Onehealth, an evidence-based decision-making software, is based on the United Nations' epidemiological reference modules to predict the effect of health services. Onehealth is a large database. The software is using activitybased costing, simulating investment costs of health system and changes of mortality in different coverage levels. By the cost of inputs/avoid deaths, it could quantify the cost of health services effectiveness and provide an intuitive basis for the rational allocation of health resources. This study introduces the relevant concepts, model structures and applications of Onehealth. We took the study of child nutrition interventions in Sudan for example and to present Onehealth tool's operating. As a new auxiliary and evidence-based decision-making software with scientific and rigorous theoretical approach, Onehealth has practical significance on the national or regional macro decision-making.
Bloodless surgery is a comprehensive and systematic perioperative treatment approach in order to avoid allogeneic transfusion for surgery，improve patient prognosis，and relieve blood shortage. Bloodless heart surgery indicates some perioperative strategies to avoid allogeneic transfusion and improve clinical outcomes，which involves participation of cardiac surgeons and other professionals during cardiac surgery. For years，many cardiac surgeons have utilized several blood management and conservation techniques during open heart surgery to avoid allogeneic transfusion. Research results from major medical centers indicate that bloodless heart surgery can shorten postoperative recovery period and improve patientprognosis. In this review，we describe basic theory and systematic methods of bloodless surgery，and summarize applicationprogress of bloodless heart surgery and current status in China.
It has been 36 years since the first version of essential medicine list (EML) was released by WHO in 1977,when 18 versions of WHO-EML and four versions of children essential medicine list have been released. In 1982, the first version of national essential medicine list (NEML) was released in China. Till 2012, there were eight versions of NEML in total. This paper introduces WHO-EML in aspects of origin, idea, definition, design, and innovation of selection methodology,principle, and workflow; compares the evolution, design, selection methodology between WHO-EML and Chinese NEML; and points out the challenges of evaluation and decision making of Chinese NEML.
ObjectiveTo explore the effect of precise management on life-saving equipment management in Surgical Intensive Care Unit (SICU). MethodsWe actualized precise management in the life-saving equipment management process in March 2014, including precise management control system, precise personnel training, and precise process management. ResultsAfter precise management, the knowledgement of life-saving equipment of the nurses increased from 90.2% (May, 2014) to 98.5%. The number of equipments repaired before (March-May, 2014) and after the management (June-August, 2014) was 65 and 47, respectively; the number of nonstandard management times in nurses after the equipments were used was 98 and 10, respectively. ConclusionPrecise management can drastically improve management efficiency, serviceability rate and service efficiency of life-saving equipment, obviously enhancing the degree of familiarity and using skills of clinical nurses, and ensuring quick and smooth emergency work. It plays an active role in securing severe patients' life.
Objective To describe the design and application of an emergency response mobile phone-based information system for infectious disease reporting. Methods Software engineering and business modeling were used to design and develope the emergency response mobile phone-based information system for infectious disease reporting. Results Seven days after the initiation of the reporting system, the reporting rate in the earthquake zone reached the level of the same period in 2007, using the mobile phone-based information system. Surveillance of the weekly report on morbidity in the earthquake zone after the initiation of the mobile phone reporting system showed the same trend as the previous three years. Conclusion The emergency response mobile phone-based information system for infectious disease reporting was an effective solution to transmit urgently needed reports and manage communicable disease surveillance information. This assured the consistency of disease surveillance and facilitated sensitive, accurate, and timely disease surveillance. It is an important backup for the internet-based direct reporting system for communicable disease.
ObjectiveTo explore the application of different digestive system management strategies in the perioperative period of thoracolumbar fracture.MethodsThe clinical data of the patients with thoracolumbar fractures and pedicle screw fixation in Affiliated Hospital of Southwest Medical University from January 2016 to January 2018 were retrospectively analyzed. According to different perioperative management strategies of the digestive system, they were divided into two groups. Patients with careful management strategy were included in the observation group, and patients with routine management were included in the control group. The baseline conditions, the abnormalities of digestive tract function at admission and before and after surgery, the postoperative first feeding time, exhaust time, defecation time, the incidence of other postoperative complications except digestive tract complication, length of stay and patient satisfaction were compared between the two groups. At 6 months after surgery, the fracture healing, loosening or fracture of internal plants were compared between the two groups.ResultA total of 121 patients were included in the study, including 67 cases in the observation group and 54 cases in the control group. There was no significant differences in the baseline conditions between the two groups (P>0.05). There were no significant differences between the two groups in the incidences of digestive system dysfunction at admission (P>0.05). The incidences of digestive system dysfunction in the observation group before and after surgery were lower than those in the control group (29.9% vs. 53.7%, P<0.05; 35.8% vs. 61.1%, P<0.05). The first eating time [(3.7±1.1) vs. (6.7±2.6) h], exhaust time [(7.8±2.3) vs. (13.6±4.2) h], defecation time [(26.7±8.1) vs. (40.9±11.2) h] and length of stay [(6.5±2.4) vs. (9.0±2.7) d] in the observation group were shorter than those in the control group (P<0.005), and the patients’ satisfaction was better than that of the control group (8.3±1.1 vs. 7.6±1.3; t=−3.208, P=0.002). There was no statistically significant difference in the incidence of postoperative complications except digestive tract complication, and the fracture healing rate, the incidence of nail-rod breakage at6 months after surgery between the two groups (P>0.05). No internal plant loosening was found in the two groups of patients within 6 months after surgery.ConclusionThe application of the careful digestive system management strategy in patients with thoracolumbar fractures can help reduce the incidence of perioperative gastrointestinal dysfunction, promote the recovery of perioperative gastrointestinal function, shorten the length of hospital stay, and improve patient satisfaction.
ObjectiveTo evaluate the role of cardiopulmonary bypass (CPB) technique in the treatment of the abdominal soft tissue tumor (ASTT). MethodClinical data of 9 patients with ASTT who underwent CPB-aided resection in zhongshan Hospital of Fudan University from April 2011 to December 2015 were analyzed retrospectively. ResultsAll patients were performed complete resection of tumor, without perioperative death. Six patients received complete CPB technique and other 3 patients received partial CPB technique. In establishment of CPB, patterns of arterial perfusion included the ascending aorta (n=6) and femoral artery (n=3); patterns of venous drainage included the inferior vena cava (n=2), superior vena cava (n=6), femoral vein (n=2), and jugular vein (n=3). Among of them, 7 patients were diagnosed as intravenous leiomyomatosis, 1 patient was diagnosed as small round cell malignant tumor, and another 1 patient was diagnosed as leiomyosarcoma. Two patients occurred postoperative complications, 1 patient was duodenal fistula, with conservative treatment to heal; another 1 patient was inferior vena cava thrombosis, with treatment of placement of the inferior vena cava filter. Nine patients received follow-up, and follow-up time was 1-57 months (the median time was 4-month), and the survival rate was 100%, no one suffered from recurrence. ConclusionsFor some patients with complicated ASTT, CPB technique can provide chance to completely resect the tumors.
ObjectiveTo explore the effect of positive implication in the operating room on the patient's mental. MethodsA total of 160 patients who received the routine laparoscopic appendectomy surgery from January 2011 to October 2012 were treated with positive implications and conventional appease routine psychological care and the fear, pain, depression and anxiety, and other indicators of the two groups were compared. ResultsThe fear scores in the control group patients were significantly higher than that in the observation group (P<0.05). The patient's perceived pain in the control group was higher than that in the observation group (P<0.05); after nursing intervention, the anxiety and depression levels in the two groups decreased significantly; the observation group had significantly higher satisfaction for the entire course of medical treatment (P<0.05). ConclusionThe positive implication in the operating room can effectively alleviate the patient's fear, anxiety, depression and perceived pain and so on and can contribute to the effect of operation and rehabilitation of the patients.
Objective To investigate the application of arm medial fascio-cutaneous flap pedicled with cutaneous nerve and nutrient vessel. Methods From February 1999 to December 2004, 18 cases of skin and soft tissue defect in axillary region, elbow and forearm were treated with arm medial fascio-cutaneous flap pedicled with cutaneous nerve and nutrient vessel. Arm medial fascio-cutaneous flap was directly transferred in 3 cases, adversely transferred in 15 cases. The flap area was 4.5 cm×8.5 cm. Results Vein circulation crisis was observed in 3 cases. Of the3 cases, 1 was necrosis and the other 2 by decompressing small vein were saved.The rest 15 cases survived.The period of follow-up was 3 to 30 months. Flap was satisfactory in appearance and function. Conclusion Arm medial fascio-cutaneous flap pedicled withcutaneous nerve and nutrient vessels can be directly or adversely transferred to repair adjacent soft tissue defect.
Three-dimensional (3D) cell culture model is a system that co-culture carriers with 3D structural materials and different types of cells in vitro to simulate the microenvironment in vivo. This novel cell culture model has been proved to be close to the natural system in vivo. In the process of cell attachment, migration, mitosis and apoptosis, it could produce biological reactions different from that of monolayer cell culture. Therefore, it can be used as an ideal model to evaluate the dynamic pharmacological effects of active substances and the metastasis process of cancer cells. This paper compared and analyzed the different characteristics of cell growth and development under two-dimensional (2D) and 3D model culture and introduced the establishment method of 3D cell model. The application progress of 3D cell culture technology in tumor model and intestinal absorption model was summarized. Finally, the application prospect of 3D cell model in the evaluation and screening of active substance was revealed. This review is expected to provide reference for the development and application of new 3D cell culture models.