ObjectiveTo summary the standard treatment for early gastric cancer. MethodsThe current early gastric cancer treatment guidelines around the world were analyzed and the standardized treatment patterns for early gastric cancer were concluded. ResultsThe accurate preoperative evaluation for early gastric cancer is the basis of standardized treatment which can be divided into staging evaluation and histological evaluation.The staging evaluation is focused on the gastric wall invasion and lymph node involvement of the tumor while the histologic evaluation emphasize the histological type and grading of the tumor.According to the precise evaluation for early gastric cancer, endoscopic surgery, laparoscopic surgery, open surgery, and multimodal therapy can be applied individually to the patients.Different treatment methods have their indications, but the indications of the therapies in different guidelines are suggested with slight differences. ConclusionIn clinical practice, the choice of treatment should be made with comprehensive consideration of diagnosis and individual characteristics of patients to achieve the most benefit on prognosis.
As the intensity of clinical and research work is high, teaching is gradually paid less attention to and the quality of education cannot be ensured. In this context, a full-time teaching position is set up in West China Hospital which is taken responsibility by qualified clinicians, to improve the teaching quality by strict management and omni-directional teaching. We introduce the setting and running of the full-time teaching position in West China Hospital in this paper.
ObjectiveTo explore a standardized model for cardiothoracic surgery resident training program based on a combined clinical and research oriented team approach. Methods We conducted this study in a nationally ranked Class AAA hospital among the eleven residents who were accepted into the program. Throughout their training periods, clinical surgical skills were taught by one-on-one mentoring by individually assigned doctoral degree advisors, other attending surgeons and doctoral degree candidates in the program. To foster their scientific curiosity and research skills, regular didactic lectures in basic science and statistical skills by the doctoral thesis advisors, supplemented by monthly journal clubs during which trainees were required to present and discuss a previously assigned topics based on recent clinical cases within the department, thus combining acquisition of clinical skills and theory/research at the same setting. ResultsEleven physicians were selected for this training path. With respect to clinical surgical skills, 4 residents were judged to be sufficient at the end of the first cycle. The other seven residents at the end of the second cycle. One trainee won the third prize in the Medical Skill Competition in the hospital. As for scientific research skills, the team produced 11 scientific articles, one of which was accepted by the annual national conference in cardiothoracic surgery and the first author was invited to present the article. The team submitted four research projects, one won funding at the provincial competition and three within the medical school. ConclusionOur proposed standardized model of cardiothoracic surgery resident training based on a combined clinical and research oriented approach appears to be practical with moderate success. Adaptation of this model by other cardiothoracic surgery training programs in the nation will further attest to its value and functionality.
Objective To explore a new teaching mode relying on the new media platform, aiming to stimulate residency standardized trainees’ interest in learning theories related to gynecology outpatient surgery, improve practical operation skills, and achieve better teaching effects. Methods The residency standardized trainees who rotate in the gynecology outpatient of West China Second University Hospital, Sichuan University between July 2021 and June 2022 were selected. According to the random number table method, the trainees were divided into the control group (using the traditional teaching mode) and the intervention group (using the teaching mode of combining the flipped classroom and simulated teaching relying on the new media platform). The assessment results, teacher evaluation, trainees self-evaluation and teaching satisfaction of the two groups were compared and analyzed. Results A total of 118 trainees were enrolled, 59 in each group. There was no significant difference in gender, age, years of training and education level between the two groups (P>0.05). The total scores of evaluation scores (87.59±4.54 vs. 85.17±3.70), teachers’ evaluation (87.05±3.79 vs. 85.14±3.75), and trainees’ self-evaluation (87.81±4.41 vs. 85.54±3.96) of trainees in the intervention group were better than those in the control group, and the differences were statistically significant (P<0.05). The clinical thinking ability [teachers’ evaluation (24.49±1.62 vs. 23.22±2.05), trainees’ self-evaluation (25.25±1.99 vs. 23.97±2.27) and operation skills [teachers’ evaluation (37.05±1.58 vs. 36.10±1.99), trainees’ self-evaluation (36.75±2.73 vs. 35.66±2.56)] of trainees in the intervention group were better than those in the control group, and the differences were statistically significant (P<0.05). The satisfaction rate of the trainees in the intervention group was 98.3%, and that of the trainees in the control group was 93.2%. The teaching satisfaction of the intervention group was better than that of the control group (P<0.05). Conclusion The teaching mode of combining flipped classroom and simulated teaching relying on the new media platform has effectively stimulated residency standardized trainees’ learning interest in gynecological outpatient surgery, improved trainees’ clinical practice ability, improved teaching satisfaction, achieved good teaching results, and can be promoted as a new teaching mode.
Under the same-day surgery mode, anesthesiologists play an important role in ensuring patient safety, eliminating medical risks, practicing the concept of enhanced recovery after surgery, and realizing comfortable diagnosis and treatment, and a standardized anesthesia management process is the key to protect patients. Based on the principled suggestions in The Consensus of Chinese Experts on Anaesthesia for Day Surgery, combined with the advanced management experience of day surgery anesthesia at home and abroad, and repeatedly revised through practice, a comprehensive, rigorous, and standardized anesthesia management process for same-day surgery was gradually explored by the First Affiliated Hospital of Dalian Medical University. This paper introduces the process from the aspects of procedure of anesthesia evaluation in same-day surgery, preoperative preparation, standardized intraoperative anesthesia management, postoperative pain management, and prevention and treatment of postoperative complications.
Objective To investigate the effectiveness of applying a standardized rehabilitation process in correction of adult clubfoot with the Ilizarov technique. Methods Thirty-eight adult patients who underwent orthopedic treatment with Ilizarov technique for clubfoot between August 2022 and December 2024 were retrospectively analyzed. The patients were divided into a study group and a control group with 19 cases in each group according to the different rehabilitation management processes and methods. The differences in baseline data such as gender, age, side, and preoperative Holden walking function grading between the two groups were not significant (P>0.05). In both groups, most of the clubfoot deformities were surgically corrected first, and the residual deformities were corrected by dynamic slow retraction with Ilizarov ring-type external fixation frame. The study group adopted standardized rehabilitation process management mode, including preoperative lower limb muscle strength training, postoperative pain and swelling management, weight-bearing management, gait and lower limb stability training. The control group adopted the conventional postoperative rehabilitation management mode. The occurrence of complications was recorded, including pin tract infection, ankle stiffness and pain, and deformity recurrence. Holden walking function grading was used to evaluate the walking ability of the patients. Clinical efficacy was evaluated by the QIN Sihe Deformity Correction Disability Repair and Functional Reconstruction Postoperative Efficacy Evaluation Scale. Patient satisfaction was evaluated by Likert score. Results Patients in both groups successfully completed surgery and rehabilitation and were followed up. The follow-up time ranged from 8 to 29 months, with a mean of 18.5 months. Among them, the follow-up time was (18.8±5.5) months in the study group and (18.2±5.7) months in the control group, and the difference between groups was not significant (t=0.316, P=0.754). The postoperative incidences of pin tract infection, ankle stiffness and pain, and deformity recurrence in the study group were 10.53%, 5.26%, and 5.26%, respectively, and in the control group were 21.05%, 36.84%, and 15.79%, respectively. And the difference between groups in the incidence of ankle stiffness and pain was significant (P=0.042). At last follow-up, both groups showed an improvement in Holden walking function grading compared to preoperative levels (P<0.05), and the grading of the study group was significantly higher than that of the control group (P=0.006). According to the QIN Sihe Deformity Correction Disability Repair and Functional Reconstruction Postoperative Efficacy Evaluation Scale, the grade difference between groups was not significant (P=0.089), and the excellent and good rates of clinical efficacy in study group and control group were 89.47% (17/19) and 73.68% (14/19), respectively. Patient satisfaction in study group was significantly better than that in control group (P=0.036). Conclusion Standardized rehabilitation process can effectively promote the postoperative functional recovery of adult clubfoot treated with Ilizarov technique, reduce the risk of complications and improve effectiveness.
Data management system is a major factor affecting the quality of clinical trial. Development of data management system include a steering group and data safety and monitoring board, data collection, database, performance of the data safety and monitoring, as well as locking of database. This article provides key issues of the five parts so as to help researchers understand the clinical trial data management system.
Objective To explore the application of the Handbook for the Training Nurses in the standardized training for nurses in pediatric surgery. Methods Twenty-four training nurses trained under the instruction of the Handbook for the Training Nurses in Department of Pediatric Surgery from July 2014 to December 2015 were included as the observation group. Their training effects were compared historically with those of twenty-four training nurses who were trained without the help of the handbook from January 2013 to June 2014 (the control group). Results After the completion of the half-year training, theoretical score of training nurses in the observation group was better than that in the control group, and the difference was significant (87.16±4.18 vs. 83.71±5.46; t=2.492, P=0.016). Meanwhile, the specialist practical skill examination of training nurses in the observation group, such as femoral vein blood collection, replacement of drainage bag and indwelling needle infusion in children, and emergency practical skill examination such as cardiopulmonary resuscitation and the use of simple respirator were higher than those in the control group; and the working performance scores of training nurses in the observation group, such as the ability to adapt to the environment, patient satisfaction, nursing document writing, work efficiency and morning questions were better than those in the control group; the differences were significant (P< 0.05). Conclusion The Handbook for the Training Nurses can help the training nurses to adjust their working environment, master the practical skills and nursing knowledge in pediatric surgery.