本文通过对我国卫生法规和文献复习的基础上,对我国平均住院日管理问题进行历史回顾，阐述缩短平均住院日的目的和意义,并以此证实在我国实施缩短平均住院日的重要性。
Objective Surgical treatment for rectal cancer has been developed for centuries. After anesthetic technics are applied， classic operation procedures for rectal cancer resection are still cited repeatedly. There are few articles regarding to the development history of surgical treatment for rectal cancer， and we summarize it chronologically. Methods We searched articles in the past 20 years， dated back to the original journal and explored the development of the operation type. Results We summarized more than 100 articles and listed more than 40 articles here. According to the articles retrieved， the surgery for rectal cancer could be dated back to 1739， spanning for more than 270 years. In the premier one hundred years， the resection area was limited and the effect of the treatment was not good. And in the recent one hundred years， the development of surgery conceptions was huge and the related knowledge and skills had been rapidly develop. The operation type for rectal cancer was gradually getting mature. Conclusions Surgery treatment for rectal cancer has been through a development of more than two hundred years， with new concepts and technics continuously fused in. Thus the meaning of surgery treatment for rectal cancer has been renewed. Introduction of total mesorectum excision， conception of 2 cm distal resective margin， development of stapling devices， preoperative chemoradiation and appplication of laparoscopic surgery have fasciliated function-preserving operations with minimal invasion， rapid recovery and high survival rate. Appearance of new drugs and improvement of local excision， preoperative chemoradiation， as well as new agents for chemotherapy and target therapy have promoted surgical resection for rectal cancer to a multidisciplinary model.
ObjectiveTo do a brief introduction and prospects for simultaneous pancreas and kidney transplanta-tion from aspects of recipient screening, choice of operative method, prognosis, quality of life, and complications. MethodDomestic and international literatures were collected to summary the effect, prognosis, and the latest progress of simultaneous pancreas and kidney transplantation in the treatment of diabetes. ResultsAs a kind of mature treatment of diabetic with end-stage renal disease, simultaneous pancreas and kidney transplantation had been carried out in most transplantation centers around the world, it had the definite therapeutic effect and controllable side effects, the life quality of posttransplantation patients would be improved notably. However, the screen of transplantation patient, the selection of transplantation operation, and the postoperative immunosuppressive protocols had not yet been reached a consensus. ConclusionsSimultaneous pancreas and kidney transplantation is the most effective treatment for type 1 diabetes patients with end-stage renal disease, it provides a more feasible and more physiological way for the secretion of insulin. Although the patient has to undergo a major operation and take some risk, simultaneous pancreas and kidney transplantation still improves the patient's survival rate and the quality of life, and reduces the incidence of complications related to diabetes. Based on the above reasons, simultaneous pancreas and kidney transplantation should be a preferred treatment for all eligible patients.
The earliest record of chest trauma surgery was B.C 3000 years. Before 15th century, chest trauma surgery only focused on simple wound treatment of the chest wall. At the beginning of 20th century, treatment of organ injury in the thoracic cavity appeared. In the 50's-80's of the 20th century, complete structure and knowledge of modern chest trauma surgery came into being. Since the 90's of the 20th century, development of new techniques such as minimally invasive surgery, new concepts such as fast-track surgery and damage control surgery, new materials, multidisciplinary cooperation, Internet technology, and translational medicine all have contributed to outcome improvement of patients with chest trauma, and will contribute to the development of chest trauma surgery in the future.
Objective To summarize the history, status quo, and prospect of robotic surgery system in domestic department of hepatobiliary surgery. Methods Related papers published in many databases, such as CNKI, VIP, WanFang, PubMed, an so on, were collected to make a review. Results With the development by nearly 8 years in our country, robotic surgery system has been preliminary used in all kinds of complicated operation in domestic department of hepatobiliary surgery, and positive results has been achieved. Currently robotic surgery technique is still in the continuous improvement and innovation. With the progression of robotic surgery technique and development of related equipment, this system would be more widely applied in domestic department of hepatobiliary surgery. Conclusions Robotic surgery system is now in the stage of development and promotion, but robotic surgery system has its unique advantages and it also has great development potential in technology. We believe that the robotic surgery system will be widely used in department of hepatobiliary surgery.
ObjectiveTo summarize the development of surgical treatment of rectal cancer.MethodReviewed the domestic and foreign literatures on surgical methods for rectal cancer.ResultsThe first real surgery for rectal cancer was performed by LisFrance in 1826. Because the early understanding of rectal cancer and its development was not clear, the operation effect was poor, and the postoperative recurrence rate was high. It was not until 1908, when Dr. Miles proposed the classic abdominoperineal resection (APR), that the recurrence of rectal cancer improved significantly. In the 20th century, there also appeared Hartmann, Dixon, Bacon, Parks, and other sphincter-preserving operations, among which Dixon surgery was the most influential. Dixon surgery had changed the focus of rectal cancer treatment from radical APR to more sphincter-preserving surgery. With the emergence of stapler, the introduction of concepts such as total mesorectal excision (TME) and circumferric resection margins (CRM), and the promotion of laparoscopic technology, resection and anastomosis of rectal cancer had a lower location, less surgical trauma, better postoperative quality of life, and higher survival rate. Modern rectal cancer surgery was gradually developing to precision and minimally invasive. Following TME, transanal total mesorectal excision (taTME) and natural orifice specimen extraction surgery (NOSES) had given a new meaning to the operation of rectal cancer.ConclusionsWith the in-depth understanding of the occurrence, development, recurrence, and metastasis of rectal cancer, surgical methods of rectal cancer are constantly developing and improving. The introduction of new concepts and surgical procedures is accompanied by controversy and doubt, which promotes the improvement of the treatment level of rectal cancer.
In this essay, classical events and related characters in the developments of clinical trial methodology were searched and summarized. The 'first' and major methodological progresses in the milestone events of clinical trials were therefore presented. This study is purposed to delineate the historically vicissitudinous progress of the clinical trial with typical figures and events, study and analyze the profound background of the renovation of clinical research methods, and provide references for clinical and scientific researchers, health policy makers and medical students to comprehensively review the history of clinical trial.
Laparoscopic Roux-en-Y gastric bypass (LRYGB) was recommended as the gold standard procedure for metabolic and bariatric surgery by the National Institutes of Health in the 1990s and then had been adopted till now, which could effectively control excess weight and treat metabolic diseases relevant to obesity in a long term. The current LRYGB procedure had been performed more than half a century of development and update, and is still constantly evolving. Standardized and precise surgical procedures are of great significance in ensuring treatment effect and reducing the incidence of complications. Thus, the author reviewed the development process of LRYGB, further understanding and emphasizing the importance of standardized and precise surgical procedures.