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@#Abstract: Objective To genotype and analyze whole genomic features of Coxsackievirus B3 (CVB3) isolated in Tianjin, to improve evolution information of CVB3 virus in Tianjin, and to provide basis for surveillance and early warning of related diseases. Methods Viral RNA was extracted from five CVB3 strains isolated in Tianjin, whole genome sequence of the virus was amplified by RT-PCR and sequenced by next-generation sequencing method, and phylogenetic and recombinant analysis were carried out. Results The open reading frame 1(ORF) of the five CVB3 strains contained 6 555 nucleotides and encoded 2 185 amino acids, and ORF2 was composed of sequences encoding 68 amino acids. The nucleotide sequence similarity ranged from 78.3%-100%, and the amino acid sequence similarity ranged from 95.7%-100%. Compared with the CVB3 prototype strain, the nucleotide sequence similarity of the five viruses was between 78.2%-79.1%, and the similarity of amino acid sequences was 94.9%-95.3%. All five viruses exhibited a T151A mutation on the VP2 protein. Additionally, the encephalitis isolate showed a K158E mutation on the VP2 protein, while one of the sewage isolates had a C234T mutation in 5' noncoding region. The five strains belonged to two different genotypes, among which the encephalitis isolate in 2016 belonged to the D genotype, while the sewage isolates in 2021 belonged to the E genotype. This is also the first report of E genotype CVB3 in northern China. The CVB3 strain may have recombinant events in non-structural protein regions, in which encephalitis isolate may recombine with a Coxsackievirus B5 (CVB5) strain, while sewage isolates may have recombinant events with a strain of ECHO virus 18 (E18). Conclusions The CVB3 isolates in Tianjin belong to D and E genotypes, and recombination events may exist in non-structural protein region of the viral genome. The results of CVB3 virus genome analysis in sewage suggests presence of CVB3 infection in the population of Tianjin, and its epidemic dominant genotype may have changed.
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Objective: To explore the current situation of work stress among nursing staff in Tianjin City and analyze its influencing factors. Methods: From August to October 2020, 26002 nursing staff from tertiary hospitals, secondary public hospitals, secondary private hospitals, primary hospitals, and other medical institutions in Tianjin City were selected as objects, and their general situation and working stress situation were surveyed by the general information questionnaire and the Nurse's Work Stressor Scale. Single factor analysis and multiple linear regression analysis were used to explore the influencing factors of work stress among nursing staff. Results: The average age of 26002 nursing staff was (33.86±8.28) years old, and the average working years were (11.84±9.12) years. There were 24874 women (95.66%) and 1128 men (4.34%). The total score of work stress was (79.82±21.69), and the average score of workload and time allocation dimension was the highest (2.55±0.79). The results of multiple linear regression analysis showed that marital status (β=-0.015, P=0.014), employment form as contract system (β=0.022, P=0.001), post as clinical nursing (β=0.048, P<0.001), education level (β=0.024, P<0.001), age (β=0.050, P<0.001), working years (β=0.075, P<0.001), and professional title (β=0.036, P<0.001) were the influencing factors of work stress, which explained 22.8% of the total variation in work stress of nursing staff (F=24.25, P<0.001) . Conclusion: The work stress among nursing staff in Tianjin City is high, the corresponding departments and nursing managers should adopt scientific management methods to reduce the workload of nursing staff according to the influencing factors of work stress, so as to create a good atmosphere for further promoting the healthy development of nursing career and nursing industry in the new era.
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Masculino , Humanos , Femenino , Adulto , Estrés Laboral/epidemiología , Personal de Enfermería , Centros de Atención Terciaria , Encuestas y Cuestionarios , EmpleoRESUMEN
Objective:To investigate the prevalence the influencing factors of metabolic syndrome among different age groups in Tianjin district.Methods:According to the ‘2015 Chinese Adult Chronic Disease and Nutrition Surveillance Program’, multi-stage cluster random sampling method was used to extract 42 communities from 7 districts in Tianjin. A total of 1 753 adult residents in the 42 communities were selected as the research subjects to analyze the relationship between the influencing factors and metabolic syndrome with descriptive epidemiological analysis. The χ2 test, non-conditional logistic regression and classification tree models were used to analyze the data. Results:The prevalence rate of metabolic syndrome in Tianjin was 30.6%, and the standardized rate was 24.5%. The prevalence rate of metabolic syndrome in Tianjin was increased with age, which was the highest in elderly people (38.9%, ≥60 years). According to the classification tree model, in youth group (18―44 years old), gender, smoking, subjective feeling of health, annual household income and sleep duration were important influencing factors of metabolic syndrome, And the standardized importance was 100%, 95.59%, 22.55%, 20.94% and 9.89%, respectively. In the middle-aged group (45―59 years old), secondhand smoke exposure, subjective feeling of health, sleep duration, the Chinese Food Pagoda (CHFP) score and living region were important influencing factors of metabolic syndrome, and the standardized importance was 100%, 98.08%, 91.04%, 45.74% and 20.15%, respectively. In the elderly group (≥60 years old), sleep duration, secondhand smoke exposure, gender, the CHFP score and living region were important influencing factors of metabolic syndrome, and the standardized importance was 100%, 46.75%, 41.87%, 41.82% and 7.60%, respectively.Conclusions:The prevalence rate of metabolic syndrome is quite high in Tianjin. Tobacco hazard (smoking and secondhand smoke exposure) and sleep duration are the common influencing factors of metabolic syndrome in all age groups. There are different emphases among different age groups in the distributions of those influencing factors, so pointed interventions should be adopted accordingly.
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Objective:To evaluate the change trend of smoking prevalence and the composition of main causes of death in Tianjin from 2010 to 2019.Methods:The study was based on the data collected in the Tianjin All Cause of Death Surveillance System from 2010 to 2019. A total of 699 372 cases were included in the study. The smoking prevalence, ex-smoking and never smoking prevalence were calculated according to different death years and gender. The proportion of smoking status was calculated according to the year of birth and gender. The distribution of smokers dying of smoking related diseases were calculated by different age-group. The change trend of smoking rate was analyzed by Joinpoint regression 4.9.0.0 statistical software. The diseases that smokers died of were expressed by proportion.Results:From 2010 to 2019, the smoking rate of dead residents decreased from 28.7% to 21.4%, and the average annual change percentage (AAPC) was -3.0% (95% CI: -3.9%, -2.2%). The same trend was shown in dead residents of different genders. The proportion of ex-smokers showed an upward trend, from 10.5% in 2010 to 14.7% in 2019; The proportion of light smokers increased with the postponement of birth year. The proportion of light smokers born at and before year 1950 was 14.7%, while the proportion of light smokers born at and after year 1981 was as high as 85.9%; the proportion of heavy smokers decreased with the year of birth. Lung cancer and cardiovascular and cerebrovascular diseases were the main causes of death of smokers and quitters. 13.86% of quitters died of lung cancer, which was slightly lower than that of smokers (16.39%) and significantly higher than that of non-smokers (5.55%). With the increase of smoking degree, the proportion of smokers who died of lung cancer also increased gradually, from 9.19% to 19.11%. Conclusions:From 2010 to 2019, the smoking prevalence of dead residents in Tianjin shows a downward trend, which is consistent with the change trend of the overall smoking prevalence of residents in Tianjin. Lung cancer, acute myocardial infarction and ischemic heart disease rank among the top three causes of death among smokers.
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【Objective】 To analyze the profile, preliminary screening and laboratory test results of voluntary blood donors in the past five years, so as to provide basis for formulating the recruitment strategy, ensuring clinical blood use and improving blood safety and quality. 【Methods】 789 570 voluntary blood donors from 2016 to 2020 were classified according to the category, and the positive rate of blood testing results was statistically analyzed. 【Results】 The proportion of transfusion-transmitted infections (TTI), including HBsAg, anti-HCV, anti-T, and anti-HIV, was led by HBsAg, except for anti-TP leading in 2018. The positive rate of ELISA items and ALT tests showed statistical significance by age groups(P0.05). The positive rate of preliminary screening and laboratory testing showed differences among occupation and educational background(P0.05). The number of HIV positive males (n=228) was higher than that of females(n=3), and the proportion of workers (23.08%~40.74%) and staff (16.67%~46.67%) were large. In 2020, however, the proportion of HIV infected students increased sharply to 21.62%. Sole HBV DNA positive cases was the most (n=460), while the number of sole HIV RNA(n=3) and HCV RNA positive cases (n=6) were rather low. 【Conclusion】 Targeted recruitment strategies should be formulated according to the profile and test results of voluntary blood donors to further improve blood test ability and ensure blood safety.
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【Objective】 To investigate the basic situation of blood donation given by university students in Tianjin and provide data to support the sustainable development of college blood donation. 【Methods】 The group blood donation in Tianjin universities from 2012 to 2021 was enrolled as the study group and other whole blood donors in the same period as the control. The statistical analysis of the two groups was conducted. 【Results】 From 2012 to 2021, the number of college blood donations in Tianjin increased from 8.93% to 21.32%, with the average annual growth rate of 12.80%, and the units of blood donated increased from 5.44% to 18.82%, with the average annual growth rate of 17.06%. The repeat donation rate in the study group was significantly lower than that of the control(20.74% vs 25.47%, P<0.05). In 2012, the specification of blood donated by college students were mainly 200 mL(87.38%), then in 2021, gradually transitioned to 400 mL(38.77%), followed by 200 mL(35.19%) and 300 mL(26.03%). The rates of 200/300 mL donation and insufficient blood donation in the study group were significantly higher than those in the control, to the contrary, the rate of 400 mL donation was lower in comparison to the control, with statistically significant differences. The deferral rates of initial screening and ALT among college donors differed significantly over the decade: HBsAg showed a significant downward trend, while Hb increased significantly(P<0.05); the deferral items in the study group was significantly lower than the control(P<0.05), except Hb. During the retest period, the deferral rates of ALT and HBV were decreasing, which was the lowest in 2018 then bounced back slightly; the deferral rate of HIV showed a increasing tendency(P<0.05). The deferral rates of all retest items in the study group were lower than those in the control(P<0.05). In the study group, no significant differences were noticed in the deferral rates of retest items by genders, except for ALT and HCV, as males were higher than females. 【Conclusion】 College student groups are an important force in blood donation. A long-term mechanism should be established to safeguard this special group and to provide targeted health education and personalised services to promote the sustainable and healthy development of blood donation in universities.
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【Objective】 To analyze the discriminatory positive rate(DPR)of individual donor-nucleic acid test (ID-NAT)mode of blood screening laboratories in the Beijing-Tianjin-Hebei Region, explore the possible reasons for DPR differences among blood station laboratories and the measures to lesson the differences, in order to lay a foundation for realizing the homogenization of detection quality of blood screening laboratories in Beijing-Tianjin-Hebei Region. 【Methods】 The number of triplex-positive samples and discriminatory -positive samples of A, B, C, and D blood station laboratories, which submitted to ID-NAT system, in Beijing-Tianjin-Hebei Region from January to December 2018 were collected by a questionnaire of Quality Supervise Index of Blood Station Laboratories in Beijing-Tianjin-Hebei Region. The triplex-positive samples were divided into solo-positive samples(NAT+ ELISA-) and dual-positive samples(NAT+ ELISA+ ). The changes of total DPR of A, B and C blood screening laboratories in different months was analyzed and compared respectively. The differences of total DPR of ID-NAT, DPR of NAT+ ELISA+ samples, and DPR between NAT+ ELISA-samples and NAT+ ELISA+ samples of A, B, and C blood screening laboratories during January 2018 to December 2018 was analyzed and compared. The difference of DPR of NAT+ ELISA-samples among A, B, C, and D blood station laboratories was also compared. 【Results】 Significant difference in total DPR was noticed in different months of A, B, and C blood station laboratories from January to December 2018(P<0.05), with the highest DPRs of A, B and C laboratory at 91.67%, 72.73%. and 80.39%, the lowest DPRs at 65.88%, 21.05%, and 7.69%, respectively. Significant statistical differences in the total DPR and the DPR of NAT+ ELISA+ samples were found among A, B, and C blood station laboratories(P<0.05). Significant statistical differences in the DPR of NAT+ ELISA- samples were found among A, B, C, and D laboratories(P<0.05). The DPR of NAT+ ELISA+ samples of A and B blood station laboratories (95.97% and 85.25%) were significantly higher than those of NAT+ ELISA-samples (36.36% and 30.71%)(P<0.05). However, the DPR of NAT+ ELISA+ samples of C blood station laboratory (32.63%) was significantly lower than that of NAT+ ELISA-samples (44.39%)(P <0.05). 【Conclusion】 There were significant differences in the total DPR, the DPR of NAT+ ELISA-samples and NAT+ ELISA+ samples that were detected by ID-NAT system in 2018 among blood station laboratories in the Beijing-Tianjin-Hebei Region, and the total discriminatory positive rate in different months was also different for the same blood station. It is necessary to explore the reasons leading to the differences and seek solutions in order to achieve the homogenization of detection quality of blood screening laboratories in Beijing-Tianjin-Hebei Region.
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Background Cumulative risk index (CRI), as a commonly used approach to estimate the joint effects of multiple air pollutants on health, has been used by few studies to construct an air quality health index (AQHI). Objective To construct an AQHI based on the CRI of air pollution in Tianjin and evaluate the validity of the AQHI. Methods Daily data on air pollutants, meteorological factors, and non-accidental deaths during 2015–2019 in Tianjin were collected to create a time-series object. Descriptive statistical analyses were used to describe the characteristics of the data. To determine the best lag day and indicative pollutant, single-pollutant and two-pollutant generalized additive models were fitted to construct the exposure-response relationships between air pollutants and non-accidental deaths. After that we evaluated a CRI of air pollution using multi-pollutant models and constructed an AQHI and its classifications based on the CRI. Finally, we compared the exposure-response associations and coefficients of the AQHI and the conventional air quality index (AQI) with non-accidental deaths, and evaluated the health risk communication validity of the AQHI using generalized cross validation (GCV) values and R2 values. Results We selected lag1 as the best lag day and PM2.5, SO2, NO2 and O3 as the appropriate pollutants according to the unqualified rates of pollutants and significant statistical results. One μg·m−3 increase of PM2.5, SO2, NO2, and O3 was associated with −0.00002, 0.00079, 0.00015, and 0.00042 increase in effect size b of the non-accidental mortality, respectively. Based on these coefficients, we calculated the CRI and AQHI. According to a pre-determined classification scheme of the AQHI, the air quality of 63% study days was low risks and that of 34% study days was median risks. The associations of AQHI and AQI with non-accidental deaths in different populations were evaluated. The results showed that the excess risks of non-accidental deaths in total, female, and male populations for per interquartile range (IQR) increase in AQHI were higher than the corresponding values of AQI. The GCV values of the AQHI model (2.694, 1.819, and 1.938, respectively) were lower than those of the AQI model (2.747, 1.850, and 1.961, respectively), and the R2 values of the AQHI model (0.849, 0.780, and 0.820, respectively) were higher than those of the AQI model (0.846, 0.776, and 0.817, respectively). Conclusion Compared with AQI, the CRI-based AQHI may communicate the air pollution-related health risk to the public more effectively in Tianjin.
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Objective:To analyze the trend of maternal mortality ratio (MMR) and death causes in Tianjin from 2011 to 2020 and to guide the management of maternal health.Methods:All the reviews data of 89 maternal death cases in Tianjin from 2011 to 2020 were retrospectively collected to analyze the trend of MMR, rank order of death causes, and death review results using Chi-square test. Results:(1) The average MMR in Tianjin was 7.97/100 000 during the study period, showing an overall fluctuating decline. The highest MMR was 12.61/100 000 in 2014 and the lowest was 3.85/100 000 in 2019. (2) Among the dead pregnant women and parturients, non-registered residents had higher proportion of women with advanced age, no steady occupation/unemployment, below junior college education, multipara, or without maternal health manual compared with the registered residents [33.33% (8/24) vs 20.00% (13/65), χ2=46.18; 100.00%(24/24) vs 69.23%(45/65), χ2=9.53; 87.50% (21/24) vs 64.62% (42/65), χ2=4.44; 79.17% (19/24) vs 44.62% (29/65), χ2=8.42; 75.00%(18/24) vs 13.85% (9/65), χ2=31.02; all P<0.05]. (3) Direct obstetric factors and indirect factors that caused death were accounted for 57.30% (51/89) and 42.70% (38/89). The top five death causes were postpartum hemorrhage, hypertensive disease during pregnancy, sudden death, venous thrombosis and pulmonary embolism, and amniotic fluid embolism. (4) In terms of the maternal death review results, 39.33% (35/89) of maternal deaths were avoidable, among which 94.29% (33/35) were caused by direct obstetric factors and 5.71% (2/35) were indirect. (5) The main influencing factors of avoidable death causes were knowledge and skills inadequacy in the health care system (62.86%, 22/35), of which 86.36% (19/22) happened in health facilities at and below the district/county level. Conclusion:It is suggested to strengthen the medical care of health facilities at and below the district/county level and the maternal health management of the non-permanent residents to ensure maternal and infant safety and to further reduce the MMR.
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【Objective】 To investigate the unqualified rate of anti-HIV detection of blood screening laboratories in Beijing-Tianjin-Hebei region, and explore the differences in anti-HIV detection ability and influencing factors in each laboratory. 【Methods】 Through filling questionnaires via e-mail, the anti-HIV ELISA unqualified rate and confirmed (WB) positive results (data) from January to December 2018 from 15 blood screening laboratories in Beijing-Tianjin-Hebei region were collected. Our laboratory was responsible for data collection and confirmation, and statistics software SPSS22.0 was used for analysis. 【Results】 1) There was a statistically significant difference among the unqualified rate of anti-HIV ELISA(6.77‱~35.71‱) and confirmed positive rate(0.60‱~3.56‱) in 15 blood screening laboratories in Beijing-Tianjin-Hebei region (P<0.05); 2) There were significant differencse among the ELISA unqualified rate and the confirmed positive rate of 8 reagents for anti-HIV detection(P<0.01), and the sensitivity of the 4th generation detection reagent and the imported reagent was higher than that of the 3rd generation reagent and the domestic reagent. The anti-HIV ELISA unqualified rate of R5 was the highest (19.08‱). 3)There were significant differences in the anti-HIV ELISA unqualified rate of R1, R2, R3, R5 and R7 reagents among different blood station laboratories(P<0.05), and there were no significant differences in the anti-HIV ELISA unqualified rate of R4, R6 and R8 reagents among different blood station laboratories(P>0.05). 4)The unqualified rate of anti-HIV ELISA of laboratories using different regents showed significant differences(P<0.05), except H, J, M. The unqualified rate of imported reagent was significantly higher than that of domestic reagents of laboratories using imported and domestic reagents combinations(P<0.05), except O. 62.5% (5/8) laboratories using domestic 3rd and 4th generation reagent combination showed significant differences in the unqualified rates among different reagents(P<0.05); 5) The positive rate of single-reagent(62.02%~95.45%)in 15 blood screening laboratories showed significant difference(P<0.001), and A was the lowest (62.02%). 【Conclusion】 The anti-HIV detection ability among 15 blood screening laboratories in Beijing-Tianjin-Hebei region is quite different. The application of different reagents is the main factor for the difference, and other factors such as personnel, instruments and test strategies also has a great impact on the detection of anti-HIV. It is still necessary to promote the process of homogenization of blood testing quality among blood screening laboratories in Beijing-Tianjin-Hebei region.
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Objective:To analyze the epidemiological characteristics and trend of stroke death among registered residents in Hexi District of Tianjin from 2007 to 2019，and to provide scientific basis for evaluation of comprehensive prevention and control strategies and measures of stroke. Methods:All death monitoring data of the residents was collected and the crude mortality， standardized mortality and annual percent change （APC） of stroke were obtained by statistical treatment. Results:A total of 15 235 stroke deaths were reported in Hexi District of Tianjin from 2007 to 2019，with an average annual mortality rate of 144.59/105. The rate was higher in males than in females （169.02/105 in males and 121.04/105 in females， P<0.001）. The crude mortality rate showed an upward trend with the year （APC=1.51%， P<0.05）. The standardized mortality rate showed a downward trend （APC=-1.39%， P<0.05）. The crude mortality of ischemic stroke showed an upward trend with the year （APC=3.15%， P<0.01）， and the trend change in standardized mortality rate had no statistical significance. The crude mortality and standardized mortality of hemorrhagic stroke showed a downward trend，with the mortality rate decreased at 2.43% per year and the standardized mortality rate decreased at the 4.50% per year （all P<0.05）. Conclusion:Stroke is the main disease affecting the health of residents in Hexi District of Tianjin. Targeted measures should be taken to reduce the mortality of stroke. Stroke prevention and control should focus on winter and spring seasons， males， elderly people and patients with ischemic stroke.
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Objective To understand the ability and level of emergency rescue at general hospitals in Tianjin city. Methods Such actions as formulating plans and examination forms, establishing assessment indicators and evaluation criteria, and simulation exercises were performed to evaluate the capacity of 28 general hospitals in terms of their organizational structure, emergency response, event reporting, and summary assessment. Results The emergency response assessment system consisted of 4 level-1 indicators, 19 level-2 indicators and 58 level-3 indicators. 28 hospitals were found high in their overall emergency response capacity, but some were found with setbacks. For example, the " organizational structure" scored the highest in 4 first-level indicators, up to 88. 91％ , while " incident report" scored the lowest, down to 67. 99％ . Among level-2 indicators, professional emergency professional procedures and initial reporting scored the lowest. Conclusions In order to further improve the ability of medical institutions to respond to emergency events, the hospitals are recommended to enhance their backup resources for emergency response, their staff′s awareness of first aid knowledge and first aid skills, as well as their timeliness of initial reports and the completeness of progress reports.
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Beijing-Tianjin-Hebei region is the " Capital Circle Area" in China, holding a strategic position and importance. The authors analyzed the medical and health service bottlenecks problems incurred by the shortage and unequal distribution of pediatric medical resources to be solved urgently. On such basis, this article introduced the experience of Beijing Children′s Hospital in a top-level design targeting at building a collaborative integrated health service system to meet children′s health requirements. The hospital created four types of proactive medical collaborative innovation, including a managed type, collaborative development type, technical support type and medical alliance type, aiming at providing a diversified Beijing-Tianjin-Hebei Integration proactive medical service model. These efforts are designed to relieve the structural setback of supply and demand of pediatric medical services and better children′s health and families′ welfare.
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OBJECTIVE To investigate the normal range of fraction exhaled nitric oxide(FeNO) in healthy schoolchildren in Beijing, Tianjin and Hebei Province. METHODS A total of 337 schoolchildren(161 males and 176 females) in Beijing, Tianjin and Hebei Province were selected randomly in our outpatient clinic and met the health standards. FeNO values were measured using NIOX. Age, height, weight and body mass index(BMI) were investigated. At the same time, skin prick tests were performed on children with suspected atopy. RESULTS Geometric mean of FeNO value in healthy schoolchildren in Beijing, Tianjin and Hebei Province was 13 ppb(part per billion, ppb), and the 95％ Confidence Interval(CI, bias distribution) was 5-23 ppb, which was related to the gender of schoolchildren(P ＜0.001). There was no signif icant cor relation between age, height, weight, body mass index(BMI) and regional differences(P all＞0.05). FeNO values were no significant difference among the three regions(P ＞0.05); the geometric mean of FeNO values were 13 ppb in Beijing, 13 ppb in Tianjin, and 14 ppb in Hebei; 95％CI was 5 to 21 ppb, 5 to 21 ppb, 5 to 23 ppb, respectively. CONCLUSION FeNO values of healthy schoolchildren in Beijing, Tianjin and Hebei provinces are only significantly correlated with gender. However, FeNO values are highest among schoolaged girls in Hebei, and 23 ppb is the 95％ normal range of FeNO in healthy schoolchildren in Beijing, Tianjin and Hebei province. Gender and regional factors must be considered when FeNO values are evaluated.
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Tianjin, as the earliest city to open up, the exchange of Chinese and Western cultures also started earlier. Therefore, today′s emergency medicine system with integrated features of Chinese and Western medicine is formed. Professor Wang Jinda, who works in Tianjin First Center Hospital, makes the theory of "treating bronchitis and treating diseases" and "three methods of three syndromes" for the treatment of severe diseases such as sepsis. The surgical aspect is the treatment of acute abdomen with the combination of Chinese and Western medicine which is proposed by Academician Wu Xianzhong who worked in Tianjin Nankai Hospital. In the aspect of acupuncture and moxibustion, Professor Guo Yi, who works in Tianjin University of Traditional Chinese Medicine, provides the twelve Jing points blood-letting therapy for cerebral diseases such as stroke. Professor Liu Xinqiao from the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine also conducts in-depth studies on brain protection after cardiopulmonary resuscitation (CPR). He proposes the importance of traditional Chinese medicine in addition to mild hypothermia and neuroprotective agents. The author summarized these achievements, in light of which looked forward to the future and proposed the concept of establishing a multi-specialist collaboration and an emergency center with obvious characteristics of integrated Chinese and Western medicine, which would pave the way for the development of integrated Chinese and Western medicine first aid.
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Under the strategic background of the "Healthy China" and the "coordinated development of Beijing-Tianjin-Hebei",based on the perspective of cross-boundary integration,taking the Beijing-Tianjin-Hebei health industry as the study case,it analyzed the basic condition of the health industry cross-boundary integration of the Beijing-Tianjin-Hebei region and considered that the Beijing-Tianjin-Hebei healthcare industry marketplace was immerse,which had good industrial foundation conditions and a certain degree of dislocation,provided with foundation for cross-border integration development.Therefore,it put forward further development path of the horizontal industry crossover and vertical industry chain integration in Beijing-Tianjin-Hebei healthcare industry,building and perfecting industrial chain,extending industrial development space,and promoting the cultivation and development of healthcare industry in three places.
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Objective To study the fundus diseases that primary and middle school students may be susceptible to suffer, and to understand the prevalence rate and constituent ratio of these diseases. Methods A total of 9 504 students were examined from November 2015 to February 2017 to find out their ocular fundus conditions. They were from all the primary and secondary schools directly subordinate to Dagang Oilfield headquarters. Among the 9 504 participants 4 998 were male and 4 506 were female,with the age span of 5 to 23 and the average age of(13.40±3.41).Our medical examination included uncorrected visual acuity examination and fundus oculi photography. The distribution of fundus diseases was analyzed,including gender,vision acuity and age composition of patients with major diseases. Results Among the 9 504 students,4 314 had emmetropic eyes,and 5 190 had refractive errors.A total of 9 126 out of the 9 504 examined students had normal ocular fundus(96.02%),while those with abnormal ocular fundus accounted for 378(3.98%).The main types of abnormal ocular fundus included the tessellation fundus 354 (3.72%), followed by the large depression of optic disk 16 (0.17%). Among all the 354 cases with tessellation fundus, 179 were male and 175 were female. There were 257 students whose visual acuity≤0.3/0.3,and the prevalence was higher in 17-19 years old students(5.86%).Conclusion It has been revealed in this epidemiological survey that the main abnormal ocular fundus of primary and middle school students in Dagang is tessellation fundus.Most of the tessellation fundus are caused by middle and high myopia,and very few are found in emmetropic students. It has also been found that the incidence of tessellation fundus increases significantly with the increase of age. The large depression of optic disk ranks the second in the abnormal ocular fundus, which is mostly physiological.
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This paper introduced the development of medical accident insurance at Tianjin Medical University General Hospital. The author summed up the achievements made in practice and analyzed the problems such as low risk awareness of the patients in their low proportion of insurance risk coverage ,lack of normalized industry standards ,and lack confidence. Other problems include the lack of top-level design of the system ,and high difficulty to plan insurance projects. The paper also recommends to strengthen the positive publicity and guidance ,to create a healthy atmosphere of public opinion;to improve the system ,standardize the industry supervision ;and encourage the introduction of policy proposals ,and to perfect the national medical risk sharing and compensation mechanism .
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To deal with the current large workload and difficulty of reconciliation for medical insurance expenses in public hospitals,it proposed a institutionalized and normalized reconciliation management process.Tianjin was selected as the object of research.Based on hospital and medical insurance institutions,it analyzed the existing problems and reasons of medical insurance on reconciliation.It proposed a medical insurance debt accounting based,medical settlement information establishment supported,medical insurance reconciliation process centered medical insurance reconciliation management work system to solve the problem of medical insurance reconciliation and promote the safety and integrity of the obligatory right for medical insurance.
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Objective To learn the present acceptance of patients from outside Tianjin by local hospitals, for improving the management of their medical services.Methods A study of the hospitals′ network system identified 5 306 inpatients from other places in 2016 as evidenced by their hospital settlement account, with analysis of the patient flow from other places by the hospitals surveyed.Medical workers of eight medical institutions which signed the online settlement contract for non-local patients were subject to questionnaire survey.Results Of the 876 respondents,the number of patients willing to receive non-local insured patients accounted for 78.08%.Non-local patients aged 60 or above accounted for 82.31% among the total non-local patients, of whom 48.55% selected hospitals with national key disciplines, and 30.53% chose those with municipal key disciplines.Conclusions An analysis is required for the demand of non-local patients in terms of the social background and population characteristics.Based on such, non-local patient population needs a better management while those with irrational needs should be discouraged with rules and regulations.