ObjectiveTo systematically review the willingness rate of Chinese residents to renew family doctors contract services. MethodsPubMed, Web of Science, EMbase, ScienceDirect, CNKI, WanFang Data and VIP databases were electronically searched to collect cross-sectional studies related to the willingness of Chinese residents to renew family doctors contract services from inception to November 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 23 cross-sectional studies involving 22 629 subjects were included. The results of meta-analysis showed that the willingness rate of Chinese residents to renew family doctors contract services was 84.2% (95%CI 80.0% to 88.3%). The results of subgroup analysis showed that contracted residents who were surveyed in 2011 to 2015 (85.7%), living in eastern (87.0%) and urban (84.7%), above age 60 (88.5%), females (85.1%), non-married (86.5%), with primary school and below education level (91.4%), with employee medical insurance (84.5%) and residents medical insurance (85.2%), not working (77.9%), with high and medium levels of health status (84.5%), with chronic diseases (86.7%), preferred to consult general diseases in primary health care institutions (89.5%), and walking to nearby community health service institutions requiring less than 30 minutes (86.9%) had a relatively high willingness to renew contracts. The contracted residents whose health status improved (91.0%), medical expenses reduced (91.5%) and medical portability improved (88.4%), more satisfied with contracted services (85.3%), more trusted in contracted doctors (87.9%), knowing family doctors’ name (86.7%) and contact information (84.2%) and enjoying visiting medical service (79.7%), telephone follow-up (79.6%), and health files establishment (80.1%) were more willing to renew contracts. ConclusionCurrent evidence suggests that the willingness of Chinese residents to renew family doctors contract services is high, however, it remains to be improved. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
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.
Objective To compare the epidemic status of nosocomial infections (NIs) among medical institutions at different levels. Methods The cross-sectional surveys on prevalence rates of NIs, distribution of NIs, and antimicrobial use were conducted through combination of bedside investigation and medical record reviewing among all in-patients of 20 medical institutions in Baoshan District, Shanghai from 00:01 to 24:00 on November 12th 2014, December 9th 2015, and November 30th 2016, respectively. Results A total of 18 762 patients were investigated, the prevalence rate of NIs in the first, second, and third class hospitals were 5.36%, 2.37%, 1.68%, respectively (χ2=88.497, P<0.05). The main NIs sites were lower respiratory tract, urinary tract, and upper respiratory tract in the first and second grade hospitals; while were other unclassified sites, respiratory tract, and upper respiratory tract in the third grade hospitals. The utilization rates for antimicrobial in the first, second, and third grade hospitals were 5.88%, 31.64%, and 42.11%, respectively (χ2=928.148, P<0.05); submission rates for specimen were 9.82%, 48.89%, and 82.39%, respectively (χ2=601.347, P<0.05). Four cases of pathogen were reported in the first grade hospitals, 94 in the second grade hospitals, and 96 in the third grade hospitals. The in-patients in different hospitals with different genders, ages, and departments had a statistical difference in prevalence rate of NIs (P<0.05) . Conclusion The first grade hospitals need to enhance the etiological examination; the third grade hospitals should severely restrict the antimicrobial utilization, and refine the prevention and control work for NIs.
ObjectiveTo evaluate the quality of life of residents in stricken area five years after Wenchuan earthquake, so as to explore the main influential factors such as gender, age, ethnic group, marriage status and the extent affected by the earthquake. MethodsUsing WHOQOL-BREF, 500 residents from Hanyuan county in Sichuan province were assessed in order to analyze their life quality and related factors. ResultsThe score on the overall WHOQOL-BREF and the level of each factor were significantly lower than the score on the normal people (P < 0.001). Male score in the factor of social relations significantly higher than female (t=3.963, P < 0.001). The overall score and the score of social factor were significantly lower in the minor than in the adults (t=-2.667, P < 0.01; t=-19.287, P < 0.001). And the quality score of social relationship was significantly lower in the single than in the married and cohabiting couples (P < 0.001; P < 0.01). ConclusionThe quality of life of residents in stricken area five years after Wenchuan earthquake was significantly lower than the national norm. There are significant differences in terms of gender, age, marriage status and earthquake damage on social relations. Steady intimate relationships with others help improve the quality of life of residents in stricken area. Besides, compared those with average damage or no damage, the residents with serious damage are relatively worse in the overall quality of life as well as environmental conditions.
ObjectivesTo systematically review the complications of knee arthroscopic surgeries in China.MethodsWe searched PubMed, EMbase, CNKI, WanFang Data and VIP databases to collect cross-sectional studies on the complications of knee arthroscopic surgeries in China from inception to March 1st, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 36 studies involving 20 740 cases were included. The results of meta-analysis showed the incidence rate of complication in knee arthroscopic surgeries in China was 9.71% (95%CI 8.20% to 11.23%). Subgroup analysis showed that the complication incidence rates in the eastern, central and western regions were 10.04% (95%CI 8.00% to 12.14%), 9.67% (95%CI 6.57% to 12.76%) and 7.47% (95%CI 6.20% to 8.73%). The complication incidence rates in the upper first-class and non-upper first-class hospitals were 9.50% (95%CI 7.83% to 11.17%) and 10.95% (95%CI 6.75% to 15.14%). The top 3 complication types with highest incidence rate included joint effusion［2.16% (95%CI 1.44% to 2.87%)］, accidental injury of native structures［1.49% (95%CI 0.96% to 2.03%)］ and hemorrhage［1.43% (95%CI 1.01% to 1.84%)］. Other severe complications including neurovascular injury, thrombosis diseases and infection were 0.06% (95%CI 0.02% to 0.11%), 0.33% (95%CI 0.19% to 0.48%) and 0.08% (95%CI 0.03% to 0.13%).ConclusionsCurrent evidence shows that the complication incidence rate of arthroscopic surgeries in China is relatively high and the complication type is complex and varied. Due to the quantity and quality of the included studies, more high-quality studies are required to verify the above conclusions in future.
ObjectivesTo systematically review the risk factors of acute fatigue in patients with stroke.MethodsPubMed, Web of Science, EMbase, The Cochrane Library, CNKI, VIP and WanFang Data databases were electronically searched to collect case-control studies, cohort studies and cross-sectional studies on the risk factors of acute fatigue in patients with stroke from inception to April, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 14 studies involving 2 658 objects and 13 risk factors were included. The results of meta-analysis showed that: female (OR=1.54, 95%CI 1.23 to 1.94, P=0.000 2), rural residence (OR=1.46, 95%CI 1.11 to 1.91, P=0.007), diabetes mellitus (OR=1.54, 95%CI 1.24 to 1.92, P<0.000 1), hyperlipidemia (OR=1.41, 95%CI 1.10 to 1.80, P=0.007), coronary heart disease (OR=1.94, 95%CI 1.30 to 2.89, P=0.001), previous stroke history (OR=1.54, 95%CI 1.07 to 2.23, P<0.000 01), pre-stroke fatigue (OR=4.51, 95%CI 3.33 to 6.09, P<0.000 01), basal ganglia stroke (OR=2.76, 95%CI 1.21 to 6.29, P<0.000 01), NIHSS >3 (OR=2.11, 95%CI 1.59 to 2.79, P<0.000 01), admission glucose level (OR=1.08, 95%CI 0.38 to 1.78, P=0.003), post-stroke sleep disorder (OR=2.40, 95%CI 1.87 to 3.07, P<0.000 01), post-stroke pain (OR=2.32, 95%CI 1.56 to 3.45, P<0.000 1) and post-stroke depression (OR=3.31, 95%CI 1.94 to 5.66, P<0.000 1) were risk factors of acute fatigue in patients with stroke.ConclusionsCurrent evidence shows that female, rural residence, diabetes mellitus, hyperlipidemia, coronary heart disease, previous stroke history, pre-stroke fatigue, basal ganglia stroke, NIHSS>3, admission glucose level, post-stroke sleep disorder, post-stroke pain and post-stroke depression are the risk factors of acute fatigue in patients with stroke. Medical staff should strengthen targeted preventive care for high-risk patients with related risk factors in order to reduce the incidence of post-stroke fatigue and improve the clinical prognosis outcome of patients.
ObjectiveTo analyze disease constitution and cost analysis of inpatients in the department of gynaecology of the Chengdu Women's and Children's Central Hospital in 2013, so as to get known of the patients' demands in diagnosis and treatment, and to provide evidence for further studies. MethodsWe collected information of 5 663 cases through medical records in 2013, standardized disease names according to the WHO international classification of diseases (ICD-10), and classified the kinds of diseases according to the first diagnosis of discharge records. Then we adopted the Excel software for data sorting and statistical analysis. Resultsa) Most of the inpatients were women at childbearing age. The diseases pectrum included 13 categories, with the top 3 systematic diseases including diseases during pregnancy/childbirth and puerperium (50.19%); diseases of the genitourinary system (29.31%), and neoplasms (15.54%). b) According to the ICD-10, the top 5 single diseases during pregnancy/childbirth and puerperium were ectopic pregnancy, abortion, missed abortion, threatened abortion, and hyperemesis during pregnancy; the top 5 single diseases of the genitourinary system were endometrial polyps, ovarian endometriosis cyst, uterine adenomyosis, female secondary infertility, and uterus adhesion; the top 5 single diseases of neoplasms were uterine fibroid, ovarian benign tumour, ovarian teratoma, cervical malignant tumour, and cervical carcinoma in situ. c) The average hospital stay in this department in 2013 were 6.31 days, and the average cost per capita were 6 051.10 yuan, with the top 3 kinds of costs including drugs (28.82%), operation (26.32%), and examination (20.09%). ConclusionMost of the inpatients are women at childbearing age in the department of gynaecology of the Chengdu Women's and Children's Central Hospital in 2013. Ectopic pregnancy, abortion and leiomyoma etc., are commonly-seen in this department. The average hospital stay of the inpatients is relatively short. Drugs and surgeries are main costs during hospitalization. Based on commonly-seen gynaecological disease burden, this hospital should urgently need to reinforce the construction of the specialized subjects, look for their own advantages, increase or adjust manpower, material resources and financial investment according to targets, so as to improve the quality and efficiency of medical service.
ObjectiveTo systematically review vitamin D nutritional status among children and adolescents in China.MethodsCNKI, CBM, WanFang Data, VIP and PubMed databases were electronically searched to collect cross-sectional studies on vitamin D nutritional status among children and adolescents in China from inception to September, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by using Stata 11.0 software.ResultsA total of 23 cross-sectional studies involving 38 047 total sample size were included.The results of meta-analysis showed that the combined vitamin D deficiency rate was 27.9% (95%CI 21.9% to 33.8%), and the inadequate rate was 31.6% (95%CI 25.7% to 37.6%).Subgroup analysis showed that vitamin D deficiency rate of females was higher than that of males (25.3% vs. 22.5%). The vitamin D deficiency rate of children aged 10 to 18 was higher than those aged 6 to 9 (44.9% vs. 32.9%). The vitamin D deficiency rate of children in the north was higher than that in south (36.1% vs. 14.8%). The vitamin D deficiency rate from 2015 to 2018 was higher than that from 2011 to 2014 (34.9% vs. 17.6%). In addition, the vitamin D deficiency rate ofurban children was higher than that of rural children (29.9% vs. 24.9%).ConclusionsThe incidence of vitamin D deficiency among children and adolescents is high in China. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo systematically evaluate the prevalence of diabetes in the elderly with frailty.MethodsPubMed, EMbase, Web of Science, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect cross-sectional studies on the prevalence of diabetes in the elderly with frailty from inception to November 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; meta-analysis was then performed by using Stata 15.0 software.ResultsA total of 21 cross-sectional studies involving 22 403 subjects were included. The pooled prevalence of diabetes in the elderly with frailty was 34% (95%CI 26% to 43%). Subgroup analysis showed that the prevalence of diabetes in patients with frailty in Asia and South America was higher than those in Europe and North America. The prevalence of diabetes in patients with frailty using physical frailty measures to evaluate frailty was higher than using multidimensional frailty measures. The prevalence of diabetes in patients with frailty in outpatient and hospital were higher than those in the community.ConclusionsCurrent evidence suggests that the prevalence of diabetes is high in the elderly with frailty.
ObjectiveTo systematically review the current status of tooth loss among elderly individuals in China.MethodsDatabases including CNKI, VIP, CBM, WanFang Data, PubMed, EMbase, and The Cochrane Library were searched to identify studies on the current status of tooth loss in the Chinese elderly from inception to December 31st, 2020. Two reviewers independently screened literature, extracted data, and assessed risk of bias of the included studies. Meta-analysis was then performed using Stata 16.0 software.ResultsA total of 26 studies with a sample size of 17 523 participants were included. The results of the meta-analysis showed that the prevalence rate of tooth loss among the Chinese elderly was 84.7% (95%CI 81.8% to 87.6%). Subgroup analysis showed that the tooth loss prevalence rates were higher in females, individuals aged over 75, and those living in rural areas or southwest China.ConclusionsThe current evidence shows that the prevalence rate of tooth loss among the Chinese elderly is high. Due to the quantity and quality of the included studies, the above conclusions are needed to be verified by more high-quality studies.