With the development of rehabilitation medicine being promoted as a national strategy, the rehabilitation medicine has developed rapidly in China, and the number of rehabilitation medicine departments in tertiary general hospitals has increased greatly. However, the discipline development faces some problems, such as unreasonable physical condition setting, nonstandard clinical path of rehabilitation technology, inaccurate discipline positioning, loopholes in safety management, inadequate rehabilitation quality control, and imperfect talent construction system. This paper attempts to discuss the strategic thinking of the development of rehabilitation medicine from six dimensions: foundation, technology, system, safety, quality control, and talents, so as to provide a reference for discipline builders.
Clinical prediction models refer to models that can predict the probability of the occurrence of a certain clinical outcome event of the research objects, and they have important value in fields such as disease risk stratification, prognosis prediction, and precision medical decision - making. To further standardize this methodology, in 2024, an international multidisciplinary expert group composed of institutions from Switzerland, the Netherlands, the United Kingdom, and others, based on the TRIPOD statement and the PROBAST assessment tool, jointly released the "Step - by - step guide for developing clinical prediction models". This guide systematically constructs 13 steps: defining the objective, creating a team, conducting a literature review, developing a protocol, choosing to develop a new model or update an existing model, defining the outcome measure, identifying candidate predictors, collecting and checking data, determining the sample size, handling missing data, fitting the prediction model, evaluating the performance of the prediction model, determining the final model, performing decision curve analysis, evaluating the predictive ability of individual predictors, writing a report and publishing the results. This paper deeply analyzes the steps of this guide, aiming to provide a reference for clinical researchers.
Transcatheter aortic valve replacement (TAVR) has been a crucial treatment for elder patients with aortic stenosis in developed countries, which is still at its beginning in China. TAVR is a risky and complicated technic; and to promise the long-term development of it, we need to build a multiple disciplinary heart team consisted of doctors from different specialties and guided by various disciplines, also to guarantee the team operates well. In order to help Chinese doctors understand heart team well, this article describes component parts and requirement for each member of the team, in aspect of cardiologist, cardiac surgeon, echocardiologist, radiologist, anesthesiologist and nursing team; and discuss team operation mechanism through pre-procedural evaluation, procedural cooperation, peri-procedural management and post-procedural follow-up.
ObjectiveTo investigate the effectiveness of combined three operations (rotated total upper eyelid skin flap, construction of double eyelid, and "Z" flap epicanthal plasty) for one stage defect repair after resection of xanthelasma palpebrarum with epicanthus. MethodsBetween December 2013 and December 2015, 12 female patients with large xanthelasma palpebrarum and epicanthus underwent rotated total upper eyelid skin flap, construction of double eyelid, and "Z" flap epicanthal plasty for one stage defect repair. The age ranged from 36 to 59 years (mean, 43 years). The course of disease was 3 to 16 years, with an average of 11 years. The initial resection was performed in 6 cases, second resection of residual xanthelasma palpebrarum in 4 cases, and 2 cases had recurrence after resection. The maximum diameter of xanthelasma palpebrarum was 0.5-1.3 cm (mean, 1.0 cm). According to CHE Junmin et al criterion, epicanthus was rated as mild in 7 cases, moderate in 3 cases, and severe in 2 cases. The blood lipid level was in normal range. ResultsPrimary healing of incision was obtained, and the flaps survived in all patients; no complication occurred. Scar hyperplasia was found in 4 cases at 1 month after operation, and the comprehensive treatment of scar was performed. All patients were followed up for 3 months to 2 years, with an average of 1.5 years. Double eyelid effects were good, and no xanthelasma palpebrarum recurred. ConclusionA combination of rotated total upper eyelid skin flap, construction of double eyelid, and "Z" flap epicanthal plasty is an effective operative procedure to repair defect after resection of xanthelasma palpebrarum with epicanthus; and better curve of double eyelid, better shape of endocanthion, and less tension of flap can be got.
ObjectiveTo carry out the construction of star ward in the day care ward, and to provide efficient, comfortable and safe service for the patients by grasping the basic work, understanding the regulations, focusing on enhancing quality of service, and deepening the connotation of high-quality nursing care construction. MethodsDuring the construction of star ward, we adopted such measures as full mobilization, strengthening nursing post management, strengthening nursing staff training, standardizing nursing services, implementation of holistic nursing of bedside work responsibility system, selection of star nurses and extension of services. ResultsAfter the construction of star ward, nursing disputes complaints in the day ward decreased, nursing satisfaction and nursing staff skills improved significantly (P<0.05). ConclusionConstruction of star ward can improve nurses' comprehensive quality, enhance the level of nursing service, improve nursing quality, and increase patients' satisfaction.
Biobank is an important platform for translational medicine, precision medicine and drug development. In the past 10 years, although the construction of biobank in China has made great progress, it still faces many challenges. This article analyzes the key issues and also puts forward specific suggestions in the management of biobank from the aspects of ethics issues, quality control of biospecimens, information management, sample and data sharing, so as to provide reference for the construction and development of a high standard biobank.
The construction of high-level talent teams is the core of building up high-level universities and hospitals, and it is an important reference index for the ranking of universities and academic disciplines. The first-class medical talent teams is an essential requirement for comprehensive hospitals to be ranked as "Double First-Class". Based on the practice of construction of high-level medical talents in West China Hospital of Sichuan University, this paper introduces the optimal appoaches in this regard.
This consensus aims to systematically standardize the establishment and management of multidisciplinary specialized disease centers within general hospitals. Based on the "1+5+7" framework (one core condition, five essential conditions, and seven enabling conditions), it clarifies the classification of centers by focusing on specific diseases, organs, or symptoms. The consensus emphasizes interdisciplinary coordination, integration of clinical specialties, and the advancement of specialized disease management, while also prioritizing improvements in patient care experience and the development of professional talent teams. It covers the full lifecycle of center development—including organizational structure, clinical services, teaching and research, and evaluation and management—providing a standardized operational pathway for the construction of specialized disease centers in general hospital settings.
Objective To construct yeast eukaryotic expression vector carrying human endostatin (ES) cDNA. Methods The functional fragment of endostatin gene in human hepatic tissue was amplified by using RT-PCR technology, and cloned into yeast pPIC9 expression vector. The positive clone was sequenced by using automatized sequencer. Results The endostatin cDNA was successfully cloned. The positive ES clone gene in pPIC9 expression vector was sieved, and its coding sequence was identified to be as same as the previously reported sequence. Conclusion The successful construction of ES gene in pPIC9 expression vector using molecular biological method maybe helpful for the high expression of ES protein, which may lay the foundation for the treatment of malignant tumor through anti-angiogenesis appoach.
Objective To summarize the recent progress of construction methods of engineered cell sheet and to forecast the possible prospect. Methods The recent original articles about investigation and appl ication of engineered cell sheet were reviewed. Several common methods were selected and expounded. Results The construction methods of engineered cell sheet mainly include temperature-responsive culture dish, salmon atelocollagen, magnetic force, surface roughness, and polyelectrolytes, which may overcome the l imits of traditional tissue engineering methods. Conclusion The construction methods of engineered cell sheet are feasible and have a bright future in the cl inical appl ication.