Objective To understand the residents’ demands and utilization of the community health services and provide a basis for the construction of reasonable medical service system. Methods From July to September 2015, a purposive sampling questionnaire survey on general team mode service to bring benefits to the community residents was conducted in 20 provincial-level administrative regions of the country. SPSS 13.0 software was used for data analysis. Results A total of 1 300 questionnaires were distributed, and 1 273 valid questionnaires were recovered. In the 221 residents who were aware of the composition of general team, the awareness rate of general team composed of traditional Chinese medical doctors and gynaecologists/pediatricians was low (70.14%, 75.11%, respectively). The awareness rate of medical services including disease diagnosis and treatment, health consultation, health education and prescription in the 1 273 residents was 70.46%, 61.19%, 59.62% and 67.56%, respectively; the residents’ top five willing to accept medical services was prescribing medicine (77.77%), infusion (74.08%), health consultation (73.21%), health education (70.54%), and planned immunization (64.49%). The biggest change of the 433 patients with chronic diseases before and after treatment in the community was the increase in self-health management (70.67%) and the healthy lifestyle improvement (56.35%). Conclusion Community general team should be oriented by the objective needs and real demands of the residents; based on the ability of medical services supply, the adjustment of the key points of medical services should be made and the rational use of medical services should be guided for the residents.
ObjectiveTo understand the status of application of Colorectal Cancer Predicted Risk Online (CRC-PRO) in colorectal cancer screening, and to analyze the possible practical value in our country.MethodsThe research literatures on the colorectal cancer risk prediction tool of CRC-PRO at home and abroad were searched. The overview and application status of this tool were reviewed.ResultsCRC-PRO could predict the 10-year risk rate of individuals developing colorectal cancer. It could quickly provide clinicians with accurate estimates of patient risk to help clinicians and patients identify screening programs and improve prevention strategies.ConclusionsCRC-PRO can not only give specific probability of risk, but also easy to operate. But based on regional differences, in the promotion of CRC-PRO, it is necessary to carry out multi-center research in more diverse populations for more extensive clinical analysis and verification, to further expand the scope of application of this tool.
ObjectiveScreening the Database from Colorectal Cancer (DACCA) based on West China Hospial data by " Operation Date”, we purposed to analyze the population characteristics of colorectal cancer patients in regional medical center within recent Database Version.MethodsThe DACCA Version was updated in December 12th, 2018. Personal data (including sex, age, blood type, height, weight, and BMI), location data (including provinces, cities, and subordinate areas in Chengdu), occupation and education data, and main diagnosis data were included in the items. Characteristic analysis was performed on each selected data item.ResultsAccording to screening, 9 633 analytical data rows were obtained. Based on the database information, there were 24 consecutive years from 1995 to 2018 into every year. We set 2005 to 2006 as the time node for the database construction. The contribution to database before 2005 (including) was 1 358, while after 2005 (not including) were 8 275. The contribution rate (contribution numbers/years) after 2005 was higher than before 2005 ［1 358/11 vs. 8 275/13, 95% CI was (–625.337, –400.831), P<0.001］. According to gender distribution, total male data were 4 669, female were 3 340, non-checked were 1 624. According to age distribution, age were from 13 to 104 ［(59±13) years］. Linear prediction was used to predict the age distribution with the " year” as the time axis. The results showed the stable linear prediction (\begin{document}$\hat y$\end{document}=0.016 1x+26.54, R2=3.42×105, P=0.601 108). According to height, height were from 138 cm to 192 cm ［(161±7)cm］, linear prediction results showed that the linear variation with height changes by value (\begin{document}$\hat y$\end{document}=0.110 5 x–60.911, R2=0.002 6, P=0.000 272). According to weight, weight were from 27.5 kg to 80.5 kg ［(59.38±10.27) kg］, linear prediction results showed that the linear variation with height changes by value (\begin{document}$\hat y$\end{document}=0.296 5x–537.24, R2=0.010 625, P=2.37×1014). Available 6 884 data showed the difference between serving areas by West China Hospital and official definition of western region. A total of 9 209 data obtained by analyzing main diagnosis, showed that the main site of disease was rectum (68.64%). Sigmoid was the main location of colon cancer (68.64%), and anal-rectal cancer was main of rectal cancer (27.06%).ConclusionPopulation characteristics from DACCA database could initially reflect the trend of increasing weight and BMI of colorectal cancer patients, and also reflect the regional distribution characteristics based on geographic information. They would be the clues for further database research.
Before transcatheter aortic valve replacement (TAVR), echocardiography is the first choice for preoperative screening of suitable patients, which can be used to observe the morphology of aortic valve, determine the cause of aortic stenosis, and evaluate the severity of aortic stenosis and other cardiac structure and function. During TAVR procedure, echocardiography is mainly used for real-time monitoring of complications and immediate postoperative evaluation. After TAVR, echocardiography can be used to evaluate the shape and function of the prosthesis valve and monitor long-term complications. This article reviews the research progress of echocardiography in TAVR for guiding clinical practice.
Surgical removal or destruction of the focal brain area is the main treatment for drug-resistant epilepsy, but it is not suitable for all patients. Epileptiologists in the United States have opted for a new type of palliative therapy called responsive neurostimulation (RNS). The RNS system continuously monitors the electrical activity of the brain in the area of possible seizures and places electrodes in the epileptic area to provide electrical stimulation when abnormal discharges are detected, stopping seizures. Controlled clinical trials have demonstrated the long-term effectiveness and safety of the RNS system, with continued improvement in seizure reduction rates over time. RNS system not only has a good effect on temporal lobe epilepsy and cortical functional area epilepsy, but also can dynamically monitor cortical EEG, so as to better understand the epilepsy status of each patient and provide personalized diagnosis and treatment. In this paper, the development history, structure, advantages and disadvantages of RNS system are reviewed, and its indications as palliative treatment for drug-resistant epilepsy are discussed.
Objective To systematically review the effectiveness of amiodarone in treating repurfusion arrhythmia (RA) after thrombolytic therapy for acute myocardial infarction (AMI), so as to provide high quality evidence for formulating the rational thrombolytic therapy for AMI. Methods Randomized controlled trails (RCTs) on amiodarone in treating RA after thrombolytic therapy for AMI were electronically retrieved in PubMed, EMbase, The Cochrane Library (Issue 3, 2012), CBM, CNKI, VIP and WanFang Data from inception to January, 2013. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed quality. Then RevMan 5.1 software was used for meta-analysis. Results A total of 5 RCTs involving 440 patients were included. The results of meta-analysis suggested that, compared with the blank control, amiodarone reduced the incidence of RA after thrombolytic therapy in treating AMI (RR=0.60, 95%CI 0.48 to 0.74, Plt;0.000 01) and the incidence of ventricular fibrillation (RR=0.47, 95%CI 0.26 to 0.85, P=0.01). It neither affected the recanalization rate of occluded arteries after thrombolytic therapy (RR=1.00, 95%CI 0.88 to 1.15, P=0.94) nor decreased the mortality after surgery (RR=0.33, 95%CI 0.10 to 1.09, P=0.07). Conclusion Current evidence indicated that, amiodarone can decrease the incidence of RA. Unfortunately, the mortality rate can’t be reduced by amiodarone. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion
ObjectiveTo explore and analyze the nutritional risk and dietary intake of patients with coronavirus disease 2019 (COVID-19), and provide data support for nutritional intervention.MethodsCOVID-19 inpatients were investigated in Wuhan Wuchang Hospital and the People’s Hospital of Wuhan University (East Area) from March 9th to 16th, 2020 by Nutrition Risk Screening 2002 (NRS 2002) scale and designed questionnaire. The energy and protein requirements were calculated according to the standard of 30 kcal/(kg·d) and 1.2 g/(kg·d). The nutritional risk, energy and protein intake, body weight and body mass index and their changes in the mild and severe patients were analyzed. The energy and protein intake of the two types of nutritional risk patients was analyzed.ResultsA total of 98 patients with COVID-19 completed the investigation, in whom 46 (46.94%) had nutritional risk, including 32 (39.02%) with mild type and 14 (87.50%) with severe type; and the difference was statistically significant (P<0.001). Compared with the usual condition, the body weight and body mass index of the two types of patients significantly decreased (P<0.01 or P<0.001); the energy and protein intake in mild type patients were significantly higher than those in the severe type patients (P<0.001); compared with the requirement, the protein intake in the two types of patients were significantly lower than the demand, while the energy and protein intake in the mild type patients were significantly lower than the requirement (P<0.05 or P<0.01). The proportion of energy and protein intakes in patients with nutritional risk was significantly higher than that in patients without nutritional risk (P<0.001 or P<0.01); the energy and protein intakes in patients without nutritional risk was significantly higher than that in patients with nutritional risk (P<0.001); the protein intakes in patients with nutritional risk was obviously insufficient (P<0.001); while the energy intake of the patients without nutritional risk was higher than the requirement (P<0.001).ConclusionsCOVID-19 patients has high incidence of nutritional risk which was higher in the severe patients compared with the mild patients. Higher incidence and lower intake of energy and protein are in the severe patients compared with those in the mild patients. Patients with nutritional risk has a higher proportion of energy and protein inadequate intake and lower intake compared with the patients without nutritional risk.
As the indications for transcatheter aortic valve replacement (TAVR) expand, multi-valve lesions are becoming more common in clinical practice. Moderate to severe atrioventricular regurgitation, particularly when persistent after TAVR, significantly increases the risk of adverse events. Therefore, many studies have evaluated factors that contribute to the improvement of atrioventricular regurgitation. However, this field remains controversial due to the heterogeneity of retrospective studies and the lack of randomized controlled trials. Despite advances in atrioventricular valve intervention techniques, evidence for atrioventricular regurgitation intervention after TAVR is still scarce. The management decision for atrioventricular regurgitation in patients who underwent TAVR is complex and must take into account the severity of valve disease, anatomical characteristics, quality of life, and procedural complexity. We conducted a review of atrioventricular regurgitation in patients who have received TAVR in hope that it will help decision-making in clinical practice.
Objective To evaluate the clinical effectiveness of valve-sparing aortic root replacement (VSARR) in the treatment of patients with dilated aortic root after operation for tetralogy of Fallot (TOF). Methods A retrospective analysis was conducted on clinical data of TOF patients with aortic root dilation who underwent VSARR in our hospital from 2016 to 2022. Results Finally 14 patients were collected, including 8 males and 6 females, with a median age of 22 years ranging from 12-48 years. Among them, 5 patients had severe aortic valve regurgitation, 4 moderate regurgitation, and 5 mild or no regurgitation. Six patients had sinus of valsalva dilation, and 8 significant dilation of the ascending aorta. One patient had residual shunt due to ventricular septal defect, and 9 severe pulmonary valve regurgitation. The David procedure was performed in 10 patients, Yacoub procedure in 2 patients, and Florida sleeve in 2 patients. There was no perioperative mortality in the group. The median follow-up time was 2.9 years (ranging from 0.4 to 6.0 years). One patient had mild aortic valve regurgitation, and the rest had minimal or no regurgitation. One patient had mild stenosis of the left ventricular outflow tract, and the rest patients had no obvious stenosis. Conclusion VSARR is a satisfactory treatment for aortic root dilation in patients with TOF, with no significant increase in the incidence of left ventricular outflow tract stenosis or aortic regurgitation during mid-term follow-up.
Objective To investigate diagnosis and treatment strategies of patients with pulmonary tuberculosis （TB） complicated by Aspergillus infection. Methods Clinical data of 38 patients with pulmonary TB complicated by Aspergillus infection who underwent surgical treatment from January 2008 to December 2010 in Chengdu Infectious Disease Hospital were retrospectively analyzed. There were 23 male patients and 15 female patients with their average age of 37.8 （23-59） years. Preoperatively，all the patients received regular anti-TB treatment for more than 2 weeks，and patients with definite Aspergillus infection received anti-Aspergillus therapy for more than 3 days with consultation of infectious disease physicians. After above treatment，26 patients underwent lobectomy，1 patient underwent right pneumonectomy，and 11 patients underwent left pneumonectomy. All the patients were followed up at the outpatient department after discharge. They were evaluated every 2 weeks in the first 3 months，every 1 month after 3 months，and every 6 months after 1 year. During follow-up，they received acid-fast bacillus smear and sputum culture to check Aspergillus，as well as CT chest scan. Results All the patients successfully received surgical resection of the pulmonary lesion without perioperative death or severe complication. Postoperative pathology examination confirmed pulmonary TB with Aspergillosis infection in all the 38 patients，whose basic diseases included TB cavity in 17 patients，TB-destroyed lung in 12 patients，and post-TB bronchiectasis in 9 patients. All the patients were followed up after discharge for 1.5-4.5 years. During follow-up，they received regular anti-TB therapy for adequate duration in addition to antifungal medications such as voriconazole. None of the 38 patients had recurrence of Aspergillus infection or pulmonary TB. One patient had hemoptysis which was controlled after proper treatment during follow-up. Conclusion Missed diagnosis rate of pulmonary TB complicated by Aspergillus infection is high. Surgical resection of the pulmonary lesion and postoperative medication treatment are the most effective treatment strategies for patients with pulmonary TB complicated by Aspergillus infection.