【摘要】 目的 了解成都市综合医院门诊患者抑郁障碍和焦虑障碍的患病率及门诊医生的识别率。 方法 2007年4-5月应用医院焦虑抑郁量表（Hospital Anxiety and Depression Scale，HADS）、患者健康问卷（Patient Health Questionnaire 15-Item，PHQ-15）对在四川大学华西医院和华西第二医院神经内科、消化内科、妇科和心血管内科门诊就诊的685例患者进行筛查。HADS≥8分者进入精神科访谈，由精神科医生使用国际神经精神科简式访谈问卷进行诊断。 结果 综合医院门诊患者抑郁障碍校正后的现患率和终身患病率分别为19.26%和22.32%，焦虑障碍校正后的现患率和终身患病率分别为9.16%和9.63%。各科患病率不同，科室间患病率的差异有统计学意义。门诊医生的识别率为10.57%。 结论 成都市综合医院门诊患者抑郁障碍和焦虑障碍的患病率较高，识别率有待提高。【Abstract】 Objective To investigate the prevalence of depressive disorders and (or) anxiety disorders and physicians’ detection rate of these disorders in general hospitals in Chengdu. Methods From April to May, 2007, a hospital-based cross-sectional survey was conducted in neurology, gastrointestinal, gynecology and vasculocardiology departments in West China Hospital and West China Second Hospital. Outpatients were screened by using Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire 15-Item (PHQ-15). Psychiatrists interviewed subjects whose score of HADS were 8 and above and made diagnoses by using Mini International Neuropsychiatric Interview (MINI) according to the criteria of Diagnostic and Statistical Manual of Mental Health Disorders 4th Edition (DSM-IV). Results The adjusted current and lifetime prevalence of depressive disorders were 19.26% and 22.32%, respectively, and those of anxiety disorders were 9.16% and 9.63%, respectively. The prevalence of depressive disorders and/or anxiety disorders among four departments had statistically significant difference. The detection rate of these disorders by outpatient physicians was 10.57%. Conclusion Prevalence of depressive disorders and anxiety disorders among outpatients in West China Hospital and West China Women and Children Hospital is high, and the rate of physicians’ detection needs to be improved.
Objective To investigate the optimal surgical approach for bilateral inguinal hernias and complex (recurrent and compound) inguinal hernia. Methods Data of eighty patients with bilateral inguinal hernias and (or) complex inguinal hernias treated by tension less hernia repair between Feb. 2007 and Jun. 2010 in Sichuan Provincial People’s Hospital were analyzed. Preperitoneal approach through inferior abdominal median incision was applied in the repair with local, lumbar or epidural anesthesia. Results Operation time was （30±10.2） min in unilateral hernia, （50±17.5） min in bilateral hernia. There was no ischemic orchitis or pain case after operation. Within 3 months following up, no recurrence occurred. Conclusion The preperitoneal approach through inferior abdominal median incision for inguinal hernia repair is proved to be effective, safe, and convenient, and especially fit for bilateral hernias and complex hernia.
ObjectiveTo evaluate the high-level disinfection effect of flexible endoscopes in the Endoscopy Center of the First People’s Hospital of Longquanyi District of Chengdu, explore the key links of flexible endoscope cleaning and disinfection, and provide theoretical guarantee and technical support for the next step of the endoscope center work.MethodsWe sampled and monitored the lumens, water and air injection ports and biopsy ports of 19 flexible endoscopes after high-level disinfection in the Endoscopy Center of the First People’s Hospital of Longquanyi District of Chengdu. A total of 307 specimens were collected from 108 flexible endoscopes. We compared the disinfection effects of different flexible endoscopes and different sampling sites, and compared the microbial detection status of different flexible endoscopes.ResultsThe qualified rates of disinfection of gastroscopes, colonoscope and duodenoscopy were 79.22%, 86.21% and 100.00%, respectively, and the difference was not statistically significant (P=0.721). The qualified rates of disinfection of the endoscopic lumen, water and air injection port and biopsy port were 87.04%, 93.00% and 94.95%, respectively, and the difference was not statistically significant (χ2=4.585, P=0.101). The qualified rates of the lumen, water and air injection port and biopsy port of gastroscope, colonoscope and duodenoscope were 84.42%, 93.10%, 100.00%, 92.96%, 92.59%, 100.00%, 94.29%, 96.30%, 100.00%, respectively. There was no statistically significant difference in the disinfection effect of various parts of different flexible endoscopes (P>0.05). Bacteriological identification showed that of the 28 specimens with excess bacteriological standards, 16 gram-positive bacteria (57.1%), and 12 gram-negative bacteria (42.9%) were found.ConclusionThe cleaning and disinfection effect of flexible endoscopes has certain defect. Endoscope should be treated in strict accordance with the technical specifications for cleaning and disinfection of the flexible endoscope to further improve the disinfection effect of the flexible endoscope.
ObjectiveTo observe and analyze the efficacy and adverse reactions of Lacosamide (LCM) in the treatment of refractory epilepsy in children and adolescents. MethodsA retrospective cohort study was conducted on 85 patients with refractory epilepsy, with 50 males and 35 females, aged 0.5 ~ 15 years with an average age of (6.90±3.61) years, who were treated in the Department of Neurology of Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, from January 2020 to March 2023. A self-controlled study was conducted by oral LCM add on treatment, and follow-up was performed to compare and observe the efficacy as well as the adverse reactions before and after the use of LCM. ResultsBy self-control, after 12 months of follow-up after addition of LCM treatment, compared with baseline, the frequency of seizures decreased after 3, 6 and 12 months of treatment, the differences were statistically significant (P<0.05), and the effective rate of analysis after 3, 6 and 12 months of addition of treatment were 36.47%, 42.35% and 41.18%, respectively. There were 22 cases without seizure after 12 months of LCM treatment, and the seizure-free rate was 25.88%. Enrolled patients used a variety of antiseizure medications at baseline, and the three drugs used by the most patients were sodium valproate in 54 cases (63.53%), levetiracetam in 41 cases (48.24%) and oxcarbazepine in 24 cases (28.24%) respectively. After addition of LCM, a total of 10 cases experienced adverse reactions, such as dizziness, headache, nausea, etc. The incidence of adverse reactions was 11.76%. The retention rate at 12 months after adding LCM was 63.5%. ConclusionsThe addition of LCM in the treatment of refractory epilepsy in children and adolescents can effectively improve the frequency of seizures, with fewer adverse reactions and higher retention rates.
Objective To investigate the changes of multidrug-resistant organisms (MDROs) in the First People’s Hospital of Longquanyi District of Chengdu around its overall relocation. Methods The First People’s Hospital of Longquanyi District of Chengdu was overall relocated on December 31st, 2016. The detection rates of MDROs and the changes in nosocomial infections before the relocation (from 2015 to 2016) and after the relocation (from 2017 to 2020) were retrospectively analyzed. Results A total of 83634 qualified specimens were submitted for inspection, 8945 strains of pathogenic bacteria were detected, and the detection rate of pathogenic bacteria was 10.70%, showing an increasing trend in yearly detection rates of pathogenic bacteria (χ2trend=8.722, P=0.003); among them, 1551 MDRO strains were detected, and the detection rate of MDROs was 17.34%, showing an increasing trend in yearly detection rates of MDROs (χ2trend=11.140, P=0.001). The detection rate of pathogenic bacteria before relocation was lower than that after relocation, and the difference was statistically significant (9.64% vs. 11.08%; χ2=35.408, P<0.001); there was no significant difference in the detection rate of MDROs before and after relocation (16.32% vs. 17.66%; χ2=2.050, P=0.152). From 2015 to 2020, the detection rates of pathogenic bacteria from sputum+throat swab specimens (χ2trend=81.764, P<0.001) and secretion+pus specimens (χ2trend=56.311, P<0.001) showed increasing trends, while the detection rates of pathogenic bacteria from blood specimens (χ2trend=110.400, P<0.001), urine specimens (χ2trend=11.919, P=0.001), and sterile body fluid specimens (χ2trend=20.158, P<0.001) showed decreasing trends. The MDRO detection rates of Escherichia coli (χ2trend=21.742, P<0.001), Staphylococcus aureus (χ2trend=47.049, P<0.001), and Pseudomonas aeruginosa (χ2trend=66.625, P<0.001) showed increasing trends, while the MDRO detection rates of Klebsiella pneumoniae (χ2trend=2.929, P=0.087) and Acinetobacter baumannii (χ2trend=0.498, P=0.481) showed no statistically linear trend, but the MDRO detection rate of Acinetobacter baumannii dropped significantly in 2017. In the targeted monitored MDROs, the proportions of nosocomial infections in methicillin-resistant Staphylococcus aureus (χ2trend=4.581, P=0.032), carbapenem-resistant Enterobacteriaceae (χ2trend=8.031, P=0.005), and carbapenem-resistant Pseudomonas aeruginosa (χ2trend=6.692, P=0.010) showed decreasing trends; there was no statistically linear trend in the proportion of nosocomial infections in carbapenem-resistant Acinetobacter baumannii (χ2trend=0.597, P=0.440); only one strain of vancomycin-resistant Enterococcus was detected in 2017, and no nosocomial infection occurred. Conclusions The overall detection rate of pathogenic bacteria and MDROs in this tertiary general hospital around relocation showed increasing trends year by year. The detection rate of pathogenic bacteria after relocation was higher than that before relocation, but the detection rate of MDROs after relocation did not differ from that before relocation. The proportion of nosocomial infections among the targeted monitored MDROs decreased.