Against the dual backdrop of increasingly mature big data applications and structural constraints in traditional human resource management models,comprehensive digital governance and reform of human resource management systems have become major challenges for public hospitals.By examining the core challenges faced by public hospitals in the big data era,it analyzes the implementation pathway of digital governance for human resource in public hospital,taking Guangdong Second People's Hospital as a practical case.lt summarizes the application effectiveness and the value of big data technology applucations in human resource management,providing support for talent system development.

Objective:To explore the possibility of using a inferior gluteal artery perforator flap (IGAPF) for breast reconstruction in the patient who did not have suitable donor site in back and abdomen.Methods:In November 2024, a 25-year-old unmarried and childless woman with right breast cancer received immediate right breast reconstruction by a right free IGAPF after modified right mastectomy in the Department of Breast and Thyroid Surgery, Second Affiliated Hospital of Hainan Medical University. The locations of perforators were confirmed by both Multi-detector computed tomography angiography (MDCTA) and portable Doppler blood flow detector before surgery. The IGAPF was designed to take the inferior gluteal wrinkle as the lower edge, the axis of the flap was parallel to the inferior gluteal wrinkle, and the width of the flap was estimated where the incision could be directly closed. The size of right IGAPF was 6.0 cm×19.0 cm. Sharp dissection was performed between the sarcolemma and muscle fibres of gluteus, then the perforators were dissected along the direction of muscle fibres of gluteus. The vascular pedicle was kept at about 8.0 cm in length. The diameter of artery was about 2.0 mm and that for the veins was about 1.5 mm. End-to-end anastomoses with the right thoracodorsal artery and vein were successfully carried out. The donor site was directly closed, and it was hidden in the inferior gluteal wrinkle. Postoperative outpatient clinical review was made.Results:Pathological examination reported: an invasive carcinoma of right breast, axillary lymph node metastasis (2/10). The patient recovered well and the flap survived without any complication, i.e. ischemic necrosis, infection and haematoma. The patient was off-bed at 3 days and discharged at 13 days after surgery. At the 40 days of postoperative follow-up, the patient achieved a good recovery and the lower limb activity was not affected by the surgery. The patient was satisfied with the reconstructed breast and donor site recovery. The patient followed with scheduled chemotherapy and subsequent radiotherapy. The volume of reconstructed breast was smaller than the other breast, of which the patient was fully informed before the surgery.Conclusion:A free IGAPF provides an alternative donor sites for achieving a breast reconstruction due to the reliable pedicle vessels and invisible donor scars.

Against the dual backdrop of increasingly mature big data applications and structural constraints in traditional human resource management models,comprehensive digital governance and reform of human resource management systems have become major challenges for public hospitals.By examining the core challenges faced by public hospitals in the big data era,it analyzes the implementation pathway of digital governance for human resource in public hospital,taking Guangdong Second People's Hospital as a practical case.lt summarizes the application effectiveness and the value of big data technology applucations in human resource management,providing support for talent system development.

Objective:To explore the possibility of using a inferior gluteal artery perforator flap (IGAPF) for breast reconstruction in the patient who did not have suitable donor site in back and abdomen.Methods:In November 2024, a 25-year-old unmarried and childless woman with right breast cancer received immediate right breast reconstruction by a right free IGAPF after modified right mastectomy in the Department of Breast and Thyroid Surgery, Second Affiliated Hospital of Hainan Medical University. The locations of perforators were confirmed by both Multi-detector computed tomography angiography (MDCTA) and portable Doppler blood flow detector before surgery. The IGAPF was designed to take the inferior gluteal wrinkle as the lower edge, the axis of the flap was parallel to the inferior gluteal wrinkle, and the width of the flap was estimated where the incision could be directly closed. The size of right IGAPF was 6.0 cm×19.0 cm. Sharp dissection was performed between the sarcolemma and muscle fibres of gluteus, then the perforators were dissected along the direction of muscle fibres of gluteus. The vascular pedicle was kept at about 8.0 cm in length. The diameter of artery was about 2.0 mm and that for the veins was about 1.5 mm. End-to-end anastomoses with the right thoracodorsal artery and vein were successfully carried out. The donor site was directly closed, and it was hidden in the inferior gluteal wrinkle. Postoperative outpatient clinical review was made.Results:Pathological examination reported: an invasive carcinoma of right breast, axillary lymph node metastasis (2/10). The patient recovered well and the flap survived without any complication, i.e. ischemic necrosis, infection and haematoma. The patient was off-bed at 3 days and discharged at 13 days after surgery. At the 40 days of postoperative follow-up, the patient achieved a good recovery and the lower limb activity was not affected by the surgery. The patient was satisfied with the reconstructed breast and donor site recovery. The patient followed with scheduled chemotherapy and subsequent radiotherapy. The volume of reconstructed breast was smaller than the other breast, of which the patient was fully informed before the surgery.Conclusion:A free IGAPF provides an alternative donor sites for achieving a breast reconstruction due to the reliable pedicle vessels and invisible donor scars.

Objective:To explore the effect of early eschar dermabrasion combined with antimicrobial soft silicone foam dressing (hereinafter referred to as foam dressing) in treating the deep partial-thickness burn wounds in children.Methods:This study was a randomized controlled trial. From June 2021 to December 2022, 78 pediatric patients with deep partial-thickness burns who met the inclusion criteria were admitted to the Department of Burns in Guiyang Steel Plant Employees Hospital. According to the random number table, the pediatric patients were divided into two groups, with 38 cases left in combined treatment group (with 20 males and 18 females, aged 26.00 (16.75, 39.75) months) and 39 cases in foam dressing group (with 21 males and 18 females, aged 19.00 (14.00, 31.00) months) after the exclusion of one dropped-out child in follow-up. The pediatric patients in combined treatment group underwent eschar dermabrasion of the wound within 48 hours after injury, the wound was covered with foam dressing after operation, and the dressing was replaced once every 7 days; for the pediatric patients in foam dressing group, the wound was sterilized within 48 hours after injury and covered with foam dressing, and the dressing was replaced once every 2 to 3 days. After the wound healing, the children in both groups were routinely applied with silicone gel twice a day for 3 weeks before started wearing elastic sleeves for more than 18 hours a day, and continuously for over than 6 months. The degree of pain during dressing change was evaluated using the children's pain behavior inventory FLACC. The adverse reactions during the treatment period, number of dressing changes, and wound healing time were observed and recorded. Six months after wound healing, the Vancouver scar scale (VSS) was used to evaluate the condition of the wound scar.Results:When changing dressing, the FLACC score for pain of pediatric patients in combined treatment group was 3.5 (2.0, 5.0), which was significantly lower than 6.0 (5.0, 8.0) in foam dressing group ( Z=-5.40, P<0.05). During the treatment period, no adverse reactions such as wound edema, fluid accumulation, or peripheral skin rash allergies occurred in any pediatric patient in both groups. The number of dressing changes of pediatric patients in combined treatment group was 3 (3, 4) times, which was significantly less than 8 (7, 10) times in foam dressing group ( Z=-7.58, P<0.05). The wound healing time of pediatric patients in combined treatment group was (19±5) days, which was significantly shorter than (25±6) days in foam dressing group ( t=-4.48, P<0.05). Six months after wound healing, the VSS score for scar of pediatric patients in combined treatment group was 5 (2, 8), which was significantly lower than 7 (5, 10) in foam dressing group ( Z=-3.05, P<0.05). Conclusions:Compared with using foam dressings alone, early eschar dermabrasion combined with foam dressings can reduce the number of dressing changes, alleviate the pain during dressing changes, and shorten the wound healing time in treating children with deep partial-thickness burns, and effectively alleviate scar hyperplasia by combining with anti-scar treatment post burns.

In recent years, public hospitals have been facing pressure from the reform of medical insurance payment methods. It is urgent to strengthen the operation and management of public hospitals. In June 2022, a tertiary public hospital utilized hospital intelligent agents to carry out refined cost management practices for medical service charging projects, sorted out medical service charging projects, designed management paths, and calculated project costs. The hospital conducted refined management on the cost of medical service charging items from three control dimensions of project unit cost with manpower, equipment and consumables, and two comparative directions with horizontal and vertical. The refined cost management practice not only pointted out the direction for global refinement cost control within the hospital, but also reduced the proportion of hospital consumption, which provided reference for improving the level of refined operation and management of public hospital hospitals.

Objective:To analyze the cost of diagnosis-intervention packet(DIP) in a certain hospital in 2021 based on hospital intelligent agents, so as to provide feasible ideas for refined management of DIP costs.Methods:On the basis of the construction of the hospital intelligent agent platform and the results of project cost accounting in the early stage, a total of 60 187 cases and 4 860 DIP diseases in the hospital in 2021 were selected as the research objects. The project superposition method was applied to calculate the unit cost of all DIP diseases in the hospital. Based on the results of DIP cost accounting, the ideas and methods of fine management of DIP costs were explored from the perspectives of DIP disease classification, management of all hospital diseases and medical insurance diseases, vertical and horizontal comparative analysis of DIP costs, and management of medical insurance cases and non medical insurance cases under the same DIP disease category.Results:Twenty-two advantageous DIP disease types, 67 key disease types, 1 590 potential disease types, and 3 181 disadvantageous disease types were identified. Introducing medical income as an intermediate indicator facilitated the classification of DIP disease types under medical insurance, 1 072 advantageous disease types, 917 key disease types, 458 potential disease types, and 815 disadvantageous disease types in medical insurance were identified. Through refined accounting, it was found that the average cost of non medical insurance cases under the same DIP disease category was generally higher than that of medical insurance cases, and there were differences in DIP costs at different levels during different time periods.Conclusions:By determining and analyzing the advantages and disadvantages of disease types in the entire hospital, common problems of disease types under the same category can be identified, and targeted control measures can be proposed. By analyzing the two dimensions of medical insurance surplus and medical surplus, the advantages and disadvantages of medical insurance diseases can be quickly determined, providing a lever for the control of medical insurance diseases. The horizontal and vertical comparative analysis of DIP costs, as well as the analysis of medical insurance cases and non medical insurance cases under the same DIP disease category, can provide feasible methods for hospitals to manage DIP costs at multiple levels and dimensions.

Application of new technical means and methods and in-depth exploration in medical service scenarios, for improving the efficiency and quality of diagnosis and treatment, improving the operation and management level and patient′s medical experience are the goals aimed by smart hospitals. Guangdong Second Provincial General Hospital, based on the technical framework of hospital intelligent twins, was exploring to build an all-scenario smart hospital. The hospital built an intelligent operations center, all-scenario smart wards and a smart security and fire protection integrated management center. These practices promoted the service synergy, provided efficient internet of everything experience, and promoted the integrated linkage management of security and fire protection. The hospital effective resolved such deficiencies as insufficient data connectivity, fragmented application scenarios, limited coverage and poor mobility, hence providing reference for the construction and application of whole-scenario smart hospitals.

In the new era, enhanced Party construction of public hospitals is the fundamental assurance for the success of Healthy China strategy. Based on field survey, in-depth interview, literature review and promotion of pilot practices, the Hospital Party Construction Guidance Committee of Guangdong Province staged a " Four Virtues" program to enhance Party construction at public hospitals in the healthcare system of the province. This program, featuring " leadership competency" , " Party branch capability" , " Party construction branding" , and " Unit showcases" , aims at the limited implementation and homogenization problems commonly found in Party construction at public hospitals. Promotion of successful pilot practices of several public hospitals effectively encouraged the " parallel development" of both medical service and Party construction, providing useful references for the hospitals in their reform/development and Party construction in the new era.

ObjectiveTo compare the therapeutic effec between sustained low-efficiency dialysis (SLED) and continuous blood purification (CBP) in critically ill patients.MethodsAccording to the treatment ways,96 critically ill patients were divided into SLED group and CBP group.A comparison was made on the biochemical indicators,in-hospital duration,hemodynamic parameters,acute physiology and chronic health evaluation (APACHE-Ⅱ ),the survival and the mortality rates.ResultsAfter treatment,the levels of serum creatine kinase isozyme MB (CK-MB),creatine kinase (CK),creatinine (Cr),glutamic-oxalacetic transaminase (AST),glutamate-pyruvate transaminase (ALT),APACHE Ⅱ score on the 1st,2nd and 7th day were lower than those prior to the treatment in both groups ( P ＜0.05).There were no statistical differences in in-hospital duration, biochemical indicators, APACHEⅡscore,hemodynamic parameters,the survival rate and the mortality rate between the two groups (P ＞ 0.05 ).ConclusionsSLED has similar hemodynamic stability with CBP,and the two methods have similar treatment effects in critically ill patients.However,SLED can be relatively economical and convenient for critically ill patients in clinical.