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OBJECTIVE： To investigate and analyze the channels by which doctors obtain related information of diagnosis and treatment about diseases， and to provide reference for management institutions to understand related information and execute continue education. METHODS： 14 public general hospitals （12 were second grade class A， 2 were third grade class A） with grade Ⅱ and above in Tangshan were selected， and a self-designed questionnaire was used to conduct a one-to-one paper questionnaire survey on the doctors on duty. The content of the survey focused on the channels to obtain related information of diagnosis and treatment （including internal communication platform for medical experts， professional Chinese medical journals， professional medical network media， professional medical training classes/courses and professional medical academic conferences）. The channels to access relevant information on diagnosis and treatment were analyzed from the hospital level， department， professional title， education backgrounds and medical years. RESULTS： A total of 2 536 questionnaires were sent out， and 2 105 questionnaires were recovered （recovery rate of 83.0％）， among which there were 2 047 valid questionnaires （effective rate of 97.2％）. Doctors in third grade hospitals obtain more relevant information through “professional Chinese medical journals” “professional medical network media” “professional medical training classes/courses” “professional medical academic conferences” and than doctors in second grade hospitals （P＜0.05 or P＜0.01）； there was no statistical significance among different departments （P＞0.05）. Doctors with deputy chief physician or above title chose “internal communication platform for medical experts” “professional Chinese medical journals” and “professional medical academic conference” more than doctors with attending physician or below title （P＜0.05 or P＜0.01）. The proportion of doctors with master’s degree or above choosing “professional Chinese medical journals” “professional medical network media” and “professional medical academic conferences” were significantly higher than that of doctors with bachelor’s degree or below （P＜0.05 or P＜0.01）. The proportion of doctors who had been in medicine experience for 11 years or more choosing “professional Chinese medical journals” and “professional medical training classes/courses” were higher than that of doctors who had been in medicine experience for 10 years or less （P＜0.05 or P＜0.01）. Overall， the doctors who choosing “internal communication platform for medical experts” and “professional medical network media” was significantly higher than that of doctors choosing “professional Chinese medical journals” “professional medical training classes/courses” and “professional medical academic conferences” （P＜0.001）. CONCLUSIONS： Doctors are more likely to choose “internal communication platform for medical experts” and “professional medical network media” channels to obtain disease diagnosis and treatment information. Medical experts’ inner exchange platforms and professional medical network media can be effectively used as an important way for medical staff to conduct continue education and improve the level of disease diagnosis and treatment.
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Objective To survey the survival status, functional status, marital status and the present situation of the survival patients with spinal cord injury 40 years after Tangshan earthquake. Methods From February to May, 2016, a total of 216 patients with spinal cord injury were surveyed with questionnaire, in which 139 cases lived centralized and 77 cases lived scattered. The questionnaire was self-designed and included eleven items and 51 questions, which related to ability of daily life, marital status, employment status and socioeconomic status and so on. Results A total of 960 (25.15%) patients with spinal cord injury survived 40 years after Tangshan earthquake. In 216 surveyed pa-tients, the employment rate was 9.3%, the married rate was 53.2%, and 44.9%earned less than 500 yuan every month. The incidence was 25.9%for pressure score, 50.50%for neuralgia (severe pain accounted for 23.51%), and 19.40%for urinary tract stones. 56%of patients could take their own basic self-care. Conclusion There were many problems such as high complication rate, low employment rate and poor economic condition in the spinal cord injury group 40 years after Tangshan earthquake.
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Objective To analyze the clinical characteristics and risk factors for adult community-acquired pneumonia (CAP) caused by Gram-negative bacilli in Tangshan, and provide reference for the early identification of Gram-negative bac?teria CAP and the clinical use of antibiotics. Methods Data of retrospective general information, physical examination, aux?iliary examination and pathogen were collected in patients with CAP in respiratory department from 6 hospitals in Tangshan between October 2011 to September 2012. According to the above data, the prognosis of patients with the team score (PORT) was calculated. The sputum samples were isolated for pathogen identification. Univariate logistic regression analysis and multivariate logistic regression analysis were performed for risk factors of Gram-negative bacilli. Results A total of 195 strains were isolated from 172 (32.45%) patients in 530 patients with CAP. There were 154 strains of Gram-negative ba?cilli (78.97%) and 41 strains of Gram-positive bacteria (21.03%) in 195 bacterial strains. Univariate logistic regression anal?ysis showed the possible risk factors of Gram-negative bacilli in patients with CAP including age≥65 years old, using antibi?otics before hospitalization, basic diseases, cerebrovascular disease, malnutrion, white blood cell abnormal, neutrophil count17.1μmol/L and blood urea nitrogen>7.1 mmol/L. Multivariate logistic regression analysis showed the independent risk factors of Gram-negative bacilli in patients with CAP including us?ing antibiotics before hospitalization (OR=2.327, 95%CI 1.453-3.725), white blood cell abnormal (OR=2.904, 95%CI 1.879-4.490), PORT classification≥Ⅲ(OR=3.839, 95%CI 2.427-6.071), and blood urea nitrogen elevated (OR=4.133, 95%CI 2.585-6.606). Conclusion Clinical empirical anti-infection treatment should consider the risk factors including using antibiotics before hospitalization, white blood cell abnormal, PORT classification≥Ⅲ and blood urea nitrogen>7.1 mmol/L in patients with susceptible to Gram-negative bacteria infection.
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@#This paper summarized the 20-year work of recovery of the patients with spinal cord in-jury(SCI)caused by earthquake in Tangshan in 1 9 76.The rehabilitation experience of the patients withSCI during different stages was discussed.
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Objective: To study the long-term effect of Tangshan earthquake on psychosomatic health of paraplegic suffers. Method: 64 paraplegic suffers of Tangshan earthquake and 64 normal controls were interviewed and assessed with self made questionnaire for psychosomatic health, SCL-90, SAS, SDS, CMI (Cornell Medical Index) and SSRS (Social Support Rating Scale). Results: 6 patients (9%) were diagnosed as PTSD according to CCMD-2-R, this rate was higher than that of normal citizen experienced the earthquake. 32 patients had Acute Stress Reaction. At present, patients' group had poorer mental health than control reflected by SCL-90, SAS, SDS and CMI. Conclusion: The severity of trauma both mentally and physically has great influence on mental health of suffers even after 25 years.