Artificial intelligence in robot system is mainly divided into two types: endoscopic robot system and intracavitary robot navigation system. The endoscopic robot system can effectively shorten the time of vascular anastomosis and occlusion during vascular bypass surgery, while the intracavitary robot navigation system has good localization and real-time observation function. Moreover, it has significant advantages in complex lesions and special anatomical locations. High cost and complicated equipment debugging are the main factors that limit the wide application of robot systems. Artificial intelligence represented by robot system has obvious advantages and broad prospects in the field of vascular surgery, but more research is needed to improve its shortcomings and to further clarify its standard operation and long-term results.
目的:評估經后腹腔鏡與開放腎囊腫去頂減壓術的臨床價值。方法:回顧性調查四川大學華西醫院2004年4月至2008年4月468例經后腹腔鏡腎囊腫去頂減壓術(A組)和2003年4月至2008年4月121例開放腎囊腫去頂減壓術(B組)的臨床資料并進行比較,統計分析兩種術式術前,術中和術后的數據資料,比如性別、年齡、側別、囊腫直徑、手術時間、術中出血量、術后下床時間、肛門排氣時間、引流管拔除時間、術后住院天數、總住院天數等。開放手術均行肋緣下切口,經后腹腔鏡均行腰部常規3孔穿刺。結果:所有手術均獲成功。A組手術時間5318±095分,術中出血628±033mL,術后肛門排氣時間2518±030h,術后下床時間3102±022h,引流管拔除時間2715±020h,術后住院490±007d,總住院895±012d;B組手術時間6772±148分,術中出血5116±077mL,術后肛門排氣時間2691±033h,術后下床時間4331±103h,引流管拔除時間2963±079h,術后住院788±018d,總住院125±029d。術前兩組基線對比無統計差異。A組手術時間、術中出血量、術后下床時間、總住院天數和術后住院天數均優于B組,差異具有統計學意義(Plt;001)。術后肛門排氣時間及引流管拔除時間無顯著性差異(Pgt;005)。結論〓:后腹腔鏡腎囊腫去頂術在手術時間、術中出血量和術后下床時間等方面明顯優于開放手術。
Objective To analyze the feasibility, possible problems and application of bilingual teaching rounds in vascular surgery teaching. Methods Ninety participants included internship, interns and residents of standardized training from 2015 to 2016 in vascular department of West China Hospital of Sichuan University were included. The questionnaire named the feasibility of bilingual rounds in surgery teaching was done and analyzed in all of these students. The results of the evaluation score from different teachers on their teaching process were also analyzed. Results Three groups could accept bilingual teaching rounds of this teaching form, and all of them were willing to be involved in, but their English levels and acceptance participate times were different. The CET4 levels of three groups did not have any difference; however, the CET6 levels had significant difference. There were significant differences in the preparation times and the review times (all P values <0.05), and there were no difference in acceptance, value and promote degree (all P values >0.1). In different teaching teachers' self assessment on the same objective, there was significant differences (all P values <0.05). Conclusion Bilingual rounds in surgery teaching have certain feasibility. Different adjustments are needed according to the English level and the grade, and higher request of the teacher is necessary.
Venous thromboembolism (VTE), comprising both deep vein thrombosis and pulmonary embolism, is a chronic illness that contributes significantly to the global burden of disease. The American College of Chest Physicians (ACCP) published the 9th edition of antithrombotic treatment guidelines for VTE (AT9) in 2012, which was first updated in 2016. In October 2021, ACCP published the 2nd update to AT9, which addressed 17 clinical questions related to VTE and presented 29 guidance statements in total. In this paper we interpreted the recommendations proposed in this update of the guidelines.
The European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines showed us venous thrombosis management in January 2022. In terms of iliac vein diseases, it retained some guiding views, upgraded some guiding views, and added some new views compared with the version 2015. It has good guidance and reference significance for medical staff and patients. The part of the guidelines about iliac vein disease is worth our interpretation.
The cultivation of clinical medical postgraduates is a way to provide qualified doctors for clinical practice, which is more focused on clinical practice. The cultivation of clinical medical postgraduates depends on their understanding of knowledge. In response to the problems existing in traditional education, the Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University has introduced new media into the cultivation of clinical medical postgraduates. New media can concretize abstract content, which is more conducive to improve learning efficiency. This article combines practical experience to explain the advantages, teaching effectiveness, challenges faced of new media, and how to better apply new media teaching.
ObjectiveTo investigate the job satisfaction, emotional state and related factors of medical staff participating in online consultation of West China Internet Hospital during the COVID-19 epidemic.MethodsThrough literature review and expert consultation (Delphi method), the questionnaire was developed, and the online consulting medical staff of West China Hospital of Sichuan University were invited to conduct the questionnaire survey from 26 January to 19 June 2020, and finally the statistical analysis was summarized.ResultsA total of 132 valid questionnaires were retrieved. Of the 132 subjects, 127 people (96.2%) expressed satisfaction or special satisfaction with the online consulting office format; 103 respondents (78.0%) said that online consulting did not affect or completely did not affect the work and life; 81 people (61.4%) consulted online more than 5 days a week, and 108 people (81.8%) worked within 2 hours a day; the vast majority (97.7%) of the research subjects were satisfied with the content of the training materials and the related support work of the coordination group. Only 29 (22.0%) of the study participants believed that the epidemic caused negative emotions, mainly due to the severity of the epidemic.ConclusionThe online consulting medical staff are satisfied with the office form, training materials and coordination work group of the COVID-19 epidemic, and think that it does not affect their work and life. 22.0% of medical staff have negative emotions, and the severity of the epidemic is the main reason.
ObjectiveTo assess whether the geriatric nutritional risk index (GNRI) of elderly patients can be used as an evaluation index for complications after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA).MethodsA total of 265 patients with EVAR who received abdominal aortic aneurysm between January 2011 to December 2017 were included in this study from West China Hospital of Sichuan University. All patients included in this study were subrenal arterial AAA. Statistical analysis of clinical data was performed. The value of GNRI in evaluating postoperative complications of EVER patients was evaluated.ResultsOf the 372 patients, 158 were included in the GNRI abnormal group (GNRI≤98), and 214 were included in the normal group (GNRI>98). Univariate analysis showed that the age (P=0.04), drinking (P=0.04), serum albumin level (P<0.001), BMI (P<0.001), GNRI (P=0.004), and stroke (P<0.05) were risk factors that affects postoperative complications of AAA. Multivariate analysis showed that preoperative GNRI [HR=0.687, 95%CI: (0.487, 0.968), P=0.032] abnormality was one of the risk factors affecting postoperative complications of AAA.ConclusionFor patients undergoing endovascular aneurysm repair of abdominal aortic aneurysm, the GNRI is one of the important indicator for predicting postoperative complications.
Objective To compare scar and incision satisfaction between Prolene polypropylene suture and conventional silk suture for dermal suture in high ligation and stripping of primary great saphenous varicose vein. Methods A total of 83 patients who met the inclusion criteria were admitted in the West China Hospital, including 27 males and 56 females. The average age was 46.7 years old, ranging from 30 to 63 years old. Forty-two patients were grade C2 and 41 were grade C3 according to the CEAP grading. Patients were divided into a polypropylene suture group (even number,n=45) and a silk suture group (odd number,n=38) according to admission date order. Prolene 5-0 polypropylene suture was used for dermal suture in the patients of the polypropylene suture group and 1# silk suture in the patients of the silk suture group. The pigments of incision area and suture area and their widths, and the points of Patient and Observer Scar Assessment Scale score (POSAS) and patient and observer satisfaction score of incision were observed on month 6 for following-up. Results ① The gender, age, body mass index, and proportion of C2 of the CEAP grading or smoking had no significant difference between these two groups (P>0.05). ② All the operations were successful and all the patients were followed up. All the incisions healed well and had no infection. There was a few subcutaneous hematoma in one incisionof the 2 patients on day 3 after operation in the two groups, which markedly improved after dressing treatment. The sutures of all the patients were removed on day 14 after operation. ③ The pigment of incision area and its width, and the points of POSAS had no significant differences between the two groups (P>0.05). The pigment of suture area and its width, and the points of patient and observer satisfaction score of the incision in the polypropylene suture group were significantly better than those in the silk suture group (P<0.05). Conclusion Prolene polypropylene suture is preference to conventional silk suture in aesthetic results and patient satisfaction for dermal suture of great saphenous varicose vein surgery.
In addition to the typical respiratory symptoms, COVID-19 patients present with clinical manifestations of cardiovascular system damage, and they are at higher risk of intensive care or mortality. The mechanism of COVID-19's impact on the cardiovascular system is still unclear, therefore we need to pay close attention to it. Based on the existing research, this paper focused on the concurrent characteristics of the cardiovascular system diseases, summarized the possible mechanisms of cardiovascular system damage, including the coronavirus invaders directly into cardiomyocytes and its conduction system, with complications or accompanying conditions such as cytokine storm, imbalance of oxygen supply and demand, drug influence, stress and other damage to cardiovascular system. Meanwhile, current clinical manifestations and treatment methods of COVID-19 were summarized.