ObjectiveTo investigate the willingness and influencing factors of clinical medicine graduate students to study abroad.MethodsFrom September 2019 to January 2020, a survey was conducted among the clinical medicine graduate students in West China School of Medicine, Sichuan University. An anonymous self-report questionnaire was used to investigate their willingness to study abroad, and the related influencing factors were analyzed.ResultsA total of 600 questionnaires were distributed, in which 518 valid questionnaires were collected. Among the 518 graduate students, 96.14% anticipated to study abroad, and 93.05% expected to subsidize the study abroad through the state-sponsored study abroad fund. The major obstacle for studying abroad for joint training was concerning the negative effects on domestic clinical work or scientific research work, resulting in failure to graduate; meanwhile, difficulty in applying was the primary obstacle for studying abroad for a doctorate.ConclusionsThere is a strong willingness for clinical medicine graduate students to study abroad. However, it is affected by graduation time and application.
Objective To review the surgical management for Chinese children urethral injury (CUI). Methods According to the evidence-based medicine principal and the approach of systematic review, we searched Chinese Biomedicine Database and PubMed, all literature retrievals were updated until September 8th, 2008. At least two reviewers independently screened the studies for eligibility, evaluated the quality with the Joanna Briggs Institute critical appraisal checklist for descriptive/cases series studies and extracted the data with excel 2003 from the eligible literatures, with confirmation of cross-check. Different views were consulted by the third party. The characteristics of literature, research quality, study content, cases characteristics, diagnosis and treatment, outcome appraisal and follow-up were analyzed. Results A total of 22 studies involving 1019 patients were included, most patients were male children. All 22 studies were descriptive researches and the study quality was low. The etiologies were mainly pelvic fracture and straddle injury as results of misadventure. The diagnosis was based on the relatively objective diagnostic tests such as urethrography, operations research and the exploration of urethral bougie etc in 16 studies. The most categories of CUI were obsolete urethral injuries such as stricture and atresia, the injury sites mainly lied in posterior urethra. The management of CUI were divided into the primary treatment included the first-stage operation and delayed-stage repair, and the second-stage management. Moreover, the individual operation was according to the injury sites and patterns. A total of 14 studies reported the outcomes of operation at various success rates (52%-100%). Except 4 studies, the others reported incomplete follow-up time, from 3 months to 16 years, but few adopted objective methods such as urethrography and urodynamic test. The main complications were urethral stricture, urinary fistula and sexual dysfunction etc. Conclusion The quality of CUI studies was low for lack of prospective randomized controlled trials. The major patients were male children with posterior urethra injuries. Because of the heterogeneitiy of the individual case, different surgeon’s managements and the variety of treatment options, we cannot make identical conclusion. We need more researches with high methodological quality. Moreover, we recommend that, following the clinical practice guideline of CUI made by Chinese Urological Association for the Chinese urologist, and then performing individual surgical management.
In the research process of uveal melanoma (UM), the Collaborative Ocular Melanoma Study (COMS) is a landmark and outstanding clinical study. Its research conclusions are the foundation for today's UM clinical work and guidelines. COMS is the first and largest randomized clinical trials conducted to date, comparing the survival outcomes of two or more treatment regimens for primary malignant intraocular tumors with high reliability. Its research design, methods, and conclusions are still widely cited in this day. Learning from the research experience of COMS, summarizing research data based on Asian populations, and studying treatment methods suitable for Asian UM patients is a powerful supplement to COMS data, but also an expansion of this global research, further improving the level of UM diagnosis and treatment in China.
ObjectiveThrough dynamic monitoring of bacterial contamination of the bedside curtain in different time periods, the bacterial contamination of the bedside curtain in different time periods was analyzed.MethodsThe bedside curtain in the pediatric ward and obstetric ward were selected, between April and September 2019. All bedside curtains were sampled for bacterial contamination on the day after the replacement of it. During the continuous use of the bedside curtain for 6 months, the bacterial contamination was monitored at 1-, 2-, 3- and 6- months respectively.ResultsA total of 2 058 samples were monitored, including 1 041 in the pediatric ward and 1 017 in the obstetric ward. After continuous use for 2 months, there was clear pollution in the bedside curtain of pediatric ward, and the unqualified rate was 65.24%. Obstetrical ward were contaminated significantly after 1 month of use, and the unqualified rate was 51.96%.ConclusionsAs part of the sickbed unit, the bedside curtain is frequently touched by the hands of patients, family members and medical personnel during use. It is suggested that the septum should be replaced once a month in common wards and in time in case of pollution. For departments received patients with low immunity, the frequency of replacement should be increased to reduce environmental risk factors.
ObjectiveTo systematically evaluate the effectiveness and safety of single-incision video-assisted thoracic surgery (VATS) versus conventional three-port VATS for primary spontaneous pneumothorax. MethodsWe searched databases including PubMed, EMbase, The Cochrane Library, CBM, CNKI and WanFang Data from inception to Dec. 2014, to collect randomized controlled trials (RCTs) and cohort studies comparing single-incision VATS and conventional three-port VATS for primary spontaneous pneumothorax. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, RevMan 5.3 software was used for meta-analysis. ResultsA total of 8 cohort studies involving 483 patients were finally included. The results of meta-analysis showed that:Compared with conventional three-port VATS, single-incision VATS had shorter operation time (MD=-3.90, 95%CI -7.22 to -0.58, P=0.02), less amount of intraoperative bleeding (MD=-9.34, 95%CI -15.26 to -3.42, P=0.002), shorter chest drainage time (MD=-0.66, 95%CI -1.02 to -0.29, P=0.000 4), lower VAS score of 24h-postoperative pain (MD=-0.90, 95%CI -1.14 to -0.66, P<0.000 01) and lower incidence of postoperative paresthesia (OR=0.15, 95% CI 0.07 to 0.31, P<0.000 01). Meanwhile, there were no statistical differences between both groups in hospital stay (MD=-0.30, 95%CI -0.63 to 0.03, P=0.08) and the recurrence of pneumothorax (OR=0.68, 95%CI 0.25 to 1.83, P=0.53). ConclusionCurrent evidence shows, single-incision VATS is superior to conventional three-port VATS in the treatment of spontaneous pneumothorax. However, due to limited quality and quantity of included studies, more large-scale, high-quality studies are needed to verify the above conclusion.
Objective To understand the effect of estradiol in different concentrations on proliferation of diverse mammary primary cells in vitro. Methods The primary cells of cancer tissue, the adjacent tissue to tumors and normal mammary tissue from patiens with breast cancer were obtained using collagenase digesting method. All the tissue samples were cultivated in vitro, and were given estradiol in different concentrations. The effect of estradiol on the proliferation of those primary cells was measured by MTT. Results Estradiol remarkedly promoted the proliferation of primary cells of cancer tissue and peritumor tissue in vitro, whose ER expression were positive. Whereas, the promotion effect of estradiol on the proliferation of normal mammary primary cells was relatively weak, and there was no correlation between the promotion effect with the expression of ER in cancer tissue. Conclusion The risks of occurrence and relapse of breast cancer would increase significantly when the concentration of estradiol is no less than 103 pmol/L in vivo.
Objective To analyze the effects of hyperuricemia (HUA) on the prevalence of dyslipidemia in the elderly. MethodsA total of 5 990 elderly people with complete and important variables from the China Health and Retirement Longitudinal Study (CHARLS) public database in 2015 were extracted. Their blood lipids, related physiological and biochemical indices, and basic demographic information were collected. The effects of HUA on the prevalence of dyslipidemia in the elderly were analyzed using the probit model, and empirical analysis was performed using the propensity score matching method (PSM). Results Among the 5 990 subjects, 13.6% of the elderly had HUA and the prevalence of dyslipidemia was 37.5%. After correcting the endogeneity among variables, the probability of dyslipidemia in elderly patients with HUA increased by 9.5%-11.7% (P<0.01), in which the probability of high triglyceridemia (TG), high total cholesterol (TC), high low-density lipoprotein cholesterol (LDL-C), and low high-density lipoprotein cholesterol (HDL-C) increased by 10.4%-11.5% (P<0.01), 2.7%-3.8% (P<0.01), 1.7%-2.3% (P<0.05), and 4.3%-4.9% (P<0.05), respectively. Conclusion HUA is associated with various types of dyslipidemia, among which its relationship with high TG and low HDL-C is strong. Targeted interventions should be taken for elderly HUA patients, aiming to reduce the rate of dyslipidemia and promote the goal of "healthy ageing" in China.
ObjectivesWith the increasing number of core outcome sets (COS) in traditional Chinese medicine (TCM), some problems gradually emerged, which may affect the popularization and application of COS. This paper analyzes the COS research status in the field of TCM based on registry and literature databases, so that researchers may pay attention to it. Methods Registry platforms and literature databases of Chinese and English were both searched from inception to June, 2022. Qualitative analysis was used to analyze the research status of COS. ResultsSeventy-two COS studies were identified from registry platforms, and the results showed some problems, such as uneven disease distribution, insufficient attention to TCM characteristics, unclear COS scope, and insufficient patient and public participation. Ninety-nine studies were identified from different databases, only 7.07% (7/99) of the studies were COS results, and few of them were cited by clinical trials and/or systematic reviews. ConclusionThe authors proposed that standardizing the registration of COS in the field of TCM, improving the methodology of COS studies, expanding the application settings of COS, and strengthening the cooperation of different stakeholder groups are important to ameliorate sustainable development of COS.
ObjectivesTo evaluate the level and variation of Chinese scholars' scientific research capability in the world by analysing the status of literature published on top-five global biomedicine journals by Chinese scholars in the past 10 years.MethodsLiterature published on NEJM, JAMA, BMJ, Lancet and PLoS Medicine from 2007 to 2016 were searched in PubMed database. Types of diseases were classified by using International Classification of Diseases (version 10) (ICD-10). Quantitatively analysis were used to classify the different authors, institutes, studies designs, quality of publication and variation.ResultsLiterature (56.4%) published on Lancet had the largest quantity among the top-five journals. Infectious and parasitic diseases, circulation system diseases, cancers, endocrine, nutrition and metabolic diseases and neuropsychiatric diseases were the top-five in disease categories list, accounting for 38.4%. In different study design, reviews (non-experimental research) and randomized controlled trials were the first and the second study types, separately.ConclusionsFor productivity of Chinese scholars’ diseases publications on top-five medical journals, the top-five specific diseases are from the top-five disease categories-infectious and parasitic diseases, circulation system diseases, cancer, endocrine, nutrition and metabolic diseases and neuropsychiatric diseases. The main study types are reviews, randomized controlled trials and cross-sectional studies.
With the publication of a vast amount of clinical research on hepatocellular carcinoma (HCC), the American Association for the Study of Liver Diseases (AASLD), the National Comprehensive Cancer Network (NCCN), the American Society of Clinical Oncology (ASCO), and the National Health Commission of China have all updated their diagnostic and treatment guidelines for HCC. There are no differences in the definition of HCC risk populations among the AASLD 2023, NCCN 2024, and China Liver Cancer Staging and Treatment Guideline (CNLC) 2024. Notably, CNLC 2024 has updated its guidance on high-risk factors and prospective surveillance for HCC based on the characteristics of HCC patients in China. The four guidelines have seen significant updates in the areas of neoadjuvant and adjuvant therapies, local treatments, and systemic treatments for HCC. CNLC 2024 refines the indications for local treatment, improves systemic treatment, and introduces new first-line therapy, including camrelizumab combined with rivoceranib or tislelizumab. The second-line therapy nivolumab plus ipilimumab for advanced HCC are recommended by AASLD 2023, NCCN 2024, and ASCO 2024, which may become a new first-line therapeutic option for patients with advanced HCC. We compare and interpret these four guidelines in this paper.