Objective To understand status and influencing factors for cervical discomfort in medical staff and to provide evidence for cervical spondylosis control. Methods We made a cervical discomfort questionnaire for medical personnel, including information about demography, life style, occupational hazard and symptoms of cervical discomfort. Then we carried out a survey from May to July 2017 in a hospital and used logistic regression model to analyze the influencing factors for cervical discomfort in medical staff. Results There were 965 medical staff participated in the survey, the response rate was 79.88% (965/1 208) . A total of 454 cases reported to have cervical discomfort, the prevalence was 47.05%. The results of multiple logistic regression analysis showed that years of service (OR4-10=2.551, 95% CI: 1.683-3.861; OR ＞10=1.767, 95% CI:1.325-2.358), air pollution in the workplace (ORgeneral=0.612, 95%CI: 0.418-0.898; ORno=0.684, 95%CI: 0.469-0.997), new business adaptability (OR=1.749, 95%CI: 1.325-2.309) were the influencing factors for cervical discomfort in medical staff. Conclusion The prevalence of cervical discomfort is high in medical staff. Years of service, working environment and new business adaptability are associated with cervical discomfort in medical staff.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries

BACKGROUNDFractional flow reserve (FFR) is currently considered as the gold standard for evaluating the functional significance of coronary stenosis. However, its potential benefits in real-world practice remain unknown in China. This study aimed to test the hypothesis that the use of FFR is associated with improved outcome and reduced cost in Chinese real-world clinical practice.

METHODSA retrospective cohort study was carried out using the database of Second Affiliated Hospital of Zhejiang University, a tertiary and high-volume center in China. Clinical events were compared using the Cox proportional hazards model during a median follow-up of 13 months.

RESULTSThe study cohort consisted of 366 consecutive patients referred for coronary revascularization with adjunct FFR and 366 matched controls, from 2010 to 2014. Major adverse cardiac events (MACEs) (death, myocardial infarction, repeated revascularization, or hospitalization for angina) at 4 years were found in 12.0% of angiography-guided patients and 4.9% in the FFR-guided group (P < 0.001). The mean number of implanted stents was significantly lower in FFR treated subjects (0.52 ± 0.82 stents) compared with the angiography-guided group (0.93 ± 0.96 stents) (P < 0.001). No difference in overall costs at initial hospitalization was observed between angiography-guided percutaneous coronary intervention (PCI) compared with FFR-guided PCI (RMB 33,000 Yuan, range: RMB 7393-44,700 Yuan) versus RMB 21,200 Yuan (RMB 19,100-47,100 Yuan) (P = 0.54). However, costs for MACEs during follow-up were significantly reduced in the FFR-guided arm (P < 0.001).

CONCLUSIONSIn the contemporary clinical practice, FFR-guided PCI is associated with decreased use of stents, improved clinical outcome, and reduced costs, compared with angiography-guided PCI.

Aged ; China ; Costs and Cost Analysis ; Female ; Fractional Flow Reserve, Myocardial ; physiology ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; economics ; methods ; Retrospective Studies

Humans ; Aortic Valve/surgery* ; Aortic Valve Stenosis/surgery* ; Calcinosis/surgery* ; Transcatheter Aortic Valve Replacement ; Heart Valve Prosthesis

Humans ; Aortic Valve/surgery* ; Aortic Valve Stenosis/surgery* ; Calcinosis/surgery* ; Transcatheter Aortic Valve Replacement ; Heart Valve Prosthesis