ObjectiveTo assess the efficacy of lymphadenectomy in different regions for esophageal squamous cell carcinomas located differently according to the lymph node grouping by Chinese expert consensus. MethodsThe medical records of 1 061 patients (886 males and 175 females with a median age of 60 (54, 65) years with esophageal cancer from March 2011 to December 2017 in our hospital were retrospectively analyzed. According to the pathological report, the lymph nodes were regrouped according to the Chinese lymph nodes grouping standard of esophageal cancer. The metastasis rate of each group of lymph nodes, the 5-year survival rate of metastatic patients and efficacy index (EI) were calculated. ResultsThe upper thoracic esophageal cancer mainly metastasized to the lymph nodes of C201-203 groups. The middle and lower thoracic tumors mainly metastasized to the lymph nodes of C205-207 groups. The lower thoracic tumor had a higher rate of metastasis to the abdominal lymph nodes. According to the metastasis rate, the mediastinal lymph nodes were divided into three regions: an upper mediastinum (C201-204), a middle mediastinum (C205-206), and a lower mediastinum (C207-209). The EIs of lymph nodes of C201-203 and C205-207 groups were higher. For patients with C201-207 groups metastasis, the 5-year survival rates ranged from 13.39% to 21.60%. For patients with positive lymph nodes in each region, tumors at different primary locations had no statistical difference in long-term survival (P>0.05). Patients with lymph nodes of C205 group in the upper thoracic tumors had lower EI and those in the middle and lower thoracic tumors had higher EIs. ConclusionThe effect of lymph node dissection in each area varies with the location of the tumor. No matter where the tumor is, it is necessary to dissect the upper mediastinal lymph nodes, especially the lymph nodes adjacent to the left and right recurrent laryngeal nerves. Group C205 should be classified into the lower mediastinal lymph nodes.
This paper systematically reviews the important events and their significance in different stages of the construction of the Chinese discipline system of wound repair, and puts forward the following suggestions for its future development: the disciplinary content should be more normalized, standardized and organized; it is necessary to break through policy restrictions, and establish multidisciplinary integrated management, seamlessly connected treatment model, and integrated combination of therapy and rehabilitation, basing on models and standards of research-oriented hospitals and departments; the application of information technology in the discipline should be strengthened; some other items and problems, such as medical management, medical supervision and medical insurance, need further in-depth research and specific solutions.
ObjectiveTo systematically review the status of alexithymia in the Chinese elderly.MethodsCNKI, VIP, CBM, WanFang Data, PubMed, EMbase, Web of Science, PsycINFO, and The Cochrane Library databases were electronically searched to collect cross-sectional studies related to the epidemiological characteristics of alexithymia among the elderly in China from inception to February 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; meta-analysis was then performed using Stata 16.0 software.ResultsA total of 11 cross-sectional studies involving 3 592 elderly individuals were included. The results of meta-analysis showed that the prevalence of alexithymia in the Chinese elderly was 36% (95%CI 30% to 42%), and the score of alexithymia was 58.59 (95%CI 54.60 to 62.57). Subgroup analyses indicated that the prevalence of alexithymia was 39% (95%CI 32% to 45%) in northern China, 33% (95%CI 30% to 37%) in northeast China, 36% (95%CI 31% to 41%) in eastern China, 51% (95%CI 44% to 58%) in central China, and 20% (95%CI 16% to 24%) in the southwest China. The prevalence rates of hospitalized, nursing home, and community elderly were 42% (95%CI 34% to 49%), 37% (95%CI 28% to 45%), and 29% (95%CI 20% to 38%), respectively. The scores of alexithymia were higher among the elderly males, 80 years or older, engaged in heavy physical work prior to retirement, suffering from severer chronic diseases, low education background, low monthly income, living alone, and low frequency of participation in group activities and visited by relatives.ConclusionsCurrent evidence shows that the overall prevalence of alexithymia is high in the Chinese elderly, and varies with regions. The levels of alexithymia among gender, age, occupation prior to retirement, number of chronic diseases, educational level, monthly income, habitation manner, the frequency of participating in group activities, and being visited by relatives and friends are different.
Objective To analyze the trend of changes in the burden of liver cancer diseases attributed to alcohol consumption in China from 1990 to 2019. Methods Data on liver cancer burden attributed to drinking in China from 1990 to 2019 were obtained from the global burden of disease 2019. Joinpoint regression model was used to analyze the temporal trend of disease burden, and age-period-cohort model was used to evaluate age, period, and cohort effects. Results From 1990 to 2019, the standardized incidence rate of liver cancer attributable to drinking among the total population, men and women showed a downward trend. The AAPC was −2.52% (95%CI −2.83% to −2.21%), 3.26% (95%CI −3.62% to −2.89%) and −2.24% (95%CI −2.61% to −1.86%), respectively; The standardized mortality rates showed a decreasing trend, with AAPC values of −2.86% (95%CI −3.46% to −2.26%), −3.48% (95%CI −4.20% to −2.76%), and −2.67% (95%CI −2.99% to −2.34%), respectively; The standardized DALY rates showed a downward trend, with AAPC values of −3.09% (95%CI −3.65% to −2.53%), −2.92% (95%CI −3.25% to −2.58%), and −3.77 (95%CI −4.21% to −3.31%), respectively. The trend changes were statistically significant (P<0.05). From 1990 to 2019, the overall risk of liver cancer incidence and death attributed to drinking in China, both in males and females, showed a trend of first increasing and then decreasing with age; As the period increased, both the overall population and the male population showed a downward trend, followed by an upward trend, while the female population remained relatively stable; The lower the risk of liver cancer incidence and death attributed to drinking as the queue progressed. Conclusion The standardized incidence rate, mortality and DALY rates of liver cancer attributable to drinking in China are generally declining, we should strengthen health education and early diagnosis and treatment for both male and elderly people to reduce the burden of liver cancer.
ObjectiveTo investigate the domestic and abroad hypertension-related clinical trial registration and to analyze the registration of hypertension-related clinical researches in China.MethodsUsing hypertension as the keyword, we searched ClinicalTrials.gov and Chinese Clinical Trial Registry (ChiCTR) from January 2008 to December 2018. We analyzed the collected data on the distribution of registered clinical researches, annual trends, sample sizes, trial progress, research types, study designs, blind methods, clinical stages, the number of participating institutions, the leading institutions, etc.ResultsThe total number of registered hypertension-related clinical trails was 4 991 all over the world, and 551 items were conducted in China. Most of the sample sizes of Chinese hypertension-related clinical trials were 100 to 999. The main types of trials were interventional studies (393 items, 71.32%), followed by observational studies (126 items, 22.87%). Randomized parallel control studies (300 items, 76.34%) were the key component of interventional studies, while cohort studies (61 items, 48.41%) were the chief component of observational studies. The main stages of clinical trials were stage Ⅲ (80 items) and stage Ⅳ (122 items). There were 369 domestic single-center clinical trials (66.97%), 89 domestic multi-center clinical trials (16.15%), and 93 international multi-center clinical trials (16.88%). Among the 93 international multi-center trials of hypertension, only 25 were led by China.ConclusionsThe number of Chinese hypertension-related clinical trial registrations increased year by year and then decreased slightly, but the amount of registrations is limited. The quantity and scale of multicenter clinical studies were not as good as America. China should strengthen the awareness of clinical research registration, strengthen the publicity and supervision of the registration of clinical researches by the department of science and management, improve the number of clinical trial registrations, make Chinese clinical researches more transparent, and strive to lead more international multi-center clinical trials.
ObjectiveThe purpose of this study was to offer new suggestions for current clinician training under the guidance of the Healthy China 2030 policy by investigating the patients’ needs.MethodsThis study surveyed adult outpatients from West China Hospital of Sichuan University between March and July, 2019 and February and May, 2020 by self-constructed questionnaires to investigate the expectation and requirements of outpatients towards medical professionals.ResultsA total of 430 questionnaires were distributed, and 402 of them (93.5%) were collected and included in this study. All questionnaire respondents expected that medical graduates should have outstanding expertise and ethical standard. The majority valued qualities such as physical and mental health (90.05%), a bachelor’s degree or higher (73.88%), knowledge on disease control and prevention (61.69%), knowledge on health care (91.29%), ability to continuously update current knowledge (70.65%), and excellent communication (71.14%) and teamwork (62.44%) skills. In addition, most patients expected that new health care providers to possess humanitarianism and professional dedication relevant traits, and could improve diagnoses and treatments via research activities. Patients’ demand for abilities such as disease control and prevention, health care, and integrative cooperation between traditional Chinese medicine and modern medicine significantly increased after the COVID-19 pandemic (P<0.05).ConclusionsNowadays, to provide health care services which meet the needs of the public, clinicians are expected to have qualities such as outstanding expertise, humanity, research and knowledge-updating skills, disease control and prevention, health care management, and capability to take the advantages of traditional Chinese medicine and modern medicine.
ObjectiveTo investigate the current status of systematic reviews/meta-analyses (SRs/MAs) registered in PROSPERO by Chinese authors, in order to provide references for improving the registration rate and quality, and finally improve the quality of SRs/MAs. MethodsWe searched PROSPERO (http://www.crd.york.ac.uk/crdweb/) from inception to December 31, 2014, to identify SRs/MAs registered by Chinese authors. Two reviewers independently screened records and extracted data. Excel 2013 was used for data input and management, and Stata 12.0 software was used for statistical analysis (Stata Corp., College Station, TX, USA). ResultsA total of 322 SRs/MAs were included. There was an increasing trend in registration number by year, and 60.6% was registered in 2014. The type of SRs/MAs was mainly the interventional (n=247, 76.7%). These SRs/MAs were related to 21 systematic diseases, and cancer ranked the top one (65, 20.2%). The authors distributed in 26 provinces, and majority of authors' institutes were "Evidence-Based Medicine Center". More than half (56.2%) of SRs/MAs were supported by fundings, but only 39.8% of SRs/MAs were performed cooperatively by two or more institutes. ConclusionThere is a rapid increase in numbers of SRs/MAs registered in PROSPERO by Chinese authors, but the absolute number is still small. The problems include the weakness of cooperative consciousness and lake of awareness in registering SRs/MAs.
Objective To investigate the correlation of the polymorphism of the estrogen receptor alpha gene Pvu II site and coronary heart disease (CHD) in Chinese population. Methods Such databases as CBM, CNKI, Wangfang database, VIP, MEDLINE, The Cochrane Library, EMbase, Springer, and Ovid were searched from their establishment date to November of 2010 to collect the case-control studies on the correlation of estrogen receptor alpha gene polymorphism Pvu II sites with coronary heart disease of the Chinese. The quality of included studies was evaluated, the available data was extracted, and then the RevMan5.0 software was used for Meta analyses. Results Nine case-control studies were included, involving 1 464 cases with coronary heart disease and 1 203 cases in the control group. The results of Meta-analyses showed that, as to the correlation of the polymorphism of ER alpha gene Pvu II site T/C and CHD, there was no significant difference in the risk of CHD between people with different genotypes, i.e. the C allele versus T allele (OR=0.95, 95%CI 0.77 to 1.17, P=0.63), genotype of (TC + CC) versus TT (OR=0.97, 95%CI 0.73 to 1.28, P=0.81), genotype of TC versus TT (OR = 0.93, 95%CI 0.68 to 1.26, P=0.64), genotype of CC versus TT (OR=0.86, 95%CI 0.57 to 1.31, P=0.49). Conclusion Estrogen receptor alpha gene polymorphism Pvu II site are not associated with the coronary heart disease in Chinese population.