1.Discussion of medical societies and public health advancement
Chinese Journal of Hospital Administration 1996;0(02):-
Medical societies, which boast the elite of the medical circles, have not only important historic missions but also great advantages in public health advancement. For this reason, their role in the following aspects ought to be brought into greater play: stepping up research on the situation and trends of public health advancement; intensifying perspective study on the prevention and treatment abroad of infectious diseases; reinforcing health education for all people; carrying out continuing medical education with regard to seasonal infectious diseases; offering prevention and treatment guidance in public health via long distance consultation networks; and making concerted efforts in tackling key problems by making use of quality human resources.
2.The expression of Wnt/beta-catenin signaling molecule in inflammatory bowel diseases treated with bone marrow mesenchymal stem cell transplantation
Yanfen XING ; Xuhong XIE ; Zhaohu YUAN ; Yejia CUI ; Yuyuan LI ; Yuqiang NIE ; Yaming WEI
Chinese Journal of Tissue Engineering Research 2015;(1):49-53
BACKGROUND:The Wnt/β-catenin signaling pathway is one of the most important signaling pathways in stem cel regulation, which is involved in regulation of cel proliferation and differentiation. OBJECTIVE:To investigate the expression of Wnt/β-catenin main signaling molecule in inflammatory bowel tissues treated with bone marrow mesenchymal stem cel transplantation. METHODS:2,4,6-Trinitrobenzene sulfonic acid was used for establishing inflammatory bowel diseases rat models. Bone marrow mesenchymal stem cels labeled with green fluorescent protein were transplanted into rat modelsviatail vein. Normal saline was injected as control. The expression of Wnt/β-catenin signaling molecule was detected in the large intestine tissue of inflammatory bowel disease rat models by quantitative RT-PCR at 14 and 28 days after transplantation. RESULTS AND CONCLUSION:Real-time quantitative PCR results showed that the expression of Wnt3a andβ-catenin in the inflammatory bowel tissue increased significantly (P < 0.05), while no difference in the expression of c-myc (P > 0.05). The expressions of Wnt3a, β-catenin and c-myc in the transplantation group were significantly lower than those in the control group after transplantation (P <0.05). These findings indicate that the Wnt/β-catenin signaling pathway plays important roles in inflammatory bowel disease and repair after bone marrow mesenchymal stem cel transplantation, while this pathway may promote stem cels differentiating into intestinal epithelium, promote recovery from inflammatory bowel disease, repair inflammatory area, and restore intestinal tissue homeostasis.
3.Clinicopathological features and survival prediction after radical resection of gastric cancer
Jun MA ; Chaoping ZHOU ; Yaming ZHANG ; Datian WANG ; Bin GAO ; Daibin TANG ; Jianwei YUAN ; Peng JIANG
International Journal of Surgery 2021;48(11):749-754,f4
Objective:To explore the prognostic factors that may affect the postoperative survival of gastric cancer by analyzing patients with radical gastrectomy.Methods:The data of 525 patients with radical gastrectomy, including 387 male and 138 female with average age (62.5±10.7) years old (ranged from 16 to 89 years), were analyzed retrospectively in Anqing Municipal Hospital between October 2010 to July 2015. The relationship between 33 variables and prognosis was analyzed by a Cox proportionalhazards regression model, meanwhile ROC curve was established in order to explore the risk factor of postopertive survival.Results:The over survival(OS) rate of all patients was 89.3% at 1 year, 68.4% at 3 years and 59.6% at 5 years. The 5-year OS rate was 81.9% at stage Ⅰ, 71.4% at stage Ⅱ and 44.1% at stage Ⅲ. In the multivariate analysis that included these factors, preoperative comorbidity ( HR=1.595, P=0.001), hemoglobin( HR=1.377, P=0.017), CA199( HR=1.618, P=0.004), tumor distribution( HR=1.943, P=0.032), pT stage( HR=1.731, P=0.012), pN stage( HR=2.118, P=0.000), signet ring cell( HR=1.642, P=0.038)and intravascular tumor thrombus( HR=1.391, P=0.039) were independent risk factors associating with postopertive survival.According to ROC curve, the following area (AUC value) could predict survival after radical gastrectomy, including CA199 (AUC=0.568), hemoglobin(AUC=0.586), preoperative comorbidity(AUC=0.554), pT stage(AUC=0.636), pN stage(AUC=0.670)and intravascular tumor thrombus(AUC=0.626)( P<0.05). Conclusion:According to ROC curve analysis, preoperative comorbidity, anemia, CA199, pN stage, pT stage and intravascular tumor thrombus played an role in predicting long-term survival after radical resection of gastric cancer.
4.The clinical study of the correlation between different types of hemorrhage transformation and serum uric acid in patients with acute cerebral infarction
Xiaobo YUAN ; Yaming FU ; Shuihong ZHENG
Chinese Journal of Postgraduates of Medicine 2021;44(11):1004-1009
Objective:To investigate the relationship between different types of hemorrhagic transformation and serum uric acid in patients with acute cerebral infarction.Methods:The clinical data of 365 patients with acute cerebral infarction in Jinhua Central Hospital of Zhejiang Province from June 2018 to December 2020 were retrospectively analyzed. The clinical data and the serum uric acid level at the time of admission were recorded, and the occurrences of hemorrhagic infarction (HI) and cerebral parenchymal hematoma (PH) were counted. The risk factors of HI and PH in patients with acute cerebral infarction were analyzed by multivariate Logistic regression analysis.Results:Among 365 patients, 328 cases had no hemorrhagic transformation (control group); 37 cases (10.1%) had hemorrhagic transformation, with 20 cases of HI (HI group) and 17 cases of PH (PH group). The uric acid in PH group was significantly lower than that in control group and HI group: (243.59 ± 61.49) μmol/L vs. (307.84 ± 80.12) and (305.45 ± 94.99) μmol/L, and there was statistical difference ( P<0.05); there was no statistical difference in uric acid between control group and HI group ( P>0.05). The patients was divided into 3 groups according to the tertiles of serum uric acid, uric acid ≤ 264.9 μmol/L was in 121 cases (Ⅰ group), 265.0 to 338.8 μmol/L was in 122 cases (Ⅱ group) and ≥338.9 μmol/L was in 122 cases (Ⅲ group). The rate of PH in Ⅲ group was significantly lower than that in Ⅰ group: 0.8% (1/122) vs. 8.3% (10/121), and there was statistical difference ( P<0.05). Taking patients without hemorrhage transformation as a reference, multivariate Logistic regression analysis result showed that diabetes, atrial fibrillation and large-area infarction were independent risk factors of HI in patients with acute cerebral infarction ( P<0.01); the age, large-area cerebral infarction, thrombolytic therapy, platelet count and uric acid were independent risk factors of PH in patients with acute cerebral infarction ( P<0.05 or <0.01). Conclusions:In patients with acute cerebral infarction, higher serum uric acid is independently correlated with lower PH, and has no correlation with HI. Serum uric acid level has certain value in predicting PH.
5.Analysis of influencing factors of red blood cell lifespan in patients with acute leukemia
Xuepeng ZHANG ; Xi YUAN ; Fan HAN ; Yaming XI
Chongqing Medicine 2024;53(11):1684-1689
Objective To analyze the red blood cell lifespan and its influencing factors in patients with acute leukemia (AL) under different disease states.Methods A total of 142 cases of patients with AL admit-ted to the department of hematology in the First Hospital of Lanzhou University from January 2022 to June 2023 were selected as the research subjects,and their red blood cell lifespan and other clinical data were col-lected.The red blood cell lifespan were compared among patients with AL under different disease states. Spearman correlation analysis was used to determine the correlation between the red blood cell lifespan with age and other laboratory indicators,and univariate analysis and multiple linear regression analysis were used to explore the influencing factors of red blood cell lifespan in patients with AL.Results Among the 142 cases of AL,there were 33 newly diagnosed cases,19 relapsed cases,8 cases of partial response+no response,and 82 cases of complete response.The red blood cell lifespan was 33.0 (9.0-147.0),52.0 (15.0-115.0),20.5 (12.0-46.0),50.0 (11.0-186.0) d,respectively.The red cell lifespan of newly diagnosed patients and pa-tients with partial response+no response was shorter than that of patients with complete response,and the differences were statistically significant (Z=-3.933,P<0.001;Z=-3.586,P=0.002).Fifteen newly di-agnosed AL patients achieved complete response after treatment,and the red blood cell lifespan was signifi-cantly prolonged compared with that at initial diagnosis[42 (14-101) d vs. 27 (9-68) d,Z=-2.179,P=0.029].The results of correlation analysis showed that the red blood cell lifespan was positively correlated with white blood cell count,red blood cell count,hemoglobin level and platelet count (P<0.05),and nega-tively correlated with blast cell count and erythropoietin level (P<0.05).The results of multiple linear re-gression analysis showed that the chromosomal abnormalities in karyotypes,FMS-like tyrosine kinase 3 (FLT3),RUNX1 gene mutations and blood transfusion were the influencing factors of red blood cell lifespan in patients with AL (B=-11.151,-24.969,-30.838,-18.784,P<0.05).Conclusion The red blood cell lifespan in patients with AL is shortened under different disease states,which could obtain a certain degree of recovery after achieving complete response after treatment (but still below the normal reference range).The red blood cell lifespan in patients with AL is related to chromosomal abnormalities in karyotypes,FLT3,RUNX1 gene mutations and short term blood transfusion.
6.Analgesic effect of intravenous anesthesia induction combined anterior lumbar quadratus block and related hemodynamic changes in patients undergoing partial nephrectomy via retroperitoneal approach
Haijun YUAN ; Xiaoxia HUANG ; Zhijian LAN ; Li FU ; Wenyong PENG ; Yaming FU
Chinese Journal of General Practitioners 2022;21(11):1063-1068
Objective:To investigate the analgesic effect of intravenous anesthesia induction combined with anterior quadratus lumborum block (AQLB)and related hemodynamic changes in patients undergoing laparoscopic retroperitoneal partial nephrectomy (RPN).Methods:A total of 116 patients undergoing elective laparoscopic partial nephrectomy for renal tumors in Jinhua Central Hospital from August 2021 to February 2022 were randomly divided into two groups with 58 cases in each group. Patients in control group received intravenous anesthesia , while those in study group received intravenous anesthesia induction with AQLB. The analgesic effect was evaluated at 1, 6, 12, 24, and 48 h after the operation. The hemodynamics were monitored at the time of entering the operating room (T 0), 3 min after induction of anesthesia (T 1), at the beginning of the operation (T 2), after the operation (T 3), and leaving the operating room (T 4). Microcirculation was assessed at 1, 6, 12, 24, and 48 h after operation. Cognitive function was assessed 30min before anesthesia, 6 h, 24 h, and 72 h after operation. Results:At 1, 6, 12, 24 and 48 h after operation, the visual analogue scale (VAS) of the resting (quiet state) pain in the study group were 3.2±1.2, 2.6±0.3,2.0±0.4, 1.5±0.4 and 0.8±0.2, which were significantly lower than those in control group (4.0±1.7, 3.4±0.7, 2.9±0.5, 1.7±0.5 and 1.2±0.3) ( t=2.93, P=0.004; t=8.00, P<0.001; t=10.07, P<0.001; t=2.38, P=0.019; t=8.45, P<0.001). There was no significant difference in heart rate and mean arterial pressure (MAP) at T 0 between two groups ; no significant difference in the heart rate at T 1, T 2, T 3 and T 4. There were significant differences in MAP levels at T 1, T 2, T 3 and T 4 between study group [(80.0±8.0)mmHg (1 mmHg=0.133 kPa), (84.4±8.4)mmHg, (80.4±5.7)mmHg, (86.4±4.7)mmHg and control group (77.1±7.5)mmHg, (88.0±8.6)mmHg, (83.0±7.7)mmHg, (92.2±6.2) mmHg; t=2.01, P=0.046; t=2.28, P=0.024; t=2.07, P=0.041; t=5.68, P<0.001]. At 6, 12, 24 and 48 h after operation, the morphological scores of tube loops in the study group were 1.0±0.2, 0.8±0.2, 0.7±0.1 and 0.7±0.1, which were lower than those in the control group (1.1 ±0.2, 0.9±0.2, 0.8±0.2 and 0.8±0.1; t=2.69, P=0.008; t=2.69, P=0.008; t=3.41, P=0.001; t=5.39 , P < 0.001). The blood flow status scores of the study group were 1.1±0.2, 0.9±0.2, 0.8±0.2 and 0.6±0.1, which were lower than those of the control group (1.2±0.2, 1.0±0.2, 0.9±0.2 and 0.7±0.1; t=2.69, P=0.008; t=2.69, P=0.008; t=2.69, P=0.008; t=5.39, P<0.001). The cognitive function scores of the study group and the control group were 24.4±1.0, 27.1±0.9 and 23.5±0.9, 26.7±0.9 at 6 h and 24 h after operation ( t=5.10, P<0.001; t=2.39, P=0.018); while there were no significant at 72 h after operation between two groups (28.2±0.9 vs. 28.1±0.8, t=0.63, P=0.529). Conclusion:Intravenous anesthesia induction combined with anterior quadratus lumborum block has a good analgesic effect in patients undergoing RPN, with stable hemodynamics and microcirculation, and not affecting cognitive function of patients.
7.Analysis of modified Clavien-Dindo classification and risk factors for postoperative early complications of radical proctectomy in rectal cancer
Jun MA ; Yaming ZHANG ; Chaoping ZHOU ; Datian WANG ; Bin GAO ; Daibin TANG ; Jianwei YUAN ; Peng JIANG
International Journal of Surgery 2019;46(8):524-529,封3
Objective To investigate the modified Clavien-Dindo classification and risk factors for postoperative early complications of radical proctectomy in rectal cancer.Methods The clinical data of 187 patients,including 99 male cases and 88 female cases with the average age (64.5 ± 10.8) years old (ranged from 37 to 87 years),with radical resection of rectal cancer were analyzed retrospectively in Anqing Hospital Affiliated of Anhui Medical University between August 2014 and October 2018,and the occurrence of early postoperative complications was analyzed according to the modified Clavien-Dindo grade system.The relationship between 32 variables and complications in the data was analyzed by single factor and multiple factors in order to explore the risk factors of early postoperative complications.Results One hundred and eighty seven patients with radical proctectomy,54 cases (28.9%,54/187) had early postoperative complications,including 15 cases of serious complications (8.0%,15/187),3 cases were performed second surgeries under general anesthesia (1.6%,3/187).Postoperative modified Clavien-Dindo Grade:12 cases with grade Ⅰ,27 cases with grade Ⅱ,11 cases with grade Ⅲ a,3 cases with grade Ⅲ b,1 case with grade Ⅳ a,no case with grade Ⅳ b and Ⅴ.The results of single factor analysis showed age (x2 =4.788,P =0.029),ASA grade (x2 =26.903,P =0.000),multiple organ resection (x2 =4.749,P =0.029),pT stage (x2 =8.080,P =0.044),pTNM stage (x2 =6.29,P =0.043),total harvested lymph node number (x2 =5.542,P =0.019).The occurrence of early complications after radical proctectomy,multi-factor analysis found that ASA grade (OR =3.539,P =0.000),pTNM stage (OR =1.846,P =0.034) was an independent risk factor for early postoperative complications of rectal cancer.The area (AUC value) under the curve of the prediction of early postoperative complications in patients with ASA grade and pTNM stage was 0.708 (95% CI:0.625-0.791,P =0.000) and 0.555 (95% CI:0.469-0.642,P =0.235).Conclusions Early complications after radical resection of rectal cancer are closely related to ASA grade and tumor pTNM staging.ASA grade can be used as a significant predictor of early complications after radical proctectomy in rectal cancer.
8.Analysis of risk factors of lymph node metastasis in early gastric cancer patients undergo operation
Daibin TANG ; Jun MA ; Jianwei YUAN ; Xiaohu HE ; Chaoping ZHOU ; Yaming ZHANG
International Journal of Surgery 2020;47(8):518-522
Objective:To investigate the relationship between clinicopathological features and lymph node metastasis(LNM)of early gastric cancer(EGC), so as to provide and theoretical guidance for the normative treatment of EGC.Methods:A retrospective analysis was performed on 128 patients with EGC who received surgical treatment from January 2016 to December 2019 in Anhui Medical University Affiliated Anqing hospital.Results:The total LNM ratio of EGC was 10.1% (13/128). Univariate analysis showed that the LNM ratio was 18.0% in patients with the largest diameter of >2 cm, higher than 5.1% in patients with the largest diameter of ≤2 cm. The LNM ratio of submucosal carcinoma (T 1b) was 21.6%, higher than 2.6% of intramucosal carcinoma (T 1a). The LNM ratio of patients with vascular invasion was 71.4%, higher than 6.7% of patients without vascular invasion. The LNM ratio was 13.1% in the total dissected lymph node group ≥15, higher than 0 in the total dissected lymph node group <15. The difference between the these groups was statistically significant( χ2=5.532, 12.101, 23.778, 4.239, P<0.05). There was no significant difference in the correlation between age, gender, tumor site, general type, degree of differentiation, and the LNM of EGC ( P>0.05). Multivariate analysis showed that submucosal carcinoma(RR=10.688, 95% CI: 1.714-66.651, P=0.011) and vascular infiltration(RR=27.209, 95% CI: 3.749-197.450, P=0.001) were the independent risk factor for the LNM of EGC. Conclusions:Patients of EGC with tumor infiltration to submucosa(T 1b), maximum diameter of lesion >2 cm, and vascular infiltration have a higher risk of LNM. Standardized D1+ or D2 lymph node dissection (≥15) should be performed for EGC patients.
9.Expression and significance of MMR protein,HER2 and Ki-67 in colorectal cancer
Fei YANG ; Yaming ZHANG ; Chaoping ZHOU ; Datian WANG ; Bin GAO ; Jun MA ; Daibin TANG ; Jianwei YUAN ; Yuxiang WANG
Chongqing Medicine 2024;53(9):1317-1322
Objective To investigate the expression and clinical significance of mismatch repair (MMR) protein,human epidermal growth factor receptor (HER)2 and Ki-67 in colorectal cancer.Methods The clini-cal data of 559 patients with colorectal cancer who underwent surgical treatment in the hospital from October 2017 to May 2022 were retrospectively analyzed.The expressions of MMR protein (MLH1,MSH2,PMS2, MSH6),HER2 and Ki-67 in colorectal cancer were detected by immunohistochemistry,and the relationship between them and the clinicopathological features of colorectal cancer was analyzed.Results Among the 559 patients with colorectal cancer,43 cases (7.7%) were deficient mismatch repair (dMMR),8 cases(1.4%) were HER2 +++,and 251 cases (44.9%) were Ki-67 +++.The expression rate of dMMR in the colorec-tal cancer patients with different age,tumor location,tumor maximum diameter,gross type,histological grade,lymph node metastasis and TNM stage was significantly different (P<0.05).The expression rate of HER2 ++/+++ in the patients with different gross types of colorectal cancer was statistically significant (P<0.05).The expression rate of Ki-67 +++ in the colorectal cancer patients with different histological types,histological grades,lymph node metastasis,distant metastasis and TNM staging was statistically signifi-cant (P<0.05).There was no correlation between MMR protein and the expression of HER2 and Ki-67 (P>0.05).Conclusion The expression of MMR proteins in colorectal cancer is closely related to its clinicopatho-logical features.
10.Distribution of potential suitable habitats for Ixodes persulcatus in Heilongjiang Province based on the maximum entropy model
Yue WANG ; Yaming ZHANG ; Shuang YUAN ; Yang DING ; Xin GUAN ; Shengnan GAO ; Guangping SONG ; Lei TANG
Chinese Journal of Endemiology 2024;43(11):885-890
Objective:To investigate the distribution of potential suitable habitats for Ixodes persulcatus in Heilongjiang Province during different climatic periods. Methods:The geographical location data of Ixodes persulcatus in Heilongjiang Province from 1980 to 2023 were collected through literature search and field ecological investigation. The environmental factor variables were downloaded from the WorldClim website and the Resource and Environmental Science and Data Platform. A combination of SDMtune, ENMTools packages, and the maximum entropy (MaxEnt) model were used to predict the potential habitats of Ixodes persulcatus in Heilongjiang Province during different climatic periods and determine its dominant environmental factors. Among them, the time range of historical climatic period data was 1970 - 2000. The future climatic period data (2021 - 2040, 2041 - 2060) were selected as the low forcing scenario (SSP126 scenario) of the shared socioeconomic pathways (SSP) in the Beijing Climate Center - Climate System Model version 2-Medium Resolution, to simulate the impact of global warming on the distribution of potential habitats for Ixodes persulcatus in Heilongjiang Province. Results:A total of 83 geographical distribution sites of Ixodes persulcatus in Heilongjiang Province were obtained. After screening, 10 environmental factors were included in the MaxEnt model. Among them, the cumulative contribution percentage of annual precipitation, average annual temperature, and vegetation type was 67.3%. Compared with historical climatic period, the total potential habitats of Ixodes persulcatus in Heilongjiang Province increased from 29.81 × 10 4 km 2 to 32.24 × 10 4 km 2 in 2041 - 2060. The center of potential habitats moved to 47.75° N, and 128.66° E, with a northwest offset of 126.07° and a migration distance of 45.83 km. Conclusion:With global climate warming, the total potential habitats of Ixodes persulcatus in Heilongjiang Province has increased, showing an overall trend of migration to the northwest.