Anticoagulation is the first-line approach in the prevention and treatment of pulmonary embolism. In some instances, however, anticoagulation fails, or cannot be administered due to a high risk of bleeding. Inferior vena cava filters are metal alloy devices that mechanically trap emboli from the deep leg veins halting their transit to the pulmonary circulation, thus providing a mechanical alternative to anticoagulation in such conditions. The Greenfield filter was developed in 1973 and was later perfected to a model that could be inserted percutaneously. Since then, this model has been the reference standard. The current class I indication for this device includes absolute contraindication to anticoagulants in the presence of acute thromboembolism and recurrent thromboembolism despite adequate therapy. Additional indications have been more recently proposed, due to the development of removable filters and of progressively less invasive techniques. Although the use of inferior vena cava filters has solid theoretical advantages, clinical efficacy and adverse event profile are still unclear. This review analyzes the most important studies related to such devices, open issues, and current guideline recommendations.

随着盆底修复手术技术的革新和重建材料的发展，女性盆底重建手术中植入物的应用日益广泛，其术式包括经阴道植入网片手术（TVM）、骶骨固定术（SC）、抗尿失禁尿道中段悬吊带术（MUS）。植入物相关并发症临床并不少见，部分并发症表现严重，许多国际学术组织、国家或地区的学术组织推出了并发症诊断登记指南或规范。中华医学会妇产科学分会妇科盆底学组，以学组专家成员为基础、同时邀请部分国内本领域专家，结合国内外最新相关文献，一同进行了深入讨论，形成了《女性盆底重建手术植入物并发症登记中国专家共识》，内容涵盖手术的登记标准、植入物并发症的登记标准［包括“类别-时间-部位（CTS）”编码分类系统及Clavien-Dindo分级］、随访及并发症登记的质量控制。必须更好地完善我国盆底重建手术（包括TVM、SC、MUS）中植入物相关并发症的登记工作。盆底重建手术涉及的人口学信息、疾病诊断与评估信息以及手术情况（包括围手术期信息、手术结局、随访情况等）均应该登记，盆底重建手术植入物并发症均应按照CTS分类和Clavien-Dindo分级进行登记，也应该注意随访及并发症登记工作的质量控制。.

Neurotechnologies offer both therapeutic and enhancement potential. In this article, we demonstrate how ethics guidelines can help with critical reflection on their potential for enhancement. We do this through the case of the hippocampal cognitive prosthesis. This prothesis developed in the US, has primarily therapeutic ends, with scope for enhancement. This technology raises several ethical issues, including as related to identity and memory, autonomy and authenticity. In the first section, we outline what we mean by enhancement, and introduce neurotechnologies generally and the hippocampal cognitive prosthesis specifically, with an introduction to generally relevant ethical issues. In the second section, we outline ethical issues pertinent to the hippocampal cognitive prosthesis and explore how ethics guidelines can help to promote essential critical reflection on a technology like this. Through all this, our emphasis is to balance between technological optimism and caution, especially where technologies have enhancement potential.

BACKGROUND: Although there have been a number of studies exploring the impact and efficacy of transfemoral prosthetic components such as knee and foot mechanisms, the empirical evidence surrounding transfemoral prosthetic interface considerations is limited. This constitutes a substantial void for practicing clinicians seeking to apply best practices for patients who use transfemoral prostheses. Recent years have seen increased production and availability of clinical practice guidelines germane to prosthetic rehabilitation. In those areas where empirical evidence is lacking, consensus clinical opinions may constitute the highest level of evidence.
OBJECTIVE: A consensus exercise was performed to generate clinical practice recommendations in the areas of transfemoral interface considerations including socket variations and critical design features, suspension and interface considerations, alignment, heat retention and dermatologic considerations, female considerations, surgical considerations, and both regulatory and ethical considerations related to osseointegration.
METHODS: This began with the generation of postulate items through systematic and narrative literature reviews. A Delphi consensus exercise was performed among clinical experts in government hospital and private clinical practice settings, culminating in a series of clinical practice recommendations associated with the prosthesis-limb interface for individuals with transfemoral amputation.
RESULTS: The completed recommendations include guidance statements relative to socket variations and critical design features, female considerations, suspension and interface considerations, surgical variations and prescription considerations, rehabilitation team considerations and both regulatory and ethical considerations related to osseointegration.
CONCLUSIONS: The Delphi process facilitated the development of practice guidelines for transfemoral prosthetic interface considerations based on aggregated subject matter expertise.

Orbital defect is a common type of maxillofacial defect, which can not be reconstructed by surgical means at present. However, there is no expert consensus on how to make prosthesis accurately and quickly to reconstruct the appearance of patients. In order to solve this problem, the Society of Prosthodontics, Chinese Stomatological Association invited several experts and professors from related professional fields in China to jointly study and develop this expert consensus. The purpose of this consensus is to comprehensively explain the knowledge of prosthesis in repairing orbital defects from the aspects of basic theory, prosthesis principles, prosthesis materials and prosthesis techniques, and to guide more prosthesis physicians to understand and master these knowledge and techniques. So as to improve the overall level of orbital defect repair and reconstruction in China, improve the quality of life of such patients, and better serve the majority of patients.
眶缺损是常见的一类颌面缺损，目前尚不能通过外科手段进行良好地重建，主要依靠眶赝复体（义眶）进行修复。如何精确、快速地制作赝复体以重建患者容貌，尚缺乏相应的专家共识。为解决这一问题，中华口腔医学会口腔颌面修复专业委员会邀请国内相关专业领域的多位专家教授共同研究并制订本专家共识。旨在从基础理论、修复原则、修复材料和修复技术等方面全面阐释赝复体修复眶缺损的有关知识，指导更多的修复医师了解并掌握这些知识和技术。从而提高我国在眶缺损修复重建领域的整体水平，提升该类患者的生存及生活质量，更好地为广大患者服务。.

BACKGROUND: Lower-limb amputations are rare but debilitating events in the lives of affected persons. Treatment of persons with amputation inherently involves many different health care professions at different stages leading to and after an amputation. There are prevailing clinical questions within the work field related to different facets of care including peri/postoperative aspects, prosthetic components, rehabilitation treatment, and health care processes.
OBJECTIVE: To provide an up-to-date multidisciplinary evidence-based guideline for health care professionals involved in the treatment of persons with lower-limb amputation in the Netherlands.
METHODS: Identification of key questions in a focus group, systematic review of the evidence (up to March 2019, using Embase and MEDLINE databases), and weighing considerations, culminating in clinical recommendations.
RESULTS: Twelve key questions were formulated. Recommendations of two key questions were upheld in line with the previous 2012 guideline. Ten systematic literature searches were performed, leading to the inclusion of 59 studies.
CONCLUSIONS: A summary of evidence-based conclusions, considerations, and recommendations of the 2020 guideline is presented.

暂无摘要。

The increasing prevalence of heart failure has led to the expanded use of left ventricle assist devices (VADs) for end-stage heart failure patients worldwide. Technological improvements witnessed the development of miniaturized VADs and their implantation through less traumatic non-full sternotomy approaches using a lateral thoracotomy (LT). Although adoption of the LT approach is steadily growing, a lack of consensus remains regarding patient selection, details of the surgical technique, and perioperative management. Furthermore, the current literature does not offer prospective randomized studies or evidence-based guidelines for LT-VAD implantation.
A worldwide group of LT-VAD experts was convened to discuss these key topics openly. After a PubMed search and review with all authors, a consensus was reached and an expert consensus paper on LT-VAD implantation was developed.
This document aims to guide clinicians in the selection of patients suitable for LT approaches and preoperative optimization. Details of operative techniques are described, with an overview of hemisternotomy and bilateral thoracotomy approaches. A review of the best surgical practices for placement of the pump, inflow cannula, and outflow graft provides advice on the best surgical strategies to avoid device malpositioning while optimizing VAD function. Experts\' opinions on cardiopulmonary bypass, postoperative management, and approaches for pump exchange and explant are presented. This review also emphasizes the critical need for multidisciplinary teams and specific training.
This expert consensus review provides a compact guide to LT for VAD implantation, from patient selection through intraoperative tips and postoperative management.

OBJECTIVE: To provide evidence-based recommendations on the use of inferior vena cava (IVC) filters in the treatment of patients with or at substantial risk of venous thromboembolic disease.
METHODS: A multidisciplinary expert panel developed key questions to address in the guideline, and a systematic review of the literature was conducted. Evidence was graded based on a standard methodology, which was used to inform the development of recommendations.
RESULTS: The systematic review identified a total of 34 studies that provided the evidence base for the guideline. The expert panel agreed on 18 recommendations.
CONCLUSIONS: Although the evidence on the use of IVC filters in patients with or at risk of venous thromboembolic disease varies in strength and quality, the panel provides recommendations for the use of IVC filters in a variety of clinical scenarios. Additional research is needed to optimize care for this patient population.

OBJECTIVE: The aims of the present study were to identify detailed positional relationship between the auditory ossicles and to provide theoretic navigational guidelines for optimal prosthesis adaptation and effective malleostapedotomy.
METHODS: Fifty sides of the temporal bone from donated cadavers were scanned by MicroCT and the malleus, incus, stapes and tympanic membrane were materialized three dimensionally using computer software. Dimensions between the auditory ossicles closely related to malleostapedotomy were measured twice.
RESULTS: The grip site of malleus handle was mean 1.8 mm superior and mean 1.3 mm anterior, and linear distance between the grip site of malleus handle and the footplate of the stapes was mean 6.5 mm. The stapes was not parallel to the tympanic membrane and rotated mean 10.7° posteriorly relative to the tympanic membrane.
CONCLUSIONS: Surgeons should start with at least 8.75 mm prosthesis to cover the upper limits of potential anatomy and then trim down to the individualization to the case. The ideal loop morphology has to be oval shape more than 1.4 mm in the long diameter and 1.0 mm in the short diameter. The wire of the prosthesis has to be bended at the two points: about 10° anteriorly at the most proximal point of the wire and about 50° superiorly at the stapes head point.