ObjectiveTo investigate the therapeutic strategies of endovascular repair for complicated Stanford type B aortic dissection. MethodThe clinical data of 36 patients with complicated Stanford type B aortic dissection treated by endovascular repair were analyzed retrospectively. ResultsThirty-six patients with complicated Stanford type B aortic dissection were treated successfully by endovascular repair. Twenty-two cases were treated by endovascular repair combined with covering left subclavian artery (LSA). Ten cases were treated by endovascular repair combined with chimney technique. Two cases were treated by endovascular repair combined with vascular prosthesis bypass from left common carotid artery to LSA. Two cases were treated by endovascular repair combined with vascular prosthesis bypass from right common carotid artery to left common carotid artery, whose proximal part were ligated. The viscera artery and lower extremity artery supply were restored gradually. No complication such as endoleak occurred. ConclusionFor endovascular repair of complicated Stanford type B aortic dissection, strategies combined with covering LSA, chimney technique, and hybrid operation of small incision could extend anchor zone, expand the range of endovascular repair of aortic dissection, improve curative effect, reduce complications.
Currently,lung cancer (LC) has one of the highest incidence rates among various malignant tumors worldwide,and the annual mortality rate of LC has ranked first among all malignant tumors. About 80% of LC patients present to the hospital in a late advanced stage and lose the chance of surgical resection. Among all the patients who receive surgical treatment,the 5-year mortality rate of patients with early TNM stages is far lower than that of patients with advanced stage LC. With the advancement of medical equipment and more people who receive routine medical examination,more and more patients with small pulmonary nodules are discovered. Limited lung resection,including wedge resection and segmental resection,can be performed with minimally invasive video-assisted thoracoscopic surgery for these patients to acquire equivalent surgical outcomes as traditional lobectomy and a much better postoperative quality of life. LC screening increases the chances of early detection and diagnosis of LC patients,so these patients can receive reasonable diagnosis and treatment at an early stage. This strategy can greatly reduce treatment cost and mortality,and achieve maximal treatment benefits with minimal economic and medical cost. This review focuses on the necessity,high-risk groups,evaluation criteria and methods of LC screening with some LC screening guidelines and research studies in order to provide reasonable and feasible screening strategies and references for clinical LC screening.
Objective To raise policy suggestions for public health bureaus by analyzing the mental health service in Chengdu City in 2004. Methods We applied descriptive methods to analyze the mental health service. Results The mental health resources in Chengdu City were insufficient and the utilization rate of health resources was low. Conclusions Strategies to improve this may include setting up mental health management sections; increasing the funds for health service; strengthening professionals training; exploiting the service field of relevant specialties and developing community mental health.
Medical quality and patient safety will be impacted by infection prevention and control directly. There will be many challenges on infection prevention and control, especially in large general hospitals. In the practice of infection prevention and control, the quality control work for infection prevention and control needs to establish a service concept, pay attention to the scientificity and precision of management. Multi-disciplinary team work and evidence-based medical study will also play an important role in infection prevention and control. Overall, quality management of infection prevention and control should be developed scientifically and normatively. Based on the practical experience of infection prevention and control, this article summarizes the experience of infection prevention and control management quality control in the First Affiliated Hospital of Zhengzhou University, in order to provide a reference for the research and management practice of infection prevention and control management quality control strategies.
ObjectiveTo investigate on preoperative hand-washing for analyzing the underlying problems, in purpose of preventing operation-related infection via strengthening the standardization of surgical hand-washing and hand-disinfection. MethodsFrom July to September 2014, surveillance video of pre-operative hand-washing was studied and analyzed. We randomly selected 100 subjects, and assessment was performed based on the self-made surgical hand-washing and hand-disinfection protocol. Grading was done strictly. The passing score was 60 or higher; a score of 70-79 meant good; and a score of 80-100 indicated excellence. ResultsIn the survey, 91 in the 100 subjects were qualified. Among the qualified subjects, there were 53% of excellence and 20% of good. The major problems included erroneous methods, step omissions, time lacking, pollution, wrong flushing method or dry-hand method, and insufficient washing time. ConclusionBased on the survey, the administration department is advised to strengthen the regulatory supervision and education training based on standard surgical hand-washing and hand-disinfection criteria, especially training interns and new staff, in purpose of reducing the incidence of operation-related infection and improving hospitalization management qualities.
Objective To analysis the common reasons for failure in orthotopic liver transplantation during preliminary experiment and propose the preventive. Methods One hundred and twenty cases in preliminary experiment using modified Kamada “two-cuff” method of orthotopic liver transplantation were retrospectively analyzed. Results The causes of failure included： lengthening of anhepatic phase (66 cases)， failed anastomosis of suprahepatic inferior vena cava (61 cases)， failed anastomosis of infrahepatic inferior vena cava (17 cases), failed anastomosis of portal vein (12 cases), unsatisfied anesthesia (8 cases). Succeed in 21 cases (17.50%, 21/120). Conclusion Improve the microsurgical operation techniques, particularly the anastomosis of suprahepatic inferior vena cava, can increase the success rate in orthotopic liver transplantation.
With the development of rehabilitation medicine being promoted as a national strategy, the rehabilitation medicine has developed rapidly in China, and the number of rehabilitation medicine departments in tertiary general hospitals has increased greatly. However, the discipline development faces some problems, such as unreasonable physical condition setting, nonstandard clinical path of rehabilitation technology, inaccurate discipline positioning, loopholes in safety management, inadequate rehabilitation quality control, and imperfect talent construction system. This paper attempts to discuss the strategic thinking of the development of rehabilitation medicine from six dimensions: foundation, technology, system, safety, quality control, and talents, so as to provide a reference for discipline builders.
ObjectiveTo identify factors and strategies for the sustainability of evidence-based health promotion programs. MethodsThe articles related to program sustainability factors and strategies were retrieved from the CNKI, WanFang Data, VIP, PubMed, and Web of Science database. The search period for English literature was from June 19, 2018, to December 3, 2024, while no start date was set for Chinese literature, the end date was the same. Three researchers independently screened studies based on predefined inclusion and exclusion criteria and subsequently extracted the basic characteristics from the included studies. Thematic analysis was conducted to identify the sustainability factors and strategies from the included studies. ResultsA total of 65 articles were included in the scoping review. Through thematic analysis, 23 factors were identified and classified into six categories: program characteristics, organization characteristics, human resources, material resources, community resources and policy resources, along with 44 strategies grouped into six categories: programming strategies, collaborative strategies, capacity-building strategies, resource mobilization strategies, communication and dissemination strategies, and evaluative strategies. ConclusionThe sustainability factors and strategies identified in this study exhibit conceptual and structural alignment with existing frameworks and strategy sets in implementation science. Concurrently, by incorporating a full life-cycle perspective, this study delineates context-specific factors and strategies tailored to the unique requirements of sustaining programs over time, thereby contributing to a more nuanced understanding of program sustainability and offering practical guidance for strengthening the longevity of evidence-based health promotion programs.