1.Analysis of the factors associated with scientific research management at the First Affiliated Hospital of Zhejiang University Medical School
Yiyi CHEN ; Zhexin SHAO ; Jiamin ZHANG
Chinese Journal of Medical Science Research Management 2012;(6):429-430
In recent years,scientific research of our hospital has achieved remarkable progress with the implementation of discipline-centered ideology,personnel training strategy and adequate incentive policy.The paper briefly introduces the achievements in scientific research and the measures adopted,and analyzed the key factors associated with science research management.
2.Research ethics and service specification for medical laboratories
Zhou YIN ; Yiyi CHEN ; Zhexin SHAO
Chinese Journal of Medical Science Research Management 2014;27(4):371-373
According to the theory of medical ethics,ethical guidelines and moral criterions for medical laboratories are proposed based on the characteristics of the laboratories.Internal management in terms of ethics need to be strengthened,and t the quality of service needs to be improved continually,so as to ensure the rights of patient,protect staffs against professional hazards,and protect the environment.
3.The effect of scenario case based learning for nurse-patient communication on empathy of undergraduate nursing students
Chen JING ; Shuyan TONG ; Miaohong CHEN ; Zhexin LIN ; Ningxiang LUO ; Liping WU ; Haiyun FANG
Modern Clinical Nursing 2017;16(11):38-42
Objective To study the effect of scenario case based learning for nurse-patient communicationon empathy of un-dergraduate nursing students. Methods The undergraduate nursing students who had completed the basic nursing courses and the course of"communication in nursing"were enrolled as participants.Seventy-two students recruited in 2013 were assigned as the control group,where only individual guidance was given before taking examination;while eighty-nine students recruited in 2014 as the inter-vention group,where a self-compiled Collection of Scenarios for Nurse-Patient Communication was given when they were preparing for the final examination and the students were required to give their own communication plans based on the scenario cases from the collec-tion.The two groups were compared in view of empathy. Result The intervention group were better in empathy ability assessment, with statistically significant difference (P<0.001). Conclusions The scenario case based learning for nurse-patient communication makes up for the shortcomings of traditional teaching methods.It encourages nursing students to think from the patients'perspective and improves the empathy ability of students.
4.Progress on hypoglycemia in premature infants
Jiani WANG ; Guoyong LUO ; Yun LI ; Zhexin CHEN ; Yong JI
International Journal of Pediatrics 2024;51(6):393-397
Neonatal hypoglycemia,a common disorder of abnormal glucose metabolism,occurs especially in preterm newborns.Hypoglycemia that occurs frequently and persistently may result in severe consequences for premature infants,including death or permanent brain damage.In recent years,an increasing number of research findings have demonstrated that the following conditions have been linked to an increased risk of hypoglycemia in preterm infants:maternal sickness during pregnancy,pharmaceutical use during pregnancy,and various pathophysiological states of the preterm infant.This review summarizes the current pathophysiological mechanism,risk factors,diagnosis,prevention,and treatment of hypoglycemia in preterm newborns through analyzing the pertinent literature that has been published recently both domestically and internationally,with the aim of early detection,early diagnosis and early treatment,and reducing the incidence of hypoglycemia.
5.Successful treatment of 11 cases of livedoid vasculopathy with rivaroxaban alone or in combination with folic acid/methylprednisolone
Baichao CHEN ; Wenwen ZHANG ; Xuhui FU ; Geng DUN ; Qingna GENG ; Zhexin WANG
Chinese Journal of Dermatology 2024;57(10):939-943
Objective:To retrospectively analyze the clinical efficacy and safety of rivaroxaban alone or in combination with folic acid/methylprednisolone in the treatment of livedoid vasculopathy (LV) .Methods:Clinical data were retrospectively collected from LV patients who were treated with rivaroxaban alone or in combination at the Department of Dermatology, Kaifeng People's Hospital from April 2020 to September 2023. Before treatment, all the patients underwent serum folate and homocysteine tests. Folic acid therapy was given to patients with low folate levels; glucocorticoid therapy was given to patients with generalized skin lesions in the extremities in the acute stage or with dense inflammatory cell infiltration around the dermal vessels on histopathological examination. Clinical symptoms (erythema, ulceration and pain) were scored before and after 8 weeks of treatment. Adverse reactions were recorded during the treatment.Results:A total of 11 patients were collected, including 6 males and 5 females; their ages ranged from 15 to 73 (29.00 ± 17.85) years, and the disease duration ranged from 1 month to 4 years (13.36 ± 15.87 months). Among the 11 patients, 3 were treated with rivaroxaban combined with methylprednisolone and folate, 1 with rivaroxaban combined with methylprednisolone, 5 with rivaroxaban combined with folate, and 2 with rivaroxaban alone. The total score of clinical symptoms was 5.00 ± 2.28 points before treatment, and significantly decreased to 1.18 ± 0.75 points after 8 weeks of treatment with rivaroxaban alone or in combination ( t = 6.90, P = 0.001). In addition, the pain scores of 5 patients who reported pain dropped to 0 point after 8 weeks of treatment. One patient experienced coagulation abnormalities after 2 weeks of treatment, and the coagulation parameters returned to normal without special treatment after 4 weeks. Conclusion:Rivaroxaban alone or in combination with folic acid/methylprednisolone was effective for the treatment of LV with a good safety profile.
6.Application of administrative reconciliation theory in the compliance management of medical institutions
Boping CHEN ; Yafang WU ; Xianjian CHEN ; Xianfeng XIA ; Weiping JI ; Leqi SHA ; Zhexin CAI
Chinese Journal of Hospital Administration 2022;38(6):463-466
Under the background of the comprehensively implementing the rule of law, the construction of legal practice of medical institutions in China is directly related to the sustainable and high-quality development of the medical service industry. However, at present, each medical institution lacked a systematic plan for the construction of legal practice, and the health administrative department mostly implemented the measures of inspection and punishment for illegal practice, which led to the situation that the illegal practice of medical institutions was " investigated but not corrected, and changed but invalid" . This paper creatively put forward the application research of administrative reconciliation theory in the legal practice management of medical and health institutions, for promoting medical and health institutions and medical staff to strengthen legal practice management, standardizing medical behavior, ensuring medical safety, and achieving high-quality development through the institutional incentive and guidance.
7.The initial experience of three-dimensional uniportal video-assisted thoracic surgery for the sleeve resection
Yiyang WANG ; Zhexin WANG ; Liang CHEN ; Haitang YANG ; Chenxi ZHONG ; Wentao FANG ; Heng ZHAO ; Feng YAO
Chinese Journal of Thoracic and Cardiovascular Surgery 2020;36(9):528-532
Objective:To discuss the safety and feasibility for the use of 3D uniportal VATS sleeve resection.Methods:Totally 32 patients with central lung cancer received 3D uniportal VATS sleeve resection(group A) from June 2017 to May 2020 at Shanghai Chest Hospital. Meanwhile, 63 patients received conventional VATS sleeve resection(group B). The clinicopathological and perioperative outcome data were retrospectively collected and analyzed.Results:The baseline clinicopathological characteristics between these two groups were statistically similar. Compared with group B, the mean operative time[(174.19±73.69)min vs.(212.46±50.02)min, P=0.004] and blood loss[(73.13±42.70)ml vs.(130.48±133.72)ml, P=0.020] of group A were decreased, harvested lymph node stations was increased(7.63±1.59 vs. 6.76±1.70, P=0.018). Lymph nodes dissected showed no statistical difference(1.31±1.58 vs 1.21±1.96, P=0.803). There was no intraoperative death in both groups. Inspiringly, group A possessed lower rate of conversion to thoracotomy(0 vs. 36.5%, P=0.000), shorter chest drainage durations[(4.88±1.15)days vs.(6.81±3.8)days, P=0.007]. Although there were no deaths during hospitalization in both groups, the incidence of postoperative complications in group A was significantly lower than that in group B(25.0% vs. 47.6%, P=0.046). It also presented more complicated operations including pulmonary artery plasty(25.0% vs. 6.3%, P=0.024) and carina plasty(12.5% vs. 1.6%, P=0.005) against group B. Conclusion:3D uniportal VATS was a safe and feasible technique for the surgical treatment of central lung cancer when conducting a thoracoscopic sleeve resection.
8.Construction of admission assessment table for geriatric syndrome
Hongyao HE ; Wen HE ; Zhexin LIN ; Gang YUAN ; Haiyun FANG ; Qin LI ; Manxuan SHEN ; Miaohong CHEN
Modern Clinical Nursing 2024;23(8):47-55
Objective To develop an inpatient assessment form for geriatric syndromes,aiming to quickly and accurately determine whether elderly inpatients are at risk of geriatric syndromes.Methods From May 2021 to December 2023,an initial item pool for the scale was proposed through literature review.Sixteen experts from four fields of geriatric nursing,nursing management,nursing education,and geriatric medicine were selected from seven institutions in six provinces and cities across the country.Two rounds of Delphi expert consultation were conducted to inquire about the assessment form.Results The enthusiasm coefficient of the two rounds of expert consultation was 100.00%,and the expert authority coefficient was 0.88.In the first round of expert consultation,the importance ratings of the three-level indicators ranged from 4.06 to 4.75,with a coefficient of variation of 0.09 to 0.25,a full score rate of 43.75%to 81.25%,and a Kendall coordination coefficient W of 0.210.In the second round of expert consultation,the importance ratings of the three-level indicators ranged from 4.63 to 4.94,with a coefficient of variation of 0.05 to 0.13,a full score rate of 62.50%to 93.75%,and a Kendall coordination coefficient W of 0.419.After two rounds of expert consultation,the inpatient assessment form for geriatric syndromes was finally determined,including 5 first-level indicators(past history,physical function,common geriatric symptoms,mental and psychological status,socioeconomic status),26 second-level indicators,and 41 third-level indicators.Conclusion The inpatient assessment form for geriatric syndromes developed in this study is scientifically and practically feasible and can be used to quickly identify the risk of geriatric syndromes in elderly inpatients.
9.A network pharmacology approach to explore mechanisms of activating blood circulation and removing blood stasis herbs in the treatment of endometriosis
Jie DING ; Zhexin NI ; Wen CHEN ; Chaoqin YU
Journal of Pharmaceutical Practice 2020;38(6):516-522
Objective To explore the possible mechanism of activating blood circulation and removing blood stasis herbs in the treatment of endometriosis (EM) with network pharmacology approach. Methods Seven kinds of commonly used activating blood circulation and removing blood stasis herbs, such as: peach kernel, safflower, zeilan, salvia miltiorrhiza, leonuri, radix cyathulae, and wang buliuxing were selected as the research subjects. TCMSP platform, a database of traditional Chinese medicine chemical ingredients, was used to retrieve the effective ingredients of 7 herbs. The targets of the effective ingredients were obtained through the Targets information software. GeneCards database was used to collect EM related target genes. Venn diagram tool was used to obtain the target genes of active ingredients of activating blood circulation and removing blood stasis herbs. Cytoscape 3.6.0 software was used to construct the active ingredient-target-disease network. KEGG database was used to analyze the signal pathways of target gene enrichment. Results A total of 94 active ingredients and 119 targets of 7 herbs were screened. Quercetin, luteolin and kaempferol were the key active components. PTGS2, PTGS1, NCOA2 and NCOA1 were the key targets. The 7 herbs have 20 related KGEE pathways, involving sex hormones, inflammation, apoptosis and angiogenesis. PI3K-Akt signaling pathway, IL-17 signaling pathway, TNF signaling pathway were the main pathways. Conclusion The treatment of EM with activating blood circulation and removing blood stasis herbs has the characteristics of multiple components, multiple targets and multiple pathways, which can relieve the pain, inflammation and menstrual disorders symptoms of EM.
10.Risk factors associated with surgical treatment of infective endocarditis
CHEN Zonghui ; LI Feng ; ZHAO Jinlong ; FU Liang ; NI Yinkai ; LU Zhexin
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2019;26(6):558-564
Objective To analyze the risk factors of the death associated with infective endocarditis, and to evaluate the timing of surgical treatment of infective endocarditis. Methods We retrospectively analyzed the clinical data of 62 patients with infective endocarditis in our hospital between August 2015 and August 2017. There were 43 males and 19 females at age of 19–75 (46.1±16.6) years. The clinical data were divided into a death group and a survival group, a paravalvular leakage group and a no periannular leakage group, an emergency operation group and a non-emergency operation group.The risk factors of infective endocarditis and the choice of operation time were analyzed. Results Three of the 62 patients (4.8%) died after surgery. Postoperative perivalvular leakage (regurgitation over 2 mm) in 8 patients, accounting for 12.9% of the total. Univariate analysis showed that albumin content, creatinine level, total cardiopulmonary bypass time and ascending aorta occlusion time were significantly associated with early postoperative mortality (P<0.05). The results of logistic analysis showed that age, preoperative albumin level, creatinine level, total cardiopulmonary bypass time, and ascending aorta occlusion time were significantly associated with early postoperative perivascular leakage (P<0.05), and long ascending aorta occlusion time is an independent risk factor for early death (P<0.05). There was no statistical difference in early death and the perivalve leakage between the emergency operation and the non emergency operation. Conclusion Patients with infective endocarditis should accept early surgical treatment. The choice of surgical approach should be selected according to the actual situation of patients. And we should pay more attention to albumin and creatinine levels in preoperative patients. In the operation, to shorten extracorporeal circulation time and aortic clamping time can improve the prognosis of patients.