目的:观察脂微球前列腺素E1联合氯沙坦对糖尿病肾病(DN)患者24 h蛋白尿和肾功能的影响。方法:63例2型糖尿病肾病患者随机分为对照组和治疗组,两组患者均给予适量运动、饮食控制、降糖、降脂等常规治疗,对照组在常规治疗基础上给予氯沙坦治疗,而治疗组则同时给予脂微球前列腺素E1和氯沙坦,疗程共12周,分别观察治疗前后两组患者空腹血糖、肾功能及24 h尿蛋白的变化。结果:治疗12周后,两组患者空腹血糖控制良好,治疗组患者肾功能较治疗前明显改善(Plt;005),且尿白蛋白排泄率较对照组明显下降,分别为（32212±5021） mL/min和（27657±3812） mL/min,两者间的差异具有显著性意义。结论:脂微球前列腺素E1联合氯沙坦能明显改善糖尿病肾病患者肾脏功能,减少24 h尿蛋白。
Objective To explore the evaluation index and appointment mechanism of healthy professional titles. Methods We collected the data of people evaluated and appointed as advanced professional titles, and the evaluation and appointment documents in West China Hospital. We analyzed the evaluation index and appointment mechanism. Results A total of 400 people gained senior title promotion. The evaluation indexes focused on academic degrees, papers, research projects, patents, as well as awards and honors. The research achievements reduced of 80% people who had gained senior titles. Conclusion Current evaluation indexes prefer to inflexible index and ignore flexible index. The appointment mechanism lacks outcome evaluation, and the professional title will not be eliminated once appointed. In the future, we should improve the evaluation index and appointment mechanism focusing on the specific characteristics of healthy professional titles.
In response to the opportunities and challenges faced by large comprehensive public hospitals in the new era, West China Hospital of Sichuan University has summarized a set of plans for various positions in public hospitals through 18 years of exploration, and provides a reference basis for the position setting of public hospitals.
The continuing medical education system of West China Hospital of Sichuan University is based on whole life cycle. We actively promote the continuing education, systematize and institutionalize the top-level design, and adopting flexible and diverse training methods. It is of great significance for a staff's entire career to continuously improve professional accomplishment, specialized knowledge and working skills, to adapt to the development of medical science and technology and the reform of health service, and to drive hospital innovation and high-quality development, so as to eventually achieve the goal of "double first-class" construction.
ObjectivesTo evaluate the efficacy and safety of four antiplatelet regimens after coronary drug-eluting stents by network meta-analysis.MethodsPubMed, The Cochrane Library, EMbase and Web of Science databases were electronically searched to collect randomized controlled trials (RCTs) of the comparison of different antiplatelet regimens after coronary drug-eluting stenting from inception to December 31st, 2019. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Network meta-analysis was then performed by using Gemtc14.3 software, Stata16.0 software and RevMan5.3 software.ResultsA total of 23 RCTs involving 45 837 patients were included. The results of network meta-analysis showed that: in terms of prevention of myocardial infarction (MI) recurrence, the aspirin monotherapy after short-term dual antiplatelet therapy was inferior to the triple antiplatelet therapy (OR=2.13, 95%CI 1.08 to 4.03). In terms of reducing the incidence of ischemic compound events, the triple antiplatelet therapy was superior to the standard dual antiplatelet therapy (OR=0.53, 95%CI 0.39 to 0.72), the aspirin monotherapy after short-term dual antiplatelet therapy (OR=0.49, 95%CI 0.35 to 0.69) and the P2Y12 inhibitor monotherapy after short-term dual antiplatelet therapy (OR=0.51, 95%CI 0.35 to 0.73). There was no statistically significant difference among the four interventions in reducing the rate of in-stent thrombosis and all-cause mortality (P>0.05). In terms of safety, the bleeding rate of aspirin monotherapy after short-term dual antiplatelet therapy was lower than that of standard dual antiplatelet therapy (OR=0.70, 95%CI 0.55 to 0.86) and triple antiplatelet therapy (OR=0.58, 95%CI 0.36 to 0.90), and the bleeding rate of P2Y12 inhibitor monotherapy after short-term dual antiplatelet therapy was also lower than that of standard dual antiplatelet therapy (OR=0.51, 95%CI 0.39 to 0.65) and triple antiplatelet therapy (OR=0.43, 95%CI 0.26 to 0.67). The probability ranking diagram showed that: in terms of the recurrence rate of MI, the rate of in-stent thrombosis and the incidence of ischemic compound events, triple antiplatelet therapy was the lowest and aspirin monotherapy after short-term dual antiplatelet therapy was the highest. However, in terms of all-cause mortality and bleeding rate, aspirin or P2Y12 inhibitor monotherapy after short-term dual antiplatelet therapy was the lowest and triple antiplatelet therapy was the highest.ConclusionsThe available evidence suggests that when the risk of ischemia is low, we should choose aspirin or P2Y12 inhibitor monotherapy after short-term dual antiplatelet therapy, and P2Y12 inhibitor monotherapy may have a lower risk of ischemia and bleeding. When the risk of ischemia is high and bleeding is low, the triple or standard dual antiplatelet therapy should be selected, and the efficacy of triple antiplatelet therapy is superior, while the safety may be inferior.
The construction of high-level talent teams is the core of building up high-level universities and hospitals, and it is an important reference index for the ranking of universities and academic disciplines. The first-class medical talent teams is an essential requirement for comprehensive hospitals to be ranked as "Double First-Class". Based on the practice of construction of high-level medical talents in West China Hospital of Sichuan University, this paper introduces the optimal appoaches in this regard.
A new human resource management system in West China Hospital of Sichuan University has been constructed to inspire work enthusiasm and innovation of the front-line medical staffs, strengthen the cohesion of the hospital, better service for patients, and promote high-quality development of the hospital. This paper introduced it and provided references for related researches.
【摘要】 目的 探讨常规MRI扫描及胰胆管造影（MRCP）对胆管梗阻性疾病的临床诊断价值。 方法 2006年4月-2010年6月，对59例胆管梗阻性疾病患者行常规MRI及MRCP检查，其中18例行动态增强扫描，并与临床诊断或手术、病理结果对照分析。MRCP采用不屏气厚层快速自旋回波（FSE）序列重度T2WI扫描，原始图像以最大信号强度投影（MIP）法进行三维重建。 结果 MRI及MRCP对胆管梗阻程度的判断和定位诊断准确率为100.0%，定性诊断准确率为91.5%，其中MRCP诊断胆管结石和恶性胆管梗阻的准确率分别为96.8%和86.9%。 结论 MRCP对胆管梗阻的定位诊断准确，结合3D原始图像、常规MRI扫描及动态增强扫描，对胆管结石和恶性胆管梗阻的定性诊断有很高的准确性。【Abstract】 Objective To evaluate the clinical diagnosis value of MRI and cholangiopancreatography (MRCP) in diagnosis of biliary obstructive disease. Methods Routine MRI and MRCP were performed on 59 patients between April 2006 and June 2010, in which dynamic enhance scan was performed on 18 patients. The results were compared with clinical diagnosis or surgical findings and pathological examination. Non-breath-hold thick slices heavy T2 weighted TSE sequence was used. The original images were reconstructed by using three-dimensional maximum-intensity-projection (MIP) algorithm. Results The accuracy of MRI and MRCP in the detection of the degree and level of bile duct obstruction was 100.0 % and the accuracy for evaluating the causes of obstruction was 91.5 %. In the diagnosis of bile duct stone and malignant biliary obstruction, the diagnostic rate of MRCP was 96.8 % and 86.9%. Conclusion Routine MRI and MRCP examination can accurately define the level of bile duct obstruction. Combining with the original images and routine images and dynamic enhance scan, the specificity for the diagnosis of bile duct stone and malignant biliary obstruction is high.
According to the characteristics of the diversified employment system of general hospitals, we have independently developed a set of personnel information platforms suitable for our hospital's operating model and work-flow which achieved establishing a novel big data management model for big personnel. After a year of trial operation, the big data management of personnel has completely covered the target management and requirements of the hospital, covering basic quality, public services, teaching work, medical work, scientific research, and other dimensions of information, which helped the hospital constructed a systematically networked and full-coveraged, personnel information system with strong early warning functions and incentives, enabling the reasonable utilization rate of human capital and continuous improvement of the quality of talent training.
West China Hospital of Sichuan University has explored and established an intelligent assistant evaluation mechanism for professional titles based on the personnel information system, which makes the evaluation more convenient, more efficient, and the whole process more open and transparent. This paper aimed to introduce it and to provide references for evidence-based decision-making of medical institutions.