1.Giving play to the advantages of information-driven networks and enhancing hospital infection management
Liping YANG ; Xinyong HU ; Changchun CHAI ; Al ET
Chinese Journal of Hospital Administration 1996;0(04):-
Based on fairly systematic and complete information networks, the software Multimedia Teaching and Clinical Practice of Hospital Infection Control was developed. By adopting information driven network and digital hospital infection management, traditional ideological concepts, operational methods and modes of training were transcended. As a result, ways of communication became more flexible, intermediate links were reduced, and the efficiency of management was enhanced.
2.Relationship of hyperglycemia to infection,MODS,and survival time in dead trauma patients
Zhanke WANG ; Changchun CHAI ; Fengtian HE ; Hong DENG ; Linshui XU ; Minrong LIU
Journal of Third Military Medical University 1984;0(01):-
Objective To investigate the relationship of hyperglycemia to trauma score,infection,MODS and survival time of the dead patients caused by trauma.Methods A total of 455 cases of dead trauma patients selected randomly from our hospital,were divided into two groups with normal blood glucose(n=57) or hyperglycemia(n=298).The RTC,GCS and the cases of infection and MODS as well as the survival time of two groups were recorded,and the coefficients of relationship between the blood glucose and the indexes of MODS in the dead trauma patients were calculated.Results The levels of RTC,GCS in the group with hyperglycemia were higher than that with normal blood glucose(P
3. Clinical study of therapeutic effect in eyebrow lifting with different incisions
Haipeng LIU ; Jiannan CHAI ; Jiaqi WANG ; Duo ZHANG
Chinese Journal of Plastic Surgery 2018;34(10):814-817
Objective:
To evaluate the therapeutic effect of choosing different surgical incisions in eyebrow lifting.
Methods:
This research recruited 87 female who underwent eyebrow lifting in our hospital from January 2015 to December 2017, with the mean age of 52.4 years ranging from 25 to 71 years. According to the degree of the upper eyelid soft tissue laxity the level of eyebrow drooping and cosmetic patients personal requirements, we performed different surgical incisions respectively. Therefore, there were 39 cases upper-eyebrow incision, 31 cases under-eyebrow incision and 17 cases combined with upper and lower eyebrow incision.
Results:
87 women who had undergone the 3 months to 4 years follow-up (average period, 6.3-month), are pleased with their eyebrow and rejuvenation after eyebrow lifting, with 90.8% (79 of 87) satisfaction, 6.9% (6 of 87) satisfaction basically and 2.3% (2 of 87) dissatisfaction. And only 2 patients had secondary surgery for unacceptable brow shape.
Conclusions
By choosing different eyebrow incisions and removing skin around the eyebrow, there were efficient ways to rectify the upper eyelid skin relaxation and eyebrow drooping, widen the double eyelid line as well as to improve crow′s-feet. We firmly believe that it is essential for surgeons to sufficiently get to know patients′ requirements and design a personalized treatment scheme according to the relaxation degree of the upper eyelid soft tissue and the shape of eye-brow.
4.Diagnosis of clonorchiasis during and after biliary tract surgery: a clinical analysis of 15 cases
Wenlei QI ; Ruoyan ZHANG ; Wengang CHAI
Journal of Clinical Hepatology 2016;32(11):2134-2137
ObjectiveTo investigate the clinical features of clonorchiasis diagnosed during biliary surgery, and to provide more comprehensive and effective information for the surgical treatment of clonorchiasis. MethodsA retrospective analysis was performed for the clinical data of 15 patients who were diagnosed with clonorchiasis during and after biliary tract surgery in our department from January 2013 to January 2016, and their clinical features were summarized. ResultsAll the 15 patients were male, among whom 5 once ate uncooked freshwater fish and shrimps. Of all patients, 8 underwent laparoscopic bile duct exploration and 7 underwent endoscopic retrograde cholangiopancreatography (ERCP). Adult Clonorchis sinensis was found in intraoperative or postoperative drainage. All the patients achieved clearance of Clonorchis sinensis after regular anthelmintic treatment. ConclusionIf bile duct exploration finds grey-black or bright-red melon seed-like floccules, clonorchiasis should be highly suspected. Intraoperative T-tube drainage is recommended, and if suspected Clonorchis sinensis is found after laparoscopic bile duct exploration and T-tube drainage or after ERCP and nasobiliary drainage, microbiological examination should be performed next. As for the patients with a definite diagnosis of clonorchiasis, they should not eat uncooked freshwater fish or shrimps and should be given regular anthelmintic treatment.
5.Efficacy of des-γ-carboxy-prothrombin in the diagnosis of hepatocellular carcinoma and its association with the clinical features of hepatocellular carcinoma
Zhi LIU ; Xiaohong DU ; Wengang CHAI
Journal of Clinical Hepatology 2024;40(10):2014-2018
ObjectiveTo investigate the value of des-γ-carboxy-prothrombin (DCP) in hepatocellular carcinoma (HCC). MethodsA retrospective analysis was performed for the clinical data of 179 HCC patients who were admitted to The First Hospital of Jilin University from January 2020 to July 2021, and 207 healthy controls were enrolled as normal group. Magnetic particle chemiluminescence immunoassay was used to measure the serological levels of alpha-fetoprotein (AFP) and DCP. The receiver operating characteristic (ROC) curve was plotted for each indicator measured alone or in combination, and the area under the ROC curve (AUC) was calculated to investigate the value of DCP combined with AFP versus AFP alone in the diagnosis of HCC and the diagnostic efficacy of DCP in AFP-negative patients. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the ROC curve was used to evaluate diagnostic efficiency; the Spearman correlation analysis was used to investigate the correlation of tumor markers with the pathological features of HCC. ResultsThe patients with HCC had significantly higher serum levels of AFP and DCP than the normal group (Z=-9.562 and -11.678, P<0.05), and combined measurement of DCP and AFP had a better value than AFP measured alone (Z=5.309, P<0.01). DCP had certain capability in the diagnosis of AFP-negative HCC patients, with an AUC of 0.789 (P<0.000 1), a sensitivity of 61.64%, and a specificity of 86.47%. Serum DCP level was positively correlated with tumor size (r=0.546, P<0.001), TNM stage (r=0.306, P<0.001), and microvascular invasion (r=0.358,P<0.001) and was negatively correlated with the degree of tumor differentiation (r=-0.220, P<0.05). ConclusionsThe combined measurement of AFP and DCP can improve the detection rate of HCC, and DCP can be used for supplementary screening in AFP-negative HCC patients. The expression level of DCP is correlated with the clinicopathological features of HCC, including tumor size, TNM stage, microvascular invasion, and the degree of tumor differentiation.
6. Bilateral hunter′s bow syndrome combined with epilepsy: a case report
Fan WU ; Mingqin ZHU ; Yating CHAI ; Hongyang SUN ; Xiaohan LI ; Jing BAI
Chinese Journal of Neurology 2019;52(9):758-761
Bow hunter′s syndrome, also known as vertebral basilar artery insufficiency, is a rare disease characterized by post-circulation blood supply insufficiency caused by mechanical or stenosis of the vertebral artery when the head and neck rotate or over-extend. To date, few cases regarding the bilateral hunter′s bow syndrome concurrent with epilepsy have been reported. A 29-year-old man was admitted to the First Hospital of Jilin University due to seizures. Results from transcranial Doppler ultrasound and carotid ultrasound showed that the patient had bilateral hunter′s bow syndrome. Further imaging examination showed that the syndrome was caused by congenital bone fusion which resulted in mechanical occlusion of C1-C2 vertebral artery. This case indicates that seizures are closely related to hunter′s bow syndrome.
7.Associations of cholecystectomy with the risk of colorectal cancer: a Mendelian randomization study.
Lanlan CHEN ; Zhongqi FAN ; Xiaodong SUN ; Wei QIU ; Wentao MU ; Kaiyuan CHAI ; Yannan CAO ; Guangyi WANG ; Guoyue LV
Chinese Medical Journal 2023;136(7):840-847
BACKGROUND:
Cholecystectomy is a standard surgery for patients suffering from gallbladder diseases, while the causal effects of cholecystectomy on colorectal cancer (CRC) and other complications are still unknown.
METHODS:
We obtained genetic variants associated with cholecystectomy at a genome-wide significant level ( P value <5 × 10 -8 ) as instrumental variables (IVs) and performed Mendelian randomization (MR) to identify the complications of cholecystectomy. Furthermore, the cholelithiasis was also treated as the exposure to compare its causal effects to those of cholecystectomy, and multivariable MR analysis was carried out to judge whether the effect of cholecystectomy was independent of cholelithiasis. The study was reported based on Strengthening the Reporting of Observational Studies in Epidemiology Using Mendelian Randomization guidelines.
RESULTS:
The selected IVs explained 1.76% variance of cholecystectomy. Our MR analysis suggested that cholecystectomy cannot elevate the risk of CRC (odds ratio [OR] =1.543, 95% confidence interval [CI]: 0.607-3.924). Also, it was not significant in either colon or rectum cancer. Intriguingly, cholecystectomy might decrease the risk of Crohn's disease (OR = 0.078, 95% CI: 0.016-0.368) and coronary heart disease (OR = 0.352, 95% CI: 0.164-0.756). However, it might increase the risk of irritable bowel syndrome (IBS) (OR = 7.573, 95% CI: 1.096-52.318). Cholelithiasis could increase the risk of CRC in the largest population (OR = 1.041, 95% CI: 1.010-1.073). The multivariable MR analysis suggested that genetic liability to cholelithiasis could increase the risk of CRC in the largest population (OR = 1.061, 95% CI: 1.002-1.125) after adjustment of cholecystectomy.
CONCLUSIONS
The study indicated that cholecystectomy might not increase the risk of CRC, but such a conclusion needs further proving by clinical equivalence. Additionally, it might increase the risk of IBS, which should be paid attention to in clinical practice.
Humans
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Mendelian Randomization Analysis
;
Irritable Bowel Syndrome
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Colorectal Neoplasms/genetics*
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Cholelithiasis/complications*
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Cholecystectomy/adverse effects*
;
Genome-Wide Association Study
;
Polymorphism, Single Nucleotide
8.Thoughts on path of R&D and registration of innovative traditional Chinese medicine with synchronous transformation of "series prescriptions".
Yan-Ling AI ; Jian-Yuan TANG ; Gang ZHOU ; Lei ZHANG ; Li-Ping QU ; Shi-Yao HUANG ; Zhong-Qi YANG ; Wei-An YUAN ; Yue-Hua ZHOU ; Ting WANG ; Jun-Ning ZHAO ; Xiao-Bo SUN ; Xiao-He XIAO ; Zi-Feng YANG ; Qing-Quan LIU ; Ming-Jun ZHU ; Xiang-Yang LENG ; Chun-Guang XIE ; Song-Yan CHAI
China Journal of Chinese Materia Medica 2022;47(4):1120-1125
Since the implementation of drug registration in China, the classification of Chinese medicine has greatly met the needs of public health and effectively guided the transformation, inheritance, and innovation of research achievements on traditional Chinese medicine(TCM). In the past 30 years, the development of new Chinese medicine has followed the registration transformation model of " one prescription for single drug". This model refers to the R&D and registration system of modern drugs, and approximates to the " law-abiding" medication method in TCM clinic, while it rarely reflects the sequential therapy of syndrome differentiation and comprehensive treatment with multiple measures. In 2017, Opinions on Deepening the Reform of Review and Approval System and Encouraging the Innovation of Drugs and Medical Devices released by the General Office of the CPC Central Committee and the General Office of the State Council pointed out that it is necessary to " establish and improve the registration and technical evaluation system in line with the characteristics of Chinese medicine, and handle the relationship between the traditional advantages of Chinese medicine and the requirements of modern drug research". Therefore, based on the development law and characteristics of TCM, clinical thinking should be highlighted in the current technical requirements and registration system of research and development of Chinese medicine. Based on the current situation of registration supervision of Chinese medicine and the modern drug research in China, the present study analyzed limitations and deficiency of " one prescription for single drug" in the research and development of Chinese medicine. Additionally, a new type of " series prescriptions" was proposed, which was consistent with clinical thinking and clinical reality. This study is expected to contribute to the independent innovation and high-quality development of the TCM industry.
China
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Drugs, Chinese Herbal/therapeutic use*
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Medicine, Chinese Traditional
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Prescriptions
;
Public Health
9.A multi-center retrospective study of perioperative chemotherapy for gastric cancer based on real-world data.
Xue Wei DING ; Zhi Chao ZHENG ; Qun ZHAO ; Gang ZHAI ; Han LIANG ; Xin WU ; Zheng Gang ZHU ; Hai Jiang WANG ; Qing Si HE ; Xian Li HE ; Yi An DU ; Lu Chuan CHEN ; Ya Wei HUA ; Chang Ming HUANG ; Ying Wei XUE ; Ye ZHOU ; Yan Bing ZHOU ; Dan WU ; Xue Dong FANG ; You Guo DAI ; Hong Wei ZHANG ; Jia Qing CAO ; Le Ping LI ; Jie CHAI ; Kai Xiong TAO ; Guo Li LI ; Zhi Gang JIE ; Jie GE ; Zhong Fa XU ; Wen Bin ZHANG ; Qi Yun LI ; Ping ZHAO ; Zhi Qiang MA ; Zhi Long YAN ; Guo Liang ZHENG ; Yang YAN ; Xiao Long TANG ; Xiang ZHOU
Chinese Journal of Gastrointestinal Surgery 2021;24(5):403-412
Objective: To explore the effect of perioperative chemotherapy on the prognosis of gastric cancer patients under real-world condition. Methods: A retrospective cohort study was carried out. Real world data of gastric cancer patients receiving perioperative chemotherapy and surgery + adjuvant chemotherapy in 33 domestic hospitals from January 1, 2014 to January 31, 2016 were collected. Inclusion criteria: (1) gastric adenocarcinoma was confirmed by histopathology, and clinical stage was cT2-4aN0-3M0 (AJCC 8th edition); (2) D2 radical gastric cancer surgery was performed; (3) at least one cycle of neoadjuvant chemotherapy (NAC) was completed; (4) at least 4 cycles of adjuvant chemotherapy (AC) [SOX (S-1+oxaliplatin) or CapeOX (capecitabine + oxaliplatin)] were completed. Exclusion criteria: (1) complicated with other malignant tumors; (2) radiotherapy received; (3) patients with incomplete data. The enrolled patients who received neoadjuvant chemotherapy and adjuvant chemotherapy were included in the perioperative chemotherapy group, and those who received only postoperative adjuvant chemotherapy were included in the surgery + adjuvant chemotherapy group. Propensity score matching (PSM) method was used to control selection bias. The primary outcome were overall survival (OS) and progression-free survival (PFS) after PSM. OS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the last effective follow-up or death. PFS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the first imaging diagnosis of tumor progression or death. The Kaplan-Meier method was used to estimate the survival rate, and the Cox proportional hazards model was used to evaluate the independent effect of perioperative chemo therapy on OS and PFS. Results: 2 045 cases were included, including 1 293 cases in the surgery+adjuvant chemotherapy group and 752 cases in the perioperative chemotherapy group. After PSM, 492 pairs were included in the analysis. There were no statistically significant differences in gender, age, body mass index, tumor stage before treatment, and tumor location between the two groups (all P>0.05). Compared with the surgery + adjuvant chemotherapy group, patients in the perioperative chemotherapy group had higher proportion of total gastrectomy (χ(2)=40.526, P<0.001), smaller maximum tumor diameter (t=3.969, P<0.001), less number of metastatic lymph nodes (t=1.343, P<0.001), lower ratio of vessel invasion (χ(2)=11.897, P=0.001) and nerve invasion (χ(2)=12.338, P<0.001). In the perioperative chemotherapy group and surgery + adjuvant chemotherapy group, 24 cases (4.9%) and 17 cases (3.4%) developed postoperative complications, respectively, and no significant difference was found between two groups (χ(2)=0.815, P=0.367). The median OS of the perioperative chemotherapy group was longer than that of the surgery + adjuvant chemotherapy group (65 months vs. 45 months, HR: 0.74, 95% CI: 0.62-0.89, P=0.001); the median PFS of the perioperative chemotherapy group was also longer than that of the surgery+adjuvant chemotherapy group (56 months vs. 36 months, HR=0.72, 95% CI:0.61-0.85, P<0.001). The forest plot results of subgroup analysis showed that both men and women could benefit from perioperative chemotherapy (all P<0.05); patients over 45 years of age (P<0.05) and with normal body mass (P<0.01) could benefit significantly; patients with cTNM stage II and III presented a trend of benefit or could benefit significantly (P<0.05); patients with signet ring cell carcinoma benefited little (P>0.05); tumors in the gastric body and gastric antrum benefited more significantly (P<0.05). Conclusion: Perioperative chemotherapy can improve the prognosis of gastric cancer patients.
Chemotherapy, Adjuvant
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Female
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Gastrectomy
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Humans
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Male
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Neoadjuvant Therapy
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Neoplasm Staging
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Prognosis
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Retrospective Studies
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Stomach Neoplasms/surgery*