Objective To provide references for the rational allocation of health personnel in rural hospitals through understanding the status of health human resources of rural hospitals in remote and poor areas of Sichuan Province. Methodes This study used cluster sampling method, combined with questionnaire survey and qualitative interviews. A total of 711 health workers of 29 rural hospitals in Pengzhou and Baoxing of Sichuan Province were interviewed. SPSS16.0 was used for descriptive analysis.Results The average age of rural hospitals health personnel in remote and poor areas of Sichuan Province was 30 years old. Post-secondary education accounted for 58.12%, and Bachelor degree or above accounted for 7.2%. The number of medium and senior professional titles account for 8.4 %. The ratio of doctors to nurses was 1:0.55. In the survey of health workers, those doctors with practice (assistant) license accounted for 38.5%, and those without any qualification occupied 27.1 %. Conclusions The professional titles of medical personnel of rural hospitals in remote and poor areas in Sichuan province are generally low. The distribution of professional categories is irrational. The staff in charge of prevention and care are inadequate. There exist a large number of unqualified medical workers. Therefore, the government should increase the investment in rural health and take measures to stabilize the team structure, introduce the talented, and strengthen the training for health personnel of rural hospitals to improve their overall quality.
Objective To study some related factors of effect on gluteus muscle contraction and provide the therapeutic basis. Methods The curative effect was assessed in 154 patients who were classified by age, patient’s condition, orthopedic degree in operation and rehabilitation with an average follow-up period of 25 months(ranging from 5 to 36 months).Results The excellent rate of 18-24 years old (25/30) was lower than that of 5 -17 years old(120/124) (Plt;0.05); the excellent rate of slight patients was higher (107/109) than that of serious patients (38/45) (Plt;0.01); the excellent rate from higher orthopedic degree was higher(111/113) than that from lower orthopedic degree(34/41) (Plt;0.01); and the excellent rate of rehabilitation was much higher (107/110) than that of general treatment (38/44) （Plt;0.05）. Conclusion Age, patient’s condition, orthopedic degree in operation and rehabilitation are important factors to affect the curative effect on gluteu muscle contraction.
ObjectiveTo systematically evaluate the effectiveness of anterior versus posterior approaches with one-stage debridement and bone grafting for surgical treatment of spinal tuberculosis. MethodsDatabases including PubMed, MEDLINE, Ovid, Elsevier, CBM, WanFang Data, CNKI and VIP were electronically searched from 2004 to 2015 to collect relevant clinical studies about the effectiveness of anterior versus posterior approaches with one-stage debridement and bone grafting for surgical treatment of spinal tuberculosis. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies, and then meta-analysis was performed using RevMan 5.2 software. ResultsA total of 11 studies involving 1 063 patients were included. The results of meta-analysis showed that: correction of Cobb angle with the posterior approach was significantly larger than that of anterior approach (MD=-2.78, 95%CI -3.73 to -1.82, P<0.000 01); the allograft fusion time of anterior approach was shorter than that of posterior approach (MD=-0.21, 95%CI -0.35 to -0.08, P=0.002). But there were no significant differences between the two groups in operation time, intraoprative blood loss, loss of Cobb angle at final follow-up and time of total hospital stay (all P values >0.05). ConclusionPosterior approach can correct the Cobb angle significantly for the spinal tuberculosis patients with kyphosis, and anterior approach has a shorter allograft fusion time, but it is not able to correct the deformity of the patient to maintain the normal sequence of the spine. For the quantity and quality limitation of the included studies, this conclusion still needs to be proved by conducting more high quality studies.
【Abstract】 Objective To explore the reasons of tendon adhesions post tendon allograft. Methods From May1990 to June 2000, 85 cases receiving tendon allograft were given tenolysis because of tendon adhesions. There were 76 males and 9 females, with an average age of 24.5 years (8-46 years). Injury was caused by machine in 38 cases, electric in 32 cases, cut in 4 cases, explosion in 4 cases and extremity mutilation in 7 cases; including 66 cases of flexor tendon deficit and 19 cases of extensor tendon deficit. Six cases had 1 tendon deficit, 79 cases had tendon deficit of more than 2. The defect region ranged from I to V. The total mobil ity of the joint was less than 220° in 73 cases. The impairment of skin, bone, nerve and vascular were treated before tendon allograft. Results Because TAM was less than 50% of TPM, the patients were given tenolysis 4-15 months after operation. And the mobil ization began at the first day after operation to improve the range of active movement. Patients were followed up 7-17 years (mean 12.7 years). TAM and TPM were in accord. Mean total mobil ity of joint was200°. Conclusion The serious of primary hurt is the important factors of tendon adhesion. Improvement of tendon selected, treatment and early mobil ization can rel ieve the tendon adhesion.
ObjectiveTo provide scientific evidence for the prevention and control of infectious diseases in hospitals through analyzing the data of notified infectious diseases collected in one general comprehensive hospital from 2009 to 2014. MethodsDescriptive method was used to analyze the data of infectious diseases reported through the reporting system in 6 years in the hospital, and then the incidence, diseases classification and transmission route were summarized. ResultsA total of 15 847 cases, covering 32 notified infectious diseases, were reported between 2009 and 2014, including 15 144 category-B (95.56%) and 703 category-C (4.44%) infectious disease cases, among which the top four were syphilis, hepatitis B, tuberculosis and acquired immune deficiency syndrome (AIDS), with AIDS showing upward trend year by year. There were also 38 H1N1 cases of emerging infectious disease cases. In the view of the trend, there was an upward trend from 2009 to 2012, while there was a downward trend from 2012 to 2014. There were cases for all age groups, and most cases occurred among patients at an age of 40 to 44, accounting for 11.25% of the total cases. Eighteen occupations were involved, and the top five in terms of the number of infections accounted for 63.96% of all the cases. ConclusionCategory-B infections have been the major diseases reported in our hospital from 2009 to 2014. Therefore, the priority of our job in the future should be focused on prevention and control of syphilis, hepatitis B, tuberculosis and AIDS.
Objective To conduct bibliometric analysis of systematic review and meta-analysis published in the Chinese Journal of Evidence-based Medicine. Methods Based on the Chinese academic periodical network as a data pool, literature on systematic reviews (involving meta-analysis) and clinical decision-making researches were retrieved in the Chinese Evidence-Based Medicine Magazine from 2001 to 2010, screened and categorized by the medical and hygienic standards of Chinese Library Classification (fourth edition), and then were counted and sorted. Results There were 425 articles about systematic reviews (involving meta-analyses) and clinical decision-making studies in the Chinese Evidence-Based Medicine Magazine, with an yearly increasing number. Basically, those articles involved all subjects such as clinical medicine, preclinical medicine, hygenics, pharmacy, and traditional Chinese medicine. Conclusion Development levels of evidence-based research in medical subjects are different, each of which has its own feature. Also, some systematic reviews do not strictly follow the Cochrane Handbook. Therefore, high-quality systematic review is still needed in each subject.
ObjectiveTo observe and evaluate the predictive value of serum cystatin C (Cys-C) on the risk of sight-threatening diabetic retinopathy (STDR). MethodsA non-randomized controlled cross-sectional clinical study. Ninety-two patients with type 2 diabetes mellitus (T2DM) who were admitted to Department of Ophthalmology of Beijing Tsinghua Changgung Hospital from January 2022 to October 2022 were included in the study. Among them, 50 were male, 42 cases were female, with the mean age of (58.24±12.49) years. The mean duration of T2DM was (13.18±8.35) years, of which 38 cases had a duration of ≥10 years. Twenty-nine cases complicated with hypertension, of which 16 cases had a duration of ≥10 years. Seventeen cases complicated with chronic kidney disease stage 2 and 23 cases were treated with lipid-lowering drugs. Hemoglobin Alc, serum Cys-C, serum lipids and renal function were tested, and urinary microalbumin/creatinine ratio (ACR) was calculated. According to the 2003 American Academy of Ophthalmology "Clinical Guidelines for Diabetic Retinopathy (DR)" and international clinical DR severity grading standards, the patients were divided into STDR and non-STDR groups, with 44 and 48 cases in each group, respectively. STDR was defined as severe non-proliferative DR, proliferative DR, and macular edema. Logistic regression was used to analyze the independent risk factors of STDR in T2DM patients. Receiver operating characteristic curve (ROC curve) was used to calculate and analyze the area under ROC curve (AUC) and the predictive value of serum Cys-C and ACR in predicting STDR in T2DM patients. ResultsSerum Cys-C levels in STDR and non-STDR groups were 1.10 (0.94, 1.28) and 0.91 (0.83, 1.02) mg/L, respectively, with ACR of 4.29 (1.05, 21.89) and 1.39 (0.77, 3.80) mg/mmol, respectively. Compared with non-STDR group, serum Cys-C and ACR in STDR group were higher, and the difference was statistically significant (Z=－3.984, －3.280; P＜0.05). Multivariate logistic regression analysis showed that serum Cys-C was an independent risk factor for STDR (odds ratio=1.337, 95% confidence interval 1.145-2.090, P=0.033), and the risk of STDR increased by 33.7% for every 0.1 mg/L increase in serum Cys-C. ROC analysis results showed that serum Cys-C＞1.065 mg/L combined with ACR＞5.84 mg/mmol predicted the AUC of STDR in T2DM patients was 0.661, with the specificity of 95.8%. ConclusionsThe high serum Cys-C level is an independent risk factor for STDR in T2DM patients. Serum Cys-C has high predictive value for the occurrence of STDR.
ObjectiveTo explore the distribution and rule of pathogen strains in the third quarter and fourth quarter of 2012, and to provide the basis for clinical medication. MethodsTo retrospectively analyze the bacterial culture and drug susceptibility test results in the third quarter and the fourth quarter of 2012. ResultsThere were isolated 932 plants in the third quarter, and 915 plants isolated in the fourth quarter. Heavy drug resistance rates of detection of Pseudomonas aeruginosa decrease slightly. There was more multiple drug resistance of A. baumanii, Escherichia coli, Klebsiella pneumoniae, and methicillin-resistant Staphylococcus aureus in the fourth quarter than in the third one. ConclusionThe resistant strain increases in the fourth quarter. We should attach importance to the clinical examination, bacterial drug resistance monitoring, and rational use of antimicrobial agents.
Objective To explore the correlation of risk factors affecting the L2-4BMD level in patients with post-menopausal osteoporosis. Methods Ninety-two patients with post-menopausal osteoporosis were surveyed with a retrospective questionnaire. We used the findings to set up a multiple stepwise regression model and perform correlation analysis with L2-4BMD levels as the dependent variable and risk factors as the independent variables. Results Assuming that age has a definite effect on the L2-4BMD level of menopausal women, menopausal age limit, history of milk drinking, menopausal age, menarche age, fracture history and bend-back entered into the multiple stepwise regression equation. Conclusions Menopausal age limit, history of milk drinking, menopausal age, menarche age, fracture history, and bend-back influence patients with menopausal osteoporosis.The menopausal age limit is especially important. Awareness of the risk factors of osteoporosis should be raised.
Objective To analyze the outcome of patients with Blunt Abdominal Injury (BAI) in the Deyang People’s Hospital after the Wenchuan Earthquake, in order to provide evidence for future improvement in emergency response after earthquakes and in the treatment of BAI patients. Methods Data on the BAI patients within 1 week after the earthquake were collected from the Information Department of the Hospital. Microsoft EXCEL was used for data input. Results A total of 23 BAI inpatients were treated, of whom 15 were from Mianzhu City and sent to hospital within 12 hours of the earthquake. This was 1.9% of the total inpatients. The BAI inpatients suffered severe and complex injuries, and 5 of them died (mortality rate: 22%). Linenectomy was conducted for patients with spleen injuries and two inpatients developed incision infection due to lack of antibiotics during the perioperative period. Conclusions It is important to establish an emergency response mechanism for medical rescue for patients with the viscera injury, including BAI, after an earthquake. This would help to guarantee rational allocation of the rescue workers, triage of the wounded, optimization of operation, as well as a reduction in mortality from BAI.