1.Survey results analysis of death cognition and hospice attitude among healthcare providers in hematology department
Zhimin YAN ; Yanquan LIU ; Minjuan ZENG ; Xiaojun CHEN ; Jiankai ZHANG ; Yue YIN ; Jianzhen SHEN ; Zhanghua QI
Journal of Leukemia & Lymphoma 2025;34(3):159-166
Objective:To investigate the current state of death cognition among healthcare providers in hematology department and their attitudes toward hospice care for patients with hematologic malignancies.Methods:A cross-sectional investigation study was conducted. A total of 198 medical staff in hematology department of 4 teaching hospitals, including the First School of Clinical Medicine of Guangdong Medical University, Fujian Medical University Union Hospital, the Affiliated Hospital of Putian University and the First Affiliated Hospital of Gannan Medical University from March 2024 to June 2024 were selected as the investigation subjects. The general situation and background of medical staff in hematology department were investigated by using the "General Sociological Questionnaire". "Death Attitude Description Scale (Chinese version)" was used to investigate the status of death cognition among medical staff in hematology department. "Frommelt Attitudes Toward Care of the Dying Scale Form B (Chinese version)" was used to investigate the hospice care attitude of medical staff in hematology department. The survey results of doctors and nurses were compared.Results:There were 105 doctors and 93 nurses in hematology department included in this study. A total of 198 qualified "General Sociology Questionnaires" were collected. After excluding 6 unqualified questionnaires, 192 copies of "Death Attitude Description Scale (Chinese version)" and "Frommelt Attitudes Toward Care of the Dying Scale Form B (Chinese version)" were collected. There were statistically significant differences in gender, educational background, political status and experience of taking care of terminally ill patients between doctors and nurses (all P < 0.05). The scores of approaching acceptance, neutral acceptance, death escape, death fear and flight acceptance were (4.35±0.37), (4.03±0.51), (2.98±0.62), (2.54±0.29) and (2.19±0.42) points, respectively in the doctor group; the corresponding scores were (3.12±0.41), (3.89±0.46), (2.66±0.63), (2.81±0.57) and (2.37±0.65) points, respectively in the nurse group, and the differences between the 2 groups were statistically significant (all P < 0.05). The total score of hospice care attitude of doctors in hematology department was (108±15) points, and that of nurses was (116±13) points, and the difference was statistically significant ( t = -3.61, P < 0.001). The hospice care attitude of doctors and nurses towards patients with hematologic malignancies is generally between positive and neutral. The nurse group showed more recognition of the positive role of the patient's family members in the process of hospice care, and the doctor group showed more recognition of the promoting role of medical staff in hospice care. There were statistically significant differences in hospice care attitude scores of medical staff in hematology department to patients with different occupational background, gender, age, place of residence, family discussion about death, whether the only child, whether they had the experience of taking care of terminally ill patients, and whether they suffered from serious illness and religious belief (all P < 0.05). Conclusions:The death cognition of medical staff in hematology department is neutral, and they show a certain sense of hospice care.
2. Diagnostic value of optical imaging combined with indocyanine green-guided sentinel lymph node biopsy in gastric cancer: a meta-analysis
Meifeng HE ; Zhanwu JIANG ; Zhiwei HAO ; Jie AN ; Jian ZHAI ; Jiankai SHEN
Chinese Journal of Gastrointestinal Surgery 2019;22(12):1196-1204
Objective:
To systematically evaluate the diagnostic value of optical imaging combined with indocyanine green (ICG)-guided sentinel lymph node (SLN) biopsy in gastric cancer, and to identify potential factors that would influence diagnostic accuracy.
Methods:
Study was carried out by searching the electronic database of PubMed, Embase, Medline, Web of Science, and the Cochrane Library with keywords as "gastric/stomach" and "cancer/carcinoma/tumor/tumour/adenocarcinoma/neoplasm" and "sentinel lymph node" and "near-infrared/NIR or fluorescent imaging" and "indocyanine green/ICG" . Literature inclusion criteria: (1) gastric cancer clinical stage was cT0-3; (2) clinical stage determined by at least 2 kinds of imaging modalities; (3) optical imaging (near-infrared or fluorescence imaging) combined with ICG-guided SLN biopsy; (4) prospective study to predict lymph node metastasis; (5) intraoperative or postoperative pathology for all lymph nodes removed; (6) patients number in the literature >10 cases. Exclusion criteria: (1) patients with a history of ICG allergy or chemoradiotherapy; (2) previous history of endoscopic mucosal resection or endoscopic submucosal dissection; (3) patients with a variety of gastrointestinal tumor; (4) case reports, conference abstracts, clinical guidelines, editorials, reviews, meta-analysis and correspondence letters; (5)
3.Diagnostic value of optical imaging combined with indocyanine green?guided sentinel lymph node biopsy in gastric cancer: a meta?analysis
Meifeng HE ; Zhanwu JIANG ; Zhiwei HAO ; Jie AN ; Jian ZHAI ; Jiankai SHEN
Chinese Journal of Gastrointestinal Surgery 2019;22(12):1196-1204
Objective To systematically evaluate the diagnostic value of optical imaging combined with indocyanine green (ICG)?guided sentinel lymph node (SLN) biopsy in gastric cancer, and to identify potential factors that would influence diagnostic accuracy. Methods Study was carried out by searching the electronic database of PubMed, Embase, Medline, Web of Science, and the Cochrane Library with keywords as"gastric/stomach"and"cancer/carcinoma/tumor/tumour/adenocarcinoma/neoplasm"and"sentinel lymph node"and"near?infrared/NIR or fluorescent imaging"and"indocyanine green/ICG". Literature inclusion criteria: (1) gastric cancer clinical stage was cT0?3; (2) clinical stage determined by at least 2 kinds of imaging modalities; (3) optical imaging (near?infrared or fluorescence imaging) combined with ICG?guided SLN biopsy; (4) prospective study to predict lymph node metastasis; (5) intraoperative or postoperative pathology for all lymph nodes removed; (6) patients number in the literature >10 cases. Exclusion criteria: (1) patients with a history of ICG allergy or chemoradiotherapy; (2) previous history of endoscopic mucosal resection or endoscopic submucosal dissection; (3) patients with a variety of gastrointestinal tumor; (4) case reports, conference abstracts, clinical guidelines, editorials, reviews, meta?analysis and correspondence letters; (5) in vitro or animal experiments; (6) insufficient diagnostic efficacy data. The meta?analysis was performed in the Stata12.0 software using the "bivariate mixed?effects model"combined with the "midas" command to pool the data. Information such as true positive value, false positive value, false negative value, and true negative value of each included articles were extracted. The literature quality assessment map was drawn to describe the overall quality of the articles; the heterogeneity analysis was performed with the forest map, with P<0.01 considered as statistical significance; the funnel plot was used to describe publication bias, with P<0.1 considered as statistically significant. Area under curve (AUC) of summary receiver operator characteristic (SROC) was used to describe the diagnostic accuracy and the AUC closer to 1 indicated higher diagnostic accuracy. If there was heterogeneity (I2>50%) among studies, regression analysis and subgroup analysis were performed. P<0.05 was considered as statistically significant. Results A total of 15 studies (1020 patients) were included. The optical imaging contained near?infrared (NIR) and fluorescent imaging (FI). The diagnostic value of optical imaging combined with ICG?guided SLN biopsy in gastric cancer was as follows: the pooled sensitivity (Sen) was 0.95 (95% CI:0.82 to 0.99), specificity (Spe) was 1.00 (95% CI: 0.92 to 1.00), positive likelihood ratio (PLR) was 30.39 (95% CI: 9.14 to 101.06), negative likelihood ratio (NLR) was 0.05 (95% CI:0.01 to 0.20), diagnostic odds ratio (DOR) was 225.54 (95% CI: 88.81 to 572.77), AUC was 1.00 (95% CI: 0.99 to 1.00), threshold value was sensitivity=0.95 (95% CI: 0.82 to 0.99) and specificity=1.00 (95% CI: 0.92 to 1.00). Deeks method revealed DOR funnel plot of SLN biopsy was not asymmetrical obviously with significant difference (P=0.01), which indicated remarkable publishing bias. Meta?subgroup analysis showed that compared to FI, NIR imaging had higher sensitivity (0.98 vs. 0.73); compared to 0 minutes, optical imaging performed 20 minutes after ICG injection had higher sensitivity (0.98 vs. 0.70); compared to mean detected number of SLN of 4, mean detected number≥4 had higher sensitivity (0.96 vs. 0.68); compared to HE stain, immunohistochemistry+HE had higher sensitivity (0.99 vs. 0.84); compared to subserous injection of ICG, submucosa injection of ICG had higher sensitivity (0.98 vs. 0.40); compared to injection of 5 g/L ICG, 0.5 g/L and 0.05 g/L had higher sensitivity (0.98 vs. 0.83); compared to cT2?3 tumor, early stage (cT1) tumor had higher sensitivity (0.96 vs. 0.72); compared to ≤ enrolled 26 cases in the study, > 26 cases had higher sensitivity (0.96 vs. 0.65); compared to papers before 2010, papers after 2010 had higher sensitivity (0.97 vs. 0.81); whose differences were all significant. Sensitivity differences between mean tumor diameter of ≤30 cm and >30 cm, open surgery and laparoscopic surgery, lymph node regional dissection and retrieved dissection were not significant (all P>0.05). Conclusions Optical imaging combined with ICG? guided SLN biopsy is clinically feasible, and especially suitable for early gastric cancer. However, the ICG being used in current studies may be overdosed. Higher sensitivity may be achieved from NIR imaging when compared with FI method.
4.Diagnostic value of optical imaging combined with indocyanine green?guided sentinel lymph node biopsy in gastric cancer: a meta?analysis
Meifeng HE ; Zhanwu JIANG ; Zhiwei HAO ; Jie AN ; Jian ZHAI ; Jiankai SHEN
Chinese Journal of Gastrointestinal Surgery 2019;22(12):1196-1204
Objective To systematically evaluate the diagnostic value of optical imaging combined with indocyanine green (ICG)?guided sentinel lymph node (SLN) biopsy in gastric cancer, and to identify potential factors that would influence diagnostic accuracy. Methods Study was carried out by searching the electronic database of PubMed, Embase, Medline, Web of Science, and the Cochrane Library with keywords as"gastric/stomach"and"cancer/carcinoma/tumor/tumour/adenocarcinoma/neoplasm"and"sentinel lymph node"and"near?infrared/NIR or fluorescent imaging"and"indocyanine green/ICG". Literature inclusion criteria: (1) gastric cancer clinical stage was cT0?3; (2) clinical stage determined by at least 2 kinds of imaging modalities; (3) optical imaging (near?infrared or fluorescence imaging) combined with ICG?guided SLN biopsy; (4) prospective study to predict lymph node metastasis; (5) intraoperative or postoperative pathology for all lymph nodes removed; (6) patients number in the literature >10 cases. Exclusion criteria: (1) patients with a history of ICG allergy or chemoradiotherapy; (2) previous history of endoscopic mucosal resection or endoscopic submucosal dissection; (3) patients with a variety of gastrointestinal tumor; (4) case reports, conference abstracts, clinical guidelines, editorials, reviews, meta?analysis and correspondence letters; (5) in vitro or animal experiments; (6) insufficient diagnostic efficacy data. The meta?analysis was performed in the Stata12.0 software using the "bivariate mixed?effects model"combined with the "midas" command to pool the data. Information such as true positive value, false positive value, false negative value, and true negative value of each included articles were extracted. The literature quality assessment map was drawn to describe the overall quality of the articles; the heterogeneity analysis was performed with the forest map, with P<0.01 considered as statistical significance; the funnel plot was used to describe publication bias, with P<0.1 considered as statistically significant. Area under curve (AUC) of summary receiver operator characteristic (SROC) was used to describe the diagnostic accuracy and the AUC closer to 1 indicated higher diagnostic accuracy. If there was heterogeneity (I2>50%) among studies, regression analysis and subgroup analysis were performed. P<0.05 was considered as statistically significant. Results A total of 15 studies (1020 patients) were included. The optical imaging contained near?infrared (NIR) and fluorescent imaging (FI). The diagnostic value of optical imaging combined with ICG?guided SLN biopsy in gastric cancer was as follows: the pooled sensitivity (Sen) was 0.95 (95% CI:0.82 to 0.99), specificity (Spe) was 1.00 (95% CI: 0.92 to 1.00), positive likelihood ratio (PLR) was 30.39 (95% CI: 9.14 to 101.06), negative likelihood ratio (NLR) was 0.05 (95% CI:0.01 to 0.20), diagnostic odds ratio (DOR) was 225.54 (95% CI: 88.81 to 572.77), AUC was 1.00 (95% CI: 0.99 to 1.00), threshold value was sensitivity=0.95 (95% CI: 0.82 to 0.99) and specificity=1.00 (95% CI: 0.92 to 1.00). Deeks method revealed DOR funnel plot of SLN biopsy was not asymmetrical obviously with significant difference (P=0.01), which indicated remarkable publishing bias. Meta?subgroup analysis showed that compared to FI, NIR imaging had higher sensitivity (0.98 vs. 0.73); compared to 0 minutes, optical imaging performed 20 minutes after ICG injection had higher sensitivity (0.98 vs. 0.70); compared to mean detected number of SLN of 4, mean detected number≥4 had higher sensitivity (0.96 vs. 0.68); compared to HE stain, immunohistochemistry+HE had higher sensitivity (0.99 vs. 0.84); compared to subserous injection of ICG, submucosa injection of ICG had higher sensitivity (0.98 vs. 0.40); compared to injection of 5 g/L ICG, 0.5 g/L and 0.05 g/L had higher sensitivity (0.98 vs. 0.83); compared to cT2?3 tumor, early stage (cT1) tumor had higher sensitivity (0.96 vs. 0.72); compared to ≤ enrolled 26 cases in the study, > 26 cases had higher sensitivity (0.96 vs. 0.65); compared to papers before 2010, papers after 2010 had higher sensitivity (0.97 vs. 0.81); whose differences were all significant. Sensitivity differences between mean tumor diameter of ≤30 cm and >30 cm, open surgery and laparoscopic surgery, lymph node regional dissection and retrieved dissection were not significant (all P>0.05). Conclusions Optical imaging combined with ICG? guided SLN biopsy is clinically feasible, and especially suitable for early gastric cancer. However, the ICG being used in current studies may be overdosed. Higher sensitivity may be achieved from NIR imaging when compared with FI method.
5.Surgical effect of laparoscopic anterior resection of rectal carcinoma with high ligate or low ligate inferior mesenteric artery: A Meta-analysis
Jiankai SHEN ; Zhanwu JIANG ; Jie AN ; Meifeng HE ; Zhenjie MA
International Journal of Surgery 2017;44(12):841-847
Objective To evaluate the surgical effect of laparoscopic anterior resection of rectal carcinoma with or without the left colic artery.Methods Through computer searching PubMed,Cochrane Library,Embase,WanFang Date and CNIK Date.Handsearching the Gray literature simultaneously.The randomized controlled trails and clinical controlled trials comparing low ligation with high ligation the inferior mesenteric artery in laparoscopic anterior resection of rectal carcinoma were colected.Data were screened,extracted and evaluated by two reviewers independently.Meta-analyses were conducted using the sofeware STATE12.0.The standardized mean difference were calculated for continuous data and odds ratio for dichotomous and the point estimates of each effect quantity and 95% confidence interval were calculated.TheI2 test was used to test the heterogeneity of the inchuded literature:if the heterogeneity was small,the fixed effects model was adopted.otherwise,the random effects models was adopted and explored the heterogeneity by sensitivity analysis or subgroup analysis.Results Forteen articles including 15 researches were met the selection criteria.The Meta-analyses showed that the grope of low ligation had lower rate of anastomotic fistula (OR =0.394,95 % CI:0.251-0.616,P =0.000) and longer opration time (SMD =0.361,95%CI:0.242-0.480,P =0.000).There is no statistical differences in the number of lymph node dissection besides the root of IMA (SMD =-0.017,95% CI:-0.130-0.097,P =0.772) intraoperative biood loss (SMD =0.083,95 % CI:-0.048-0.214,P =0.213).Conclusions In spite of reserved the left colic artery had longer operation time it can reducedrate of anastomotic fistula effectively and there is no statistical differences in the number of lymph node dissection besides the root of IMA,intraoperative blood loss.It is possible to promote the use of reserved the left colic artery in laparoscopic anterior resection of rectal carcinoma.
7.Establishment and Evaluation of TCM Quality of Life Scale for Knee Osteoarthritis
Xiaohui ZHENG ; Jiankai WANG ; Zepei SHEN ; Feng HUANG
Journal of Guangzhou University of Traditional Chinese Medicine 2001;0(03):-
【Objective】To create a TCM quality of life(QOL)scale for knee osteoarthritis(OA)and to evaluate QOL of knee OA patients treated by warming collaterals and activating blood therapy.【Methods】QOL of 32 patients with knee OA was evaluated by the created TCM QOL scale and SF-36 questionnaire respectively before and after collaterals-warming and blood-activating treatment by Jingu Tongxiao Pill.【Results】The scoring results of TCM QOL scale showed that syndrome manifestation scoring,activities of daily life(ADL)scoring and comprehensive scoring were decreased after treatment(P

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