1.Theoretical Logic,Realistic Bottlenecks and Solutions to Relieve the High-Quality Development of Digital Health Industry Driven by New Quality Productivity
Shaoyang SONG ; Xue BAI ; Yujie YANG ; Guodong ZHANG ; Qinghai ZOU
Chinese Health Economics 2024;43(11):53-59
High-quality development of digital health industry is an important symbol of realizing a healthy and digital China,and it is a new economic growth point.Using literature and other research methods,it comprehensively explores the theoretical logic,practical bottlenecks and solutions to the high-quality development of digital health industry driven by new quality productivity.It concludes that the new quality productivity can promote the high-quality development of digital health industry by strengthening the effect of institutional innovation,creating a good development environment for the industry;strengthening the effect of structural optimization,driving the upgrading of the industry;strengthening the effect of strengthening and complementing the chain,prolonging the industrial value chain;strengthening the effect of organizational remodeling,improving the industrial organizational system;and strengthening the effect of factor enhancement,fostering the high-end innovation factors.Aiming at the bottlenecks of unsound institutional mechanism,deep structural traps,low-end locking of the value chain,weak integration capacity of health organizations,and insufficient allocation of innovative elements,proposing to promote the deep integration of new elements and resources,and to accumulate the kinetic energy of innovation and development of the digital health industry;strengthening the status of digital health enterprise as the main body of innovation,and to stimulate the vitality of health management organizations;vertically and horizontally integrating the digital health industry chain,and comprehensively excavating the value of the digital health industry;driving the digital health industry to change the new and new,rooting the foundation of digital health industry development;deepening the reform of the digital health management system and mechanism,and improving the system to ensure the relief of the system.
2.Theoretical Logic,Realistic Bottlenecks and Solutions to Relieve the High-Quality Development of Digital Health Industry Driven by New Quality Productivity
Shaoyang SONG ; Xue BAI ; Yujie YANG ; Guodong ZHANG ; Qinghai ZOU
Chinese Health Economics 2024;43(11):53-59
High-quality development of digital health industry is an important symbol of realizing a healthy and digital China,and it is a new economic growth point.Using literature and other research methods,it comprehensively explores the theoretical logic,practical bottlenecks and solutions to the high-quality development of digital health industry driven by new quality productivity.It concludes that the new quality productivity can promote the high-quality development of digital health industry by strengthening the effect of institutional innovation,creating a good development environment for the industry;strengthening the effect of structural optimization,driving the upgrading of the industry;strengthening the effect of strengthening and complementing the chain,prolonging the industrial value chain;strengthening the effect of organizational remodeling,improving the industrial organizational system;and strengthening the effect of factor enhancement,fostering the high-end innovation factors.Aiming at the bottlenecks of unsound institutional mechanism,deep structural traps,low-end locking of the value chain,weak integration capacity of health organizations,and insufficient allocation of innovative elements,proposing to promote the deep integration of new elements and resources,and to accumulate the kinetic energy of innovation and development of the digital health industry;strengthening the status of digital health enterprise as the main body of innovation,and to stimulate the vitality of health management organizations;vertically and horizontally integrating the digital health industry chain,and comprehensively excavating the value of the digital health industry;driving the digital health industry to change the new and new,rooting the foundation of digital health industry development;deepening the reform of the digital health management system and mechanism,and improving the system to ensure the relief of the system.
3.Theoretical Logic,Realistic Bottlenecks and Solutions to Relieve the High-Quality Development of Digital Health Industry Driven by New Quality Productivity
Shaoyang SONG ; Xue BAI ; Yujie YANG ; Guodong ZHANG ; Qinghai ZOU
Chinese Health Economics 2024;43(11):53-59
High-quality development of digital health industry is an important symbol of realizing a healthy and digital China,and it is a new economic growth point.Using literature and other research methods,it comprehensively explores the theoretical logic,practical bottlenecks and solutions to the high-quality development of digital health industry driven by new quality productivity.It concludes that the new quality productivity can promote the high-quality development of digital health industry by strengthening the effect of institutional innovation,creating a good development environment for the industry;strengthening the effect of structural optimization,driving the upgrading of the industry;strengthening the effect of strengthening and complementing the chain,prolonging the industrial value chain;strengthening the effect of organizational remodeling,improving the industrial organizational system;and strengthening the effect of factor enhancement,fostering the high-end innovation factors.Aiming at the bottlenecks of unsound institutional mechanism,deep structural traps,low-end locking of the value chain,weak integration capacity of health organizations,and insufficient allocation of innovative elements,proposing to promote the deep integration of new elements and resources,and to accumulate the kinetic energy of innovation and development of the digital health industry;strengthening the status of digital health enterprise as the main body of innovation,and to stimulate the vitality of health management organizations;vertically and horizontally integrating the digital health industry chain,and comprehensively excavating the value of the digital health industry;driving the digital health industry to change the new and new,rooting the foundation of digital health industry development;deepening the reform of the digital health management system and mechanism,and improving the system to ensure the relief of the system.
4.Theoretical Logic,Realistic Bottlenecks and Solutions to Relieve the High-Quality Development of Digital Health Industry Driven by New Quality Productivity
Shaoyang SONG ; Xue BAI ; Yujie YANG ; Guodong ZHANG ; Qinghai ZOU
Chinese Health Economics 2024;43(11):53-59
High-quality development of digital health industry is an important symbol of realizing a healthy and digital China,and it is a new economic growth point.Using literature and other research methods,it comprehensively explores the theoretical logic,practical bottlenecks and solutions to the high-quality development of digital health industry driven by new quality productivity.It concludes that the new quality productivity can promote the high-quality development of digital health industry by strengthening the effect of institutional innovation,creating a good development environment for the industry;strengthening the effect of structural optimization,driving the upgrading of the industry;strengthening the effect of strengthening and complementing the chain,prolonging the industrial value chain;strengthening the effect of organizational remodeling,improving the industrial organizational system;and strengthening the effect of factor enhancement,fostering the high-end innovation factors.Aiming at the bottlenecks of unsound institutional mechanism,deep structural traps,low-end locking of the value chain,weak integration capacity of health organizations,and insufficient allocation of innovative elements,proposing to promote the deep integration of new elements and resources,and to accumulate the kinetic energy of innovation and development of the digital health industry;strengthening the status of digital health enterprise as the main body of innovation,and to stimulate the vitality of health management organizations;vertically and horizontally integrating the digital health industry chain,and comprehensively excavating the value of the digital health industry;driving the digital health industry to change the new and new,rooting the foundation of digital health industry development;deepening the reform of the digital health management system and mechanism,and improving the system to ensure the relief of the system.
5.Theoretical Logic,Realistic Bottlenecks and Solutions to Relieve the High-Quality Development of Digital Health Industry Driven by New Quality Productivity
Shaoyang SONG ; Xue BAI ; Yujie YANG ; Guodong ZHANG ; Qinghai ZOU
Chinese Health Economics 2024;43(11):53-59
High-quality development of digital health industry is an important symbol of realizing a healthy and digital China,and it is a new economic growth point.Using literature and other research methods,it comprehensively explores the theoretical logic,practical bottlenecks and solutions to the high-quality development of digital health industry driven by new quality productivity.It concludes that the new quality productivity can promote the high-quality development of digital health industry by strengthening the effect of institutional innovation,creating a good development environment for the industry;strengthening the effect of structural optimization,driving the upgrading of the industry;strengthening the effect of strengthening and complementing the chain,prolonging the industrial value chain;strengthening the effect of organizational remodeling,improving the industrial organizational system;and strengthening the effect of factor enhancement,fostering the high-end innovation factors.Aiming at the bottlenecks of unsound institutional mechanism,deep structural traps,low-end locking of the value chain,weak integration capacity of health organizations,and insufficient allocation of innovative elements,proposing to promote the deep integration of new elements and resources,and to accumulate the kinetic energy of innovation and development of the digital health industry;strengthening the status of digital health enterprise as the main body of innovation,and to stimulate the vitality of health management organizations;vertically and horizontally integrating the digital health industry chain,and comprehensively excavating the value of the digital health industry;driving the digital health industry to change the new and new,rooting the foundation of digital health industry development;deepening the reform of the digital health management system and mechanism,and improving the system to ensure the relief of the system.
6.Theoretical Logic,Realistic Bottlenecks and Solutions to Relieve the High-Quality Development of Digital Health Industry Driven by New Quality Productivity
Shaoyang SONG ; Xue BAI ; Yujie YANG ; Guodong ZHANG ; Qinghai ZOU
Chinese Health Economics 2024;43(11):53-59
High-quality development of digital health industry is an important symbol of realizing a healthy and digital China,and it is a new economic growth point.Using literature and other research methods,it comprehensively explores the theoretical logic,practical bottlenecks and solutions to the high-quality development of digital health industry driven by new quality productivity.It concludes that the new quality productivity can promote the high-quality development of digital health industry by strengthening the effect of institutional innovation,creating a good development environment for the industry;strengthening the effect of structural optimization,driving the upgrading of the industry;strengthening the effect of strengthening and complementing the chain,prolonging the industrial value chain;strengthening the effect of organizational remodeling,improving the industrial organizational system;and strengthening the effect of factor enhancement,fostering the high-end innovation factors.Aiming at the bottlenecks of unsound institutional mechanism,deep structural traps,low-end locking of the value chain,weak integration capacity of health organizations,and insufficient allocation of innovative elements,proposing to promote the deep integration of new elements and resources,and to accumulate the kinetic energy of innovation and development of the digital health industry;strengthening the status of digital health enterprise as the main body of innovation,and to stimulate the vitality of health management organizations;vertically and horizontally integrating the digital health industry chain,and comprehensively excavating the value of the digital health industry;driving the digital health industry to change the new and new,rooting the foundation of digital health industry development;deepening the reform of the digital health management system and mechanism,and improving the system to ensure the relief of the system.
7.Design of anterolateral thigh perforator flap aided by three-dimensional printing technique for repairing irregular extremity wounds
Chengwei GE ; Guodong JIANG ; Kai WANG ; Zhigang CHE ; Junnan CHENG ; Zhicheng TENG ; Song YUAN ; Jihui JU
Chinese Journal of Plastic Surgery 2024;40(9):946-953
Objective:To investigate the clinical effect of three-dimensional(3D) flap model accurately designed before the operation in repairing irregular wounds of limbs with anterolateral thigh(ALT) perforator flap.Methods:The data of patients with ALT flaps designed with 3D printing technology to repair irregular soft tissue defects of limbs in Suzhou Ruihua Orthopedic Hospital from January to October 2022 were retrospectively analyzed. After the wound was scanned by 3D scanner before surgery, the wound model was printed. The ALT flap was precisely designed and harvested for covering the wound according to the body surface projection of the perforator vessel in the anterolateral femoral region located by color Doppler ultrasound before surgery. The survival of the flap, the healing of the donor and recipient sites and the occurrence of complications were observed and followed up after the operation. The effect of wound repair was evaluated by the comprehensive efficacy evaluation scale of the skin flap. The total score was 100 points, which was divided into excellent (90-100 points), good (75-89 points), fair (60-74 points) and poor (< 60 points).Results:A total of 34 patients were enrolled, including 26 males and 8 females, aged 18-75 years, with an average age of 45.5 years. Injury sites: wrist in 17 cases, foot in 10 cases, ankle in 7 cases. The operation time was 2.0-4.5 h (mean 3.3 h), and all donor sites were sutured directly. Vascular crisis occurred in 2 cases after skin flap transplantation. After surgical exploration, the transplanted skin flap survived, and the other skin flaps survived successfully. All 34 patients were followed up for 6 to 10 months, with an average of 8 months. All the donor sites of the skin flap healed primarily, and the wound healing time of the recipient site was 10-44 days, with an average of 20 days. At the last follow-up, the skin flap was good in color and texture, and the sensation returned to S1 and S2 grades. There were scars left in the donor site, no cicatricial contracture, pain and other discomfort, and no other serious complications. The results of flap evaluation were 80-91 points, with an average of 86 points. Among them, 25 cases were excellent, 6 cases were good, 3 cases were fair, and the excellent and good rate was 91%(31/34).Conclusion:The application of 3D printing technology assisted the design of ALT perforator flap to repair irregular wounds of limbs can significantly reduce the intraoperative design time of the flap, which is in line with the concept of precise design and incision of the flap, and has good clinical effect, and can effectively reduce the trauma and complications of the donor site.
8.Design of anterolateral thigh perforator flap aided by three-dimensional printing technique for repairing irregular extremity wounds
Chengwei GE ; Guodong JIANG ; Kai WANG ; Zhigang CHE ; Junnan CHENG ; Zhicheng TENG ; Song YUAN ; Jihui JU
Chinese Journal of Plastic Surgery 2024;40(9):946-953
Objective:To investigate the clinical effect of three-dimensional(3D) flap model accurately designed before the operation in repairing irregular wounds of limbs with anterolateral thigh(ALT) perforator flap.Methods:The data of patients with ALT flaps designed with 3D printing technology to repair irregular soft tissue defects of limbs in Suzhou Ruihua Orthopedic Hospital from January to October 2022 were retrospectively analyzed. After the wound was scanned by 3D scanner before surgery, the wound model was printed. The ALT flap was precisely designed and harvested for covering the wound according to the body surface projection of the perforator vessel in the anterolateral femoral region located by color Doppler ultrasound before surgery. The survival of the flap, the healing of the donor and recipient sites and the occurrence of complications were observed and followed up after the operation. The effect of wound repair was evaluated by the comprehensive efficacy evaluation scale of the skin flap. The total score was 100 points, which was divided into excellent (90-100 points), good (75-89 points), fair (60-74 points) and poor (< 60 points).Results:A total of 34 patients were enrolled, including 26 males and 8 females, aged 18-75 years, with an average age of 45.5 years. Injury sites: wrist in 17 cases, foot in 10 cases, ankle in 7 cases. The operation time was 2.0-4.5 h (mean 3.3 h), and all donor sites were sutured directly. Vascular crisis occurred in 2 cases after skin flap transplantation. After surgical exploration, the transplanted skin flap survived, and the other skin flaps survived successfully. All 34 patients were followed up for 6 to 10 months, with an average of 8 months. All the donor sites of the skin flap healed primarily, and the wound healing time of the recipient site was 10-44 days, with an average of 20 days. At the last follow-up, the skin flap was good in color and texture, and the sensation returned to S1 and S2 grades. There were scars left in the donor site, no cicatricial contracture, pain and other discomfort, and no other serious complications. The results of flap evaluation were 80-91 points, with an average of 86 points. Among them, 25 cases were excellent, 6 cases were good, 3 cases were fair, and the excellent and good rate was 91%(31/34).Conclusion:The application of 3D printing technology assisted the design of ALT perforator flap to repair irregular wounds of limbs can significantly reduce the intraoperative design time of the flap, which is in line with the concept of precise design and incision of the flap, and has good clinical effect, and can effectively reduce the trauma and complications of the donor site.
9.Effects of early debridement and conservative eschar removal followed by wound coverage with acellular dermal matrix in the treatment of children with deep burns
Yan LIANG ; Wen SHI ; Yang SHAO ; Xinzhuang LIU ; Hongmin GONG ; Guohui CAO ; Cong GAO ; Naijun XIN ; Guodong SONG
Chinese Journal of Burns 2024;40(4):348-357
Objective:To explore the effects of early debridement and conservative eschar removal followed by wound coverage with acellular dermal matrix (ADM), i.e., early surgery, in the treatment of children with deep burns.Methods:This study was a retrospective cohort study. From January 2017 to December 2022, 278 deep burned hospitalized children aged 1-7 years who met the inclusion criteria were admitted to Central Hospital Affiliated to Shandong First Medical University. According to the differences in treatment processes, 134 children who underwent early surgery+routine dressing change were enrolled in eschar removal+dressing change group (77 males and 57 females, aged 1 (1, 2) years), and 144 children who underwent only routine dressing change were enrolled in dressing change alone group (90 males and 54 females, aged 1 (1, 2) years). Fifty-one children without full-thickness burns in eschar removal+dressing change group were enrolled in eschar removal+dressing change group 1 (26 males and 25 females, aged 1 (1, 2) years), and 57 cases of the 83 children with full-thickness burns who did not undergo autologous skin grafting at the same time of early surgery (namely early skin grafting) in eschar removal+dressing change group were included in eschar removal+dressing change group 2 (37 males and 20 females, aged 1 (1, 2) years). Seventy-six children without full-thickness burns in dressing change alone group were included in dressing change alone group 1 (51 males and 25 females, aged 1 (1, 3) years), and 68 children with full-thickness burns in dressing change alone group were included in dressing change alone group 2 (39 males and 29 females, aged 1 (1, 2) years). For deep partial-thickness burn wounds and small full-thickness burn wounds in eschar removal+dressing change group, the eschar removal was performed on the basis of retaining a thin layer of denatured dermis so as to preserve the healthy tissue of the wound base, and ADM was applied to all wounds externally after eschar removal. For larger full-thickness burn wounds in this group, especially those located in the functional part of joints, eschar removal to the plane layer of viable tissue and early autologous skin grafting was needed. When the superficial wounds of children healed or tended to heal, the residual wounds were evaluated, and elective autologous skin grafting was performed if it was difficult to heal within 14 days. The healing time, intervention healing time, times of operation/dressing change, and times of intervention operation/dressing change in children with deep partial-thickness burn wounds of children in eschar removal+dressing change group, dressing change alone group, eschar removal+dressing change group 1, and dressing change alone group 1 were recorded. At the last follow-up (follow-up period was set to 7-12 months), the modified Vancouver scar scale (mVSS) scores of the most severe area of scar hyperplasia of healed deep partial-thickness burn wounds of 54 children in eschar removal+dressing change group and 48 children in dressing change alone group were recorded. The healing time and times of operation/dressing change of all burn wounds of children in eschar removal+dressing change group and dressing change alone group, and the healing time and times of operation/dressing change of full-thickness burn wounds of children in eschar removal+dressing change group 2 and dressing change alone group 2 were recorded. The incidences of wound infection, sepsis, fever, and fever after 5 days of burns in children of eschar removal+dressing change group and dressing change alone group during wound healing.Results:Compared with those in dressing change alone group, the healing time and intervention healing time were significantly shortened, and the times of operation/dressing change and times of intervention operation/dressing change were significantly reduced in children with deep partial-thickness burn wounds in eschar removal+dressing change group (with Z values of -11.00, -11.33, -12.64, and -11.65, respectively, P<0.05). Compared with those in dressing change alone group 1, the healing time and intervention healing time were significantly shortened, and the times of operation/dressing change and times of intervention operation/dressing change were significantly reduced in children with deep partial-thickness burn wounds in eschar removal+dressing change group 1 (with Z values of 6.57, 6.46, 8.04, and 6.57, respectively, P<0.05). At the last follow-up, the mVSS score of the most severe scar hyperplasia area of healed deep partial-thickness burn wounds of 54 children in eschar removal+dressing change group was 4.00 (3.00,5.00), which was significantly lower than 6.50 (5.00,7.00) of 48 children in dressing change alone group ( Z =-4.67, P<0.05).Compared with those in dressing change alone group, the healing time was significantly shortened, and times of operation/dressing change was significantly reduced in all burn wounds in eschar removal+dressing change group (with Z values of -5.20 and -6.34, respectively, P<0.05). Compared with those in dressing change alone group 2, the healing time was significantly shortened, and times of operation/dressing change was significantly reduced in full-thickness burn wounds in eschar removal+dressing change group 2 (with Z values of -5.22 and -5.73, respectively, P<0.05). During wound healing, the probabilities of fever and fever after 5 days of burns in children of eschar removal+dressing change group were significantly lower than those in dressing change alone group (with χ2 values of 4.13 and 3.91, respectively, P<0.05); only 1 child in dressing change alone group developed sepsis, and there was no statistically significant difference in the wound infection rate of children in the two groups ( P>0.05). Conclusions:For children with deep burns, early surgery, and early skin grafting or elective autologous skin grafting as needed, have better short-term and long-term effects than those without early surgery.
10.Effects of anterolateral femoral perforator flaps pedicled with oblique branch of lateral circumflex femoral artery and carrying fascia lata in repairing destructive wounds and rebuilding function of hands or feet
Chengwei GE ; Guodong JIANG ; Junnan CHENG ; Liping GUO ; Zhigang CHE ; Song YUAN ; Jihui JU
Chinese Journal of Burns 2024;40(9):842-848
Objective:To investigate the effects of anterolateral femoral perforator flaps pedicled with oblique branch of lateral circumflex femoral artery and carrying fascia lata in repairing destructive wounds and rebuilding function of hands or feet.Methods:This study was a retrospective observational study. From January 2022 to March 2023, 16 patients with destructive wounds in hands or feet combined with extensor tendon defects who met the inclusion criteria were admitted to Suzhou Ruihua Orthopedic Hospital, including 12 males and 4 females, aged 3 to 63 years. The wounds were located on the hands in 12 cases and on the feet in 4 cases. The number of defective extensor tendon ranged one to five, and the length of the defect ranged from 2.5 to 6.0 cm. The wound area was 11.0 cm×5.5 cm to 29.0 cm×9.5 cm after debridement. The wounds were repaired with anterolateral femoral perforator flaps pedicled with oblique branch of lateral circumflex femoral artery and carrying fascia lata, and the flap area was 12.0 cm×6.5 cm to 30.0 cm×11.0 cm. The fascia lata was used to repair the extensor tendon defects, and the harvesting area of fascia lata was 8.0 cm×3.0 cm to 12.0 cm×8.0 cm. The wounds in flap donor areas in 15 patients were sutured directly, and the wound in flap donor area in 1 patient was covered with medium-thickness skin graft from lower abdomen. The survival of flaps and the wound healing in donor and recipient areas of flaps were observed within 1 week after operation. The number of patients who underwent thinning and plastic surgery or tenolysis was recorded during postoperative follow-up. At the last follow-up, the recovery of sensory function of the transplanted flaps on hands or feet was evaluated, the efficacy of flap repair was evaluated according to the comprehensive flap evaluation scale, and the function of hands was evaluated according to the trial standards for evaluation of partial function of upper extremity by the Hand Surgery Society of Chinese Medical Association. The following two indexes were compared, including the measured total active motion of the injured fingers and the foot function assessed using Maryland foot function scale between before surgery and at the last follow-up.Results:Arterial crisis occurred in flaps in 2 patients after operation, and the flaps survived after timely exploration; the flaps in the rest patients survived well after operation. No obvious scar hyperplasia or ulceration was observed in donor and recipient areas of flaps after operation. All patients were followed up for 8 to 16 months, of which 6 patients underwent flap thinning and plastic surgery 6 to 7 months after operation, and 4 patients underwent tenolysis 3 to 6 months after operation. At the last follow-up, the recovery of sensory function of flaps reached S1 level in 5 cases and S2 level in 11 cases, and the two-point discrimination only had 1 point. The efficacy of flap repair scored 80 to 91, which were evaluated as excellent in 5 cases, good in 9 cases, and acceptable in 2 cases. The hand function was evaluated as excellent in 5 cases, good in 5 cases, and acceptable in 2 cases. The active extension function of the injured finger/toe was reconstructed successfully, and the total active motion of the injured finger was (225±22)° at the last follow-up, which was significantly higher than (117±20)° before surgery ( t=119.59, P<0.05); the foot function score was 86±7 at the last follow-up, which was significantly higher than 29±7 before surgery ( t=222.68, P<0.05), and the foot function was evaluated as excellent in 2 cases, good in 1 case, and acceptable in 1 case. Conclusions:The operation of harvesting the anterolateral femoral perforator flap pedicled with oblique branch of lateral circumflex femoral artery is relatively simple. After the wounds on hands or feet being repaired with the flaps, the appearance and function are good, with no obvious scar hyperplasia in donor and recipient areas of flaps. The fascia lata carried by the flap can repair the extensor tendon defect at the same time and improve the movement of the finger/toe.

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