Objective To review the recent research progress on shoulder arthroplasty, and to predict future research direction. Methods Recent l iterature concerned the shoulder arthroplasty was reviewed and analyzed in terms of appl iedanatomy, designs of prosthesis, patterns of prosthesis and fixation ways of prosthesis. Results The shoulder arthroplastyrepresented the treatments of choice for the patients with end-stage shoulder diseases and traumatic diseases. It could provide good and stable results in pain rel ief and functional outcomes. Conclusion There are still many controversies about the patterns of prosthesis, fixation ways and kinds of materials in cl inical practice. Currently, the main research is about the designs of the glenoid prosthesis and the cl inical practice in young patients.
ObjectiveTo do a brief introduction and prospects for simultaneous pancreas and kidney transplanta-tion from aspects of recipient screening, choice of operative method, prognosis, quality of life, and complications. MethodDomestic and international literatures were collected to summary the effect, prognosis, and the latest progress of simultaneous pancreas and kidney transplantation in the treatment of diabetes. ResultsAs a kind of mature treatment of diabetic with end-stage renal disease, simultaneous pancreas and kidney transplantation had been carried out in most transplantation centers around the world, it had the definite therapeutic effect and controllable side effects, the life quality of posttransplantation patients would be improved notably. However, the screen of transplantation patient, the selection of transplantation operation, and the postoperative immunosuppressive protocols had not yet been reached a consensus. ConclusionsSimultaneous pancreas and kidney transplantation is the most effective treatment for type 1 diabetes patients with end-stage renal disease, it provides a more feasible and more physiological way for the secretion of insulin. Although the patient has to undergo a major operation and take some risk, simultaneous pancreas and kidney transplantation still improves the patient's survival rate and the quality of life, and reduces the incidence of complications related to diabetes. Based on the above reasons, simultaneous pancreas and kidney transplantation should be a preferred treatment for all eligible patients.
Objective To explore the feasibility, safety, efficacy and mechanism of intraoperative regional chemotherapy of advanced gastric cancer.Methods The related literatures were reviewed and analyzed. Results Compared with systemic chemotherapy, intraoperative regional chemotherapy of advanced gastric cancer could increase blood drug concentration of cancerous tissue, reduce the systemic toxic side effects, increase survival rate and improve the quality of life. Conclusion Intraoperative regional chemotherapy, as an adjuvant treatment of advanced gastric cancer, has been gradually applied to clinic because of the definite curative effect, which is worth popularizing. However, it needs systemic researches and accumulation of cases.
ObjectiveTo investigate the knowledge of drug safety among parents of some children with epilepsy in Henan Province, and to provide a basic advice for drug safety and health education for children with epilepsy.sMethodUsing a questionnaire to parents of epilepsy children from the Children's Hospital in Henan Province and the First Affiliated Hospital of Zhengzhou University in July 2019, a total of 336 questionnaire were conducted by the professionals responsible for after the training, including parents and children basic situation, drug habits and attitudes, medication safety consciousness and antibiotic drug use knowledge.Results320 questionnaire were collected, 314 of which were valid questionnaires, with an effective rate of 98.1%. 66 (21%) of parents chose juice or milk for oral administration, and 87 (27.7%) of parents chose sugar water. 104 (33.1%) of the parents chose to stop the medication immediately after the child's condition improved. 126 (40.1%) of parents believe that combination of two or more antibiotics is more effective, 178 (56.7%) of parents will give their children antibiotics when they have a cold or fever, and more than 254 (80%) of parents are not aware of adverse reactions to antibiotics.ConclusionIn the investigation, the parents of children with epilepsy in Henan Province still have insufficient knowledge of safe drug use, and there are many non-standard drug use behaviors. Local medical professionals for epilepsy should be strengthened to guide and monitor the children and their parents.
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.
Objective To know the training status and expectation of village doctors in remote and poor areas of Sichuan province and to provide the preferences for developing a viable and efficient training model. Methods The cluster sampling method, combined with questionnaire surveys and qualitative interviews, was used. A total of 463 village doctors of 302 village clinics in Pengzhou and Baoxing of Sichuan province were interviewed. Results The “three-side” phenomenon including the doctor being old, poor academic background and lack of female doctor in remote and poor areas of Sichuan was serious. In-service village doctors’ knowledge on public health and Chinese medicine increased through training. There were differences between the training village doctors participated and that they had expected. The cost of the training was somewhat high for rural doctors. The training system has not been established yet in remote areas. Conclusions Both quantity and quality should be considered in in-service village doctor training in remote areas of Sichuan Province, which should also consider local conditions and farmers’ needs . The in-service training system should be developed as soon as possible. It is suggested that the treatment of village doctors should be improved. Cultivating more young village doctors should be based on the stability of the medical team.
ObjectiveTo systematically investigate the current status of reporting health economics evidence in clinical practice guidelines and expert consensuses published in China from 2021 to 2023, providing references for the formulation and revision of guidelines and consensuses in our country. MethodsComputer searches were conducted in the CNKI, CBM, WanFang Data, China Academic Journals Full-text Database, PubMed, and Web of Science to collect clinical practice guidelines and expert consensuses published in China from 2021 to 2023. Two researchers independently screened the literature, extracted information on the inclusion of economic evidence in guidelines and consensuses, and then used quantitative analysis methods for description. ResultsA total of 4 236 relevant articles were included, of which 1 066 (25.17%) reported health economics evidence; 120 (11.26%) reported health economics evidence in the formation of recommendation opinions; 109 (10.23%) reported health economics evidence in the grading of evidence quality; 832 (78.05%) reported health economics evidence in the interpretation and explanation of recommendation opinions. ConclusionThe reporting rate of health economics evidence in clinical practice guidelines and expert consensuses published in China is not high. The reporting rate of health economics evidence in consensuses is lower than that in guidelines. It is recommended that during the formulation process of guidelines and consensuses, the application of health economics evidence should be further strengthened in aspects such as the formation of recommendation opinions, the grading of evidence quality, and the interpretation and explanation of recommendation opinions, in order to improve the scientific, rigorous, and applicability of clinical practice guidelines and expert consensuses, and to play the role of guidelines and consensuses in optimizing the allocation of health resources, improving clinical diagnosis and treatment effects, and enhancing the quality of medical care.
Objective To investigate the current status of clinical and research developments in Lanzhou University in China, to provide reference data for establishing a coordinated, multi-sectional, research orientated and internationally competitive program in biomedical sciences. Methods Three types of questionnaire containing 57 items were designed for 8 secondary departments in clinical and basic sciences. Another type of questionnaire was distributed to 200 clinicians, researchers, lecturers, and administrators in both clinical and basic sciences from August to September 2005. We searched SCI, CSCD, CSTPCD, CBM and CNKI for research articles published by Lanzhou University, commercial development of research derived from the University, and general and competitiveness evaluations of the University. In addition, seminars, site visits, and expert interviews were also conducted.Results The response rates for the questionnaires were 100% and 91% respectively. The investigation included the identification and evaluation of research and clinical departments, human resources in the three branches of biomedical sciences (clinical, research and education), including academic title, educational background, age distribution, research area and funding (leading investigators included), and publication records. The numbers of undergraduate and graduate students and their CET-4 score (pass rate) were also analyzed. Based on the information obtained, six secondary databases were established and evaluated..Conclusions The merger of Lanzhou University and Lanzhou Medical College has created an opportunity for further development in biomedical research and clinical science. Facing new challenges and difficulties, we should take this responsibility to work together to make the University a national and international center of clinical, research and education in medical sciences.
Objective To investigate the current status of clinical nursing risks to nursing students, so as to provide scientific references for medical universities and policy makers. Methods The self-designed questionnaires were distributed to 360 clinical nursing students in four Third-Level hospitals. The group leaders were trained as investigators regularly. All the other nursing students were asked to fill in the questionnaire alone within 30 minutes. The questions issued were the following four aspects: general information of nursing students, clinical intern operating situation, nursing defects and awareness of nursing risks. Results Among the total 400 questionnaires distributed, 360 valid ones were retrieved (90%). The analysis showed all 21 nursing operations could be performed by students alone, and 80% of the nursing students believed that they were able to do 11 routine operations alone, such as bed-making and vital sign monitoring. The incidence rate of eight nursing defects was between 0.56% and 12.22%. As for the four questions about nursing risks, 49.44% of the nursing students operated alone before getting themselves ready because of their eagerness for such experiences. According to the nursing students, the departments with the highest nursing risks ranked as emergency, operating theatre, surgery, pediatrics, internal medicine, and gynecology and obstetrics. Conclusion The current situation of clinical nursing risks to nursing interns is still far from being satisfactory, so it is necessary to improve the training at university, regulate the clinical education, and ensure the intern safety for nursing students.
With the rapid development of medicine and the emergence of new evidence, the formulation of living guidelines is significant in guiding clinical practice and providing timely and effective references for clinical workers. This article summarizes the status of living guidelines, and puts forward thoughts and suggestions on the challenges and opportunities of the development of living guidelines, in order to promote the development of living guidelines and provide a reference for guideline developers and users.