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简介：TeleconferenceonIntegratedReformofPublicHospitalsatCountyLevelwasconvenedonApril4,2014inBeijing.LiKeqiang,MemberoftheStandingCommitteeofthePoliticalBureauofCPCCentralCommitteeandPremieroftheStateCouncilhadmadeimportantinstructions,'PublichospitalsatcountylevelarethemainbodyofChina'smedicalhealthservicesystem,areserving900millionruralresidentsandareakeylinkinsolvingtheproblemsofexpensivemedicalbillsanddifficult

简介：AbstractBackground:The 2019 novel coronavirus (2019-nCoV) causing an outbreak of pneumonia in Wuhan, Hubei province of China was isolated in January 2020. This study aims to investigate its epidemiologic history, and analyze the clinical characteristics, treatment regimens, and prognosis of patients infected with 2019-nCoV during this outbreak.Methods:Clinical data from 137 2019-nCoV-infected patients admitted to the respiratory departments of nine tertiary hospitals in Hubei province from December 30, 2019 to January 24, 2020 were retrospectively collected, including general status, clinical manifestations, laboratory test results, imaging characteristics, and treatment regimens.Results:None of the 137 patients (61 males, 76 females, aged 20-83 years, median age 57 years) had a definite history of exposure to Huanan Seafood Wholesale Market. Major initial symptoms included fever (112/137, 81.8%), coughing (66/137, 48.2%), and muscle pain or fatigue (44/137, 32.1%), with other, less typical initial symptoms observed at low frequency, including heart palpitations, diarrhea, and headache. Nearly 80% of the patients had normal or decreased white blood cell counts, and 72.3% (99/137) had lymphocytopenia. Lung involvement was present in all cases, with most chest computed tomography scans showing lesions in multiple lung lobes, some of which were dense; ground-glass opacity co-existed with consolidation shadows or cord-like shadows. Given the lack of effective drugs, treatment focused on symptomatic and respiratory support. Immunoglobulin G was delivered to some critically ill patients according to their conditions. Systemic corticosteroid treatment did not show significant benefits. Notably, early respiratory support facilitated disease recovery and improved prognosis. The risk of death was primarily associated with age, underlying chronic diseases, and median interval from the appearance of initial symptoms to dyspnea.Conclusions:The majority of patients with 2019-nCoV pneumonia present with fever as the first symptom, and most of them still showed typical manifestations of viral pneumonia on chest imaging. Middle-aged and elderly patients with underlying comorbidities are susceptible to respiratory failure and may have a poorer prognosis.

简介：摘要The global outbreak of coronavirus disease 2019 has created an unprecedented challenge to the society. Currently, the United States stands as the most affected country, and the entire healthcare system is affected, from emergency department, intensive care unit, postacute care, outpatient, to home care. Considering the debility, neurological, pulmonary, neuromuscular, and cognitive complications, rehabilitation professionals can play an important role in the recovery process for individuals with coronavirus disease 2019. Clinicians across the nation′s rehabilitation system have already begun working to initiate intensive care unit-based rehabilitation care and develop programs, settings, and specialized care to meet the short- and long-term needs of these individuals. We describe the anticipated rehabilitation demands and the strategies to meet the needs of this population. The complications from coronavirus disease 2019 can be reduced by (1) delivering interdisciplinary rehabilitation that is initiated early and continued throughout the acute hospital stay, (2) providing patient/family education for self-care after discharge from inpatient rehabilitation at either acute or subacute settings, and (3) continuing rehabilitation care in the outpatient setting and at home through ongoing therapy either in-person or via telehealth.

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简介：Inthisstudy,financialpositionandfinancialperformanceofpublichospitals(PH)inTurkeywereanalyzed.Financialstatementsof948publichospitalsbetween2008and2017wereusedinanalysis.Financialstatementswereanalyzedbyratioanalysistechniquetoanalyzethefinancialstatusandfinancialperformanceofpublichospitals.WiththeZ-scoreanalysistechnique,theriskoffinancialfailureofpublichospitalswasmeasured.Thecredibilityofpublichospitalswasmeasuredbytheratinganalysistechnique.Itwasdeterminedthattheaccumulatedlossesinpublichospitalsloweredtheequitybelowzero,theinstitutionshastroublewithpayingdebt,andthecreditriskofpublichospitalsishigh.

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简介：AbstractImportance:There are a variety of musculoskeletal malformations and injuries that can occur in newborns. These can be a significant cause of perinatal death or a reason for miscarriage and can lead to long-term functional issues if not managed appropriately. There is no systematic and well-established screening program for neonatal musculoskeletal malformations and injuries in China now.Objective:To report the incidence and types of congenital musculoskeletal malformations in two hospitals in Shenzhen City, to explore and discuss the details of the screening procedure and improve future prevention and treatment.Methods:From October 2013 to May 2014, 2564 one-day-old newborns were screened by a pediatric orthopedic physical examination, in combination with ultrasonography when required, and the incidence and variety of diseases were recorded statistically.Results:Among 2564 screened newborns, the following musculoskeletal conditions were identified: congenital muscular torticollis (CMT) (seven cases, 0.27%), hip subluxation (four cases, 0.16%), hip dysplasia (47 cases, 1.83%), congenital talipes equinovarus (CTEV) (two cases, 0.08%), congenital talipes calcaneovalgus (15 cases, 0.58%), polydactyly (nine cases, 0.35%), syndactyly (one case, 0.04%), and spinal hemivertebra (one case, 0.04%). Additionally, there were five (0.19%) neonates with birth injuries.Interpretation:It is feasible to carry out neonatal screening and identification of musculoskeletal malformations and birth injuries in China. This is helpful as timely detection and early intervention for many of these conditions can avoid permanent functional impairment in these children.

简介：Inthepresentstudy,thedrug-resistancegenesencodingβ-lactamases,aminoglycosidemodifyingenzymes,DNAtopoisomerasesandintegronaswellastheirmolecularepidemiologywereinvestigatedbymeansofanalyzingthedrug-resistanceandmolecularepidemiologyofAcinebacterbaumanniiisolatedfromtheclinicalsamplesintwohospitalsinQiangzhouandHuzhoucityofJiangsuandZhejiangprovincefromJuly2000toMarch2005.Theminimalinhibitoryconcentrations(MICs)ofthese307isolatesweredetectedbyautomaticmicrobiologicalsystem,and35strainsagainst5-fluoro-quinoloneswereperformedbyagardilutionassay.Meanwhile,theresistantgenesin80isolateswereamplifiedbyPCRwithidentificationbyDNAsequencer.Itwasfoundthatmostofthe307isolatesofA.baumanniiwereresistanttomultipleantibioticstested,inwhichtheresistanceratesoftheisolatesagainstpiperacillin,piperacillin/tazobactam,amoxacillin/clavulanicacid,cefotaxime,ceftazidime,cefepime,gentamicin,amikacin,ciprofloxacin,chloramphenicolandsulfamethoxazole/trimethoprimwereallabove35%,butthoseofimipenemandmeropenemwerequitelow,rangedonly2.6%and3.3%.Inaddition,itwasalsodemonstratedthatthepositiveratesofTEMandSHVβ-lactamasegenesaccountedfor93.8%and22.5%respectively,andthoseoftheaminoglycoside-modifyingenzymegenesincludingaacC1,aacC2,aacC3,aacC4,aacC4A,aphA6,ant(2')-Iandant(3')Iwere58.8%,8.8%,7.5%,28.8%,45.0%,2.5%,28.8%and65.0%respectively.Themutationsinthequinolone-resistantdeterminingregion(QRDR)ofgyrAandparCgenesindicatedthatsubstitutioninSer-83residueofGyrAproteinwasmostfrequentlyoccurredamongstrainswithMICforciprofloxacinofmorethan4μg/ml,whereasadoublemutationatSer-83residueofgyrAandSer-80ofparCwasfoundinstrainswithMICofciprofloxacinofmorethan8μg/ml.Astothepositiveratesofclass1integron(IntI-1)andqacE△1-sul-1,itwasfoundtobe60.0%and77.5%respectively

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简介：AbstractBackground:The coronavirus disease 2019 (COVID-19) is not only attacking physical health, but it is also increasing psychological suffering. This study aimed to observe the impact of the COVID-19 pandemic on mental health outcomes among patients with mild to moderate illness in Fangcang shelter hospitals.Methods:We conducted an observational, cross-sectional study of 129 patients with mild to moderate illness from Jiangxia Fangcang shelter hospitals in Wuhan, China. The participants were assessed by quantifying their symptoms of depression, anxiety, insomnia, and stressful life events and analyzing potential risk factors associated with these symptoms. Using correlation analysis, we examined associations between exposure to COVID-19 and subsequent psychological distress in response to the outbreak.Results:In total, 49.6% of participants had depressive or anxiety symptoms. The depressive and anxiety symptoms were highly related to sleep disturbances and hypochondriasis (all r > 0.50, P < 0.01). The impact of the event was positively related to depressive symptoms, anxiety symptoms, sleep disturbances, hypochondriasis and life events (all r > 0.35, P < 0.01) but was negatively related to psychological resilience (r = -0.41, P < 0.01). The presence of the COVID-19 infection in this setting was associated with increased anxiety, depression and stress levels, and decreased sleep quality, and seriously affected patients’ quality of life as well as adversely affecting the course and prognosis of physical diseases.Conclusion:The sleep quality, anxiety, and depression of COVID-19 patients in Fangcang shelter hospitals were significantly related to the impact of the epidemic.

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简介：摘要: 2019年末，突然暴发的新冠肺炎疫情暴露出我国医疗基础设施严重不足、重大突发公共卫生事件应急体系不健全、医疗救治服务能力较弱等问题，对公立医院建筑未来的转变和发展持续受到社会关注。“新基建”的本质特征对我国公立医院基础设施建设发展趋势进行分析，通过BIM 技术在方舱医院的设计阶段、生产阶段、施工阶段的具体应用进行阐述。实现5G绿色智慧医院将趋势融入到医院建设发展中，打造三位一体的新型智慧型医院。提出方舱医院在人性化设计、快捷转换、“平疫结合”和模块化设计等方面的方法。

简介：BACKGROUND:Intracerebralhemorrhage(ICH)andcoronaryheartdisease(CHD)havethesamepathologicalbase,atherosclerosis,andthesimilarriskfactors,suchassmoking,drinking,hypertension,hyperlipemia,diabetesmellitus,etc;butthedistributionsoftwodiseasesareverydifferentinthepopulations.Thismayberelatedtotheexposureofriskfactorsanddifferenteffectsofriskfactorsontwodiseases.OBJECTIVE:ToanalyzethedistributiondifferenceofriskfactorsforICHandCHDinthepopulationsofTongliaocityofNeiMonggolAutonomousRegion.DESIGN:Retrospectiveanalysis.SETTING:SchoolofRadiationMedicineandPublicHealth,SoochowUniversity;TongliaoHospital,NeiMonggolAutonomousRegion.PARTICIPANTS:Randomsamplingwasusedtoselect6hospitalsfrom10hospitalsaffiliatedtoTongliaoCityofNeiMonggolAutonomousRegion.Totally1672medicalrecordsofpatientswithICHand2195medicalrecordsofpatientswithCHDadmittedtoDepartmentofNeurologyandDepartmentofCardiovascularInternalMedicineofabove-mentioned6hospitalsbetweenJanuary2003andDecember2005werecollectedaccordingtotheinvestigationneed.METHODS:Thesubjects,whosemedicalrecordswereinvolved,wereperformedretrospectiveanalysiswithpre-preparedquestionnaire'StrokeandCoronaryHeartDiseaseEpidemiologicQuestionnaire'.Themaincontentsincluded:①Socialdemographycondition:Thedistributionsofgender,age,nationality,etc.②Previoushistoryofdisease:hypertension,diabetesmellitus,etc.③Relatedriskfactors:systolicbloodpressure,diastolicbloodpressure,totalcholesterol,triglyceride,high-densitylipoproteincholesterol,low-densitylipoproteincholesterol,smoking,drinkingandglucose(GLU).ThedatabaseofEpidatawastransformedtoSPSSdatabase.Single-andmultiple-factornon-conditionalLogisticregressionanalysiswereperformedonthedata,andORvalueand95%CIwerecalculated.Thedistributiondifferencesofriskfactorsfortwodiseaseswerecompared