Objective To explore the delay in help-seeking by breast cancer patients in Sichuan province. Methods A cross-sectional survey was performed in 327 patients with breast cancer from 7 first-level hospitals in Sichuan province, from July 2006 to January 2007. The following items were assessed: the time of symptom onset, the time of help-seeking, the time of definitive diagnosis, and the time of cancer treatment. The median times of patient delay, medical delay and total delay were computed. Results A total of 327 patients were surveyed and 312 questionnaires were distributed, with a response rate of 95%; 308 were retrieved, with a retrieval rate of 99%; and 283 were identified as valid, with a valid retrieval rate of 92%. The median time of total delay was 94 days, with an incidence of 50.2%; the median time of patient delay was 50 days, with an incidence of 35.7%; the median time of medical delay was 10 days, with an incidence of 16.7%.Conclusion Help-seeking delay by breast cancer patients is common in Sichuan province. Since patient delay contributes most to the total delay, it is important to control this portion.
ObjectiveTo explore the quality of life (QOL) of rural cognitive function impaired elderly in Guangyuan city and analysis the influencing factors, in order to provide evidence for improving the QOL of rural cognitive function impaired elderly. MethodsBy stratified cluster sampling method, Mini-Mental State Examination (MMSE) was adopted in the cognitive function impaired screening in Guangyuan rural area of Sichuan province in 2012, then we used SF-12 questionnaire to evaluate the QOL of those rural elderly (more than 60 years old) whose cognitive function was impaired. ResultsA total of 270 rural cognitive function impaired elderly were selected from 735 old people. The results of QOL assessment showed that:the mean of physical component summary (PCS) was 37.93±11.55, and the mean of mental component summary (MCS) was 44.07±13.14. Gender, age, education levels, economic situation of the selfassessment, chronic disease, being engaging in physical labour and daily life care were correlated with the score of QOL. ConclusionIn order to improve their QOL, we should help the elderly with cognitive function impaired and focus on prevention and individual treatment; their special difficulties should be fully considered when making the policy of health care and social security.
ObjectiveTo investigate the development, production and use of children’s drugs in Sichuan Province, analyze the problems existing in these links, and provide suggestions for ensuring that children’s needs for drugs are met. MethodsThe self-filling electronic questionnaire was used to investigate the production, procurement and use of children’s drugs in 14 pharmaceutical companies producing children’s drugs and 20 general hospitals with pediatric departments or children’s hospitals in Sichuan province. ResultsThe 14 surveyed pharmaceutical companies reported that 116 children’s drugs were being developed or produced (75 first-class children’s drugs with exact medication information for children, 41 second-class children’s drugs only noted as children's discretionary reduction or use according to clinician’s instructions), out of which 109 (93.97%) drugs had been approved for marketing, 21 (18.10%) were national essential medicines and 76 (65.52%) were covered by national basic medical insurance. The dosage forms of first-class children's drugs were mainly tablets (28, 37.34%) and granules (19, 25.34%), while oral solution (3, 4.00%), syrup (5, 6.67%) and other dosage forms suitable for children were less. According to the surveyed results on the use of children's drugs in hospitals, there were 57 children’s drugs whose minimum use units needed to be manually divided into smaller ones on average in each hospital, and it was the most common operation pattern that pharmacists informed nurses, patients or patients’ family members of the dose splitting methods and then splitting drugs’ minimum use units by themselves. ConclusionThere is a great demand for splitting minimum use units of drugs whose strength is too big for children in medical institutions, and some children’s drugs need to be developed and further modified to meet the clinical children’s drug needs. We should further increase investments and policy supports for the children’s drugs, promote children’s clinical trials, and encourage the research and development of children’s drugs.
Objective To perform a cross-sectional study on mental situations of parents of student victims in Wenchuan earthquake and analysis the data to produce best evidences for the government on their decision-making. Methods By the use of questionnaires, interviewer, and observation, we performed field study on 225 student victims’ parents selected by simple random sampling to collect their demographic characteristics, economic and mental status. Results (1) Of the 123 student victims the only child of the family account for 91.87%, female account for 50.41%, the pupil and below, the middle school student, and the college account for 48.78%, 50.41%, 0.81% respectively. (2) Mental and behavior differences between fathers and mothers were significant. (3) The parents declining to accept the death of their children are not in a good social support. (4) The parents with good family economics and high education are more likely to accept the death of children. Conclusion (1) We should build a ‘Mutual Aid’ organization to help those parents construct a good social support net. (2) To take the advantage of rural hospitals to build the long-acting mechanism of the psychological intervention. (3) To perform the psychological intervention corresponding to right period and right aimed group.
ObjectiveTo investigate the prevalence of chronic obstructive pulmonary disease (COPD) and related risk factors in two districts and five counties in Jiaxing city of Zhejiang province. MethodsWe randomly selected people over the age of 40 in 10 communities of two districts and five counties in Jiaxing city by cluster sampling and random sampling to investigate the prevalence of COPD from January 2013 to December 2013. All included patients received pulmonary function test at the same time. ResultsA total of 1 256 cases of adults over the age of 40 were included, among which, 1 056 cases with complete data and qualified for pulmonary function test. There were 410 males with mean age of 58.74±11.62, and 646 females with mean age of 59.45±11.72. The overall prevalence of COPD was 13.60%. Male and female prevalence rates were 13.90% and 13.41%, respectively. Divided by age, the prevalence of the age of 40 to 50 was 3.38%, the age of 51 to 60 was 9.57%, the age of 61 to 70 was 19.15%, and the age of above 70 was 29.35%. The results of multivariate logistic regression analysis showed that the main risk factors of COPD were smoking, passive smoking, history of dust exposure, chronic respiratory disease history and age. ConclusionThe total prevalence of COPD in Jiaxing area is high, and the female prevalence rate is especially higher than the national average level, which is the epidemiological characteristic of this area. Because the risk factors of COPD are complex, an integrated control strategy should be adopted.
ObjectiveTo analyze the quality of the randomized controlled trials (RCTs) included in the systematic review in the anti-infection field in the elderly.MethodsA comprehensive and systematic literature search in PubMed, EMbase, CNKI, The Cochrane Library, WanFang Data, VIP and CBM was conducted to collect systematic review or meta-analysis which involoved anti-infection RCTs in the elderly from inception to February 17th, 2020. The results of Cochrane risk of bias assessment of the included RCTs were analyzed.ResultsA total of 8 systematic reviews were included, involving 19 RCTs and 6 735 participants. The sample size of the RCTs ranged from 23 to 2538, and the published date were from 1980 to 2020. The included RCTs focused on postoperative infection, urinary tract infection, Clostridium Difficile infection and so on. The included RCTs had methodological quality issues. Among the assessment results of low risk of bias, the domains of selection bias (random sequence generation) and selection bias (allocation hiding) had the lowest proportion (47.3%, 36.8%). Among the assessment results of unclear risk of bias, the domains of selection bias (random sequence generation) and selection bias (allocation hiding) had the highest proportion (42.1%, 52.6%). Among the assessment results of high risk of bias, the domains of measurement bias and performance bias had the highest proportion (21.1%, 21.1%).ConclusionsThe quality of RCTs in the field of anti-infection in the elderly requires further improvement. High-quality anti-infection RCTs for the elderly should be developed in future to better guide clinical practice.
ObjectiveTo survey and analyze the trend of congenital heart disease (CHD) of regions distribution and medical payment model in Children's Hospital of Gansu Province over the past 11 years, and to provide evidence for diagnosis and treatment strategies for CHD children. MethodsMedical records of the CHD children hospitalized in the Children's Hospital of Gansu Province from 2001 to 2011 were completely collected. Regional distribution, year and other basic information of them were extracted. Data was then analyzed using the SPSS 16.0 software. ResultsA total of 591 CHD children were included. Most of them came from Middle-Long, accounting for 68.87%; while the number of CHD children in the region of East-Long and He-xi had a tendency of growth by year, with average growth speed of 189.42% and 27.62%, respectively. Most of them came from the region which is economic class Ⅲ, accounting for 35.64% (highest) with average growth speed (203.45%). Most of the treatment costs were self-supported before 2005, and health insurance and other social aids were consistently increasing after 2005. Most of the institutions for initial visit were town-level hospitals, accounting for 55.50%, and with average growth speed of 170.18%. ConclusionThe medical demand of CHD children in less-developed regions in Gansu province increases year by year. Government-guided healthcare system should be established and improved so as to basically guarantee the prevention and treatment of CHD in less-developed regions.
ObjectiveTo investigate the management of hospital infection control of 23 hospitals in Sichuan province, China for making the questionnaires and providing basic data of the China-U.S. cooperative program on emerging and re-emerging infectious diseases "The Nosocomial Infection Surveillance Project in China". MethodsWe selected 23 representative hospitals from different regions of Sichuan in the survey for the management of hospital infection control. The survey included basic situation of the hospital such as the hospital level, ownership, number of beds, employees and discharged patients, the situation of hospital infection management such as the organization of management, the previous surveillance for prevalence of nosocomial infection, the composition of the staff, and the distribution pattern of important pathogens. ResultsThere were 18 Triple A hospitals, 1 Double A hospital, 4 Triple B hospitals were investigated, of which there were21 general hospitals and 2 specialty hospitals. The total number of patient beds were 26 801. The total numbers of staff were 32 757 including 8 571 doctors, 13 611 nurses, 1 391 technicians and 1 014 pharmacists. In 2010, the total numbers of out-patients, operations, and discharged patients were 16 127 038, 334 057, and 776 806, and the length of mean hospital stays were 11.30 days. All hospitals established the hospital infection control department with 105 infection control professionals. Most of the staffs of infection control department had medical or nursing background with college, or undergraduate level. Nineteen hospitals (82.61%) did the surveillance for the prevalence of nosocomial infection. The last surveillance showed the mean rate of hospital infection was 2.58%. Lower respiratory tract, upper respiratory tract and surgical site infection were top three infections. The annual number of culture specimens totalled 267 061; the average positive rate was 33.06%. Escherichia coli, klebsiella pneumoniae, pseudomonasaeruginosa, staphylococcus aureus and acinetobacter baumannii were top five infectious bacteria. ConclusionThe survey on the hospital infection control management could help us understand the overall situation of the hospital infection control. Also it could found the weaknesses and targeted interventions for the future project, and ensure the authenticity and reliability of the data for this research project eventually.
ObjectivesTo establish statistical analysis and result reporting model for evaluation of the applicability of the clinical guidelines. We conducted an empirical study for clinical guidelines for the prevention and treatment of type 2 diabetes in China.MethodsA cross-sectional survey was conducted to select 6 to 8 doctors in geriatric, endocrinology, nephrology or related departments from medical institutions. The questionnaire was filled by doctors at a conference and electronic questionnaires were sent to those who did not attend the conference. Descriptive analysis was carried out for characteristics of evaluators, scores of each dimension, access to guidelines and factors affecting implementation. The Kruskal-Wallis rank-sum test and Nemenyi test were used for multi-group comparison and pairwise comparison. Multiple linear regressions with the stepwise strategy were used to screen out the association factors.ResultsA total of 725 questionnaires were collected in this survey. There were 722 valid questionnaires with an active recovery rate of 99.6%. The results showed the accessibility score was lowest and the acceptability score was highest. The results of multi-group comparison and multiple linear regression analysis showed that familiarity with the guidelines was the influencing factor of each score (P<0.05). The guidelines were primarily obtained from academic conferences (52.1%), WeChat (45.4%), and biomedical literature databases (43.5%). Among the evaluators, 44 (41.9%) believed that there were implementation obstacles in the guidelines, among which 136 (18.8%), 134 (18.5%) and 133 (18.4%) believed that implementation obstacles were medical personnel factor, patient factor and environmental factor.ConclusionsIn this study, a data analysis and result report model for the assessment of the applicability of the guidelines is established to provide evidence for the development/revision of the guidelines.
ObjectiveTo investigate and analyze the antibiotic use in Sichuan Province. MethodsAntibiotic use of inpatients was investigated in 23 hospitals on the day of June 25, 2011. ResultsThe percentage of antibiotic use was 42.4% in the total 27 144 inpatients, the range of which was between 24.3% and 63.3% for each hospital. And 63.8% of the antibiotic use was for therapeutic purpose, and 72.2% used only one antibiotic drug. A total of 36.9% of the patients receiving antibiotic treatment for therapeutic use sent samples for pathogenic detection. With the increase of the size of the hospital (judged by the number of beds), antimicrobial drug utilization decreased with statistical significance (χ2=411.834, P=0.000). With the improvement of regional economic level (judged by per-capita GDP of each region), the hospital antimicrobial usage decreased with statistical significance (χ2=500.093, P=0.000). The three types of antimicrobial drug most frequently used were other β-lactam antibiotics, penicillin and third generation cephalosporin. ConclusionAntibiotic use is reasonable in Sichuan Province as a whole. However, it is necessary to reduce irrational use of antimicrobial agents continuously, and to strengthen the management of clinical antibiotic usage among inpatients.