ObjectiveTo investigate the feasibility and effect of early pulmonary rehabilitation (PR) in patients after acute exacerbation of chronic obstructive pulmonary disease (COPD) in a district hospital. MethodsA single-centre prospective study was conducted. The COPD patients after an episode of acute exacerbation and referred to the outpatient department were recruited from January 2013 to December 2014. They were randomized to a group with PR (PR group) and a group without PR (wPR group). The following data were recorded and evaluated including age, gender, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1 as a percentage of the predicted value (FEV1% pred).The baseline and the post-PR medical research council scale (MRC), St. George's respiratory questionnaire (SGRQ), and six-minute walk distance (6MWD) were also compared. ResultsA total of 91 cases were enrolled with 46 cases in the PR group and 45 cases in the wPR group. The age, gender, the severity of COPD were similar in two groups (P > 0.05). The MRC score and SGRQ score of the PR group were significantly improved 3 months later compare with the baseline (P < 0.05), and did not changed significantly in the wPR group (P > 0.05). There were 26 patients whose SGRQ scores decreased > 4 in the PR group (26/46, 56.5%), which was significantly higher than the wPR group (7/45, 15.6%) (P < 0.05). The 6MWD of the PR group was significantly increased 3 months later compare with the baseline (P < 0.05), and did not changed significantly in the wPR group (P > 0.05). There were 22 patients whose 6MWD increased > 54 meters in the PR group (22/46, 47.8%), which was significantly higher than the wPR group (9/45, 20.0%) (P < 0.05). ConclusionsIt is feasible and safety to perform early PR in patients after acute exacerbation of COPD in the district hospital. The early PR can improve the MRC score, SGQR score, and 6MWD in COPD patients.
As a tool for building consensus among groups, Delphi technique has been widely used in healthcare research which is appropriate for clinical questions where quantitative methods are unlikely to yield results that can be successfully implemented in practice. Researchers in palliative care developed standards for conducting and reporting Delphi studies (CREDES). This paper introduces and interprets the specific content of CREDES standards, with a view to providing reference for the evaluation of Delphi research design quality and report transparency.
Medicine bears the responsibility for human health. Technical competence, service standards, professional ethics and social accountability constitute the soul of this profession. The principles of nonmaleficence, beneficence, respect for autonomy and justice help to establish good doctor-patient relationship and regulate medical services, which has been fixed by international and domestic professional norms. Besides to ensure its truth, effectiveness and safety, medical research also should require certain rendering of subject's autonomy, minimizing risks and maintaining social justice. Some procedures have established for supporting it. Modern medical education furnishes suitable human resources for medical profession, which directly affects the accessibility and outcomes of health services. Its objectives, operations and assessments are increasingly taking shape. Faced with the current issues of healthcare equity, worsening doctor-patient relationship, scandals and ethical controversies in medical research, and the failing of medical education to fully match social needs, evidence-based medical methodology is extending to policy and social sciences for identifying and creating high-quality scientific evidence to improve the quality of decision-making.
The era of big data has brought a big revolution that will transform the way we live, work, and think. In medical field, as the development of social economics and medicine since 21 century, the human disease spectrum has been changing, the disease type has been increasing, and the complexity of the etiology, diagnosis and treatment of disease have been gradually increasing. In order to improve the healthy level, and explore the law of disease occurrence and development, we should constantly research to find discipline in enormous knowledge by fully mining and using the big medical data. It will be helpful to improve the level medical information management. And it can be supportive to the diagnosis, treatment, clinical practice and decision-making. We did the review under the background of big data, and the mean contact of this review is about the origin, meaning, classification, features of big data as well as the research process, application and future development of data mining, especially clinical data mining.
ObjectiveTo investigate the annual publication volume, paper type distribution, journal quartile distribution, and citation status of SCI journal papers published by West China Hospital, Sichuan University, to provide a reference for optimizing the publication-based research evaluation system. MethodsA cross-sectional study was conducted. The Web of Science Core Collection was electronically searched to retrieve all papers affiliated with West China Hospital, Sichuan University. After screening, SCI journal papers up to December 31, 2024, in which the first author’s first affiliation was West China Hospital, Sichuan University published were included. Citation information as of December 31, 2024 was further obtained from the Web of Science Core Collection. R 4.2.2 software was used to analyze the annual quantity, journal quartile, paper type and citation distribution of SCI papers. ResultsA total of 38 005 papers were included. Original articles accounted for the highest proportion (62.06%), followed by reviews (17.66%), meeting abstracts (10.16%), letters (6.17%), and editorials (3.95%). Overall, 55.11% of the papers were published in JCR Q1 journals, and the proportion of Q1 papers showed a trend of initial decline followed by a rise over time. By the end of 2024, the total number of citations all included papers was 534 338, with an average number of citations of 14.06 per paper. The proportion of papers that received no citations within 2 years of publication was 29.65%. The 2-year average citation frequency ranked reviews (11.18) > original articles (5.99) > editorials (1.78) > letters (1.23) > meeting abstracts (0.23), and ranked as Q1 (7.61) > Q2 (4.28) > Q3 (3.18) > Q4 (1.56) when classified by JCR quartile. However, the 2-year citation rate was Q2 (75.67%) > Q3 (71.00%) > Q1 (68.78%) > Q4 (53.98%). ConclusionThe annual publication volume, the proportion of high-level Q1 journal papers, and the citation rate and average citation frequency of West China Hospital all showed an increasing trend. Nevertheless, structural problems such as a high proportion of uncited papers and a lack of high-impact papers remain.