The West China hospital of Sichuan university has underwent four times emergency medical rescue (EMR) of earthquakes, measuring 5.7 Ms to 8.0 Ms on the Richter scale, happened at Wenchuan, Yushu, Yiliang and Lushan in recent 5 years, which gradually improved and supplemented Wenchuan experience. After Lushan earthquake, a total of 392 patients were received during 2 weeks. Among 321 hospitalized patients, there were 39 (12.15%) patients with critical injury and 14 (4.36%) patients who needed intensive care. 184 operations were performed. Based on the experiences of resource centralization, multidisciplinary cooperation, and hierarchical management, zero death, a new medical record, has been achieved among 43 patients with critical injury after centralized admission and treatment. A total of 12 medical rescue teams involving 88 healthcare workers were sent to the epicenter to join and guide EMR. Besides, rehabilitation and psychological experts came to Lushan on the first day of earthquake, and started clinical intervention of mental and physical health for people needed on the second day.
The paper summarizes three revolution trends of medical service mode in the age of 5th generation mobile networks (5G), including artificial intelligence & intelligent medical service, internet of things & internet hospital, and intelligent hospital. Artificial intelligence & intelligent medical service mainly covers artificial-intelligence-assisted diagnosis, artificial-intelligence medical decision-making, and artificial-intelligence-assisted new drug research & development. Internet of things & internet hospital mainly covers internet hospitals, internet care, cloud pharmacies, and medical imaging clouds. Intelligent hospitals mainly cover intelligent clinics, intelligent wards, and intelligent management. The revolution trends count on not only techniques such as 5G, but also the support and cooperation of the government and society. The risk of information and data leak needs attention.
Precision medicine is a novel medical modality based on genome sequencing, bioinformatics and big data science. The studies regarding tuberculosis always concentrated on the bacteria and host in the setting of precision medicine. This review mainly introduces the application of precision medicine in the diagnosis and treatment of tuberculosis. The limits of the Chinese studies with respect to precision medicine in tuberculosis are also discussed. Moreover, the article predicates its future development.
Objective To discuss the effectiveness of salmeterol in treating a case of chronic obstructive pulmonary disease (COPD). Methods Aimed at the effectiveness of salmeterol in treating COPD patients, a comprehensive search was conducted in EMbase Web (2007 to 2011) and EBSCOhost Web (2000 to 2010) to obtain and evaluate the relevant systematic reviews, meta-analysis and randomized controlled trials (RCTs), and finally to apply the best evidence in clinical practice. Results There were 2 systematic reviews, 3 meta-analyses and 172 RCTs in the initial retrieval; and 12 RCTs and 1 meta-analysis were finally included after being screened. The results indicated a significant improvement in lung function, clinical symptoms and life quality after inhalation of sameterol in COPD patients. The patient had a good effect when the above evidence was applied at the patient’s will. Conclusion The inhalation of salmeterol for COPD can significantly improve lung function, alleviate clinic symptoms and improve life quality of the patients. But there are still some side-effects which should be considered in practical applications.
With the rapid development of information technology, medical reforms in various countries are moving towards informatization, and internet medical projects have been carried out gradually. Internet hospitals, as one of the manifestations of internet medical projects, have the advantages of improving the efficiency of medical services, revitalizing and effectively sinking high-quality medical resources, and therefore has become the focus of China’s next stage of medical reform. However, internet hospitals are innovative and local products of China, leading its practices lack of domestic and foreign theoretical research, as well as experience, which results in government policies and hospital management strategies are both moving forward in groping, and the construction outcomes vary. Therefore, this article aims to analyze the comprehensive dilemmas currently confronted by internet hospitals in China in different stages of construction, operation and management based on PDCA cycle, and thus, puts forward corresponding construction thinking and analysis in a targeted manner, and proposes guidance for the further development of internet hospitals.
Lung cancer in never-smokers has been identified as a separate disease entity. Notably, the proportion of this distinct disease has been reported to increase in recent decades. Due to its occult onset and lack of clinical specificity, patients with this disease are always diagnosed with advanced stage. This review summarizes the current literatures about the risk factors, clinicopathological characteristics, molecular features, and prognosis of lung cancer in never-smokers, which will enhance our understanding and facilitate the precise management of this distinct disease.
Early diagnosis of lung cancer is difficult because of it’s lacking in distinctive clinical characteristics. With the development of CT technology for chest, the detection rate of pulmonary nodules is increasing year by year and acquires extensive attention. Therefore, the accurate clinical diagnosis to identify the character of solitary pulmonary nodules is urgently needed. However, the current clinical applications of different diagnosis have pluses and minuses. In this paper, we mainly review the diagnosis, management strategies and the existing problems of solitary pulmonary nodules based on the cancer-screening guidelines of Fleischner Society, American College of Chest Physicians, National Comprehensive Cancer Network, Evaluation of Pulmonary Nodules: Clinical Practice Consensus Guidelines for Asia, and Chinese Consensus on Pulmonary Nodules, and clinical research progress of pulmonary nodules.
Objective To investigate the relationship between smoking and lung cancer by evidence-based evaluation. Methods Using Meta-analysis method, the results of 29 case-control studies involving the relationship between smoking and lung cancer in recent decade were analyzed by Review Manager 4. 2 software. Results The association between smoking and lung cancer was significant ( Z =12. 16, P lt; 0. 000 01) , and the pooled OR value was 5. 75( 4. 34, 7. 62) . The population attributable risk percentage( PARP) of smoking was 69. 16% . The pooled OR of 1-10 cpd( cigarettes per day) , 10-20 cpd, 20-40 cpd and more than 40 cpd were 1. 97( 1. 69, 2. 30) , 5. 20( 3. 54, 7. 62) , 7. 46( 5. 22, 10. 67) and 15. 14 ( 5. 27, 43. 44) respectively. The pooled OR of less than 20 years of smoking duration, 20-40 years and more than 40 years were 1. 25( 1. 01, 1. 53) , 5. 10( 3. 03, 8. 57) and 10. 77( 7. 30, 15. 89) respectively. While the pooled ORof less than 10 pack-years, 10-20 pack-years, 20-40 pack-years and more than 40 pack-years were 1. 73( 1. 01, 2. 96) , 3. 73 ( 3. 02, 4. 61) , 5. 69 ( 3. 79, 8. 54) and 8. 41 ( 4. 56, 15. 51) respectively. The pooled OR of initial smoking age less than 15 years old, 15-20 years old and more than 20 years old were 13. 31( 7. 09, 24. 97) , 7. 21( 4. 51, 11. 52) and 4. 74( 3. 47, 6. 47) respectively. The pooled OR of quitting smoking for 1-10 years, 10-20 years and more than 20 years were 7. 16( 4. 70, 10. 91) , 2. 12( 1. 16, 3. 86)and 1. 47 ( 0. 67, 3. 20 ) respectively, and more than 20 years of quitting smoking had no significant difference. The pooled OR of light smoking and deep smoking were 3. 26( 1. 24, 8. 58) and 8. 07( 4. 67, 13. 94) respectively. Conclusions Smoking is an important risk factor of lung cancer. Meta-anlalysis revealed cigarettes comsuption per day, smoking duration, total amount of cigarettes ( pack-years) , smoking behaviour( depth) , initial age of smoking and duration of quitting smoking can increase the risk of lung cancer.
Targeted initiatives of West China Hospital of Sichuan University to cope with coronavirus disease 2019 epidemic in three stages were summarized, including “three reconstructions” to mobilize in pre-epidemic stage, “three earlies” strategy to precisely treat critically ill patients in epidemic stage, and “three orderlies” to resume hospital operation in post-epidemic stage. The development of comprehensive hospitals in China after the epidemic was also discussed. It’s recommended to continuously strengthen the role of emergency response, early warning, comprehensive treatment, high-level talent training, international exchange, regional leadership, and collaborative innovation, in response to the shortcomings exposed in the epidemic.
ObjectiveTo explore the prognostic value of fasting blood glucose concentration in patients with newly diagnosed lung cancer.MethodsThe clinical data of 956 patients with lung cancer who were first diagnosed at West China Hospital of Sichuan University between January 2008 and December 2011 were retrospectively analyzed. The patients were followed up for more than 5 years. Using the fasting blood glucose concentration of 6.1 mmol/L as the cut-off value, the patients were divided into the hyperglycemia group and the control group. Kaplan-Meier method was used for survival analysis, and log-rank test was used to analyze the survival of different groups. Univariate and multivariate Cox proportional hazard models were used to evaluate the prognostic variables.ResultsThere were 166 patients in the hyperglycemia group with a 5-year overall survival rate of 23.5%, and 790 patients in the control group with a 5-year survival rate of 30.8%, and the difference between the two groups was statistically significant (P=0.008). Univariate Cox proportional hazard analysis found that blood glucose concentration, gender, age, smoking history, staging, and whether surgery were factors that affected the 5-year survival rate of patients (P<0.05); multivariate Cox proportional hazard analysis showed that blood glucose concentration [hazard ratio (HR)=1.235, 95% confidence interval (CI) (1.013, 1.504), P=0.036], age [HR=1.305, 95%CI (1.110, 1.534), P=0.001], smoking history [HR=1.210, 95%CI (1.033, 1.418), P=0.018], staging [HR=1.546, 95%CI (1.172, 2.040), P=0.002], and whether surgical treatment [HR=0.330, 95%CI (0.257, 0.424), P<0.001] were independent factors which influenced 5-year survival rate. Blood glucose concentration, age, smoking history, and staging were independent risk factors.ConclusionFasting blood glucose concentration is able to be a prognostic factor for patients with newly diagnosed lung cancer.