25 April 2017, Volume 24 Issue 2

    

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  Application of ARIMA and SARIMA model in predicting hospital outpatients and discharges

  Lian Hengli, Yu Jianqin, Fu Yinghui

  journal1. 2017, 24(2): 81-84. https://doi.org/10.3969/j.issn.1006-5253.2017.02.001

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  Objective The ARIMA and SARIMA model were used to analyze and predict the number of outpatients and discharges. Methods We collected outpatient and discharge numbers in a hospital each month from January 2011 to June 2016, used ARIMA and SARIMA model to analyze data, and validated data from July 2016 to October 2016 to predict outpatients and discharges from November 2016 to June 2017. SPSS 17.0statistical software was used for model fitting and forecast. Results The ARIMA (6, 0) was the optimal fitting model in predicting hospital outpatients, and the SARIMA,1,1 (0), (0, 0) (excluding constant) was the optimal fitting model in predicting hospital discharges. Both models could be well fitted in predicting outpatients and discharges from July 2016 to October 2016. The prediction with the two models from November 2016 to June 2017 conformed to the change trend of outpatients and discharges, and the actual values fell in the 95% upper and lower limits of prediction. Conclusion The ARIMA and SARIMA models have strong practical value in prediction of short-term outpatients and discharges, and can provide the reference to hospital health resource allocation and scientific management.   
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  Epidemiological surveillance of hand, foot and mouth disease in a hospital in Binzhou from 2010 to 2015

  Zhang Yupei, Zhang Liguo, Ding Guofeng.

  journal1. 2017, 24(2): 85-87. https://doi.org/10.3969/j.issn.1006-5253.2017.02.002

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  Objective To understand the epidemiological profiles of hand, foot and mouth disease (HFMD) in our hospital in binzhou from 2010 to 2015, and to provide scientific basis for making the prevention and control stategies of HFMD. Methods Patients with HFMD who were treated in the hospital were selected from January 2010 to December 2015 to carry out a descriptive epidemiological analysis on the data. Results From 2010 to 2015, the reported HFMD cases were 2423, 3191, 1765, 2788, 2684 and 994 annually and 14385 totally, including 223 cases of severe cases (1.55%). The highest onset peak was in June (29.75%). Children under the age of five accounted for the most (86.94%). and the incident rate of men was higher than that of women (1.61∶1). Outpatients were the main source of hand, foot and mouth disease. Conclusion The annual HFMD outbreaks occurred in our hospital during 2010 to 2015. Children under five years old, male, scattered and childcare children were the main susceptible populations. It is needed to strengthen health education and intervention measures to these main groups. Effective isolation measures and correct health concept are the key to control hand, foot and mouth disease.
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  Investigation and analysis of hepatitis B serology of the crowd in Gaomi in 2014

  Qiu Deshan, Xu Dong, Wang yi

  journal1. 2017, 24(2): 88-91. https://doi.org/10.3969/j.issn.1006-5253.2017.02.003

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  Objective To understand the epidemic status of hepatitis B (HBV) in Gaomi, and provide scientific basis for improving the strategy of hepatitis B vaccine. Methods In October 2014, a stratified multi-stage random sampling method was adopted to investigate the prevalence of serum epidemiology in Gaomi among 1~, 5~, 15~ and 30~59 year-old group resident population. Enzyme linked immunosorbent assay (ELISA) was used to detect HBsAg, Anti-HBs, Anti-HBc, HBeAg and Anti-Hbe. Results A total of 497 people were investigated, the prevalence rate of HBV, HBsAg positive rate, Anti-HBs positive rate and Anti-HBc positive rate were 12.55%, 1.42%, 52.02% and 12.55% respectively. The differences of HBV prevalence rate, HBsAg positive rate, positive rate of Anti-HBs, and positive rate Anti-HBc between men and women had no statistical significance (χ²=0.03,0.41,0.25 and 0.01, P>0.05). Among the age groups: the prevalence rate of HBV among 1~, 5~, 15~ and 30~59 group were 2.14%, 0.99%, 17.53% and 26.28% respectively. The difference was statistically significant (χ²=55.10, P<0.01). The rate for the 5~ year-old group was the lowest, the rate for the 30~59 year-old group was the highest, showing a increasing trend with the age growth. HBsAg positive rate for 1 to 5~year-old group wasn′t detected out, those for 15~, 30~59 age groups were 2.06% and 3.21%, without statistically significant differences (χ²=7.32, P>0.05). The positive rates of Anti-HBs: 1~, 5~, 15~ and 30~59 year-old groups were 67.86%, 55.45%, 54.64%, 33.97% respectively. The difference was statistically significant (χ²=35.16, P<0.01), showing a decreasing trend with the age growth. The positive rates of Anti-HBc for 1~, 5~, 15~and 30~59 were 2.14%, 0.99%, 17.53%, 26.28% respectively. The difference was statistically significant (χ²=55.10, P<0.01), with the 5~ year-old group the lowest, and the rate increased with age. Conclusion Gaomi is still the moderate endemic area of hepatitis B, and the prevalence of HBV in adolescents and adults is higher than that in children. The implementation of the ″neonatal HePB vaccination″ as the main hepatitis B control strategy in Gaomi City has achieved remarkable results.   
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  Analysis of the epidemiological characteristics of measles in Weifang from 2013 to 2015

  Wang Hongmei, Wu Haiyan, Qiu Deshan

  journal1. 2017, 24(2): 92-94. https://doi.org/10.3969/j.issn.1006-5253.2017.02.004

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  Objective To research the epidemic situation of measles in Weifang from 2013 to 2015,so as to provide scientific evidence for the control and elimination of this disease. Methods Descriptive epidemiologic methods was applied to analyzing the epidemic regularity of measles in Weifang from 2013 to 2015. Results In total, 542cases of confirmed measles were reported in Weifang during these two years (from 2013 to 2015), with the average incidence rate of 19.5 per million. No measles-related death were observed. The epidemic peak of measles was from March to August. Meanwhile, most cases concentrated in four regions including Anqiu, Kuiwen, Shouguang and Fangzi, accounting for 71.96%(390/542)of all cases. The age of these patients ranged form 3 monthes to 62 years, in which a great majority were children between 0 and 5 years old and adults between 20 and 50 years old. The three most common occupations of measles patients were scattered children, farmers and workers, with the scattered children being the highest proportion,accounting for 36.90% (200/542), respectively. Notably, 96 cases had the history of measles vaccine immunity, 75 cases did not, while the immunity history was unclear for 371 cases. There were 2 measles outbreaks occurring in Anqiu and Shouguang, respectively. Conclusion Measles disease incidence rates occupy the low level, and the majority of the cases are 0-5-year-old children and 20-50-year-old adults inWeifang from 2013 to 2015.   
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  Analysis of the influencing factors of hospitalization costs of gastric cancer surgery patients

  Cang bai, Zhou wei

  journal1. 2017, 24(2): 95-97. https://doi.org/10.3969/j.issn.1006-5253.2017.02.005

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  Objective To analyze the influence factors of hospitalization costs of patients with gastric cancer surgery, so as to provide a reference for effectively controlling the hospitalization costs. Methods The medical records of 1 079 gastric cancer surgery patients were collected from a provincial cancer hospital. The statistical methods of descriptive analysis, ANOVA and Path analysis were used to analyze the composition and influential factors of hospitalization costs. Results The highest percent of hospitalization costs was material costs (42.13%), followed by drug costs (31.25%) and they were the main factors that influenced the hospitalization costs, with the path coefficients 0.540 and 0.289 respectively. Length of stay, the number of accompanied diseases, combined gastric and other visceras resection, using the VIP room also correlated?significantly with the hospitalization cost, with path coefficient 0.002, 0.007, 0.018 and 0.029 respectively. Conclusion The hospital must supervise the rationality of high value medical consumable material and the use of clinical medicine, control the number of senior ward, shorten hospital stays reasonably, and reduce the hospitalization costs effectively.   
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  Effects of different anesthesia methods on ischemia reperfusion injury in patients undergoing hepatectomy

  Cen Shenghua, Fu Haiqing, Hu Jiayan

  journal1. 2017, 24(2): 98-101. https://doi.org/10.3969/j.issn.1006-5253.2017.02.006

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  Objective To explore and analyze the effects of different anesthesia methods on ischemia-reperfusion injury in patients undergoing hepatectomy. Methods Forty hospitalization patients with liver resection from January 2014 to January 2016 were selected and divided into observation group and control group according to random number table, 20 cases in each group. The control group was treated with sevoflurane and sulfentanyl, while the observation group was treated with propofol and remifentanil. We observed and recorded the general sitiuation and blood flow dynamics of hepatic portal occlusion before blocking, during blocking, 30min after blocking,60min after blocking, and one day after surgery, including heart rate, central venous pressure and mean arterial pressure (ALT), and aspartate aminotransferase (γ-GGT), gamma glutamyl transferase (MDA), MDA), T-SOD (superoxide dismutase) level. Results There was no significant difference in the general situation and in hemodynamic parameters such as HR, MAP and CVP before and after blocking of hepatic portal occlusion between the two groups (P>0.05). By the analysis of variance, ALT concentration difference of the two groups of patients before and after hepatic portal occlusion was statisticallysignificant (P<0.05), ALT concentration in patients increased during hepatic portal occlusion, and with the passage of time, ALT concentration of two groups decreased gradually, while ALT concentration of postoperative 1D patients significantly increased after blocking (P<0.05), but ALT concentration of observation group were significantly lower than that of control group (P<0.05), with statistical significance. Gamma γ-GGT concentration difference of the two groups of patients before and after hepatic portal occlusion was statistically significant (P<0.05). Gamma γ-GGT concentration of the observation group decreased after blocking, and 60min after blocking was significantly lower than that before blocking with statistical significance (P<0.05).Gamma γ-GGT concentration of the observation group one day after surgery increased,with no significant difference compared with that before blocking (P>0.05). Gamma γ-GGT concentration of the control group with hepatic portal occlusion one day after surgery didn't induced obviously, while that one day aftger surgery compared with that before blocking, with statistical significance (P<0.05). MDA concentration difference of the two groups of patients before and after hepatic portal occlusion was statistically significant (P<0.05). MDA concentration of the two groups of patients after hepatic portal occlusion increased,and reached to the highest one day after surgery, but the increase level of the obervation group was significantly lower than that of the control group, with statistical significance (P<0.05). T-SOD concentration difference of the two groups of patients before and after hepatic portal occlusion was statistically significant (P<0.05). T-SOD concentration of both groups after hepatic portal occlusion decreased, but the decrease level of the observation group was lower than that of the control group, with statistical significance (P<0.05). Conclusion Propofol remifentanil maintenance can effectively reduce liver resection in patients with hepatic portal occlusion after ischemia reperfusion injury, and compared with sevoflurane-sulfentanyl maintenance, it does not increase the hemodynamic fluctuations, so it is worthy of promotion.
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  Investigation analysis on risk factors of liver cirrhosis ascites with spontaneous bacterial peritonitis

  Wang Hongjuan, Lai Haidan, Tao Zhaodi

  journal1. 2017, 24(2): 102-104. https://doi.org/10.3969/j.issn.1006-5253.2017.02.007

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  Objective To explore correlated risk factors of liver cirrhosis ascites with spontaneous bacterial peritonitis (SBP), then to provide basis for prevention and treatment of SBP patients. Methods Retrospectively we collected data of 200 patients with liver cirrhosis ascites, and according to the incidence of SBP, these cases were divided into the case group (n=57) and the control group (n=143). Then single factor and multiple factor analysis methods were used to analyze the risk factors of liver cirrhosis ascites with SBP. Results The incidence rate of liver cirrhosis ascites with SBP was 28.5% (57/200). Multiple factors analysis result showed that the risk factors of SBP included alimentary tract hemorrhage (OR=1.813), diarrhea (OR=2.181), serum TBIL (OR=2.125), albumin of ascites (OR=2.881) and Child-pugh grades (OR=2.300). Conclusion The incidence rate of liver cirrhosis ascites with SBP lies was high. Many risk factors affected its incidence, such as alimentary tract hemorrhage, diarrhea, high serum bilirubin, low level albumin of ascites and high grade of Child-pugh.    
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  Prediction of coronary artery stenosis with logistics model

  Zhang Qi, Liu Lingchong, Li Guijie, Song Gesheng, Shi Hao, Wang Bin

  journal1. 2017, 24(2): 105-107. https://doi.org/10.3969/j.issn.1006-5253.2017.02.008

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  Objective The clinics needs a non-invasive, non traumatic diagnosis of coronary heart disease and corocnary artery stenosis. To evaluate the relationship between coronary artery stenosis and blood pressure, blood fat and blood sugar, and combine them with age and sex to establish logistics forecast model. To explore the feasibility of noninvasive diagnosis of coronary artery stenosis. Methods We collected a total of 894 patients who accepted coronary artery angiography examination in our hospital, with an average age of 58, including 545 male and 347 female cases. DSA results were used to classify stenosis group (with more than one branch of coronary artery stenosis, 744 cases) and no stenosis group (without coronary artery stenosis, 150 cases). Blood pressure, fasting blood glucose, triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol were measured in both groups. T test was used to analyze the differences of each index between both groups, and the logistics model was fitted to built a prediction model with these indexes. Results Age, gender, fasting blood glucose, serum total cholesterol and high density fat cholesterol differences had statistical significance (P<0.05) between two groups. The proportion of male patients and patients with hypertension in stenosis group was higher than that in no stenosis group; the proportion of women in no stenosis group was higher than that of men. There was no significant difference in triglyceride and low density lipoprotein cholesterol between both groups (P<0.05). The age, sex, blood pressure, fasting blood glucose, total cholesterol and high density lipoprotein cholesterol were fitted to the logistics model, and the AUC was 0.751. High density lipoprotein in coronary heart disease (CHD) was a kind of protection material. Elderly male, hypertension, total cholesterol were risk factors for coronary heart disease. Conclusion The logistics model has certain significance in the prediction of coronary stenosis, and can realize the diagnosis of coronary stenosis to a certain extent.   
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  Analysis of the composition of hospital orthopedics type in recent years in Huzhou

  Hu Keyu, Tan Junming,Shen Lianbing

  journal1. 2017, 24(2): 108-110. https://doi.org/10.3969/j.issn.1006-5253.2017.02.009

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  Objective To explore bone type constituent, the age and other information of patients admitted in recent years, and to provide a better basis for treatment. Methods Basic information of rthopaedics hospitalization patients in our hospital from 2012 to 2015 was analyzed, mainly including bone type composition, age distribution and hospitalization time. Results Lumbar disc herniation rose from third in 2012 to first in 2014 and in 2015, followed by cervical spondylotic myelopathy, knee osteoarthritis, fracture of lumbar vertebra and hand injury sequently. The age survey results showed more and more young patients were with different types of bone injury. And time statistics showed that in recent years more patients selected long-term hospitalization, in order to ensure the best treatment effect. Conclusion The clinical treatment plans should be increased for the top 5 illnesses and should provide best rehabilitation training. People also need to pay attention to their eating habits and rest time, and to reduce the risk of bone fracture occurred to the greatest degree.