Objective To investigate the safety and feasibility of hysteroscopic treatment for retained products of conception (RPOC) combined with enhanced myometrial vascularity (EMV) in ambulatory surgery mode. Methods A retrospective analysis was conducted on the clinical data of patients who underwent hysteroscopic treatment for RPOC combined with EMV in ambulatory surgery mode at West China Second University Hospital between May 2021 and May 2024, including their basic information and surgical related conditions. Results A total of 54 patients were included, with an average age of (33.37±4.54) years and an average number of pregnancies of 3.14±1.56. The preoperative blood level of human chorionic gonadotropin was 11.45 (5.00, 82.96) mU/mL. Color Doppler ultrasound showed an average size of pregnancy residue (2.47±0.77) cm. The average peak systolic velocity was (55.13±18.55) cm/s. The intraoperative blood loss was 17.63 (1.00, 300.00) mL. The average surgical time was (30.07±20.64) minutes. The hospital stay was 0.69 (0.50, 1.00) days. There was 1 case of postoperative complications (incidence rate 1.9%), which had the second hysteroscopy to remove retained pregnancy tissue one month after the first surgery due to RPOC. There were 6 cases of postoperative re pregnancy. Conclusion Hysteroscopic treatment for RPOC combined with EMV in ambulatory surgery mode is safe and feasible, and is worth promoting.
Objective To investigate the impact of optimized preoperative fasting scheme for gynecological day surgery with general anesthesia. Methods We retrospectively selected 639 patients undergoing gynecological day surgery with general anesthesia between June 2021 and August 2021 in the day surgery department of West China Second University Hospital of Sichuan University as the control group, and 920 patients undergoing gynecological day surgery with general anesthesia in the same hospital between November 2021 and February 2022 as the observational group. The patients in the control group were treated with routine preoperative fasting scheme, and the ones in the observational group were treated with optimized preoperative fasting scheme. The differences in preoperative duration of water deprivation, intraoperative and postoperative incidences of aspiration, and postoperative first anal exhaust time between the two groups were compared. Results The preoperative duration of water deprivation in the control group was longer than that in the observational group [(12.49±2.63) vs. (6.69±2.76) h, P<0.05]. The incidences of intraoperative and postoperative aspiration were both 0. The postoperative first anal exhaust time in the control group was later than that in the observational group [(11.51±6.58) vs. (8.19±4.13) h, P<0.05]. Conclusions For patients undergoing gynecological day surgery with general anesthesia, the implementation of the optimized preoperative fasting scheme can effectively shorten the preoperative duration of water deprivation, without increasing the risk of anesthesia. It can accelerate the recovery of intestinal function for gynecological laparoscopic day surgery with general anesthesia, promote the implementation of enhanced recovery after surgery, and improve the efficiency of day surgery.
Objective To provide reference for medical risk management by evidence-based evaluation of the status of coal-mining risk management in China. Methods We searched databases of EI (1969 to 2005), SDOS (1995 to 2005), Vip (1989 to 2005), Wanfang (up to 2005), and CNKI (1994 to 2005), as well as some official websites, for English and Chinese articles related to coal-mining safety, risk management, precaution, and response to mine disasters in China. Results Total of 19 articles, including 9 official documents, 4 research articles, and 6 expert comments were included. Recently the number of coal-mining disasters has declined in China, but still much larger than that in US. The safety status of small coal mines (90% of total coal mines in China) was much more severe. The response and precaution system of coal mining disaster in China was poor. Conclusion Medical service in China may take the following measures based on lessons from coal mining industry to improve its risk management: ① Strengthen the management of small clinics (68.24% of total medical organizations in China); ② Train doctors and nurses to upgrade their perception of medical risk; ③ Establish self-report system of medical malpractices, errors, and accidents.