1.Short-term impact of fast track surgery combined with minimally invasive surgery on elderly patients with colorectal cancer
Xianjun LIANG ; Zhouliang ZHANG ; Shuai GUO ; Jianhua LIANG ; Yusha YANG
China Journal of Endoscopy 2016;22(2):65-69
Objective To analyze the short-term impact of fast track surgery (FTS) combined with minimally inva-sive surgery on elderly patients with colorectal cancer. Methods 200 patients with colorectal cancer received laparo-scopic surgery from July 2013 to July 2015 were selected and randomly divided into control group and FTS group. Patients in control group received conventional perioperative treatment and patients in FTS group received perioper-ative management according to fast track surgery. Status of intraoperative, postoperative recovery and the postopera-tive complication rate were compared between the two groups. Patients' quality of life were analyzed after two weeks of operation. Results Compared with the control group, the blood loss, operation time and number of lymph node dissection of patients in FTS group showed no significant difference ( > 0.05). Flatus time, ambulation time, start eating time, the infusion time and length of hospital stay in FTS group was significantly shorter than the control group, the difference was statistically significant ( <0.05). The total cost of hospitalization of FTS group was signifi-cantly lower than the control group ( <0.05). The incidence of sore throat, abdominal distension, lung infections and overall complications incidence rate in FTS group were significantly lower than the control group, the difference was statistically significant ( <0.05). The satisfaction rate in FTS group was 96.0%(96/100), and was significantly high-er than the control group 82.0 %(82/100), the difference was statistically significant ( < 0.05). QLQ-C30 results showed that scores of overall health, emotional function and social function of FTS group were significantly higher than the control group ( <0.05), and scores of nausea and vomiting, pain, insomnia, anorexia, constipation were sig-nificantly lower than the control group ( < 0.05). Conclusion Laparoscopy combined with FTS is safe and effective in treatment of colorectal cancer in the elderly patients, which can promote postoperative rehabilitation, improve pa-tient satisfaction and quality of life in short term.
2.Investigation and analysis of the basic medical security system in Guangxi
Yanli ZUO ; Jijun YANG ; Yusha GUO ; Fang SU ; Caiyuan WU ; Shu LI
Chinese Journal of Hospital Administration 2013;29(8):582-585
Objective To understand the performance of the basic medical security system in Guangxi for decision-making support on the development planning of the system during the 12th FiveYear Plan in Guangxi.Methods Descriptive statistics were made to analyze the annual report data of Guangxi's basic medical security system during 2009 to 2011,regarding the basic medical security for urban workers and that for urban residents,as well as those of the new rural cooperative medical system.Results The survey found that the three basic medical security systems in Guangxi have almost achieved full coverage; the compensation ratio keeps rising as the inpatient expenses of urban residents was up to 62.21%,64.96% and 66.96% respectively from 2009 to 2011,and that for urban residents up to 34.26%,39.96% and 49.68% respectively; the ratio for those covered by the new rural cooperative medical system has been maintained at 45% for the three years; the coverage of the systems keeps expanding.Conclusion Recommend to integrate pilots of the three security systems and carry out serious diseases pilot programs; encourage reform of the payment system at institutions at or above county level; reform the risk-pooling of disease management of at primary medical institutions; strengthen the information systems of basic medical insurance system,in an effort to ensure the sound development of the basic medical insurance system.
3.Analysis of the management staff and funds allocation in the new rural cooperative medical system in Guangxi
Yanli ZUO ; Sheng WANG ; Yusha GUO ; Fang SU ; Caiyuan WU ; Shu LI
Chinese Journal of Hospital Administration 2014;30(8):629-631
Objective To learn the management staff and funds allocation of the NRCMS in Guangxi,and come up with solution accordingly.Methods Collection of the annual report data of NRCMS in Guangxi from 2009 to 2012,and calculation of the management personnel and funds expenditure.Results The management personnel of NRCMS in Guangxi is found with a 1000-person gap between the actual staffing and approved staffing quota; the management funds rise year by year which come mostly from fiscal appropriation.Yet it accounts for less than 2.00% and with a high rate of surplus; per-capita funds for management personnel rise significantly,along with their per-capital salaries,yet the highest fall below 25000 yuan per year per person.Conclusion Staffing quota should be fixed more rationally to ensure the number and competence of NRCMS management staff; more funds and better use of management funds are required.