Objective To explore the factors which influence the doctor-patient relationship and to provide evidence to help decision makers improve hospital management and construct a harmonious doctor-patient relationship. Methods Discharged patients of West China Hospital from 2003-2006 were randomly selected and asked to complete a specially designed questionnaire. Results In total, 8 000 questionnaires were distributed and 2 526 were returned. The retrieval rate was 31.57%. The responses showed that non-medical factors have became the main factors affecting the doctor-patient relationship (91.8%). Other important factors included medical cost (21.5%) and doctor-patient communication (11.51%). Conclusion We should boost hospital management level, train non-medical staff, save costs and improve doctor-patient communication.
Objective To provide evidence for the construction of a hospital emergency mechanism for internal supervision, based on and analysis of demands and the identification of effective measures. Methods The concepts of evidence-based health care and management methods were applied. Through the systematic collection of relevant information from CNKI and other sources, and in the light of empirical evidence following the Wenchuan earthquake, suggestions were presented. Results We identified 182 studies. The hospital emergency mechanism for internal supervision is very important in dealing with unexpected incidents. The implementation, funding and material support are the focus of supervision. Cooperation, discipline, and standardized procedures are the key to an effective mechanism. Conclusions It is suggested that the construction of a hospital emergency mechanism for internal supervision should involve prevention, response and recovery.
In the era of we-media, the external publicity work of hospitals has some problems, such as the content deviating from the needs of the audience, the internal and external publicity platforms being not separate, the synchronized operation of diversified platforms being difficult, and the stereotyped expression mode affecting the communication effect. Based on the practical experience and remarkable achievements of West China Hospital of Sichuan University in we-media construction, this paper puts forward that public hospitals should choose suitable content, channels, and ways of expression in order to give full play to we-media in their external publicity work.
ObjectiveTo construct an evaluation index system for the dissemination influence of new media health science popularization, providing a quantitative evaluation tool for comprehensively assessing the dissemination influence of health science communication works. MethodsMeta integration, Delphi method and analytic hierarchy process (AHP) were used to build a preliminary evaluation index system, form a framework of the evaluation index system, and calculate the weight values of the evaluation indexes, respectively. ResultsA total of 18 studies were included through retrieval. On the basis of preliminary evaluation index system, ten experts in related professional fields were invited to participate in two rounds of expert consultation, resulting in an evaluation index system framework that includes 2 first-level indicators, 4 second-level indicators, and 9 third-level indicators. ConclusionA preliminary evaluation index system for the dissemination and influence of new media health science communication works, which is reliable, universally applicable, and has a reasonable structure, is constructed.
Objectives To survey the training needs of the management reserve talents in West China Hospital of Sichuan University, so as to provide evidence for improving the pertinence and effectiveness of the training system. Methods A survey of training needs in terms of training contents and methods was performed on 181 management reserve talents in our hospital by self-designed questionnaire. The survey results were descriptively analyzed based on rate and percentage. Results Among the 181 questionnaires issued, 148 (81.8%) were recovered. For the training contents, 59.5% of them concerned more about enhancement of management ability, with the top three most preferred training contents as personnel management, systematic management thinking, and work management. For the training methods, internal training, external communication, and external teachers were the three most preferred. Conclusions To enable the management reserve talents transit from medical to management positions, the hospital should classify them according to the needs and requirements of the organization, the position and the talent him/herself. Based on such classification, customized training can be carried out with innovative training modules.
In order to solve the saturation distortion phenomenon of R component in fingertip video image, this paper proposes an iterative threshold segmentation algorithm, which adaptively generates the region to be detected for the R component, and extracts the human pulse signal by calculating the gray mean value of the region to be detected. The original pulse signal has baseline drift and high frequency noise. Combining with the characteristics of pulse signal, a zero phase digital filter is designed to filter out noise interference. Fingertip video images are collected on different smartphones, and the region to be detected is extracted by the algorithm proposed in this paper. Considering that the fingertip’s pressure will be different during each measurement, this paper makes a comparative analysis of pulse signals extracted under different pressures. In order to verify the accuracy of the algorithm proposed in this paper in heart rate detection, a comparative experiment of heart rate detection was conducted. The results show that the algorithm proposed in this paper can accurately extract human heart rate information and has certain portability, which provides certain theoretical help for further development of physiological monitoring application on smartphone platform.
ObjectiveTo summarize the clinical features of pulmonary mucoepidermoid carcinoma (PMEC) and improve the level of the diagnosis and therapy.MethodsA case of PMEC was reported and related literatures were reviewed in PubMed, WanFang data and China National Knowledge Infrastructure.ResultsA 21-year-old female patient, complaining of cough and expectoration for 5 months, intermittent hemoptysis for 3 months and repeated fever more than 4 days, was hospitalized in March 2017. After admission, the patient was diagnosed as low-grade PMEC and received anti-infection, fibrobronchoscope sputum aspiration and alveolar lavage therapy. During the hospitalization, the anti-infection of the patients was not much effective, and the chest CT examination suggested space-occupying lesions in the middle lobe of the right lung. After the surgical removal of the right lung, the syndrome of the patient was improved. A total of 13 patients were reviewed, there was no obvious gender difference, and the median age was about 40 years old (most frequently occurred in younger adults with an average age less than 50 years). Frequent clinical manifestations were cough, fever and hemoptysis, which were often accompanied with atelectasis. Most of the patients could be improved after surgical resection, and a few need comprehensive treatment including radiotherapy, chemotherapy and targeted treatment, etc.ConclusionsPMEC is rare and the etiology is still unclear. The pathology is mainly low-grade. Majority of patients with PMEC could be cured after surgical resection.
ObjectiveTo systematically review the impact of ACEI/ARB (angiotensin converting enzyme inhibitor/ angiotensin receptor antagonist) treatment on the clinical outcomes of Chinese patients with COVID-19 infections. MethodsPubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang Data, and VIP databases were electronically searched to collect cohort studies on the impact of the treatment with ACEI/ARB on the clinical outcomes of Chinese patients with COVID-19 infections from January 2020 to January 2022. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 17 cohort studies involving 4 912 subjects were included. The results of meta-analysis showed that patients who were prescribed ACEI/ARB had shorter hospital stays (SMD=−0.28, 95%CI −0.46 to −0.11, P=0.002) and a lower mortality rate (OR=0.47, 95%CI 0.36 to 0.62, P<0.000 01) than patients who did not take ACEI/ARB. ConclusionCurrent evidence shows that the use of ACEI/ARB drugs can improve the clinical prognosis of Chinese patients with COVID-19 infections. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To comprehensively observe, recognize, learn and understand the clinical features of tuberculous meningitis (TBM). Methods We retrospectively analyzed the general data, clinical manifestations, clinical examinations and treatment prognosis of 152 patients with TBM who were hospitalized in the Second Affiliated Hospital of Zunyi Medical College between January 2016 and February 2017. Results The mean age of the 152 patients with TBM was (43.9±20.4) years old, the ratio of male to female was 1.45:1, and the average length of hospital stay was (20.0±18.9) days. The clinical manifestations were mainly headache [95.4% (145/152)], nausea and vomiting [42.8% (65/152)], and fever [61.8% (94/152)]. The main co-morbidities were secondary pulmonary tuberculosis [52.0% (79/152)], hematogenous disseminated tuberculosis [37.5% (57/152)], and tuberculous pleurisy [30.9% (47/152)]. The positive rate of γ-interferon release test was 90.8% (129/142), and the brain pressure of lumbar puncture was elevated. The typical biochemical changes of cerebrospinal fluid were " low glucose, low chlorine, and high protein”. The positive rate of tuberculosis smear was extremely low, and the positive rate of GeneXpert MTB/RIF in cerebrospinal fluid was 21.9% (7/32). The TBM patiens were prone to combine with hypoproteinemia, the proportion reached 29.6% (45/152), and the proportion of hyponatremia reached 45.3% (69/152). Treated with early diagnosis and treatment, 92.1% (140/152) improved and discharged. Conclusions TBM patients are mainly young and middle-aged with various clinical manifestations and less respiratory symptoms; and are easy to be combined with pulmonary tuberculosis and other extrapulmonary tuberculosis. γ-interferon release test and cerebrospinal fluid GeneXpert MTB/RIF can be used for the auxiliary diagnosis of tuberculosis. Early detection, early diagnosis and treatment, rational and regular chemotherapy, strengthening symptomatic supportive treatment, and improving the precise diagnosis and treatment of TBM, can improve its clinical prognosis.
Objective To analyze the effect of stump-preserving repair on rotator cuff healing and shoulder function for degenerative total rotator cuff tears. Methods A clinical data of 152 patients with degenerative total rotator cuff tears, who underwent arthroscopic repair between April 2019 and May 2022, was retrospectively analyzed. There were 76 males and 76 females with an average age of 55.4 years (range, 24-78 years). MRI was performed at 6 months postoperatively to evaluate the rotator cuff healing according to the Sugaya classification. Pre- and intra-operative related factors were included for univariate analysis, including age (≥60 years/<60 years), gender (male/female), passive activity disorder (yes/no), disease duration (≤3 months/>3 months), stump-preserving repair (yes/no), use of suture bridge technique (yes/no), shoulder joint abduction angle at knotting (<45°/≥45°), acromioplasty (yes/no), glucocorticoid injection (yes/no), time for patients to start postoperative passive exercise (≤2 weeks/>2 weeks), and time for patients to start postoperative active exercise (≤3 months/>3 months). The influencing factors of tendon healing were screened; further logistic regression was used to conduct multivariate analysis to screen for risk factors. Two sets of data were balanced by propensity score matching. The American Shoulder and Elbow Surgeons (ASES) score and Constant-Murley score of shoulder joint function at 6 and 12 months postoperatively, as well as rotator cuff healing rate at 6 months postoperatively, were compared between groups based on whether or not stump-preserving repair was used. Results All patients were followed up 12-33 months (mean, 23.8 months). MRI at 25-31 weeks postoperatively showed the 121 cases of rotator cuff healing and 31 cases of non healing. Univariate analysis showed that the disease duration, stump-preserving repair, shoulder joint abduction angle at knotting, and the time for patients to start postoperative active exercise were the influencing factors of rotator cuff healing (P<0.05). Multivariate analysis showed that non-stump-preserving repair, shoulder abduction angle more than 45° at knotting, and the time to start active exercise within 3 months postoperatively were risk factors affecting rotator cuff healing (P<0.05). A total of 51 pairs of cases were matched based on the grouping criteria of whether the disease duration exceeded 3 months, whether the shoulder abduction angle at knotting exceeded 45°, and whether the time to start postoperative active exercise exceeded 3 months. The rotator cuff healing rate, ASES score, and Constant-Murley score of the preserving repair group at 6 months postoperatively were superior to those of the non-preserving repair group, and the differences were significant (P<0.05). There was no significant difference in ASES score and Constant-Murley score between the two groups at 12 months postoperatively (P>0.05). Conclusion For degenerative total rotator cuff tears, the stump-preserving repair can shorten the healing time and promote the shoulder function recovery, but has no significant effect on shoulder function at 1 year postoperatively.