25 December 2018, Volume 25 Issue 6

    

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Statistical Methods and Applications
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  Analysis of influencing factors on treatment quality of acute myocardial infarction based on empirical logit transformation

  Ning Hui, Wang Chao, Wang Yun, Liu Meina

  journal1. 2018, 25(6): 401-404. https://doi.org/10.3969/j.issn.1006-5253.2018.06.001

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  Objective The comprehensive score of treatment quality of AMI patients was calculated and empirical Logit transformation was performed. To obtain the factors affecting the quality of treatment, To provide data support for the improvement of treatment quality.Methods The data of AMI patients were collected, the treatment quality of AMI patients was evaluated with 11 indexes, and the comprehensive scores of index utilization rate and treatment quality of patients were calculated. The empirical Logit transformation was carried out for the comprehensive score to obtain the transformation value of the comprehensive score for statistical description. The target variable was taken as the comprehensive score of the empirical Logit transformation, and the linear regression model was used to analyze the influencing factors of treatment quality.Results In this study, 4 137 AMI patients were collected. The highest utilization rate was the use of clopidogrel during hospitalization, and the lowest was the 12-lead ECG before hospitalization. The comprehensive score of the empirical Logit transformation followed the normal distribution. The maximum value of the comprehensive score of the outpatient admission was 0.705 4±0.645 5, and the minimum value of the hospitalization days 7 days and below was 0.194 3±0.605 1. The analysis results of influencing factors of treatment quality showed that the treatment quality was poor in older age, emergency admission, infarction location in the lower wall and multi-wall. The quality of treatment was better in admission during the weekend, increased hospital stay and hospitalization expenses, and fewer complications.Conclusion Linear regression was used to analyze the influencing factors of comprehensive score of treatment quality, the normality of comprehensive score of treatment quality should be considered from the data point of view, and Logit transformation of data is suggested. In order to improve the treatment quality of AMI patients, attention should be paid to patients who are older, hospitalized in emergency, admitted during working days, and have more myocardial infarction sites, more complications and shorter hospitalization time.
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  Analysis of influencing factors on non-small cell lung cancer treatment quality based on evaluation indicators

  Li Jingkun, Li Xi, Liu Meina

  journal1. 2018, 25(6): 405-409. https://doi.org/10.3969/j.issn.1006-5253.2018.06.002

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  Objective To analyze the factors that affecting the treatment quality of non-small cell lung cancer based on the treatment quality evaluation indicators of non-small cell lung cancer, and to provide data support for improving the treatment quality of non-small cell lung cancer.Methods Based on the treatment quality evaluation index system of non-small cell lung cancer, we calculated the treatment quality score of patients, and the patients were divided into the high-quality group and the low-quality group with the mean score as the boundary. Single factor and multiple factor logistic regression were used to analyze the influencing factors of the treatment quality of non-small cell lung cancer.Results The mean score of treatment quality for non-small cell lung cancer was 0.67, and the numbers of patients in the high score group and in the low score group were 1 438 and 1 596. The results showed that the influencing factors of treatment quality included age, hospital, occupation, past history, lymph node dissection and pathological stage (P< 0.05). The rate of low quality was 61.92% in general hospitals and 45.42% in specialized hospitals. The treatment quality of elderly patients was poor (OR=2.790 3, 95% CI:1.8511～4.206 1). Patients with previous history (OR=0.787 1, 95% CI:0.671 7～0.922 3) and lymph node dissection (OR=0.592 7, 95% CI:0.407 7～0.861 5) had higher quality scores.Conclusion Analysis of influencing factors on non-small cell lung cancer treatment quality suggests that lymph node dissection has a positive effect on improving the treatment quality of NSCLC, and the specialization of the hospital is conducive to providing more high-quality treatment.
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  Risk factor analysis of type 2 diabetes mellitus complicated with diabetic retinopathy in a hospital in Wenzhou city

  Chen Yi, Wu Yingying, Dai Fangfang

  journal1. 2018, 25(6): 410-413. https://doi.org/10.3969/j.issn.1006-5253.2018.06.003

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  Objective To analyze the risk factors of type 2 diabetes mellitus complicated with diabetic retinopathy (DR) in Wenzhou city, and to provide reference for clinical prevention and treatment.Methods Totally 864 patients with type 2 diabetes who were examined from January 2016 to April 2018 in Wenzhou City were enrolled. According to the presence or absence of DR lesions, they were divided into the DR group including 263 patients and the non-DR group including 601 patients. The general clinical data and laboratory data of all patients were collected to analyze the epidemiology and risk factors of type 2 diabetes complicated with diabetic retinopathy.Results Two hundred and sixty-three cases with diabetic retinopathy were detected in 864 patients with type 2 diabetes, and the detection rate was 30.4%. The prevalence rates of male and female were 28.7% and 33.3%. The incidences of DR in patients with diabetes aged under 50, from 50 to under 60, from 60 to under 70, 70 and above were 25.0%, 26.0%, 44.5%, and 35.1% respectively. The incidences of DR in the course of diabetes under 5 years, from 5 to under 15 years, 15 and above years were 12.2%, 36.7%, and 63.8% respectively. The multivariate analysis showed that age, course of disease, family history, DBP, FBG, HbA1c, and ALB were independent risk factors for type 2 diabetes mellitus complicated with diabetic retinopathy with statistical significant difference (P<0.05).Conclusion Among patients with type 2 diabetes in Wenzhou City, the risk of diabetic retinopathy is high, and DR is closely related to age, course of disease, family history, blood pressure, FBG, HbA1c, and ALB levels. It is suggested that effective intervention should be taken to prevent the occurrence of DR in patients with type 2 diabetes at risk.
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  Risk factor analysis on nosocomial infection of burn patients

  Zhou Meiling

  journal1. 2018, 25(6): 414-416. https://doi.org/10.3969/j.issn.1006-5253.2018.06.004

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  Objective To explore the characteristics and risk factors of nosocomial infection of burn patients, and to provide prevention strategy for it.Methods Totally 376 burn inpatients were investigated retrospectively, and they were divided into the infection group (n=89) and the non-infection group (n=287) according to nosocomial infection. The incidence rate and sites of nosocomial infection were described, and the high risk factors of nosocomial infection were screened by single factor comparison method and multiple factors logistic regression method.Results The incidence rate of nosocomial infection in these 376 burn inpatients was 23.67% (89/376), and the sites of infection were mainly in wound infection (59.55%) and respiratory tract infection (21.35%). Multiple factor analysis result showed that the independent risk factors of nosocomial infection of burn patients included concomitant underlying diseases (OR=2.459, 95%CI:1.513～3.998), area of burn (OR=3.435, 95%CI:2.090～5.647), invasive operation (OR=3.778, 95%CI:2.097～6.807), use of multiple antibiotics (OR=7.040, 95%CI:4.240～11.688), hypoproteinemia (OR=5.173, 95%CI:3.165～8.455) and residual wound (OR=4.755, 95%CI:2.660～8.501).Conclusion The incidence of nosocomial infection is relatively high in burn patients. We should adopt prevention measures such as strengthening nutritional support, raising organism immunity, elimination of residual wounds and scarring, rational use of antibiotics, and strict implementation of aseptic operation, to gradually cut down the incidence rate of nosocomial infection of burn patients.
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  Investigation and risk factors analysis of venous transfusion extravasation in neonates

  Hu Lili

  journal1. 2018, 25(6): 417-419. https://doi.org/10.3969/j.issn.1006-5253.2018.06.005

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  Objective To investigate the venous transfusion extravasation and its risk factors in neonates.Methods Totally 1 100 neonates with venous transfusion were selected from October 2015 to July 2018 in our hospital, the venous transfusion extravasation in neonates was investigated and the risk factors was analyzed.Results In this survey, extravasation of intravenous infusion occurred in 200 cases, and the incidence rate was 18.18%. The univariate analysis showed that, premature delivery, drug infusion and catheterization of vascular elasticity, location, and working years of nurses were related to extravasation of intravenous infusion of neonates (P<0.05). The logistic multivariate analysis showed that, the premature delivery, irritant infusion, poor elasticity of drug and catheter, non-axillary vein position, working years of nurses less than 6 years were the independent risk factors for intravenous infusion exudation in neonates (P<0.05).Conclusions The extravasation rate of intravenous infusion in neonates is high, which is related to many factors, and the risk factors such as premature delivery, irritant infusion drugs and poor elasticity of catheterization vessels, non-axillary vein sites, working years of nurses less than 6 years should be monitored and monitored, so it's worth further clinical promotion.
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  Analysis of sleep disturbance and its influencing factors in elderly patients with hemodialysis

  Xu Wennü

  journal1. 2018, 25(6): 420-422. https://doi.org/10.3969/j.issn.1006-5253.2018.06.006

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  Objective To discuss the sleep disturbance and its influencing factors in elderly patients with hemodialysis.Methods Totally 120 elderly patients with hemodialysis were selected from January 2015 to October 2017 in our Hospital. The Pittsburgh Sleep Quality Index (PSQI) was used to investigate the status of sleep disorders, and the influencing factors of sleep disorders were analyzed.Results In this survey, 70 cases (58.33%) had sleep disorders, and the scores of sleep quality, sleep time, sleep disorders, sleeping drugs and other factors in the patients with sleep disorders were significantly higher than those in the patients with non-sleep disorders, and the difference was statistically significant (P<0.05). The single factor analysis showed that age, duration of dialysis, calcium and phosphorus product, pruritus and restless legs syndrome were associated with sleep disorders (P<0.05). The logistic regression analysis showed that age over 70 years old, duration of dialysis 3 years and above, serum calcium and phosphorus product 4.40 mmol2/L2 and above, skin pruritus and restless leg syndrome were the independent influencing factors of sleep disorders (P<0.05).Conclusions There is the severe sleep disorders in elderly patients with hemodialysis, and age, duration of dialysis, calcium and phosphorus product, pruritus and restless legs syndrome are the main factors for inducing the sleep disorders of patients.
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  Factor analysis of the composition of hospitalization expenses of fracture patients

  Wen Donglan

  journal1. 2018, 25(6): 423-425. https://doi.org/10.3969/j.issn.1006-5253.2018.06.007

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  Objective To explore the main influencing factors of the cost of hospitalized patients with fractures in a hospital, to provide some reference basis for reducing the financial burden of patients, evaluating the rationality of medical expenses, effectively controlling medical expenses, and to lay a solid foundation for paying for single disease and applying DRGS.Methods The inpatient expenses of 2 656 fracture patients in a hospital's statistical medical record management system were collected as samples from January 1, 2014, to December 31, 2016. SPSS 22.0 software was used for data entry, principal component and factor analysis, and various inpatient expenses were statistically analyzed and studied.Results Among the hospitalization expenses in this survey, western medicine expenses accounted for 18.74%, Chinese medicine expenses 5.01%, comprehensive medical service fees 22.50%, diagnosis expenses 19.87%, treatment expenses 12.84%, rehabilitation expenses 1.06%, traditional Chinese medicine treatment expenses 1.22%, blood and blood product expenses 1.25%, and consumable expenses 17.50%. There were three common factors affecting the hospitalization cost of fracture patients, which were named as diagnosis cost factor, treatment cost factor and traditional Chinese medicine cost factor.Conclusion To control the costs of diagnosis and treatment and traditional Chinese medicine rehabilitation is the key to controlling the medical cost of fracture patients.
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  Application of disease related groups (DRGs) and weighted TOPSIS method in medical performance appraisal of department in traditional Chinese medicine (TCM) hospital

  Yang Yechun

  journal1. 2018, 25(6): 426-429. https://doi.org/10.3969/j.issn.1006-5253.2018.06.008

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  Objective To investigate TCM and other performance appraisal indexes based on DRGs and to evaluate medical performance of departments in a TCM hospital with the use of DRGs and weighted TOPSIS method for refined management.Methods Based on DRGs, the performance appraisal indexes of TCM treatment and medicine were structured. The medical performance in departments of orthopedics was evaluated through ability, efficiency, quality and TCM.Results The DRG groups and severity were different in the four departments of orthopedics.Rehabilitation orthopedics was the best in TCM index. The comprehensive ranking in performance appraisement was rehabilitation orthopedics, joint orthopedics, traumatic orthopedics and spinal orthopedics.Conclusion DRGs is an effective, accurate method in performance appraisement. The indexes of TCM treatment and medicine were helpful in TCM ability appraisement. By the ways of DRGs and TOPSIS, the advantages and disadvantages in different departments would be found to help the refined management.
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  Application of the disease control file in the surveillance system of suspected vaccination abnormality in Weifang from 2013 to 2017

  Zhou Wei, Qiu Deshan

  journal1. 2018, 25(6): 430-433. https://doi.org/10.3969/j.issn.1006-5253.2018.06.009

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  Objective To collect archival information data of Adverse Events Following Immunization in Weifang from 2013 to 2017, and to evaluate the operation of AEFI monitoring system.Methods The index of AEFI data collected from the AEFI information management system was analyzed by descriptive epidemiological method in Weifang city from 2013 to 2017.Results Totally 8 816 AEFI cases were reported in Weifang city from 2013 to 2017, with the reported incidence rate 50.24/10⁵, including 8 764 cases of general reaction accounting for 99.41%, 46 cases of abnormal reaction accounting for 0.52%, and 6 cases of coincidence accounting for 0.07%. The reporting rate within 48 hours after the discovery was 99.87%. There were 6 803 cases under 2 years old, accounting for 77.17%, and 4 568 children under 1 year old accounting for 51.81%. There were 795 cases of 9 months old, accounting for 17.56%, 685 cases of 4 months old accounting for 15.13%, and 540 cases of 10 months old accounting for 11.93%. And 7 565 cases occurred one day dafter vaccination accounting for 85.81%. The most frequent clinical symptoms were fever, local swelling, and induration in 8 761 patients accounting for 99.38%. The vaccine reported AEFI more frequent was DPT without cell vaccine in 2 416 cases, accounting for 27.40%.Conclusion The sensitivity of AEFI monitoring in Weifang is high.
     
Hospital Management
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  Practice and reflection of physicians′ human resource allocation measurement of tertiary hospitals based on clinical workload

  Yan Han, Cai Yanji, Ou Zhenyu, Ouyang Ming

  journal1. 2018, 25(6): 434-436. https://doi.org/10.3969/j.issn.1006-5253.2018.06.010

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  Physicians are the core component of hospital human resources, and the rational calculation of physicians′ human resources is related to the sustainable development of hospitals. This article discusses the present state of measuring physicians′ human resources in China. What′s more, it introduces the practice of physicians′ human resource allocation scheme based on A hospital in Guangzhou. In the last place, it brings up some deep thinking: first, the scientific and reasonable estimation methods of physicians′ human resources allocation scheme should be further explored; second, it is necessary to achieve the dynamic management of the physicians′ human resources measurement; third, it is necessary to reconstruct measurement guidance of physicians' human resource allocation on the national level.
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  Establishment and evaluation of a pharmaceutical intervention procedure for chronic pulmonary disease patients with dry powder inhalers

  Shi Dongming, Xu Haofeng, Yang Huajun, Du Junwei, Ye Xiaofen

  journal1. 2018, 25(6): 437-440. https://doi.org/10.3969/j.issn.1006-5253.2018.06.011

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  Objective To evaluate the effect of pharmaceutical intervention procedures on the efficacy of dry powder inhalers in patients with chronic pulmonary disease by establishing a standard model.Methods Patients in the intervention group were consecutively intervened for 6 months using the established pharmacological intervention procedure and evaluation criteria. The control group received only routine follow-up. The DPI operating score, lung function index, symptom self-assessment, disease control, drug-related knowledge and number of patients in emergency were evaluated before and after the treatment for the two groups.Results In the intervention group, after 6 months of pharmacological monitoring, the inhalation device operation score and CAT/ACT score of the patients with chronic obstructive pulmonary disease (COPD) were significantly improved compared with the control group (t=3.790, 4.661, P<0.05). The difference was also significant compared with the control group (q=3.108, 2.539, P<0.05). After 6 months of treatment for asthma patients, the inhalation device operation score, FEV1% predicted value, and ACT score of the intervention group were significantly higher than those of the control group (t=4.622, 3.912, 7.418, P<0.05). The difference between the two groups was also significant (q=2.698, 2.089, 2.264, P<0.05). In addition, the number of patients in the intervention group was significantly lower than that that in the control group (χ²=4.85, P<0.05), and the scores of the drug-related knowledge questionnaires were significantly higher than those in the control group (χ²=6.68, P<0.05). The number of people with good adherence was higher than that in the control group (χ²=8.15, P<0.05).Conclusions The establishment of standard medication intervention procedure for inhalants can improve the standardization and effectiveness of inhalation therapy, stabilize disease progression, and have good practical and scientific value in disease management and treatment.
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  Clinical features and health education analysis of patients with chemotherapy by PICC of nasopharyngeal carcinoma in Wenzhou

  Chen Xiaofang, Kong Limin, Yang Yuyan

  journal1. 2018, 25(6): 441-443. https://doi.org/10.3969/j.issn.1006-5253.2018.06.012

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  Objective To analyze the clinical features and the application effect of PICC catheter chemotherapy in patients with nasopharyngeal carcinoma in Wenzhou.Methods Totally 840 patients with nasopharyngeal carcinoma from October 2015 to May 2017 in Wenzhou were selected for the study. The clinical characteristics of the patient's onset age, pathological classification, lymph node metastasis, nasal symptoms and ear symptoms were statistically discussed. Then, according to the random table method, 840 cases patients were randomly divided into the observation group (n=420) and the control group (n=420). The observation group was given PICC catheter for chemotherapy and healthy education, the control group was treated with shallow intravenous indwelling needle for chemotherapy, and the incidence of postoperative adverse complications was recorded in two groups.Results The incidence of nasopharyngeal cancer gradually increased with age and the highest incidence rate was 60.59% for patients aged 40 to under 60 years old. There were 755 cases of squamous cell carcinoma, 26 cases of vesicular nucleus carcinoma and 59 cases of undifferentiated carcinoma. The incidence of various clinical symptoms was 66.07% of cervical lymph node metastasis, 56.67% of the nose symptoms, 12.02% of ear symptoms, 30.05% headache, 19.64% cranial nerve injury, and 4.05% distant metastasis. 42.05% cases presented only one symptom when diagnosed. After chemotherapy, the incidence of adverse complications in the observation group was 5.48%, significantly lower than the 26.43% of the control group, and the difference was statistically significant (P<0.05).Conclusion Squamous cell carcinoma is the main type of nasopharyngeal carcinoma and the clinical characteristics of nasopharyngeal carcinoma are atypical. PICC catheter chemotherapy can reduce the incidence of adverse complications, improve the quality of life of patients, and is worthy of clinical application.
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  Analysis on hospitalization cost of inhabitants in Liaobu town, Dongguan city from 2014 to 2015

  Lu Jianjun, Ran Peng, Hu Fang, Feng Yingqing, Zhou Yingling

  journal1. 2018, 25(6): 444-446. https://doi.org/10.3969/j.issn.1006-5253.2018.06.013

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  Objective To analyze the hospitalization cost of inhabits in Liaobu town from 2014 to 2015, and provide a basis for improving the graded diagnosis and treatment policy.Methods A retrospective study was conducted to analyze the choice of hospitals, average hospitalization cost and self-payment ratio.Results There were 31,443 medical insurance accounts in total, of which 8 663 (27.55%) were in local town hospitals, 21,880 (69.59%) were local city hospitals, and 900 (2.86%) were hospitals in other cities. According to the hospital location, inpatients were divided into the group in the town, the group in the city, and the group in other cities for further analysis. The median hospitalization cost and average self-payment ratio of the group in other cities were obviously higher than those of the other two groups. The median length of stay of the three groups were similar.Conclusion In recent years, the expenditure of medical insurance hospitalization expenses in Liaobu town, Dongguan city was basically in line with the policy expectations of graded diagnosis and treatment systems, and we should further strengthen the policy to control the medical cost and reduce the burden of inpatients.
Health Surey
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  Research on the living status of healthy and long-lived old people in Laizhou longevity village

  Sun Xiaohong, Li Lele, Gao Limin, Yang Nan, Cui Xikun, Huang Fei

  journal1. 2018, 25(6): 447-450. https://doi.org/10.3969/j.issn.1006-5253.2018.06.014

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  Objective Through the investigation and analysis of Laizhou old people′s living conditions and life satisfaction, to improve the quality of life of the old people, in order to provide the theoretical basis for Laizhou city work management.Methods Random sampling method was applied and questionnaires were used to investigate the influencing factors of the elderly including general data, self-care ability, personality traits, and cognitive abilities.Results The scores of self-care ability were 8.31 ± 3.37, the scores of personality traits were 17.03 ± 3.22 and the cognitive ability scores were 44.28±7.96. 97.4% of the elderly could independently control defecation, 69.2% of the elderly could independently have meals, 56.4% of the elderly could have indoor activities independently, 43.6% of the elderly could go to the toilet independently, 38.5% of the elderly could dress themselves independently, and 33.3% of the elderly could shower independently. Positive attitudes (trying to look on the bright side of things, liking to be clean, being independent, and being happy now) accounted for the high percentages of 64.1%, 71.2%, 46.2%, and 30.8% respectively, while the negative attitudes (feeling nervous, being lonely, and feeling useless) accounted for the low percentages of 0, 0, and 20.5% respectively.Conclusion The old people in Laizhou longevity village have higher self-management ability, optimistic character and good cognition. As they grow older, their body functions degenerate gradually. So we should pay more attention to elderly people for higher life satisfaction.
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  Plasma lipid level and distribution in staff of a hospital in Shaoxing area

  Lin Jianchao, Chen Li′na, Zhang Liping, Zhang Xiaohua, Jiang Ying, Chen Yejun, Ge Menghua

  journal1. 2018, 25(6): 451-453. https://doi.org/10.3969/j.issn.1006-5253.2018.06.015

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  Objective To examine the plasma lipid level and distribution in workers of a hospital in Shaoxing city.Methods The complete survey method was used to investigate 1 279 staff of a hospital aged 20 to 60 from January to February, 2018, and general physical examination and lipid monitoring were performed. They were divided into 20 to 30 years old group, 31 to 40 years old group, 41 to 50 years old group and 51 to 60 years old group and the dyslipidemia and the distribution characteristics in each group were analyzed.Results Levels of total cholesterol(TC), triglyceride(TG) and low-density lipoprotein cholesterol (LDL-C) were significantly different among these age groups (all P＜0.01). TC, TG and LDL-C levels in the staff aged 31 years old and above were all significantly higher than those in the group of 20 to 30 years old (all P＜0.01). TC, TG, and LDL-C levels of males were all significantly higher those of females (all P＜0.01). HDL-C levels in males were lower than those in females. The incidence of dyslipidemia of the staff was 19.23% and it was significantly higher in males than that in females (36.86% VS 12.0%, P＜0.01). The prevalence of high TC, high TG, and low LDL-C increased with age, and chi-square test showed statistically significant differences (all P<0.01).Conclusion The prevalence of dyslipidemia in the hospital staff (36.86%) is lower than the overall prevalence of dyslipidemia in Chinese adults (40.40%). The prevalence of dyslipidemia is higher in males than in females. Male staff should be the focus of prevention in dyslipidemia crowd.
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  Investigation and analysis of cognition and demand of pelvic floor rehabilitation for 860 rural women of childbearing age with health examination

  Zhu Huimin, Xu Xiaoxiao

  journal1. 2018, 25(6): 454-456. https://doi.org/10.3969/j.issn.1006-5253.2018.06.016

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  Objective To investigate and analyze the cognition and demand of pelvic floor rehabilitation for 860 rural women of childbearing age with health examination.Methods Totally 860 rural women of childbearing age with health examination were selected from June 2017 to June 2018 in our Hospital, and the self-made questionnaire was used to assess the cognition and demand of pelvic floor rehabilitation.Results In this survey, there were 644 cases (74.88%) with pelvic floor abnormality and 299 cases (34.77%) with pelvic floor dysfunction (PFD), 309 cases (35.93%) understood the symptoms of PFD and 135 cases (15.70%) understood the PFD symptoms; the highest requirement for the pelvic floor rehabilitation was the pelvic floor exercise with 355 cases (41.28%), and the highest guidance method of the pelvic floor rehabilitation was medical and nursing education with 500 cases (58.14%); the leading priority factor for whether women were willing to accept pelvic floor rehabilitation was shyness with 564 cases (65.58%). The scores of cognition and demand of pelvic floor rehabilitation in the women under 30 years old were significantly higher than those in the women 30 years old and above, and the difference was statistically significant (P<0.05).Conclusions Rural women of childbearing age have low awareness and high demand for pelvic floor rehabilitation, and women under 30 years old have higher cognition and demand, so medical and nursing staff should strengthen health education for women, especially the guidance of pelvic floor exercise and psychological guidance.
     
Classification of diseases
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  The difference between diseases coding search methodologies and their improvement

  Zhong Cen,Yang Fahui

  journal1. 2018, 25(6): 457-459. https://doi.org/10.3969/j.issn.1006-5253.2018.06.017

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  Objective Optimize the coding search capability of the computer and improve the efficiency of discharge diagnosis coding of the hospital staff.Methods The search algorithms were improved, earch results were compared to assess the strengths and weaknesses of various algorithms.Results Optimization of search algorithms can increase the correlation between retrieve results and expected results.Conclusion Search results from improved search algorithms can significantly enhance the efficiency of the diagnosis coding.
Hospitalization Statistics
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  Analysis of clinical data of 167 cases of brucellosis in a tertiary hospital of binzhou

  Zhang Liguo, Zhang Ping, Li Dongmei, Ding Guofeng

  journal1. 2018, 25(6): 460-463. https://doi.org/10.3969/j.issn.1006-5253.2018.06.018

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  Objective The clinical data of 167 cases of brucellosis patients confirmed in a tertiary hospital in Binzhou city were analyzed to improve the diagnosis and treatment of brucellosis by clinicians.Methods Descriptive analysis was used to analyze the data of patients diagnosed with brucellosis in a tertiary hospital from January 2012 to December 2015.Results Totally 167 cases were confirmed from January 2012 to December 2015. There were 14 cases in 2012, 13 cases in 2013, and more cases in 2014 with 81 and in 2015 with 59 respectively. The highest incidence of brucellosis was from March to August, and the highest incidence was in May with the most confirmed patients. The number of patients fell month by month from September. The high-risk group was male patients over 50 years old, accounting for 29.34%, and children patients were not uncommon, with children under 10 years old accounting for 4.19%, mostly in rural areas. Most of the patients presented fever, hydrosis, and joint pain, and some patients developed splenomegaly and headaches. All of the 167 patients completed the tiger red plate agglutination test and all were positive. Adults were treated with doxycycline, rifampicin capsule and levofloxacin, while children were treated with rifampicin and sulfamethoxazole for 8 weeks. Symptoms disappeared completely in 161 cases (96.41%), improved in 6 cases (3.59%), and the total effective rate was 100.00%.Conclusion The clinical manifestations of brucellosis are various, and patients with atypical symptoms are easy to be misdiagnosed. Children should be paid more attention.
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  Effect of laparoscopic common bile duct on quality of life and prognosis of complex hepatolithiasis

  Wang Li, Lin Haiqing, Fu Lijun, Hu Chunying, Wang Haixia

  journal1. 2018, 25(6): 464-466. https://doi.org/10.3969/j.issn.1006-5253.2018.06.019

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  Objective To investigate the effect of laparoscopic common bile duct on the quality of life and prognosis of complex hepatolithiasis.Methods One hundred and four patients with complicated hepatolithiasis were divided into the study group (laparoscopic common bile duct, 52 cases) and control group (open bile duct exploration, 52 cases) according to the random number table. The operation-related indexes, quality of life scores, complications and recurrence of stones were observed and compared between the two groups.Results The bleeding volume, operation time, anal exhaust time, treatment cost and hospital stay in the study group were all less than those in the control group, and the differences were statistically significant (t =-12.275, -8.675, -9.962, -14.008, -7.603, all P<0.05). The quality of life of the study group was higher than that of the control group (t=-13.406, P<0.05). The incidence of complications and the recurrence rate of stone of the study group were lower than those of the control group, and the difference was statistically significant ( χ² =7.081,3.983, all P<0.05).Conclusion Laparoscopic common bile duct exploration of complicated hepatolithiasis can shorten the operation time, reduce the amount of intraoperative bleeding and cost of treatment, can significantly improve the quality of life of patients, and the prognosis is good, so it is worth promoting the application.
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  Analysis of rehabilitation nursing effect on patients with ICU severe craniocerebral injury based on Omaha system

  Zhao Yufang, Zhu Beilei, Ye Mangmang

  journal1. 2018, 25(6): 467-469. https://doi.org/10.3969/j.issn.1006-5253.2018.06.020

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  Objective To explore the effect of rehabilitation nursing on patients with ICU severe craniocerebral injury based on Omaha system. Methods Totally 100 cases of ICU severe craniocerebral injury were studied in our hospital from October 2017 to October 2016. According to the end numbers of the patients' entrance ID numbers, the patients were randomly divided into the control group and the observation group. The control group received routine nursing, and the observation group received the Omaha system intervention nursing besides routine nursing. The clinical effects, hospitalization, psychological status and satisfaction of the two groups of patients were compared and analyzed. Results The total effective rate and nursing satisfaction rate in the observation group (98%, 96%) were significantly higher than those in the control group (86%, 84%), and the difference between the two groups was statistically significant (P<0.05). The hospitalization cost of the observation group was obviously lower than that of the control group, the time of hospitalization of ICU was shorter than that of the control group, and the difference between the two groups was statistically significant (P<0.05). Before nursing, there was no significant difference in SDS score and SAS score between the two groups (P>0.05). After nursing, the SDS scores and SAS scores of the two groups were significantly decreased, the SDS scores and SAS scores of the observation group were significantly lower than those of the control group, and the difference between the two groups was statistically significant (P<0.05). Conclusion Rehabilitation nursing based on Omaha system for ICU patients with severe craniocerebral injury can improve treatment effect and patient satisfaction and help patients recover at an early date, which is worthy of clinical application and promotion.
     
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  Analysis of disease characteristics and prognosis of ICU inpatients in a geriatric hospital

  Xu Taoyan, Chen Hongyu, Wu Shuai

  journal1. 2018, 25(6): 470-473. https://doi.org/10.3969/j.issn.1006-5253.2018.06.021

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  Objective To understand the hospitalization status of patients in Intensive Care Unit (ICU) in our hospital in recent 2 years, and to provide reference information for the construction of various departments in our hospital.Methods Totally 200 ICU patients admitted from June 2016 to June 2018 in our hospital were collected. All of them kept complete medical records. The disease types, age distribution, prognosis and nosocomial infection of ICU patients were analyzed.Results Malignant tumors, cerebrovascular accidents and trauma accounted for 26.50%, 22.50% and 21.00% respectively, followed by acute abdomen, pneumonia, and cardiovascular diseases, etc. The ratio of disease spectrum was significantly different (P<0.01). Trauma was predominant for ICU patients aged 1 to 18 years old, malignant tumors and trauma were predominant for patients aged 19 to 40 years old and 41 to 65 years old, and malignant tumors and cerebrovascular accident were predominant for patients aged 66 to 82 years old. The disease spectrum composition of different age groups was significantly different (P<0.01). After treatment, 73.50% of patients in ICU were transferred to other departments, and the ratio was significantly higher than death 20.00% and discharge 6.50%. There was a significant difference in the composition of prognosis and outcome (P<0.01). The highest conversion rate of ICU was 31.97% of malignant tumor, 23.81% of cerebrovascular accident. The highest mortality rate was 40.00% of the patients with trauma. There was a significant difference in the ratio of disease spectrum between ICU transfer and death (P<0.01). The nosocomial infection rate in ICU was 16.50%, and the nosocomial infection rate increased gradually with the extension of ICU stay.Conclusions The disease spectrum composition of ICU patients, the disease spectrum composition of different age groups, the prognosis of different diseases and nosocomial infection rate have significant characteristics, reflecting the characteristics of complex disease spectrum and multi-disciplinary diseases. And these patients were in critical condition, and were easy to death and nosocomial infection and so on. Combined with statistical information, the construction of related disciplines and the integration of medical resources should be strengthened accordingly to improve ICU medical treatment services.
     
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  Analysis of risk factors and preventive measures on pulmonary embolism in the aged

  Wang Yingzhi, Chen Xiaoyun, Hou Dongjiao

  journal1. 2018, 25(6): 474-475. https://doi.org/10.3969/j.issn.1006-5253.2018.06.022

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  Objective To explore the correlated risk factors of pulmonary embolism (PE) in the aged, and provide preventive measures for PE.Methods Eighty old people with PE were retrospectively selected as the case group, and 80 aged people without PE were randomly selected as the control group. All the patients were carried out a retrospective survey. The methods of χ² test and multiple logistic regression were used to screen the risk factors of PE in the aged.Results According to the sorting result of OR value, multiple logistic regression method showed that the risk factors of PE in the age included DVT (OR=5.436), Malignant tumor (OR=4.221), trauma and surgery (OR=3.931), COPD (OR=3.529), atrial fibrillation (OR=3.114) and bone fracture (OR=2.266).Conclusion The causes and risk factors of PE in elderly patients are very complicated. Risk factors for elderly patients should be early evaluated, in order to take precautions and treatment measures early, to cut down the incidence rate of PE in the aged, and improve the prognosis of PE patients.
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  Study on the poor incisions healing and influencing factors of healing in caesarean section

  Wang Fang, Sun Hongxia

  journal1. 2018, 25(6): 476-478. https://doi.org/10.3969/j.issn.1006-5253.2018.06.023

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  Objective To explore the situation of caesarean section healing in hospital, analyze the influencing factors of the incomplete incision healing, so that special management could be aimed at key population for maternal health care and postoperative medical treatment to promote group health.Methods Present status was investigated of basic information and healing of cesarean section of patients in a hospital in 2017. Chi square test, t test and binary logistic regression model were used to analyze the effects of incomplete incision healing on hospitalization costs and hospital days, and the important risk factors influencing healing were analyzed.Results The hospitalization time was longer and the cost of hospitalization was higher than those of the normal group. High risk factors affecting incision healing include diabetes, anemia, previous cesarean deliveries, hypoproteinemia, higher body mass index (BMI BMI>30 kg/m²), and advanced age (over 35 years old ). The effect of biological hemostatic materials after surgery remained to be verified.Conclusion The correct assessment is given to the high-risk population, the special management is carried out, and the operation time is shortened by improving the quality of the operation, preventing infection and other multiple measures to jointly promote the benign healing of cesarean section and protect women's reproductive health.
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  Analysis of causes of cesarean section among maternal women with “two children”

  Zhang Huixian, Li Hua, Zhou Li′na, Ye Jiesuo

  journal1. 2018, 25(6): 479-481. https://doi.org/10.3969/j.issn.1006-5253.2018.06.024

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  Objective To analyze the causes of cesarean section among maternal women with “one child” and ”two children”, in order to reduce the caesarean section rate.Methods The research focused on 3 498 maternal women from department of gynaecology and obstetrics of ningbo women and children's hospital, and clinical data of all the maternal women were analyzed retrospectively. The conditions of cesarean section between the two groups were statistically analyzed, so were the sources of information of delivery mode for maternal women with “one child” and “two children” and the main causes of cesarean section.Results The cesarean section rate of maternal women with “two children” was apparently higher than that of maternal women with “one child”, and there were significant differences between the two groups (P<0.01). Among 1 668 maternal women with “one child”, the most important sources of information that affected 617 (36.99%) maternal women′ delivery mode were the Internet, TV, newspaper and magazines. Among 1 830 maternal women with “two children”, the most important sources of information that affected 657 (35.90%) maternal women′ delivery mode was learning in pregnant women school. Social factors, abnormal stage of labor, birth canal and the factors of fetus were the main causes of cesarean section among maternal women with “one child”. Cicatricial uterine, pregnancy complications and social factors were the main causes of cesarean section among maternal women with “two children”.Conclusion The cesarean section rate of maternal women with “two children” is higher. Cicatricial uterine, pregnancy complications and social factors are the main causes of cesarean section among maternal women with “two children” and need more attention.