Objective To know the training status and expectation of village doctors in remote and poor areas of Sichuan province and to provide the preferences for developing a viable and efficient training model. Methods The cluster sampling method, combined with questionnaire surveys and qualitative interviews, was used. A total of 463 village doctors of 302 village clinics in Pengzhou and Baoxing of Sichuan province were interviewed. Results The “three-side” phenomenon including the doctor being old, poor academic background and lack of female doctor in remote and poor areas of Sichuan was serious. In-service village doctors’ knowledge on public health and Chinese medicine increased through training. There were differences between the training village doctors participated and that they had expected. The cost of the training was somewhat high for rural doctors. The training system has not been established yet in remote areas. Conclusions Both quantity and quality should be considered in in-service village doctor training in remote areas of Sichuan Province, which should also consider local conditions and farmers’ needs . The in-service training system should be developed as soon as possible. It is suggested that the treatment of village doctors should be improved. Cultivating more young village doctors should be based on the stability of the medical team.
Background and Objective Organ transplantation has become an essential and irreplaceable treatment for patients with organ failure. Although organ transplantation was introduced to China in the 1960s, it has witnessed rapid development in recent years. However, problems have been identified in the course of its development. We aim to present both medical and legal points of view on organ transplantation, to compare the current status of organ transplantation in China with that in developed countries, and discuss the challenges China faces in developing its own legislation for organ transplantation. Methods We searched the websites of WHO, NIH, AST, UNOS, and governments, as well as relevant conference proceedings and expert consensus documents. Articles or documents involving organ transplantation legislation were identified. Results We included 10 legal documents, 1 regulation, 9 government documents, and 4 expert consensus documents. Organ transplantation legislation started in the 1960s in the United Kingdom, and was soon followed by New Zealand and the United States. The first law on brain death was enacted in the United States in 1978. Since 1991, the World Health Assembly (WHA) and other non-governmental organizations have issued 7 consensus documents in order to regulate behaviors related to organ transplantation. China including Hong Kong, Macau and Chinese Taipei has not yet formulated any law on organ transplantation. Conclusion At least six challenges about organ transplantation and brain death legislation in China are identified: ① death definition and source of organ donors; ② prevention of organ transplant tourism; ③ risk assessment and insurance for living donors; ④ defining who has the right to choose about potential organ donation for an individual: whether spouses, parents, or children; ⑤ whether an organ donor should receive compensation; ⑥ whether brain death and organ transplant laws should be formulated separately.
With the rapid development of medicine and the emergence of new evidence, the formulation of living guidelines is significant in guiding clinical practice and providing timely and effective references for clinical workers. This article summarizes the status of living guidelines, and puts forward thoughts and suggestions on the challenges and opportunities of the development of living guidelines, in order to promote the development of living guidelines and provide a reference for guideline developers and users.
ObjectiveTo investigate the current situation of domestic registry studies, and to provide basis for future research.MethodsWorld Health Organization (WHO) registration platform, ClinicalTrials.gov registration platform and other registration platforms were searched to collect the registered registration studies in Mainland China from inception to July 31st, 2018. Two researchers collected and collated data, analyzed by descriptive statistical methods, and then python-igraph package in Python 3.5 was used to draw the network diagram.ResultsA total of 247 studies were retrieved, mainly for disease registry and pharmaceutical product registry. Cohort and case-series were the principally study design. The research focused on chronic diseases such as cardiovascular and cerebrovascular diseases, and research sites were based on the economically developed area, for example, Beijing, Shanghai and Guangdong. The network diagram of study design and disease system shows that cohort research design is widely used in the nervous system and circulatory system; the network diagram of the research sites and disease system found that Beijing mainly studied circulatory and nervous system diseases, Shanghai mainly studied circulatory system diseases, and Guangdong relatively studied more on nervous system and urinary system diseases.ConclusionThe increasing number of registry studies in China reflects the importance of long-term outcome assessment of diseases.
ObjectiveTo investigate the knowledge of drug safety among parents of some children with epilepsy in Henan Province, and to provide a basic advice for drug safety and health education for children with epilepsy.sMethodUsing a questionnaire to parents of epilepsy children from the Children's Hospital in Henan Province and the First Affiliated Hospital of Zhengzhou University in July 2019, a total of 336 questionnaire were conducted by the professionals responsible for after the training, including parents and children basic situation, drug habits and attitudes, medication safety consciousness and antibiotic drug use knowledge.Results320 questionnaire were collected, 314 of which were valid questionnaires, with an effective rate of 98.1%. 66 (21%) of parents chose juice or milk for oral administration, and 87 (27.7%) of parents chose sugar water. 104 (33.1%) of the parents chose to stop the medication immediately after the child's condition improved. 126 (40.1%) of parents believe that combination of two or more antibiotics is more effective, 178 (56.7%) of parents will give their children antibiotics when they have a cold or fever, and more than 254 (80%) of parents are not aware of adverse reactions to antibiotics.ConclusionIn the investigation, the parents of children with epilepsy in Henan Province still have insufficient knowledge of safe drug use, and there are many non-standard drug use behaviors. Local medical professionals for epilepsy should be strengthened to guide and monitor the children and their parents.
Objective To review the recent research progress on shoulder arthroplasty, and to predict future research direction. Methods Recent l iterature concerned the shoulder arthroplasty was reviewed and analyzed in terms of appl iedanatomy, designs of prosthesis, patterns of prosthesis and fixation ways of prosthesis. Results The shoulder arthroplastyrepresented the treatments of choice for the patients with end-stage shoulder diseases and traumatic diseases. It could provide good and stable results in pain rel ief and functional outcomes. Conclusion There are still many controversies about the patterns of prosthesis, fixation ways and kinds of materials in cl inical practice. Currently, the main research is about the designs of the glenoid prosthesis and the cl inical practice in young patients.
ObjectiveTo understand the development of clinical nutrition departments in western China, analyze the main problems and factors restricting its development, and provide a basis for promoting the construction and development of clinical nutrition departments in western China and formulating clinical nutrition management standards.MethodsQuestionnaires were used to investigate the development of clinical nutrition services in some hospitals in 11 provinces/municipalities/autonomous regions in western China (except Tibet) in March 2019. ResultsA total of 230 hospitals participated in the survey. Most clinical nutrition departments set up outpatient clinics (76.1%), with an average annual number of outpatients of 884; most of them carried out nutrition inspection visit/follow-up work (86.5%), and the average number of inspection visit/follow-ups was 3 876. Most hospitals had incomplete hardware and software facilities in the clinical nutrition departments. The charging items for diagnosis and treatment were complicated, and the charging standards were uneven. There were still 47.0% of the clinical nutrition departments of hospitals that did not offer diagnosis and treatment charging items. The surveyed hospitals believed that the talent team was the number one factor restricting the development of the clinical nutrition department, and regular skills training was the number one project that urgently needed the help of the Clinical Nutrition Discipline Alliance of West China Hospital of Sichuan University.ConclusionIn the future, the western region should increase the investment in hardware and software facilities, strive for policy support for maintaining department operations and formulate unified standards to regulate the development of disciplines.
Objective To investigate the current status of clinical nursing risks to nursing students, so as to provide scientific references for medical universities and policy makers. Methods The self-designed questionnaires were distributed to 360 clinical nursing students in four Third-Level hospitals. The group leaders were trained as investigators regularly. All the other nursing students were asked to fill in the questionnaire alone within 30 minutes. The questions issued were the following four aspects: general information of nursing students, clinical intern operating situation, nursing defects and awareness of nursing risks. Results Among the total 400 questionnaires distributed, 360 valid ones were retrieved (90%). The analysis showed all 21 nursing operations could be performed by students alone, and 80% of the nursing students believed that they were able to do 11 routine operations alone, such as bed-making and vital sign monitoring. The incidence rate of eight nursing defects was between 0.56% and 12.22%. As for the four questions about nursing risks, 49.44% of the nursing students operated alone before getting themselves ready because of their eagerness for such experiences. According to the nursing students, the departments with the highest nursing risks ranked as emergency, operating theatre, surgery, pediatrics, internal medicine, and gynecology and obstetrics. Conclusion The current situation of clinical nursing risks to nursing interns is still far from being satisfactory, so it is necessary to improve the training at university, regulate the clinical education, and ensure the intern safety for nursing students.
Objective To investigate the current status of clinical and research developments in Lanzhou University in China, to provide reference data for establishing a coordinated, multi-sectional, research orientated and internationally competitive program in biomedical sciences. Methods Three types of questionnaire containing 57 items were designed for 8 secondary departments in clinical and basic sciences. Another type of questionnaire was distributed to 200 clinicians, researchers, lecturers, and administrators in both clinical and basic sciences from August to September 2005. We searched SCI, CSCD, CSTPCD, CBM and CNKI for research articles published by Lanzhou University, commercial development of research derived from the University, and general and competitiveness evaluations of the University. In addition, seminars, site visits, and expert interviews were also conducted.Results The response rates for the questionnaires were 100% and 91% respectively. The investigation included the identification and evaluation of research and clinical departments, human resources in the three branches of biomedical sciences (clinical, research and education), including academic title, educational background, age distribution, research area and funding (leading investigators included), and publication records. The numbers of undergraduate and graduate students and their CET-4 score (pass rate) were also analyzed. Based on the information obtained, six secondary databases were established and evaluated..Conclusions The merger of Lanzhou University and Lanzhou Medical College has created an opportunity for further development in biomedical research and clinical science. Facing new challenges and difficulties, we should take this responsibility to work together to make the University a national and international center of clinical, research and education in medical sciences.
ObjectiveTo systematically investigate the current status of reporting health economics evidence in clinical practice guidelines and expert consensuses published in China from 2021 to 2023, providing references for the formulation and revision of guidelines and consensuses in our country. MethodsComputer searches were conducted in the CNKI, CBM, WanFang Data, China Academic Journals Full-text Database, PubMed, and Web of Science to collect clinical practice guidelines and expert consensuses published in China from 2021 to 2023. Two researchers independently screened the literature, extracted information on the inclusion of economic evidence in guidelines and consensuses, and then used quantitative analysis methods for description. ResultsA total of 4 236 relevant articles were included, of which 1 066 (25.17%) reported health economics evidence; 120 (11.26%) reported health economics evidence in the formation of recommendation opinions; 109 (10.23%) reported health economics evidence in the grading of evidence quality; 832 (78.05%) reported health economics evidence in the interpretation and explanation of recommendation opinions. ConclusionThe reporting rate of health economics evidence in clinical practice guidelines and expert consensuses published in China is not high. The reporting rate of health economics evidence in consensuses is lower than that in guidelines. It is recommended that during the formulation process of guidelines and consensuses, the application of health economics evidence should be further strengthened in aspects such as the formation of recommendation opinions, the grading of evidence quality, and the interpretation and explanation of recommendation opinions, in order to improve the scientific, rigorous, and applicability of clinical practice guidelines and expert consensuses, and to play the role of guidelines and consensuses in optimizing the allocation of health resources, improving clinical diagnosis and treatment effects, and enhancing the quality of medical care.
