Association rule regarding chronic disease-relevant risk factors for the adults in Haidian District / 中南大学学报(医学版)

Objective:To investigate the association patterns of chronic disease-relevant risk factors for the adults in Haidian District.Methods:Data for chronic disease-relevant risk factors for 3 219 adults in Haidian District in 2014 were collected and analyzed.SPSS 18.0 was used for statistical description and logistic regression.SPSS Modeler 14.1 was used to explore the association among the chronic disease-relevant risk factors.Results:Among men,5 patterns of chronic disease-relevant risk factors were identified,which suggested that heavy drinking,inadequate intake of fruit and vegetables,and physical inactivity were associated with smoking while inadequate intake of fruit and vegetables and smoking were associated with physical inactivity.Among women,one pattern of chronic disease-relevant risk factor was identified,which suggested that inadequate intake of fruit and vegetables was associated with physical inactivity.Conclusion:Chronic disease-relevant risk factors are intercorrelated among the adults in Haidian District.Information on patterns of chronic disease-relevant risk factors could assist interventions targeting multiple behaviors simultaneously.

Study on out-of-pocket expenditure and related factors among cancer inpatients with Hunan Provincial Urban Employee Basic Medical Insurance / 中南大学学报(医学版)

OBJECTIVE@#To explore the level and influential factors for out-of-pocket (OOP) expenditure regarding Hunan Provincial Urban Employee Basic Medical Insurance (UEBMI) and to provide evidence for improvement of medical insurance payment system.
@*METHODS@#Stratified random sampling method was used to obtain 10 527 records of cancer inpatients from January 2011 to December 2014. Social demographic and expenditure information were collected from UEBMI information system. The proportion of OOP expenditure for inpatient and each part of the cost was described. Multiple linear regression was used to analyze main related factors of OOP expenditure.
@*RESULTS@#The median proportion of OOP for inpatients costs was 20.11%, and remained stable from 2011 to 2014. The main related factors for OOP expenditure were age, civil servant, retirment status, hospital level, cost of hospitalization, hospitalization duration, medicine cost, proportion of general medical service charges, treatment cost, expenses of examination and laboratory test, and cancer type.
@*CONCLUSION@#OOP expenditure among UEBMI cancer inpatients was under control and stable. The level can well reflect the policy preferences. It could be further improved through the control of related factors, particularly the hospital level.

Socioecological risk factors among interpersonal violence perpetrators / 中华行为医学与脑科学杂志

The violence behavior is a kind of aggressive behaviors or attempt to hurt another person psychologically,physically or in other forms.Recently,violent incidents occur more and more frequently,and especially among teenagers.A number of concerns on violence continue to rise,and interpersonal violence is the most concerned type.Perpetrators are violence implementers who determine the occurrence and outcome of violence.Many studies provided the risk factors of interpersonal violence,that expounds the influence of personal level,interpersonal relationship,community background and social factors of interpersonal violence.The establishment of the socioecological risk-factor structural model which focuses on the perpetrators' indi vidual,is of great significance for the effective intervention for interpersonal violence.

Satisfaction degree in outpatients and the influential factors at national essential medicine system in primary health care institutions of Yiyang / 中南大学学报(医学版)

OBJECTIVE@#To analyze the satisfaction degree in outpatients and influential factors at national essential medicine system in primary health care institution of Yiyang and to provide useful information for the sustainable development of the national essential medicine system in China.
@*METHODS@#A multi-stage random sampling method was conducted. A total of 525 outpatients were randomly selected in 21 primary health care institution. Their satisfaction degree on national essential medicine system were investigated through anonymous survey.
@*RESULTS@#Categories of medical institutions, age, education, medicare categories and occupation were influential factors, with statistical significance (P<0.05). 
@*CONCLUSION@#There's no difference among different class of outpatients' attitude on national essential medicine system. Categories of medical institutions, age, education, medicare categories and occupation are influential factors for outpatients' attitude.

Effect of implementation of essential medicine system in the primary health care institution in China / 中南大学学报(医学版)

Our primary health care institution began to implement national essential medicine system in 2009. In past fi ve years, the goal of national essential medicine system has been initially achieved. For examples, medicine price is steadily reducing, the quality of medical services is improving and residents' satisfaction is substantial increasing every year. However, at the same time, we also found some urgent problems needed to be solved. For examples, the range of national essential medicine is limited, which is difficult to guarantee the quality of essential medication. In addition, how to compensate the primary health care institution is still a question.

Comprehensive evaluation of sample data in medical research / 中南大学学报(医学版)

Comprehensive evaluation methods are generally used to assess the population data. When we need to estimate the sample data in special situations, the impacts brought by the sampling error should be considered. Due to lack of the accurate measurement for the sensitivity and stability in the comprehensive evaluation methods, sampling errors usually cannot be estimated in the sampling research. Monte Carlo simulation was used in this article to solve the probability of the ordering results, and the matlab programs were presented. Based on the simulated results, we change the conventional “absolute conclusion” of comprehensive evaluation methods to “probability results” for the sample data, and put forward a new sorting and ranking method for the results of comprehensive evaluation.

Study on health care demands of outpatients with benign prostatic hyperplasia using multilevel model / 中华老年医学杂志

Objective To evaluate the patient's health care demands in communication,diagnosis,treatment and medical counseling of geriatric BPH outpatients in China.Methods A survey study was carried out in 33 medical centers from 11 different cities in China (North:Lanzhou,Beijing,Shenyang; South:Chengdu,Changsha,Wuhan,Jinan,Nanjing,Hangzhou,Shanghai,Guangzhou).2027 BPH outpatients aged (60 years participated in the survey to measure their health care demands using a questionnaire.Results There were 955 cases (47.1％) thinking communication is necessary before inspection items by a doctor,807 (39.8 ％)thinking communication is necessary before determining the treatment program,389 cases(19.2％) thinking respection items by a doctor is necessary,730 cases(36.0％)the treatment program by a doctor is necessary,849 cases (41.9 ％)thinking health guidance on BPH dignosis is necessary,934 cases (46.1 ％)thinking health guidance on BPH treatment is necessary,The multilevel model showed the demands scores data is similarity among the north and the south.And the patients with more severe lower urinary tract symptoms have more demands on communication and medical counseling.Conclusions It is to get better therapy,considering the patient's health care demands.

Effect of nutrition and food safety education among middle school students in a poverty-stricken county in west China / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the effect of nutrition and food safety education among middle school students in a poverty-stricken county in west China, and to explore the better education model for further education.@*METHODS@#Students of grade 7 to 9 were selected from 4 middle schools in the country through multi-stage cluster sampling for the questionnaire, and the schools were assigned into an intervention group or a control group. After students in the intervention schools completed one year nutrition and food safety education with the textbooks, students were chosen from the same 4 schools to finish the same questionnaire again.@*RESULTS@#A total of 410 students from grade 7 to 9 were selected at the baseline study, and 474 students in the final study. The essential characteristics of the 2 groups were not statistically significant (P>0.05). In the baseline investigation, the differences in the scores on nutrition and food safety knowledge, attitude and practice between the 2 groups were not significant (P>0.05). In the final study, the scores on the knowledge, attitude of nutrition knowledge learning, and dietary habits among students in the intervention group were significantly higher than those in the control group (P0.05).@*CONCLUSION@#Nutrition and food safety education can improve the nutrition and food safety knowledge effectively. The curriculum should be further standardized and different emphases should be set up to different grades to cultivate healthy diet behaviors.

Comparison of the diagnosis and medication strategy for patient of benign prostatic hyperplasia between urologist and geriatrician in China / 中华泌尿外科杂志

Objective To promote the standardization of medical practice in China by comparing the discrepancies of diagnosis and medication strategies for benign prostatic hyperplasia (BPH) between urologists and geriatricians.Methods Departments of urology and geriatrics in general hospitals in China were selected through stratified sampling and 145 315 patients who went for the outpatient service in certain days during December 2011 to December 2012 were recruited by cluster.Questionnaires were completed by corresponding doctors and data of patient clinical characteristics as well as diagnostic and therapeutic pattern were collected.Results A total of 142 511 valid questionnaires were collected with 119 426 from urology and 23 085 from geriatrics.The average age of BPH patients was (68.34±8.61) years and the average IPSS was 17.93±4.73.The rates of diagnostic method were IPSS (99.2％),ultrasonic inspection (86.0％),digital rectal examination (DRE) (66.0％) and urine flow rate test (55.2％).The rate of ultrasonic application was lower while the rates of other methods were higher among urologists (P＜0.01) ; the rate of DRE among urologists was 2.2 times to that among geriatricians.For patients with moderate or severe symptoms,most urologists (72.1％ in moderate patients and 79.9％ in severe patients) applied drug-combination strategy and the rate was 2 times to that among geriatricians (P＜0.01).In contrast,most geriatricians (59.7％ in moderate patients and 56.1％ in severe patients) applied single drug to BPH patients.Urologists utilized α-receptor blockers,plant preparations and traditional Chinese medicine more frequently than geriatricians (P＜0.01).Conclusions Urologists performed more integrated diagnosis strategy compared with geriatricians.The urologists tended to use 5α-reductase inhibitor combined with α-receptor blocker to treat BPH patients with moderate or severe symptoms,while geriatricians preferred 5α-reductase inhibitor alone.

Comparison of the diagnostic and therapeutic strategies for patients with benign prostatic hyperplasia between doctors in general hospitals and community hospitals in urban China / 中华老年医学杂志

Objective To comparing the diagnostic and therapeutic strategies for patients with benign prostatic hyperplasia(BPH) between doctors in general hospitals and community hospitals,and to provide scientific clues for the standardization in medical practice.Methods General and community hospitals in urban China were selected via the stratified sampling.127,325 outpatients in these hospitals from December 2011 to December 2012 were randomly recruited.Results The average age of patients was(67.82±8.62) years.There were significant differences in I-PSS,prostate volume,urinary flow rate(UFR) and result of digital rectal examination(DRE) between patients in general and community hospitals.The rates of diagnostic applications were different between doctors in the two kinds of hospitals except I-PSS.Compared with community hospitals,DRE was more frequently applied while ultrasonic inspection and UFR test were less used in general hospitals in North China.A totally opposite situation was observed in East China as compared with the north.The application rates of DRE and UFR test were lower and ultrasonic inspection rate was higher in community hospitals than in general hospitals in South China.Pharmacotherapy was the most common treatment for BPH patients in both types of hospitals(97.53 ％).The rates of drug combinations were statistically different but both were close to 75％ in the two types of hospitals.In community hospitals,the percentage of patients receiving watchful waiting with severe symptoms and signs were lower than that of patients receiving watchful waiting with moderate symptoms and signs,but the percentage of patients receiving operation was not significantly increased.On the contrary,the percentage of patients receiving operation with severe symptoms and signs was higher than that of patients receiving operation with moderate symptoms and signs in general hospitals,but the percentage of patients receiving watchful waiting was not decreased.Conclusions Applications of diagnostic methods are significantly different between doctors in general hospitals and community hospitals and vary among regions.Therapeutic strategies are correlated with the severity of obstructive symptoms or signs.The medication strategy is similar between the two types of doctors.

Evaluation on medical treatment outcomes of two operative methods of benign prostatic hyperplasia / 中华老年医学杂志

Objective To synthetically evaluate medical treatment outcomes of two operative methods on benign prostatic hyperplasia (BPH),and to provide evidence for therapeutic regimen selection.Methods Prospective cohort study was applied.BPH patients were treated by two operative methods randomly,follow-up observations were carried out at 3 months,6 months,and 48 months after the treatment.IPSS and BPHQLS were adopted to evaluate prostate and quality of life of patients at different time.The weight coefficients of IPSS score,quality of life score and general hospitalization expense in the comprehensive evaluation were defined by the Delphi Method.Results The synthetic score of both groups showed ascending trend,comprehend evaluation of scores got after treatment for 3 months (OP group was 7.6±0.7,TURP group was 7.4±0.8),6 months(OP group was 6.9 ± 0.9,TURP group was 6.9 ± 1.1) showed no significant differences between two groups(P＞0.05),curative effect of OP group was better than TURP group at 48 moths(OP group was 8.3±0.9 score,TURP group was 7.6± 0.8 score) (P＜0.05).Conclusions The curative effect of OP group was better than TURP group at 48 months.

The efficacy of α1-adrenergic receptor blocker, 5α-reductase inhibitor or combination therapy in benign prostatic hyperplasia / 中华老年医学杂志

Objective To compare the efficacy of α1 adrenergic receptor blocker,5α-reductase inhibitor or combination therapy in benign prostatic hyperplasia (BPH),and to explore the application of multi-level statistical model in assessment of BPH treatments.Methods Pragmatic clinical trials (PCT) design was used.BPH patients received drug therapy including α-adrenergic receptor blocker,5α reductase inhibitor,and combination therapy were followed up for 4 years.Multilevel statistical model was used to compare the scores of international prostate symtom score(IPSS) and BPH qality of life scale(QLS) among the 3 therapeutic regimens.Results The intra class correlation coefficients of I-PSS and BPH-QLS were 0.6136 and 0.6946 respectively,which indicated that both data were hierarchical structured.During the follow-up period,scores of IPSS and BPH-QLS were improved along with the drug therapy in 3 regimens.There was curve relationship between treatment time and IPSS and BPH-QLS scores in 3 regimens (all P＜0.05),and there was no significant differences in the trend of curves between the 3 regimens (P＞0.05).Conclusions For BPH patients with moderate symptoms bothering the quality of life,α-adrenergic receptor blocker,5α-reductase inhibitor,or combination therapy are significantly effective in reducing symptoms and improving quality of life.There are no efficacy differences among the 3 drug therapy during the 4-years follow-up.Compared with traditional analysis,multilevel statistical model is a more suitable and precise method for assessment of BPH treatments.

Development of green hospitals home and abroad / 中南大学学报(医学版)

Green hospital construction is a new challenge for medical industry after global sustainable development strategy was put forward. The core connotation of green hospital includes green building, green healthcare, patient safety, and doctor-patient harmony. Many countries have established green building evaluation system to deal with energy crisis. Leadership in Energy and Environmental Design (LEED), Green Guide for Health Care (GGHC) in the U.S., and Evaluation System for Green Hospital Building (CSUS/GBC 2-2011) in China have guiding signiifcance for the development of green hospitals in China. The evaluation system of green hospitals home and abroad still focuses on green building, and establishment of suitable synthesis evaluation system of green hospitals in China needs further research.

A novel improved TOPSIS method and its application in medical science / 中南大学学报(医学版)

The TOPSIS method is a static comprehensive evaluation method for wide range applications. However, it encounters the reverse order problem in practical applications. Moreover, its evaluation value Ci only reflects the relative proximity of each evaluation object inside but not to the degree of closeness to the ideal optimal solution. The evaluation value is also limited to distinguish between the ranges of merit ranking. Since TOPSIS method has the wide range of applications, it is necessary to overcome the drawbacks of TOPSIS method. This article proposes a new improved TOPSIS method, which shows strict isotonicity and is more sensitive than the traditional TOPSIS method. The medical application based on this improved TOPSIS method is introduced.

Multilevel models analysis on influencing factors of overweight and obesity in the elderly from Changsha city / 中华老年医学杂志

Objective To investigate the current situation and influencing factors of overweight and obesity in the elderly from Changsha city.Methods Using stratified sampling,2500 elderly in Changsha were included for the investigation by questionnaire and physical examination.The influencing factors were analyzed with univariate analysis and two-level models.Results Among 2500 persons,the valid questionnaires were 2254,the effective rate was 90.16％.About 39.71％ (895/2254) of Changsha's elderly were in overweight and obesity (BMI≥ 24 kg/m2).Univariate analysis showed that there were significant differences in BMI among different area,education degree,income,marital status,drinking wine,drinking tea,physical exercises and occupation (x2＝ 304.17,18.39,19.35,12.93,13.29,11.77,12.87,12.84,all P＜0.05).The results of two-level models indicated that the independent influencing factors were income,physical exercises,drinking wine,age and occupation.Conclusions It is necessary to take interventional measures against elderly obesity and to encourage the elderly taking physical exercises and keeping reasonable diets.

Basic aspects of data analysis and teaching in medical scientific research / 中华老年医学杂志

Statistical analysis includes statistical description and inference. The former one describes central and dispersion tendency,sampling error and characteristics of data distribution.The key of statistical description is how to properly select the relevant statistic which primarily depends on three elements:characteristics of sample,type of data and its characteristics of distribution.Secondly,we should pay attention to correct matching and combination use of statistics. Statistical inference includes parameter estimation and hypothesis testing. We usually use interval estimation to do parameter estimation.The correct selection of the methods of hypothesis testing needs the following six factors,research purpose,number of research factors,number of groups or research level,types of experiment design,data types and distribution characteristics,and the sample size.

Prohibited substances in cosmetics: prospect of the toxicity of acrylamide / 中南大学学报(医学版)

Prohibited substances in cosmetics refer to substances which must not be among the raw material ingredients of cosmetic products. These substances are absorbed mostly through skin, as well as via lung and gastrointestinal tract. Polyacrylamide is ubiquitously used in industry and its decomposition residue acrylamide (ACR) easily finds its way into cosmetic products. ACR can either be oxidized to epoxide glycidamide or conjugated with glutathione, hemoglobin or DNA; ultimately it is excreted in urine. ACR causes neurotoxicity, reproductive toxicity and tumors in rodents. Occupational exposure to ACR causes neurotoxicity in humans; however, epidemiological evidence have not unambiguously answered the question of whether ACR exposure can increase cancer risk for humans.

Knowledge, attitude and practice of respiratory infection in middle school students in Changsha / 中南大学学报(医学版)

OBJECTIVE@#To understand the knowledge, attitude and practice (KAP) to cope with common respiratory infection in middle school students in Changsha and to strengthen health education on respiratory infection.@*METHODS@#The 5 districts in Changsha were included. One junior school and one high school were randomly selected from each district, from which a cluster sample class in each was randomly selected. An anonymous questionnaire was used to survey 560 students in the first and second year students in each school.@*RESULTS@#In terms of basic knowledge of common respiratory diseases 56.6% of students had adequate "total awareness" scores, whereby the rate among urban students was higher than that of rural ones. In situations of respiratory infection outbreaks, 55.9% of students were actively knowledgeable of common respiratory disease, 43.4% of the students read related news, and 80.0% of the students followed the advisories of schools, teachers and parents. Students' knowledge of correct measures to prevent common respiratory infection was 79.5%, with girls ranking higher than boys, and urban students higher than rural ones. Students' knowledge of correct measures to treat these diseases properly was 65.7%. The Internet, television and radio were the students' main sources of knowledge.@*CONCLUSION@#KAP levels of common respiratory infection among middle school students in Changsha is low. Schools, especially rural schools, should strengthen the health education and explore more effective methods of health education. The responsible public health authorities should exploit the Internet and mass media to disseminate accurate and pertinent health information.

Analyses of cosmetic sanitary quality in Hunan Province in 2010 / 中南大学学报(医学版)

OBJECTIVE@#To establish a scientific foundation for cosmetic supervision and administration based on the analysis of the sanitary quality of cosmetics in Hunan Province during 2010.@*METHODS@#According to Cosmetic Sanitary Standards (set by the Ministry of Health, People's Republic of China), 150 random samples of cosmetics in Hunan were assayed both for microbial items (including total plate count, fungus and yeast, fecal coliform, staphylococcus aureus, pseudomonas aeruginosa) and chemical items (including 17 kinds of prohibited substances and 14 kinds of restricted substances).@*RESULTS@#The total rate of cosmetics failing to meet the standards was 22.0% of the 150 samples; specific rates for failing perfumes, skin care products (eye cream) and deodorant products were, relatively, 70.6%, 60.00%, and 44.4%. Four kinds of prohibited substances, including diethyl phthalate, acrylamide, asbestos and neodymium, as well as 2 kinds of restricted substances, including triclosan and formaldehyde, were found to exceed standards. None of microbial items exceeded standard levels.@*CONCLUSION@#The sanitary quality control of cosmetics is lax. Administrative departments should not only reinforce their post-production supervision with respect to cosmetics, but also consolidate their control over the process of cosmetic production in order to solve the problem of toxic residues or illegal and intentional adulterations.

A comprehensive evaluation of the health services in Hunan Province / 中南大学学报(医学版)

OBJECTIVE@#To establish a comprehensive evaluation system for the development of health services, and to assess the levels of health services in 2008 and 2009 in Hunan compared with seven other provinces in central China, so as to provide a basis for hygiene management decisions.@*METHODS@#In order to establish a comprehensive evaluation system, a Delphi method, a boundary value method, and an RSR method were applied, respectively, to survey indices of health service development, to screen indices, and to determine index weights. A weighted TOPSIS method was used to evaluate the development status of health services of the eight provinces.@*RESULTS@#The Cronbach's alpha coefficient of the questionnaire was 0.884, indicating a proper surface validity and a content validity. The expert positive coefficient, authority coefficient and Kendall coefficient were 93.75%, 0.8117, and 0.31, respectively. A comprehensive evaluation system, which consisted of 3 primary indices, 10 secondary indices and 52 tertiary indices, was established. The result of the comprehensive evaluation showed that the health services development of Hunan Province ranked 7th and 6th among the 8 central provinces for 2008 and 2009, respectively.@*CONCLUSION@#The established, comprehensive evaluation system has a high reliability. Health services development of Hunan Province is relatively backward among the 8 central provinces.