INTRODUCTIONThe National Health and Family Planning Commission of People＇s Republic of China released the ＂Regulations on canceling the admission approval of the third class medical technologies and relevant works＂...INTRODUCTIONThe National Health and Family Planning Commission of People＇s Republic of China released the ＂Regulations on canceling the admission approval of the third class medical technologies and relevant works＂ in July 2015. According to the new regulation, the obligations and responsibilities of health administration departments for the admission approval of the clinical applications on the third- and the second-class medical technologies will be transferred to medical institutions that perform the operations.展开更多
Background With the rapid development of computer technology, digital medicine has become a new direction in surgery. The application of digital medicine in hepatic surgery is still at the early stage and less reporte...Background With the rapid development of computer technology, digital medicine has become a new direction in surgery. The application of digital medicine in hepatic surgery is still at the early stage and less reported in the literature. The aim of this study was to apply digital medical technology in the context of hepatic surgery. Methods Data from 64-slice helical computed tomography of 17 patients, including 13 with hepatocellular carcinoma and 4 with hepatic hemangioma, were imported into independently developed medical image software program, segmentation and three-dimensional reconstruction were performed. The three-dimensional models were then processed with the FreeForm Modeling System. We used virtual surgical instruments to perform surgery on the models. Simulated surgeries included six hepatic segmentectomies, four left hemihepatectomies, three right hemihepatectomies for hepatocellular carcinoma, one hepatic segmentectomy, two stripping surgeries, and one irregular segmentectomy combined with stripping surgery for hemangioma. For resections involving more than three hepatic segments, total and residual functional hepatic volumes were measured before and after simulation surgery, and the resection ratio was calculated.Results The anatomy of the models was distinct and was used to localize lesions. We used virtual surgical instruments to perform simulated surgeries and used the models to optimize actual surgeries. We were able to minimize resection volume as well as surgical risk.Conclusions Digital medical technology is helpful in the diagnosis of hepatic disease and in optimizing surgical plans. Three-dimensional models can decrease surgical risk and help prevent postoperative hepatic failure.展开更多
Background： The development and application of medical technologies reflect the medical quality and clinical capacity of a hospital. It is also an effective approach in upgrading medical service and core competitiven...Background： The development and application of medical technologies reflect the medical quality and clinical capacity of a hospital. It is also an effective approach in upgrading medical service and core competitiveness among medical institutions. This study aimed to build a quantitative medical technology evaluation system through questionnaire survey within medical institutions to perforna an assessment to medical technologies more objectively and accurately, and promote the management of medical quality technologies and ensure the medical safety of various operations among the hospitals. Methods： A two-leveled quantitative medical technology evaluation system was built through a two-round questionnaire survey of chosen experts. The Delphi method was applied in identifying the structure of evaluation system and indicators. The judgment of the experts on the indicators was adopted in building the matrix so that the weight coefficient and maximum eigenvalue （λ. max）, consistency index （CI）, and random consistency ratio （CR） could be obtained and collected. The results were verified through consistency tests, and the index weight coefficient of each indicator was conducted and calculated through analytical hierarchy process. Results： Twenty-six experts of different medical fields were involved in the questionnaire survey, 25 of whom successfully responded to the two-round research. Altogether, 4 primary indicators （safety, effectiveness, innovativeness, and benefits）, as well as 13 secondary indicators, were included in the evaluation system. The matrix is built to conduct the λ max, CI, and CR of each expert in the survey, and the index weight coefficients of primary indicators were 0.33, 0.28, 0.27, and 0.12, respectively, and the index weight coefficients of secondary indicators were conducted and calculated accordingly. Conclusions： As the two-round questionnaire survey of experts and statistical analysis were performed and credibility of the results was verified through consistency evaluation test, the study established a quantitative medical technology evaluation system model and assessment indicators within medical institutions based on the Delphi method and analytical hierarchy process. Moreover, further verifications, adjustments, and optimizations of the system and indicators will be performed in follow-up studies.展开更多
Objective： To construct a quantitative ethical evaluation index system for the clinical approval of medical technology in China. Methods： Exploratory factor analysis （EFA） and first-order confirmatory factor analy...Objective： To construct a quantitative ethical evaluation index system for the clinical approval of medical technology in China. Methods： Exploratory factor analysis （EFA） and first-order confirmatory factor analysis （CFA） based on a structure equation model （SEM）, higher-order CFA and normalisation were used to establish an ethical evaluation index system for the clinical approval of medical technology. Data were processed in SPSS 13.0 and Lisre 15.3. Results： There were 52 third class indices, 15 second class indices, and 3 first class indices in this ethical evaluation index system. The weight of each index was calculated by normalisation. Conclusion： This study developed a three-level ethical evaluation index system, comprising 70 indices, for the clinical approval of medical technology.展开更多
Ⅰ. ORGANIZATION AND PERSONNEL At present there are 795 research institutes in China (in 1987 there were 351 independent ones and 441 affiliated ones) under the Chinese Academy of Medical Science,the Chinese Academy o...Ⅰ. ORGANIZATION AND PERSONNEL At present there are 795 research institutes in China (in 1987 there were 351 independent ones and 441 affiliated ones) under the Chinese Academy of Medical Science,the Chinese Academy of Preventive Medicine,the Academy of Traditional Chinese Medicine and the Chinese Academy of Military Medicine.They are playing the role of research centers for basic and clinical medicine,preventive medicine,traditional Chinese medicine,and mili-展开更多
Medical detection technology-from biochemical analysis to medical imaging has witnessed tremendous progress in the past decades,driven by the breakthrough of biomedical and scientific theories,the innovation of engine...Medical detection technology-from biochemical analysis to medical imaging has witnessed tremendous progress in the past decades,driven by the breakthrough of biomedical and scientific theories,the innovation of engineering techniques,as well as the discovery of new contrast mechanisms.These substantial progresses have significantly promoted展开更多
We have a scarcity of health care professionals in the rural areas and therefore we can offer medical services from a distance to the underserved rural population.
The thoracolumbar spine,due to its large range of motion and relatively fragile anatomical structure,is prone to traumatic fractures and has become one of the common types of fractures in clinical practice.Thoracic an...The thoracolumbar spine,due to its large range of motion and relatively fragile anatomical structure,is prone to traumatic fractures and has become one of the common types of fractures in clinical practice.Thoracic and lumbar fractures may lead to spinal instability,spinal stenosis,etc.,and early restoration of vertebral height and sequence is necessary.Although the technique of transpedicular screw internal fixation for traumatic vertebrae is effective in the short term,in the long run,there may be adverse situations such as fixation breakage and loosening,leading to loss of vertebral height and kyphosis deformity.The technique of internal fixation of injured vertebrae with screws is considered to minimize postoperative complications and is worthy of promotion and use.With the advancement of medical technology,imaging,and biomechanics,the treatment methods for thoracolumbar spinal fractures are becoming increasingly diverse.展开更多
Medical technologies refers to the measures taken for the purpose of diagnosing and curing diseases,alleviating illnesses,reducing the pain,as well as helping patients restore health and prolonging their lives.Accordi...Medical technologies refers to the measures taken for the purpose of diagnosing and curing diseases,alleviating illnesses,reducing the pain,as well as helping patients restore health and prolonging their lives.According to the regulation on the clinical application of medical technology published by the Ministry of Health in 2009,medical technologies are divided into three classes according to their safety and effectiveness.Comparing with second and third class medical technologies,first class medical technologies are more accurate in their safety and validity.1 Now that the Ministry of Health had made clear requirements for the management of the second and third class technologies,the first class technologies still lack specific standards for their admission as well as development management.2.Keywords：first class medical technologies; admission management; standards; working patterns展开更多
This essay analyzes the scientific evidence that forms the basis of bioactive materials,covering the fundamental understanding of bioactivity phenomena and correlation with the mechanisms of biocompatibility of biomat...This essay analyzes the scientific evidence that forms the basis of bioactive materials,covering the fundamental understanding of bioactivity phenomena and correlation with the mechanisms of biocompatibility of biomaterials.This is a detailed assessment of performance in areas such as bone-induction,cell adhesion,immunomodulation,thrombogenicity and antimicrobial behavior.Bioactivity is the modulation of biological activity by characteristics of the interfacial region that incorporates the material surface and the immediate local host tissue.Although the term‘bioactive material’is widely used and has a well understood general meaning,it would be useful now to concentrate on this interfacial region,considered as‘the bioactivity zone’.Bioactivity phenomena are either due to topographical/micromechanical characteristics,or to biologically active species that are presented in the bioactivity zone.Examples of topographical/micromechanical effects are the modulation of the osteoblast-osteoclast balance,nanotopographical regulation of cell adhesion,and bactericidal nanostructures.Regulation of bioactivity by biologically active species include their influence,especially of metal ions,on signaling pathways in bone formation,the role of cell adhesion molecules and bioactive peptides in cell attachment,macrophage polarization by immunoregulatory molecules and antimicrobial peptides.While much experimental data exists to demonstrate the potential of such phenomena,there are considerable barriers to their effective clinical translation.This essay shows that there is solid scientific evidence of the existence of bioactivity mechanisms that are associated with some types of biomaterials,especially when the material is modified in a manner designed to specifically induce that activity.展开更多
文摘INTRODUCTIONThe National Health and Family Planning Commission of People＇s Republic of China released the ＂Regulations on canceling the admission approval of the third class medical technologies and relevant works＂ in July 2015. According to the new regulation, the obligations and responsibilities of health administration departments for the admission approval of the clinical applications on the third- and the second-class medical technologies will be transferred to medical institutions that perform the operations.
基金This research was funded by the National Hlgh-Tech Research and Development Program of China （863 Program） （No. 2006AA2Z346）, Guangdong Province Science Foundation Group Program （No. 6200171）, National Nature Science Foundation of China （No. 30470493）, and Science and Technology Projects of Guangdong Province （No. 2003C34303）.
文摘Background With the rapid development of computer technology, digital medicine has become a new direction in surgery. The application of digital medicine in hepatic surgery is still at the early stage and less reported in the literature. The aim of this study was to apply digital medical technology in the context of hepatic surgery. Methods Data from 64-slice helical computed tomography of 17 patients, including 13 with hepatocellular carcinoma and 4 with hepatic hemangioma, were imported into independently developed medical image software program, segmentation and three-dimensional reconstruction were performed. The three-dimensional models were then processed with the FreeForm Modeling System. We used virtual surgical instruments to perform surgery on the models. Simulated surgeries included six hepatic segmentectomies, four left hemihepatectomies, three right hemihepatectomies for hepatocellular carcinoma, one hepatic segmentectomy, two stripping surgeries, and one irregular segmentectomy combined with stripping surgery for hemangioma. For resections involving more than three hepatic segments, total and residual functional hepatic volumes were measured before and after simulation surgery, and the resection ratio was calculated.Results The anatomy of the models was distinct and was used to localize lesions. We used virtual surgical instruments to perform simulated surgeries and used the models to optimize actual surgeries. We were able to minimize resection volume as well as surgical risk.Conclusions Digital medical technology is helpful in the diagnosis of hepatic disease and in optimizing surgical plans. Three-dimensional models can decrease surgical risk and help prevent postoperative hepatic failure.
文摘Background： The development and application of medical technologies reflect the medical quality and clinical capacity of a hospital. It is also an effective approach in upgrading medical service and core competitiveness among medical institutions. This study aimed to build a quantitative medical technology evaluation system through questionnaire survey within medical institutions to perforna an assessment to medical technologies more objectively and accurately, and promote the management of medical quality technologies and ensure the medical safety of various operations among the hospitals. Methods： A two-leveled quantitative medical technology evaluation system was built through a two-round questionnaire survey of chosen experts. The Delphi method was applied in identifying the structure of evaluation system and indicators. The judgment of the experts on the indicators was adopted in building the matrix so that the weight coefficient and maximum eigenvalue （λ. max）, consistency index （CI）, and random consistency ratio （CR） could be obtained and collected. The results were verified through consistency tests, and the index weight coefficient of each indicator was conducted and calculated through analytical hierarchy process. Results： Twenty-six experts of different medical fields were involved in the questionnaire survey, 25 of whom successfully responded to the two-round research. Altogether, 4 primary indicators （safety, effectiveness, innovativeness, and benefits）, as well as 13 secondary indicators, were included in the evaluation system. The matrix is built to conduct the λ max, CI, and CR of each expert in the survey, and the index weight coefficients of primary indicators were 0.33, 0.28, 0.27, and 0.12, respectively, and the index weight coefficients of secondary indicators were conducted and calculated accordingly. Conclusions： As the two-round questionnaire survey of experts and statistical analysis were performed and credibility of the results was verified through consistency evaluation test, the study established a quantitative medical technology evaluation system model and assessment indicators within medical institutions based on the Delphi method and analytical hierarchy process. Moreover, further verifications, adjustments, and optimizations of the system and indicators will be performed in follow-up studies.
基金Supported by National Natural Science Fundation of China(No.71173054)Guangdong Province Physiology and Social Science Fund(No.GD10CZX02)
文摘Objective： To construct a quantitative ethical evaluation index system for the clinical approval of medical technology in China. Methods： Exploratory factor analysis （EFA） and first-order confirmatory factor analysis （CFA） based on a structure equation model （SEM）, higher-order CFA and normalisation were used to establish an ethical evaluation index system for the clinical approval of medical technology. Data were processed in SPSS 13.0 and Lisre 15.3. Results： There were 52 third class indices, 15 second class indices, and 3 first class indices in this ethical evaluation index system. The weight of each index was calculated by normalisation. Conclusion： This study developed a three-level ethical evaluation index system, comprising 70 indices, for the clinical approval of medical technology.
文摘Ⅰ. ORGANIZATION AND PERSONNEL At present there are 795 research institutes in China (in 1987 there were 351 independent ones and 441 affiliated ones) under the Chinese Academy of Medical Science,the Chinese Academy of Preventive Medicine,the Academy of Traditional Chinese Medicine and the Chinese Academy of Military Medicine.They are playing the role of research centers for basic and clinical medicine,preventive medicine,traditional Chinese medicine,and mili-
文摘Medical detection technology-from biochemical analysis to medical imaging has witnessed tremendous progress in the past decades,driven by the breakthrough of biomedical and scientific theories,the innovation of engineering techniques,as well as the discovery of new contrast mechanisms.These substantial progresses have significantly promoted
文摘We have a scarcity of health care professionals in the rural areas and therefore we can offer medical services from a distance to the underserved rural population.
文摘The thoracolumbar spine,due to its large range of motion and relatively fragile anatomical structure,is prone to traumatic fractures and has become one of the common types of fractures in clinical practice.Thoracic and lumbar fractures may lead to spinal instability,spinal stenosis,etc.,and early restoration of vertebral height and sequence is necessary.Although the technique of transpedicular screw internal fixation for traumatic vertebrae is effective in the short term,in the long run,there may be adverse situations such as fixation breakage and loosening,leading to loss of vertebral height and kyphosis deformity.The technique of internal fixation of injured vertebrae with screws is considered to minimize postoperative complications and is worthy of promotion and use.With the advancement of medical technology,imaging,and biomechanics,the treatment methods for thoracolumbar spinal fractures are becoming increasingly diverse.
文摘Medical technologies refers to the measures taken for the purpose of diagnosing and curing diseases,alleviating illnesses,reducing the pain,as well as helping patients restore health and prolonging their lives.According to the regulation on the clinical application of medical technology published by the Ministry of Health in 2009,medical technologies are divided into three classes according to their safety and effectiveness.Comparing with second and third class medical technologies,first class medical technologies are more accurate in their safety and validity.1 Now that the Ministry of Health had made clear requirements for the management of the second and third class technologies,the first class technologies still lack specific standards for their admission as well as development management.2.Keywords：first class medical technologies; admission management; standards; working patterns
文摘This essay analyzes the scientific evidence that forms the basis of bioactive materials,covering the fundamental understanding of bioactivity phenomena and correlation with the mechanisms of biocompatibility of biomaterials.This is a detailed assessment of performance in areas such as bone-induction,cell adhesion,immunomodulation,thrombogenicity and antimicrobial behavior.Bioactivity is the modulation of biological activity by characteristics of the interfacial region that incorporates the material surface and the immediate local host tissue.Although the term‘bioactive material’is widely used and has a well understood general meaning,it would be useful now to concentrate on this interfacial region,considered as‘the bioactivity zone’.Bioactivity phenomena are either due to topographical/micromechanical characteristics,or to biologically active species that are presented in the bioactivity zone.Examples of topographical/micromechanical effects are the modulation of the osteoblast-osteoclast balance,nanotopographical regulation of cell adhesion,and bactericidal nanostructures.Regulation of bioactivity by biologically active species include their influence,especially of metal ions,on signaling pathways in bone formation,the role of cell adhesion molecules and bioactive peptides in cell attachment,macrophage polarization by immunoregulatory molecules and antimicrobial peptides.While much experimental data exists to demonstrate the potential of such phenomena,there are considerable barriers to their effective clinical translation.This essay shows that there is solid scientific evidence of the existence of bioactivity mechanisms that are associated with some types of biomaterials,especially when the material is modified in a manner designed to specifically induce that activity.
