ObjectiveTo analyze the diagnosis status and epidemiological characteristics of anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDAR encephalitis) in the Sichuan province of China. MethodsIn the retrospective survey study, data of cases suspected as autoimmune encephalitis in Sichuan province from January 2012 to February 2017 were collected from the third-party test center.The diagnosis status and epidemiological characteristics of anti-NMDAR encephalitis were analyzed. Results① A total of 1 714 cases had been suspected as autoimmune encephalitis with anti NMDA receptor antibodies tested.In hospitals of capital city, cerebrospinal fluid or serum of 1 511 cases were tested since 2012.In other cities, 203 cases were tested since 2014.Hospitals with anti NMDA receptor antibodies tested increased by year.The cases distributed in the department of neurology, psychology, pychiatric, ICU, pediatrics, geriatrics, otolaryngology, infection, the mergency department and pneumology.② Cases with anti NMDA receptor antibodies tested increased by year.A total of 155 cases were confirmed as anti-NMDAR encephalitis, with the average onset age of (27.9±12.0) years ranged from 9 years to 77 years, including 89 women and 66 male.The female average age were (26.5±11.31) years, while the male were(29.0±13.0) years.③ Among the 155 confirmed cases, 127 cases with detailed clinical data were analyzed further.Seizure and behavior disorder were the main symptoms at onset.Among the 127 cases, 107 cases were misdiagnosed at their first hospital visit, with the misdiagnose rate of 84.3%.18 cases were reported with tumors (17 female), mainly with teratoma(11/17). ConclusionIn Sichuan province, the doctors of hospitals in non-capital city should strengthen the identification of autoimmune encephalitis.Anti-NMDAR encephalitis could be misdiagnosed easily and non-neurological physicians should also take attention;
Objective To analyze the articles published by graduate students of West China School of Medicine in Sichuan University from 2013 to 2017. Methods Outcome indicators which includes the quantity of papers, annual distribution, paper category and papers cited by SCI were analyzed through bibliometrics methods. Statistical analysis was performed using SPSS 18.0 software. Results From 2013 to 2017, a total of 5 490 articles were published by postgraduate students in the school as first or co-first author. The average number of publication was 2.19 per student, in which 655 postgraduate students published 3 or more articles, accounting for 26.12%. A total of 2 849 articles were cited by SCI, accounting for 51.89%. The total number of publication and proportion of SCI were growing gradually. The average impact factor of each article was 2.791 and the highest impact factor for each single article was 55.7. Students who graduated from "985 university" published more articles in total and the articles cited by SCI than those from "non-985 university". Conclusion In recent years, the quality of articles published by graduate students from West China School of Medicine in Sichuan University has been improving gradually. The articles published by students graduated from "985 university" were more cited by SCI than those from "non-985 university" .
ObjectivesTo analyze epidemiological characteristics of leprosy in Sichuan province from 2000 to 2017.MethodsCase data of all new leprosy patients in Sichuan province from 2000 to 2017 were collected. A retrospective analysis of its epidemiological characteristics was performed by using SPSS 19.0 software.ResultsA total of 3 208 cases of leprosy were detected during 2000 to 2017, of whom 2 197 (71.28%) were male, 885 (28.72%) were female. The younger cases whose ages were less than 14 were 82 (2.66%), and the cases with grade 2 disabilities were 614 (19.92%). The mean age of male was older than female (41.64±14.26 vs. 38.89±15.12 years, P<0.05). The grade 2 disability rate of male was significantly higher than that of female (20.94% vs. 17.40%, P<0.05). Self-report was the most common method of discovery. But the ratio of male who were detected through contact examination was significantly lower than that detected through dermatological clinic, self-report, clues check and report (the ratio of male to female was 1.57, 2.38, 2.88, 2.48, 2.37, respectively, P<0.05).ConclusionsThe case detection of leprosy declines annually in Sichuan province from 2000 to 2017, especially in high-endemic area and male patients. Female patients are younger than male patients when they are detected. The grade 2 disability situation of male patients is significantly more serious than that of female patients. Self-report is the most common way of discovery, while women are more passive.
Objective To analyze the rationality of emergency medication in the West China Hospital after Lushan earthquake based on the actual drug use of earthquake victims. Methods We applied DDDs and DUI as evaluation index, input data using Excel software, and analyzed if the emergency medication was required for the injury/illness and the rationality of emergency medication. Results Earthquake victims mainly had trauma and wound infection and they were given antibiotics as main treatment one week after the earthquake. Drugs for the respiratory system and digestive system were mainly used in patients who mainly manifested as non-traumatic diseases and internal diseases four weeks after the earthquake. Among 49 kinds of drugs which could be calculated for the value of DUI, injection accounted for a larger proportion than non-injection (59.18% vs. 40.82%). The results showed that, the medication (DUI=1) only accounted for 12.24%; the medication (DUIlt;1, Mean=0.65) accounted for 38.78%, which implied insufficient drug use; the medication (DUIgt;1, Mean=1.77) accounted for 46.94%, which implied drug overuse. Conclusion Medication for every system is basically timely and rational when treating symptoms and causes in the West China Hospital within one month after Lushan earthquake. However, the rationality of emergency medications using DUI=1 under normal conditions still needs to be further verified.
The number of clinical guidelines developed and published in different countries is increasing worldwide. Too many guidelines do not remain in regular use, even though the aim is to implement them in clinical practice. The scientific validity and reliability of the guidelines need to be reviewed. Here is a case presented to show how to optimally use the evidence-based guideline to improve clinical decision making.
Objective To survey the current status of residents’ health examination in township medical units in Shuangliu county, so as to provide references for exploring the residents’ health examination mode suitable for the well-off rural hospitals, and for improving the effects of physical examination. Methods The self-designed questionnaires were made to survey the current situation of health examination for the residents in 24 township medical units in Shuangliu County, including 3 central township hospitals, 3 community health centers and 18 general township hospitals; and the outline was designed to interview the people responsible for managing and implementing the resident’s examination work. The Epidate 3.1 was used for data input, the SPSS 17.0 was used for descriptive statistics and stratified analysis, and the classification method was adopted for qualitative research of personal interview data. Results The number of primary health care units for carrying out residents’ health examination got gradually increased year by year from 2008 to 2010; and all 24 township-level medical units had already carried out that examination by 2010. But some issues still existed such as lower participation rate and ineffective utilization of the archives. Conclusion a) It is necessary to prepare well, enhance organizing, expand publicity, and increase participation rate when primary health care units carry out the health examination for residents; b) It is necessary requires to fasten the informatization construction of health archives, and to quicken the process and analysis of examination information; and c) It is advisable to constantly optimize the examination items according to exam information, to improve the qualification of medical staffs, and to fasten the construction of exam team.
ObjectivesTo explore the poor population’s cognition and satisfaction on medical assistance policies in Sichuan province, so as to provide evidence for improving health poverty alleviation policies.Methods A telephone survey was conducted between October and December 2017 among 1 280 poor individuals in Sichuan Province, with multi-stage stratified random sampling. The contents of the survey included general demographics of the poor population, and knowledge and satisfaction of health poverty alleviation policies.ResultsThe awareness rate of medical assistance policy was 91.80%, and the satisfaction rate was 91.88%. Poor individuals from non-poor counties, who had been out of poverty, and who reported that they had not signed up for family doctors, had low awareness of poverty alleviation policies. Poor individuals from non-poor counties, who usually went to the municipal hospital, who reported that they have not signed up for family doctors, and who do not know about health policies for poverty alleviation had a lower satisfaction rate.ConclusionsThe overall awareness rate and satisfaction rate of medical assistance policies in Sichuan province are relatively high, however, there are still some shortage. In the future, more attention should be paid to strengthen the promotion of health poverty alleviation policies for non-poor areas and those who had been lifted out of poverty, speeding up the contract service of family doctors and exploring ways to further alleviate the burden of medical expense of patients with serious diseases.
ObjectiveTo retrospectively investigate the drug use of over-60-year inpatients with lung cancer in the West China Hospital of Sichuan University in 2011, and to compare with outpatients with lung cancer concurrently, so as to evaluate the rationality of drug use among over-60-year inpatients with lung cancer in the West China Hospital. MethodsThe information of over-60-year inpatients with lung cancer as initial diagnosis in the West China Hospital in 2011 was collected from the hospital information system (HIS), including patient information, drug use information, cost information, etc. Data rearrangement and analysis by classes and costs were carried out using Microsoft Excel 2010 software. Resultsa) There was 2 215 person-times of over-60-year inpatients with lung cancer in the West China Hospital of Sichuan University in 2011. A total of 5 classes, 63 kinds of anti-tumor and adjuvant therapy drugs were involved. The total drug use frequency was 12 398 person-times. The average medicine cost was 774.93 yuan. b) The ratio of patients using 1 to 4 kinds of drugs was 34.31%, 5 to 10 kinds was 41.9%, and 11 to 15 kinds was 12.63%. c) For etiological treatment, the ratio of chemotherapy drugs was 99.45%, and the most used was cisplatin. d) For symptomatic treatment, the ratio of analgesics was 66.69%; the ratio of antitussive drugs was 21.33%; and the ratio of skeletal related events prevention drugs was 11.98%. e) For anti-ADR treatment, the ratio of antiemetic drugs was 55.07%; the ratio of stomach protection drugs was 32.63%; and the ratio of hepatic protection drugs was 12.30%. f) For other treatment, the ratio of immunopotentiating drugs was 59.46%; and the ratio of hematopoietic growth factor was 25.42%. g) For Chinese patent medicine, drugs used over 400 person-times were Diyushengbai tablet, Javanica oil emulsion injection, Aidi injection, and Huisheng oral liquid. h) For single/combined treatment, the ratio of two-drug combined chemotherapy was 78.38%, one analgesics drug treatment was 66.21%, one hepatic protection drug treatment was 83.41%, two-drug combined antanacathartic treatment was 45.88%, one stomach protection drug treatment was 90.53%, one immunopotentiating drug treatment was 90.53%, one hematopoietic growth factor treatment was 82.31%, and one Chinese patent medicine treatment was 37.39%, respectively; and antitussive and skeletal related events prevention drugs were used alone. i) The use frequency of the top 10 drugs were: pantoprazole, tropisetron, ondansetron, diphenhydramine, thymopentin, cisplatin, Diyushengbai tablet, tramadol, Javanica oil emulsion injection, and Aidi injection. j) Compared with outpatients, inpatients drug use frequency was higher in chemotherapy, analgesics, antiemetic, stomach protection, hepatic protection drugs, and Chinese patent medicine; but lower in skeletal related events prevention drug; and similar to the drug use situation of outpatients in immunopotentiating drugs and hematopoietic growth factor drugs. ConclusionThe antitumor therapies were mainly the combination of two chemotherapy drugs or single drug regimen for over-60-year inpatients with lung cancer in the West China hospital of Sichuan University in 2011. The most frequently used adjuvant therapies are antalgic, antiemetic and stomach protection drugs. Chinese patent medicine and immunopotentiating drugs are in common use as well.
ObjectiveTo analyze the state of rehabilitation after Lushan earthquake for improving the rehabilitation and personnel training system. MethodsFrom April 21st to May 5th, 2013, we collected data related to earthquake victims and the staff structure from West China Hospital, Leshan Downtown Hospital, Emeishan Hospital of Traditional Chinese Medicine (TCM), and Ya'an People's Hospital through interview and field investigation. ResultsTwo weeks after the earthquake, 25 220 victims received treatments in Sichuan Province, 6 545 surgeries were conducted, and 947 victims received postoperative early rehabilitation. A total of 392 victims received treatments in West China Hospital, Sichuan University, including 321 in-patients. In Leshan Downtown Hospital, Emeishan Hospital of TCM and Ya'an People's Hospital, the proportion of rehabilitation doctors reached 11.5% among all the doctors, the rehabilitation nurses reached to 8.6% among all nurses, and the rehabilitation therapists with certification reached to 4/5. ConclusionThe construction of the rehabilitation system and discipline, the cultivation of professional personnel, and popularization of rehabilitation concept are essential for development of rehabilitation in Sichuan province.