ObjectiveTo evaluate the infiuence of doctor-nurse double check table applied before operation on the completion of preoperative preparation in gastrointestinal surgery department of class-three grade-one hospitals. MethodsA total of 647 selective operation patients from April to September 2013 in the Department of Gastrointestinal Surgery were divided into observation group (n=315) and control group (n=332) based on admission time. After training for medical staff, the check tables were filled, and relatively high frequency issues were followed up for quality tracking. The completion of preoperative preparation was compared between the two groups after operation. ResultsCompared with the control group, the completion of preoperative preparation and satisfaction of patients of the observation group were significantly higher and the operation delay was significantly lower (P<0.05). ConclusionPreoperative application of doctor-nurse double check table can significantly improve the completion rate of preoperative preparation, the operation delay phenomenon and satisfaction of patients, promote the communication between doctors and nurses, reduce the risk of operation, and ensure the safety of surgical patients.
Objective To evaluate the effect of the local del ivery of basic fibroblast growth factor 2 (bFGF-2) on the osseointegration around titanium implant of diabetic rats. Methods The bFGF-2-loaded poly (lactic-co-glycol ic acid) microspheres were prepared by water/oil/water (W/O/W) double-emulsion solvent evaporation method. Thirty-five male SPF level Sprague Dawley rats, weighing 220-250 g and aged 9 weeks, were selected as experimental animals. Ten rats were fedwith the routine diet as normal control group. The other 25 rats were made the diabetic animal model by giving high fat-sugar diet and a low dose streptozotocin (30 mg/ kg) intravenously; 20 rats were made the diabetic animal model successfully. Then 20 rats were randomly divided into diabetic control group (n=10) and bFGF-2 intervention group (n=10). A hole was drilled in the right tibia bone of all rats, and the titanium implant treated by micro-arc oxidation surface was planted into the hole. Simultaneously, the previously prepared microspheres and blood were mixed and were loaded on the surface of the implant before it was implanted into the rats of the bFGF-2 intervention group. At 4 and 8 weeks, the tibia containing implants was harvested, embedded with resin and made undecalcified tissue sl ices to compare the osseointegration. Results At 4 weeks, the implants of the normal control group were surrounded by new lamellar bone with continuity; whereas the tissue around the implants of the diabetic control group contained l ittle woven bone and some fibrous tissue; and obvious new formed bone with continuity was observed in bFGF-2 intervention group. At 8 weeks, the results of 3 groups were similar to those at 4 weeks. At 4 weeks, the percentage of bone-implant contact (BIC) in diabetic control group was significantly less than those in normal control group (P lt; 0.05) and in bFGF-2 intervention group (P lt; 0.05); the BIC in bFGF-2 intervention group was less than in normal control group, but showing no significant difference (P gt; 0.05). After 8 weeks, the BIC in normal control group and in bFGF-2 intervention group were significantly greater than that in diabetic control group (P lt; 0.05), but there was no significant difference between bFGF-2 intervention group and normal control group (P gt; 0.05). Conclusion Local del ivery of bFGF-2 around titanium implants may improve the osseointegration in diabetic rats.
Objective To provide basis for cl inical appl ication of ANKYLOS dental implants by following up alveolar bone status of 318 pieces of restored ANKYLOS dental implants. Methods Between February 2008 and August 2009, 170 patients with dentition defect underwent placement of ANKYLOS dental implants (318 pieces). There were 74 males (133 pieces) and 96 females (185 pieces) with an average age of 43.8 years (range, 23-68 years). After operation, the periapicalX-ray films were taken to observe osseointegration around the neck of implant, alveolar bone resorption, and survival ofimplants. Results All patients were followed up at 6, 12, and 24 months after operation. There were 9 failure implants witha total dental implants survival rate of 97.17% (309/318): 3 at 6 months, 4 at 6-12 months, and 2 at 12-24 months, showing no significant difference in dental implants survival rate among 3 time points (χ2=0.470 3, P=0.492 8). New bone formed around the neck of implant in 4 cases at 6 months and in 31 cases at 12 months; at 6, 12, and 24 months, the bone increase was (0.392 7 ± 0.217 4), (0.633 5 ± 0.202 1), and (0.709 0 ± 0.199 1) mm, respectively, showing significant differences among 3 time points (P lt; 0.05). At 6, 12, and 24 months after operation, the bone loss of other patients was (0.392 7 ± 0.217 4), (0.716 7 ± 0.220 3), and (0.723 2 ± 0.215 4) mm, respectively, showing significant differences among 3 time points (P lt; 0.05). Conclusion After restoration with ANKYLOS dental implant, alveolar bone status is good and the implant success rate is high during short-term follow-up. But further observation and study are required for long-term effectivness.
ObjectiveTo improve the comprehensive service ability of the hospital, improve the satisfaction of medical care, implement the requirements of fine management, and enrich the connotation of hospital internal performance improvement.MethodsIn July 2017, based on the concept of approach-deployment-learning-integration, the internal performance improvement model of Children’s Hospital Affiliated to Fudan University was constructed to form a management closed loop.ResultsFrom 2016 to 2019, the average length of hospital stay was reduced from 6.90 d to 6.47 d, the patient satisfaction was elevated from 92.89% to 93.80%, the proportion of drugs was reduced from 35.25% to 30.44%, the proportion of materials was reduced from 23.35% to 18.55%, and the proportion of difficult operations of grade Ⅲ and Ⅳ was elevated from 66.98% to 67.68%.ConclusionThe improvement of key performance indicators depends on the implementation of external policies, the integration of scientific management elements, the cooperation of multiple subjects, and the construction of information system.
In order to promote the openness, transparency and standardization of clinical trials, improve the scientific and reliability of results, and reserve the manpower, material, and financial resources in the process of clinical trials, this study constructed an integrated intelligent management platform for clinical trials, which could carry out various types of clinical trials such as randomized controlled trials, non-randomized controlled trials, cohort studies, case-control studies, and cross-sectional studies simultaneously. The platform covers the whole process of scheme design, recruitment, follow-up, data analysis, and quality control. This paper mainly introduced the practical needs, design concept, basic framework and technical highlights to provide auxiliary tools for promoting the standardization and intelligence of clinical trials with energy saving and optimal efficiency.
Medical information exchange and integration is the effective method to solve the interoperability and medical information island, and is the basis of medical information sharing. In this paper, we take medical texts and medical images as the basic integrated objects, DICOM, HL7 messages and datasets as the integrated units, efficient DICOM, HL7 message construction and parsing methods as basis, design and realize a universal medical information integration and exchange service middleware. Experimental results show that the prototype system could perform medical information integration and exchange among relational database, HL7 and DICOM message, provide a feasible scheme to solve the medical information island and lay a good foundation for establishing the unified medical information integration and sharing platform. The middleware has been applied in the project named "development and demonstration of opened medical information integration system".
Integration of heterogeneous systems is the key to hospital information construction due to complexity of the healthcare environment. Currently, during the process of healthcare information system integration, people participating in integration project usually communicate by free-format document, which impairs the efficiency and adaptability of integration. A method utilizing business process model and notation (BPMN) to model integration requirement and automatically transforming it to executable integration configuration was proposed in this paper. Based on the method, a tool was developed to model integration requirement and transform it to integration configuration. In addition, an integration case in radiology scenario was used to verify the method.
The comprehensive clinical evaluation of drugs is fundamental work that promotes drugs return to clinical value and it has become one of the most important areas of clinical pharmacy in recent years. The existing literature focuses on the construction of comprehensive clinical evaluation index system or the quantification of index values. However, relatively few studies concerning the value integration method, which may lead to the suboptimal scheme being selected as the optimal scheme. Therefore, this study summarizes various comprehensive value integration methods from the aspects of background, principles and applicable situations, to provide methodological references for comprehensive clinical evaluation in China.
With the continuous development of new drugs and immunotherapy, the survival period of patient with multiple myeloma (MM) is continuously prolonged, and the disease is becoming chronic. Due to the involvement of multiple systems and numerous complications, the daily nursing for MM faces significant challenges. The doctor-nurse-patient integration model and the whole life cycle health management model for daily nursing of MM are expected to reduce the social burden related to diseases, improve patients’ quality of life, and reduce medical costs. This article provides a review on three aspects of MM doctor-nurse-patient integration, whole life cycle health management, and daily health management involving multiple systems.
As an emerging technology, artificial intelligence (AI) uses human theory and technology for robots to study, develop, learn and identify human technologies. Thoracic surgeons should be aware of new opportunities that may affect their daily practice by the direct use of AI technology, or indirect use in the relevant medical fields (radiology, pathology, and respiratory medicine). The purpose of this paper is to review the application status and future development of AI associated with thoracic surgery, diagnosis of AI-related lung cancer, prognosis-assisted decision-making programs and robotic surgery. While AI technology has made rapid progress in many areas, the medical industry only accounts for a small part of AI use, and AI technology is gradually becoming widespread in the diagnosis, treatment, rehabilitation, and care of diseases. The future of AI is bright and full of innovative perspectives. The field of thoracic surgery has conducted valuable exploration and practice on AI, and will receive more and more influence and promotion from AI.