Management Measures for Preventing Postoperative Incision Infections in General Surgery at Primary Hospitals

Objective:To analyze the management measures and effects of preventing postoperative incision infections in the general surgery department of primary hospitals.Methods:Forty-nine surgical patients with 11 healthcare workers who were admitted to the general surgery department of the primary hospital between August 2021 and August 2022 were selected as the routine group for routine incision infection management.Forty-nine surgical patients with 11 healthcare workers admitted to the same department between September 2022 and September 2023 were selected as the prevention group for prophylactic management of postoperative incision infections.The incision infection rate,knowledge,attitude,and practice(KAP)scores,and management satisfaction of the patients as well as the management skill scores of healthcare workers were compared between the two groups.Results:The rate of postoperative incision infection in the prevention group was lower than that in the routine group;after implementing management measures,patients in the prevention group had higher KAP scores than those in the routine group;patients in the prevention group were more satisfied with the management than those in the routine group;and healthcare workers in the prevention group had higher scores than those in the routine group,with P<0.05 for the comparison between the groups.Conclusion:The implementation of preventive management for general surgery patients in primary hospitals can reduce the incidence of postoperative incision infection and improve the KAP of patients,with higher management satisfaction.It can also enhance the management skills of healthcare workers,thus improving their overall management level.

Multi-disciplinary treatment for hepatocellular carcinoma in primary hospitals in China during the COVID-19 epidemic

Hepatocellular carcinoma(HCC)is a common malignant tumor in the Chinese population.Due to its high degree of malignancy,rapid progression,and poor prognosis,it mainly requires multi-disciplinary treatment(MDT)in the clinic.In December 2019,COVID-19,a novel coronavirus pneumonia,broke out in Wuhan,China.It has rapidly spread across the country,with various places launching a level I response to major public health emergencies and traffic being restricted.Most patients with HCC were only able to attend primary hospitals,while the MDT model for HCC in provincial hospitals was restricted.Therefore,it was a huge task for clinicians in primary hospitals to ensure MDT was given to patients with HCC during the level I response to major public health emergencies.How to formulate a reasonable MDT mode for patients with HCC according to local conditions was worthy of consideration by hepatobiliary surgeons in primary hospitals.

FORGET: Pilot of an Innovative and Simple History Based Screening Tool for Dementia Community Clinics and Acute Medical Hospitals

The aim of this study is to pilot FORGET as screening tool for dementia in community OP clinic and acute medical hospital assessments. Sample size included 30 each of memory clinic and acute medical hospital patients. Assessments included FORGET and MMSE. Psychometric test parameters were calculated for FORGET (Cut-off >1 in OP clinic and >3 in acute medical hospital). Of 30 referrals to memory clinic, 25 had dementia. A score >1 on FORGET had sensitivity 80%, specificity 80%, PPV 95.24%, NPV 44.44%, OR 16.00 (p = 0.02) for diagnosis of dementia. Of 30 acute hospital referrals, 20 had dementia. A score >3 on FORGET had sensitivity 95%, specificity 90%, PPV 95% and NPV 90%, OR 171 (p = 0.0005). FORGET at a score of >1 in community and >3 in acute medical hospital is a useful screening tool for dementia.

Practice and New Direction of Promoting the Construction of Managing System of Modern Hospital

If we want to enhance the medical level of modern hospital,we not only need to make the career morality and professional capability of the medical staff,but also require the perfection of the governance institution of hospital in accordance with the development of society.That said,the medical staff will provide the patients with the best service,which is significant to the development of hospital.In addition,every hospital should conduct deepening reform of public hospital comprehensively to respond to call of the government.And the hospital should also put forward professional and comprehensive managing system based on the concrete conditions of the hospital.That is how the hospital can serve the people better.That said,this article focuses on how to promote the system of managing the modern hospital.

Impact of pharmaceutical intervention on the rational use of antibiotics in primary hospital

Evidence based pharmaceutical interventions focusing on the characteristics of antibiotics use in primary hospitals were investigated to optimize the use of antibiotics. Four pharmaceutical interventions were set up in this study： 1） different levels of antibiotic management system were developed; 2） usage of antibiotics was reported in a monthly journal for the entire hospital; 3） early antibiotics warning system was started; 4） communication between pharmacists and physicians was strengthened. Use of antibiotics in 2007 （before intervention） and 2008 （after intervention） in department of respiratory medicine was analyzed. Significant differences （P〈0.01） in antibiotics use before and after intervention were observed. Use of antibiotics was changed from focusing on one category of drugs to a rotation of a wide range of agents. Evidence based, sound pharmaceutical interventions were effective means to ensure the rational use of antibiotics.

Advantage of surgical intensive care unit(SICU)predominant by cardiothoracic surgeons in multiple trauma management in a primary hospital

Purpose It is a challenge for the primary hospitals to manage multiple trauma patients.In this article,we explored the advantage of establishing a surgical intensive care unit(SICU)predominant by cardiothoracic surgeons in the early management of multiple trauma.Methods This was a retrospective study and patients with multiple trauma in our hospital were collected and divided into two groups,based on time period and treat modes:group A(retrospective observation group)where patients were treated with the traditional treatment mode from January 2017 to December 2017 and group B(study group)where patients were treated in the SICU predominant by cardiothoracic surgeons from January 2018 to December 2018.Clinical data including demographics,injury severity score(ISS),causes of injury,time intervals from reception to entering SICU or operating room and mortality three days after injuries were collected.Data were analyzed by SPSS 20.0 software.Categorical variables were presented as number and/or frequency and continuous variables as mean±SD.Results Altogether 406 patients were included in this study,including 217 patients in group A and 189 patients in group B.General data between the two groups revealed no significant difference:mean age(years)(35.51±12.97 vs.33.62±13.61,p=0.631),gender distribution(mean/female,130/87 vs.116/73,p=0.589)and ISS(15.92±7.95 vs.16.16±6.89,p=0.698).Fall from height were the dominant mechanism of injury,with 135 cases in group A(71.4%)and 121 cases in group B(55.8%),followed by traffic accidents.Injury mechanism showed no significant differences between two groups(p=1.256).Introduction of the SICU significantly improved the care of trauma patients,regarding speed and mortality.Time intervals between reception and entering SICU or operating room was(108.23±6.72)min and(45.67±7.96)min in group A and B,respectively(p=0.001).Mortality three days after injuries was 13.89%and 5.53%in group A and B,respectively(p=0.005).Conclusion Establishing a SICU predominant by cardiothoracic surgeons can reduce the early mortality rates in multiple trauma patients.

Development Path and Urgency of Further Strengthening Construction of Public Hospitals Based on Novel Coronavirus Pneumonia Treatment

During the outbreak of novel coronavirus pneumonia(NCP)in Wuhan,public hospitals have played an important role in intensive care,case guidance and scheme optimization.At the same time,it also faces unprecedented challenges and tests.Based on the treatment of severe patients in Wuhan,combined with the treatment practice in Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology,this paper puts forward the urgency of further strengthening the construction of public hospitals,discusses the feasible path for promoting the development of public hospitals,so as to meet the growing medical needs of the people,improve the ability to respond to major public health emergencies,and effectively guarantee the safety of people's lives and the promotion of a healthy China construction.

Ex vivo 3D osteocyte network construction with primary murine bone cells

Osteocytes reside as three-dimensionally（3D） networked cells in the lacunocanalicular structure of bones and regulate bone and mineral homeostasis. Despite of their important regulatory roles, in vitro studies of osteocytes have been challenging because：（1） current cell lines do not sufficiently represent the phenotypic features of mature osteocytes and（2） primary cells rapidly differentiate to osteoblasts upon isolation. In this study, we used a 3D perfusion culture approach to：（1） construct the 3D cellular network of primary murine osteocytes by biomimetic assembly with microbeads and（2） reproduce ex vivo the phenotype of primary murine osteocytes, for the first time to our best knowledge. In order to enable 3D construction with a sufficient number of viable cells, we used a proliferated osteoblastic population of healthy cells outgrown from digested bone chips. The diameter of microbeads was controlled to：（1） distribute and entrap cells within the interstitial spaces between the microbeads and（2） maintain average cell-to-cell distance to be about 19 mm. The entrapped cells formed a 3D cellular network by extending and connecting their processes through openings between the microbeads. Also, with increasing culture time, the entrapped cells exhibited the characteristic gene expressions（SOST and FGF23） and nonproliferative behavior of mature osteocytes. In contrast, 2D-cultured cells continued their osteoblastic differentiation and proliferation. This 3D biomimetic approach is expected to provide a new means of：（1） studying flow-induced shear stress on the mechanotransduction function of primary osteocytes,（2） studying physiological functions of 3D-networked osteocytes with in vitro convenience,and（3） developing clinically relevant human bone disease models.

Research on the Construction of Remote Plant and Animal Hospital in Omnimedia Era

According to characteristics of information communication and sevices in omnimedia era, this paper studied the plan of constructing remote plant end animal hospital, which provided remote diagnosis service by expert team of doctors based on the co-building and sharing medical case resource bases through the reasonable management model on cloud services platform, and discussed the model for service and commerce of remote plant and animal hospital.

Service Delivery Factors That Influence Utilization of HIV Integrated Primary Health Care Programme in Embu Referral Hospital, Kenya

Globally, there are approximately 36.7 million people living with HIV. Integration of HIV treatment with primary care services improves effectiveness, efficiency and equity in service delivery. The study sought to establish service delivery factors that influenced utilization of integrated HIV and primary health care services in Embu Teaching and Referral hospital. A descriptive cross-sectional survey design was used to collect data at a specific period and point of time from a sample of 302 seropositive clients who were selected using simple random method. Data collection tool was structured and semi-structured questionnaire. The tool was reliable at Cronbach’s alpha of 0.817. SPSS version 23 was used to analyze the data. A binary logistic regression model was used to predict the relationship between service delivery and utilization of integrated services. Results: Majority of the respondents (59.6%) were aged over 35 years with majority being female (58.9%) and the married were 57.6% of the total sample. On service delivery factors, majority (94.7%) felt that their health status had improved. Action taken when clients developed side effects, 78.8% reported that the drugs were changed. Action taken following drug side effects significantly affected utilization, χ2 = 1.305, p = 0.001, df = 1. The findings showed that waiting time significantly influenced utilization, χ2 = 9.284, df = 1, p = 0.002. Source of information on self care also significantly influenced utilization, χ2 = 10.689, df = 1, p = 0.001. Kind of treatment at the facility also significantly influenced utilization, χ2 = 5.713, p = 0.048. Conclusion: significant factors that influenced utilization of integrated services were source of health care information, secondly waiting time was another factor which influenced utilization. Majority of the respondents were satisfied with duration of time they take before they were served;they reported to take utmost 1 hour to be attended to and action taken by health care provider following side effects was another factor that influenced the utilization.

The Construction and Application of Digital Resources in Rural Primary School English Teaching and Learning

To arouse rural primary school students’ English learning interest, broaden their horizon and promote their critical thinking, we construct a series of dig-ital education resources which include not only language points of phonetics, vocabulary, language skills of English teaching and learning but western and Chinese cultures. The results show teachers and students’ roles and discourse power changed by using the digital education resources in the process of rural primary school English teaching and learning.

Empirical Research on Current Construction Situation of Primary and Middle School Teachers in New Era

Teachers are the top priority to develop the education.The thesis,first of all,has structured the index system of current teachers’construction situation in the new era.Then,the thesis has adopted the independent sample test and analysis of variance to analyze the difference of current teachers’construction situation in different dimensions on the basis of questionnaire data collected from teachers in five provinces and cities in the new era.Finally,the thesis has given some suggestions on improving teachers’situation in the new era from four aspects such as the improvement of the treatment guarantee mechanism for primary and middle school teachers,the operation of the cooperation mechanism among colleges,government and primary and middle school in cultivating students,the formation of training system on teachers’personal growth process and the establishment of the evaluation standard of teachers’titles as well as the standard evaluation procedure of professional titles.

Significance of Primary Treatment Selection in the Efficiency of Wastewater Treatment in Constructed Wetlands (CWs)

This research explores strategies to enhance the efficiency of secondary treatment in Vertical Flow Constructed Wetlands (CW) in Montenegro. The focus is on selecting appropriate primary treatment methods alongside three distinct substrate types to improve wastewater treatment efficacy. The study examines the combination of two primary treatments with different substrate types in constructed wetlands (CW1, CW2, and CW3). The primary treatments include the existing wastewater treatment plant (WWTP) in Podgorica, involving coarse material removal through screens, inert material separation in aerated sand traps, and sediment and suspended matter removal in primary sedimentation tanks. The Extreme Separator (ExSep) was employed to evaluate its efficacy as a primary treatment method. The research demonstrates that the efficiency of CW can be significantly enhanced by selecting suitable primary treatment methods and substrates in Podgorica’s conditions. The most promising results were achieved by combining ExSep as a primary treatment with secondary treatment in CW-3. The removal efficiencies after CW3 for COD, BOD, and TSS exceeded 89%, 93%, and 91%, respectively. The outcomes underscore the significance of primary treatment in mitigating pollutant loads before discharge into the constructed wetlands, emphasizing potential areas for further optimization in wastewater treatment practices to enhance environmental sustainability and water quality management.

Research on the Construction of Pharmacy Organization and the Development of Pharmaceutical Services in China’s Primary Medical and Health Institutions—Based on the Survey of 5 Provinces

Objective To explore the current situation and problems of the pharmacy organization and pharmaceutical services in primary medical and health institutions so as to provide a reference for improving relevant policies.Methods Multi-stage stratified random sampling was used to collect questionnaires from primary medical and health institutions in 5 provinces,and 102 questionnaires were distributed.Then Excel 2016 and IBM SPSS 21.0 software were applied for descriptive statistical analysis,chi-square test and multiple response analysis.Results and Conclusion A total of 92 primary medical and health institutions participated in the survey,and 92 valid questionnaires were recovered.The survey shows that 54.1%of the institutions have established more than 8 pharmaceutical administration regulations.63.5%and 31.8%of the institutions have formulated pharmaceutical administration and pharmacotherapy team charters(or management systems).29.7%of institutions have pharmacy personnel in accordance with relevant regulations.The higher proportion of pharmacy services are prescription review and adjustment,medication guidance,collecting and reporting adverse reactions,medication errors and medication hazard information.Primary medical and health institutions still need to further improve their pharmaceutical administration system,organizational structure,pharmacy professional training and clinical pharmacy service.

Sociodemographic and Scanographic Aspects of Primary Bronchopulmonary Cancer in a Hospital in Mali

Summary: A malignant tumour that develops from the bronchial epithelium and then invades the lungs. It ranks third after colorectal and breast cancer. In Mali, computed tomography (CT) is the main imaging tool used at all stages of treatment. We had initiated this study with the objective of specifying the place of CT in the diagnosis of primary bronchopulmonary cancer at the hospital of Mali. Method: This is a prospective and descriptive study conducted by the Medical Imaging and Thoracic Surgery departments at Mali Hospital from March 2014 to February 2015. All the patients who have benefited from a CT scan and presenting at least one histologically confirmed bronchopulmonary tumor were included. Results: We were recruiting 60 patients with bronchopulmonary cancers out of 500 referred for a thoracic CT scan performed, a frequency of 12%. There was one male patient with a sex ratio of 4H/1F. The average age was 60 years. The history of smoking was 85%. The symptoms were dominated by general condition (63.33%), cough (25%) and haemoptysis (58.33%). CT scans were performed in all patients. The lesions were located more in the lower lobes (71%). The tumours were: heterogeneous tissue density (70%), spiculated contours (80%), and the histology was more non-small cell carcinoma. Conclusion: The incidence of bronchopulmonary cancer is very high and its prognosis is poor at an advanced stage. The evaluative role of CT and biopsy guidance has given it a place of choice in its management. The diagnosis of certainty remains histology.

Comprehensive analysis of the impact of primary percutaneous coronary intervention on patients with ST-segment elevation myocardial infarction

This comprehensive analysis by Saeed and Faeq investigates the impact of primary percutaneous coronary intervention(pPCI)on mortality among patients with ST-segment elevation myocardial infarction(STEMI)at the Erbil Cardiac Center.Analyzing data from 96 consecutive STEMI patients,the study identified significant predictors of in-hospital mortality,emphasizing the critical impact of time of hospital arrival post-symptom onset on overall prognosis.Findings indicate that factors such as atypical presentation,cardiogenic shock,chronic kidney disease,and specific coronary complications are associated with higher mortality rates.The study underscores the necessity of prompt medical intervention for improving survival outcomes in STEMI patients,especially in the high-risk subgroup.This research offers valuable insights into optimizing STEMI management and enhancing patient survival rates through effective and timely pPCI.

Key Points and Difficulties in the Management of a New Guangzhou 12th People’s Hospital Branch

During the 13th Five-Year Plan period,to improve medical and health services,the Guangzhou Municipal government invested billions in medical construction.During that time,Guangzhou was renewing its approval procedures for construction projects,and the COVID-19 outbreak changed the requirements of hospital construction.In addition to focusing more on spatial planning and layout,the integration of specialized departments,large-scale medical equipment,and numerous intelligent systems increased the complexity of hospital construction projects.The success of these projects often hinges on the quality of the management team.If a hospital construction project manager lacks experience and an understanding of the project’s key aspects,they may struggle with organization,management,and problem-solving,leading to rework,resource waste,and delays.This paper uses the construction of a new Guangzhou 12th People’s Hospital branch as an example to describe the key points and difficulties in each stage of project construction and proposes solutions for the management of similar projects in the future.

论项目管理在HIS系统建设中的重要作用

在HIS系统建设中引入项目管理,按照项目管理的方法,启动、计划、执行、控制和结束项目有现实意义。在分析传统方法的基础上,结合项目管理的理论、方法和工具,研究了HIS系统建设过程中需要关注的问题。

基于HIS基础的产褥期随访系统的构建

目的构建基于HIS(hospital information system,HIS)基础的产褥期随访系统。方法以南通区域卫生信息平台和南通医联为信息平台基础,由母婴病区专科护理小组和延续护理信息系统研发团队对妇产科出院产妇进行延续护理需求调查和半结构式访谈,并向20名省内外护理和护理教育专家进行2轮咨询,同时咨询伦理委员会成员、法律顾问,再与HIS运维工程师、软件开发工程师、硬件提供商、网络运营商、卫生管理人员、市场推广人员等17人进行半结构式访谈,最终确定基于HIS基础的产褥期随访系统模块。并于试用4个月时对29名医护人员及318名签约用户进行系统使用满意度的调查。结果产褥期随访系统模块主要有健康提醒、健康讲坛、专家讲座、问卷调查、问医生及跟踪干预。医护人员及签约用户对系统的安全性、时效性、稳定性及外观设计的满意度,分别为100%(29/29)、98.11%(312/318),86.21%(25/29)、88.05%(280/318),96.55%(28/29)、97.48%(310/318),93.10%(27/29)、94.97%(302/318)。结论基于HIS基础的产褥期随访系统较传统的产褥期随访具有高效性、针对性及安全性,团队成员、产妇及家属均比较满意,将院内护理和院外护理很好的衔接,有利于提高产妇产褥期护理质量。