Key strategies of ICU in promoting organ donation: a relay for life / 器官移植

Organ transplantation is an effective treatment for end-stage organ failure. However, organ shortage has always been a common problem faced by countries around the world. The recognition and active participation of intensive care unit (ICU) medical staff in organ donation contributes to promoting the development of organ donation, thereby alleviating the shortage of donor organ. In this article, the key strategies of ICU donor management to promote organ donation and the key strategies of ICU medical staff management to promote organ donation were summarized, aiming to provide reference for organ donation practitioners (especially ICU medical staff) and jointly facilitate the professional development of organ donation.

O desafio da equidade: fatores associados aos gastos com a produção ambulatorial na atenção secundária / The equity challenge: factors associated with outpatient production expenditures in secondary care

Objetivo: Analisar quais as variáveis socioeconômicas, estruturais e demográficas possuem maior associação com a produção e os gastos ambulatoriais de média complexidade no estado de Minas Gerais no ano de 2014. Métodos: Estudo ecológico, analítico observacional em uma população de 853 municípios do estado de Minas Gerais agregados por 77 Comissões Intergestoras Regionais (CIRs). Foram realizadas análises descritivas, bivariada e multivariada, entre o gasto com a produção e variáveis explicativas sociodemográficas e econômicas, cobertura da estratégia saúde da família, número de médicos especialistas e de atenção básica, e oferta (equipamentos) dos serviços em média complexidade. Resultados: A caracterização socioeconômica, demográfica e de estrutura dos serviços de saúde das CIRs indicou heterogeneidade nessas variáveis. Foi evidenciada correlação positiva entre a produção e o gasto per capita ambulatorial em média complexidade com as variáveis: produto interno bruto (PIB), renda média domiciliar per capita, índice de desenvolvimento humano municipal (IDHM), condição de habitação, sexo feminino e médicos especialistas e de atenção básica. Evidenciaram-se ainda correlações negativas com as variáveis: taxa de analfabetismo e cobertura da estratégia saúde da família. Na regressão linear múltipla, a variável condição de habitação apresentou maior valor preditivo em relação à produção per capita em média complexidade e as variáveis "médicos especialistas", "condições de habitação" e "equipamento RX" mostraram maior valor preditivo para gasto per capita em média complexidade. Conclusão: Os resultados fornecem evidências de que a infraestrutura e a condição socioeconômica das CIRs estão determinando a maior produção e gastos ambulatoriais de média complexidade, pois regiões com menor infraestrutura e condição socioeconômica tendem a gastar menos

Objective: To analyze which socioeconomic, structural and demographic variables have a more relevant association with the production and outpatient expenses of medium complexity in the state of Minas Gerais during 2014. Methods: Ecological, observational analytical study with a population of 853 municipalities in the state of Minas Gerais aggregated by 77 Regional Interactive Commissions (RICs). Descriptive, bivariate and multivariate analyzes were performed between production expenditure and socio-demographic variables and economics, coverage of the Family Health Strategy, number of specialist doctors and Basic Care, and supply (equipment) of services in medium complexity. Results: The socioeconomic, demographic and structural characterization of the health services of the RICs indicated heterogeneity in these variables. Positive correlation between production and outpatient per capita expenditure was evidenced in average complexity with the following variables: GDP, average household income per capita, HDI, housing condition, female gender, medical specialists and basic care. There were also negative correlations with the variables: Illiteracy rate and coverage of the family health strategy. In the multiple linear regression the housing condition variable presented a higher predictive value in relation to per capita production in medium complexity, and the variables "medical specialists", "housing conditions" and "RX equipment" showed higher predictive value for per capita expenditure in complexity. Conclusion: The results provide evidence that the infrastructure and the socioeconomic status of RICs are determining the higher production and outpatient expenses of medium complexity, since regions with lower infrastructure and socioeconomic conditions tend to spend less.

Effects of gross tumor volume and positive lymph node volume on prognosis of intensity-modulated radiotherapy for esophageal squamous cell carcinoma / 中华放射肿瘤学杂志

Objective To analyze the effects of gross tumor volume(GTV-T)and positive lymph node volume(GTV-LN)on the prognosis of radical concurrent chemoradiotherapy for esophageal squamous cell carcinoma(ESCC). Methods A total of 79 patients with stage N1ESCC undergoing radical radiotherapy in our hospital from 2012 to 2015 were enrolled as subjects. GTV-T and GTV-LN were calculated by the Pinnacle39.0 treatment planning system. The receiver operating characteristic(ROC)curves were used to evaluate the value of the GTV-LN/GTV-T ratio in the prediction of local recurrence(LR)and distant metastasis(DM)of ESCC. Results The median follow-up time was 17.2 months in all patients. The ROC curves were made using the GTV-LN/GTV-T ratio. The optimal cut-off values of GTV-LN/GTV-T ratio for predicting the risk of LR and DM were 0.34 and 0.59, respectively. The statistical analysis revealed that the LR rates were 50% and 8% in patients with GTV-LN/GTV-T ratios of<0.34 and ≥0.34, respectively(P<0.01), while the DM rates were 11% and 43% in patients with GTV-LN/GTV-T ratios of<0.59 and ≥0.59, respectively(P= 0.003). Conclusions The GTV-LN/GTV-T ratio may be a predictor of LR and DM in patients with ESCC. Further studies on the GTV-LN/GTV-T ratio may help to make personalized chemoradiotherapy strategies for patients with ESCC.

Practice and Exploration for the Teaching of New Drug Clinical Research / 中国药房

OBJECTIVE:To Provide reference for improving teaching levels of New Drug Clinical Research and training for pharmaceutical research talents. METHODS:The experiment teaching in 2013 graduate student of the Fourth Military Medical Uni-versity was taken as a pilot,different teaching methods were introduced in various chapters of New Drug Clinical Research,and ap-praisal system was perfected. RESULTS & CONCLUSIONS:Some appropriate methods are established,for example,conductive teaching,problem-based learning,spot-teaching and bilingual-teaching. The appraisal system including usual performance and re-search proposal is established,it has improved enthusiasm and initiative of students,promoted teaching quality,obtained certain achievements,which provides reference for the training methods on the cultivation of innovative and professional pharmaceutical tal-ents.