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        west china medical publishers
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        find Keyword "大型" 26 results
        • 大型“C”臂實時引導下經電子支氣管鏡小導管膿腔沖洗治療肺膿腫的臨床觀察

          目的探討大型"C"臂實時引導下經電子支氣管鏡小導管膿腔沖洗治療肺膿腫的療效。 方法將12例肺膿腫患者隨機分為治療組和對照組, 每組各6例。對照組患者予以止咳、化痰、抗感染及體位引流等常規治療。治療組患者在上述治療的基礎上加用大型"C"臂實時引導下經電子支氣管鏡小導管膿腔沖洗治療。兩組患者的療程均為3周。 結果對照組患者的總有效率為68.8%;治療組患者的總有效率為100.0%, 兩組總有效率比較差異有統計學意義(P<0.05)。治療組患者的住院時間、抗生素應用時間及血降鈣素原恢復正常時間均較對照組明顯縮短(P<0.05)。治療組電子支氣管鏡治療過程中未出現嚴重并發癥。 結論大型"C"臂實時引導下經電子支氣管鏡小導管膿腔沖洗治療肺膿腫具有療效確切、治愈率高、療程短的特點。

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        • Development and application of a real-world-data-based indicator system to evaluate the use of diagnostic large medical equipment

          ObjectivesTo develop a real-world-data-based monitoring system for diagnostic large medical equipment, and to use PET/CT as a carrier for validation. MethodsWe used literature survey, site investigation, and two-rounds of modified Delphi methods to develop the indicator system, and used the analytic hierarchy process method to determine the weight of each indicator. We collected real-world PET/CT data from four tertiary hospitals from July to December 2022, and monitored the use of PET/CT in each hospital. ResultsQuestionnaire recovery rates of 2 rounds were 100% and 88%, respectively, the expert authority coefficient was greater than 0.70, and the coordination coefficients of experts in the total index were 0.307 and 0.471 (P<0.001). A three-level indicator system was established to monitor the use of large medical equipment, with three first-level indicators (clinical use, implementation, and other efficiencies), eight second-level indicators, and 15 third-level indicators. Empirical experiment found different hospitals vary in efficiency (of clinical use), staff status, and economic and research efficiency, while remained similar in other indicators. ConclusionWe developed a monitoring system for diagnostic large medical equipment based on real-world data, and used PET/CT as a carrier for validation. These findings provided theoretical and empirical foundations for the management of diagnostic large medical equipment in China.

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        • The analysis of outpatient navigation service system in large hospitals

          Objective To optimize the environment of outpatient clinics in large hospitals, facilitate the patients’ visits and improve the comprehensive management level. Methods From September to November 2015, 2 hospitals in each part of a provincial city (middle, east, west, north and south), a total of 10 hospitals were chosed by convenient sampling method. The forms, types and distribution of outpatient navigation service system were investigated and analyzed by using a self-designed questionnaire. Results There were a total of 14 forms of counseling-guide services in the 10 hospitals. Just 1 hospital provided all the 14 forms of counseling-guide services, and 2 hospitals provided 13 forms of counseling-guide services, which were relatively complete. While the other 7 large hospitals provided only 4 to 6 forms of counseling-guide services, which were relatively simple. Conclusion Qualified outpatient navigation service system can help patients to receive more effective treatment, optimize the environment, highlighting the modern hospital humanistic service and the concept of intelligent service and scientific management.

          Release date:2017-09-22 03:44 Export PDF Favorites Scan
        • Exploration of big data management of personnel in large-scale general hospitals based on personnel information system

          According to the characteristics of the diversified employment system of general hospitals, we have independently developed a set of personnel information platforms suitable for our hospital's operating model and work-flow which achieved establishing a novel big data management model for big personnel. After a year of trial operation, the big data management of personnel has completely covered the target management and requirements of the hospital, covering basic quality, public services, teaching work, medical work, scientific research, and other dimensions of information, which helped the hospital constructed a systematically networked and full-coveraged, personnel information system with strong early warning functions and incentives, enabling the reasonable utilization rate of human capital and continuous improvement of the quality of talent training.

          Release date:2021-07-22 06:18 Export PDF Favorites Scan
        • Application and value of bibliometrics in evidence-based hospital disciplinary management practices

          Efficient disciplinary management in hospitals plays an important role in improving the level of medical services, promoting talent development, elevating research levels, and enhancing the overall strength of hospitals. At present, large comprehensive hospitals are facing increasingly complex challenges and problems in disciplinary construction and management. Bibliometrics, as a tool for literature analysis and evaluation, can assist hospitals in carrying out disciplinary management. This article explores the application and value of bibliometrics in hospital disciplinary management from the perspectives of disciplinary planning, optimizing resource allocation, evaluating disciplinary level, and exploring hot topics and development trends in disciplinary fields, and hopes to provide reference and ideas for peers.

          Release date:2023-12-25 11:45 Export PDF Favorites Scan
        • Research on the usage behavior of scientific research management system in public hospitals based on unified theory of acceptance and use of technology

          Objective To explore the influencing factors of the usage behavior of the scientific research management system and provide references for hospitals in constructing scientific research management systems. Methods Data were collected through questionnaires in April 2024. Based on the unified theory of acceptance and use of technology (UTAUT), the information system success model, and the self-efficacy theory, a research model on the influencing factors of the usage behavior of the scientific research management system among medical staff was constructed from the dual perspectives of users and information systems. The structural equation model was utilized to explore the influencing factors of the usage behavior of the scientific research management system. Results A total of 527 questionnaires were collected. Among them, there were 157 males and 370 females. The overall Cronbach α coefficient of the questionnaire was 0.916, and the KMO value was 0.896. For Bartlett’s test of sphericity (P<0.001). The composite reliability of each latent variable was greater than 0.7, and the average variance extracted was greater than 0.5. Therefore, this questionnaire had good reliability and validity. The research showed that information quality, performance expectancy, effort expectancy, and system quality all had significant positive impacts on the usage intention of users of the scientific research management system (P<0.05). Meanwhile, facilitating conditions and usage intention both had significant positive impacts on the usage behavior of users (P<0.05). Conclusions The construction of the scientific research management system should be guided by management needs, comprehensively sort out the general scientific research work needs of medical staff. Through the apply information-based means, various forms of training, and strengthening policy guidance, the aim is to improve the intelligence level of system operations, enhance the convenience of user self-service, and promote the effective construction of the ecosystem of the scientific research management system.

          Release date:2024-12-27 02:33 Export PDF Favorites Scan
        • Comparison of different transforaminal endoscope approaches in treatment of serious lumbar disc herniation

          ObjectiveTo investigate the difference between four transforaminal endoscopic approaches in the treatment of serious lumbar disc herniation.MethodsBetween October 2010 and February 2015, a total of 122 patients with serious lumbar disc herniation were enrolled and treated with discectomy under transforaminal endoscope. The patients were divided into 4 groups according to the different approaches. The transforaminal endoscopic spine system (TESSYS) technology was used in group A (31 cases), Yeung endoscopic spine system (YESS) technology was used in group B (30 cases), improved transforaminal endoscopic access (ITEA) technology was used in group C (31 cases), and interlaminar dorsal access (IDA) technology was used in group D (30 cases). There was no significant difference in gender, age, disease duration, lesion segment, and preoperative visual analogue scale (VAS) score of low back pain, VAS score of bilateral lower extremities pain, Oswestry disability index (ODI), intervertebral height, lumbar curvature index (LCI), and disc degeneration grading between groups (P>0.05). The removal volume of nucleus pulposus was compared; after operation, VAS score, ODI score, LCI, intervertebral height, and disc degeneration grading were used to evaluate the effectiveness.ResultsThe removal volumes of nucleus pulposus in groups A, B, C, and D were (3.6±0.9), (3.5±0.7), (4.6±1.0), (3.1±1.1) cm3, respectively. There were significant differences between groups (P<0.05). All incisions healed by first intention, and no early postoperative complications was found. All cases were followed up 12-35 months, with an average of 24 months. During follow-up, there was no recurrence of nucleus pulposus herniation, infection of intervertebral space, cerebrospinal fluid leakage, epidural hematoma, or other complications. At last follow-up, the VAS scores of low back pain and bilateral lower extremities pain, and ODI scores in each group significantly improved when compared with those before operation (P<0.05); there was no significant difference in the scores and improvements between groups after operation (P>0.05). At last follow-up, the disc degeneration grading in group B significantly improved when compared with that before operation (P<0.05); there was no significant difference between groups (P>0.05). At last follow-up, there was no significant difference in LCI of each group when compared with that before operation (P>0.05); and there was no significant difference in LCI and loss value between groups (P>0.05). There was no significant difference in the intervertebral height of the 4 groups at immediate after operation and last follow-up when compared with preoperative value (P>0.05), and there was no significant difference between groups at immediate after operation and last follow-up (P>0.05).ConclusionApplication of transforaminal endoscope in the treatment of serious lumbar disc herniation has great clinical outcomes. The ITEA technology can obtain a wider field of view and be more convenient to find and remove the degenerative nucleus pulposus. However, the appropriate approach should be selected according to the symptoms and characteristics of lumbar disc herniation.

          Release date:2020-04-15 09:18 Export PDF Favorites Scan
        • Percutaneous occlusion of major aortopulmonary collaterals in children after cardiac surgery

          Objective Tho evaluate the outcomes of early percutaneous occlusion of these residual major aortopulmonary collateral arteries after heart surgery. Methods This was a retrospective review of children undergoing early percutaneous embolization of major aortopulmonary collateral arteries after cardiac surgery. From January 2013 to February 2017, 52 consecutive patients with postoperative residual major aortopulmonary collateral arteries were treated with percutaneous embolization (38 males, 14 females; median age of 10.0 months, interquartile range 14.0 months; median weight 8.6 kg, interquartile range 4.4 kg). Fifty-one patients were cyanotic and 1 patient was acyanotic. Forty-nine patients underwent corrective surgery and 3 patients underwent B-T shunt. Results Typical symptoms and signs of major aortopulmonary collateral arteries included: elevated left atrial pressure; focal lung infiltration, pink or blood-stained frothy sputum. The median time interval from cardiac surgery to percutaneous occlusion of major aortopulmonary collateral arteries was 5 (9) d, median duration of mechanic ventilation support since occlusion was 72 (159) h, mechanic ventilation support was 239 (480) h and median duration of intensive care unit was 19 (29) d. There was no death in this group. Conclusion Angiocardiography could be able to demonstrate the existence of postoperative major aortopulmonary collateral arteries. The early percutaneous occlusion appears to be simple, safe and effective.

          Release date:2018-06-26 05:41 Export PDF Favorites Scan
        • Analysis and discussion on the 3-year physical examination results of employees in a large financial enterprise

          Objective To investigate and analyze the 3-year physical examination results of the employees of a large financial enterprise in Chengdu, explore the key factors of health management and provide scientific basis for implementing reasonable health management. Methods The physical examination results of the employees of a large financial enterprise in Chengdu from 2012 to 2014 were analyzed, and the common abnormal results in the physical examination were summarized. Results The proportion of the employees whose physical examination results were completely normal in 2012, 2013, and 2014 was 4.97%, 2.01%, and 1.48%, respectively, showing a decreasing trend. Overweight, fatty liver and elevated triglycerides were always the top three of the abnormal examination results; the detection rates of which in the male staff were much higher than those in the female staff (P<0.05). In the female staff, the detection rate of overweight was always in the first place; the detection rate of columnar ectopy was always in the top three; the detection rate of liver cyst was in third place in 2013; and the detection rate of Nabothian cyst was in the second place in 2014. Conclusion The health management program of employees of this large financial enterprise is poor, thus health management should be paid enough attention to improve the employees’ physical quality.

          Release date:2017-10-27 11:09 Export PDF Favorites Scan
        • Endoscopic Reversal Mucosal Resection for Ultra-low Rectal Large Laterally Spreading Tumor

          目的 探討內鏡反轉黏膜切除術治療超低位直腸大型側向發育型腫瘤的價值。 方法 回顧性分析四川大學華西醫院消化內鏡中心2010年1月-2011年12月間38例內鏡反轉黏膜切除術治療超低位直腸大型側向發育型腫瘤病變殘留、治療效果。 結果 38例患者,男18例,女20例,年齡8~80歲;病變下緣距肛門齒狀線1~4.0 cm24例,侵及齒狀線14例。病變大小(按病變最大徑分類):1.5~3.0 cm 12例,3.1~4.0 cm 8例,4.1~5.0 cm4例,5.1~7.0 cm 10例,10 cm 4例。病變直徑在5.0 cm以下的24例患者,經首次手術治療腫瘤完整切除,術后2例灶性癌變,追加外科手術;其余22例2個月復查,病變無殘留,6個月復查,2例復發,經再次手術病變完整切除。隨訪1年,全部未見復發,治愈率為100%,無殘留。病變直徑5.1~7.0 cm的10例患者,經首次手術治療腫瘤分次切除,2個月復查,6例病變完整切除無殘留,6個月復查,其中2例復發,經再次內鏡下手術切完病變,隨訪1年,無復發;另4例有殘留,經再次內鏡下手術切完病變,6個月復查無復發,隨訪1年,4例均未見復發。病變直徑10 cm 的4例患者,經多次手術后復查均有病變殘留,無法完全切除,患者拒絕外科手術。5.1 cm以上病變治愈率71.43%,殘留率高達57.14%。本組術后出血16例,感染1例,直腸狹窄1例,肛門墜脹3例,無穿孔發生。 結論 內鏡反轉黏膜切除術治療超低位直腸大型側向發育型腫瘤有效,對5.0 cm以下病變能一次完整切除,5.1 cm以上病變殘留率高,需再次內鏡下手術,10 cm以上病變切除不完全。應慎重選擇病例,術后密切隨訪。

          Release date:2016-09-07 02:34 Export PDF Favorites Scan
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