1.Research and construction of physician professionalism at home and abroad
Chinese Journal of Medical Science Research Management 2012;(6):402-405
This paper reviews the development of physician professionalism and its research at home and abroad in recent decades.Content,evaluation,the problems and challenges,and the affecting factors of physician professionalism are analyzed.With regard to the status quo of physician professionalism in China,some ideas to improve and build physician professionalism in China are proposed.
2.Therapeutic Observation of Twirling Manipulations at Quchi (LI 11) for Primary Hypertension
Yan ZOU ; Xiaoxiao Lü ; Zhiping LUO
Shanghai Journal of Acupuncture and Moxibustion 2015;(9):847-849
Objective To observe the clinical efficacy of acupuncture in treating primary hypertension and the effect of twirling reinforcing-reducing manipulations on the treatment of primary hypertension. Methods Totally 126 patients with primary hypertension were randomized into treatment group 1 of 40 cases, treatment group 2 of 44 cases, and a control group of 42 cases. The treatment groups were both intervened by acupuncture at Quchi (LI 11), while twirling reinforcing-reducing manipulations (twirling towards left) were applied in treatment group 1, while the manipulations (twirling towards right) were applied in treatment group 2;the control group was intervened by medication. The change of blood pressure after 10 min treatment was observed, and the clinical efficacies were compared. Results The total effective rate was 85.0%in treatment group 1, versus 88.6%in treatment group 2 and 61.9% in the control group, and the total effective rates in the two treatment groups were significantly different from that in the control group (P<0.05). In the two treatment groups, the systolic pressure and diastolic pressure respectively after 10 min treatment and 30 min treatment were markedly different from those 10 min before treatment in the same group (P<0.05). In the two treatment groups, the systolic pressure and diastolic pressure after 30 min treatment were markedly different from those after 10 min treatment in the same group (P<0.05). In the control group, the systolic pressure and diastolic pressure were significantly different from those 10 min before treatment in the same group (P<0.05). There were no significant inter-group differences in comparing the systolic pressure and diastolic pressure after 30 min treatment (P>0.05). Conclusions Acupuncture at Quchi (LI 11) is an effective approach in treating primary hypertension, and the reinforcing manipulation and reducing manipulation are both effective.
3.Distribution of pathogenic bacteria of nosocomial infections in intensive care unit and its drug-resistances
Liming YANG ; Qingrong MENG ; Xiaoxiao YAN
Chinese Journal of Postgraduates of Medicine 2014;37(z1):4-6
Objective To investigate the distribution of pathogenic of nosocomial infections in intensive care unit (ICU) and the tendencies of its drug-resistances.Methods All of 130 patients of nosocomial infection from March 2009 to March 2013.Results Of all the nosocomial infection pathogens,gram-negative(G-) bacteria was the main(53.76%).The first five pathogens were E.coli(13.9%),E.faecalis (11.3%),A.baumannii (10.3%),S.aureus (9.8%) and K.pneumoniae (8.3%).The lower resistant to pseudomonas aeruginosa were amikacin (5.3%).A.baumannii increases rapidly and its resistances was severe.Two trains of E.faecalis were resistant to vancomycin.Conclusion G-bacteria is the main pathogens in ICU,fungal has upward tendency.The multidrug resistances of A.baumannii and E.faecalis were severe; Target monitoring is an effective surveillance method to reduce the prevalence of the nosocomial infection in ICU.
4.Clinical Effect of Mild Hypothermia Combined with Puncture Aspiration Operation on the Hypertensive Intracerebral Hemorrhage and Its Effect on the Serum TNF-α, IL-6 and CRP Levels
Haibo JIA ; Xiaoxiao YAN ; Hongbo REN ; Zhiheng HU ; Zhenzeng FAN
Progress in Modern Biomedicine 2017;17(24):4739-4742,4754
Objective:To explore the clinical effect of mild hypothermia combined with puncture aspiration operation on the hypertensive intracerebral hemorrhage and its effect on the serum TNF-α,IL-6 and CRP levels.Methods:112 cases of patients with hypertensive intracerebral hemorrhage admitted in our hospital from February 2015 to August 2016 were selected as the research objectives and randomly divides into 2 groups with 56 cases in each group.Both groups were treated with minimally puncture aspiration,and mild hypothermia was performed in the observation group additionally,the clinical effect,complication,short-term prognosis,serum TNF-α,IL-6,CRP levels at different time points before and after operation were compared between two groups.Results:The overall effective rate of observation group was 92.86%,which was significantly higher than of the control group(76.79%.P<0.05).The incidence of MODS and complications were 0% and 26.79% respectively,which were significantly lower than those of the control group(P<0.05).The serum TNF-α,IL-6,CRP levels of observation group were significantly decreased on the 3rd and 7th day postoperation,which were significantly lower than those before operation (P<0.01).The serum TNF-α,IL-6,CRP levels of control group on the 3rd day postoperation were similar to those before operation (P>0.05),but the serum TNF-α,IL-6,CRP levels on the 7th day postoperation were significantly decreased (P<0.01).The serum TNF-α,IL-6,CRP levels on the 3rd,7th day postoperation were significantly lower than those of the control group at same time points (P<0.01).The favorable prognosis of observation group was 80.36%,which was significantly higher than that of the control group (62.50%,P<0.05).Conclusion:Mild hypothermia combined with puncture aspiration operation could effectively reduce the neurological deficits,inhibit the inflammatory response and decrease the mortality.
5.Relationship between expression of interleukin 6 in tumor microenvironment and prognosis in patients with natural killer/T cell lymphoma
Qichun CAI ; Bing BAI ; Yan GAO ; Xiaoxiao WANG ; Huiqiang HUANG
Journal of Leukemia & Lymphoma 2017;26(7):396-399
Objective To investigate the expression of interleukin 6 (IL-6) in tumor microenvironment of natural killer/T cell lymphoma (NKTCL) and its relationship with clinical characteristics and prognosis. Methods From January 2005 to December 2012, 93 patients with NKTCL and available paraffin-embedded tissue in Sun Yat-sen University Cancer Center were included. The expression or IL-6 in tumor microenvironment was investigated by immunohistochemistry. The positive IL-6 expression was identified as≥10 cells/HP. The enumeration data and measurement data were compared by t test andχ2 test, respectively. Overall survival (OS) and progression free survival (PFS) were estimated with the Kaplan-Meier method. Survival rates were compared by the Log-rank test. Statistical significance was determined at a level of P<0.05. Results The median count of IL-6 positive cell number was 21 cells/HPF (range, 0-150 cells/HP), and 61.29%(57/93) patients were positive. Positive IL-6 expression was mostly associated with fever and high Korean prognostic index (KPI) score (both P< 0.05). The serum c-reactive protein (CRP) level was (29.28 ± 2.62) mg/L in IL-6 positive patients and (11.14±2.77) mg/L in IL-6 negative patients (t= -2.276, P= 0.025). Patients with negative IL-6 expression had better survival, with 52.7 % of 5-year PFS rate,and 60.0 % of 5-year OS rate; the 5-year PFS and OS rates in those with IL-6 positive were 23.6 % and 27.1 %, respectively (both P= 0.001). Conclusion The high expression of IL-6 in patients with NKTCL might be associated with adverse clinical feature and poor survival.
6.Correlation between mRNA expression of protocadherin-10 and prognosis in gastric cancer
Ying LIN ; Yan YAN ; Zheng WU ; Xiaoxiao GE ; Fengjuan LIN ; Jin LI
China Oncology 2017;27(1):7-13
Background and purpose:Promoter methylation ofPCDH10, a gene encoding protocadherin 10, has been found to be correlated to poor prognosis in gastric cancer (GC) patients. However, the relationship between the expression of PCDH10 and prognosis in GC remained unknown. This study aimed to explore the relationship be-tween the expression of PCDH10 and clinicopathological features and prognosis of GC, and to identify biomarker for predictions of recurrence and survival of GC.Methods:mRNA expressions of PCDH10 in 115 pairs of GC tissues and adjacent normal tissues were detected by real-time lfuorescence quantitative polymerase chain reaction (RTFQ-PCR). The correlation between PCDH10 expression level and clinicopathological features and prognosis of GC was analyzed. Prediction models for 5-year recurrence and 5-year survival were established using logistic regression method.Results:Progression-free survival (PFS) and overall survival (OS) were signiifcantly prolonged in patients with PCDH10 low expression compared to patients without PCDH10 low expression (P=0.046 andP=0.033 respectively). PCDH10 low expression signiifcantly correlated with less lymph node metastasis (P=0.001) and earlier TNM staging (P=0.001), and was more common in female than in male (P=0.040). The mRNA expression of PCDH10 did not correlate with age, Lauren classiifcation, T stage, neural invasion or vascular invasion. Univariate Cox analysis showed Lauren classiifca-tion, T stage, N stage, M stage and PCDH10 expression signiifcantly correlated with PFS and OS. Logistic regression models for the prediction of 5-year recurrence or 5-year survival based on clinicopathological features included Lauren classiifcation, T stage, N stage and M stage as variables. Logistic regression models for the prediction of 5-year recur-rence or 5-year survival based on PCDH10 expression included Lauren classiifcation, T stage, M stage and PCDH10 expression level but not N stage as variables. The models based on PCDH10 expression had the same effciencies as models based on clinical parameters in predicting 5-year recurrence or 5-year survival for GC patients.Conclusion:PCDH10 low expression correlated with better prognosis, less lymph node metastasis and earlier TNM stage in GC patients. Low expression of PCDH10 may be a biomarker of better survival for GC patients. Logistic regression model based on PCDH10 mRNA expression may serve as a prediction model when patients have unknown lymph node metas-tasis status.
7.Preparation and characterization of oxaliplatin-loaded nanostructured lipid carriers.
Hui ZHOU ; Lipeng QIU ; Xiaoxiao YAN ; Lin LI ; Xiang LI ; Lu WANG ; Mei LIU ; Dongkai WANG
Acta Pharmaceutica Sinica 2010;45(9):1177-82
Oxaliplatin-loaded nanostuctured lipid carriers (OP-NLC) were prepared by ultrasonic emulsification method. And its optimal prescription was selected by orthogonal design. The laser light scattering technique, zeta potential analyzer, TEM, DSC, XRD and HPLC were employed to study the physicochemical parameters of OP-NLC, which displayed in terms of particle size, zeta potential, crystalline, drug loading and encapsulation efficiency. The results showed that OP-NLC had an average diameter of (111 +/- 20) nm, zeta potential of (-27.4 +/- 13.1) mV, encapsulation efficiency of (77.4 +/- 2.5) % and drug content of (0.8 +/- 1.5) mg mL(-1). TEM, DSC and XRD indicated that OP-NLC was spherical and the drug was dispersed as nanoparticles by means of non-crystalline. The in vitro release test showed that the drug could be sustained-released from NLC in buffer solution (pH 4.5) after a burst release in initial phase.
8.Long-term Outcomes of Patients with Newly Diagnosed NK/T-cell Lymphoma Treated by EPOCH Regimen
Zexiao LIN ; Yan GAO ; Huiqiang HUANG ; Xubin LIN ; Qingqing CAI ; Zhongjun XIA ; Xiaoxiao WANG ; Wenqi JIANG
Journal of Sun Yat-sen University(Medical Sciences) 2010;31(2):274-277
[Objective]This study was aimed to evaluate treatment outcomes and toxicity of continuous-infusion EPOCH regimen for NK/T-cell lymphoma(NK/TCL).[Methods]From June 2003 to June 2008,34 patients including 30 nasal NK/TCL (88.2%)and 4 nasal type NK/TCL(11.8%)received doxorubicin,vincfistine,etoposide over 96 hours infusion with bolus eyelophosphamide and oral predinisone(EPOCH)chemotherapy as first-line treatment.Median cycles of EPOCH administered were 2.5(1-6 cycles).Additional involved field radiation therapy(IFRT)was administered to patients with localized nasal focus after chemotherapy.[Results]Among 34 patients,33 were eligible for response evaluation.The response rate(RR)was 60.6% (20/33)with complete remission(CR)rate of 45.5%(15/33).The RR of patients with nasal NK/TCL was 66.7%(20/30)with CR rate of 50%(15/30).Only one of the 3 nasal type NK/TCL patients achieved stable disease(SD),the other 2 had progressive disease(PD)during chemotherapy.After a median follow-up of 22(2-68)months,the estimated 3-year overall survival rate(OS)was 52.2%.For patients with nasal NK/TCL,the estimated median survival time was not reached,the 3-year OS was 59.4%.For patients with nasal type NK/TCL,the estimated median survival time was only 7 months.The CR rate was 75.0% for localized nasal NK/TCL who received initial EPOCH chemotherapy followed IFRT with the 3-year OS of 75.0%.Major adverse effect was myelosuppression.The incidence of grade Ⅲ~Ⅳ neutropenia was 30.9%.No treatment-related mortality occurred.[Conclusions]EPOCH regiment was effective and well tolerant for nasal NK/TCL.Combined EPOCH chemotherapy followed by IFRT produced promising outcome for patients with localized disease.However,patients with nasal type NK/TCL responded poorly and more efficacious treatment strategies are urgently needed.
9.Clinical Outcomes of Patients with Relapse and Refractory Non-Hodgkin's Lymphoma Treated by DHAOx Regimen
Qingqing CAI ; Yan GAO ; Ying ZHOU ; Qing BU ; Xubin LIN ; Xiaoxiao WANG ; Zexiao LIN ; Huiqiang HUANG
Journal of Sun Yat-sen University(Medical Sciences) 2010;31(2):269-273
[Objective]To evaluate the clinical efficacy and side effects of DHAOx±R regimen in the patients with relapsed and refractory non-Hodgkin's lymphoma(NHL).[Methods]Twenty patients with relapsed or refractory NHL were enrolled into this study in Cancer Center of Sun Yat-sen University.These patients were treated with DHAOx±R regimen(Dexamethasone 20 mg/day intravenous(Ⅳ)on day 1 to day 4,cytarabine 2 000 mg/m~2 3 h Ⅳ,every 12 hours on day 2;oxaliplatin 130 mg/m~2 2 h Ⅳ on day 1;with or without rituximab 375 ms/m~2 on day 0).Six patients were followed by high dose chemotherapy with autologous peripheral blood stem cell transplantation.Response to treatment wag assessed according to The International Working Group Criteria,including CR,PR,SD and PD.Side effects were graded according to WHO criteria,including 0-Ⅳ grades.[Results]Twenty patients received 47 cycles chemotherapy,13 patients(65%)received DHAOx chemotherapy and 7(35%)received DHAOx+R.The response rate(RR)for the whole group was 55%(11/20)with comeplete response(CR)rate 35%(7/20).The response can also be obtained in the patients who were already treated by platinum-based regimen before.The major toxicity Wag myelosuppression.The incidence of grade Ⅲ~Ⅳ neutropenia Wag 35%(16/47),and febrile neutropenia was 17%(8/47).The incidence of grade Ⅲ~Ⅳ thrombocytopenia was 20%(9/47).Eight cycles(17%)occurred mild neumtoxicity.With median follow-up of 12 months,1 and 2-year overall survival rate were 70.6%.[Conclusion]DHAOx was an effective regimen for recurrent and relapsed NHL patients with mild side effects and further investigation is needed.
10.Mutation analysis of ATP2C1 gene in patients with Hailey-Hailey disease
Xiaoxiao YAN ; Hongqing TIAN ; Yongxiang YU ; Guangjin WANG ; Zhongxiang SHI ; Furen ZHANG
Chinese Journal of Dermatology 2010;43(6):393-395
Objective To detect the mutations in ATP2C1 gene of 5 sporadic patients with Hailey-Hailey disease (HHD).Methods Five sporadic patients with HHD collected from the outpatient clinic setting were recruited into this study with informed consent.Blood samples were taken from all patients and 100 unrelated human controls.and DNA was extracted from these samples.Mutation scanning was carried out for ATP2C1 gene by polymerase chain reaction (PCR) and direct sequencing.Results The diagnosis of all cases was confirmed by typical clinical manifestation,cutaneous pathology and immunofluorescence pathology.Five novel mutations.including a deletion mutation (2025delG),three missence mutations (L269R,C348R,A651D) and a non-sense mutation (Q259X) were identified in these cases.No mutations were detected in any of the 100 controls.Conclusion Five novel mutations in ATP2C1 gene have been identified for Hailey-Hailey disease.