ObjectiveTo explore the innovative application and effect of lead-type close medical consortium under the epidemic situation of coronavirus disease 2019 (COVID-19).MethodsDuring the epidemic of COVID-19, Jintang First People’s Hospital implemented a series of innovative countermeasures under the guidance of West China Hospital of Sichuan University, the leading hospital of a lead-type close medical consortium. To verify the implementation effect of the countermeasures, the patient satisfaction questionnaire and medical personnel satisfaction questionnaire were administered in confirmed or suspected COVID-19 patients and anti-epidemic healthcare workers. The relevant health economic indicators were extracted through the hospital information system for descriptive analysis.ResultsA total of 16 patients were included, including 10 confirmed patients and 6 suspected patients. The median score of patient satisfaction was 66. All patients were cured and discharged. A total of 56 healthcare workers were included, including 18 doctors and 38 nurses, with a median satisfaction score of 81. The average length of hospital stay of patients was 11.00 d, the average hospitalization cost was 5 117.35 yuan; the average drug cost was 1 099.95 yuan, accounted for 21.49%; the average material cost was 38.63 yuan, accounted for 0.75%.ConclusionsThe innovative application of the lead-type close medical consortium in the treatment of patients with COVID-19 plays an important role in the prevention and control of epidemic, and has achieved remarkable results in patients treatment, patients satisfaction, and hospital management. It is worthy of being widely popularized.
Since smart phones have been developed, significant advances in the function of mobile phone due to the development of software, hardware and accessories have been reached. Till now, smart phones have been engaged in daily life with an increasing impact. As a new medical model, mobile phone medicine is emerging and has found widespread applications in medicine, especially in diagnosing, monitoring and screening various diseases. In addition, mobile phone medical application shows great potential trend to improve healthcare in resource-limited regions due to its advantageous features of portability and information communication capability. Nowadays, the scientific and technological issues related to mobile phone medicine have attracted worldwide attention. In this review, we summarize state-of-the-art advances of mobile phone medicine with focus on its diagnostics applications in order to expand the fields of their applications and promote healthcare informatization.
Objective To observe clinical effects of burn wounds treatment with bovine amnion and to screen the best method of preparing and storing of bovine amnion. Methods From January 2004 to January 2005,We selected randomly 58 patients with superficial Ⅱ° wound, deepⅡ° wound, autografting area for removal of eschars and tangential excision, fetching skin area or residual burn wound . Using auto-control, every burn wound was divided into 3 parts and was treated with 3 dressings: bovine amnion dealt with by 0.1% chlorhexidine（group A）, bovine amnion dealt with by 0.4% glutaraldehyde（group B） and vaseline gauze dressing（group C as control）. The clinical effects were compared between different groupsand the method of preparing and storing bovine amnion was evaluated. Results The dressing texture of group A was softer than that of group B, and its flexibility was fine. The pretreatment was not necessary for dressing in group A. When the dressing was used on burn wounds in groups A and B, painwas slight, but pain was obvious in group C; healing time in groups A and B was much less than that in group C, showing statistically significant difference(P＜0.01). There was no statistically significant difference in healing time between groups A and B (P＞0.05). The infection ratio of burn wound in deepⅡ° wound and residual burn wound of groups A and B is much lower than that of group C, showing statistically significant difference (P＜0.05); in theother burn wounds there was no significant difference (P＞0.05). There was no statistically significant difference between groups A and B (P＞0.05). Conclusion Bovine amnion could make benefit on burn wounds healing, reduce infection ratio of burn wounds, could be used on different kinds of burn wounds. The clinical effect between bovine amnion dealt with by glutaraldehyde and by chlorhexidine is similar. Whereas the latter is more easy to be popularized.
ObjectiveTo explore the effect of positive implication in the operating room on the patient's mental. MethodsA total of 160 patients who received the routine laparoscopic appendectomy surgery from January 2011 to October 2012 were treated with positive implications and conventional appease routine psychological care and the fear, pain, depression and anxiety, and other indicators of the two groups were compared. ResultsThe fear scores in the control group patients were significantly higher than that in the observation group (P<0.05). The patient's perceived pain in the control group was higher than that in the observation group (P<0.05); after nursing intervention, the anxiety and depression levels in the two groups decreased significantly; the observation group had significantly higher satisfaction for the entire course of medical treatment (P<0.05). ConclusionThe positive implication in the operating room can effectively alleviate the patient's fear, anxiety, depression and perceived pain and so on and can contribute to the effect of operation and rehabilitation of the patients.
ObjectiveTo investigate the effect of using hemoglobin-revised trauma score (HB-RTS) on predicting mortality risk in trunk injury patients. MethodsAccording to case control study rules, medical records of patients with trunk injury who were treated between July 2011 and October 2013, were collected. Patients were divided into two groups according to their survival prognosis within 28 days. The HB-RTS, revised trauma score (RTS), and injury severity score (ISS) of the two groups were calculated. The receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) and Youden's index were calculated. And then, we selected the optimal cutoff value using HB-RTS and RTS to predict the trunk injury patients' mortality and calculated their sensitivity, specificity, and accuracy. In the end, the correlation of ISS with HB-RTS and RTS using linear correlation analysis method was analyzed. ResultsBesides RTS, HB-RTS and ISS in the death group were statistically significant higher than that in the survival group. The AUC of HB-RTS and RTS of the two groups were 0.922 and 0.888, respectively. The sensitivity of HB-RTS and RTS were 91.5% and 83%; and the specificity of HB-RTS and RTS were 95.7% and 76.6%, respectively. The correlation of HB-RTS and ISS was -0.592, while the correlation of RTS and ISS was 0.585. ConclusionCompared to RTS, ROC of HB-RTS is enlarged, the specificity is increased, and the sensitivity is decreased. HB-RTS has stronger correlation with ISS than with RTS. The predictive effect of HB-RTS is higher than RTS in predicting mortality of trunk injury patients.
ObjectiveTo explore the application of different digestive system management strategies in the perioperative period of thoracolumbar fracture.MethodsThe clinical data of the patients with thoracolumbar fractures and pedicle screw fixation in Affiliated Hospital of Southwest Medical University from January 2016 to January 2018 were retrospectively analyzed. According to different perioperative management strategies of the digestive system, they were divided into two groups. Patients with careful management strategy were included in the observation group, and patients with routine management were included in the control group. The baseline conditions, the abnormalities of digestive tract function at admission and before and after surgery, the postoperative first feeding time, exhaust time, defecation time, the incidence of other postoperative complications except digestive tract complication, length of stay and patient satisfaction were compared between the two groups. At 6 months after surgery, the fracture healing, loosening or fracture of internal plants were compared between the two groups.ResultA total of 121 patients were included in the study, including 67 cases in the observation group and 54 cases in the control group. There was no significant differences in the baseline conditions between the two groups (P>0.05). There were no significant differences between the two groups in the incidences of digestive system dysfunction at admission (P>0.05). The incidences of digestive system dysfunction in the observation group before and after surgery were lower than those in the control group (29.9% vs. 53.7%, P<0.05; 35.8% vs. 61.1%, P<0.05). The first eating time [(3.7±1.1) vs. (6.7±2.6) h], exhaust time [(7.8±2.3) vs. (13.6±4.2) h], defecation time [(26.7±8.1) vs. (40.9±11.2) h] and length of stay [(6.5±2.4) vs. (9.0±2.7) d] in the observation group were shorter than those in the control group (P<0.005), and the patients’ satisfaction was better than that of the control group (8.3±1.1 vs. 7.6±1.3; t=−3.208, P=0.002). There was no statistically significant difference in the incidence of postoperative complications except digestive tract complication, and the fracture healing rate, the incidence of nail-rod breakage at6 months after surgery between the two groups (P>0.05). No internal plant loosening was found in the two groups of patients within 6 months after surgery.ConclusionThe application of the careful digestive system management strategy in patients with thoracolumbar fractures can help reduce the incidence of perioperative gastrointestinal dysfunction, promote the recovery of perioperative gastrointestinal function, shorten the length of hospital stay, and improve patient satisfaction.
The Core Outcome Set-STAndards for Reporting (COS-STAR) is a latest guide tool made by Core Outcome Measures in Effectiveness Trials (COMET) group. It can enhance the transparency and completeness of Core Outcome Set (COS) report. This paper introduces the generation process, report items and application of COS-STAR to provide reference for domestic similar researches.
Bloodless surgery is a comprehensive and systematic perioperative treatment approach in order to avoid allogeneic transfusion for surgery，improve patient prognosis，and relieve blood shortage. Bloodless heart surgery indicates some perioperative strategies to avoid allogeneic transfusion and improve clinical outcomes，which involves participation of cardiac surgeons and other professionals during cardiac surgery. For years，many cardiac surgeons have utilized several blood management and conservation techniques during open heart surgery to avoid allogeneic transfusion. Research results from major medical centers indicate that bloodless heart surgery can shorten postoperative recovery period and improve patientprognosis. In this review，we describe basic theory and systematic methods of bloodless surgery，and summarize applicationprogress of bloodless heart surgery and current status in China.
Objective To summarize the application and prospect of susceptibility weighted imaging （SWI） in diagnosis of hepatic disease. Methods The application of SWI in diagnosis of hepatic disease was analyzed retrospectively via reviewed the literatures home and abroad, and to look forward to the future of the clinical values of SWI. Results A number of hepatic diseases such as cirrhosis, hematochromatosis， and malignant tumors could induce iron overload in hepatic cell and Kuffper cell. Because of SWI is sensitive to vein， vascular abnormality, haemorrhage （including all kinds of metabolities after bleeding）， iron overload， calcification, and so on, so the use of SWI in hepatic disease is explored continually. Conclusions SWI may be a new method for diagnosis of hepatic disease, which can supply more valuable information for clinician.
Objective To introduce the appropriate application of statistical analysis method in medical science and technology articles. Methods Expatiated the correct application of statistical theories in statistical package, statistical analysis methods and test criterion which compose the basic statistical content in an article.Results If the distribution of numerical variable is normal, mean and standard deviance can be used to describe this variable. In the same way, t test and analysis of variance (ANOVA) can be used to test the difference of mean in each group. If it is not normal, median and range can be used to describe the variable and rank sum test can be used to test the difference of distribution in each group. Categorical variable can be described by rate, proportion and ratio. There are chi-square test, fisher’s exact test and ranksum test to test the difference of rates. Conclusion It is the key of choosing rational statistical methods to distinguish the type of design and variable.