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.
Objectives To assess the efficacy and safety of standard trauma craniectomy (STC), compared with limited craniectomy (LC) for severe traumatic brain injury (sTBI) with refractory intracranial hypertension. Methods We searched the Cochrane Central Register of Controlled Trials-Central (The Cochrane Library Issue 3, 2008), MEDLINE (1966 to October 2008), EMbase (1984 to October 2008), CMB-disc (1979 to October 2006) and CNKI (1979 to October 2008) for completed studies, as well as clinical trial registries for ongoing studies and completed studies with unpublished data. The reference of included studies and relevant supplement or conference abstracts were handsearched. The search results were extracted, and then the quality of included studies was assessed using RevMan 5.0. Meta-analysis was conducted if the data was similar enough. Results Two randomized controlled trials (RCTs) involving 716 participants were identified. Compared with the LC group, the STC group had statistically significant, more favorable outcome on the basis of the Glasgow Outcome Scale, using measures such as mortality, efficiency, and survival, compared with those of LC group, which had statistic difference. The mean ICP fell more rapidly and to a lower level in the STC group than in the LC group. There was no statistically significant difference on the incidence of postoperative complications, including delayed hematoma, incision cerebrospinal fluid fistula, encephalomyelocele, traumatic epilepsy, and intracranial infection as well. Conclusion The efficacy of STC is superior to LC for severe TBI with refractory intracranial hypertension resulting from unilateral frontotemporoparietal contusion with or without intracerebral or subdural hematoma.
Intravitreal drug injection is a treatment for common chronic fundus diseases such as age-related macular degeneration and diabetic retinopathy. The “14th Five-Year” National Eye Health Plan (2021-2025) recommends focusing on fundus diseases and improve the management mode of patients with chronic eye diseases. Therefore, it is imperative to explore how to further optimize the service process of intravitreal injection under the premise of guaranteeing patients' medical safety, to promote medical service efficiency and standardized management level and improve the medical experience of patients. Based on the quality control standard of vitreous cavity injection for retinopathy in China, Chinese fundus disease and related field experts developed the present expert consensus on the establishment of a one-stop intravitreal injection model and the management of its organization after a serious, comprehensive, and complete discussion, focusing on a standardized operation process, quality control, and safety management, providing more references for establishing a suitable intravitreal injection management model for ophthalmology and promoting the development of diagnostic and treatment models for fundus disease in China.
Dynamic medication management can help to improve efficacy and save consumption in such trials when an investigational medication is expensive or in short supply or has a fairly short shelf-life in a long-lasting clinical trial, or, if protocol changes during study period. We presented the standard operating procedure of dynamic medication management and drug labeling through an instance of double-blind randomized controlled trial of Chinese Medicine for hepatopathy. Compared to conventional drug labeling, dynamic medication management and drug labeling is more flexibility to deal with problems during the study period, such as protocol update, medication waste, and outdated medication and so on. Appropriate method and reasonable procedure can ensure the precise implementation for drug labeling and medication management of double-blinded randomized controlled trials.
Objective Tissue engineering advance in supplying the reparative and reconstructive medicine with promising tissue engineered medical products(TEMPs) and the new therapy alternative. The related supervision and administration of TEMPs is being developed and the standard research of TEMPs is also in progress. The Food and Drug Administration(FDA) of the United States has treated TEMPs as combined products and supervised them according to the level of risk to patients. Lately, FDA has determined that the Center for Devices and Radiological Health (CDRH) should take charge of examination and approval of TEMPs, with the cooperation of the Center for Biological Evaluations and Research(CBER). The regulatory controls have been established respectively in European Union and Japan. In China, TEMPs are identified as medical devices combined with cells. The Department of Medical Device of the State Food and Drug Administration (SFDA) is responsible for the examination and approval of TEMPs, and National Institute for the Control of Pharmaceutical amp; Biological Products(NICPBP) is responsible for evaluation tests. The standards of TEMPs are formulated mainly by the American Society of Testing Materials(ASTM) and International Standardization Organization(ISO).
Sample size, mean and standard deviation are necessary when conducting meta-analysis for continuous outcomes. Advanced methods of data extraction were needed if the mean and the standard deviation couldn’t be obtained from a literature directly. Eight methods were introduced and two examples were given to illustrate how to apply the methods.
Objective To compare the cl inical results between high-flexion and standard cruciate-stabling prostheses in total knee arthroplasty (TKA) by using the 36-item short form health survey (SF-36). Methods Between August 2007 and January 2009, 98 patients (106 knees) underwent TKA with standard cruciate-stabl ing prostheses (standard group), and 46 patients (50 knees) underwent TKA with high-flexion prostheses (high-flexion group). In standard group, there were30 males (32 knees) and 68 females (74 knees) with an age of (70.0 ± 3.5) years, including 78 cases (82 knees) of osteoarthritis (OA) and 20 cases (24 knees) of rheumatoid arthritis (RA) with a disease duration of (14.5 ± 3.3) years; the Hospital for Special Surgery Scoring System (HSS) and the range of motion (ROM) were 56.1 ± 21.6 and (89.0 ± 16.1)°, respectively. In high-flexion group, there were 8 males (10 knees) and 38 females (40 knees) with an age of (68.6 ± 8.9) years, including 44 cases (47 knees) of OA and 2 cases (3 knees) of RA with a disease duration of (13.9 ± 4.1) years; the HSS and ROM were 58.9 ± 25.3 and (91.0 ± 19.3)°, respectively. There was no significant difference in the general data (P gt; 0.05) between 2 groups, so the cl inical data of 2 groups had comparabil ity. Results In standard group, poor wound heal ing and persistent headache caused by cerebrospinal fluid leakage occurred in 1 case, respectively. In high-flexion group, transient common peroneal nerve palsy occurred in 1 case. There was significant difference (P lt; 0.05) in the hospital ization expense between standard group [ (39 000 ± 6 000)] and highflexion goup [ (52 000 ± 8 000)]. The follow-up time was 12-26 months (18 months on average) in standard group (91 cases, 98 knees) and 11-19 months (13 months on average) in high-flexion group (44 cases, 47 knees). The SF-36 showed significant difference in role-physical score (P lt; 0.05), but no significant difference in other 7 indices scores (P gt; 0.05). At the final follow-up, the ROM was (129.1 ± 19.2)° in high-flexion group and (123.6 ± 16.7)° in standard group; showing significant difference (P lt; 0.05). The HSS was 91.2 ± 17.6 in high-flexion group and 92.5 ± 14.5 in standard group; showing no significant difference (P gt; 0.05). Conclusion After TKA, the ROM in high-flexion group is superior to that in standard group, but there is no obvious advantages in terms of the HSS and SF- 36 outcomes.
The Diabetic Foot and Peripheral Vascular Disease Study Group, Chinese Diabetes Society, released an expert advice Recommendations of Chinese Experts on the Standardized Diagnosis and Treatment of Diabetic Foot During Coronavirus Disease (COVID-19) Pandemic, and the International Diabetic Foot Care Group and D-Foot International released a document Fast-track Pathway for Diabetic Foot Ulceration During COVID-19 Crisis: A Document from International Diabetic Foot Care Group and D-Foot International during the 2020 outbreak, respectively. Both have the same goals, but the implementation focuses are different. The aim of this article is to give an interpretation of both expert advices in terms of the general principles, the epidemic prevention and control, the family, community and hospitalization management model of diabetic foot, the holistic principle of diabetic foot standardized management, and the telemedicine application in the late epidemic period.
With the acceleration of population aging, the health problems and care service needs of the elderly are increasing, while the capacity for family-based care is declining. To address these challenges, China has proposed the "integrated medical and nursing care" service model, which integrates medical and health services with elderly care. Geriatric medicine is one of the key technical components of this integrated service model. This study aims to construct a technical standard system for geriatric medicine within the integrated medical and elderly care services. It mainly includes the basic principles, overall framework, structure, and explanations of the geriatric medicine technical standard system, providing a technical and directional framework for the geriatric medicine technical standard system in the context of integrated medical and elderly care services.
Consensus reporting items for studies in primary care (CRISP) is a newly developed measurement tool developed abroad to standardize primary health care research, so as to improve the quality of reporting and enhance the applicability, comprehensiveness, transparency and operability of reporting. The report contains 24 Entries that follow the Introduction, Methods, Results, Discussion (IMRaD) format, and is primarily concerned with describing the research team, the patients, the study subjects, the health status, the clinical experience, the health care team, the interventions, the study interventions, and the findings in the PHC study / implementation of results, etc. This article introduces and interprets the reporting guidelines to help researchers better understand and apply this statement to improve the quality of reporting in primary health care research