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An introduction to Australian Thoracic and Cardiovascular Surgical Training System and Suggestion on the Establishment of a Thoracic and Cardiovascular Surgical Training system in China

Intra-Abdominal Coeliac Plexus Block to Treat Unresectable Pancreatic Cancer Pain

【Abstract】　Objective　The effects and the complications of anhydrous alcohol intra-abdominal coeliac plexus block were studied for treating unresectable pancreatic cancer pain. Methods　From Jan.2001 to Sep.2005, 61 patients with severe pancreatic cancer pain and accompanied gastrointestinal tract obstruction were treated by anhydrous alcohol intra-abdominal coeliac plexus block and palliative surgical therapy. Pain-relief, KPS and complications in 3 months after operation were observed. Results　The cancer pain in all patients was controlled in one week after the block (P＜0.05). KPS was improved (P＜0.05). Three months after operation, 45(86.5%) patients were without pain or with only light pain. There were no severe complications. Conclusion　Anhydrous alcohol intra-abdominal coeliac plexus block is a method with safe and good effective and less complications for the treatment of pancreatic carcinomatous pain.

三种手术矫治静脉窦型房间隔缺损的临床结果

目的 总结静脉窦型房间隔缺损（SVASD）合并部分性肺静脉异位连接（PAPVC）外科治疗的临床结果。 方法 回顾性分析 2000 年 1 月至 2016 年 12 月湖南省儿童医院 49 例 SVASD/PAPVC 患者的临床资料，其中男 21 例、女 28 例，年龄 5 个月～14 岁，平均年龄（4.7±2.1）岁。肺静脉异位连接位置位于右房者 9 例，位于右房与上腔静脉连接部者 12 例，位于上腔静脉者 28 例。根据手术方式分为三组，A 组 29 例采用单片心包补片修补，B 组 12 例采用双片心包补片修补，C 组 8 例将上腔静脉近心端引入左房、上腔静脉远心端与右心耳吻合（Warden 手术）进行矫治。 结果 手术效果满意，心内无残余分流，无手术死亡病例，无再手术者，无肺静脉回流梗阻病例出现。随访 6 个月至 15 年，术后 7 例上腔静脉流速增高，其中 A 组 4 例（13.8%），B 组 2 例（9.5%），C 组 1 例（12.5%）。术后 7 例窦房结功能异常，其中 A 组 3 例（10.3%，随访恢复窦性心律），B 组 4 例（19.0%，随访时 3 例恢复窦性心律，1 例为结性心律），C 组无窦房结功能异常病例出现。 结论 SVASD 多伴有右侧肺静脉异位连接，矫正 SVASD 时应注意防止上腔静脉和右侧肺静脉回流梗阻，并避免影响窦房结功能，选择适当的手术方式可以减少并发症的发生。Warden 手术能有效避免窦房结功能的影响，对于异位连接位置位于上腔静脉高位者，Warden 法应作为首选。

Quantitative evaluation of China’s clinical research policies based on the PMC index model

ObjectiveTo analyze the policy environment of clinical research in China, providing valuable insights for the formulation and enhancement of policies. MethodsAt the national level in our country, policies related to clinical research were selected as the research subject. The method of text mining was employed to extract high-frequency words from policy texts. By constructing the policy modeling consistency (PMC) index model, evaluations of the relevant policies regarding clinical research in our country were quantified from multiple dimensions including internal consistency, effectiveness, and scope of influence. ResultsThe average PMC index of 22 clinical research policies in our country was 6.87. Among them, 10 policies demonstrated an excellent performance, while 12 policies were considered qualified. This suggested that the overall quality of clinical research policies at the national level was good, yet there was still considerable room for improvement. ConclusionPolicies regarding clinical research have entered a high-speed development stage and exhibit basic completeness in China. However, these policies appear somewhat independent of each other and inadequate rule of law.

Correlation between Cadmium and Alzheimer's Disease:A Meta-analysis

ObjectiveTo systematically review the relationship between Cadmium (Cd) level and Alzheimer's disease (AD). MethodWe searched PubMed, EMbase, CNKI, WanFang Data and CBM databases from inception to December 2014 to collect case-control studies about the relationship between Cd level and AD. Two reviewers screened literature, extracted data and evaluated the risk of bias of included studies, and then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 11 studies were included, among them 8 studies were included into final meta-analysis. Three studies including 154 patients and 141 controls reported the relationship of serum Cd concentrations and AD, and the result of meta-analysis showed that the higher serum Cd level was found in the AD group than the control group (SMD=0.36, 95%CI 0.12 to 0.59, P=0.003). Six studies including 358 patients and 423 controls reported the relationship of blood Cd concentrations and AD, and the result of meta-analysis showed that there was no significant difference of blood Cd levels between both groups (SMD=0.35, 95%CI -0.14 to 0.84, P=0.16). ConclusionSerum Cd concentrations may be associated with AD, but blood Cd concentrations not. Due to the limitation of quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

Association between bullying behaviors and risk of non-suicidal self-injuries among adolescents: a meta-analysis

ObjectivesTo systematically review the association between bullying and risk of non-suicidal self-injury among adolescents.MethodsPubMed, MEDLINE, EMbase, The Cochrane Library, CNKI and WanFang Data were searched from inception to September 1st 2017 to collect studies on the association between bullying and non-suicidal self-injuries. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies by Agency for Healthcare Research and Quality (AHRQ). Then, meta-analysis was performed using CMA 2.2 software.ResultsA total of 23 studies involving 18 819 participates were finally included. The results of meta-analysis showed that bullying victims reported more NSSI than uninvolved adolescents (OR=2.41, 95%CI 1.96 to 2.96, P<0.001). The bullying perpetrators reported more NSSI than uninvolved adolescents (OR=2.26, 95%CI 1.39 to 3.68,P=0.001). Individuals acting as both victims and perpetrators could also increase risks of NSSI (OR=2.76, 95%CI 1.17 to 6.51, P=0.02). Using meta-regression, it was found that the relation between NSSI and bullying victimization was significantly moderated by age, with studies in which respondents were younger reporting larger effect sizes than studies in which respondents were older (B=–0.33, 95%CI –0.38 –0.28, P<0.001).ConclusionsThe current study demonstrates that involvement in bullying in any capacity is associated with non-suicidal self-injuries. Due to the limitation of research, more studies are required to verify above conclusions.

Demands Assessment on Portable Medicine Kit of Rural Households among Model Well-off Township Hospital in Eastern, Central and Western China

Objective　To understand the demands on portable medicine kit of rural residents in well-off township hospitals, and to provide the basis for scientifically designing portable medicine kit for rural residents. Methods　The methods of combining simple random sampling and cluster sampling were used to investigate and analyze the demands on portable medicine kit for 162 households from three well-off township hospitals in Shanghai, Zhejiang, and Sichuan province, respectively. Results　The demand rate of 162 rural households on portable medicine kit was 75.3% (122/162). The main drugs that demanders expected in the portable medicine kit were cold medicine (86.1%), wound paste (82.0%), cooling oil (61.5%), essential balm (54.9%) and antihypertensive (34.4%); and the main medical devices that demanders expected were thermometer (82%), cotton swab (73%) and sphygmomanometer (32.8%). The sizes of portable medicine kit that demanders expected were 23.7±8.5 cm in length, 17.1±6.4 cm in width, and 14.1±6.5 cm in height. The main function characteristics of portable medicine kit that demanders expected were applicability (74.6%), safety (60.7%), light weight (68.0%), economics (60.7%), and waterproof (46.7%). A total of 72.1% of demanders expected the price of less than 15 yuan, and 91.8% expected kit made of hard materials as plastic as the first choice. Conclusion　The demand rate of rural residents on portable medicine kit is higher in well-off township hospital. The design and production of portable medicine kit should fully meet the demands of rural residents. Only when sufficiant respect for the market demand is paid, can the promotion and application of portable kits will be ensured.