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Objective:To analyze the changes of hospitalization rates in different regions, medical institutions and populations in China from 2009 to 2019, so as to provide reference for the country to make relevant decisions.Methods:The data of China′s health statistical yearbook from 2009 to 2019 were obtained, and the changes of hospitalization rate and the number of hospitalizations per 100 outpatient and emergency admissions in different regions and medical institutions, and hospitalization rate of different populations and different diseases were analyzed. Descriptive analysis and frequency analysis were used.Results:The hospitalization rate in China continued to rise, from 9.95% in 2009 to 19.03% in 2019. Among them, the hospitalization rate in the eastern, central and western regions increased from 9.7%, 9.9% and 10.8% to 17.0%, 19.3% and 21.5% respectively, with an average annual growth rate of 5.8%, 6.9% and 7.1% respectively. The number of inpatients in public hospitals increased by 1.2 times and that in private hospitals increased by 4.5 times. The number of inpatients in tertiary, secondary and primary hospitals and primary medical institutions increased by 292.9%, 80.8%, 166.4% and 4.5% respectively.From 2009 to 2018, the number of hospitalizations per 100 outpatient and emergency admissions in the hospital increased from 4.5 to 5.7, and decreased to 5.6 in 2019. The increase of hospitalization rate of urban residents was less than that of rural residents. The hospitalization rate of residents aged 0-4 and ≥55 years increased the fastest. In recent years, the discharge diseases were mainly common diseases, chronic diseases and frequently occurring diseases, including pneumonia, acute upper respiratory tract infection, diabetes, and hypertension.Conclusions:During the ten years of medical reform, the hospitalization rate in China has continued to rise, and the overall trend is reasonable. There are significant differences in the changes of hospitalization rates between urban and rural areas, regions and populations in China.
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The pathogenesis of autistic spectrum disorders is complicated and the exact etiology and pathogenesis remain unclear. Major advances in spatial information technology have revealed the potential of spatial information technology as an effective tool in research and treatment for children with autistic spectrum disorders. However, there are too many fragmented research topics. According to recent reports on spatial information technology, there is no precedent for the application of spatial information technology in autistic spectrum disorders in China. Space information technology analysis for autistic spectrum disorders can be divided into the following steps: pre analysis, spatial clustering analysis, spatial model analysis, and interpretation of related results. It is hopeful that the space information technology can provide proposals for the future research on the pathogenesis of autistic spectrum disorders in our country.
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Child , Humans , Autistic Disorder , China , Cluster Analysis , Information Technology , Spatial AnalysisABSTRACT
Evidence-based medicine (EBM) is a kind of clinic practice where clinicians use the best and the latest available evidence to diagnose and treat patients, and both evidence providers and users need to identify and control different kinds of biases in medical research.Directed acyclic graphsis is a tool to explore the causal relationship.The possible biases in the study can be revealed in a simple graphical language.The use of directed acyclic graphs could avoid the occurrence of bias and improve the quality of medical research and better guide clinical practice.
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The particularity and complexity of medical support in the United Nations peacekeeping operations bring various ethical problems to medical staff of the second-grade peacekeeping hospitals during their work.This paper analyzed the ethical dilemma in terms of the relevant provisions of the United Nations,the medical humanitarianism principle,lack of medical resources and the principle of fairness,emergency treatment and informed consent,cultural differences and the principle of optimal health,occupational protection requirements and respect to the human rights.In addition,it discussed the countermeasures from personnel selection,the laws and regulations,the training of medical norms and foreign customs,the concept of “patient-centered”,and the humanitarian treatment,providing a theoretical basis for solving the problems of medical support in peacekeeping operations.
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Objective:To explore the prognosis of posttraumatic stress disorder (PTSD) in flood survivors 13 years after they had been diagnosed with PTSD symptoms,and investigate the relationship between their personality traits and the prognosis of PTSD.Method:In this cross-sectional study,the survivors of Dongting Lake flood in 1998-1999 in Hunan in China,who were investigated and screened as PTSD symptoms positive in 2000 were selected as the target population,from which a sample of 200subjects was drawn using amulti-stage random sampling method.The Posttraumatic Stress Disorder Scale Civilian Version (PCL-C) was used to examine and re-screen the participants of PTSD symptoms in order to explore the prognosis of PTSD.Participants whose PCL-C scores were equal to 44 or higher were classified as the PTSD symptoms positive group,while those with PCL-C scores less than 44 were classified as the recovered group.Personality traits were then assessed,using the Revised Eysenck Personality Questionnaire Short Scale for Chinese (EPQ-RSC),in both the recovered group and the PTSD symptoms positive group.Finally,the multivariate logistic regression analysis was used to investigate the relationship between the prognosis of PTSD and personality traits.Results:Totally 200 subjects were eligible for this study and completed the questionnaires,but 16 of them had their questionnaires excluded from data analysis because they provided incomplete information.Thus,the response rate was 92.0％.According to the PCL-C's cut-off score,22 participants were still screened as PTSD symptoms positive and were classified as the PTSD symptoms positive group,whereas the other 162 participants were screened as PTSD symptoms negative and were classified as the recovered group.Compared with the recovered group,the EPQ-RSC extroversion scores for the PTSD symptoms positive group were significantly lower [(51.8 ± 10.7) vs.(45.1 ± 13.2),P ＜ 0.05] and their neuroticism scores were significantly higher [(46.5 ± 10.1) vs.(58.3 ± 12.2),P ＜ 0.05].The multivariate logistic regression analysis showed,after adjusting for the variables such as gender and age,that higher neuroticism (OR ＝ 3.63,95％ CI:1.05 -12.54) was a risk factor for the persistent PTSD symptoms in the flood survivors.Conclusions:It suggests that neuroticism is associated with prognosis of PTSD in flood survivors,those with higher neuroticism scores appear to have problems to recover from PTSD.
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OBJECTIVE@#To evaluate the effect of video-assisted thoracoscopic sympathectomy at the T4 level on plantar hyperhidrosis in the treatment of palmoplantar hyperhidrosis. @*METHODS@#The clinical data of 28 patients with primary palmoplantar hyperhidrosis, who were admited in our hospital from June 2009 to May 2014, was analyzed. All patients were qualified to bilateral thoracoscopic transaction of the sympathetic chain at the thoracic level T4. Patients completed a self-administered hyperhidrosis questionnaire and scoring before and after procedure. Follow-up data were obtained at 1 and 6 months after the surgery. @*RESULTS@#Endoscopic thoracic sympathectomy at the thoracic level T4 was performed successfully for all cases. Palmar hyperhidrosis was completely alleviated after the operation and no recurrence was observed during follow-up. The ratio for initial improvement of plantar hyperhidrosis was 28.6% (8/28) at 1 month after the surgery followed by a recurrence of plantar hyperhidrosis. No case continued to show the improvement of palmoplantar hyperhidrosis at 6 months after the sympathectomy. Twenty-seven patients (96.4%) were very satisfied with the outcome of the operation, 1 patient (3.6%) satisfied and no patient regretted the surgical procedure. @*CONCLUSION@#T4 thoracoscopic sympathectomy could initialliy alleviate plantar hyperhidrosis in some patients with palmoplantar hyperhidrosis, but the improvement was not sustained over a long period. It could not be used to treat plantar hyperhidrosis.
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Humans , Foot , Hyperhidrosis , Recurrence , Surveys and Questionnaires , Sympathectomy , Sympathetic Nervous System , Thoracic Surgery, Video-AssistedABSTRACT
Objective To explore the long-term prognosis and influence of social support and coping style of patients with post-traumatic stress disorder (PTSD) after suffering from floods.Methods Patients suffered PTSD due to Dongting lake flood in 1998 were selected through cluster random sampling.PTSD scale civilian version (PCL-C) was used to examine and diagnose the participants in this study.PTSD was then evaluated by the social support rating scale (SSRS) and the simple coping style questionnaire (SCSQ).Results Among all the 120 subjects,14(11.67％) of them were diagnosed as having PTSD.Compared with the rehabilitation group,scores on subjective support,objective support,total social support and positive coping,total of coping style from the nonrehabilitation group all appeared significant low (P＜0.05).Data from the multivariate logistic regression showed that social support (OR=0.281,95％CI:0.117-0.678) and coping style (OR=0.293,95％ CI:0.128-0.672) were protective factors of the chronic PTSD after the floods while disaster experience (OR=1.626,95％CI:1.118-2.365) appeared as a risk factor.Conclusion Chronic PTSD developed after the floods called for attention.Better social support,positive coping style could significantly improve the long-term prognosis of patients with PTSD after the floods.
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Objective To explore the long-term prognosis and influence of social support and coping style of patients with post-traumatic stress disorder (PTSD) after suffering from floods.Methods Patients suffered PTSD due to Dongting lake flood in 1998 were selected through cluster random sampling.PTSD scale civilian version (PCL-C) was used to examine and diagnose the participants in this study.PTSD was then evaluated by the social support rating scale (SSRS) and the simple coping style questionnaire (SCSQ).Results Among all the 120 subjects,14(11.67％) of them were diagnosed as having PTSD.Compared with the rehabilitation group,scores on subjective support,objective support,total social support and positive coping,total of coping style from the nonrehabilitation group all appeared significant low (P＜0.05).Data from the multivariate logistic regression showed that social support (OR=0.281,95％CI:0.117-0.678) and coping style (OR=0.293,95％ CI:0.128-0.672) were protective factors of the chronic PTSD after the floods while disaster experience (OR=1.626,95％CI:1.118-2.365) appeared as a risk factor.Conclusion Chronic PTSD developed after the floods called for attention.Better social support,positive coping style could significantly improve the long-term prognosis of patients with PTSD after the floods.
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OBJECTIVE@#To assess the quality of life in patients with primary palmar hyperhidrosis before and after T4 endoscopic thoracic sympathicotomy (ETS) using the modified rating scales system for life quality. @*METHODS@#Between June, 2009 and May, 2014, forty-eight patients with primary palmar hyperhidrosis received ETS at the thoracic level T4. Patients completed self assessment of life quality by the modified rating scales system before and after the surgery. Follow-up data including effectiveness of operation, patient satisfaction and life quality were obtained at 1 and 6 months after the surgery. @*RESULTS@#ETS at the thoracic level T4 was performed successfully for all cases. No mortality or serious complications were observed. No one needed thoracotomy in the period of surgery. Mild or moderate compensatory sweating was appeared in 38 cases (79.1%) or 1 case (2.1%), respectively. None severe case was observed after T4 ETS. About 97.9% of the patients were very satisfied with the result of the operation and no patient regretted the surgical procedure. All patients answered the quality of life (QoL) questionnaire and showed the improvement of QoL after the procedure (F=763.67, P<0.001). @*CONCLUSION@#Primary palmar hyperhidrosis led to the reduction of life quality. ETS at T4 level could reduce sweating production and improve QoL in patients with primary palmar hyperhidrosis.
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Humans , Endoscopy , Hyperhidrosis , General Surgery , Patient Satisfaction , Quality of Life , Surveys and Questionnaires , Sweating , Sympathectomy , Thoracotomy , Treatment OutcomeABSTRACT
According to the practical problems including uneven distribution of medical resources in border areas , the difficulty of medical treatment for grass-roots unit, the low efficiency of referral between hospitals , and untimely mastery of health conditions of offi-ciers and soldiers , we constructed and developed a telemedicine information system based on hospital medical database with the backig of military integrated information network platform .A joint regional service platform among hospitals was constructed to realize high efficien -cy of medical referrals for officers and soldiers , computerization of personal medical information transmission , digitalization of health re-cords management , and paperless medical audit .The system provides convenient and high quality health care services , improves the level and efficiency of medical service , and enhances the ability of medical support to the troops by informationization .
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A biomedical entity association evolution network was constructed by mining the implicit associations in PubMed-covered literature, which can help scientific researchers to form new scientific hypotheses, to analyze the topological features of associated network, to study the scientific literature-enriched knowledge structure, associa-tions, development rules, to introduce new visual angles and methods for literature-based knowledge discovery, and to improve the knowledge discovery efficiency.
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In the present study, packaging system composed of pAAV-CMV-GFP, pAAV-RC and pHelper were transfected into human embryonic kidney 293 cells (HEK293 cells) mediated by polyethyleneimine (PEI) to explore an optimal transfection condition. Different total plasmid DNA dosages (1, 2, 3, 4, 5, 6 μg) and different PEI/Plasmid ratios (1:1, 3:1, 5:1, 7:1) were tested with detection of green fluorescence protein (GFP) with ImagePro Plus6. 0 Software. Then transfection efficiency of the optimized transfection system was further observed for different time periods(12, 24, 36, 48, 60, 72 h). The results showed that total plasmid dosage of 4 μg/well with PEI/plasmid ratio of 3 : 1-5 : 1 was an efficient transfection condition. Transfection efficiency-time curve was an S-shaped curve. Transfection efficiency reached a plateau at 60 h after transfection. The optimized conditions for PEI-mediated transfection at the optimal time result in enhanced transfection efficiency of triple plasmid into HEK293 cells.
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Humans , Green Fluorescent Proteins , HEK293 Cells , Plasmids , Polyethyleneimine , Transfection , MethodsABSTRACT
Iliac arteriovenous ifstula (AVF) usually manifests in a wide range of symptoms similar to typical deep venous thrombosis (DVT), which often lead to delayed diagnosis or misdiagnosis. We reported a 51-year old woman who was performed lumbar discectomy and showed a progressive abdominal distention, dyspnea, and swollen left leg. She was initially diagnosed as deep vein thrombosis and the ifnal diagnosis was arteriovenous ifstula. hTe ifstula was successfully sealed by an endovascular covered stent. No further recurrence was found atfer a half year’s follow-up. hTis article summarized the experience regarding iliac arteriovenous ifstula misdiagnosed, and discussed the differential diagnosis between arteriovenous ifstula and pulmonary thromboembolism causedby deep vein thrombosis.
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Objective: To analyze the clinical characteristics of young patients with acute myocardial infarction (AMI), discuss the key points of health education in young patients with AMI, enhance the understanding of patients, and improve the prognosis of AMI in the young patients. Methods: hTe patients were chosen in XiangyaHospital from September 2012 to September 2013. We consulted the medical records, analyzed the clinical characteristics and results of coronary angiogram in young patients (age≤45), and compared with old patients (age≥60). Results: There were 69 young patients with AMI, about 14.2% of all the patients with AMI. Of the 69 young patients, 59 were male (85.5%) and 10 were female (14.5%). Compared with the old patients, the percentages of smoking, drinking, hyperlipidemia and overweight were much higher;the percentages of hypertension and diabetes were much lower in young patients. The coronary angiogram showed that the constituent ratios of insigniifcant disease and single-vessel disease inthe young patients were higher than those in the old patients; the constituent ratios of double-vessel disease and triple-vessel disease in the young patients were lower than those in the old patients. Conclusion: The clinical characteristics of young patients withAMI are different from the old patients.Health education should be conducted in the youth, and new diet and lifestyle should be advocated.
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To explore the relationship between posttraumatic stress disorder [PTSD] and preflood behavioral characteristics among children aged 7-15 years in Hunan, China. In 2000, a retrospective study was carried out among children who had been exposed to the 1998 floods in Hunan. A multistage sampling method was used to select subjects from the flood-affected areas. A structured questionnaire administered to the children selected was used to diagnose PTSD based on the DSM-IV criteria. A parent questionnaire was used to measure preflood behavioral characteristics related to health, behavioral, and habit problems. The association between PTSD and preflood behavioral characteristics was assessed using chi[2]-tests and multivariate logistic regression. A total of 7,038 children from 13,450 households, aged 7-15 years, were investigated. The overall prevalence of PTSD was 2.05%. Generally, the PTSD-positive rate increased with increasing scores for behavioral characteristics. Preflood behavioral characteristics are an important factor influencing the prevalence of PTSD among children exposed to floods. It is therefore necessary to give special attention to children with behavioral problems in order to reduce the psychological impact of floods
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Objective To investigate the infection of hemorrhagic fever with renal syndrome (HFRS) in host animals and inapparent infection of HFRS in general population in Dongting Lake areas after floods. Methods The night trapping method was used to capture rodents. The immunofluorescence assays were used to detect the hantavirus (HV) antigens and antibodies in rodents lung and in the serum of general population. Nonconditional logistic regression was applied to analyze risk factors for inapparent infection with HV. Results In flood region,draw-near flood region and new migration region,rodent density was 6.95%,6.28%, and 8.67%, respectively, and the virus-carrying rate in rodents was 15.07%,9.25%, and 4.47%, respectively. The virus-carrying rat index was the highest in flood region (0.10). Apodemus agrarius was the dominant species. The standardized positive rate of HV antibody in general population from above mentioned regions was 4.49%, 3.11%, and 3.13%, respectively. There was no significant difference among different age or gender groups. The results of logistic regression analysis indicated that people who were involved in construction of water conservancy facilities in winter or practice of rat extermination at home were the principal factors related to inapparent infection with HV. Conclusion The virus-carrying rate in main host animals of HV in the 3 regions is high, whereas the positive rate of HV antibody is low in general population. Comprehensive measures should be taken to prevent and control HFRS, such as reinforcing surveillance of HFRS, strengthening deratization, and preventive inoculation.
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OBJECTIVE@#To investigate the infection of leptospirosa of host animals and the immune level of healthy population in flood areas.@*METHODS@#Korth culture was used to culture leptospira for rodent kidney and oxen urine sample. The serogroups of leptospira and leptospira antibody were tested by microscopic agglutination test (MAT).@*RESULTS@#In flood regions, draw-near-flood region, and new migration region, rodent density was 6.95%, 6.28%, and 8.67%, respectively. The positive rates of rodent with leptospira was 4.63%, 1.35%, and 3.13%, respectively. Leptospira positive rates of oxen urine were 5.88%, 5.98%, and 1.75%, respectively. The main serogroup of leptospira was Icterhamorrhagic and Canicola serogroup. The positive rates of leptospirosa antibody in healthy population was 45.91%, 62.30%, and 58.67%in these 3 regions respectively, which was significantly higher than the average level in China. The dominant serogroups of leptospira in health population were icterhamorrhagic, autumnalis, canicola, pomona and bataviae. The positive rate of antibody had no difference among different age groups.@*CONCLUSION@#The main host animals are rodents and oxen infected with leptospira and the positive rate of leptospira antibody is high in healthy population in the study area. The dominant serogroups in host animals are similar to that in healthy population, which is mostly icterhaemorrhagic.
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Animals , Cattle , Humans , Rats , Antibodies, Bacterial , Blood , Urine , China , Epidemiology , Disasters , Floods , Leptospira interrogans , Allergy and Immunology , Leptospirosis , Epidemiology , Prevalence , Seroepidemiologic StudiesABSTRACT
Objective:To explore the incidence of PTSD and its risk factors among adults in flood district.Methods:Diagnostic and Statistical Manual of Mental Disorders(Ⅳ Edition) were used to examine and diagnose the victims.Results:The positive rate of PTSD was 33.8%.The results of logistic regression analysis showed that style of flood (OR=4.07),having been besieged by the flood when waiting for resue(OR=2.65),seeing other people drowned by flood(OR=2.77),having the experience of staying with the dead in flood(OR=3.14) and level of satisfaction with sustaining(OR=0.72) were risk factors.Conclusion:PTSD is a not uncommon mental disorder among adults in flood district in our country and psychosocial intervention is needed.
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Objective In order to explore the incidence of PTSD and its risk factors after flood. Methods Diagnostic and Statistical Manual of Mental Disorders (Ⅳ Edition) was used to examine and diagnose the victims in flood district. Results The positive rate of PTSD was 30 9%.The results of logistic regression analysis showed that sex(OR=2 32), age (OR=1 83),style of flood (OR=3 71)and dissatisfaction for sustaining (OR=0 84)were risk factors. Conclusions PTSD is a common mental disorder after flood in our country. Preventive measures should be taken to protect population from PTSD in flood district.
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Objective: To observe the oral care effects of finger toothbrush. Methods: The finger toothbrush worn on the index finger was made of silica gel .It was used to brush the in vitro healthy teeth pulled out on the same day and the standard hard plaster tooth model and to brush the in vivo healthy teeth in adults; the bacteria in the finger toothbrush, The dentofacial pluque and the abrasion on the tooth model were tested respectively. Results: After in vivo use the bacteria remained in the finger toothbrush were fewer than those in the commonly used toothbrush(1 683.24?1 355.59 and 2 353.76?1 582.06 respectively). The dentofacial plaque was decreased in the same extent by the two kinds of toothbrushes. The zero rate of abrasion on the tooth model was 93.3%(28/30) by finger toothbrush and 23.3%(14/30) by the commonly used toothbrush. Conclusion: The finger toothbrush worn on finger can remove dentofacial plaque effectively and produce a lower abrasion on tooth.