25 April 2022, Volume 29 Issue 2

    

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  Association between non-alcoholic fatty liver disease and risk of cardiovascular diseases in physical examination population

  Shui Mingming，Shi Ming， Li Yanping，Zhang Chen，Dang Shaonong

  journal1. 2022, 29(2): 81-86. https://doi.org/10.3969/j.issn.1006-5253.2022.02.001

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  Objective To study the prevalence of nonalcoholic fatty liver disease (NAFLD) among physical examination population in Xianyang City, and to analyze the relationship between NAFLD and risk of cardiovascular diseases, so as to provide basis and suggestions for the prevention of cardiovascular diseases in population with NAFLD.Methods Totally 15 766 subjects were selected from the Health Management Center of Xianyang Central Hospital in 2019. Blood pressure, height, weight, blood glucose, blood lipid and other indices were collected to diagnose fatty liver by ultrasound. The 10 year risk assessment method of atherosclerotic cardiovascular disease (ASCVD) provided by the Guidelines for the Prevention of Cardiovascular Diseases in China (2017) was used to estimate the risk of ASCVD in the examined population in the next 10 years. Multiple logistic regression analysis was used to analyze the relationship between NAFLD and the risk of ASCVD in the next 10 years.Results The overall prevalence of NAFLD was 38.3%, men had a higher prevalence than women (43.8% vs 29.6%) , and the prevalence of NAFLD was different in age groups (χ²=272.57, P<0.001). The risk of ASCVD in the next 10 years showed that the extremely high-risk was 2.0%, the high risk was 14.3%, the intermediate risk was 13.4% and the low risk was  70.3%. After controlling for age, sex, diabetes, hypertension, overweight or obesity, dyslipidemia and smoking confounding factors, compared with non NAFLD population, the risk of ASCVD in NAFLD population in the next 10 years increased by 31% (or = 1.31, 95%ci: 1.12~1.52), and the or values in male and female population were 1.35 (95%ci:1.12~1.61) and 1.20 (95%ci:0.86~1.68) respectively. The relationship between NAFLD and the risk of cardiovascular disease remained unchanged after excluding extremely high-risk groups. Conclusion The prevalence of NAFLD is high among the physical examination population in Xianyang city. NAFLD can increase the risk of ASCVD in the next 10 years. It is suggested that the risk assessment of cardiovascular disease should be carried out among the physical examination population of NAFLD, especially men, in order to slow down the progress of cardiovascular disease control.
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  Characteristics and influencing factors of symptom cluster of pregnant women in the third trimester

  Jiang Tingting, Chen Yanyan, Pan Qiongqiong, Wang Xiaomei

  journal1. 2022, 29(2): 87-92. https://doi.org/10.3969/j.issn.1006-5253.2022.02.002

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  Objective  To investigate and analyze the current situation of symptoms of pregnant women in the third trimester, in order to provide reference for symptom management of pregnant women in the third trimester.Methods From April to May 2021, pregnant women in the obstetric outpatient department of our hospital were selected as the research subjects, and the Memory Symptoms Assessment Scale was used for the questionnaire. T-test and ANOVA were used for univariate analysis, and multiple linear regression analysis was used for multivariate analysis.Results Totally 279 valid questionnaires were collected. Among all symptom clusters, the highest score was 0.90±0.30 points for the sleep-related symptom cluster. The results of multivariate analysis showed that the influencing factors of body image disorder symptom cluster included residence(t=-3.868, P＜0.001) and prenatal education (t=-2.976, P=0.003), the influencing factors of sleep-related symptom cluster included prenatal education (t=6.021, P＜0.001) and age (t=5.313, P＜0.001), the influencing factors of intestinal symptom cluster included gestational age (t=39.983, P＜0.001), and the influencing factors of symptom cluster with poor activity endurance included prenatal education (t=6.139, P＜0.001) and age(t=5.181, P＜0.001).Conclusion Pregnant women in the third trimester of pregnancy experience more severe sleep-related symptoms. The symptoms of pregnant women in the third trimester of pregnancy are influenced by many factors: the body image disorder symptoms of pregnant women living in rural areas are more obvious, the sleep-related symptoms of older pregnant women are more obvious, the intestinal related symptoms of pregnant women near delivery are more obvious, and the activity endurance of older pregnant women decreases.
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  Distribution characteristics of disease spectrum of discharged patients in a general hospital in Shandong Province

  Wu Hongpeng, Xiao Qimin, Zhou Xiaozhi

  journal1. 2022, 29(2): 93-98. https://doi.org/10.3969/j.issn.1006-5253.2022.02.003

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  Objective To understand the distribution characteristics of disease spectrum of discharged patients in a hospital, so as to provide basis for the hospital to reasonably allocate resources and improve the quality of medical service and medical technology.Methods We extracted the information on the first page of medical records of discharged patients from 2015 to 2019 in the hospital information system, established an Excel database, and analyzed the sequence analysis and composition ratio of various distribution characteristics of the disease system.Results From 2015 to 2019, nine disease systems ranked in the top ten. The male to female ratio of discharged patients was 0.95∶〖KG-*2/3〗1. The average length of stay of discharged patients decreased year by year. The proportion of discharged patients in all age groups was the most in the 60 years old and above group, and showed an increasing trend year by year. The composition ratio of below 5-year-old group decreased year by year. The way of discharged patients leaving hospital was mainly under medical advice, and the trend was increasing year by year, while the way of nonmedical advice was decreasing. The top 4 causes of systemic diseases in discharged patients were tumor (40.56%), circulatory system diseases (29.96%), respiratory system diseases (7.27%), and injury and poisoning (6.79%).Conclusion According to the distribution characteristics of disease spectrum, the hospital can formulate diagnosis and treatment technologies for common and frequently occurring diseases of people of different genders and ages, and focus on strengthening the discipline construction of tumor, cardio cerebrovascular, pediatrics and respiratory related majors to meet the medical needs of radiation areas.
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  Nosocomial infection in a second-grade general hospital from 2017 to 2020

  Han Shuanghai, Ma Dehui, Xie Ming, Long Yan

  journal1. 2022, 29(2): 99-102. https://doi.org/10.3969/j.issn.1006-5253.2022.02.004

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  Objective To investigate the situation of nosocomial infection in a secondgrade general hospital and provide evidence for the prevention and control of nosocomial infection.Methods The data of inpatients in a hospital from January 1, 2017 to December 31, 2020 were retrospectively collected. The nosocomial infection cases were statistically analyzed, and the distribution characteristics of nosocomial infection cases were described in terms of the occurrence time, patients′ age, the infection sites and the pathogen submission for examination.Results The nosocomial infection incidence of a hospital from 2017 to 2020 were 0.52%, 0.58%, 0.64% and 0.36%, respectively, and there was significant difference in the nosocomial infection (χ²=25.795, P＜0.05). The incidence of nosocomial infection in the intensive care unit was the highest in the 4 years, with the nosocomial infection rate of 3.74%. The main infection sites were respiratory system and surgical sites. The proportion of infected patients over 60 years old was 39.87%. The detection of pathogens showed that gramnegative bacteria were dominant.Conclusion Monitoring of nosocomial infection cases was underreported. The incidence of nosocomial infection was higher in departments with serious basic diseases such as the intensive care unit and the neurosurgery. The main infection sites were respiratory system sites and surgical sites. It is necessary to strengthen the mon itoring of nosocomial infection cases, strengthen the management of nosocomial infection in ICU and neurosurgery departments, strengthen the management of pathogen examination of infected patients, improve the compliance of hand hygiene of the medical staff, and reduce the occurrence of nosocomial infection.
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  Current status and influencing factors of multimorbidities of elderly people in Guangdong Province

  Liu Guihao, Xue Yunlian

  journal1. 2022, 29(2): 103-107. https://doi.org/10.3969/j.issn.1006-5253.2022.02.005

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  Objective To analyze the current status and influencing factors of multimorbidities of elderly people in Guangdong Province.Methods Data were collected from the follow-up data of the elderly in Guangdong of China Health and Retirement Longitudinal Study (CHARLS) in 2018. Logisitic regression was used to analyze the influencing factors of two or more multimorbidities and the influencing factors of two multimorbidities of the elderly over 60 years old.Results Seventy-one point six percent of the elderly had chronic diseases, among which the rate of two or more multimorbidities was 43.7%. Multimorbidities of hypertension and rheumarthrosis were the most common forms of multimorbidity in the elderly. Religious belief was an independent factor affecting the multimorbidity of the two chronic diseases in the elderly population (OR=3.120, 95%CI: 1.095-8.888). Age (OR=1.043, 95%CI: 1.015-1.072), evening sleep time (OR=0.897, 95%CI: 0.815-0.987), nap time (OR=1.006, 95%CI: 1.002-1.010), smoking cessation (OR=2.058, 95%CI: 1.106-3.830) and depression score (OR=1.023, 95%CI: 1.006-1.040) were the influencing factors for two or more multimorbidities.Conclusion It is of positive significance to pay attention to medical treatment, ensure adequate night sleep, maintain proper nap time and keep comfortable mood are important for the health of the elderly in Guangdong Province.
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  ]Investigation on the knowledge, attitude and practice of sexual education of freshmen students in a medical college

  Wang Jiaxin，Shao Yinbao， Cheng Xingxing，Hu Daibao，Chen Hao， Chen Baifeng

  journal1. 2022, 29(2): 108-111. https://doi.org/10.3969/j.issn.1006-5253.2022.02.006

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  Objective To understand the current situation of sex education, sexuality knowledge, attitude toward sex and the sexual behavior of freshmen in a medical school, and to provide reference for carrying out sex education for freshmen.Methods Stratified clustering sampling was used to select 800 freshmen in a medical college, and self-filled questionnaire was used to make a prevalence survey to analyze the relevant knowledge, attitude and practice of sex education of freshmen.Results Three hundred and fifty-seven freshmen (46.18%) had not received family sex education. There were statistically differences in the family sex education among different genders and different residence places (P<0.05). The gender, registered residence and parents′ educational level of the subjects were different in their attitudes towards premarital sexual behavior (P<0.05). There were statistical differences in sexual behaviors among subjects of different genders, ages, place of domicile and marital status of their parents (P<0.05).Conclusion The freshmen are lack of family sex education, so targeted measures should be -adopted- to strengthen the sex education in the families and at colleges to enhance students′ senses of self-preservation.
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  Investigation on acne prevalence and cognition of senior high school students in Tai′an City

  Wang Suzhi，Dongmei，Zhang Yichun，Li Hongyun

  journal1. 2022, 29(2): 112-117. https://doi.org/10.3969/j.issn.1006-5253.2022.02.007

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  Objective To investigate the prevalence of acne and the cognition level of acne among senior middle school students in Taian City, and to provide the reference for acne prevention and treatment among senior middle school students.Methods A random sampling approach was used to enroll 304 senior middle school students. These students were surveyed with a self-designed questionnaire and physician diagnoses, in which demographic variables, prevalence rate, and basic knowledge of acne were included.Results The acne prevalence rate was  55.3% among 304 high school students in Tai ′an City, and the -overall awareness rate of basic knowledge of acne was 45.8%. Unconditional logistic regression analysis showed that oily and fried foods intakes (OR=1.951, 95%CI:1.065-3.576) and family history (OR=4.535, 95%CI:1.912-10.759) were main risk factors for acne, while gender (female) (OR=0.473, 95%CI:0.264-0.849), skin care habit (OR=0.337, 95%CI:0.169-0.669), and light diet (OR=0.387, 95%CI:0.183-0.821) were the protective factors to reduce acne.Conclusion The senior middle school students in Tai′an have a higher prevalence of acne, and they have a lower level of awareness of acne. Healthy diet and good skin care habits contribute to reducing the incidence of acne.
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  Ａnalysis of hospitalized cases of respiratory system in medical institutions with the secondary level and above in Ningbo from 2017 to 2021

  Luo Shenglan, Zhang Qihua

  journal1. 2022, 29(2): 118-121. https://doi.org/10.3969/j.issn.1006-5253.2022.02.008

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  Objective To analyze the age and gender distribution, disease spectrum, death spectrum and hospitalization cost of respiratory inpatients in medical institutions of the secondary level and above in Ningbo, and to provide reference for the formulation of respiratory disease surveillance, regional health planning and medical security policies.Methods The data of the inpatients with respiratory system in medical institutions of the secondary level and above in Ningbo from 2017 to 2021 were extracted from "Zhejiang Health Information Network direct reporting system", and analyzed statistically with SAS 9.4 software.Results Of 554 441 cases with respiratory system, male patients were more than female patients, and there was a significant difference in the proportion of male and female patients with different years and the number of male patients was more than that of female patients (Z=3.13, P<0.05). There were significant differences in the proportion of inpatients among different age groups (Z=125.38, P<0.05). The average length of hospitalization was 8.98 days and the average hospitalization cost was  10 593.62-yuan. The average length of stay and the average cost of hospitalization increased with age. Pneumonia, other diseases of upper respiratory tract and respiratory malignant tumor were the top 3 respiratory diseases, while respiratory malignant tumor was the first cause of death of respiratory system diseases.Conclusion There were more males with respiratory diseases than females. The average length of stay and average cost increased with age, and corresponding prevention and control measures should be formulated according to different genders and ages.
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  Characteristic analysis of 563 inpatient deaths

  Chen Huiqiong， Zhou Dan

  journal1. 2022, 29(2): 122-124. https://doi.org/10.3969/j.issn.1006-5253.2022.02.009

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  Objective To understand the basic characteristic analysis, composition and changes of death causes of inpatient deaths in a tertiary public hospital.Methods The medical record information retrieval system of the hospital was used to sort and analyze the data of age, gender, and main diagnosis of in-hospital deaths.Results From 2013 to 2020, there were 184 052-discharged patients and 563 hospitalized deaths, with a total case fatality rate of 3.06‰; the fatality rate of males was high than that of females and the difference was statistically significant (χ2=95.329, P<0.001). During the 8 years, the overall fatality rate of inpatients showed an increasing trend (χ2=4.921, P=0.027); the inpatient fatality rate of men showed a gradual increase (χ2=4.278, P=0.039), but the inpatient fatality rate of women was relatively stable (χ2=0.003, P=0.955). There were more males than females who died in hospital (2.09∶〖KG-*2/3〗1); the proportion of males and females in each age group was not completely consistent (χ2=24.141, P=0.004). The top three causes of death in hospitalized patients were tumors (28.77%), circulatory system diseases (24.69%), injury, poisoning and some other consequences of external causes (17.58%).Conclusion The in-hospital mortality rate of males is much higher than that of females. The society should pay attention to the health of males, and strengthen the prevention and intervention of tumors and circulatory system diseases.
  
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  Analysis on hospitalization expenses and its influencing factors of breast cancer patients in a tertiary hospital in Hainan Province

  Tu Aixian，Zhu Hongrui

  journal1. 2022, 29(2): 125-129. https://doi.org/10.3969/j.issn.1006-5253.2022.02.010

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  Objective To investigate the inpatient cost of breast cancer patients and analyze its influencing factors, so as to provide basis for reducing the medical cost burden of breast cancer patients and establishing reasonable medical insurance system.Methods The inpatient cost information of 1 279 patients with breast cancer in a tertiary hospital in Hainan Province in 2020 was collected. Descriptive analysis, rank sum test and multiple linear regression were used to analyze the hospitalization cost structure of breast cancer patients and its influencing factors. Results Pharmaceutical expenses accounted for the largest proportion (44.34%) in the structure of hospitalization expenses, treatment expenses, material expenses, surgery expenses, and bed expenses accounted for 14.49%, 4.21%, 2.76%, and 2.22% respectively, and other expenses totaled 31.97%. In the amount of medical insurance pooling payment, the amount of medical insurance pooling payment for urban worker patients (8 903.00 yuan) was higher than that for urban and rural residents (7 871.00 yuan). Univariate analysis showed that length of stay and treatment mode had influence on hospitalization cost. Multiple linear regression analysis showed that the length of stay and treatment mode were the main factors affecting hospitalization costs, and their standardized regression coefficients were 0.607 and 0.252, respectively.Conclusion It is necessary to improve the awareness of the prevention and treatment of breast cancer in the whole society, rationally control hospitalization days and drug proportion to reduce hospitalization expenses, and adjust the level of medical insurance treatment to reduce the burden of patients.
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  Equity study of resource allocation of general practitioners in China from 2015 to 2019

  Zhang Jinchi，Song Jia，Ma Dongping， Wang Qiang，Chen Xi

  journal1. 2022, 29(2): 130-135. https://doi.org/10.3969/j.issn.1006-5253.2022.02.011

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  Objective To analyze the distribution differences and allocation fairness of general practitioner resources  among- provinces and regions in China from 2015 to 2019, and provide useful references for optimizing resource allocation of  general practitioners in China.Methods Data related to general practitioners in China from 2015 to 2019 were collected, and the health resource agglomeration degree (HRAD) was used to calculate the geographic equity and demographic equity in the allocation of general practitioner resources in China.Results From 2015 to 2019, the number of general practitioners per 10 000 population in China increased from 1.37 to 2.61, with an average annual growth rate of 17.95%; HRAD in the eastern region decreased from 5.186 to 4.809, and HRAD-i/PAD-i decreased from 1.348 to 1.245; HRAD in the central region increased from  1.299  to 1.430, and HRAD-i/PAD-i increased from 0.761 to 0.845; HRAD in the western region increased from 0.285 to 0.308, and HRAD-i/PAD-i increased from 0.743 to 0.802.Conclusion There is a shortage of general practitioners in China with uneven regional allocation. It is suggested that on the basis of continuous increase of the volume of general practitioner resources, on the one hand, the allocation of general practitioner resources in each region should be reasonably optimized, and on the other hand, the training system and incentive mechanism of general practitioners should be continuously improved to effectively enhance the quality and ability of general practitioners to serve primary health.
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  Comparative study on service capability of secondary traditional Chinese medicine hospitals in "one circuit and two wings" area of Chongqing

  Liu Ying, Luo Yun, Chen Quan

  journal1. 2022, 29(2): 136-139. https://doi.org/10.3969/j.issn.1006-5253.2022.02.012

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  Objective To compare the service capacity of secondary TCM hospitals in  "one circuit and two wings" area of Chongqing, and to provide reference for policy making.Methods Literature research and expert consultation were used to establish the service capacity index of secondary TCM hospitals, and the questionnaire survey was used to compare the regional medical service status.Result Metropolitan area in the health resources and scale, medical personnel, scientific research and teaching was in advantage position, area of the southeast of Chongqing on the service ability of traditional Chinese medicine was superior to other two areas, financial subsidies made up for the three regional imbalances of different level, and there were respective deficiencies in medical quality, safety and information construction in different regions.Conclusion There are differences  in the service ability of secondary TCM hospitals in "one circuit and two wings" area of Chongqing. In order to improve the service capacity of different regions in a balanced way, it′s necessary to rationally allocate health resources, strengthen the introduction and training of talents, and improve the ability of scientific research and teaching, improve service ability of traditional Chinese medicine, improve hospital efficiency, promote the balance of income and expenditure, strengthen medical safety and quality, and promote the informatization construction.
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  Research on nursing human resource prediction based on GM (1,1) model during the 14th Five-Year Plan Period in Shaoxing

  Zhang Chunxia, Ruan Weiliang, Lin Jianchao

  journal1. 2022, 29(2): 140-143. https://doi.org/10.3969/j.issn.1006-5253.2022.02.013

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  Objective To predict the regional nursing and health human resources with the use of GM (1,1) model by taking the prediction of the number of nurses per thousand permanent residents as an example, in order to provide decision support for the health management department.Methods The number of registered nurses per thousand resident population in Shao-xing from 2011 to 2020 was collected, and the GM(1,1) model was used to predict and analyze the demand for regional nurses.Results The number of nurses per thousand resident population in the region predicted by GM (1,1) model showed an upward trend in the next three years. The fitting error between the predicted value and the actual value was small, and the prediction accuracy was excellent (C=0.231, α=-0.066). According to the model, the number of registered nurses per 1 000 resident population in Shaoxing predicted from 2021 to 2023 will reach 3.72, 3.97, and 4.25, respectively.Conclusion The GM(1,1) model can fit the demand changes for regional nursing human resources in time series data, and can provide a basis for scientific and rational allocation of regional health human resources. 
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  Implementation of the multivariate meta-analysis of distributed lag non-linear model in R software

  Chen Dongzhen，Yin Jia，Ding Guoyong， Liu Zhidong，Liu Xuena，Lu Hua，Li Xiaomei

  journal1. 2022, 29(2): 144-149. https://doi.org/10.3969/j.issn.1006-5253.2022.02.014

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  Objective To implement the procedure of distributed lag non-linear model (DLNM) and multivariate meta-analysis in R software.Methods A specific step of two-stage analysis of DLNM and multivariate meta-analysis was carried out in R software through a time series data.Results The two-stage analysis of DLNM and multivariate meta-analysis was successfully implemented in R software.Conclusion R software can be used to construct DLNM and conduct multivariate meta-analysis flexibly and conveniently, and the method can be widely used in environmental epidemiology.
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  Application of SAS interactive matrix language in the nutrient data processing of dietary investigation

  Zhang Binyan, Mi Baibing, Wang Yutong, Liu Huimeng, Dang Shaonong, Yan Hong

  journal1. 2022, 29(2): 150-155. https://doi.org/10.3969/j.issn.1006-5253.2022.02.015

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  Objective To introduce the calculation of nutrient intake based on SAS interactive matrix language for semi-quantitative food frequency questionnaire (SQFFQ) and its application in nutritional epidemiological dietary investigation.Methods Three thousand women who completed SQFFQ were randomly selected from a large-scale birth defect investigation dataset in Shaanxi Province as a training dataset using the simple random sampling method by PROC SURVEYSELECT program with SAS 9.4. Next, the interactive matrix language PROC IML programming was used to demonstrate the calculation of SQFFQ nutrient intake.Results According to the principle of matrix operation, PROC IML was used to obtain the calculation module and 3 000 samples were validated to obtain 25 nutrients intake. Meanwhile, in the SAS log output window, the execution time of the PROC IML process was 0.59 s, which was efficient and fast.Conclusion The SAS interactive matrix language was used to calculate the nutrient intake of SQFFQ with high efficiency, simplicity and accuracy, which was suitable for SQFFQ analysis.
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  Research status of disease diagnosis related subgroups in hospital management in China

  Wu Li， Lü Zhijie，Li Qiushuang， Liu Shan， Hong Xuewen

  journal1. 2022, 29(2): 156-160. https://doi.org/10.3969/j.issn.1006-5253.2022.02.016

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  Objective To explore the application status and hot research trend of DRG in hospital management in China and provide reference and thinking for the refined management of my country.Methods The relevant literatures of DRG in hospital management in China collected by CNKI and Wanfang database were taken as the research objects, and CiteSpace software was used to analyze the authors, institutions and key words in the literatures.Results Based on the analysis of 724 articles after weight removal, it was found that the number of articles has increased rapidly in recent years, and the research team of core authors was formed, but the research institutions were scattered and inter-agency cooperation needed to be strengthened. Sixteen clusters have been formed. Performance evaluation, cost management and DRG payment have become hot issues in hospital-management  in recent years.Conclusion The role of DRG in hospital management is a process of continuous improvement and dynamic improvement. It is of great significance for hospital managers to strengthen their active exploration in DRG for the fine management of hospitals under the current background.