Investigation on the development of interventional radiology discipline in Chinese provincial-level cancer hospital / 中华放射学杂志

Objective:To investigate the current status of interventional radiology discipline in the provincial-level and national cancer hospitals of China, and to provide supportive data for the future systematic construction of interventional radiology.Methods:A questionnaire was used to survey 32 provincial and national cancer hospitals of China. The survey included data such as discipline settings, medical treatment, medical education, and scientific research. Then descriptive statistical analysis was performed based on the data.Results:All 32 provincial and national cancer hospitals of China had interventional radiology services and were equipped with independent wards; the deployment rates of DSA, ultrasound, CT, and radiofrequency ablation equipments were: 100%(32/32), 81.3%(26/32), 40.6%(13/32), and 75.0%(24/32), respectively. Of all 32 hospitals, 27 (84.4%) had performed more than 1 000 interventional operations per year. The proportion of hospitals that had interventional subspecialties was 21.9% (7/32). As for the interventional radiology doctors in these hospitals, the ratio of doctors with a background of medical imaging specialty was 69.6%(256/368); the proportion of doctors with ages ≤ 45 years old was 72.0%(265/368); and the ratio of doctors with a master degree was 79.9%(294/368). Among the 32 hospitals, 22 (68.8%) had more than 500 000 yuan research funds in intervention radiology discipline, and 71.9%(23/32) had intervention radiology discipline postgraduate tutors.Conclusions:The overall development of interventional radiology discipline in provincial-level and national cancer hospitals is good. The discipline development pattern might set a good example for interventional radiology discipline construction in general hospitals.

BREAST CANCER SURVIVAL IN A BRAZILIAN CANCER CENTER: A COHORT STUDY OF 5, 095 PATIENTS / Sobrevida do câncer de mama em um centro de câncer brasileiro: um estudo de coorte de 5. 095 pacientes

Objectives: To describe the age group, clinical stage at diagnosis, treatment, and survival rates of breast cancer patients treated in a Brazilian specialized Cancer Center. Method: A hospital-based retrospective cohort study is presented herein, on women with breast cancer diagnosed between January 1, 2000 and December 31, 2012. Data were extracted from the Hospital Cancer Registry of the A.C.Camargo Cancer Center. Data on age group, histology of the tumor, TNM classification, clinical stage and treatments were described in absolute and relative frequencies for three periods. Survival curves were estimated with the Kaplan-Meier estimator. Hazard ratio (HR) and 95% confidence interval (95%CI) were calculated for all variables. Results: A total of 5,095 female breast cancer patients were identified, with most stages classified as I and II (60%). The overall survival was 82.7% for the period of 2000­2004, and 89.9% for 2010­2012 (p<0.001). Patients with invasive ductal carcinoma, who were treated with surgery and hormonal therapy, showed a reduction in the risk of death in the most recent period HRadj=0.42 (95%CI 0.34­0.53) (2010­2012). Conclusions: Early stage diagnosis and combined treatment (including HT) are predictive prognostic factors for high survival rates in patients with invasive breast cancer. Specialized cancer centers can provide valuable indications regarding cancer control policies, evaluating overall survival for breast cancer and its associated prognosis.

Objetivos: Descrever as faixas etárias, estadiamento clínico ao diagnóstico, tratamento e sobrevida global das pacientes com câncer de mama tratadas em um centro de câncer brasileiro. Método: Estudo de uma coorte retrospectiva de base hospitalar, com mulheres diagnosticadas de câncer de mama entre 1º de janeiro de 2000 e 31 de dezembro de 2012. Os dados foram extraídos do Registro Hospitalar de Câncer do A. C. Camargo Cancer Center. Faixa etária, tipo histológico, classificação TNM, estadiamento clínico e tratamento foram descritos em frequência absoluta e relativa estratificados em três períodos. As curvas de sobrevida global foram estimadas pelo método de Kaplan-Meier. A Hazard ratio (HR) com intervalo de confiança de 95% foram calculados para todas as variáveis. Resultados: O total de 5.095 pacientes mulheres com câncer de mama foi identificado, a maioria era estágio inicial 60% (I e II). A sobrevida global foi de 82,7% para o período de 2000­2004 e 89,9% para 2010­2012 (p<0,001). Pacientes com carcinoma ductal invasivo que foram tratadas com cirurgia e hormonioterapia, mostraram redução do risco de morte no período mais recente HRaj=0,42 (0,34­0,53 em 2010­2012). Conclusões: Diagnóstico precoce e tratamento combinado (incluindo hormonioterapia) são fatores prognósticos preditivos para altas taxas de sobrevida em pacientes com câncer de mama invasivo. Centros especializados em câncer podem prover informações valiosas sobre as políticas de controle do câncer, avaliando a sobrevida global do câncer de mama e fatores associados ao prognóstico.

Thinking on the development of Shanxi Provincial Cancer Hospital for 67 years / 肿瘤研究与临床

Shanxi Provincial Cancer Hospital has a history of 67 years. The continuous development of the hospital reflects the tremendous advances of cancer prevention and treatment in China. The article reviews the development process of Shanxi Provincial Cancer Hospital and puts forward some ideas for hospital development under the new situation.

A decade′s review for the foundation, establishment and development of the Department of Minimally Invasive Gastrointestinal Surgery in Peking University Cancer Hospital / 中华胃肠外科杂志

Department of minimally invasive gastrointestinal surgery in Peking University Cancer Hospital (also named as Department of Gastrointestinal Surgery IV) was established on April 7, 2009. Up to now, ten years have passed since its foundation. As the first department built in specialized cancer hospital, which mainly focuses on laparoscopic surgery, its foundation and development has a very important historical and practical significance in the development of surgical oncology in China. Reviewing the rapid growth of the Department of Minimally Invasive Gastrointestinal Surgery over the past decade, on the one hand, it has benefited from the opportunities of the times and the support of leaders in Peking University Cancer Hospital at that time. More importantly, the progress owes to the pioneering Professor Su Xiangqian, who is brave and innovative, with indomitable spirit and advanced management philosophy. With rigorous training, the ability of the team has been steadily enhanced, the competitiveness has been gradually improved, and the development direction which focuses on laparoscopic gastric cancer surgery and laparoscopic colorectal cancer surgery has been established. Now, the Department of Minimally Invasive Gastrointestinal Surgery has become a well-known domestic gastrointestinal tumor center. In the past ten years, under the leadership of Professor Su Xiangqian, the growth of this team is innovative and comprehensive: (1) Introduce the internationally advanced Baldrige medical service management framework, and propose the "management by principle" concept to improve the core competitiveness of the department; (2) Establish an academic brand by laparoscopic standardized surgery training courses for gastrointestinal tumors, promote cooperation and exchange at home and abroad, and participate in international multi-center clinical research projects; (3) Adhere to the "formation of a research-oriented department, conducting clinical and basic research simultaneously" as the development direction; (4) Stick to the core development concept of team building and cultivate professional talents. Looking forward to the future, our team will not forget the beginning of the heart, and move forward! In the next ten years, we will break through ourselves and continue to pursue the higher level!

Study on the corrlation between workplace violence and empathy fatigue of nurses in tumor hospital / 中国实用护理杂志

Objective To investigate the workplace violence and empathy fatigue of nurses in tumor hospitals, and analyze the factors that affect the empathy fatigue of nurses in tumor hospitals, so as to provide references for nurses to prevent job burnout and quit their jobs. Methods Using the method of convenient sampling, 865 nursing staff in Cancer Hospital Affiliated to Harbin Medical University were selected as the research subjects. The general data questionnaire, the workplace violence measurement frequency scale and the empathy fatigue scale were used to investigate. Results Tumor hospital nurses workplace violence zero frequency in 261 cases, accounted for 30.17％, the frequency of 336 cases, accounted for 38.84％, 245 cases of intermediate frequency accounted for 28.32％, high frequency of 23 cases accounted for 2.66％; the feeling of fatigue and mild in 171 cases, accounted for 19.77％, 339 cases of moderate and severe in 355 cases, accounted for 39.19％, and 41.04％respectively;negative correlation workplace violence and empathy fatigue compassion satisfaction score (r=-0.164, P<0.01), and occupation burnout, secondary traumatic stress scores were positively correlated (r= 0.149, 0.196, P<0.01); nurse education and workplace violence is compassion satisfaction of the main influence factors(t = 8.284,-4.664, P<0.01); workplace violence, working age and age is the main influencing factors of occupation burnout(t=8.905, 4.114, 2.986, P<0.01);workplace violence (department of radiology), and education is the main influence factors of secondary traumatic stress(t=8.242,-5.822,-3.644,P<0.01). Conclusions The incidence of workplace violence is highamong nurses in tumor hospitals. The empathy fatigue of nurses in the tumor hospitals is more serious. It is necessary for nursing managers to give comprehensive intervention strategies, reduce the incidence of workplace violence and improve the empathy fatigue of nurses.

Safe Handling of Cytotoxic Drugs and Use of Personal Protective Equipment among Nurses at a Regional Cancer Center

PURPOSE: This purpose of this study was to identify the level of safe-handling of cytotoxic drugs and use of PPE (Personal Protective Equipment) among nurses at a regional cancer center in South Korea. METHODS: This was a cross-sectional descriptive study. The participants were 131 nurses who care for cancer patients undergoing chemotherapy. Demographic information, safe-handling of cytotoxic drugs and use of PPE were collected using questionnaires from May 7 to 25, 2018. RESULTS: Response rate was 98.4%. The mean age of the nurses was 28.2±4.4 years and their clinical nursing experience was 4.34±3.93 years. The mean scores out of 5 for the participants' safe handling of cytotoxic drugs was 3.73± 0.43. In use of PPE, the mean score of wearing gloves, masks, and gowns were 3.89±.77, 3.06±1.04, and 2.34±0.98, respectively. The main reason for not wearing PPE was ‘too busy’ (62.8%). The level of safe-handling of cytotoxic drugs was not significantly different according to any variables, but the use of PPE was significantly different according to age (p=.021). CONCLUSION: The findings showed that nurses had exposure to cytotoxic drugs in the processes of preparation, administration, cleaning of spills, and handling of patient waste. Education programs and continuous monitoring are needed to improve the use of PPE among nurses and trigger the appropriate motivation for consistent personal protection.

Epidemiología descriptiva del cáncer en la edad pediátrica en el Hospital del Niño Dr. José Renán Esquivel, 2001-2010 y 2011-2014

Objetivo:Describir la incidencia, supervivencia, mortalidad, tasa específica de mortalidad y tasa de incidencia en los niños menores de 15 años en el Hospital del Niño en el período 2001 al 2010 y 2011 al 2014. Material y métodos:Tipo de estudio descriptivo, retrospectivo, transversal. Resultados:En el periódo del 2001-2010 fueron diagnosticados 146 pacientes y del 2010-2014 un total de 69, mientras que la tasa de supervivencia en ambos periodos fue del 67% y 75% respectivamente. El grupo de más alta incidencia está en el rango de edad de 1 a 4 años.La tasa de mortalidad por tumores en menores de 15 años por 100,000 niños fue de 4.49 y la tasa de incidencia de 20.57 por 1,000,000 de niños menores de 15 años.

Objective: To describe the incidence, survival, mortality, specific mortality rate and incidence rate in children under 15 years of age at the Hospital del Niño from 2001 to 2010 and from 2011 to 2014. Material and methods: Descriptive, retrospective, transversal study. Results: In the 2001-2010 period, 146 patients were diagnosed, and from 2010-2014 a total of 69 , while the survival rate in both periods was 67% and 75%, respectively. The group with the highest incidence is in the age range 1 to 4 years.The tumor mortality rate in children under 15 years per 100,000 children was 4.49 and the incidence rate was 20.6 per 1,000,000 children under the age of 15 years.

"Implementation Effect of ""Zero Profit Drug Sales"" in a Class Ⅲ Grade Ⅰ Cancer Hospital" / 中国医院管理

Objective To study the influence of drug zero rate policy in Class Ⅲ[Grade Ⅰ cancer hospital,and to research hospital income and patients' economic burden.Methods Collecting financial data from 2012 to 2015 and analyze the variances before and after the zero rate policy.Results After the implementation of drug zero rate policy,business volume kept ncreasing,the fiscal subsidy income rose,income proportion of western medicine and Chinese patent drug dropped,outpatient service drug cost per time increased,while hospitalization drug cost per time decreased.Conclusion The reasonability of drug use can be achieved through improving drug price mechanism and deepening the medical insurance payment system.

Special Review of 66 Patients Treated with Vancomycin in a Cancer Hospital / 中国药师

Objective:To evaluate the clinical application of vancomycin in a cancer hospital in order to promote the rational use of vancomycin. Methods:The records of 66 patients treated with vancomycin in 2015 were reviewed and analyzed in the respects of in-dications of medication, pathogenic examination, usage and dosage, course of treatment, drug combination, drug monitoring and drug utilization index(DUI). Results:Among the 66 cases, most drug use was rational, which accounted for 69. 70% with DUI of 0. 82. There were still several types of irrational drug use including no medication indications, irrational usage and dosage, too long or too short course of treatment, irrational combination and prophylactic use time. Conclusion:The application of vancomycin is basically ra-tional, while irrational phenomenon still exists. The management and supervision should be further strengthened in order to promote clinical rational drug use and ensure medication safety of patients.

Discussion and reflections based on the management mode of hospital laboratory / 中华医学科研管理杂志

Objective To investigate the hospital laboratory management mode.Methods We used literature review and comparative analysis to understand the different laboratory management mode,explore suitable operation mechanisms for hospital research and the development of hospital la boratory.Through a variety of measures to improve the efficiency and level of management,we tried to ensure the high efficiency and high quality operation of clinical laboratory,hospital science research,personnel training,discipline construction to provide quality services.Results There were two kinds of hospital laboratory management modes,which were centralized and decentralized management mode.Both management modes had advantages and disadvantages.We thought the centralized-decentralized binding mode was an ideal combination.Based of this mode,we implemented a number of initiatives and achieved significant results.Conclusions From the scale of hospital and its long-term development,centralized decentralized binding mode is a kind of ideal mode.

Construction of evaluation index system of nursing quality for cancer hospital / 中国实用护理杂志

Objective To establish a scientific and sensitive evaluation index system of nursing quality for cancer hospital. Methods The evaluation index system of nursing quality for cancer hospital was formulated based on literature,semi- structured interviews and expert group discussion. Then, developing the evaluation index system of nursing quality for cancer hospital by two rounds of Delphi consultation. Results The experts′ authority coefficient was 0.862. The nursing quality indicators included 5 first-level indicators,9 second-level indicators and 73 third-level indicators. The Kendall coordination coefficients of the importance of the three level indicators were 0.354,0.217,and 0.243, The Kendall coordination coefficients of the feasibility of the three level indicators were 0.234,0.313,and 0.339. Conclusions Scientific nature and concentration indicator system of nursing quality for cancer hospital was developed. It will be used to provide quantitative basis for the control of nursing quality in cancer hospital.

Analysis of the peer review comments of the proposals submitted to NSFC by Peking University Cancer Hospital during 2010-2014 / 中华医学科研管理杂志

The National Natural Science Foundation of China is one of the most important fund channels for basic research in Peking University Cancer Hospital (hereinafter referred to as our hospital).Peer review was used for application review.In this article,the feedback opinions of applications from 2010 to 2014 for our hospital were categorized,summarized and analyzed.The common reasons of failure and corresponding measures were put forward to provide references for the applicants and scientific research managers for formulating relevant plicies.

Analysis of the Utilization of National Essential Medicines in a Cancer Hospital of Shandong Province in the First Half Year of 2014 / 中国药房

OBJECTIVE:To provide reference for the further implementation of national essential medicines. METHODS:The drugs consumption data of outpatients and inpatients in our hospital from Jan. 1 to Jun. 30,2014 were statistically analyzed. RE-SULTS:Variety numbers of national essential medicines in our hospital occupied 37.38%(228/610) in total drugs variety numbers of the whole hospital,consumption sum of national essential medicines occupied 9.80%(817.02 million yuan/8 338.12 million yu-an) in all drugs consumption sum. The first 20 national essential medicines listed in consumption sum were mainly anti-cancer drugs and water,electrolyte and acid-base balance regulation drugs. CONCLUSIONS:In the utilization of national essential medi-cines,variety proportion and consumption sum ratio in our hospital are relatively low. It is suggested to make clear the use require-ments of national essential medicines in cancer hospitals to make more reasonable and scientific selection of anti-tumor medicines in National Essential Medicines List and reasonably increase the assistant medicines related to the treatment of neoplastic diseases;hos-pitals should take effective measures to promote the usage rate of national essential medicines.

Analysis of hospitalization expenses of malignancy in Shanxi Cancer Hospital from 2003 to 2010 / 肿瘤研究与临床

Objective To understand the malignancy hospitalization expense of malignancy in Shanxi Cancer Hospital and provide a reference for the effective control of hospitalization expense.Methods 89 716 malignancy hospitalization cases in Shanxi Cancer Hospital from 2003 to 2010 were reviewed.Hospital costs of top six malignant tumors were analyzed.Results The hospitalization expense of 6 kinds of malignancy increased in varying degrees.In all cancer patients,the top six number of cases were lung cancer,cervical cancer,stomach cancer,breast cancer,esophageal cancer and colon cancer,there were a total of 89 716 passengers.The growth rate of cervix malignancy' s expense was the fastest.Conclusion Malignancy hospitalization is expensive,comprehensive measures need to be used to control the expense and make full use of health resources.

Single Dose and Dosage Frequency of Analgesic Drugs in 9 Chinese Cancer Hospitals in 2012 / 中国药师

Objective:To evaluate the single dose and dosage frequency of analgesic drugs in 9 Chinese cancer hospitals in 2012. Methods:Using a retrospective method, the utilization of analgesic drugs in 9 cancer hospitals in the year of 2012 was analyzed statis-tically. Results:Most of single dosage of 15 analgesic drugs was consistent with the package inserts except for flunarizine and pethidine oral preparations with single overdose up to 50%. Most of dosage frequency of 21 analgesic drugs was consistent with the package in-serts except for oxycodone/acetaminophen, dihydrocodeine/paracetamol and dezocine with inconsistent dosage frequency ratio up to 30%. Conclusion:Most of single dose and dosage frequency of analgesic drugs is consistent with the package inserts. There is some unreasonable usage that should be paid attention to. Clinicians should be more cautious in analgesic drug use to make correct and ra-tional decision on dose and frequency, meanwhile, drug use in patients should be monitored to ensure the medication safety.

Laços de sociabilidade, filantropia e o Hospital do Câncer do Rio de Janeiro (1922-1936) / Ties of sociability, philanthropy, and the Cancer Hospital in Rio de Janeiro (1922-1936)

Este artigo tem por objetivo estudar a construção do Hospital do Câncer na cidade do Rio de Janeiro, a partir de uma análise das ações e dos grupos sociais envolvidos com a filantropia na cidade, durante a Primeira República. Para tal, apresenta-se um estudo prosopográfico inicial dessa elite, apontando para sua configuração na criação da instituição. Um segundo recorte refere-se às ações filantrópicas de Guilherme Guinle nesse período.

The article explores construction of the Cancer Hospital in Rio de Janeiro from the perspective of an analysis of the city's social groups and their activities involving philanthropy under the First Republic. It offers a preliminary prosopographical study of this elite and examines how it helped to shape creation of the medical facility. The article also addresses Guilherme Guinle's philanthropic initiatives during the period.

Fatores prognósticos envolvidos nas ressecções alargadas de pacientes portadores de adenocarcinoma colônico

Foram estudados, de 1953 a 1996, 95 pacientes portadores de adenocarcinomas colônicos, submetidos à ressecções alargadas, no Departamento de Cirurgia Pélvica do Hospital do Câncer A.C.Camargo, objetivando avaliar a influência de fatores clínicos, cirúrgicos e anatomopatológicos no prognóstico. As lâminas do tumor primário foram revistas por um único patologista. As variáveis clínicas estudadas foram: sexo, idade, estado geral, sinais e sintomas, índices de avaliação nutricional e década do tratamento. Foram analisados em relação à cirurgia: localização do tumor, situação a admissão, intenção cirúrgica, tipo de cirurgia, número de órgãos ressecados, forma de ressecção, transfusão sangüínea, duração da cirurgia e tempos de ressecção. Do tumor primário estudaram-se as seguintes variáveis: estádio clínico-patológico Astler e Coller modificado e pTNM de 1997, grau de malignidade, subtipo histológico, embolização sangüínea e linfática, invasão perineural, infiltrado linfocitário e eosinofilico e invasão capsular linfonodal e margem cirúrgica de ressecção. A associação das variáveis foi feita pelo teste de qui-quadrado; a análise do risco de complicação e óbito pós-operatório, através da regressão logistica múltipla: as análises de sobrevida, pela técnica de KAPLAN e MEIER: e os riscos relativos multifatoriais de recorrência e óbito, pelo modelo de regressão de COX. Na análise da sobrevida global e livre de doença foram avaliados 83 pacientes, excluindo-se aqueles atendidos após 1993. A minoria dos pacientes encontrava-se em bom estado geral (43,2%), e 78,9% deles foram submetidos à cirurgia curativa. As taxas de complicação e óbito pós-operatório foram 55,7% e 23,2%, respectivamente. No estudo anatomopatológico das peças operatórias, 47,6% das aderências eram inflamatórias, 59% não apresentavam metástase linfonodal, 3,6% das margens eram comprometidas, 8,4% dos pacientes apresentavam doença metastática à distância e 73,5% não apresentavam embolização vascular sangüínea. As cirurgias com intenção paliativa, definida pela macroscopia, foram reclassificadas em função da presença de margens livres anatomopatológicas e da presença de doença metastática ressecável. A mudança frente à intenção da cirurgia ocorreu em 13,6% dos casos. A sobrevida global variou de 0,1 a 295,5 meses, com sobrevida mediana de 47,7 meses. A taxa de perdidos de seguimento foi de 10,6%. Observou-se recorrência da doença em 30 pacientes. A sobrevida atuarial aos cinco anos foi de 49,4%. Na avaliação do risco de recorrência, apenas a embolização sangüínea teve impacto (p=0,02). As cirurgias com intenção curativa e ausência de embolização sangüínea determinaram o menor risco de óbito por câncer (p<0,001). O estado geral contribuiu significantemente para a complicação pós-operatória (p=0,01). Pacientes com mau estado geral submetidos à cirurgia paliativa apresentaram as maiores taxas de óbito pós-operatório (p=0,01). As complicações pós-operatórias que determinaram maior risco de óbito foram as cardiopulmonares e sepse abdominal

A retrospective study of 95 patients treated at the Department of Pelvic Surgery of the A.C.Camargo Hospital from 1953 to 1996 was undertaken aimed at the evaluation of clinical, surgical and pathologic factors in prognostic of patients submitted to extended resection for colonic adenocarcinomas. Single pathologist reviewed slides of the primary tumor. The clinical variables studied were sex, age, general condition, signs and symptoms, nutritional index and decade of treatment. The following surgical variables were studied: tumor localization, situation at admission, intention and type of surgery, number of organs resected, surgical blood transfusion, surgical length, resection time. The pathological variables were: invasion of the wall, lymph node localization, histology, level of histological differentiation, blood and lymphatic embolus, perineural invasion, eosinophilic and linfocitic infiltrate, micrometastasis, capsular invasion and margin of resection. The modified Astler & Coller classification and TNM of 1997 were used for clinical staging. The correlation among variables was done by the chi-square test; the analyses of the actuarial survival rate performed according to the KAPLAN & MEIER technique and the multifactorial relative risk of recurrence and death by the COX regression technique. The analyze of survival was done in 83 patients, excluding cases treated over 1993. The minory of patients were in good general condition (43,2%) and 78,9% were submitted to curative surgeries. Morbidity and mortality rates of this surgery were 55,7% and 23,3% respectively. The clinical and pathologic studied showed that 47,6% of adherence were inflammatory, 59% of lymph nodes were free, 3,6% of surgical margins were free, 8,4% had metastatic disease and 73,5% absent blood embolus. Surgeries with palliative intention changed classification in function of free pathologic margins and all metastatic disease resected. The change was done in 13,6% of cases. Follow-up of patients ranged from 0,1 to 295,5 months with a median of 47,7. There were 10,6% patients lost of follow up. Thirty patients had recurrent disease. The overall survival at 5 years was 49,4%. Blood embolization was related with recurrent disease (p=0,02). The association of type of curative surgery (p<0,001) and blood embolization (p=0,004) was related to risk of death (p<0,001). Multivariate analysis revealed that complications were associated to patient's condition on admission (p=0,01), and death was related to surgical intention and patient's condition on admission (p=0,001). The post-operative complications related to death were cardiopulmonary and abdominal sepsis