摘要
Objective:To explore the experience and learning curve of single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach.Methods:Clinical data of 138 patients undergoing single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via oral vestibular approach from Sep. 2019 to Dec. 2021 in the Department of Thyroid and Breast Surgery of Affiliated Hospital of North Sichuan Medical College were retrospectively analyzed. The cumulative sum (CUSUM) method and best-fit curve analysis were used to compare the differences in each index such as operative time, intraoperative bleeding, number of lymph nodes cleared in the central region and postoperative related complications at various stages of the learning curve.Results:All 138 patients underwent single-line suspension rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach, and one patient was converted to open surgery due to large intraoperative bleeding in the mass. There were 14 males and 124 females, mean age (36.07±8.49) years (20-55 years), thyroid tumor size (7.74±6.49) mm (2.4-50mm), 5 cases underwent Subtotal thyroidectomy, 129 cases underwent Unilateral lobectomy + lymph node dissection in the middle region, and 4 cases total thyroidectomy + central zone lymph node dissection. The number of surgical cases corresponding to the apex of the CUSUM learning curve was 45, and the learning curve was divided into two stages: the learning improvement stage (1-45 cases) and the mastery stage (46-138 cases). The operative time, intraoperative bleeding, postoperative hospital stay, and chin numbness were all lower in the proficiency period than in the learning and training period ( P<0.05), and the number of lymph nodes cleared in the central region was larger than that in the learning and improvement stage ( P<0.05), while the differences in other indexes between the two stages were not statistically significant ( P>0.05) . Conclusion:The single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach has clinical application value and is worth promoting, and the number of surgical cases to be accumulated to master this technique is 45.
摘要
The frequent several ethical events in recent years suggested carry out the construction of ethical governance system involving human health-related research under the background of national governance. The subjects of ethical governance include the government, medical institutions, universities, scientific research institutes, enterprise, ethics committees, researchers, the public, etc., the multiple subjects are interrelated and interact with each other to restrict and standardize ethics through different governance tools. However, there are some problems in China’s ethical governance, such as the relative lag in the construction of ethical governance concept and system, insufficient multi-party participation, the difficulty in sole legislation to solve risk and ethical problems, the specification cannot be met, inadequate supervision, insufficient accountability for violations, researchers lack ethical awareness, ethical education lags behind and insufficient information disclosure to the public. It should be taken such as countermeasures as paying attention to the theoretical research of ethical governance system, strengthening the construction of ethical governance system, pluralistic co governance, agile governance, strengthening legislation, improving norms, implementing supervision, strengthening the construction of ethics committee, talent training, training researchers, ethical education, popular science public, academic self-discipline, information disclosure and public participation, so as to build a scientific and technological ethics governance system in line with China’s national conditions and in line with international standards, and contribute China’s wisdom for world ethical governance.
摘要
To construct a simple and two-way interactive doctor-patient communication mode, in order to provide guidance tools for doctor-patient communication, improve the effectiveness of doctor-patient communication for cancer patients, optimize medical experience, reduce doctor-patient disputes, and provide new perspectives and ideas for the study of doctor-patient communication. Literature review and qualitative research were used to construct the index framework of ESER doctor-patient communication model, and Delphi method was used to revise and improve the index content, and evaluate its reliability and validity. The results showed that after two rounds of expert letter consultation, the final ESER doctor-patient communication mode was established, including 4 primary-level indicators, 8 second-level indicators and 40 third-level indicators. The positive coefficient of experts was 100% in both rounds. The authority coefficient of experts was 0.85 in the first round and 0.91 in the second round, indicated a high degree of overall authority. Coefficient of variation (CV) were less than 0.25, and the Kendall’s W coefficient for significant χ2 test, P values were less than 0.05, which was statistically significant. It can be considered that the coordination degree of experts was high; Cronbach’s α coefficients in the first and second rounds of importance evaluation were 0.952 and 0.971, respectively, which indicated that the index framework had good reliability and validity. Based on the needs of cancer patients for doctor-patient communication, build a two-way interactive ESER doctor-patient communication mode, integrate medicine and humanities, which can be used as a guiding tool for medical staff to communicate with cancer patients, so as to enable doctors and patients to achieve mutual trust, cooperation and win-win results.
摘要
With the deepening reform of ideological and political education, Medical Parasitology teaching needs to update the teaching concept, change the teaching ideas, as well as keep trying to combine ideological and political education with the curriculum content closely. In addition to teaching students’ basic knowledge and practical skills, teachers are needed to cultivate their moral literacy and political awareness through course teaching, so as to provide the basis for students’ subsequent adaptations to social environments and jobs. Currently, the study of ideological and political education in Medical Parasitology teaching is still in the exploratory stage. Therefore, colleges and universities need to carry out effective construction of ideological and political education in Medical Parasitology teaching, in order to achieve good teaching outcomes and provide insights into ideological and political education in teaching.
摘要
Objective To investigate the risk factors for re-fracture after percutaneous kyphoplasty (PKP) in elderly patients with osteoporotic thoracolumbar compression fractures and to construct a line graph prediction model. Methods One hundred and eighty-two elderly patients with osteoporotic thoracolumbar compression fractures treated with PKP from January 2016 to November 2019 were selected for the study‚ and the patients were continuously followed up for 3 years after surgery. Clinical data were collected from both groups; Receiver operating characteristic (ROC) curve analysis was performed on the measures; Logistic regression analysis was performed to determine the independent risk factors affecting postoperative re-fracture in PKP; the R language software 4. 0 “rms” package was used to construct a predictive model for the line graph‚ and the calibration and decision curves were used to internally validate the predictive model for the line graph and for clinical evaluation of predictive performance. Results The differences between the two groups were statistically significant (P0. 22‚ which could provide a net clinical benefit‚ and the net clinical benefit was higher than the independent predictors. Conclusion BMD‚ number of injured vertebrae‚ single-segment cement injection‚ cement leakage‚ pre-and post-PKP vertebral height difference‚ and posterior convexity angle change are independent risk factors affecting the recurrent fracture after PKP in elderly patients with osteoporotic thoracolumbar compression fracture‚ and this study constructs a column line graph model to predict the recurrent fracture after PKP in elderly patients with osteoporotic thoracolumbar compression fracture as a predictor for clinical. This study provides an important reference for clinical prevention and treatment‚ and has clinical application value.
摘要
Objective:To investigate the current status of research on the construction of leadership indicator system in the medical field at home and abroad, and to analyze the characteristics of the indicator system therein.Methods:This was a bibliometric study. The group applied subject keywords to search relevant literature on the construction of leadership indicator system in the medical field at home and abroad on English websites PubMed, Web of Science, Google Scholar, CINAHL, Scopus and Chinese websites Baidu Academic, CNKI, CQVIP, Wanfang Data Knowledge Service Platform, with a time frame of 2016-2023. The basic characteristics of the literature, the theoretical framework of the research application and the research theme were extracted, and the content of the indicator system in the literature was reviewed and summarized.Results:A total of 21 literatures were included, including 7 Chinese literatures and 14 English literatures. Of these literatures, 10 focused on physician leadership, 5 on medical manager leadership, and 2 on general practitioner leadership. Among 16 research literatures, 9 informed the theoretical basis of leadership, and 4 literatures were applied research. Five main themes were identified: leadership studies of individual healthcare administrators, leadership development in healthcare, interest and attitudes of healthcare workers towards leadership learning, applications of leadership in healthcare, and the impact of leadership in healthcare on patients and healthcare organizations.Conclusions:At present, research on the construction of the leadership indicator system in the medical field presents is diverse, with differences in theoretical basis and content. The original and empirical research is still insufficient.
摘要
With the development of the diagnosis and treatment for rare diseases and the promotion of the construction of ′Double First-Class′ Universities in China, the libraries of medical schools have to make full use of their strengths to better face new challenges in discipline construction proactively. This article refers to resource and information service practices related to the rare disease carried out by medical libraries in China and in other countries; explores the possibilities of building up the resource and information in the future, aiming at improving the awareness of rare diseases among medical students, researchers, and the general public. The article also focuses on the need for strengthening the support for teaching and research into rare diseases, hoping to contribute to the overall improvement of the diagnosis, treatment, and educational research in rare diseases in China.
摘要
Cervical cancer is a malignant tumor that can be effectively controlled and eventually eliminated through etiological prevention, pathogenic prevention, and clinical prevention. In China, some problems exist in comprehensive prevention and control system for cervical cancer, such as uneven development, insufficient capacity building, and scattered institutions. In 2022, the Hubei Provincial Government launched a province-wide project to provide free cervical cancer screening for 12.67 million women aged 35-64 from 2022 to 2024. It is a historic opportunity and of great significance to fully utilize the scale and team advantages of this full-coverage cervical cancer screening, build integrated outpatient clinic for cervical cancer prevention in grassroots maternal and child health hospitals, and implement standardized construction and management. The expert group of the Cervical Disease Prevention and Control Professional Committee of Hubei Maternal and Child Health Association formulated this consensus based on the latest progress and the actual situation in Hubei. The consensus elucidated the general requirements, HPV vaccination outpatient construction standards and workflow, cervical cancer screening outpatient construction standards and workflow, colposcopy outpatient construction standards and workflow, precancerous lesion treatment outpatient construction standards and workflow, the follow-up after treatment of precancerous lesions, public education, etc. This consensus is suitable for guiding the standardized construction and management of integrated outpatient clinics for cervical cancer prevention and control in grassroots (county, district) maternal and child health hospitals in Hubei province.
摘要
Objective To explore the construction idea and application method of knowledge base and knowledge mining system for the prevention and treatment of diseases in traditional Chinese medicine.Methods Guided by the theory of traditional Chinese medicine(TCM),firstly,the knowledge system of TCM Prevention and treatment was sorted out,and the structure and relationship of TCM Prevention and treatment knowledge base were designed according to the classification method of TCM Prevention and treatment;Secondly,according to the needs of pre treatment research,the ancient and modern literature data sources and knowledge collection methods of TCM pre treatment database are proposed;Then,under the framework of the pre treatment classification system,the core knowledge is studied in the aspects of professional annotation,relationship extraction,knowledge audit,and a variety of data mining algorithms are introduced to analyze and mine the knowledge;Finally,the massive data obtained are combined with big data analysis and computer machine learning to realize intelligent information collection,disease analysis and diagnosis and treatment suggestions.Results Under the guidance of traditional Chinese medicine theory,the knowledge base of traditional Chinese medicine for prevention and treatment of diseases can digitize,digitize and intellectualize the basic knowledge and clinical knowledge of traditional Chinese medicine for prevention and treatment of diseases,and can objectively mine and analyze the data,providing a basis for the service and sharing of knowledge of traditional Chinese medicine for prevention and treatment of diseases.Conclusion The knowledge base of TCM Prevention and treatment is an important way for the digital storage of TCM Prevention and treatment knowledge,and provides literature knowledge support and objective evidence of data mining for TCM Prevention and treatment research.
摘要
Objective:To explore the construction and application of an evidence-based practice plan for early postoperative activity in postoperative patients with large area cerebral infarction.Methods:Ninety-six postoperative patients with large area cerebral infarction admitted to Wenzhou Central Hospital from July 2021 to April 2023 were selected as the study subjects for a Clinical trial. They were divided into the control group (48 cases) and the observation group (48 cases) by random number table method. The control group received routine postoperative care for neurosurgery, while the observation group received evidence-based systematic early activity training. Both groups were followed up until 1 month after the patient was discharged from the hospital. The time of postoperative hospitalization, hospitalization expenses, vital signs and pain investigation 48 h after surgery, daily living ability before intervention and 7 d, 1 month after discharge, neurological function before intervention and 7 d and 1 month after surgery, and complications during follow-up between the two groups were compared.Results:In the control group, there were 29 males and 19 females, with an average age of 43-67(56.87 ± 1.76) years. In the observation group, there were 31 males and 17 females, with an average age of 43-68 (57.02 ± 1.82) years. The postoperative hospital stay in the observation group was (6.87 ± 0.65) d, in the control group was (9.06 ± 0.72) d, the difference between them was significant ( t=15.64, P<0.05). 48 hours after surgery, the heart rate, breathing rate and mean arterial pressure in the observation group were (71.65 ± 0, 45) times/min, (14.76 ± 0.36) times/min and (76.98 ± 5.65) mmHg(1 mmHg=0.133 kPa), which were different with those in the control group, (82.76 ± 2.65) times/min, (18.76 ± 2.87) times/min and (93.76 ± 5.93) mmHg ( t=28.64, 9.58 and 14.19, all P<0.05). Seven days after discharge, the score of Activities of Daily Living and the National Institutes of Health Neurological Impairment Scale in the observation group were (84.65 ± 2.45) and (23.65 ± 2.65), which were different than the (79.76 ± 1.97) and (28.54 ± 2.73) in the control group ( t=10.26, 8.91, both P<0.05). A month after discharge, the score of Activities of Daily Living and the National Institutes of Health Neurological Impairment Scale in the observation group were (95.45 ± 1.43) and (18.65 ± 1.98), while in the control group were (87.87 ± 1.39) and (21.54 ± 2.76), the difference between them were significant ( t=26.33, 5.90, both P<0.05). The total incidence of complications such as postoperative bleeding, postoperative infection and hypoxemia in the observation group was 20.83% (10/48), which was significant lower than the 68.75% (33/48) in the control group ( χ2=22.28, P<0.05). Conclusions:Evidence-based systematic early activity training could significantly alleviate postoperative pain in patients with large area cerebral infarction after surgery, improve their daily living ability and neurological function, further effectively shorten their hospitalization time, and reduce the occurrence of complications.
摘要
With the continuous deepening of aging in our country,the demand and importance of medical care and health management of the elderly are becoming more and more prominent,and the construction of discipline system of medical care and health management of the elderly provides powerful talent support for promoting the development of aging cause and the development of medical care and health industry.However,there are still many shortcomings in the professional construction and talent cultivation in the field of medical care and health management of the elderly in our country.Universities are still exploring and practicing in this area,and there is an urgent need to strengthen the construction of disciplinary systems and promote the development of the medical care and health industry.This paper introduces the construction of discipline system of medical care and health management of the elderly,analyzes the existing problems,looks forward to its future development direction,and elaborates the specific measures and characteristics in the construction of discipline system of medical care and health management of the elderly.
摘要
Microsurgery is not only a technology, but also a science. Microsurgery was enlisted as a tier-three discipline in the Classification of National Clinical Medicine Disciplines (Discipline code 320.2715) in 1992. In the new era, the discipline development of microsurgery should be inherited, innovated, realistic and pragmatic, and it also relies on the other surgical specialties to expand the applications of microsurgery. Microsurgery technology should firmly adhere to its core competitiveness and hold high the banner of microsurgical characteristics by offering the best possible serves to all the clinical surgical disciplines; Pay equal attention to medicine, teaching and scientific researches; Unite, collaborate and strengthen academic exchanges at home and abroad; Focus on talent training (i.e. exports of great country, leading figures, etc.) and support the development of private hospitals specialised in microsurgery. The supportive roles of the Chinese Journal of Microsurgery shall be further enforced to facilitate the discipline development of microsurgery and promoting high-quality development of microsurgery.
摘要
Objective:To construct a scientific and technological evaluation system based on the needs of the pilot program for building a national high-quality hospital and establishing a national medical center.Methods:Xiangya Hospital of Central South University gradually improved its academic evaluation system by following the guidelines outlined in national authorities′ documents regarding "abolishing the five only" and "setting new standards", adhering to the guiding principles of "quality, contribution, efficiency, and impact" and employing the principles of "high-standard evaluation, quantitative evaluation, representative work evaluation, and third-party evaluation" .Results:The hospital established a comprehensive, scientific, and quantifiable indicator pool. These indicators were applied to various aspects of medical innovation evaluation, including awarding incentives, discipline assessment, professional promotion, personnel assessment, mentor selection for graduates, and excellence evaluation. Simultaneously, the hospital developed an intelligent platform for medical innovation evaluation and assessment in university-affiliated hospitals based on performance management theory.Conclusions:Through the construction and practice of the Xiangya technology evaluation system, the hospital further improved and optimized its academic evaluation work, guiding researchers to high-quality innovation and efficient translational research, ultimately promoting the high-quality development of the hospital.
摘要
Discipline construction is the main focus of the high-quality development of public hospitals. The authors elaborated on the practice of Zhongshan Hospital(Xiamen), Fudan University, based on the " double-center" homogenization management, implementing the 123456 strategy of " integrated management and homogeneous development" in discipline construction. The hospital has promoted discipline construction from six aspects: building discipline cluster, promoting talent cultivation, building science and technology innovation platform, precise personnel classification, medical and education collaborative education, and information sharing and support. It has achieved new development goals of filling weak discipline gaps, transforming talent transfusion into hematopoietic, and integrating medical, educational, research and management innovation. However, it also encountered difficulties such as homogenization barrier of discipline construction, shortage of excellent talents, and limited brand influence of superior disciplines. The authors put forward suggestions from three dimensions: deepening homogeneous management, building talent echelon, and increasing publicity, in order to provide experience for the high-quality development of other hospitals.
摘要
[Objective]To explore the construction measures of a new pattern of tutor-postgraduate relationship under the background of striving for"double first-class"traditional Chinese medicine(TCM)university,in order to continuously improve the quality of postgraduate training in TCM universities.[Methods]Under the background of striving for"double first-class"TCM universities,this paper introduces the practical significance of building a good mentoring relationship,and analyzes the outstanding problems existing in the mentoring relationship in the current TCM universities from the perspective of tutors and postgraduates-the two main subjects.[Results]Through the establishment of a good mentoring relationship,the tutor-postgraduate relationship has generally been positively influenced,and the communication between teachers and students has become closer and more efficient.Through a series of positive incentive mechanisms,tutors are more active in providing support and help to postgraduates in academic guidance,academic guidance and life care,and postgraduates are more active in cooperating with tutors in various scientific research work.The quantity and quality of academic papers published by postgraduates have been significantly improved,and the scientific research and teaching work of the tutor team have been carried out more efficiently with remarkable progress.[Conclusion]Starting from the three aspects of strengthening the positive core value of"respecting teachers and medicine",perfecting the relevant system and correcting the imbalance of the tutor-postgraduate relationship,the School of Basic Medicine of Zhejiang Chinese Medical University focuses on exploring the new mode of building a good tutor-postgraduate relationship,and puts forward feasible suggestions through a series of measures.This mode has significantly improved the tutor-postgraduate relationship.It not only plays a positive role in improving postgraduates'professional level and communication-scientific research-innovation ability,but also provides a guarantee for tutors to complete teaching and scientific research work successfully,which is worthy of further improvement and promotion.
摘要
BackgroundThe existing tools in China for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint do not sufficiently consider the specialty in psychiatric practice， and the scale items are somewhat cumbersome to use， which together restrict their further promotion and application. Accordingly， there is an urgent need for developing a more scientific assessment tool. ObjectiveTo construct a scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint and to verify its reliability and validity， so as to provide a generic tool for the assessment. MethodsBased on the theoretical framework of the knowledge-attitude-practice model， the preliminary scale was formed through systematic literature review， qualitative interview and Delphi method. From July to December 2021， a stratified sampling was utilized to select 729 psychiatric nurses from tertiary， secondary and primary （including unclassified medical institutions and grassroots hospitals） psychiatric hospitals in Guangdong Province. The formal scale was developed through item analysis， exploratory factor analysis and confirmatory factor analysis. The validity of the scale was evaluated by content validity and structure validity， and the reliability was verified by procedures including Cronbach's α coefficient， test-retest reliability， and split-half reliability. ResultsA total of 12 items of three dimensions （knowledge， attitude， practice） were included in the scale for assessing psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint. The scale-level content validity index （S-CVI） was 0.941， and the item-level content validity index （I-CVI） ranged from 0.812 to 1.000. Exploratory factor analysis extracted three common factors， and the cumulative variance contribution rate was 62.948%. The confirmatory factor yielded adequate fit. Cronbach's α coefficient was found to be 0.887 for the scale， 0.819 for knowledge dimension， 0.842 for attitude dimension， and 0.831 for practice dimension. The split-half reliability and test-retest reliability for the scale were 0.712 and 0.922， respectively. ConclusionThe scale shows satisfactory reliability and validity， which can be used to assess psychiatric nurses' knowledge， attitude and practice towards the use of protective restraint. ［Funded by Guangdong Clinical Teaching Base Teaching Reform Research Project （number， 2021JD119）］
摘要
AIM: To analyze the influencing factors of postoperative dry eye complication after corneal transplantation and to build a nomogram prediction model.METHODS: Clinical data were collected on 117 patients who underwent corneal transplantation at our hospital from March 2021 to February 2023. They were divided into dry eye group(n=96)and non-dry eye group(n=21)according to whether there was a postoperative dry eye. The risk factors of postoperative complication of dry eye after corneal transplantation were analyzed, the nomogram prediction model for predicting postoperative complication of dry eye after corneal transplantation was constructed, and the internal validation of the model and the prediction efficacy were assessed by calibration curves and decision curves, respectively.RESULTS: Comorbid diabetes mellitus, comorbid sleep disorders, comorbid meibomian gland dysfunction, chronic eye drop abuse, chronic corneal contact lens wear, interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α)were the risk factors for the complication of dry eye after corneal transplantation(P<0.05). The nomogram model predicted a C-index of 0.890(95% CI 0.877-0.903). The nomogram model had a threshold >0.07, and the nomogram model provided higher net clinical benefit than the single index in all cases.CONCLUSION: The nomogram model built in this study based on the factors affecting the complication of dry eye after corneal transplantation has a good predictive value for the complication of dry eye after corneal transplantation.
摘要
Empowered by the rapid development of artificial intelligence technology and information security technology, basic medicine, translational medicine, and clinical medicine have entered a new era. In this process, the relevant data such as text, genetics, images, and videos have increased at an astonishing rate. Traditional specialized disease databases cannot adapt to the multimodality of data and the multicentralization of data sources in the present/future. Therefore, establishing a next-generation multimodal and multicenter collaborative specialized disease database that is suitable for secure data sharing and ethical in clinical research is essential. This paper expounds the concept and basic framework of developing a next-generation clinical research disease database with universal use, emphasizing the establishment of a multimodal data integration mechanism, a multicenter collaborative system supported by privacy-preserving computing, highly intelligent software and hardware entities, and an integrated operational management mode. It also introduces the application of this concept in the construction of a breast cancer three-dimensional life database, a project of China Breast Cancer Innovation Alliance.
摘要
Using constructivism theory， this study explored the relationship between the "origin" and "flow" of academic schools in traditional Chinese medicine （TCM）， clarified the developmental patterns of schools， and provided insights for the modernization， inheritance， and innovation of current schools. Academic schools originate from different cultural sources， and their differentiation and development are similar to the replication， spread and variation of biological "genes". The theoretical characteristics of constructivism align well with the principles of formation and differentiation of academic schools. The construction of academic thoughts and core diagnostic and therapeutic concepts within each school can be seen as a multilevel unity of self-construction， mutual construction among individuals， and social construction. Firstly， individual medical practitioners choose and inherit from the origins of TCM， integrating personalized understanding， which then differentiates into various schools in the history of academia. Secondly， during the process of cultural inheritance， medical practitioners from different times and regions gradually form academic schools and local medical schools through the method of "tailoring strategies to three categories of etiological factors" and mutual construction among individuals. Finally， in the context of the scientific， standardized， and intelligent development of modern medicine， the further evolution of academic schools needs to follow the evolutionary laws of traditional medicine， combine with the health needs of the new era， adopt a social construction approach， facilitate multi-party participation in the inheritance and innovation of academic thoughts and clinical experiences， and utilize the internet and intelligent technology means to empower modern development.
摘要
With the development of the diagnosis and treatment for rare diseases and the promotion of the construction of ′Double First-Class′ Universities in China, the libraries of medical schools have to make full use of their strengths to better face new challenges in discipline construction proactively. This article refers to resource and information service practices related to the rare disease carried out by medical libraries in China and in other countries; explores the possibilities of building up the resource and information in the future, aiming at improving the awareness of rare diseases among medical students, researchers, and the general public. The article also focuses on the need for strengthening the support for teaching and research into rare diseases, hoping to contribute to the overall improvement of the diagnosis, treatment, and educational research in rare diseases in China.