The characteristics and influencing factors of medicine cost for orthopedic surgery patients in hospitals of Shanxi province / 中国药房

OBJECTIVE To analyze the characteristics and influencing factors of medicine cost for orthopedic surgery patients in Shanxi province， and to provide reference for the rational management of medicine cost in orthopedic surgery patients. METHODS A retrospective analysis was conducted on the case information of 584 204 orthopedic surgery patients in Shanxi province from 2016 to 2021. Medicine cost was analyzed by year， region， hospital level， type of surgery and type of surgical incision. Single factor analysis and generalized linear regression model were used to analyze the influencing factors of total medicine cost， and structural equation model was used for verification. RESULTS The research findings indicated that joint replacement surgery （42.61%） and post-fracture external fixation surgery （12.60%） were the most common types of procedures. There was statistical significance in medicine cost for different surgical types among different regions and hospital levels （P＜0.05）. In the Jinzhong region， the total medicine cost for post-fracture external fixation surgery was the highest （[ 11 719.97±4 374.73） yuan]， while in tertiary grade A hospitals， the total medicine cost for post-fracture external fixation surgery was also the highest （[ 13 584.71±4 531.82） yuan]. Among class Ⅰ incision surgeries， the cost of antibiotics for post-fracture external fixation surgery was the highest （[ 1 176.25±341.42） yuan]. Generalized linear regression model revealed that hospital location， hospital level， gender， payment method， length of hospital stays， and surgical type were the independent influencing factors for total medicine cost （P＜0.05）. Structural equation model further disclosed that hospital level， payment type， and surgical type had significant effects on total medicine cost （P＜0.05）. CONCLUSIONS Attention should be paid to the high cost of antibiotics for class Ⅰ incision surgery， and further research on their rational use should be conducted.

Epidemiology and exposure management of rabies in Shanxi Province， 2011‒2022 / 上海预防医学

ObjectiveTo analyze the epidemiological features and influencing factors of rabies in Shanxi Province，and to provide evidence to further promote the elimination of rabies in Shanxi Province. MethodsThe incidence data of rabies in Shanxi from 2011 to 2022 were collected and subjected to descriptive analysis. ResultsFrom 2011 to 2022， a total of 348 rabies cases were reported in Shanxi Province， with an average annual incidence of 0.080 3/105. The incidence of rabies showed a downward trend overall. The highest incidence was in August. The cases were mainly farmers， mostly males， and most cases were reported between 50 and 69 years old. The data of cases showed that dogs were the main animals attacking human （93.96%）. The incubation period of most cases was 1‒3 months （37.37%）.The main exposure site was hand（51.33%）. Only 2.66% cases with grade Ⅲ exposure were injected with passive immune agents. ConclusionThe incidence of rabies in Shanxi Province continues to decrease， but there are still loopholes in prevention and control measures. It is necessary to strengthen the management and immunization of dogs，health education， and standardized procedures after exposure to maintain the achievements in the prevention and control of rabies.

Preliminary study of machine learning in the screening of proteinuria in rural areas of Shanxi province / 中华肾脏病杂志

Objective:To screen the incidence of proteinuria in rural areas of Shanxi province and construct a risk prediction model of proteinuria based on machine learning algorithm.Methods:It was a cross-sectional investigation study. The residents ≥30 years old in rural areas of Shanxi province from April to November 2019 were screened by multi-stage stratified sampling method, and data from questionnaire surveys, physical examinations, and laboratory examinations were collected. Urine albumin/creatinine ratio ≥30 mg/g was defined as proteinuria, and the incidence of proteinuria was calculated. Subjects were divided into proteinuria group and non-proteinuria group. The machine learning binary classification model of proteinuria and non-proteinuria was constructed based on the stackable integrated logistic regression algorithm (SE-LR), logistic regression, support vector machine, decision tree, random forest and extreme gradient lift algorithms, respectively. The area under the receiver operating characteristic curve, accuracy, recall, and F1 weights were used to evaluate the predictive efficiency of the comparison models. Finally, the importance of the predictive features of the model with the best overall performance was ranked.Results:There were 8 869 rural residents included in the study, aged (58.59±9.49) years old, with 3 872 males (43.66%) and 4 997 females (56.34%). The prevalence of proteinuria in rural areas of Shanxi province was 13.49% (1 196/8 869). Blood pressure, pulse, body mass index, waist circumference, proportion of obesity or overweight, proportion of hypertension, proportion of moderate to severe salt intake, glycosylated hemoglobin, uric pH value, urinary specific gravity, proportion of positive urinary occult blood, proportion of positive urinary glucose, proportion of positive urinary ketone body, proportion of urinary red blood cell count ≥5/μl, proportion of urinary white blood cell count ≥10/μl and urinary α1 microglobulin in the proteinuria group were all higher than those in the non-proteinuria group (all P<0.05). The proportions of lack of exercise and drinking history in the proteinuria group were lower than those in non-proteinuria group (both P<0.05). The overall performance of SE-LR model was the best, with the area under the curve (0.736, 95% CI 0.719-0.746) slightly lower than that of the logistic regression model (0.745, 95% CI 0.680-0.762), and the highest accuracy (0.844), recall rate (0.621) and F1 weighting value (0.801). In the SE-LR model, the orders of importance of the top 10 features were urinary α1- microglobulin, urinary occult blood, urinary sugar, uric acid basicity, smoking history,overweight or obesity, body mass index, total cholesterol, glycosylated hemoglobin and hypertension. Conclusions:The prevalence of proteinuria is high in rural areas of Shanxi province. The risk prediction model of proteinuria established by machine learning algorithm can predict the risk of proteinuria and identify its risk factors, which can provide a scientific basis for disease prevention, intervention, and treatment in the community and clinic to a certain extent.

Analysis of lung cancer incidence and death in the cancer registration areas of Shanxi Province in 2017 / 肿瘤研究与临床

Objective:To investigate the incidence and mortality of lung cancer in the cancer registration areas of Shanxi Province in 2017.Methods:The cancer registration data reported by 12 tumor registration areas of Shanxi in 2017 were sorted out and stratified by urban and rural areas and gender. The number of incidence and death ,the crude incidence and mortality, the cumulative rate (0-74 years), age-specific incidence and mortality, Chinese population standardized rate and world population standardized rate were calculated. The incidence and mortality were standardized by the 2000 China census standard population composition and Segi's world standard population composition.Results:In 2017, there were 2 275 new cases and 1 736 deaths of lung cancer in the tumor registration area of Shanxi Province. The crude incidence rate of lung cancer was 46.72/100 000 (male 63.99/100 000, female 28.80/100 000, urban area 58.05/100 000, rural area 39.09/100 000), Chinese population standardized rate was 31.67/100 000, the world population standardized rate was 32.10/100 000, and the cumulative rate (0-74 years) was 3.87/100 000. The crude mortality rate was 35.65/100,000 (male 49.84/100,000, female 20.93/100,000, urban area 44.53/100,000, rural area 29.67/100 000), Chinese population standardized rate was 23.82/100 000, the world population standardized rate was 24.14/100 000, and the cumulative rate (0-74 years) was 2.69/100,000. Overall, the age-specific incidence and mortality of lung cancer in 2017 were at a low level in 0-44 years age group, and increased rapidly after 45 years age group, and reached a peak in 85 years age group. The incidence and mortality of lung cancer in males were higher than that in females. Although there were some differences in the incidence and mortality of patients with different ago range in urban and rural areas, the overall trend was similar.Conclusions:Lung cancer is the most common malignant tumor threatening the health of residents in Shanxi Province. Male, urban areas and middle-aged and elderly population are the focus of cancer prevention and control in Shanxi Province. Lung cancer prevention and control should be targeted carried out according to the differences between urban and rural areas and gender.

Association between Baseline SBP/DBP and All-Cause Mortality in Residents of Shanxi, China: A Population-based Cohort Study from 2002 to 2015 / 生物医学与环境科学（英文）

Objective@#To investigate the association between blood pressure and all-cause mortality in Shanxi, China.@*Methods@#The '2002 China Nutrition and Health Survey' baseline data in Shanxi province was used. A retrospective investigation was performed in 2015. The effects of SBP and DBP on the all-cause mortality were analyzed using the Cox regression model. The hazard ratio ( @*Results@#The follow-up rate was 76.52% over 13 years, while the cumulative mortality rate for all participants was 917.12/100,000 person-years. The mortality rose with an increasing SBP ( @*Conclusion@#Adults with SBP > 160 mmHg and DBP > 100 mmHg had a higher mortality risk. Sex and age difference was noted in both DBP and mortality risk.

Analysis on the experience of inpatients at tertiary hospitals in Shanxi province / 中华医院管理杂志

Objective@#To evaluate the medical services of tertiary hospitals in Shanxi province from the perspective of patients and provide references for improving the quality of medical services.@*Methods@#From April to December 2018, 1 358 patients at 8 tertiary hospitals in Shanxi province were selected for the survey of medical service quality evaluation scale based on patient experience, while the status quo of patient experience in tertiary hospitals in Shanxi province was evaluated, and the multivariate mixed linear model was constructed based on the three-level model of hospital-department-patient to analyze the relevant factors of patient experience. If the quantitative data conform to the normal distribution, it was expressed as ±s. Otherwise, it was expressed as M(QR).@*Results@#The patient experience score was 626±126, which was in the middle level. Whether the hospital was directly affiliated to the teaching hospital, and patient factors(marriage, occupation, education, medical insurance, number of hospital stays, etc.)were the main factors that affect the patient experience score(P<0.05).@*Conclusions@#Through the investigation, the influence characteristics of patients′ medical experience were discussed to improve the medical service and the overall service level.

Survey on standardized general practice residency training program in Shanxi province / 中华全科医师杂志

A Survey on the current general practice residency training was carried out in January 2018 among 1 114 general practitioners (GPs) who attended the standardized residency training program during 2014-2017.Basic information was obtained from the management department,other information was obtained from questionnaire.Total 1089 valid questionnaires were received with a retrieval rate of 97.8％.The survey showed that the ratios of male trainees,trainees aged 20-30 years and with bachelor degree were increasing during 2014-2017.The participants were more satisfied with the teaching quality in general hospital bases than that in community practice bases.Participants suggested to improve teaching quality,add teaching contents of humanity courses and TCM knowledge.Only14.4％(157/1 089) participants choose GPs as their career because liked this specialty.And 77.7％(846/1 089) GPs understood the main work of GP.There were 81.4％(887/1 089) participants wanted to work in;77.7％(846/1 089) participants thought that the prospect of general practice would be excellent or good.Increasing income,professional promotion and a sense of social recognition were their wishes.Standardized residency training is crucial for general practitioners to upgrade their quality and competence,to improve training quality and to develop incentive policies are necessary.

Survey on standardized general practice residency training program in Shanxi province / 中华全科医师杂志

A Survey on the current general practice residency training was carried out in January 2018 among 1 114 general practitioners (GPs) who attended the standardized residency training program during 2014-2017. Basic information was obtained from the management department, other information was obtained from questionnaire. Total 1089 valid questionnaires were received with a retrieval rate of 97.8%. The survey showed that the ratios of male trainees, trainees aged 20-30 years and with bachelor degree were increasing during 2014-2017. The participants were more satisfied with the teaching quality in general hospital bases than that in community practice bases. Participants suggested to improve teaching quality, add teaching contents of humanity courses and TCM knowledge. Only14.4%(157/1 089) participants choose GPs as their career because liked this specialty. And 77.7%(846/1 089) GPs understood the main work of GP. There were 81.4%(887/1 089) participants wanted to work in; 77.7%(846/1 089) participants thought that the prospect of general practice would be excellent or good. Increasing income, professional promotion and a sense of social recognition were their wishes. Standardized residency training is crucial for general practitioners to upgrade their quality and competence, to improve training quality and to develop incentive policies are necessary.

Development history of tumor radiotherapy in Shanxi province / 肿瘤研究与临床

Tumor radiotherapy is established on the basis of clinical oncology, radio-physics and radiobiology, and has become one of the three major therapeutic methods for malignant tumors. With the pace of socialist construction in China, the subject of radiotherapy in Shanxi province has developed from scratch and from small to large for more than 60 years. Remarkable achievements have been made in the establishment of departments, the updating of technical equipment, the increase of employees and clinical scientific research. This article reviews and summarizes the development history of tumor radiotherapy in Shanxi province.

Production situation and corresponding development strategy of Chinese materia medica injections in Shanxi Province / 中草药

Shanxi is a major province of the Chinese materia medica injections (CMMIs) industry in China. There are 18 manufacturers of CMMIs in Shanxi Province, which can manufacture 30 different kinds of CMMIs. In this paper, the superior manufacturing enterprises, the exclusive and the competitive CMMIs products, as well as their quality control and scientific research situation were summarized and analyzed. In combination with the policies for CMMIs in China, the challenges as well as the further research ideas and strategies for the development of CMMIs industry in China has been put forward.

Cognitive study on the practicing environment of physicians in Shanxi province / 中华医院管理杂志

Objective To analyze the views and perceptions of practicing physicians on the practicing environment in the province,in order to provide policy reference for improvement.Methods By means of equi-probability and multi-stage sampling, 3 570 valid questionnaires were collected and analyzed from site survey which consist of the subj ective evaluation,and measures to identify and prevent medical professional risk.Results Overall assessment of the practice environment of physicians in Shanxi province is low,as those holding the environment asniceandacceptableaccounting for 4.8% and 21.7%,only 47.0% of physicians in tertiary hospitals hold the environment as very bad,while only 6.1% of those in level-1 hospitals share this view.92.4% of the physicians surveyed hold compliance of laws and regulations and technical specifications as key to prevention of medical dispute,yet most of them do not expect the media to be obj ective,fair and accurate in their coverage of events.Conclusions It is recommended to strengthen communication with the media for obj ective coverage of the limits of medicine,and explore the mechanism to take care of medical disputes by physicians,and improve their medical risk control capabilities,for a better practicing environment.

Analysis of knowledge-attitude-practice about rational drug use among urban and rural tumor patients in Shanxi province / 肿瘤研究与临床

Objective To study the difference on knowledge-attitude-practice about rational drug use in tumor patients between urban and rural in Shanxi province, and to provide evidence for further development on health education of rational drug use. Methods A questionnaire investigation was conducted among tumor inpatients in Shanxi Cancer Hospital from May 22 in 2014 to May 30 in 2014. Results A total of 990 tumor patients were involved, including 499 urban patients accounting for 50.4 % and 491 rural patients accounting for 49.6 %. The tumor patients′awareness rates of 'the purchase of antibiotics needs a prescription' in urban and rural areas were the highest, 74.9 % (374/499) and 67.0 % (329/491), respectively, and the awareness rates of 'the meaning of OTC on the medicine package' were the lowest, 22.0 % (110/499) and 18.1 % (89/491), respectively. 96.2%(480/499) urban and 92.7%(455/491) rural tumor patients had developed a correct attitude towards 'irrational drug use will affect health and even life-threatening' which ranked the highest, and the rates of correct attitude towards 'adverse drug reaction is the medical accident' were the lowest, 55.5 %(277/499) and 48.1 % (236/491), respectively. The correct behavior rates of 'read the drug instructions' in urban and rural tumor patients were the highest, 97.8% (488/499) and 95.1 % (467/491), respectively, and the correct behavior rates of 'the expired drug recovery to nearby regular pharmacy' were the lowest, 9.2 %(46/499) and 7.5 % (37/491), respectively. Conclusions The knowledge-attitude-practice about rational drug among urban and rural tumor patients in Shanxi province is not optimistic. It should be provided that individual health education in daily work in order to promote rational drug use, prolong survival time and improve the quality of life for tumor patients.

Improving the Human Resources Structure and Promoting the Development of Hospital Libraries——survey and research on human resources structure of hospital libraries in Shanxi province / 医学信息学杂志

The paper analyzes the structure and operation status of human resources structure in hospital libraries of Shanxi province from following aspects: educational background, titles, gender, age and other relevant aspects, then discusses how to improve the distri-bution and proposes strategy for enhancing the quality of personnel.