Patterns of skin diseases among outpatients attending Hospital of Dermatology of Chinese Academy of Medical Sciences in 2019 / 中华皮肤科杂志

Objective:To clarify patterns of skin diseases among outpatients at first and return visits to Hospital of Dermatology of Chinese Academy of Medical Sciences in 2019.Methods:Data were collected from the outpatient electronic medical record information system in Hospital of Dermatology of Chinese Academy of Medical Sciences from January 1st to December 31st, 2019, and patterns of skin diseases among outpatients at first and return visits were analyzed retrospectively.Results:The total number of outpatient consultations was 1 440 580 in 2019, including 941 755 (65.37%) first visits and 498 825 (34.63%) return visits, and the daily average number of outpatient consultations was 4 332. The top 10 most prevalent skin diseases were eczema, acne, urticaria, psoriasis, seborrheic dermatitis, vitiligo, neurodermatitis, pigmented nevus, tinea pedis and onychomycosis among outpatients at the first visits, with the number of outpatient visits being 739 175 and accounting for 78.49% of the total first visits; the top 10 most prevalent skin diseases among outpatients at the return visits were eczema, acne, psoriasis, urticaria, vitiligo, seborrheic dermatitis, neurodermatitis, pigmented nevus, keloid and rosacea, with the number of outpatient visits being 399 594 and accounting for 80.11% of the total return visits.Conclusion:In 2019, skin diseases predominated by common diseases, such as eczema and acne, among outpatients at Hospital of Dermatology of Chinese Academy of Medical Sciences.

Effect analysis of the medical treatment for first-visit patients based on Internet technology in a cancer hospital / 中华医院管理杂志

Objective:To analyze the effectiveness of the consultation system for first-visit patients at the breast center during COVID-19 epidemic, and to provide reference for other departments and medical institutions.Methods:4 647 patients who used the consultation system from May 12, 2020 to December 31, 2020 and 4 622 patients who came to the hospital for treatment in the same period of 2019 before the application of the system were used as the research objects. Chi-square test and independent sample t-test were used to compare the patients′ age, source, proportion of patients who actually need treatment, and the waiting time from appointment to treatment. The medical cost saved after the application of the system was calculated. Results:After the application of consultation system, the proportion of elderly patients in first-visit patients increased from 15.9% to 17.9%, the proportion of patients who were not from Beijing increased from 70.2% to 74.3%, the proportion of patients who really need treatment increased from 41.4% to 71.5%, and the waiting time from appointment to treatment decreased from 5.0±4.8 days to 3.9±2.3 days, with significant differences( P<0.05). After the application of the system, a total of 6.177 million yuan was saved for patients, with an average of 3 895 yuan for each patient. Conclusions:The application of the first-visit consultation system is conducive to deepening the content of pre-diagnosis services, improving the accessability to high-quality medical resources, promoting the effective utilization rate of medical resources, shortening the waiting days, and saving medical costs.

Epidemiology and trend forecast of newly diagnosed pulmonary tuberculosis patients in Meishan City , 2014-2019 / 公共卫生与预防医学

Objective To understand the epidemiological characteristics of the newly diagnosed pulmonary tuberculosis patients in Meishan City from 2014 to 2019, and to carry out trend prediction and analysis, so as to provide theoretical basis for the formulation of prevention and control strategies. Methods Raw data of newly diagnosed tuberculosis patients in Meishan City from 2014 to 2019 were collected from Meishan Statistical Yearbook. And Excel was used to manage the raw data. The epidemiological characteristics of newly diagnosed pulmonary tuberculosis patients in Meishan City from 2014 to 2019 were analyzed, and the epidemic trend of pulmonary tuberculosis in Meishan City in the next two years was predicted by grey GM(1,1) model. Results From 2014 to 2019, a total of 1 832 smear positive pulmonary tuberculosis cases were reported in Meishan City. The annual average reported incidence rate of smear positive pulmonary tuberculosis was 26.95/100 000. The overall incidence rate of smear positive pulmonary tuberculosis showed a downward trend. Among the 1 832 newly diagnosed tuberculosis cases, the majority were male, aged 31~40 years old, spring onset, township residence and rural residence, farmers and students. The predicted incidence of pulmonary tuberculosis in Meishan City from 2014 to 2019 based on grey GM(1,1) model is basically consistent with the actual incidence, and the predicted incidence of pulmonary tuberculosis in 2020 and 2021 are 27.68/100 000 and 30.25/100 000 respectively. Conclusion The incidence of newly diagnosed pulmonary tuberculosis in Meishan City from 2014 to 2019 has a downward trend in general, while it may increase in the next two years, so the prevention and control measures for high-risk groups, regions and seasons should be strengthened.

Clinical Characteristics of Chronic Otolaryngeal Patients Treated with Kampo Medicines / 日本東洋医学雑誌

The background and course of Kampo treatment in 39 patients with uncontrollable otolaryngeal symptoms treated between April 2013 and March 2016, in the Department of Kampo Medicine at Tohoku University Hospital, were analyzed retrospectively. An improvement in overall symptoms was noted with Kampo treatment in 28 of 39 cases (71%). The commonly reported subjective symptoms included glossodynia (7 cases), postnasal drip (4 cases), oral discomfort (4 cases), dizziness (3 cases), and taste disorder (3 cases). Analysis using the classification of qi, blood, and fluid revealed that cases with qi stagnation pattern (15 of 18 cases) were effectively treated with Kampo treatment. Prior reports support our finding that smoothing qi with Kampo medicine is effective in alleviating some chronic symptoms. The symptoms improved within 6 weeks after the treatment was initiated. Therefore, a 6-week period can be considered sufficient to determine the effectiveness of Kampo medicine. Many of the patients for whom Kampo treatment was not effective had depression and domestic stress. In conclusion, Kampo treatment may be effectively used to treat uncontrollable, chronic otolaryngeal symptoms in selected cases that are unresponsive to Western medicine.

school oral health education should focus on the consumption of sugars and cares should be put into the differences between urban and rural area. In addition, strengthening publicity of the sealant retention project,raising public awareness, and improving sealant retention quality are necessary to ensure the anti-caries effect / 口腔疾病防治

Objective@#To analyze the correlation between stage of oral disease and the transformation of children dental anxiety in first visit. @*Methods@#Children aged 45 to 74 months (13.7~6.2) years old with molar caries in the first visit were selected and divided into three groups: the acute stage group, the non-acute stage group, and the conventional examination group. The face version of the modified child dental anxiety scale (MCDASf) was used to evaluate the changes of anxiety before and after treatment. @*Results@#The data of correlation among 3 groups about dental anxiety showed a statistical difference (χ2 = 9.132, P = 0.010). Compared with acute stage group and non-acute stage group, a statistical significance in dental anxiety can be found (P<0.012 5). There was no correlation between anxiety prognosis and gender (P>0.05). @*Conclusion @#The occurrence and transformation of dental anxiety in children varied with different stage of oral disease. Dental anxiety can be improved significantly by appropriate therapy and behavior management.

Analysis of residents′ willingness to hierarchical medical system and their intention of first visit hospitals / 中华医院管理杂志

Objective To analyze the residents′ willingness to hierarchical medical system and their intention of first visit hospitals.Methods Customized questionnaire was used for in-home survey of 1 500 households in three cities of Shandong province,with 773 of the residents aware of hierarchical medical system used as the study samples.Descriptive analysis and multi factor Logistic regression were employed for statistical analysis of their intention.Results 85.0% the residents expressed willingness to embrace hierarchical medical system.55.0% of the residents prefer primary medical institutions as their first visit in case of mild illness,a choice chosen by more rural residents(58.9%)than urban residents(48.0%),a difference of statistical significance(P<0.01).In the case of severe illness,87.3% of them prefer major hospitals as their first visit,and more urban residents(94.3%)take this option than the rural residents(83.3%),a difference of statistical significance(P<0.01).Service ability of medical institutions and residents′ concept for medical service played a key role in their choice of first visit hospitals.Conclusions The key to ensuring the implementation effect of hierarchical medical system lies in better service ability of primary medical institutions and correction of residents′ irrational medication concepts.

Patients’ Expectations Of Orthodontic Treatment During Their Initial Visit: A Questionnaire Study

Aim: The aim of this study was to assess the patients’ expectations from orthodontic treatment in order to provide optimal treatment based on their expectations resulting in patient satisfaction. Materials and methods: A prevalidated questionnaire was used to measure the patients’ responses, which included questions about expectations of their initial visit, the type of orthodontic treatment expected, problems associated with treatment, duration and frequency of attendance, benefits and complications of treatment. Descriptive analyses were used to calculate the responses of the patients. Results: This study showed that improved dento-facial appearance and gain in confidence were the most common expectations among the patients’ in both the genders. Conclusions: Measuring patients’ expectations from orthodontic treatment before initiation of treatment by the orthodontists might lead to more satisfaction and less disappointment.

International approaches to coordinated care delivery systems / 中华医院管理杂志

This paper summarized practices and experiences of other countries in coordinated care delivery system building,and described the care delivery systems used in various healthcare fundraising patterns.It is found that most countries have defined duties and service coverage of healthcare institutions at all the levels and measures to ensure rational patient flow.In the end,the paper concluded found experiences of these countries and inspirations for China.

Are doctors assessing patients with hypertension appropriately at their initial presentation?

<p><b>INTRODUCTION</b>The aim of this study was to determine the extent to which primary care doctors assessed patients newly diagnosed with hypertension for the risk factors of cardiovascular disease (CVD) during the patients' first clinic visit for hypertension. The study also aimed to examine the trend of assessment for CVD risk factors over a 15-year period.</p><p><b>METHODS</b>This retrospective study was conducted between January and May 2012. Data was extracted from the paper-based medical records of patients with hypertension using a 1:4 systematic random sampling method. Data collected included CVD risk factors and a history of target organ damage (TOD), which were identified during the patient's first visit to the primary care doctor for hypertension, as well as the results of the physical examinations and investigations performed during the same visit.</p><p><b>RESULTS</b>A total of 1,060 medical records were reviewed. We found that assessment of CVD risk factors during the first clinic visit for hypertension was poor (5.4%-40.8%). Assessments for a history of TOD were found in only 5.8%-11.8% of the records, and documented physical examinations and investigations for the assessment of TOD and secondary hypertension ranged from 0.1%-63.3%. Over time, there was a decreasing trend in the percentage of documented physical examinations performed, but an increasing trend in the percentage of investigations ordered.</p><p><b>CONCLUSION</b>There was poor assessment of the patients' CVD risk factors, secondary causes of hypertension and TOD at their first clinic visit for hypertension. The trends observed in the assessment suggest an over-reliance on investigations over clinical examinations.</p>

The Distributional Changes in the First-Visit Psychiatric Child and Adolescent Outpatients at a University Hospital over a Ten-Year Period

OBJECTIVES: The purpose of this study was to investigate changes in child and adolescent outpatients at a university hospital in Daegu from 2004 to 2013. METHODS: The subjects were first-visit patients under 18 years old, who visited Dongsan Medical Center, Keimyung University, from January 1, 2004 to December 31, 2013. Computerized medical records of 2,738 patients (male 1,906, female 832) were reviewed. RESULTS: The ratio of male to female was 2.3 : 1 in the period of study. The most prevalent age category was 7-9 years. The mean age was 10.12+/-4.68 years (9.84+/-4.59 years in males, 10.76+/-4.81 years in females). The ratio of child and adolescent patients to total outpatients was 27.0%. The most common diagnostic category was the attention-deficit hyperactivity disorder (ADHD) group, followed by the mental retardation (MR) group. In males, the ADHD, MR, communication disorder groups were more prevalent, but in females, the MR, ADHD, depressive disorder groups were more prevalent. CONCLUSION: The female to male ratio and total mean age were on the rise. The ADHD group was the most prevalent and the depressive disorder group was also on the rise in this period.

Patrones de lactancia en bebés, su primer contacto con el azúcar y el dentista / Patterns of breastfeeding in infants, their first contact with the sugar and the dentist

El objetivo de esta investigación fue evaluar el patrón de lactancia, primer contacto con el azúcar y primera visita al dentista de los bebés con relación al estado socioeconómico familiar. Participaron 129 niños de 0 a 36 meses, cuyos datos fueron obtenidos por medio de un cuestionario realizado a las madres y exámenes clínicos bucales de los bebés en ambulatorios públicos y privados. La forma de lactancia más utilizada fue artificial (59%), siendo empleada desde el inicio de la vida y volviéndose más prevalente con el aumento de la edad. El primer contacto con el azúcar ocurrió principalmente después de los 3 meses de edad, sin embargo, 20% de las madres ofrecieron azúcar a sus hijos antes de los tres primeros meses de vida. El mayor número de bebés acudieron durante el primer año de vida al dentista (43%) siendo la prevención su principal motivo (65%). La prevalencia de actividad de caries para la muestra fue de 17%. Estos resultados correspondieron a madres que poseían grado escolar secundario y superior completo y recibían de 1 a 3 salarios mínimos. Conclusión: el patrón de amamantamiento en bebés es esencialmente artificial en los primeros meses de vida, lo que contribuye para que ocurra el primer contacto con el azúcar muy precozmente. La primera visita al dentista ocurre generalmente durante el primer año de vida del bebé

To analyze the pattern of feeding, first contact with sugar and first babies visit to the dentist with respect to family socioeconomic status. One hundred and twenty nine children, from 0 to 36 months, participated in the study. The data was obtained through a questionnaire conducted for their mothers and clinical oral exams of the babies in public and private outpatient departments. Results: bottle feeding was most widely used (59%), being employed since the beginning of the life and becoming more prevalent with the increasing age. The first contact with sugar occurred mostly after 3 months of life; however, 20% of mothers offered sugar for their children before the first three months of life. Most of the babies visited the dentist within their first year of life (43%) and the main reason was prevention (65%). All these results corresponded to mothers who had completed high school and higher education, as well as perceive 1 to 3 minimum wages. The pattern of breastfeeding in babies is essentially artificial in the first months of life, which contributes to appear the first contact with the sugar very early. The first visit to the dentist occurs during the first year of life of the baby

Cluster Analysis of First-visit Patients' Answers for Japanese-Oriental Kampo Questionnaire Supporting the Empirical Decision of Sho-syndrome / 日本東洋医学雑誌

Sho-syndrome was analyzed by cluster analysis of answers to a set of questionnaire presented to first-visit patients at a hospital of Japanese-Oriental (<i>Kampo</i>) medicine. The answers from 270 new patients were classified into 3 groups by hierarchical cluster analysis, with a total of 202 non-female related items. We looked at which Sho-syndromes of metabolic (Mb: “<i>Kan</i>-” _??_-), gastrointestinal (Gi: “<i>Hi</i>” _??_-), respiratory (Rp: “<i>Hai</i>-” _??_-), or water and mineral-balance (Wm: “<i>Zin</i>-” _??_-) deficiency (“<i>Kyo</i>” _??_) disorders were included, in one of the groups at high frequencies. Water and mineral-balance deficiency disorders were in Group II and III, while metabolic deficiency disorders were in Group III. We conclude that the results of this analysis support the rationale for the empirical determination of <i>Sho</i>-syndrome, in addition to pulse diagnosis by <i>Kampo</i>-clinicians who examine patients.

Analysis of X-ray Results for 1000 Pediatric Cases / 医疗卫生装备

Objective To enhance the prevention consciousness of pediatric cases in X-ray examination procedure through manifestation analysis of 1000 cases inspected in our department. Methods 1000 cases were extracted from the pediatric cases examined in our department between August, 2003 and April,2004. Results The sensitive organs such as gonad, thyroid, lens, thymus and galactophore of infants etc accepted higher radiation frequency (?2 test P