ObjectiveTo evaluate clinical efficacy of the modified Sugiura procedure with cardia transection in treatment of recurrent portal hypertension with upper gastrointestinal bleeding. MethodsFrom January 2007 to January 2015, there were 28 cases of recurrent portal hypertension with upper gastrointestinal bleeding were treated by the modified Sugiura procedure with cardia transection in The Second People's Hospital of Yichang and The Zigui County People's Hospital, collecting the clinical data of them and then summarizing the therapeutic effect. ResultsAll cases underwent surgery successfully with no operative death. The operative time was 120-300 minutes with an average of 160 minutes. About surgical blood loss was 100-500 mL, with an average of 210 mL. Two cases suffered from postoperative gastrointestinal bleeding, 6 cases suffered from postoperative gastric dysfunction, and no one suffered from anastomotic leakage, anastomotic stenosis, and portal vein thrombosis. Three cases died in reason of liver failure and hepatic coma. There were 24 cases were followed up for 6-60 months, with the median of 33 months. No recurrence of gastrointestinal bleeding happened during the follow-up period. Sixteen cases underwent gastroscopy in 6 months after surgery, according to the results, the clinical effect was fine. For grade of varicose veinsm, there were 14 cases of grade GⅠ and 2 cases of grade GⅡ. For shape of varicose veins, there were 11 cases of grade F1 and 5 cases of grade F2. ConclusionThe modified Sugiura procedure with cardia transection is a safe and thorough operation for recurrent portal hypertension with bleeding.
目的:探討不同治療方法對急性痛風性膝關節炎的治療效果。方法:自2006年9月～2008年3月共收治42例急性痛風性膝關節炎患者。對21例急性痛風性膝關節炎患者采取藥物保守治療,21例行關節鏡手術配合藥物治療。兩組治療前后采用WOMAC評分對膝關節功能進行評定,用student-t檢驗進行統計學分析。結果:保守組:隨訪發現關節癥狀好轉不明顯,復發率19.05％;WOMAC評分治療前49～72分,治療后69～85分。關節鏡手術配合藥物組:隨訪發現關節癥狀均明顯緩解,關節功能恢復良好,傷口甲級愈合,無術后并發癥,6個月無復發病例;WOMAC評分治療前49～71分,治療后75～96分。兩組治療前后及之間有顯著性差異,保守組(t=-9.864,Plt;0.001);關節鏡手術配合藥物組(t=-11.267,Plt;0.001);兩組之間(t=-2.366,Plt;0.023)。結論:比較以上2種治療方法,關節鏡手術治療急性痛風性膝關節炎具有創傷小、起效快、效果明顯、關節功能恢復滿意等特有優勢,結合藥物治療,能取得良好的治療效果。
ObjectiveTo systematically review the effects of the promotion of appropriate health technology in China and provide reference for improving the promotion of appropriate health technologies. MethodsDatabases including CBM, VIP, CNKI and WanFang Data were searched for studies about the appropriate health technology in China from inception to August 2014. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies by the evaluation criteria for descriptive studies of MAStARI, an assessment tool developed by JBI Evidence-Based Health Care Center. And then, qualitative descriptive analysis method was used to comprehensively analyze the data from four aspects: medical institutions, regulators, technology promotion medical staff and patients. ResultsA total of 23 cross-sectional studies and one before-after study were included. The results of qualitative analysis showed that: 1) the technology utilization rate of appropriate health technology extension institutions was more than 70%, the number of outpatients of township and village organizations increased significantly than that of the county level institutions; 2) director of technology extension and managers of hospital were in favor of the promotion of appropriate technology for its good effectiveness, safety, lower medical costs, and skill improvement of medical staff; 3) medical staff mastered the appropriate health technology, they were willing to promote appropriate technology and spoke highly of it for its safety, feasibility and economic effect, and improved their level of technology; 4) in patients' opinion, the appropriate technology reduced the disease course and cost, they spoke highly of it for its acceptance, efficacy and safety. ConclusionCurrent evidence shows that the promotion of appropriate health technology has achieved good effects. The satisfaction of medical institutions, managers, health service staff and patient is high, but these research results are of poor quality, mostly subjective evaluation, lack of scientific, rational, objective and consistent evaluation criteria, which cannot be used as evaluation evidence for the promotion of appropriate health technology.
Objective To evaluated the application effect of reverse digital modeling combined with three-dimensional (3D)-printed disease models in the standardized training of orthopedic residents focusing on pelvic tumors. Methods From August 2022 to August 2023, 60 orthopedic residents from West China Hospital, Sichuan University were randomly assigned to a trial group (n=30) and a control group (n=30). The trial group received instruction using reverse digital modeling and 3D-printed pelvic tumor models, while the control group underwent traditional teaching methods. Teaching outcomes were evaluated and compared between groups through knowledge tests, practical skill assessments, and satisfaction surveys. Results Before training, there was no statistically significant difference in knowledge tests or practical skill assessments between the two groups (P>0.05). After training, the trial group showed significantly better performance than the control group in knowledge tests (90.5±5.2 vs. 78.4±6.8, P<0.05), skill assessments (92.7±4.9 vs. 81.3±6.2, P<0.05), and satisfaction surveys (9.40±1.10 vs. 7.60±1.20, P<0.05). One month after training, the trial group still showed significantly better performance than the control group in knowledge tests (88.1±6.4 vs. 72.3±7.1, P<0.05) and skill assessments (90.3±5.8 vs. 75.6±6.9, P<0.05). Conclusions Reverse digital modeling combined with 3D printing offers an intuitive and effective teaching approach that improves comprehension of pelvic tumor anatomy and strengthens clinical and technical competencies. This method significantly enhances learning outcomes in standardized residency training and holds promise for broader integration into medical education.
ObjectivesTo systematically review the differences of operative outcomes between early surgery and delayed surgery in multiple ligament injury of knee joint (MLIK) patients.MethodsPubMed, The Cochrane Library, EMbase, CNKI, CBM, WanFang Data and VIP databases were searched to collect cohort studies about operative outcomes of different surgery times in MLIK patients from inception to September 23rd, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 8 cohort studies involving 153 early and 90 delayed operatively treated patients were included. The results of meta-analysis showed that: compared with delayed surgery, early surgery received higher Lysholm score (MD=7.52, 95%CI 2.00 to 13.04, P=0.008) and superior IKDC score rate (OR=2.97, 95%CI 1.51 to 5.84, P=0.002). There were no significant differences in Tegner score (MD=–0.08, 95%CI –1.07 to 0.92, P=0.88) and ROM (MD=4.08, 95%CI –2.38 to 10.55, P=0.22) between two groups. The main adverse reactions of MLIK included neurovascular injury, deep venous thrombosis of lower extremities, common peroneal nerve injury, tourniquet paralysis and limited joint activity. Early surgery had a lower incidence of complications than delayed surgery (7.1% vs. 30%).ConclusionThe current evidence shows that early surgery can receive higher Lysholm score and superior IKDC score rate in treatment of MLIK, and have a lower incidence of complications. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.