ObjectiveTo investigate the medical quality of rehabilitation departments in medical institutions at all levels in Shenzhen and analyze the problems, so as to promote the continuous improvement of rehabilitation care quality in this city.MethodsFrom September to November 2019, a field investigation was carried out in 53 rehabilitation departments in Shenzhen. Five dimensions were scored by experts, including professional capacity, rules and regulations, knowledge and skills, supervision and feedback, and hospital infection control. Descriptive statistical analysis was used to characterize the data, and one-way analysis of variance was used to analyze the difference among different level hospitals.ResultsThe average score of rehabilitation medical care quality in Shenzhen was 83.98±8.28. The average score of tertiary, secondary, and primary hospitals were 85.61±7.02, 84.54±7.83, and 77.55±10.60, respectively, and the difference among different level hospitals was statistically significant (P<0.05). According to the standard score, the highest score was in the dimension of supervision feedback (95.75±6.50), and the lowest score was in the dimension of knowledge and skills (77.27±14.64).ConclusionThe overall quality of rehabilitation care in Shenzhen needs to be improved, and the management and professional training systems need to be established.
Objective To investigate the mastery of the management knowledge of patients with atrial fibrillation after coronary artery bypass grafting by cardiac surgeons in Beijing tertiary hospitals, and the practice status and obstacles of following the guidelines for postoperative atrial fibrillation. Methods A convenient sampling method was used to select cardiac surgeons from four tertiary hospitals in Beijing, and a self-designed questionnaire on the management of postoperative atrial fibrillation patients was used. Results A total of 227 valid questionnaires were collected. Only 47.9% of doctors and 12.8% of nurses passed in knowledge, and 31.3% of doctors and 28.5% of nurses passed in behavior. Among them, risk factor assessment, preventive medication, stroke and bleeding risk assessment were the weakest. "Lack of departmental requirements" was identified as a common barrier to healthcare workers' adherence to guidelines. Job title and participation in training were common influencing factors that affected the knowledge and behavior of healthcare workers, and knowledge level was an important factor affecting healthcare worker behavior. Conclusion In order to improve the effect of CABG surgery and improve the quality of postoperative patient management, hospitals should further strengthen the knowledge and skills training of medical staff on the management guidelines of postoperative atrial fibrillation with CABG, formulate relevant systems to ensure the clinical implementation of guidelines.
ObjectiveTo understand the development of clinical nutrition departments in western China, analyze the main problems and factors restricting its development, and provide a basis for promoting the construction and development of clinical nutrition departments in western China and formulating clinical nutrition management standards.MethodsQuestionnaires were used to investigate the development of clinical nutrition services in some hospitals in 11 provinces/municipalities/autonomous regions in western China (except Tibet) in March 2019. ResultsA total of 230 hospitals participated in the survey. Most clinical nutrition departments set up outpatient clinics (76.1%), with an average annual number of outpatients of 884; most of them carried out nutrition inspection visit/follow-up work (86.5%), and the average number of inspection visit/follow-ups was 3 876. Most hospitals had incomplete hardware and software facilities in the clinical nutrition departments. The charging items for diagnosis and treatment were complicated, and the charging standards were uneven. There were still 47.0% of the clinical nutrition departments of hospitals that did not offer diagnosis and treatment charging items. The surveyed hospitals believed that the talent team was the number one factor restricting the development of the clinical nutrition department, and regular skills training was the number one project that urgently needed the help of the Clinical Nutrition Discipline Alliance of West China Hospital of Sichuan University.ConclusionIn the future, the western region should increase the investment in hardware and software facilities, strive for policy support for maintaining department operations and formulate unified standards to regulate the development of disciplines.
ObjectiveTo investigate the clinical value of DNA ploidy analysis system in the diagnosis of benignancy or malignancy with bronchial brushing or bronchoalveolar lavage fluid. MethodsWe studied 96 bronchial brush tablets or bronchoalveolar lavage fluid specimens confirmed pathologically between June 2012 and June 2013, in which there were 49 cases of benignancy and 47 malignancies. Bronchial brush pieces were acquired by clinicians when they performed bronchoscopy for the patients. Each bronchoalveolar lavage fluid specimen was made into two slides, of which one was stained by HE method for cytology analysis, and the other was stained with Feulgen method for DNA ploidy analysis through automatic imaging cytometer. ResultsThe specificity, sensitivity and accuracy of the routine cytological investigation were respectively 85.7%, 78.7% and 77.1%, while the three indexes for DNA ploidy analysis were 100.0%, 91.5% and 95.8%, respectively. ConclusionDNA ploidy analysis can improve the bronchial brushing or bronchoalveolar lavage fluid positive rate, and compared with cytological investigation, it is more specific and more sensitive with a high clinical value.
摘要:目的：评价围手术期预防性应用抗菌药物现状及合理性。方法：采用回顾性调查的方法，随机抽查2009年度Ⅰ类切口手术围手术期病案500份，设计外科围手术期预防性应用抗生素调查表，对预防用药的适应证、用药种类、联合用药、给药时机及持续时间进行统计分析。结果：未使用抗生素5例，预防性使用抗生素495例，其中不合理80例（16.00％）。预防性使用抗生素总品规数为540，其中头孢菌素类453例（83.89%），青霉素类（包括加酶抑制剂）26例（4.81%），喹诺酮类44例（8.15%）。选用头孢唑啉钠178例（32.96%）居第一位，头孢替唑钠第二，151例（2796%）。结论：Ⅰ类切口手术患者围手术期预防性使用抗菌药物较为合理，但仍存在用药指征把握不严，抗菌药物的选择、抗菌药物使用时间较长等问题，有待进一步规范化管理。Abstract: Objective: To understand the current application of perioperative preventive antibiotics, and their rationality. Methods: Five hundred perioperative records of patients with incision Ⅰ were randomly chosen and surveyed in 2009. A questionnaire for prophylactic use of antimicrobial was designed. The indication of antimicrobial use, the species, combination, timing and drug duration were analyzed. Results: Our of 500, 495 used antimicrobial and 80 were unreasonable; 540 kinds of antimicrobial were used, included cephalosporin 453 cases (83.89%), penicillin class (including plus enzyme inhibitors) in 26 cases (4.81%), quinolone 44 cases (8.15%). Cefazolin sodium (178 patients, 32.96%) ranked first, second was cefazolin sodium (151, 27.96%). Conclusion: Perioperative use of antimicrobial prophylaxis in patients with incision Ⅰ is reasonable, but standardization management should be strengthened in the indication, species, and duration.
Objective To perform a cross-sectional study on mental situations of parents of student victims in Wenchuan earthquake and analysis the data to produce best evidences for the government on their decision-making. Methods By the use of questionnaires, interviewer, and observation, we performed field study on 225 student victims’ parents selected by simple random sampling to collect their demographic characteristics, economic and mental status. Results (1) Of the 123 student victims the only child of the family account for 91.87%, female account for 50.41%, the pupil and below, the middle school student, and the college account for 48.78%, 50.41%, 0.81% respectively. (2) Mental and behavior differences between fathers and mothers were significant. (3) The parents declining to accept the death of their children are not in a good social support. (4) The parents with good family economics and high education are more likely to accept the death of children. Conclusion (1) We should build a ‘Mutual Aid’ organization to help those parents construct a good social support net. (2) To take the advantage of rural hospitals to build the long-acting mechanism of the psychological intervention. (3) To perform the psychological intervention corresponding to right period and right aimed group.
Objective To evaluate the current status of human resources in healthcare-associated infection prevention and control (infection control) in Jiangxi Province, and explore the impact of emergency public health events on the human resources of infection control professionals in various levels and types of medical institutions. Methods From October 1st to 31st, 2023, questionnaire and on-site interviews were conducted to investigate the human resources situation of infection control professionals in various levels and types of medical institutions in Jiangxi Province. Three stages were selected for the investigation: before the outbreak of COVID-19 (before the event, December 2019), during the event (June 2022), and after the transition of COVID-19 (after the event, June 2023), focusing on the characteristics of human resources between before the event and after the event by the comparative analysis. Results Finally, 289 medical institutions were included. There was a statistically significant difference in the number of infection control professionals in medical institutions among 2019, 2022, and 2023 (χ2=189.677, P<0.001). The number of infection control professionals in 2019 was lower than that in 2022 (P<0.001) and 2023 (P<0.001), but there was no statistically significant difference between 2022 and 2023 (P=0.242). The number of infection control professionals per thousand beds in 2019, 2022, and 2023 was 4.40, 6.16, and 5.76, respectively. There was no statistically significant difference between 2019 and 2023 in terms of professional titles, gender, educational level, or professional background (P>0.05). Conclusion Emergency public health events have promoted the increase in the number of infection control professionals, but there is no statistical significance in the professional titles, educational level, or professional background of infection control professionals.
ObjectivTo investigate the incidence of depression and its etiological factors in patients with hypospadias after operation. MethodsFrom January to June 2015, we investigated the incidence of depression symptoms among patients with hypospadias after surgical treatment from January 1990 to December 1994 in Zhangzhou Affiliated Hospital of Fujian Medical University, and we matched them with mentally healthy adults of the same age to 1:1 ratio. Zung Self-Rating Depression Scale and Correlation Factor Questionnaire were used to investigate and analyze the related factors of depression symptoms between the patients with hypospadias and the healthy males. ResultsA total of 80 patients with hypospadias after surgical treatment and 80 healthy males as control were included. There were no significant differences in male secondary sexual development, testis development, serum testosterone levels and postoperative length and girth of the penis in two groups. The incidence rate of depression symptoms was 45.0% (16/80) in the hypospadias patients after operation, extremely significantly higher than 6.3% (5/80) in the control group (χ2=6.632, P=0.01). The result of multiple stepwise regression analysis showed that the main risk factors of depression symptoms were worries about dissatisfaction with penile and scrotal appearance (F=16.210 3, P=0.001), sexual satisfaction (F=4.621 2, P=0.036) and sexual function (F=4.103 2, P=0.043). ConclusionSymptoms of depression often occur in hypospadias patients after operation, and the major etiological factors are dissatisfaction with penile and scrotal appearance, sexual satisfaction and sexual function.
ObjectiveTo analyze the epidemiological characteristics and factors and detection ways of leprosy in Zhushan county in Hubei province, so as to provide scientific basis for developing measures to treat and prevent leprosy after basic elimination. MethodsWe summarized the detection rate, incidence and prevalence of leprosy in Zhushan county in Hubei province during 1955-2012; compared the stage when detecting leprosy, deformity/disability rates and costs according to different detection ways; and conducted descriptive epidemiological analysis. ResultsLeprosy outbreak distribution in Zhushan county in Hubei province covered 17 villages/towns, of which patients were the most in 4 southeast villages/towns. Among 123 cases of patients with leprosy, the youngest aged 4, the oldest aged 74, and the patients aged 20-39 were the most (42.28%); the sex ratio were 1.73 to 1 (male to female); most patients were peasants (83.74%); the main infection sources were family members and neighbours (45.53%, respectively); economic level, health and living condition were the main factors relevant to the prevalence of leprosy; and applying tests in people with foci contact history detected the most patients with leprosy on early stage, which caused the lowest deformity/disability rates. ConclusionWe should consistently strengthen the training of medical personnel; improve medical personnel ability of detecting leprosy; take tests for people with foci contact history and tracking as active detection ways; monitoring patients' family members as well as close contacts during 10-year latent period; and conduct timely tracking, so as to in time detect, isolate, and treat patients with leprosy, reduce the incidence of deformity/disability, and control the transition of leprosy.
Objective To investigate the awareness and clinical needs of wearable artificial kidney among maintenance hemodialysis (MHD) patients, and to analyze the related influencing factors. Methods MHD patients were recruited from 2 tertiary hospitals in Sichuan province between April and June 2021. The convenient sampling method was used to select patients. The factors influencing the awareness and demand of MHD patients for wearable artificial kidney were analyzed. Results A total of 119 MHD patients were included. The awareness of wearable artificial kidney among the patients was mainly “never heard” (61 cases) and “heard” (58 cases). Most MHD patients (60 cases) were willing to use and participate in clinical trials in the future. The results of logistic regression indicated that the cost on household economy and treatment effect on life quality were the influencing factors for MHD patients’ awareness of wearable artificial kidney (P＜0.05). The average duration of single dialysis and the impact of treatment on working or studying were the influencing factors for MHD patients’ needs of wearable artificial kidney (P＜0.05). Conclusions The awareness of wearable artificial kidney is low among MHD patients. However, most MHD patients showed great interest in the wearable artificial kidney after preliminary understanding, suggesting that the future clinical application of wearable artificial kidney has great demand.