【Abstract】 Objective To disscuss the therapeutic method of the postoperative infection after hip arthroplasty andcompare the results of one-stage revision and two-stage revision. Methods From January 1999 to December 2005, 15 casesof infection after hip arthroplasty were treated, including 10 males and 5 females, with a mean age of 63 years (54-71 years).The locations were left hip in 8 cases and right hip in 7 cases. The first operation was hip prosthesis replacement in 6 cases andtatol hip arthroplasty in 9 cases. Infection occurred after 1 month in 6 cases and after 6 months in 9 cases. The preoperativetemperature and ruting blood test were normal, the mean erythrocyte sedimentation rate(ESR) was 61 mm/h (34-80 mm/h),mean C-reactive protein(CRP) was 11.7 mg/L(5.4-21.0 mg/L). The mean Harris score was 33 (25 - 40). The X-ray films showedthat periosteal reaction, osteolysis and loosening of prosthesis occurred. The time from the first operation to revision operationwas 1-41 months (mean 7.3 months). The results of bacterial culture were positive in 11 cases. One-stage revision wasperformed in 10 ases, two-stage revision was performed in 5 cases. Results Of 15 cases, 6 were classified as early postoperativeinfection, 9 cases as late chonic infection. The microorganism cultures results of joint aspiration or pus in sinus werepositive in 11 cases and negative in 4 cases before operation and during operation; 8 had staphylococcus epidermids infection,2 escherichia col i infection and 1 staphylococcus aureus infection. Incision of revision operation healed by first ention. Nore-infection, swell ing and tenderness occurred after 19 months (12-37 months) of follow-up. Pain of hip joint disappeared in14 cases, and only 1 case had mild pain when walking. ESR and CRP after operation decreased to normal range. The mean Harrisscore increased significantly to 84.2(79-92) after revision, showing significant difference when compared with that beforeoperation (P ＜ 0.05). Conclusion For postoperative infection after total hip arthroplasty, it is still possible to have satisfactorycl inical outcome by one-stage or two-stage revision as long as clear diaglosis and correct treatment can made.【Key words】 Hip arthroplasty Postoperative compl ications Infection Revision operation
Objective To analyze the challenges and growth of the clinical medicine undergraduates who participated in the China Scholarship Council funded international research exchange program, to provide a basis for the policy formulation and management of the follow-up projects. MethodsClinical medicine undergraduates from West China School of Medicine, Sichuan University who participated in the China Scholarship Council funded international research exchange program from 2013 to 2019 were selected. The survey was conducted using a self-designed questionnaire. Results A total of 64 clinical medicine undergraduates were surveyed. The laboratory safety training rates in the United States, Canada, and China were 100.00% (34/34), 100.00% (30/30), and 70.31% (45/64), respectively. The laboratory technical training rates were 97.06% (33/34), 90% (27/30), and 43.75% (28/64), respectively. During the experimental process, clinical medicine undergraduates from the United States [94.12% (32/34)], Canada [93.33% (28/30)], and China [65.63% (42/64)] would seek assistance from relevant personnel. The difficulty (H=47.798, P<0.001) and convenience (H=30.135, P<0.001) of booking laboratory instruments and equipment vary among the three countries. There were no statistically significant difference in the frequency, form, and research direction sources of guidance from mentors (P＞0.05). Majority of students thought the experience was helpful for scientific research thinking (59 people) and experimental skills (52 people), with 23 people obtained research output. Despite encountering challenges in study (11 people), life (8 people), language (14 people), and culture (11 people), the experience had positive impact on hobbies (35 people), independent living ability (55 people), and self-confidence (41 people). The students also had developed an international perspective (61 people), improved English ability (59 people), and progressed self-learning ability (57 people). Conclusions By participating in international research exchange programs, undergraduates can enhance their comprehensive research ability. Although there may be problems and challenges during the adaptation process, it also brings growth and self-confidence at the same time.
ObjectiveTo explore the psychological process and needs of the second victims of medical adverse events after the occurrence of adverse events, so as to provide reference for the psychological intervention strategies of medical institutions for the second victims of medical adverse events.MethodsThe second victims of medical adverse events in the First People’s Hospital of Ziyang were selected from April to July 2019. Qualitative research method was used to conduct semi-structured in-depth interviews with the second victims. Colaizzi method was used to analyze the transcripts through reading and rereading, coding, and thematizing. ResultsA total of 22 second victims of medical adverse events were interviewed. The second victims of medical adverse events experienced negative emotional experience, and the desire to seek emotional support was urgent. The psychological process of the second victims of medical adverse events mainly involved five stages: fear, anxiety, depression, guilt and recovery. Emotional support hada positive effect on regression. Conversely, negative or lack of emotional support had a negative effect on regression. ConclusionsThe emotional experience of the second victims of medical adverse events is relatively staged, and the recovery and regression are greatly affected by internal and external factors. Hospital administrators should take active measures and establish an emotional support mechanism for adverse events in order to reduce psychosomatic injuries and improve medical quality and efficiency.
ObjectiveTo investigate the basic situation of existing medical English teaching methods and objects, develop medical English course content and teaching methods, and evaluate teaching effectiveness. Methods The existing medical English teaching methods were summarized based on literature retrieval, and both the basic level of medical students and data related to teaching effectiveness were collected by questionnaire surveys. Results Medical English teaching could be optimized by adjusting the content of medical English teaching, increasing the proportion of English teaching, and emphasizing the application of emerging electronic products in extracurricular English learning. Teaching methods could adopt various forms such as flipped classrooms. A questionnaire survey showed that most of the students (64.94%) were not satisfied with their current English level. These students fully recognized the importance of medical English. Based on the above results, medical English courses were offered in two semesters. This course adopts theoretical lectures, small-class teaching and other teaching methods. Scenario simulation and flipped classroom were also used. Conclusion Medical English courses should include medical vocabulary, clinical medical English, vocational medical English and academic medical English. Flipped classroom and other teaching methods should be flexibly applied.
With the promoting of “the Belt and Road Initiative”, medical assistance to Xinjiang is one ofthe important tasks of public hospitals in China. West China Hospital of Sichuan University actively explores the“Huaxi-Karamay” model of multi-disciplinary group assistance and scientific and technological assistance to Xinjiang, and leverages the technical leadership and leading role of medical experts to improve the medical and health service capabilities of Karamay, especially in chronic diseases management. This article takes the People’s Hospital ofKaramay City in Xinjiang province as an example to discuss the exploration and practice of the new chronic diseasemanagement model of the endocrinology and metabolism center with medical assistance from West China Hospital ofSichuan University, aiming to provide a certain reference for the in-depth development of medical aid to Xinjiang in thefuture.