Objective To access the feasibility, effectiveness and safety of transcatheter closure of ventricular septal defects(VSD) in 17patients. Methods Seventeen patients, aged 4 23 years, were selected by transthoracic echocardiography. The location of VSD was perimembranous in 16 patients and was muscular in 1 patient. And 1 patient with aneurysm formation. All cases had no severe pulmonary hypertension or right to left shunt. Membranous VSD underwent transcatheter closure with Amplatzer membranous VSD occluder or membranous VSD occluder made in China. Muscular VSD was closed by Amplatzer patent ductus arteriosus occluder. Results The VSD diameter ranged from 2.3 10.5 mm(5.75±2.10 mm). The device diameter ranged from 412 mm (7.12±1.67 mm). After application of the prosthesis there was no residual shunt in all patients. One patient developed grade I atrioventricular block and complete right bundle branch block. Two patients developed right bundle branch block after 3 4 days. No other compli...更多cations were observed in 1 12 months follow up. Conclusion The transcatheter closure of VSD appears to be a safe and effective method.
Atrial fibrillation, as the most common arrhythmia currently, can lead to secondary post-stroke cognitive dysfunction and chronic brain damage through various pathways, increasing the risk of cognitive dysfunction and affecting patient prognosis. The prevention and treatment drugs for cognitive dysfunction associated with atrial fibrillation mainly include anticoagulants, heart rhythm and heart rate control drugs, statins, and antihypertensive drugs. At present, there is still some controversy over the medication for cognitive dysfunction associated with atrial fibrillation, lacking guidelines and expert consensus. It is urgent and necessary to find safe, economical, and effective drugs to improve the cognitive function of atrial fibrillation patients. This article summarizes the recent advances in drug therapy for cognitive dysfunction associated with atrial fibrillation, in order to provide a reference for the treatment of cognitive dysfunction associated with atrial fibrillation in clinical practice.
ObjectiveTo explore the supervision and inspection mechanism of hospital-acquired infection management at hospital-level in order to promote continuous quality improvement of hospital-acquired infection control. MethodsInstead of inspecting hospital departments only by hospital infection control professionals, the clinical hospital infection control nurses were also involved in the two cross-inspections carried out respectively in September and December, 2013, which shared the same contents, methods, and the inspectors. According to standard procedures, on-site view and inquiry methods were adopted to check the implementation of the system and measures and the infection control knowledge among medical staff. Inspection results were written down to feed back to each department with a unified form. The problems found during the two inspections were classified to be analyzed and solved. The results of the two inspections were compared to understand whether the effect of continuous quality improvement can be achieved through cross-inspections and subsequent work. ResultsThe excellent rate of department and overall accuracy rate of the second inspection increased with statistical significance compared to that of the first inspection (χ2=619.902, P=0.000; χ2=40.347, P=0.000). Meanwhile, the correct rate of each module and infection control knowledge among all kinds of medical staff also increased compared with the first inspection with statistically significant differences (P<0.05). ConclusionLong-term mechanism of cross-inspection involving hospital infection control nurses should be established to facilitate the continuous quality improvement of hospital-acquired infection management.
The present study aimed to investigate the impact of hypothyroidism on left ventricular systolic function using real-time three-dimensional speckle tracking imaging (RT3D-STI). Thirty hypothyroidism patients and forty healthy volunteers were recruited and received RT3D-STI measurement of global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS). A comparison of differences between the hypothyroidism patients and those in the healthy group was carried out and we obtained the results as followings. The values of GLS were (-18.93°3.89) vs. (-21.44°1.99), with P<0.01, GRS were (51.13°11.95) vs. (56.10°5.76), with P<0.0; and GAS were (-31.63°5.38) vs. (-34.40°2.32), with P<0.01, i.e. they were lower in hypothyroidism group than those in the health group. While GCS were (-17.75°1.92) vs. (-17.03°3.45), with P>0.05, which were not significantly different between the two groups. In linear regression, GLS showed significant correlation with both TSH (b=-0.69, P<0.01) and FT3(b=0.71, P<0.01). Meanwhile, the GRS (b=2.98, P<0.05) and GAS (b=3.11, P<0.05) linearly correlated with FT3 level. In conclusion, the present study shows that the global longitudinal and radial moves of left ventricular are weaker in patients with hypothyroidism than healthy controls. And the impairment of left ventricular function would aggravate as FSH rises or FT3 declines.
Objective To survey the current situation of the sharp injury in medical workers, and to provide scientific evidence for the prevention and protection of sharp injury. Methods Through applying the questionnaire of sharp injuries designed by Zhongshan Hospital, Shanghai Fudan University, 10% of the workers in all departments of West China Hospital of Sichuan University were selected as respondents according to their job categories. The main contents of the survey included the general information of respondents, reporting after sharp injuries, training participation, and the exposure sources, operations, premises and equipments related to sharp injuries over the past one year.Results Of 840 questionnaires distributed, 100% were valid. The ratio of male was 23% while the female was 72%. There were 50.20% of all respondents who once got injured, and 75% of the respondents having the history of sharp injury worked less than 10 years. The nurses, house keepers and physicians were in the top three positions of suffering from sharp injury; and the operating room was ranked as the highest risk department for sharp injuries. The known haematogenous exposure sources were 69 cases of hepatitis B, 19 syphilis, 6 hepatitis C, and 3 HIV. There were 62% of the respondents who had ever attended related training, and only 11.61% of the injured respondents reported their sharp injuries. Conclusion The incidence rate of the sharp injury is high, but the report rate is low. The operating room is the high risk department, and nurses, house keepers, and physicians are the high risk population for sharp injuries. The prevention and protection and training for sharp injury in target departments and population should be strengthened.
ObjectiveTo investigate and analyze the antibiotic use in Sichuan Province. MethodsAntibiotic use of inpatients was investigated in 23 hospitals on the day of June 25, 2011. ResultsThe percentage of antibiotic use was 42.4% in the total 27 144 inpatients, the range of which was between 24.3% and 63.3% for each hospital. And 63.8% of the antibiotic use was for therapeutic purpose, and 72.2% used only one antibiotic drug. A total of 36.9% of the patients receiving antibiotic treatment for therapeutic use sent samples for pathogenic detection. With the increase of the size of the hospital (judged by the number of beds), antimicrobial drug utilization decreased with statistical significance (χ2=411.834, P=0.000). With the improvement of regional economic level (judged by per-capita GDP of each region), the hospital antimicrobial usage decreased with statistical significance (χ2=500.093, P=0.000). The three types of antimicrobial drug most frequently used were other β-lactam antibiotics, penicillin and third generation cephalosporin. ConclusionAntibiotic use is reasonable in Sichuan Province as a whole. However, it is necessary to reduce irrational use of antimicrobial agents continuously, and to strengthen the management of clinical antibiotic usage among inpatients.
After the occurrence of public health emergencies, as the most direct front position, how to carry out medical treatment orderly, effectively, rapidly and safely in a short time has become the focus and difficulty of epidemic control. After the outbreak of 2019 novel coronavirus pneumonia (2019-nCoV), West China Hospital of Sichuan University, as a large-scale general hospital under the supervision of the CPC central committee, put people's life safety and health first, and attach great importance to the prevention and control of the epidemic. This paper introduces the ten measures taken by West China Hospital of Sichuan University to fight against the 2019-nCoV pneumonia, in order to provide reference for other hospitals.