ObjectiveTo explore the application of discharge planning model in Respiratory Department. MethodWe developed discharge planning model in the Respiratory Department and performed standardized management on inpatients by assessing, planning, implementing and following up the whole process. A total of 716 discharged patients before the implementation of the planning model (January to March 2014) were designated as the control group, and 739 discharged patients after the model implementation (April to June 2014) were regarded as the observation group. Then, we compared such indexes as the rate of discharge planning, average length of hospital stay, retention rate of discharged patients, the number of new hospital admissions and medical orders during the time of weak nurse strength, and inpatient satisfaction before and after the model implementation. ResultsAfter implementation of discharge planning model, all observed indicators were significantly better in the observation group (P<0.05). ConclusionsImplementation of discharge planning model can effectively promote physician-nurse cooperation, plan health guidance for discharged patients, make them be ready to return to society and family, improve patients' satisfaction, and achieve the aim of patient-oriented high quality care. Meanwhile, it also can shorten the average length of hospital stay, reduce orders during the time of weak strength. It can not only ensure the ward medical indexes, but is helpful to manage nursing schedule.
ObjectiveTo review and summarize the clinical data and survival information of patients with cholangiocarcinoma treated by surgery, and to explore the clinical and pathological features of cholangiocarcinoma, and the relationship between intraoperative and postoperative characteristics and prognosis. MethodsWe retrospectively analyzed the clinical data of 678 cholangiocarcinoma patients after operation in the PLA General Hospital from January 2004 to December 2010, including the follow-up results of 397 cases. Only 293 patients with surgical resection of cholangiocarcinoma and non-surgical reasons for death were analyzed using Cox proportional hazards model. All indicators were analyzed by univariate and multivariate analysis. ResultsThe median follow-up time was 55.9 months. As of the end of follow-up, there were 158 cases of recurrence (53.9%) and 223 cases of death (76.1%). The median overall survival time was 21.2 months, and 1-year, 3-year and 5-year survival rates were 71.7%, 38.2% and 10.6%, respectively. Tumor differentiation, TNM stage, surgical margin, intraoperative blood transfusion, tumor location, alkaline phosphatase levels in blood and recurrence were independent risk factors for overall survival time. ConclusionLow degree of tumor differentiation, advanced TNM stage, cancer invasion on the surgical margin, intraoperative blood transfusion, tumor located outside the liver, alkaline phosphatase levels in blood higher than normal, and cholangiocarcinoma tumor recurrence are risk factors for overall survival rate in patients with cholangiocarcinoma.