ABSTRACT
Objective:Based on the clinical indicators of severe community-acquired pneumonia in emergency department, the early warning indicators of critical condition were constructed.Methods:The general information, vital signs before entering ICU, laboratory indexes and the survival rate in 30 days of 118 patients with community-acquired pneumonia were retrospectively collected in the emergency care unit of Peking Union Medical College Hospital from January to December 2018. The indexes of death patients (24 cases) and alive patients (98 cases) underwent comparative analysis, using ROC curve to predict the clinical outcome and reliable parameters of emergency patients with community-acquired pneumonia. The best cutoff value was determined according to Youden index and then undergoing multiple factors Logistic stepwise regression analysis. Then early warning model of critical degree was finally built.Results:Eleven indicators were used to predict the criticality of patients with acute community-acquired pneumonia, including AVPU (alert, voice, pain, unresponsive) score, Glasgow Coma Scale(GCS), heart rate, pulse oxygen saturation (SpO 2), fraction of inspiration O 2, oxygenation index,potential of hydrogen, blood potassium (K +), bilirubin, urea nitrogen, and C reactive protein, the optimal cutoff values were 2 points, 8 points, 91 times per minute, 0.94, 41%, 81.20%, 7.38, 4.0 mmol/L, 10.90 μmol/L, 2.23 mmol/L, and 41.5 mg/L. Multiple Logistic stepwise regression showed that the independent factors for predicting death were GCS score, SpO 2 and urea nitrogen, and the predictive ability of the early-warning model was 83.7%. Conclusions:GCS score, SpO 2 and urea nitrogen are effective early warning indicators for the severity of severe community-acquired pneumonia in emergency department, which are conducive to the rapid and efficient early identification and treatment of critically ill patients. Therefore, they are worthy of promotion and application in clinical practice.
ABSTRACT
Objective To establish a scientific, operational monitoring and early warning index system for schistosomiasis, so as to provide scientific evidence for promoting the scientification and standardization of early warning system in Poyang Lake Eco-economic Region. Methods Two rounds of Delphi experts’ interviews were applied to construct Index system. The weight value of each indicator was determined by the Analytic Hierarchy process and improvable proportionate allocation method. Reliability, validity of index system and the rationality of index weight distribution can be evaluated in site investigation. Results The Index system included 3 first-order indicators, 9 second-order indicators, and 35 third-order indicators. The 3 first-order indicators were endemic status, environmental and social factors, control measures, with the weight value of 0.531 0, 0.101 5 and 0.367 5, respectively. For the 9 second-order indicators, the highest weight value was for Infection status of human and livestock (0.179 5)and the lowest for social factors(0.050 6). During site investigation, the Cronbach’s alpha and spit half reliability of the total index system and three first-order indicators were all over 0.90, the Kendall W coefficient for the data collected in site investigation and Delphi consultation was 0.742 (P=0.018). Conclusions The Monitoring and Early Warning Index System for Schistosomiasis is suitable for the infection status of Poyang Lake Eco-economic region. The reliability and validity of index system are satisfactory, and the indicator weight distribution is rational.
ABSTRACT
Chinese medicine prices often have sharp rise or fall, and even the impact of short-term price rise on the quality of feed can't be ignored.On the other hand, the production of traditional Chinese medicine is strictly subject to resource constraints, so much of the industrial production due to lack of or prohibited use of resources must bestopped. Based on 203 Chinese patent medicines in the National Essential Drugs (2012 Edition), the factors that influence the supply of essential drugs of traditional Chinese medicine were analyzed and seven indicators for the supply of essential medicines were designed in this paper. According to the Chinese herbal medicine resources survey and dynamic monitoring service system data, a multi-index comprehensive evaluation model based on radar chart analysis was proposed, providing a holistic and overall evaluation of the supply situation of essential drugs of traditional Chinese medicine. The evaluation results were concise, clear and intuitive. In this paper, Jiuwei Qianghuo Wan and Ganmao Qingre Keli were taken as the examples to prove that the proposed comprehensive evaluation method is concise, clear, intuitive, credible and practical.