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Objective:To evaluate the comprehensive strength of the specialties included in the medical service capacity improvement project of Henan provincial medical and health institutions, analyze the influencing factors, and provide scientific basis for the specialty construction.Methods:A total of 52 specialties were included in the project. According to the content of construction assessment and acceptance, the questionnaire was designed and filled in by the persons in charge of the specialties from the aspects of basic conditions, medical technical team, medical service ability, medical quality, scientific research and teaching ability. TOPSIS method was used to evaluate the comprehensive strength of specialty, and the main influencing factors were analyzed by single factor analysis, Mann-Whitney U test, correlation analysis and multiple stepwise regression analysis. Results:The research and teaching ability of the specialties had the strongest correlation with the comprehensive strength of the specialties. The scientific research and teaching ability was strongly related to the medical service ability. The number of people holding the post of academic institutes at or above provincial level, the number of industry standards or national guidelines, the number of academic conferences hosted at or above the provincial level, the number of postgraduate training, the number of papers published in SCI and core journals were the main influencing factors of scientific research and teaching ability.Conclusions:It is necessary to improve the level of scientific research and teaching in key specialty to promote the improvement of medical service ability. We should pay more attention to the construction of high-level talents, the cultivation of research-oriented talents, the application of new medical technology and original research.
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Objective:To understand the output of research and education of clinical key Specialties in Henan Province, to analyze the current situation and existing problems, and to provide scientific evidence and suggestions for the improvement of specialist ability.Methods:Through the questionnaire survey to collect the scientific research data of key specialties from 2015 to 2019, apply Epidata 3.0 to input the data, use SPSS 21.0 software to carry out test and Mann Whitney U test, and carry out a comparative analysis of the national and provincial clinical key specialty discipline leaders, medical talent team, academic, scientific research and education output in Henan Province. Results:Academic literacy and scientific research ability of leaders of national and provincial key clinical specialties in Henan Province are equal. However, there is still a big gap in scientific research and education ability between national and provincial key clinical specialties in Henan Province.Conclusions:The provincial key clinical specialties need to improve the ability of scientific research and education in a more holistic way, further strengthen the medical talents team, and focus on the exchange of high-level academic platform and the cultivation of research talents.
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Objective To study the development of the first county-level key clinical specialized talent teams in Henan province. Methods Data on the first 30 county-level key clinical specialized talent teams were collected through questionnaire in 2014 and 2017 respectively, and signed rank sum test was conducted to analyze such facts as the changes of medical service volume, academic titles and scientific researches of discipline leaders before and after such construction. McNemar′s test and chi-square test were conducted to study the age structure, seniority, education and technical title makeup of these discipline leaders. Such tests were also conducted to study the age structure, seniority, education and technical title makeup of the talents. These efforts aim to discern the construction achievement of the key clinical specialties. Results The indexes of healthcare capacities of the first batch of clinical key specialties were observed as improved ( P <0. 05 ) in terms of the medical service volume. Of the discipline leaders′ age structure, the 51 -60 age groups accounted for 40. 0％ and 66. 7％ respectively, before and after the construction, scoring a difference of statistical significance ( P <0. 05 ); the number of senior physicians increased by 80 persons, the number of physicians having master or above titles increased by 40 persons;the number of physicians participating in continuing education held by these specialties grew from 146. 50 to 262. 50(P<0. 05). Conclusions The volume of medical service of the first batch of county-level clinical key specialties has been elevated, and a group of talents of high education and senior titles have been recruited. Whereas, the title structure needs to be improved, and more young academic leaders are expected, while more opportunities of further education and training are also expected for the physicians, in order to enhance their professional ability.
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CD4 count is the standard method for determining eligibility for highly active antiretroviral therapy (HAART) and monitoring HIV/AIDS disease progression, but it is not widely available in resource-limited settings. This study examined the correlation between total lymphocyte count (TLC) and CD4 count of HIV-infected patients before and after HAART, and assessed the thresholds of TLC for making decisions about the initiation and for monitoring HAART. A retrospective study was performed, and 665 HIV-infected patients with TLC and CD4 count from four counties (Shangcai, Queshan, Shenqiu and Weishi) were included in the study. Pearson correlation and receiver operating characteristic (ROC) were used. TLC and CD4 count after HAART was significantly increased as compared with pre-HAART (P<0.01). An overall positive correlation was noted between TLC and CD4 count (pre-HAART, r=0.73, P=0.0001; follow-up HAART, r=0.56, P=0.0001). The ROC curve between TLC and CD4 count showed that TLC ≤ 1200 cells/mm(3) could predict CD4 < 200 cells/mm(3) with a sensitivity of 71.12%, specificity of 66.35% at pre-HAART. After 12-month HAART, the optimum prediction for CD4 count < 200 cells/mm3 was a TLC ≤ 1300 cells/mm(3), with a sensitivity of 63.27%, and a specificity of 74.84%. Further finding indicated that TLC change was positively correlated to CD4 change (r=0.77, P=0.0001) at the time point of 12-month treatment, and the best prediction point of TLC change for CD4 increasing was 135 cells/mm(3). TLC and its change can be used as a surrogate marker for CD4 count and its change of HIV-infected individuals for making decisions about the initiation and for monitoring HAART in resource-limited settings.