BACKGROUNDLong-term use of antiplatelet agents, statins, beta-blockers and angiotensin-converting enzyme inhibitors are proven therapies for secondary prevention in acute coronary syndrome. However, little is known of physicians' opinion about their use in China.

METHODSIn 2010, standard questionnaires were posted to chief cardiologists in 1397 geographically diverse and representative sample of tertiary and secondary hospitals in China, collecting information about their opinions on the recommended treatments for acute coronary syndrome.

RESULTSA total of 1009 (72%) cardiologists responded with a valid questionnaire. Of them, 77% reported routine use of all the four main secondary preventive treatments, with little difference between secondary and tertiary hospitals (75% vs. 79%, P = 0.16). Of the cardiologists reporting routine or selective use of aspirin, beta-blockers, statins and angiotensin-converting enzyme inhibitors, 94%, 85%, 73% and 86% would recommend indefinite use respectively. For all the 4 treatments combined, only 63.5% reported indefinite use at the same time, with no significant difference between secondary and tertiary hospitals (62% vs. 65%, P = 0.17), nor between hospitals with or without fast track for primary percutaneous coronary intervention (66% vs. 61%, P = 0.50).

CONCLUSIONSAlthough Chinese cardiologists seem well informed about the value of main secondary preventive treatments for acute coronary syndrome, there is still gap in their understanding of the need for combined and prolonged use of these treatments.

Acute Coronary Syndrome ; prevention & control ; China ; Coronary Disease ; prevention & control ; Humans ; Physicians ; statistics & numerical data ; Secondary Prevention ; methods ; Surveys and Questionnaires

OBJECTIVEThe aim of this study was to evaluate quantitatively the effectiveness and feasibility of the modified supracrestal fiberotomy (MSF) and the contact point reproximation (CPR) in decreasing the relapse of anterior segments rotating and/or crowding after orthodontic treatment.

METHODSA total of 129 patients with crowding and/or rotated anterior teeth were selected for this study, and the average age was 13.07 years (54 males, 75 females). The modified supracrestal fiberotomy was performed on the anterior segments of patients in the experimental group (48 cases). After the anterior teeth were aligned, 23 of the 48 cases received a further treatment of the contact point reproximation on the anterior segments (the subgroup of MSF + CPR), and the other 25 subjects did not receive this treatment (the subgroup of MSF). The control group consisted of 81 cases. All cases wore Hawley retainers for 1.8 to 2.3 years, and all the patients were revisited 2.4 years postretention. The maxillary and mandibular dental models of all the patients were taken before treatment (T1), at the end of the treatment (T2) and 2.4 years postretention (T3).

RESULTSThe relapse rate in the experimental group [(T3-T2)/T1 x 100%] was 21.6%, lower than that in the control group (P < 0.001). The relapse rate of mandible in the subgroup of MSF + CPR was 6.56% lower than that of the subgroup of MSF (P < 0.05). But the relapse rate of maxillary in the subgroups of MSF + CPR was similar as that of the subgroup of MSF (P > 0.05).

CONCLUSIONThe modified supracrestal fiberotomy can effectively alleviate relapse after orthodontic treatment of the crowding and/or rotation of anterior teeth. The treatment combining MSF and CPR can help maintain the stability of post-retention of mandibular anterior teeth.

Adolescent ; Child, Preschool ; Female ; Humans ; Male ; Malocclusion ; therapy ; Orthodontics, Corrective ; methods ; Risk Factors ; Rotation ; Secondary Prevention ; Sex Factors ; Statistics, Nonparametric ; Tooth Extraction ; Tooth Movement Techniques ; Treatment Outcome

OBJECTIVETo describe the implementation of secondary prevention measures (blood pressure measure, test of blood lipid, and screening test for breast cancer and cervix uteri) on chronic diseases in different populations.

METHODSThe indicators on proportion of receiving blood pressure measurement, tests on blood lipid, screening of breast cancer and cervix uteri in research samples, as well as awareness of the risk of hypertension and hyper lipid were calculated based on results from 1BRFS questionnaire by weight on age structures from 2000 census.

RESULTS22% and 5% of people under research understood the risk of hypertension and hyper lipid on their health. In addition, proportion of receiving these screening tests in sample populations were low. Secondly, the main target population including females over 50 years old but the proportion of screening breast cancer among those females over 50 years old was lower than that in females over 25 years old. Besides educational, occupational and geographic factors, the types of medical insurance for people also were important factors affecting the proportion of receiving screening tests.

CONCLUSIONScreening tests were important second prevention measures for reducing severity of the diseases. Except blood pressure tests among people over 35 years old, proportions of receiving other screening tests were very low. There were significant differences of receiving these screening tests in people by education occupation, geographic areas and types of medical insurance. In addition, the policy of screening was not clear on target orientation. It is necessary for developing guideline of screening to guide the screening programs.

Adult ; Blood Pressure ; Breast Neoplasms ; prevention & control ; China ; Chronic Disease ; prevention & control ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Insurance, Health ; statistics & numerical data ; Lipids ; blood ; Male ; Mass Screening ; statistics & numerical data ; Secondary Prevention ; methods ; statistics & numerical data ; Uterine Cervical Neoplasms ; prevention & control

In North Korea, the prevalence of hepatitis B is high due to natural factors, gaps in vaccination, and the lack of antiviral treatment. Aid projects are urgently needed, however impeded by North Korea's political and economical situation and isolation. The feasibility of a joint North Korean and German humanitarian hepatitis B prevention program was assessed. Part 1: Hepatitis B vaccination catch-up campaign. Part 2: Implementation of endoscopic ligation of esophageal varices (EVL) by trainings in Germany and North Korea. By vaccinating 7 million children between 2010 and 2012, the hepatitis B vaccination gap was closed. Coverage of 99.23% was reached. A total of 11 hepatitis B-induced liver cirrhosis patients (mean age 41.1 yr) with severe esophageal varices and previous bleedings were successfully treated by EVL without major complications. A clinical standard operating procedure, a feedback system and a follow-up plan were developed. The bi-modal preventive strategy was implemented successfully. Parts of the project can serve as an example for other low-income countries, however its general transferability is limited due to the special circumstances in North Korea.
Adult ; Combined Modality Therapy/methods/statistics & numerical data ; Democratic People's Republic of Korea/epidemiology ; Esophageal and Gastric Varices/*embryology/*surgery ; Esophagoscopy/statistics & numerical data ; Feasibility Studies ; Female ; Hepatitis B/*epidemiology/*prevention & control ; Hepatitis B Vaccines/*administration & dosage ; Humans ; Male ; Mass Vaccination/*statistics & numerical data ; Middle Aged ; Prevalence ; Retrospective Studies ; Risk Factors ; Secondary Prevention/methods/statistics & numerical data ; Treatment Outcome

Pulmonary surfactant (PS) therapy was proven to be highly successful for the treatment of respiratory distress syndrome in premature infants. As a results, early prophylactic (EP) PS therapy has been introduced recently in Europe, the US and Korea. However, no multi-center study was compared EP and late selective (LS) PS therapies in Korea. We performed a retrospective multi-center study to compare the outcomes of EP and LS PS therapies in very preterm infants. We analyzed clinical morbidity and mortality for 1,291 infants in 2010 (LS group) and 1,249 infants in 2011 (EP group); the infants were born <30 weeks of gestation and had birth weight < or =1,250 g, and were chosen from 53 neonatal intensive care units in Korea. Compared to the LS group (22.5%), the overall mortality was better in the EP group (19.9%) and there was no increased need for retreatment.There were additional benefits in the EP group such as fewer associated complications. To the best of knowledge, our study is the first nationwide Korean study to compare the outcomes of EP and LS therapies, and it provides evidences that EP PS therapy is important in very preterm infants to improve for survival and reduce morbidities.
Female ; Humans ; Infant, Extremely Premature ; Male ; Prevalence ; Pulmonary Surfactants/*administration & dosage ; Republic of Korea/epidemiology ; Respiratory Distress Syndrome, Newborn/diagnosis/*mortality/*prevention & control ; Risk Factors ; Secondary Prevention/methods/*statistics & numerical data ; Survival Rate ; Treatment Outcome

Pulmonary surfactant (PS) therapy was proven to be highly successful for the treatment of respiratory distress syndrome in premature infants. As a results, early prophylactic (EP) PS therapy has been introduced recently in Europe, the US and Korea. However, no multi-center study was compared EP and late selective (LS) PS therapies in Korea. We performed a retrospective multi-center study to compare the outcomes of EP and LS PS therapies in very preterm infants. We analyzed clinical morbidity and mortality for 1,291 infants in 2010 (LS group) and 1,249 infants in 2011 (EP group); the infants were born <30 weeks of gestation and had birth weight < or =1,250 g, and were chosen from 53 neonatal intensive care units in Korea. Compared to the LS group (22.5%), the overall mortality was better in the EP group (19.9%) and there was no increased need for retreatment.There were additional benefits in the EP group such as fewer associated complications. To the best of knowledge, our study is the first nationwide Korean study to compare the outcomes of EP and LS therapies, and it provides evidences that EP PS therapy is important in very preterm infants to improve for survival and reduce morbidities.
Female ; Humans ; Infant, Extremely Premature ; Male ; Prevalence ; Pulmonary Surfactants/*administration & dosage ; Republic of Korea/epidemiology ; Respiratory Distress Syndrome, Newborn/diagnosis/*mortality/*prevention & control ; Risk Factors ; Secondary Prevention/methods/*statistics & numerical data ; Survival Rate ; Treatment Outcome

The purpose of this study was to evaluate treatment patterns, outcome and prognosticators for patients with leptomeningeal metastases from solid tumor. Medical records of 80 patients from January 1, 2004 to May 31, 2011 were retrospectively reviewed. Most frequent site of origin was the lung (59%) followed by the breast (25%). Most patients were treated with intrathecal chemotherapy (90%) and/or whole brain radiotherapy (67.5%). Systemic therapy was offered to 27 patients (33.8%). Percentage of patients treated with single, dual, and triple modality were 32.5%, 43.8%, and 23.8%, respectively. Median survival was 2.7 months and 1 yr survival rate was 11.3%. Multivariate analysis showed that negative cerebrospinal fluid cytology, fewer chemotherapy regimen prior to leptomeningeal metastases, whole brain radiotherapy, systemic therapy, and combined modality treatment (median survival; single 1.4 vs. dual 2.8 vs. triple 8.3 months, P<0.001) had statistical significance on survival. Subgroup analysis of non-small cell lung cancer (NSCLC) patients showed that targeted therapy had significant independent impact on survival (median survival; 10.5 vs. 3.0 months, P=0.008). Unlike previous reports, survival of patients with NSCLC primary was comparable to breast primary. Furthermore, combined modality treatment for all patients and additionally targeted therapy for NSCLC patients should be considered in the treatment of leptomeningeal metastases from solid tumor.
Adult ; Aged ; Chemoradiotherapy/methods/*mortality/*statistics & numerical data ; Disease-Free Survival ; Female ; Humans ; Male ; Meningeal Neoplasms/mortality/*secondary/*therapy ; Middle Aged ; Neoplasm Recurrence, Local/*mortality/*prevention & control ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Survival Rate ; Treatment Outcome

PURPOSE: We conducted a prospective single-center study to evaluate the possibility of discontinuation of dutasteride after combination therapy with an alpha blocker for benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: We prospectively treated BPH patients with an alpha blocker and dutasteride (0.5 mg/d). Patients who had been treated with alpha blockers against BPH for more than 2 months were eligible, and 20 patients were included in the study. After 6 months of combination therapy, dutasteride was discontinued. Patients were followed for 12 months after cessation. Prostate volume, intraprostatic architecture determined by transrectal ultrasound, peak urinary flow rate, postvoid residual urine volume, and the serum prostate-specific antigen level were evaluated every 6 months, and the International Prostate Symptom Score and overactive bladder symptom score (OABSS) every 3 months. Patients were allowed to restart dutasteride during the follow-up period according to their desire. RESULTS: Twelve patients (12/20, 60%) restarted the combination therapy from 6 to 12 months into the follow-up period. For patients who restarted dutasteride, the prostate volume and OABSS had increased and worsened after discontinuation, respectively. A visible transition zone with a clear border on transrectal ultrasound at baseline and regrowth of the prostate after discontinuation of dutasteride were risk factors for restarting the therapy (Mann-Whitney U test: p=0.008, p=0.017). CONCLUSIONS: Prostatic enlargement after discontinuation of dutasteride differs among patients. Rapid regrowth of the prostate leads to deterioration of storage symptoms and a tendency to restart dutasteride. Baseline intraprostatic architecture may be a predictive factor for whether the patient is a good candidate for discontinuation.
5-alpha Reductase Inhibitors/administration & dosage/adverse effects ; *Adrenergic alpha-Antagonists/administration & dosage/adverse effects ; Aged ; Drug Monitoring ; Drug Therapy, Combination/methods ; *Dutasteride/administration & dosage/adverse effects ; Follow-Up Studies ; Humans ; Japan ; Male ; Middle Aged ; Organ Size ; Prospective Studies ; *Prostate/drug effects/pathology/ultrasonography ; Prostate-Specific Antigen/analysis ; *Prostatic Hyperplasia/drug therapy/pathology ; Secondary Prevention/methods/statistics & numerical data ; Treatment Outcome ; Withholding Treatment