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This article summarizes the current status of the application of ablation in thyroid tumors with reference to relevant guidelines and expert consensus.The application of ablation in treating benign thyroid tumors has gradually gained maturity in recent years,but the application in malignant thyroid tumors is controversial.Currently,some clinical practices are constantly trying to broaden the application of ablation in treating malignant thyroid tumors.Ablation,which is mainly applied to benign thyroid tumors,has good prognosis and high patient satisfaction.Since this technique cannot avoid the potential recurrence risk of malignant thyroid tumors or eradicate local or distant occult metastases,the indications for the use of ablation in malignant thyroid tumors should be strictly controlled.
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For the past few years, the indocyanine green fluorescence imaging has been widely used in the diagnosis and treatment of biliary tract diseases. Fluorescence visualization of the biliary system by indocyanine green accurately localize the diseased tissue and identify the biliary structures precisely, which effectively avoids the damage to the natural biliary structure and greatly improves the accuracy and safety of biliary surgery. However, the application of this new technology in biliary surgery is still at the exploratory stage, showing great potential for application while also exposing many problems and controversies. It is believed that with the continuous development and improvement, the indocyanine green fluorescence cholangiography will play a more important role in the diagnosis and treatment of biliary tract diseases in the future, and bring more benefits to patients.
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Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.
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Tele-robotic surgery technology, which is a novel method for surgeons to operate on patients in different places with the assistance of surgical robots through high-speed network. Tele-robotic surgery can overcome space restrictions, perform surgery efficiently, cut down redundancy time, reduce the cost of medical resources, and avoid the risk of patient transport. With the support of the fifth generation of mobile communication technology (5G), the information transmitted between robots could be faster and more accurate, and the development of Tele-robotic surgery has entered a new stage. This paper mainly analyzes the development of surgical robot technology based on 5G communication technology, and summarizes the application and future development direction of remote hepatobiliary and pancreatic surgery.
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Blockchain technology integrates a series of complex technologies such as distributed accounting,peer-to-peer transmission,cryptography,smart contracts,consensus algorithms,etc.,providing services for controlling,storing,sharing,and managing data.At present,clinical nursing data is growing exponentially,and blockchain technology can be well used to process a large amount of clinical nursing data,bringing many advantages to clinical nursing.This article provides an overview of the current research status of blockchain technology in clinical nursing,with a focus on application types,advantages,and difficulties and challenges in the application process.It also proposes suggestions for designing data models and formats that meet specifications and standards,providing decision support for the application and development of blockchain technology in clinical nursing in China,thereby improving the quality of nursing services.
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This paper summarizes the status of application and research of Fu's subcutaneous needling for peripheral facial paralysis, and the characteristics of different stages of peripheral facial paralysis treated with Fu's subcutaneous needling are analyzed from the aspects of intervention timing, protocol design, needle insertion point, sweeping and reperfusion activity, tube retaining time and acupuncture frequency. It is found that there are no norms and standards in sweeping and reperfusion, tube retention and acupuncture frequency in clinical application,and the exploration of staged treatment is insufficient in the research. In the future, it is necessary to form standardized operation to promote clinical promotion, and improve the research on treatment rules and mechanism according to the characteristics of disease stage.
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Humanos , Paralisia Facial/terapia , Procedimentos Cirúrgicos Vasculares , Terapia por Acupuntura , AgulhasRESUMO
Fermented Chinese medicine has long been used. Amid the advance for preservation of experience, the connotation of fermented Chinese medicine has been enriched and improved. However, fermented Chinese medicine prescriptions generally contain a lot of medicinals. The fermentation process is complicated and the conventional fermentation conditions fail to be strictly controlled. In addition, the judgment of the fermentation end point is highly subjective. As a result, quality of fermented Chinese medicine is of great difference among regions and unstable. At the moment, the quality standards of fermented Chinese medicine are generally outdated and different among regions, with simple quality control methods and lacking objective safe fermentation-specific evaluation indictors. It is difficult to comprehensively evaluate and control the quality of fermented medicine. These problems have aroused concern in the industry and also affected the clinical application of fermented Chinese medicine. This article summarized and analyzed the application, quality standards, and the modernization of fermentation technology and quality control methods of fermented Chinese medicine and proposed suggestions for improving the quality standards of the medicine, with a view to improving the overall quality of it.
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Medicina Tradicional Chinesa , Padrões de Referência , Controle de Qualidade , FermentaçãoRESUMO
The application status of acupuncture and moxibustion therapy for assisted reproductive field in the United States was analyzed, and the existing problems and future development directions were discussed. According to the survey on the 456 websites of assisted reproductive clinic in the United States mentioned in the report of U.S. Centers for Disease Control and Prevention (CDC), 111 clinics among 456 assisted reproductive clinics recommend and used acupuncture and moxibustion therapy, accounting for 24.3%. Acupuncture and moxibustion therapy had obvious effect, good safety and low cost, and the assisted reproductive institutions in the United States had a high degree of application and recognition to acupuncture and moxibustion therapy. However, some problems, such as immature treatment scheme, unclear mechanism and imperfect insurance policies, still existed. In the future, the advantages of Chinese traditional acupuncture and moxibustion should combine with international modern assisted reproductive technology, and multi-center and large-sample clinical randomized controlled trials and basic experimental research on the mechanism of acupuncture and moxibustion for assisted reproduction should be carried out.
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Acupuntura , Terapia por Acupuntura , Medicina Tradicional Chinesa , Moxibustão , Reprodução , Estados UnidosRESUMO
Objective:To analyze the application status and problems of clinical decision support system(CDSS) in medical institutions in China, and put forward corresponding suggestions.Methods:From April to May in 2020, a questionnaire survey was conducted in 1 013 medical institutions in 31 provinces of China. The contents of the questionnaire included the current situation of CDSS installation and deployment, the purpose of establishment, the source of knowledge base, the content to be optimized and the factors hindering the use.Results:199(19.64%) medical institutions had CDSS, among which 123 were used in the whole hospital and 76 in some departments; 426 medical institutions did not use CDSS, but had plans to use it. It was found that the current CDSS system had setbacks, such as big cognitive difference, lack of authority in knowledge, high difficulty in data governance, lack of industry standards and so on.Conclusions:In the future, the standardized use of CDSS in medical institutions could be promoted from the aspects of raising awareness, establishing knowledge authority and establishing standards.
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Electronic health record is an important part of medical information research and has been widely used in medical institutions to help medical personnel deal with various medical information. However, due to the lack of standardized nursing language, nurses are often unable to reuse nursing data in electronic health records, which hinders the further development of medical information sharing and electronic health records. The use of standardized nursing language can support efficient and complete nursing documents in electronic health records and meet the requirements of clinical and data interoperability. This paper summarizes the definition and significance of electronic health record and standardized nursing language and the application status of standardized nursing language based on electronic health record, so as to provide scientific reference for the development and improvement of electronic health record in China.
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Due to the definite curative effect,stable drug properties and low incidence of adverse reactions,the external traditional Chinese medicine(TCM) ointment for rheumatism treatment has attracted more and more attention from scholars at home and abroad.Based on the external TCM ointment for the treatment of rheumatism approved by China Food and Drug Administration(CFDA),this paper would comb and analyze their dosage forms,varieties,specifications,etc.On the other hand,this article summarizes the application of the new formulation technology,prescription research,study on the forming process,pharmacodynamics and safety research,etc.The problems existing in this area were pointed out,such as lack of new preparations;less research on the penetration material basis,the penetration enhancing mechanism,and the penetration enhancing law;the selection of detection indicators of quality control standards is not comprehensive enough;qualitative and quantitative studies of pharmacokinetics are relatively scarce and so on.Meanwhile,proper measures and suggestions are put forward.Not only the formulation classification and specification description of external TCM ointment should be standardized,but also new dosage forms such as intelligentized,controlled release and targeted preparations of Chinese medicine should be actively introduced;the study of transdermal activity of transdermal enhancer itself should be strengthened,and investigating the correlation between the transdermal absorption of the agent itself and promoting transdermal absorption;the biological effect index or indicators that combine chemical and biological effects should be used,and learning from the latest research achievements of multidimensional spectroscopy of Chinese herbal medicine,thereby establishing scientific detection indicators and quality control methods that conform to modern transdermal concept.
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With the development of perinatal medicine,the proportion and number of hospitalized preterm infants are increasing year by year.However,preterm infants are often dependent on intravenous nutrition to maintain their growth and development due to their immature digestive function and high nutritional requirements (especially in extremelypremature infants and extremelylow birth weight infants).The application of parenterai nutrition can not only reduce the inhalation pneumonia and neonatal necrotizing enterocolitis and other related complications caused by intestinal feeding,but also meet the nutritional needs of preterm infants who cannot tolerate intestinal feeding in a short term,and play an important role in improving the survival rate of preterm infants and improving the prognosis of diseases.The present situation and development of clinical application of intravenous nutrition in preterm infants were reviewed.
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Electronic health record is an important part of medical information research and has been widely used in medical institutions to help medical personnel deal with various medical information. However, due to the lack of standardized nursing language, nurses are often unable to reuse nursing data in electronic health records, which hinders the further development of medical information sharing and electronic health records. The use of standardized nursing language can support efficient and complete nursing documents in electronic health records and meet the requirements of clinical and data interoperability. This paper summarizes the definition and significance of electronic health record and standardized nursing language and the application status of standardized nursing language based on electronic health record, so as to provide scientific reference for the development and improvement of electronic health record in China.
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Analysis the positive literature at home and abroad and understand the status by searching the CNKI, Wanfang, Cqvip Chinese databases for the descriptive analysis of the literature. At present, positive psychology is still in the theoretical and construction stage, nursing intervention model is not yet mature, but providing useful ideas and try on promoting patients to improve mental health and quality of life, for the nurse to provide theoretical basis and reference in the future.
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In recent years,antibiotics have been playing more and more important roles in maintaining human health with the increasing variety and quantity.However,under the influence of different reasons caused by subjective or objective factors,antibiotics irrational use has induced bacterial resistance and adverse reactions,which are becoming more and more serious.The paper put forward the countermeasures of antibiotics irrational use and provided reference for rational use of antibiotics based on the present situation analysis in China and foreign experience in order to control the irrational use.
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The deepening and popularization of visual management methods provide a solution for the difficult problems in clinical nursing management, which is of great significance for simplifying clinical nursing procedures, improving work efficiency and ensuring patient safety. The purpose of this paper is to introduce the connotation of visual management and the status of clinical nursing application in China, and to explore the existing problems in the application process and the enlightenment to the nursing staff, to look forward to its future development trend, and provide reference for the further research and visualization management of nursing managers.
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OBJECTIVE: To know the current application status of the adjuvant drugs in our country, and preliminary explore the management measures of adjuvant drugs. METHODS: Through searching, reading, and summarizing the relevant content and literature, the application status of adjuvant drugs in China and the global demand for rationalization of drug use were reviewed. A few questionnaires that associated with adjuvant drugs were designed by Delphi method to investigate the medicine experts nationwide and to explore the management countermeasures of adjuvant drugs. RESULTS: The survey showed that 98% of medical institutions existing adjuvant drugs use of unreasonable/no specification. The medicine experts believe that there are unreasonable usages such as traditional Chinese medicine injections, cancer drugs except for chemotherapy drugs, etc. The unified management of adjuvant drugs application should determined by the state. CONCLUSION: The excessive use of adjuvant drugs ubiquitous in our country. Key monitoring varieties directory of adjuvant drugs and the limit to the drugs' use indicators to evaluate the rationality of drug use should be set. And there can be a special review team to review the use of adjuvant at regular intervals in order to standardize the clinical application of adjuvant drugs.
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The application of structured education in patients with type 2 diabetes mellitus showed significant effect. This paper introduced relevant content of structured education, the application status quo of structured education in patients with type 2 diabetes mellitus at home and abroad, aiming to provide reference for exploring health education models of patients with diabetes mellitus and reduce patients' complications, thus improving their quality of life.
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Chinese herbal decoction pieces are the basic approaches for clinical traditional Chinese medicine (TCM), reflecting the features and advantages of TCM. In order to investigate the clinical application status and features of Chinese herbal decoction pieces, the questionnaire on application of commonly used Chinese herbal decoction pieces was designed in this study for analysis of the application situations of Chinese herbal decoction pieces from 56 medical institutions in 10 provinces. The results showed 549 varieties of Chinese herbs and 801 varieties of decoction pieces were used on clinic. They can be classified into 19 categories according to their effects. The varieties of Gancao (Glycyrrhizae Radix et Rhizoma), Huangqi (Astragali Radix), Dihuang (Rehmanniae Radix), Chuanxiong (Chuanxiong Rhizoma), Baizhu (Atractylodis Macrocephale Rhizima), Huangqin (Scutellariae Radix), Danggui (Angelicae Sinenses Radix), Baishao (Paeoniae Radix Alba) and Maidong (Ophiopogonis Radix) were most common ones; the application of Chinese herbal decoction pieces from different medical institutions was differentiated from areas to areas. The survey results reflected the general situation about application of decoction pieces, providing the basic data for recording and completing Chinese herbal decoction pieces in essential drug system, with certain reference significance for the production of Chinese medicinal materials and the allocation of the varieties of Chinese herbal decoction pieces.
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To investigate health information standards application status in disease prevention and control institutions in Chinese medical reform demonstration area , and make analysis of ex-isting problems. [Methods] Part of the provincial, municipal disease prevention and control institutions were selected from Chinese medical reform demonstration area , and information from them collected through questionnaires. [Results] Of the 84 disease prevention and control institutions selected , 24.43%of in-stitutions had begun construction of information in accordance with health information standards issued by Ministry of Health.And the application rate was 32.11%for health information standards in the information system of the disease prevention and control institutions . [ Conclusion ] Health information standards has been used in disease prevention and control institutions for construction of information , but the applica-tion rate is low , and there have been remarkable differences found at different levels of disease prevention and control institutions .It is thought that application of health information standards should be further pro-moted and practiced in the disease prevention and control institutions .