25 February 2021, Volume 28 Issue 1

    

• Select all
  |

• Select
  Establishment of nomogram model for patients with surgical site infection after spinal surgery

  Zhou Peimin, Zheng Shu, Huang Zhihong, Wang Dafeng

  journal1. 2021, 28(1): 1-5. https://doi.org/10.3969/j.issn.1006-5253.2021.01.001

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To develop a nomogram to predict surgical site infection (SSI) after spinal surgery, so as to help medical staff to plan preventive strategies to reduce the incidence of SSI. Methods We retrospectively selected 2 348 patients undergoing spinal surgery at Wenzhou People's Hospital from May 2012 to May 2019. Univariate and multivariate logistic regression models were used to determine independent predictors for SSI after spinal surgery and a nomogram was constructed to predict SSI after spinal surgery based on each predictive factor. The area under the receiver operating characteristic curve (AUC) was used to assess the discriminatory ability of the nomogram and the consistency of the nomogram was tested using calibration plot and Hosmer-Lemeshow  goodness of fit test (H-L test). Results In univariate and multivariate analysis, current smoking (OR=2.242, 95%CI:1.125-4.469), diabetes (OR=0.932, 95%CI:1.260-5.113), operation time≥180 min (R=7.256, 95%CI:3.537-14.886), ASA ≥ grade III (OR=2.963, 95% CI:1.454-6.037) and blood transfusion (autologous blood OR=3.685, 95%CI:1.203-11.284; allogeneic blood OR=6.443, 95%CI:2.765-15.017) were identified as significant independent predictors. The nomogram was developed using these independent predictors. The AUC of the multivariate model for discrimination was 0.818 (95%CI:0.802-0.863). The calibration plot and H-L test (χ2=12.337, P=0.195) showed good consistency between predicted and observed outcomes. Conclusion The nomogram based on smoking, diabetes, operation time, ASA classification and blood transfusion has potential as a clinically useful predictive tool of SSI after spinal surgery.

   
• Select
  Analysis of risk factors for non-reflow after percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction based on random forest algorithm

  Yu Xiao

  journal1. 2021, 28(1): 6-11. https://doi.org/10.3969/j.issn.1006-5253.2021.01.002

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To investigate the risk factors of no-reflow after percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) based on random forest algorithm. Methods  A retrospective observational study was carried out in one hospital from January 2013 to June 2019. The general clinical data of the patients, various blood indicators and PCI postoperative conditions were collected. Random forest algorithm and multivariate logistic regression analysis were used to analyze the risk factors. Results We collected 352 STEMI patients who met the inclusion criteria, of which 63 had no reflow and 289 had reflow. We constructed a random forest models, C-index to assess discrimination performance in the training dataset was 0.980 and C-index to assess discrimination performance in the test dataset was 0.840. The variables mean platelet volume to lymphocyte ratio (MPVLR), length of lesion, hypertension, pain-to-balloon time (PBT), lymphocyte count (LYM) and platelet to lymphocyte ratio (PLR) were selected. Multivariate logistic regression further showed that MPVLR, hypertension, PBT, LYM and PLR were independent risk factors affecting no-reflow after PCI in patients with acute STEMI.Conclusion Random forest analysis combined with multivariate logistic regression showed that MPVLR, hypertension, PBT, LYM and PLR were independent risk factors affecting noreflow after PCI in patients with acute STEMI, which could provide a basis for rapid and simple risk analysis and early intervention of medical staff.
• Select
  Retrospective study on clinical occurrence characteristics of pressure ulcers brought out of hospital in a tertiary hospital

  Li Jing, Li Xian

  journal1. 2021, 28(1): 12-15. https://doi.org/10.3969/j.issn.1006-5253.2021.01.003

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To analyze the clinical characteristics of out-of-hospital pressure ulcers and provide a reference for preventing out-of-hospital pressure ulcers. Methods A retrospective study was used to collect data on pressure ulcers reported in all departments from January 1, 2017 to December 31, 2019, and statistical analysis was conducted of the patients′ general information and basic information on pressure ulcers. Results Eighty-seven point two percent families brought into pressure ulcers, and 12.8% of nonfamilies (nursing homes, medical institutions); 61.0% of men, 39.0% of women; 79.5% over 65 years old, with a higher proportion of age groups concentrated at the age of 75-84 old years (266 cases, 31.8%); 82.6% of internal medicine patients, the top three pressure ulcers were departments of tumor, intensive care unit, and neurology; the most common sites were sacral tail, hip, buttock, heel, ankle; the main stages of pressure ulcers were stage Ⅰ, stage Ⅱ, and non-stage; about 48.4% of the pressure ulcer wound area exceeded 10 scores; after nursing care of pressure ulcers, the patients improved and healed significantly before the treatment. Conclusion Statistical analysis of the occurrence characteristics of patients with pressure ulcers outside the hospital for 3 years can provide reference basis for guiding nursing staff to make preventive measures against pressure ulcers and reduce the incidence of pressure ulcers brought out of the hospital.
• Select
  Analysis of the characteristics of remote transmission of 12-lead ECG in 343 pre-hospital patients with chest pain

  Ling Qiaoqiao, Xie Jie, Mou Licheng, Hou Yuehui

  journal1. 2021, 28(1): 16-19. https://doi.org/10.3969/j.issn.1006-5253.2021.01.004

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To provide advice for local prehospital emergency management and remote transmission mode by analyzing the characteristics of remote transmission of 12-lead ECG in pre-hospital patients with chest pain in Taizhou. Methods A retrospective analysis was conducted on data of 343 pre-hospital patients with chest pain in six hospitals from January 1, 2019 to December 31, 2019 from the Taizhou Emergency Center. Results The time distribution of 343 pre-hospital patients with chest pain was in July, August, and September during the year, Friday, Saturday, and Sunday during the week, and 18∶00-21∶00, 6∶00-9∶00 and 12∶00-15∶00 during the day. Among 196 patients with chest pain in 6 hospitals, 12-lead ECG was used, with an average utilization rate of 57.14%, of which 159 patients had remote ECG transmission, with an average transmission rate of 81.12%; there was no statistical difference in FMC-to-B time and D-to-B time between WeChat transmission group and vehicle transmission system group (P>0.05). Conclusion Medical institutions can improve the utilization rate of 12-lead ECG for pre-hospital patients with chest pain. For some primary hospitals, the WeChat group transmission method can be used to replace the vehiclemounted transmission system to remotely transmit the ECG results.
• Select
  Analysis of the death situation among inpatients in a tertiary hospital in Shanghai from 2014 to 2019

  Liu Yinmei, Zhang Zhenjun, Wan Qiuping, Yu Hong

  journal1. 2021, 28(1): 20-24. https://doi.org/10.3969/j.issn.1006-5253.2021.01.005

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To analyze the characteristics of the causes of death in a tertiary hospital in Shanghai during six years, and to provide reference for the rational allocation of medical resources. Methods The basic information of 3 598 inpatient deaths from January 1, 2014 to December 31, 2019 was collected and analyzed with SAS 9.2 software according to ICD-10 classification standard. Results The case fatality rate of hospitalized patients was 0.67% from 2014 to 2019, and the fatality rate of male patients was higher than that of female patients (χ2=143, P<0.001). The mortality age of female［M(IQR)］82(14) years old was higher than that of male［M(IQR)］77(20) years old, and the difference was statistically significant (Z=10.08, P<0.001). The mortality increased with age, and there was significant difference in Cochran Armitage trend test (Z=2.95, P=0.003). The causes of death were different between age groups, there were 5 deaths under 20 years old, including 2 cases of respiratory system disease, 1 case of circulatory system disease, 1 case of perinatal conditions disease, and 1 case of symptoms / signs / clinical abnormalities. Malignant tumor and circulatory system disease were the main causes of death from 20 to 69 years old. Circulatory system disease, malignant tumor and respiratory diseases were the main causes of death over 70 years old. The three leading causes of death were circulatory diseases (40.05%), malignant tumors (31.88%) and respiratory diseases (11.92%). Conclusion Circulatory system disease, malignant tumor and respiratory system disease were the main causes of death. We should pay attention to improving the level of medical technology and multidisciplinary comprehensive treatment ability, and pay attention to the early screening and intervention of diseases, so as to reduce the mortality.
• Select
  Study on the influence of pre-hospital examination on average hospitalization days based on interrupted time series model

  Yang Peng, Pang Fan, Zhao Qing, Wang Yujin, Zhao Jia, Shang Lei, Liu Ya

  journal1. 2021, 28(1): 25-28. https://doi.org/10.3969/j.issn.1006-5253.2021.01.006

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To evaluate the effect of pre-hospital examination on average hospitalization days. Methods The two most common diseases in otorhinolaryngology (adenoid hypertrophy, otitis media) and hematology (leukemia, lymphoma) were selected respectively, and the patient data of 144 months before and after 6 years of pre-hospital examination were extracted from the hospital electronic medical record database. The interrupted time-series method was used to analyze the change trend of the average hospitalization days before and after the pre-hospital examination application. Results After the application of pre-hospital examination, the average hospitalization days of adenoid hypertrophy, otitis media and lymphoma decreased by 1.7 days, 2.8 days and 2.6 days (P<0.05) respectively, whereas Leukemia decreased by 0.2 days (P>0.05). Adjusted by age, gender and admission condition, the slope of average hospitalization days declined significantly (P<0.05) for adenoid hypertrophy and otitis media, insignificantly (P=0.29) for lymphoma, and did not decrease but increased for leukemia after pre-hospital examination implemented for 1 month. Seventy-two months after the implementation of the examination, except for leukemia, the change slope of adenoid hypertrophy, otitis media, and lymphoma were all slightly higher than right after the implementation, but remained at an obvious lower level than before the implementation. Conclusion No matter for the short-term or long-term trend, pre-hospital examination application has a significant reduction in the average hospitalization days for diseases with better treatment effects (adenoid hypertrophy, otitis media, lymphoma), and has almost no reduction for the disease (leukemia) with longer hospitalization days and poor treatment effects.
• Select
  Survey on the inpatient deaths in a tertiary hospital in Beijing from 2010 to 2019

  Li Dongjie, Shi Jin, Ren Hongyan

  journal1. 2021, 28(1): 29-33. https://doi.org/10.3969/j.issn.1006-5253.2021.01.007

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To understand the distribution characteristics of inpatient deaths in a hospital, find out the cause of the changing trend of inpatient death rate, and provide reference for hospital management and area public health service. Methods The data on first pages of medical records were collected in a tertiary hospital from 2010 to 2019, and death causes were classified according to the classification criteria of ICD-10. The cross-table analysis, chi-square test and correlation analysis were used to analyze the basic information about patients, the rank of death causes, the changing of inpatient mortality. Results Cancer and cardiovascular disease were the top two causes of death for both men and women. The nosocomial mortality had been falling in the last decade. This falling had an intense relationship with decrease in quantities of cardiovascular disease and tumor. The deaths from respiratory diseases in men were on the rise. Conclusion Hospitals should pay more attention to the prevention, diagnosis, treatment about tumor, cardiovascular disease and respiratory diseases to reduce the incidence and mortality of these diseases and improve the qualify of life.
• Select
  Death causes analysis among inpatients from a hospital between 2009 and 2019

  Wang Jian, Pang Jing, Lu Wenqiao

  journal1. 2021, 28(1): 34-37. https://doi.org/10.3969/j.issn.1006-5253.2021.01.008

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To explore the causes of death in hospitalized patients during the 11 years and provide basis for rational allocation of medical resources. Methods According to ICD-10 disease classification, a descriptive epidemiological study was performed on the causes of death in hospitalized patients between 2009 and 2019. Results Between 2009 and 2019, the case fatality rate (CFR) decreased yearly (χ2=237, P<0.001) and the average CFR was 1.12%. The analysis of multiple logistic regression showed that, the highest CFR occurred in the group aged 65 and above (OR=50.11, 95%CI: 30.65-81.92), male (OR=1.42, 95%CI: 1.34-1.51), the region in native (OR=1.66, 95%CI: 1.52-1.82),the emergency admission (OR=3.42, 95%CI: 3.20-3.66), only western medicine treatment (OR=6.67, 95%CI: 4.51-9.88), nonoperative patient (OR=5.43, 95%CI: 4.70-6.28).The top 3 causes of death were tumor (30.75%), circulatory disease (26.75%), and respiratory disease (20.52%), respectively; among them the main causes were digestive organs malignant neoplasms, ischaemic heart diseases and other diseases of the respiratory system, respectively. Conclusion The prevention and treatment of the top 3 causes of death diseases should be strengthened; clinically targeted intervention should be strengthened for population of 65 years old and above and male, and internal medicine diseases; diagnosis and treatment should be combined with traditional Chinese and western medicine.
• Select
  Analysis of the disease composition of inpatients in the psychiatric department of a tertiary Chinese hospital 

  Zhang Panpan

  journal1. 2021, 28(1): 38-40. https://doi.org/10.3969/j.issn.1006-5253.2021.01.009

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To analyze the composition and distribution of diseases in the psychiatric department of a tertiary TCM hospital, and provide theoretical basis for mental illness prevention and discipline construction. Methods A retrospective analysis of the first page data of 4178 psychiatric inpatient records in a Chinese hospital was performed. Gender, age, main diagnosis of discharge, length of stay, hospitalization expenses and other information were collected for statistical analysis. Results The top 5 diseases of inpatients in the psychiatric department were schizophrenia, depression, anxiety, acute stress response and epileptic psychosis, with a cumulative constituent ratio of 94.16%. the proportion of men (65.35%) suffering from schizophrenia was greater than that of women (34.65%); the proportion of female patients with depression, anxiety and acute stress reaction diseases was higher than that of male patients (P<0.001). On the whole, patients with mental illness between 31 and 45 years old accounted for the highest proportion (35.38%). Among them, patients with schizophrenia (46.62%), acute stress response (30.48%), and epileptic psychosis (49.38%) accounted for the largest proportion in the 31-45 year-old age group; depression patients accounted for the largest proportion in the 16-30 year-old age group (24.11%); anxiety patients in the over 60 years old age group accounted for the largest proportion (39.35%).Conclusion Schizophrenia is the main disease admitted in the psychiatric department. Men and young adults are high-risk groups. The prevention and treatment of this type of disease should be strengthened.
• Select
  Statistical analysis of 1859 injured patients in the department of orthopedics in 2019

  Yao Li, Yan Jianyang, Yang Jing

  journal1. 2021, 28(1): 41-43. https://doi.org/10.3969/j.issn.1006-5253.2021.01.010

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To analyze the case characteristics of orthopedic injury patients, so as to provide basis for improving the prevention and treatment of orthopedic injury in this region. Methods  Totally 1 859 patients with injury in the department of orthopedics in a hospital from January to December 2019 were enrolled, and the characteristics of injured patients in different genders, ages, injury causes and injury sites were retrospectively analyzed. Results Among all the 1 859 cases, there were 974 males (52.39%) and 885 females (47.61%), aged 4 months to 96 years old (mean 51.4±22.14). The average age of male patients was (44.59±21.16) years old, and the average age of female patients was (58.96±20.71) years old. And using age 60 as the demarcation point, the difference in gender between groups was statistically significant (P<0.001). The most common cause of injury was fall on the same plane (40.45%), followed by traffic accidents (28.08%), and the composition ratio of the injury causes between the male and female was statistically significant (P<0.001). Sites of injury: lower limbs (42.55%), upper limbs (33.08%), trunk (15.49%), multiple or other parts (5.86%), and head and neck (3.01%). The composition ratio of the injury sites between the different injury causes was statistically significant (P<0.001). Conclusion  The majority of injuring causes were fall on the same plane, traffic accidents and objects/appliance mechanical accidents. Thus, people should strengthen the consciousness of risk prevention in their daily life. The hospital should improve the pre-hospital emergency system of orthopedics, build up a professional team of trauma orthopedics and carry out follow-up work for injured patients.
• Select
  Periodic analysis of the change of inpatient number in the outpatient department of a hospital

  Dai Jiankun

  journal1. 2021, 28(1): 44-47. https://doi.org/10.3969/j.issn.1006-5253.2021.01.011

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To analyze and evaluate the reasons for the changes in the number of outpatients in a hospital, and to provide decision-making suggestions for the hospital management. Methods Based on the data provided by the statistical report of outpatient visits in a hospital in recent 5 years, the time series direct average seasonal index method was used to analyze the data. Results The peak season of outpatient visits in the hospital was December, January and May, and the off-season was September, February and August. The intra-week ratio showed that the number of outpatient visits was the highest on Monday, began to decline on Tuesday, dropped to the lowest point on Thursday, climbed slowly on Friday, and rose to the peak on Saturday and Sunday of  next Monday, completing a periodic cycle of outpatient visits. The peak season of hospitalization was December, January and November, and the off-season was February, September and August. The intra-week ratio showed that the number of hospitalizations was the highest on Monday, gradually decreased from Tuesday to Sunday, and rose to the peak of next Monday, completing a periodic cycle of hospitalization. Conclusion The number of outpatient visits was the lowest in September, the number of inpatient visits was the lowest in February, and the number of outpatient visits was the highest on Monday in the hospital.
• Select
  Trends of outpatient and emergency amount in oral hospitals during COVID-19 epidemic

  Tian Yuan, Yao Min, Fang Jiakun, Sun Yannan

  journal1. 2021, 28(1): 48-52. https://doi.org/10.3969/j.issn.1006-5253.2021.01.012

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To analyze the trend of the outpatient and emergency amount in oral hospitals during the epidemic of COVID-19, which can provide data support for the arrangement of diagnosis and treatment in the future. Methods The data of outpatient and emergency amount from February 1, 2020 to July 31, 2020 were collected and compared with the data of the same period in 2019 to analyze the trend and change of patient amount. Results Since February 2020, the total number of outpatient amount decreased by 72.9% compared with the same period of the previous year, but it was gradually recovered. Except for a significant decrease in February, June and July, the number of emergency pitients increased slightly, which was less than the previous year. The main reasons for emergency patients were acute and chronic pulpitis, periodontitis and other general oral -emergencies, similar to the same period of the previous year.Conclusion During the epidemic period, oral hospitals were significantly affected. With the normalization of epidemic prevention and control, the normal diagnosis and treatment order should be gradually restored, so as to ensure patients' medical needs.
• Select
  Analysis of medical service radius of a hospital from the perspective of DRGs

  Jiang Guojian, He Guobin, Xu Minhui, Zheng Pan, Zhu Jingjing, Guo Jiayi

  journal1. 2021, 28(1): 53-56. https://doi.org/10.3969/j.issn.1006-5253.2021.01.013

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To provide the decision-making basis for the scientific development planning of the hospital, by analyzing the medical service radius and its variation trend of a hospital. Methods The first page information of medical records and DRGs operation indicators from 2016 to 2019 were obtained, and the changes of various business indicators were statistically analyzed according to the administrative region of the patients′ current address. Results The number of discharged patients and DRGs group in all regions of the hospital increased year by year, and the patient composition ratio at city level decreased year by year (χ2trend=441.74, P<0.001). The CMI value was higher in patients from other cities than from local city. MDCY (burns), MDCN (diseases and dysfunction of the female reproductive system), MDCQ (diseases and dysfunction of the blood, hematopoietic and immune organs) and other MDC as well as orthopedics and traumatology, neurosurgery, and cardiothoracic surgery showed increased regional radiation capacity. Conclusion On the whole, the radiation scope of medical services in a hospital has been expanding year by year. In the future, measures such as continuous improvement of medical quality and efficiency, active implementation of graded diagnosis and treatment, and strengthening of discipline construction should be taken to provide more high-quality and efficient medical services for patients in the local city and surrounding area.
• Select
  Analysis of patent information of tertiary public hospitals in China from 2010 to 2019

  Ding Hanjie, Bao Jie, Chen Yuan, Yan Congcong, Wen Xin, Gu Hua

  journal1. 2021, 28(1): 57-61. https://doi.org/10.3969/j.issn.1006-5253.2021.01.014

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To analyze the general situation of patent application and authorization of 1 497 tertiary public hospitals in China from 2010 to 2019, to provide reference and basis for improving the awareness of intellectual property protection in public hospitals and promoting the application and transformation of patents in the field of medical and health care at the same time. Methods Patent data were searched through Baiteng net patent database, and SPSS 19.0 was used for statistical analysis. Results From 2010 to 2019, there were a total of 94 321 from 1 497 tertiary public hospitalsin china, among which 62 377 were for utility model patents and 31 944 for invention patents. The total number of valid patents was 46 532, accounting for 49.33% of the total number of patent applications. The number of invalid patents was 26 520, accounting for 28.12% of the total number of patent-applications. The number of patent applications and valid patents was positively correlated with the GDP and the number of health technicians per thousand population (r=0.949, 0.882, 0.938, 0.861 respectively, P<0.05). The provinces with more than 1000 patent applications were mainly distributed in east China, central China, south China and southwest China. There were 26 provinces and municipalities that jointly applied for patents. The number of patents jointly applied for accounted for 0.47% of the total number of patent applications. Conclusion The number of patent applications of tertiary public hospitals increased year by year. The utility model patents are the main ones, the number of invention patents is small, and the patent failure rate is high. Patent-area distribution is uneven. It is suggested that all localities establish and improve the training system and incentive measures for patent applications, encourage the application of invention patents, and increase the total number and quality of patents.
• Select
  Research on the mode of performance bonus distribution in ward nursing based on work quality

  Feng Min, Chen Yingning.

  journal1. 2021, 28(1): 62-65. https://doi.org/10.3969/j.issn.1006-5253.2021.01.015

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  In this article, we establish the multidimensional assessment rules covering ethics, ability, frequency, performance and other dimensions, by taking quality of care as the core, supplemented by taking quantity and benefit into consideration. The assessment results will be converted into percentages in proportion and linked to the performance bonus. After implementing the performance bonus in ward nursing, the integrated quality of nurses has been comprehensively improved, thus guaranteeing the nursing safety and promoting the sustainable development of the hospital.
• Select
  Comprehensive evaluation of open medicine project in tertiary general hospitals in a city by using entropy weight method

  Sun Huanhuan.

  journal1. 2021, 28(1): 66-68. https://doi.org/10.3969/j.issn.1006-5253.2021.01.016

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To evaluate the implementation of the open medical project in Shaoxing tertiary general hospitals by using entropy weight method. Methods Ten representative indicators were selected as the evaluation index system, and the entropy weight method was used to determine the weight of each evaluation index. Results According to the entropy weight method, the ranking of 7 tertiary general hospitals were D, C, F, G, B, E and A. Conclusion The evaluation results obtained by using the entropy weight method were consistent with the current status of the implementation of open medical project in various hospitals. The entropy weight method can objectively reflect the implementation of open medical project.
• Select
  Cognition analysis of graded diagnosis and treatment between doctors and patients in a tertiary hospital

  Cui Qianqian, Liu Xuewei, Zhang Yu, Ge Aimin, Li Jiacheng,Kong Yang.

  journal1. 2021, 28(1): 69-72. https://doi.org/10.3969/j.issn.1006-5253.2021.01.017

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To understand the cognition of doctors and patients on graded healthcare, and to explore the factors affecting the patient's willingness to seek medical treatment and the awareness of the doctors and patients on the classification and treatment. Methods The accidental sampling method was adopted. One hundred and eighty-three patients and 92 medical staff of a tertiary hospital in Binzhou were investigated with questionnaires and unstructured interviews. According to logistic regression, the factors affecting the cognition of both doctors and patients on graded healthcare were analyzed. Results Among the surveyed subjects, 38.2% of the patients said they understood the hierarchical diagnosis and treatment system, and 44.1% of the patients chose the primary hospital for the first consultation when they were sick.The higher the educational background, the higher the awareness of graded diagnosis and treatment (P<0.001).And patients who understand the hierarchical diagnosis and treatment system are more inclined to choose primary hospitals for the first diagnosis.70.6% of medical staff said they understood the hierarchical diagnosis and treatment system, but medical staff in different positions have different perceptions of hierarchical diagnosis and treatment, and clinicians have higher awareness of hierarchical diagnosis and treatment (P<0.001). Conclusion The awareness of both doctors and patients on hierarchical diagnosis and treatment needs to be improved, and the willingness of patients to choose primary care at the grassroots level is also low.Both doctors and patients should strengthen the promotion of graded diagnosis and treatment, increase the awareness of both doctors and patients, and increase investment in primary medical institutions, actively improve the primary diagnosis and treatment environment, comprehensively improve primary service capabilities, and attract patients to choose primary diagnosis.
• Select
  Screening rate of syphilis antibody and its characteristics in blood donors in Wenzhou

  Zhu Zimiao, Liu Yanfei, Xie Bufei, Cai Shufeng, Zhang Feng.

  journal1. 2021, 28(1): 73-77. https://doi.org/10.3969/j.issn.1006-5253.2021.01.018

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To explore positive screening rate of syphilis in the blood donors in Wenzhou, analyze its epidemiological characteristics and provide scientific basis for its prevention and control. Methods ELISA was used to detect the syphilis antibodies in the blood samples from voluntary donors in Wenzhou from 2016 to 2018. The detection and epidemiological characteristics of syphilis in the blood donors were analyzed. Results Totally 286 322 valid blood donation samples were received in Wenzhou from 2016 to 2018, of which 1 011 were positive in the primary screening of syphilis and the positive rate was 0.35%. There was lack of significance between the male (0.35%) and the female (0.36%) regarding the prevalence of syphilis (P>0.05). The positive rates of different age groups were significantly different. Results from pairwise comparison suggested that the positive rate of syphilis in the 31-45 years old group (0.40%) was significantly higher than that in the 18-30 years old group (0.33%) and the 46-60 years old group (0.31%). There were significant differences among different occupation groups and pairwise comparisons suggested: others (0.62%)>businessmen/the self-employed (0.38%)>teachers/cadres (0.16%)>students (0.09%), (P<0.001). There were significant differences among different education groups and pairwise comparisons suggested: junior high school and below (0.53%)>senior high School / technical secondary school (0.37%)>junior college and above (0.24%), (P<0.001). There was lack of significance among different blood types, different blood collection sites regarding the prevalence of syphilis (P>0.05). Conclusion According to the characteristics of syphilis in Wenzhou, the key prevention and control measures should be taken for the female, low age group, high age group, other occupations, businessmen/selfemployed, and low education population, so as to further reduce the incidence of syphilis among the population.
• Select
  Current status and influencing factors of social support among medical staff under the COVID-19 epidemic

  Zhang Xiaohong, Zhang Chuanmeng, Yu Ping.

  journal1. 2021, 28(1): 78-81. https://doi.org/10.3969/j.issn.1006-5253.2021.01.019

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective  To understand the current status of social support for medical staff in the epidemic of the corona virus disease 2019 (COVID-19) and explore its influencing factors, in order to improve the social support of medical staff and provide a scientific basis for improving their physical and mental health. Methods General information questionnaires and social support rating scale (SSRS) were used to conduct an online questionnaire survey on 707 medical staff in 6 secondary and higher hospitals in Taizhou to understand the current social support status of medical staff in the epidemic situation. Univariate analysis and binary logistic regression analysis were used to analyze the influencing factors. Results The recovery rate of the effective questionnaires was 98.16%, and the total score of the social support scale of 694 medical staff was (35.20±7.33), which was not statistically different from the domestic norm score (34.56±3.73) (P=0.335). Medical staff with old age, high professional title and high family income per capita and married had higher total scores of social support, subjective support dimensions, and objective support dimensions than others (P<0.05); the total score of social support, the scores of subjective support dimension and objective support dimension, and support utilization dimension score of medical staff without fear of new coronary pneumonia, without sense of conscious uselessness, and with high sleep quality were higher than those in other groups (P<0.05). The analysis results of the influencing factors of low-level social support of medical staff showed that married medical workers (OR=0.25, 95%CI: 0.10-0.62) and those with high sleep quality (OR=0.34, 95%CI: 0.11-1.00) were less likely to obtain low level of social support, which was a protective factor. Conscious uselessness (OR=2.59, 95% CI: 0.93-7.19) was a risk factor. Conclusion Under the epidemic situation, medical staff had received due social support, and there were many influencing factors. Emphasis should be placed on the social support of medical staff who are unmarried/ divorced, poor sleep quality or have a strong sense of uselessness to better meet the needs of their physical and mental health.
• Select
  Study on present situation and influencing factors of nurses′ intent to stay during the COVID-19 epidemic

  Li Dongmei, Zhao Xiaomin.

  journal1. 2021, 28(1): 82-85. https://doi.org/10.3969/j.issn.1006-5253.2021.01.020

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To investigate nurses′ intent to stay during COVID-19 and explore its influencing factors. Methods With the help of the wenjuanxing online survey platform, the general information questionnaire, nurses′ job stressor scale and nurses′ intent to stay questionnaire were used for the survey. Results Totally 519 valid questionnaires were received in this study. The total score of nurses′ intent to stay was (22.12±4.36), which was higher than the results of domestic research in recent 5 years (P<0.05). The independent influencing factors of nurses′ intent to stay were professional choice, working years, whether the department had colleagues to help Hubei, whether to let their children study medicine, problems in nursing profession and work, problems in patient care, and problems in management and interpersonal relationship (P<0.05). Conclusion The perceived intent to stay is above the middle level, which is higher than many domestic researches in recent 5 years. However, nursing managers still need to pay attention to the reasonable needs of nurses, optimize manpower allocation, and further improve the nurses′ intent to stay.
• Select
  Ensemble learning based on super learner algorithm and its application in prediction modeling for longitudinal censored data

  Yang Yuhui, Wang Jingxian, Zhao Peng, Li Yemian, Chen Fangyao.

  journal1. 2021, 28(1): 86-90. https://doi.org/10.3969/j.issn.1006-5253.2021.01.021

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective  Ensemble learning is a novel approach to improving learning accuracy in machine learning field recently. This paper aims to introduce the application of ensemble learning method based on super learner algorithm in the prediction modeling of longitudinal censored data and its implementation of R language. Methods This paper introduced the principle in modeling longitudinal censored data based on super learner algorithm and its implementation method with R-programming language. In addition, tumor survival data from TCGA database were used for real data analysis to illustrate its performance in practice. Results The estimation methods for model parameters and definition of ensemble learning parameters based on super learner algorithm are more flexible. In actual data analysis, super learner algorithm can make full use of the obtained data to establish the prediction model. The prediction accuracy of the model is 0.8737 (95% CI: 0.7897-0.9330) and the C-index is 0.883, so the prediction performance is good. Conclusion The ensemble learning approach with super learner algorithm provides a new choice for the prediction analysis based on longitudinal censored data.
• Select
  Comparison of the performance of seven classifiers on unbalanced gene expression data

  Li Jingwei, Liu Yan, Lu Zhen.

  journal1. 2021, 28(1): 91-96. https://doi.org/10.3969/j.issn.1006-5253.2021.01.022

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To investigate if the class imbalance poses additional challenges when dealing with class prediction of gene expression data, to evaluate the performance of seven types of classifiers on class-imbalanced data on a publicly available data set, in order to provide a theoretical basis for subsequent research. Methods We obtained different levels of class imbalance by repeatedly randomly selecting subsets of the samples from the public data set: training sets (N_n=10 vs N_p=10,15,20,30,35, and N_n=15 vs N_p=5,10,15,25,30); the test sets were balanced (N_n=20 vs N_p=20). We trained the classifiers on them and compare the classification effect of single sampling classification and 100 sampling average. Results As the number of positive samples in the data set increases, the overall sensitivity of the classification algorithm shows an upward trend, while the specificity shows a downward trend. In the colon cancer data set, AdaBoost, NB, and RF algorithms performed well, while support vector machines performed poorly and were unstable. In the leukemia data set, the overall performance of the NB algorithm is the best and stable, and the classification effect of AdaBoost, C4.5 and RF algorithms is better but fluctuates greatly.Conclusion Class imbalance, data characteristics and algorithm selection affect classification for high-dimensional data. And the results of a single analysis are contingent, with poor reproducibility. Researchers using class-imbalanced data should be careful in selecting algorithm and they should always use an appropriate method for dealing with the class imbalance problem.