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Objective:To conduct a systematic review and Meta-analysis of the efficacy and safety of Apatinib and tegafur in colonic cancer.Methods:With "Apatinib" "Tegafur" "Colonic cancer" as keywords, PubMed, Embase, Web of Science, Cochrane Library, WanFang Data, VIP, CNKI and CBM were searched from inception to December 2020 to collect randomized controlled trail about treatment for colonic cancer with Apatinib and Tegafur. Evaluated the portion remission and stable duration and progression-free survival. Meta-analysis was performed by using RevMan 5.3 software.Results:Meta-analysis showed that in colonic cancer patients, the portion remission and stable duration, tumor progression of Apatinib were not inferior to those of Tegafur ( RR=1.10, 95% CI: 0.71-1.71, P=0.640; RR=0.51, 95% CI: 0.28-1.32, P=0.205). But for progression-free survival, Apatinib was superior to Tegafur in overall patients( SMD=0.90, 95% CI: 0.42-1.37, P<0.000 1). Conclusion:In the treatment of colon cancer, compared with Tegafur, Apatinib can effectively improve the progression-free survival and has better overall survival.
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Objective To systematically investigate the clinical efficiency and safety of ligation of inter sphincteric fistula tract versus incision-thread-drawing procedure for complicated anal fistula.Methods Searched PubMed,The Cochrane Library,CNKI,WanFang Data,and VIP from inception to May 2016,to collect randomized controlled trials of ligation of inter sphincteric fistula tract versus incision-thread-drawing procedure for complicated anal fistula.Search term included ligation of inter sphincteric fistula tract,fistula,incision-thread-drawing procedure,randomized controlled trial.The literatures were screened according to inclusive criteria,data were extracted and the quality of included studies was evaluated,and then meta-analysis was performed using RevMan 5.2 soft ware.A total of 5 randomized controlled trials including 305 patients were included.Results The results of meta-analysis showed that compared with incision-thread-drawing procedure,ligation of inter sphincteric fistula tract had a significant difference in amount of bleeding during surgery (MD =-18.30,95％ CI:-19.91 ～-16.69,P ＜ 0.000 01),the duration of pain (MD =-4.38,95％ CI:-4.69 ～-4.08,P ＜ 0.000 01),healing time (MD =-10.28,95％ CI:-15.71 ～-4.86,P =0.0002),hospital stay (MD =-7.44,95％CI:-10.87～-4.02,P＜0.000 1),recurrence rate (OR=0.31,95％CI:0.10～0.91,P=0.03).There was no significant difference in Operation time (MD =-5.83,95 ％ CI:-7.64 ～-4.02,P ＜ 0.000 01),effective percentage (OR =4.35,95％ CI:0.89 ～ 21.32,P =0.07) between both groups.Conclusion Compared with incision-thread-drawing procedure,ligation of inter sphincteric fistula tract shows significant advantage in cure rate,postoperative healing time,reducing post-operation pain,anal function protection and recurrence rate.
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Under National Health Insurance system ( NHI) , Taiwan implemented “Family Physician Integrat-ed Health care Plan” by focusing on the key functions of primary medical institutions and family physicians. This plan had continuously strengthened the family physician system and the quality of integrated health care provision. Taiwan’s achievements and experiences were valuable for Mainland China. This paper first introduced the health sys-tem and health care provision system of primary medical institutions in Taiwan from the aspects of financing, pay-ment, health care delivery system structure, and market-capture institutions. Then, we made a comprehensive intro-duction on the policy objectives, organization structures, operation system, service schemes and health insurance pay-ment system of this plan. Finally we proposed the suggestion for integrated health care provision system in Mainland China. It is of vital importance that government should design the integrated service provision system by focusing on the key functions of family physicians. It is also of equal significance that the health administrative departments should cooperate with health insurance administrative departments to gain sufficient policy and funding resources for the plan’s successful implementation.
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Objective To review the feedback from trainees and trainers of interactive clinical skill training workshop for general practice.Methods An interactive clinical training workshop was held on October,2014,medical staff from 17 provinces or municipalities attended the workshop.Feedback from 86 trainees was collected by questionnaire survey,while the feedback from 12 trainers was collected by focus group.Results Total 86 questionnaires were collected from trainees with a response rate of 100％.The average working year of trainees was 15.6 ; 38.4％ of them were general practitioners in community health centers; and most of them had no similar trainings before.Among 86 trainees,70 (81.4％) thought that the training contents were relevant to their daily work,76 (88.4％) thought that workshop was good method for the training.More than 55.0％ trainees told that the training contents met their expectation ; 76 (88.4％) thought that the workshop was well conducted in general,68 (79.1％) were willing to participate similar training workshops in the future.However,the contents probably need similar training advised by the trainers in the questionnaire were not agreed by trainees.The trainers thought the width and depth of training contents should be modified according to the trainees' level.Basic knowledge,basic clinical skill and common diseases should be emphasized ; and the concept of general practice and indications of referral were among the important but difficult parts in the training.For an interactive clinical skill training,teaching materials preparation,lacale control and local teaching facilities were all important.Conclusions Clinical skill training is an important part of general practitioners' training,and workshop is an effective way for training.The training contentd should be more closer to the daily work of general practitioners.