1.Current status of subjective well-being and its influencing factors among young administrative manage-ment staff in Shanghai's public hospitals
Hao WANG ; Jing XU ; Xuezhi LI ; Hui WANG ; Jianying MIN
Modern Hospital 2024;24(5):699-702
Objective This study focuses on the construction and cultivation of young administrative management per-sonnel in Shanghai's public hospitals,aiming to provide scientific support for the development of high-quality young administra-tive management professionals in public hospitals.Methods Utilizing an anonymous online survey,this research collected data on the current state of subjective well-being and its influencing factors among the targeted groups from hospitals.Analysis of vari-ance and multivariate analysis were conducted to analyze potential factors affecting their sense of well-being.Results A total of 171 cases were included in the survey,with an average score of 80.37.This group of respondents exhibited a higher level of sub-jective well-being compared to the national norm.Notably,young administrative staff who had obtained Shanghai residency,had a surplus income,spent time with family after work,had career advancement opportunities,felt a strong connection to their work's value,and received affirmation from family members,demonstrated higher subjective well-being scores,with significant statisti-cal differences(P<0.05).Conversely,those with an income ranging from 0 to 100 000,and those who felt overwhelmed by their current roles,scored lower on well-being,with significant statistical differences(P<0.05).Conclusion This study sug-gests that by bolstering professional security and job stability,fostering a set of correct values and a sense of work identity,and improving job satisfaction and competence,the subjective well-being of this group can be further elevated.This,in turn,can in-ject new momentum into the high-quality development of public hospitals.
2.Relationship of impaired glucose regulation with slow flow or no reflow during percutaneous coronary intervention in patients with ST segment elevation myocardial infarction
Rui MIAO ; Man ZHANG ; Xuezhi WANG ; Yafeng HAO ; Li LIN ; Huijuan QUAN
Journal of Clinical Medicine in Practice 2024;28(9):40-44
Objective To investigate the relationship between impaired glucose regulation (IGR) and slow flow or no reflow (SF/NRF) during percutaneous coronary intervention (PCI) in patients with ST segment elevation myocardial infarction (STEMI). Methods Clinical materials of 80 STEMI patients with SF/NRF and 84 STEMI patients without SF/NRF in the hospital from October 2021 to October 2022 were retrospectively collected, including blood glucose, total cholesterol (TC), triglyceride (TG), cardiac troponin Ⅰ (cTnⅠ), fibrinogen, left ventricular ejection fraction (LVEF), D-dimer, uric acid, homocysteine, the ratio of absolute value of neutrophils to absolute value of lymphocytes (NLR), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and 2 h postprandial blood glucose level. Logistic regression model was used to analyze the influencing factors of SF/NRF in STEMI patients with PCI; the receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of fasting blood glucose and 2 h postprandial blood glucose levels for SF/NRF in STEMI patients with PCI. Results Compared with non-SF/NRF group, the levels of cTnⅠ, fibrinogen and HDL-C in SF/NRF group were significantly higher, while the levels of systolic blood pressure (SBP), diastolic blood pressure (DBP) and NLR were significantly lower (
3.Analysis of the First Diagnosis Symptom and Its Influencing Factors in 500 Patients with Lung Cancer.
Xin ZHANG ; Puyuan XING ; Xuezhi HAO ; Junling LI
Chinese Journal of Lung Cancer 2018;21(5):408-412
BACKGROUND:
As the morbidity and mortality in lung cancer keep raising, we are here to discuss the effect of clinical features especially the initial symptomon on diagnosis and follow-up treatment of newly diagnosed lung cancer patients.
METHODS:
The clinical features of the 500 patients with lung cancer in our hospital from March, 2017 to May, 2017 were analyzed retrospectively, including the initial symptom, stage, biomarkers, pathology, etc. RESULTS: There were 266 famle (53.3%), 372 adenocarcinoma (74.4%), 285 smokers (58%), status score of most patients (98.2%) was 0-1. 58.2% (n=291) of all the patients got biomarkers test, of which epidermal growth factor receptor (EGFR) mutations was 61.2%(178/291), anaplasticlymphoma kinase (ALK) fusion gene positive was 4.1% (12/291). Smoking status, initial symptom, pathological typing, TNM staging and EGFR mutation were the main factors affecting follow-up treatment.
CONCLUSIONS
Patients with typical symptoms have shorter diagnosis time. Smoking status, lung cancer-related symptoms, pathology, TNM staging and EGFR mutation status are the main factors that affect the follow-up treatment.
Adult
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Aged
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Aged, 80 and over
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Anaplastic Lymphoma Kinase
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China
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ErbB Receptors
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genetics
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metabolism
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Female
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Humans
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Lung Neoplasms
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diagnosis
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genetics
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metabolism
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pathology
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Male
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Middle Aged
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Mutation
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Receptor Protein-Tyrosine Kinases
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genetics
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metabolism
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Retrospective Studies
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Smokers
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statistics & numerical data
4.Utility of Multiple Increased Lung Cancer Tumor Markers in Treatment of Patients with Advanced Lung Adenocarcinoma
PENG YAN ; WANG YAN ; HAO XUEZHI ; LI JUNLING ; LIU YUTAO ; WANG HONGYU
Chinese Journal of Lung Cancer 2017;20(10):690-694
Background and objective Among frequently-used tumor markers in lung cancer, carcinoembry-onic antigen (CEA) and carbohydrate antigen 125 (CA125), cytokeratin 19 (CYFRA21-1) and squamous carcinoma antigen (SCC), neuron specific enolase (NSE) and pro-gastrin-releasing peptide (ProGRP) are respectively expressed highly in lung adenocarcinoma, lung squamous carcinoma and small cell lung cancer. By comparing patients with multiple increased tumor markers (group A) and patients with increase of CEA and/or CA125 (group B), this study aims to investigate the utility of multiple increased tumor markers in therapeutic evaluation and prediction of disease relapsing in patients with advanced lung adenocarcinoma. Methods Patients with stage IV lung adenocarcinoma who receiving the first line chemotherapy in Cancer Hospital, Chinese Academy of Medical Sciences were enrolled and ret-rospectively analyzed. Clinical characteristic, serum tumor markers before chemotherapy, efficacy evaluation, progres-sion-free survival (PFS) were analyzed. Results Except CEA and CA125, the highest ratio of increased tumor mark-ersin group A was CYFRA21-1 (93%), then was NSE (36%), SCC (13%) and ProGRP (12%). Patients with multiple increased tumor markers tend to have more distant metastasis(P<0.001)and shorter PFS(median PFS 5.3 months vs 7.3 months, P=0.016). The relapse risk was lower in patients who accepted maintenance therapy than those who didn' t accept maintenance therapy in both groups (P<0.001). Conclusion Patients with multiple increased tumor markers have high risk of relapse, and maintenance therapy can reduce relapse risk.
5.Retrospective analysis of albumin-bound paclitaxel in the treatment of elderly patients with advanced non-small cell lung cancer
Puyuan XING ; Xuezhi HAO ; Yan WANG ; Xingsheng HU ; Junling LI
Chinese Journal of Oncology 2016;38(8):615-619
Objective To observe the safety and short?term efficacy of sigle drug albumin?bound paclitaxel (ABP) in the treatment of elderly patients with advanced non?small cell lung cancer (NSCLC). Methods A total of 23 elderly patients with advanced NSCLC who received weekly ABP regimen (130 mg/m2/week) in our hospital from October 2011 to March 2014 were retrospectively evaluated. The short?term efficacy, progression?free survival ( PFS) , and overall survival ( OS) were analyzed. Results The median treatment period was 4 cycles (2?10 cycles). Partial response, stable disease, progressive disease, overall response rate, and disease control rate were 26.1%, 43.5%, 30.4%, 26.1% and 69.6%, respectively. The median PFS was 5.33 months (95% CI:2.95?7.70 months), while the median OS was 40.33 months (95% CI:29.82?50.83 months). Major adverse events included leucopenia (82.6%), neutropenia (78.3%), nausea or vomiting (56.5%), fatigue (52.2%), peripheral neuropathy (26.1%), myalgia/arthralgia (30.4%), thrombocytopenia ( 13. 0%) and arrhythmia ( 4. 3%) . The patients accompanied with chronic diseases had significantly higher incidence rate of peripheral neuropathy and myalgia/arthralgia compared with the patients without accompanied chronic diseases ( 50. 0% vs. 9. 1% and 66. 7% vs. 9. 1%, P<0. 05 for both ) . Conclusion The weekly single drug ABP regimen is effective and well?tolerated in elderly patients with advanced NSCLC.
6.Trend analysis and clinicopathological characteristics of 198 young patients with advanced lung adenocarcinoma
Yanfang LI ; Yan WANG ; Junling LI ; Xuezhi HAO ; Xingsheng HU ; Hongyu WANG
Chinese Journal of Oncology 2016;38(10):750-755
Objective The aim of this study was to analyze the trend of incidence, clinicopathological characteristics and therapy of young ( less than 40 years old) patients with advanced lung adenocarcinoma, and to identify the prognostic factors. Methods The clinical data of 198 young patients with advanced lung adenocarcinoma were collected from the Cancer hospital and Institute of Chinese academy of Medical Sciences from January 2001 to June 2012. To analyze the trend of incidence, clinicopathological characteristics and therapy and evaluate the independent prognostic factors affecting survival time with Cox proportional hazards model. Results From 2001 to 2012, the incidence of lung adenocarcinoma in young patients was increased year by year. Among the 198 patients, 92 were males and 106 were females. Their age was from 20 to 40 with a median age of 34 years. Most patients had poorly differentiated adenocarcinoma ( 46. 7%) whereas 36.7% of the cases had moderately differentiated tumor. Among the 198 patients, there were 25 patients with stage ⅢB ( 12. 6%) and 173 ( 87. 4%) cases of stage Ⅳ cancer. The 1?, 3? and 5?year survival rates were 70. 7%, 21. 6% and 10. 3%, respectively. Among the198 cases, patients who received epidermal growth factor receptor?tyrosine kinase inhibitor ( EGFR?TKI ) therapy, the median OS ( 25. 6 months) was significantly longer than that of patients who never received EGFR?TKI therapy (13.3 months) (P<0.001). Since 2009, the number of cases detected for EGFR gene was gradually increased, and the median OS of patients diagnosed from 2010 to 2012 was 22 months, significantly higher than that of 16 months of patients diagnosed during 2001?2009 (P=0.019). The Cox regression analysis showed that the performance status, extra?pulmonary metastasis and whether received EGFR?TKI therapy were independent prognostic factors. Conclusions The incidence rate of lung adenocarcinoma in young patients has an increasing trend. They have a high proportion of women and of poor differentiation. The patients can get benefits from EGFR?TKI therapy. Mutivariate Cox regression analysis shows that the performance status, extra?pulmonary metastasis and whether received EGFR?TKI therapy are independent prognostic factors for young patients with advanced lung adenocarcinoma.
7.Efifcacy of Cetuximab in Combination with Chemotherapy in Advanced Non-small Cell Lung Cancer
YANG SHENG ; WANG YAN ; HU XINGSHENG ; WANG HONGYU ; HAO XUEZHI ; XU JIANPING ; WANG LIN ; WANG BIN ; LI JUNLING ; ZHAO LONGMEI ; JIANG PEIDI ; QU FENGLIAN ; ZHANG XIANGRU ; SHI YUANKAI
Chinese Journal of Lung Cancer 2016;19(5):263-268
Background and objective Cetuximab is a monoclonal antibody directed against epidermal growth fac-tor receptor. Emerging evidence showed improved effcacy with the addition of cetuximab to chemotherapy in advanced non-small cell lung cancer (NSCLC), but the data in oriental population are limited. hTe aim of this study is to investigate the eff-cacy of cetuximab in combination with chemotherapy in Chinese patients with advanced NSCLC.Methods NSCLC patients receiving cetuximab in combination with chemotherapy in Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College were enrolled and retrospectively analyzed. Clinical characteristic, effcacy, outcome and toxicity data were analyzed.Results A total of 40 patients were enrolled into this study in which 29 were male, 36 with adenocarcinoma. In the 23 patients who had received palliative chemotherapy previously (with a median of 2 prior chemotherapy regimens), the median progression-free survival (PFS) atfer the last prior chemotherapy regimen was 2.3 months. For the overall population, 13 (32.5%) patients achieved partial response atfer cetuximab in combination with chemotherapy. Response rate were 52.9% (9/17) and 17.4% (4/23) in chemotherapy-naive patients and chemotherapy-treated patients, respectively (P=0.018). hTe median PFS was 4.8 months for the overall population. In chemotherapy-naive patients and chemotherapy-treated patients, the median PFS was 8.4 months and 4.1 months, respectively (P=0.062). hTe estimated median overall survival was 17.1 months. Toxicities were generally manageable and no treatment-related deaths occurred.Conclusion Cetuximab in addition to che-motherapy appears to be associated with promising effcacy and acceptable toxicity proifle in Chinese patients with advanced NSCLC. Further validation is needed.
8.Utility of NSE, ProGRP and LDH in Diagnosis and Treatment in Patients with Small Cell Lung Cancer
PENG YAN ; WANG YAN ; LI JUNLING ; HAO XUEZHI ; HU XINGSHENG
Chinese Journal of Lung Cancer 2016;19(9):590-594
Background and objective Small cell lung cancer (SCLC) is a rapidly growing tumor with character-istic of neuroendocrine cellular function. Neuron speciifc enolase (NSE), pro-gastrin-releasing peptide (ProGRP) and lactic dehydrogenase (LDH) are valuable in diagnosis and treatment of SCLC. By analyzing the variation of NSE, ProGRP and LDH before and atfer treatment, the aim of this study is to investigate the effcacy of tumor markers in diagnostic staging, therapeu-tic evaluation and prediction of disease relapsing.Methods Patients with SCLC who receiving the ifrst line chemotherapy in Cancer Hospital, Chinese Academy of Medical Sciences were enrolled and retrospectively analyzed. Clinical characteristic (includes NSE, ProGRP and LDH level before and atfer 2 cycles chemotherapy), effcacy evaluation, progression-free survival (PFS) were analyzed.Results Before treatment, Serum NSE, ProGRP and LDH in patients with extensive disease (ED) were signiifcantly higher than those with limited disease (LD)(allP<0.005); NSE level increased obviously accompanied by increase of lymph nodes stage in LD group (P=0.010); Patients with weight reduction when diagnosis had higher NSE and LDH than those without loss of weight (P=0.032,P=0.014). Atfer 2 cycles chemotherapy, decrease of NSE and ProGRP in effective group was higher than which in stable and ineffective groups (P=0.015,P=0.002). hTe relapse risk was lower in patients who accepted>4 cycles chemotherapy and with obvious decrease of ProGRP than those who accepted ≤4 cycles chemotherapy and with less obvious decrease of ProGRP in LD group; ED patients with no more than 2 distant metastasis, normal LDH level before treat-ment and obvious decrease of ProGRP atfer chemotherapy had lower short term relapse risk. In addition, the types of relapse (sensitive relapse, drug resistance relapse and refractory relapse) were negatively correlated with decrease of ProGRP (P=0.044). By multivariate analysis, numbers of chemotherapy cycle was independent prognostic factor for PFS in LD SCLC; numbers of distant metastasis and decrease of ProGRP were independent prognostic factors for PFS in ED SCLC.Conclusion Increase level of serum tumor markers is related to tumor burden. Decrease level of ProGRP atfer treatment may prognose effcacy and relapse risk.
9.Clinical Analysis of 58 Patients with Small Cell Lung Cancer Combined with Squamous Cell Cancer
LUO YANG ; MEN YU ; HUI ZHOUGUANG ; LI JUNLING ; HAO XUEZHI ; XING PUYUAN
Chinese Journal of Lung Cancer 2016;19(10):659-664
Background and objectiveSmall cell lung cancer combined with squamous cell carcinoma are rare. hTe aim of this study was to analyze the clinicopathological characteristics and treatment, and explored the prognostic factors of this disease.MethodsBetween January 2004 and December 2012, 58 patients with cytopathologically conifrmed small cell lung cancers combined with squamous cell carcinoma were retrospectively analyzed.Kaplan-Meier methods were used to calculate the survival rate, andLog-rank test was used to examine differences between arms. hTeCox regression model was used to analyze the independent factors affecting the overall survival (OS).Results hTe OS of the 58 patients was 22.7 months with a range of 0.3 to 124.3 months. In univariate analysis, Karnofsky performance score before treatment, extensive disease, tumor stage were the considered prognostic factors affecting the OS rate (P<0.05).Cox multivariate analysis showed that only the tumor-node-metastasis (TNM) stage was the independent prognostic factor (P=0.019). hTe majority of the patients received multimodality therapy and chemotherapy was the main treatment. Distant metastasis was the main reasonfor the treatment failure.ConclusionCombined therapy with chemotherapy as the main treatment should be adopted in therapeutic regimen of the patients with small cell lung cancers combined with squamous cell carcinoma. TNM stage was the independent prognos-tic factor inlfuencing the OS.
10.Nimotuzumab Combined with Chemotherapy as Second- or Later-line in the Treatment of Advanced Lung Squamous Cell Carcinoma
LUO YANG ; LI JUNLING ; WANG YAN ; HAO XUEZHI ; QU FENGLIAN
Chinese Journal of Lung Cancer 2016;19(10):665-669
Background and objective Epidermal growth factor receptor (EGFR) is commonly overexpressed in lung squamous cell carcinoma and has been associated with impaired prognosis. hTe aim of this study was to observe the ef-ifcacy and safety of nimotuzumab, a anti-EGFR monoclonal antibody, combined with chemotherapy as second- or later-line in the treatment of advanced lung squamous cell carcinoma.Methods A retrospective analysis of clinical data was conducted in 13 patients with advanced lung squamous cell carcinoma, who were administered with nimotuzumab combined with chemo-therapy as second-line or later-line treatment. hTe effcacy of therapy was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and safety by National Cancer Institute Common Toxicity Criteria (NCI-CTC) 4.0.Results Of the 13 advanced squamous-cell lung cancer patients, one patient had complete response (CR), 2 patients had partial re-sponse (PR), 4 cases had stable disease (SD), and 6 patients had progressive disease. hTe overall response rate (ORR) was 23.1% and clinical beneift rate (CBR) was 53.8%. EGFR expression were detected by immunohistochemistry in 6 patients and the results showed 5 patients were EGFR 3+ and the other was EGFR 2+. Of these 6 EGFR positive patients, 1 case had CR, 1 case had PR and 4 cases had SD; ORR was 33.3% and CBR was 100.0%. Grade 3/4 hematological toxicities were observed in 3 (23.1%) patients, and non-hametological toxicities were mild. Nimotuzumab-associated skin rash was found in 2 (15.4%) patients.ConclusionNimotuzumab combined with chemotherapy as second- or later-line therapy for advanced squamous cell lung carcinoma was active and well-tolerated, especially for those patients with EGFR positive.


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