Hospital trusteeship means that the property owners of the hospital, through the form of contract and for the purpose of value preservation and proliferation, authorize a corporation or human being with strong administrative management capabilities and risk-bearing abilities to manage the hospital. With the deepening medical reform, the model has been gradually widely used. In this context, a well-known public hospital became the trustee of a newly established comprehensive private hospital. Taking the greatest advantage of its medical quality management, the trustee used SWOT (strengths, weaknesses, opportunities, and threats) analysis to develop efficient decision-making mechanism, strengthened the process optimization transformation, and improved the innovative means of information technology for the development of the new hospital, which has achieved very good results.
ObjectiveTo research on the condition of constipation during the first 30 days after hip fracture. MethodsOne hundred and four patients with hip fracture treated between May 2014 and March 2015 participated in this study. We judged whether there was constipation by recording the defecation pattern and stool consistency in three time periods: from admission to the time just before surgery, from the end of surgery to the time of discharge, and from discharge to 30 days after injury. The defecation pattern was assessed using Bristol Stool Scale and a scale of four-stage defecation was used to assess the stool consistency. ResultsThere were 51.9% (54) of the patients who developed constipation during the first time period, 69.0% (69) during the second time period, and 63.4% (59) in the third time period. The proportion increased by 17% during the second period over the first (P=0.003), while there was no significant difference between the latter two time periods (P=0.581). Normal defecation pattern was re-established 9.7 days after surgery, though 23.7% (22) of the patients did not re-establish normal defecation pattern within the first 30 days after injury. ConclusionThe incidence of constipation during the first 30 days after hip fracture is high. The results imply that further studies are needed to prevent constipation.
ObjectiveTo investigate the situation of further medical education in students in our hospital from 2010 to 2014, and provide insights into how to elevate the teaching and management quality of continuing medical education (CME). MethodWe collected and statistically analyzed the electronic information of students in our hospital between January 2010 and 2014 December, including gender, ethnicity, age, education, and job title. ResultsThere were totally 7 478 students who received further education in the five years, and most of them were between 26 and 35 years old with junior titles and bachelor's degree. The number of students from minorities, county hospitals, medical school affiliated hospitals, provincial hospitals and hospitals from other provinces increased year by year. But there were still some problems in the present situation of further medical education in our hospital, including: lacking detailed publicity work, complicated student sources, different working capabilities of the students, and difficult regulation of uniform education planning. ConclusionsTo solve the problems, we need to properly balance the number of students and the quality of the training, make scientific enrollment plan, strengthen the CME publicity work, improve the quality of students, draw up differentiation cultivation plan, strictly implement examination and evaluation, and constantly improve the information feedback system.
ObjectiveTo analyze the clinical outcomes of 3D-printing assisting minimally invasive fixation of calcaneal fractures. MethodsThe study included 12 patients who were diagnosed with calcaneal fractures between October 2014 and May 2015. Using a real-size 3D-printed calcaneus model, the calcaneal locking plate could be preshaped before the operation and used with a minimally invasive approach to achieve rigid plate fixation just as with the lateral approach. Complications and surgery time were recorded and functional results were evaluated using the American Orthopaedic Foot Society ankle-metapedes score (AOFAS). The reduction of fracture was evaluated using the Bohler angle and Gissane angle. ResultsThere was no relevant postoperative complications. All fractures got bone union. The mean postoperative Bohler angle was (29.4±6.1) ° and the mean postoperative Gissane angle was (121.4±12.6) °. The difference in Bohler angle and calcaneal Gissane angle before and after the surgery was significant (P ＜ 0.01) . The mean postoperative AOFAS score was 75.2±5.4, and the fine/excellent rate was 83.3%. ConclusionWe believe this novel technique can be useful for the operative treatment of displaced intra-articular calcaneal fractures.
ObjectiveTo evaluate the impact of local infiltration analgesia on postoperative pain after hip arthroplasty. MethodsRelevant randomized controlled trials comparing the analgesia effect and adverse effects between local infiltration analgesia group and non-local infiltration analgesia group (control group) were identified from Cochrane Library, Embase, PubMed, China National Knowledge Infrastructure, VIP database and Wanfang database from their establishment until May 2016. A systematic review was performed to compare the pain scores and adverse events between those two groups. Effective data were pooled for Meta-analysis with software RevMan 5.2.0. ResultsTwelve eligible trials were identified in this study. The pain scores of the two groups of patients during rest time after surgery were significantly different[WMD=-19.06, 95%CI (-21.51, -16.62), P<0.000 01]; the pain scores were also significantly different during activity time[WMD=-11.45, 95%CI (-15.56, -7.34), P<0.000 01]. There was significant difference in postoperative nausea and vomiting between the two groups[RR=0.59, 95%CI (0.42, 0.84), P=0.003]. The pain degree and incidence of nausea and vomiting in the local infiltration analgesia group were lower than the control group, but there was no significant difference between the two groups in terms of urinary retention, itch and hypotension (P>0.05). ConclusionLocal infiltration analgesia is effective in reducing postoperative pain without any additional adverse reactions.
ObjectiveTo explore the influence of 3D printing assisting educational intervention on the anxiety and sleep outcomes in the patients with trauma. MethodA total of 40 patients were selected between October 2014 and June 2015. The patients were randomly divided into the intervention group and control group with 20 patients in each. The outcomes from admitted to the 7th day after the surgery were evaluated, including visual analogue scale (VAS) scores, state-trait anxiety inventory (STAI) score, Likert score, and the condition of anxiety, pain, and sleep outcomes. ResultsThe differences in VAS scores, STAI scores, and Likert scores between the two groups were significant (P<0.05). Conclusions3D printing assisting educational intervention is a useful intervention that can improve post-operative outcomes for the patients with trauma.