Objective To investigate the clinical significance of intra-abdominal pressure measure in patients with liver transplantation by summarizing the data of 143 cases. Methods Intra-abdominal pressure was indirectly measured by urinary bladder pressure. Intra-abdominal pressure over 10 cm H2O (1 cm H2O=0.098 kPa) was regarded as intra-abdominal hypertension (IAH), and 10＜pressure≤15 cm H2O as gradeⅠ, 15＜pressure≤25 cm H2O as grade Ⅱ, 25＜pressure≤35 cm H2O as grade Ⅲ, over 35 cm H2O as grade Ⅳ. The parameters of circulatory system, respiratory system, renal function and the postoperative intra-abdominal pressure for 7 days were recorded to every patient, and the parameters of each grade IAH group were contrasted with non-IAH group. ResultsAmong 143 cases, 45 cases were IAH (31.5%), in which 18 cases belonged to grade Ⅰ, 13 cases belonged to grade Ⅱ, 11 cases belonged to grade Ⅲ, while 3 cases belonged to grade Ⅳ. Compared with those in non-IAH group, SCr and BUN significantly increased (P＜0.05, P＜0.01), PaO2 significantly decreased (P＜0.05, P＜0.01) in each grade IAH group; Respiratory frequency (RF), heart rate (HR) and PaCO2 significantly increased (P＜0.05, P＜0.01) in some grade IAH group (HR in grade Ⅱ, Ⅲ and Ⅳ, RF and PaCO2 in grade Ⅲ and Ⅳ). Conclusions Intra-abdominal hypertension would affect liver function by impaired circulatory, respiratory and renal function. So, it is necessary to measure intra-abdominal pressure for patients after liver transplantation, which can help to choose appropriate treatment.
ObjectiveTo investigate the effect of noninvasive positive-pressure ventilation for elderly patients with chronic obstructive pulmonary disease (COPD) combined with left heart failure. MethodsA total of 152 patients (70-85 years old) diagnosed with COPD combined with left heart failure and treated in our hospital between June 2011 and January 2015 were randomly divided into trial group (noninvasive positive-pressure ventilation with routine treatment, n=76) and control group (routine treatment, n=76). Respiratory rate, heart rate, blood pressure, pH, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of oxygen (PaO2) and left ventricular ejection fraction (LVEF) were analyzed and compared between the two groups after treatment. We did t-test to analyze the difference of these indexes between the two groups statistically. ResultsRespiratory rate, heart rate and PaCO2 in both of the two groups after the treatment were significantly lower than those before the treatment (P<0.001), while PaO2 and LVEF in both of the two groups after the treatment were significantly higher than those before the treatment (P<0.001). The systolic pressure and diastolic pressure in both of the two groups after the treatment didn't differ much from those before the treatment (P>0.05). The pH value after the treatment increased only in the trial group compared with that before the treatment (P<0.05). The respiratory rate, heart rate, pH value, PaO2, PaCO2 and LVEF after the treatment in trial group were meliorated compared with those in the control group (P<0.05). ConclusionTreatment with noninvasive positive-pressure ventilation for elderly patients with COPD combined with left heart failure is more efficient than the routine treatment.
ObjectiveTo explore the plan-do-check-action (PDCA) circulation method in reducing errors in general inspection items of health examination and to improve the quality of examination. MethodsUsing PDCA circulation method, the reasons of errors in general items of health examination for 39 individuals examinied between August and December 2010 were analyzed. Rectification was carried out according to the reasons, and the differences in the incidence rate of errors in general items of health examination before (from August to December, 2010) and after the rectification was (from Auguest to December, 2011) was compared. ResultsAfter the rectification, the incidence of errors in general items of health examination (0.08%) was significantly lower than that before the rectification (0.45%) (P<0.05). ConclusionPDCA circulation method can effectively reduce the incidence of errors in general items of health examination thus may ensure the medical quality.
The national policy on high-quality development of hospitals proposes to strengthen information technology support and actively promote the multi-disciplinary team (MDT) model. How to use the “Internet Plus” technology and operation mode to promote MDT communication and improve the efficiency of diagnosis and treatment in the digital and intelligent information age is a direction worthy of attention and research. This paper systematically reviews the current development status of MDT informatization construction at home and abroad. Based on the current challenges and opportunities, it makes prospects for the future development of MDT informatization construction from the aspects of strengthening the digital and intelligent support of MDT operation, connecting MDT “information silos”, and deepening the construction of MDT supervision and effect evaluation system, etc.
Objective To analyze the implementation of multi-disciplinary team (MDT) clinic for thyroid eye disease (TED) and explore the significance of TED MDT clinic. Methods A retrospective analysis was conducted on the medical records of patients who visited TED MDT clinic at West China Hospital of Sichuan University between December 1, 2022 and November 30, 2024. Patient condition indicators were collected and MDT outpatient operation indicators were statistically analyzed. Results During the study period, a total of 696 patients were admitted to the TED MDT clinic, with an average age of (51.14±12.00) years. All patients were diagnosed with TED and showed symptoms of extraocular muscle involvement and restricted eye movement. According to the NOSPECS clinical grading system, all patients were classified as grade 4 or above. Among them, 693 patients’ orbital enhanced MRI showed that the extraocular muscles were in an inflammatory active phase, and 690 patients received periarbital injection of triamcinolone acetonide, precise orbital radiation therapy, and thyroid function regulation. During the research period, TED MDT clinic received a total of 90 visits, with an average of 7.73 patients per visit. The patient satisfaction rate was 99.67%, and there were no cases of experts being late, absent, or doctors with insufficient qualifications to participate in discussions. ConclusionThe TED MDT clinic has been well developed, and the experts within the team attach great importance to it, making it valuable for continued large-scale promotion.
Social Evaluation is an important reference to guide the reform and development of a public hospital. In view of the patient, hospital stakeholders and the public, West China Hospital of Sichuan University creatively constructed a social evaluation system, including patient satisfaction degree, expert appraisal and online public comment, in order to maintain a good medical environment. After several years of construction and application, the system has been quite effective in promote the development of the hospital. In the assessment of patients' satisfaction degree toward the hospital, we made a great improvement.
Rare diseases are a kind of diseases with very low incidence and prevalence. They are difficult to diagnose, treat and use drugs. Multi-disciplinary team (MDT) has become the main mode of modern medical diagnosis and treatment. Many hospitals at home and abroad have begun to apply MDT in the diagnosis and treatment of rare diseases. This paper introduces the MDT mode of rare diseases at home and abroad, focusing on the mode, work flow and content of the MDT service system for rare diseases in West China Hospital of Sichuan University, and discusses the problems and optimization suggestions of the current construction of the MDT service system for rare diseases. The purpose is to provide some reference for the establishment of MDT model of rare diseases in China.
Rare diseases are a collective term for a category of diseases with extremely low incidence or prevalence rates. They are characterized by a variety of diseases, difficult diagnosis, complex conditions, etc. Only about 5% of rare diseases have treatment drugs. They impose a heavy burden on society and the families of rare diseases patients, and are a major global challenge. Rare diseases medical talents are an important component of the development of the rare diseases industry. After years of practical exploration, the construction of rare diseases medical talent training systems at home and abroad has gradually achieved results. This article analyzes the current situation of medical talent cultivation in the field of rare diseases, and proposes thoughts and suggestions for the cultivation of rare diseases medical talents in China, providing reference for the construction of the rare patient talent system.