ObjectiveTo systematically evaluate the efficacy and safety of computer-aided detection (CADe) and conventional colonoscopy in identifying colorectal adenomas and polyps. MethodsThe PubMed, Embase, Cochrane Library, Web of Science, WanFang Data, VIP, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) comparing the effectiveness and safety of CADe assisted colonoscopy and conventional colonoscopy in detecting colorectal tumors from 2014 to April 2023. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included literature. Meta-analysis was performed by RevMan 5.3 software. ResultsA total of 9 RCTs were included, with a total of 6 393 patients. Compared with conventional colonoscopy, the CADe system significantly improved the adenoma detection rate (ADR) (RR=1.22, 95%CI 1.10 to 1.35, P<0.01) and polyp detection rate (PDR) (RR=1.19, 95%CI 1.04 to 1.36, P=0.01). It also reduced the missed diagnosis rate (AMR) of adenomas (RR=0.48, 95%CI 0.34 to 0.67, P<0.01) and the missed diagnosis rate (PMR) of polyps (RR=0.39, 95%CI 0.25 to 0.59, P<0.01). The PDR of proximal polyps significantly increased, while the PDR of ≤5 mm polyps slightly increased, but the PDR of >10mm and pedunculated polyps significantly decreased. The AMR of the cecum, transverse colon, descending colon, and sigmoid colon was significantly reduced. There was no statistically significant difference in the withdrawal time between the two groups. Conclusion The CADe system can increase the detection rate of adenomas and polyps, and reduce the missed diagnosis rate. The detection rate of polyps is related to their location, size, and shape, while the missed diagnosis rate of adenomas is related to their location.
Skeletal muscle and metabolic function are important factors affecting the health status of the elderly. Branched-chain amino acids (BCAA) can improve muscle recovery, reduce muscle soreness after exercise, and BCAA can also enhance metabolic health, helping to regulate blood sugar levels and improve insulin sensitivity in the elderly. In addition, BCAA can improve cognitive function, reducing the risk of age-related cognitive decline. This article reviews the relationship between BCAA and aging, skeletal muscle, and metabolic diseases, explaining how BCAA can support and promote muscle mass and function in the elderly, as well as have a positive impact on metabolic health and cognitive function.
ObjectiveTo explore the effect of doctor-nurse-patient communication area established in the ward.
MethodsBefore (July to September 2013) and three months after (October to December 2013) the establishment of doctor-nurse-patient communication area, 30 doctors, 30 nurses and 216 patients or their family members were respectively investigated by questionnaires and interviews, and the data were collected and compared by t test.
ResultsThirty questionnaires for doctors, 30 for nurses and 216 for patients or their family members were issued before and after the establishment of doctor-nurse-patient communication area. The response rate for the questionnaires was 100%. After the implementation of doctor-nurse-patient communication area, the satisfaction of patients' family members, nurses' awareness of the patients' condition and implementation of health education were significantly higher than those before the implementation (P < 0.05).
ConclusionThe doctor-nurse-patient communication area established in the surgical ward can promote the trust between the patients and medical staff, create a good atmosphere to understand the needs of patients, meet patients' demand as far as possible and improve communication ability of medical staff, which makes doctors, nurses and patients more satisfied.
ObjectiveTo explore the effect of "HIS" nursing service mode in promoting the quality of clinical nursing service for key specialties in the department of gastrointestinal surgery.
MethodsIn the Department of Gastrointestinal Surgery, West China Hospital of Sichuan University, "HIS" nursing service mode was carried out on January 1, 2012.Questionnaires surveying hospitalized patients' satisfaction before (n=360, between January and December 2011) and after (n=360, between January and December 2012) the implementation of "HIS" nursing service mode were retrospectively compared and analyzed.
ResultsThe patients' general satisfaction score was improved significantly from 83.27±5.71 to 97.92±6.23 after the implementation of "HIS" nursing service mode (t=-8.001, P < 0.05).For all the 14 items in the satisfaction questionnaire, the differences before and after the implementation had statistical significance (P < 0.05).
ConclusionThe "HIS" nursing service mode can effectively improve patients' satisfaction of clinical nursing service for key specialties in the department of gastrointestinal surgery, and it is worthy of further promotion.
ObjectiveTo explore the leakage management and skin care by improved homemade portable vacuum sealing drainage device used for enterocutaneous fistula, in order to solve such confusing problems as leakage collection and nursing for patients with inconvenient activity.
MethodsThe homemade portable vacuum sealing drainage device was made by using hydrophilic fiber of silver ion antimicrobial dressings, leak-proof strings, skin protective film, transparent patches, sputum suction tube, bottle of portable infusion, and negative pressure drainage bottle. Between January 2011 and September 2013, patients with enterocutaneous fistula admitted into our hospital were divided into traditional treatment group and portable vacuum sealing treatment group according to the admission time, and traditional center negative pressure suction treatment and portable negative pressure drainage method were used respectively for the two groups of patients. We verified the effect of the mobile vacuum sealing drainage device through comparing these two groups in terms of wound healing time, redness, burst and impregnation of the skin.
ResultsThe wound healing time was significantly shorter for patients in the portable vacuum sealing drainage treatment group (P<0.05), and patients in this group also had a lower occurrence of skin redness, impregnation and burst.
ConclusionHomemade portable negative pressure drainage device for enterocutaneous fistula patients can reduce the incidence of skin complications such as redness, impregnation and burst, promote patients' activity, and reduce the patients' pain.
ObjectiveTo evaluate the infiuence of doctor-nurse double check table applied before operation on the completion of preoperative preparation in gastrointestinal surgery department of class-three grade-one hospitals.
MethodsA total of 647 selective operation patients from April to September 2013 in the Department of Gastrointestinal Surgery were divided into observation group (n=315) and control group (n=332) based on admission time. After training for medical staff, the check tables were filled, and relatively high frequency issues were followed up for quality tracking. The completion of preoperative preparation was compared between the two groups after operation.
ResultsCompared with the control group, the completion of preoperative preparation and satisfaction of patients of the observation group were significantly higher and the operation delay was significantly lower (P<0.05).
ConclusionPreoperative application of doctor-nurse double check table can significantly improve the completion rate of preoperative preparation, the operation delay phenomenon and satisfaction of patients, promote the communication between doctors and nurses, reduce the risk of operation, and ensure the safety of surgical patients.
【摘要】 目的 調查胃癌患者的營養風險及營養支持應用現狀。 方法 2009年9月-2010年1月，對某三甲醫院普外科收治的120例胃癌住院患者營養情況進行營養風險篩查2002（nutritional risk screening 2002，NRS 2002）評估，并就營養支持應用方式進行分析。 結果 所有患者中營養不足和營養風險的發生率分別為11.7%和27.5%；在33例有營養風險患者中，有26例（78.8％）接受了營養支持；在無營養風險的87例患者中，有30例（34.5％）接受了營養支持。 結論 對有營養風險的患者進行必要的營養支持，對于減少患者住院期間感染性并發癥或其他不良臨床結局的發生有積極作用。NRS 2002的方法簡便，適用于胃癌患者的營養風險篩查，但醫護人員需要進一步加強對腸外、腸內營養指南的認識。【Abstract】 Objective To investigate the clinical situation of nutritional risk screening for hospitalized patients with gastric cancer. Methods From September 2009 to January 2010, we applied nutrition risk screening 2002 (NRS 2002) to investigate the nutritional status of 120 hospitalized gastric cancer patients in the surgery department of a tertiary hospital, and analyzed the way of nutritional support for these patients. Results Among all the patients, the incidences of undernutrtion and nutritional risk were respectively 11.7% and 27.5%. Twenty-six out of the 33 nutritional risk patients received nutrition support, and 30 out of the 87 patients without nutritional risk received nutrition support. Conclusions Nutritional support for patients with nutritional risk is important in decreasing the occurrence of in-hospital infectious complications and other bad clinical outcomes. NRS 2002 is a simple and easy tool for predicting the nutrition risk in hospitalized gastric cancer patients, but the guideline of enteral nutrition and parenteral nutrition must be reinforced among doctors and nurses.
