Evaluation on the effect of teacher simulate standardized patient consultation training in pediatric practical teaching / 中华医学教育探索杂志

Objective:To evaluate the effect of teacher simulate standardized patient (TSSP) consultation training in pediatric practical teaching.Methods:A total of 120 interns from the five-year clinical medicine major of Batch 2015 were randomly divided into experimental group and control group. In the experimental group, 60 interns were trained by TSSP for consultation after admission. After the training, the clinical parents of the children were consulted and the children were physically examined under the guidance of teachers. In the control group, 60 interns were trained according to the same requirements, but TSSP consultation training was not included. At the end of the practice, the performance, operation skills and medical record writing ability of the interns were compared, and the satisfaction of the experimental group was investigated. SPSS 25.0 software was used for t test and chi-square test. Results:The medical record writing results of the experimental group were (96.15±3.00) points, significantly higher than that of the control group [(81.02±3.29) points], and the differences were statistically significant ( t = 26.38; P < 0.001). In the mini-clinical evaluation exercise (Mini-CEX), the scores of medical history collection, communication skills, humanistic care and physical examination were significantly higher than those of the control group ( t= 15.41, 17.67, 15.39 respectively; all P < 0.001). The experimental group had high satisfaction with the teaching method of TSSP consultation training. Conclusion:TSSP consultation training improves the intern medical record writing ability, doctor-patient communication ability, clinical operation ability, stimulates the learning interest of interns, trains the trainee doctors humanistic consciousness, integrates into the ideological and political education, effectively ensures the quality of practical teaching of pediatrics, and obtains recognition from intern, which is worth promoting.

Analysis of the efficacy of lung cancer screening in urban areas of Henan Province by low-dose computed tomography from 2013 to 2017 / 中华肿瘤杂志

Objective@#To evaluate the efficacy of lung cancer screening in urban areas of Henan province by low-dose computed tomography (LDCT) from 2013 to 2017.@*Methods@#A cluster sampling method was used to select the residents of 40-74 years old in Henan province to investigate the risk factors and conduct lung cancer risk assessment. Subjects with high risk of lung cancer received LDCT for screening.@*Results@#A total of 179 002 residents completed the lung cancer risk assessment, and 35 672 subjects were identified as high risk of lung cancer, with a high risk rate of 19.93%. A total of 13 383 subjects with high risk received LDCT, and the screening rate was 37.52%. There were 786 cases diagnosed as positive nodules, and the detection rate was 5.87%. Among them, 755 cases of solid/partial solid nodule were ≥5 mm, 23 cases of non-solid nodules were ≥8 mm, 8 cases were intratracheal nodules, and 115 cases were diagnosed as suspicious lung cancer. The detection rate in males was 6.74%, which was higher than 5.02% in females. The detection rate was positively related with age (P<0.05).@*Conclusions@#The application of LDCT is a useful screening method which can elevate the early detection rate of positive nodules and other related diseases in lungs. In the future, males and older populations should be paid more attention to improve screening efficacy.

Estimation on the incidence and mortality of kidney cancer in China, in 2014 / 中华流行病学杂志

Objective To estimate the incidence and mortality of kidney cancer in China in 2014,based on the cancer registration data.Data was collected through the National Central Cancer Registry (NCCR).Methods All together,449 cancer registries submitted required data on incidence and deaths of kidney cancer occurred in 2014,to the NCCR.After evaluation on the quality of data,339 registries were accepted for analysis and stratified by areas (urban/rural) and age groups.Combined with data from the National population in 2014,the nationwide incidence and mortality of kidney cancer were estimated.Data from the 2000 National census was used,and with Segi's population used for the rates of age-standardized incidence/mortality.Results The qualified 339 cancer registries covered a total population of 288 243 347,with 144 061 915 in urban and 144 181 432 in rural areas.The percentage of morphologically verified cases and cases with only available death certificates were 72.70％ and 1.27％,respectively.The mortality to incidence ratio was 0.37.The estimates of new cases were around 68 300 in whole China,in 2014,with a crude incidence rate as 4.99/100 000 (95％CI:4.95/100 000-5.03/100 000).The age-standardized incidence rates of kidney cancer,estimated by China standard population (ASR China) and world standard population (ASR world)were 3.43/100 000 (95％CI:3.40/100 000-3.46/100 000) and 3.40/100 000 (95％CI:3.37/100 000-3.43/100 000),respectively.The cumulative incidence rate of kidney cancer was 0.40％ in China.The crude and ASR China incidence rates for males appeared as 6.09/100 000 (6.03/100 000-6.15/100 000)and 4.32/100 000 (4.28/100 000-4.36/100 000),respectively,whereas those were 3.84/100 000 (3.79/100 000-3.89/100 000) and 2.54/100 000 (2.50/100 000-2.58/100 000) for females.The crude and ASR China incidence rates in urban areas appeared as 6.60/100 000 (95％CI:6.54/100 000-6.66/100 000) and 4.25/100 000 (95％ CI:4.21/100 000-4.29/100 000),respectively,whereas those were 3.05/100 000 (95％CI:3.01/100 000-3.09/100 000) and 2.29/100 000 (95％CI:2.25/100 000-2.33/100 000) in rural areas.The estimates of kidney cancer deaths were around 25 600 in the country,in 2014,with a crude mortality rate of 1.87/100 000 (95％CI:1.85/100 000-1.89/100 000).The ASR China and ASR world mortality rates appeared as 1.16/100 000 (95 ％ CI:1.14/100 000-1.18/100 000)and 1.16/100 000(95％CI:1.14/100 000-1.18/100 000),respectively,with a cumulative mortality rate (0-74 years old) of 0.12％.The crude and ASR China mortality rates were 2.31/100 000 (95％CI:2.27/100 000-2.35/100 000) and 1.52/100 000 (95％ CI:1.50/100 000-1.54/100 000) for males,respectively,whereas those were 1.41/100 000 (95％CI:1.38/100 000-1.44/100 000) and 0.81/100 000(95％CI:0.79/100 000-0.83/100 000) for females.The crude andASR China mortality rates were 2.49/100 000 (95％CI:2.45/100 000-2.53/100 000) and 1.42/100 000 (95％CI:1.40/100 000-1.44/100 000)in urban areas,respectively,whereas those were 1.12/100 000 (95％CI:1.09/100 000-1.15/100 000)and 0.78/100 000 (95％ CI:0.76/100 000-0.80/100 000) in the rural areas.Conclusions Both the incidence and mortality of kidney cancer seemed low,in China.However,the incidence of kidney cancer had greatly increased.Our findings suggested that prevention and control strategies for kidney cancer should be focused on males in the urban areas.

Estimation on the incidence and mortality of kidney cancer in China, in 2014 / 中华流行病学杂志

Objective To estimate the incidence and mortality of kidney cancer in China in 2014,based on the cancer registration data.Data was collected through the National Central Cancer Registry (NCCR).Methods All together,449 cancer registries submitted required data on incidence and deaths of kidney cancer occurred in 2014,to the NCCR.After evaluation on the quality of data,339 registries were accepted for analysis and stratified by areas (urban/rural) and age groups.Combined with data from the National population in 2014,the nationwide incidence and mortality of kidney cancer were estimated.Data from the 2000 National census was used,and with Segi's population used for the rates of age-standardized incidence/mortality.Results The qualified 339 cancer registries covered a total population of 288 243 347,with 144 061 915 in urban and 144 181 432 in rural areas.The percentage of morphologically verified cases and cases with only available death certificates were 72.70％ and 1.27％,respectively.The mortality to incidence ratio was 0.37.The estimates of new cases were around 68 300 in whole China,in 2014,with a crude incidence rate as 4.99/100 000 (95％CI:4.95/100 000-5.03/100 000).The age-standardized incidence rates of kidney cancer,estimated by China standard population (ASR China) and world standard population (ASR world)were 3.43/100 000 (95％CI:3.40/100 000-3.46/100 000) and 3.40/100 000 (95％CI:3.37/100 000-3.43/100 000),respectively.The cumulative incidence rate of kidney cancer was 0.40％ in China.The crude and ASR China incidence rates for males appeared as 6.09/100 000 (6.03/100 000-6.15/100 000)and 4.32/100 000 (4.28/100 000-4.36/100 000),respectively,whereas those were 3.84/100 000 (3.79/100 000-3.89/100 000) and 2.54/100 000 (2.50/100 000-2.58/100 000) for females.The crude and ASR China incidence rates in urban areas appeared as 6.60/100 000 (95％CI:6.54/100 000-6.66/100 000) and 4.25/100 000 (95％ CI:4.21/100 000-4.29/100 000),respectively,whereas those were 3.05/100 000 (95％CI:3.01/100 000-3.09/100 000) and 2.29/100 000 (95％CI:2.25/100 000-2.33/100 000) in rural areas.The estimates of kidney cancer deaths were around 25 600 in the country,in 2014,with a crude mortality rate of 1.87/100 000 (95％CI:1.85/100 000-1.89/100 000).The ASR China and ASR world mortality rates appeared as 1.16/100 000 (95 ％ CI:1.14/100 000-1.18/100 000)and 1.16/100 000(95％CI:1.14/100 000-1.18/100 000),respectively,with a cumulative mortality rate (0-74 years old) of 0.12％.The crude and ASR China mortality rates were 2.31/100 000 (95％CI:2.27/100 000-2.35/100 000) and 1.52/100 000 (95％ CI:1.50/100 000-1.54/100 000) for males,respectively,whereas those were 1.41/100 000 (95％CI:1.38/100 000-1.44/100 000) and 0.81/100 000(95％CI:0.79/100 000-0.83/100 000) for females.The crude andASR China mortality rates were 2.49/100 000 (95％CI:2.45/100 000-2.53/100 000) and 1.42/100 000 (95％CI:1.40/100 000-1.44/100 000)in urban areas,respectively,whereas those were 1.12/100 000 (95％CI:1.09/100 000-1.15/100 000)and 0.78/100 000 (95％ CI:0.76/100 000-0.80/100 000) in the rural areas.Conclusions Both the incidence and mortality of kidney cancer seemed low,in China.However,the incidence of kidney cancer had greatly increased.Our findings suggested that prevention and control strategies for kidney cancer should be focused on males in the urban areas.

Analysis survival of screening and non-screening patients of esophageal cancer in Linzhou city / 中华预防医学杂志

Objective@#To evaluate effect of screening of esophageal cancer though comparing difference of survival level between screening and non-screening patients in Linzhou city.@*Methods@#The records pathologically diagnosed as serious hyperplasia/carcinoma and esophageal cancer were drawn from database of first round screening in Linzhou city from 2005-2013 and were assigned to the screening group. The records of new esophageal cancer cases which diagnosed within 2 years before, screening from the same village aged from 40 to 69, were drawn from database of cancer registry in Linzhou city and were assigned to the non-screening group. Five or 10 year survival rate with 95%CI of patients with different malignant degree diseases in the screening group and the patients with esophageal cancer in the non-screening group was calculated respectively. The survival curves between the screening and non-screening group were compared by Log rank method.@*Results@#All 26 908 persons were examined in first round screening in Linzhou city from 2005 to 2013. There were 374 persons with serious hyperplasia/carcinoma in situ, 157 persons with esophageal cancer (141 intramucosal carcinomas/submucosal cancers, 16 invasive cancers). The 5 year survival rate of serious hyperplasia/carcinoma, intramucosal carcinoma/submucosal cancer and invasive cancer were 95.0% (95%CI: 91.7%-97.0%) , 72.0% (95%CI: 62.7%-79.3%) and 41.7% (95%CI: 17.4%-64.6%) separately. The 5 year survival rate of esophageal cancer in screening and non-screening group were 68.7% (95%CI:59.9%-75.9%) and 40.8% (95%CI: 36.4%-45.2%). The 10 year survival rate of esophageal cancer in screening and non-screening group were 58.0% (95% CI: 44.6%-69.3%) and 34.3% (95% CI:29.1%-39.5%). The 5 or 10 year survival rate of esophageal cancer in the screening group were higher than that in the non-screening group in whatever sex or age. The survival distribution of the screening group was better than non-screening group (χ2=38.88, P<0.001).@*Conclusion@#More precancerous lesions and early esophageal cancer can be detected and patients' survival level was improved through organized esophageal cancer screening, which provided support to evaluate value of organized screening.

Incidence and survival of esophageal cancer with different histological types in Linzhou between 2003 and 2012 / 中华预防医学杂志

Objective@#To investigate the incidence and survival of esophageal cancer with different histological types and to understand the incidence trend and burden of esophageal cancer in Linzhou during 2003-2012.@*Methods@#All incidence records of esophageal cancer and population reported were collected from Linzhou Cancer Registry during 2003-2012. Incidence rate was calculated using gender and histological types. Age standardized incidence rate was calculated according to world Segi's population and Chinese census data in 2000. Age standardized incidence rate by world population between 2003 and 2012 was analyzed with JoinPoint regression model and estimated annual percentage change (EAPC) was calculated. 5-year survival rate was calculated with Kaplan-Meier model.@*Results@#There were 8 229 esophageal cancer cases in Linzhou during 2003-2012. The average annual incidence rate was 80.08/100 000 (8 229/10 276 481). Among all esophageal cancer cases, 7 019 (85.3%) were diagnosed as esophageal squamous cell carcinoma (ESCC). In Linzhou, the age standardized incidence rate by Chinese standard population and by world standard population was 80.92/100 000 and 81.85/100 000 in 2003, 67.97/100 000 and 68.63/100 000 in 2012. JoinPoint regression model showed that EAPC was-12.9% (95%CI:-16.4%--9.1%) for other and unspecified histological type between 2003 and 2012. The EAPC was-5.5% (95%CI:-9.2%--1.6%) for esophageal cancer between 2007 and 2012,-5.4% (95%CI:-7.0%--3.9%) for esophageal cancer in female between 2006 and 2012,-4.9% (95%CI:-9.5%--0.1%) for ESCC between 2007 and 2012. The 5-year prevalence of esophageal cancer was 215.49 per 100 000 (2 337/1 084 493), and 5 489 died within 5 years after incidence. 5-year survival rate of esophageal cancer was 34.6% (95%CI: 33.5%-35.6%).@*Conclusion@#Esophageal cancer had a decreasing trend in Linzhou. The survival rate was increasing. But, esophageal cancer was still a major burden in Linzhou. The major histological type was ESCC. ESCC had a similar decreasing trend with esophageal cancer.

Effect of improving compliance to multidrug-resistant organism prevention and control measures on reducing MDRO healthcare-associated infection / 中国感染控制杂志

Objective To understand the effect of improving compliance rate to multidrug-resistant organism (MDRO)prevention and control measures on reducing MDRO transmission in the intensive care unit (ICU ). Methods All patients in 5 ICUs of a hospital in March-June 2014 were chosen,March 1-April 30,2014 was base-line survey stage,May 1-June 30,2014 was intervention stage (comprehensive intervention measures were taken), the implementation of patients contact isolation measures,as well as awareness of MDRO-related knowledge among health care workers(HCWs)in 5 ICUs before and after intervention were compared respectively. Results HCWs' awareness rates of MDRO transmission modes,contact isolation measures,and informing of department transfer after intervention were all higher than before intervention(100.00% vs 67.22% ,98.89% vs 61.11% ,93.33% vs 45 .56% ,respectively);except single-room isolation,compliance rates to other prevention and control measures (including doctor's advice on isolation,bedside isolation,wearing isolation gowns,adding isolation logo)were all higher than before intervention(>70% vs <50% ,all P<0.01). Detection rate of MDROs after intervention was lower than before intervention (7.16% [90/1257]vs 9.65% [117/1212],χ2= 5.00,P= 0.03). Conclusion Com-prehensive intervention measures can improve HCWs'compliance to prevention and control measures on MDROs, and reduce the transmission of MDROs.

Healthcare-associated methicillin-resistant Staphylococcus aureus infec-tion outbreak in neurosurgical intensive care unit / 中国感染控制杂志

Objective To investigate the causes of an outbreak of healthcare-associated infection with methicillin-resist-ant Staphylococcus aureus (MRSA)in a neurosurgical intensive care unit(NSICU).Methods Epidemiological investigation on 8 patients with lower respiratory tract infection (LRTI)in a NSICU between June 15 and June 28,2104 were performed by combination methods of prospective and retrospective survey.Results The attack rate of MRSA LRTI in NSICU patients was 22.86%,a total of 16 MRSA isolates were detected from patients’clinical specimens,nasal vestibule,as well as hospital surroundings during the period,pulsed-field gel electrophoresis (PFGE)result revealed that infection outbreak was caused by two subtypes of MRSA;risk factors analysis showed that long length of stay in ICU and aspiration of spu-tum through bronchoscopy were risk factors for MRSA LRTI.Conclusion Contamination of bronchoscope was the key factor for this epidemic spread of healthcare-associated MRSA infection.