west china medical publishers
Keyword
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Keyword "模式" 284 results
  • Practical exploration of improving the rate of pathogen examination before antibiotic treatment in inpatients based on FOCUS-PDCA

    Improving the rate of pathogen examination before antibiotic treatment is of great significance for clarifying pathogen diagnosis and curbing bacterial resistance, and is also one of the important goals for improving national medical quality and safety. In response to the current problem of low pathogen examination rates, Chengdu Women’s and Children’s Central Hospital adopts a FOCUS-PDCA model, has explored measures such as current situation investigation, root cause analysis, intervention plan formulation, countermeasure implementation, and effect evaluation to improve the rate of pathogen examination before antibiotic treatment in inpatients. This article mainly elaborates on the above model, which has practical significance for ensuring the rational use of antibiotics in inpatients.

    Release date:2024-04-25 02:18 Export PDF Favorites Scan
  • Application of failure mode and effect analysis in the detection of severe acute respiratory syndrome coronavirus 2 nucleic acid

    ObjectiveTo use failure mode and effect analysis (FMEA) to check and improve the risk of severe acute respiratory syndrome coronavirus 2 nucleic acid detection, and explore the application effect of FMEA in the emergency inspection items.MethodsFMEA was used to sort out the whole process of severe acute respiratory syndrome coronavirus 2 nucleic acid detection from January 30 to February 21, 2020. By establishing the theme, setting up a team, analyzing the failure mode and potential influencing factors. Then calculate the risk priority number (RPN), formulate preventive measures and implement continuous improvement according to the analysis results.ResultsA total of 2 138 cases were included. After improvement, the number of potential failure modes has been reduced by 2 (17 vs.19); the value of total RPN decreased (3 527.49 vs. 1 858.28). There was significant difference in average RPN before and after improvement [(185.66±74.34) vs. (97.80±37.97); t=6.128, P<0.001].ConclusionsIn the early stage of emergency inspection items, using FMEA can systematically check the risk factors in the process, develop improvement measures. It also can effectively reduce the risk of severe acute respiratory syndrome coronavirus 2 nucleic acid detection in hospital.

    Release date:2021-09-24 01:23 Export PDF Favorites Scan
  • The management of a patient with obstructive jaundice and hepatic bile duct tumor by multi-disciplinary team

    Objective To diagnose and treat a patient with obstructive jaundice and hepatic bile duct tumor by multi-disciplinary team (MDT) and to provide individualized treatment. Methods By MDT model, a patient with obstructive jaundice and hepatic bile duct tumor, who was ever misdiagnosed as hilar cholangiocarcinoma, was discussed. The diagnosis, perioperative period management, and operation scheme were carried out by the MDT. Results After discussion of MDT, the patient was diagnosed as " hepatocellular carcinoma with bile duct tumor thrombi”, not " hilar cholangiocarcinoma”. Although hepatocellular carcinoma with bile duct tumor thrombi was end-stage disease, radical treatment was still considered. A plan of treatment was carried out by the MDT. Firstly, the percutaneous transhepatic cholangial drainage was operated for the predicted reserved half liver to relieve biliary obstruction. Secondly, hemihepatectomy combined with bile duct resection was carried out by the surgery team. The patient had nice postoperative recovery and there was no tumor recurrence after 6-month follow-up after surgery up to now. Conclusions MDT model do not only reduce misdiagnose, but also can provide the best therapeutic regimen and individualized treatment for patient presented with obstructive jaundice and hepatic bile duct tumor.

    Release date:2018-04-11 02:55 Export PDF Favorites Scan
  • 神经衰弱的鉴别诊断模式

    【摘要】为探讨神经衰弱鉴别诊断的规范化方法,提高其准确性。 将必备组合症状、病因、内在关系、严重程度、病程、排除症状和非器质性病变基础七方面做为神经衰弱鉴别诊断模式的要素,用神经症二重辩证施治进行临床验证。验证表明,神经衰弱与伴发神经衰弱症状的其他疾病相比,具有明显的差异。其中必备组合症状、病因和内在关系,是鉴别诊断的核心;排除症状、非器质性病变基础是重要参考标准,但在某些特定情况下是否成为鉴别诊断的依据,应视情况而定;严重程度和病程仍有意义。神经衰弱的鉴别诊断模式具备了更加缜密规范准确的优点。

    Release date:2016-09-08 09:51 Export PDF Favorites Scan
  • Research progress in the diagnosis and treatment of peripheral exudative hemorrhagic choroidal retinopathy

    Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is a peripheral retinal disease characterized by subretinal hemorrhage and/or subretinal pigment epithelial hemorrhage or exudation. It is often misdiagnosed as age-related macular degeneration, polypoidal chorioretinopathy or choroidal melanoma. With the development of multimodal imaging, PEHCR has different features under different examinations, such as B-scan ultrasound, fluorescein fundus angiography, optical coherence tomography and so on, which contributes to differention from other diseases. Clinical treatments for the disease include intravitreal injection of retinal photocoagulation therapy, anti-vascular endothelial growth factor, pars plana vitrectomyand so on, but there is still no universal consensus. In order to gain a deeper understanding of the clinical features, treatment options and prognosis of PEHCR, minimize missed diagnoses and misdiagnoses, and improve treatment efficiency, further research is required.

    Release date:2023-11-16 05:57 Export PDF Favorites Scan
  • Pattern of Clinical Ward Round on the Department of Oncology in Hospital

    肿瘤患者常常具有不适应情绪和行为反应,如焦虑、抑郁、悲伤、愤怒、恐惧等。针对这类患者的特征,我们对肿瘤科查房模式进行探讨,旨在缓解患者的不良情绪,提高肿瘤患者的治疗疗效,降低医疗风险。

    Release date:2016-08-26 02:21 Export PDF Favorites Scan
  • Clinical and multimodel image features in patients of acute macular neuroretinopathy associated with COVID-19

    Objective To observe the clinical and multimodel image features in patients of acute macular neuroretinopathy (AMN) associated with COVID-19. MethodsClinical data and multimodal imaging results in 12 patients (24 eyes) of AMN associated with COVID-19 which were diagnosed in our Department of Ophthalmology, The Second Hospital of The Army Medical University ranging from December 2022 to January 2023 were included. All patients were examined by best-corrected visual acuity (BCVA), color fundus photography, optical coherence tomography (OCT), OCT angiography (OCTA), visual field tests, high-resolution computed tomography of the lungs and inflammation-related laboratory tests. After diagnosis, patients were reveived methylcobalamin and Ginaton therapy, 6 patients receiced intravenous dripping of dexamethasone. The follow-up time of this study was 4 weeks. ResultsThere were 1 male (2 eyes) and 11 females (22 eyes), with the mean age of (29.00±5.17) years. For all cases, decreased vision presented 1 to 2 days after patients being suffered from several flu-like symptoms of COVID-19. Ten eyes in 5 patients were at the acute phrase of AMN, which the vision decrease occurred 1-5 days after they were diagnosed with COVID-19; 14 eyes in 7 patients were at the progressive stage of AMN, which they were diagnosed with COVID-19 for more than 5 days. The BCVA of patients were 0.02-0.9, in company with one or more central/pericentral scotoma. Fundus ophthalmoscopy revealed reddish-brown lesion around macula, IR imaging demonstrated localized areas of hypo-shape lesions in the macula. For 16 eyes, their OCTA revealed a decreased density of blood flow in the deep layer of retinal capillary plexus, and OCT revealed that high reflex bands existed in the outer nuclear layer (ONL) and outer plexiform layer of the retina at the acute phrase of AMN, in accompany with hypo-reflection in ellipsoid zone (EZ) and interdigitation zone (IZ); for retina at the progressive stage of AMN, ONL became thinner in some cases and the continuation interruption occurred in EZ and IZ. For en-face OCT, high reflex bands with clear edges existed in the ONL and EZ layer of the retina at the acute phrase of AMN, but no high reflex bands existed in the ONL and EZ layers of the retina at the progressive stage of AMN. Instead, hypo-reflection with similar shape occurred in the EZ and IZ layers at the progressive stage of AMN. During treatment, 5 patients at the acute phrase reported a shrinking central scotomas and raised BCVA, otherwise the BCVA of 7 patients at the progressive stage changed slightly. For 10 eyes at the acute phrase of AMN, OCT revealed that the high reflex bands of ONL and OPL missed within 1 week. En-face OCT revealed the hyper-reflection in the ONL and EZ layers of retina in the acute phrase of AMN receded within 1 week, but hypo-reflection of ONL and EZ still presented. ConclusionsFor AMN associated with COVID-19, IR imaging demonstrated localized areas of hypo-shape lesions in the macula. OCT revealed high reflex bands in ONL and OPL of the retina at the acute phrase of AMN, but hypo-reflection of ONL and EZ still presented. The continuation interruption occurred in EZ and IZ at the progressive phrase. En-face OCT revealed hyper-reflection in ONL and EZ of the retina at the acute phrase which receded within 1 week, and hypo-reflection in EZ and IZ of the retina presented at all phrases during AMN progression.

    Release date:2023-03-17 03:30 Export PDF Favorites Scan
  • Application of the “3+2” model and the “seven-step method” in a case of 5G remote robotic distal gastrectomy for gastric cancer

    ObjectiveTo explore the application of 5G remote robotic surgery in distal gastrectomy for gastric cancer and evaluate the feasibility and advantages of the “3+2” model “seven-step method”. MethodsThe situations at preoperative, intraoperative and postoperative follow-up of a patient who underwent 5G remote robotic distal gastrectomy for gastric cancer with “3+2” model “seven-step method” in Gansu Provincial People’s Hospital were summarized, and based on our experience of robotic surgery, the application advantages of “3+2” model “seven-step method” in 5G remote robotic distal gastrectomy for gastric cancer was explored. ResultsThe operative time of this case was 190 min, the intraoperative blood loss was 50 mL, the network delay was 43.554 ms, and no intraoperative adverse events occurred. After a one-year follow-up, the patient recovered well, with no complications, good diet and good quality of life. ConclusionsThe “3+2” model “seven-step method” is feasible for 5G remote robotic distal gastrectomy. Further research requires an increased sample size and extended follow-up period.

    Release date:2024-12-27 11:26 Export PDF Favorites Scan
  • Management and Nursing Pattern for Ambulatory Surgery Ward

    Ambulatory surgery ward is a fast and effective way of treating, nursing and patients’ education. We report the practice of ambulatory surgery ward in West China Hospital of Sichuan University about patients’ reception, treatment and nursing, medical safety, health education and post-operative follow-up. Results show that ambulatory surgery ward would guarantee patients’ safety, shorten hospitalization days and decrease medical cost, with more than 98% of patients’ satisfaction.

    Release date:2016-09-07 11:23 Export PDF Favorites Scan
  • 互联互通,共享发展——急诊医学未来发展模式的探索

    Release date: Export PDF Favorites Scan
29 pages Previous 1 2 3 ... 29 Next

Format

Content