Natural history of spinal muscular atrophy in children: an analysis of 117 cases / 中国当代儿科杂志

OBJECTIVES@#To study the natural history of spinal muscular atrophy (SMA) in Chongqing and surrounding areas, China, and to provide a clinical basis for comprehensive management and gene modification therapy for SMA.@*METHODS@#A retrospective analysis was performed on the medical data and survival status of 117 children with SMA.@*RESULTS@#Of the 117 children, 62 (53.0%) had type 1 SMA, 45 (38.5%) had type 2 SMA, and 10 (8.5%) had type 3 SMA, with a median age of onset of 2 months, 10 months, and 15 months, respectively. Compared with the children with type 2 SMA or type 3 SMA, the children with type 1 SMA had significantly shorter time to onset, consultation, and confirmed diagnosis (@*CONCLUSIONS@#There are differences in clinical manifestations and survival rates among children with different types of SMA. The children with type 1 SMA have a low survival rate, and those with type 2 SMA may have non-linear regression of motor ability. Early identification and management of SMA should be performed in clinical practice.

Competency based progressive evaluation and feedback system in internal medicine standard resident training in Peking Union Medical College Hospital / 基础医学与临床

Objective To establish a new competency based evaluation and feedback system, which can evaluate real-time how the residents perform and get feedbacks for improvement .Methods Based on the situation and re-quirements of standard resident training in China , and learn from experiences of other countries, we designed a new progressive evaluation and feedback system, and use the system to evaluation 6 clinic post-doctors in internal medicine department who graduate in 2016.Results This evaluation and feedback system not only reflect a total score of each resident evaluated, but also show advantages and weakness in each competency.Conclusions To implement this progressive evaluation and feedback system into the process of standard resident training can provide a feasible way to formatively and progressively evaluation residents and help them to improve , which is of critical importance.

A prevalence study on occupational stress and hypertension among steel production workers / 中国职业医学

OBJECTIVE: To analyze the correlation between occupational stress and hypertension in steel production workers.METHODS: By the stratified cluster sampling method,1 580 steel production workers from an iron and steel group company were selected as study subjects. Occupational stress was measured by the Chinese version of Job Content Questionnaire.The identification of having occupational stress was the ratio of job requirement dimension score over job self-decision dimension score turned to be ≥1. 00. The steel production workers' blood pressure was measured by the updated mercury sphygmomanometer. The effect of occupational stress on blood pressure in steel production workers was analyzed. RESULTS: The dimension score of job self-decision in hypertension group was lower than that in non-hypertension group [20( 16,23) vs 20( 17,24) scores,P < 0. 05]. There was no statistical significant difference in occupational stress ratio,job requirement and social support dimension scores between two groups( P > 0. 05). The multiple logistic regression analysis showed that job self-decision and social support scores were negatively correlated with the incidence of hypertension [odds ratios( 95% confidence intervals) were 0. 68( 0. 51,0. 90) and 0. 54( 0. 45,0. 76),P < 0. 01]. CONCLUSION: Job selfdecision and social support are the influencing factors of the incidence of hypertension in steel production workers. The correlation among occupational stress,job requirement and hypertension are not found in steel production workers.

General integral medicine: the strategic direction for complex health interventions / 中国中西医结合杂志

Nowadays, the simple combination of Western medicine (WM) and complementary and alternative medicine (CAM) cannot resolve all the health problems and various requirements. This article proposed the general integral medicine (GIM) theoretical model, which declares the disease causes analysis, clinical intervention and outcomes assessment should be recognized, managed and evaluated both from physiological, psychological, and spiritual status, and all the four dimensions: orthodox medicine (WM, Chinese medicine, etc.), individual inherent characteristics (emotion, attitude, psychology, etc.), cultural influences (doctors, caregivers, groups care, etc.), and natural environment and social systems (economic status, social security system, environmental pollution, etc). As for health outcomes assessment, a more comprehensive system including biological, doctors, patients, health intimate, social and environmental evaluations were required. The GIM model has individualized, dynamic, standardized, objective, systematic inherent characteristics, and opening and compatible external characteristics. It aims to provide the new theoretical guidance and strategic development direction for complex health interventions, and solve various medical related psychological and social problems.

Literature review and analysis of the application of health outcome assessment instruments in Chinese medicine / 中西医结合学报

<p><b>OBJECTIVE</b>To evaluate the application of health assessment instruments in Chinese medicine.</p><p><b>METHODS</b>According to a pre-defined search strategy, a comprehensive literature search for all articles published in China National Knowledge Infrastructure databases was conducted. The resulting articles that met the defined inclusion and exclusion criteria were used for analysis.</p><p><b>RESULTS</b>A total of 97 instruments for health outcome assessment in Chinese medicine have been used in fundamental and theoretical research, and 14 of these were also used in 29 clinical trials that were randomized controlled trials, or descriptive or cross-sectional studies. In 2 152 Chinese medicine-based studies that used instruments in their methodology, more than 150 questionnaires were identified. Among the identified questionnaires, 51 were used in more than 10 articles (0.5%). Most of these instruments were developed in Western countries and few studies (4%) used the instrument as the primary evidence for their conclusions.</p><p><b>CONCLUSION</b>Usage of instruments for health outcome assessment in Chinese medicine is increasing rapidly; however, current limitations include selection rationale, result interpretation and standardization, which must be addressed accordingly.</p>

Literature review and analysis of the development of health outcomes assessment instruments in Chinese medicine / 中西医结合学报

<p><b>OBJECTIVE</b>To evaluate the development of health outcomes assessment instruments in Chinese medicine.</p><p><b>METHODS</b>A comprehensive literature search for all published articles in China National Knowledge Infrastructure Database, Chongqing VIP Database and WANFANG Data was conducted. The studies that met the inclusion and exclusion criteria were used to extract information according to a predesigned assessment instrument.</p><p><b>RESULTS</b>A total of 97 instruments for health outcome assessment in Chinese medicine were identified. Of these questionnaires, 7 were generic, 12 were condition-specific and 78 were disease-specific. All instruments were suitable for adults, children, and both men and women. These instruments aimed to evaluate the health-related quality of life, signs and symptoms as well as patient satisfaction and doctor-reported outcome. However, the descriptions were poorly constructed for some of the most basic parameters, such as the domains and items, administrative mode, response options, memory recall periods, burden evaluation, format, copyright, content validity, and other properties.</p><p><b>CONCLUSION</b>The instrument development for health outcomes assessment in Chinese medicine is increasing rapidly; however, there are many limitations in current methodologies and standards, and further studies are needed.</p>