Methods To explore the level of delirium knowledge of geriatric nurses in Sichuan province and analyze the factors, so as to provide the basis for systematic and targeted knowledge training on delirium and clinical management. Methods Using the self-designed “the Questionnaire of Elderly Delirium Knowledge”, geriatric nurses from 22 hospitals in Sichuan province were investigated through a convenient sampling method from September 2018 to February 2019. Results A total of 475 geriatric nurses were investigated. The average delirium knowledge score of the 475 geriatric nurses was 69.51±12.42. Multiple linear regression analysis showed that the main factors affecting the score of delirium-related knowledge were the education of nurses (P=0.037), technical title (P<0.001), years of working in the geriatric department (P=0.001), and the level of working hospital (P=0.001). Conclusions The level of delirium knowledge of geriatric nurses is low and can not meet the needs of clinical work. Nursing managers should carry out delirium knowledge training according to the different characteristics of nurses.
Objective To determine whether lymph node-targeted chemotherapy with carbon nanoparticles absorbing 5-FU affects expressions of bcl-2, bax and caspase-3 in gastric cancer tissues, metastatic lymph nodes and normal gastric mucosa. Methods Twenty-eight patients with gastric cancer in our department were divided into lymph node-targeted chemotherapy (LNTC) group and control group from October 2005 to August 2006. The patients were treated with carbon nanoparticles absorbing 5-FU before operation in LNTC group and those were operated directly in control group. The gastric cancer tissues, metastatic lymph nodes and normal gastric mucosa were collected after operation. The expressions of bcl-2, bax and caspase-3 in those tissues were determined by immunohistochemical technique. Results In LNTC group, the positive expression rate of bcl-2 in gastric cancer tissues and metastatic lymph nodes was significantly lower than those in control group (28.6% vs . 78.6% , 25.0% vs . 70.0% , P ＜ 0.05), the positive expression rate of bax (85.7% vs . 28.6% , 80.0% vs . 30.0% ) and caspase-3 (57.1% vs . 14.3% , 55.0% vs . 15.0% ) in gastric cancer tissues and metastatic lymph nodes was significantly higher than those in control group ( P ＜ 0.05). The positive expression rate of bcl-2, bax and caspase-3 in normal gastric mucosa was not significantly different between two groups ( P ＞ 0.05). Conclusion The lymph node-targeted chemotherapy with carbon nanoparticles absorbing 5-FU can down-regulate the expression of bcl-2 and up-regulate the expression of bax and caspase-3 in gastric cancer tissues and metastatic lymph nodes, and therefore by affecting the expression levels of these apoptosis molecules may be one of the ways to induce tumor cell apoptosis.
ObjectiveTo investigate the management of hospital infection control of 23 hospitals in Sichuan province, China for making the questionnaires and providing basic data of the China-U.S. cooperative program on emerging and re-emerging infectious diseases "The Nosocomial Infection Surveillance Project in China". MethodsWe selected 23 representative hospitals from different regions of Sichuan in the survey for the management of hospital infection control. The survey included basic situation of the hospital such as the hospital level, ownership, number of beds, employees and discharged patients, the situation of hospital infection management such as the organization of management, the previous surveillance for prevalence of nosocomial infection, the composition of the staff, and the distribution pattern of important pathogens. ResultsThere were 18 Triple A hospitals, 1 Double A hospital, 4 Triple B hospitals were investigated, of which there were21 general hospitals and 2 specialty hospitals. The total number of patient beds were 26 801. The total numbers of staff were 32 757 including 8 571 doctors, 13 611 nurses, 1 391 technicians and 1 014 pharmacists. In 2010, the total numbers of out-patients, operations, and discharged patients were 16 127 038, 334 057, and 776 806, and the length of mean hospital stays were 11.30 days. All hospitals established the hospital infection control department with 105 infection control professionals. Most of the staffs of infection control department had medical or nursing background with college, or undergraduate level. Nineteen hospitals (82.61%) did the surveillance for the prevalence of nosocomial infection. The last surveillance showed the mean rate of hospital infection was 2.58%. Lower respiratory tract, upper respiratory tract and surgical site infection were top three infections. The annual number of culture specimens totalled 267 061; the average positive rate was 33.06%. Escherichia coli, klebsiella pneumoniae, pseudomonasaeruginosa, staphylococcus aureus and acinetobacter baumannii were top five infectious bacteria. ConclusionThe survey on the hospital infection control management could help us understand the overall situation of the hospital infection control. Also it could found the weaknesses and targeted interventions for the future project, and ensure the authenticity and reliability of the data for this research project eventually.
Health poverty alleviation is an important practice in implementing the basic strategy of precision poverty alleviation. It is also an important measure to win the battle against poverty in rural areas. Through the investigation of local medical and health conditions, West China Hospital of Sichuan University built a demand-oriented framework for medical poverty alleviation in Ganzi Prefecture, and gradually carried out precision top-level design, discipline construction, technical training, talent training, endemic disease prevention and control; through establishinga regional medical cooperation network, built featured specialies, built the backbone of medical and health forces, achieved the prevention of endemic diseases throughout life cycle, and improved the overall medical and health service capacity of Ganzi Prefecture. This article introduces the exploration and practice of the demand-oriented model in Ganzi Prefecture by West China Hospital of Sichuan University, aiming at providing a guide for the precision health poverty alleviation in China.
Objective To comparatively analyze the rationality of emergency medication after Wenchuan earthquake with that after Lushan earthquake in West China Hospital of Sichuan University, based on the use of medicine of the victim’s disease spectrum. Method By using Excel, defined daily dose system (DDDs) and drug utilization index (DUI) were used as the evaluation indexes to analyze the rationality of emergency medication in West China Hospital of Sichuan University within one month after Wenchuan earthquake and Lushan earthquake. Results Within one month after Wenchuan and Lushan earthquake, there were 1 839 and 488 victims treated in the hospital, respectively. Within one month after the two earthquakes, the variation tendency of DDDs of drugs and number of victims was consistent, and the consistency was better in Lushan earthquake than that in Wenchuan earthquake. Among the 60 drugs which DDDs were ranked top five in their pharmacological class (top ten for antimicrobials) in Wenchuan earthquake, the majority of them were injections (injections vs. non-injections: 70.0% vs. 30.0%); the results showed that the medication (DUI=1) only accounted for 10.0%, the medication (DUI<1) accounted for 28.3%, which implied that the use of drugs was insufficient, the medication (DUI>1) accounted for 61.7%, which implied that drugs were overused; the average of DUI was 1.61. And in Lushan earthquake, injections also accounted for a larger proportion than non-injections (63.3%vs. 36.7%); the results showed that the medication (DUI=1) accounted for 15.0%, the medication (DUI<1) accounted for 38.3%, the medication (DUI>1) accounted for 46.7%; the average of DUI was 1.30. Conclusions Base on the DUI, we draw the conclusion that the rationality of emergency drug use and the timeliness of emergency drug supply were better in Lushan earthquake than those in Wenchuan earthquake. But the rationality of using the DUI, which is an evaluation index for normal conditions, to evaluate the emergency conditions still needs to be further verified.
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.
Objective To evaluate the quality of randomized controlled trials in otorhinolaryngology in China and provide to comprehend the possibility of its contribution in providing reliable, evidence in clinical practice; thus providing evidence to elevate the clinical treatment level. Methods Five Chinese clinical otorhinolaryngology journals were searched and randomized controlled trials were identified and analyzed according to the standards of evidence-based medicine. Results Two hundred and eighty seven issues were referred to and eighty-one randomized controlled trials were identified and analyzed. Of these randomized controlled trials, 34.57% (28/81) had definite diagnostic standards, 38.27% (31/81) had inclusion standards and 33.33% (27/81) had exclusion standards; only 1.23% (1/81) got the approval of the participants; 40.74% (33/81) had moderate sample size; 3.70% (3/81) had large sample size and no one mentioned sample size estimation; 81.48% (66/81) didn’t report the method of randomization and 38.27% (31/81) had baseline comparison; 18.52% (15/81) didn’t define the control interventions and 8.64% (7/81) even didn’t explicate the experimental interventions; 32.10% (26/81) used blank comparison; 86.42% (70/81) didn’t use blindness; 37.04% (30/81) didn’t mention the adverse effects; 23.46% (19/81) used accredited standards to evaluate the outcomes; l l.11% (9/81) mentioned the loss of participants and only 1.23% (1/81) treated the loss with statistics methods. Conclusions The quantity and quality of the otorbinolaryngologic randomized controlled trials in present review can not meet the clinical need. Higher quality of randomized controlled trials are required to improve the level of prevention and the treatment of otorhinolaryngologic diseases.
This paper reviews the implementation of disease prevention and control policy of Sichuan province in three historic stages, and analyses the situation, challenges and tasks about disease prevention and controlling in future, based on the new requirements about hygiene and medicine. Three strategies should be taken: 1) to improve the capacity and quality of health service; 2) to optimize the structure of institutions and talent teams; 3) to focus on the Healthy Sichuan construction, the treatment-prevention synergy, and the poverty health care.
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.
Objective To survey the present situation of medical equipment configuration of township hospitals in Shuangliu County, to provide baseline data for the next step of discussing the well-off township hospital medical equipment configuration standards. Methods According to the national guidance on device configuration in township hospitals, the questionnaire was made to survey 24 county township medical units (i.e. 3 central township hospitals, 3 community health centers, and 18 general township hospitals). The descriptive and stratified analysis was performed for the survey results. Results The condition of medical equipment configuration in the 3 central hospitals was better than that in the 3 community health centers which was better than that in the 18 general hospitals. The emergency equipment configuration such as defibrillator units, breathing airbags, and tracheotomy package was poor. Annual inspection rate of medical metering equipment was lower than expectation. In 2010, a total of 127 medical measuring equipments from 98.5% of the township hospitals applied annual inspection, among which, only the total annual rate of black and white B ultrasonic and X-ray machine reached above 60%; the rate of blood cells analyzer, ECG monitoring instrument, and biochemical analyzer were between 50% to 60%; and the rate of urine analyzer was the lowest at 4.5%. Conclusion It is the right time to strengthen the first aid equipment configuration in township hospitals and to enhance the annual inspection rate of the medical measuring equipment, so that the safety use and accuracy detecting can be guaranteed.