1.Medical quality control management and discipline progress of plastic and aesthetic major under the background of high-quality development policy
Mingzi ZHANG ; Loubin SI ; Jiaojie ZHENG ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Chinese Journal of Plastic Surgery 2024;40(4):357-361
In 2022, general president Xi Jinping pointed out that "high-quality development is the top task of building China into a modern socialist country in all respects" at the 20th National Congress of the Communist Party of China. Since then, various industries have embraced the trend of high-quality development. This article aims to provide a specific reference point for the high-quality development of the plastic and aesthetic industry, based on the understanding of national policy documents and combined with the current situation and characteristics of the plastic and aesthetic specialty.
2.Medical quality control management and discipline progress of plastic and aesthetic major under the background of high-quality development policy
Mingzi ZHANG ; Loubin SI ; Jiaojie ZHENG ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Chinese Journal of Plastic Surgery 2024;40(4):357-361
In 2022, general president Xi Jinping pointed out that "high-quality development is the top task of building China into a modern socialist country in all respects" at the 20th National Congress of the Communist Party of China. Since then, various industries have embraced the trend of high-quality development. This article aims to provide a specific reference point for the high-quality development of the plastic and aesthetic industry, based on the understanding of national policy documents and combined with the current situation and characteristics of the plastic and aesthetic specialty.
3.Effect Evaluation of Responsible Segmental Decompression Combined with Orthopedic Fixation of Short-Segment Fusion Surgery for Treating Degenerative Lumbar Scoliosis
Hui ZENG ; Gangqiang WU ; Can HUANG ; Xiaojun HAN ; Bo LIU ; Cheng CHEN ; Long MA ; Bowen ZHANG ; Honghai WANG
Journal of Medical Biomechanics 2024;39(5):896-902
Objective To investigate the therapeutic effect of segmental decompression combined with corrective short-segment fusion surgery for the treatment of degenerative lumbar scoliosis.Methods In total,124 patients with degenerative lumbar scoliosis were selected and divided into short-and long-segment fusion groups using the random number table method,with 62 patients in each group.Posterior short-segment decompression,fixation,and fusion were performed in the short-segment fusion group;the fusion segment was the adjacent lumbar vertebra.Posterior long-segment decompression,fixation,and fusion were performed in the long-segment fusion group;the fusion segments included multiple adjacent lumbar vertebrae.At the 6th month after surgery,the coronal Cobb angle of lumbar convexity,sagittal Cobb angle of lumbar lordosis,intervertebral foramen height,intervertebral space height,intervertebral foramen area,spinal canal area,spinal canal diameter,Japanese Orthopedic Association(JOA)score,Oswestry Disability Index(ODI),degree of pain in the lower back and lower limbs,and postoperative complications were compared between the groups.Results The Cobb angle of the coronal lumbar scoliosis in the short-and long-segment fusion groups was significantly higher than that before surgery(P<0.05).At the 6th month after surgery,the intervertebral foramen height,intervertebral space height,intervertebral foramen area,spinal canal area,and spinal canal diameter in both groups increased,and those in the short-segment fusion group were higher than those in the long-segment fusion group(P<0.05);at the 6th month after the operation,the JOA scores of the short-segment and long-segment fusion groups were higher than those before surgery,and the JOA score of the short-segment fusion group was higher than that of the long-segment fusion group(P<0.05).The ODI score was lower than that before surgery in the short-and long-segment fusion groups,and the ODI score in the short-segment fusion group was lower than that in the long-segment fusion group(P<0.05).At the 6th month after surgery,the pain scores of the lower back and lower limbs in the short-and long-segment fusion groups were significantly higher than those before surgery(P<0.05).There were two cases of dural tears during decompression caused by lamina dura adhesion in the long-segment fusion group,and no serious complications were observed in the short-segment fusion group.Conclusions Both short-and long-segment decompression fixation fusion using a posterior approach can achieve good therapeutic effects for treating degenerative lumbar scoliosis.However,compared to the long-segment fusion group,the short-segment fusion group undergoing short-segment decompression fixation fusion through a posterior approach had a shorter surgical period,lower intraoperative blood loss,better recovery of lumbar function,and a lower risk of postoperative complications.
4.Multicenter evaluation of minimal residual disease monitoring in early induction therapy for treatment of childhood acute lymphoblastic leukemia
Xiaojun WU ; Ning LIAO ; Huirong MAI ; Xinyu LI ; Wuqing WAN ; Lihua YANG ; Libin HUANG ; Xiangqin LUO ; Chuan TIAN ; Qiwen CHEN ; Xingjiang LONG ; Yunyan HE ; Ying WANG ; Chi-Kong LI ; Honggui XU
Chinese Journal of Pediatrics 2024;62(4):337-344
Objective:To evaluate the role of minimal residual disease (MRD) monitoring during early induction therapy for the treatment of childhood acute lymphoblastic leukemia (ALL).Methods:This was a multicenter retrospective cohort study. Clinical data of 1 164 ALL patients first diagnosed between October 2016 and June 2019 was collected from 16 hospitals in South China Children′s Leukemia Group. According to MRD assay on day 15 of early induction therapy, they were divided into MRD<0.10% group, MRD 0.10%-<10.00% group and MRD≥10.00% group. According to MRD assay on day 33, they were divided into MRD<0.01% group, MRD 0.01%-<1.00% group and MRD≥1.00% group. Age, onset white blood cell count, central nervous system leukemia (CNSL), molecular genetic characteristics and other data were compared between groups. Kaplan-Meier method was used for survival analysis. Cox regression model was used to analyze prognostic factors.Results:Of the 1 164 enrolled patients, there were 692 males and 472 females. The age of diagnosis was 4.7 (0.5, 17.4) years. The white blood cell count at initial diagnosis was 10.7 (0.4, 1 409.0) ×10 9/L. Among all patients, 53 cases (4.6%) had CNSL. The follow-up time was 47.6 (0.5, 68.8) months. The 5-year overall survival (OS) and 5-year relapse-free survival (RFS) rates were (93.1±0.8) % and (90.3±1.1) %. On day 15 of early induction therapy, there were 466 cases in the MRD<0.10% group, 523 cases in the MRD 0.10%-<10.00% group and 175 cases in the MRD≥10.00% group. The 5-year OS rates of the MRD<0.10% group, MRD 0.10%-<10.00% group and MRD≥10.00% group were (95.4±1.0) %, (93.3±1.1) %, (85.4±2.9) %, respectively, while the RFS rates were (93.2±1.6) %, (90.8±1.4) %, (78.9±4.3) %, respectively ( χ2=16.47, 21.06, both P<0.05). On day 33 of early induction therapy, there were 925 cases in the MRD <0.01% group, 164 cases in the MRD 0.01%-<1.00% group and 59 cases in the MRD≥1.00% group. The 5-year RFS rates in the MRD 0.01%-<1.00% group was lowest among three groups ((91.4±1.2) % vs. (84.5±3.2) % vs. (87.9±5.1) %). The difference between three groups is statistically significant ( χ2=9.11, P=0.010). Among ALL patients with MRD≥10.00% on day 15 of induction therapy, there were 80 cases in the MRD <0.01% group on day 33, 45 cases in the MRD 0.01%-<1.00% group on day 33 and 45 cases in the MRD≥1.00% group on day 33. The 5-year RFS rates of three groups were (83.9±6.0)%, (67.1±8.2)%, (83.3±6.9)% respectively ( χ2=6.90, P=0.032). Univariate analysis was performed in the MRD≥10.00% group on day 15 and the MRD 0.01%-<1.00% group on day 33.The 5-year RFS rate of children with CNSL was significantly lower than that without CNSL in the MRD≥10.00% group on day 15 ((50.0±20.4)% vs. (80.3±4.4)%, χ2=4.13, P=0.042). Patients with CNSL or MLL gene rearrangement in the MRD 0.01%-<1.00% group on day 33 had significant lower 5-year RFS rate compared to those without CNSL or MLL gene rearrangement ((50.0±25.0)% vs. (85.5±3.1)%, χ2=4.06, P=0.044;(58.3±18.6)% vs. (85.7±3.2)%, χ2=9.44, P=0.002). Multivariate analysis showed that age ( OR=0.58, 95% CI 0.35-0.97) and white blood cell count at first diagnosis ( OR=0.43, 95% CI 0.27-0.70) were independent risk factors for OS. The MRD level on day 15 ( OR=0.55,95% CI 0.31-0.97), ETV6-RUNX1 fusion gene ( OR=0.13,95% CI 0.03-0.54), MLL gene rearrangement ( OR=2.55,95% CI 1.18-5.53) and white blood cell count at initial diagnosis ( OR=0.52,95% CI 0.33-0.81) were independent prognostic factors for RFS. Conclusions:The higher the level of MRD in early induction therapy, the worse the OS. The MRD levels on day 15 is an independent prognostic factor for RFS.The MRD in early induction therapy guided accurate risk stratification and individualized treatment can improve the survival rate of pediatric ALL.
5.Journey and Significance of Quality Control in Medical Safety for China's Plastic Surgery and Aesthetic Medicine Professions
Jiaojie ZHENG ; Mingzi ZHANG ; Loubin SI ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1233-1237
Medical quality and safety are essential safeguards for the harmonious society in China, directly affecting people's sense of security and happiness. Continuously improving medical quality and ensuring medical safety are fundamental and essential to implementing the strategies of the Party Central Committee and the State Council, and promoting the construction of a healthy China. In recent years, with the rapid development of China's economy and the people's increasing emphasis on their own health and safety, China's plastic surgery industry has achieved significant progress and yielded outstanding results. However, along with the rapid growth of the industry, medical quality issues and safety accidents have occurred frequently, attracting widespread attention from all sectors of society. This article briefly outlines the history of quality management and quality control for medical quality and safety in China's plastic surgery specialty. It explores the development of quality management from its origin to medical quality management, as well as the responsibilities and contributions of the National Plastic Surgery Quality Control Center in improving industry standards and ensuring patient safety. It aims to provide support for the standardized management of the plastic surgery industry in the future, so as to promote its healthy and sustainable development.
6.Construction of Medical Quality Control Indicators System for Chinese Plastic and Aesthetic Major
Mingzi ZHANG ; Loubin SI ; Jiuzuo HUANG ; Nanze YU ; Jiaojie ZHENG ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1318-1324
To construct a quality control indicators system for Chinese plastic and aesthetic major and lay foundation for medical quality control. National Quality Control Center of Plastic and Aesthetic Major established a working group in February 2023. Guided by the "structure-process-outcome" theory, the working group formulated medical quality control indicators for Plastic and Aesthetic major by learning from relevant indicators of other majors, reviewing literature, discussing in meetings, and combining opinions from quality control experts. The quality control indicators system was finally established by Delphi expert consultation. Delphi survey was 100% of 2 rounds. The authorities of 2 rounds of expert consultation were 0.854 and 0.857. The harmonious coefficients were 0.387 of primary indicators and 0.425 of secondary indicators( The quality control indicators system established in this study for Plastic and Aesthetic major in China has a certain degree of scientificity and rationality, which offers reference for medical quality control of Plastic and Aesthetic major in China. However, this system should be improved and ameliorated in practical application.
7.Data Development Trend of Public/Private Medical Institutions in Chinese Plastic and Aesthetic Major
Mingzi ZHANG ; Loubin SI ; Jiaojie ZHENG ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1325-1333
To compare and understand the trends in quality control data changes in public and private medical institutions specializing in plastic and aesthetic major in China over the past three years. The national quality control center of plastic and aesthetic major formulated quality control indicators, collected indicator data through the National Clinical Improvement System, conducted feedback verification on the data, organized and summarized the final data, and convened expert committees to analyze the data change trends. In the past three years, the number of both public and private medical institutions specializing in plastic and aesthetic major has shown an upward trend. The number of doctors increased significantly in 2022, with over 90% of doctors in public institutions (about 70% in private institutions) receiving higher education. In recent years, the proportion of doctors from other specialties engaging in plastic and aesthetic activities has increased. The proportion of inpatients seeking aesthetic treatments has also increased. Among outpatient patients, the proportion of injection procedures was relatively low. About one-third of private medical institutions have not yet adopted an electronic medical record system. Data feedback is the cornerstone of medical quality control in Chinese plastic and aesthetic major. Existing data indicates that the related industry is developing steadily, but there is still room for improvement in terms of some indicator data. However, due to the limited data from private medical institutions, it is still necessary to encourage them to improve their reporting enthusiasm in order to conduct a more comprehensive assessment in the future.
8.Journey and Significance of Quality Control in Medical Safety for China's Plastic Surgery and Aesthetic Medicine Professions
Jiaojie ZHENG ; Mingzi ZHANG ; Loubin SI ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1233-1237
Medical quality and safety are essential safeguards for the harmonious society in China, directly affecting people's sense of security and happiness. Continuously improving medical quality and ensuring medical safety are fundamental and essential to implementing the strategies of the Party Central Committee and the State Council, and promoting the construction of a healthy China. In recent years, with the rapid development of China's economy and the people's increasing emphasis on their own health and safety, China's plastic surgery industry has achieved significant progress and yielded outstanding results. However, along with the rapid growth of the industry, medical quality issues and safety accidents have occurred frequently, attracting widespread attention from all sectors of society. This article briefly outlines the history of quality management and quality control for medical quality and safety in China's plastic surgery specialty. It explores the development of quality management from its origin to medical quality management, as well as the responsibilities and contributions of the National Plastic Surgery Quality Control Center in improving industry standards and ensuring patient safety. It aims to provide support for the standardized management of the plastic surgery industry in the future, so as to promote its healthy and sustainable development.
9.Construction of Medical Quality Control Indicators System for Chinese Plastic and Aesthetic Major
Mingzi ZHANG ; Loubin SI ; Jiuzuo HUANG ; Nanze YU ; Jiaojie ZHENG ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1318-1324
To construct a quality control indicators system for Chinese plastic and aesthetic major and lay foundation for medical quality control. National Quality Control Center of Plastic and Aesthetic Major established a working group in February 2023. Guided by the "structure-process-outcome" theory, the working group formulated medical quality control indicators for Plastic and Aesthetic major by learning from relevant indicators of other majors, reviewing literature, discussing in meetings, and combining opinions from quality control experts. The quality control indicators system was finally established by Delphi expert consultation. Delphi survey was 100% of 2 rounds. The authorities of 2 rounds of expert consultation were 0.854 and 0.857. The harmonious coefficients were 0.387 of primary indicators and 0.425 of secondary indicators( The quality control indicators system established in this study for Plastic and Aesthetic major in China has a certain degree of scientificity and rationality, which offers reference for medical quality control of Plastic and Aesthetic major in China. However, this system should be improved and ameliorated in practical application.
10.Data Development Trend of Public/Private Medical Institutions in Chinese Plastic and Aesthetic Major
Mingzi ZHANG ; Loubin SI ; Jiaojie ZHENG ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1325-1333
To compare and understand the trends in quality control data changes in public and private medical institutions specializing in plastic and aesthetic major in China over the past three years. The national quality control center of plastic and aesthetic major formulated quality control indicators, collected indicator data through the National Clinical Improvement System, conducted feedback verification on the data, organized and summarized the final data, and convened expert committees to analyze the data change trends. In the past three years, the number of both public and private medical institutions specializing in plastic and aesthetic major has shown an upward trend. The number of doctors increased significantly in 2022, with over 90% of doctors in public institutions (about 70% in private institutions) receiving higher education. In recent years, the proportion of doctors from other specialties engaging in plastic and aesthetic activities has increased. The proportion of inpatients seeking aesthetic treatments has also increased. Among outpatient patients, the proportion of injection procedures was relatively low. About one-third of private medical institutions have not yet adopted an electronic medical record system. Data feedback is the cornerstone of medical quality control in Chinese plastic and aesthetic major. Existing data indicates that the related industry is developing steadily, but there is still room for improvement in terms of some indicator data. However, due to the limited data from private medical institutions, it is still necessary to encourage them to improve their reporting enthusiasm in order to conduct a more comprehensive assessment in the future.

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