ObjectiveTo analyze the roles of three scoring systems, i.e. Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ, Ranson’s criteria, and Sequential Organ Failure Assessment (SOFA), in predicting mortality in patients with severe acute pancreatitis (SAP) admitted to intensive care unit (ICU), and explore the independent risk factors for mortality in SAP patients.MethodsThe electronic medical records of SAP patients who admitted to ICU of West China Hospital, Sichuan University between July 2014 and July 2019 were retrospectively analyzed. Data of the first APACHE Ⅱ, Ranson’s criteria, SOFA score, duration of mechanical ventilation, the use of vasoactive drugs and renal replacement therapy, and outcomes were obtained. The receiver operator characteristic (ROC) curve was used to evaluate the value of APACHE Ⅱ score, Ranson’s criteria, and SOFA score in predicting the prognosis of SAP. Logistic regression models were created to analyze the independent effects of factors on mortality.ResultsA total of 290 SAP patients hospitalized in ICU were screened retrospectively, from whom 60 patients were excluded, and 230 patients including 162 males and 68 females aged (51.1±13.7) years were finally included. The ICU mortality of the 230 patients with SAP was 27.8% (64/230), with 166 patients in the survival group and 64 patients in the death group. The areas under ROC curves of APACHE Ⅱ, Ranson’s criteria, APACHE Ⅱ combined with Ranson’s criteria, and SOFA score in predicting mortality in SAP patients admitted to ICU were 0.769, 0.741, 0.802, and 0.625, respectively. The result showed that APACHE Ⅱcombined with Ranson’s criteria was superior to any single scoring system in predicting ICU death of SAP patients. The result of logistic regression analysis showed that APACHE Ⅱ score [odds ratio (OR)=1.841, 95% confidence interval (CI) (1.022, 2.651), P=0.002], Ranson’s criteria [OR=1.542, 95%CI (1.152, 2.053), P=0.004], glycemic lability index [OR=1.321, 95%CI (1.021, 1.862), P=0.008], the use of vasoactive drugs [OR=15.572, 95%CI (6.073, 39.899), P<0.001], and renal replacement therapy [OR=4.463, 95%CI (1.901, 10.512), P=0.001] contributed independently to the risk of mortality.ConclusionsAPACHE Ⅱ combined with Ranson’s criteria is better than SOFA score in the prediction of mortality in SAP patients admitted to ICU. APACHE Ⅱ score, Ranson’s criteria, glycemic lability index, the use of vasoactive drugs and renal replacement therapy contribute independently to the risk of ICU mortality in patients with SAP.
Objective To develop a behavioral assessment scale for medication management plans in women of childbearing age with epilepsy and to test its reliability and validity. Methods Based on the Theory of Planned Behavior, a pool of questionnaire items was initially drafted through literature review and focus group discussions. A two-round Delphi expert consultation was conducted with 15 experts to form a test version of the behavioral assessment scale for medication management plans in women of childbearing age with epilepsy (including 27 items and 5 dimensions). Convenience sampling was used to conduct surveys among women of childbearing age with epilepsy in some tertiary hospitals in Chuxiong, Shenzhen and Wuhan from February to May 2024 (the first time) and from June to October 2024 (the second time). ResultsThe effective recovery rates of the two rounds of questionnaires were 95.5% and 94.6%, respectively. The final scale included 24 items and 5 dimensions, with good reliability and validity: the content validity index (S-CVI) was 0.934, Cronbach's α coefficient was 0.876, split-half reliability was 0.819, and test-retest reliability was 0.901; exploratory factor analysis extracted 5 factors (cumulative variance explained rate 73.97%, item load 0.42~0.85), and confirmatory factor analysis showed that the model had good fit (χ2/df=1.849, RMSEA=0.075, CFI, GFI, AGFI, IFI, TLI all>0.85). Conclusion The scale meets the reliability and validity standards and can be used to assess the medication management plans and behaviors of women of childbearing age with epilepsy.
As the aging of the population intensifies, the incidence of dementia continues to increase year by year. However, the general public's lack of awareness about dementia, combined with the complexity of the cognitive assessment process, often results in many dementia patients being diagnosed in the moderate to late stages of the disease, missing the crucial window for therapeutic intervention. This significantly affects the mental and physical health and quality of life of the elderly. With the continuous advancements in medical and information technology, the application of electronic tools in cognitive assessment is gradually increasing. This study summarizes the current application of electronic cognitive assessment tools to provide references for the development of electronic cognitive assessment tools suitable for the elderly in China.
Patient safety culture is an extension of the concept of safety culture in medical institutions and is a hot spot of current patient safety research. In recent years, patient safety culture research has developed rapidly, and new assessment tools and related research have emerged. There is a correlation between cultural factors and safety outcomes, and changing the patient safety culture can improve patient outcomes. This paper focuses on the literature review of patient safety and outpatient safety assessment tools published in China and abroad, analyzes and compares the performance characteristics of domestic and foreign assessment tools, and provides reference for the future patient safety culture research.
Objective To summarize the assessment methods of anal function after low/ultralow rectal anastomosis in patients with rectal cancer. Methods Domestic and international publications on the study of evaluation of anal function after low/ultralow rectal anastomosis in patients with rectal cancer were collected and reviewed. Results Anal function of patients with rectal cancer was usually evaluated by feeling of discharge, continence, perceptual function of rectum, defecate frequency, and defecation time, anal manometry and three-dimensional vector manometry were used as well. Recovery of anal function in patients with rectal cancer after low/ultralow rectal anastomosis depended on the integrity of anal canal, length of remaining rectum, level of anastomosis, and integrity of mucosa. Conclusions Subjective assessment methods and auxiliary measuring instruments are the common means to evaluate the rectal-anal function. Subjective assessment method is simple and direct, but its accuracy is low; Auxiliary measuring instruments have high accuracy, while their examination costs are high and that of costs are not popular, the new assessment methods are needed for further research.
Objective To give a review and commentary on the treatment of acute foot and ankle injuries. Methods Based on the treatment experience and recent l iterature, a commentary on acute foot and ankle injuries were given, included the basic and cl inical research results, evaluation before operation, and treatment methods of the soft tissue and bone injuries. Results The treatment of acute foot and ankle injuries is still a hot point in orthopaedic surgery. Operative and non-operative treatment of fresh Achilles tendon rupture can achieve satisfactory results, and early weight-bearing do not increase the re-rupture rate. The time delay between first debridement and injury within 24 hours does not increase the infection rate. For the treatment of severe ankle fractures, attentions should be paid to the cartilage injury, and anatomic reduction, good real ignment, and the congruity recovery are very important. The treatment determination of calcaneal fractures depends on the fully understanding injury mechanisms, classifications, and treatment method. Talus fractures should try to be treated by experienced surgeons. Operation and fixation methods of Lisfranc injury depends on different injury types. Conclusion Acute foot and ankle injuries are common in cl inical, to achieve a satisfactory result in evaluation and treatment, it is important to have a fully evaluation of the injury type, and choose the best operation time and suitable treatment methods, as well as to fully understand the biomechanical characteristics of different regions.
The reporting checklist of health technology assessment (HTA) was a tool developed by the International Network of Agencies for Health Technology Assessment (INAHTA) to be used to guide the reporting of HTA. Experiential evidence showed that the tool was effective to improve the reporting quality of HTA and also could be used as a reference in performing HTA and translating the research evidence into decision-making. This paper introduced the background, developing process and main contents of the checklist, so as to improve the reporting quality of HTA in China.
ObjectivesTo provide methodology support for the tracking assessment of specific resolution execution through evidence-based construction of tracking assessment index system for resolution execution of WHO essential medicine accessibility resolution, so as to further promote and improve the establishment of national essential medicine policies, and offer a methodology reference to survey and assess the resolution executions in other public health fields.MethodsA multi-disciplinary team was set up to preliminarily construct the index system by means of earlier system assessment index through index screening based on Delphi method. The weight of each index was determined by analytic hierarchy process.ResultsAfter two rounds of expert consultation, the index system available for resolution execution measures and results of WHO essential medicine accessibility were established, including 9 indexes of resolution execution measures. Meanwhile, the execution results of index contained 4 first class indexes, 13 second class indexes and 36 third class indexes. Each of the indexes obtained its own weight according to degree of importance.ConclusionsIn this study, the assessment index for resolution execution of essential medicine accessibility is established, however, the empirical research is still required to further verify the scientificity as well as feasibility of this index system.
ObjectiveTo introduce and preliminarily apply a tool for assessing the importance of research questions (Australia & New Zealand Musculoskeletal Clinical Trials Network Research Question Importance Tool, ANZMUSC-RQIT), thereby providing a methodological reference for selecting research questions. MethodsAn overview of the development process and main content of ANZMUSC-RQIT is provided, and an exploratory application of the tool is conducted to evaluate clinical research questions in the field of musculoskeletal disorders (MSKDs) within Chinese Medicine (CM). ResultsANZMUSC-RQIT assesses the importance of specific research questions across five dimensions. Currently, clinical research on MSKDs in CM often focuses on the consensus among stakeholders regarding the importance of issues, prioritizes addressing problems that pose a significant burden on patients, and aims to alleviate clinical symptoms as the main intervention goal. The total score of ANZMUSC-RQIT is positively correlated with journal impact but shows no statistically significant relationship with citation frequency. Additionally, national funding support is positively correlated with the RQIT total score of the research question. ConclusionThe development of ANZMUSC-RQIT provides valuable reference and inspiration for selecting future research questions. However, to more effectively assess the importance of CM clinical research questions, there is a pressing need to develop an evaluation tool tailored to the specific characteristics of CM clinical research.
Objective To retrospectively analyze the clinical and imaging features of multi-segmental lumbar intervertebral disc protrusion and its treatment with the limited recessive decompression operation. Methods Twenty two patients (14 males and 8 females, aged 49-68 years) were admitted to hospital from March 1999 to March 2004. They suffered from multisegmental lumbar intervertebral disc protrusion that involved L1S1 and were treated with the limited recessive decompression operation. Results The follow-up for 4-21 months showed that 16 of the patients had an excellent outcome, 5 had a good outcome, and 1 had fair outcome. There were nosuch operative complications as nerve root lesions and putamen lesions. Conclusion The limited recessive decompression operation is one of the available good treatments for multi-segmental lumbar intervertebral disc protrusion. It solves problems of herniation and stenosis and maintains stability ofthe spine.