1.The criteria and exploration of the neurosurgical base for standardized residency training
Shijuan SHI ; Wei YANG ; Mi TIAN ; Lin YANG ; Feiyan WENG ; Xia CAO ; Shiyong LIU ; Chunqing ZHANG ; Song LI ; Ping ZHAO ; Shengqing LÜ
Chinese Journal of Medical Education Research 2022;21(9):1211-1215
Here, we took base construction of neurosurgery as example to discuss and analyze according to requirements and evaluation indexes of base construction in Xinqiao Hospital, and put forward the specific objectives, measures and implementations of base construction. Foremost, we summarized experiences and overcame shortcomings through interpreting and implementing scheme of our base construction, which would help to improve the construction of standardized residency training base in China.
2.The development and validation of risk prediction model for lung cancer: a systematic review
Zhangyan LYU ; Fengwei TAN ; Chunqing LIN ; Jiang LI ; Yalong WANG ; Hongda CHEN ; Jiansong REN ; Jufang SHI ; Xiaoshuang FENG ; Luopei WEI ; Xin LI ; Yan WEN ; Wanqing CHEN ; Min DAI ; Ni LI ; Jie HE
Chinese Journal of Preventive Medicine 2020;54(4):430-437
Objective:To systematically understand the global research progress in the construction and validation of lung cancer risk prediction models.Methods:"lung neoplasms" , "lung cancer" , "lung carcinoma" , "lung tumor" , "risk" , "malignancy" , "carcinogenesis" , "prediction" , "assessment" , "model" , "tool" , "score" , "paradigm" , and "algorithm" were used as search keywords. Original articles were systematically searched from Chinese databases (CNKI, and Wanfang) and English databases (PubMed, Embase, Cochrane, and Web of Science) published prior to December 2018. The language of studies was restricted to Chinese and English. The inclusion criteria were human oriented studies with complete information for model development, validation and evaluation. The exclusion criteria were informal publications such as conference abstracts, Chinese dissertation papers, and research materials such as reviews, letters, and news reports. A total of 33 papers involving 27 models were included. The population characteristics of all included studies, study design, predicting factors and the performance of models were analyzed and compared.Results:Among 27 models, the number of American-based, European-based and Asian-based model studies was 12, 6 and 9, respectively. In addition, there were 6 Chinese-based model studies. According to the factors fitted into the models, these studies could be divided into traditional epidemiological models (11 studies), clinical index models (6 studies), and genetic index models (10 studies). 15 models were not validated after construction or were cross-validated only in the internal population, and the extrapolation effect of models was not effectively evaluated; 8 models were validated in single external population; only 4 models were verified in multiple external populations (3-7); the area under the curve (AUC) of models ranged from 0.57 to 0.90.Conclusion:Research on risk prediction models for lung cancer is in development stage. In addition to the lack of external validation of existing models, the exploration of potential clinical indicators was also limited.
3.Exploratory research on developing lung cancer risk prediction model in female non-smokers
Zhangyan LYU ; Ni LI ; Shuohua CHEN ; Gang WANG ; Fengwei TAN ; Xiaoshuang FENG ; Xin LI ; Yan WEN ; Zhuoyu YANG ; Yalong WANG ; Jiang LI ; Hongda CHEN ; Chunqing LIN ; Jiansong REN ; Jufang SHI ; Shouling WU ; Min DAI ; Jie HE
Chinese Journal of Preventive Medicine 2020;54(11):1261-1267
Objective:To develop a lung cancer risk prediction model for female non-smokers.Methods:Based on the Kailuan prospective dynamic cohort (2006.05-2015.12), a nested case-control study was conducted. Participants diagnosed with primary pathologically confirmed lung cancer during follow-up were identified as the case group, and others were identified as the control group. A total of 24 701 subjects were included in the study, including 86 lung cancer cases and 24 615 control population, respectively. Questionnaires, physical examinations, and laboratory tests were conducted to collect relevant information. Multivariable-adjusted logistic regressions were conducted to develop a lung cancer risk prediction model. Area Under the Curve (AUC) and Hosmer-Lemeshow tests were used to evaluate discrimination and calibration, respectively. Ten-fold cross-validation was used for internal validation.Results:Two sets of models were developed: the simple model (including age and monthly income) and the metabolic index model [including age, monthly income, fasting blood glucose (FBG), total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C)].The AUC (95%CI) [0.745 (0.719-0.771)] of the metabolic index model was higher than that of the simple prediction model [0.688 (0.660-0.716)] ( P=0.004). Both the simple model ( PHL=0.287) and the metabolic index model ( PHL=0.134) were well-calibrated. The results of ten-fold cross-validation indicated sufficient stability, with an average AUC of 0.699 and a standard error (SD) of 0.010. Conclusion:By incorporating metabolic markers, accurate and reliable lung cancer risk prediction model for female non smokers could be developed.
4.The development and validation of risk prediction model for lung cancer: a systematic review
Zhangyan LYU ; Fengwei TAN ; Chunqing LIN ; Jiang LI ; Yalong WANG ; Hongda CHEN ; Jiansong REN ; Jufang SHI ; Xiaoshuang FENG ; Luopei WEI ; Xin LI ; Yan WEN ; Wanqing CHEN ; Min DAI ; Ni LI ; Jie HE
Chinese Journal of Preventive Medicine 2020;54(4):430-437
Objective:To systematically understand the global research progress in the construction and validation of lung cancer risk prediction models.Methods:"lung neoplasms" , "lung cancer" , "lung carcinoma" , "lung tumor" , "risk" , "malignancy" , "carcinogenesis" , "prediction" , "assessment" , "model" , "tool" , "score" , "paradigm" , and "algorithm" were used as search keywords. Original articles were systematically searched from Chinese databases (CNKI, and Wanfang) and English databases (PubMed, Embase, Cochrane, and Web of Science) published prior to December 2018. The language of studies was restricted to Chinese and English. The inclusion criteria were human oriented studies with complete information for model development, validation and evaluation. The exclusion criteria were informal publications such as conference abstracts, Chinese dissertation papers, and research materials such as reviews, letters, and news reports. A total of 33 papers involving 27 models were included. The population characteristics of all included studies, study design, predicting factors and the performance of models were analyzed and compared.Results:Among 27 models, the number of American-based, European-based and Asian-based model studies was 12, 6 and 9, respectively. In addition, there were 6 Chinese-based model studies. According to the factors fitted into the models, these studies could be divided into traditional epidemiological models (11 studies), clinical index models (6 studies), and genetic index models (10 studies). 15 models were not validated after construction or were cross-validated only in the internal population, and the extrapolation effect of models was not effectively evaluated; 8 models were validated in single external population; only 4 models were verified in multiple external populations (3-7); the area under the curve (AUC) of models ranged from 0.57 to 0.90.Conclusion:Research on risk prediction models for lung cancer is in development stage. In addition to the lack of external validation of existing models, the exploration of potential clinical indicators was also limited.
5.Exploratory research on developing lung cancer risk prediction model in female non-smokers
Zhangyan LYU ; Ni LI ; Shuohua CHEN ; Gang WANG ; Fengwei TAN ; Xiaoshuang FENG ; Xin LI ; Yan WEN ; Zhuoyu YANG ; Yalong WANG ; Jiang LI ; Hongda CHEN ; Chunqing LIN ; Jiansong REN ; Jufang SHI ; Shouling WU ; Min DAI ; Jie HE
Chinese Journal of Preventive Medicine 2020;54(11):1261-1267
Objective:To develop a lung cancer risk prediction model for female non-smokers.Methods:Based on the Kailuan prospective dynamic cohort (2006.05-2015.12), a nested case-control study was conducted. Participants diagnosed with primary pathologically confirmed lung cancer during follow-up were identified as the case group, and others were identified as the control group. A total of 24 701 subjects were included in the study, including 86 lung cancer cases and 24 615 control population, respectively. Questionnaires, physical examinations, and laboratory tests were conducted to collect relevant information. Multivariable-adjusted logistic regressions were conducted to develop a lung cancer risk prediction model. Area Under the Curve (AUC) and Hosmer-Lemeshow tests were used to evaluate discrimination and calibration, respectively. Ten-fold cross-validation was used for internal validation.Results:Two sets of models were developed: the simple model (including age and monthly income) and the metabolic index model [including age, monthly income, fasting blood glucose (FBG), total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C)].The AUC (95%CI) [0.745 (0.719-0.771)] of the metabolic index model was higher than that of the simple prediction model [0.688 (0.660-0.716)] ( P=0.004). Both the simple model ( PHL=0.287) and the metabolic index model ( PHL=0.134) were well-calibrated. The results of ten-fold cross-validation indicated sufficient stability, with an average AUC of 0.699 and a standard error (SD) of 0.010. Conclusion:By incorporating metabolic markers, accurate and reliable lung cancer risk prediction model for female non smokers could be developed.
6.Comparison of postoperative pain and foreign body sensation in patients with inguinal hernia treated by laparoscopic transabdominal preperitoneal and open transinguinal preperitoneal
Feng GAO ; Mingyi ZHAO ; Junqing LIN ; Tao CHEN ; Jianping SHAO ; Chunqing LIU
International Journal of Surgery 2019;46(5):311-314
Objective To compara the postoperative pain and foreign body sensation in patients with inguinal hernia treated by laparoscopic transabdominal preperitoneal (TAPP) and open transinguinal preperitoneal (TIPP).Methods Retrospective analysis of clinical data of 180 patients with inguinal hernia admitted to the Daxing District People's Hospital of Capital Medical University from January 2016 to January 2018,male 158 cases,female 22 cases,average age 56 years old,age range 23-80 years old.Including 110 patients in the TAPP group and 70 patients in the TIPP group,patients in the TAPP group were treated with laparoscopic TAPP,and patients in the TIPP group were treated with open TIPP.Pain degree was assessed with pain visual analogue scale (VAS) postoperatively at 3 weeks,3 months and 6 months.The incidence of chronic pain was measured at 3 weeks,3 months,and 6 months after surgery,and the incidence of foreign body sensation at 3 months was recorded.Measurement data were expressed as mean ± standard deviation (Mean ± SD),t test was used for comparison between groups;Chi-square test was used for compare the count data between groups.Results At 3 weeks,3 months,and 6 months after surgery,the mean value of pain VAS in the TAPP group was lowerthan in the TIPP group [(0.07 ± 0.40) scores vs (0.37 ± 0.94) scores,(0.03 ± 0.16) scores vs (0.24 ± 0.69) scores,(0.01 ± 0.10) scores vs (0.14 ± 046) scores],and the difference was statistically significant (P =0.004,0.002,0.004).The incidence of pain in the TAPP group was 3.6%,2.7%,and 0.9% at 3 weeks,3 months,and 6 months after surgery,respectively.The incidence of pain in the TIPP group was 14.3%,11.4%,and 10.0%,respectively.The difference was statistically significant (P =0.021,0.040,0.012).At 3 months postoperatively,there were 2 cases (1.8%) in the TAPP group and 12 cases (17.1%) in the TIPP group with the foreign body sensation.The difference between the two groups was statistically significant (x2 =14.006,P =0.000).Conclusion Compared with the open TIPP,the laparoscopic TAPP is used to repair the inguinal hemia,The postoperative pain is milder,and the incidence of chronic pain and foreign body sensation was lower.
7.Clinical effect of laparoscopic and open umbilical hernia repair for adult umbilical hernia
Mingyi ZHAO ; Feng GAO ; Tao CHEN ; Jianping SHAO ; Junqing LIN ; Chunqing LIU
International Journal of Surgery 2019;46(4):246-250
Objective To compare the clinical effect of laparoscopic and open umbilical hernia repair for adult umbilicalhernia.Methods Eighty-threepatients with adult umbilical hernia admitted to People's Hospital of Beijing Daxing District from Feb.2008 to Jan.2017 were randomly divided into laparoscopic umbilical hernia repair group (n =38) and open umbilical hernia repair group (n =45).Patients in laparoscopic umbilical hernia repair group accepted laparoscopic umbilical hernia repair with intraperitoneal onlay mesh (n =38),while patients in open umbilical hernia repair group accepted traditional umbilical hernia repairtreatment.Operation time,hospital stay,blood loss,seroma/hematoma formation,wound infection,incomplete bowel obstruction and recurrence were compared between the two groups with the software of SPSS 22.0.The outpatient consultation was performed at 2 weeks,1 month,3 months,and 6 months after operation.The follow-up contents were wound condition,pain,and whether there were any masses in the umbilicus.After every 3 months of telephone follow-up or outpatient review,whether there were any masses in the umbilicus,the average follow-up time was 14 months.Results All operations were successfully completed.The operation time of laparoscopic umbilical hernia repair group was shorter than open umbilical hernia repair group [(31 ± 8) min vs (48 ± 10) min,P < 0.01],and hospital stay were significantly shortened in laparoscopic umbilical hernia repair group (P < 0.05).The amount of bleeding of the laparoscopic umbilical hernia repair group decreased significantly than open umbilical hernia repair group [(40 ± 18) ml vs (62 ± 25) ml,P < 0.01].The postoperative painof the laparoscopic umbilical hernia repair group was mild than open umbilical hernia repair group (P < 0.05).The postoperative complications include seroma,wound infection and incomplete bowel obstruction.There were no significant differences between the two groups of seroma,incision infection and recurrence (P > 0.05).The difference of the incidence of incomplete bowel obstruction between the two groups was statistically significant (P =0.019) . The total postoperative complication rate was significantly lower in laparoscopic umbilical hernia repair group than in open umbilical hernia repair group(x2 =5.328,P =0.021).Conclusions Laparoscopic umbilical hernia repair has short operation time,less bleeding,and satisfactory postoperative pain.It is worthy of advocacy for umbilical hernia patients who can tolerate general anesthesia.
8.Distribution of human papillomavirus (HPV) among HPV positive cervical adenocarcinoma cases detected by laser capture microdissection (LCM)
Bin LIU ; Zeni WU ; Xiaoyang LIU ; Haikui SUN ; Qing LI ; Chunqing LIN ; Liang ZENG ; Jianfeng CUI ; Xiaohong YU ; Xun ZHANG ; Ling LI ; Wen CHEN
Chinese Journal of Oncology 2016;38(4):277-282
Objective To investigate the distribution of human papillomavirus ( HPV ) in the diseased areas cut from HPV?positive cervical adenocarcinoma ( ADC ) detected by laser capture microdissection ( LCM ) . Methods Paraffin?embedded specimens diagnosed as ADC between 2005 and 2010 were collected from 9 hospitals in 7 regions across China. HPV genotyping was conducted on paraffin sections using sandwich technique and LCM in order to identify HPV infection in the tumor tissues. HE and p16 immunohistochemistry staining were performed to make histological diagnosis. Results A total of 169 cervical adenocarcinoma cases were recruited, including 94 cases of mucinous adenocarcinoma ( ADC?CX) , 9 cases of adenosquamous carcinoma ( ASC) , 19 cases of minimal deviation adenocarcinoma ( ADC?MIN) , 14 cases of clear cell adenocarcinoma ( ADC?CC) , 8 cases of endometrioid adenocarcinoma ( ADC?ENDO) , 9 cases of serous adenocarcinoma ( ADC?SER ) and 16 cases of adenocarcinoma not otherwise specified (ADC?NOS). Fourteen types of high risk HPV were detected in the whole tissue section (WTS). HPV16 was the most common type, and the second was HPV18 and HPV52, respectively. Compared with WTS, the HPV?positive rate detected by LCM was lower. The HPV positive rates were significantly different among different subtypes of cervical adenocarcinoma ( P<0.001) . After LCM, the HPV positive rate was 50.8% and 66.7% in the single infection and multiple, infection groups respectively (P=0.14). The positive rates of p16 was significantly different among different subtypes of cervical adenocarcinoma ( P<0.001) . p16?positive rate was 73. 9% in the HPV?positive samples after LCM, significantly higher than the 38. 5% of negative samples ( P<0.001) . Conclusions Laser capture dissection technique can more precisely reflect the HPV distribution in cervical adenocarcinomas. The etiological association between HPV infection and cervical adenocarcinoma occurrence is not as close as that reported in the literature.
9.Distribution of human papillomavirus (HPV) among HPV positive cervical adenocarcinoma cases detected by laser capture microdissection (LCM)
Bin LIU ; Zeni WU ; Xiaoyang LIU ; Haikui SUN ; Qing LI ; Chunqing LIN ; Liang ZENG ; Jianfeng CUI ; Xiaohong YU ; Xun ZHANG ; Ling LI ; Wen CHEN
Chinese Journal of Oncology 2016;38(4):277-282
Objective To investigate the distribution of human papillomavirus ( HPV ) in the diseased areas cut from HPV?positive cervical adenocarcinoma ( ADC ) detected by laser capture microdissection ( LCM ) . Methods Paraffin?embedded specimens diagnosed as ADC between 2005 and 2010 were collected from 9 hospitals in 7 regions across China. HPV genotyping was conducted on paraffin sections using sandwich technique and LCM in order to identify HPV infection in the tumor tissues. HE and p16 immunohistochemistry staining were performed to make histological diagnosis. Results A total of 169 cervical adenocarcinoma cases were recruited, including 94 cases of mucinous adenocarcinoma ( ADC?CX) , 9 cases of adenosquamous carcinoma ( ASC) , 19 cases of minimal deviation adenocarcinoma ( ADC?MIN) , 14 cases of clear cell adenocarcinoma ( ADC?CC) , 8 cases of endometrioid adenocarcinoma ( ADC?ENDO) , 9 cases of serous adenocarcinoma ( ADC?SER ) and 16 cases of adenocarcinoma not otherwise specified (ADC?NOS). Fourteen types of high risk HPV were detected in the whole tissue section (WTS). HPV16 was the most common type, and the second was HPV18 and HPV52, respectively. Compared with WTS, the HPV?positive rate detected by LCM was lower. The HPV positive rates were significantly different among different subtypes of cervical adenocarcinoma ( P<0.001) . After LCM, the HPV positive rate was 50.8% and 66.7% in the single infection and multiple, infection groups respectively (P=0.14). The positive rates of p16 was significantly different among different subtypes of cervical adenocarcinoma ( P<0.001) . p16?positive rate was 73. 9% in the HPV?positive samples after LCM, significantly higher than the 38. 5% of negative samples ( P<0.001) . Conclusions Laser capture dissection technique can more precisely reflect the HPV distribution in cervical adenocarcinomas. The etiological association between HPV infection and cervical adenocarcinoma occurrence is not as close as that reported in the literature.
10.Balloon dilatation therapy for treating dysphagia after brainstem stroke: A fMRI study
Xiaomei WEI ; Zulin DOU ; Shaofeng ZHAO ; Chunqing XIE ; Wusheng LIN ; Yujue WANG
Chinese Journal of Physical Medicine and Rehabilitation 2015;37(12):892-898
Objective To explore the effects of modified balloon dilatation therapy for treating upper esophageal sphincter dysfunction after a brainstem stroke.Methods Ten healthy adult volunteers and 20 dysphagic patients with upper esophageal sphincter dysfunction after a brainstem stroke were recruited.The 20 patients were divided into a balloon dilatation therapy group of ten who were treated with catheter balloon dilatation therapy, and a control group of ten who received conventional therapy.All were given block-designed task fMRI scans guided by a matched visual presentation system before and after the treatment.Results Widespread activation was observed in both hemispheres, including the bilateral cerebral cortex, the brainstem and the cerebellum, but the activated areas were significantly smaller in the stroke patients before treatment.After the treatment, seven patients in the balloon dilatation group were totally orally fed, while only three patients in the control group recovered totally oral intake.After dilatation, significantly more regions were activated, including the anterior cingulate, insula, supplementary motor area, precuneus and the frontal lobe.They were activated with relatively low voxels in the treatment group, while in the control group significant activation was observed only in the precuneus after treatment.Conclusion Modified balloon dilatation therapy can increase activation of the cortex and subcortical structures related to swallowing, promoting better swallowing function.

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