1.Policy analysis on targeted admission medical education program in rural areas
Chinese Journal of Health Policy 2017;10(5):34-38
This paper analyzes the document contents of targeted admission medical students in 16 provinces of China in 2016.Through analyses of the characteristics of the program, this study found that, 1) the number of admissions is determined by the national level and issued to the provincial level, where rural students are the main source of students, undergraduate program is the main enrollment category, and clinical medicine and traditional Chinese medicine are the main majors of admission;2) the number of admissions and the actual demand of health professionals of primary health care institutions do not match, the incubation period is too long, there is a shortage of targeted training model, contract signing is difficult to implement, and other problems.Therefore, in accordance with the problems, this paper suggests that, 1) the government should increase the number of admissions to match with the demands;2) a three-year bachelor's degree should be set up in order to shorten the incubation period;3) the training model of targeted admission medical students should be changed;and 4) various powerful measures should be carried out to attract and keep excellent health care professionals.
2.Distribution and Antibiotic Susceptibility of Pathogens Isolated in 76 Cases of Neonatal Septicemia
Gongliao WANG ; Liyu SONG ; Yunfeng HUANG ; Biyan CHEN
Chinese Journal of Nosocomiology 2006;0(06):-
OBJECTIVE To investigate pathogens in neonatal septicemia and the antimicrobial resistance of these bacteria in recent years to guide the clinical treatment.METHODS The data of 76 neonatal septicemia confirmed by hemoculture from Jan 2005 to Jan 2008 in our hospital were analyzed retrospectively.RESULTS Coagulase-negative Staphylococcus(CNS) were the main pathogens,among which their were 47.36% of S.epidermidis,10.53% of S.haemolyticus,9.21% of S.aureus,and the others of 7.88% Escherichia coli.Bacteria were highly resistant to penicillin,ampicillin and erythromycin.Vancomycin,imipenem,ciprofloxacin and amikacin were the most sensitive drugs.CONCLUSIONS Gram-positive cocci are main pathogens in neonatal septicemia,in which the CNS are the most common ones.To choose sensitive antibiotics bases on the drug sensitivity tests may decrease the occurrence of drug resistance to bacteria and increase the clinical curative effects.
3.Effect of aerobic exercise on genome expression in human skeletal muscle
Biyan HUANG ; Jiebing KE ; Xiang ZHANG ; Zhongyi FU ; Li JIANG ; Yi SUN ; Wang WANG
Chinese Journal of Tissue Engineering Research 2009;13(28):5580-5584
OBJECTIVE: To evaluate the effect of aerobic exercise on genome expression in human skeletal muscle. METHODS: Six healthy sedentary elderly men aged (66+9) years were selected from military cadre retirement centers and after exercise. Testing indices included height, weight, vital capacity, step index and maximal oxygen uptake. Needle biopsies were obtained from the skeletal muscle before and after the last training. Total RNA extracted from the samples was hybridized to Affymetrix U 133A platform, the gene expression datum was analyzed.RESULTS: Aerobic exercise was shown to improve cardiorespiratory function and reduce body fat of elder subjects. It could alter the genome expression in human skeletal muscle, the number of genes that passed filtering criteria was 725. The most differently expressed genes (n=20) were investigated in this study, in which there were 3 upregulated and 17 downregulated. According to gene function annotations, the differential genes were classified into 8 categories which concerned cellular component and biological process, Kyoto Encyclopedia of Genes and Genomes (KEGG) searching showed 4 genes' metabolism pathway. CONCLUSION: Systematic aerobic exercise upregulates expression of enzyme genes concerning tricarboxylic acid cycle, and downregulates expression of genes conceming muscle protein synthesis and sphingolipid. It is suggested that aerobic exercise is good to protect human nerves' integrity, exerts positive action on anti-aging and accelerate the aerobic metabolism of lipid materials in vivo.
4.The value of combined tests of hemoglobin electrophoresis and genetic testing in neonatal cord blood screening for β-thalassemia
Li LIN ; Qiuli CHEN ; Yuan WEI ; Biyan CHEN ; Liang WANG ; Sheng HE
International Journal of Laboratory Medicine 2016;37(19):2689-2691
Objective To explore the clinic utility of Hb A level in neonatal cord blood screening for β‐thalassemia .Methods A total of 1 599 neonatal cord specimens whose parents were carriers of β‐thalassemia prenatal diagnosised by routine molecular genet‐ic were collected by cordocentesis .These samples were analyzed by the capillary electrophoresis system (Sebia) .Results Among 1 599 fetuses ,186 were diagnosed as β‐thalassemia carriers ,68 were β‐thalasseima intermedia/major .ROC analysis demonstrated that the optimal cutoff value for identifying β‐thalassemia carrier from the Hb A level was 5 .15% (sensitivity = 83 .9% , specificity = 82 .3% ) ,and that was 3 .2% for β‐thalasseima intermedia/major (sensitivity = 100 .0% ,specificity = 99 .4% ) .Conclu‐sion The Hb A level of cord blood was an effective marker to screen the β‐thalassemia for fetuses and is therefore well‐suited for clinical diagnostic use .
5.Simultaneous Determination of 7 Components in Qingkailing Oral Liquid by HPLC-MS/MS
Jinyun WU ; Kaiwei CAI ; Hongying CHEN ; Jiaqi WANG ; Biyan PAN ; Zhiyong XIE ; Qiongfeng LIAO
Traditional Chinese Drug Research & Clinical Pharmacology 2024;35(2):257-262
Objective An HPLC-MS/MS method was established for the simultaneous determination of 7 components in Qingkailing Oral Liquid.Methods The assay was performed on a Waters ACQUITY UPLC BEH C18 column(2.1 mm×10 mm,1.7 μm)and the sample was eluted with a gradient mobile phase containing 10 mmol·L-1 of ammonium acetate and 0.1%of formic acid in water(A)-methanol(B).The mass spectrometry was carried out by electrospray ionization(ESI)with positive/negative ions in multiple reaction monitoring(MRM)mode for quantitative analysis.Results The linear ranges of adenine,chlorogenic acid,caffeic acid,geniposide,baicalin,hyodeoxycholic acid and cholic acid were 0.100 4-3.213,0.784 5-8.982,0.998-3.194,0.622 5-19.92,25.05-300.6,2.513-30.15 and 7.775-93.30 μg·mL-1(r≥0.999 0).The average recoveries(n=6)were 100.9%,98.74%,101.2%,100.2%,100.8%,99.97%and 98.94%with RSD of 1.58%,0.59%,1.78%,1.25%,0.65%,1.69%and 1.07%.The contents of the above mentioned 7 components in 15 tested samples were in the ranges of 0.12-0.18,0.19-0.24,0.06-0.09,0.34-0.37,4.54-4.85,0.49-0.67 and 1.82-2.19 mg·mL-1.The contents of 7 components in tested sample from different manufacturers were closed.Conclusion The method has shown good sensitivity,accuracy,and repeatability.The study can provide reference and data support for the quality control and subsequent research of Qingkailing Oral Liquid.
6.Hematological phenotype analysis of fetuses and patients with hemoglobin H disease
Li LIN ; Yangjin ZUO ; Biyan CHEN ; Chaofan ZHOU ; Liang WANG ; Qiuli CHEN ; Jingsi LUO ; Sheng HE
Chinese Journal of Endemiology 2023;42(6):459-466
Objective:To analyze the relationship between hematological and genotype characteristics of fetuses and patients with hemoglobin (Hb) H disease and their natural disease progression.Methods:From 2010 to 2022, a total of 1 252 blood samples from fetuses and patients with Hb H disease who visited the Guangxi Zhuang Autonomous Regional Maternal and Child Health Hospital were collected (including 174 umbilical cord blood samples, 1 062 peripheral blood samples from patients over 2 years old, and 16 peripheral blood samples from patients with rare cases of genotype Hb H). Additionally, 278 peripheral blood samples were collected from patients aged 0 - 2 years old with Hb H 3.7, Hb H 4.2, Hb H CS, and Hb H WS disease for the study of trends in red blood cell development. Multiple probe hybridization and microarray comparative genomic hybridization technology combined with first-generation Sanger sequencing were used for rare mutation detection.Results:Among the 1 062 Hb H disease patients over 2 years old, 62.34% (662/1 062) had gene deletion (--/-α), of which Hb H 3.7 (-- SEA/-α 3.7) and Hb H 4.2 (-- SEA/-α 4.2) were the most common, accounting for 42.28% (449/1 062) and 19.11% (203/1 062) of the total, respectively. Among the non-deletion genotypes (--/αα T or α Tα/αα T), Hb H CS (-- SEA/α CS), Hb H WS (-- SEA/α WS) and α CSα/α CSα accounted for 16.85% (179/1 062), 16.48% (175/1 062) and 1.98% (21/1 062), respectively. The 81.12% (537/662) of patients with deletional Hb H disease showed mild to moderate anemia, with Hb H detection rates ranging from 75% to 80%. Among non-deletional Hb H disease, Hb H WS disease showed the mild (blood Hb concentration > 95 g/L in 90% of patients) phenotype while Hb H CS and Hb H QS (-- SEA/αα QS) patients had moderate to severe anemia, with Hb H detected in peripheral blood at higher levels than in other types of Hb H disease patients. Except for Hb H CS and Hb H QS, which did not show a significant increase in Hb A2 levels when complicated with β-thalassemia, Hb A2 levels were increased (> 3.5%) in all other types of Hb H disease patients. When Hb H disease was complicated with β-thalassemia, Hb H peaks were not detected in either type of Hb H disease. The results of red blood cell development trend detection showed that erythrocyte counts were elevated in patients with Hb H disease compared to their normal counterparts; whereas, blood Hb, mean erythrocyte volume (MCV) and mean erythrocyte hemoglobin content (MCH) were lower than in their normal counterparts ( P < 0.05) and decreased to the minimum at 6 months to 1 year of age. Patients with Hb H CS disease, as the most severe form of anemia, had the highest MCV values ( P < 0.001). The results of fetal cord blood with Hb H disease showed that α CSα/α CSα caused severe intrauterine anemia, followed by Hb H QS and Hb H CS. The content of Hb Bart's in umbilical cord blood was negatively correlated with the severity of anemia ( rs = - 0.58, P < 0.001). When Hb H disease was complicated with β-thalassemia, there was no significant improvement in fetal anemia, and the Hb Bart's content did not change significantly ( P > 0.05). In addition, Hb H 21.9 (-α 21.9kb/-- SEA) and Hb H 2.4 (-α 2.4/-- SEA) were common in patients with deletion rare Hb H. In patients with non-deletion rare Hb H, αα Amsterdam-A1/-- SEA and αα Hb G-Georgia/-- SEA were both first reported. Conclusions:There is heterogeneity in clinical manifestations of patients with different types of Hb H disease or same type of Hb H disease at different developmental stages. When patients with Hb H are complicated with β-thalassemia, the phenotype of patients with the deletion type is improved, while that of patients with the non-deletion type is not. Compared to normal individuals, patients with Hb H disease have lower blood Hb concentration, MCV and MCH, and more rapid physiological changes in red blood cells.
7.Clinical efficacy of redo rectal resection and coloanal anastomosis
Zuolin ZHOU ; Yanjiong HE ; Qiyuan QIN ; Biyan SHAO ; Miaomiao ZHU ; Rui LUO ; Qi GUAN ; Xiaoyan HUANG ; Huaiming WANG ; Hui WANG ; Tenghui MA
Chinese Journal of Digestive Surgery 2023;22(6):755-761
Objective:To investigate the clinical efficacy of redo rectal resection and coloanal anastomosis.Methods:The retrospective and descriptive study was conducted. The clinicopatholo-gical data of 49 patients who underwent redo rectal resection and coloanal anastomosis for the treatment of local recurrence of tumors and failure of colorectal or coloanal anastomosis after rectal resection in the Sixth Affiliated Hospital of Sun Yat-sen University from November 2012 to December 2021 were collected. There were 32 males and 17 females, aged 57(range,31-87)years. Redo rectal resection and coloanal anastomosis was performed according to the patient′s situations. Observa-tion indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distri-bution were represented as M( Q1, Q3) or M(range). Count data were described as absolute numbers or percentages. Results:(1) Surgical situations. All 49 patients underwent redo rectal resection and coloanal anastomosis successfully, with the interval between the initial surgery and the reopera-tion as 14.2(7.1,24.3)months. The operation time and volume of intraoperative bold loss of 49 patients in the redo rectal resection and coloanal anastomosis was 313(251,398)minutes and 125(50,400)mL, respectively. Of the 49 patients, there were 38 cases receiving laparoscopic surgery including 12 cases with transanoscopic laparoscopic assisted surgery, 11 cases receiving open surgery including 2 cases as conversion to open surgery, there were 20 cases undergoing Bacon surgery, 14 cases undergoing Dixon surgery, 12 cases undergoing Parks surgery, 2 cases undergoing intersphincter resection and 1 case undergoing Kraske surgery, there were 20 cases undergoing rectum dragging out excision and secondary colonic anastomosis, 13 cases undergoing dragging out excision single anastomosis, 12 cases undergoing rectum dragging out excision double anastomosis, 4 cases undergoing first-stage manual anastomosis, there were 21 cases with enterostomy before surgery, 16 cases with prophylactic enterostomy after surgery, 12 cases without prophylactic enterostomy after surgery. The duration of postoperative hospital stay of 49 patients was (14±7)days. (2) Postoperative situations. Fifteen of 49 patients underwent postoperative complications, including 8 cases with grade Ⅱ Clevien-Dindo complications and 7 cases with ≥grade Ⅲ Clevien-Dindo complications. None of 49 patient underwent postoperative transferring to intensive care unit and no patient died during hospitalization. Results of postoperative histopathological examination in 23 patients with tumor local recurrence showed negative incision margin of the surgical specimen. (3) Follow-up. All 49 patients underwent post-operative follow-up of 90 days. There were 42 cases undergoing redo rectal resection and coloanal anastomosis successfully and 7 cases failed. Of the 37 patients with enterostomy, 20 cases failed in closing fistula, and 17 cases succeed. There were 46 patients receiving follow-up with the median time as 16.1(7.5,34.6)months. The questionnaire response rate for low anterior resection syndrome (LARS) score was 48.3%(14/29). Of the patients who underwent redo coloanal anastomosis and closure of stoma successfully, there were 9 cases with mild-to-moderate LARS.Conclusion:Redo rectal resection and coloanal anastomosis is safe and feasible for patients undergoing local recurr-ence of tumors and failure of colorectal or coloanal anastomosis after rectal resection, which can successfully restore intestinal continuity in patients and avoid permanent enterostomy.