Branch Hospital Research Articles

The Impacts of Friendship, Advice and Negative Ties on Intention To Leave: The case of nurses in a special branch hospital

OBJECTIVES: The high turnover rate of nurses has been a matter of debate among scholars. Nurses’ social interaction patterns and the social structure they are situated within may provide clues about possible causes of their high turnover intentions. This study aims to investigate the possible effects of negative and positive ties on the intention of turnover among nurses. DESIGN & SETTING: A hybrid research methodology was used. Social network analysis was used to reveal the positions of the nurses (n = 126) in the positive and negative networks. A statistical model was formed with varying types of centrality measures, intragroup conflict, and intention to leave variables. The data was collected from all the nurses working in a special branch hospital. RESULTS AND CONCLUSION: The findings of the study clearly indicate that negative interactions directly and indirectly affect the intention to leave, and the nurses demand professional support from their colleagues. The findings also show the existence of a fragmented social structure among nurses, which suggests the increased importance of brokerage roles. Managers should closely monitor the negative interactions among nurses, and they need to use conflict management techniques frequently to reduce hostile relations in the business environment. Managers should especially seek ways to increase altruistic tendencies among colleagues because nurses demand professional support ties more than friendship relations.

The Association of Glutathione S-Transferase P1 Polymorphism to Imatinib Mesylate Resistance in Chronic Myelogenous Leukemia Patients According to Haematology Response at General Hospital Haji Adam Malik and Branch Hospital in Kota Medan

Objective: Variations in the genes coding for drug metabolism enzymes may explain the variability response to treatment. Previous studies reported that GSTP1 polymorphism was associated with the incidence of Imatinib Mesylate resistance as first-line therapy in CML patients. This study aims to determine the association between GSTP1 polymorphism and Imatinib Mesylate resistance in CML patients according to haematology response. Methods: Total of 46 people (consisting of 23 CML patients with Imatinib Mesilat resistance and 23 CML patients without Imatinib Mesilat resistance) at General Hospital H. Adam Malik and branch hospital in Medan City, Indonesia was analyzed in this study. Blood samples were taken for examination of GSTP1 polymorphism through Polymerase Chain Reaction (PCR). Resistance status was taken from medical records based on ELN criteria. Data were analyzed using Fisher's Exact test; p value <0,05 was applied to each statistical test as significant. Result: The distribution of research subjects characteristic was divided into imatinib resistance and non-imatinib resistance groups. In both cases, the highest frequency was found in male (65,2% and 69,6%) in 35-44 years old group (34,8% and 39,1%). In the imatinib resistance group, the highest frequency was found in Javanese (39,1%) and GSTP1 polymorphism Ile/Ile (65,2%). In the non-imatinib-resistant group, the highest frequency was found in Batak tribe (43,5%) and GSTP1 polymorphism Ile/Val (52,2%). This study found 11 cases of leukocytosis and 7 cases of thrombocytosis in the imatinib resistance group. According to statistical measurement, p value was 0,142 (p>0,05). Conclusion: The association of GSTP1 polymorphism to imatinib mesylate resistance in chronic myelogenous leukemia patients according to haematology response was not significant. Keywords: Chronic Myeloid Leukemia, GSTP1 Polymorphism, Imatinib Mesylate Resistance.

Preoperative serum fibrinogen as a valuable predictor in the nomogram predicting overall survival of postoperative patients with gallbladder cancer.

Coagulation and fibrinolysis activation are frequently observed in cancer patients, and the tumors in these cases are thought to be associated with a higher risk of invasion, metastasis and worse long-term outcome. The specific aim of this study was to develop an effective prognostic nomogram to help make individualized estimates for patients with resected gallbladder cancer (GBC). Patients with resected GBC who were diagnosed between 2006 and 2014 at Xinhua Hospital were selected. Model performance was measured by c-index and calibration curve. The results were further validated using bootstrap and a cohort of 38 patients from a branch hospital who underwent surgery from 2006 to 2014. Backward stepwise selection and Lasso were applied respectively to select predictors. T stage, N stage, and preoperative serum fibrinogen were included in the final model. Predictions correlated well with observed 1- and 3-year survival. The c-index for predicting survival was 0.74 (95% confidence interval, 0.70-0.78), which was statistically higher than that of the AJCC 7th system and Nevin system (P=0.04, 0.04, respectively). In the validation cohort, the nomogram performed better than the other two staging systems (c-index: 0.71 vs. 0.67 and 0.67). The validated nomogram is a practical tool for predicting the overall survival (OS) of postoperative GBC patients. Preoperative serum fibrinogen levels were associated with tumor progression and may be an independent predictor for GBC patients.

Antibiogram of Biofilm Producing Bacteria Isolated from Urine of Patients in Three Hospitals in Port Harcourt, Rivers State

Aim: The aim of this study was to determine the antibiogram of biofilm producing bacteria isolated from urine of patients in three hospitals in Port Harcourt, Rivers State.
 Study Design: The study employs statistical analysis of the data and interpretation
 Place and Duration of Study: The study was conducted at three (3) hospitals; University of Port Harcourt Teaching Hospital (UPTH), Meridian Hospital D / line branch (MRD1) and Meridian Hospital Ikoku branch, all located in Port Harcourt, Rivers State. Sample collection was for three (3) months, analysis was carried out daily and it lasted for six (6) months.
 Methodology: A total of Forty-five (45) urine samples were collected for a period of three (3) months from the three (3) hospitals. The samples were labelled properly, according to date and time of collection. The collected samples were subjected to standard microbiological procedures which includes standard plate counts, identification, biofilm screening, sensitivity testing using Kirby-Bauer disk diffusion method, Phenotypic screening of extended spectrum beta lactamase and molecular characterization of the isolates
 Results: The results of the bacterial population of urine samples from the hospitals showed that the total heterotrophic bacterial counts for Meridian Hospital D/line (MRD1), Meridian Hospital Ikoku (MRD2) and University of Port Harcourt Teaching Hospital (UPTH) ranged from 4.93 - 6.30 x107cfu/ml. The Total coliform count ranged from 1.89-3.04 x106cfu/ml for Meridian Hospital D/line (MRD1), Meridian Hospital Ikoku (MRD2) and University of Port Harcourt Teaching Hospital (UPTH). Total faecal coliform counts ranged from 0.78-1.11 x105CFU/ml for Meridian Hospital D/line (MRD1), Meridian Hospital Ikoku (MRD2) and University of Port Harcourt Teaching Hospital (UPTH). A total of fifty-eight (58) bacterial isolates were isolated from urine of patients and 36(62.1%) isolates were identified as biofilm producers. The biofilm bacteria identified were 17.2% Staphylococcus,6.9% E. coli, 10.3% Pseudomonas, 6.9% Proteus ,10.3% Bacillus and 10.3% Enterococcus species. Biofilm forming ability of bacteria is considered a virulent factor and it is implicated to being a possible cause of increased resistance to most antibiotics. Varying susceptibility pattern was observed among biofilm isolates. Biofilm bacteria were resistant to several groups of antibiotics. Ofloxacin, Gentamycin, Imipenem and Nitrofurantoin can be used as drug of interest for most bacterial biofilm urinary tract infections. CTX-M and TET A gene were identified in the biofilm bacteria in this study to be possible factors that confer resistance to antibiotics. The presence of icaD and papC gene in the isolates whose genome were studied have been found to be possible factors that confers biofilm producing ability. This study indicates the emergence and rapid spread of biofilm producing bacteria and their resistance to antibiotics. Therefore, strict infection control practices as well as therapeutic guidance for confirmed infections should be rapidly initiated.

Clinical Implications of Neurological Comorbidities and Complications in ICU Patients with COVID-19.

Clinical implications of neurological problems during intensive care unit (ICU) care for coronavirus disease 2019 (COVID-19) patients are unknown. This study aimed to describe the clinical implications of preexisting neurological comorbidities and new-onset neurological complications in ICU patients with COVID-19. ICU patients who were isolated and treated for COVID-19 between 19 February 2020 and 3 May 2020, from one tertiary hospital and one government-designated branch hospital were included. Clinical data including previous neurological disorders were extracted from electronic medical records. All neurological complications were evaluated by neurointensivists. Multiple logistic regression analysis was performed to investigate independent factors in ICU mortality. The median age of 52 ICU patients with COVID-19 was 73 years. Nineteen (36.5%) patients had preexisting neurological comorbidities, and new-onset neurological complications occurred in 23 (44.2%) during ICU admission. Patients with preexisting neurological comorbidities required tracheostomy more frequently and more ventilator and ICU days than those without. Patients with new-onset neurological complications experienced more medical complications and had higher ICU severity score and ICU mortality rates. New-onset neurological complications remained an independent factor for ICU mortality. Many COVID-19 patients in the ICU have preexisting neurological comorbidities, making them at a high risk of new-onset neurological complications.

English

BACKGROUND We wanted to evaluate the effect of caregiver burden on quality of life of the cancer patient caregivers. METHODS This research was conducted as an analytical cross-sectional study. The study population comprised of caregivers of patients, who were receiving treatment in the chemotherapy unit of a branch hospital. 466 caregivers who participated in the study comprised the sample of the research. The research data was collected using “Demographic Data Form”, “Zarit Burden Interview”, and “Caregiver Quality of Life Scale-Cancer”. RESULTS Among the participants, 71.2 % were females and average age was 44.80 ± 13.76. It was concluded that certain qualifications of the caregivers such as educational status, income levels, another family member with cancer diagnosis, and having support in caregiving process affected the quality of life of the caregivers. Burden scale score was 32.41, and quality of life scale score was 89.83. It was determined that there was a negative and strong relationship between the burden scale and quality of life scale. Presence of another individual with cancer in the family, receiving support, conditions arising from the caregiving process, such as affected health, having marital difficulties were found to affect the burden of caregiving. CONCLUSIONS It was determined that there was a negative, strong relationship between the caregiver burden and quality of life. In line with these results, it is suggested that interventional and qualitative studies should be conducted on the caregivers in order to define their caregiver burden and evaluate their lifestyles. KEY WORDS Cancer, Care Giver, Burden, Quality of Life

Clinical Features and Required Aids of Transferred Severe Trauma Patients.

It is crucial to identify the pivotal factors for transferring patients with major trauma. We aim to delineate the clinical features and required aids of severe trauma patients and identify the differences between those who were admitted directly to a trauma center and those transferred from other hospitals. We retrospectively reviewed all hospitalized trauma patients discharged from the ward in Chi-Mei Medical Center from January 1, 2017 to December 31, 2018. Of 5,846 patients, we identified 1,061 patients with Injury Severity Score >15, of which 92 patients were transferred from two branch hospitals (branch group), 172 patients were transferred from other hospitals (other group), and 797 patients were admitted directly through the emergency department (control group). We compared the clinical variables between control and the other two groups. The branch group included a high proportion of pediatric patients (control: 1.8%, other: 2.3%, and branch: 6.5%). The branch group demonstrated higher requirements for life-saving interventions and arterial embolization (branch vs. control, life-saving interventions: 26.1% vs. 17.6%, p = 0.046; arterial embolization: 9.8% vs. 3.5%, p = 0.004). However, no statistically significant differences were observed between the control group and other group in terms of requirements of life-saving interventions. The prognoses were similar between the groups. Our trauma center can provide pediatric trauma care and timely life-saving interventions to help severe trauma patients transferred from other hospitals. The branch hospitals benefit mostly from the aid. Better network connection and information sharing between hospitals might play crucial roles in the management of transferred severe trauma patients.

Characteristics of peripheral blood leukocyte differential counts in patients with COVID-19

To investigate the early changes of peripheral blood leukocyte differential counts in patients with COVID-19. Ten patients with COVID-19 and 30 patients with other viral pneumonia (non-COVID-19) admitted to The Sixth People's Hospital of Shanghai and Jinshan Branch Hospital from January 22 to February 17, 2020 were enrolled in this study. The differential counts of white blood cells (WBC) were analyzed. Patients in COVID-19 group showed relatively lower absolute WBC count 4.95(3.90,6.03)×10(9)/L, lymphocyte absolute count 1.20(0.98,1.50)×10(9)/L and eosinophil absolute count 0.01(0.01,0.01)×10(9)/L. Leukopenia developed in two patients(2/10), lymphocytopenia also in two patients(2/10). Seven over ten patients presented with eosinophil cytopenia. In non-COVID-19 group, absolute WBC count was 8.20(6.78,9.03)×10(9)/L (P<0.001), lymphocyte absolute count 1.75(1.20,2.53)×10(9)/L(P=0.036), eosinophil absolute count 0.02(0.01,0.03)×10(9)/L(P=0.005). Lymphocytopenia occurred in 16.7% patients, eosinophil cytopenia in 16.7% patients too. In conclusion, leukopenia, lymphocytopenia and eosinophil cytopenia are more common in COVID-19 patients than those in non-COVID-19 patients.

Contributions from Japan to gastrointestinal endoscopy training and development: Special report.

Contributions from Japan to gastrointestinal endoscopy training and development: Special report.

Characteristics of peripheral blood leukocyte differential counts in patients with COVID-19

To investigate the early changes of peripheral blood leukocyte differential counts in patients with COVID-19. Ten patients with COVID-19 and 30 patients with other viral pneumonia (non-COVID-19) admitted to Shanghai Jiao Tong University Affiliated Sixth People's Hospital and Jinshan Branch Hospital from January 22 to February 17, 2020 were enrolled in this study. The differential counts of white blood cells were analyzed. Patients in COVID-19 group showed relatively lower absolute white blood cell (WBC) count 4.95(3.90,6.03)×10(9)/L, lymphocyte absolute count 1.20(0.98,1.50)×10(9)/L and eosinophil absolute count 0.01(0.01,0.01)×10(9)/L. Leukopenia developed in two patients(2/10), lymphocytopenia also in two patients(2/10). Seven over ten patients presented with eosinophil cytopenia. In non-COVID-19 group, absolute WBC count was 8.20 (6.78,9.03) ×10(9)/L (P<0.001), lymphocyte absolute count 1.75(1.20,2.53)×10(9)/L(P=0.036), eosinophil absolute count 0.02(0.01,0.03)×10(9)/L(P=0.05). Lymphocytopenia occurred in (16.7%) patients, eosinophil cytopenia in 16.7% patients too. In conclusion, leukopenia, lymphocytopenia and eosinophil cytopenia are more common in COVID-19 patients than those in non- COVID-19 patients.

Effect of a deep-learning computer-aided detection system on adenoma detection during colonoscopy (CADe-DB trial): a double-blind randomised study

Colonoscopy with computer-aided detection (CADe) has been shown in non-blinded trials to improve detection of colon polyps and adenomas by providing visual alarms during the procedure. We aimed to assess the effectiveness of a CADe system that avoids potential operational bias. We did a double-blind randomised trial at the endoscopy centre in Caotang branch hospital of Sichuan Provincial People's Hospital in China. We enrolled consecutive patients (aged 18-75 years) presenting for diagnostic and screening colonoscopy. We excluded patients with a history of inflammatory bowel disease, colorectal cancer, or colorectal surgery or who had a contraindication for biopsy; we also excluded patients who had previously had an unsuccessful colonoscopy and who had a high suspicion for polyposis syndromes, inflammatory bowel disease, and colorectal cancer. We allocated patients (1:1) to colonoscopy with either the CADe system or a sham system. Randomisation was by computer-generated random number allocation. Patients and the endoscopist were unaware of the random assignment. To achieve masking, the output of the system was shown on a second monitor that was only visible to an observer who was responsible for reporting the alerts. The primary outcome was the adenoma detection rate (ADR), which is the proportion of individuals having a complete colonoscopy, from caecum to rectum, who had one or more adenomas detected. The primary analysis was per protocol. We also analysed characteristics of polyps and adenomas missed initially by endoscopists but detected by the CADe system. This trial is complete and is registered with http://www.chictr.org.cn, ChiCTR1800017675. Between Sept 3, 2018, and Jan 11, 2019, 1046 patients were enrolled to the study, of whom 36 were excluded before randomisation, 508 were allocated colonoscopy with polyp detection using the CADe system, and 502 were allocated colonoscopy with the sham system. After further excluding patients who met exclusion criteria, 484 patients in the CADe group and 478 in the sham group were included in analyses. The ADR was significantly greater in the CADe group than in the sham group, with 165 (34%) of 484 patients allocated to the CADe system having one or more adenomas detected versus 132 (28%) of 478 allocated to the sham system (odds ratio 1·36, 95% CI 1·03-1·79; p=0·030). No complications were reported among all colonoscopy procedures. Polyps initially missed by the endoscopist but identified by the CADe system were generally small in size, isochromatic, flat in shape, had an unclear boundary, were partly behind colon folds, and were on the edge of the visual field. Polyps initially missed by the endoscopist had characteristics that are sometimes difficult for skilled endoscopists to recognise. Such polyps could be detected using a high-performance CADe system during colonoscopy. The effect of CADe during colonoscopy on the incidence of interval colorectal cancer should be investigated. None.

Fürdő – kórház – fogadó: Buda déli „határnegyede” a 18. században

This study aims to demonstrate sanitary aspects of the outskirts of Buda on the southern Gellért Hillside, which separated itself markedly from the city centre in the 18th century. This area, by its separation, was a proper place for establishing temporary hospitals during the two major plague epidemics of the century (1709–1710 and 1738–1740). Similarly, the small nearby island of Danube used earlier as a meadow, served as a place for separation of patients at the same time. The name of the two contemporary hospitals, the plague cemetery and the chapel founded in memoriam of the plague victims commemorate the raving pestilence. On the other hand, the area played a key role in bathing culture by the so-called ’Muddy Bath’ (Sáros fürdő, Blockbad, the predecessor of today’s Gellért Bath). Close to the bath, popular among soldiers, there was founded a garrison branch hospital at the end of the century, as a result of which the area was gradually transformed into a military-sanitary centre in the 19th century.

Assessment of technical efficiency of public hospitals in Turkey.

Turkish public hospitals have been subjected to health care reform because of increasing cost pressure, inequities in access to health care, poor quality of care and limited patient responsiveness in the last three decades. This study investigates the impact of recent hospital reforms on the efficiency of public hospitals. The study provides a comprehensive evaluation of the efficiency of Turkish hospitals by using Data Envelopment Analysis (DEA). The estimation of efficiency of 669 public hospitals of Turkey is performed by an output-oriented model of DEA under the assumption of variable return-to-scale by using data collected from the Ministry of Health (MoH) over the period 2013-17. The average efficiency score is equal to 0.83 for all MoH hospitals. Considering the hospital type, the efficiency scores of training and research hospitals are higher than those of the general and branch hospitals. In addition, considering the hospital size, huge-scale hospitals have the highest efficiency score in all years. Moreover, overcrowded regions such as Marmara and South-eastern Anatolia regions had higher efficiency scores than other geographical regions. The results indicate that recent health reforms did not significantly enhance hospital efficiency. Thus, policymakers and managers should take the necessary precautions to increase hospital efficiency.

Risk factors for acute myocardial infarction in patients younger and middle age

We investigated 300 patients with primary and repeat MI, among them 197 have been complicated by myocardial infarction, including 142 patients with - myocardial infarction with tooth Q. Patients were divided into two age groups: young (under 45 years) - 70 people and middle-aged (46 to 60 years) - 230. All patients were treated between 2006 and 2012 in Bukhara branch and regional RSCEMH Heart Hospital.&#x0D; The results of these studies indicate that the major risk factors for coronary heart disease are (male sex, lipid disorders, hypertension, physical inactivity, smoking, chronic foci of infections, excessive body weight) are found in most patients with myocardial infarction before the age of 60 years. The most important for the prevention of the disease and its complications in both groups of patients were corrected lipid metabolism disorders, smoking cessation, rehabilitation centers of infections, the normalization of physical activity.

Correlation between fasting blood glucose and hepatocarcinogenesis: a multicentre retrospective study (A report of 94 264 cases)

Correlation between fasting blood glucose and hepatocarcinogenesis: a multicentre retrospective study (A report of 94 264 cases)

Correlation between different body mass indexes and incidence of digestive carcinoma: a multicentre retrospective study (A report of 95 177 cases)

Correlation between different body mass indexes and incidence of digestive carcinoma: a multicentre retrospective study (A report of 95 177 cases)

An Internet of Things based COPD managing system: Its development, challenges and first experiences

AimIn order to improve stable COPD patients’ management and reduce exacerbation, we established an Internet of Things based COPD managing system in Qingpu District Shanghai City. MethodsThis system is composed of a clinical information database, a 1 M box, a handheld portable spirometer and mobile APPs. This database could collect the exacerbation treatment data from Zhongshan Hospital Qingpu Branch, the largest tertiary healthcare provider in local area, and the follow-up data of stable patients from the 11 primary hospitals through a 1 M box. The lung function data could be tested and uploaded in a real-time way by the handheld portable spirometer. Different smart-phone APPs were developed for the patients and physicians to establish direct communication to improve the disease control. Notably, the clinical data of patients was classified, transferred and stored in an anonymous and encrypted way to preserve the privacy. ResultsAfter starting use in August 2016, 537 inpatients and 13,665 out patients’ follow-up data were recorded in this system automatically.3838 COPD patients were brought to COPD management using this system including 2857 male and 981 female patients. Physicians in Qingpu Branch and primary hospitals endeavored to provide homogenized management for those patients. ConclusionsThis IOT system facilitated the collection, storage, transmission and analysis of most COPD patient’s follow-up and exacerbation data, which could be of great potential to improve the management of COPD in local area.

Assessment of left ventricular functions by strain and strain rate echocardiography in asymptomatic type II diabetic patients

Background and aim The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eye, kidneys, heart and blood vessels, as treatment to reverse this disorder is more likely to be effective at an early (preclinical) stage, defining the mechanism of diabetic cardiomyopathy may be important to its selective treatment. Aim to assess the left ventricle (LV) function using tissue Doppler (TD) strain and strain rate imaging to detect early LV functions affection in type II diabetic patients without overt heart disease. Patients and methods the study included 60 persons presented in Al Azhar University (Asyut branch) Hospital in the period between November 2014 and January 2016. Were divided into two groups: group (1): 30 diabetic patients with normal (ejection fraction) EF and normal coronaries, group (2): 30 individual without diabetes mellitus (DM) with normal EF as a control group. The following was done for the two groups: 1. Complete History taking and complete general and cardiac clinical examination, resting 12 leads electrocardiography (ECG). 2. Laboratory investigation to diagnose diabetes and the control of the disease. 3. Transthoracic echo examination: 4. TD Strain and strain rate of the LV. Results In comparison between group (1) and group (2) the LV strain and strain rate was found to be significantly lower in group (1) as compared to group (2). Among group I, duration of DM was significantly correlated with decreased strain rate in posterior septum only. There was no correlation between methods of control and the degree of control and the impairment of strain and strain rate. From the present study we found that left ventricular strain and strain rate by conventional echo could reveal the presence of subclinical diabetic cardiomyopathy. Conclusions Type 2 DM deteriorates both LV systolic and diastolic performance. Diabetic patients showed some changes in strain and SR of LV walls at rest especially when the duration of diabetes increased. Strain and SR by TD is superior to conventional Doppler in early detection and evaluation of systolic and diastolic dysfunction in type 2 diabetic patients.

The Collection of Epidemiological Data of the Women Undergoing Mammography in Suburban Area of Mersin

Background: The study aimed to evaluate the epidemiologic data of our patients with mammography examinations, pre-examinations, and evaluation of them. Materials and Methods: This cross-sectional study was conducted by asking specific questions by face-to-face interviewing 500 female patients who lived in the suburban areas of Mersin between April 2011 and November 2011 and who applied to the maternity branch hospital for mammography surveys. The data are evaluated proportionally; numerical values are given in percent and n=n1/total number. Results: The majority of the cases (87%, n=435/500) consisted of women aged 40-60 years. The majority of cases (80%, n=400/500) reported that the education level was primary school graduate or lower. In our patients, 54% (n=270/500) had no previous mammography screening, 43% (n=215/500) had irregular mammography screening, 3% (n=15/500) had a regular mammography scan. 55% (n=275/500) did not know what the mammography was and why it was withdrawn; 45% (n=225/500) did not know enough. Our cases of 12% (n=60/500) had a history of breast cancer in the family. Conclusion: Collection of epidemiologic data belonging to the patient before the mammography screening will benefit the planning of future surveys, and it is seen that they are also contributing to the reporting of mammography.

Predictive value of serum uric acid on new-onset cholelithiasis (a report of 97 469 cases)

Objective To explore the predictive value of serum uric acid on new-onset cholelithiasis. Methods The retrospective cohort study was conducted. The data of 97 469 subjects who participated health examination at the Kailuan General Hospital Affiliated to the North China University of Science and Technology, Kailuan Linxi Hospital, Kailuan Zhaogezhuang Hospital, Kailuan Tangjiazhuang Hospital, Kailuan Fan′gezhuang Hospital, Kailuan Lyujiatuo Hospital, Kailuan Jinggezhuang Hospital, Kailuan Linnancang Hospital, Kailuan Qianjiaying Hospital, Kailuan Majiagou Hospital and Kailuan Branch Hospital from June 2006 to December 2015 were collected. Epidemiological investigation, anthropometric parameters and biochemical indicators were collected. All the subjects were allocated into 4 groups according to squartiles of serum uric acid: 24 140 with serum uric acid <232 μmol/L in the Q1 group, 24 473 with 232 μmol/L≤ serum uric acid <282 μmol/L in the Q2 group, 24 382 with 282 μmol/L≤ serum uric acid <338 μmol/L in the Q3 group and 24 474 with serum uric acid ≥338 μmol/L in the Q4 group. Observation indicators: (1) comparisons of clinical characteristics among the 4 groups; (2) incidence of cholelithiasis in the 4 groups; (3) effects of serum uric acid on the new-onset cholelithiasis: ① the dose-response relationship between serum uric acid and the risk of cholelithiasis, ② comparisons of the fitting degree of serum uric acid on the cholelithiasis model, ③ effects of different serum uric acid levels on incidence of cholelithiasis after stratification by sex, ④ serum uric acid of different gender on the boxplots, ⑤ effects of different serum uric acid levels on the incidence of cholelithiasis after stratification by age. Measurement data with normal distribution were expressed as ±s, and comparisons among groups were analyzed using the one-way ANOVA. Measurement data with skewed distribution is expressed by M (Q), and comparisons among groups were analyzed using the nonparametric Krustal-willis test. Count data were represented by percentage, and comparisons among groups were analyzed using chi-square test. The incidences of cholethiasis in 4 groups of different serum uric acid were calculated by person-year incidence. Restrictive cubic spline regression was used to calculate the dose-response relation between the continuous variable and the risks of new-onset cholelithiasis and 95% confidence interval (CI). COX regression model was used to analyze the hazard ratio (HR) and 95%CI of different serum uric acid levels on new-onset cholelithiasis. Likelihood ratio test and akaike information criterion (AIC) were used to calculate the fitting degree of serum uric acid on new-onset cholelithiasis model. Boxplots were used to describe serum uric acid in different genders. Results (1) comparisons of clinical characteristics among the 4 groups: sex (male), age, body mass index (BMI), systolic pressure, diastolic pressure, fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high sensitive C-reactive protein, diabetes, hypertension, smoking, drinking and physical exercise were 15 162, (50±11)years, (24±3)kg/m2, (123±21)mmHg (1 mmHg=0.133 kPa), (82±12)mmHg, (5.6±2.0)mmol/L, (4.8±1.2)mmol/L, 1.14 mmol/L (range, 0.81-1.63 mmol/L), 0.70 mmol/L (range, 0.23-2.23 mmol/L), 2 537, 9 415, 4 575, 2 380, 2 649 in the Q1 group, 19 079, (51±12)years, (25±3)kg/m2, (130±21)mmHg, (83±12)mmHg, (5.5±1.7)mmol/L, (4.9±1.2)mmol/L, 1.20 mmol/L (range, 0.86-1.76 mmol/L), 0.71 mmol/L (range, 0.28-1.98 mmol/L), 2 287, 10 124, 6 918, 3 649, 3 288 in the Q2 group, 21 132, (52±13)years, (25±3)kg/m2, (132±21)mmHg, (84±12)mmHg, (5.5±1.6)mmol/L, (5.0±1.2)mmol/L, 1.29 mmol/L (range, 0.91-1.94 mmol/L), 0.80 mmol/L (range, 0.30-2.06 mmol/L), 2 027, 10 755, 8 259, 4 730, 3 958 in the Q3 group, 22 651, (53±14)years, (26±3)kg/m2, (134±21)mmHg, (85±12)mmHg, (5.4±1.5)mmol/L, (5.1±1.2)mmol/L, 1.54 mmol/L (range, 1.05-2.35 mmol/L), 1.02 mmol/L (range, 0.43-2.50 mmol/L), 1 981, 12 082, 9 562, 6 209, 4 758 in the Q4 group, respectively, with statistically significant differences among the 4 groups (χ2=7 624.63, F=279.93, 961.91, 330.84, 271.40, 38.25, 353.18, H=3 406.30, 912.23, χ2=108.15, 590.49, 2567.07, 2 209.21, 760.15, P 0.05). In male participants, adjusted for age, BMI, TC, TG, diabetes, hypertension, smoking, drinking and physical exercise, risks of new-onset cholelithiasis in Q2, Q3 and Q4 groups were increased compared with Q1 group (HR=1.17, 1.24, 1.30, 95%CI: 1.06-1.30, 1.12-1.37, 1.18-1.44, P 0.05), however, risk of new-onset cholelithiasis was increased in the Q4 group (HR=1.15, 95%CI: 1.02-1.28, P 60 years old, adjusted for sex, BMI, TC, TG, diabetes, hypertension, smoking, drinking and physical exercise, risk of new-onset cholelithiasis in the Q2 groups was not increased compared with Q1 group (HR=1.16, 95%CI: 0.99-1.36, P>0.05), however, risks of new-onset cholelithiasis were increased in the Q3 and Q4 groups (HR=1.19, 1.21, 95%CI: 1.02-1.40, 1.04-1.41, P<0.05). Conclusion Elevated serum uric acid is an independent risk factor for the new-onset cholelithiasis. Key words: Cholelithiasis; Serum uric acid; Incidence; Risk factor