Objective To review the study on adi pose derived stem cells (ADSCs) in the therapy of urological diseases. Methods The recent l iterature concerning ADSCs in bladder repair, urethral reconstruction, incontinence treatment, and erectile dysfunction treatment was reviewed. Results The appl ication of tissue engineering using ADSCs has made significant achievements in the treatment of urological diseases and in animal studies, and has been initially used in cl inicaland has achieved a good therapeutic effect. Conclusion Tissue engineering using ADSCs has good prospects in the study on urological diseases, and is expected to widely used in the treatment of urological diseases.
Objective To evaluate the effect of urgent psychological crisis intervention for 148 patients who were transferred to other provinces to receive treatment after the Wenchuan earthquake. Methods We randomly selected 148 patients from the disaster area who received treatment in The Third Hospital of Mianyang City and then transferred to other provinces. A self-designed questionnaire, SAS, and SDS scales were administered to all patients 7 days and 1 day before their transfer. After the initial assessment, all patients received urgent psychological interventions including catharsis, leading, explanation, and cognition reconstruction. Results After psychological intervention, both the full score and the standardized score of SAS and SDS declined significantly (Plt;0.01). Conclusion Earthquake sufferers who were transferred to other provinces to receive treatment had psychological problems. Crisis psychological intervention may have improved their psychological status effectively.
ObjectiveTo systematically review the teaching effects of Seminar teaching model versus lecture-based learning (LBL) teaching model on clinical medical students in China.MethodsPubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Internet, WanFang Data and VIP database were electronically searched for randomized controlled trials (RCTs) on Seminar versus LBL applied in clinical medical students in China, from the establishment of database to October 2017. The Meta-analysis was performed using RevMan 5.2 software.ResultsA total of 12 RCTs with 741 students were enrolled, including 380 in Seminar teaching group and 361 in LBL teaching group. The results of Meta-analysis demonstrated that the basic theory score [standard mean difference (SMD)=1.17, 95% confidence interval (CI) (0.72, 1.62), P<0.000 01], the clinical skill score [SMD=1.33, 95%CI (0.82, 1.83), P<0.000 01], the classroom atmosphere score ［SMD=1.51, 95%CI (1.13, 1.90), P<0.000 01］, the team score [SMD=0.86, 95%CI (0.50, 1.22), P<0.000 01], and the autonomous learning ability score [SMD=2.25, 95%CI (0.31, 4.18), P=0.02] of Seminar teaching group were superior to those in the LBL teaching group.ConclusionThe Seminar teaching model is superior to the LBL teaching model in clinical medical students.
Objective To analyze the articles published by graduate students of West China School of Medicine in Sichuan University from 2013 to 2017. Methods Outcome indicators which includes the quantity of papers, annual distribution, paper category and papers cited by SCI were analyzed through bibliometrics methods. Statistical analysis was performed using SPSS 18.0 software. Results From 2013 to 2017, a total of 5 490 articles were published by postgraduate students in the school as first or co-first author. The average number of publication was 2.19 per student, in which 655 postgraduate students published 3 or more articles, accounting for 26.12%. A total of 2 849 articles were cited by SCI, accounting for 51.89%. The total number of publication and proportion of SCI were growing gradually. The average impact factor of each article was 2.791 and the highest impact factor for each single article was 55.7. Students who graduated from "985 university" published more articles in total and the articles cited by SCI than those from "non-985 university". Conclusion In recent years, the quality of articles published by graduate students from West China School of Medicine in Sichuan University has been improving gradually. The articles published by students graduated from "985 university" were more cited by SCI than those from "non-985 university" .
ObjectiveTo investigate the clinical medicine of Sichuan University graduate students degree of satisfaction about the tutors’ performance of the responsibility from all aspects, providing the basis to enhance the guidance level of tutors and to improve the quality of graduate students. MethodsA total of 1 589 graduate students from the 2014 to 2016 session of West China School of Medicine in Sichuan University were investigated by self-made questionnaires.ResultsClinical medical graduate students’ satisfaction of the tutor performance of the responsibility rate was 90.94%, significantly higher than the national graduate level (P<0.001); the highest rating was the evaluation of the ideological and moral cultivation of the tutor (which rate was 96.55%), the lowest satisfaction rate was on the responsibility of caring about the living conditions of students (which rate was 89.79%); There were differences of gender and education level in graduate students degree of satisfaction about the tutors’ performance of the responsibility (P<0.001), male graduate satisfaction was higher than that of female graduate students, doctoral student satisfaction was higher than that of postgraduates. ConclusionThe system of strengthen tutors education responsibility teacher education system of Sichuan University is effective, and the condition of implement tutors responsibility of education is good, but still need to enhance the duty of tutor about caring more on graduate students mental health and living status.
ObjectivesTo systematically review the efficacy of traditional Chinese medicine for arrhythmia caused by anthracycline drugs.MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of traditional Chinese medicine for arrhythmia caused by anthracycline drugs from inception to October 2017. Two reviewers independently screened literature, extracted data and evaluated risk of bias of included studies. Meta-analysis was then performed by Revman 5.3 software.ResultsA total of 4 RCTs involving 312 patients were included. The results of meta-analysis showed that: the incidence of tachycardia in the Wenxin granule treatment group was lower than that in the control group (RR=0.35, 95%CI 0.18 to 0.67, P=0.002). Baoxinkang was more effective than antioxidant western medicine in protecting myocardial SOD activity (RR=2.25, 95%CI 1.74 to 2.76, P<0.000 01). But there was no significant difference between two groups on the incidence of atrial premature beats (RR=0.40, 95%CI 0.15 to 1.08,P=0.07), premature ventricular contractions (RR=0.56, 95%CI 0.23 to 1.34, P=0.19) and atrial fibrillation (RR=0.41, 95%CI 0.11 to 1.53, P=0.18). In addition, there was no significant difference between Wenxin granules and amiodarone in treating arrhythmia induced by anthracycline. The addition of Wenxin granules on the basis of anthracycline antitumor chemotherapy regimens was not effective in delaying disease progression compared with anthracycline alone. Wenxin granules could not change the SOD level of breast cancer patients with cardiotoxicity caused by anthracycline chemotherapy, compared with chemotherapy and basic treatment.ConclusionsThe current evidence shows that Wenxin granules can prevent and reduce anthracycline-induced tachycardia, but its efficacy in improving the overall efficiency, preventing and reducing atrial premature beats, premature ventricular contractions, atrial fibrillation, and SOD levels are unclear. Baoxinkang can protect myocardial SOD activity. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Objective To compare the long-term cost-utility of three first-generation EGFR-TKIs targeted drugs, gefitinib, icotinib, and erlotinib as first-line treatments for advanced non-small cell lung cancer (NSCLC). Methods Real-world data were collected from 1 511 patients with advanced NSCLC treated with first-generation EGFR-TKIs as first-line treatment at West China Hospital of Sichuan University from 2009 to 2019. A three-state Markov model was established to evaluate the clinical efficacy, safety and cost-utility of three first-generation EGFR-TKIs targeted drugs. The transition probability of each state was obtained by survival analysis, the direct and indirect costs were calculated by the bottom-up method, the health utility value was obtained through literature research, the incremental cost effectiveness ratio (ICER) and quality-adjusted life years (QALYs) were calculated, and sensitivity analyses and Monte Carlo simulations were performed. Results There was no significant difference in clinical efficacy among the three first-generation EGFR-TKIs in the treatment of NSCLC. The incidence of skin rash and liver injury caused by gefitinib was significantly higher than that caused by icotinib and erlotinib (P<0.05). The average economic burden of patients treated with icotinib was the lowest (CNY 192 535.3) (P<0.01). The cost-utility ratio of icotinib (CNY 132 985.9/QALYs) was much lower than that of gefitinib (CNY 205 005.3/QALYs) and erlotinib (CNY 172 893.1/QALYs). Conclusion Compared with the three first-generation EGFR-TKIs drugs, icotinib is the most cost-effective.
Improving the rate of pathogen examination before antibiotic treatment is of great significance for clarifying pathogen diagnosis and curbing bacterial resistance, and is also one of the important goals for improving national medical quality and safety. In response to the current problem of low pathogen examination rates, Chengdu Women’s and Children’s Central Hospital adopts a FOCUS-PDCA model, has explored measures such as current situation investigation, root cause analysis, intervention plan formulation, countermeasure implementation, and effect evaluation to improve the rate of pathogen examination before antibiotic treatment in inpatients. This article mainly elaborates on the above model, which has practical significance for ensuring the rational use of antibiotics in inpatients.
ObjectiveTo investigate the effectiveness of establishment of chest pain center and optimized process in the diagnostic and treatment progress and short-term prognostic value of acute non-ST segment elevation myocardial infarction (NSTEMI) patients. MethodsThis was a retrospective study. We included NSTEMI patients admitted in the Emergency Department in our hospital, 41 patients admitted before the establishment of the chest pain center (April 2015) were included as group A (30 males and 11 females at age of 64.7±11.8 years), 42 patients after the establishment of the chest pain center (April 2016) as group B (31 males and 11 females at age of 64.6±11.8 years), and 38 patients after the establishment of the chest pain center (April 2017) as group C (30 males and 8 females at age of 62.6±10.0 years). The clinical outcomes of the three groups were compared.ResultsThe time from admission to electrocardiogram was 20.0 (17.0, 25.5) min in the group A, 4.0 (2.8, 5.0) min in the group B, and 3.0 (2.0, 4.0) min in the group C (P<0.001). The first doctor's non-electrocardiogram advice time was 13.0 (10.0, 18.0) min, 9.5 (6.8, 15.3) min, and 9.0 (7.0, 12.0) min (P=0.001) in the three groups, respectively. The diagnostic confirmed time was 139.4±48.5 min, 71.1±51.5 min, 63.9±41.9 min (P<0.001). The proportion of patients receiving emergency dual anti-platelet load dose treatment was 53.1%, 70.0%, 100.0% (P=0.001), respectively. The time of receiving emergency dual anti-platelet load dose treatment was 208.0 (72.0, 529.0) min, 259.0 (91.0, 340.0) min, and 125.0 (86.0, 170.0) min (P=0.044) in the three groups, respectively. Emergency percutaneous coronary artery intervention (PCI) start time was 60.9 (42.1, 95.8) hours, 61.3 (43.3, 92.2) hours, 30.5 (2.8, 44.1) hours (P<0.001) in the three groups, respectively. Among them, the moderate risk patients’ PCI starting time was 63.0 (48.1, 94.2) hours, 62.3 (42.1, 116.2) hours, and 40.1 (17.2, 60.4) hours (P>0.05), respectively. The high risk patients’ PCI starting time was 47.9 (23.7, 102.4) hours, 55.2 (44.0, 89.6) hours, 23.2 (1.7, 41.8) hours in the three groups, respectively (P<0.001). The hospitalization time of the patients was 7.0 (5.4, 9.4) days, 5.9 (4.9, 8.7) days, 4.7 (3.1, 6.2) days in the three groups (P<0.001), respectively. The hospitalization time of the moderate risk patients was 6.9 (4.9, 8.8) days, 6.4 (4.9, 8.0) days, 4.8 (3.2, 6.5) days in the three groups (P>0.05), respectively. The hospitalization time of the high risk patients was 7.1 (5.5, 9.9) days, 5.9 (4.6, 9.8) days, and 4.4 (3.0, 6.1) days, respectively (P<0.001). The fatality rate of inpatients was 4.9%, 0.0%, and 0.0%, respectively (P>0.05). The correlation coefficient of hospitalization time, diagnosis confirmed time and PCI starting time was 0.219 and 0.456 (P<0.05), respectively.ConclusionThe establishment and optimized process of chest pain center can accelerate the time of early diagnosis of NSTEMI, which is helpful to obtain stratified and graded standardized treatment for patients according to their conditions, to accelerate the specific treatment process of high risk NSTEMI patients, and shorten the hospitalization time.
ObjectiveTo compare the dosimetric differences among flattening filter free intensity modulated radiotherapy (3FIMRT), flattening filter free volumetric modulated arc therapy (3FVMAT), filter free intensity modulated radiotherapy (IMRT), and filter free volumetric modulated arc therapy (VMAT) for hyperthyroidism exophthalmus patients.MethodsComputed tomography (CT) scans of 29 patients, who were diagnosed with hyperthyroidism exophthalmus and treated with radiation therapy between September 2016 and September 2017, were selected for study. Four treatment plans with the same dose prescription and objective constrains were designed for each patient based on their images, consisting of IMRT, VMAT, 3FIMRT, and 3FVMAT. The target dosimetric distribution, normal tissue radiation dose, monitor units, and treatment time of each plan were evaluated.ResultsFour types of plans were all able to satisfy the clinical treatment requirements, and there were no significant differences in maximum dose, mean dose (Dmean), homogeneity index of the targets (P>0.05). For the parameters minimum dose, V50%, conformity index (CI), gradient index of the targets, statistically significant differences were observed among the four kinds of technologies (F=10.920, 35.860, 11.320, 17.790; P<0.05). The CI of IMRT and 3FIMRT were superior to those of VMAT and 3FVMAT, but there was no significant difference between IMRT and 3FIMRT. In terms of Lens Dmean and Brain Dmean, statistically significant differences were observed among the four kinds of technologies (F=5.054, 83.780; P<0.05). For Lens Dmean and Brain Dmean, 3FVMAT achieved better sparing effects when compared with the other three plans. The total monitor units and treatment time did not significantly differ between 3FVMAT and VMAT. The mean monitor units of 3FVMAT were 65.07% and 70.22% less than that of IMRT and 3FIMRT respectively. The mean treatment time of 3FVMAT were 48.1% and 35.24% less than that of IMRT and 3FIMRT respectively.Conclusion3FVMAT can bring more dosimetric advantages for hyperthyroidism exophthalmus radiation therapy when compared with IMRT, 3FIMRT, and VMAT.