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2020 Vol. 27, No. 4
Published: 2020-08-25
 
 
289 Application of 10-fold cross-validation in the evaluation of generalization ability of prediction models and the realization in R
Liang Zichao, Li Zhiwei, Lai Keng, Lin Zhuochen, Li Tiegang, Zhang Jinxin.
DOI: 10.3969/j.issn.1006-5253.2020.04.001
Objective To introduce the basic principle of 10-fold cross-validation, and use R to show the application of 10-fold cross-validation in the evaluation of the generalization ability of prediction models in an example. Methods The logistic regression model was used with 10-fold cross-validation as the evaluation method to predict the treatment outcome of drug-resistant tuberculosis patients. At the same time, the 5-fold, 10-fold, and leave-one-out cross-validation were used to compare the parameters of evaluation. Results Different divisions of training and test sets have influence on the parameters of evaluation. Compared with other cross-validation methods, the parameters of evaluation from 10-fold cross-validation have a higher stability and efficiency than other numbers of fold. Conclusion In the evaluation of the application effects of machine learning models, the comprehensive performance of 10-fold cross-validation is prominent and the generalization ability of different models can be objectively measured.
2020 Vol. 27 (4): 289-292 [Abstract] ( 109 ) HTML (1 KB)  PDF (2885 KB)  ( 426 )
293 Research on the long-term change trend of inpatient expenses of a tertiary hospital in Shenzhen based on grey correlation analysis
Wu Xiaoyun, Tang Xuemin, Liu Xueyan, Zheng Yinxiong, Yu Changrong.
DOI: DOI:10.3969/j.issn.1006-5253.2020.04.002
Objective To analyze the structure and main influence factors of hospitalization expenses, and the difference of the change trend between the insured and the self-paying population, andto put forward pertinent suggestions to control the medical expenses. Methods The grey correlation analysis method was used to analyze the medical expenses of inpatients in a hospital from 2007 to 2017, and to distinguish between the insured and the self-paying population. Results From 2007 to 2017, the average medical expenses continued to rise. In 2011, the average expenses of self-paying patients began to exceed those of insured patients. The cost of medicine and consumables were the main factor affecting medical expenses. Medicine expenses have been effectively controlled, but the cost of consumables is rising continuously. Conclusion The focus of medical expense control in the future is the cost of medical consumables. At the same time, we should continue the pricing reform of medical service, improve the pricing standards that embody the labor value of medical staff, promote the healthy adjustment of medical expenses and guide the healthy development of the medical industry.
2020 Vol. 27 (4): 293-297 [Abstract] ( 47 ) HTML (1 KB)  PDF (5987 KB)  ( 191 )
298 Gray correlation analysis and trend prediction on average general hospitalization expenses: example of joint replacement patients
Hou Jifei, Hu Chuan, Wang Yue, Li Jing, Zhang Yun.
DOI: 10.3969/j.issn.1006-5253.2020.04.003
To provide scientific basis and suggestion for further reasonable control of hospitalization expenses about joint replacement patients and reduce their economic burden. Methods Gray correlation analysis and grey prediction model(1,1) were used to analyze the influencing factors of the hospitalization expenses from 2013 to 2018, and then to forecast drug proportion and overall average hospitalization costs per patient from 2019 to 2023. Results Consumables fee and drug cost were main factors for average total hospitalization expenses; from 2019 to 2023, the predictive value of drug proportion and average total hospitalization costs were presented the downward trend. Conclusion Hospitalization expenses about surgical patients have been controlled, and technical value of medical staff has been upgraded.The hospital should continue to control the cost of consumables and drugs, accelerate to implement enhanced recovery after surgery, speed up the reform of supporting measures, and maintain a good trend of development.
2020 Vol. 27 (4): 298-302 [Abstract] ( 78 ) HTML (1 KB)  PDF (873 KB)  ( 299 )
303 Construction of the index system of professional quality evaluation of coders based on analytic hierarchy process
Wu Youmei, Guo Jiayi, Xu Minhui, Wu Lijuan,Zheng Pan, He Guobin.
DOI: 10.3969/j.issn.1006-5253.2020.04.004
Objective To construct a scientific, reasonable and practical evaluation system for the professional quality of coders, and to provide reference for the talent construction, training and evaluation of Chinese coding team. Methods The evaIuation index system for professional quality of coders was determined by literature research method and expert scoring method, and the weights of each index were calculated by analytic hierarchy process. Results The professional quality evaluation system of coders have 2 first-level indicators, 6 second-level indicators and 47 thirdlevel indicators. The top three thirdlevel indicators combination weights are "the mastery degree of disease physiology, clinical manifestations, surgical procedure, anatomy knowledge"(0.049 7), "keep on learning new code structure and the classification rules"(0.045 9), and "the ability of summarizing and drawing inferences " (0.039 9). Conclusion In this study, a professional quality evaluation system of coders was constructed, which provided a reference basis for the cultivation and evaluation of coders. However, further empirical research was still needed for continuous improvement.
2020 Vol. 27 (4): 303-307 [Abstract] ( 81 ) HTML (1 KB)  PDF (864 KB)  ( 215 )
308 Anxiety status and logistic regression analysis of the influencing factors in elderly patients with insomnia
Yang Zhaoxi, Wan Ailan, Liu Lidan, Wu Guojiang, Xu Mengxia, Tian Yangli.
DOI: 10.3969/j.issn.1006-5253.2020.04.005
Objective To investigate the anxiety status of elderly patients with sleep disorder and analyze its influencing factors. Methods Totally 155 elderly patients with sleep disorders who were admitted to the Department of Psychosomatic Medicine of the First Affiliated Hospital of Nanchang University from September 2018 to May 2019 were selected, and the patients were investigated with Hamilton anxiety scale (HAMA), Eysenck personality questionnaire (EPQ-N) and Toronto alexithymia scale (TAS-20). Results Eighty-two percent (127/150) of the elderly patients with sleep disorder had anxiety symptoms in varying degrees, and the HAMA score was (17.06 ±9.68). The results of Logistic regression analysis showed that male, high educational level and high family income were the protective factors of anxiety symptoms in elderly patients with sleep disorder(P＜0.05). Unstable neurotic personality and alexithymia were the risk factors of anxiety symptoms (P＜0.05). Conclusion Most elderly patients with sleep disorders had different degrees of anxiety symptoms. And it was affected by gender, education, family income, neurotic personality type and alexithymia.
2020 Vol. 27 (4): 308-310 [Abstract] ( 57 ) HTML (1 KB)  PDF (1199 KB)  ( 280 )
311 Investigation on risk factors of children Kawasaki disease complication with coronary artery lesion
Zhou Lizhen, Wang Yangyan.
DOI: 10.3969/j.issn.1006-5253.2020.04.006
Objective To explore the incidence rate and risk factors of children Kawasaki disease (KD) complication with coronary artery lesion (CAL). Methods Totally 283 children with KD were retrospectively investigated, and they were divided into the CAL group and the NCAL group according to the occurrence of coronary artery disease. The incidence rate of CAL in children with KD was described, and the high risk factors of CAL in children with KD were screened by χ2 test and multiple factors logistic regression methods. Results The incidence rate of CAL in 283 children with KD was 31.10%. The risk factors of CAL in children with KD included heating time (OR=2.818), delayed diagnosis and treatment (OR=3.459), hs-CRP (OR=3.815), erythrocyte sedimentation rate (OR=4.031), cTnI (OR=5.618) and IVIG resistance (OR=4.618). Conclusion Children KD have a high incidence rate of CAL. To aim directly at these above high risk factors, we should early screen, diagnose and treat children with KD, to cut down the incidence rate of CAL, and improve the prognosis of children with KD.
2020 Vol. 27 (4): 311-314 [Abstract] ( 57 ) HTML (1 KB)  PDF (1200 KB)  ( 213 )
315 Analysis of related factors of hypotension in hemodialysis patients
Yang Xiao, Chen Zengchao, Wang Lei.
DOI: 10.3969/j.issn.1006-5253.2020.04.007
Objective To explore and analyze the related influencing factors of hypotension in hemodialysis patients. Methods Totally 105 hemodialysis patients admitted to our hospital from October 2016 to September 2019 were selected as study subjects. According to whether hypotension occurred, they were divided into the observation group (hypotension) and the control group (nonhypotension), including 48 cases in the observation group and 57 cases in the control group. Retrospective analysis was used to compare the clinical data of the two groups of patients to analyze and summarize the related factors of hypotension in hemodialysis patients. Results The results of single factor analysis showed that age, body mass index, dialysis mode, ultrafiltration volume, ultrafiltration rate, hemoglobin, albumin,fasting blood glucose and PTH levels of hemodialysis patients were all influencing factors of hypotension in hemodialysis patients (P＜0.05). Multifactor results showed that age ≥60 years old, ultrafiltration rate ≥2 000 mL, ultrafiltration volume ≥10 mL/min, fasting blood glucose ≥7.8 mmol/L and PTH≥400 pg/mL were risk factors for hypotension in hemodialysis patients (P＜0.05), and albumin ≥25 g/L was a protective factor for hypotension in hemodialysis patients (P＜0.05). Conclusion Older age, higher ultrafiltration rate, larger ultrafiltration volume, lower albumin, higher blood glucose and higher PTH level are risk factors for hypotension in hemodialysis patients.
2020 Vol. 27 (4): 315-318 [Abstract] ( 59 ) HTML (1 KB)  PDF (855 KB)  ( 167 )
319 Analysis of deep vein thrombosis after femoral neck fracture and its influencing factors
Gu Lianhua, Wu Huiguo, Lu Yongwei, Xu Hongwei, Zhou Youlong, Chen Xing.
DOI: 10.3969/j.issn.1006-5253.2020.04.008
Objective To explore the occurrence of deep venous thrombosis (DVT) after femoral neck fracture and analyze its influencing factors. Methods Totally 120 patients with femoral neck fractures admitted to our hospital from January 2018 to September 2019 were selected and divided into the DVT group and the non-DVT group. Age, sex, Body Mass Index (BMI), smoking history, hemoglobin a1c, total cholesterol, triglyceride(TG) as well as fracture lateral position, ASA classification, anesthesia method, operation time, operation method and intraoperative blood transfusion volume were compared between two groups. The influencing factors of deep vein thrombosis after femoral neck fracture were analyzed with multivariate logistic regression. Results The incidence of DVT in patients with smoking history, with Hip arthroplasty, triglyceride>1.7mmol/L, glycosylated hemoglobin >6%, body mass index>25 kg/m2, with intravenous inhalation anesthesia were significantly higher, and the difference was statistically significant (χ2=4.144, 3.902, 4.257, 4.123,4.018, 3.902, all P＜0.05). Multivariate Logistic regression analysis showed that high body mass index, smoking history, high Hemoglobin a1c, high triglycerides and hip-joint replacement surgery were the risk factors of DVT incidence (OR=5.037, 7.935, 4.999, 3.976, 5.098, all P＜0.05). ConclusionThe incidence of DVT after femoral neck fracture was high, and  body mass index, smoking history, high Hemoglobin a1c, high triglycerides and hipjoint replacement surgery were the risk factors of DVT incidence. Preventive intervention should be strengthened in patients with high risk factors.
2020 Vol. 27 (4): 319-321 [Abstract] ( 63 ) HTML (1 KB)  PDF (850 KB)  ( 179 )
322 Expression and significance of TSHR, TTF-1 and Pax-8 in papillary thyroid carcinoma
Liu Lin, Wang Lizhe, Zhang Yongqing, Li Rujiang, Zhuang Baoxiang
DOI: 10.3969/j.issn.1006-5253.2020.04.009
Objective To investigate the expression and significance of thyrotropic-stimulating hormore receptor (TSHR), thyroid transcription factor-1 (TTF-1), paired box gene-8 (Pax-8) in papillary thyroid carcinoma (PTC), Hashimoto′s disease (HT) with PTC, nodular goiter (NG) and normal thyroid tissues. Methods From September 2018 to June 2019, thyroid tissues confirmed in the Endocrine Department of our hospital and operated in the Thyroid Surgery were collected, including 16 cases of simple PTC, 24 cases of HT combined with PTC, 32 cases of nodular goiter and 40 cases of normal thyroid tissues adjacent to the carcinoma. The thyroid tissues obtained during the operation were treated with dehydration, transparency and embedding. Immunohistochemical staining of TSHR, TTF-1 and Pax-8 was performed, and the staining results were observed under the microscope.The Chi-square test was used to compare the intergroup rates, and when the difference was statistically significant, Chisquare partition was used to make pairwise comparison. Results 1) There were significant difference about the strong positive expression of TSHR and TTF-1 among four groups of thyroid tissue (P＜0.001,P=0.004), while no significant difference in the strong expression of Pax-8 were found among four groups of thyroid tissue (P=0.642). 2) After adjusting the statistical examination level α′=0.008, pairwise comparison showed that the strong positive expression of TSHR in PTC group was lower than that in NG and normal thyroid tissue(P＜0.001, P=0.002);the strong positive expression of TSHR in HT combined with PTC group was lower than that in NG (P=0.001); while the strong positive expression of TTF-1 in HT combined with PTC group was lower than that in NG (P=0.002).However,there was no significant difference of the strong positive expression of TSHR, TTF-1 in other groups respectively (P>0.008). 3)The positive expression of TSHR,TTF-1 were not related to age, tumor diameter and lymph node metastasis. However, the positive expression of Pax-8 inpatients with lymph node metastasis was lower than that without lymph node metastasis (P=0.030), and the expression of Pax-8 was not related to gender, age, and tumor diameter. Conclusion The strong positive expression of TSHR and TTF-1 in PTC group was lower than that in NG and paracancerous normal thyroid tissues. There was no difference in the expression of Pax8 in different types of thyroid tissues. The lower expression of Pax-8 in PTC tissues might result in lymph node metastasis.
2020 Vol. 27 (4): 322-325 [Abstract] ( 60 ) HTML (1 KB)  PDF (863 KB)  ( 180 )
326 Analysis on risk factors of ventilator associated pneumonia of the elderly patients in ICU
Yang Dandan, Zhang Wei, Zhang Wenyuan.
DOI: 10.3969/j.issn.1006-5253.2020.04.010
Objective To explore the incidence rate and risk factors of ventilator associated pneumonia (VAP) of the elderly patients with mechanical ventilation in ICU, and provide measures of prevention. Methods Totally 1 564 cases of the elderly patients with mechanical ventilation in ICU were retrospectively investigated. The incidence rate of VAP of the elderly patients with mechanical ventilation in ICU was analyzed, and the risk factors of VAP were respectively screened by χ2 test and multiple factor Logistic regression method. Results The incidence rate of VAP of the elderly patients with mechanical ventilation in ICU was 20.97% (328/1564). Multiple factor analysis result showed that the risk factors of VAP of the elderly patients with mechanical ventilation in ICU included consciousness disorder (OR=3.149), mechanical ventilation time≥5 d (OR=3.766), indwelling time≥7 d (OR=4.195), gastric reflux (OR=2.883), broad-spectrum antibiotics≥7 d (OR=5.339), use of acid preparation (OR=2.370) and hypoproteinemia (OR=3.515). Conclusion The incidence rate of VAP of the elderly patients with mechanical ventilation in ICU is more than 20%. To aim directly at these above high risk factors, prevention measures should be adopted early to cut down the incidence rate of VAP and improve prognosis.
2020 Vol. 27 (4): 326-329 [Abstract] ( 63 ) HTML (1 KB)  PDF (850 KB)  ( 206 )
330 Effect evaluation of clinical pathway of 10 diseases in a tertiary hospital in Guangxi
Zhou Hongzhen, Wu Yunhong, Teng Yanfei, Zhou Lin, Wei Mingchao, Wei Fang.
DOI: 10.3969/j.issn.1006-5253.2020.04.011
Objective To evaluate the implementation effect of clinical pathways of 10 diseases in a tertiary hospital in Guangxi. Methods Ten diseases of new clinical pathways from January to June 2018 were selected, and the cases within the previous year of the implementation of clinical pathway were put into the control group, and the cases within one year after the implementation of the clinical pathway were put into the pathway group.The hospitalization days, hospitalization expenses, and disease outcomes of the two groups were compared. Results Totally 1 133 cases were included in the pathway group and 914 cases were included in the control group. The hospitalization days, total expenses and drug proportion in the pathway group were smaller than those in the control group, and the treatment efficiency in the pathway group was higher than that in the control group,with the differences statistically significant (P<0.05). Some indexes of diseases did not achieve the expected effects after the clinical pathway was implemented. The hospitalization days and drug proportion in the pathway group of cerebral ischemic diseases were higher than those in the control group, the total expenses of the pathway group of the phimosis day surgery were larger than that of the control group, the drug proportion of the pathway group of the craniocerebral injury and ureteral stent was higher than that of the control group, the material proportion of the pathway group of schizophrenia and cervical masses day surgery was larger than that of the control group,and the differences were statistically significant (P<0.05). Conclusion The hospital has achieved certain results in implementing the clinical pathway, but some problems still need to be improved. The hospital can take targeted improvement measures to improve the relevant processes of the clinical pathway.
2020 Vol. 27 (4): 330-334 [Abstract] ( 72 ) HTML (1 KB)  PDF (864 KB)  ( 92 )
335 Analysis of the changes in the composition of patients′ hospitalization expenses in a tertiary hospital in Xinjiang
Zhu Yanhua, Lu Xiaolei, Qian Lijuan, Lu Bingli.
DOI: 10.3969/j.issn.1006-5253.2020.04.012
Objective To provide basis for reasonable cost control management of medical institutions by analyzing the change trend of patients′ hospitalization expenses in a hospital from 2015 to 2019. Methods The structural change analysis method was adopted, and Excel 2007 was used to analyze the data. Results The hospitalization expenses first increased and then slightly decreased, among which the drug and other expenses decreased year by year; the laboratory expenses, inspection expenses and surgical treatment expenses increased year by year, and the latter two remained stable up to 2018; the drug expenses and material expenses changed in a negative direction, the expenses such as the inspection expenses all changed in a positive direction; the contribution rate of the drug expenses, surgical treatment expenses and material expenses was relatively large for structural variability. Conclusion The development of medical technology, the adjustment of the price of health material, the price of drugs and the price of medical services will all affect the change of the structure of medical expenses. The medical management department is supposed to adopt the comprehensive management measures to manage and control, so as to make the structure of medical expenses more inclined to rationalization.
2020 Vol. 27 (4): 335-338 [Abstract] ( 64 ) HTML (1 KB)  PDF (7952 KB)  ( 114 )
339 Analysis of the current situation of personnel turnover in a comprehensive tertiary hospital in Hebei Province from 2016 to 2018
Qiao Xujie, Chen Sufeng, Zhang Juan, Zhang Yashu, Qin Anqi, Zhang Xinping .
DOI: 10.3969/j.issn.1006-5253.2020.04.013
Objective To understand the general law of the flow of personnel, provide some reference and suggestions for the management of talents by the personnel department, and provide a certain reference for the reasonable flow of health personnel in the region. Methods Through the statistics of the turnover of employees in a tertiary hospital in Hebei Province during the three years from 2016 to 2018, a database was established. Comprehensive information was used to analyze the phenomenon and reasons of human mobility through interviews with personnel of the Personnel Department. Results The inflowing personnel were larger than the outflowing personnel. The mobile workers were mainly doctors and nursing staff, agent staff, employment staff and authorized staff, mostly with junior titles and undergraduate degrees, ≤30 years old, and women. Conclusion The promotion opportunities, remuneration benefits, family situation and public opinion pressure are the main factors for the flow of health personnel. It is recommended to strengthen the personnel management of hospitals, reform the hospital employment system, improve the talent reserve mechanism and talent introduction mechanism, developing dominant disciplines, establish a perfect performance appraisal system, and focus on ability and performance, separate evaluation and appointment, retain talents, reduce staff turnover.
2020 Vol. 27 (4): 339-344 [Abstract] ( 65 ) HTML (1 KB)  PDF (875 KB)  ( 205 )
345 Effect of emergency classification on the treatment efficiency and nursing satisfaction of emergency patients
Lei Taoying.
DOI: 10.3969/j.issn.1006-5253.2020.04.014
Objective To explore the effect of emergency condition grading on the treatment efficiency and nursing satisfaction for emergency patients. Methods Totally 158 patients admitted to the Emergency Department from November to December 2018 were randomly selected as the control group, and they were given routine grading method. While 162 patients admitted to the same department from January to February 2019 were randomly selected as the observation group, and they were assessed by four-level grading criteria. The two groups were compared of the efficiency of treatment and nursing satisfaction. Results The waiting time, medication time and treatment time of the observation group were shorter than those of the control group, while the hospitalization rate was lower than that of the control group, and the difference was statistically significant (P<0.05). The overall satisfaction of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). Conclusion Emergency condition grading can improve the efficiency and satisfaction of emergency patients, and improve the experience of patients.
2020 Vol. 27 (4): 345-348 [Abstract] ( 57 ) HTML (1 KB)  PDF (2645 KB)  ( 274 )
349 Study on the incidence and the influencing factors of colorectal cancer in Hanting District of Weifang
Ma Jinjin, Feng Yikuan, Zhang Yuying,Jiang Bing,Yi Wenjing,Ding Yanle.
DOI: 10.3969/j.issn.1006-5253.2020.04.015
Objective To explore the incidence and influencing factors of colorectal cancer and to understand the prevalence of colorectal cancer in Hantang District, Weifang City, Shandong Province, so as to provide evidence for the prevention of colorectal cancer and screening of high-risk population. Methods The newly diagnosed cases of primary colorectal cancer in Hanting District from 2016 to 2018 were collected and the incidence trend was analyzed. A 1∶2 matched casecontrol study was conducted to investigate 105 colorectal cancer patients and 210 normal controls to explore the influencing factors of colorectal cancer. Results In 2018, the incidence of colorectal cancer in Hanting District was 28.15/100 000, and the incidence of colorectal cancer in people over 40 years of age increased gradually. And multivariate logistic regression analysis showed that family history of tumors,irregular meals, pickled food and fat meat were risk factors for colorectal cancer (P＜0.05, OR>1), while sleep quality was protective factors for colorectal cancer. Conclusion From 2016 to 2018, the incidence of colorectal cancer in Hanting District is higher than that in China showing an increasing trend year by year and there was age differences. Therefore, strengthening the early intervention of highrisk population in this area is of great significance to reduce the incidence and mortality of colorectal cancer.
2020 Vol. 27 (4): 349-353 [Abstract] ( 45 ) HTML (1 KB)  PDF (922 KB)  ( 218 )
354 Analysis of myopia and related risk factors of elementary school students in Mentougou District of Beijing
Zhou Guirong，Zhang Fang， Dong Lixue
DOI: 10.3969/j.issn.1006-5253.2020.04.016
Objective To understand the prevalence of myopia and related risk factors among elementary school students in Mentougou District of Beijing. Methods A stratified cluster sampling method was used to select 3 882 elementary school students in the district for nakedeye vision testing, automatic computer optometry and questionnaire survey. Results The myopia rate of primary school students surveyed was 32.97%, and the myopia rate of girls was 34.80%, higher than that of boys (31.16%) (χ2=5.816, P=0.016). The myopia rate also increased with the grade (r=0.997,t=27.385, P0.001). Multivariate logistic regression analysis: the time used for doing homework more than 2 hours every day after school, time used in the computer for more than 2 hours a day, time used by teachers with the electronic screen for more than 15 minutes per class, reading a book or electronic screen under direct sunlight, time in watching TV or playing computer games without the limit of parents, and the break between classes in the teaching building were risk factors for myopia (OR=1.219, 95%CI:1.048-1.418; OR=1.489, 95% CI:1.066-2.097; OR=1.209, 95% CI:1.049-1.392; OR=2.316, 95% CI:1.639-3.271；OR=1.282, 95% CI:1.003-1.640；OR=1.206，95% CI:1.041-1.397). One of the parents was myopia and both parents were nearsighted, were risk factors for myopia (OR=1.558, 95% CI:1.270-1.911; OR=1.394, 95% CI:1.166-1.667; OR=2.058，95% CI:1.682-2.518).Conclusion The myopia rate of girls in elementary schools in Mentougou District of Beijing was higher than that of boys, and it increased with grades. The main risk factors related to myopia were long eye use time, time in watching TV or playing computer games without the limit of parents, improper use of eyes.
 
2020 Vol. 27 (4): 354-357 [Abstract] ( 65 ) HTML (1 KB)  PDF (925 KB)  ( 193 )
358 Coding of main diagnosis and treatment procedures for lung cancer
Ye Qian, Guo Jiayi, Zheng Pan, Zheng Suting, Wang Saibin, Xu Minhui, Guo Xiaodong.
DOI: 10.3969/j.issn.1006-5253.2020.03.017

Objective To explore the operation code of main diagnosis and treatment methods of lung cancer.Methods The main diagnostic operations in the field of lung cancer mainly include transbronchial needle aspiration biopsy, transbron chial lung biopsy, transbronchoscope pollution protection brush technology and bronchoalveolar lavage, etc.; while the therapeutic operations mainly include high frequency electric cauterization technology, cryoablation, endotracheal stent implantation, radiofrequency ablation of lung cancer and radioactive particle implantation through bronchoscope, etc. In this paper, we analyzed the clinical knowledge of the aforementioned diagnosis and treatment operations, and then sorted out and summarized the corresponding codes based on the classification principles of ICD-9-CM-3.Results Different diagnosis and treatment methods, operation sites and approaches led to different operation classification codes.Conclusion In order to accurately code and fully express medical record information, coders need to fully understand the latest clinical technologies, master the principles of surgical classification, and review the medical records carefully.

 

 
2020 Vol. 27 (4): 358-361 [Abstract] ( 75 ) HTML (1 KB)  PDF (851 KB)  ( 1359 )
362 Realization of entropy weight method to determine evaluation index weight in Excel
Lin Jianchao
DOI: 10.3969/j.issn.10065253.2020.04.018
Objective To determine the weight of the evaluation index with the use of the entropy weight method. Mehods The program function of Excel office software was used to calculate the weight of evaluation indicators.Results Excel program can calculate the weight of each evaluation index quickly and accurately.Conclusion The realization of entropy weight method to determine evaluation index weights in Excel holds lessons for evaluation of medical quality.

 
2020 Vol. 27 (4): 362-364 [Abstract] ( 96 ) HTML (1 KB)  PDF (10944 KB)  ( 96 )
365 Realization of accurate data statistics for day ward with retrieval module  designed
Zhu Lin.
DOI: 10.3969/j.issn.1006-5253.2020.04.019
Objective To solve the needs of accurate data statistics for day ward, with a retrieval module designed. Methods This paper introduces design basis and ideas, designs PL/SQL program,  embeds SQL query statements in the CMIS system program, and uses cases to analyze the operation process and module function. Results Through manual, day ward logo, the use of module for comparison, it is of high practical value to use the retrieval module for information statistics of day ward.Conclusion The module could ensure the accuracy of day patient information. The value of information is reflected, and better services are provided for clinical, scientific research, management analysis, and data excavation.

 
2020 Vol. 27 (4): 365-367 [Abstract] ( 44 ) HTML (1 KB)  PDF (3713 KB)  ( 168 )
368 Development of the software of breast ultrasound screening ability assessment system for doctors in Shenzhen community breast cancer screening network
Li Huan, Wang Enli, Shao Zhuang, Wang Xinwang
DOI: 10.3969/j.issn.1006-5253.2020.04.020
Objective To design a simple, easy-to-use, high-efficient and safe breast ultrasound screening system software for doctors in Shenzhen community breast cancer screening network.Methods Based on ASP.NET platform development of Microsoft, the main programming languages are C and JavaScript. The popular interface layout and self-developed view engine are used to ensure the system easy to use. Remote procedure call is used to communicate with the database to ensure the data security.Results Tested online by six social health centers in Shenzhen as test users according to the navigation interface of breast ultrasound screening ability assessment system, the test results show that it is convenient for users to input, add, modify the data of the test cases and upload the ultrasonic images, ensuring "the screening results are available after input".Conclusion The software can help doctors of 600 social health centers in Shenzhen which have been trained in ultrasound skills in community breast cancer screening outlets to sort out the image and data of ultrasound screening of breast cancer in Shenzhen women online and judge the results, and then to carry out online assessment on the breast ultrasound screening ability of doctors in community breast cancer screening outlets. At the same time, it can be used as a part of the special service package signed by the basic level of family doctors in Shenzhen, and it has a good application prospect.
2020 Vol. 27 (4): 368-370 [Abstract] ( 44 ) HTML (1 KB)  PDF (7277 KB)  ( 18 )
371 Research progress on cognition and intervention of children′s parents on adverse effects of immunization
Duan Wenjing, Lu Ying, Yan Bo, Lin Aihua
DOI: 10.3969/j.issn.1006-5253.2020.04.021
understanding parents′ awareness of adverse events following immunization(AEFI) and exerting interventions are effective measures to promote immunization. This article summarized on this topic, and the results indicated that non-floating subjects with a high level of education and who lived in cities had a higher awareness of( AEFI)related knowledge. Health education is the most commonly used intervention, and it has been reported to be effective in different studies, while there is still no evaluation on long-term effects. Internet-based interventions were not seen in current studies. In addition, previous studies have not found the effect of internet-based interventions on cognitive intervention of adverse effects of vaccination.It is necessary to carry out well-designed further randomized control trials with a large sample size to explore the effects of different interventions, especially effects of long-term intervention.
2020 Vol. 27 (4): 371-374 [Abstract] ( 90 ) HTML (1 KB)  PDF (515 KB)  ( 259 )
375 Seasonal change trend analysis of the number of inpatients in a southern province from 2010 to 2019.
Chen Long
DOI: 10.3969/j.issn.1006-5253.2020.04.022
Objective To analyze the change rule of the number of inpatients in a southern province from 2010 to 2019, and to provide scientific basis for health resource allocation, planning and development, scientific management and service improvement in the province.Methods Based on the monthly data of the inpatients in the province in 10 years, the time series analysis method was adopted to calculate the quarterly and monthly seasonal index through the moving average method to find out the seasonal variation rule of the inpatients.Results The number of inpationts in this southern province has been steadily increasing yearly for ten years.Seasonal indexes of January, February, September and October were less than 100%,and the seasonal indexes in the remaining months were greater than 100%.The seasonal indexes of the first quarter were less than 100% and those of the remaining quarters were greater than 100%.Conclusion Inpatient medical services are growing steadily year by year. It is necessary to constantly improve the capacity of inpatient admission and treatment, rationally make use of the changing characteristics of inpatient demand in "offseason" and "peak season", and formulate appropriate response measures to meet the increasing needs of the people for inpatient services.

 
2020 Vol. 27 (4): 375-378 [Abstract] ( 66 ) HTML (1 KB)  PDF (1418 KB)  ( 195 )
379 Statistical analysis of death cases in the emergency department of a tertiary hospital in Guangzhou from 2014 to 2018   
Xie Wei
DOI: 10.3969/j.issn.1006-5253.2020.04.023
Objective To analyze the cause of death and distribution rule of emergency death in a tertiary hospital in Guangzhou in the past five years, in order to further improve the emergency treatment level of the hospital, and formulate preventive measures and provide reference basis.Methods A retrospective analysis of 1 588 deaths was conducted in the emergency department from 2014 to 2018. The International Classification of Diseases (ICD-10) was used to encode the cause of death, and descriptive statistics and analytical methods were used to analyze the epidemiological characteristics of the deaths in the Emergency Department of the hospital.Results Among the 1 588 emergency deaths, males were more than females (male to female ratio 1.42 ∶1), and the maximum number of deaths was in the group of 80-89 years old(34.13%).Conclusion Among the root causes of death, circulatory disease (I00-I99)ranked the first  (39.86%), the second was tumor (C00-D48), accounting for 22.10%, and the third was respiratory diseases (J00-J99), accounting for 21.47%. It is suggested to conduct regular physical examination, pay attention to the elderly and male groups, conduct early screening for elderly people and cancer patients, improve community health management, raise residents′ health awareness, advocate healthy lifestyle, improve the firstaid treatment system, and reduce the risk of death in emergency.
 
2020 Vol. 27 (4): 379-381 [Abstract] ( 49 ) HTML (1 KB)  PDF (492 KB)  ( 182 )
382 Investigation of nosocomial infections in the infusion room of a tertiary children′s hospital
Zhang Xiaoxiao, Cheng Xiaowei, Chen Si.
DOI: 10.3969/j.issn.1006-5253.2020.04.024
Objective To investigate the situation and risk factors of nosocomial infections in the outpatient transfusion room of a tertiary children′s hospital, and to provide a basis for the formulation of preventive measures.Methods Totally 178 children who were treated in the outpatient transfusion room of our hospital from July 2018 to May 2019 were included in this study. The relevant data were collected, the incidence of nosocomial infections was analyzed, and the risk factors were analyzed.Results Among the 178 outpatients in the infusion room, 30 cases of nosocomial infection occurred and the incidence rate was 16.85%.Among the infection types, the incidences of gastrointestinal infection, upper respiratory tract infection and respiratory tract infection were higher, which were 46.67%, 30.00% and 16.67%. Logistic analysis showed that, age (<3 years old), nurse′s seniority (<4 years), infusion time (≥9 d), the number of infusion rooms (≥20 people) and the application of antibacterial drugs (unreasonable) were risk factors for nosocomial infection in the outpatient infusion room.(OR>1, P<0.05).Conclusion The risk factors for hospital infection in the infusion room of the children′s hospital are longterm infusion, lowage children, and lowgrade nurses, large number of infusion rooms and unreasonable use of antibacterial drugs. It is especially important to take targeted interventions to control nosocomial infections.
 
2020 Vol. 27 (4): 382-384 [Abstract] ( 78 ) HTML (1 KB)  PDF (498 KB)  ( 83 )
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