Retrospective Evaluation of Non-Invasive Assessment Based on Routine Laboratory Markers for Assessing Advanced Liver Fibrosis in Chronic Hepatitis B Patients.

Background: At present, there is a lack of cheap, effective and convenient detection methods for hepatitis B-related liver fibrosis, especially in the developing area. Aim: To evaluate the non-invasive methods for the significant and advanced fibrosis stage in chronic hepatitis B virus (HBV) patients in basic hospitals and to assess their diagnostic utility. Methods: The study included 436 consecutive naive HBV individuals who had their livers biopsied. They were examined in one week using aspartate aminotransferase-to-aspartate aminotransferase ratio (AAR), age-platelet index (API), aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis-4 (FIB-4), Forns, gamma-glutamyl transpeptidase-to-platelet ratio (GPR), S-index and transient elastography (TE). Scheuer scoring system was used to determine the histologic fibrosis grades (S0-S4). The diagnostic effectiveness was assessed using AUROCs and the DeLong test, both of which were based on statistical comparisons. Results: For both substantial (≧S2) and advanced (≧S3) fibrosis phases, TE had good diagnostic performance in determining the hepatic fibrosis. Similar diagnostic performance was shown with Forns and S-index when it came to detecting fibrosis stages lower than S3. One model's diagnostic value was not significantly improved by combining serum models. Correlation coefficients between clinical features and fibrosis phases were greatest for Forns (r = 0.397), S-index (r = 0.382) and TE (r = 0.535) when compared to other variables. Conclusion: This investigation showed that Forns and S-index may be helpful strategies for detecting advanced fibrosis in HBV patients admitted to community hospitals.

[The Hospital Admision Register (CMBD) use for the analisys of hospital aquired pressure ulcer at the region of Valencia (2012-2015)]. / Utilidad del uso del registro de altas hospitalarias (CMBD) para el análisis de las úlceras por presión adquiridas durante la hospitalización en la Comunidad Valenciana (2012-2015).

OBJECTIVE: The Pressure Ulcer is a recognised healthcare adverse event and a public health problem. The main goal in this work was to understand the status of the Hospital Acquired Pressure Ulcer (HAPU) from the public hospitals of the Valencian Community before (2012) and during the process of implementation of a specific prevention and treatment Practice Guideline for this matter (2013-2015). METHODS: Retrospective study through the Minimum Basic Hospital Data Set (MBDS), and taking its variables as the input. The database had 15.594 cases of hospitalization with 71 variables. The tools utilized were classical statistical analysis, Multidimensional Scaling Analysis (MDS) and Self-Organized Maps (SOM). RESULTS: The 90,83% of the admission in hospitals related to pressure ulcer treatment were admitted for a different reason than pressure ulcer itself and acquire it at the hospital. In relation to those Hospital Acquired Pressure Ulcer (HAPU) a temporal pattern was discovered, in a six-month cycle decreasing in August and September and increasing at the beginning of the year. The five main diagnoses associated to the HAPU had been detected and remain stable all over the study. A hospital classification has been done related to their behaviour based on its admissions as well, retrieving four types of behaviour. CONCLUSIONS: The MBDS proves to be a useful tool to retrieve a general overview of HAPU and identifying the risk patient profile where prevention strategies have to be strengthened.

OBJETIVO: Las úlceras por presión son un grave problema de salud pública y están reconocidas como un evento adverso de la atención sanitaria. El objetivo de este trabajo fue conocer el escenario de las Úlceras Por Presión (UPP) adquiridas en los hospitales públicos de la Comunidad Valenciana antes (2012) y durante el proceso de implementación de una Guía de Práctica Clínica (GPC) específica de prevención y tratamiento de este problema de salud (2013-2015). METODOS: Estudio retrospectivo a través del uso del Registro de Altas Hospitalarias (CMBD) de todos los hospitales públicos de la Comunidad Valenciana. La base de datos contenía 15.594 episodios de hospitalización con 71 variables. Se utilizó el análisis estadístico clásico, el análisis multidimensional escalado (MDS) y los mapas autoorganizados (SOM). RESULTADOS: El 90,83% de los pacientes que al alta se les había diagnosticado UPP ingresaron por otros motivos distintos al de UPP, pero adquirieron UPP durante su proceso de hospitalización. Se observó un patrón temporal, que coincidía cada 6 meses, con descenso durante los meses de agosto y septiembre y subidas en los primeros meses del año. Se determinaron cinco diagnósticos principales asociados, que coincidieron en todo el periodo de estudio. También se clasificaron cuatro tipos de comportamiento hospitalario, en relación a sus tendencias en las altas con diagnóstico de UPP. CONCLUSIONES: El CMBD ha contribuido de forma positiva en la caracterización del entorno de la hospitalización en la adquisición de UPP, configurando el perfil de pacientes de riesgo en los que hay que extremar las estrategias de prevención de UPP.

Application of"double-tutorial system"on practice of higher vocational laboratory medical students / 中华医学教育探索杂志

In order to improve the practice effect of the vocational college students in the laboratory of basic hospital, this subject explored the "double-tutorial system" in the practice of higher vocational college students. The selection criteria of whole mentoring and professional tutors, the specific duties of tutors and the assessment standards of both tutors and students were determined according to local condi-tions of the personnel structure in basic hospital. The implementation of "double-tutorial system" promoted the professional ethics, interpersonal communication ability, psychological quality and professional profi-ciency of the higher vocational college students. Meanwhile, young teachers in the department enhanced their teaching ability, professional skills and self-confidence, so that the technical personnel construction of the department was strengthened.

The practice and experience of improving the level of research management in basic hospital / 中华医学科研管理杂志

To investigate the current situation of research management in basic hospital,sum up the experience and effects,study the efficient method to improve the level of research management.

Effect of video-assisted thoracoscopic surgery in thoracic disease / 局解手术学杂志

Objective To investigate the effect of video-assisted thoracoscopic surgery( VATS) in thoracic disease,and the feasibility to carry out VATS for basic hospital. Methods The data of VATS treatment were collected to compare the differences between study group and control group,and evaluate the the feasibility to carry out VATS for basic hospital. Results The operation time was (100. 75±22. 72) min, blood loss was (54. 27±26. 21) mL,postoperative drainage was (920. 67±171. 99) mL. The postoperative complications were fewer,post-operative hospital stay was shorter,incision time was shorter(P=0. 000) and pain scores was lower(P=0. 000) in study group than that in control group. Basic hospital has the capacity to conduct this technical. Conclusion VATS is feasible to carry out in basic hospital.

Research in continuing education method for nurses in basic general hospitals / 中国实用护理杂志

Objective To select the best education content and method through analysis. Methods A retrospective study was carried out in nurses about education content,activity style and the condition of reaching quality standard from 2000 to 2006.The continuing education management frame was set up and used year-cost system and responsibility to the human method. Results The rate of reaching quality standard increase distinctly after application of new management method. Conclusions Application of year-cost system and responsibility to the human method helped nurses to reach the score requirement set by the Ministry of Public Health.They learned new theory,new knowledge and new technique to increase their general quality.