Objective To explore the clinical value, latest research progress, and clinical controversy of total neoadjuvant therapy (TNT) in locally advanced rectal cancer (LARC). Method We searched and reviewed on the latest literatures about studies of the clinical research of TNT in LARC. Results TNT could make the tumor downstage rapidly and improve the patients’ treatment compliance. In terms of organ preservation rate, 3-year disease-free survival and pathological complete remission rate, TNT had advantages and was a especial potential treatment strategy compared with traditional methods. Conclusions TNT decreases local recurrence rate and improves the long-term survival. For LARC patients with strong desire for organ preservation, TNT is a good treatment choice and has the value of clinical promotion.
Objective To integrate augmented reality (AR) into the whole process of health management and observe its application effect in hip replacement patients. Methods Patients undergoing hip replacement in the Department of Orthopedic Surgery of West China Hospital, Sichuan University between April and September 2022 were selected. According to the random number table method, patients were divided into a trial group and a control group. The trial group adopted the whole process AR health management mode, and the control group adopted the conventional health education mode. The joint function score, functional exercise compliance, coping difficulties after discharge, Huaxi Emotional-distress Index and satisfaction of the two groups at different time points were compared. Results A total of 80 patients were included, with 40 patients in each group. At each follow-up time point after surgery, the scores of Harris Hip Score and Post-Discharge Coping Difficulty Scale among trial group patients were better than those of the control group patients (P<0.05). There was no statistically significant difference in the Huaxi Emotional-distress Index scores between the two groups (P>0.05). The compliance rate of functional exercise in the trial group (P=0.025) and the patient satisfaction were higher than those in the control group (Z=−4.918, P<0.05). Conclusions The AR-based whole process health management can make it easier for patients to grasp functional exercise (preoperative pre-exercise, postoperative rehabilitation), post-hospital health guidance and other educational knowledge. This new health management is conducive to enhancing patients’ exercise compliance, strengthening joint function recovery, daily living ability and patient satisfaction.It can be promoted and applied in clinical practice.
ObjectiveTo summarize the experience of the whole process management of hepatocellular carcinoma (HCC) patients with high-risk of recurrence and metastasis based on the multidisciplinary team (MDT) mode, and to improve the clinicians’ understanding of the concept of whole process management, so as to improve the survival rate of patients with HCC. MethodThe clinicopathologic data of a HCC patient with high-risk of recurrence and metastasis admitted to the Division of Liver Surgery, Department of General Surgery, West China Hospital of Sichuan University were retrospectively analyzed. ResultsA 52-year-old male patient was diagnosed with HCC with intrahepatic metastasis (China liver cancer staging Ⅱ b, Barcelona Clinic Liver Cancer stage B) after admission due to “epigastric discomfort for 1+-month and liver occupying for 1+-week”. Through discussion by the MDT mode, the allogeneic liver transplantation was performed after successful downstaging following two conversion therapies. No serious complications occurred after operation, and the patient was discharged on the 23rd day after operation. Up to now, pulmonary bacterial and fungal infections and pulmonary metastases had been found during the postoperative follow-up. After anti-infective therapy and targeted therapy combined with radiotherapy, the patient was significantly relieved, had survived for 34 months after operation, and was still under regular follow-up. ConclusionsFor HCC patients with high-risk of recurrence and metastasis, MDT mode has a good clinical benefit for the whole process management of patient. Through the MDT model, the diagnosis, treatment, and follow-up of HCC are organically integrated, and the patient’ s diagnosis and treatment plans are dynamically adjusted to realize the whole process management of HCC patient, and to raise the survival rate and improve quality of life of HCC patient.
摘要:目的:探讨临床教学的全程制度化管理及其效果。方法:通过健全组织,完善制度,加强教学、临床及实习生管理、建立激励机制等措施,进行全程制度化的规范管理。结果:教学质量显著提高,不良事件鲜见,无恶性事件发生。近来医院已有6篇教学论文公开发表,4个先进集体和8名先进个人受到医院表彰,5名优秀带教教师和8名实习生受到各学院奖励。结论:临床教学全程制度化管理是提高教学质量的切实有效途径。Abstract: Objective: To investigate system management during the entire clinical teaching process and its effect. Methods: To robust organization, perfect rules, strengthen management of clinical teaching and intern student, and establish encouragement mechanism,and other measures, so as to conduct standard system management during the entire process. Results: Quality of teaching improved notably, bad event was scarce, no malignant event occurred. There were six teaching articles issued publicly, four advanced collectives and eight advanced individuals had been praised by hospital, and five excellent teachers,eight intern students had been rewarded by each college. Conclusion: System management during the entire clinical teaching process is an effective way to improve teaching quality.
目的 研究自体动静脉内瘘全程规范化护理的可实施性及优势。 方法 制定自体动静脉内瘘全程规范化护理工作流程及标准，将2011年6月－8月经自体动静脉内瘘行维持性血液透析患者随机分为观察组（125例）和对照组（115例），分别予以全程规范化护理和普通护理，对比分析两组之间内瘘不良事件发生率、患者满意度、护士认同度等指标的差异。 结果 两组内瘘不良事件发生率分别为8.0%和21.0%，患者满意度分别为98.4%和84.3%，差异均有统计学意义（P＜0.05）；两组护士对本组护理模式认同度均为90.0%，差异无统计学意义（P＞0.05）。 结论 自体动静脉内瘘全程规范化护理模式能有效降低内瘘不良事件发生率并显著提高患者满意度，值得临床推广。
Rare diseases are characterized by low incidence rates, complex etiologies, and multi-system involvement. In China, the patient population exceeds 20 million, who face challenges such as difficulty accessing medical care, obtaining accurate diagnoses, and managing their conditions. To address these challenges, West China Hospital of Sichuan University has developed a comprehensive “pre-diagnosis, diagnosis, and post-diagnosis” management model for rare diseases, with a focus on “internet plus digital intelligence empowerment”. This approach enhances accessibility in the pre-diagnosis phase, improves diagnostic efficiency during diagnosis, and achieves full-cycle management post-diagnosis, establishing a continuous care system that ensures “medical support beyond the hospital”. This article introduces the innovative exploration and practical experience of West China Hospital of Sichuan University in the holistic management of rare diseases, and provide a reference for its subsequent promotion.
The administration of radioactive iodine-131 (131I) is one of the representative traditional targeted therapy for post-surgical differentiated thyroid carcinoma (DTC). As DTC tumor cells largely preserve the capability of thyroid follicular epithelial cells, including the expression of the sodium iodide symporter (NIS), 131I can be selectively internalized by these cells once introduced into the body. The simultaneous emitting of both γ-ray and β-ray from 131I featured its unique theranostic value in managing DTC, through γ-ray to detect the residual thyroid tissue and DTC lesions via nuclear medical imaging, while through β-ray to yield the precise tumoricidal effect as well as remnant thyroid ablation. This theranostic potential of 131I significantly enhances progression-free survival, disease-specific survival, and overall survival in DTC patients with residual/recurrent/metastatic lesions as long as they are capable of iodine uptake. Nevertheless, the clinical application of 131I, despite its “precise” treatment philosophy, remains far from precision medicine while clinical practice, which urges further refinement in pre-treatment assessment, dosage tailoring, and post-treatment efficacy evaluation to fully capitalize on its theranostic benefits. Recently, with the accumulation of evidence-based medical data, 131I treatment has evolved with respect to treatment principles, pre-treatment risk stratification, post-treatment dynamic assessment, and comprehensive patient management, with an aim to optimize the diagnostic and therapeutic precision of 131I. Here we briefly review and update the recent advance on 131I management on DTC.
This review thoroughly investigates the application and advancements of artificial intelligence (AI) technology in the comprehensive management of lung cancer. AI is utilized at various stages of lung cancer diagnosis and treatment through techniques such as computer vision, deep learning, and natural language processing. In the early diagnosis stage, AI assists in identifying high-risk populations and, in conjunction with pathological techniques, accomplishes functions like histological classification of lung cancer tissues, prediction of molecular markers, and quantitative analysis of immunohistochemistry. During the treatment stage, AI integrates multimodal data to aid in formulating individualized treatment plans and enhances efficiency via clinical decision support systems (CDSS). In the follow-up stage, continuous patient monitoring and optimization of follow-up strategies are realized through imaging, remote monitoring, and intelligent follow-up systems. The prospects for AI medical technology are promising. However, it still confronts challenges such as weak generalizability, poor interpretability of AI decisions, and ethical and legal issues.
ObjectiveTo explore the effect of full nutritional management pattern on perioperative nutritional status in patients with head and neck malignancies. MethodsSixty-four patients with head and neck cancer treated in our department between March 2012 and June 2013 were randomly divided into control group and study group with 32 in each. The control group received conventional dietary guidance, while patients in the study group were given full nutritional management. Nutritional Risk Screening Scale 2002 (NRS-2002) was used for nutrition screening and assessment before surgery (after admission) and after surgery (3 days after surgery). The study group received full nutritional support, along with nutrition-related physical examination and biochemical tests, and observation of postoperative complications, and hospital stay and costs were also observed. ResultsNutritional risk existed in 29.7%-48.4% of the head and neck cancer patients during various stages of the perioperative period. Through the full nutritional support, patients in the study group had a significantly lower risk than those in the control group (P<0.01). Body mass index, triceps skinfold thickness, mid-arm muscle circumference, prealbumin, and creatinine in the study group were significantly more improved compared with the control group (P<0.01). No significant difference was detected in blood urea and serum albumin between the two groups. Postoperative complications in the study group was significantly lower (P<0.05), and hospital stay and costs were significantly lower than the control group (P<0.001). ConclusionFull nutritional management pattern can significantly improve the perioperative nutritional status in head and neck cancer patients. Early detection of nutritional risk and malnutrition (foot) in the patients and carrying out normal and scientific nutrition intervention are helpful in the rehabilitation of these patients. We suggest that qualified hospitals should carry out the full nutritional management model managed by a Nutrition Support Team for patients with malignancies.