With the development of information technology and the increasing demand for vaccination services among the people, it is a definite trend to enhance the quality of vaccination services through digitization. This article starts with a clear concept of digital services for vaccination, introduces the current development status in China and abroad, analyzes the advantages and disadvantages of existing models in leading regions, takes a glean from the summation, and proposes targeted solutions. This study suggests establishing a departmental coordination mechanism for data interconnection and sharing, formulating data standards and functional specifications, enhancing the functionalities of the immunization planning information system, strengthening data collection and analytical usage, and intensifying appointment management and science and health education to provide expert guidance for the construction of digital vaccination services across the country in the future.

With the development of information technology and the increasing demand for vaccination services among the people, it is a definite trend to enhance the quality of vaccination services through digitization. This article starts with a clear concept of digital services for vaccination, introduces the current development status in China and abroad, analyzes the advantages and disadvantages of existing models in leading regions, takes a glean from the summation, and proposes targeted solutions. This study suggests establishing a departmental coordination mechanism for data interconnection and sharing, formulating data standards and functional specifications, enhancing the functionalities of the immunization planning information system, strengthening data collection and analytical usage, and intensifying appointment management and science and health education to provide expert guidance for the construction of digital vaccination services across the country in the future.

【Objective】 To achieve supervision and management of the whole business process of blood center, raise productivity and ensure blood quality by enabling blood center managers comprehensively grasp the key business operation situation of the whole process at anytime and anywhere. 【Methods】 A whole business process supervision and management system was established covering background of preparation, business scope, content of position supervision and management, overall framework design, interface design of management and supervision management, physical database design, program development and online debugging, and was integrated with the blood bank management information system. The display and management were through a mobile APP to record key indicators of business process from blood collection to blood supply timely and comprehensively. Statistical analysis was conducted on total collection volume, total preparation volume and total supply volume, as well as discarding rate of test unqualified and of non-test unqualified (lipemic blood excluded) in 2023 and 2022. 【Results】 We established a mobile APP based on a blood bank management information system for business supervision and management of whole process, and achieved management by phones. After its implementation in 2023, the total collection volume, total preparation volume and total supply volume in 2023 were all higher than those in 2022, with growth rates of 5.88% (13 247/225 454 U), 4.73% (24 156/510 698 U), and 6.70% (34 814/519 914 U), respectively. The discarding rate in 2023 was lower than that in 2022 (0.54%, 2 868/534 854 U) vs (0.60%, 3 047/510 698 U) (P<0.01), and the non-test unqualified discarding rate (lipemic blood excluded) in 2023 was significantly lower than that in 2022(0.12%, 649/534 854 U) vs (0.19%, 991/510 698 U)(P<0.01). 【Conclusion】 The construction of supervision and management system of a whole business process based on blood bank management information system can meet the standardized service needs of managers at anytime and anywhere, continuously raise productivity and the standardization and scientific level of blood bank management, thus ensuring blood supply.

OBJECTIVE: To compare the mid- and long-term effectiveness of patellar resurfacing versus non-resurfacing in primary total knee arthroplasty (TKA). METHODS: Twenty-six patients who underwent bilateral TKA between March 2013 and September 2015 were selected as the study subjects. One side was randomly chosen for patellar resurfacing (resurfacing group), and the other side was not (control group). There were 4 males and 22 females, the age ranged from 51 to 65 years, with an average of 59 years. According to Kellgren-Lawrence classification, there were 21 cases of grade Ⅳ and 5 cases of grade Ⅲ in both knees. There was no significant difference in the surgical side, and preoperative clinical and functional scores of the Knee Society Score (KSS), visual analogue scale (VAS) score, and the composition ratio of anterior knee pain localization points between the two groups ( P>0.05). The operation time, intraoperative blood loss, postoperative abnormal signs such as patellar clunk, feeling of constraint, patellar tendon weakness, crepitus, or snow-on-glass sensation, and the occurrence of complications were recorded and compared. Patient subjective evaluations included Forgotten Joint Score (FJS) and the degree of difficulty in high-level knee activities (including flexion with load bearing, going upstairs, going downstairs, squatting and standing up, kneeling, knee extension, and crossing legs for 7 items); KSS clinical/functional scores and VAS scores were used to evaluate the recovery of knee joint function, and the location of anterior knee pain was determined by a localization diagram. RESULTS: The operation time of the resurfacing group was significantly longer than that of the control group ( P<0.05), and there was no significant difference in intraoperative blood loss between the two groups ( P>0.05). All patients' incisions healed by first intention; the hospital stay ranged from 8 to 23 days, with an average of 12.6 days. All patients were followed up 9-11 years, with an average of 9.7 years. Except for 1 case who died of multiple organ failure due to internal diseases at 9 years after operation and 5 cases with incomplete radiological data, the rest 20 patients were assessed radiologically and found that 1 side of the knee joint in the control group had patellar dislocation; the remaining patients had no prosthetic failure (fracture, loosening, displacement, etc.), patellar fracture, patellar necrosis, patellar instability, patellar tendon rupture, prosthetic revision, etc. No patients had reoperations due to patellar-related complications or anterior knee pain in both knee joints. At 2 years postoperatively and at last follow-up, there was no significant difference in the incidence of abnormal signs such as patellar clunk, feeling of constraint, patellar tendon weakness, crepitus, or snow-on-glass sensation, the incidence of high-level knee activity difficulty, and the composition ratio of anterior knee pain localization between the two groups ( P>0.05). The KSS clinical scores, functional scores, and VAS scores of both groups significantly improved compared to preoperative ones ( P<0.05); there was no significant difference in the comparison between the two groups at the two time points postoperatively ( P>0.05). At 2 years postoperatively and at last follow-up, there was no significant difference in FJS scores between the two groups ( P>0.05). CONCLUSION Patellar resurfacing or not has similar mid- and long-term effectiveness in primary TKA.
Humans ; Arthroplasty, Replacement, Knee/methods* ; Male ; Middle Aged ; Female ; Patella/surgery* ; Aged ; Treatment Outcome ; Range of Motion, Articular ; Knee Joint/surgery* ; Knee Prosthesis ; Pain Measurement ; Osteoarthritis, Knee/surgery* ; Pain, Postoperative/etiology* ; Follow-Up Studies ; Postoperative Complications ; Recovery of Function

Effects of heat treatment conditions (including temperature and time) on the shape memory recovery and corrosion resistance of NiTi self-expanding vascular stents were studied based on working mechanism and clinical use. The
Alloys ; Corrosion ; Hot Temperature ; Materials Testing ; Stents ; Surface Properties ; Temperature ; Titanium

Objective:To evaluate the performance and the accuracy of surgical robot for mandibular reconstruction based on intelligent surgical planning.Methods:115 CT scanning images of normal mandible (57 males, 48 females, 40.3±9.1 years old, from February 2010 to May 2019) and 115 CT scanning images of mandible with tumor (62 males, 53 females, 55.6±7.2 years old, from March 2008 to August 2019) from Shanghai Ninth People’s Hospital were selected. The surgical robot system including work station, UR robot, optical navigation system, 6 dimensional force senor and surgical instrument. A 3D V-Net for mandible preoperational segmentation from CT scans was proposed and used to segment the mandible of a 54-year-old male patient who received mandible reconstruction with fibular flaps. The machine learning algorithm was used to aid surgical planning for maxillo-mandibular defect by detecting landmarks. The accuracy was defined as the distance between corresponding landmarks on the intact mandible. The robot could locate the target according to surgical planning and perform fibula osteotomy through force-motion control. The CT scanning of limb and head from the patient (male, 54 years old) was used for phantom experiments. 30 osteotomies on 5 3D-priented resin phantom were carried out. The pre- and post-operative images were compared to calculate the accuracy. The descriptive results were in the format of Mean±SD.Results:The average accuracy of V-Net for mandible segmentation was 96.581% and the time cost was less than 30 seconds. The average error of feature points on mandible was (2.24±1.74) mm. The residual length error was (1.02±0.45) mm and angle error was (0.96±0.42) degree in robotic-assisted osteotomy according to 3 cases of phantom experiments. The surgical robot could perform osteotomy safely and steadily within 15 min.Conclusions:Intelligent surgical planning can precisely segment the mandible and determine its landmarks. Robot for mandibular reconstruction can perform fibular osteotomy precisely with the pre-operative planning.

Objective:To evaluate the performance and the accuracy of surgical robot for mandibular reconstruction based on intelligent surgical planning.Methods:115 CT scanning images of normal mandible (57 males, 48 females, 40.3±9.1 years old, from February 2010 to May 2019) and 115 CT scanning images of mandible with tumor (62 males, 53 females, 55.6±7.2 years old, from March 2008 to August 2019) from Shanghai Ninth People’s Hospital were selected. The surgical robot system including work station, UR robot, optical navigation system, 6 dimensional force senor and surgical instrument. A 3D V-Net for mandible preoperational segmentation from CT scans was proposed and used to segment the mandible of a 54-year-old male patient who received mandible reconstruction with fibular flaps. The machine learning algorithm was used to aid surgical planning for maxillo-mandibular defect by detecting landmarks. The accuracy was defined as the distance between corresponding landmarks on the intact mandible. The robot could locate the target according to surgical planning and perform fibula osteotomy through force-motion control. The CT scanning of limb and head from the patient (male, 54 years old) was used for phantom experiments. 30 osteotomies on 5 3D-priented resin phantom were carried out. The pre- and post-operative images were compared to calculate the accuracy. The descriptive results were in the format of Mean±SD.Results:The average accuracy of V-Net for mandible segmentation was 96.581% and the time cost was less than 30 seconds. The average error of feature points on mandible was (2.24±1.74) mm. The residual length error was (1.02±0.45) mm and angle error was (0.96±0.42) degree in robotic-assisted osteotomy according to 3 cases of phantom experiments. The surgical robot could perform osteotomy safely and steadily within 15 min.Conclusions:Intelligent surgical planning can precisely segment the mandible and determine its landmarks. Robot for mandibular reconstruction can perform fibular osteotomy precisely with the pre-operative planning.

Background and purpose:As one of the most fatal malignant tumors in China, the morbidity and mortality of lung cancer remain high. Early diagnosis and normative treatment is the key to improve the prognosis of lung cancer. The aim of this study was to explore the practice of early lung cancer screening with low-dose spiral computed tomography (CT) based on the current situation in community health service, with integration of superior resources of med-ical institutions at all levels in Shanghai.Methods:From Aug. 2013 to Aug. 2014, we screened high-risk population in selected communities of Minhang District, Shanghai, for early diagnosis of lung cancer with low-dose spiral CT combined with multidisciplinary comprehensive treatment models including minimally invasive surgery, exploring the medical service network covering prevention, diagnosis, treatment, rehabilitation and follow-up.Results:Screening population is 11 332 (male 7 144, female 4 188); Twenty-nine cases with pathological diagnosis of malignant tumor, including 27 cases of pri-mary lung cancer, 1 case of lung metastasis, 1 case of breast cancer. The morbidity of primary lung cancer is 238.26×10-5. There were 22 cases of Stage 0-Ⅰ lung cancer accounting for 81.48% of all diagnosed primary lung cancer.Conclusion:Based on community health service, screening with low-dose spiral CT could improve the early diagnosis rate of lung can-cer with feasibility and validity, which could be applicable in qualified eligible medical center and community in China.

OBJECTIVE:To investigate the effect of rapid rehabilitation surgery assisted to fluorouracil,oxaliplatin,leucovo-rin(FOLFOX)on postoperative recovery,complications and quality of life in patients with colorectal cancer. METHODS:60 pa-tients with colorectal cancer were randomly divided into control group(30 cases)and observation group(30 cases). After resection of colorectal cancer,control group received 85 mg/m2 Oxaliplatin for injection,2 h intravenous infusion,d1+200 mg/m2 Calcium le-vofolinate for injection,intravenous infusion,once a day,d1-2+400 mg/m2 Fluorouracil injection,intravenous infusion,once a day, d1-5 then 600 mg/m2 for 22 h intravenous infusion,d1-2. Observation was additionally given rapid rehabilitation surgery. 2-week was regarded as 1 course,it lasted 12 courses. Urinary retention time,anal exhaust time,first defecation time,postoperative hospital-ization time,scores of life quality (overall health,emotional function,mental health,physiological functions,physical function,so-matic pain,vitality,social function)in 2 groups were observed,and the incidence of postoperative complications was recorded. RE-SULTS:The urinary retention time,anal exhaust time,first defecation time,postoperative hospitalization time in observation group were significantly shorter than control group,the incidence of postoperative complications in observation group was signifi-cantly lower than control group,overall health,emotional function and mental health score were significantly higher than control group,the differences were statistically significant(P<0.05),but there were no significant differences in physiological functions, physical function,somatic pain,vitality,social function score in 2 groups (P>0.05). CONCLUSIONS:Rapid rehabilitation sur-gery assisted to FOLFOX chemotherapy can reduce the incidence of postoperative complications in patients with colorectal cancer, improve quality of life,shorten hospitalization time and promote postoperative recovery.

Objective To investigate the protective effects on the renal allografts from brain dead (BD) donor rats pretreated with bone marrow mesenchymal stem cells (MSCs).Method Three groups [normal transplant group (G1).BD transplant group (G2),and MSCs pretreated + BD transplant group (G3)] were set up.Male F344 rats served as donors and male Lewis rats as recipients.In G1,kidneys from F344 donor rats were implanted into Lewis recipients.In G2,kidneys from F344 BD donor rats were engrafted into Lewis recipients.In G3,after BD was established in F344 rats,MSCs were given intravenously to the rats.The kidneys harvested 6 h later were transplanted to Lewis recipients.Cyclosporine was intromuscularly given daily to the recipient rats for 10 days.Right kidneys were resected from recipients on day 10.Creatinine level was examined on day 14,21,28,and 35.Renal allografts harvested on day 35 were pathologically detected.The irnmunochemistry expression of interleukin (IL)-1β and tumor necrotic factor (TNF)-α in renal allograft tissue was tested.Result Serum creatinine levels in G2 were remarkably higher than those in G1 and G3 (P＜0.01) on day 14,21,28,and 35 postoperatively.The creatinine levels on the above mentioned time points had no statistically significant difference between G3 and G1 except on day 21.Postoperative pathological changes in G2 of both pronounced infiltration of mononuclear cells and tubular epithelia[inflammation were notably increased in renal allografts as compared with those in G1 and G3.There was no obvious difference between G1 and G3 in infiltrated mononuclear cells and tubular epithelial inflammation.Positive expression levels of both IL-1β and TNF-α in glomerular,tubular and interstitial epithelial cells were statistically enhanced in G2 as compared with those in G1 and G3 (H =7.210,P =0.027),while there was no statistically significant difference in the expression of both IL-1[β and TNF-α between G1 and G3.Conclusion Brain dead donor rats pretreated with bone marrow MSCs might reduce renal allograft injury via decreasing both inflammatory cell infiltration and IL-1β and TNF-α expression.