Wuhan Leishenshan Hospital was built within 12 days during the key period of fighting against coronavirus disease 2019 (COVID-19) in Wuhan. It was a field infectious disease hospital with 1500 beds. Due to the emergency of the epidemic situation, the operation mode of “parallel of construction, acceptance, training and treatment” was employed. During the peak period, nearly 3000 medical workers and 13000 builders worked on the same site. In 67 days, 2 011 patients with COVID-19 were treated. Through the bundle infection prevention and control (IPC) measures, Wuhan Leishenshan Hospital achieved zero infection, zero accident, and low level pollution of SARS-CoV-2 (0.3%) by environment monitoring. The bundle IPC measures of Leishenshan Hospital not only provided prevention and control experience for other field infectious disease hospitals at domestic and abroad during the period of COVID-19, but also put forward ideas and work flow for other medical institutions to deal with emerging infectious diseases.
ObjectiveTo understand the characteristics of and risk factors for nosocomial infection in a newly built branch of a university teaching hospital, in order to investigate the control measures for prevention and control of nosocomial infection. MethodsA total of 598 cases of nosocomial infection from April 2012 to June 2014 were enrolled in this study. We analyzed statistically such indexes as nosocomial infection rate, infection site, pathogen detection, and use of antibiotics. Meantime, infection point-prevalence survey was introduced by means of medical record checking and bedside visiting. ResultsAmong all the 44 085 discharged patients between April 2012 and June 2014, there were 598 cases of nosocomial infection with an infection rate of 1.36%. Departments with a high nosocomial infection rate included Intensive Care Unit (ICU) (9.79%), Department of Orthopedics (2.98%), Department of Geriatrics (2.62%), and Department of Hematology (1.64%). The top four nosocomial infection sites were lower respiratory tract (45.32%), urinary tract (13.21%), operative incision (8.86%), and blood stream (8.86%). The samples of 570 nosocomial infections were delivered for examination with a sample-delivering rate of 95.32%. The most common pathogens were acinetobacter Baumanii (17.02%), Klebsiella pneumoniae (14.21%), Escherichia coli (13.68%), Pseudomonas aeruginosa (11.93%), and Staphylococcus aureus (9.12%). And urinary tract intubation (42.81%), admission of ICU (28.60%), and application of corticosteroid and immunosuppressive agents (26.42%) were the top three independent risk factors for nosocomial infection. ConclusionGeneral and comprehensive monitoring is an effective method for the hospital to detect high-risk departments, factors and patients for nosocomial infection, providing a theoretical basis for prevention and control of nosocomial infection.
OBJECTIVE: To study the effective protective measures to ensure sufficient blood supply to the jejunal segment in reconstruction of esophagus. METHODS: According to evidence based on medicine, we analyzed retrospectively 69 patients (48 cicatricial stenosis due to chemical burn, 21 defects due to excision of esophagus cancer), whose esophagus were reconstructed with free jejunal graft(in 28 cases) and with pedicle jejunal graft (in 41 cases) from 1980 to 2001. RESULTS: All patients were followed up for 1-21 years. Of 43 patients treated before 1996, 5 complicated by anastomotic leakage, 1 by strangulated intestinal obstruction; of 26 patients treated after 1996 (6 with free jejunal graft, 20 with pedicle jejunal graft), only one case complicated by anastomotic leakage. CONCLUSION: The preservative measures for good blood supply to the jejunal segment include the following aspects: (1) complete marginal vascular arcade without tension in the mesojejunum; (2) vessel anastomosis smooth; (3) 4-finger width pathway of jejunum; (4) the stable arterial blood pressure (more than 8 kPa); (5) a single-row anastomosis; and (6) the comprehensive preoperative management.
摘要:目的:探討經尿道前列腺電切術中糖尿病患者血糖變化以及處理對策。方法:2006年7月~ 2009年1月共對80例患有前列腺增生合并糖尿病患者行TURP,同期對80例單純性前列腺增生患者進行相同手術,回顧分析其術前、術中30 min、60 min、90 min 指尖血糖變化及干預情況。結果:治療組80例患者,51例術中血糖值明顯低于術前,分別為1.8～3 mmol/L;對照組術前與術中血糖值基本一致,血糖波動于4.5～5.6 mmol/L。結論:糖尿病患者糖的儲備能力差,在行經尿道電切術中易發生低血糖綜合征,術中及時的血糖監測及干預對保證患者的安全有重要意義。Abstract: Objective: To study the changes and measures against the glucose in the operation of the Diabetes by TURP. Methods:Eighty patients with prostate combining diabetes operated from July 2006 to Jan. 2009 were reviewed, and 80 prostate treated at the same period with the same operation measure were selected as control. The preoperative glucose, intraoperative glucose (30′, 60′,90′) of fingertip, and countermeasures were studied and compared between the two groups. Results:Fiftyone cases of the experimental group of intraoperative blood glucose was significantly lower than preoperative values, respectively 1.83 mmol/ L; control group preoperative and intraoperative blood glucose values were basically the same, blood glucose fluctuations in the 4.55.6 mmol/L. Conclusion: The capacity in patients with diabetes is poor, easy to hypoglycemia syndrome in the act of TURP surgery, intraoperative blood glucose monitoring and timely intervention to ensure patient safety significance.
Acoustic environment is an important part of the overall environment of a hospital. Acoustic environmental pollution will have varying degrees of impact on human physiology and psychology. Acoustic environmental pollution in outpatient clinics has become a major concern for visitors and medical staff. Exploring the causes of outpatient acoustic environment pollution and adopting active countermeasures are effective methods to control outpatient acoustic environment pollution. This article will review the current situation of acoustic environmental pollution in outpatient clinics and the impact of acoustic environmental pollution on medical staff and visitors, and analyze the common causes of outpatient acoustic environmental pollution based on actual conditions, and propose corresponding solutions for the corresponding causes. It aims to provide a reference for clinically effective control of acoustic environmental pollution in outpatient clinics.
Objective To analyze the causes for day surgery cancellations before admission or on the same day of operation, and put forward targeted measures to improve the medical resource utilization and patient satisfaction. Methods The basic information and clinical data of patients who had been scheduled for surgery in the Day Surgery Center of West China Hospital, Sichuan University between January 2018 and September 2021 were collected. The reasons for the surgery cancellations before admission or on the same day of operation were analyzed. Results From January 2018 to September 2021, a total of 45176 patients were successfully scheduled for day surgery, and 44300 patients completed surgery as planned. A total of 876 operations (1.94%) were cancelled after being scheduled, including 546 (1.21%) before admission and 330 (0.73%) on the surgery day. Ranked from high to low according to the cancellation rates, the top five departments were Department of Dermatology, Department of Vascular Surgery, Department of Hepatobiliary Surgery, Department of Otorhinolaryngology, Head and Neck Surgery, and Department of Gastroenterology, with a cancellation rate of 3.38% (8/237), 2.90% (25/863), 2.85% (101/3548), 2.48% (171/6893), and 1.91% (260/13578), respectively. In the reasons for cancellations, patient factors accounted for 57.31% (502/876) and medical management factors accounted for 42.69% (374/876). Conclusions The cancellations of day surgery mainly occur before admission, and are mainly caused by patient factors. It is necessary to strengthen the preoperative education for day surgery patients, and enhance the communication and cooperation between surgery physicians, nurses and technicians, in order to reduce the operation cancellation rate and make reasonable and efficient use of medical resources.
Patient-reported outcome measures (PROM) measure attribute studies refer to studies conducted by investigators to validate the measurement attributes of PROM. The consensus-based standards for the selection of health measurement instruments (COSMIN), an international consensus standard for the selection of health measurement instruments, divides this attribute into three aspects: reliability, validity and responsiveness, and adds interpretability as an additional important feature for evaluating PROM. The purpose of this paper is to introduce the verification methods and principles of the three major measurement attributes in the COSMIN consensus, as well as the significance and direction of interpretability evaluation, and to provide international methodological experience and reference for the development of high-quality PROM psychometric attribute verification in China.
By reviewing and analyzing the domestic and international rehabilitation medicine education, we try to forecast the development of rehabilitation medicine of Sichuan, and moreover, to summarize and analyze the problems and difficulties of rehabilitation medicine education in this province. Then, we put forward the development countermeasures of Sichuan rehabilitation medicine education from the aspect of talent training object and mode, in order to gradually establish and improve a rehabilitation medicine education system that can adapt to the training requirements of modern medicine, to cultivate talents of rehabilitation medicine suitable for national construction needs at every level, and to improve the overall quality of Sichuan rehabilitation medicine education and build a medical rehabilitation highland in West China.
This article introduces the measures that the scientific research base of West China Hospital has taken in its emergent response to the unexpected huge Wenchuan earthquake disaster, including safe evacuation, safety examination and removal of hidden dangers, damage reporting and a series of subsequent measures.
Objective To evaluate the effects of mass immunization campaign on the epidemiological characteristics of measles. Methods Comparison was made between the incidences of measles before and after the mass immunization campaign in 2007 in Shunqing prefecture of Nanchong city. Results The total number of the reported measles cases reached 460 during 2004 to 2007 in Shunqing prefecture of Nanchong city, and the respective annual rates of incidence were 4.04, 23.53, 11.84, and 33.57, respectively per 100 000 heads. Cases reported from April to July accounted to 73.91% of the total (340/460). Children under 15 were reported to have the highest incidence rate and accounted to 83.70% of the total (385/460), of which incidences of children under 1 accounted to 0%, 10.81%, 13.51% and 25.82%, respectively. Only 20.00% of the subjects (92/460) in this study had a definite history of measles vaccination. After the mass immunization campaign in September, 2007, only 10 cases were reported in 2008 and the incidence rate was 1.58 per 100 000 heads, a 95.29% decrease in incidence rate in comparison with that of the last year. Conclusion The mass immunization campaign has achieved substantial results.