1.Searching of journal club and lab meeting jointly applied to academic postgraduate training of obstetrics and gynecology
Jianming TANG ; Li HONG ; Shasha HONG ; Jie MIN ; Yang LI ; Qifan ZHANG
Chinese Journal of Medical Education Research 2015;14(11):1089-1092
Academic medical postgraduate recruitment and training is facing a new dilemma due to the overall implementation of resident standardization training and the combination of postgraduate education in professional master degree of clinical medicine and resident standardization training.We optimize and marry together journal club and lab meeting education methods in academic medical postgraduate training of obstetrics and gynecology on the basis of its teaching characteristics, and develop a new form of academic graduate student training of obstetrics and gynecology.This new method is expected to effectively improve the academic postgraduates' research interests, research capacity and the teaching quality of obstetrics and gynecology for academic postgraduates.
2.Mechanism, detection and clinical implication of tumor heterogeneity
Qifan YANG ; Yangyang LIU ; Yulan ZENG ; Yuting LIU ; Li LIU
Journal of International Oncology 2017;44(12):922-925
In recent years,with the rapid development of the Next Generation Sequencing,the tumor heterogeneity has attracted widespread attention.It has been clear that heterogeneity in the same patient includes inter-tumor heterogeneity and intra-tumor heterogeneity.The former exists between different tumor lesions,such as primary tumor and metastatic tumor,and the latter occurs in different cancer cells.Tumor heterogeneity represents the ongoing challenge in the field of cancer treatment and brings great difficulty for the precision medicine.Therefore,it is possible to achieve accurate diagnosis and therapy for tumor patients by detecting the subclone of tumors and adjusting the treatment plan in time.
3.Review of a new investigation method based on wastewater-based epidemiology
Jinxin ZANG ; Qifan YANG ; Na WANG
Shanghai Journal of Preventive Medicine 2022;34(4):394-398
Due to the lack of real-time monitoring information of traditional epidemiological investigation methods, in recent years, a new method of obtaining relevant epidemiological information through wastewater analysis has become an effective way to maintain the health of the population, which is called wastewater-based epidemiology. Information obtained from the chemical analysis of wastewater can be used to estimate exposure or consumption of chemicals. This work introduces the principle and the investigation method of wastewater-based epidemiology. Compared with traditional epidemiological survey methods, the advantages and disadvantages of wastewater-based epidemiology are analyzed. Development and prospects of wastewater-based epidemiological investigation methods in China are analyzed and some suggestions are discussed.
4.Safety of minimally invasive liver resection for resectable hepatocellular carcinoma complica-ted with portal hypertension: a multicenter study
Junhao ZHENG ; Guangchao YANG ; Zhanzhi MENG ; Wei CAI ; Li CAO ; Xukun WU ; Yedong LIU ; Mingheng LIAO ; Jieyi SHI ; Xin WANG ; Yao LI ; Qifan ZHANG ; Qiang GAO ; Jiwei HUANG ; Zhibo ZHANG ; Jianwei LI ; Dalong YIN ; Yong MA ; Xiao LIANG
Chinese Journal of Digestive Surgery 2023;22(4):481-488
Objective:To investigate the safety of minimally invasive liver resection for resectable hepatocellular carcinoma (HCC) complicated with portal hypertension.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 807 patients with resectable HCC who underwent minimally invasive liver resection in 8 medical centers, including Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine et al, from June 2011 to November 2022 were collected. There were 670 males and 137 females, aged 58(50,66)years. Of the 807 patients, 173 cases with portal hypertension were divided into the portal hypertension group, and 634 cases without portal hypertension were divided into the non-portal hypertension group. Observation indicators: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) intraoperative and post-operative situations; (3) subgroup analysis. Propensity score matching was done by the 1:1 nearest neighbor matching method, with the caliper setting as 0.001. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was constructed using the non-parameter rank sun test. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of the 807 patients, 268 cases were successfully matched, including 134 cases in the portal hypertension group and 134 cases in the non-portal hypertension group. The elimination of the tumor diameter and robot-assisted surgery confounding bias ensured comparability between the two groups after propensity score matching. (2) Intraoperative and postoperative situations. The occlusion time of porta hepatis, cases with intraoperative blood transfusion, cases with postoperative complication, cases with complication >Ⅱ grade of Clavien-Dindo classification, cases of Clavien-Dindo classification as Ⅰ grade, Ⅱ grade, Ⅲ grade, Ⅳ grade, cases with liver related complication were 27.0(15.0,43.0)minutes, 33, 55, 15, 13, 29, 14, 1, 37 in the portal hypertension group, versus 35.0(22.0,60.0)minutes, 17, 25, 5, 14, 9, 4, 1, 13 in the non-portal hypertension group, showing significant differences in the above indicators between the two groups ( Z=-2.15, χ2=6.30, 16.39, 4.38, 20.72, 14.16, P<0.05). (3) Subgroup analysis. Results of subgroups analysis showed that in cases with major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 243.5(174.6,296.3)minutes, 200.0(150.0,600.0)mL, 7.5(6.0,13.0)days in the portal hypertension group, versus 270.0(180.0,314.5)minutes, 200.0 (75.0,450.0)mL, 7.0(5.5,10.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.54, -1.73, -0.92, P>0.05). In cases with non-major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 8.0(5.0,10.0)days in the portal hypertension group, versus 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.5,9.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-1.39, -0.10, 1.05, P>0.05). In cases with anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 210.0(150.0,285.0)minutes, 150.0(50.0,200.0)mL, 8.0(6.0,9.3)days in the portal hypertension group, versus 225.5(146.3,306.8)minutes, 100.0(50.0,250.0)mL, 7.0(6.0,9.0)days in the non-portal hypertension group, showing no significant difference in the above indica-tors between the two groups ( Z=-0.75, -0.26, -0.91, P>0.05). In cases with non-anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 173.5(120.0,231.5)minutes, 175.0(50.0,300.0)mL, 7.0(5.0,11.0)days in the portal hyper-tension group, versus 186.0(123.0,262.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.0,9.5)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.97, -1.12, -0.98, P>0.05). Conclusion:Minimally invasive liver resection or even major liver resection is safe and feasible for screened HCC patients complicated with portal hyper-tension, but attention should be paid to the prevention and treatment of postoperative complications.
5.Distribution and exposure assessment of phthalic acid esters (PAEs) in indoor dust of Shanghai
Qifan YANG ; Bing SHEN ; Jingting CAI ; Zhongling LIU ; Yi LI ; Sichao FENG ; Yihui ZHOU ; Silan LU ; Hong ZHAO ; Zhiling YE ; Jianjing XIONG
Shanghai Journal of Preventive Medicine 2022;34(3):247-251
Objective To characterize the distribution and assess the exposure to phthalic acid esters (PAEs) in the indoor dust of Shanghai City. Methods Samples were collected from 33 sampling sites, including homes, hotels, offices and public places, in Shanghai in 2018, 2019, and 2020. The samples were pretreated by 100 sieves, extracted and concentrated, and then analyzed by gas chromatography-mass spectrometry in selected ion mode (SIM). Results Results on the characteristics of PAEs in indoor dust in different places showed that concentrations of PAEs were in a range of <0.01-2 464 mg·kg-1.The average concentration of 16 PAEs was 613 mg·kg-1. Bis(2-ethylhexyl) phthalate (DEHP), di-iso-butyl phthalate (DiBP), di-n-butyl phthalate (DBP) and di-n-octyl phthalate (DnOP) were the main components of PAEs in indoor dust, accounting for approximately 99.5% of 16 PAEs. The intake of DEHP, DBP, DEP and BBP was lower than the tolerable daily intake (TDI) and reference doses (RfD) set by EU CSTEE and U.S. EPA. Conclusion Average daily dose (ADD) via indoor dust is estimated, and the order of intake through different pathways is hand-oral intake>skin contact>respiratory inhalation. Exposure risk of PAEs in children is greater than that in adults.