肝胆相照,胰路前行——浙医二院肝胆胰外科MDT团队暨浙江省胰腺癌综合诊治科技创新团队

<正>浙江大学医学院附属第二医院肝胆胰外科多学科联合诊治团队(multidisciplinary team,MDT)暨浙江省胰腺癌综合诊治科技创新团队,由我国著名的肝胆胰外科和肝脏移植专家梁廷波教授领衔,联合该院肝胆胰外科、消化内科、放射科、肿瘤内科、肿瘤放疗科、超声科、介入科、病理科、护理等10余学科专家组建,旨在通过构建多学科交叉、整合和集中的诊疗模式,充分发挥各学科专长,最大程度为患者提供安全、科学、有效、优质的医疗服务,推动肿瘤患者的个体化、规范化综合治疗。     

传承 创新 团结 合作 国际化——《中华显微外科杂志》2020年新使命

为了响应国家建设国际一流科技期刊的号召,《中华显微外科杂志》秉承"传承、创新、团结、合作、国际化"新使命,2020年将增设"世界显微外科大师""中国显微外科先驱"栏目;编撰《中国显微外科中英文文献目录索引》《中华显微外科杂志历届编委画册》;开设"《中华显微外科杂志》传承与创新论坛",树立学术交流的新品牌;着力培养坚持显微外科一线工作的中、青年骨干;参与国际学术交流,加强与国际同行的合作;增加符合国际惯例的中、英文题目及摘要,增加中文参考文献对应的英文标注;有针对性地创造条件进入国际数据检索库,提升杂志国际影响力。     

团结协作、无私奉献，迎接新世纪

今年是建国５０年，在这５０年中我国泌尿外科和其他学科一样取得了辉煌的成绩。回顾建国以前，在２０年代我国大城市的少数大医院中外科内已经开始有泌尿外科专业医师；在建国前的几十年中专业论文仅６０篇，中文专业书籍仅有一本。新中国成立后的５０年中，泌尿外科作为一个专业从大城市大医院发展到中小城市，泌尿外科专业队伍不断扩大，１９５９年建国１０周年时，已出版泌尿外科专业书刊５种、翻译１３种，发表论文６００篇以上，并开始自制泌尿外科器械如膀胱镜、人工肾等。６０年代起，肾上腺外科的工作进入了泌尿外科范围。改革、开…     

糖尿病团队管理模式的实施

糖尿病是一种影响各系统乃至心理健康的疾病。对糖尿病病人进行科学的管理 ,教会其掌握糖尿病自我护理的知识与技能已迫在眉捷 ,需要各科医生、护士、营养师及心理学家等专业人员的共同管理 ,即团队管理。糖尿病的团队管理在美国已形成完整的体系。无数的实验已从不同角度证明其效果明显优于传统的治疗 [1～ 3 ] 。 2 0 0 0年我院参照美国罗马琳达大学医学中心糖尿病病人的教育与管理模式 ,结合我院实际开展糖尿病的团队管理。现将实施方法介绍如下。1　小组成员及职责1 .1　医生内分泌科全体医生 5名 ,包括内分泌科主任、副主任医师各 1名 …     

护理团队冲突的研究进展

综述国内外护理团队冲突的内容、冲突测评工具、冲突影响因素、冲突处理对策.护理团队冲突包括任务冲突、关系冲突、过程冲突;提出应提高护理人员冲突处理技巧及团队协作能力,提高管理者冲突处理水平,以避免或减少团队冲突,提高工作效率.     

蓬勃发展的烧伤救治团队

天津市第一中心医院烧伤科是天津市重要的烧伤医疗救治单位,其前身是1958年第一中心医院成立的烧伤专业组.当时在上海瑞金医院成功救治危重烧伤患者邱财康的带动下,我院成功抢救了烧伤患者赵明山(总面积86%,Ⅲ度面积69%TBSA),为此荣获"全国卫生红旗先进单位"称号.     

团结和谐——忆上海麻醉学会的发展

上海麻醉学会创建于1980年2月2日,历经9届迄今已逾27年,为上海麻醉事业的发展做出了重大贡献,给我留下的最深刻的印象是:团结和谐.第一届主任委员是吴珏,副主任委员是李杏芳、王景阳.吴老和李老彼此相互尊重,发扬民主、展开学术活动;1978年编写出版<实用麻醉学>,发行达5万余册,为普及和提高全国麻醉学术水平发挥了重要的作用.学会举办了麻醉学进修班,制订麻醉住院医师培养规划,编写<上海市麻醉学诊疗护理常规>并联合组成麻醉学重点学科;举办全国第一届心血管胸腔麻醉学会议,召开中华医学会第六次全国麻醉学术会议,以后又相继举行了第八届长江流域麻醉学术会议等.当今,在新的历史条件下,学会应更好地团结广大医护人员,用科学发展观,赶超国际先进水平.     

Is a full team required for emergency management of pediatric trauma?

Pediatric trauma centers often do not meet the guidelines requiring a trauma team as recommended by the American Academy of Pediatrics (AAP). We reviewed our experience with a team consisting of a pediatric emergency physician, resident, nurse, and respiratory therapist. The surgical and pediatric critical care residents and staff were available within 5 minutes. We conducted a retrospective chart review of 146 patients (aged 8.1 +/- 4.8 years) between 1987 and 1989, with Injury Severity Scores (ISS) greater than or equal to 16 or admitted to the pediatric critical care unit. The time of presentation, surgical services consulted, and the nature of the injury were obtained from chart review. The Pediatric Trauma Score (PTS), the Revised Trauma Score (RTS), the Injury Severity Score (ISS), Glasgow Coma Scale (GCS) score, and Pediatric Risk of Mortality (PRISM) were used to determine the severity of insult and physiologic derangement on admission. The Modified Injury Severity Score (MISS) was determined and the Delta score for Disability Assessment was assigned at discharge. The Delta score was also determined at 3-month intervals up to one year. The probability of survival (Ps) was calculated, using the ISS and RTS. The Z statistic for this group of patients was then determined, using the Major Trauma Outcome Study (MTOS) methodology. The percentages of patients who were normal, disabled, and dead were 61%, 31.5%, and 7.5%, respectively, at 6 months follow-up. Eleven deaths were expected based on PRISM and TRISS analysis. Our mortality and morbidity figures were comparable with those of centers with teams based on AAP guidelines.(ABSTRACT TRUNCATED AT 250 WORDS)     

Keeping the spirit high: why trauma team training is (sometimes) implemented

Background: Systematic and multiprofessional trauma team training using simulation was introduced in Norway in 1997. The concept was developed out of necessity in two district general hospitals and one university hospital but gradually spread to 45 of Norway's 50 acute-care hospitals over the next decade. Implementation in the hospitals has varied from being a single training experience to becoming a regular training and part of quality improvement. The aim of this study was to better understand why only some hospitals achieved implementation of regular trauma team training, despite the intentions of all hospitals to do so.
Methods: Focus group interviews were conducted with multiprofessional respondents in seven hospitals, including small and large hospitals and hospitals with and without regular team training. Interviews were transcribed and analyzed using a Grounded Theory approach.
Results: 'Keeping the spirit high' appeared to be the way to achieve implementation. This was achieved through 'enthusiasm,'strategies and alliances,' and 'using spin-offs.' It seems that the combination of enthusiasts, managerial support, and strategic planning are key factors for professionals trying to implement new activities.
Conclusions: Committed health professionals planning to implement new methods for training and preparedness in hospitals should have one or more enthusiasts, secure support at the administrative level, and plan the implementation taking all stakeholders into consideration.     

The extended surgical team

The extended surgical team encompasses a variety of non-medical healthcare practitioners who work alongside junior doctors in delivering care to patients. In large part, their roles have developed in response to workforce shortages and working time changes. A variety of roles exist including Physician Associates, Surgical Care Practitioners, Advanced Clinical Practitioners and Surgical First Assistants. These roles have different training pathways and different regulators. They work across the emergency and elective surgical patient pathway with some roles being primarily theatre based. There is evidence that they enhance training for junior surgical trainees by enabling better attendance at daytime training sessions in the operating theatre and the outpatient clinic. They also appear to be well received by patients.