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Contemporary college students have low levels of health literacy, facing problems such as weak awareness of health care, unhealthy diet habits, insufficient physical activity, and inadequate emergency response to public health emergencies. The reasons may be related to weak personal awareness of health literacy, imperfect health education system, shortage of health literacy education talents, lack of family health literacy education, and the insufficient social investment in health literacy cultivation. Faced with this current situation, the government, universities, families, individuals, and society should respond to the call of "Healthy China 2030" Plan Outline, regard improving college students’ health literacy level as their own responsibility, help them eliminate or reduce the risk factors affecting health, improve their health literacy level and quality of life, and contribute to the Healthy China strategy.
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Frailty is currently one of the hot research topics in geriatric medicine.With decreased physiological reserve of multiple systems and reduced anti-stress ability as its main manifestations, frailty results in a range of adverse outcomes.On the other hand, chronic pain is a common clinical syndrome that threatens physical and mental health of the elderly.The relationship between frailty and chronic pain is receiving increasing attention because both of them are important risk factors for impaired quality of life of elderly individuals.In this review, we summarize the correlation between frailty and chronic pain, and its possible underlying mechanisms, in order to provide new ideas for frailty identification and intervention and effective chronic pain management.
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Objective:To explore the application and effect of peri-operative recovery-quality-directed teaching reform for clinical internship training of anesthesiology.Methods:A total of 60 interns of five-year program anesthesiology from the Department of Anesthesiology of Chongqing Medical University were recruited for this teaching reform and randomly allocated to teaching reform group ( n=30) and control group ( n=30). Students in control group received conventional training for internship of clinical anesthesiology and follow-up, while students in teaching reform group received additional recovery-quality-directed clinical rounds per teaching week and patients discussed in those rounds were followed up until 30 days after operation. At the end of internship, teaching satisfaction, graduation test scores and patients' satisfaction were compared. SPSS 21.0 was used for t test. Results:Compared with those students in control group, interns in teaching reform group had significantly higher scores on teaching satisfaction [(9.1±1.3) vs. (6.7±1.9), P<0.05], graduation test scores [(80.0±5.0) vs. (67.0±6.0), P<0.05] and patients' satisfaction [(92.0±6.0) vs. (83.0±11.0), P<0.05]. Conclusion:Recovery-quality-directed peri-operative teaching reform can enhance the professional identity and sense of responsibility of anesthesiology students, improve their teaching satisfaction and theoretical knowledge level, and improve the satisfaction of related patients with anesthesia services.
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Objective:To evaluate the effects of different rates of compliance with the enhanced recovery after surgery (ERAS) protocol on postoperative recovery in patients undergoing hysterectomy.Methods:A total of 312 patients, aged 18-60 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for hysterectomy, were enrolled in the study.ERAS protocol was implemented.The patients were divided into 3 groups based on compliance rates: compliance rate<70% group (group A), 70%≤compliance rate<85% group (group B) and compliance rate≥85% group (group C). The development of postoperative complications, hospitalization time, patients′ satisfaction score and hospitalization cost were recorded. Results:Compared with group A ( n=88) and group B ( n=118), the total incidence of complications was significantly decreased in group C ( n=96) ( P<0.05). The patients′ satisfaction scores were gradually increased in A, B, and C groups on the day of discharge and at 30 days after discharge ( P<0.05). Conclusions:Higher compliance with the ERAS protocol is helpful for postoperative recovery in patients undergoing hysterectomy.
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Objective To evaluate the value of perioperative multimodal stratified analgesia guided by PPRS-CYMZ 2.0. Methods One hundred and sixteen patients of both sexes, aged 16-85 yr, of A-merican Society of Anesthesiologists physical statusⅠ-Ⅲ, scheduled for elective surgery in our hospital in August 2016, were included in this study and assigned into empirical analgesia group(group E, n=79) and stratified analgesia group(group S, n=73). The risk of postoperative pain was estimated by an expe-rienced associate chief anesthesiologist based on his clinical experience, and the perioperative analgesic protocol was determined in group E. The risk of postoperative pain was assessed using the perioperative pain risk scale PPRS-CYMZ 2.0 by another experienced associate chief anesthesiologist, the risk was stratified according to the scores, and the corresponding stratified analgesic protocol was determined in group S. Vis-ual analog scale scores and parents′satisfaction with analgesia were recorded on postoperative day 30. The requirement for preventive analgesia, total pressing times of patient-controlled analgesia(PCA)pump in 0-6 h, 6-24 h and 24-72 h periods, PCA background infusion dose and consumption of rescue analgesics were recorded. The development of adverse events during postoperative hospital stay and postoperative re-covery were also recorded. Analgesia-related parameters of medical economics were calculated. Results There was no significant difference in postoperative pain risk stratification between group E and group S(P>0.05), and the majority of patients were at moderate risk. Compared with group E, no significant change was found in visual analog scale scores on postoperative day 30, PCA background infusion dose or incidence of postoperative adverse effects(P>0.05), the requirement for preventive analgesia and satisfaction scores were significantly increased in high risk patients, the consumption of rescue analgesics was decreased in moderate risk patients(P<0.05), no significant change was found in the total pressing times of PCA pump in each time period in low risk patients(P>0.05), the total pressing times of PCA pump was significantly decreased, and the direct analgesic cost per patient and total analgesic cost were decreased in moderate and high risk patients, and the first ambulation time and length of postoperative hospital stay were shortened in high risk patients in group S(P<0.05). Conclusion PPRS-CYMZ 2.0 can achieve perioperative multi-modal stratified analgesia and individualized treatment.
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In view of the problems that anesthesiology medical students have such as poor commu-nication awareness, lack of communication skills, lack of confidence, and so on, it is particularly important to improve the students’ doctor-patient communication ability, guarantee their medical quality and reduce the dispute between doctors and patients. In the teaching practice, we improve students’ ability of doctor-patient communication by paying more attention to the education of medical ethics, strengthening the train-ing of professional knowledge and skills, optimizing the curriculum structure, improving the quality of teachers, the implementation of case teaching , and establishing a comprehensive evaluation mechanism etc , and have got good results.
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Objective To evaluate the effect of infiltration anesthesia at Calot's triangle on postoperative analgesia in the patients undergoing laparoscopic cholecystectomy.Methods One hundred and forty patients,aged 18-64 yr,with 18 kg/m2 ≤ body mass index ≤ 31 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic cholecystectomy,were randomly divided into 2 groups (n =70 each):control group (group A) and infiltration anesthesia at Calot's triangle group (group B).In group B,1％ ropivacaine 10 ml was injected into Calot's triangle before dissection of the gallbladder,while the equal volume of normal saline was injected into Calot's triangle in group A.The patients in both groups received patient-controlled intravenous analgesia (PCIA) for 48 h starting from 10 min before the end of surgery.The VAS score was maintained below 4 during PCIA.When VAS score ≥ 4,lasting for more than 30 min,tramadol 1.5 mg/kg was injected intravenously.The consumption of physic liquor for PCIA,and requirement for tramadol were recorded.The incidence of puncture-related damage to Calot's triangle and local anesthetic intoxication and adverse effects such as nausea and vomiting within 48 h after surgery were also recorded.The first postoperative flatus time was recorded.Results Compared with group A,the consumption of physic liquor for PCIA,requirement for tramadol,and consumption of tramadol were significantly reduced,and no significant change was found in the incidence of nausea and vomiting and the first postoperative flatus time in group B.No puncture-related damage to Calot's triangle occurred in A and B groups.There was no local anesthetic intoxication in group B.Conclusion Infiltration anesthesia at Calot's triangle can optimize postoperative analgesia in the patients undergoing laparoscopic cholecystectomy.
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Anesthesia quality control is essential to guarantee the safety of patients undergoing surgeries.Emphasis should be placed on developing the interns' awareness of anesthesia quality control.The interns' awareness of anesthesia quality could be preliminary formed by strengthening the orientation,training standard and proficient anesthesia skills,consolidating theoretical knowledge,cultivating professional responsibility as well as excellent psychological quality,which also enable interns to be perfect anesthesiologists in the future.
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Objective To determine the risk factors for emergence agitation (EA) during the recovery period after general anesthesia.Methods One thousand and thirty-four patients of both sexes aged 18-89 yr undergoing general anesthesia were divided into EA group and non-EA group.EA occurring during recovery from general anesthesia was assessed by using Riker sedation-agitation scale.Age,sex,complication,education,medical history,ASA physical status,type and duration of anesthesia and operation,volume of blood loss,fluid replacement,urine volume,duration of stay in PACU,number of drainage tubes and so forth were recorded.Multivariate logistic regression was used to analyze the risk factors for the occurrence of EA.Results Thirty-six patients developed EA during recovery from anesthesia.The incidence of EA was 3.5 ％.Logistic regression indicated that high risk operation,premedication with diazepam,induction of anesthesia without midazolom and fluid replacement during operation were the risk factors for EA (P ＜ 0.05).Conclusion High-risk operation,premedication with diazepam,induction of anesthesia without midazolom and fluid replacement during operation are the risk factors for EA during recovery from general anesthesia.