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Objective:To study the relation ship between the branch patterns of inferior mesenteric artery (IMA) and imaging pelvic measurement parameters for anastomotic leakage (AL) after anterior resection (AR) of rectal cancer.Methods:Five hundred thirty-four patient were enrolled from Jan 2008 to Dec 2018 at the General Surgery Department of Guizhou Provincial People's Hospital. The AL related imaging risk factors were analyzed by chi-square test or Fisher's exact test.Results:AL was found in 36 (6.7%) patients. AL related mortality rate was 11.1% (4/36) compared to 0.4% (2/498) in those without the complications of no AL cases ( P<0.001). Seven pelvic imaging measurement results were attained in 412 patients including anteroposterior diameter of the inlet of the pelvis, anteroposterior diameter of the outlet of the pelvis, upper edge of the symphysis pubis to the tip of the coccyx, sacrococcygeal distance angle from the lower edge of the pubis to the upper edge of the pubis to the sacral promontory, distance between the ischial spines and that of ischial tuberosity. Univariate analysis showed that there was no significant relationship between the above 7 pelvic measurement parameters and the occurrence of AL (all P>0.05). There was no significant relationship between branch patterns of IMA and AL after rectal cancer surgery ( P=0.712). Conclusion:AL as a severe postoperative complication in rectal cancer patients undergoing AR procedure were caused by multiple factors. Neither IMA branch patters nor pelvic imaging measurement seem to be related to the occurrence of AL after AR for rectal cancer.
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Objective@#To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control.@*Methods@#A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed.@*Results@#A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group.@*Conclusion@#In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.
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Objective To explore the neurasthenia situation of the population attending the postgraduate exam in medical class and its influencing factors .Methods The random cluster sampling method was adopted .The influencing factors were per‐formed the χ2 test and Logistic regression analysis .Results According to the inclusion criteria and exclusion criteria ,36 positive ca‐ses were screened out ,accounting for 8 .89% of participants ,which was higher than the value of the general population ;the statisti‐cally significant differences were noted in the factors of the confidence of attending the postgraduate exam ,stress ,adjusting ability , interpersonal situation ,reading duration ,sleep ,nutrition and dietary (P<0 .05) .Conclusion Attending the postgraduate exam such highly intensitive mental activity is the important reason causing neurasthenia among the population attending the postgraduate ex‐am ,which mainly display in the aspects of stress size ,bearing ability facing stress and regulation .
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Objective To screen the hierarchical,mutually supplementary Appropriate Technology in Health suitable for the promotion and application in the county and township two-level medical institutions in Chongqing for gradually establishing and per-fecting the grading and classification of Appropriate Technology in Health database,and expanding Appropriate Technology in Health reserves.Methods Using Lv Yalan[1] assessment index system of appropriate health technology,then the experts′scoring method in the field was adopted for evaluating and screening the Chongqing Municipal Science and Technology Proj ectbased on stratification of diagnosis and treatment of disease complementary appropriate technology research,evaluation and integration dem-onstrationAppropriate Technology in Health group[2].Results The comprehensive scores of various techniques were high,in which the lowest score was 94.61 points,including:the drug seretide inhalation technique 98.24 points,the drug salbutamol inhala-tion technique 98.56 points,inhaled medications to control asthma technique 97.08 points,the drug spiriva(tiotropium)inhalation technique 97.97 points,6-min walk test 96.31 points,pulmonary ventilation function inspection technique 95.61,summary pulmo-nary function testing technique 94.59,children bronchial get up early screening technique 94.59,child bronchial asthma detection technique-C-AT(children′s asthma control test)evaluation form 96.94.Conclusion According to the inclusion criteria for Appro-priate Technology in Health and the experts′scores,9 items of Appropriate Technology in Health included by preliminary screening are selected for putting in storage,combined with the health resources and the prevalence rate in the demonstration counties and townships,these 9 items of technology may be promoted and applied.
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Objective To combine grey relation analysis and partial least squares regression model to establish the forecasting model of per-patient hospitalization expenses .Methods Gray relational analysis was used to filter out the main factors affecting per-patient hospitalization expenses ,and then collinearity was examined between these factors .Partial least squares regression was used to establish prediction model of per-patient hospitalization expenses ,and the prediction accuracy was proved .Results After filtered by gray relational analysis ,the order of the importance of factors affecting per-patient hospitalization expenses was the west-ern medicine fee ,traditional Chinese medicine fees ,diagnosis and treat fees ,other fees ,inspection fees ,bed fees and operation fees . The established partial least squares regression model had a higher accuracy on fitting and prediction ,with low average relative er-ror ,respectively ,-0 .000 2% and 0 .349 3% .Conclusion The gray relational analysis and partial least squares regression are suit-able for the influencing factors and prediction analysis of hospitalization costs .It provides a reference for data with the small sample size and high collinearity between the variables .
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Objective To explore operating efficiency of county-level public hospital by using data envelopment analysis ,provide reference ,and basis for health decision-making .Methods The health resources data of 16 county-level public hospitals were ran-domly selected from 2008 to 2011 ,its relative efficiency were studied by data envelopment analysis method of CCR-CRS and BCC-VRS model ,the change trend from 2008 to 2011 were analyzed through the Malmquist productivity index .Results The average ef-ficiency value was 0 .938 in 16 county-level hospitals in 2011 ,7 hospitals was DEA efficient and 9 hospitals was non-DEA efficient (8 hospitals with Scale efficiency decline gradually ,another one with increasing gradually ) .The total factor productivity increased 2 .5% from 2008 to 2011 average annual ,the productivity first decreased from 2008 to 2009 ,and then increased from 2009 to 2011 . Conclusion The overall efficiency 16 county-level hospitals is not high ,it is necessary to develope hospital scale reasonable , strength hospitals′management level and improve technical ability of doctors .
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Objective To explore the promotion model with the sustainable development of appropriate technologies in rural health. Methods After a large-scale government-led, administrative intervention mode (Ⅰ mode) , the mode (Ⅱ mode) dominated by the third sector and participated in by the whole society was used in some counties, and Ⅲ model, an enterprise-led and market economy controlled mode was adopted in Tongliang County. Results The primary care doctor and patient satisfaction in the third sector participation mode, and the personal experiences of doctors in enterprise-led mode were evaluated as excellence. The differences of experience of both doctors and patients between the third sector-led and government-led were statistically significant (P<0.01) ; he third sector-led mode was better than government-led mode. Conclusion It needs to establish a long-term pattern with the government supervision and policy support, the third sector and business management, full community participation, and regulation of market economy rules for the sustainable promotion model of appropriate technologies in rural health.
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Objective To evaluate the necessity of indwelling gastrointestinal decompression after gastrectomy. Methods Eight publications on the necessity of gastrointestinal decompression after gastrecomy were colleted, data on recovery time of gastrointestinal function and hospital stay, complications,and motality were Meta-analyzed using fixed effect model and random effect model. Results Eight randomized trails including 975 patients were qualified and included in this study. The differences in time to oral intake ( WMD =0. 61, 95% CI: 0. 17 - 1.05, P ＜ 0. 05 ) and hospital stay ( WMD = 1.20, 95% CI:0. 05 -2. 36, P ＜ 0. 05 ) between the decompression group and non-decompression group were statistically significant, but the difference in time to flatus (WMD = 0. 31,95% CI: -0. 07- 0. 69, P ＞ 0. 05 ) was not significant. There were no significant differences in complications such as nausea and vomiting ( OR = 1.43,95% CI: 0. 61 - 3.31, P ＞ 0. 05 ), pulmonary infection and atelectasis ( OR = 1.43, 95 % CI: 0. 82 - 2. 49,P＞0.05), anastomotic leakage (OR = 1.17, 95%CI: 0.54-2.49, P ＞0.05), abdominal abscess ( OR = 1.08, 95% CI: 0. 50 - 2. 34, P ＞ 0. 05 ), wound dehiscence ( OR = 1.47, 95% CI: 0. 43 - 4. 95,P ＞ 0. 05 ) between the two groups, except for fever ( OR = 1.76, 95% CI: 1.11 - 2. 78, P ＜ 0. 05 ), which was found more frequent in decompression group than in non-decompression group. Conclusions Routine gastrointestinal decompression after gastrectomy was not conductive to the recovery of gastrointestinal function, and could not reduce the incidence of postoperative complications. Postoperative GI decompression increased fever incidence rate and prolonged hospital stay.
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This thesis mainly expounds the design ideas and the realization methods of medical statistics question database management system.Specifically speaking,the function modules,data structure and business processes of the system are designed based on the analysis of questions,test papers and the needs of system functions.We choose Visual Basic 6.0 to develop the system interface,establish the question database with Access 2003,and make use of Word 2003 to output documents.This system can achieve the separation of teaching and testing effectively which can make examinations more normal and scientific.
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OBJECTIVE To study the risk factors of surgical wound infection among patients in department of general surgery.METHODS The factors on surgical wound infection were investigted by retrospective study.RESULTS The surgical wound infection rate was 4.26%in department of general surgery in our hospital,the infection rate in type Ⅰ operation was 0.80%,and the infection rate in types Ⅱ and Ⅲ was 7.03%.Gender,age,obesity,diabetes,classification of incision,character of operation and operation time were the risk factors of surgical wound infection among patients in department of general surgery.CONCLUSIONS Strengthening monitor and regulation of risk factors can degrade surgical wound infection rate.
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Objective:Offer practical experience and theoretical basis for the popularization of Country Feasible Medical Technology(CFMT)in our nation,and explore the best mold and mechanism for popularization of CFMT at the actual situation of our nation,especially to the western rural areas.Methods:We launch the popularization and demonstration of CFMT in two countries of Chongqing City.Results:In 2005 and 2006,we adopted different modes of popularization about CFMT,and obtained different effects;besides,the CFMT reduces the difficult and expensive condition of seeing a doctor to some extent,and wins wide welcome and praise from health workers and masses.Conclusions:For the popularization of CFMT in western rural areas,the best mold is 'government-control & market-guidance' Mold.And the most suitable mechanism is a synergistic effect of many mechanisms,in which Consultation & Combined Action mechanism,Social Mobilization mechanism,Proper Financial Compensation mechanism,and Restriction & Inspiritment mechanism is the four main mechanisms.Besides,to summarize experiences the participation of college and scientific research institute is needed in the whole process of research project.
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Objective To find out a new teaching pattern of Medical Statistics for medical postgraduate students.Methods To manifest the longitudinal thought of the medical research process from the teaching idea,the teaching content arrangement and the teaching method utilization.Results To discuss the superiority of the new pattern which provides the content frame and the teaching method based on the integrating theory and the practice.Conclusion The teaching reformation of Medical Statistics must be advantageous in improving the learner’s power of the medical scientific research,including selection of the scientific research topic,application of project,the quality control of the project,analysis of the material and inference of the conclusion,paper writing,self-appraisement and achievement evaluation.
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Objective To investigate the electrophysiological characteristics of the atrium in patients with atrial fibrillation (AF) during electrophysiological study (EPS) Methods Seventy two patients with presence of AF during EPS were selected as Group AF , and the other 78 patients without AF as Group control All the patients had no AF history and structural heart diseases P A, P CSd, S1 A1, S2 A2, Max CD, CD zone and ERP HRA were measured as the electrophysiological parameters Results P A, P CSd, S1 A1, S2 A2, Max CD and CD zone were significantly longer in Group AF than in Group control , ERP HRA was shorter in Group AF Conclusion The decreased atrial conduction and the shorter atrial effective refractory period may be the electrophysiological basis for the occurrence of AF
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Two new single chain ribosome—inactivating proteins,polygonin2 from the roots ofPolygonatum odoratum and momordin2,from the seeds of Momordica charantia,inhinited pro-teib synthesis potentially in rabbit reticulocyte lysate,but were relatively low toxic to Molt—4 cells.polygonin2 and momordin2 were conjugated to H65 monoclonal antibody that recognizedhuman T lymphocyte CD5 surface antigen using a heterobifunctional crosslinking reagent 2—iminothiolane.The resulting immunotoxins,referred to as H65—PGN2 and H65—MOR2,showed potent specific cytotoxicity to target cell Molt—4 and human peripheral blood T lympho-cyte,but had no effect on human hematopoietic cells.Injection of Molt—4 cells s.c.into Balb/cnu/nu mice developed into a solid tumor.Administration of the H65—PGN2 or H65—MOR2immunotoxins i.p.10 ug per mice at 48—h intervals suppressed tumor growth specifically.Theresulting showed that clinical studied were warranted to use these conjugates for the therapy ofautoimmune diseases as well as the ex vivo purging of T lymphocyte in ABMT.
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Objective To understand the health level of people living in county and the situation between the requirement and utilization of health service for rural residents in Chongqing as well as the main influential factors by investigating the basic condition and hospitalization expenditure. Methods Three county hospitals were included in our study: county general hospital, Chinese traditional medicine hospital, and maternal care hospital. The hospitalized patients from the three hospitals were investigated on a certain day by questionaire and the data of discharged patients in a month were collected and analyzed by SAS8.0 software. Results Factors such as the hospital type, sex, age, the cost for sickbed, diagnosis and treatment fee and so on were significantly associated with the total cost for hospitalization. Expensive hospitalization fee harms the quantity and quality of health service required by rural residents. Conclusion The utilization rate of health service by female was lower than by male in rural area. The total utilization rate of health service has been improved since the new policy about rural health service was carried out. People over 45 years old are the main consumers of health service. Peasants are still main consumers to medical organization at county level. Suitable technic of health service for county hospitals should be carried out in time.