网络化治理的慢性病管理文献计量分析与质量评价

目的了解网络化治理的慢性病管理研究发展趋势,为慢性病健康管理提供研究方向与信息支持。方法通过在中国知网(CNKI)数据库检索网络化治理的慢性病管理方面的关键词,获得相关文献,采用文献计量软件Cite Space绘制知识图谱,使用美国卫生保健质量和研究机构(AHRQ)推荐的质量评价标准对文献进行评价。结果共筛选出相关论文638篇,文献集中在2016-2022年发表,发文的各团队之间合作较为薄弱。关键词聚类分析结果显示,该领域研究聚焦为3类:1)网络化治理慢性病的具体实施途径;2)网络化治理的具体慢性疾病及人群;3)网络化治理慢性病的理论模式。随着时代发展,该领域现主要聚焦于借助互联网进行健康管理,“老年人”“小组工作”“综述”是该领域近期发文热点。文献质量评价结果显示,我国网络化治理的慢性病管理文献中以中等质量文献占比最多。结论我国网络化治理的慢性病管理领域的研究热度正逐步降低,其热点主题集中于“老年人”“小组工作”“综述”,我国网络化治理的慢性病管理领域研究还需在纳入与排除标准、解释排除对象、明确慢性病诊断标准等方面做更详细的工作。

ICU医护人员医疗成本意识现状及其影响因素分析

目的 了解重症监护病房(ICU)医护人员医疗成本意识的现状及其影响因素。方法 采用便利抽样法,于2022年9—12月选取四川省6所三甲综合医院工作的397名ICU医护人员为研究对象,采用汉化版医护人员医疗成本意识量表进行调查,并对ICU医护人员医疗成本意识的相关因素进行统计分析。结果 纳入医护人员中,医师132名、护士265名。ICU医护人员医疗成本意识整体水平较好,其中感知到控制医疗成本的责任维度最好,而感知到控制医疗成本的参与维度相对较差。有191名(48.11%)医护人员在学生期间或工作后均未接受过医疗成本效益的相关课程与培训。多因素线性回归分析提示,学生期间修读过关于医疗成本效益的课程(OR=3.924)、接受过医院或科室开展的关于医疗成本效益的培训(OR=1.542)是ICU医护人员医疗成本意识水平的影响因素。结论 医疗成本效益的专业培训可提高ICU医护人员医疗成本意识水平,建议在医学生培养课程中引入医疗成本效益课程,将医疗成本效益培训融合到医学继续教育中。

Analysis on Characters and Growth Factors of academicians of Agriculture Faculty of Chinese Academy of Engineering

The research analyzed birthplace, work site and Work unit, discipline, agri- cultural product variety, current age, and selected age, as well as internal and exter- nal factors for growth, which providers references for exploring development of high- level agricultural S＆T talents and formulation of relevant policies.

Epidemiological trends and geographic variation in hospital admissions for diverticulitis in the United States

AIM:To characterize the increasing incidence and geographic variation of acute diverticulitis.METHODS:Using the nationwide inpatient sample (NIS) we identified a cohort who had been admitted with diverticulitis between 1998 and 2005.We calculated age-,sex-,and region-specific rates of hospitalizations for diverticulitis over time.RESULTS:The age-adjusted hospitalization rate for diverticulitis increased from 61.8 per 100000 to 75.5 per 100 000 between 1998 and 2005,and increased similarly in both sexes.Diverticulitis-associated admissions were male-predominant in those younger than age 45 years but were female-predominant thereafter.Admission rates increased the most among those<45 years,while remaining unchanged for those≥65 years.By 2005,the majority of hospitalized patients were<65 years.Age-adjusted rates of diverticulitis-associated hospitalizations were lower in the West(50.4/100000) compared to the Northeast(77.7/100000),South (73.9/100000),and Midwest(71.0/100000).CONCLUSION:Diverticulitis-associated hospitalizations have steeply risen,especially in young adults.These epidemiological trends vary by geographic region and warrant further investigation into potential dietary and environmental etiologies.

Return on Investment after Implementation of a Centralized Automated Storage System in a Hospital Pharmacy

An ADS （automated dispensing system） was implemented in our hospital pharmacy in 2008 to optimize and secure the medication process. The main objective of this study was to compare the projected and the real ROI （return on investment）, after seven years of use. ROI was calculated annually （from 2008 to 2015）, by deducting the cost of investment （ADS buying and implementation, maintenance, repairs and ADS upgrade） from the cost saving （drugs stock reduction and decrease of pharmacy staff dedicated to global dispensing）. In 2015, total costs saving （＋$1,141,987） were divided between decreasing drug stock value and reduction of pharmacy staff. Total costs of investment （-$978,656） were acquisition, maintenance, repairs and an unplanned upgrade costs. Finally, the real ROI was ＋$163,331 after seven years of use. In 2008, projected ROI was ＋$410,786. The real payback period has been increased by approximately two years （six years of use, instead of four years as expected）. Despite their cost, ADSs are a worthwhile investment, leading to a ROI within a few years. These economic considerations should be put into perspective with optimization of drugs stock management, greater efficiency of the global dispensing process, securitization of medication process and redeployment of pharmacy staff.

Truth telling for patients with esophageal squamous cell carcinoma in Henan,China

Objective: This study aims to investigate the truth-telling status and the relevant factors of esophageal squamous cell carcinoma(ESCC) patients in Henan, China.Methods: A cross-sectional study from April to June 2015 using questionnaires was given to 301 family members of hospitalized ESCC patients based in three affiliated hospitals of Zhengzhou University(i.e., The First Hospital, The Second Hospital, and Tumor Hospital) and Anyang Tumor Hospital.Results: Among the 41.9%(126/301) hospitalized ESCC patients who knew of their true diagnoses, only 4.0% patients were informed by their corresponding responsible doctors, 39.7% by their family members, and 56.3% by themselves. Univariate analyses showed that disclosure of confirmed ESCC diagnosis to patients was correlated with gender, family history of cancer(FHC), education level, vocation, hospital administrative level, and attitudes of family members(P < 0.05). Furthermore,multivariate analysis indicated that attitude of family members was the most important and an independent factor for diagnosis disclosure. Those patients with a negative FHC, under-education, manual occupation, advanced stages, and hospitalized in municipal hospitals exhibited a low rate of truth telling.Conclusions: Truth telling for ESCC patients in Henan is not prevalent and may be improved through consultation with family members, particularly for patients with a negative FHC, poor education, manual occupation, and advanced stages.

Improvement of Isomerization Process of Crude Isoamylene with Tertiary-amyl-alcohol Addition

The present work contributed to a new developed production method for enhancing the quality of isoamylene （IA） by adding a small amount of tertiary amyl alcohol （TAA） to the catalyst of strong acid cation exchange resin. TAA improved the selectivity of 2-methyl-2-butene （2M2B） at a high conversion level for the isomerization of IA. Compared with the other results from the current IA units, the conversion of 2-methyl- 1-butene （2M1B）, the mass ratio of 2M2B to 2M1B and the selectivity of 2M2B were increased from 0.5474, 7.32 and 0.6864 to 0.72, 12 and 0.95, respectively, while the dimers content in the products decreased from 4.38% to below 1.0%. Optimized conditions for IA isomerization consisted of temperature between 28 and 33℃ and system pressure of 0.5 MPa, weight hourly space velocity of 8.0 h-1 with TAA mass fraction of 0.7%-0.9% in raw material. The results in lab supported bases for the developed process in industrial application which was later proved to be successful. In addition, a possible mechanism of the isomerization process was speculated to propose a key step of water formation in the TAA-added isomerization process and a verified experiment was conducted to support this speculation.

Surgical treatment of ulcerative colitis in the biologic therapy era

Recently introduced in the treatment algorithms and guidelines for the treatment of ulcerative colitis,biological therapy is an effective treatment option for patients with an acute severe flare not responsive to conventional treatments and for patients with steroid dependent disease.The reduction in hospitalization and surgical intervention for patients affected by ulcerative colitis after the introduction of biologic treatment remains to be proven.Furthermore,these agents seem to be associated with increase in cost of treatment and risk for serious postoperative complications.Restorative proctocolectomy with ileal pouch-anal anastomosis is the surgical treatment of choice in ulcerative colitis patients.Surgery is traditionally recommended as salvage therapy when medical management fails,and,despite advances in medical therapy,colectomy rates remain unchanged between 20% and 30%.To overcome the reported increase in postoperative complications in patients on biologic therapies,several surgical strategies have been developed to maintain long-term pouch failure rate around 10%,as previously reported.Surgical staging along with the development of minimally invasive surgery are among the most promising advances in this field.

Interannual and interdecadal variability of East Asian monsoon and its relation to oceanic processes: a review

A key component of the East Asian climate system is seasonally varying monsoon wind. Its interannual and interdecadal variability, as we1l as underlying oceanic processes, is the subject of a recent project completed by the Chinese Academy of Sciences. A series of research progress in the areas of monsoon winds, ocean responses, upwelling and productivity has been made and reviewed by this paper.

The Hospital Assessment Tool： An Integrated Solution to Evaluate and Reduce Solid Medical Waste

The Hospital Assessment Tool （HAT） is an assessment technique that provides technical support to the healthcare industry for accessing solid waste generation, selecting products, and work practices to eliminate or reduce environmental hazards and solid waste, and to maintain quality patient care. Since 2007, this tool has been applied as part of an innovative partnership between the Lucas County Solid Waste Management District and College of Engineering of the University of Toledo. The purpose of this paper is to provide a complete overview and framework of this program and the HAT so that other institutions may learn from it and adopt similar concepts to help reduce solid waste generation and improve economic conditions in their regions. A focus of this paper is a discussion of a case study that details the process and results of an assessment conducted at a large hospital in Northwest, Ohio, USA. Also, included in this paper is a discussion of the project＇s background, a comparison to similar project＇s between colleges and government agencies, and results and benefits of the program, and an overview of the opportunities and barriers to this type of research. The project demonstrates that through a cooperative effort and a creative alliance, businesses, governments, universities, and industries can work together to improve environmental quality, reduce waste, and improve profitability. The project also educates college students through practical, real-world environmental work experience and trains them to become future environmental leaders

Prognostic factors of response to endoscopic treatment in painful chronic pancreatitis

AIM To evaluate the endoscopic treatment efficacy and prognostic factors of long-term response to treatment for painful chronic pancreatitis.METHODS This retrospective analysis identified 168 patients with painful chronic pancreatitis hospitalized during January 2010-January 2015 in a Romanian tertiary referral center. Data on demographics, medical history, alcohol consumption, smoking habit, clinical parameters, type and number of endoscopic procedures and hospital admissions number were collected from the medical charts and analyzed. The absence or substantial reduction of pain(mild pain) at the end of the follow-up associated with the technical success of endotherapy was considered as clinical success. RESULTS Among the 168 patients with painful chronic pancreatitis admitted to our department during the study period, 39(23.21%) had optimal response to the medical therapy. One hundred and twenty-nine patients required endoscopic treatment. The median follow-up period was 15 mo(range, 0-60 mo). Overall, technical success of endotherapy was achieved in 105 patients(81.39%). More than two-thirds of patients(82.78%) had substantial improvement of pain after the endoscopic treatment, including frequency and severity of the pain attacks. Patients younger than 40 years had significantly more successful endoscopic procedures(P = 0.041). Clinical success was higher in non-smoking patients(P = 0.003). The hospital admission rate was higher in patients with recognized alcohol consumption(P = 0.03) and in smokers(P = 0.027). The number and location of pancreatic stones and locations of strictures did not significantly influence the technical success(P > 0.05) or the clinical success(P > 0.05).CONCLUSION Younger age than 40 years can be considered an important factor positively influencing endoscopic treatment outcome in patients with painful chronic pancreatitis.

A Study of Higher Vocational Students＇ English Listening Comprehension Within the Framework of Relevance Theory

Listening comprehension plays a crucial and necessary part in people＇s daily communication and Second Language Acquisition （SLA）. It is an important way to communicate with others; also it is the foundation of mastering a foreign language. However, the higher vocational students usually lack the background information about the listening materials and seldom know how to make inferences according to the specific contexts. The author conducted an empirical study lasting one semester in Higher Vocational College of Dahongying University trying to apply Relevance Theory to listening comprehension and guide listening comprehension learning within the framework of Relevance Theory to finally improve higher vocational students＇ ability of listening comprehension.

Discussion on the Self-maintenance and Support mode of Training Equipment in Higher Vocational Colleges

University teaching and research equipment maintenance costs, rising with the rapid development of the school. Equipment as a teaching resource, should give full play to its role in the efficiency at the same time, from quality improve equipment management, reduce material consumption, two aspects of efforts to reduce maintenance costs, reduce maintenance expenses. This article by the necessity of self- maintenance, feasibility analysis and establish a competitive mechanism, and that this is a feasible way out equipment maintenance work of vocational collejzes need to adaot to the situation.

Discussion on the Self-maintenance and Support mode of Training Equipment in Higher Vocational Colleges

University teaching and research equipment maintenance costs, rising with the rapid development of the school. Equipment as a teaching resource, should give full play to its role in the efficiency at the same time, from quality improve equipment management, reduce material consumption, two aspects of efforts to reduce maintenance costs, reduce maintenance expenses. This article by the necessity of self- maintenance, feasibility analysis and establish a competitive mechanism, and that this is a feasible way out equipment maintenance work of vocational colleges need to adapt to the situation.

New Method for Synthesis of Formamide from CO_2

The research team headed by Ding Kuiling working in the State Key Laboratory of Metallorganic Chemistry at the CAS Shanghai Institute of Organic Chemistry by using the princer type ruthenium complex catalyst has successfully developed a new method for effectively synthesizing formamide compounds from CO_2,H2 and primary or secondary amines serving as the feedstocks.

我们家的鸡

小时候,我们家有个很大很大的院子,我常常做梦又回到了那里。刚搬到那儿时,院子里空荡荡的,什么都没有。后来,我们家和左右邻居家之间修起一道围墙,各自成院。为了说话方便,我们和左边邻居家的小孩儿把门口旁边的墙顶拆了几块砖,可还是要再踩着两块砖才能看得到对方的脸,我们不想出去玩时,就趴在墙上的豁口那儿说很久的话。后来,妈妈又买了些鸡,但喂鸡的事情大多时候都是我做。

Prevalence and treatment of hypertension in China： impacts of 2017 American College of Cardiology/American Heart Association High Blood Pressure Guideline

The definition, recommended treatment thresholds and targets of hypertension have been updated in the recent 2017 American College of Cardiology/American Heart Association(ACC/AHA) Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults. However,the impacts of this guideline on Chinese population are currently unknown. In this study, we aim to provide updated data in China using criteria from the updated guideline. A multistage, stratified sampling method was used to obtain a representative sample of 50,171 adults aged 18 years and above.Hypertension was defined as an average systolic blood pressure !130 mm Hg, or an average diastolic blood pressure !80 mm Hg, or self-reported use of antihypertensive medications in past 2 weeks. The weighted prevalence of hypertension was 60.1%(95% confidence interval [CI] 59.3%–61.0%). The treatment rate and recommended treatment rate were 16.8%(95% CI 16.1%–17.6%) and 53.7%(95% CI52.6%–54.9%), respectively; the gap was more prominent among men and participants from rural areas.Hence, the adoption of the 2017 ACC/AHA guideline will lead to a substantial increase in both prevalence and number of patients needing treatment in China. The applicability of this guideline should be carefully evaluated based on evidence from Chinese population.

Engineering imaging probes and molecular machines for nanomedicine

Nanomedicine is an emerging field that integrates nanotechnology, biomolecular engineering, life sciences and medicine; it is expected to produce major breakthroughs in medical diagnostics and therapeutics. Due to the size-compatibility of nano-scale structures and devices with proteins and nucleic acids, the design, synthesis and application of nanoprobes, nanocarders and nanomachines provide unprecedented opportunities for achieving a better control of biological processes, and drastic im- provements in disease detection, therapy, and prevention. Recent advances in nanomedicine include the development of func- tional nanoparticle based molecular imaging probes, nano-structured materials as drug/gene carders for in vivo delivery, and engineered molecular machines for treating single-gene disorders. This review focuses on the development of molecular imag- ing probes and engineered nucleases for nanomedicine, including quantum dot bioconjugates, quantum dot-fluorescent protein FRET probes, molecular beacons, magnetic and gold nanoparticle based imaging contrast agents, and the design and validation of zinc finger nucleases （ZFNs） and TAL effector nucleases （TALENs） for gene targeting. The challenges in translating nano- medicine approaches to clinical applications are discussed.

Impact of the zero-markup drug policy on volume of medical service:based on 57 county hospitals of China

In the present study,we aimed to assess the long-term impact of zero-markup drug policy on volume of medical service in county hospitals of China.This study used 57 county hospitals’records of medical service from 2011 to 2015,and a fixed effect model was applied to examine the impact of the zero-markup drug policy on volume of medical service.The outcome indicators included the number of patient visits,the number of prescriptions,the number of discharged patients,the length of stay,the number of patients who had surgeries and the number of patients who had CT or MRI,monthly.The number of hospitals which implemented the zero-markup drug policy was increased continuously.By the end of 2015,41 hospitals(71.9%)implemented this policy.The panel regression showed that most indicators were insignificantly decreased,including the number of patient visits(P<0.01),the length of stay(P<0.05),the number of patients who had surgeries(P<0.01)and the number of patients who had CT or MRI(P<0.01).However,the number of prescriptions and the number of discharged patients were not significantly changed.The implementation of the zero-markup drug policy might affect the reduction of the volume of medical service in county-level hospitals and the reason needs to be clarified in future studies.

Recent Progress in Distributed Optical Fiber Raman Photon Sensors at China Jiliang University

A brief review of recent progress in researches, productions and applications of full distributed fiber Raman photon sensors at China Jiliang University （CJLU） is presented. In order to improve the measurement distance, the accuracy, the space resolution, the ability of multi-parameter measurements, and the intelligence of full distributed fiber sensor systems, a new generation fiber sensor technology based on the optical fiber nonlinear scattering fusion principle is proposed. A series of new generation full distributed fiber sensors are investigated and designed, which consist of new generation ultra-long distance full distributed fiber Raman and Rayleigh scattering photon sensors integrated with a fiber Raman amplifier, auto-correction full distributed fiber Raman photon temperature sensors based on Raman correlation dual sources, full distributed fiber Raman photon temperature sensors based on a pulse coding source, full distributed fiber Raman photon temperature sensors using a fiber Raman wavelength shifter, a new type of Brillouin optical time domain analyzers （BOTDAs） integrated with a fiber Raman amplifier for replacing a fiber Brillouin amplifier, full distributed fiber Raman and Brillouin photon sensors integrated with a fiber Raman amplifier, and full distributed fiber Brillouin photon sensors integrated with a fiber Brillouin frequency shifter. The Internet of things is believed as one of candidates of the next technological revolution, which has driven hundreds of millions of class markets. Sensor networks are important components of the Internet of things. The full distributed optical fiber sensor network （Rayleigh, Raman, and Brillouin scattering） is a 3S （smart materials, smart structure, and smart skill） system, which is easy to construct smart fiber sensor networks. The distributed optical fiber sensor can be embedded in the power grids, railways, bridges, tunnels, roads, constructions, water supply systems, dams, oil and gas pipelines and other facilities, and can be integrated with wireless networks.