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Objective:To evaluate the viability and clinical effect of polyfoliate anterolateral thigh perforator flap (ALTPF) in reconstruction of large soft tissue defect around ankle.Methods:From June 2019 to October 2022, large soft tissue defects around ankle of 11 patients were reconstructed with ALTPF in the Department of Orthopaedics of the First Affiliated Hospital of Nanchang University. The causes of injury were traffic accident in 8 patients and heavy objects in 3 patients. All wounds were large defects (15.0 cm×14.0 cm-30.0 cm×20.0 cm) and combined with various degrees of infection. Intraoperatively, polyfoliate ALTPFs sized 16.0 cm×14.5 cm-23.0 cm×18.5 cm were used in reconstruction of the defects. Deep dead spaces were filled with antibiotic bone cement, and direct suture was performed to close the donor sites or by skin grafting repair. Postoperative follow-ups were scheduled at 1, 3 and 6 months, and 6 monthly thereafter at outpatient clinics and via telephone interviews. The appearance and colour of the flaps and healing of donor sites were recorded together with evaluation of the recovery of ankle motor function according to the ankle-hindfoot rating scale of American Orthopaedic Foot and Ankle Society (AOFAS).Results:All flaps survived. No haematoma or secondary infection occurred at the recipient site after surgery. All donor sites healed primarily. One patient had venous occlusion at the distal end of the polyfoliate ALTPF. The flap survived completely at 1 week after distal venous bloodletting. Postoperative follow-ups lasted 6-24 (15.27±5.21) months. All flaps had good blood supply with satisfactory appearance, similar colour and texture to the recipient sites, and without obvious bloat nor ulceration. Only a linear scar or few skin graft scar was left at the flap donor sites in concealed locations. The mean AOFAS ankle-hindfoot score was (88.36±10.21) point. There were 6 cases of excellent, 4 cases of good, and 1 case of fair.Conclusion:A polyfoliate ALTPF is an ideal flap for reconstruction of soft tissue defects around ankle by converting the length of a flap to the width.
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Objective:To understand the current situation and problems in the construction of research wards in Beijing municipal hospitals, and put forward corresponding strategies and suggestions to explore the path for the construction of research hospitals.Methods:From March 2020 to May 2021, through the method of questionnaire and expert interview, the bed and personnel allocation, projects undertaken, review efficiency and problems faced by the research wards of 22 Beijing municipal hospitals were analyzed in depth.Results:82%(18/22)of the municipal hospitals explored the construction of research wards, and 27%(6/22) were Beijing Demonstration research wards construction units. In 2020, the overall performance of the construction of research ward was as follows: the investment of clinical research resources was increased, the ability of clinical research was enhanced, the ability to serve enterprises in Beijing was improved, the efficiency of examination was improved, but the enrollment rate of clinical research(including clinical trials) was reduced. At present, the main problems were focused on investment, personnel and informatization.Conclusions:The construction of research wards in Beijing municipal hospitals is developing steadily, but there are still some problems, such as lack of clinical research talents, performance incentive and guarantee to be strengthened. In the future, we should strengthen the training of clinical research talents, improve the incentive and guarantee mechanism, promote the integration of industry, university and research, accelerate the construction of clinical research information system, further improve the hospital′s clinical research ability and level, and accumulate experience for the construction of research hospitals.
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Objective:Construct a set of evaluation system of scientific and technological innovation index of Beijing municipal hospitals, so as to lay a foundation for the systematic evaluation of scientific and technological innovation capacities of such hospitals.Methods:By using the methods of literature review and expert consultation, the composition and weight of scientific and technological innovation index of Beijing municipal hospitals are determined.Results:The evaluation system includes 5 first-level indexes, 13 second-level indexes and 17 third-level indexes, which including innovation resource index, talent development index, academic contribution index, development vitality index and industry support index.Conclusions:The evaluation system of scientific and technological innovation index of Beijing municipal hospitals pays attention to the talent development and high-quality output, innovation introduces development vitality index and industrial support index, which is a useful exploration for the " collectivization" horizontal quantitative evaluation of scientific and technological innovation capacity.
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Collaborative development among medical practice, education and research is a strategic decision of the country in disciplinary development guided by the innovation-driven strategy. In October 2017, Beijing Hospitals Authority organized 18 tertiary hospitals with pediatrics discipline and founded a collaborative development center for pediatrics. This center operated in a model featuring both leadership of due authorities and autonomous administration. Two of the specialized pediatrics hospitals work as leading units, and existing high quality pediatrics resources of the member hospitals were pooled to establish an academics committee and an executive committee. A development system was established with disciplinary construction as the focus, collaborative development as the goal and horizontal collaboration as the means. It was designed to explore a new model featuring overall planning and standardized management of the discipline, building of a shared platform for clinical capacity development, joint development of continued medical education and talent cultivation, as well as diversified and multi-centered research and platform resources sharing. This model can effectively promote the overall development level of pediatrics in Beijing municipal hospitals.
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Objective:To analyze the application for and funding for individual key clinical specialties under the Youth Program at the approved hospital groups, for suggestions on future development of hospitals.Methods:Based on the Youth Program data of the applications and approval as summarized by Beijing Hospitals Authority from year 2015 through 2018, 22 municipal hospitals were classified into three groups with more, less and none key clinical specialties respectively(the more group, the less group and the non group for short). The categories were made according to the number of state key clinical specialties approved by National Health Commission and key specialties approved by the National Administration of Traditional Chinese Medicine. χ2 test was used to compare the baseline situation, the approval rate of project applications, and the categories of approved project among the three hospital groups. Results:During 2015—2018 period, the number of applicants for Youth Program was 1 128 persons/cases. The groups with more, less, and none key clinical specialties were 7, 10, 5 respectively. In the more specialties group, the applicants of seniority less than five years accounted for 40.93%, who had higher than those of the other two groups( χ2=13.794, P=0.032), and higher doctoral degree applicants(80.31%) as well. The difference was statistically significant( χ2=116.611, P<0.001). The approval rate of the Youth Program in 2015—2018 in the group with key clinical specialties vs. the group with none key clinical specialties was 36.09%(166/460) rersus. 29.04%(194/668) with significant difference( χ2=6.222, P=0.013). The approval rate of the departments with more key clinical specialties was 37.82%, higher than those of less and none key clinical specialties(approval rate at 31.82% and 21.50%, respectively), with significant difference( χ2=16.897, P<0.001). However, there was no significant difference between the approval rates of key specialties group and non-key specialties in each hospital group( P>0.05). Of the three groups, the proportion of clinical medical projects in each group was all higher than such other types as scientific research, medical technology, hospital administration and nursing. Conclusions:The applications and approval rate of key specialties under the Youth Program were higher than the rest, reflecting the discipline advantage. At the same time, it can play an important leading role in the construction of research-oriented hospitals. It is necessary to further strengthen the showcase role of specialties, for encouraging innovative talents cultivation of other specialties, in the hope for promoting the construction of research-oriented hospitals in their clinical, scientific research, medical technology, management and nursing comprehensively.
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Discipline development is the core power of hospital development,which is highly emphasized by Beijing Municipal Administration of Hospitals.To meet the demands of public hospitals reform and requirements of municipal hospitals development,performance evaluation is used as a tool for municipal hospitals in their fine management.This paper introduced the research performance evaluation system and index design of Beijing’s municipal hospitals,with a summary and analysis the operating and practices.