Objective To evaluate the performance on the project of health system recovery using World Bank loan for ‘5.12’ Wenchuan earthquake after three years of these projects have been finished. Methods From March to December 2016, we formulated evaluation frameworks and indicators, used statistical reports and surveys to collect data of the 60 post-earthquake recovery projects using World Bank loan in Chengdu, Deyang and some other cities. Data of pre-earthquake (2007) and post-earthquake (2015) were compared. The evaluation indicators included institutional size, institutional environment, institutional services and social benefits. A descriptive analysis was performed using SPSS 22.0 software. Results Compared with the year of 2007, in 2015, the building and utilized for business purpose areas of loan benefited hospitals increased 4.49 and 3.58 times, respectively. The budgeted and actual beds count increased 43% and 55%, respectively. All inside structure and processes of hospitals were optimized, and green areas, parking slots and waiting areas increased greatly. Headcount of budgeted and actual increased 15.09% and 70.31%, respectively. Qualifications of healthcare technicians were improved in country level hospitals as well; there were more undergraduates and more senior competent personnel. In maternal and child health care hospitals and township hospitals, more diploma holders and personnel who had passed the middle level professional appraisals were observed. Numbers of hospital treatments, hospitalizations counts, numbers of surgeries performed increased 2.0, 2.1, and 2.0 times, respectively. Accuracy of diagnosis on hospitalized counts increased 3.12%. Utilizations of bed counts increased from 63.87% to 66.53%. The average duration of hospitalizations decreased from 7.36 days to 7.10 days. Numbers of clinical and surgery types increased 928 and 285, respectively. Both customer and staff satisfactory score reached 4.5 points in 2015. Conclusion The completed projects of health system recovery using World Bank loan for ‘5.12’ Wenchuan earthquake is running well, and meet the expectations.
Objective To evaluate quality and current status of traditional Chinese medicine (TCM) guidelines and consensus, and to promote the improvements in the quality of guidelines and consensus. Methods A systematic collection of TCM guidelines and consensus published in medical journals in 2022 was conducted. We used scientific, transparent, and applicable ranking tools (STAR) for evaluation, analyzed the scoring rates (%), and assessed the quality level and influencing factors of guidelines and consensus through methods such as comparison and stratification. Results A total of 130 TCM guidelines and consensus were included. Guideline areas with higher scores included recommendations (65.3%), evidence (55.9%), and guideline development groups (54.2%). In the case of consensus, higher scores were observed in recommendations (38.7%), guideline development groups (37.0%), and funding (30.0%). The total score rate of TCM guidelines exceeded that of national guidelines, while the consensus rate was lower. Stratified analysis revealed statistical differences in guideline score rates among journals and issuing institutions, as well as significant differences in consensus score rates among journals, formulation institutions, subjects, and funding categories. Conclusion The quantity and quality of TCM guidelines and consensus are on a positive trajectory, with higher quality levels in guidelines than in consensus. The overall quality of TCM guidelines surpasses that of national guidelines, particularly emphasizing the scientificity of guideline formulation. However, the overall quality of consensus remains lower than that of the national consensus. Factors such as journals, formulation institutions, subjects, and funding categories are identified as potential influences on the quality of TCM guidelines and consensus.
Objective To set up and to evaluate an acute closed brain injury model in rats. Methods The acute closed brain injury was produced in rats by using an impactor consisting of a stand, a guide tube, a weight and a footplate. Ninetysix SD rats were divided into a control group(n＝32, no impact), a mild injury group(n＝32, impact once at force level of 400 g·cm) and a severe injury group(n＝32, impact once at force level of 800 g·cm) to elucidate the physiological responses, the pathophysiological changes and brain edema after brain injury at different injury levels. Results In the mild injury group and the severe injury group, a sudden rise or reduction of blood pressure, deep and fast breath apnea, and pain reflects inhibition were observed. The responses were more obvious in the severe injury group than in the mild injury group. The water content of the brain increased after 6 hours of injury. The pathological contusion and edema of brain were noted or above the impact force level of 800 g·cm. When the impact force rose to or over 1200g·cm, the animals died of persistent apnea mostly. Conclusion Although the established closed brain injury model with different biomechanical mechanisms as the clinical brain injury, it is in conformity with pathological changes and pathophysiological characteristics of acute clinical brain injury, it can be utilized extensively because of its convenient and practice.
【摘要】 目的 探討高血壓危象評估和處理原則及對高血壓危象急診處理的指導意義。 方法 依據高血壓危象評估和處理原則對2008年1月-2009年12月期間收治的160例高血壓危象患者進行診斷和治療。結果 160例高血壓危象患者中,高血壓急癥134例,高血壓亞急癥26例。高血壓急癥中,以心腦血管病變為主,包括腦卒中、急性冠脈綜合征和急性左側心力衰竭。依據高血壓危象評估和處理原則進行急診處理,能夠對高血壓危象進行準確評估和有效處理,減少診治失誤,降低死亡率并改善預后。結論 有關高血壓危象的評估和處理原則能夠指導高血壓危象的急診處理,取得良好的預后。【Abstract】 Objective To investigate the principles of evaluation and management of hypertensive crises in order to guide emergency clinical practice for better managements and prognosis. Methods One hundred and sixty patients with hypertensive crises admitted to our department from January 2008 to December 2009 had been diagnosed and treated. Results There were 134 patients with hypertensive emergencies (HE) and 26 patients with hypertensive urgencies(HU)in accordance with those principle. Cardiocerebralvascular diseases were the main symptom of HE including stroke, acute coronary syndrome and acute left ventricular failure. According to those principles,the emergency management was carried out, accuracy evaluation and effective management of hypertensive crises could reduce wrong diagnosis and treatment,decrease mortality and improve prognosis. Conclusion The principle of evaluation and management of hypertensive crises could guide the emergency management of hypertensive crises and obtain better prognosis．
Objective To evaluate the right usage of statistical methods in medical articles. Methods 544 theses from eight medical journalspublished during1998 and 2005 were analyzed. Results 136 theses had obvious statistical errors,accounting for 25.00%. The main types of the errors were: the wrong methods of data analyzing for 61.76%, diagram error for 14.71%, nonstatistical dealing for8.82%, the mixture of rate and ratio for 8.82%, and the other error for 5.88%. Conclusion The statistical methods should be highly valued. Despite handing themanuscript to the specialist in the same field, the statistician checking system should be built through the process of manuscript dealing.
Objective To evaluate the effect of triple arthrodesison treating complications of calcaneus fractures. Methods From 1990to 2001, 12 patients with the complications of calcaneus fractures underwent the triple arthrodesis(subtalar,talaronavicular and calcaneocuboid joints). Ollier incision was applied to all patients. Peroneal tenolysis was required in 2 patients and a decompression and transposition of tibialnerve in 1 patient.Of the 12 patients, 7 were males and 5 were females. Their ages ranged from 29 to 64 years. Complications, like pain and deformity, occurred 5 to 22 months after the operation(18 months on average).Preoperative score, fibulocalcaneal distance, Bohler angle, differenceof talardeclination angle and height of hind foot were 40.00±5.22, 0.41±0.03 cm, 12.00±3.40°, 17.00±3.32° and 4.12±0.35 cm respectively. Results All patients were followed up from 3 to 13 years with an average of 7 years. Postoperative score, tibulocalcaneal distance, B[AKo¨]hler angle, difference of talar declination angle and height of hind foot were 75.00±6.46，0.73±0.02 cm， 31.00±5.61°，9.00±3.15° and 6.75±0.62 cm respectively. There were significant differences in these indexes(P＜0.05). Conclusion To evaluate the complications of calcaneus fractures and to adopt proper operative procedures are necessary. To restore theheight of hind foot and the anatomical relationship between hind foot and calcaneus is the key factor to success.
ObjectiveTo explore the comprehensive hospital administrative management system for urban and rural cooperation in the process of medical reform. MethodsBy reviewing literature and interviewing directors of the administrative departments and hospital medical staff, we gradually established and improved the administrative management system for urban and rural hospital counterpart support. ResultsBetween 2010 and 2013, 123 medical workers were dispatched to support eight county-level hospitals, after which the comprehensive capacity, and technology and quality control in those hospitals were largely improved. Till the end of 2013, two of those hospitals were promoted to be grade-three class-B comprehensive hospitals; two were promoted as grade-two class-A comprehensive hospitals; three passed the reassessment to be grade-two class-A comprehensive hospitals; and another three county-level medical centers were promoted to be city-level key disciplines. ConclusionThe comprehensive administrative management system improves the management level of grass-roots hospitals at the county level; promotes the social public welfare of tertiary public hospital counterpart support; facilitates the process of medical system reform at the county level; establishes a series of administrative management modes such as unified support, personnel management, assessment standards and evaluation system; and promotes the sustainability of long-term counterpart support system.
ObjectiveTo observe the effect of silver dressings on treating diabetic foot ulcer infection. MethodsA total of 105 patients with diabetic foot ulcers treated from May 2012 to April 2014 were randomly divided into two groups:group A and B. Patients in group A were treated with imported silver ion alginate dressing, while group B was treated with domestic nanometer silver dressing. All patients were given basic treatment, and the effect of silver dressing was evaluated by observing bacterial clearance rate and wound healing score. ResultsThere were significant improvement in bacterial clearance rate and wound healing score in both two groups after treatment. The bacterial clearance rate was similar between the two groups (P>0.05). However, the descending trend of wound healing score in group A was significantly more obvious than group B (P<0.01). ConclusionBoth two silver dressings are effective in the treatment of diabetic foot ulcer infection, but the effectiveness of silver ion alginate dressing is superior. Bacterial clearance rate and wound healing score are objective and applicable index to evaluate the treatment effects of silver dressing.
ObjectiveTo systematically review the studies on the clinical comprehensive evaluation system of drugs at home and abroad. MethodsThe PubMed, EMbase, Cochrane Library, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect the literature and policy documents of the clinical comprehensive evaluation system of drugs from inception to October 31, 2022. The evaluation organization, evaluation perspective, application scope, domains and criteria were sorted out, and the evaluation of different types of drugs was analyzed in detail. ResultsA total of 101 clinical comprehensive evaluation systems of drugs were included. The publishing time was from 2009 to 2022, and the number of published articles increased. The first author mainly came from 26 countries, including China (n=34), Canada (n=11), the United States (n=10), and Spain (n=10). Forty-seven articles reported the evaluation perspective. All evaluation systems could be used for drug evaluation, of which 43 could be used as universal evaluation tools, and 58 could be used for the evaluation of specific drugs, mainly including anti-tumor drugs (n=15), orphan drugs (n=10) and traditional Chinese medicine (n=7). The number of evaluation domains varied from 2 to 22, and the number of criteria varied from 4 to 56. Among them, economics (n=73), effectiveness (n=72), safety (n=54), disease demand/burden (n=34), and innovation (n=24) were the most frequent evaluation domains. ConclusionThe research on clinical comprehensive evaluation of drugs at home and abroad has grown up. During the implementation of clinical comprehensive evaluation of Chinese patent medicine, it is necessary to clarify the evaluation perspective, define the evaluation scope, and determine the evaluation domains.
Objective To explore the evaluation index and appointment mechanism of healthy professional titles. Methods We collected the data of people evaluated and appointed as advanced professional titles, and the evaluation and appointment documents in West China Hospital. We analyzed the evaluation index and appointment mechanism. Results A total of 400 people gained senior title promotion. The evaluation indexes focused on academic degrees, papers, research projects, patents, as well as awards and honors. The research achievements reduced of 80% people who had gained senior titles. Conclusion Current evaluation indexes prefer to inflexible index and ignore flexible index. The appointment mechanism lacks outcome evaluation, and the professional title will not be eliminated once appointed. In the future, we should improve the evaluation index and appointment mechanism focusing on the specific characteristics of healthy professional titles.