【摘要】 目的 探討整體護理在壓瘡治療中的應用和效果。 方法 2006年1月-2009年11月對98例壓瘡患者采用整體護理程序，從評估、提出護理診斷、實施護理措施以及評價作用效果四個方面對患者進行護理。 結果 50例壓瘡完全愈合，38例壓瘡經過護理后達到顯效標準，10例壓瘡經過護理后好轉。 結論 整體護理應用于壓瘡患者可取得滿意的效果。【Abstract】 Objective To assess the application and effects of holistic nursing in the treatment of pressure sore. Methods Ninety-eight patients with pressure sores were treated from January 2006 to November 2009 in this department, accompanying with the holistic nursing which includes assessment, proposed nursing diagnosis, implementation and evaluation of the effect. Results Fifty patients were completely healed, 38 patients showed obvious effect and 10 patients relieved slightly. Conclusion The holistic nursing has satisfactory effects on the patients with pressure sores.
Objective To explore a scientific disease cost accounting. Method Disease cost accounting = disease cost accounting of clinic pathway + disease basis cost accounting. Conclusions It is the tendency with the medical reform for the social security department to pay by disease for the hospitals, as a result, both social security department and hospitals have to resort to the scientific way in terms of cost accounting of disease. And it is practical and effective by means of cost accounting for clinic pathway.
Objective To analyze the efficacy of breast-conserving surgery with adjuvant radiation therapy (BCS+RT) vs. mastectomy (MAST) for early breast cancer among young Chinese patients. Methods Young female breast cancer patients (≤40 years old) treated at West China Hospital of Sichuan University between January 1st, 2008, and December 31st, 2019 were analyzed for clinical staging, molecular subtypes, surgical techniques, and prognostic assessments using follow-up data. Results Of 974 eligible patients in this study, 211 underwent BCS+RT and 763 underwent MAST. The Kaplan-Meier analyses indicated that there was no significant difference in the 5-year locoregional recurrence-free survival rate (99.1% vs. 99.4%, P=0.299), distant metastasis-free survival rate (97.9% vs. 96.4%, P=0.309), breast cancer-specific survival rate (100.0% vs. 97.0%, P=0.209), or overall survival rate (99.4% vs. 96.8%, P=0.342) between patients who underwent BCS+RT and those who underwent MAST. The multiple Cox proportional hazards regression analyses revealed that the treatment approach (BCS+RT or MAST) did not significantly predict locoregional recurrence-free survival (P=0.427), distant metastasis-free survival (P=0.154), breast cancer-specific survival (P=0.155), or overall survival (P=0.263). Subgroup analyses showed that there was no statistically significant difference in survival outcomes between BCS+RT and MAST in different clinical stages or molecular subtypes. Clinical stage and molecular subtype should also not be regarded as independent factors in deciding the treatment approach. Conclusions Receiving BCS+RT or MAST treatment does not affect the survival outcomes of young early-stage breast cancer patients, showing similar efficacy across various clinical stages and molecular subtypes. Choosing BCS+RT is considered safe for early-stage young female breast cancer patients eligible for breast conservation.
Esophageal cancer is the seventh most common cancer worldwide. On August 29, 2023, National Comprehensive Cancer Network (NCCN) released the NCCN esophageal and esophagogastric junction cancers clinical practice guidelines in oncology (version 3. 2023). This article aims to highlight the key updates in treatment and follow-up recommendations between the version 3 and the version 2 in 2023, providing the latest guidance for the management of esophageal cancer in our country.
【摘要】 目的 探討深吸氣量（inspiratory capacity，IC）與慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）患者臨床特征的相關性。 方法 2009年12月-2010年6月納入84例穩定期COPD患者，測定6分鐘步行試驗（6-minute walk test，6MWT）、圣喬治生活問卷評分（St George′s respiratory questionnaire，SGRQ）及肺功能檢查:第1秒用力呼氣容積（forced expirotovy volume in one second，FEV1）、IC、IC與肺總量（total lung capacity，TLC）比值（IC/TLC）等相關指標，并進行相關性分析。 結果 6MWT值與FEV1無明顯直線相關（r=0.14，Pgt;0.1）；6MWT值與FEV1≥60%無明顯直線相關（r=0.16，Pgt;0.1）；6MWT值與IC值呈正的直線相關（r=0.317，Plt;0.01）；6MWT值與IC/TLC值呈正的直線相關（r=0.274，Plt;0.01）；SGRQ值與FEV1呈負的直線相關（r=-0.307，Plt;0.01）；SGRQ值與IC值無直線相關（r=-0.001，Pgt;0.25）；SGRQ值與IC/TLC值無直線相關（r=-0.003，Pgt;0.25）。 結論 對COPD患者，IC比FEV1更準確地反映患者的運動耐量的程度，FEV1比IC更準確地反映患者呼吸困難的嚴重程度。【Abstract】 Objective To explore the relationship between the inspiratory capacity (IC) and clinical characters of stable chronic obstructive pulmonary disease (COPD). Methods Between December 2009 and June 2010, 84 patients with stable COPD were enrolled. Lung function (FEV1, IC, IC/TLC) ,6 minute walk-test (6MWT) and St George′s respiratory questionnaire (SGRQ) were examined. The relationship among FEV1, IC, IC/TLC, and the results of 6MWT and SGRQ by Pearson correlation analysis. Results There was no linear correlation between 6MWT and FEV1 （r=0.14，Pgt;0.1）, and 6MWT and FEV1≥60% （r=0.16，Pgt;0.1）. There was positive correlation between 6MWT and IC （r=0.317，Plt;0.01）, and 6MWT and IC/TLC （r=0.274，Plt;0.01）. There was negative correlation between SGRQ and FEV1 （r=-0.307，Plt;0.01）; and no linear correlation between SGRQ and IC （r=-0.001，Pgt;0.25）, and SGRQ and IC/TLC （r=-0.003，Pgt;0.25）. Conclusion In stable COPD patients, IC may be more accurate than FEV1 in refection of exercise tolerance while FEV1 may be more sensitive than IC in evaluation of dyspnea.
ObjectiveTo reveal the potential mechanism of cisplatin resistance in non-small cell lung cancer A549 cells by comparing the expression profiles of wild-type A549 cells and cisplatin-resistant A549 cells (A549/DPP) through whole transcriptome sequencing analysis.MethodsThe cisplatin resistant A549 (A549/DDP) cell line was first established. Then, the whole-transcriptome analysis was conducted both on A549 and A549/DDP cells. Next, the differentially expressed RNAs of lncRNA-seq, circRNA-seq, and miRNA-seq data were identified, respectively, followed by functional enrichment analysis. Finally, a comprehensive analysis based on the whole transcriptome data was performed and the construction of the ceRNA network was carried out.ResultsA total of 4 517 lncRNA, 123 circRNA, and 145 miRNA were differentially expressed in A549/DDP cells compared with the A549 cell line. These different RNAs were significantly enriched in cancer-related pathways. The ceRNA network contained 12 miRNAs, 4 circRNAs, 23 lncRNAs, and 9 mRNA nodes, of which hsa-miR-125a-5p and hsa-miR-125b-5p were important miRNAs based on the topological analysis.ConclusionTumor necrosis factor signaling pathway and p53 signaling pathway are involved in A549/DPP resistance. Hsa-miR-125a-5p and hsa-miR-125b-5p may be potential targets for reversing cisplatin resistance.
As an advanced mode of diagnosis and treatment, day surgery is widely carried out in foreign countries. Although it started late in China, it has been gradually valued and vigorously promoted in medical and health field in recent years. The effective implementation of day surgery in hospital cannot be separated from the strong support of performance management system. Through introducing the performance management experiences in promoting day surgery mode in West China Hospital of Sichuan University, this article discusses how to construct an effective whole-course performance management system for day surgery combined with operation management through three mechanisms: the management committee mechanism, the operation management mechanism and the performance assessment mechanism, which are based on the structure-process-outcome dimensions of quality management system, at the three levels of hospital, department and position, so as to provide a reference for developing day surgery in China.
ObjectiveTo compare the patient-reported outcomes regarding function, joint amnesia, and the quality of life after unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA). Methods The clinical data of patients who received UKA or TKA between September 2017 and June 2018 were retrospectively analyzed. After propensity score matching, 40 patients (40 knees) each in TKA group and UKA group were finally included in the study. There was no significant difference between the two groups in gender, age, body mass index, surgical side, preoperative knee range of motion, Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score, clinical and function scores of knee society score (KSS) (P>0.05). At 2 years after operation, WOMAC score, KSS clinical and function scores were performed on the two groups of patients, and compared with preoperative ones; knee injury and osteoarthritis outcome score-physical function short form (KOOS-PS), short-form 36 health survey scale (SF-36 scale), and forgotten joint score (FJS) were also performed. Results At 2 years after operation, the total score of WOMAC, the clinical and function scores of KSS in the two groups significantly improved when compared with preoperative ones (P<0.05), but there was no significant difference in the total score of WOMAC, the individual score of WOMAC, the clinical and function scores of KSS between the two groups (P>0.05). The total KOOS-PS score in the UKA group was significantly lower than that in the TKA group (t=4.243, P=0.000), and the scores of writhing/knee rotation, kneeling, and squatting in the UKA group were significantly lower than those in the TKA group (P<0.05). The total FJS score in the UKA group was significantly higher than that in the TKA group (t=?6.334, P=0.000). In the UKA group, the scores of 7 items were significantly lower than those of the TKA group (P<0.05) including when walking over 15 minutes, when climbing stairs, when walking on uneven ground, when standing for long periods, when doing housework or gardening, when taking a walk or hiking, and when doing your favorite sport. The SF-36 scales of physiological function, energy, social function, emotional function, and mental health in the UKA group were significantly higher than those in the TKA group (P<0.05). Conclusion Compared with TKA, patients treated with UKA may have better knee function recovery, joint amnesia, and higher quality of life.
