3.Analysis of the factors affecting ambiguous medical records in DRGs
Ya LIU ; Xiaojuan LI ; Yue WANG ; Teng FEI ; Wenjing ZHANG
Chinese Journal of Hospital Administration 2015;31(11):875-878
Objective Analyze the causes of ambiguous medical records to provide evidence for the DRGs.Methods 268 Ambiguous medical records were selected from 17 751 surgery medical records between 2010 and 2014 based on major diagnosis and major surgery.The single factor Chi-square test was used to study the influence of various inpatient characteristics on the occurrence of ambiguous medical records, and those significant variables were given assignment to find influencing factors of ambiguous medical records by using logistic regression analysis.Results Ambiguous medical records account for 1.51% of all surgical medical records.Logistic regression analysis results show that such risk factors as discharging from internal medicine, death of patient, transfer between departments, elderly, long time of hospitalization, and tumor patients, as contributing to ambiguous medical records.All the results are statistically significant (P<0.05), including discharging from which departments (OR=6.595, 95%CI..5.043 ~ 8.625), death of patient (OR=3.787, 95% CI: 2.611 ~ 5.492) and transfer between departments (OR =2.746, 95% CI: 2.061 ~ 3.659), which rank important risk factors for ambiguous medical records.Conclusion Analysis of the causes of ambiguous medical records provides important evidences for the hospital to improve its medical record quality management.
4.Immunohistochemical study on the expression of caspase, bax, bcl-2 and c-kit after SCI in Bufo bufogargarizan.
Ping LI ; Yu ZHANG ; Ya-Fei CAI ; Yan WANG
Chinese Journal of Applied Physiology 2011;27(4):399-401
Animals
;
Bufo bufo
;
Caspase 3
;
genetics
;
metabolism
;
Female
;
Immunohistochemistry
;
Male
;
Proto-Oncogene Proteins c-bcl-2
;
genetics
;
metabolism
;
Proto-Oncogene Proteins c-kit
;
genetics
;
metabolism
;
Spinal Cord
;
metabolism
;
Spinal Cord Injuries
;
metabolism
;
bcl-2-Associated X Protein
;
genetics
;
metabolism
5.MiR-21 Suppresses Anoikis through Targeting PDCD4 and PTEN in Human Esophageal Adenocarcinoma
Meng-Ya ZHAO ; La-Mei WANG ; Jing LIU ; Xing HUANG ; Jing LIU ; Ya-Fei ZHANG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2018;38(2):245-251
Anoikis is a form of apoptosis induced upon cell detachment from extracellular matrix.It has been determined that acquisition of resistance to anoikis is a critical step for tumor cell metastasis.MiR-21,the most prominent oncomiR,plays an important role in tumor progression.In this study,we revealed that up-regulation of miR-21 in human esophageal adenocarcinoma (EA) is associated with lymph node metastasis and poor survival rate.Because of the established anti-apoptosis effect of miR-21,it is tempting to speculate that miR-21 might contribute to tumor metastasis by regulating anoikis,qRT-PCR analysis demonstrated that miR-21 expression in OE33/AR cells (subpopulation of human EA OE33 cells that acquired resistance to anoikis) was significantly increased.Also,transfection of miR-21 mimics provided OE33 cells resisting to anoikis.By luciferase assays,we verified that PDCD4 and PTEN were the functional targets of miR-21.In mouse model,via tail vein injection experiment,we showed that the metastasis formation of OE33 cells in vivo could be mediated by changing the miR-21 expression pattern.Taken together,our findings suggested that miR-21 was involved in the regulation of anoikis in human EA cells.Targeting miR-21 may provide a novel strategy to prevent metastasis.
6.Ocular surface alteration after radiofrequency thermocoagulation therapy in trigeminal neuralgia
Zhen-jia, ZHANG ; Li-ya, WANG ; Jing, WANG ; Xiao-fei, YU
Chinese Journal of Experimental Ophthalmology 2013;(6):597-601
Background Radiofrequency thermocoagulation is one of the effective therapies for trigeminal neuralgia.Corneal nerve is important substance of radiofrequency thermocoagulation ocular surface,which support the normal structure and function of cornea.Most of corneal nerves come from ophthalmic branch of trigeminal nerve.However,the change of ocular surface microenvironment following radiofrequency thermocoagulation treatment in the patient with trigeminal neuralgiais unclear.Objective This study was to analyze ocular surface change after radiofrequency thermocoagulation therapy in patients with trigeminal neuralgia.Methods Twenty-eight eyes of 28patients with trigeminal neuralgia underwent radiofrequency thermocoagulation therapy were enrolled in this study.The contralateral eyes were regarded as the control group.The central corneal sensitivity,function of lacrimal secretion (Schiemer 1 test),tear break-up time(BUT),corneal fluorescence staining and laser scanning confocal microscopic examination were performed before and after surgery in operative eyes and compared with the fellow eye.Informed consent was obtained before any relevant medical procedure from each patient.Results No significant differences was found before surgery in the central corneal sensitivity,the Schiemer Ⅰ test,BUT,corneal fluorescence staining and densities value of corneal subepithelial nerve plexus between the treating eyes and fellow eyes(Z =-1.511,-1.119,-0.428,-0.378,-0.854; P =0.131,0.263,0.669,0.705,0.393).1n the third day after radiofrequencythermocoagulation therapy,compared with pre-treatment,no significant differences were seen in BUT result,Schirmer Ⅰ test and the score of ocular surface fluorescence staining (Z =-0.620,-0.315,-1.732;P =0.535,0.753,0.083).Corneal sensitivity and subbasal nerve density were lowed 3 days after surgery (Z =-2.708,-2.813 ; P =0.007,0.005).One month after treatment,differences of all indexes mentioned above showed statistical significance between treating eyes and fellow eyes(Z=-3.888,-2.373,-3.311,-2.535 ; P =0.000,0.018,0.001,0.011).The corneal subepithelial nerve was thinner and sparse and dendritic cells on the cornea were found in the eyes received radiofrequency thermocoagulation therapy.Conclusions The secretion of tears and the stability of tear film are poorer and the corneal sensitivity and subbasal nerve density are affected in a certain extent in the eye received radiofrequency thermocoagulation therapy.
7.Clinical features and surgical treatment on a family with congenital fibrosis of the extraocular muscles
Jian-Fei, ZHANG ; Ya-Li, WANG ; Jing, CHEN ; Shan-Li, QIAO
International Eye Science 2014;(8):1542-1544
AIM: To investigate the clinical characteristics, surgical outcome and curative effect of congenital fibrosis of the extraocular muscles ( CFEOM) .
METHODS: The eye exam of members in a Chinese family with CFEOM includes visual acuity, intraocular pressure, dilated fundus exam, extraocular muscle function test, orbital CT scan, and ultrasound. We did extraocular muscle surgery or frontalis suspension procedure for affected subjects in the family.
RESULTS: The incidence of CFEOM in this family was 31%. All patients were affected bilateraly with symptom of congenital eye movement disorder, ptosis, hypotropia, perverted convergence on upgaze and chin up head position. As the age grows, the diseases worsen unobviously. No other systemic disorder was found. Surgical treatment improved the anomalous head position although the ocular movement disorder preserved.
CONCLUSION: The pattern of inheritance in our serial patients are autosomal dominant. Surgery can improve chin up head position and cosmetic appearance. However, the eye movement deficiency cannot be improved.
8.Morphologlc changes of the meibomian gland and its correlation with dry eye in blepharitis patient
Jing, LI ; Zhong-zhong, XU ; Xiao-fei, YU ; Jin, LI ; Li-ya, WANG
Chinese Journal of Experimental Ophthalmology 2012;30(6):557-561
Background Blepharitis is a common ocular surface disease.It is associated with the disorder of lipid secretion of meibomian gland.The change of tear film stability can cause dry eye symptoms,so blepharitis is thought to be one of the factors causing dry eye,but the relation between them is in study. Objective This study was to observe the morphology of meibomian gland in blepharitis patients and to investigate the correlation of morphology of meibomian gland with dry eye. Methods A series of case-observational study was designed in this study.A total of 83 eyes of consecutive 83 blepharitis patients were enrolled in Henan Eye Institute from October 2010 to April 2011.Blepharitis was diagnosed based on American Preferred Practice Pattern Guidelines.Some relevant ocular examinations were performed under the informed consent of the subjects,including the anterior segment manifestation by the slit lamp,such as meibography,lid margin abnormality,and the dry eye-relevant examinations,such as tear film break-up time (BUT),Schirmer test Ⅰ and corneal fluorescein staining also been carried out.Tear film shape was examined by film interference images and scored.Absent degree of meibomian gland was graded under a Noncontact Infrared Meibography.The correlations of absent degree of meibomian gland with ocular syndrome score,dry eye examination results were evaluated using Spearman rank correlation coefficients.Informed consent was obtained prior to this trail. Results No significant difference in the frequencies of blepharitis was found between male and female among different ages (x2 =2.69,P =0.75 ).Absent grading of the meibomian glands was positively correlated with age of blepharitis patients ( r =0.58,P =0.00 ),lid margin abnormality scores ( r =0.64,P =0.00 ),conjuntival hyperemia score ( r=0.50,P =0.00),tear film interference imaging grade ( r =0.23,P =0.04 ),corneal fluorescein staining score( r =0.50,P =0.00 ) but was negatively correlated with BUT ( r =-0.32,P =0.00 ).No significant correlation was found between meibography grading and gender( r =-0.09 ; P =0.99 ) or Schirmer test Ⅰ ( r =-0.05;P =0.69 ).No significant difference was found in meibography grading between male and female in different age groups(Z=-0.09,P=0.93). Conclusions Blepharitis can irriter dry eye symptom because of overevaporation of tear fluid and abnormality of secreting function of meibomian glands.The missing of the meibomain glands increases with age in the patients with blepharitis.Noncontact Meibography System is an assistant tool to the diagnosis of blepharitis.
9.Clinical Study on Qingfei Sanjie Pills Combined with Targeted Cryoablation Therapy for Treatment of Elderly Patients with Advanced Non-Small Cell Lung Cancer
qiang Ya WEI ; fei Xiao ZHANG ; yan Hai WANG
Chinese Journal of Information on Traditional Chinese Medicine 2017;24(11):26-29
Objective To study the clinical efficacy of Qingfei Sanjie Pills combined with targeted cryoablation therapy on elderly patients with advanced non-small cell lung cancer (NSCLC) and its influence on the levels of immune function in patients. Methods Totally 94 elderly patients with NSCLC were divided into observation group and control group, with 47 cases in each group. Both groups were given targeted cryoablation therapy and under CT review after surgery to observe lesions condition. Observation group was given Qingfei Sanjie Pills, once a bottle, twice a day, orally, for three months. Recent efficacy of the two groups were evaluated. The levels of IgG, IgA, CD3+, CD4+, CD8+, and complications in the two groups were detected. The survival rate of 1 year, 2 years and 3 years in the two groups were observed. Results Two cases in the observation group and three cases in the control group were invalid. The total effective rate was 84.4% (38/45) in observation group and 65.9% (29/44) in the control group, with statistical significance (P<0.05). After the treatment, the levels of IgG, IgA, CD3+, CD4+and CD8+in the observation group were significantly higher than the control group (P<0.05). After treatment, the incidence rates of increased cough, postoperative pain, bloody sputum, fever and nausea and vomiting in the observation group were lower than the control group. The 1 year, 2 years and 3 years survival rates were 91.1%, 75.6% and 64.4% in observation group, and 79.5%,63.6% and 52.3% in the control group,with statistical significance(P<0.05).Conclusion Qingfei Sanjie Pills combined with targeted cryoablation therapy on elderly patients with advanced NSCLC has good clinical efficacy, which can improve immune system of patients and increase survival rate.
10.Scientific Evaluation of TCM Clinical Outcomes Rating Scale for Heart Failure Based on Patients Report.
Zhi-qiang ZHAO ; Jing-yuan MAO ; Xian-liang WANG ; Ya-zhu HOU ; Ying-fei BI
Chinese Journal of Integrated Traditional and Western Medicine 2016;36(3):300-305
OBJECTIVETo evaluate the reliability, validity, and responsiveness of traditional Chinese medicine (TCM) clinical outcomes rating scale for heart failure (HF) based on patients' report.
METHODSTCM clinical outcomes rating scale for HF (TCM-HF-PRO) were evaluated based on 340 HF patients' report from multiple centers. The completion of the investigation was recorded. Cronbach's α coefficient and split-half reliability were used for reliability analysis, and factor analysis was used to assess the construct validity of the rating scale. Pearson correlation analysis was then used for criterion validity analysis. Discriminant analysis was used to assess the responsiveness of the scale. All 340 HF patients having complete TCM-HF-PRO data were assigned to the treatment group and the control group by central randomization. The total TCM-HF-PRO scores of the two groups were compared using paired t-test to reflect the longitude responsiveness of the scale before treatment and at week 2 after treatment.
RESULTS(1) The recycling rate of the scale was 100.0%. One of them was not filled completely, which was rejected thereby. So the completion rate was 99.7%. The completion time for TCM-HF-PRO scale ranged 15 to 25 min. (2) The Cronbach's α coefficient of rating scale was 0.903, split-half reliability was 0.844 and 0.849. (3) Confirmatory factor analysis showed that 7 factors and items formed according to maximum load factor basically coincided with the construct of the rating scale, 7 factors accumulated contribution rate was 43.8%. TCM clinical outcomes rating scale for HF based on patients' report was relatively better correlated with the Minnesota living with HF questionnaire (r = 0.726, P < 0.01). (4) Discriminant analysis showed that the rating scale correctly classified more than 78.8% of case studies having confirmed initial differential diagnosis by experts. The total scale of the rating scale decreased more in the two group after treatment, with significant difference as compared with before treatment (P < 0.01.
CONCLUSIONTCM clinical outcomes rating scale for HF based on patients' report had good reliability, validity and responsiveness, hence it could be used to assess clinical efficacy for HF patients.
Diagnosis, Differential ; Discriminant Analysis ; Factor Analysis, Statistical ; Heart Failure ; diagnosis ; Humans ; Medicine, Chinese Traditional ; methods ; standards ; Reproducibility of Results ; Surveys and Questionnaires