Objective To investigate the method and effect of endovascular treatment for ilio-femoral venous post-thrombotic syndrome.Methods We retrospectively analyzed the clinical data of 47 patients,who underwent endovascular treatment for ilio-femoral venous post-thrombotic syndrome from January 2010 to December 2013.Patients received transjugular iliofemoral venous thrombectomy,percutaneous angioplasty (PTA) and/or endovascular stent placement after inferior vena cava filter was implanted.Results All patients were successfully treated with angioplasty and stent placement.The ilio-femoral venous were patent after the placement of the stent.Chronic ulcer in 7 patients healed within one month.The patency rate of the affected limb at 6 months was 88.9％,occlusion rate was 11.1％.No reblocked cases were found during venous ultrasound follow-up.After treatment,the circumference difference of low limb between affected and normal limb decreased from (2.46 ± 0.98) cm to (0.70 ± 0.19) cm (P ＜0.05) at the level of 15 cm above knee,and from (3.28 ±0.85) cm to (0.83 ±0.26) cm (P＜0.05) at the level of 15 cm below knee.Villalta score decreased from (12.0 ± 1.9) to (6.9 ±2.2,P ＜ 0.05) and symptoms were significantly improved.Conclusions Ilio-femoral venous stenting provides a safe,effective and minimal invasive approach for the treatment of post-thrombotic syndrome.Acceptable patency rates can be expected through short-term follow-up.

Objective To evaluate the value of thoracotomy through small right subaxillary oblique incision for pediatric ventricular septal defect(VSD). Methods From November 2001 to December 2008,1539 children with VSD underwent thoracotomy through small right subaxillary oblique incision in our hospital.At the fourth intercostal space between the anterior and middle axillary lines,a straight or oblique incision was made,then along the inferior edge of the fourth rib the chest was opened,and the right edge of the pericardium was fixed at the thoracic retractor.Afterwards,off-pump circulation was established and minimally invasive cardiac surgery was carried out.Results The procedure was completed successfully in all the 1539 patients.The cross-clamp time was(22.8?11.4) min(11 to 48 min),and CPB time was(33.0?14.9) min(27 to 64 min).Two patients(0.13%,2/1539) died in 24 hours after the operation.One of them died of severe allergic reaction to protamine.And the other died of severe low cardiac output in 4 hours after the surgery,because of an injury to the left coronary artery.In this series,the postoperative complications included incisional infection in 3 cases,atelectasis in 9,perfusion lung in 5,low cardiac output in 5,infectious endocarditis in 3 and acute renal failure in 4.These 29 cases were discharged after the complications being cured.Follow-up was available in 1446 cases for(47.0?11.2) months(range,6~91 months).During the period,small residual shunts in the VSD were detected in 5 cases,and other cases showed no abnormalities.Conclusions Thoracotomy through small right subaxillary oblique incision is minimally invasive,safe and effective for pediatric VSD.

Objective:To explore the application effect of global trigger tool (GTT) in detecting adverse events in ICU patients.Methods:According to contents of triggers in the GTT white paper, combined with the scope of domestic adverse event reporting and some ICU indexes, 16 triggers were established. A total of 1 683 medical records were collected from ICU of the Second People's Hospital of Liaocheng in Shandong Province from July 2018 to June 2019. According to the inclusion/exclusion criteria, 421 medical records of discharged patients were randomly selected according to the number of sampling intervals and 420 medical records were reviewed after eliminating repeated medical records. GTT method was used for retrospective analysis.Results:Of the 420 medical records actually used for review, 14 of the 16 triggers were positive, and the positive frequency of triggers was 128 cases, involving 62 patients. Adverse events were identified 51 times, involving 43 patients, with a detection rate of 10.24% (43/420) . Among the 51 cases of adverse events, 37 cases (72.55%) were Grade E, 13 cases (25.49%) were Grade F, and 1 case (1.96%) was Grade H. No Grade G or I was found. In the same year, 18 cases of adverse events were reported voluntarily in ICU, the reporting rate was 1.07% (18/1 683) .Conclusions:GTT can be effectively applied to the detection of adverse events in ICU patients, and a properly designed trigger can improve the detection rate.

Outpatient humanistic care refered to providing a full process of caring medical services to outpatients. In order to standardize the human caring services for outpatients in medical institutions, promote the comprehensive service level of outpatient services, and improve the patient′s medical experience, Chinese Association for Life Care issued the group standard of Management Norms for Human caring of Outpatients in April 2023. This standard clarified the relevant terms and definitions of human caring for outpatients, specified the basic requirements for human caring, the humanistic quality and care responsibilities of outpatient staff, the outpatient care environment and facilities, the outpatient care process and measures, and quality management. It designed standardized and personalized full process care service norms, providing references for medical institutions at all levels to promote the development of human caring for outpatients.