ObjectiveTo summarize the evolving concept in treatment of intertrochanteric fractures and the development of internal fixation devices. MethodsRelated literature concerning the implant devices to treat intertrochanteric fractures was reviewed and analyzed in terms of the biomechanical characteristics, clinical application, and complications. ResultsThe treatment of intertrochanteric fractures has undergone an evolving concept from conservative treatment to surgical treatment. Surgery strategies include extramedullary fixation and intramedullary fixation. Intramedullary fixation has gradually become the main treatment of intertrochanteric fractures due to its minimally invasive and biomechanical advantages. However, the current intramedullary fixation system still can not reconstruct the medial cortical support of the proximal femur, which leads to some failures in the treatment of unstable fractures. ConclusionThe development of internal fixation of intertrochanteric fractures is based on the deep understanding and biomechanical theory of intertrochanteric fractures in clinical practice. In the future, the updated design of internal fixation devices will depend on the treatment principle of reconstruction of medial support and secondary stabilization of intertrochanteric fractures, and finally the purpose of improving success rate and reducing postoperative complications of intertrochanteric fracture will achieved.
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.
Objective To review the characteristics and deficiencies of various liposuction methods to provide reference for choosing more suitable liposuction in clinic and ideas for the improvement and development of liposuction equipment. Methods The literature related to liposuction in recent years was consulted, and the principle, indications as well as existing problems were reviewed. Results Liposuction can be divided into two categories according to the principles of fat separation. The first type relies on physical cutting to separate fat, including suction-assisted liposuction (SAL), power-assisted liposuction (PAL), and water-assisted liposuction (WAL). SAL and PAL are simple to operate and low in price, but the effect of liposuction mainly depends on the experience of the surgeon, and complications such as uneven appearance, hematoma, and ecchymosis may occur. WAL saves time and effort, but has lower cost performance. The second type relies on energy destruction to separate fat, including ultrasound-assisted liposuction, laser-assisted liposuction, and radiofrequency-assisted liposuction. This type of surgery has the advantages of less trauma, fast postoperative recovery, and skin tightening. However, the equipment is more expensive, and has a risk of skin burns. Conclusion Liposuction can effectively reduce local fat accumulation, but it still has limitations. Equipment improvement and fat transplantation are important directions for liposuction’s future development.
Acute pancreatitis is a common surgical acute abdomen in clinical practice. With the development of minimally invasive technology, more and more treatment methods are being applied to acute pancreatitis, especially for severe acute pancreatitis and acute biliary pancreatitis. At present, the efficacy of integrated traditional Chinese and Western medicine in the treatment of acute pancreatitis has been widely recognized. In terms of minimally invasive diagnosis and treatment of acute pancreatitis, the “SELECT” concept of integrated traditional Chinese and Western medicine minimally invasive diagnosis and treatment has emerged. Based on the severity and etiology of acute pancreatitis, the optimal combination of multiple endoscope (Spyglass, encoscopic retrograde cholangiopancreatography, laparoscopy, endoscopic ultrasound, choledochoscopy) is selected, and combined with traditional Chinese medicine treatment. With a patient-centered approach, we have achieved minimally invasive, individualized, and precise treatment of acute pancreatitis through the integration of traditional Chinese and Western medicine.
The article summarized the national and international history and current situation of healthcare-associated infection control, and analyzed the tendency of new technique and progress in healthcare-associated infection control according to the experience in research and practice.
Outcome-based education (OBE) emphasizes student learning outcomes as the core, utilizing a backward design approach to construct the curriculum. In teaching practice based on OBE, teachers need to develop a blueprint in advance that is closely aligned with the content of the teaching, aiming to promote deep learning and ensure that students can fully demonstrate their learning outcomes. Electroencephalogram (EEG) is a widely used technology in the field of neuroscience, and the special EEG changes convey a variety of information, which is crucial to the study of diseases. However, due to its specialization and learning difficulty, EEG teaching has been facing many challenges. Under the guidance of OBE concept, traditional knowledge lecture and problem-based learning (PBL) are organically integrated, combined with case analysis and flipped classroom teaching mode, which are applied in EEG teaching practice, in order to obtain more ideal teaching effect.
Evidence-based medicine (EBM) provides a reliable evidence decision-making model for the medical field. The concepts and methods of EBM are gradually extended to other disciplines. At present, the paradigm of evidence-based science (EBS) is formally proposed, which is not only based on a methodological cooperation between different disciplines, but also a deeper potential driving force in optimizing the operation process of knowledge. The advantages of EBS helps promote its extension to other disciplines through standardization concepts and systematic methods, through which the common theories and supporting organization of EBS are formed. Under the guideline of EBS, the evidence-based concepts and methods will play a supportive role in scientific development.
ObjectiveTo explore the effect of humanistic ideas applied for high quality nursing service in grass-root hospitals. MethodsIn the process of high quality nursing service between January 2011 and December 2013, humanistic philosophy was adopted. We provided humanistic nursing care for the patients, and humanistic management and care for doctors and nurses. Then, we used self-made questionnaire to do survey on the satisfaction degree in 1 200 patients, 500 nurses and 100 doctors in a third-grade class-A hospital. ResultsThrough the application of humanistic management idea, the satisfaction degree of all patients, nurses and doctors was significantly raised. ConclusionHumanistic concept applied in high quality nursing service inspires the enthusiasm and activity of nurses, promotes their nursing mode, and raise the nursing quality, which satisfies all the patients nurses and doctors.
Hepatocellular carcinoma (HCC) is a malignancy with high incidence and poor prognosis. Most patients with HCC are diagnosed at an intermediate-advanced stage, losing the opportunity for surgical resection. Although transcatheter arterial chemoembolization (TACE) is recommended for intermediate-advanced stage HCC, supported by evidence from multiple randomized controlled trials, its efficacy is often limited by high-risk factors such as large tumor burden, vascular tumor thrombosis, arteriovenous shunting, or infiltrative growth pattern. In recent years, accumulating evidence has established hepatic arterial infusion chemotherapy (HAIC) as an effective treatment for intermediate-advanced stage HCC, especially in patients with these high-risk features, as it can significantly enhance local tumor control and prolong survival. Recent studies and clinical practice have demonstrated that TACE and HAIC, as two effective intra-arterial therapies, possess distinct mechanisms of action. Their rational combination allows for technical complementarity, yielding a synergistic anti-tumor effect and further improving outcomes in high-risk patients with intermediate-advanced stage HCC. In this context, based on relevant literature and clinical experience, this article discusses the theoretical rationale, technical essentials, appropriate patient selection, and clinical evidence for combining TACE with HAIC in the treatment of HCC, aiming to provide references for its standardized application and wider clinical adoption.