ObjectiveTo analyze the papers in cardiovascular surgery field indexed by SCI-Expended between 2008 year and 2012 year from the authors in Chinese Mainland. MethodsWe searched Web of Science database(2008-2012)on-line and collected the papers on cardiovascular surgery written by the authors in Chinese Mainland. The data of publication time, type of article, journal name, and author name were recorded. ResultsA total of 427 papers in cardio-vascular surgery field were published from Chinese Mainland including 401 original articles, 10 conference papers, and 16 reviews. Although the number of papers has been increasing since 2008 year, the increase slowed down recently. Most of those authors came from few heart centers in Beijing, Guangdong, and Shanghai. Most of these papers were published in 7 journals in cardiovascular surgery field with low impact factor. ConclusionThe authors in Chinese Mainland in cardiovascular field should design more scientific research and improve academic level of paper with high quote rate.
Evidence-based orthodontics has developed rapidly in recent years, but the lack of a good quality, clinical evidence base is a problem for orthodontic practice. All orthodontists should keep the concept of evidence-based medicine in mind during patient-oriented practice. This would help us to improve our practice and to make the best clinical decisions.
ObjectiveTo summarize the experiences of surgical treatment of sternal dehiscence after cardiac surgery. MethodsFrom January 2011 to January 2014, 7 patients with sternal dehiscence after cardiac surgery were admitted to our hospital. There were 4 male patients and 3 females with an age of 35-72 (52.5±13.4) years old. Two patients accepted coronary artery bypass, 4 underwent mechanical valve replacement and 1 underwent Sun’s procedure. The necrotic bones were debrided and sternal wires completely removed. After the original wires were completely extracted, the infected tissues behind the sternum were removed. Part of the pectoralis major was released with free tension on both sides when suturing was carried out over the sternal defect. Negative pressure drainage tube was used for full drainage. ResultsAll the patients were discharged from hospital with very good recovery. The sternal wound was healing well with normal thoracic appearance, and none of the patients had recurrent infections. ConclusionsPatients with sternal dehiscence after cardiac surgical procedure should undergo surgical debridement. Stabilizing the sternum, rich blood supply and improvement of overall condition of the patients are very important for recovery.
目的 分析心脏手术相关医疗纠纷的临床及法医学特点，并就发生原因进行剖析及提出相应防范措施。 方法 对2002年1月－2011年12月四川华西法医学鉴定中心受理的四川省各级医疗机构发生的17例与心脏手术相关的医疗纠纷法医学鉴定资料进行回顾性分析。 结果 17例心脏手术相关医疗纠纷中，12例进行了尸体解剖死因鉴定，死亡原因有心脏传导系统出血，术后感染，低心排量综合症、肺动脉高压、失血性休克致死等。其余5例加上尸体解剖2例在内共7例进行了医疗过错鉴定，存在的医疗过错包括术前检查不完善，告知不充分，手术操作不细致，术后观察、处理不足，医疗记录不完整等。 结论 心脏手术相关医疗纠纷与术后并发症关系密切，医护人员应重视对心脏术后并发症的防治。尸体解剖对解决心脏术后死亡引起的医疗纠纷具有重要意义。
目的 分析骨科医疗纠纷的原因及特点，为医疗纠纷的防范提供参考。 方法 收集2010年1月－2011年12月四川华西法医学鉴定中心涉及四川省各级医疗机构的骨科医疗纠纷鉴定案例55例，进行回顾性分析。 结果 55例骨科医疗纠纷中2010年25例，2011年30例；医源性医疗纠纷41例（74.5%），非医源性医疗纠纷14例（25.5%）。医源性医疗纠纷中医疗机构存在的问题主要以手术操作不当及失误为主（15例，占27.3%），其次为医患沟通不到位（8例，占14.5%）。 结论 骨科医疗纠纷防范的关键在于医务人员认真履行其诊疗义务。
ObjectiveTo analyze the clinical and pathologic features of paraquat poisoning, discuss the damage mechanism of pulmonary fibrosis caused by paraquat poisoning. MethodsWe retrospectively analyzed the paraquat poisoning-related cases collected in recent years from January 2010 to December 2013, and compared the clinical features and pathologic changes between acute and chronic paraquat poisoning cases. ResultsThe main clinical and pathologic manifestation of paraquat poisoning was multiple organ damage, especially with lung as its target organ. In acute poisoning deaths, the lung injury was characterized by the pulmonary edema and formation of lung transparent membrane; In chronic poisoning deaths, the injury was characterized by the formation of lung transparent membrane and pulmonary fibrosis. ConclusionIn order to make an earlier diagnosis in clinical cases, we should strengthen the cognition of clinical manifestations and damage mechanism of paraquat poisoning. To obtain an accurate conclusion in forensic medicine appraisal, we should draw a comprehensive analysis of the forensic case, the clinical data, the toxicological analysis and the autopsical results.
ObjectiveTo explore the common causes and the clinical pathological characteristics of infant death which occurred after vaccination. MethodsThe study retrospectively analyzed the data of 13 cases of infant death occurring after vaccination from January 2009 to September 2014 in West China Medico-legal Expertise Center. ResultsAmong the 13 cases of infant death, 12 were dead from lethal respiratory system and cardiovascular system diseases, 1 from mechanic asphyxia caused by milk intake. All cases were coupling disease death and had no direct correlation with vaccination. ConclusionSystematic and comprehensive forensic pathological examination is helpful to clarify the cause of death, reveal the relationship between vaccination and the cause of death, and contribute to proper processing of such incidents.