=0.45, 95%CI: 0.21-0.88), those with BMI ≥24.0 kg/m2 (OR=0.66, 95%CI: 0.43-1.01), those who had more daily fruit or vegetable intake (OR=0.61, 95%CI: 0.38-0.97), those who had more daily meat intake (OR=0.49, 95%CI: 0.23-0.97), and those who had no smoking history (OR=0.66, 95%CI: 0.45-0.95) or passive smoking exposure (OR=0.61, 95%CI: 0.37-0.97). Conclusions: Among HBV infected patients, moderate physical exercise was negatively associated with the prevalence of NAFLD. Women, young people, those who had low education level, those who had low annual income, those with hypertension, those with high BMI, those who had more daily fruit or vegetable and meat intakes, and those who had no smoking history or passive smoking exposure might be more sensitive to the protective effect.

Predictive study on school absences due to illness with seasonal exponential smoothing method / 中华疾病控制杂志

Objective To establish a suitable exponential smoothing prediction model for school absentees due to illness, to discuss its application value for predicting school absences due to illness, and to provide a basis for early warning of absence due to illness. Methods Numbers of schools absences by year and month due to illness in 30 primary schools from November 2015 to June 2017 were collected from symptom monitoring system of border county, southern Yunnan and Simple seasonal model, Winters addition model and Winters multiplication model were used to build simulation. The data of July 2017 to December 2017 were used for model validation. The three models were overall compared and evaluated through indicator analysis, statistical analysis and residual diagram analysis. The best model was selected to predict school absences due to illness from January 2018 to March 2018. Results Simple seasonal model, Winters addition model and Winters multiplication model were used to fit the variation trend of number of school absences due to illness in time series. The root mean square error (RMSE) of three models were 445.11, 420.99 and 258.75; R2adj were 0.72, 0.72 and 0.77; R2 were 0.92, 0.93 and 0.98; P values of Ljung-Box Q were 0.54, 0.43 and 0.21. As for prediction method linear trend, Alpha were 0.999, 1.000 and 0.298. The average relative error between predicted value and actual value was 9.62%, 21.90% and 7.52%. Conclusion Winters multiplication model has practical value to predict school absence due to illness and provide scientific basis for early identification of abnormal signals.

The prevalence of five common chronic diseases and multi-morbidity and its relationship with socioeconomic position among rural older adults in Yunnan Province / 中华疾病控制杂志

Objective To analyze the relationship between socioeconomic position and prevalence of hypertension, diabetes, coronary heart disease, stroke, chronic obstructive pulmonary diseases (COPD) and multi-morbidity among older adults in rural Yunnan Province. Methods A total of 4 833 older adults aged 60 years and over were selected by multi-stage stratified random sampling method in rural Yunnan Province. Information was acquired from questionnaire and health examination. Principal component analysis was used to construct the socioeconomic comprehensive score. Results The prevalence of hypertension, diabetes, stroke, coronary heart disease, COPD and multi-morbidity in target persons was 50.6%, 10.2%, 6.4%, 5.5%, 5.4% and 16.1% respectively. The prevalence of hypertension and diabetes was much higher in female compared with male (both P<0.05), in contrast the prevalence of COPD was much higher in male than female( 2=5.499, P=0.019)The prevalence of hypertension, stroke, coronary heart disease, COPD and multi-morbidity was increased with age(all P<0.05);Minority ethnic were more likely to develop hypertension, coronary heart disease, COPD and multi-morbidity than Han ethnic(all P<0.05). The results of multivariate logistic regression analysis showed that older adults with lower socioeconomic position had higher probability of suffering from hypertension, coronary heart disease, stroke, COPD and multi-morbidity (all P<0.05). Conclusions There are significant socioeconomic differences between socioeconomic position and prevalence of five major chronic diseases and multi-morbidity among older adults in rural Yunnan province. Older adults with low socioeconomic position should be key population for future prevention and control of chronic diseases.

Study on sleep quality status and its relationship with cardiovascular disease in rural elderly in Ning’er county, Yunnan province / 中华疾病控制杂志

Objective To analyze the sleep quality status and its relationship with cardiovascular disease in rural elderly in Yunnan Province. Methods Multistage stratified random sampling method was used to select 1629 residents aged 60 years and over from Ning Er County in Yunnan province. Each participant received questionnaire survey and physical examination. Multivariate logistic regression analysis was used to analyze the relationship between sleep quality status and cardiovascular disease. Results Among the study population, the overall Pittsburgh Sleep Quality Index (PSQI) score was 7.48±3.89,and was 6.67±3.69 for males and 8.07±3.92 for females. The prevalence of sleep disorder, hypertension, coronary heart disease and stroke were 56.78%, 52.85%, 8.16% and 8.66%, respectively. Females had higher prevalence of sleep disorder than males (62.81% and 48.55%，P<0.001). The elderly with lower annual average family per capital income and bad access to medical services had higher prevalence of sleep disorder than their counterparts (P<0.001).The elderly with sleep disorder was more likely to suffer from hypertension, coronary heart disease and stroke (P<0.05). Conclusion The prevalence of sleep disorder is high in rural elderly in Yunnan Province. Improving sleep quality among the elderly can prevent and control cardiovascular diseases to a certain degree.

Three new diterpenoid alkaloids isolated from Aconitum brevicalcaratum / 中国天然药物

In the present study, three new aconitine-type diterpenoid alkaloids brochyponines A-C (1-3) were isolated from the roots of Aconitum brevicalcaratum. Their structures were established on the basis of extensive spectroscopic analyses (IR, HR-ESI-MS, and 1D and 2D NMR). The NMR data of salt form for compound 1 in CDCl were also measured.

Three new diterpenoid alkaloids isolated from Aconitum brevicalcaratum / 中国天然药物

In the present study, three new aconitine-type diterpenoid alkaloids brochyponines A-C (1-3) were isolated from the roots of Aconitum brevicalcaratum. Their structures were established on the basis of extensive spectroscopic analyses (IR, HR-ESI-MS, and 1D and 2D NMR). The NMR data of salt form for compound 1 in CDCl were also measured.

The Prevalence,Awareness, Treatment, Control and Self-management of Diabetes among the Elderly in Midu County / 昆明医科大学学报

Objective To analyze the prevalence, awareness, treatment, control and self-management of diabetes among the elderly in Midu County of Yunnan province. Methods A stratified random sampling method was used to carry out on-site questionnaire survey and blood glucose measurement among 1,603 older people aged≥60 in Midu County of Yunnan province. Results The overall prevalence, awareness, treatment and control rate of diabetes among the elderly were 10.11％, 56.17％, 75.82％and 37.36％respectively. The rates of self-monitoring of blood glucose, taking medicine prescribed by doctors and hypoglycemic measures in the last two weeks were 43.96％, 80.22％ and 98.90％ respectively. People with higher average annual income had higher prevalence of diabetes ( <0.05) . The awareness rate of diabetes in women (67.42％) was significantly higher than that in males (42.47％, <0.01). Self monitoring of blood glucose in patients with house toilet (46.99％) in house was higher than those without toilet (12.50％, <0.05). The higher the level of education, the higher the rate of taking medicine prescribed by doctors ( <0.05) . Patients who do not live alone and have toilet in house have a higher rate of weight control (67.07％and 66.27％) than those living alone and without toilet (22.22％and 25％,<0.05).Conclusions The findings indicate a relatively high prevalence of diabetes and low level of self-management of diabetes among older people in Midu County. It should adopt targeted diabetes health education and intervention according to different characteristics of the population so as to improve their level of diabetes self-management.

Status and Influencing Factors of Public Health Services Utilization among Rural Patients with Severe Mental Illness in Yunnan Province / 昆明医科大学学报

Objective The aim of this study was to analyze the status and influencing factors of public health service utilization in rural patients with severe mental illness in Yunnan province. Methods The main caregivers of patients with severe mental illness in Yunnan province were selected by stratified cluster sampling method. Multivariate logistic regression was used to analyze the influencing factors of public health service utilization. Results A total of 284 cases of rural patients with severe mental illness were investigated, including 144 males (50.7％) and 140 females (49.3％) . The rate of medical file filing, follow-up rate of village doctor, participation rate of free physical examination and health education acceptance rate among patients with severe mental illness were 89.8％, 84.9％, 73.2％and 56.7％respectively (<0.05) . Female patients had higher participation rate of free physical examination than male patients, and patients having work and patients with controlled disease condition and their caregivers had higher rates of health education acceptance rate than their counterparts ( <0.05) . Conclusion Measures should be taken to strengthen the work of medical examination for male patients, and to expand health education activities for patients having no work and patients with uncontrolled disease condition, so as to improve the public health service utilization in rural areas of Yunnan province.

National Natural Science Foundation-supported papers in the field of epidemiological methods and health statistics: A trend analysis / 中华医学图书情报杂志

The National Natural Science Foundation-supported papers in the field of epidemiological methods and health statistics since 1987 were analyzed by trend analysis in order to have a better understanding of the development,current situation and history in the field of epidemiological methods and health statistics,and provide reference for the selection of topics,approval of projects and optimization of supporting structure in the field of epidemiological methods and health statistics.

Prevalence of Diabetes and Its Impact on Quality of Life among Jingpo Ethnic Residents in Yunnan Province / 昆明医科大学学报

Objective To analyze the prevalence of diabetes and its impact on the quality of life (QOL) among Jingpo ethinic residents in Yunnan province.Methods Questionnaire survey and fasting blood glucose (FBG) testing were conducted among 1367 Jingpo residents aged ≥ 35 years selected with random sampling method in Mangshi municipality of Dehong prefecture in Yunnan province.The Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) was used in the survey.Results The prevalence rate of diabetes among the Jingpo residents was 4.1％,and 4.2％ for males,4.0％ for females.Among Jingpo diabetic patients,mean scores for the domains of physical functioning (PF),role physical (RP),bodily pain (BP),general health (GH),vitality (VT),social function (SF),role emotional (RE),mental health (MH),physical component summary (PCS) and mental component summary (MCS) were (84.64 ±16.81),(53.13 ±45.24),(71.70 ± 24.28),(49.46 ± 21.38),(65.09 ± 11.02),(90.08 ± 14.00),(79.17 ± 39.98),(70.29 ± 13.73),(57.12 ± 9.39) and (55.07 ± 6.58),respectively.The identified diabetic patients had significantly lower QOL scores for the doamins of PF,RP,BP and PCS than their counterparts,respectively (P＜0.05).The results of the multiple linear regression analysis showed that older Jingpo residents had lower scores in the domain of PCS and MCS (P＜0.01);men has lower scores in the domain of PCS and MCS than women (P＜0.01);the higher the level of education,the higher the scores of PCS and MCS (P＜0.01);married Jingpo residents had higher scores in domain of PCS than those of unmarried and divorced (P＜0.01);the diabetic patients had lower scores of PCS than their counterparts (P＜0.01).Conclusion It is necessary to strengthen the health education for the elderly and people with low level of education,and improve the management of patients with diabetes,so as to effectively improve the QOL of Jingpo ethnic minority residents.

Study of optimization for the cream base of benzhydramine hydroehloride / 药学实践杂志

Objective To optimize the cream base of benzhydramine hydroehloride .Methods Five nonionic surfactants as an emulsifier were used to prepare benzhydramine hydroehloride creams .The five sorts of cream were evaluated from the ap-pearance ,preliminary stability ,accelerated test stability and room temperature stability .Results Benzhydramine hydroehloride cream could be prepared using five nonionic surfactants .On appearance of smoothness ,gloss and spread ,formula E was best but formula A was worst ,while formulas B and D were close and worse than formula E only .In the stability tests ,all of creams had no obvious change after the centrifugal experiment and the low temperature experiment .In the high temperature ex-periment ,the formula E was stable ,formulas A ,B and D showed a little appearance change ,and the formula C became layered bleeding .In room temperature ,the formula C became bleeding after five days ,which happened to the formula A after one month ,and formula B after two months .The formulas D and E had no obvious change until six months in room temperature . Conclusion The formulas D and E were stable ,which had clinical application value .

Analysis on the Influencing Factors of Overdrinking / 昆明医科大学学报

Objective To provide useful information on reducing risky drinking for the Dept.of Public Health taking a county in Yunnan province as an example to explore the risk factors related to risky drinking.Methods A total of 574 participants identified as Miao,Yi and Han People at or older than 12 years old,who had been living there for 6 months or more were selected and surveyed in 5 townships in the county through stratified sampling.Alcohol consumption was collected using the beverage-specific quantity frequency (BSQF) method and analyzed using binary logistic regression and chi-square test.Results The number of drinkers in the family,undesirable drinking environment among friends and enculturation (β =0.073) could increase the likelihood of risky drinking.Risky drinking pattern was positively associated with age (β =1.006),and negatively associated with gender (β =-2.947) and awareness of risky drinking among rural residents.Conclusion The important measures to control risky drinking behavior in terms of health promotion and education include reducing the number of drinkers in the family,and preventing from undesirable drinking environment among friends and harmful drinking culture.These measures are crucial to prevent early onset of alcohol drinking among teenagers and to reduce risky drinking among middle aged and aged population.

The Distribution of Body Weight Related Index and Relationship with Cardiovascular Diseases in Rural Residents of Yunnan Province / 昆明医科大学学报

Objective The aim of this study was to investigate the distribution of body weight related index and to explore the relationship between weight related index and cardiovascular diseases in rural residents in Yunnan Province. Methods By random cluster sampling method,rural residents were selected in Yunnan Province. The data were collected by face-to-face questionnaire and medical examination. Results 4070 rural residents in Yunnan participated in this study. The survey results showed that gender,age,education level and ethnicity affected both the distribution of body weight related index and low body weight,overweight,obesity,and central obesity(P < 0.05). Compared with low body weight,non overweight,non obesity and non central obesity group,non low body weight,overweight,obesity and central obesity group had higher prevalence rate of hypertension(P < 0.01). Among central obesity group,the prevalence rate of coronary heart disease was higher than non central obesity group(P < 0.01). Conclusion The distribution of body weight related index in rural residents of Yunnan province showed some special characteristic. The overweight,obesity,and central obesity were related to cardiovascular diseases. Change unhealthy living habits or behavior as well as improving their cultural quality have effects on controlling body weight related index and help to reduce the prevalence rates of overweight,obesity and central obesity which can further reduce the prevalence rates of cardiovascular diseases.

Analysis of 572 Cases of Drug-induced Liver Injury Induced by Anti-infective Agents / 中国药房

OBJECTIVE:To investigate the condition and characteristics of drug-induced liver injury (DILI) of anti-infective agents and provide reference for the prevention and treatment of anti-infective agents related DILI. METHODS:Based on retrospective analysis,a total of 572 DILI reports of anti-infective agents were collected from PLA ADR monitoring center during 2009 to 2013, and then analyzed statistically in terms of patient’s age and gender,main diagonosis,categories of DILI-inducing drugs,type,route of administration,occurrence time,lab indicator,DILI types and clinical manifestations,the application of liver protective drugs,out-comes,etc. RESULTS:Among 572 DILI cases,there were 412 cases(72.03%)of male patients and 160 cases(27.97%)of female patients,and average age of the patients was(44.54±23.75)years old. ADRs were related to 57 kinds of anti-infective agents in 6 cat-egories. Rifampin was the most frequent in suspected drugs,followed by isoniazid,moxifloxacin,fluconazole,azithromycin,cefurox-ime, cefoperazone/sulbactam, levofloxacin, cefoxitin and voriconazole. Intravenous infusion was the main administration route (74.48%). The occurrence time of ADRs was mainly within two weeks (86.19%). Hepatocellular damage (93.33%) was the main type in 360 cases of ADR for evaluation of liver injury types. The majority of cases(82.17%)were cured or improved after drug with-drawal and symptomatic treatment. CONCLUSIONS:Cephalosporin,fluoroquinolones,antituberculosis and antifungal drugs might be the common agents which caused liver injury. Hepatocellular damage is the most frequent type. Most of patients have a favourable prognosis. Clinical medical staffs should strengthen the awareness of DILI caused by anti-infective agents and ehance the prevetion of it.

Analysis of Prevalence of Cardiovascular Disease Risk Factors among Nurses with High Job Stress in Kunming / 昆明医科大学学报

Objective To analyze the prevalence of cardiovascular disease (CVD) risk factors among nurses with high job stress in a Kunming tertiary hospital. Method The health data from 46 nurses who had gotten a medical examination between August 1 and November 30,2013 in the first people's hospital retrospectively analyzed .Results 76%of 46 nurses enrolled in this study had inordinately CVD risk factors,the top prevalence of CVD risk factors was dyslipidemia (58.9%),followed by hyperviscosity (45.5%),electrocardiographic abnormality (30.8%),overweight (19.2%),and hypertension (9.2%) . Moreover,there was significant differences of CVD risk factors among different departments ( <0.05),which the overall prevalence rate being highest among nurses working in the operating room. Conclusion The nurses with high job stress from tertiary hospital have high risks of CVD,therefore intervention measures should be taken to reduce the risk of CVD.

Analysis of the Prevalence and Economic Burden of Diabetes in Guandu District of Kunming / 昆明医科大学学报

Objective To analyze the prevalence and economic burden of diabetes in Guandu district of Kunming. Methods We used probability proportional to size (PPS) sampling method to select representative sample of 4595 residents aged 18 or over from this district. Each participant received face to face questionnaire interview and physical examination. We applied different methods to measure the direct,indirect and intangible costs of diabetes. Results In the study population, the overall prevalence of diabetes was 6.2%,and females had higher prevalence of diabetes than males (6.2%vs. 5.6%, <0.05) . The DALY/1000 population of diabetes was 3.52, among which males and females were 5.18 and 6.70, respectively. Mean unit direct costs, indirect costs and intangible costs of diabetes were 3464.49 Yuan,84.48 Yuan and 4 045.97 Yuan,respectively. The total economic burden of diabetes was 401.84 million Yuan. Intangible costs represented the largest component of economic burden of diabetes,followed by direct costs. Conclusion The huge economic burden of diabetes has become the cause for concern in Guandu district. Effective measures are needed to reduce the economic burden of diabetes.

Analysis of association of economic burden of hypertension with tobacco exposure in Luoping county of Yunnan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the association between hypertension and tobacco exposure Luoping county of Yunnan province and estimate the direct cost attributable to hypertension .</p><p><b>METHODS</b>Using Probability proportional to size (PPS) sampling method, 5000 rural residents aged over 18 years were selected from 12 townships in Luoping county, Yunnan province in April 2011, from which 4611 subjects completed the survey. Self-designed questionnaires were used to collect general information, smoking status, costs for outpatient consultation, inpatient, treatment, medication, travel, accommodation and extra-nutrition caused by hypertension as well as the information of health-related behavior. Their height, weight, waist circumference, hip circumference and blood pressure were measured. The direct economic burden of hypertension was calculated. Chi-square (χ(2)) test was used to compare gender differences of hypertension prevalence, smoking and passive smoking. And t test was used to compare the differences of direct economic burden of hypertension among different gender, smoking and passive smoking status. Multivariable logistic regression model was used to analyze the influence factors of hypertension.</p><p><b>RESULTS</b>Among the 4611 subjects, the age was (46.90 ± 16.74) years old. Male accounted for 49.8% (2294/4611) and female 50.2% (2317/4611) . The smoking rate was higher in males (75.7% (1736/2294)) than in females(1.6% (38/2317)) (χ(2) = 2669.21, P < 0.01). The passive smoking rate was lower in males (10.0% (230/2294)) than in females (46.2% (1070/2317)) (χ(2) = 744.27, P < 0.05). Non-tobacco exposure rate in males (14.3% (328/1537)) was lower than in females (52.2% (1209/1537)) (χ(2) = 744.37, P < 0.05) . The risk of hypertension in smokers and passive smokers were higher than those without tobacco exposure, OR (95%CI) was 1.41 (1.15-1.71) (P < 0.05) and 1.31 (1.07-1.63) (P < 0.05) respectively. The per capita direct cost of hypertension was (3444.09 ± 3067.83) Yuan. Of this, tobacco exposure (4552.46 ± 3189.05) Yuan was higher than non-tobacco exposure (1907.71 ± 1383.94) Yuan (t = -3.81, P < 0.05) . Moreover, smokers were (6951.71 ± 3422.87) Yuan higher than passive smokers (3128.09 ± 2083.17) Yuan (t = 3.19, P < 0.05) and males (5827.39 ± 3240.50) Yuan were higher than females (2633.03 ± 2569.01) Yuan (t = 3.22, P < 0.05) . The total direct costs of hypertension attributable to smoking and SHS was 41 million and 38 million, respectively.</p><p><b>CONCLUSION</b>Both smoking and SHS had significant impact on prevalence and economic burden of hypertension in Luoping county. Implementing effective strategies to control tobacco exposure is useful to reduce the economic burden of hypertension in the study region.</p>

Self-Management Ability and Influencing Factors among People with Type 2 Diabetes in Kunming / 昆明医科大学学报

Objective To investigate the diabetes self-management (DSM) ability and influencing factors in patients with type 2 diabetes in Kunming. Methods A face to face questionnaire survey was conducted on type 2 diabetes patients admitted in the 1st Affiliated Hospital of Kunming Medical University from November 2010 to April 2012. Diabetes self-management instrument ( DSMI) was used to test self-management behavior, and psychological status was assessed by Problem Areas in Diabetes (PAID-5).Results 300 patients participated in the survey.The participant population consisted of 120 males (41.8%) and 168 females (58.2%) .A total of 190 patients (68%) suffered from DM related psychological problems.The mean DSM score was 95.23±20.6, and mean scores for the domain of integration DM care into one’s life, self-regulations, interaction with health professionals,self-blood monitoring glucose,and adherence to recommended regimen were 28.11±6.15,25.22± 5.67,23.06±6.41,10.98±2.96,and 8.75±2.21,respectively. There was no significant difference in the mean score between males and females (P>0.05) .Patients with psychological problems had lower scores in five DSM dimensions than those without psychological problems (P<0.05) . The result of multiple regression showed higher level blood glucose was negatively associated with DSM score, whereas patients with higher income was associated with a higher DSM score (P<0.05) .Conclusions The DSM situation is not good among patients with type 2 diabetes in Kunming, and most of the patients suffer from psychological problem. It is necessary to enhance the effective health education among diabetic patients.