1.Investigation and analysis of professional ethics of clinical medical postgraduates
Ping ZHANG ; Xing WU ; Jiaao YU ; Shi TANG ; Baorong CHI
Chinese Journal of Medical Education Research 2017;16(5):537-540
Objective To understand the cognition of clinical medical postgraduates' professional ethics,in order to provide the basis for the further development of graduate professional ethics education.Methods The survey was carried out among 650 graduate students of the first hospital of Jilin University by self-designed questionnaires.The questionnaires included the general situation and the understanding of professional ethics of medicine.All data were analyzed by SPSS 17.0,using Chi-square test to compare the results in different grades about the understanding of professional ethics.Results In this study,a total of 650 questionnaires were issued,and 629 valid questionnaires were collected with a recovery rate of 96.7%.Most graduates' professional values were in line with the socialist core values.For example,for the attitude of medical workers to accept red envelopes,410 graduate students (65.2%) firmly opposed to accepting this behavior.For the purpose of the study medicine,there was no statistically significant difference among different grades (P=0.273).For the attitude of red paper,the main problem in medical ethics education and the biggest factor for graduates,there was statistically significant difference among different grades (P=0.012,P=0.002,P=0.002,respectively).Conclusion At present,the professional ethics of postgraduates in clinical medicine is in good condition,but still needs to be improved.We can give further education and guidance to students for the problems existing in graduate students of different grades.
2.Analysis of Bile Leakage after Primary Ductal Closure Following Choledochotomy
Yiben WANG ; Xiaobing ZENG ; Chi WU ; Yu ZHU ; Limin LIU
Chinese Journal of Bases and Clinics in General Surgery 2003;0(04):-
0.05).In the group with primary common bile duct suture,the occurrence of bile leakage was relative with hyperglycemia(P0.05).Conclusion It is the key factors,including chosing appropriate patients, intraoperative special examination, careful manipulation and effective medical treatment that can reduce the morbidity of bile leakage.
3.Effect of carotid artery flow changes on the stability of plaque and typing characteristics of cerebral infarction
Xiaoling WU ; Jianping HAO ; Shuzhen WANG ; Hongxia YU ; Luxiang CHI
Journal of Regional Anatomy and Operative Surgery 2014;(3):229-233
objective To observe the influence of hemodynamic changes caused by extracranial carotid stenosis on the plaque stability, and analyze the relationship of cerebral infarction classification,criminal artery stenosis degree and plaque stability to offer evidence for evalu-ating nosogenesis,clinical diagnosis,treatment and prevention of cerebral infarction. Methods CDFI,CTA were performed in 168 patients with acute cerebral infarction,some moderate and severe and occlusive carotid artery which were demonstrated by CTA and CDFI were further checked by DSA during convalescence. Totally 168 acute cerebral infarction patients were divided into 5 groups based on the criminal artery stenosis degree. To evaluate the plaque stability and flow field changes with CDFI and CTA,OCSP clinical classification and brain image clas-sification were finished according to CTA. Patients were classified into 4 subtypes,namely cortical infarction,basal ganglion infarction,corona radiata infarction and posterior infarction,according to the lesion distributions. Observe the changes of flow field and stability of plaque,and compare the relationship between different degree of stenosis and the classification of lesion of infarction. Results Among the 168 criminal arteries,there was 17. 9% of normal,22. 6% of mild stenosis,30. 9% of moderate stenosis,14. 8% of severe stenosis,and 14. 3% of occlu-sion,and the moderate stenosis proportion was the highest. When the stenosis degree was over 50%,it may lead to the changes of flow field, speeding up of blood flow,forming of turbulent flow,and increasing of plaque instability in which lipid plaque and admixture plaque was the highest. PACI is the commonest in all moderate groups. Admixture plaque is usually seen in severe stenosis and occlusion, while fibrous plaque is usually seen in mild stenosis. Conclusion Moderate carotid stenosis may lead to the increase of plaque instability as a result of the changes of flow field,and it may prone to artery-artery embolization.
4.CT guided embedding of 125I by puncturing tissue through the cutis in patients with metastatic lung tumors
Chi CAO ; Long CHENG ; Dahai YU ; Guojun LI ; Ning CUI ; Haijiang WU
Chinese Journal of Nuclear Medicine and Molecular Imaging 2013;(1):46-48
Objective To explore the clinical application and safety of treatment of percutaneous radioactive 125I seed implantation treatment in lung metastases under CT guidance.Methods Twenty-seven lung metastatic malignancy cases (67 nodules) were studied.Eighteen cases (46 nodules) were hepatic cancer,4 cases (9 nodules) were prostate cancer,and 5 cases (12 nodules) were breast carcinoma.Diameters of lung nodules ranged from 0.5 cm to 4.0 cm with an average diameter of 2.1 cm.125I seeds were embedded under CT guidance,using 2 to 33 particles/nodule with an activity of 18.5 to 29.6 MBq/grain for each particle.Tumor matched peripheral dose was 90-120 Gy.Postoperative validation and quality evaluation followed.Results Four months later,24 nodules showed CR,30 showed PR,5 showed NC and 8 showed PD.The total effective rate was 80.6% (54/67).In the course of treatment,11 patients had pneumothorax,3 had heavy lung compression and 4 had hemoptysis.All conditions were improved by pleural puncture or under close follow-up observation.Conclusion 125I seed implantation is an effective and safe technique in treatment of metastatic lung tumors under CT guidance.
5.Correlation analysis on risk factors in 30 cases of intracranial vascular stenosis artery aneurysm
Xiaoling WU ; Shuzhen WANG ; Hongxia YU ; Luxiang CHI ; Lirong LI ; Qiufen WANG
Chongqing Medicine 2014;(11):1323-1325,1328
Objective To analyze the imageological characteristics of intracranial vascular multiple stenosis aneurysms and to e-valuate the influence of cerebral vascular stenosis caused hemodynamic change on the aneurysm occurrence .Methods The clinical data of 30 inpatients with intracranial arterial multiple stenosis aneurysms diagnosed by CTA and DSA ,who were hospitalized due to ischemic cerebrovascular disease in the neurology department of 251 Hospital of Beijing Military Region from January 2007 to May 2012 ,were retrospectively analyzed and taken as the observation group ;contemporaneous 30 cases of aneurysm without in-tracranial and extracranial arterial stenosis admitted to the neurosurgery department were taken as the control group .The gender , age of onset ,number of aneurysms ,whether or not complicating hypertension ,diabetes ,smoking ,hyperlipemia ,plaque of extracrani-al carotid artery ,ischemic stroke and cerebral arterial abnormal development were compared between the two groups .The Logistic single factor and multi-factor correlation analysis was adopted to evaluate the correlation between the aneurysm occurrence with the hemodynamic changes caused by atherosclerotic stenosis .Results Cystic multiple aneurysms were common in the observation group ,which was up to 4 in number ,the age was more than 60 years ,the majority was complicated by hypertension ,diabetes ,hyper-lipemia ,cerebral stroke ,plaque of extracranial carotid artery and intracranial arterial multiple stenosis were common .Aneurysms mostly occurred in intracranial artery with severe stenosis .The gender differences were unobvious .The control group was domina-ted by young patients .Single aneurysm was more common without intracranial artery multiple stenosis .The occurrence rate of ca-rotid arterial plaque and cerebral stroke was lower .The partial patients had smoking ,hyperlipidemia and hypertension .The Logistic regression analysis between the two groups showed that ischemic stroke ,cerebral arterial development abnormality and atheroscle-rosis plaque of extracranial carotid artery had significant correlation .Conclusion The aneurysm occurrence is related with cerebral arterial atherosclerotic stenosis ,which becomes the important factor leading to aneurysm formation and should arouse attention to conduct early diagnosis and early treatment .
6.Experimental Establishment of Life Cycle of Clonorchis sinensis
Chi LIANG ; Xuchu HU ; Zhiyue LV ; Zhongdao WU ; Xinbing YU ; Jin XU ; Huanqin ZHENG
Chinese Journal of Parasitology and Parasitic Diseases 1987;0(02):-
Objective To establish and maintain the life cycle of Clonorchis sinensis in laboratory.Methods Adult worms and eggs of Clonorchis sinensis were collected from naturally infected cats.Eggs were ingested by freshwater snails in aquarium.When the cercariae were released from infected snails, they invaded into freshwater fishes.From the 30th day on after the release of cercariae, the infection rate and metacercariae density in freshwater fishes were determined.Results After 95 days the infected snails began shedding cercariae in a temperature range of 24.3-37.2 ℃, and no cercariae were found under 20 ℃.The infection rate in the snails Parafossarulus striatulus and Alocinma longicornis was 12.5% and 18.0%, respectively.Metacercariae were found in fish at 30 days after cercariae infection, and matured metacercariae were detected in 45 days.The number of metacercariae per gram of fish meat in Pseudorasbora parva, Ctenopharyngodon idellus, Rhodeus sinensis, Hypophthalmichthys nobilis, Cirrhinus molitorella, Carassius auratus, Cyprinus carpio and Oreochromis niloticus was 1 792, 16, 8, 6, 5, 4, 4, and 2, respectively.Rats and cats were fed with metacercariae from fish to receive adult worms.Conclusion Life cycle of Clonorchis sinensis has been established and maintained in the laboratory.
7.IMPROVING TOBACCO QUALITY BY FUNGAL LEAVENS
Xiao-Ga ZHENG ; Xiu-Guo ZHANG ; Tian-Yu ZHANG ; Xun-Chi WU ;
Microbiology 1992;0(06):-
Effects of 7 fungus strains on tobacco quality by applying fungal leavens on upper leaves were studied. Results showed that BF03, BF06 and BF63 can remarkably change the chemical components of tobacco, such as soluble sugar, protein, nicotine etc., and make them more harmonious. And the smoking quality of the flue-cured tobacco leaves treated was much better than the control.
8.Clinical and pathological analysis of primary biliary cirrhosis-autoimmune hepatitis overlap syndrome
Chi-Hong WU ; Xiao-Yuan XU ; Hai-Ying LU ; Yan-Yan YU ; Gui-Qiang WANG ;
Journal of Peking University(Health Sciences) 2003;0(06):-
Objective:To explore clinical and histopathological characteristics of primary biliary cirrho-sis-autoimmune hepatitis overlap syndrome.Methods:Clinical data and pathological findings of 10 pa-tients were reviewed.Results:Serum glutamine transpeptidase,alkaline phosphatase levels,alaninetransaminase,aspartate transaminase,serum IgG and IgM were elevated in all the patients.They were allpositive for anti-mitochondrial antibody and AMA-M2.Nine patients were positive for anti-nuclear anti-body and one patient was positive for anti liver-kidney microsome antibody.Liver biopsies in these pa-tients revealed:ten patients had bile duct lesion,hepatitis activities ranged from moderate to severe,andfibrosis ranged from S1 to S3.Conclusion:PBC-AIH overlap syndrome is mostly found in middle-agedwomen.It has the clinical and histopathological characteristics of both PBC and AIH.Accurate andprompt diagnosis of overlap syndrome patients should be based on the clinical presentation,biochemicaland immune indexes,and hepalic pathological changes.
9.Ultrasound-guided percutaneous nephrostomy for the treatment of cancer-related hy-dronephrosis:a report of 289 cases
Tao LI ; Xiang WU ; Jinfeng WU ; Chi ZHANG ; Junming PENG ; Chengbo YU ; Yongbao WEI ; Yanrong ZHANG ; Liefu YE ; Xiangxun GAO
Chinese Journal of Clinical Oncology 2016;43(16):723-726
Objective:To investigate the methods and complications of ultrasound-guided percutaneous nephrostomy (PCN) for treat-ing cancer-related hydronephrosis. Methods:From June 2003 to December 2015, 289 patients (342 kidneys) with cancer-related hy-dronephrosis were treated by ultrasound-guided PCN in Fujian Provincial Hospital. Among the 97 cases of renal insufficiency, 4 pa-tients were treated with hemodialysis before PCN. Except for the anterior mid calyx of nine kidneys in nine patients, the posterior mid or lower pole calyx of all other kidneys was punctured with ultrasound guidance. With the one-step PCN technique, 8F pigtail nephros-tomy tubes were placed into six kidneys in six patients;with the Seldinger PCN technique, 14F balloon and Malecot catheters were placed into 25 kidneys in 25 patients and 311 kidneys in 258 patients, respectively. Results:No severe bleeding and injury in the intes-tine, liver, spleen, pleura, or lung occurred. Two pigtail tubes were blocked one week after PCN. Seven balloon catheters failed to drain well because of the tip and balloon of the catheters located in the proximal part of the dilated ureters. Four balloons slipped out of the collection system of the kidney because of the auto-deflation of three balloons and one case of meager renal parenchyma failing to hold the balloon after a severe hydronephrosis was emptied. All, except 1, Malecot catheter drained well, and 8/9 PCNs through anteri-or mid calyx were successful. Serum creatinine levels were significantly decreased in all the 97 patients with renal insufficiency, of which 81 cases returned to normal, and no one needed persistent hemodialysis. Conclusion:Ultrasound-guided PCN is safe and effec-tive for treating cancer-related hydronephrosis. For appropriately selected patients, puncturing the anterior mid calyx may be an op-tion without additional complications. One-step pigtail nephrostomy tubes are recommended for patients with poor systemic condi-tions. For patients with long life expectancy or suspected complicated urinary infection, large sized Malecot catheters should be consid-ered.
10.The efficacy and safety of ureteral stenting after transurethral resection (TUR) of bladder tumors involving the ureteral orifice
Tao LI ; Xiang WU ; Junming PENG ; Jinfeng WU ; Chi ZHANG ; Chengbo YU ; Yongbao WEI ; Yanrong ZHANG ; Liefu YE ; Xiangxun GAO
Chinese Journal of Urology 2016;37(9):677-680
Objective To evaluate the efficacy and safety of ureteral stenting after transurethral resection ( TUR) of bladder tumors involving the ureteral orifice.Methods From March 2009 to November 2015,34 cases of non-muscle invasive bladder tumor including 28 male and 6 female aged from 26 to 79 years( mean 51 years) were treated by TUR.14 cases had single tumor and 20 had multiple tumors,and 29 were primary and 5 were recurrent.All the patients had tumors involving the ureteral orifice without preoperative hydronephrosis revealed by IVU or CTU examination.The tumors were resected into the deep muscle layer and the involved ureteral orifices were resected during the procedure,and after that a double-J ureteral stent was placed in 18 cases.All patients received one immediate intravesical instillation of 50mg epirubicin after TUR, and further scheme of adjuvant intravesical chemotherapy instillations were made according to the pathological diagnosis.Ureteral stents were removed 10-12 weeks after TUR,and cystoscopy and urinary tract ultrasound examinations were performed every 3 months for 1-2 years postoperatively. Results The operations were successful without complications.No serious adverse reaction occurred in immediate and further adjuvant intravesical chemotherapy.During the follow-up period of 3-71 months, no ureteral stricture, hydronephrosis or tumor recurrence in the upper urinary tract occurred in all the 18 patients with ureteral stent, and the resected ureteral orifices recovered well with normal appearance and ejecting urine.Hydronephrosis was observed in 3 of 16 patients without ureteral stent including 2 cases of nontumoral stenosis at the ureterovesical junction requiring ureteral reimplantation and 1 case of lower ureteral tumor on the involved side requiring nephroureterectomy and bladder cuff excision.No patient complained of symptoms secondary to vesicoureteral reflux or continuous unrelievable lower urinary tract symptoms.2 cases of bladder tumor recurred out of the resected area.Conclusions Ureteral stenting after TUR of bladder tumors involving the ureteral orifice can prevent stricture at the ureterovesical junction without increasing the risk of tumor cell seeding along the upper urinary tract.The existence of a double-J ureteral stent does not increase complications of adjuvant intravesical chemotherapy, and also won't cause intolerable lower urinary tract symptoms.