1.The Reform of Japan ’ s Long-term Care Insurance Policy and the References
Lülin ZHOU ; Xiaotian ZHANG ; Wada YASUNORI
Chinese Health Economics 2013;(12):112-116
Through the reforming of public long-term care insurance, Japan has solved difficulties on the elderly care and provided positive experiences for the establishment of long-term care in China. The background , history and contents of long-term care insurance system are introduced. The establishment effects of the system are analyzed based on comparative method , reasonable suggestions of establishing long-term care insurance system in China are proposed combined with the national condition.
2.Maternal intrarenal artery Doppler velocimetry in pregnancy-induced hypertension
Yuqing ZHOU ; Juehua ZHANG ; Xiaotian LI
Chinese Journal of Ultrasonography 1999;8(6):333-335
Objective To evaluate the value of Doppler indices of intrarenal artery (IRA) in clinicobservation in pregnancy induced hypertension(PIH).MethodsForty-six cases of PIH underwent Doppler measurment of PI,RI in IRA,and 186 normotensive pregnant women were measured as control.Results ①There was a larger increase of IRAPI and IRARI in PIH than in normal prgnant(P<0.001),and IRAPI is significantly higher in moderate and severe PIHs than in mild PIH(P<0.001),②IRAPI,IRARI correlate positively with classification of PIH(P<0.001),proteinuria(P<0.001)and MAP(P<0.05),and IRAPI is the best one.Conclusions It is of a certain significance to the clinical observation and treatment of PIH by using color Doppler to examine the indices of IRA in the pregnant women with PIH.
3.Investigation on prevention and treatment status of VTE in pregnant women of general hospitals and specialized hospitals in China
Yutong CUI ; Xiaotian LI ; Qiongjie ZHOU
Chinese Journal of Obstetrics and Gynecology 2021;56(5):310-316
Objective:To investigate the prevention and treatment status of venous thromboembolism (VTE) of pregnant women in general hospitals and specialized hospitals in China.Methods:This study was a cross-sectional survey about VTE prevention and treatment in 112 hospitals across China from January 1st to December 31st, 2019, including general information, resource accessibility, hospital system and strategy. According to the characteristics, the hospitals were divided into general hospital group (70 hospitals) and specialized hospital group (42 hospitals). The basic information, VTE diagnosis and treatment resources, prevention systems and the preference of the VTE risk assessment form of the two groups were compared. Logistic regression was used to analyze the proportion of VTE incidence and related factors in the two groups of hospitals.Results:(1) The median annual delivery volume of the general hospital group was significantly lower than that of the specialized hospital group (3 428 vs 9 969 cases, P<0.01), the diagnostic accessibility of CT pulmonary angiography (CTPA) was significantly higher than that of the specialized hospital [92.9% (65/70) vs 59.5% (25/42), P<0.01], and the proportion of obstetric VTE risk assessment was significantly higher than that of the specialized hospital group [85.7% (60/70) vs 66.7% (28/42), P=0.017]. (2) Among the 88 hospitals using the VTE risk assessment sheet, the utilization rate of the evaluation sheet recommended by the obstetric VTE guideline in specialized hospitals (78.6%, 22/28) was higher than that of general hospitals (48.3%, 29/60), and the difference was statistically significant ( P=0.007). (3) The proportion of VTE incidence in general hospital group was 0.126% (360/286 517), and the proportion of VTE incidence in specialized hospital group was 0.032% (154/484 111). Logistic regression analysis showed that the OR value of the specialized hospital group was 0.253 (95% CI: 0.209-0.305) and the difference was statistically significant ( P<0.01) compared with the general hospital group. After adjusting the hospital level, B-ultrasonography and CTPA accessibility, whether to establish a risk assessment and obstetric VTE system, the proportion of VTE incidence in specialized hospitals was still lower than that in general hospitals ( OR=0.307, 95% CI: 0.251-0.376, P<0.01). Conclusions:General hospitals have higher access to resources for diagnosing VTE than specialized hospitals, and the VTE evaluation system is better implemented. The utilization rate of the obstetric VTE guidelines in specialized hospitals is higher than that of general hospitals.
4.Feasibility study of intra-utero surgical repair of fetal lamb
Huan XU ; Xiaotian LI ; Mingming PAN ; Guangxing ZHOU
Chinese Journal of Obstetrics and Gynecology 2001;0(01):-
Objective To evaluate the feasibility of intra-utero fetal lamb surgical repair. Methods Six twin lambs underwent surgery intra-utero at 112 days of gestation (term 140~160 days). After maternal laparotomy and Hysterotomy, fetal lamb′s toe was excised or its cleft lip was repaired in one of twin. Results At 30 to 32 days post operation,five lambs were spontamcously delivered and the other was cesarean delivery to full term gestation. Fetal wounds healed without inflammation and scar formation. Conclusions The methods of fetal lamb intro utero surgical repair is feasible.
5.Effect analysis of clinical pathway teaching method in respiratory medicine
Haijing WANG ; Heping YANG ; Xiangdong ZHOU ; Xiaotian DAI
Chinese Journal of Medical Education Research 2014;(8):805-808
Objective To study the application effect of clinical pathway teaching in respiratory medicine. Methods Seventy clinical medical students of our department during 2007 to 2009 were randomly divided into two groups. The control group (35 students) was treated by traditional teaching ways, while the experimental group(35 students) was treated by clinical pathway teaching ways, with 5 to 6 students forming a small group. Teachers provided one copy of the CP version to each person in advance. Then progressive questions and discussions were conducted according to the diagnosis, dif-ferential diagnosis and treatment of CP. After its implementation for a certain time, students were co-mprehensively assessed by the practice examination and questionnaire and the statistical analysis was performed by using SPSS 17.0 version statistics software. Results The experimental group's total aver-age score was (90.00±4.00) points, while the control group's total average score was (76.00±7.20) points. There was significant difference between the two groups(P=0.001). The effect of these two kinds of teaching was evaluated and compared in stimulating interest in learning (P=0.002), improving the analytical ability(P=0.004),improving self-study ability(P=0.001), deepening the under-standing of the basic concepts(P=0.112), improving the innovation ability (P=0.005), improving the efficiency of learning(P=0.034), improving clinical comprehensive ability(P=0.016), and improving the ability of language expression(P=0.000), showing that teaching method of clinical pathway could significantly improve clinical teaching effect, and there was statistically significant difference between them. Conclusion Clinical pathway teaching has obvious advantages in cultivating students' diagnostic thinking and clin-ical ability to solve practical problems, and therefore it has better clinical teaching effect than the tra-ditional teaching method.
6.Effects of Recombinant Human IGF-1 on Kidney in Diabetic Rats
Kangmei ZHOU ; Xiaotian LI ; Yiliang ZHUANG ; Guangxing ZHOU ; Guoqiang WU ; Linlin SHEN ; Youming YANG
Fudan University Journal of Medical Sciences 2000;27(3):197-200,221
PurposeTo observe the effects of rhIGF-1 on kidney in diabetic rats. MethodsUsing biochemistry, radioimmunoassay, molecular biology (RT-PCR). Results(1) 24 h UAER,24 h uriary volume in rhIGF-1 group is lower than that of diabetic control group; (2) The level of sertan IGF-1 ,kidney IGF-1 and IGF-1 mRNA in diabetic control group is lower than that of normal control group;The level of serum IGF-1 in rhIGF-1 group is higher than that of diabetic control group;no differences were found in the levels of kidney IGF-1 and kidney IGF-1 mRNA between diabetic control group and rhIGF-1 group; (3) The level of serum GH in diabetic control group is higher than that of normal control group; The level of serum GH in rhIGF-1 group is lower than that of diabetic control group; (4) rhIGF-1 might have some protective effects on diabetic nephropathy via electron microscope. ConclusionsrhIGF-1 doesn't increase the damage of diabetic kidney tissue.
7.Chromosomal abnormalities and adverse pregnancy outcome with maternal serum second trimester triple screening test for fetal Down syndrome in 4 860 Chinese women
Yanping XIA ; Mingwei ZHU ; Xiaotian LI ; Heping ZHOU ; Jing WANG ; Juxiang LV ; Nanbert ZHONG
Journal of Peking University(Health Sciences) 2006;38(1):49-52
Objective:To investigate the efficiency of maternal serum triple screening for the genetic abnormality in second-trimester and the morbidity of adverse pregnancy outcome in false positive results of the test. Methods: A total of 4 680 pregnant women with singleton pregnancies assigned in Obs & Gyn Hospital, Fudan University, underwent triple screening test (alpha fetoprotein, AFP; human chorionic gonadotropin, HCG and unconjugated estriol, uE3) by fluorescence enzyme immunoassay between 2003 and 2005. The valid MoM (Multiples of Median) value of mid-trimester serum AFP, uE3, and hCG and risk assessments was provided by Beckman Coulter Co. When applied in the prenatal Down syndrome screening service. The study compares the incidence of chromosomal abnormalities with Down syndrome in screen positive women and compares to the MoM value established in the literature. The risks of having a fetus with congenital abnormalities or of developing obstetric complications in the screen positive women with their matched controls.Results:The MoM values for the triple tests of our study are similar to established values of literature. Only 51.01% women with pregnancies agree to receive screening. Amniocentesis utilization rate was 55.12% in the screen-positive pregnancies. The false positive rate was 6.89% and the median of maternal age of the women was 28.13 (range 19 to 49) years old. Chromosomal abnormalities were identified in 21 pregnancies, including 9 cases of trisomy 21.The detection rate was 77.77%. Pregnancies with positive screening results had a significantly higher risk of adverse outcomes than those with negative results (P< 0.05). Whereas there was no difference in the incidences of fetal congenital appearance or skeleton abnormality. Conclusion: Adjusting MoM values of local unaffected populations is limited to increasing the detection rate. Because chromosomal defects have variable exhibitions, amniocentesis utilization is still a choice for screen-positive pregnancies. Screen-positive pregnancies had increased risk of chromosomal abnormalities.
8.Determination of active metabolites of cytosine arabinoside in HL-60 cells
Jinqing TANG ; Xiaotian XIE ; Wei LI ; Xiaohong QIAO ; Wei SHI ; Xiaoxun ZHOU ; Yuexia SHAO
Journal of Clinical Pediatrics 2013;(6):522-525
10.3969/j.issn.1000-3606.2013.06.007
9.Prognostic significance of preoperative peripheral blood neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in patients with ovarian cancer
Liwei ZHANG ; Huiying PAN ; Xiaotian YAO ; Tianqin WANG ; Xiaoxin ZHOU ; Yu WANG
Journal of Shanghai Jiaotong University(Medical Science) 2017;37(5):627-631
Objective · To explored the correlation of preoperative peripheral blood neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) with clinical characteristics and prognosis of ovarian cancer. Methods · Patients' clinicopathological data of 127 cases of benign tumors and 286 cases of malignant tumor were collected, and the correlation between the level NLR and PLR in patients with ovarian cancer clinical pathology indicators and overall survival was analyzed. Results · preoperative NLR and PLR levels in patients with ovarian cancer were higher than those in benign tumors(P=0.000). The optimal cut-off point of NLR and PLR were 3.0 and 151. There was statistical significant difference between the high level of NLR group (NLR ≥ 3) and the low level of NLR group in pathological type, FIGO staging, lymph node metastasis, CA125 level and the amount of ascites (P<0.05). There was statistical significant difference between the high level of PLR group (PLR ≥ 151) and the low level of PLR group in FIGO stage,transfer status, CA125 level and quantity of ascites (P<0.05). The median survival time for NLR/PLR in the high level group were 33 and 33.5 months lower than that ofthe corresponding group of 44.5 and 49.5 months (P=0.044, P=0.000). Multivariate Cox regression analysis showed that PLR ≥ 151 were independent risk factors affectOS in ovarian cancer patients (HR=1.936, 95% CI=1.013-3.698, P=0.045). Conclusion · The elevated blood preoperative PLR indicates poor prognosis of ovarian cancer patients. Preoperative PLR may serve as an important independent prognostic factor for ovarian cancer patients.
10.Mechanism of L-asparaginase resistance in chiIdren with acute IymphobIastic Ieukemia
Chinese Journal of Applied Clinical Pediatrics 2019;34(3):166-169
F-asparaginask(F-LSP)is onk of thk cke agknts in thk long-tkrm chkmothkrape of lemphoid malignanciks in childrkn with acutk lemphoblastic lkuckmia(LFF)and non Hodgcin's lemphoma(NHF). If F-LSP rksistanck occurs in patiknts,it is highle suggkstivk of poor prognosis. Thkrkfork,thk mkchanism of F-LSP rksistanck is a major stude in thk fikld of diagnosis and trkatmknt of lkuckmia in childrkn. Ovkr thk ekars,rklatkd studiks havk shown that thk bask lkvkl of asparagink senthktask in tumor cklls,bonk marrow hkmatopoiktic support cklls,somk advkrsk mkta-bolic changks aftkr F-LSP chkmothkrape,and thk F-LSP silkncing inactivation induckd be sklf nkutralizing antibode can lkad to F-LSP rksistanck. In this papkr,according to thk litkraturk rklatkd rkports in rkcknt ekars,providk rkfkrknck for domkstic collkaguks,in ordkr to carre out thk rklkvant basic and clinical rkskarch,to providk thkorktical basis for thk rkalization of individualization of chkmothkrape.