Self-reported diabetes treatment among Chinese middle-aged and older adults with diabetes:Comparison of urban residents,migrants in urban settings,and rural residents

Purpose:To compare self-reported diabetes treatments among Chinese urban residents,rural migrants in urban settings,and rural residents.Methods:Data from 993 diabetics at least 45 years of age were collected from the China Health and Retirement Longitudinal Study conducted in 2011.Multiple logistic regressions were performed to examine the associations between individual characteristics and diabetes treatments.Results:In total,719/993(72.4%)of the respondents received treatment for diabetes;of which<8% used insulin therapy.Urban residents were more likely than rural residents to use insulin therapy[odds ratio(OR)=0.44,confidence interval(CI):0.20-0.99;p<0.05],and more likely to use traditional Chinese medicine than migrants(OR=0.30,CI:0.10-0.96;p<0.05).Overall,rural residents showed lower treatment rates than urban and migrant populations.Conclusion:Efforts to improve and enhance diabetes treatments,particularly among rural residents,are urgently needed in China.

Implementation of regional Acute Stroke Care Map increases thrombolysis rates for acute ischaemic stroke in Chinese urban area in only 3 months

Background The rate of intravenous thrombolysis for acute ischaemic stroke remains low in China.We investigated whether the implementation of a citywide Acute Stroke Care Map(ASCaM)is associated with an improvement of acute stroke care quality in a Chinese urban area.Methods The ASCaM comprises 10 improvement strategies and has been implemented through a network consisting of 20 tertiary hospitals.We identified 7827 patients with ischaemic stroke admitted from April to October 2017,and 506 patients underwent thrombolysis were finally included for analysis.Results Compared with‘pre-ASCaM period’,we observed an increased rate of administration of tissue plasminogen activator within 4.5 hours(65.4% vs 54.5%;adjusted OR,1.724;95% CI 1.21 to 2.45;p=0.003)during‘ASCaM period’.In multivariate analysis models,‘ASCaM period’was associated with a significant reduction in onset-to door time(114.1±55.7 vs 135.7±58.4 min,p=0.0002)and onset-to needle time(ONT)(169.2±58.1 vs 195.6±59.3 min,p<0.0001).Yet no change was found in door-to needle time.Clinical outcomes such as symptomatic intracranial haemorrhage,favourable functional outcome(modified Rankin Scale≤2)and in-hospital mortality remained unchanged.Conclusion The implementation of ASCaM was significantly associated with increased rates of intravenous thrombolysis and shorter ONT.The ASCaM may,in proof-of principle,serve as a model to reduce treatment delay and increase thrombolysis rates in Chinese urban areas and possibly other highly populated Asian regions.

Exploring the intention of Using Aspirated Cascade to Replace Tandem Cascades

In the present paper,computational fluid dynamics(CFD) simulations were executed to exploring the intent of using aspirated cascade to replace tandem cascades.Firstly,the ONERA tandem cascades were investigated,and the performance of the cascades at the design point were listed,such as diffusion factor,total pressure loss coefficient,deviation angle etc.For replacing the ONERA tandem cascades,a new cascade was designed with the codes BLADEGEN developed by the authors.The quasi 3-D calculations were carried out using the collection of programs for cascade analysis and design,MISES.The cascade was analyzed and designed by using this code.And the cascade was simulated and analyzed by commercial CFD software.It is found there is an obvious separation on the suction side.Based on the 3D CFD simulation results of the cascade without aspiration,an aspirated cascade was designed by introducing a slot on the suction side.The performance of the aspirated cascade was investigated and compared with the tandem cascades,indicated that under the same inlet condition,the total pressure loss of the single row aspirated cascade was less than that of the tandem cascades,and the outlet static pressure is higher than that of the tandem cascades.Meanwhile,the different suction slot location,suction width and suction mass flow are studied for the aspirated cascade.

腹部超声检查对产后腹直肌分离的诊断价值

目的探讨腹部超声检查对产后腹直肌分离(DRA)的诊断价值。方法选择2018年10月至2020年10月于温州市中西医结合医院进行产检并最终分娩的产妇300例为研究对象,分别采用指测法和腹部高频超声进行DRA程度检测,统计DRA发生情况,分析腹部超声与指测法对于DRA的诊断效能差异,比较DRA产妇与非DRA产妇不同时期不同位置腹直肌间隔距离超声检测数值差异。结果全部产妇中DRA总体发生率为57.67%(173/300);经产妇DRA发生率[73.38%(102/139)]显著高于初产妇[44.10%(71/160)](χ^(2)=26.20,P<0.001);剖宫产分娩产妇DRA发生率[68.52%(74/108)]显著高于经阴道分娩产妇[51.56%(99/192)](χ^(2)=8.14,P=0.004)。腹部超声检查对于DRA的诊断灵敏度、特异度和准确度(99.42%、98.42%、99.00%)均显著高于指测法检测(80.35%、85.04%、82.33%)(χ^(2)=34.61、15.00、49.23,均P<0.001)。DRA产妇孕36周和产后2周不同位置腹直肌间隔距离均显著小于非DRA产妇(t=5.17~7.46,均P<0.001)。结论腹部超声检查对于产后DRA的早期诊断和康复治疗具有较高临床应用价值。