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.
ObjectiveTo retrospectively investigate the drug use of over-60-year inpatients with lung cancer in the West China Hospital of Sichuan University in 2011, and to compare with outpatients with lung cancer concurrently, so as to evaluate the rationality of drug use among over-60-year inpatients with lung cancer in the West China Hospital. MethodsThe information of over-60-year inpatients with lung cancer as initial diagnosis in the West China Hospital in 2011 was collected from the hospital information system (HIS), including patient information, drug use information, cost information, etc. Data rearrangement and analysis by classes and costs were carried out using Microsoft Excel 2010 software. Resultsa) There was 2 215 person-times of over-60-year inpatients with lung cancer in the West China Hospital of Sichuan University in 2011. A total of 5 classes, 63 kinds of anti-tumor and adjuvant therapy drugs were involved. The total drug use frequency was 12 398 person-times. The average medicine cost was 774.93 yuan. b) The ratio of patients using 1 to 4 kinds of drugs was 34.31%, 5 to 10 kinds was 41.9%, and 11 to 15 kinds was 12.63%. c) For etiological treatment, the ratio of chemotherapy drugs was 99.45%, and the most used was cisplatin. d) For symptomatic treatment, the ratio of analgesics was 66.69%; the ratio of antitussive drugs was 21.33%; and the ratio of skeletal related events prevention drugs was 11.98%. e) For anti-ADR treatment, the ratio of antiemetic drugs was 55.07%; the ratio of stomach protection drugs was 32.63%; and the ratio of hepatic protection drugs was 12.30%. f) For other treatment, the ratio of immunopotentiating drugs was 59.46%; and the ratio of hematopoietic growth factor was 25.42%. g) For Chinese patent medicine, drugs used over 400 person-times were Diyushengbai tablet, Javanica oil emulsion injection, Aidi injection, and Huisheng oral liquid. h) For single/combined treatment, the ratio of two-drug combined chemotherapy was 78.38%, one analgesics drug treatment was 66.21%, one hepatic protection drug treatment was 83.41%, two-drug combined antanacathartic treatment was 45.88%, one stomach protection drug treatment was 90.53%, one immunopotentiating drug treatment was 90.53%, one hematopoietic growth factor treatment was 82.31%, and one Chinese patent medicine treatment was 37.39%, respectively; and antitussive and skeletal related events prevention drugs were used alone. i) The use frequency of the top 10 drugs were: pantoprazole, tropisetron, ondansetron, diphenhydramine, thymopentin, cisplatin, Diyushengbai tablet, tramadol, Javanica oil emulsion injection, and Aidi injection. j) Compared with outpatients, inpatients drug use frequency was higher in chemotherapy, analgesics, antiemetic, stomach protection, hepatic protection drugs, and Chinese patent medicine; but lower in skeletal related events prevention drug; and similar to the drug use situation of outpatients in immunopotentiating drugs and hematopoietic growth factor drugs. ConclusionThe antitumor therapies were mainly the combination of two chemotherapy drugs or single drug regimen for over-60-year inpatients with lung cancer in the West China hospital of Sichuan University in 2011. The most frequently used adjuvant therapies are antalgic, antiemetic and stomach protection drugs. Chinese patent medicine and immunopotentiating drugs are in common use as well.
Abstract: Objective To analyze the characteristics of pathogens isolated from patients with lung cancer after surgery, and provide instructions for the prevention and treatment of postoperative infection. Methods A retrospective investigation of the pathogenic microbiology data of 159 patients（142 males and 17 females with average age at 61.8±9.6 years) with lung cancer after surgery in West China Hospital from January 2009 to December 2011 was performed.We got the specimen from the patients by routine methods, identified the pathogens, and conducted drug susceptibility tests in vitro. Results The pathogens were mainly isolated from sputum of the patients （90.6%, 155/171）. Canidia albicans（25.7%, 44/171）, Klebsiella pneumonia（15.2%, 26/171）, Acinetobacter calcoaceticus-A. baumannii（13.4%, 23/171）and Pseudomonas aeruginosa（8.2%, 14/171） were the predominant species. Among A. calcoaceticus-A. baumannii isolates, 39.1%（9/23） of them were multidrug resistant strains. And 23.1%（6/26）of K. pneumonia isolates produced extended spectrum beta-lactamases. P. aeruginosa isolates showed high in vitro susceptibility to the antibacterial agents. Conclusion Pathogens are mainly isolated from sputum of patients after surgery for lung cancer. Canidia albicans and gram-negative bacilli are predominant isolates and should be the major targets for the prevention and treatment of postoperative infection.
By analyzing the current situation and problems of China’s precision healthy poverty alleviation, combining the current situation of poverty alleviation areas and its own clinical and regional advantages, West China Hospital of Sichuan University explores a practical “West China Way” to solve the healthy poverty problem. We insist on demand orientation, build the top-level design, and implement precise policies. Starting with the promotion of health screening, we actualizes hospital management, multi-disciplinary collaboration, integrated medical care construction according to regional needs, “double-group” style assistance, stratified and graded training, and telemedicine education. As the combination of “transfusion” and “hematopoiesis”, we help the local areas to build modern systems of hospital management, technology, and human resource.
ObjectiveTo retrospectively investigate the medication structure and evaluate the rationality among over-60-year outpatients with lung cancer in the West China Hospital of Sichuan University in 2011. MethodsThe data was extracted from the hospital information system (HIS). Excel 2010 software was used for statistical analysis. Resultsa) The total of over-60-year outpatients with lung cancer were 17 296 person-times, of which 12 606 persons-times patients with no medication accounted for 72.88%. The monotherapy in patients with medication accounted for 75.76%. b) There were 5 types of tumour related drugs, including 56 kinds of different drugs, and the total frequency was 6 460 and the average cost was 2 219.38 yuan. The first three drugs classified by 5 types were traditional Chinese drugs (TCM, 28.50%), other therapy (24.91%), and etiological treatment (22.23%). c) For etiological treatment, tyrosine kinase inhibitors (TKI) accounted for 59.96%, and the first three drugs were gefitinib, recombinant human endostatin, and erlotinib. d) For symptomatic treatment, analgesic drugs accounted for 43.65%; and the first three drugs were tramadol hydrochloride sustained-release tablets, sodium zoledronic oxycodone, and acetaminophen. e) For ADR therapy, liver drugs accounted for 40.97%; and the first three drugs were palonosetron hydrochloride, licorice, and diammonium pantoprazole. f) Other treatment involved immunopotentiating drugs and hematopoietic growth factors, the ratios were 62.65% and 37.35%, and the first three drugs were thymalfasin, thymopentin, and recombinant interleukin-11. g) Huisheng, Banao capsule and Bailing capsule were at the first three usage in TCM, the ratios of which were 51.06%, 15.37%, and 13.91%. h) The top ten drugs were Huisheng oral liquid, gefitinib and thymus AFP, thymopentin recombinant interleukin-11, chelating compound spot capsules, recombinant human endostatin, tramadol hydrochloride extended release tablets, sodium, zole dronic, and Bailing capsule. ConclusionThe antitumor therapies were mainly TKI single drug regimen for over-60-year outpatients with lung cancer in the West China hospital of Sichuan University in 2011. The most frequently used adjuvant therapies are antalgic, antitussive and skeletal related events prevention drugs. Besides, Chinese patent medicines are in common use as well.
Objective To analyze the articles published by graduate students of West China School of Medicine in Sichuan University from 2013 to 2017. Methods Outcome indicators which includes the quantity of papers, annual distribution, paper category and papers cited by SCI were analyzed through bibliometrics methods. Statistical analysis was performed using SPSS 18.0 software. Results From 2013 to 2017, a total of 5 490 articles were published by postgraduate students in the school as first or co-first author. The average number of publication was 2.19 per student, in which 655 postgraduate students published 3 or more articles, accounting for 26.12%. A total of 2 849 articles were cited by SCI, accounting for 51.89%. The total number of publication and proportion of SCI were growing gradually. The average impact factor of each article was 2.791 and the highest impact factor for each single article was 55.7. Students who graduated from "985 university" published more articles in total and the articles cited by SCI than those from "non-985 university". Conclusion In recent years, the quality of articles published by graduate students from West China School of Medicine in Sichuan University has been improving gradually. The articles published by students graduated from "985 university" were more cited by SCI than those from "non-985 university" .
Objective To investigate HCV genotypes in HCV patients in West China Hospital of Sichuan University, and to analyze the major genotypes and clinical characteristics. Methods From March 2011 to September 2016, 4 520 HCV patients who were successfully genotyped HCV genotypes were enrolled in West China Hospital of Sichuan University. The genotypes distributions and the characteristics of laboratory characteristics of liver function, the viral loading were all analyzed. In addition, the genotypes in HCC patients, liver cirrhosis, HBC/HCV co-infection were also analyzed. Results HCV genotypes of HCV patients were divided into five genotypes of 1, 2, 3, 4, 6 and 23 subtypes, including predominant genotypes/subtypes 1b, 1*, 3b, 2a, 3a and 6a, accounting for 66.42%, 8.01%, 6.57%, 4.54%, 4.29%, and 3.41%, respectively. Subtype 1b was the predominant subtype for both sex. In male patients, the levels of ALT were highest in 6a subtype, while in female, the levels of ALT were highest in 3a subtype. For the 94 liver cirrhosis patients, 42 patients were 1b subtypes; as for the 6 HCC patients, 1b and 3b subtypes were the only detected. Conclusion HCV genotypes/subtypes of HCV patients in West China Hospital of Sichuan University have unique characteristics of distribution, while the predominant genotype/subtypes are 1b,1*, 3b, 2a, 3a, 6a.
West China Hospital of Sichuan University as a national-level regional medical center in the western part of the country, focused on the actual situation in Tibet and actively carried out precision health poverty alleviation work. Guided by " precision”, the hospital has built a close-knit medical association – Hospital of Tibet People’s Government in Chengdu Office, and through the comprehensive improvement of medical care, teaching, scientific research, and management, creates a medical and health service system with Tibet characteristics. Combining " blood transfusion” and " hematopoietic” to build a " West China Model” for precision health poverty alleviation, West China Hospital of Sichuan University fully demonstrates the public welfare and responsibility of a national-level regional medical center, and constantly exerts regional radiation and leading role, promotes the medical and health service system continuous improvement in Tibet.
Objective To determine whether Xingnaojing injection can improve functional outcome without causing harm in patients with intracerebral hemorrhage. Methods We searched the electronic bibl iographic databases: Cochrane Central Register of Controlled Trials(CENTRAL, Issue 3, 2007), MEDLINE (1996 to November 2007),EMBASE (1984 to November 2007) and China Biological Medicine Database (1978 to November 2007). We also did handsearching to identify other publ ished and unpubl ished data. Data were extracted and evaluated by two reviewers independently with a designed extraction form. The Cochrane Collaboration’s RevMan 4.2.10 was used for data analysis. Results Thirteen randomized trials involving 1 035 patients were included. The number of people who had died or were dependent at the end of long-term follow-up (at least 3 months) were reported in three trials. Eleven trials measured neurological deficit at the end of treatment. No severe adverse events were reported. The results of meta-analyses indicated that Xingnaojing injection might decrease the number of death or dependency compared to the control group, but the difference was not statistically significant (Peto-OR 0.57, 95％CI 0.32 to 1.01); and Xingnaojing injection were associated with a significant improvement in neurological deficit (Peto-OR 3.70, 95%CI 2.67 to 5.13). Conclusion The evidence currently available showed that Xingnaojing injection may decrease the risk of death or dependency, and can also reduce neurological deficit in patients with intracerebral hemorrhage. However, more high-qual ity trials are needed.
Objective To provide baseline date for further research by retrospectively investigating the disease constitution of over-60-year old patients in the West China Hospital of Sichuan University in 2011. Methods The information of over-60-year old outpatients was extracted from HIS and their diagnoses were classified by ICD-10. The data of single disease among top 3 categories of diseases were rearranged and analyzed by Excel software. Results The total of over-60-year old outpatients was 895 123 person-time in 2011, accounting for 19.65%, including 716 826 person-time in specialist outpatient clinics. The specialist diagnoses of 683 491 person-time could be classified by ICD-10, accounting for 95.35% of specialist outpatients. The top 12 diseases were neoplasm, circulatory, digestive, factors influencing health status and contacting with health services, respiratory, musculoskeletal system and connective tissues, nervous, eyes, symptoms/signs and abnormal clinical and laboratory findings, non-classified, mental and behavioral disorders, endocrine, and genitourinary system diseases, and the cumulative constituent ratio was 92.96%. The main pathogenic sites of neoplasm were bronchus and lung (21.98%), esophagus (8.66%), stomach (8.10%), rectum (7.37%), prostate (5.86%), and liver and intrahepatic bile ducts (5.55%), with a cumulative constituent ratio of 57.72%. The main disease burden in circulatory system was hypertension (39.50%), chronic ischaemic heart disease (11.17%), and cerebral infarction (9.70%), and the cumulative constituent ratio was 60.38%. While the main disease burden in digestive system was gastritis and duodenitis (24.98%), other diseases of digestive system (9.26%), and other diseases of liver (8.90%), and the cumulative constituent ratio was 43.13%. There were more female than male among the over-60-year old outpatients (50.67% vs. 49.33%), and male was higher than female only in the incidence of neoplasm, respiratory, factors influencing health status and contacting with health services, and genitourinary system diseases. The disease constitution ratio of 60-69 years old patients was 58.21%. The top 3 neoplasm were the malignant tumors in digestive (38.20%), respiratory and intrathoracic organs (24.70%), and lymphoid, haematopoietic and related tissue (11.97%), with a cumulative constituent ratio of 74.87%. Conclusion The top 3 disease burden of over-60-year old outpatients in West China Hospital were neoplasm, circulatory and digestive diseases, which reflects the trend and law of treatment demands of old patients. It needs to deeply analyze the frequency and flow pattern of patients, and to provide evidence for preventing and treating geriatric diseases.