ObjectiveTo analyze the health examination results of hospital retirees, understand their health status and provide the evidence for health management. MethodsThe data were collected from our 1 089 hospital retirees (51-96 years old) who received health examination in West China Hospital of Sichuan University from January to December 2013, including 345 males and 744 females, with a mean age of 70 years. The data were analyzed by SPSS 16.0 software. ResultsHypertension, dyslipidemia and diabetes were the three chronic diseases with the highest detectable rate, and the rate was respectively 49.49%, 44.90% and 31.04%. The detectable rate of hypertension was not significantly different between male and female. The rate of dyslipidemia in females was higher than that in males. The rate of diabetes in males was higher than that in females. The detectable rate of hypertension and diabetes increased with the increase of age. The detectable rate of dyslipidemia had no significant relationship with age. ConclusionThe health condition of retirees cannot be neglected. We need to strengthen the health management for the retirees.
ObjectiveTo explore the implementation of standardized training of general practitioners system in China. MethodsA total of 25 bases of training general practitioners and its collaborative community service centers, which were located in the east and western region of China, met the inclusion criteria; qualitative interviews and questionnaires were done between November 2012 and November 2013, including 456 teachers, 281 students, and 166 teaching management staff. Survey content involved implementation of standardized training system, teaching method and so on. ResultsSatisfaction rate of training general practitioners training system with teachers, students, and administrators was 76.2%, 71.3%, and 86.3%, respectively (χ2=92.372, P<0.001). The average satisfaction rate of training model, teaching programme, teaching materials, teaching arrangements, the examination system, the quality of training, and supporting policies was 95.7%, 92.1%, 73.8%, 65.7%, 72.5%, 86.8%, and 48.9%, respectively (χ2=813.196, P<0.001). Satisfaction rate of teaching method with teachers, students, and administrators was 81.1%, 74.4%, and 67.7%, respectively (χ2=40.159, P<0.001). ConclusionSatisfaction rates of training general practitioners training system and teaching method with teachers, students, and administrators are low. The main impact factors are:the syllabus and textbooks are not practical, qualified teachers are short, teaching arrangements is unreasonable, teaching content is specialization, government support is inadequate and so on.
ObjectiveTo assess the method and the results of tricuspid annuloplasty performed(TVP) with the Edwards MC3 ring. MethodsWe retrospectively analyzed the clinical data of 312 patients with functional tricuspid regurgitation(FTR) secondary to left-sided valve disease in our hospital from June 2012 through May 2014. There were 147 males and 165 females at mean age of 55.7±7.3 years. ResultsThere was no death in the patients because of the planting of MC3 ring. The mean follow-up rate was 99.4%(310/312) for 2 patients immigration abroad. The follow-up time was 0-24(14.2±4.7) months. The ultrasoundcardiogram showed that all the ejection fraction(EF) of right ventricle improved compared with preoperation(P<0.05). The pulmonary artery systolic pressure(SPAP), both internal diameter and regurgitation volume of right ventricle were decreased(P<0.05). In the 310 patients, 302 patients(97.4%) were with the TR class 0-Ⅰ, 5 patients(1.6%) with class Ⅱ, 3 patients(1.0%) with class Ⅲ. There was no severe TR or no patient with reoperation. ConclusionThe MC3 ring is easy for planting and has good repeatability, which provides stable and satisfactory results for plasty of the tricuspid annulus with seldom residue or recurrent TR.
ObjectiveTo summarize the surgical experience of aortic regurgitation with lower ejection fraction (EF). MethodsWe retrospectively analyzed the clinical data of 34 patients with aortic regurgitation and lower ejection fraction received aortic valve replacement in the General Hospital of Shenyang Military Region between January 2012 and December 2013. There were 27 males and 7 females with age of 21-74 (51.03±12.06) years. All surgical procedures were performed under general anesthesia during cardiopulmonary bypass. ResultsThere was no operative mortality. Cardiopulmonary bypass time was 40-155 (60.92±22.89) minutes, aortic clamping time varied from 24 to 79 (37.12±12.61) minutes. Postoperative ventilator-assisted time was 4 to 67 (16.12±12.74) hours. The patients were discharged 8-15 (11.03±2.04) days after surgery. When discharged, EF value was 30% to 48% (41%±4%) and significantly improved compared with that before operation (P<0.01). Pulmonary artery systolic pressure varied from 33 to 50 (38.35±4.35) mm Hg and decreased significantly than that before operation (P<0.01). Left ventricular end-diastolic volume reduced to 168-380 (269.12±52.01) ml and obviously decreased than that before operation (P<0.01). ConclusionSurgical treatment can be carried out on patients with aortic insufficiency and lower EF. Treatment results are satisfactory.
ObjectiveTo investigate the relationship of epithelial mesenchymal transition (EMT) related proteins expressions in invasive ductal carcinoma of breast to its clinicopathologic features and prognosis. MethodsThe expressions of EMT related proteins (Vimentin, E-cadherin, and MMP2) in the 118 cases of invasive ductal carcinoma of breast and 30 cases of corresponding normal breast tissues adjacent to cancer were detected by immunohistochemistry. The relationship of EMT related proteins expressions to age, tumor site, tumor size, lymph node metastasis, histological grade, TNM stage or prognosis of the patients with invasive ductal carcinoma of breast was analyzed. Results①The positive rates of the Vimentin protein and MMP2 protein in the invasive ductal carcinoma of breast were significantly higher than those in the corresponding normal breast tissues adjacent to cancer﹝Vimentin protein: 50.8% (60/118) versus 10.0% (3/30), P < 0.05; MMP2 protein: 63.6% (75/118) versus 6.7% (2/30), P < 0.05﹞, the positive rate of E-cadherin in the invasive ductal carcinoma of breast was significantly lower than that in the corresponding normal breast tissues adjacent to cancer ﹝56.8% (67/118) versus 93.3% (28/30), P < 0.05﹞.②The positive rate of the Vimentin protein expression in the invasive ductal carcinoma tissue was positively related with the lymph node metastasis and TNM staging (rs=0.346, P < 0.05; rs=0.231, P < 0.05). The positive rate of the E-cadherin or MMP2 protein expression was negatively or positively related with the tumor size, lymph node metastasis, histological grade, and TNM stage (E-cadherin: rs=-0.444, P < 0.05; rs=-0.493, P < 0.05; rs=-0.323, P < 0.05; rs=-0.474, P < 0.05. MMP2: rs=0.361, P < 0.05; rs=0.434, P < 0.05; rs=0.396, P < 0.05; rs=0.376, P < 0.05).③The Kaplan-Meier survival curve analysis showed that the positive expressions of Vimentin and MMP2 were stronger, the tumor free survival time was shorter (P < 0.05), and the positive expression of E-cadherin was stronger, the tumor free survival time was longer (P < 0.05). ConclusionJoint detection of EMT related proteins (Vimentin, E-cadherin, MMP2) of invasive ductal carcinoma tissue of breast could predict the pathological grade and clinical stage, as well as effective prognosis of patients with invasive ductal carcinoma of breast in clinical.
ObjectiveTo investigate the restoration of left atrial function and its relationship with atrial fibrosis of patients after mitral valve replacement (MVR)and concomitant radiofrequency ablation (RFA)for atrial fibrillation (AF). MethodsClinical data of 32 patients with mitral valve disease and chronic AF who underwent surgical treatment in General Hospital of Shenyang Military Area Command from January to August 2010 were retrospectively analyzed in this cohort study. There were 11 male and 21 female patients with their age of 49.8±8.7 years. There were 14 patients with rheumatic mitral stenosis (MS), 8 patients with rheumatic MS and mitral regurgitation, and 10 patients with mitral valve prolapse. Preoperative AF duration was 3.6±4.6 years. All the patients received MVR and concomitant RFA for AF. According to the cutting off extent of left atrial fibrosis (10.9%), all the 32 patients were divided into 2 groups. There were 19 patients with more severe left atrial fibrosis ( > 10.9%)in group A and 13 patients with milder left atrial fibrosis ( < 10.9%)in group B. Immunohistochemistry was performed to examined left atrial fibrosis, and echocardiography was performed to examined the structure and function of left atrium. ResultsThere was no perioperative death. Cardiopulmonary bypass time was 84.6±22.6 minutes, aortic cross-clamping time was 47.6±15.6 minutes, and ICU stay was 3.2±1.5 days. All the 32 patients were followed up for longer than 6 months (1.3±0.6 years). The extent of left atrial fibrosis of the 32 patients was 4.8%-18.3% (10.7%±4.2%). There was no statistical difference in left atrial diameter (LAD), left atrial fractional area change (LAFAC)or mitral annular motion between group A and group B preoperatively and 3 months after surgery respectively (P > 0.05). At 6 month after surgery, LAD of group B was significantly smaller than that of group A (P < 0.05), late diastolic mitral annular velocity (Am)of group B was significantly higher than that of group A (P < 0.05), and there was also some improvement in LAFAC of group B compared with group A (P=0.067). Among the 32 patients, 28 patients (87.5%)restored sinus rhythm (SR)3 months after surgery, and 21 patients (65.6%)maintained SR longer than 6 months after surgery. Patients in group B were more likely to maintain SR than patients in group A (P=0.010). ConclusionImprovement of left atrial function can be observed 6 month after MVR and concomitant RFA for AF, which is related to the extent of left atrial fibrosis.