Chronic kidney disease (CKD) has been highlighted as one of the most important public health problems due to sharply climbing incidence and prevalence. To efficiently attenuate the disease burden and improve the disease management, not only active and effective treatment should be administrated, but also comprehensive follow-up nursing management with innovative and evolving spirits should be implemented. Thus dynamic changes of diseases could be acquired in time and patients are under appropriate medical instruction as soon as possible. This editorial is based on quickly developing medical big data resources and advanced internet techniques, from both aspects of patients and health care providers, briefly talking about integrated management strategy of CKD and its future development in China.
As an emerging technology, artificial intelligence (AI) uses human theory and technology for robots to study, develop, learn and identify human technologies. Thoracic surgeons should be aware of new opportunities that may affect their daily practice by the direct use of AI technology, or indirect use in the relevant medical fields (radiology, pathology, and respiratory medicine). The purpose of this paper is to review the application status and future development of AI associated with thoracic surgery, diagnosis of AI-related lung cancer, prognosis-assisted decision-making programs and robotic surgery. While AI technology has made rapid progress in many areas, the medical industry only accounts for a small part of AI use, and AI technology is gradually becoming widespread in the diagnosis, treatment, rehabilitation, and care of diseases. The future of AI is bright and full of innovative perspectives. The field of thoracic surgery has conducted valuable exploration and practice on AI, and will receive more and more influence and promotion from AI.
Objective To carry out the systematic clinical management to reduce the incidence of femoral pseudoaneurysm after interventional treatment. Methods A historical controlled study was used to compare the management effect before (from October 2012 to October 2013) and after (from March 2014 to March 2015) the application of doctor-nurse integrated systematic clinical management mode. This work mode enhanced cooperation between doctors and nurses, formed the clinical path for nursing workflows and contingency plans, and strengthened specialized education and training for nurses. Results After the implementation of systematic clinical management, the incidence of femoral pseudoaneurysm was significantly lower than before (1.0% vs. 2.7%), and the difference was statistically significant (P<0.05). Conclusions The systematic clinical management, carrying out in the doctor-nurse integration mode, can improve the quality of nursing and reduce the incidence of femoral pseudoaneurysm. And the management model has achieved remarkable results. So it is worth to be applied in the clinical practices.
At present, the whole lifecycle management of vascular access for hemodialysis in China is still in its early stages. Faced with a large group of chronic kidney disease patients, hospitals at all levels lack systematic and continuous nursing management models. To address the issue of lacking continuous and effective nursing management of vascular access for dialysis during the period from hospitalization for autologous arteriovenous fistula surgery to outpatient maintenance hemodialysis treatment, this article introduces the background, specific implementation methods, and preliminary results of the new model of integrated medical and nursing follow-up management of vascular access for patients with hemodialysis during hospitalization and outpatient period constructed by the Wenjiang Hemodialysis Center of West China Hospital, Sichuan University. The purpose is to explore a new model for continuous and effective management of vascular access for hemodialysis patients.
Integrated TOF-PET/MR is a multimodal imaging system which can acquire high-quality magnetic resonance (MR) and positron emission tomography (PET) images at the same time, and it has time of flight (TOF) function. The TOF-PET system usually features better image quality compared to traditional PET because it is capable of localizing the lesion on the line of response where annihilation takes place. TOF technology measures the time difference between the detectors on which the two 180-degrees-seperated photons generated from positron annihilation are received. Since every individual crystal might be prone to its timing bias, timing calibration is needed for a TOF-PET system to work properly. Three approaches of timing calibration are introduced in this article. The first one named as fan-beam method is an iterative method that measures the bias of the Gaussian distribution of timing offset created from a fan-beam area constructed using geometric techniques. The second one is to find solutions of the overdetermination equations set using L1 norm minimization and is called L1-norm method. The last one called L2-norm method is to build histogram of the TOF and find the peak, and uses L2 norm minimization to get the result. This article focuses on the comparison of the amount of the data and the calculation time needed by each of the three methods. To avoid location error of the cylinder radioactive source during data collection, we developed a location calibration algorithm which could calculate accurate position of the source and reduce image artifacts. The experiment results indicate that the three approaches introduced in this article could enhance the qualities of PET images and standardized uptake values of cancer regions, so the timing calibration of integrated TOF-PET/MR system was realized. The fan-beam method has the best image quality, especially in small lesions. In integrated TOF-PET/MR timing calibration, we recommend using fan-beam method.
Chronic kidney disease (CKD) is a public health issue of global concern, and nutritional management of CKD can improve the nutritional status of patients and slow down the progression of the disease. However, nutrition management is a complex scientific issue, and there are few clinical practices of nutrition management in CKD, so there is an urgent need for a theoretical framework of nutrition management to guide the construction of a scientific and standardized program. This review will systematically describe the relationship between nutrition and kidney disease, sort out the current status of nutrition management in CKD in China, introduce the experience of CKD medical and nursing nutrition integration in West China Hospital of Sichuan University, and provide thoughts for further improvement of standardized scientific formulation of nutrition management strategy.
Chronic kidney diease has a high incidence. It is a major disease that seriously endangers human health. The integrated management of chronic kidney disease, through etiological treatment of chronic kidney disease, delaying the deterioration of renal function, and the combination of hemodialysis, peritoneal dialysis and kidney transplantation for end-stage kidney disease treatment, is a scientific and effective full-course management of chronic kidney disease. The integrated management of chronic kidney disease is the key to reduce the mortality and disability rates. At the same time, it is a more important and far-reaching task to emphasize early popularization of science, screening, prevention and intervention to reduce the incidence of kidney disease.