Objective:To construct a competency-oriented assessment index system based on entrustable professional activities (EPAs) for 5-year undergraduate clinical medical students in oncology internship.Methods:From June to December 2023, the scoping review approach and Bicomb 2.0 were used to construct and manage an item pool. The draft of EPAs and competencies was designed based on truncated word frequency. SPSS 25.0 was used for cluster analysis and UCINET 6.0 was used for visualization. Combining the characteristics and consensus of oncology, a multi-center expert group used the KJ method to draft the framework of EPAs and competencies. Subsequently, the expert group defined milestones and mapped the milestones to the framework to establish the assessment system.Results:Based on 26 included studies, a draft was created containing 19 EPA indicators and 72 competency characteristic indicators. After cluster analysis, 13 experts from 6 medical institutions established a framework including 13 EPAs and 10 competencies as well as 50 milestones, leading to the construction of the "EPAs-competencies-milestones" assessment system.Conclusions:The "EPAs-competencies-milestones" assessment system aligns with the trend of reform, demonstrating universality, specificity, and scientificity. It provides a reference for the development and assessment of oncology internship courses in medical universities.

Objective:To construct a competency-oriented assessment index system based on entrustable professional activities (EPAs) for 5-year undergraduate clinical medical students in oncology internship.Methods:From June to December 2023, the scoping review approach and Bicomb 2.0 were used to construct and manage an item pool. The draft of EPAs and competencies was designed based on truncated word frequency. SPSS 25.0 was used for cluster analysis and UCINET 6.0 was used for visualization. Combining the characteristics and consensus of oncology, a multi-center expert group used the KJ method to draft the framework of EPAs and competencies. Subsequently, the expert group defined milestones and mapped the milestones to the framework to establish the assessment system.Results:Based on 26 included studies, a draft was created containing 19 EPA indicators and 72 competency characteristic indicators. After cluster analysis, 13 experts from 6 medical institutions established a framework including 13 EPAs and 10 competencies as well as 50 milestones, leading to the construction of the "EPAs-competencies-milestones" assessment system.Conclusions:The "EPAs-competencies-milestones" assessment system aligns with the trend of reform, demonstrating universality, specificity, and scientificity. It provides a reference for the development and assessment of oncology internship courses in medical universities.

Objective:To study the clinical application value of the data security governance path and countermeasures of information-based medical equipment maintenance management. Methods:The User Service Two Context (US2C) model was used to divide data governance indicators of medical equipment maintenance management,and the indicators of governance capability,governance effect and governance efficiency were evaluated from the conditional factors of users,services,internal environment and external environment,the necessity of antecedent factors and the coverage rate of combination conditions were analyzed by fuzzy set qualitative comparative analysis (fsQCA),and the security governance management path of security,data volume and system standardization was developed. The maintenance management data of 285 sets of medical equipment in clinical use in The Sixth Affiliated Hospital of South China University of Technology (Foshan Nanhai District People's Hospital) from 2020 to 2023 were selected,and the maintenance management data of 256 sets of equipment in the period from 2020 to 2021 adopted conventional management mode,and the maintenance management data of 268 sets (including 239 sets in use in conventional management) of medical equipment during 2022-2023 adopted the security governance model. A self-made questionnaire was used to investigate whether the amount of maintenance management data met the actual needs of 120 participants who used the equipment. The security,frequency of use and operation quality of medical equipment maintenance management data of the two management modes were compared. Results:The average risk rate of medical equipment maintenance management data using security governance mode was (1.333±0.741)％,which was lower than that of conventional management mode,the average accuracy and effectiveness were (93.925±3.432)％and (88.500±4.404)％,respectively,Which were higher those of the conventional management mode,the differences was statistically significant (t=2.298,4.784,P<0.05). The average satisfaction rate of the 120 participants who used the equipment was (94.367±3.093)％ of the medical equipment maintenance management data using the safety governance model,which was higher than that of the conventional management mode,and the difference was statistically significant (t=4.365,P<0.05). The frequency of use of medical equipment failure data,maintenance item data and management input data of the security governance mode were (4.092±1.709) times/year,(4.341±1.397) times/year and (3.821±0.976) times/year,respectively,which were higher than those of the conventional management mode,the difference was statistically significant (t=2.101,4.400,6.386,P<0.05). The failure frequencies of medical electronic equipment,life support equipment,operating room equipment,medical laboratory equipment and other medical equipment using the security governance mode were (0.831±0.335) times/year,(0.927±0.293) times/year,(1.085±0.439) times/year,(0.702±0.047) times/year and (1.456±0.485) times/year,respectively 0.485),which were lower than those of the conventional management mode,and the difference was statistically significant (t=5.330,5.486,4.756,6.974,3.598,P<0.05). Conclusion:The data security governance path and management countermeasures of information-based medical equipment maintenance management can standardize the medical equipment maintenance management data collection process,improve data security performance,improve data application efficiency,and improve equipment operation quality.

Objective:To study the clinical application value of the data security governance path and countermeasures of information-based medical equipment maintenance management. Methods:The User Service Two Context (US2C) model was used to divide data governance indicators of medical equipment maintenance management,and the indicators of governance capability,governance effect and governance efficiency were evaluated from the conditional factors of users,services,internal environment and external environment,the necessity of antecedent factors and the coverage rate of combination conditions were analyzed by fuzzy set qualitative comparative analysis (fsQCA),and the security governance management path of security,data volume and system standardization was developed. The maintenance management data of 285 sets of medical equipment in clinical use in The Sixth Affiliated Hospital of South China University of Technology (Foshan Nanhai District People's Hospital) from 2020 to 2023 were selected,and the maintenance management data of 256 sets of equipment in the period from 2020 to 2021 adopted conventional management mode,and the maintenance management data of 268 sets (including 239 sets in use in conventional management) of medical equipment during 2022-2023 adopted the security governance model. A self-made questionnaire was used to investigate whether the amount of maintenance management data met the actual needs of 120 participants who used the equipment. The security,frequency of use and operation quality of medical equipment maintenance management data of the two management modes were compared. Results:The average risk rate of medical equipment maintenance management data using security governance mode was (1.333±0.741)％,which was lower than that of conventional management mode,the average accuracy and effectiveness were (93.925±3.432)％and (88.500±4.404)％,respectively,Which were higher those of the conventional management mode,the differences was statistically significant (t=2.298,4.784,P<0.05). The average satisfaction rate of the 120 participants who used the equipment was (94.367±3.093)％ of the medical equipment maintenance management data using the safety governance model,which was higher than that of the conventional management mode,and the difference was statistically significant (t=4.365,P<0.05). The frequency of use of medical equipment failure data,maintenance item data and management input data of the security governance mode were (4.092±1.709) times/year,(4.341±1.397) times/year and (3.821±0.976) times/year,respectively,which were higher than those of the conventional management mode,the difference was statistically significant (t=2.101,4.400,6.386,P<0.05). The failure frequencies of medical electronic equipment,life support equipment,operating room equipment,medical laboratory equipment and other medical equipment using the security governance mode were (0.831±0.335) times/year,(0.927±0.293) times/year,(1.085±0.439) times/year,(0.702±0.047) times/year and (1.456±0.485) times/year,respectively 0.485),which were lower than those of the conventional management mode,and the difference was statistically significant (t=5.330,5.486,4.756,6.974,3.598,P<0.05). Conclusion:The data security governance path and management countermeasures of information-based medical equipment maintenance management can standardize the medical equipment maintenance management data collection process,improve data security performance,improve data application efficiency,and improve equipment operation quality.

Objective:To explore the effectiveness of autologous fat grafting in the treatment of undesirable skin expansion.Methods:Patients' data were reviewed from 2011 to 2016, including the expanded regions with early signs of skin complications in face and neck. The effects of fat grafting group and control group were evaluated by follow-up records of expansion volume, skin thickness, skin texture and local capillary reaction.Results:Fat grafting could increase the thickness of expanded skin. It also improved the texture of expanded skin, with 0.83± 0.71 points before treatment and 1.30±0.66 points after treatment ( P=0.04). The local capillary reaction was also improved from 1.06±0.54 points before treatment and 1.45±0.51 points after treatment ( P=0.03). The expansion in the fat grafting group was 2.21±0.57 times before treatment and 2.94±0.83 times after treatment. In the control group, the expansion was 2.19 times when it showed early signs, and no obvious changes were observed during the follow-up period. Conclusions:Autologous fat grafting can effectively treat complications of skin expansion, prolong expansion process and promote tissue regeneration.

Objective:The purpose of this study is to establish the trajectory of targeted grafting for facial fat compartment based on anatomical research, and then bring it to clinical practice.Methods:The boundary of fat compartment and the relationship of adjacent vessel and nerve were clarified through autopsy. The recommended injection points and trajectory for targeted fat grafting were established on the anatomical findings. Retrospective clinical data of facial rejuvenation of 46 patients through targeted fat grafting were collected from June 2017 to June 2019 in Shanghai Ninth People’s Hospital. The result of 3D scanning were analyzed to evaluate the survival rate of fat grafts.Results:There were subcutaneous superficial fat compartments in the frontal region, and there were both deep and superficial fat compartments in the temporal and middle face. According to the anatomical characteristics, a targeted fat grafting technique was established with the frontal hairline and the oral commissure corner mucosa as the entry points. In the clinical study, 46 patients were evaluated by 3D scanning 6 months after the last fat grafting. The amount of fat grafts in the temporal region was (17.84±8.47) ml and (11.2±2.44) ml was left after operation, and the survival rate was 63%. The amount of fat grafts in mid-face was (26.81±10.36) ml and (16.09±4.48) ml was left after operation, and the survival rate was 60%. Overall satisfaction rate of patients was 93% (43/46).Conclusions:Compartment-based targeted fat grafting is an accurate injection method, which meets the requirement of physiological augmentation. The trajectory of targeted fat grafting will further improve the efficacy and safety of injection.

Objective:The purpose of this study is to establish the trajectory of targeted grafting for facial fat compartment based on anatomical research, and then bring it to clinical practice.Methods:The boundary of fat compartment and the relationship of adjacent vessel and nerve were clarified through autopsy. The recommended injection points and trajectory for targeted fat grafting were established on the anatomical findings. Retrospective clinical data of facial rejuvenation of 46 patients through targeted fat grafting were collected from June 2017 to June 2019 in Shanghai Ninth People’s Hospital. The result of 3D scanning were analyzed to evaluate the survival rate of fat grafts.Results:There were subcutaneous superficial fat compartments in the frontal region, and there were both deep and superficial fat compartments in the temporal and middle face. According to the anatomical characteristics, a targeted fat grafting technique was established with the frontal hairline and the oral commissure corner mucosa as the entry points. In the clinical study, 46 patients were evaluated by 3D scanning 6 months after the last fat grafting. The amount of fat grafts in the temporal region was (17.84±8.47) ml and (11.2±2.44) ml was left after operation, and the survival rate was 63%. The amount of fat grafts in mid-face was (26.81±10.36) ml and (16.09±4.48) ml was left after operation, and the survival rate was 60%. Overall satisfaction rate of patients was 93% (43/46).Conclusions:Compartment-based targeted fat grafting is an accurate injection method, which meets the requirement of physiological augmentation. The trajectory of targeted fat grafting will further improve the efficacy and safety of injection.

Objective To evaluate the efficacy of embolization for spinal intramedullary arteriovenous malformations.Methods 25 patients with spinal intramedullary arteriovenous malformations (AVMs) were reviewed. Embolic therapy was conducted in 4 patients by introducing the tip of a catheter into the segmental arteries and injecting lyophilized dura or polyvinyl alcohol(PVA). Microcatheter were navigated into the feeding arteries and injected PVA in 9 patients, and NBCA in 7 patients. Embosphere was used after embolizing an aneurysm in the feeding artery with NBCA in one pateint. Results Spinal angiography immediately after embolization disclosed that the lesion were obliterated almost entirely in 12 cases and partially in others. The anterior or posterior spinal artery was preserved in all patients recently. The clinical follow-up period after embolization ranged from 6 to 60 months. 16 patients improved but four patients did not show any improvement.Conclusions Embolization appears to be the treatment of first choice in the management of juvenile or partial glomus AVMs which are not amenable to surgery.

Objective To evaluate the treatment of spinal cord vascular malformations by endo vascular therapy. Methods All 41 patients including 3 cases were embolized by 3 0 silk line segments, 14 cases by selective embolization of dry dura particles, 16 by PVA and 8 cases by NBCA. Results Lesions were completely embolized in 27 cases, and partialy embolized in 14 cases. Paralysis of limbs were significantly improved in 36 cases, the other 5 cases showed no improvement on account of previous resection of the lesions. During 32 months follow up period, 18 cases recovered completely but with recurrence in 5. Conclusion Endovascular therapy is effective for spinal cord vascular malformations.

90%) in 57, 70%-90% in 27 cases, 50～70% in 8 cases,