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.
Objective To analyze the incidence and mortality of asthma in China from 1990 to 2019, and to explore the influence of age, period and cohort on the incidence and mortality of asthma. Methods Using the Global Burden of Disease (GBD) 2019 database, the incidence and mortality of asthma in China from 1990 to 2019 were analyzed, and the time variation trend of age-standardized incidence and mortality was analyzed by using Joinpoint software, and the average annual variation percentage was calculated. The age-period-cohort model was constructed to analyze the influence of age, period and birth cohort on the incidence and mortality trend of asthma. Results In 2019, the incidence of asthma in China was 264.44/100 000, and the mortality rate was 1.74/100 000. The incidence rate of asthma in males (300.94/100 000) and mortality rate (1.99/100 000) were higher than those in females (226.51/100 000 and 1.49/100 000). From 1990 to 2019, the age-standardized incidence of asthma in China showed a downward trend, but the trend was not statistically significant (P>0. 05), and the age-standardized mortality showed a downward trend, with an average annual decrease of 4.90%, with a statistically significant trend (P<0.05). The results of age effect showed that the incidence of asthma in China showed a downward trend, and the death first showed a downward trend, and then increased in the age group of 55-59. The results of period effect show that the risk of asthma is decreasing, and then it is increasing from 2015 to 2019, and the risk of asthma mortality is decreasing. The results of cohort effect show that the later people are born, the lower the risk of asthma onset and death. The death of asthma is attributed to behavioral risk, high body mass index and tobacco, and the occupational risk tends to decrease. ConclusionsFrom 1990 to 2019, the incidence and mortality of asthma in China showed a decreasing trend, and the incidence and mortality of men were higher than that of women. The risk factors of behavioral risk, high body mass index and tobacco were still on the rise, so corresponding measures should be taken to carry out early screening, early detection, and early treatment for key populations.
An experimental study was designed on the treatment of 8 superficial burn wounds and 5 wounds after removing the split-thickness skin grafts with 200GS permanent magnetic flat dressings, and some of the wounds were chosen at random which did not received any treatment and would be served as control. It was noted that the volume of exudate in the treatment group was 11.9 50.7％ less than that of the control group, and the total protein, the albumin and globulin contents in the treatment cases were far less in exudate than those of the control cases. It was concluded that the magnetic therapy not only decresed the exudate, but also diminished the amount of total protein, albumin and globulin in the exudating fluid and it was of benefit to wound recovery.
This article introduces the exploration and establishment of “grass-roots Party building + targeted poverty alleviation” model by the Party Branch of Emergency Department of West China Hospital of Sichuan University, and discusses how to establish the “trinity mode” of management support, personnel training, and on-site guidance under the leading of grass-roots Party building through a series of the branches combined activities, according to the core idea of “strengthening the Party construction, bringing people closer together, and promoting development”. The aim is to form a long-term mechanism of grass-roots Party building and targeted medical poverty alleviation through continuously implementing this model, which can benefit more people in remote and ethnic minority areas and contribute to “Healthy China 2030”.
Objective To summary the incidence rate and trends of cancers in China. MethodsBy compiling and analyzing the Chinese Cancer Registry Annual Report from 2008 to 2021, we summarized the regional and population distribution characteristics of overall and high-incidence rate cancers in China and analyzed influencing factors. ResultsFrom 2005 to 2018, the overall crude incidence of cancers in China showed a continuous upward trend. The incidence rate in the eastern region (incidence rate was 353.26/100 000 in 2018, the following data were crude incidence rate in 2018) was significantly higher than those in the central (269.47/100 000) and western regions (253.71/100 000), while the incidence rates in the central and western regions were closer. 2005–2018, the incidence rates of male was higher than that of female, and the population aged 80 years old or older (2 741.02/100 000) had the highest incidence rate of cancers, and the incidence rate of people aged 0–14 years old (41.38/100 000) was the lowest. From 2005–2018 (except for 2009), lung cancer (65.05/100 000), gastric cancer (27.03/100 000), liver cancer (27.42/100 000), colorectal cancer (30.51/100 000), and breast cancer (43.02/100 000) were the top 5 highest incidence rates of China’s cancers, of which lung cancer ranked the first in different regions, and the ranking of other cancers varied in different regions. The top 5 cancers in males’ incidence rates from 2005 to 2018 were lung cancer (83.45/100 000), gastric cancer (37.12/100 000), liver cancer (40.02/100 000), colorectal cancer (35.32/100 000) and esophageal cancer (26.30/100 000); the top 5 cancers in females’incidence rates had changed a lot in different years, breast cancer, lung cancer, colorectal cancer, gastric cancer, liver cancer, thyroid cancer and cervical cancer had all been in the top 5, for example, in 2018, the top 5 cancers in female were lung cancer (46.10/100 000), breast cancer (43.02/100 000), colorectal cancer (25.56/100 000), thyroid cancer (24.60/100 000) and cervical cancer (18.10/100 000).ConclusionsThe crude incidence rate of cancers in China continues to rise, with the cancer spectrum showing new characteristics that combine high-incidence rate cancers in developed countries (e.g., breast cancer, colorectal cancer) with common cancers in developing countries (e.g., gastric cancer, liver cancer). The situation of cancer prevention and control remains challenging.
ObjectivesTo evaluate the fairness of medical resource allocation in the five provinces in Northwest China from 2006 to 2017 so as to provide scientific basis for the optimal allocation of medical resources in Northwest China.MethodsThe Gini coefficient and Theil index were adopted to evaluate the fairness of medical resource allocation from the two dimensions of population and geography.ResultsThe Gini coefficient was above 0.4 in terms of population allocation and geographical distribution in the five provinces in Northwest China from 2006 to 2011, which indicated the medical resources were unbalanced in the five provinces. The Gini coefficient had gradually declined from 0.4 from 2012 to 2017, which indicated the equity of medical resource allocation in the five provinces in Northwest China had gradually become reasonable. The total Thiel index of medical resources in the five northwest provinces in Northwest China from 2006 to 2017 ranged from 0.0829 to 0.187 4. Equity of medical resource allocation: allocation by population was superior to that by geography.ConclusionsIt is necessary to optimize the structure of human medical resources in the five northwest provinces, promote the coordinated development of medical human resources allocation, and narrow the gap of medical resources among the five provinces in Northwest China.
Abstract： Objective To analyze the manifestation, treatment，outcome and potentially predisposing risk factors of perioperative thromboembolism after cavo-pulmonary connection, and to assess the effects of our prophylactic antithrombotic strategy. Methods Clinical data of 264 cases of bidirectional Glenn and 224 cases of total cavopulmonary connection （TCPC） operations undertaken from September 2005 to December 2010 in Fu wai hospital were retrospectively analyzed. Perioperative thromboembolic complications occurred in 9 patients. 5 of them were after bidirectional Glenn, 4 were after TCPC. Most of the 9 patients had at least one thrombi-related risk factor. The routine prophylactic antithrombotic therapy after these operations were intravenous infusion of heparin 10 U/（kg·h） initially, followed with oral aspirin 1-3 mg/（kg·d）. Results Thromboembolic events occurred within 7 days after the operation in 6 cases, appeared 2 to 4 weeks after the surgery in 3 cases. All 9 patients received anticoagulation with heparin. One patient also undertook take-down operation. 3 （33%） patients died, accounting for 33% （1/3）, and 18% （2/11） of the early deaths after bidirectional Glenn and TCPC operations. Clinical symptoms improved or disappeared in the remaining 6 patients. Conclusion The mortality of perioperative thromboembolic complications after cavo-pulmonary connection is high, consisting of the important cause of early deaths after these procedures. Our prophylactic anticoagulation strategy proved to be effective, though some thrombi-relatedrisk factors still need to be avoided.
In order to promote the responsible development of precision medicine in China, the current situation of precision medicine in three major fields (clinical, research and commercial) was briefly introduced, and key ethical issues or disputes in each field (including informed consent, return of incidental findings, and allocation of medical resources in the clinical field; informed consent, return of research results, and data use and sharing in the research field; genetic counseling, clinical utility of genetic testing, and use of data in the field of direct-to-consumer genetic testing) were discussed. It is necessary to actively meet these ethical challenges for the development of precision medicine in China.