Complications of proliferative diabetic retinopathy have become the major indications of vitrectomy. The surgery, however, is not basically a causative therapy. The visual function after operation depends on the degree of retinal ischemia and damage induced. The surgery itself has a potential for severe complications. Therefore it is important to better understand the pathology and to master surgical strategy and techniques in order to improve surgical outcomes and reduce the surgical complications. (Chin J Ocul Fundus Dis,2007,23:234-237)
Diabetes mellitus patients are usually at high risk of developing tuberculosis, the immune dysfunction caused by long-term high blood sugar, which can increase the susceptibility to tuberculosis. Severe tuberculosis could accelerate the course of diabetes mellitus and pose great difficulty to the clinical treatment. Therefore, early detection of potential tuberculosis patients in diabetes mellitus patients through tuberculosis screening and implementation of “three early” treatment can greatly improve the quality life of patients. This review summarizes the feasibility of tuberculosis screening in patients with diabetes mellitus, and to provide reference for the prevention and control of diabetes mellitus combined with tuberculosis.
ObjectiveTo compare the effectiveness of flexible fixation and rigid fixation in the treatment of ankle pronation-external rotation fractures with distal tibiofibular syndesmosis.MethodsA retrospective analysis was made on the clinical data of 50 patients with ankle pronation-external rotation fractures and distal tibiofibular syndesmosis treated between January 2013 and December 2015. Suture-button fixation was used in 23 patients (flexible fixation group) and cortical screw fixation in 27 patients (rigid fixation group). There was no significant difference in age, gender, weight, side, fracture type, and time from trauma to surgery between 2 groups (P>0.05). The operation time, medial clear space (MCS), tibiofibular clear space (TFCS), tibiofibular overlap (TFO), American Orthopaedic Foot and Ankle Society (AOFAS) score, and Foot and Ankle Disability Index (FADI) score were compared between 2 groups.ResultsThe operation time was (83.0±9.1) minutes in the flexible fixation group and was (79.6±13.1) minutes in the rigid fixation group, showing no significant difference (t=1.052, P=0.265). All patients achieved healing of incision by first intention. The patients were followed up 12-20 months (mean, 14 months). The X-ray films showed good healing of fracture in 2 groups. There was no screw fracture, delayed union or nounion. The fracture healing time was (12.1±2.5) months in the flexible fixation group and was (11.3±3.2) months in the rigid fixation group, showing no significant difference between 2 groups (t=1.024, P=0.192). Reduction loss occurred after removal of screw in 2 cases of the rigid fixation group. At last follow-up, there was no significant difference in MCS, TFCS, TFO, AOFAS score and FADI score between 2 groups (P>0.05).ConclusionSuture-button fixation has similar effectiveness to screw fixation in ankle function and imaging findings, and flexible fixation has lower risk of reduction loss of distal tibiofibular syndesmosis than rigid fixation.
Objective To evaluate the performance on the project of health system recovery using World Bank loan for ‘5.12’ Wenchuan earthquake after three years of these projects have been finished. Methods From March to December 2016, we formulated evaluation frameworks and indicators, used statistical reports and surveys to collect data of the 60 post-earthquake recovery projects using World Bank loan in Chengdu, Deyang and some other cities. Data of pre-earthquake (2007) and post-earthquake (2015) were compared. The evaluation indicators included institutional size, institutional environment, institutional services and social benefits. A descriptive analysis was performed using SPSS 22.0 software. Results Compared with the year of 2007, in 2015, the building and utilized for business purpose areas of loan benefited hospitals increased 4.49 and 3.58 times, respectively. The budgeted and actual beds count increased 43% and 55%, respectively. All inside structure and processes of hospitals were optimized, and green areas, parking slots and waiting areas increased greatly. Headcount of budgeted and actual increased 15.09% and 70.31%, respectively. Qualifications of healthcare technicians were improved in country level hospitals as well; there were more undergraduates and more senior competent personnel. In maternal and child health care hospitals and township hospitals, more diploma holders and personnel who had passed the middle level professional appraisals were observed. Numbers of hospital treatments, hospitalizations counts, numbers of surgeries performed increased 2.0, 2.1, and 2.0 times, respectively. Accuracy of diagnosis on hospitalized counts increased 3.12%. Utilizations of bed counts increased from 63.87% to 66.53%. The average duration of hospitalizations decreased from 7.36 days to 7.10 days. Numbers of clinical and surgery types increased 928 and 285, respectively. Both customer and staff satisfactory score reached 4.5 points in 2015. Conclusion The completed projects of health system recovery using World Bank loan for ‘5.12’ Wenchuan earthquake is running well, and meet the expectations.
【摘要】 目的 了解四川省医护人员工作倦怠状况，分析其影响因素，为卫生行政管理部门进行有效的预防和干预提供依据。 方法 2008年8月采用分层随机抽样方法，对2 588名医护人员进行调查。 结果 有明显工作倦怠感的医护人员占被调查人员总数的1/4，其年龄、性别、文化程度、职称、专业类别与专业工作年数、行政业务管理职务与医疗机构级别等是影响工作倦怠的主要因素。 结论 优化医院人员配置，营造良好的工作环境和条件，重视和加强对医护人员专业知识、技能培训，对医护人员的工作付出及时予以积极评价等，是避免和降低医护人员工作倦怠的有效措施。【Abstract】 Objective To understand the situation of job burnout and its influential factors among doctors and nurses of Sichuan province and so as to provide evidences for relative departments to prevent job burnout. Methods Stratified random sampling was adopted to investigate 2588 doctors and nurses in August, 2008. Results The percentage of doctors and nurses with evident job burnout in Sichuan province was about 25%. And it was mainly affected by sex, age, education level, job title, job specialty, work experience, administration duty and level of medical institution. Conclusion Relative departments should emphasize on optimizing personnel combination, constructing favorable work condition, reinforcing professional knowledge and skill training, commending work achievement in time in order to avoid and reduce job burnout of doctors and nurses effectively.
【摘要】 目的 了解四川省基层医疗卫生机构基本医疗功能开展情况，以便有针对性地采取措施，提高基层医疗卫生机构的服务能力。 方法 2008年8月采用自填式问卷调查的方法，对基层医疗卫生机构开展的基本医疗功能情况进行调查。 结果 基层医疗卫生机构提供的三类基本医疗功能（基本检查项目、常见病诊疗、家庭诊疗及转诊）总体情况不甚理想，基本检查项目开展情况社区卫生服务中心好于乡镇/街道卫生院。一级项目中除社区卫生服务中心转出服务开展比例达100%外，大部分医疗卫生机构一级、二级项目开展不全，社区卫生服务中心与乡镇/街道卫生院X线检查开展比例均在50%左右，常见病诊疗部分一级项目开展机构的比例不到30%。家庭诊疗及转诊二级项目两类机构开展比例均较低。 结论 基层医疗卫生机构提供的基本医疗功能特别是常见病诊疗项目有待加强。【Abstract】 Objective To understand the situation of basic medical services in primary medical institutions of Sichuan province so as to take related measures to improve the medical services in primary medical institutions. Methods We used self-administered questionnaires to investigate the basic medical services in primary medical institutions in August, 2008. Results The general situation of the three types of basic medical services (basic examination items, common disease diagnosis and treatment, family diagnosis and treatment and referrals) was not very good, but the development of basic examination items in the community health service center was better than that in villages and town hospitals or street service center. Among all kinds of first-grade medical health services, except for that the referral service in community health service center accounted for 100%, most of the first and second-grade medical health services were not fully developed. The proportion of X ray detection in community health service center and villages and town hospitals or street service center was about 50%, and the development of common disease diagnosis and treatment among the first grade medical health services accounted for only 30%. The proportion of family diagnosis and treatment and referrals was low. Conclusion The basic medial services in primary medical institutions should be strengthened, especially for the common disease diagnosis and treatment.