1.Development and validation of a prognostic nomogram model for patients with the lower third and abdominal oesophageal adenocarcinoma
Zhengshui XU ; Dandan LIU ; Jiantao JIANG ; Ranran KONG ; Jianzhong LI ; Yuefeng MA ; Zhenchuan MA ; Jia CHEN ; Minxia ZHU ; Shaomin LI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(02):201-207
Objective To establish an individualized nomogram model and evaluate its efficacy to provide a possible evaluation basis for the prognosis of lower third and abdominal part of oesophageal adenocarcinoma (EAC). Methods Lower third and abdominal part of EAC patients from 2010 to 2015 were chosen from the SEER Research Plus Database (17 Regs, 2022nov sub). The patients were randomly allocated to the training cohort and the internal validation cohort with a ratio of 7∶3 using bootstrap resampling. The Cox proportional hazards regression analysis was used to determine significant contributors to overall survival (OS) in EAC patients, which would be elected to construct the nomogram prediction model. C-index, calibration curve and receiver operating characteristic (ROC) curve were performed to evaluate its efficacy. Finally, the efficacy to evaluate the OS of EAC patients was compared between the nomogram prediction model and TNM staging system. Results In total, 3945 patients with lower third and abdominal part of EAC were enrolled, including 3475 males and 470 females with a median age of 65 (57-72) years. The 2761 patients were allocated to the training cohort and the remaining 1184 patients to the internal validation cohort. In the training and the internal validation cohorts, the C-index of the nomogram model was 0.705 and 0.713, respectively. Meanwhile, the calibration curve also suggested that the nomogram model had a strong capability of predicting 1-, 3-, and 5-year OS rates of EAC patients. The nomogram also had a higher efficacy than the TNM staging system in predicting 1-, 3-, and 5-year OS rates of EAC patients. Conclusion This nomogram prediction model has a high efficiency for predicting OS in the patients with lower third and abdominal part of EAC, which is higher than that of the current TNM staging system.
2.Effect of postoperative radiotherapy after complete resection in patients with stage ⅢA-N2 non-small cell lung cancer: A propensity score matching analysis
Zhengshui XU ; Minxia ZHU ; Jiantao JIANG ; Shiyuan LIU ; Jia CHEN ; Danjie ZHANG ; Jianzhong LI ; Liangzhang SUN ; Shaomin LI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(07):1006-1012
Objective To evaluate the value of postoperative radiotherapy (PORT) in patients with stage ⅢA-N2 non-small cell lung cancer who received complete resection and chemotherapy. Methods Patients with stage ⅢA-N2 non-small cell lung cancer who received complete resection and chemotherapy were chosen from the SEER Research Plus Database [17 Registries, November 2012 Submission (2000-2019)]. The patients were divided into a PORT group and a non-PORT group according to whether the PORT was used. To balance baseline characteristics between non-PORT and PORT groups, R software was used to conduct a propensity score matching (PSM) with a ratio of 1 : 1 and a matching tolerance of 0.01. Both the Cox regression analysis and Kaplan-Meier survival analysis were conducted to evaluate the value of PORT in terms of overall survival (OS) and disease-specific survival (DSS). Results In total, 2468 patients with stage ⅢA-N2 non-small cell lung cancer were enrolled, including 1078 males and 1390 females with a median age of 65 (58-71) years. There were 1336 patients in the PORT group, and 1132 patients in the non-PORT group. Cox regression analysis showed that PORT was not significantly associated with OS (multivariate analysis: HR=1.051, 95%CI 0.949-1.164, P=0.338) and DSS (multivariate analysis: HR=1.094, 95%CI 0.976-1.225, P=0.123). No statistical difference was found in the OS or DSS between non-PORT group and PORT group after PSM analysis (P>0.05). Conclusion PORT does not have a survival benefit for patients with stage ⅢA-N2 non-small cell lung cancer who received complete resection and chemotherapy.
3.Current status and trends in the modernization of pulse diagnosis research: a bibliometric analysis based on CiteSpace and VOSviewer
ZHANG Fenfen ; ZHU Guoshuang ; CHEN Jiali ; ZHANG Jianhong ; DONG Sihui ; CHENG Shaomin
Digital Chinese Medicine 2023;6(4):405-415
Objective:
To provide ideas for the modernization of pulse diagnosis in traditional Chinese medicine (TCM) by comparing and analyzing the current status and trends of modern research on pulse diagnosis in China and abroad, using bibliometric and visualization software.
Methods:
Modern research literature on pulse diagnosis was searched in China National Knowledge Infrastructure (CNKI) database from the foundation to May 31, 2023, and in Science Citation Index Expanded (SCIE) from January 1, 2003, to May 31, 2023. After further screening, Microsoft Excel 2019 was used for statistical analysis of publication volume, and CiteSpace (6.1.R6) and VOSviewer (1.6.20) softwares were employed for visual analysis of journals, countries/regions, authors, institutions, keywords, etc.
Results:
This study included a total of 764 articles in Chinese and 1 459 articles in English. The publication trend of pulse diagnosis research in SCIE database showed an overall fluctuating upward trend, while it exhibited a fluctuating downward trend after 2007 in CNKI database. The volume of English research literature has consistently exceeded that of Chinese literature since 2009. Publications on pulse diagnosis research involved 74 countries/regions. The related journals covered various disciplinary fields, including mathematics, physics, chemistry, and computer science. The most prolific author in CNKI database was WANG Yiqin (Shanghai University of Traditional Chinese Medicine), while the highest number of publications was attributed to ZHANG David (The Hong Kong Polytechnic University) in SCIE database. High-volume institutions in pulse diagnosis research in China and abroad were predominantly TCM research institutions. However, comprehensive universities and other research institutions also made noteworthy contributions. In recent years, hot topics in the modernization of pulse diagnosis research in China included pulse waves, sensors, and artificial intelligence. Foreign research focused on pulse diagnosis systems, sensors, pulse feature extraction, pulse signal analysis, pulse detection, and efficiency of use.
Conclusion
Chinese scholars have shown notable participation and emphasis in the modernization research of pulse diagnosis, involving a wide range of disciplinary fields and indicating a characteristic of multidisciplinary cross-fusion development. The hotspots andtrends in the modernization of pulse diagnosis research primarily concentrate on the study of pulse condition and signal acquisition, the integration, development, and optimization of various algorithms with pulse diagnosis equipment, and the practical application research of existing objectified outcomes of pulse diagnosis.
4.Analysis of influencing factors of frailty in elderly patients with coronary heart disease and comparative study of screening value of related scales
Xuelian ZHOU ; Hongwei YU ; Xiao MIAO ; Shaomin WANG ; Xiaobo LI ; Liqun ZHU ; Songmei CAO
Clinical Medicine of China 2022;38(5):429-434
Objective:To explore the influencing factors of frailty in elderly patients with coronary heart disease (CHD), and to compare and analyze the value of different frailty scales in screening elderly patients with coronary heart disease.Methods:Using cross-sectional research methods,elderly patients with coronary heart disease from November 2019 to January 2020 in the Department of Cardiology of a tertiary hospital in Zhenjiang City were selected as the research objects. The frailty status of the patients was evaluated by the frailty index scale, and the patients were divided into frailty group (54 cases) and non-frailty group (149 cases) according to the evaluation results. F-test was used for the comparison between measurement data groups conforming to normal distribution, and χ 2 test or exact probability method was used for the comparison of counting data. Multivariate Logistic regression was used to analyze the main influencing factors of elderly patients with coronary heart disease. The correlation and consistency of clinical frail scale, frail scale and frail index were compared and analyzed were analyzed by Spearman correlation and Kappa test. ROC curve was used to analyze the sensitivity, specificity and the area under the working characteristic curve. Results:The age ((78.96±6.78) years), the percentage of monocytes >10% (31.48% (17/54)), the specific index for coronary heart disease ≥4 points (57.41% (31/54)), Barthel index <100 points (85.19% (46/54)), the mini nutritional assessment scale <24 points (66.67% (36/54)) of the patients in the frail group was higher than these in non-frail group ((73.94±5.89) years old, 12.08%(18/149), 7.38%(11/149), 22.15%(33/149), 14.77%(22/149)), the differences were statistically significant (statistical values were t=5.15, χ 2=10.46, χ 2=60.45, χ 2=66.26, χ 2=52.32; P values were <0.001,0.001,<0.001,<0.001,<0.001,respectively). The results of multivariate Logistic regression analysis showed that the percentage of monocytes >10% ( OR=5.927, 95% CI:1.854-18.947), the mini nutritional assessment scale <24 ( OR=7.026, 95% CI:2.660-18.555),the specific index for coronary heart disease ≥4 points ( OR=3.333, 95% CI:1.889-26.850,) and Barthel index <100 points ( OR=15.649, 95% CI:5.403-45.321) are the main effects of frailty in elderly patients with coronary heart disease factors ( P values were 0.003,<0.001,<0.001, and <0.001, respectively). Taking the frailty index as the gold standard, the sensitivity of the clinical frailty scale and FRAIL scale were 85.19% and 85.19%, respectively, and the specificity was 90.60% and 94.63%, respectively, with no significant difference (χ 2 values were 0.000 and 1.767; all P>0.05). The Kappa of the clinical frailty scale scale was <0.75, while the Kappa of the FRAIL scale was >0.75. The consistency of the frail scale with the gold standard was better than that of the clinical frailty scale scale. Conclusion:The percentage of monocytes, the specific index for coronary heart disease, the mini nutritional assessment scale and Barthel index are the main factors affecting the frailty of elderly patients with coronary heart disease. Taking the frailty index score as the standard, the consistency between the screening results of frail scale and frailty index score is better than that of clinical frailty scale scale, which has clinical application value.
5.Long-term Survivals, Toxicities and the Role of Chemotherapy in Early-Stage Nasopharyngeal Carcinoma Patients Treated with Intensity-Modulated Radiation Therapy: A Retrospective Study with 15-Year Follow-up
Lin WANG ; Jingjing MIAO ; Huageng HUANG ; Boyu CHEN ; Xiao XIAO ; Manyi ZHU ; Yingshan LIANG ; Weiwei XIAO ; Shaomin HUANG ; Yinglin PENG ; Xiaowu DENG ; Xing LV ; Weixiong XIA ; Yanqun XIANG ; Xiang GUO ; Fei HAN ; Chong ZHAO
Cancer Research and Treatment 2022;54(1):118-129
Purpose:
This study was aimed to investigate long-term survivals and toxicities of early-stage nasopharyngeal carcinoma (NPC) in endemic area, evaluating the role of chemotherapy in stage II patients.
Materials and Methods:
Totally 187 patients with newly diagnosed NPC and restaged American Joint Committee on Cancer/ International Union Against Cancer 8th T1-2N0-1M0 were retrospectively recruited. All received intensity-modulated radiotherapy (IMRT)±chemotherapy (CT) from 2001 to 2010.
Results:
With 15.7-year median follow-up, 10-year locoregional recurrence-free survival, distant metastasis-free survival (DMFS), disease-specific survival (DSS), and overall survival (OS) were 93.3%, 93.5%, 92.9% and 88.2%, respectively. Multivariable analyses showed cervical lymph nodes positive and pre-treatment prognostic nutritional index ≥ 52.0 could independently predict DMFS (p=0.036 and p=0.011), DSS (p=0.014 and p=0.026), and OS (p=0.002 and p < 0.001); Charlson comorbidity index < 3 points could predict DSS (p=0.011); age > 45 years (p=0.002) and pre-treatment lactate dehydrogenase ≥ 240 U/L (p < 0.001) predicted OS. No grade 4 late toxicity happened; grade 3 late toxicities included subcutaneous fibrosis (4.3%), deafness or otitis (4.8%), skin dystrophy (2.1%), and xerostomia (1.1%). No differences on survivals were shown between IMRT+CT vs. IMRT alone in stage II patients, even in T2N1M0 (p > 0.05). Unsurprising, patients in IMRT+CT had more acute gastrointestinal reaction, myelosuppression, mucositis, late ear toxicity, and cranial nerve injury (all p < 0.05) than IMRT alone group.
Conclusion
Superior tumor control and satisfying long-term outcomes could be achieved with IMRT in early-stage NPC with mild late toxicities. As CT would bring more toxicities, it should be carefully performed to stage II patients.
6.Study on knowledge, attitudes and practices of pulse oximetry among pediatric healthcare providers in China and their influencing factors
Fengxia XUE ; Yuejie ZHENG ; Adong SHEN ; Hanmin LIU ; Xing CHEN ; Lili ZHONG ; Guangmin NONG ; Xin SUN ; Gen LU ; Shenggang DING ; Yuanxun FANG ; Jiahua PAN ; Zhiying HAN ; Yun SUN ; Qiang CHEN ; Yi JIANG ; Xiaoping ZHU ; Suping TANG ; Xiufang WANG ; Changshan LIU ; Shaomin REN ; Zhimin CHEN ; Deyu ZHAO ; Yong YIN ; Rongfang ZHANG ; Ming LI ; Yunxiao SHANG ; Yaping MU ; Shuhua AN ; Yangzom YESHE ; Peiru XU ; Yan XING ; Baoping XU ; Jing ZHAO ; Shi CHEN ; Wei XIANG ; Lihong LI ; Enmei LIU ; Yuxin SONG ; Yonghong YANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2022;37(23):1807-1812
Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.
7.An empirical study on the evaluation system of clinical nurse training in hospitals of traditional Chinese and Western medicine based on post competency
Shaomin SONG ; Xiaorong LIU ; Fengmei WANG ; Wenwen LI ; Leilei ZHU ; Yanyang WANG ; Chao LIU ; Danyu ZHANG
Chinese Journal of Medical Education Research 2021;20(10):1206-1210
Objective:To evaluate the discrimination, reliability and validity of the evaluation system of clinical nurse training based on post competency in hospitals of traditional Chinese and Western medicine.Methods:From August 2018 to January 2019, 271 clinical nurses from a three-A hospital were selected by convenient sampling method. The competency of clinical nurses was assessed on the spot by case tracking method. The discrimination, reliability and validity of the evaluation system were tested by item analysis, Cronbach's α coefficient and confirmatory factor analysis.Results:The evaluation system had good discrimination, reliability and validity. Among the four scales of the evaluation system, there were significant differences in the high score and the low score of all items ( P < 0.05). The Cronbach's α coefficient of each dimension of the four scales was 0.769-0.898. Four structural equation model diagrams were established, the AVE (average variance extracted) of each dimension was 0.51-0.74, factor load was 0.53-0.93, C.R. (composite reliability) was 0.79-0.91, and the discrimination validity was up to the standard. Conclusion:This system provides a reference for the establishment of scientific, objective, measurable and homogeneous clinical nurse training evaluation tools.
8. Construction of competency model for evaluating clinical nurses in hospital of Integrated Traditional Chinese and Western Medicine
Fengmei WANG ; Xiaorong LIU ; Shaomin SONG ; Hua CHEN ; Leilei ZHU ; Yanyang WANG ; Ying DA ; Chao LIU ; Danyu ZHANG
Chinese Journal of Medical Education Research 2019;18(9):946-951
Objective:
To construct the objective and quantifiable model for evaluating clinical nurses' competency in hospital of Integrated Traditional Chinese and Western Medicine.
Methods:
From December 2016 to August 2017, preliminary formulation of evaluation indicators was constructed through semi-structured interviews, combined with literature analysis. 21 experts from five hospitals of Traditional Chinese Medicine and medical universities were selected using Delphi method for performing two rounds of consultations and weight assignment of indexes. Data was logged and processed using SPSS 16.0.
Results:
The preliminary system of the competency model included four items of Level one and 20 items of Level two. The weight coefficients of the first level indicators were 0.260 9, 0.259 8, 0.257 0 and 0.222 4. The positive coefficients from consulations of experts were 100.00% and 95.24%, respectively. Authority coefficient was 0.88. The coefficients of variation were 0.092 3 to 0.162 8 and 0.043 0 to 0.182 7, respectively.
Conclusions
This model can provide guidance for the training objective of nurses' competency and serve as an instrument for hospital managers to evaluate nurses in hospital of Integrated Traditional Chinese and Western Medicine.
9.Early intervention for severe stenosis of non-infarct related artery in patients with acute ST-segment elevation myocardial infarction and multi-vessel disease
Guizhou MA ; Ronghe XU ; Ping CHEN ; Zhixiong CAI ; Zhidan ZHU ; Shaomin CHEN ; Jianqiang HUANG ; Ying WANG ; Wenliang WANG
The Journal of Practical Medicine 2018;34(9):1508-1512
Objective To explore the clinical feasibility and safety of early intervention for severe stenosis of non-infarct related artery(non-IRA)in patients with acute ST-segment elevation myocardial infarction(STEMI) and multi-vessel disease(MVD)after successful primary percutaneous coronary intervention(PCI)for infarct-asso-ciated artery(IRA). Methods From May 1st,2011 to December 30th,2016,165 patients with STEMI and MVD were enrolled in our study. After the completion of primary PCI in IRA ,75 patients still in the hospital agreed to undergo a second staged PCI in severe stenosis of non-infarct arteries. We analyzed the in-hospital adverse events ,the length of hospital stay and clinical outcomes during the follow-up in the study population. Results There was no significant difference in the incidence of adverse events between the two groups during hos-pitalization. However,compared to patients treated with the IRA-only PCI,those treated with early intervention for severe stenosis of non-IRA was associated with greater benefits for clinical outcomes(including rehospitalization for heart failure,rehospitalization for ACS,recurrent angina pectoris,necessity for reintervention)during the follow-up except for the all-cause mortality. Conclusion Early intervention for severe stenosis of non-IRA is a feasible and safe procedure in patients with acute STEMI and MVD after successful primary PCI.
10.Effects of Taohechengqitang joint danazol on CA125 and gonadal hormone in endometriosis
Dehong GAO ; Shaomin DU ; Li ZHU ; Fengyun WANG ; Haiyan WANG
Chinese Journal of Biochemical Pharmaceutics 2016;36(4):115-117
Objective To observe the effects of Taohechengqitang combined with danazol on CA125 and gonadal hormone in the treatment of patients with endometriosis.Methods 77 cases from July 2014 to January 2015 in department of obstetrics and gynecology of Daqing Longnan hospital were selected and divided into observation group of 40 cases and control group of 37 cases according to double-blind randomized.The observation group were treated with Taohechengqitang joint danazol treatment, and the control group were treated with danazol alone.The estradiol ( E2 ) , progestogen (P), cancer antigen 125 (CA125), thromboxane B2 (TXB2), endometrial cysts size and dysmenorrheal score pre-and post-treatment between two groups were compared.Results The contents of E2 and P post-treatment in observation group were lower than those in control group (P<0.05).The serum TXB2 and CA125 levels post-treatment in observation group were lower than those in control group (P<0.05).The endometrial cysts size and dysmenorrheal score post-treatment in observation group were lower than those in control group (P<0.05).The total efficacy in observation group was higher than that in control group (P<0.05).Conclusion Taohechengqitang combined with Danazol could reduce the CA125, E2 and P levels, relieve symptoms of dysmenorrhea and reduce the cyst volume, whose efficacy is exact.

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