【Abstract】 Objective To explore the reasons of tendon adhesions post tendon allograft. Methods From May1990 to June 2000, 85 cases receiving tendon allograft were given tenolysis because of tendon adhesions. There were 76 males and 9 females, with an average age of 24.5 years (8-46 years). Injury was caused by machine in 38 cases, electric in 32 cases, cut in 4 cases, explosion in 4 cases and extremity mutilation in 7 cases; including 66 cases of flexor tendon deficit and 19 cases of extensor tendon deficit. Six cases had 1 tendon deficit, 79 cases had tendon deficit of more than 2. The defect region ranged from I to V. The total mobil ity of the joint was less than 220° in 73 cases. The impairment of skin, bone, nerve and vascular were treated before tendon allograft. Results Because TAM was less than 50% of TPM, the patients were given tenolysis 4-15 months after operation. And the mobil ization began at the first day after operation to improve the range of active movement. Patients were followed up 7-17 years (mean 12.7 years). TAM and TPM were in accord. Mean total mobil ity of joint was200°. Conclusion The serious of primary hurt is the important factors of tendon adhesion. Improvement of tendon selected, treatment and early mobil ization can rel ieve the tendon adhesion.
In order to improve the understanding of pragmatic randomized controlled trial (pRCT), to promote high-quality implementation of such trials, and to provide technical guidance for researchers to conduct such trials scientifically, the working group of China REal world data and studies ALliance (ChinaREAL) hereby develop a technical guidance. The guidance provides technical specifications of pRCT in terms of the concept and scope of application, planning and study design, conduct, data management and quality control, statistical analysis, and ethical issues. It emphasizes that the trial sites and settings, patient population, interventions, controls, outcomes, follow-ups and other factors should be considered when planning and designing. Meanwhile, the guidance recommends that estimation of sample sizes for different types of trial designs should be based on individual pRCTs, and it also provides suggestions for data management, quality control, principles of statistical analysis, analysis requirements for each type of trial designs, and ethical considerations.
Objective To provide references for the rational allocation of health personnel in rural hospitals through understanding the status of health human resources of rural hospitals in remote and poor areas of Sichuan Province. Methodes This study used cluster sampling method, combined with questionnaire survey and qualitative interviews. A total of 711 health workers of 29 rural hospitals in Pengzhou and Baoxing of Sichuan Province were interviewed. SPSS16.0 was used for descriptive analysis.Results The average age of rural hospitals health personnel in remote and poor areas of Sichuan Province was 30 years old. Post-secondary education accounted for 58.12%, and Bachelor degree or above accounted for 7.2%. The number of medium and senior professional titles account for 8.4 %. The ratio of doctors to nurses was 1:0.55. In the survey of health workers, those doctors with practice (assistant) license accounted for 38.5%, and those without any qualification occupied 27.1 %. Conclusions The professional titles of medical personnel of rural hospitals in remote and poor areas in Sichuan province are generally low. The distribution of professional categories is irrational. The staff in charge of prevention and care are inadequate. There exist a large number of unqualified medical workers. Therefore, the government should increase the investment in rural health and take measures to stabilize the team structure, introduce the talented, and strengthen the training for health personnel of rural hospitals to improve their overall quality.
Objective To analyze the complaint characteristics of emergency department of women and children’s specialized hospital, and to provide a basis for improving medical service quality, enhancing hospital management, increasing satisfaction, and reducing complaint rates in specialized hospitals. Methods Using the Healthcare Complaint Analysis Tool classification framework, a retrospective analysis was conducted on complaints from the Emergency Department of West China Second University Hospital of Sichuan University. Results The total number of complaints from 2020 to 2022 was 525, and the number of complaints had been increasing year by year. There were 196 complaints against personnel and 329 complaints against regions. There were 320 complaints related to management issues (61.0%), 143 complaints related to doctor-patient relationship issues (27.2%), and 62 complaints related to clinical issues (11.8%). The complained areas were mainly fever clinics (193 cases), and the complained personnel were mainly nurses (82 cases). Conclusion The emergency department of women and children’s specialized hospitals is different from comprehensive hospitals, and active optimization should be carried out to address the main issues. While continuously improving the level of medical technology, it is also necessary to strengthen information technology construction, optimize medical procedures, improve environmental facilities, and provide psychological support for patients and their caregivers.
ObjectiveTo explore the family function on patients with depression and its influential factors, in order to provide a basis for family support treatment for the patients. MethodsA total of 122 depressed patients from Mental Health Center of West China Hospital between February 2012 and June 2013, and one of their family members were chosen to be the study subjects. Another 122 non-clinical controls and one of their family members were recruited from a community near Sichuan University were regarded as the controls. All the subjects were asked to finish the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Family Assessment Device (FAD). Additionally, the patients received a diagnostic interview to provide the features of their depression. ResultsThe general average score of Q-LES-Q in families with depressed patients was significantly lower than that in the control families (t=-6.243, P<0.01). The general average score of each dimension in FAD for families with depressed patients was significantly higher than that for control families (t=3.644, 3.872, 2.694, 3.369, 5.369, 4.941, 5.241; P<0.01). According to FAD health division scoring, the unhealthy proportion in terms of communication, emotional reaction, emotional link, behavioral control and general function for families with depressed patients was significantly higher than that for control families (χ2=6.778, 23.698, 26.580, 39.875, 17.123, 10.712; P<0.05). The Q-LES-Q scores and the five FAD dimensional scores (except role and affective involvement) were negatively correlated (r=-0.388, -0.188, -0.200, -0.276, -0.370; P<0.05). The scores of perceived social support for families with depressed patients had significant positive correlations with the scores of all FAD dimensions except affective involvement (r=0.363, 0.345, 0.244, 0.418, 0.328, 0.457; P<0.05). The risk factors for unhealthy family function included: female (OR=1.141, P<0.05), poor education (OR=0.948, P<0.01), first-episode (OR=1.416, P<0.05), suicidal attempt (OR=1.014, P<0.05), incomplete suicide (OR=1.367, P<0.01) and depression episode number (OR=1.035, P<0.05). ConclusionDepression is associated with impaired family function in Chinese families. Female, poor education, first episode of depression, suicidal attempt, incomplete suicide and depression episode number are the influential factors for family function on patients with depression.
ObjectiveTo analyze the status quo of outcome indicators in the randomized controlled trials (RCTs) of premature ovarian failure (POF)/primary ovarian insufficiency (POI) published at home and abroad, and provide a sufficient basis for the selection of outcome indicators in related studies in the future.MethodsChina National Knowledge Infrastructure, Chongqing VIP Data, Wanfang Data, SinoMed, PubMed, the Cochrane Library, and Embase were searched for RCT articles of POF/POI published between the establishment of the databases and June 2021. Two researchers independently screened and extracted the literature, and finally summarized the outcome indicators of the included studies.ResultsA total of 186 articles meeting the inclusion criteria were selected, including 180 articles in Chinese and 6 articles in English. The choice of outcome indicators was diverse. Of the 186 articles, 2 Chinese articles and 1 English article used primary and secondary outcome indicators; 19 Chinese articles and 4 English articles used independent indicators, 4 Chinese articles used composite indicators, and 157 Chinese articles and 2 English articles used both independent indicators and composite indicators.ConclusionsThe selection and use of outcome indicators in clinical RCTs of POF/POI are not standardized, and there are problems such as neglect of primary and secondary outcome indicators, and lack of standards for the selection of clinical research outcome indicators. As a result, the credibility of the curative effect is reduced, and the results of similar studies cannot be combined and compared.
ObjectiveTo summarize regional and body distributions, diagnosis, treatment, and prognosis of echinococcosis outside liver in China. MethodsThe published literatures about echinococcosis outside liver in China (not including Hong Kong, Macao and Taiwan regions) from 2000 to 2015 were searched in the databases of CNKI and Wanfang. Data were extracted by using a standardized form and a retrospective clinical analysis was performed. ResultsA total of 66 published literatures about echinococcosis outside liver and data of 884 cases reported were collected. The regional proportions of cases reported were different, five high regions were Xinjiang (68.73%), Tibet (8.77%), Ningxia (6.75%), Qinghai (6.41%), Gansu (5.62%). The organ distributions of cases reported were also different, five high organs were lung (61.09%), bone (9.95%), brain (9.73%), spleen (8.60%), and kidney (6.22%). The main clinical symptoms of patients with echinococcosis outside liver included general asymptoms and organ dysfunction, and the most common examinations were X-ray (30.77%), B ultrasound (7.47%),CT(17.43%), MR (1.59%), and laboratory (36.31%). The main therapy choice was operation (73.30%), and some patients were performed operation combined with drug therapy. ConclusionRegional distribution of echinococcosis outside liver is almost the same as total echinococcosis, and distributed more in organs rich in blood supply, its clinical diagnosis mainly depends on imaging and immunology examination, and operation is still the main therapy choice.
Objective To determine the risk factors for acute lung injury（ALI） early after orthotopic liver transplantation.Methods The perioperative clinical data of all 275 patients who had undergone orthotopic liver transplantation were analysed retrospectively.Several statistically significant risk factors were screened out with univarite analysis，then independent risk factors were determined with multivariate stepwise logistic regression analysis.Results Of the all 275 patients，the morbidity of ALI was 9.8% with a mortality of 22.2%.Univariate analysis showed that the occurrence of ALI was associated with preoperative infection，severe hepatitis，renal dysfunction，massive blood transfusion in operation，long non-hepatic period and long cold ischemic time.Multivarite stepwise logistic regression analysis revealed that the independent risk factors for ALI were massive blood transfusion in operation（OR=12.12，95%CI 0.958-25.364），longer non-hepatic period（OR=1.23，95%CI 1.034-1.410） and longer cold ischemic time（OR=22.35，95%CI 1.266-43.421）.Conclusion Massive blood transfusion in operation，long non-hepatic period and long cold ischemic time were independent risk factors for ALI early after orthotopic liver transplantation.
Objective To analyze retrospectively the 1861 wounded inpatients and deaths in West China Hospital of Sichuan University after the Wenchuan earthquake, so as to provide reference for the improvement of emergency plans for the disaster of earthquake and the establishment of state-level regional medical centers. Methods The analysis was based on the data provided by the Department of Information of the Hospital up until July 23. The software of Microsoft EXCEL was used for data input, and SPSS 11.5 was used for statistical analysis. Results Up to July 23, 2728 cases from the disaster area have been treated in the hospital, of whom 872 were admitted into the emergency department and 1856 into the inpatient department (974 men, median age 43 years; 882 women, median age 46 years). Most patients were sent to the hospital within the first 2 weeks after the quake (82.4%), and the number of inpatients reached its peak on Day 8 after the quake (976 cases). The majority of the inpatients were discharged on Day 9 to Day 18 after the quake (60.2%). The wounded were mainly from Deyang, Aba Prefecture and Dujiangyan. The admission diagnoses were mainly fracture (54.84%), craniocerebral injury (9.81%) and thoracoabdominal injury (7.54%). There were totally 33 deaths, including 5 pre-hospital deaths, 1 emergency death and 27 inpatient deaths. Conclusion The development of an emergency plan for the medical rescue after an earthquake disaster is an essential step to enhance the emergent response capability, improve the scientific process of field triage, transport and transfer, and ensure the rational allocation and application of healthcare resources after any unexpected big disasters in the future.
Objective To explore the correlation of risk factors affecting the L2-4BMD level in patients with post-menopausal osteoporosis. Methods Ninety-two patients with post-menopausal osteoporosis were surveyed with a retrospective questionnaire. We used the findings to set up a multiple stepwise regression model and perform correlation analysis with L2-4BMD levels as the dependent variable and risk factors as the independent variables. Results Assuming that age has a definite effect on the L2-4BMD level of menopausal women, menopausal age limit, history of milk drinking, menopausal age, menarche age, fracture history and bend-back entered into the multiple stepwise regression equation. Conclusions Menopausal age limit, history of milk drinking, menopausal age, menarche age, fracture history, and bend-back influence patients with menopausal osteoporosis.The menopausal age limit is especially important. Awareness of the risk factors of osteoporosis should be raised.