Chronic disease is a major threat to human health. Fundus disease has become a major ophthalmic disease affecting daily life. Although great breakthroughs have been made in the treatment, compared with other chronic disease management, the management of patients with fundus disease is still in its infancy. To strengthen the management exploration of patients with fundus diseases, establish a management model of fundus diseases and strive to improve patients' awareness of fundus diseases and adherence to treatment and follow-up are the great challenges at present. All ophthalmic centers should strengthen patient education, establish a regional cooperation network, support the construction of grassroots medical capacity, cultivate talents, enhance training, promote the standardized treatment of fundus diseases, standardize fundus imaging inspection and diagnosis, and promote the homogeneous construction of diagnosis and treatment of chronic fundus diseases. We will accelerate the construction of a hierarchical diagnosis and treatment system and the ability to link consultation and referral. Through systematic management and intervention of fundus diseases, a large number of patients with fundus diseases will receive early screening, diagnosis, standardized continuous treatment and systematic management, and improve the quality of life of patients with fundus diseases.
Objective To estimate healthy life expectancy of residents aged 30 and above in Jianyang, Sichuan province, and comprehensively evaluate the health status of the population, so as to provide reference and basis for the formulation of health-related public policies. Methods The population data, death data and health status data of Jianyang city in 2018 were collected, and the self-rated health life expectancy and life expectancy without chronic diseases of residents aged 30 and above were calculated by Sullivan method, and their proportion in life expectancy was calculated. Results A total of 4 482 residents aged 30 years and above were included in Jinyang city, of whom 3 989 were self-rated healthy, accounting for 89.00% of self-rated health, and 1 988 were suffering from chronic diseases, with a chronic disease prevalence rate of 44.36%. In the age group of 30-64, the self-rated health life expectancy of women was significantly higher than that of men (P<0.05), and in the age group of 40-44, the life expectancy without chronic diseases of women was significantly lower than that of men (P<0.05), and the differences were not statistically significant when comparing different genders in other age groups (P>0.05). With the increase of age, the proportion of residents’ self-rated health and the proportion of life expectancy without chronic diseases in healthy life expectancy gradually declined. Conclusions The chronic disease has become the main factor affecting the health of middle-aged and elderly population, especially female population. It is suggested that active measures should be taken to deal with chronic diseases and the elderly health support system should be strengthened to improve healthy life expectancy of residents in Jianyang city.
The prevention and control of chronic diseases is a major need that urgently needs to be solved in China. Traditional Chinese medicine has unique advantages in preventing and treating chronic diseases. However, insufficient patient engagement may be found in the selection and evaluation of traditional Chinese medicine for the prevention and treatment of chronic diseases. In recent years, patient-centered clinical research has become a hot topic. A patient-centered methodological framework is proposed for the selection and evaluation of traditional Chinese medicine for preventing and treating chronic diseases. It incorporates some patient-centered studies based on the evidence-based medicine practice model, and will provide a scientific basis for screening traditional Chinese medicine for preventing and treating chronic diseases, improving the efficiency of traditional Chinese medicine services, improving price policies, and updating medical insurance catalogs.
Objective To evaluate the application effect of quality control circle (QCC) in improving the number of cases received in the follow-up management of chronic kidney disease (CKD). Methods The outpatient and inpatient CKD patients who were filed in the CKD follow-up management center of West China Hospital of Sichuan University from March 10 to October 10, 2020 were selected. We analyzed the reasons that affected CKD patients’ willingness to file by carrying out QCC, improved the case collection by establishing standardized processes, broadened the collection channels, established a collective team, strengthened training management and education of CKD patients and their families, so as to increase the number of cases received in CKD follow-up management. Then, we observed the score of active ability of QCC members before and after this activity. Results After the implementation of QCC activities, the number of follow-up cases increased from 8 per month to 15 per month. The target achievement rate was 140%, and the progress rate was 87.5%. The ability of all circle members in the evaluation indicators of team training has been improved. Conclusions QCC activity can effectively improve the number of cases received in CKD follow-up management. It is helpful for the medical staff to provide better disease management for CKD patients.
ObjectiveTo explore the prevalence and risk factors of hypertension and diabetes in floating population in Hubei province, so as to provide reference for the prevention of chronic disease of floating population. MethodA multi-stages sampling was performed among six counties in Hubei province in 2012, according to the different occupations. A questionnaire survey was conducted to collect the demography, sociology and health-related behavioral characteristics of subjects. Then a univariate analysis and a multivariate analysis were conducted by SPSS 20.0 software. ResultsA total of 1 800 individuals were surveyed, and the prevalence of hypertension and diabetes in floating population was 22.7% and 4.9%, respectively. Univariate analysis indicated that significant associations were found between hypertension and such factors as age, occupations, smoking and life satisfaction (all P values < 0.05); and significant associations were found between diabetes and such factors as occupations, educational level and BMI (all P values < 0.05). The results of further logistic regression analysis showed that age (OR=2.194, 95% CI 1.940 to 2.483, P=0.001) and life satisfaction (OR=0.291, 95% CI 0.248 to 0.341, P=0.002) were independent risk factors of hypertension, and educational level (OR=3.219, 95%CI 2.016 to 7.565, P=0.011) and gender (OR=0.568, 95% CI 0.323 to 0.999, P=0.049) were independent risk factors of diabetes. ConclusionsThe prevalence of hypertension and diabetes are relative high in floating population of Hubei Province. Increasing age and low life satisfaction are independent risk factors of hypertension in floating population, while male and low educational level are independent risks factors of diabetes.
Objective To investigate the satisfaction of patients who signed up for chronic disease continuous health management services, so as to provide a theoretical basis for improving service quality. Methods We conducted an online anonymous survey by issuing an electronic questionnaire to all patients who met the inclusion criteria through the short message platform of the hospital from October 8th to 19th, 2021, and used χ2 test and logistic regression to compare the differences in satisfaction among different patients and explore the factors affecting satisfaction. Results A total of 3311 short messages were send out, and 816 valid copies of questionnaire were recalled. The total satisfaction was 77.3%, and the satisfaction before, during and after service were 86.0%, 75.2% and 73.7%, respectively. The items with low satisfaction included service pricing (58.9%), online follow-up (57.5%) and overall cost reduction (43.9%). There were significant differences in satisfaction among patients of different permanent addresses and health status (P<0.05). The multiple binary logistic regression analysis showed that the respondents in Chengdu city had lower satisfaction than those outside Sichuan province [odds ratio (OR)=0.377, 95% confidence interval (CI) (0.156, 0.908), P=0.030], and the respondents with poor, general, and good self-reported health status had lower satisfaction than those with very good self-reported health status [OR=0.196, 95%CI (0.067, 0.577), P=0.003; OR=0.165, 95%CI (0.058, 0.468), P=0.001; OR=0.317, 95%CI (0.108, 0.927), P=0.036]. Conclusions The patients’ satisfaction with chronic disease continuous health management services is at a high level. The next step should focus on service pricing and online follow-up, and strive to improve the service experience of people with low satisfaction.
长期以来人们一直将吸烟, 包括吸烟成瘾看作是一种习惯, 并没有将其视为一种疾病。这样使得戒烟变得很困难和复杂。吸烟之所以长期广泛流行并造成十分严重的社会经济危害, 原因包括一系列生物、心理、社会因素, 其中最重要的原因是由于香烟烟雾中的尼古丁是一种可以使人成瘾的物质, 使得吸烟人产生烟草依赖。1998 年世界卫生组织正式提出烟草依赖是一种慢性病, 列入国际疾病分类( ICD-10,F17. 2) 。这在吸烟与控烟历史上具有划时代的意义, 将会使控烟工作从此进入一个与以往不同的时代。
ObjectiveTo systematically review the efficacy of discharge preparation service in elderly patients with chronic diseases.MethodsCNKI, WanFang Data, VIP, Web of Science, The Cochrane Library, PubMed and EMbase databases were electronically searched to collect randomized controlled trails (RCTs) on the discharge preparation service for elderly patients with chronic diseases from January, 2000 to January, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 7 RCTs, involving 884 patients were included. The results of meta-analysis showed that: after the hospitalization preparation service, the incidence of acute complication (RR=0.38, 95%CI 0.15 to 0.98, P=0.04), patient compliance behavior (SMD=0.54, 95% CI 0.25 to 0.83, P=0.000 3), exercise capacity (SMD=2.65, 95%CI 0.25 to 5.04, P=0.03), and nursing satisfaction (SMD=0.71, 95%CI 0.10 to 1.33, P=0.02) significantly improved. However, there were no significant differences in emergency hospital admission for acute complications (RR=0.25, 95%CI 0.06 to 1.11, P=0.07), self-care ability (SMD=2.18, 95%CI −1.02 to 5.38, P=0.18), activity of daily living (ADL) (SMD=0.56, 95%CI −0.47 to 1.59, P=0.28).ConclusionsThe current evidence shows that after implementation of the discharge preparation service, the incidence of acute complication, compliance behavior, exercise ability, and service satisfaction of the elderly patients with chronic diseases are significantly improved. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusion.
Objective To evaluate the quality of studies assessing the value of serum hyaluronic acid in the diagnosis of liver fibrosis, to analyze the sources of bias and variation, and to estimate the accuracy of serum hyaluronic acid in diagnosing early liver cirrhosis and liver fibrosis in patients with chronic viral hepatitis.Methods We searched MEDLINE (1966 to June 2006), EMbase (1974 to June 2006), CBMdisc (1978 to April 2005), CNKI (2005 to June 2006) and VIP (2005 to June 2006) for studies assessing the diagnostic value of serum hyaluronic acid for liver fibrosis in patients with chronic viral hepatitis. We checked the references in the reports of included studies. QUADAS items were used for quality assessment. Meta-disc software was used to analyze sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic test odds ratio for the pooled analysis and heterogeneity test. DPS2005 software was used to draw SROC curves for those without heterogeneity. Results In total 24 studies were included: 12 published in Chinese and 12 published in English. Results of the pooled analysis showed that, as for radioimmunoassay (RIA), the pooled LR+ of the studies involving the diagnosis of liver cirrhosis and the differentiation of absent/present liver fibrosis were 7.029 and 3.608; and the pooled LR- were 0.198 and 0.319, respectively. As for enzyme-linked immunosorbent assay (ELISA), the pooled LR+ of the studies involving the diagnosis of liver cirrhosis, the differentiation of mild/severe and absent/present liver fibrosis were 6.093, 9.806 and 4.308; and the pooled LR- were 0.354, 0.347 and 0.563, respectively. Conclusion The biases identified from the 24 studies are mainly due to reference standard review bias. By both RIA and ELISA methods, serum hyaluronic acid has a sound value in diagnosing live cirrhosis. Its value in differentiating absent/present liver fibrosis is also acceptable. However, its value in differentiating mild/severe liver fibrosis needs to be further studied.