Objective:To establish and assess the quality control and improvement system for metabolic and bariatric surgery in Beijing.Methods:Based on relevant documents from the National Health Commission and the Beijing Municipal Health Commission,and referencing the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) by the American Society for Metabolic and Bariatric Surgery,a quality control system was developed under the Beijing Quality Control and Improvement Center of Metabolic and Bariatric Surgery. The system incorporated on-site evaluations,data registration,and specialized training. From May to December 2023,on-site assessments were conducted at 21 hospitals in Beijing performing bariatric surgery,evaluating personnel qualifications,infrastructure,clinical workflows,and postoperative follow-up. A quality control database was created to collect real-time surgical data,and training was provided for data entry and professional skills. Assessment results were classified as excellent,qualified,or needing improvement,with rectification suggestions offered and follow-up visits conducted to track progress.Results:All 21 hospitals achieved a 100% compliance rate for surgical indications, 16 (76.2%) met standardized surgical operation criteria,and 14 (66.7%) had standardized postoperative management. However,only 5 (23.8%) achieved a 12-month postoperative follow-up rate of ≥60%,and 4 (19.1%) had established specialized databases. Key challenges included insufficient specialized staffing (19.1%), lack of multidisciplinary collaboration (47.6%), inadequate equipment (57.1%), and low follow-up rates (57.1%). The database collected data from over 2 000 patients across 111 fields. After rectification, specialized database coverage rose to 61.9% (13 hospitals). Multi-level training programs developed backbone physicians and specialized nurses,significantly addressing the shortage of specialized personnel.Conclusion:The quality control system established in this study,through the integration of on-site evaluation,data registration,and specialized training,effectively enhances the standardization of surgical practices and data management capabilities.

Objective:To establish and assess the quality control and improvement system for metabolic and bariatric surgery in Beijing.Methods:Based on relevant documents from the National Health Commission and the Beijing Municipal Health Commission,and referencing the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) by the American Society for Metabolic and Bariatric Surgery,a quality control system was developed under the Beijing Quality Control and Improvement Center of Metabolic and Bariatric Surgery. The system incorporated on-site evaluations,data registration,and specialized training. From May to December 2023,on-site assessments were conducted at 21 hospitals in Beijing performing bariatric surgery,evaluating personnel qualifications,infrastructure,clinical workflows,and postoperative follow-up. A quality control database was created to collect real-time surgical data,and training was provided for data entry and professional skills. Assessment results were classified as excellent,qualified,or needing improvement,with rectification suggestions offered and follow-up visits conducted to track progress.Results:All 21 hospitals achieved a 100% compliance rate for surgical indications, 16 (76.2%) met standardized surgical operation criteria,and 14 (66.7%) had standardized postoperative management. However,only 5 (23.8%) achieved a 12-month postoperative follow-up rate of ≥60%,and 4 (19.1%) had established specialized databases. Key challenges included insufficient specialized staffing (19.1%), lack of multidisciplinary collaboration (47.6%), inadequate equipment (57.1%), and low follow-up rates (57.1%). The database collected data from over 2 000 patients across 111 fields. After rectification, specialized database coverage rose to 61.9% (13 hospitals). Multi-level training programs developed backbone physicians and specialized nurses,significantly addressing the shortage of specialized personnel.Conclusion:The quality control system established in this study,through the integration of on-site evaluation,data registration,and specialized training,effectively enhances the standardization of surgical practices and data management capabilities.

Abdomen/diagnostic imaging* ; Artificial Intelligence ; Body Composition ; Magnetic Resonance Imaging ; Practice Guidelines as Topic

Objective:To investigate the clinical effect of laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity with non-alcoholic fatty liver disease (NAFLD).Methods:The clinical data of 115 obese patients with NAFLD who underwent LSG surgery at Beijing Tiantan Hospital were analyzed.Results:LSG was successful in a 115 patients, and the body weight and BMI decreased gradually, and were significantly lower than the preoperative level (all P<0.001). EWL% increased and was 73.1%±30.1% at 12 months after operation. The postoperative triglyceride level decreased and was significantly lower than the preoperative level (all P<0.05). Most patients were complicated with abnormal liver function before surgery, and ALT, AST and GGT levels decreased to the normal range 3 months after surgery (all P<0.05). Albumin level was significantly higher 3 months after operation than before operation ( P<0.001). At 12 months postoperatively, the severity grade of fatty liver on ultrasound was significantly lower than that before surgery ( P<0.001). Conclusion:Laparoscopic sleeve gastrectomy can significantly improve lipid metabolism index, liver function index and fatty liver index in NAFLD patients along with weight loss .

Objective To explore the effect of externally-applied white plaster on cervical radiodermatitis.Methods Ninety patients with cervical radiodermatitis were equally divided into the observation group and control group according to their admission order.Patients in the control group were treated with furacilin through moist packing as well as routine nursing and the patients in the observation group were given white plaster for external application as well as nursing healthcare education.The two groups were compared in terms of clinical effect,average treatment during,and adverse reactions.Results The total effectiveness rate in the observation group was significantly higher than that of the control group and the average treatment duration was significantly shorter (P<0.05).There were no obvious adverse reactions in both groups.Conchusions The white plaster is clinically effective for the treatment of cervical radiodermatitis.It is advantageous due to shortened curative course and no adverse reactions.

Objective The evaluation and possibility of percutaneous fenestration for ischemic complications of aortic dissection were disccused. Methods A male patient with aortic dissetion (type: DeBakey Ⅲb) accompanyed by lower extremities pararises was undertaken percutaneous fenestration. Results Both the lower leg's blood flow was recovered with symptom free. Bilateral femoral and dorsal foot pulsations could be feeled. Conclusion Percutaneous fenestration for ischemic complications of aortic dissection is a safe and effective management, but should be done earlier.

Forty-eight cases of atrial septum secundum defect were repaired and followed up with M-mode echocardiography postoperatively for three months to three yaers respectively.All the cases showed a significant reduction of the inner diameter of the right ventricle after operation,and in 23% of the cases, the inner diameter even returned to the normal range. In 92% of the acses, the intervetricular septal paradoxical motion resumed the normal pattern. In most cases, the inner diameter of the left ventricle increased markedly.In 11 cases with repeated follow-up studies, it was found that three months after operation, the interventricular septal paradoxical motion became normal in 7 cases and the motion flattened in three cases. In 18 cases with a 3-year follow-up history, it was found that the recovery of the heart condition showed no relation to the age of the patient. This is likely to suggest that the age factor exerts no influence on the postoperative recovery of the cases having the atrial septal defect repaired.

This article is to report the result and experience of the clinical application of the extraluminal circumferential-suture ligation to close the bronchial stumps after pulmonary resections. This method was used for 469 times in 400 patients with various diseases including tuberculosis, lung cancer, and chronic suppurative disease with excellent results. After the use of this method, the incidence of the dreadful postoperative complication of broncho-pleural fistula was reduced to only 0.25%, and it never occurred when a main or a large bronchus was involved.It is pointed out that the advantage of this extraluminal circumferential-suture ligation method cannot be overemphasized and its success lies on two crucial steps as follows:1. The traditional open method to divide a bronchus is substituted with the new close method, which can avoid spraying the highly infectious bronchial contents into the pleural cavity to cause contamination. Thus the main source of infection is cut off.2. Every stitch of the circumferential suture is done extraluminally without penetrating the whole thickness of the bronchial wall or entering the infections bronchial lumen, which will further minimize the chance of infection.

Fifty cases with chronic rheumatic valvular disease were examined with two dimensional echocardiography to evaluate the valvular pathology preoperatively. The echocardiographic findings were correlated and compared with the operative findings.It was found that 89% of the thickening pattern cases and 75% of the funnel-shaped cases showed thickening of the leaf-lets- All the 28 membranous cases showed diastolic doming and restricted tip motion of the anterior leaflet in different degrees. In the 4 funnel-shaped cases, 3 showed restricted tip and body motion of the leaflets and the 4th case showed stiffness of the leaflet base. 63% of the mitral regurgitation cases were confirmed at operation.It is concluded that preoperative evaluation of the valvular pathology with two dimensional echocardiography is helpful in selection of suitable operative candidates.

This article is to report three cases of total anomalous pulmonary venous drainage(TAPVD). 2 out of the 3 cases were of the supracardiac form and they were corrected by anastomosis between the trunk of the pulmonary vein and the left atrium with excellent result. The third case was of the intracardiac form. The patient died in the late postoperative period of pulmonary venous obstruction due to the improper judgement during the operative procedure of compartmentalization. Meanwhile, the embryogensis, clinical manifestations, diagnosis, and operative proceduresfof TAPVD were reviewed and discussed.