Inhalation injury is caused by inhalation of heat, toxic or irritating gases which lead to respiratory and pulmonary parenchyma damage. At present, the clinical understanding about it is still limited and lack of effective diagnosis and treatment standard. Based on the experience of diagnosis and treatment of domestic inhalation injury, combined with reports of international researches, criteria (expert consensus) for inhalation injury were systematically discussed from pathological and pathophysiological changes, clinical diagnosis and evaluation, and clinical treatment, which provides reference for clinical diagnosis and treatment of patients inflicted with inhalation injury.
Burns, Inhalation ; Consensus ; Humans ; Lung ; Smoke Inhalation Injury ; diagnosis ; therapy

AIMTo determine the long-term outcome, effectiveness and patient satisfaction of congenital penile curvature correction by plication of tunica albuginea.

METHODSFrom January 1992 to January 2002, 106 young patients underwent surgical correction of congenital penile curvature by corporeal plication. Indications for operation were difficult or impossible vaginal penetration and cosmetic problems. The technique of corporeal plication consists of placing longitudinal plication sutures of 2-zero braided polyester on the convex side of the curvature until the curvature is corrected when erection is artificially induced. Results of this procedure were obtained by retrospective chart reviews and questionnaires via mail. Long-term follow-up ranged from 11 to 132 (mean 69.3) months and data were available for 68 patients.

RESULTSPenile straightening was excellent in 62 patients (91 %) and good with less than 15 degree of residual curvature in 6 patients (9 %). Sixty-seven patients reported no change in erectile rigidity or maintenance postoperatively, while 1 described early detumescence. Shortening of the penis without functional problems was noted by 26 patients (38 %). Thirty-Five patients (51 %) reported feeling palpable indurations (suture knots) on the penis. Temporary numbness of glans penis was described in 3 patients. Overall, 60 patients were very satisfied, 6 satisfied, 2 unsatisfied.

CONCLUSIONCorporeal plication is an effective and durable procedure with a high rate of patient satisfaction.

Adolescent ; Adult ; Follow-Up Studies ; Humans ; Male ; Penile Erection ; Penis ; abnormalities ; surgery ; Retrospective Studies ; Surgical Procedures, Operative ; Treatment Outcome

Objective: To evaluate the subjective well-being feelings of people aged ≥50 years in Shanghai by using the Day Reconstruction Method (DRM) and explore the related factors. Methods: A cross-sectional survey was conducted from October 2009 to June 2010 among people aged ≥50 years selected through multistage random cluster sampling in Shanghai. DRM was used to assess participants' subjective well-being by net effect and U-index. Univariate and multivariate linear regression models were used to explore the related factors. Results: A total of 8 075 participants were included, with average age of 63.1 years. The mean net effect value was 1.24 (95%CI:1.15-1.33), and the mean U-index was 1.55% (95%CI:1.10%-1.99%). After adjusted for demographic factors, univariate liner regression model indicated that age, education level, marital status, family wealth, residence, self-rated health status, WHODAS score and prevalence of chronic disease were associated with subjective well-being, and multivariate liner regression model indicated that higher WHODAS score was associated with lower net effect value (P<0.05). Conclusion: The subjective well-being feelings of people aged ≥50 years in Shanghai might be associated with age, education level, marital status, family wealth, residence, self-rated health status and WHODAS score. Enhanced social support and appropriate social security system might facilitate the improvement of the subjective well-being of the elderly.
Aged ; Aged, 80 and over ; China ; Cross-Sectional Studies ; Emotions ; Health Status ; Humans ; Middle Aged ; Social Support

OBJECTIVETo determine the feasibility and assess the validity of noncontact endocardial mapping to guide ablation of hemodynamically unstable or nonsustained ventricular tachycardia (VT).

METHODSNoncontact mapping permitted individual-beat analysis of ventricular arrhythmias. Three-dimensional electroanatomical mapping allowed detailed reconstruction of a chamber geometry and activation sequence. Eighteen hemodynamically unstable or nonsustained VTs were induced (cycle length: 336 ms +/- 58 ms) in 17 patients and mapped by noncontact mapping using an EnSite 3000 system performed for the guidance of catheter ablation.

RESULTSThree patients were mapped during premature ventricular complexes (PVCs) because sustained VT could not be induced. Analysis of the archived noncontact activation maps was performed to identify the exit site and/or the diastolic pathway of the VT reentry circuit. The endocardial exit sites 10 ms +/- 16 ms before QRS were defined in 9 right ventricular outflow tract (RVOT) and 5 ischemic VTs. The diastolic pathway was identified in 5 ischemic VTs. The earliest endocardial diastolic activity preceded the QRS onset by 60.1 ms +/- 42.6 ms. The earliest activation sites were identify in 3 patients with nonsustained VTs or PVCs. Radiofrequency current was applied around the exit site or to create a line of block across the diastolic pathway. Catheter ablation was performed in 17/18 (94%) VTs and 15/17 (88%) VTs was successfully ablated. Two (67%) of the three patients with non-sustained VTs were mapped and successfully ablated during PVCs. Catheter ablation was not performed in 1 patient (peri-Hisian VT) and was unsuccessful in 2 patients.

CONCLUSIONNoncontact endocardial mapping is able to be used to guide ablation of untolerated or nonsustained VTs.

Adult ; Catheter Ablation ; methods ; Electrophysiologic Techniques, Cardiac ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Tachycardia, Ventricular ; physiopathology ; surgery

INTRODUCTIONThis study compares the attitudes between preclinical and clinical medical students towards radiology, following the introduction of a new radiology curriculum for 1st year students.

MATERIALS AND METHODSRevision of the 1st year medical school curriculum for the academic year of 2008/9 with the inclusion of 13 one-hour formal radiology lectures integrated with each body system was done in an undergraduate Southeast Asian medical school. In the old curriculum, 1st and 2nd year medical students are not exposed to radiology. They received limited radiology teaching in their 3rd and 5th years with 2 one-hour lectures as part of their medicine and surgery rotations. In the 4th year, they have a one week non-examinable posting in radiology. A survey was administered to preclinical (new curriculum) and clinical (old curriculum) students. Survey responses were tabulated and attitudes between preclinical and clinical students were compared.

RESULTSMore than half of the preclinical students (155 out of 270 students, 59%) and 90 out of 720 clinical students (12.5%) responded. Students exposed to the new curriculum had attended one or two dedicated radiology lectures and were considering radiology as a clinical elective. Both groups of students did not feel familiar with radiology as with other specialties, were not considering radiology as a career, but felt that radiology was interesting and important to the overall practice of medicine.

CONCLUSIONSExposure of 1st year students to radiology increases their interest in the subject. Further intervention, fi ne-tuning of the curriculum and follow-up surveys will be carried out to see if this interest persists throughout their clinical years.

Attitude of Health Personnel ; Clinical Clerkship ; Clinical Competence ; statistics & numerical data ; Curriculum ; Education, Medical, Undergraduate ; Educational Measurement ; Educational Status ; Health Care Surveys ; Health Knowledge, Attitudes, Practice ; Humans ; Radiology ; education ; Schools, Medical ; statistics & numerical data ; Singapore ; Students, Medical ; psychology ; statistics & numerical data ; Surveys and Questionnaires

Inhalation injury is caused by inhalation of heat, toxic or irritating gases which lead to respiratory and pulmonary parenchyma damage. At present, the clinical understanding about it is still limited and lack of effective diagnosis and treatment standard. Based on the experience of diagnosis and treatment of domestic inhalation injury, combined with reports of international researches, criteria (expert consensus) for inhalation injury were systematically discussed from pathological and pathophysiological changes, clinical diagnosis and evaluation, and clinical treatment, which provides reference for clinical diagnosis and treatment of patients inflicted with inhalation injury.
Burns, Inhalation ; Consensus ; Humans ; Lung ; Practice Guidelines as Topic ; Smoke Inhalation Injury ; diagnosis ; therapy

As the most important phase in standardization activity, implementation saves as the essence. CDC in China are the major institutions undertaking disease control and prevention. Implementing the standards of public health provides technical basis for CDC to complete the task of disease control and prevention. In the study, spot conversation and questionnaire were used to investigate the implementation of standards on public health in CDC. Results showed that the staff of CDC got to know the standards through the Internet. The departments of CDC which conducted training and sent staff to attend training courses accounted for 50.00%(25/50) and 34.00%(17/50), respectively. State mandatory rule is still the main reason for relevant departments to implement the standards of the public health. Government promotion activities facilitate the implementation of Standards, and the degree of familiarity with Standards affects the implementation as well. The paper summarizes the existing problems, such as the lack of coordination between departments of public health at provincial level or below, lack of access to standards, and the need to strengthen the training of the standard implementation etc. It puts forward some suggestions to strengthen the implementation of public health Standards.
China/epidemiology* ; Communicable Disease Control/organization & administration* ; Communicable Diseases/epidemiology* ; Humans ; Preventive Health Services/organization & administration* ; Public Health/standards* ; Public Health Practice ; United States

This paper introduced the Revised Cochrane Risk of Bias Tool RoB2.0 for cluster-randomized control trials (CRCT) and compared RoB2.0 of CRCT with individually randomized, parallel group trials, and illustrated the application of RoB2.0 for CRCT in a published CRCT. Special signal questions were designed for CRCT according to its specialty that different from individually randomized, parallel group trials in RoB2.0 and also providing information on risk of bias about CRCT in systematic reviews for the synthesis of evidence.
Bias ; Humans ; Randomized Controlled Trials as Topic ; Risk ; Risk Assessment/methods*

This paper introduces the Risk of Bias in Systematic Review (ROBIS), including: 1) the development of ROBIS, 2) three phases of ROBIS tool judging the overall risk of bias that related to systematic reviews, and 3) illustration on the application of ROBIS in a published systematic review. ROBIS is the first rigorously developed tool which is specifically designed to assess the risk of bias in systematic reviews. ROBIS will help improve the process of risk assessment on bias which appeared in overviews and guidelines.
Humans ; Bias ; Risk Assessment/methods* ; Systematic Reviews as Topic

This paper introduces the tools related to Quality In Prognosis Studies (QUIPS) to assess the risk of bias in studies of prognostic factors and the relevant points of assessment and to illustrate the application of QUIPS in published prognostic research. The QUIPS tool identified 6 important areas to consider when evaluating validity and bias in studies of prognostic factors including participation, attrition, measurement on prognostic factors, outcomes, confounding factors, statistical analysis and reporting. It also provided a new method for evaluation on bias in the areas of prognostic research.
Bias ; Humans ; Prognosis ; Quality Improvement ; Research Design