ObjectiveTo investigate the economic burden of the disposal of medical personnel after occupational exposure in medical institution.MethodA retrospective survey method was used to investigate and analyze the costs of inspection, treatment, and vaccination of 112 medical personnel after occupational exposure from January 2014 to December 2016.ResultsAfter the occupational exposure, the per capita economic burden on the medical institution for the exposed personnel was (331.80±66.16) yuan; the main expenditure item was the inspection expenses (93.53%); and the expenditure after the exposure of hepatitis B virus accounted for 75.40%, which ranked the top one in the expenditures of blood-derived infectious diseases. Occupational exposure was most likely to occur when dealing with sharps, and the cost of hospital spending accounted for 47.26%. After strengthening interventions such as standard prevention, the per capita cost of occupational exposures in the hospital from 2015 to 2016 showed a downward trend (P<0.05).ConclusionsOccupational exposure of medical personnel may cause a certain economic burden on medical institution. It is necessary to strengthen occupational protection, raise awareness of standard prevention, and reduce occupational exposure.
Objective To investigate the application of multi-detector row spiral CT （MDCT） and multi-planer reconstruction （MPR） in identify the anatomy detail of normal adult groin region. Methods We retrospectively collected the CT images of 50 adult subjects with normal groin anatomic structure underwent groin region thin-slice MDCT scans between July and December 2009, 30 males and 20 females, obtained the coronal and sagittal views by MPR, investigated the value of different plans in identifying anatomic detail. Results Bilateral inferior epigastric artery (100/100, 100%), spermatic cord (60/60, 100%), and round ligament of uterus (40/40, 100%) were well identified on all plans in all subjects. The bilateral “radiological femoral triangle” could be demonstrated on coronal views in all subjects (100/100, 100%). The bilateral inguinal ligament were visible on coronal view in all subjects (100/100, 100%) and on sagittal views in 34 subjects (68/100, 68%), but on axial views was identified in 3 male subjects (6/100, 6%). The bilateral inguinal canal and deep inguinal ring were reliably visible on coronal views in all subjects (100/100, 100%), and on sagittal views in 46 subjects (92/100, 92%). On coronal views, the widths of inguinal canal was (0.97±0.35) cm in left, (0.89±0.23) cm in right for males, and (0.62±0.11) cm in left, (0.71±0.11) cm in right for females. No significant difference was found between two sides (P=0.059 in males， P=0.067 in females), but there were significant differences between males and females (P=0.007 in left， P=0.009 in right). Transverse diameter of deep inguinal ring was (1.32±0.31) cm in left, (1.31±0.36) cm in right for males, and (1.07±0.35) cm in left, (1.07±0.30) cm in right for females. No significant difference was found between two sides (P=0.344 in males， P=0.638 in females), but there were significant differences between males and females (P=0.001 in left， P=0.002 in right). Conclusion MDCT with different plans plays an important role in identify the anatomic details of groin region, the coronal views especially.
目的 比较不同学历护理专业大学毕业生面试成绩的差异，为临床教学和学生就业提供参考。 方法 2012年4月对43名参加面试的护理专业毕业大学生进行笔试与操作考试，采用SPSS 16.0软件比较大专生及本科生面试成绩的差异，并分析学历与面试成绩的相关性。 结果 本科生笔试成绩在71～100分数段的比例高于大专生（χ2=5.324，P=0.031）。本科生笔试成绩高于大专生（t=3.097，P=0.004），且在专业实践题型上的失分低于大专毕业生（t=−2.471，P=0.018）。多重线性逐步回归分析中，笔试成绩的影响因素有学历（β=−8.990，P=0.005）、是否获得奖学金（β=9.990，P=0.002）；面试成绩总分的影响因素为学历（β=−12.676，P=0.015）。 结论 应加快护理教育改革与发展，注重能力培养，促进学生就业。
Objective To explore a new teaching mode relying on the new media platform, aiming to stimulate residency standardized trainees’ interest in learning theories related to gynecology outpatient surgery, improve practical operation skills, and achieve better teaching effects. Methods The residency standardized trainees who rotate in the gynecology outpatient of West China Second University Hospital, Sichuan University between July 2021 and June 2022 were selected. According to the random number table method, the trainees were divided into the control group (using the traditional teaching mode) and the intervention group (using the teaching mode of combining the flipped classroom and simulated teaching relying on the new media platform). The assessment results, teacher evaluation, trainees self-evaluation and teaching satisfaction of the two groups were compared and analyzed. Results A total of 118 trainees were enrolled, 59 in each group. There was no significant difference in gender, age, years of training and education level between the two groups (P>0.05). The total scores of evaluation scores (87.59±4.54 vs. 85.17±3.70), teachers’ evaluation (87.05±3.79 vs. 85.14±3.75), and trainees’ self-evaluation (87.81±4.41 vs. 85.54±3.96) of trainees in the intervention group were better than those in the control group, and the differences were statistically significant (P<0.05). The clinical thinking ability [teachers’ evaluation (24.49±1.62 vs. 23.22±2.05), trainees’ self-evaluation (25.25±1.99 vs. 23.97±2.27) and operation skills [teachers’ evaluation (37.05±1.58 vs. 36.10±1.99), trainees’ self-evaluation (36.75±2.73 vs. 35.66±2.56)] of trainees in the intervention group were better than those in the control group, and the differences were statistically significant (P<0.05). The satisfaction rate of the trainees in the intervention group was 98.3%, and that of the trainees in the control group was 93.2%. The teaching satisfaction of the intervention group was better than that of the control group (P<0.05). Conclusion The teaching mode of combining flipped classroom and simulated teaching relying on the new media platform has effectively stimulated residency standardized trainees’ learning interest in gynecological outpatient surgery, improved trainees’ clinical practice ability, improved teaching satisfaction, achieved good teaching results, and can be promoted as a new teaching mode.
Objective To explore the clinical effect and complications of lumbar plexus block through different approaches on perioperative analgesia in aged proximal femur surgery, and find the best method for analgesia in these patients. Methods From January to December 2015, 150 elderly patients scheduled for proximal femur surgery were randomly divided into three groups: psoas compartment block (PCB group, n=50), Winnie " 3 in 1” block (Winnie group, n=50), and fascia iliaca compartment block (FICB group, n=50). Twelve hours before surgery, guided by ultrasound and nerve stimulator, lumbar plexus blocks were performed in all the patients, then patient-controlled analgesia (the formula and the usage were the same) was done. All patients received epidural anesthesia, and were maintained postoperative analgesia for 72 hours. If Rest Visual Analogue Scale>3 or Initiative Movement Visual Analogue Scale>4, sufentanyl 10 μgi.m. was given. Muscle strength grades and complications were recorded. Anesthetic effect of sensory block of femoral, lateral femoral cutaneous, and obturator nerves were measured and recorded too. Results There were two cases of epidural block, and one case of puncture point bleeding in group PCB; no complication in the other groups was found. There was no remedy for inadequate analgesia in the three groups. Compared with group PCB, the muscle strength grades during postoperative 24–72 hours in group FICB were higher (P<0.05). The successful rate of the block of lateral femoral cutaneous nerves was 64%, 91% and 96% in group Winnie, group PCB and group FICB, respectively, and the differences between the three groups were all statistically significant (P<0.05). The successful rate of the block of obturator nerves in group FICB (62%) was lower than that in group PCB (89%) and Winnie group (84%) (P<0.05). Conclusion Continuous fascia iliaca compartment block on perioperative analgesia in aged proximal femur surgery, with exact effect, less complications and simple operation, is better than the psoas compartment block and Winne " 3 in 1” nerve block.
ObjectiveTo systematically evaluate the risk prediction models for postoperative pulmonary infection in patients with esophageal cancer, providing an objective basis for clinical selection and optimization of models. MethodsA systematic search was conducted in Chinese and English databases such as VIP, Wanfang, CNKI, PubMed, Cochrane Library, EMbase, Web of Science, and CBM for studies related to the risk prediction models of postoperative pulmonary infection in patients with esophageal cancer from the inception to September 30, 2024. The PROBAST tool was used to assess the quality of prognostic model research, and the RevMan 5.4 software was used for meta-analysis of predictive factors. ResultsA total of 17 articles were included, containing 26 pulmonary infection risk prediction models. The area under the receiver operating characteristic curve (AUC) ranged from 0.627 to 0.942, among which 22 models had good predictive performance (AUC>0.7). Quality assessment through the PROBAST tool revealed that all 17 articles had a high risk of bias. Meta-analysis results showed that common predictive factors for postoperative pulmonary infection in esophageal cancer included smoking history (OR=1.97), smoking index ≥200 (cigarettes-years) (OR=4.38), smoking index ≥400 (cigarettes-years) (OR=2.00), age (OR=1.39), comorbid diabetes (OR=2.13), comorbid emphysema or chronic obstructive pulmonary disease (OR=1.55), low plasma albumin levels (OR=1.17), prognostic nutritional index (OR=4.45), history of related lung diseases (OR=2.10), tumor location (OR=2.32), surgical approach (OR=2.21), operation time (OR=1.73), preoperative serum calcitonin levels (OR=3.06), anastomotic leakage (OR=3.39), reduced forced expiratory volume in the first second/forced vital capacity ratio (OR=0.86), and hoarseness (OR=2.23). ConclusionAt present, the risk prediction models for postoperative pulmonary infection in esophageal cancer are still in the stage of continuous development and optimization, and their research quality needs to be further improved. Future research can refer to the predictive factors summarized in this study based on meta-analysis, combined with clinical practice, to select appropriate methods to construct and validate the risk prediction models for postoperative pulmonary infection in esophageal cancer, thus providing early targeted preventive strategies for high-risk patients.
Objective To analyze the clinical manifestations, diagnosis, treatment and prognosis of bone hydatid disease in China by literature review. Methods We searched the databases of China National Knowledge Infrastructure and Wanfang for case reports of bone hydatid disease published from 2000 to 2015 in China. Data were extracted by using a standardized form and a retrospective clinical analysis was performed. Results A total of 21 relevant literatures published from 2000 to 2015 were included, including 87 cases of bone hydatid disease treated from 1975 to 2015. The regional distribution of bone hydatid disease was mainly concentrated in the animal husbandry areas in China. In terms of diagnosis basis, imaging examination was mentioned in 54 cases (62.1%), laboratory examination was mentioned in 32 cases (36.8%), and pathologic examination was mentioned in 8 cases (9.2%), etc. Surgical treatment was the main treatment, and some treatments were combined with chemotherapy. The outcomes of bone hydatid disease were relatively poor. In the 44 cases whose outcomes were reported, 26 cases (59.1%) had recurrence, 18 cases were cured (40.9%), 10 cases (22.7%) underwent re-operation, and 2 cases (4.5%) died. Conclusions Bone hydatid disease is rare. Surgical treatment is still the main method for treating bone hydatid disease. The rate of recurrence of bone hydatidosis is relatively high, so it is very important to explore new methods for diagnosis and treatment of bone hydatid disease.
Objective To investigate safety and therapeutic effect of total pancreatectomy plus splenectomy for patient with pancreatic cancer. Methods The preoperative clinical data, surgical treatment, and postoperative conditions of 1 patient with pancreatic cancer who underwent the total pancreatectomy plus splenectomy in the Affiliated Hospital of Qinghai University in January 2018 were retrospectively analyzed. Results Combination of the patient clinical history, physical examination, laboratory and radiologic results, the patient was diagnosed with the pancreatic cancer. Then the patient underwent the Whipple procedure. During the operation, it was found that the texture of the pancreas was hard, and the spleen arteriovenous were considered to be invaded, and the multiple frozen section analysis during the operation showed that the surgical margin was positive. Eventually, the total pancreatectomy plus splenectomy was performed. The postoperative pathological analysis results revealed to the well-moderately differentiated tubular adenocarcinoma. When the condition of patient became stable, the pancreatin and insulin were required for long time. No severe complications occurred. The patient survived well after the surgery and no recurrence was observed for following-up of 3 months. Conclusion With improvement of surgical techniques and enhancement of postoperative management, total pancreatectomy can be used as a treatment for pancreatic cancer and it is still safe and feasible.
Objective To detect and analize the expressions and it’s clinical significance of apoptosis factors in hepatic alveolar echinococcosis tissues by using antibody chip technology. Methods The liver tissue specimens (including the edge of lesions and normal liver tissues) of surgical resection of 6 patients with hepatic alveolar echinococcosis in Affiliated Hospital of Qinghai University were collected. The tissue protein was extracted and the level of apoptosis was detected by antibody chip technology. The data were analyzed by AAH-APO-G1 software. Results The expression levels of 5 kinds of apoptosis factors (Bad, Fas, IGFBP-3, P21 and XIAP) in the liver tissues of the marginal zone of hepatic alveolar echinococcosis were compared with that of the normal liver tissues, and the difference was statistically significant (P<0.05). The expression levels of Bad, Fas, IGFBP-3 and P21 were up-regulated, and the expression level of XIAP was down regulated. Conclusions Apoptosis-related factors play a role in the progression of the hepatic alveolar echinococcosis, there may be contact with the immune escape mechanisms, while promote apoptosis factor and inhibitory apoptosis factor that may exist the function imbalance, so more in-depth exploration the mechanism of apoptosis factors on hepatic alveolar echinococcosis in diagnosis and treatment have important significance.