The Superficial Face Dissection as an Example for Integrating Clinical Approaches, Authentic Learning, and Changing Perspectives in Anatomy Dissection

Anatomy education for medical students in the United Kingdom and Republic of Ireland in 2019: A 20-year follow-up

Anatomical education in the United Kingdom (UK) and Ireland has long been under scrutiny, especially since the reforms triggered in 1993 by the General Medical Council's "Tomorrow's Doctors." The aim of the current study was to investigate the state of medical student anatomy education in the UK and Ireland in 2019. In all, 39 medical schools completed the survey (100% response rate) and trained 10,093 medical students per year cohort. The teachers comprised 760 individuals, of these 143 were employed on full-time teaching contracts and 103 were employed on education and research contracts. Since a previous survey in 1999, the number of part-time staff has increased by 300%, including a significant increase in the number of anatomy demonstrators. In 2019, anatomy was predominantly taught to medical students in either a system-based or hybrid curriculum. In all, 34 medical schools (87%) used human cadavers to teach anatomy, with a total of 1,363 donors being used per annum. Gross anatomy teaching was integrated with medical imaging in 95% of medical schools, embryology in 81%, living anatomy in 78%, neuroanatomy in 73%, and histology in 68.3%. Throughout their five years of study, medical students are allocated on average 85 h of taught time for gross anatomy, 24 h for neuroanatomy, 24 h for histology, 11 h for living anatomy, and 10 for embryology. In the past 20 years, there has been an average loss of 39 h dedicated to gross anatomy teaching and a reduction in time dedicated to all other anatomy sub-disciplines.

Issues in Teaching Vascular Anatomy: Thoughts and Suggestions from the Clinician's Point of View

The role of anatomy in modern curricula is under reform due to competency of other rapidly evolving subjects and the rapid evolution of several practical aspects and applications dictating modernization of teaching methods as well as of teaching demands. Moreover, modern practice of medicine has put the arterial and vascular system in the center of numerous minimally invasive techniques. Therefore, regardless of their specialty, most doctors should have a very clear and precise knowledge of the vascular anatomy and the basic access techniques from the early years. This viewpoint commentary reflects the experience of the two authors in applying the principles and content of surgical vascular anatomy in undergraduate anatomy teaching and discusses the rationale of this. Moreover, it is suggested that cadaveric dissections should be modified with emphasis on standard surgical vascular exposures and the multidisciplinary teaching of vascular anatomy as a means not only to gain optimal long-term knowledge retention, but also to emphasize through realistic examples on the practical clinical value of vascular anatomy.

Transcatheter arterial chemoembolization combined with microwave ablation for treatment of early liver cancer: Efficacy and prognostic factors for progression-free survival

BACKGROUND

Transcatheter arterial chemoembolization (TACE) and microwave ablation (MWA) are the main methods for the treatment of liver cancer worldwide. TACE can block the blood vessels of liver cancer and clearly show the area where the tumor is located. The solid tumor can be completely ablated by MWA. However, postoperative recurrence is still a difficult problem to solve.

AIM

To assess the efficacy of TACE combined with MWA in the treatment of liver cancer at early Barcelona clinic liver cancer (BCLC) stage and identify the factors affecting recurrence.

METHODS

A retrospective analysis was performed on 42 patients with post-hepatitis B virus (HBV) liver cancer at early BCLC stage who underwent TACE combined with MWA at our hospital from February 2016 to November 2017. After surgery, the efficacy was evaluated and complications were recorded. The patients were followed at 1 mo, 2 mo, 3, mo 6 mo, 12 mo, and 18 mo after WMA for CT, alpha fetoprotein (AFP), liver function, or hepatic angiography, and the time to recurrence was recorded.

RESULTS

By the last follow-up, the total effective rate was 61.5% and the lesion control rate was 84.2%. The median progression-free-survival (PFS) was 7.3 mo (range, 2.3-34). Univariate analysis showed that female patients had a PFS of 14 mo and male patients had a PFS of 11 mo. Patients ≥ 60 years of age had a PFS of 3.8 mo, and patients < 60 years of age had a PFS of 8.9 mo. The PFS of patients with tumor < 3 cm, 3 to 5 cm, and 5-10 cm was 14, 10.5, and 11.2 mo, respectively. The PFS of patients with single tumor and multiple tumors was 13.6 and 4 mo, respectively. The PFS of patients with Child A and Child B disease was 20.8 mo vs 11.2 mo. The PFS of BCLC stage 0 patients and BCLC stage A patients was 15.5 mo vs 11.2 mo. HBV-DNA positive patients had a PFS of 11.2 mo, and HBV-DNA negative patients had a PFS of 13.3 mo. The median PFS of HBeAg-positive cases was 11.2 mo, and that of HBeAg-negative cases was 13.3 mo. Univariate analysis showed that gender, age, Child grade, number of tumors, and BCLC stage were significantly correlated with PFS, but tumor size, preoperative HBV-DNA, and HBeAg status did not. In multivariate analysis, Child grade, BCLC stage, and gender were identified to be independent risk factors for PFS in early BCLC stage liver cancer patients undergoing sequential treatment of TACE and MWA (P < 0.05).

CONCLUSION

TACE combined with MWA is safe and effective in the treatment of early BCLC stage liver cancer. Child grade, BCLC stage, and gender may affect postoperative recurrence.