【Abstract】 Objective To summarize the application and research status of the hip protector (HP) and to discuss the current problems and further research direction. Methods HP related literature in recent years was reviewed and analyzed. Results Biomechanics experiment studies have shown that HP could protect hip joint from fractures caused by falling, however, the protective effect of HP has not shown clinically. Conclusion HP biomechanical experiments show better protective effect, which may be related with the lower impact energy; in clinical application, poor compliance of HP is considered as the main reason of weak protective effect.
ObjectiveBased on the off-label drug use (OLDU) record application of Alprostadil injection (LipoPGE1) which was the only one rejected in the Guangdong General Hospital in 2013, the interventional measures were carried out to reduce unreasonable off-label drug use of Lipo-PGE1.
MethodsMedical orders about OLDU in dosage of Lipo-PGE1 were intervened in through education, communication and monitoring. The situation of drug use was summarized in all departments after intervention through exporting all the medical orders about inpatients' use of LipoPGE1 during hospitalization in August, 2013 to July, 2014 and OLDU incidence in dosage, prescribed daily dose (PDD) and drug use density (DUD) in each department were calculated. The interventional effect was analyzed by comparing with the baseline data.
Resultsa) A total of 78 044 medical orders involving 6 426 case-times were analyzed. According to the data of cases, medical orders and drug use amount, the OLDU incidences were 8.68%, 5.87% and 10.53%, respectively, compared with 34.43%, 25.16% and 41.37% before intervention had declined significantly (P < 0.05). OLDU occurred in 69.44% departments (25/36) before intervention and declined to 55.56% (20/36) after intervention. b) OLDU incidences of 22 departments were declined after intervention. There were 2 departments with the OLDU incidence in dose > 20%: ICU (39.68%) and cardiac surgery (32.78%). c) After the intervention, the PDD of the whole hospital fell to 10.52μg from 12.77μg and DUD fell to 8.87 from 15.12. There were 20 departments whose PDDs were off-label and 3 departments whose PDDs were above the average level of the whole hospital after the intervention. The three departments were ICU (13.61μg), cardiac surgery (12.68μg) and rheumatology (11.26μg).
ConclusionExtensive publicity and education, targeted communication and regular monitoring and feedback are effective measures to intervene in unreasonable OLDU. After intervention, the phenomenon of off-label drug use of Lipo-PGE1 is improved significantly. This study provides a workable avenue to manage off-label drug use in hospital.
ObjectiveTo analysis the situation of health management service project for patients with hypertension in basic public health service project of Sichuan province from 2015 to 2016, and to provide enhancing suggestions for community prevention of hypertension.MethodsA total of 42 health clinics or community health service centers, 21 counties and 21 cities were extracted each year by method of multistage stratified random sampling from 2015 to 2016. In each institution, we sampled 10 residents, health records of hypertension. Telephone survey was used to judge the accuracy and standard ability of services the patients received according to the national basic public health service specifications, such as personal information, physical examing records, follow up information.The blood pressure of the last follow-up was recorded.ResultsRate of the managed hypertension was from 42.09% to 40.31% (χ2=115.33, P<0.05), rate of the records with accurate information was from 84.29% to 88.79% (χ2=1.94, P=0.16), and rate of the patients received normative services was from 69.49% to 72.33% (χ2=0.54, P=0.57). The control rate of blood pressure was from 82.66% to 85.37% (χ2=0.52, P=0.48). The standardization of the service could obviously improve blood pressure control rates (χ2=22.61, P<0.05).ConclusionProgress has been achieved in health management service of hypertension in Sichuan province from 2015 to 2016, however the standardization of the service is needed to be further enhanced.
ObjectiveTo evaluate the application of modified perineal stapled prolapse resection in treatment of external rectal prolapse, and to assess the preliminary efficacy.
MethodsClinical data of 11 patients with external rectal prolapse underwent modified perineal stapled prolapse resection in The First Affiliated Hospital of Guangzhou University of Chinese Medicine between December 2013 and August 2015 were collected for retrospectively analysis.
ResultsAll patients with external rectal prolapse were performed modified perineal stapled prolapse resection with general anesthesia and (or) epidural anesthesia. The average operation time was (53.6±6.1) min (40-85 min) and the average blood loss was (35.3±10.1) mL (20-60 mL). The time of the first flatus was less than 24 h after operation, the time of the first defecation was (44.6±3.3) h (40-52 h) after operation. The average hospital stay was (9.7±1.8) d (7-12 d) and average cost was (34 635.8±1 268.8) RMB (31 796-36 212 RMB). None of them occurred serious complications such as uncontrollable anastomotic stoma bleeding, anastomotic leakage, pelvic abscess, bowel obstruction, and anastomotic straitness. All of the 11 patients were followed up for (4.7±0.8) months (3-7 months), and all patients did not suffered from recurrence and fecal incontinence during follow-up period.
ConclusionsThe essential procedure for modified perineal stapled prolapse resection is cutting the prolapse open at 3 and 9 clock directly at the same time by linear staplers, and dissecting mesorectum before using the contour satpler. Modified perineal stapled prolapse resection is a safe and effective operation technique for the external rectal prolapse.
Objective To compare perioperative results between transventricular and transatrialtransventricular approaches in repairing tetralogy of Fallot (TOF), and to improve the surgical results. Methods The data of 1 423 consecutive patients who underwent complete repair of TOF between January 1998 and December 2007 were reviewed. 736 patients were repaired by the transventricular approach,and 687 patients by the transatrialtransventricular approach. Results Patients repaired by transventricular approach decreased from 100% in 1998 to 65% in 2002, and by transatrialtransventricular approach increased from 35% in 2002 to 79% in 2007. Aortic clamping time, cardiopulmonary bypass (CPB) time,mechanical ventilation time,and intensive care unit (ICU) stay in patients repaired by transatrialtransventricular approach had less than those in patients repaired by transventricular approach. No difference in transvalve patch ratio.There was lower morbidity in patients repaired by transatrialtransventricular approach in one to two organ systems dysfunction than that in patients repaired by transventricular approach. No difference in three or more organ systems dysfunction between them. Rate of residual ventricular septal defect(VSD), right ventricule to mean pulmonary artery (MPA) pressure gradient, tricuspid regurgitation, pulmonary artery regurgitation and arrhythmia in patients repaired by transatrialtransventricular approach were less than those in patients repaired by transventricular approach. Reoperative rate and mortality in patients repaired by transatrialtransventricular approach were less than those in patients repaired by transventricular approach. Conclusion TOF repair by the transatrialtransventricular approach fits to the actual conditions in China.
Objective To investigate the effects of online follow-up mode and online + offline follow-up mode on rehabilitation after total hip arthroplasty. Methods Patients who underwent total hip arthroplasty in the Department of Orthopedic Surgery, West China Hospital of Sichuan University between August and December 2022 were selected. According to personal preference, the included patients were divided into an observation group and a control group. The observation group underwent comprehensive follow-up mode, while the control group underwent simple online follow-up mode. Joint function, daily living ability, Huaxi Emotional-distress Index, follow-up satisfaction, complications and readmission were compared between the two groups at 3, 8, 26 and 52 weeks after surgery. Results A total of 83 patients were included. Among them, there were 41 cases in the control group and 42 cases in the observation group. There was no statistically significant difference in personal basic information and disease-related data between the two groups (P>0.05). The joint function and daily living ability of the observation group were better than those of the control group at 8, 26, and 52 weeks after surgery (P<0.05). There was no significant difference between the two groups in Huaxi Emotional-distress Index and follow-up satisfaction at 52 weeks after operation (P>0.05). The incidence of complications in the observation group was lower than that in the control group (P<0.05). Conclusions The comprehensive follow-up model has more advantages in direct physical assessment, wound assessment, in-depth communication, timely feedback and adjustment, which can improve patients’ postoperative joint function, enhance their daily life ability, and reduce the occurrence of postoperative complications.
