Lung cancer is a malignant tumor with the highest incidence and mortality in China. Early diagnosis and early treatment is the key to improve the survival and prognosis of patients with lung cancer. In recent years, many studies have focused on biomarkers of lung cancer. Emerging biomarkers tests have shown some potential in lung cancer screening. Combining biomarkers, imaging omics and artificial intelligence to establish a comprehensive model for lung cancer screening and prediction may be the development direction for improving lung cancer screening in the future. This paper summarizes the application of biomarkers in lung cancer screening, introduces the emerging biomarkers and new technologies, and discusses the application prospects of biomarkers in lung cancer screening, in order to providea theoretical basis for improving screening, early diagnosis and early treatment of lung cancer.
小气道病变曾经是全球呼吸界研究的热点，许多肺功能测定方法和指标被用于小气道功能的诊断，其后热度骤减，最近又引起一些学者的重视。
Objective To observe the feature of post-operative hyperglycemia after coronary artery bypass grafting(CABG) surgery in department of intensive care unit（ICU） patients.Methods Patients who had CABG surgery in Zhongshan Hospital from January 2005 to December 2005 were enrolled.Data were collected including the history of diabetes，pre-operative and post-operative blood glucose(BG) levels，and the time that post-operative hyperglycemia and peak BG occurred.The patients were divided into diabetic and non-diabetic groups according to the diabetic history.The data were compared and analyzed between the two groups.Results 200 patients were enrolled in this study.The incidence of post-operative hyperglycemia was 77%，and about 99.4% occurred in the first 24 hours admitted to ICU，which was independent on diabetic history (χ2=2.58，P=0.108)，but was related to the BG level above 6.1 mmol/L (χ2=12.31，P=0.000).In 80% of the patients，peak BG occurred in the first 24 hours admitted to ICU，which was significantly earlier in the non-diabetic group compared with the diabetic group (8.5 h vs 18.5 h，P=0.02 ).In the patients who had post-operative hyperglycemia，the median time of the BG peak is 10 hours，and 75.3% of the BG peak occurred in the first 24 hours admitted to ICU.Conclusion There is a high incidence of post-operative hyperglycemia in post-CABG patients which always occur within 24 hours after operation and relate to pre-operative high BG.
Objective To investigate the relative factors of sleep disorders in patients after arthroscopic knee surgery.MethodsThe clinical data of 155 patients undergoing arthroscopic knee surgery in West China Hospital of Sichuan University from October 1st 2017 to April 1st 2018 were analyzed. The sleep quality index was assessed by the Pittsburgh Sleep Quality Index. According to the scores, the patients were divided into two groups: the sleep disorder group and the non-sleep disorder group. Mindfulness level were evaluated by Mindful Attention Awareness Scale (MAAS). The binary logistic regression was used to assess the relationship between MAAS and sleep disorders.ResultsAmong the enrolled cases, there were 135 males and 20 females, with an average age of (34.12±12.13) years; 64 patients had poor sleep quality. The results of univariate analysis showed that the payment method, single or bilateral lesions, and MAAS score were the factors affecting sleep (P<0.05). The results of multivariate analysis indicated that with medical insurance [odds ratio (OR)=0.118, 95% confidence interval (CI) (0.021, 0.671), P=0.016], postoperative pain [OR=3.379, 95%CI (1.164, 9.812), P=0.025], bilateral lesions [OR=3.842, 95%CI (1.040, 14.191), P=0.044], and MAAS score ≥68 [OR=0.046, 95%CI (0.018, 0.121), P<0.001] were independent predictive factors for sleep disorders (P<0.05). Conclusion Postoperative pain reduction and mindfulness training may improve the patients’ sleep quality and reduce the incidence of sleep disorders.
ObjectivesTo systematically review the incidence of various outcomes in non-visualization of the fetal gallbladder (NVFGB) fetuses by prenatal ultrasonography.MethodsPubMed, The Cochrane Library, Elsevier, ClinicalKey, CBM, CNKI and WanFang Data databases were electronically searched to collect studies on NVFGB fetuses by prenatal ultrasonography from January 1990 to March 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed by using R 3.5.2 software.ResultsA total of 9 studies were included. The results of meta-analysis showed that: the incidence of fetal biliary atresia was 1.0%, with 2.0% in the isolated and 3.0% in the non-isolated. The incidence of cystic fibrosis was 6.0%, with 2.0% in the isolated and 9.0% in the non-isolated. The incidence of chromosomal abnormality was 5.0%, and 31.0% in non-isolated. The incidence of other malformations other than those described above was 13.0%, with 44.0% in the non-isolated. The incidence of gallbladder agenesis or absent gallbladder was 22.0%, with 28.0% in the isolated. The incidence of later visualization of gallbladder and normal fetal outcomes was 53.0%, with 63.0% in the isolated.ConclusionsCurrent evidence shows that most non-visualization of the fetal gallbladder can identify the presence of gallbladder during late gestation or neonatal ultrasonography. The exactly isolated non-visualization of the fetal gallbladder is highly related to the fetal gallbladder agenesis or the absence of the gallbladder. The non-isolated non-visualization of the fetal gallbladder is highly related to biliary atresia, cystic fibrosis (particularly in the presence of fetal bowel echogenicity), and chromosomal abnormalities (especially chromosome aneuploidy).
ObjectiveTo analyze the risk factors of postoperative cognitive dysfunction (POCD) in elderly patients after abdominal surgery. MethodsThe clinical data of 2 286 patients over 60 years old after abdominal surgery were retrospectively analyzed, which were divided into non-POCD group with 2 248 patients and POCD group with 38 patients. The influencing factors of POCD in elderly patients after abdominal surgery, including the age, gender, anesthetic way, the premedication, cormobided with lung or heart disease, diabetes, jaundice, anemia or hypoproteinemia, the duration of surgery, and postoperative analgesia protocols, were analyzed between two groups. ResultsThe age, anesthetic way, cormobided with lung or heart disease, diabetes, jaundice, with or without continuous postoperative effective analgesia, and surgery duration over four hours were relevant with POCD (Plt;0.05), while gender, the premedication, and preexisted anemia or hypoproteinemia were not relevant with that (Pgt;0.05). ConclusionAge over 70 years, general anaesthesia, cormobided with lung or heart disease, diabetes, jaundice, surgery duration over four hours, and incomplete postoperative analgesia are the risk factors of POCD after abdominal surgery.
Objective To assess the effectiveness of intensive versus routine education on diabetes mellitus for preventing diabetic foot ulcer. Methods We electronically searched CENTRAL (Issue 1, 2013), PubMed (1978-2013), EMbase (1978-2013), VIP (1989-2013) and WanFang Data (1980-2013), hand-searched correlated proceedings and retrieved the references of included studies, for the randomized controlled trials on intensive versus routine education on diabetes mellitus for preventing diabetic foot ulcer all over the world. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results Twelve trials involving 1 841 patients were finally included. The results of meta-analysis showed that: a) the incidence of diabetic foot ulcer in the intensive education group was lower than the routine group, with a significant difference (RR=0.51, 95%CI 0.30 to 0.84, P=0.008); b) two groups were alike in the amputation rate, with no significant difference (OR=0.54, 95%CI 0.17 to 1.67, P=0.28); and c) the score of knowledge on diabetes mellitus was higher in the intensive education group than in the routine education group, with a significant difference (MD=7.32, 95%CI 3.57 to 11.06, P=0.000 1). Conclusion Current evidence shows that: compared with routine education, intensive education could reduce the incidence of diabetic foot ulcer effectively. However, the above conclusion should be verified by conducting more high quality studies.
Family members are crucial for medical disputes. From the psychology and social perspective, the paper analyzes a specific medical dispute case, and discusses the psychological care for (potential) " shidu” (loss of the only child) family. Based on the current social context, an early intervention suggestion is proposed, that is to provide the whole-process psychological intervention to the special patients’ families. The intervention includes: regular psychological evaluation and psychological support if necessary; providing disease knowledge and death education; providing continuous psychological care by the hospital and community; offerring more psychological care for " shidu” family by society.
Objective To evaluate the diagnostic accuracy of Wilson score for predicating difficult intubation. Methods Such databases as PubMed, EMbase, CNKI, WanFang Data and VIP were searched to collect the studies about Wilson score for predicating difficult intubation published from inception to January 2013. Two reviewers independently screened the studies, extracted the data, and assessed the methodological quality by QUADAS. The analysis was conducted by using Meta-Disc 1.4 software, and the random effect model was chosen to calculate the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and the 95%CI. The summary receiver operating characteristic (SROC) curve was drawn and the area under the curve (AUC) was calculated in order to comprehensively assess the total diagnostic accuracy of Wilson score for predicating difficult intubation. Results A total of 9 studies involving 6 506 subjects were included. The results of meta-analysis showed that: the pooled sensitivity was 0.57 (95%CI 0.53 to 0.62), specificity was 0.89 (95%CI 0.88 to 0.90), positive likelihood ratio was 6.11 (95%CI 4.63 to 8.07), negative likelihood ratio was 0.52 (95%CI 0.41 to 0.66), diagnostic odds ratio was 12.76 (95%CI 8.60 to 18.93), and the AUC of SROC was 0.84. Conclusion Wilson score plays a role in predicating difficult intubation, while some other clinical indicators also need to be taken into consideration in its application.
Objective To investigate the effects of pain specialist nurse training (PSNT) on nurse’s pain management knowledge and attitude. Methods By distributing the “questionnaire of pain management knowledge and attitude”, 95 certified nurses, who were from 24 hospitals of different levels in Sichuan, Chongqing, Yunnan and Xinjiang, were investigated to survey their knowledge and attitude changes before and after PSNT. The data were analyzed by t-test. Results A total of 190 questionnaires were distributed to 95 nurses, and 190 returned, with a effective response rate of 100%. The result showed that, the total score after training (34.00±5.30) was significantly higher than that before training (17.58±4.00), with a significant difference (P=0.000). Conclusion The pain specialist nurse training can improve nurses’ knowledge and their attitudes on pain management.