Shortly after Wenchuan earthquake, the administrative leaders of West China Hospital accurately defined the role of the hospital during the medical rescue work as the treatment center for the seriously wounded, the supporting center for the local hospitals/clinics of the disaster areas, and the logistic supporting center for medical teams from other provinces. Integrated leadership of management and with efficient multi-department coordination and cooperation were emphasized. The mode of the hospital was immediately transformed from the regular state into a double-track emergent state. Scientific allocation and dispatch of resources were ensured to meet the ever-changing demand from all levels of rescue work. Three stages were defined based on the conditions of the wounded delivered to the hospital, with different main focuses for each stage. Owing to the multi-disciplinary cooperation and concerted efforts of a large number of experts from other provinces or even other countries, effective and efficient medical rescue service has been offered to all the wounded. Up to June 2nd, 2?618 cases from the disaster area have been treated, of whom 1 751 admitted into the inpatient department, 1 135 seriously wounded, 127 admitted into the Intensive Care Unit, 1 239 underwent operations and 77 treated with hemodialysis, with an inpatient mortality lower than 0.7%. Moreover, even during such a period of time, the routine medical service has been offered as regular to patients other than the wounded in the disaster.
A 7.1-magnitude earthquake hit china again, 702 days after Wenchuan Earthquake at Yushu prefecture of Qinghai province, 4000 meters above sea level. Up to April 19th, the death toll climbed to 1706, with 256 missing and 12128 injured. West China Hospital, as a regional state-level hospital of Ministry of Health, organized the first batch of medical team with relief supplies at the first day after Yushu earthquake and rushed to Yushu taking part into the rescue effort in golden seventy-two hours. The second day after Yushu earthquake, medical apparatus and drugs valued 5,000,000 RMB were delivered to the rescue site and the second batch of medical team were positioned. Within thirty three hours after the earthquake, 102 people, including 93 earthquake related injuries and 9 armed police with severe altitude illness, were sent to our hospital by air in four batches successively. Based on the first-hand experience of medical rescue in Wenchuan Earthquake, a series of diagnosis and treatment criteria which were built and developed with evidence-based method, and “four concentration principles”, namely concentrating the wounded, concentrating the experts, concentrating resources, and concentrating treatments, our medical rescue in Yushu earthquake were carried out appropriately. Up to 12 am., April 19th, 93 cases from the disaster area have been treated, of whom 54 seriously wounded, 58 underwent operations and none death. The experience learnt from Wenchuan Earthquake have been used, improved and sublimated more rapidly, more appropriately, more effectively in the Yushu earthquake medical rescue.
Objective To summarize the early outcomes and clinical experience in the use of skeletonized internal mammary artery(IMA) for coronary artery bypass grafting(CABG). Methods From January 2004 to June 2007, a total of 139 patients underwent CABG and received skeletonized arteries in this hospital. Results The number of distal anastomoses was 3.6±1.7,there was no sternal wound infection or thoracic cavity effusion. Two patients died (1.4%), the complications incidence was 5.8%(8/139) lung infections 3 cases, incision infections 2 cases, and low cardiac output syndrome 3 cases.All complications were well treated by using antibiotics, dressing change and positive inotrope, and the follow-up period was 2 to 34 months(20.6±5.9 months); 110 patients were followed up (80.3%). All living patients were free from angina after operation and showed I-II class heart function (New York Heart Association). Conclusion Using skeletonized IMA is? a safe and effective method in CABG.
本文通過對我國衛生法規和文獻復習的基礎上,對我國平均住院日管理問題進行歷史回顧，闡述縮短平均住院日的目的和意義,并以此證實在我國實施縮短平均住院日的重要性。
戰略聯盟理論被眾多的醫院重視和認同，越來越多的醫院通過“網絡+聯盟”的方式組建戰略聯盟；盡管企業戰略聯盟的理論和實踐已取得了深入的發展，但醫療行業戰略聯盟的理論還很不完善，尤其是缺乏對醫院戰略聯盟績效評價方面系統和深入的研究。本文從聯盟外部環境因素、成員自身特性、成員關系特征以及信息傳遞方式等方面對醫院戰略聯盟績效的影響因素進行了分析，建立了一個較為完整的理論評價模型，并在此基礎上提出了相關建議。
Abstract： Diseases prognosis is often influenced by multiple factors, and some intricate non-linear relationships exist among those factors. Artificial neural network （ANN）, an artificial intelligence model, simulates the work mode of biological neurons and has a b capability to analyze multi-factor non-linear relationships. In recent years, ANN is increasingly applied in clinical medical fields, especially for the prediction of disease prognosis. This article focuses on the basic principles of ANN and its application in disease prognosis research.
【摘要】 目的 探討雙水平無創正壓通氣(BiPAP)對心臟外科術后需要二次機械輔助通氣患者的治療效果。方法 2008年9月—2009年9月，收集心臟外科手術后成功脫離呼吸機輔助通氣后心功能衰竭或呼吸功能衰竭需要二次機械通氣的患者,符合納入及排除標準者共53例，進行回顧性分析,根據治療方案分為無創通氣組(32例)和有創通氣組(21例),在需要機械通氣時(T1),機械通氣后30 min(T2),機械通氣后2 h(T3)及預計脫離機械通氣時(T4),分別統計患者心率、血氣分析等情況,比較氧分壓、ICU停留時間及術后至出院時間。結果 給予輔助通氣前,兩組患者的心率及PO2無統計學差異(Pgt;0.05)。給予輔助通氣后,無創通氣組患者的心率由T1(130.8±21.10)次/min,下降到T2(125.60±21.36)次/min,T3(101.70±13.73)次/min,T4(87.40±9.35)次/min；PO2由T1(64.70±14.12) mm Hg,上升到T2 (121.40±30.19) mm Hg，T3 (140.40±25.29) mm Hg，T4 (132.90±16.33) mm Hg。有創通氣組患者的心率由T1 (138.27±21. 39)次/min,下降到T2(118.18±18.03)次/min，T3(100.00±11.73)次/min，T4(87.00±10.70)次/min；PO2由T1 (61.45±13.56) mm Hg上升到T2(122.55±29.50) mm Hg，T3(138.91±24.77) mm Hg，T4(133.55±18.00) mm Hg。兩組患者心率及PO2均較輔助通氣前降低(Plt;0.05)。兩組患者之間各時間點心率及PO2比較無差異(Pgt;0.05)。無創通氣組的ICU停留時間及術后至出院時間分別為(1.75±2.97) d及(9.14±4.11) d，均低于有創通氣組的(4.38±5.13) d及(14.00±0.82) d,有統計學意義(Plt;005)。結論 雙水平無創正壓通氣可用于心臟外科術后需要二次機械通氣的患者。
Theory of risk control was introduced to medical instruments quality control management in West China Hospital. A quality control system for the whole life cycle management of instruments has been established, which includes evaluation before instrument purchase, policy and management of bidding, operation training, safe maintenance, maintenance management and waste disposal. Medical instrument quality system was introduced to provide information for medical instrument risk control and quality management in a large, general Chinese hospital.
After the Wenchuan Earthquake on May 12th, 2008, under the b leadership of the SichuanProvincial Party Committee, the People’s Government of Sichuan Province, and the Ministry of Health of the People’sRepublic of China, the Medical Security Team working at the Sichuan Provincial Headquarters for Wenchuan Earthquakeand Disaster Relief Work constructed a secure medical material distribution system through coordination and interactionamong and between regions, systems, and departments.
目的 分析華西醫院門診患者對掛號單上就診信息的知曉和依從情況及其影響因素，以進一步優化就診流程，提高患者滿意度。 方法 將2012年2月5日－2月10日就診的患者作為調查對象，采用方便抽樣法和問卷面對面訪談法對739例就診者進行調查，并運用R×C列聯表χ2檢驗分析其影響因素。 結果 90.7%的患者能夠積極閱讀掛號單上的信息，并依照信息順利就診。但也有部分患者因文化程度及醫院服務疏漏導致無法順利就診。 結論 應該加大對文化程度偏低者和老年患者的宣傳指導，改進醫院服務方式，完善就診信息系統功能，進一步提高醫院服務水平。