Objective To assess the methodological quality of pediatric COVID-19 guidelines using the AGREE Ⅱ. Methods Domestic and foreign pediatric COVID-19 guidelines from inception to 1st Oct 2021 were electronically searched in PubMed, CBM, CNKI, VIP, WanFang Data, Medlive, NGC, GIN, and NICE databases and relevant websites. Two researchers independently assessed the methodological quality of the guidelines by using AGREE Ⅱ. Results A total of 21 guidelines were included. The AGREE Ⅱ results revealed that the average scores of included guidelines in 6 domains (scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence) were 62.70%, 36.24%, 20.34%, 50.42%, 22.12% and 53.17%, respectively. ConclusionThe methodological quality of pediatric COVID-19 guidelines is poor. Guideline developers should follow the requirements of AGREE Ⅱ in guideline development.
Objective To assess the effectiveness of the course of “Being a Friend with Patients”. Methods There were three parts in this course: (1) To experience what the empathy was, by counseling activities; (2) To accompany patients in hospital; (3) To share the experience after accompanying. There were 118 participants who were freshmen at the end of 2005. Results and Conclusions According to feedback from the students, they understand empathy and how the patients feel after the counseling. The course is accepted by all students. It may help students to be more attentive to and concerned about their patients, and to provied help for them.
The original meaning of “allocation concealment” is that the statistician and the trial designer who generated the random sequence and allocation sequence should not recruit and allocate the participants for the purpose of avoiding selection bias. In the process of generating allocation sequence, combined blinding measures are so called “setting blinding”, for instance, by using “double simulation”. We use a example to describe how to perform an adequate allocation and conceal the sequence, and setting blinding. Another example is used to describe how to report the methods of randomization, allocation concealment and the effect of blinding, etc.
ObjectiveTo explore the practical effects of multi-disciplinary team (MDT) management model in the management of multidrug-resistant organisms (MDROs).MethodsIn 2015, the multi-drug resistant MDT was established, and MDT meetings were held regularly to focus on the problems in the management of MDROs and related measures to prevent and control nosocomial infections of MDROs.ResultsThe detection rate of MDROs from 2014 to 2017 was 9.20% (304/3 303), 7.11% (334/4 699), 8.01% (406/5 072), and 7.81% (354/4 533), respectively. The difference was statistically significant (χ2=11.803, P=0.008), in which the detection rates of carbapenem-resistant Acinetobacter baumannii (CRABA), carbapenem-resistant Pseudomonas aeruginosa, and carbapenem-resistant Enterobacteriaceae (CRE) changed significantly (χ2=39.022, 17.052, 12.211; P<0.05). From 2014 to 2017, the proportion of multi-drug resistant infections decreased year by year, from 84.54% to 52.82%, and the proportion of multi-drug resistant hospital infections also declined, from 46.05% to 23.16%; the nosocomial infection case-time rate decreased from 0.24% to 0.13% year-on-year; the proportion of multi-drug resistant hospital infections in total hospital infections was 9.07%, 11.17%, 10.47%, and 6.16%, respectively; in the distribution of multi-drug resistant nosocomial infection bacteria, the proportion of methicillin-resistant Staphylococcus aureus, CRABA, CRE hospital infections accounted for the number of MDROs detected decreased year by year. The use rate of antibiotics decreased from 46.58% in 2014 to 42.93% in 2017, and the rate of pathogens increased from 64.83% in 2014 to 84.59% in 2017.ConclusionThe MDT management mode is effective for the management and control of MDROs, which can reduce the detection rate, infection rate, hospital infection rate, and antibacterial drug use rate, increase the pathogen detection rate, and make the prevention and control of MDROs more scientific and standardized.
This article takes the regional cooperative medical service practice provided by the West China Hospital of Sichuan University as example, analyzes several problems with regional medical service practice in western region based on the introduction of the general situation and system of regional cooperative medical service provided by the West China Hospital. The problems are:lack of motivation to promote regional collaborative medical care, serious lag of policies, and lack of stratified configuration of tests/exams quality standards and construction standards of medical information system platform. This article puts forward the key point to promote western regional medical collaboration:strengthening government dominance, and establishing suitable medical insurance system and regional laboratory examination centre.
With the aggravation of population aging, the medical and care needs of the elderly have increased significantly. Nowadays the integrated elderly care and medical services have been greatly promoted and various services modes have been developed in different regions. In order to promote the healthy development of integrated elderly care and medical services in China, we summarized the practical experience of integrated elderly care and medical services implemented in various parts of China, including six typical service modes such as elderly care in medical services, medical care in elderly care, cooperation between medical services and elderly care, community radiation, family doctor embedded and “Internet+”. Moreover, we compared their providers, service methods, construction specifications, service standards, regulatory agencies and payment methods. Finally, we analyzed the problems and their causes, and proposed corresponding improvements for outstanding problems in the practice of integrated elderly care and medical services in China.
Infiltrative optic neuropathy (ION) is characterized by the infiltration of tumor cells or inflammatory cells in the optic nerve and its sheath. ION is rare in clinic practice, and ION caused by direct infiltration or metastasis of malignant tumors is easily misdiagnosed as optic perineuritis or optic neuritis, which means delayed proper treatment and makes patients risking possible side effects of steroid therapy. Currently, ophthalmologists are lack of sufficient knowledge about ION, which contributes to the high rate of misdiagnosis and missed diagnosis of ION in clinical practice. The diagnosis and treatment of ION have not yet formed systematic standardized guidelines. Therefore, Neuro-ophthalmology Group of Ophthalmology Branch of Chinese Medical Association organized experts to propose consenus of opinions on definition, diagnosis and treatment of ION, which helps to guide clinical diagnosis and treatment of ION, as well as basic researches about ION.
Objective?To evaluate Mental Imagery on rehabilitation of functions in patients with stroke. Methods?Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMbase, PEDro (www.pedro.org.au), OpenSIGLE, National Technical Information Service (NTIS), CNKI, VIP, Wanfang Data, and CBM were searched for the Randomized controlled trials (RCTs) of Mental Imagery on rehabilitation of functions in patients with stroke from the date of establishment of the databases to October 2010. The bibliographies of the included studies were searched, too. Three independent researchers evaluated the included studies using GRADE. The extracted data were analyzed by RevMan 5.0.25 and GRAEDprofiler 3.2.2. Results?A total 16 trials were discovered. Meta-analyses showed that at the end of 4th, 6th, and 8th, compared with conventional rehabilitation, the mental practice increased the score measured by FMA (WMD=7.81, 95%CI 1.96 to 13.65; WMD=13.89, 95%CI 4.53 to 23.25; and WMD=9.45, 95%CI 3.67 to 15.23, respectively) and ARAT (WMD=5.70, 95%CI 3.17 to 8.22, P=0.30). The 4 outcomes were all of low quality in the GRADE system. Conclusion?The current evidence shows mental practice could improve the upper limb function in patients after stroke, and the side effects of mental practice are not found in meta-analyses. Compared with other rehabilitative therapies, it is simper, of lower input costs, and of low operating costs. The clinicians should recommend it. Due to the limitations of the included studies, more large-sample, high-quality RCTs are required.
ObjectiveTo carry out the work of overseeing transparent administration of clinical department affairs, have clear knowledge on the progress of making clinical department affairs public, and find out problems the staff focus most.
MethodQuestionnaire survey was used, combined with the participation of various meetings, interviews with staff, access to documents and other ways between November and December 2013.
ResultsIt showed that the rate of transparent administration of clinical department affairs was (78.39±18.55)%. Among all the affairs, policy ones had the highest scores (over 85%), while the rates of research and academic tenure, financial transactions and remuneration allocation, personnel arrangements and training were the lowest (below 75%), and faculty focused on these affairs.
ConclusionsFive methods can improve the rate of transparent administration of clinical department affairs effectively:enough attention from clinical departments, concerning what employees focus on, utilizing methods rationally, strong supervision and making full use of monitoring.
The continuing medical education system of West China Hospital of Sichuan University is based on whole life cycle. We actively promote the continuing education, systematize and institutionalize the top-level design, and adopting flexible and diverse training methods. It is of great significance for a staff's entire career to continuously improve professional accomplishment, specialized knowledge and working skills, to adapt to the development of medical science and technology and the reform of health service, and to drive hospital innovation and high-quality development, so as to eventually achieve the goal of "double first-class" construction.
