BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations.This manuscript explores the multidisciplinary appro...BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations.This manuscript explores the multidisciplinary approach to understanding and managing pituitary macroadenomas,integrating neurosurgery,endocrinology,radiology,and pathology perspectives.AIM To summarize the literature on pituitary macroadenoma and outline the possible multidisciplinary approach in the diagnosis,management,and rehabilitation of individuals with pituitary adenomas,to add to already preexisting knowledge,in managing these cases enhancing better ocular and systemic outcomes.METHODS A search was conducted on an online publication database(PubMed)using the term“pituitary adenoma”including all results published over twenty years(2004-2024).Results were sorted for relevance,language,and completeness.RESULTS A total of 176 records were returned.The guidelines of the PRISMA 2020 statement were followed in this study.A total of 23 records were excluded due to being out of scope while a further 13 records were duplicates.Another 17 records were not available as full-length articles and were also excluded.The references of each included record was further searched for relevant publications.A total of 141 records were therefore used in this minireview.CONCLUSION Pituitary macroadenomas pose substantial clinical challenges due to their size and potential for significant hormonal and neurological impact,modern therapeutic strategies offer effective management options.Early detection and comprehensive treatment are essential for optimizing patient outcomes and maintaining quality of life.Continued research and advancements in medical technology are likely to further enhance the management and prognosis of this condition in the future.展开更多
Objective:To explore the experiences of palliative care multidisciplinary teams from the perspective of pluralistic synergy theory,aiming to enhance team collaboration.Method:Utilizing a qualitative research methodolo...Objective:To explore the experiences of palliative care multidisciplinary teams from the perspective of pluralistic synergy theory,aiming to enhance team collaboration.Method:Utilizing a qualitative research methodology,we conducted in-depth interviews with 15 palliative care team members to collect data.Results:The operational framework of palliative care multidisciplinary teams under pluralistic synergy theory involves:enhancing collaboration among team members;developing a comprehensive management model for the team;rationalizing the allocation of work tasks and durations;improving team communication and interaction through effective communication mechanisms and platforms;cultivating skilled professionals;and establishing a robust health record management system.Conclusion:The operational mechanism,informed by pluralistic synergy theory,advances the development of palliative care.展开更多
BACKGROUND Lynch syndrome(LS),an autosomal dominant genetic disorder,is distinguished by germline mutations in the DNA mismatch repair genes,including MLH1.These mutations confer an elevated risk for the development o...BACKGROUND Lynch syndrome(LS),an autosomal dominant genetic disorder,is distinguished by germline mutations in the DNA mismatch repair genes,including MLH1.These mutations confer an elevated risk for the development of colorectal cancer(CRC)and an array of other malignancies.Timely detection,facilitated by genetic profiling and stringent molecular surveillance,is crucial.It enables the implementation of customized therapeutic strategies,which have the potential to markedly enhance patient outcomes.Despite its significant public health impact,LS is frequently underdiagnosed,underscoring the necessity for increased vigilance and the adoption of precision medicine tactics.CASE SUMMARY This case presentation focuses on a 54-year-old male patient with a strong familial predisposition to colon cancer,who was identified to have LS-associated multiple colorectal neoplasms.Utilizing a comprehensive,multidisciplinary therapeutic strategy that encompassed precision medicine,immunotherapy with pembrolizumab,and stringent molecular residual disease monitoring,we effectively managed his advanced CRC.This tailored approach led to the achievement of sustained clinical remission exceeding 30 months,illustrating the promise of personalized treatment protocols in optimizing outcomes for individuals with LS and associated colorectal malignancies.CONCLUSION A synergistic,multidisciplinary approach is essential for managing LS-associated CRC,advocating for personalized care pathways in precision medicine.展开更多
BACKGROUND Currently,there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization(TACE)on patients with hepatocellular carcinoma...BACKGROUND Currently,there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization(TACE)on patients with hepatocellular carcinoma(HCC),underscoring the urgent need for higher-level research in this area.AIM To investigate the association of multidisciplinary treatment strategies with the immunological,coagulation,and tumor biomarker responses after post-TACE in HCC.METHODS This retrospective analysis included 100 patients with HCC who were categorized based on the treatment approach into the control(patients treated with TACE alone)and experimental groups(patients receiving multidisciplinary treatment strategies post-TACE).Participant characteristics,short-term efficacy,and safety assessment as well as immunological,coagulation,and tumor biomarker res-ponses between the two groups were collected and compared.RESULTS Compared with the control group,the experimental group demonstrated a superior overall response rate,along with an increased fibrinogen,markedly improved immunological biomarker,lower prothrombin time,thrombin time,alpha-fetoprotein,carcinoembryonic antigen,and carbohydrate antigen 199 levels,as well as a decreased abnormal prothrombin incidence,and a lower overall rate of adverse reactions.Notably,no significant difference in the activated partial thromboplastin time and D-dimer levels was observed between the two groups.CONCLUSION Multidisciplinary treatment strategies post-TACE have improved the treatment outcome,the immunological response,and the coagulation function,lowered the tumor biomarker response levels,and reduced the risk of adverse reactions in patients with HCC.展开更多
This letter discusses the critical yet underrecognized intersection of chronic renal insufficiency and Nocardia brasiliensis skin infection in the case reported by Zhang et al,emphasizing the diagnostic challenges and...This letter discusses the critical yet underrecognized intersection of chronic renal insufficiency and Nocardia brasiliensis skin infection in the case reported by Zhang et al,emphasizing the diagnostic challenges and therapeutic complexities in the context of advanced age,comorbidities,and immunocompromised populations.The study’s strengths included its integration of immunological profiling and precision medicine,demonstrating that a tailored low-dose trimethoprimsulfamethoxazole regimen with pharmacokinetic monitoring can improve outcomes in geriatric patients with chronic renal insufficiency while mitigating nephrotoxicity risks.However,its limitations included a single-case design,reliance on phenotypic diagnostics,and the lack of information regarding comorbidity interactions.The findings support the use of advanced molecular tools for rapid pathogen identification and identification of co-infection.Future studies should prioritize elucidating the synergistic effects of chronic kidney disease-uremia and immunosuppression on Nocardia colonization,developing biomarkers for early detection,and conducting global epidemiological studies in endemic regions.This case underscores the importance of interdisciplinary collaboration and innovative diagnostics to optimize management of nocardiosis in vulnerable populations.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)ranks as the sixth most common cancer and the third-leading cause of cancer-related deaths worldwide.The multidisciplinary tumor board(MDTB)has been recognized for improving out...BACKGROUND Hepatocellular carcinoma(HCC)ranks as the sixth most common cancer and the third-leading cause of cancer-related deaths worldwide.The multidisciplinary tumor board(MDTB)has been recognized for improving outcomes in cancer management,but its role in patients with HCC undergoing liver transplantation(LT)remains underexplored.AIM To evaluate the impact of an MDTB on survival outcomes in patients with HCC undergoing LT.METHODS We retrospectively analyzed 393 patients with HCC who underwent LT at our institution from October 2015 to October 2021.Patients were categorized into the MDTB and non-MDTB groups.We compared preoperative and postoperative characteristics,overall survival(OS),and disease-free survival(DFS)between the two groups.RESULTS Within the University of California,San Francisco(UCSF)criteria,no significant differences in OS and DFS were noted between the MDTB and non-MDTB groups.However,for patients who exceeded the UCSF criteria,the MDTB group exhibited a substantial improvement in both OS and DFS.The 1-year,3-year,and 5-year OS rates for the MDTB group in this subgroup were 88.68%,75.29%,and 61.78%,respectively,compared to 83.02%,64.07%,and 38.25%,respectively in the non-MDTB group.Similarly,DFS rates were 89.47%,71.35%,and 63.52%,respectively,vs 82.18%,53.78%,and 34.04%,respectively.CONCLUSION The MDTB approach was particularly beneficial for patients with HCC exceeding the UCSF criteria,significantly improving OS and DFS.These findings advocate for integrating MDTB into clinical practice for optimizing the management of high-risk patients with HCC undergoing LT.展开更多
Crush syndrome demands an integrated multidisciplinary approach that spans acute surgical decisions and long-term functional recovery.In response to Khan et al’s recent systematic review,we propose complementary pers...Crush syndrome demands an integrated multidisciplinary approach that spans acute surgical decisions and long-term functional recovery.In response to Khan et al’s recent systematic review,we propose complementary perspectives that address two underrepresented dimensions:Vascular surgical decision-making and psychiatric rehabilitation.We emphasize the use of intraoperative technologies such as indocyanine green fluorescence angiography and compartment pressure monitoring to guide limb salvage strategies and reperfusion management.Additionally,we advocate for the systematic integration of mental health screening and trauma-informed psychiatric care to address the high prevalence of psychological distress in survivors.Embedding these domains into standardized protocols could enhance both short-and long-term outcomes,particularly in highimpact trauma and disaster settings.展开更多
Currently,the use of immune checkpoint inhibitors(ICIs)has shown notable clinical efficacy in treating various malignant tumors,significantly improving patient prognosis.However,while ICIs enhance the body’s anti-tum...Currently,the use of immune checkpoint inhibitors(ICIs)has shown notable clinical efficacy in treating various malignant tumors,significantly improving patient prognosis.However,while ICIs enhance the body’s anti-tumor effects,they can also trigger immune-related adverse events(irAEs),with ICI-associated colitis being one of the more prevalent forms.This condition can disrupt treatment,necessitate drug discontinuation,and adversely affect therapeutic outcomes.In severe cases,irAEs may even become life-threatening.A recent case report by Hong et al highlights the importance of vigilance for ICI-associated colitis in patients experiencing symptoms such as diarrhea and abdominal pain,which can arise both during and even after completion of ICI treatment.Early identification,multidisciplinary management,and continuous monitoring of patients are essential steps to further improve outcomes.展开更多
BACKGROUND Postoperative patients with gastrointestinal tumors are at high risk for poor wound healing and psychological distress,such as anxiety and depression,which can negatively impact recovery and quality of life...BACKGROUND Postoperative patients with gastrointestinal tumors are at high risk for poor wound healing and psychological distress,such as anxiety and depression,which can negatively impact recovery and quality of life.Multidisciplinary team(MDT)collaborative nursing has emerged as a comprehensive care approach that may address both physical and psychological needs.AIM To explored the impact of MDT collaborative nursing on wound healing and anxiety/depression symptoms in postoperative patients with gastrointestinal tumors.METHODS A retrospective analysis was conducted on 364 patients with gastrointestinal tumours admitted to our hospital between January 2022 and December 2024.Based on differing postoperative nursing approaches,two groups were established:the MDT group(n=196)and the control group(n=168).The control group received conventional nursing interventions,while the MDT group received MDT collaborative nursing.The study compared wound healing outcomes,pre-intervention and one-month post-intervention Hospital Anxiety and Depression Scale(HADS)scores,Functional Assessment of Cancer Therapy-General(FACT-G)quality of life scores,and complication rates between the two groups.RESULTS The MDT group demonstrated a Grade A wound healing rate of 88.27%and total treatment compliance of 99.49%,both significantly higher than the control group(75.00%and 95.83%,respectively).The complication incidence rate was 3.06%in the MDT group,lower than the control group(8.93%),with all differences statistically significant(P<0.05).After one month of intervention,patients in the MDT group demonstrated lower Anxiety Self-Rating Scale and Depression Self-Rating Scale scores on the HADS scale compared to the control group.Conversely,their scores on the FACT-G scale for physical,social/family,emotional,and functional domains were higher than those in the control group,with all differences being statistically significant(P<0.05).CONCLUSION MDT collaborative care promotes wound healing in patients undergoing gastrointestinal tumour surgery,alleviates anxiety and depressive symptoms,enhances treatment adherence and quality of life,and reduces the incidence of complications.展开更多
The rising prevalence of chronic multimorbidity poses substantial challenges to healthcare systems,necessitating the development of innovative management strategies to optimize patient care and system efficiency.The s...The rising prevalence of chronic multimorbidity poses substantial challenges to healthcare systems,necessitating the development of innovative management strategies to optimize patient care and system efficiency.The study by Fontalba-Navas et al investigates the implementation of a novel high complexity unit(HCU)specifically designed to improve the management of patients with chronic complex conditions.By adopting a multidisciplinary approach,the HCU aims to provide comprehensive,patient-centered care that enhances health outcomes and alleviates the strain on traditional hospital services.Utilizing a longitudinal analysis of data from the Basic Minimum Data Set,this study compares hospitalization metrics among the HCU,Internal Medicine,and other departments within a regional hospital throughout 2022.The findings reveal that the HCU's integrated care model significantly reduces readmission rates and boosts patient satisfaction compared to conventional care practices.The study highlights the HCU's potential as a replicable model for managing chronic multimorbidity,emphasizing its effectiveness in minimizing unnecessary hospitalizations and enhancing the overall quality of patient care.This innovative approach not only addresses the complexities associated with chronic multimorbid conditions but also offers a sustainable framework for healthcare systems confronting similar challenges.展开更多
Objectives:This study was conducted to determine the effect of multidisciplinary nursing intervention(MNI)on interdialytic weight gain(IDWG)and quality of life(QoL)among chronic hemodialysis patients.Materials and Met...Objectives:This study was conducted to determine the effect of multidisciplinary nursing intervention(MNI)on interdialytic weight gain(IDWG)and quality of life(QoL)among chronic hemodialysis patients.Materials and Methods:Quantitative research approach with randomized-controlled,single-blind trial was conducted among 120 chronic hemodialysis patients in Institute of Medical Sciences and SUM Hospital Bhubaneswar,Odisha,India from February 2023 to February 2024.Participants were randomly assigned into the experimental group(n1=65)and control group(n2=55)by block randomization methods.The experimental group received the intervention phase up to the 6th week,along with the usual treatment,and the control group received only standard treatment up to the end of the study.After that,they received the diet chart plan and fluid distribution timetable.Results:Significant improvements were found in IDWG and QoL for the experimental group.The experimental group exhibited a sharp decline in weight gain within the group(F=20.05,P<0.001)between the group(F=13.02,P<0.001),interaction effects between the groups across the time point(F=5.67,P<0.005).Kidney disease QoL scores(KDQOL^(TM)36)increased from 49.38±9.56 to 58.63±6.04 in the experimental group,compared to an increase from 50.84±9.25 to 52.04±8.02 in the control group.Conclusion:This trial showed that MNIs significantly reduced IDWG and improved KDQOL^(TM)36 scores,with the experimental group outperforming the control,highlighting the intervention’s effectiveness.展开更多
Unlike traditional propeller-driven underwater vehicles,blended-wing-body underwater gliders(BWBUGs)achieve zigzag gliding through periodic adjustments of their net buoyancy,enhancing their cruising capabilities while...Unlike traditional propeller-driven underwater vehicles,blended-wing-body underwater gliders(BWBUGs)achieve zigzag gliding through periodic adjustments of their net buoyancy,enhancing their cruising capabilities while mini-mizing energy consumption.However,enhancing gliding performance is challenging due to the complex system design and limited design experience.To address this challenge,this paper introduces a model-based,multidisciplinary system design optimization method for BWBUGs at the conceptual design stage.First,a model-based,multidisciplinary co-simulation design framework is established to evaluate both system-level and disciplinary indices of BWBUG performance.A data-driven,many-objective multidisciplinary optimization is subsequently employed to explore the design space,yielding 32 Pareto optimal solutions.Finally,a model-based physical system simulation,which represents the design with the largest hyper-volume contribution among the 32 final designs,is established.Its gliding perfor-mance,validated by component behavior,lays the groundwork for constructing the entire system’s digital prototype.In conclusion,this model-based,multidisciplinary design optimization method effectively generates design schemes for innovative underwater vehicles,facilitating the development of digital prototypes.展开更多
Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative ...Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative potential of comprehensive perioperative disinfection and isolation protocols in gastrointestinal surgery,demonstrating a 55%reduction in postoperative infection rates and attenuation of systemic inflammation.Their findings underscore the critical role of multidisciplinary strategies—such as preoperative povidone-iodine decolonization,intraoperative laminar airflow systems,and strict postoperative wound care—in mitigating infection risk and preserving organ function.However,the study revealed persistent gaps in protocol standardization and compliance monitoring,particularly in resource-limited settings.Although these measures reduce reliance on antibiotics and align with global antimicrobial resistance containment efforts,challenges such as the high cost of technology and issues with contextual adaptability warrant urgent attention.This study conclusively demonstrated that structured perioperative disinfection protocols significantly transform surgical outcomes by creating comprehensive infection barriers that extend beyond traditional antibiotic prophylaxis.Future priorities include prospective multicenter trials to validate efficacy,cost-benefit analyses for equitable implementation,and integration of artificial intelligence-driven innovations to optimize infection prevention.This study redefines infection control as a cornerstone of surgical quality,urging collaborative action to bridge the gap between clinical evidence and real-world practice.展开更多
BACKGROUND Prolonged recovery following colorectal cancer(CRC)surgery can result in physiological discomfort and psychological stress,underscoring the importance of effective perioperative care to enhance patient outc...BACKGROUND Prolonged recovery following colorectal cancer(CRC)surgery can result in physiological discomfort and psychological stress,underscoring the importance of effective perioperative care to enhance patient outcomes.AIM To evaluate the impact of multidisciplinary collaborative enhanced recovery after surgery(ERAS)nursing on patients undergoing CRC surgery.METHODS This study included 100 patients who underwent CRC surgery between August 2022 and August 2024.Patients were divided into two groups based on the perioperative nursing approach.The control group(n=50)received conventional nursing care,whereas the observation group(n=50)received multidisciplinary collaborative ERAS nursing.Postoperative recovery time,disease perception,pain levels,coping strategies,self-management efficacy,and quality of life were compared between the two groups.RESULTS Compared with the control group,the observation group exhibited significantly shorter times to ambulation,gastrointestinal motility,first meal intake,and hospital stay(P<0.05).No significant differences were observed in pre-nursing indicators between the two groups(P>0.05).After nursing,both groups showed improvements in disease perception scores,self-management efficacy,and quality of life scores,along with reductions in pain levels and coping strategy scores,except for the confrontative and venting dimensions.The observation group demonstrated significantly greater improvements in these scores,with significant intergroup and intragroup differences(P<0.05).CONCLUSION Multidisciplinary collaborative ERAS nursing can facilitate postoperative recovery in patients with CRC,enhance disease cognition,alleviate pain,and encourage active coping,thereby improving self-management efficacy and quality of life.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)present a significant healthcare challenge attributable to their high rates of disability and the limitations of applied traditional nursing approaches.Effective management is crit...BACKGROUND Diabetic foot ulcers(DFUs)present a significant healthcare challenge attributable to their high rates of disability and the limitations of applied traditional nursing approaches.Effective management is critical for uneventful health outcomes.AIM To investigate the effects of multidisciplinary team(MDT)nursing interventions and blood glucose control on the negative emotions and satisfaction of DFUhealing patients.METHODS This retrospective cohort study included 115 patients with DFUs,divided into MDT and blood glucose control intervention group(n=60)and standard care control group(n=55).The comparison factors were wound area,new granulation tissue coverage area,wound healing rate,2-hour postprandial blood glucose level,fasting plasma glucose level,Hamilton Anxiety Scale score,Hamilton Depression Scale score,and nursing satisfaction.RESULTS After 4 weeks,the average wound area reduced from 22.04±6.48 cm^(2)to 11.96±3.63 cm^(2)(P<0.05).New granulation tissue coverage area reached 52.85±18.39 cm^(2) for the intervention group and 28.39±9.94 cm^(2)(P<0.05)in the control group,respectively.The healing rate was significantly higher in the intervention group than in the control group(91.7%vs 76.4%,P<0.05).Fasting plasma glucose decreased more sharply in the intervention group(from 8.36±0.98 mmol/L to 6.91±1.23 mmol/L)than in the control group(8.41±1.05 mmol/L to 7.81±1.27 mmol/L),with the intervention group maintaining significantly lower levels(P<0.05).The intervention group demonstrated a significantly greater reduction in 2-hour postprandial blood glucose levels(11.35±2.67 mmol/L to 7.52±1.38 mmol/L)compared to the control group(11.61±3.01 mmol/L to 8.72±1.63 mmol/L;P<0.05).Hamilton Anxiety Scale and Hamilton Depression Scale scores were significantly lower in the intervention group(P<0.05).Patient satisfaction with nursing was 93.33%and 74.55%in the intervention and control groups,respectively(P<0.05).CONCLUSION MDT combined with blood glucose control enhanced healing rates and positively influenced emotional well-being and satisfaction among patients.This strategy holds potential for application in clinical practice.展开更多
BACKGROUND Surgical resection is the primary treatment for gastric cancer,but it often leads to slow recovery,high complications,and poor psychological health.The effectiveness of enhanced recovery after surgery(ERAS)...BACKGROUND Surgical resection is the primary treatment for gastric cancer,but it often leads to slow recovery,high complications,and poor psychological health.The effectiveness of enhanced recovery after surgery(ERAS)as a new nursing model postsurgery remains uncertain.AIM To investigate the clinical effect of accelerated recovery nursing program based on multidisciplinary collaboration model in gastric cancer surgery.METHODS A total of 120 patients who underwent radical gastrectomy at our hospital from January 2023 to December 2024 were included in the study.They were divided into two groups of 60 each:The control group,which received routine care,and the study group,which received ERAS based on multidisciplinary collaboration.Both groups received care until discharge.We compared gastrointestinal recovery,psychological status,Short Form 36 Health Survey scores,Pittsburgh Sleep Quality Index,complications,and nursing satisfaction between the two groups.RESULTS The study group had significantly shorter defecation time,bowel sound recovery time,and flatus time compared to the control group(P<0.05).The Hamilton Anxiety Scale and Hamilton Depression Rating Scale scores were also significantly lower in the study group(P<0.05).Additionally,the study group reported better sleep quality(P<0.05)and had fewer postoperative complications.Their Short Form 36 Health Survey scores and nursing satisfaction were higher than those of the control group,with all differences being statistically significant(P<0.05).CONCLUSION The ERAS based on multidisciplinary collaboration in patients undergoing radical gastrectomy can accelerate postoperative recovery,reduce the occurrence of complications,and improve psychological state,quality of life,sleep quality and nursing satisfaction.展开更多
BACKGROUND:Ischemic stroke refers to a disorder in the blood supply to a local area of brain tissue for various reasons and is characterized by high morbidity,mortality,and disability.Early reperfusion of brain tissue...BACKGROUND:Ischemic stroke refers to a disorder in the blood supply to a local area of brain tissue for various reasons and is characterized by high morbidity,mortality,and disability.Early reperfusion of brain tissue at risk of injury is crucial for the treatment of acute ischemic stroke.The purpose of this study was to evaluate comfort levels in managing acute stroke patients with hypoxemia who required endotracheal intubation after multidisciplinary in situ simulation training and to shorten the door-to-image time.METHODS:This quality improvement project utilized a comprehensive multidisciplinary in situ simulation exercise.A total of 53 participants completed the two-day in situ simulation training.The main outcome was the self-reported comfort levels of participants in managing acute stroke patients with hypoxemia requiring endotracheal intubation before and after simulation training.A 5-point Likert scale was used to measure participant comfort.A paired-sample t-test was used to compare the mean self-reported comfort scores of participants,as well as the endotracheal intubation time and door-to-image time on the fi rst and second days of in situ simulation training.The door-to-image time before and after the training was also recorded.RESULTS:The findings indicated that in situ simulation training could enhance participant comfort when managing acute stroke patients with hypoxemia who required endotracheal intubation and shorten door-to-image time.For the emergency management of hypoxemia or tracheal intubation,the mean post-training self-reported comfort score was signifi cantly higher than the mean pre-training comfort score(hypoxemia:4.53±0.64 vs.3.62±0.69,t=-11.046,P<0.001;tracheal intubation:3.98±0.72 vs.3.43±0.72,t=-6.940,P<0.001).We also observed a decrease in the tracheal intubation and door-to-image time and a decreasing trend in the door-to-image time,which continued after the training.CONCLUSION:Our study demonstrates that the implementation of in situ simulation training in a clinical environment with a multidisciplinary approach may improve the ability and confi dence of stroke team members,optimize the fi rst-aid process,and eff ectively shorten the door-to-image time of stroke patients with emergency complications.展开更多
Critical care medicine focuses on understanding the pathophysiological mechanisms and treatment approaches for life-threatening conditions,including sepsis,severe trauma/burns,hemorrhagic shock,heatstroke,and acute pa...Critical care medicine focuses on understanding the pathophysiological mechanisms and treatment approaches for life-threatening conditions,including sepsis,severe trauma/burns,hemorrhagic shock,heatstroke,and acute pancreatitis,all of which have high incidence rates.These conditions are primarily characterized by acute multi-organ dysfunction,with sudden onset,severe illness,and high mortality rates.Additionally,critical care treatment demands substantial medical resources,imposing significant economic burdens on patients’families and society.In recent years,critical care medicine has achieved notable progress,especially in multidisciplinary integration with immunology-based fields.Collaboration across disciplines has not only accelerated advancements in critical care but also propelled the rapid development of modern immunology.This paper provides an overview and assessment of the cross-disciplinary fusion between critical care medicine and immunology,exploring how these fields related extensions mutually enhance each other.It further analyzes China’s potential to become a global leader in this area within the next 5 to 10 years.展开更多
Recently,we read the article“Pathologically successful conversion hepatectomy for advanced giant hepatocellular carcinoma after multidisciplinary therapy:A case report and review of the literature”published in the W...Recently,we read the article“Pathologically successful conversion hepatectomy for advanced giant hepatocellular carcinoma after multidisciplinary therapy:A case report and review of the literature”published in the World Journal of Gastrointestinal Oncology.The prognosis of advanced hepatocellular carcinoma(HCC)is poor,and multidisciplinary comprehensive treatment is currently the main research direction.This case report demonstrated the efficacy of the combination therapy of transcatheter arterial chemoembolization,hepatic arterial infusion chemotherapy,epclusa,lenvatinib and sintilimab for a patient with advanced HCC,and the report can serve as a reference for clinical practice.We would also like to share some of our views.展开更多
In this research,a Multidisciplinary Design Optimization approach is proposed for the dual-spin guided flying projectile design considering external and internal parts of the body as design variables.In this way,a par...In this research,a Multidisciplinary Design Optimization approach is proposed for the dual-spin guided flying projectile design considering external and internal parts of the body as design variables.In this way,a parametric formulation is developed.All related disciplines,including structure,aerodynamics,guidance,and control are considered.Minimum total mass,maximum aerodynamic control effectiveness,minimum miss distance,maximum yield stress in all subsystems,controllability and gyroscopic stability constraints are some of objectives/constraints taken into account.The problem is formulated in All-At-Ones Multidisciplinary Design Optimization approach structure and solved by Simulated Annealing and minimax algorithms.The optimal configurations are evaluated in various aspects.The resulted optimal configurations have met all design objectives and constraints.展开更多
文摘BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations.This manuscript explores the multidisciplinary approach to understanding and managing pituitary macroadenomas,integrating neurosurgery,endocrinology,radiology,and pathology perspectives.AIM To summarize the literature on pituitary macroadenoma and outline the possible multidisciplinary approach in the diagnosis,management,and rehabilitation of individuals with pituitary adenomas,to add to already preexisting knowledge,in managing these cases enhancing better ocular and systemic outcomes.METHODS A search was conducted on an online publication database(PubMed)using the term“pituitary adenoma”including all results published over twenty years(2004-2024).Results were sorted for relevance,language,and completeness.RESULTS A total of 176 records were returned.The guidelines of the PRISMA 2020 statement were followed in this study.A total of 23 records were excluded due to being out of scope while a further 13 records were duplicates.Another 17 records were not available as full-length articles and were also excluded.The references of each included record was further searched for relevant publications.A total of 141 records were therefore used in this minireview.CONCLUSION Pituitary macroadenomas pose substantial clinical challenges due to their size and potential for significant hormonal and neurological impact,modern therapeutic strategies offer effective management options.Early detection and comprehensive treatment are essential for optimizing patient outcomes and maintaining quality of life.Continued research and advancements in medical technology are likely to further enhance the management and prognosis of this condition in the future.
文摘Objective:To explore the experiences of palliative care multidisciplinary teams from the perspective of pluralistic synergy theory,aiming to enhance team collaboration.Method:Utilizing a qualitative research methodology,we conducted in-depth interviews with 15 palliative care team members to collect data.Results:The operational framework of palliative care multidisciplinary teams under pluralistic synergy theory involves:enhancing collaboration among team members;developing a comprehensive management model for the team;rationalizing the allocation of work tasks and durations;improving team communication and interaction through effective communication mechanisms and platforms;cultivating skilled professionals;and establishing a robust health record management system.Conclusion:The operational mechanism,informed by pluralistic synergy theory,advances the development of palliative care.
基金Supported by the National Natural Science Foundation of China,No.81972790the Natural Science Foundation of Gansu Province,China,No.22JR5RA004.
文摘BACKGROUND Lynch syndrome(LS),an autosomal dominant genetic disorder,is distinguished by germline mutations in the DNA mismatch repair genes,including MLH1.These mutations confer an elevated risk for the development of colorectal cancer(CRC)and an array of other malignancies.Timely detection,facilitated by genetic profiling and stringent molecular surveillance,is crucial.It enables the implementation of customized therapeutic strategies,which have the potential to markedly enhance patient outcomes.Despite its significant public health impact,LS is frequently underdiagnosed,underscoring the necessity for increased vigilance and the adoption of precision medicine tactics.CASE SUMMARY This case presentation focuses on a 54-year-old male patient with a strong familial predisposition to colon cancer,who was identified to have LS-associated multiple colorectal neoplasms.Utilizing a comprehensive,multidisciplinary therapeutic strategy that encompassed precision medicine,immunotherapy with pembrolizumab,and stringent molecular residual disease monitoring,we effectively managed his advanced CRC.This tailored approach led to the achievement of sustained clinical remission exceeding 30 months,illustrating the promise of personalized treatment protocols in optimizing outcomes for individuals with LS and associated colorectal malignancies.CONCLUSION A synergistic,multidisciplinary approach is essential for managing LS-associated CRC,advocating for personalized care pathways in precision medicine.
文摘BACKGROUND Currently,there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization(TACE)on patients with hepatocellular carcinoma(HCC),underscoring the urgent need for higher-level research in this area.AIM To investigate the association of multidisciplinary treatment strategies with the immunological,coagulation,and tumor biomarker responses after post-TACE in HCC.METHODS This retrospective analysis included 100 patients with HCC who were categorized based on the treatment approach into the control(patients treated with TACE alone)and experimental groups(patients receiving multidisciplinary treatment strategies post-TACE).Participant characteristics,short-term efficacy,and safety assessment as well as immunological,coagulation,and tumor biomarker res-ponses between the two groups were collected and compared.RESULTS Compared with the control group,the experimental group demonstrated a superior overall response rate,along with an increased fibrinogen,markedly improved immunological biomarker,lower prothrombin time,thrombin time,alpha-fetoprotein,carcinoembryonic antigen,and carbohydrate antigen 199 levels,as well as a decreased abnormal prothrombin incidence,and a lower overall rate of adverse reactions.Notably,no significant difference in the activated partial thromboplastin time and D-dimer levels was observed between the two groups.CONCLUSION Multidisciplinary treatment strategies post-TACE have improved the treatment outcome,the immunological response,and the coagulation function,lowered the tumor biomarker response levels,and reduced the risk of adverse reactions in patients with HCC.
文摘This letter discusses the critical yet underrecognized intersection of chronic renal insufficiency and Nocardia brasiliensis skin infection in the case reported by Zhang et al,emphasizing the diagnostic challenges and therapeutic complexities in the context of advanced age,comorbidities,and immunocompromised populations.The study’s strengths included its integration of immunological profiling and precision medicine,demonstrating that a tailored low-dose trimethoprimsulfamethoxazole regimen with pharmacokinetic monitoring can improve outcomes in geriatric patients with chronic renal insufficiency while mitigating nephrotoxicity risks.However,its limitations included a single-case design,reliance on phenotypic diagnostics,and the lack of information regarding comorbidity interactions.The findings support the use of advanced molecular tools for rapid pathogen identification and identification of co-infection.Future studies should prioritize elucidating the synergistic effects of chronic kidney disease-uremia and immunosuppression on Nocardia colonization,developing biomarkers for early detection,and conducting global epidemiological studies in endemic regions.This case underscores the importance of interdisciplinary collaboration and innovative diagnostics to optimize management of nocardiosis in vulnerable populations.
基金Supported by Natural Science Foundation of Tianjin,No.21JCYBJC01140Key Project of Tianjin Science and Technology Bureau Applied Basic Research,No.23JCZDJC01200+1 种基金Key Project of Scientific Research Plan of Tianjin Municipal Education Commission,No.2023YXZD07Project of Tianjin Science and Technology Bureau Applied Basic Research,No.23JCYBJC01800.
文摘BACKGROUND Hepatocellular carcinoma(HCC)ranks as the sixth most common cancer and the third-leading cause of cancer-related deaths worldwide.The multidisciplinary tumor board(MDTB)has been recognized for improving outcomes in cancer management,but its role in patients with HCC undergoing liver transplantation(LT)remains underexplored.AIM To evaluate the impact of an MDTB on survival outcomes in patients with HCC undergoing LT.METHODS We retrospectively analyzed 393 patients with HCC who underwent LT at our institution from October 2015 to October 2021.Patients were categorized into the MDTB and non-MDTB groups.We compared preoperative and postoperative characteristics,overall survival(OS),and disease-free survival(DFS)between the two groups.RESULTS Within the University of California,San Francisco(UCSF)criteria,no significant differences in OS and DFS were noted between the MDTB and non-MDTB groups.However,for patients who exceeded the UCSF criteria,the MDTB group exhibited a substantial improvement in both OS and DFS.The 1-year,3-year,and 5-year OS rates for the MDTB group in this subgroup were 88.68%,75.29%,and 61.78%,respectively,compared to 83.02%,64.07%,and 38.25%,respectively in the non-MDTB group.Similarly,DFS rates were 89.47%,71.35%,and 63.52%,respectively,vs 82.18%,53.78%,and 34.04%,respectively.CONCLUSION The MDTB approach was particularly beneficial for patients with HCC exceeding the UCSF criteria,significantly improving OS and DFS.These findings advocate for integrating MDTB into clinical practice for optimizing the management of high-risk patients with HCC undergoing LT.
文摘Crush syndrome demands an integrated multidisciplinary approach that spans acute surgical decisions and long-term functional recovery.In response to Khan et al’s recent systematic review,we propose complementary perspectives that address two underrepresented dimensions:Vascular surgical decision-making and psychiatric rehabilitation.We emphasize the use of intraoperative technologies such as indocyanine green fluorescence angiography and compartment pressure monitoring to guide limb salvage strategies and reperfusion management.Additionally,we advocate for the systematic integration of mental health screening and trauma-informed psychiatric care to address the high prevalence of psychological distress in survivors.Embedding these domains into standardized protocols could enhance both short-and long-term outcomes,particularly in highimpact trauma and disaster settings.
基金Supported by 2021 Key Topic of Qinghai Provincial Health System–Guiding Plan Topic,No.2021-WJZDX-43.
文摘Currently,the use of immune checkpoint inhibitors(ICIs)has shown notable clinical efficacy in treating various malignant tumors,significantly improving patient prognosis.However,while ICIs enhance the body’s anti-tumor effects,they can also trigger immune-related adverse events(irAEs),with ICI-associated colitis being one of the more prevalent forms.This condition can disrupt treatment,necessitate drug discontinuation,and adversely affect therapeutic outcomes.In severe cases,irAEs may even become life-threatening.A recent case report by Hong et al highlights the importance of vigilance for ICI-associated colitis in patients experiencing symptoms such as diarrhea and abdominal pain,which can arise both during and even after completion of ICI treatment.Early identification,multidisciplinary management,and continuous monitoring of patients are essential steps to further improve outcomes.
文摘BACKGROUND Postoperative patients with gastrointestinal tumors are at high risk for poor wound healing and psychological distress,such as anxiety and depression,which can negatively impact recovery and quality of life.Multidisciplinary team(MDT)collaborative nursing has emerged as a comprehensive care approach that may address both physical and psychological needs.AIM To explored the impact of MDT collaborative nursing on wound healing and anxiety/depression symptoms in postoperative patients with gastrointestinal tumors.METHODS A retrospective analysis was conducted on 364 patients with gastrointestinal tumours admitted to our hospital between January 2022 and December 2024.Based on differing postoperative nursing approaches,two groups were established:the MDT group(n=196)and the control group(n=168).The control group received conventional nursing interventions,while the MDT group received MDT collaborative nursing.The study compared wound healing outcomes,pre-intervention and one-month post-intervention Hospital Anxiety and Depression Scale(HADS)scores,Functional Assessment of Cancer Therapy-General(FACT-G)quality of life scores,and complication rates between the two groups.RESULTS The MDT group demonstrated a Grade A wound healing rate of 88.27%and total treatment compliance of 99.49%,both significantly higher than the control group(75.00%and 95.83%,respectively).The complication incidence rate was 3.06%in the MDT group,lower than the control group(8.93%),with all differences statistically significant(P<0.05).After one month of intervention,patients in the MDT group demonstrated lower Anxiety Self-Rating Scale and Depression Self-Rating Scale scores on the HADS scale compared to the control group.Conversely,their scores on the FACT-G scale for physical,social/family,emotional,and functional domains were higher than those in the control group,with all differences being statistically significant(P<0.05).CONCLUSION MDT collaborative care promotes wound healing in patients undergoing gastrointestinal tumour surgery,alleviates anxiety and depressive symptoms,enhances treatment adherence and quality of life,and reduces the incidence of complications.
基金Supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education,No.NRF-RS-2023-00237287.
文摘The rising prevalence of chronic multimorbidity poses substantial challenges to healthcare systems,necessitating the development of innovative management strategies to optimize patient care and system efficiency.The study by Fontalba-Navas et al investigates the implementation of a novel high complexity unit(HCU)specifically designed to improve the management of patients with chronic complex conditions.By adopting a multidisciplinary approach,the HCU aims to provide comprehensive,patient-centered care that enhances health outcomes and alleviates the strain on traditional hospital services.Utilizing a longitudinal analysis of data from the Basic Minimum Data Set,this study compares hospitalization metrics among the HCU,Internal Medicine,and other departments within a regional hospital throughout 2022.The findings reveal that the HCU's integrated care model significantly reduces readmission rates and boosts patient satisfaction compared to conventional care practices.The study highlights the HCU's potential as a replicable model for managing chronic multimorbidity,emphasizing its effectiveness in minimizing unnecessary hospitalizations and enhancing the overall quality of patient care.This innovative approach not only addresses the complexities associated with chronic multimorbid conditions but also offers a sustainable framework for healthcare systems confronting similar challenges.
文摘Objectives:This study was conducted to determine the effect of multidisciplinary nursing intervention(MNI)on interdialytic weight gain(IDWG)and quality of life(QoL)among chronic hemodialysis patients.Materials and Methods:Quantitative research approach with randomized-controlled,single-blind trial was conducted among 120 chronic hemodialysis patients in Institute of Medical Sciences and SUM Hospital Bhubaneswar,Odisha,India from February 2023 to February 2024.Participants were randomly assigned into the experimental group(n1=65)and control group(n2=55)by block randomization methods.The experimental group received the intervention phase up to the 6th week,along with the usual treatment,and the control group received only standard treatment up to the end of the study.After that,they received the diet chart plan and fluid distribution timetable.Results:Significant improvements were found in IDWG and QoL for the experimental group.The experimental group exhibited a sharp decline in weight gain within the group(F=20.05,P<0.001)between the group(F=13.02,P<0.001),interaction effects between the groups across the time point(F=5.67,P<0.005).Kidney disease QoL scores(KDQOL^(TM)36)increased from 49.38±9.56 to 58.63±6.04 in the experimental group,compared to an increase from 50.84±9.25 to 52.04±8.02 in the control group.Conclusion:This trial showed that MNIs significantly reduced IDWG and improved KDQOL^(TM)36 scores,with the experimental group outperforming the control,highlighting the intervention’s effectiveness.
基金supported by the Postdoctoral Fellowship Program of CPSF(Grant No.GZC20242194)the National Natural Science Foundation of China(Grant Nos.52175251 and 52205268)+1 种基金the Industry Key Technology Research Fund Project of Northwestern Polytechnical University(Grant No.HYGJXM202318)the National Basic Scientific Research Program(Grant No.JCKY2021206B005).
文摘Unlike traditional propeller-driven underwater vehicles,blended-wing-body underwater gliders(BWBUGs)achieve zigzag gliding through periodic adjustments of their net buoyancy,enhancing their cruising capabilities while mini-mizing energy consumption.However,enhancing gliding performance is challenging due to the complex system design and limited design experience.To address this challenge,this paper introduces a model-based,multidisciplinary system design optimization method for BWBUGs at the conceptual design stage.First,a model-based,multidisciplinary co-simulation design framework is established to evaluate both system-level and disciplinary indices of BWBUG performance.A data-driven,many-objective multidisciplinary optimization is subsequently employed to explore the design space,yielding 32 Pareto optimal solutions.Finally,a model-based physical system simulation,which represents the design with the largest hyper-volume contribution among the 32 final designs,is established.Its gliding perfor-mance,validated by component behavior,lays the groundwork for constructing the entire system’s digital prototype.In conclusion,this model-based,multidisciplinary design optimization method effectively generates design schemes for innovative underwater vehicles,facilitating the development of digital prototypes.
文摘Surgical site infections remain a significant challenge in gastrointestinal surgery,despite advances in surgical techniques and antimicrobial therapy.Wang et al’s retrospective analysis highlights the transformative potential of comprehensive perioperative disinfection and isolation protocols in gastrointestinal surgery,demonstrating a 55%reduction in postoperative infection rates and attenuation of systemic inflammation.Their findings underscore the critical role of multidisciplinary strategies—such as preoperative povidone-iodine decolonization,intraoperative laminar airflow systems,and strict postoperative wound care—in mitigating infection risk and preserving organ function.However,the study revealed persistent gaps in protocol standardization and compliance monitoring,particularly in resource-limited settings.Although these measures reduce reliance on antibiotics and align with global antimicrobial resistance containment efforts,challenges such as the high cost of technology and issues with contextual adaptability warrant urgent attention.This study conclusively demonstrated that structured perioperative disinfection protocols significantly transform surgical outcomes by creating comprehensive infection barriers that extend beyond traditional antibiotic prophylaxis.Future priorities include prospective multicenter trials to validate efficacy,cost-benefit analyses for equitable implementation,and integration of artificial intelligence-driven innovations to optimize infection prevention.This study redefines infection control as a cornerstone of surgical quality,urging collaborative action to bridge the gap between clinical evidence and real-world practice.
文摘BACKGROUND Prolonged recovery following colorectal cancer(CRC)surgery can result in physiological discomfort and psychological stress,underscoring the importance of effective perioperative care to enhance patient outcomes.AIM To evaluate the impact of multidisciplinary collaborative enhanced recovery after surgery(ERAS)nursing on patients undergoing CRC surgery.METHODS This study included 100 patients who underwent CRC surgery between August 2022 and August 2024.Patients were divided into two groups based on the perioperative nursing approach.The control group(n=50)received conventional nursing care,whereas the observation group(n=50)received multidisciplinary collaborative ERAS nursing.Postoperative recovery time,disease perception,pain levels,coping strategies,self-management efficacy,and quality of life were compared between the two groups.RESULTS Compared with the control group,the observation group exhibited significantly shorter times to ambulation,gastrointestinal motility,first meal intake,and hospital stay(P<0.05).No significant differences were observed in pre-nursing indicators between the two groups(P>0.05).After nursing,both groups showed improvements in disease perception scores,self-management efficacy,and quality of life scores,along with reductions in pain levels and coping strategy scores,except for the confrontative and venting dimensions.The observation group demonstrated significantly greater improvements in these scores,with significant intergroup and intragroup differences(P<0.05).CONCLUSION Multidisciplinary collaborative ERAS nursing can facilitate postoperative recovery in patients with CRC,enhance disease cognition,alleviate pain,and encourage active coping,thereby improving self-management efficacy and quality of life.
基金Supported by the Zhejiang Provincial Science and Technology Plan for Traditional Chinese Medicine,No.2025ZL594Municipal-Level Science and Technology Plan Project of Zhejiang Province,No.2023ZD039.
文摘BACKGROUND Diabetic foot ulcers(DFUs)present a significant healthcare challenge attributable to their high rates of disability and the limitations of applied traditional nursing approaches.Effective management is critical for uneventful health outcomes.AIM To investigate the effects of multidisciplinary team(MDT)nursing interventions and blood glucose control on the negative emotions and satisfaction of DFUhealing patients.METHODS This retrospective cohort study included 115 patients with DFUs,divided into MDT and blood glucose control intervention group(n=60)and standard care control group(n=55).The comparison factors were wound area,new granulation tissue coverage area,wound healing rate,2-hour postprandial blood glucose level,fasting plasma glucose level,Hamilton Anxiety Scale score,Hamilton Depression Scale score,and nursing satisfaction.RESULTS After 4 weeks,the average wound area reduced from 22.04±6.48 cm^(2)to 11.96±3.63 cm^(2)(P<0.05).New granulation tissue coverage area reached 52.85±18.39 cm^(2) for the intervention group and 28.39±9.94 cm^(2)(P<0.05)in the control group,respectively.The healing rate was significantly higher in the intervention group than in the control group(91.7%vs 76.4%,P<0.05).Fasting plasma glucose decreased more sharply in the intervention group(from 8.36±0.98 mmol/L to 6.91±1.23 mmol/L)than in the control group(8.41±1.05 mmol/L to 7.81±1.27 mmol/L),with the intervention group maintaining significantly lower levels(P<0.05).The intervention group demonstrated a significantly greater reduction in 2-hour postprandial blood glucose levels(11.35±2.67 mmol/L to 7.52±1.38 mmol/L)compared to the control group(11.61±3.01 mmol/L to 8.72±1.63 mmol/L;P<0.05).Hamilton Anxiety Scale and Hamilton Depression Scale scores were significantly lower in the intervention group(P<0.05).Patient satisfaction with nursing was 93.33%and 74.55%in the intervention and control groups,respectively(P<0.05).CONCLUSION MDT combined with blood glucose control enhanced healing rates and positively influenced emotional well-being and satisfaction among patients.This strategy holds potential for application in clinical practice.
文摘BACKGROUND Surgical resection is the primary treatment for gastric cancer,but it often leads to slow recovery,high complications,and poor psychological health.The effectiveness of enhanced recovery after surgery(ERAS)as a new nursing model postsurgery remains uncertain.AIM To investigate the clinical effect of accelerated recovery nursing program based on multidisciplinary collaboration model in gastric cancer surgery.METHODS A total of 120 patients who underwent radical gastrectomy at our hospital from January 2023 to December 2024 were included in the study.They were divided into two groups of 60 each:The control group,which received routine care,and the study group,which received ERAS based on multidisciplinary collaboration.Both groups received care until discharge.We compared gastrointestinal recovery,psychological status,Short Form 36 Health Survey scores,Pittsburgh Sleep Quality Index,complications,and nursing satisfaction between the two groups.RESULTS The study group had significantly shorter defecation time,bowel sound recovery time,and flatus time compared to the control group(P<0.05).The Hamilton Anxiety Scale and Hamilton Depression Rating Scale scores were also significantly lower in the study group(P<0.05).Additionally,the study group reported better sleep quality(P<0.05)and had fewer postoperative complications.Their Short Form 36 Health Survey scores and nursing satisfaction were higher than those of the control group,with all differences being statistically significant(P<0.05).CONCLUSION The ERAS based on multidisciplinary collaboration in patients undergoing radical gastrectomy can accelerate postoperative recovery,reduce the occurrence of complications,and improve psychological state,quality of life,sleep quality and nursing satisfaction.
基金supported by Hangzhou Construction Fund of Key Medical Disciplines(OO20200265)Zhejiang Medical and Health Science and Technology Plan Project(2020KY687)+1 种基金Hangzhou Science and Technology Development Project(20200401B04)Hangzhou Biomedical and Health Industry Development Supporting Technology Projects(2021WJCY256).
文摘BACKGROUND:Ischemic stroke refers to a disorder in the blood supply to a local area of brain tissue for various reasons and is characterized by high morbidity,mortality,and disability.Early reperfusion of brain tissue at risk of injury is crucial for the treatment of acute ischemic stroke.The purpose of this study was to evaluate comfort levels in managing acute stroke patients with hypoxemia who required endotracheal intubation after multidisciplinary in situ simulation training and to shorten the door-to-image time.METHODS:This quality improvement project utilized a comprehensive multidisciplinary in situ simulation exercise.A total of 53 participants completed the two-day in situ simulation training.The main outcome was the self-reported comfort levels of participants in managing acute stroke patients with hypoxemia requiring endotracheal intubation before and after simulation training.A 5-point Likert scale was used to measure participant comfort.A paired-sample t-test was used to compare the mean self-reported comfort scores of participants,as well as the endotracheal intubation time and door-to-image time on the fi rst and second days of in situ simulation training.The door-to-image time before and after the training was also recorded.RESULTS:The findings indicated that in situ simulation training could enhance participant comfort when managing acute stroke patients with hypoxemia who required endotracheal intubation and shorten door-to-image time.For the emergency management of hypoxemia or tracheal intubation,the mean post-training self-reported comfort score was signifi cantly higher than the mean pre-training comfort score(hypoxemia:4.53±0.64 vs.3.62±0.69,t=-11.046,P<0.001;tracheal intubation:3.98±0.72 vs.3.43±0.72,t=-6.940,P<0.001).We also observed a decrease in the tracheal intubation and door-to-image time and a decreasing trend in the door-to-image time,which continued after the training.CONCLUSION:Our study demonstrates that the implementation of in situ simulation training in a clinical environment with a multidisciplinary approach may improve the ability and confi dence of stroke team members,optimize the fi rst-aid process,and eff ectively shorten the door-to-image time of stroke patients with emergency complications.
基金supported by the National Science Foundation for Distinguished Young Scholars,China(82025021).
文摘Critical care medicine focuses on understanding the pathophysiological mechanisms and treatment approaches for life-threatening conditions,including sepsis,severe trauma/burns,hemorrhagic shock,heatstroke,and acute pancreatitis,all of which have high incidence rates.These conditions are primarily characterized by acute multi-organ dysfunction,with sudden onset,severe illness,and high mortality rates.Additionally,critical care treatment demands substantial medical resources,imposing significant economic burdens on patients’families and society.In recent years,critical care medicine has achieved notable progress,especially in multidisciplinary integration with immunology-based fields.Collaboration across disciplines has not only accelerated advancements in critical care but also propelled the rapid development of modern immunology.This paper provides an overview and assessment of the cross-disciplinary fusion between critical care medicine and immunology,exploring how these fields related extensions mutually enhance each other.It further analyzes China’s potential to become a global leader in this area within the next 5 to 10 years.
文摘Recently,we read the article“Pathologically successful conversion hepatectomy for advanced giant hepatocellular carcinoma after multidisciplinary therapy:A case report and review of the literature”published in the World Journal of Gastrointestinal Oncology.The prognosis of advanced hepatocellular carcinoma(HCC)is poor,and multidisciplinary comprehensive treatment is currently the main research direction.This case report demonstrated the efficacy of the combination therapy of transcatheter arterial chemoembolization,hepatic arterial infusion chemotherapy,epclusa,lenvatinib and sintilimab for a patient with advanced HCC,and the report can serve as a reference for clinical practice.We would also like to share some of our views.
文摘In this research,a Multidisciplinary Design Optimization approach is proposed for the dual-spin guided flying projectile design considering external and internal parts of the body as design variables.In this way,a parametric formulation is developed.All related disciplines,including structure,aerodynamics,guidance,and control are considered.Minimum total mass,maximum aerodynamic control effectiveness,minimum miss distance,maximum yield stress in all subsystems,controllability and gyroscopic stability constraints are some of objectives/constraints taken into account.The problem is formulated in All-At-Ones Multidisciplinary Design Optimization approach structure and solved by Simulated Annealing and minimax algorithms.The optimal configurations are evaluated in various aspects.The resulted optimal configurations have met all design objectives and constraints.
