The annual incidence of diabetic foot ulcers in China is as high as 8.1%, which ranks first among the causes of chronic wounds in China. Although through the efforts of several generations of podiatrists and the building of multidisciplinary collaboration team, the major amputation rate in patients with diabetic foot ulcers in China has been decreased significantly, it is still far higher than the level of developed countries in Europe and the United States. Therefore, in order to cope with the increasing occurrence and recurrence of refractory diabetic foot ulcers, in addition to further optimizing the construction of multidisciplinary collaboration team, it is an urgent topic for us to explore the construction of a multidisciplinary integrated team to seamlessly connect the diagnosis and treatment of different aspects of foot disease. This article describes the importance and necessity of building a wound repair center with Chinese characteristics, which is a model of multidisciplinary integrated team, aiming at provide a theoretical basis for establishing a multidisciplinary integrated management model and realizing seamless connection between diagnosis and treatment, so as to further improve the cure rate of diabetic foot ulcers.
Ambulatory surgery ward is a fast and effective way of treating, nursing and patients’ education. We report the practice of ambulatory surgery ward in West China Hospital of Sichuan University about patients’ reception, treatment and nursing, medical safety, health education and post-operative follow-up. Results show that ambulatory surgery ward would guarantee patients’ safety, shorten hospitalization days and decrease medical cost, with more than 98% of patients’ satisfaction.
Objective
To explore the application effects of innovative health education on patients undergoing ambulatory laparoscopic cholecystectomy (LC).
Methods
A total of 139 patients undergoing ambulatory LC from November to December 2016 were selected as the control group, receiving the traditional health education; and other 141 patients undergoing ambulatory LC from February to March 2017 were selected as the observation group, receiving the innovative health education. The two groups were followed up and observed 1 day, 2, and 28 days after the discharge, and the incidence rates of adverse reactions such as postoperative pain, bleeding and incision infection were measured, and the disease knowledge mastery, self-care skills, medication compliance and satisfaction to nursing and hospital were evaluated.
Results
The total incidence rate of adverse reactions was 7.8% in the observation group and 25.2% in the control group (P<0.001). Medication compliance from high to low was 90, 46 and 5 cases in the observation group and 59, 64 and 16 cases in the control group (P<0.001). In the observation group, the scores of disease knowledge mastery, self-care cognition, nursing satisfaction and hospital satisfaction were 93.4±5.5, 91.4±4.5, 96.4±3.7 and 98.1±3.7, respectively, which were higher than those in the control group (83.8±8.7, 83.2±9.1, 91.5±9.2 and 94.8±7.3, respectively) with statistical significance (P<0.001).
Conclusion
Innovative health education has certain application effects on ambulatory LC, and it can significantly improve disease knowledge mastery and self-care cognition, and help to ensure the medical quality and safety during perioperative period, and improve the patients’ satisfaction.
Objective To understand the incidence and severity of postoperative acute pain in patients undergoing day surgery, and to explore the influencing factors of moderate to severe pain after surgery, so as to provide a reference for pain management in day surgery. Methods Convenience sampling method was used to select patients undergoing day surgery under multi-modal pain management in West China Hospital of Sichuan University between April and August 2020, and the general conditions, surgical conditions, and postoperative pain of the patients were investigated. According to the degree of postoperative pain, patients were divided into mild pain group and moderate to severe pain group. Logistic regression analysis was used to explore the influencing factors of postoperative pain in the two groups. Results A total of 509 patients were finally included, of which 69 patients presented with moderate to severe pain. Logistic regression analysis showed that patient age [odds ratio (OR)=0.970, 95% confidence interval (CI) (0.946, 0.993), P=0.012], pain threshold [OR=1.348, 95%CI (1.048, 1.734), P=0.020] and postoperative drainage tube [OR=2.752, 95%CI (1.090, 6.938), P=0.017] were the influencing factors of moderate to severe pain after surgery. Conclusion Under multimodal pain management, the incidence of moderate to severe pain in day surgery patients is low, and medical staff should further strengthen pain management from the factors affecting pain to reduce the incidence of moderate to severe pain after surgery.
ObjectiveTo establish a systematic, scientific, and sensitive index system to provide a scientific basis for quality evaluation and comprehensive quality management of day surgery nursing.MethodsThe databases of Wanfang, China National Knowledge Infrastructure, CQVIP, PubMed, and Web of Science were searched. The retrieval time was from the establishment of the databases to 15th July, 2019. Based on the “structure-process-outcome” management model, Delphi method was used to conduct two rounds of expert consultation for nursing experts related to day surgery in five tertiary hospitals. The results of the consultation were sorted out and the consensus of experts was obtained, so as to determine the quality-sensitive indicators of day surgery nursing.ResultsA total of 20 nursing experts participated in the questionnaire survey. The final evaluation indicators determined by expert correspondence included 1 structural indicator, 9 process indicators, and 4 outcome indicators.ConclusionsThe construction of quality evaluation standard of day surgery nursing not only embodies the connotation of nursing management of day surgery, but also puts forward clear requirements and quality standards for specialized nursing management. It has high reliability, scientificity, and strong operability, which can effectively improve the quality of nursing management and service level of day surgery.
Objective:To observe the inhibited effect and its mechani sm of estro gen on lightinduced apoptosis of retinal photoreceptor cells.
Methods:Twenty female Sprague-Dawley rats were randomly divided into two groups: ovariectomized (OV) group and OV and estrogen (E2) replacement (OV+E2) group, with 10 rats in each group. All of the rats were exposed to the cyclic illumination under 12 hou r light and 12 hour dark condition with the light intensity of (600plusmn;35.4) lx ( a total of 14 times). All of the right eyes were extracted and the thickness of r etinal outer nuclear layer (ONL) was measured. Terminal deoxynucleotidyl Transfe rasemediated dUTP nick end labeling (TUNEL) method was used to evaluate positi v e apoptosis cells in ONL. The expression of nitric oxide synthase (NOS) in retin al cells was detected by immunohistochemistry with image analysis method.
Results:The thickness of ONL in OV group was obviously thinner than that in the OV+ E2 group. The number of positive apoptosis of the cells was (0.0275plusmn;0.0069) c el ls/mu;m2 in OV group and (0.0162plusmn;0.0054) cells/mu;m2 in OV+E2group; the di fferen ce between the two groups was significant (t=4.1370，P=0.0012). The values o f in tegral optical density of NOS positively stained cells in retinal inner nuclear layer was (0.3675plusmn;0.0662) in the OV group and (0.2941plusmn;0.0350) in OV+E2 group ; the difference between the two groups was significant (t=3.4885, P=0.0031).
Conclusion:Estrogen can protect retina from light injuries by regu lating NOS synthesis and inhibiting apoptosis of photoreceptor cells.
ObjectiveTo evaluate the protective effect of estrogen on survival of retinal ganglion cells (RGCs) after transient retinal ischemia-reperfusion (RIR) in rats.MethodsRIR was induced in 60 ovariectomized adult rats (OVX) by increasing intraocular pressure via an intracameral catheter. All of the rats were divided into two groups randomly: in experimental group, the rats underwent a subcutaneous injection with 17β-estrodiol（100 μg/kg） 2 hours before retinal ischemia; and in the control group, saline water was injected correspondingly. The number of RGCs and the thickness of the inner retinal layers were mesured by HE staining method before and 12, 24, 48, and 72 hours after reperfusion. TdT-mediated biotin-dUTP nick end labelling (TUNEL) staining technique was used to examine the apoptosis of RGCs.ResultsTwenty-four and 48 hours after reperfusion, the number of apoptotic cells in experimental group was obvious lower than that in the control group(Plt;0.05), and the number of RGCs in experimental group was higher than that in the control group(Plt;0.05).ConclusionEstrogen can protect retinal neurons from transient RIR in ovariectomized rats.(Chin J Ocul Fundus Dis, 2005,21:177-179)
By learning the nearly ten years’ experience and summaries in day surgery, West China Hospital of Sichuan University drafts a series of standards for day surgery management. This article mainly introduces the pre-administration management standards of West China Hospital of Sichuan University, involving: standards for the management of surgeons, nurses, patients, and the type of operation; standards for pre-administration work procedure; standards for pre-administration health education; standards for appointment, scheduling, and coordination for day surgery; and standards for surgery notification. This paper aims to share experience with peer professionals, and provide theoretical basis and practical guidance for the standardization and development of day surgery, as well as the establishment of a safe day surgery management system.
Bacterial biofilm is the key problem of chronic wound infection and difficult healing. How to prevent and control bacterial biofilm and improve the prognosis of chronic wound has become a research hotspot in the field of wound care. This paper will summarize from the following aspects: four major stages in the process of chronic wound bacteria biofilm formation (surface adhesion, formation of small colonies, biofilm maturation, and dispersion and separation); characteristics of host immune response in the presence of biofilms; morphological, microbiological, and molecular detection methods for biofilms; and progress in in vitro trials, animal trials, clinical trials, and new therapeutic methods of biofilm. The purpose of this review is to provide evidence for the treatment of biofilms for chronic wounds.
