目的:调查分析临床医务人员对医疗废物分类知识的知晓程度及存在问题。方法:随机抽查我院临床医务人员210人,填写医疗废物分类知识调查问卷。结果:我院临床医务人员对医疗废物分类知晓程度较低,其中护士对多数问题的知晓率高于医生和护工,医生和护工之间其知晓率没有统计学差异。结论:医疗废物管理的首要环节是医疗废物的分类收集,提高临床医务人员对相关知识的知晓率至关重要。
Recently, with the development of technology, the 5th generation mobile communication technology (5G) is developing day by day. Mobile medical industry has a huge market in our country. As a strategic emerging industry in China, 5G will focus on the medical care industry, enhance the service quality of medical care, enable innovative applications and services, and make the medical industry more digital, networked and intelligent. 5G has an epoch-making significance for improving the quality of health monitoring and self-care ability, and promoting medical care development. Therefore, this paper introduces the definition, advantages, and significance of 5G and its application status in medical care, in order to lay a foundation for promoting the deep integration of 5G and medical care.
ObjectiveTo investigate the effect of different use time of intermittent pneumatic compression (IPC) on the incidence of deep vein thrombosis (DVT) of lower extremities after arthroplasty.MethodsBetween October 2018 and February 2019, 94 patients who planned to undergo unilateral total hip or knee arthroplsty and met the selection criteria were randomly divided into a control group (47 cases) and a trial group (47 cases). There was no significant difference in gender, age, surgical site, and surgical reason between the two groups (P>0.05). After returning to the ward, all patients were treated with IPC. And the IPC was used until 9:00 pm on the day after operation in the trial group and until 8:00 am the next day after operation in the control group. The levels of hemoglobin, platelet count, D-dimer, hospital stay, treatment costs, patients’ satisfaction with IPC, the parameters of thromboelastrography [kinetics (K value), freezing angle (α angle), reaction time (R value), maximum amplitude (MA value)], visual analogue scale (VAS) score, circumference difference of calf before and after operation, Pittsburgh sleep assessment score, and the incidence of DVT of lower limbs were recorded and compared between the two groups.ResultsThe K value and D-dimer before operation were significant different between the two groups (P<0.05). There was no significant difference in pre- and post-operative hemoglobin, platelet count, and the other parameters of thromboelastography between the two groups (P>0.05). There was no significant difference in pre- and post-operative VAS scores and post-operative circumference difference of calf between the two groups (P>0.05). The sleep assessment score of the trial group at 1 day after operation was significant lower than that of the control group (t=2.107, P=0.038). There was no significant difference in the hospital stay and treatment costs between the two groups (P>0.05). There was 1 case (2.1%) of DVT, 3 cases (6.4%) of intermuscular venous thrombosis, and 1 case (2.1%) of infection in the trial group, and 2 cases (4.3%), 4 cases (8.5%), and 0 (0) in the control group. The differences were not significant (P>0.05). After the completion of postoperative IPC treatment, the satisfaction rates of using IPC were 89.4%(42/47) in the trial group and 70.2% (33/47) in the control group, and the difference was not significant (χ2=0.097, P=0.104).ConclusionIPC using for a short period of time after arthroplasty do not increase the degrees of the pain and the swelling of calf; it can effectively prevent DVT of the lower extremity, improve the quality of sleep in patients, and is good for the limbs rehabilitation.
With the rapid development of artificial intelligence and natural language processing technologies, ChatGPT (Chat Generative Pre-trained Transformer) has been preliminarily applied in the medical domain. ChatGPT has the advantage of generating coherent and logically reasonable natural language based on big data, and some scholars have conducted preliminary discussions on its application and effectiveness in the medical domain. This article will summarize the application progress of ChatGPT in medical education, assisted clinical decision-making, and medical research based on the authors’ experience in applying ChatGPT, and look forward to its future development trends. At the same time, this article will also conduct an in-depth analysis of the challenges and limitations of ChatGPT in practical medical applications, laying the foundation for the standardized use of ChatGPT in the medical domain.
ObjectiveTo explore the postoperative effect of preoperative anemia on patients undergoing unilateral total hip arthroplasty (THA).MethodsA total of 200 patients undergoing unilateral primary THA from July to September 2018 were selected. According to the preoperative hemoglobin level and the World Health Organization definition of anemia (hemoglobin below 120 g/L for women and below 130 g/L for men), the patients were divided into the non-anemia group and the anemia group. All anemia patients were given dietary guidance and balanced diet before the operation, and no drug treatment was given. Both groups adopted accelerated rehabilitation strategy during the perioperative period, and postoperative anemia was treated according to a unified standard. The intraoperative blood loss and length of operation of the two groups were recorded. The presence of anemia on the first postoperative day, postoperative blood transfusion rate, incidence of postoperative complications (hypotension, nausea and vomiting on the first postoperative day, and infection-related unplanned readmission within 90 days after discharge), range of motion of the hip joint (hip flexion and hip abduction), and length of hospital stay were compared between the two groups.ResultsIn the 200 patients, 51 (25.50%) presented anemia before surgery and 149 did not. There were 114 cases developing mild anemia and 7 cases developing moderate anemia after surgery in the non-anemia group, with an anemia incidence of 81.21%; in the anemia group, there were 30 cases of mild anemia and 20 cases of moderate anemia, and 1 case did not have anemia after surgery. The postoperative transfusion rates of the non-anemia group and the anemia group were 2.01% and 11.76%, respectively, and the incidences of postoperative complications were 7.38% and 35.29%, respectively; the differences were statistically significant (P<0.05). However, there was no statistically significant difference in hip mobility or length of hospital stay between the two groups (P>0.05).ConclusionsQuite a few patients undergoing THA have anemia before surgery. The incidence of postoperative anemia is high due to the trauma and massive bleeding of the operation, and preoperative anemia will aggravate anemia after surgery. Preoperative anemia can increase the perioperative transfusion rate of THA patients, increase the incidence of postoperative complications, and affect the hospitalization experience of patients.
In recent years, reports of domestic robot-assisted total knee arthroplasty have gradually increased. In response to problems that may arise during the perioperative period, West China Hospital of Sichuan University has adopted measures such as the establishment of multidisciplinary team, adequate preoperative evaluation, precise intraoperative operations, and whole process optimization management (incision management, pain management, functional exercise and follow-up management). Combined with the actual clinical situation, a domestic robot-assisted total knee arthroplasty management program during the perioperative period was explored and formulated to promote the recovery of patients. This article introduces the above-mentioned program, and aims to provide a reference for the management optimization of domestic robot-assisted total knee arthroplasty during the perioperative period.
Objective To summarize the best evidence of preoperative prehabilitation for patients undergoing total joint replacement/total knee replacement (THA/TKA), and to provide reference for clinical work in the context of enhanced recovery after surgery (ERAS), in order to speed up the postoperative rehabilitation process of patients undergoing THA/TKA. Methods Up To Date, BMJ Practice, National Institute for Health and Care Excellence, Cochrane Library, JBI Evidence-Based Health Care Center Database, Guidelines International Network, www.guide.medlive.cn, PubMed, China National Knowledge Infrastructure, VIPdata, and WanFang Data were searched by computer for literature about preoperative prehabilitation of THA/TKA patients. The retrieval time was from the establishment of the databases to May 31, 2022. The quality of the included literature was evaluated by 2 researchers with evidence-based training. Results A total of 11 publications were included, including 1 guideline, 3 expert consensuses, 3 systematic reviews, and 4 randomized controlled trials, covering 6 aspects of multidisciplinary team, patient education, drug management, nutritional guidance, index control, and exercise intervention. A total of 16 best evidences of preoperative prehabilitation in patients with THA/TKA were extracted, including 9 A-level recommendations and 7 B-level recommendations. Conclusions THA/TKA prehabilitation includes various comprehensive interventions. With the development of ERAS in orthopaedics, the best evidence extracted can be used by clinical staff for THA/TKA. Evidence-based evidence is provided for patients to formulate prehabilitation programs.
At present, the 2019-nCoV epidemic situation is in severe and complex period. In order to prevent the virus from invading and infecting, it is very important and urgent for medical personnel to protect themselves. However, in the process of using protective equipment by medical personnel, the performance of device related pressure injuries (DRPI) caused by pain, numbness, redness, and even breakage caused by the equipment has seriously endangered the health of medical personnel. This article, based on Prevention and Treatment of Pressure Ulcers/Injuries: Quick Reference Guide 2019, references, and clinical experiences of wound specialists in West China Hospital of Sichuan University, summarize the preventive and protective measures of West China Hospital for medical personnel to prevent DRPI, so as to provide clinical preventive measurements for medical personnel.
In order to adapt to the development of the new medical care model, West China Hospital of Sichuan University established a multidisciplinary follow-up team, established follow-up health files, implemented follow-up health management, assessed the risk of abnormal indicators, guided rehabilitation, established green medical treatment channels, managed follow-up data, prevented health management risks, and continuously improved quality. Through these measures, West China Hospital of Sichuan University has established a standardized and systematic follow-up management model for patients with cervical spondylosis after discharge, in order to promote the functional rehabilitation of patients during the perioperative period, and improve patient satisfaction. This article introduces this contract-based follow-up management model, which aims to provide a reference for other medical institutions to establish a good follow-up management system for patients with cervical spondylosis.
In the context of accelerated rehabilitation, nutritional support for patients with orthopedic cervical spondylosis is an important condition for lessening postoperative stress response, reducing postoperative complications, shortening patient’s length of hospital stay, lowering medical expenses, and promoting early recovery of patients. Based on this, West China Hospital of Sichuan University explored and established the West China Hospital program for nutritional management in cervical spondylosis from the aspects of team building, nutritional assessment and monitoring, and nutritional intervention.