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find Keyword "诊疗" 126 results
  • Current Opinion on Multidisciplinary Treatment Model for Gastric Cancer

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  • 双心护理在冠状动脉介入诊疗术患者中的应用

    目的探讨双心护理对于行冠状动脉介入诊疗患者的作用。 方法选取2013年3月-11月在心内科住院并行介入诊疗的冠状动脉粥样硬化性心脏病患者100例,按入院单双日将患者分为对照组和干预组;对照组给予常规护理;干预组在给予常规护理基础上实施心理护理。利用焦虑评估值、心率、术后并发症评价两组患者护理效果。 结果干预组实施双心护理后,其焦虑评估值、心率、术后并发症发生率均低于对照组,满意度高于对照组,两组比较差异有统计学意义(P<0.01)。 结论双心护理有利于患者术前、术中、术后的配合,减少并发症的发生,提高患者满意度。

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  • Clinical application of multidisciplinary team co-management in geriatric hip fractures

    Objective To observe the clinical application of multidisciplinary team (MDT) treatment in the management of geriatric hip fractures and evaluate its effectiveness. Methods The clinical data of 76 elderly patients with hip fracture managed by MDT approach between August 2016 and February 2018 (MDT group) were retrospectively analyzed and compared with 102 patients managed by traditional orthopedics approach between January 2014 and December 2015 (conventional group). There was no significant difference in gender, age, fracture type, surgical procedure, and other general data between the two groups (P>0.05). However, the number of comorbidities in the MDT group was significantly higher than that in the conventional group (t=6.295, P=0.000), and the proportion of the number of comorbidities between the two groups was also significantly different (χ2=28.442, P=0.000). The consultation rate and transfer rate, time to surgery, rate of surgery within 2 or 3 days, operation time, postoperative hospitalization stay, length of hospitalization stay, hospitalization expense, rate of loss to follow-up, and mortality during hospitalization, 30-day mortality, 90-day mortality, and 1-year mortality after operation were compared between the two groups. Results The rates of total consultations of the conventional group and the MDT group were 56.86% (58/102) and 56.58% (43/76), respectively, and the rates of total transferred patients were 15.69% (16/102) and 15.79% (12/76), respectively, with no significant differences (P>0.05). Among them, the proportion of patients who transferred into intensive care unit (ICU) in conventional group was significantly higher than that in MDT group and the rates of patients who received geriatric consultation or transferred into geriatric department in MDT group were both significantly higher than those in conventional group (P<0.05). There was no significant difference in rates of other department consultation or transfer between the two groups (P>0.05). The time to surgery, operation time, postoperative hospitalization stay, and length of hospitalization stay in MDT group were significantly less than those in conventional group, but the proportion of patients who received surgery within 3 days in MDT group was significantly higher than that in conventional group (P<0.05). There was no significant difference in the proportion of patients who received surgery within 2 days (χ2=2.027, P=0.155). The hospitalization expenses of total patients, femoral neck fracture, and intertrochanteric fracture subgroups in MDT group were all significantly higher than those in conventional group (P<0.05). However, there was no significant difference in hospitalization expense of subtrochanteric fracture subgroup between the two groups (Z=−1.715, P=0.086). The rate of loss to follow-up in conventional group and MDT group was 6.86% (7/102) and 3.95% (3/76), respectively, with no significant difference (χ2=0.698, P=0.403). The mortalities at hospitalization, 1 month, 3 months, and 1 year after operation in conventional group were 0, 1.05% (1/95), 3.16% (3/95), and 7.37% (7/95), respectively, and in MDT group were 0, 0, 2.74% (2/73), 6.85% (5/73), respectively, showing no significant differences in mortalities between the two groups (P>0.05). Conclusion MDT model in the management of geriatric hip fractures has been shown to reduce time to surgery, postoperative hospitalization stay, length of hospitalization stay, operation time, and the proportion of patients who received ICU consultation or transferred into ICU. Furthermore, MDT can improve the capacity for developing operations for patients with complex medical conditions and make medical resources used more rationally.

    Release date:2019-09-18 09:49 Export PDF Favorites Scan
  • Effectiveness analysis of 5G remote robotic surgery in pelvic fracture treatment

    Objective To investigate the effectiveness of 5G remote robotic surgery in the treatment of pelvic fractures. Methods A retrospective analysis was conducted on the clinical data of 160 patients with pelvic fractures admitted between July 2023 and June 2024 who met the selection criteria. Among these patients, 80 underwent internal fixation surgery with the assistance of 5G remote robotic surgery (5G group), while 80 received local robotic surgical assistance (control group). Baseline characteristics, including gender, age, body mass index, disease duration, cause of injury, and fracture classification, were compared between the two groups, and no significant difference was found (P>0.05). The incision length, operation time, intraoperative blood loss, hospital stay, accuracy of screw placement, maximum residual displacement postoperatively, quality of fracture reduction, incidence of complications, Majeed pelvic function score and classification at last follow-up were recorded and compared between the two groups. Results In the 5G group, 180 screws were implanted during surgery, while 213 screws were implanted in the control group. The 5G group demonstrated significantly reduced intraoperative blood loss and shorter incision length compared to the control group (P<0.05). No significant difference was observed between the two groups in terms of operation time or hospital stay (P>0.05). Radiographic evaluation revealed excellent and good reduction rates of 98.8% (79/80) in the 5G group and 97.5% (78/80) in the control group, while excellent and good screw placement accuracy rates were 98.3% (177/180) in the 5G group and 95.8% (204/213) in the control group. No significant difference was found between the two groups in maximum residual displacement, reduction quality, or screw placement accuracy (P>0.05). All patients were followed up 7-16 months (mean, 11.3 months), with no significant difference in follow-up duration between the groups (P>0.05). No perioperative or follow-up complication, such as wound infection, iatrogenic fractures, iatrogenic neurovascular injury, screw loosening or breakage, or nonunion, were observed in either group. The control group exhibited a worse degree of gait alteration compared to the 5G group (P<0.05), while no significant difference was found in incidences of squatting limitation or persistent pain (P>0.05). At last follow-up, no significant difference was observed between the groups in Majeed pelvic function scores or grading (P>0.05). Conclusion Compared with the local surgery group, 5G remote robotic surgery supported by remote expert technical guidance demonstrated smaller incision lengths, less intraoperative blood loss, and fewer postoperative complications, and was shown to be a precise, minimally invasive, safe, and reliable surgical method.

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  • Application of artificial intelligence based on multimodal fundus image data in the diagnosis and treatment of cardiovascular diseases

    Cardiovascular diseases is the leading cause of threat to human life and health worldwide. Early risk assessment, timely diagnosis, and prognosis evaluation are critical to the treatment of cardiovascular diseases. Currently, the evaluation of diagnosis and prognosis of cardiovascular diseases mainly relies on imaging examinations such as coronary CT and coronary angiography, which are expensive, time-consuming, partly invasive, and require high professional competence of the operator, making it difficult to promote in the community or in areas where medical resources are scarce. The fundus microcirculation is a part of the human microcirculation and has similar embryological origins and physiopathological features to cardiovascular circulation. Several studies have revealed fundus imaging biomarkers associated with cardiovascular diseases, and developed and validated intelligent diagnosis and treatment models for cardiovascular diseases based on fundus imaging data. Fundus imaging is expected to be an important adjunct to cardiovascular disease diagnosis and treatment given its noninvasive and convenient nature. The purpose of this review is to summarize the current research status, challenges, and future prospects of the application of artificial intelligence based on multimodal fundus imaging data in cardiovascular disease diagnosis and treatment.

    Release date:2023-08-31 05:57 Export PDF Favorites Scan
  • 经MDT治疗后获得长期生存的晚期肝癌病例临床分析

    目的 通过多学科诊疗(MDT)机制治疗晚期肝癌,探索将其变为慢性疾病的可能。 方法 采用MDT机制治疗晚期肝癌患者,结合患者具体病情,多次MDT诊疗确定个体化的综合治疗方案,包括多次经皮肝动脉化疗栓塞术(TACE)、手术切除、免疫治疗、抗病毒治疗、多次微波消融、放射治疗等治疗手段。 结果 晚期肝癌患者经治疗后已无瘤生存5年多,恢复正常工作和生活。 结论 MDT机制下制定个体化的方案,适时采取合理的、安全的治疗手段,可以提高肝细胞肝癌(hepatocellular carcinoma,HCC)的治疗效果,从而使患者的生存获益,有将晚期HCC变成慢性疾病的可能性。

    Release date:2017-01-18 08:04 Export PDF Favorites Scan
  • A review of studies on priority evaluation of patient admission

    Patient priority evaluation has been studied and applied abroad for a long time, which is a mature theory and widely used in practice now. This article uses the priority, patients, waiting list and criteria as keywords to search Wiley Inter Science, Web of Science, Scopus Pub Med, The Cochrane Library, Science Direct, Springer, and Jstor database (searching time is up to December 2017), to collect relevant indicators for patient admission priority evaluation. In addition, relevant citations and grey literature were searched, and experts from relevant fields in China were consulted to obtain more comprehensive research literature. On this basis, this article describes the concept of patient admission priority evaluation, and describes the meanings of the indicators and the countries of application from the three dimensions of clinical indicators, expected results, and social factors. It is considered that the research and implementation of the evaluation of the priority of patient admission has been relatively many. However, there are only a few related researches in the country and without unity. There is no systematic patient-related priority evaluation. It is necessary to use foreign mature theory research to establish a hospital admission priority evaluation system suitable for China’s national conditions.

    Release date:2018-12-24 02:03 Export PDF Favorites Scan
  • The interpretation of the Chinese Society of Clinical Oncology clinical guidelines for the diagnosis and treatment of diffuse large B-cell lymphoma

    Diffuse large B-cell lymphoma is highly heterogeneous and is diagnosed according to the 2016 World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues. The decision of treatment should be upon age, International Prognostic Index score and the tolerability of chemotherapy. High-dose chemotherapy and autologous stem cell transplantation is the standard care for relapsed, chemotherapy sensitive patients. Clinical trials are recommended in specific conditions.

    Release date:2019-04-22 04:14 Export PDF Favorites Scan
  • Effect of multi-disciplinary treatment on surgical outcome and satisfaction of patients undergoing primary unilateral total knee arthroplasty

    Objective To study the effect of multi-disciplinary treatment (MDT) on the surgical efficacy and satisfaction of patients undergoing total knee arthroplasty (TKA) for the first time. Methods The clinical data of patients who underwent unilateral TKA for single-compartment osteoarthritis of the knee in the General Hospital of Ningxia Medical University between January and September 2022 were retrospectively collected and analyzed. According to whether MDT was performed on patients during the perioperative period, they were divided into MDT group and traditional group. Perioperative nutrition-related indicators, perioperative complications, total hospitalization time, Visual Analogue Scale (VAS), and Hospital for Special Surgery Knee Score (HSS) before and after surgery were detected and recorded. Results A total of 95 patients were included. Among them, there were 42 cases in the MDT group and 53 cases in the traditional group. The postoperative complications and total hospital stay of patients in the MDT group were lower than those in the traditional group, and their satisfaction scores were higher than those in the traditional group (P<0.05). The perioperative serum total protein (TP), hemoglobin (Hb), serum albumin (ALB) levels, VAS score, and HSS score of both groups of patients changed over time. The intra group comparison results showed that compared with preoperative, the levels of TP, Hb, and ALB in both groups decreased on the 1st and 3rd postoperative days (P<0.05). On the 3rd day after surgery, the levels of TP, Hb, ALB in the MDT group and Hb, ALB in the traditional group were lower than on the 1st day after surgery (P<0.05). There was no statistically significant difference in TP levels between the traditional group on the 3rd day after surgery and the 1st day after surgery (P>0.05). The results of intra group comparison at different time points showed that there were statistically significant differences in VAS score and HSS score between the two groups (P<0.05). Conclusion The application of MDT in elderly patients undergoing unilateral TKA for the first time can shorten the total hospitalization time, reduce the incidence of perioperative complications, and improve the surgical efficacy and patient satisfaction.

    Release date:2023-06-21 09:43 Export PDF Favorites Scan
  • A review of pathogenesis and diagnosis and treatment of vaccine-associated uveitis

    Vaccine-associated uveitis (VAU) usually refers to a rare adverse reaction that occurs after vaccination. The clinical manifestations of VAU are most often anterior with mild symptoms and responded promptly to topical corticosteroids. However, more severe forms of posterior and panuveitis may also occur, such as multiple evanescent white dot syndrome, Vogt-Koyanagi-Harada syndrome, and acute posterior multifocal placoid pigment epitheliopathy. The pathogenesis of VAU is still unclear. Currently, it mainly includes vaccine Shoenfeld syndrome, type Ⅲ hypersensitivity reaction caused by immune complex deposition, direct infection with live attenuated vaccine, and molecular mimicry theory. VAU is self-limiting, and most patients heal without treatment. In the future, it is recommended to ask all patients with uveitis about their recent vaccination history in the clinic. For patients with inactivated vaccine or recombinant/subunit vaccination history, the possibility of developing Shoenfeld syndrome should be considered, and the history, signs and symptoms related to autoimmune diseases should be carefully looked for.

    Release date:2023-09-12 09:11 Export PDF Favorites Scan
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