Objective To provide a reference for the exploration to the characteristic specialized subjects in well-off township hospital construction principle, thought and standard through investigating the basic medical units in Shuangliu County. Methods Self-designed questionnaires were made to survey the current situation of characteristic professional subjects in 24 county township medical units comprehensively (i.e. 3 central township hospitals, 3 community health centers, and 18 general township hospitals). Epidate 3.1 was used for data input, SPSS 17.0 was used for descriptive statistics and stratified analysis. Results Fifteen among 24 township hospitals in Shuangliu County set up 21 characteristic specialized subjects, accounted for 62.5%; Traditional Chinese Medicine Orthopedics Subjects were set up in 9 hospitals, accounted for 42.9% ranked as the top; Chinese Medicine Rehabilitation Physiotherapy Subjects were set up in 6 hospitals, accounted for 28.6% ranked as the second. Conclusion The characteristic specialized subjects in township hospitals should be established with reasonable planning and construction according to diagnosis and therapy demand for local disease and hospital’s condition, so as to promote characteristic medical services in market competition by subject construction. Traditional Chinese Medicine Orthopedics Subject and Chinese Medicine Rehabilitation Physiotherapy Subject are worth to be established and spread as characteristic specialized subject.
Objective To explore the clinical epidemiologic characteristics and tendency of gastric cancer during recently ten years in northern Henan province. Methods The clinical data of 1 090 patients with gastric cancer in our department were collected from January 1998 to May 2008. The ten-year period was divided into two groups: previous 5 years group (n=433) and post 5 years group (n=657). The age, gender, pathologic characteristics and the relationship between age and pathologic features were analyzed retrospectively. Results ①The patient’s age was 15-83 years old 〔mean （57.60±10.84） years old〕 and men-momen ratio was 3.71∶1 in previous 5-year group. The patient’s age was 18-82 years old 〔mean （58.95±10.81）years old〕 and men-momen ratio was 2.84∶1 in post 5-year group. There was no significant difference in age or gender between two groups （Pgt;0.05）. ②Gastric cancer arised in cardia and gastric fundus more common and for the incidence of the site no change was found in two groups. The incidence of gastric antrum cancer descended but that of gastric body arised. ③The mean age of patients with gastrocardiac cancer was significantly different (Plt;0.05) between two groups. No significant difference occurred on the mean age of patients with gastric antrum (Pgt;0.05) or gastric body cancer (Pgt;0.05). The mean age of patients with highly malignant tumor (signet ring cell cancer, poorly differentiated adenocarcinoma and undifferentiated carcinoma) was significantly different compared with that of patients with lowly malignant tumor (well differentiated and moderately differentiated adenocarcinoma) (Plt;0.05). ④The proportion of patients with highly and lowly malignant tumor presented significantly different between the previous 5 years and the post 5 years (Plt;0.05). ⑤The proportion of early gastric cancer was very low and no correlation was found between infiltrating depth and age in all patients (Pgt;0.05). Conclusion Cardia and gastric fundus is the most common site of gastric cancer in northern Henan province. The patients with gastrocardiac cancer are often older but gastric antrum and gastric body cancer patients are younger. Highly malignant gastric cancer is often found in youths, however, lowly malignant gastric cancer occurred predominantly in elderly. The proportion of gastric cancer found early is very low in northern Henan province.
OBJECTIVE: To review the research advance of the preparation and characteristics of small intestinal submucosa(SIS). METHODS: Recent original articles related to such aspects of small intestinal submucosa were reviewed extensively. RESULTS: Small intestinal submucosa was an easily obtained biomaterial. SIS was a bio-absorbable and degradable material. SIS had tissue specific regeneration properties. CONCLUSION: SIS is a suitable bio-derived material for tissue engineering of blood vessel, muscle tendon, urinary bladder and abdomen.
ObjectiveTo explore the application of cardiac enhanced MRI in acute myocardial infarction with normal result of coronary angiography. MethodsOn October 18, 2013, a male patient underwent coronary angiography under the local anesthesia. Mild coronary stenosis both in left and right side were found in the surgery, but the results of dynamic cardiogram and myocardial markers were abnormal, which accorded with the clinical procedure of myocardial infarction. The patient underwent cardiac enhanced MRI at the 6th day and was finally diagnosed as acute myocardial infarction. We reviewed the database to find out the significance of cardiac enhanced MRI in diagnosis of acute myocardial infarction. ResultsAlthough coronary angiography was the gold standard for the diagnosis of coronary diseases, it had limitations in the diagnosis of coronary eccentric stenosis, branch vascular stenosis and coronary spasm. Cardiac enhanced MRI had the advantages of accurate measurement of the attenuation of myocardium and exhibition of functional changes of ischemic myocardium. ConclusionCardiac enhanced MRI is important for the diagnosis of myocardial infarction with normal result of coronary angiography.
Objective To summarize the characteristics of surgery-related near misses including events composition, cause of incident, specialty category, personnel allocation etc, and to provide experience of feedforward control for the nurses in operating room and a clinical basis of safety standards for the management of operating rooms. Method The 240 surgery-related near misses occurred between July 2014 and July 2016 were retrospectively analyzed, using frequencies and percentiles to describe the count data. Results The 240 surgery-related near misses were mainly associated with surgical stitches (91 cases, 37.9%), surgical dressings (52 cases, 21.7%) and surgical instruments (45 cases, 18.8%). The main features of the 91 cases of surgical stitching included loss of suture needles (40.7%, 37/91) and fracture events (37.4%, 34/91). Among the 52 cases of surgical dressings, the most commonly were gauze dressing events (43 cases, 82.7%), in which 19 were with unclear numbers of retained gauzes in the reoperation patient’s body, and 15 were postoperative counting anomalies. Among the 45 cases of surgical instruments, the fracture and defect were the most common (21 cases, 46.7%). Conclusion The operation nurses should focus on the prevention of suture needle loss, the surgical dressings loss and the fracture and defect of surgical instruments, etc, to reduce or avoid the surgery-related near misses.
ObjectiveTo explore the echocardiography characteristics of aortic valve disease (AVD) among different ethnic groups in Xinjiang.MethodsThe data of a large sample (n=130 358) of different ethnic groups in Xinjiang based on the results of echocardiography were analyzed between January 2011 and December 2016, and the echocardiography characteristics of AVD among the Han nationality and different ethnic minorities in Xinjiang were summarized.ResultsThe study recruited 130 358 patients, involving Han nationality (58.49%) and 33 ethnic minorities. The ethnic minorities included the Uygur (27.42%), Kazak (7.47%), Hui nationality (3.48%) and other minorities (3.13%). Apart from Uygur, Kazak and Hui nationality, no description was given due to the small sample sizes of other minorities (3.13%). In the total study population, the prevalence of aortic valve stenosis (AS) was 0.44%, and the prevalence of severe AS was 0.10%; the prevalence of aortic valve regurgitation (AR) was 0.37%, and the prevalence of severe AR was 0.02%; the prevalence of aortic valve calcification (AVC) was 6.51%, and the highest AVC prevalence existed in ≥75 years old age group (24.45%); the prevalence of bicuspid aortic valve (BAV) was 0.54%, and the highest BAV prevalence existed in 18-44 years old age group (0.86%). Among different ethnic groups, the Uygur had the highest prevalence in terms of AS (0.60%), AR (0.63%) and BAV (0.88%), while the Han had the lowest prevalence in terms of AS (0.37%) and AR (0.24%), but the highest AVC prevalence existed in the Han nationality (7.83%). The etiology of AVD showed that the degenerative valve changes was the main cause of AS with the largest proportion of 61.97%. While the aorta root diseases (35.97%) and BAV (22.87%) were the main etiology of AR.ConclusionsIn Xinjiang the overall prevalence of AVD is low. In the elderly population, the Uygur, Kazak and Hui nationality have the higher AS prevalence than the Han nationality does. Different ethnic groups have different AVD characteristics based on the echocardiography. In the Uygur group, AVD presents the younger age of onset; the prevalence of BAV is the highest in the Uygur population, while the lowest in the Hui nationality.
Objectives To investigate the risk factors, clinical features, and clinical outcomes of severe cerebral infarction (SCI), and explore the association between different risk factors and outcomes in SCI. Methods We prospectively registered consecutive cases of acute ischemic stroke at the neurological wards of West China Hospital, Sichuan University from January 1st, 2008 to May 27th, 2013. Patients with ischemic stroke within 30 days of symptom onset were included. SCI was defined as the score of National Institutes of Health Stroke Scale greater than 15. Data were collected on clinical and biological variables, risk factors for stroke and the presence of comorbidities. The data management and analysis were performed with the SPSS 16.0 package. Univariate and multivariate analysis were used to analyze the predictors of SCI and its outcomes. Results Of the 3 364 enrolled cases, 348 (10.3%) were SCI. Compared with non-SCI (NSCI), SCI patients were older, with a lower proportion of males, higher NIHSS scores, lower Glasgow Coma Scale (GCS) scores, and higher proportions of previous heart disease history and previous stroke history, and lower hemoglobin levels on admission. SCI group had a greater proportion of large-artery atherosclerosis (LAA) and cardioembolism (CE) and less proportion of small artery occlusive infarction. After adjustment for the confounders, age [odds ratio (OR)=1.020, 95% confidence interval (CI) (1.010, 1.031), P<0.001], LAA [OR=1.442, 95%CI (1.062, 1.958), P=0.019], and CE [OR=1.919, 95%CI (1.319, 2.793), P=0.001] were independently associated with SCI. The case fatality and case fatality or disability with SCI were 32.1% and 83.3% at the end of 3 months, and 41.8% and 79.3% at the end of 1 year. Among different types, patients with undetermined type had the highest mortality rate, with patients with LAA being the lowest (P≤0.001). There was no significant association between TOAST type and the rate of fatality or disability. Multiple factor analysis showed that the most important independent predictive factor of prognosis was age. Meanwhile, sex and previous stroke history were also the independent predictive factors for death at the 3rd month. Hyperlipidemia, valvular heart disease, and GCS score on admission were independent predictive factors for death/disability at the 3rd month. Conclusions Our study indicates that patients with SCI accounted for 10.3% of acute ischemic stroke. The case fatality or disability in SCI patients are higher than those in NSCI patients. The old age, LAA and CE are independent predictive factors of SCI. Age is the most important prognostic factor of patients with SCI.
ObjectivesTo analyze epidemiological characteristics of leprosy in Sichuan province from 2000 to 2017.MethodsCase data of all new leprosy patients in Sichuan province from 2000 to 2017 were collected. A retrospective analysis of its epidemiological characteristics was performed by using SPSS 19.0 software.ResultsA total of 3 208 cases of leprosy were detected during 2000 to 2017, of whom 2 197 (71.28%) were male, 885 (28.72%) were female. The younger cases whose ages were less than 14 were 82 (2.66%), and the cases with grade 2 disabilities were 614 (19.92%). The mean age of male was older than female (41.64±14.26 vs. 38.89±15.12 years, P<0.05). The grade 2 disability rate of male was significantly higher than that of female (20.94% vs. 17.40%, P<0.05). Self-report was the most common method of discovery. But the ratio of male who were detected through contact examination was significantly lower than that detected through dermatological clinic, self-report, clues check and report (the ratio of male to female was 1.57, 2.38, 2.88, 2.48, 2.37, respectively, P<0.05).ConclusionsThe case detection of leprosy declines annually in Sichuan province from 2000 to 2017, especially in high-endemic area and male patients. Female patients are younger than male patients when they are detected. The grade 2 disability situation of male patients is significantly more serious than that of female patients. Self-report is the most common way of discovery, while women are more passive.
ObjectivesTo explore the characteristics of Chinese methodological studies on patient compliance in clinical trials so as to provide reference for clinical trial of patient compliance in future.MethodsCNKI, VIP, CBM and WanFang Data databases were electronically searched to collect methodological studies on patient compliance in clinical trials published in Chinese language from January 2000 to December 2018. Two reviewers independently screened literature, extracted data and then, qualitative analysis of document characteristics was then performed.ResultsA total of 84 articles were included, in which 68 were studies on Western medicine and 16 were studies on traditional Chinese medicine (TCM). The results showed that: the quantity of studies on patient compliance increased along with time. However, those in TCM field did not increase. All included studies summarized their strategies to improve patient compliance, however key information for quality evaluation were missing.ConclusionsThere is still a lack of research on how to improve patients’ compliance in clinical trials to ensure the reliability of the results. Existing studies have not systematically and comprehensively explored the influencing factors of patients’ compliance. Clinical trials researchers in China have not focused sufficiently to patients’ compliance and lack the proper methodology to frame studies.
ObjectiveTo construct a prediction model of diabetics distal symmetric polyneuropathy (DSPN) based on neural network algorithm and the characteristic data of traditional Chinese medicine and Western medicine. MethodsFrom the inpatients with diabetes in the First Affiliated Hospital of Anhui University of Chinese Medicine from 2017 to 2022, 4 071 cases with complete data were selected. The early warning model of DSPN was established by using neural network, and 49 indicators including general epidemiological data, laboratory examination, signs and symptoms of traditional Chinese medicine were included to analyze the potential risk factors of DSPN, and the weight values of variable features were sorted. Validation was performed using ten-fold crossover, and the model was measured by accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and AUC value. ResultsThe mean duration of diabetes in the DSPN group was about 4 years longer than that in the non-DSPN group (P<0.001). Compared with non-DSPN patients, DSPN patients had a significantly higher proportion of Chinese medicine symptoms and signs such as numbness of limb, limb pain, dizziness and palpitations, fatigue, thirst with desire to drink, dry mouth and throat, blurred vision, frequent urination, slow reaction, dull complexion, purple tongue, thready pulse and hesitant pulse (P<0.001). In this study, the DSPN neural network prediction model was established by integrating traditional Chinese and Western medicine feature data. The AUC of the model was 0.945 3, the accuracy was 87.68%, the sensitivity was 73.9%, the specificity was 92.7%, the positive predictive value was 78.7%, and the negative predictive value was 90.72%. ConclusionThe fusion of Chinese and Western medicine characteristic data has great clinical value for early diagnosis, and the established model has high accuracy and diagnostic efficacy, which can provide practical tools for DSPN screening and diagnosis in diabetic population.