Open surgical approach for two coincidental splenic artery aneurysms: a case report / 世界急诊医学杂志（英文）

@#Several factors can contribute to the formation of aneurysms, including hemodynamic changes, polyarteritis nodosa, bacterial endocarditis, vasculitis, fibromuscular dysplasia, vascular malformation, and cystic medial necrosis.[1,2] Surgery is recommended for splenic artery aneurysms (SAAs) greater than 25 mm in diameter, and several surgical approaches are used, including open surgery, laparoscopic surgery, and percutaneous embolization. Laparoscopic surgery might be associated with an increased risk of pancreatic leakage compared to the open surgery approach. Open surgery without complete aneurysm resection should be preferred for patients with large SAAs in close contact with the pancreas. Here, we report a patient with two splenic artery aneurysms.

The observation on the efficacy of super-selective renal artery embolization in the treatment of patients with traumatic renal hemorrhage who failed to respond to conservative treatment / 中国医师进修杂志

Objective:To evaluate the efficacy of super-selective renal artery embolization (SRAE) in the treatment of patients with traumatic renal hemorrhage who failed to respond to conservative treatment.Methods:A total of 64 patients with traumatic renal hemorrhage admitted to Wenling First People′s Hospital from May 2018 to May 2020 were selected as the study subjects. All patients were treated with SRAE, the clinical efficacy, angiographic performance, renal function, complications, postoperative blood transfusion rate and renal retention rate of the patients were observed.Results:There were 62 cases among 64 cases with traumatic renal hemorrhage were successfully embolized once, with a success rate of 96.88%(62/64). By angiography, 46.88%(30/64) of the patients had pseudoaneurysms, 29.69% (19/64) had renal arteriovenous fistula, 9.38% (6/64) had pseudoaneurysms complicated with renal arteriovenous fistula and 14.06% (9/64) had contrast extravasation. Bleeding points were observed in all patients, and the proportions of 1 bleeding point, 2 bleeding points and 3 bleeding points were 73.44%(47/64), 20.31% (13/64) and 6.25% (4/64), respectively. The proportions of upper, middle and lower bleeding points were 18.75% (12/64), 37.50% (24/64) and 43.75% (28/64). On the 7th day after the surgery, the levels of hemoglobin (Hb) and haematocrit (Hct) were higher than those before surgery: (91.79 ± 23.58) g/L vs. (90.45 ± 22.31) g/L, 0.272 ± 0.070 vs. 0.262 ± 0.068; the level of serum creatinine (SCr) was lower than that before surgery: (82.97 ± 25.32) μmol/L vs. (84.57 ± 24.51) μmol/L, the differences were statistically significant ( P<0.05). The total incidence of postoperative complications was 26.56% (17/64). The renal retention rate was 100.00% (64/64) and the proportion of blood transfusion patients was 39.06% (25/64). Conclusions:SRAE can play a good hemostatic effect in patients with traumatic renal hemorrhage that failed to respond to conservative treatment. It is safe and reliable with a low incidence of complications, and can better protect renal tissue function.

Construction of medical ethics counseling system in China / 中华医院管理杂志

This paper, on top of its introduction of the concept of medical ethics counseling, analyzed the necessity of establishing a medical ethics consultation system in China.By reviewing the development of the medical ethics counseling system in other countries, the authors, in view of China′s medical practice, put forward specific recommendations on establishing a medical ethics counseling system in China.Issues on the construction of organ donation ethics counseling system in China were also discussed in focus.

Research on hospital social work at public hospitals in Zhejiang province / 中华医院管理杂志

Objective To learn the social demands and development status of social work for the hospitals and explore optimization strategies.Methods 9 general hospitals and specialist hospitals in Zhejiang were surveyed, to identify the existing systemic, structural and mechanical problems of the social work at its initial stage.Results 39.7％ of the medical staff and 10.6％ of patients and their families knew and heard of the hospital social work,and 84.1％ of the medical staff and 50.4％ patients and their families have different levels of requirements for hospital social work.Hospital social work is poorly positioned functionally, in terms of the responsibilities and service coverage;those workers engaged are poorly professional.Conclusion Social work of public hospitals should develop from a top-level design and overall planning, and clear systematic and structural roadblocks found in such key elements as policies and systems, functional positioning, duty scope, service scope, organizational structure, team building and social recognition.These efforts will provide support and guarantee for the professional development hospital social work.