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Objective To explore the cognitive level and demand of chronic disease prevention and treatment integration in the County hospitals and primary health care institutions. Methods A stratified cluster sampling method was used to investigate the medical staff of five county-level hospitals and 39 community health service centers in Liandu District, Yunhe County and Jingning County, and qualitative interviews and on-site questionnaire survey were carried out among 573 medical staff from August to October in 2016. Results A total of 252 medical personnel at the county level or above, accounting for 43.98％, and 321 medical personnel in primary health care institutions, accounting for 56.04％. And 96.86％ of the medical staff thought it is necessary to integrate medical treatment and prevention. Only 32.98％ think that the local medical and anti-integration were the real ones and only 36.13％ have contacted the"top five prevention and control offices" at the county level. Two-way referral of key chronic patients and promotion of grassroots promotion of appropriate technology were better. And 77.38％ of medical staff at medical institutions above the county level and 75.70％ of medical personnel of primary medical institutions participated in the two-way referral work, with 66.67％ of county level medical staff of above medical institutions and 93.46％ medical staffs of primary medical institutions participated in the promotion of grassroots workplaces for appropriate technologies. And 82.72％ of the medical staff held or participated in appropriate technical training courses for chronic diseases within one year, but the proportion of holding or participating in ≥3 times was only 24.08％. Conclusion The work that county level five platform to promote chronic disease prevention and control of chronic disease prevention and treatment of medical integration still need to be strengthened. We should use the appropriate training mode to improve comprehensive prevention and treatment of chronic diseases among primary medical staff.
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Objective To analyze serum vitamin D level in patients with type 2 diabetes mellitus(T2DM),and to provide evidence for the intervention.Methods A total of 270 blood samples from patients with T2DM by multi -stage random sampling in 1 0 streets/towns in Lishui City were collected to test 25 -hydroxyvitamin D level by high performance liquid chromatography - tandem mass spectrometry.Results The average level of 270 case of T2DM patients '25 -hydroxyvitamin D was (22.97 ±8.07)ng/mL.Gender,household registration,BMI stage and 25 -hydroxyvitamin D level were statistically significant,respectively (Z =4.1 3,P <0.05),(Z =2.44,P <0.05),(F =3.21 ,P <0.05).By multiple linear regression analysis,we found that gender,household registration and length of outdoor exercise time was related to vitamin D level,the B value were -5.1 78,2.369,and 2.026,respectively(P <0.05).Conclusion T2DM patients had lower level vitamin D in their blood.Vitamin D had negative correlation with gender,household registration, and outdoor exercise time.T2DMpatients’vitamin D monitoring and outdoor activities should be strengthened.
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Objective TolearnthehealthstatusofemptynesterswithdiabetesinthemountainssouthwestofZhejiangand toexploretheinfluencingfactors.Methods Usingthemethodofstratified-random-clustersampling,78emptynesters with diabetes and 1 56 non -empty nesters with diabetes who come from five streets and 1 0 towns of 30 community (or village)were selected and investigated by questionnaire and physical examination were conducted.Univariate analysis were conducted to compare the differences about lifestyle,biochemical indicators and health status between the two groups and multivariateunconditionallogisticregressionanalysiswereconductedtoanalyzetheinfluencingfactors.Results The prevalence of hypertension of empty nest group was 70.51%,and the prevalence of hypertension of non-empty nest group was 58.97%.Fasting blood glucose level of empty nest group was 9.39 ±5.73 mmol/L,higher than that of the non-empty nest group(P<0.05 ).There was significant difference between the two groups in other indicators,such as drinking rate,high -salt diet rate,obesity rate,triglyceride levels,regular exercise rate,vegetables/fruits ≥4 days/week proportion,fish/meat≥4 days/week,awareness of their own blood pressure and blood sugar awareness (P<0.05).After adjustment for age,the obesity rate,abnormal rate of triglycerides,fish/meat(≥4 days/week)intake,regular exercise rate,blood pressure and blood sugar awareness rate were lower among non-empty nesters with diabetes,and overweight rate,systolic blood pressure abnormal rate,fasting glucose ratio,alcohol and high salt diet were higher in empty nest group patientswithdiabetes.Conclusion Emptynesterswithdiabeteshavearelativelyhighproportionoflackofexercise, inadequate nutrition intake,alcohol consumption,high-salt diet and lack of health knowledge and other unhealthy factors. The community health services and individual guidance for the empty nesters should be strengthened to improve the health status of empty nesters with diabetes.
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Objective To explore the risk factors of type 2 diabetes mellitus(T2DM)in mountainous countryside residents in order to provide relevant intervention measures.Methods 80 new cases of T2DM were selected from pingyuan community in Liandu District of Lishui City as case group,and 1 60 normal people were selected as control group at the same time and places,in which the 1∶2 matched design of case -control study method was used.Conditional Logistic regression analysis was applied in this study.Results The multiple conditional logistic regression analysis suggested that primary family history,history of hypertension,abdominal obesity were the risk factors of T2DM(OR=2.08,1.55 and 2.78 respectively);while education level,exercise and fish intake were the protective factors(OR=0.74,0.59 and 0.32 respectively).Conclusion T2DM is the result of both genetic factors and environmental factors.Moreover,health education,balanced diet and proper physical exercise should be encouraged among residents to prevent T2DM in mountainous countryside.