【摘要】 目的 了解甲型H1N1流感发热病区门诊就诊高峰期患者焦虑状况及相关因素，采取针对性护理措施减轻患者焦虑情绪。 方法 2009年11月上旬-12月上旬采用一般资料调查和Zung′s焦虑自评量表（SAS）对219例患者进行调查分析。 结果 219例患者SAS平均分为（33.70±8.60）分，其中17例SAS总分≥50分，存在焦虑情绪，发生率7.76%。多元回归分析结果显示，在年龄、性别、城乡差异、发热程度等因素中，与焦虑症状有关的主要因素为年龄和发热程度。 结论 甲型H1N1流感发热病区门诊就诊高峰期患者焦虑情绪明显高于常模，应引起重视，在门诊工作中加强心理护理，减轻和尽力消除患者的焦虑情绪，以免对病情产生不利影响，不利于控制流感疫情。【Abstract】 Objective To investigate the anxiety status and related factors of H1N1 patients at influenza peak of fever clinics,and to take specific measures to reduce anxiety in patients. Methods The general information and Zung′s self rating anxiety scale (SAS) were taken to analyze 219 patients from early November to early December 2009. Results The average SAS score of the 219 patients was 33.70±8.60, in which there were 17 patients (7.76%) with total scores ≥ 50 and anxiety. Multiple regression analysis showed that the age and temperature were related factors among age, gender, urban-rural differences, and fever. Conclusion The survey suggests that the pafients at the H1N1 influenza peak of fever clinics are significantly more anxious than normal anxiety. Out-patient work should strengthen psychological care to reduce and try to eliminate the anxiety of patients, in order to avoid adverse impact which is not conducive to control influenza outbreaks.
目的 总结大型灾害情况下，急诊伤员信息收集流程，为制定大型灾害救援提供证据支持。 方法 回顾性分析汶川地震（2008年5月12日－6月2日）和玉树地震（2010年4月14日－5月1日）伤员信息收集方法，总结两次地震伤员信息收集管理过程中发现的问题及取得的经验。 结果 通过制作地震伤员登记表、调整病历收集与管理模式、分诊提前、伤员信息登记提前，调整急诊功能分区、头像采集技术的使用、成批伤员信息资料袋和分诊信息卡的应用，最大限度地保证了伤员信息收集的完整性。 结论 地震伤员信息资料的准确性、完整性、及时性在伤员的救治、伤员的查找、伤员的转归和各类医疗信息的收集，以及制定大型灾害事故应急预案等方面起着非常重要的作用。
目的 研究乳腺癌患者雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER-2）表达情况及免疫组织化学分子亚型分布。 方法 对2003年1月－2008年9月四川大学华西医院病理科3 365例乳腺癌病理报告存档资料进行激素受体（ER/PR）、HER-2表达情况及免疫组织化学分子亚型分布进行分析。 结果 3 365例确诊的乳腺癌患者中，ER阳性1 824例（54.2%），PR阳性1 841例（54.7%），HER-2过表达284例（8.4%）。相关分析显示ER与PR表达呈正相关（P＜0.001），HER-2与ER、PR表达均呈负相关（P＜0.001）。免疫组织化学分子亚型结果显示luminal A型最常见，为1 993例（59.2%）；basal-like型为623例（18.5%）；HER-2过表达型为169例（5.0%）；luminal B型最少，为115例（3.4%）；未分类的为465例（13.8%）。 结论 乳腺癌患者激素受体及HER-2表达有特殊性，激素受体阳性率＞50%，HER-2阳性率在不同研究中显示出不同的结果，尚需进一步研究；ER、PR与HER-2具有良好的相关性；免疫组织化学分子亚型中luminal A型最常见。
【摘要】 目的 探讨口服百草枯中毒患者口腔护理的方法及早期护理的临床意义。 方法 2009年1月-2010年3月，采用半随机方法将62例白草枯中毒患者按中毒时间的长短分A组（中毒时间lt;3 d，n=32）、B组（中毒时间gt;3 d，n=3），比较两组患者口腔溃疡的治愈率、并发症发生状况，分析早期口腔护理的必要性。 结果 A组患者百草枯所致的口腔黏膜损害明显减轻，并发症发生率降低，为改善预后提供了条件，显示了早期加强口腔护理的成效。 结论 重视百草枯早期口腔护理，能够减轻口腔糜烂溃疡痛苦，减少并发症，提高患者生活质量。【Abstract】 Objective To investigate the clinical significance of early oral care for paraquat-poisoned patients. Methods A quasi-randomized controlled trial was used. A total of 62 paraquat-poisoned patients (from January 2009 to March 2010) were divided into experimental group and control group in order to compare the healing rate of oral ulcer, complications and the necessity of early oral care between the two groups. Results The oral mucosa lesions in experimental group obviously alleviated and the complications decreased. The effective early oral care provided the very favorable conditions for better prognosis. Conclusion The early oral care for paraquat-poisoned patients could relieve the pain of oral ulcer, reduce the complications and improve patient′s life quality.
During the prevention and control of coronavirus disease 2019, West China Hospital of Sichuan University urgently set up 4 medical tents to conduct centralized screening of fever patients, effectively avoiding cross-infection, and at the same time alleviating the pressure on the Department of Emergency Medicine and improving the efficiency of medical treatment for patients with fever. Later, in order to actively respond to China’s severe acute respiratory syndrome coronavirus 2 nucleic acid detection policy, 5 tents were adjusted to carry out the severe acute respiratory syndrome coronavirus 2 nucleic acid detection. This article introduces the function setting, personnel arrangement and protective measures of medical tents in West China Hospital of Sichuan University during the prevention and control of coronavirus disease 2019. It aims to share the experience of urgently setting up medical tents in the prevention and control of coronavirus disease 2019, with a view to provide a reference for the construction of medical tents in other medical institutions.
目的 检测血管内皮生长因子（VEGF）、白细胞分化抗原34（CD34）及CXC趋化因子受体4（CXCR4）在转移性鼻咽癌患者鼻咽部肿瘤组织中的表达，探讨它们与鼻咽癌各种临床病理因素的关系以及它们之间的相互联系。 方法 采用免疫组织化学链霉素抗生物素蛋白-过氧化物酶连结法检测2003年3月－2009年5月35例转移性鼻咽癌患者VEGF、CD34及CXCR4在鼻咽部肿瘤组织中的表达情况，结合患者临床病理特征进行分析。 结果 转移性鼻咽癌患者鼻咽部肿瘤组织中的VEGF及CXCR4阳性表达率分别为62.9%（22∕35）和42.9%（15∕35），CD34计数为11～92，平均43.2 ± 20.5。无肺转移较有肺转移的患者VEGF的阳性表达率高（78.9%、43.8%，P=0.043），多器官转移较单器官转移的患者CXCR4的表达强度高（62.5%、26.3%，P=0.044）。 结论 VEGF表达阳性的患者易发生肺转移；CXCR4强表达的患者易发生多器官转移。
Objective To analyze the characteristics of patients transferred by ambulances to emergency department before and after coronavirus disease 2019 epidemic, in order to improve the efficiency of emergency triage, optimize the utilization of emergency resources, and provide a reference for standardized tiered medical services in different situation. Methods The patients’ information collected through Wenjuanxing questionnaire was extracted, who were transferred by ambulances to the Emergency Department of West China Hospital of Sichuan University between December 27th, 2018 and April 28th, 2019 (before epidemic), or between December 27th, 2019 and April 28th, 2020 (during epidemic), or between December 27th, 2020 and April 28th, 2021 [in regular epidemic prevention and control period (REPCP)]. The general information, sources, reasons for referral, disease spectrum and triage levels of patients in the three periods were compared. Results There were 3993, 2252 and 1851 cases before epidemic, during epidemic, and in REPCP, respectively. The differences in gender and age among the three periods were not statistically significant (P>0.05). The percentage of referrals from tertiary hospitals in each period was 74.00%, 72.65%, and 76.12%, respectively, which was higher in REPCP than that during epidemic (P<0.05). The percentage of direct referrals from emergency department in each period was 41.00%, 42.14%, and 44.46%, respectively, which was higher in REPCP than that before epidemic (P<0.05). The percentage of two-way referrals in each period was 37.79%, 36.63%, and 34.36%, respectively, which was lower in REPCP than that before epidemic (P<0.05). During epidemic and in REPCP, the proportions of referrals due to “need for surgery” (24.72%, 27.84%, and 28.74%, respectively) and “request by family members” (49.64%, 53.33%, and 56.24%, respectively) increased compared with those before epidemic (P<0.05), while the proportion of referrals due to “critical illness” decreased compared with that before epidemic (40.20%, 35.21%, and 33.17%, respectively; P<0.05); the proportion of referrals due to “diagnosis unknown” decreased in REPCP compared with that before epidemic (15.50%, 13.90%, and 11.89%, respectively; P<0.05). The proportion of acute aortic syndromes in REPCP increased compared with that during epidemic (3.46%, 2.98%, and 4.65%, respectively; P<0.05), the proportion of trauma in REPCP increased compared with that before epidemic (13.72%, 15.76%, and 17.77%, respectively; P<0.05), and the proportion of pneumonia/acute exacerbation of chronic obstructive pulmonary disease during epidemic and in REPCP decreased compared with that before epidemic (8.44%, 3.73%, and 3.84%, respectively; P<0.05). The proportion of critically ill patients referred in each period was 72.88%, 75.58%, and 79.15%, respectively, which was the highest in REPCP (P<0.05). Conclusions The epidemic has a significant impact on emergency ambulance referrals, and emergency triage needs to be continuously optimised and improved in staff, facilities, processes and management. It is necessary to further improve the implementation of hierarchical diagnosis and treatment, strengthen information communication between referral and emergency departments of receiving hospitals, and improve referral efficiency.
This article introduces the exploration and establishment of “grass-roots Party building + targeted poverty alleviation” model by the Party Branch of Emergency Department of West China Hospital of Sichuan University, and discusses how to establish the “trinity mode” of management support, personnel training, and on-site guidance under the leading of grass-roots Party building through a series of the branches combined activities, according to the core idea of “strengthening the Party construction, bringing people closer together, and promoting development”. The aim is to form a long-term mechanism of grass-roots Party building and targeted medical poverty alleviation through continuously implementing this model, which can benefit more people in remote and ethnic minority areas and contribute to “Healthy China 2030”.