ABSTRACT
Real-world study is increasingly becoming an important source of evidence for changing clinical practice, especially for clinical problems that can′t be randomized. In recent years, real-world research in the field of breast cancer has gradually became a boom. Existing research results have begun to assist in the epidemiological analysis of breast cancer, promote the approval of rare diseases diagnosis and indication, and promote the analysis of real-world treatment status and evaluation of curative effects. Chinese scholars have also established databases and carried out relevant real-world research, providing real-world evidence for clinical practice in China. But domestic research is still in its infancy. The number of real-world research literature published by domestic scholars is relatively small, and there is a lack of pragmatic randomized clinical trial and real-world research for decision-making. In the future, we need to take advantage of the abundant diagnosis and treatment resources, further improve the database, and carry out real-world study on drug development based on population data in China.
ABSTRACT
Artificial intelligence clinical decision-support system is an important direction of artificial intelligence in the medical field. Both international and domestic researchers are exploring the application value of intelligent decision-making system in the field of cancer. But at the same time of the craze, there are still some problems in the intelligent decision-making system. Combining the work of the research groups in this field, this paper explores the current confusions and solutions, and hopes to help clinicians better understand intelligent decision-making. It is believed that with the deepening of the concept and the advancement of technology, intelligent decision-making will become a good help for doctors in the future.
ABSTRACT
In the past two years, researchers have been exploring the precision medicine. Thanks to the development of sequence industry and clinical study, the big data about the precision medicine have been more and more sufficient. However, how to deal with the precision data is still a question for clinicians. We focus on the hot issues that disturb clinicians most, wanting to help them to make suitable decisions between the traditional and precision medicine of breast cancer. We believe the precision medicine is on the way.
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Objective To determine the independent risk factors for sepsis in patients with large area burns.Methods The study enrolled 307 patients with large area burns treated from June 2014 to June 2015.Related variables included age,gender,visit time,emergency eschar open,burn index,tangential excision of eschar during shock stage,delayed resuscitation during shock stage,oxygen pressure(PaO2),carbon dioxide pressure (PaCO2),assisted ventilation mode,mechanical ventilation time,inhalation injury,prophylactic tracheotomy,continuous lactic acid rise,refractory hypernatremia,heart-lung disease history,and diabetes history.Correlation of the variables with the incidence of sepsis was observed.Independent predictors of sepsis in patients with large burns were differentiated using the Logistic regression analysis.Results Delayed resuscitation during shock period (OR =1.747,95％ CI 1.822-7.431,P ＜ 0.05),continuous lactic acid rise (OR =1.758,95％ CI 1.137-4.002,P ＜ 0.05),refractory hypernatremia (OR =2.985,95％ CI 1.074-6.782,P ＜ 0.05),moderate and severe inhalation injury(OR =14.764,95％ CI 0.892-47.323,P ＜ 0.05) and burn index (OR =5.017,95％ CI 1.075-23.572,P ＜ 0.05) were found be independently associated with sepsis in patients with large burns.Conclusions These independent risk factors for sepsis in large area burn patients deserve more attention.Early and timely treatment measures may reduce the incidence of sepsis.
ABSTRACT
BACKGROUND:Pediatric knee dysfunction is a congenital malformation. Fusion and fixation can effectively eliminate pain, but no joint has active function. Total knee arthroplasty is a safe and effective method to relieve pain and to rebuild its function. With the continuous development of total knee arthroplasty, the type of knee prostheses is more. OBJECTIVE: To study the efficacy of different reconstruction methods for children with stunted knee arthroplasty. METHODS:120 knee stunted children were equaly divided into treatment group and control group depended on the reconstruction, and then al children were given the artificial knee replacement surgery and were completed by the same group of physicians. In the control group, stable fixed platform prosthesis was selected. In the treatment group, the non-limiting prosthetic-posterior cruciate ligament resection of low contact pressure rotating platform prosthesis was given. Operative time, blood loss, postoperative hospital stay, and complications were observed in both groups. Al patients were folowed up for 3 months. Knee function was assessed by Hospital for Special Surgery and American knee society knee score. Multivariate regression analysis was used to analyze the possible factors affecting Hospital for Special Surgery score during folow up. RESULTS AND CONCLUSION: No significant difference in operative time, blood loss and postoperative hospital stay was compared in both groups (P> 0.05). The postoperative overal incidences of inflammatory response, wound healing, periprosthetic infection, and joint stiff were significantly lower in the treatment group than in the control group (P 80 served as a standard. Multivariate regression analysis results showed that age, type of prosthesis, and varus deformity were the major independent risk factors for affecting joint replacement (P< 0.05). Results indicate that knee arthroplasty for knee dysfunction obtained good prognostic effect. Simultaneously, the non-limiting application of prosthetic reconstruction can effectively reduce postoperative complications and improve knee function.