ObjectiveTo summarize the experience of the whole process management of hepatocellular carcinoma (HCC) patients with high-risk of recurrence and metastasis based on the multidisciplinary team (MDT) mode, and to improve the clinicians’ understanding of the concept of whole process management, so as to improve the survival rate of patients with HCC. MethodThe clinicopathologic data of a HCC patient with high-risk of recurrence and metastasis admitted to the Division of Liver Surgery, Department of General Surgery, West China Hospital of Sichuan University were retrospectively analyzed. ResultsA 52-year-old male patient was diagnosed with HCC with intrahepatic metastasis (China liver cancer staging Ⅱ b, Barcelona Clinic Liver Cancer stage B) after admission due to “epigastric discomfort for 1+-month and liver occupying for 1+-week”. Through discussion by the MDT mode, the allogeneic liver transplantation was performed after successful downstaging following two conversion therapies. No serious complications occurred after operation, and the patient was discharged on the 23rd day after operation. Up to now, pulmonary bacterial and fungal infections and pulmonary metastases had been found during the postoperative follow-up. After anti-infective therapy and targeted therapy combined with radiotherapy, the patient was significantly relieved, had survived for 34 months after operation, and was still under regular follow-up. ConclusionsFor HCC patients with high-risk of recurrence and metastasis, MDT mode has a good clinical benefit for the whole process management of patient. Through the MDT model, the diagnosis, treatment, and follow-up of HCC are organically integrated, and the patient’ s diagnosis and treatment plans are dynamically adjusted to realize the whole process management of HCC patient, and to raise the survival rate and improve quality of life of HCC patient.
Objective To explore the clinical value, latest research progress, and clinical controversy of total neoadjuvant therapy (TNT) in locally advanced rectal cancer (LARC). Method We searched and reviewed on the latest literatures about studies of the clinical research of TNT in LARC. Results TNT could make the tumor downstage rapidly and improve the patients’ treatment compliance. In terms of organ preservation rate, 3-year disease-free survival and pathological complete remission rate, TNT had advantages and was a especial potential treatment strategy compared with traditional methods. Conclusions TNT decreases local recurrence rate and improves the long-term survival. For LARC patients with strong desire for organ preservation, TNT is a good treatment choice and has the value of clinical promotion.
With the implementation of the “Health China 2030” strategy, sports medicine has played an increasingly important role in clinical treatment, chronic disease management, and population health promotion. West China Hospital of Sichuan University has actively explored the development and optimization of its sports medicine discipline outpatient management system, establishing a comprehensive model that integrates diagnosis and treatment, functional rehabilitation, exercise-based health management, and extended care services. This article systematically summarizes the practical experiences of the sports medicine outpatient department, including subspecialty setting, exercise prescription services, outpatient assistant mechanisms, online expert teams, multi-campus coordination, and full-process health management. Emphasizing a function-oriented and patient-centered approach, the article also discusses the extended value of outpatient services in translational research, smart healthcare, and preventive health strategies. This model provides a replicable and scalable reference for the development of sports medicine outpatient clinics.
Objective To analyze the advantages and disadvantages of various neoadjuvant therapy , provide reference for clinical diagnosis and treatment, and provide direction for further research and exploration. Method The recent domestic and international medical databases (PubMed, EMBASE, Cochrane Library, VIP database, CNKI, WanFang database, etc.) were searched and the relevant literature on neoadjuvant therapy for locally advanced rectal cancer (LARC) were reviewed. Results Neoadjuvant therapy could decrease tumor staging, increase anal reserving rate, and reduce local recurrence rate, but it does not significantly reduce the rates of distant metastasis and lateral lymph node metastasis, nor does it improve long-term survival. More and more optimization neoadjuvant therapy had emerged. Molecular targeted drugs and immunotherapy were being attempted for clinical using, combined with research on emerging biomarkers, to improve the therapeutic efficacy of LARC patients, reduce treatment related side effects, and improve patient survival benefits. Conclusions Neoadjuvant therapy is the standard treatment strategy for LARC, and the exploration of neoadjuvant treatment models is expected to further improve treatment effectiveness, reduce toxic side effects, and improve survival prognosis. By combining tumor molecular biology indicators to identify and screen beneficiaries, it is expected to become an important direction for future research.
This review thoroughly investigates the application and advancements of artificial intelligence (AI) technology in the comprehensive management of lung cancer. AI is utilized at various stages of lung cancer diagnosis and treatment through techniques such as computer vision, deep learning, and natural language processing. In the early diagnosis stage, AI assists in identifying high-risk populations and, in conjunction with pathological techniques, accomplishes functions like histological classification of lung cancer tissues, prediction of molecular markers, and quantitative analysis of immunohistochemistry. During the treatment stage, AI integrates multimodal data to aid in formulating individualized treatment plans and enhances efficiency via clinical decision support systems (CDSS). In the follow-up stage, continuous patient monitoring and optimization of follow-up strategies are realized through imaging, remote monitoring, and intelligent follow-up systems. The prospects for AI medical technology are promising. However, it still confronts challenges such as weak generalizability, poor interpretability of AI decisions, and ethical and legal issues.
目的:总结两年来深入感染病区的临床药学工作。 方法：根据两年来在感染病区的试点，总结药师在临床的工作内容、方法、体会和经验。结果：药师下临床，有助于医疗质量的提高，防止潜在医疗过程中用药风险，也有助于患者依从性的增加和推动临床合理用药。结论：药师下临床的基础是扎实全面的专业知识，但离不开医院领导重视和相关法规的支持。
摘要:目的:探讨临床教学的全程制度化管理及其效果。方法:通过健全组织,完善制度,加强教学、临床及实习生管理、建立激励机制等措施,进行全程制度化的规范管理。结果:教学质量显著提高,不良事件鲜见,无恶性事件发生。近来医院已有6篇教学论文公开发表,4个先进集体和8名先进个人受到医院表彰,5名优秀带教教师和8名实习生受到各学院奖励。结论:临床教学全程制度化管理是提高教学质量的切实有效途径。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.
目的 研究自体动静脉内瘘全程规范化护理的可实施性及优势。 方法 制定自体动静脉内瘘全程规范化护理工作流程及标准，将2011年6月－8月经自体动静脉内瘘行维持性血液透析患者随机分为观察组（125例）和对照组（115例），分别予以全程规范化护理和普通护理，对比分析两组之间内瘘不良事件发生率、患者满意度、护士认同度等指标的差异。 结果 两组内瘘不良事件发生率分别为8.0%和21.0%，患者满意度分别为98.4%和84.3%，差异均有统计学意义（P＜0.05）；两组护士对本组护理模式认同度均为90.0%，差异无统计学意义（P＞0.05）。 结论 自体动静脉内瘘全程规范化护理模式能有效降低内瘘不良事件发生率并显著提高患者满意度，值得临床推广。
ObjectiveTo discuss the effect of the whole-course management model of intermittent catheterization (IC) in patients with neurogenic bladder (NB).MethodsPatients with NB caused by incomplete spinal cord injury admitted to Department of Rehabilitation Medicine of West China Hospital of Sichuan University between May and October 2019 were selected. According to the random number table, the patients were randomly divided into the trial group and the control group. The control group adopted the traditional management mode of IC, and the trial group adopted the whole-course management mode of IC. The urination diary (single catheterization volume, residual urine volume, and times of urine leakage), bacteria count and leukocyte count in urine routine were compared between the two groups.ResultsFinally 80 patients were included, with 40 cases in each group. There was no significant difference in urination diary, bacteria count or leukocyte count in urine routine between the two groups (P>0.05). There was no significant difference between the two groups in urination diary in the second week of management (P>0.05). At the 12th week of management, there were statistically significant differences in urination diary between the two groups (P<0.05). The bacteria count and leukocyte count in the second and 12th week of the management in the trial group were lower than those in the control group (P<0.05).ConclusionsThe whole-course management of IC for patients with NB caused by incomplete spinal cord injury can effectively improve bladder volume, and reduce residual urine volume and times of urine leakage. It also can reduce the incidence of urinary tract infection, reduce urinary complications, and ultimately improve the quality of life of patients.
Lung cancer is the malignant tumor with the highest incidence and mortality rate in China. Early diagnosis and treatment are key to improving the survival rate and reducing the mortality rate for lung cancer patients. This article introduces the integrated management model for patients with pulmonary nodules/lung cancer developed by West China Hospital of Sichuan University based on “internet plus” and health service team of treatment, nursing, and care. The Integrated Care Management Center has established a multidisciplinary team, using internet platforms and artificial intelligence tools to develop a whole life cycle health service system for patients with pulmonary nodules/lung cancer, which is from the screening of high-risk population for lung cancer, the intelligent risk stratification and follow-up management of pulmonary nodules, the subsequent standardized diagnosis and treatment of lung cancer and comorbidity management, until the patient’s demise. After the implementation of this model, the malignancy rate in surgically treated patients with pulmonary nodules reached 85.08%, and the patient satisfaction score was 95.76. This model provides a new idea and reference for the innovation of chronic disease service model and the management of pulmonary nodules and lung cancer.