It has been absent from an accepted criteria for normalization and quality control of the thoracic surgery until now. The ideal assessing instrument which will be used to evaluate the technical skills and surgical procedures should present a few vital characterizations below: objectivity, speciality in the content, detailed structure, and quantifiability. Objective structured assessment of technical skills (OSATS) has developed as a reliable method of surgical skills measurement. This article focuses on the history of OSATS and its prospect in the thoracic surgery area by reviewing relevant literatures.
ObjectiveTo analyze the value of structured electronic medical records for pulmonary nodules in increasing the ability of outpatient service and hospital management by resident physicians.MethodsWe included 40 trainees [94 males and 26 females aged 22-31 (26.45±2.81) years] who were trained in the standardized training base for surgical residents in our hospital from January 2018 to January 2021. The trainees were randomly divided into two groups including a structured group using the structured electronic medical record for pulmonary nodule and an unstructured group using unstructured electronic medical record designed by our department. The time of completing hospitalization records and first-time course records, the quality of course records, the accuracy of issuing admission orders, the quality of teaching rounds, and patient’s satisfaction between the two groups were analyzed and compared.Results(1) The average time in the structured group to complete inpatient medical records was significantly shorter than that of the unstructured group (53.61±8.12 min vs. 84.25±16.09 min, P<0.010); the average time in the structured group to complete the first-time course record was shorter than that of the unstructured group (13.20±5.43 min vs. 27.51±8.62 min, P<0.010), and there was a significant statistical difference between the two groups. (2) The overall teaching round quality score of the students in the structured group was significantly higher than that in the unstructured group (84.21±15.61 vs. 70.91±12.28, P<0.010). (3) The score of the medical record writing quality of the structured group was significantly higher than that of the unstructured group (80.25±9.22 vs. 74.22±5.40, P<0.010).ConclusionThe structured electronic medical record specific for pulmonary nodules can effectively improve the training efficiency in the standardized training of surgical residents, improve the clinical ability to deal with pulmonary nodules, improve the integrity and accuracy of key clinical data collected by students, and improve doctor-patient relationship.
The patients with rectal cancer account for 50% or more of patients with colorectal cancer. The rectal magnetic resonance imaging (MRI) plays a pivotal role in clinical practice for evaluating the treatment baseline of tumors. The structured report of MRI serves as the foundation so as to promote homogenized, standardized, and normalized diagnosis and treatment of rectal cancer. We presented the MRI-based baseline evaluation structured reporting system for rectal cancer developed by West China Hospital of Sichuan University, aiming to advance the standardization and normalization of imaging reports for treatment baseline assessment in rectal cancer.
ObjectiveTo prepare hierarchically structured fibrous scaffolds with different morphologies, and to explore the additional dimensionality for tuning the physicochemical properties of the scaffolds and the effect of their hemocompatibility and cytocompatibility.MethodsElectrospinning poly (e-caprolactone) (PCL)/polyvinylpyrrolidone (PVP) bicomponent fibers (PCL∶PVP mass ratios were 8∶2 and 5∶5 respectively), and the surface porous fibrous scaffolds were prepared by extracting PVP components. The scaffolds were labeled PCL-P8 and PCL-P5 respectively according to the mass ratio of polymer. In addition, shish-kebab (SK) structured scaffolds with different kebab sizes were created by solution incubation method, which use electrospun PCL fibers as shish while PCL chains in solution crystallizes on the fiber surface. The PCL fibrous scaffolds with smooth surface was established as control group. The hierarchically structured fibrous scaffolds were characterized by field emission scanning electron microspore, water contact angle tests, and differential scanning calorimeter (DSC) experiments. The venous blood of New Zealand white rabbits was taken and hemolysis and coagulation tests were used to characterize the blood compatibility of the scaffolds. The proliferation of the pig iliac artery endothelial cell (PIEC) on the scaffolds was detected by cell counting kit 8 (CCK-8) method, and the biocompatibility of the scaffolds was evaluated.ResultsField emission scanning electron microscopy showed that porous morphology appeared on the surface of PCL/PVP bicomponent fibers after extracting PVP. In addition, SK structure with periodic arrangement was successfully prepared by solution induction, and the longer the crystallization time, the larger the lamellar size and periodic distance. The contact angle and DSC measurements showed that when compared with smooth PCL fiber scaffolds, the crystallinity of PCL surface porous fibrous scaffolds and PCL-SK fibrous scaffolds increased, while the hydrophobicity of PCL-SK fibrous scaffolds increased, but the hydrophobicity of PCL porous scaffolds did not change significantly. The hemolysis test showed that the hemolysis rate of PCL surface porous fibrous scaffolds and PCL-SK fibrous scaffolds was higher than that of PCL fibrous scaffolds. According to American Society of Materials and Tests (ASTM) F756-08 standard, all scaffolds were non-hemolytic materials and were suitable for blood contact materials. Coagulation test showed that the coagulation index of PCL surface porous fibrous scaffolds and PCL-SK fibrous scaffolds was higher than that of PCL fibrous scaffolds at 5 and 10 minutes of culture. CCK-8 assay showed that both hierarchically structured fibrous scaffolds were more conducive to PIEC proliferation than PCL fibrous scaffold.ConclusionBased on electrospinning technology, solution-induced and blend phase separation methods can be used to construct multi-scale fiber scaffolds with different morphologies, which can not only regulate the surface physicochemical properties of the scaffolds, but also have good blood compatibility and biocompatibility. The hierarchically structured fibrous scaffolds have high application potential in the field of tissue engineering.
The informatization construction in medical field not only brings convenience to clinical doctors, but also creates huge data for clinical research. Taking the application of information technology in thoracic surgery as an example, we decide to talk about the establishment and application of esophageal cancer database based on standardized and structured electronic medical records. The aim, through the construction of database, is to improve clinical doctors’ management ability of esophageal cancer, to provide reference of the information construction to medical colleagues, and to promote the application of information in medicine.
The radiology diagnosis report encapsulates radiologists’ comprehensive analytical insights and deep interpretive understanding of patients’ imaging data, serving as an essential basis for disease diagnosis, clinical treatment planning, and prognosis assessment. As the primary medium through which radiologists contribute substantively to patient’s care, traditional free-text reports represent subjective interpretations shaped by individual experience and stylistic preferences. Such reliance on personal factors can introduce inconsistencies and limitations in clinical applications. To address these challenges, structured radiology reporting has been developed. We present a concise overview of the origins, developmental trajectory, current landscape, and emerging trends of structured radiology reports, highlighting their role in advancing standardized.
This paper explores the relationship between the cardiac volume and time, which is applied to control dynamic heart phantom. We selected 50 patients to collect their cardiac computed tomography angiography (CTA) images, which have 20 points in time series CTA images using retrospective electrocardiograph gating, and measure the volume of four chamber in 20-time points with cardiac function analysis software. Then we grouped patients by gender, age, weight, height, heartbeat, and utilize repeated measurement design to conduct statistical analyses. We proposed structured sparse learning to estimate the mathematic expression of cardiac volume variation. The research indicates that all patients’ groups are statistically significant in time factor (P = 0.000); there are interactive effects between time and gender groups in left ventricle (F = 8.597, P = 0.006) while no interactive effects in other chambers with the remaining groups; and the different weight groups’ volume is statistically significant in right ventricle (F = 9.004, P = 0.005) while no statistical significance in other chambers with remaining groups. The accuracy of cardiac volume and time relationship utilizing structured sparse learning is close to the least square method, but the former’s expression is more concise and more robust. The number of nonzero basic function of the structured sparse model is just 2.2 percent of that of least square model. Hence, the work provides more the accurate and concise expression of the cardiac for cardiac motion simulation.
Liver cancer is a highly prevalent malignancy of the digestive system in China. Hepatic imaging examinations, including CT and MRI, play a critical role in the screening, diagnosis, and therapeutic evaluation of liver cancer. To standardize terminology, reduce variability in imaging interpretation, and improve diagnostic consistency and accuracy, the Department of Radiology of West China Hospital of Sichuan University has developed a CT/MRI structured reporting specifically designed for high-risk populations of primary liver cancer, which is based on the 2018 version of the Liver Imaging Reporting and Data System published by the American College of Radiology. We introduce the design background, core elements, and practical application experience of the CT/MRI structured reporting developed by West China Hospital of Sichuan University, aiming to promote the standardization and uniformity of hepatic imaging evaluation for high-risk populations of liver cancer.
Objective To review the latest development in the research on the application of the electrostatic spinning technology in preparation of the nanometer high polymer scaffold. Methods The related articles published at home and abroad during the recent years were extensively reviewed and comprehensively analyzed. Results Micro/nano-structure and space topology on the surfaces of the scaffold materials, especially the weaving structure, were considered to have an important effect on the cell adhesion, proliferation, directional growth, and biological activation. The electrospun scaffold was reported to have a resemblance to the structure of the extracellular matrix and could be used as a promising scaffold for the tissue engineeringapplication. The electrospun scaffolds were applied to the cartilage, bone, blood vessel, heart, and nerve tissue engineering fields. Conclusion The nanostructured polymer scaffold can support the cell adhesion, proliferation, location, and differentiation，and this kind of scaffold has a considerable value in the tissue engineering field.
Assistant general practitioner training is an important way to provide qualified doctors for primary healthcare institutions, with a focus on the practical application of clinical knowledge and skills, as well as the diagnosis and treatment of common diseases. Panzhihua Iron and Steel Group General Hospital has introduced the electronic library in collaboration with clinical thinking and intelligent examination system based on the traditional training mode into the assistant general practitioner training. Compared to traditional training model, it can improve learning effectiveness, clinical theory, and practical skills of assistant general practitioners. Based on the above new teaching experience, this article deeply explores the advantages and problems faced by this teaching model, aiming to better promote it.