Objective To investigate the inpatient disease constitution of Jili Community Health Service Center (JCHSC) in Liuyang City of Hunan Province from 2008 to 2010, so as to learn about the local burden of diseases and to provide baseline data for further study. Methods Both questionnaire and focus interviews were applied to collect inpatients’ records in JCHSC between 2008 and 2010. Based on the primary diagnosis on hospital discharge record, the diseases were standardized and classified according to the International Classification of Disease, 10th Edition (ICD-10). Data including general information of the inpatients and discharge diagnosis were rearranged and analyzed by using Microsoft Excel 2003 and SPSS 13.0 software. Results a) The total numbers of inpatients were 4 804, 6 011 and 6 552 in 2008, 2009 and 2010, respectively, and males were less than famales (37.89% vs. 62.11%, 37.68% vs. 62.32%, 41.09% vs. 58.91%); b)The disease spectrum included 19 to 21 categories, accounting for 90.5% to 100% of ICD-10; c) The top 5 systematic diseases accounted for 78.91%-83.61%, including circulate, digestive, pregnancy, parturition and puerperium, genitourinary, and respiratory system diseases; d) The top 15 single diseases were coronary heart disease, urinary calculi, cholecyslithiasis or accompanied with cholecystitis, chronic gastritis, hypertension, diabetes, chronic bronchitis, pulmonary infection and inguinal hernia; and e) In these 3 years, most of the inpatients suffered from chronic diseases rather than acute diseases, mostly over 35 years old; while the acute diseases were commonly seen in patients younger than 15 years old. Conclusion a) In recent 3 years, the major inpatient systematic diseases are circulate, digestive, pregnancy, parturition and puerperium, genitourinary, and respiratory system diseases. The chronic diseases are more than the acute, and mainly focus on coronary heart disease, urinary calculi and chronic bronchitis; b) Nine common inpatient disease spectrum of the top 15 single diseases keep same in recent 3 years; and c) Further attention should be paid to the chronic patients over 35 years old and the acute patients less than 15 years old.
Objective To investigate the disease constitution and cost of inpatients in Gaozha Central Township Health Center (GzC) in Wuzhong City of Ningxia Hui Autonomous Region from 2008 to 2010, so as to provide baseline data for further research. Methods A questionnaire combined with a special interview was carried out, and case records and cost information of GzC inpatients in 2008, 2009 and 2010 (from January to November) were collected. The diseases in discharge record were classified according to International Classification of Diseases (ICD-10) based on the first diagnose and the cost was analyzed. Data including general information of the inpatients, discharge diagnosis, hospitalization expenses, and drug cost etc. were rearranged and analyzed by Excel software. Results a) The total number of the inpatients was 1124, 642 and 747 in 2008, 2009 and 2010, respectively. The female was more than the male in both 2008 (59.34% vs. 40.66%) and 2009 (60.75% vs. 39.25%), and their disease spectrum included 17 categories, which accounted for 81% of ICD-10; b) The top six most commonly seen systematic diseases with a constituent ratio from 86.63% to 92.06% in recent three years were as follows: the respiratory system, digestive system, circulatory system, genitourinary system, injury and toxicosis, skeletal musculature and connective tissue disease. Except the injury and toxicosis, the other five systematic diseases were commonly seen in females rather than in males; c) The top 15 monopathies in recent three years were pulmonary infection, tracheitis or bronchitis, coronary heart disease, soft tissue injury, gastritis or chronic gastritis, upper respiratory infection, hypertension, urinary tract infection, prolapse of lumbar intervertebral disc, pelvic inflammation, fracture, pneumocardial diseases, superficial injury, chronic cholecystitis and arthritis; d) The main burdens of disease for inpatients focused on 35-54 age groups, then followed by the age groups above 55 in 2008 and 2009. Except the injury and toxicosis, the other diseases were commonly seen in females rather than in males. Pulmonary infection focused on the age groups above 35; the onset of hypertension increased obviously and a sharp rise of hypertension existed in the 45-54 age groups in 2008, but the hypertention focused on 35-44 age groups in 2009; e) The total inpatients with top 15 monopathies accounted for 64.06% to 71.21%, including 8-9 chronic diseases ranking higher in 2010, and 6-7 acute diseases focusing on infection and injury; and f) The average costs of chronic diseases were higher than those of acute diseases. Conclusion a) There is a big gap between GzC and Yong’an Central Township Health Center (YaC) regarding the level of the regional economic development, the situation of disease burden and cost of inpatients. The former is demonstrated as general Central Township Health Center, while the latter as affluent Central Township Health Center in western China; b) In recent three years, the main systematic diseases are in respiratory, circulatory and digestive system; the inpatients suffer from more chronic diseases rather than acute diseases in their young age; the acute diseases mainly include infection and injury, and the pulmonary infection has ranked as the first during the past three years; c) The inpatients in 2008 and 2009 are mainly in ages of 35 to 54, and then are over 55 years old. Except the injury and toxicosis, the other diseases were commonly seen in females rather than in males; d) The patients’ average costs of chronic diseases for hospitalization and drug in 2010 were lower than those of YaC. Consideration on reasonable constitution of the cost for hospitalization should be paid attention to; and e) It is urgent to strengthen the construction of infrastructure and informatization in GzC.
Objective To investigate the disease constitution and drug application of inpatients in Yong’an Central Township Health Center (YaC) in Shuangliu County of Sichuan province in 2009, so as to provide baseline data for further research. Method Questionnaire and focus interview were carried out, case records and drug application information of YaC inpatients in 2009 were collected. The diseases were classified according to ICD-10 based on first diagnose. Drug application was analyzed based on pharmaceutical dosage form, pharmaceutical effect, cost, and clinical departments. Data including general information of the inpatients, discharge diagnosis, hospitalization expenses, and drug cost etc. were rearranged and analyzed by Excel software. Result a) The total number of inpatients was 4 335 and the female/male was 55.59% vs. 44.1%, their disease spectrum included 18 categories, which accounted for 85% of disease classes of ICD-10; b) The inpatients suffered from top 5 systematic diseases were 3 531, accounted for 81.45%, which included the respiratory, digestive, urinary tract and urogenital, circulatory systems, as well as trauma and toxicosis. Except the trauma and toxicosis, the female was more than the male in all the rest main systematic diseases; c) The top 15 single diseases were chronic bronchitis in acute stage, acute upper respiratory infection, pneumonia, acute gastroenteritis, chronic bronchitis, urinary stone, acute appendicitis, chronic gastritis, acute gastritis, vertebrobasilar ischemia, cesarean section, fracture, acute urticaria, and meniere disease; d) The total inpatients with top 15 single diseases accounted for 59.81%, including 6 chronic diseases and 9 acute diseases. The patients’ average costs of chronic disease were higher than that of acute disease; and e) The proportion of western medicine cost accounted for 80% to 90% of total cost, and the cost of anti-microbial drugs and drugs of humoral regulation ranked as the top two. Conclusion a) The inpatients in 2009 are mainly in age of 25 to 59, and over 60 years old as well. The top two diseases mainly attacked are in respiratory and digestive systems, acute diseases are more than the chronic; b) Except for pneumonia, urinary stone, uroschesis, urinary stone, trauma, and toxicosis, the female inpatients are more than the male for complaining all other diseases; c) The number of inpatients received hysterotomy is as 4.24 times as that of natural labor, and the rationality should be paid attention to; d) The commonly used drugs, according to the costs, involve in 4 kinds of drugs and 1 kind of vaccine, which are in accordance with the main burden of the diseases; e) Supervision should be focused on the drugs of high cost or the one most frequently used; and f) The 0.9% Sodium chloride injection, Glucose injection and Cefuroxime listed in the EML (2009) satisfy the needs of treatment for YaC inpatients in 2009.
This paper tried to address how to apply the relative concepts and methods of evidence-based medicine in clinical practice of cardiology, especially in diagnosis and treatment, with an aim to promote the cardiovascular evidence-based medicine in China.
The randomized controlled trial is the best evidence in the evidence-based medicine. The cardiovascular disease internal department is the typical example of the evidence-based medicine. A serial large-scale randomized controlled trials provided the evidence and improved clinical treatment level. For normal development of a large-scale randomized controlled trials need to enhance the standard management.
摘要:目的:调查呼和浩特市地区变应性疾病患者常见变应原的分布情况。方法:以720例变应性疾病的患者为研究对象,进行11种吸入性变应原皮肤点刺试验,测定致敏变应原。结果:720例变应性疾病患者中577例(80.1％)变应原测试有阳性反应。577例阳性病例中艾蒿阳性率最高,315例(54.6％),其次是螨虫254例(44.0％)。结论:艾蒿、螨虫是呼和浩特市地区变应性疾病的最常见变应原。Abstract: Objective: To study the distribution of common allergens among patients of allergic diseases in Hohhot area.Method: Seven hundred and twenty cases of allergic disease were selected and 11 items of inhaled allergen skin prick tests were carried out to determine the allergens.Results:Five hundred and seventyseven patients out of the 720 (801％) reacted positively to allergen tests.Three hundreds aned fifty cases (546％) were positive in the mugwort,254 cases (440％) were positive in the mites.Conclusion: Mugwort and mites are the most common allergens in Hohhot area.
Objective To reveal the relationship between the iodine nutrition and the change of spectrum of thyroiddiseases by analyzing the change of spectrum of thyroid diseases in different iodine environments before and after the implementation of universal salt iodization （USI）. Methods To compare the urinary iodine concentration between the normal people （1 000 cases） and the patients with thyroid diseases （5 998 cases） by surgical operations who were from 4 cities of Guangxi Zhuang Autonomous Region， covering the iodine deficient areas and the iodine rich areas. Results After the USI was put into practice， the proportions of nodular goiter decreased， but the proportions of toxic nodular goiter， thyroid papillary carcinoma， and Hashimoto thyroiditis were higher than those before USI （P＜0.05）. The urinaryiodine concentrations of nodular goiter， Graves disease， toxic nodular goiter， thyroid papillary carcinoma， and Hashimotothyroiditis were higher than those before the measure was taken （P＜0.05）. The urinary iodine concentration of patients with thyroid was higher than that of normal people （P＜0.05）， and the urinary iodine concentration of patients with thyroidand normal people was higher than those before the USI （P＜0.05）. Conclusions The change of spectrum of thyroid diseases in Guangxi Zhuang Autonomous Region is obvious within 10 years after USI had been taken. The excessive intake of iodine may be one of the dangerous factors leading to toxic nodular goiter， thyroid papillary carcinoma， and Hashimoto thyroiditis.
Objective To explore the perioperative management of the coexisting diseases for the elderly patients with gastric cancer. Methods The clinical data of perioperative management for coexisting diseases in 528 patients with gastric cancer over 70 years old treated in the First Affiliated Hospital of China Medical University from March 1980 to November 2008 were analyzed retrospectively. Results The main coexisting diseases included cardiovascuclar disease (259 cases, 49.05%), respiratory disease (161 cases, 30.49%), diabetes (72 cases, 13.64%). Adjusting blood pressure and blood glucose, improving cardiopulmonary function, and hepatic and renal function were mainly given. The common postoperative complications included intestinal obstruction (10 cases), pneumonia (10 cases), reflux esophagitis (9 cases), functional evacuation disorder of gastric remnant (7 cases), and anastomotic leakage (5 cases). Ten patients died during perioperative period: 6 died of heart and lung failure, 2 of acute myocardial infarction, 1 of anastomotic leakage, 1 of intestinal obstruction. Conclusions The common coexisting diseases in the elderly patients with gastric cancer are hypertension， bronchitis and diabetes. Complete assessment of the patient’s general health before operation and intensive perioperative management of the coexisting diseases not only can decrease the risk of surgical procedures， but also decrease the incidence of complication and perioperative mortality.
Objective To explore the perioperative management of the coexisting diseases for the elderly patients with gastric cancer. Methods The clinical data of perioperative management for coexisting diseases in 528 patients with gastric cancer over 70 years old treated in the First Affiliated Hospital of China Medical University from March 1980 to November 2008 were analyzed retrospectively. Results The main coexisting diseases included cardiovascuclar disease (259 cases, 49.05%), respiratory disease (161 cases, 30.49%), diabetes (72 cases, 13.64%). Adjusting blood pressure and blood glucose, improving cardiopulmonary function, and hepatic and renal function were mainly given. The common postoperative complications included intestinal obstruction (10 cases), pneumonia (10 cases), reflux esophagitis (9 cases), functional evacuation disorder of gastric remnant (7 cases), and anastomotic leakage (5 cases). Ten patients died during perioperative period: 6 died of heart and lung failure, 2 of acute myocardial infarction, 1 of anastomotic leakage, 1 of intestinal obstruction. Conclusions The common coexisting diseases in the elderly patients with gastric cancer are hypertension， bronchitis and diabetes. Complete assessment of the patient’s general health before operation and intensive perioperative management of the coexisting diseases not only can decrease the risk of surgical procedures， but also decrease the incidence of complication and perioperative mortality.
Objective To assess the combined management of lower limb chronic venous diseases according to the CEAP classification. Methods One hundred and twenty patients were classified according to the CEAP classification. Based on clinical presentation and image study, all patients were treated with combined management plan including oppression, medication and surgery. Results All 120 patients (135 limbs) were followed up in clinic, the local recurrence rate was 18.52%(25/135). Conclusion CEAP classification expounds the developing process of lower limb chronic venous diseases. With CEAP, we can avoid the blind spot in the treatment and expand the extent of combined therapy. Accordingly, CEAP classification is useful in the treatment and diagnosis of chronic venous diseases.