Construction and effectiveness evaluation of surgical complication monitoring mode based on medical record homepage data / 中华医院管理杂志

Objective:To explore the establishment of a surgical complication monitoring mode based on data on the medical record homepage, and analyze its impact on the trend of changes in surgical complication incidence.Methods:A monitoring mode of surgical complication was developed based on the " structure-process-results" framework by using surgical complication rates derived from performance appraisal for a tertiary general hospital in Guangzhou. The number of surgical complications and the number of discharged surgical patients was collected from the hospital from January 2019 to June 2022 through the home page collection system for performance appraisal of national tertiary public hospitals. Descriptive analysis was used to analyze the incidence of surgical complications, and Joinpoint regression was used to analyze the trend of changes in the incidence of surgical complications. Monthly percentage change ( MPC) and average monthly percentage change ( AMPC) were calculated. Results:Since the hospital began implementing the surgical complication monitoring mode in May 2021, the incidence of surgical complications had decreased from 2.55% in June 2021 to 0.82% in June 2022, with an MPC of -5.58% ( P=0.024), which was better than the changes from January 2019 to May 2021 ( MPC=0.18%, P=0.755). Conclusions:The surgical complication monitoring mode constructed by the hospital can effectively reduce the incidence of surgical complications, providing reference for optimizing hospital′s medical quality management process and decision-making mode.

Comparison of three lymph node staging systems in predicting overall survival for gastric cancer patients after radical resection / 中华胃肠外科杂志

<p><b>OBJECTIVES</b>To compare the prognostic value of three lymph node(N) staging systems, including the number of metastatic lymph nodes(pN), the metastatic lymph node ratio (Nr) and the log odds of positive lymph nodes (LODDS), in gastric cancer patients after radical resection.</p><p><b>METHODS</b>Clinical and pathological data of 1 796 patients who underwent gastric cancer radical resection with complete follow-up information from January 2000 to December 2010 at Sun Yat-sen University Cancer Center were retrospectively analyzed. For each patient, N stages were classified according to three lymph node staging systems (pN, Nr, and LODDS). The relationship between each N staging was examined. Survival was analyzed using the Cox's proportional hazard model, and discrimination of staging system was determined using the change value of Chi squared statistic (▹χ) from the log-likelihood test. A larger ▹χvalue indicates a better discriminatory ability. The homogeneity of 5-year overall survival across each pN stage within each Nr and LODDS stage was compared by using the log-rank test. The subgroup analysis was performed to evaluate whether each of the competing system was affected by the number of lymph nodes retrieved.</p><p><b>RESULTS</b>The mean number of lymph node examined and positive nodes in the entire cohort was 21.1±12.1 and 7.9±8.2,respectively. The median overall survival of all the patients was 45 months (95% CI: 42.6 to 47.4 months), and the 5-year survival rate was 55.0%(95% CI: 52.6% to 57.4%). The ▹χof Nr system was 198.546, which was higher than that of pN(191.255) and LODDS(196.557) system. Except for the pN3b stage, significant heterogeneity was found among patients of different Nr subcategories in 5-year overall survival rate (all P<0.05) within each pN stage. While there was no significant difference in overall survival when any of the Nr stages was stratified by pN stages(all P>0.05). Significant difference in survival among patients of different LODDS subcategories was also seen within each pN stage. But for the LODDS system, the survival rate was similar among patients of different pN subcategories (all P>0.05) apart from the LODDS3 stage. The hazard ratios of patients with insufficient lymph nodes examined (≤15) were higher than those with sufficient nodes examined (>15) when the pN classification was used (all P<0.05), whereas similar results were not found if the Nr or LODDS classification was applied.</p><p><b>CONCLUSION</b>Compared with the pN staging system, both the Nr and LODDS staging system, especially the former, have a higher degree of discrimination ability and robustness to predict the prognosis in patients with gastric cancer after radical resection.</p>

Inhibitory effects of cetylpyridinium chloride buccal tablets on dental plaque / 实用口腔医学杂志

Objective:To investigate the effects of cetylpyridinium chloride buccal tablets(CCBT)on dental plaque control.Meth-ods:60 patients with gingivitis,mild or moderate,or chronic periodontitis were divided into control group(without drug treatment), CCBT group (treated with CCBT)and CHX group (treated with compound chlorhexidine gargle)according to the randomized con-trolled single-blind principle.Quigley-Hein plaque index (PI)and bleeding index (BI)of the subjects were recorded,tumor necro-sis factor (TNF-α)and interleukin (IL-1β)in gingival crevicular fluid (GCF)were measured by ELISA before and after 2 weeks'trial.Results:After 2-week treatment,PI and BI in CCBT and CHX groups decreased(P0.05). In control group PI was decreased(P005).Conclusion:CCBT is effective in inhibiting plaque accumulation and decreasing GCF TNF-αlevel.