Objective To evaluate the necessity and safety of implanting temporary vena eava fihers to prevent pulmonary emboli in patients of lower extremity fractures concomitant with acute deep venous thrombosis(DVT). Methods A total of 782 patients with lower extremity fractures were complicated with DVT perioperatively. Among them, 91 received temporary vena cava filters implantation before orthopedic operations for the prevention of pulmonary embolism. All patients were followed up post-operation. Results Vena cava filters were successfully implanted in 89 patients. Mean implantation time was 27 days (range from 14 to 42 days). Thrombus trapped within the filters were found in 78 patients (87.6%) after the filters removal. Eight-two filters (92.1%) were retrived successfully at the first attempt as scheduled. Seven filters(7.9%) with big trapped thrombi were removed at the 2nd attempt after additional thrombolytic therapy. No patients needed a permanent filter. No fetal pulmonary embolism (PE) or other major complications were detected during the three to six months follow-ups period. Conclusion Temporary vena cava filter can reduce the incidence and mortality of pulmonary embolism as well as the occurrence of mid- or long-term complications in lower limb fracture patients complicated with DVT.

Objective:To construct a self-examination index system for hospital legal practice, and provide effective reference for the self-examination work of hospital practice in accordance with the law.Methods:From May 2021 to September 2022, a multi-dimensional and multi-level indicator system was initially constructed through literature review and expert interviews; Delphi expert consultation method was used to carry out a three-round questionnaire survey, experts were invited to assess the importance of indicators, and the weight values of indicators were processed by using analytic hierarchy process-fuzzy comprehensive evaluation method.Results:The Cs value of consulting experts′ familiarity with the survey content was 0.84, Ca value of judgment basis was 0.78, Cr value of authoritative evaluation was 0.81, and Kendall W value was 0.630. The index system of hospital self-examination included 5 first-level indexes, 19 second-level indexes, and 30 third-level indicators. The 5 first-level indicators included institutional practice, personnel practice, disinfection and prevention of infectious disease, online diagnosis and treatment, and anti-fraud insurance, with weights of 0.235, 0.186, 0.188, 0.185, and 0.206 respectively. Among the second-level indicators, the weights of rational use of medical insurance fund, internet hospital and internet diagnosis and treatment, organization qualification and practice behavior were the highest, with values of 0.206, 0.185, 0.122 and 0.113 respectively. Among the third-level indicators, the internet hospital physician qualification, whether the hospital had obtained the license to practice, cracking down on fraudulent insurance practices, real-name medical treatment, and reasonable and standardized use of health insurance costs had the highest weight, which were 0.185, 0.122, 0.076, 0.065, and 0.065, respectively. Conclusions:The self-examination index system of medical institutions is scientific, which could help the medical institutions to practice self-examination and ensure medical quality and safety.