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Objective:To evaluate the ophthalmic service ability of county hospitals in China based on the improved DS evidence theory.Methods:Convenient sampling method was used to select the data of ophthalmology department of 9 county hospitals in eastern, central and Western China in 2019. The improved DS evidence theory method based on Mahalanobis distance weight coefficient was applied to evaluate the medical service ability, and the evaluation results were compared with the classical evidence theory method.Results:The regional development of ophthalmic service capacity in counties of China was uneven, and there were regional differences in the evaluation results of some indicators. Hospitals in the eastern region were generally leading in the evaluation of a number of indicators related to the amount of medical services. The numbers of inpatient operations, outpatient operations, bed turnover times, bed utilization rate, number of inpatients, number of outpatients, number of patients in the eastern region were 3.25, 1.60, 1.81, 1.61, 2.64, 2.63 and 4.47 times of the numbers of hospitals in western region. Compared with the classical evidence theory method, the analysis results of the improved DS evidence theory method were consistent with the actual business development of each hospital, and the evaluation results were credible, which could more effectively reduce the uncertainty in the evaluation results.Conclusions:Ophthalmic service ability of county hospitals in China needs to be continuously improved. Improved DS evidence theory can be adopted to make continuous evaluation.
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<p><b>OBJECTIVE</b>To investigate the prospective association of fibroblast growth factor 21 (FGF-21) with NAFLD development in a 5-year prospective study involving a population-based cohort comprising 352 Chinese subjects.</p><p><b>METHODS</b>The clinical data of subjects were recorded, serum FGF-21 levels at baseline and follow-up were measured using an enzyme-linked immunosorbent assay,whether FGF-21 was independent predictor of NAFLD development were identified using logistic regressions. Chi-square test, non-parametric test and logistic regression analysis were used in statistical analyses.</p><p><b>RESULTS</b>(1) Serum FGF-21 levels of NAFLD group was significantly higher than that of non-NAFLD group (318.34(169.64,520.77)pg/ml vs 197.22 (121.57, 318.76) pg/ml, Probability value less than 0.05). (2)At follow-up,significant increase of FGF-21 level was observed in those subjects who developed NAFLD (399.4 (253.9,754.2) pg/ml vs 318.34(169.64, 520.77)pg/ml, Probability value less than 0.05), but in non-NAFLD group, there was no significant difference of FGF-21 level between baseline and follow-up. (3) BMI, TC, HOMA-IR and FGF-21 were independent predictors of NAFLD through logistic regressions.</p><p><b>CONCLUSION</b>High FGF-21 levels was independent predictor of NAFLD, it may be useful for early diagnosis and intervention of NAFLD.</p>
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Humans , Enzyme-Linked Immunosorbent Assay , Follow-Up Studies , Interleukins , Logistic Models , Non-alcoholic Fatty Liver Disease , Prospective StudiesABSTRACT
Objective To explore the value of carbox dioxide(CO2 )for the upper gastrointestinal endoscopic mucosal dissection(ESD).Methods A total of 158 patients who underwent ESD from January 2012 to May 2014 at Endoscopy Center of Dongguan Hospital were enrolled in the study.The patients were randomly divided into air group and CO2 group.The arterial partial pressure of CO2 (PaCO2 ),the monitering results of SpO2 before,during,afte operation,abdominal pain after operation and postoperative complications were assessed.The safety and advantage of CO2 of the upper gastrointestinal ESD were comparative ana-lyzed.Results PaCO2 of air group and CO2 group during the ESD procedures [(47.8 ±5.4)mmHg, (45.1 ±5.5)mmHg]was significantly higher than that before[(37.2 ±4.6)mmHg,(36.3 ±3.9)mmHg] (P 0.05);all the SpO2 were greater than 90%,and it was not significantly different between the two groups(P >0.05). The abdominal pain score of CO2 group was significantly lower than that of air group less than 2 h after wake-up (P 0.05).The bleeding rate of air group and CO2 group during and after operation was not significantly different (P >0.05),and there were no other serious complications.Conclusion CO2 is safe in the upper gastroin-testinal ESD,and it can reduce postoperative abdominal pain,so it is suitable for clinical application.
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Objective To explore the application of CO2 as an insufflation agent in patients under-going colonoscopy by comparing carbon dioxide(CO2 )and air.Methods Consecutive 681 patients who un-derwent conventional colonoscopy from January to May in 2014 at endoscopy center of our hospital were in-cluded.The patients were randomly divided into the air group and CO2 group.The gas flow,capacity,oper-ation time,PaCO2 and abdominal pain during and 20 min,40 min,1 h,2 h,12 h,24 h after colonoscopy were recorded.The safety and advantages of CO2 in the colonoscopy were analyzed.Results The intubation time of CO2 group was significantly shorter than that of air group (P 0.05).There was also no difference in air flow and the total volume between the two groups (P >0.05).PaCO2 of two groups were within the nor-mal range.PaCO2 during examination was significantly higher than that before and 20 minutes after examina-tion (P 0.05).The abdominal pain scores during and 20 min,40 min,1 h,2 h after the examination of air group were signifi-cantly higher than those of CO2 group (P 0.05).Conclusion CO2 is safe and could reduce abdominal discomfort after colonoscopy,which is suit-able for clinical application.