Objective To investigate the healthcare system reform in traditional Chinese medicine (TCM) hospitals in Sichuan and analyze the existing issues at this stage. Methods All public TCM hospitals in Sichuan (a total of 210) were selected to collect information through the National Comprehensive Statistical Network Direct Reporting Information System for the investigation of the healthcare system reform. The survey was conducted in July 2024, and the data collection relied on the relevant information reported by the sample hospitals from January 1st to December 31st, 2023. This study only analyzed the basic situation, staffing, TCM services, and information technology construction of TCM hospitals. Results A total of 210 survey questionnaires were collected, with a 100% response rate. The survey revealed that licensed practitioners of TCM (including licensed assistant practitioners) accounted for 59.2% of the total number of licensed practitioners, and TCM professional and technical personnel accounted for 50.4% of the total number of pharmaceutical professional and technical personnel. The median number of TCM medical technology projects carried out by the surveyed institutions was 52, the median proportion of outpatient TCM medical service income to outpatient medical income was 8.6%, and the median proportion of inpatient TCM medical service income to inpatient medical income was 13.7%. The proportion of discharged patients primarily treated with TCM was 30.6%, and the coverage rate of TCM-dominant disease types among inpatients in TCM medical institutions was 44.8%. A total of 52 institutions (24.8%) had achieved interconnectivity between prescription information and retail pharmacies, while 158 institutions (75.2%) had not. Among tertiary medical institutions, 67 had achieved level 4 in electronic medical record application functionality, while 32 were at level 3 or below. Conclusions After years of in-depth healthcare system reform, the construction and services of TCM hospitals in Sichuan have seen some development. However, there are still some shortcomings, such as insufficient TCM talent allocation, low utilization rate of TCM medical technology, unclear characteristics of TCM treatment, and low level of electronic medical record informatization. Therefore, it is necessary to further strengthen the cultivation and introduction of TCM talents, vigorously develop TCM characteristics, promote informatization construction, and promote the inheritance, innovation, and high-quality development of TCM.
Objective To investigate the method and the cl inical outcomes of reconstruction of the knee stability after resection of tumors of the proximal fibula. Methods The cl inical data were retrospectively analyzed, from 16 patients with tumors of the proximal fibula undergoing proximal fibular resections and reconstructions of the lateral collateral ligament and the tendon of the biceps femoris with anchors between January 2008 and December 2009 (test group). Five patients underwent proximal fibular resection but were not given reconstruction surgery at the same period as the control group. There was no significant difference in gender, ages, disease duration, and tumor site between 2 groups (P gt; 0.05). Lateral stress test was performed after operation; X-ray films were taken to measure the joint space. Musculoskeletal Tumor Society (MSTS) functional score system was used to evaluate the joint function. Results All incisions healed by first intention in 2 groups. Iatrogenic complete peroneal nerve function loss occurred in patients undergoing Malawer type II surgical resection. The patients in both groups were followed up 12 to 36 months, with an average of 30 months. One patient with osteosarcoma of the test group developed local recurrence, and died of lung and systemic metastases after 12 months; the other patients had no recurrence. At last follow-up, the results of knee lateral stress test were negative in the test group, and the joint space increased and was classified as grade A; the results of knee lateral stress test were positive in the control group, and the joint space was classified as grade D. The MSTS score was 97.5 ± 3.5 in the test group and 87.5 ± 3.5 in the control group, showing significant difference (t=2.85, P=0.01). Conclusion The reconstruction of the bony attachment of the lateral collateral ligament and the tendon of the biceps femoris with anchors after resection of the proximal fibula is a safe, rel iable, and simple technique to reconstruct knee stabil ity after resection of tumors of the proximal fibula.