2.Discussion of hospitals' reform of the property right system
Wei FAN ; Huixian HU ; Tuqiang LI
Chinese Journal of Hospital Administration 1996;0(09):-
By analyzing the crisis of survival in 2 hospitals, the authors argue that reform of the hospital property right system may be a way out. However, in the process of the reform, hospitals may face some problems. One problem is how to ensure the steady transition and sustained development of a hospital if the whole of it is sold out to an enterprise run by the local people. Another problem is how to safeguard the status, salary and welfare of the staff. To ensure the success of the reform, the following measures need to be taken: ①strengthening leadership, seeking unity of thinking, and clarifying the guiding ideology; ②formulating rigorous and detailed plans so as to guarantee a steady transition; ③making proper arrangements for the placement of the staff after the change of the property right system so as to ensure the ideological stability of the staff.
3.Predictive value of trauma index on the prognosis in patients with traumatic spinal cord injury
Journal of Clinical Surgery 2017;25(1):65-66,67
Objective To investigate the predictive value of trauma index on the prognosis in pa-tients with traumatic spinal cord injury.Methods Enrolled 168 cases of patients with traumatic spinal cord injury,the traumatic index score and the American Spinal Injury Association (ASIA)grade were as-sessed on admission,then followed up for 6 months,the Spearman correlation analysis was performed to a-nalysis the relationship between trauma index and ASIA grade,and Receiver operating curve (ROC)anal-ysis was used to evaluate the relationship between trauma index and prognosis.Results There was a sig-nificant negative correlation between trauma index score and ASIA grade(r =-0.68,P <0.01).A total of 157 cases (93.5%)completed follow-up,the trauma index score had a good predictive value on the traumatic death in these patients,it's sensitivity was 71.4%,specificity was 76.1%,the best cut-off point was 25 points(P <0.01 );Compared with the low score group (<25 points),the high group (≥25 points)showed a lower ASIA grade and higher mortality,the differences were statistically significant (P <0.01).Conclusion The trauma index score was related with the spinal cord injury,and it is a predictive factor of poor prognosis in patients with traumatic spinal cord injury.
4.Influence of age on prevalence rates of chronic complications of hospitalized aged patients with hypertension——analysis of 17,682 cases
Hua CUI ; Yixin HU ; Li FAN ; Guoliang HU ; Wei DAI
Journal of Geriatric Cardiology 2009;6(2):91-94
Objective To understand the relationship between age and chronic complications in hospitalized aged patients with hypertension, to provide evidence for hypertension prevention and control. Methods To retrospectively analyze the clinical and laboratory data on 17,682 patients with essential hypertension during Jan 1st,1993-Dee 12th, 2008 in PLA general hospital. Results 1)Among all of the inrolled cases, those aged 60-64 account for 27.87%, 65-69 years group account for 26.55%, 70-74 years group accounted for 23.96%, 75-79 years group accounted for 14.14%, 80-84 years group accounted for 5.26%, 85-89 years group accounted for 1.69%, > 90 years accounted for 0.41%. 2) The prevalence rate of chronic complications in 60-69 years group were 31.3-31.2% for diabetes and,22.6-27.0% for cerebrovascular disease, 9.5-11.1% for myocardial infarction, 6.7-9.1% for heart failure, 5.8-6.0% for renal dysfanction 4.9-6.8% for atrial fibrillation, 0.1-0.3% for multiple organ dysfunction syndrome (MODS) in the elderly(P <0.05 ). 3) The first four complications of hypertension were diabetes(33.5%), cerebrovascular disease (31.9%), myocardial infarction(13.2%) and heart failure(12.3%) in 70-74 years group (P<0.05), cerebrovascular disease (42.8%), diabetes (32.8%), heart failure (16.5%) and myocardial infarction(15.9%) in 75-79 years group (P<0.05), cerebrovascular disease (45.4%), diabetes (35.0%), heart failure (21.1%) and myocardial infarction(15.9%) in 80-84 years group (P<0.05), cerebrovascular disease(42.5%), diabetes (35.8%), heart failure (23.1%) and renal dysfanction (17.7%) in 85-89 years group(P<0.05 ),and cerebrovascular disease (45. 2%), heart failure(31.5%), diabetes (26.0%) and renal dysfanction (20.5%) in patients more than 90 years group (P<0.05). Conclusions The prevalence rate and kinds of chronic complications in hospitalized aged patients with hypertension were changed with the increasing age, and the first kind of complication is cerebrovascular disease. It is of more importance to prevent the occurrence of renal dysfanction and heart failure in those hypertension patients who were more than 80 years old.
5.The protective effects of edaravone combined with ulinastatin on the treatment of brain injury in rats with severe acute pancreatitis
Xiaohong WANG ; Ronglong WEI ; Hui FAN ; Jianghong HU
Chinese Journal of Hepatobiliary Surgery 2013;19(7):544-549
Objective To investigate the protective effects of edaravone combined with ulinastatin on the treatment of brain injury in rats with severe acute pancreatitis.Methods A total of 100 male Sprague-Dawley rats were randomly divided into 10 groups that consisted of a normal control 6 and 48 hour group,a SAP 6 and 48 hour group,an edaravone treated 6 and 48 hour group,a ulinastatin treated 6 and 48 hour group,and finally a combination of edaravone and ulinastatin treated 6 and 48 hour group.Each group included 10 rats.Neurobehavioral scores were observed and a series of blood,pancreatic tissue,and brain tissue samples were obtained at 6 and 48 hours after operation.Serum amylase,brain tissue Evans Blue content,brain tissue water content,and the histopathological change of the pancreas and brain tissues were observed.Serum TNF-α was detected by RIA.The TNF-α mRNA and nuclear factor kappa B(NF-κB) p65 activity in brain tissues were measured with RT-PCR and immunohistochemistry,respectively.Results In contrast to the 48 hour SAP,edaravone treated,and ulinastatin treated groups,the serum amylase,brain tissue Evans Blue content,brain tissue water content,histopathological score of the rat pancreas and brain tissue,serum TNF-a,TNF-a mRNA,and NF-κB p65 activity in brain tissues significantly decreased while neurobehavioral scores significantly increased in the 48 hour combined edaravone and ulinastatin treatment group (P<0.01).Conclusion Edaravone combined with ulinastatin can play a protective role on brain injury in rats with severe acute pancreatitis.
7.Clinical curative effect observation of ultra pulse CO2 laser combined with collagen dressing in treatment of primary cutaneous amyloidosis
Bin YIN ; Huanhuan SHI ; Fan LI ; Ping XU ; Wei HU
Journal of Chinese Physician 2015;17(2):202-204
Objective To investigate the clinical efficacy and safety of ultra pulse CO2 laser combined with collagen dressing in treatment of cutaneous amyloidosis.Methods A total of 68 cases of primary cutaneous amyloidosis patients according to the different treatment methods was divided into two groups:the control group (n =33 cases) that was given acitretin capsules oral and topical compound flumetasone ointment packet treatment,and observation group (n =35 cases) with ultra pulse CO2 laser combined with collagen dressing external treatment.Two groups were observed in patients with curative effect and adverse reaction.Results Disease of integral observation group after treatment was significantly lower than the control group(t =3.12,P <0.05).The observation group had the efficiency of [88.6% (31/35)] that was significantly higher than that of control group[17/33(51.5%),x2 =11.23,P <.0.01].The observation group had significantly shorter healing time [(5.38 ± 1.81) d] compared to the control group [(10.75 ±2.06)d,t =11.39,P < 0.01].The observation group did not have recurrence,which was significantly different from the control group (x2 =4.90,P < 0.05).Conclusions Ultra pulse CO2 laser combined with collagen dressing in treatment of primary cutaneous amyloidosis is a kind of effective treatment methods with remarkable curative effect and less adverse reactions.It is worthy of clinical application.
8.Value of 18F-FDG PET/CT with Volume Metabolic Parameters for Prognosis Evaluation in Limited-Disease Small Cell Lung Cancer
Xiaoping LIN ; Wei FAN ; Peiyan LIANG ; Yingying HU ; Xu ZHANG
Journal of Sun Yat-sen University(Medical Sciences) 2017;38(5):765-773
[Objective]To investigate the prognostic value of 18F-FDG PET/CT with different metabolic parameters in newly diagnosed limited-disease(LD)small cell lung cancer(SCLC).[Methods]Retrospective analysis was carried out in the patients between June 2005 to December 2016 in our hospital confirmed of LD SCLC by pathology or cytology and comprehensive imaging. Fifty-four patients were recruited. Record the general characteristics of patients,pre-treatment KPS score,smoking status,weight loss,serum LDH,NSE,OS,PFS. All lesions(primary lesions + metastases)were sketched out within one VOI,and the SUVmax, SUVmean and SUVpeak in the VOI were automatically measured and recorded. The automatic measurement was performed by the fixed threshold method. The thresholds of tumor of MTV and TLG were 40% and 50% of SUVmax. The TLG and MTV were identified as TLG40%,TLG50%,MTV40% and MTV50% respectively. Kaplan-Meier method was used for survival analysis. All the prognostic factors were analyzed by Cox model.[Result]The median SUVmax was 13.92(2.61~43.28),the median of SUVmean was 8.31(1.71~26.85) and the median of SUVpeak was 10.51(1.49 ~ 27.48). The median of TLG40% was 340.22(16.58 ~ 2827.26),the median of TLG50%was 215.645(1.70 ~ 2270.36),the median of MTV40% was 36.71(1.15 ~ 259.47 cm3),the median of MTV50% was 19.65(0.93 ~1900.00)cm3. Univariate and multivariate analysis of metabolic index and prognosis showed that TLG50% was the prognostic factor of OS(P = 0.013),but not of PFS(P > 0.05). The SUVmax,SUVmean and SUVpeak were not the prognostic factors of OS and PFS(P >0.05).[Conclusion]The volume metabolic parameters TLG50%was the independent prognostic factor of the overall survival time of the LD SCLC. The volume metabolic parameters (TLG and MTV) of 18F-FDG PET/CT were related to the prognosis of SCLC ,which could provide the basis for individual chemotherapy.
9.Clinical research of lower extremity biomechanical rotation and patellofemoral pain in women
Tingxu FAN ; Wei HUANG ; Ning HU ; Cheng CHEN
Chongqing Medicine 2014;(32):4276-4279,4292
Objective The purpose of this investigation was to discuss the relationship between the rotation of lower extremity biomechanics and patellofemoral pain(PFP) .Methods With normal volunteers as controls ,patients with PFP were scanned by ul‐trathin CT ,keeping the bilateral lower extremity straight neutral .The anatomy parameters were measured and analysed ,such as femoral neck anteversion(FNA) ,femoral neck shaft angle(NSA) ,posterior condylar angle(PCA) ,femoral rotation relative to tibia (FRRT) ,tibial torsion angle(TTA) and patella tilt angle(PTA) .Results Compared with control group ,the PFP group FNA ,FR‐RT ,PCA ,TTA and PTA increase statistically significant (P<0 .05) ,while the NSA is no statistical difference (P>0 .05) .It could be found that PTA had the most obvious influence on the VAS score ,followed by FNA and TTA ;and PTA had the most obvious influence on the WOMAC function score ,followed by TTA ;and significant negative correlation could be found between PTA and age (r= -0 .548 ,P<0 .05) .Conclusion PTA is a sensitive indicator to assess VAS score and WOMAC function score for individ‐uals with PFPS .Increases of PTA ,FNA ,PCA ,FRRT and TTA are associated with PFP for women .
10.Effect of Preoperative Acute Hypervolemic Hemodilution with HES 130/0.4 and Polygeline on Hemodynamics in Undergoing Thoracotomy Patients
Binghua WEI ; Yanhong HUANG ; Changke LI ; Kaiming FAN ; Zhengrong HU
Journal of Medical Research 2006;0(07):-
Objective To investigate the effect of preoperative acute hypervolemic hemodilution with 6% hydroxyethyl starch 130/0.4(HES130/0.4)and polygeline on hemodynamic response and variance regularity of hemodynamic response in open-and close-thoracic cavity in undergoing thoracotomy patients. Methods Sixty patients undergoing thoracotomy,ASA physical status ⅠorⅡ,aged 20~65 yeansold,weighing 45~70kg,were randomly divided three group:HES130/0.4 group ( group A,n=20) ,Polygeline group ( group B,n=20) and Ringer's solution group (group C,n=20).They were respectively infused 20ml/ (kg?h) with HES130/0.4,polygeline and Ringer's solution in one hour before infuseing followed Ringer's 10ml/ (kg?h). The Blood Pressure (BP) and heart rate (HR) were recorded.RPP was calculated before induction(baseline),5min before and 10 min after open thoracic cavity,5min before and 10min after close thoracic cavity. And central venous pressure (CVP) was measured at immediately after deep venous puncture ,5min before and 10min after open thoracic cavity,5min before and 10min after close thoracic cavity. Results The changes of hemodynamics in Ringer's solution group in operation were obvious as compared with baseline before operation.HES130/0.4 and polygeline were relatively stable.Two groups had no significant difference.The CVP of HES130/0.4 and polygeline groups increased obviously before and after open thoracic cavity,but the blood pressure was relatively stable.Only systolic blood pressure increased obviously as compared with Ringer's solution group at 5min before open thoracic cavity. At 10min after open thoracic cavity,HR and CVP in three groups increased obviously as compared with 5 min before open thoracic cavity.At 5 min before close thoracic cavity,blood pressure and CVP in three groups decreased obviously as compared with 10 min after open thoracic cavity. Conclusion The preoperative acute hypervolemic hemodilution with HES 130/ 0.4 and polygeline in undergoing thoracotomy patients can keep hemodynamics more stable and improve tolerance of patients to withstand hypovolemics.