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  • Quality appraisal of clinical practice guidelines and consensus for the management of fragility fractures in China by AGREE Ⅱ and AGREE-China

    Objective To verify the applicability of AGREE-China and select high-quality clinical practice guidelines (CPGs) or consensus for the management of fragility fractures (FF) in China by evaluating their methodological quality. Methods CBM, CNKI, WanFang Data, VIP databases and related CPGs websites were electronically searched. Two reviewers independently screened literature, extracted data, and checked each other. Quality appraisal of CPGs or consensus were evaluated by AGREE Ⅱ and AGREE-China, and weighted Kappa value and intraclass correlation coefficients (ICC) were calculated to illustrate the consistency of the two tools. Results Nine CPGs and sixteen consensuses were included. Among the six domains in AGREE Ⅱ, "scope and purpose" domain (62.22%) scored higher than "clarity of presentation" domain (45.67%). The "stakeholder involvement" domain (34.89%) and "applicability" domain (38.17%) both exceeded 30%, while "rigor of development" domain (18.79%) and "editorial independence" domain (13.33%) were lower. Among the five domains in AGREE-China, "conflict of interest" domain (72.80%) was higher, followed by "usability/feasibility" domain (49.87%), while "scientificity/preciseness" domain (20.36%), "effectiveness/safety" domain (25.20%) and "economic efficiency" domain (14.40%) were lower. The weighted Kappa value of recommendations from the two tools was 0.694 (P<0.001), showing moderate consistency. ICC values of the same items and two evaluators were all greater than 0.85 (P<0.001) with high consistency. Three high-quality CPGs were consistently selected by the two tools. Conclusion AGREE Ⅱ holds high consistency with AGREE-China; however, AGREE-China is more suitable for the quality appraisal of Chinese CPGs or consensus. The methodological quality of CPGs or consensus for the management of FF in China needs to be further improved.

    Release date:2022-03-29 02:59 Export PDF Favorites Scan
  • Exploration and construction of “West China Hospital-Mabian model” of targeted health poverty alleviation in ethnic minority areas

    This paper analyzes the health status and predicament of Mabian Yi Autonomous County before accepting assistance from West China Hospital of Sichuan University in 2016, and expounds the measures and achievements of West China Hospital of Sichuan University in building a “West China Hospital-Mabian model” of precision health poverty alleviation combining its own advantages and oriented by the needs of health poverty alleviation of Mabian Yi Autonomous County. The main contents of the model are putting an emphasis on the application and promotion of appropriate technologies, paying equal attention to technical and management help, combining “blood transfusion” and “hematopoiesis”, and taking the construction of a chimeric medical association as the carrier. The “West China Hospital-Mabian model” of precision health poverty alleviation provides a reference for continuously and systematically improving the technical level, service capacity and management level of grassroots hospitals in ethnic minority areas.

    Release date:2020-02-24 05:02 Export PDF Favorites Scan
  • Prevalence of senile pruritus in Chinese population: a meta-analysis

    ObjectivesTo systematically review the prevalence of senile pruritus (SP) in Chinese population.MethodsPubMed, EMbase, CENTRAL, CINAHL, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect cross-sectional studies on the prevalence of SP in Chinese population from inception to May 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by Stata 12.0 software.ResultsA total of 11 studies involving 13 398 patients were included. The results of meta-analysis showed that, the overall prevalence of SP was 31.0% (95%CI 18.0% to 44.0%). Subgroup analysis showed that the prevalence rate of male was 34.9% (95%CI 18.6% to 88.5%). The prevalence rates of SP among 60, 70, 80 and 90 age groups were 20.0% (95%CI 14.2% to 25.7%), 48.4% (95%CI 21.5% to 75.3%), 53% (95%CI 12.4% to 93.5%), and 58.5% (95%CI 22.4% to 94.6%), respectively. The prevalence rates of SP in community, hospital and cadre relaxation club were 33.4% (95%CI 31.3% to 35.6%), 40.4% (95%CI 22% to 58.7%), and 14.4% (95%CI 1.1% to 27.7%), respectively. The prevalence rates of SP in southern China and northern China were 26.7% (95%CI 18.7% to 34.7%) and 36.8% (95%CI 21.8% to 51.7%), respectively.ConclusionsThe overall prevalence rate of SP in the Chinese population is high. The prevalence rates of SP among ages, regions and research sites are different.

    Release date:2020-06-18 09:20 Export PDF Favorites Scan
  • Incidence rate of college students’ internet addiction in China: a meta-analysis

    ObjectiveTo systematically review the incidence of internet addiction disorder among college students in China.MethodsPubMed, EMbase, VIP, WanFang Data and CNKI databases were electronically searched to collect cross-sectional studies on incidence rate of college students’ internet addiction in China from inception to February 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by Stata 16.0 software.ResultsA total of 65 cross-sectional studies involving 87 702 subjects were included. The results of meta-analysis showed that: the overall incidence of college students’ internet addiction in China was 10.7% (95%CI 9.6% to 11.8%). The incidence of internet addiction from 2011 to 2018 (11.7%, 95%CI 10.2% to 13.2%) was higher than that from 2005 to 2010 (9.6%, 95%CI 8.1% to 11.1%). The incidence in male students (14.6%, 95%CI 13.1% to 16.0%) was higher than that in female students (6.9%, 95%CI 5.9% to 7.8%). The incidence of urban students (12.2%, 95%CI 9.3% to 15.2%) was higher than that of rural students (9.0%, 95%CI 7.3% to 10.6%). The incidence of students who were not satisfied with their major (16.2%, 95%CI 5.5% to 26.8%) was higher than that of satisfied (5.0%, 95%CI 1.3% to 8.8%). The incidence of students with poor academic performance (29.4%, 95%CI 11.9% to 47%) was higher than of excellent academic performance (4.1%, 95%CI 1.9% to 6.4%).ConclusionsThe incidence rate of internet addiction among college students in China shows an obvious upward trend. There are differences in the incidence rates of internet addiction among college students in different regions. The incidence rates of internet addiction are different among different genders, degree of satisfaction with their majors and academic achievements.

    Release date:2021-02-05 02:57 Export PDF Favorites Scan
  • Public anticipation of clinician graduates in the new era of healthy China: a questionnaire-based cross-sectional study

    ObjectiveThe purpose of this study was to offer new suggestions for current clinician training under the guidance of the Healthy China 2030 policy by investigating the patients’ needs.MethodsThis study surveyed adult outpatients from West China Hospital of Sichuan University between March and July, 2019 and February and May, 2020 by self-constructed questionnaires to investigate the expectation and requirements of outpatients towards medical professionals.ResultsA total of 430 questionnaires were distributed, and 402 of them (93.5%) were collected and included in this study. All questionnaire respondents expected that medical graduates should have outstanding expertise and ethical standard. The majority valued qualities such as physical and mental health (90.05%), a bachelor’s degree or higher (73.88%), knowledge on disease control and prevention (61.69%), knowledge on health care (91.29%), ability to continuously update current knowledge (70.65%), and excellent communication (71.14%) and teamwork (62.44%) skills. In addition, most patients expected that new health care providers to possess humanitarianism and professional dedication relevant traits, and could improve diagnoses and treatments via research activities. Patients’ demand for abilities such as disease control and prevention, health care, and integrative cooperation between traditional Chinese medicine and modern medicine significantly increased after the COVID-19 pandemic (P<0.05).ConclusionsNowadays, to provide health care services which meet the needs of the public, clinicians are expected to have qualities such as outstanding expertise, humanity, research and knowledge-updating skills, disease control and prevention, health care management, and capability to take the advantages of traditional Chinese medicine and modern medicine.

    Release date:2021-03-19 07:04 Export PDF Favorites Scan
  • Analysis of the disease burden of esophageal cancer and gastric cancer in China from 1990 to 2021

    Objective To assess the evolving disease burden of esophageal and gastric cancers in China from 1990 to 2021, with a focus on gender disparities, and construct a predictive model to forecast disease trends from 2022 to 2031, aiming to optimize targeted prevention strategies. MethodsEpidemiological data for esophageal and gastric cancers in China (1990-2021) were extracted from the Global Burden of Disease (GBD) 2021 database. Temporal trends were analyzed using Joinpoint regression (version 4.9.1.0), and future trends were predicted via the GM (1, 1) model under grey system theory. ResultsFrom 1990 to 2021, tobacco- and alcohol-attributable burdens of esophageal cancer increased, while tobacco- and diet-related burdens of gastric cancer showed no significant change. Deaths and disability-adjusted life years (DALY) for esophageal cancer rose by 40.61% and 17.89%, respectively; gastric cancer deaths increased by 18.95%, though DALY decreased by 1.22%. Both cancers exhibited significant declines in age-standardized mortality rates (−45.78% for esophageal cancer, −53.29% for gastric cancer) and age-standardized DALY rates (−51.45% for esophageal cancer, −57.58% for gastric cancer). China’s age-standardized mortality and DALY rates for both cancers remained consistently higher than global averages. Males exhibited disproportionately higher burdens than females. Predictive modeling projected continued but decelerating declines in disease burdens for both cancers by 2031. ConclusionOver three decades, China achieves measurable reductions in esophageal and gastric cancer burdens, though gastric cancer burdens remain higher than esophageal cancer. Persistent disparities relative to global levels, elevated male burdens, and aging demographics highlight the urgency for prioritized interventions targeting high-risk populations.

    Release date:2025-09-22 05:53 Export PDF Favorites Scan
  • 头皮撕脱伤超时游离回植

    OBJECTIVE: To investigate a treatment method for overtime avulsion of scalp. METHODS: Form October 1992 to July 2001, we treated 7 cases of avulsed scalp, which had been wounded more than 12 hours and accompanied with shock and head wound, with split thickness scalp skin grafting. RESULTS: Except for partial necrosis of scalp in center of bare area of skull, more than 90% of grafting split thickness scalp skin survived in 4 cases and more than 80% in 3 cases, and presented satisfactory appearance during following up. The bare area had no periosteum above 4 cm in diameter needed to graft split thickness skin after skull was covered granulation tissue. CONCLUSION: The limits of time of scalp skin grafting will be prolonged as long as the processes are settled properly to maintain the skin of body.

    Release date:2016-09-01 09:35 Export PDF Favorites Scan
  • 经关节突入路治疗韧带骨化型胸椎管狭窄症

    Objective To investegate the effectiveness of transarticular approach in treating thoracic spinal stenosis due to ossification of l igamentum flavum (OLF) and ossification of posterior longitudinal l igament (OPLL) at the samelevel. Methods A retrospective analysis was performed in 35 patients with single-level thoracic spinal stenosis of calcifiedl igament who accepted transarticular approaching operation between January 2006 and March 2008. There were 12 males and 23 females with an age range of 40-67 years (mean, 58.6 years), including 16 cases of thoracic OLF, 11 cases of thoracic OPLL, and 8 cases of thoracic OPLL and OLF. The disease duration was 8-48 months (mean, 16 months). The affected segments included T2, 3 in 4 cases, T3, 4 in 3 cases , T4, 5 in 1 case , T6, 7 in 3 cases , T7, 8 in 1 case , T8, 9 in 2 cases , T9, 10 in 5 cases , T10, 11 in 9 cases, and T11, 12 in 7 cases. CT and MRI were taken to definite the ossification position and the condition of thoracic spinal stenosis. The Japanese Orthopaedic Association (JOA) score was 6.1 ± 1.3 before operation. According to Otani scoring system, the results were excellent in 3 cases, good in 16 cases, fair in 11 cases, and poor in 5 cases. Results All operations were successful, and no nerve injury occurred. Allincisions healed at stage I. Cerebrospinal fluid leakage occurred in 5 cases, and recovered after symptomatic treatment. One case had epidural hematoma 6 hours after operation, and the muscle strength recovered after symptomatic treatment. All cases were followed up 1.5-2.6 years (mean, 2.1 years) and the symptoms were improved in different degrees; no neurological symptoms deteriorated and spinal instabil ity occurred. The JOA score had a significant recovery at 3 months (9.2 ± 1.8) and at last follow-up (9.6 ± 2.3) when compared with preoperative value (P lt; 0.05). At last follow-up, the rate of the cl inical improvement was 71.43% ± 18.20%. According to Otani scoring system at last follow-up, the results were excellent in 12 cases, good in 15 cases, fair in 6 cases, and poor in 2 cases with an excellent and good rate of 77.14%, showing significant difference when compared with preoperative value (u=2.711, P=0.007). Conclusion The transarticular approach in treating thoracic spinal stenosis of calcified l igament can obtain goodcl inical results. Moreover, extra attention should be paid to during operation so as to avoid catastrophic spinal cord injury.

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • Evidence-based Decision-making in Public Health, China ––Challenge and Exploration

    Release date:2016-09-07 02:11 Export PDF Favorites Scan
  • Elasticity of the demand for health care services in China: a systematic review

    Objective To investigate the elasticity of demand for health care services in China, and to provide suggestions for further studies. Methods Databases including PubMed, The Cochrane Library (Issue 10, 2015), EMbase, CNKI, VIP and WanFang Data were searched from inception to December 2015 to collect studies about price elasticity or income elasticity of demand for health care services. Literatures were screened and related information was independently extracted by two reviewers. Then qualitative approaches were applied to describe the elasticity. Results A total of 31 studies were included. Estimates of the own-price elasticity of demand for health care services ranged from –2.520 to 2.944 in 25 studies; 2 studies estimated cross-price elasticity between outpatient and inpatient service and one study estimated cross-price elasticity between different levels of inpatient services and all estimates were positive; Estimates of the income elasticity ranged from –0.020 to 2.480 in 28 studies. Demand for inpatient services was more income sensitive than the demand for outpatient services and urban citizens were more sensitive to income than their rural counterparts. Conclusion Health service is insensitive to price and belongs to necessity; inpatient service and outpatient service are substitutes for each other and different levels of inpatient services are substitutes for each other; government are supposed to tackle with the unbalanced increase of the demand of outpatient and inpatient services along with the increase of income to guide rational health-seeking behaviors.

    Release date:2017-05-18 02:12 Export PDF Favorites Scan
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