【摘要】 目的 研究两种不同的衰减系数转换方法对正电子发射计算机断层显像/计算机体层扫描（PET/CT） 标准摄取值（SUV）测量值的影响。 方法 2009年11-12月，从经过PET/CT氟代脱氧葡萄糖（FDG）显像患者中选取20例，其口腔中均有金属假牙。以四段转换法和二段转换法重建全身衰减校正断层图像。分别选取3种高密度区域和7种低密度区域，测量其最大SUV和平均SUV，比较两种转换方法SUV测量值。 结果 平均SUV：二段转换法的3种高密度区域SUV降低，在7种低密度区域中，1种区域增高，1种区域降低（P值均lt;0.05）。最大SUV：二段转换法的2种高密度区域的SUV降低，在7种低密度区域中，1种区域增高，2种靠近高密度组织的区域降低（P值均lt;0.05）。 结论 二段转换法能降低高密度区域的SUV，可用于减小体内金属植入物和CT对比剂造成的过度校正。【Abstract】 Objective To explore the effect of two attenuation correction algorithms on PET/CT SUV measurement. Methods From November to December 2009, the PET Slice of 20 patients with metallic dental implant were reconstructed with four-and two-section algorithms respectively. Mean SUV and maximum SUV were measured in three high-density areas and 7 low-density areas. Paired t test were performed to compare the differences. Results Mean SUV: two-section algorithm produced significantly lower SUV in all the three high-density areas; in the 7 low-density areas, SUV increased obviously in one area and decreased apparently in one area (Plt;0.05). Maximum SUV: two-section algorithm produced significantly lower SUV in two high-density areas, SUV increased obviously in one area and decreased apparently in two areas which was adjacent to the high density areas (Plt;0.05). Conclusion Two-section algorithm produces lower SUV measurement value than the four-section algorithm does, and it is useful in PET/CT studies for patients with metallic dental implant and when CT contrast is used.
After Wenchuan earthquake on May 12, West China Medical School/ West China Hospital of Sichuan University organized a youth volunteer team for earthquake rescue and relief. A volunteer network was formed and relevant service regulations were formulated immediately. Volunteers have played an important role in post-earthquake evacuation of patients, emergency reception, ward care, on-call service, a service to help people find family members, telecommunications and some other major tasks.
Coronavirus disease 2019 epidemic is a serious and infectious public health event that causes physical damage and may also have an impact on mental health. West China Hospital of Sichuan University combines the internet hospital platform with the traditional telephone model, establishes a new coronavirus disease 2019 intervention integration platform, and builds a new “four-in-one” medical service system, which contains epidemic consultation, psychological consultation, self-evaluation and home prevention and control. It has established a way for the public to communicate with professional, reduced the spread of coronavirus disease 2019 in space, and effectively carried out psychological decompression and comfort work, disseminated the knowledge of fighting coronavirus disease 2019, and provided medical advice. This article mainly introduces the out-of-hospital psychological intervention model of West China Hospital of Sichuan University during the coronavirus disease 2019 epidemic, and aims to provide a reference for exploring the psychological intervention methods for major public health emergencies.
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.
By analyzing the current situation and problems of China’s precision healthy poverty alleviation, combining the current situation of poverty alleviation areas and its own clinical and regional advantages, West China Hospital of Sichuan University explores a practical “West China Way” to solve the healthy poverty problem. We insist on demand orientation, build the top-level design, and implement precise policies. Starting with the promotion of health screening, we actualizes hospital management, multi-disciplinary collaboration, integrated medical care construction according to regional needs, “double-group” style assistance, stratified and graded training, and telemedicine education. As the combination of “transfusion” and “hematopoiesis”, we help the local areas to build modern systems of hospital management, technology, and human resource.
Objective To analyze the costs of emergency medication in the West China Hospital within one month after Lushan earthquake based on actual medication of the victims’ disease spectrum. Methods We collected emergency medication data as evaluation index in the West China Hospital within one month after Lushan earthquake, including daily cost, cumulative percentage of pharmacology category, average cost per day/person, average cost per day/person when DUI=1, difference between average cost per day /person, and average cost per day/person when DUI=1, etc. Then, we input data using Excel software for statistically analyzing the costs of emergency medication within one month after the earthquake. Results During one month after the earthquake, the costs changed consistently with the number of victims, which implied the change of costs was rational. Injuries were classified into 6 categories and 12 kinds according to ICD-10. The costs of medication accounted for 71% of the total costs. Six kinds of illness accounted for 21%. Medication for injuries was classified into 3 categories and 18 kinds; average cost per day was 186.87 yuan and average cost per person was 1 702.70 yuan. Medication for illness was classified into 5 categories and 28 kinds; average cost per day was 38.96 yuan and average cost per person was 185.13 yuan. The mean value of average cost per day/person of injection was 14.52/5.08 times more than that of non-injection. Meanwhile, the mean value of average cost per day/person of imported medication was 7.10/5.28 times more than that of domestic medication. Conclusion The factors that impact the medication costs include: a) disease burden and traumatic conditions of the sick and wound; b) administration pathway (injection vs. non-injection); c) imported or domestic medication; and d) the rationality of taking DUI as evaluation index. When DUIgt;1, injection through the vein and imported medication take a larger share which increase the costs of medication. Emergency rescue package should mainly prepare for the injury. In order to ensure the timely, safe and effective medication, injection should be given priority to. We also should take into consideration crash-resistance/anti-quake package, reasonable dosage, convenience-to-use of drugs as well as the needs of the illness.
Objective To collect and analyze the data of emergency medicine supply for both Wenchuan and Lushan earthquakes victims in the West China Hospital, so as to provide evidence for scientifically and efficiently carrying out the logistical support for emergency rescue medicines supply, and improving the coping capacity for those similar public health emergencies. Methods Both medicine constituent ratios and DDDs were taken as evaluation indexes, and the data were input by Excel software. Then the following items were analyzed: the use and cost of emergency medicine for victims admitted in the hospital from one day to one month after earthquake, as well as, the acceptance, allocation and use of the donation medicines for both Wenchuan and Lusan earthquakes. Results During the first month after Lushan earthquake, the victims used 26 categories of medicines involving 455 drug specifications in the West China Hospital. The dosage and DDDs of therapeutic medicines were higher than those of ancillary medicines. The donation medicines for Lushan earthquake accepted by the hospital were in 8 categories involving 16 drug specifications, and they were all used to rescue the victims in the hospital. Based on the hospital emergency medicine supply system oriented by the information of victim’s medicine use, the drug specification and total drug cost of the donation medicines for Lushan earthquake decreased by 90.91% and 89.73%, respectively, indicating a more accurate and efficient system compared with those for Wenchuan earthquake. Conclusion The implementation of the hospital emergency medicine supply system oriented by the information of victim’s medicine use is helpful to improve the time efficiency and pertinence of earthquake medical rescue.
ObjectiveTo retrospectively investigate the medication structure and evaluate the rationality among over-60-year outpatients with lung cancer in the West China Hospital of Sichuan University in 2011. MethodsThe data was extracted from the hospital information system (HIS). Excel 2010 software was used for statistical analysis. Resultsa) The total of over-60-year outpatients with lung cancer were 17 296 person-times, of which 12 606 persons-times patients with no medication accounted for 72.88%. The monotherapy in patients with medication accounted for 75.76%. b) There were 5 types of tumour related drugs, including 56 kinds of different drugs, and the total frequency was 6 460 and the average cost was 2 219.38 yuan. The first three drugs classified by 5 types were traditional Chinese drugs (TCM, 28.50%), other therapy (24.91%), and etiological treatment (22.23%). c) For etiological treatment, tyrosine kinase inhibitors (TKI) accounted for 59.96%, and the first three drugs were gefitinib, recombinant human endostatin, and erlotinib. d) For symptomatic treatment, analgesic drugs accounted for 43.65%; and the first three drugs were tramadol hydrochloride sustained-release tablets, sodium zoledronic oxycodone, and acetaminophen. e) For ADR therapy, liver drugs accounted for 40.97%; and the first three drugs were palonosetron hydrochloride, licorice, and diammonium pantoprazole. f) Other treatment involved immunopotentiating drugs and hematopoietic growth factors, the ratios were 62.65% and 37.35%, and the first three drugs were thymalfasin, thymopentin, and recombinant interleukin-11. g) Huisheng, Banao capsule and Bailing capsule were at the first three usage in TCM, the ratios of which were 51.06%, 15.37%, and 13.91%. h) The top ten drugs were Huisheng oral liquid, gefitinib and thymus AFP, thymopentin recombinant interleukin-11, chelating compound spot capsules, recombinant human endostatin, tramadol hydrochloride extended release tablets, sodium, zole dronic, and Bailing capsule. ConclusionThe antitumor therapies were mainly TKI single drug regimen for over-60-year outpatients with lung cancer in the West China hospital of Sichuan University in 2011. The most frequently used adjuvant therapies are antalgic, antitussive and skeletal related events prevention drugs. Besides, Chinese patent medicines are in common use as well.