Emergency treatment of ocular trauma is a systematic and complicated work. Rapid and correct diagnosis and treatment are needed to maximize the recovery of ocular structure and function. In recent years, China has made remarkable progress in the emergency treatment of ocular trauma, including the development of Expert consensus on the norms of emergency treatment of ocular trauma in China (2019), the establishment of a national ocular trauma database, and the development of VisionGo Artificial Intelligence prediction system for ocular trauma. These measures improve the treatment level of ocular trauma and provide support for the prediction of postoperative visual acuity in severe traumatic eyes. However, with the development of economy and society, the characteristics of ocular trauma in our country have changed. For example, the majority of hospitalized patients were open ocular injuries, farmers and workers were the main occupational groups, and the proportion of eye injuries caused by traffic injuries increased year by year, and the proportion of women and minors increased. Although the annual loss of life of ocular trauma disability in China has decreased faster than the world average, the emergency treatment of ocular trauma still faces many challenges, such as regional differences, insufficient primary medical resources, lack of standardized training, and insufficient promotion of emergency treatment standards. In order to cope with these challenges, it is necessary to further strengthen the popularization of science and technology for the prevention and treatment of ocular trauma, standardize the emergency treatment process, strengthen the training of grass-roots medical personnel, strengthen the safety of emergency surgery, and pay special attention to the particularity of children's ocular trauma. In addition, relevant research has been actively carried out to establish a complete database of emergency patients with ocular trauma to promote the accurate prevention and treatment of ocular trauma.
Objective Tissue engineering advance in supplying the reparative and reconstructive medicine with promising tissue engineered medical products(TEMPs) and the new therapy alternative. The related supervision and administration of TEMPs is being developed and the standard research of TEMPs is also in progress. The Food and Drug Administration(FDA) of the United States has treated TEMPs as combined products and supervised them according to the level of risk to patients. Lately, FDA has determined that the Center for Devices and Radiological Health (CDRH) should take charge of examination and approval of TEMPs, with the cooperation of the Center for Biological Evaluations and Research(CBER). The regulatory controls have been established respectively in European Union and Japan. In China, TEMPs are identified as medical devices combined with cells. The Department of Medical Device of the State Food and Drug Administration (SFDA) is responsible for the examination and approval of TEMPs, and National Institute for the Control of Pharmaceutical amp; Biological Products(NICPBP) is responsible for evaluation tests. The standards of TEMPs are formulated mainly by the American Society of Testing Materials(ASTM) and International Standardization Organization(ISO).
ObjectiveTo analyze and evaluate the effect of the pharmacist-participated standardized drug management measures on improving the quality of drug management in day surgery center.MethodsDay surgery center carried out the pharmacist-participated standardized drug management since January 2019, including establishing a drug management group, strengthening the drug management specification, enhancing the training for standardized drug management, carrying out periodic inspection by pharmacist, etc. The Drug Management Quality Assessment Table was used to evaluate and compare the quality of drug management in day surgery center before standardized management (October 2018) and after standardized management (October 2019).ResultsThrough the standardized management, the quality of drug management in day surgery center was effectively improved, and the total score of drug quality management increased from 88.0 points before standardized management to 95.0 points after standardized management.ConclusionThe participation of pharmacists in the standardized drug management can effectively improve the quality of drug management in day surgery center, and ensure the safety of patients.
ObjectiveTo analyze the value of structured electronic medical records for pulmonary nodules in increasing the ability of outpatient service and hospital management by resident physicians.MethodsWe included 40 trainees [94 males and 26 females aged 22-31 (26.45±2.81) years] who were trained in the standardized training base for surgical residents in our hospital from January 2018 to January 2021. The trainees were randomly divided into two groups including a structured group using the structured electronic medical record for pulmonary nodule and an unstructured group using unstructured electronic medical record designed by our department. The time of completing hospitalization records and first-time course records, the quality of course records, the accuracy of issuing admission orders, the quality of teaching rounds, and patient’s satisfaction between the two groups were analyzed and compared.Results(1) The average time in the structured group to complete inpatient medical records was significantly shorter than that of the unstructured group (53.61±8.12 min vs. 84.25±16.09 min, P<0.010); the average time in the structured group to complete the first-time course record was shorter than that of the unstructured group (13.20±5.43 min vs. 27.51±8.62 min, P<0.010), and there was a significant statistical difference between the two groups. (2) The overall teaching round quality score of the students in the structured group was significantly higher than that in the unstructured group (84.21±15.61 vs. 70.91±12.28, P<0.010). (3) The score of the medical record writing quality of the structured group was significantly higher than that of the unstructured group (80.25±9.22 vs. 74.22±5.40, P<0.010).ConclusionThe structured electronic medical record specific for pulmonary nodules can effectively improve the training efficiency in the standardized training of surgical residents, improve the clinical ability to deal with pulmonary nodules, improve the integrity and accuracy of key clinical data collected by students, and improve doctor-patient relationship.
Objective To improve the satisfaction of standardized remote consultation of epilepsy center in patients with refractory epilepsy, and initially establish a standardized remote consultation model of three-level comprehensive epilepsy center. Methods Based on the characteristics of our epilepsy center, we designed a set of standardized remote consultation process of epilepsy center in tertiary hospitals, including sorting out patient data before consultation, improving examination, application of multi-modal technology during consultation, notification of results after consultation, and decision of operation time and method. A total of 209 patients who received remote consultation in our epilepsy center from January 2022 to June 2023 were selected as the observation group, and 150 patients who received offline consultation in our epilepsy center during the same period were randomly selected as the control group. The satisfaction of patients in the two groups on the service of doctors and nurses in consultation and the consultation results were compared. Results Through the application of the new multi-modal remote consultation mode, the number of consultations gradually increased, Compared with the offline consultation mode, there was no significant difference in patients' satisfaction with the service of doctors and nurses in remote consultation mode (P<0.05). Conclusion The establishment of standardized remote consultation mode in epilepsy center has effectively reduced the economic burden of patients, simplified the medical treatment process and improved the service quality, but the consultation quality has not been affected.
ObjectiveTo discuss the effect of the whole-course management model of intermittent catheterization (IC) in patients with neurogenic bladder (NB).MethodsPatients with NB caused by incomplete spinal cord injury admitted to Department of Rehabilitation Medicine of West China Hospital of Sichuan University between May and October 2019 were selected. According to the random number table, the patients were randomly divided into the trial group and the control group. The control group adopted the traditional management mode of IC, and the trial group adopted the whole-course management mode of IC. The urination diary (single catheterization volume, residual urine volume, and times of urine leakage), bacteria count and leukocyte count in urine routine were compared between the two groups.ResultsFinally 80 patients were included, with 40 cases in each group. There was no significant difference in urination diary, bacteria count or leukocyte count in urine routine between the two groups (P>0.05). There was no significant difference between the two groups in urination diary in the second week of management (P>0.05). At the 12th week of management, there were statistically significant differences in urination diary between the two groups (P<0.05). The bacteria count and leukocyte count in the second and 12th week of the management in the trial group were lower than those in the control group (P<0.05).ConclusionsThe whole-course management of IC for patients with NB caused by incomplete spinal cord injury can effectively improve bladder volume, and reduce residual urine volume and times of urine leakage. It also can reduce the incidence of urinary tract infection, reduce urinary complications, and ultimately improve the quality of life of patients.
ObjectiveTo summary the standard treatment for early gastric cancer. MethodsThe current early gastric cancer treatment guidelines around the world were analyzed and the standardized treatment patterns for early gastric cancer were concluded. ResultsThe accurate preoperative evaluation for early gastric cancer is the basis of standardized treatment which can be divided into staging evaluation and histological evaluation.The staging evaluation is focused on the gastric wall invasion and lymph node involvement of the tumor while the histologic evaluation emphasize the histological type and grading of the tumor.According to the precise evaluation for early gastric cancer, endoscopic surgery, laparoscopic surgery, open surgery, and multimodal therapy can be applied individually to the patients.Different treatment methods have their indications, but the indications of the therapies in different guidelines are suggested with slight differences. ConclusionIn clinical practice, the choice of treatment should be made with comprehensive consideration of diagnosis and individual characteristics of patients to achieve the most benefit on prognosis.
Objectives To assess the efficacy and safety of standard trauma craniectomy (STC), compared with limited craniectomy (LC) for severe traumatic brain injury (sTBI) with refractory intracranial hypertension. Methods We searched the Cochrane Central Register of Controlled Trials-Central (The Cochrane Library Issue 3, 2008), MEDLINE (1966 to October 2008), EMbase (1984 to October 2008), CMB-disc (1979 to October 2006) and CNKI (1979 to October 2008) for completed studies, as well as clinical trial registries for ongoing studies and completed studies with unpublished data. The reference of included studies and relevant supplement or conference abstracts were handsearched. The search results were extracted, and then the quality of included studies was assessed using RevMan 5.0. Meta-analysis was conducted if the data was similar enough. Results Two randomized controlled trials (RCTs) involving 716 participants were identified. Compared with the LC group, the STC group had statistically significant, more favorable outcome on the basis of the Glasgow Outcome Scale, using measures such as mortality, efficiency, and survival, compared with those of LC group, which had statistic difference. The mean ICP fell more rapidly and to a lower level in the STC group than in the LC group. There was no statistically significant difference on the incidence of postoperative complications, including delayed hematoma, incision cerebrospinal fluid fistula, encephalomyelocele, traumatic epilepsy, and intracranial infection as well. Conclusion The efficacy of STC is superior to LC for severe TBI with refractory intracranial hypertension resulting from unilateral frontotemporoparietal contusion with or without intracerebral or subdural hematoma.
Objective To explore the application of the Handbook for the Training Nurses in the standardized training for nurses in pediatric surgery. Methods Twenty-four training nurses trained under the instruction of the Handbook for the Training Nurses in Department of Pediatric Surgery from July 2014 to December 2015 were included as the observation group. Their training effects were compared historically with those of twenty-four training nurses who were trained without the help of the handbook from January 2013 to June 2014 (the control group). Results After the completion of the half-year training, theoretical score of training nurses in the observation group was better than that in the control group, and the difference was significant (87.16±4.18 vs. 83.71±5.46; t=2.492, P=0.016). Meanwhile, the specialist practical skill examination of training nurses in the observation group, such as femoral vein blood collection, replacement of drainage bag and indwelling needle infusion in children, and emergency practical skill examination such as cardiopulmonary resuscitation and the use of simple respirator were higher than those in the control group; and the working performance scores of training nurses in the observation group, such as the ability to adapt to the environment, patient satisfaction, nursing document writing, work efficiency and morning questions were better than those in the control group; the differences were significant (P< 0.05). Conclusion The Handbook for the Training Nurses can help the training nurses to adjust their working environment, master the practical skills and nursing knowledge in pediatric surgery.
The Core Outcome Set-STAndards for Reporting (COS-STAR) is a latest guide tool made by Core Outcome Measures in Effectiveness Trials (COMET) group. It can enhance the transparency and completeness of Core Outcome Set (COS) report. This paper introduces the generation process, report items and application of COS-STAR to provide reference for domestic similar researches.