Policy Evolution,Implementation Dilemma and Breakthrough on Medical Service Price Items Normative Management and Its Enlightenment / 中国卫生经济

It reviewed the policies related to the standardized management of medical service price items,analyzed the current difficulties in the implementation of medical service price regulations:the technical specifications of national medical service price item are heavy and cannot be dynamically adjusted with technological innovation;provincial level item access control is not strict,and the elements of the same price item are not completely unified,affecting the horizontal comparison.The policy suggestions to speed up the improvement of the medical service price item specifications include:medical services that are allowed to be applied and have clear technical specifications are accepted as the scope of new price item declaration;promote the separation of technology and consumption,except for consumables and reagents,which are priced separately according to service items+special consum-ables;priority should be given to responding to the legitimate demand for medical technology improvement innovations through cur-rent price item compatibility;contrast technical specifications and item guidelines,integrating current price items,improving item standardization and compatibility;complete the innovation and economic evaluation of the newly declared item price,check the quality,and reasonably determine the increment.

Diet of crab-eating fox (Cerdocyon thous) in two conservation units of the Amazon rainforest, Brazil

Abstract The present study aimed to evaluate the diet of the free-living crab-eating fox by identifying the stomach contents of the 17 crab-eating foxes (Cerdocyon thous) roadkilled in two conservation units, both located in the Amazon rainforest. The food items were quantified by frequency of occurrence (FO) and percentage of occurrence (PO). The stomach contents were analysed for dry matter (DM), crude protein (CP), crude fibre (CF), ether extract (EE), and mineral matter (MM). Nitrogen-free extractives (NFE), metabolisable energy (ME) values, as well as the energy need for maintenance were estimated. The composition of the diet for the crab-eating fox presented 29 food items from the different taxonomic groups, with a greater diversity of items of animal origin (n=22), although the highest frequency of occurrence was gramineae (Poaceae) (41.18%). Among the items of animal origin, 21% were mammals, 18% reptiles, 10% amphibians, 9% invertebrates and 3% birds. A high content of CF (62.76%) were determined. Nitrogen-free extractive and dry matter averages were 5.91% and 141.82 kcal/100g, respectively. The average maintenance energy was 447.01 kcal/day. These findings suggesting that the crab-eating foxes have a generalist diet with an omnivorous diet in the Amazon basin, feeding on gramineae, fruits, insects, snakes, amphibians, birds and small mammals and have the same feeding habit that present in other Brazilian biomes.

Resumo Este estudo objetivou analisar a dieta do cachorro-do-mato, de vida livre, por meio da identificação do conteúdo estomacal de 17 Cerdocyon thous atropelados em duas unidades de conservação da Floresta Amazônica. O conteúdo estomacal foi analisado e os itens alimentares foram quantificados pela frequência de ocorrência (FO) e percentagem de ocorrência (PO). Também foram avaliados os teores de matéria seca (MS), proteína bruta (PB), fibra bruta (FB), extrato etéreo (EE) e, matéria mineral (MM). Foram estimados o extrativo não-nitrogenado (ENN), a energia metabolizável (EM) e a necessidade energética de manutenção. A composição da dieta do cachorro-do-mato apresentou 29 itens alimentares dos diferentes grupos taxonômicos, tendo uma maior diversidade de itens de origem animal (n=22), ainda que a maior FO tenha sido de gramíneas (Poaceae) (41.18%). Dentre os itens de origem animal, 21% eram mamíferos, 18% répteis, 10% anfíbios, 9% invertebrados e 3% aves. Determinou-se um alto teor de FB (62.76%). A média do ENN e da MS foi 5.91% e 141.82 kcal/100g, respectivamente. A média da energia de manutenção foi 447.01 kcal/dia. Estes achados sugerem que o cachorro-do-mato encontrado na Bacia Amazônica é um animal generalista com uma dieta onívora, se alimentando de gramíneas, frutos, insetos, serpentes, anfíbios, aves e pequenos mamíferos, portanto com o mesmo hábito alimentar relatado a esta espécie quando encontrada em outros biomas brasileiros.

Diet of crab-eating fox (Cerdocyon thous) in two conservation units of the Amazon rainforest, Brazil / Dieta do cachorro-do-mato (Cerdocyon thous) em duas unidades de conservação da Floresta Amazônica, Brasil

Abstract The present study aimed to evaluate the diet of the free-living crab-eating fox by identifying the stomach contents of the 17 crab-eating foxes (Cerdocyon thous) roadkilled in two conservation units, both located in the Amazon rainforest. The food items were quantified by frequency of occurrence (FO) and percentage of occurrence (PO). The stomach contents were analysed for dry matter (DM), crude protein (CP), crude fibre (CF), ether extract (EE), and mineral matter (MM). Nitrogen-free extractives (NFE), metabolisable energy (ME) values, as well as the energy need for maintenance were estimated. The composition of the diet for the crab-eating fox presented 29 food items from the different taxonomic groups, with a greater diversity of items of animal origin (n=22), although the highest frequency of occurrence was gramineae (Poaceae) (41.18%). Among the items of animal origin, 21% were mammals, 18% reptiles, 10% amphibians, 9% invertebrates and 3% birds. A high content of CF (62.76%) were determined. Nitrogen-free extractive and dry matter averages were 5.91% and 141.82 kcal/100g, respectively. The average maintenance energy was 447.01 kcal/day. These findings suggesting that the crab-eating foxes have a generalist diet with an omnivorous diet in the Amazon basin, feeding on gramineae, fruits, insects, snakes, amphibians, birds and small mammals and have the same feeding habit that present in other Brazilian biomes.

Resumo Este estudo objetivou analisar a dieta do cachorro-do-mato, de vida livre, por meio da identificação do conteúdo estomacal de 17 Cerdocyon thous atropelados em duas unidades de conservação da Floresta Amazônica. O conteúdo estomacal foi analisado e os itens alimentares foram quantificados pela frequência de ocorrência (FO) e percentagem de ocorrência (PO). Também foram avaliados os teores de matéria seca (MS), proteína bruta (PB), fibra bruta (FB), extrato etéreo (EE) e, matéria mineral (MM). Foram estimados o extrativo não-nitrogenado (ENN), a energia metabolizável (EM) e a necessidade energética de manutenção. A composição da dieta do cachorro-do-mato apresentou 29 itens alimentares dos diferentes grupos taxonômicos, tendo uma maior diversidade de itens de origem animal (n=22), ainda que a maior FO tenha sido de gramíneas (Poaceae) (41.18%). Dentre os itens de origem animal, 21% eram mamíferos, 18% répteis, 10% anfíbios, 9% invertebrados e 3% aves. Determinou-se um alto teor de FB (62.76%). A média do ENN e da MS foi 5.91% e 141.82 kcal/100g, respectivamente. A média da energia de manutenção foi 447.01 kcal/dia. Estes achados sugerem que o cachorro-do-mato encontrado na Bacia Amazônica é um animal generalista com uma dieta onívora, se alimentando de gramíneas, frutos, insetos, serpentes, anfíbios, aves e pequenos mamíferos, portanto com o mesmo hábito alimentar relatado a esta espécie quando encontrada em outros biomas brasileiros.

Re-evaluation of systematic reviews of acupuncture and moxibustion for childhood autism / 中国针灸

OBJECTIVE@#To re-evaluate the systematic review/Meta-analysis of acupuncture and moxibustion for childhood autism (CA), aiming to provide decision-making basis for clinical diagnosis and treatment.@*METHODS@#The systematic review and/or Meta-analysis of acupuncture and moxibustion for CA were searched in PubMed, EMbase, Cochrane Library, SinoMed, CNKI and Wanfang databases. The retrieval time was from the database establishment to May 5th, 2022. PRISMA (preferred reporting items for systematic reviews and Meta-analyses) was used to evaluate the report quality, and AMSTAR 2 (a measurement tool to assess systematic reviews 2) was used to evaluate the methodological quality, bubble map was used to construct the evidence map and GRADE was used to evaluate the quality of evidence.@*RESULTS@#A total of 9 systematic reviews were included. The PRISMA scores ranged from 13 to 26. The report quality was low, and there was a serious lack in the aspects of program and registration, search, other analysis and funding. The main problems in methodology included not making prespecified protocol, incomplete retrieval strategy, not providing a list of excluded literatures, and incomplete explanation on heterogeneity analysis and bias risk. The evidence map showed that 6 conclusions were valid, 2 conclusions were possible valid and 1 conclusion was uncertain valid. The overall quality of evidence was low, and the main factors leading to the downgrade were limitations, followed by inconsistency, imprecision and publication bias.@*CONCLUSION@#Acupuncture and moxibustion has a certain effect for CA, but the quality of reporting, methodology and evidence in included literature need to be improved. It is suggested to perform high-quality and standardized research in the future to provide evidence-based basis.

On-Site Assessment of a Cryogenic Disinfectant for the Alpine Environment and Outer Packaging of Frozen Items / 生物医学与环境科学（英文）

OBJECTIVE@#To study the effectiveness and feasibility of cryogenic disinfectants in different cold scenarios and analyze the key points of on-site cryogenic disinfection.@*METHODS@#Qingdao and Suifenhe were selected as application sites for the manual or mechanical spraying of cryogenic disinfectants. The same amount of disinfectant (3,000 mg/L) was applied on cold chain food packaging, cold chain containers, transport vehicles, alpine environments, and article surfaces. The killing log value of the cryogenic disinfectant against the indicator microorganisms ( Staphylococcus aureus and Escherichia coli) was used to evaluate the on-site disinfection effect.@*RESULTS@#When using 3,000 mg/L with an action time of 10 min on the ground in alpine regions, the surface of frozen items, cold-chain containers, and cold chain food packaging in supermarkets, all external surfaces were successfully disinfected, with a pass rate of 100%. The disinfection pass rates for cold chain food packaging and cold chain transport vehicles of centralized supervised warehouses and food processing enterprises were 12.5% (15/120), 81.67% (49/60), and 93.33% (14/15), respectively; yet, the surfaces were not fully sprayed.@*CONCLUSION@#Cryogenic disinfectants are effective in disinfecting alpine environments and the outer packaging of frozen items. The application of cryogenic disinfectants should be regulated to ensure that they cover all surfaces of the disinfected object, thus ensuring effective cryogenic disinfection.

The analysis of risk factors and strategies of surgical items count near misses / 中国实用护理杂志

Objective:To describe the characteristics and analyze risk factors for surgical items count near-miss errors stemming from the self-incident reports of staff nurses from operating room, to reduce the risk of counting surgical items and prevent the occurrence of the relative adverse events.Methods:This was a retrospective study. Used the self-made checklist to retrospect the surgical items count errors, relative characteristics and reasons from the operating room nurses of Department of Anesthesiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University reported from January 2017 to December 2021. Grey Relational Analysis was used to analyze and identify the risk elements.Results:A total of 98 surgical items count near-miss errors were reported by nurses.The unclear items were mainly classified into 6 categories, of which 52.04% (51/98) were disposable surgical items, 24.49% (24/98) were fine parts of surgical instruments, 14.28% (14/98) were implants, 5.10% (5/98) were electrosurgical instruments, 3.06% (3/98) were power systems, and 1.02% (1/98) were medical lasers; the disposable surgical items were the highest risk of surgical items count near-miss errors (non-standard behaviors of surgeons ξ 1=0.333); among the 9 risk factors, non-standard behaviors of surgeons ( r1 = 0.673), instrument nurses improper operation ( r4 = 0.691) and surgeons errors ( r2 = 0.693) were the most important influence factors. Conclusions:Analyzing the possible system risk factors resulting from the near-miss error could be a useful method for nurses to generate hierarchical risk-control strategies and improve surgical items count safety for patients. This com prerent the occurrence of adverse events.

Attention Situation of Chinese Patent Medicine for Constipation in Traditional Chinese Medicine Diagnosis and Treatment Guidelines/Consensus and National Reimbursement Drug List / 中国实验方剂学杂志

ObjectiveTo evaluate the methodological quality of traditional Chinese medicine （TCM） diagnosis and treatment guidelines/consensus of constipation with Appraisal of Guidelines for Research and Evaluation Ⅱ （AGREE Ⅱ）tool， and to study the attention situation of the included Chinese patent medicines in China's National Reimbursement Drug List in the guidelines/consensus. MethodThe data of CNKI，VIP，Wanfang Data，SinoMed，PubMed and Cochrane from the inception of the databases to October 2021 were searched to collect the TCM diagnosis and treatment guidelines/consensus of constipation. Then，the diagnosis and treatment standards and recommended Chinese patent medicines were extracted. Two researchers assessed the methodological quality of the guidelines/consensus with AGREE Ⅱ tool independently. The quality of reports was evaluated by Reporting Items for practice Guidelines in HealThcare （RIGHT） Statement. The recommended Chinese patent medicines in the guidelines/consensus were compared with those in the National Reimbursement Drug List. ResultEleven consensus and 2 guidelines were included，involving 794 experts. The scores of AGREE II were clarity of presentation（59.0%），scope and purpose（44.0%），stakeholder involvement（23.1%），rigor of development （12.1%），applicability （11.1%），and editorial independence （8.3%） from high to low. Five articles were recommended at B level（recommended after revision） and 8 articles were at C level （not recommended）. The average scores of RIGHT Statement were as follows：basic information （93.59%），background （57.69%），evidence （18.46%），recommendations （20.88%），review and quality assurance （19.23%），funding，declaration and management of interests （0.00%）， and other information （0.00%）. The included guidelines/consensus recommended a total of 27 Chinese patent medicines，among which 20 were included in the National Reimbursement Drug List，with 4 species of Class A and 16 species of Class B， accounting for 74.1% of all recommended Chinese patent medicines. Ten purgative Chinese patent medicines in the National Reimbursement Drug List were recommended by the guidelines/consensus，accounting for 50% of all purgative drugs， and 8 were not recommended. There were prescriptions for purgation， for promoting digestion and removing food stagnation， for clearing heat and purging fire，and for warming the middle and dissipating cold，Tibetan medicine and Mongolian medicine. ConclusionBy the AGREE Ⅱ assessment，the methodological quality of the TCM diagnosis and treatment guidelines/consensus of constipation included in this study needed to be improved in the future. The report quality evaluated with RIGHT Statement was low. Most drugs included in the National Reimbursement Drug List were paid attention in the TCM diagnosis and treatment guidelines/consensus of constipation. Moreover，the drugs included in the National Reimbursement Drug List could basically fulfill the clinical needs reflexed from the guidelines/consensus recommendations. However， the reasons of some drugs failing to be included in the National Reimbursement Drug List needed to be studied in the future.

Research progress and thinking on cost accounting of medical service items based on cost equivalent method / 中华医院管理杂志

Through literature research, this paper analyzed the research progress of medical service project cost accounting based on cost equivalent method. According to the calculation mode of cost equivalent value, this method could be divided into two types, namely, equivalent coefficient method and point method. This paper classified and summarized the application status of cost equivalent method in the cost accounting of medical service projects, analyzed the advantages of cost equivalent method, such as being able to consider a variety of cost drivers, concise accounting process and strong operability, discussed the existing problems of this method, and put forward suggestions for further deepening the application of cost equivalent method and strengthening hospital cost accounting, such as strengthening the summary and case publicity of cost equivalent method, reasonably combining and applying various methods, and scientifically and reasonably developing hospital cost accounting information construction, so as to help build a scientific and accurate cost accounting system for medical service project.

The clinical study of thromboelas-tography combined with coagulation four items and platelet count to guide platelet transfusion in critically ill patients / 中国输血杂志

【Objective】 To explore the clinical value of thromboelas-tography, coagulation four items and platelet count in guiding platelet transfusion in critically ill patients. 【Methods】 A total of 188 critically ill patients in Intensive Care Unit of our hospital from January 2020 to January 2022 were selected as subjects, and were divided into study group(n=89) and the control(n=99) according to the presence of bleeding symptoms. T-test was used for comparative analysis between the two groups. Spearman was used to analyze the correlation between TEG, coagulation four items and platelet count, and binary Logistic regression analysis was used to predict the influential factors of bleeding in critically ill patients, ROC curve was used to analyze the guiding value of the above-mentioned indexes for platelet transfusion. 【Results】 1) K and PT values in the study group, above the normal range, were significantly higher than those in the control, while the Angle value, MA value, CI value, FIB value and platelet count were significantly lower than those of the control, among which MA value, CI value and platelet count were below the normal range. 2) TEG, coagulation four items and platelet count were correlated. MA and CI values were positively correlated with platelet count, instead, R and K values were negatively correlated. R value was positively correlated with PT and APTT, CI value, on the contrary, was negatively correlated, K value was positively correlated with PT, while Angle value and MA value were negatively correlated. 3) Binary Logistic regression analysis showed that decreased MA value and decreased platelet count were independent risk factors for predicting bleeding in critically ill patients(P<0.05). 4) ROC curve analysis showed that the areas under ROC curve corresponding to Angle value, MA value, CI value, FIB value and platelet count were 0.866, 0.932, 0.9, 0.838 and 0.987(P<0.05). The sensitivity was highest in platelet count and lowest in FIB. The specificity was highest in MA and lowest in Angle. Compared with the single index, the area under the curve of the combined index(K value, MA value, CI value, PT value and platelet count) was 0.995(P<0.05), Yoden index 0.944, sensitivity 100%, specificity 93.3%, all higher than the individual index. 【Conclusion】 Thromboelas-tography combined with coagulation four items and platelet count can be used to accurately predict the critically ill patients with bleeding risk. To guide clinical platelets transfusion, the combined use of indexes, including K value, MA, CI value, PT and platelet count, is superior to separate use of them as the former showed better sensitivity and specificity, demonstrating a good clinical value.

Priorização de projetos de recursos hídricos sob a perspectiva de modelos de apoio à decisão multicritério: uma revisão sistemática / Prioritization of water resources projects from the perspective of multicriteria decision aid models: a systematic review

Resumo Este estudo apresenta a análise da literatura científica quanto à aplicação de modelos de apoio à decisão multicritério na priorização de projetos de recursos hídricos, por meio de uma revisão sistemática. Metodologicamente, a pesquisa caracteriza-se como diagnóstico-descritiva. Para a realização da revisão sistemática, seguiu-se o protocolo Preferred Reporting Items for Systematic Reviews and Meta-Analyses. No que tange à análise dos dados, após o levantamento do portfólio bibliográfico, realizou-se uma bibliometria com o auxílio dos softwares VOSviewer e UCINET 6 em conjunto com o NetDraw, e posteriormente se procedeu à metassíntese. Como principais resultados, percebeu-se: (i) uma carência na produção científica sobre o tema investigado (23 artigos); (ii) a recorrente aplicação de métodos de apoio à decisão multicritério na priorização de projetos de recursos hídricos; (iii) o destaque para o governo e companhias de saneamento com setores de maior interesse em projetos de recursos hídricos; (iv) a falta de informação sobre os atores envolvidos na priorização dos projetos e as técnicas que apoiam o consenso da decisão; e (v) além da preocupação econômica, a importância que vem sendo dada às dimensões social e ambiental. A contribuição prática deste estudo é dada pelo conhecimento gerado para as companhias e instituições que desejem realizar a priorização de projetos de recursos hídricos, uma vez que são exibidas metodologias, técnicas, dimensões e critérios que vêm sendo considerados cientificamente na priorização de projetos no setor de recursos hídricos. Já a contribuição teórica é realizada por meio da apresentação de um panorama atual do tema objeto de estudo, de forma a permitir a identificação de lacunas e apontando áreas em desenvolvimento para pesquisas futuras.

Abstract This study presents the analysis of the scientific literature on the application of multicriteria decision aid models in the prioritization of water resources projects through a systematic review. Methodologically, the research is characterized as descriptive diagnosis. For the systematic review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol was followed. Regarding data analysis, after surveying a bibliographic portfolio, a bibliometry was carried out with the aid of VOSviewer and UCINET 6 software, in addition to NetDraw software; subsequently, a metasynthesis was performed. As main results, the following aspects were observed: (i) lack of scientific production on the investigated topic (23 articles); (ii) recurring application of multicriteria decision aid methods in prioritizing water resource projects; (iii) emphasis on the government and sanitation companies with sectors of greatest interest in water resources projects; (iv) lack of information about the actors involved in the prioritization of projects and the techniques that support the decision consensus; and (v) in addition to the economic concern, the importance that has been given to social and environmental dimensions. The practical contribution of this study consists in the knowledge generated for companies and institutions that intend to prioritize water resource projects, as this study presents the methodologies, techniques, dimensions, and criteria that have been scientifically considered in the prioritization of projects in the water resources sector. The theoretical contribution consists in the presentation of a current overview of the topic under study, in such a way to allow the identification of gaps and indicating areas under development for future research.

Cost accounting for diagnosis items based on virtual standardized clinical chemistry laboratory / 中华医院管理杂志

Objective:Cost accounting for its diagnosis items based on virtual standardized clinical chemistry laboratory.Methods:Relevant data of clinical chemistry laboratories from January to June 2019 were extracted from the laboratory information systems of 10 hospitals in Shanghai, and three health economic experts and the directors of their laboratory departments were interviewed in this regard.On such basis, a virtual standardized clinical chemistry laboratory was constructed. The project cost of the virtual laboratory was calculated from the aspects of supplies exhaust, labor and others. The routine clinical chemistry diagnosis items were clustered according to the principle of laboratory methods, and the cost differences of items in the same cluster were compared using paired t test. Results:The cost of rate method and dry chemical method in testing alanine aminotransferase was 5.12 and 11.63 respectively, and that of immune turbidimetry and immune scattering turbidimetry method in testing immunoglobulin G was 20.00 and 22.26 respectively. Cluster analysis was conducted on 214 routine clinical biochemical diagnostic items, of which 202 items were classified into 42 clusters. The average of clinical chemistry items accounted for 91.7%(4 493/4 900)of the total per day. Based on enzymology, the calculation costs of alanine aminotransferase(rate method), aspartate aminotransferase(rate method), cholesterol(enzyme method)and uric acid(enzyme method)was 5.12, 5.10, 5.24 and 5.14 respectively, presenting no statistical difference( P>0.05). Conclusions:Research on the cost accounting method of clinical chemistry laboratory diagnosis items constructed includes labor cost, reflects the technical labor value of medical staff. Cost accounting based on project clustering can provide references for medical service pricing and financial management of hospitals.

Analysis on testing items and standards in radiological health technical service / 中国辐射卫生

To provide a reference for the application and scientific management of radiological health service testing standards, we systematically analyzed the current status of the testing items and standards in the testing of radiological health service agencies, discussed the deficiency in the update, improvement and standard framework of radiological health service testing standards and the role of radiological health service testing.

Prognostic analysis of critically ill patients with coagulation dysfunction by thrombelastogram and coagulation 4 items combined APACHEⅡ score / 中国输血杂志

【Objective】 To explore the prognosis of critically ill patients with coagulation dysfunction using thrombelastogram(TEG) and coagulation four items combined with APACHEⅡ score. 【Methods】 From March 2017 to March 2020, 287 critically ill patients with coagulation dysfunction in our hospital were selected as the study group, and 303 patients with normal coagulation function during the same period were set as the control. The study group was divided into low-risk group(group A), intermediate-risk group(group B) and high-risk group (group C) based on the APACHEⅡ score, and into survival group and death group according to the prognosis. The difference of TEG, coagulation four items, and APACHEⅡ scores between the two groups were analyzed. The correlation and difference between TEG, coagulation four items and APACHE II score in the study group were analyzed. The ROC curve was drawn to analyze the prognostic predictive value of research indicators. 【Results】 Blood coagulation function related indicators in the study group fluctuated significantly: in comparison to the control, the CI value, MA value, and α angle were smaller, while the K time and R time were longer; among the coagulation four items, PT, APTT and TT were higher; Fg level was lower, and the APACHE Ⅱ score was higher(P0.05). There were significant differences between the TEG and coagulation function related index levels in patients with different prognosis. Compared with the survivals, the CI value, MA value and α angle of the dead group were smaller, while the K time and R time were longer; and among the coagulation four items, PT, APTT, and TT were higher, the Fg level was lower, and the APACHEⅡ score was higher (PP4\\P5>APACHE Ⅱ score>P1>P2. 【Conclusion】 TEG, coagulation four items, and APACHE Ⅱ score can be used to assess the severity of patients with severe coagulation dysfunction. and the combined application of the 3 indicators are of high value in predicting the prognosis of such patients, and can provide reference for clinical formulation or adjustment of intervention programs to correct coagulation dysfunction.

Correlation between hemolysis degree and antibody IgG subtypes contained in infant serum and erythrocyte eluates / 中国输血杂志

【Objective】 To analyze the effects of IgG subtypes(IgG 1 and IgG3) of antibodies contained in infant serum and erythrocyte eluates on hemolytic disease of the newborn(HDN), so as to provide reference for its early clinical diagnosis and treatment. 【Methods】 49 newborns with HDN in our hospital from June 2019 to March 2020 were detected for three hemolytic tests(direct antiglobulin test, elution test and indirect antiglobulin test), as well as the components of IgG1 and IgG3 in eluates. The correlation analysis was conducted by combining birth hours (physiological jaundice) and hemolytic degrees (total bilirubin, indirect bilirubin, and hemoglobin). 【Results】 In the 44 cases of IgG1 and IgG3 subtype detection of infant RBC eluates, regression equations could be established between total bilirubin, indirect bilirubin and birth hours, and between hemoglobin and elution test, and linear regression relationships were found (P<0.05). In the 28 cases of IgG1 and IgG3 subtype detection of infant serum, regression equations could be established between total bilirubin, indirect bilirubin, birth time and IgG3 subtype, and between hemoglobin and IgG1 subtype (P<0.05), and linear regression relationships were found (all P<0.05). Three infants, presenting IgG1 and IgG2 subtypes(+ ) and three hemolysis tests(-), were all second pregnancy, constituted by Rh-HDN of 2 case and other-system-HDN 1. 【Conclusion】 The degree of HDN is directly related to IgG1 and IgG3 antibodies in infant blood plasma. In addition to the total bilirubin and indirect bilirubin, the changes of IgG3 antibodies in infant plasma and IgG1 antibody in anemic infants should be monitored. If IgG1 and IgG3 antibodies are yielded even with all negative ABO-HDN hemolysis tests, non-ABO-HDN should be considered in time to achieve accurate diagnosis and treatment.

Differential item functioning analysis of the Bar-On Emotional Quotient Inventory (EQ-i) across gender and age groups: an iterative hybrid ordinal logistic regression / Funcionamiento diferencial de los ítems del Inventario de Cociente Emocional de Bar-On (EQ-i): una regresión logística ordinal híbrida iterativa

Abstract There has been a heated debate on emotional intelligence (EI) and, more particularly, on the Bar-On Emotional Quotient Inventory (EQ-i) measuring all dimensions of emotional intelligence. To ensure measurement equivalence of EQ-i, the present article evaluated whether statements phrased in EQ-i questionnaire have equivalent meaning across respondents, regardless of their sex and age group membership. For 2,078 participants, three EI subscale (item 50 in reality testing, items 4 and 19 in stress tolerance, and items 7, 52, and 82 in interpersonal) for age groups had clinically significant Differential item functioning (DIF). So previous observed associations between EI and age might be misleading and deserve further study after removing or replacing DIF items.

Resumen En medio del acalorado debate sobre la Inteligencia Emocional, este estudio retoma el Inventario de Cociente Emocional Bar-On (EQ-i), que mide todas las dimensiones de este constructo psicológico. Con el fin de comprobar la equivalencia de medición de EQ-i, se comprueba si las declaraciones formuladas en el cuestionario EQ-i tienen un significado equivalente entre los encuestados, independientemente de su sexo y grupo de edad. Se aplicó a los 2078 participantes las tres subescalas de IE. Se halló un funcionamiento diferencial de los ítems (DIF) clínicamente significativo. Por lo tanto, las asociaciones observadas anteriormente entre la IE y la edad pueden ser espurias y merecen un estudio adicional después de eliminar o reemplazar los elementos DIF.

Neutrophil scattering data driven pre-microscopic flagging of acute leukemic cases

ABSTRACT Background: The hematology analyzer, Sysmex XN-1000, generates white blood cell count with varying scattering intensities during a complete blood count (CBC) analysis. Objectives: The objectives of the study were to study the predictive role of median and coefficient of variation of neutrophil scattering items in blood samples for differentiation of leukemic subjects. Methods: We evaluated six neutrophil scattering parameters: neutrophil side scatter mean intensity, neutrophil side fluorescence light (SFL) mean intensity, neutrophil forward scatter mean intensity, neutrophil side scatter area distribution width (NE-WX), neutrophil SFL area distribution width (NE-WY), and neutrophil forward scatter area distribution width (NE-WZ), measured in white blood cell differential scattergram generated by the hematology analyzer (Sysmex XN-1000) at an academic medical center. Results: We collected 433 blood samples from acute myeloid leukemia (AML) and acute lymphoid leukemia (ALL) cases and normal controls. AML group showed highly significant differences in the mean values compared with the control group. Out of six neutrophil scattering items, NE-WX, NE-WY, and NE-WZ showed high efficiency, with area under the curve (AUC) values of 0.764, 0.748, and 0.757, respectively, to differentiate AML from ALL cases and control groups. When comparing combined acute leukemia cases (AML plus ALL) with the control group, NE-WX, NE-WY, and NE-WZ generated highly significant AUC values (0.840, 0.884, and 0.801, respectively). Conclusion: The neutrophil scattering parameters generated during CBC analysis provide a new tool for the prediction of acute leukemia and its lineage.

Reproducibilidad y validez del Picker Patient Experience (versión con 26 ítems) en participantes de investigaciones en Medellín, Colombia, en 2018 / Reproducibility and validity of the Picker Patient Experience (26-item version) in research participants in Medellin, Colombia, in 2018 / Reprodutibilidade e validade da Picker Patient Experience (versão com 26 itens) em participantes da pesquisa em Medellín, Colômbia, em 2018

Resumen Objetivo: Evaluar la reproducibilidad y validez del Picker Patient Experience versión con 26 ítems, en participantes de investigaciones de una institución de alta complejidad de Medellín, Colombia, en 2018. Metodología: Evaluación psicométrica en 241 sujetos, mediante fiabilidad con el alfa de Cronbach, consistencia interna con correlaciones de Spearman, validez de apariencia, contenido y predictiva con análisis factorial. Resultados: Más del 90% de los participantes calificó positivamente la claridad de la información, relación con personal asistencial y la atención. El alfa de Cronbach fue 0,70 (intervalo de confianza -IC- 95%=0,64-0,76); las correlaciones en la consistencia interna fueron mayores que 0,30 en la mitad de los ítems; en la validez de contenido, el porcentaje de éxito fue mayor al 90%; la validez predictiva fue moderada, con una proporción de la varianza explicada del 55%. En una escala de cero (peor resultado) a cien (mejor), el 50% de los valores centrales del Picker Patient Experience osciló entre 80,8 y 92,3, con rango entre 62 y 98, lo que demuestra la excelente percepción de calidad en el grupo de estudio, sin diferencias estadísticas según la edad, el número de hijos, la escolaridad, el estrato socioeconómico de la vivienda, el estado civil, ni la ocupación. Solo se halló asociación estadística con el sexo, siendo menor la mediana del puntaje en las mujeres (Me=85; rango intercuartil -RI-=81-92) en comparación con los hombres (Me=87; RI=83-94). Conclusión: Se dispone de una escala reproducible, válida y útil para la percepción de calidad en investigaciones con 26 ítems, correspondiente a una modificación de la versión en español del Picker Patient Experience versión con 33 ítems. Esto es de gran relevancia, al considerar que la calidad asistencial requiere la inclusión de la perspectiva del paciente con constructos psicométricamente robustos.

Abstract Objective: To evaluate the reproducibility and validity of the 26-item Picker Patient Experience, in research participants of a high complexity institution in Medellin, Colombia, in 2018. Methodology: Psychometric evaluation in 241 subjects, through reliability with Cronbach's alpha, internal consistency with Spearman correlations, appearance, content and predictive validity with factor analysis. Results: Over 90% of participants positively rated the clarity of the information, relationship with care staff and care. Cronbach's alpha was 0.70 (confidence interval - CI - 95% = 0.64-0.76); the correlations in internal consistency were greater than 0.30 in half of the items; in the content validity, the success rate was greater than 90%; predictive validity was moderate, with a proportion of variance explained of 55%. On a scale of zero (worst result) to one hundred (best), 50% of the central values of the Picker Patient Experience ranged between 80.8 and 92.3, with a range between 62 and 98, demonstrating the excellent perception of quality in the study group, with no statistical differences according to age, number of children, schooling, socioeconomic status of housing, marital status, or occupation. The only statistical association was found with sex, the median score being lower in women (Me = 85; interquartile range —IR— = 81-92) compared to men (Me = 87; IR = 83-94). Conclusion: There is a reproducible, valid and useful scale for the perception of quality in research with 26 items, corresponding to a modification of the Spanish version of the 33-item Picker Patient Experience. This is of great relevance, considering that the quality of care requires the inclusion of the patient's perspective with psychometrically robust constructs.

Resumo Objetivo: Avaliar a reprodutibilidade e a validade do Picker Patient Experience versão com 26 itens, em participantes de pesquisas de uma instituição altamente complexa em Medellín, na Colômbia, em 2018. Metodologia: Avaliação psicométrica em 241 sujeitos, através da confiabilidade com o alfa de Cronbach, consistência interna com correlações de Spearman, validade de aparência, conteúdo e preditiva com análise fatorial. Resultados: Mais de 90% dos participantes qualificaram positivamente a clareza das informações, o relacionamento com a equipe de assistência e o atendimento. O alfa de Cronbach foi de 0,70 (intervalo de confiança —ic— 95 % = 0,64-0,76); as correlações na consistência interna foram superiores a 0,30 na metade dos itens; na validade do conteúdo, a percentagem de sucesso foi superior a 90 %; a validade preditiva foi moderada, com proporção da variância explicada de 55 %. Em uma escala de zero (pior resultado) a cem (o melhor), 50 % dos valores centrais da Paciente Picker Experience oscilou entre 80,8 e 92,3, com um intervalo entre 62 e 98, demonstrando a excelente percepção de qualidade no grupo de estudo, sem diferenças estatísticas segundo a idade, o número de filhos, a escolaridade, a condição socioeconômica da moradia, o estado civil nem a ocupação. Somente foi achada associação estatística com o sexo, sendo mais baixa a mediana dos pontos nas mulheres (Me = 85; intervalo interquartil —RI— = 81-92) em comparação aos homens (Me = 87; ri = 83-94). Conclusão: Existe uma escala reproduzível, válida e útil para a percepção de qualidade em pesquisas com 26 itens, correspondendo a uma modificação da versão em espanhol da versão Picker Patient Experience com 33 itens. Isso é de grande relevância, considerando que a qualidade da assistência requer a inclusão da perspectiva do paciente em constructos psicometricamente robustos.

Evaluation of methodological and reporting quality of the clinical practice guidelines on Henoch-Schonlein purpura by AGREEII and RIGHT / 解放军医学杂志

Objectives To evaluate the current methodological and reporting quality of clinical practice guidelines on Henoch-Schonlein purpura (HSP) for providing the reference for the development of high quality HSP clinical practice guidelines. Methods Databases as PubMed, NICE, Medlive, WHO, Wanfang Data, CNKI, VIP and CBM were electronically searched to collect the clinical practice guidelines on HSP from Jan. 2010 to Dec. 2019. Two reviewers independently screened literature, extracted data and evaluated the methodological and reporting quality by using appraisal of guidelines research and evaluation Ⅱ (AGREEⅡ) and Reporting Items for Practice Guidelines in Healthcare (RIGHT) tools, respectively. Results A total of five HSP clinical practice guidelines were included, three of which are evidence-based guidelines, and the remaining two are based on expert consensus; and three guidelines for clinical practice in traditional Chinese medicine and two for western medicine were selected for evaluation. The AGREEⅡevaluation showed that the HSP guidelines had higher scores in terms of "scope and purpose" (67.8%) and "clarity of presentation" (57.2%), while the average scores were lower in another four areas, i.e. stakeholder involvement (25.6%), rigor of development (33.3%), applicability (9.2%) and editorial independence (43.3%). The RIGHT evaluation showed that, for five HSP guidelines, the corresponding reporting rates of "basic information", "background", "evidence", "recommendations", "review and quality assurance", "funding and conflict of interest statement and management" and "other information" accounted for 0%, 20%, 20%, 0%, 0%, 0% and 0%. A total of 75 recommendations of HSP clinical practice guidelines were classified into 7 for the diagnosis and 68 for the treatment. Conclusions The methodological and reporting quality of HSP clinical practice guidelines are still to be improved. The guidelines should be developed in strict accordance with AGREEⅡand RIGHT.

Normativity of overview report of the systematic review of acupuncture and moxibustion at home and abroad based on PRIO-harms scale / 中国针灸

OBJECTIVE@#To evaluate and compare the normativity of overview report of systematic review (Overviews) of acupuncture and moxibustion at home and abroad so as to further improve the report quality of Overviews of acupuncture and moxibustion in China and provide reliable evidences.@*METHODS@#The articles relevant with Overviews of acupuncture and moxibustion at home and abroad were retrieved by computer from the databases of CNKI, VIP, Wanfang, China BioMedical Literature database (SinoMed), PubMed, Embase and Conchrane Library, dated from the time of establishment to February 12, 2019. The preferred reporting items for Overviews (PRIO-harms) was adopted to evaluate their normativity and make the comparison of the articles between China and foreign countries.@*RESULTS@#A total of 13 articles of Overviews of acupuncture and moxibustion were included, 9 articles of them were of Chinese version and the rest were of English version. The results of PRIO-harms indicated that the proportions of the item numbers related to adequate, partial and inadequate adherence of Chinese version were 3.7%, 63.8% and 32.5%, and those of English version were 12.0%, 57.4% and 30.6% respectively. The reports on the item 10 "additional search for primary studies", the item 12 "data items" and the item 26 "Dual/(co-)authorship" were inadequate adherence by 100% in the articles of both Chinese and English version.@*CONCLUSION@#The overall information of English article report is better than Chinese one, but the reports of either Chinese or English articles are not so satisfactory. It is suggested that the Overviews report should be in reference to the specification in PRIO-harms and the Chinese researchers should study the advantages of English article report and improve the normalization and report quality so as to obtain the high-quality evidences in evidence-based medicine.

Report Quality of Clinical Practice Guidelines of Rehabilitation Based on RIGHT / 中国康复理论与实践

@#Objective To evaluate the quality of reporting of clinical practice guidelines of rehabilitation.Methods A comprehensive retrieve was performed in electronic databases of PubMed, EMBASE, CNKI, China Biology Medicine disc, Wanfang data, etc., from January 1, 2017 to January 11, 2020. Supplementary searches had been done on relevant websites. Two researchers reviewed literatures and assessed the reporting quality independently by using Reporting Items for Practice Guidelines in Healthcare (RIGHT), and any disagreements needed to be discussed in a consensus meeting.Results A total of 16 guidelines were included, with an average reporting rate of (44.8±27.9)%. Among the seven domains of RIGHT, basic information was reported the highest (57.3%), and evidence (31.3%) and other information (31.3%) was the lowest. The reporting rate was less as the guidelines published in China than in foreign contries (OR = 0.80, 95%CI 0.56-1.16), in original version than in update version (OR = 0.79, 95%CI 0.54-1.16); and higher as developed by various societies or associations than developed by non-societies or associations (OR = 1.15, 95%CI 0.82-1.61), however, no statistically significant difference was found in above comparisons.Conclusion Current clinical practice guidelines of rehabilitation reported with low quality. It is proposed that future guideline developers should report guidelines after RIGHT statements, including key information and content, in order to improve the quality of reporting guidelines.