ObjectiveTo compare the effectiveness of radiofrequency ablation (RFA) combined with transilluminated powered phlebectomy (TIPP) vs. high ligation and stripping (HLS) combined with TIPP in patients with varicose veins of lower limbs.MethodsA retrospective analysis was made on the clinical data of 190 patients (206 limbs) of varicose veins of lower limbs who underwent surgical treatment in our hospital from December 2017 to July 2018, of them 88 patients (96 limbs) in RFA combined with TIPP group and other 102 patients (110 limbs) in HLS combined with TIPP group. The treatment effectiveness and quality of life was assessed with venous clinical severity score (VCSS) and chronic venous insufficiency questionnaire (CIVIQ-14) in three months and one year after surgery. Doppler ultrasound was used to evaluate the closure of great saphenous vein.ResultsBaseline characteristics were similar between the two groups (P>0.05). The RFA combined with TIPP group was better than the HLS combined with TIPP group in operation time, intraoperative bleeding, hospital stay time, postoperative bed time, resumption time of activities, as well as incidences of skin induration and limb numb (P<0.05). Occlusion rates of great saphenous vein in 3 months was 93.8% (90/96) in the RFA combined with TIPP group and 97.3% (107/110) in the HLS combined with TIPP group, and in one year was 91.7% (88/96) and 97.3% (107/110) respectively, there was no significant difference between the two groups at the same time point (P>0.05). The VCSS scores and CIVIQ-14 scores also improved significantly in two groups in 3 months and 1 year follow up (P<0.05), but there was no significant differences between the two groups at the same time point (P>0.05).ConclusionsRFA combined with TIPP is an effective method for the treatment of varicose veins of lower limbs. Compared with HLS, RFA has the same good effectiveness and quality of life, but it has the advantages of short operation time, rapid postoperative recovery, and less postoperative complications.
Objective To understand the new characteristics of clinical symptoms of patients with mild COVID-19 during the prevalence of SARS-CoV-2 Omicron, and provide basis for better prevention and treatment of COVID-19.Methods A cross-sectional retrospective study was conducted with WeChat questionnaire among medical staff with COVID-19 recently, who come from the Third Affiliated Hospital of Chongqing Medical University and The Second Affiliated Hospital of Army Medical University.Results A total of 630 valid questionnaires was received. 99.2% of infected people had been vaccinated against COVID-19. 2.4% of infected persons developed pneumonia and 2.1% were hospitalized. The most common symptoms after infection were coughing (89.7%), fever (83.0%), fatigue (84.1%), headache and dizziness (75.7%), muscle soreness (72.7%), sore throat (62.1%), nasal congestion and runny nose (60.6%), expectoration (71.6%), anorexia (58.0%) and taste loss (40.2%). The incidence of gastrointestinal symptoms and cardiovascular symptoms was relatively low (17.8% and 31.0% respectively). The severity of self-reported symptoms of most infected persons was moderate or severe. The proportion of serious symptoms reported was coughing (23.8%), sore throat (27.0%), headache and dizziness (17.9%). The severity of symptoms reported by young group (<35 years old) was significantly higher than that of older group (>35 years old). Fever was the highest at 38 to 39 ℃ (52.4%). 77.0% of fever sustained for 1 to 3 days. At the time of investigation, the viral detection turned negative in 60.6% of infected people, and the time of turning negative was mostly 7 to 10 days. More than half of the infected persons still had different symptoms, among which cough (43.7%) and fatigue (23.8%) were the most common.Conclusions Most subjects with mild COVID-19 infection have obvious upper respiratory tract and systemic symptoms, the most prominent is the high incidence of cough, which has become a new feature of omicron infection. And most of the infected people have moderate to severe symptoms, and the younger ones have more severer symptoms.
Objective
To investigate the opinions of operating room nurse (ORN) on enhanced recovery after surgery (ERAS).
Methods
A questionnaire survey was performed among 215 ORNs in West China Hospital. There were 10 males and 205 females at age of 33.4±8.84 years.
Results
A total of 154 ORNs (71.6%) thought that we already had very good ERAS theory but we still needed more practice. Thirty-four ORNs(15.8%) thought that the application of ERAS was poor in our clinic comparing to other countries.A percentage of 84.2% (181/215) ORNs thought the criteria to judge whether the ERAS succeed or not should be average days of hospitalization, patients' feeling, and experience and social satisfactions. Besides, 78.1% (168/215) ORNs selected team building as the key point of ERAS success. There were 91.2% (196/215) ORNs who believed expert consensus and ERAS guide should be worked out and propagandized through academic forum or conference in order to popularize the ERAS.
Conclusion
The theory of ERAS has already been accepted by almost all the clinicians and team building is the best way to make ERAS work well.
Objective To compare BODE index with GOLD staging for the severity evaluation in patients with chronic obstructive pulmonary disease ( COPD) . To investigate the relationship between BODE index and quality of life. Methods A total of 100 patients with stable COPD were enrolled. All participants were examined with lung function test and St George’s Respiratory Questionnaire ( SGRQ) for evaluation of quality of life. BODE index and it’s four components including body mass index( BMI) , airflow obstruction ( FEV1%pred) , dyspnea( MMRC) , and exercise capacity( 6MWD) were calculated. The participants were divided into four groups of severity using GOLD guidelines and BODE index quartiles. Results The associations between SGRQ total score and SGRQ subscales, and BODE index were significant( P lt;0. 01) .BODE index was a significant predictor of the quality of life, explaining 41. 3% of the total score of the SGRQ ( P lt;0. 01) . However, GOLD classification showed a correlation only with SGRQ activity score ( P lt;0. 05) but not with other SGRQ scores. There were significant differences in SGRQ total score and SGRQsubscales between different severity groups of BODE index( P lt;0. 01) . But there was no difference in SGRQ score between different severity groups of GOLD classification, except SGRQ activity score. Conclusion BODE scoring system is better correlated with the quality of life as assessed by the disease severity inpatients with COPD than the GOLD staging criteria.
Objective To verify the reliability and validity of a self-developed satisfaction evaluation questionnaire for outpatient department employees in public hospitals, and to provide suitable tools for conducting such surveys. Methods Two anonymous surveys were conducted on all employees of the Outpatient Department of West China Hospital of Sichuan University in July 2019 and November 2021, respectively. Questionnaire items were screened using methods such as item distribution, coefficient of variation, and decision value, and the reliability and validity of the questionnaire were evaluated using Spearman-Brown coefficient and Cronbach’s α coefficient, exploratory factor analysis, and confirmatory factor analysis. Results The final questionnaire retained 14 items, which could be divided into two dimensions: work conditions and interpersonal environment, and the overall fit index of structural equation model were as follows: χ2/ν=6.957, the standardized root mean square residual was 0.061, the root mean square error of approximation was 0.147, the goodness-of-fit index was 0.796, the adjusted goodness-of-fit index was 0.719, the normed fit index was 0.849, the relative fit index was 0.819, the incremental fit index was 0.868, the Tucker-Lewis Index was 0.841, and the comparative fit index was 0.867. The combined reliability of the two factors in the questionnaire was 0.94 and 0.91, respectively. The average variance extraction was 0.67 and 0.76, respectively, and the square root of the average variance extraction was 0.82 and 0.87, respectively, both of which were greater than the correlation coefficient of 0.71 between the two factors. The Spearman-Brown coefficient of the final questionnaire was 0.913, and the Cronbach’s α coefficients for the overall and two dimensions were 0.953, 0.937, and 0.910, respectively. Conclusion The reliability and validity of the satisfaction evaluation questionnaire for outpatient department employees in public hospitals are good and the questionnaire can be applied to practical surveys.
[Abstract]Postoperative lung cancer patients experience a significant symptom burden that severely impacts their quality of life. Accurate assessment of their health experience during recovery is critical to postoperative management. Patient-reported outcomes (PROs), which provide valuable insights into health from the patient's perspective, are increasingly used in the postoperative management of lung cancer patients. This article reviews the existing patient-reported outcome measures (PROMs) for lung cancer patients, focusing on their measurement dimensions, clinical applicability, and current usage. It aims to provide a foundation for their scientific application, optimize postoperative management strategies, and promote high-quality recovery and management.
ObjectiveThe current medical questionnaire resources are mainly processed and organized at the document level, which hampers user access and reuse at the questionnaire item level. This study aims to propose a multi-class classification of items in medical questionnaires in low-resource scenarios, and to support fine-grained organization and provision of medical questionnaires resources. MethodsWe introduced a novel, BERT-based, prompt learning approach for multi-class classification of items in medical questionnaires. First, we curated a small corpus of lung cancer medical assessment items by collecting relevant clinical assessment questionnaires, extracting function and domain classifications, and manually annotating the items with "function-domain" combination labels. We then employed prompt learning by feeding the customized template into BERT. The masked positions were predicted and filled, followed by mapping the populated text to labels. This process enables the multi-class classification of item texts in medical questionnaires. ResultsThe constructed corpus comprised 347 clinical assessment items for lung cancer, across nine "function-domain" labels. The experimental results indicated that the proposed method achieved an average accuracy of 93% on our self-constructed dataset, outperforming the runner-up GAN-BERT by approximately 6%. ConclusionThe proposed method can maintain robust performance while minimizing the cost of building medical questionnaire item corpora, illustrating its promotion value of research and practice in medical questionnaire classification.
Objective
To analyze the current status and difficulties of ERAS applicated in thoracic surgery in different regional hospitals.
Methods
A total of 773 valid questionnaires were collected during the First West China Forum on Chest ERAS and analyzed by geographical distribution. The content of the questionnaire was divided into two parts, including the respondents’ institute and personal information, as well as 10 questions about ERAS.
Results
There were 83.57%, 83.82%, 89.58%, 93.75%, 94.74% and 92.86% of surgeons and nurses in Sichuan province, municipalities, the eastern, western, southern and northern respectively who believed that ERAS in all surgeries should be used. There were 61.84%, 60.29%, 65.97%, 81.25%, 73.68% and 75.00% of surgeons and nurses who thought that the concept of ERAS was more in the theory than in the practice; 77.99%, 80.88%, 74.31%, 78.13%, 83.33% and 69.64% of respondents agreed that average hospital stay, patients’ experience and social satisfaction should be the evaluation standard of ERAS practice while 58.50%, 63.24%, 54.86%, 62.50%, 70.18% and 58.93% of respondents believed that immature procedure, lack of consensus and specifications and insecurity for doctors were the reasons for poor compliance of ERAS; 63.23%, 67.65%, 59.72%, 68.75%, 72.81% and 67.86% of respondents thought that the best team of ERAS should be based on the combination of subject integration, surgery orientation and surgeon-nurse teamwork; 43.73%, 44.12%, 43.75%, 46.88%, 59.65% and 41.07% of respondents thought that multidisciplinary cooperation, multi-modality conducted and surgical programming should be the best way for ERAS implementation; 72.98%, 69.12%, 62.50%, 65.63%, 80.70% and 55.36% of responders agreed that the ERAS forum or conference should include the norms and consensus, analysis and implementation of projects and the status and progress of ERAS.
Conclusion
There are more consistent views on the clinical application of ERAS in all regions. The subject integration, surgeon-nurse teamwork and multidisciplinary, multi-modality cooperation are the best team and best way for ERAS program implementation.
ObjectiveTo investigate the therapeutic effect of glucosamine hydrochloride on chronic lumbago and backache.
MethodsWe selected 328 outpatients with chronic lumbago and backache diagnosed between May 2014 and May 2015, and randomly (with single blind method) divided them into study group (n=172) and control group (n=156). Patients in the control group were treated with ibuprofen and placebo, while those in the study group were treated with ibuprofen and glucosamine hydrochloride. The short-form McGill pain questionnaire (SF-MPQ) was used for investigation at three time points (before the treatment, one month and two months after the treatment).
ResultsThe score of SF-MPQ in the study group was 64.34±23.35 before the treatment, 44.04±13.22 one month after the treatment, and 19.87±8.11 two months after the treatment. While in the control group, the results at those three time points were 65.19±24.12, 47.04±11.36, and 54.44±21.39, respectively. There was no obvious difference between the two groups one month after the treatment (P>0.05). The pain was alleviated in both of the two groups one month after the treatment, while the therapeutic effect in the study group was significantly better than that in the control group two months after the treatment (P<0.05). Archenteric complications were found in 3 patients (1.74%) in the study group and 2 (1.28%) in the control group without a significant difference (P>0.05).
ConclusionGlucosamine hydrochloride may effectively alleviate the lumbago and backache without any obvious adverse reactions.
Objective To investigate the free influenza vaccination of health care workers in major departments and explore the possible influencing factors of influenza vaccination of staff. Methods In November 2021, a questionnaire survey was conducted among health care workers who received free influenza vaccination in 19 major departments of West China Hospital of Sichuan University, and the un-vaccinated workers’ information was obtained from the registration system of staff information. Multiple logistic regression model was used to analyze the possible influencing factors of free influenza vaccination. Results The coverage rate of centralized free influenza vaccination of staff in major departments was 32.7% (1101/3369). Multiple logistic regression analysis showed that workers who were female [odds ratio (OR)=1.853, 95% confidence interval (CI) (1.481, 2.318), P<0.001], with an educational background of high school or below [OR=4.304, 95%CI (2.484, 7.455), P<0.001], engaged in nursing work [OR=2.341, 95%CI (1.701, 3.221), P<0.001], and with 11 or more years of working experience [OR=2.410, 95%CI (1.657, 3.505), P<0.001] were more likely to inject influenza vaccine, and workers who had a bachelor’s degree were less likely to inject influenza vaccine. Conclusions The rate of free influenza vaccination among medical staff is low. In order to mobilize the enthusiasm of influenza vaccination among medical staff, it is necessary to analyze the characteristics of the population and take targeted measures to improve the level of vaccination among medical staff.
