BACKGROUND The features of gastric cancer based on the anatomic site remain unknown in northern China patients.AIM To analyze gastric cancer features and associated trends based on the anatomical site in northern Chin...BACKGROUND The features of gastric cancer based on the anatomic site remain unknown in northern China patients.AIM To analyze gastric cancer features and associated trends based on the anatomical site in northern China patients.METHODS This cross-sectional study used incident gastric cancer case data from 10 Peking University-affiliated hospitals(2014 to 2018).The clinical and prevailing local features were analyzed.RESULTS A total of 10709 patients were enrolled,including antral(42.97%),cardia(34.30%),and stomach body(18.41%)gastric cancer cases.Cancer in the cardia had the highest male:female ratio,proportion of elderly patients,and patients with complications,including hypertension,diabetes,cerebrovascular,and coronary diseases(P<0.001).gastric cancer involving the antrum showed the lowest proportion of patients from rural areas and accounted for the highest hospitalization rate and cost(each P<0.001).The proportion of patients with cancer involving the cardia increased with an increase in the number of gastroesophageal reflux disease cases during the same period(P<0.001).Multivariate analysis revealed that tumor location in the cardia increased the risk of inhospital mortality(P=0.046).Anatomical subsite was not linked to postoperative complications.CONCLUSION The features of gastric cancer based on the anatomical site differ between northern China and other regions,both globally and within the country.Social factors may account for these differences and should affect policy-making and clinical practice.展开更多
Practice-based research networks (PBRN) seek to improve healthcare through the use of research, quality improvement, and collaborative learning. When used by nontraditional models of care such as the nurse managed hea...Practice-based research networks (PBRN) seek to improve healthcare through the use of research, quality improvement, and collaborative learning. When used by nontraditional models of care such as the nurse managed healthcare center (NMHC), PBRNs can be incorporated into successful quality improvement (QI) programs. UT Health Services is a NMHC utilizing a PBRN as one component of a comprehensive QI program in an effort to deliver high quality healthcare.展开更多
AIM: To investigate whether regional geography influences ethnic and gender trends for the development of gastric cancer(GC).METHODS: This retrospective analysis of the INVISION patient database at Louisiana State Uni...AIM: To investigate whether regional geography influences ethnic and gender trends for the development of gastric cancer(GC).METHODS: This retrospective analysis of the INVISION patient database at Louisiana State University Health Sciences Center-Shreveport(LSUHSC-S), a southern United States regional hospital, was performed from 2005-2011. Using the international statistical classification of diseases 9(ICD-9), inpatient, day surgery outpatient, and emergency outpatient diagnosis codes entered into medical records were used to identify GC patients. For each study year, the patients were evaluated for age, ethnicity, and gender, and each patient was counted only once throughout the study. Subsequent patient encounters were counted as visits and separated by inpatient and clinic visits. Complex or severe disease may require more frequent and intensive clinical management; therefore, we evaluated annual clinic visits as "surrogate markers" of disease severity. Finally, we studied the primary diagnosis for Helicobacter pylori(H. pylori) infection(ICD-9 code 41.86) as an additional factor that might increase the risk of GC.RESULTS: A total of 285 patients were diagnosed with GC at LSUHSC-S between 2005 and 2011. African Americans(181 patients, 89 males and 92 females, 63.5% of total patients) had significantly higher frequencies of GC diagnosis compared with non-Hispanic whites(104 patients, 54 males and 50 females, 36.5% of total patients), at a ratio of 1.74(P = 0.002). Within each ethnic group, men and women were diagnosed at approximately equal annual rates. Our findings differed significantly from United States national trends, which found that African American females and white females had lower risks for GC than their corresponding male counterparts. The United States national trend between 2005 and 2011 showed that African Americans males had a higher incidence of GC, with an annual mean(per 100000) of 16.31 ± 0.76 compared with white males(9 ± 0.1, P < 0.001), African American females(8.7 ± 0.34, P < 0.001) and white females(4.05 ± 0.07, P < 0.001). Among the GC patients, the number of clinic visits was highest among African American males(195.1 ± 28.1), who had significantly more clinic visits than African Americans females(123 ± 13.02, P < 0.05), white males(41.57 ± 4.74, P < 0.001) and white females(35 ± 8.9, P < 0.001). Similar trends were found for inpatient visits, with an annual mean of 11.43 ± 1.5 forAfrican American males, followed by African American females(7.29 ± 1.36), white males(2.57 ± 0.69) and white females(1.57 ± 0.612). African American males had significantly more inpatient visits than white males(P < 0.001), and African American females had more inpatient visits than white females(P < 0.01). African American patients showed the highest frequency of H. pylori positive status, with approximately 72% vs 28% for the white patients. CONCLUSION: Increase in GC diagnoses among women at LSUHSC-S is significantly higher than United States national averages, suggesting local geographic and socioeconomic influences may alter GC disease course.展开更多
Development of the telencephalon relies upon several signaling centers-localized cellular populations that supply secreted factors to pattern the cortical neuroepithelium.One such signaling center is the cortical hem,...Development of the telencephalon relies upon several signaling centers-localized cellular populations that supply secreted factors to pattern the cortical neuroepithelium.One such signaling center is the cortical hem,which arises during embryonic development at the telencephalic dorsal midline,adjacent to the choroid plexus and hippocampal primordium(Figure 1A).While the cortical hem has also been described in reptiles and birds,most of our knowledge about the developmental roles of the cortical hem is derived from the analysis in mice.The cortical hem produces several types of secreted molecules,including wingless-related integration site(Wnt)and bone morphogenetic(Bmp)proteins.The cortical hem is particularly important for the development of the hippocampus,which is involved in learning and memory,and the neocortex,which is the most complex brain region that mediates multiple types of behavior and higher cognitive functions(Mangale et al.,2008;Dal-Valle-Anton and Borrell,2022).展开更多
The 2nd Natural Product Synthesis-Young Investigator Forum(NPS-YIF)was held in Peking University Health Science Cen-ter,on June 16–19,2013,Beijing,China.The forum was hosted by the Division of Organic Chemistry,Chine...The 2nd Natural Product Synthesis-Young Investigator Forum(NPS-YIF)was held in Peking University Health Science Cen-ter,on June 16–19,2013,Beijing,China.The forum was hosted by the Division of Organic Chemistry,Chinese Chemical Society,organized by the State Key Laboratory ofNatural and Biomimetic Drugs,School of Pharmaceutical Sciences,Peking University.In the symposiums,five domestic specialistsin natural product synthesis were invited to give plenary lectures,and 16 young investigators delivered excellent invited lectures.There were more than 60 distinguished young scholars from famous universities and research institutes and nearly 60 graduatestudents attended the event.展开更多
The“Double First-Class”construction focuses on the development of disciplinary connotations and the improvement of talent cultivation quality,posing higher demands on the teaching mode and talent supply of public he...The“Double First-Class”construction focuses on the development of disciplinary connotations and the improvement of talent cultivation quality,posing higher demands on the teaching mode and talent supply of public health and preventive medicine disciplines.Environmental health,as a core course in public health and preventive medicine,directly relates to the cultivation of effective composite public health talents.Based on the core orientation of the“Double First-Class”construction and combining the talent cultivation and course characteristics of environmental health,this paper explores the significance of teaching reform and talent cultivation in environmental health from the perspective of“Double First-Class”construction.It also investigates the paths for teaching reform and talent cultivation from multiple dimensions,aiming to provide references for cultivating high-quality professionals who meet the needs of national public health development and ecological environmental protection.展开更多
This study examined the development of technician teams on large-scale instrument platforms in universities,using the State Key Laboratory of Natural and Biomimetic Drugs in the Peking University School of Pharmaceuti...This study examined the development of technician teams on large-scale instrument platforms in universities,using the State Key Laboratory of Natural and Biomimetic Drugs in the Peking University School of Pharmaceutical Sciences as a case study.Data were collected through questionnaire surveys and interviews conducted in 2017,followed by a questionnaire survey in 2023,offering both subjective and objective insights.The evolution of the platform’s technician team over the past 5 years was analyzed,highlighting key experiences and identifying ongoing challenges.Recommendations to enhance technician team development include recruiting skilled faculty,clearly defining job responsibilities,and refining the assessment and incentive systems.展开更多
Universities serve as pivotal platforms for cultivating postdoctoral talent,particularly in pharmaceutical sciences.This study provided an empirical assessment of the key determinants influencing research productivity...Universities serve as pivotal platforms for cultivating postdoctoral talent,particularly in pharmaceutical sciences.This study provided an empirical assessment of the key determinants influencing research productivity among postdoctoral fellows in this field.We analyzed a cohort of postdoctoral researchers who entered the School of Pharmaceutical Sciences at Peking University between October 2016 and December 2024,gathering comprehensive data on their demographic characteristics and scholarly accomplishments throughout their fellowship.Indicators of postdoctoral success encompassed securing research funding,publishing scholarly articles,and filing patent applications.To identify the principal factors shaping these outcomes,we employed logistic regression analysis.The findings demonstrated that postdoctoral fellows enrolled in incentive programs exhibited markedly higher success rates in acquiring research grants,especially high-tier funding,as well as in publishing both general and high-impact research articles.Conversely,fellows engaged in interdisciplinary research showed significantly reduced success rates in obtaining both general and high-level grants.Additionally,extended fellowship durations were positively correlated with greater likelihoods of publishing high-impact papers and achieving patents.Notably,postdoctoral fellows specializing in Pharmaceutical Analysis had a significantly higher probability of securing prestigious research grants,while those focusing on Pharmaceutics demonstrated a superior capacity for research publication.Regarding intellectual property,fellows mentored by supervisors with overseas experience were substantially more likely to obtain patents,whereas those guided by tenure-track supervisors exhibited lower patent acquisition rates.In light of these insights,we proposed several recommendations for postdoctoral management bodies within pharmaceutical academic institutions.These included refining selection criteria for postdoctoral candidates,amplifying support through incentive mechanisms,enhancing interdisciplinary fellows’integration into pharmaceutical research paradigms,and optimizing postdoctoral training frameworks to nurture academic excellence and research innovation.展开更多
Standardized datasets are foundational to healthcare informatization by enhancing data quality and unleashing the value of data elements.Using bibliometrics and content analysis,this study examines China's healthc...Standardized datasets are foundational to healthcare informatization by enhancing data quality and unleashing the value of data elements.Using bibliometrics and content analysis,this study examines China's healthcare dataset standards from 2011 to 2025.It analyzes their evolution across types,applications,institutions,and themes,highlighting key achievements including substantial growth in quantity,optimized typology,expansion into innovative application scenarios such as health decision support,and broadened institutional involvement.The study also identifies critical challenges,including imbalanced development,insufficient quality control,and a lack of essential metadata—such as authoritative data element mappings and privacy annotations—which hampers the delivery of intelligent services.To address these challenges,the study proposes a multi-faceted strategy focused on optimizing the standard system's architecture,enhancing quality and implementation,and advancing both data governance—through authoritative tracing and privacy protection—and intelligent service provision.These strategies aim to promote the application of dataset standards,thereby fostering and securing the development of new productive forces in healthcare.展开更多
Objective The study aim was to investigate the effects of exposure to multiple environmental organic pollutants on cardiopulmonary health with a focus on the potential mediating role of oxidative stress.Methods A repe...Objective The study aim was to investigate the effects of exposure to multiple environmental organic pollutants on cardiopulmonary health with a focus on the potential mediating role of oxidative stress.Methods A repeated-measures randomized crossover study involving healthy college students in Beijing was conducted. Biological samples, including morning urine and venous blood, were collected to measure concentrations of 29 typical organic pollutants, including hydroxy polycyclic aromatic hydrocarbons(OH-PAHs), bisphenol A and its substitutes, phthalates and their metabolites, parabens,and five biomarkers of oxidative stress. Health assessments included blood pressure measurements and lung function indicators.Results Urinary concentrations of 2-hydroxyphenanthrene(2-OH-PHE)(β = 4.35% [95% confidence interval(CI): 0.85%, 7.97%]), 3-hydroxyphenanthrene(β = 3.44% [95% CI: 0.19%, 6.79%]), and 4-hydroxyphenanthrene(4-OH-PHE)(β = 5.78% [95% CI: 1.27%, 10.5%]) were significantly and positively associated with systolic blood pressure. Exposures to 1-hydroxypyrene(1-OH-PYR)(β = 3.05% [95% CI:-4.66%,-1.41%]), 2-OH-PHE(β = 2.68% [95% CI:-4%,-1.34%]), and 4-OH-PHE(β = 3% [95% CI:-4.68%,-1.29%]) were negatively associated with the ratio of forced expiratory volume in the first second to forced vital capacity. These findings highlight the adverse effects of exposure to multiple pollutants on cardiopulmonary health. Biomarkers of oxidative stress, including 8-hydroxy-2'-deoxyguanosine and extracellular superoxide dismutase, mediated the effects of multiple OH-PAHs on blood pressure and lung function.Conclusion Exposure to multiple organic pollutants can adversely affect cardiopulmonary health.Oxidative stress is a key mediator of the effects of OH-PAHs on blood pressure and lung function.展开更多
Microglia are the macrophages that populate the brain parenchyma.Research in the past decades has identified them as both essential guardians of the brain and significant contributors to various neurological diseases....Microglia are the macrophages that populate the brain parenchyma.Research in the past decades has identified them as both essential guardians of the brain and significant contributors to various neurological diseases.A highly versatile cell type,microglia have been shown to fulfill a multitude of critical roles in the central nervous system,including facilitating neurogenesis and myelination,pruning synapses,removing debris and waste,modulating neuronal activity,supporting the blood-brain barrier,repairing tissue damage,and surveilling against microbial invasions under physiological conditions(Prinz et al.,2021;Paolicelli et al.,2022).展开更多
BACKGROUND Non-erosive reflux disease(NERD),the main gastroesophageal reflux subtype,features reflux symptoms without mucosal damage.Anxiety links to visceral hypersensitivity in NERD,yet mechanisms and animal models ...BACKGROUND Non-erosive reflux disease(NERD),the main gastroesophageal reflux subtype,features reflux symptoms without mucosal damage.Anxiety links to visceral hypersensitivity in NERD,yet mechanisms and animal models are unclear.AIM To establish a translational NERD rat model with anxiety comorbidity via tail clamping and study corticotropin-releasing hormone(CRH)-mediated neuroimmune pathways in visceral hypersensitivity and esophageal injury.METHODS Sprague-Dawley(SD)and Wistar rats were grouped into sham,model,and modified groups(n=10 each).The treatments for the modified groups were as follows:SD rats received ovalbumin/aluminum hydroxide suspension+acid perfusion±tail clamping(40 minutes/day for 7 days),while Wistar rats received fructose water+tail clamping.Esophageal pathology,visceral sensitivity,and behavior were assessed.Serum CRH,calcitonin gene-related peptide(CGRP),5-hydroxytryptamine(5-HT),and mast cell tryptase(MCT)and central amygdala(CeA)CRH mRNA were measured via ELISA and qRT-PCR.RESULTS Tail clamping induced anxiety,worsening visceral hypersensitivity(lower abdominal withdrawal reflex thresholds,P<0.05)and esophageal injury(dilated intercellular spaces and mitochondrial edema).Both models showed raised serum CRH,CGRP,5-HT,and MCT(P<0.01)and CeA CRH mRNA expression(P<0.01).Behavioral tests confirmed anxiety-like phenotypes.NERD-anxiety rats showed clinical-like symptom severity without erosion.CONCLUSION Tail clamping induces anxiety in NERD models,worsening visceral hypersensitivity via CRH neuroimmune dysregulation,offering a translational model and highlighting CRH as a treatment target.展开更多
AIM:To investigate the long-term outcomes in acute primary angle closure(APAC)patients treated with lens extraction(LE)surgery and to identify risk factors for glaucomatous optic neuropathy(GON).METHODS:In this longit...AIM:To investigate the long-term outcomes in acute primary angle closure(APAC)patients treated with lens extraction(LE)surgery and to identify risk factors for glaucomatous optic neuropathy(GON).METHODS:In this longitudinal observational study,detailed medical histories of APAC patients and comprehensive ophthalmic examinations at final followup were collected.Logistic regression analysis was performed to identify predictors of blindness.Univariate and multivariate linear regression analyses were conducted to determine risk factors associated with visual outcomes.RESULTS:This study included 39 affected eyes of 31 subjects(26 females)with an average age of 74.1±8.0y.At 6.7±4.2y after APAC attack,2(5.7%)eyes had bestcorrected visual acuity(VA)worse than 3/60.Advanced glaucomatous visual field loss was observed in 15(39.5%)affected eyes and 5(25.0%)fellow eyes.Nine affected eyes(23.7%)had GON,and 11(28.9%)were blind.Six(15.4%)affected eyes and 2(9.1%)fellow eyes had suspicious progression.A significantly higher blindness rate in factory workers compared to office workers.Logistic regression identified that worse VA at attack(OR 10.568,95%CI 1.288-86.695;P=0.028)and worse early postoperative VA(OR 13.214,95%CI 1.157-150.881;P=0.038)were risk factors for blindness.Multivariate regression showed that longer duration of elevated intraocular pressure(P=0.004)and worse early postoperative VA(P=0.009)were associated with worse visual outcomes.CONCLUSION:Despite LE surgery,some APAC patients experience continued visual function deterioration.Lifelong monitoring is necessary.Target pressure and progression rates should be re-evaluated during follow-up.展开更多
Prostatic carcinoma(PCa)has become one of the most common cancers among men worldwide,with both incidence and mortality rates steadily rising.Although current treatments are effective in the early stages of PCa,many c...Prostatic carcinoma(PCa)has become one of the most common cancers among men worldwide,with both incidence and mortality rates steadily rising.Although current treatments are effective in the early stages of PCa,many cases eventually progress to castration-resistant prostate cancer(CRPC),and led to treatment failure.To develop new therapeutic strategies to ameliorate the survival of PCa patients then has pressed the need on medicinal researchers.Of traditional Chinese medicinal herbs,Angelica gigas Naka(AGN),and its major pyranocoumarins were broadly reported on the effect of anti-PCa.However,existing reviews mainly focus on decursin(D),decursinol angelate(DA),and decursinol(DOH),without fully exploring other coumarins in AGN.Moreover,most reviews discuss general anticancer effects,with limited emphasis on PCa specifically.This review made a comprehensive summary of the coumarin components of AGN,and depicted the anti-PCa effects and mechanisms,giving a solid research support for drug discovery and development.This review also featured pharmacokinetic advantages and therapeutic potential of DOH,in order to suggest possibilities to overcome the in vivo transformation limitations of D and DA,and shed light on CRPC treatment.We also recommend future studies focus on more in vivo evidence,safety and toxicity evaluation,and clinical validation in humans.展开更多
In recent years,exosomes have garnered extensive attention as therapeutic agents and early diagnostic markers in neurodegenerative disease research.Exosomes are small and can effectively cross the blood-brain barrier,...In recent years,exosomes have garnered extensive attention as therapeutic agents and early diagnostic markers in neurodegenerative disease research.Exosomes are small and can effectively cross the blood-brain barrier,allowing them to target deep brain lesions.Recent studies have demonstrated that exosomes derived from different cell types may exert therapeutic effects by regulating the expression of various inflammatory cytokines,mRNAs,and disease-related proteins,thereby halting the progression of neurodegenerative diseases and exhibiting beneficial effects.However,exosomes are composed of lipid bilayer membranes and lack the ability to recognize specific target cells.This limitation can lead to side effects and toxicity when they interact with non-specific cells.Growing evidence suggests that surface-modified exosomes have enhanced targeting capabilities and can be used as targeted drug-delivery vehicles that show promising results in the treatment of neurodegenerative diseases.In this review,we provide an up-to-date overview of existing research aimed at devising approaches to modify exosomes and elucidating their therapeutic potential in neurodegenerative diseases.Our findings indicate that exosomes can efficiently cross the blood-brain barrier to facilitate drug delivery and can also serve as early diagnostic markers for neurodegenerative diseases.We introduce the strategies being used to enhance exosome targeting,including genetic engineering,chemical modifications(both covalent,such as click chemistry and metabolic engineering,and non-covalent,such as polyvalent electrostatic and hydrophobic interactions,ligand-receptor binding,aptamer-based modifications,and the incorporation of CP05-anchored peptides),and nanomaterial modifications.Research into these strategies has confirmed that exosomes have significant therapeutic potential for neurodegenerative diseases.However,several challenges remain in the clinical application of exosomes.Improvements are needed in preparation,characterization,and optimization methods,as well as in reducing the adverse reactions associated with their use.Additionally,the range of applications and the safety of exosomes require further research and evaluation.展开更多
We aim to review the literature and provide guidance on preventive health measures in inflammatory bowel disease(IBD). Structured searches were performed in Pub Med,MEDLINE,EMBASE,Web of Science and Cochrane Library f...We aim to review the literature and provide guidance on preventive health measures in inflammatory bowel disease(IBD). Structured searches were performed in Pub Med,MEDLINE,EMBASE,Web of Science and Cochrane Library from January 1976 to June 2016 using the following keywords:(inflammatory bowel disease OR Crohn's disease OR ulcerative colitis) AND(health maintenance OR preventive health OR health promotion). Abstracts of the articles selected from each of these multiple searches were reviewed,and those meeting the inclusion criteria(that is,providing data regarding preventive health or health maintenance in IBD patients) were recorded. Reference lists from the selected articles were manually reviewed to identify further relevant studies. Patients with IBD are at increased risk of developing adverse events related to the disease course,therapeutic interventions,or non-adherence to medication. Recent studies have suggested that IBD patients do not receive preventive services with the same thoroughness as patients with other chronic diseases. Preventive health measures can avert morbidity and improve the quality of life of patients with IBD. Gastroenterologists and primary care physicians(PCPs) should have an up to date working knowledge of preventive health measures for IBD patients. A holistic approach and better communication between gastroenterologists and PCPs with explicit clarification of roles will prevent duplication of services and streamline care.展开更多
Many patients with rare diseases not only suffer from more severe conditions but often receive less disease management, which is one significant public health concern globally. Few practice-based surveys focus on the ...Many patients with rare diseases not only suffer from more severe conditions but often receive less disease management, which is one significant public health concern globally. Few practice-based surveys focus on the care of patients with rare diseases. In the present study, we aimed to investigate medical service utilization, economic burden and health status of patients with rare diseases in China. A cross-sectional questionnaire survey focusing on patients with rare diseases was conducted. Descriptive analysis was conducted to examine the sociodemographic characteristics, medical service utilization, economic burden and health status. Logistic regression analysis was applied to explore influencing factors of self-rated health. A total of 982 patients with 81 types of diseases were included in this survey. We found that 58.2% of patients experienced misdiagnosis, and 35.2% of the patients were misdiagnosed for at least five times. Moreover, 65.8% of patients traveled to hospitals to seek medical services, and 92.1% of patients paid expenses for their treatment. However, only 1.3% of patients could afford their medical expenditure without debts, and 86.8% of patients regarded their health status as bad or moderate. Significant factors correlated with health status were economic status, gender, age, employment and household size. From this study, the accessibility of medical service utilization, the affordability of medical economic burden, and the condition of health status for patients with rare disease in China were considerably poor. Basic medical insurance did not play its role in improving the utilization of medical services and the affordability of medical costs. Social support should be encouraged to improve patients＇ health status.展开更多
Irrational use of medicines is a major problem worldwide, and it is believed there would be positive correlation between the National Essential Medicines Policies(NEMPs) and the level of rational use of medicines(RUMs...Irrational use of medicines is a major problem worldwide, and it is believed there would be positive correlation between the National Essential Medicines Policies(NEMPs) and the level of rational use of medicines(RUMs). Though there is some early evidence on the NEMPs’ effects on RUMs in China, the evidence is scarce, and conclusions vary. In the present study, we aimed to evaluate the impacts of the NEMPs of China on the RUMs in the primary health care institutions(PHCs). A cross-sectional survey was conducted in 2010. A total of 201 PHCs from six provinces of China were selected, and 39 181 prescriptions were extracted from January to June, 2010. Six indicators were used and tested by independent-samples T test. We found that the average number of drugs per prescription in PHCs with NEMP implementation(the treatment group) was significantly higher than that of the group without NEMP implementation(the control group)(3.37 vs. 2.83, P<0.01). There was no significant difference in the average cost per prescription(81.43 vs. 75.02). The percentage of prescriptions, including an antibiotic(53.40% vs. 36.48%, P<0.01) or an injection(40.54% vs. 27.94%, P<0.01), was higher in the treatment group, and the percentage of drugs prescribed by general name was significantly lower(83.71% vs. 93.11%, P<0.01). For the percentage of drugs prescribed from essential medicines list, the treatment group exhibited the higher ratio(76.12% vs. 53.45%, P<0.01). From this study, the NEMPs were not likely to have a positive impact on RUMs. China still needed efforts to improve the selection, the absence of physicians’ active involvement, and the patients’ habits of irrational medication use.展开更多
To demonstrate the clinical outcomes of a multicenter experience and to suggest guidelines for choosing a suction method.METHODSThis retrospective study at 5 medical centers involved 58 consecutive patients undergoing...To demonstrate the clinical outcomes of a multicenter experience and to suggest guidelines for choosing a suction method.METHODSThis retrospective study at 5 medical centers involved 58 consecutive patients undergoing over-the-scope clips(OTSCs)placement.The overall rates of technical success(TSR),clinical success(CSR),complications,and procedure time were analyzed as major outcomes.Subsequently,56 patients,excluding two cases that used the Anchor device,were divided into two groups:14 cases of simple suction(SS-group)and 42 cases using the Twin Grasper(TG-group).Secondary evaluation was performed to clarify the predictors of OTSC success.RESULTSThe TSR,CSR,complication rate,and median procedure time were 89.7%,84.5%,1.8%,and 8(range 1-36)min,respectively,demonstrating good outcomes.However,significant differences were observed between the two groups in terms of the mean procedure time(5.9 min vs 14.1 min).The CSR of the SS-and TG-groups among cases with a maximum defect size≤10 mm and immediate or acute refractory bleeding was 100%,which suggests that SS is a better method than TG in terms of time efficacy.The CSR in the SS-group(78.6%),despite the technical success of the SS method(TSR,100%),tended to decrease due to delayed leakage compared to that in the TG-group(TSR,CSR;88.1%),indicating that TG may be desirable for leaks and fistulae with defects of the entire layer.CONCLUSIONOTSC system is a safe and effective therapeutic option for gastrointestinal defects.Individualized selection of the suction method based on particular clinical conditions may contribute to the improvement of OTSC success.展开更多
基金Supported by the National Natural Science Foundation of China,No.81972702,No.91959110,and No.62173005reviewed and approved by the Ethics Committee of Peking University Third Hospital(Approval No.IRB00006761-M2019387).
文摘BACKGROUND The features of gastric cancer based on the anatomic site remain unknown in northern China patients.AIM To analyze gastric cancer features and associated trends based on the anatomical site in northern China patients.METHODS This cross-sectional study used incident gastric cancer case data from 10 Peking University-affiliated hospitals(2014 to 2018).The clinical and prevailing local features were analyzed.RESULTS A total of 10709 patients were enrolled,including antral(42.97%),cardia(34.30%),and stomach body(18.41%)gastric cancer cases.Cancer in the cardia had the highest male:female ratio,proportion of elderly patients,and patients with complications,including hypertension,diabetes,cerebrovascular,and coronary diseases(P<0.001).gastric cancer involving the antrum showed the lowest proportion of patients from rural areas and accounted for the highest hospitalization rate and cost(each P<0.001).The proportion of patients with cancer involving the cardia increased with an increase in the number of gastroesophageal reflux disease cases during the same period(P<0.001).Multivariate analysis revealed that tumor location in the cardia increased the risk of inhospital mortality(P=0.046).Anatomical subsite was not linked to postoperative complications.CONCLUSION The features of gastric cancer based on the anatomical site differ between northern China and other regions,both globally and within the country.Social factors may account for these differences and should affect policy-making and clinical practice.
文摘Practice-based research networks (PBRN) seek to improve healthcare through the use of research, quality improvement, and collaborative learning. When used by nontraditional models of care such as the nurse managed healthcare center (NMHC), PBRNs can be incorporated into successful quality improvement (QI) programs. UT Health Services is a NMHC utilizing a PBRN as one component of a comprehensive QI program in an effort to deliver high quality healthcare.
基金Supported by National Institute of General Medical Sciences of the National Institutes of Health under award,No.P30GM110703the Department of Defense,No.PR100451the German Research Foundation,No.DFG,F.B.BE 5619/1-1
文摘AIM: To investigate whether regional geography influences ethnic and gender trends for the development of gastric cancer(GC).METHODS: This retrospective analysis of the INVISION patient database at Louisiana State University Health Sciences Center-Shreveport(LSUHSC-S), a southern United States regional hospital, was performed from 2005-2011. Using the international statistical classification of diseases 9(ICD-9), inpatient, day surgery outpatient, and emergency outpatient diagnosis codes entered into medical records were used to identify GC patients. For each study year, the patients were evaluated for age, ethnicity, and gender, and each patient was counted only once throughout the study. Subsequent patient encounters were counted as visits and separated by inpatient and clinic visits. Complex or severe disease may require more frequent and intensive clinical management; therefore, we evaluated annual clinic visits as "surrogate markers" of disease severity. Finally, we studied the primary diagnosis for Helicobacter pylori(H. pylori) infection(ICD-9 code 41.86) as an additional factor that might increase the risk of GC.RESULTS: A total of 285 patients were diagnosed with GC at LSUHSC-S between 2005 and 2011. African Americans(181 patients, 89 males and 92 females, 63.5% of total patients) had significantly higher frequencies of GC diagnosis compared with non-Hispanic whites(104 patients, 54 males and 50 females, 36.5% of total patients), at a ratio of 1.74(P = 0.002). Within each ethnic group, men and women were diagnosed at approximately equal annual rates. Our findings differed significantly from United States national trends, which found that African American females and white females had lower risks for GC than their corresponding male counterparts. The United States national trend between 2005 and 2011 showed that African Americans males had a higher incidence of GC, with an annual mean(per 100000) of 16.31 ± 0.76 compared with white males(9 ± 0.1, P < 0.001), African American females(8.7 ± 0.34, P < 0.001) and white females(4.05 ± 0.07, P < 0.001). Among the GC patients, the number of clinic visits was highest among African American males(195.1 ± 28.1), who had significantly more clinic visits than African Americans females(123 ± 13.02, P < 0.05), white males(41.57 ± 4.74, P < 0.001) and white females(35 ± 8.9, P < 0.001). Similar trends were found for inpatient visits, with an annual mean of 11.43 ± 1.5 forAfrican American males, followed by African American females(7.29 ± 1.36), white males(2.57 ± 0.69) and white females(1.57 ± 0.612). African American males had significantly more inpatient visits than white males(P < 0.001), and African American females had more inpatient visits than white females(P < 0.01). African American patients showed the highest frequency of H. pylori positive status, with approximately 72% vs 28% for the white patients. CONCLUSION: Increase in GC diagnoses among women at LSUHSC-S is significantly higher than United States national averages, suggesting local geographic and socioeconomic influences may alter GC disease course.
基金supported by R01 NS093009 grant from NIH(to VVC).
文摘Development of the telencephalon relies upon several signaling centers-localized cellular populations that supply secreted factors to pattern the cortical neuroepithelium.One such signaling center is the cortical hem,which arises during embryonic development at the telencephalic dorsal midline,adjacent to the choroid plexus and hippocampal primordium(Figure 1A).While the cortical hem has also been described in reptiles and birds,most of our knowledge about the developmental roles of the cortical hem is derived from the analysis in mice.The cortical hem produces several types of secreted molecules,including wingless-related integration site(Wnt)and bone morphogenetic(Bmp)proteins.The cortical hem is particularly important for the development of the hippocampus,which is involved in learning and memory,and the neocortex,which is the most complex brain region that mediates multiple types of behavior and higher cognitive functions(Mangale et al.,2008;Dal-Valle-Anton and Borrell,2022).
文摘The 2nd Natural Product Synthesis-Young Investigator Forum(NPS-YIF)was held in Peking University Health Science Cen-ter,on June 16–19,2013,Beijing,China.The forum was hosted by the Division of Organic Chemistry,Chinese Chemical Society,organized by the State Key Laboratory ofNatural and Biomimetic Drugs,School of Pharmaceutical Sciences,Peking University.In the symposiums,five domestic specialistsin natural product synthesis were invited to give plenary lectures,and 16 young investigators delivered excellent invited lectures.There were more than 60 distinguished young scholars from famous universities and research institutes and nearly 60 graduatestudents attended the event.
文摘The“Double First-Class”construction focuses on the development of disciplinary connotations and the improvement of talent cultivation quality,posing higher demands on the teaching mode and talent supply of public health and preventive medicine disciplines.Environmental health,as a core course in public health and preventive medicine,directly relates to the cultivation of effective composite public health talents.Based on the core orientation of the“Double First-Class”construction and combining the talent cultivation and course characteristics of environmental health,this paper explores the significance of teaching reform and talent cultivation in environmental health from the perspective of“Double First-Class”construction.It also investigates the paths for teaching reform and talent cultivation from multiple dimensions,aiming to provide references for cultivating high-quality professionals who meet the needs of national public health development and ecological environmental protection.
文摘This study examined the development of technician teams on large-scale instrument platforms in universities,using the State Key Laboratory of Natural and Biomimetic Drugs in the Peking University School of Pharmaceutical Sciences as a case study.Data were collected through questionnaire surveys and interviews conducted in 2017,followed by a questionnaire survey in 2023,offering both subjective and objective insights.The evolution of the platform’s technician team over the past 5 years was analyzed,highlighting key experiences and identifying ongoing challenges.Recommendations to enhance technician team development include recruiting skilled faculty,clearly defining job responsibilities,and refining the assessment and incentive systems.
文摘Universities serve as pivotal platforms for cultivating postdoctoral talent,particularly in pharmaceutical sciences.This study provided an empirical assessment of the key determinants influencing research productivity among postdoctoral fellows in this field.We analyzed a cohort of postdoctoral researchers who entered the School of Pharmaceutical Sciences at Peking University between October 2016 and December 2024,gathering comprehensive data on their demographic characteristics and scholarly accomplishments throughout their fellowship.Indicators of postdoctoral success encompassed securing research funding,publishing scholarly articles,and filing patent applications.To identify the principal factors shaping these outcomes,we employed logistic regression analysis.The findings demonstrated that postdoctoral fellows enrolled in incentive programs exhibited markedly higher success rates in acquiring research grants,especially high-tier funding,as well as in publishing both general and high-impact research articles.Conversely,fellows engaged in interdisciplinary research showed significantly reduced success rates in obtaining both general and high-level grants.Additionally,extended fellowship durations were positively correlated with greater likelihoods of publishing high-impact papers and achieving patents.Notably,postdoctoral fellows specializing in Pharmaceutical Analysis had a significantly higher probability of securing prestigious research grants,while those focusing on Pharmaceutics demonstrated a superior capacity for research publication.Regarding intellectual property,fellows mentored by supervisors with overseas experience were substantially more likely to obtain patents,whereas those guided by tenure-track supervisors exhibited lower patent acquisition rates.In light of these insights,we proposed several recommendations for postdoctoral management bodies within pharmaceutical academic institutions.These included refining selection criteria for postdoctoral candidates,amplifying support through incentive mechanisms,enhancing interdisciplinary fellows’integration into pharmaceutical research paradigms,and optimizing postdoctoral training frameworks to nurture academic excellence and research innovation.
文摘Standardized datasets are foundational to healthcare informatization by enhancing data quality and unleashing the value of data elements.Using bibliometrics and content analysis,this study examines China's healthcare dataset standards from 2011 to 2025.It analyzes their evolution across types,applications,institutions,and themes,highlighting key achievements including substantial growth in quantity,optimized typology,expansion into innovative application scenarios such as health decision support,and broadened institutional involvement.The study also identifies critical challenges,including imbalanced development,insufficient quality control,and a lack of essential metadata—such as authoritative data element mappings and privacy annotations—which hampers the delivery of intelligent services.To address these challenges,the study proposes a multi-faceted strategy focused on optimizing the standard system's architecture,enhancing quality and implementation,and advancing both data governance—through authoritative tracing and privacy protection—and intelligent service provision.These strategies aim to promote the application of dataset standards,thereby fostering and securing the development of new productive forces in healthcare.
基金supported by the National Key Research&Development Program of the Ministry of Science and Technology of China(2022YFE0134900,2023YFC3708305,2023YFC3708302)Strategy Priority Research Program(Category B)of the Chinese Academy of Sciences(No.XDB0750300)National Natural Science Foundation of China(Grant No.42477455,42077390).
文摘Objective The study aim was to investigate the effects of exposure to multiple environmental organic pollutants on cardiopulmonary health with a focus on the potential mediating role of oxidative stress.Methods A repeated-measures randomized crossover study involving healthy college students in Beijing was conducted. Biological samples, including morning urine and venous blood, were collected to measure concentrations of 29 typical organic pollutants, including hydroxy polycyclic aromatic hydrocarbons(OH-PAHs), bisphenol A and its substitutes, phthalates and their metabolites, parabens,and five biomarkers of oxidative stress. Health assessments included blood pressure measurements and lung function indicators.Results Urinary concentrations of 2-hydroxyphenanthrene(2-OH-PHE)(β = 4.35% [95% confidence interval(CI): 0.85%, 7.97%]), 3-hydroxyphenanthrene(β = 3.44% [95% CI: 0.19%, 6.79%]), and 4-hydroxyphenanthrene(4-OH-PHE)(β = 5.78% [95% CI: 1.27%, 10.5%]) were significantly and positively associated with systolic blood pressure. Exposures to 1-hydroxypyrene(1-OH-PYR)(β = 3.05% [95% CI:-4.66%,-1.41%]), 2-OH-PHE(β = 2.68% [95% CI:-4%,-1.34%]), and 4-OH-PHE(β = 3% [95% CI:-4.68%,-1.29%]) were negatively associated with the ratio of forced expiratory volume in the first second to forced vital capacity. These findings highlight the adverse effects of exposure to multiple pollutants on cardiopulmonary health. Biomarkers of oxidative stress, including 8-hydroxy-2'-deoxyguanosine and extracellular superoxide dismutase, mediated the effects of multiple OH-PAHs on blood pressure and lung function.Conclusion Exposure to multiple organic pollutants can adversely affect cardiopulmonary health.Oxidative stress is a key mediator of the effects of OH-PAHs on blood pressure and lung function.
基金funded by NIH grants HL154720-03S1, AG057587, AG074283, DK122708-03S1, BrightFocus ADR A20183775Brown Foundation 2020 Healthy Aging Initiative (to WC)
文摘Microglia are the macrophages that populate the brain parenchyma.Research in the past decades has identified them as both essential guardians of the brain and significant contributors to various neurological diseases.A highly versatile cell type,microglia have been shown to fulfill a multitude of critical roles in the central nervous system,including facilitating neurogenesis and myelination,pruning synapses,removing debris and waste,modulating neuronal activity,supporting the blood-brain barrier,repairing tissue damage,and surveilling against microbial invasions under physiological conditions(Prinz et al.,2021;Paolicelli et al.,2022).
基金supported by a grant from NIH(R01AI132695)to RM。
文摘Chronic wasting disease—a prion disease affecting cervids:Many neurological conditions,including Alzheimer's and Parkinson's diseases,amyotrophic lateral sclerosis,frontotemporal dementias,among others,are caused by the accumulation of misfolded proteins in the brain.These diseases affect not only humans,but also animals.
基金Supported by the National Key Specialty of Traditional Chinese Medicine(Spleen and Stomach Diseases),No.0500004National Natural Science Foundation of China,No.82205104 and No.82104850+1 种基金Hospital Capability Enhancement Project of Xiyuan Hospital,CACMS,No.XYZX0303-07the Fundamental Research Funds for the Central Public Welfare Research Institutes,Excellent Young Scientists Training Program of China Academy of Chinese Medical Sciences,No.ZZ16-YQ-002.
文摘BACKGROUND Non-erosive reflux disease(NERD),the main gastroesophageal reflux subtype,features reflux symptoms without mucosal damage.Anxiety links to visceral hypersensitivity in NERD,yet mechanisms and animal models are unclear.AIM To establish a translational NERD rat model with anxiety comorbidity via tail clamping and study corticotropin-releasing hormone(CRH)-mediated neuroimmune pathways in visceral hypersensitivity and esophageal injury.METHODS Sprague-Dawley(SD)and Wistar rats were grouped into sham,model,and modified groups(n=10 each).The treatments for the modified groups were as follows:SD rats received ovalbumin/aluminum hydroxide suspension+acid perfusion±tail clamping(40 minutes/day for 7 days),while Wistar rats received fructose water+tail clamping.Esophageal pathology,visceral sensitivity,and behavior were assessed.Serum CRH,calcitonin gene-related peptide(CGRP),5-hydroxytryptamine(5-HT),and mast cell tryptase(MCT)and central amygdala(CeA)CRH mRNA were measured via ELISA and qRT-PCR.RESULTS Tail clamping induced anxiety,worsening visceral hypersensitivity(lower abdominal withdrawal reflex thresholds,P<0.05)and esophageal injury(dilated intercellular spaces and mitochondrial edema).Both models showed raised serum CRH,CGRP,5-HT,and MCT(P<0.01)and CeA CRH mRNA expression(P<0.01).Behavioral tests confirmed anxiety-like phenotypes.NERD-anxiety rats showed clinical-like symptom severity without erosion.CONCLUSION Tail clamping induces anxiety in NERD models,worsening visceral hypersensitivity via CRH neuroimmune dysregulation,offering a translational model and highlighting CRH as a treatment target.
文摘AIM:To investigate the long-term outcomes in acute primary angle closure(APAC)patients treated with lens extraction(LE)surgery and to identify risk factors for glaucomatous optic neuropathy(GON).METHODS:In this longitudinal observational study,detailed medical histories of APAC patients and comprehensive ophthalmic examinations at final followup were collected.Logistic regression analysis was performed to identify predictors of blindness.Univariate and multivariate linear regression analyses were conducted to determine risk factors associated with visual outcomes.RESULTS:This study included 39 affected eyes of 31 subjects(26 females)with an average age of 74.1±8.0y.At 6.7±4.2y after APAC attack,2(5.7%)eyes had bestcorrected visual acuity(VA)worse than 3/60.Advanced glaucomatous visual field loss was observed in 15(39.5%)affected eyes and 5(25.0%)fellow eyes.Nine affected eyes(23.7%)had GON,and 11(28.9%)were blind.Six(15.4%)affected eyes and 2(9.1%)fellow eyes had suspicious progression.A significantly higher blindness rate in factory workers compared to office workers.Logistic regression identified that worse VA at attack(OR 10.568,95%CI 1.288-86.695;P=0.028)and worse early postoperative VA(OR 13.214,95%CI 1.157-150.881;P=0.038)were risk factors for blindness.Multivariate regression showed that longer duration of elevated intraocular pressure(P=0.004)and worse early postoperative VA(P=0.009)were associated with worse visual outcomes.CONCLUSION:Despite LE surgery,some APAC patients experience continued visual function deterioration.Lifelong monitoring is necessary.Target pressure and progression rates should be re-evaluated during follow-up.
基金supported by the Natural Science Foundation of Guangdong Province(grant number 2021A1515011485)the Traditional Chinese Medicine Multidisciplinary Innovation Team Program of Liaoning Province(grant number LNZYYCXTD-JCCX-002)+1 种基金the Key Laboratory foundation of Ministry of Education for TCM Viscera State Theory and Applications of Liaoning University of Traditional Chinese Medicine(grant number.zyzx1807)“Three levels”Talent Construction Projects in Zhuhai College of Science and Technology.
文摘Prostatic carcinoma(PCa)has become one of the most common cancers among men worldwide,with both incidence and mortality rates steadily rising.Although current treatments are effective in the early stages of PCa,many cases eventually progress to castration-resistant prostate cancer(CRPC),and led to treatment failure.To develop new therapeutic strategies to ameliorate the survival of PCa patients then has pressed the need on medicinal researchers.Of traditional Chinese medicinal herbs,Angelica gigas Naka(AGN),and its major pyranocoumarins were broadly reported on the effect of anti-PCa.However,existing reviews mainly focus on decursin(D),decursinol angelate(DA),and decursinol(DOH),without fully exploring other coumarins in AGN.Moreover,most reviews discuss general anticancer effects,with limited emphasis on PCa specifically.This review made a comprehensive summary of the coumarin components of AGN,and depicted the anti-PCa effects and mechanisms,giving a solid research support for drug discovery and development.This review also featured pharmacokinetic advantages and therapeutic potential of DOH,in order to suggest possibilities to overcome the in vivo transformation limitations of D and DA,and shed light on CRPC treatment.We also recommend future studies focus on more in vivo evidence,safety and toxicity evaluation,and clinical validation in humans.
基金supported by the National Natural Science Foundation of China,No.22103055(to JG)the Natural Science Foundation of Hebei Province,No.F2024110001(to HC)Open Project of Tianjin Key Laboratory of Optoelectronic Detection Technology and System,Nos.2024LODTS215(to NL),2024LODTS216(to XS).
文摘In recent years,exosomes have garnered extensive attention as therapeutic agents and early diagnostic markers in neurodegenerative disease research.Exosomes are small and can effectively cross the blood-brain barrier,allowing them to target deep brain lesions.Recent studies have demonstrated that exosomes derived from different cell types may exert therapeutic effects by regulating the expression of various inflammatory cytokines,mRNAs,and disease-related proteins,thereby halting the progression of neurodegenerative diseases and exhibiting beneficial effects.However,exosomes are composed of lipid bilayer membranes and lack the ability to recognize specific target cells.This limitation can lead to side effects and toxicity when they interact with non-specific cells.Growing evidence suggests that surface-modified exosomes have enhanced targeting capabilities and can be used as targeted drug-delivery vehicles that show promising results in the treatment of neurodegenerative diseases.In this review,we provide an up-to-date overview of existing research aimed at devising approaches to modify exosomes and elucidating their therapeutic potential in neurodegenerative diseases.Our findings indicate that exosomes can efficiently cross the blood-brain barrier to facilitate drug delivery and can also serve as early diagnostic markers for neurodegenerative diseases.We introduce the strategies being used to enhance exosome targeting,including genetic engineering,chemical modifications(both covalent,such as click chemistry and metabolic engineering,and non-covalent,such as polyvalent electrostatic and hydrophobic interactions,ligand-receptor binding,aptamer-based modifications,and the incorporation of CP05-anchored peptides),and nanomaterial modifications.Research into these strategies has confirmed that exosomes have significant therapeutic potential for neurodegenerative diseases.However,several challenges remain in the clinical application of exosomes.Improvements are needed in preparation,characterization,and optimization methods,as well as in reducing the adverse reactions associated with their use.Additionally,the range of applications and the safety of exosomes require further research and evaluation.
文摘We aim to review the literature and provide guidance on preventive health measures in inflammatory bowel disease(IBD). Structured searches were performed in Pub Med,MEDLINE,EMBASE,Web of Science and Cochrane Library from January 1976 to June 2016 using the following keywords:(inflammatory bowel disease OR Crohn's disease OR ulcerative colitis) AND(health maintenance OR preventive health OR health promotion). Abstracts of the articles selected from each of these multiple searches were reviewed,and those meeting the inclusion criteria(that is,providing data regarding preventive health or health maintenance in IBD patients) were recorded. Reference lists from the selected articles were manually reviewed to identify further relevant studies. Patients with IBD are at increased risk of developing adverse events related to the disease course,therapeutic interventions,or non-adherence to medication. Recent studies have suggested that IBD patients do not receive preventive services with the same thoroughness as patients with other chronic diseases. Preventive health measures can avert morbidity and improve the quality of life of patients with IBD. Gastroenterologists and primary care physicians(PCPs) should have an up to date working knowledge of preventive health measures for IBD patients. A holistic approach and better communication between gastroenterologists and PCPs with explicit clarification of roles will prevent duplication of services and streamline care.
文摘Many patients with rare diseases not only suffer from more severe conditions but often receive less disease management, which is one significant public health concern globally. Few practice-based surveys focus on the care of patients with rare diseases. In the present study, we aimed to investigate medical service utilization, economic burden and health status of patients with rare diseases in China. A cross-sectional questionnaire survey focusing on patients with rare diseases was conducted. Descriptive analysis was conducted to examine the sociodemographic characteristics, medical service utilization, economic burden and health status. Logistic regression analysis was applied to explore influencing factors of self-rated health. A total of 982 patients with 81 types of diseases were included in this survey. We found that 58.2% of patients experienced misdiagnosis, and 35.2% of the patients were misdiagnosed for at least five times. Moreover, 65.8% of patients traveled to hospitals to seek medical services, and 92.1% of patients paid expenses for their treatment. However, only 1.3% of patients could afford their medical expenditure without debts, and 86.8% of patients regarded their health status as bad or moderate. Significant factors correlated with health status were economic status, gender, age, employment and household size. From this study, the accessibility of medical service utilization, the affordability of medical economic burden, and the condition of health status for patients with rare disease in China were considerably poor. Basic medical insurance did not play its role in improving the utilization of medical services and the affordability of medical costs. Social support should be encouraged to improve patients＇ health status.
基金National Natural Science Foundation of China(Grant No.71303011,71774005)
文摘Irrational use of medicines is a major problem worldwide, and it is believed there would be positive correlation between the National Essential Medicines Policies(NEMPs) and the level of rational use of medicines(RUMs). Though there is some early evidence on the NEMPs’ effects on RUMs in China, the evidence is scarce, and conclusions vary. In the present study, we aimed to evaluate the impacts of the NEMPs of China on the RUMs in the primary health care institutions(PHCs). A cross-sectional survey was conducted in 2010. A total of 201 PHCs from six provinces of China were selected, and 39 181 prescriptions were extracted from January to June, 2010. Six indicators were used and tested by independent-samples T test. We found that the average number of drugs per prescription in PHCs with NEMP implementation(the treatment group) was significantly higher than that of the group without NEMP implementation(the control group)(3.37 vs. 2.83, P<0.01). There was no significant difference in the average cost per prescription(81.43 vs. 75.02). The percentage of prescriptions, including an antibiotic(53.40% vs. 36.48%, P<0.01) or an injection(40.54% vs. 27.94%, P<0.01), was higher in the treatment group, and the percentage of drugs prescribed by general name was significantly lower(83.71% vs. 93.11%, P<0.01). For the percentage of drugs prescribed from essential medicines list, the treatment group exhibited the higher ratio(76.12% vs. 53.45%, P<0.01). From this study, the NEMPs were not likely to have a positive impact on RUMs. China still needed efforts to improve the selection, the absence of physicians’ active involvement, and the patients’ habits of irrational medication use.
文摘To demonstrate the clinical outcomes of a multicenter experience and to suggest guidelines for choosing a suction method.METHODSThis retrospective study at 5 medical centers involved 58 consecutive patients undergoing over-the-scope clips(OTSCs)placement.The overall rates of technical success(TSR),clinical success(CSR),complications,and procedure time were analyzed as major outcomes.Subsequently,56 patients,excluding two cases that used the Anchor device,were divided into two groups:14 cases of simple suction(SS-group)and 42 cases using the Twin Grasper(TG-group).Secondary evaluation was performed to clarify the predictors of OTSC success.RESULTSThe TSR,CSR,complication rate,and median procedure time were 89.7%,84.5%,1.8%,and 8(range 1-36)min,respectively,demonstrating good outcomes.However,significant differences were observed between the two groups in terms of the mean procedure time(5.9 min vs 14.1 min).The CSR of the SS-and TG-groups among cases with a maximum defect size≤10 mm and immediate or acute refractory bleeding was 100%,which suggests that SS is a better method than TG in terms of time efficacy.The CSR in the SS-group(78.6%),despite the technical success of the SS method(TSR,100%),tended to decrease due to delayed leakage compared to that in the TG-group(TSR,CSR;88.1%),indicating that TG may be desirable for leaks and fistulae with defects of the entire layer.CONCLUSIONOTSC system is a safe and effective therapeutic option for gastrointestinal defects.Individualized selection of the suction method based on particular clinical conditions may contribute to the improvement of OTSC success.
