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25 April 2021, Volume 28 Issue 2
    

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  • Li Jingkun, Wang Xinyu, Li Xi, Wang Chao, Liu Meina
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    Objective To analyze the trend of utilization rate of treatment quality evaluation index for ST-segment elevation myocardial infarction (STEMI) from 2011 to 2017; to calculate the comprehensive treatment quality score of acute myocardial infarction to obtain the variation trend and variation of the comprehensive quality, and to provide evidence for improving the quality of STEMI treatment. Methods Twelve STEMI treatment quality evaluation indicators which were recommended by I kind in STEMI treatment guidelines were selected, and data of STEMI patients were extracted from the singledisease surveillance system to calculate the utilization rate of the STEMI treatment evaluation indicator. The denominator weighting method was used to obtain the comprehensive score and variation of treatment quality, and the trend test was conducted. Results Compared with 2011, among the 12 treatment quality indicators, the utilization rate of PCI within 90 min of hospital arrival increased the most, and the use rate of beta blockers immediately after hospital arrival decreased the most, showing a statistically significant trend test. Between 2011 and 2017, the comprehensive score of hospitals did not change obviously with time, but the interquartile interval increased with time. Conclusion The utilization rate of most of the treatment quality indexes of STEMI in China has been significantly improved; the trend of hospital comprehensive score was stable, but the variation between hospitals was enlarged.
  • Zhao Yuanyuan, Yang Niannian, Dai Juan, Jin Qiman, Zhang Xiaoxia, Yan Yaqiong
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    Objective To analyze the mortality rate of chronic obstructive pulmonary disease (COPD) and its trend in residents in Wuhan from 2009 to 2018.  Methods COPD mortality data from 2009 to 2018 were from Wuhan population based mortality surveillance system. The crude and standardized mortality rates of COPD were calculated of different geographic distribution, different gender and different age, and the trend over years were analyzed. The software SAS 9.4 was used for linear regression analysis, and the annual percent change (APC) was calculated. Results The crude mortality rate and the standardized mortality rate of COPD were 33.01/100 000 and 23.03/100 000 respectively in residents in Wuhan from 2009 to 2018. The crude mortality rate showed an increasing trend from 2009 to 2018 and the APC was 4.08%, (P<0.05). The crude mortality rate was 41.23/100 000 in males and 24.47/100 000 in females(χ2=6.37, P<0.05). The crude mortality rate was 35.29/100000 in rural areas and 32.28/100 000 in urban areas, and there was no statistical significance(χ2=0.20, P>0.05). The crude mortality rate showed increasing trends in males and rural areas, and the APC were 4.08% (P<0.05) and 5.10% (P<0.05) respectively. There was no statistical significance in the trends of females and urban areas, and the APC was 2.02% (P>0.05). Except for those aged 35-45 years old, the standardized mortality rate of COPD in all age groups showed a downward trend from 2009 to 2018. Conclusion The COPD mortality in residents in Wuhan increased from 2009 to 2018. More attention should be paid to reducing COPD mortality in rural residents, males and elderly population.
  • Li Xiaoling, Yang Fen, Ye Yiyi, Su Jianjun, Zhang Zhi
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    Objective To analyze the risk factors for recurrence of acute ischemic stroke (AIS) and assess the risk of recurrence. Methods Based on the historical medical record data, a retrospective study with 1 779 new hospitalized AIS cases (age≥ 8 years) admitted in a hospital from 2011 to 2017 was carried out, and AIS recurrence in Shenzhen was assessed based on a multivariate cox regression model.Results Hypertension (HR=2.862), drinking history (HR=1.002), NIHSS≥4 points (HR=2.868) and Essen≥3 points (HR=2.997-4.743) were high-risk predictors of recurrence in AIS patients (P<0.05). Conclusion Hypertension, drinking history, high NIHSS and Essen scores are risk factors for AIS recurrence. Early screening and strengthening management of AIS patients is the key to preventing AIS recurrence.
  • Liao Haidong, Yan Xiong, Zhang Qiantong
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    Objective To investigate the epidemiological characteristics of accidental injuries and the situation of out-of-hospital treatment in Zhoushan Island New District, and to analyze the possible problems in the process of first aid treatment on the spot. Methods Retrospective analysis was carried out on accidental injury data from January to December 2019 by 120 ambulances sent to the emergency department of the hospital with complete pre-hospital first aid records, 941 cases met the inclusion criteria, and SPSS 17.0 was used for statistical analysis. Results Males were more injured accidentally than females in Zhoushan Island New District, with a rate of 1.36∶1. Age is concentrated in 30-50 years old, and education level is concentrated in primary school and below. The time distribution of different occupational injuries: there were two peak periods of fishermen injuries from February to April and from September to November; the injuries of migrant workers in construction sites were mainly from February to March and from July to September; the injuries of workers and students were mainly from January to February and from June to August; the incidence time distribution of professional and technical personnel, preschool children and other occupations had no obvious peak period. The top 3 injury types were fall/sprain, traffic injury and bluntforce trauma and the main injury sites were upper limbs and head. The incidence of traffic injury was the highest among the migrant workers in the construction site and the professional technicians, and the incidence of fall/sprain was the highest in the other occupations. The duration of serious injury and light injury were (3.5±3.3) h and (1.7±1.6) h respectively. The duration of serious injury was longer than that of light injury (P<0.05) and the degree of injury was proportional to the duration of the disease. There were more minor injuries among the patients treated with first aid on the spot than serious injuries, and there was significant difference between the patients treated with first aid on the spot (P<0.05). Conclusion Relevant departments should strengthen the supervision of various industries and the training of risk prevention in safe operations. The hospital makes a targeted emergency plan to improve the success rate of pre-hospital first aid.
  • Tan Kangming, Zhou Qin, Wu Zhenyu.
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    Objective To investigate the risk of second primary bladder cancer (SPBC) in prostate cancer patients after radiation therapy and to assess the robustness of the results to unmeasured confounding. Methods Data from the surveillance, epidemiology and end results (SEER) database of prostate cancer patients with a clear pathological diagnosis from 2004 to 2009 were selected. Patients were divided into radiotherapy and non-radiotherapy groups according to whether they received radiotherapy or not. PSM was applied to match the two groups of patients, the risk of SPBC in post-radiation prostate cancer patients was evaluated using a competing risk model, and sensitivity analysis for unobserved confounders was performed to assess the robustness of results.Results Totally 83 064 radical prostatectomy patients were included in this study, of whom 5 141 (88 with SPBC) and 77 923 (753 with SPBC) were categorized into radiotherapy and non-radiotherapy group. Pre and post=matching competing risk models showed that radiotherapy increased the risk of SPBC in patients undergoing radical prostatectomy (pre-matching SHR=1.438, 95% CI=1.133-1.824, P=0.003; post-matching SHR=1.586, 95%CI=1.076-2.215, P=0.007). Sensitivity analysis showed that the association of unmeasured confounding with radiotherapy and SPBC OR=1.65, and SHR=1.84 could make the observed difference in SPBC between radiotherapy and non-radiotherapy patients insignificant. Conclusion  The increased risk of SPBC in prostate cancer patients due to radiotherapy should be judged with caution, and a confounding factor with a relatively low association with outcome or treatment may nullify the results.
  • Zhang Qi, Sun Lin, Liu Meina
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    Objective To construct the co-expression network Henoch-Schonlein purpura nephritis (HSPN) of children to screen the functional modules and key genes that related with the progression of HSPN, so as to explore the safe and non-invasive biomarkers of renal injury for the diagnosis, treatment and prognosis of HSPN. Methods We analyzed the correlations between clinical indicators and HSPN progression, and screened the differentially expressed genes between HSP and HSPN patients. Network modules related to the clinical indicators were obtained through weighted gene co-expression network analysis, and GO enrichment analysis was performed for genes in these modules. Key genes were selected according to MM and GS, and their expressions were analyzed in the four progression groups of HSP, HSPN type I, HSPN type II and HSPN type III. Results Hematuria/proteinuria, serum IgA, CRP and C3 were related with the progression of HSPN. Totally 2 399 genes were differentially expressed in HSPN patients, and ten modules were obtained by weighted gene co-expression network analysis, three of which were most relevant to the clinical indicators. Genes in the modules were mainly enriched in the biological processes of immune response mediated by neutrophils, cytokine activity, leukocyte migration, platelet alpha granules and cell adhesion. Eight genes were selected as key genes for the progression of HSPN, namely GPX1-201, INHBA-201, PHLDA1-201, VEGFA-205, CALM2 -201, CDKN2D-202, LDLRAP1-201 and MAP1LC3B-201. Four of them were involved in biological processes such as inflammation and immune response, and cell cycle regulation. Conclusion The three functional modules obtained in this paper affected the clinical indicators related with HSPN progression by participating in biological processes such as inflammation, immune response, and coagulation response; the selected eight key genes were of biological significance and may become the potential biomarkers for progression and kidney injury of HSPN, which might provide guidance and direction for further studying of the HSPN progression mechanism and exploring the potential biomarkers.
  • Lu Zhen, Liu Yan, Li Jingwei
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    Objective To evaluate the performance of the survival risk gene screening algorithm CoxLASSO-ISIS-N based on the noise-reduction risk gene network, and compare it with five other algorithms to analyze the pros and cons of the algorithm, with a view to providing a new idea of the survival risk gene screening of highdimensional gene expression data. Methods Aiming at the survival risk gene screening problem of highdimensional gene expression data with noise, simulated data and real data were used to analyze six algorithms (CoxLASSO, CoxLASSO-N, CoxLASSO-SIS, CoxLASSO-SIS-N, CoxLASSO-ISIS and CoxLASSO-ISIS-N) to compare and analyze the pros and cons of the algorithms. Results The algorithm CoxLASSO-ISIS-N has the best and most stable performance in the overall estimation effect of the model(LR and CS), the ratio of interpreted information (R2) and consistency (CI). Conclusion CoxLASSO-ISIS-N, a survival risk gene screening algorithm based on noise reduction risk gene network, can reduce noise on highdimensional gene expression data with noise, so as to more accurately screen survival risk genes, better reflect the relationship between the occurrence of death or other outcomes and highdimensional gene expression data and provide a basis for clinical diagnosis and prognosis management.
  • Yang Zhaoxi, Wan Ailan, Huang Xiaoyan, Liang Yanli, Huang Wenmei
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    Objective To explore the relationship between sleep quality and well-being in the elderly and the intermediary effect of state-anxiety between them. Methods One hundred and fifty-five elderly patients with insomnia in the department of psychosomatic medicine of the First Affiliated Hospital of Nanchang University from September 2018 to May 2019 were investigated with Pittsburgh sleeping quality index (PSQI), state-trait anxiety questionnaire (STAI) and memorial university of Newfoundland scale of happiness (MUNSH). Results The STAI score of female patients was higher than that of male patients, and the MUNSH score of patients living alone was lower than that of non-living alone patients (P<0.05). Sleep quality index score was negatively correlated with well-being (r=-0.557, P<0.05), state-trait anxiety was negatively correlated with well-being (r=-0.634, P<0.05), and state-trait anxiety was positively correlated with sleep quality index score (r=0.510, P<0.05). Structural equation model showed that sleep quality had a negative effect on happiness (β=-0.28, P<0.05) and a positive effect on state-trait anxiety (β=0.70, P<0.05), and state-trait anxiety had a negative effect on well-being (β=-0.64, P<0.05). Conclusion State-trait anxiety plays an intermediary role in elderly patients with insomnia. Sleep quality not only directly affects happiness, but also affects the happiness of elderly patients with insomnia through state-trait anxiety.
  • Lao Yahong
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    Objective To discuss the application of grey model (1,1) in the prediction of outpatient volume, so as to provide methodology reference for forecasting the number of outpatient in general hospitals. Methods The grey model GM (1,1) was used to predict and fit the outpatient number, and the relative error was calculated, and the prediction was extrapolated. Results The number predicted by the grey model GM (1,1) and the actual value had a small fitting error, and the accuracy rating of model prediction was excellent (P>0.95). Conclusion The grey model GM(1,1) can provide quantitative reference data for the hospital to arrange outpatient work, and provide scientific decision-making basis for the refined management of modern hospitals.
  • Huang Huanhuan, Zheng Jufang, Yu Shanzhao.
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    Objective To construct a prediction model of diarrhea risk in patients with acute cerebral infarction (ACI) during nasal feeding. Methods A retrospective study was carried out to analyze the clinical data of nasal feeding patients with ACI in the department of intensive care unit and department of neurology from January 2016 to June 2018. The relevant data of the patients were collected. The statistical analysis of SPSS 25.0 software and R 3.6.1 software were applied to construct the nomograph prediction model and evaluate it. Results We collected data of 114 ACI patients with nasal feeding who met the inclusion criteria, of which 42 had diarrhea and 72 had no diarrhea. The use of antibiotics was a risk factor for diarrhea risk in ACI patients with nasal feeding (OR=2.643, 95%CI 1.144-6.289); the use of cellulose containing nutrient solution was a protective factor for diarrhea risk in ACI patients with nasal feeding (OR=0.293, 95%CI 0.117-0.707). Using probiotics, antibiotics and cellulose containing nutrient solution as predictive factor variables, the nomograph prediction model was established. The area under curve (AUC) calculated by ROC curve was 0.732, showing  that the accuracy of the model was good. The evaluation of Calibration curve and Decision curve showed that the consistency and benefits of the model were still available. Conclusion The use of antibiotics is a risk factor for diarrhea in ACI patients with nasal feeding, and the use of cellulose containing nutrient solution is a protective factor for diarrhea in ACI patients with nasal feeding. The accuracy of the prediction model of diarrhea risk in ACI patients with nasal feeding based on the use of probiotics, antibiotics and cellulose containing nutrient solution is accurate, which has certain value for risk prediction and nursing intervention. It could be further verified by the data of multi centers and large samples.
  • Wu Linghong, Ding Li, Ding Rensheng.
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    Objective To describe the hospitalization expenses of stroke patients and analyze the influencing factors, so as to provide targeted and operable measures for reasonable control and reduction of hospitalization expenses. Methods Totally 2343 inpatients with stroke (I60-I64) in the inpatient medical record database of a hospital in 2019 were collected, and univariate analysis and path analysis were used to analyze the influencing factors of hospitalization expenses of stroke patients. Results The average hospitalization cost of stroke patients was 21531 yuan. Among them, drug fees and inspection fees accounted for a relatively large proportion. There were statistically significant differences in the number of hospitalization days, drug costs, and total costs of patients with different ages, medical payment methods, service area radius, hospital admissions, presence or absence of hypertension, surgery, and other diagnoses (P<0.05). The SEM results showed that the drug cost (β=0.73, P<0.05) was the most important influencing factor of hospitalization expenses, followed by the length of hospitalization (β=0.53, P<0.05). The presence or absence of surgery, admission status, number of other diagnoses, service area radius, age, presence or absence of hypertension, and medical payment methods also had an impact on the cost of hospitalization, with  -0.52, 0.14, 0.12, 0.06, -0.06, -0.04, and -0.03 (P<0.05). Conclusion Drug fees, length of stay, surgery, admission status, number of other diagnoses, radius of service area, age, hypertension, and medical payment methods have a significant effect on the total hospitalization cost. Drug cost is the most important factor. The cost of hospitalization of stroke patients can be controlled and reduced by controlling the cost of drugs and shortening the length of hospitalization.
  • Liu Guihao, Xue Yunlian, Wang Sheng, Geng Qingshan.
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    Objective To investigate the number of disease-involved systems of elders and its influence on death for inpatients. Methods According to the international statistical classification of diseases and related health problems (ICD-10), the disease-involved systems of elderly inpatients in a hospital in Guangdong Province were classified. Logistic regression was used to analyze the influence of number of disease-involved systems on death and roc curve was used to analyze its predictive value for the death of inpatients. Results The proportion of diseases involving two or more systems and four or more systems in the hospitalized elders were 76.80% and 30.05% respectively. The proportion of diseases involving 5 or more systems was 20.87% in males, which was statistically higher than that in females (15.30%) (P<0.05). The more number of disease-related systems, the greater the risk of death for older patients (OR=1.471). After adjusting for the effects of age, sex, hospitalization days, transfer section, route of admission, source of patient, operation, combined operation, and case classification, the risk of death for patients would increase 21.00% when number of disease-related systems added one. Number of disease-involved systems had certain predictive value for death of elders in the hospital, with area under roc curve was 0.734 (95% CI: 0.711-0.758). Conclusion Number of disease-related systems was an independent risk factor for hospitalized elders (≥60 years), which suggested that close attention to the number of disease-related systems should be paid and multi-disciplinary codiagnosis and treatment model needed to be established in order to maintain the health status of elders.
  • Chen Ying, Lu Ran, Li Chao.
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    Objective To explore the disease composition of the death cases in a hospital in the last 4 years,  and to provide reference for disease prevention and treatment. Methods All detailed information of inpatients′ deaths from January 2016 to December 2019 was extracted to classify the diseases according to international Classification of diseases (ICD-10), and the age, sex, and disease composition of the death cases was analyzed. Results A total of 2 266 patients died in the hospital from 2016 to 2019, with a fatality rate of 0.8%. The number of hospitalized patients increased year by year, while the fatality rate decreased year by year (P<0.05). There were 1,431 male deaths and 835 female deaths, with a male-to-female ratio of 1.71 to 1. Diseases of the tumor system (30.6%), circulatory system (27.5%) and respiratory system (17.9%), cause of injury poisoning (10.6%) and digestive system (6.1%) ranked the top 5, accounting for 91.7% of the total number of deaths. The first two causes of death in males and females were the same, both were other respiratory diseases and pulmonary malignancies, and there was no gender difference between the two diseases (P>0.05). In addition to tumor and injury poisoning, circulatory, respiratory and digestive diseases were on the rise with age. Except for respiratory diseases, other four diseases showed a downward trend over 70 years old. Conclusion The prevention and treatment of tumors, circulatory diseases and respiratory diseases should be targeted to reduce the fatality rate. According to the characteristics of diseases at all ages, targeted preventive measures can reduce the risk of death and improve the quality of life.
  • Xu Mengqiu, Ding Liping.
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    Objective To analyze the delivery and hospitalization expenses of two-child puerpera in a hospital. Methods From February 2006 to August 2020, 2 474 puerpera were selected from the first page of inpatient medical records, and 4 948 research samples were formed. The basic situation of puerpera were described, as well as constituent ratios and rank of the major diagnoses. The t-test of two groups of independent samples was used to compare the age of delivery, length of stay and hospitalization expenses of women with vaginal delivery and cesarean section. The influence factors of hospitalization expense were screened with multivariate linear regression analysis. Results The year-on-year growth rate of two-child puerpera was 123.53% in 2014, 109.36% in 2016, and stabilized after 2016. The total number of vaginal delivery women (n1=2780) was higher than that of caesarean delivery women (n2=2168). The average age of delivery, average length of stay and average expenses of hospitalization of the vaginal delivery group were all lower than those of the caesarean delivery group, and the differences were statistically significant. In multivariate regression analysis of hospitalization expenses, age of delivery, delivery mode, policy of "single two-child", policy of "universal two-child", hospitalization days, comorbidities and complications entered into the regression equation (F=2926.669,P<0.001,R2=0.784). Conclusion The two-child policy has promoted the peak period of two-child births, which entered a stable period after 2016. The age of childbirth and the cost of hospitalization gradually increased, the age difference of childbirth increased, and the length of stay gradually decreased. In the vaginal delivery group, the proportion of spontaneous vertex delivery of women giving birth to the second child was lower than that of women giving birth to the first child, but the proportion of gestational diabetes was higher. In the cesarean delivery group, the first major diagnosis of women giving birth to the first child was selective caesarean birth, but the first major diagnosis of women giving birth to a second child was pregnancy with uterine scar. Age of delivery, delivery mode, two-child policy, length of stay ,comorbidities and complications were independent influence factors of hospitalization expenses.
  • Jia Huili, Yang Hua, Zhang Juan, Xiao Ming.
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    Objective To evaluate the effect of quality control in surgical process on improving the quality of perioperative medical records. Methods Ten percent of the perioperative medical records in 2019 were randomly examined for quality control, and the quality defects of medical records before and after quality control intervention in the surgical process were compared and analyzed. Results The quality defect rates of the 11 medical records in the intervention group were all lower than those in the control group, including power of attorney, informed notice, preoperative summary, preoperative discussion, surgeon′s ward round record, anesthesia visit record, surgical safety check, surgical record, first postoperative course, anesthesia records surgical approval (P<0.01). The top three indicators for improving the quality of medical records were the first postoperative course, power of attorney, and anesthesia visit records, which reduced by 23.95 percent, 16.64 percent, and 15.32 percent respectively. Conclusion Defects in the quality of medical records include inadequate implementation of the core system, incomplete informed notification, and poor quality of medical record writing. The quality of medical records could be improved by strengthening medical record quality control, conducting medical law knowledge training, and strengthening medical record writing quality training.
  • Wang Dan.
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    Objective To evaluate the data status of the front page of inpatient medical records, analyze the reasons, and put forward improvement measures, according to the performance evaluation standard of tertiary public hospitals. Methods The front page data of medical records of all tertiary public hospitals in 2019 were extracted from provincial health management service evaluation center, and statistical analysis was conducted from coding errors and non coding errors. Results Totally 2246799 medical records of 80 tertiary public hospitals in our province in 2019 were selected. The number of medical records with wrong quality control code was 395 139, accounting for 17.59% of the total medical records, and the number of non coding wrong medical records in the front pages of medical records was 881 590, accounting for 39.24% of the total medical records. Conclusion The data quality of the front page of the medical records plays an important role in reflecting the comprehensive level of the hospital. We should strengthen the data quality control, ensure the standardization and normalization of the reported data, and ensure the objectivity and authenticity of the data.
  • Wang Qian, Zhang Xiaojian.
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    Objecrive To analyze the influence of the "open two-child policy" on the number of births and its mechanism by using ARMAX model with intervention, so as to provide reference for the adjustment of family planning policies. Methods The variation trend of time series of births from January 2013 to December 2019 was analyzed, and the ARMAX models without intervention, pulse intervention and ladder intervention were constructed respectively. Moreover, the ability of the model to model and interpret the data was evaluated from the aspects of goodness of fit, residual normal white noise test and model parameter significance test. Results The modeling and interpreting ability of pulse intervention ARMA(1,0)-X model was better than that of ARMAX model without intervention and step intervention, and the autoregression parameters, linear trend parameters and part of the intervention parameters were statistically significant, and passed the residual normal white noise test. Conclusion The pulse intervention ARMAX model can well explain the variation trend of the number of births. The results of intervention analysis showed that the "open two-child policy" significantly stimulates the population′s fertility desire, but the stimulation effect exists for a short time and declines rapidly, which still has a certain gap with the expectation of long-term policy stimulation.
  • Han Dong, Liu Feng, Guan Xiaoqian. 
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    Objective Usually, the indicators of diagnosis-related groups (DRGs) are used to evaluate the capability of general hospitals. When they are used in the internal evaluation of hospitals, existing indicators are not suitable for direct comparison of clinical specialties due to the large differences between specialties. This paper discusses the application of DRGs index system in hospital evaluation, and puts forward the specialized competence index and its calculation method. Methods Based on the DRGs grouping results of a hospital in 2018 and the DRGs data of the province in which the hospital is located, the problems existing in the application of the existing DRGs index system in the specialty evaluation of the hospital are demonstrated, and a new evaluation index-specialty competence index is proposed to compare and evaluate the clinical departments. Results The new index could effectively make up for the "incomparable" problem of DRGs index system in the evaluation of clinical departments within the hospital, and can reflect the specialized ability of clinical departments to a certain extent. Conclusion The specialized competence index based on DRGs not only makes each clinical department comparable, but also reflects the comprehensive medical service ability of the clinical departments to a certain extent.
  • He Liping, Zheng Lijiao, Liu Yuanting.
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    Objective To evaluate the effect of bed allocation by using diagnosis related groups. Methods Data from inpatient medical record front sheet of 76 852 patients in 2018 were analyzed, and groups were divided according to whether to accept the allocation of beds. The ability, efficiency and safety of treatment were described in the two groups. The t-test was used to compare the difference of case weight, average length of stay and average cost per time between groups and chi-square test was used to compare the difference of case fatality rate among different risk groups. Results Twenty-three major disease categories and 305 diagnosis related groups were detected in the group with bed allocation. Comparing to the non-bed allocation group, among the top 10 diagnosis related groups of hospital admissions, 5 diagnosis related groups including BR23, FM49, BR21, ES13 and ES15 had lower average length of stay and average cost, which were statistically significant (P<0.05). ET13 in the group with bed allocation had lower average cost (P<0.001) while GU15 had higher average cost (P=0.047) than that in the non-bed allocation group. Case-mix index was higher (CMI=1.25, P=0.009) and the mortality of medium-high risk and high risk group was lower in the group with bed allocation (mortality was 1.0%, P=0.047) than that in the non-bed allocation group. Conclusion The hospital bed allocation can increase the capacity and efficiency of admission. The allocation of beds can improve the capacity and efficiency of treatment, and at the same time include safety, and achieve good results.
  • Zhou Ying, Zhong Fade, Zhuang Li.
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    Objective To understand the clinical blood management and personnel development status of blood transfusion departments in private hospitals of Ningbo, and to provide theoretical basis for promoting the blood transfusion department construction and clinical blood management. Methods Twenty-nine private hospitals of Ningbo were selected to fill up the questionnaires. The survey included basic information of the hospital, the situation of clinical blood management, and personnel structure of blood transfusion department. Results Independent blood transfusion departments were set in 17.24% private hospitals and only 13.79% had fulltime staff. All 29 private hospitals have set up clinical blood transfusion management organizations, and more than 90% have made and executed the files of clinical blood transfusion. From 2014 to 2018, the average number of staff of blood transfusion department was 100, all staff were technicians with medical laboratory specialty, and among them 55% were with bachelor′s; staffs with senior, intermediate and junior titles accounted for 8%, 15 % and 72 %, respectively. The average turnover rate of blood transfusion department was 13%, among whom 86.36% were junior title staff. Conclusion In recent years, the blood transfusion departments of Ningbo private hospitals have made some progress in blood use management and team building, and the clinical blood use management tends to be standardized and the personnel structure tends to be reasonable.
  • Peng Wenwen, Wang Lu, Xie Fei.
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    Objective To analyze the operation efficiency of clinical departments in a tertiary hospital in Guangxi, provide reference for hospital operation managers, and put forward countermeasures and suggestions on how to effectively improve the operation efficiency of clinical departments in the tertiary hospital. Methods Based on five operational indicators of 39 clinical departments in a tertiary hospital in Guangxi in 2019, CCR model was used to analyze the comprehensive efficiency of department operation, BCC model was used to analyze the pure technical efficiency and scale efficiency of department operation, and the operation efficiency of internal medicine system and surgical system of clinical department was analyzed and evaluated. Results Among the 39 clinical departments in the hospital, 9 departments are overall effective, including 4 internal medicine departments and 5 surgical departments; among the remaining 30 invalid departments, 11 departments were technically efficient, 2 were internal medicine systems, 9 were surgical systems, and there were no efficient departments of scale efficiency; 9 departments′ returned to scale remain unchanged, 18 departments′ returned to scale increase, and 12 departments′ returned to scale decrease. Conclusion Each clinical department should reasonably allocate medical resources, improve the technical difficulty of accepting and treating diseases, and optimize hospital diagnosis and treatment services, so as to improve the operation efficiency of clinical departments and the overall operation efficiency of the hospital.
  • Lü Yunhong, Lin Aihua.
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    Nasopharyngeal carcinoma (NPC) is one of the most common malignances in head and neck, with the characteristics of high degree of malignancy, easy-metastasis and unapparent early symptoms. Understanding its risk factors will contribute to the prevention for this malignance. Therefore, this review will summarize the current epidemiology studies of NPC and focus on its risk factors, so as to provide references for the early prevention of NPC.