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.
Objective To analyze the correlation between frailty syndrome and lower limb motor function in hospitalized elderly patients. Methods Convenience sampling method was used to select inpatients aged 65 and above from the Center of Gerontology and Geriatrics of West China Hospital, Sichuan University between December 2022 and May 2023. The FRAIL Scale, Short Physical Performance Battery (SPPB), and Timed Up and Go Test (TUGT) were used to evaluate the degree of frailty and lower limb motor function, and to explore the correlation between frailty and lower limb motor function. Results A total of 501 elderly patients were included, including 325 males (64.9%) and 176 females (35.1%); 256 cases of frailty (51.1%), 161 cases of pre-frailty (32.1%), and 84 cases of non-frailty (16.8%). The incidence of frailty in hospitalized elderly male patients was higher than that in female patients (P<0.05); The incidence of frailty in patients aged 80-99 was higher than that in patients aged 65-79 (P<0.05). The Spearman correlation analysis results showed that all dimensions of SPPB were negatively correlated with frailty (P<0.001), while TUGT was positively correlated with frailty (r=0.776, P<0.001). The results of multiple linear regression analysis showed that the worse the motor function of the lower limbs, the higher the debilitation score. Conclusions Frailty syndrome in hospitalized elderly patients is closely related to lower limb motor function. Lower limb motor function assessment can be used to predict the onset of frailty in clinical practice, and interventions to improve lower limb motor function can be used to improve the frailty of elderly patients.
ObjectiveTo evaluate the teaching effect of Patient based Problem-Based Learning (PPBL) vs. conventional bedside teaching (CBT) instudents of eight years medical program. MethodSix students of Eight years medical program in two grades from volunteer registration were randomized into PPBL group and the other students were recruited into CBT group. After one year study, the test score in module TBL test, written test in final exam and mutual score were evaluated to compare the teaching effect of two groups. ResultsThe baseline of the two groups were matched when comparing their grades in Diagnoses Course. After trainee period, there were no significant differences between two groups of the test score in module TBL test, written test in final exam and mutual score. ConclusionThe PPBL mode is not inferior to conventional bedside teaching. Furthermore, with advantage in developing the competency of communication, cooperation and manage the information, PPBL has its special value and should be popularized.
With the transformation of bio-psycho-social medical mode and the development of evidence-based medicine, people gradually realize that the new concept, patient-centered, can improve health awareness, promote harmonious doctor-patient trust and improve the satisfaction of patients. In this context, decision-aided system for patient appeared. It aims to encourage individuals to make specific choices according to their personal values and preferences after grasping relevant information of healthcare options. In addition, to facilitate the shared decision making, the decision aid can also upgrade the quality of care and improve doctor-patient relationship. This article gives an overview of the development of decision-aided system for patient, what it contains, how to develop and assess it, and the way to use it.
Continuous renal replacement therapy (CRRT) is the treatment of choice for critically ill patients with hemodynamic instability who require renal replacement therapy. This review summarizes the impact of CRRT treatment on nutritional support in critically ill patients, including: energy increase caused by citrate-based anticoagulants, energy loss caused by glucose-free replacement fluid and dialysate, a large amount of amino acids loss in the effluent, and the influences on the way of lipid emulsion administration, capacity, electrolyte, vitamins, and trace elements. It is hoped that the intensive care unit doctors, nephrologists, and nutritionists can fully cooperate to determine the CRRT prescription and the nutritional support prescription.
ObjectiveTo investigate the influence of hemoglobin level on in-hospital outcome of elderly patients with acute coronary syndrome (ACS).MethodsThis study retrospectively collected 262 elderly patients with ACS in the First Hospital of Tsinghua University from January 2015 to August 2019. Patients were divided into 4 groups according to the hemoglobin level. Patients with hemoglobin level≤121.75 g/L were classified into group A (n=65), patients with hemoglobin level between 121.76 and 132.50 g/L were classified into group B (n=66), patients with hemoglobin level between 132.51 and 144.00 g/L were classified into group C (n=69), and patients with hemoglobin level≥144.01 g/L were classified into group D (n=62). The primary endpoints of this study were in-hospital major adverse cardiovascular events, including all-cause death, reinfarction, acute or subacute stent thrombosis and cardiac arrest. Logistic regression analysis was used to explore the effect of hemoglobin on the in-hospital prognosis of elderly patients with ACS.ResultsLogistic regression analysis showed that the odds ratio of hemoglobin level in the major adverse cardiovascular events assessment was 0.971, the 95% confidence interval was (0.946, 0.996) and the P value was 0.024, while the odds ratio of hemoglobin level in the all-cause death assessment was 0.957, the 95% confidence interval was (0.929, 0.987) and the P value was 0.005.ConclusionLow hemoglobin level is a risk factor for in-hospital adverse events in the elderly patients with ACS.
Objective To investigate inpatient disease constitution in Traditional Chinese Medicine (TCM) Hospital of Xinjiang Uygur Autonomous Region from 2008 to 2010, in order to provide baseline data for medicine allocation of hospitals in western China and development of TCM hospitals. Methods A questionnaire combined with a subject interview was carried out, and the case records of inpatients from 2008 to 2010 were collected. The diseases in discharge records were classified according to International Classification of Diseases (ICD-10) based on the first diagnosis. Data including general information of the inpatients, discharge diagnosis etc. were rearranged and analyzed by Excel software. Results a) The top four systematic diseases seen commonly from 2008 to 2010 were as follows: circulatory system diseases, musculoskeletal system and connective tissue diseases, respiratory system diseases and digestive system diseases. The top four single diseases were hypertension, intervertebral disc disease, diabetes, bronchitis, emphysema and other chronic obstructive pulmonary diseases. Respiratory system diseases ranked the third in 2009 and 2010 from the fourth in 2008, and circulatory system diseases had ranked the first during the past three years; b) The following diseases as hypertension, bronchial emphysema and other chronic obstructive pulmonary diseases, diabetes, fractures, airway (bronchus, lung) cancer, and viral hepatitis were commonly seen in males rather than in females. By contrast, intervertebral disc disease, gallstone disease and cholecystitis, and anemia were commonly seen in females; and c) Hypertension was commonly seen in the aged above 60 years old; intervertebral disc disease mainly focused on the patients at the age of 15 to 59; and bronchial emphysema and other chronic obstructive pulmonary diseases, airway (bronchus, lung) cancer involved in the patients who were mostly over 60 years old. Conclusion a) The top four systematic diseases seen commonly from 2008to 2010 are as follows: circulatory system diseases, musculoskeletal system and connective tissue diseases, respiratory system diseases and digestive system diseases. The top four single diseases are hypertension, intervertebral disc disease, diabetes, bronchitis, emphysema and other chronic obstructive pulmonary diseases. So these diseases should be taken into well consideration when making development plans by hospital and complementing essential drugs list by local development; b) Chronic diseases become the main disease for troubling Xinjiang population; and c) Male and female are susceptible to different diseases which should be rationally avoided in order to prevent the induced occurrence.
ObjectiveTo systematically review the current status of doctor-patient conflicts in China.MethodsWe searched CNKI and CSSCI databases to collect literatures about the doctor-patient conflicts from inception to April 23rd, 2017. The literatures were categorized by the published time, the high-frequency vocabulary, the citation frequency, the researching discipline, the researching facility, the quality of literature, the theme of literature and so on. The current research status of the doctor-patient conflicts was analyzed.ResultsA total of 226 literatures were included, in which 72 defined and classified the doctor-patient conflicts, 122 analyzed the causing reasons of doctor-patient conflicts, and 160 analyzed the governance paths of doctor-patient conflicts. The research disciplinary vision was limited to the policies, regulations and the medical education and so on, and the researches in psychology or economics disciplinary vision were insufficient. The medical and comprehensive universities were the main research units of the studies of the doctor-patient conflicts. The frequency and quality of the researches about doctor-patient conflicts were low.ConclusionThe classified studies of doctor-patient conflicts are insufficient, so the scientific and manageable classified criterions are needed in the further studies. Systematic studies in influential factors of doctor-patient conflicts are insufficient, so the occurring mechanisms of conflicts are needed to be done by systematical researches on patient-centered way. The studies of governance paths of doctor-patient conflicts are insufficient, so the strategies of classified and systematical management which according to the different conflicting forms and entire process of the conflict occurrence should be put forward.
ObjectiveTo introduce the progresses and applications of nutritional status assessment in hospitalized patients. MethodsThe related literatures of nutritional status assessment were reviewed. ResultsThe rates of malnutrition and nutritional risk were high in hospitalized patients worldwide. Traditional nutrition assessment tools were not in common use in all hospitalized patients. All clinical health care workers should use the most suitable tool when faced with different patients. ConclusionAll hospitalized patients should be screened for nutritional risk on admission in order to improve clinical outcomes and reduce overall treatment costs.