With the advancement of thyroid tumor treatment concepts and the progress of standardized treatment processes nationwide, the 5-year survival rate of thyroid tumors in China has risen from 67.5% in 2003 to 84.3% in 2015. As China has been continuously enriching its treatment options for advanced thyroid cancer in recent years, gradually improving the standardized treatment system for early and intermediate thyroid cancer, enhancing multidisciplinary collaboration methods and concepts, and regularizing scientific statistics, the survival rate of thyroid tumors continues to improve. We still need to consider the future development direction and core driving force of China’s thyroid discipline, correctly view the “prosperous” stage of domestic thyroid discipline development, and actively review the future development direction of China’s thyroid discipline.
Objective To explore clinical effect of failure mode and effect analysis in improving the submission rate of pathogen examination in counterpart supported high-altitude county hospitals, and formulate practical measures and methods suitable for high-altitude county hospitals to improve the submission rate of pathogen examination. Methods Patients admitted to the People’s Hospital of Ganzi County between January and December 2024 were selected. The data of hospitalized patients between January and June 2024 were as the control group, and the data of hospitalized patients between July and December 2024 were as the intervention group. The study analyzed and compared the submission rate of pathogen testing and the pass rate of microbiological test specimens before antimicrobial treatment between the two groups. Results A total of 3 984 patients were included. Among them, there were 1 748 cases in the control group and 2 236 cases in the intervention group. A total of 10 risk factors and 2 high-risk points were identified. There were statistically significant differences in the submission rate of pathogen specimens before antibiotic treatment [36.21% (633/1 748) vs. 49.33% (1 103/2 236); χ2=68.646, P<0.001] and the qualified rate of microbiological test specimens [26.75% (122/456) vs. 36.45% (261/716); χ2=11.910, P=0.001] between the control group and the intervention group. Conclusions Failure mode and effect analysis can effectively find out the weak points in low pathogen examination submission rate in high-altitude county hospitals. According to the high-risk points to guide the formulation of relevant measures, the pathogen submission rate in the region can be effectively improved.
The increasing deteriorative trend of doctor-patient relationship (DPR) have destroyed patient safety, doctor safety and social stability in China. DPR is a complicated social problem related to multidisciplinary and multi-factor interactions. A series of researches providing different views on how to improve DPR in China have been published in recently years. Evidence-based medicine (EBM) aims to deal with massive information by producing, synthesizing and disseminating evidence from complex interventions. We tried to explore the trait of DPR by EBM methods. We provided evidence on research trends, topics and methods by systematic database retrieval, classification by screening, and quality assessment. Through dissection, attribution, and visualization of interactions and relationships between factors, we provided an evidence-supported framework for improvement of DPR. We identified gaps, defects or deficiencies in existing research, and promoted further research. We continued to follow up the research and faced a challenge: Reflection and frustration in the process of establishing the quality evaluation system of qualitative research. We found that the study of complex humanities and social sciences by reference to evidence-based methodology might be: providing a structured, panoramic perspective for complex social problems on " de-fragmentation”, providing a framework for social governance through classification and hierarchy, and calling for a more tolerant attitude and more comprehensive application of methodologies.
ObjectiveTo construct a structural equation model of the mechanism of the role of medical humanities literacy in job competency and to conduct empirical analysis to verify the supporting role of medical humanities literacy in cultivating job competency. MethodsLiterature research was conducted to select the initial indicator system for medical humanities literacy and job competency, and then a conceptual model was constructed. Questionnaire data from four hospitals in Chengdu were collected. Through exploratory factor analysis, an indicator system for medical humanities literacy and job competency more suitable for the research population was obtained and the conceptual model was adjusted. Finally, the positive mechanism of medical humanities literacy on job competency was verified using confirmatory factor analysis (structural equation model). ResultsThe Cronbach's alpha coefficient of the overall questionnaire involved in the exploratory and confirmatory factor analyses was greater than 0.9, and the KMO values of the questionnaire were greater than 0.8, with a Bartlett's sphericity test P value less than 0.01, indicating good reliability and validity of the questionnaire. The model fit of the structural equation model met the requirements, with a chi-square degree of freedom ratio (CMIN/df) of 2.768, root mean square error of approximation (RMSEA) of 0.077, comparative fit index (CFI) of 0.891, normalized fit index (NFI) of 0.840, and incremental fit index (IFI) of 0.891. ConclusionThe improvement of individual characteristics in job competency is mainly influenced by medical humanities knowledge and spirit. The improvement of cognitive characteristics in job competency is mainly influenced by medical humanities knowledge and ability. The improvement of achievement characteristics in job competency is mainly influenced by medical humanities ability and spirit. The improvement of management characteristics in job competency is mainly influenced by medical humanities spirit.
目的:信息系統的改進應用是為確保急診科預檢分診處將來能使醫院對自然災害事件的傷員救治時以最便捷、最快速的方式錄入自然災害事件傷員的信息資料和快速評估傷情，優先準確的將傷員按病情和就診區域分類，以便暢通及時救治傷員；在治療中和日后便于識別、查找、統計災害事件傷員。方法:LIS（檢驗系統）+ RIS（影像系統）+ HIS（無紙化辦公系統）三合一系統和增加自然災害傷員的“錄入信息資料”眉欄。結果:進一步改進信息網絡應用系統后，能滿足一般患者信息資料錄入和自然災害事件應急狀況下的患者資料錄入，實現電子病歷和電子處方等信息網絡系統，達到院內、科內資源共享。
Objective A set of core index sets applicable to the treatment of ischemic stroke (IS) by traditional Chinese medicine (TCM) has been constructed to IS as a basis for final determination of core index sets. Methods The exploratory sequence design of mixed methods research (MMR) was used to conduct qualitative research first and quantitative research, and the research model of quantitative research was determined based on the qualitative research results. In the qualitative research stage, focus groups composed of TCM encephalopathy and neurology experts, core indicator set methodology experts, clinical pharmacists of encephalopathy and researchers with more than 10 years of experience were selected by purpose sampling method, and focus group meetings were held around the theme of "indicator domain, indicator hierarchy and indicator attribution". Based on the discussion results, the meeting further designed the quantitative research questionnaire. A questionnaire survey was conducted among medical professionals with TCM background nationwide from September 11 to October 11, 2023, using convenient sampling method. Results In the qualitative research stage, 11 categories of IS index domain were successfully divided, including functional impairment evaluation, imaging index, daily living ability evaluation, TCM therapeutic characteristic index and TCM intervention advantage index. In the quantitative research part, 50 valid questionnaires were collected from 23 hospitals in 13 provinces, with a recovery rate of 76.92%. The recovery rate of the second round was 100%. In the end, the initial list of IS indicators in different stages of disease course was developed. The acute stage included 43 second-level evaluation indexes, 8 third-level evaluation indexes and 87 fourth-level evaluation indexes under 8 index domains. The recovery period includes 45 second-level evaluation indexes, 8 third-level evaluation indexes and 72 fourth-level evaluation indexes under 10 index domains. The sequelae stage included 33 second-level evaluation indicators, 8 third-level evaluation indicators and 70 fourth-level evaluation indicators in 9 indicator domains. Conclusion Based on the exploratory sequence design of MMR, this study successfully divide the index domain that IS scientific, in line with the characteristics of the disease and can reflect the characteristics of the intervention effect of TCM, ensuring the scientific and applicability of the initial IS index list, and laying a solid foundation for the construction of a comprehensive, objective and practical core index set.