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Spinal infection is a serious health-threatening clinical condition, which more frequently occurs in solid organ transplantation receipients than in non transplant receipients. With the increase of solid organ transplantation, the incidence of secondary spinal infection has been increased in recent years. The symptoms and signs of secondary spinal infection are not obvious, and early diagnosis and treatment are difficult, leading to recurrent attacks and protracted disease courses. This article reviews the progress in the diagnosis and treatment of secondary spinal infection after solid organ transplantation.
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Since December 2019, an outbreak of novel coronavirus pneumonia (COVID-19) in Wuhan, Hubei Province, which has caused wide public concern all through the world. Although artificial intelligence is a priority development fields in recent years, there is no study on the application and effect of AI in this epidemic. Based on the application of AI scenarios in typical cases, the research analyzes the practice and effectiveness of AI in epidemic surveillance, clinical diagnose, public health management and other related scientific research. Besides, combined with the current situation of development, some suggestions are put forward in order to better play the role of artificial intelligence in the public health emergency system in China.
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Objective To evaluated the effectiveness and influence of a pay for performance incentive program on the comprehensive management in patients with type 2 diabetes. Methods The large-sample prospective study recruited 1359 eligible adult patients who were residents and had health record from three community health centers of Shanghai Jiading District. The method of randomized complete block design was used to classify the subjects into 4 groups. The physicians incentive group included 337 subjects, while the patients incentive group 338 subjects, the physicians and patients incentive group 331 subjects, the control group which the physicians and the patients would not have the incentive 353 subjects respectively. We established a cooperative pathway between community health care centers and general hospital, trained community health workers, equipped with the necessary clinical drugs, and finally, the Advance System for Diabetes Management system was used to carry out the tele-medicine. The type 2 diabetes mellitus patients, which were set goal in blood glucose and blood pressure control, managed by the general practitioners, the daily health behavior of the patients were regulated. All subjects in the patients incentive groups received the incentives if they can obtain or/and maintain the ideal level of HbA1C during the 2-years study period. The control group would not receive any incentives but would be provided with diabetes education booklet and group educational courses for diabetes mellitus control as usual. Results After 12 months and 24 months, HbA1C , systolic blood pressure, diastolic blood pressure, total cholesterol, fasting blood glucose in the four groups were all lower than baseline levels (P<0. 05), while the time of related exercise parameters and the rate of HbA1C achieving target in the study groups were higher than baseline (P<0. 05). Besides, the time of related exercise, time of moderate exercise intensity, time of strenuous exercise intensity, and the rate of HbA1C achieving target ( after 24 months:49. 0％, 53. 2％, 51. 8％, 54. 4％, P<0. 05 ) had statistical significance among the physicians incentive, the patients incentive, the physicians and patients incentive, and the control groups. Logistic regression analysis showed that the duration of diabetes, the baseline HbA1C , whether using the insulin, taking hypoglycemic drugs are the main factors of the study with statistical significance (all P<0. 05). Conclusions Based on general practitioners-specialist cooperation tele-medicine, by regulating the daily health behavior and using the intervention of pay for performance, the new diabetes care model could improve the treatment effect of type 2 diabetes to some extent, especially the exercise time and its intensity. Besides, the duration of diabetes, the baseline of HbA1C , the using of insulin and hypoglycemic drugs turned out to be the main factors of the study.
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Objective To evaluate the necessity and practicability of optimizing the management of type 2 diabetes mellitus in community after acquiring the peer education and the music therapy to their physical and mental issues and sleep problems. Methods Totally 179 type 2 diabetes mellitus patients who were followed up in Ruijin 2nd community health service center, the random numbers table used to randomize the patients into 2 groups:control group ( 97 cases) and experiment group ( 96 cases), the conventional treatment was used in control group. Besides the conventional treatment measures, the peer support was used by patients in the experiment group. In the second step, 45 patients were met the inclusion and the exclusion criteria, the random numbers table used to randomize the patients into 2 groups:the multiple intervention group (22 cases) and the conventional treatment group (23 cases), the multiple intervention included the music therapy, the peer support and the sleep health education, the conventional treatment included the conventional treatment and the sleep health education. The t test was used to compare the patient's HbA1c and other quantitative data in two groups of patients after the intervention. Results In the first stage of research, compared with the control group patients, the patients 'HbA1c in intervention group was significantly improvement after 6 months(7.26%±1.37%vs.7.53%±1.63%,t=2.148, P<0.05),besides, the intervention group individuals achieved significant improvement in diabetic self-management behaviors and self-efficacy after 6 months, and the improvement in self-efficacy of peer support group was significant different compared with routinely educated patients(104.09±16.40 vs.110.96± 13.86,t=2.120,P<0.05), and the PHQ-9(5.95 ± 4.02 vs.2.55 ± 1.67,t=2.630,P<0.05)between the two group had significant difference, while no improvement was found in PSQI, BMI, and WHR between intervention group and control group. Conclusions Peer support could improve the blood glucose metabolism in patients with type 2 diabetes. With the effect of yoga music and physical exercises, peer support can improve the quality of sleep and decrease depression in T2DM patients, who also have sleep disorders and mild depression.