1.Research on policy framework, standards system and application of disability data
Yaru YANG ; Zhuoying QIU ; Zhongyan WANG ; Di CHEN ; Jian YANG ; Qi JING ; Na AN ; Tiantian WAN ; Xiaojia XIN ; Xiaoqin LIU ; Yuanjun DONG ; Xiangxia REN ; Ye LIU ; Yifan TIAN ; Xueli LÜ
Chinese Journal of Rehabilitation Theory and Practice 2024;30(12):1365-1375
		                        		
		                        			
		                        			ObjectiveTo systematically analyze international disability data policies and standards, as well as the application of disability data in policymaking, service optimization and inclusive social development, and to clarify the importance of international disability data policies, standard systems and disability data application for the development of disability-related services. MethodsThrough the analysis of policy content and research on the data standard system, this study explored the disability data policy framework, standard system and technical path of data interoperability and integration of international organizations including the United Nations (United Nations Statistics Division and United Nations Children's Fund), World Health Orgnization, United Nations Educational Scientific and Cultural Organization, and International Labour Organization. ResultsInternational organizations established disability data policy frameworks based on their respective mandates, involving data and service development, data standards, data governance, and data application. The international community established a disability data standard system for disability data collection, coding, exchange, interoperability, statistical analysis, data fusion and application. Building a standardized disability data standard system based on the framework of international health classification standards such as International Classification of Functioning, Disability and Health, and International Classification of Diseases, Eleventh Revision would ensure the consistency of cross-national disability data policies, and the interoperability and comparability of disability data, promoting the development of data-driven disability-related services, accurately identifying the service needs of people with disabilities, and optimizing service provision, thereby improving the quality of life and social participation of people with disabilities. ConclusionThe construction and implementation of international disability data policies and data standards have promoted the standardization and interoperability of disability data. With the application of big data, artificial intelligence and blockchain technologies in disability data, international cooperation and cross-industry data fusion in the field of disability data have been promoted, further promoting the development of data-driven disability services, ensuring equal opportunities for people with disabilities to enjoy service resources, and improving the coverage and quality of disability services. 
		                        		
		                        		
		                        		
		                        	
2.Meta-analysis of risk factors for rheumatoid arthritis complicated with interstitial pulmonary disease
Ling ZHANG ; Lili WANG ; Lixia LIU ; Xiaojuan WANG ; Xueli REN ; Yinxian LI
Chinese Journal of Rheumatology 2023;27(12):820-828
		                        		
		                        			
		                        			Objective:A meta-analysis was conducted to investigate the risk factors of interstitial lung disease in patients with RA to provide a reliable reference for clinical practice.Methods:Publications of the China Knowledge Network, Vipshop, Wanfang, China Biomedical Literature Database, EMbase, PubMed, and Cochrane Library databases were searched to obtain literature on cohort studies and case-control studies for risk factors for RA complicated with interstitial lung disease from the time of database creation until December 31, 2022. Literature screening, information extraction, and final quality evaluation were performed independently by two investigators. The extracted data were analyzed using RevMan 5.3 software.Results:A total of 31 studies with a total of 26 747 patients were included in this study, of which 4 799 patients(17.94%) were patients with RA complicated with interstitial lung disease. A total of 12 risk factors were obtained included: advanced age [ OR (95% CI) =1.07(1.04, 1.09), P<0.001], high age at onset [ OR (95% CI) =2.11(1.17, 3.82), P=0.010], male [ OR (95% CI) =1.95(1.34, 2.84), P<0.001], long duration of disease [ OR (95% CI) =1.10(1.08, 1.13), P<0.001], smoking [ OR (95% CI) =2.47(1.57, 4.04), P<0.001], high disease activity [ OR (95% CI) =(1.21, 2.54), P=0.003), cough [ OR (95% CI) =6.10 (2.40, 15.52), P<0.001], decreased pulmonary carbon monoxide diffusing capacity [ OR (95% CI) =0.93(0.89, 0.96), P<0.001], and high titer anti-CCP antibody [ OR (95% CI) =1.14(1.03, 1.26), P=0.010], high titer RF [ OR (95% CI) =2.37(1.70, 3.29), P<0.001], high level of immunoglobulin A [ OR (95% CI) =1.26 (1.09, 1.46), P=0.002] and high level of glycoprotein antigen 125 [ OR (95% CI) =3.66 (1.81, 7.41), P<0.001]. Conclusion:The existing evidence have shown that advanced age, high age at onset, male, long disease duration, smoking, high disease activity, cough, decreased pulmonary carbon monoxide diffusing capacity, high titer anti-CCP antibody and RF, high level of immunoglobulin A and high level of glycoprotein antigen 125 are the main risk factors for interstitial lung disease in patients with rheumatoid arthritis. However, the evidence of Raynaud's phenomenon and tumor marker CA153 as risk factors for RA complicated with interstitial lung disease is not strong, and further high-quality prospective cohort studies are needed.
		                        		
		                        		
		                        		
		                        	
3.Bismuth, esomeprazole, metronidazole, and minocycline or tetracycline as a first-line regimen for Helicobacter pylori eradication: A randomized controlled trial.
Baojun SUO ; Xueli TIAN ; Hua ZHANG ; Haoping LU ; Cailing LI ; Yuxin ZHANG ; Xinlu REN ; Xingyu YAO ; Liya ZHOU ; Zhiqiang SONG
Chinese Medical Journal 2023;136(8):933-940
		                        		
		                        			BACKGROUND:
		                        			Given the general unavailability, common adverse effects, and complicated administration of tetracycline, the clinical application of classic bismuth quadruple therapy (BQT) is greatly limited. Whether minocycline can replace tetracycline for Helicobacter pylori ( H . pylori ) eradication is unknown. We aimed to compare the eradication rate, safety, and compliance between minocycline- and tetracycline-containing BQT as first-line regimens.
		                        		
		                        			METHODS:
		                        			This randomized controlled trial was conducted on 434 naïve patients with H . pylori infection. The participants were randomly assigned to 14-day minocycline-containing BQT group (bismuth potassium citrate 110 mg q.i.d., esomeprazole 20 mg b.i.d., metronidazole 400 mg q.i.d., and minocycline 100 mg b.i.d.) and tetracycline-containing BQT group (bismuth potassium citrate/esomeprazole/metronidazole with doses same as above and tetracycline 500 mg q.i.d.). Safety and compliance were assessed within 3 days after eradication. Urea breath test was performed at 4-8 weeks after eradication to evaluate outcome. We used a noninferiority test to compare the eradication rates of the two groups. The intergroup differences were evaluated using Pearson chi-squared or Fisher's exact test for categorical variables and Student's t -test for continuous variables.
		                        		
		                        			RESULTS:
		                        			As for the eradication rates of minocycline- and tetracycline-containing BQT, the results of both intention-to-treat (ITT) and per-protocol (PP) analyses showed that the difference rate of lower limit of 95% confidence interval (CI) was >-10.0% (ITT analysis: 181/217 [83.4%] vs . 180/217 [82.9%], with a rate difference of 0.5% [-6.9% to 7.9%]; PP analysis: 177/193 [91.7%] vs . 176/191 [92.1%], with a rate difference of -0.4% [-5.6% to 6.4%]). Except for dizziness more common (35/215 [16.3%] vs . 13/214 [6.1%], P = 0.001) in minocycline-containing therapy groups, the incidences of adverse events (75/215 [34.9%] vs . 88/214 [41.1%]) and compliance (195/215 [90.7%] vs . 192/214 [89.7%]) were similar between the two groups.
		                        		
		                        			CONCLUSION:
		                        			The eradication efficacy of minocycline-containing BQT was noninferior to tetracycline-containing BQT as first-line regimen for H . pylori eradication with similar safety and compliance.
		                        		
		                        			TRIAL REGISTRATION
		                        			ClinicalTrials.gov, ChiCTR 1900023646.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Bismuth/therapeutic use*
		                        			;
		                        		
		                        			Metronidazole/therapeutic use*
		                        			;
		                        		
		                        			Esomeprazole/pharmacology*
		                        			;
		                        		
		                        			Minocycline/pharmacology*
		                        			;
		                        		
		                        			Helicobacter pylori
		                        			;
		                        		
		                        			Potassium Citrate/therapeutic use*
		                        			;
		                        		
		                        			Anti-Bacterial Agents
		                        			;
		                        		
		                        			Tetracycline/adverse effects*
		                        			;
		                        		
		                        			Helicobacter Infections/drug therapy*
		                        			;
		                        		
		                        			Drug Therapy, Combination
		                        			;
		                        		
		                        			Amoxicillin
		                        			
		                        		
		                        	
4.HIV infection rate, high-risk behavior and pre-exposure prophylaxis/post-exposure prophylaxis in men who have sex with men in Beijing
Dongyan XIA ; Xueli SU ; Guowu LIU ; Xianlong REN ; Juan WANG ; Guiying LI ; Jing CHEN ; Conghui XU ; Hongyan LU
Chinese Journal of Epidemiology 2023;44(9):1390-1396
		                        		
		                        			
		                        			Objective:To understand the incidence of HIV infection, high risk behaviors and pre-exposure prophylaxis/post-exposure prophylaxis (PrEP/PEP) utilization in men who have sex with men (MSM) in Beijing.Methods:Sample size was estimated to be 1 227 persons and 207 person year respectively in the survey and the cohort by using Epi Info 7.0 software. Using convenient sampling method, MSM were recruited by using Wechat app. Questionnaire was completed online to collect the information about demographic characteristics, high risk behavior, and utilization of PrEP/PEP of the MSM. MSM collected dry blood spot (DBS) samples by themselves, and mailed the DBS samples to laboratory for HIV nucleic acid testing. Open cohort was established and those with HIV negative nucleic acid testing results were followed up. Non-conditional binary logistic regression method was used to identify the associated factors for high risk anal sex in the last month and having multiple homosexual partners in the last month.Results:A total of 1 147 MSM were recruited, and follow up for 236 person years was conducted in 956 MSM with negative HIV nucleic acid testing results. The detection rate of new HIV infection was 1.3 per 100 person-years (3/236). During the last month, the proportions of consistent condom use in anal sex and oral sex were 50.7% (238/469) and 4.9% (23/469). In the MSM, 5.9% (43/723) had sex with HIV positive partners in the last month. 9.8% (103/1 049) used PrEP, and 8.7% (91/1 049) used PEP. The proportion of consistent condom use in PrEP and PEP were 34.3% (24/70) and 72.2% (39/54) respectively. Logistic regression analysis revealed that compared with those who used no PrEP/PEP, those who used PrEP/PEP were more likely to have unprotected anal sex in the last month (a OR=3.16, 95% CI:1.45-7.18), and more likely to have multiple homosexual partners in the last month (a OR=2.64, 95% CI:1.19-6.30), and compared with those who used no Rush Popper or drugs in the last month, those who used Rush Popper or drugs in the last month were more likely to have unprotected anal sex in the last month (a OR=2.34, 95% CI:1.67-3.30), and more likely to have multiple homosexual partners (a OR=2.42,95% CI:1.76-3.33). Conclusions:It is necessary to strengthen the health education to promote condom use and introduce the harm of drug use in MSM. In PrEP and PEP services, it is still necessary to suggest consistent condom use for MSM.
		                        		
		                        		
		                        		
		                        	
5.Analysis of factors influencing the quality of Internet+ nursing services based on structural equation modelling
Zhifang REN ; Xueli GAO ; Yanling WANG ; Lili ZHANG ; Qian XIAO
Chinese Journal of Modern Nursing 2023;29(21):2897-2901
		                        		
		                        			
		                        			Objective:To explore the influencing factors of Internet + nursing service quality.Methods:Using a convenience sampling method, 290 nursing staff who had implemented Internet+ nursing services in Beijing and Tianjin were selected for a questionnaire survey from January to February 2022, and structural equation model was used to analyze the influencing factors and the path of action of service quality.Results:The structural equations constructed fit well, with gender, degree of service difficulty and degree of service motivation being direct influences on the quality of Internet+ nursing services, with degree of service difficulty also having an indirect effect on service quality through degree of service motivation.Conclusions:The quality of Internet+ nursing services is influenced by multiple factors and pathways. The relevant authorities can conduct a comprehensive assessment of the factors and pathways and manage them in a targeted manner to improve the quality of services.
		                        		
		                        		
		                        		
		                        	
6.Epidemiological characteristics, diagnosis, treatment and prognosis of gallbladder cancer in China: a report of 6 159 cases
Xuheng SUN ; Yijun WANG ; Wei ZHANG ; Yajun GENG ; Yongsheng LI ; Tai REN ; Maolan LI ; Xu'an WANG ; Xiangsong WU ; Wenguang WU ; Wei CHEN ; Tao CHEN ; Min HE ; Hui WANG ; Linhua YANG ; Lu ZOU ; Peng PU ; Mingjie YANG ; Zhaonan LIU ; Wenqi TAO ; Jiayi FENG ; Ziheng JIA ; Zhiyuan ZHENG ; Lijing ZHONG ; Yuanying QIAN ; Ping DONG ; Xuefeng WANG ; Jun GU ; Lianxin LIU ; Yeben QIAN ; Jianfeng GU ; Yong LIU ; Yunfu CUI ; Bei SUN ; Bing LI ; Chenghao SHAO ; Xiaoqing JIANG ; Qiang MA ; Jinfang ZHENG ; Changjun LIU ; Hong CAO ; Xiaoliang CHEN ; Qiyun LI ; Lin WANG ; Kunhua WANG ; Lei ZHANG ; Linhui ZHENG ; Chunfu ZHU ; Hongyu CAI ; Jingyu CAO ; Haihong ZHU ; Jun LIU ; Xueyi DANG ; Jiansheng LIU ; Xueli ZHANG ; Junming XU ; Zhewei FEI ; Xiaoping YANG ; Jiahua YANG ; Zaiyang ZHANG ; Xulin WANG ; Yi WANG ; Jihui HAO ; Qiyu ZHANG ; Huihan JIN ; Chang LIU ; Wei HAN ; Jun YAN ; Buqiang WU ; Chaoliu DAI ; Wencai LYU ; Zhiwei QUAN ; Shuyou PENG ; Wei GONG ; Yingbin LIU
Chinese Journal of Digestive Surgery 2022;21(1):114-128
		                        		
		                        			
		                        			Objective:To investigate the epidemiological characteristics, diagnosis, treat-ment and prognosis of gallbladder cancer in China from 2010 to 2017.Methods:The single disease retrospective registration cohort study was conducted. Based on the concept of the real world study, the clinicopathological data, from multicenter retrospective clinical data database of gallbladder cancer of Chinese Research Group of Gallbladder Cancer (CRGGC), of 6 159 patients with gallbladder cancer who were admitted to 42 hospitals from January 2010 to December 2017 were collected. Observation indicators: (1) case resources; (2) age and sex distribution; (3) diagnosis; (4) surgical treatment and prognosis; (5) multimodality therapy and prognosis. The follow-up data of the 42 hospitals were collected and analyzed by the CRGGC. The main outcome indicator was the overall survival time from date of operation for surgical patients or date of diagnosis for non-surgical patients to the end of outcome event or the last follow-up. Measurement data with normal distribu-tion were represented as Mean±SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range), and com-parison between groups was conducted using the U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis was performed using the Logistic forced regression model, and variables with P<0.1 in the univariate analysis were included for multivariate analysis. Multivariate analysis was performed using the Logistic stepwise regression model. The life table method was used to calculate survival rates and the Kaplan-Meier method was used to draw survival curves. Log-rank test was used for survival analysis. Results:(1) Case resources: of the 42 hospitals, there were 35 class A of tertiary hospitals and 7 class B of tertiary hospitals, 16 hospitals with high admission of gallbladder cancer and 26 hospitals with low admission of gallbladder cancer, respectively. Geographical distribution of the 42 hospitals: there were 9 hospitals in central China, 5 hospitals in northeast China, 22 hospitals in eastern China and 6 hospitals in western China. Geographical distribution of the 6 159 patients: there were 2 154 cases(34.973%) from central China, 705 cases(11.447%) from northeast China, 1 969 cases(31.969%) from eastern China and 1 331 cases(21.611%) from western China. The total average number of cases undergoing diagnosis and treatment in hospitals of the 6 159 patients was 18.3±4.5 per year, in which the average number of cases undergoing diagnosis and treatment in hospitals of 4 974 patients(80.760%) from hospitals with high admission of gallbladder cancer was 38.8±8.9 per year and the average number of cases undergoing diagnosis and treatment in hospitals of 1 185 patients(19.240%) from hospitals with low admission of gallbladder cancer was 5.7±1.9 per year. (2) Age and sex distribution: the age of 6 159 patients diagnosed as gallbladder cancer was 64(56,71) years, in which the age of 2 247 male patients(36.483%) diagnosed as gallbladder cancer was 64(58,71)years and the age of 3 912 female patients(63.517%) diagnosed as gallbladder cancer was 63(55,71)years. The sex ratio of female to male was 1.74:1. Of 6 159 patients, 3 886 cases(63.095%) were diagnosed as gallbladder cancer at 56 to 75 years old. There was a significant difference on age at diagnosis between male and female patients ( Z=-3.99, P<0.001). (3) Diagnosis: of 6 159 patients, 2 503 cases(40.640%) were initially diagnosed as gallbladder cancer and 3 656 cases(59.360%) were initially diagnosed as non-gallbladder cancer. There were 2 110 patients(34.259%) not undergoing surgical treatment, of which 200 cases(9.479%) were initially diagnosed as gallbladder cancer and 1 910 cases(90.521%) were initially diagnosed as non-gallbladder cancer. There were 4 049 patients(65.741%) undergoing surgical treatment, of which 2 303 cases(56.878%) were initially diagnosed as gallbladder cancer and 1 746 cases(43.122%) were initial diagnosed as non-gallbladder cancer. Of the 1 746 patients who were initially diagnosed as non-gallbladder cancer, there were 774 cases(19.116%) diagnosed as gallbladder cancer during operation and 972 cases(24.006%) diagnosed as gallbladder cancer after operation. Of 6 159 patients, there were 2 521 cases(40.932%), 2 335 cases(37.912%) and 1 114 cases(18.087%) undergoing ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) examination before initial diagnosis, respec-tively, and there were 3 259 cases(52.914%), 3 172 cases(51.502%) and 4 016 cases(65.205%) undergoing serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis, respectively. One patient may underwent multiple examinations. Results of univariate analysis showed that geographical distribution of hospitals (eastern China or western China), age ≥72 years, gallbladder cancer annual admission of hospitals, whether undergoing ultrasound, CT, MRI, serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis were related factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.45, 1.98, 0.69, 0.68, 2.43, 0.41, 1.63, 0.41, 0.39, 0.42, 95% confidence interval as 1.21-1.74, 1.64-2.40, 0.59-0.80, 0.60-0.78, 2.19-2.70, 0.37-0.45, 1.43-1.86, 0.37-0.45, 0.35-0.43, 0.38-0.47, P<0.05). Results of multivariate analysis showed that geographical distribution of hospitals (eastern China or western China), sex, age ≥72 years, gallbladder cancer annual admission of hospitals and cases undergoing ultrasound, CT, serum CA19-9 examination before initially diagnosis were indepen-dent influencing factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.36, 1.42, 0.89, 0.67, 1.85, 1.56, 1.57, 0.39, 95% confidence interval as 1.13-1.64, 1.16-1.73, 0.79-0.99, 0.57-0.78, 1.60-2.14, 1.38-1.77, 1.38-1.79, 0.35-0.43, P<0.05). (4) Surgical treatment and prognosis. Of the 4 049 patients undergoing surgical treatment, there were 2 447 cases(60.435%) with complete pathological staging data and follow-up data. Cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb were 85(3.474%), 201(8.214%), 71(2.902%), 890(36.371%), 382(15.611%), 33(1.348%) and 785(32.080%), respectively. The median follow-up time and median postoperative overall survival time of the 2 447 cases were 55.75 months (95% confidence interval as 52.78-58.35) and 23.46 months (95% confidence interval as 21.23-25.71), respectively. There was a significant difference in the overall survival between cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb ( χ2=512.47, P<0.001). Of the 4 049 patients undergoing surgical treatment, there were 2 988 cases(73.796%) with resectable tumor, 177 cases(4.371%) with unresectable tumor and 884 cases(21.833%) with tumor unassessable for resectabi-lity. Of the 2 988 cases with resectable tumor, there were 2 036 cases(68.139%) undergoing radical resection, 504 cases(16.867%) undergoing non-radical resection and 448 cases(14.994%) with operation unassessable for curative effect. Of the 2 447 cases with complete pathological staging data and follow-up data who underwent surgical treatment, there were 53 cases(2.166%) with unresectable tumor, 300 cases(12.260%) with resectable tumor and receiving non-radical resection, 1 441 cases(58.888%) with resectable tumor and receiving radical resection, 653 cases(26.686%) with resectable tumor and receiving operation unassessable for curative effect. There were 733 cases not undergoing surgical treatment with complete pathological staging data and follow-up data. There was a significant difference in the overall survival between cases not undergoing surgical treatment, cases undergoing surgical treatment for unresectable tumor, cases undergoing non-radical resection for resectable tumor and cases undergoing radical resection for resectable tumor ( χ2=121.04, P<0.001). (5) Multimodality therapy and prognosis: of 6 159 patients, there were 541 cases(8.784%) under-going postoperative adjuvant chemotherapy and advanced chemotherapy, 76 cases(1.234%) under-going radiotherapy. There were 1 170 advanced gallbladder cancer (pathological staging ≥stage Ⅲa) patients undergoing radical resection, including 126 cases(10.769%) with post-operative adjuvant chemotherapy and 1 044 cases(89.231%) without postoperative adjuvant chemo-therapy. There was no significant difference in the overall survival between cases with post-operative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.23, P=0.629). There were 658 patients with pathological staging as stage Ⅲa who underwent radical resection, including 66 cases(10.030%) with postoperative adjuvant chemotherapy and 592 cases(89.970%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.05, P=0.817). There were 512 patients with pathological staging ≥stage Ⅲb who underwent radical resection, including 60 cases(11.719%) with postoperative adjuvant chemotherapy and 452 cases(88.281%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemo-therapy and cases without post-operative adjuvant chemo-therapy ( χ2=1.50, P=0.220). Conclusions:There are more women than men with gallbladder cancer in China and more than half of patients are diagnosed at the age of 56 to 75 years. Cases undergoing ultrasound, CT, serum CA19-9 examination before initial diagnosis are independent influencing factors influencing initial diagnosis of gallbladder cancer patients. Preoperative resectability evaluation can improve the therapy strategy and patient prognosis. Adjuvant chemotherapy for gallbladder cancer is not standardized and in low proportion in China.
		                        		
		                        		
		                        		
		                        	
7.Construction of "Internet +" nurse core competency evaluation index system
Zhifang REN ; Xueli GAO ; Yanling WANG ; Mingna ZHANG ; Lili ZHANG ; Qian XIAO
Chinese Journal of Modern Nursing 2022;28(22):2969-2974
		                        		
		                        			
		                        			Objective:To construct the "Internet +" nurse core competency evaluation index system.Methods:Combined with the policy analysis and literature research, a preliminary item pool was formed. The semi-structured interview was conducted to form a preliminary "Internet+" nurse core competency evaluation index system. From June to August 2021, the Delphi method was used to conduct three rounds of consultation with 19 experts, and finally determine the contents of the index system. The weights of indicators at all levels were calculated in combination with analytic hierarchy process.Results:Among three rounds of expert consultation, the questionnaire recovery rates were 100%, 100%, and 94.7% respectively, and the expert authority coefficients were 0.862, 0.857, and 0.841, and the Kendall coefficients were 0.228, 0.296, and 0.295 with statistical differences ( P<0.001) . The finally established "Internet +" nurse core competency evaluation index system included 4 first-level indicators, 16 second-level indicators and 59 third-level indicators of professional knowledge, professional skills, comprehensive ability and personal characteristics. Conclusions:The constructed "Internet +" nurse core competency evaluation index system is reliable, scientific and practical, and can be used as a basis for evaluating "Internet +" nurses' service capabilities.
		                        		
		                        		
		                        		
		                        	
8.Hospital diagnosis and surgery master data management practice
Xiaoxia REN ; Jia ZHANG ; Mu ZHANG ; Xueli YUAN ; Juan WANG
Chinese Journal of Hospital Administration 2020;36(9):751-753
		                        		
		                        			
		                        			Facing the problems of inconsistent standards and lack of standardized management procedures in the management of hospital diagnosis and surgical operation master data, the hospital redefined the metadata and data model by analyzing the data characteristics and the requirements of different application scenarios, cleaned and transformed the existing data to form a standardized unified standard for distribution, and established a complete data lifecycle management process.Finally, the consistency, integrity and controllability of diagnosis and operation data in each system could be realized, and the management level of diagnosis and operation master data could be effectively improved.
		                        		
		                        		
		                        		
		                        	
9.Analysis of treatment modalities and prognosis of patients with gallbladder cancer in China from 2010 to 2017
Tai REN ; Yongsheng LI ; Yajun GENG ; Maolan LI ; Xiangsong WU ; Wenguang WU ; Xu′an WANG ; Yijun SHU ; Runfa BAO ; Ping DONG ; Wei GONG ; Jun GU ; Xuefeng WANG ; Jianhua LU ; Jiasheng MU ; Weihua PAN ; Xi ZHANG ; Xueli ZHANG ; Zhewei FEI ; Zaiyang ZHANG ; Yi WANG ; Hong CAO ; Bei SUN ; Yunfu CUI ; Chunfu ZHU ; Bing LI ; Linhui ZHENG ; Yeben QIAN ; Jun LIU ; Xueyi DANG ; Chang LIU ; Shuyou PENG ; Zhiwei QUAN ; Yingbin LIU
Chinese Journal of Surgery 2020;58(9):697-706
		                        		
		                        			
		                        			Objective:To evaluate the clinical characteristics and prognosis of gallbladder cancer (GBC) patients in China.Methods:This retrospective multicenter cohort study enrolled 3 528 consecutive GBC patients diagnosed between January 2010 to December 2017 in 15 hospitals from 10 provinces. There were 1 345 (38.12%) males and 2 183 (61.88%) females.The age of diagnosis was (63.7±10.8) years old (range: 26 to 99 years old) .There were 213 patients (6.04%) in stage 0 to Ⅰ, whereas 1 059 (30.02%) in stage Ⅱ to Ⅲ, 1 874 (53.12%) in stage Ⅳ, and 382 (10.83%) unavailable. Surgery was performed on 2 255 patients (63.92%) . Three hundred and thirty-six patients received chemotherapy or radiotherapy (9.52%; of which 172 were palliative); 1 101 (31.21%) received only supportive treatment.The patient source, treatment and surgery, pathology, concomitant gallstone, and prognosis were analyzed.Results:Among the 3 528 GBC patients, 959 (27.18%) were from East China, 603 (17.09%) from East-North China, 1 533 (43.45%) from Central China, and 433(12.27%) from West China. Among the 1 578 resectable tumor, 665 (42.14%) underwent radical surgery, 913 (57.86%) underwent surgery that failed to follow the guidelines.Eight hundred and ninety-one (56.46%) patients were diagnosed before surgery, 254 (16.10%) during surgery, and 381 (24.14%) after surgery (time point of diagnosis couldn′t be determined in 52 patients) .Among the 1 578 patients with resectable tumor, 759 (48.10%) had concomitant gallstone.Among the 665 patients underwent radical surgery, 69 (10.4%) showed positive resection margin, 510 (76.7%) showed negative resection margin, and 86 (12.9%) unreported margin status.The 5-year overall survival rate (5yOS) for the 3 528-patient cohort was 23.0%.The 5yOS for patients with resectable tumor was 39.6%, for patients with stage ⅣB tumor without surgery was 5.4%, and for patients with stage ⅣB tumor underwent palliative surgery was 4.7%.Conclusions:More than half GBC patients in China are diagnosed in stage Ⅳ.Curative intent surgery is valuable in improving prognosis of resectable GBC.The treatment of GBC needs further standardization.Effective comprehensive treatment for GBC is in urgent need.
		                        		
		                        		
		                        		
		                        	
10.Analysis of treatment modalities and prognosis of patients with gallbladder cancer in China from 2010 to 2017
Tai REN ; Yongsheng LI ; Yajun GENG ; Maolan LI ; Xiangsong WU ; Wenguang WU ; Xu′an WANG ; Yijun SHU ; Runfa BAO ; Ping DONG ; Wei GONG ; Jun GU ; Xuefeng WANG ; Jianhua LU ; Jiasheng MU ; Weihua PAN ; Xi ZHANG ; Xueli ZHANG ; Zhewei FEI ; Zaiyang ZHANG ; Yi WANG ; Hong CAO ; Bei SUN ; Yunfu CUI ; Chunfu ZHU ; Bing LI ; Linhui ZHENG ; Yeben QIAN ; Jun LIU ; Xueyi DANG ; Chang LIU ; Shuyou PENG ; Zhiwei QUAN ; Yingbin LIU
Chinese Journal of Surgery 2020;58(9):697-706
		                        		
		                        			
		                        			Objective:To evaluate the clinical characteristics and prognosis of gallbladder cancer (GBC) patients in China.Methods:This retrospective multicenter cohort study enrolled 3 528 consecutive GBC patients diagnosed between January 2010 to December 2017 in 15 hospitals from 10 provinces. There were 1 345 (38.12%) males and 2 183 (61.88%) females.The age of diagnosis was (63.7±10.8) years old (range: 26 to 99 years old) .There were 213 patients (6.04%) in stage 0 to Ⅰ, whereas 1 059 (30.02%) in stage Ⅱ to Ⅲ, 1 874 (53.12%) in stage Ⅳ, and 382 (10.83%) unavailable. Surgery was performed on 2 255 patients (63.92%) . Three hundred and thirty-six patients received chemotherapy or radiotherapy (9.52%; of which 172 were palliative); 1 101 (31.21%) received only supportive treatment.The patient source, treatment and surgery, pathology, concomitant gallstone, and prognosis were analyzed.Results:Among the 3 528 GBC patients, 959 (27.18%) were from East China, 603 (17.09%) from East-North China, 1 533 (43.45%) from Central China, and 433(12.27%) from West China. Among the 1 578 resectable tumor, 665 (42.14%) underwent radical surgery, 913 (57.86%) underwent surgery that failed to follow the guidelines.Eight hundred and ninety-one (56.46%) patients were diagnosed before surgery, 254 (16.10%) during surgery, and 381 (24.14%) after surgery (time point of diagnosis couldn′t be determined in 52 patients) .Among the 1 578 patients with resectable tumor, 759 (48.10%) had concomitant gallstone.Among the 665 patients underwent radical surgery, 69 (10.4%) showed positive resection margin, 510 (76.7%) showed negative resection margin, and 86 (12.9%) unreported margin status.The 5-year overall survival rate (5yOS) for the 3 528-patient cohort was 23.0%.The 5yOS for patients with resectable tumor was 39.6%, for patients with stage ⅣB tumor without surgery was 5.4%, and for patients with stage ⅣB tumor underwent palliative surgery was 4.7%.Conclusions:More than half GBC patients in China are diagnosed in stage Ⅳ.Curative intent surgery is valuable in improving prognosis of resectable GBC.The treatment of GBC needs further standardization.Effective comprehensive treatment for GBC is in urgent need.
		                        		
		                        		
		                        		
		                        	
            
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