Hongxia Tang’s research while affiliated with Chengdu Medical College and other places

Background With the popularity of smart phones and the development of information technology, more and more patients are adopting diabetes APPs for self-management. However, at present, there are few research reports on the effect of those APPs coming from China. Objective The purpose of this study was to evaluate the effectiveness and applicability of an APP for blood glucose control that is widely popular among Chinese patients with type 2 diabetes mellitus (T2DM). Methods This is a 2-center, factorial design, with equal proportional distribution, and superiority trial conducted in outpatient endocrinology clinics at two tertiary hospitals in Chengdu, China. The trial enrolled smartphone-literature individuals aged at least 18 years old who have been diagnosed with T2DM based on glycosylated hemoglobin A1c (HbA1c) of at least 7.0%. The subjects were randomly divided into 4 groups, which were the usual care group (G1); the telephone follow-up group (G2); the APP group (G3); the APP & telephone follow-up group (G4). After 6 months of these interventions, the primary outcome was HbA1c, and the secondary outcomes were blood pressure (BP), body mass index (BMI), frequency of self-monitoring of blood glucose (SMBG), and satisfaction with the APP. Results 273 patients with type 2 diabetes were included in the study, among which 226 (82.8%) were followed up at the 3rd month and 220 (80.6%) at the 6th month. There was no significant difference in HbA1c attainment rate among the four groups after intervention (P >.05), but the HbA1c attainment rate in the two APP groups was higher than that in the other groups. The systolic blood pressure (SBP) of the two APP groups was significantly lower than that of the other groups (P <.05). There was no significant difference in the compliance rate of SMBG among the four groups (P >.05). Each item of the participants’ satisfaction evaluation of the APP scored more than 4.5 points. Conclusions The diabetes APP has a tendency to improve the HbA1c compliance rate of T2DM patients. The APP can help reduce patients’ BP, and patients have a high satisfaction evaluation of the APP. Therefore, the study supports the use of the APP for self-management in people with type 2 diabetes. Clinical Trial Registration https://www.chictr.org.cn, identifier ChiCTR2100042297.

Objective The aim of this study was to evaluate the present status of self-management behavior and glycemic control in individuals diagnosed with Type 2 Diabetes Mellitus (T2D), as well as to examine the impact of health quotient (HQ) and time management skills on both self-management behavior and glycemic control. Methods Between October 2022 and March 2023, a purposive sampling method had been utilized to select 215 participants with type T2D. The survey concluded a general information questionnaire, an HQ scale, a diabetes time management questionnaire and a self-management behavior questionnaire. The health quotient(HQ)encompasses the individuals’ knowledge, attitude toward health, and the ability to maintain their own well-being. The diabetes time management questionnaire was reverse-scored, with higher scores indicating an enhanced competence in time management. The path among variables was analyzed using structural equation modeling(SEM). Results SEM showed that the direct effect of HQ on time management was −0.566 (p < 0.05), the direct effect of time management on the effect of self-management was −0.617 (p < 0.05), the direct effect of HQ on self-management was 0.156, and the indirect effect was 0.349 (p < 0.05); the relationship between health quotient and self-management was partially mediated by time management, with a mediating effect size of 68.8%. In addition, self-management had a direct effect on HbAlc, with a size of −0.394 (p < 0.05); The impacts of both HQ and time management on HbAlc were found to be mediated by self-management, with HQ demonstrating an indirect effect of −0.199 (p < 0.05) and time management showing an indirect effect of 0.244 (p < 0.05). Conclusion Health quotient and time management in patients with T2D serve as catalysts for self-management behavior. They affect HbAlc level indirectly through self-management practices. The suggestion is to prioritize the cultivation of rational time organization and management skills in T2D patients, as well as enhance their health quotient level. This can facilitate a more effective improvement in patients’ self-management behaviors, ultimately achieving the objective of maintaining optimal glycemic control.

Background Light influences the secretion of melatonin in the body and regulates circadian rhythms, which play an important role in sleep and mood. The light level of rooms in long-term care facilities is usually far below the threshold required to regulate the body’s circadian rhythm, and insufficient light can easily lead to sleep and mood disturbances among older residents in nursing homes. Therefore, the objective of this study was to investigate the effects of light therapy on sleep and circadian rhythm in older adults with type 2 diabetes residing in long-term care facilities. Methods This study was a prospective, single-blind, randomized controlled trial. Participants were randomly assigned to either the light therapy (LT) group or the control group and received the intervention for four weeks. Primary outcomes included the Pittsburgh Sleep Quality Index (PSQI) and objective sleep parameters recorded by a sleep monitoring bracelet, Morningness-Eveningness Questionnaire (MEQ). The secondary outcome included glycated serum protein (GSP). Data was collected at three time points: at baseline (T0), immediate post-treatment (T1), and 4-week follow-up (T2). A linear mixed model analysis was used to analyzed the data. Results We enrolled 45 long-term care residents. Compared with the control group, significant reductions in PSQI scores were observed at T1 and T2. At T2, the sleep score of objective sleep parameters was significantly higher in the LT group compared to the control group. Additionally, compared to the baseline T0, MEQ scores were significantly lower in the LT group at T1 and T2, with no significant difference in the control group. There was no significant difference between groups in glycated serum protein values at T1 and T2. However, compared to T0, glycated serum protein values decreased in the LT group while increased in the control group at T2. Conclusion Light therapy had a positive effect on subjective sleep quality and circadian rhythm time type in long-term care residents with type 2 diabetes, and had a possible delayed effect on objective sleep. However, no discernible alterations in blood glucose levels were detected in this study.

In the initial stage of the COVID-19 outbreak, this disease was not well known by the general public, including professional medical personnel. In the face of such a severe infectious public health event, they endured huge physical and psychological pressure under the lack of effective epidemic prevention materials and the unclear diagnostic criteria.Due to the particularity, complexity and variability of the patient of psychiatric staff, they bore severer physical and mental pressure than other ordinary medical staff. thus we report the nursing experience in a patient with fever and psychotic disorder who did not cooperate with treatment during the initial stage of the COVID-19 outbreak. This case can provide information that would enable better nursing in the future for patients with psychotic disorder during the period of COVID-19 pandemic and other infectious diseases.

Background Continuous glucose monitoring (CGM) has revolutionized diabetes management, but a comprehensive analysis of its clinical implementation is lacking. This study aims to explore CGM in diabetes practice over the past decade using bibliometric analysis. It will identify trends, research focal points, and provide a framework for future investigations. Materials and methods The Web of Science Core Collection (WOSCC) was utilized to acquire literature pertaining to the employment of continuous glucose monitoring (CGM) in diabetes that was published between the years 2012 and 2022, and to conduct a comprehensive analysis of the associated citation data. To achieve bibliometric visualization and analysis of the collated data, the bibliography package in the Rstudio(v.4.2.2), Citespace 6.2.R4, and VOS viewer were employed. Results A total of 3024 eligible publications were extracted from 91 countries, with the United States being the leading country in terms of the number of issued articles. Furthermore, the annual publication rate has shown a gradual increase during the past decade. Among the various journals in this field, DIABETES TECHNOLOGY & THERAPEUTICS was identified as the most highly cited one. Keyword clustering analysis of the extracted publications indicates that the research hotspots in the past decade have primarily focused on “continuous glucose monitoring”, “glycemic variability”, “type 1 diabetes”, “hypoglycemia”, and “glycemic control”. Moreover, the analysis of keyword emergence reveals that “Time In Range” and “Young Adult” represent the current research frontiers for the years 2012-2022. Conclusion The concept of Time in Range (TIR) has garnered considerable attention as a significant area of inquiry and an emerging research trend in the clinical practice of Continuous Glucose Monitoring (CGM) for Diabetes Mellitus. Moreover, recent investigations have demonstrated a growing focus on young adults with type 1 diabetes as the research population of interest. In the foreseeable future, research endeavors will persist in the pursuit of improving glycemic management among young adults through the utilization of continuous glucose monitoring (CGM) technology, while also delving into the examination of the Time in Range metric via supplementary clinical investigations.

Background: China has the largest number of individuals with type 2 diabetes mellitus (T2DM) in the world, and most lack knowledge about glycemic control and health management. This trial will examine whether a smartphone application can improve blood glucose management among individuals with T2DM. Methods: This will be a 2-center, factorial design, equal proportional distribution, superiority trial conducted in outpatient endocrinology clinics at two tertiary hospitals in Chengdu, China. The trial will enroll smartphone-literature individuals at least 18 years old who have been diagnosed with T2DM based on glycosylated hemoglobin (HbA1c) of at least 7.0%. Individuals will be randomly assigned to receive routine care with standard education about T2DM and glycemic control (Control), routine care as well as weekly telephone reminders to self-monitor blood glucose (Reminder), routine care and a smartphone application providing information about glycemic control and health management with T2DM (App), or the combination of routine care, the smartphone application, and weekly telephone reminders (App + Reminder). After 6 months of these interventions, participants will be analyzed for the primary outcome of HbA1c as well as the secondary outcomes of blood glucose monitoring frequency, body mass index, blood pressure, knowledge about diabetes, health beliefs related to diabetes, diabetes self-management behavior, and satisfaction with the smartphone application. Discussion: This trial will determine whether a smartphone application can improve glycemic management among Chinese with T2DM. The findings may help guide the development of effective applications in China and elsewhere. Trial registration: Registration in the Chinese Clinical Trial Registry (ChiCTR) under registration number ChiCTR2100042297: https://www.chictr.org.cn/bin/userProject . 17 January 2021.

Background The increasing burden of mental health problems continues in the post‐COVID‐19 era, and nursing interns were particularly likely to experience negative emotions during the pandemic. Both psychological resilience and social support affect negative emotion, but the relationship among the three has not been explored in nursing interns in the postpandemic era. Objectives To explore the current prevalence of negative emotions among nursing interns and the role of psychological resilience in mediating the relationship between social support and negative emotions in the postpandemic era. Methods A cross‐sectional survey of 788 nursing interns was conducted. The instruments included Psychological Resilience Scale, Social Support Scale, Beck Anxiety Scale and Beck Depression Scale. Structural equation modeling was applied to analyze the mediating role of psychological resilience. Results The prevalence of anxiety disorder among nursing interns was 24.7%, while that of depression was 10.5%. Pearson correlation analysis showed that both social support and psychological resilience negatively correlated with negative emotions, while psychological resilience positively correlated with social support. Psychological resilience showed a partial mediating effect (53.9%) between social support and negative emotion, with an effect value of −0.1456. Conclusion Psychological resilience and social support protect nursing students from negative emotions, and psychological resilience partially mediates the relationship between social support and negative emotion in the postpandemic era.

Background: China has the largest number of individuals with type 2 diabetes mellitus (T2DM) in the world, and most lack knowledge about glycemic control and health management. This trial will examine whether a smartphone application can improve blood glucose management among individuals with T2DM. Methods: This will be a multicenter randomized controlled trial conducted in outpatient endocrinology clinics at two tertiary hospitals in Chengdu, China. The trial will enroll smartphone-literature individuals at least 18 years old who have been diagnosed with T2DM based on glycosylated hemoglobin (HbA1c) of at least 7.0%. Individuals will be randomly assigned to receive routine care with standard education about T2DM and glycemic control (Control), routine care as well as weekly telephone reminders to self-monitor blood glucose (Reminder), routine care and a smartphone application providing information about glycemic control and health management with T2DM (App), or the combination of routine care, the smartphone application and weekly telephone reminders (App+Reminder). After six months of these interventions, participants will be analyzed for the primary outcome of HbA1c as well as the secondary outcomes of blood glucose monitoring frequency, body mass index, waist-hip ratio, blood pressure, diabetes-related medical costs, disease progression or improvement, knowledge about diabetes, health beliefs related to diabetes, diabetes self-management behavior, and satisfaction with the smartphone application. Discussion: This trial will determine whether a smartphone application can improve glycemic management among Chinese with T2DM. The findings may help guide the development of effective applications in China and elsewhere. Trial registration: The trial was prospectively registered on January 17, 2021 at the Chinese Clinical Trial Registry (ChiCTR) under registration number ChiCTR2100042297.

Objectives Because light can regulate sleep rhythms, numerous studies have investigated whether light therapy can improve sleep disorders in older people, but its efficacy remains controversial. Therefore, this systematic review aimed to examine and summarize current evidence about the efficacy of light therapy to improve sleep for older people in residential long-term care. Design Systematic review. Setting and participants Older people living in long-term care settings. Methods Systematic searches were conducted in the databases PubMed, Web of Science, Cochrane, EMBASE, CINAHL, China National Knowledge Infrastructure, China Science and Technology Journal Database, WanFang, Chinese Biomedical Literature Database, and in reference lists within relevant articles. Studies were eligible for inclusion if they evaluated light therapy for older people with sleep disorders in long-term care settings. Results This systematic review includes 21 articles, summarizing light therapy with different durations and intensities. The light intervention was typically administered between 7:00 and 12:00 am for 30-120 minutes. The interventions lasted from 1 week to several months, and the intensity of the light intervention usually ranged from 2500 to 10,000 lux. Short-term exposure (30-60 minutes) with high light levels (≥10,000 lux), relatively long-term exposure (1-2 hours) with moderate light levels (2500-10,000 lux), or long-term exposure (1-4 hours or full day) with low light levels (≤2500 lux) were associated with improved sleep indicators for older people in long-term care settings. Conclusions and implications The efficacy of light therapy in long-term care settings may be affected by the duration of exposure, time and length of intervention, intensity of light, and equipment used to administer the therapy. Further research must be conducted to optimize light therapy parameters. Large, high-quality randomized controlled trials are needed to deepen our understanding of the effects of light therapy on sleep in older people living in long-term care settings.