Objective To discover the similarities and differences between CBM and MEDLINE databases in the field of post-earthquake health issue research characteristics in order to provide references and aids to the scientific research administration, professional education and training, research subjects selection and project finance support. Methods CBM and MEDLINE databases (from January 1987 to December 2009) were systematically searched to obtain literature about post-earthquake health issues. Those studies were classified and compared by the characteristics of research objects, health issues, research periods, and types of study design. Results A total of 701 literature from CBM and 387 from MEDLINE were included. MEDLINE database provided more studies focusing on victims of natural calamities with specific age description than CBM (Plt;0.05). Research peak of CBM database centralized in the period of three months after earthquake (n=645, 92%), while MEDLINE was three years after the earthquake (n=191, 87.2%). Studies from both databases similarly focused on physical trauma and psychiatric/psychological issues (two types of health issues in total: CBM: n=727, 86.1%; MEDLINE: n=358, 83.4%). Investigations from CBM were primarily designed for retrospective and descriptive research (n=439, 62.6%), cross-sectional investigations (n=146, 20.8%) and case report (n=86, 12.3%) while MEDLINE focalized on cross-sectional investigations (n=177, 45.7%) and retrospective and descriptive research (n=146, 37.7%). Conclusion Compared to MEDLINE, studies from CBM database are relatively weak in the post-earthquake health issues of population with specific age characters, long-term health issues, levels of evidence and types of research design. The possible reasons are insufficient attention to the post-earthquake health issues, inadequate preparation for the research or limited knowledge about research methods.
Objective To explore the effect of standardized use of antibiotics on clinical indicators after thoracic surgery, such as pulmonary infection rate, incision infection rate, average length of hospital stay and total hospitalization cost. Methods We selected 468 patients (an observation group) who were hospitalized and received thoracic surgery from August to October 2011, 3 months after the implementation of the preventive antibiotics use protocol for thoracic surgery in West China Hospital, Sichuan University, and selected 343 patients (a control group) in the same period of the previous year (from August to October 2010). There were 326 males and 142 females with a mean age of 52.0±15.5 years in the observation group, and 251 males and 92 females with a mean age of 51.4±15.9 years in the control group. The level of antibiotic use, medication time, antibiotics cost, postoperative incision infection, incidence of pulmonary infection, postoperative hospital stay and total hospitalization cost were compared between the two groups. Results Compared with the control group, the time for preventive use of antibiotics was significantly shorter in the observation group (3.6±2.4 d vs. 6.1±3.1 d, P=0.020) and the total cost of antibiotic use significantly reduced (1 230.0±2 151.0 yuan vs.2 252.0±1 764.0 yuan, P<0.001). There was no significant difference between the two groups in hospitalization cost(36 345.0±13 320.0 yuanvs. 35 821.0±11 991.0 yuan, P=0.566), postoperative hospital stay (10.6±8.4 d vs. 10.7±5.3 d, P=0.390), the incidence of postoperative wound infection or postoperative pulmonary infection (1.5% vs. 2.3%, P=0.430; 19.2% vs. 22.2%, P=0.330). Conclusion The standardized use of antibiotics in thoracic surgery does not cause postoperative pulmonary infection and incision infection, and has no negative impact on clinical indicators. Significantly reducing the level of antibiotics use may have a positive effect on reducing medication time, in-hospital infection and the incidence of drug-resistant strains.
ObjectiveTo explore the safety and effectiveness of video-assisted thoracoscopic surgery (VATS) pneumonectomy for bronchiectasis.MethodsThe clinical data of 164 patients undergoing VATS pneumonectomy or open thoracotomy for bronchiectasis in our hospital from March 2002 to July 2012 were retrospectively analyzed. Patients were divided into two groups according to different surgical methods: a thoracotomy group (122 patients, 63 males, 59 females) and a thoracoscopic surgery group (42 patients, 15 males, 27 females). Surgical and follow-up indicators were compared between the two groups.ResultsThere was no difference between the two groups in the blood loss, operation time, perioperative mortality or complication. However patients undergoing VATS had shorter length of postoperative stay than those undergoing thoracotomy (6.9±2.6 d vs. 8.1±3.1 d, P=0.030). In the thoracoscopic surgery group, 3 patients were lost to follow-up and in the thoracotomy group, 5 patients were lost to follow-up. In a median follow-up of 51 months (ranging from 2 to 116 months), 36 patients (92.3%) fully recovered with no sputum or haemoptysis and 3 (7.7%) partially recovered with a reduced sputum or haemoptysis in the thoracoscopic surgery group; 105 (89.7%) fully recovered with no sputum or haemoptysis, 10 (8.5%) partially recovered with a reduced sputum or haemoptysis while 2 (1.7%) without any improvement in the thoracotomy group with no statistical difference (P=0.700).ConclusionVATS pneumonectomy for bronchiectasis is equivalent to thoracotomy in terms of safety and effectiveness, and can be used as an alternative surgical procedure for the treatment of bronchiectasis.