1.Management of corona virus disease-19 (COVID-19): the Zhejiang experience.
Kaijin XU ; Hongliu CAI ; Yihong SHEN ; Qin NI ; Yu CHEN ; Shaohua HU ; Jianping LI ; Huafen WANG ; Liang YU ; He HUANG ; Yunqing QIU ; Guoqing WEI ; Qiang FANG ; Jianying ZHOU ; Jifang SHENG ; Tingbo LIANG ; Lanjuan LI
Journal of Zhejiang University. Medical sciences 2020;49(1):0-0
The current epidemic situation of corona virus disease-19 (COVID-19) still remained severe. As the National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital of Zhejiang University School of Medicine is the primary medical care center for COVID-19 inZhejiang Province. Based on the present expert consensus carried out by National Health Commission and National Administration of Traditional Chinese Medicine, our team summarized and established an effective treatment strategy centered on "Four-Anti and Two-Balance" for clinical practice. The "Four-Anti and Two-Balance"strategy included antivirus, anti-shock, anti-hyoxemia, anti-secondary infection, and maintaining of water, electrolyte and acid base balance and microecological balance. Meanwhile, integrated multidisciplinarypersonalized treatment was recommended to improve therapeutic effect. The importance of early viralogical detection, dynamic monitoring of inflammatory indexes and chest radiograph was emphasized in clinical decision-making. Sputum was observed with the highest positive rate of RT-PCR results. Viral nucleic acids could be detected in10% patients'blood samples at acute periodand 50% of patients had positive RT-PCR results in their feces. We also isolated alive viral strains from feces, indicating potential infectiousness of feces.Dynamic cytokine detection was necessary to timely identifyingcytokine storms and application of artificial liver blood purification system. The "Four-Anti and Two-Balance"strategyeffectively increased cure rate and reduced mortality. Early antiviral treatment could alleviate disease severity and prevent illness progression, and we found lopinavir/ritonavir combined with abidol showed antiviraleffects in COVID-19. Shock and hypoxemia were usually caused by cytokine storms. The artificial liver blood purification system could rapidly remove inflammatory mediators and block cytokine storm.Moreover, it also favoredthe balance of fluid, electrolyte and acid-base and thus improved treatment efficacy in critical illness. For cases of severe illness, early and also short periods of moderate glucocorticoid was supported. Patients with oxygenation index below 200 mmHg should be transferred to intensive medical center. Conservative oxygen therapy was preferred and noninvasive ventilation was not recommended. Patients with mechanical ventilation should be strictly supervised with cluster ventilator-associated pneumonia prevention strategies. Antimicrobial prophylaxis should be prescribed rationally and was not recommended except for patients with long course of disease, repeated fever and elevated procalcitonin (PCT), meanwhile secondary fungal infection should be concerned.Some patients with COVID-19 showed intestinal microbialdysbiosis with decreasedprobiotics such as and . Nutritional and gastrointestinal function should be assessed for all patients.Nutritional support and application of prebiotics or probiotics were suggested to regulate the balance of intestinal microbiota and reduce the risk of secondary infection due to bacterial translocation. Anxiety and fear were common in patients with COVID-19. Therefore, we established dynamic assessment and warning for psychological crisis. We also integrated Chinese medicine in treatment to promote disease rehabilitation through classification methods of traditional Chinese medicine. We optimized nursing process for severe patients to promote their rehabilitation. It remained unclear about viral clearance pattern after the SARS-CoV-2 infection. Therefore, two weeks' quarantine for discharged patients was required and a regular following up was also needed.The Zhejiang experience above and suggestions have been implemented in our center and achieved good results. However, since COVID-19 was a newly emerging disease, more work was warranted to improve strategies of prevention, diagnosis and treatment for COVID-19.
2. Study on the health literacy and related factors of the cancer prevention consciousness among urban residents in China from 2015 to 2017
Chengcheng LIU ; Chunlei SHI ; Jufang SHI ; Ayan MAO ; Huiyao HUANG ; Pei DONG ; Fangzhou BAI ; Yunsi CHEN ; Debin WANG ; Guoxiang LIU ; Xianzhen LIAO ; Yana BAI ; Xiaojie SUN ; Jiansong REN ; Li YANG ; Donghua WEI ; Bingbing SONG ; Haike LEI ; Yuqin LIU ; Yongzhen ZHANG ; Siying REN ; Jinyi ZHOU ; Jialin WANG ; Jiyong GONG ; Lianzheng YU ; Yunyong LIU ; Lin ZHU ; Lanwei GUO ; Youging WANG ; Yutong HE ; Peian LOU ; Bo CAI ; Xiaohua SUN ; Shouling WU ; Xiao QI ; Kai ZHANG ; Ni LI ; Wanghong XU ; Wuqi QIU ; Min DAI ; Wanqing CHEN
Chinese Journal of Preventive Medicine 2020;54(1):47-53
Objective:
To understand the health literacy and relevant factors of cancer prevention consciousness in Chinese urban residents from 2015 to 2017.
Methods:
A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of demographic characteristics and cancer prevention consciousness focusing on nine common risk factors, including smoking, alcohol, fiber food, food in hot temperature or pickled food, chewing betel nut, helicobacter pylori, moldy food, hepatitis B infection, estrogen, and exercise. The logistic regression model was adopted to identify the influencing factors.
Results:
The overall health literacy of the cancer prevention consciousness was 77.4% (24 980 participants), with 77.4% (12 018 participants), 79.9% (6 406 participants), 77.2% (1 766 participants) and 74.5% (4 709 participants) in each group (
3. Analysis on the consciousness of the cancer early detection and its influencing factors among urban residents in China from 2015 to 2017
Ayan MAO ; Jufang SHI ; Wuqi QIU ; Chengcheng LIU ; Pei DONG ; Huiyao HUANG ; Kun WANG ; Debin WANG ; Guoxiang LIU ; Xianzhen LIAO ; Yana BAI ; Xiaojie SUN ; Jiansong REN ; Li YANG ; Donghua WEI ; Bingbing SONG ; Haike LEI ; Yuqin LIU ; Yongzhen ZHANG ; Siying REN ; Jinyi ZHOU ; Jialin WANG ; Jiyong GONG ; Lianzheng YU ; Yunyong LIU ; Lin ZHU ; Lanwei GUO ; Youqing WANG ; Yutong HE ; Peian LOU ; Bo CAI ; Xiaohua SUN ; Shouling WU ; Xiao QI ; Kai ZHANG ; Ni LI ; Min DAI ; Wanqing CHEN
Chinese Journal of Preventive Medicine 2020;54(1):54-61
Objective:
To understand the consciousness of the cancer early detection among urban residents and identify the influencing factors from 2015 to 2017.
Methods:
A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. Self-designed questionnaires were used to collect population, socioeconomic indicators, self-cancer risk assessment, regular participation in physical examination and other information. The multivariate logistic regression model was used to identify the factors of people who had not regularly participated in the regular physical examination in the past five years.
Results:
The self-assessment results of 32 357 residents showed that there were 27.54% (8 882) of total study population with self-reported cancer risk, 45.48% (14 671) without cancer risk and 26.98% (8 704) with unclear judgement on their own cancer risk. Among population with cancer risk, 79.84% (7 091) considered physical examination accounted. In the past five years, there were 21 105 (65.43%) residents participated in regular physical examination and 11 148 (34.56%) participated in non-scheduled one, respectively. The multivariate logistic regression analysis showed that compared with unmarried and western region residents, divorced, middle and eastern region residents had a stronger consciousness to participate in the regular physical examination (
4. Analysis on the consciousness of the early cancer diagnosis and its related factors among urban residents in China from 2015 to 2017
Xuan CHENG ; Pei DONG ; Jufang SHI ; Wuqi QIU ; Chengcheng LIU ; Kun WANG ; Huiyao HUANG ; Yana BAI ; Xiaojie SUN ; Debin WANG ; Guoxiang LIU ; Xianzhen LIAO ; Li YANG ; Donghua WEI ; Bingbing SONG ; Haike LEI ; Yuqin LIU ; Yongzhen ZHANG ; Siying REN ; Jinyi ZHOU ; Jialin WANG ; Jiyong GONG ; Lianzheng YU ; Yunyong LIU ; Lin ZHU ; Lanwei GUO ; Youqing WANG ; Yutong HE ; Peian LOU ; Bo CAI ; Xiaohua SUN ; Shouling WU ; Xiao QI ; Kai ZHANG ; Ni LI ; Jiansong REN ; Wanqing CHEN ; Min DAI ; Ayan MAO
Chinese Journal of Preventive Medicine 2020;54(1):62-68
Objective:
To understand the consciousness of the cancer early diagnosis among urban residents and identify the related factors from 2015 to 2017.
Methods:
A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The general demographic characteristics, the consciousness of the cancer early diagnosis (whether people would have a willingness or encourage their relatives/friends to confirm the abnormal results once which were detected from the physical examination) and other information were collected by using the self-designed questionnaire. The non-conditional logistic regression model was used to identify the relateol factors related to the consciousness of the cancer early diagnosis.
Results:
As for residents with abnormal result from the physical examination, 89.29% (28 802) of residents would choose to seek medical treatment for further diagnosis. If their relatives/friends had abnormal results from the physical examination, 89.55% (28 886) of residents would encourage their relatives/friends to confirm the diagnosis in time. The non-conditional logistic regression model analysis showed that compared with the public institution staff/civil servants, annual household income less than 20 000 CNY, the western region and the cancer risk assessment/screening intervention population, the company staff, annual household income about 40 000 CNY and more, and the residents from the middle and eastern region had a stronger consciousness to seek further diagnosis; while the unemployed residents and community residents were less likely to seek further diagnosis (
5. Analysis on the consciousness of the early cancer treatment and its influencing factors among urban residents in China from 2015 to 2017
Huichao LI ; Kun WANG ; Yannan YUAN ; Ayan MAO ; Chengcheng LIU ; Shuo LIU ; Lei YANG ; Huiyao HUANG ; Pei DONG ; Debin WANG ; Guoxiang LIU ; Xianzhen LIAO ; Yana BAI ; Xiaojie SUN ; Jiansong REN ; Li YANG ; Donghua WEI ; Bingbing SONG ; Haike LEI ; Yuqin LIU ; Yongzhen ZHANG ; Siying REN ; Jinyi ZHOU ; Jialin WANG ; Jiyong GONG ; Lianzheng YU ; Yunyong LIU ; Lin ZHU ; Lanwei GUO ; Youqing WANG ; Yutong HE ; Peian LOU ; Bo CAI ; Xiaohua SUN ; Shouling WU ; Xiao QI ; Kai ZHANG ; Ni LI ; Min DAI ; Wanqing CHEN ; Ning WANG ; Wuqi QIU ; Jufang SHI
Chinese Journal of Preventive Medicine 2020;54(1):69-75
Objective:
To understand the consciousness of the cancer early treatment and its demographic and socioeconomic factors.
Methods:
A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China (CanSPUC) from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The questionnaire collected personal information, the consciousness of the cancer early treatment and relevant factors. The Chi square test was used to compare the difference between the consciousness of the cancer early treatment and relevant factors among the four groups. The logistic regression model was used to analyze the influencing factors related to the consciousness of the cancer early treatment.
Results:
With the assumption of being diagnosed as precancer or cancer, 89.97% of community residents, 91.84% of cancer risk assessment/screening population, 93.00% of cancer patients and 91.52% of occupational population would accept active treatments (
6. Analysis on the health literacy of the cancer prevention and treatment and its related factors among urban residents in China from 2015 to 2017
Pei DONG ; Jufang SHI ; Wuqi QIU ; Chengcheng LIU ; Kun WANG ; Huiyao HUANG ; Debin WANG ; Guoxiang LIU ; Xianzhen LIAO ; Yana BAI ; Xiaojie SUN ; Jiansong REN ; Li YANG ; Donghua WEI ; Bingbing SONG ; Haike LEI ; Yuqin LIU ; Yongzhen ZHANG ; Siying REN ; Jinyi ZHOU ; Jialin WANG ; Jiyong GONG ; Lianzheng YU ; Yunyong LIU ; Lin ZHU ; Lanwei GUO ; Youqing WANG ; Yutong HE ; Peian LOU ; Bo CAI ; Xiaohua SUN ; Shouling WU ; Xiao QI ; Kai ZHANG ; Ni LI ; Min DAI ; Wanqing CHEN ; Ayan MAO ; Jie HE
Chinese Journal of Preventive Medicine 2020;54(1):76-83
Objective:
To understand the health literacy of the cancer prevention and treatment among urban residents of China, and explore the related factors.
Methods:
A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China (CanSPUC) from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The health literacy of the cancer prevention, early discovery, early diagnosis, early treatment and the demands of cancer prevention and treatment knowledge was analyzed. The level of health literacy among different groups were calculated and compared. The binary logistic regression model was used to analyze the influencing factors of the health literacy of the cancer prevention and treatment.
Results:
The level of health literacy of the cancer prevention and treatment was 56.97% among all study population; in each group it was 55.01% for community residents, 59.08% for cancer risk assessment/screening population, 61.99% for cancer patients and 57.31% for occupational population, respectively (
7. Analysis on the demand, access and related factors of cancer prevention and treatment knowledge among urban residents in China from 2015 to 2017
Kun WANG ; Chengcheng LIU ; Ayan MAO ; Jufang SHI ; Pei DONG ; Huiyao HUANG ; Debin WANG ; Guoxiang LIU ; Xianzhen LIAO ; Yana BAI ; Xiaojie SUN ; Jiansong REN ; Li YANG ; Donghua WEI ; Bingbing SONG ; Haike LEI ; Yuqin LIU ; Yongzhen ZHANG ; Siying REN ; Jinyi ZHOU ; Jialin WANG ; Jiyong GONG ; Lianzheng YU ; Yunyong LIU ; Lin ZHU ; Lanwei GUO ; Youqing WANG ; Yutong HE ; Peian LOU ; Bo CAI ; Xiaohua SUN ; Shouling WU ; Xiao QI ; Kai ZHANG ; Ni LI ; Wanqing CHEN ; Wuqi QIU ; Min DAI
Chinese Journal of Preventive Medicine 2020;54(1):84-91
Objective:
To investigate the demand and access to the cancer prevention and treatment knowledge and related factors among urban residents in China from 2015 to 2017.
Methods:
A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of general demographic characteristics, the demand and access to cancer prevention and treatment knowledge, and the influencing factors of the attitude. The Chi-square test was used to analyze the difference of the demand of the cancer prevention knowledge among different groups and the corresponding factors of the cancer prevention and treatment knowledge were analyzed by using the logistic regression model.
Results:
The proportion of residents who need the cancer prevention and treatment knowledge was 79.5%. The demand rate of the inducement, symptom and diagnosis methods of cancer in the occupational population was highest, about 66.8%, 71.0% and 20.8%, respectively. The demand rate of treatment methods and cost in current cancer patients was the highest, about the 45.9% and 21.9%, respectively. The top three sources to acquire the cancer prevention and treatment knowledge were "broadcast or television" (69.5%), "books, newspapers, posters or brochures" (44.7%) and "family and friends" (33.8%). The multivariate analysis showed that compared with public institution personnel/civil servants, unmarried/cohabiting/divorced/widowed and others, annual household income less than 20 000 CNY, from the eastern region, people without cancer diagnosis and people with self-assessment of cancer risk, the demand rate of cancer prevention and treatment knowledge was higher in enterprise personnel/workers, married, annual household income between 60 000 CNY and 150 000 CNY, from the central region, people with cancer and people with unclear cancer risk (all
8.Thoughts on improving the teaching effect of pathophysiology
Dewei CHEN ; Wenjuan HE ; Bing NI ; Zhiqi GAO
Chinese Journal of Medical Education Research 2019;18(2):152-155
Pathophysiology is a subject that studies the occurrence,development and mechanism of diseases.It plays important roles in medical education and is an important and difficult point in medical education.Based on our teaching experience and the characteristics of pathophysiology,this paper puts forward the idea of “Focus on learning”,aiming to resolve the problems of insufficient communication,unsound teaching design and single teaching method,etc.existed in teaching process.The active communication with students,a good job of teaching design and the reasonable application of various teaching methods and techniques should be carried out to improve the teaching effect of pathophysiology.
10.Discussion of the reform of pathophysiological experimental teaching
Zhiqi GAO ; Zhongwei TANG ; Wenjuan HE ; Bing NI ; Jun YIN ; Mengjie ZHANG ; Dewei CHEN
Chinese Journal of Medical Education Research 2019;18(5):469-471
The theories of pathophysiology come from experimental research,and experimental teaching is an important part of pathophysiology course.Experimental teaching can cultivate the abilities of independent thinking and comprehensive analysis in students,improve their practical skills,and enhance their understanding and application of theoretical knowledge.However,teaching reform should be carried out due to the drawbacks of current pathophysiological experimental teaching.With the teaching idea centered on learning,the quality of pathophysiological experimental teaching can be enhanced by rational arrangement of experimental courses,optimization of teaching contents,and comprehensive application of various teaching models,so as to effectively improve the level of theoretical knowledge and comprehensive practical ability among students.

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