ObjectiveTo evaluate the reliability and validity of Guideline Implementation Success Assessment Tool (A-GIST). MethodsWith the guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition) as the target guideline, health care providers and patients from different hospitals across the country were investigated by questionnaire using A-GIST. Spearman-Brown coefficient and Cronbach's α coefficient were used to evaluate the split-half reliability and internal consistency reliability, while the structural validity, convergent validity and discriminant validity were investigated by confirmatory factor analysis based on structural equation. ResultsThe internal consistency reliability and split half reliability coefficients of the whole tool and each dimension ranged from 0.650 to 0.986. The scale-level content validity index (S-CVI/Ave) of content validity was 0.846. Confirmatory factor analysis showed that, the χ2/df of two sections of the tool were 8.695 and 6.123, respectively. The root mean square residual (RMR), the standard root mean square residual (SRMR) and the root mean square error of approximation (RMSEA) were under or almost under the threshold. Besides, the goodness-of-fit index (GFI) of them were 0.901 and 0.822, the adjusted goodness-of-fit index (AGFI) were 0.836 and 0.787, and the parsimonious normed fit index (PNFI) were 0.545 and 0.788, respectively. ConclusionGuideline Implementation Success Assessment Tool (A-GIST) was proved to be valid and reliable, and it shows that it is necessary to optimize the items under the dimensions of maintenance and evaluation of diagnosis and treatment effect in the future.
ObjectiveTo introduce and preliminarily apply a tool for assessing the importance of research questions (Australia & New Zealand Musculoskeletal Clinical Trials Network Research Question Importance Tool, ANZMUSC-RQIT), thereby providing a methodological reference for selecting research questions. MethodsAn overview of the development process and main content of ANZMUSC-RQIT is provided, and an exploratory application of the tool is conducted to evaluate clinical research questions in the field of musculoskeletal disorders (MSKDs) within Chinese Medicine (CM). ResultsANZMUSC-RQIT assesses the importance of specific research questions across five dimensions. Currently, clinical research on MSKDs in CM often focuses on the consensus among stakeholders regarding the importance of issues, prioritizes addressing problems that pose a significant burden on patients, and aims to alleviate clinical symptoms as the main intervention goal. The total score of ANZMUSC-RQIT is positively correlated with journal impact but shows no statistically significant relationship with citation frequency. Additionally, national funding support is positively correlated with the RQIT total score of the research question. ConclusionThe development of ANZMUSC-RQIT provides valuable reference and inspiration for selecting future research questions. However, to more effectively assess the importance of CM clinical research questions, there is a pressing need to develop an evaluation tool tailored to the specific characteristics of CM clinical research.
ObjectiveTo investigate the association between polymorphism of V4,F+1 in ADAM33 (adisintegrin and metalloproteinase 33) gene and COPD in a northwestern Uighur population. MethodsA total of 100 Uighur COPD patients and 140 healthy volunteers were recruited in the study. Genotypes were determined by restriction fragment lengthpolymorphism(PCR-RFLP). All subjects had a epidemiological investigation including modified british medical research council(mMRC),COPD assessment test(CAT),and pulmonary function test. The 100 Uighur COPD patients were assessed by revised GOLD2011. ResultsAssessed by revised GOLD2011,the patients of A,B and C grade accounted for 22%,35% and 30%,respectively. There was no statistical significance in the distributions of the V4,F+1 alleles between the patients and the controls(P>0.05). There was no statistical significance between SNPs in ADAM33(V4 and F+1) with the decreased lung function and the grade of COPD(P>0.05). ConclusionThere was no association between polymorphism of V4,F+1 in ADAM33 gene and COPD in a northwestern Uighur population.
Objective To explore the characteristics of cognitive impairment in patients with alcohol dependence, and analyze the related influencing factors. Methods The Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the cognitive function of 65 alcohol dependent patients hospitalized between January 1st and December 31st, 2014. The features of cognitive impairment and related influencing factors were analyzed. Results The differences of MoCA attention and delayed recall between different drinking year groups had statistical significance (P<0.05). The correlations of drinking year with MoCA attention (r=–0.250,P=0.044), and with delayed recall (r=–0.326,P=0.008) were both negative. MoCA scores, naming, attention and delayed recall were different statistically among different age groups (P<0.05). The correlations of ages with MoCA scores (r=–0.429,P<0.001), naming (r=–0.261,P=0.035), attention (r=–0.391,P=0.001) and delayed recall (r=–0.461,P<0.001) were all negative. MoCA scores, the visuoconstructional skills, language, abstraction and delayed recall were significantly different among different education level groups (P<0.05). The correlations of education level with MoCA scores (rs=0.650,P<0.001), the visuoconstructional skills (rs=0.540,P<0.001), language (rs=0.486,P<0.001), abstraction (r=0.602,P<0.001) and delayed recall (rs=0.593,P<0.001) were all positive. Ages had an effect on MoCA scores by multiple linear regression analysis (P<0.01). Conclusions For alcohol dependent patients with cognitive impairment, cognitive function is correlated with drinking year, age and education level. The cognitive function is much serious in patients with older age and longer drinking years. This kind of patients should be focused on and intervened early.
Objective To retrospectively analyze the clinical and imaging features of multi-segmental lumbar intervertebral disc protrusion and its treatment with the limited recessive decompression operation. Methods Twenty two patients (14 males and 8 females, aged 49-68 years) were admitted to hospital from March 1999 to March 2004. They suffered from multisegmental lumbar intervertebral disc protrusion that involved L1S1 and were treated with the limited recessive decompression operation. Results The follow-up for 4-21 months showed that 16 of the patients had an excellent outcome, 5 had a good outcome, and 1 had fair outcome. There were nosuch operative complications as nerve root lesions and putamen lesions. Conclusion The limited recessive decompression operation is one of the available good treatments for multi-segmental lumbar intervertebral disc protrusion. It solves problems of herniation and stenosis and maintains stability ofthe spine.
Patient safety culture is an extension of the concept of safety culture in medical institutions and is a hot spot of current patient safety research. In recent years, patient safety culture research has developed rapidly, and new assessment tools and related research have emerged. There is a correlation between cultural factors and safety outcomes, and changing the patient safety culture can improve patient outcomes. This paper focuses on the literature review of patient safety and outpatient safety assessment tools published in China and abroad, analyzes and compares the performance characteristics of domestic and foreign assessment tools, and provides reference for the future patient safety culture research.
Objective To investigate the impact of genetic factors on mental health status in child and adolescent twins. Methods A total of 102 pairs of twins aged 6 to 16 years were recruited with the support from educational committees and schools. After the guardians of these twins had signed an informed consent form, the Chinese version growth and the state of health evaluation (Development and Well-Bing Assessment, DAWBA) were completed by the parents of these twins to investigate their mental health status. Buccal mucosa samples were collected from all twins for DNA extraction and zygosity identification test. Result A total of 102 pairs of twins were recruited, among whom 93 pairs finished the investigation, including 50 monozygotic pairs and 43 dizygotic pairs. The results of emotional symptoms and behavior symptoms and the impact of symptoms from the DAWBA screening questionnaire showed that the intrapair correlation coeficien of the emotional disorder and the oppositional/conduct disorder and the impact in monozygotic twins were more remarkable than those in dizygotie twins, including separation anxiety (MZ group correlation coefficient (r) = 0.821, Plt;0.01; DZ group r=0.348, Plt;0.01), generalized anxiety (MZ group r=0.546, Plt;0.01; DZ group r=0.309, Plt;0.01), a special terror symptoms (MZ group r=0.849, Plt;0.01; DZ group r=0.726, Plt;0.01 ), and oppositional defiant / conduct disorder (MZ group r=0.237, Plt;0.01; DZ group r=0.163, Plt;0.01), attention deficit - hyperactivity disorder (MZ group r=0.640, Plt;0.01; DZ group r=0.198, Plt;0.01), autistic symptoms (MZ group r=0.680, Plt;0.01; DZ group r=0.372, Plt;0.01). Conclusion Genetic factors play an important role in mental health status of child twins.
ObjectivesTo construct a follow-up evaluation indicator system on the implementation of the WHO resolution of " Access to essential medicines” by systematic review, and to provide a methodological support for tracking the implementation of the resolution, with a view to providing evidence of decision-making to promote the accessibility of essential medicines and further promote and improve the national essential medicine policy. It also provides a methodological reference for investigating the implementation of other public health sector resolutions.MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CBM, WanFang Data and CNKI databases and relevant international or national official websites of pharmaceutical administration department or academic organization were searched to collect studies on accessibility of WHO essential drugs from inception to February, 2016. Two researchers independently screened literature, extracted data, and qualitative analysis was used to sort out and screen the evaluation indicators for the implementation of the WHO resolution of "Access to essential medicines".ResultsA total of 60 relevant literatures, three guides and 19 progress reports of the World Health Assembly from official websites were included. Through the screening of indicators, we could get two parts: the indicators of measures to implement the resolution and the indicators of the results of the implementation of the resolution.ConclusionsThis study analyzes the implementation of the resolution of the health system in the progress report of the World Health Assembly 2013–2015, divides the implementation of the resolution into two parts: the implementation of the resolution and the results of the implementation of the resolution. An indicator system for establishing measures and evaluation the resolution has been found. Expert consultations will be further developed to establish the final indicators for the implementation of the "Access to essential medicines".
As the aging of the population intensifies, the incidence of dementia continues to increase year by year. However, the general public's lack of awareness about dementia, combined with the complexity of the cognitive assessment process, often results in many dementia patients being diagnosed in the moderate to late stages of the disease, missing the crucial window for therapeutic intervention. This significantly affects the mental and physical health and quality of life of the elderly. With the continuous advancements in medical and information technology, the application of electronic tools in cognitive assessment is gradually increasing. This study summarizes the current application of electronic cognitive assessment tools to provide references for the development of electronic cognitive assessment tools suitable for the elderly in China.
Objective To evaluate the application of the Huaxi Intelligent Endoscopic Skill Training and Assessment System in minimally invasive surgery (MIS) skills training and provide insights for optimizing MIS training models, we analyzed trainee performance during training and assessment. Methods A retrospective analysis was conducted on the use of this system across 28 medical institutions from January 2022 to January 2025. Results By January 2025, the standardized deployment of 139 simulation units had been completed. A total of 403 trainees from various surgical specialties, including thoracic surgery and general surgery, participated in five customized endoscopic skill training modules: endoscopic recognition, grasping training, positioning and placement, cutting training, and suturing training. Throughout the training period, a total of 78 participants took part in 27 formal assessments. Correlation analysis based on Spearman showed that pre-assessment training pass rates were significantly correlated with final assessment scores, indicating enhancing the quality of each training module and overall training efficacy is a key to improving the effectiveness of MIS training. Conclusion The Huaxi Intelligent Endoscopic Skill Training and Assessment System effectively supports MIS training and evaluation.