【摘要】 目的 加强输血管理是保障血液合理利用和临床用血安全的重要手段。 方法 通过对医院临床用血情况的分析，以减少手术输血为切入点，采取强化意识，严控指征，完善术前准备，倡导自体输血，加强考核管理等方式促进临床合理用血。 结果 有效提升了医疗服务品质，保障医疗安全。 结论 其方法与措施此方法与措施供大型医院医疗管理参考借鉴。【Abstract】 Objective Strengthening blood transfusion management is an important means to ensure reasonable blood usage and clinical security during blood use. Methods With reducing surgery blood transfusion as a breakthrough point, We promotes clinical reasonable blood use and medical service quality by strengthening awareness of health workers, controlling indicators strictly, perfecting preoperative preparation, initiating autologous blood transfusion, enhancing assessment and management, and so on. Results The medical service quality was improved and the medical safety was ensured. Conclusion The experience could provide a reference for medical management in large hospitals.
During the medical rescue of Wenchuan earthquake, as a hospital which mainly admitted the severely wounded, West China Hospital immediately shifted to the double-track emergent system from the previous single-track system and dispatched sufficient manpower and materials. The beds in the Department of Orthopaedics were increased to 680. In addition, in order to ensure effective treatment, the hospital dealt with the wounded based on their specific conditions in different stages and optimized the flow of admission of the wounded. Besides, we opened the referral channel for the wounded. Up to June 2nd, 2008, a total of 2 618 wounded people have been treated in to the hospital, and 648 with minor injuries after proper treatment have been referred to the nearby basic-level hospitals.
放射防护管理是保证放射诊疗质量和安全的重要手段。通过健全组织架构，规范制度流程，强化人员培训，加强档案建设，构建多部门联动工作机制，完善监督考核等多种方式，全面规范放射防护管理，有效提升了医院医疗服务品质，保障了医疗安全，其思路与方法可供大型医院医疗管理参考借鉴。
【摘要】目的介绍华西医院支援西部地区卫生工程项目的实践和成效。方法过去5年间，华西医院响应国家号召，通过各种帮扶形式，开展了一系列对口支援活动。结果华西医院利用自身的资源优势，通过各种帮扶形式，提高基层医院的医疗救治水平和综合服务能力，为建立城市支援农村卫生工作的长效机制进行了积极的实践和探索，取得显著成效。结论基层卫生事业与人民健康需求和现代医学进步存在着相当的差距，医疗体制改革对部属部管医院的对口支援提出了更高的要求，对口支援的许多细节还需要我们去进一步完善。【Abstract】Objective To introduce the practice and progress of the supportive rural hygiene program of West China Hospital. Methods In the past five years, West China Hospital had made a lot of supportive rural hygiene practice. Results West China Hospital made good use of its own advantages in resources to develop the treatment level and the comprehensive service capability of primary hospital. West China Hospital did a lot of practice to establish the effective system of assistance of city medical care to rural areas, and had already achieved remarkable effects. Conclusionre is a lot of disparity between the basic public health or the requirement of people and the modern medicine progress. Many details for support should be further consummated.
Objective To provide experimental evidence for the clinical application of ischemia therapy to treating pancreatic cancer. Methods After the model of pancreatic transplanted cancer was established in nude mice with orthotransplantation of human pancreatic cancer cell line into the pancreas, the ischemia of the right lobe of the pancreas was induced with ligation of the gastroduodenal, inferior pancreaticoduodenal and dorsal pancreatic arteries. Effects of regional ischemia on the growth of transplanted cancer and the pathomorphology of the transplanted cancer and pericancerous tissue were investigated. Results The transplanted cancer grew slower and its doubling time was longer in the ischemic group than in the control. On the 3rd, 7th and 14th day after operation, the size of transplanted cancer, the proliferative index and protein content of the cancer cells were significantly lower in the ischemic group than in the control (Ｐ＜0.01). Optical microscopy revealed large areas of coagulation necrosis, necrobiotic cells and the infiltration of inflammatory cells. The atrophy of acini, fibrosis and the infiltration of lymphocyte cells were found in pericancerous tissue. Conclusion Regional ischemia can destroy and inhibit the pancreatic transplanted cancer in nude mice effectively. The ischemia changes of pericancerous tissue may be unfavourable for the growth of the pancreatic transplanted cancer.
Based on the practice of large tertiary hospitals in clinical pathway (CP) entrance management, we implemented a fine CP management model with standardized clinical diagnosis and treatment, and encouraged the department to continuously optimize the path form, expand CP coverage and improve the entry rate in a flexible path. Combining PDCA cycles with CP management, it can promote the realization of management goals and achieve continuous improvement, while providing operable (repeatable) methods to the practice of hospital CP management.
Consultation is an important form for the diagnosis and treatment of severe diseases, and consultation management is an important content of medical management work, which directly affects the medical quality and treatment efficiency of the hospital. With the help of information network platform, our hospital has realized electronic consultation system online through scientific development, training enhancement, and safeguard mechanism improvement. The system can optimize consultation work process effectively, improve the consultation work, save manpower cost and help construction of hospital informatization.
Objective According to characteristics of the wounded, we discussed the key points of Triage Algorithm during the large scale disasters occurring. It will provide some suggestion for establ ishment the triage process, matching with reasonable medical resources on time and making medical care promotion. Method Analysis the data of patients sent to emergency department of West China Hospital in different periods after temblor, and make conclusion on alternation of the triage process. Result A total of 2621 wounded people have been treated in West China Hospital three weeks after earthquake. The severity of patients in a seimic disaster sent to hospital changed as time went on. The percentage of skin and soft tissue injuries and l imbs fractures is 45%. The percentage of crush injury is 4.3%. There are five cases of gas gangrene and none of hospital cross-infection. Conclusion Triage the victims after earthquake dynamically increases the survival rate and decreases the mortal ity and overtriage rate, the key process of triage systems should be modified dynamically with characters alternation of the victims after China Wenchuan earthquake, the rescue level and effect can be made progress.
Objective To evaluate the clinical efficacy and safety of domestic cefepime in the treatment of acute bacterial lower respiratory tract infection. Methods A randomized, single-blind, controlled clinical trial was performed. The positive control was imported cefepime. The dosages of cefepime were 1g for moderate infection and 2g for severe infection, twice a day intravenously. The duration of the treatment was 7-10 days. Results Thirty-one patients were enrolled in the trial, of whom 30 were evaluable (15 in the triagroup and 15 in the control group). No significant differences were observed between the trial group and the control group with respect to the cure rate (40% vs. 27%), the effective rate (80% vs. 87%), the bacterial clearance rate (92% vs. 100%), and the incidence of adverse drug reactions (12.5% vs. 13%) (Pgt;0.05). Conclusion Domestic cefepime injection is effective and safe in the treatment of acute bacterial lower respiratory tract infection.
ObjectiveTo investigate the situation of further medical education in students in our hospital from 2010 to 2014, and provide insights into how to elevate the teaching and management quality of continuing medical education (CME). MethodWe collected and statistically analyzed the electronic information of students in our hospital between January 2010 and 2014 December, including gender, ethnicity, age, education, and job title. ResultsThere were totally 7 478 students who received further education in the five years, and most of them were between 26 and 35 years old with junior titles and bachelor's degree. The number of students from minorities, county hospitals, medical school affiliated hospitals, provincial hospitals and hospitals from other provinces increased year by year. But there were still some problems in the present situation of further medical education in our hospital, including: lacking detailed publicity work, complicated student sources, different working capabilities of the students, and difficult regulation of uniform education planning. ConclusionsTo solve the problems, we need to properly balance the number of students and the quality of the training, make scientific enrollment plan, strengthen the CME publicity work, improve the quality of students, draw up differentiation cultivation plan, strictly implement examination and evaluation, and constantly improve the information feedback system.