1.Influence of intravenous esketamine infusion on anesthetic effect and awakening quality in elderly patients undergoing laparoscopic prostate cancer surgery
Kewei WU ; Sheng LI ; Shuyu DENG ; Dongdong CHEN ; Xinxia YANG ; Lihong HU
Chongqing Medicine 2025;54(1):108-113
Objective To investigate the influence of intravenous esketamine infusion on anesthetic effect and awakening quality in elderly patients undergoing laparoscopic surgery for prostate cancer.Methods One hundred and twenty patients with laparoscopic radical prostatectomy were selected and divided into the esketamine group(group E)and control group(group C)by the random number table method,60 ca-ses in each group.The group E used esketamine for anesthesia induction and maintenance,while the group C received the same amount of physiological saline at the same time during operation process as control.The es-ketamine pumping infusion or normal saline in the two groups was stopped at 30 min before operation end.In addition,the types and doses of other drugs used during the induction and maintenance phase of anesthesia were identical between the two groups.The use total amounts of anesthetic drugs during perioperative period were recorded.The heart rate(HR)and mean arterial pressure(MAP)were recorded before operation(T1),instantly before tracheal intubation(T2),at 1 min after tracheal intubation(T3),1 h during surgery(T4),end of skin suture(T5),and 5 min after extubation(T6)in the two groups respectively;the anesthetic recovery time after extubation was recorded.The Riker sedation and restlessness score was used to conduct the agita-tion evaluation,the incidence rates of agitation and bucking and the resuscitation room stay time were recor-ded.The pain VAS score was used to conduct the pain evaluation in the patients.The incidence rates of ad-verse events such as respiratory depression,shiverring,nausea,vomiting,drowsiness after extubation were re-corded.Results The perioperative doses of resutanil and propofol in the group E were significantly lower than those in the group C,and the difference was statistically significant(P<0.05).HR and MAP at T2 in the group E were higher than those in the group C,while HR and MAP at T3 in the group E were lower than those in the group C.The recovery time after extubation in the group E was longer than that in the group C,the agitation incidence rate,acute bucking incidence rate and VAS score were lower,the stay time in the recov-ery room was shorter.The incidence rate of drowsiness in the group E was significantly higher than that in the group C(P<0.05).The incidence rates of other adverse events had no statistical differnece(P>0.05).Con-clusion Esketamine is safe and effective in the elderly patients with laparoscopic prostate cancer surgery,which is conducive to stabilize the hemodynamic parameters and reduce the incidence rate of agitation and buc-king.
2.Exploration and Current Status Analysis of Pharmaceutical Service Fees in China
Shan DU ; Jinqi LI ; Yong YANG ; Min CHEN ; Yuan BIAN ; Xinxia LIU
Herald of Medicine 2024;43(9):1398-1404
Objective To summarize the exploration and current situation of pharmaceutical service fees in China,to analyze it in conjunction with practices in foreign countries,and to provide references for further improvement of pharmaceutical service fees in China.Methods The official websites of the National Health Commissi,National Healthcare Security Administration,and their provincial braches were retrieved to summarize the changes in policies in China and the latest pharmaceutical service fees policies in each province.At the same time,databases such as CNKI,VIP,and Pubmed were searched to summarize research on pharmaceutical service fees.Results There were some studies in China on the calculation of pharmaceutical service costs and fee standards,but they mostly focused on pharmacy dispensing services,with less discussion on the technical and labor value of specific pharmaceutical services,while international research in this area was relatively abundant.Currently,eight provinces and one municipality directly under the central government have issued medical service price items related to pharmaceutical service,with differences in fee items,fee standards,medical insurance payment ratios,and monitoring and evaluation indicators.Conclusions The inclusion of pharmaceutical services in the national medical pricing system recognizes the transformation of pharmaceutical services and the value of pharmacists.However,it is still in the early stages,and there is room for improvement and enhancement.
3.Practices on"Center-Multidisciplinary Team"Structure for Rare Disease Management in General Hospitals
Yu ZHUANG ; Yuan ZHONG ; Xinxia WU ; Xuedong XU ; Rong MU ; Xiaohui ZHU ; Rong LI ; Wei FU
Chinese Hospital Management 2024;44(9):37-40
Objectives It was a preliminary exploration on rare disease management of comprehensive hospital based on the"Center-Multidisciplinary Team"structure.Methods By applying interrupted time series analysis,the characteristics and related medical service of rare disease patients discharged from sample hospitals from 2021 to 2023 were measured.Results The results showed that the hospital served 19 825 rare disease patients from 2021 to 2023.The proportion of patients whose main diagnosis were rare diseases was approximately 27%.The interrupted time series technique indicated that the expected proportion of rare disease patients increased instantly by 1.89 thousand points.The capability to diagnose has significantly improved,with a growing trend on volume of bioinformatics analysis services for rare diseases patients.Conclusion The rare disease management based on the"Center-Team"structure can increase the attention of medical staff to rare diseases,strengthen the diagnostic capacity of rare diseases,and make patient management more continuous and disciplinary co-operation more efficient without significantly increasing the input burden on hospitals.
4.Practices on"Center-Multidisciplinary Team"Structure for Rare Disease Management in General Hospitals
Yu ZHUANG ; Yuan ZHONG ; Xinxia WU ; Xuedong XU ; Rong MU ; Xiaohui ZHU ; Rong LI ; Wei FU
Chinese Hospital Management 2024;44(9):37-40
Objectives It was a preliminary exploration on rare disease management of comprehensive hospital based on the"Center-Multidisciplinary Team"structure.Methods By applying interrupted time series analysis,the characteristics and related medical service of rare disease patients discharged from sample hospitals from 2021 to 2023 were measured.Results The results showed that the hospital served 19 825 rare disease patients from 2021 to 2023.The proportion of patients whose main diagnosis were rare diseases was approximately 27%.The interrupted time series technique indicated that the expected proportion of rare disease patients increased instantly by 1.89 thousand points.The capability to diagnose has significantly improved,with a growing trend on volume of bioinformatics analysis services for rare diseases patients.Conclusion The rare disease management based on the"Center-Team"structure can increase the attention of medical staff to rare diseases,strengthen the diagnostic capacity of rare diseases,and make patient management more continuous and disciplinary co-operation more efficient without significantly increasing the input burden on hospitals.
5.Practices on"Center-Multidisciplinary Team"Structure for Rare Disease Management in General Hospitals
Yu ZHUANG ; Yuan ZHONG ; Xinxia WU ; Xuedong XU ; Rong MU ; Xiaohui ZHU ; Rong LI ; Wei FU
Chinese Hospital Management 2024;44(9):37-40
Objectives It was a preliminary exploration on rare disease management of comprehensive hospital based on the"Center-Multidisciplinary Team"structure.Methods By applying interrupted time series analysis,the characteristics and related medical service of rare disease patients discharged from sample hospitals from 2021 to 2023 were measured.Results The results showed that the hospital served 19 825 rare disease patients from 2021 to 2023.The proportion of patients whose main diagnosis were rare diseases was approximately 27%.The interrupted time series technique indicated that the expected proportion of rare disease patients increased instantly by 1.89 thousand points.The capability to diagnose has significantly improved,with a growing trend on volume of bioinformatics analysis services for rare diseases patients.Conclusion The rare disease management based on the"Center-Team"structure can increase the attention of medical staff to rare diseases,strengthen the diagnostic capacity of rare diseases,and make patient management more continuous and disciplinary co-operation more efficient without significantly increasing the input burden on hospitals.
6.Practices on"Center-Multidisciplinary Team"Structure for Rare Disease Management in General Hospitals
Yu ZHUANG ; Yuan ZHONG ; Xinxia WU ; Xuedong XU ; Rong MU ; Xiaohui ZHU ; Rong LI ; Wei FU
Chinese Hospital Management 2024;44(9):37-40
Objectives It was a preliminary exploration on rare disease management of comprehensive hospital based on the"Center-Multidisciplinary Team"structure.Methods By applying interrupted time series analysis,the characteristics and related medical service of rare disease patients discharged from sample hospitals from 2021 to 2023 were measured.Results The results showed that the hospital served 19 825 rare disease patients from 2021 to 2023.The proportion of patients whose main diagnosis were rare diseases was approximately 27%.The interrupted time series technique indicated that the expected proportion of rare disease patients increased instantly by 1.89 thousand points.The capability to diagnose has significantly improved,with a growing trend on volume of bioinformatics analysis services for rare diseases patients.Conclusion The rare disease management based on the"Center-Team"structure can increase the attention of medical staff to rare diseases,strengthen the diagnostic capacity of rare diseases,and make patient management more continuous and disciplinary co-operation more efficient without significantly increasing the input burden on hospitals.
7.Practices on"Center-Multidisciplinary Team"Structure for Rare Disease Management in General Hospitals
Yu ZHUANG ; Yuan ZHONG ; Xinxia WU ; Xuedong XU ; Rong MU ; Xiaohui ZHU ; Rong LI ; Wei FU
Chinese Hospital Management 2024;44(9):37-40
Objectives It was a preliminary exploration on rare disease management of comprehensive hospital based on the"Center-Multidisciplinary Team"structure.Methods By applying interrupted time series analysis,the characteristics and related medical service of rare disease patients discharged from sample hospitals from 2021 to 2023 were measured.Results The results showed that the hospital served 19 825 rare disease patients from 2021 to 2023.The proportion of patients whose main diagnosis were rare diseases was approximately 27%.The interrupted time series technique indicated that the expected proportion of rare disease patients increased instantly by 1.89 thousand points.The capability to diagnose has significantly improved,with a growing trend on volume of bioinformatics analysis services for rare diseases patients.Conclusion The rare disease management based on the"Center-Team"structure can increase the attention of medical staff to rare diseases,strengthen the diagnostic capacity of rare diseases,and make patient management more continuous and disciplinary co-operation more efficient without significantly increasing the input burden on hospitals.
8.Practices on"Center-Multidisciplinary Team"Structure for Rare Disease Management in General Hospitals
Yu ZHUANG ; Yuan ZHONG ; Xinxia WU ; Xuedong XU ; Rong MU ; Xiaohui ZHU ; Rong LI ; Wei FU
Chinese Hospital Management 2024;44(9):37-40
Objectives It was a preliminary exploration on rare disease management of comprehensive hospital based on the"Center-Multidisciplinary Team"structure.Methods By applying interrupted time series analysis,the characteristics and related medical service of rare disease patients discharged from sample hospitals from 2021 to 2023 were measured.Results The results showed that the hospital served 19 825 rare disease patients from 2021 to 2023.The proportion of patients whose main diagnosis were rare diseases was approximately 27%.The interrupted time series technique indicated that the expected proportion of rare disease patients increased instantly by 1.89 thousand points.The capability to diagnose has significantly improved,with a growing trend on volume of bioinformatics analysis services for rare diseases patients.Conclusion The rare disease management based on the"Center-Team"structure can increase the attention of medical staff to rare diseases,strengthen the diagnostic capacity of rare diseases,and make patient management more continuous and disciplinary co-operation more efficient without significantly increasing the input burden on hospitals.
9.Practices on"Center-Multidisciplinary Team"Structure for Rare Disease Management in General Hospitals
Yu ZHUANG ; Yuan ZHONG ; Xinxia WU ; Xuedong XU ; Rong MU ; Xiaohui ZHU ; Rong LI ; Wei FU
Chinese Hospital Management 2024;44(9):37-40
Objectives It was a preliminary exploration on rare disease management of comprehensive hospital based on the"Center-Multidisciplinary Team"structure.Methods By applying interrupted time series analysis,the characteristics and related medical service of rare disease patients discharged from sample hospitals from 2021 to 2023 were measured.Results The results showed that the hospital served 19 825 rare disease patients from 2021 to 2023.The proportion of patients whose main diagnosis were rare diseases was approximately 27%.The interrupted time series technique indicated that the expected proportion of rare disease patients increased instantly by 1.89 thousand points.The capability to diagnose has significantly improved,with a growing trend on volume of bioinformatics analysis services for rare diseases patients.Conclusion The rare disease management based on the"Center-Team"structure can increase the attention of medical staff to rare diseases,strengthen the diagnostic capacity of rare diseases,and make patient management more continuous and disciplinary co-operation more efficient without significantly increasing the input burden on hospitals.
10.Practices on"Center-Multidisciplinary Team"Structure for Rare Disease Management in General Hospitals
Yu ZHUANG ; Yuan ZHONG ; Xinxia WU ; Xuedong XU ; Rong MU ; Xiaohui ZHU ; Rong LI ; Wei FU
Chinese Hospital Management 2024;44(9):37-40
Objectives It was a preliminary exploration on rare disease management of comprehensive hospital based on the"Center-Multidisciplinary Team"structure.Methods By applying interrupted time series analysis,the characteristics and related medical service of rare disease patients discharged from sample hospitals from 2021 to 2023 were measured.Results The results showed that the hospital served 19 825 rare disease patients from 2021 to 2023.The proportion of patients whose main diagnosis were rare diseases was approximately 27%.The interrupted time series technique indicated that the expected proportion of rare disease patients increased instantly by 1.89 thousand points.The capability to diagnose has significantly improved,with a growing trend on volume of bioinformatics analysis services for rare diseases patients.Conclusion The rare disease management based on the"Center-Team"structure can increase the attention of medical staff to rare diseases,strengthen the diagnostic capacity of rare diseases,and make patient management more continuous and disciplinary co-operation more efficient without significantly increasing the input burden on hospitals.

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