Design and application of an information management platform for medical device innovation and transformation / 中华医学科研管理杂志

Objective:To promote clinical innovation and patent transformation, Ningbo First Hospital built a medical device innovation and transformation management information platform to optimize the supply of clinical innovation and transformation resources and explore a new path of clinical innovation and transformation management.Methods:A series of processes of medical device innovation research, patent declaration, and transformation were managed by the cloud data platform based on Springboot micro-service architecture. The functions and practices of the medical device innovation and transformation management information platform were elaborated on in detail, and the problems in the platform construction were discussed.Results:The medical device innovation and transformation management information platform has been accepted and recognized by clinical care, enterprises, and third-party agents for shortening the research and development and transformation time of innovative projects.Conclusions:The medical device innovation and transformation management information platform can promote the output and achievement transformation of clinical innovative projects.

Effect of standardized process management of early enteral nutrition after operation on rapid recovery of elderly patients with gastric cancer / 中华临床营养杂志

Objective To explore the clinical effect of applying standard process management in early enteral nutrition support for elderly patients with gastric cancer after operation. Methods A total of142 elderly patients with gastric cancer in our hospital were randomly divided into control group ( n=71) treated with the traditional nursing of enteral nutrition and intervention group ( n=71) adopting the standardized process man-agement, and then enteral nutrition tolerance, complications, nutritional status and recovery of gastrointestinal function were compared between the two groups. Results There was no significant difference in age, sex and preoperative nutritional condition and operation situation between the two groups ( P>0. 05) . The incidence of nutritional intolerance and the cost of nutritional support were lower than those in the control group ( P<0. 05) . The completion rate of enteral nutrition target in the intervention group was significantly higher than that in the control group ( P<0. 05) . The anal exsufflation time and defecation time of patients in the intervention group were shorter than those in the control group ( P<0. 05) . There was no significant difference in pulmonary infec-tion, incision infection and postoperative hospital stay between the two groups ( P>0. 05 ) . Conclusions Standardized process management of early enteral nutrition after operation could significantly improve the toler-ance of enteral nutrition, meanwhile, it has positive significance in promoting rapid recovery of elderly patients with gastric cancer.

Effect of early enteral nutrition and parenteral nutrition on the postoperative outcomes of patients with gastric cancer and nutritional riskin enhanced recovery after surgery / 中华临床营养杂志

Objective@#To explore the effect of early enteral nutrition(EEN) and parenteral nutrition(PN) on the postoperative outcomes of patients with gastric cancer and nutritional risk in enhanced recovery after surgery.@*Methods@#A total of 130 patients with gastric cancer hospitalized in department of surgery of Ningbo First Hospitalfrom September 2016 to May 2018 were selected and divided into early enteral nutrition support group (EEN) which was placed with jejunal nutrition tube during the operation, and enteral nutrition started within 12-24 hours after the operation, and parenteral nutrition support group (PN) which was given parenteral nutrition support one day after surgery. Patients in both groups were given nutrients of equal heat and nitrogen.The incidence of nutrition-related complications, the incidence of infection-related complications, the length of postoperative hospital stay and the time of anal exhaust were compared between the two groups.@*Results@#The incidence of nutrition-related complications was 10 cases (15.38%) and 4 cases (6.15%)in EEN group and PN group, that was not statistically different (P=0.157). The incidence of infection-related complications was 3 cases (4.61%) and 5 cases (7.69%) in EEN group and PN group, that was not statistically different (P=0.715). The postoperative hospital stay was 11 days (range, 10-15) and 12 days (range, 11-13)in EEN group and PN group, that was not statistically different (P=0.233). The first anal exhaust time and defecation timewere 64 hours (range, 52-77) and 87 hours (range, 76-100) in EEN group and 72 hours(range, 60-86) and 96 hours(range, 86-120) in PN group, that was statistically different(P=0.001, P=0.034).@*Conclusion@#Enhanced recovery after surgery, early enteral nutrition after gastric cancer surgery may promote the recovery of intestinal function, but the complications and hospital stay after operation are not improved.

Clinical observation of " needles therapy" in treating acute cerebral infarction and its effect on autophagy / 中国针灸

<p><b>OBJECTIVE</b>To observe the difference of clinical efficacy between " needles therapy" and conventional acupuncture in patients with acute cerebral infarction (ACI) and its relationship with autophagy.</p><p><b>METHODS</b>Sixty patients with ACI were randomly divided into an observation group (30 cases and 2 dropping) and a control group (30 cases and 3 dropping). Conventional drugs were applied in the two groups. In the observation group, acupuncture was applied at Dazhui (GV 14), Fengchi (GB 20), Qiangjian (GV 18), Baihui (GV 20), Shenting (GV 24), Yintang (GV 29), Shuigou (GV 26), Quchi (LI 11, affected side), Hegu (LI 4, affected side), Zusanli (ST 36, affected side), and EA was connected at Baihui (GV 20) and Yintang (GV 29). After 30 min, the EA and non-governor vessel acupoints were removed, and the governor vessel points were continued for 20 min. Twirling was used twice every 5 min, 1 min a time. In the control group, acupuncture was applied at Baihui (GV 20), Yintang (GV 29), Quchi (LI 11, affected side), Waiguan (TE 5, affected side), Shousanli (LI 10, affected side), Hegu (LI 4), Zusanli (ST 36), Sanyinjiao (SP 6, affected side), Taixi (KI 3, affected side), Taichong (LR 3, affected side). EA was connected at Zusanli (ST 36) and Hegu (LI 4). The treatment was given for 10 days, once every day with needle retained for 30 min. National Institute of Health stroke scale (NIHSS), mini-mental state examination (MMSE), modified Barthel index (MBI) scores were observed before and after treatment in the two groups. The clinical efficacy, the changes of contents of LC3-II and Beclin1 in peripheral serum were judged.</p><p><b>RESULTS</b>After treatment, NIHSS score was lower than that before treatment, and MMSE score and MBI score were higher than those before treatment (all <0.01), and the result in the observation group was better than that in the control group (all <0.05). Contents of LC3-Ⅱ and Beclin1 in peripheral serum were higher than those before treatment in the two groups (both <0.01), and the result in the observation group was better than that in the control group (both <0.05). The total effective rate in the observation group was 92.9% (26/28), which was better than 70.4% (19/27) in the control group (both <0.05).</p><p><b>CONCLUSION</b>" needles therapy" have better effect to relieve the clinical symptoms of patients with acute cerebral infarction than conventional acupuncture, which may be related to the increasing number of autophagic bodies and autophagy activity.</p>

Compliance of breast cancer patients with postoperative peripherally inserted central catheter in upper limb motion / 中华临床营养杂志

Objective To investigate compliance of breast cancer patients with postoperative peripherally inserted central catheter (PICC) in terms of upper limb motion, to formulate practical plan of upper limb motion, and to improve the compliance in the patients with PICC catheter.Methods A total of 75 patients after breast cancer operation with PICC for chemotherapy were selected from Department of Thyroid and Breast Surgery for upper limb activity instructions.Plan-Do-Check-Act method was used to evaluate the feasibility and effectiveness.Two cycles were performed in two weeks.Patients' compliance was assessed by the inquiry method.Results After practicing and refining nursing process, perfecting the risk assessment table, adjusting the education time, etc., the cognition and acceptance of the significance of upper limb motion were improved in the patients.The compliance of the patients to the upper limb motion instructions was satisfactory.Conclusions The upper limb motion scheme in this study was modified and perfected through application, research, and practice.This scheme could enhance the compliance of patients in terms of upper limb motion.

Surgical treatment of pancreatic cystic neoplasms / 临床肝胆病杂志

Cystic neoplasms of the pancreas are rare lesions,usually without typical clinical manifestations.This article summarizes the clin-icopathological features and surgical treatment of common cystic neoplasms of the pancreas,including serous cystic neoplasm (SCN),mu-cinous cystic neoplasm (MCN),intraductal papillary mucinous neoplasm (IPMN),and solid pseudopapillary neoplasm (SPN).The clini-copathological features are independent prognostic factors for patients.More attention should be paid to correct diagnosis and appropriate sur-gical strategy for each cystic neoplasm of the pancreas.