目的 探讨吻合器痔上黏膜环形切除钉合术(PPH)手术操作规范。 方法 对《PPH暂行规范》(修订)“术中操作” 中的两个关键性步骤进行分析、讨论。结果 《PPH暂行规范》(修订)中的手术操作指导存在不便操作、相互矛盾、难以取得理想效果等问题。在PPH操作中,适度牵拉后置入肛管扩张器以充分显露痔上黏膜,原位6~8针均匀而恰到好处的黏膜下层双荷包缝合,以痔核上缘作为荷包缝合的主要定位依据,荷包缝好松开牵拉钳后用食指或无创伤钳裹纱布将痔核及脱出的肛管组织尽量往直肠内推送复位,以及收紧吻合器时持续用力牵引荷包线,旋紧吻合器直至最紧状态时才予以击发是保证PPH手术顺利进行和增加切割组织宽度的重要操作技巧。结论 对《PPH暂行规范》(修订)的探讨得出的操作技巧宜在规范中予以推荐和强调。
Primary bronchopulmonary carcinoma occurs in the bronchial mucosa epithelium, also called lung cancer (LC), and has currently become the first cause of death of malignant tumors in China. With constant efforts of Chinese physicians, the diagnosis and management of LC has made certain progress, but standardized surgery for LC still varies to a great extent due to difference regions, nature of medical centers, and technical levels. Complete and standardized surgical resection can provide good long-term survival for patients with stageⅠ, Ⅱand partly ⅢA LC, and cannot be a substitute for other treatment, which shows the importance of standardized surgery. As the most solid member, surgery plays a decisive role in comprehensive multidisciplinary treatment of LC. Today's medical development requires thoracic surgeons to provide most standardized and individualized treatment with principles of evidence-based medicine. This review focuses on progress of standardized surgery for stage Ⅰto ⅢA LC.
目的 依托四川大学华西医院的临床资源,建立了一个规范化、标准化的肿瘤组织标本库,对临床医学研究提供了珍贵的资源。 方法 于2009年6月创建四川大学华西医院肿瘤组织标本库、进行质量控制、规范化管理及总结实践经验。 结果 从创建肿瘤组织标本库至2012年2月,共收集各类肿瘤(胃、食管、肝、肺、肠、乳腺、胰腺、甲状腺、纵隔、肾脏、喉、脑)组织标本44 609例,包括肿瘤组织、肿瘤旁组织(距离肿瘤组织2 cm的组织)和切缘远端非肿瘤组织(距离肿瘤组织>5 cm的组织)。对肿瘤组织标本进行有效和科学的管理,为科研提供了便利和高质量的资源。 结论 建立了一个国际标准化、规范化、信息完善的肿瘤组织标本库,可为肿瘤的发生、发展、转移及生物标志物的研究提供高质量的标本。
Emergency treatment of ocular trauma is a systematic and complicated work. Rapid and correct diagnosis and treatment are needed to maximize the recovery of ocular structure and function. In recent years, China has made remarkable progress in the emergency treatment of ocular trauma, including the development of Expert consensus on the norms of emergency treatment of ocular trauma in China (2019), the establishment of a national ocular trauma database, and the development of VisionGo Artificial Intelligence prediction system for ocular trauma. These measures improve the treatment level of ocular trauma and provide support for the prediction of postoperative visual acuity in severe traumatic eyes. However, with the development of economy and society, the characteristics of ocular trauma in our country have changed. For example, the majority of hospitalized patients were open ocular injuries, farmers and workers were the main occupational groups, and the proportion of eye injuries caused by traffic injuries increased year by year, and the proportion of women and minors increased. Although the annual loss of life of ocular trauma disability in China has decreased faster than the world average, the emergency treatment of ocular trauma still faces many challenges, such as regional differences, insufficient primary medical resources, lack of standardized training, and insufficient promotion of emergency treatment standards. In order to cope with these challenges, it is necessary to further strengthen the popularization of science and technology for the prevention and treatment of ocular trauma, standardize the emergency treatment process, strengthen the training of grass-roots medical personnel, strengthen the safety of emergency surgery, and pay special attention to the particularity of children's ocular trauma. In addition, relevant research has been actively carried out to establish a complete database of emergency patients with ocular trauma to promote the accurate prevention and treatment of ocular trauma.
ObjectiveTo analyze and evaluate the effect of the pharmacist-participated standardized drug management measures on improving the quality of drug management in day surgery center.MethodsDay surgery center carried out the pharmacist-participated standardized drug management since January 2019, including establishing a drug management group, strengthening the drug management specification, enhancing the training for standardized drug management, carrying out periodic inspection by pharmacist, etc. The Drug Management Quality Assessment Table was used to evaluate and compare the quality of drug management in day surgery center before standardized management (October 2018) and after standardized management (October 2019).ResultsThrough the standardized management, the quality of drug management in day surgery center was effectively improved, and the total score of drug quality management increased from 88.0 points before standardized management to 95.0 points after standardized management.ConclusionThe participation of pharmacists in the standardized drug management can effectively improve the quality of drug management in day surgery center, and ensure the safety of patients.