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Innovation is an important way to promote economic development and social progress. Recent years have seen rapid development of biological sciences. In response to social demands and the needs for developing an innovative country, fostering innovative talents in the field of biosciences has become a significant initiative supported by national policies and the needs from talent market. Taking the innovative talent training mode implemented by Zhejiang Normal University in the field of biological sciences as an example, this paper comprehensively introduces several key aspects of the mode. This includes establishing a mentorship system as the foundation, carrying out curriculum reform through project competitions and practical platforms, and promoting synergy among industry, academia, and research in talent training. This training mode has achieved positive results in practice, promoting the training of outstanding innovative talents in biological science majors, and may facilitate the reform of talent training in similar majors.
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Humans , Biological Science Disciplines , Industry , Policy , UniversitiesABSTRACT
@#A cemental tear is defined as an incomplete or complete detachment of the cementum along the dentino-cemental junction (CDJ) or the incremental line within the body of the cementum, which can also involve part of the root dentine adjacent to the cementum. The pathogenesis of cemental tears is not fully elucidated. From the literature review, possible predisposing factors were identified, including tooth type, sex, age, periodontitis, previous periodontal treatment or root canal treatment, history of dental trauma, and occlusal trauma or excessive occlusal force. The morphology of cemental tears can be either piece-shaped or U-shaped, which usually contributes to periodontal and periapical breakdown. Clinically, cemental tears have a unitary periodontal pocket and present with symptoms mimicking localized periodontitis, apical periodontitis, and vertical root fractures. Imaging examination is of great significance for the clinical diagnosis of cemental tears, which often manifest as thin ‘prickle-like’ radiopaque masses located longitudinally adjacent to the affected root surface. Exploratory surgery is needed in some cases. Although intraoperative cemental fragments and cemental lines on the root surface can assist in the diagnostic process, histopathology examination is the gold standard for the diagnosis of cemental tears. The treatment methods vary depending on the timing of the correct diagnosis and the clinical or radiological manifestations. With the development of regenerative biomaterials and the development of intentional replantation, an increasing number of affected teeth can survive for a long time. The aim of this review is to systematically describe the biological basis and predisposing factors, clinical features, radiographic and histological characteristics, diagnosis and clinical management of cemental tears, and treatment outcomes to help make a clear diagnosis and develop a personalized treatment plan.
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@#Objective To analyze a new classification of the left apicoposterior segmental bronchus and summarize its clinical significance. Methods We accessed the computed tomography imaging data of the inpatients treated in the Department of Thoracic Surgery, Henan Provincial People's Hospital between January and November 2021. We observed and classified the branching pattern of the left apicoposterior segmental bronchus (B1+2) using three-dimensional computed tomography bronchography and angiography (3D-CTBA) technique. And we filtered out the patients who underwent thoracoscopic left apicoposterior segmentectomy and analyzed their clinical data retrospectively to summarize the instructing significance of different bronchial classification in the accurate and safe operation of left apicoposterior segmentectomy. Results Finally 240 patients were collected, including 131 males and 109 females with a median age of 51.0 (19.0-77.0) years. The anatomical pattern of the left apicoposterior segmental bronchus was divided into four main types based on the branching pattern of the outer subsegmental bronchi (B1+2c): type Ⅰ 10% (24 patients), type Ⅱ 54% (130 patients) , type Ⅲ 17% (40 patients) , type Ⅳ 18% (43 patients) and other variations 1% (3 patients). Thirty-two patients smoothly underwent thoracoscopic left apicoposterior segmentectomy, including 23 patients of type Ⅰ and type Ⅱ receiving LS1+2 resection, the other 9 patients of type Ⅲ and type Ⅳ receiving LS1+2 resection (3 patients), LS1+2c resection (4 patients) and LS1+2(a+b) resection (2 patients). Conclusion This new classification systematically and concisely elucidates the branching characteristics of the left apicoposterior bronchus. Different branching types are instructive to the left apicoposterior segmentectomy.
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Objective To explore the changes of metabonomics in blood of mice after high-voltage electric shock,then screen out the significantly changed differential metabolites and metabolic pathways.Methods The head of C57BL/6J mice was subjected to high-voltage electric shock(electric shock group)or exposed to acoustic and optical stimulation of high-voltage electric(control group),then the whole blood from mice were collected to separate serum.The dual platform combined metabonomic analysis based on gas chromatography-mass spectrometer(GC-MS)and liquid chromatography-mass spectrometer(LC-MS)was performed and orthogonal partial least squares discriminant analysis(OPLS-DA)was used to screen the differential metabolites and related metabolic pathways.Results A total of 415 differential metabolites were screened out in metabonomics in blood of mice after high-voltage electric shock,including 187 up-regulated and 228 down-regulated metabolites.These differentially metabolites were significantly enriched in metabolic pathways including central carbon metabolism in cancer,glucagon signaling pathway,etc.Conclusion By establishing the model of high-voltage electrical injury on experimental mice,this study reveals the significant change of metabolite content and metabolic pathway in blood by high-voltage electrical injury.Which provides a basis for the damage of blood metabolic activity by high-voltage electrical injury,and suggests the potential harm of high-voltage electrical injury to blood metabolic activity in the whole body.
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Objective:To conduct empirical research on the economic operation monitoring and evaluation index system of public hospitals in Guangzhou,and analyze the economic operation of sample public hospitals based on the comprehensive evaluation re-sults.Methods:A total of 15 public hospitals in Guangzhou are selected as samples,and their data from 2020 to 2022 are selected for standard deviation standardization.The standardized scores of each hospital were calculated and summarized by multiplying the standardized values of each index by its weight,and analyzed and compared.Results:The economic performance of these three types of hospitals in 2022 is not ideal,and there is room for improvement in risk management and development management.Among them,comprehensive hospitals and specialized hospitals have the highest scores in 2021,followed by 2022,and the lowest scores in 2020;traditional Chinese medicine hospitals have the highest score in 2021,followed by 2020,and the lowest score in 2022.Conclusion:The indicator system meets the development requirements of public hospitals,and the indicator data can be obtained,which is suit-able for monitoring and evaluating the economic operation of public hospitals.
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Objective:To analyze and explain the influences of the professional background of the directors of public hospitals on the economic operation of the hospital,and to provide research support for training compound hospital management talents and improving the relevant policies of public hospital director management.Methods:The fixed effect model was used to conduct a quantitative analysis based on the data of individual directors and hospital economic performance of public hospitals in Guangdong from 2005 to 2018.Results:Compared with hospitals whose directors without clinical medical backgrounds,the medical income,the number of admissions and medical expenditure of the hospitals whose directors with clinical medical backgrounds were lower,and turnover of bed rate was higher,the differences were statistically significant(P＜0.05).Compared with hospitals where the directors had not obtained a degree related to management and did not participate in management training,the asset-liability ratio and management cost of the hospital where the directors had obtained a degree or participated in the training were lower,and the liquidity ratio was higher,with statistical significance(P＜0.05).Conclusion:For the economic operation indicators closely related to clinical work,directors with clinical medical background have a more significant impact because of their advantages in clinical front-line learning and work experience.For the economic operation indicators closely related to asset management,administration and cost management,directors with management learning experience can better reveal and exert their advantages in applying advanced management concepts,methods and tools,and have a more significant impact.
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Objective:To analyze the current economic operation status of public hospitals at all levels and types in Beijing,and propose corresponding policy recommendations.Methods:Quantitative analysis was conducted on the economic operation status of public hospitals at all management levels,levels,and types in Beijing from 2019 to 2021.Results:The efficiency of inpatient services in tertiary hospitals is higher than that in secondary hospitals,while the efficiency of outpatient services in tertiary hospitals is lower in secondary hospitals.The proportion of financial allocation revenue and personnel expenses in central level hospitals is relatively low,and the balance of income and expenditure is better than that of municipal and district level hospitals.The income structure of comprehensive hospitals is gradually optimized,and the balance of income and expenditure in specialized hospitals is relatively good.Conclusion:The government plays a"baton"role in policy guidance,combining the functional positioning and disciplinary characteristics of public hospitals,optimizing the allocation of medical resources,and improving operational efficiency.The pricing authority will further improve the dynamic adjustment mechanism for medical service prices.The hospital formulates cost management goals based on the characteristics of the department,achieving"one policy for one department".Hospitals adhere to the principle of suitability,while ensuring medical quality,reasonably control costs and achieve maximum resource efficiency.
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Objective:Efficiency is a key factor in the sustainable operation of the medical insurance system.By measuring the current efficiency of the urban employee basic medical insurance system in 31 provinces in China from 2020 to 2021,it discovers possible problems,and provides reference suggestions for improving the efficiency of the system.Methods:Using the super efficiency SBM model based on unexpected output and the Malmquist index to measure the static and dynamic efficiency of employee medical in-surance in 31 provinces in China,and using Tobit regression analysis to analyze its influencing factors.Results:The overall compre-hensive efficiency of the national employee medical insurance operation is 0.826 in 2020 and 0.827 in 2021 respectively.The efficien-cy of employee medical insurance operation in the eastern region is significantly higher than that in the central and westem regions.Over 60％of provinces have inefficient operation of employee medical insurance.The overall total factor productivity of employee medical insurance operation is showing a downward trend,and the decline in technological progress is the main limiting factor.The level of economic development has a significant promotion effect on the efficiency of employee medical insurance operation,and the degree of population aging has a significant inhibitory effect on it.Conclusion:The efficiency of employee medical insurance opera-tion in China still needs to be improved,and there is a significant efficiency gap among different regions.Therefore,investment and attention should be increased in the central and western regions to bridge regional gaps and promote the equity development of medi-cal insurance.Therefore,the reform efforts should be continuously intensified to achieve technological progress.In addition,attention should also be paid to the driving role of economic development in the efficiency of employee medical insurance operation and the for-mulation of positive policies on population aging.
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Literature analysis,expert consultation,case analysis and other methods were used to establish a public hospital specialty operation evaluation system suitable for high-quality development,including 2 first-level indicators of medical ability and economic operation and 13 second-level indicators.Urology surgery in the pilot hospital was taken as an example to carry out surgical operation effect evaluation.To strengthen the evaluation of public hospital specialized operation,it should pay attention to the evaluation of medical capacity,strengthen the cooperation of functional departments,and improve the supporting policies of operation,for better promoting the development of high-quality operation of hospitals.
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Through the SWOT analysis of the operating room of a public hospital,it finds out the blocking points and pain points in the operating room during the operation process.Combined with PDCA circular management,it breaks the difficulties in the operating room process,and truly penetrates the concept and essence of"improving quality and efficiency"into the daily operation and management of the operating room,further implements refined management,and promotes the high-quality and sustainable development of the hospital.
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Aiming at the background of budget management reform in public hospitals and the problems existing in the implemen-tation process,it discusses how to strengthen procurement budget management from the perspective of operation management,im-prove the efficiency and effect of budget funds,reduce costs and increase efficiency,prevent risks,and promote high-quality development.It is suggested that efforts should be made to connect procurement budget management with the top-level design of public hospital development,explore the coordination between fund budget and project process management,unify rigid budget constraints with dynamic adjustment,and establish a multi-dimensional,whole-process procurement budget performance evaluation system.
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Objective:To summarize the surgical management experience on intestinal fistula(IF)patients with phasedtherapy and staged operation.Methods:Retrospectively analyzing the clin-ical data of 255 IF patientsin Beijing Tsinghua Changgung Hospital from January 2016 to December 2019,including age,gender,primary disease,IF causes,IF locations,IF numbers,IF natures,IF times,IF diagnoses and evaluations,nutritional risks,nutritional support,and infection statuses.Ac-cording to the pathophysiological characteristics of IF patients,IF therapy included three phases:Phase Ⅰ(IF acute onset),Phase Ⅱ(IF stable maintenance),Phase Ⅲ(IF deterministic operation).The IF deterministic operation included one-stage operation and multi-stage operation.The relationship between strategies and effects were analyzed in each treatment stage.Results:All 141 patients in Phase Ⅰ entered into Phase Ⅱ,in which 112 cases received complete treatment,28 cases gave up,and 1 case died.In 112 caseswho received complete treatment,75 cases were cured(83.7％),37 cases remained infected.The 37 cases that remained infected were combined with the 114 cases who were primarily hospitalized at Phase Ⅲ,were classified into 151 cases who received IF deter-ministic operations,in which 134 cases received stage Ⅰ surgery,and 17 cases received multi-stage surgery.138 cases were cured(91.4％).Conclusion:Intestinal fistula patients could exhibit a better cure ratio throughphasestherapy,which include the acute onset phase,stable maintenance phase,and deterministic operation phase.It is important to classify IF patients into the correct phase and conduct the corresponding treatment.The staged operations are also the key to the intestinal fistula-surgical strategy.
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Objective:To establish an ultrasound prediction model of postoperative recurrence in patients with papillary thyroid carcinoma(PTC)after complete endoscopic radical surgery.Meth-ods:264 patients with PTC who underwent complete endoscopic radical surgery for the first time in our hospital from February 2017 to March 2020 were retrospectively collected.They were divided in-to recurrence group and non recurrence group according to whether there was recurrence after surgery.The clinical data,nodule diameter,nodule number,internal echo,microcalcification and other ultrasonic data of the two groups were compared.Single factor,Lasso and Logistic regression mod-els were used to analyze the influencing factors of postoperative recurrence of PTC patients,and an nomogram model was established based on the selected indicators.Results:Compared with the non recurrence group,the patients in the recurrence group had larger nodule diameter,irregular nod-ule edge,aspect ratio＞1,microcalcification and capsule invasion(P＜0.05).Nodular diameter＞10 mm,irregular edge,aspect ratio＞1,microcalcification and capsule invasion were independent risk factors for postoperative recurrence of PTC patients(P＜0.05).The C-index of the constructed nomogram model was 0.756(95％Cl:0.684～0.830),and the AUC of the ROC curve was 0.895(95％Cl:0.866～0.915);The calibration curve results show that the average deviation is 0.027,and the predic-tion probability fits the actual probability well;The clinical decision curve is far away from the extreme curve and has good clinical applicability.Conclusion:The nomogram model based on nodule size,irregular margin,microcalcification,aspect ratio＞1,and capsule invasion has good accuracy in pre-dicting the recurrence of PTC patients after complete endoscopic radical surgery,and has certain clinical significance.
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Objective To investigate the effect of Qufu Shengji ointment combined with ulinastatin in the treatment of wound healing after perianal surgery and its effect on the level of inflammatory factors.Methods Patients who underwent perianal surgery in Guilin Hospital of Integrated Traditional Chinese and Western Medicine from July 2020 to January 2022 were randomly divided into control group and test group.The patients in both groups were treated with conventional debridement therapy and ulinastatin,and the test group was treated with Qufu Shengji ointment.The wound healing efficacy,TCM symptom score,inflammatory factor level,growth factor level and treatment safety of the two groups were compared.Results A total of 116 patients were included in the study,including 58 patients in the test group and 58 in the control group.The total effective rate of the test group(91.38％)was higher than that of the control group(75.86％),and the difference was statistically significant(P＜0.05).After treatment,the TCM syndrome score levels of interleukin-17A(IL-17A),C-reactive protein(CRP)and serum amyloid A(SAA)in the test group were lower than those in the control group(P＜0.05).The levels of vascular endothelial growth factor receptor 1(VEGFR1),fibroblast growth factor receptor(FGFR)and transforming growth factor-β1(TGF-β1)were higher than those in the control group(P＜0.05).The anal function index was higher than that of the control group(P＜0.05).The incidence of adverse reactions between the two groups was 13.79％and 8.62％,respectively,and the difference was not statistically significant(P＞0.05).Conclusion The effect of Qufu Shengji ointment combined with ulinastatin in the treatment of wound healing after perianal surgery is significant,which can improve the TCM syndrome,reduce inflammatory factors,and upregulate growth factors,and has good safety.
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Objective:Based on the relevance risk analysis of medical equipment,to formulate process management strategies to improve the clinical operation efficiency of medical equipment.Methods:The risk matrix was evaluated from the perspectives of subject,quality,environment,system and diagnosis and treatment perspective,the comprehensive evaluation model of relevance risk was established,and multiple process management countermeasures were formulated.400 sets of medical equipment in clinical use in Shanghai Eighth People's Hospital from April 2021 to March 2022 were selected and divided into the control group and the observation group by the digital table method,with 200 sets in each group.The control group adopted the individualized risk analysis method for process management,and the observation group adopted the relevance risk analysis method for process management.The risk level and operation benefits of the two groups of medical equipment were compared and analyzed.Results:The high risk rates of medical imaging diagnostic and auxiliary equipment,surgical treatment equipment,life support and first aid equipment,extracorporeal circulation and blood processing equipment,health monitoring and rehabilitation equipment in the observation group were 17.39%(4/23),14.58%(7/28),12.24%(6/49),5.55%(1/18)and5.06%(5/62),respectively,which were lower than those in the control group,the difference was statistically significant(x2=4.132,4.009,6.275,4.833,4.859,P<0.05).The scores of cost benefit,social benefit,diagnosis and treatment benefit and development benefit of medical equipment in the observation group were(91.37±6.15)points,(92.78±3.80)points,(95.25±2.09)points and(90.51±3.82)points,respectively,which were higher than those in the control group,the difference was statistically significant(t=2.392,3.877,4.841,2.504,P<0.05).Conclusion:The relevance risk analysis method can reduce the probability and hazard degree of medical equipment safety risks,improve the clinical operation efficiency of medical equipment,and the process management strategy is in line with the actual needs of the medical equipment lifecycle management.
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Objective:To build a data-driven operation and maintenance management model for large-scale medical imaging equipment,and to analyze its application value in medical equipment management.Methods:The data-driven operation and maintenance management mode of large-scale medical imaging equipment was composed of operation and maintenance management mode architecture,equipment health status monitoring management platform architecture,historical data fault diagnosis model architecture and operation and maintenance management.16 medical imaging equipment in clinical use in Chengdu Public Health Clinical Medical Center from January 2020 to February 2022 were selected,and the traditional medical imaging equipment operation and maintenance management mode(referred to as traditional mode)and data-driven large-scale medical imaging equipment operation and maintenance management mode(referred to as data-driven mode)were adopted respectively for management according to different management modes.The imaging effect of equipment image,the frequency of equipment failure,the cost effectiveness of equipment and the satisfaction score of equipment management personnel were compared between the two management modes.Results:The scores of accuracy of diagnosis results,accuracy of patient information,image position qualification rate,image clarity,image pass rate,image quality rate and total image imaging score of the data-driven model were(9.78±1.25)points,(9.88±1.11)points,(9.54±1.08)points,(9.66±1.27)points and(9.83±1.43)points,(9.86±1.63)points and(58.55±1.44)points,respectively,which were higher than those in the traditional mode,the difference was statistically significant(t=4.958,5.268,6.522,4.327,9.765,3.923,21.474,P<0.05).The self-repair and human-made failures occurred 22 times and 10 times respectively in the data-driven model,which were lower than those of the traditional model,and 24 times of long-term use faults,which was higher than that of the traditional model,the difference was statistically significant(x2=4.363,4.294,18.692,P<0.05).The satisfaction scores of radiologists,equipment maintenance personnel,imaging technicians and patients with the data-driven mode were(94.52±6.15)points,(91.19±5.35)points,(89.27±4.93)points and(92.24±5.51)points,respectively,which were higher than those of the traditional mode,the difference was statistically significant(t=6.504,5.534,6.821,9.556,P<0.05).Conclusion:The operation and maintenance management mode based on data driven of large medical imaging equipment can improve the imaging quality of imaging equipment,reduce the incidence of failure,reduce equipment maintenance and maintenance costs,and improve user satisfaction.
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Optimizing operation management mode is the core task to promote the high-quality development of public hospitals.Drawing on the typical experiences and practices of operation and management of representative in-ternational hospitals in the United States,the United Kingdom,Singapore and West China Hospital of Sichuan Univer-sity,Shanghai Jiao Tong University School of Medicine Affiliated Xinhua Hospital,Jilin University China-Japanese Union Hospital of Jilin University,and carrying out a full range of comparative analyses.Put forward the new situation of China's public hospital operations and management to establish a"big operations management"concept.By iden-tifying the operation management role,rationalizing the operation management organization structure and training operation management compound talents to discuss stablishing a committee system,integrating multi-departmental resources to form a scientific and sound problem identificaiton,feedback,consultation and improvement of working mechanism,and promote the high-quality development of publit hospitals.
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Comprehensively improving the new efficiency of high-quality development of public hospitals is the key top-level design for deepening the reform of public hospitals during the"14th Five-Year Plan"period.In view of the changes in the macro environment faced by public hospitals in recent years,such as the cancellation of the addi-tion of pharmaceutical consumables and the deep promotion of the reform of payment methods,as well as the out-standing problems existing at the micro level of public hospital operation,such as the separation of diagnosis and treatment business from economic operation activities,extensive decision-making methods,unreasonable alloca-tion of resources and urgent optimization of processes.By referring to relevant theories such as value management theory,a new"trinity"public hospital lean operation management model based on"integration of industry and fi-nance,lean operation and evidence-based decision-making"is explored and constructed.It breaks the relatively parallel operation barriers of clinical diagnosis and treatment business and economic operation management,innovates a new method of linear staff management with the integration of industry and finance,gives full play to the role of experts in governing hospitals,and integrates the professional committee system driven by"technology+manage-men"into the hospital decision-making staff system to provide data evidence-based basis for assisting the hospital leadership to make scientific decisions.
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Pulmonary nodular lesions include benign and malignant pulmonary nodules. Lung adenocarcinoma is the most common type of malignant pulmonary nodules. Lung adenocarcinoma includes precursor gland lesions minimally invasive adenocarcinoma, invasive mucinous adenocarcinoma and invasive non mucinous adenocarcinoma. The surgical methods and prognosis vary depending on the pathological subtypes. At present, it is proposed that the proportion of micropapillary, solid components in tumor alveolar dissemination and subtypes directly affect surgical methods and prognosis. Therefore, this article proposes that wedge lung resection can be performed for precursor glandular lesions. Subpulmonary lobectomy can be performed for minimally invasive adenocarcinoma. Invasive adenocarcinoma requires lobectomy and lymph node dissection. Even if patients with stage Ia lung adenocarcinoma who contain solid components in tumor alveolar dissemination , micropapillary, and pleural invasion components are recommended for postoperative adjuvant treatment.
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Objective:To evaluate the effect of ultrasound-guided subserratus anterior plane block on postoperative analgesia in patients un-dergoing laparoscopic radical gastrectomy.Methods:Sixty patients who underwent elective laparoscopic radical gastrectomy were enrolled between May 2022 and October 2023 at Tianjin Medical University Cancer Institute&Hospital.Patients were assigned into two groups us-ing a random number table method:the control(group C)and the ultrasound-guided serratus anterior plane block(SAPB)(group S).Patient-controlled intravenous analgesia(PCIA)was administered at the end of the surgery.After surgery,visual analogue scale(VAS)of static pain scores was evaluated at 1,6,12,24,and 48 hours.PCIA pump was started at the VAS pain score≥4 after surgery,and sufentanil 0.1μg/kg was intravenously injected when the efficacy was inadequate.The requirement for PCIA use,time to first postoperative anal exhaust,first postoperative out-of-bed activity,first oral intake,and the duration of hospitalization stay were recorded for the two groups.Results:VAS scores were significantly lower at postoperative 1,6,and 12 h in group S than in group C(P<0.05).Additionally,the number of effective uses of PCIA,and rescue analgesia were significantly lower in group S[(6.1±0.4)(2)]than in group C[(18.6±1.4)(17)](P<0.001).The time to first postoperative anal exhaust,first postoperative out-of-bed activity,first oral intake,and duration of hospital stay were shortened in group S than in group C(P<0.05).There were no significant differences in other parameters between these two groups.Conclusion:Ultrasound-guided SAPB can reduce postoperative pain and facilitate fast recovery in laparoscopic radical gastrectomy patients.