To thoroughly implement the strategic deployment outlined in the Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance and Innovative Development of Traditional Chinese Medicine regarding research on dominant diseases of traditional Chinese medicine and to uphold the development philosophy of equal emphasis on traditional Chinese medicine and western medicine，the China Association of Chinese Medicine has fully played a leading academic role by systematically organizing and conducting a series of academic youth salons on clinical dominant diseases of traditional Chinese medicine. On September 13，2024，the 36^th Youth Salon on Clinical Dominant Diseases was successfully held in Nanjing，focusing on the advantages of traditional Chinese medicine and the integrative traditional Chinese medicine and western medicine in the diagnosis and treatment of erectile dysfunction （ED）. The conference brought together leading experts from traditional Chinese medicine，western medicine，and interdisciplinary fields，facilitating in-depth multidisciplinary discussions that led to key consensus on optimizing traditional Chinese medicine treatment protocols for ED，researching and developing new drugs of traditional Chinese medicine，and advancing interdisciplinary development in traditional Chinese medicine. This salon systematically sorted out the clinical strengths and distinctive features of traditional Chinese medicine in the diagnosis and treatment of ED. Based on current research foundations and clinical needs，it identified key directions for future scientific layout and scientific research tackling： （1） Standardization of syndrome differentiation system of traditional Chinese medicine for ED. （2） Optimization and standardization of intervention methods of integrated traditional Chinese medicine and western medicine. （3） High-quality clinical research guided by evidence-based medicine. （4） In-depth analysis of the pharmacological mechanisms of traditional Chinese medicine in the treatment of ED. （5） Clinical translation and application promotion of new drugs of traditional Chinese medicine. （6） Interdisciplinary integration and innovation in traditional Chinese medicine. For each research direction，key focus areas，expected objectives，and clinical value were further refined，along with the establishment of a scientifically sound priority funding level evaluation system. Therefore，building on the series of salons on the ED-focused dominant diseases of traditional Chinese medicine，this paper provides standardized guidance for clinical practice of traditional Chinese medicine in ED management，effectively contributing to the high-quality development of traditional Chinese medicine. It serves as a valuable reference for national scientific and technological strategic layout， research and development decision-making in new drugs of traditional Chinese medicine，research topic planning，and clinical guideline formulation.

Under the background of breaking the " five only" evaluation criteria, continuously optimizing the scientific research performance evaluation system of hospitals to mobilize the enthusiasm and creativity of scientific researchers and guide the direction of scientific research development plays an important role in enhancing the overall scientific research capability of hospitals. Through literature analysis and expert consultation, a certain hospital has constructed a personal scientific research performance evaluation index system for medical staff in tertiary public hospitals, oriented towards innovation quality and member contributions, and began to implement it throughout the hospital in 2021. This index system included four categories of scientific research performance: vertical scientific research projects, academic influence, science and technology awards, and transformation of achievements, with a total of 20 indicators. The annual scientific research performance score of an individual would serve as the basis for the distribution of year-end scientific research performance and an important reference for applying for key and major projects within the hospital. After the application of this evaluation index system, the enthusiasm of medical staff for scientific research has been effectively stimulated. The average individual scientific research performance score increased from 0.974 in 2020 to 1.220 in 2023. All scientific research indicators involved in the evaluation system have shown growth, with a significant increase in high-quality results. This evaluation system can provide a reference for the scientific research performance evaluation of public hospitals under the background of breaking the " five only" evaluation criteria.

OBJECTIVE: To investigate the effectiveness of free palmaris longus tendon graft reconstruction in the treatment of gouty tophus erosion lesions in flexor tendon of wrist and hand. METHODS: A retrospective analysis was conducted on 8 patients with gouty tophus erosion lesions in flexor tendon of wrist and hand who underwent free palmaris longus tendon graft reconstruction between June 2017 and December 2023. All patients were male, aged 22-65 years, with an average of 45.9 years. The duration of gout history ranged from 2 to 18 years, with an average of 8.8 years. The duration from the discovery of gouty tophus to operation ranged from 12 to 26 months, with an average of 17.6 months. The gouty tophus eroded the flexor pollicis longus tendon in 4 cases, with Verdan flexor tendon zones being Ⅰ-Ⅱ in 1 case and Ⅳ-Ⅴ in 3 cases. The flexor digitorum profundus tendons were affected in 2 cases for the index finger, 1 for the middle finger, and 1 for the ring finger, all located in zone Ⅳ-Ⅴ. The long axis of the gouty tophus ranged from 2.3 to 4.5 cm, with an average of 3.4 cm. All 8 patients presented with limited finger flexion and extension. Among them, 4 cases were accompanied by median nerve compression symptoms, and 1 case had associated bone and joint destruction in the hand. The total active motion (TAM) of the affected finger was (81.3±30.2)° before operation according to the hand function evaluation criteria for tendon repair by the Chinese Society of Hand Surgery of the Chinese Medical Association, and the functional evaluation was poor. The harvested palmaris longus tendon intraoperatively was 7-9 cm in length. RESULTS: Surgical incisions in all 8 patients healed by first intention, with no infections, graft non-union, or significant adhesion complications. All patients were followed up 8-25 months, with an average of 14.8 months. Numbness symptoms resolved in all 4 patients who presented with median nerve compression symptoms. Patients did not experience wrist pain or other discomfort, and function was not compromised. At last follow-up, according to the hand function evaluation criteria for tendon repair by the Chinese Society of Hand Surgery of the Chinese Medical Association, the TAM of 8 patients was (197.5±55.8)°, which significantly improved when compared with that before operation ( t=11.638, P<0.001); the hand function of 1 patient with gouty tophus in zone Ⅰ-Ⅱ flexor pollicis longus tendon was good, and the other 7 patients were excellent. CONCLUSION Free palmaris longus tendon graft reconstruction demonstrates good effectiveness in treating gouty tophus erosion lesions in flexor tendon of wrist and hand.
Humans ; Middle Aged ; Male ; Adult ; Tendons/surgery* ; Retrospective Studies ; Aged ; Gout/complications* ; Wrist/surgery* ; Plastic Surgery Procedures/methods* ; Hand/surgery* ; Treatment Outcome ; Young Adult

OBJECTIVE: To explore the effectiveness of multi-segment inverted Y-shaped vein transplantation using the anterior lateral malleolar venous network for repair of amputated palm injury distal to the superficial palmar arch. METHODS: Between September 2018 and July 2023, 5 patients with amputated palm injury distal to the superficial palmar arch were treated. There were 3 males and 2 females with an average age of 35.4 years (range, 29-52 years). The time from injury to admission was 1-6 hours (mean, 3.2 hours). The multi-segment inverted Y-shaped vein transplantation in the anterior lateral malleolar venous network were used to repair the common and proper palmar digital arteries; the another anterior lateral malleolar venous network was used to repair the dorsal vein of the hand. The soft tissue defect of dorsal hand in 1 patient was repaired with the pedicled ilioinguinal flap, and the wound at the donor site was directly sutured. Postoperative treatment included anti-infection therapy, antispasmodic therapy, and thrombosis prevention measures. RESULTS: The partial necrosis of the fingertip of the thumb occurred in 1 case, and the marginal necrosis of the abdominal flap after operation occurred in 1 case. The remaining fingers showed good blood supply with normal tension. The incision at donor site of the abdominal flap healed by first intention. All patients were followed up 8-41 months (median, 19 months). At last follow-up, the hand contour was satisfactory; the grasping function, opposition function, and proprioception recovered, and two-point discrimination ranged from 5 to 7 mm (mean, 6 mm). According to the upper extremity function evaluation criteria issued by Hand Surgery Society of the Chinese Medical Association, the functional outcomes were excellent in 3 cases, good in 1 case, and fair in 1 case. CONCLUSION The multi-segment inverted Y-shaped vein transplantation using the anterior lateral malleolar venous network for repairing defects in the common and proper palmar digital arteries distal to the superficial palmar arch offers advantages such as superficial location, flexible harvesting, and high compatibility. This technique has demonstrated favorable outcomes in complex transmetacarpal amputation reconstruction.
Humans ; Adult ; Male ; Female ; Hand Injuries/surgery* ; Middle Aged ; Plastic Surgery Procedures/methods* ; Veins/transplantation* ; Surgical Flaps/blood supply* ; Hand/surgery* ; Treatment Outcome ; Soft Tissue Injuries/surgery*

Objective To investigate the learning curve of CT-guided percutaneous lung biopsy.Methods Using cumulative sum(CUSUM)analysis method,the clinical data from 110 patients,who underwent CT-guided percutaneous lung biopsy performed by the same physician at the First Affiliated Hospital of Zhengzhou University of China between May 2024 and October 2024,were retrospectively analyzed.The CUSUM learning curve was fitted,and R2 was used to assess the goodness of fit.The baseline and perioperative data were compared between different stages of the learning curve so as to determine the number of accomplished surgical cases that was required for a physician to reach the proficiency stage from the learning stage in performing CT-guided percutaneous lung biopsy.Results Successful CT-guided percutaneous lung biopsy was accomplished in all patients,with a mean operation time of(20.2+3.4)minutes(range of 15-29 minutes).With the accumulation of surgical cases,the operation time showed a gradual downward trend.The learning curve was best fitted with a cubic equation,the equation was as follows:CUSUM(110)=0.000 3x3-0.081 3x2+5.597 9x+0.774 3(where x representing the number of cases),with a goodness-of-fit coefficient R2=0.991.The fitted curve reached its peak at the performance of the 46th case,which was used as the cutoff point to divide the learning curve into two phases.Compared with the learning phase,in the proficiency phase the incidence of complications was significantly lower(pneumothorax:18.8％vs 37.0％,P=0.033)and the mean operation time was obviously shorter[(18.33+2.31)min vs(22.80±3.02)min,P＜0.001].Conclusion Through precise CUSUM analysis of the learning curves obtained from 110 patients receiving CT-guided percutaneous lung biopsy,the results of this study indicates that it requires to accomplish 46 operations before a physician can skillfully master the technique of CT-guided percutaneous lung biopsy.

The transformation of medical models and the growing demand for healthcare necessitate the establishment of one-stop multimorbidity management clinics within general practice departments of general hospitals to enhance clinical management of patients with multiple chronic conditions. This study employed SWOT analysis to evaluate the internal conditions (strengths and weaknesses) and external conditions (opportunities and threats) associated with establishing such clinics. The analysis revealed that the strengths of general practice departments in general hospitals for establishing a multimorbidity clinic include abundant medical resources, the comprehensive nature of general practice functions, and multidisciplinary collaboration. Opportunities are presented by public health needs, supportive government policies, and technological advancements. However, weaknesses include shortages of qualified human resources, the high complexity of patient management, increased medical costs, limitations in insurance reimbursement, and difficulties in performance evaluation. Threats encompass an underdeveloped general practitioner system, patients′ traditional healthcare-seeking habits, medico-legal and ethical challenges, and a lack of directly transferable experience. Based on this analysis, the paper proposes strategies and measures for developing multimorbidity clinics within general practice departments of general hospitals in China, aiming to provide a theoretical foundation for their promotion and development.

Objective:To validate the application value and safety of blunt-tip needle technique for computer tomography (CT)-guided percutaneous biopsy of pancreatic lesions.Methods:Clinical data of 103 patients with pancreatic lesions undergoing CT-guided percutaneous biopsy with blunt-tip needle approach in the First Affiliated Hospital of Zhengzhou University from October 2021 to October 2023 were retrospectively analyzed, including 64 males and 39 females, aged (61.5±12.3) years. According to the access routes, procedures were divided into regular group ( n=70) and hard-to-reach group ( n=33). Technical data such as the duration of procedure, number of needle correction scans, and the incidence of complications were recorded. The technical success rate, diagnostic yield, accuracy, sensitivity, specificity, and false-negative rates were compared between groups. Results:The overall technical success rate was 100%(103/103). According to postoperative pathology and clinical follow-ups, the final diagnosis of 103 patients was 98 cases with neoplastic lesions and 5 with non-neoplastic lesions. The overall diagnostic rate of percutaneous biopsy was 91.3%(94/103), with a false negative rate of 5.8%(6/103), sensitivity of 92.9%(90/98), and specificity of 100%(90/90). Duration of procedure [(22.8±6.3) min vs. (22.4±7.9) min], number of needle correction scans [5.0 (3.0, 6.0) times vs. 5.0 (4.0, 7.5) times], length of target access [(69.9±15.4) mm vs. (73.7±17.4) mm], diagnostic yield [90.0%(63/70) vs. 93.9%(31/33)], and accuracy rate [90.0%(63/70) vs. 93.9%(31/33)] were comparable between regular group and hard-to-reach group (all P>0.05). Complications occurred in 8 patients, including 5 patients with hemorrhage and 3 with pancreatitis, which were successfully managed with conventional therapy. The incidence of complications were similar between the hard-to-reach and regular group [9.1%(3/33) vs. 7.1%(5/70), χ2=0.12, P=0.730]. Conclusion:CT-guided percutaneous biopsy in the diagnosis of pancreatic lesions with blunt-tip needle approach has a satisfactory technical success rate, diagnostic yield, accuracy, and safety, which can be used in patients with hard-to-reach lesions.

Objective:To validate the application value and safety of blunt-tip needle technique for computer tomography (CT)-guided percutaneous biopsy of pancreatic lesions.Methods:Clinical data of 103 patients with pancreatic lesions undergoing CT-guided percutaneous biopsy with blunt-tip needle approach in the First Affiliated Hospital of Zhengzhou University from October 2021 to October 2023 were retrospectively analyzed, including 64 males and 39 females, aged (61.5±12.3) years. According to the access routes, procedures were divided into regular group ( n=70) and hard-to-reach group ( n=33). Technical data such as the duration of procedure, number of needle correction scans, and the incidence of complications were recorded. The technical success rate, diagnostic yield, accuracy, sensitivity, specificity, and false-negative rates were compared between groups. Results:The overall technical success rate was 100%(103/103). According to postoperative pathology and clinical follow-ups, the final diagnosis of 103 patients was 98 cases with neoplastic lesions and 5 with non-neoplastic lesions. The overall diagnostic rate of percutaneous biopsy was 91.3%(94/103), with a false negative rate of 5.8%(6/103), sensitivity of 92.9%(90/98), and specificity of 100%(90/90). Duration of procedure [(22.8±6.3) min vs. (22.4±7.9) min], number of needle correction scans [5.0 (3.0, 6.0) times vs. 5.0 (4.0, 7.5) times], length of target access [(69.9±15.4) mm vs. (73.7±17.4) mm], diagnostic yield [90.0%(63/70) vs. 93.9%(31/33)], and accuracy rate [90.0%(63/70) vs. 93.9%(31/33)] were comparable between regular group and hard-to-reach group (all P>0.05). Complications occurred in 8 patients, including 5 patients with hemorrhage and 3 with pancreatitis, which were successfully managed with conventional therapy. The incidence of complications were similar between the hard-to-reach and regular group [9.1%(3/33) vs. 7.1%(5/70), χ2=0.12, P=0.730]. Conclusion:CT-guided percutaneous biopsy in the diagnosis of pancreatic lesions with blunt-tip needle approach has a satisfactory technical success rate, diagnostic yield, accuracy, and safety, which can be used in patients with hard-to-reach lesions.

The transformation of medical models and the growing demand for healthcare necessitate the establishment of one-stop multimorbidity management clinics within general practice departments of general hospitals to enhance clinical management of patients with multiple chronic conditions. This study employed SWOT analysis to evaluate the internal conditions (strengths and weaknesses) and external conditions (opportunities and threats) associated with establishing such clinics. The analysis revealed that the strengths of general practice departments in general hospitals for establishing a multimorbidity clinic include abundant medical resources, the comprehensive nature of general practice functions, and multidisciplinary collaboration. Opportunities are presented by public health needs, supportive government policies, and technological advancements. However, weaknesses include shortages of qualified human resources, the high complexity of patient management, increased medical costs, limitations in insurance reimbursement, and difficulties in performance evaluation. Threats encompass an underdeveloped general practitioner system, patients′ traditional healthcare-seeking habits, medico-legal and ethical challenges, and a lack of directly transferable experience. Based on this analysis, the paper proposes strategies and measures for developing multimorbidity clinics within general practice departments of general hospitals in China, aiming to provide a theoretical foundation for their promotion and development.

Under the background of breaking the " five only" evaluation criteria, continuously optimizing the scientific research performance evaluation system of hospitals to mobilize the enthusiasm and creativity of scientific researchers and guide the direction of scientific research development plays an important role in enhancing the overall scientific research capability of hospitals. Through literature analysis and expert consultation, a certain hospital has constructed a personal scientific research performance evaluation index system for medical staff in tertiary public hospitals, oriented towards innovation quality and member contributions, and began to implement it throughout the hospital in 2021. This index system included four categories of scientific research performance: vertical scientific research projects, academic influence, science and technology awards, and transformation of achievements, with a total of 20 indicators. The annual scientific research performance score of an individual would serve as the basis for the distribution of year-end scientific research performance and an important reference for applying for key and major projects within the hospital. After the application of this evaluation index system, the enthusiasm of medical staff for scientific research has been effectively stimulated. The average individual scientific research performance score increased from 0.974 in 2020 to 1.220 in 2023. All scientific research indicators involved in the evaluation system have shown growth, with a significant increase in high-quality results. This evaluation system can provide a reference for the scientific research performance evaluation of public hospitals under the background of breaking the " five only" evaluation criteria.