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@#Neurofibromatosis type 1(NF1) is an autosomal dominant hereditary neoplastic disease caused by mutations in the <i>NF1</i> gene. Features of disorder typically appear in early childhood. The clinical phenotypes of the patients are diverse but neurofibromas is the main feature. Patients with NF1 also suffer from multi-system involvement and have high risk of malignant tumor. NF1 poses significant challenges for diagnosis, treatment, follow-up and patients management. Therefore, it is imperative to develop a multidisciplinary collaborative diagnosis and treatment protocol. Under the leadership of China Alliance for Rare Diseases, a multidisciplinary diagnosis and treatment collaborative team for NF1 has been formed and worked out the guideline. This guideline intends to lift the diagnosis and treatment level for NF1 and to provide the guideline for standardized treatment for NF1 patients in China.
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In recent years, organ donation and transplantation have entered a stage of steady development in China. Nevertheless, the shortage of transplant organs and the contradiction between supply and demand of organs are still the bottlenecks to achieve the strategy of "self-sufficiency in organ transplantation" advocated by the World Health Organization (WHO). The key reasons for donor loss described in the "critical pathway of organ donation" defined by the WHO include the identification and referral of potential donors and the maintenance and repair of organs. Smooth development, high efficiency and high-quality development of organ donation cannot be achieved without the support of intensive care medicine, which are highly associated with the cognition, recognition and participation of intensive care unit(ICU) staff. In this article, research progress in ICU staff’s cognition, attitude and willingness for organ donation were reviewed and relevant influencing factors were discussed, aiming to offer targeted suggestions on how to resolve these difficulties.
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Objective To refine and summarize the research status and development trend of organ donation discipline in China. Methods Relevant Chinese and English literatures related to organ donation were searched from China National Knowledge Infrastructure (CNKI) and Web of Science core collection database from January 1, 2018 to December 31, 2022. Visual analysis was performed by the CiteSpace software from the number of published articles, keywords, journal source distribution, cooperation network of core authors, main research institutions, and citation of key literatures, etc. Results A total of 792 articles were published from 2018 to 2022, with an average annual number of 158 articles, which showed a rapidly upward trend. Among them, 182 articles were published in the form of postgraduate dissertation, accounting for 23%. Common keywords included organ transplantation, brain death, cardiac death, willingness/cognition/attitude, legal system, influencing factor/risk factor, infection/complication, Organ Procurement Organization, prognosis/quality, education for college students/medical students, extracorporeal membrane oxygenation, children, ischemia-reperfusion injury, donor-derived infection, ethics, expended criteria donor, nursing and coordinator, etc. Keyword clustering hotspots focused on the theme of “organ donation” and branched into multiple disciplines. The publications of research results were characterized with pluralism and diversity, and the research contents were centered on medicine and spanned a wide range of disciplines. A large proportion of researches were published by the teams from large-scale organ transplantation institutions, and relatively close cooperative relationship was formed within the institutions. However, the intensity of cooperation among different institutions was relatively low, and the cooperative relationship among authors was insufficient, which failed to form an intimate academic network. The top five countries worldwide regarding the number of published articles were the U.S. (n=940), U.K. (n=377), Spain (n=263), Canada (n=241) and China (n=181), indicating that the achievements of Chinese researchers have been gradually recognized in the international academic community. Conclusions From the quantity and content of published articles in recent years, “organ donation” has laid certain research foundation in China. It is one of the topics concerned and widely studied by multiple academic communities in China. Relevant research issues have multidisciplinary, plural and diverse characteristics.
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@#Endodontic microsurgery is a vital treatment modality for teeth with persistent periradicular pathoses that have not responded to nonsurgical retreatment. The principle is to determine the reason for failure, completely eliminate the infection and promote periapical healing. Within recent years, endodontic microsurgery has evolved to become standardized and presents with a high success rate. However, its outcome is still influenced by many factors, including anatomy, periodontal condition, crown-to-root ratio, occlusion, the type of periradicular lesion, and prosthesis. Moreover, endodontists always concentrate on “the apex”, paying little attention to the general preoperative evaluation, accurate diagnosis, and comprehensive treatment plan. This article reviews the latest literature on these issues and the clinical experience of our research group and discusses the correlation between endodontic microsurgery and other oral disciplines, including periodontology, prosthodontics, oral implantology, oral and maxillofacial surgery and orthodontics. The oral interdisciplinary assessment should be made with comprehensive consideration of the root canal system, periradicular lesion, adjacent anatomical relationships, periodontal condition, occlusion, and esthetic rehabilitation. Based on these findings, the continuity of treatment will be optimized, and the best treatment plan will be proposed to provide clinical strategies for the diagnosis and treatment of complex periradicular diseases.
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Anomalous aortic origin of a coronary artery is a rare abnormal coronary artery development disease, which affects myocardial blood perfusion in the absence of significant coronary artery stenosis. Such patients have a high risk of sudden death, and their disease progresses rapidly, and their clinical manifestations are easily confused with myocardial diseases. We report a case of a 13-year-old young patient whose diagnosis was confirmed, the condition was stabilized at an early stage, and the abnormal coronary structure was corrected by coronary decapitation through a multidisciplinary combination of cardiology, cardiac surgery, ICU, and imaging. This article focuses on the diagnosis and treatment of these patients.
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PURPOSE@#Hemodynamically unstable patients with pelvic fractures still represent a challenge to trauma surgeons and have a very high mortality. This study was designed to explore the effect of the interventions of direct preperitoneal pelvic packing for the hemodynamically unstable pelvic fractures.@*METHODS@#This retrospective study enrolled 67 cases of severe pelvic fractures with unstable hemodynamics from October 2011 to December 2019. All patients presented in our emergency center and received preperitoneal pelvic packing were included in this study. The indication was persistent systolic blood pressure ≤90 mmHg during initial resuscitation and after transfusion of two units of red blood cells. Patients with hemodynamic stability who need no preperitoneal pelvic packing to control bleeding were excluded. Their demographic characteristics, clinical features, laboratory results, therapeutic interventions, adverse events, and prognostic outcomes were collected from digital information system of electronic medical records. Statistics were described as mean ± standard deviation or medium and analyzed using pair sample t-test or Mann-Whitney U-test.@*RESULTS@#The patients' average age was 41.6 years, ranging from 10 to 88 years. Among them, 45 cases were male (67.2%) and 22 cases were female (32.8%). Significant difference was found regarding the systolic blood pressure (mmHg) in the emergency department (78.4 ± 13.9) and after preperitoneal pelvic packing in the surgery intensive care unit (100.1 ± 17.6) (p < 0.05). Simultaneously, the arterial base deficit (mmol/L) were significantly lower in the surgery intensive care unit (median -6, interquartile range -8 to -2) than in the emergency department (median -10, interquartile range -14 to -8) (p < 0.05). After preperitoneal pelvic packing, 15 patients (22.4%) underwent pelvic angiography for persistent hypotension or suspected ongoing haemorrhage. The overall mortality rate was 29.5% (20 of 67).@*CONCLUSIONS@#Preperitoneal pelvic packing, as a useful surgical technique, is less invasive and can be very efficient in early intra-pelvic bleed control.
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ABSTRACT: Historically, the agave pulquero (Agave spp.) has played an important ecological, economic, social, and cultural role in Mexico. Based on a systematic exploratory review of 125 scientific documents, four areas of knowledge associated with the study of agave pulquero were identified: i) biochemistry (46,4%), ii) socioeconomics (20%), iii) cultural studies (11,2%), and iv) agroecology (22,4%). Research converges on the need to value and preserve agaves since they can play an important role in rural development actions and the life quality of future societies, depending on the diversity of food, industrial, agro-ecological and cultural uses they provide. However, there is a fragmentary construction of the research problems that prevent a comprehensive vision of the producing territories as subjects of development. It is concluded that it is necessary to generate interdisciplinary perspectives for the valorization of the agave pulquero as an asset of rural development, based on inclusive innovation strategies, adapted to the specific needs of producers and consumers.
RESUMO: Historicamente, o agave pulquero (Agave spp.) tem desempenhado um importante papel ecológico, econômico, social e cultural no México. Com base em uma revisão exploratória sistemática de 125 documentos científicos, quatro áreas de conhecimento associadas ao estudo do agave pulquero foram identificadas: i) bioquímica (46,4%), ii) socioeconomia (20%), iii) estudos culturais (11, 2%) e iv) agroecologia (22,4%). A pesquisa converge para a necessidade de valorizar e preservar as agaves, uma vez que podem desempenhar um papel importante nas ações de desenvolvimento rural e na qualidade de vida das sociedades futuras, dependendo da diversidade de usos alimentícios, industriais, agroecológicos e culturais que proporcionam. No entanto, há uma construção fragmentária dos problemas de pesquisa que impedem uma visão abrangente dos territórios produtores como sujeitos de desenvolvimento Conclui-se que é necessário gerar perspectivas interdisciplinares para a valorização do agave pulquero como um ativo de desenvolvimento rural, baseado em estratégias de inovação inclusivas, adaptadas às necessidades específicas de produtores e consumidores.
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Multidiscipline team ( MDT ) provides comprehensive, cross-discipline treatment solutions and effective diagnosis for major, complicated and rare diseases, featuring significantly clinical outcomes. It deserves efforts on how to introduce MDT from clinical work to hospital administration. To this end, this article discussed the application of MDT model at large-scale public hospital administration. MDT hospital administration teams, and such management methods as project management and PDCA, as well as information technology systems were called into play. These measures have effectively resolved long-standing roadblocks commonly encountered, and removed horizontal barriers, sharply raising work efficiency.
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Objective To study the teaching innovation of the scientific experiment exploration course in biomedical engineering specialty based on its characteristics involving in animal physiological parameters acquisition, circuit system design, signal processing and etc. Methods The course aimed to guide the student in observation learning, practice and inquiry with considerations on course significance,basic principles for designing the course,implementation scheme of course teaching, suggestions for course improvement, instances of practical teaching and etc. Results Four basic principles were proposed for course teaching. An implementation scheme was determined with emphases on teaching materials, theory, practice, discussion and exploration. The course had the rule being inquiry, and some suggestions were put forward about student feedback, scientific research progress, experiment platform renewal and etc. Conclusion Teaching practice proves that the improved course contributes to enhancing the student's understanding of experiment exploration of biomedical engineering specialty and to promoting multi-discipline fusion and cross-over personnel training, and thus is of great reference for other universities.
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Se presenta un paciente del sexo masculino de 36 años de edad, que en el momento del inicio del cuadro clínico, a partir de un trauma leve, debutó con fiebre, dolor y aumento de temperatura a nivel del muslo derecho, se valoró como un posible hematoma abscedado por lo que requirió ingreso y tratamiento quirúrgico. Posterior al alta y dos meses de evolución, regresa al centro hospitalario por presentar una evolución tórpida con un aumento de volumen de tipo tumoral se ingresó, estudió y se valoró por un equipo de especialistas multidisciplinarios decidiendo una nueva intervención quirúgica en base a los resultados de laboratorio y estudios imagino lógicos, se le realizó exéresis de la tumoración (a nivel del vasto externo) con margen oncológico y enviado para anatomía patológica, informado como un sarcoma pleomórfico, llevó posteriormente tratamiento adyuvante de quimioterapia, contando con 10 años de sobrevivencia en la actualidad y totalmente asintomático.
The case of a male patient aged 36 years is presented. The clinical characteristics are the following: after a light trauma, he had fever, pain, temperature increase in the right thigh. It was diagnosed as a possible abscessed hematoma and the patient was admitted in the hospital and surgically treated. After discharging and two-months evolution, he came back to the hospital presenting a torpid evolution with a tumoral-kind volume increase. He was readmitted, studied and evaluated by a team of multidiscipline specialists, who decided a new surgical intervention based on the laboratory and imaging studies. Tumor was removed (at the level of external vastus) with oncologic margin and send to pathologic anatomy. It was informed as a pleomorphic sarcoma. An adjuvant chemotherapeutic treatment was applied later. Currently, the patient has survived 10 years and is totally asymptomatic.
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[Summary] Clinical studies have confirmed that metabolic surgery is an effective method for the treatment of diabetes ,which can significantly relieve symptoms of type 2 diabetes ,improve various complications and reduce cardiovascular events. Currently ,major limitations of this technique in clinical practice in China include the lack of understanding on surgical benefits ,difficulty in selection of surgery indications and division‐based treatment modalities. Thus ,we should explore a cooperation model of multi‐discipline teams ,understand the mechanisms of type 2 diabetes remission by metabolic surgery and develop physician internist leading standard post‐operation management. These strategies will greatly promote the development of metabolic surgery for type 2 diabetes in China.
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<b>Objective：</b>Care Cafe® aims to remove the barriers between medical treatment, nursing, and welfare, particularly with regard to actual practice. This study was conducted to investigate the changes in local integration using the Care Cafe®. <b>Method：</b>Participants in Care Cafe® filled out the questionnaire before and after attending. We used the Mixed Method to compare the results. This method provides analysis on changes in“quantify the quality of communication and cooperation among medical, nursing, and welfare services in a region”scale points, as well as content analysis on the free-opinion space. <b>Results：</b>The“quantify the quality of communication and cooperation”scale points increased significantly overall, as well as on the subscale. The effect size ranged form 0.32 to 0.36. We also had various successes in the content analysis of the free-opinion space, such as building face-to-face relationships in multiple occupations, that being one of the main purposes of Care Cafe®, as well as providing support, learning through discussion, and generating social capital. <b>Conclusion：</b>Care Cafe® may be a useful tool for improving local, multi-discipline cooperation involving medical treatment, nursing, and welfare.
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<b>Aim</b>: Many methods aiming to achieve face-to-face, multi-discipline healthcare cooperation have been attempted in Japan in order to optimize the community care system. There are however, many obstacles to the commencement or successful coordination of meetings, seminars, and workshops for health care professionals, particularly longterm cooperation and financial constraints. We have developed methods to solve these problems. <b>Methods</b>: We invented a new method, called Care Café based on the philosophical and sociological ideals utilized by the World Café. Care Café is held on a regular basis to facilitate communication and cooperation between healthcare professionals with the aim of finding solutions to mutual problems. <b>Results</b>: Care Café has been held on a monthly basis in Asahikawa, where it started. There have been 9 Care Café events in Asahikawa so far, with the number of healthcare professionals in attendance totaling approximately 700. The concept of Care Café is earning greater recognition in Japan, and Care Café events have now been held in 16 different Japanese cities, for an aggregate total of 29 events nationwide. We have received Care Café reports from participating cities detailing successful multi-discipline healthcare cooperation in solving medical issues. <b>Conclusions</b>: Care Café started in Asahikawa. It has been spreading among healthcare professionals nationwide. We expect Care Café to establish and develop new face-toface, multi-discipline healthcare cooperation.