BACKGROUND Acute traumatic spinal cord injury(ATSCI)usually results in disability,yet data on contemporary national trends of ATSCI incidence are limited.AIM To provide a systematic and basic theoretical basis for imp...BACKGROUND Acute traumatic spinal cord injury(ATSCI)usually results in disability,yet data on contemporary national trends of ATSCI incidence are limited.AIM To provide a systematic and basic theoretical basis for improving the treatment of acute spinal cord injury.METHODS Data from the Peking University Third Hospital Inpatient Sample databases were analyzed.A total of 304 patients with ATSCI were included from 2012 to 2017.The epidemiological data,treatment,complications and clinical outcomes of these patients were reviewed.RESULTS Of the 304 patients,257(84.5%)were male,and 75%of the patients were 55 years old or younger.135 patients had improved follow-up American Spinal Injury Association(ASIA)grades(44.4%).Only 14 patients with ASIA grade A improved.A statistically significant difference in prognosis between patients who underwent surgery within 72 h and those who underwent surgery after 72 h was observed(P<0.05).Surgery within 72 h resulted in better prognosis.The Steroid group and the Non-Steroid group showed a significant difference in outcome among patients with ASIA grades A and B(P<0.05).Patients with pneumonia had a poorer prognosis than patients without pneumonia(P<0.05).Surgery within 72 h resulted in better prognosis.CONCLUSION This study found that there was no significant difference in hospitalization time and prognosis between the Steroid group and the Non-Steroid group,but the patients with severe spinal cord injury(ASIA grades A and B)who underwent surgery combined with steroid therapy had a better prognosis than those who underwent surgery alone.The disastrous consequences of ATSCI and lack of consensus on the management strategy are obvious.Further improvements in treatment planns are needed in order to obtain more reliable functional outcomes.展开更多
The ＂Center of Excellence＂ concept has been employed in healthcare for several decades. This concept has been adopted in several disciplines; such as bariatric surgery, orthopedic surgery, diabetes and stroke. The m...The ＂Center of Excellence＂ concept has been employed in healthcare for several decades. This concept has been adopted in several disciplines; such as bariatric surgery, orthopedic surgery, diabetes and stroke. The most successful model in surgery thus far has been the bariatric program, with a very extensive network and a large prospective database. Recently, the American As-sociation of Gynecologic Laparoscopists has introduced this concept in gynecologic surgery. The ＂Center Of Excellence in Minimally Invasive Gynecology＂ （COEMIG） designation program has been introduced with the goals of increasing safety and efficiency, cutting cost and increasing patient awareness and access to mini-mally invasive surgical options for women. The program may harbor challenges as well, such as human and fnancial resources, and diffculties with implementation and maintenance of such designation. This commen-tary describes the COEMIG designation process, along with its potential benefits and possible challenges. Though no studies have been published to date on the value of this concept in the feld of gynecologic surgery, we envision this commentary to provoke such studies to examine the relative value of this new program.展开更多
美国胸外科学会(American Association for Thoracic Surgery,AATS)第98届年会于2018年4月28日至5月1日在美国加州圣迭戈市召开。本届年会围绕胸外科临床、基础研究热点,公布了多项研究成果,内容包括早期肺癌国际多中心研究的部分结果...美国胸外科学会(American Association for Thoracic Surgery,AATS)第98届年会于2018年4月28日至5月1日在美国加州圣迭戈市召开。本届年会围绕胸外科临床、基础研究热点,公布了多项研究成果,内容包括早期肺癌国际多中心研究的部分结果、大数据研究对肺癌诊疗指南的影响、手术与立体定向放疗疗效比较、肺癌免疫治疗、食管癌术前新辅助放化疗方案选择、食管癌术后复发方式及危险因素分析、食管良性疾病治疗新术式、气管隆突手术经验、肺移植供肺相关研究进展以及体外膜肺氧合在肺移植中的应用等。本文按照肺癌外科、食管外科、气管外科、肺移植进行分类,就会议公布的研究成果进行荟萃和报道。展开更多
Renal injuries are classified,based on the American Association for the Surgery of Trauma classification,in to five grades of injury.Several imaging modalities have been available for assessing the grade of renal inju...Renal injuries are classified,based on the American Association for the Surgery of Trauma classification,in to five grades of injury.Several imaging modalities have been available for assessing the grade of renal injury,each with their usefulness and limitations.Currently,plain radiographs and intravenous urography have no role in the evaluation of patients with suspected renal injury.Ultrasonography(USG) has a limited role in evaluating patients with suspected retroperitoneal injury;however,it plays an important role during follow up in patients with urinoma formation.USG helps to monitor the size of a urinoma and also for the drainage procedure.The role of selective renal arteriography is mainly limited to an interventional purpose rather than for diagnostic utility.Retrograde pyelography is useful in assessing ureteral and renal pelvis integrity in suspected ureteropelvic junction injury and for an interventional purpose,like placing a stent across the site of ureteric injury.Magnetic resonance imaging has no role in acute renal injuries.Multidetector computed tomography is the modality of choice in the evaluation of renal injuries.It is also useful in evaluating traumatic injuries to kidneys with preexisting abnormalities and can help to define the extent of penetrating injuries in patients with stab wounds in the flank region.The combination of imaging findings along with clinical information is important in the management of the individual patient.This article will describe a spectrum of renal injuries encountered in a trauma setting.展开更多
文摘BACKGROUND Acute traumatic spinal cord injury(ATSCI)usually results in disability,yet data on contemporary national trends of ATSCI incidence are limited.AIM To provide a systematic and basic theoretical basis for improving the treatment of acute spinal cord injury.METHODS Data from the Peking University Third Hospital Inpatient Sample databases were analyzed.A total of 304 patients with ATSCI were included from 2012 to 2017.The epidemiological data,treatment,complications and clinical outcomes of these patients were reviewed.RESULTS Of the 304 patients,257(84.5%)were male,and 75%of the patients were 55 years old or younger.135 patients had improved follow-up American Spinal Injury Association(ASIA)grades(44.4%).Only 14 patients with ASIA grade A improved.A statistically significant difference in prognosis between patients who underwent surgery within 72 h and those who underwent surgery after 72 h was observed(P<0.05).Surgery within 72 h resulted in better prognosis.The Steroid group and the Non-Steroid group showed a significant difference in outcome among patients with ASIA grades A and B(P<0.05).Patients with pneumonia had a poorer prognosis than patients without pneumonia(P<0.05).Surgery within 72 h resulted in better prognosis.CONCLUSION This study found that there was no significant difference in hospitalization time and prognosis between the Steroid group and the Non-Steroid group,but the patients with severe spinal cord injury(ASIA grades A and B)who underwent surgery combined with steroid therapy had a better prognosis than those who underwent surgery alone.The disastrous consequences of ATSCI and lack of consensus on the management strategy are obvious.Further improvements in treatment planns are needed in order to obtain more reliable functional outcomes.
文摘The ＂Center of Excellence＂ concept has been employed in healthcare for several decades. This concept has been adopted in several disciplines; such as bariatric surgery, orthopedic surgery, diabetes and stroke. The most successful model in surgery thus far has been the bariatric program, with a very extensive network and a large prospective database. Recently, the American As-sociation of Gynecologic Laparoscopists has introduced this concept in gynecologic surgery. The ＂Center Of Excellence in Minimally Invasive Gynecology＂ （COEMIG） designation program has been introduced with the goals of increasing safety and efficiency, cutting cost and increasing patient awareness and access to mini-mally invasive surgical options for women. The program may harbor challenges as well, such as human and fnancial resources, and diffculties with implementation and maintenance of such designation. This commen-tary describes the COEMIG designation process, along with its potential benefits and possible challenges. Though no studies have been published to date on the value of this concept in the feld of gynecologic surgery, we envision this commentary to provoke such studies to examine the relative value of this new program.
文摘美国胸外科学会(American Association for Thoracic Surgery,AATS)第98届年会于2018年4月28日至5月1日在美国加州圣迭戈市召开。本届年会围绕胸外科临床、基础研究热点,公布了多项研究成果,内容包括早期肺癌国际多中心研究的部分结果、大数据研究对肺癌诊疗指南的影响、手术与立体定向放疗疗效比较、肺癌免疫治疗、食管癌术前新辅助放化疗方案选择、食管癌术后复发方式及危险因素分析、食管良性疾病治疗新术式、气管隆突手术经验、肺移植供肺相关研究进展以及体外膜肺氧合在肺移植中的应用等。本文按照肺癌外科、食管外科、气管外科、肺移植进行分类,就会议公布的研究成果进行荟萃和报道。
文摘Renal injuries are classified,based on the American Association for the Surgery of Trauma classification,in to five grades of injury.Several imaging modalities have been available for assessing the grade of renal injury,each with their usefulness and limitations.Currently,plain radiographs and intravenous urography have no role in the evaluation of patients with suspected renal injury.Ultrasonography(USG) has a limited role in evaluating patients with suspected retroperitoneal injury;however,it plays an important role during follow up in patients with urinoma formation.USG helps to monitor the size of a urinoma and also for the drainage procedure.The role of selective renal arteriography is mainly limited to an interventional purpose rather than for diagnostic utility.Retrograde pyelography is useful in assessing ureteral and renal pelvis integrity in suspected ureteropelvic junction injury and for an interventional purpose,like placing a stent across the site of ureteric injury.Magnetic resonance imaging has no role in acute renal injuries.Multidetector computed tomography is the modality of choice in the evaluation of renal injuries.It is also useful in evaluating traumatic injuries to kidneys with preexisting abnormalities and can help to define the extent of penetrating injuries in patients with stab wounds in the flank region.The combination of imaging findings along with clinical information is important in the management of the individual patient.This article will describe a spectrum of renal injuries encountered in a trauma setting.
