Medical dissertation topic report essay 1
On the current situation and development trend of clinical medical testing
Over the past few decades, China's clinical medicine has made steady and rapid development, along with the development of evidence-based medicine has also played a wide range of applications in clinical medicine. Clinical laboratory disciplines have been developed from medical testing to medicine, the laboratory is no longer the previous auxiliary departments, and gradually associated with the clinical, has become an independent discipline. Medical testing is a scientific and modern physical and chemical knowledge and means to carry out medical diagnosis of the discipline, its main research on how to use scientific experimental techniques and advanced equipment to provide the basis for clinical diagnosis and treatment. Medical testing involves basic medicine, biochemistry, clinical medicine, management and many other subjects, the use of these disciplines can quickly and accurately provide a diagnosis of the disease is indeed the basis of modern medical work is an indispensable link.
The development of China's laboratory medicine
In recent years, China's clinical medical testing education has been the rapid development of the early 1950s, China will be in the secondary school health schools to open a medical testing profession, to cultivate the primary and intermediate medical testing-related personnel. 1983 have been set up in the higher medical school undergraduate medical testing, and for the medical testing of China to train a large number of medical testing-related personnel. China has trained a large number of medical testing-related higher education personnel. Until now, China's medical testing personnel training system has been completed, forming a set of professional training channels. Now has formed a clear goal, with a general test specialist, master's degree and doctoral degree (medical science degree), seven-year master's degree (medical degree), adult test specialist, senior test specialist and other levels of complete and diverse forms of education system. This perfect talent training system for China's clinical testing medical careers to train a large number of outstanding talent, and make the basic quality of clinical testing personnel to get a piece of the general improvement.
China's quality control management system started late, but some disciplines as well as the formation of a more reasonable quality control system. At present, pre-analytical quality control, analysis of quality control and post-analytical quality control have achieved a certain degree of good development, which can already basically ensure the accuracy and comparability of the results. At the same time, with the deepening of reform and opening up and economic growth, China is also vigorously using international information technology exchanges, learning and the introduction of advanced professional technology and testing equipment from developed countries.
The main problems in China's clinical medical testing
Resource management is unreasonable: At present, many hospitals do not do a good job of resource management, which is embodied in the following specific: the staffing is unreasonable (there is a part of the staffing of the job is too much or too little of the situation) and the allocation of medical equipment is not reasonable. Irrational allocation of personnel has led to the loosening of the test team, each other can not form a strong cooperation, the test process there are misuse and unreasonable, resulting in errors in the test results. And this human resources allocation of unreasonable phenomenon will also bring some problems, such as duplication of staff equipment in the same hospital will cause a waste of resources; due to the dispersion of staffing, but also make the whole system is not unified management, so that the hospital staff can not improve the quality of business.
Incomplete test medical theory system: Although in recent years China's clinical medicine has made great progress, but the development of China's medical testing field in the development of the main focus on the construction of hardware, more inclined to the replacement of equipment, but ignored the theory of the test of the degree of importance of medicine. At present, China's medical testing can only be regarded as experimental medical laboratory science which has not yet formed a set of perfect, new theoretical system. For medical testing issues on the scientific research capacity is low, the innovation of the relevant personnel (scientific research) awareness is weak, this phenomenon has hindered the good development trend of laboratory medicine.
Quality control is not in place: the lack of good quality control will not only affect the accuracy of the test results, but it may also mislead the clinical diagnosis and treatment, to the patient's health, and serious or even endanger the patient's life. Quality control work in any case must pay attention to, but part of the test personnel because of the development and application of modern equipment, began to gradually dilute the importance of quality control work.
The future development trend of clinical medical testing
Improve the quality of personnel: China's laboratory medicine is developing towards informationization and automation. So we should be based on the needs of society and the development of laboratory medicine to train high-quality testing personnel to adapt to the new era. First of all, clinical medical testing inspectors must have a solid professional foundation, which includes basic knowledge of clinical medicine, physical chemistry and other related knowledge. Secondly, clinical laboratory personnel must have professional equipment operation skills, equipment operation standardization can affect the accuracy of the test results. Finally, the education should also be guided by efforts to broaden the knowledge of clinical laboratory personnel. Can not be limited to the knowledge of the specialty, but also other related knowledge should be understood.
Strengthen the construction of information technology: the new era is the era of information technology, information technology is the development trend of the new century, many industries are using information technology, and has achieved good development. In the field of clinical medical testing to establish the collection and processing of information to achieve information **** enjoy the purpose of the information system has been an inevitable trend. Its main performance in the laboratory will use more automated ways to transmit test results, and through the computer Internet will be transmitted to the laboratory and clinical results, and even the realization of hospitals and hospitals, the city and the city and the international exchange of information. Resources **** enjoy, promote communication and cooperation between the industry and so on.
The development of automation: at this stage, most of the domestic test departments of various types of automated analytical instruments are single-machine automation, while the trend of the development of testing instruments in developed countries is to connect the machines in series, forming an assembly line mode of operation, that is, automation. Therefore, in order to improve the efficiency of the test work and test results, we must also be on par with the developed countries to realize the automation of the test. With the development of computer technology and the improvement of modern laboratory science, many of the previous manual test subjects are now gradually replaced by automated instruments, the speed of the test and the number of test items are much higher than in the past. This is the development trend of our future medical testing work in the equipment.
Medical dissertation opening report essay 2
The basis, purpose and significance of the selection of the topic:
Fractures do not heal is a common orthopedic clinical conditions, which are more common in the long bones of the limbs, such as the tibia, femur, humerus, etc., for the long bones of the limbs fracture does not heal the second operation of our hospitals more than bone grafting with the LCP to re-fix the internal fixation. Autologous iliac bone as bone grafting material has more advantages: such as simple sampling, good histocompatibility, no graft rejection, strong osteoinductive effect, etc. These advantages make iliac bone become a kind of optimal bone grafting material, which has been clinically formed **** knowledge. Bone grafting is an important method to treat non-union of fracture, and its mechanism is the scaffolding effect caused by creeping substitution and the role of supplying minerals, and the conditions for the smooth progress of creeping substitution require accurate repositioning, adequate bone grafting and strong fixation. In order to achieve adequate bone grafting and promote early fracture healing, we used intramedullary and intramedullary 36?bone grafting, external wire ring ligature, and strong internal fixation with LCP, and followed up 3~1 months after surgery to analyze the clinical efficacy of the surgery according to the healing and functional recovery. The purpose of the selected topic is to explore the improved surgical methods and efficacy of treating non-union of long bone fractures of the extremities, and to provide reference for clinical treatment.
The topic of the current domestic and foreign research dynamics, level
Treatment of fracture non-union, can be divided into surgical treatment and non-surgical treatment, of which the most important surgical treatment is bone grafting plus change the broken end of the internal fixation. The application of autologous bone grafting for the treatment of fracture non-union is remarkable and has formed **** knowledge. Bone grafting is an important method for treating bone nonunion, and the bone grafting method is mostly used in the clinic, which is combined with intramedullary and intramedullary bone grafting. Entering along the muscle gap, carefully peeling off the fracture site under the periosteum, taking out the internal fixation device, removing the scar between the broken ends of the bone, biting off the sclerotic bone, opening up the medullary cavity, trimming the fracture end, resetting the fracture, and then removing the bone in accordance with the bone defects. Intramedullary bone grafting should be done with a bone rod slightly thicker than the medullary cavity and close to the bone of the medullary cavity; extramedullary supramedullary grafting should be done with screws to fix the grafted bone; bone fragments should be filled in the residual space sufficiently, so as to fulfill the purpose and requirements of bone grafting. The creeping substitution of autogenous cortico-cortical bone grafting shortens the fracture healing process. Fresh autogenous bone is biologically active, with no immune rejection, no risk of infectious diseases, and osteoconductive and osteoinductive abilities.
Medical dissertation opening report sample medical dissertation opening report sample internal fixation must adhere to the following principles, the original plate internal fixation, can be replaced with a locking intramedullary pins or longer plate placed on the tension side; the original interlocking intramedullary pins internal fixation, you can choose to use a larger number of intramedullary pins or plate internal fixation; the original short plate internal fixation, can be changed to a longer steel plate. Bone grafting was required in all cases. After the replacement of the internal fixation, the postoperative cast external fixation, should be early muscle contraction exercise activities, scab growth is good, go to the cast to start joint flexion and extension exercise. However, clinicians should treat specific problems according to the growth of the bone scab, and it can be treated according to the growth of the bone scab. When discharged from the hospital, the patient must be instructed in detail about the precautions to be taken, and cooperate with the doctor until the fracture is completely healed.LCP plate internal fixation is suitable for the long bone fracture of the limb that does not heal, and it can be used to fix the fragmented and grafted bone by the tensile force screws and lock the fracture end with axial compression. The key of the surgery is to remove all the scar connective tissue of the fracture end, remove all the sclerotic bone at the end of the bone, expose the normal bone, drill through the medullary cavity, and the implanted bone must be firmly embedded in the defect area, and the gap should be filled with cancellous bone, etc. The postoperative functional exercise should be actively and correctly instructed. Postoperative functional exercises should be instructed correctly and followed up strictly on a regular basis. Avoid early and incorrect weight bearing. In summary, autologous bone grafting is effective, safe and secure for the treatment of fracture non-union, and is widely used with mature technology, so it is worth advocating.
Main content of the study
Source of cases
The cases in this study were collected from the orthopedic ward of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine
Time of collection
May to January
Selection of cases
Diagnostic criteria
(1) History: clear history of traumatic injuries, no healing after 6 months of fracture, and no healing of the fracture. months without healing and no tendency for further healing for 3 months.
Symptoms: the patient has angulation, rotation, lateral displacement of the fracture end, shortening deformity or segmental bone defect, pain or inability to hold weight, and localized pain under stress.
(3) Signs: local sinus tract formation, pus, pseudo joint formation or accompanied by local soft tissue scarring, defects, etc.
(4) Auxiliary examination: X-ray manifestations: sclerosis of the bone ends, the medullary cavity is closed; the bone ends are atrophic and lax, with a large gap in the middle; or sclerosis of the bone ends, and each other become a pseudo joint of pestle and mortar and so on, any of the three forms of fracture can be designated as non-union.
Inclusion criteria:
(1) meet the diagnostic criteria of the disease;
the average healing time of the fracture is more than half a year, and there is a pseudo joint formation;
(3) the average healing time of the fracture is more than half a year, and repeated review of the X-ray film shows that the fracture line
is clearly visible, and there is no internal and external bone scabs, or very little internal and external bone scabs;
(4) the average healing time of the fracture is more than half a year, and there is no internal and external bone scabs. >
(4) radiographs show widening of the fracture line, dense sclerosis of the bone surface at the fracture end, closed bone marrow cavity, osteoporosis, no trabecular bone formation between the bone scabs, or accompanied by obvious bone defects;
(5) clinical manifestations of the infection of the bone, defects, deformities, unequal limb lengths, local sinus tracts, pus, and so on.
Criteria for excluded cases:
(1) Those who do not meet the above diagnostic criteria
Patients with severe medical illnesses who cannot tolerate surgery
(3) Patients with psychiatric disorders
Methods of therapeutic effect observation
Evaluation of the healing of the bone nonunion should include a double evaluation of the bone healing and the functional recovery:
(1) The evaluation criteria of bone healing and functional recovery should be as follows. ) Bone healing evaluation criteria: the results of this evaluation are determined by four indicators: bone healing, infection, deformity and limb length, of which the bone healing criteria for X-ray fracture line fuzzy, there is a continuous bone idiosyncrasy through the fracture line, no abnormal activity of the fracture after removing or trying to loosen the external fixation, the lower limbs can be walked painlessly, the upper limbs hold the fracture with a sense of stability. Evaluation Criteria:
Superior: fracture healing, no infection, deformity of the broken end "?
Good:Fracture healing, no infection, deformity of the broken end ?"CM?±, bilateral limb unequal length ?"CM?±.
Good:Fracture healing and two of the other three criteria.
Fair: fracture healing and one of the other three criteria.
Poor: Fracture not healed or re-fractured or healed but without any of the other three criteria.
Functional evaluation criteria
Functional evaluation is divided into the upper limb and lower limb, the upper limb is mainly considered flexibility, while the lower limb is mainly for weight-bearing walking.
Lower limb evaluation indexes are set as the following five: ① obvious claudication; ② stiffness of any joint of the ankle or knee (when the knee is fully extended or the ankle is fully dorsiflexed, the range of motion is 15 or more than that of the normal or contralateral side); ③ poor soft tissue; ④ there is a limitation of the activity or the existence of pain affecting sleep; ⑤ loss of working ability or inability to take care of their own lives.
Excellent: the ability to work and no other four indicators.
Good: Ability to work with one or two of the above four indicators.
Possible: Ability to work and three to four of the above indicators.
Poor: incapacitated or unable to take care of themselves, regardless of whether the other indicators are present.
The evaluation of upper limb function is based on Seu and Hdlly's criteria for evaluation of upper limb function [3]
The observation indexes are three: pain, range of motion of the joints, and the ability to perform daily activities.
l:Functional evaluation criteria of the upper limb
Score Pain Limited range of motion of any joint Daily activities
Poor None
After exertion or fatigue
Persistence
Slight limitation
Severe limitation
Progress and arrangement of the project:
Collection of cases and follow-up
Writing and finalization of the paper
Feasibility analysis
Non-union of fractures of long bones of the limbs is difficult to cure due to the high number of complications, and the process of functional recovery is lengthy after the surgery. This study focuses on the analysis of the treatment effect of Shandong Hospital of Traditional Chinese Medicine on the non-union of long bone fractures of the extremities by applying wire ring ligation 36?bone grafting with LCP internal fixation in recent years, so the feasibility of the topic selection is strong. The research of the topic has also received strong support from various departments and divisions of the school and the attached hospital. It is believed that the topic can be successfully completed.
Main references
[1] Xu Shao-Ting, Ge Bao-Feng, Xu Yin-Kan, et al. Practical Orthopaedics [M] Beijing People's Army Medical Publishing House,
Wang Yi-Zhong, et al. Bone and Joint Injuries [M] People's Health Publishing House,
[3] Xia He-Tao Introduction to the Combined External Fixator [EB/OL] Beijing Institute of Bone External Fixation Technology,5
[4] Jiang Xieyun Orthopaedic Clinical Efficacy Evaluation Criteria [M] People's Health Publishing House, 5