ObjectiveTo investigate the anesthesia management of transcatheter ultrasound-guided percutaneous interventional therapy for pediatric patients with congenital heart disease at a mobile surgical platform. Methods From March to July 2023, 13 patients in remote areas underwent interventional surgery on the mobile truck operating platform. The patients undergoing general anesthesia using non-tracheal intubation were collected. ResultsFinally, 8 patients received monitored anesthesia care (MAC) with local anesthesia-assisted sedation and analgesia drugs under the supervision of anesthesiologists (general anesthesia using non-tracheal intubation), due to the patients having difficulty cooperating with the surgery (young age, nervous mood, and crying), including 5 males and 3 females with an average age of 6.95±3.29 years and an average weight of 19.50±6.04 kg. There were 6 patients diagnosed with atrial septal defect, 1 patient with residual shunt after patent ductus arteriosus ligation, and 1 patient with severe pulmonary stenosis by transthoracic ultrasonography. The surgical process was smooth, analgesia was perfect, anesthesia and surgical effect were satisfactory, postoperative recovery was satisfactory, and there were no surgical or anesthesia complications. The anesthesia time was 41.53±8.62 min, the operation time was 39.88±8.52 min, and the recovery time was 41.50±14.56 min. Conclusion Transthoracic ultrasound-guided interventional surgery is a minimally invasive approach for congenital heart disease, offering the advantages of zero radiation exposure. Non-tracheal general anesthesia preserved spontaneous breathing can be safely and effectively administered to pediatric patients who cannot cooperate in mobile operating platform.
Objective To explore a new teaching mode relying on the new media platform, aiming to stimulate residency standardized trainees’ interest in learning theories related to gynecology outpatient surgery, improve practical operation skills, and achieve better teaching effects. Methods The residency standardized trainees who rotate in the gynecology outpatient of West China Second University Hospital, Sichuan University between July 2021 and June 2022 were selected. According to the random number table method, the trainees were divided into the control group (using the traditional teaching mode) and the intervention group (using the teaching mode of combining the flipped classroom and simulated teaching relying on the new media platform). The assessment results, teacher evaluation, trainees self-evaluation and teaching satisfaction of the two groups were compared and analyzed. Results A total of 118 trainees were enrolled, 59 in each group. There was no significant difference in gender, age, years of training and education level between the two groups (P>0.05). The total scores of evaluation scores (87.59±4.54 vs. 85.17±3.70), teachers’ evaluation (87.05±3.79 vs. 85.14±3.75), and trainees’ self-evaluation (87.81±4.41 vs. 85.54±3.96) of trainees in the intervention group were better than those in the control group, and the differences were statistically significant (P<0.05). The clinical thinking ability [teachers’ evaluation (24.49±1.62 vs. 23.22±2.05), trainees’ self-evaluation (25.25±1.99 vs. 23.97±2.27) and operation skills [teachers’ evaluation (37.05±1.58 vs. 36.10±1.99), trainees’ self-evaluation (36.75±2.73 vs. 35.66±2.56)] of trainees in the intervention group were better than those in the control group, and the differences were statistically significant (P<0.05). The satisfaction rate of the trainees in the intervention group was 98.3%, and that of the trainees in the control group was 93.2%. The teaching satisfaction of the intervention group was better than that of the control group (P<0.05). Conclusion The teaching mode of combining flipped classroom and simulated teaching relying on the new media platform has effectively stimulated residency standardized trainees’ learning interest in gynecological outpatient surgery, improved trainees’ clinical practice ability, improved teaching satisfaction, achieved good teaching results, and can be promoted as a new teaching mode.
In order to promote the effective development of hospital day surgery mode, a construction method of information management platform that meets the characteristics of day surgery mode is presented. By analyzing the business process of the day surgery mode, the system architecture of the information platform is given; according to the difficulty of the surgical scheduling, the two-stage surgical scheduling algorithm based on the ranking theory is given; by analyzing the day surgery data statistically, a multi-angle surgical index analysis module is provided. The information management of the day surgery mode has been realized, and the work efficiency has been improved. A reasonable day surgery information platform construction can help to optimize the daytime surgical procedure and promote the smooth development of day surgery.
ObjectiveTo investigate the effectiveness of rotating-platform prosthesis for valgus knee deformity in total knee arthroplasty (TKA). MethodsA retrospective analysis was made on the clinical date of 25 cases (28 knees) of valgus deformity undergoing primary TKA by using Gemini MK II rotating-platform prosthesis. There were 6 males (7 knees) and 19 females (21 knees), aged from 47 to 82 years, with an average age of 64.8 years. The unilateral knee was involved in 22 cases and the bilateral knees in 3 cases. The causes included osteoarthritis in 20 cases (22 knees), rheumatoid arthritis in 4 cases (5 knees), and traumatic arthritis in 1 case (1 knee). The disease duration was 2-22 years (mean, 10.4 years). The main clinical symptoms were arthralgia combined with limited movement. According to the Keblish grade, there were 13 knees of mild deformity, 11 knees of moderate deformity, and 4 knees of severe deformity. ResultsAll incisions healed by first intension. No complications of infection, cutaneous necrosis, deep venous thrombosis, and pulmonary embolism occurred. The postoperative follow-up duration was 12-60 months (mean, 25.4 months). Medial instability and palsies of nervus peroneus communis occurred in 1 and 2 cases respectively, and all were cured after symptomatic treatment. No patellar and polysthylene insert dislocation, prosthetic loosening or infection was observed. The Hospital for Special Surgery (HSS) score, femoral tibial angle, maximun flexion and extension angles, knee range of motion, and patellar score were significantly improved at last follow-up when compared with preoperative ones (P<0.01). ConclusionThe rotating-platform prosthesis for valgus deformity can obtain satisfactory effectiveness, but it requires precise soft tissue balancing technology, and the long-term effectiveness remains further observation.
ObjectiveTo summarize the research progress of tissue engineered bile duct in recent years.MethodsThis paper summarized recently-published papers related to tissue-engineered bile duct on in vitro test platform, scaffold materials, acquisition methods of seed cells, and in vivo repair effectiveness after the fusion of seed cells and materials, in an attempt to review the basic and clinical application studies of tissue-engineered bile duct.ResultsTissue-engineered bile duct had been developing rapidly. At present, great progress had been made in the fields of in vitro test platform, scaffold materials, seed cells, and repair effectiveness in animal models. However, further study was still needed in terms of its clinical application. The external bile duct platform included 3D printing and biological simulation; in the aspect of scaffold material, apart from the progress of various artificial materials, acellular matrix was introduced; the selection of seed cells included the induction and differentiation of bile duct-derived stem cells, human bone marrow mesenchymal stem cells (hMSCs), hepatic oval cell (HOC), pluripotent stem cells (PSCs), and other stem cells; animal models of tissue-engineered bile ducts had also achieved good results in animals such as pigs and dogs.ConclusionThe development of tissue-engineered bile duct will promote the progress of fundamental in vitro studies on extrahepatic biliary tract diseases, thus introducing new options to the clinical treatment of extrahepatic biliary tract injuries.
Objective To analyze the current state, evaluate the accuracy, and determine the influencing factors of hypertension-related subscriptions from official health WeChat accounts. Methods The 36 official health WeChat accounts on the WeChat official accounts monthly list │ September 2022 China WeChat Top 500·New Rank certification were searched using the term "hypertension". We identified diabetes-related subscriptions published from April 1, 2022 to September 30, 2022. The accuracy of subscriptions was analyzed according to the consistency with clinical practice guidelines and was independently assessed by two specialists. SPSS 22.0 software was used for data analysis. Results One hundred and one subscriptions from 36 official health WeChat accounts were included. Forty-seven (46.5%) subscriptions were evaluated as consistent, seven (6.9%) subscriptions were evaluated as inconsistent, and forty-seven (46.5%) subscriptions were evaluated as unconfirmed. The differences between the numbers of reads, "wow" and "like" per thousand reads, were statistically significant. Consistency rates were higher for tweets backed by evidence and experts, and for tweets posted by public figures with the accreditation type "government". Conclusion Hypertension tweets have a good audience base, some of the content is inconsistent with current clinical guideline recommendations, and readers have little ability to screen them. There is a need to develop and improve the review mechanism for writing and publishing hypertension tweets on WeChat.
ObjectiveTo explore the function of information system platform in the management of outpatient registration source. MethodsOn the basis of registration appointment system, we surveyed again on outpatients traffic between February 6th and 10th in 2012 to find out find out the disadvantages of outpatient service procedures. Certain measures were taken for improvement, especially the management of registration source. ResultsAfter improvement by certain measures, queuing phenomenon and the degree of congestion in the waiting area were improved. To some extent, the satisfaction of patients and doctors was raised from 91% to 93%. ConclusionStandardizing outpatient administration and behavior of patients by information system platform has a good effect and is worth promoting.
ObjectivesTo analyze the development of acupuncture registered trials based on WHO international clinical trial registration platform (ICTRP) in the past 5 years.MethodsWHO ICTRP database was electronically searched to collect acupuncture-related clinical trials registered from January 1st, 2014 to December 31st, 2018. Two reviewers independently screened items, extracted data, and descriptive analysis was performed for the included trials.ResultsThe results showed that there were 1 556 registered clinical trials on acupuncture, and the most registered year was 2017. China was in the main country in applying for acupuncture-related clinical trials, however, the most registered unit was Kyung Hee University in Korea. The trials were mainly interventional research, mostly used randomized, blinded methods, and design modes were mainly based on parallel trials. In clinical trial phase, the majority were in the clinical trial period of treatment of new technologies. The field of clinical research was expected to be on pain in the future.ConclusionsAlthough acupuncture research is currently in a good stage of development, it should still value on the quality and innovative training of relevant trials, strengthen Chinese ties with other countries, focus on regional, domestic and international cooperation, expand research types, and enhance acupuncture applicability.
ObjectiveTo investigate the current situation of domestic registry studies, and to provide basis for future research.MethodsWorld Health Organization (WHO) registration platform, ClinicalTrials.gov registration platform and other registration platforms were searched to collect the registered registration studies in Mainland China from inception to July 31st, 2018. Two researchers collected and collated data, analyzed by descriptive statistical methods, and then python-igraph package in Python 3.5 was used to draw the network diagram.ResultsA total of 247 studies were retrieved, mainly for disease registry and pharmaceutical product registry. Cohort and case-series were the principally study design. The research focused on chronic diseases such as cardiovascular and cerebrovascular diseases, and research sites were based on the economically developed area, for example, Beijing, Shanghai and Guangdong. The network diagram of study design and disease system shows that cohort research design is widely used in the nervous system and circulatory system; the network diagram of the research sites and disease system found that Beijing mainly studied circulatory and nervous system diseases, Shanghai mainly studied circulatory system diseases, and Guangdong relatively studied more on nervous system and urinary system diseases.ConclusionThe increasing number of registry studies in China reflects the importance of long-term outcome assessment of diseases.
Platform daytime chemotherapy means that the hospital sets up a fixed area for daytime chemotherapy, and all patients with daytime chemotherapy are treated in the same area. The platform daytime chemotherapy center has the advantages of further optimizing the limited hospital resources, reducing the consumption of medical resources, and improving the efficiency of bed use and patient satisfaction. Its construction is the further sublimation of tumor treatment concept, harmonious relationship between doctors and patients, and humanistic care. This article shares the construction experience of the platform daytime chemotherapy center from the definition, orientation, operation mechanism, ward configuration, drug access, patient access and management mode, and puts forward suggestions that the promotion of the platform daytime chemotherapy center should be carried out from the aspects of policy support, hospital vigorously promoting and self-management breakthrough.