Objectives Performance of critical injury treatment among extremely-hit areas after great earthquake was retrospectively analyzed to provide references for policy-making as reducing mortality and disable rate besides increasing rehabilitation rate for global post-quake medical relief. Methods Retrospective analysis, primary research and secondary research were comprehensively applied. Results 1.According to incomplete statistics datum, there were 30,620 self-save injured among extremely-hit areas in 72 post-quake hours. And, the number of critical injured took 22% of the total inpatient injured. 2. Mortalities decreased successively from that of municipal healthcare centers in extremely-hit areas to that municipal medical units in peripheral quake-hit areas and then to those of municipal, provincial and MOH-affiliated hospitals as 12.21%, 4.50%, 2.50% and 2.17% respectively. 3. Injured with fractures on body, limbs or unknown-parts, severe conditions as well as other kinds of non-traumatic diseases received in second-line hospitals were much more than those treated in first-line hospitals with more severe injuries. 4. Among 10,373 injured in stable conditions transferred to third-line hospitals, 99.07% were discharged off hospitals with mortality as 0.017% during 4 post-quake months. Conclusions The medical relief model as “supervising body helping subordinate unit, severely-stricken areas assisting extremely-hit ones, quake-hit areas supporting both extremely-hit and severely-stricken ones, and save-saving amp; mutual assistance applied between extremely-hit areas” is roughly established for injured from severely-stricken areas after Wenchuan earthquake. 2. “Four concentration treatment” principle for those injured in critical conditions did effectively reduce mortality（15.06%→2.9%）. 3. Timely, scientific and standard on-site triage and post-medical transfer under guidance of accurate injury information determine rescue effect for the injured, while there is large space to fulfill as for treatment for critical diseases among extremely-hit areas under extreme conditions after Wenchuan earthquake.
Objective To use visualization methods to illustrate and compare major subjects, domains, and developments in evidence-based medicine (EBM) in recent years. Methods We analyzed MeSH terms and keywords in EBM articles in the MEDLINE and CNKI databases, and developed subject charts, research field relationship charts, and strategy coordination charts using word co-occurrence, PFNET algorithms, and visualization methods. Results Rapid developments and growth are taking place in EBM in China and around the world. Studies on humans comprised 94.4% of the EBM studies that we identified, while animal studies accounted for 2.6% (three quarters of these animal studies were on primates). The six countries with the largest number of EBM articles and the eight host nations for the 108 journals with the most EBM publications were from high-income countries. In China, 31 provinces, municipalities, and autonomous regions have published EBM articles, although most of these publications come from the more highly-developed areas of the country. The investigation of word co-occurrence showed that EBM articles outside of China involve seven main fields: “Therapy”, “Methods”, “Standards”, “Research”, “Education”, ”Nursing” and “Organization and Administration”. Five of these fields (“Therapy”, “Nursing”, “Research”, “Education” and “Management”) were common to China but the top seven fields for this country included “Traditional Chinese Medicine (TCM)” and “Information resources”; and did not include “Methods” and “Standards”. Furthermore, studies on “Nursing” and “Research” were not as advanced in China as in other countries. Conclusion There are similarities between China and the rest of the world in several areas in the EBM literature but also some important differences. Throughout the world, the most resource-rich regions or organizations tend to have the most well-developed EBM. These regions and organizations are producing more evidence and conducting more methodology research than the less resourced regions and organizations. There is an urgent need for these regions and organizations to strengthen their use of evidence, to learn more about the philosophy that underpins EBM, and to improve accessibility to, and use of, evidence in choices about health care.
Objective To provide baseline datum for further evidence-based selecting essential health technology or essential medicine by comparing the top 15 inpatient diseases in the three pilot township clinics in western China from 2008 to 2010. Methods With the key words as disease spectrum, constitution of disease, inpatient disease category, inpatient diseases and so on, such databases as CBM, CNKI, VIP, WanFang and official websites of Ministry of Health were searched on computer, and the manual search was also conducted in combination to extract the related datum of provinces where the pilot township health centers were situated. The Excel software was used for data classification and analyses. Results (1) Among the 16 included literatures including 15 journal papers and 1 master thesis, 4 scored from zero to 3.5, 9 scored from 3.5 to 6.75, and the left 3 scored 7 or more than 7; (2) The common inpatient diseases in the township health centers in eastern, central and western regions in China were different. The upper respiratory tract infection, acute/chronic bronchitis, acute/chronic gastritis and appendicitis were the common inpatient diseases in the township health centers throughout China. The pneumonia, emphysema, cholelithiasis, cholecystitis, and acute/chronic gastroenteritis were the common inpatient diseases in the township health centers in southwest and northwest regions. The top 15 inpatient diseases in the three pilot township clinics in this study covered all the common inpatient diseases in the township health centers in southwest and northwest regions in China; (3) The total number of the top 15 inpatient diseases of the three pilot township health centers in western China between 2008 and 2010 was 35, including 20 chronic and 15 acute diseases. The chronic diseases were chronic bronchitis, chronic gastritis, hypertension, lumbar/cervical disease, cholelithiasis or cholecystitis, coronary heart disease, chronic pulmonary heart disease, urinary calculi, pelvic inflammation, vertebrobasilar insufficiency, arthritis, acute exacerbation of chronic bronchitis, Meniere’s disease, chronic obstructive emphysema, myocardial ischemia, prostatitis, etc.. The acute diseases were upper respiratory tract infection, pulmonary infection, fracture, superficial injury, acute appendicitis, acute bronchitis, urinary tract infection, acute gastritis, acute gastroenteritis, delivery amp; cesarean section, soft tissue injury, acute urticaria, etc.; and (4) While the common inpatient disease categories were relatively centralized and stable, but some of them were different in regions, inpatients’ age and sex structure. Conclusion (1) There are some differences in the common inpatient diseases in the township health centers among eastern, central and western regions in China, thus it is necessary to select essential health technology and essential medicine according to local conditions; (2) As a good representation, the common inpatients diseases in the three pilot township health centers in western China can provide the baseline evidence for selecting essential health technology and essential medicine for the township health centers in western China; (3) There are lack of national/regional statistics, survey data and evidence-based research on disease spectrum of the township health centers currently. While the investigation methods or statistics measurements/quality of these included studies are variable without standard regulation; and (4) It suggests that the state and every provinces should implement and improve the statistic analysis of disease spectrum of the township health centers, train staffs and fulfill the construction of information system.
Objective To investigate the output of evidence-based medicine (EBM) researchers in China and elsewhere by examining the EBM domains they work within and the networks that exist among them; using visualization methods to analyze these relationships. This maps the current situation and helps with the identification of areas for future growth. Method We used co-citation matrixes with Pathfinder networks and hierarchical clustering algorithms, and constructed a co-author matrix which were analyzed with a whole network approach. The analyzed matrixes were visualized with the UCINET program. Result Much of the development of EBM has been centered around three authors, David Sackett, Gordon Guyatt and L Manchikanti, within three different clusters. The main authors of EBM articles in China were divided into nine academic domains. The relations among core authors of articles indexed by the Science Citation Index (SCI) was loose. There was a ber co-authorship network among core authors in the Chinese literature, with three groups and 21 cliques. Nine distinct academic communities appeared to have formed around Li Youping, Liu Ming and Zhang Mingming. Conclusion The EBM literature contains several key clusters, with universities in high-income countries being the source of the majority of articles. Outside China, McMaster University in Canada, the original home of EBM, is the dominant producer of EBM publications. In China, Sichuan University is the main source of EBM publications. The EBM cooperation network in China is comprised of three major groups, the largest and most productive in this sample is led by Li Youping with Liu Ming, Zhang Mingming, Li Jing, Wang Li, Wu Taixiang, and Liu Guanjian as central members.
Objectives We conducted a literature review of 33 kinds of Traditional Chinese medicine injections (CMIs) on the national essential medicine list (2004 edition) of China in ADR articles to retrieve basic ADR information and research trends related to CMIs and to provide evidence for the research and development as well as the rational use of CMIs, particularly pharmacovigilance and risk management of CMIs. Methods We electronically searched Chinese Biomedical Literature Database (CBM, Jan. 1978-April 2009), the China National Knowledge Infrastructure Database (CNKI, Jan. 1979-April 2009), Chinese Science and Technology Periodical Database (VIP, Jan. 1989-April 2009) and the Traditional Chinese Medicine Database (Jan. 1984 April 2009). We also retrieved the websites of Ministry of Health and State Food and Drug Administration, to collect data about CMIs ADRs reports and regulations from “Newsletter of Adverse Drug Reactions” (Issue 1 to 22). Then we descriptively analyzed all the results on the year published, periodicals and types of study design of included ADR literatures, the major CMIs as well as the regulations about their ADRs. Results (1) There were 5 405 citations found in total and 2160 were removed because of duplication. After screening the title, abstract and full text of the selected papers, 1 010 studies finally met the eligible criteria. (2) The total and cumulative amount of research articles published about CMIs ADRs significantly increases over time. (3) The included 1,010 articles were scattered among 297 periodicals. A total of 55 journals on pharmaceutical medicine, containing 399 articles, accounted for 39.50% of total; 64 journals on traditional Chinese medicine and pharmaceutical medicine, containing only 197 articles, amounted for 19.50% of total. Only 22 periodicals were included on the core journals of the Beijing University List (2008 edition) (8.94% of the total journals in the list), which published 129 articles (12.77% of the total articles published). (4) We categorized the articles included into eight categories based on their content and study methodology. There were: 348 case reports and 254 case series which accounted for 34.46% and 25.15% of the total articles, 119 overviews (11.78%), 116 randomized controlled trials (11.49%), 78 cross-sectional studies (7.72%), 61 ADR literature analyses (6.04%), and 28 non-randomized controlled clinical studies (2.77%). (5) In the three of top ten journals, "Adverse Drug Reactions Journal", "China Medical Herald", and "Chinese Pharmaceuticals" published literature accounted for 5.84%, 3.76% and 2.67% of the total respectively. (6) The reports of ADRs to Shuanghuanglian, Qingkailing and Yuxingcao injections were the most in all reports for CMIs (All the three injections had more than 200 articles, accounting for 41.95% of the total). The Ministry of Health and the State Food and Drug Administration took measures to supervise them. (7) The four kinds of CMIs (Shuanghuanglian, Ciwujia, Yuxingcao, and Yinzhihuang injections) among the top 5 reported ADR literatures were removed from the market or were suspended for sale. The varieties and numbers of reports for CMIs ADRs have relationship with the supervision to them. Conclusions (1) Articles published on CMIs ADRs increased year by year, but overall the research is of low quality and is scattered in a large number of sources. (2) It is very urgent to create a clear standard to grade ADRs of CMIs for the risk management. (3) It is necessary to enforce safety re-evaluation work for CMIs and to promote the clinical rational use.
We systematically and retrospectively analyzed the experience and lessons from the command system, medical rescue force deployment, medical treatment, public health response for infectious disease control, and health counterpart assistance for emergency medical rescue after the 2008 earthquake in Wenchuan, Sichuan Province, China. We propose that emergency medical rescue after tremendous catastrophes in China link responses at the national, provincial, city, and county levels, to set up an effective and cooperative medical relief forces coordination system and an effective triage system and rehabilitation plan. In addition, infectious disease control should be planned and assessed more quickly, and developing vital functions of pairing-assistance as a means with Chinese characteristic. Our aim is to provide a useful reference for medical rescue after natural catastrophes worldwide, especially after earthquakes.