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find Author "宋九林" 5 results
  • Survey of Medical Undergraduates’ Satisfactory Degree to Doctor-Patient Communication Education

    Objective To study the current situation of doctor-patient communication education for medical undergraduates, and meanwhile to analyze the students’ satisfactory degree to communication education and its influencing factors, so as to provide sound suggestions to promote the students’ clinical communication abilities. Methods Using simple sampling, 50% of the students who majored in clinical medicine in grade 2006-2009 in West China Medical School of Sichuan University were selected as respondents. The investigation was conducted by face to face talk with a self-designed questionnaire. The data were input using EpiData 3.0 software and the results were analyzed by SPSS 13.0 software. Results A total of 450 questionnaires were distributed, and 404 were validly retrieved (89.78%). Among the respondents, 74.3% of them were satisfied with the current situation of doctor-patient communication education; 75.7% of them begun to know doctor-patient communication education since the stage of learning basic knowledge; 49.8% of them were trained by means of problem-based-learning (PBL); and 65.5% of them were trained with auxiliary standardized patient (SP). “Grade”, “Gender”, “SP used” and “PBL used” were the main factors affecting the satisfactory degree to current doctor-patient communication education (P=0.029, 0.023, 0.012, and 0.029, respectively). Conclusion The medical undergraduates’ satisfactory degree to current doctor-patient communication education is generally high, but it is also affected by various factors. Although doctor-patient communication education has started early, the training system is still problematic and the teaching resources coverage is limited. So in order to make a further systematic, standardized, overall designed education for students’ cognition and communication skills, the medical colleges should open integrated doctor-patient communication curriculum that combines with both PBL and SP auxiliary teaching methods, and covers all the undergraduate learning stage.

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  • 新型冠状病毒性肺炎疫情时期器官移植调整策略及体会

    目的探讨新型冠状病毒性肺炎(简称新冠肺炎)疫情时期器官捐献移植工作的调整策略,总结经验。方法解读新冠肺炎疫情期间器官移植工作指南和第一版专家共识后,四川大学华西医院器官移植中心制定了器官移植调整方法。结果于 2020 年 1 月 24 日至 2020 年 2 月 6 日进行公民逝世后器官捐献 4 例,均为男性,平均年龄 39.5 岁。捐献后共行器官移植手术 8 例,其中肝脏移植 4 例,肾脏移植 4 例。移植受体平均年龄 48 岁,男 6 例,女2 例。8 例移植手术顺利,7 例患者无输血。手术后患者恢复顺利,无外科并发症发生,无感染相关并发症发生。结论新冠肺炎疫情期间,通过调整方法和流程,可以安全开展器官移植工作和实现疫情防控。

    Release date:2020-03-30 08:25 Export PDF Favorites Scan
  • Technical improvement and effect of donor red blood cell transfusion in liver transplantation with donation after citizen death

    ObjectiveTo explore modified methods and outcomes of collection of donor blood from donation after citizen death (DCD). MethodThe clinicopathologic data of 26 DCD donors underwent phase Ⅰ clinical trials and 6 patients who received donor blood by modified collection technique from May 2020 to November 2021 in the West China Hospital of Sichuan University were collected retrospectively. ResultsCompared with the data of 26 DCD donors at phase Ⅰ clinical trials, after the modified collection technique, the blood collection volume, the concentrated red blood cells following filtration, centrifugation, and the amount of concentrated red blood cell/kg body mass were more (P<0.05). In addition, compared with the components of stored red blood cell suspension, the pH value, sodium and chloride ions concentrations of the red blood cell suspension obtained after modified collection technique were higher (P<0.05), the potassium ion concentration was <1 mmol/L, and the lactic acid concentration of none of blood was >15 mmol/L. ConclusionThe adoption of the modified collection technique increases the amount of donor red blood collected, and its biochemical and electrolyte indicators are more in line with physiological requirements than those of stored blood.

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  • Impact of arterial reconstruction type on early ischemic-type biliary lesion after liver transplantation

    ObjectiveTo investigate the effect of recipient hepatic artery reconstruction site selection on early ischemic-type biliary lesion (ITBL) after liver transplantation. Methods The clinical data of 656 cadaver liver transplantation were collected retrospectively from January 2015 to January 2020 in the Liver Transplantation Center of West China Hospital of Sichuan University and the Institute of Organ Transplantation of Tongji Hospital Affiliated to Huazhong University of Science and Technology. Patients were divided into two groups according to the reconstruction sites of recipient arteries. The distal group was anastomosed at left hepatic artery, right hepatic artery or proper hepatic artery. The proximal group was anastomosed at the gastroduodenal artery, the common hepatic artery or the common hepatic artery-gastroduodenal artery bifurcation. To investigate the differences in the incidence of early postoperative complications between the two groups and the factors influencing the development of ITBL within one year after transplantation. Results Of 656 patients, 262 were in the distal group and 394 were in the proximal group. The incidence of hepatic artery thrombosis was lower in the proximal group than that in the distal group (χ²=5.675, P=0.017), while the differences in the incidences of ITBL-related graft failure and rejection-related graft failure were not statistically significant when compared (all P>0.05). Multivariate logistic regression results showed that hepatic artery thrombosis [OR=4.453, 95%CI (1.318, 15.050), P=0.016] and cold ischemia time >6 h [OR=1.844, 95%CI (1.014, 3.353), P=0.045] were risk factors for early postoperative ITBL in the liver transplant patients, while different hepatic artery reconstruction categories were not risk factors for ITBL [OR=1.166, 95% CI (0.630, 2.157), P=0.625]. Conclusion Hepatic artery anastomosis reconstruction with the recipient common hepatic artery, gastroduodenal artery, and Carrel flap at the common hepatic artery-gastroduodenal artery bifurcation can somewhat reduce the difficulty of anastomosis and does not increase the risk of postoperative ITBL.

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  • Expert consensus on dual-graft liver transplantation in West China Hospital

    Living donor liver transplantation is one of the main solutions to the organ supply-demand discrepancy at present. However, there was a risk of the recipient developing small-for-size syndrome due to insufficient graft volume, while an excessively large graft volume for donation might lead to postoperative liver failure for the donor. In this context, the dual-graft liver transplantation had emerged, which could minimize the volume of liver resection from the each donor to ensure the donor’s safety and provide the adequate volume of liver for the recipient. Yet, this procedure is less commonly performed in our country. In order to promote the steady implementation of dual-graft liver transplantation in China and serve as an important supplement to the donor pool, the West China Hospital of Sichuan University organized relevant experts and draw on the mature experiences of advanced countries in the field of transplantation jointly formulated the “Expert consensus on dual-graft liver transplantation”. The consensus had been developed around aspects such as donor evaluation and selection, surgical methods, and postoperative complications.

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