Objective To discuss the performance of multi-disciplinary team (MDT) of colorectal cancer treatment within West China Hospital in Sichuan University. Methods To compare the therapeutic effect between groups of MDT model and non-MDT model by retrospectively analyzing the data of patients who diagnosed colorectal cancer and accepted in-hospital therapy during December 2006 and May 2007. Results The in-hospital days of the MDT model group during the perioperative period and in the surgical ward were less than that of the non-MDT model group ( Plt; 0. 05) , but there was no significant difference between the two groups about the total hospitalization time. And the MDT model group had a higher rate of cancer resection ( P lt; 0. 05) . Although the incidence of anastomotic leakage and bleeding as early postoperative complications didn’t show any variations between the two groups , the non-MDT model groupencountered more early postoperative ileus ( Plt; 0. 05) . During the 5－ 10 months follow-up , there came out less cancer recurrence rate in the MDT model group than the other ( P lt; 0. 05) . And the morbidity of anastomotic stricture and ileus didn’t show any statistical difference between the two groups. Conclusion The combined-therapy st rategy ofcolorectal cancer has showed a priority to routine ways , not only the more reasonable time arrangement for therapy , but also the more satisfied surgical outcomes. However , the factors correlated to the efficacy of the MDT model are not clear ; the MDT model still needs to be improved that a morereasonable and effective perioperative MDT model may come t rue.
Objective To develop a technique that can directly demonstrate collateral sprouting of intact nerve fibers at endtoside neurorrhaphy site. Methods Five Wistar adult rats were used in this study. The common peroneal nerves at one side were sectioned at the level of knee joint, and their distal ends were sutured to the tibial nerves after removal of a 1 mm-diameter window in the epineurium. Three months after the operation, the nerve segments at neurorrhaphy site and the normal tibial nerves at the contralateral site were harvested. The specimens were fixed in 10% formaldehyde and postfixed in 1% osmium tetroxide, thenmacerated in glycerol. Single fiber was teased out in pure glycerol under an operative microscope, then transferred to a slide and observed under light microscope. The nerve segments at neurorrhaphy site and distal peroneal nerves were alsoharvested for histological evaluation. Results At the neurorrhaphy site, small nerve fibers sprouted from a donor nerve fiber near node’s of Ranvier. While such phenomena were not found in normal tibial nerve. From the longitudinal sectionof neurorrhaphy site, bundles of nerve fibers ranged from tibial nerve to peroneal nerve were observed. Lots of regenerative nerve fibers emerged in distal peroneal nerve. Conclusion The phenomena of collateral sprouting at end-to-side neurorrhaphy site can be demonstrated directly by nerve fiber micro-tease technique.
The national policy on high-quality development of hospitals proposes to strengthen information technology support and actively promote the multi-disciplinary team (MDT) model. How to use the “Internet Plus” technology and operation mode to promote MDT communication and improve the efficiency of diagnosis and treatment in the digital and intelligent information age is a direction worthy of attention and research. This paper systematically reviews the current development status of MDT informatization construction at home and abroad. Based on the current challenges and opportunities, it makes prospects for the future development of MDT informatization construction from the aspects of strengthening the digital and intelligent support of MDT operation, connecting MDT “information silos”, and deepening the construction of MDT supervision and effect evaluation system, etc.
" Inquiry-small class” teaching mode is a novel teaching method aimed at cultivating the clinical capability and professionalism and promoting comprehensive development of medical students. Small-class teaching mode prioritize students and promotes deep interaction between teaching and learning. Therefore, integrating small class teaching into large class teaching is essential. This paper attempts to explore the applications and prospects of " Inquiry-small class” teaching mode in clinical medicine education through summarizing teaching concept and design, learning resources, exam reform, teacher-student interaction and other aspects of the course " endocrine and metabolic disease (bilingual)”, offered by West China School of Medicine in Sichuan University, so as to provide more reference for the future " Inquiry-small class” teaching reform.
Objective To develop a multidisciplinary nursing program for Prader-Willi syndrome with spinal deformity and evaluate its effectiveness in clinical practice. Methods In July 2016, a multidisciplinary collaborative team was established before the treatment of children with Prader-Willi syndrome complicated with spinal deformity. For the nursing difficulties in the perioperative period, relevant literature was consulted, and a multidisciplinary collaborative nursing plan was formulated, which included nutrition management and blood glucose control, management of obstructive sleep apnea hypopnea syndrome, behavioral intervention related to mental change, and early identification and management of complications. The developed multidisciplinary collaborative nursing program was applied to three children with Prader-Willi syndrome complicated with spinal deformity in Peking Union Medical College Hospital from July 2016 to October 2018, and their postoperative recovery was evaluated. Results One child had inguinal skin ulceration when admitted to hospital, which was significantly improved after active treatment. The perioperative blood glucose level control of the three children was satisfactory, and there was no postoperative gastrointestinal dysfunction, deep wound infection, respiratory complications, internal fixation failure or other complications, and no asphyxia, fall, loss, or other adverse events. The follow-up compliance after discharge was 100%. Conclusions Multidisciplinary collaboration programs can escort patient’ safety and promote their recovery, improve the professional level of nursing staff, and reflect the nursing value. As a working mode, it can be further popularized and used for reference in the nursing of other difficult diseases.
Objective To analyze the disease burden of liver cancer caused by nonalcoholic steatohepatitis (NASH) among the Chinese population by utilizing the latest global burden of disease (GBD) 2021 data, and conduct a comparative analysis with the global situation, so as to provide references and lessons for the formulation of public health policies and disease management plans in China. Methods GBD 2021 database publicly released in May 2024 was searched and relevant disease burden data of liver cancer caused by NASH in China and globally from 1990 to 2021 was sorted out. Joinpoint regression model was employed to calculate the average annual percentage change (AAPC) of the age-standardized rates of various burden indicators in order to evaluate the changing characteristics of disease epidemiology over time. Meanwhile, Bayesian method was used to predict the number of incidences and deaths of liver cancer caused by NASH in China and globally from 2022 to 2045. Results Compared with 1990, in 2021, the number of incidences, prevalence, deaths, disability-adjusted life years, age-standardized incidence rate and age-standardized prevalence rate of liver cancer caused by NASH in the overall, male and female populations in China and globally all increased. Moreover, in 1990 and 2021, all the burden indicators of the Chinese male population were higher than those of the female population in the corresponding years. The overall trend analysis showed that during the 32 years from 1990 to 2021, the age-standardized incidence rate [AAPC=0.44%, 95%CI (0.35%, 0.53%), P<0.001] and the age-standardized prevalence rate [AAPC=0.92%, 95%CI (0.73%, 1.11%), P<0.001] of liver cancer caused by NASH in the overall population in China both showed a significant upward trend. In addition, in 1990 and 2021, the age-standardized rates of all the burden indicators of the overall population in China were higher than the global levels in the corresponding years. The prediction results of the Bayesian model showed that from 2022 to 2045, the number of incidences and deaths of liver cancer caused by NASH in the overall, male and female populations in China and globally will generally show an upward trend. Conclusions The disease burden of liver cancer caused by NASH in China and globally is generally on the rise. In order to curb the increasing disease burden, it is necessary to formulate relevant public health policies and disease management plans in a timely manner.
Objective To explore the application and effects of Seminar case teaching method in teaching surgical nursing. Methods Nursing students of the Yiyang Junior Medical College were divided into two groups (140 students/group). Seminar case teaching was applied in the trial group, while traditional teaching method (classroom teaching or instruction) was applied in the control group. The two groups used the same materials, and were taught by the same teacher team during the same course. After the courses, surgical knowledge and skills were evaluated using theory exams and operation tests (tools included communication ability scale as well as the California Critical Thinking Dispositions Inventory Scale for students’ ability and quality levels, and an anonymous questionnaire for teaching satisfaction) were analyzed between the two groups. Results The scores of the trial group were higher than those of the control group in theory exams and operation tests, with a significant difference (Plt;0.01). The before-after score differences of communication skills and critical thinking ability of the trial group were also higher than those of the control group, with a significant difference (Plt;0.01). The result of the anonymous questionnaire showed that, the students in the trial group had better satisfaction about Seminar case teaching method. Conclusion Seminar case teaching method applied in surgical nursing teaching is feasible and effective, which is better than traditional teaching method in improving knowledge, ability, and quality of nursing students.
Objective To explore the application of multi-disciplinary team (MDT) clinics in fetal developmental abnormalities. Methods A retrospective analysis method was used to collect case data of fetal developmental abnormalities and completion of prenatal MDT clinics diagnosis and treatment in pregnant women who were registered in the Department of Obstetrics of West China Second Hospital, Sichuan University between December 2021 and November 2022. The situation of pregnant women and fetuses was summarized and analyzed. Results There were 19362 registered pregnant women, of which 1125 (5.8%) had abnormal fetal development. Among them, 272 (24.2%) received prenatal MDT clinics diagnosis and treatment. Fetal developmental abnormalities were mainly characterized by structural abnormalities (208 cases, 76.5%), with the top three being central nervous system abnormalities, circulatory system abnormalities, and multiple malformations. There were 202 pregnant women who continue to conceive, and 70 cases had undergone induced labor, with an induced labor rate of 25.7%. The top three main causes of induced abortion were multiple malformations, central nervous system abnormalities, and circulatory system abnormalities. After prenatal MDT clinics diagnosis and treatment, the diagnosis of fetal developmental abnormalities in 46 pregnant women were corrected. Conclusion Prenatal MDT clinics are helpful for the early comprehensive evaluation of fetal developmental abnormalities and the determination of diagnosis and treatment plans.
Objective To evaluate the changes in oral health knowledge, behavior and attitude of undergraduate students majoring in preventive medicine before and after the course “Oral Preventive Medicine”, and to provide empirical evidence for the teaching reform of preventive medicine undergraduate programs, thereby enhancing teaching effectiveness and the significance of the course. Methods A questionnaire survey was conducted among the undergraduate students majoring in preventive medicine at the West China School of Public Health, Sichuan University in 2024, before and after the compulsory course “Oral Preventive Medicine”. Results A total of 124 undergraduate students majoring in preventive medicine were surveyed. After the course, undergraduate students majoring in preventive medicine had changed their oral related knowledge, behaviors, and attitudes. The correctness of the answers and the usage rate of Bass brushing technique were both increased; The self-evaluation of oral health status (χ2=5.017, P=0.025) and brushing effect (χ2=22.200, P<0.001) were both improved; The perceived benefits of brushing (t=2.515, P=0.013) and behavioral intention to brush teeth (t=5.381, P<0.001) were both improved, while the perceived barriers to brushing was reduced (t=?3.999, P<0.001). Conclusions The course “Oral Preventive Medicine” effectively enhanced the oral health literacy of undergraduate students majoring in preventive medicine, confirming its practical value in undergraduate teaching reform. It provides an important reference for optimizing the curriculum system of preventive medicine, has positive significance for cultivating public health talents with comprehensive health literacy.
This article is based on the work practice of Medical-lnsurance-Medicine Linkage carried out by the Nanping First Hospital Affiliated to Fujian Medical University under the reform of payment based on diagnosis related group (DRG). It outlines the connotation and extension of Medical-lnsurance-Medicine Linkage in the hospital, including concept definition, organizational structure, the relationship between DRG payment and Medical-lnsurance-Medicine Linkage, and summarizes the specific measures and positive results of the Medical-lnsurance-Medicine Linkage work mechanism from four aspects: medical quality management, medical insurance management, medical drugs/consumables management, and performance evaluation. These experiences are of great significance for improving the quality and efficiency of medical care, actively responding to the reform of medical insurance payment methods, enhancing the level of medical services in public hospitals, and achieving a win situation among the medical insurance management departments, hospitals, and patients.