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。
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.
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.
Objective To retrieve and summarize evidence of non-pharmacological interventions for sleep disorders in patients with osteoarthritis (OA), and to organize and evaluate the extracted evidence to provide evidence-based interventions for sleep disorders in patients with OA. Methods The relevant literature on non-pharmacological interventions for sleep disorders in patients with OA in BMJ Best Practice, UpToDate, JBI evidence-based healthcare center database, National Institute for Health and Clinical Excellence, Registered Nurses’ Association of Ontario, Guidelines International Network, Medlive guidelines network, Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure and Wanfang was systematically searched. The search deadline was June 30th, 2024. The retrieved results were integrated and analyzed to form evidence of non pharmacological interventions for sleep disorders in patients with OA. Results A total of 13 articles were included, including 1 evidence report, 5 guidelines, 2 expert consensus papers, 3 systematic reviews, and 2 randomized controlled trials. The summarized evidence involves six aspects of sleep screening, specialist visits, assessment tools, cognitive behavioral therapy, exercise therapy, and other measures, totaling 20 pieces of evidence. Conclusion Non-pharmacological interventions for sleep disorders of patients with OA include multiple aspects, and this evidence can provide theoretical basis for developing intervention plans for sleep disorder of patients with OA, thereby improving their sleep quality and enhancing quality of life.
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.
Wearable devices, as an important component of digital health, are gradually penetrating into the clinical nursing field. This paper explores the current applications of wearable devices in the field of clinical nursing, with a focus on their significant roles in real-time monitoring of physiological parameters, disease management, functional rehabilitation exercises. Additionally, it analyzes the challenges these devices face, such as the need for standardized development, data security and privacy protection, and cost-benefit analysis. This paper also proposes measures to address these challenges, including enhancing policy formulation, promoting standardization, and fostering technological innovation, with the aim of providing valuable insights for the advancement of high-quality clinical nursing practices.
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 evaluate the effectiveness of the shared decision-making scheme in postoperative out-of-hospital extended care for patients with total hip/knee arthroplasty (THA/TKA). Methods Patients who underwent THA/TKA in the Department of Orthopedic Surgery at West China Hospital of Sichuan University between October 2023 and April 2024 were included using convenience sampling. Patients were divided into the control group (odd-numbered dates) and the intervention group (even-numbered dates) based on the surgical dates. The intervention group was received care guided by a shared decision-making protocol, whereas the control group was followed the standard post-arthroplasty follow-up procedures. Differences between the two groups were compared in terms of decision-making capacity, decision satisfaction, and hip/knee function at the following time points: on the day of discharge, 3 weeks after discharge, 2 months after discharge, and 3 months after discharge. Results A total of 118 patients were included, with 59 cases in each group. There were no significant differences in demographic and clinical characteristics between the two groups (P>0.05). In terms of decision-making, compared with the control group, the experimental group had stronger decision-making ability, lower decision-making conflict, and more satisfaction with the decision-making process (P<0.05). In terms of joint function, the experimental group showed better joint function than the control group at 3 weeks, 2 months, and 3 months after surgery (P<0.05). There was no significant difference in the pain dimension of the Western Ontario and McMaster Universities Osteoarthritis index between the two groups (P=0.199). Conclusions Compared with the traditional follow-up protocol, the shared decision-making protocol can enhance patient engagement in medical decision-making, reduce decisional conflict, improve satisfaction with the decision-making process, and simultaneously promote joint functional recovery and expedite the rehabilitation process.
Orthopedic joint replacement surgery is an important means of treating moderate to severe joint diseases. Preoperative pre-rehabilitation plays a significant role in enhancing the success rate of surgery, reducing postoperative complications, and promoting early recovery of patients. The joint surgery team of Department of Orthopedic Surgery of West China Hospital, Sichuan University, has developed a West China Hospital program for preoperative pre-rehabilitation of orthopedic joint replacement based on the concept of enhanced recovery after surgery, comprehensive research at home and abroad, and their own clinical experience. The purpose of this article is to systematically explain the background, team building and responsibilities, and detailed preoperative re-habilitation program for joint replacement surgery, in order to provide a reference for clinical practice, help optimize preoperative management, and improve the overall treatment effect of patients.