Spanning two decades since the 1st generation spinal robotics inception, the robot-assisted spine surgery (RSS) technology has evolved through generations, culminating in the 4th generation characterized by real-time visual navigation and wire-free screw placement. The fundamental principles of RSS technology include surgical planning, tracking, image registration, and robotic arm control technologies. Currently, RSS technology is maturely employed in thoracolumbar procedures and is progressively being applied in cervical surgeries, spinal tumor resections, and percutaneous operations, offering advantages in reducing tissue trauma and exposure to radiation, thereby improving patient outcomes. Emerging research also focuses on the cost-effectiveness of clinical applications and robot-specific complications. With the integration of artificial intelligence into surgical planning, RSS technology is poised to further incorporate emerging technologies and expand its application across a broader clinical spectrum.
In 2021, China launched a national pilot project of diagnosis-intervention packet (DIP) in 71 cities, which is an important measure of medical insurance payment system reform. DIP was originated in Guangdong. This paper summarizes the reform experience and effectiveness of Guangzhou and Shenzhen, discusses how to promote the reform of DIP in the national pilot cities from the medical insurance agencies aspect and the hospitals aspect, so as to provide a reference for the national pilot cities.
目的 了解5.12汶川大地震24個月后震區小學生的心理健康狀況，為進行震后長期心理危機干預提供依據。 方法 于2010年5月即汶川大地震發生后24個月，分別使用創傷應激量表兒童版（CRIES-13）、兒童抑郁障礙自評量表（DSRSC）、長處與困難問卷（SDQ）學生版，調查了553名來自于彭州災區的小學生的心理健康狀況及其影響因素。 結果 ① 災區小學生CRIES-13總分為（22.98 ± 12.29）分，其中大于劃界分（30分）者為143人，占總人數的25.9%；女性總分高于男性（Z=?2.031，P=0.042）；震后被轉移至安全地點的時間越長（OR=1.025，P=0.012）、家人傷亡越嚴重（OR=1.141，P=0.021），其CRIES-13總分大于劃界分的可能性越高。② 災區小學生DSRSC總分為（11.07 ± 5.78）分，其中總分大于劃界分（15分）者為120人，占總人數的21.7%；女性總分高于男性（Z=?2.508，P=0.012）；災區小學生的年齡（r=0.098，P=0.021）、震后被轉移至安全地點的時間（r=0.117，P=0.004）與DSRSC總分呈正相關。③ 災區小學生SDQ總困難因子得分為（14.97 ± 5.44）分，62.9%的人報告自身存在主觀困難；女性的情緒因子、親社會因子得分高于男性（Z=?3.123，P=0.002；Z=?2.243，P=0.025）；年齡越大，品行因子（χ2=7.604，P=0.023）、親社會因子（χ2=8.102；P=0.017）得分增加。 結論 震后災區小學生的心理健康狀況受到性別、年齡、震后被轉移至安全地點的時間、家人傷亡程度的影響，震后長期心理危機干預應綜合考慮這些相關因素以確定高危人群。
目的：探討新生兒先天性腸閉鎖患兒在圍手術期間的護理措施。方法：分析26例新生兒先天性腸閉鎖患兒術前、術后護理措施。結果：本組患兒除1例術后放棄治療，5例術后因新生兒肺炎轉入新生兒科繼續治療外，其余20例均痊愈，平均住院日為10天。結論：對本組患兒通過術前積極保暖，有效的胃腸減壓，靜脈補液，糾正水、電解質紊亂；術后采取加強氣道濕化，胸部物理療法等措施進行呼吸道管理，嚴格執行消毒隔離制度，預防感染，合理腸內聯合腸外營養支持等護理措施，減少并發癥的發生，提高了患兒的生存質量。
目的：探討物理治療在新生兒經會陰肛門形成術中的治療效果，提高護理質量。方法：將103例新生兒肛門直腸畸形患兒，隨機分為實驗組和對照組，對照組實施常規護理治療。實驗組在常規護理治療基礎上，實施物理治療。結果：物理治療實驗組患兒肛周的局部紅腫情況明顯低于對照組（P＜0.05），實驗組患兒的平均住院日較對照組明顯縮短（P＜0.05）。結論：物理治療能降低新生兒經會陰肛門成形術術后并發癥的發生率，縮短住院天數，降低醫療費用，提高護理質量。
Objective To investigate the characteristics of cognitive function and its correlation to neuroendocrine status in patients with refractory depression. Methods A total of 41 patients diagnosed by ICD-10 as depression onset who have been treated with more than two antidepressants drugs, fulfilled the criteria of refractory depression. Another 40 patients diagnosed by ICD-10 as depression onset but who have not been treated, or have been treated with only one antidepressant drug were selected as controls. Patients in both groups were evaluated by WAIS-RC, STROOP, VF, TRAILS A, B, TOH and M-WCST, and the concentrations of CORT, ACTH, T3, FT3, T4, FT4, TSH were also determined. Results A significant difference was found in VF between the refractory depression group and the control group. This showed that the damage to short-term memory, attention and interference rejection capability was much more serious in the refractory depression group. The ACTH concentration in the refractory depression group was significantly different from that of the control group, which indicated that the damage to the Hypothalamic-pituitary-adrenal axis was more serious in the refractory depression group. In particular in relation to memory and attention defect. Conclusion Changes in the levels of CORT, ACTH, TSH, FT3 and T4 may be correlated to cognitive function damage in patients with refractory depression.
Objective To analyze the risk factors of prethrombotic state of obstructive sleep apnea and hyponea syndrome (OSAHS), providing basis and reference for the prevention of prethrombotic state of OSAHS. Methods Two hundred and thirty-eight patients excluding the presence of possible effects of coagulation factors from June 2014 to July 2016 were diagnosed as OSAHS by polysomnography (PSG) and underwent coagulation, thrombosis, fibrinolysis, and inflammatory factors testing. Fifty-six patients met the standard of prethrombotic state (prethrombotic state group) and 59 patients randomly selected from the remaining 182 patients did not meet the standard (non-prethrombotic state group). The age, sex, body mass index (BMI), sleep apnea and hypopnea index (AHI), interleukin-6 (IL-6), complicating chronic obstructive pulmonary disease (COPD) and hypertension were compared between two groups. Results Non conditional Logistic regression analysis showed that the risk factors of prethrombotic state of OSAHS were age (OR=1.202, 95%CI: 1.107 to 1.305), IL-6 (OR=1.127, 95%CI: 1.014 to 1.252), AHI (OR=1.151, 95%CI: 1.055 to 1.256), and complicating COPD (OR=4.749, 95%CI: 1.046 to 21.555). Conclusion Age, AHI, IL-6, and complicating COPD may be the risk factors of prethrombotic state of OSAHS, among which complicating COPD may be the most important risk factor.
This article is based on the work practice of Deyang People’s Hospital in carrying out financial digital transformation under the background of artificial intelligence technology. It clarifies the concepts of financial digitization and artificial intelligence technology, summarizes the practical path of hospital financial digital transformation, and analyzes the specific applications and implementation effects of intelligent filling of expense reimbursement forms, intelligent review of documents, and intelligent management of medical insurance funds. These experiences have positive significance for optimizing financial business processes, improving data quality and utilization efficiency, and enhancing employee satisfaction. They can provide a reference for the digital transformation of financial management in public hospitals and the reconstruction of the value positioning of hospital financial management.
Objective To analyze morbility，risk factors，etiology，treatment and outcome of nosocomial pulmonary fungal infections in respiratory intensive care unit（RICU）.Methods Forty-seven respiratory RICU patients with nosocomial pulmonary fungal infections between July 2000 and June 2005 were retrospectively analyzed.Results All of the 47 cases were clinically diagnosed as probable nosocomial pulmonary fungal infections，with the morbidity of 10.8% significantly higher than general wards（1.8%，Plt;0.005）.COPD and bacterial pneumonia were the major underlying diseases of respiratory system with a percent of 38.30% and 36.17%，respectively.Forty-one patients (87.2%) had risk factors for fungal infections.Compared with general wards，the proportion of Aspergillosis was higher in RICU without significant difference (Pgt;0.1)；the proportions of Candida glabrata and Candida tropicalis were higher too，but that of Candida krusei was relatively low.The effective rate of antifungal treatment was 79.1% and fluconazol was the most common used antifungal agents.The mortality of fungal infection in RICU was higher than that of general wards but without significant difference（Pgt;0.1）.Conclusion The morbidity of nosocomial pulmonary fungal infection in respiratory RICU is higher than that in general wards.The proportions of infection caused by Aspergilli and some Candida resistant to fluconazol is relatively high.Early and effective treatment is needed in these patients considering the poor prognosis.
Coronary angiography (CAG) as a typical imaging modality for the diagnosis of coronary diseases hasbeen widely employed in clinical practices. For CAG-based computer-aided diagnosis systems, accurate vessel segmentation plays a fundamental role. However, patients with bradycardia usually have a pacemaker which frequently interferes the vessel segmentation. In this case, the segmentation of vessels will be hard. To mitigate interferences of pacemakers and then extract main vessels more effectively in CAG images, we propose an approach. At first, a pseudo CAG (pCAG) image is generated through a part of a CAG sequence, in which the pacemaker exists. Then, a local feature descriptor is employed to register the relative location of pacemaker between the pCAG image and the target CAG image. Finally, combining the registration result and segmentation results of main vessels and pacemaker, interferences of pacemaker are removed and the segmentation of main vessels is improved. The proposed method is evaluated based on 11 CAG images with pacemakers acquired in clinical practices. An optimization ratio of the Dice coefficient is 12.04%, which demonstrates that our method can remove overlapping pacemakers and achieve the improvement of main vessel segmentation in CAG images.Our method can further become a helpful component in a CAG-based computer-aided diagnosis system, improving its diagnosis accuracy and efficiency.