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BackgroundTelemedicine has been used widely in China and has benefited a large number of patients, but little is known about the overall development of telemedicine. ObjectiveThe aim of this study was to perform a national survey to identify the overall implementation and application of telemedicine in Chinese tertiary hospitals and provide a scientific basis for the successful expansion of telemedicine in the future. MethodsThe method of probability proportionate to size sampling was adopted to collect data from 161 tertiary hospitals in 29 provinces, autonomous regions, and municipalities. Charts and statistical tests were applied to compare the development of telemedicine, including management, network, data storage, software and hardware equipment, and application of telemedicine. Ordinal logistic regression was used to analyze the relationship between these factors and telemedicine service effect. ResultsApproximately 93.8% (151/161) of the tertiary hospitals carried out telemedicine services in business-to-business mode. The most widely used type of telemedicine network was the virtual private network with a usage rate of 55.3% (89/161). Only a few tertiary hospitals did not establish data security and cybersecurity measures. Of the 161 hospitals that took part in the survey, 100 (62.1%) conducted remote videoconferencing supported by hardware instead of software. The top 5 telemedicine services implemented in the hospitals were teleconsultation, remote education, telediagnosis of medical images, tele-electrocardiography, and telepathology, with coverage rates of 86.3% (139/161), 57.1% (92/161), 49.7% (80/161), 37.9% (61/161), and 33.5% (54/161), respectively. The average annual service volume of teleconsultation reached 714 cases per hospital. Teleconsultation and telediagnosis were the core charging services. Multivariate analysis indicated that the adoption of direct-to-consumer mode (P=.003), support from scientific research funds (P=.01), charging for services (P

BackgroundThe internet has caused the explosive growth of medical information and has greatly improved the availability of medical knowledge. This makes the internet one of the main ways for residents to obtain medical information and knowledge before seeking medical treatment. However, little has been researched on how the internet affects medical decisions. ObjectiveThe purpose of this study was to explore the associations between internet behaviors and medical decisions among Chinese adults aged 18 or over, including whether to go to the hospital and which level of medical institution to choose. MethodsWith the adult residents (≥18 years old) in 12 regions including urban and rural areas taken as the research objects, the differences in medical choices of adults with various characteristics were analyzed, and generalized linear mixed models were adopted to analyze the longitudinal data of the China Health Nutrition Survey from 2006 to 2015. ResultsAdult groups with different ages, genders, education levels, regions, places of residence, severities of illness and injury, years of suffering from hypertension, and history of chronic diseases showed diverse medical decisions, and the differences were statistically significant (P

Given the increasing environmental pollution around the world, air pollutants such as particulate matters (PM) have been becoming typical carcinogenic factors to cause lung cancer. The PM with aerodynamic diameter less than or equal to 2.5 μm (PM2.5) plays an important role in lung cancer mortality. However, effects of PM2.5 on the mortality of lung cancer patients have not been investigated well. The purpose of this study is to assess the associations between PM2.5 exposure and lung cancer-related mortality, by regions and races. This systematic review was developed and conducted according to PRISMA protocol. A comprehensive literature search for peer-reviewed studies published up to October 2021 was conducted using the electronic databases PubMed, EMBASE, and Cochrane Library. The identified records were carefully evaluated following the PICOS criteria. Relative risks (RRs) and 95% confidence interval (CI) of lung cancer mortality associated with PM2.5 were extracted and meta-analyzed. The Chi-squared test, Begg's test, and Eggerr analysis were performed to assess the heterogeneity and publication bias. Sensitivity analysis and subgroup analysis were also conducted to make sure the authenticity and stability of the present study. In total, 16 studies met the inclusion criteria. For the overall effects of PM2.5 on lung cancer-related mortality, there was heterogeneity among the included studies (I2 = 62.30%, P < 0.01); thus, the random effects model was chosen to conduct related analysis. The pooled adjusted RR of lung cancer mortality associated with PM2.5 was 1.12 (95% CI: 1.09–1.15) for per 10 µg/m3 increase in PM2.5 concentrations. For different continents, the RRs of subgroup analysis in North-America, Asia, and Europe were 1.16 (1.09–1.22), 1.08 (CI: 1.07–1.09), and 1.14 (CI: 1.04–1.23), respectively. Subgroup analysis by race showed that for Mongoloid RR = 1.08 (1.07–1.09), and for Caucasoid RR = 1.13 (CI: 1.11–1.15). With per 10 µg/m3 increase in PM2.5, the mortality rate of Caucasoid lung cancer patients increased by 1.13 times, greater than that of the Mongoloid. Increase in PM2.5 concentrations is associated positively with the mortality of lung cancer patients. For different regions and races, the adverse effects of PM2.5 are discrepant. Our Findings can provide necessary evidence to protect public health further from air pollution. [ABSTRACT FROM AUTHOR]