ObjectiveTo investigate the relationship of diaphragmatic mobility (ΔM) evaluated by ultrasonography with quality of life and athletic ability in patients with chronic obstructive pulmonary disease (COPD) , and analyze the factors those affect the diaphragmatic mobility.MethodsA total of 48 male patients with stable COPD were recruited in the study. The body height, body weight, diaphragmatic mobility, airflow obstruction (FEV1%pred), and exercise capacity (6MWD) were measured. The quality of life was assessed using the St. George’s Respiratory Questionnaire (SGRQ).ResultsThe minimum value of ΔM was 1.89 cm and the maximal value was 8.11 cm in the COPD patients. There were significant correlationship between ΔM and the SGRQ score of the total score, symptom score, impact points, activity points and 6MWD, with correlation coefficients of –0.474, –0.416, –0.432, –0.502 and 0.536, respectively. Multivariate stepwise regression analysis showed that the factors influencing ΔM were height (β=0.407, P=0.021) and FEV1%pred (β=–0.391, P=0.035).ConclusionsDiaphragmatic mobility and quality of life are closely related in COPD patients. The height and FEV1%pred have the greatest effect on diaphragmatic activity. The smaller diaphragm mobility is relevant to the worse quality of life and the smaller activity capacity.
Objective To evaluate the reliability and validity of the Chinese version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS) in preoperative anxiety in patients with local anesthesia. Methods From May to December 2020, a convenient sampling method was used to conduct an APAIS questionnaire survey on patients undergoing percutaneous renal biopsy in the Department of Nephrology, West China Hospital, Sichuan University, and the reliability and validity of the scale were analyzed. ResultsA total of 460 questionnaires were distributed and 444 valid questionnaires were returned, with a valid response rate of 96.5%. The Cronbach α of APAIS was 0.896, the Guttman split-half reliability was 0.811, and the content validity index was 0.891. The model fit was 12.122 for the chi-square fit index/degree of freedom, 0.916 for the goodness-of-fit index, 0.902 for the value-added fit index, 0.079 for the root mean square error of approximation, and 0.946 for the comparative fit index. The APAIS anxiety subscale score was positively correlated with the 7-item Generalized Anxiety Disorder Scale score (r=0.518, P<0.001). Conclusion The APAIS has good reliability and validity for evaluating the level of preoperative anxiety in patients with local anesthesia, but the application of the scale in other conditions requires further testing.
ObjectiveTo explore the application and effect of clinical nursing pathway based on information-knowledge-attitude-practice (IKPA) theory in percutaneous renal needle biopsy.MethodsThis is a historical control study. A total of 460 patients who underwent percutaneous renal biopsy in West China Hospital of Sichuan University between April and December 2020 were prospectively recruited as the pathway group, and a clinical nursing pathway based on IKAP theory was implemented. By contrast, the data of 617 patients who underwent percutaneous renal biopsy and received routine care in the same hospital between April and December 2019 were retrospectively collected as the control group. The length of hospital stay, hospitalization expenses, the incidences of postoperative complications (macroscopic haematuria, perirenal hematoma, and acute urinary retention), the incidence of postoperative postural hypotension, and the management enrollment rate of chronic kidney disease patients were compared between the two groups.ResultsThe length of hospital stay [median (lower quartile, upper quartile): 8 (7, 11) vs. 8 (7, 12) d] and the hospitalization expenses [median (lower quartile, upper quartile): 7380.50 (6401.86, 8789.21) vs. 8167.00 (6816.50, 10044.50) yuan] were less in the pathway group than those in the control group, the incidences of postoperative macroscopic haematuria (1.52% vs. 6.97%) and perirenal hematoma (2.61% vs. 5.02%) were lower in the pathway group than those in the control group, the management enrollment rate of chronic kidney disease patients was higher in the pathway group than that in the control group (26.09% vs. 6.16%), and the differences between the two groups were statistically significant (P<0.05). The differences in the incidences of acute urinary retention (8.26% vs. 11.18%) and postoperative postural hypotension (0.00% vs. 0.81%) between the two groups were not statistically significant (P>0.05).ConclusionThe application of clinical nursing pathway in percutaneous renal needle biopsy can effectively reduce the length of hospital stay and hospitalization expenses, and improve the management enrollment rate of chronic kidney disease patients.
Objectives To detect expressions of heat shock protein 70 (HSP70) and glial fibrillary acidic protein (GFAP) , and to estimate the post-injury interval after concussion of brain via the ratios of percentage of HSP70/GFAP-positive cells. Methods We established a brain concussion model of rat. Tissue levels of HSP70 and GFAP were determined by immunohistochemical staining at different time points after injury. Finally, the relationship between the ratio of percentage of HSP70/GFAP-positive cells and the post-injury interval was measured. Results The ratio of percentage of positive cells (increased from 7.15 to 11.73) and the percentage of HSP70-positive cells (P<0.05, compared with control group) increased, and the percentage of GFAP-positive cells did not change remarkably (P<0.05, compared with control group); the post-injury interval was between 0.5 hour and 3 hours. High ratio (>6.66) and high percentage of HSP70 and GFAP-positive cells (P<0.05, compared with control group) indicated the post-injury interval was between 3 and 12 hours. A low ratio (<6.66) and high percentage of HSP70 and GFAP-positive cells (P<0.05, compared with control group) suggested that the post-injury interval was later than 12 hours. Conclusion By analyzing the variation rule of the ratio of percentage positive cells after brain concussion, the post-injury interval after concussion of brain could be estimated.
Objective To use bibliometrics to identify research hotspots and emerging trends in the use of artificial intelligence (AI) in healthcare-associated infections (HAI), as well as to offer a resource for more relevant research. Methods The literature on AI and HAI from the Science Citation Index Expanded database of the Web of Science Core Collection was retrieved through computer searches, covering the period from January 1, 1994, to January 22, 2024. VOSviewer (v1.6.19) and CiteSpace (v6.1. R6) software were utilized for bibliometric analysis, creating knowledge maps that include research cooperation networks and keyword analysis. Results A total of 305 documents were included, and both the number of early publications and the frequency of citations were at a very low level for a long time before showing an annual increase trend after 2018. The United States had the most published documents among the 50 countries/regions from where they were sourced. Harvard University was the scientific research institution with the most publications, while Professor Evans HL of the Medical University of South Carolina was the scholar with the most publications. Research on AI in the field of HAI primarily focused on three aspects: AI algorithms and technologies, monitoring and prediction of HAI, and the accuracy of HAI diagnosis and prediction. These findings were based on keyword co-occurrence and clustering analysis. Conclusions A new phase of AI research in the subject of HAI has begun. More in-depth research can be done in the future for the hot direction, as there is still a gap between China’s academic accomplishments in this subject and the advanced level of the world.
目的:調查在校醫學生對醫療相關法律法規及醫患關系的認知,為醫學生教育提出建議。方法:使用自制調查問卷,對四川大學華西校區不同專業方向及學歷層次的在校醫學生進行整群隨機抽樣,將所得數據錄入計算機建立數據庫,進行統計分析。結果:(1) 在對醫療法規相關知識的知曉率上,研究生高于本科生,臨床相關專業高于非臨床相關專業;(2) 醫學生對醫療法規相關知識及醫患關系的認知主要來自于課外,來自于課堂教學的很少,并且大多數醫學生支持開設相關法律課程;(3) 過半數的醫學生認為醫患溝通不足是導致醫療糾紛的首要原因;(4) 大多數醫學生認為目前醫患之間存在信任危機,且這種狀況對他們今后的擇業觀造成了負面影響。結論:在醫學生中開展相關醫療法律課程等人文學科課程是符合當前國內醫療衛生事業發展需要的。
Objective To identify the chief factors influencing the hospitalization expenses in fracture patients with health insurance so as to provide information for the control of irrational increase in medical expenses and reform in the mode of medical insurance payment. Methods A total of 113 fracture patients with medical insurance in a hospital of a certain city from September 2006 to April 2007 were included and statistical analysis was performed by using multinomial linear regression analysis. Results The major factors influencing the hospitalization expenses in fracture patients with health insurance included the proportion of material fees and drug fees, length of stay, performance of operations and blood transfusion and etc. Conclusion Lowering the proportion of material fees and drug fees reasonably, reducing the length of hospital stay and avoiding operations and blood transfusion were the key to the control of hospitalization expenses for fracture. It is imperative to speed up and deepen the reform in medical insurance system, formulate scientific diagnostic and treatment routines and clinical pathways as well as expense standards, and try out the payment on certain single disease such as fracture.
OBJECTIVE: To investigate the mechanism of overhealing alleviation by salvia miltiorrhiza (SM) in wound healing. METHODS: Fibroblasts were cultured in vitro, and SM was applied with different concentrations (40, 80, 160 and 320 micrograms/ml) and time(the 1st, 2nd, 3rd, 4th and 5th days) to influence their autocrine. The levels of transforming growth factor-β1 (TGF-β1) and epidermal growth factor (EGF) were determined by ELIAS and radioimmunoassay respectively. RESULTS: The SM could inhibit autocrine of TGF-β1 by fibroblasts (P lt; 0.05). However, it did not affect autocrine of EGF (P gt; 0.05). CONCLUSION: The above results indicate that SM reduces overhealing by inhibiting the autocrine of TGF-β1 selectively.
目的 以問卷調查形式了解患者對就醫現狀及醫患關系的認知度，以期為醫療機構管理者完善醫療服務行為，構建和諧醫患關系提供參考依據。 方法 2009年8月－11月，采用自制問卷對6所不同醫院因傷/病住院治療終結患者進行調查，并對調查結果進行統計分析。 結果 大多數被調查者認為目前“看病貴”，且收入水平對醫療服務的選擇有影響；醫患信任程度與醫患溝通呈正相關；被調查者對醫患糾紛的認知主要來自于媒體的報導，且認為媒體報導是公正的。 結論 醫療機構管理者應強化醫護人員“以人為本”的理念，加強醫患溝通，以防范服務性醫患糾紛；政府應深化醫藥衛生體制改革，以解決“看病貴”問題；媒體應加大力度宣傳普及醫療相關法律法規及知識，以引導人民群眾盡可能正確客觀看待醫療結果，摒除不切實際的醫療高期待。
目的 討論糖尿病遠端對稱性多發性神經病變（DSPN）的篩查對減少糖尿病足潰瘍發生的作用及護理方法。 方法 2011年5月－2012年2月對137例入選患者進行神經病變癥狀篩查和體征檢查，并根據患者神經傳導功能檢查（NCS）結果作出最終診斷，由專職糖尿病足護士和健康教育護士給予患者針對性的預防教育和護理指導。 結果 根據神經病變癥狀、5項體征檢查及NCS結果，確診74例（54.01%），臨床診斷4例（2.91%），疑似10例（7.30%），亞臨床8例（5.84%），無41例（29.93%）。 結論 強調最好通過臨床問診和體格檢查來達到早期篩查、早期發現，并由專科護士針對性地指導患者采取有效的足部管理和預防措施,從而預防糖尿病足部潰瘍的發生。