Based on the blueprint of the training center for clinical skills of our hospital,this paper discusses the effect of‘the market for lemons’in its booking system from the perspective of economics of information,uses ...Based on the blueprint of the training center for clinical skills of our hospital,this paper discusses the effect of‘the market for lemons’in its booking system from the perspective of economics of information,uses the law of large numbers and the central limit theorem to model to carry out the case study of FAHSYSU Simulation T,and takes measures of offsetting adverse selections to increase booking efficiency.The paper also analyzes how to apply the ancient Chinese theory that man is an integral part of nature to wipe out‘the market for lemons’.展开更多
To further improve the ability of pre-hospital and in-hospital collaborative treatment, strengthen emergency multidisciplinary cooperation and construct a scientific, rational and efficient emergency system, under the...To further improve the ability of pre-hospital and in-hospital collaborative treatment, strengthen emergency multidisciplinary cooperation and construct a scientific, rational and efficient emergency system, under the support of former chairman Yu Xue-zhong, Dr. Li Chun-sheng and numerous colleagues in the industry, the Emergency Medicine Society of the Chinese Medical Association appeal to us to draft Construction of Emergency and Pre-hospital Platform. Based on this background, the platform of emergency and pre-hospital first aid helps to build a 'one horizontal and one Longitudinal' treatment model, using the horizontal and longitudinal patterns to integrate emergency medical resources to satisfy the automatic information integration and intelligent analysis sharing, realizing the emergency management visualization and medical information digitization, simplifying the medical process and establishing a perfect standard for the emergent diseases, thereby ultimately achieving efficient diagnosis and scientific treatment.展开更多
This paper presents the results from a survey of first-level hospitals in Urumqi,China.The survey had two parts:the first part was aimed at understanding the operation of the ethics committees of first-level hospitals...This paper presents the results from a survey of first-level hospitals in Urumqi,China.The survey had two parts:the first part was aimed at understanding the operation of the ethics committees of first-level hospitals,including the process for electing members and the variety of members' backgrounds.Information was also gathered about the establishment of criteria,operational rules and regulations,and standard operational procedures.The aim of the second part was to investigate the level of understanding among technicians and doctors about the function of the ethics committees.This paper identifies and analyzes some deficiencies found in the operation of hospital ethics committees,offers some constructive suggestions for improvement,and promotes the role of the Xinjiang Uygur autonomous region hospital ethics committees.展开更多
<strong>Objective: </strong>The purpose is to formulate treatment strategies of batches of the wounded and partial first-aid procedures, and further improve the emergency rescue capability of hospitals. &l...<strong>Objective: </strong>The purpose is to formulate treatment strategies of batches of the wounded and partial first-aid procedures, and further improve the emergency rescue capability of hospitals. <strong>Methods: </strong>This study analyzed the emergency treatment case that we participated in. In this case, we used various means to start the emergency plan, run the emergency procedures, optimize diagnosis, treatment, and rescue procedures, mobilize medical rescue resources, provide a reference for emergency command decisions, formulate a set of coping strategies of tertiary general hospitals on public emergencies. <strong>Results:</strong> Through the scientific and effective management of our hospital, 20 wounded have been discharged from the hospital and achieved the ideal effect of zero deaths in the hospital. <strong>Conclusions:</strong> The new mode of first-aid and health emergency management on the scene of modern disaster needs to find ways to minimize the loss of life and property brought by public emergencies, integrate the various sections of modern disaster medicine, integrate a large number of international and domestic basic and clinical research achievements of disaster first-aid, and upgrade to information, digital system.展开更多
Objective:This study aimed to assess the feasibility and safety of the SHURUI single-port robotic surgical system for a range of major urological surgeries.Methods:In this prospective,multicenter clinical trial,we exa...Objective:This study aimed to assess the feasibility and safety of the SHURUI single-port robotic surgical system for a range of major urological surgeries.Methods:In this prospective,multicenter clinical trial,we examined the effectiveness of the SHURUI single-port robotic surgical system in urological interventions.The first 50 patients from four centers in China underwent single-port surgeries including partial nephrectomy,radical prostatectomy,partial adrenalectomy,and pyeloureteroplasty,exclusively by the SHURUI single-port robotic surgical system.The study's primary endpoints focused on the success of surgeries,defined as no deviations from planned procedures,no need for more than one port,and no re-operations within 24 h after surgery.Secondary endpoints encompassed a range of surgical metrics,functional outcomes,and patient demographic data.Clinical assessments were conducted before surgery,before discharge,and 1 month after discharge.Results:The surgical procedures were executed successfully without requiring intraoperative conversions or transfusions.Both estimated blood loss and operation durations were maintained within satisfactory limits.For each type of surgery,the mean console times and estimated blood loss were 179.8(standard deviation[SD]39.4)min and 125.6(SD 126.0)mL for radical prostatectomy,126.7(SD 47.8)min and 39.2(SD 54.4)mL for partial nephrectomy,112.6(SD 37.4)min and 20.0(SD 13.2)mL for partial adrenalectomy,and 148.0(SD 18.2)min and 18.0(SD 17.9)mL for pyeloureteroplasty,respectively.Across the cohort,17 patients experienced a total of 25 adverse events,while 10 postoperative complications,all rated as Clavien-Dindo grade I,were encountered by eight patients.All patients had shown recovery or improvement from these events before the end of this trial.Conclusion:The SHURUI single-port robotic surgical system demonstrated feasibility and safety in the performance of major urological surgeries.These initial findings highlight the system's potential,though further research and longer follow-up are required to assess long-term outcomes.展开更多
The rise of antimicrobial resistance,particularly in healthcare-associated infections caused by carbapenem-resistant Gram-negative pathogens,poses a critical global challenge.The extensive use of carbapenems has exace...The rise of antimicrobial resistance,particularly in healthcare-associated infections caused by carbapenem-resistant Gram-negative pathogens,poses a critical global challenge.The extensive use of carbapenems has exacerbated this issue by increasing selective pressure within bacterial populations.This study aimed to investigate the association between carbapenem consumption and resistance rates in four priority Gram-negative bacteria:Escherichia coli(EC),Klebsiella pneumoniae(KP),Acinetobacter baumannii(AB),and Pseudomonas aeruginosa(PA).Retrospective data were collected from the First Affiliated Hospital of Zhengzhou University,covering the period from January 2010 to December 2022.Trends in carbapenem consumption and resistance were analyzed using the Mann-Kendall test to assess statistical significance and the Sen’s slope(SS)estimator to determine the magnitude of change.Correlations between carbapenem use and bacterial resistance rates were evaluated via Spearman correlation analysis.Over the study period,the consumption of meropenem,imipenem,biapenem,and total carbapenems exhibited a significant upward trend(|Z|>1.96,SS>0).Correspondingly,the resistance rates of EC and KP to meropenem and imipenem also increased significantly(|Z|>1.96,SS>0).A strong positive correlation was observed between the resistance rate of EC to meropenem and the defined daily doses(DDDs)of meropenem(r=0.732,P<0.05)and between EC resistance to imipenem and its DDDs(r=0.49,P<0.05).Similar significant correlations were identified for KP.However,no significant associations were found between carbapenem resistance in AB or PA and carbapenem consumption.These findings underscored the strong correlation between carbapenem use and the resistance rates of EC and KP,highlighting the urgent need for stringent control and stewardship of carbapenem use in clinical settings to mitigate or delay the development of bacterial drug resistance.展开更多
Objective:To build a set of teaching staff construction and teaching quality monitoring system suitable for clinical practice teaching in affiliated hospitals of medical colleges,achieve continuous improvement of clin...Objective:To build a set of teaching staff construction and teaching quality monitoring system suitable for clinical practice teaching in affiliated hospitals of medical colleges,achieve continuous improvement of clinical education and teaching level,and ensure the quality of medical education talent cultivation.Methods:A modern clinical practice teaching quality monitoring system is constructed based on organizational structure construction,teaching staff system construction,quality control system construction,and information platform construction,combined with external audit and evaluation.Results:The hospital has established a Faculty Development and Teaching Evaluation Office specifically responsible for the cultivation of clinical teachers and the evaluation and supervision of teaching quality.A relatively complete teacher construction and teaching quality monitoring system has also been established for clinical practice teaching,thus achieving integration with the school’s quality control system in terms of management mechanism.At the same time,a set of teaching quality control mode based on the“Internet+”platform has been created by means of informatization.At present,this mode has won three national computer software copyrights and two second prizes for school-level teaching achievements.Conclusion:Through five years of practice,an“Internet+”teaching quality evaluation and monitoring system with the characteristics of teaching hospitals affiliated to local medical colleges has been established.In order to further standardize the training system of clinical teachers in affiliated hospitals,achieve self-monitoring and self-improvement in terms of teaching quality,and ensure the continuous improvement of clinical teaching quality,we will continue to promote the development of clinical teachers with quality and excellence,enrich the main team of quality monitoring,guide the transformation of the education mode from being“centered on teachers”to being“centered on students,”and realize the integration of internal and external quality monitoring systems.展开更多
This study draws on the classic theories and research achievements of university teacher development,and from the perspective of role conflict in social psychology,proposes policy recommendations for the development o...This study draws on the classic theories and research achievements of university teacher development,and from the perspective of role conflict in social psychology,proposes policy recommendations for the development of clinical teachers in medical colleges,including following different stages of teacher development and designing teaching development strategies at different levels;designing the content and form of teaching development activities to meet the temporal and spatial needs of clinical teachers;and building an academic community for clinical teachers to promote the creation of teaching development behaviors.展开更多
Objective:This article aims to deeply analyze the feedback on teacher training in an affiliated hospital,so as to clarify the current needs and situation of teacher training and provide a scientific basis for further ...Objective:This article aims to deeply analyze the feedback on teacher training in an affiliated hospital,so as to clarify the current needs and situation of teacher training and provide a scientific basis for further optimizing the teacher training system.Methods:The current situation and needs of teacher training in the affiliated hospital were collected by designing and distributing Tomato Form questionnaires on the DingTalk platform.The questionnaire adopted a percent-point system,all of which were indeterminate multiple-choice questions.Results:The average age of the clinical teachers participating in the survey was 40.44±7.85 years old,with an average teaching length of 4–10 years.The results showed that 60.20%of teachers think that the amount of teacher training in an affiliated hospital is sufficient;91.10%of teachers think that the factors affecting training conflict with working hours;97.96%of teachers believe that the training time has an impact on the training effect;81.63%of teachers prefer online training;51.53%of teachers tend to arrange training time on working days;33.16%of teachers tend to train once a month;17.78%of teachers prefer to receive training on clinical theoretical courses and practical teaching norms and skills content.Conclusion:Based on the above survey results,we propose to build a comprehensive management mechanism for teacher training,including improving the access,training,and assessment mechanism for clinical teachers,and adjusting and optimizing the training program according to actual needs.At the same time,an effective communication platform should be built to promote the deep integration of teaching and practice and enhance social recognition,so as to comprehensively improve the teaching quality and medical service of the hospital.展开更多
Objective:Adverse-risk acute myeloid leukemia(AML)patients should receive allogeneic hematopoietic stem cell transplantation(allo-HSCT)at first complete remission(CR1).However,the influence of prior therapies[i.e.,ven...Objective:Adverse-risk acute myeloid leukemia(AML)patients should receive allogeneic hematopoietic stem cell transplantation(allo-HSCT)at first complete remission(CR1).However,the influence of prior therapies[i.e.,venetoclax plus azacitidine(VEN-AZA)or intensive chemotherapy(IC)]on post-transplant outcomes remains inconclusive.This multicenter,retrospective study compared the post-transplant outcomes between patients receiving VEN-AZA and those receiving IC before allo-HSCT.Methods:This study was based on the transplant database of TROPHY group.Consecutive adverse-risk AML patients receiving allo-HSCT from January 2021 to June 2023 were screened in five Chinese transplant centers.Patients were categorized into VEN-AZA group if they received venetoclax combined with azacitidine as first-line therapy followed by allo-HSCT.Patients who received first-line therapy consisting of a mainstay treatment of cytarabine and anthracycline followed by allo-HSCT were categorized into IC group.Results:In the total cohort,the 3-year probabilities of overall survival,leukemia-free survival,and event-free survival were better in the IC group than VEN-AZA group,particularly for patients with ASXL1 mutations or SF3B1 mutations.However,the survival of the VEN-AZA group was not superior to that of IC group in patients aged≥55 years or those with the hematopoietic cell transplantation-comorbidity index scores≥1 before allo-HSCT.After propensity score matching(median age:VEN-AZA group:57 years;IC group:55 years),only the probability of overall survival for the IC group was better than that of VEN-AZA group(93.6%vs.78.0%,P=0.034)at the 1-year follow-up;however,all of the other clinical outcomes were comparable between the VEN-AZA and IC groups.The TP53 mutation was independently associated with post-transplant relapse and survival.Conclusions:Our results suggest that IC remains the cornerstone of therapy,whereas VEN-AZA may also be used in younger patients and medically fit patients with adverse-risk AML who are receiving allo-HSCT in CR1.展开更多
Taking role conflict as the starting point,this article examines and reflects on the development of clinical teachers.In the process of the occurrence,development,and resolution of role conflicts among clinical teache...Taking role conflict as the starting point,this article examines and reflects on the development of clinical teachers.In the process of the occurrence,development,and resolution of role conflicts among clinical teachers,there are many hidden issues related to the development of clinical teachers.The development of clinical teacher teaching and role conflict management contain similar educational philosophies and practical issues.This study draws on classic theories and research achievements in the development of university teachers and conducts theoretical analysis and practical reflection on the development of clinical teachers in medical colleges from the perspective of role conflict in social psychology.Policy recommendations are proposed,including strengthening the construction of teaching systems at the hospital organizational environment level,enhancing the role identity and teacher beliefs of clinical teachers,promoting their teaching development and academic learning,and ensuring their normal teaching investment;promoting leadership support at the level of interpersonal interaction and leveraging the role of colleague support in alleviating role conflicts;enhancing individual teacher beliefs,teacher role learning,and role skills.展开更多
BACKGROUND Extramedullary plasmacytoma(EMP)represents one of the rarer forms of plasma cell malignancies,capable of impacting a variety of tissues and organs throughout the body.The majority of EMP cases are predomina...BACKGROUND Extramedullary plasmacytoma(EMP)represents one of the rarer forms of plasma cell malignancies,capable of impacting a variety of tissues and organs throughout the body.The majority of EMP cases are predominantly found in the head and neck region,especially within the laryngopharynx,as well as in the gastrointestinal tract.While there have been documented instances of oropharyngeal involvement in EMP cases in the academic literature,it is important to note that EMP specifically affecting the uvula is exceedingly uncommon.Furthermore,it is noteworthy that over 60% of epithelial carcinomas in the upper respiratory tract and oropharynx tend to metastasize to the cervical lymph nodes,indicating a propensity for regional spread in these types of cancers.In this context,we present a rare case of extramedullary plasmacytoma where the uvula served as the initially affected site.This case emphasizes the need for heightened awareness among clinicians regarding such unusual comorbidities,as early recognition and diagnosis can significantly influence patient management and treatment outcomes.In addition,a review of the relevant literature is included to further educate and inform healthcare professionals about this rare presentation,ultimately aiming to enhance clinical understanding and improve patient care in similar situations.CASE SUMMARY A 51-year-old man was admitted to our hospital because of a slowly enlarging neck mass.A physical examination revealed a palpable left lymph node,and magnetic resonance imaging(MRI)of the oropharynx and the neck showed a soft tissue mass in the oropharynx and enlargement of multiple lymph nodes in the neck.The soft tissue mass was diagnosed as plasmacytoma by immunohistochemical analysis.Monoclonal immunoglobulins and bone marrow biopsy showed normal results.Therefore,we diagnosed that as EMP of the uvula.After four cycles of adjuvant chemotherapy dominated by bortezomib,MRI reexamination showed a significant reduction of the mass in the oropharynx and the cervical lymph nodes.Afterwards,the λ light chain returned to normal levels.There was no evidence of evolution to multiple myeloma.CONCLUSION We have reported a rare case of extramedullary plasmacytoma with the uvula as the first affected site and the relevant literature is reviewed to improve clinicians'awareness of such rare comorbidities.展开更多
On November 3,2025,United Therapeutics Corporation(Nasdaq:UTHR)announced the first clinical xenotransplantation within its EXPAND study,involving transplantation of the UKidney into a patient with end‐stage renal dis...On November 3,2025,United Therapeutics Corporation(Nasdaq:UTHR)announced the first clinical xenotransplantation within its EXPAND study,involving transplantation of the UKidney into a patient with end‐stage renal disease(ESRD)at New York University(NYU)Langone Health.The UKidney is a genetically engineered porcine kidney incorporating 10 gene modifications-6 human gene insertions to enhance immunologic compatibility and 4 porcine gene knockouts to minimize rejection risk and control graft growth[1].In the context of the first xenotransplantation studies,“EXPAND”refers to the US Food and Drug Administration(FDA)“expanded access”program,often colloquially known as compassionate use.展开更多
A clinical trial of nab-paclitaxel plus capecitabine as a first-line treatment for advanced biliary tract cancers was conducted.We analyzed the development of systemic therapy recommended by the National Comprehensive...A clinical trial of nab-paclitaxel plus capecitabine as a first-line treatment for advanced biliary tract cancers was conducted.We analyzed the development of systemic therapy recommended by the National Comprehensive Cancer Network guidelines and the development of nab-paclitaxel combination chemotherapy for advanced biliary tract cancers(BTCs)and concluded that nab-paclitaxel plus capecitabine is a promising first-line regimen for advanced BTCs.展开更多
Full cost accounting,as a comprehensive cost measurement method,integrates direct and indirect costs to reallocate costs across departments.Performance evaluation serves as a method to assess a hospital’s overall per...Full cost accounting,as a comprehensive cost measurement method,integrates direct and indirect costs to reallocate costs across departments.Performance evaluation serves as a method to assess a hospital’s overall performance and management capabilities.Both full cost accounting and performance evaluation are critical tools in the financial management of public hospitals,playing pivotal roles in accounting practices.The concepts of full cost accounting and performance evaluation were investigated in this study,and the existing challenges and the theoretical basis for their integration were analyzed.An integrated model was constructed,and its application cases and effectiveness in the financial management of public hospitals were discussed.Finally,measures to integrate full cost accounting and performance evaluation were proposed,including improving full cost accounting mechanisms,standardizing accounting practices,optimizing cost allocation methods,establishing a unified management platform,and fostering collaboration among stakeholders.This study provides new insights to enhance the quality and efficiency of financial management in public hospitals,laying a foundation for their sustainable development.展开更多
Objective:In the Radiology Department of Mzuzu Central Hospital(MCH),daily training for radiographers now includes content on Computed Tomography(CT)image quality control and equipment maintenance to ensure the normal...Objective:In the Radiology Department of Mzuzu Central Hospital(MCH),daily training for radiographers now includes content on Computed Tomography(CT)image quality control and equipment maintenance to ensure the normal,continuous,and stable operation of the 16-slice spiral CT scanner.Methods:Through comprehensive analysis of relevant equipment,we have identified key parameters that significantly impact CT image quality.Innovative optimization strategies and solutions targeting these parameters have been developed and integrated into daily training programs.Furthermore,starting from an examination of prevalent failure modes observed in CT equipment,we delve into essential maintenance and preservation techniques that CT technologists must master to ensure optimal system performance.Results:(1)Crucial factors affecting CT image quality include artifacts,noise,partial volume effects,and surrounding gap phenomena,alongside spatial and density resolutions,CT dose,reconstruction algorithms,and human factors during the scanning process.In the daily training for radiographers,emphasis is placed on strictly implementing image quality control measures at every stage of the CT scanning process and skillfully applying advanced scanning and image processing techniques.By doing so,we can provide clinicians with accurate and reliable imaging references for diagnosis and treatment.(2)Strategies for CT equipment maintenance:①Environmental inspection of the CT room to ensure cleanliness and hygiene.②Rational and accurate operation,including calibration software proficiency.③Regular maintenance and servicing for minimizing machine downtime.④Maintenance of the CT X-ray tube.CT technicians can become proficient in equipment maintenance and upkeep techniques through training,which can significantly extend the service life of CT systems and reduce the occurrence of malfunctions.Conclusion:Through the regular implementation of rigorous CT image quality control training for radiology technicians,coupled with diligent and proactive CT equipment maintenance,we have observed profound and beneficial impacts on improving image quality.The accuracy and fidelity of radiological data ultimately leads to more accurate diagnoses and effective treatments.展开更多
Objective:To explore the trend of detection and antimicrobial resistance of Serratia marcescens with different infection types for 7 consecutive years,to provide a reference for future studies for the control of S.mar...Objective:To explore the trend of detection and antimicrobial resistance of Serratia marcescens with different infection types for 7 consecutive years,to provide a reference for future studies for the control of S.marcescens infections and a rational selection of antibiotics.Methods:S.marcescens isolates were collected from 2014 to 2020,and the trend of detection and antimicrobial resistance were analyzed according to different types of infection.Results:For 7 consecutive years,the data showed that patients with S.marcescens infections were mainly from the intensive care unit(ICU)(384 isolates,40.98%),and the isolates recovered were mainly from sputum samples(743 isolates,79.30%).The number of isolated strains increased every year,and the average rate of detection ranged from 0.60%to 0.80%.The detection rate of S.marcescens with hospital-acquired infections(HAI)showed a downward trend and that of S.marcescens with colonization showed an upward trend.The detection rate of multidrug-resistant S.marcescens fluctuated between 8.33%–16.89%.The resistance rate of S.marcescens to piperacillin was 17.0%–29.06%and the resistance rate to piperacillin tazobactam was 2.95%–13.13%.For cephalosporin antibiotics,the resistance rates of S.marcescens to cefuroxime and cefazolin were>99%and the resistance rates to ceftazidime and cefepime were<13%.The resistance rate of S.marcescens to aminoglycoside antibiotics,especially amikacin,was the lowest.The resistance rate of S.marcescens with community-acquired infections(CAI)to carbapenems was higher than that with HAI and colonization.Conclusion:The different infection types of S.marcescens have different detection and epidemic trends.In addition,resistance to carbapenems is different across the strains.展开更多
Objectives: To propose the improvements measures by analysing the influencing factors of hand hygiene (HH) compliance by observing the behaviour of health care workers (HCWs). Method: The observational study was condu...Objectives: To propose the improvements measures by analysing the influencing factors of hand hygiene (HH) compliance by observing the behaviour of health care workers (HCWs). Method: The observational study was conducted at a public tertiary hospital in Zhejiang, China, from September 2018 to March 2021. A total of 58 HH observers were trained to conduct a direct observation on the HH behaviors of personnel in the hospital amongst the health care workers. We have observed over 9000 hand hygiene opportunities. The collected data were classified according to time factors, department parameters, and profession conduct of the observed. Hand hygiene (HH) compliance rates were calculated for each category, and a chi-square test was used to analyze differences of the HH compliance rates. Furthermore, binary logistic regression was used for multivariate analysis in each of the hand hygiene moments. Results: The HH compliance rates of HCWs were statistically different before and after the Corona Virus Disease 2019 (COVID-19) pandemic, in the morning and the afternoon, this was observed per parameters stated into objectives on weekdays vs non weekdays. And we found that HH compliance rates drop off a cliff from weekdays to non-weekdays. Conclusions: COVID-19, departments, professions, and weekdays were all factors that influence HH compliance amongst HCWs. However, the influencing factors were not all present in every HH behavior, and had different intensities of influence on HH compliance amongst the HCWs. These findings provide some reference for us to propose improvement measures.展开更多
BACKGROUND The risk factors and prediction models for diabetic foot(DF)remain incompletely understood,with several potential factors still requiring in-depth investigations.AIM To identify risk factors for new-onset D...BACKGROUND The risk factors and prediction models for diabetic foot(DF)remain incompletely understood,with several potential factors still requiring in-depth investigations.AIM To identify risk factors for new-onset DF and develop a robust prediction model for hospitalized patients with type 2 diabetes.METHODS We included 6301 hospitalized patients with type 2 diabetes from January 2016 to December 2021.A univariate Cox model and least absolute shrinkage and selection operator analyses were applied to select the appropriate predictors.Nonlinear associations between continuous variables and the risk of DF were explored using restricted cubic spline functions.The Cox model was further employed to evaluate the impact of risk factors on DF.The area under the curve(AUC)was measured to evaluate the accuracy of the prediction model.RESULTS Seventy-five diabetic inpatients experienced DF.The incidence density of DF was 4.5/1000 person-years.A long duration of diabetes,lower extremity arterial disease,lower serum albumin,fasting plasma glucose(FPG),and diabetic nephropathy were independently associated with DF.Among these risk factors,the serum albumin concentration was inversely associated with DF,with a hazard ratio(HR)and 95%confidence interval(CI)of 0.91(0.88-0.95)(P<0.001).Additionally,a U-shaped nonlinear relationship was observed between the FPG level and DF.After adjusting for other variables,the HRs and 95%CI for FPG<4.4 mmol/L and≥7.0 mmol/L were 3.99(1.55-10.25)(P=0.004)and 3.12(1.66-5.87)(P<0.001),respectively,which was greater than the mid-range level(4.4-6.9 mmol/L).The AUC for predicting DF over 3 years was 0.797.CONCLUSION FPG demonstrated a U-shaped relationship with DF.Serum albumin levels were negatively associated with DF.The prediction nomogram model of DF showed good discrimination ability using diabetes duration,lower extremity arterial disease,serum albumin,FPG,and diabetic nephropathy(Clinicaltrial.gov NCT05519163).展开更多
To the Editor:Hepatitis caused by the hepatitis C virus(HCV)infection has a long course,insidious onset,and slow progression.Patients with hepatitis C are often in the late stages by the time of diagnoses.The long-ter...To the Editor:Hepatitis caused by the hepatitis C virus(HCV)infection has a long course,insidious onset,and slow progression.Patients with hepatitis C are often in the late stages by the time of diagnoses.The long-term chronic damage caused by HCV leads to impaired liver function,portal hypertension,liver fibrosis,cirrhosis and even hepatocellular carcinoma(HCC)[1,2].Therefore,it is imperative to improve the diagnosis and treatment of hepatitis C.In 2016,World Health Organization(WHO)set the goal of“eliminating viral hep-atitis as a public health hazard by 2030”.Some associations intro-duced guidelines for hepatitis C screening and treatment.After a period of effort,in 2020,the number of people receiving treatment for chronic HCV infection had significantly increased compared to the number in 2015,and the HCV-related mortality rate had de-creased.Nevertheless,nearly 80%of infected individuals have not been timely diagnosed and treated[3,4].Like many other coun-tries,China still faces a significant gap in achieving the goal of hep-atitis C elimination,and some literature indicated limited public awareness and high medication costs might slow the progress of policy implementation[5-7].How to effectively improve the diag-nosis and treatment of hepatitis C has garnered widespread global attention.展开更多
文摘Based on the blueprint of the training center for clinical skills of our hospital,this paper discusses the effect of‘the market for lemons’in its booking system from the perspective of economics of information,uses the law of large numbers and the central limit theorem to model to carry out the case study of FAHSYSU Simulation T,and takes measures of offsetting adverse selections to increase booking efficiency.The paper also analyzes how to apply the ancient Chinese theory that man is an integral part of nature to wipe out‘the market for lemons’.
文摘To further improve the ability of pre-hospital and in-hospital collaborative treatment, strengthen emergency multidisciplinary cooperation and construct a scientific, rational and efficient emergency system, under the support of former chairman Yu Xue-zhong, Dr. Li Chun-sheng and numerous colleagues in the industry, the Emergency Medicine Society of the Chinese Medical Association appeal to us to draft Construction of Emergency and Pre-hospital Platform. Based on this background, the platform of emergency and pre-hospital first aid helps to build a 'one horizontal and one Longitudinal' treatment model, using the horizontal and longitudinal patterns to integrate emergency medical resources to satisfy the automatic information integration and intelligent analysis sharing, realizing the emergency management visualization and medical information digitization, simplifying the medical process and establishing a perfect standard for the emergent diseases, thereby ultimately achieving efficient diagnosis and scientific treatment.
基金Project (No. 12XSH010) supported by the National Social Science Foundation of China
文摘This paper presents the results from a survey of first-level hospitals in Urumqi,China.The survey had two parts:the first part was aimed at understanding the operation of the ethics committees of first-level hospitals,including the process for electing members and the variety of members' backgrounds.Information was also gathered about the establishment of criteria,operational rules and regulations,and standard operational procedures.The aim of the second part was to investigate the level of understanding among technicians and doctors about the function of the ethics committees.This paper identifies and analyzes some deficiencies found in the operation of hospital ethics committees,offers some constructive suggestions for improvement,and promotes the role of the Xinjiang Uygur autonomous region hospital ethics committees.
文摘<strong>Objective: </strong>The purpose is to formulate treatment strategies of batches of the wounded and partial first-aid procedures, and further improve the emergency rescue capability of hospitals. <strong>Methods: </strong>This study analyzed the emergency treatment case that we participated in. In this case, we used various means to start the emergency plan, run the emergency procedures, optimize diagnosis, treatment, and rescue procedures, mobilize medical rescue resources, provide a reference for emergency command decisions, formulate a set of coping strategies of tertiary general hospitals on public emergencies. <strong>Results:</strong> Through the scientific and effective management of our hospital, 20 wounded have been discharged from the hospital and achieved the ideal effect of zero deaths in the hospital. <strong>Conclusions:</strong> The new mode of first-aid and health emergency management on the scene of modern disaster needs to find ways to minimize the loss of life and property brought by public emergencies, integrate the various sections of modern disaster medicine, integrate a large number of international and domestic basic and clinical research achievements of disaster first-aid, and upgrade to information, digital system.
基金funded by the National Key Research and Development Program of China(Grant No.2022YFB4700904 to Wang L)the Shanghai Shenkang Hospital Development Center's project for the Promotion of Clinical Skills and Clinical Innovation Three-Year Action Plan(Project No.SHDC2022CRT006 to Wang L and SHDC2022CRS010B to Tang S).
文摘Objective:This study aimed to assess the feasibility and safety of the SHURUI single-port robotic surgical system for a range of major urological surgeries.Methods:In this prospective,multicenter clinical trial,we examined the effectiveness of the SHURUI single-port robotic surgical system in urological interventions.The first 50 patients from four centers in China underwent single-port surgeries including partial nephrectomy,radical prostatectomy,partial adrenalectomy,and pyeloureteroplasty,exclusively by the SHURUI single-port robotic surgical system.The study's primary endpoints focused on the success of surgeries,defined as no deviations from planned procedures,no need for more than one port,and no re-operations within 24 h after surgery.Secondary endpoints encompassed a range of surgical metrics,functional outcomes,and patient demographic data.Clinical assessments were conducted before surgery,before discharge,and 1 month after discharge.Results:The surgical procedures were executed successfully without requiring intraoperative conversions or transfusions.Both estimated blood loss and operation durations were maintained within satisfactory limits.For each type of surgery,the mean console times and estimated blood loss were 179.8(standard deviation[SD]39.4)min and 125.6(SD 126.0)mL for radical prostatectomy,126.7(SD 47.8)min and 39.2(SD 54.4)mL for partial nephrectomy,112.6(SD 37.4)min and 20.0(SD 13.2)mL for partial adrenalectomy,and 148.0(SD 18.2)min and 18.0(SD 17.9)mL for pyeloureteroplasty,respectively.Across the cohort,17 patients experienced a total of 25 adverse events,while 10 postoperative complications,all rated as Clavien-Dindo grade I,were encountered by eight patients.All patients had shown recovery or improvement from these events before the end of this trial.Conclusion:The SHURUI single-port robotic surgical system demonstrated feasibility and safety in the performance of major urological surgeries.These initial findings highlight the system's potential,though further research and longer follow-up are required to assess long-term outcomes.
基金The Henan Key Research and Development and Promotion Project(Grant No.232102310245)the Joint Construction Project of Medical Science and Technology of Henan Province(Grant No.LHGJ20220426).
文摘The rise of antimicrobial resistance,particularly in healthcare-associated infections caused by carbapenem-resistant Gram-negative pathogens,poses a critical global challenge.The extensive use of carbapenems has exacerbated this issue by increasing selective pressure within bacterial populations.This study aimed to investigate the association between carbapenem consumption and resistance rates in four priority Gram-negative bacteria:Escherichia coli(EC),Klebsiella pneumoniae(KP),Acinetobacter baumannii(AB),and Pseudomonas aeruginosa(PA).Retrospective data were collected from the First Affiliated Hospital of Zhengzhou University,covering the period from January 2010 to December 2022.Trends in carbapenem consumption and resistance were analyzed using the Mann-Kendall test to assess statistical significance and the Sen’s slope(SS)estimator to determine the magnitude of change.Correlations between carbapenem use and bacterial resistance rates were evaluated via Spearman correlation analysis.Over the study period,the consumption of meropenem,imipenem,biapenem,and total carbapenems exhibited a significant upward trend(|Z|>1.96,SS>0).Correspondingly,the resistance rates of EC and KP to meropenem and imipenem also increased significantly(|Z|>1.96,SS>0).A strong positive correlation was observed between the resistance rate of EC to meropenem and the defined daily doses(DDDs)of meropenem(r=0.732,P<0.05)and between EC resistance to imipenem and its DDDs(r=0.49,P<0.05).Similar significant correlations were identified for KP.However,no significant associations were found between carbapenem resistance in AB or PA and carbapenem consumption.These findings underscored the strong correlation between carbapenem use and the resistance rates of EC and KP,highlighting the urgent need for stringent control and stewardship of carbapenem use in clinical settings to mitigate or delay the development of bacterial drug resistance.
基金supported by the 2020 Education and Teaching Reform Research Project of Xi’an Medical University,“Construction of‘Double-Qualified’Teachers in Affiliated Hospitals Based on‘Online Learning Platform for Clinical Teachers’and Construction and Practice of Quality Assurance System”(Project Number:2020JG-02)the 2021 Shaanxi Undergraduate and Higher Continuing Education Teaching Reform Research Project of Shaanxi Provincial Department of Education,“Construction of Teaching Staff Based on‘Online Learning Platform for Clinical Teachers of the First Affiliated Hospital of Xi’an Medical University’and Construction and Practice of Quality Assurance System”(Project Number:21BZ066).
文摘Objective:To build a set of teaching staff construction and teaching quality monitoring system suitable for clinical practice teaching in affiliated hospitals of medical colleges,achieve continuous improvement of clinical education and teaching level,and ensure the quality of medical education talent cultivation.Methods:A modern clinical practice teaching quality monitoring system is constructed based on organizational structure construction,teaching staff system construction,quality control system construction,and information platform construction,combined with external audit and evaluation.Results:The hospital has established a Faculty Development and Teaching Evaluation Office specifically responsible for the cultivation of clinical teachers and the evaluation and supervision of teaching quality.A relatively complete teacher construction and teaching quality monitoring system has also been established for clinical practice teaching,thus achieving integration with the school’s quality control system in terms of management mechanism.At the same time,a set of teaching quality control mode based on the“Internet+”platform has been created by means of informatization.At present,this mode has won three national computer software copyrights and two second prizes for school-level teaching achievements.Conclusion:Through five years of practice,an“Internet+”teaching quality evaluation and monitoring system with the characteristics of teaching hospitals affiliated to local medical colleges has been established.In order to further standardize the training system of clinical teachers in affiliated hospitals,achieve self-monitoring and self-improvement in terms of teaching quality,and ensure the continuous improvement of clinical teaching quality,we will continue to promote the development of clinical teachers with quality and excellence,enrich the main team of quality monitoring,guide the transformation of the education mode from being“centered on teachers”to being“centered on students,”and realize the integration of internal and external quality monitoring systems.
基金2023 Shaanxi Teacher Development Research Program“Research on the Construction and Improvement Path of a Teaching Engagement Model for Double-Qualified Teachers in Medical Colleges”(Project number:2023JSQ011)。
文摘This study draws on the classic theories and research achievements of university teacher development,and from the perspective of role conflict in social psychology,proposes policy recommendations for the development of clinical teachers in medical colleges,including following different stages of teacher development and designing teaching development strategies at different levels;designing the content and form of teaching development activities to meet the temporal and spatial needs of clinical teachers;and building an academic community for clinical teachers to promote the creation of teaching development behaviors.
基金2023 Shaanxi Teacher Development Research Program“Research on the Construction and Improvement Path of a Teaching Engagement Model for Double Qualified Teachers in Medical Colleges”(2023JSQ011)2022 Education and Teaching Reform Research Project of Xi’an Medical University“Construction and Practice of the Teaching Quality Assurance System in the Three-Level Teaching Base of General Practice Medicine under the Internet+Model”(2022JG-05)。
文摘Objective:This article aims to deeply analyze the feedback on teacher training in an affiliated hospital,so as to clarify the current needs and situation of teacher training and provide a scientific basis for further optimizing the teacher training system.Methods:The current situation and needs of teacher training in the affiliated hospital were collected by designing and distributing Tomato Form questionnaires on the DingTalk platform.The questionnaire adopted a percent-point system,all of which were indeterminate multiple-choice questions.Results:The average age of the clinical teachers participating in the survey was 40.44±7.85 years old,with an average teaching length of 4–10 years.The results showed that 60.20%of teachers think that the amount of teacher training in an affiliated hospital is sufficient;91.10%of teachers think that the factors affecting training conflict with working hours;97.96%of teachers believe that the training time has an impact on the training effect;81.63%of teachers prefer online training;51.53%of teachers tend to arrange training time on working days;33.16%of teachers tend to train once a month;17.78%of teachers prefer to receive training on clinical theoretical courses and practical teaching norms and skills content.Conclusion:Based on the above survey results,we propose to build a comprehensive management mechanism for teacher training,including improving the access,training,and assessment mechanism for clinical teachers,and adjusting and optimizing the training program according to actual needs.At the same time,an effective communication platform should be built to promote the deep integration of teaching and practice and enhance social recognition,so as to comprehensively improve the teaching quality and medical service of the hospital.
基金supported by the Beijing Natural Science Foundation(No.Z230016)the National Key Research and Development Program of China(No.2022YFC 2502606)+4 种基金the Major Program of the National Natural Science Foundation of China(No.82293630)the Peking University Medicine Fund for the World’s Leading Discipline or Discipline Cluster Development(No.71003Y3035)the Plan Project of Tongzhou Municipal Science and Technology(No.KJ2024CX045)the National Natural Science Foundation of China(No.82170208)the Fundamental Research Funds for the Central Universities。
文摘Objective:Adverse-risk acute myeloid leukemia(AML)patients should receive allogeneic hematopoietic stem cell transplantation(allo-HSCT)at first complete remission(CR1).However,the influence of prior therapies[i.e.,venetoclax plus azacitidine(VEN-AZA)or intensive chemotherapy(IC)]on post-transplant outcomes remains inconclusive.This multicenter,retrospective study compared the post-transplant outcomes between patients receiving VEN-AZA and those receiving IC before allo-HSCT.Methods:This study was based on the transplant database of TROPHY group.Consecutive adverse-risk AML patients receiving allo-HSCT from January 2021 to June 2023 were screened in five Chinese transplant centers.Patients were categorized into VEN-AZA group if they received venetoclax combined with azacitidine as first-line therapy followed by allo-HSCT.Patients who received first-line therapy consisting of a mainstay treatment of cytarabine and anthracycline followed by allo-HSCT were categorized into IC group.Results:In the total cohort,the 3-year probabilities of overall survival,leukemia-free survival,and event-free survival were better in the IC group than VEN-AZA group,particularly for patients with ASXL1 mutations or SF3B1 mutations.However,the survival of the VEN-AZA group was not superior to that of IC group in patients aged≥55 years or those with the hematopoietic cell transplantation-comorbidity index scores≥1 before allo-HSCT.After propensity score matching(median age:VEN-AZA group:57 years;IC group:55 years),only the probability of overall survival for the IC group was better than that of VEN-AZA group(93.6%vs.78.0%,P=0.034)at the 1-year follow-up;however,all of the other clinical outcomes were comparable between the VEN-AZA and IC groups.The TP53 mutation was independently associated with post-transplant relapse and survival.Conclusions:Our results suggest that IC remains the cornerstone of therapy,whereas VEN-AZA may also be used in younger patients and medically fit patients with adverse-risk AML who are receiving allo-HSCT in CR1.
基金2023 Shaanxi Teacher Development Research Program“Research on the Construction and Improvement Path of a Teaching Engagement Model for Double-Qualified Teachers in Medical Colleges”(Project number:2023JSQ011)。
文摘Taking role conflict as the starting point,this article examines and reflects on the development of clinical teachers.In the process of the occurrence,development,and resolution of role conflicts among clinical teachers,there are many hidden issues related to the development of clinical teachers.The development of clinical teacher teaching and role conflict management contain similar educational philosophies and practical issues.This study draws on classic theories and research achievements in the development of university teachers and conducts theoretical analysis and practical reflection on the development of clinical teachers in medical colleges from the perspective of role conflict in social psychology.Policy recommendations are proposed,including strengthening the construction of teaching systems at the hospital organizational environment level,enhancing the role identity and teacher beliefs of clinical teachers,promoting their teaching development and academic learning,and ensuring their normal teaching investment;promoting leadership support at the level of interpersonal interaction and leveraging the role of colleague support in alleviating role conflicts;enhancing individual teacher beliefs,teacher role learning,and role skills.
基金Supported by Hunan Innovative Province Construction Special Task Book,No.2021SK4050Innovation Platform and Talent Program of Hunan Province,No.2023JJ30609.
文摘BACKGROUND Extramedullary plasmacytoma(EMP)represents one of the rarer forms of plasma cell malignancies,capable of impacting a variety of tissues and organs throughout the body.The majority of EMP cases are predominantly found in the head and neck region,especially within the laryngopharynx,as well as in the gastrointestinal tract.While there have been documented instances of oropharyngeal involvement in EMP cases in the academic literature,it is important to note that EMP specifically affecting the uvula is exceedingly uncommon.Furthermore,it is noteworthy that over 60% of epithelial carcinomas in the upper respiratory tract and oropharynx tend to metastasize to the cervical lymph nodes,indicating a propensity for regional spread in these types of cancers.In this context,we present a rare case of extramedullary plasmacytoma where the uvula served as the initially affected site.This case emphasizes the need for heightened awareness among clinicians regarding such unusual comorbidities,as early recognition and diagnosis can significantly influence patient management and treatment outcomes.In addition,a review of the relevant literature is included to further educate and inform healthcare professionals about this rare presentation,ultimately aiming to enhance clinical understanding and improve patient care in similar situations.CASE SUMMARY A 51-year-old man was admitted to our hospital because of a slowly enlarging neck mass.A physical examination revealed a palpable left lymph node,and magnetic resonance imaging(MRI)of the oropharynx and the neck showed a soft tissue mass in the oropharynx and enlargement of multiple lymph nodes in the neck.The soft tissue mass was diagnosed as plasmacytoma by immunohistochemical analysis.Monoclonal immunoglobulins and bone marrow biopsy showed normal results.Therefore,we diagnosed that as EMP of the uvula.After four cycles of adjuvant chemotherapy dominated by bortezomib,MRI reexamination showed a significant reduction of the mass in the oropharynx and the cervical lymph nodes.Afterwards,the λ light chain returned to normal levels.There was no evidence of evolution to multiple myeloma.CONCLUSION We have reported a rare case of extramedullary plasmacytoma with the uvula as the first affected site and the relevant literature is reviewed to improve clinicians'awareness of such rare comorbidities.
文摘On November 3,2025,United Therapeutics Corporation(Nasdaq:UTHR)announced the first clinical xenotransplantation within its EXPAND study,involving transplantation of the UKidney into a patient with end‐stage renal disease(ESRD)at New York University(NYU)Langone Health.The UKidney is a genetically engineered porcine kidney incorporating 10 gene modifications-6 human gene insertions to enhance immunologic compatibility and 4 porcine gene knockouts to minimize rejection risk and control graft growth[1].In the context of the first xenotransplantation studies,“EXPAND”refers to the US Food and Drug Administration(FDA)“expanded access”program,often colloquially known as compassionate use.
文摘A clinical trial of nab-paclitaxel plus capecitabine as a first-line treatment for advanced biliary tract cancers was conducted.We analyzed the development of systemic therapy recommended by the National Comprehensive Cancer Network guidelines and the development of nab-paclitaxel combination chemotherapy for advanced biliary tract cancers(BTCs)and concluded that nab-paclitaxel plus capecitabine is a promising first-line regimen for advanced BTCs.
文摘Full cost accounting,as a comprehensive cost measurement method,integrates direct and indirect costs to reallocate costs across departments.Performance evaluation serves as a method to assess a hospital’s overall performance and management capabilities.Both full cost accounting and performance evaluation are critical tools in the financial management of public hospitals,playing pivotal roles in accounting practices.The concepts of full cost accounting and performance evaluation were investigated in this study,and the existing challenges and the theoretical basis for their integration were analyzed.An integrated model was constructed,and its application cases and effectiveness in the financial management of public hospitals were discussed.Finally,measures to integrate full cost accounting and performance evaluation were proposed,including improving full cost accounting mechanisms,standardizing accounting practices,optimizing cost allocation methods,establishing a unified management platform,and fostering collaboration among stakeholders.This study provides new insights to enhance the quality and efficiency of financial management in public hospitals,laying a foundation for their sustainable development.
基金supported by the First Affiliated Hospital of Xi’an Jiaotong University Teaching Reform Project(Grant No.JG2023-0206 and JG2022-0324).
文摘Objective:In the Radiology Department of Mzuzu Central Hospital(MCH),daily training for radiographers now includes content on Computed Tomography(CT)image quality control and equipment maintenance to ensure the normal,continuous,and stable operation of the 16-slice spiral CT scanner.Methods:Through comprehensive analysis of relevant equipment,we have identified key parameters that significantly impact CT image quality.Innovative optimization strategies and solutions targeting these parameters have been developed and integrated into daily training programs.Furthermore,starting from an examination of prevalent failure modes observed in CT equipment,we delve into essential maintenance and preservation techniques that CT technologists must master to ensure optimal system performance.Results:(1)Crucial factors affecting CT image quality include artifacts,noise,partial volume effects,and surrounding gap phenomena,alongside spatial and density resolutions,CT dose,reconstruction algorithms,and human factors during the scanning process.In the daily training for radiographers,emphasis is placed on strictly implementing image quality control measures at every stage of the CT scanning process and skillfully applying advanced scanning and image processing techniques.By doing so,we can provide clinicians with accurate and reliable imaging references for diagnosis and treatment.(2)Strategies for CT equipment maintenance:①Environmental inspection of the CT room to ensure cleanliness and hygiene.②Rational and accurate operation,including calibration software proficiency.③Regular maintenance and servicing for minimizing machine downtime.④Maintenance of the CT X-ray tube.CT technicians can become proficient in equipment maintenance and upkeep techniques through training,which can significantly extend the service life of CT systems and reduce the occurrence of malfunctions.Conclusion:Through the regular implementation of rigorous CT image quality control training for radiology technicians,coupled with diligent and proactive CT equipment maintenance,we have observed profound and beneficial impacts on improving image quality.The accuracy and fidelity of radiological data ultimately leads to more accurate diagnoses and effective treatments.
基金Hospital Management Innovation Program of Jiangsu Hospital Association in 2021(Project No.:JSYGY-3-2021-511)。
文摘Objective:To explore the trend of detection and antimicrobial resistance of Serratia marcescens with different infection types for 7 consecutive years,to provide a reference for future studies for the control of S.marcescens infections and a rational selection of antibiotics.Methods:S.marcescens isolates were collected from 2014 to 2020,and the trend of detection and antimicrobial resistance were analyzed according to different types of infection.Results:For 7 consecutive years,the data showed that patients with S.marcescens infections were mainly from the intensive care unit(ICU)(384 isolates,40.98%),and the isolates recovered were mainly from sputum samples(743 isolates,79.30%).The number of isolated strains increased every year,and the average rate of detection ranged from 0.60%to 0.80%.The detection rate of S.marcescens with hospital-acquired infections(HAI)showed a downward trend and that of S.marcescens with colonization showed an upward trend.The detection rate of multidrug-resistant S.marcescens fluctuated between 8.33%–16.89%.The resistance rate of S.marcescens to piperacillin was 17.0%–29.06%and the resistance rate to piperacillin tazobactam was 2.95%–13.13%.For cephalosporin antibiotics,the resistance rates of S.marcescens to cefuroxime and cefazolin were>99%and the resistance rates to ceftazidime and cefepime were<13%.The resistance rate of S.marcescens to aminoglycoside antibiotics,especially amikacin,was the lowest.The resistance rate of S.marcescens with community-acquired infections(CAI)to carbapenems was higher than that with HAI and colonization.Conclusion:The different infection types of S.marcescens have different detection and epidemic trends.In addition,resistance to carbapenems is different across the strains.
文摘Objectives: To propose the improvements measures by analysing the influencing factors of hand hygiene (HH) compliance by observing the behaviour of health care workers (HCWs). Method: The observational study was conducted at a public tertiary hospital in Zhejiang, China, from September 2018 to March 2021. A total of 58 HH observers were trained to conduct a direct observation on the HH behaviors of personnel in the hospital amongst the health care workers. We have observed over 9000 hand hygiene opportunities. The collected data were classified according to time factors, department parameters, and profession conduct of the observed. Hand hygiene (HH) compliance rates were calculated for each category, and a chi-square test was used to analyze differences of the HH compliance rates. Furthermore, binary logistic regression was used for multivariate analysis in each of the hand hygiene moments. Results: The HH compliance rates of HCWs were statistically different before and after the Corona Virus Disease 2019 (COVID-19) pandemic, in the morning and the afternoon, this was observed per parameters stated into objectives on weekdays vs non weekdays. And we found that HH compliance rates drop off a cliff from weekdays to non-weekdays. Conclusions: COVID-19, departments, professions, and weekdays were all factors that influence HH compliance amongst HCWs. However, the influencing factors were not all present in every HH behavior, and had different intensities of influence on HH compliance amongst the HCWs. These findings provide some reference for us to propose improvement measures.
基金Supported by National Natural Science Foundation of China,No.81972947Academic Promotion Programme of Shandong First Medical University,No.2019LJ005.
文摘BACKGROUND The risk factors and prediction models for diabetic foot(DF)remain incompletely understood,with several potential factors still requiring in-depth investigations.AIM To identify risk factors for new-onset DF and develop a robust prediction model for hospitalized patients with type 2 diabetes.METHODS We included 6301 hospitalized patients with type 2 diabetes from January 2016 to December 2021.A univariate Cox model and least absolute shrinkage and selection operator analyses were applied to select the appropriate predictors.Nonlinear associations between continuous variables and the risk of DF were explored using restricted cubic spline functions.The Cox model was further employed to evaluate the impact of risk factors on DF.The area under the curve(AUC)was measured to evaluate the accuracy of the prediction model.RESULTS Seventy-five diabetic inpatients experienced DF.The incidence density of DF was 4.5/1000 person-years.A long duration of diabetes,lower extremity arterial disease,lower serum albumin,fasting plasma glucose(FPG),and diabetic nephropathy were independently associated with DF.Among these risk factors,the serum albumin concentration was inversely associated with DF,with a hazard ratio(HR)and 95%confidence interval(CI)of 0.91(0.88-0.95)(P<0.001).Additionally,a U-shaped nonlinear relationship was observed between the FPG level and DF.After adjusting for other variables,the HRs and 95%CI for FPG<4.4 mmol/L and≥7.0 mmol/L were 3.99(1.55-10.25)(P=0.004)and 3.12(1.66-5.87)(P<0.001),respectively,which was greater than the mid-range level(4.4-6.9 mmol/L).The AUC for predicting DF over 3 years was 0.797.CONCLUSION FPG demonstrated a U-shaped relationship with DF.Serum albumin levels were negatively associated with DF.The prediction nomogram model of DF showed good discrimination ability using diabetes duration,lower extremity arterial disease,serum albumin,FPG,and diabetic nephropathy(Clinicaltrial.gov NCT05519163).
基金supported by a grant from the R&D Program of China(2022YFC2304500).
文摘To the Editor:Hepatitis caused by the hepatitis C virus(HCV)infection has a long course,insidious onset,and slow progression.Patients with hepatitis C are often in the late stages by the time of diagnoses.The long-term chronic damage caused by HCV leads to impaired liver function,portal hypertension,liver fibrosis,cirrhosis and even hepatocellular carcinoma(HCC)[1,2].Therefore,it is imperative to improve the diagnosis and treatment of hepatitis C.In 2016,World Health Organization(WHO)set the goal of“eliminating viral hep-atitis as a public health hazard by 2030”.Some associations intro-duced guidelines for hepatitis C screening and treatment.After a period of effort,in 2020,the number of people receiving treatment for chronic HCV infection had significantly increased compared to the number in 2015,and the HCV-related mortality rate had de-creased.Nevertheless,nearly 80%of infected individuals have not been timely diagnosed and treated[3,4].Like many other coun-tries,China still faces a significant gap in achieving the goal of hep-atitis C elimination,and some literature indicated limited public awareness and high medication costs might slow the progress of policy implementation[5-7].How to effectively improve the diag-nosis and treatment of hepatitis C has garnered widespread global attention.
