Objective To evaluate diagnostic value of antifilaggrin autoantibodies (AFA) for rheumatoid arthritis (RA). Methods A systematic, comprehensive literature search was conducted in PubMed (1966 to 2010.8), The Cochrane Library (issue 8, 2010), EMbase (1974 to 2010.8), CBM (1978 to 2010.8), CNKI (1994 to 2010.8), VIP (1989 to 2010.8) and Chinese Medical Association of Digital Periodicals (1997 to 2010.8). The diagnosis studies on AFA versus the standards of American College of Rheumatology for RA were included. QUADAS items were used to evaluate the quality of the included studies. Meta-disc software (version 1.4) was used to analyze data. Sensitivity (SEN), specificity (SPE), positive likelihood ratio (+LR), negative likelihood ratio (–LR) and summary receiver operating characteristic curve (SROC) were calculated to assess the diagnostic value of individual diagnostic tests. Results A total of 18 articles were included, involving 6 971 cases of subjects from 7 countries. Results of meta-analysis showed that, compared with the standards of American College of Rheumatology, pooled SEN, SPE, +LR, –LR, and SROC curve of AFA were 0.52 (0.50, 0.54), 0.93 (0.92, 0.94), 7.11 (5.35, 9.45), 0.53 (0.48, 0.60), 13.82 (9.93, 19.24), and 0.834 7, respectively. Conclusion IBT, ELISA detection of AFA are of high efficiency in the diagnosis of RA. However, the antigen from human breast skin is not conducive to clinical application.
Objective To investigate the feedback of continuing medical education (CME) based on short message service (SMS) for village doctors in Gaolan County of Gansu Province, and to explore how to improve the efficiency of CME based on SMS. Methods A total of 75 village doctors were investigated with a questionnaire when attending the training program conducted by the Health Bureau of Gaolan County. Results A total of 75 valid questionnaires were collected back. The statistical analyses showed that 56% of the doctors received the majority of the messages sent to them, of whom, 98% could read the messages promptly, 81% saved the majority of the messages they received, 98% could read the saved massages occasionally, 25% transmitted messages to others, 93% thought that the messages might be helpful in varying degrees, 96% would like to continue receiving the messages in the future, 51% thought the biggest shortcoming of the messages was the poor relevance to their concern, and 70% wanted the most to receive short messages about clinical diagnosis and treatment. At present, 39% of the doctors thought the most convenient approaches to get the updated medical knowledge are attending the study or training program organized by higher authorities, while 37% thought those are reading short messages on the mobile, websites or papers. Conclusion The village doctors are willing to receive the short messages about the best clinical evidence. However, both the receiving rate and use rate of the short messages have yet to improve. A complete SMS transmission system and highly-relevant contents are regarded as important guarantees for improving the receiving rate and use rate.
Objective To investigate the decision-making situation of doctors in the township hospitals in Gaolan, Gansu province, and to discuss its scientificity and rationality. Methods Self-designed questionnaire was adopted to investigate the clinical decision-making situation of 108 doctors from 7 township hospitals in Gaolan county. The investigation contained three parts as follows: basic information of respondents, general information of clinical decision-making evidence, and comparison between respondents’ decision-making situation and current best clinical evidence. Results Among the total 108 questionnaires distributed, 89 valid were retrieved. The feedback showed that 79% of the doctors diagnosed and treated patients in accordance with medical textbooks; 53% took curative effect into consideration in the first place; 33% failed to consider patients’ willingness properly when making clinical decisions; and 52% made clinical therapy regimen for common diseases based on the evidence which was different from that in BMJ published Clinical Evidence. Conclusion While making clinical decisions, doctors in the township hospitals do not adequately refer to the best clinical evidence as their decision-making basis, and fail to take patients’ value and willingness into consideration properly. It is necessary to promote the concept of evidence-based medicine and spread the best evidence in the township health departments.
Objective By investigating the employment situation and intentions of medical students, to provide scientific evidence for guiding students’ employment by relevant departments, and to give references for formulating reasonable medical personnel training and distribution policy by health administrations. Methods The medical students of Grade 2005 in Lanzhou University were investigated by using a self-designed questionnaire. Results Among 397 questionnaires distributed, 337 were returned (84.8%). The analyses showed, when hunting a job, 45% of the respondents thought the “opportunities for personal development” was the most important factor, 61% thought the influence of parents’ or family’s desires was “greater” or “extremely greater”, 85% thought the job matching their majors was “important” or “very important”, 57% thought it is “easier” to get a content job by their majors, 51% held that the “fewer opportunities” were the most unfavorable conditions for working in township hospitals, 68% wouldn’t directly choose township hospitals after graduation, and 67% still gave up the choice even if an official position was provided. Conclusion The medical students attach great importance to the opportunities for their personal development, but they lack self-consciousness in choosing the occupation. They are optimistic about the employment but lack passion for primary hospitals. Meanwhile, they aren’t familiar with national policy guidance; their employment fields are narrow.
Objective To investigate the villagers’ cognitive degree of health knowledge in Gaolan county, Gansu province, so as to explore new methods to promote health education and spread health knowledge in rural areas. Methods Through non-random sampling methods, the questionnaires were distributed to the residents in Shagang village, Manwan village and Yanzi village, and the data were then statistically analyzed by using Epidata 3.1 and Excel 2003 softwares. Results A total of 290 questionnaires were distributed and retrieved with 100% valid rate. Only 23% of the surveyed had physical examination in the last one year; 75% thought they were lack of health knowledge; 92% would like to obtain health knowledge in regular; 86% thought lack of health knowledge was the reason of their or their relatives’ diseases; 74% obtained health knowledge by watching TV; 59% went to their village clinic first when suffering from mild symptoms of common diseases; and only 6% did exercises in their leisure time. Conclusion Most people in rural areas don’t pay enough attention to their health condition and are lack of high-quality health knowledge resources as well as consciousness of physical training. So it is not only necessary to strengthen health education, but also urgent to promote physical and mental health education in rural areas.