This article introduces the exploration and establishment of “grass-roots Party building + targeted poverty alleviation” model by the Party Branch of Emergency Department of West China Hospital of Sichuan University, and discusses how to establish the “trinity mode” of management support, personnel training, and on-site guidance under the leading of grass-roots Party building through a series of the branches combined activities, according to the core idea of “strengthening the Party construction, bringing people closer together, and promoting development”. The aim is to form a long-term mechanism of grass-roots Party building and targeted medical poverty alleviation through continuously implementing this model, which can benefit more people in remote and ethnic minority areas and contribute to “Healthy China 2030”.
Objective To explore the concept, contents and existing problems of the fast-track programmes in colorectal surgery. Methods The literatures about the applied status and opinion of the modality applied in the surgical treatment of the colorectal cancer and fundament investigation in recent years were collected and reviewed. Results The fast-track programmes enhance recovery of the patients who underwent the colorectal resection with the combination of multimodal techniques and approaches. Conclusion The fast-track programmes in colorectal surgery is the typical modality of the multi-disciplinary treatment, this modality can decrease the complications and reduce the hospital stay with preserve the well physiological fundament of the patients.
Brain computer interface is a control system between brain and outside devices by transforming electroencephalogram (EEG) signal. The brain computer interface system does not depend on the normal output pathways, such as peripheral nerve and muscle tissue, so it can provide a new way of the communication control for paralysis or nerve muscle damaged disabled persons. Steady state visual evoked potential (SSVEP) is one of non-invasive EEG signals, and it has been widely used in research in recent years. SSVEP is a kind of rhythmic brain activity simulated by continuous visual stimuli. SSVEP frequency is composed of a fixed visual stimulation frequency and its harmonic frequencies. The two-dimensional ensemble empirical mode decomposition (2D-EEMD) is an improved algorithm of the classical empirical mode decomposition (EMD) algorithm which extended the decomposition to two-dimensional direction. 2D-EEMD has been widely used in ocean hurricane, nuclear magnetic resonance imaging (MRI), Lena image and other related image processing fields. The present study shown in this paper initiatively applies 2D-EEMD to SSVEP. The decomposition, the 2-D picture of intrinsic mode function (IMF), can show the SSVEP frequency clearly. The SSVEP IMFs which had filtered noise and artifacts were mapped into the head picture to reflect the time changing trend of brain responding visual stimuli, and to reflect responding intension based on different brain regions. The results showed that the occipital region had the strongest response. Finally, this study used short-time Fourier transform (STFT) to detect SSVEP frequency of the 2D-EEMD reconstructed signal, and the accuracy rate increased by 16%.
We described our understanding of EBM, the ‘three principles＇ and ‘five steps＇ to practice it. EBM is an embodiment of human moral rule and axiom in clinical medicine; it is an advanced clinical model and medical practical methodology; it results from a basis of developed and perfected clinical research methodology, best evidence database, information technology. We also discussed the relationship between EBM and traditional Chinese medicine （TCM） modernization. The definition of modernization of TCM was suggested as scientifical standardization and internationalization. TCM theory in fact is not a basic but a clinical practice theory. EBM model should become the standard model of TCM practice to accelarate the standardization of TCM diagnostic technique and therapy. The key is not try to explain TCM theories with modern medical theroies, but work out common effectiveness evaluation criteria. Only when the effectiveness is intemationally acknowledged, can TCM be internationalized.
Day surgery is regarded as a breakthrough in promoting the construction of hierarchical diagnosis and treatment because of its advantages such as effectively shortening the length of hospital stay and making full use of medical resources. In order to comply with the national policies, medical development, patient needs, and other factors, as a comprehensive tertiary hospital, Zhengzhou Central Hospital Affiliated to Zhengzhou University taking regional synergy as a carrier, combining with 92 medical units, actively explores the rational flow of patients with day surgery in the region, through implementing clinical path management, controlling surgery expenses and drug and consumables proportions, purchasing medical health insurance for day surgery patients to ensure patient safety, opening a green channel for patients at the grassroots level, effectively using the medical insurance to co-ordinate funds, and rationally planning medical treatment procedures, ect.
Objective To evaluate the clinical features of acute macular neuroretinopathy (AMN) associated with COVID-19. MethodsA retrospective case series studies. A total of 12 eyes of 8 patients diagnosed of AMN associated with COVID-19 at Peking University People’s Hospital from December 5, 2022 to January 5, 2023 were included. Of the 8 patients, 2 were male (4 eyes) and 6 were female (8 eyes), with an average age of (29.38±8.60) years. All patients underwent best-corrected visual acuity (BCVA), spectral-domain optical coherence tomography (OCT), and infra-red fundus photography (IR). After definite diagnosis, the patients were given symptomatic treatment such as local vasodilation, anti-inflammatory and systemic circulation improvement and nutritional nerve. Follow-up time was 21-30 days weeks. Clinical manifestations, OCT and IR image characteristics, and treatment outcomes were retrospectively analyzed. ResultsThe time from diagnosis of COVID-19 to the onset of ocular symptoms was (3.00±0.93) days. Among 12 eyes, 6 had complaints of paracentral scotoma, with 2 of them accompanied by visual acuity loss; and 6 had complaints of dark shadows in the vision, with 2 of them accompanied by visual acuity loss. At the initial examination, 2 eyes had a BCVA of less than 0.05, 2 eyes had a BCVA between 0.4 and 0.6, and 8 eyes had a BCVA between 0.8 and 1.0. At the last follow-up, visual symptoms improved in 7 eyes and remained unchanged in 5 eyes. Fundus color photography showed reddish-brown lesions in the macular area. Spectral-domain OCT revealed localized thickening and strong reflection of the outer plexiform layer (OPL) in the macular area, patchy strong reflections in the outer nuclear layer (ONL), and varying degrees of local discontinuity in the adjacent external limiting membrane, ellipsoid zone/interdigitation zone (EZ/IZ), with reduced local reflection in the adjacent retinal pigment epithelium layer in 2 eyes. The strong reflection area of the ONL on corresponding structural OCT was observed more clearly as a lesion range with strong reflection on en-face OCT. The incomplete structure of the EZ/IZ band was observed more clearly as a lesion range with weak reflection on en-face OCT. IR showed several clear-bordered and weakly reflecting lesions at the center of the macula, with the tip pointing to the fovea. ConclusionsAMN associated with COVID-19 tends to occur in young females. The OCT findings of AMN are characterized by strong reflections in the OPL and ONL, and lesion ranges can be observed more clearly at different levels using en-face OCT. The lesions on IR appear as weak reflections.
Objective To compare administration of incidence reporting systems for healthcare risk management in the United Kingdom, the United States, Canada, Australia, and Taiwan, and to provide evidence and recommendations for healthcare risk management policy in China. Methods We searched the official websites of the healthcare risk management agencies of the four countries and one district for laws, regulatory documents, research reports, reviews, and evaluation forms concerned with healthcare risk management and assessment. Descriptive comparative analysis was performed on relevant documents. Results (1) A total of 142 documents were included in this study. The United States had the most relevant documents (68). (2) The type of incidents from reporting systems has expanded from medication errors and hospital-acquired infections to near-misses, and now includes all patient safety incidents. (3) The incidence-reporting systems can be grouped into two models: government-led and legal/regulatory/NGO-collaborative. (4) In two cases, reporting systems were established for specific incident types: One for death or serious injury events (the sentinel events database in Britain, SIRL), and one for healthcare-associated infections (NHSN in America). (5) Compared to the four countries, Taiwan’s system put more emphasis on public welfare, confidentiality, and information sharing. The contents of reporting there covered every aspect of risk management to create a more secure environment. Conclusion (1) Britain’s national reporting and learning system was representative of a government-led model; (2) The United States was the earliest country to have a reporting system, which included a limited range of incident types. Management of incidents became more reliable with increased application of laws, regulations, and guidances; (3) Both the Canadian and the Australian systems drew from the American experience and are still developing; (4) The Taiwanese system was comprehensive and is an instructional case.
It is difficult to select the appropriate ventilation mode in clinical mechanical ventilation. This paper presents a nonlinear multi-compartment lung model to solve the difficulty. The purpose is to optimize respiratory airflow patterns and get the minimum of the work of inspiratory phrase and lung volume acceleration, minimum of the elastic potential energy and rapidity of airflow rate changes of expiratory phrase. Sigmoidal function is used to smooth the respiratory function of nonlinear equations. The equations are established to solve nonlinear boundary conditions BVP, and finally the problem was solved with gradient descent method. Experimental results showed that lung volume and the rate of airflow after optimization had good sensitivity and convergence speed. The results provide a theoretical basis for the development of multivariable controller monitoring critically ill mechanically ventilated patients.
ObjectiveTo develop Knowledge attitude behavior and practice (KABP) health education path table, and to explore its application in health education of physician-nurse collaboration for children with epilepsy, and provide practical reference for health education of children with epilepsy.MethodsA convenient sampling method was used to select 94 family units of children with epilepsy and their main caregivers from the Department of Neurology in Hunan Children’s Hospital from September 2018 to March 2019. Divided into observation group and control group, 47 cases in each group. In the control group, the health care education was carried out by the conventional method of medical personnel’s one-way input of knowledge. The observation group conducted health education through interactive participation in the path of the health education path of KABP on the basis of regular health education. Then compared the effect of the health education between the two groups.ResultsAfter the intervention, the quality of life scores of the observation group were significantly higher than the control group (P<0.01). The relevant knowledge scores of main caregivers at 1 and 3 months after discharge were significant higher than those in the control group (P=0.008, P=0.001). The medication compliance scores of children with epilepsy at 1 and 3 months after discharge were significant higher than those in the control group (P=0.010, P=0.006).ConclusionsThe KABP health education pathway can improve the knowledge level of caregivers, as well as the medication compliance and quality of life of children with epilepsy.
Objective To analyze the scientific research output of West China Hospital of Sichuan University from 2015 to 2020, so as to evaluate the effectiveness of new scientific research management model. Methods From January 2018, a series of management measures were introduced, including improving research incentive policies, integrating and supporting resources, constructing a scientific quantitative research performance evaluation system, and establishing an information-based research service model. The changes of scientific research output before (2015-2017) and after (2018-2020) the implementation of the management measures were analyzed to evaluate the quality and effectiveness of the management model. Results A total of 10141 high-quality research papers were seized and 2311 research projects were approved. After the implementation of the measures, the absolute number of papers published and projects approved increased significantly. In terms of high-quality papers published after the implementation of the measures, the increase rate reached 46.80%, among which the number of interdisciplinary papers increased by 116.05%, the number of reviews increased by 96.13%, the numbers of papers published in Area 2 and Area 1 increased by 114.67% and 75.00%, respectively, and the number of co-author papers increased by over seven times. In terms of scientific research projects approved after the implementation of the measures, the number of projects approved by the National Natural Science Foundation of China (NSFC) increased by 21.03%, and the number of provincial and ministerial projects increased by 110.17%, with the people in charge becoming younger. The number of principal investigators of NSFC increased by 1.67 times. The number of projects managed by intermediate and undetermined professional titles increased by 64.71% and 68.63%, respectively. The number of projects approved by youth and general fund increased by 30.26% and 14.16% respectively. The number of people in charge of provincial and ministerial projects increased by 1.45 times. The number of projects managed by deputy senior and intermediate titles increased by 1.64 times and 1.54 times, respectively. Key research and development projects, key projects, international cooperation projects, and basic application projects saw a significant increase. Conclusions After the implementation of management measures, the number and overall level of research papers have been improved, and the cross-cooperation between clinical and basic research has been gradually started. The number of projects approved increased significantly, and the project leaders tended to be younger. The high-quality cultivation and continuous growth of scientific research talents achieved initial results.
