Abstract: Objective To analyze the characteristics of pathogens isolated from patients with lung cancer after surgery, and provide instructions for the prevention and treatment of postoperative infection. Methods A retrospective investigation of the pathogenic microbiology data of 159 patients（142 males and 17 females with average age at 61.8±9.6 years) with lung cancer after surgery in West China Hospital from January 2009 to December 2011 was performed.We got the specimen from the patients by routine methods, identified the pathogens, and conducted drug susceptibility tests in vitro. Results The pathogens were mainly isolated from sputum of the patients （90.6%, 155/171）. Canidia albicans（25.7%, 44/171）, Klebsiella pneumonia（15.2%, 26/171）, Acinetobacter calcoaceticus-A. baumannii（13.4%, 23/171）and Pseudomonas aeruginosa（8.2%, 14/171） were the predominant species. Among A. calcoaceticus-A. baumannii isolates, 39.1%（9/23） of them were multidrug resistant strains. And 23.1%（6/26）of K. pneumonia isolates produced extended spectrum beta-lactamases. P. aeruginosa isolates showed high in vitro susceptibility to the antibacterial agents. Conclusion Pathogens are mainly isolated from sputum of patients after surgery for lung cancer. Canidia albicans and gram-negative bacilli are predominant isolates and should be the major targets for the prevention and treatment of postoperative infection.
This article introduces a dynamical stratified blocked randomized algorithm when the static stratified blocked randomized algorithm is not suitable to resolve the problem caused by uncertain stratified factors and levels during calculation of the sample size at the stage of clinical trial design. Prior to the start of the clinical trial, a list of random numbers is created by blocked randomized algorithm. During field implementation, a block of random numbers is dynamically allocated to a stratify level. Thereafter, a subject is randomized into different groups in that block. The study of Chinese medicine for gastric cancer anemia and blood hypercoagulability is used as an example to illustrate how to design and implement dynamic stratified block randomized algorithm. The results show that the dynamic stratified block randomized algorithm is more flexible and adaptable than the static stratified blocked randomized algorithm. However, its application is more complex and requires higher standards in clinical trials.
ObjectivesTo study surgical outcomes and safety of unilateral anterior temporal lobectomy (ATL) in patients with intractable bilateral temporal lobe epilepsy (TLE) and dominant seizure-onset in unilateral temporal lobe. MethodsTwenty three carefully selected patients with bilaterial TLE and dominant seizure-onset in unilateral temporal lobe were enrolled and divided into surgery and medicine groups according to the treatment.Seizure control were recorded for 2 to 5 years.Changes of full scale of intelligence quotient(IQ),and overall quality of life (QOL),percentage of therapeutic satisfaction,and surgical complications were analyzed 2 years after enrolling. ResultsFavor seizure control (Engel Class I and Class Ⅱ) reached 66.7% (10/15),60% (9/15),and 50% (5/10) at 1,2 and 5 years follow-up after unilateral ATL respectively,the percentages in medicine group is 12.5%,0% and 0% accordingly,and there were significant differences in seizures controls between patients with unilateral ATL and cases with medicine.Significantly differences were also found in changes of patients'QOL and full scale IQ at 2 years follow-up between surgery and medicine groups,and average score of overall QOL improved 5.27±6.45 in surgery group,and declined 1.40±3.58 in medicine group.In ATL group,patients with short preoperative history of seizure presented more favor seizure control than those with long preoperative history,and patients with favor seizure control and short preoperative history of seizure had more chance to improve QOL and IQ after ATL. ConclusionIntracranial EEG is vital in diagnosis of bilateral TLE.Unilateral ATL presents favor seizure control and did not render serious memory and IQ injury in carefully selected patients with true bilateral TLE and dominant seizure-onset in unilateral temporal lobe.
Objective To investigate the students’ satisfaction on teaching content, teaching staff, organizations etc. of the evidence-based medical postgraduate summer school, so as to provide references for further effective training. Methods A self-made questionnaire with cluster sampling was used to investigate the regular students who had participated in the whole course of the evidence-based medical postgraduate summer school, and the feedbacks were analyzed. Results The total number of the questionnaires was 112 and the number of the effective questionnaires was 101; the effective recovery rate was 90.2%. The students were from 32 universities and medical institutions involving 36 disciplines in 26 provinces. A total of 93.1% of the students were satisfied with the general training organization and management, but the satisfaction rates of the class environment and the time arrangement were only 51.5% and 58.4%, respectively. The satisfaction rates of the whole course setting and the teaching materials were 84.2% and 90.1%, respectively. The satisfaction rate of the teaching content of “the progress of the evidence-based medicine” was up to 93.0%. Over 93.1% of the students believed that the teachers were great in teaching skills, but only 73.3% of the students thought that the interaction between teachers and students was plenty. Conclusion This summer school has active students, a great effect and a high overall satisfaction rate. The summer school is beneficial to the cultivation of innovative postgraduates, construction of excellent teaching teams, development of evidence-based medicine discipline and building of The Network Center for Evidence-Based Medicine Education. The satisfaction rate of the summer school training can get promoted by increasing schooling investments, appropriately prolonging training time, setting different subjects in different semesters and enhancing the teaching interaction.
Objective To investigate inpatient disease constitution in Traditional Chinese Medicine (TCM) Hospital of Xinjiang Uygur Autonomous Region from 2008 to 2010, in order to provide baseline data for medicine allocation of hospitals in western China and development of TCM hospitals. Methods A questionnaire combined with a subject interview was carried out, and the case records of inpatients from 2008 to 2010 were collected. The diseases in discharge records were classified according to International Classification of Diseases (ICD-10) based on the first diagnosis. Data including general information of the inpatients, discharge diagnosis etc. were rearranged and analyzed by Excel software. Results a) The top four systematic diseases seen commonly from 2008 to 2010 were as follows: circulatory system diseases, musculoskeletal system and connective tissue diseases, respiratory system diseases and digestive system diseases. The top four single diseases were hypertension, intervertebral disc disease, diabetes, bronchitis, emphysema and other chronic obstructive pulmonary diseases. Respiratory system diseases ranked the third in 2009 and 2010 from the fourth in 2008, and circulatory system diseases had ranked the first during the past three years; b) The following diseases as hypertension, bronchial emphysema and other chronic obstructive pulmonary diseases, diabetes, fractures, airway (bronchus, lung) cancer, and viral hepatitis were commonly seen in males rather than in females. By contrast, intervertebral disc disease, gallstone disease and cholecystitis, and anemia were commonly seen in females; and c) Hypertension was commonly seen in the aged above 60 years old; intervertebral disc disease mainly focused on the patients at the age of 15 to 59; and bronchial emphysema and other chronic obstructive pulmonary diseases, airway (bronchus, lung) cancer involved in the patients who were mostly over 60 years old. Conclusion a) The top four systematic diseases seen commonly from 2008to 2010 are as follows: circulatory system diseases, musculoskeletal system and connective tissue diseases, respiratory system diseases and digestive system diseases. The top four single diseases are hypertension, intervertebral disc disease, diabetes, bronchitis, emphysema and other chronic obstructive pulmonary diseases. So these diseases should be taken into well consideration when making development plans by hospital and complementing essential drugs list by local development; b) Chronic diseases become the main disease for troubling Xinjiang population; and c) Male and female are susceptible to different diseases which should be rationally avoided in order to prevent the induced occurrence.
Objective To compare the survey results of the 8-year program students of clinical medicine discipline before and after the implementation of system-based integrated course reform, to provide feedback for system-based integrated course reform. Methods The questionnaire survey was continuously conducted for 2 years among the 8-year program students in grade of 2005 and 2006, so as to investigate their attitudes towards the integrated clinical courses, then relevant improvement of teaching measures were performed according to their feedback, and the difference of teaching effects between those 2 years was finally compared. Results A total of 79 students in grade 2005 and 78 students in grade 2006 were investigated. The baseline data were matched between the 2 grades. The results of statistical analysis showed that, the overall cognition (χ2=32.924, Plt;0.000 1) and assessment (t=−2.900, P=0.004) of integrated courses among students in grade 2006 got more improved in comparison with the students in grade 2005, and more students tended to select integrated courses, but there was no statistical difference. Conclusion Although system-based integrated clinical course as a new thing has its limitations, the reform idea and direction are still approved by students, so it is worth popularizing.
In the new era of development, countries in the world have realized the importance of cultivating interdisciplinary and innovative talents, and China is also paying more and more attention to the cultivation of medicine-engineering talents. Compared with the cultivation of single discipline postgraduates, the cultivation of medicine-engineering postgraduates involves effective integration of multiple disciplines, and its cultivation difficulty is greater. At present, China is still in the exploration stage of the medicine-engineering postgraduates training model. Therefore, this article intends to summarize the relatively mature and advanced medicine-engineering postgraduates training models at home and abroad, and extract experiences that are in line with China’s actual development, providing some suggestions for the establishment of postgraduates training systems of medicine-engineering interdisciplinary in China.
Objective To estimate the quality and efficacy of the academic thesis of compound anisodine in traumatic optic neuropathies(TON) treatment. Method We searched Chinese database last updated in April 2007 for published magazine papers using ldquo;anisodinerdquo; amp; ldquo;optic-neuropathyrdquo; amp; ldquo;traumardquo; or ldquo;blunt trauma rdquo; as key words，and analyzed them using the standard of evidence-based medicine (EBM)． Result 6 RCTs with a total of 415 eyes included are retrieved , and the OR value is 6.54 with a 95%CI of［4.14，10.35］，P＜0.00001, the difference is sig nificant; subcategory analyses are made and both show significant difference( P＜0.0001). Conclusion The existing evidence supports that prognosis of TON is better when compound anisodine are adopt in treatment, and this effect is significant in steroid treatment. Compound anisodine can be used alone for TON treatment. However, because there are only 6 thesis are retrieved and all of them have methodolo gical short-comings，the evidence is not convincing．There is an urgent need of well-planed, large-scale and multiple-center studies to assess the role of compound anisodine in traumatic optic neuropathies treatment． (Chin J Ocul Fundus Dis,2008,24:103-106)