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·AIM: To compare the clinical effects of 2.2mm coaxial micro-incision and 3.0mm standard incision in cataract phacoemulsification surgery. ·METHODS: A total of 67 patients (80 eyes) were randomly divided into two groups. Cataract phacoemulsification and artificial lens implantation surgery was carried out with 2. 2mm coaxial micro -incision (Group A, 40 eyes) and 3. 0 mm standard incision(Group B, 40 eyes), respectively. The effective phacoemulsification time and average ultrasound energy, corneal endothelial cell count, corneal edema, corneal astigmatism, postoperative visual acuity and postoperative complications were compared between the two groups. ·RESULTS: Effective phacoemulsification time of Group A and Group B was 8. 18 ± 11. 22s and 7. 82 ± 2. 12s, respectively, and the difference had no statistical significance(P> 0. 05); average ultrasonic energy was (17.25 ± 4.22)% and (17.64 ± 4.27)%, respectively, and the difference was not statistical significance(P>0.05). There was no significant difference in endothelial cells between the two groups of corneal endothelial cells at 1wk after surgery compared with that before operation (P>0.05). On the first day after surgery, corneal edema was observed in some patients. There were 9 eyes in Group A,6 eyes in Group B,corneal edema relief or subsidence after 3d to 5d. There was significant difference in corneal astigmatism change between the two groups at 1wk (P<0.05), but there was no significant difference at 1 and 3mo after operation (P>0.05). The changes of corneal astigmatism before and after operation in Group A were insignificant (P>0. 05), while the changes of corneal astigmatism before and after operation in Group B were significantly different (P< 0. 05). At 1 and 3mo after operation, the astigmatism of each group tended to be stable, and the corneal astigmatism in the two groups after 1 and 3mo had no statistical significant difference (P> 0. 05). The uncorrected visual acuity (UCVA) differences of the two groups was statistically significant at 1d,1wk and 1mo after operation (P<0.05), but there was no significant difference between the two groups in UCVA after 3mo (P>0.05). ·CONCLUSION: For soft or medium - hard nucleus cataract, compared with the traditional 3. 0mm small-incision coaxial phacoemulsification, the 2.2mm micro-incision coaxial phacoemulsification can effectively reduce the surgically induced astigmatism, and the astigmatism state is relatively stable, and conducive to early recovery of visual acuity.
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The application of transesophageal echocardiography (TEE) in perioperative monitoring was introduced,and its involvement in non-cardiac surgery was described.The advantages and disadvantages of TEE were analyzed when applied to cardiac and non-cardiac operations for congenital heart disease,coronary disease,vascular heart disease,aorta disease and etc.The abuse of vasoactive drug or fluid is avoided due to subjective evaluation on cardiac function and volume load.TEE facilitates the anesthetist in diagnosis and evaluation of the patient with heart diseases,and the surgeon in immediate assessment of the operation,which can be used for real-time monitoring of cardiac function and hemodynamics.
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Objective:To observe and analyze the effects of information intelligence technology in hospital operation decision.Methods:Relevant factors have been analyzed vertically before and after the application of information intelligence technology in Beijing Cancer Hospital.In this case,data should be analyzed before and after the usage of the information intelligence technology,in terms of medical quality (bed usage,average length of hospitalization,the number of cases,etc.),workloads (number of visits,number of discharged patients,etc.),social benefits (patient satisfaction and employee satisfaction),and economic benefits (total assets,net assets,fixed assets,business income,per capita business income,etc.).Results:Mter the implementation of information intelligence technology,bed occupancy rate and the number of discharged was higher than that before implementation,as well as average length of hospitalization was significantly lower than before.Secondly,the number of visits,discharged persons,total assets,net assets,business income and per capita business income and the satisfaction rate of patients and staff after the implementation of the information intelligence technology were significantly higher than those before.Conclusion:Information intelligence technology could improve medical process and service efficiency,as well as reduce medical disputes and doctor-patient contradiction in hospital operation decision-making.Moreover,the satisfaction of doctors and patients could be ameliorated,manpower and material resources could be saved significantly as well,and the management efficiency would be effectively improved.
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OBJECTIVE:To promote the supervision and management of clinical trial by institution. METHODS:The structure and function of clinical trial management system(CTMS)developed by our hospital and other enterprise together were analyzed to evaluate the application and operation result of CTMS. RESULTS & CONCLUSIONS:CTMS of our hospital is made up of foun-dation,efficiency and strategy. It is equipped with role allocation,information exchange and report,information warning,drug tracking,clinical trial process control,quality control of electronic record,electronic signature and integration and connection with other system,etc. Relevant operation procedure is established to promote standardization and institutionalization of CTMS. Due to the application of CTMS,the cooperation among departments become smoother,and management level have been enhanced in dai-ly management,pharmacy management,subjects and document administration. It also simplifies the work of researcher and reduc-es the human error by the autogeneration of trial records and tables with the system. Consequently,the monitor coveraged through-out all the trial process.
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[Objective]To evaluate the curative effects of the posterior or anterior lumbar interbody fusion for the treatment of superior position intervertebral disc herniation. [Method] Forty-seven patients with superior position intervertebral disc herniation were followed up.There were 29 males and 18 females with mean age of 53.3 years(from 35 to 67 years).Twewty-five patients were treated with posterior lumbar interbody fusion(PLIF)using facet joint autograft and cage additional of pedicle screw internal fixation(posterior way group),and 22 patients were treated with anterior disckectomy,bone graft and plates internal fixation(anterior way group).The mean follow-up time was 53.5?5 months(from 24 to 78 months).The clinical results were compared between two groups.Clinical functional assessment standard was used to evaluate the clinical curative effect.The changes of the therapeutic effects,the radiographic findings and complications were evaluated.[Result]In regard to the operation time and bleeding,the posterior way group was superior to anterior way group.There was no difference between the two groups in clinical recovery rates and nerve root injury rates.Complications included dural tear(n=3),and pedicle screw deviating(n=1) in the posterior way group;and dural tear(n=2),unilateral transient lower extremity paresthesia(n=3),and hard controlled singultation(n=1) in the anterior way group.The rates of bone fusion were 96.00% and 95.45% in the posterior and anterior way groups. [Conclusion] Operation for the superior position intervertebral disc herniation is effective.The posterior lumbar interbody fusion using facet joint autograft and cage additional of pedicle screw internal fixation to shorten the operation time and decrease bleeding is recommend for the treatment of superior position intervertebral disc herniation.