The ulcer resulting from snake-bite injury was characterized by deep and wide tissue necrosis and secondary infection. The patient was at high risk of loss of function of his extremity. From 1989 to 1996, 16 cases with deep ulcer of the upper extremity resulting from snake-bite injury were treated with different types of axial thoraco-abdominal skin flaps, depending on the location of the ulcer. Thoraco-umbilical skin flap was used in 2 cases, lateral thoracoabdominal skin flap in 1 case, iliolumbar skin flaps in 5 cases, lower abdominal skin flaps in 6 cases, lower abdominal divided foliated skin flap in 1 case and Y-shaped hypogastric skin flap in 1 case. Reparative operation was carried out within 3 weeks after injury and primary repair were undertaken in 6 of them. The pedicles were divided in 17 to 24 days after operation. Twelve flaps survived. Three of the 6 flaps had mild signs of inflammation which disappeared after administration of antibiotics. One had necrosis of the distal part of the flap, and was healed with split skin graft. This type of skin flap was an ideal method for the treatment of snake-bite injury of the upper extremity.
An experimental study was designed on the treatment of 8 superficial burn wounds and 5 wounds after removing the split-thickness skin grafts with 200GS permanent magnetic flat dressings, and some of the wounds were chosen at random which did not received any treatment and would be served as control. It was noted that the volume of exudate in the treatment group was 11.9 50.7％ less than that of the control group, and the total protein, the albumin and globulin contents in the treatment cases were far less in exudate than those of the control cases. It was concluded that the magnetic therapy not only decresed the exudate, but also diminished the amount of total protein, albumin and globulin in the exudating fluid and it was of benefit to wound recovery.
Objective To summarize and analyze the experience of Canadian hospital report, including report contents, indicators system and result application, so as to provide basis for improving Chinese hospital information report and enhancing healthcare regulation. Methods Official networks and databases in Canada were searched, and relative policies, documents, research reports and information reports were included. Results Canadian Hospital Report Project carried out by Canadian Institute for Health Information was effective for gathering and comparing hospitals’ information, and regulating healthcare service. Ontario Hospital Report Project, as a local policy based on national hospital report project, was a good example of local government to improve healthcare service regulation. Conclusion Canadian Hospital Report and Ontario Hospital Report enlighten us that, carrying out the comparison of hospitals in the same type, ensuring the comparability of data, setting comprehensive and scientific report contents and indicators, and emphasizing the self-evaluation function and self-improvement function of the hospital performance evaluation.
ObjectiveTo investigate the distribution and drug resistance of the pathogens isolated from hospitalized pediatric patients with respiratory tract infections, and to provide guidance for empiric therapy. MethodsRespiratory tract specimens from hospitalized pediatric patients with respiratory tract infections from 2011 to 2015 were collected, and the strains were identified and the drug susceptibility was tested. ResultsA total of 1995 strains of pathogens, 1281 (64.21%) from boys and 714 (35.79%) from girls, were isolated from 6236 specimens and the detection rate was 31.99%. The mean age of the hospitalized pediatric patients was (1.22±2.05) years (ranged from 1 day to 14 years). 1393 (69.82%) pediatric patients were younger than 1 year. Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Candida albicans and Acinetobacter baumannii ranked the top five species, accounting for 29.82%, 15.09%, 13.18%, 12.73% and 5.91%, respectively. 1995 strains included gram-negative bacteria (50.93%), gram-positive bacteria (35.29%), and fungi (13.78%). The resistance rate of Staphylococcus aureus to oxacillin was 31.76%, but it was 100% sensitive to vancomycin and linezolid. The resistant rate of gram-negative bacteria to imipenem was ranged from 1.52% to 5.93%. The resistant rate of gram-negative bacteria to ceftazidime, cefepime, piperacillin tazobactam and tobramycin was less than 30.00%. ConclusionsThe infants whose age are younger than 1 year comprise the majority of the hospitalized pediatric patients with respiratory tract infections. The proportion of male is more than that of female. Staphylococcus aureus and enterobacteriaceae were the main isolated pathogens. There is difference in drug resistance between different pathogens, so antibiotics should be chosen according to the results of drug sensitivity testing.
Health poverty alleviation is an important practice in implementing the basic strategy of precision poverty alleviation. It is also an important measure to win the battle against poverty in rural areas. Through the investigation of local medical and health conditions, West China Hospital of Sichuan University built a demand-oriented framework for medical poverty alleviation in Ganzi Prefecture, and gradually carried out precision top-level design, discipline construction, technical training, talent training, endemic disease prevention and control; through establishinga regional medical cooperation network, built featured specialies, built the backbone of medical and health forces, achieved the prevention of endemic diseases throughout life cycle, and improved the overall medical and health service capacity of Ganzi Prefecture. This article introduces the exploration and practice of the demand-oriented model in Ganzi Prefecture by West China Hospital of Sichuan University, aiming at providing a guide for the precision health poverty alleviation in China.
ObjectivesTo explore classification management method of evidence-based evidence for medical consumables based on cost multiplication and to conduct empirical test.MethodsFour quadrants was used to explore the classification management of consumables evidence.Results95.22% of the “recommended” items in the consumables department were “recommended” by the group. 100% of group “recommended” items passed the committee resolution. Advice of consumables department and group was highly relevant with decision of commission.ConclusionsOne-dimensional recommendations allow the decision-making of group and committee to be more convenient. Cost calculation is based on all consumables required for medical treatment, which is similar to reality. The classification threshold requires further optimization, and the classification basis requires continual adjustment under different conditions of hospital. The evidence-based evidence evaluation method for medical consumables based on incremental cost ratio is a simple and rapid hospital health technology assessment method suitable for China’s national conditions.
Improving the quality of infection management in outpatient and emergency departments is crucial for ensuring medical safety and advancing infection control practices. To enhance the level of infection management in outpatient and emergency departments, Tengzhou Central People’s Hospital developed a two round risk assessment system for outpatient and emergency departments hospital infection management using risk matrix and failure mode and effects analysis methods, including hospital-outpatient and emergency departments, very high risk outpatient and emergency departments-high risk point. Based on the enterprise risk management integration framework, the risk management system has been optimized to provide decision support for the prevention and control of outpatient and emergency departments hospital infection. This article will introduce the practical exploration experience of optimizing management in outpatient and emergency departments hospital infection based on risk assessment.
Objective To investigate inpatients disease constitution, costs and rational drug use in the Karamay Central Hospital in 2014 and provide baseline data for further evidence-based study. Methods The information of disease classification, single disease drug use and expenditure of inpatients in 2014 were collected from the Hospital Information System (HIS) of Karamay Central Hospital. We classified the diseases according to the international classification of diseases coding (ICD-10), and analyzed the data by Microsoft Excel 2007 software including frequency, proportion, cumulative proportion and sample average. Results ① A total of 24 936 inpatients in 2014 were included, with male to female ratio being 0.96 to 1 and minority rate being 22.95%. The top three systematic diseases were respiratory diseases, diseases concerning pregnancy, child birth and puerperium and circulatory system diseases respectively; ② The top three age groups were 25 to 59, ≥60 and 0 to 4 respectively; ③ The top three costs per capita of single disease were pulmonary infectious, tumor chemotherapy and symptomatic treatment respectively; the top three western medicine costs per capita were tumor chemotherapy, symptomatic treatment and pulmonary infection; the top three Chinese medicine costs per capita were chronic kidney disease (CKD), angina and ischemic stroke. Conclusion The single diseases ranking and percentage of inpatients in 2014 of Karamay Central Hospital were different from the disease burden of Xinjiang Uygur Autonomous Region, the country and even the whole world. Based on the above results, the respiratory diseases and circulatory diseases were selected as the systematic evidence-based pharmacy study goal.
Zhaojue is a deeply impoverished county located in Liangshan Autonomous Prefecture with high prevalence of human immunodeficiency virus infection. Based on local conditions, West China Hospital of Sichuan University has established a targeted supporting mode called “three-level organization and five-in-one”. This mode integrates administrative support teams, multiple disciplinary technical support teams and on-site expert teams to achieve five goals, including building effective teams, promoting clinical practice, enhancing skill training, focusing on academics and building a systematic platform. This model has improved the ability of treatment on human immunodeficiency virus infection and overall health services in Zhaojue County. It also reflects the responsibility of West China Hospital of Sichuan University in poverty alleviation and public welfare.