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Objective:To analyze the relevant situation of hospital patents, and to put forward suggestions to improve the efficiency of patent transformation.Methods:The Patsnap database was used to analyze the general trend, technical field distribution, application contribution, cooperative application, patent value, and achievement transformation of Peking University Cancer Hospital from 2012 to 2021, to provide a reference for the patent layout and achievement transformation of the hospital.Results:Through analysis, the number of hospital patent applications in recent years is obviously increasing, mainly for invention patents; the patent IPC classification is concentrated in A61, C12, C07, and other technical fields; the first inventors of the patents are concentrated; the cooperative patent applications were rare; the patent values are not high.Conclusions:The hospital should build an achievement promotion platform, establish a science and innovation community, set up an incubation fund, and innovate a transformation mode, to improve innovation-driven efficiency.
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Objective:To investigate the symptom clusters and influencing factors among breast cancer patients receiving aromatase inhibitor treatment and to provide a theoretical basis for the symptom clusters management.Methods:From April 2020 to January 2021, 253 breast cancer patients were recruited in Peking University Cancer Hospital by convenient sampling method. All the patients were cross-sectional investigated by the demographic and clinical characteristics questionnaire, the M.D. Anderson Symptom Inventory, the Hospital Anxiety and Depression Scale. The principal component analysis was used to extract the symptom clusters and the multiple linear regression was used to analyze the risk factors.Results:During the period of breast cancer patients receiving aromatase inhibitor treatment, three symptom clusters were identified: sick symptom cluster, treatment related-psychological symptom cluster, digestive symptoms cluster. The prevalence of the three symptom clusters was 49.4%(125/253), 45.1%(114/253), 22.5%(57/253), respectively. The median severity of the three symptom clusters was 2.80, 2.00, 0.67, respectively. Multiple linear regression analysis showed that anxiety and education level were the influencing factors of sick symptom cluster ( β=0.25, -0.25, all P<0.05), anxiety, depression and educational level were the influencing factors of treatment related-psychological symptom cluster ( β = 0.34, 0.20, -0.16, all P<0.05), anxiety, depression and chemotherapy history were the influencing factors of digestive symptom cluster ( β= 0.17, 0.18, -0.13, all P<0.05). Conclusions:Breast cancer patients with aromatase inhibitor treatment are affected by symptom clusters. In order to relieve the symptom clusters, we need pay attention to the mentation, the education level and prerious treatment of the patients.
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Objective:To analyze some problems identified in the transformation of scientific and technological achievements in hospitals and put forward corresponding strategies in order to provide reference for other hospitals.Methods:This paper analyzes some problems identified in the transformation of scientific and technological achievements in hospitals.Results:The common problems identified in the research include: too many steps in the transformation of scientific and technological achievements, market information is asymmetry, there is also risks of leakage and infringement, lack of professional institutions and specialized talents. Several strategies to solve these problems were proposed.Conclusions:The management department needs to create a good external environment to adapt to the transformation of achievements. That is to integrate the intellectual property layout and the transformation of achievements; optimize the transformation model; implement the whole process of security supervision to protect the confidentiality; improve the construction of transformation platform; strengthen the construction of professional talent team. This can promote the "bench-to-bed" transition of medical scientific research, as well as assure the long-term development of scientific and technological innovation.
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Objective:To investigate the clinical effect of laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity with non-alcoholic fatty liver disease (NAFLD).Methods:The clinical data of 115 obese patients with NAFLD who underwent LSG surgery at Beijing Tiantan Hospital were analyzed.Results:LSG was successful in a 115 patients, and the body weight and BMI decreased gradually, and were significantly lower than the preoperative level (all P<0.001). EWL% increased and was 73.1%±30.1% at 12 months after operation. The postoperative triglyceride level decreased and was significantly lower than the preoperative level (all P<0.05). Most patients were complicated with abnormal liver function before surgery, and ALT, AST and GGT levels decreased to the normal range 3 months after surgery (all P<0.05). Albumin level was significantly higher 3 months after operation than before operation ( P<0.001). At 12 months postoperatively, the severity grade of fatty liver on ultrasound was significantly lower than that before surgery ( P<0.001). Conclusion:Laparoscopic sleeve gastrectomy can significantly improve lipid metabolism index, liver function index and fatty liver index in NAFLD patients along with weight loss .
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Objective:To establish a performance evaluation index system and evaluation method for young scientists in hospitals, and to provide reliable evidence for management departments in evaluating, selecting outstanding young scientists and formulating tailored training programs.Methods:Literature analysis, expert consultation, analytic hierarchy process and data envelopment analysis were adopted in this article to evaluate the scientific research performance of young scientists in hospitals.Results:The scientific research data of young scientists under 45 years of age in Peking University Cancer Hospital from 2015 to 2019 were collected, and their scale efficiency and technical efficiency were analyzed by using index system and its weight and propose the improvement measures to achieve the purpose of evaluation and reform.Conclusions:This method is useful for the effective evaluation of the young scientists in the hospital, and is helpful to improve the level of scientific research management, as well as realize the virtuous circle of matching the input and output of scientific and technological innovation.
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Objective To investigate the current status analysis the risk factors of medical adhesive related skin injury(MARSI) in neonates in NICU, in order to provide guidance in prevention and nursing of the skin injury. Methods Convenience sampling five NICU in Shenyang, prospective investigate the incidence of MARSI of neonates during the NICU stay, and analysis the incidence , injury type distribution and risk factors. Results The incidence of MARSI in neonates in NICU was 12.8%(53/413);the major injury type of MARSI was epidermal stripping(47.2%,25/53)and skin tear(35.8%,19/53) in mechanical injury;Logistic analysis showed that the independent risk factors of MARSI were the use of stomach tube, dehydrate skin and blue light therapy (χ2=5.953, 9.806 and 7.568, P<0.05). Conclusions MARSI is frequency interrupted in neonates during the NICU stay, correct selection of medical adhesive products, application of suitable paste and remove skills are helpful to reduce the incidence of MARSI in neonates during the NICU stay.
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Objective To compare the efficacy, safety, and the life quality of patients with early gastric cancer ( EGC) between endoscopic submucosal dissection ( ESD) and surgical treatment. Methods A total of 460 cases with EGC receiving endoscopic therapy or surgical treatment were collected from October 2009 to January 2015 in the Cancer Hospital, Chinese Academy of Medical Sciences. The clinical efficacy and life quality of ESD and surgical treatment for EGC patients were retrospectively analyzed. Results There were 434 cases collected in the study, including 208 cases ( 229 lesions) in the ESD group and 226 cases in the surgery group. For the short-term clinical outcomes of the ESD group, the hospitalization time ( 7. 85 ± 3. 18 d VS 16. 68±5. 89 d, P<0. 001), hospitalization cost (3782. 30±1898. 84 CNY VS 9685. 60± 3643. 97 CNY, P<0. 001 ) and complications [ 0 ( 0/208 ) VS 6. 2% ( 14/226 ) , P<0. 001 ] were statistically different compared with those of the surgery group. For the long-term clinical outcomes, there was no statistical significance on recurrence rate[0. 4%(1/229) VS 0. 9% (2/226), P=0. 622] between the two groups. The cumulative multiple hazard probability curve showed that the ESD group had a significantly higher risk of multiple primary lesions than the surgery group ( P=0. 004) after the same follow-up period. In order to exclude the influence of confounding factors, COX regression model was used to control the age and other factors, and multiple primary risks of the two groups were also statistically significant ( P=0. 013) . The health score of self-evaluation and life quality between the two groups were statistically significant ( P<0. 001) . Conclusion For the short-term clinical outcomes, the ESD group was better than the surgery group. For the long-term clinical outcomes, multiple primary risks were higher in the ESD group than those in the surgery group, but most of the multiple primary cases were successfully treated with a second ESD. The health score of self-evaluation and life quality were better in the ESD group than those in the surgery group.
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Objective To compare the efficacy, safety, and the life quality of patients with early gastric cancer ( EGC) between endoscopic submucosal dissection ( ESD) and surgical treatment. Methods A total of 460 cases with EGC receiving endoscopic therapy or surgical treatment were collected from October 2009 to January 2015 in the Cancer Hospital, Chinese Academy of Medical Sciences. The clinical efficacy and life quality of ESD and surgical treatment for EGC patients were retrospectively analyzed. Results There were 434 cases collected in the study, including 208 cases ( 229 lesions) in the ESD group and 226 cases in the surgery group. For the short-term clinical outcomes of the ESD group, the hospitalization time ( 7. 85 ± 3. 18 d VS 16. 68±5. 89 d, P<0. 001), hospitalization cost (3782. 30±1898. 84 CNY VS 9685. 60± 3643. 97 CNY, P<0. 001 ) and complications [ 0 ( 0/208 ) VS 6. 2% ( 14/226 ) , P<0. 001 ] were statistically different compared with those of the surgery group. For the long-term clinical outcomes, there was no statistical significance on recurrence rate[0. 4%(1/229) VS 0. 9% (2/226), P=0. 622] between the two groups. The cumulative multiple hazard probability curve showed that the ESD group had a significantly higher risk of multiple primary lesions than the surgery group ( P=0. 004) after the same follow-up period. In order to exclude the influence of confounding factors, COX regression model was used to control the age and other factors, and multiple primary risks of the two groups were also statistically significant ( P=0. 013) . The health score of self-evaluation and life quality between the two groups were statistically significant ( P<0. 001) . Conclusion For the short-term clinical outcomes, the ESD group was better than the surgery group. For the long-term clinical outcomes, multiple primary risks were higher in the ESD group than those in the surgery group, but most of the multiple primary cases were successfully treated with a second ESD. The health score of self-evaluation and life quality were better in the ESD group than those in the surgery group.
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<p><b>OBJECTIVE</b>To investigate the security and efficacy of a new endoscopic closure method of large defects after endoscopic full-thickness resection (EFTR) double purse-string suture using two endoloops and metallic clips via single-channel endoscopy.</p><p><b>METHODS</b>Clinical data of 23 cases with submucosal tumors (SMT) who received endoscopic resection from June 2015 to July 2016 in our National Cancer Center were collected. For gastric and esophageal SMTs or the mucosa layer injured during submucosal tunneling endoscopic resection (STER), double purse-string suture was conducted after EFTR. The key steps of closure were as follows: the endoloop was installed onto the delivery system and inserted into the gastric cavity to the defect location with endoscopy and then opened; the clips were transported into the gastric cavity from the biopsy channel; the endoloop was fixed onto the full thickness of gastric wall along the edge of the defect by clips one by one between the interval of about 5 mm; the endoloop was tightened slowly till the entire circumference of the defect was sutured, thus, one purse-string suture was done; in accordance with the operation above, another endoloop was released, and the second endoloop was fixed at 5-10 mm to the outer edge of the original one, and tied the endoloop gently; this sequence was continued till there was no gap, thus, the double-purse string suture was finished. A total of 23 patients were enrolled in the study, including 18 with gastric tumor and 5 with esophageal tumor, 15 males and 8 females, with the average age of 56 (19 to 76) years.</p><p><b>RESULTS</b>Eighteen cases of gastric SMT were successfully treated by endoscopic EFTR and double purse-string suture. The esophageal mucosa layer of all the 5 cases of esophageal SMT, including tumors of 3 cases located in cervical esophagus at 15-20 cm from the fore-tooth, 1 esophageal leiomyoma case complicated with squamous cell carcinoma in situ, and 1 case of mucosal layer injury during submucosal tunneling endoscopic resection (STER), was successfully repaired by using double purse-string suture. The mean maximum diameter of tumor was 2.3 cm, and the average suture time was 22.8 min. Postoperative pathology showed that 13 cases were gastrointestinal stromal tumors (GIST), 7 cases were leiomyoma, 2 cases were neurilemmoma, and 1 case was leiomyoma complicated with early squamous cell carcinoma in situ. No severe complications occurred during or after the operation.</p><p><b>CONCLUSIONS</b>The double purse-string suture by using metallic clips and endoloops with single channel endoscope is a relatively safe, easy, and reliable technique for repairing large gastric defect after EFTR. For cervical esophageal SMT, or the SMT combined with superficial mucosal lesions, and for the mucosa layer injury during submucosal tunneling endoscopic resection(STER), double purse-string suture is helpful to perform the closure.</p>
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<p><b>OBJECTIVE</b>To explore the risk factors contributing to the progression-free survival rate of patients undergoing endoscopic non-curative resection.</p><p><b>METHODS</b>Clinicopathological data of patients with early colorectal carcinoma and intraepithelial neoplasia undergoing endoscopic resection in our department from January 2009 to January 2015 were collected. Associated factors affecting the progression-free survival rate of the early colorectal carcinoma after endoscopic non-curative resection were analyzed. Any of the following conditions was defined as endoscopic non-curative resection: (1) positive lateral or vertical cutting margin; (2) submucosa invasion depth ≥1 000 μm; (3) vascular or lymphatic invasion; (4) low differentiation, including signet ring cell carcinoma or mucinous adenocarcinoma; (5) high grade tumor budding.</p><p><b>RESULTS</b>Clinicopathological data of 840 cases were collected. According to China's Endoscopic Screening, Diagnosis and Treatment Guidelines for Early Colorectal Cancer, 56(56/840, 6.7%) cases were defined as the non-curative resection, the metastasis or recurrence rate was 14.3%(8/56), 3-year progression-free survival rate was 85.7%(48/56), and 3-year overall survival rate was 94.6%(53/56). Univariate prognostic analysis showed that 3-year progression-free survival rate in low and moderate-high differentiation adenocarcinoma was 25.0% and 90.4%(χ=6.711, P=0.010), in patients with submucosa invasion depth ≥2 000 μm and <2 000 μm was 75.0% and 93.8%(χ=6.745, P=0.009), and in patients with and without vascular or lymphatic invasion was 60.0% and 88.2%(χ=7.708, P=0.005), whose differences were all significant. Multivariate Cox regression analysis revealed that low differentiation adencarcinoma (P=0.015, HR=8.021, 95%CI: 1.499-42.921), invasion depth ≥2 000 μm (HR=6.823, 95%CI: 1.299-35.848) and vascular or lymphatic invasion (HR=18.143, 95%CI: 2.079-158.358) were independent risk factors for the progression-free survival rate of the early colorectal carcinoma after endoscopic non-curative resection.</p><p><b>CONCLUSION</b>Pathology after endoscopic non-curative resection for early colorectal carcinoma indicates that low differentiation adenocarcinoma, submucosa invasion depth ≥2 000 μm and vascular or lymphatic invasion are independent risk factors of poor prognosis.</p>
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With a high incidence of esophageal cancer in our country, the treatment of esophageal cancer is a major clinical challenge. Most of the patients with esophageal cancer do not receive treatment at early stage, and the 5-year survival rate is less than 20%. The change of esophageal cancer is a slow, multi-stage, multi-step evolution process, so the early treatment of esophageal cancer is of great significance. For early esophageal carcinoma involving only in the mucous membrane or shallow submucosal membrane, the endoscopic treatment can achieve a radical cure, which is comparable to surgical curative efficacy, and has the advantages of little trauma, less pain and quicker recovery. The 5-year survival rate can be more than 95%. This paper summarizes the progress and development of endoscopic treatment of early esophageal cancer in recent years in China in order to standardize the clinical application and improve the clinical curative efficacy.
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Humans , China , Endoscopy , Esophageal Neoplasms , General Surgery , Mucous Membrane , Pathology , Survival RateABSTRACT
Objective To systematically evaluate the effects of the different postoperative exercise programs on the rehabilitation (such as shoulder range of motion,the incidence of the lymphedema and postoperative complications) of breast cancer patients.Methods The relevant randomized controlled trials which were retrieved from January 2008 to October 2013 were searched in the databases of the Pubmed,Embase,Ovid,Cochrane Library,China Biomedical Literature Database (CBM),China National Knowledge Infrastructure (CNKI),Wanfang Data,VIP.Two reviewers independently screened the literature according to the inclusive and exclusive criteria,extracted the data,and assessed the quality.The RevMan 5.2 software was used for Meta-analysis.Results Finally 10 randomized controlled trial involving 1 110 patients were included.The Metaanalysis showed that progressive exercise program compared to usual exercise obviously modified the shoulder anteflexion [MD =33.04 (26.85-39.23) and 28.05 (21.81-34.30)],abduction [MD =31.06 (8.17-53.95) and 31.39(24.96-37.82)],extorsion [MD=18.47(13.44-23.50) and 16.02(8.35-23.68)] 1 month and 3 months after surgery (P＜ 0.05),extension 1 month after surgery,adduction 3 months after surgery.It also decreased the incidence of the lymphedema.Conclusions It gives us some evidence that the progressive exercise program can promote the rehabilitation of the postoperative breast cancer patients.
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To evaluate scientific research development of clinical departments of Peking University Cancer Hospital,we used SCI database to analyze the production of SCI papers of the hospital staff and searched h-index for principal investigators.We also explored the influence factors on scientific research to provide references for scientific research management and discipline construction.
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This article reviewed the digestive system characteristics,enteral nutrition style,milk choice,the starting time of enteral nutrition,the velocity of milk volume increased and the ideal growth velocity of very low birth weight infants.The aim was to investigate the effect of the different starting time of enteral nutrition on their digestive function and the growth velocity,in order to find the suitable starting time of enteral nutrition,providing the basis for clinical enteral nutrition program of very low birth weight infant.
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This paper summarizes the nursing experience of 9 very low birth weight infants with catheter-related infections. Among the 132 very low birth weight infants with PICC,9 cases suffered from catheter-related infections. Three cases showed positive results on the germiculture of catheter tip and blood, two cases showed positive result only on the germiculture of blood, and four cases showed negative results on both germiculture of catheter tip and blood. One infant's parent gave up the treatment and eight cases were cured. It is suggested that closely monitoring the signs of infections and taking effective treatment and nursing care as early as possible were the key points of infection control.