E-health is regarded as a strategic tool to achieve a human-oriented integrated service model. This study introduced the e-health framework of the World Health Organization, and conducted a comparative study of the different e-health development characteristics in the United Kingdom, United States, Australia, Canada and other countries. Based on the results, we analyzed the practical problems in e-health development in China, and suggested possible policy approaches for strategies of e-health development to support the policy of e-health development in China.
Objective To systematically evaluate the qualitative research on disease experience of breast cancer patients. Methods China National Knowledge Infrastructure, WanFang Data, and Web of Science were searched for qualitative research on disease experience of breast cancer patients till April 15, 2022. JBI was used to evaluate the quality of the literatures, and meta-integration was used to systematic evaluation. Results A total of 36 literatures were included. Among them, there were 177 clear research results, and a total of 14 complete research results were extracted, including positive experience and negative experience, which were summarized into 7 categories. 7 categories included physical experience, psychological experience, family and social support, disease knowledge needs, medical humanistic care, medical treatment process, coping. Two integrated results were synthesized, including disease experience and medical treatment experience. Conclusions In the whole process of breast cancer patients’ illness and medical treatment, they need not only guidance and support, but also medical humanistic care to help them respond to their own changes in a timely manner. The quality of life of patients can be improved by providing them with sufficient disease related information, striving to improve the medical treatment process, establishing and improving their all-round support system.
ObjectiveTo evaluate the weight loss outcomes, metabolic disease remission, and complications profiles of laparoscopic sleeve gastrectomy (LSG) based on a large single-center cohort experience. MethodsA retrospective observational study was conducted. Clinical data of patients who underwent LSG at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from June 2021 to June 2024 were collected based on predefined inclusion and exclusion criteria. The outcomes including percentage of total weight loss (%TWL), metabolic disease remission, and the incidence of postoperative complications were assessed. ResultsA total of 1 568 patients met the inclusion and exclusion criteria were finally included, including 304 males and 1 264 females. The age at surgery was (31.51±8.01）years old, and the body mass index was (37.26±4.18) kg/m2. At 1 year after surgery, the %TWL was (32.84±6.38)%, and the complete remission rate of diabetes was 96.2% (304/316). Complications within 1 year after surgery: 1 (0.06%) case of postoperative bleeding, 2 (0.13%) cases of gastric leakage, 1 (0.06%) case of vitamin B1 deficiency, and 1 (0.06%) case of unilateral common peroneal nerve entrapment injury. The total complications rate was 0.32% (5/1 568). No mortality was observed. ConclusionsLSG has significant short-term efficacy and higher safety in treatment of obesity and related metabolic diseases. In particular, experiences in aspects such as complications prevention and multidisciplinary follow-up management could provide references for centers in the early stage of development.
ObjectiveTo understand the experiences of out-patient services of the elderly patients, and to analyze the impact factors of the satisfaction of elderly patients, so as to produce evidence for healthcare quality improvement. MethodsBased on the data collected from the out-patient survey of the 2015 Evaluation of the National Healthcare Improvement Initiative, we compared the disparities of patient satisfaction among different age-groups, between different geographic regions and different types of hospitals. We conducted multivariate binary logistic regression analysis to identify factors, associated with the satisfaction of the elderly outpatients. We also compared satisfaction of the Chinese elderly patients with healthcare services with other countries. ResultsSatisfaction scores of the Chinese elderly out-patients were statistically significant higher than that of the young and middle aged out-patients in the domains of hospital environment (satisfaction score=4.42), process efficiency (satisfaction score=4.20), and overall satisfaction (satisfaction score=4.47) (P < 0.001). On the contrary, the elderly out-patients were less satisfied in the domain of hospital informationization experience (satisfaction score=4.25) than the young and middle aged out-patients. This was also the case for the three indicators under this domain, including convenient appointment (satisfaction score=4.27), diversified payment methods (satisfaction score=4.24) and self-service devices (satisfaction score=4.26) (P < 0.001). Western region and traditional Chinese hospitals had significantly lower elderly outpatient satisfaction comparing with eastern and central regions, and general & specialist hospitals (P < 0.05). Trustful doctor-patient relationship (OR=3.45), respected and comfortable care (OR=1.45), clear and reliable mechanism and channel for praise and complain (OR=1.39), length of communication time with doctors (OR=1.35) and length of waiting time until consultation is acceptable (OR=1.29) were the major factors associated with the overall satisfaction of the elderly out-patients. The overall satisfaction of the Chinese elderly out-patients is a bit lower than that in our neighboring country Japan. The satisfaction towards length of communication with doctors of the Chinese elderly patients is lower than that in most of the industrialized countries. ConclusionSpecial demands of the elderly patients should be carefully considered by hospitals in the process of developing new appointment methods and hospital informationization with the aim of healthcare improvement. Longer communication time with doctors, shorter waiting time until consultation, improving human care and building efficiency mechanism and channel for praise and complain are the priorities for future healthcare improvement.
In the context of informatization and digitization, medical big data has become crucial for promoting medical research and technological innovation, posing unprecedented challenges to the construction and operation of big data research supercomputing platforms. This article systematically elaborates on the construction plan of the scientific research supercomputing platform of the West China Biomedical Big Data Center of Sichuan University, as well as the management and service models that support data research. It also compares the scale and operation of existing scientific research supercomputing platforms at home and abroad, providing a reference for the construction and management of medical big data scientific research supercomputing platforms in other institutions.
ObjectiveTo investigate the occurrence and treatment of postoperative complications after laparoscopic laparoscopic pylorus-preserving pancreaticoduodenectomy (LPPPD) or pancreaticoduodenectomy (LPD). MethodThe clinical data of 130 patients undergoing LPD from October 2010 to December 2015 in West China Hospital of Sichuan University were analyzed retrospectively. ResultsOf 130 patients, postoperative complications occurred in 55 cases, including 24 cases of pancreatic fistula, 14 cases of gastric emptying disorder, 3 cases of anastomotic bleeding, 6 cases of peritoneal infection, 1 case of bile leakage, 1 case of venous thrombosis, 1 case of chylous leakage, 5 cases of peritoneal effusion, without the occurrence of stress ulcer and incision complications. There were significant difference in the incidence of pancreatic fistula (P=0.025), gastric emptying disorder (P=0.034), anastomotic bleeding (P=0.020), and peritoneal infection (P=0.016) among prophase group, metaphase group, and the later stage group. ConclusionsThe most common complication after LPD is pancreatic fistula. With the improvement of surgical techniques and procedures, incidences of some postoperative complications decreases gradually.
Objective To evaluate the safety and efficacy of surgical resection for the second and the third hepatic portal tumor. Methods The clinical data of 39 patients who underwent surgical resection of the second and the third hepatic portal tumor were analyzed from May 2012 to May 2017 in our hospital. Among them, there were 29 patients with primary liver cancer, 6 patients with hepatic hemangioma, 2 patients with focal liver hyperplasia, and 2 patients with liver metastasis from colon cancer. Results Right liver resection was performed in 11 patients, left liver resection in 7 patients, left outer lobe resection in 6 patients, right trefoil excision in 5 patients, Ⅴand Ⅷ segment resection in 4 patients, Ⅶ and Ⅷ segment resection in 4 patients, local resection in 2 patients. In the resection, there were 16 patients without interruption of hepatic inflow, 21 patients with interrupted portal blood flow, 2 patients with total hepatic blood flow occlusion. The operative time of the 39 patients was 150–270 min (mean of 190 min), the intraoperative blood loss was 100–2 000 mL (mean of 680 mL). Postoperative bile leakage occurred in 2 patients, bleeding occurred in 1 patient, and no liver failure occurred. Twenty-six patients were followed-up of 31 liver cancer patients, and the follow-up time was 3–40 months, the median time was 8 months. During follow-up period, 12 patients died, 9 patients died of tumor recurrence, 3 patients died from liver failure. Of 8 patients, 5 patients with benign liver disease were followed-up for 7–18 months with living healthy, and the median time was 9 months. Conclusion The risk of surgical resection of tumors invaded the second and the third hepatic portal is mainly the accurate functional assessment of residual liver and the correct treatment of the main branches of the hepatic veins.
In 2021, China launched a national pilot project of diagnosis-intervention packet (DIP) in 71 cities, which is an important measure of medical insurance payment system reform. DIP was originated in Guangdong. This paper summarizes the reform experience and effectiveness of Guangzhou and Shenzhen, discusses how to promote the reform of DIP in the national pilot cities from the medical insurance agencies aspect and the hospitals aspect, so as to provide a reference for the national pilot cities.
This article outlined the background and the concept of health decision support system (HDSS), discussed its application status in medical service, hospital management, public health management and other fields in the following four developed countries: United States, UK, Canada and Australia. It also introduced the main functions of MYCIN, CPOE, DHCP, Panorama etc., and summarized the above four countries’ successful experiences, including, actively promoting the application of decision support technology in health field through closely combining with the practical needs, valuing evidenced-based resources development and repository research, making scientific health policy to guide the orderly development of decision support systems, and strengthening the construction of E-health infrastructure and core systems, in hopes of providing reference for the development of health decision support system in China.
Optometry involves knowledge from multiple fields such as biology, physics, chemistry, psychophysics, and medicine. Traditional undergraduate education in optometry mainly focuses on knowledge transmission and lacks interaction, resulting in low student interest and unsatisfactory teaching outcomes. In order to improve this situation, the teaching team of Department of Optometry and Visual Science, West China School of Medicine, Sichuan University proposed a method of integrating real visual experiences into teaching. By combining multimedia tools and existing methods, real visual phenomena and personal visual experiences are integrated into the curriculum. This new teaching method stimulates students’ interest in learning, increases classroom interaction, promotes knowledge understanding and application through vivid visual phenomena and students’ own visual experiences. This article will introduce the above teaching method.