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find Author "姚蓉" 17 results
  • Research on the Health Educational Status of Parents of Children with Hand, Foot and Mouth Disease and Its Influence Factors

    ObjectiveTo observe the effect of health education on hand, foot and mouth disease knowledge of the parents and their psychological status, in order to provide a reference for regulating clinical intervention measures. MethodsBetween October 2011 and February 2013, self-made questionnaire was used to survey the parents of 286 children with hand, foot and mouth disease for their knowledge about the disease. We promoted health education including distributing pamphlets, holding lectures, and carrying out psychological counseling. Then, parents' knowledge and their psychological status were compared before and after the implementation of health education. ResultsAfter health education, parents' suspicion, anxiety, fear, indulgence in children and other negative psychological scores were significantly lower than those before intervention (P<0.05). Their knowledge on the disease was also significantly enhanced (P<0.05). Gender, age and educational background were the main influence factors for health education. ConclusionMulti-form comprehensive health education can enhance parents' knowledge on hand, foot and mouth disease effectively and alleviate various negative psychological situations, which assists them to participate in the treatment work actively, thus greatly promotes early rehabilitation of the child patients.

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  • The application of macrolides in the treatment of asthma

    抗生素在哮喘当中的应用一直备受争议。近年的研究主要集中于大环内酯类抗生素(Macrolides)的非抗菌效应,已有研究发现l4元环和l5元环的大环内酯类抗生素具有类激素样抗炎活性[1]。作为新一代大环内酯类衍生物的泰利霉素(Telithromycin)由于其独特的抗细菌耐药性,一问世便受到广泛关注,而近期公布的TELICAST试验(The Telithromycin,Chlamydophila,and Asthma Trial)中关于其在哮喘急性加重疗效方面的结果更是令人振奋。该试验发现,对已确诊的哮喘急性加重期患者,在指南推荐的常规治疗基础上加用为期10 d的泰利霉素口服(800 mg/d),可使哮喘症状评分明显下降,肺功能指标改善,但其发挥疗效的机制尚不十分清楚[2]。

    Release date:2016-08-30 11:37 Export PDF Favorites Scan
  • Research status of clinical risk assessment in patients with acute alcohol intoxication

    Acute alcohol intoxication is one of the most common poisoning diseases in emergency departments. The main clinical manifestations are nervous system symptoms, with various comorbidities, hidden complications, and high risk of adverse events, and it often takes up more medical resources in emergency departments. This article summarizes the necessity, basis, and existing methods of clinical risk assessment for acute alcohol intoxication, in order to provide a reference for early identification of high-risk patients and optimization of management in emergency departments.

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  • 对地震挤压伤患者院前急救的反思与研讨

    目的:为挤压伤者的院前急救进行反思和研讨,提出一些新建议,以提高这类伤员的抢救成功率。材料和方法:本文特利用循证医学技术和方法,通过病例分析和文献回顾总结的方式。结果:通过文献回顾和病例分析,地震中挤压伤的院前处理应该注意以下几点:首先是重视早期补液的重要性,特别是液体的类型、量和补碱利尿时机;其次是局部患肢结扎,肢体处理和情绪的稳定;最后伤者获救后切忌盲目转运,现场分拣和急救后再转运。结论:应重视地震伤员院前急救过程中的规范化处理,以期最终改善预后,减少急性肾功衰和脓毒血症的发生,降低病残率和死亡率。

    Release date:2016-09-08 09:56 Export PDF Favorites Scan
  • 丙戊酸钠致全身严重剥脱性皮炎一例

    Release date:2017-03-27 11:42 Export PDF Favorites Scan
  • Practice of hospital incident command system in the outbreak of coronavirus disease 2019

    Hospital incident command system is a series of management systems for emergencies response of hospitals from the United States. Some hospitals in many countries have applied this system, but it has not yet been applied in China. In the process of responding to the coronavirus disease 2019 epidemic, West China Hospital of Sichuan University managed coronavirus disease 2019 patients through a standardized and programmatic model using the concept and framework of hospital incident command system, which included organizing hospital incident management team, carrying out incident action plan, space management, personnel management, material management and information management, in order to carry out standardized and procedural crisis response. This article introduces these management measures of West China Hospital of Sichuan University, aiming to provide a reference for establishing a more complete hospital emergency management system in line with China’s system in the future.

    Release date:2021-04-15 05:32 Export PDF Favorites Scan
  • Clinical Features of Patients with Bee Stings Anaphylaxis and the Related Risk Factors

    ObjectiveTo identify the clinical features of and risk factors for allergic reaction to bee stings in Sichuan. MethodWe retrospectively analyzed the clinical data of 387 patients with bee stings admitted to the Emergency Department of nine hospitals in Sichuan during January 1, 2010 to December 31, 2011, and evaluated the risk factors for bee sting anaphylaxis with logistic regression analysis, and explored the influence of anaphylaxis on death with Fisher exact probability method. ResultsAmong the 387 patients with bee stings, 41 (10.6%) had allergic reactions. The age in patients from the anaphylaxis group was significantly older than those in the non-anaphylaxis group (P<0.05). Logistic regression analysis showed that age was an independent risk factor for allergic reaction in patients with bee stings[OR=0.983, 95%CI (0.967, 0.999), P=0.042]. All the patients with allergic reactions were prescribed with systemic corticosteroids, and 16 were prescribed with antihistamine drugs, but no patients were prescribed with epinephrine. Among the 16 patients with systemic allergic reaction, 12 were given less than 1000 mL intravenous rehydration per 24 h, 2 were given 1000-3000 mL intravenous rehydration, and only 2 were given more than 3 000 mL intravenous rehydration. The mortality of allergic patients was significantly higher than that of the non-allergic group (9.8% vs 1.4%, P<0.05). ConclusionsThe mortality of anaphylaxis patients is significantly higher than that of the non-anaphylaxis group. Age is an independent risk factor for allergic reactions to bee stings. Treatment of bee stings related to severe allergic reaction needs to be further standardized.

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  • Construction of Sepsis-Related Coagulo-Inflammatory Score and it’s prognostic effects on sepsis

    Objective To build a score with the coagulation, inflammation indexes of sepsis patients, named Sepsis-Related Coagulo-Inflammatory Score (SRCIS), and then evaluate the prognostic capability of it in predicting the 28-day mortality of septic patients after the diagnosis. Methods In this prospective nested case-control study, we recruited septic patients according to the Sepsis 3.0 standards, who visited the Emergency Department, West China Hospital of Sichuan University from September 2017 to January 2018. Multiple factor analysis was conducted to confirm which coagulation or inflammation biomarkers were independent risk factors related to the 28-day mortality after their diagnosis. After that, the SRCIS was built based on those independent risk factors. Finally, receiver operating characteristic curve (ROC) analysis was conducted to verify its prognostic capability for the 28-day mortality of septic patients. Results A total of 123 cases were included. Among them, 17 patients died within 28 days, and the mortality rate was 13.8%. There were no significant differences in the demographic characteristics or comorbidities between the survival group and dead group (P>0.05). Multivariate logistic analysis showed that both activated partial thromboplastin time (APTT) [odds ratio (OR)=1.015, 95% confidence interval (CI) (1.017, 1.189), P=0.017] and C-reactive protein (CRP) [OR=1.100, 95%CI (1.006, 1.025), P=0.002] were independent risk factors for predicting the 28-day mortality of septic patients. ROC analysis indicated that the cut-off values of APTT and CRP predicting the 28-day mortality rate of sepsis were 39.25 seconds and 198.05 mg/L, respectively, and the areas under the curve (AUC) of them were 0.618 and 0.671, respectively. The results indicated that the mortality increased from 8.79% to 28.13%, when APTT prolonged to no less than 39.25 seconds (P<0.05). The mortality also increased from 8.89% to 27.27% when CRP elevated to no less than 198.05 mg/L (P<0.05). The AUC of SRCIS in predicting the 28-day mortality of patients with sepsis was 0.707, which was better than that of Sequential Organ Failure Assessment (SOFA) (AUC=0.681) and quick Sequential Organ Failure Assessment (qSOFA) (AUC=0.695). The corresponding 28-day mortality rates for patients with sepsis were 6.94%, 16.22%, and 42.86% (P<0.05), respectively, when the SRCIS score were 0, 1, and 2. Conclusions APTT and CRP are independent risk factors in predicting the 28-day mortality of patients with sepsis. Compared with traditional scoring systems such as SOFA and qSOFA, SRCIS performances better in predicting the 28-day mortality for patients with sepsis.

    Release date:2018-11-22 04:28 Export PDF Favorites Scan
  • Impact of coronavirus disease 2019 epidemic on emergency ambulance referrals

    Objective To analyze the characteristics of patients transferred by ambulances to emergency department before and after coronavirus disease 2019 epidemic, in order to improve the efficiency of emergency triage, optimize the utilization of emergency resources, and provide a reference for standardized tiered medical services in different situation. Methods The patients’ information collected through Wenjuanxing questionnaire was extracted, who were transferred by ambulances to the Emergency Department of West China Hospital of Sichuan University between December 27th, 2018 and April 28th, 2019 (before epidemic), or between December 27th, 2019 and April 28th, 2020 (during epidemic), or between December 27th, 2020 and April 28th, 2021 [in regular epidemic prevention and control period (REPCP)]. The general information, sources, reasons for referral, disease spectrum and triage levels of patients in the three periods were compared. Results There were 3993, 2252 and 1851 cases before epidemic, during epidemic, and in REPCP, respectively. The differences in gender and age among the three periods were not statistically significant (P>0.05). The percentage of referrals from tertiary hospitals in each period was 74.00%, 72.65%, and 76.12%, respectively, which was higher in REPCP than that during epidemic (P<0.05). The percentage of direct referrals from emergency department in each period was 41.00%, 42.14%, and 44.46%, respectively, which was higher in REPCP than that before epidemic (P<0.05). The percentage of two-way referrals in each period was 37.79%, 36.63%, and 34.36%, respectively, which was lower in REPCP than that before epidemic (P<0.05). During epidemic and in REPCP, the proportions of referrals due to “need for surgery” (24.72%, 27.84%, and 28.74%, respectively) and “request by family members” (49.64%, 53.33%, and 56.24%, respectively) increased compared with those before epidemic (P<0.05), while the proportion of referrals due to “critical illness” decreased compared with that before epidemic (40.20%, 35.21%, and 33.17%, respectively; P<0.05); the proportion of referrals due to “diagnosis unknown” decreased in REPCP compared with that before epidemic (15.50%, 13.90%, and 11.89%, respectively; P<0.05). The proportion of acute aortic syndromes in REPCP increased compared with that during epidemic (3.46%, 2.98%, and 4.65%, respectively; P<0.05), the proportion of trauma in REPCP increased compared with that before epidemic (13.72%, 15.76%, and 17.77%, respectively; P<0.05), and the proportion of pneumonia/acute exacerbation of chronic obstructive pulmonary disease during epidemic and in REPCP decreased compared with that before epidemic (8.44%, 3.73%, and 3.84%, respectively; P<0.05). The proportion of critically ill patients referred in each period was 72.88%, 75.58%, and 79.15%, respectively, which was the highest in REPCP (P<0.05). Conclusions The epidemic has a significant impact on emergency ambulance referrals, and emergency triage needs to be continuously optimised and improved in staff, facilities, processes and management. It is necessary to further improve the implementation of hierarchical diagnosis and treatment, strengthen information communication between referral and emergency departments of receiving hospitals, and improve referral efficiency.

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  • Predictive value of the simplified signs scoring system for the severity and prognosis of patients with COVID-19: A multicenter observational study

    ObjectiveTo explore the predictive value of a simplified signs scoring system for the severity and prognosis of patients with coronavirus disease 2019 (COVID-19). Methods Clinical data of 1 605 confirmed patients with COVID-19 from January to May 2020 in 45 hospitals of Sichuan and Hubei Provinces were retrospectively analyzed. The patients were divided into a mild group (n=1150, 508 males, average age of 51.32±16.26 years) and a severe group (n=455, 248 males, average age of 57.63±16.16 years). ResultsAge, male proportion, respiratory rate, systolic blood pressure and mean arterial pressure in the severe group were higher than those in the mild group (P<0.05). Peripheral oxygen saturation (SpO2) and Glasgow coma scale (GCS) were lower than those in the mild group (P<0.05). Multivariate logistic regression analysis showed that age, respiratory rate, SpO2, and GCS were independent risk factors for severe patients with COVID-19. Based on the above indicators, the receiver operating characteristic (ROC) curve analysis showed that the area under the curve of the simplified signs scoring system for predicting severe patients was 0.822, which was higher than that of the quick sequential organ failure assessment (qSOFA) score and modified early warning score (MEWS, 0.629 and 0.631, P<0.001). The ROC analysis showed that the area under the curve of the simplified signs scoring system for predicting death was 0.796, higher than that of qSOFA score and MEWS score (0.710 and 0.706, P<0.001). ConclusionAge, respiratory rate, SpO2 and GCS are independent risk factors for severe patients with COVID-19. The simplified signs scoring system based on these four indicators may be used to predict patient's risk of severe illness or early death.

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