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2019 Vol. 26, No. 4
Published: 2019-08-25
 
 
241 Achievements, challenges and suggestions in the development of health care in the new era
Zhang Xuegao
DOI: 10.3969/j.issn.1006-5253.2019.04.001
This paper reviews the main achievements of the development of health care in recent 10 years and the challenges of health care work at present, and provides information support for implementing the healthy China strategy and deepening the reform of medical and health care system. The analysis shows that the health level of Chinese people has been improved significantly, ranking among middle income countries. The national health insurance system has been improved and the level of security has been improved. The health service system continued to be improved, and the accessibility, quality and satisfaction of residents of the medical and health services increased significantly. We have been making orderly progress in making it available to the public, and effectively ensuring the development of health programs. With the development of social economy, the current health work is also facing the challenges of unbalanced and insufficient development, the unestablished human-oriented integrated service system, the aging of population, and the increasing burden of chronic diseases.
2019 Vol. 26 (4): 241-245 [Abstract] ( 70 ) HTML (1 KB)  PDF (841 KB)  ( 253 )
246 Analysis on risk factors of prognosis of hepatocirrhosis patients with hepatic encephalopathy
Yu Bianbian,Jin Keyin
DOI: 10.3969/j.issn.1006-5253.2019.0４.002
Objective To explore the risk factors of poor prognosis of hepatocirrhosis patients with hepatic encephalopathy (HE), and provide preventive strategy for it.Methods Totally 259 hepatocirrhosis patients with HE were investigateda with followingup, and these patients were divided into the poor prognosis group (65 cases) and the good prognosis group (194 cases) according to the prognosis condition of patients. The poor prognosis rate of HE was analyzed, and the risk factors of poor prognosis of HE were screened with multiple factors logistic regression method. Results The poor prognosis rate of HE in this study was 25.10% (65/259). Multiple factor logistic regression method showed that the risk factors of poor prognosis of HE included childpugh grades (OR=3.688, 95%CI:1.861～7.309), HE stages (OR=10.612, 95%CI:3.807～29.579), infection (OR=2.268, 95%CI:1.290～3.989), electrolyte disturbance (OR=2.604, 95%CI:1.472～4.606) and abnormal blood ammonia (OR=4.341, 95%CI:2.341～8.047).Conclusion Hepatocirrhosis patients with HE has a high rate of poor prognosis. And its high risk factors contain poor liver function, high stage of HE, infection, electrolyte disturbance and abnormal blood ammonia. We should formulate prevention strategy and intervention measures to aim directly at these high risk factors.
2019 Vol. 26 (4): 246-248 [Abstract] ( 88 ) HTML (1 KB)  PDF (833 KB)  ( 156 )
249 Nested casecontrol study on risk factors of acute kidney injury of critically ill patients
Li Xiuyuan, Gao Jinxia, Zhang Zenglei, Lü Hengjuan, Song Qiuying, Li Qiang, Ye Hongting
DOI: 10.3969/j.issn.1006-5253.2019.04.00３

Objective To explore the risk factors of acute kidney injury (AKI) in critically ill patients.Methods In a prospective nested casecontrol study, critically ill patients who were admitted to the ICU ward of a tertiary hospital were followed up as a cohort. They were divided into the case group and the control group according to the acute kidney injury, and the clinical basic characteristics of both groups were compared. Multivariate logistic regression was used to analyze the influencing factors of AKI in critically ill patients.Results Totally 426 critically ill patients meeting the inclusion criteria entered the cohort, with 112 patients in the case group and 314 patients in the control group. There were significant differences between both groups in gender, age, APACHE II score, number of extrarenal organ failure, severe infection, CKD, hypertension, diabetes, surgery, arterial oxygen partial pressure, lactic acid, blood calcium, serum creatinine, platelets, blood urea nitrogen, serum creatinine, aspartate aminotransferase, and brain natriuretic peptide (P<0.05). Multivariate logistic regression analysis showed that the risk factors for AKI of critically ill patients included age, APACHE II score, and extrarenal organ failure. number, severe infection, CKD, surgery, serum creatinine, and brain natriuretic peptide, with the probability lower than 0.001.Conclusion Old age, high APACHE II score, extrarenal organ failure, severe infection, CKD, surgery, elevated serum creatinine, and elevated brain natriuretic peptide were major risk factors for AKI of critically ill patients, and the abovementioned abnormal indicators suggest increased risk of AKI in patients, so attention should be paid in the c
2019 Vol. 26 (4): 249-252 [Abstract] ( 76 ) HTML (1 KB)  PDF (244 KB)  ( 80 )
253 Clinical features and risk factors analysis on the incidence of hypoglycemia in newborns
Jin Ye
DOI: 10.3969/j.issn.1006-5253.2019.04.00４

Objective To explore the clinical features and correlated risk factors analysis on the incidence of hypoglycemia in newborns. Methods Totally 312 newborns with hypoglycemia were chosen as the hypoglycemic group, and 312 newborns
2019 Vol. 26 (4): 253-255 [Abstract] ( 92 ) HTML (1 KB)  PDF (837 KB)  ( 124 )
256 Influence factor analysis of using ordinal ploytomous logistic regression in prognosis of knee osteoarthritis patients
Xu Zejie, Xu Xuemeng
DOI: 10.3969/j.issn.1006-5253.2019.04.005
objective To analyze the clinical features and influence factors of knee osteoarthritis patients.Methods A retrospective survey was conducted of 2 191 knee osteoarthritis patients in our hospital from 2016 to 2018, including gender, age, onset seasons, hospitalization days, case classification, and treatment methods and outcomes. Ordinal ploytomous logistic regression was used to analyze the influencing factors of the outcome of patients with knee arrhythmias.Results The incidence rates of knee osteoarthritis in summer and autumn (58.20%) were higher than those in spring and winter (41.8%). Age, case classification and treatment methods were the influence factors of the outcome (P<0.05), and gender, onset seasons and hospitalization days were not the significant influence factors of the outcome (P>0.05). Compared with general patients, critical patients had a poor prognosis (OR=0.31, P=0.01). Knee arthroplasty (OR=3.50, P<0.001), knee injection (OR=3.60, P<0.001) and arthroscopic therapy (OR=1.80, P<0.001) had better prognosis than traditional treatment.Conclusion It is important to prevent the occurrence of knee Osteoarthritis in summer and autumn and milder patients should be treated as early as possible.
2019 Vol. 26 (4): 256-258 [Abstract] ( 55 ) HTML (1 KB)  PDF (886 KB)  ( 188 )
259 Analysis of the application effect of information-motivation-behavior skill model in the outside hospital management of cerebral apoplexy patients
Zhu Liyan, Lan Huolian
DOI: 10.3969/j.issn.1006-5253.2019.04.006
Objective To analyze the application effect of information-motivation-behavior skill (IMB) model in the outside hospital management of cerebral apoplexy patients.Methods Totally 88 patients with cerebral apoplexy who were diagnosed and met the inclusion criteria in our hospital were selected from Jan. 2017 to Feb. 2018, and they were randomly divided into the observation group (n=44) and the control group (n=44) according to the random number table method. The control group was treated with routine outside hospital management, and the observation group was treated with IMB model intervention besides routine outside hospital management. The rate of reaching standard of clinical related indicators, the incidence and treatment of nursing problems, and the quality of life after intervention were compared between the two groups.Results After discharge, the rates of reaching standard of blood pressure, Hba1c and blood lipid of the observation group were significantly higher than those of the control group (P<0.05). There were no significant differences in the rate of reaching standard of coagulation function and body mass index (BMI) between the two groups (P>0.05). The incidence of nursing problems of the observation group was significantly lower than that of the control group (P<0.05), while the correct rate of handling nursing problems was significantly higher than that of the control group (P<0.05). After the intervention, the quality of life of the observation group was significantly higher than that of the control group (P<0.05).Conclusion IMB model has significant effects in the outside hospital management of cerebral apoplexy patients.
2019 Vol. 26 (4): 259-262 [Abstract] ( 50 ) HTML (1 KB)  PDF (843 KB)  ( 82 )
263 Risk factors of TORCH infection in pregnancy and its impact on pregnancy outcome
Xu Guoqin
DOI: 10.3969/j.issn.1006-5253.2019.04.007
Objective To investigate the risk factors of TORCH infection in pregnancy and its influence on pregnancy outcome.Methods Totally 960 cases of pregnant women who underwent maternity examination in our hospital from February 2017 to January 2018 were selected as the study subjects. Cytomegalovirus (CMV), Toxoplasma gondii (TOX), rubella virus (RV) and herpes simplex virus (HSV) infection were detected in all pregnant women. Clinical data were collected including the age of all pregnant women which were divided into the group under 34 years old and the group of 34 years old and above, educational level, adverse pregnancy history (including abortion, premature delivery, fetal malformation, and stillbirth, etc.), income level which was divided into the group lower than 3 200 yuan and the group of 3 200 yuan and above according to the average wage of our city, family background (rural and urban), and animal contact history. The pregnancy outcomes of all pregnant women were followed up.Results In 960 pregnant women, 77 cases of TORCH infection were detected and the infection rate was 8.02%. They were treated as the infection group. Among them, 31 cases were CMV-IgM positive (3.23%), 7 cases were TOX-IgM positive (0.73%), 16 cases were RV-IgM positive (1.67%) and 23 cases were HSV-IgM positive (2.40%). Univariate analysis showed that education level, adverse pregnancy history and animal contact history were risk factors for TORCH infection in pregnant women. Multivariate logistic regression analysis showed that education level, adverse pregnancy history and animal contact history were independent risk factors for TORCH infection in pregnant women. The incidence of preterm birth, abortion, stillbirth, intrauterine infection and fetal growth retardation was higher in the infected group than that in the noninfected group (P<0.05).Conclusion Educational level, adverse pregnancy history and animal contact history are independent risk factors for TORCH infection in pregnant women. TORCH infection can cause severe pregnancy outcomes.
2019 Vol. 26 (4): 263-265 [Abstract] ( 63 ) HTML (1 KB)  PDF (836 KB)  ( 147 )
266 Analysis of risk factors for diabetic nephropathy complicated with proteinuria
Zhou Haiyan, Chen Ru, Gu Na
DOI: 10.3969/j.issn.1006-5253.2019.04.008
Objective To explore the risk factors of diabetic nephropathy complicated with proteinuria, and provide evidence for relevant departments to develop preventive measures.Methods Totally 92 patients with diabetes mellitus admitted to a hospital from July 2016 to December 2018 were enrolled. Selfmade questionnaires were used to collect patientrelated data and laboratory tests and multivariate logistic regression was used to screen for risk factors for diabetic nephropathy complicated with proteinuria.Results Among 92 patients with diabetes, 28 cases of diabetic nephropathy with proteinuria, the incidence rate was 30.43%. Multivariate logistic stepwise regression analysis showed that the course of disease (OR=2.195), BMI (OR=1.634), LDL-C (OR=1.829), TG (OR=1.259), HbAlc (OR=1.642), UA (OR= 1.579) and hypertension (OR=1.381) were risk factors for diabetic nephropathy with proteinuria (P<0.05).Conclusion Active health education, shortening the course of disease, reduction of body weight, and control of blood pressure and blood lipids can reduce the incidence of diabetic nephropathy with proteinuria.
2019 Vol. 26 (4): 266-268 [Abstract] ( 57 ) HTML (1 KB)  PDF (837 KB)  ( 350 )
269 Analysis of correlation risk factors of neonatal respiratory failure
Li Jinghua
DOI: 10.3969/j.issn.1006-5253.2019.04.009

Objective To explore the related risk factors and prevention and treatment measures of neonatal respiratory failure.Methods Totally 186 neonates with respiratory failure and 188 neonates without respiratory failure in the intensive care unit admitted to our hospital from January 2016 to December 2018 were collected, and the number of primary diseases and related factors of neonatal failure in the two groups were compared.Results The proportion of rural children, preterm delivery, cesarean section, multiple pregnancy, intrauterine distress and pregnancy complications in the study group were higher than those in the control group, and the difference was statistically significant (P<0.05). Among the primary diseases of neonatal respiratory failure, the proportions of amniotic fluid aspiration pneumonia, meconium aspiration syndrome, respiratory distress syndrome, congenital heart disease and birth asphyxia in the study group were higher than those in the control group, with statistically significant differences (P<0.05). The results of logistic multivariate analysis showed that preterm delivery, cesarean section, amniotic fluid aspiration pneumonia, respiratory distress syndrome and birth asphyxia were the independent risk factors of neonatal respiratory failure (P<0.05).Conclusion The cause of neonatal respiratory failure is related to many factors, so it is necessary to strengthen the monitoring of the living place, premature delivery, cesarean section, amniotic fluid aspiration pneumonia, respiratory distress syndrome, birth asphyxia and other risk factors.
2019 Vol. 26 (4): 269-271 [Abstract] ( 49 ) HTML (1 KB)  PDF (832 KB)  ( 210 )
272 Analysis of factors related to patients' compliance to hormone replacement therapy as treatment for climacteric syndrome
Yu Xiaojuan, Li Yaqin
DOI: 10.3969/j.issn.1006-5253.2019.04.010

Objective  To explore factors related to hormone replacement therapy (HRT) in compliance of patients with climacteric syndrome.Methods A retrospective analysis was conducted on 105 patients with climacteric syndrome who received hormone replacement therapy from February 2014 to March 2018 in our hospital. The differences of factors affecting patients' HRT compliance were compared.Results Of the 105 patients, 40 (38.09%) had poor compliance and 65 (61.91%) had good compliance. Univariate analysis showed that education level, occupation, economic income, marital status, cognition, family support, medical expenses, medical conditions, adverse reactions and doctor-patient relationship all had significant effects on patient HRT compliance. Logistic regression analysis showed that low level of education, manual labor occupation, poor economic income, single marital status, lack of cognitive status, lack of family support, selfpay for medical expenses, inconvenient medical conditions, adverse reactions and poor doctorpatient relationship were risk factors for poor HRT compliance.Conclusion There are numerous factors affecting HRT compliance in menopausal syndrome. It is necessary to improve the compliance of HRT by combining the actual situation of patients and implementing targeted measures.
2019 Vol. 26 (4): 272-274 [Abstract] ( 62 ) HTML (1 KB)  PDF (830 KB)  ( 98 )
275 Application of systematic occupational therapy in rehabilitation treatment of patients with chronic schizophrenia
Shen Yunmei, Zhou Yan, Huang Guoxiu, Wang Lingai, Xu Meiyu
DOI: 10.3969/j.issn.1006-5253.2019.04.011
Objective To analyze the effect of systematic occupational therapy in rehabilitation treatment of patients with chronic schizophrenia.Methods Totally 86 patients with chronic schizophrenia diagnosed in our hospital and who met the inclusion criteriafrom Jan. 2018 to June 2018 were selected as the research objects, and the random number table method was used to divide them into the observation group and the control group. and they were divided into observation group and control group by random number table method. Patients in the control group were treated with routine antipsychotic drugs and closed nursing management.Patients in the observation group were given systematic occupational therapy besides that in the control group. The mental status, quality of life and social function of the two groups before and after nursing intervention were compared.Results After the nursing intervention, the scores of the brief psychiatric rating scale (BPRS) of the two groups were significantly lower than those beforethe intervention. The difference between before and after the intervention of the observation group was (13.71±2.25), and that of the control group was (6.65±3.12).The difference of the observation group was significantly larger than that of the control group (t=12.035, P＜0.001).Scoresof generic Quality of Life Inventory-74 (GQOLI-74) of the two groups of patients were higher than those before the intervention.The differences of the observation group in material life, mental health, and social function dimensions before and after the intervention were (1.59±1.12), (7.02±2.26), (8.23±2.15), and (6.70±3.55), while those of the control group were (0.92±0.25), (0.92±0.25), (2.68±2.14), and (3.14±2.25).The differences of the observation group were significantly larger than those of the control group (t=3.829, 11.290, 5.554, P＜0.001).The scores of the Scale of Social Skills for Psychiatric Inpatients(SSPI) in both groups were significantly lower than those before the intervention. The difference of observation group was (5.78±1.35)before and after intervention, and that of the control group was (1.97±0.31).The difference of the observation group was significantly larger than that of the control group (t=18.037, P＜0.001).ConclusionThe application of systematic occupational therapy in rehabilitation of patients with chronic schizophrenia is significant and worthy of clinical promotion.
2019 Vol. 26 (4): 275-277 [Abstract] ( 69 ) HTML (1 KB)  PDF (834 KB)  ( 114 )
278 Analysis on influencing factors and strategy of drug treatment compliance of patients with type 2 diabetes mellitus
Du Xiuqin.
DOI: 10.3969/j.issn.1006-5253.2019.04.012
Objective  To explore the drug treatment compliance and its correlated influencing factors of type 2 diabetes mellitus (T2DM), and provided intervention strategy for it.Methods Totally 220 cases with T2DM were investigated with following-up, and theses patients were divided into the good compliance group and the poor compliance group according to the compliance of treatment. The correlated risk factors were screened by multiple factors non-conditional logistic regression method.ResultsThe poor compliance rate of T2DM patients in this study was 37.3% (82/220). Multiple factors analysis result indicated that the factors of high age (OR=2.537，95%CI：1.118～5.417), bad relationship between doctors and patients (OR=3.387，95%CI：1.777～6.455), lack of knowledge of diabetes (OR=3.428，95%CI：1.897～6.196), adverse drug reaction (OR=3.869，95%CI：2.157～6.938), many kinds of drugs (OR=3.209，95%CI：1.741～5.915) and complications (OR=5.523，95%CI：2.760～11.055).Conclusion There is a bad drug compliance of treatment of T2 DM patients. We should enhance health education, followingup and management of the elderly patients, and medication instruction after leaving hospital, and we should also correctly cope with doctorpatient relationship, in order to raise treatment compliance of patients.
2019 Vol. 26 (4): 278-280 [Abstract] ( 67 ) HTML (1 KB)  PDF (892 KB)  ( 574 )
281 Analysis of quality of life and influencing factors in patients with type 2 diabetes
Chen Daina
DOI: 10.3969/j.issn.1006-5253.2019.04.013
Objective  To analyze the current quality of life and its influencing factors in patients with type 2 diabetes.Methods Totally 500 patients with type 2 diabetes admitted to our hospital from February to October 2018 were chosen with random number table method. Questionnaires were used to collect the general data, and with the quality of life scale, univariate analysis and multiple linear regression analysis were used to analyze the factors influencing the quality of life.Results  The quality of life of patients with type 2 diabetes was generally low. According to single factor analysis, the factors affecting quality of life mainly included drinking, education, disease duration and the number of complications. The quality of life of drinking patients was poor. The higher education, the longer the course of the disease, and the fewer number of complications showed the higher quality of life. The results of multiple linear regression analysis showed that R2=0.128, which were djusted to R2=0.121, F=18.154, and P<0.001. That meant patients without drinking, high education, long duration of disease and few number of complications were the main influencing factors of quality of life.Conclusion The quality of life is affected by drinking, the degree of education and the number of complications. Therefore, improving the patient's disease awareness, abstaining from alcohol, controlling their own physical condition, and reducing the incidence of complications are the keys to ensuring the quality of life.
2019 Vol. 26 (4): 281-282 [Abstract] ( 74 ) HTML (1 KB)  PDF (174 KB)  ( 179 )
283 Disease spectrum of inpatients admitted to the Neurology Department in a hospital of the coastal area from 2014 to 2018
Xia Yongmei, Li Caixia, Yu Ling, Ye Honghui
DOI: 10.3969/j.issn.1006-5253.2019.04.014
Objective  To explore the composition and characteristics of the disease spectrum of inpatients in the Department of Neurology in the coastal area between 2014 and 2018, and to provide scientific basis for disease prevention and treatment clinically.Methods The clinical data of inpatients in the Neurology Department from Jan. 2014 to Dec. 2018 were extracted from the data system of the hospital and analyzed retrospectively. The 10th revision of the International Statistical Classification of Diseases (ICD-10) was used to classify the cases, and descriptive statistical analysis was conducted on the number of patients.
2019 Vol. 26 (4): 283-285 [Abstract] ( 65 ) HTML (1 KB)  PDF (940 KB)  ( 138 )
286 Comprehensive evaluation of the medical quality of some tertiary coastal hospital from 2013 to 2018
Chen Xiaoping, He Fei, Yan Yubing
DOI: 10.3969/j.issn.1006-5253.2019.04.015
Objective  To research on the comprehensive evaluation of the medical quality of some tertiary coastal hospital from 2013 to 2018 to provide basis reference for comprehensive examination and scientific administration of the hospital.Methods Rank sum ratio (RSR) method was used for the selected eighteen indexes to evaluate comprehensively the medical quality in this hospital from 2013 to 2018.Results The overall medical quality of this hospital has been on the rise in the past six years. There was a significant difference in the RSR mean value of three different levels (P<0.05) by single factor analysis, and the comprehensive evaluation of the medical quality was the worst in 2014, and the best in 2018.Conclusion The result of the evaluation of the medical quality with rank sum ratio (RSR) method is scientific and straightforward for the coastal hospital, so RSR is suitable for the comprehensive evaluation of the medical quality of hospitals.
2019 Vol. 26 (4): 286-288 [Abstract] ( 55 ) HTML (1 KB)  PDF (836 KB)  ( 154 )
289 Application of DRGs evaluation system in hospital management operation mode
Jia Nong, Luo Wei
DOI: 10.3969/j.issn.1006-5253.2019.04.016
Objective To explore the management and operation mode of DRGs index system in a hospital.Methods Medical record front page and coding data were standardized and the management model was constructed based on the DRGs index system. DRGs specialist system in clinical departments was established and the communication platform was set up. DRGs indexes were introduced into the department performance appraisal system.Results Through the framework of the management and operation system, the integration of all resources of the hospital, the linkage of multiple departments, the introduction of DRGs index system into the hospital management, and the solid basic work, the quality of the first page of the medical records of the hospital has improved, hospital connotation management has achieved results, and the comprehensive ranking of hospitals at the same level in the province has increased.Conclusion Management pays off and the hospital management has stepped into a new milestone by building a scientific and standardized operation mode based on DRGs index, promoting basic work in a standardized way, and gradually moving from the evaluation of subjective impression to the objective evaluation based on data and scientific basis.
2019 Vol. 26 (4): 289-292 [Abstract] ( 64 ) HTML (1 KB)  PDF (231 KB)  ( 268 )
293 Application study on dietary intervention combined with psychological development training in the practice for patients with impaired glucose regulation
Wang Zhe, Song Yang
DOI: 10.3969/j.issn.1006-5253.2019.04.017
Objective  To explore the effect of the intervention model combining dietary intervention with psychological development training, and to provide reference for intervention work in primary hospitals.Methods Patients found in the physical examination of People's Hospital of Dingtao District of Heze from January to March 2018 to have met the standards of impaired glucose regulation and suitable for participating in the study were randomly divided into the intervention group and the control group. The intervention group was given a sixmonth dietary intervention combined with psychological development training. The control group was only given dietary guidance according to routine medical advice after physical examination.Results Compared with the control group, the total dietary energy intake level of the intervention group was significantly controlled (P＜0.01), fat intake was reduced (P＜0.05), and dietary fiber intake was significantly increased (P＜0.01). The fasting blood sugar (P＜0.01), postprandial blood sugar (P＜0.05) and triglyceride (P＜0.01) of the intervention group were all controlled.Conclusion Compared with the control group, dietary intervention combined with psychological development training is helpful to control the development of the disease. This mode is suitable for promotion in primary medical institutions.
2019 Vol. 26 (4): 293-296 [Abstract] ( 53 ) HTML (1 KB)  PDF (845 KB)  ( 213 )
297 Application of followup procedure management in the postoperative patients with liver cancer
Wang Jie
DOI: 10.3969/j.issn.1006-5253.2019.04.018
Objective To analyze the application of enhanced followup management in patients with hepatocellular carcinoma.Methods Totally 96 patients with liver cancer who were hospitalized in our hospital from April 2015 to June 2016 were divided into the control group and the observation group according to the random number table method, and the two groups were followed up from the discharge. The control group received the routine followup method, and the observation group received the followup procedure management. After one year followup, the survival quality, therapeutic compliance and satisfaction of followup were compared between the two groups.Results In the control group, the scores of somatic function, fatigue symptom, loss of appetite, sleep disturbance and diarrhea were all significantly improved, while in the observation group, except for no obvious change in the difficulty in breathing and the economic situation, other aspects improved obviously and the improvement degrees of the observation group were better than those of the control group (P<0.05). Time review, regular medication, and diet treatment compliance in the observation group were significantly higher than those in the control group on (P<0.05). The scores of the contents of followup, the way of followup and the effects of followup in the observation group were significantly higher than those in the control group (P<0.05), and the overall followup satisfaction score in the observation group was significantly higher than that in the control group (P<0.05).Conclusion The followup procedure management has positive effects on improving the quality of life of liver cancer patients and improving treatment compliance and satisfaction.
2019 Vol. 26 (4): 297-300 [Abstract] ( 63 ) HTML (1 KB)  PDF (843 KB)  ( 94 )
301 Effect of visual health education management based on bedside IPAD on the satisfaction degree of obstetric inpatients
Sun Qian, Ye Qiong
DOI: 10.3969/j.issn.1006-5253.2019.04.019
Objective To explore the effect of visual health education management based on bedside IPAD on the satisfaction degree of obstetric inpatients.Methods A randomized controlled study design was used to divide the inpatients into groups with digital random table. In the control group, 44 cases were given routine health education. In the observation group, 44 cases were treated with visual health education management based on bedside IPAD. The quality of life and satisfaction degree data of the two groups were collected, and the differences between the two groups were statistically analyzed.Results The quality of life score (70.47±6.43) and satisfaction degree score (26.67±2.45) of the observation group were higher than those of the control group (45.47±6.36, 20.67±3.04), the difference was statistically significant(t=18.34,10.19, P＜0.01).Conclusion Visual health education management based on bedside IPAD can improve the quality of life and improve the satisfaction degree of obstetric inpatients.
2019 Vol. 26 (4): 301-303 [Abstract] ( 63 ) HTML (1 KB)  PDF (829 KB)  ( 115 )
304 Effectiveness evaluation of clinical health education pathway application in cirrhotic ascites patients
Fan Jingjing, Huang Xiandan, Wang Haini
DOI: 10.3969/j.issn.1006-5253.2019.04.020
Objective To explore the intervention effect of clinical health education pathway in cirrhotic ascites patients.Methods Totally 120 cirrhotic ascites patients were randomly divided into the control group and the observation group, with 60 cases in each group. The control group was given usual health education, and the observation group received clinical health education pathway. The indexes of standardreaching rate of health knowledge, treatment compliance, selfcare ability and incidence rate of complications were compared between the two groups after intervention.Results After intervention, the standardreaching rate of health knowledge in the observation group was 86.67%, higher than that in the control group (66.67%, P<0.05), and the treatment compliance in the observation group was 93.33%, higher than that in the control group. The scores of health knowledge, selfrecognition, selfresponsibility and self nursing skills in the observation group were all higher than those in the control group (P<0.05). But the incidence rate of complication in the observation group was 10.00%, lower than that in the control group (26.67%, P<0.05).Conclusion The intervention of clinical health education pathway could raise the mastery degree of knowledge, treatment compliance and selfnursing ability, cut down the incidence rate of complications, and improve the prognosis of cirrhotic ascites patients.
2019 Vol. 26 (4): 304-306 [Abstract] ( 67 ) HTML (1 KB)  PDF (833 KB)  ( 186 )
307 Diagnosis and operation filling and coding defect of the first page of high rate paying cases based on DRGs payment
Liang Jingxing, Zhao Yuebao, Huang Yong, Wu Yuewen, Huang Xiaolin, Lun Yanhong, Ye Mingkun, Yang Hongjuan, Wu Xiaomin, Xie Liling, Zhou Tingting
DOI: 10.3969/j.issn.1006-5253.2019.04.021
Objective To analyze the defective problems existing in the data filling in the front page of medical records of the high rate cases whose cost were more than twice the average cost based on DRGs payment in a hospital, and to put forward improvement measures.Methods The hospital received the high rate cases which were grouped by DRGs and settled expenses between January, 2018 and June, 2018 from the Social Security Bureau's feedback. Combined with DRGs payment mode, under the guidance of the diagnosis operation selection standard announced by the Health Development Planning Commission and the Principles of International Classification of Diseases, selfcheck and retrospective analysis were conducted, and the defects were classified and counted with 6 cases of high rate paying.Results Totally 111 of 526 high rate cases had defect problems related to clinicians and coders, with defective rate 21.11%, and among them, 47, 20, 12 and 29 cases were clinicians' main diagnostic error selection, main operation error selection , main diagnosis and operation error selection, and missing of diagnosis or operation, respectively. The percentage of errors was 42.34%, 18.02%, 10.81% and 26.13% respectively. The coders' main diagnosis coding error and main surgical coding error were 2 and 1 cases respectively, with error rate 1.8% and 0.9% respectively.Conclusion The high rate paying cases caused by the defects of the filling diagnosis and operation and the coding defects on the front page of medical records were closely related to the quality of filling by clinicians and the coding level of coders. Effective measures are to train clinicians to correctly select diagnosis and operation, improve coders' professional skills, and optimize coders' work, so as to reduce high rate cases caused by defective problems.
2019 Vol. 26 (4): 307-310 [Abstract] ( 56 ) HTML (1 KB)  PDF (897 KB)  ( 538 )
311 Investigation on the cognitive status of the national essential medicine system of outpatients in Zhoushan City
Qiu Lin
DOI: 10.3969/j.issn.1006-5253.2019.04.022
Objective To investigate the cognitive status of the national essential medicine system among outpatients in Zhoushan City and explore its influence factors, in order to provide reference for decisionmaking.Methods A questionnaire survey was conducted among 1 500 outpatients in a tertiary hospital and the community health service center.Results Totally 1 398valid questionnaires were collected, with an effective recovery rate of 93.2%. The awareness rate of the national essential medicine system of outpatient patients was 42.2%, and the proportion of community health service center was higher than that of the general hospital. The main channels of awareness were doctor introduction (53.39%) and network (48.31%). And 58.81% outpatients thought that they were benefited greatly from the system, 50.5% outpatients were satisfied with the curative effect of the essential medicine, 32.03% outpatients thought that the medicine price was lower, 67.29% outpatients thought that the essential medicine were well equipped, 20.34% outpatients thought they would choose essential medicine on their own initiative, with the proportion of community health service center higher than that of the general hospital, 43.39% outpatients would ask doctors about essential medicine initiatively, 30.34% outpatients went to community health service to see doctors and bought medicine more frequently and the proportion of community patients buying medicines in the community was higher than that in general hospitals, 78.47% out patients advocated giving priority to essential medicine, 56.73% outpatients would pay attention to the changes of essential medicine policy initiatively, and 76.76% outpatients were willing to publicize the essential medicine system.Conclusion The main ways for outpatients to understand the national essential medicine system are doctor introduction and network. The recognition level and recognition degree of the system are not high, the support degree is high, and the drug use behavior is not affected by the system.
2019 Vol. 26 (4): 311-315 [Abstract] ( 75 ) HTML (1 KB)  PDF (849 KB)  ( 100 )
316 Investigation and countermeasure research on community doctors' cognitive tendency of graded diagnosis and treatment
Liu Guobing
DOI: 10.3969/j.issn.1006-5253.2019.04.023
Objective To investigate the cognition of the graded diagnosis and treatment of the community residents through the investigation of the graded diagnosis and treatment of the staff of the community health service center in Haidian District, to investigate the staff's perception and recognition of graded diagnosis and treatment, to explore the existing problems and causes, and to put forward countermeasures.Methods Questionnaires were used to evaluate indicators with statistical methods.Results The study found that the professional titles were mainly concentrated in the attending physicians and primary physicians, with the academic level 53.17% of the undergraduate education, followed by junior college education 24.6%, and the number of doctors and nurses accounted for 53.62% of the total. In the course of the study, the attitudes of the attending physicians and primary physicians in promoting the graded diagnosis and treatment work were also investigated, and the result P>0.05 indicated that there was no difference in the attitudes of doctors with different professional titles in promoting the graded diagnosis and treatment work. The support attitude of doctors with a bachelor's degree and a junior college degree towards the promotion of graded diagnosis and treatment was investigated, and the result P>0.05 indicated that there was no difference in the support attitude of doctors with different degrees towards the promotion of graded diagnosis and treatment. The above data showed that doctors with different professional titles and educational backgrounds held a consistent attitude towards the promotion of graded diagnosis and treatment.Conclusion The promotion of graded diagnosis and treatment to achieve the policy goal of "primary diagnosis, twoway referral, rapid division and treatment, up and down linkage" is conducive to the mobility of patients and the overall reintegration of medical resources, it enhances the service capacity of primary medical institutions, enhances the service relationship between residents and doctors, and improves the utilization efficiency of medical resources.
2019 Vol. 26 (4): 316-318 [Abstract] ( 55 ) HTML (1 KB)  PDF (826 KB)  ( 119 )
319 Investigation on HBV infection status of pregnant women and risk factors of HBV intrauterine infection in Yinzhou District of Ningbo City
Zeng Xiaoyi, He Xiaoling, Xu Lili, Huang Mengjia
DOI: 10.3969/j.issn.1006-5253.2019.0４.024
Objective To explore the status quo of HBV infection in pregnant women in Yinzhou District of Ningbo City and related risk factors of HBV intrauterine infection, and provide reference for clinical HBV prevention.Methods Questionnaire analysis was conducted on 1 100 pregnant women who first established health cards in the hospital, simultaneously chemiluminescence was used to detect serum hepatitis B markers in pregnant women. According to the results, 182 pregnant women with hepatitis B surface antigen (HBsAg) positive were followed up until the pregnant woman gave birth, and the placental tissue and cord blood of pregnant women during childbirth were collected. The umbilical cord blood HBsAg was detected with enzyme linked immunosorbent assay (ELISA), the blood and blood HBV-DNA of pregnant women was detected with realtime PCR, and the HBsAg of the placenta tissue was detected with immunohistochemistry. Unconditional logistic regression analysis and χ2  test were used to analyze the influence factors of HBV intrauterine infection.Results Among the 1 100 pregnant women, 182 pregnant women were found to be HBsAg positive, and the HBV infection rate was 16.55%. Through cord blood test, a total of 36 HBV intrauterine infections occurred in 182 pregnant women, and the HBV infection rate was 19.78%. The survey results showed that The main risk factors for HBV intrauterine infection in pregnant women included prepregnancy overweight, placental HBsAg positive, and maternal serum hepatitis B E antigen (HBeAg) positive (OR=3.377, 5.155, 4.651, P<0.05).Conclusion For obese pregnant women with HBsAg and HbeAg positive, the incidence of HBV intrauterine infection is large, so they must be given high priority, and they need to improve their own protection awareness, strengthen preventive measures, so as to avoid the risk of infection.
2019 Vol. 26 (4): 319-320 [Abstract] ( 77 ) HTML (1 KB)  PDF (181 KB)  ( 183 )
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