By reviewing and analyzing the domestic and international rehabilitation medicine education, we try to forecast the development of rehabilitation medicine of Sichuan, and moreover, to summarize and analyze the problems and difficulties of rehabilitation medicine education in this province. Then, we put forward the development countermeasures of Sichuan rehabilitation medicine education from the aspect of talent training object and mode, in order to gradually establish and improve a rehabilitation medicine education system that can adapt to the training requirements of modern medicine, to cultivate talents of rehabilitation medicine suitable for national construction needs at every level, and to improve the overall quality of Sichuan rehabilitation medicine education and build a medical rehabilitation highland in West China.
ObjectiveTo examine changes of in-hospitalization mortality for arterial switch operation (ASO) for the patients with D-transposition of the great arteries (TGA) in our hospital. MethodsWe retrospectively analyzed the clinical data of 473 consecutive TGA patients undergoing ASO to assess temporal trends of in-hospital mortality between 2001 and 2012 year. The patients in every 2 years were brought together into a group. By this way, all the patients were divided into 6 groups. In risk-adjusted analyses, mortality of each group between 2001 and 2012 year were compared within the 6 groups. ResultsAmong all the patients, 29 in-hospital deaths occurred. Between 2001 and 2012 year, the prevalence of preoperative factors-including age (P=0.13), gender (P=0.94), height (P=0.29), weight (P=0.21), combined with pulmonary hypertension (P=0.59), training for left ventricle (P=0.14), and anatomy of coronary arteries (P=0.27) did not significantly change. Crude mortality significantly decreased during that period (17.4% in the first group vs. 4.1% in the sixth group, P<0.001). Adjusted mortality also significantly became better in the ten years (the sixth group vs. the first group, odds ratio 0.098, 95% confidence interval, 0.018-0.550，P=0.01). ConclusionBetween 2001 and 2012 year, the prevalence of risk factors among TGA patients undergoing ASO remains unchanged, but the in-hospital mortality substantial decreases.
Restricted cubic spline function is an ideal model in trend approximation, which is widely used in doseresponse meta-analysis. The spline function, based on parameter technique, is a smoothly joined piecewise polynomial of each knot, with a cubic polynomial in each sub-interval of the slope which fits well in the non-linear trend by changing the number and (or) the sites of the knots. We have introduced the methodology of linear and non-linear slope model in dose-response meta-analysis in the previous article, and in this one, we will give a more detailed discussion on restricted cubic spline function mainly in the following aspects: model building, parameters pooling and knots selecting.
Objective To explore the predicted precision of discharged patients number using curve estimation combined with trend-season model. Methods Curve estimation and trend-season model were both applied, and the quarterly number of discharged patients of 363 hospital from 2009 to 2015 was collected and analyzed in order to predict discharged patients in 2016. Relative error between predicted value and actual number was also calculated. Results An optimal quadratic regression equation Yt=3 006.050 1+202.350 8×t–3.544 4×t2 was established (Coefficient of determination R2=0.927, P<0.001), and a total of 23 462 discharged patients were predicted based on this equation combined with trend-season model, with a relative error of 1.79% compared to the actual number. Conclusion The curve estimation combined with trend-season model is a convenient and visual tool for predicting analysis. It has a high predicted accuracy in predicting the number of hospital discharged patients or outpatients, which can provide a reference basis for hospital operation and management.
ObjectiveTo explore the continuous changing trend of healthcare-associated infection prevalence rate in a children’s hospital.MethodsFrom July 2012 to November 2018, a cross-sectional survey was conducted to investigate the prevalence of healthcare-associated infections in hospitalized children for seven consecutive years by combining case-checking and bedside survey.ResultsA total of 10 310 hospitalized children were investigated in the past seven years. The incidence of healthcare-associated infections from 2012 to 2018 was 2.08%, 4.84%, 1.59%, 3.76%, 1.63%, 1.74%, and 2.08%, respectively, showing a statistically significant downward trend (LLA=7.631, P=0.006). The departments with higher proportion of healthcare-associated infections were pediatric surgery (50.0%), pediatric medicine (44.8%), neonatal medicine (2.8%), and intensive care units (2.4%) . Viruses (38.8%) were the most common pathogens of healthcare-associated infections, followed by Gram-negative bacteria (34.3%) .ConclusionsThe prevalence of healthcare-associated infections in the children’s hospital showed a downward trend year by year. Pediatric surgery is the most common occurrence department, and viruses are the most common pathogens. It can provide evidence for prevention and control of healthcare-associated infection in children’s hospitals.
ObjectiveTo investigate the trend of serum bilirubin in patients with liver cirrhosis before and after transjugular intrahepatic portosystemic shunt (TIPS).MethodsThe data of patients with cirrhotic portal hypertension who underwent TIPS between October 2016 and June 2018 were collected retrospectively, including liver function before and after surgery (1 week, 1 month, 3 months, and 6 months after surgery), preoperative and postoperative portal vein pressure, and the Child-Pugh scores, model for end-stage liver disease (MELD) scores, and albumin-bilirubin (ALBI) scores. Paired t-test was used for the statistical measurement data. The total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL) levels at five time points were analyzed by analysis of variance of repeated measurement data with its own before and after comparison, and Wilcoxon signed ranks test was used for the ordered data.ResultsA total of 60 patients were included.The portal vein pressure was (27.86±2.53) mm Hg (1 mm Hg=0.133 kPa) before TIPS and (17.22±2.33) mm Hg after TIPS, and the difference was statistically significant (P<0.05). The common logarithm of the serum TBIL level [lg(TBIL)] before surgery and 1 week, 1 month, 3 months, and 6 months after surgery were (1.27±0.23), (1.44±0.21), (1.51±0.20), (1.56±0.22), (1.48±0.19) lg(μmol/L), respectively, and the difference was statistically significant (P<0.001). The common logarithm of the serum DBIL level [lg(DBIL)] at the five time periods were (0.90±0.26), (1.14±0.24), (1.18±0.25), (1.21±0.28), (1.08±0.21) lg(μmol/L), respectively, and the difference was statistically significant (P<0.001). The common logarithm of the serum IBIL level [lg(IBIL)] at the five time periods were (1.00±0.23), (1.13±0.22), (1.20±0.23), (1.26±0.21), (1.22±0.23) lg(μmol/L), respectively, and the difference was statistically significant (P<0.001). There were no statistically significant differences in the three liver reserve function scores (Child-Pugh, MELD, and ALBI, respectively) before and six months after operation (P>0.05). The differences in the composition of Child-Pugh and ALBI before and after surgery were not statistically significant (P>0.05).ConclusionsTIPS has a significant effect on reducing portal hypertension. Serum bilirubin levels continue to increase during a period after TIPS, but begin to decrease within 6 months.
ObjectiveTo investigate the prevalence rate of nosocomial infection in West China Hospital of Sichuan University and to analyze the implementation effect of nosocomial infection control measures, so as to provide reference for infection control.MethodsAn investigation of the prevalence rate of nosocomial infections was performed on patients who were admitted in West China Hospital of Sichuan University from 0:00-24:00 on a day of every late June from 2012 to 2018 by using bedside investigation in combination with inpatient medical record query, and the data was verified, summarized, and statistically analyzed by the professionals of Nosocomial Infection Management Department.ResultsFrom 2012 to 2018, the prevalence rates of nosocomial infections were 5.19%, 4.20%, 3.94%, 4.26%, 4.29%, 4.25%, and 2.97% in West China Hospital of Sichuan University, which tended to decline (χ2=32.826, P<0.001). There was no significant difference in annual total infection rate in the Department of Internal Medicine, however, the infection rate in the Department of Hematology tended to decline (χ2=6.127, P<0.05); in the Department of Surgical Medicine, the total infection rate tended to decline(χ2=18.721, P<0.001); in particular, the infection rate in the Department of Thoracic Surgery tended to decline(χ2=3.906, P<0.05); the annual difference in infection rate in the Intensive Care Unit (ICU) was not statistically significant. The key site of nosocomial infection was dominated by the lower respiratory tract, and the annual difference was not statistically significant. In particular, postoperative pneumonia has increased since 2014 (χ2=9.56, P=0.002). The nosocomial pathogens which had the highest constituent ratio over the years were Acinetobacter baumannii (in 2012, 2013, 2014, 2017, and 2018), Klebsiella pneumonia (in 2015), and Escherichia coli (in 2016). The annual difference in rate of antimicrobial use was not statistically significant(χ2=3.75, P=0.053), while the rate of antimicrobial use in the ICU tended to decline (χ2=30.42, P=0.000).ConclusionsThe prevalence rate of nosocomial infection in West China Hospital of Sichuan University tends to decline. However, sufficient attention still requires to be paid to lower respiratory tract infection, particularly for patients with postoperative pneumonia.
Objective To understand the research status and trend of value co-creation in China’s medical service field, so as to provide reference for the application research of value co-creation in China’s medical service field. Methods China National Knowledge Infrastructure was searched literature about the value co-creation in China’s medical service field retrieved from January 1, 2013 to December 1, 2021. CiteSpace V software is used to draw the keyword co-occurrence map, cluster analysis and timeline view, and analyze the overall process and evolution of literature publication interannual change, journal and discipline distribution, organization and author distribution, literature citation and so on. Results A total of 40 literatures were included, including 30 journals and 10 dissertations. The number of documents on value co-creation research in China’s medical service field showed an increasing trend year by year. The top journals in terms of published papers include Journal of Management Science, Chinese Hospital Management, Journal of Management Case Studies. Southern Medical University, Shanghai Jiaotong University and Tianjin University ranked among the institutions with a large number of documents. The top three authors in the number of published articles were Mai Shumin, Chen Huifang and Wei Qinggang. The relevant literature mainly comes from medicine and health, economy and management science. The research mainly focuses on many hot spots, such as service leading logic, internet medical care, service innovation, patient participation, doctor-patient relationship and so on. Conclusions The hot-spot research trend of value co-creation in the field of medical services in China is prominent, but the overall number of research is insufficient, the theoretical system of value co-creation is fragmented, and the core author group has not been formed yet. In the future, China needs to speed up the value co-creation theory and application research in the field of medical services, and realize the specific and systematic research transformation.
ObjectiveTo understand research hotspots and future development trends in the field of familial exudative vitreoretinopathy (FEVR) from 2014 to 2023. MethodsRelevant literature on FEVR was retrieved using the Web of Science Core Collection (SSCI and SCI-Expanded) from the Institute for Scientific Information. The bibliometric analysis software CiteSpace 6.2.R3 was used to analyze countries or regions, institutions, authors, co-cited references, and keywords. ResultsA total of 316 FEVR-related articles were included. The annual number of publications in this field showed a fluctuating upward trend from 2014 to 2023, with the highest number of publications in 2022, 51 papers (16.14%, 51/316); and the lowest in 2015, 15 papers (4.75%, 15/316). China had the highest number of publications, with 137 papers (43.35%, 137/316). Among institutions, Shanghai Jiao Tong University ranked first with 43 papers, while Professor Zhao Peiquan from Xinhua Hospital of Shanghai Jiao Tong University, had the highest number of publications among authors, with 34 papers. The country with the highest betweenness centrality was the United States, 0.91; the institution was the Chinese Academy of Medical Sciences, 0.16; and the author was Ding Xiaoyan, 0.12. The 316 papers were clustered into four research areas: #0 clinical characteristics, #1 ndp, #2 norrie disease, and #3 retinopathy of prematurity. Keywords such as "Chinese patients," "TSPAN12," "variants," and "spectrum" remained highly frequent up to 2023. ConclusionsThe number of publications on FEVR research from 2014 to 2023 show a growth trend, with Chinese research institutions and scholars contributing the most. Research on pathogenic genotypes and clinical phenotypes remains a crucial direction for future development.