[Objective] To explore the effectiveness of applying the PDCA (Plan-Do-Check-Act) cycle to enhance the compatibility rate of five Rh blood group antigen phenotypes between donors and recipients across multiple hospital campuses. [Methods] Clinical blood transfusion data from May to July 2022 were selected. Specific improvement measures were formulated based on the survey results, and the PDCA cycle management model was implemented from August 2022. The post-intervention phase spanned from August 2022 to October 2023. The Rh phenotype compatibility rate, the detection rate of Rh system antibodies, and the proportion of Rh system antibodies among unexpected antibodies were compared between the pre-intervention phase (May to July 2022) and the post-intervention phase. [Results] After the continuous improvement with the PDCA cycle, the compatibility rate for the five Rh blood group antigen phenotypes between donors and recipients from August to October 2023 reached 81.90%, significantly higher than the 70.54% recorded during the pre-intervention phase (May to July 2022, P<0.01), and displayed a quarterly upward trend (β=0.028, P<0.05). The detection rate of Rh blood group system antibodies (β=-9.839×10^-5, P<0.05) and its proportion among all detected antibodies (β=-0.022, P<0.05) showed a quarterly decreasing trend, both demonstrating a negative correlation with the enhanced compatibility rate (r values of -0.981 and -0.911, respectively; P<0.05). [Conclusion] The implementation of targeted measures through the PDCA cycle can effectively increase the compatibility rate of five Rh blood group antigen phenotypes between donors and recipients, reduce the occurrence of unexpected Rh blood group antibodies, thereby lowering the risk of transfusion and enhancing the quality and safety of medical care.

Objective: To characterize the incidence density of systematic lupus erythematosus (SLE) in Yinzhou District of Ningbo from 2016 to 2021, and compare the age and gender specific differences. Methods: A retrospective cohort study was conducted based on the related data from 2015 to 2021 collected from the Health Information Platform of Yinzhou. Suspected SLE cases in local residents were identified by fuzzy matching of International Classification of Diseases 10^th edition code "M32" or Chinese text "lupus". The classification criteria from Systemic Lupus International Collaboration Clinics-2012 and The European League Against Rheumatism/American College of Rheumatology-2019 were used for case verification. SLE cases were identified with specific algorithm based on verification results, and new cases were identified with 1 year as the washout period. The incidence density and 95%CI were estimated by Poisson distribution. Results: From 2016 to 2021, a total of 1 551 921 permanent residents were registered in Yinzhou, in whom 51.52% were women. The M(Q₁,Q₃) age at enrollment was 40.38 (27.54, 53.54) years. The M(Q₁,Q₃) of follow-up person-years was 3.83 (0.41, 5.83) years. There were 451 new SLE cases, in which 352 were women (78.05%). The 6-year incidence density was 8.14/100 000 person-years (95%CI: 7.41/100 000 person-years-8.93/100 000 person-years) for the total population, 3.68/100 000 person-years (95%CI: 2.99/100 000 person-years-4.48/100 000 person-years) for men and 12.37/100 000 person-years (95%CI: 11.11/100 000 person-years- 13.73/100 000 person-years) for women. The incidence density in men appeared a small peak at 20-29 years old, and began to increase with age from 40 years old. The incidence density in women was highest in age group 20-29 years (16.57/100 000 person-years) and remained to be high until 30-79 years old. The incidence density of SLE in Yinzhou show no significant temporal trend from 2016 to 2021 (men: P=0.848; women: P=1.000). Conclusions: The incidence density of SLE in Yinzhou from 2016 to 2021 was similar to those of other areas in China. SLE has a high incidence in women, especially in the young and elderly, suggesting that more attention should be paid to the diagnosis and treatment of SLE in women.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Asian People ; Incidence ; Lupus Erythematosus, Systemic/diagnosis* ; Retrospective Studies ; China/epidemiology*

Objective: To construct a cervical cancer risk prediction model based on nested case-control study design and Yinzhou Health Information Platform in Ningbo, and provide reliable reference for self-risk assessment of cervical cancer in local women. Methods: In local women aged 25-75 years old who had no history of cervical cancer registered in Yinzhou before October 31, 2018, a follow up was conducted for at least three years, the patients who developed cervical cancer during the follow up period were selected as the case group and matched with a control group at a ratio of 1∶10. The prediction indicators before the onset was used in model construction. Variables were selected by Lasso-logistic regression, the variables with non-zero β were selected to fit the logistic regression model and Bootstrap was used for internal validation. The discrimination of the model was evaluated by area under the receiver operating characteristic curve(AUROC), and the calibration was evaluated by calibration curve and Hosmer-Lemeshow test. Results: The prediction indicators included in the final model were age, smoking status, history of cervicitis, history of adenomyosis, HPV testing, and thinprep cytologic test. The AUROC calculated in the internal validation was 0.740 (95%CI:0.739-0.740), and the calibration curve was almost identical with the ideal curve, P=0.991 in Hosmer-Lemeshow test, indicating that the model discrimination and calibration were good. Conclusions: In this study, a simple and practical cervical cancer risk prediction model was developed. The model can be used in general population with strong interpretability, good discrimination and calibration in internal validation, which can provide a reference for women to assess their risk of cervical cancer.

OBJECTIVE: To describe the distribution characteristics of inflammatory bowel disease among permanent residents in Yinzhou District, Ningbo City, and to understand the disease burden and development trend of inflammatory bowel disease in this area. METHODS: Using the retrospective cohort design, we collected the registration information of all permanent residents in the residents' health files of the Yinzhou Regional Health Information Platform from 2010 to 2020, and used electronic medical records to follow up their inflammatory bowel disease visits. A one-year wash-out period was set, and the patients who were diagnosed with the primary diagnosis for the first time after one year of registration were re-garded as new cases. The incidence density and 95% confidence interval (CI) of inflammatory bowel disease were estimated by Poisson distribution. RESULTS: From 2011 to 2020, a total of 1 496 427 permanent residents in Yinzhou District were included, of which 729 996 were male (48.78%). The total follow-up person-years were 8 081 030.82, and the median follow-up person-years were 5.41 [interquartile range (IQR): 5.29]. During the study period, there were 1 217 new cases of inflammatory bowel disease, of which males (624 cases, 51.27%) were more than females (593 cases, 48.73%). The total incidence density was 15.06/100 000 person-years (95%CI: 14.23, 15.93). Among all new cases, there were 1 106 cases (90.88%) of ulcerative colitis, with an incidence density of 13.69 per 100 000 person-years (95%CI: 12.89, 14.52); 70 cases (5.75%) of Crohn's disease, with an incidence density of 0.87 per 100 000 person-years (95%CI: 0.68, 1.09); and 41 cases (3.37%) of indeterminate colitis, with an incidence density of 0.51 per 100 000 person-years (95%CI: 0.36, 0.69). The median age of onset of ulcerative colitis was 50.82 years old (IQR: 18.77), with the highest proportion (15.01%) in the 45-49 years group. The incidence density of ulcerative colitis gradually increased with age, reaching a relatively high level in the 45-49 years group (20.53/100 000 person-years; 95%CI: 17.63, 23.78), followed by a slight increase. And the incidence density in the 65-69 years group was the highest (25.44/100 000 person-years; 95%CI: 20.85, 30.75), with a rapid decrease in the 75-79 years group. The median age of onset of Crohn's disease was 44.34 years (IQR: 33.41), with the highest proportion (12.86%) in the 25-29 years group. Due to the small number of new cases of Crohn's disease, the age distribution fluctuated greatly, with peaks both in young and old people. From 2011 to 2020, the incidence density of inflammatory bowel disease in Yinzhou District was at a low level from 2011 to 2013, and showed a rapid upward trend from 2014 to 2016, reaching a peak of 24.62 per 100 000 person-years in 2016 (95%CI: 21.31, 28.30), and slightly decreased in 2017-2020. CONCLUSION The incidence density of inflammatory bowel disease in Yinzhou District from 2011 to 2020 was at a relatively high level, and medical institutions and health departments need to pay attention to the burden of disease caused by it.
Adolescent ; Adult ; Chronic Disease ; Colitis, Ulcerative/epidemiology* ; Crohn Disease/epidemiology* ; Female ; Humans ; Incidence ; Inflammatory Bowel Diseases/epidemiology* ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVE: To develop a new classification of acromion based on the subacromial impingement theory and the Rockwood tilt view. And explore the application value of the new classification in the diagnosis and treatment of rotator cuff tear. METHODS: The clinical data of 101 patients underwent shoulder arthroscopic surgery for impingement syndrome or rotator cuff tear from January to December 2017 were retrospectively analyzed. There were 34 males and 67 females, aged from 34 to 76 years with an average of (56.31±9.63) years old, course of disease from 2 to 12 months with average of 6 months. Preoperative radiographs of the routine anteroposterior view, Rockwood tilt view and the supraspinatus outlet view were obtained. Based on the subacromial impingement theory and Rockwood radiographs, the morphology of the acromion can be divided into three types:typeⅠ(flat type), typeⅡ(bump type), and type Ⅲ (impingement type). Two observers classified 101 shoulder Rockwood radiographs according to the new classification method and the supraspinatus Outlet radiographs according to the traditional acromial morphological classification method. Supraspinatus tendon injuries were classified into no tear, partial-thickness tear, and full-thickness tear according to the arthroscopic findings. Concordance test (Kappa value) between the inter-observer and intra-observer was carried out for the new classification method and the traditional classification method respectively. The rank sum test was used to compare the mean acromiohumeral distance(AHD) of the three acromion forms in the new acromion classification method. Spearman rank correlation test and Gamma method were used to analyze the correlation between the new acromion classification method and the degree of supraspinatus tendon tear. RESULTS: The inter-observer consistency analysis of the new classification system was significantly better than that of the traditional classification (0.827 vs 0.278), the intra-observer consistency analysis of the new classification system were also significantly better than that of the traditional classification (0.921 vs 0.448, 0.890 vs 0.539). There was no statistical significance in the AHD among three types of the new classification(H=2.186, P>0.05). In all 101 patients, the highest proportion of impingement type acromion was 45.5% (46 cases), followed by bump type acromion was 36.6% (37 cases), and flat type acromion was 17.8% (18 cases). The incidence of supraspinatus tendon tear in the patients with impingement type acromion was significantly higher than that of the other two types of acromion, there was a spearman rank correlation between the new acromion type and the degree of the supraspinatus tendon tear(rs=0.719, P<0.001). CONCLUSION Rockwood radiographs of the shoulder can well display the anterolateral osteophytes of the acromion. The new acromion classification method based on Rockwood radiographs has high reliability and good reproducibility, in which impingement type of acromion is closely related to supraspinatus tendon tear. Compared with the traditional classification and AHD, the new classification method has more diagnostic value than for rotator cuff injury.
Acromion/surgery* ; Aged ; Female ; Humans ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Reproducibility of Results ; Retrospective Studies ; Rotator Cuff/surgery* ; Rotator Cuff Injuries/surgery* ; Rupture ; Shoulder Impingement Syndrome/surgery*

Objective: To describe the distribution and trend of rheumatoid arthritis (RA) in adults in the Yinzhou district from 2011 to 2020 and compare the incidence differences in different ages and genders. Methods: Using the retrospective cohort design, we collected all new cases diagnosed with RA between 2011 to 2020 from the Yinzhou Regional Health Information Platform (YRHIP). Poisson distribution was used to estimate RA's incidence density and 95%CI. Results: From 2011 to 2020, 1 280 012 permanent residents in Yinzhou district were included, of which 665 361 were female (51.98%). The total follow-up person-years were 7 198 513.61, and the median follow-up person-year was 5.41 years (P₂₅=3.50, P₇₅=8.32). During the study period, there were 2 350 new cases of RA, of which 1 460 were female (62.13%). The 10-year incidence density of the population was 32.65/100 000 person-years (95%CI: 31.34/100 000 person-years-33.99/100 000 person-years), that of females was 39.17/100 000 person-years (95%CI: 37.19/100 000 person-years-41.24/100 000 person-years), and that of the male was 25.64/100 000 person-years (95%CI: 23.98/100 000 person-years-27.38/100 000 person-years), the gender difference was statistically significant (P<0.001). The incidence risk in all age groups above 30 years old was higher than that in the 18-29 years old group (P<0.001), and the incidence risk increased with age from 18-79 years old while decreased slightly with age ≥80 years old. The lowest incidence density was 15.30/100 000 person-years in 2013 (95%CI:12.62/100 000 person-years-18.38/100 000 person- years), and the highest was 56.70/100 000 person-years in 2016 (95%CI: 51.24/100 000 person- years - 62.58/100 000 person-years), with statistically significant differences among different years (P=0.004). Conclusions: From 2011 to 2020, the incidence density of RA in adults in Yinzhou district first increased, then decreased, and tended to stabilize. There were differences in incidence density in different years, ages, and genders.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Arthritis, Rheumatoid/epidemiology* ; Cohort Studies ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Retrospective Studies ; Sex Factors ; Young Adult

OBJECTIVE: To explore the feasibility and clinical effects of arthroscopic treatment for the calcific tendinitis at soft tissues around hip. METHODS: A total of 16 patients diagnosed as the calcific tendinitis at soft tissues around hip from May 2013 to July 2018 were retrospectively analyzed. All the 16 patients received arthroscopic procedures. There were 10 males and 6 females with an average age of 35 to 63 (44.50±6.67) years old and 9 left hips, 6 right hips were involved. The course of disease were 1 to 8(3.18±1.97) days. Clinical effects were evaluated with visual analogue scale(VAS), modified Harris hip scores (HHS), nonarthritic hip score (NAHS) and imaging examinations before operation, 1 day after operation and the final follow-up. RESULTS: All 16 patients successfully finished the arthroscopic procedures in 0.5 to 1.2 (0.75±0.21) hours. Primary healing of incision were obtained without any complications of infection, wound hematocele and neurovascular injury. All 16 patients received an average postoperative follow-up of 6 to 12 (9.6±2.3) months. Before operation, the VAS were 7.88±0.72, modified HHS were 29.25±3.23, NAHS were 27.42±3.08. The 1st day postoperative VAS were 2.19±0.66, modified HHS were 82.56± 5.64, NAHS were 82.11±2.94, all the difference were statistically significant between before and 1 day after operation ( CONCLUSION Arthroscopic treatment for the calcific tendinitis at soft tissues around hip is effective.It has advantages of minimal invasive, rapid pain relief, rapid hip joint function recovery and definite clinical effects.
Adult ; Arthroscopy ; Female ; Follow-Up Studies ; Hip/surgery* ; Hip Joint/surgery* ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tendinopathy/surgery* ; Treatment Outcome

OBJECTIVE: To describe the distribution and trend of infantile epilepsy among infants under 36 months in Ningbo, Zhejiang Province. METHODS: Using the birth cohort design, we retrospectively collected the local born infants in Ningbo national health information platform from 2015 to 2019, and took the first visit of epilepsy in the electronic medical record of the platform as the new case. The incidence density and 95% confidence interval (CI) of epilepsy were estimated by Poisson distribution. RESULTS: From 2015 to 2019, a total of 294 900 children were born in Ningbo, with male accounting for 51.92%. The total person-years of observation were 595 300, while the median follow-up person-years was 2.31 [interquartile range (IQR): 1.90]. There were 575 new onset epilepsy patients during the whole observation period. The total number of visits was 2 599, with an average of 4.52. The total incidence density was 96.59/100 000 person-years (95%CI: 88.85-104.82). The median age of onset was 13 months (IQR: 15), 0-12 months old infants had the highest incidence density (102.18/100 000 person-years), 25-36 months old infants had the lowest incidence density (89.68/100 000 person-years), and the difference was not statistically significant (P>0.05). The incidence density of male was 97.58/100 000 person-years, female was 95.53/100 000 person-years, and the difference was not statistically significant (P>0.05). Fenghua was the highest (130.54/100 000 person-years, 95%CI: 94.47-175.83) and Ninghai was the lowest (66.44/100 000 person-years, 95%CI: 47.02-91. 19), with significant difference (P < 0.05). There was no significant difference in the incidence density in different birth years (P>0.05). There was significant difference in the incidence density between 0-12 months old infants in different calendar years (P_trend < 0.05). In this age group, the incidence density was the lowest in 2015 (69.41/100 000 person-years, 95%CI: 41.79-108.39), and the highest in 2019 (225.61/100 000 person-years, 95%CI: 186.10-271.03). There was no significant difference in the incidence density between 13-24 and 25-36 months old infants in different calendar years (P>0.05). CONCLUSION The incidence density of epilepsy in 0-36 months old infants in Ningbo City from 2015 to 2019 was low as a whole, and there was no difference in age group, gender, and year of birth. The incidence density of 0-12 months old infants increased with the year.
Child, Preschool ; Cities ; Epilepsy/epidemiology* ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Retrospective Studies

OBJECTIVE: To describe the epidemiological and etiological characteristics of hand, foot and mouth disease (HFMD) among children aged 5 years and younger in Ningbo after the access of entero-virus-A71 vaccine (2016 to 2019). METHODS: A retrospective cohort study were performed in children aged 5 years and younger in Ningbo from 2016 to 2019. Data for incidence of HFMD was collected from the National Notifiable Disease Surveillance Reporting System and the Electronic Medical Records (EMRs) System, while the demographic information was derived from the Immunization Information System. Speci-mens were detected by real-time fluorescence quantitative PCR and the Wilson method was used to estimate the incidence rate and 95% confidence interval. RESULTS: From 2016 to 2019, a total of 1 044 800 residential children were observed in this population-based cohort. In the study, 102 471 cases of HFMD were diagnosed in 2 651 081 person-years, revealing an overall incidence density of 3 865.25/100 000 person-years. There was no significant decline in the number of the cases after the vaccine was available. The number of the patients of hand foot mouth disease during the four years was 93 421, of whom 84 875 (90.85%) had only one incident record, while 8 946 (9.15%) had 2 or more cases in this period; there were 69 771 (66.06%) patients who only needed to see a doctor once for each disease, 19.92% of the patients needed to be treated twice, and 14 801 (14.02%) patients needed to go to the hospital or clinic three times or more. The incidence of HFMD showed obvious seasonality and periodicity, which mainly concentrated in April to July each year, and the epidemic cycle was 2 years; most of the cases were 1 to 3-year old children, with more cases in male. The incidence density varied across the region, with the highest density observed in Ninghai (4 524.76/100 000 person-years), followed by Xiangshan (3 984.22/100 000 person-years). In 3 748 library-conformed cases, 2 834(75.61%) were detected positive, among which enterovirus-A71, Cox-A16 and other enteroviruses accounted for 9.03%, 31.55% and 59.42%, respectively. During the study period, the cumulative coverage of enterovirus-A71 vaccine increased year by year, with the proportion of enterovirus-A71 and severe cases both gradually decreasing. CONCLUSION The current status of hand, foot and mouth disease in Ningbo is still serious. Children under 3-year old (especially male children aged 1 year) were the key population for prevention and control. Vaccination might lead to changes in major pathogenic virus type, of which more attention should be paid to the potential impact on disease surveillance, prevention and control.
Child ; Child, Preschool ; China/epidemiology* ; Enterovirus ; Enterovirus Infections ; Hand, Foot and Mouth Disease/epidemiology* ; Humans ; Incidence ; Infant ; Male ; Retrospective Studies

Objective: To preliminarily analyze the prediction efficiency of multimodal MRI-based radiomics model for preoperative glioma IDH1 gene expression type. Methods: The MRI data of 108 surgery-proven glioma patients from May 2015 to January 2019 were retrospectively analyzed, and the MRI data included axial T₁WI,T₂WI,fluid attenuated inversion recovery (FLAIR),DWI imaging and enhanced T₁WI sequence.Forty-seven cases were IDH1 mutant type, and 61 cases were IDH1 wild type. All patients were divided into training and validation groups according to the 7∶3 ratio of the random forest model. Seventy-three cases were in training group, and 35 cases were in validation group. Independent predictors of IDH1 mutation were screened by univariate analysis combined with multivariate logistic regression analysis (P<0.05) in order to construct a random forest diagnosis model of general clinical information and conventional MRI morphological features.General clinical information and conventional MRI morphological features included gender, age, umbers of cases of left and right hemispheres, location of tumors, maximum diameter of tumors, peritumoral edema, intratumoral cystic degeneration, enhancement and ADC value of tumors. The ROI was manually outlined by MaZda software in the most obvious level of 5 sequences of tumor mass and the radiomics features were extracted, including the gray-level co-occurrence matrix(GLCM), the run-length matrix(RUN), the absolute gradient(GRA),the auto-regressive model(ARM) and wavelets transform(WAV). The least absolute shrinkage and selection operator (LASSO)regression were used to select image radiomics features with a method of 10 fold cross -validation and to reduce the dimensions. The screened image radiomics labels were combined with the conventional morphological feature independent predictors to construct a multimodal MRI-based random forest model, and the validation data set was used to evaluate the accuracy and diagnostic efficiency of each model. The sensitivity and specificity of conventional MRI morphological feature model and multimodal MRI-based radiomics prediction model were evaluated dynamically by drawing ROC curves, and the prediction efficiency of the two models was quantified by using AUC statistical indicators. The model classification error rate under different outcomes and the classification error rate of out of bag(OOB)were used to evaluate the stability of the multimodal MRI-based random forest model. The contribution rate of each variable to the model was reflected by the characteristic variables importance assessment map. Results: Univariate regression analysis of the conventional MRI morphological characteristics showed that peritumoral edema, cystic degeneration and enhancement were the three independent predictors of IDH1 gene expression (P<0.01). LASSO algorithm and 10-fold cross-validation identified six robust radiomic features including high frequency coefficients of wavelet transform (WavEnHH_s-4) of T₂WI, S(4,4) inverse difference of gray uniformity measurement (InvDfMom),S(5,0) Entropy (entropy),WavEnHH_s-4 of T₁WI enhancement, S(1,1) InvDfMom,S(1, -1) Entropy Difference (DifEntrp)of Flair.The error rate of classification for different outcomes and classification error rate of random forest OOB data of multimodal MRI radiomics diagnosis model finally stabilized at 10%. The results of Characteristic Variable Importance Assessment Map: Mean Decrease Accuracy and Mean Decrease Gini index were consistent, which showed that besides three conventional MRI morphological predictors peritumoral edema, enhancement and cystic degeneration, the radiomics labels also played a key role in the model. The results of ROC curve showed that the accuracy, specificity, sensitivity and AUC of conventional MRI morphological feature model were 82.7%, 68.4%, 90.9% and 0.835, respectively, and those of multimodal MRI-based radiomics model were 88.5%, 89.5%, 87.8% and 0.956 respectively. Conclusion Multimodal MRI-based radiomics random forest model can improve the predictive efficiency of preoperative glioma IDH1 gene expression type more quantitatively.