Report on early childhood development practices in China from a global health perspective / 中国儿童保健杂志

As the health disparities among children indirectly reflect the unfair distribution of national child healthcare, education, and other infrastructure, early childhood health development is a globally significant public health concern. On a global scale, 193 countries have endorsed The 2030 Agenda for Sustainable Development and have explored various development strategies. The government placing children′s interests and their rights at the core of their efforts to achieve the Sustainable Development Goals(SDGs) is essential, China has made substantial progress in improving children′s well-being over several decades of continuous effort and practice. However, challenges persist, including regional development imbalances, insufficient service capabilities in impoverished rural areas, and emerging issues like obesity, myopia, and mental health problems. China still needs to meet the growing health needs of children fully. From a global health perspective, this article systematically reviews the current status of global early childhood health development, outlines the significant milestones and best practices in China′s early childhood development efforts, and also anticipates the focus and challenges in early childhood development in China based on global trends, hoping to contribute to further research in this field.

Estimation of physician demand based on an unequal weight combination forecasting model / 中华医院管理杂志

Objective:To measure the demand of physicians in 2020-2035 period by constructing an unequal weight combination forecasting model, and to provide scientific reference for health manpower planning.Methods:This study called into play the trend extrapolation method, human/population ratio method and health service demand method to preliminarily predict the demand of physicians in 2020-2035, followed by Delphi method to carry out unequal weight combination of the results of these three methods. Hence the physicians demand in 2020-2035 in China was calculated.Results:Based on the unequal weight combination forecasting model, the physicians demand of the period in China was estimated to increase from 2.64 people / 1 000 population to 3.67 people / 1 000 population, and the physicians demand to gradually increase at a growth rate in gradual slowdown.Conclusions:This research used the unequal weight combination forecast model, based on the service demand and the historical situation. It is suggested that relevant policies of medical education and specialists division be made based on both the demand and the factors affecting the supply and demand balance of physicians.

Evaluation of Prescription Rationality in Children's Branch of Our Hospital during 2012-2016 / 中国药房

OBJECTIVE:To provide scientific reference for rational,effective and economical drug use in pediatric depart-ment. METHODS:A total of 9771 prescriptions were randomly selected from children's branch of our hospital during May 2012-Apr. 2016. Those prescriptions were analyzed statistically in respects of drug type,prescription cost,utilization rate of injec-tion,utilization rate of essential medicine,clinical diagnosis,irrational drug use,use of antibiotics,etc. RESULTS:Among 9771 prescriptions,2.91 types of drugs were used in each prescription,and each prescription expended 77.10 yuan;utilization rate of in-jection was 57.11％,and that of national essential medicine was 67.80％. Respiratory tract disease was main disease (84.17％). There were 284 irrational prescriptions(2.91％),including 156 non-standard prescriptions,165 unsuitable prescriptions and 65 ex-traordinary prescriptions. Utilization rate of antibiotics was 18.25％,among which that of Cefoxitin sodium injection was the high-est(15.48％),but its utilization index was the lowest(0.58). The detection rate of microorganism isolated from bronchitis patients was in low level(45.10％). CONCLUSIONS:The rate of qualified prescription in the children's branch of our Hospital is higher than the requirement of the former Ministry of Public Health concerning the rate of qualified prescription >95％;utilization rate of antibiotics and injection are both in high level. In the future,it is necessary to strengthen prescription evaluation and promote stan-dard and rational use of drugs so as to guarantee safe,effective and economical use of drugs in clinic.

Neruomodulation treatment for patients under persistent vegetative state / 中华神经医学杂志

Objective To investigate the effect of neruomodulation treatment,including deep brain stimulation (DBS) and spinal cord stimulation (SCS),on patients under persistent vegetative state (PVS).Methods Fifty-three patients diagnosed as having PVS,admitted to our hospital from July 2011 to December 2012,were chosen in our study; after selection,42 patients were enrolled (27 males and 15 females,mean 42.9±5.47 years old) and prospectively divided into control group (n=20) and surgical group (n=22).Patients from surgical group received DBS (n=5) and SCS (n=17) treatments,while patients from control group underwent routine rehabilitation activities.Behavioral assessments were repeatedly performed using Revised Coma-Recovery Scale (CRS-R).Some patients underwent functional magnetic resonance imaging (fMRI) to further assess the outcomes.Clinical baseline values were collected and compared to follow-up data.Results No statistical significant differences of age,duration of coma and CRS-R scores were noted between the two groups before treatment.Thirty-seven patients (17 in control group and 20 in surgical group) got follow-up for 6-24 months (median 11.2 months); seven patients in the surgical group emerged from PVS to achieve consistent discemible behavioral evidence of consciousness with a recovery rate of 35 ％ (7/20),while only 1 from the control group with a recovery rate of 5.9％(1/17); significant difference was noted between the two groups (P＜0.05).Improvement in behavioral assessments (CRS-R scores) in the surgical group was significantly better than that in the control group (P＜0.05); however,no significant difference of CRS-R scores was noted between patients received DBS and SCS treatment (P＞0.05).The fMRI showed good consistency of activation of resting state default network key area and function connected degree with clinical assessment.Conclusion Neuromodulation therapy can effectively promote awareness of PVS patients based on rigorous selection criteria; DBS and SCS treatments show no difference in the clinical efficacy.

Epidemiological investigation of 615 patients with chemical burns in eastern China / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the epidemiological factors in the first aid, early management, and treatment of chemical burns.</p><p><b>METHODS</b>Medical records of 615 inpatients with chemical burns out of 2682 burn patients hospitalized from January 2001 to December 2010 were screened to retrospectively analyze the clinical data, including gender, age, burn area and depth, occurrence regularity, injury cause, injury-causing chemicals, wound site, complications, pre-hospital management, treatment and prognosis. Annual number of burn patients and annual number of patients with chemical burns were statistically analyzed with linear trend test.</p><p><b>RESULTS</b>(1) Among all the chemical burn patients, 562 (91.4%) were male and 53 (8.6%) female. The mean age of patients was (32 ± 12) years. Burn area ranged from 1% to 95%, with mean area of (30 ± 25)% TBSA. Full-thickness burn area ranged from 0 to 85%, with mean area of (18 ± 24)% TBSA. (2) The annual number of burn patients showed a slow trend of increase during the last decade (χ(2) = 4.009, P < 0.05). There was no statistically significant difference in the annual number of patients with chemical burns among the last decade (χ(2) = 0.060, P > 0.05). Chemical burns mainly occurred in summer and autumn, and the incidence gradually increased in April, peaked in August, and then gradually decreased. (3) Five hundred and seventy-two cases (93.0%) were injured while working, among these patients 70.8% (405/572) were injured in private enterprises. (4) Acid was the most common injury-causing chemical (299 patients, accounting for 48.6%). (5) The extremities and head were the most involved areas. (6) Among 615 patients with chemical burns, 47 cases (7.6%) were complicated by inhalation injury, 94 cases (15.3%) by ocular burns, 51 cases (8.3%) by combined injury, and 67 cases (10.9%) by poisoning. (7) Most patients did not receive (30.4%, 187/615) or only insufficient (61.1%, 376/615) immediate irrigation after injury in pre-hospital management. (8) Two hundred and twelve patients (34.5%) underwent skin grafting or flap transplantation after early total or tangential excision of eschar within one week post injury. Among all the patients, 599 cases were cured with 11 eyes becoming blind in 8 patients, and sixteen patients died with a mortality rate of 2.6%.</p><p><b>CONCLUSIONS</b>Patients with chemical burns accounted for a high proportion of the burn patients admitted to our unit in the same period, and they were mainly injured while working. Sufficient irrigation and immediate detoxification are key points in the treatment of chemical burns. Early total or tangential excision of eschar of deep wounds could reduce the possibility of poisoning.</p>