1.Ethical Suggestions for Fetal Echocardiography Examination and Counseling Service
Yutong LIANG ; Tian ZHOU ; Zhen WANG
Chinese Medical Ethics 2015;(3):335-337
The application of fetal echocardiography in clinical is increasing , more and more patients need de-tailed consulting services .The following suggestions are made:Echocardiographic doctors should set up the consulting service consciousness , provide consulting with patience , popularity and carefulness; the doctors should understand the patients and their family′s emotions and also pay attention to the psychological care;environmental requirements for patients′echocardiographic examination and counseling service;encouraging multidisciplinary join the participa-tion of consulting services .
2.Characteristics and inspirations of medical assurance for martial arts events in Beijing Olympic Games
Hang WU ; Kuo LIANG ; Changyi SUN ; Yutong WU
Chinese Journal of Hospital Administration 2009;25(6):400-402
Objective To probe into characteristics of medical assurance for medical service preparation, medical staff deployment and injury treatment/rescue for martial arts competitions in Beijing Olympic Games. Methods Collecting data of all injuries treated onsite of martial art venues and in clinics of such venues, for statistical analysis of the injury occasions, injury location, injury types and post-injury treatment. Results During the test games, injuries found in martial arts repertoire competitions account for 0. 92% of all athletes in the category, mostly waist and lower limbs injury; injuries found in sanshou competitions account for 12.4% of all athletes in the category, mostly blunt trauma on head/face, body, perineum and four limbs, along with skin lacerations and 16 heavily wounded transferred to hospitals for rescue. No injuries are found in official games of martial arts repertoire competitions; in sanshou competitions, injuries account for 5. 5% of all athletes of the category, without heavy injuries for hospital rescue. Conclusion Athletes tend to be exposed to greater risk of injury in sanshou than in repertoire competition, headcount of injuries and injury heaviness in test games are higher than official games, probability of injuries of athletes of middle level is higher than those of other levels. Medical staff of professional surgeons of multidisciplinary skills are recommended.
3.Analysis of colorectal cancer incidence and mortality rates during the last 40 years in Hebei Province
Daojuan LI ; Di LIANG ; Jing JIN ; Denggui WEN ; Baoen SHAN ; Yutong HE
China Oncology 2017;27(3):212-218
Background and purpose: Colorectal cancer is one of the most common gastrointestinal cancers. There were about 1.36 million new cases of colorectal cancer, which was the third highest incidence of malignant tu-mors of the world in 2012. It was the fourth leading cause of cancer death and became a serious threat to human health. The aim of the study was to estimate the colorectal cancer burden in Hebei Province with the data of cancer registries areas and analyze the trend of colorectal cancer mortality rates with three of the Hebei Province death retrospective surveys. Methods: Nine cancer registries in Hebei Province submitted cancer registry data from 2010 to 2012 to the Hebei Provincial Cancer Registry Center. The pooled data were stratified by gender and age (0, 1-4, 5-9, 10-14…80+). Proportions and incidence/mortality rates for colorectal cancer were calculated. Incidence and mortality rates were age-standardized to Chinese population census in 2000 and world Segi's population standard. Colorectal cancer mortal-ity data during the periods 1973-1975, 1990-1992 and 2004-2005 were extracted from the death retrospective surveys and analyzed. Mortality and incidence rate data from Cixian County from 1988 to 2012 and Shexian County from 2000 to 2012 were obtained in each county and analyzed using Joinpoint regression model. Results: The estimated number of newly diagnosed colorectal cancer cases and deaths from 2010 to 2012 in cancer registry areas of Hebei Provinc were 2303 and 1229, respectively. The crude incidence rate of colorectal cancer was 16.48/100000 (male 18.12/100000 and female 14.77/100000). The age-standardized incidence rate by Chinese population census (ASRC) in 2000 was 13.74/100000. The colorectal cancer mortality rate was 8.79/100000 (male 10.23/100000 and female 7.31/100000). The age-standardized mortality rate by Chinese population census (ASRC) in 2000 was 7.59/100000. The mortality rates of colorectal cancer displayed a significant increasing trend in Hebei Province from 1973-1975 to 2010-2012, with an increased rate of 28.03%. In Cixian County, the annual percentage change (APC) of colorectal cancer incidence rate was 3.55, while the APC of colorectal cancer mortality rate was 1.64 for males from 1988 to 2012. In Shexian County, the APC of colorectal cancer incidence rates were 4.68 and 9.17 for males and females from 2000 to 2012, respectively;the APC of colorectal cancer mortality was 5.61 for males in Shexian County. Conclusion: The incidence and mortality rates of colorectal cancer showed an increasing trend in Hebei Province over the past 40 years. It is an important task that colorectal cancer screening is strengthened to reduce morbidity and mortality of the colorectal cancer in Hebei Province.
4.Protective effect of Tongxinluo on mini-swine model of acute myocardial infarction and reperfusion damaged by oxidative stress
Lian DUAN ; Yuejin YANG ; Haitao ZHANG ; Yutong CHENG ; Sheng KANG ; Jinglin ZHAO ; Liang MENG ; Yi TIAN ; Jue YE ; Xianmin MENG
Chinese Journal of Pathophysiology 2010;26(3):430-434
AIM: To assess the degree of oxidative damage during acute myocardial infarction and reperfusion, and to clarify the protective effect of Tongxinluo in mini-swine model. METHODS: Thirty mini-swines were randomized into 5 study groups: sham group, model group, low dose (0.05 g·kg~(-1)·d~(-1)), medium dose (0.2 g·kg~(-1)·d~(-1)) and high dose (0.5 g·kg~(-1)·d~(-1)) of Tongxinluo groups (pretreated with Tongxinluo for 3 d). Animals except in sham group were subjected to 3 h of coronary occlusion followed by 1 h of reperfusion. Concentrations of total antioxidative capability (T-AOC), total superoxide dismutase (T-SOD), reduced glutathione (GSH) and malondialdehyde (MDA) in blood sample and the myocardium were measured. RESULTS: (1) T-AOC, T-SOD and GSH in serum significantly decreased (all P<0.05), while MDA significantly increased (P<0.01) at 3 h after AMI in comparison with those at baseline. Compared to those at 3 h after AMI, the contents of T-AOC, T-SOD and GSH at 1 h after reperfusion significantly decreased (all P<0.01), accompanied by increase of MDA (P<0.01). (2) Compared to those in normal area, levels of T-AOC, T-SOD and GSH in reperfusion myocardium decreased significantly (all P<0.01) and MDA increased significantly (P<0.01). T-AOC, T-SOD and GSH in no-reflow myocardium further decreased (all P<0.01) and MDA increased (P<0.01) as compared to those in reperfusion myocardium. (3) Compared to model group, medium dose of Tongxinluo increased the contents of T-AOC and T-SOD and reduced MDA production in serum at 3 h after AMI (all P<0.05), while medium dose of Tongxinluo increased T-SOD level at 1 h after reperfusion (P<0.05). High dose of Tongxinluo increased the levels of T-AOC and T-SOD and decreased MDA content in serum at 3 h after AMI and 1 h after reperfusion (all P<0.05). (4) The medium dose of Tongxinluo increased T-AOC content (P<0.05) and reduced MDA (P<0.05) in reperfusion myocardium, while high dose of Tongxinluo increased T-AOC, T-SOD and GSH (all P<0.05), reduced MDA (P<0.01) in reperfusion myocardium, and also increased T-AOC, T-SOD (all P<0.05), reduced MDA (P<0.01) in no-reflow area as compared to those in model group. CONCLUSION: Impairment of antioxidant defense system in vivo and imbalance of redox homeostasis in myocardium region might play an important role in the pathogenesis of no-reflow after myocardial acute infarction following reperfusion. Tongxinluo protects myocardium from reperfusion injury by improving antioxidant defense and attenuating oxidative damage.
5.Correlation of arterial total compliance and carotid-femoral pulse wave velocity: an echocardiographic study
Yutong LIANG ; Yong YANG ; Pengfei CHEN ; Tian ZHOU ; Zhen WANG
Chinese Journal of Medical Ultrasound (Electronic Edition) 2017;14(9):671-675
Objective To explore the correlation between arterial total compliance indices, stroke volume/pulse pressure (SV/PP), SV adjusted by body surface area/PP (SV′/PP) and carotid-femoral pulse wave velocity (PWV), and investigate the value of SV/PP, SV′/PP in the evaluation of clinical arterial stiffness (AS). Methods Forty-five hospitalized patients with coronary heart disease (CHD) in Tangdu Hospital of Fourth Military Medical University from March to December 2016 were included in this study (CHD group). Forty-five healthy volunteers who took a health checkup in Tangdu Hospital at the same period were also included as healthy controls. SV was measured by echocardiography, and the PP was calculated through traditional blood pressure measurement. Body surface area was calculated by Du Bois formula. Carotid-femoral PWV was measured by Doppler ultrasonography. Unpaired t test was used to compare the AS indices between CHD group and healthy controls. Spearman correlation analysis was used to evaluate the correlation between SV/PP, SV′/PP and carotid-femoral PWV.Results SV/PP, SV′/PP were decreased [(1.23±0.26) ml/mmHg vs(1.37±0.27) ml/mmHg, (0.66±0.13) ml/m2?mmHg vs(0.74±0.15) ml/m2?mmHg, 1 mmHg=0.133 kPa], carotid-femoral PWV was increased [(9.49±2.05) m/s vs(8.16±1.07) m/s] in CHD patients when compared with control group with statistical significance (t=2.0971,P<0.05;t=2.1643,P<0.05;t=2.8321,P<0.01, respectively). Both SV/PP and SV′/PP in healthy controls and CHD group inversely correlated with the corresponding Carotid-femoral PWV (healthy controls:r=-0.64,-0.56, bothP<0.001; CHD group:r=-0.53, P=0.0002,r=0.61,P<0.001). While SV′/PP showed a stronger correlation with carotid-femoral PWV. Conclusions Arterial total compliance decreases and AS increases in CHD patients compared with healthy controls. SV/PP, derived from echocardiography and blood pressure measurement, correlates with carotid-femoral PWV, the″golden standard″ index of AS. After adjusted by body surface area, SV′/PP correlates more strongly with carotid-femoral PWV. SV/PP and SV′/PP are expected to provide a simple and convenient way for clinical noninvasive AS evaluation.
6.Prognostic value of blood neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with gastric cancer.
Shumei LI ; Xiaoli XU ; Di LIANG ; Guo TIAN ; Shan SONG ; Yutong HE
Chinese Journal of Oncology 2014;36(12):910-915
OBJECTIVETo explore the prognostic value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with gastric cancer.
METHODS591 cases of gastric cancer pathologically diagnosed at the Fourth Hospital of Hebei Medical University in 2006 were included in this study. The clinical information including age and gender, cancer, treatment, and the first blood test information at admission were collected from the medical record room and analyzed. The patients were followed up to March 15, 2012. The survival was calculated by Kaplan-Meier analysis. The differences between groups were compared using Log-rank test. Cox regression was used to analyze the factors which may affect the survival of the patients. Software SPSS 13.0 was used for statistical analysis.
RESULTSIn 2006, a total of 591 patients were enrolled in this study in accordance with the inclusion criteria. By the end of the study, 538 cases were followed up. The follow-up rate was 91.0%. Among them 353 cases died of gastric cancer, 185 patients are still alive. In the whole group of 538 cases, the 1-, 3-, and 5-year survival rate was 69.9%, 47.0%, and 37.5%, respectively. In the low NLR group, the 1-, 3-, and 5-year survival rate was 76.1%, 50.1%, and 42.7%, respectively, while those of the high NLR group was 53.1%, 38.6%, and 23.4%, respectively, showing a significant difference between the two groups (P < 0.05). Univariate analysis showed that the survival rate was significantly correlated with age, pathological type, TNM stage, operation, NLR and PLR (P < 0.05 for all). Multivariate analysis showed that TNM stage, operation, NLR and age of patients were independent risk factors for the prognosis of gastric cancer (P < 0.05 for all). According to the sub-site stratified analysis, TNM stage, operation and NLR were independent risk factors for gastric cardia adenocarcinoma (P < 0.05 for all), and age, TNM stage, operation for distal gastric cancer (P < 0.05 for all). PLR was not an independent prognostic factor of survival in patients with gastric cancer.
CONCLUSIONNLR may be an independent prognostic factor of gastric cancer.
Adenocarcinoma ; Aged ; Blood Platelets ; Female ; Hematologic Tests ; methods ; Humans ; Kaplan-Meier Estimate ; Lymphocyte Subsets ; Lymphocytes ; Male ; Middle Aged ; Neutrophils ; Prognosis ; Stomach Neoplasms ; diagnosis ; Survival Rate
7.The impact of the hospital-level initial funding for overseas returnee on the ability of scientific research projects of young people in the third class hospital
Yutong FENG ; Dongming LIU ; Yuping YANG ; Huiqing WANG ; Hui LIU ; Dawei WANG ; Lijun LIANG ; Liyuan TAO ; Jie QIAO
Chinese Journal of Medical Science Research Management 2019;32(3):199-202
Objective Through the investigation of the research funding status of returnees before and after their long-term (more than 3 months) study at abroad in a three class hospital,this paper analyzed the influence of the hospital level initial funding to help young talent to obtain scientific research funding,discussed appropriate measurement to enhance the scientific research capacity of hospital young talents to provide reference for management.Methods Long-term sponsored study abroad returnees from 2005 to 2015 of this hospital were recruited as subjects,divided into two groups according to whether they got the hospital-level initial funding after returning,comparative analysis was conducted to understand the influence of such funding to help obtaining subsequent research projects of these young talents.Results The number of subjects per capita returned to the obtained group was higher than that of the non obtained group,and the proportion of high-level subjects at provincial and ministerial levels was higher than that of the non-obtained group (P<0.05),and the average time interval between the groups after returning home was less than that of the non-obtained group (P<0.05).Conclusions The hospital-level initial funding for overseas returnee can obviously improve the quality and speed of the subsequent projects of the young talents in the hospital,and have a significant positive effect on mobilizing the enthusiasm for scientific research,improving their scientific re search ability,and improving the overall scientific research level and competitiveness of the hospital.
8.Comparison of clinical effects of three criteria for postoperative pulmonary complications
Yutong ZHANG ; Liang JIN ; Hong YU ; Xuefei LI ; Hai YU
Chinese Journal of Anesthesiology 2022;42(9):1054-1058
Objective:To compare the clinical effects of the three criteria for postoperative pulmonary complications (PPCs).Methods:The clinical data of patients underwent thoracoscopic lung resection between January 2021 and July 2021 in our hospital were retrospectively analyzed.PPCs were assessed using the Melbourne Group Scale (MGS), European Perioperative Clinical Outcome (EPCO) and Standardized Endpoints for Perioperative Medicine (StEP) criteria.The patients were divided into PPC group and non-PPC group according to the above criteria.The diagnostic rates of PPCs of the three criteria were recorded.Cohen′s weighted kappa coefficient was used to evaluate the agreement between the three criteria.Logistic regression method was used to analyze the association between PPCs diagnosed by different criteria and risk of adverse prognostic events developed.Results:A total of 397 patients who underwent thoracoscopic lung surgery were included in this study.The rate of PPCs diagnosed by MGS criterion was significantly lower than those by EPCO and StEP criteria ( P<0.001), and the rate of PPCs diagnosed by EPCO criterion was significantly higher than those by StEP criterion ( P<0.001). The diagnostic agreement between EPCO criterion and StEP criterion was good ( κ=0.624, P<0.001), while the diagnostic agreement between EPCO criterion, StEP criterion and MGS criterion was poor ( κ=0.101, P<0.001; κ=0.210, P<0.001). Univariate and multivariate logistic regression analysis showed that PPCs diagnosed by EPCO and StEP criteria increased the risk of adverse prognostic events developed ( P<0.001). Conclusions:The EPCO and StEP criteria are superior to MGS criterion with regard to the diagnostic and prognostic value for pulmonary complications following thoracoscopic lung resection, and the EPCO criterion had a higher sensitivity.
9.Incidence and mortality of cancers appeared in the Hebei provincial cancer registry system in 2011
Yutong HE ; Di LIANG ; Daojuan LI ; Jingbo ZHAI ; Bo LIU ; Junqing ZHU ; Baoen SHAN
Chinese Journal of Epidemiology 2015;36(8):846-851
Objective To analyze the cancer incidence and mortality in Hebei cancer registry available areas in 2011.Methods Data were collected from 8 population-based cancer registries systems in Hebei province.Incidence and mortality rates stratified by areas (urban/rural),sex,age group and cancer site were analyzed.10 common cancers in different groups,proportions and cumulative rates were calculated.The Chinese population census in the year 2000 and Segi's populations were used for age-standardized incidence/mortality rates.Results In all the 8 cancer registries that covering a total of 4 573 293 population (2 139 779 in urban and 2 433 514 in rural areas),data was used for the analysis.The total new cancer incidence cases and deaths were 11 269 and 7 477,respectively.All the morphologically verified cancer cases (MV%) accounted for 75.26% while 3.85% of the incident cases were identified only through death certification records (DCO%).The mortality to incidence ratio appeared as 0.66.The crude incidence appeared in the Hebei cancer registration areas was 246.41/105 (264.55/105 in males and 227.75/105 in females).The age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) appeared as 207.13/105 and 206.61/105 respectively,with the cumulative incidence rates as (0-74 age years old) 23.57%.The cancer incidence and ASIRC were 242.64/105 and 200.19/105 in urban areas,whereas 249.72/105 and 214.11/105,respectively in rural areas.The crude mortality in Hebei cancer registration areas was 163.49/105(196.54/105 in male,129.51/105 in female),with age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) as 144.48/105 and 147.69/105.The cumulative mortality rate (0-74 age years old) was 14.71%.The cancer mortality (167.91/105) in rural areas seemed higher than the mortality (158.47/105) in urban areas.The most common sites of cancers were:stomach,lung,esophagus,breast,liver and colorectal,which accounted for 71.66% of all the cancer cases.Lung cancer,stomach cancer,esophagus cancer,liver cancer and colorectal cancer were the major causes responsible for the cancer deaths in the areas with data of cancer registration,which accounted for 74.79% of all the cancer deaths.Conclusion The coverage of Hebei cancer registration population could reflect the cancer burden in various areas and populations.The most commonly seen cancers were stomach,lung,esophagus,breast,liver,and colorectal,in Hebei province.In order to reduce the burden of cancers,prevention and control measures should be strengthened.
10.Current situation of emergency medical service system for patients with acute myocardial infarction in Hebei Province and its influence on treatment and prognosis
Yutong LI ; Hengbo GAO ; Dongqi YAO ; Hao XIAO ; Yanling DONG ; Baopu LYU ; Liang LIU ; Hui CHEN ; Yiqing SUN ; Yingping TIAN
Chinese Journal of Emergency Medicine 2021;30(7):809-815
Objective:To investigate the current situation of emergency medical service (EMS) system and its effect on treatment of the acute stage and short- and long-term prognosis in patients with acute myocardial infarction in Hebei province.Methods:Totally 2 961 patients with acute myocardial infarction who were admitted to major tertiary and some representative secondary hospitals in Hebei province from January 2016 to December 2016 were collected. According to the pattern of arriving hospital, all the patients were divided into the EMS group and self-transport group. The general conditions, time from onset to treatment, treatment methods, in-hospital mortality rate and 3-year mortality rate were compared between the two groups.Results:Of the included 2 961 patients, 33.13% of them were transported through EMS and 66.87% of them by private transport. Patients with a history of hypertension and ST-segment elevation myocardial infarction were more likely to choose EMS, and the difference was statistically significant ( P<0.05). Moreover, patients in the EMS group were more likely to go to tertiary hospitals for treatment (88.58% vs 85.76%, P=0.033). The time from onset to treatment of the EMS group was significantly shorter than that of the self-transport group (160 min vs 185 min, P<0.01), and the proportion of patients in the EMS group from onset-to-door time in <3 h and 3-6 h was higher than that of the self-transport group (55.76% vs 49.14%, 21.41% vs 19.09%, P<0.01). Compared with the self-transport group, the EMS group has a higher rate of reperfusion therapy (67.48% vs 61.67%, P=0.002). Patients in the EMS group had a higher in-hospital mortality rate in the acute stage (7.03% vs 4.44%, P=0.003), but its 3-year mortality rate was lower than that of the self-transport group (17.31% vs 20.77%, P<0.05). Conclusions:EMS can shorten symptom-onset-to-arrival time, increase the rate of reperfusion therapy and improve long-term prognosis of patients with acute myocardial infarction.