Prenatal diagnosis, as one of the core components in the prevention and control of birth defects, is constrained by both “time sensitivity” and “data availability”. The diagnostic model driven by expert experience and manual interpretation can no longer meet the demands of rapidly evolving detection technologies, which generate massive, high-dimensional data. Additionally, issues such as delayed professional training and regional development imbalances further hinder the overall improvement of prenatal diagnosis efficacy. This article systematically elaborates on typical application scenarios of artificial intelligence-assisted prenatal diagnosis from two core aspects: the intelligent optimization of diagnostic technologies and the standardization of institutional and personnel management. It also explores the potential of emerging intelligent technologies like federated learning and digital twins, aiming to promote the transformation and upgrading of the prenatal diagnosis field from standardization and normalization toward precision and systematic high-quality development.
The fight for rights between people is human nature and this is especially prominent in commercial and market economies. This issue is particularly acute when it concerns life and health. In recent years the upholding of patients’ rights has collided with the old systems of medical ethics and legal issues, to the extant of partial extinguishing. Considering conflicts between patients and physicians, we need to have a position on this issue and decide what should be done about it? Conflict not only causes us embarrassment, but also encourages us to seek answers through better communication between patients and physicians.
Objective To summarize the current research progress about influence of patellofemoral osteoarthritis on clinical outcome of unicompartmental knee arthroplasty (UKA). Methods The recent related literature was extensively reviewed and summarized, including pros and cons to regard the patellofemoral osteoarthritis as the contraindication. Results Previous studies regarded patellofemoral osteoarthritis as the contraindication of UKA. Most of current researches show that the damage to the articular cartilage of the patellofemoral joint to the extent of full-thickness cartilage loss has no influence on outcome of UKA. There is no correlation between preoperative anterior knee pain or medial patellofemoral joint degeneration and the clinical outcome. However, lateral subluxation of the patella has an adverse impact on postoperative curative effect. Degeneration of the lateral patellofemoral joint may be a risk factor of the outcome. Conclusion Patellofemoral osteoarthritis should not be the absolute contraindication of UKA. The effect of degeneration of the lateral patellofemoral joint is not clear at present, and still needs further studies in the future.
摘要:目的:探討臨床教學的全程制度化管理及其效果。方法:通過健全組織,完善制度,加強教學、臨床及實習生管理、建立激勵機制等措施,進行全程制度化的規范管理。結果:教學質量顯著提高,不良事件鮮見,無惡性事件發生。近來醫院已有6篇教學論文公開發表,4個先進集體和8名先進個人受到醫院表彰,5名優秀帶教教師和8名實習生受到各學院獎勵。結論:臨床教學全程制度化管理是提高教學質量的切實有效途徑。Abstract: Objective: To investigate system management during the entire clinical teaching process and its effect. Methods: To robust organization, perfect rules, strengthen management of clinical teaching and intern student, and establish encouragement mechanism,and other measures, so as to conduct standard system management during the entire process. Results: Quality of teaching improved notably, bad event was scarce, no malignant event occurred. There were six teaching articles issued publicly, four advanced collectives and eight advanced individuals had been praised by hospital, and five excellent teachers,eight intern students had been rewarded by each college. Conclusion: System management during the entire clinical teaching process is an effective way to improve teaching quality.
摘要:目的:動態監測急性胰腺炎(AP)患者外周血C反應蛋白(CRP)水平,探討CRP對AP的早期診斷與病情評估的參考價值。方法:分別檢測75例SAP患者和75例 MAP患者入院后第1、3、5、7、9天外周血CRP水平,并進行分析比較。結果: MAP組患者CRP高峰值出現在住院第3天,第7天開始下降,14天后恢復正常。而SAP組患者住院第1天即可出現CRP顯著增高,且下降速度緩慢,在后期CRP仍可維持在一個較高水平。入院第1天,SAP組血清CRP水平均顯著高于MAP組(Plt;0.01)。輕癥與重癥組(無并發癥或有并發癥)之間患者血清CRP水平差異均有高度顯著性(Plt;0.01)。結論: 動態監測CRP可作為AP早期診斷、疾病嚴重程度評估及預后判斷的一個獨立的衡量指標,值得臨床推廣應用。Abstract: Objective: To dynamic monitoring of acute pancreatitis (AP) in patients with Creactive protein (CRP) levels, CRP on the AP to explore the early diagnosis and prognostic evaluation of the reference value. Methods: 75 cases of SAP patients were examined and 75 patients with mild acute pancreatitis (MAP) after admission in patients with CRP levels in peripheral blood 1,3,5,7,9 days, and conduct analysis and comparison of. Results:MAP peak value of CRP in patients in hospital the first 3 days, 7 day drop in 14 days after return to normal. The SAP Group 1st day of hospitalization was significantly higher CRP can occur, and the rate of decline is slow, in the latter part of CRP can be maintained at a high level. Admission day 1, SAP serum levels of CRP were significantly higher than the MAP group (Plt;0.01). Between mild and severe group, no complications and complications in patients with serum CRP levels of SAP differences were highly significant (Plt;0.01). Conclusion:Dynamic monitoring of CRP can be used as AP early diagnosis, disease severity assessment and prognosis of an independent measure worthy of clinical application.
ObjectiveTo investigate the clinical features and influencing factors for new-onset atrial fibrillation (AF) early after coronary artery bypass grafting.MethodsThe clinical data of 339 patients undergoing coronary artery bypass grafting in our hospital from January 2012 to January 2019 were retrospectively analyzed. There were 267 males and 72 females with an average age of 37-83 (58.03±8.90) years. The clinical features and influencing factors for new-onset AF after surgery were investigated.ResultsThere were 234 patients of off-pump coronary artery bypass grafting (OPCABG), with 36 (15.4%) new-onset AF patients after operation, among whom 16.1% were males and 12.5% were females. There were 105 patients of on-pump coronary artery bypass grafting (CABG), with 39 (37.1%) new-onset AF patients, among whom 40.7% were males and 25.0% were females. The incidence was higher after the CABG surgery than that after the OPCABG surgery (37.1% vs. 15.4%, P<0.05). There was no statistical difference in the incidence rate between males and females (P>0.05). The incidence of new-onset AF after surgery was higher in ≥60 years patients for both operations (18.9% and 45.8%), which was significantly higher than that in <45 years patients (P<0.05). For both operations, the incidence of new-onset AF after surgery was high on the second day (24-48 h) after surgery, and most of the AF lasted for 1 day (P<0.05). The hypertension (OR=4.983, P=0.036), frequent premature atrial contraction or atrial tachycardia (OR=17.682, P=0.002), postoperative creatine kinase isoenzyme MB (CKMB) (OR=0.152, P=0.042), left anterior and posterior diameters (OR=17.614, P<0.001) and preoperative ejection fraction (OR=7.094, P=0.011) were influencing factors for new-onset AF after OPCABG. Diabetes (OR=11.631, P=0.020), other cardiac malformations (OR=29.023, P=0.002), frequent premature ventricular contraction or ventricular tachycardia (OR=0.047, P=0.001), and postoperative CKMB (OR=3.672, P=0.040) were influencing factors for new-onset AF after CABG.ConclusionThe incidence of new-onset AF after CABG is higher than that after OPCABG, and it increases with age increasing. There is no difference in the incidence between males and females. The influencing factors for the two operations are different.
Sharing clinical trial data can increase the transparency of clinical trials and improve the its authenticity. The current requirements of clinical research data transparency is not fully adequate, and it is still difficult to create an environment in which the sharing of the clinical trial data becomes the norm. The article analyzed various concerns on data sharing and proposed solutions in data ownership, technology, implementation, and legal issues systematically, calling for clinical trial data sharing in order to promote transparency of clinical trials, and looking forward to minimize the risks and maximize the benefits of data sharing.
Objective To review the current progress of clinical and experimental research of vascularized lymph node transfer for lymphedema. Methods The domestic and abroad literature about vascularized lymph node transfer in treatment of lymphedema was reviewed and analyzed. Results Experimental studies in animal model indicate that vascularized lymph node transfer can improve lymph node survival and show a promising effectiveness in reducing lymphedema. " Lymphatic wick” and " lymph pump” were the two main hypotheses proposed to explain the potential functional mechanism of vascularized lymph node transfer in treatment of lymphedema. Improvement in lymphedema symptoms are reported in most of the clinical trials, but the level of evidence to advocate this procedure in the treatment of lymphedema remains low because of the small number of the cases and problems in their methodologies. Conclusion Based on current evidence, vascularized lymph node transfer seems to be a promising treatment for lymphedema, but long-term well-designed studies are required to further explore the effectiveness of this procedure.
ObjectiveTo review the clinical research progress of spinal epidural lipomatosis (SEL). Methods The clinical studies on SEL at home and abroad in recent years were extensively reviewed, and the pathogenesis, clinical and imaging manifestations, and treatment status of SEL were summarized and analyzed. ResultsSEL is a disease characterized by compression of the spinal cord and nerve roots due to abnormal accumulation of epidural adipose tissue in the spinal canal. Its prevalence and diagnosis rate are low and the pathogenesis is not fully understood. MRI is the most sensitive and specific diagnostic test for SEL. Surgical decompression and removal of excess adipose tissue are the only options for patients with acute SEL or those who have failed conservative management, and conservative management should be considered for other patients. ConclusionSEL is a rare disease and related research still needs to be improved. In the future, high-quality, multi-center and large-sample studies will be of great significance for evaluating the choice of treatment methods and effectiveness of SEL patients.
Objective To summarize the research progress in the diagnosis and treatment of pancreatic cystic neoplasms (PCNs). Method The guidelines and literatures related to the diagnosis and treatment of PCNs were collected and reviewed. Results At present, there was still no clear method to distinguish the types of PCNs and their benign and malignant, and there was still a dispute between domestic and foreign guidelines on the diagnosis and treatment of PCNs. Conclusion Clinical researchers still need to carry out more research, provide higher quality evidence, resolve the disputes existing in different guidelines, standardize the diagnosis and treatment process of PCNs, thus, PCNs can be identified early, diagnosed accurately and intervened in time.