1.Application of nomogram in the risk assessment of postoperative recurrence of gastrointestinal stromal tumor
Chinese Journal of Digestive Surgery 2015;14(5):438-440
Gastrointestinal stromal tumor (GIST) is originated from the gastrointestinal mesenchymal stem cells,composed of undifferentiated or pluripotent spindle and epithelioid cells,often occurs in the whole range of the gastrointestinal tract and occasionally in the omentum,mesenterium and other areas which are outside of digestive tract.The treatment is difficult due to broad-spectrum biological behaviour of GIST,while surgery may be the only potential method for curing GIST with a risk of recurrence.Currently,there is still not an evaluative standard in the choice of surgery or imatinib therapy as well as the risk of recurrence.The F/NIH consensus,Armed Forces Institute of Pathology (AFIP) standard,modified standard of National Institutes of Health(NIH) and consensus of mathematical model which have been widely used cannot accurately evaluate risk probability of recurrence,so the current researches have focused on the postoperative risk assessment for GIST.In recent years,the nomogram model has been applied to predict the risk of GIST recurrence by some scholars,with the better outcomes.
2.The application and exploration of PBL teaching method in the teaching of gynecology and obstetrics
Xiaowen SHEN ; Tian CHEN ; Haiyan WANG
Chinese Journal of Medical Education Research 2006;0(12):-
The PBL Teaching Method has implemented in the department of gynecology and obstetrics of Fudan University since 2004.This new method cultivates the students'ability to ask and answer the questions to collaborate,to comiderate problems conpletely and the ability to consult information and solve problems quickly.Teachers and department should improve the teaching and manage level.
3.Peasants as beneficiaries of the new rural cooperative medical system (NRCM) in Beijing
Guihua MA ; Wenhu CHANG ; Hui TIAN ; Shengjin ZOU ; Xiaowen CHEN
Chinese Journal of Hospital Administration 2010;26(2):104-106
Objective To find out whether the benefits entitled to peasants have increased since NRCM is in place in Beijing, and to analyze the extent of such benefit increase if any. Methods The first is to calculate changes to the reimbursement ratio of hospitalization charges for the peasants covered by NRCM; the second is to calculate the role played by NRCM for alleviating the catastrophic health expenditure of peasants. Results The reimbursement ratio of hospitalization charges for peasants covered by NRCM rose from 32.4% in 2004 to 45.4% in 2007. Survey data from districts and counties in the sampling test indicate that NRCM has gained an ever growing power in alleviating the catastrophic expenditure of peasants. Conclusion Recent years have witnessed a marked growth in medical charges, peasants' income, and peasants' demand for medical services. Against such a background, NRCM can still sharply downsize their catastrophic health expenditure, and its role keeps intensifying. This proves that the fund raising speed of NRCM has greatly outpaced the growth of medical charges and peasants' demand for medical services, and NRCM is playing a more effective role in alleviating the peasants from poverty caused by diseases.
4.Clinical study on the relationship between obstructive sleep apnea hypopnea syndrome and circadian rhythm ;of onset in acute ST -segment elevation myocardial infarction
Weiping CHEN ; Song ZHU ; Dongbo TIAN ; Jinghua XIAO ; Xiaowen LIAO ; Yifei ZHANG ; Peng WANG
Chinese Journal of Primary Medicine and Pharmacy 2017;24(3):321-325
Objective To investigate the influence of severity of obstructive sleep apnea hypopnea syndrome (OSAHS)on acute ST -segment elevation myocardial infarction (STEMI).Methods 86 STEMI patients were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).Clinical data about biochemical index,cardiac function index and the duration of STEMI onset were compared between OSAHS group and control group.Logistic statistic analysis was used to investigate the risk factors that influ-ence the circadian rhythm of onset in STEMI.Results A total of 86 patients met the inclusion criteria,they were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).The incidence rate of STEMI onset during 0600 am~1 159 am was significantly higher in OSAHS group compared to control group(20.8% vs.44.7%,χ2 =5.626,P=0.018).This variation was weaken in mild OSAHS group compared to moderate-severe OSAHS group(20.8% vs.31.3%,χ2 =0.726,P=0.394;20.8% vs.54.5%,χ2 =7.956,P=0.005).Multivariate logistic analysis showed that the severity of OSAHS was a risk factor to the STEMI onset during 0600 am~1159 am(OR=2.458,95%CI 1.110~5.439,P=0.027).Conclusion The severity of OSAHS significantly increases the STEMI onset during 0600 am~1 159 am.
5.Application value of cruciform anastomosis in the laparoscopic radical resection of colon cancer
Xiaobo LIANG ; Dongbo LIU ; Liping WANG ; Zhenhua WANG ; Guolong MA ; Yi WANG ; Xiaowen TIAN
Chinese Journal of Digestive Surgery 2016;15(8):836-839
Objective To evaluate the safety and feasibility of cruciform anastomosis in the laparoscopic radical resection of colon cancer.Methods The retrospective descriptive study was adopted.The clinicopathologic data of 9 patients with colon cancer who were admitted to the Shanxi Provincial Caner Hospital between December 2011 to October 2013 were collected.After the laparoscopic free colon and dissection of lymph nodes,the proximal and distal ends of the colon tumor were cut off using an ENDO-GIA,cutting one small incision on the both side of stump,and ENDO-GIA was put into the incision to staple the mesentery of colonic wall,finally,the beak-like common incision was closed by ENDO-GIA and digestive tract construction was conducted.Observation indices:(1)operative indices:operation time,time of cruciform colon anastomosis,volume of intraoperative blood loss,conversion to open surgery.(2)Tumor indices:number of lymph nodes dissected,distance to resection margin,R resection.(3)Surgical complications:anastomotic stoma incompetence,anastomotic leakage,anastomotic stenosis,twisting of bowel,wound liquefaction infection.(4)Postoperative recovery time:time for initial out-of-bed activity,time to anal exsufflation,time for fluid diet intake,duration of postoperative hospital stay.(5)Follow-up situations:follow-up using outpatient examination was conducted up to April 2014.Karnofsky performance status(KPS)score was used to evaluate the health conditions and tumor recurrence of anastomotic stoma and colonic cavity stenosis were detected by fibercoloscope.Measurement data with normal distribution were presented as x±s.Results(1)Operative indices:9 patients received successful total laparoscopic resection of colon cancer+D3 lymph node dissection+cruciform anastomosis,without conversion to open surgery.Operation time,time of cruciform colon anastomosis and volume of intraoperative blood loss were respectively(140±50)minutes,(43±26)minutes and(62±56)mL.(2)Tumor indices:the number of lymph nodes dissected was 17±6 percase.The distance to resection margin was more than 8 cm,and pathological findings showed no residual cancer.(3)Surgical complications:9 patients had no postoperative complications.(4)Postoperative recovery time:time for initial out-of-bed activity,time to anal exsufflation,time for fluid diet intake and duration of hospital stay were respectively(1.8±0.9)days,(2.4±1.2)days,(3.6±1.7)days and(9.6±2.5)days.All the patients were discharged from hospital at postoperative day 12,without the occurrence of readmission within postoperative day 30.(5)Follow-up situations:all the patients were followed up by outpatient examination at postoperative month 6,with KPS score≥90 and without the occurrence of tumor recurrence of anastomotic stoma and colonic cavity stenosis.Conclusion Cruciform anastomosis in the laparoscopic radical resection of colon cancer is safe and feasible.
6.Study of acute lymphoblastic leukemia and acute myeloid leukemia gene mutation in children
Xin TIAN ; Yali WANG ; Jingpei CHEN ; Xiaowen LIU ; Jing SUN ; Chunhui YANG
Chinese Journal of Applied Clinical Pediatrics 2017;32(3):172-176
Acute leukemia is the most common malignant tumor in children in our country.Its pathogenesis includes transformation of proto oncogene,tumor suppressor gene distortion,inhibition of apoptosis etc..Under the action of carcinogenic factors,chromosome mutation,deletion,rearrangement or gene amplification can lead to the structural variation of proto oncogenes and tumor suppressor genes,resulting in a new fusion gene.Some of these genes are tran-scription factors regulating cell proliferation,differentiation,aging and death,when the gene is mutated,directly affect the downstream signaling pathways,leading to cell proliferation,apoptosis and enhanced (or)differentiation disorders, leading to leukemia.In recent years,with the development of gene sequencing technology,more and more leukemia prognostic genes have been displayed in public view and applied in clinical treatment and prognosis,relapse,etc..
7.Effect of hyponatremia on complications and prognosis in patients with acute exacerbation of chronic obstruc-tive pulmonary disease
Jinghua XIAO ; Dongbo TIAN ; Zisheng CHEN ; Weiping CHEN ; Xiaowen LIAO ; Yifei ZHANG
Chinese Journal of Primary Medicine and Pharmacy 2017;24(6):916-919
Objective To observe the complications and mortality of hyponatremia in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods The patients with acute exacerbation of chronic obstructive pulmonary disease were selected and divided into non -hyponatremia group(252 cases)and hyponatremia group(65 cases).The differences in the general status,serum ions,blood gas,APACHE Ⅱ score,complications dur-ing the hospitalization,using of ventilator and mortality between the two groups were compared,and drew the receiver operating characteristic(ROC)curve,to acquire higher serum sodium cut -off values.Results In the hyponatremia group,the body weight was (68.3 ±14.4)kg,BMI was (25.5 ±4.9)kg/m2 ,those in the non -hyponatremia group were (74.9 ±15.9)kg and (28.2 ±5.3)kg/m2 respectively,there were statistically significant differences(t =2.009,8.494,all P <0.05).The incidence rate of pneumonia in the hyponatremia group was 23.1%,which was higher than 13.1% in the non -hyponatremia group(χ2 =4.007,P =0.045).The hospital days of the hyponatremia group was (13.1 ±8.9)d,which was longer than (7.8 ±4.9)d of the non -hyponatremia group(t =15.638,P =0.000).The invasive ventilation days of the hyponatremia group was (1.1 ±0.4)d,which was longer than (0.9 ± 0.1)d of the non -hyponatremia group(t =2.885,P =0.004).The non invasive ventilation days of the hyponatremia group was (3.1 ±0.8)d,which was longer than (0.8 ±0.3)d of the non -hyponatremia group (t =2.984,P =0.003).The hospital mortality rate of the hyponatremia group was 12.3%,which was higher than 3.1% of the non -hyponatremia group(χ2 =7.189,P =0.007).The 90 -day mortality rate of the hyponatremia group was 29.2%, which was higher than 15.1% of the non -hyponatremia group(χ2 =7.017,P =0.008).When the serum sodium cut-off value was 128.8mmol/L by drawing ROC curve,the mortality rate in patients with lower than this value was 26.3%,while the mortality rate in patients with higher than the value was 3.7%.Conclusion Hyponatremia is related with the severity and prognosis of acute exacerbation of chronic obstructive pulmonary disease.It is most important to prevent and correct hyponatremia at early disease stage.
8.Clinical Study on 2 Routes of Vancomycin Administration Assisting with Continuous Drainage in the Treat-ment of Intracranial Infection Secondary to Traumatic Brain Injury
Xiaowen TIAN ; Cuizhu CAI ; Rufeng ZHAO ; Fang WANG ; Shishuang XU ; Lei WANG
China Pharmacy 2017;28(5):653-655,656
OBJECTIVE:To investigate clinical efficacy of cerebroventricular perfusion and intrathecal perfusion of vancomy-cin assisting with continuous drainage in the treatment of intracranial infection secondary to traumatic brain injury,and its effects on cerebrospinal fluid indexes and intracranial pressure. METHODS:One hundred and eighty patients with intracranial infection secondary to traumatic brain injury selected from Sanya Hospital of TCM during Jan. 2012 to Jun. 2015 were randomly divided into control group and observation group according to lottery,with 90 cases in each group. They were given cerebroventricular perfu-sion and intrathecal perfusion of vancomycin(20 mg dissolved in 5 mL normal saline)in cella lateralis and lumbar cisterna respec-tively combined with continuous drainage,q12 h. Both groups received treatment for 7 d.Clinical efficacy,the time of infection con-trol were compared between 2 groups as well as body temperature,intracranial pressure and cerebrospinal fluid indexes before and after treatment,and the occurrence of ADR. RESULTS:After treatment,total response rate of observation group (95.56%) was significantly higher than that of control group (77.78%),with statistical significance (P<0.05). The time of infection control in observation group [(9.67 ± 1.10)d] was significantly shorter than in control group [(11.84 ± 1.29)d],with statistical significance (P<0.05). Body temperature,intracranial pressure,cerebrospinal fluid protein and leukocyte of 2 groups were significantly lower than before treatment;cerebrospinal fluid glucose level was increased significantly compared to before treatment;above indexes of observation group were significantly better than those of control group,with statistical significance(P<0.05).There was no statisti-cal significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:The intrathecal perfusion of vancomycin as-sisting with continuous drainage in the treatment of intracranial infection secondary to traumatic brain injury can effectively speed up the rehabilitation process,reduce the body temperature and intracranial pressure,and is helpful to improve the relevant cerebro-spinal fluid indexes. Therapeutic efficacy of it is better than that of cerebroventricular perfusion.
9.Multi-center clinical studies on pazufloxacin sodium chloride injection in treatment for acute bacterial infections
Jing YANG ; Gengzhi GE ; Tian XIA ; Baoyuan CHEN ; Xiaowen HAN ; Bing LIU ; Lixian HE ; Xiaoqiang DING ; Zhongyi HUANG ; Zhongmin QIU ; Jun MA ; Ce SHEN ; Niansong WANG
Chinese Journal of General Practitioners 2008;7(1):19-21
Objective To evaluate efficacy and safety of locally-produced pazufloxacin mesilate sodium chloride injection in the treatment of bacterial infections of respiratory and urinary tract.Methods A multi-center double-blind randomized controlled clinical trial was carried out to evaluate efficacy and safety of pazufloxacin mesilate sodium chloride in treatment for acute bacterial infection, as compared to those of levofloxacin hydrochloride and glucose injection as control treatment.A total of 244 patients with acute bacterial infection of respiratory and urinary tract were enrolled in the studies.120 in trial group and 120 in control group, with four withdrawals.Pazufloxacin mesilate and levofloxacin were administered intravenously by drip at a dose of 300 mg and 200 mg, every 12 hours for 7 to 14 days for trial and control groups, respectively.Resuits Overall efficacy of pazufloxacin mesilate was 77.0 percent and 93.5 percent in treatment for acute bacterial infections of respiratory and urinary tract.respectively, and that of levofloxacin was 80.6 percent and 89.6 percent, respectively.Overall bacterial clearance rate WaS 91.5 percent for pazufloxacin mesilate, 89.6 percent for respiratory tract infection and 94.1 percent for urinary tract infection, respectively.and 93.4 percent for levofloxacin, 97.3 percent for respiratory tract infection and 89.7 percent for urinary tract infection, respectively.No significant difference in adverse drug reactions between the two groups(P>0.05)was found, with 4.88 percent and 7.44 percent for trial and control groups, respectively.Conclusions Pazufloxacin mesilate sodium chloride injection produced locally is a safe and effective antibiotic in treatment for acute infections of respiratory and urinary tract.
10. Epidemiological characteristics of Brucella species isolated from different regions of the world using the MLVA genotyping
Guozhong TIAN ; Dianying LU ; Dongri PIAO ; Hongyan ZHAO ; Xiaowen YANG ; Hai JIANG
Chinese Journal of Epidemiology 2019;40(6):676-681
Objective:
To study the molecular-epidemiological characteristics of Brucella species isolated from different countries, using the multiple locus tandem-repeat (MLVA) analysis.
Methods:
Eleven variable-number tandem-repeat (VNTR) loci were selected. VNTR strains of Brucella isolated from 48 different countries in 1953-2013, were analyzed by using the BioNumerics software. Unweighted Paired Arithmetic Average method was used to cluster and draw phylogenetic tree as well as the minimum spannin.
Results:
The evolutionary relationship of Brucella phylogenetic tree was consistent with the classical biological typing method. However, the