Objective To investigate baseline data of the current status of patients in China, and thus to develop strategies to get patients involved in evidence-based medicine (EBM). Method 300 questionnaires with 17 questions were distributed to the in-patients in West China Hospital, Sichuan University. Statistical software such as SPASS 10. 0 was applied to analyze all the data. Results No patients had ever heard of EBM. Most patients did not know much information about their diseases, but had a b desire to learn from their doctors. Most of them would like to be involved in the treatment decision-making and hoped that their doctors would care about their preference. The cost and the effectiveness of the treatment were the most important issues that patient concerned about. Conclusions The dissemination of health information is very limited for patients and the accessibility of effective health information depends much on the direct communication with their doctors. Promoting patient involved in EBM is fairly a hard and long way to go based on the actual reality of the country.
Objective To retrospectively analyze and classify 23 open fractures that resulted in severe infection, in order to provide evidence that can be used in future disaster scenarios. Methods Based on medical records of 23 cases of open fracture and subsequent bacterial infection, we analyzed the clinical diagnosis, treatment, laboratory tests, bacterial smear of wound secretion, and the bacterial culture of the wound secretion. We then analyzed which antimicrobial agents were used and how they were applied, and the subsequent effect on controlling the serious infection.? Results All cases were related to seismic injury and belonged to class VI open fracture. Eight cases were male and 15 were female. All cases had similar symptoms such as chills, fever, large scale muscle necrosis, and severe infection. A direct smear of the wound showed that the number of cases with one bacterial infection was 6 (26.09%), the number that had double bacterial infections was 12 (52.18%), and the number with multiple bacterial infections was 5 (21.74%).There were 18 strains of 11 types of bacteria recovered from wound samples. Conclusion Early treatment with the joint application of multiple antibacterial agents, early debridement, and adequate drainage all helped to control the infection and avoid nosocomial infection. Employing these strategies in the future will control infection in disaster situations.
ObjectiveTo explore the standardized index system of quality control for single disease of day surgery in Shanghai municipal hospitals.MethodsFrom April to November 2020, through literature research and comprehensive analysis of research results, the framework of quality control index system for single disease of day surgery focusing on obstructive sleep apnea hypopnea syndrome surgery and laparoscopic cholecystectomy was constructed; Delphi method was used to evaluate the quality of day surgery in terms of results, objectivity, statistics, sensitivity, accessibility, quantifiability, importance, and guidance. Finally, the final indicators were screened out.ResultsAfter three rounds of Delphi investigation, 18 experts finally formed 14 general indexes and 14 personalized indexes (6 for obstructive sleep apnea hypopnea syndrome and 8 for laparoscopic cholecystectomy) in the single disease of day surgery quality control index system.ConclusionsThe general indexes and personalized indexes quantifying the quality control index for single disease of day surgery are conducive to the standardization and standardized management of day surgery, and can provide a reference for improving the medical quality and safety, and sustainable development of day surgery.
Objective To explore the clinical characteristics of patients with severe pandemic H1N1 Influenza in Sichuan and risk factors related to patients’ prognosis. Methods We observed 135 severe patients who came to hospitals for pandemic H1N1 Influenza from 12 cities in Sichuan, China,between September 12, 2009 to December 14, 2009, and described their baseline characteristics, treatment,and outcomes. A stepwise multiple Logistic-regression analysis was used to evaluate the independentpredictors of death. Results Of the 135 patients we studied, 86 patients were male. The average age was ( 28. 2 ±19. 3) years old, while patients between 19 to 45 years of age accounted for 47. 4% . 96 patients ( 71. 1% ) presented with fever. 51 patients( 37. 8% ) had comorbid conditions. The most frequent organdysfunction was seen in lung ( 71. 1% ) , liver( 27. 4% ) and cardia( 24. 4%) ; 130 patients( 96. 3% ) had received oseltamivir, 26 patients ( 19. 3% ) required mechanical ventilation. 12 of the 135 patients died.Compared with the survivors, patients who died were more likely to have a higher age, lower average bloodpressure when admitted, more organ dysfunction, and more likely to have cardia or nervous system dysfunction. The nonsurvivors also seemed to have less opportunity to be exposed to neuraminidase inhibitors, and have more demand for mechanical ventilation. The P value were all under 0. 05. The multipleLogistic-regression analysis showed the independent predictors of death were the average blood pressure when admitted and the demand for mechanical ventilation . The P value were both under 0. 05. The OR value was 0. 86(95% CI 0. 002-0. 936) and 13. 86( 95% CI 1. 146-16. 583) , respectively. Conclusions For these severe patients with pandemic H1N1 Influenza we study, the male patients are more than female. Most patients are between 19 to 45 years of age. The most frequent organ dysfunction is seen in lung, liver and cardia. The mortality of these patients is 8. 9% . Compared with the survivors, patients who died were morelikely to have a higher age, lower average blood pressure when admitted, more organ dysfunction, and more likely to have cardia ornervous systemdysfunction. The nonsurvivors also seemed to have less opportunity to be exposed to neuraminidase inhibitors, and more demand for mechanical ventilation. The multiple Logisticregression analysis showed the independent predictors of death are the average blood pressure and the demand for mechanical ventilation. The OR value is 0. 86 ( 95% CI 0. 002-0. 936) and 13. 86 ( 95% CI1. 146-16. 583) respectively.