Periodontal therapy for hopeless mandibular anterior teeth: a retrospective case report with a multidisciplinary approach and a 20-year follow-up

Introduction: This case report presents the intentional periodontal maintenance of two periodontal hopeless lower central incisors with a multidisciplinary approach and 20-year follow-up. Case presentation: A 36-year-old male, in 2001, was diagnosed with aggressive periodontitis, gingival swelling, bleeding, and mandibular central incisors with mobility and poor prognosis. Following periodontal therapy (phase I), root canal treatment, and occlusal adjustment, #31 and #41 were gently extracted to remove the granulation tissues, calculus, and infected cementum from the root surface. Then, tetracycline-HCl was applied for 5 minutes on the root surfaces. The teeth were repositioned into the sockets and splinted with a lingual bar. At 3 months, the bar was removed, and a free gingival autogenous graft was done to improve the local keratinized tissue width. Mobility scores, pocket depths, and clinical attachment levels were recorded, and radiographs were taken at 1, 5, and 20 years. The 5-year follow-up showed that the teeth were clinically and radiographically in function. There was a reduction in probing depth and a gain in clinical attachment and radiographic alveolar bone levels. After 20 years, #41 was stable, but #31 had external root resorption, leading to a new treatment plan (dental implants) and extraction. Conclusion: The clinical result of this case was satisfactory for 20 years. Intentional periodontal maintenance of the teeth may be an alternative treatment, even considering the high level of complexity.

Percepções dos profissionais da atenção básica em saúde sobre a responsabilidade no cuidado integral às pessoas com transtornos mentais / Perceptions of primary care professionals about responsibility for comprehensive health care for people with mental disorders

A Reforma Psiquiátrica Brasileira possibilitou a reinserção das pessoas com transtornos mentais na sociedade. Isso acarretou a necessidade de implementar outras formas de olhar e acompanhar essa população, instigando a construção do cuidado em liberdade. Assim, objetivou-se identificar as percepções dos profissionais da atenção básica em saúde sobre a responsabilidade no cuidado integral à pessoa com transtorno mental e/ou sofrimento mental. Trata-se de um estudo descritivo, de abordagem qualitativa, realizado com sete profisionais de uma equipe de Saúde da Família, na região metropolitana de Porto Alegre, Sul do Brasil. Os dados foram coletados por meio de entrevistas individuais e analisados conforme análise de conteúdo. Evidenciou-se que existe o movimento de tomada de responsabilidade por parte dos profissionais entrevistados, a partir da construção de cuidado e acompanhamento em saúde mental. Influenciam esse movimento aspectos como: a escuta, a construção do vínculo, o estigma como modificador da percepção e os fluxos/encaminhamentos para outros serviços. A enfermagem demonstrou ter um papel fundamental na tomada de responsabilidade na atenção básica, em que o profissional enfermeiro é visto como referência na realização dos cuidados e capacitação da equipe.

The Brazilian Psychiatric Reform enabled the reintegration of people with mental disorders into society. This led to the need to implement other ways of looking at and supporting this population, encouraging the construction of care in freedom. Thus, the aim was to identify the perceptions of primary health care professionals regarding responsibility for comprehensive care for people with mental disorders and/or mental distress. This is a descriptive study with a qualitative approach, conducted with seven professionals from a Family Health Team in the metropolitan region of Porto Alegre, Southern Brazil. Data were collected through individual interviews and analyzed using content analysis. It was evident that there is a movement towards taking responsibility on the part of the interviewed professionals, through the construction of mental health care and monitoring. Aspects influencing this movement include: listening; building rapport; stigma as a modifier of perception; and referrals to other services. Nursing demonstrated a fundamental role in taking responsibility in primary care, where the nurse professional is seen as a reference in providing care and training the team.

Demanda de cuidado nutricional de crianças com transtorno do espectro autista em uma região de acesso remoto / Demandas de atención nutricional de niños con trastorno del espectro autista en una región de acceso remoto / Nutritional care demands of children with autism spectrum disorder in a remote access region

Introdução: O transtorno do espectro autista é uma condição neuropsiquiátrica que demanda atenção interdisciplinar e multiprofissional. A abordagem nutricional é necessária frente aos possíveis sintomas associados, como seletividade alimentar e alterações do hábito intestinal. Famílias residentes em locais de acesso limitado à serviços de saúde podem possuir dificuldades para o adequado acompanhamento. Objetivo: Relatar a experiência de atendimentos em nutrição realizados pela Liga Acadêmica de Nutrição e Saúde Coletiva a crianças com transtorno do espectro autista explorando as principais demandas identificadas e enfrentadas em uma região de acesso remoto. Metodologia: Abordagem descritiva, do tipo relato de experiência, de atendimentos realizados no município de Coari, interior do Amazonas. Os encontros foram realizados com vista a identificar demandas e refletir sobre a melhor maneira de auxiliar as crianças com essas comorbidades. Resultados: Foram atendidas 9 crianças, nem todas com o diagnóstico fechado. Seletividade alimentar, distúrbios gastrointestinais e excesso de peso foram desafios recorrentes. Nota-se a carência da percepção da importância do acompanhamento nutricional, em um cenário de relatos importantes sobre as dificuldades no acesso a medicações, por falta no município ou por ausência de recursos para aquisição, assim como terapias especializadas. Aspectos que se tornam ainda mais desafiadores frente à distância geográfica e carência de profissionais especializados e que realizem uma atenção multiprofissional. Conclusões: O acompanhamento nutricional adequado é essencial para atender às necessidades específicas e melhorar a qualidade de vida dessas crianças. Diante das limitações identificadas na região, são necessários esforços contínuos para desenvolver soluções que garantam uma assistência inclusiva e eficaz às crianças com transtorno do espectro autista no interior do Amazonas. A colaboração entre instituições, a conscientização da comunidade e o fortalecimento da rede de saúde local são cruciais para promover uma abordagem abrangente e de alta qualidade para essas crianças e suas famílias (AU).

Introduction: Autism spectrum disorder is a neuropsychiatric condition that demands interdisciplinary and multidisciplinary attention. Nutritional intervention is necessary in the face of possible associated symptoms, such as food selectivity and changes in bowel habits. Families living in places with limited access to health services may have difficulties in obtaining adequate support and follow-up.Objective: Reporting the experience of nutrition services provided by the Academic League of Nutrition and Public Health to children with autism spectrum disorder, exploring the main identified demands and challengesfaced in a remote access region. Methodology:Descriptive approach, experience of an report, of services provided in the municipality of Coari, in the interiorof Amazonas. The meetings were held with the aim identifying demands and reflecting on the best way to assistchildren with these comorbidities. Results: Ninechildren attended to, not all with a confirmed diagnosis. Food selectivity, gastrointestinal disorders and overweight were recurring challenges. There is a lack of perception of the importance of nutritional monitoring, in a scenario where there areimportant reportsofdifficulties in accessing medications, either due to lack of availability in the municipality or lack of resources for acquisition, as well as specialized therapies. Theseaspects become even more challenging given the geographical distance and scarcity of specialized professionals whocanprovide multidisciplinary care. Conclusions: Adequate nutritional monitoring is essential to meet the specific needs and improve the quality of life of these children. Given the limitations identified in the region, continuous efforts are needed to develop solutions that guarantee inclusive and effective assistance for children with autism spectrum disorder in the interior of Amazonas. Collaboration between institutions, community awareness, and strengthening the local health network are crucial to promoting a comprehensive, high-quality approach for these children and their families (AU).

Introducción: El trastorno del espectro autista es una condiciónneuropsiquiátrica que requiere atención interdisciplinaria y multidisciplinaria. El enfoque nutricionales frente a losposibles síntomas, como selectividad alimentaria y alteraciones delhábitosintestinales. Las familias que viven en lugares con accesolimitado a los servicios de salud pueden tener dificultades para recibir un seguimiento adecuado. Objetivo: Reportar la experiencia de los servicios de nutrición brindados por la Liga Académica de Nutrición y Salud Pública a niños con trastorno del espectro autista, explorando las principales demandas identificadas y enfrentadas en una región de acceso remoto.Metodología: Enfoque descriptivo, relato de experiencia, de los servicios prestados en Coari, en el interior de Amazonas. Los encuentros se realizaron con el objetivo de identificar demandas y reflexionar sobre la mejor manera de ayudar. Resultados:Se atendieron 9 niños, no todos con diagnóstico confirmado. Selectividad alimentaria, trastornos gastrointestinales y exceso de peso fueron desafíos recurrentes. Se observa una falta percepción de la importancia del seguimiento nutricional, en un escenario de informes importantes sobre las dificultades en el acceso a medicamentos, debido a lafaltade suministro en el municipio o a la falta de recursos para su adquisición, así como terapias especializadas. Estosaspectos que se vuelven aún más desafiantes dada la distancia geográfica y falta de profesionales especializados que brinden una atención multidisciplinaria.Conclusiones: Un adecuado seguimiento nutricional es fundamental para satisfacerlas necesidades específicas y mejorar la calidad de vida de estos niños. Antelas limitaciones identificadas, se necesitan esfuerzos continuos para desarrollar soluciones que garanticen una atención inclusiva y efectiva estosniños en el interior de Amazonas. Colaboración entre instituciones, concientización comunitaria y fortalecimiento de la red de salud local son cruciales para promover un enfoque integral y de alta calidad para estos niños com trastorno del espectro autista y sus familias (AU).

Application status of risk assessment models for periodontal disease / 口腔疾病防治

@#Risk assessment models for periodontal disease provide dentists with a precise and consolidated evaluation of the prognosis of periodontitis, enabling the formulation of personalized treatment plans. Periodontal risk assessment systems have been widely applied in clinical practice and research. The application fields of periodontal risk assessment systems vary based on the distinctions between clinical periodontal parameters and risk factors. The assessment models listed below are commonly used in clinical practice, including the periodontal risk calculator (PRC), which is an individual-based periodontal risk assessment tool that collects both periodontal and systemic information for prediction; the periodontal assessment tool (PAT), which allows for quantitative differentiation of stages of periodontal disease; the periodontal risk assessment (PRA) and modified periodontal risk assessment (mPRA), which are easy to use; and the classification and regression trees (CART), which assess the periodontal prognosis based on a single affected tooth. Additionally, there are orthodontic-periodontal combined risk assessment systems and implant periapical risk assessment systems tailored for patients needing multidisciplinary treatment. This review focuses on the current application status of periodontal risk assessment systems.

Different methods for treating pulmonary arteriovenous malformation under multi-disciplinary treatment model / 中国介入影像与治疗学

Objective To observe the effectiveness and safety of different methods under multi-disciplinary treatment(MDT)model for treating pulmonary arteriovenous malformation(PAVM).Methods MDT were retrospectively performed in 31 patients with PAVM.The effectiveness and safety of interventional therapy,surgical treatment and conservative therapy for PAVM were compared.Results Among 31 cases of PAVM,22 cases underwent interventional therapies(interventional group),4 cases received surgical treatments(surgical group)and 5 cases underwent conservative therapies(conservative group).In interventional group,PAVM was successfully embolized in all 22 cases,with the technical success rate was 100％(22/22).Pleurisy was occurred in 3 cases(3/22,13.64％),while recurrence of PAVM was noticed in 4 cases(4/22,18.18％)during follow-up.No recurrence occurred in interventional group after the second interventional therapies.In surgical group,4 cases were successfully treated with thoracoscopic lobectomy,with the technical success rate of 100％(4/4).No postoperative complication occurred,while recurrence of PAVM was noticed in 2 cases(2/4,50.00％)during follow-up,including 1 case underwent interventional therapy and 1 case underwent conservative therapy.In conservative group,progressive PAVM was observed in 3 cases(3/5,60.00％),including 2 cases who were cured with interventional therapy and 1 case died of stroke after conservative therapy.Conclusion Individualized treatments of PAVM were feasible under MDT model.Compared with surgical treatments and conservative therapies,interventional therapies of PAVM were more effective and relatively safe.

Interrupted Time Series Study on the Service Efficiency and Cost Structure of Appendectomy in Children / 中国卫生经济

Objective:To analyze the changes in service efficiency and cost structure before and after implementing multidisci-plinary treatment in the GD19(appendectomy with perforation,suppuration,gangrene,etc.)and GD29(appendectomy)groups of pedi-atric specialty medical institutions.Methods:The case data of GD19 and GD29 groups of medical insurance patients in sample hospi-tals in Beijing from 2021 to 2022 were collected.Mann Whitney U test was used to analyze the changes of medical expenses and effi-ciency indicators,and intermittent time series model was established to analyze the change trend.Results:Compared to 2021,the av-erage hospitalization expenses of GD19 group in 2022 decreased by 2 462.00 yuan year-on-year,and that of GD29 group decreased by 2 042.60 yuan year-on-year(P＜0.05).Among them,the cost of medicines,consumables,examinations and tests and treatment have all decreased.In the month when the management measures were implemented,the average consumption cost of GD19 group de-creased by 920.00 yuan(P＜0.05),and the average consumption cost of GD29 group decreased by 632.50 yuan.The average length of stay in GD29 group decreased from 3.74 days to 2.78 days(P＜0.05).Conclusion:After the implementation of management mea-sures,the cost of drug consumables in GD19 group and GD29 group was controlled,the cost level was reduced,and the operation effi-ciency was improved.It is suggested to adhere to the management measures of selection of key DRG groups and multidisciplinary con-sultation,mobilize the management enthusiasm of clinical departments,and strengthen the demonstration and optimization of pediatric DRG grouping and payment scheme.

Study on the relationship between multidisciplinary teamwork behavior and organizational factors in tertiary public hospitals in Hangzhou:Based on moderated mediation model / 中国卫生政策研究

Objective:Analyze the impact of organizational factors on multidisciplinary teamwork behavior in tertiary public hospitals in Hangzhou,as well as the role mechanism of team atmosphere and team leadership.Provide suggestions for fully mobilizing their teamwork enthusiasm and improving teamwork efficiency.Methods:From January 2022 to March 2022,a questionnaire survey was conducted on multidisciplinary team members in tertiary public hospitals in Hangzhou using purposive sampling,and a total of 452 valid questionnaires were collected;Use the Process plugin in SPSS 26.0 software to test the moderated mediation model.Results:Positive organizational factors have a positive promoting impact on multidisciplinary teamwork behavior(β = 0.128,P<0.001),team atmosphere plays a mediating role between organizational factors and multidisciplinary teamwork behavior(β =0.063,P<0.001),and team leadership plays a negative moderating role between organizational factors and team atmosphere(β =-0.011,P<0.001).Conclusions:The behavior of multidisciplinary teamwork is influenced by multiple factors such as organizational factors,team atmosphere,and team leadership.Therefore,the hospital should actively explore a long-term operation mechanism for multidisciplinary teamwork that conforms to the characteristics of the hospital,improve top-level design,strengthen organizational investment,create a harmonious cooperation atmosphere within the team,enhance team cohesion,use shared leadership for team decision-making,and grant team members sufficient autonomy and decision-making power.

A Systematic Review of the Effectiveness Evaluation Tools for Multidisciplinary Diagnosis and Treatment of Tumors / 中国医院管理

Objective To understand the effectiveness evaluation research of tumor MDT,and analyze the development status and differences of evaluation tools at home and abroad,to provide reference for the subsequent summary evaluation and continuous improvement of tumor MDT,and the strengthening of MDT supervision.Methods Four literature databases at home and abroad were searched to obtain relevant literatures,and literature screening and systematic review were conducted.Results A total of 87 literatures were included,including 26 literatures in Chinese and 61 literatures in English;the most published years were 2020;the main countries of the first authors were the UK.Foreign evaluation tools focus on the key elements of structure and process,while evaluation systems in China focus on the index content at the result level.Conclusion In China,the scientific and comprehensive selection of tumor MDT evaluation indicators needs to be improved,the analysis of influencing factors on the structure and process of MDT needs to be strengthened,and the extrapolation of the existing evaluation systems need to be verified.It is suggested to strengthen the evidence support of evaluation index selection,attach importance to the evaluation of process links,promote the in-depth study of the influencing factors of tumor MDT,and further encourage the empirical application of the existing evaluation system.

Development and current status of multidisciplinary diagnosis and treatment model in hepato-pancreato-biliary diseases / 中华肝胆外科杂志

Hepato-pancreato-biliary diseases (HPBD) are often complicated. The diagnosis and treatment of HPBD involve many disciplines. The malignant degree of hepatobiliary pancreatic system is high, and the prognosis of patients is poor. The multidisciplinary team (MDT) brings specialists from different disciplines together to make a comprehensive and individualized treatment for patients. MDT is emerging in HPBD in recent years. MDT helps improve the accuracy of diagnosis and prognosis. However, there are still some controversies and obstacles in the application of MDT for patients with HPBD. We reviewed the development, current status and experience of MDT in the field of HPBD, analyze the current controversy and obstacles, and providing reference for its future application.

Endovascular therapy combined with laparoscopic surgery for acute mesentery artery occlusion / 中华普通外科杂志

Objective:To explore the efficacy and safety of endovascular intervention combined with preoperative laparoscopic exploration in the treatment of patients with acute mesenteric artery ischemia.Methods:This was a prospective cohort study (NCT04686981). The study enrolled 31 patients with acute mesenteric artery ischemia from Oct 1, 2020 to Oct 1, 2022. Among them, 26 patients (84%) were male, with a mean age of (67±13) years and a mean time to onset of (21±8) hours. All patients underwent laparoscopic exploration in the hybrid operating room. If the presence of intestinal necrosis or suspected necrosis was clearly determined, the patient would undergo open surgery (mesenteric artery embolization, intestinal resection and intestinal double stoma) as the treatment by gastrointestinal surgeon. If intestinal necrosis or suspected necrosis was not found by laparoscopy, the patient would undergo endovascular intervention by vascular surgeon. The primary observational endpoints of this study were the proportion of patients who were not dependent on total parenteral nutrition and all-cause mortality within 30 days after operation. The secondary observational endpoints were the rate of mesenteric vascular patency within 30 days and the proportion of interventions that were converted to open surgery.Results:Six patients underwent open surgery and 25 patients underwent endovascular intervention, including 13 cases of thrombus reduction alone, 3 cases of stent implantation during the same period after reduction, and 9 cases of stent implantation alone. Twenty-four patients (77%) were completely weaned from the TPN within 30 days after the procedure, and all-cause mortality was observed in 3 cases (9.7%). The patency rate of the mesenteric artery within 30 days after the procedure was 82.1%. The rate of conversion to open surgery after intervention was 16%.Conclusions:Endovascular intervention combined with preoperative laparoscopic exploration can clarify intestinal ischemia in acute mesenteric patients as early as possible, and individualized treatment strategies for each patient by multidisciplinary care team can potentially improve the prognosis of such patients.

Efficacy of multidisciplinary team combined with Da Vinci robot-assisted thoracic surgery in the treatment of early non-small cell lung cancer: A retrospective study in a single center / 中国胸心血管外科临床杂志

@#Objective To investigate the clinical efficacy of multidisciplinary team (MDT) model combined with Da Vinci robot-assisted thoracic surgery in the treatment of early non-small cell lung cancer (NSCLC). Methods From July 2020 to December 2021, the patients with NSCLC who received Da Vinci robot-assisted thoracic surgery in the Department of Thoracic Surgery, General Hospital of Northern Theater Command were collected. According to whether MDT were performed before hospitalization, the patients were divided into an MDT group and a common group. The recovery and clinical efficacy were compared between the two groups. Results A total of 187 patients were enrolled, including 81 males and 106 females, aged 63 (56, 67) years. There were 85 patients in the MDT group, and 102 patients in the common group. Compared with the common group, the MDT group had lower incidence of postoperative complications (9.4% vs. 29.4%, P=0.017), shorter intraoperative operation time [55 (45, 61) min vs. 79 (65, 90) min, P<0.001], and less intraoperative blood loss [25 (20, 30) mL vs. 30 (20, 50) mL, P=0.029] in the same operation mode. In addition, the drainage volume on the second postoperative day [270 (200, 350) mL vs. 215 (190, 300) mL, P=0.004], the number of dissected lymph nodes groups [6 (5, 6) groups vs. 5 (3, 6) groups, P=0.004] and the number of dissected lymph nodes [16 (13, 21) vs. 13 (9, 20), P=0.005] in the MDT group were significantly better than those in the common group. The differences in the postoperative intubation time and postoperative hospital stay between the two groups were not statistically significant (P>0.05). Conclusion MDT combined with Da Vinci robot-assisted thoracic surgery can further reduce the risk of surgery, improve the clinical treatment effect, reduce the incidence of postoperative complications, and accelerate the rehabilitation of patients.

Diagnosis and treatment of prostate mucosa adenocarcinoma under multidisciplinary diagnosis and treatment mode: 2 cases report and literature review / 现代泌尿外科杂志

【Objective】 To explore the clinicopathological characteristics and comprehensive treatment strategies of prostate mucosa adenocarcinoma under multidisciplinary diagnosis and treatment (MDT) mode. 【Methods】 Data of two patients with typical prostate mucosa adenocarcinoma treated in our hospital during Sep.2020 and Apr.2023 were retrospectively analyzed. 【Results】 In case 1, the clinical manifestation was macroscopic hematuria; multiparametric magnetic resonance imaging (mpMRI) indicated solid prostatic nodules, clinical stage T4N1Mx; initial prostate specific antigen (PSA) was 1.2 ng/mL; 6868Ga-prostate specific membrane antigen PET/CT (68Ga-PSMA PET/CT) suggested abnormal uptake of nuclear lesions in the prostate (SUV4.2-5.3); biopsy results indicated invasive mucinous adenocarcinoma.After prostate and pelvic field radiotherapy + androgen deprivation therapy (ADT) + antihypertensive treatment, lesions were significantly reduced, and hematuria symptoms were relieved.In case 2, the clinical manifestation was dysuria; initial PSA was 91.78 ng/mL; mpMRI suggested invasion of prostate mass into the bladder and clinical stage of T4N1M1b; 68Ga-PSMA PET/CT indicated prostate and pelvic lymph nodes, and multiple bone lesions showed increased nuclide uptake; biopsy results indicated prostate adenocarcinoma with mucinous adenocarcinoma.Initial endocrine treatment was performed.After 3 months, PSA was reduced to 0.083 ng/mL, and imaging showed the tumor was significantly reduced.Robotic-assisted laparoscopic tumor prostatectomy with extended pelvic lymph node dissection was performed, and endocrine adjuvant therapy was continued after surgery. 【Conclusion】 Prostate mucosa adenocarcinoma has different clinicopathological characteristics and prognosis from conventional acinar adenocarcinoma, and the whole-process management under MDT mode is of great value in the diagnosis and treatment of this disease.

Preliminary Exploration on the Establishment of the Department of Rare Diseases at Peking Union Medical College Hospital / 罕见病研究

The establishment of the Department of Rare Diseases at Peking Union Medical College Hospital (PUMCH) is a landmark in the disciplinary development of the rare diseases. The establishment of the department will booster the prominence of the influence and leading position of the PUMCH in the field of rare diseases. In addition, the department is instrumental in the development of the hospital of high-quality. The department aims at delivery of better medical care for patients with rare diseases, the training of specialists in rare diseases, and avancement of the preventing and treating rare diseases in China.This paper preliminarily discusses the working basis, significance and discipline development plan of the department of rare diseases at PUMCH.

Aphasia in Right Hemiparesis and Pain in Left Waist: A Deceiving Case in Vascular Ehlers-Danlos Syndrome / 罕见病研究

The Ehlers-Danlos syndrome(EDS)is a rare inherent connective tissue disorder. The prevalence of EDS in the population is estimated at one out of ten thousand to one out of a hundred thousand. The vascular EDS(vEDS) are rare among the subtypes but are the worst in prognosis. The article reports a case of vEDS admitted to the hospital. The patient was a young man complaining of a sudden onset of aphasia in right hemiparalysis and severe left abdominal pain for unknown reasons. The diagnosis was made after the genetic testing. The patient suffered from vEDS. Then, the multi-disciplinary team(MDT)made a treatment plan tailored to this young patient. The complexity in classification and delusive presentations of the EDS make the correct diagnosis very challenging. This article hopes to report this case and to share the experiences to the better understanding of this disease.

Application of multi-disciplinary team mode in prevention and control of multidrug resistant organism infection in lung transplant recipients / 器官移植

<b>Objective</b> To evaluate the effectiveness of multi-disciplinary team (MDT) mode in the prevention and control of multidrug resistant organism (MDRO) infection in lung transplant recipients. <b>Methods</b> Lung transplant recipients admitted to the hospital from 2019 to 2022 were enrolled. MDT expert group was established in January, 2020. A series of prevention and control measures were conducted. The implementation rate of MDRO prevention and control measures and the detection rate of MDRO on the environmental surface from 2020 to 2022, and the detection rate of MDRO in lung transplant recipients from 2019 to 2022 were analyzed. <b>Results</b> The overall implementation rate of MDRO prevention and control measures for medical staff was increased from 64.9% in 2020 to 91.6% in 2022, showing an increasing trend year by year (<i>P</i><0.05). The detection rate of MDRO on the environmental surface was decreased from 28% in 2020 to 9% in 2022, showing a downward trend year by year (<i>P</i><0.05). The detection rate of MDRO in lung transplant recipients was decreased from 66.7% in 2019 to 44.3% in 2022, showing a decreasing trend year by year (<i>P</i><0.001). <b>Conclusions</b> MDT mode management may enhance the implementation of MDRO prevention and control measures for medical staff, effectively reduce the infection rate of MDRO in lung transplant recipients and the detection rate of MDRO on the environmental surface, which is worthy of widespread application.

Effects of nurse-led multidisciplinary cooperative nutrition intervention on nutritional indicator of patients with stroke / 重庆医学

Objective To explore the impact of nurse-led multidisciplinary collaborative nutrition inter-vention on the nutritional indicators in the patients with stroke.Methods A total of 100 patients with stroke admitted in this hospital from January to December 2020 were selected as the study subjects and divided into the observation group and control group by the propensity score matching,50 cases in each group.The control group was given the traditional nutrition intervention,and the observation group was given the nurse-led mul-tidisciplinary cooperative nutrition intervention.The blood,nutritional and biochemical indicators,physique monitoring indicators and nutritional risk indicators were compared between the two groups.Results The levels of total protein(TP),albumin(ALB),hemoglobin(Hb),prealbumin(PAB),body mass index(BMI),upper arm muscle circumference(AMC)and triceps skin fold thickness(TSF)on 21 d after admission in both groups were increased compared with those on 2,15 d after admission,and which on 15 d after admission were higher than those on 2 d after admission(P＜0.05),moreover the above indicators levels on 15,21 d after ad-mission in the observation group were higher than those in the control group,and the differences were statisti-cally significant(P＜0.05).Body mass index(BMI),upper arm circumference(AMC)and triceps skinfold thickness(TSF)in both groups on 21 d of admission were higher than those on 2,15 d of admission(P＜0.05).The nutritional risk screening 2002(NRS2002)score on 21 d after admission in the two groups were decreased compared with those on 2,15 d after admission,while which on 15 d after admission was decreased compared with that on 2 d after admission,moreover the NRS2002 score on 15,21 d after admission in the ob-servation group were lower than those in the control group,and the differences were statistically significant(P＜0.05).Conclusion Giving the nurse-led multidisciplinary cooperative nutrition intervention could im-prove the blood nutritional and biochemical indicators and physique monitoring indicators,and reduce the nu-tritional risk of the patients with stroke.

Effect Evaluation of Multidisciplinary Collaborative Diagnosis and Treatment Model for Children with Brain Injury / 昆明医科大学学报

Objective To summarize the experience of multi-disciplinary team(MDT)in the pediatric department of Qujing Maternal and Child Health Hospital,and to evaluate the effectiveness of MDT on neonatal brain injury.Methods The clinical data of children with brain injury and treated in the pediatrics department of Qujing Maternal and Child Health Hospital from November 2019 to April 2023 were collected.The children with brain injury and treated from October 2019 to June 2020 were regarded as the non-MDT group,and the children with brain injury and treated from July 2020 to April 2023 were regarded as the MDT group for comparative analysis.Chi-square test/t-test was used to compare and analyze the clinical data of the two groups.Results Among the 890 cases of pediatric brain injury,there were 519 males and 371 females.The median and quartiles of the age distribution for the two groups were as follows:MDT group 2.00(0.82,5.00)years and non-MDT group 1.00(1.00,4.00)years.Craniocerebral injury was the main type of brain injury in both groups,in addition,among children with craniocerebral injury and intracranial hemorrhage,the cure rate of MDT group was higher than that of non-MDT group,and the difference was statistically significant(P<0.05).Among the 405 children in MDT group,154(38.0%)underwent the surgery,while among the 485 children in non-MDT group,121(24.9%)underwent the surgery.The difference was statistically significant(P<0.05).23.2% of children in MDT group were in critical condition during the hospitalization,which was significantly lower than that in non-MDT group(30.5%),and the difference was statistically significant(P<0.05).The unhealed rate of MDT group(2.0%)was also significantly lower than that of non-MDT group(5.6%),the cure rate of MDT group(40.5%)was significantly higher than that of non-MDT group(34.4%),and there was a statistically significant difference(P<0.05).The expense of treatment,medicine and sanitary materials in MDT group were lower than those in non-MDT group,and the differences were statistically significant(P<0.05).The multivariate Logistic regression model analysis of the cure rate of children with brain injury showed that the MDT model could effectively improve the cure rate of children with brain injury(RR = 1.513,95% CI = 1.134-2.020).The results of multiple linear regression model analysis showed that there was no statistical difference in the effect of MDT on the actual hospitalization days of children(P>0.05).Conclusion Using MDT model to diagnose and treat children with brain injury is helpful to improve the cure rate,reduce the risk of children's disease aggravation,and achieve the significant therapeutic effects in children with brain injury.MDT model is worth popularizing and applying in children with brain injury.

All-round and full-cycle management of primary hyperparathyroidism / 中华内分泌外科杂志

Primary hyperparathyroidism is a disease with a large potential population. Some cases of primary hyperparathyroidism are non-primary, preventable and curable at early stage, requiring long-term follow-up after surgery. Therefore, all-round and full-cycle management are necessary for primary hyperparathyroidism, which involves an enhancing focus on etiological prevention, early detection, prompt diagnosis, timely intervention, multi-disciplinary standardized diagnosis and treatment, and postoperative scientific management. Meanwhile, implementing a "12+5+1" multidisciplinary joint diagnosis and treatment model, along with a two-way referral model, to achieve the transition from a disease-oriented diagnostic and treatment model to a patient-oriented, all-round and full-cycle interdisciplinary management model. This management can reduce the incidence and recurrence rate of primary hyperparathyroidism, and related osteoporosis or osteopenia, fractures, nephrolithiasis, metastatic vascular calcification, and systemic abnormal migratory calcium deposits, improve the overall quality of life and prognosis of patients.

Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine：Fibromyalgia Syndrome / 中国实验方剂学杂志

Fibromyalgia syndrome （FMS） is a refractory， chronic non-articular rheumatic disease characterized by widespread pain throughout the body， for which there are no satisfactory therapeutic drugs or options. There are rich Chinese medical therapies， and some non-drug therapies， such as acupuncture， Tai Chi， and Ba-Duan-Jin， have shown satisfactory efficacy and safety and definite advantages of simultaneously adjusting mind and body. FMS is taken as a disease responding specifically to traditional Chinese medicine （TCM） by the National Administration of Traditional Chinese Medicine in 2018. In order to clarify the research progress in FMS and the clinical advantages of TCM/integrated Chinese and Western medicine， the China Academy of Chinese Medicine organized a seminar for nearly 20 experts in Chinese and Western medicine， including rheumatology， psychology， acupuncture and moxibustion， and encephalopathy， with the topic of difficulties in clinical diagnosis and treatment of FMS and advantages of TCM and Western medicine. The recommendations were reached on the difficulties in early diagnosis and solutions of FMS， mitigation of common non-specific symptoms， preferential analgesic therapy， TCM pathogenesis and treatment advantages， and direction of treatment with integrated Chinese and Western medicine. FMS is currently facing the triple dilemma of low early correct diagnosis， poor patient participation， and unsatisfactory benefit from pure Western medicine treatment. To solve the above problems， this paper suggests that rheumatologists should serve as the main diagnostic force of this disease， and they should improve patient participation in treatment decision-making， implement exercise therapy， and fully utilize the holistic and multidimensional features of TCM， which is effective in alleviating pain， improving mood， and decreasing adverse events. In addition， it is suggested that FMS treatment should rely on both TCM and Western medicine and adopt multidisciplinary joint treatment， which is expected to improve the standard of diagnosis and treatment of FMS in China.

Application of multidisciplinary in situ simulation training in the treatment of acute ischemic stroke: a quality improvement project / 世界急诊医学杂志（英文）

@#BACKGROUND: Ischemic stroke refers to a disorder in the blood supply to a local area of brain tissue for various reasons and is characterized by high morbidity, mortality, and disability. Early reperfusion of brain tissue at risk of injury is crucial for the treatment of acute ischemic stroke. The purpose of this study was to evaluate comfort levels in managing acute stroke patients with hypoxemia who required endotracheal intubation after multidisciplinary in situ simulation training and to shorten the door-to-image time. METHODS: This quality improvement project utilized a comprehensive multidisciplinary in situ simulation exercise. A total of 53 participants completed the two-day in situ simulation training. The main outcome was the self-reported comfort levels of participants in managing acute stroke patients with hypoxemia requiring endotracheal intubation before and after simulation training. A 5-point Likert scale was used to measure participant comfort. A paired-sample t-test was used to compare the mean self-reported comfort scores of participants, as well as the endotracheal intubation time and door-to-image time on the first and second days of in situ simulation training. The door-to-image time before and after the training was also recorded. RESULTS: The findings indicated that in situ simulation training could enhance participant comfort when managing acute stroke patients with hypoxemia who required endotracheal intubation and shorten door-to-image time. For the emergency management of hypoxemia or tracheal intubation, the mean post-training self-reported comfort score was significantly higher than the mean pre-training comfort score (hypoxemia: 4.53±0.64 vs. 3.62±0.69, t= -11.046, P<0.001; tracheal intubation: 3.98±0.72 vs. 3.43±0.72, t= -6.940, P<0.001). We also observed a decrease in the tracheal intubation and door-to-image time and a decreasing trend in the door-to-image time, which continued after the training. CONCLUSION: Our study demonstrates that the implementation of in situ simulation training in a clinical environment with a multidisciplinary approach may improve the ability and confidence of stroke team members, optimize the first-aid process, and effectively shorten the door-to-image time of stroke patients with emergency complications.