Objective To investigate the clinical effectiveness of the total Flavones of Hippophae Rhamnoides L. (TFH) and compare its cost-effectiveness ratio with enalapril in patients with essential hypertension. Methods Among 3 971 staff members in two universities, 155 eligible patients with blood pressure (BP) ≥160/100 mmHg were screened and included in this study. By using a random number table, the patients were randomized to the two groups: TFH was given to the treatment group while enalapril in the control group. At the end of the six week, BP, total cost and cost-effectiveness ratio were measured in both TFH and enalapril groups. Results After six weeks, blood pressures in the TFH and enalapril groups decreased by 12.7±11.6/8.1±5.1 mmHg and 15.2±9.7/10.1±7.3 mmHg respectively, while the improvement rates of BP were 73.24% (52/71) and 74.65% (53/71) respectively. There were no differences between TFH and enalapril groups in lowering BP amplitude and total effectiveness rate. The incidence of side effect in TFH group was 11.27% (8/71), which was significantly lower than that of enalapril 29.6% (21/71). The total cost of TFH group was 9 294.6 RMB with the cost effectiveness ratio of 732/1 147 RMB per mmHg and 179 RMB per case. In the enalapril group, the total cost added up to 13 236 RMB with cost effectiveness ratio of 870/1 310 per mmHg and 250 RMB per case. Sensitivity analysis indicated that TFH was better than enalapril with respect to clinical economic value even when enalapril price dropped to 1.8 RMB for tablet (5 mg). Conclusion Compared with enalapril, TFH is an effective and economic drug in treating patients with hypertension.
ObjectiveTo evaluate the smoking environment, its related knowledge and difference between urban and rural areas in Chengdu. MethodsIn December 2010, we randomly sampled and investigated 60 dwellers aged from 35 to 70 from urban and rural communities, who were 1:1 paired by the age and sex. Questionnaires survey was used. ResultsThere were 48.3% (29/60) dwellers thought that smoking should be allowed freely at home, of which 30.0% (9/30)rural homes had no rules about smoking prohibited. There were 93.3% (28/30) urban dwellers supported male smoking. About 86.7%-98.3% urban dwellers realized that many diseases such as heart disease, stroke, and lung cancer may be due to smoking. And 16.7% urban dwellers also realized that cigarettes can result in diabetes mellitus, but none of rural dwellers did. The publicity of smoking cessation among urban dwellers (91.7%) by mass media was better than rural ones (0.0%). There were 95.0% dwellers denied any institution or organization for smoking control. ConclusionThe dwellers were short of cognition about restrictions of smoking environment and non-smoking knowledge. It's different between urban and rural area in tobacco advertisement and publicity of smoking cessation. We should continue enhancing public education, forbiding tobacco advertisement and providing institutions for smoking control.
ObjectiveTo explore the effect of non-pharmaceutical therapy in patient with hypertension in Chengdu. MethodsFrom October 2010 to October 2011, a total of 33 general practitioners from 14 community health-care centers in Chengdu were trained by 2009 "Hypertension Guideline" of China for grass-root; each practitioner was required to manage 25 hypertensive patients during one year, based on standardized project. We evaluated the effect of non-pharmaceutical therapy before and after project and the antihypertensive effects from different therapy. ResultsBy the end of 2011, a total of 632 hypertensive patients[aged from 36 to 79 with an average of 65.72±8.55; 263 males with the mean age of (66.41±9.10) years old, 369 females with the mean age of (65.22±8.10) years old], who were eligible for criteria with complete data had been managed for one year. The non-pharmaceutical management includes quitting smoke, limiting alcohol, limiting salt diet, reducing weight and increasing regular physical activity. At the beginning of this project, the acceptance rate of such management were 75.96%, 71.43%, 99.01%, 73.28%, and 85.00%, respectively. After one year of such non-pharmaceutical management, the proportion of patient, who suffered from smoking, alcohol drinking, excess salty diet, overweight and obesity, and lack of physical exercise, decreased from 8.54%, 5.54%, 16.00%, 55.06%, and 23.73% to 3.80%, 1.42%, 2.69%, 34.43%, and 11.39%, respectively with statistical difference (P<0.001). Overweight and obesity is the main risk factor related to lifestyle. During one year management, Systolic blood pressure decreased by 25.81, 23.71, and 27.78 mm Hg (1 mm Hg=0.133 kPa) in the patients with non-pharmaceutical therapy, pharmaceutical therapy, and both, respectively; diastolic blood pressure decreased by 10.23, 3.99, and 10.46 mm Hg, respectively, in the three groups with statistical difference (P<0.05). ConclusionThrough the hypertension management, strengthening the cognition of non-pharmaceutical therapy for general practitioner can reduce both high blood pressure risk and cardiovascular risk significantly and comprehensively.
ObjectiveTo investigate the prevalence of hypertension and to find the cardiovascular risk factors in the urban residents of Chengdu city. MethodsBy cluster sampling, a population of 994 inhabitants were selected from 14 urban communities in Chengdu city between February and October 2010. They were 35-70 years old and had resided in the area for over 2 years. Hypertension questionnaire was used and physical examinations were taken to investigate. The definition of hypertension was determined by the Guidelines of Hypertension Prevention and Control made by National Revision Committee in 2010. Logistic regression model was used to define the risk factors for hypertension. ResultsThe prevalence rate of hypertension was 44.87%, and the standardized prevalence rate was 39.21% (male:41.07%, female:38.20%). The difference of prevalence rate between males and females was not significant (P>0.05). The prevalence rate of hypertension increased significantly with age. By multi-factor logistic regression analysis, age (OR=1.103, P<0.001), serum uric acid (OR=1.003, P=0.001), heart rate (OR=1.014, P=0.027), and waist circumference (OR=1.624, P<0.001) were the risk factors for hypertension. ConclusionThe prevalence rate of hypertension is high in urban communities of Chengdu city, and age, serum uric acid, heart rate, and waist circumference are the risk factors for hypertension.
Objective To understand the residents’ demands and utilization of the community health services and provide a basis for the construction of reasonable medical service system. Methods From July to September 2015, a purposive sampling questionnaire survey on general team mode service to bring benefits to the community residents was conducted in 20 provincial-level administrative regions of the country. SPSS 13.0 software was used for data analysis. Results A total of 1 300 questionnaires were distributed, and 1 273 valid questionnaires were recovered. In the 221 residents who were aware of the composition of general team, the awareness rate of general team composed of traditional Chinese medical doctors and gynaecologists/pediatricians was low (70.14%, 75.11%, respectively). The awareness rate of medical services including disease diagnosis and treatment, health consultation, health education and prescription in the 1 273 residents was 70.46%, 61.19%, 59.62% and 67.56%, respectively; the residents’ top five willing to accept medical services was prescribing medicine (77.77%), infusion (74.08%), health consultation (73.21%), health education (70.54%), and planned immunization (64.49%). The biggest change of the 433 patients with chronic diseases before and after treatment in the community was the increase in self-health management (70.67%) and the healthy lifestyle improvement (56.35%). Conclusion Community general team should be oriented by the objective needs and real demands of the residents; based on the ability of medical services supply, the adjustment of the key points of medical services should be made and the rational use of medical services should be guided for the residents.
Objective To investigate the influencing factors in the service volume of primary health care institutions in Chengdu, and provide references for promoting the hierarchical diagnosis and treatment. Methods A self-administered questionnaire was used to investigate the service volume of a total of 390 primary health care institutions (including community health service centers and township hospitals) across 22 districts and counties of Chengdu from October to November 2016. Rank sum test, rank correlation analysis and multiple linear regression model were used to analyze the influencing factors of outpatient visits in the institutions. Results The median annual amount of outpatient visits was 60 493 in community health service centers and 31 374 in township hospitals. Between community health service centers and township hospitals, the difference in median daily visits per doctor was not significant (14.41 vs. 13.29), but the median daily visits per doctor in general practitioners (12.22 vs. 8.16), rehabilitation physicians (10.10 vs. 6.34) and traditional Chinese medical doctors (4.82 vs. 6.17) varied considerably. Multiple linear regression analysis showed that the amount of outpatient visits in community health service centers was related to the amount of intermediate physicians, while the amount of outpatient visits in township hospitals was related to the setup of dental clinics, the amount of primary physicians, the amount of beds and population to be served (P<0.05). Conclusions Differences exist in the service volume among primary health care institutions in Chengdu. It’s necessary to make proper plans for the management of administrative offices and the allocation of personnel, so as to improve medical services of primary health care institutions.
Objective To evaluate the methodological and reporting quality of systematic reviews/meta-analyses related to the efficacy and safety of corticosteroid-assisted treatment for severe pneumonia. Methods PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, WanFang Data and VIP databases were searched by computer, and the systematic reviews/meta-analyses of corticosteroid hormone as an auxiliary means for the treatment of severe pneumonia which were published from establishment of the databases to October 25th, 2018 were searched. A Measurement Tool to Assess Systematic Review-2 (AMSTAR-2) was used to assess the methodological quality of the included studies, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to evaluate the quality of literature reports. Results A total of 16 systematic reviews/meta-analyses were included, all of which were non-Cochrane systematic reviews. In terms of methodological quality assessed by AMSTAR-2, there was no plan in all studies; only one study explained the reasons for inclusion in the study type; eight studies did not describe the dose and follow-up time of the intervention/control measures in detail; three studies did not indicate the evaluation tools and did not describe the risk bias; six studies did not explicitly examine publication bias. In terms of reporting quality assessed by PRISMA, all studies had no pre-registered study protocol or registration number; thirteen studies did not describe the specific amount of articles retrieved from each database; three studies did not present their retrieval strategies or excluded reasons in detail; no funding sources were identified in included studies; eight studies reported both whether the study was funded and whether there was a conflict of interest. Conclusions At present, there are many systematic review/meta-analysis studies on the efficacy and safety of corticosteroid-assisted treatment for severe pneumonia, and the overall quality of the study has been gradually improved. However, the common problems in the study are relatively prominent. The follow-up period and dose of intervention in the study of severe pneumonia are different, so the baseline is difficult to be unified. Suggestions: strengthening the training of researchers, standardize the research process, and report articles in strict accordance with the PRISMA statement; subgroup analysis being conducted according to the dose and duration of the hormone.