【摘要】 目的 了解甲型H1N1流感發熱病區門診就診高峰期患者焦慮狀況及相關因素，采取針對性護理措施減輕患者焦慮情緒。 方法 2009年11月上旬-12月上旬采用一般資料調查和Zung′s焦慮自評量表（SAS）對219例患者進行調查分析。 結果 219例患者SAS平均分為（33.70±8.60）分，其中17例SAS總分≥50分，存在焦慮情緒，發生率7.76%。多元回歸分析結果顯示，在年齡、性別、城鄉差異、發熱程度等因素中，與焦慮癥狀有關的主要因素為年齡和發熱程度。 結論 甲型H1N1流感發熱病區門診就診高峰期患者焦慮情緒明顯高于常模，應引起重視，在門診工作中加強心理護理，減輕和盡力消除患者的焦慮情緒，以免對病情產生不利影響，不利于控制流感疫情。【Abstract】 Objective To investigate the anxiety status and related factors of H1N1 patients at influenza peak of fever clinics,and to take specific measures to reduce anxiety in patients. Methods The general information and Zung′s self rating anxiety scale (SAS) were taken to analyze 219 patients from early November to early December 2009. Results The average SAS score of the 219 patients was 33.70±8.60, in which there were 17 patients (7.76%) with total scores ≥ 50 and anxiety. Multiple regression analysis showed that the age and temperature were related factors among age, gender, urban-rural differences, and fever. Conclusion The survey suggests that the pafients at the H1N1 influenza peak of fever clinics are significantly more anxious than normal anxiety. Out-patient work should strengthen psychological care to reduce and try to eliminate the anxiety of patients, in order to avoid adverse impact which is not conducive to control influenza outbreaks.
目的 總結大型災害情況下，急診傷員信息收集流程，為制定大型災害救援提供證據支持。 方法 回顧性分析汶川地震（2008年5月12日－6月2日）和玉樹地震（2010年4月14日－5月1日）傷員信息收集方法，總結兩次地震傷員信息收集管理過程中發現的問題及取得的經驗。 結果 通過制作地震傷員登記表、調整病歷收集與管理模式、分診提前、傷員信息登記提前，調整急診功能分區、頭像采集技術的使用、成批傷員信息資料袋和分診信息卡的應用，最大限度地保證了傷員信息收集的完整性。 結論 地震傷員信息資料的準確性、完整性、及時性在傷員的救治、傷員的查找、傷員的轉歸和各類醫療信息的收集，以及制定大型災害事故應急預案等方面起著非常重要的作用。
目的 研究乳腺癌患者雌激素受體（ER）、孕激素受體（PR）、人表皮生長因子受體2（HER-2）表達情況及免疫組織化學分子亞型分布。 方法 對2003年1月－2008年9月四川大學華西醫院病理科3 365例乳腺癌病理報告存檔資料進行激素受體（ER/PR）、HER-2表達情況及免疫組織化學分子亞型分布進行分析。 結果 3 365例確診的乳腺癌患者中，ER陽性1 824例（54.2%），PR陽性1 841例（54.7%），HER-2過表達284例（8.4%）。相關分析顯示ER與PR表達呈正相關（P＜0.001），HER-2與ER、PR表達均呈負相關（P＜0.001）。免疫組織化學分子亞型結果顯示luminal A型最常見，為1 993例（59.2%）；basal-like型為623例（18.5%）；HER-2過表達型為169例（5.0%）；luminal B型最少，為115例（3.4%）；未分類的為465例（13.8%）。 結論 乳腺癌患者激素受體及HER-2表達有特殊性，激素受體陽性率＞50%，HER-2陽性率在不同研究中顯示出不同的結果，尚需進一步研究；ER、PR與HER-2具有良好的相關性；免疫組織化學分子亞型中luminal A型最常見。
【摘要】 目的 探討口服百草枯中毒患者口腔護理的方法及早期護理的臨床意義。 方法 2009年1月-2010年3月，采用半隨機方法將62例白草枯中毒患者按中毒時間的長短分A組（中毒時間lt;3 d，n=32）、B組（中毒時間gt;3 d，n=3），比較兩組患者口腔潰瘍的治愈率、并發癥發生狀況，分析早期口腔護理的必要性。 結果 A組患者百草枯所致的口腔黏膜損害明顯減輕，并發癥發生率降低，為改善預后提供了條件，顯示了早期加強口腔護理的成效。 結論 重視百草枯早期口腔護理，能夠減輕口腔糜爛潰瘍痛苦，減少并發癥，提高患者生活質量。【Abstract】 Objective To investigate the clinical significance of early oral care for paraquat-poisoned patients. Methods A quasi-randomized controlled trial was used. A total of 62 paraquat-poisoned patients (from January 2009 to March 2010) were divided into experimental group and control group in order to compare the healing rate of oral ulcer, complications and the necessity of early oral care between the two groups. Results The oral mucosa lesions in experimental group obviously alleviated and the complications decreased. The effective early oral care provided the very favorable conditions for better prognosis. Conclusion The early oral care for paraquat-poisoned patients could relieve the pain of oral ulcer, reduce the complications and improve patient′s life quality.
During the prevention and control of coronavirus disease 2019, West China Hospital of Sichuan University urgently set up 4 medical tents to conduct centralized screening of fever patients, effectively avoiding cross-infection, and at the same time alleviating the pressure on the Department of Emergency Medicine and improving the efficiency of medical treatment for patients with fever. Later, in order to actively respond to China’s severe acute respiratory syndrome coronavirus 2 nucleic acid detection policy, 5 tents were adjusted to carry out the severe acute respiratory syndrome coronavirus 2 nucleic acid detection. This article introduces the function setting, personnel arrangement and protective measures of medical tents in West China Hospital of Sichuan University during the prevention and control of coronavirus disease 2019. It aims to share the experience of urgently setting up medical tents in the prevention and control of coronavirus disease 2019, with a view to provide a reference for the construction of medical tents in other medical institutions.
目的 檢測血管內皮生長因子（VEGF）、白細胞分化抗原34（CD34）及CXC趨化因子受體4（CXCR4）在轉移性鼻咽癌患者鼻咽部腫瘤組織中的表達，探討它們與鼻咽癌各種臨床病理因素的關系以及它們之間的相互聯系。 方法 采用免疫組織化學鏈霉素抗生物素蛋白-過氧化物酶連結法檢測2003年3月－2009年5月35例轉移性鼻咽癌患者VEGF、CD34及CXCR4在鼻咽部腫瘤組織中的表達情況，結合患者臨床病理特征進行分析。 結果 轉移性鼻咽癌患者鼻咽部腫瘤組織中的VEGF及CXCR4陽性表達率分別為62.9%（22∕35）和42.9%（15∕35），CD34計數為11～92，平均43.2 ± 20.5。無肺轉移較有肺轉移的患者VEGF的陽性表達率高（78.9%、43.8%，P=0.043），多器官轉移較單器官轉移的患者CXCR4的表達強度高（62.5%、26.3%，P=0.044）。 結論 VEGF表達陽性的患者易發生肺轉移；CXCR4強表達的患者易發生多器官轉移。
Objective To analyze the characteristics of patients transferred by ambulances to emergency department before and after coronavirus disease 2019 epidemic, in order to improve the efficiency of emergency triage, optimize the utilization of emergency resources, and provide a reference for standardized tiered medical services in different situation. Methods The patients’ information collected through Wenjuanxing questionnaire was extracted, who were transferred by ambulances to the Emergency Department of West China Hospital of Sichuan University between December 27th, 2018 and April 28th, 2019 (before epidemic), or between December 27th, 2019 and April 28th, 2020 (during epidemic), or between December 27th, 2020 and April 28th, 2021 [in regular epidemic prevention and control period (REPCP)]. The general information, sources, reasons for referral, disease spectrum and triage levels of patients in the three periods were compared. Results There were 3993, 2252 and 1851 cases before epidemic, during epidemic, and in REPCP, respectively. The differences in gender and age among the three periods were not statistically significant (P>0.05). The percentage of referrals from tertiary hospitals in each period was 74.00%, 72.65%, and 76.12%, respectively, which was higher in REPCP than that during epidemic (P<0.05). The percentage of direct referrals from emergency department in each period was 41.00%, 42.14%, and 44.46%, respectively, which was higher in REPCP than that before epidemic (P<0.05). The percentage of two-way referrals in each period was 37.79%, 36.63%, and 34.36%, respectively, which was lower in REPCP than that before epidemic (P<0.05). During epidemic and in REPCP, the proportions of referrals due to “need for surgery” (24.72%, 27.84%, and 28.74%, respectively) and “request by family members” (49.64%, 53.33%, and 56.24%, respectively) increased compared with those before epidemic (P<0.05), while the proportion of referrals due to “critical illness” decreased compared with that before epidemic (40.20%, 35.21%, and 33.17%, respectively; P<0.05); the proportion of referrals due to “diagnosis unknown” decreased in REPCP compared with that before epidemic (15.50%, 13.90%, and 11.89%, respectively; P<0.05). The proportion of acute aortic syndromes in REPCP increased compared with that during epidemic (3.46%, 2.98%, and 4.65%, respectively; P<0.05), the proportion of trauma in REPCP increased compared with that before epidemic (13.72%, 15.76%, and 17.77%, respectively; P<0.05), and the proportion of pneumonia/acute exacerbation of chronic obstructive pulmonary disease during epidemic and in REPCP decreased compared with that before epidemic (8.44%, 3.73%, and 3.84%, respectively; P<0.05). The proportion of critically ill patients referred in each period was 72.88%, 75.58%, and 79.15%, respectively, which was the highest in REPCP (P<0.05). Conclusions The epidemic has a significant impact on emergency ambulance referrals, and emergency triage needs to be continuously optimised and improved in staff, facilities, processes and management. It is necessary to further improve the implementation of hierarchical diagnosis and treatment, strengthen information communication between referral and emergency departments of receiving hospitals, and improve referral efficiency.
This article introduces the exploration and establishment of “grass-roots Party building + targeted poverty alleviation” model by the Party Branch of Emergency Department of West China Hospital of Sichuan University, and discusses how to establish the “trinity mode” of management support, personnel training, and on-site guidance under the leading of grass-roots Party building through a series of the branches combined activities, according to the core idea of “strengthening the Party construction, bringing people closer together, and promoting development”. The aim is to form a long-term mechanism of grass-roots Party building and targeted medical poverty alleviation through continuously implementing this model, which can benefit more people in remote and ethnic minority areas and contribute to “Healthy China 2030”.