Objective To construct an information hospital service system and discuss the application effect of information construction in the hospital service center. Methods Patients admitted to West China Hospital of Sichuan University between June 2022 and January 2023 were selected. We innovatively practiced intelligent safety gate, self-appointment admission registration, pre-hospital examination and advance migration, pre-hospital health education, an age-appropriate transformation of information service, and other information service measures to investigate the medical experience of patients, and compared patients’ satisfaction with medical treatment under four admission management methods (Huayitong APP, WeChat, self-service machine, and manual management). Results A total of 1452 patients were surveyed. The overall satisfaction score for medical treatment of patients was (4.98±0.04) points. Among them, Huayitong APP was (4.99±0.03) points, WeChat was (4.98±0.13) points, self-service machine was (4.97±0.05) points, and manual treatment was (4.92±0.11) points. There was a statistically significant difference between groups in overall satisfaction with different admission procedures (F=68.582, P<0.001). Since the information construction of the hospital admission service center was carried out, the average time of admission was (12.4±2.3) minutes, and 89.4% (1 298/1 452) of patients thought the time of admission was ideal. Conclusions The information construction of a hospital admission service center can effectively improve patients’ medical experience and enhance patient satisfaction. In the future, it is necessary to explore the influencing factors of patients’ satisfaction with information construction, and constantly improve and upgrade the information construction of hospital admission service centers.
Objective Endoplasmic reticulum stress (ERS) mediated apoptosis is one of the eukaryotic cellularapoptotic pathways, to investigate the potential role of ERS during myocardium apoptosis in rats with severe burninjury. Methods Sixty-four 7-week-old male Wistar rats, weighing 200-220 g, were randomly divided into 2 groups. Thirtypercentage of total body surface area full-thickness thermal injury was produced in 32 rats of burn group, while sham burn wasproduced in 32 rats of control group. The heart tissues were harvested from 8 rats in each group at 1, 4, 7, and 14 days after burnto observe the changes of myocardium ultrastructure with transmission electron microscope (TEM). Myocardium apoptosis wasdetected with TUNEL assay. The expressions of glucose regulated protein 78 (GRP 78), C/EBP-homologous protein (CHOP),and cleaved Caspase 12 in different pathways of ERS were analysed with Western blot. Results All rats survived during theexperiment. Apoptotic changes of cardiomyocytes were observed in burn group, and the apoptosis index in burn group wassignificantly higher than that in control group at each time point (P lt; 0.05), and it reached peak at 7 days after burn injury(P lt; 0.05). The expressions of myocardial GRP 78, CHOP, and cleaved Caspase 12 showed persistent elevation in burn group.The expressions of GRP 78 and cleaved Caspase 12 in burn group were significantly higher than those in control group at eachtime point (P lt; 0.05), while the expression of CHOP was higher than that in control group at the other time points (P lt; 0.05)except 1st day after burn injury. Conclusion ERS and CHOP, Caspase 12 mediated apoptotic pathway are activated inmyocardium after severe burn injury, and this may be one pathway of myocardium apoptosis.
Objective To analyze the benign-malignant outcomes of pulmonary nodules in surgical patients and their influencing factors, and provide evidence and ideas for optimizing and improving the integrated management model of pulmonary nodules. Methods From October to December 2023, a convenience sampling method was used to select patients who underwent lung surgery at West China Hospital, Sichuan University between July 2022 and June 2023 for this study. The malignancy rate of postoperative pathological results of pulmonary nodules and its influencing factors were analyzed using univariate analysis and multiple logistic regression. Results A total of 4600 surgical patients with pulmonary nodules were included, with a malignancy rate of 88.65% (4078/4600) and a benign rate of 11.35% (522/4600). Univariate analysis showed significant differences in malignancy rates among different genders, ages, methods of pulmonary nodule detection, and smoking histories (P<0.05); however, no significant difference was found regarding place of birth or family history of lung cancer (P>0.05). Multiple logistic regression analysis indicated that females [odds ratio (OR)=1.533, 95% confidence interval (CI) (1.271, 1.850)], older age groups [61-75 vs. ≤30 years: OR=1.640, 95%CI (1.021, 2.634); >75 vs. ≤30 years: OR=2.690, 95%CI (1.062, 6.814)], and pulmonary nodules detected during physical examinations [OR=1.286, 95%CI (1.064, 1.554)] were high-risk factors for malignancy, with statistical significance (P<0.05). Conclusion In the integrated management of pulmonary nodules, it is crucial not to overlook females or older patients, as they may be more significant influencing factors than smoking; furthermore, lung examinations are effective means of early detection of malignant lung tumors and are worth promoting and popularizing.
ObjectiveTo systematically review the prevalence of osteoarthritis in Chinese aged 40 and above from January 2000 to December 2019.MethodsPubMed, ScienceDirect, Wiley Online Library, The Cochrane Library, CBM, VIP, CNKI and WanFang Data databases were electronically searched to collect cross-sectional studies on osteoarthritis in Chinese aged 40 and above from January 1st, 2000 to December 31st, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed using R 3.5.2 software.ResultsA total of 29 cross-sectional studies with a total sample of 60 711 cases and 19 707 patients were included. The results of meta-analysis showed that, the crude prevalence of osteoarthritis in Chinese aged 40 and over was 38.46% (95%CI 24.31% to 46.22%). Subgroup analysis results showed that the prevalence of lumbar osteoarthritis was the highest (24.79%, 95%CI 13.28% to 27.37%), followed by knee osteoarthritis prevalence (20.50%, 95%CI 14.51% to 27.23%) which increased with age. The prevalence of knee osteoarthritis in females (25.14%, 95%CI 19.54% to 31.19%) was higher than that in males (18.99%, 95%CI 13.86% to 24.71%). The prevalence of knee and lumbar osteoarthritis in rural areas was higher than that in urban areas. The prevalence of knee osteoarthritis in western China (23.59%, 95%CI 18.34% to 30.35%) was higher than that in eastern China (18.36%, 95%CI 12.43% to 27.92%) and central China (15.54%, 95%CI 11.22% to 21.53%). The prevalence of lumbar osteoarthritis in western China (31.17%, 95%CI 19.21% to 50.60%) was higher than that in eastern China (24.38%, 95%CI 16.26% to 36.54%). The incidence of cervical osteoarthritis in the eastern China (20.49%, 95%CI 13.90% to 30.21%) was higher than that in the western China (12.32% 95%CI 8.09% to 18.75%). The prevalence of hand osteoarthritis in western China (6.85%, 95%CI 2.71% to 8.13%) was higher than that in eastern China (2.7%, 95%CI 1.33% to 5.48%).ConclusionsCurrent evidence shows that the prevalence of osteoarthritis in Chinese aged 40 and above is high, and the prevalence of lumbar osteoarthritis is the highest, and the prevalence in western China is higher than that in eastern and central China, followed by knee osteoarthritis, in which the prevalence in females, rural areas, and western China is high. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.
ObjectiveTo summarize the results of surgical treatment for 79 patients with coarctation of the aorta (CoA) combined with complex anomalies (CA) in recent years.MethodsThe data from 79 patients with CoA combined with CA admitted to Guangzhou Women and Children's Medical Center between January 19, 2010 and September 7, 2017 were collected and analyzed. There were 52 males and 27 females. The median age was 71 days, and the median weight was 4.3 kg. There were 26 patients combined with tracheostenosis and 7 patients with preoperative tracheal intubation. Extended end-to-side anastomosis was used to correct the CoA, and the associated cardiac abnormalities were treated simultaneously by an incision through median sternotomy. All operations were performed by the same group of surgeons.ResultsThe median deep hypothermic circulatory arrest was 18 (13-28) minutes, the median aorta cross-clamp time was 62 (15-199) minutes, the median cardiopulmonary bypass time was 145 (71-674) minutes, the median ventilation time was 72 (9-960) hours, the median length of ICU stay was 144 (12-1 944) hours, and the median length of hospital stay was 24 (2-93) days. Early death occurred in 9 patients and late death occurred in 5 patients. Reoperation occurred in 28 patients and recoarctation developed in 10 patients. After operation, transcoarctation gradient was reduced, and the transcutaneous oxygen saturation, C-reactive protein (CRP), lactate and creatinine were increased. Compared to the survival group, both preoperative and postoperative transcutaneous oxygen saturation were worse and the postoperative levels of plasma brain natriuretic peptide (BNP) and CRP were higher in the death group.ConclusionCorrecting the CoA and the associated CA simultaneously with extended end-to-side anastomosis by an incision through median sternotomy is effective and safe, and the outcomes of immediate and medial-term are satisfactory. Improving oxygenation and limiting elevation of BNP and CRP levels may reduce the death rate.
ObjectiveTo evaluate the early- and mid-term outcomes of surgical repair of persistent truncus arteriosus in children in a single institution of China.MethodsThe clinical data of 27 consecutive patients with persistent truncus arteriosus undergoing surgical repair in Guangzhou Women and Children’s Medical Center from November 2009 to May 2018 were retrospectively reviewed. There were 14 males and 13 females. Median age was 3.0 months (range: 13 days -11 years), of whom 10 (37.0%) were older than 6 months. ResultsThere were three early deaths with a mortality of 11.1%. The main complications included VSD partial repair in 2 patients, complete atrioventricular block in one patient. The mean follow-up time was 24.5±19.3 months (range: 1–76 months). There were three late deaths, and two patients lost follow. Echocardiology showed seven patients of right heart outflow tract obstruction, including three in pulmonary artery trunk, and four of pulmonary artery branches. One patient showed moderate aortic valve regurgitation. None required re-intervention during the follow-up. Survival estimates for the entire cohort following surgery were both 76.1% (95%CI 59.2% to 92.9%) at 1 year and 5 years.ConclusionThe surgical repair of persistent truncus arteriosus (PTA) remains challenges. The early- and mid-term outcomes of surgical repair of persistent truncus arteriosus are acceptable. For older children with severe pulmonary artery hypertension and/or trunk valve regurgitation, the risk of death is still higher. Some children have the higher risk of late right heart obstructive lesions.
Objective Since 2009, assessment of asthma control in Global Initiative for Asthma (GINA) includes current clinical control and future risk. " Current clinical control” is replaced by " symptom control” in GINA 2015, and lung function is excluded from assessment of current clinical control. This study was designed to investigate the agreement in current asthma control assessment between GINA 2009 and 2015, and to explore whether FEV1 monitoring plays an important role in this context. Methods A cross-sectional study was conducted among patients with stable asthma (n=138). The levels of asthma control were graded by GINA 2009 and GINA 2015, respectively. Demographic data, spirometry, exacerbations in the past 12 months, peripheral blood cells, induced sputum were collected. Kappa coefficient was used to measure the agreement of the two asthma control tools. Association of the asthma control levels using the two tools with the exacerbations in the past 12 months was examined by Spearman correlations. Additionally, associations of lung function with the exacerbations in the past 12 months were analyzed. Results Agreement in assessing current asthma control between GINA 2009 and 2015 was moderate (Kappa=0.595, P<0.001). Compared with GINA 2009, the patients with well-controlled asthma assessed by GINA 2015 had worse FEV1%pred [(89.9±12.9)% vs. (79.9±18.2)%, P=0.013], the partly controlled subjects assessed by GINA 2015 had worse asthma control scores in ACQ-6 score (0.8±0.7 vs. 1.1±0.7, P=0.028) and ACT score (20.7±2.5 vs. 19.4±2.5, P=0.007). Furthermore, asthma control levels assessed by either GINA 2015 or 2009 were related to exacerbations in the past 12 months and stronger relationship was presented in GINA 2015 (r=–0.268 for GINA 2015 vs. r=–0.212 for GINA 2009, respectively). In addition, there were no differences in cell counts in induced sputum or peripheral blood or IgE level in peripheral blood in patients with different asthma control levels assessing by GINA 2009 and 2015. Conclusions Our study indicates that it has a moderate agreement of assessing current asthma control between GINA 2015 and 2009. Compared with GINA 2009, absence of FEV1 monitoring from GINA 2015 would result in worse lung function in well-controlled asthma and worse asthma control scores in partly controlled asthma. Addition of FEV1 monitoring to GINA 2015 would weaken the relationship between current asthma control and future asthma outcomes, although it didn't reach statistical significance. Our study supports that GINA 2015 lacking lung function monitoring in current asthma control assessment is applicable in clinical practice.
Unilateral absence of a pulmonary artery (UAPA) is a rare congenital malformation resulting from the failed development or premature involution of the sixth aortic arch during embryogenesis, leading to a failure to establish a connection with the main pulmonary artery. Currently, there is a notable lack of consensus regarding the surgical management of UAPA in China. Drawing upon the latest clinical research, this consensus aims to summarize surgical approaches and techniques to improve the clinical management of UAPA patients and serve as a scientific reference for physicians specializing in pediatric cardiology and structural heart disease. This consensus aims to promote the standardization of UAPA diagnosis and treatment, thereby facilitating improved patient outcomes and long-term management, and stimulating the continuous development and innovation of surgical treatment for this condition in China.
Objective To introduce the myocutaneous flap in blepharoplasty and summarize its clinical efficacy. Methods Between January 2013 and March 2016, 1 560 patients underwent blepharoplasty with myocutaneous flap. Of them, 158 patients were followed up over 6 months and included in the study. There were 18 males and 140 females with the average age of 23.4 years (range, 18-35 years). The unilateral side was involved in 13 cases and bilateral sides in 145 cases. The patients had narrow double eyelid, shallow double eyelid, single eyelid, bloated upper eyelid, and upper eyelid skin relaxation. During operation, the tissue between the orbicular muscle of eye and the tarsus was trimmed layer by layer; the orbicularis oculi muscle, capillary network, and the front fascia of tarsus were retained, and the full-thickness skin, muscle, and the front fascia of tarsus were sutured by anatomical apposition. Results Incision healed at stage I. All patients were followed up 6 months to 2 years (mean, 8.3 months). During follow-up period, shallow or extinctive double-eyelid line was observed in 9 cases (12 eyes), and satisfactory results were achieved after trimming front fascia of tarsus and suturing. Good clinical results were obtained in the other patients, who had natural and coherent double eyelid without obvious scar or depression at resection margin. Conclusion Myocutaneous flap for blepharoplasty has many advantages of fast recovery, little wound, light swelling, permanent effects, and good appearance.
ObjectiveTo investigate the regulatory effect of long chain non-coding RNA (lncRNA) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) adsorbing microRNA-124 (miR-124) on osteogenic differentiation of mesenchymal stem cells (MSCs).MethodsC3H10T1/2 cells derived from mouse embryos were cultured in vitro, then randomly divided into control group (group A), lncRNA MALAT1 no-load plasmid group (group B), lncRNA MALAT1 overexpression plasmid group (group C), lncRNA MALAT1 small interfering RNA (siRNA) group (group D), and lncRNA MALAT1 siRNA negative control group (group E). The cells were transfected into plasmids and siRNA, then induced to differentiate into osteoblasts. Alkaline phosphatase (ALP) and alizarin red staining were used to detect the osteogenic differentiation of cells in each group, real-time fluorescence quantitative (qRT-PCR) analysis was used to detect the expressions of lncRNA MALAT, miR-124, and osteogenesis-related genes such as Runt-related transcription factor 2 (Runx2), osteopontin (OPN), and osteocalcin (OCN) in each group. Double luciferase reporter gene was used to detect the targeting regulation of lncRNA MALAT1 to miR-124.ResultsThe relative contents of ALP positive cells, mineralized nodule, and the relative mRNA expressions of lncRNA MALAT1, Runx2, OPN, and OCN in group C were significantly higher than those in other groups (P<0.05), while in group D significantly lower than in other groups (P<0.05); the relative expression of miR-124 in group C was significantly lower than that in other groups(P<0.05), while in group D significantly higher than in other groups (P<0.05). There was no significant difference in these indexes between groups A, B, and E (P>0.05). The results of double luciferase reporter gene assay showed that lncRNA MALAT1 targeting down-regulated the expression of miR-124.ConclusionLncRNA MALAT1 can targeting down-regulate the expression of miR-124 and promote the osteogenic differentiation of MSCs.