Day surgery has become an international and domestic medical service model, and it has received more and more attention from hospital administrators in terms of innovation and practical benefits for hospital management. However, from the perspective of standardization management, management norms have still been wanted. This paper introduces the general specification of clinical pathway management for day surgery in West China Hospital of Sichuan University, in order to provide reference for subsequent research, and hopes to provide certain standard models to provide reference for clinical pathway management practice.
On September 27, 2022, the first international standard of Diagnosis and Classification of Optic Neuritis was published online in Lancet Neurology, the top journal of neurology. The publication of this standard fills the gap in the international diagnosis and classification of optic neuritis (ON), promotes the consistency of the global diagnosis classification of ON, and helps ophthalmologists and neurologists to diagnose ON more accurately in the future. In recent decades, although Chinese ophthalmologists have made great progress in their understanding of ON and diagnosis and treatment level, it is still necessary to continue to strengthen the standardized training of Chinese neuro-ophthalmologist specialists, cooperate to establish a national ON clinical epidemiology database, carry out Chinese multi-center clinical studies, and further verify and optimize the international ON diagnostic system in future clinical practice. The ON diagnostic standards and treatment standards are gradually improved for China.
ObjectiveTo investigate on preoperative hand-washing for analyzing the underlying problems, in purpose of preventing operation-related infection via strengthening the standardization of surgical hand-washing and hand-disinfection. MethodsFrom July to September 2014, surveillance video of pre-operative hand-washing was studied and analyzed. We randomly selected 100 subjects, and assessment was performed based on the self-made surgical hand-washing and hand-disinfection protocol. Grading was done strictly. The passing score was 60 or higher; a score of 70-79 meant good; and a score of 80-100 indicated excellence. ResultsIn the survey, 91 in the 100 subjects were qualified. Among the qualified subjects, there were 53% of excellence and 20% of good. The major problems included erroneous methods, step omissions, time lacking, pollution, wrong flushing method or dry-hand method, and insufficient washing time. ConclusionBased on the survey, the administration department is advised to strengthen the regulatory supervision and education training based on standard surgical hand-washing and hand-disinfection criteria, especially training interns and new staff, in purpose of reducing the incidence of operation-related infection and improving hospitalization management qualities.
The averages and standard deviations of several subgroups in a study are sometimes need to be combined in meta-analysis, the calculating method to do this was given in this paper. Firstly, a commonly used incorrect calculating method to do the combination was pointed out; it origins from metrology and should be applied in the combination of standard deviations of several groups of measurements of the same object, and it's not fit for the combination of several subgroups' data in meta-analysis. Meanwhile the calculating error of this method was tested with real and constructed data and its impact on the conclusion of meta-analysis was analyzed. The incorrect method may result in a big calculating error with the real research data and even lead to an incorrect conclusion with the constructed data. The correct formula was deduced and given, the calculating result of the correct formula equals the true value when neglecting the round error. The error analysis of the incorrect method was then done with the correct formula and an accurate combination result can only be got when meeting the condition given by this paper. The correct method in this paper should be used to combine standard deviations in the future researches.
Quality control refers to the general term of operation technology which activities to meet the quality requirements. Quality control is not only the need of the development of the laboratory itself, but also the important requirement of the laboratory accreditation organization for the development of the laboratory. To carry out quality control, first of all, a complete quality control system should be established. According to the pathological experiment process, which can be divided into pre-analysis, in-analysis and post-analysis quality control. There are some similarities between special staining and hematoxylin-eosin staining, but the details are slightly different. There are many kinds of special dyeing items, and each dyeing step is complicated, so it is difficult to control the quality according to the quality control technology of conventional pathological staining. This article reviews the whole process quality control of special dyeing by summarizing the literature and work experience, so as to contribute to the subsequent improvement of the quality of special dyeing.
ObjectiveTo briefly describe the specific contents of the “four-dimensional integration” standardized training model for neurology residents and analyze the implementation effects.MethodsSince September 2019, the Standard Training Center for Residents in Department of Neurology, Xuanwu Hospital of Capital Medical University trained residents under “four-dimensional integration” standardized training model, including primary knowledge teaching, basic skill training, clinical thinking training, and student group learning. The effect of the “four-dimensional integration” model was measured by comparing the midterm assessment results after four months of training of the resident trainees in Grade 2019 under the “four-dimensional integration” training mode (n=37) with those of the resident trainees in Grade 2018 under regular training mode (n=32). The midterm assessment was conducted through standardized and objective clinical examinations, including three evaluations (theory, skills, and clinical drills), and the pass rate of tests was evaluated through Fisher’s exact probability method for comparison between training groups.ResultsThere was no significant difference in the pass rate of theoretical assessment (100.0% vs. 96.9%, P=0.464) or the pass rate of Mini-Clinical Evaluation Exercise (100.0% vs. 90.6%, P=0.095) between the two groups. The pass rate of skill assessment in Grade 2019 was significantly higher than that of the students in Grade 2018 (94.6% vs. 71.9%, P=0.018).ConclusionThe “four-dimensional integration” standardized training model for neurology residents and it effect are worthy of recognition, which can provide a reference for medical teaching, especially for the standardized training of resident physicians.
ObjectiveTo analyze the relationship between maximum standardized uptake value (SUVmax) of primary tumor detected by 18F-FDG positron emission tomography/computed tomography (PET/CT) and clinicopathologic factors in stageⅠnon-small cell lung cancer (NSCLC), and investigate the prognostic value of PET/CT on pathological feature. MethodsWe retrospectively analyzed clinical data of 182 patients with stageⅠNSCLC who underwent 18F-FDG PET/CT scan before lobectomy or segmentectomy in China-Japan Friendship Hospital from April 2013 to June 2014. There were 121 male and 61 female patients with their ages of 34-85 (68.1±9.8) years. Clinicopathologic factors including sex, age, smoking history, histology, TNM stage, T stage, tumor size, lymphatic vessel invasion, blood vessel invasion (BVI) and visceral pleural invasion were evaluated to identify the independent factors affecting SUVmax by univariate and multivariate regression analysis. The diagnostic efficiency and best cut-off point of SUVmax were calculated by the receiver operating characteristic curve. ResultsThe univariate analysis identified that sex (P=0.015), smoking history (P=0.001), histology (P < 0.001), TNM stage (P=0.004), T stage (P=0.001), tumor size (P < 0.001), BVI (P=0.001) were factors affecting SUVmax. Only histology (P=0.001), tumor size (P=0.006), BVI (P=0.009) were found to be significant independent factors according to multivariate regression analysis. The SUVmax of primary tumor was a predictor for BVI with the highest diagnostic accuracy at a cut-off value of 4.85, the sensitivity and specificity were 65.5% and 71.7%. ConclusionThe SUVmax is correlated with histology, tumor size and BVI in stageⅠNSCLC, higher in patients with non-adenocarcinoma, lager tumor and positive BVI. Furthermore, the probability of BVI could be predicted by SUVmax of the primary tumor.
Real-world data studies have experienced rapid development in recent years, however, misunderstandings persist. This paper aims to improve practice and promote standardization by updating the categorization of real-world data, proposing two conceptual frameworks for conducting real-world data studies, developing the concepts of research data infrastructure and clarifying the misconceptions on registry database, and discussing future development.
Objective To explore the application of the Handbook for the Training Nurses in the standardized training for nurses in pediatric surgery. Methods Twenty-four training nurses trained under the instruction of the Handbook for the Training Nurses in Department of Pediatric Surgery from July 2014 to December 2015 were included as the observation group. Their training effects were compared historically with those of twenty-four training nurses who were trained without the help of the handbook from January 2013 to June 2014 (the control group). Results After the completion of the half-year training, theoretical score of training nurses in the observation group was better than that in the control group, and the difference was significant (87.16±4.18 vs. 83.71±5.46; t=2.492, P=0.016). Meanwhile, the specialist practical skill examination of training nurses in the observation group, such as femoral vein blood collection, replacement of drainage bag and indwelling needle infusion in children, and emergency practical skill examination such as cardiopulmonary resuscitation and the use of simple respirator were higher than those in the control group; and the working performance scores of training nurses in the observation group, such as the ability to adapt to the environment, patient satisfaction, nursing document writing, work efficiency and morning questions were better than those in the control group; the differences were significant (P< 0.05). Conclusion The Handbook for the Training Nurses can help the training nurses to adjust their working environment, master the practical skills and nursing knowledge in pediatric surgery.
The informatization construction in medical field not only brings convenience to clinical doctors, but also creates huge data for clinical research. Taking the application of information technology in thoracic surgery as an example, we decide to talk about the establishment and application of esophageal cancer database based on standardized and structured electronic medical records. The aim, through the construction of database, is to improve clinical doctors’ management ability of esophageal cancer, to provide reference of the information construction to medical colleagues, and to promote the application of information in medicine.