25 December 2021, Volume 28 Issue 6

    

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  Research on the evaluation of health technical talents under the background of "breaking the five only"

  Shao Shuhan, Zhao Shengtian, Pang Yucheng

  journal1. 2021, 28(6): 481-484. https://doi.org/10.3969/j.issn.1006-5253.2021.06.001

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  After the socialism with Chinese characteristics has entered a new era, people have a higher demand for health. As the most core human resource in the field of health care, health technical talents play a more and more prominent role. As a baton, evaluation plays an important guiding role in the growth and development of health technical talents. Under the background of "breaking the five only", the evaluation of health technical talents also needs new changes. By combing the views of scholars at home and abroad, this paper analyzes the existing evaluation methods and indicators, so as to provide reference for the construction of evaluation system of health technical talents based on actual contributions and competence.
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  Application of random forest model and logistic regression model in predicting arteriovenous fistula dysfunction in maintenance hemodialysis patients

  Zheng Shi, Mei Youying, Wang Yihan, Pan Ruoling, Nan Xiaoling

  journal1. 2021, 28(6): 485-490. https://doi.org/10.3969/j.issn.1006-5253.2021.06.002

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  Objective To compare the performance of random forest model and the logistic regression model in the prediction of arteriovenous fistula (AVF) failure in maintenance hemodialysis patients.Methods Totally 588 patients with maintenance hemodialysis in the Blood Purification Center of Wenzhou Integrated Traditional Chinese and Western Medicine Hospital from May 2017 to November 2020 were enrolled in this study. The random forest algorithm as well as logistic regression analysis were separately applied to construct arteriovenous fistula dysfunction models, and the receiver operating characteristic curve was used to evaluate the predictive efficacy of the 2 models.Results The random forest model showed that geriatric nutritional risk index, alkaline phosphatase, age, platelet count, hematocrit, calcium phosphate product, C-reactive protein, prothrombin time, gender, and triglycerides were variables that had a significant impact on the prediction of the dysfunction of AVF. The AUC of the random forest prediction model was 0.911 (95% CI: 0.857-0.964, P<0.001) and that of the logistic regression prediction model was 0.755 (95% CI: 0.649-0.862, P<0.001). The AUC of the random forest prediction model via Z-test was greater than that of the logistic regression prediction model (Z=2.600, P=0.009). Multivariate logistic regression analysis showed that age (OR=1.035, 95%CI:1.017-1.054), smoking history (OR=2.543, 95%CI:1.457-4.439), diabetes mellitus (OR= 3.194, 95% CI:1.891-5.396), higher calcium phosphorus product (OR=1.023, 95%CI:1.007-1.039), and intradialytic hypotension (OR=2.393, 95% CI:1.064-5.379) were independent risk factors for the development of AVF dysfunction in maintenance hemodialysis patients, while higher geriatric nutritional risk index (OR=0.855, 95% CI:0.820-0.891) was an independentprotective factor for the development of AVF dysfunction. Conclusion Compared with logistic regression model, random forest model has better prediction effect on AVF dysfunction, while logistic regression can intuitively explain the results, and the two can complement each other.
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  Status and influencing factors of low-salt and low-fat diet in elderly patients with coronary heart disease

  Lu Ankang，Yu Miao，Dong Jianxiu， Ma Jiahui， Chang Wenhong，Han Jing， Wang Jianhui

  journal1. 2021, 28(6): 491-495. https://doi.org/10.3969/j.issn.1006-5253.2021.06.003

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  Objective To analyze the status and explore its main influencing factors of low-salt and low-fat diet in elderly patients with coronary heart disease discharged from hospitals for 1 year, in order to provide theoretical basis for scientific and effective guidance to conduct healthy diet.Methods From July 2017 to November 2017, 714 elderly patients with coronary heart disease in three regions of Hebei Province who have been discharged for one year were investigated, and patients′ information was collected through self-designed questionnaires and the coronary heart disease self-management scale. The diet status and the affecting factors were analyzed by logistics regression.Results Among the 714 patients, 522 (73.1%) were male and 192 ( 26.9 %) were female. The age ranged from 60 to 95 years old. And 225 patients (31.5%) with CHD adhered to a low-salt and low-fat diet discharged from hospital after one year. There were differences in the number of diseased vessels, depression, smoking and drinking in elderly patients with coronary heart disease ( P <0.05). Logistics regression analysis showed that the diseased vessels (double branch lesions:  OR=0.567, 95%CI:  0.353-0.911; multi branch lesions:  OR=2.418, 95%CI: 1.351-4.328), depression (mild:  OR=5.367, 95%CI:  2.594-11.107; moderate and severe:  OR=3.782, 95%CI: 1.826-7.835), smoking (once a while: OR=4.105, 95%CI : 2.261-7.456; often:  OR=1.985, 95%CI:  0.973-4.051) were the main influencing factors for the low-salt and low-fat diet of elderly patients with CHD. Conclusion The situation of low-salt and low-fat diet in elderly patients with CHD was unsatisfactory, and low salt and low fat diet has poor long-term performance for elderly patients with coronary heart disease with multiple vessel disease, depression and smoking.
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  Meta-analysis of the number of teleconsultations, the purpose of teleconsultations and the satisfaction in Chinese hospitals

  Cui Fangfang,He Xianying,Zhao Jie

  journal1. 2021, 28(6): 496-501. https://doi.org/10.3969/j.issn.1006-5253.2021.06.004

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  Objective comprehensively evaluate the distribution of teleconsultations, the teleconsultation purpose, and the teleconsultation satisfaction in different disciplines in China with the method of meta-analysis.Methods We systemically searched the literatures about teleconsultations published from 2000 to 2021 in different data resources. Meta-analysis was conducted by Stata 16.0 software to assess the constituent ratios of teleconsultations in different  disciplines with the screened literatures, as well as the constituent ratio of purpose and satisfaction of teleconsultations.Results Twenty-six qualified literatures were enrolled in our research. The constituent ratios of teleconsultations for internal medicine department, surgery department and medical technological department were 41.3%, 54.3% and 4.2%, respectively. The teleconsultations of internal medicine were mainly distributed in respiratory medicine department, neurology department and oncology department, with the constituent ratio 8.6%, 12.6%, and 8.9%, respectively. Whereas the teleconsultations of surgery were chiefly distributed in neurosurgery department and orthopedics department, with the constituent ratio  5.5% and 7.6%, respectively. The purpose of applying for teleconsultations was mainly to provide diagnosis and treatment opinions, accounting for 52.9%. The satisfaction of patients and doctors with teleconsultations was 86.9% and 92.6%, respectively.Conclusion The main disciplines of teleconsultations in China are neurology, oncology, and orthopedics. Seeking advice for diagnosis and treatment is the main purpose of applying for teleconsultations. Patients′ satisfaction with teleconsultations is lower comparing with doctors′. Therefore, resources should be invested in disciplines that account for a high proportion of teleconsultations. Furthermore, in order to improve the satisfaction of teleconsultations, and better play the role of teleconsultations in disease diagnosis and treatment, more work should be done to strengthen the promotion of teleconsultations, and optimize the consultation process.
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  Subtype identification in lower grade glioma based on specific enhancers

  Yan Guangcan, Tian Wei, Liu Meina

  journal1. 2021, 28(6): 502-507. https://doi.org/10.3969/j.issn.1006-5253.2021.06.005

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  Objective Patients with lower grade glioma (LGG) have high heterogeneity and different prognosis. Thus, we identify the precise subtypes in LGG patients based on specific enhancers, to provide reference for clinical treatment and profound mechanism.Methods Data of LGG patients were downloaded from TCGA and CGGA databases. LGG subtypes were identified using K-means clustering after constructing the signatures regulated by specific enhancers and verified in independent external datasets. Further, GSVA was performed to analyze signal pathway, immune microenvironment estimation was performed with CIBERSORT algorithm, and overall survival was compared with survival analysis.Results Fifty target genes regulated by-specific-enhancers were screened, and 5 subtypes were obtained by LGG typing, which were denoted as A1-A5. There were significant differences in signal pathway activity and immune microenvironment among different types. A5 had the worst survival, while A3 and A4 had the best outcome.Conclusion Five LGG subtypes were obtained in this study, which are robust in external verification. There are significant differences in pathway activity and clinical characteristics associated with LGG subtypes. The results of this study can provide a reference for precise treatment and management of patients.
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  Meta analysis of sST2 and prognosis of acute heart failure

  Liu Zhen, Zhang Ning, Shi Xinye, Liu Jingyang, Dong Wenjing, Sun Jingwu

  journal1. 2021, 28(6): 508-512. https://doi.org/10.3969/j.issn.1006-5253.2021.06.006

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  Objective To systematically evaluate the prognostic value of soluble growth stimulating gene 2 protein (sST2), a newly recommended marker of heart failure, in patients with acute heart failure.Methods Wanfang, VIP, CNKI and PubMed were searched with computers, and the Chinese and English literatures related to the evaluation of prognosis of acute heart failure by serum sST2 from the establishment of the database to January 31, 2021 were searched. Two evaluators independently screened the literature, extracted the data and evaluated the quality of the articles.Results sST2 was related to the poor prognosis of patients with acute heart failure. The risk of complex cardiovascular events (HR:1.79, 95%CI:1.44-2.22), all-cause death (HR:2.24, 95%CI:1.60-3.12), heart failure readmission (HR:1.31,95%CI:1.07-1.60) and cardiovascular death (HR:2.78, 95%CI:2.07-3.73) in patients with acute heart failure with elevated sST2 were higher than those with normal sST2. Subgroup analysis: there were differences in the prediction of end events between systolic blood pressure level≥19 kPa (140 mmHg) and systolic blood pressure level<19 kPa (140 mmHg) by sST2, and it was more predictive for end events with systolic blood pressure level<19 kPa (140 mmHg).Conclusion The incidence of adverse events in patients with acute heart failure with increased sST2 is significantly higher.
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  Construction and evaluation of a statistical model for COVID-19 imported cases in Xiamen

  Zhang Yidun, Tong Yiqi, Huang Shijie, Huang Siying, Zhuang Fuzhen

  journal1. 2021, 28(6): 513-517. https://doi.org/10.3969/j.issn.1006-5253.2021.06.007

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  Objective To analyze the risk of imported COVID-19 cases in Xiamen, and to provide data support for the public health department to prevent the spread of imported cases; to assess the future shortage of medical resources in Xiamen, and to provide a reference basis for administrative decisions.Methods A statistical model was constructed to predict imported cases in Xiamen. Due to the small number of initial samples in Xiamen, the model was first initialized based on the overseas import situation of Guangzhou, and then fitted based on the daily epidemic situation in Xiamen. Considering the constant change of entry policies and the rapid development of epidemic in various countries (regions), a dictionary was constructed and maintained to dynamically calculate the risk weights of travelers from different countries. Finally, exponential smoothing method was used to update the parameters of the model.Results From March 23, 2020 to December 31, 2020, Xiamen reported a total of 277 imported cases in which asymptomatic infections were included, and 257 cases were predicted by our model. The experimental results showed that the F1-score of our proposed model reached 77.3%.Conclusion The statistical model has good predictive-ability.
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  Application of quartile regression method in influencing factor analysis for inpatient cost of adult leukemia

  journal1. 2021, 28(6): 518-522. https://doi.org/10.3969/j.issn.1006-5253.2021.06.008

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  Objective To analyze the influencing factors of hospitalization expenses of leukemia patients insured in Tianjin by quartile regression method, and to provide a reference for effective rapid analysis of medical expenses and further reform and improvement of medical insurance system.Methods Totally 5 044 cases diagnosed as with leukemia were collected from Tianjin urban residents basic medical insurance database system from 2003 to 2013, and the quartile regression method was used to analyze the influencing factors of cost.Results Compared with the multiple linear regression, the quartile regression model was more comprehensive in terms of analytical power and estimation results through data modeling and analysis. The results of the 25th, 50th and 75th quartile regression model showed that age and gender had different effects on the total hospitalization cost in different quartiles, that is, the relationship was not linear（P＜0.05）. There was a significant difference in the cost of the patients with different gender, age, type of personnel, operation or not, and hospitalization days (P＜0.05).Conclusion The quartile regression method can describe the overall condition distribution of explained variables more completely, and also analyze how explanatory variables affect the different quartiles of the explanatory variables. Factors such as gender, age, type of personnel, operation or not, hospitalization days and so on can affect the total hospitalization cost of different quartiles.
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  Analysis of the clinical characteristics of patients with overlength hospitalization in a hospital in Shenzhen from 2006 to 2020

  Chen Huiqiong, Zhou Dan

  journal1. 2021, 28(6): 523-527. https://doi.org/10.3969/j.issn.1006-5253.2021.06.009

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  Objective To explore the clinical features of patients with overlength hospitalization days, in order to provide basis for shortening average hospitalization days, rational utilization of medical resources and improving the hospital management level.Methods Based on the information of the first page of medical records of patients discharged from a tertiary general hospital in Bao′an District of Shenzhen from 2006 to 2020, patients with overlength hospitalization were analyzed and stratified by year, gender, age, International Classification of Diseases (ICD-10), discharge departments and disease distribution.Results Among 330-478 discharged patients, 6905 patients (2.09%) were with overlength hospitalization. There were 4978 male patients (72.09%) and 1927 female patients (27.91%); patients aged 30 to less than 45 years old accounted for the largest proportion, with 2115 cases (30.63%), followed by those aged 45 to less than 60 years old with 1795 cases (26.00%); discharged patients were mainly from the surgery (71.60%) and internal medicine departments (27.10%). The first two kinds of ICD-10 diseases were injury, poisoning and some other consequences of external causes, with 4008 cases (58.04%), followed by circulatory diseases with 1162 cases (16.83%). The top three diseases were intracranial injury, fracture of leg (including ankle) and intracerebral hemorrhage, with 1697 cases (24.58%).Conclusion Patients with overlength hospitalization were mainly in surgery and internal medicine departments, and and the length of hospitalization was long and the cost was high, so the hospital management department should scientifically manage and shorten the length of hospitalization of patients with overlength hospitalization.
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  Performance evaluation of inpatient medical service in the neurology department of a hospital based on DRG

  Wang Jian, Wang Jingyi

  journal1. 2021, 28(6): 528-532. https://doi.org/10.3969/j.issn.1006-5253.2021.06.010

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  Objective To evaluate the hospital service performance of inpatients in the neurology department based on the diagnosis related groups (DRG), and to provide the basis for fine management of the hospital. Methods The performance of inpatient medical service in the department of neurology from January 2020 to June 2021 was analyzed by using six indexes including capability, efficiency and safety. Results The comprehensive evaluation of medical service performance was best in ward A and worst in ward C. In terms of ability, the case combination index was the highest in ward A and the lowest in ward C. In terms of efficiency, ward D had the best time consumption index and cost consumption index, while ward A had the worst. In terms of cost composition, diagnosis, Western medicine, traditional Chinese medicine and comprehensive medical service expenses accounted for 84.48% of hospitalization expenses; through cost splitting, the cost consumption index of each item in different wards was different. Conclusion There is deviation in the ability and efficiency of each ward in the neurology department. DRG index can be applied to evaluate the performance of each ward in the hospital, and the medical ability and efficiency can be evaluated objectively and fairly.
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  Change analysis of medical income structure in a tertiary hospital from 2019 to the first half of 2021

  Tan Si, Yang Yang, Fu Jiao

  journal1. 2021, 28(6): 533-537. https://doi.org/10.3969/j.issn.1006-5253.2021.06.011

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  Objective To analyze the changes of medical cost structure in the "pre-outbreak- peacetime and wartime combination" stages of COVID-19, and evaluate the effect of hospital structural adjustment in the latter stage, so as to provide reference for improving hospital economic benefits and controlling the rapid growth of medical costs. Methods Based on the data of hospital income structure from 2019 to the first half of 2021, descriptive statistics and structural variation analysis were used. Results In the first half of 2020, compared with the second half of 2019, the number of outpatient and emergency visits decreased by 29.6%, and the number of inpatients decreased by 25.3% (P<0.05). The number of outpatient and emergency visits in the first half of 2021 recovered to the level of the first half of 2019 (P>0.05), the number of inpatients decreased by 15.7%, the number of operations increased by 58.0%, the number of grade 4 operations increased from 59.5 to 134.0, and the number of minimally invasive operations increased from 175.0 to 241.0 (P<0.05). From 2019 to the first half of 2021, the variation degree of outpatient income structure was 13.57%, and the average annual variation degree of outpatient income structure was 3.0%. From 2019 to the first half of 2021, the items that caused great changes in the structure of outpatient fees were medicine income, registration income, laboratory income and sanitary material income, with a cumulative contribution rate of 87.10%. The increase of registration fees and chemical examination income was the main factor driving the growth of outpatient fees. From 2019 to the first half of 2021, the variation degree of inpatient income structure was 11.89%. From 2019 to the first half of 2021, the items that caused the big change of inpatient cost structure were medicine income, surgery income, treatment income and laboratory income, with a cumulative contribution rate of 81.38%. The increase of surgery income and treatment income was the main factor to accelerate the With the rapid decline of hospital business volume growth of inpatient income. Conclusion under the COVID-19 epidemic, hospitals should actively carry out the structural adjustment, reduce the consumption of drugs and sanitary materials, increase the income of surgery and treatment, gradually optimize the medical income structure, and improve the economic benefits of the hospital.
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  Discussion on classification and coding of adult congenital cardiovascular disease and interventional therapy

  Zhang Fan, Zheng Jing

  journal1. 2021, 28(6): 538-541. https://doi.org/10.3969/j.issn.1006-5253.2021.06.012

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  Objective To investigate the classification codes of adult congenital cardiovascular disease and interventional therapy. Methods By studying the information and literature on interventional treatment of adult congenital cardiovascular disease and adult congenital heart disease in cardiology, according to the classification principle of international disease and surgical operation, we carefully read the medical records for accurate coding of ICD-10 and ICD-9-CM-3. Results Primary atrial septal defect was classified to Q21.2; secondary atrial septal defect was classified to Q21.1; ventricular septal defect was classified to Q21.0; patent ductus arteriosus was classified to Q25.0; pulmonary stenosis was classified to Q25.6; bicuspid aortic valve was classified to Q23.1; tricuspid valvular malformation was classified to Q22.5; congenital aortic coarctation was classified to Q23.0; aortic sinus aneurysm was classified to Q25.4; the tetralogy of fallot was classified to Q21.3. Percutaneous balloon pulmonary valvuloplasty (PBPV) and percutaneous balloon aortic valvuloplasty (PBAV) were classified to 35.96; patent ductus arteriosus closure was classified to 38.85; atrial septal defect closure was classified to 35.52; the interval defect closure was classified to 35.55. Conclusion The coders must undergo professional study and assessment, master ICD classification principles and coding skills, learn and accumulate clinical medical knowledge and understand new medical advances, actively communicate with clinicians in daily work, establish coding quality control mechanisms, and continuously improve coding quality.
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  Analysis of 90 ambiguous medical records in a tertiary general hospital

  He Jianxia, Zhao Jun, Yang Fahui

  journal1. 2021, 28(6): 542-545. https://doi.org/10.3969/j.issn.1006-5253.2021.06.013

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  Objective To analyze 90 ambiguous medical records in a hospital, summarize the existing problems, and put forward improvement measures, in order to reduce the occurrence of ambiguous medical records. Methods The home page information of discharge medical records of a tertiary general hospital in Chengdu in 2020 was uploaded to the Sichuan health data analysis and decision support cloud platform. After grouping, ambiguous medical records were screened out. Clinicians and coders were organized to classify ambiguous medical records, analyze the causes, and make correction and grouping. Results Among the 90 ambiguous medical records, 36 ambiguous medical records were caused by wrong filling in the first page (including 27 major diagnostic errors and 9 major surgical operation errors); 4 cases of multiple diseases were hospitalized at the same time; 50 copies were with unreasonable grouping rules of DRG grouping device. Conclusion The main causes of ambiguous medical records are that clinicians do not master the main diagnosis and operation selection principles, coders have limited clinical knowledge, and department management is not optimized. In order to reduce the incidence of ambiguous medical records, we should strengthen the standardized training of clinicians, improve the comprehensive quality of coders, and optimize the management of hospital departments.
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  Application of SQL query in statistical work in an obstetrics and gynecology hospital

  Zhou Zheying, Shi Jiamin, Huang Rui

  journal1. 2021, 28(6): 546-550. https://doi.org/10.3969/j.issn.1006-5253.2021.06.014

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  Statistics data can be deep retrieved through SQL query in hospital statistics in the era of big data. This paper shows the application of SQL in the new challenge of hospital statistics by analyzing four examples of horizontal correlation, vertical extractions, different time correlation, and different subject correlation, to provide references for the application of hospital statistical methods.
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  Investigation on knowledge, attitude and practice of medical workers and medical students about COVID-19 in Anhui Province

  Hou Shanbing, Liu Huan, Tao Xiubin, Zhang Ming, Zhou Zhiqing, Teng Xiaoju, Zhou Haoran, Kong Qianying, Wang Xin

  journal1. 2021, 28(6): 551-557. https://doi.org/10.3969/j.issn.1006-5253.2021.06.015

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  Objective To understand the current situation of knowledge, attitude and practice (KAP) ability of some medical workers and medical students on COVID-19 in Anhui Province in the post-epidemic era, and to provide reference for the training and intervention of relevant departments. Methods The questionnaire was designed and conducted online by questionnaire stars, and the data were analyzed by using chi square test, logistic regression analysis and Pearson correlation analysis. Results There were 1 602 (74.72%) of the 2 144 health care workers and medical students qualified to know about COVID-19; logistic regression analysis revealed that being vaccinated (OR=1.849, 95%CI:1.487-2.300), being exposed to suspected/confirmed patients (OR=1.728, 95%CI:1.204-2.479), and graduate degree or above (OR=4.384, 95%CI:2.698-7.123) were protective factors for the cognitive qualification of knowledge related to COVID-19; risk factors were people with average self-rated health status (OR=0.620; 95%CI:0.469-0.820), people with good self-rated health status (OR=0.594; 95%CI:0.478-0.739), and divorced people (OR=0.205; 95%CI:0.048-0.871); the mean score of COVID-19 cognitive attitude was (34.16±4.15) points, and the mean score of COVID-19 prevention practice ability was (52.62±8.00) points. Pearson analysis showed that the electronic health literacy of healthcare workers and medical students was positively correlated with COVID-19 attitudes and COVID-19 prevention practices (r=0.530), r=0.469, P<0.01). Conclusion The cognitive education of COVID-19 by medical workers and medical students in Anhui Province can be further deepened, and the relevant departments of relevant units should further strengthen the in-depth study of COVID-19 by staff and medical students.
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  Investigation of family members′ knowledge demand for prevention of acute enteritis in children aged 5 and below

  Zhang Jiejing, Chen Shanshan, Sun Fei

  journal1. 2021, 28(6): 558-561. https://doi.org/10.3969/j.issn.1006-5253.2021.06.016

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  Objective To investigate and analyze the needs of family members of children aged 5 and below in the infusion area for the prevention of acute enteritis in order to provide health education experience support for family members of children. Methods A self-made questionnaire was used to investigate 1 807 family members of children aged 5 and below treated in our hospital′s infusion area from June 2019 to January 2021, and statistical analysis was conducted on the family members′ knowledge of acute enteritis prevention and health education needs. Results Totally 1 810 questionnaires were issued, and 1 807 qualified questionnaires were recovered, with a pass rate of 99.83%. Among the surveyed subjects, 666 cases passed the knowledge of acute enteritis prevention, and the pass rate was 36.86%. The results of multivariate logistic regression analysis showed that women (OR=4.450), the self-employed (OR=0.240), farmers/migrant workers (OR=0.378), the unemployed (OR=0.521), with college degree (OR=1.595), with bachelor′s degree and above (OR=2.757), the family′s per capita monthly income 2 000＜5 000 yuan (OR=1.522), and monthly income≥5 000 yuan (OR=3.054) were the influencing factors for the mastery of acute enteritis prevention knowledge. And 94.96% of the children′s relatives had acute enteritis prevention knowledge needs (1 716/1 807), and 77.97% of them expected to obtain relevant knowledge through the Internet (1 409/1 807). Conclusion Family members of children of 5 years old and below in the children′s infusion area have a low pass rate of acute enteritis prevention knowledge. It is recommended to use the Internet to focus on strengthening promotion and education on the prevention of acute enteritis in children among male family members, farmers/migrant workers, people with low education level and lowincome groups.
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  Myopia trend analysis of primary and secondary school students in a province based on partial connection number

  Chen Wei, Zhao Keqin

  journal1. 2021, 28(6): 562-567. https://doi.org/10.3969/j.issn.1006-5253.2021.06.017

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  Objective To explore the application of partial connection coefficient in the analysis of myopia trend of primary and middle school students, to provide decision support for prevention and control of myopia for primary and middle school students. Methods Firstly, the rates of mild myopia, moderate myopia and high myopia in each age group of primary and secondary school students were converted into the ternary association number of homonyms and differences against myopia with the mild myopia rate as the reference, and the second-order total partial association number of homonyms and differences against myopia in each age group was calculated. Results The myopia of 6 to 9 years old students shows a decreasing trend, while the myopia of 10-18 years old students showed a slow increasing trend, with the increasing rate 1.8%-6.5%; the aggravating rate of girls in the 10-year-old group was 3.4%, 1.89 times higher than that of boys; there was no significant difference in the aggravating trend of myopia between boys and girls aged 11 to 15, the trend of myopia exacerbation in boys from 16 to 18 years old was significantly higher than that in girls, and the key stage of myopia prevention and control for boys and girls was from 10 to 13 years old. Conclusion The partial connection coefficient can be used in the analysis of myopia trend of primary and middle school students, and the implementation of "double reduction" measures is the premise to slow down the trend of myopia in primary and secondary school students.
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  Research status of pragmatic randomized controlled trials in China

  Lü Zhijie, Wu Li, Li Qiushuang, Liu Shan

  journal1. 2021, 28(6): 568-572. https://doi.org/10.3969/j.issn.1006-5253.2021.06.018

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  Objective To review the published literatures on the pragmatic randomized controlled trials (pRCT) in China and to analyze the current status and hotspots of pRCT research. Methods The literatures of pRCT published by Chinese scholars from CNKI, Wanfang and Web of Science were reviewed since the establishment of the database to 31 July 2021. CiteSpace software was utilized to analyze the authors, institutions, keywords, and burst terms. Results Totally 196 Chinese and English literatures were published, and the number of articles was increasing year by year, with 79 Chinese literatures distributed in 44 journals and 117 English literatures distributed in 71 journals. The Institute of Clinical Basic Medicine of China Academy of Chinese Medical Sciences (7 articles) published the most Chinese literatures, while the University of Hong Kong (34 articles) published the most English literatures (34 literatures). The clustering label words of Chinese literature were clinical trial, RCT, evidence-based medicine, comprehensive scheme of Traditional Chinese Medicine (TCM), clinical trial scheme, clinical research and pharmacoeconomics. The clustering results of English literature needed to be further condensed. There were 4 and 5 burst terms in Chinese and English literatures respectively, which lasted for only from 1 to 3 years. Conclusion research hotspots of pRCT in China mainly focused on four fields, namely comprehensive clinical trial program of TCM, clinical trial in real world research, evidence-based medicine and pharmacoeconomics. However, the core authors of the research were few, the research institutions were scattered, and inter-agency cooperation needed to be strengthened.
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  Characteristics and new developments of the International Classification of Health Interventions

  Wang Jiaying

  journal1. 2021, 28(6): 573-576. https://doi.org/10.3969/j.issn.1006-5253.2021.06.019

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  The author introduced the basic model framework, coding rules, chapter structure and application scope of the International Classification of Health Interventions (ICHI), and analyzed its difference with the third volume of the International Classification of Diseases Clinical Revision (ICD-9-CM-3). ICHI has the advantages of convenient mastering and application, more complete classification of surgery and operation, wide application range and simultaneous international development of classification. Therefore, ICHI is conducive to the exchange of international health intervention data, thereby contributing to the application of health technology and the verification of the effectiveness of intervention measures.