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.
[Abstract]Patients with atrial fibrillation complicated with kidney disease have a high risk of stroke and bleeding, and have some limitations or contraindications to oral anticoagulants. Left atrial appendage closure has been used as an alternative to oral anticoagulation in patients with atrial fibrillation, but its efficacy and safety in patients with atrial fibrillation and chronic kidney disease need to be further confirmed. This paper intends to review the research progress of left atrial appendage occlusion in patients with atrial fibrillation complicated with chronic renal insufficiency.
Epigenetics refers to heritable changes in gene expression independent of DNA nucleotide sequence itself, and the main mechanisms include DNA methylation, histone modifications, noncoding RNAs, and so on. Vascular disease is a chronic disease regulated by the interaction between environmental and genetic factors. In recent years, more and more studies have confirmed that epigenetic regulation plays an important role in the occurrence and development of vascular diseases. This article reviews recent advances in epigenetics in vascular disease.
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.
Circadian rhythm is a physiological regulation mechanism evolved by the body to adapt to the 24-hour fluctuations in the internal and external environment. It plays an important role in many physiological and pathological processes including the immune system. Neutrophils are the most important immune cells in the human circulation, and their numbers and phenotypes also show obvious circadian fluctuations. A growing number of studies have shown that the cellular and molecular mechanisms of neutrophil circadian rhythms are disease-related. Combining the latest research on neutrophil circadian rhythm, this article briefly introduces the recruitment of neutrophils in the bone marrow, the aging of neutrophils and their infiltration into various tissues of the body, and discusses the interventions. It also discusses the therapeutic prospects based on neutrophil circadian rhythm-related mechanisms from the perspectives of intervening neutrophil aging-related chemokines and chronotherapy.
Objective To explore the application value of standardized patient (SP)-based teaching method in the teaching of medical history taking for international students. Methods During the autumn semester of 2017, 96 international medical students were randomly divided into two groups, with 48 students in the SP-based teaching group and 48 students in the conventional teaching group. The test scores of medical history taking in English in internal medical practice of the two groups were compared. The teaching feedback from the international students was collected and evaluated by online questionnaire survey. Results The scores of medical history taking examination in internal medical practice of the students using SP-based teaching method were higher than those of the students using conventional teaching method (86.5±9.7 vs.78.2±10.6), and the difference was statistically significant (t=3.983, P<0.001). According to the questionnaire analysis, in terms of whether the current teaching method could enhance learning interest, improve communication ability, promote clinical skills, train clinical thinking, and highlight humanistic care, students with positive views in the SP-based teaching group accounted for 92.86%, 97.62%, 85.71%, 90.48%, and 95.24%, respectively, while students with positive views in the conventional teaching group accounted for 90.00%, 87.50%, 82.50%, 77.50%, and 97.50%, respectively, and the differences were not statistically significant (P>0.05). Conclusions Well-trained SP has a good application value in clinical practice of internal medicine and diagnostics teaching for international students. SP-based teaching method has been accepted and supported by the majority of international medical students who have experienced it.
Within the context of the "Healthy China Strategy" and the "Biology-Psychology-Society" medical model, the goals, content and methods of medical education have undergone tremendous changes. To keep up with the pace of development of medical technology and medical concepts, medical education requires major reforms, and medical teaching models requires reconstruction. Based on previous investigations and discussions and considering the West China medical education as an example, this paper summarizes the difficulties that will be faced in the transformation and reform of modern medical education and discusses and analyzes the future direction of medical education reform.
ObjectiveTo explore the predictive value of a simple prediction model for patients with acute myocardial infarction.MethodsClinical data of 280 patients with acute ST-segment elevation myocardial infarction (STEMI) in the Department of Emergence Medicine, West China Hospital of Sichuan University from January 2019 to January 2020 were retrospectively analyzed. The patients were divided into a death group (n=34) and a survival group (n=246).ResultsAge, heart rate, body mass index (BMI), global registry of acute coronary events (GRACE), thrombolysis in myocardial infarction trial (TIMI) score, blood urea nitrogen, serum cystatin C and D-dimer in the survival group were less or lower than those in the death group (P<0.05). Left ventricle ejection fraction and the level of albumin, triglyceride, total cholesterol and low density lipoprotein cholesterol were higher and the incidence of Killip class≥Ⅲ was lower in the survival group compared to the death group (P<0.05). Multivariate logistic regression analysis showed that age, BMI, heart rate, diastolic blood pressure, and systolic blood pressure were independent risk factors for all-cause death in STEMI patients. Receiver operating characteristic (ROC) curve analysis showed that the area under the curve of simple prediction model for predicting death was 0.802, and similar to that of GRACE (0.816). The H-L test showed that the simple model had high accuracy in predicting death (χ2=3.77, P=0.877). Pearson correlation analysis showed that the simple prediction model was significantly correlated with the GRACE (r=0.651, P<0.001) and coronary artery stenosis score (r=0.210, P=0.001).ConclusionThe simple prediction model may be used to predict the hospitalization and long-term outcomes of STEMI patients, which is helpful to stratify high risk patients and to guide treatment.
Obesity, sleep disorders, psychological stress, sedentary are modifiable cardiovascular risk factors. There is growing evidence that these risk factors may accelerate the chronic inflammatory process of atherosclerosis and lead to myocardial infarction. Studies on the role of immune cells and their related immune mechanisms in atherosclerosis have shown that the above modifiable risk factors can affect the hematopoiesis of the bone marrow system, affect the production of immune cells and phenotypes, and then affect the progress of atherosclerosis. This review will focus on the effects of modifiable cardiovascular risk factors on the progression of atherosclerosis through the role of the innate immune system.
The Chinese Guidelines on Diagnosis and Management of Atrial Fibrillation, jointly formulated by the Chinese Society of Cardiology, Chinese Medical Association and the Heart Rhythm Committee of Chinese Society of Biomedical Engineering, was first released on June 15, 2023. The guidelines elaborate the various aspects of atrial fibrillation management, in which emergency management of atrial fibrillation is also an integral part. This article interpreted the emergency management part in the guidelines in detail by reviewing relevant literature.