In China, liver transplantation is an important discipline in the field of organ transplantation. China Liver Transplant Registry (CLTR) is a scientific project that has been set up to advance surgical techniques and ...In China, liver transplantation is an important discipline in the field of organ transplantation. China Liver Transplant Registry (CLTR) is a scientific project that has been set up to advance surgical techniques and procedures and to improve both short-and long-term post-transplant follow-up and outcome of the liver recipients. CLTR also serves as a robust data support platform for the National Liver Transplant Quality Control Center in the quest to upscale its quality control protocols. The mission of CLTR is to register all liver transplantation activities in the mainland of China and to conduct scientific analyses of the collected data. The huge number of compiled cases and the scientific research conducted over the past decade based on this database drastically revolutionized the clinical practice in the country. All CLTR activities and projects will be a guarantee to foster progresses of liver transplantation in China in a more scientific way, to standardize the systematic care in the field of liver transplantation.展开更多
BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related co...BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related complications in colorectal cancer patients who underwent stoma creation.METHODS Patients with stoma was prospectively recorded in the established stoma system.Data was collected from this stoma management system from November 2021 through May 2024.The rates of stoma-related complications were assessed,and potential risk factors were analyzed using univariate and multivariate logistic regression models.RESULTS A total of 734 patients were included in the analysis.The results showed that 12.3%of patients experienced stoma-related complications,with mucocutaneous separation,edema,and skin excoriation being the most common complications.The majority(90%)of complications were classified as grade 2 according to the Clavien-Dindo classification.Surgical factors,such as blood loss volume greater than 500 mL and open surgery,were significantly associated with stoma complications.Additionally,stoma features like location,shape,color,height,and edema were important factors in the association with complications.Body mass index over 30 kg/m²was also found to be a significant risk factor.CONCLUSION These findings highlight the need for a holistic approach to preventing and managing stoma complications,considering both patient-related and surgical factors.展开更多
BACKGROUND Truliant®posterior stabilized(PS)and Truliant cruciate retaining(CR)are two designs used for total knee arthroplasty.Survivorship and reason for revision rates are now available from the American Joint...BACKGROUND Truliant®posterior stabilized(PS)and Truliant cruciate retaining(CR)are two designs used for total knee arthroplasty.Survivorship and reason for revision rates are now available from the American Joint Replacement Registry(AJRR)at short-term time points for both Truliant designs.It was hypothesized that Truliant PS and Truliant CR perform comparably to similar designs in terms of survivorship.AIM To analyze short-term survivorship of Truliant PS or CR total knee arthroplasty relative to non-Truliant PS or CR total knee arthroplasty.METHODS Utilizing data from the AJRR,a retrospective review was performed for subjects who underwent implantation of Truliant PS,Truliant CR,non-Truliant PS,and non-Truliant CR designs as of June 30,2022.Survivorship and reasons for revision were compared statistically between Truliant PS vs non-Truliant PS as well as Truliant CR vs non-Truliant CR groups.Cumulative percent revision rates were compared across three registries,AJRR,Australian Orthopaedic Association National Joint Replacement Registry(AOANJRR),and the United Kingdom National Joint Registry(UK NJR).RESULTS Truliant PS survivorship was 97.95%at the four-year mark,while Truliant CR survivorship was 99.61%at the three-year mark.There were no significant differences in survivorship hazard ratios or reasons for revision for both Truliant groups vs non-Truliant comparison aggregate groups at short-term time points.Cumulative percent revision rate comparisons were made to device appropriate groups from AJRR,AOANJRR,and UK NJR data.Truliant PS cumulative percent revision rates were similar to non-Truliant cumulative percent revision rates in the AJRR and similar to AOANJRR and UKNJR at both one and three years.Truliant CR cumulative percent revision rates were lower than aggregate AJRR,AOANJRR,and UK NJR cumulative percent revision rates at the one-year and three-year marks.CONCLUSION This study demonstrates high survivorship for Truliant PS total knee arthroplasty out to four-years and Truliant CR total knee arthroplasty out to three-years of follow-up.展开更多
BACKGROUND Mild cognitive impairment(MCI)and subjective cognitive decline(SCD)are risk indicators for dementia and require ongoing management.Traditional Korean medicine(TKM)commonly employs acupuncture and herbal med...BACKGROUND Mild cognitive impairment(MCI)and subjective cognitive decline(SCD)are risk indicators for dementia and require ongoing management.Traditional Korean medicine(TKM)commonly employs acupuncture and herbal medicine for cognitive impairment;yet,clinical research on acupotomy is lacking.Although most TKM treatments occur in primary care,the research is largely hospital-based.This registry was established to systematically collect real-world data on the clinical progress,efficacy,and safety of TKM with acupotomy for patients with MCI or SCD in primary care.It is hypothesized that TKM with acupotomy improves cognitive function and is safe for these patients.AIM To establish an MCI or SCD registry of patients receiving TKM,including acupotomy,to analyze its clinical efficacy and safety.METHODS This observational registry study will be conducted across 22 medical institutions;approximately 500 participants will be recruited.Data—sociodemographic information,medication history,height,weight,vital signs,and assessment questionnaires(Montreal Cognitive Assessment-Korean,short form of Korean-Everyday Cognition,Numeric Rating Scale,Korean version of the Insomnia Severity Index)—will be collected at 3-month intervals over a year.This study will also document the TKM treatment administered and any adverse events.Routine TKM procedures will be followed,with acupuncture and acupotomy administered as per protocol;treatments including herbal medicine,Chuna therapy,and moxibustion may be administered at the practitioner’s discretion.RESULTS The registry will capture a wide range of real-world clinical data regarding demographic profiles,treatment processes,and adverse events.This detailed documentation is expected to clarify patient characteristics,evaluate the clinical course,and identify factors that may affect cognitive improvement in patients with MCI and SCD.CONCLUSION This research may provide evidence supporting acupotomy for cognitive impairment in primary care by confirming its efficacy and safety,providing preliminary evidence for TKM-based interventions aimed at improving cognitive function.展开更多
BACKGROUND Antithrombotic strategies after percutaneous coronary interventions(PCI)in elderly patients on oral anticoagulant therapy(OAT)are debated due to the balance between ischemic and bleeding risks.Recent guidel...BACKGROUND Antithrombotic strategies after percutaneous coronary interventions(PCI)in elderly patients on oral anticoagulant therapy(OAT)are debated due to the balance between ischemic and bleeding risks.Recent guidelines recommend early transitioning from triple antithrombotic therapy to dual antithrombotic therapy,but there are limited data on elderly patients.METHODS We performed a post-hoc age-specific analysis of the PERSEO Registry population aimed to compare clinical features,therapeutic strategies,and outcomes of individuals aged≥80 years and<80 years who were on OAT and underwent PCI with stent.The primary endpoint was net adverse clinical events at 1-year follow-up.Secondary endpoints included major adverse cardiac and cerebral events(MACCE),major bleeding[Bleeding Academic Research Consortium(BARC)type 3–5],and clinically relevant bleeding(BARC type 2-5).RESULTS Among the 1234 patients enrolled,31%of patients were aged≥80 years(84±3 years,76% males).Compared to younger patients,elderly patients had higher rates of comorbidities such as hypertension,anaemia or chronic kidney disease,and atrial fibrillation was the leading indication for OAT.Elderly patients were more often discharged on dual antithrombotic therapy(23%)compared to younger patients(13%)(P<0.0001).They experienced higher net adverse clinical events(38%vs.21%,P<0.001),MACCE(24%vs.12%,P<0.001),as well as higher bleeding rates.Specifically,rates of major bleeding(9%vs.6%,P=0.026),and clinically relevant bleeding(21%vs.12%,P<0.001)were significantly higher in elderly patients.CONCLUSIONS Elderly patients on OAT undergoing PCI are a particular frail population with higher risk of MACCE and bleeding compared to younger patients despite a less aggressive antithrombotic therapy.展开更多
Objective:This is a comprehensive overview of long-term cancer survival in Zhejiang Province,China.Hybrid analysis,a combination of cohort and period analysis,has been proposed to derive up-to-date cancer survival est...Objective:This is a comprehensive overview of long-term cancer survival in Zhejiang Province,China.Hybrid analysis,a combination of cohort and period analysis,has been proposed to derive up-to-date cancer survival estimates.Using this approach,we aimed to timely and accurately analyze the 5-year relative survival(RS)and net survival(NS)in cancer registries of Zhejiang Province,China.Methods:A total of 255,725 new cancer cases diagnosed during 2013-2017 were included in 14 cancer registries in Zhejiang Province,China,with a follow-up on vital status until the end of 2019.The hybrid analysis was used to calculate the 5-year RS and 5-year NS during 2018-2019 for overall and stratifications by sex,cancer type,region,and age at diagnosis.Results:During 2018-2019,the age-standardized 5-year RS and NS for overall cancer in Zhejiang was 47.5%and 48.6%,respectively.The age-standardized 5-year RS for cancers of women(55.4%)was higher than that of men(40.0%),and the rate of urban areas(49.7%)was higher than that of rural areas(43.1%).The 5-year RS declined along with age,from 84.4%for ages<45 years to 23.7%for ages>74 years.Our results of the RS and NS showed the similar trend and no significant difference.The top five cancers with top age-standardized 5-year RS were thyroid cancer(96.0%),breast cancer(84.3%),testicular cancer(79.9%),prostate cancer(77.2%),and bladder cancer(70.6%),and the five cancers with the lowest age-standardized 5-year RS were pancreatic cancer(6.0%),liver cancer(15.6%),gallbladder cancer(17.1%),esophageal cancer(22.7%),and leukemia(31.0%).Conclusions:We reported the most up-to-date 5-year cancer RS and NS in Zhejiang Province,China for the first time,and found that the 5-year survival for cancer patients in Zhejiang during 2018-2019 was relatively high.The population-based cancer registries are recognized as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems.展开更多
Background: Hemodialysis is the most widely used renal replacement therapy in developing countries such as Cote d’Ivoire. Objective: To study the outcome of chronic hemodialysis patients in public centres in Abidjan ...Background: Hemodialysis is the most widely used renal replacement therapy in developing countries such as Cote d’Ivoire. Objective: To study the outcome of chronic hemodialysis patients in public centres in Abidjan using data from the Renal Registry of Cote d’Ivoire (2RCI). Method: This was a prospective analytical cohort study of End Stage Kidney Disease (ESKD) patients undergoing iterative hemodialysis in the network of public hemodialysis centres in Abidjan and who had been registered in the 2RCI register by September 2018. Results: Our study involved 363 cases out of 379 patients registered in the 2RCI registry database in 2018. The mean age of the patients was 47.3 ± 12.1 years, with a male predominance (sex ratio 1.97). In 70.24% of cases, they had no health insurance. The average duration of dialysis for our patients was 6.94 ± 4.1 years, with extremes of 2 and 28 years. This duration was less than 5 years in 44.3% of cases, between 6 and 10 years in 42.9% and more than 10 years in 12.6% of cases. The comorbidities found were hypertension in 95.6% of cases, diabetes in 7.8% and HIV in 4.6%. Anemia was found in 68% of cases and stroke in 8.6%. During the study period, 161 deaths were observed, representing a mortality rate of 44.35%. Acute lung oedema (29.8%), stroke (6.8%) and other cardiovascular diseases (19.3%) were the main causes of death. In multivariate analysis, factors such as age ≥ 65 years (HR = 3.66;CI 95% = 1.55 - 8.67;p = 0.003), “married/coupled” status (HR = 2.02;CI 95% = 1.24 - 3.31;p = 0.005) and normal weight at the start of dialysis (OR = 9.59, CI95% = 4.19 - 21.95;p = 0.001) were associated with the risk of death. Conclusion: Hemodialysis is performed in Abidjan on young patients. The mortality rate after three years of dialysis is very high. Hence the need to pursue the policy of decentralizing public centres and optimizing access to dialysis in terms of quality and quantity in order to improve patient survival.展开更多
BACKGROUND: Less attention is directed toward gaining a better understanding of the burden and prevention of injuries, in low and middle income countries(LMICs). We report the establishment of a trauma registry at the...BACKGROUND: Less attention is directed toward gaining a better understanding of the burden and prevention of injuries, in low and middle income countries(LMICs). We report the establishment of a trauma registry at the Adult Emergency and Trauma Centre(AETC) at Queen Elizabeth Central Hospital(QECH) in Blantyre, Malawi and identify high risk geographic areas. METHODS: We devised a paper based two-page trauma registry form. Ten data clerks and all AETC clinicians were trained to complete demographic and clinical details respectively. Descriptive data, regression and hotspot analyses were done using STATA 15 statistical package and ArcGIS(16) software respectively.RESULTS: There were 3,747 patients from May 2013 to May 2015. The most common mechanisms of injury were assault(38.2%), and road traffi c injuries(31.6%). The majority had soft tissue injury(53.1%), while 23.8% had no diagnosis indicated. Fractures(OR 19.94 [15.34–25.93]), head injury and internal organ injury(OR 29.5 [16.29–53.4]), and use of ambulance(OR 1.57 [1.06–2.33]) were found to be predictive of increased odds of being admitted to hospital while assault(OR 0.69 [0.52–0.91]) was found to be associated with less odds of being admitted to hospital. Hot spot analysis showed that at 99% confidence interval, Ndirande, Mbayani and Limbe were the top hot spots for injury occurrence. CONCLUSION: We have described the process of establishing an integrated and potentially sustainable trauma registry. Signifi cant data were captured to provide details on the epidemiology of trauma and insight on how care could be improved at AETC and surrounding health facilities. This approach may be relevant in similar poor resource settings.展开更多
Objectives To investigate the rate of anticoagulant use,the reasons for not prescribing anticoagulant,and the factors associated with non-prescription of anticoagulant in older Thai adults with non-valvular atrial fib...Objectives To investigate the rate of anticoagulant use,the reasons for not prescribing anticoagulant,and the factors associated with non-prescription of anticoagulant in older Thai adults with non-valvular atrial fibrillation.Methods A multicenter registry of patients with non-valvular atrial fibrillation was conducted during 2014 to 2017 in Thailand.Demographic,medical history,antithrombotic medication,non-antithrombotic medication,and laboratory data were collected and analyzed.Data were compared between the older adult (≥ 65 years) and younger adult (< 65 years) groups.The reasons why anticoagulant was not prescribed were collected,and predictive factors were identified.Results A total of 3218 patients (1873 males) with an average age of 67.3 ± 11.3 years were included.Almost two-thirds (61.0%) of patients were in the older adult group.Anticoagulant was prescribed in 2422 patients (75.3%): 81.4% in the older adult group and 65.7% in the younger adult group.The three main reasons for not prescribing anticoagulant were already taking antiplatelets,patient refusal,and bleeding risk.These reasons were more common in older adults as compared to younger adults.Multivariate analysis revealed current use of antiplatelets to be the most important factor that predict the non-prescription of anticoagulant in older population.Conclusions The prevalence of anticoagulant prescription among older Thai adults with atrial fibrillation is 81.4%.Taking antiplatelet drugs was found to be the strongest reason that predicts the non-prescription of anticoagulant in this patient population.A guideline should be developed to optimize the use of anticoagulant and antiplatelet in older adults.展开更多
OBJECTIVE: To evaluate the risk of ischemic stroke endpoints by establishing risk assessment models that combine Traditional Chinese Medicine(TCM)and modern medicine indicators.METHODS/DESIGN: The proposed study is a ...OBJECTIVE: To evaluate the risk of ischemic stroke endpoints by establishing risk assessment models that combine Traditional Chinese Medicine(TCM)and modern medicine indicators.METHODS/DESIGN: The proposed study is a registry-based participant survey conducted in seven hospitals nationwide in China. After obtaining informed consent, 3000 patients diagnosed with ischemic stroke will be recruited. One-year follow-ups will be performed on-site in hospitals and by telephone to track endpoint events. Comparative analysis of the prevalence of endpoint events and other TCM or modern medicine features in different groups will be conducted using frequency analysis and χ2tests, and the results will be expressed as composition ratios. Comparative analysis of quantitative scores and related patterns or symptoms will be conducted using a rank-sum test. Correlation analysis of endpoint events and TCM or modern medicine factors will be performed using a multivariate Cox proportional hazard model.DISCUSSION: Previous reports have described modern medicine indicator-based risk assessment models for ischemic stroke endpoint events, but no such studies have included TCM features. Our new risk assessment model combines TCM and modern medicine indicators and thus has the potential to facilitate early warning, early intervention, and early control of ischemic stroke endpoint events.展开更多
Premature ovarian insufficiency（POI） affects seriously physical and mental health of the patients. Studies show that acupuncture may be promising in treating POI. yet evidence is insufficient. International patient ...Premature ovarian insufficiency（POI） affects seriously physical and mental health of the patients. Studies show that acupuncture may be promising in treating POI. yet evidence is insufficient. International patient registry, one form of observational study, is designed for evaluating effectiveness and safety of acupuncture in real-world clinical settings. We will face a series of opportunities and challenges. The opportunities are as follows：（1） Interdisciplinary cooperation can improve the effect of acupuncture for POI.（2） The protocol for acupuncture to treat POI has room for improvement.（3） The patient registry study can make up the shortcomings of randomized controlled trials.（4） The patient registry study can collect real-world data and explore responses of different populations to acupuncture and can be the foundation for the successive studies. International patient registry may face technological, ethical and financial challenges, while the established International Patient Registry Platform of Acupuncture-Moxibustion（www.amreg.org：8082/v3） is actively responding to these challenges. Till now there have been more than 300 patients of POI enrolled on this platform.展开更多
Background Cardiac implantable electronic devices （CIEDs） greatly improve survival and life quality of patients. However, there are gender differences regarding both the utilization and benefit of these devices. In ...Background Cardiac implantable electronic devices （CIEDs） greatly improve survival and life quality of patients. However, there are gender differences regarding both the utilization and benefit of these devices. In this prospective CIED registry, we aim to appraise the gender differences in CIED utilization in China. Methods Twenty centers from 14 provinces in China were included in our registry study. All patients who underwent a CIED implantation in these twenty centers between Jan 2015 and Dec 2016 were included. Results A total of 8570 patients were enrolled in the baseline cohort, including 7203 pacemaker, 664 implantable cardiac defibrillators （ICD） implants and 703 cardiac resynchronization therapy device （CRT/D）. Totally, 4117 （48.0%） CIED patients were female, and more than 59% pacemaker patients were female, but women account only one third of ICD or CRT/D implantation in this registry. There were significant differences between genders at pacemaker and ICD indications. Female was more likely received a pacemaker due to sick sinus syndrome （SSS） （63.9% vs. 51.0%, P 〈 0.001）. Female patients receiving an ICD were more likely due to cardiac ion channel disease （29.2% vs. 4.2%, P 〈 0.001）. The percentage of utilization of dual-chamber pacemaker in female patients was significantly higher than male （85.3% vs. 81.1%, P 〈 0.001）. But male patients were more likely received a cardiac resynchronization therapy devices with defibrillator than female （56.5% vs. 41.9%, P = 0.001）. In pacemaker patient, male was more likely to have structure heart disease （31.3% vs. 28.0%, P = 0.002）. In ICD patient, male patients were more likely to have ischemic heart disease （48.2% vs. 29.2%, P 〈 0.001）. The mean age of women at the time of CRT/D implantation was older than men （P = 0.014）. Nonischemic cardiomyopathy （70.9%） was the most common etiology in the patients who underwent the treat？ment of CRT/D, no matter male or female. Conclusions In real-world setting, female do have different epidemiology, pathophysiology and clinical presentation of many cardiac rhythm disorders when compared with male, and all these factors may affect the utilization of CIED implantation. But it also possibility that cultural and socioeconomic features may play a role in this apparent discrimination.展开更多
Introduction The mission of the WHO International Clinical Trials Registry Platform is to ensure that a complete view of research is accessible to all those involved in health care decision making. This will improve r...Introduction The mission of the WHO International Clinical Trials Registry Platform is to ensure that a complete view of research is accessible to all those involved in health care decision making. This will improve research transparency and will ultimately strengthen the validity and value of the scientific evidence base. The registration of all interventional trials is a scientific, ethical and moral responsibility.展开更多
BACKGROUND There remains a dearth of Asian epidemiological literature for paediatric inflammatory bowel disease(PIBD).AIM To describe the presenting features of PIBD from 7 Asia-Pacific pediatric gastroenterology cent...BACKGROUND There remains a dearth of Asian epidemiological literature for paediatric inflammatory bowel disease(PIBD).AIM To describe the presenting features of PIBD from 7 Asia-Pacific pediatric gastroenterology centers via a central standardised electronic data platform.METHODS Clinical,endoscopic and radiologic data at diagnosis from the registry were extracted between 1^(st) January 1995 to 31^(st) December 2019.Disease phenotypic characteristics were classified as per the Paris classification system.RESULTS There was a distinct rise in new PIBD cases:Nearly half(48.6%)of the cohort was diagnosed in the most recent 5 years(2015-2019).The ratio of Crohn’s disease(CD):Ulcerative colitis(UC):IBDUnclassified was 55.9%:38.3%:5.8%.The mean age was 9.07 years with a high proportion of very early onset IBD(VEO-IBD)(29.3%)and EO-IBD(52.7%).An over-representation of the Indian/South Asian ethnic group was observed which accounted for 37.0% of the overall Singapore/Malaysia subcohort(6.8%-9.0%Indians in census).Indian/South Asian CD patients were also most likely to present with symptomatic perianal disease(P=0.003).CD patients presented with significantly more constitutional symptoms(fever,anorexia,malaise/fatigue and muscle-wasting)than UC and higher inflammatory indices(higher C-reactive protein and lower albumin levels).CONCLUSION We observed a high incidence of VEO-IBD and an over-representation of the Indian ethnicity.South Asian CD patients were more likely to have symptomatic perianal disease.展开更多
OBJECTIVE:To analyze the current status of clinical trial registration of Traditional Chinese Medicine(TCM)for the treatment of neurological diseases.METHODS:Interventional clinical trials of TCM treatment for ischemi...OBJECTIVE:To analyze the current status of clinical trial registration of Traditional Chinese Medicine(TCM)for the treatment of neurological diseases.METHODS:Interventional clinical trials of TCM treatment for ischemic stroke,hemorrhagic stroke,vascular cognitive impairment,tension-type headache before September 22,2020 on the platform of Chinese Clinical Trial Registry(Chi CTR),and Clinical Trials.gov were searched.Two researchers independently selected the literature and extracted data.RESULTS:A total of 180 interventional clinical trials were included for analysis.Out of 180 trials,127 were from Chi CTR and 53 from Clinical Trials.gov.The countries primary sponsoring the included trials were China(176,97.8%),and the common categories of primary sponsors were hospital(131,72.8%).Among the study design,the largest proportion of allocation was randomized(172,95.6%),interventional model assignment was parallel(163,90.6%),masking was double blind 49(27.2%),and the sample size was≤400(144,80.0%).The trials were most carried out at a single center(102,56.7%).Among the included studies,112(62.2%)registered on Chi CTR attached the ethical approval documents.In terms of trial stages,50(27.7%)studies were in phaseⅣ.The mostly used intervention was Chinese herbal medicines(99,55%),acupuncture(68,37.8%)was the second.By searching the registration number on China National Knowledge Infrastructure Database and Pub Med,38(21.1%)registered trials were published,including 25 protocol studies and 14 research results with one(NCT02275949)published both the protocol and the results.CONCLUSIONS:Irregular and inadequate reporting,untimely update and publication,insufficient information on traditional medicine unique characteristics,and lack of international collaborations are the problems existing in the interventional clinical registration trials of traditional medicine treatment on neurological diseases.More efforts need to be made from the above aspects to standardize and improve the registration of traditional medicine trials.展开更多
基金supported by grants from the National Natural Science Foundation of China (82470690 and 92159202)the Major Research Plan of Key Research and Development Project of Zhejiang Province (2024C03149 and 2023C03046)。
文摘In China, liver transplantation is an important discipline in the field of organ transplantation. China Liver Transplant Registry (CLTR) is a scientific project that has been set up to advance surgical techniques and procedures and to improve both short-and long-term post-transplant follow-up and outcome of the liver recipients. CLTR also serves as a robust data support platform for the National Liver Transplant Quality Control Center in the quest to upscale its quality control protocols. The mission of CLTR is to register all liver transplantation activities in the mainland of China and to conduct scientific analyses of the collected data. The huge number of compiled cases and the scientific research conducted over the past decade based on this database drastically revolutionized the clinical practice in the country. All CLTR activities and projects will be a guarantee to foster progresses of liver transplantation in China in a more scientific way, to standardize the systematic care in the field of liver transplantation.
基金Beijing Municipal Administration of Hospitals Incubating Program,No.PZ20200272018 Beijing Talent Incubating Funding,No.2018-4+3 种基金National Natural Science Foundation of China,No.81773214Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support,No.ZYLX202116the National Key R&D Program of China,No.2021YFF1201104Science Foundation of Peking University Cancer Hospital-2023,No.JC202310.
文摘BACKGROUND Stoma creation is a common procedure in colorectal cancer surgery,however,stoma-related complications remain a significant concern.AIM To investigate the incidence,types,and risk factors of stoma-related complications in colorectal cancer patients who underwent stoma creation.METHODS Patients with stoma was prospectively recorded in the established stoma system.Data was collected from this stoma management system from November 2021 through May 2024.The rates of stoma-related complications were assessed,and potential risk factors were analyzed using univariate and multivariate logistic regression models.RESULTS A total of 734 patients were included in the analysis.The results showed that 12.3%of patients experienced stoma-related complications,with mucocutaneous separation,edema,and skin excoriation being the most common complications.The majority(90%)of complications were classified as grade 2 according to the Clavien-Dindo classification.Surgical factors,such as blood loss volume greater than 500 mL and open surgery,were significantly associated with stoma complications.Additionally,stoma features like location,shape,color,height,and edema were important factors in the association with complications.Body mass index over 30 kg/m²was also found to be a significant risk factor.CONCLUSION These findings highlight the need for a holistic approach to preventing and managing stoma complications,considering both patient-related and surgical factors.
文摘BACKGROUND Truliant®posterior stabilized(PS)and Truliant cruciate retaining(CR)are two designs used for total knee arthroplasty.Survivorship and reason for revision rates are now available from the American Joint Replacement Registry(AJRR)at short-term time points for both Truliant designs.It was hypothesized that Truliant PS and Truliant CR perform comparably to similar designs in terms of survivorship.AIM To analyze short-term survivorship of Truliant PS or CR total knee arthroplasty relative to non-Truliant PS or CR total knee arthroplasty.METHODS Utilizing data from the AJRR,a retrospective review was performed for subjects who underwent implantation of Truliant PS,Truliant CR,non-Truliant PS,and non-Truliant CR designs as of June 30,2022.Survivorship and reasons for revision were compared statistically between Truliant PS vs non-Truliant PS as well as Truliant CR vs non-Truliant CR groups.Cumulative percent revision rates were compared across three registries,AJRR,Australian Orthopaedic Association National Joint Replacement Registry(AOANJRR),and the United Kingdom National Joint Registry(UK NJR).RESULTS Truliant PS survivorship was 97.95%at the four-year mark,while Truliant CR survivorship was 99.61%at the three-year mark.There were no significant differences in survivorship hazard ratios or reasons for revision for both Truliant groups vs non-Truliant comparison aggregate groups at short-term time points.Cumulative percent revision rate comparisons were made to device appropriate groups from AJRR,AOANJRR,and UK NJR data.Truliant PS cumulative percent revision rates were similar to non-Truliant cumulative percent revision rates in the AJRR and similar to AOANJRR and UKNJR at both one and three years.Truliant CR cumulative percent revision rates were lower than aggregate AJRR,AOANJRR,and UK NJR cumulative percent revision rates at the one-year and three-year marks.CONCLUSION This study demonstrates high survivorship for Truliant PS total knee arthroplasty out to four-years and Truliant CR total knee arthroplasty out to three-years of follow-up.
基金Supported by The Korea Health Technology Project through the Korea Health Industry Development Institute,funded by the Ministry of Health and Welfare,Republic of Korea,No.RS-2023-KH138802.
文摘BACKGROUND Mild cognitive impairment(MCI)and subjective cognitive decline(SCD)are risk indicators for dementia and require ongoing management.Traditional Korean medicine(TKM)commonly employs acupuncture and herbal medicine for cognitive impairment;yet,clinical research on acupotomy is lacking.Although most TKM treatments occur in primary care,the research is largely hospital-based.This registry was established to systematically collect real-world data on the clinical progress,efficacy,and safety of TKM with acupotomy for patients with MCI or SCD in primary care.It is hypothesized that TKM with acupotomy improves cognitive function and is safe for these patients.AIM To establish an MCI or SCD registry of patients receiving TKM,including acupotomy,to analyze its clinical efficacy and safety.METHODS This observational registry study will be conducted across 22 medical institutions;approximately 500 participants will be recruited.Data—sociodemographic information,medication history,height,weight,vital signs,and assessment questionnaires(Montreal Cognitive Assessment-Korean,short form of Korean-Everyday Cognition,Numeric Rating Scale,Korean version of the Insomnia Severity Index)—will be collected at 3-month intervals over a year.This study will also document the TKM treatment administered and any adverse events.Routine TKM procedures will be followed,with acupuncture and acupotomy administered as per protocol;treatments including herbal medicine,Chuna therapy,and moxibustion may be administered at the practitioner’s discretion.RESULTS The registry will capture a wide range of real-world clinical data regarding demographic profiles,treatment processes,and adverse events.This detailed documentation is expected to clarify patient characteristics,evaluate the clinical course,and identify factors that may affect cognitive improvement in patients with MCI and SCD.CONCLUSION This research may provide evidence supporting acupotomy for cognitive impairment in primary care by confirming its efficacy and safety,providing preliminary evidence for TKM-based interventions aimed at improving cognitive function.
基金was given by a 2017 Research Grant of the Italian Society of Interventional Cardiology (SICI-GISE)
文摘BACKGROUND Antithrombotic strategies after percutaneous coronary interventions(PCI)in elderly patients on oral anticoagulant therapy(OAT)are debated due to the balance between ischemic and bleeding risks.Recent guidelines recommend early transitioning from triple antithrombotic therapy to dual antithrombotic therapy,but there are limited data on elderly patients.METHODS We performed a post-hoc age-specific analysis of the PERSEO Registry population aimed to compare clinical features,therapeutic strategies,and outcomes of individuals aged≥80 years and<80 years who were on OAT and underwent PCI with stent.The primary endpoint was net adverse clinical events at 1-year follow-up.Secondary endpoints included major adverse cardiac and cerebral events(MACCE),major bleeding[Bleeding Academic Research Consortium(BARC)type 3–5],and clinically relevant bleeding(BARC type 2-5).RESULTS Among the 1234 patients enrolled,31%of patients were aged≥80 years(84±3 years,76% males).Compared to younger patients,elderly patients had higher rates of comorbidities such as hypertension,anaemia or chronic kidney disease,and atrial fibrillation was the leading indication for OAT.Elderly patients were more often discharged on dual antithrombotic therapy(23%)compared to younger patients(13%)(P<0.0001).They experienced higher net adverse clinical events(38%vs.21%,P<0.001),MACCE(24%vs.12%,P<0.001),as well as higher bleeding rates.Specifically,rates of major bleeding(9%vs.6%,P=0.026),and clinically relevant bleeding(21%vs.12%,P<0.001)were significantly higher in elderly patients.CONCLUSIONS Elderly patients on OAT undergoing PCI are a particular frail population with higher risk of MACCE and bleeding compared to younger patients despite a less aggressive antithrombotic therapy.
基金funded by Healthy Zhejiang One Million People Cohort(grant number:K-20230085).
文摘Objective:This is a comprehensive overview of long-term cancer survival in Zhejiang Province,China.Hybrid analysis,a combination of cohort and period analysis,has been proposed to derive up-to-date cancer survival estimates.Using this approach,we aimed to timely and accurately analyze the 5-year relative survival(RS)and net survival(NS)in cancer registries of Zhejiang Province,China.Methods:A total of 255,725 new cancer cases diagnosed during 2013-2017 were included in 14 cancer registries in Zhejiang Province,China,with a follow-up on vital status until the end of 2019.The hybrid analysis was used to calculate the 5-year RS and 5-year NS during 2018-2019 for overall and stratifications by sex,cancer type,region,and age at diagnosis.Results:During 2018-2019,the age-standardized 5-year RS and NS for overall cancer in Zhejiang was 47.5%and 48.6%,respectively.The age-standardized 5-year RS for cancers of women(55.4%)was higher than that of men(40.0%),and the rate of urban areas(49.7%)was higher than that of rural areas(43.1%).The 5-year RS declined along with age,from 84.4%for ages<45 years to 23.7%for ages>74 years.Our results of the RS and NS showed the similar trend and no significant difference.The top five cancers with top age-standardized 5-year RS were thyroid cancer(96.0%),breast cancer(84.3%),testicular cancer(79.9%),prostate cancer(77.2%),and bladder cancer(70.6%),and the five cancers with the lowest age-standardized 5-year RS were pancreatic cancer(6.0%),liver cancer(15.6%),gallbladder cancer(17.1%),esophageal cancer(22.7%),and leukemia(31.0%).Conclusions:We reported the most up-to-date 5-year cancer RS and NS in Zhejiang Province,China for the first time,and found that the 5-year survival for cancer patients in Zhejiang during 2018-2019 was relatively high.The population-based cancer registries are recognized as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems.
文摘Background: Hemodialysis is the most widely used renal replacement therapy in developing countries such as Cote d’Ivoire. Objective: To study the outcome of chronic hemodialysis patients in public centres in Abidjan using data from the Renal Registry of Cote d’Ivoire (2RCI). Method: This was a prospective analytical cohort study of End Stage Kidney Disease (ESKD) patients undergoing iterative hemodialysis in the network of public hemodialysis centres in Abidjan and who had been registered in the 2RCI register by September 2018. Results: Our study involved 363 cases out of 379 patients registered in the 2RCI registry database in 2018. The mean age of the patients was 47.3 ± 12.1 years, with a male predominance (sex ratio 1.97). In 70.24% of cases, they had no health insurance. The average duration of dialysis for our patients was 6.94 ± 4.1 years, with extremes of 2 and 28 years. This duration was less than 5 years in 44.3% of cases, between 6 and 10 years in 42.9% and more than 10 years in 12.6% of cases. The comorbidities found were hypertension in 95.6% of cases, diabetes in 7.8% and HIV in 4.6%. Anemia was found in 68% of cases and stroke in 8.6%. During the study period, 161 deaths were observed, representing a mortality rate of 44.35%. Acute lung oedema (29.8%), stroke (6.8%) and other cardiovascular diseases (19.3%) were the main causes of death. In multivariate analysis, factors such as age ≥ 65 years (HR = 3.66;CI 95% = 1.55 - 8.67;p = 0.003), “married/coupled” status (HR = 2.02;CI 95% = 1.24 - 3.31;p = 0.005) and normal weight at the start of dialysis (OR = 9.59, CI95% = 4.19 - 21.95;p = 0.001) were associated with the risk of death. Conclusion: Hemodialysis is performed in Abidjan on young patients. The mortality rate after three years of dialysis is very high. Hence the need to pursue the policy of decentralizing public centres and optimizing access to dialysis in terms of quality and quantity in order to improve patient survival.
基金The trauma registry project was supported financially by the Health Partnership Scheme funded by the Tropical Health and Education Trust(THET)funded by the UK Department for International Development(DFID)
文摘BACKGROUND: Less attention is directed toward gaining a better understanding of the burden and prevention of injuries, in low and middle income countries(LMICs). We report the establishment of a trauma registry at the Adult Emergency and Trauma Centre(AETC) at Queen Elizabeth Central Hospital(QECH) in Blantyre, Malawi and identify high risk geographic areas. METHODS: We devised a paper based two-page trauma registry form. Ten data clerks and all AETC clinicians were trained to complete demographic and clinical details respectively. Descriptive data, regression and hotspot analyses were done using STATA 15 statistical package and ArcGIS(16) software respectively.RESULTS: There were 3,747 patients from May 2013 to May 2015. The most common mechanisms of injury were assault(38.2%), and road traffi c injuries(31.6%). The majority had soft tissue injury(53.1%), while 23.8% had no diagnosis indicated. Fractures(OR 19.94 [15.34–25.93]), head injury and internal organ injury(OR 29.5 [16.29–53.4]), and use of ambulance(OR 1.57 [1.06–2.33]) were found to be predictive of increased odds of being admitted to hospital while assault(OR 0.69 [0.52–0.91]) was found to be associated with less odds of being admitted to hospital. Hot spot analysis showed that at 99% confidence interval, Ndirande, Mbayani and Limbe were the top hot spots for injury occurrence. CONCLUSION: We have described the process of establishing an integrated and potentially sustainable trauma registry. Signifi cant data were captured to provide details on the epidemiology of trauma and insight on how care could be improved at AETC and surrounding health facilities. This approach may be relevant in similar poor resource settings.
基金funded by the Health Systems Research Institute (HSRI), Nonthaburi, Thailand (grant no. 59-053)the Heart Association of Thailand under the Royal Patronage of H.M. the King, Bangkok, ThailandThe Royal College of Physicians of Thailand, Bangkok, Thailand
文摘Objectives To investigate the rate of anticoagulant use,the reasons for not prescribing anticoagulant,and the factors associated with non-prescription of anticoagulant in older Thai adults with non-valvular atrial fibrillation.Methods A multicenter registry of patients with non-valvular atrial fibrillation was conducted during 2014 to 2017 in Thailand.Demographic,medical history,antithrombotic medication,non-antithrombotic medication,and laboratory data were collected and analyzed.Data were compared between the older adult (≥ 65 years) and younger adult (< 65 years) groups.The reasons why anticoagulant was not prescribed were collected,and predictive factors were identified.Results A total of 3218 patients (1873 males) with an average age of 67.3 ± 11.3 years were included.Almost two-thirds (61.0%) of patients were in the older adult group.Anticoagulant was prescribed in 2422 patients (75.3%): 81.4% in the older adult group and 65.7% in the younger adult group.The three main reasons for not prescribing anticoagulant were already taking antiplatelets,patient refusal,and bleeding risk.These reasons were more common in older adults as compared to younger adults.Multivariate analysis revealed current use of antiplatelets to be the most important factor that predict the non-prescription of anticoagulant in older population.Conclusions The prevalence of anticoagulant prescription among older Thai adults with atrial fibrillation is 81.4%.Taking antiplatelet drugs was found to be the strongest reason that predicts the non-prescription of anticoagulant in this patient population.A guideline should be developed to optimize the use of anticoagulant and antiplatelet in older adults.
基金Supported by Special Research Project by the State Administration of Traditional Chinese Medicine:Traditional Chinese Medicine Health Management Based Risk Assessment System Development and Demonstration for Recurrence of Ischemic Stroke(No.201507003-8)
文摘OBJECTIVE: To evaluate the risk of ischemic stroke endpoints by establishing risk assessment models that combine Traditional Chinese Medicine(TCM)and modern medicine indicators.METHODS/DESIGN: The proposed study is a registry-based participant survey conducted in seven hospitals nationwide in China. After obtaining informed consent, 3000 patients diagnosed with ischemic stroke will be recruited. One-year follow-ups will be performed on-site in hospitals and by telephone to track endpoint events. Comparative analysis of the prevalence of endpoint events and other TCM or modern medicine features in different groups will be conducted using frequency analysis and χ2tests, and the results will be expressed as composition ratios. Comparative analysis of quantitative scores and related patterns or symptoms will be conducted using a rank-sum test. Correlation analysis of endpoint events and TCM or modern medicine factors will be performed using a multivariate Cox proportional hazard model.DISCUSSION: Previous reports have described modern medicine indicator-based risk assessment models for ischemic stroke endpoint events, but no such studies have included TCM features. Our new risk assessment model combines TCM and modern medicine indicators and thus has the potential to facilitate early warning, early intervention, and early control of ischemic stroke endpoint events.
基金Supported by Ministry of Science and Technology of the People's Republic of China through the Twelfth Five-Year National Science and Technology Pillar Program(2012BAI24B02)~~
文摘Premature ovarian insufficiency（POI） affects seriously physical and mental health of the patients. Studies show that acupuncture may be promising in treating POI. yet evidence is insufficient. International patient registry, one form of observational study, is designed for evaluating effectiveness and safety of acupuncture in real-world clinical settings. We will face a series of opportunities and challenges. The opportunities are as follows：（1） Interdisciplinary cooperation can improve the effect of acupuncture for POI.（2） The protocol for acupuncture to treat POI has room for improvement.（3） The patient registry study can make up the shortcomings of randomized controlled trials.（4） The patient registry study can collect real-world data and explore responses of different populations to acupuncture and can be the foundation for the successive studies. International patient registry may face technological, ethical and financial challenges, while the established International Patient Registry Platform of Acupuncture-Moxibustion（www.amreg.org：8082/v3） is actively responding to these challenges. Till now there have been more than 300 patients of POI enrolled on this platform.
文摘Background Cardiac implantable electronic devices （CIEDs） greatly improve survival and life quality of patients. However, there are gender differences regarding both the utilization and benefit of these devices. In this prospective CIED registry, we aim to appraise the gender differences in CIED utilization in China. Methods Twenty centers from 14 provinces in China were included in our registry study. All patients who underwent a CIED implantation in these twenty centers between Jan 2015 and Dec 2016 were included. Results A total of 8570 patients were enrolled in the baseline cohort, including 7203 pacemaker, 664 implantable cardiac defibrillators （ICD） implants and 703 cardiac resynchronization therapy device （CRT/D）. Totally, 4117 （48.0%） CIED patients were female, and more than 59% pacemaker patients were female, but women account only one third of ICD or CRT/D implantation in this registry. There were significant differences between genders at pacemaker and ICD indications. Female was more likely received a pacemaker due to sick sinus syndrome （SSS） （63.9% vs. 51.0%, P 〈 0.001）. Female patients receiving an ICD were more likely due to cardiac ion channel disease （29.2% vs. 4.2%, P 〈 0.001）. The percentage of utilization of dual-chamber pacemaker in female patients was significantly higher than male （85.3% vs. 81.1%, P 〈 0.001）. But male patients were more likely received a cardiac resynchronization therapy devices with defibrillator than female （56.5% vs. 41.9%, P = 0.001）. In pacemaker patient, male was more likely to have structure heart disease （31.3% vs. 28.0%, P = 0.002）. In ICD patient, male patients were more likely to have ischemic heart disease （48.2% vs. 29.2%, P 〈 0.001）. The mean age of women at the time of CRT/D implantation was older than men （P = 0.014）. Nonischemic cardiomyopathy （70.9%） was the most common etiology in the patients who underwent the treat？ment of CRT/D, no matter male or female. Conclusions In real-world setting, female do have different epidemiology, pathophysiology and clinical presentation of many cardiac rhythm disorders when compared with male, and all these factors may affect the utilization of CIED implantation. But it also possibility that cultural and socioeconomic features may play a role in this apparent discrimination.
文摘Introduction The mission of the WHO International Clinical Trials Registry Platform is to ensure that a complete view of research is accessible to all those involved in health care decision making. This will improve research transparency and will ultimately strengthen the validity and value of the scientific evidence base. The registration of all interventional trials is a scientific, ethical and moral responsibility.
文摘BACKGROUND There remains a dearth of Asian epidemiological literature for paediatric inflammatory bowel disease(PIBD).AIM To describe the presenting features of PIBD from 7 Asia-Pacific pediatric gastroenterology centers via a central standardised electronic data platform.METHODS Clinical,endoscopic and radiologic data at diagnosis from the registry were extracted between 1^(st) January 1995 to 31^(st) December 2019.Disease phenotypic characteristics were classified as per the Paris classification system.RESULTS There was a distinct rise in new PIBD cases:Nearly half(48.6%)of the cohort was diagnosed in the most recent 5 years(2015-2019).The ratio of Crohn’s disease(CD):Ulcerative colitis(UC):IBDUnclassified was 55.9%:38.3%:5.8%.The mean age was 9.07 years with a high proportion of very early onset IBD(VEO-IBD)(29.3%)and EO-IBD(52.7%).An over-representation of the Indian/South Asian ethnic group was observed which accounted for 37.0% of the overall Singapore/Malaysia subcohort(6.8%-9.0%Indians in census).Indian/South Asian CD patients were also most likely to present with symptomatic perianal disease(P=0.003).CD patients presented with significantly more constitutional symptoms(fever,anorexia,malaise/fatigue and muscle-wasting)than UC and higher inflammatory indices(higher C-reactive protein and lower albumin levels).CONCLUSION We observed a high incidence of VEO-IBD and an over-representation of the Indian ethnicity.South Asian CD patients were more likely to have symptomatic perianal disease.
基金Supported by NATCM TCM Inheritance and Innovation Hundred-Thousand-Ten Thousand“Talents Project Qi Huang Scholar)-National TCM Leading Personnel Support Program(NATCM Personnel and Education Department[2018]No.12)”Research on optimizing construction of evidence-based ability of traditional Chinese medicine encephalopathy(No.ZZ13-024-3),Special fund for basic scientific research business expenses of central public welfare scientific research institutes。
文摘OBJECTIVE:To analyze the current status of clinical trial registration of Traditional Chinese Medicine(TCM)for the treatment of neurological diseases.METHODS:Interventional clinical trials of TCM treatment for ischemic stroke,hemorrhagic stroke,vascular cognitive impairment,tension-type headache before September 22,2020 on the platform of Chinese Clinical Trial Registry(Chi CTR),and Clinical Trials.gov were searched.Two researchers independently selected the literature and extracted data.RESULTS:A total of 180 interventional clinical trials were included for analysis.Out of 180 trials,127 were from Chi CTR and 53 from Clinical Trials.gov.The countries primary sponsoring the included trials were China(176,97.8%),and the common categories of primary sponsors were hospital(131,72.8%).Among the study design,the largest proportion of allocation was randomized(172,95.6%),interventional model assignment was parallel(163,90.6%),masking was double blind 49(27.2%),and the sample size was≤400(144,80.0%).The trials were most carried out at a single center(102,56.7%).Among the included studies,112(62.2%)registered on Chi CTR attached the ethical approval documents.In terms of trial stages,50(27.7%)studies were in phaseⅣ.The mostly used intervention was Chinese herbal medicines(99,55%),acupuncture(68,37.8%)was the second.By searching the registration number on China National Knowledge Infrastructure Database and Pub Med,38(21.1%)registered trials were published,including 25 protocol studies and 14 research results with one(NCT02275949)published both the protocol and the results.CONCLUSIONS:Irregular and inadequate reporting,untimely update and publication,insufficient information on traditional medicine unique characteristics,and lack of international collaborations are the problems existing in the interventional clinical registration trials of traditional medicine treatment on neurological diseases.More efforts need to be made from the above aspects to standardize and improve the registration of traditional medicine trials.
