1.Sex difference of echocardiographic characteristics and prognosis in patients with moderate to severe bicuspid aortic stenosis
Baoqi FENG ; Feiwei LU ; Zheqing YANG ; Jun LI ; Cuizhen PAN ; Xianhong SHU ; Yongshi WANG
Chinese Journal of Clinical Medicine 2025;32(5):785-792
Objective To explore the sex difference in clinical manifestations, echocardiographic features and prognosis of patients with bicuspid aortic valve (BAV) combined with moderate to severe aortic stenosis (AS). Methods The clinical data and echocardiographic follow-up parameters of patients diagnosed with BAV combined with moderate to severe AS at Zhongshan Hospital, Fudan University, from July 30, 2010 to August 1, 2015 were retrospectively collected. The composite endpoint was defined as all-cause mortality or surgical intervention. Kaplan-Meier survival curve and log-rank test were used to compare the risk of composite endpoint events between male and female patients, and Cox regression models were used to analyze independent risk factors for composite endpoint events. Results A total of 144 patients were included, with 69 males and 75 females, and a median age of 60 years. Compared to males, female patients were younger (58[46, 65] years vs 61[54, 67] years, P=0.046), had a lower proportion of aortic valve calcification (61.1% vs 81.1%, P=0.009), and a higher peak transvalvular pressure gradient (72[59, 88] mmHg vs 63[55, 72] mmHg, P=0.002). In terms of left ventricular remodeling types, the proportion of concentric remodeling was higher in females than in males (36.0% vs 15.9%, P=0.006), while the proportion of eccentric hypertrophy was lower in females than in males (10.7% vs 29.0%, P=0.006). The proportion of female patients classified as New York Heart Association (NYHA) functional class Ⅲ-Ⅳ was higher than that of males (45.3% vs 17.4%, P<0.001), and left ventricular ejection fraction was higher in females (68%[65%, 72%] vs 65%[60%, 70%], P=0.003). With a median follow-up of 49 months, Kaplan-Meier survival analysis showed that the risk of composite endpoint events was higher in females than in males (P<0.001). Independent risk factors for composite endpoint events included female (HR=1.74, 95%CI 1.02-2.96, P=0.042), severe AS (HR=1.99, 95%CI 1.18-3.36, P=0.010), and NYHA functional class Ⅲ-Ⅳ (HR=2.08, 95% CI 1.24-3.47, P=0.005). Conclusions Sex significantly affects the clinical manifestations, echocardiographic characteristics, and prognosis of patients with BAV combined with moderate to severe AS, suggesting that sex-specific echocardiographic assessment and follow-up monitoring should be conducted for these patients.
2.The differential diagnostic value of left ventricular segmental myocardial strain in cardiac amyloidosis and non-obstructive hypertrophic cardiomyopathy
Yang LIU ; Fangmin MENG ; Nianwei ZHOU ; Lina LUAN ; Cuizhen PAN ; Xianhong SHU
Chinese Journal of Clinical Medicine 2024;31(6):889-897
Objective To explore the difference of the left ventricular global longitudinal strain (GLS) and the segment strains between cardiac amyloidosis (CA) and non-obstructive hypertrophic cardiomyopathy (HCM). Methods Twenty patients with immunoglobulin light chain cardiac amyloidosis (AL-CA) as CA group and 20 patients with non-obstructive HCM selected as controls (HCM group) were enrolled from January 2016 to April 2022 in Zhongshan Hospital, Fudan University. All patients underwent two-dimensional speckle tracking echocardiography (2D-STE). The left ventricle GLS and the segmental strains were calculated. The values of these strains to distinguish AL-CA from HCM were analyzed by receiver operating characteristic (ROC) curves and logistic regression analysis. Results In the CA group, the GLS parameters (3P, 4Ch, 2Ch, 3Ch), as well as the left ventricle segmental strains (MID-ANT/LAT, MID-INF/SEPT, BASAL-ANT/LAT, BASAL-INF/SEPT, MID-ANT, MID-INF, BASAL-ANT, BASAL-INF, MID-INF/LAT, BASAL-ANT/SEPT, and BASAL-INF/LAT) were all lower than those in the HCM group (P<0.01). ROC results showed that GLS(4Ch), GLS(2Ch), GLS(3Ch), GLS(3P), BASAL-ANT/LAT, BASAL-INF/SEPT, BASAL-ANT, BASAL-INF, BASAL-ANT/SEPT and BASAL-INF/LAT had good efficacy in distinguishing AL-CA from HCM. Logistic regression analysis showed that BASAL-ANT/LAT was an independent factor in distinguishing AL-CA from HCM (P<0.01). The consistency of test results was good. Conclusions The left ventricular segmental myocardial strains show good efficacy in distinguishing AL-CA from HCM, and BASAL-ANT/LAT has highest application value.
3.Construction and Application of Comprehensive Evaluation System of Operation Benefit of Clinical Departments in Cancer Hospitals
Jin WU ; Yan WU ; Binru FANG ; Shunjie JIANG ; Yongting YANG ; Hao ZHANG ; Xianhong HUANG ; Xiaohe WANG ; Liming ZHU
Chinese Hospital Management 2024;44(8):33-36
Objective To build a comprehensive evaluation system for the operating benefit of clinical departments in cancer hospitals,so as to provide data support for the fine operation management of hospitals.Methods Literature review and semi-structured interview were used to form the index pool.Two rounds of Delphi expert consultation were used to determine the index of the evaluation system,and the analytic hierarchy process was used to determine the index weight.Finally,the weighted TOPSIS was used for empirical case analysis.Results The positive coefficient in the two rounds of Delphi expert consultation were 82.6%and 100%,the authority coefficient was 0.808,and the coordination coefficient was between 0 and 1.All indexes at all levels passed the consistency test.Finally,a comprehensive evaluation system consisting of 4 dimensions,19 indexes in surgery,16 indicators in radiotherapy and 16 indicators in internal medicine was constructed.Indicators at all levels were tested for consistency,resulting in the construction of a comprehensive evaluation system consisting of 4 dimensions,19 indicators for surgery and 16 indicators each for radiotherapy and internal medicine departments.Conclusion The comprehensive evaluation system of operating benefit of clinical departments in cancer hospitals can help hospitals and departments to find out the shortcomings of operation,build the path of operating benefit improvement,and realize the connotation improvement and high-quality development of hospitals.
4.Research on the Improvement Path of Medical Staff's Report Intention on Adverse Events Based on Technology Acceptance Model
Jin WU ; Xinlu TONG ; Binru FANG ; Yu QIAN ; Yuwei FAN ; Xianhong HUANG ; Yongting YANG ; Liming ZHU
Chinese Hospital Management 2024;44(11):51-54,78
Objective Based on the technology acceptance model,to explore the influence mechanism of technical support,perceived interactivity,perceived usefulness,perceived ease of use and perceived risk on medical staff's report intention on adverse events,and to provide path suggestions for improving medical staff's report intention adverse events.Methods The multi-stage sampling method was used to select 637 medical staffs of tertiary public hospitals in Hangzhou who used the information-based platform to report adverse events as the research respondents,and the self-developed scale of report intention on adverse events was used as the research tool,monofactor analysis were conducted by Wilcoxon rank-sum test,and the structural equation model was used to analyze the influence path of their report intention on adverse events.Results Perceived ease of use and perceived usefulness have positive effects on medical staff's report intention on adverse events(β=0.264,0.658;P<0.001);Perceived risk negatively affected the medical staff's report intention on adverse events(β=-0.143,P<0.001).The indirect effects of perceived usefulness and perceived ease of use on medical staff's report intention on adverse events are 0.538 and 0.205,respectively.Conclusion Perceived usefulness and perceived ease of use plays a mediating role in perceived interactivity and medical staff's report intention on adverse events.
5.Construction and Application of Comprehensive Evaluation System of Operation Benefit of Clinical Departments in Cancer Hospitals
Jin WU ; Yan WU ; Binru FANG ; Shunjie JIANG ; Yongting YANG ; Hao ZHANG ; Xianhong HUANG ; Xiaohe WANG ; Liming ZHU
Chinese Hospital Management 2024;44(8):33-36
Objective To build a comprehensive evaluation system for the operating benefit of clinical departments in cancer hospitals,so as to provide data support for the fine operation management of hospitals.Methods Literature review and semi-structured interview were used to form the index pool.Two rounds of Delphi expert consultation were used to determine the index of the evaluation system,and the analytic hierarchy process was used to determine the index weight.Finally,the weighted TOPSIS was used for empirical case analysis.Results The positive coefficient in the two rounds of Delphi expert consultation were 82.6%and 100%,the authority coefficient was 0.808,and the coordination coefficient was between 0 and 1.All indexes at all levels passed the consistency test.Finally,a comprehensive evaluation system consisting of 4 dimensions,19 indexes in surgery,16 indicators in radiotherapy and 16 indicators in internal medicine was constructed.Indicators at all levels were tested for consistency,resulting in the construction of a comprehensive evaluation system consisting of 4 dimensions,19 indicators for surgery and 16 indicators each for radiotherapy and internal medicine departments.Conclusion The comprehensive evaluation system of operating benefit of clinical departments in cancer hospitals can help hospitals and departments to find out the shortcomings of operation,build the path of operating benefit improvement,and realize the connotation improvement and high-quality development of hospitals.
6.Research on the Improvement Path of Medical Staff's Report Intention on Adverse Events Based on Technology Acceptance Model
Jin WU ; Xinlu TONG ; Binru FANG ; Yu QIAN ; Yuwei FAN ; Xianhong HUANG ; Yongting YANG ; Liming ZHU
Chinese Hospital Management 2024;44(11):51-54,78
Objective Based on the technology acceptance model,to explore the influence mechanism of technical support,perceived interactivity,perceived usefulness,perceived ease of use and perceived risk on medical staff's report intention on adverse events,and to provide path suggestions for improving medical staff's report intention adverse events.Methods The multi-stage sampling method was used to select 637 medical staffs of tertiary public hospitals in Hangzhou who used the information-based platform to report adverse events as the research respondents,and the self-developed scale of report intention on adverse events was used as the research tool,monofactor analysis were conducted by Wilcoxon rank-sum test,and the structural equation model was used to analyze the influence path of their report intention on adverse events.Results Perceived ease of use and perceived usefulness have positive effects on medical staff's report intention on adverse events(β=0.264,0.658;P<0.001);Perceived risk negatively affected the medical staff's report intention on adverse events(β=-0.143,P<0.001).The indirect effects of perceived usefulness and perceived ease of use on medical staff's report intention on adverse events are 0.538 and 0.205,respectively.Conclusion Perceived usefulness and perceived ease of use plays a mediating role in perceived interactivity and medical staff's report intention on adverse events.
7.Construction and Application of Comprehensive Evaluation System of Operation Benefit of Clinical Departments in Cancer Hospitals
Jin WU ; Yan WU ; Binru FANG ; Shunjie JIANG ; Yongting YANG ; Hao ZHANG ; Xianhong HUANG ; Xiaohe WANG ; Liming ZHU
Chinese Hospital Management 2024;44(8):33-36
Objective To build a comprehensive evaluation system for the operating benefit of clinical departments in cancer hospitals,so as to provide data support for the fine operation management of hospitals.Methods Literature review and semi-structured interview were used to form the index pool.Two rounds of Delphi expert consultation were used to determine the index of the evaluation system,and the analytic hierarchy process was used to determine the index weight.Finally,the weighted TOPSIS was used for empirical case analysis.Results The positive coefficient in the two rounds of Delphi expert consultation were 82.6%and 100%,the authority coefficient was 0.808,and the coordination coefficient was between 0 and 1.All indexes at all levels passed the consistency test.Finally,a comprehensive evaluation system consisting of 4 dimensions,19 indexes in surgery,16 indicators in radiotherapy and 16 indicators in internal medicine was constructed.Indicators at all levels were tested for consistency,resulting in the construction of a comprehensive evaluation system consisting of 4 dimensions,19 indicators for surgery and 16 indicators each for radiotherapy and internal medicine departments.Conclusion The comprehensive evaluation system of operating benefit of clinical departments in cancer hospitals can help hospitals and departments to find out the shortcomings of operation,build the path of operating benefit improvement,and realize the connotation improvement and high-quality development of hospitals.
8.Research on the Improvement Path of Medical Staff's Report Intention on Adverse Events Based on Technology Acceptance Model
Jin WU ; Xinlu TONG ; Binru FANG ; Yu QIAN ; Yuwei FAN ; Xianhong HUANG ; Yongting YANG ; Liming ZHU
Chinese Hospital Management 2024;44(11):51-54,78
Objective Based on the technology acceptance model,to explore the influence mechanism of technical support,perceived interactivity,perceived usefulness,perceived ease of use and perceived risk on medical staff's report intention on adverse events,and to provide path suggestions for improving medical staff's report intention adverse events.Methods The multi-stage sampling method was used to select 637 medical staffs of tertiary public hospitals in Hangzhou who used the information-based platform to report adverse events as the research respondents,and the self-developed scale of report intention on adverse events was used as the research tool,monofactor analysis were conducted by Wilcoxon rank-sum test,and the structural equation model was used to analyze the influence path of their report intention on adverse events.Results Perceived ease of use and perceived usefulness have positive effects on medical staff's report intention on adverse events(β=0.264,0.658;P<0.001);Perceived risk negatively affected the medical staff's report intention on adverse events(β=-0.143,P<0.001).The indirect effects of perceived usefulness and perceived ease of use on medical staff's report intention on adverse events are 0.538 and 0.205,respectively.Conclusion Perceived usefulness and perceived ease of use plays a mediating role in perceived interactivity and medical staff's report intention on adverse events.
9.Construction and Application of Comprehensive Evaluation System of Operation Benefit of Clinical Departments in Cancer Hospitals
Jin WU ; Yan WU ; Binru FANG ; Shunjie JIANG ; Yongting YANG ; Hao ZHANG ; Xianhong HUANG ; Xiaohe WANG ; Liming ZHU
Chinese Hospital Management 2024;44(8):33-36
Objective To build a comprehensive evaluation system for the operating benefit of clinical departments in cancer hospitals,so as to provide data support for the fine operation management of hospitals.Methods Literature review and semi-structured interview were used to form the index pool.Two rounds of Delphi expert consultation were used to determine the index of the evaluation system,and the analytic hierarchy process was used to determine the index weight.Finally,the weighted TOPSIS was used for empirical case analysis.Results The positive coefficient in the two rounds of Delphi expert consultation were 82.6%and 100%,the authority coefficient was 0.808,and the coordination coefficient was between 0 and 1.All indexes at all levels passed the consistency test.Finally,a comprehensive evaluation system consisting of 4 dimensions,19 indexes in surgery,16 indicators in radiotherapy and 16 indicators in internal medicine was constructed.Indicators at all levels were tested for consistency,resulting in the construction of a comprehensive evaluation system consisting of 4 dimensions,19 indicators for surgery and 16 indicators each for radiotherapy and internal medicine departments.Conclusion The comprehensive evaluation system of operating benefit of clinical departments in cancer hospitals can help hospitals and departments to find out the shortcomings of operation,build the path of operating benefit improvement,and realize the connotation improvement and high-quality development of hospitals.
10.Research on the Improvement Path of Medical Staff's Report Intention on Adverse Events Based on Technology Acceptance Model
Jin WU ; Xinlu TONG ; Binru FANG ; Yu QIAN ; Yuwei FAN ; Xianhong HUANG ; Yongting YANG ; Liming ZHU
Chinese Hospital Management 2024;44(11):51-54,78
Objective Based on the technology acceptance model,to explore the influence mechanism of technical support,perceived interactivity,perceived usefulness,perceived ease of use and perceived risk on medical staff's report intention on adverse events,and to provide path suggestions for improving medical staff's report intention adverse events.Methods The multi-stage sampling method was used to select 637 medical staffs of tertiary public hospitals in Hangzhou who used the information-based platform to report adverse events as the research respondents,and the self-developed scale of report intention on adverse events was used as the research tool,monofactor analysis were conducted by Wilcoxon rank-sum test,and the structural equation model was used to analyze the influence path of their report intention on adverse events.Results Perceived ease of use and perceived usefulness have positive effects on medical staff's report intention on adverse events(β=0.264,0.658;P<0.001);Perceived risk negatively affected the medical staff's report intention on adverse events(β=-0.143,P<0.001).The indirect effects of perceived usefulness and perceived ease of use on medical staff's report intention on adverse events are 0.538 and 0.205,respectively.Conclusion Perceived usefulness and perceived ease of use plays a mediating role in perceived interactivity and medical staff's report intention on adverse events.

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