通過對1999年1月至2007年8月，肝移植病人術后門診復查的情況做一總結，通過護理干預，使病人復查得到極大方便，并拓展了護理工作領域，提高了門診護理工作的質量，并提升了醫院的形象。
Ambulatory surgery ward is a fast and effective way of treating, nursing and patients’ education. We report the practice of ambulatory surgery ward in West China Hospital of Sichuan University about patients’ reception, treatment and nursing, medical safety, health education and post-operative follow-up. Results show that ambulatory surgery ward would guarantee patients’ safety, shorten hospitalization days and decrease medical cost, with more than 98% of patients’ satisfaction.
The annual incidence of diabetic foot ulcers in China is as high as 8.1%, which ranks first among the causes of chronic wounds in China. Although through the efforts of several generations of podiatrists and the building of multidisciplinary collaboration team, the major amputation rate in patients with diabetic foot ulcers in China has been decreased significantly, it is still far higher than the level of developed countries in Europe and the United States. Therefore, in order to cope with the increasing occurrence and recurrence of refractory diabetic foot ulcers, in addition to further optimizing the construction of multidisciplinary collaboration team, it is an urgent topic for us to explore the construction of a multidisciplinary integrated team to seamlessly connect the diagnosis and treatment of different aspects of foot disease. This article describes the importance and necessity of building a wound repair center with Chinese characteristics, which is a model of multidisciplinary integrated team, aiming at provide a theoretical basis for establishing a multidisciplinary integrated management model and realizing seamless connection between diagnosis and treatment, so as to further improve the cure rate of diabetic foot ulcers.
ObjectiveTo evaluate the protective effect of estrogen on survival of retinal ganglion cells (RGCs) after transient retinal ischemia-reperfusion (RIR) in rats.MethodsRIR was induced in 60 ovariectomized adult rats (OVX) by increasing intraocular pressure via an intracameral catheter. All of the rats were divided into two groups randomly: in experimental group, the rats underwent a subcutaneous injection with 17β-estrodiol（100 μg/kg） 2 hours before retinal ischemia; and in the control group, saline water was injected correspondingly. The number of RGCs and the thickness of the inner retinal layers were mesured by HE staining method before and 12, 24, 48, and 72 hours after reperfusion. TdT-mediated biotin-dUTP nick end labelling (TUNEL) staining technique was used to examine the apoptosis of RGCs.ResultsTwenty-four and 48 hours after reperfusion, the number of apoptotic cells in experimental group was obvious lower than that in the control group(Plt;0.05), and the number of RGCs in experimental group was higher than that in the control group(Plt;0.05).ConclusionEstrogen can protect retinal neurons from transient RIR in ovariectomized rats.(Chin J Ocul Fundus Dis, 2005,21:177-179)
To retrospectively summarize the medical rescue organization and strategy of West China Hospital medical team during the Wenchuan earthquake so as to provide reference for rescue practice in the future. We emphasize that the key point to improve the efficiency of rescue is scientifically assigning and util izing medical resource according to the demand at the actual locale of the earthquake and the characters of various stages of the earthquake .
As the concept of enhanced recovery after surgery (ERAS) has promoted the revolution of day surgery, more complicated surgery such as radical resection of early cancer and other fourth-level surgery can be performed in day surgery mode. Since 2010, West China Hospital of Sichuan University has introduced ERAS program and gradually performed fourth-level surgery in day surgery center. With the measures of reasonable inclusion criteria, team construction, and optimization of treatment and nursing procedures, the quality and safety of day surgery are guaranteed. Between January 2019 and August 2023, a total of 2531 patients underwent 24-hour fourth-level day surgery for early cancer, with a delayed discharge rate of 2.09%, a readmission rate of 2.57%, and a readmission rate of 1.11%, without death case, and the patient satisfaction was above 98%. The perioperative management scheme of fourth-level day surgery provides a reference for the management of day surgery for more diseases.
ObjectiveTo explore the utility and advantage of same-day surgery mode of Mammotome minimally invasive operation (MMT) in ambulatory surgery center, and summarize the key points of clinical management.MethodsFemale patients who underwent MMT in West China Hospital of Sichuan University between June and December 2019 were included. According to the operation mode, the patients were divided into same-day surgery group and routine group (routine day operation). The perioperative data were analyzed.ResultsA total of 1 297 female patients were included. Among them, 571 cases were in the same-day surgery group and 726 cases were in the routine group. There was no significant difference in baseline data, intra-operative bleeding volume, operation time, or complication rate between the two groups (P>0.05). There were significant differences in the number of masses (χ2=13.384, P<0.001), pathological type (χ2=11.990, P=0.007) and operation method (χ2=89.185, P<0.001). The length of hospital stay in the same-day surgery group was significantly shorter than that in the routine group (Z=–29.746, P<0.001); the cost of biopsy (Z=–8.549, P<0.001), the cost of surgical instruments (Z=–9.564, P<0.001), and the total cost of hospitalization (Z=–10.378, P<0.001) in the same-day surgery group were less than those in the routine group. In addition, the result of generalized estimating equation showed that the postoperative pain scores of patients in the same-day surgery group were lower than those in the routine group (P<0.001).ConclusionsThe same-day surgery mode of MMT is safe and feasible with high time economic benefits, which is worthy promoting in ambulatory surgery center. Cautions should addressed with patients’ safe and high-quality health education.
ObjectiveTo establish a systematic, scientific, and sensitive index system to provide a scientific basis for quality evaluation and comprehensive quality management of day surgery nursing.MethodsThe databases of Wanfang, China National Knowledge Infrastructure, CQVIP, PubMed, and Web of Science were searched. The retrieval time was from the establishment of the databases to 15th July, 2019. Based on the “structure-process-outcome” management model, Delphi method was used to conduct two rounds of expert consultation for nursing experts related to day surgery in five tertiary hospitals. The results of the consultation were sorted out and the consensus of experts was obtained, so as to determine the quality-sensitive indicators of day surgery nursing.ResultsA total of 20 nursing experts participated in the questionnaire survey. The final evaluation indicators determined by expert correspondence included 1 structural indicator, 9 process indicators, and 4 outcome indicators.ConclusionsThe construction of quality evaluation standard of day surgery nursing not only embodies the connotation of nursing management of day surgery, but also puts forward clear requirements and quality standards for specialized nursing management. It has high reliability, scientificity, and strong operability, which can effectively improve the quality of nursing management and service level of day surgery.
Objective To discuss the running effect of the modified hospital-community integrated two-way-referral service mode in day surgery. Methods The hospital-community integrated two-way-referral service mode in day surgery was built in May 2014 by our center, and applied in the communities’ health service network in Chenghua District, Wuhou District, and Jinjiang District. From March 2017 some improvements of the mode were made, such as assigning specific person for the management of two-way-referral, conducting lectures in communities to train the community medical staff, and carrying out gratuitous treatment. The community acceptance rate and patients satisfaction were retrospectively analyzed between March of 2016 and March of 2017, and the number of upward referral (from community to hospital) was retrospectively analyzed between March to June of 2016 and March to June of 2017. Results The community acceptance rate was elevated from 81.3% to 99.1% and the patients satisfaction was improved from 95.4% to 100.0%, and the differences between the two periods were statistically significant (P<0.05). The number of upward referral increased from 0 to 23. Conclusions The modified hospital-community integrated service mode could optimize the course of surgery appointment, and make it convenient for patients. Furthermore, it also adjusts the reasonable allocation of medical resource effectively and promotes the implementation of national hierarchical medical system.
Objective:To observe the inhibited effect and its mechani sm of estro gen on lightinduced apoptosis of retinal photoreceptor cells. Methods:Twenty female Sprague-Dawley rats were randomly divided into two groups: ovariectomized (OV) group and OV and estrogen (E2) replacement (OV+E2) group, with 10 rats in each group. All of the rats were exposed to the cyclic illumination under 12 hou r light and 12 hour dark condition with the light intensity of (600plusmn;35.4) lx ( a total of 14 times). All of the right eyes were extracted and the thickness of r etinal outer nuclear layer (ONL) was measured. Terminal deoxynucleotidyl Transfe rasemediated dUTP nick end labeling (TUNEL) method was used to evaluate positi v e apoptosis cells in ONL. The expression of nitric oxide synthase (NOS) in retin al cells was detected by immunohistochemistry with image analysis method. Results:The thickness of ONL in OV group was obviously thinner than that in the OV+ E2 group. The number of positive apoptosis of the cells was (0.0275plusmn;0.0069) c el ls/mu;m2 in OV group and (0.0162plusmn;0.0054) cells/mu;m2 in OV+E2group; the di fferen ce between the two groups was significant (t=4.1370，P=0.0012). The values o f in tegral optical density of NOS positively stained cells in retinal inner nuclear layer was (0.3675plusmn;0.0662) in the OV group and (0.2941plusmn;0.0350) in OV+E2 group ; the difference between the two groups was significant (t=3.4885, P=0.0031). Conclusion:Estrogen can protect retina from light injuries by regu lating NOS synthesis and inhibiting apoptosis of photoreceptor cells.