1.Effect of Different Medical Insurance Payments on the Hospital Performance Index
Jing LIU ; Jie CAO ; Qianjun XIAO
Modern Hospital 2017;17(5):664-665,669
Objective To analyze the effect of different medical insurance payments on medical expenses so as to provide some suggestions for Guangdong Provincial Department of Offsite Medical Insurance Administration in its future policy-making.Methods An statistic analysis was conducted of medical expenses among patients who chose different medical insurance payments and their average length of stay.Results Medical expenses and average length of stay were statistically different among patients who chose different payments.Conclusion The medicare reimbursement′s inclusion of prevention and diagnosis should be recommended to establish a flexible referral system, reinforce the payments reform and increase the efficiency of social security funds.
2.Clinial implication of tThe expression of Aurora B in normal endometrium and endometrial carcinoma.
Puxi, LI ; Qianjun, ZHOU ; Lirong, REN ; Lan, XIAO
Journal of Huazhong University of Science and Technology (Medical Sciences) 2008;28(3):337-339
The expression of Aurora B in normal endometria and endometrial carcinomas and its relation with clinicopathologic parameters of endometrial carcinomas were investigated. Streptavidin-biotin peroxidase (SP) immunohistochemical technique was used to detect the expression of Aurora B in 10 cases of normal proliferative phase endometria, 10 cases of normal secretory phase endometria and 72 cases of endometrial carcinomas respectively. According to the 1988 International Federation of Gynecology and Obstetrics (FIGO) grade, there were 37 patients in grade 1, 23 in grade 2 and 12 in grade 3 respectively. According to the FIGO stage, there were 59 patients in stage I-II and 13 patients in stage III-IV. Aurora B was expressed in both normal proliferative phase endometria, secretory phase endometria and endometrial carcinomas, but its positive labeling index (PLI) in proliferative phase endometria was significantly higher than that in secretory phase endometria (P<0.01) and endometrial carcinomas (P<0.01). The PLI of Aurora B was lower in tumors with well differentiation (G(1)), low surgical staging (I-II), and =1/2 myometrial invasion than that in tumors with moderate and low differentiation (G(2)-G(3)), higher surgical staging (III-IV), and >1/2 myometrial invasion (all P<0.01). Aurora B exerts its functions in the replication of normal endometrial glandular cells; Expression of Aurora B is significantly correlated with biologic behavior of endometrial carcinoma, indicating that Aurora B may be a promising prognostic factor in endometrial carcinoma.
Carcinoma/*metabolism
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Cell Proliferation
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Endometrial Neoplasms/*metabolism
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Endometrium/*metabolism
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Gene Expression Regulation
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Gene Expression Regulation, Neoplastic
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Immunohistochemistry
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Prognosis
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Protein-Serine-Threonine Kinases/*biosynthesis
3.Clinial Implication of tThe Expression of Aurora B in Normal Endometrium and Endometrial Carcinoma
LI PUXI ; ZHOU QIANJUN ; REN LIRONG ; XIAO LAN
Journal of Huazhong University of Science and Technology (Medical Sciences) 2008;28(3):337-339
The expression of Aurora B in normal endometria and endometrial carcinomas and its relation with clinicopathologic parameters of endometrial carcinomas were investigated. Streptavidin-biotin peroxidase (SP) immunohistochemical technique was used to detect the expression of Aurora B in 10 cases of normal proliferative phase endometria, 10 cases of normal secretory phase endometria and 72 cases of endometrial carcinomas respectively. According to the 1988 International Federation of Gynecology and Obstetrics (FIGO) grade, there were 37 patients in grade 1, 23 in grade 2 and 12 in grade 3 respectively. According to the FIGO stage, there were 59 patients in stage Ⅰ-Ⅱ and 13 patients in stage Ⅲ-Ⅳ. Aurora B was expressed in both normal proliferative phase endometria, secretory phase endometria and endometrial carcinomas, but its positive labeling index (PLI) in proliferative phase endometria was significantly higher than that in secretory phase endometria (P<0.01) and endometrial carcinomas (P<0.01). The PLI of Aurora B was lower in tumors with well differentiation (G1), low surgical staging (Ⅰ-Ⅱ), and≤1/2 myometrial invasion than that in tumors with moderate and low differentiation (G2-G3), higher surgical staging(Ⅲ-Ⅳ), and>1/2 myometrial invasion (all P<0.01). Aurora B exerts its functions in the replication of normal endometrial glandular cells; Expression of Aurora B is significantly correlated with biologic behavior of endometrial carcinoma, indicating that Aurora B may be a promising prognostic factor in endometrial carcinoma.
4.Upright Integrated Relaxation Pressure Predicts Symptom Outcome for Esophagogastric Junction Outflow Obstruction
Songfeng CHEN ; Mengya LIANG ; Niandi TAN ; Mengyu ZHANG ; Yuqing LIN ; Peixian CAO ; Qianjun ZHUANG ; Yinglian XIAO
Journal of Neurogastroenterology and Motility 2021;27(3):363-369
Background/Aims:
Esophagogastric junction outflow obstruction (EGJOO) is characterized by elevated integrated relaxation pressure (IRP) and preserved esophageal peristalsis. The clinical significance of EGJOO is uncertain. This study aim to describe the clinical characteristics of these patients and to find out potential parameters to predict patients’ symptom outcome.
Methods:
Consecutive patients who received high-resolution manometry examination in our hospital in 2013-2019 and met the diagnostic criteria of EGJOO were retrospectively included. Motility and reflux parameters as well as endoscopy and barium esophagogram results were studied and compared. Patients were also followed up to record their treatment methods and symptom outcomes.
Results:
A total of 138 EGJOO (accounting for 5.2% of total patients taking high-resolution manometry examination in our hospital) patients were included. Only 2.9% of these patients had persistent dysphagia. A total of 81.8% of EGJOO patients had symptom resolution during follow-up. Patients with persistent dysphagia had significantly higher upright IRP (16.6 [10.3, 19.8] vs 7.8 [3.2, 11.5]; P = 0.026) than those without. Upright IRP can effectively distinguished patients with persistent dysphagia (area under curve: 0.826; P = 0.026) using optimal cut-off value of 9.05 mmHg.
Conclusion
EGJOO patients with persistent dysphagia and higher upright IRP (median > 9.05 mmHg) needs further evaluation and aggressive management.
5.Upright Integrated Relaxation Pressure Predicts Symptom Outcome for Esophagogastric Junction Outflow Obstruction
Songfeng CHEN ; Mengya LIANG ; Niandi TAN ; Mengyu ZHANG ; Yuqing LIN ; Peixian CAO ; Qianjun ZHUANG ; Yinglian XIAO
Journal of Neurogastroenterology and Motility 2021;27(3):363-369
Background/Aims:
Esophagogastric junction outflow obstruction (EGJOO) is characterized by elevated integrated relaxation pressure (IRP) and preserved esophageal peristalsis. The clinical significance of EGJOO is uncertain. This study aim to describe the clinical characteristics of these patients and to find out potential parameters to predict patients’ symptom outcome.
Methods:
Consecutive patients who received high-resolution manometry examination in our hospital in 2013-2019 and met the diagnostic criteria of EGJOO were retrospectively included. Motility and reflux parameters as well as endoscopy and barium esophagogram results were studied and compared. Patients were also followed up to record their treatment methods and symptom outcomes.
Results:
A total of 138 EGJOO (accounting for 5.2% of total patients taking high-resolution manometry examination in our hospital) patients were included. Only 2.9% of these patients had persistent dysphagia. A total of 81.8% of EGJOO patients had symptom resolution during follow-up. Patients with persistent dysphagia had significantly higher upright IRP (16.6 [10.3, 19.8] vs 7.8 [3.2, 11.5]; P = 0.026) than those without. Upright IRP can effectively distinguished patients with persistent dysphagia (area under curve: 0.826; P = 0.026) using optimal cut-off value of 9.05 mmHg.
Conclusion
EGJOO patients with persistent dysphagia and higher upright IRP (median > 9.05 mmHg) needs further evaluation and aggressive management.
6.The Disease Spectrum and Natural History of Patients With Abdominal Bloating or Distension:A Longitudinal Study
Fangfei CHEN ; Niandi TAN ; Songfeng CHEN ; Qianjun ZHUANG ; Mengyu ZHANG ; Yinglian XIAO
Journal of Neurogastroenterology and Motility 2024;30(1):64-72
Background/Aims:
Abdominal bloating or distension (AB/D) is a common complaint in the outpatient of gastroenterology department. Since the potential contributors are numerous and complex, a longitudinal study on the disease spectrum and natural history of patients was performed to better understand the key factors of AB/D.
Methods:
Consecutive patients with the chief complaint of AB/D referred to the outpatient clinic were screened. Functional gastrointestinal disorders (FGIDs) were diagnosed according to Rome IV criteria. A 3-year follow-up was performed to seek for the changes in symptoms as well as disease spectrum.
Results:
A total of 261 participants were enrolled and 139 completed the follow-up. Most patients suffered from moderate to severe symptoms more than 1 day per week. Common causes of AB/D were FGIDs (51.7%) and organic diseases (17.2%). The latter group was older with lower body mass index (BMI). Functional dyspepsia was the most common type of FGIDs in AB/D. The symptoms of 18.0% of participants failed to improve at the end of the 3-year follow-up, and those diagnosed with FGIDs were most likely to continue to suffer. Abdominal pain was a positive predictive factor for good prognosis in the FGIDs group. Besides, only 22.7% of participants had a consistent diagnosis of FGIDs during follow-up.
Conclusions
FGIDs are the most common diagnosis in patients with AB/D. Symptoms were especially hard to be improved. Classification diagnoses of FGIDs in AB/D patients fluctuated significantly over time.
7.Application of echocardiography Z score in pediatric dilated cardiomyopathy
Limiao XIAO ; Wenjuan CHEN ; Xingxing DUAN ; Yuan HU ; Qianjun LIU ; Wenfang YUAN
Chinese Journal of Medical Imaging Technology 2018;34(1):144-148
The children with dilated cardiomyopathy (DCM) are in the different stages of growth and development,so the measurements of the cardiac size and the function in the echocardiography can change with those growth and development.But the influence factors of growth and development had been ignored by the previous standards,which was not conducive to evaluate the efficacy of drugs and the prognosis of patients.The disadvantages above can be overcome by converting the echocardiographic measurements into the Z score after correction of the body surface area.With the development of the ultrasonic technology,there have been some studies of the Z score combined with the ultrasound to assess the left/right ventricular heart function and prognosis in children with dilated cardiomyopathy.The progresses of Z score in children with dilated cardiomyopathy were reviewed in this article.
8.Achalasia: The Current Clinical Dilemma and Possible Pathogenesis
Xingyu JIA ; Songfeng CHEN ; Qianjun ZHUANG ; Niandi TAN ; Mengyu ZHANG ; Yi CUI ; Jinhui WANG ; Xiangbin XING ; Yinglian XIAO
Journal of Neurogastroenterology and Motility 2023;29(2):145-155
Achalasia is a primary esophageal motility disorder manifested by dysphagia and chest pain that impair patients’ quality of life, and it also leads to chronic esophageal inflammation by food retention and increases the risk of esophageal cancer. Although achalasia has long been reported, the epidemiology, diagnosis and treatment of achalasia are not fully understood. The current clinical dilemma of achalasia is mainly due to its unclear pathogenesis. In this paper, epidemiology, diagnosis treatment, as well as possible pathogenesis of achalasia will be reviewed and summarized. The proposed hypothesis on the pathogenesis of achalasia is that genetically susceptible populations potentially have a higher risk of infection with viruses, triggering autoimmune and inflammation responses to inhibitory neurons in lower esophageal sphincter.
9.Overlapping Reflux Symptoms in Functional Dyspepsia Are Mostly Unrelated to Gastroesophageal Reflux
Songfeng CHEN ; Xingyu JIA ; Qianjun ZHUANG ; Xun HOU ; Kewin T H SIAH ; Mengyu ZHANG ; Fangfei CHEN ; Niandi TAN ; Junnan HU ; Yinglian XIAO
Journal of Neurogastroenterology and Motility 2025;31(2):218-226
Background/Aims:
Reflux symptoms frequently present in patients diagnosed with functional dyspepsia (FD). This investigation sought to elucidate the contribution of gastroesophageal reflux in the overlap relationship.
Methods:
Consecutive patients presenting with reflux symptoms and/or FD symptoms were prospectively included. Comprehensive assessments, including symptoms evaluation, endoscopy, esophageal functional examinations (high-resolution manometry and reflux monitoring), and proton pump inhibitor (PPI) treatment efficacy evaluation, were conducted in these patients.
Results:
The study enrolled 315 patients, 43.2% of which had concurrent FD symptoms and overlapping reflux symptoms. Notably, a mere 28.7% of patients in the overlap symptoms group had objective gastroesophageal reflux disease evidences (the grade of esophagitis≥ B or the acid exposure time ≥ 4.2%). Functional heartburn was demonstrated to be the main cause of overlapping reflux symptoms(55.1%). Reflux parameters analysis revealed that the reflux burden in the overlap symptoms group paralleled that of the FD symptoms group, with both registering lower levels than the reflux symptoms group (P < 0.05). Furthermore, PPI response rates were notably diminished in the overlap symptoms group (P < 0.001), even for those with objective gastroesophageal reflux disease evidences.
Conclusions
The study illuminated that overlapping reflux symptoms in FD was common. Strikingly, these symptoms primarily diverged from reflux etiology and exhibited suboptimal responses to PPI intervention. These findings challenge prevailing paradigms and accentuate the imperative for nuanced therapeutic approaches tailored to the distinctive characteristics of overlapping reflux symptoms in the context of FD.
10.Overlapping Reflux Symptoms in Functional Dyspepsia Are Mostly Unrelated to Gastroesophageal Reflux
Songfeng CHEN ; Xingyu JIA ; Qianjun ZHUANG ; Xun HOU ; Kewin T H SIAH ; Mengyu ZHANG ; Fangfei CHEN ; Niandi TAN ; Junnan HU ; Yinglian XIAO
Journal of Neurogastroenterology and Motility 2025;31(2):218-226
Background/Aims:
Reflux symptoms frequently present in patients diagnosed with functional dyspepsia (FD). This investigation sought to elucidate the contribution of gastroesophageal reflux in the overlap relationship.
Methods:
Consecutive patients presenting with reflux symptoms and/or FD symptoms were prospectively included. Comprehensive assessments, including symptoms evaluation, endoscopy, esophageal functional examinations (high-resolution manometry and reflux monitoring), and proton pump inhibitor (PPI) treatment efficacy evaluation, were conducted in these patients.
Results:
The study enrolled 315 patients, 43.2% of which had concurrent FD symptoms and overlapping reflux symptoms. Notably, a mere 28.7% of patients in the overlap symptoms group had objective gastroesophageal reflux disease evidences (the grade of esophagitis≥ B or the acid exposure time ≥ 4.2%). Functional heartburn was demonstrated to be the main cause of overlapping reflux symptoms(55.1%). Reflux parameters analysis revealed that the reflux burden in the overlap symptoms group paralleled that of the FD symptoms group, with both registering lower levels than the reflux symptoms group (P < 0.05). Furthermore, PPI response rates were notably diminished in the overlap symptoms group (P < 0.001), even for those with objective gastroesophageal reflux disease evidences.
Conclusions
The study illuminated that overlapping reflux symptoms in FD was common. Strikingly, these symptoms primarily diverged from reflux etiology and exhibited suboptimal responses to PPI intervention. These findings challenge prevailing paradigms and accentuate the imperative for nuanced therapeutic approaches tailored to the distinctive characteristics of overlapping reflux symptoms in the context of FD.