Implication of Reported Viral Hepatitis Incidence Rate Change in Hubei Province, China, between 2004-2010

This study examined the change of reported incidence rate for viral hepatitis in Hubei province, China, between 2004 to 2010 to provide scientific evidence for viral hepatitis control. Reported viral hepatitis infection cases were queried from Centre for Disease Control of Hubei Province, China. The incidence of viral hepatitis A decreased steadily across the study period. Viral hepatitis B composed 85% of the viral hepatitis cases. When reported incidence rates for chronic hepatitis B increased, the rates of acute and unclassified cases dropped from 2005 to 2010. The reported viral hepatitis B incidence rate for males was around 1.5-2 times higher than for females. The average annual percentage change of reported viral hepatitis B incidence rates was 4%. The same index for viral hepatitis C was 28%. The reported viral hepatitis B incidence rate of people under 20 years old declined over the period. This decrease was mainly attributed to the recent implementation of vaccination plan. Reported incidence rate of viral hepatitis E also rose in those years. Having a better understanding on reported incidence rates of the present surveillance system is important for developing strategies for further prevention of viral hepatitis. In addition, the data showed that a surveillance system that differentiates new and former infected cases will be more effective in providing evidence for disease control.

Simple colonoscopy reporting system checking the detection rate of colon polyps

AIM: To present a simple colonoscopy reporting system that can be checked easily the detection rate of colon polyps.METHODS: A simple colonoscopy reporting system Kosin Gastroenterology(KG quality reporting system) was developed. The polyp detection rate(PDR),adenoma detection rate(ADR),serrated polyp detection rate(SDR),and advanced adenoma detection rate(AADR) are easily calculated to use this system.RESULTS: In our gastroenterology center,the PDR,ADR,SDR,and AADR test results from each gastroenterologist were updated,every month. Between June 2014,when the program was started,and December 2014,the overall PDR and ADR in our center were 62.5% and 41.4%,respectively. And the overall SDR and AADR were 7.5% and 12.1%,respectively.CONCLUSION: We envision that KG quality reporting system can be applied to develop a comprehensive system to check colon polyp detection rates in other gastroenterology centers.

Fish Consumption Advisories and the Surprising Relationship to Prevalence Rate of Developmental Disability as Reported by Public Schools

According to the Environmental Protection Agency (EPA), fish consumption is the most significant route of mercury exposure, and the concern is greatest for women of childbearing age due to the potential for neurodevelopmental effects on a developing fetus. Rates of developmental disorders vary. But in 2008 it was demonstrated that the rate of autism is higher near industries that emit heavy metals. Furthermore past research findings can be taken to show that where a pregnancy occurred may predict later autism likelihood in the offspring more than where diagnosis occurs. If mercury plays any role in developmental disabilities, the rate of disability should relate to any reliable direct measure of contamination. The current research focuses on one index of environmental mercury contamination. Specifically, mercury-related fish advisories are found to be a surprisingly strong predictor of a state’s autism rate, r = 0.48, p < 0.001. The relationship remains strong after controlling for student to teacher ratio and per pupil spending. It is argued that a secular increase in autism has been occurring and that prenatal exposure to heavy metal toxins may play a significant role. Because we suspect this finding may be of some interest, the full data set is provided in the appendix so that researchers can independently analyze the key findings which rely on CDC, EPA and IDEA data sets.

2019—2021年兰州市严重精神障碍患者管理治疗状况分析

目的:分析2019—2021年兰州市严重精神障碍患者管理治疗状况,为兰州市制定防治措施及精神卫生政策提供科学依据。方法:提取甘肃省严重精神障碍信息系统中2019—2021年兰州市严重精神障碍患者相关数据,并用Excel 2007进行统计分析。结果:甘肃省精神卫生监测信息系统显示2019—2021年兰州市在册严重精神障碍患者为11 310例、11 914例、12 295例,报告患病率为3.03‰、 3.19‰、 3.42‰,规范管理率为73.48%、 76.16%、 80.21%,患者面访率为72.25%、79.04%、81.53%,患者规律服药率为32.74%、43.76%、52.05%。结论:2019—2021年兰州市严重精神障碍患者报告患病率、规范管理率、患者面访率以及患者规律服药率均有提高,但报告患病率水平和患者规律服药率水平仍低于国家要求。严重精神障碍患者和家属的病耻感是导致报告患病率与规范管理率偏低的主要原因,而精神卫生资源分布的不均衡性导致远郊患者规律服药率偏低。

品管圈活动对腔镜手术器械报损率的影响研究

目的 探索应用品管圈手法对腔镜手术器械报损率的影响效果。方法 组建多部门联合的品管圈小组,选定“降低腔镜手术器械的报损率”为主题,选取改善前2022年8—10月复用腔镜手术器械3520件,其报损率2.33%,以其损坏类型作为研究对象,分析器械部件缺失和内芯、外鞘、手柄混淆的现状,进行解析并制定对策,应用愚巧法改进培训方案、创建“四点式”腔镜手术器械保养流程方法、修订细化查检表等措施。选取改善后2022年11月至2023年2月腔镜手术器械5213件为研究对象,研究其报损率来分析此次改善措施的效果。结果 改善后5213件腔镜手术器械的报损率降低至0.27%,差异有统计学意义(P<0.001),目标达成率为137.33%。对处理流程中的8种问题类型的两组数据进行比较,改善后均低于改善前,差异有统计学意义(P<0.001)。品管圈实施后,圈成员的品管圈手法、团队合作能力、沟通能力、责任心、专业能力、解决问题能力都有一定程度提升。结论 通过品管圈活动在降低腔镜手术器械报损率的同时,科学应用管理工具多部门联动规范工作流程、制定器械报损的评分标准可以落实手供同行评议督查模式,保障医疗器械使用安全,值得应用推广。

Reconstruction of incidence reporting rate for SARS-CoV-2 Delta variant of COVID-19 pandemic in the US

In recent years,advanced regularization techniques have emerged as a powerful tool aimed at stable estimation of infectious disease parameters that are crucial for future projections,prevention,and control.Unlike other system parameters,i.e.,incubation and recovery rates,the case reporting rate,Ψ,and the time-dependent effective reproduction number,R_(e)t,are directly influenced by a large number of factors making it impossible to pre-estimate these parameters in any meaningful way.In this study,we propose a novel iteratively-regularized trust-region optimization algorithm,combined with SuSvIuIvRD compartmental model,for stable reconstruction ofΨand R_(e)t from reported epidemic data on vaccination percentages,incidence cases,and daily deaths.The innovative regularization procedure exploits(and takes full advantage of)a unique structure of the Jacobian and Hessian approximation for the nonlinear observation operator.The proposed inversion method is thoroughly tested with synthetic and real SARS-CoV-2 Delta variant data for different regions in the United States of America from July 9,2021,to November 25,2021.Our study shows that case reporting rate during the Delta wave of COVID-19 pandemic in the US is between 12%and 37%,with most states being in the range from 15%to 25%.This confirms earlier accounts on considerable under-reporting of COVID-19 cases due to the impact of”silent spreaders”and the limitations of testing.

微生物检验过程中微滤膜分离技术的应用价值

目的探讨微生物检验过程中微滤膜分离技术的应用价值。方法以2022年1月—2023年6月济南市疾病预防控制中心接收的86份微生物待检样本为研究对象。从每份待检样本中各取10 mL以平板计数法进行微生物检验,另各取10 mL基于微滤膜分离技术获取菌细胞进行微生物检验。比较2种检验方法的微生物检出率、微生物检验出报告时间与活菌回收率,评价检验效果。结果2种方法共检出阳性样本47份,其中微滤膜分离技术检出45份,占比为95.74%,平板计数法检出阳性样本47份,占比为100%。2种方法的初检86份样本的阳性检出率比较,差异无统计学意义(P>0.05);基于复检结果,微滤膜分离技术初诊漏检2例,2种方法的复检阳性率与漏检率比较,差异无统计学意义(P>0.05)。微滤膜分离技术的平均培养时间(20.24±3.17)h,短于平板计数法的(32.75±4.36)h,差异有统计学意义(P<0.05)。随机抽样回收率实验,微滤膜分离技术的阳性菌回收率分别为87.69%、87.50%、79.07%、67.86%、83.51%,高于平板计数法的72.01%、71.38%、64.19%、47.32%、65.64%,差异有统计学意义(P<0.05)。结论微生物检验中应用微滤膜分离技术的阳性检出率与平板计数法相当,但前者的培养时间更短,微生物检验出报告时间早,阳性菌回收率更高,效果优于平板计数法。

某三甲医院药品不良反应回顾性分析

目的:回顾和分析某三甲医院药品不良反应(ADR),了解该院药品ADR发生的特征及规律,为临床更加安全、有效、合理地用药提供参考。方法:收集2022年1—12月该院上报国家药品不良反应监测中心的396例ADR报告,对ADR报告进行回顾性统计分析。结果:该院上报的396例ADR报告中,男女性别比为1:1,45~64岁的患者发生ADR的比例最高(154例,占38.89%);报告者以医生为主(290例,占73.23%);静脉给药方式引发ADR最多(273例,占68.94%);抗感染药引起的ADR最多(158例,占39.90%);ADR累及器官或系统以皮肤及其附件最多(241例,占60.86%);99.75%(395/396)的ADR患者经治疗后好转或痊愈。结论:需加强针对临床医生和护士的ADR知识培训,提高对ADR的认识、上报率和上报质量,促进临床合理用药。

基于中国医院药物警戒系统建立地高辛不良事件主动监测电子触发器

目的 基于中国医院药物警戒系统(CHPS)探索建立地高辛药品不良事件(ADE)主动监测电子触发器。方法 通过查阅文献、药品说明书和不良反应数据库等,拟定地高辛ADE电子触发器初始条目;采用德尔菲(Delphi)专家调查法,对电子触发器条目进行修订;利用某三甲医院使用地高辛的住院患者病历进行回顾性审查,计算电子触发器的阳性预测值(PPV),并与医院不良事件自发上报数据进行比对。结果 初拟地高辛ADE电子触发器条目18项,经德尔菲法调查和讨论后,利用CHPS系统集成建模工具,将16项电子触发器条目设置成主动监测方案,其中实验室指标4项、解毒剂2项、临床症状7项、干预措施3项,电子触发器总体PPV为29.37%(79/269)。电子触发器检出并经人工审核确定的真阳性ADE病例41例,检出率为13.67%(41/300),而不良反应监测系统同期自发上报率为0。结论 基于CHPS建立的电子触发器可有效用于主动监测医疗机构ADE,增强监测敏感性,提高不良反应上报率。

PDCA循环法对急诊标本周转时间合格率的影响

目的探讨运用PDCA循环法后,急诊检验标本周转时间(TAT)合格率的变化。方法统计分析西北妇女儿童医院医学检验中心2022年1月至4月共8455例急诊标本报告,统计标本TAT合格率并采用鱼骨图分析不合格原因及处理措施;统计运用PDCA循环法后2022年5月至2023年1月共20140例急诊标本报告,比较PDCA循环法实施前后急诊标本TAT合格率的变化。结果PDCA实施后,急诊标本TAT合格率高于PDCA实施前,差异有高度统计学意义(P<0.001)。其中不同急诊项目中,除免疫发光外,急诊血常规、尿常规、粪常规、血凝四项和生化标本TAT合格率均较PDCA循环前升高,差异有高度统计学意义(P<0.001)。结论通过PDCA循环管理法,西北妇女儿童医院医学检验中心急诊标本TAT合格率得到了明显提升,这不仅提升了检验效率和临床服务,同时对急、危重患者的及时救治具有重要意义。

基于简化的甲状腺影像报告和数据系统预测甲状腺癌被膜侵犯

目的通过简化甲状腺影像报告和数据系统(TI-RADS)的赋值过程并提出新的分级系统,探讨简化的TI-RADS(sTIRADS)预测甲状腺癌被膜侵犯的可行性。资料与方法回顾性分析2018年1月—2021年1月首都医科大学附属北京天坛医院749个甲状腺结节的超声声像图,根据病理结果分为良性组230个、恶性组519个。收集两组超声征象,并计算OR值(OR>1赋值1分,OR<1赋值0分),使用受试者工作特征曲线评价sTI-RADS鉴别良、恶性结节的效能;根据手术结果筛选出明确记录与被膜有关系的265例恶性结节并分为有被膜侵犯组67例和无被膜侵犯组198例,对两组患者超声及临床资料进行单因素及Logistic回归分析。结果749例甲状腺结节赋值为0、1、2、3、4、5分对应的恶性率分别为1.52%、7.69%、38.24%、76.00%、90.75%、93.75%;以≥3分作为诊断甲状腺恶性结节的临界值时,敏感度和特异度分别为94.03%和67.39%;sTI-RADS分级为:3级,0分,恶性率<2%;4a级,1分,恶性率2%~10%;4b级,2分,恶性率10%~50%;4c级,3分,恶性率50%~90%;5级,4分或5分,恶性率>90%。有被膜侵犯组和无被膜侵犯组常规超声见被膜受累与sTI-RADS分级差异有统计学意义(χ^(2)/t=12.88、-1.26,P≤0.2);常规超声见被膜受累是甲状腺癌被膜侵犯的独立预测因素(P<0.01),sTI-RADS不是甲状腺癌被膜侵犯的独立预测因素(P=0.80)。结论sTI-RADS在甲状腺良、恶性结节鉴别诊断中具有较高效能,甲状腺癌被膜侵犯组中sTI-RADS分级更高,而常规超声见被膜受累是甲状腺癌被膜侵犯的独立预测因素。

ESG报告文本质量对ESG评级分歧的影响

作为衡量上市公司ESG表现的重要指标,第三方评级机构发布的ESG评级受到了利益相关者的广泛关注。然而,不同评级机构对于同一家公司的ESG评级存在分歧,导致利益相关者难以准确了解公司真实的ESG表现。作为评级机构的重要信息来源,ESG报告的文本质量会影响评级机构对公司ESG表现的判断,进而影响评级分歧。以2018-2022年我国A股上市公司为样本,运用文本分析技术从语调、可读性、报告长度、前瞻性信息四个文本语言特征的角度构建上市公司ESG报告文本质量指标,探究ESG报告文本质量对ESG评级分歧的影响。研究发现,ESG报告文本质量越高,ESG评级分歧越小。进一步分析发现,ESG报告的语调越消极、可读性越强、长度越长、前瞻性信息越多,ESG评级分歧就越小。此外,ESG报告文本质量的提高对环境、社会责任和公司治理等不同维度的评级分歧均有显著抑制作用;相较于自愿披露,强制披露下ESG报告文本质量的提高对ESG评级分歧的抑制作用更为显著。因此,上市公司应高度重视ESG报告的文本质量,确保ESG报告逻辑清晰、易于理解、内容详实且具有前瞻性;监管机构应扩大强制披露ESG报告的上市公司范围,并加强对ESG报告文本质量的监管。

基于Python的平均流量自动计算报送系统的设计与实现

平均流量信息报送是水情工作重要任务之一。通过使用Python、pymssql、SQL Server、JSON等相关技术,设计并实现一个自动计算并报送日、旬、月平均流量的系统,实现平均流量的自动计算、自动报送功能。该系统自动计算速度快、耗时少、计算结果准确,可减轻水文测站的一部分工作量,提升工作效率,降低失误率,具有一定的实用价值。

TI-RADS 4类甲状腺结节患者的超声弹性应变率比值与结节性质的关联

目的探讨甲状腺影像报告和数据系统(TI-RADS)4类甲状腺结节患者的超声弹性应变率比值(strain ratio,SR)与结节性质的关联。方法选择2018年1月~2023年2月于武汉科技大学附属汉阳医院接受治疗的95例甲状腺结节患者(结节数共128枚)为研究对象,根据病理学检查结果分为良性组(n=50)和恶性组(n=45),比较两组患者的一般资料。利用最小绝对收缩选择算子(least absolute shrinkage and selection operator,LASSO)回归法和多因素Logistic回归分析影响患者结节性质的危险因素。按SR从低到高等分为五分位数组(Q1~Q5),比较5组患者的临床资料特征,并采用多因素Logistic回归分析SR与恶性结节风险的相关性,建立限制性立方样条Logistic回归模型分析其剂量-反应关系。采用限制性三次样条回归法分析SR与甲状腺恶性结节中央区淋巴结转移风险的非线性关联。建立回归方程y=1-1/(1+e-z)预测模型并进行验证。结果良性组与恶性组患者在舒张末期血流速度(end diastolic velocity,EDV)、促甲状腺激素(TSH)、收缩期峰值血流速度(peak systolic velocity,PSV)、阻力指数(resistance index,RI)、SR之间的差异均有统计学意义(P<0.05);LASSO回归和多因素Logistic回归分析显示调整潜在混杂因素后,发现TSH、PSV、RI增大、EDV及SR降低均为影响患者结节性质的独立危险因素(P<0.05);SR与恶性结节风险存在独立相关性(OR=0.60,95%CI 0.41~0.81,P<0.001),且SR从低到高五分位数组趋势性检验差异有统计学意义(P趋势<0.001);限制性立方样条模型分析显示,男性或女性的SR与恶性结节风险均不存在非线性关系。限制性三次样条回归分析显示,SR和甲状腺恶性结节中央区淋巴结转移风险存在显著相关性。SR=-2.1时,线性P<0.0001。经Bootstrap自抽样,预测模型区分度、准确度较好。结论TI-RADS4类甲状腺结节患者的SR和结节性质具有独立相关性,SR能够通过病灶组织的硬度判断结节性质,对患者结节性质具有较好的预测价值。

主动管理空气消毒机效果分析

目的通过加强空气消毒机购置后的一系列主动管理措施,改善空气消毒机的日常工作状态,保障临床科室的空气质量。方法选择某三甲医院3个科室使用的73台壁挂式高压静电场空气消毒机(深圳某厂生产),其中Ⅱ类环境的介入手术室15台,Ⅲ类环境的肾病透析中心和普通内科病区分别为18台、40台。开展空气消毒机的使用培训、相关政策法规学习培训与考核,并建立科室双向随访响应评估制度,对上述主动管理措施实施前后空气消毒机的设备开机率、设备故障率、设备报修率和前置过滤网质量进行对比研究。结果普通内科病区主动管理前,空气消毒机设备开机率58.4%,设备故障率72.5%,设备报修率10.3%;主动管理后,设备开机率89.1%,设备故障率25.0%,设备报修率100.0%;主动管理前后设备开机率、设备故障率、设备报修率比较,差异有显著统计学意义(P=0.000)。肾病透析中心主动管理前,空气消毒机设备开机率64.6%,设备故障率19.4%,设备报修率28.6%;主动管理后,设备开机率91.0%,设备故障率8.3%,设备报修率100.0%;主动管理前后比较,差异有显著统计学意义(P=0.000)。介入手术室主动管理前,空气消毒机设备开机率77.5%,设备故障率20.0%,设备报修率100.0%;主动管理后,设备开机率95.8%,设备故障率13.3%,设备报修率100.0%;主动管理前后比较,开机率差异有显著统计学意义(P=0.000);设备故障率和设备报修率虽有差异,但差异无统计学意义。主动管理前,普通内科病区、肾病透析中心、介入手术室前置过滤网质量分别为(8.88±1.00)g、(8.51±0.78)g、(10.17±1.50)g,主动管理后普通内科病区、肾病透析中心、介入手术室前置过滤网质量分别为(10.72±0.86)g、(11.78±0.70)g、(10.73±0.64)g。普通内科病区、肾病透析中心、介入手术室前置过滤网质量明显高于主动管理前,其中普通内科病区、肾病透析中心前置过滤网质量差异有统计学意义(P<0.05);而介入手术室前置过滤网质量差异无统计学意义(P=0.338)。结论通过设备管理部门的主动管理和临床科室的配合,临床科室空气消毒机的使用工况得到明显改善,院内感染控制质量、设备管理科对临床科室的服务质量均获得提升,管理效果显著。

Analysis of State Homicide Rates Using Statistical Ranking and Selection Procedures

Nonparametric and parametric subset selection procedures are used in the analysis of state homicide rates (SHRs), for the year 2005 and years 2014-2020, to identify subsets of states that contain the “best” (lowest SHR) and “worst” (highest SHR) rates with a prescribed probability. A new Bayesian model is developed and applied to the SHR data and the results are contrasted with those obtained with the subset selection procedures. All analyses are applied within the context of a two-way block design.

Study on Early Warning Signals of Report on Adverse Reactions of Spontaneous Reporting System of Runzao Zhiyang Capsule

Spontaneous reporting system(SRS) is an important way to monitor the adverse drug reaction(ADR) and discover the ADR signal for marketed drugs. It can detect adverse reaction signals timely and effectively, and prevent the occurrence of drug damage. Runzao Zhiyang Capsule is mainly composed of Radix Polygoni Multiflor, Radix Polygoni Multiflori Preparata, Radix Rehmanniae Recens, Radix Sophorae Flavescentis, Folium Mori and Urtica dentata Hand.-Mazz. It has the functions of nourishing blood, nourishing yin, expelling wind to relieve itching and moistening the intestines to relieve constipation. It is mainly used for skin itching, acne, constipation and other diseases caused by blood deficiency and wind dryness. The large, national SRS database of ADRs needs effective evaluation methods. We reported on the use of Bayesian confidence propagation neural network method(BCPNN) and reporting rate ratio method(PRR) with propensity score to control confounding variables. The tendency score method was used to control the hybrid bias produced by SRS data analysis. After the calculation of PRR and BCPNN, the score of "diarrhea", "rash" and "gastric dysfunction" showed that there was an early warning before and after matching. To sum up, it indicated that diarrhea, rash and gastric dysfunction were early warning signs.

长岛地震窗预报效能评估

1研究背景。“地震窗”或“震情窗”是指一些地震频度较高、地震丛集的小区域,如一些大震的余震区、经常发生小震群的区域等,这些区域对构造应力场的变化比较敏感,该区域地震频度或应变能等的异常变化有可能反映附近或较大区域的应力场的变化,从而可用于提取周围较大地区可能发生中强以上地震的前兆信息。“地震窗”可作为监视区域应力场的窗口,常用于地震短期预报。目前华北地区已用于震情监视的地震窗有邢台、海城、唐山等老震区和河南林州、安徽霍山等小震群区,山东地区常用的有“长岛地震窗”和“博山地震窗”。

Dietary manipulation and testosterone replacement therapy may explain changes in body composition after spinal cord injury: A retrospective case report

BACKGROUND Reduced level of physical activity,high-fat diet and skeletal muscle atrophy are key factors that are likely to contribute to deleterious changes in body composition and metabolic following spinal cord injury (SCI).Reduced caloric intake with lowering percentage macronutrients of fat and increasing protein intake may likely to improve body composition parameters and decrease ectopic adiposity after SCI.AIM To highlight the effects of dietary manipulation and testosterone replacement therapy (TRT) on body composition after SCI METHODS A 31-year-old male with T5 SCI was administered transdermal TRT daily for 16 wk.Caloric intake and percentage macronutrients were analyzed using dietary recalls.Magnetic resonance imaging and dual-energy x-ray absorptiometry were used to measure changes in body composition.RESULTS Caloric intake and fat percentage were reduced by 445 kcal/d and 6.5%,respectively.Total body weight decreased by 8%,body fat decreased by 29%,and lean mass increased by 7%.Thigh subcutaneous adipose tissue cross-sectional area was reduced by 31%.CONCLUSION Manipulation of caloric intake,fat percentage,and protein percentage may have influenced body composition after SCI.

践行“征信为民”理念助力龙江经济发展——访中国人民银行黑龙江省分行党委委员、副行长赵庆德

近年来,中国人民银行黑龙江省分行深入践行“征信为民”服务理念,助力龙江经济发展。一是不断优化征信服务工作管理流程,多渠道满足群众征信服务需求;二是持续探索征信助农模式和路径,促进金融更好服务“三农”经济发展;三是推动动产融资统一登记公示系统和中征应收账款融资服务平台的应用,助力黑龙江省动产融资业务取得积极进展;四是全力推动黑龙江省征信体系建设,积极推动筹建黑龙江省级地方征信平台;五是不断强化对辖内金融信用信息基础数据库接入机构征信业务行为的监督管理,从严履行监管职责;六是积极推进央行内部(企业)评级工作,拓宽金融机构再贷款渠道;七是持续加大征信宣传力度,不断拓展征信宣传的广度和深度。